Epidermal growth factor receptor (EGFR) gene mutation examination is now performed in most medical institutions in order to select the molecular targeted medicine for lung cancer. It became clear that the positive rate of the biopsy material was lower than that of the surgical sample in this hospital. The cause was attributed to false negatives due to low tumor cell content in biopsy specimens. We investigated the presence of the mutation using surgical samples and preoperative biopsy specimens from the same patients in 13 cases. Furthermore, we investigated the tumor cell content of the biopsy specimens by cell counting. Results showed that 3 of 6 biopsy specimens that were associated with positive surgical samples were judged to be negative. The tumor cell content was less than 5% in all negative cases. Regarding EGFR gene mutation examination, we should carefully determine tumor cell content when using biopsy specimens.

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　　To ensure the safe work of elderly farmers, we focused on the features of non-fatal, fall-related injuries not due to agricultural machines. Farmers’ compensation injury claims were utilized to characterize the fall-related injuries at work in Fukuoka prefecture between 2008 and 2009. A total of 1,040 (630 men) farmers’ compensation injury claims were analyzed. The age group with the highest percentage of fall accidents was 75 to 79 years for men, and 70 to 74 years for women. For the female group (≥65 years of age) compared with the reference group (≤64 years of age), the percentage of hip/back injuries by falls/slipping was higher (19.2% vs. 10.7%;p<0.05), but the percentage of hand/wrist injuries were lower (6.7% vs. 25.0%;p>0.05). The ladder/step ladder was the most frequent source of injury, causing falls/loss of balance in the female group, but the percentage was lower than that in the reference group (32.3% vs. 50.0%;p<0.05). Inclines were another source of injury due to falls/loss of balance in the female group with a percentage higher than that in the reference group (14.7% vs. 11.5%;p<0.05), but the tree/tree branch were sources of injury with a lower percentage (7.4% vs. 15.4%;p<0.05). Vegetable field/tea field were places of injury due to falls/tripping with a higher percentage in the female group vs the reference group (31.0% vs. 15.0%;p<0.01), but the barn/warehouse were places of injury with a lower percentage in the female group (8.5% vs. 30.0%;p<0.01). Fracture was the leading form of injury in all three types of fall accidents with a higher percentage among female farmers compared with male farmers (falls/slipping:62.5% vs. 35.5%, p<0.01;falls/loss of balance:61.8% vs. 45.9%, p<0.01;falls/tripping:49.3% vs. 34.4%, p<0.05). Our data suggest useful information that should be considered in ensuring the safe work of elderly farmers.

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　　Although axillary lymph node dissection (ALND) is conventionally indicated for metastasis in the sentinel lymph node (SLN), the omission of ALND is being discussed more often in recent years. However, because of the lack of specific guidelines, it is unclear which cases should be treated without ALND. In this study, we performed one-step nucleic acid amplification of the SLN with metastasis to determine the total tumor load (TTL), that is, the number of cytokeratin (CK) 19 mRNA copies. After ultrasonography (US) of ALN, the ultrasonographic findings were combined with TTL to rate SLN metastasis. In the rating, a total score was obtained by assigning 1 point each for (a) TTL of ≥15000 copies/μL, (b) US findings of a long-to-short LN diameter ratio of ≤2, and (c) US findings of no echogenic hilus. We then investigated the association between the total score and metastasis in the non-SLN. Results showed that while 87.5% (5/6) of patients with positive non-SLN scored ≥2 points, only 3.1% (1/34) of patients with negative non-SLN did so, suggesting that a total copy number of CK19 mRNA, US findings of a long-to-short LN diameter ratio, and the presence/absence of echogenic hilus are important predictors for non-SLN metastasis. This novel scoring system is expected to help determine which patients need ALND or what postoperative therapy is necessary.

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