Chemotherapy-induced peripheral neuropathy (CIPN) is a frequently observed treatment-related adverse effect, particularly associated with taxane-based chemotherapy, which affects the quality of life of the patients. To date, CIPN has been subjectively evaluated by patients or physicians. Intraepidermal electrical stimulation (IES) may be applied to evaluate the function of small fibers by measuring pain threshold, and assess the degree of diabetic peripheral neuropathy. The aim of the present study was to evaluate CIPN objectively by using IES. The pain threshold measured by IES in patients with gynecological cancer who underwent taxane-based chemotherapy was compared with the clinical grading scale of peripheral neuropathy (National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0). A total of 57 patients were evaluated (151 measurements). The median age of the patients was 63 years. The number of measurements with clinical grades of 0, 1 and ≥2 was 49, 57 and 45, respectively. The mean pain threshold was 0.1, 0.14 and 0.18 mA for grades 0, 1 and ≥2, respectively. Therefore, the mean pain threshold significantly increased with the progression of the clinical grade. The measurement of pain threshold by using IES may be a reliable indicator for quantitative evaluation of CIPN.

Highlights Uterine laceration is extremely rare and little known, however it sometimes causes massive intraperitoneal bleeding and has poor prognosis. Inner myometrial laceration may be caused by intrapartum physical stress, whereas uterine laceration in relatively early pregnancy might be occurred by tissue inadaptable for uterine enlargement. To diagnosis uterine laceration in early pregnancy is quite difficult because of the absence of specific clinical findings. Not only uterine rupture but also uterine laceration should be considered, and exploratory laparotomy should be performed appropriately when hemoperitoneum is strongly suspected.