Purpose: No standard therapies are available for the elderly with breast cancer and they tend to refuse to undergo treatment because of complications and shorter-life expectancy. In this study, feasible therapies were examined by evaluating cases we had experienced in our hospital.Methods: We report the results of a study on 12 seniors with breast cancer at age 80 and over in regard to preoperative examinations, operative procedures, histopathological examinations and adjuvant therapies.Results: Preoperative examinations were performed before mammography, ultrasonography (US), computed tomography, enhanced MRI of breast and fine-needle aspiration cytology. Though it was necessary to get their consent for biopsy under local anesthesia, we could perform US-guided core needle biopsy without their objections resistance. The first half of patients underwent mastectomy with lymph node dissection, whereas the second half had less invasive surgeries, such as partial resection of the breast and sentinel lymph node biopsy (SLNB). Histological checks revealed invasive carcinoma in 11 cases and the hormone receptor positive in 11 cases. Adjuvant therapy was performed with endocrine and fluoropyrimidine drugs orally administered. Irradiation to the remaining breast after partial resection was omitted by administering endocrine drugs.Conclusions: Elderly cases were apt to shun undergoing surgery, chemotherapy and radiation therapy, but they were treated with curative therapy by proposing less invasive partial resection, SLNB and adjuvant therapy. We should not omit lymph node dissection and adjuvant therapy just because the patients are elderly. However, less invasive and curative treatment based on the guideline should also be taken into full account.

The purpose of this study was to compare joint torque and the activity pattern of eight muscles crossing the ankle, knee and hip joints during three kinds of squats with different speeds (Slow, Normal, Quick) . Ten male athletes performed squats at three different speeds. Variables such as net torque and power about the joint were calculated during the descending and ascending phase of each squat. At the same time, surface electrodes were placed over the eight lower extremity muscles, and %iEMG was also measured during the ascending phase of each squat.
During the descending phase, the activity of elector spinae (ES), Gluteus maximus (Gmax), Gluteus medius (Gmed), Rectus femoris (RF), Biceps femoris (BF), Adductor longus (AL), and Vastus lateralis (VL) muscles was significantly greater for Quick squats than Normal and Slow squats, whereas during the ascending phase, activity was significantly greater for Quick and Normal squats than for Slow squats. Mean torque around the hip joint increased significantly when switching from Slow to Quick squats in the descending phase; and during the ascending phase, mean torque was sig nificantly greater for Quick and Normal squats than for Slow squats. The median frequency (MDF) of an electromyogram of the Gmax was significantly lower for Normal squats than for Quick squats ; and in the ascending phase, the MDF of the BF was significantly lower for Normal squats than for Quick and Slow squats.
Quick squats use the stretch-shortening cycle so that the load around the Gmax may increase. Although mean muscle activity for Slow squats was smaller than for Nomal squats, MDF was greater. MDF was greater for Slow squats suggesting that Slow squats mobilize type-II fibers in spite of the slow movement ; and is, therefore, useful for strength training with low risk of injury.

Objective: Pharmacists need to know at what positioning a drug is recommended in clinical practice guidelines when they make prescription proposals.  However, the format of guidelines and the definition of recommendation grades differ between academic societies, making it difficult to comprehensively extract only the information one needs.  Therefore, we developed a guideline utilization system to support prescription proposals by pharmacists.
Methods: We built a database comprised of clinical practice guidelines on pharmacological therapy for breast cancer and breast cancer-related conditions.  FileMaker®was used in the development of the system.
Result: This system allows the comprehensive extraction of clinical questions and recommendations from multiple guidelines by means of standardized keywords.
Conclusion: This system supports prescription proposals by pharmacists when generating pharmacological therapy protocols or when in discussions with healthcare professionals as information on the positioning of therapeutic agents in different guidelines and recommended drugs is readily available.

We have used two methods for education of pathology at the Yokohama City University School of Medicine: 1) clinicopathological conferences on autopsy cases and 2) journal club using “Case Records of the Massachusetts General Hospital” published in the New England Journal of Medicine. Both methods are extremely effective for stimulating students' enthusiasm for learning, improving presentation skills, and consolidating the minds of students as future medical staff members. Furthermore, journal club enhances the affinity for reading medical English.

Background: Dementia is a critical late-life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. Methods: We analyzed data from 597 older adults (median age 73.0 years, interquartile range 69.0–78.0 years; 62.6% females). We applied the food frequency score to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied "none" were categorized into the "non-eating out" group. Results: The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]=1.97, 95% confidence interval [CI] 1.20–3.20), while low dietary diversity was associated with MCI (OR=1.72; 95% CI 1.02–2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation=0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index=0.984). Conclusions Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.

Background: Dementia is a critical late-life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. Methods: We analyzed data from 597 older adults (median age 73.0 years, interquartile range 69.0–78.0 years; 62.6% females). We applied the food frequency score to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied "none" were categorized into the "non-eating out" group. Results: The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]=1.97, 95% confidence interval [CI] 1.20–3.20), while low dietary diversity was associated with MCI (OR=1.72; 95% CI 1.02–2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation=0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index=0.984). Conclusions Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.

Background: Dementia is a critical late-life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. Methods: We analyzed data from 597 older adults (median age 73.0 years, interquartile range 69.0–78.0 years; 62.6% females). We applied the food frequency score to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied "none" were categorized into the "non-eating out" group. Results: The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]=1.97, 95% confidence interval [CI] 1.20–3.20), while low dietary diversity was associated with MCI (OR=1.72; 95% CI 1.02–2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation=0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index=0.984). Conclusions Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.

Background: Dementia is a critical late-life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. Methods: We analyzed data from 597 older adults (median age 73.0 years, interquartile range 69.0–78.0 years; 62.6% females). We applied the food frequency score to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied "none" were categorized into the "non-eating out" group. Results: The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]=1.97, 95% confidence interval [CI] 1.20–3.20), while low dietary diversity was associated with MCI (OR=1.72; 95% CI 1.02–2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation=0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index=0.984). Conclusions Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.