1.Metastatic Skin Carcinoma.
Hidetsugu SATO ; Seigo HIGASHI ; Jun YAMAGUCHI ; Kazumi TSUJINO ; Shuichi INABA ; Takashi YOSHIKAWA ; Tsuguo TERAI ; Yoshiaki SEKISHITA ; Masaru FUJIMORI ; Tsuneo SHIONO ; Shinjuro KUROSHIMA ; Norihiko TSUMURA ; Isao KAWAGUCHI ; Takeshi NISHIOKA ; Hiroki SHIRATO ; Kazuaki TAKAHASHI ; Shigeo SAKASHITA ; Masanobu KUMAKIRI
Journal of the Japanese Association of Rural Medicine 1994;43(4):964-968
We reported nine cases of metastatic skin carcinoma experienced at the Department of Dermatology, Obihiro Kosei Hospital during the period from April 1991 to March 1993. Lung was the most common primary lesion (four out of nine cases), followed by uterus (two) and stomach, breast, and kidney (one each). The clinical features of the metastases were classified into nodular (five cases), inflammatory (one case) and sclerotic (three cases) types. Peculiar zoster-like inflammation was seen in metastatic gastric cancer. Pathologically, adenocarcinoma was more common than squamous cell carcinoma. The average interval between the diagnosis of the primary cancers and the development of the skin metastases was about 30±25 months. The average life span after the detection of the skin metastases was 6.8±5.6 months. Poor prognosis of skin metastasis was thus reconfirmed.
2.Association between Aortic Calcification Burden and the Severity of Erectile Dysfunction in Men Undergoing Dialysis: A Cross-Sectional Study
Naoki FUJITA ; Shingo HATAKEYAMA ; Masaki MOMOTA ; Yuki TOBISAWA ; Tohru YONEYAMA ; Teppei OKAMOTO ; Hayato YAMAMOTO ; Takahiro YONEYAMA ; Yasuhiro HASHIMOTO ; Kazuaki YOSHIKAWA ; Chikara OHYAMA
The World Journal of Men's Health 2023;41(2):373-381
Purpose:
Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis.
Materials and Methods:
This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED.
Results:
The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022).
Conclusions
Aortic calcification burden was independently associated with severe ED.
3.Can Erectile Dysfunction Severity Predict Major Adverse Cardiovascular Events in Men Undergoing Dialysis? A Prospective Cohort Study
Naoki FUJITA ; Masaki MOMOTA ; Yusuke OZAKI ; Yuki TOBISAWA ; Tohru YONEYAMA ; Teppei OKAMOTO ; Hayato YAMAMOTO ; Shingo HATAKEYAMA ; Takahiro YONEYAMA ; Yasuhiro HASHIMOTO ; Kazuaki YOSHIKAWA ; Chikara OHYAMA
The World Journal of Men's Health 2023;41(4):900-908
Purpose:
To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis.
Materials and Methods:
This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated.
Results:
The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively).
Conclusions
ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.