1.Clinicopathological Study on Five Male Breast Cancer Cases Experienced During Past 10 Years
Hideki KOBAYASHI ; Hirokatsu MORIAI ; Terumi FUTAKI ; Hiroko MATSUKI ; Takashi DOI ; Fusakuni KURODA ; Yoshihiro NOZAWA
Journal of the Japanese Association of Rural Medicine 2015;64(1):8-13
We experienced five cases of male breast cancer for during the past 10 years from 2002 through 2011, and performed the clinicopathologic study. Male breast cancer accounts for as low as 1.59% of all breast cancers, and the average age at occurrence is 70.4 years. In every case of ours the tumor was located around the nipple with its nodular diameter not exceeding 2.0 cm. By histological types, our case consisted of two papillotubular carcinoma, two solid-tubular carcinoma and one scirrhous carcinoma. Pathological findings showed that all cancers had infiltrated into the surrounding fat tissues of the mammary gland and four of them into the overlying skin. One case of papillotubular carcinoma was diagnosed as neuroendocrine carcinoma. Four cancers examined for ER and PgR were all positive, but all cases for HER2 was negative. There was a tendency for the age and clinical history of breast cancer to be older and longer in men than in women. Information about male breast cancer should be disseminated more widely and more effects toward early detection should be made.
2.Predictors of Poor Outcome in Patients with Acute Cerebral Infarction.
Nobuhiro DOUGU ; Shutaro TAKASHIMA ; Etsuko SASAHARA ; Yoshiharu TAGUCHI ; Shigeo TOYODA ; Tadakazu HIRAI ; Takashi NOZAWA ; Kortaro TANAKA ; Hiroshi INOUE
Journal of Clinical Neurology 2011;7(4):197-202
BACKGROUND AND PURPOSE: Plasma D-dimer levels are elevated during the acute phase of cerebral infarction (CI). We investigated whether the D-dimer level on admission and other clinical characteristics could be used to predict the poor outcome of patients with acute CI. METHODS: The clinical characteristics and plasma D-dimer levels measured within 3 days of onset were compared according to outcome among patients with acute CI. RESULTS: In total, 359 consecutive patients (mean age, 71.8 years) were examined, of which 174 had a poor outcome [score on the modified Rankin scale (mRS) > or =3] at 30 days after hospitalization. The mean mRS score was higher and a poor outcome was observed more frequently among women than among men (p<0.001 for each). The proportions of women, cardioembolism, atrial fibrillation, advanced age (> or =75 years), prior history of CI or transient ischemic attack, and elevated D-dimer level (> or =1.0 microg/mL) were significantly higher among patients with a poor outcome than among those with a good outcome. A multivariate analysis showed that elevated D-dimer level [> or =1.0 microg/mL; odds ratio (OR), 2.45; 95% confidence interval (95% CI), 1.52-3.89; p<0.01], advanced age (OR, 1.93; 95% CI, 1.21-3.07; p<0.01), and female gender (OR, 1.75; 95% CI, 1.08-2.83; p=0.02) were independent predictors of a poor outcome. CONCLUSIONS: Certain clinical characteristics (gender and advanced age) and an elevated D-dimer level upon admission can be used to predict the outcome of patients with acute CI at 30 days after hospitalization.
Atrial Fibrillation
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Cerebral Infarction
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Female
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Fibrin Fibrinogen Degradation Products
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Hospitalization
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Humans
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Ischemic Attack, Transient
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Male
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Multivariate Analysis
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Odds Ratio
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Plasma
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Stroke
3.S1-2 Waon therapy for ischemic heart disease
Takashi NOZAWA ; Mitsuo SOBAJIMA ; Hiroyuki IHORI ; Yasutaka FUKUI ; Hiroshi INOUE
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2014;77(5):407-407
Objectives: Waon therapy relieves ischemic symptoms in patients with peripheral arterial disease. Waon therapy increases capillary density and blood flow in ischemic hindlimbs of mice (Circ J 2006;70:463). Moreover, we have shown that Waon therapy increases capillary densities of non-infarcted myocardium of rat with myocardial infarction in association with increases in myocardial expression of eNOS and VEGF mRNA (Am J Physiol Heart Circ Physiol 2011;301:H548). Taken together, Waon therapy may improve myocardial blood flow in patients with severe coronary artery disease. Accordingly, the purpose of the present study was to investigate whether repeated Waon therapy could improve myocardial perfusion in patients with ischemia related to chronic total occlusion (CTO) of coronary arteries. Patients and Methods: Twenty-four patients who had myocardial ischemia in the CTO-related area were examined. The Waon group (n=16) was treated daily for 3 weeks with a 60°C far infrared-ray dry sauna bath for 15 minutes and then kept in a bed covered with blankets for 30 minutes. The severity of ischemia was quantified by thallium-201 myocardial perfusion scintigraphy with adenosine before and after 3-week Waon therapy. Treadmill exercise test, flow-mediated dilation (FMD) of the brachial artery, and the number of circulating CD34-positive bone marrow-derived cells, a putative precursor of endothelial progenitor cells, were determined. The control group (n=8) underwent myocardial perfusion scintigraphy twice with a 3-week interval. Results: In the control group, neither summed stress score (SSS) nor summed difference score (SDS) of myocardial scintigraphy changed. However, Waon therapy improved both SSS (16±7 to 9±6, p<0.01) and SDS (7±4 to 3±2, p<0.01), and the improvement was greater in patients with higher SSS and SDS scores at the baseline. Waon therapy extended treadmill exercise time (430±185 to 511±192 sec, p<0.01) and improved FMD (4.1±1.3 to 5.9±1.8%, p<0.05), but tended to decrease the number of circulating CD34-positive cells. Conclusions: Waon therapy improves CTO-related myocardial ischemia in association with improvement of vascular endothelial function. This therapy could be a complementary and alternative tool in patients with severe coronary lesions not suitable for coronary intervention.