BACKGROUND: The second derivative of the finger photoplethysmogram (SDPTG) is an indicator of arterial stiffness. The present study was conducted to clarify the factor structure of indices of the SDPTG in combination with components of the metabolic syndrome (MetS), to elucidate the significance of the SDPTG among various cardiovascular risk factors. METHODS: The SDPTG was determined in the second forefinger of the left hand in 1,055 male workers (mean age, 44.2+/-6.4 years). Among 4 waves of SDPTG components, the ratios of the height of the "a" wave to that of the "b" and "d" waves were expressed as b/a and d/a, and used as SDPTG indices for the analysis. RESULTS: Principal axis factoring analysis was conducted using age, SDPTG indices, components of MetS, and the serum levels of C-reactive protein (CRP) and uric acid. Three factors were extracted, and the SDPTG indices were categorized in combination with age as the third factor. Metabolic components and the SDPTG indices were independently categorized. These three factors explained 44.4% of the total variation. Multiple logistic regression analysis revealed age, d/a, serum uric acid, serum CRP, and regular exercise as independent determinants of the risk of MetS. The odds ratios (95% confidence intervals) were 1.08 (1.04 to 1.11), 0.10 (0.01 to 0.73), 1.24 (1.06 to 1.44), 3.59 (2.37 to 5.42), and 0.48 (0.28 to 0.82), respectively. CONCLUSION: The SDPTG indices were categorized in combination with age, and they differed in characteristics from components of MetS or inflammatory markers. In addition, this cross-sectional study also revealed decrease of the d/a as a risk factor for the development of MetS.
Axis, Cervical Vertebra ; C-Reactive Protein ; Cross-Sectional Studies ; Factor Analysis, Statistical ; Fingers ; Hand ; Humans ; Logistic Models ; Male ; Odds Ratio ; Risk Factors ; Uric Acid ; Vascular Stiffness

Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.
therapeutic aspects ; seconds ; Lesion, NOS ; Nasal ; Acne Rosacea

For patients with epidermal growth factor receptor (EGFR) mutation-positive lung cancer, the relationship between the dose or duration of treatment with tyrosine kinase inhibitor (TKI) and overall survival remains unclear. Here, we analyzed clinical data of 39 patients who were diagnosed with EGFR mutation-positive non-small cell lung cancer and treated with TKI, but subsequently died. Several parameters were measured in this study: overall survival; first, second, and overall TKI therapy durations; first TKI intensity (actual dose/normal dose); and TKI rate (overall TKI therapy duration/overall survival). The response rate to TKI therapy was 50%, and the median survival was 553 days. After TKI therapy failed, 38.5% patients were re-challenged with TKI. We observed a moderate relationship [r = 0.534, 95% confidential interval (CI) = 0.263 to 0.727, P < 0.001] between overall TKI therapy duration and overall survival. However, we found no relationship between overall survival and first TKI intensity (r = 0.073, 95% CI = -0.380 to 0.247, P = 0.657) or TKI rate (r = 0.0345, 95% CI = -0.284 to 0.346, P = 0.835). Non-small cell lung cancer patients with mutation-positive tumors remained on TKI therapy for, on average, 33% of the overall survival time. These findings suggest that patients with EGFR mutation-positive tumors should not stick to using TKIs.
Aged ; Aged, 80 and over ; Antineoplastic Agents ; administration & dosage ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; genetics ; Dose-Response Relationship, Drug ; Erlotinib Hydrochloride ; Female ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; Protein Kinase Inhibitors ; administration & dosage ; therapeutic use ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; Quinazolines ; administration & dosage ; therapeutic use ; Receptor, Epidermal Growth Factor ; genetics ; Survival Rate

The patient is a 71-year-old man. After receiving chemoradiotherapy (CRTx) for an unresectable esophageal cancer, he developed sudden hematemesis during a follow-up examination. Subsequent imaging via contrast-enhanced computed tomography (CT) showed leakage of the contrast medium from the descending aorta into the esophagus. Consequently, an aortoesophageal fistula (AEF) was diagnosed and an emergency thoracic endovascular aortic stent graft repair (TEVAR) was scheduled. However, during the preparation for surgery, the patient vomited a large amount of blood and went into cardiopulmonary arrest. Following the administration of cardiopulmonary resuscitation, a Sengstaken-Blakemore tube (SB-tube) was inserted intranasally to control bleeding and TEVAR was performed to save his life. Although a gastrostomy was necessary after the surgery, the patient was transferred from the hospital on the 32nd day without any complications. Nonetheless, his general condition deteriorated as the cancer progressed and he died on the 103rd postoperative day. It is generally reported that the risk for esophageal perforation is 10-20% in CRTx for unresectable esophageal cancer. Although issues regarding the long-term prognosis of patients treated with TEVAR have been highlighted in recent years, there have also been reports of life-saving cases following its use; in this case, the patient was discharged home after SB-tube insertion and TEVAR with prompt treatment, resulting in his life being prolonged for an estimated 3 months.