Metastasis to the finger of oral floor squamous cell carcinoma: A case report

When cetuximab is used, diagnosing finger metastasis can be difficult due to the side effects of paronychia and color changes of nails. Finger metastasis may be a marker of multiple metastasis; therefore, it can lead to a poor prognosis

Studies of the efficacy and safety of methotrexate at dosages over 8 mg/week using the IORRA cohort database

The maximum dosage of methotrexate (MTX) for treatment of rheumatoid arthritis (RA) formally approved in Japan is 8 mg/week. We intended to examine the efficacy and safety of MTX at dosages over 8 mg/week in Japanese rheumatoid arthritis patients using the large Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort database. Among 9,122 patients registered in the IORRA database from the October 2000 survey to the October 2007 survey, 5,201 patients who had been treated with MTX were selected. We attempted to overcome the drawbacks innate to nonrandomized studies by using longitudinal analyses and multifactorial logistic regression analyses. Cross-sectional analysis of data obtained from the October 2007 survey indicated that dosages of MTX higher than 8 mg/week were used in 27.5% of patients treated with MTX. Longitudinal analyses based on data from three consecutive phases showed that final Disease Activity Score-28 (DAS28) values were significantly lower [n = 260, mean difference 0.563, 95% confidence interval (CI) 0.438–0.688, P < 2.2 × 10−22, two-sided paired t test] than initial values when MTX was increased from 8 mg/week or lower to over 8 mg/week. In addition, longitudinal analyses based on data from two consecutive phases indicated decreases in DAS28 values of 0.26 ± 1.04 (n = 690, P = 6.78 × 10−11, two-sided paired t test) when MTX dosages were increased from 8 mg/week or lower to over 8 mg/week, compared with decreases of 0.07 ± 0.89 (n = 2,125, P = 0.000307) when the dosage was maintained at 8 mg/week. The decreases in DAS28 values were significantly larger in the former than the latter (P = 2.27 × 10−6, two-sided unpaired t test). Concerning safety of MTX at dosages over 8 mg/week, we performed logistic regression analysis in which the objective variable was the existence or nonexistence of self-reported side-effects and the explanatory variable was the MTX dosage in the former phase, with adjustments made for age, sex, body mass index (BMI), steroid administration, folic acid administration, concomitant pulmonary diseases, and renal dysfunction. The results indicated that MTX dosages over 8 mg/week did not have any association with either severe or severe + moderate side-effects. These data regarding both efficacy and safety of MTX at dosages over 8 mg/week in Japanese RA patients would provide the basis for use of the drug at dosages currently not formally approved by the Japanese government

Development of Power stock exercise for prevention of Locomotive Syndrome

要介護の危険性が高い状態であるロコモティブシンドロームの予防を目的としてストックやポールを活用した「パワー・ストック・エクササイズ」を開発した。この運動プログラムの特長は，健常な中高年者から後期高齢者，低体力者まで様々な体力レベルの方が実施可能なことである。ストックを利用することにより安全に運動することが出来，また運動負荷の調整も可能となる。さらに正しいフォームの獲得にも有効である。トレーニングメニューの中核は「フラミンゴバランス」と「カンガルー運動」と「カモシカステップ」で構成されている。これらの運動プログラムの実践によりバランス機能と筋力，ステップワークの改善が期待される。We developed the exercise program named 'Power stock exercise' for preventing locomotive syndrome. The strong point of this program is that the person of various physical strength levels can carry out. Even the elderly people to whom muscular power fell can practice the exercise. The strong point of this program is safety, and the 2nd strong point is being able to adjust the load of exercise. In addition, stock is utilizable also as an item for gaining the right training form. The main exercise consists of flamingo balance, kangaroo exercise, and antelope step. We think that they are effective in a balance function, the muscular power of the leg, and improvement in a step work. We will verify the effect of this exercise program from now on