Understanding factors associated with physical activity (PA) is important to promote PA. The purpose of the present study was to investigate factors associated with achieving PA guideline in 293 Japanese adolescents (140 boys and 153 girls). Time spent in moderate to vigorous PA (MVPA) was accessed by using accelerometers. Based on MVPA, the participants were classified as “Active” (≥60 min/day of MVPA) or “Inactive” (<60 min/day of MVPA). Anthropometry, age, screen time, mental health, participation in after-school sport activities, sleep status, and breakfast status were measured as factors potentially associated with achieving PA guideline. Adjusted logistic regression analyses revealed that after-school sports activities were positively associated with the probability of being Active for both sexes (odds ratios [ORs] [95% confidence intervals (CI)] = 3.90 [1.13-13.49] for boys, 4.80 [1.80-12.81] for girls). In addition, body fat was negatively associated with a reduced likelihood of being Active for girls (ORs [95%CI] = 0.93 [0.87-0.97]). Two factor ANOVA revealed that those in Inactive group had significantly lower PA levels than those in Active group on both regular curriculum and extra-curriculum (F _{(1, 138)} = 152.50 for boys, F _{(1, 151)} = 181.95 for girls, p < 0.001). In addition, for girls, there was a significant interaction effect between domain (regular curriculum vs. extra-curriculum) and after-school sport activities (F _{(1, 151)} = 4.91, p = 0.028), suggesting that obtaining higher PA levels on extra-curriculum might be difficult for those who do not belong to any after-school sport activities. Therefore, promoting PA on regular curriculum (i.e., physical education lessons and recess) might be alternative ways to increase PA levels for those individuals. Furthermore, special attention may be needed for girls who have higher body fat to promote PA.

The purpose of the present study was to examine the associations between physical fitness and body fatness with blood lipid profile in 231 Japanese children and adolescents (12.1 ± 1.5 years). The primary outcomes of the present study were a lipid risk score which was calculated by summing up z scores of three lipid items (triglycerides, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol). Physical fitness was assessed by using the Japanese standardised fitness test. For body fatness, a percentage of overweight was calculated with using age-, sex-, height-specific standardised body mass. For combined analysis (fitness × fatness), the participants were cross-tabulated into four groups (Non-Obese/Higher-Fit, Non-Obese/Lower-Fit, Obese/Higher-Fit, and Obese/Lower-Fit). The results demonstrated that the participants in fitness categories A/B [most fit] and C [middle] demonstrated the lower (better) lipid risk score than the participants in fitness categories D/E [least fit] (F _{(2, 222)} = 6.03, p = .003). For body fatness, the lipid risk score in obese group was significantly higher (worse) than that in thin and normal groups (F _{(2, 222)} = 6.08, p = .004). The combined analysis showed that there was a significant interaction (fitness × fatness) on the lipid risk score (F _{(1, 221)} = 4.05, p = .047), suggesting that Obese/Lower-Fit group had the worst risk score compared to the other groups. The present study suggests that improving both fitness and body fatness might be important for better lipid profile in Japanese children and adolescents.

A 60-year-old woman underwent surgical treatment of postinfarction ventricular septal perforation (VSP) in the early phase after receiving total cardiopulmonary bypass without aortic occlusion. VSP developed four days after anterior myocardial infarction. On admission, inraaortic balloon pumping was used to obtain hemodynamic stabilization. On the day of admission, emergency total cardiopulmonary bypass was performed. VSP was closed with a Dacron felt patch positioned on the left side of the septum. The anterior wall of the left ventricle was closed with Dacron felt strips and reinforced using a Gore-Tex sheet. Postoperative hemodynamics improved significantly. Although the operation while the heart was beating was difficult technically, the total cardiopulmonary bypass time of this method was not longer than that of operations under cardioplegic arrest. Further more, the area of infarction was easily distinguished by color and bleeding. The surgery during normothermic heart beat was effective in preventing further ischemia of the myocardium. The surgical treatment of VSP in the early phase during normothermic heart beat under total cardiopulmonary bypass was considered to be more effective and safer than operations under cardioplegic arrest.

This study was designed to assess the correlation of brain natriuretic peptide (BNP) levels with cardiac function and to determine the usefulness of BNP as a prognostic marker in patients undergoing cardiac valvular surgery. We measured plasma levels of BNP in 53 patients who had undergone aortic valve replacement (AVR) or aortic and mitral valve replacement (DVR) more than 1 year earlier. These cases were divided into the aortic stenosis (AS) group and an aortic regurgitation (AR) group. Fifty-two patients were in NYHA class I, and 43 (82.7%) of them had plasma levels of BNP above the normal range. There were significant correlations between the plasma levels of BNP and ejection fraction (EF) in both the AS and AR groups (r=-0.460, p<0.05; r=-0.529, p<0.01). In the AR group, BNP showed significant correlations with LVMI and LVDd (r=-0.469, p<0.05; r=0.680, p<0.0001), whereas, in the AS group, BNP showed no significant correlation with these factors. The most remarkable finding was the development of heart failure in 3 patients whose plasma levels of BNP were over 80pg/ml, despite remaining in NYHA I during follow-up. We concluded that plasma levels of BNP in a late phase after AVR or DVR can be an excellent biochemical marker for predicting of heart failure and overall prognosis.

The case involved a 73-year-old woman who underwent surgical resection for right renal cell carcinoma extending to the inferior vena cava. During surgery the tumor thrombus disappeared from the inferior vena cava. We performed transesophageal echocardiography and detected the tumor thrombus in the right ventricle. Therefore, we immediately tried to remove the thrombus using cardiopulmonary bypass. However, we could not find the tumor thrombus in the right ventricle or in the main pulmonary artery. We used angioscopy of the pulmonary artery and detected the tumor thrombus at the orifice of the inferior pulmonary artery. The tumor thrombus was removed under direct visualization. In the event of an intraoperative pulmonary embolism, simple and safe techniques for exact and rapid diagnosis are needed. Intraoperative angioscopy allows direct visualization of the pulmonary arterial branches and appears to be very useful for detection of tumor thrombi even in emergency cases.

Background/Aims: The frequency and details of nonalcoholic fatty liver disease (NAFLD) complications in patients with inflammatory bowel disease (IBD) remain unclear. This study aimed to clarify characteristics of NAFLD in patients with IBD. Methods: We retrospectively identified and enrolled patients with IBD diagnosed with or without NAFLD by undergoing abdominal computed tomography (CT) at our institution between 2005 and 2020. The primary endpoint was the complication rate of NAFLD in patients with IBD. Secondary endpoints were the clinical characteristics of nonobese patients with IBD and comorbid NAFLD and their association with nutritional and inflammatory parameters. Results: Twenty-one (21.9%) of 96 eligible patients with IBD also had NAFLD. In nonobese patients (defined as patients with a body mass index <25 kg/m2), C-reactive protein (CRP; P<0.001) and alanine aminotransferase (P=0.018) levels were higher and the albumin level (P=0.005) and prognostic nutritional index (PNI; P=0.002) values were lower in patients with NAFLD than in those without NAFLD. The PNI value was positively correlated (P<0.001) and the CRP level was negatively correlated (P=0.001) with the hepatosplenic ratio. However, in the NAFLD combined group, PNI (P<0.05) and CRP values (P<0.001) were improved over time after CT imaging by continuing IBD treatment. Conclusions Worsening nutritional and inflammatory status in IBD patients is associated with complications of NAFLD. Diagnosis of NAFLD in IBD patients using CT imaging might be useful not only for early detection of NAFLD but also in assessing the need for therapeutic intervention for IBD.