To develop a simple test of endurance capacity in the elderly, we evaluated the reliability and validity of the shuttle stamina walk test (SSTw), in which the running in the shuttle stamina test (SST : 3-minute shuttle running along a 10-meter course) was changed to walking.
We found that: 1) The walking distance in the SSTw was correlated with Vo₂max (r=0.827), 2) the walking distance showed a correlation between the first test and a re-test (r=0.853), 3) the mean peak heart rate during the test was 86.3% of the estimated maximum heart rate with no difference according to age or sex, 4) subjective evaluation of the intensity of exercise was expressed as“fairly light”or“somewhat hard”by 73.7% of the subjects, 5) the results of the SSTw reflected the subjects' self-evaluation of endurance capacity, and 6) the age-related percentage reduction of the walking distance in the SSTw was similar to that in V₂max in subjects aged 40 years and above.
These results suggest that the SSTw, a simple test of endurance capacity that can be performed safely over a wide range of middle-aged to elderly people including those in late old age and those with a low fitness level, has sufficient reliability and validity.

An Elderly Health and Fitness Promotion Program was carried out in the 32 on areas of Ichihazama Town (now Kurihara City), Miyagi Prefecture to promote the health of the elderly population by making as many townspeople as possible aware of their health and fitness levels, and develop active lifestyles. We evaluated the effectiveness of this program on the basis of the results during the past 4 years.In 2001, the Elderly Health and Fitness Promotion Program was started in each of the town's 32 administration areas. The number of participants continued to increase until it exceeded 600 in 2004, with increases in the percentages of males, those aged 80 years or above, and those withlimited ADL among the participants. While the results of fitness tests varied widely and were very low in some participants, changes in the fitness level were small in regular participants.

The current requirement for biomarkers to detect hepatitis B virus (HBV) infection is polarized. One is a fully-automated and highly sensitive measurement system; the other is a simple system for point-of-care testing (POCT) in resource-limited areas. Hepatitis B core-related antigen (HBcrAg) reflects intrahepatic covalently closed circular DNA and serum HBV DNA. Even in patients with undetectable serum HBV DNA or HBsAg loss, HBcrAg may remain detectable. Decreased HBcrAg levels are associated with reduction of the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B. Recently, a fully-automated, novel high-sensitivity HBcrAg assay (iTACT-HBcrAg, cut-off value: 2.1 logIU/mL) has been developed. This attractive assay has been released in Japan very recently. iTACT-HBcrAg can be useful for monitoring HBV reactivation and prediction of HCC occurrence, as an alternative to HBV DNA. Moreover, monitoring HBcrAg may be suitable for determining the therapeutic effectiveness of approved drugs and novel drugs under development. Presently, international guidelines recommend anti-HBV prophylaxis for pregnant women with high viral loads to prevent mother-to-child transmission of HBV. However, >95% of HBV-infected individuals live in countries where HBV DNA quantification is not available. Worldwide elimination of HBV needs the scaling-up of examination and medication services in resource-limited areas. Based on this situation, a rapid and easy HBcrAg assay as a POCT is valuable. This review provides the latest information regarding the clinical use of a new surrogate marker, HBcrAg, in HBV management, based on iTACT-HBcrAg or POCT, and introduces novel agents targeting HBV RNA/protein.

Hepatitis B virus (HBV) cannot be eliminated completely from infected hepatocytes because of the presence of intrahepatic covalently closed circular DNA (cccDNA). As chronic hepatitis B (CHB) can progress to cirrhosis and hepatocellular carcinoma (HCC), it is important to manage CHB to prevent HCC development in high-risk patients with high viral replicative activity or advanced fibrosis. Serum biomarkers are noninvasive and valuable for the management of CHB. Hepatitis B core-related antigen (HBcrAg) correlates with serum HBV DNA and intrahepatic cccDNA. In CHB patients with undetectable serum HBV DNA or loss of HBsAg, HBcrAg still can be detected and the decrease in HBcrAg levels is significantly associated with hopeful outcomes. Therefore, HBcrAg can predict HCC occurrence or recurrence. Measurement of the Mac-2 binding protein glycosylation isomer (M2BPGi) has been introduced for the evaluation of liver fibrosis. Because elevated M2BPGi in CHB is related to liver fibrosis and the prediction of HCC development, monitoring its progression is essential. Because alpha fetoprotein (AFP) has insufficient sensitivity and specificity for early-stage HCC, a combination of AFP plus protein induced by vitamin K absence factor II, or AFP plus Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein might improve the diagnosis of HCC development. Additionally, Dickkopf-1 and circulating immunoglobulin G antibodies are the novel markers to diagnose HCC or assess HCC prognosis. This review provides an overview of novel HBV biomarkers used for the management of intrahepatic viral replicative activity, liver fibrosis, and HCC development.

We report a very rare case of negative pressure pulmonary edema (NPPE) that occurred immediately after anterior cervical discectomy and fusion (ACDF). The patient was a 25-year-old man who sustained a facet fracture-dislocation of C5 during a traffic accident. After ACDF, he developed NPPE and needed mechanical ventilation. Fortunately, he recovered fully within 24 hours. NPPE is a rare postoperative complication that may occur after cervical spine surgery. The aims of this report are to present information regarding the diagnosis and emergent treatment of NPPE, and to review the previous literature regarding this serious complication.
Accidents, Traffic ; Adult ; Diagnosis ; Diskectomy ; Humans ; Postoperative Complications ; Pulmonary Edema* ; Respiration, Artificial ; Spine*

Prospective clinical study.

Prospective clinical study.

STUDY DESIGN: Retrospective cross-sectional study. PURPOSE: To determine the prevalence of idiopathic scoliosis, define the distribution of the curve magnitude, evaluate the accuracy of Moire topography as a screening tool, and investigate the cost-effectiveness of our screening system. OVERVIEW OF LITERATURE: Early detection of idiopathic scoliosis provides the opportunity for conservative treatment before the deformity is noticeable. We believe that scoliosis screening in schools is useful for detection; however, screening programs are controversial owing to over referral of students who do not require further testing or follow-up. In Japan, school scoliosis screening programs are mandated by law with individual policies determined by local educational committees. We selected Moire topography as the scoliosis screening tool for schools in Nara City. METHODS: We selected Moire topography as the scoliosis screening tool for schools in Nara City. We screened boys and girls aged 11-14 years and reviewed the school scoliosis screening results from 1990 to 2012. RESULTS: A total of 195,149 children aged 11-14 years were screened. The prevalence of scoliosis (defined as > or =10degrees curvature) was 0.057%, 0.010%, and 0.059% in fifth, sixth, and seventh grade boys and 0.337%, 0.369%, and 0.727% in fifth, sixth, and seventh grade girls, respectively. The false-positive rate of our Moire topography was 66.7%. The minimum cost incurred for scoliosis detection in one student was 2,000 USD. CONCLUSIONS: The overall prevalence of scoliosis was low in the students of Nara City schools. Over 23 years, the prevalence of scoliosis in girls increased compared to that in the first decade of the study.
Adolescent* ; Child ; Congenital Abnormalities ; Costs and Cost Analysis ; Cross-Sectional Studies* ; Female ; Follow-Up Studies ; Humans ; Japan ; Jurisprudence ; Mass Screening* ; Moire Topography ; Prevalence ; Referral and Consultation ; Retrospective Studies* ; Scoliosis*