Recent advances in pediatric medicine have led to increasing numbers of severely disabled children who require medical care at home. Severely disabled children were defined as those who have or are at increased risk of having a chronic physical and developmental condition. On April 1, 2015, we conducted a survey of these children aged 18 years or younger living in the Saku region of Nagano Prefecture. Forty severely disabled children were identified in the Saku region, accounting for 0.02% of the population. Thirty children were being cared for at home and 10 had been institutionalized. The underlying illness or disorder occurred in the perinatal period in 21 children (52.5%). We further investigated the medical care and social support of those severely disabled children living at home. There were 8 children with an extremely severe disability and 7 with a moderately severe disability. Fifteen children did not fall into either category. One patient regularly received medical examination and care via visiting serv­ices and the remaining patients received outpatient care. Visiting nurses provided support and care for 10 children (33%), especially those who needed medical care, such as for tracheostomy and gastrostomy. Thirteen children (43.3%) used a short-stay service, and 19 children (63%) used outpatient support (after-school daycare service/day care service for holidays). Short-stay facilities and child day care services are lacking. The custody support system needs to be enhanced in this region for children and their family members to lead healthy lives.

In this study, we investigated the effect of exercise training on serum and liver chblesterol levels and on biosynthesis of liver cholesterol in rats. The training was carried out at low [Low-Ex, 60% max O₂ consumption (VO₂) ] and high (High-Ex, 75% max VO₂) intensities for 16 weeks. The energy expenditure was adjusted to be equivalent. The succinate dehydrogenase activities of gastrocnemius muscle in the Low-Ex group and High-Ex group were higher than that of control, 36% and 109% (p<0.05) respectively. The levels of total and high density lipoprotein cholesterol in serum were 14-26% lower than those of control, but no difference was detected between the trained groups. The activity of HMG-CoA reductase in liver microsome was significantly higher than that of control for both trained groups. However, the stimulation of this enzyme activity was not changed by training intensity.

Background/Aims: Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood. Methods: This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group). Results: We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011). Conclusions Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.

Purpose: This study aimed at identifying the nature of nursing for patients who have appearance changes due to cancer treatment. Methods: Nurses’ focus group interviews were conducted at two cancer hospitals. The data were analyzed qualitatively. This study was approved by the Research Ethics Committee at the study hospitals. Results: Six focus group interviews were conducted, including a total of 21 participants. The participants’ mean age was 39.2 (SD=6.0) years. Their mean years of professional experience was 16.3 (SD=5.8) years. The participants also included a total of 16 Certified Nurse Specialists and Certified Nurses. Interviews took an average of 42 minutes. Four core categories derived from interviews were: “providing information in advance that is necessary for those having the risk of appearance changes to predict and to prepare,” “providing support to enhance patients’ self-care according to the processes of appearance changes in their daily lives,” “advocating patients’ decision to improve their quality of life,” and “utilizing specialty of multi disciplines through care coordination and collaboration.” Conclusions: Further study will systematically analyze details of appearance changes and necessary care associated with different cancer treatment methods, organ sites, and treatment cycles.

AIMTo evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography (US) to determine the critical testicular volume indicating normal testicular function by each method.

METHODSTotal testicular volume (right plus left testicular volume) was measured in 794 testes in 397 men with infertility (mean age, 35.6 years) using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length X width X height X 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more.

RESULTSMean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography.

CONCLUSIONTesticular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US.

Adult ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Male ; diagnostic imaging ; Luteinizing Hormone ; blood ; Male ; Organ Size ; Semen ; Sperm Motility ; Testis ; diagnostic imaging ; pathology ; physiopathology ; Testosterone ; blood ; Ultrasonography

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Endolymphatic Sac ; diagnostic imaging ; Female ; Humans ; Male ; Meniere Disease ; diagnostic imaging ; Middle Aged ; Otolithic Membrane ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

A 52-year old woman was referred to our hospital because of abdominal pain and restlessness. A chest contrast-enhanced CT showed huge pericardial effusion and intraluminal defects in the main pulmonary artery. We could not make a diagnosis based on the cytology of the pericardial effusion and histopathology of the mass with a sample taken by a catheter. Therefore, we undertook biopsies of the mass by median sternotomy, which led to the diagnosis of pulmonary intimal sarcoma. The tumor resection was performed to release the right ventricular outflow stenosis. We tried to resect the tumor as much as possible, and reconstructed the pulmonary artery and aortic root. She was discharged to home and survived 5 months after surgery.