Background: Vertebral compression fractures (VCFs) are associated with reduced gait ability and functional impairment in older adults. Factors related to walking aid use at discharge remain unclear. This study examined associations between walking aid use and physical function at discharge. Methods: This cross-sectional study included 143 patients with VCFs discharged from Kurume Rehabilitation Hospital. Participants were classified into independent ambulation and walking aid groups, the latter subdivided into cane and walker users. Pain, cognitive function, handgrip strength, 30-second chair stand test, Berg Balance Scale (BBS), and skeletal muscle mass index (SMI) were assessed at discharge. Logistic regression identified factors associated with walking aid use, and exploratory analysis compared cane and walker users. Receiver operating characteristic (ROC) analysis was used to determine the BBS cutoff. Results: BBS at discharge was significantly associated with walking aid use (odds ratio [OR]=0.85; 95% confidence interval [CI] 0.77–0.93; p<0.001). In exploratory analysis, pain (OR=1.43; 95% CI 1.03–1.96; p=0.029) and SMI (OR=0.40; 95% CI 0.20–0.79; p=0.010) were associated with cane versus walker use. The optimal BBS cutoff was 48.5 (area under the curve [AUC]=0.83). Conclusion BBS was associated with the distinction between independent ambulation and walking aid use, while pain and SMI were associated with differences among walking aid users. These findings may inform clinical decision-making for walking aid selection at discharge.

Purpose：We aimed to build a predictive model for ADL, applicable to all patients admitted to a convalescent rehabilitation ward, that uses a simple index as explanatory variables, which is accessible early during hospitalization.Methods：We included 1153 patients admitted to our convalescent rehabilitation ward. Stepwise multiple regression analysis was conducted using 18 Functional Independence Measure (FIM) sub-items at admission, with sex, age, and time since onset as explanatory variables. The total FIM motor score was calculated by summing 13 motor sub-items at discharge. Cross-validation was performed on 85 participants, independent of the analysis group, to confirm the model's clinical applicability.Results：The multiple regression analysis results for the analysis group showed a significant equation with an R2 of 0.712. In the validation group with 85 patients, difference between the predicted and actual FIM scores at discharge was compared between the two groups, and a strong correlation of r=0.888 (p＜0.019 was observed, without any significant difference between the groups.Conclusion：This model is less labor intensive when constructing a prediction equation because the objective variable is easily obtained. Our findings indicate that other convalescent rehabilitation wards can develop prognostic models using their data and implement them clinically.

Purpose：We aimed to build a predictive model for ADL, applicable to all patients admitted to a convalescent rehabilitation ward, that uses a simple index as explanatory variables, which is accessible early during hospitalization.Methods：We included 1153 patients admitted to our convalescent rehabilitation ward. Stepwise multiple regression analysis was conducted using 18 Functional Independence Measure (FIM) sub-items at admission, with sex, age, and time since onset as explanatory variables. The total FIM motor score was calculated by summing 13 motor sub-items at discharge. Cross-validation was performed on 85 participants, independent of the analysis group, to confirm the model's clinical applicability.Results：The multiple regression analysis results for the analysis group showed a significant equation with an R2 of 0.712. In the validation group with 85 patients, difference between the predicted and actual FIM scores at discharge was compared between the two groups, and a strong correlation of r=0.888 (p＜0.01) was observed, without any significant difference between the groups.Conclusion：This model is less labor intensive when constructing a prediction equation because the objective variable is easily obtained. Our findings indicate that other convalescent rehabilitation wards can develop prognostic models using their data and implement them clinically.

Background/Aims: Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. Methods: The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. Results: In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06–16.2). Conclusions Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).

Background/Aims: Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC. Methods: This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021. Only patients diagnosed with HPNGC were enrolled, and their clinicopathological and endoscopic features were analyzed in detail. Results: The prevalence of HPNGC in the present study was 2.6% (54/2112). The types of HPNGC observed in each gastric region were as follows: advanced gastric cancer was observed in the cardia; gastric adenocarcinoma of fundic-gland differentiation, gastric adenocarcinoma of foveolar-type presenting with whitish elevation and raspberry-like foveolar-type gastric adenocarcinoma, gastric adenocarcinoma arising in polyposis, and gastric adenocarcinoma with autoimmune gastritis were observed in the fundic gland region ranging from the gastric fornix to the gastric body; signet-ring cell carcinoma was observed in the gastric-pyloric transition region ranging from the lower gastric body to the gastric angle; and well-differentiated tubular adenocarcinoma with low-grade atypia was observed in the antrum. Conclusions This study revealed that tumors from each gastric region exhibited distinct macroscopic and histological types in HPNGC.

Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

Transabdominal ultrasound (TAUS) is useful in all aspects of lesion screening, monitoring activity, or treating/diagnosing any related complications of inflammatory bowel disease. Its ability to screen or diagnose complications is almost the same as that of other methods, such as CT or MRI. Moreover, its noninvasiveness makes it a first-line examination method. A TAUS image depicting ulcerative colitis will show large intestinal wall thickening that is continuous from the rectum, which is mainly due to mucosal layer thickening, while for Crohn’s disease, a TAUS image is characterized by a diversity in the areas affected, distribution, and layer structure. Indicators of activity monitoring include wall thickness, wall structure, and vascular tests that use Doppler ultrasound or contrast agents. While all of these have been reported to be useful, at this time, no single parameter has been established as superior to others; therefore, a comprehensive evaluation of these parameters is justified. In addition, evaluating the elasticity of lesions using elastography is particularly useful for distinguishing between fibrous and inflammatory stenoses. However, the lack of objectivity is the biggest drawback of using ultrasound. Standardizing and popularizing the ultrasound process will be necessary, including scanning methods, equipment settings, and image analysis.