The purpose of this cross-sectional study is to investigate the difference in physical activity among elderly living in different areas in Japan (“Bunkyo Ward in Tokyo” (Bunkyo) and “Fuchu City in Tokyo” (Fuchu) as urban areas, and “Oyama Town in Shizuoka” (Oyama) as a non-urban area). Participants were 1859 community-dwelling residents aged 65-74 years, randomly selected from the residential registry (response rate: 68.9%). A mail survey using self-administered questionnaires was conducted. Multivariate logistic regression analyses were used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) of various types of physical activity (eg, walking (Walking), going out (Going-out), bicycling (Bicycling), exercise habits (Exercise)), according to residential areas (reference category: Fuchu), stratified by gender, adjusting for socio-demographic variables. There was a significant difference in Going-out (ORs = 0.61 (95% CI: 0.44-0.86) for men, 0.48 (0.33-0.69) for women)), and Bicycling (0.04 (0.03-0.07) for men, 0.04 (0.02-0.07) for women) in Oyama compared to Fuchu. Furthermore, for women, there was a significant difference in Walking (0.56 (0.38-0.81)) and Exercise (0.59 (0.41-0.85)) in Oyama compared to Fuchu. There was a significant difference in Bicycling and Going-out for men in Bunkyo compared to Fuchu, but there was not a significant difference in other items. Low physical activity levels were observed in the elderly in the non-urban area compared to urban areas. The association was stronger in women. Regional difference might need to be taken into account for an effective physical activity intervention.

Previous studies reported that endoscopic resection is effective for the treatment of superficial pharyngeal cancers, as for digestive tract cancers. However, the optimal treatment for superficial cancer of the uvula has not been established because of the rarity of this condition. We present two male patients in their 70s with superficial cancer of the uvula, detected with upper gastrointestinal endoscopy. Both patients underwent surgical resection of the uvula under general anesthesia. The extent of the lesions was determined by means of gastrointestinal endoscopy by using magnifying observation with narrow-band imaging, enabling the performance of minimally invasive surgery. Endoscopic submucosal dissection was performed to achieve en bloc resection of the intramucosal carcinoma that had infiltrated the area adjacent to the uvula. Gastrointestinal endoscopists should carefully examine the laryngopharynx to avoid missing superficial cancers. Our minimally invasive treatment for superficial cancer of the uvula had favorable postoperative outcomes, and prevented postoperative loss of breathing, swallowing, and articulation functions.
Anesthesia, General ; Deglutition ; Endoscopy, Gastrointestinal ; Gastrointestinal Tract ; Humans ; Hypopharynx ; Male ; Minimally Invasive Surgical Procedures* ; Pharyngeal Neoplasms ; Respiration ; Uvula*

Background/Aims: Asymptomatic esophageal eosinophilia (aEE) is considered to be a potential precursor of eosinophilic esophagitis (EoE). However, there are few clinical parameters that can be used to evaluate the disease. Therefore, we aimed to clarify the factors involved in the symptoms of EoE by examining the clinicopathological differences between aEE and EoE. Methods: We reviewed 41 patients with esophageal eosinophilia who underwent endoscopic ultrasonography and high-resolution manometry. They were divided into the aEE group (n=16) and the EoE group (n=25) using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score. The patients’ clinicopathological findings were collected and examined. Results: The median Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score was 3.0 in the aEE group and 10.0 in the EoE group. There was no significant difference in patient characteristics, endoscopic findings and pathological findings. The cutoff value for wall thickening was 3.13 mm for the total esophageal wall thickness and 2.30 mm for the thickness from the surface to the muscular layer (total esophageal wall thickness: 84.0% sensitivity, 75.0% specificity; thickness from the surface to the muscular layer: 84.0% sensitivity, 68.7% specificity).The high-resolution manometry study was abnormal in seven patients (43.8%) in the aEE group and in 12 (48.0%) in the EoE group. The contractile front velocity was slower in the EoE group (p=0.026). Conclusions The esophageal wall thickening in the lower portion of the esophagus is an important clinical factors related to the symptoms in patients with EoE.