To promote habitual participation in physical activity, a 3-month program for lifestyle physical activity intervention (L group) and structured exercise intervention (E group) was carried out in a community in Okayama Prefecture. One year later, we compared the two intervention groups in terms of cost-effectiveness and behavioral change in habitual physical activity. A total of 250 subjects voluntarily participated in the lifestyle physical activity intervention ; and a total of 42 subjects participated in the structured exercise intervention. The number of participants decreased to 115 (46%) and 21 (50%), respectively, one year later. However, the proportion of subjects who practice endurance exercise increased significantly in both L and E groups ; and an additional 35 subjects (30%) started to practice endurance exercise in L group and 5 (24%) in E group after the interventions. The cost-effectiveness for a person newly starting the endurance exercise practice in the L group intervention was 29,206 yen ; and the E group intervention was 124,731 yen, a ratio of 1/4.3. The study suggests that the cost-effectiveness for the lifestyle physical activity intervention was 4 times better than the structured exercise intervention.

OBJECTIVESTo explore the potential use of ultrasound measurement (SoundScan 2000 Compact, Myriad Ultrasound Systems Ltd., Rehovot, Israel), and to assess both quantitative and qualitative properties of bone.

METHODSThe speed of sound waves (SOS; m/s) propagating along the cortical bone was determined at the tibial shaft. The performance, reliability, validity, and clinical application of this system were evaluated in Japanese subjects.

RESULTSIn phantom experiments, validity of this system was 0.04 (%), coefficient variation (CV: %) in same-day tests was 0.12, in five-separate-day tests was 0.13, and in independent operators was 0.11, respectively. In experiments with Japanese subjects, CV in same-day tests was 0.38, in five-separate-day tests was 0.99, and in independent operators was 0.90, respectively. In addition, cortical bone status of 1176 Japanese subjects (372 males, 804 females) was clinically evaluated by SoundScan 2000 Compact. SOS was negatively correlated with body fat percentage (%), body fat (kg) and waist hip ratio in females and subjects with higher weight bearing index (leg strength/body weight; WBI) have higher SOS in females under the age of forty.

CONCLUSIONSThese findings indicate that the SoundScan 2000 Compact is a highly reliable and valid method for determining cortical bone status and body composition and WBI are closely related to cortical bone status in Japanese females.

Adult ; Age Factors ; Bone Density ; Bone and Bones ; diagnostic imaging ; Female ; Humans ; Japan ; Male ; Middle Aged ; Sex Factors ; Tibia ; diagnostic imaging ; Ultrasonography

OBJECTIVESWe investigated the correlation between changes in body weight and body composition parameters.

METHODSWe used the data of 2635 Japanese (40.2±12.2 years) at baseline and at 1-year follow-up from a database of 13522 subjects, which is available at the Okayama Southern Institute of Health in Okayama prefecture, Japan. Body weight, waist circumference at the umbilical level, hip circumference, and body fat percentage were used in the analyses.

RESULTSBody composition parameters were significantly reduced after 1 year. Changes in body weight significantly correlated with changes in waist circumference, changes in hip circumference, and changes in body fat percentage. A decrease in body weight of 3 kg corresponded to a 3.45 cm decrease in waist circumference in men and a 2.83 cm decrease in that in women.

CONCLUSIONA decrease in body weight of 3 kg corresponded to an almost 3 cm decrease in waist circumference at the umbilical level in Japanese men and women.

We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

Background/Aims: Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease. Methods: We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists. Results: Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom. Conclusions Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.