Today, well over 160, 000 patients undergo dialysis throughout Japan. The number of patients who are newly required to receive it is increasing year by year. Given that situation, our hospital has annually held a seminar since October 1994 for patients with renal diseases. The purpose is to slow the deterioration of renal function and to delay the introduction of dialysis by encouraging the patients to acquire a habit of taking high calory, low protein food.
This seminar must have help the patients get more knowledgeable about morbidity and learn the benefit of low protein rice-based diet. Now that three years have passed since the opening of the course, we reviewed the outcome, comparing the effects of old and new restrict diets.
A difference began to appear 9-2 months after the lst seminar between the seminar participants and the non-participants (control group) who received guidance only at the outpatient ward. The average rate of decrease in the serum creatine level of those participants who eated lowprotein rice was 0.029 and that of those participants who did not eat the restricted food was 0.166 (p<0.05), compared with 0.262 in the control group. We concluded that the difference is ascribable to the effect of the seminar. We would like to contribute to the well-being of the patients by enriching the content of the seminar and continuing to hold it.

Since distal femoral varus osteotomy (DFO)
Asian Continental Ancestry Group ; Humans ; Japan ; Knee ; Osteoarthritis ; Osteotomy ; Tibia ; Weight-Bearing

Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

Intermittent exercise performance in a hot environment is lower than in temperate conditions. Cooling strategies at rest are important; however, the appropriate cooling temperature is not clear. The purpose of this study was to investigate the effect of temperature for cooling leg during half-time (HT) on intermittent exercise performance. Eleven men performed two pre-tests and three experimental trials of a 2 × 30 min intermittent exercise protocol in the heat (33°C; 50% relative humidity). During HT, three experimental conditions were set: no cooling (CON), cooling at the thigh using 12°C ice packs (COOL), and cooling at the thigh using 0°C ice packs (ICE) for 15 min. During the 2nd half, which consisted of 5 s maximal power pedaling every minute separated by 50 s of unloaded pedaling (80 rpm) and rest (5 s), the subjects repeated 2 × 15 sets of the intermittent exercise protocol. The peak power output under the COOL condition (694 ± 80 W) was significantly higher than that of the CON (653 ± 84 W). Thigh skin and deep temperatures showed a significant difference between each condition. In the COOL, thermal sensation was significantly lower, and thermal comfort was significantly higher. In a protocol that simulates intermittent athletic competitions such as soccer in a hot environment, using ice packs at 12°C to cool the thigh during HT lowered thigh skin and deep temperatures and improved heat perception and intermittent exercise performance. This cooling strategy is practical, suggesting that it would be effective for actual competitive situations.