The present study was attempted to examine whether the cold-induced vasodilation is affected by maturation and aging. Twelve prepubertal boys (10-11 yrs), 15 young men (18-26 yrs), and 8 older men (66-78 yrs) immersed their middle finger in ice-water for 15 min under air condition of 27°C and 40% RH. Before the immersion, no age-related differences were observed in skin temperature of middle finger (T_fin) . The time required for the first rise of T_fin after the immersion (TTR) was significantly longer in the older men than in the boys and young men. T_fin at the first rise after the immersion (TFR), highest value of Tfin after the first rise (HST) and the mean value of T_fin during the immersion (MST) were significantly lower in the boys than in the young men. The integral value of T_fin from the onset of cold-induced vasodilation to the end of the immersion (CIVD_index) was significantly lower in the boys and older men than in the young men. TTR, TFR, HST, MST, and CIVD_ifldex did not correlate significantly with maximal oxygen uptake, mean skinfold thicknesses at seven body sites, and length and girth of the middle finger. Oral temperature (Tor) did not change between before and after the immersion regardless of age, although the Tar in the boys was significantly higher than in the young and older men. There were no age differences in the relationship of thermal sensation or pain sensation and T_fin. These results suggest that boys and older men have inferior cold-induced vasodilation compared to young men, and that the mechanisms of inferior cold-induced vasodilation are different in these two groups.

Since 1993, our hospital has been entrusted by the Gifu Prefectural Government with the operation of the home health care system in the region. Hospital healthnurses, keeping in close contact with other medical institutions and self-goverinig bodies, have endeavored to support the health and medical care of home patients.
Initially, there was much to be desired in the way some government offices were addressing to home health care and care coordination for patients when they were discharged from hospital. These inadequacies have largely been corrected and in 1998 a comprehensive home care system came into being.
Our effort to restructure the home care system has been crowned with success in many ways. Formerly there were many cases in which individual organizations rendered services separately, but now hospitals, local medical associations and government offices have come to play on the team, which has made it possible to provide home care effectively and efficiently. Moreover, the hospital staff have become fully aware of the importance of home care.

The current requirement for biomarkers to detect hepatitis B virus (HBV) infection is polarized. One is a fully-automated and highly sensitive measurement system; the other is a simple system for point-of-care testing (POCT) in resource-limited areas. Hepatitis B core-related antigen (HBcrAg) reflects intrahepatic covalently closed circular DNA and serum HBV DNA. Even in patients with undetectable serum HBV DNA or HBsAg loss, HBcrAg may remain detectable. Decreased HBcrAg levels are associated with reduction of the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B. Recently, a fully-automated, novel high-sensitivity HBcrAg assay (iTACT-HBcrAg, cut-off value: 2.1 logIU/mL) has been developed. This attractive assay has been released in Japan very recently. iTACT-HBcrAg can be useful for monitoring HBV reactivation and prediction of HCC occurrence, as an alternative to HBV DNA. Moreover, monitoring HBcrAg may be suitable for determining the therapeutic effectiveness of approved drugs and novel drugs under development. Presently, international guidelines recommend anti-HBV prophylaxis for pregnant women with high viral loads to prevent mother-to-child transmission of HBV. However, >95% of HBV-infected individuals live in countries where HBV DNA quantification is not available. Worldwide elimination of HBV needs the scaling-up of examination and medication services in resource-limited areas. Based on this situation, a rapid and easy HBcrAg assay as a POCT is valuable. This review provides the latest information regarding the clinical use of a new surrogate marker, HBcrAg, in HBV management, based on iTACT-HBcrAg or POCT, and introduces novel agents targeting HBV RNA/protein.

Hepatitis B virus (HBV) cannot be eliminated completely from infected hepatocytes because of the presence of intrahepatic covalently closed circular DNA (cccDNA). As chronic hepatitis B (CHB) can progress to cirrhosis and hepatocellular carcinoma (HCC), it is important to manage CHB to prevent HCC development in high-risk patients with high viral replicative activity or advanced fibrosis. Serum biomarkers are noninvasive and valuable for the management of CHB. Hepatitis B core-related antigen (HBcrAg) correlates with serum HBV DNA and intrahepatic cccDNA. In CHB patients with undetectable serum HBV DNA or loss of HBsAg, HBcrAg still can be detected and the decrease in HBcrAg levels is significantly associated with hopeful outcomes. Therefore, HBcrAg can predict HCC occurrence or recurrence. Measurement of the Mac-2 binding protein glycosylation isomer (M2BPGi) has been introduced for the evaluation of liver fibrosis. Because elevated M2BPGi in CHB is related to liver fibrosis and the prediction of HCC development, monitoring its progression is essential. Because alpha fetoprotein (AFP) has insufficient sensitivity and specificity for early-stage HCC, a combination of AFP plus protein induced by vitamin K absence factor II, or AFP plus Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein might improve the diagnosis of HCC development. Additionally, Dickkopf-1 and circulating immunoglobulin G antibodies are the novel markers to diagnose HCC or assess HCC prognosis. This review provides an overview of novel HBV biomarkers used for the management of intrahepatic viral replicative activity, liver fibrosis, and HCC development.

The UBE woven 150cc WYK graft is a non-sealed graft that became available commercially in January 2005, and does not need to be preclotted before implantation. Subjects in this study comprised 50 patients with abdominal aortic aneurysms or common iliac arterial aneurysms, who received prosthetic Y grafts in our institution. Subjects were divided into 2 groups: the U group (n=26), with implantation of the UBE graft, and the I group (n=24) who received implantation of an INTERGARD^TM woven Y graft. Intraoperative bleeding, inflammatory response and duration of postoperative hospitalization were evaluated in each group. Significant differences were noted between C-reactive protein levels, frequency of recurrence of fever and duration of postoperative hospitalization. No differences were noted between intraoperative bleeding and time. The UBE woven 150cc WYK graft, compared with the INTERGARD^TM woven Y graft, required no extra time for implantation and appeared to offer advantages such reduced immunoreaction after surgery. However, follow-up for sufficient late-phase evaluation of the grafts is required.