Cancer chemoprevention utilizing food components is attracted because of its easily availability in humans. Bitter melon (Momordica charantia) (BMO) and pomegranate (Punica granatum L.) (PGO) seed oils contain a large amount of conjugated linolenic acid (CLN). In the first we demonstrated that BMO inhibits the development of azoxymethane (AOM)-induced putative precursor lesions for colonic adenocarcinoma in rats. Subsequently, we investigated the modifying effects of dietary administration of BMO or PGO on the development of colonic neoplasms using an animal colon carcinogenesis model initiated with a colon carcinogen AOM. Male F344 rats were given two weekly subcutaneous injections of AOM (20 mg/kg body weight) to induce colonic neoplasms. They were fed with the diets containing 0.01%, 0.1% and 1% BMO or PGO during the entire experimental period (for 32 weeks), starting one week before the first dosing of AOM. At the end of the study, the incidence and multiplicity of colonic adenocarcinoma were reduced in the "AOM+BMO" and "AOM+PGO" groups, when compared with the "gAOM alone" group. The contents of conjugated linoleic acid (CLA: 9c,11t-18:2) in the liver and colonic mucosa of rats fed BMO or PGO were elevated in a dose-dependent manner. Also, dietary BMO or PGO enhanced expression of peroxisome proliferator-activated receptor (PPAR)γ protein in the colonic mucosa. These findings may suggest that BMO or PGO rich in CLN can suppress AOM-induced colon carcinogenesis through the modification of lipid composition in the colon and liver and/or increased expression of PPARγ protein level in the colon mucosa. Our results might provide scientific evidence of an effective dietary chemopreventive approach using BMO and PGO seed oils rich in CLN to cancer chemoprevention, especially colon cancer development.

Several studies have reported that molecular hydrogen (H₂) acts as a therapeutic medical gas owing to scavenging reactive oxygen species (ROS). However, little is known about effects of H₂ on exercise-induced oxidative stress. The purpose of this study was to investigate the effects of weekly hydrogen bathing on exercise-induced oxidative stress and delayed-onset muscle soreness (DOMS). Nine healthy and active young men participated in this study, and each subject performed hydrogen bathing trial and placebo bathing trial in a crossover design. The subjects performed downhill running (8 % decline) at 75 % peak oxygen uptake (VO₂peak) for 30 min, and each subjects conducted hydrogen or placebo bathing for 20 min, respectively, 1-6 days after downhill running. Before and after exercise, we measured visual analogue scale (VAS) and collected blood samples (Pre- and 5 min, 60 min after the end of bathing, 1day, 2days, 3days, 7days after downhill running). Blood sample analyses include creatine kinase (CK), myoglobin (Mb), malondialdehyde (MDA), reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), myeloperoxidase (MPO), interleukin-6 (IL-6), interleukin-17a (IL-17a) and lactate concentrations. Weekly hydrogen bathing had no effects of exercise-induced oxidative stress and muscle damage. On the other hand, hydrogen bathing significantly reduced DOMS (VAS) 1 and 2days after downhill running (p=0.033). These findings suggest that hydrogen bath after downhill exercise can be effective for reduction of DOMS.

Purpose: It is unclear whether high-definition (HD) imaging improves visibility and diagnostic ability in early gastric cancer (EGC) compared with standard-definition (SD) imaging. We aimed to compare the diagnostic performance and visibility scores of HD and SD ultraslim endoscopes in EGC. Materials and Methods: We used HD and SD ultraslim endoscopes to obtain 60 images with similar compositions of gastric environments. Of the 60 images, 30 showed EGC (15 images for each modality) and 30 showed no EGC (15 images for each modality). Seventeen endoscopists evaluated the presence and location of the lesions in each image. Diagnostic ability was compared between modalities. The color difference between a lesion and the surrounding mucosa (ΔE) was measured and compared between the modalities. Results: The ability of HD to detect EGC was significantly higher than that of SD (accuracy:80.8% vs. 71.6%, P=0.017; sensitivity: 94.9% vs. 76.5%, P<0.001; positive predictive value, 76.2% vs. 55.3%, P<0.001; and negative predictive value (NPV), 94.1% vs. 73.5%, P<0.001).The ability of HD to determine the horizontal extent of EGC was significantly higher than that of SD (accuracy: 71.0% vs. 57.8%, P=0.004; sensitivity: 75.3% vs. 49.0%, P<0.001; NPV, 72.9% vs. 55.9%, P<0.001; and area under the curve: 0.891 vs. 0.631, P=0.038). The mean ΔE was significantly higher for HD than for SD (10.3 vs. 5.9, P=0.011). Conclusions The HD ultraslim endoscope showed a higher diagnostic performance in EGC than the SD endoscope because it provided good color contrast.

BACKGROUND: Synovial chondromatosis occurs rarely in the shoulder, and its details remain unclear. The purpose of this study was to clarify the clinical results of surgical resection and the histopathological findings of synovial chondromatosis in the shoulder. METHODS: Ten shoulders with synovial chondromatosis that had been operatively resected were reviewed retrospectively. Osteochondral lesions were present in the glenohumeral joint in six shoulders and in the subacromial space in four shoulders. Two patients had a history of trauma with glenohumeral dislocation without recurrent instability, and the other seven patients (eight shoulders) did not have any traumatic episodes or past illness involving the ipsilateral shoulder girdle. The occurrences of osteochondral lesions, inferior humeral osteophytes, and acromial spurs were assessed on radiographs before resection, just after resection, and at final follow-up. The Constant scores were compared before resection and at final follow-up with Wilcoxon signed-rank tests. Resected lesions were histopathologically differentiated between primary and secondary synovial chondromatosis. RESULTS: Inferior humeral osteophytes were found in five shoulders with synovial chondromatosis in the glenohumeral joint, and all four shoulders with synovial chondromatosis in the subacromial space had acromial spur formation. Osteochondral lesions appeared to have been successfully removed in all shoulders on postoperative radiographs. At the final follow-up, however, one shoulder with secondary synovial chondromatosis in the subacromial space showed recurrence of osteochondral lesions and acromial spur formation. The mean Constant score improved significantly from 53.0 points before resection to 76.0 points at a mean follow-up of 6.0 years (p = 0.002). On histopathological evaluation, one shoulder was diagnosed as having primary synovial chondromatosis, while nine shoulders had secondary synovial chondromatosis. CONCLUSIONS The present study showed that resection of shoulder osteochondral lesions successfully relieved the clinical symptoms and that primary synovial chondromatosis is less common than secondary synovial chondromatosis in the shoulder. Although most of the present osteochondral lesions were clinically determined to be primary chondromatosis, only one case was histopathologically categorized as primary synovial chondromatosis. These results suggest that histopathological identification is needed to differentiate between primary and secondary synovial chondromatosis.

Background/Aims: Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC. Methods: This was a post hoc analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis. Results: Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days.GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence. Conclusions Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.

The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as grade 1 (strong) or grade 2 (weak) according to the concepts of the grading of recommendations assessment, development, and evaluation system. The 31 CQs covered the six topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, and (6) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.

To investigate the factors affecting the rate of improvement in endurance exercise performance following pre-cooling with ice slurry, we focused on individual physical characteristics and thermoregulatory capacity. Twenty-four healthy adults (12 males and 12 females) ingested 7.5g kg-1 of either ice slurry at -1°C (ICE) or control water at 20°C (CON) before cycling at 55% VO2max and continued cycling until the rectal temperature reached 38.5°C or untill exhaustion in a hot environment (controlled at 38°C, 40% relative humidity). The relationship between the rate of improvement in exercise performance and physical characteristics and thermoregulatory factors (changes in rectal temperature, the rate of rectal temperature increase, whole body sweat loss, mean metabolic heat production, and heat storage) was investigated. No correlation was noted between the rate of improvement in exercise performance and physical characteristics and heat storage. On the other hand, the rate of improvement in exercise performance showed significant correlations with changes in rectal temperature (r = -0.497), the rate of rectal temperature increases during exercise (r = -0.784), whole body sweat loss (r = 0.407), and mean metabolic heat production (r = -0.436). The rate of inhibition of sweating and the rate of increase in metabolic heat production by ice slurry ingestion during exercise have been suggested to be related to the rate of improvement in exercise performance. On the other hand, there was no relationship between body composition or VO2max and the rate of improvement in exercise performance.

Treatment for malignancy bowel obstruction (MBO) includes surgery, gastrointestinal stenting, nasogastric tube, percutaneous endoscopic gastrostomy, and drug therapy. Drug therapy such as octreotide acetate significantly reduces the quality of life of patients because oral intake is no longer possible and continuous intravenous infusion is required. After a multidisciplinary conference including the department of gastrointestinal surgery and the department of palliative medicine, we could perform staging laparoscopy on a nutritionally-depleted patient with MBO and laparoscopic jejunostomy as a palliative surgery. As a result, she could discontinue from administration of octreotide acetate and resume oral intake.

Objective: Histological verification of epithelioid cell granuloma is important in diagnosing sarcoidosis; tissue sampling is a worldwide requirement. In 2006, to reduce medical expenses and avoid invasive procedures, diagnostic criteria without histological verification were permitted by the Japanese government. In 2015, new diagnostic criteria, allowed clinical diagnoses based on only respiratory, ocular, and cardiac systems with at least a two-system involvement, increasing the need to sample tissue from clinically unevaluable organs in suspected sarcoidosis. This study aimed to compare the characteristics of patients who were diagnosed with sarcoidosis according to the 2006 and 2015 criteria.Materials and Methods: Using the 2015 version, we re-evaluated the characteristics of 264 patients with diagnosed or suspected sarcoidosis according to the 2006 criteria, at Jichi Medical University Hospital between 2004 and 2012 (clinical diagnosis, 84; histological diagnosis, 117; suspected sarcoidosis 63).Results: Thirty-nine patients were diagnosed with suspected sarcoidosis due to the absence of at least a two-system involvement; two patients had insufficient laboratory data suggestive of sarcoidosis. Six patients moved from suspected sarcoidosis to a histological diagnosis because of a greater leniency in the criteria for supportive findings. The 2015 diagnostic criteria excluded patients with organ involvement without a requirement for systemic steroids from the clinical diagnosis group. A case of schwannoma, erroneously placed in the clinical diagnosis group by the 2006 criteria, was reclassified according to the 2015 criteria.Conclusion: The 2015 version is preferable for clinically diagnosing sarcoidosis, even without histological specimens, and provides guidance for indications for systemic treatment.

Objective: Pulmonary mycobacterium avium complex (MAC) disease is increasing significantly worldwide. Several studies have investigated the clinical features of pulmonary MAC disease in the setting of cancer. Here, we aimed to clarify the clinical characteristics of patients with cancer with recent onset of pulmonary MAC disease and the effect of cancer on the onset of this disease.Patients and Methods: Of the 323 consecutive Japanese patients newly diagnosed with pulmonary MAC disease at Jichi Medical University Hospital between and 2006–2017, we retrospectively reviewed 79 consecutive patients with cancer.Results: Seventeen patients had lung cancer (21.0%), while 62 had non-lung cancer. Of the 17 patients with lung cancer, 16 had adenocarcinoma of which 10 had stage I to III disease; 8 of the 10 patients had not received chemotherapy. Sixteen patients with lung cancer had a MAC infection in the ipsilateral lung. Notably, 9 of the 11 lung cancer patients who did not undergo surgery had a MAC infection in the affected lobe. Of the 39 patients with the most common types of non-lung cancer (14 had gastric cancer, 13 had colorectal cancer, and 12 had breast cancer), 22 had stage I to III disease, and 18 of these 22 had not received chemotherapy.Conclusion: Lung cancer may act as a local factor contributing to the onset of pulmonary MAC disease in the ipsilateral lung. However, the underlying mechanism by which a history of cancer might affect the onset of pulmonary MAC disease remains unclear. Further investigation into this mechanism is needed.