Objective: To evaluate the reliability and validity of this new measure, called the caregivers’ fear of falling index (CFFI). Methods: The study surveyed home-based rehabilitation patients with fall-related fracture, and their primary caregivers. The characteristics of these patients were evaluated, and the caregivers were surveyed using the CFFI and Falls Efficacy Scale-International (FES-I). The reliability of the CFFI was assessed using item-total correlation, while the validity of the CFFI was evaluated through correlation coefficients calculated between the CFFI and the FES-I. Results: The participants were 51 patient-caregiver pairs. The internal consistency of the CFFI showed an alpha coefficient of 0.904. No items were excluded in the corrected item-total correlations. The CFFI showed a moderate correlation with FES-I (r=0.432, p=0.002). Conclusion This study found the CFFI to be a reliable and valid tool for measuring the primary caregivers’ fear. The CFFI may be a useful tool for healthcare professionals to identify and supporting these primary caregivers.

Purpose: Promoter DNA methylation of various genes has been associated with metachronous gastric cancer (MGC). The cancer-specific methylation gene, cysteine dioxygenase type 1 (CDO1), has been implicated in the occurrence of residual gastric cancer. We evaluated whether DNA methylation of CDO1 could be a predictive biomarker of MGC using specimens of MGC developing on scars after endoscopic submucosal dissection (ESD). Materials and Methods: CDO1 methylation values (TaqMeth values) were compared between 33 patients with early gastric cancer (EGC) with no confirmed metachronous lesions at >3 years after ESD (non-MGC: nMGC group) and 11 patients with MGC developing on scars after ESD (MGCSE groups: EGC at the first ESD [MGCSE-1 group], EGC at the second ESD for treating MGC developing on scars after ESD [MGCSE-2 group]). Each EGC specimen was measured at five locations (at tumor [T] and the 4-point tumor-adjacent noncancerous mucosa [TAM]). Results: In the nMGC group, the TaqMeth values for T were significantly higher than that for TAM (P=0.0006). In the MGCSE groups, TAM (MGCSE-1) exhibited significantly higher TaqMeth values than TAM (nMGC) (P<0.0001) and TAM (MGCSE-2) (P=0.0041), suggesting that TAM (MGCSE-1) exhibited CDO1 hypermethylation similar to T (P=0.3638). The area under the curve for discriminating the highest TaqMeth value of TAM (MGCSE-1) from that of TAM (nMGC) was 0.81, and using the cut-off value of 43.4, CDO1 hypermethylation effectively enriched the MGCSE groups (P<0.0001). Conclusions CDO1 hypermethylation has been implicated in the occurrence of MGC, suggesting its potential as a promising MGC predictor.

In food science, natural ingredients that can inhibit dipeptidyl peptidase IV ( DPP IV ) may be useful for preventing diabetes mellitus. This study aimed to evaluate the effectiveness of bonito dashi having a high DPP IV inhibitory activity (IC50 ; 3049 µg/ ml) on the postprandial increase in blood glucose levels in 14 subjects. Bonito dashi (5 g) was subsequently subjected to oral glucose tolerance tests. Blood glucose levels of all subjects were measured at fasting and at 30 min after ingesting of bonito dashi or of warmed tap water as a control, and were also measured at 30, 45, 60, 75, 90, 120, and 150 min after ingestion of cooked rice. The maximum blood glucose level between 0 and 150 min after ingesting of bonito dashi was for 30 min, of warmed tap water for 45 min ). The blood glucose levels after ingestion of bonito dashi and warmed tap water were 135.6 ± 8.7 mg/ dl and 140.3 mg/ dl, respectively at 30 min ( p = 0.602 ); 135.6 ± 8.7 mg/ dl and 144.1 ± 10.7 mg/ dl, respectively at 45 min ( p = 0.057 ); 120.0 ± 4.9 mg/ dl and 136.8 ± 7.8 mg/ dl, respectively at 60 min ( p = 0.063 ); 110.0 ± 5.9 mg/ dl and 134.9 ± 6.9 mg/ dl, respectively at 75 min ( p = 0.006 ); 110.3 ± 6.8 mg/ dl and 129.3 ± 6.6 mg/ dl, respectively, at 90 min ( p = 0.036 ); 103.4 ± 4.1 mg/ dl and 118.7 ± 8.0 mg/ dl, respectively, at 120 min ( p = 0.091 ); 91.5 ± 3.8 mg/ dl and 102.3 ± 5.9 mg/ dl, respectively, at 150 min ( p = 0.232 ). The area under the curve for blood glucose levels after ingestion of bonito dashi and warmed tap water was 4753.1 ± 439.7 mg/ dl ×min and 6879.4 ± 728.1 mg/ dl ×min, respectively ( p = 0.005 ). Postprandial increase in blood glucose levels was lower in subjects ingestion of bonito dashi than in those ingestion of the warmed tap water. No serious adverse events related to ingestion of bonito dashi were observed. Our findings suggested that the ingestion of bonito dashi (5 g) suppressed postprandial increase in blood glucose levels in our subjects.

A 71-year-old man presented to our hospital with sudden-onset epigastric pain. He reported a history of undergoing the following operations : aortic valve replacement for aortic regurgitation 11 years earlier and graft replacement of the ascending aorta for acute type A aortic dissection, 1 year earlier. His systolic blood pressure was 70 mmHg, and computed tomography revealed a pseudoaneurysm of the distal anastomosis of the ascending aorta with a connection to the right pulmonary artery. Cardiopulmonary bypass was established with cannulation of the right axillary artery and the right femoral vein, and systemic cooling was initiated before sternotomy. We identified an area showing 3 cm dehiscence at the distal aortic anastomosis after hypothermic circulatory arrest and selective cerebral perfusion. The ascending aorta was replaced as hemiarch replacement, and the defect in the right pulmonary artery was closed with bovine pericardium. The patient's postoperative course was uneventful, and he was transferred to a rehabilitation hospital on the 22nd postoperative day.

Spinal cord injury (SCI) is a main concern in patients who undergo thoracic endovascular therapy (TEVAR), because the blood flow of the vertebro-basilar artery may be reduced due to the left subclavian artery (LSA) occlusion. If the left vertebral artery originates directly from the aorta, which is called the isolated left vertebral artery (ILVA), a technical consideration for strategies regarding blood perfusion of the ILVA during TEVARs is required. We hereby aim to report three patients (No.1, No.2, and No.3) who underwent an ILVA translocation and TEVAR with Zone 2 landing for aortic dissection. The diameter of the ILVA was 4.2, 2.3, and 2.2 mm, respectively, and the right vertebral artery (RVA) was dominant in all cases. In Patient No.1 and No.2 (ILVA diameter: 4.2 and 2.3 mm, respectively), the ILVA was anastomosed directly to the left common carotid artery. In Patient No.2, the translocated ILVA was occluded resulting in SCI, but the SCI improved when blood pressure was augmented. In Patient No.3 (ILVA diameter: 2.2 mm), the saphenous vein graft was interposed between the ILVA and the bypass artery because the ILVA diameter was small, but postoperatively, the ILVA remained patent, and no paraplegia was observed. The occlusion of ILVA could cause SCI, even if the RVA is larger than the LVA. Reconstruction of the ILVA is a critical procedure to prevent postoperative SCIs in patients undergoing TEVARs.