High fat diet consumption induces fat accumulation in the liver. An understanding of when liver fat accumulation begins is important for exploring the mechanisms underlying fatty liver. The aim of this study was to investigate the processes of fat accumulation in the liver during high fat diet consumption with or without exercise using computed tomography (CT). Male 6 week old C57BL/6J mice were randomly assigned to the normal diet or high fat diet group. After 6 weeks, mice in the high-fat diet group were further divided into voluntary wheel exercise (HFD+Ex) and no exercise (HFD) groups. We measured body weight, food intake and locomotor activity in all mice. Liver fat accumulation was measured by CT scan weekly. Blood and tissue sampling was performed at the end of the experimental period. Following the 6 week exercise period, total body, mesenteric fat and liver weight in the HFD+Ex group were significantly lower than those in the HFD group. Alanine aminotransferase levels improved in HFD+Ex mice compared with those of HFD mice. The hounsfield unit value in HFD mice decreased between 3 and 8 weeks, suggesting that liver fat accumulation accelerated during this period. In contrast this decrease was not observed one week after exercise in HFD+Ex mice. These results suggest that liver fat accumulation estimated by CT was not observed until the 3rd week of high fat feeding while the effects of voluntary wheel exercise appeared immediately.

Background/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens. Methods: Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined. Results: Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001). Conclusions For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.

Background/Aims: Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens. Methods: Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined. Results: Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001). Conclusions For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.

Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

Objective：This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods：This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results：This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion：The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.

Objective：This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods：This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results：This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion：The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.