Objective: Advanced ovarian clear cell carcinoma (OCCC) is associated with poor outcomes owing to chemoresistance. Bevacizumab (Bev) is increasingly being used to treat advanced ovarian cancer; however, its efficacy in OCCC remains unclear. This study evaluated the treatment outcomes of frontline bevacizumab chemotherapy in patients with OCCC. Methods: This retrospective multi-institutional study included patients diagnosed with advanced OCCC at eight institutions in Japan between 2008 and 2018. Patients were categorized into pre and post-market groups based on the Bev approval dates. Progressionfree survival (PFS) and overall survival (OS) were analyzed using univariate and multivariate methods. Additionally, patients were classified into Bev-treated (Bev+) and non-Bev-treated (Bev−) groups, and their prognoses were compared. Results: A total of 96 patients were in the pre-market group and 82 in the post-market group. The post-market group had a significantly higher proportion of patients with poor performance status and patients who underwent interval debulking surgery (p<0.01 and p<0.01, respectively). Univariate analysis demonstrated a better PFS in the post-market group (p=0.041). In multivariate analysis, better PFS (hazard ratio [HR]=0.52; p=0.002) and OS (HR=0.47; p=0.002) were observed in the post-market group than in the pre-market group.Bev+ patients had significantly better PFS and OS than Bev− patients in univariate (p<0.001 and p<0.001, respectively) and multivariate analyses (PFS: HR=0.36; p<0.001 and OS:HR=0.21; p=0.001, respectively). Conclusion Incorporating Bev into frontline chemotherapy may improve outcomes in patients with advanced OCCC.

　　Chronic kidney disease (CKD) has recently been reported to be an independent risk factor for stroke. However, a detailed analysis was yet to be conducted according to stroke subtype. We attempted to determine the risk factors for stroke using data from the “specific health checkup” for metabolic syndrome conducted by the 9 hospitals affiliated with the Akita Prefectural Federation of Agricultural Cooperatives, and evaluate and determine the risk factors for stroke. There were 401 patients who had undergone metabolic syndrome checkups from 2007 and 2010 and suffered from stroke afterwards within 3 years after the screening. The controls were all 69,407 subjects who were screened during the same period. The predictors examined were sex, age, blood pressure, BMI, cholesterol values (HDL・LDL), history of diabetes mellitus, presence of atrial fibrillation, CKD, and drinking and smoking habits. Analysis was conducted using logistic regression. The risk factors for stroke as a whole were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking history. For cerebral infarction, the risk factors were male sex, age, blood pressure, diabetes, atrial fibrillation, CKD, and smoking habit. The risk factors for cerebral hemorrhage were age, blood pressure, and CKD. For subarachnoid hemorrhage, the risk factors were female sex, age, blood pressure, low HDLemia, and CKD. In conclusion, CKD is an independent risk factor for the 3 subtypes of stroke, and in particular plays an important role as a higher risk factor for cerebral hemorrhage. Smoking cessation and controls of blood pressure, diabetes and atrial fibrillation are the important measures for stroke prevention. In addition, the further intervention should also be targeted to those with the result of CKD revealed by specific health checkups.

The purpose of the present study was to determine whetehr differences exist between nine experimental conditions mixing 10°, 40°and 70°of hip joint angles with knee joint angles, when thirteen subjects performed the same response task. In the experiment 1, each subject was asked to stand on the inside two of the four mat switches (500×700 mm) and keep the assigned joint angles during a second of preparatory period. After the period, each subject was asked to respond with a step out on either the right or the left outside mat switch as quickly as possible. Then the data was collected analyzing the whole body choice response time (RESPONSE TIME) defined as the interval time from the signal to respond with step out, the whole body choice reaction time (REACTION TIME) defined as the interval time from the signal to reaction with lifting the leg for responding to the step out, and the movement time (MOVEMENT TIME) defined as the interval time subtracting RESPONSE TIME from REACTION TIME. Moreover, in the experiment 2, the data was collected and analyzed from the onset time of various forces from the two force platforms on which each subject stood instead of the mat switch and EMG which was led from the right side of m. rectus femoris, m, biceps femoris, m. gastrocnemius, m. tibialis anterior and the left side of m. quardriceps femoris, during performance of the response task. The results were as follows:
1. The subjects' posture with each 70°flexion of the hip and the knee joint revealed the shortest RESPONSE TIME, because of the shortened MOVEMNT TIME, compared with the other posture. Conversely, the posture with 70° flexion of the knee joint showed an expanded REACTION TIME.
2. The knee joint angle was an important factor effecting both REACTION TIME and MOVEMENT TIME, rather than the hip joint angle for the task of the experiment, since flexion of the knee joint expanded the REACTION TIME, but shortened the MOVEMENT TIME.
3. The result of the force platform measurements indicated that the posture with each 70°flexion of the hip and the knee joint was shorter than that with each 10°flexion of them at the onset time of the first reaction force after the reaction signal, and that the order of response for the task was beginning at the leg for responding, followed by the other leg for keeping stability.
4. Conclusive evidence for a shortened RESPONSE TIME was found in the facilitation of the central nervous system, which revealed the preliminary muscle activity and the stabilizing of the posture.