Background/Aims: Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease. Methods: We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists. Results: Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom. Conclusions Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.

This study aimed to explore the association of breakfast (BF) dietary patterns with physical activity (PA) and fitness in elementary school children. This study enrolled 242 school children of 5th and 6th grade. BF dietary patterns were evaluated by questionnaires on whether the child consumes the following food categories: staple, main dish, side dish, soup, milk or dairy products, and fruit. Individual PA levels were categorized into high and low PA groups using a PA scale for children. The measured 8 assessments of physical fitness scores were converted to Z-scores normalized for sex, age and height as previously reported. High PA group had significantly higher scores in running and muscle strength as well as in the total score of physical fitness. The frequency of eating BF (with or without BF omission) and the level of PA were not significantly related in both sexes. However, in girl children, BF, including staple, main dish, side dish, and soup, was significantly more prevalent in high PA group than low PA group (55.9% vs. 32.1%; χ2 = 5.638, p = 0.018). A similar tendency was observed in girls who had BF, including staple, main dish, and side dish (49.0% vs. 31.1%; χ2 = 3.720, p = 0.054). No associations between dietary patterns and PA were observed in boys. The results suggested that the frequency of eating BF was not associated with PA levels, which was significantly related to physical fitness in Japanese 5th and 6th grade elementary school children. In contrast, the results indicated that a high-quality BF dietary pattern, such as a meal including staple, main dish, side dish, and soup, might be associated with a physically active girl child.

OBJECTIVEHie (cold sensation) is one of the most well-known health complaints in Japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho (cold disorder). This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary.

METHODSTwo hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 Health Survey Standard Version (SF-8) was used to measure health-related quality of life (QOL). The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item.

RESULTSThe 1st factor (hie factor) was correlated with hie (r = 0.546), dry mouth (r = 0.332), lower-extremity edema (r = 0.450), headrushes (r = 0.470), shoulder stiffness (r = 0.311), headrushes with chills (r = 0.726), and fatigue (r = 0.359). Cronbach's α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was β = -0.387 for physical component score (P < 0.001) and β = -0.243 for mental component score (P < 0.001).

CONCLUSIONThis study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.

OBJECTIVEHie (cold sensation) is one of the most common health complaints in Japan. Those who suffer from severe hie are considered as having hiesho (cold disorder). However, exact hiesho symptoms have not been defined clearly and the decision as to whether a person suffers from hiesho is subjective and based on self-awareness. The study was conducted in attempt to develop a standardized hiesho diagnostic scale.

METHODSSubjects comprised 1 146 students. From the self-awareness of hiesho symptoms, males and females were divided into hiesho and non-hiesho groups. Physical, behavioral and adaptive characteristics were compared using the 24-item questionnaire (four-grade survey) and indicators for hiesho symptoms were extracted. Based on the scores, a receiver operating characteristic curve was drawn for the total ordinal scale score of the extracted items in relation to the presence and absence of hiesho symptoms, and an optimal cutoff value was determined.

RESULTSThe self-awareness of having hiesho was found in 23.2% males and in 55.6% females. The sensitivity was 84.5% for males and 83.3% for females in the hiesho groups, and the specificity was 86.0% for males and 85.2% for females in the non-hiesho groups.

CONCLUSIONA questionnaire consisting of the extracted items may be useful to identify hiesho in young males and females with a high level of accuracy.

Adult ; Cold Temperature ; Female ; Humans ; Male ; Surveys and Questionnaires ; Thermosensing

Recently, the palliative care team (PCT) at our hospital has included dentists. Among a total of 127 cancer patientsand required PCT intervention from 2009 to 2014, 17 patients (13.3%) had oral symptoms. Therefore, the PCT held discussions in order to determine the optimal way to treat each patient. Various symptoms, including oral pain, dry mouth, taste disturbance, furred tongue, excessive amounts of saliva, appetite loss, and trismus were treated by the dentists. As a result, the oral findings improved in all patients, while the oral symptoms improved in 16 of the 17 patients (94%). Thanks to the fact that dentists have joined the PCT, oral symptoms are effectively relieved, and PCT members now have an increased interest in oral cavity complications. Furthermore, conducting thorough examinations of the oral cavity by the PCT not only results in an improved QOL, but it has also increased the interest in the oral cavity on the part of the PCT. Therefore, more effective palliative care is expected to be achieved by promoting increased cooperation with more clinical departments.

OBJECTIVEThe morphological and color characteristics of the tongue sublingual veins (SLVs) can manifest differently within the subjects, depending on the way their tongue is curled upward. This study was conducted in order to investigate the clinical relevancy of tongue SLV diagnosis in relation to menstrual clinical symptoms (pain, clots, heavy, and scanty), using three different inspection procedures (IP1, IP2, and IP3).

METHODSThree-hundred and seventy-seven female patients were asked to stick out their tongues in three specific ways which were intended to create different tongue protrusion angles. The SLV parameters for thickness (TK), length (LE), color (CL), shape (SP), and nodules (ND) were then evaluated.

RESULTSAccording to the results of the Wald χ2 test, IP1 provides the best model for pain (R2=0.155), IP3 for clots (R2=0.437), IP2 for heavy (R2=0.268), and scanty (R2=0.192). Abnormal SLV diagnostic parameters were most strongly associated with the clinical symptom of clots (R2=0.492).

CONCLUSIONWhile the study showed the relations between tongue SLV features and menstrual clinical symptoms, as well it showed that IP2 was the best overall predictor for the symptomatic indexes used in this study, and using one particular SLV inspection procedure may not be sufficient. The application of a particular inspection method alone may cause under- or over-estimation of SLV abnormalities.

Adult ; Color ; Female ; Follow-Up Studies ; Humans ; Menstruation ; Middle Aged ; Retrospective Studies ; Tongue ; pathology ; Tongue Diseases ; diagnosis ; Young Adult

This study aimed to examine the effects of an 8-week physical activity program, which mainly comprised home-based bench-stepping exercise training at the intensity of lactate threshold (LT), on mental health (MH), health-related quality of life (HRQOL), and physical fitness in Japanese returnees from China. Thirty Japanese returnees (63 ± 9 y) participated in the exercise program. Another six subjects were enrolled as the control group. The subjects performed 212 ± 57 min of training, and their daily step counts were increased. Aerobic capacity (LT: 4.5 ± 0.8 vs. 5.5 ± 1.1 METs), lower limb strength (30-s chair stand test [CS-30]: 19.1 ± 5.5 vs. 21.3 ± 5.1 times), and sit-and-reach flexibility (sitting-posture body anteflexion: 36.1 ± 9.4 vs. 39.0 ± 8.4 cm) were significantly increased after the intervention compared with before the intervention. Furthermore, MH, as assessed by the total score of the GHQ-28 (3.4 ± 4.4 vs. 0.3 ± 0.8 points), and the mental component score (MCS) of HRQOL, as evaluated by the SF-36v2 (55.1 ± 11.4 vs. 58.5 ± 10.0), were significantly changed in a positive manner. However, a two-way repeated measures ANOVA (group × period) showed significant interactions for LT and MCS (p<0.05), and a tendency for interactions of CS-30 (p=0.063) and the total score of the GHQ-28 (p=0.098). These results indicate that this bench-stepping exercise program could become a useful health support program for improving physical fitness, as well as MH and HRQOL, in Japanese returnees.

OBJECTIVETo determine whether any difference exists in the skin-temperature responses of the lower limbs to hot-stone application relative to one-site and three-site abdominal application.

METHODSTwenty-five female students participated in experimental sessions after a random allocation: 14 participants received a hot-stone application on the umbilicus, superior-umbilicus, and inferior-umbilicus regions (hereafter referred to as the three-site stimulation group); and 11 participants received the hot-stone application on the umbilicus region only (hereafter referred to as the one-site stimulation group). Heated stones were applied for 9 min to participants in both groups. Four arbitrary frames (the lower leg, ankle, proximal foot, and distal foot regions) were created in order to observe and analyze the skin temperature of a lower limb using a thermograph. Observation periods were as follows: before hot-stone stimulation, immediately after stimulation, and 5, 10, 15, and 20 min after stimulation.

RESULTSThere was a significant offset interaction of distal foot skin temperature between the groups. The left-side distal foot skin temperature increased at 15 and 20 min following the three-site abdominal hot-stone stimulation. The right-side distal foot skin temperature increased immediately and at 5, 10, 15, and 20 min following the three-site abdominal hot-stone stimulation. No significant change in distal foot skin temperature was observed following the one-site stimulation.

CONCLUSIONLower-limb skin temperature was altered following hot-stone stimulation applied to the abdomen, and the one-site stimulation and three-site stimulation yielded different distal foot skin-temperature reactions.

Adult ; Hot Temperature ; therapeutic use ; Humans ; Lower Extremity ; Male ; Massage ; methods ; Skin Temperature

OBJECTIVEThe aim of this study was to examine the changes in natural killer (NK) cell activity, pulse rate, and pain intensity among older adults before and after acupuncture treatment.

METHODSFifty-six individuals (16 males and 40 females), age 60 to 82 years (mean age 72.4 ± 5.0), who were experiencing pain in the shoulder, low back, or knee, participated in the study. NK cell activity, leukocyte differentiation (granulocytes and lymphocytes), pulse rate, and blood pressure values obtained. Pain intensity was used to analyze NK cell activity, leukocytes (granulocyte counts and granulocyte-to-lymphocyte ratio), and the VAS score in accordance with the location of pain complaints before and after acupuncture treatment.

RESULTSNK cell activity decreased after acupuncture treatment for pain in the shoulder-pain and knee-pain groups. Further, the lymphocyte and granulocyte counts increased after acupuncture treatment for the shoulder-pain group. Pulse rate decreased for the shoulder-pain, low-back-pain, and knee-pain groups after acupuncture treatment. The VAS score decreased after acupuncture treatment for the shoulder-pain, low-back-pain, and knee-pain groups.

CONCLUSIONThis study showed that in older adults, acupuncture treatment decreases pulse rate, relieves pain in the shoulder, low back, and knee, and reduces NK-cell activity.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Blood Pressure ; Female ; Heart Rate ; Humans ; Killer Cells, Natural ; immunology ; Low Back Pain ; immunology ; physiopathology ; therapy ; Male ; Middle Aged ; Pain Measurement ; Shoulder Pain ; immunology ; physiopathology ; therapy ; Treatment Outcome

PURPOSE: Sonic hedgehog (Shh) signaling and epithelial-mesenchymal transition (EMT) are both known to relate to cancer progression. The purpose of this study was to investigate the role of Shh signaling and EMT in renal cell carcinoma (RCC). MATERIALS AND METHODS: Cell proliferation was assayed in RCC cell lines in the presence or absence of a Shh signaling stimulator, recombinant Shh (r-Shh) protein, or a Shh signaling inhibitor, cyclopamine. Real-time reverse transcription-polymerase chain reaction (RT-PCR) was performed to study the expression of EMT markers (E-cadherin, N-cadherin, and vimentin) and osteonectin. The expression of Ki-67, Gli-1, osteonectin, and EMT markers in nephrectomy specimens from RCC patients was also measured by immunohistochemical (IHC) staining. RESULTS: RCC cells showed enhanced cell proliferation by r-Shh protein, whereas cell proliferation was suppressed by the addition of cyclopamine in RenCa cells. Real-time RT-PCR showed that r-Shh suppressed the expression of E-cadherin and that this suppression was partly blocked by cyclopamine alone in RenCa cells. In the IHC results, osteonectin significantly correlated with vein sinus invasion (p=0.0218), and the expression of vimentin significantly correlated with lymphatic invasion (p=0.0392). CONCLUSIONS: Shh signaling and EMT play roles in RCC progression, and the Shh signaling inhibitor cyclopamine might be a possible molecular targeted therapeutic strategy for RCC.
Cadherins ; Carcinoma, Renal Cell ; Cell Line ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Hedgehogs ; Humans ; Nephrectomy ; Osteonectin ; Polymethacrylic Acids ; Veins ; Veratrum Alkaloids ; Vimentin