Background: Vertebral compression fractures (VCFs) are associated with reduced gait ability and functional impairment in older adults. Factors related to walking aid use at discharge remain unclear. This study examined associations between walking aid use and physical function at discharge. Methods: This cross-sectional study included 143 patients with VCFs discharged from Kurume Rehabilitation Hospital. Participants were classified into independent ambulation and walking aid groups, the latter subdivided into cane and walker users. Pain, cognitive function, handgrip strength, 30-second chair stand test, Berg Balance Scale (BBS), and skeletal muscle mass index (SMI) were assessed at discharge. Logistic regression identified factors associated with walking aid use, and exploratory analysis compared cane and walker users. Receiver operating characteristic (ROC) analysis was used to determine the BBS cutoff. Results: BBS at discharge was significantly associated with walking aid use (odds ratio [OR]=0.85; 95% confidence interval [CI] 0.77–0.93; p<0.001). In exploratory analysis, pain (OR=1.43; 95% CI 1.03–1.96; p=0.029) and SMI (OR=0.40; 95% CI 0.20–0.79; p=0.010) were associated with cane versus walker use. The optimal BBS cutoff was 48.5 (area under the curve [AUC]=0.83). Conclusion BBS was associated with the distinction between independent ambulation and walking aid use, while pain and SMI were associated with differences among walking aid users. These findings may inform clinical decision-making for walking aid selection at discharge.

Background/Aims: Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI). Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed. Results: Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006). Conclusions RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.

Background/Aims: Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI). Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed. Results: Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006). Conclusions RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.

Background/Aims: Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI). Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed. Results: Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006). Conclusions RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.

Objective: To develop a nomogram-based model for predicting the time required to reestablish independent walking on level ground in stroke patients with hemiplegia admitted to a convalescent rehabilitation ward, based on available information at admission.Methods: This retrospective study included 228 patients with stroke-induced hemiplegia who were admitted to the convalescent rehabilitation ward of our hospital. The assessed outcome was the proportion of patients who achieved independent walking at 30, 60, 90, and 120 days after stroke onset. Candidate predictors at admission included age, sex, stroke type, side of paresis, number of days from onset to admission, ability to get up, lower extremity Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) score, and total motor and cognitive Functional Independence Measure (FIM) scores. Cox proportional hazards analysis was used to identify significant predictors, and a nomogram was developed.Results: The multivariate analysis identified age, number of days from onset, ability to get up, BBS score, and total FIM motor and cognitive scores as significant predictors. The nomogram demonstrated high predictive performance (C-index: 0.858; bootstrap: 0.851) with good calibration.Conclusion: This model may assist clinicians in estimating the probability of achieving independent walking on level ground at 30, 60, 90, and 120 days after stroke onset, supporting early goal setting and individualized rehabilitation planning.

Purpose: The prognosis for patients with metastatic renal cell carcinoma (RCC) has markedly improved with the advent of molecular targeted agents and immune checkpoint inhibitors. However, few studies have reported the outcomes of systemic therapy in metastatic RCC patients undergoing dialysis. This study aimed to evaluate the clinical outcomes of systemic therapy for metastatic RCC patients on dialysis. Materials and Methods: We retrospectively reviewed 253 patients with metastatic RCC (17 on dialysis and 236 not on dialysis) who received systemic therapy at Keio University Hospital in Japan. Progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) were assessed using the Kaplan-Meier method. Results: Clear cell RCC was diagnosed pathologically in 52.9% of dialysis patients and 82.6% of nondialysis patients (p=0.007). Among dialysis patients, 58.8% were classified as intermediate risk and 41.2% as poor risk. Regarding first-line therapy, 4 dialysis patients received cytokine therapy, 11 received tyrosine kinase inhibitors, 1 received mammalian target of rapamycin inhibitors, and 1 received immune checkpoint inhibitors. The median PFS (6.9 months, p<0.001), OS (21.2 months, p=0.001), and CSS (29.1 months, p=0.003) were all significantly shorter in dialysis patients. After propensity score matching, no significant difference was observed in PFS. However, significant differences persisted in OS and CSS between the dialysis and nondialysis groups. Conclusion Both OS and CSS were significantly shorter in dialysis patients with metastatic RCC compared to those not on dialysis.

Purpose: This study was performed to evaluate the prognostic value of preoperative C-reactive protein to albumin ratio (CAR) in older patients with colorectal cancer (CRC) undergoing curative resection. Methods: We retrospectively analyzed 244 older patients (aged 75 years or higher) with pathological stage II or III CRC who underwent curative surgery between 2008 and 2016. The optimal value of CAR was calculated and its correlation with the clinicopathological factors and prognosis was examined. Results: The optimal cutoff value of the CAR was 0.085. High preoperative CAR was significantly associated with high carcinoembryonic antigen levels (P=0.001), larger tumor size (P<0.001), and pT factor (P=0.001). On multivariate analysis, high CAR was independent prognostic factor for relapse-free survival (P=0.042) and overall survival (P=0.001). Conclusion Preoperative elevated CAR could be considered as an adverse predictor of both relapse-free survival and overall survival in older patients with CRC undergoing curative surgery.