Purpose: We identified the risk factors for remnant gastric cancer (RGC) based on remnant gastric mucosal characteristics and gastritis morphology in patients undergoing distal gastrectomy. Materials and Methods: This multicenter retrospective study included 100 patients with RGC after distal gastrectomy and 550 patients without RGC treated between 2013 and 2020.Endoscopic findings, including anastomotic redness, red streaks, enlarged folds, bile reflux as anastomotic findings, as well as disappearance of the regular arrangement of collecting venules (RAC), atrophic gastritis, and intestinal metaplasia as background gastric mucosal findings, were evaluated. Disease risk score matching (1:1) was adjusted for baseline characteristics. Logistic regression analysis was used to develop a risk score model to stratify RGC risk into low, moderate, and high categories. Results: After matching, 96 patients with RGC and 96 controls were analyzed. Anastomotic redness and red streaks, as well as the disappearance of RAC and atrophic gastritis, were significantly more frequent in the RGC group than in the control group, whereas enlarged folds and bile reflux showed no significant differences. Risk scores were assigned as follows:anastomotic redness, 2; red streaks, 3; disappearance of RAC, 7; and atrophic gastritis, 3. The total score stratified patients into high (≥15), moderate (7–14), and low risk (≤6). The positive and negative predictive values were 67.7% and 83.3%, respectively. Conclusions The endoscopic findings of anastomotic redness, red streaks, RAC disappearance, and atrophic gastritis were significantly associated with RGC development.The proposed risk-scoring model could serve as a stratification tool for RGC surveillance.

Purpose: This study aimed to analyze the terminal care attitudes of healthcare members engaged in palliative care and the factors associated with these attitudes. Methods: We conducted a survey for healthcare members engaging in palliative care including oncologists and palliative care doctors using the Japanese version of the Frommelt Attitudes Toward Care of the Dying (FATCOD B-J), a scale that measures the attitude of medical stuff toward the care of dying patients. Results: A total of 223 (response rate=42.2%) responses were obtained and analyzed. Multiple regression analysis using the FATCOD B-J total score as the objective variable showed that 30s had lower partial regression coefficients than 40s (−3.8). Higher “satisfaction from work” and “interest in palliative care” were associated with greater partial regression coefficients (+5.7, +6.2). Conclusion: A sense of satisfaction and interest in palliative care may be important to cultivate terminal care attitudes among health care providers involved in palliative care.

A 70-year-old man receiving neoadjuvant chemotherapy (5FU+CDDP) for esophageal cancer was transferred to our hospital for the treatment of asymptomatic thrombus in the ascending aorta. Enhanced computed tomography revealed a low-density mass of 34×16 mm in diameter on the posterior surface of the ascending aorta. We performed thrombectomy and suture plication of the aortic intima under hypothermic circulatory arrest. Intraoperative epiaortic echo showed the mass was floating in the aorta. The patient was discharged from the hospital on the 18th postoperative day. Most patients with aortic thrombus are diagnosed under conditions of peripheral embolism. Asymptomatic thrombus in the ascending aorta is extremely rare. We herein report a case of thrombectomy for asymptomatic thrombus in the ascending aorta.

A seminar was held with “the development of research on auricular acupuncture” as the main theme. In this seminar, the recent development of auricular acupuncture in Japan and abroad, its action mechanism, and clinical effects were reviewed, and the findings were comprehensively evaluated.
Concerning basic research on the effects of auricular acupuncture on obesity, the relationship between the auricle and hypothalamo-autonomic system and individual variation associated with differences in the condition of patients receiving the treatment were reported. As for the action mechanism, leptin expressed in white adi-pose tissue (WAT) due to acupuncture stimulation of the auricle was reported to bind to leptin receptors (Ob-R) in both peripheries and the center and suppress food intake.
Concerning clinical effects of auricular acupuncture, the results reported in Japan indicating its effectiveness for the treatment of obesity were presented. However, no overall conclusion was reached, because papers published abroad were not consistent in the therapeutic procedure or evaluation parameters. Auricular acupuncture appeared to be clinically effective for analgesia and the treatment of drug addiction but ineffective as an anti-smoking treatment.

Before, and at various time intervals after a marathon race, we examined the changes in serum β -enolase concentration in 6 healthy, non-athlete volunteers and compared then with changes in serum creatine kinase (CK) and creative kinase MB isozyme (CK-MB) activities. The enzyme β-enolase (a β and ββ) exists in skeletal and heart muscle, where it catalyzes the step in the glycolytic pathway between 2-phosphoglycerate and phosphoenolpyruvate. For determination of β-enolase concentration, serum was analyzed by the sandwich enzyme immunoassay method. The β-enolase concentration was significantly increased from the pre-race value. At 6 h after the race, the β-enolase concentration became maximal in all subjects, while CK and CK-MB activities did so in one and two subjects, respectively. CK and CK-MB activities peaked at 24 h in five and four subjects, respectively. The rise and fall of β-enolase concentration was faster than those of CK and CK-MB activities. Therefore, assay of β-enolase concentration has considerable advantage for early detection of skeletal muscle damage and is highly specific and sensitive. The mean β-enolase concentration±S. D. before and immediately after, and 6, 24, 48 h and 1 week after the race was 7.7±5.96, 204±87.6, 400±292.0, 214±166.3, 41.1±30.89, and 6.5±2.20 ng/ml, respectively. There was a significant correlation between the peak β-enolase concentration and peak CK activity (r=0.981, p<0.05) and peak CK-MB activity (r=0.926, p<0.05) . However, there was no significant correlation between β-enolase concentration and Vo₂max.
These results suggest that serum β-enolase concentration may be a more effective marker of skeletal muscle damage after prolonged exercise, as well as for determination of CK activity.