Background/Aims: To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 10-mm-diameter FCSEMS. Methods: This single-center retrospective cohort study included patients who underwent initial transpapillary metal stenting for UR-MDBO. Propensity score matching (1:1) analysis was performed. Results: Of 133/68 patients who underwent 6-mm/10-mm-diameter FCSEMS deployment, 59 in each group were selected. The median time to recurrent biliary obstruction was not significantly different between the groups (p=0.46). In contrast, use of the 6-mm-diameter FCSEMS resulted in a significantly reduced incidence of stent-related adverse events (AEs) (p=0.016), especially cholecystitis (p=0.032), and patients aged <70 years were particularly affected by this significant reduction. Among the patients in the end-stage cohort who were unable to continue chemotherapy after FCSEMS deployment, the free rate of stent-related events, including recurrent biliary obstruction and stent-related AEs, was significantly higher in the 6-mm group (p=0.027). Conclusions For UR-MDBO, a 6-mm-diameter FCSEMS can be an optimal and safe option in the younger cohort with a relatively high risk of AEs and in the end-stage cohort requiring safer drainage without interference from stent-related events during times of poor prognosis.

Background/Aims: To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 10-mm-diameter FCSEMS. Methods: This single-center retrospective cohort study included patients who underwent initial transpapillary metal stenting for UR-MDBO. Propensity score matching (1:1) analysis was performed. Results: Of 133/68 patients who underwent 6-mm/10-mm-diameter FCSEMS deployment, 59 in each group were selected. The median time to recurrent biliary obstruction was not significantly different between the groups (p=0.46). In contrast, use of the 6-mm-diameter FCSEMS resulted in a significantly reduced incidence of stent-related adverse events (AEs) (p=0.016), especially cholecystitis (p=0.032), and patients aged <70 years were particularly affected by this significant reduction. Among the patients in the end-stage cohort who were unable to continue chemotherapy after FCSEMS deployment, the free rate of stent-related events, including recurrent biliary obstruction and stent-related AEs, was significantly higher in the 6-mm group (p=0.027). Conclusions For UR-MDBO, a 6-mm-diameter FCSEMS can be an optimal and safe option in the younger cohort with a relatively high risk of AEs and in the end-stage cohort requiring safer drainage without interference from stent-related events during times of poor prognosis.

Background/Aims: To date, only thinner-diameter metal stents have been evaluated for unresectable malignant distal biliary obstruction (UR-MDBO). This study investigated the outcomes and optimal cohorts for a 6-mm-diameter fully covered self-expandable metal stent (FCSEMS) compared with those for a 10-mm-diameter FCSEMS. Methods: This single-center retrospective cohort study included patients who underwent initial transpapillary metal stenting for UR-MDBO. Propensity score matching (1:1) analysis was performed. Results: Of 133/68 patients who underwent 6-mm/10-mm-diameter FCSEMS deployment, 59 in each group were selected. The median time to recurrent biliary obstruction was not significantly different between the groups (p=0.46). In contrast, use of the 6-mm-diameter FCSEMS resulted in a significantly reduced incidence of stent-related adverse events (AEs) (p=0.016), especially cholecystitis (p=0.032), and patients aged <70 years were particularly affected by this significant reduction. Among the patients in the end-stage cohort who were unable to continue chemotherapy after FCSEMS deployment, the free rate of stent-related events, including recurrent biliary obstruction and stent-related AEs, was significantly higher in the 6-mm group (p=0.027). Conclusions For UR-MDBO, a 6-mm-diameter FCSEMS can be an optimal and safe option in the younger cohort with a relatively high risk of AEs and in the end-stage cohort requiring safer drainage without interference from stent-related events during times of poor prognosis.

No abstract available.
Abscess* ; Mycoplasma hominis* ; Mycoplasma*

Background : The effects of rehabilitation on hemodialysis patients are unknown. We assessed the effects and investigated the association between rehabilitation treatment effects and all-cause mortality. Methods : This prospective cohort study included 120 patients on maintenance hemodialysis. ADL was assessed using the Functional Independence Measure (FIM) score (total points, 126), which comprises 13 motor items (total points, 91) and five cognitive items (total points, 35). A survival curve was constructed using the Kaplan-Meier analysis and stratified into an increase or no-increase of the FIM score. Multivariable logistic regression analysis was used to determine factors associated with the effects of rehabilitation. Discriminative sensitivity of FIM cognitive items for an increase in total FIM was estimated using the area under the receiver operating characteristic (AuROC) curve. Results : The average total FIM score increased from 64.2±3.6 to 75.8±3.0, and the increase in FIM motor and cognitive items was 11.0±1.3 and 0.5±0.6, respectively. The cumulative survival rate within 2.5 years was significantly higher in the FIM increase group than that in the FIM no-increase group. FIM cognitive items and anemia were significantly associated with rehabilitation effects, and AuROC showed that a cutoff of 34 points in cognitive FIM had moderate discriminative sensitivity for a total FIM increase (AuC, 0.719 ; p<0.0008). Conclusions : Rehabilitating hemodialysis patients improved their FIM score (particularly the motor items), and a higher FIM score resulted in a better prognosis. The effectiveness of rehabilitation depends on maintaining a perfect FIM cognitive score.

The present study was performed to investigate the effects of 120 km walking, 40 km a day for 3 successive days on the condition that taking rest and foods freely, upon physical functions for healthy male and female subjects. All measurements were enforced at postabsorptive state early in the morning for the 10 successive days including the days of walking. Blood pressure, heart rate, and body weight were measured every morning. Blood samplings enforced, too. Urine collections were enforced from first day to 7 th day. The results obtained were as follows;
1) There were no changes in heart rate, blood pressure, and body weight, which were measured early in the morning, before and after 120 km walking.
2) Serum GOT and GPT activities had little changes, while serum LDH, α-HBDH, and CK activities increased gradually after walking.
3) Serum CK-MB activities, which indicate myocardial injury, increased after walking, on the contrary CK-MB/CK ratio decreased. It was suggested that effects of 120km walking to myocardium were rather than slight ones.
4) In spite of the same sorce in which serum CK-MB and LDH-1 were resulted, both did'nt exhibit same patterns in serum.
5) Serum lipids decreased gradually after walking.
6) Urinary excretion of creatinine and uric acid increased after 120km walking especially.
7) If it is allowed to take sufficient foods and rest, 120km walking, 40km a day for 3 successive days, would not result in such a physical stress over the following days.

Effects of taurine on the functions of the body and metabolism with 3km running upon taking a diet, which is constituted of lowest possible amount of carbohydrate and highest possible amount of fat and protein, were investigated in 25 male and female subjects of age thirties by double blind test method. The results were as follows
1) Taurine administration (T. A.) proved to inhibit the degree of increase in heart rate and increase the maximal degree of pulse pressure in response to 3 km running.
2) T. A. proved to inhibit the degree of increase in serum creatine kinase isozyme MB (CK-MB) activities and CK-MB/CK ratio.
3) T. A. proved to inhibit the decrease of serum total protein values immediately before running and in the following morning. Similar trends in terms of the particuler times were observed, too, in the case of the degree of decrease of serum triglycerides values.
4) T. A. seemed to accelerate the utilization of saturated fatty acids especially.
5) Three kilometer running seemed to increase in serum taurine concentrations from several hours after running to the morning immediately after running.

Effects of 5 km running upon taking a low-carbohydrate, high-fat and protein diet on the body, in fourteen healthy young males and three healthy young females, all being affected by taurine inducement, were investigated by double blind test method. The results obtained were as follows ;
1) As to the degree of in heart rate upon 5 km running, in males, there were no differences between taurine administration group (M-group) and placebo administration group (P-group) . But in females, recordings in P-group were much larger than those of M-group.
2) As to the degree of increase in systolic blood pressure upon 5 km running, in males, no differences between both groups were observed, but in females, recordings in P-group were larger than those of M-group.
3) Both serum creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) activities did not recover to pre-exercise levels during 3 days after 5 km running in both groups of both sexes.
4) In the rate of CK-MB against CK, not only P-group of females had extraordinary high levels immediately after 5 km running, but also P-group of both sexes had higher levels on 3rd and 5th day after 5 km runnning than M-group.
5) In both sexes P-group was larger than M-group in the degree of increase in blood lactate and serum triglyceride levels.
6) As to the changes in serum total protein levels, in males, no differences between both groups were observed, but in females, P-group had extraordinary low levels on 1st day after 5 km running and maintained low levels during 5 days recovery.
7) As to the changes in both serum total fatty acids levels and the rate of unsaturated fatty acids against total fatty acids, no differences were observed between both groups of both sexes.
8) As to the degree of increase in plasma noradrenalin and adrenalin levels, in males, no differences between both groups were observed, but in females, recordings in M-group were larger than those of P-group.

Effects of sit-up exercise in the healthy adults to the point of exhaustion on the respiratory-circulatory functions and oxygen consumption were studied in thirtyone males and thirtysix females whose age varied between twenty and thirtyf our years old. The subjects were classified into two groups, the superior and the inferior, according to the number of sit-ups to reach the exhaustion point. Collected vallues were compared between the pre-exercise and the post-exercise records. The results were as follows ;
1) No sex differences in the inferior group were found in the degree of increase in systolic pressure, heart rate and respiratory rate.
2) In the superior group, no sex difference was found in the degree of increase in respiration rate, but male subjects were greater than female subjects in the degree of increase in both systolic pressure and heart rate.
3) In males, when the superior subjects were compared with the inferior subjects, the former were greater than the latter in the degree of increase in both systolic pressure and heart rate, but in females no differences were found.
4) In males the more the degree of increase in blood pressure, the more the degree of increase in heart rate. In contrast with males, in females there were no relation between them were observed.
5) It was recognized that relative metabolic rate varied in values from 4.7-13.5 and there was a tendency among the inferior subjects to have a large relative metabolic rate.