Background/Aims: Patients with acute cholecystitis (AC) after metallic stent (MS) placement for malignant biliary obstruction (MBO) have a high surgical risk. We performed percutaneous transhepatic gallbladder aspiration (PTGBA) as the first treatment for AC. We aimed to identify the risk factors for AC after MS placement and the poor response factors of PTGBA. Methods: We enrolled 401 patients who underwent MS placement for MBO between April 2011 and March 2020. The incidence of AC was 10.7%. Of these 43 patients, 37 underwent PTGBA as the first treatment. The patients’ responses to PTGBA were divided into good and poor response groups. Results: There were 20 patients in good response group and 17 patients in poor response group. Risk factors for cholecystitis after MS placement included cystic duct obstruction (p<0.001) and covered MS (p<0.001). Cystic duct obstruction (p=0.003) and uncovered MS (p=0.011) demonstrated significantly poor responses to PTGBA. Cystic duct obstruction is a risk factor for cholecystitis and poor response factor for PTGBA, whereas covered MS is a risk factor for cholecystitis and an uncovered MS is a poor response factor of PTGBA for cholecystitis. Conclusions The onset and poor response factors of AC after MS placement were different between covered and uncovered MS. PTGBA can be a viable option for AC after MS placement, especially in patients with covered MS.

BACKGROUND: Although fat accumulation in human organs is associated with a variety of diseases, there is little evidence about the effect of a fatty pancreas on the development of subclinical chronic pancreatitis over the clinical course. METHODS: We conducted a prospective cohort study from 2008 to 2014 of patients who underwent a medical checkup consultation for fat accumulated in the pancreas. Patients included in the analysis were divided into a non-fatty pancreas group (n = 9710) and fatty pancreas group (n = 223). The primary end point was the odds ratio (OR) for chronic pancreatitis associated with fatty pancreas, which was diagnosed using ultrasonography. We used a multiple logistic regression model to estimate the OR and the corresponding 95% confidence interval (CI). RESULTS: Ninety-two people were diagnosed with chronic pancreatitis, including both presumptive and definitive diagnoses. Twelve people were diagnosed with chronic pancreatitis by ultrasonography among the 223 patients with fatty pancreas, and 80 patients among 9710 were diagnosed with non-fatty pancreas. The crude OR was 6.85 (95% CI 3.68, 12.75), and the multiple adjusted OR was 3.96 (95% CI 2.04, 7.66). CONCLUSIONS Fat accumulation in the pancreas could be a risk factor for developing subclinical chronic pancreatitis.
Adipose Tissue ; diagnostic imaging ; pathology ; Adult ; Alcohol Drinking ; epidemiology ; Female ; Humans ; Japan ; epidemiology ; Life Style ; Logistic Models ; Male ; Middle Aged ; Pancreas ; diagnostic imaging ; pathology ; Pancreatitis, Chronic ; diagnosis ; epidemiology ; etiology ; Physical Examination ; Prospective Studies ; Risk Factors ; Smoking ; epidemiology

Radionuclide therapy (RNT) stands on the delivery of radiation to tumors or non-tumor target organs using radiopharmaceuticals that are designed to have specific affinity to targets. RNT is recently called molecular radiotherapy (MRT) by some advocators in order to emphasize its characteristics as radiotherapy and the relevance of dosimetry-guided optimization of treatment. Moreover, RNT requires relevant radiation protection standards because it employs unsealed radionuclides and gives therapeutic radiation doses in humans. On the basis of these radiation protection standards, the development and use of radiopharmaceuticals for combined application through diagnostics and therapeutics lead to theranostic approaches that will enhance the efficacy and safety of treatment by implementing dosimetry-based individualization.
Humans ; Radiation Protection ; Radioisotopes ; Radiopharmaceuticals ; Radiotherapy ; Theranostic Nanomedicine

Radionuclide therapy (RNT) stands on the delivery of radiation to tumors or non-tumor target organs using radiopharmaceuticals that are designed to have specific affinity to targets. RNT is recently called molecular radiotherapy (MRT) by some advocators in order to emphasize its characteristics as radiotherapy and the relevance of dosimetry-guided optimization of treatment. Moreover, RNT requires relevant radiation protection standards because it employs unsealed radionuclides and gives therapeutic radiation doses in humans. On the basis of these radiation protection standards, the development and use of radiopharmaceuticals for combined application through diagnostics and therapeutics lead to theranostic approaches that will enhance the efficacy and safety of treatment by implementing dosimetry-based individualization.

The purpose of present study was to investigate the cerebral oxygenation and oxygen uptake (VO₂) during exercise of a combined circuit training (CCT) and a circuit resistance training (CRT). Nine healthy young male subjects performed the following two trails on separate days: 1) CCT trail (three circuits of aerobic exercise for 5 min at 50%VO₂max and 1 set of four resistance exercises at 50% one-repetition maximum) and 2) CRT trail (six circuits of the same resistance exercises and intensity as for CCT without aerobic exercise). Exercise duration of these trails was 30 minutes. Cerebral oxygenation was determined by near infrared spectroscopy, and VO₂ was measured by breath by breath methods. Cerebral oxygenation and VO₂ were continuously monitored during the exercise. Oxyhemoglobin and total hemoglobin concentration during CCT trail was significantly higher than during CRT trail (p<0.05). Average VO₂ and energy expenditure during CCT trail were significantly higher than during CRT trail (p<0.05). These results suggest that a single bout of circuit resistance training combined with aerobic exercise induced greater energy expenditure and cerebral oxygenation than those induced by a resistance training with the same exercise duration.

The purpose of this study was to investigate the acute effects on excess post-exercise oxygen consumption (EPOC) of low intensity and slow-movement repetitive resistance exercise in moderately trained young men. Seven healthy trained young men (age=22±3 yr ; height=172.5±4.0 cm ; weight=69.5±8.3 kg ; VO₂max=47.3±6.0 ml/kg/min) performed the following three exercise patterns on separate days : 1) high-intensity (80% one-repetition maximum : 1RM) and regular-movement repetitive exercise (1 second each of concentric and eccentric action, termed high and regular exercise (HRE) ; 2) low-intensity (50%1RM), regular-movement repetitive exercise (same movement speed as for HRE but termed low and regular exercise (LRE); and 3) low-intensity (50%1RM), slow-movement repetitive exercise (4 sec each of concentric and eccentric action, termed low and slow exercise (LSE). These three exercise patterns consisted of three sets of four exercises performed to maximum repetition. All subjects completed the three exercise sessions in a randomized and counterbalanced fashion. Oxygen consumption (VO₂) and heart rate (HR) were continuously monitored during the exercise sessions and for 90 min afterwards. EPOC over 90 min was thus observed after completing the three exercise patterns. However, there were no significant differences in EPOC among the three exercise patterns. The results of this study suggest that low-intensity and slow-movement repetitive resistance exercise with maintaining muscular tension (LSE) is likely to increase EPOC to the same extent as HRE and LRE exercise patterns.

A 54-year-old woman complained of prolonged fever. Echocardiography showed severe mitral regurgitation with vegetation, and computed tomography showed right coronary artery (RCA) fistula to the coronary sinus (CS). Blood culture revealed Strep. viridans, thus a diagnosis of active infective endocarditis was established. The patient underwent urgent surgery. Surgical findings showed that vegetation was located in A3 to P3 of the mitral valve. The patient underwent mitral valve repair using a glutalualdehyde-treated autologous pericardial patch and artificial chordea. Epicardial ligation for fistula was performed. Her postoperative course was uneventful.

15 healthy elderly adults (68.6±4.5 years old) participated in this study and were chosen at random for either super low-velocity repetition training (SLT : n=7) or general low-velocity repetition training (GLT : n=8). All subjects performed machine training leg work twice a week for 6 months. Training contents of SLT and GLT were programmed as follows : SLT (Method : 4 seconds of lifting and 6 sec of lowering) and GLT (Method : 2 sec of lifting and 2 sec of lowering). Muscular strength testing was adopted during isometric knee extension using Cybex6000, and body composition was measured by DXA method. As a result, increases in peak torque values and 5 sec average torques value were significantly different in both groups, pre- and post-training (p<0.05). However, there was no significant difference between the two groups. Fat mass significantly decreased during post-training in both groups (p<0.05); however, there was no significant difference between the groups. SLT showed that increases in maximum muscular strength and endurance were similar to GLT. Thus, low-intensity and low-velocity repetition training is suggested as an effective method for elderly adults to increase lower limb muscular strength.

The purpose of this study was to investigate the intensity of exercise load which increases urinary 8-hydroxydeoxyguanosine (8-OHdG) excretion and the effect of antioxidant supplementation on urinary 8-OHdG excretion after a single bout of exercise. The subjects included 6 healthy males with the following characteristics : age ; 24.0±1.1 years, height ; 174.0±8.5 cm, weight ; 71.5±15.4 kg, BMI ; 23.2±3.4 kg/m². The urinary concentration of 8-OHdG was measured by the two-column-switching high-performance liquid chromatography (HPLC) method. After 7 days of supplementation, the time course of the urinary 8-OHdG excretion was observed following treadmill running at 70% VO₂max.Significant increases in the urinary 8-OHdG excretion were detected at 2 h (p<0.01) and 4 h (p<0.05) after exercise.After 7 days of supplementation, a significant increase in the urinary 8-OHdG excretion was detected 1 h after exercise (p<0.05); however, it returned to the initial level 2 h after exercise. Therefore, oxidative DNA damage induced by a single bout of exercise was diminished by antioxidant supplementation.

The purpose of this study was to evaluate the fat-free mass (FFM) of the total body, the upper limbs, and the lower limbs in healthy subjects and basketball players obtained by the new 8-electrode segmental bioelectrical impedance analysis (S-BIA) and to compare the results with the FFM obtained by DXA. The participants were 30 healthy subjects (15 men and 15 women) aged 24.9±3.5 years old and 15 female basketball players aged 23.1±3.1 years old. In the healthy subjects, positive correlations (p<0.001) were observed between the FFM obtained by S-BIA and DXA of the total body (r=0.973), the upper limbs (r=0.956), and the lower limbs (r=0.954). Similarly, in the basketball players, positive correlations (p<0.001, p<0.01) were observed between the FFM obtained by S-BIA and DXA of the total body (r=0.943), the upper limbs (r=0.743), and the lower limbs (r=0.934). The results suggest that the new 8-electrode S-BIA is a valid and convenient method for analyzing body composition of the total body and the body segments in healthy subjects and athletes.