Purpose: Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis. Materials and Methods: This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED. Results: The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022). Conclusions Aortic calcification burden was independently associated with severe ED.

Purpose: To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis. Materials and Methods: This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated. Results: The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively). Conclusions ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.

Purpose: Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in stages II, III, and liver metastasis after curative resection using propensity-matched analysis. Methods: Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed. Results: There were 110 patients with stage II, 100 patients with stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with stage II and 32 pairs with stage III were identified. In the patients with stage II, overall survival (OS) and recurrence-free survival (RFS) were not significantly different for right- and left-sided colon cancers. In the patients with stage III, OS and RFS were significantly worse in right-sided colon cancer. In those with liver metastasis, OS of right-sided colon cancer was significantly worse than left-sided disease, while RFS was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer. Conclusion Sidedness of colon cancer had a significant and varied prognostic impact in patients with stage II, III, and liver metastasis after curative resection.

The incidence of cerebral infarction due to Takayasu's arteritis is relatively low, and there are few reports on rehabilitation for this condition. We report the case of a patient with Takayasu's arteritis, repeated expansion of cerebral infarction, and subclavian steal syndrome who required careful observation at the start of ambulation. A 17-year-old male was diagnosed with Takayasu's arteritis complicated by subclavian steal syndrome eleven months ago. He was admitted for the treatment of cerebral infarction in the right side of the middle cerebral artery. One day after admission, the area of the infarction expanded. Next day, after he started ambulation (16 days after admission), the area of the infarction further expanded despite ongoing medical treatments, including corticosteroid and immunosuppressant administration. Cerebral blood flow scintigraphy showed stenosis of right middle cerebral, right internal carotid, right common carotid, brachiocephalic, left subclavian, and left vertebral arteries.These arterial stenosis progressed in the two weeks following admission. Thereafter, he complained of dimmed vision more frequently when he raised his body to an upright position. The rehabilitation schedule had to be carefully adjusted according to his symptoms. Two and a half months later, angiographic examination showed development of adequate collateral circulation from the bilateral intercostal arteries to both vertebral arteries. After we confirmed the collateral circulation, we allowed him to use a wheelchair. The confirmation of collateral circulation by image analysis is important in order to decide the time to start ambulation in patients with Takayasu's arteritis (early phase) along with repeated cerebral ischemia.

BACKGROUND: Previous studies have reported that exposure to paraben (Pb) and triclosan (TCS) is associated with allergies. However, Pb and TCS exposure in the Japanese population is not fully understood. OBJECTIVES: The present study was aimed to examine such exposure among Japanese individuals with allergic diseases. METHODS: This cross-sectional study included the International Study of Asthma and Allergies in Childhood questionnaire survey to evaluate allergic outcomes and the collection of urine samples to examine Pb and TCS exposure. RESULTS: Pb containing daily commodities was used in 84.8% children. Pb use was positively associated with current atopic dermatitis (adjusted odds ratio, 4.61; 95% confidence interval, 1.23–17.3). Urinary Pb concentrations were increased significantly in those with current atopic dermatitis (AD) (median, 4.58 vs. 0; p < 0.0001), and showed an increased tendency in those with current wheeze (median, 3.45 vs. 1.81; p = 0.0535) in participants ≤15 years old. Urinary TCS concentration was under the limit of detection in all children. CONCLUSION: Urinary levels of Pb were associated with current AD in children. We should pay more attention about Pb and TCS.
Asian Continental Ancestry Group ; Asthma ; Child ; Cross-Sectional Studies ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Limit of Detection ; Odds Ratio ; Respiratory Sounds ; Triclosan

The incidence of cerebral infarction due to Takayasu's arteritis is relatively low, and there are few reports on rehabilitation for this condition. We report the case of a patient with Takayasu's arteritis, repeated expansion of cerebral infarction, and subclavian steal syndrome who required careful observation at the start of ambulation. A 17-year-old male was diagnosed with Takayasu's arteritis complicated by subclavian steal syndrome eleven months ago. He was admitted for the treatment of cerebral infarction in the right side of the middle cerebral artery. One day after admission, the area of the infarction expanded. Next day, after he started ambulation (16 days after admission), the area of the infarction further expanded despite ongoing medical treatments, including corticosteroid and immunosuppressant administration. Cerebral blood flow scintigraphy showed stenosis of right middle cerebral, right internal carotid, right common carotid, brachiocephalic, left subclavian, and left vertebral arteries.These arterial stenosis progressed in the two weeks following admission. Thereafter, he complained of dimmed vision more frequently when he raised his body to an upright position. The rehabilitation schedule had to be carefully adjusted according to his symptoms. Two and a half months later, angiographic examination showed development of adequate collateral circulation from the bilateral intercostal arteries to both vertebral arteries. After we confirmed the collateral circulation, we allowed him to use a wheelchair. The confirmation of collateral circulation by image analysis is important in order to decide the time to start ambulation in patients with Takayasu's arteritis (early phase) along with repeated cerebral ischemia.

Several prospective studies on laparoscopy-assisted distal gastrectomy for early gastric cancer have been initiated, but no prospective study evaluating laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy has been completed to date. A non-randomized confirmatory trial was commenced in April 2015 to evaluate the safety of laparoscopy-assisted total gastrectomy and laparoscopy-assisted proximal gastrectomy for clinical stage I gastric cancer. A total of 245 patients will be accrued from 42 Japanese institutions over 3 years. The primary endpoint is the proportion of patients with anastomotic leakage. The secondary endpoints are overall survival, relapse-free survival, proportion of patients with completed laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy, proportion of patients with conversion to open surgery, adverse events, and short-term clinical outcomes. The UMIN Clinical Trials Registry number is UMIN000017155.
Anastomotic Leak ; Asian Continental Ancestry Group ; Conversion to Open Surgery ; Gastrectomy* ; Humans ; Japan* ; Laparoscopy ; Medical Oncology* ; Non-Randomized Controlled Trials as Topic ; Prospective Studies ; Stomach Neoplasms*

Although there are a number of reported cases of increased cerebral blood flow during exercise, there are no reports on the relation between changes of blood flow during exercise and attentional function. The purpose of this study is to clarify the relation between changes of blood flow during exercise with AT intensity and attentional function, using near-infrared spectral analysis. The subjects were 10 healthy males. The research protocol was to conduct steady load exercise. We randomly conducted two invention trials: 1) an exercise/task trial in which a trail making test (TMT) was performed as an attentional assignment during steady load exercise, and 2) a rest/task trial in which TMT was performed during rest as a control. As a result, we observed the following: increase of oxy-Hb in the prefrontal cortex during AT exercise, the significant shortening of TMT during exercise from 69.1±10.2 seconds to63.2±7.2seconds, and, with further control, that the more oxy-Hb rises, the more TMT time is shortened. From these results, it is suggested that 10 minutes of exercise would improve attentional function, and furthermore, there is a possibility that increased cerebral blood flow may be involved with the improvement of attentional function.

The aim of the present study was to examine whether amount of oral cortisol, immunoglobulin A (IgA), chromogranin A (CgA) and inflammatory cytokines, might be affected by prolonged strenuous exercise. Ten young male volunteers either exercised on recumbent ergometer at 75 % VO₂ max for 60 min (exercise session) or sat quietly (resting session). Saliva samples were obtained at 60 min intervals during sessions for measurements of salivary stress markers (cortisol, IgA and CgA), salivary inflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and osmolality. Saliva flow rate was decreased and saliva osmolality was increased during the 60-min exercise. Saliva cortisol and CgA concentrations and secretion rates were increased during and after the exercise, whereas saliva IgA concentration and secretion rates were decreased after the exercise. Salivary inflammatory cytokines was increased during and after the exercise. The present findings suggested a single bout of prolonged strenuous exercise caused a transient increase in the salivary cortisol, CgA and inflammatory cytokines levels, whereas salivary IgA concentration and secretion rates were decreased after the exercise. Further studies, however, are needed to delineate whether or not salivary stress markers and inflammatory cytokines may be used as biological markers to determine the host responses to acute prolonged strenuous exercise.

The purpose of this study was to examine the effects of aquatic exercise training on the trunk muscles function and activities of daily living in abdominal obese women. Nineteen abdominal obese (abdominal circumference: 90 cm or more) and fifteen age-matched non-obese women were recruited as participants in this study. The aquatic exercise training (60 min/day, three days/week for 8 weeks) based on abdominal twists for activating the trunk muscle function. Physical parameters, biochemical characteristics, arteriosclerotic parameters and activities of daily living scores were assessed before and after the training period. In both groups showed abdominal circumference, percent of body fat, blood pressure and lower extremity muscle strength increased significantly after aquatic exercising training. In particular, endurance capacity of abdominal and back muscles increased significantly and activities of daily living scores were significantly improved in the obese group. Moreover, the improvement in the strength of lower extremities and improvement in the activities of daily living scores, such as climbing and descending stairs, in the obese group tended to be higher than non-obese women. Additionally, in abdominal obese group, the amount of the reduction of abdominal circumference was significantly associated with that of the increase in the strength of lower extremities. Taken together, these findings suggest the possibilities that the present aquatic exercise training based on trunk muscle exercise improving the function of trunk and lower extremity muscles with reduction in the abdominal obesity, contributing to improve activities of daily living in abdominal obese women.