Background/Aims: Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures. Methods: We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022. Results: Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient. Conclusions The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.

BACKGROUND/AIMS: Changes in lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antiviral therapy have been reported in recent years. However, the clinical aspects of disturbed lipid metabolism in chronic HCV infection have not been fully elucidated. METHODS: Dynamic changes in serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and apolipoprotein levels in patients infected with HCV genotype 1b were examined during combination therapy with daclatasvir (DCV) and asunaprevir (ASV). RESULTS: Total, LDL−, and HDL-cholesterol levels increased rapidly and persistently after week 4. Apolipoprotein (apo) A-I, apo B, apo C-II, and apo C-III levels were significantly higher at week 4 than at week 0. In contrast, apo A-II and apo E levels were significantly lower. The differences in LDL− and HDL-cholesterol levels were positively correlated with those of apo B and apo A-I, respectively. Interestingly, in patients with non-sustained virological response, these cholesterol levels decreased rapidly after viral breakthrough or viral relapse. Furthermore, similar changes were observed for apo A-I, apo B and apo C-III levels. CONCLUSIONS: Clearance of HCV using combination therapy with DCV and ASV results in rapid changes in serum lipid profiles, suggesting an influence of HCV infection on disturbed lipid metabolism.
Apolipoprotein A-I ; Apolipoprotein A-II ; Apolipoprotein C-II ; Apolipoprotein C-III ; Apolipoproteins ; Apolipoproteins B ; Apolipoproteins E ; Cholesterol ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Lipid Metabolism ; Lipoproteins ; Recurrence

Objectives: The aim of this study is to examine the effects of lactic fermenting beverage ANP71 on defecation, blood pressure, immune function, constitution of Traditional Chinese Medicine (TCM) and safety.Methods: An open Clinical study was conducted on 15 healthy adults (female 11, male 4). ANP71 150ml per day was administrated for 4 weeks. At week 0, 1 and 4, blood samples were collected. blood pressure, immune function and constitutionwere measured.Results:① Defecation amount and exhilarating feeling increased. Abdominal feeling of fullness decreased.② Decrease of blood pressure was observed. ③ The change of parameters of blood biochemistry was in normal range. ④ Humoral immunity was predominant(Th1/Th2 decreased). ⑤ In constitution of TCM, Gentleness type, Yang-deficiency type, Yin-deficiency type, Phlegm-wetness type, wet-heat type and Qi-depression type were improved. ⑥ No significant adverse events were observed.Conclusion: Lactic fermenting beverage ANP71 appears to have benefits in improving defecation and constitutional problems. Various other biological effects of ANP71 were also observed.

Extract of Lentinula edodes mycelia (LEM) reportedly maintains and improves the quality of life (QOL) of patients with cancer who undergo chemotherapy. We investigated the influence of LEM extract on the QOL of 73 Japanese patients with different backgrounds and stages of cancer who were undergoing various types of therapy at 16 institutions. All patients were orally administered with LEM (1200 mg/day) for four weeks. We compared changes in their QOL before and after taking LEM using the EORTC-QLQ-C30. The QOL scores for emotional function and fatigue were significantly improved after LEM intake. Global QOL and physical function scores improved only in patients with cancer at stages III and IV. These findings suggest that oral LEM intake improves the QOL of patients with advanced cancer.

【Objective】

To investigate the role of the back and foot muscles during lateral weight-shifting in the standing position by examining the corresponding muscle activity patterns associated with a postural change.

【Methods】

The subjects were 24 healthy men (age 24.3 ± 2.6 [mean ± SD] years). The following parameters were recorded : center of pressure (COP) ; surface electromyograms of the multifidus, iliocostalis, longissimus (bilateral), peroneus, and foot supinator (on the moving side) muscles ; and video imaging during lateral weight-shifting after 2 seconds in the standing position.

【Results】

Horizontal movement of the pelvis resulted in elevation of the non-moving side from the middle of the COP, with moving side displacement. In the lower limbs, lateral weight shifting resulted in an outward tilt due to foot pronation. Activity of the multifidus, iliocostalis, and longissimus muscles on the non-moving side, and the peroneus and foot supinator muscles on the moving side, tended to increase with displacement of the COP on the moving side.

【Conclusion】

The multifidus, iliocostalis, and longissimus muscles were involved in lateral flexion of the thoracolumbar area and elevation of the pelvis on the non-moving side. Simultaneously, the foot supinator and peroneus muscles were involved in pronation of the grounded foot.

Treating a thoracic aortic aneurysm (TAA) after coronary artery bypass graft (CABG) surgery requires an appropriate surgical procedure to preserve the functional graft. We present a case of hybrid procedure of thoracic endovascular aortic repair combined with a redo off-pump CABG via median sternotomy. The patient was a 76-year-old man with a history of CABG and abdominal aortic replacement in a different country. Chest computed tomography revealed a saccular-shaped aortic aneurysm in the distal aortic arch with diameter of 5.6 cm. Coronary angiography revealed theLIMA graft was patent but anastomosed to the diagonal branch and the left anterior descending artery (LAD) was totally occluded and was opacified through the right coronary artery. Significant ischemic change in the anteroseptal wall suggested a requirement of surgical revascularization of LAD. The chest was opened via re-midsternotomy. Then the 3 arch vessels were reconstructed with a trifurcated artificial graft attached to the ascending aorta and coronary artery bypass grafting was performed on the beating heart. Finally, the aneurysm was excluded by introducing a stent graft through the graft to zone 0. The patient's postoperative course was uneventful and he was discharged on postoperative day 16. A hybrid procedure via median sternotomy was useful in the surgery for TAA with the functional LIMA after CABG.

Japanese version of the Constitution in Chinese Medicine Questionnaire (CCMQ-J) in Chinese consists of 60 items for 9 sub-scales called Gentleness, Qi-deficiency, Yang-deficiency, Yin-deficiency, Phlegm-wetness, Wet-heat, Blood-stasis, Qi-depression, and Special diathesis. Each question is answered by choosing one form 5 grades of a Likert scale where the grades from 1 to 5 corresponding to Never, Rarely, Sometimes, Often and Always, respectively. In the present study, we examined the relationship of scores based on 597 respondents to 60 items. We tentatively classified 60 items into 12 groups by utilizing the Ward’s hierarchical clustering method and discussed similarity of items and 9 body conditions. Body Mass Index (BMI) and age can be explained by the score of 60 items by partial least square model. Significantly high correlation coefficients between real and estimated values were obtained for BMI (0.81 for male and 0.82 for female) and age (0.82 for male and 0.83 for female). Those results indicate that the answers to the 60 items can reflect aging and BMI properties and CCMQ-J can be used to assess the situation of health for evaluating the actual aging conditions in human.

Although introduced to Japan as a health food, Huaier granule emerged with abundant evidence, both from fundamental and clinical researches, and is being prescribed clinically in China, since it was originally developed as a new pharmaceutical. Huaier granule has a wide range of application and this review narrow down to the effects of it to hepatocellular carcinoma, the most reported one.

Objectives: To study the effect of astaxanthin contained drink to skin conditionMethod: The study was conducted to the Japanese females between age over thirty to less than fifty , who had weakening of skin (including aging, sag and dry skin) and skin dullness. In order to conduct the objective evaluation, the comparison between the groups by the double-blind test was taken. Twenty of subjects were randomly allocated to the intake group of astaxanthin contained drink (astaxanthin 3mg contained) and the placebo group. After eight weeks intake of the drink, each group was evaluated with skin water contents, transepidermal water loss, skin elasticity, VISIA and skin texture etc.Result: In between the groups, the intake group of astaxanthin contained drink was greatly excellent in the categories of skin moisture, transepidermal water loss, skin elasticity , erythema dose and skin texture.Conclusion:Astaxanthin has protecting effect of skin barrier and is considered to increase the water retention capability to reduce skin dryness. Astaxanthin is also effective to erythema dose, skin elasticity and skin texture.　As no adverse events resulting from the test drink was seen, such food containing astaxanthin is considered as a safe and useful health functional food material to skin.