Background: Poor lifestyle habits may worsen nonalcoholic fatty liver disease (NAFLD), with progression to nonalcoholic steatohepatitis (NASH) and cirrhosis. This study investigated the association between glycemic control status and hepatic histological findings to elucidate the effect of glycemic control on NAFLD. Methods: This observational study included 331 patients diagnosed with NAFLD by liver biopsy. Effects of the glycemic control status on histological findings of NAFLD were evaluated by comparing the following four glycemic status groups defined by the glycosylated hemoglobin (HbA1c) level at the time of NAFLD diagnosis: ≤5.4%, 5.5%–6.4%, 6.5%–7.4%, and ≥7.5%. Results: Compared with the lowest HbA1c group (≤5.4%), the higher HbA1c groups (5.5%–6.4%, 6.5%–7.4%, and ≥7.5%) were associated with advanced liver fibrosis and high NAFLD activity score (NAS). On multivariate analysis, an HbA1c level of 6.5%– 7.4% group was significantly associated with advanced fibrosis compared with the lowest HbA1c group after adjusting for age, sex, hemoglobin, alanine aminotransferase, and creatinine levels. When further controlling for body mass index and uric acid, total cholesterol, and triglyceride levels, the higher HbA1c groups were significantly associated with advanced fibrosis compared with the lowest HbA1c group. On the other hand, compared with the lowest HbA1c group, the higher HbA1c groups were also associated with a high NAS in both multivariate analyses. Conclusion Glycemic control is associated with NAFLD exacerbation, with even a mild deterioration in glycemic control, especially a HbA1c level of 6.5%–7.4%, contributing to NAFLD progression.

Background/Aims: Although certain allergic diseases have been reported to be associated with the prevalence of functional dyspepsia (FD) and irritable bowel syndrome (IBS), it is unclear whether the presence of multiple allergic diseases further increases the prevalence of FD and IBS.The aim of this study is to determine this issue in young people. Methods: A cohort of 8923 Japanese university students was enrolled and diagnoses of FD and IBS were confirmed using Rome III criteria.Allergic disorders diagnosed at medical institutions were obtained by means of a self-administered questionnaire. Results: The prevalence of FD, IBS, and their overlap was found to be 1.9%, 6.5%, and 1.1%, respectively. Pollen allergy was independently positively correlated with FD, IBS, and overlap of FD and IBS. Allergic rhinitis was positively linked to IBS. Drug allergy was positively associated with FD. The presence of multiple allergic diseases was positively correlated with FD and IBS (FD: adjusted OR for 2 allergic diseases: 1.95 [95% CI, 1.24-2.98], P for trend = 0.003; and IBS: adjusted OR for 1 allergic disease: 1.40 [95% CI, 1.15-1.69], 2 allergic diseases 1.47 [95% CI, 1.12-1.91], and 3 or more allergic diseases: 2.22 [95% CI, 1.45-3.28], P for trend = 0.001). Additionally, the concomitant existence of multiple allergic diseases was also demonstrated to have a trend that correlated with the overlap of FD and IBS (P for trend = 0.018). Conclusion Allergic disease multimorbidity is positively correlated with the prevalence of FD and IBS in a young population.

This study aimed to evaluate the effects of ingesting yogurt fermented with Lactobacillus delbrueckii subsp. bulgaricus (OLL1073R-1) on the immune function of healthy university men track and field athletes. Study design Randomized, double-blind, placebo-controlled, parallel-group study. A total of 37 track and field athletes aged ≥18 years were randomly assigned into two groups. For 2 weeks, two bottles of yogurt fermented with OLL1073R-1 and Streptococcus thermophilus OLS3059 or placebo sour milk were ingested daily to the participants. During the intake period, a 1-week training camp was held and participants were subjected to strenuous exercise. Natural killer (NK) cell activity, which is the primary endpoint, was significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level of the yogurt group. The two-way repeated measures analysis of variance showed an interaction effect in the NK cell activity change (P=0.018) and a significant difference between the groups after the 2-week ingestion (P=0.015). Among the secondary endpoints, cytokines and chemokines levels involved in activating innate immunity maintained or enhanced only in the yogurt group. ALT, LDH, and CK significantly elevated only in the placebo group. Furthermore, amino acid levels were significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level in the yogurt group. Consuming yogurt fermented with OLL1073R-1 prevents the decline in immune function associated with strenuous exercise. Additionally, the yogurt may contribute to stable physical condition.

To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injection insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM).

BACKGROUND/AIMS: Gastric motility abnormalities have been considered to be pathophysiological features of functional dyspepsia (FD) that are closely related to dyspepsia symptoms, especially postprandial distress syndrome (PDS). The aims of this study are to (1) investigate the prevalence of gastric motility disorders and (2) evaluate the association between gastric motility abnormalities and dyspeptic symptoms using gastric scintigraphy in the PDS type of FD. METHODS: Forty healthy subjects and 94 PDS type FD patients were enrolled in the study. The volunteers and patients ingested a radiolabeled (technetium-99m) solid test meal, and scintigraphic images were recorded. Gastric accommodation and emptying were assessed by scintigraphic imaging. The patients’ dyspeptic symptoms were also explored using self-completed symptom questionnaires with 10 variables (4 scales, 0–3 points) at the same time. RESULTS: In 94 Japanese FD patients, the prevalence of impaired gastric accommodation and delayed emptying were 14.9% (14/94) and 10.6% (10/94), respectively. Gastric motility abnormalities were seen in 25.5% (24/94) of FD patients. There was no association between gastric motility abnormalities and dyspeptic symptoms. CONCLUSIONS: Gastric motility abnormalities were seen in 25.5% of Japanese PDS type FD patients. However, there was no association between gastric motility abnormalities and dyspeptic symptoms on gastric scintigraphy.
Asian Continental Ancestry Group ; Dyspepsia* ; Healthy Volunteers ; Humans ; Meals ; Prevalence* ; Radionuclide Imaging ; Stomach ; Volunteers ; Weights and Measures

BACKGROUND: Mizoribine (MZR) is an immunosuppressive drug used in Japan for treating patients with lupus nephritis and nephrotic syndrome and has been also reportedly effective in patients with immunoglobulin A (IgA) nephropathy. However, to date, few randomized control studies of MZR are performed in patients with IgA nephropathy. Therefore, this prospective, open-label, randomized, controlled trial aimed to investigate the efficacy and safety of adding MZR to standard treatment in these patients, and was conducted between April 1, 2009, and March 31, 2016, as a multicenter study. METHODS: Patients were randomly assigned (1:1) to receiving standard treatment plus MZR (MZR group) or standard treatment (control group). MZR was administered orally at a dose of 150 mg once daily for 12 months. RESULTS: Primary outcomes were the percentage reduction in urinary protein excretion from baseline and the rate of patients with hematuria disappearance 36 months after study initiation. Secondary outcomes were the rate of patients with proteinuria disappearance, clinical remission rate, absolute changes in estimated glomerular filtration rate from baseline, and the change in daily dose of prednisolone. Forty-two patients were randomly assigned to MZR (n = 21) and control groups (n = 21). Nine patients in MZR group and 15 patients in the control group completed the study. No significant differences were observed between the two groups with respect to primary and secondary outcomes. CONCLUSION: The addition of MZR to standard treatment has no beneficial effect on reducing urinary protein excretion and hematuria when treating patients with IgA nephropathy.
Glomerular Filtration Rate ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulins* ; Japan ; Lupus Nephritis ; Nephrotic Syndrome ; Prednisolone ; Prospective Studies ; Proteinuria

Research highlights the importance of maintaining pre-diagnosis physical activity levels for breast cancer survivors post-treatment. However, many survivors have difficulty engaging in physical activity due to cancer-related fatigue. The aim of this study was to explore how participation in a 12-week yoga intervention impacted fatigue and physical activity. 20 individuals with breast cancer diagnosis participated in a 12-week yoga intervention. The yoga intervention included modified hatha yoga postures and consisted of 10 min. of warm-up, 45 min. of yoga postures, 10 min. of breath work, and 10 min. of supine resting pose (savasana), for a total of 75 min. Assessments were administered at 3 time points: pre (T1), post (T2) yoga intervention and at a 12-week follow-up (T3). Measures included self-reported fatigue (Cancer Fatigue Scale) and physical activity (accelerometer step counts). One-way ANOVA were used to examine how fatigue scores and steps counts were changed over the course of the intervention. Total fatigue score (FS) and daily step (DS) counts at each time point were T1 (FS=21.6±8.9, DS=7709±2036), T2 (FS=14.0±8.3, DS=8429±2722), and T3 (FS=16.8±6.9, DS=8406±3389). Significant improvements in physical fatigue T1 (p<0.05, η² = 0.14) and cognitive fatigue (p<0.01, η² = 0.11) were seen at T1-T2. No significant changes were seen in psychological fatigue. 12 participants (65%) had high fatigue levels at T1, which decreased to 5 participants (27.8%) at T2. 12 participants (66.7%) increased daily steps at T2 and 8 participants (44.4%) continued to increase at T3. There were negative correlations between fatigue scores and step counts at all time points (r=-0.45~-0.55). Participation in a 12-week yoga program was associated with improved cancer-related fatigue.

The Consensus of this Committee is:

1) To change the name of the present committee from "Premedical Education Committee" to "Committee on Behavioral and Social Science" ; accordingly to discuss theoretical foundations, clinical application, learning objectives and outcomes of behavioral and social science in Japanese medical schools.

2) To collect actual case studies of teaching behavioral and social sciences in Japanese medical schools and create a database for such practices.

3) To develop behavioral and social science curriculum content in Japanese medical schools.

4) To organize training courses for teaching methods for behavioral and social science curricula and develop standardized teaching methods and materials.

[Objective] The purpose of this study is to examine the effects of press tack needles (PTNs) on subjective assessment of symptoms such as heaviness, stiffness and lassitude in the lower limbs during walking, or in everyday life. Sham PTNs are used for the purpose of comparison.
[Methods] The subject is a male in his seventies who has a daily routine of walking 10,000 steps; experiences heaviness, stiffness and lassitude in his lower limbs; and has spinal or internal disease. Intervention: PTNs or sham PTNs are randomly chosen and worn on the subject's body for two days. The subject fills out a questionnaire regarding subjective assessment of symptom relief in his lower limbs during the following three time periods; in advance of the use of PTN, in the evening during the use of PTN, and the following evening. PTNs are applied to a total of 10 sites around both sides of his lower limbs depending on symptomatic or tender areas. Assessment: A questionnaire, in which a Visual Analog Scale (VAS) is introduced, is filled out three times per trial, that is, thirty records from ten trials are finally kept. Differences can be seen in the result answered the following evening. The results regarding the use of PTNs and the results regarding the use of sham PTN are analyzed respectively by randomization test (R test).
[Result] Significant difference was shown in the heaviness of the lower limbs for both the PTN and sham in the evening of the next day (P < 0.05). Significant difference was shown in the stiffness of the lower limbs for both the PTN and sham in the evening of the next day (P < 0.05).
[Conclusion] A PTN is attached for two days when there is a feeling in the lower limbs of heaviness and stiffness, even with spinal disease, liver disease or varicose veins in the lower extremities. It is suggested that PTNs are effective in decrease of symptoms.

OBJECTIVES: The purpose of the study was to examine the relationships among the psychological, social, and environmental factors influencing the utilization of senior centers among older adults in Korea. METHODS: A questionnaire survey was administered to two types of older adults who lived in Seoul, Korea: 262 older adults who used senior centers (3 places) and 156 older adults who did not use senior centers. RESULTS: Our results showed clearly that the utilization of the senior centers in Korea is affected by higher self-efficacy (odds ratio [OR], 6.08; 95% confidence interval [CI], 3.31 to 12.32), higher perceived benefits (OR, 1.71; 95% CI, 1.16 to 4.36), lower perceived barriers (OR, 6.43; 95% CI, 3.07 to 11.45), higher family support (OR, 4.21; 95% CI, 2.02 to 8.77), and higher support from friends (OR, 4.08; 95% CI, 2.38 to 7.81). The results also showed that participants whose total travel time was 15 to 29 minutes (OR, 2.84; 95% CI, 1.21 to 3.64) or less than 14 minutes (OR, 4.68; 95% CI, 3.41 to 8.41) were more likely to use a senior center than those who had to travel more than 30 minutes. CONCLUSIONS: This study showed that the utilization of senior centers in Korea is affected by psychological, social, and environmental factors, specifically by self-efficacy, perceived benefits, perceived barriers, social support, convenience of transportation, and total travel time to the senior centers. The effects of longer-term utilization of the senior centers by non-users on health-related outcomes in a large population warrant attention.
Aged ; Aging/*psychology ; Community Health Centers/statistics & numerical data/*utilization ; Cross-Sectional Studies ; *Environment ; Female ; Health Services for the Aged/statistics & numerical data/*utilization ; Health Surveys ; Humans ; Korea ; Male ; Questionnaires ; Self Efficacy ; *Social Behavior ; Social Support ; Time Factors ; Travel