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Central venous port (CVP) is a widely used totally implantable venous access device. Recognition of risks associated with CVP-related complications is clinically important for safe, reliable, and long-term intravenous access. We therefore investigated factors associated with CVP infection and evulsion, including the device type. A total of 308 consecutive patients with initial CVP implantation between January 2011 and December 2017 were retrospectively reviewed, and the association of clinical features with CVP-related complications were analyzed. Intraoperative and postoperative complications occurred in 11 (3.6%) and 39 (12.7%) patients, respectively. The overall rate of CVP availability at six months was 91.4%. Malignancy and 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymer-coated catheter use were negatively associated with the incidence of CVP infections. Accordingly, malignancy and MPC polymer-coated catheter use were independent predictors for lower CVP evulsion rate (odds ratio, 0.23 and 0.18, respectively). Furthermore, both factors were significantly associated with longer CVP availability (hazard ratio, 0.24 and 0.27, respectively). This retrospective study identified factors associated with CVP-related complications and long-term CVP availability. Notably, MPC polymer-coated catheter use was significantly associated with a lower rate of CVP infection and longer CVP availability, suggesting the preventive effect of MPC coating on CVP infection.

BackgroundFOLFOX therapy, a standard treatment for colorectal cancer (CRC), causes a rare, but serious adverse event, hyperammonemia. However, the risk factors of hyperammonemia remain unknown.MethodsWe examined 74 patients who received mFOLFOX6 therapy with or without biologics for CRC between April 2013 and March 2018 in Yaizu City Hospital. Clinicopathological factors were retrospectively reviewed in association with hyperammonemia, and risk factors of hyperammonemia during mFOLFOX6 therapy were analyzed in 32 patients with the available data.ResultsSeven patients developed hyperammonemia, with onset exclusively on day 2 or 3 in the first cycle of therapy. They were treated with branched chain amino acid administration and hydration; however, one patient with stage G4 chronic kidney disease (CKD) died. By multivariate analysis, estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 was independently associated with hyperammonemia during FOLFOX therapy (odds ratio: 9.0, p = 0.040).ConclusionsReduced eGFR is considered a risk factor of developing hyperammonemia during FOLFOX therapy. Serum ammonia levels should be monitored especially during the first cycle of FOLFOX therapy in patients with CKD stage G3 or higher.

Motivated by developments in information technology, recording personal parameters with health devices is effective in health promotion. Today’s indoor individual lifestyles often involve using electrical appliances. We developed a health support system combined with wireless electricity monitoring and investigated whether electricity use is associated with residents’ vital data and lifestyles. We recruited 116 participants in February 2013. Their vital and electricity use data were collected daily. They completed a self-administered questionnaire. Among participants living alone, electricity from 20 February to 11 March 2013 was negatively associated with high-density lipoprotein (HDL) ( P  = 0.008) and positively associated with low-density lipoprotein (LDL) ( P  = 0.007) and neutral fat ( P  = 0.020) levels. Among all participants, electricity use was negatively associated with vegetable intake ( P  = 0.044) and step count ( P  = 0.040). Temperature sensitivity in winter was negatively associated with the LDL/HDL ratio for both men and women. For men, temperature sensitivity in winter was negatively related with alcohol intake; for women, it was positively related to body fat percentage and abdominal circumference and negatively correlated to vegetable intake. Temperature sensitivity in summer was positively associated with vegetable intake for men and women. In conclusion, electricity use was related to vital data and lifestyles and influenced by temperature.

Background Acute appendicitis has been reported to be managed with non-operative therapy at relatively high successful rate. However, risk factors for negative outcome have not been established. Method Three hundred eighty consecutive patients who underwent initial therapy for suspected appendicitis were reviewed. They were divided into three groups: operation group, the group successfully managed with non-operative therapy (success group), and the group required surgical conversion (failure group). Preoperative clinical data were compared among the groups and risk factors for negative outcomes were investigated. Result Thirteen patients were excluded due to contraindication for non-operative therapy. Of the remaining 367 patients, 143 patients (39.0%) were primarily treated with surgery, and 224 patients (61.0%) were initially managed with antibiotics. Among the 224 patients, 91 patients (40.6%) were refractory to antibiotics and converted to surgery after more than 24 h usage of antibiotics. Multivariate analysis revealed that elevated C-reactive protein (CRP) level (>4 mg/dL) and presence of appendicolith were significant risk factors for conversion. Morbidity rate showed no significant difference between the operative and failure groups. Conclusion Elevated CRP concentration and appendicolith may predict the negative outcome in non-operative management. However, immediate appendectomy can possibly be avoided at least 24 h without increasing morbidity under the usage of antibiotics.

In Lake Togo (Tottori prefecture, Japan), the vitamin B 12 content of the brackish-water bivalve Corbicula japonica remained high (17.3–22.5 μg/100 g wet weight of the edible portion) throughout the year, except during August and September. We evaluated whether the bivalve contained true vitamin B 12 or other corrinoid compounds that are inactive in humans by purifying the compounds and identifying them using LC/ESI–MS/MS chromatograms. The results indicated that “true” vitamin B 12 predominated in the bivalve, although small amounts of inactive corrinoid compounds (pseudovitamin B 12 and three unidentified compounds) were also found.

Although sepsis after surgery for colorectal perforation frequently results in severe coagulation disorders and consequent death of the patient, the correlation between coagulation abnormalities and postoperative mortality of colorectal perforation has not been clarified. The medical records of 101 consecutive patients receiving surgery for colorectal perforations between January 1994 and July 2006 were retrospectively reviewed. The abnormalities of preoperative laboratory data reflecting coagulation disorders and other possible risk factors were analyzed by univariate and multivariate analysis. Prolonged prothrombin time and activated partial thromboplastin time significantly correlated with a poor prognosis (both P < 0.001). Among the several risk factors analyzed, only the presence of coagulation disorders was an independent predictive factor of postoperative mortality. Prolonged prothrombin time and activated partial thromboplastin time are useful prognostic factors for predicting the surgical outcome for patients with colorectal perforation.

Differences in the reproductive traits of Pacific bluefin tuna Thunnus orientalis (PBF) in the Sea of Japan (SOJ) were investigated to evaluate the reproductive potential in 3 fishing grounds (i.e. northern, central and southern areas). The size distribution of PBF differed among the fishing grounds, with smaller fish (100–130 cm in fork length, FL) being caught in the central and northern areas of the SOJ. Spawning-capable females were found at sea surface temperatures (SSTs) between 17 and 25°C, with most SSTs >21°C. Seasonal changes in SST differed among the fishing grounds, and the period when SST exceeded 21°C differed in each fishing ground. Spawning-capable females were found at different times among the fishing grounds, and were observed throughout the fishing season in the southern area of the SOJ. The mean ± SD relative batch fecundity was estimated to be 69.8 ± 45.3 and 92.7 ± 43.1 oocytes g−1 in the central and southern areas of the SOJ, respectively. The total spawning fraction was 0.2, 0.38 and 0.73 in the northern, central and southern areas of the SOJ, respectively. SST and FL were positively correlated with the batch fecundity. In addition, FL, SST and location affected the probability of occurrence of spawning-capable fish among mature fish. Therefore, the difference in the observed reproductive potential of PBF among fishing grounds in the SOJ can be linked to the differences in seasonal increases in SST and the size distribution of adult fish.

Abstract A 63-year-old woman was admitted with abdominal pain two months after laparoscopic abdominoperineal resection for rectal cancer. Computed tomography revealed dilated small intestine had passed through a defect between the lifted sigmoid colon and abdominal wall. She was diagnosed with small bowel obstruction without strangulation due to internal hernia and managed nonoperatively based on her wish. Recurrence of intestinal obstruction occurred for which curative surgery was performed laparoscopically. The herniated intestine was restored to the normal position, and the hernia orifice was closed using barbed suture, on laparoscopic management. Internal hernia is a rare complication after colostomy that requires surgical management. Although laparoscopic approach on re-operation is difficult, laparoscopic surgery may be suitable for patients with IHAC in terms of required less use of adhesiolysis.

In Lake Togo (Tottori prefecture, Japan), the vitamin B^sub 12^ content of the brackish-water bivalve Corbicula japonica remained high (17.3-22.5 [mu]g/100 g wet weight of the edible portion) throughout the year, except during August and September. We evaluated whether the bivalve contained true vitamin B^sub 12^ or other corrinoid compounds that are inactive in humans by purifying the compounds and identifying them using LC/ESI-MS/MS chromatograms. The results indicated that \"true\" vitamin B^sub 12^ predominated in the bivalve, although small amounts of inactive corrinoid compounds (pseudovitamin B^sub 12^ and three unidentified compounds) were also found.[PUBLICATION ABSTRACT]

In Lake Togo (Tottori prefecture, Japan), the vitamin B sub(12) content of the brackish-water bivalve Corbicula japonica remained high (17.3-22.5 mu g/100 g wet weight of the edible portion) throughout the year, except during August and September. We evaluated whether the bivalve contained true vitamin B sub(12) or other corrinoid compounds that are inactive in humans by purifying the compounds and identifying them using LC/ESI-MS/MS chromatograms. The results indicated that \"true\" vitamin B sub(12) predominated in the bivalve, although small amounts of inactive corrinoid compounds (pseudovitamin B sub(12) and three unidentified compounds) were also found.