Background: Gastrointestinal symptom-specific anxiety (GSA) has been reported to impact symptom severity in irritable bowel syndrome (IBS), suggesting that GSA may be an important treatment outcome. The present study explored whether higher levels of GSA were associated with increased risk of having IBS, and whether individuals with IBS were at greater risk for severe gastrointestinal (GI) symptoms. Methods: Participants comprised 1156 university students. The Rome III modular questionnaire was used to assess for IBS. GSA was measured using the Japanese version of the Visceral Sensitivity Index (VSI). IBS-SI was used to assess severity of GI symptoms. Data were analyzed using univariate and multivariate logistic regression analysis. Results: The prevalence rate of IBS (provisional diagnosis, based on Rome III questionnaire responses) was 21%. Logistic regression analysis was performed using the VSI cutoff point as the independent variable, and the presence or absence of IBS as the dependent variable. Results indicate that for individuals above the VSI cutoff point, the adjusted odds ratio for having IBS was 2.64 (95% CI: 1.87-3.71). Furthermore, results indicate that in participants with high GSA, adjusted odds ratios for severity of IBS symptoms were 0.44 (95% CI: 0.33-0.58) for subclinical, 1.15 (95% CI: 0.90–1.46) for mild symptoms, 2.19 (95% CI: 1.57–3.07) for moderate symptoms, and 5.63 (95% CI: 2.24–14.15) for severe symptoms. Conclusion:Higher VSI scores were associated with having risk factors for IBS and greater severity of IBS symptoms.

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　The relationship between tongue pressure and relevant factors including cardiovascular disease (CVD)-related factors in community-dwelling middle- and old-aged people is still controversial. To clarify the relationship between tongue pressure and relevant factors including CVD-related factors in community-dwelling middle- and old-aged people. We included 638 Japanese community-dwelling adults (241 men and 397 women) who participated in the screening program and agreed to participate in this study. We measured the tongue pressure using a JMS tongue pressure measuring instrument^® with a disposal oral balloon probe, and we conducted multivariate linear regression analysis to evaluate the relationship between tongue pressure and other existing parameters adjusted for CVD-related confounding factors. We showed that tongue pressure was significantly correlated with age (β = −0.114), sex (β = 6.374, Men=2, Women=1), lean body mass (β = 0.278), and log grip strength (β = 22.438). Our study showed that these parameters were all independent explanatory valuables for tongue pressure in community-dwelling middle- and old-aged people. Age, sex, grip strength, and lean body mass were all independent explanatory valuables for tongue pressure in community-dwelling middle- and old-aged people.

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Objectives: Cases of schizophrenia are commonly complicated with obesity and diabetes mellitus partially caused by excessive eating associated with the use of second-generation antipsychotics (SGAs). We aimed to study the efficacy of glucagon-like peptide-1 in patients with schizophrenia under treatment with SGAs. Methods: Diabetic patients with schizophrenia were included if their HbA1c levels increased more than 1% and/or their weight increased more than 3 kg after treatment with SGAs. Patients who developed diabetes after treatment with SGAs were also included. The participants were treated with GLP-1 receptor agonists for one year, and their changes in weight and HbA1c and any adverse events were evaluated. Results: Seven patients were treated with GLP-1 receptor agonists; their mean age was 46.1 yrs old (range; 26 to 59), mean body weight was 85.3 kg (65.5 to 96.8), and mean BMI was 33.8 (27 to 38.7). Five of them showed improvement in their HbA1c levels of 1.2% (0.1 to 3.4, p=0.089) with a weight loss of 3.7 kg (-9.6 to +3.5, p=0.14) on average. The adverse effects observed were all gastrointestinal, but were not severe enough to cause termination of the GLP-1 receptor agonist treatment. The GLP-1 receptor agonist was not effective in one patient, and another patient terminated the treatment in a few months. Conclusions: Although the number of patients studied was small, GLP-1 receptor agonists seem to be effective for treating diabetes and bringing about weight loss in patients with schizophrenia under treatment with SGAs.

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[Objective] The objective of this study was to investigate the suppressive effect of antibiotics and presence or absence of glucose on biofilm formation on metal surfaces by coagulase-negative Staphylococci. [Materials and Methods] Bacterial strains included a standard biofilm-forming strain of Staphylococcus epidermidis, nonbiofilm-forming strain of Staphylococcus hominis, and two clinical strains of Staphylococcus epidermidis isolated from implantrelated infection (IRI). Vancomycin (VCM) was used as the antibiotic. Trypticase soy broth (TSB) and TSB without dextrose (TSB w/o D) were used as growth media. Each strain was adhered to stainless steel washers and cultured in different growth media with various VCM concentrations for different lengths of time. The degree of biofilm formation was measured as the biofilm coverage rate (BCR). [Results] BCR decreased with increasing VCM concentration and shorter incubation time; however, the degree of suppression varied by strain. BCR was lower for strains cultured in TSB w/o D than for those in TSB. BCR for 8-h incubation group was significantly reduced at lower VCM concentrations in TSB w/o D than in TSB. [Conclusions] Biofilm formation was suppressed in absence of glucose environments, suggesting the importance of controlling blood glucose levels during the perioperative period to prevent IRI.

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Chronic pulmonary aspergillosis (CPA) is slowly progressive inflammatory pulmonary syndrome due to infection of Aspergillus spp. We conducted a randomized, multicenter, open-label trial comparing intravenous liposomal amphotericin B (L-AMB) of 2.5-5.0 mg/kg once daily with intravenous voriconazole (VRCZ) of 6 mg/kg twice on Day 1 followed by 4 mg/kg twice daily. Treatment effectiveness was defined by clinical, and radiological improvement at both 2 weeks after the initial administration and at the end of therapy. The total of 166 patients were recruited and 83 patients for each drug group were assigned. Total of 51 and 59 cases of L-AMB and VRCZ, respectively were assessed as per-protocol populations. The difference in efficacy rates between L-AMB and VRCZ was not significant, either after 2 weeks [49.0% vs. 59.3%; the absolute difference, 10.3% with a 95% confidence interval (CI), -8.4 to 29.00, P=0.279] or at the end of therapy (52.9% vs. 67.8%; the absolute difference, 14.9% with a 95% CI, -3.4 to 33.2, P=0.111). In the safety evaluation, no statistical difference of occurrence rates in both LAMB and VRCZ group (54.2% vs. 59.0%, P=0.531). L-AMB was as effective as VRCZ with no significant difference of adverse effects in the treatment of CPA. (UMIN Clinical Trials Registry number, UMIN000002236.)

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Aims: Slow walking speed in older subjects was reported to be associated with an increased risk of cardiovascular mortality. On the other hand, minor allele frequency of the single nucleotide polymorphism (SNP) rs3782886 is reported to be positively associated with coronary artery disease. Therefore, the rs3782886 genotype might be associated with walking speed later in life. However, no studies have reported on the influence of rs3782886 on walking speed in elderly subjects. Methods: To evaluate the influence of SNP rs3782886 on walking speed in later life, we conducted a cross-sectional study of 562 elderly women aged 60 years and over who had undertaken a general health check-up between 2014 and 2015. Faster walking speed was defined by a questionnaire which asked, “Do you walk faster than your contemporaries?” (yes, no). Results: Of the total study population, with regard to the rs3782886 genotype, 356 subjects showed major homo (A/A), 177 hetero (A/G) and 29 minor homo (G/G). Independent of known cardiovascular risk factors, with major homo as the reference group, the adjusted odds ratio and 95% confidence interval for faster walking speed were 0.92 (0.54, 1.58) for hetero and 0.39 (0.16, 0.97) for minor homo. Conclusion: Independent of classical cardiovascular risk factors, the SNP rs3782886 was found to be associated with faster walking speed, as defined by a questionnaire, in elderly Japanese women. This result represents an efficient tool to clarify the mechanism of rs3782886 as a risk factor for cardiovascular disease.

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　Thrombomodulin, a thrombin receptor on the surface of endothelial cells, plays an important role not only in maintaining normal hemostatic balance but also in in utero development. Plasma thrombomodulin has been used in the clinical setting as a marker of endothelial damage in adults; however, the clinical values for neonates have not yet been determined. Intrauterine growth restriction has deleterious effects on mortality and morbidity in both term and preterm infants. The purpose of the present study was to examine whether or not the association between thrombomodulin and gestational age differed between appropriate-for-date (AFD) and light-for-date (LFD) infants. We measured the thrombomodulin levels in the umbilical cord bloodderived plasma of 388 neonates divided into LFD and AFD infants and analyzed their association with gestational age, birth weight, umbilical cord blood pH, and Apgar scores. The plasma thrombomodulin levels were higher in neonates than in adults. There was an inverse correlation between the gestational age and thrombomodulin levels in AFD infants; however, LFD infants presented high plasma thrombomodulin levels throughout the gestational ages examined. While plasma thrombomodulin levels correlated with gestational age and differed between LFD and AFD infants, no clear correlations were seen with Apgar scores, birth weight, cord blood pH or base excess in a multivariate analysis. While such high plasma thrombomodulin levels in preterm infants may reflect their normal physiological background, the difference between the AFD and LFD infants may be caused by pathological processes other than asphyxiation events in LFD infants.

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