Background/Aims: This multi-center study in Japan aimed to clarify whether any significant differences in clinical characteristics and symptoms exist between patients with functional dyspepsia (FD) and those with refractory FD, that is, FD with pancreatic enzyme abnormalities (FDP), and determine the severity of the pancreatic enzyme abnormalities affecting FD symptoms or exocrine pancreatic dysfunction by comparing relevant factors.

　Methods: In total, 111 consecutive patients who presented with FD (n＝46) or FD-P (n＝42) based on Rome III classification and 23 controls were recruited from four institutions in Japan. Their clinical characteristics and clinical symptoms were assessed using questionnaires. We measured the levels of five pancreatic enzymes (amylase, lipase, trypsin, phospholipase A2, and elastase-1) in the sera of the patients with FD and FD-P. Pancreatic exocrine function was analyzed using N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BT-PABA). Patients with FD-P (n＝19) consented and underwent endosonography (Olympus EUS-UCT 260 convex scanning endosonography).

　Results: No significant differences were noted in age, sex or body mass index (BMI) between patients with FD and FD-P. An abnormal trypsin level was the most prevalent change in the pancreatic enzymes of patients with FD-P. Severe pancreatic enzyme abnormalities in more than four of the tested pancreatic enzymes were observed in approximately 13％ of patients with FD-P. The triglyceride concentration was higher in patients with FD-P than in those with FD. Conversely, no significant association was detected among the presence of exocrine pancreatic dysfunction, pancreatic enzyme abnormalties, and clinical symptoms in patients with FD-P.

　Conclusions: Trypsin level is a useful marker for distinguishing FD from FD-P. Further studies are warranted to clarify whether the severity of pancreatic enzyme abnormalities and exocrine pancreatic dysfunction affect the pathophysiology of patients with FD-P.

　Objectives: The purpose of this study was to clarify the differences in heat production between Hiesho (cold sensitivity) and non-Hiesho.

　Subjects: Thirty-three subjects were divided into two groups: the Hiesho group (males; n＝6, females; n＝11) and the non-Hiesho group (males; n＝6, females; n＝ 10).

　Methods: Heart rate, blood pressure, tympanic and hallux temperature, autonomic nervous activities index, soft lean mass and skeletal muscle mass of the Hiesho group and the non-Hiesho group were compared using SPSS Statistics 27.　

　Results: Sympathetic nervous activity (both males and females) in the Hiesho group was more dominant than parasympathetic nervous activity. On the other hand, the mean soft lean mass and skeletal muscle mass (both males and females) in the Hiesho group were reduced compared to those of the non-Hiesho group.

　Conclusion: In the Hiesho group, sympathetic nervous activities enhanced and the mean muscle mass were reduced. Therefore, low heat production might be one of the reasons for physiological mechanism of Hiesho.

　Background: It has been reported that the incidence of dementia is higher in patients with type 2 diabetes, and that the arteriosclerosis index score is a predictor of the onset of dementia in this group.

　Purpose: The purpose of this study was to investigate whether carotid intima-media thickness (IMT) was a predictor of the onset of dementia in type 2 diabetes patients.

　Method: Max IMT was determined by carotid artery echo and the Hasegawa Dementia Rating Scale-Revised score obtained in 85 type 2 diabetes outpatients who were followed for an average of 4.7 years. Dementia was newly diagnosed in 15 of this group. The contributing factors for onset of dementia were determined by multivariable logistic analysis.

　Results: Age, male sex, presence of cardiovascular disease, and max IMT (Odds Ratio: 5.515, 95％ CI: 1.408−10.000, p＝0.005) were identified as contributing factors in the onset of dementia in patients with type 2 diabetes.

　Conclusion: The present results suggest that there is a relationship between carotid IMT and the onset of dementia in type 2 diabetes patients.