[Purpose] To examine the associations of independent access to transportation with life-space mobility and physical activity among users of day-care rehabilitation facilities. [Participants and Methods] We monitored the physical activity of 24 participants attending day-care rehabilitation facilities using an accelerometer. We categorized activity as sedentary behavior (1.0-1.5 metabolic equivalents [METs]), light-intensity physical activity (1.6-2.9 METs), and moderate-to-vigorous physical activity (≥3.0 METs) and calculated daily averages for each. Life-space was assessed using the Life-Space Assessment scores. Participants were divided into two groups: those with independently available transportation and those without. We compared the life-space and physical activity levels between the groups. [Results] Life-Space Assessment scores were significantly higher among participants with available transportation than among those without available transportation. However, no significant difference was found in overall physical activity. [Conclusion] Transportation availability was associated with a larger life-space but was not significantly associated with physical activity.
Type 1 autoimmune pancreatitis (AIP) is a unique form of pancreatitis characterized by IgG4-related inflammation and corticosteroid (CS) responsiveness, but long-term outcomes remain unclear. We evaluated 10-year relapse, malignancy, metabolic/nutritional changes, and survival. We retrospectively analyzed 83 CS-treated patients with type 1 AIP followed for ≥ 10 years or until death, assessing: relapse and risk factors; standardized incidence ratios (SIRs) and risk factors for malignancies; 10-year changes in HbA1c and serum albumin; CS-related adverse events; and overall survival (OS). Cumulative relapse rates at 1, 3, 5, 7, and 10 years were 11.0
Purpose Conventional muscle strength assessment relies heavily on a subject’s voluntary effort. This exploratory study aimed to develop and internally validate regression models for the non-invasive estimation of isometric knee extension strength using ultrasound-derived indices—echo intensity (EI), muscle thickness (MT), and resting muscle stiffness of the quadriceps femoris—combined with participants’ physical characteristics. Methods Fifty-two healthy adult males (mean age, 44.3 ± 15.1 year) were enrolled. Ultrasound imaging of the rectus femoris (RF) and vastus intermedius (VI) was performed at 25% and 50% of the thigh length while participants rested in the supine position. Isometric knee extension strength was measured using a hand-held dynamometer. After assessing multicollinearity, multivariable regression analyses with backward elimination were performed to develop predictive models. Internal validation was subsequently conducted using 2,000 bootstrap resamples. Results Muscle stiffness of the VI was excluded because of poor measurement reliability. Four significant predictive models were ultimately developed (adjusted R ² = 0.219–0.244). The selected predictors included age, height, body weight, RF MT, and corrected EI values for both the RF and VI. Bootstrap validation demonstrated that all models were statistically stable, with acceptable |Bias|/|B| values and Cook’s distances. Conclusion Regression models incorporating ultrasound-derived muscle indices and physical characteristics can provide a non-invasive approach for estimating knee extension strength. Although the developed models demonstrated acceptable internal stability, their overall explanatory power remained modest.
Cases of gallbladder carcinoma containing poorly cohesive and signet-ring cell components are extremely rare, and their clinical characteristics remain unclear. We report a case involving a 70-year-old man who presented with fever and abdominal pain. Imaging at admission revealed diffuse gallbladder wall thickening and peritoneal metastatic nodules around the gallbladder, leading to a diagnosis of advanced gallbladder carcinoma; however, concurrent cholecystitis was suspected because of persistent fever and elevated inflammatory markers. The patient showed no response to antimicrobial therapy or gallbladder drainage, raising concern for tumor-associated inflammation and cancer-related pain. Bile cytology did not yield a definitive diagnosis; the patient showed unusually rapid enlargement of peritoneal metastases and died 2 months after presentation. Autopsy with immunohistopathological analysis confirmed advanced poorly differentiated gallbladder carcinoma with focal poorly cohesive and signet-ring cell features. This case illustrates that rare histological subtypes of gallbladder carcinoma may progress rapidly with extensive peritoneal metastatic nodules. Moreover, in such atypical variants of gallbladder carcinoma, early consideration of oncologic treatment is important while simultaneously controlling the infection.
Malakoplakia is a rare chronic granulomatous disease associated with impaired macrophage phagocytosis of bacteria. Because colonic malakoplakia presents with varied endoscopic appearances, its characteristic features have not been clearly defined, and differentiation from colorectal neoplasms during endoscopy may be difficult. We report a case of colonic malakoplakia with adenomatous features evaluated using magnifying narrow-band imaging (NBI). A patient receiving hemodialysis and corticosteroid therapy for immunoglobulin A nephropathy underwent total colonoscopy after a positive fecal immunochemical test. Two reddish polyps were identified in the ascending colon. Magnifying NBI showed either absent or regular surface patterns with fine, thread-like vessels, along with areas resembling adenomatous changes. Although malignant features were not observed, a definitive diagnosis could not be established endoscopically. Consequently, both lesions were resected using cold snare polypectomy. Histopathological examination revealed a granulation tissue-like inflammatory lesion composed of histiocytes containing Michaelis-Gutmann bodies in the lamina propria and submucosa, leading to a diagnosis of malakoplakia. Based on this diagnosis, a surveillance colonoscopy was scheduled for 1 year later.
