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Objectives Endoscopic mucosal resection (EMR) is useful for removing colon polyps and is generally carried out by one doctor. It is occasionally difficult for colorectal polyps to be removed by EMR. In such cases, EMR is performed by the main doctor and an assistant doctor (the two-person method). However, the efficacy and safety of EMR in the two-person method remain unclear. This study aimed to compare the procedure time and incomplete resection rate (IRR) by the two- and single-person methods of EMR for polyp removal. Materials and Methods Data from colorectal polyps resected by EMR were reviewed retrospectively and divided into two groups: general procedure/single- (n = 215) or two-person method (n = 56). The IRR, the procedure time, and the incidence of adverse events were compared between these methods. Results A total of 152 patients and 271 lesions were included in this study. The mean procedure time for polypectomy was significantly shorter in the two-person method group than in the general procedure group (median time: 3.38 minutes vs. 6.56 minutes; p

The hepatocellular carcinoma (HCC) with intrahepatic and bone metastasis shows poor survival of averagely 3 months. The bone metastasis and HCC itself might cause cancer-associated pain. An intrathecal (IT) analgesia might contribute to improve QOL and prolong surviving time (ST). A 71-year-old male presented with temperature and appetite loss continuing for 2 months. He looked pale and malaise. Computed tomography and tumor markers elevation confirmed diagnosis of HCC stage IV. To treat him, molecularly targeted therapy was started but abandoned because of side effects of life-threatening convulsions and loss of consciousness. Since this time, pain control strategy was planned as advance care plan. After dermal and oral opioids were administered, IT analgesia was introduced to conquer uncontrollable pelvic pain due to metastatic osteolytic lesions. Owing to IT analgesia against severe cancer-related pain, he had lived for 46 months. Comparing with reviews in which average ST is 3 months, this is the case with the longer ST in bone-metastatic HCC. From our experience, it must be emphasized that relieving cancer-related pain strategy for patients with progressive bone-metastatic HCC might contribute to prolong ST longer when adjuvant therapy has been failed.

IntroductionWe sought to assess the Japanese diet by examining the current dietary intake in Japan using the global reference diet from the EAT-Lancet Commission (Planetary Health Diet; PHD), from the perspective of protein intake in different age groups.MethodsAverage dietary intake by food group in the Japan National Health and Nutrition Survey 2019 (NHNS 2019) was converted to the PHD food groups, and the diet gap (DG) (%) of the global reference of the PHD was calculated by age group.ResultsAlthough the DG of the intake was excessive compared with the global reference of the PHD in most food groups in all age groups (7.1–416%), the intake exceeded the upper limit of the range only for red meat (640%). Red meat had the highest DG among subjects in their 40s, although the DG decreased with increasing age. Protein intake was within the possible range and did not greatly exceed the recommended dietary intake in the Japanese standard.DiscussionThe current Japanese diet contains an excessive intake of red meat in terms of the global reference of the PHD. This trend is similar to that previously reported in various western regions and countries. However, the Japanese diet does not significantly exceed the recommended protein intake for Japanese people, suggesting that the PHD is an environmentally friendly and healthy choice for younger and older age groups in an aging Japanese society. Policy makers need to develop sustainable and healthy food-based dietary guidelines in addition to providing food and nutrition education and developing a food environment that encourages sustainable and healthy choices to support dietary change.