Eating out inevitably tends to get frustrated in hurried days. I took breakfast, I did not eat much vegetables. The reason why we can not maintain a good balance is "Is there anything else you care about and there is not enough room to think about that!" Is it honest?

Nonetheless, I think that I think that I can try a healthy meal today.

On April 19th "Food Day Day"


First of all, 19 days of each month by the Cabinet Office the day of the food education , but I have been defined as (※ 1) . In addition, on April 19, it seems that it is set as the day of food education by private companies (* 2) . In other words, it is the day of double food education .



(* 1) Established in 2005 according to the basic education promotion promotion plan based on the Basic Eating Law.
(* 2) Mitsubishi Corporation established from a pun of 419. The enactment date is unknown.

A little more healthy meal than usual


I do not say difficult things to eat according to the " meal balance guide " that I learned in lessons when I was a junior high or high school student . I just want you to try something more healthy everyday than usual.

Regardless of age and gender, breakfast has many bread schools. However, it is often said that staple food is healthier and better than old. What is it in the first place?


If you look only at calories, there should not be much difference. Rather, it has a lower calorie than a bowl of rice bowl (1 cup of rice: 269 kcal, bread 1/6 cuts: 158 kcal) compared to bread.

Mr. Kazuki Enone of a managed nutritionist says, "At the end of the day it is simple but at the end of the day to eat" (wanibooks), from these four points, we prefer "rice" rather than "bread" to staple food It is talking. Even so, I can not stop the bread habit in the morning (laugh)

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© aluxum / iStock
01.
Lipid: rice <Bread
When you compare 1 cup of rice with bread (6 slices), the calorie is indeed lower in bread. However, lipid, rice: About 0.5 g, (depending on the type) bread: about 2 - 4 g is a standard. It contains several times as many lipids as rice .

02.
No rice is added
The biggest difference is this. If you just cook white rice, no rice is added. On the other hand, bread has oil, sugar, salt and so on, and many contain additives such as yeast food, emulsifier, Na acetate, sweetener, flavor and so on. Incidentally, "trans fatty acid" which is sometimes included in bread is a component that becomes subject to regulation in the whole country as it is harmful to the body.

03.
Side dishes calories and lipids
There are many low-calorie Japanese dishes such as grilled fish, miso soup, simmered dish, and natto, which are often combined with rice. In the case of bread, those with high lipids such as bacon egg and potage soup match well. If you apply jam or butter, it is natural that it will be more calorie.

04.
Number of bites
Even with a stubbornness, it is ritual to rice. As with rice, grain eating increases the frequency of chewing, making it easier to get a feeling of fullness. It is also easy to prevent snacking if you do so.

...... But I like bread!
From this point on, rice is still healthier. But I can not stop tasty bread! It is ideal that the ratio of main meal of rice and other food (including noodles) is about 9: 1. If you eat 3 meals every day , we recommend a balance of about one meal on the 3rd .

By the way, if you eat bread, the one with low degree of whitening such as whole grains is healthier.

I want to exercise for the summer! Running seems to be the easiest, even if you do not join the gym. But, I'm not good at driving ... .... The model of Victoria Secret, Karlie Kloss, was also originally disliked running. Such she is Caroline Burke's that was conscious in order to finish the full marathon and sunny the " Elite Daily introduced me to in the article of".


Let's start with this as a trigger !
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For running, in particular for inexperienced people, the hurdles are expensive and I do not know how to approach them. It may be the workout method of Karlie Kloss who will give you such a heavy back .

She started running as a training for the half marathon in Paris and finished the first full marathon in New York as soon as possible . Now is also the same time entrepreneurs and there under the name model , the cover of "Forbes" celebrities decorate up.

Even if I can not imagine myself who is still running now, I would like to take advice from her seriously. I will introduce "5 aims" that will lead you to "runner's high" with Kloss's comments.

01.
Aim for
sustainability by finding the environment to be inspired
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Each person has different circumstances in which results can be obtained. Then, let's first find an "environment where you can enjoy running". Some people like to run with running machines that will instantly run speed and distance, others who like outdoor running that throws themselves naturally.

Karlie Kloss is a sudden outdoor faction . She talks like this.

I do not seem to be suitable for running machines. I think it took time to start running, because I was trying my machine all the time. The scenery does not change, it does not fit in imaichi ne.

02.
I think to succeed
Movement of the body may be "physical activity" to the last, but it is also fact that the mental state greatly affects it. In other words, to maintain motivation for workouts, it is important to have a mindset of "to succeed". Until you can do it, you only need to do "pretending", so it is key point to challenge with confidence.

Kloss talks about the rejection that he had in running .

At that time, I was deciding my own thing. "I am not a runner". But when I cease to decide, I finally got to think "Let's challenge the half marathon, let's run."

03.
Have a certain level of competitiveness
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Just having a little competitive spirit, you have to follow the next step.

Of course, getting competitive spirit and support from running companions is also a hand, but myself is a sufficient competitor. For example, to run faster than last time, aim for a long distance. It is a wonderful ambition to aim both of them.

Kloss also implied the importance of competitiveness .

I am originally competitive. So when there are people who can run faster than I can, I'll push myself as closely as possible to match them.

04. Carefully routine
after workout
The quality of the workout is dependent on whether you regularly work from your body. Therefore, let's try not to lose your stretch, hydration and then ingest the necessary nutrition so that you can fully recover after running.

Advice for Kloss to deliver voices against running is to take moisture firmly.

Anyway to drink plenty of water! I try to take plenty of water before and after workout. Afterwards I'm charged with energy by drinking protein shake and ingesting the necessary nutrition.
05. Grasp
running as a change of pace
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Running is a good opportunity to rest your brain one step away from a chaotic and busy day and to check your own axis. Some people refresh their minds with meditation, but just by jogging with sneakers can make the brain clearer .

The following is from Kloss' s interview.

Running is the time you can look back on yourself without being disturbed by anything. So I feel like refreshing. Because you can bring only what is really important to you to the axis of your mind, after running, you can think "OK, I will do my best tomorrow."

Introduction
Cancer has become a very familiar illness. In life, one in two people will be cancer, one in three will die from cancer. It is a colorectal cancer that is one of the five major cancers, but it is said that 100,000 people are going to have colon cancer every year, aging and eating habits to Westernized, these two points increase colon cancer It is related.
The wave of aging is difficult to do anything, and what we can do to eradicate colorectal cancer is in the early detection by preventive and medical examination including improvement of dietary habits. However, there is a limit to "Taking one or two foods and nutrients in the diet into issues" in order to prevent specific cancers.
We recommend balanced diet and abdomen, moderate exercise, a good night's sleep, participation in medical examinations. Below is an overview of colorectal cancer.

Diagnosis of colorectal cancer
The length of the colon in general adults is said to be about 1.5 m. Symptoms vary slightly depending on where you can do the same colorectal cancer. For example, if it is on the right side of the large intestine, it touches anemia and a lump, on the left side it is abdomen, constipation finally is bowel obstruction, and furthermore when approaching to the anus side blood mixes with feces (Fig. 1). If you can do it, I would like to have a diagnosis before such symptoms appear.

For early diagnosis
There is a fecal occult blood test that senses a small amount of blood contained in feces from colon cancer and is used for colon cancer screening. If fecal occult blood was positive (a little blood is contained in the stool), further examination is required. However, fecal occult blood is not equal colorectal cancer. In cases where it becomes positive with colon polyp, enteritis, hemorrhoid disease, etc., and, as a result, the cause is not clear, is the majority.
On the other hand, fecal occult blood negatives are not safe. It is because it is not always bleeding from colorectal cancer. PET examination is also a cumbersome and too expensive examination method to find out early colorectal cancer from a large number of people efficiently.
Unfortunately there is no simple, cheap and reliable diagnostic method leading to diagnosis at an early stage. It is a practical way to consult a doctor if you are aware of the symptoms mentioned above or you have a large number of cancer patients in families / relatives with blood, while regularly taking advantage of medical examinations and human dogs.

To diagnose the presence of colorectal cancer and its part
After colonoscopy examining the large intestine by inserting an endoscope of about 1.3 m in length from the anus, we undergo CT colonography at our hospital. It is an alternative to the colonoscopy examination which indirectly looks inside the large intestine by popping barium and air from the anus which had been done so far and it became possible to visualize the running of the blood vessel simultaneously (Fig. 2, 3).　

Once diagnosed as colon cancer
If necessary, check whether you are stuck (invading) to the organs in the vicinity of the colon cancer, whether it is flying (transiting to distant organs), chest X-ray examination, CT examination or abdominal echocardiography We will investigate in detail.

Treatment of colorectal cancer
From the point of view of treatment
There are 4 types of surgical therapy (including endoscopic treatment), chemotherapy, radiotherapy, and others.
Laparoscopic surgery: Depending on the progress and size of the cancer, surgery for inserting a television camera or surgical instrument from a tiny wound with tummy is performed actively in our hospital.

From the viewpoint of therapeutic purpose
There are 4 kinds of treatment for cancer which becomes a primary cause in the large intestine, treatment for metastasis, treatment for preventing recurrence.
If the spread of cancer is limited, surgical therapy and radiation therapy are performed, and when cancer is spread throughout the body, chemotherapy is performed. Immunotherapy and gene therapy are still not common.

What is adjuvant therapy
Needless to say, even in the case of early cancer, there are cases where cancer spreads along the flow of blood and lymph at a site away from the cancer lesion that is the primary cause of cancer. After surgery sufficiently removes the cancer, the treatment to control such spread is called postoperative adjuvant therapy. Its purpose is to prevent recurrence, and chemotherapy and radiation therapy can be cited as a treatment method.
On the other hand, there is also a preoperative adjuvant therapy. The aim is to reduce cancer by performing chemotherapy or radiotherapy before surgery for highly advanced cancer. Those that could not be removed become resectable, and in addition, it may be possible to resect with small surgery.

About chemotherapy
Chemotherapy is required depending on the degree of cancer progression (stage). The drugs used include anticancer drugs that kill cancer cells, 5-FU (5-FU), irinotecan (CPT-11) developed in Japan, oxaliplatin, trifluridine, and further cancer Bevacizumab, which is an angiogenesis inhibitor (which is an angiogenesis inhibitor), cetuximab and panitumumab, which is an anti-EGFR antibody that blocks part of the network of cancer cells, and molecular targeted drugs such as legorafenib that blocks in a wider range.

Internal treatment
Treatment by oral administration is also reviewed.
Oral drugs of 5-FU type developed in Japan are attracting attention in Europe and the United States. As adjuvant chemotherapy for postoperative adjuvant chemotherapy for colorectal cancer that has progressed to a certain extent, it is simple compared to intravenous injection and the outcome of treatment is comparable. Even in the case of highly advanced cancer or recurrence which is difficult to resect by surgery, by combining with injectable medicine, a treatment method comparable to the outcome of treatment can be compared with the method by only injection, It came to be seen.

Exogenous chemotherapy
In our hospital considering the patient's burden, we are focusing on outpatient chemotherapy. In chemotherapy combined with the above-mentioned molecular targeted drugs, annual expenses may exceed 10 million yen, so there is a high medical care cost system to alleviate individual burden.

On side effects of antineoplastic drugs
Anticancer drugs are taken up more frequently in cell proliferation rate. Generally cancer cells are expected to be effective because cell division proliferation is active. However, normal human body also has a population of divisive proliferation. Stem cells in the bone marrow that make the origin of blood (blood cells), gastrointestinal tract, reproductive system, cells in the root of the hair. Naturally, many of anticancer drugs are taken into these cells and will be affected. Therefore, side effects such as myelosuppression, nausea / vomiting, diarrhea, hair loss etc. will appear. Although it is called a side effect, it can be said to be the original action if considering the property of anticancer drug that it is taken in and acts on cells with fast growth rate.
However, when chemotherapy is completed, many side effects will be eliminated promptly. It may take more than a few months to completely recover. On the other hand, there is an individual difference. Some race, or even the same Japanese people, have side effects strongly. Irinotecan (CPT - 11) is a commonly used anticancer agent for colorectal cancer, but in people with abnormal enzyme related to this there is a strong toxicity of (CPT - 11). A certain degree of discrimination is possible by genetic testing.
On the other hand, it is a molecular target drug, but there are special side effects. Cancer will make a new blood vessel to secure necessary blood to grow cancer, but there is medicine called bevacizumab (released in June 2007) to suppress this. Although side effects include hypertension and nose bleeding, serious things such as arterial occlusion are rarely caused.
We exchange information to proliferate cancer cells. Cetuximab (released in July 2008) and panitumumab (released in June 2010) are anti-EGFR antibodies that block a part of this information network. Adverse events are mainly skin disorders such as rashes and skin cracks. From April 2010, K-RAS gene mutation testing, which determines the therapeutic effect beforehand, is now undertaken in insurance medical treatment. In May, 20th, Legolafenib which blocks a wider range of information networks was released, there are many skin disorders as side effects, high blood pressure, bleeding, rarely liver failure, etc.

Ⅰ. Introduction
The number of deaths of primary liver cancer in our country increased from 8291 (1958) to 34637 (2002). By gender, men were 23,815 (2002), women was 11822 (2002). After that, the number of deceased people has decreased, but it exceeds 30,000 a year in the past.
Possible cause of decrease in the number of liver cancer deaths are as follows:
1) Increase in other diseases and deaths due to the aging of the age group of primary liver cancer
2) Diffusion of periodic imaging diagnosis for hepatitis virus positive people accounting for approximately 90% of patients Increase in early detection cases by
③ Increase in carcinogenesis by antiviral therapy
④ Advances in the treatment of liver cancer


may be considered. 
However, because hepatocellular carcinoma is poor in subjective symptoms, it is still found in advanced hepatocellular carcinoma, except for patients who are enclosed as high-risk group of liver cancer and regular imaging diagnosis is done Current situation is that there are many cases.
Progressive hepatocellular carcinoma is not clearly defined, but (
1) giant liver cancer with a maximum tumor size greater than 10 cm (
2) cases with advanced vascular invasion (
3) multiple cases in the liver (
4)
a case with distant metastasis is advanced In addition, it is difficult to treat patients with hepatopathy degree C or Child-PughC in which the liver reserve capacity has decreased. For each case, it is a principle to accurately grasp the pathology such as primary tumor, vascular invasion, metastatic lesion, liver reserve and the like, and to perform custom-made treatment according to each case in principle, and a multidisciplinary treatment is desired I will.

Ⅱ. Origin of hepatocellular carcinoma
Cirrhosis and liver cancer in Asian countries are dominated by HBV-positive individuals. For example, in Korea, 74% of liver cancer is positive for HBs antigen, HCV antibody positivity is 9%, alcoholicity is only 7%, while the cause of cirrhosis and liver cancer in our country is few HBV and HCV positive It is occupied principally. At the 44 th Annual Meeting of the Japanese Society of Hepatology held in 2008, results of each institution were gathered from the main facilities nationwide, and the causes were analyzed for 17262 cases of liver cirrhosis (FIG. 1) and 16117 cases of hepatocellular carcinoma (FIG. 2) It was. In Japan overall, 73% of liver cancer is positive for HCV antibody, 14% is positive for HBs antigen, and it is very different from South Korea's achievement. In Japan, the cause of cirrhosis of cirrhosis has been investigated 5 times from the General Assembly of the Japanese Gastroenterology Society of 1983 to the Japan Society of Hepatic Societies in 2011. B type hepatocellular carcinoma is almost constant in the number of deceased but due to the increase in type C hepatocellular carcinoma the proportion of type B has decreased from 23.3% in 1983 to 13.1% in 2011 I will. In addition, in the results after 1998, which is a survey after the diagnosis of HCV was established, the non-B non-C type increased from 21.8% to 26.2%. It is believed that both B and C hepatocellular carcinomas will decrease in the future and non-B non-C hepatocellular carcinomas such as NASH (nonalcoholic steatohepatitis) liver cancer will increase.

Ⅲ. Progression classification of hepatocellular carcinoma and treatment algorithm
Progression classification and prognosis
The degree of progression of hepatocarcinoma described in the handling regulation of primary liver cancer is classified as Stage I to IV according to the highest numerical value of each patient by obtaining the progress value of that patient by each item. Life prognosis of hepatocellular carcinoma greatly influences not only tumor progression but also liver reserve. In the treatment regulations for primary liver cancer, we present classification of hepatopathy degree incorporating ICG burden test instead of hepatic encephalopathy in Child-Pugh classification. The 5-year survival rate of hepatectomized cases was 59%, 45.3%, and 35.0% for liver damage degree A, B, and C, respectively.

Ⅴ. in conclusion
Even at our hospital, any treatment other than liver transplantation is possible, but it is important to start treatment at the stage of chronic hepatitis because it is not cancer. For hepatitis C, it changed from traditional interferon treatment to treatment with oral medicine, and more than 90% virus removal became possible. Also in hepatitis B it has become possible to stabilize hepatitis and prevention of cancer with nucleic acid analog formulation. Early diagnosis of NASH (nonalcoholic steatohepatitis), which is expected to increase in the future, will lead to the prevention of NASH liver cancer.