Anti-phospholipid antibody syndrome (APLS) is characterized by the presence of anti-phospholipid antibodies, arterial or venous thrombosis, recurrent abortion, and thrombocytopenia. Although heart valve abnormalities are found in most patients with APLS, acute type A dissection associated with APLS is rare. A 44-year-old woman with systemic lupus erythematosus and APLS, who had been treated with corticosteroids, immunosuppressive agents, and warfarin, was admitted with severe back pain. Computed tomography demonstrated aortic dissection extending from the ascending to the abdominal aorta. Emergency ascending aorta replacement was performed. The hypercoagulation associated with APLS made it difficult to achieve optimal postoperative anticoagulant control. Moreover, corticosteroids and immunosuppressive agents may result in postoperative infection. However, this patient was discharged without complications 14 days after the operation.

A 65-year-old man was admitted with a high fever and back pain. Because magnetic resonance imaging revealed osteomyelitis in the lumbar spine, we started antibiotic therapy. Echocardiography revealed large vegetation on the tricuspid valve, and abdominal contrast computed tomography revealed a pancreatic abscess. As the vegetation increased in size and mobility it became non-responsive to medical treatment, and surgical removal of the vegetation with tricuspid valve repair were therefore performed. After additional antibiotic therapy, he was discharged 42 days after surgery. No further recurrence of endocarditis has been observed as of the time of writing.

Introduction: Our aim was to examine the changes in the self-rated frequency of activities among elderly residents living in communities during the self-restraint period associated with the Coronavirus Disease 2019 (COVID-19) pandemic.Methods: Regular outpatients aged 75 years or older who visited the hospital or clinic at the Center for Community Medicine in north-western Gifu prefecture between May 11 and May 22, 2020 were selected as participants. The frequency of outings, walks, outdoor exercise, indoor exercise, farm work, communication and interaction, such as at community salons, direct communication with friends and estranged family members, and remote communication by telephone and video calls was surveyed using a questionnaire method at four levels: "0 days", "1-2 days", "3-4 days", and "5 days to every day" per week in the two weeks prior to the visit and in the same period in the previous year.Results: In total, 292 people aged 75-95 years participated in the study. There was an increase in the number of respondents who reported a lower frequency of going out, walking, farming, outdoor exercise, home exercise, visiting community salons, and direct conversation than in the previous year. There was a significant difference between the two groups (P<0.05).Conclusion: In this study, the self-rated frequency of physical activity and social activity decreased among community-dwelling elderly due to the COVID-19 epidemic, suggesting a reduction in these activities.

Objective: To determine the appropriate time points to start regular exercise which could reduce age-related anxiety and impaired social behavior. Methods: For this study, 8-week-old male Wistar rats were divided into three groups: no exercise (NoEX), short-term exercise (S-Ex), and long-term exercise (L-Ex) groups. S-Ex-group rats started treadmill exercise at 12 months of age, while L-Ex rats started from at 2 months of age. Exercise rats were forced to walk on the treadmill three times per week, with 1- to 2-day intervals for 10 minutes during the first 2 weeks, at 10 m/min until 17 months of age, and at 8 m/min thereafter. At 19 months of age, behavioral tests were performed to assess the effects of exercise on age-induced behavioral change as well as quantitative polymerase chain reaction were done to uncover the mechanism behind the behavioral changes. Results: Anxiety-like behavior was improved by long-term exercise. Additionally, rats belonging to the S-Ex and L-Ex groups showed improved social behavior and increased curiosity about interesting objects. The qPCR data showed that treadmill exercise suppressed the expression of immediate-early genes in the prefrontal cortex of the aged rats. Conclusion This study suggests that long-term exercise represses early response genes, and in this way, it increases resistance to stress, diminishes anxiety-related behavior, and improves social behavior. These findings underscore the need to consider appropriate time to start exercise to prevent stress induced anxiety related behavior.