Cirrhosis is a chronic condition that can lead to liver failure. Currently, the viable option for decreasing mortality is liver transplantation. However, transplant surgery is highly invasive. Therefore, cell-based therapy has been developed as an alternative. Based on promising findings from preclinical research, some new trials have been registered. One of them was autologous bone marrow cell infusion therapy and found that ameliorating liver fibrosis activated liver regeneration. Now, majority of trials focus on low-immunogenicity mesenchymal stem cells (MSCs) appropriate for allogeneic administration. However, despite about 20 years of research, only a limited number of cell-based therapies have entered routine practice. Furthermore, potential shortcomings of cell-based therapy include a limit on the number of cells, which may be administered, as well as their failure to infiltrate target organs. On the other hand, these research show that MSCs act as “conducting cells” and regulate host cells including macrophages via extracellular vesicles (EVs) or exosome signals, leading to ameliorate liver fibrosis and promote regeneration. Therefore, the concept of cell-free therapy, which makes use of cell-derived EVs or exosomes, is attracting attention. Cell-free therapies may be safely administered in large doses and are able to infiltrate target organs. However, development of cell-free therapy exhibits its own set of challenges and such therapy may not be completely curative in the context of liver disease. This review describes the history of cell-based therapy research and recent advances in cell-free therapy, as well as discussing the need for more effective therapies.

STUDY DESIGN: A retrospective study. PURPOSE: The aims of this study were to investigate the diagnostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in PET/computed tomography (CT) in the evaluation of spinal metastatic lesions. OVERVIEW OF LITERATURE: Recent studies described limitations regarding how many lesions with abnormal 18F-FDG PET findings in the bone show corresponding morphologic abnormalities. METHODS: The subjects for this retrospective study were 227 patients with primary malignant tumors, who were suspected of having spinal metastases. They underwent combined whole-body 18F-FDG PET/CT scanning for evaluation of known neoplasms in the whole spine. 99mTc-methylene diphosphonate bone scan was performed within 2 weeks following PET/CT examinations. The final diagnosis of spinal metastasis was established by histopathological examination regarding bone biopsy or magnetic resonance imaging (MRI) findings, and follow-up MRI, CT and 18F-FDG PET for extensively wide lesions with subsequent progression. RESULTS: From a total of 504 spinal lesions in 227 patients, 224 lesions showed discordant image findings. For 122 metastatic lesions with confirmed diagnosis, the sensitivity/specificity of bone scan and FDG PET were 84%/21% and 89%/76%, respectively. In 102 true-positive metastatic lesions, the bone scan depicted predominantly osteosclerotic changes in 36% and osteolytic changes in 19%. In 109 true-positive lesions of FDG PET, osteolytic changes were depicted predominantly in 38% while osteosclerotic changes were portrayed in 15%. CONCLUSIONS: 18F-FDG PET in PET/CT could be used as a substitute for bone scan in the evaluation of spinal metastasis, especially for patients with spinal osteolytic lesions on CT.
Biopsy ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Spine ; Technetium Tc 99m Medronate

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).
Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

 The effects of bathing in a solution of artificial bath additive including inorganic salts and carbon dioxide (CO2-bathing: 41°C, 10 minutes; the concentration of carbon dioxide was 160-180 ppm, and that of inorganic salts was about 64 ppm) on the cardiovascular system, body flexibility, muscle stiffness and the subjective feeling of bathing were compared with those of no bathing and plain water bathing in the healthy subjects.  The deep body temperature and skin blood flow increased after bathing, and the increases after CO2-bathing were significantly greater than those after plain water bathing. Body flexibility after CO2-bathing was similar to that of no bathing and plain water bathing.  Stiffness of the trapezius muscle was decreased at both 15 min and 30 min after CO2-bathing and plain water bathing, with no change in no bathing. The changes at 15 min after CO2-bathing and plain water bathing were statistically significant. Stiffness in the latissimus dorsi muscle decreased at both 15 min and 30 min after CO2-bathing and plain water bathing, with no change in no bathing. However, only these changes at 15 min and 30 min after CO2-bathing were statistically significant.  A large decrease in the stiffness of the trapezius muscle by its isometric contraction was observed during both CO2-bathing and plain water bathing, and the decrease after CO2-bathing was greater than that after plain water bathing. These changes did not reach statistical significance.  Improvements in subjective feeling of bathing were observed after both plain water bathing and CO2-bathing. Improvements after CO2-bathing in stiffness of muscle, ease of movements and mental relaxation were statistically greater than those after plain water bathing.  Compared with plain water bathing, CO2-bathing showed additional effects on muscle stiffness and subjective feeling of bathing. Further research is needed to confirm the effectiveness of the CO2-bathing alone and combined with isometric movements on muscle stiffness.