We encountered a terminally ill patient, who had resigned as hospital nurse soon after she had fallen ill. As a former health professional, she was acting the good patient and performing her part as a member of the family. The patient was suffering social pain, so much so that she seemed to be unable to express what was really on her mind. One day, the ex-nurse gave us her precious nurse pin. It was when it occurred to us that what the patient had said and behaved was an expression of spiritual pain. Then, we started exploring the meaning of what she had said and done and tried to get at the structure of her spiritual pain referring to Murata's three structures of the spiritual pain of terminally ill patients: “time existence,” “relational existence” and “autogenic existence.” Eventually, we found that her behavior to respond to the wish of her family and to keep a good relationship with her physicians, which she herself regarded as social pain, was to sweep away uneasiness about and fear of being left alone, that is, the spiritual pain associated with “relational existence.” We also found that the spiritual pain associated with “time existence” intermingled with her wish to continue to be a nurse as expressed in the handing over of her nurse's pin.
Pain ; Patients ; Nurses ; seconds ; SOCIAL

Strenuous exercise induces upper respiratory tract infection (URTI), whereas moderate exercise prevents URTI. This study aimed to assess the incidence of URTI and the association between URTI episodes and exercise duration in Japanese collegiate athletes. A cross-sectional survey was conducted with 1,740 participants; 1,235 responses were eligible for analysis. Participants were classified into three groups: control group (weekly total exercise duration <60 min, n=405), exercise group (weekly total exercise duration >60 min, n=193), and athlete group (joined a sports club and weekly exercise frequency >5 days, n=637). We requested the following information from participants: basic characteristics, incidence of URTI symptoms (fever, runny or plugged nose, sore throat, and cough) or influenza for each month over the past year, day of the week exercise is typically performed, and duration of exercise per week. The incidence of URTI episodes per year was significantly lower in the athlete group (2.0 ± 2.4 episodes) compared to the control group (2.6 ± 2.4 episodes, p<0.001). The incidence of URTI episodes did not significantly differ between the control group and exercise group (2.9 ± 2.9 episodes, p=0.607). Although the frequency of URTI episodes and exercise duration were not significantly associated among male athletes (p=0.209), they were positively associated in female athletes (p=0.027). These results indicate that Japanese collegiate athletes experience fewer URTI episodes than non-athletes, but athletes who exercise for long durations may frequently experience URTI, particularly female athletes.

Guanylyl cyclase C (GC-C) is a member of a family of enzymes that metabolize GTP to cGMP and was first identified as a receptor for heat-stable enterotoxin. Guanylin (GNY) has since been identified as an endogenous ligand for GC-C in the intestine of several mammalian species. The GNY/GC-C system regulates ion transportation and pH in the mucosa. Recently, it was reported that GC-C and GNY are involved in lipid metabolism in rat mesenteric adipose tissue macrophages. To examine the role of GC-C and GNY in lipid metabolism in cattle, we used a bovine mesenteric adipocyte primary culture system and a coculture system for bovine adipocytes and GNY-/GC-C-expressing macrophages. Fat droplets were observed to accumulate in bovine mesenteric adipocytes cultured alone, whereas few fat droplets accumulated in adipocytes indirectly cocultured with macrophages. We also observed that GC-C was present in bovine mesenteric adipose tissue, and that fat droplet accumulation decreased after in vitro GNY administration. Expressions of mRNAs encoding lipogenic factors decreased significantly in adipocytes after either coculture or GNY administration. These results suggest that the GNY/GC-C system is part of the control system for lipid accumulation in bovine mesenteric adipose tissue.
Adipocytes ; Adipose Tissue* ; Animals ; Cattle* ; Coculture Techniques ; Enterotoxins ; Guanosine Triphosphate ; Guanylate Cyclase* ; Humans ; Hydrogen-Ion Concentration ; In Vitro Techniques ; Intestines ; Ion Transport ; Lipid Metabolism ; Macrophages ; Mucous Membrane ; Rats ; RNA, Messenger