An 81-year-old woman sustained a fracture of the vertebra, resulting in grace deformation. After surgery for the spinal fixation, she suffered from left femoral neuropathic pain and motor weakness of both lower extremities. Daily repetitive transcranial magnetic stimulation (rTMS) of the lower extremity area in the right motor cortex was applied using a figure-8 coil connected to a magnetic stimulator (MagPro R30；Nagventure)．One thousand pulses per session were delivered (10 trains of 10Hz for 10 seconds with 25-seconds intertrain interval) in one day, and this treatment continued for 2 weeks except Sunday. The intensity of rTMS was set at the resting motor threshold for that day. rTMS together with physical therapy resulted in a remarkable amelioration of the femoral pain and motor weakness of both lower extremities. Pain on a Visual Analogue Scale dropped from 70％ to 22％, and walking speed and walking rate increased. Functional Independence Measure score increased from 58 to 79, and Euro QOL 5 score increased from 0.419 to 0.768. As previously reported in cases of post-stroke pain and motor weakness, rTMS together with physical therapy exerted measurable beneficial effects on intractable pain and motor weakness caused by spinal orthodontic fixation.

The purpose of this study was to examine epidemiology of injury in a male collegiate volleyball team in Japan during 2019 season. Thirty-six collegiate male volleyball players were followed during 2019 season. Injuries that required more than 24 hours to recover were classified as Time Loss (TL) injury, and those that required less than 24 hours were classified as Non-Time Loss (NTL) injury. Exposure was calculated by total number of players and hours of participation. Then, we computed injury rate per 1000 Player Hour (PH) and 1000 Athlete Exposure (AE) as outcome measures. A chi-square test was utilized to statistically compare. Eighteen injuries occurred and the overall injury rate was 1.28/1000PH and 2.05/1000AE, respectively. Of which, 11 cases were NTL injuries (0.78/1000PH, 1.26/1000AE) and 7 cases were TL injuries (0.50/1000PH, 0.80/1000AE). Within the 7 TL injuries, 5 (0.36/1000PH, 0.57/1000AE) were of minor severity. Most TL injury were classified as chronic in nature (n=5, 0.36/1000PH, 0.57/1000AE). There was no statistically significant difference between injury rate of match (n=2, 1.33/1000PH, 2.88/1000AE) and training (n=16, 1.27/1000PH, 1.98/1000AE). The most frequently injured body part in training was lower back (n=7, 0.56/1000PH, 0.87/1000AE). In match, highest injury rate was observed in ankle (n=2, 1.33/1000PH, 2.88/1000AE). In conclusion, our results showed relatively low injury rate, and majority of reported injuries were categorized as minor severity. Our study also demonstrated injury characteristics of Japanese male collegiate players that lower back injuries were prevalent in training, and acute ankle injury rate was highest in match.

A 67-year-old man with Stage IV gastric cancer (cT3N2M1) received chemotherapy. However, he had progressive disease and then, received palliative care. One day, he was admitted for difficulty in body movement. He had severe anemia (Hb: 3.4 g/dl) caused by tumor bleeding and needed frequent blood transfusions. Palliative radiotherapy (RT) was conducted to control the bleeding. However, hemostasis was not achieved despite daily palliative RT and blood transfusions. Gastrointestinal endoscopy showed oozing blood from gastric cancer and his Hb levels dropped to 2.8 g/dl. Transcatheter arterial embolization (TAE) with gelatin sponge was performed as salvage therapy. TAE was effective and his Hb levels improved to 8.0 g/dl, and he was discharged from the hospital. RT is an effective modality for gastric bleeding control in gastric cancer. However, salvage therapy is sometimes needed but difficult to conduct. TAE was effective salvage therapy in this case.