Background: Living alone and limited social interaction are associated with frailty, while low satisfaction with interactions is associated with negative health outcomes. However, the effects of living arrangements, interaction frequency, and interaction satisfaction on physical frailty remain unclear. This study examined the associations among living arrangements, the frequency and satisfaction of social interactions, and physical frailty among community-dwelling older adults. Methods: A cross-sectional study was conducted among 5,538 community-dwelling adults aged 60 or older living in Aichi Prefecture, Japan. The revised Japanese version of the Cardiovascular Health Study criteria evaluated physical frailty. Frequency and satisfaction of social interactions were evaluated using the National Center for Geriatrics and Gerontology–Social Network Scale (SNS). Logistic regression analysis was conducted by living arrangement, with physical frailty as the dependent variable and the SNS as the explanatory variable. In the sensitivity analysis, SNS was categorized into two groups based on the median, then combined with living arrangements into four groups to examine the association with physical frailty. Results: A total of 338 (6.3%) participants were classified as physically frail. Participants with high SNS scores showed significantly lower odds of physical frailty regardless of living arrangement (OR: 0.36, 95% confidence interval [CI]: 0.16-0.80; OR: 0.66, 95% CI: 0.45-0.96). Sensitivity analysis similarly showed the high SNS group had lower ORs for physical frailty, regardless of living arrangements. Conclusion High frequency and satisfaction with social interactions were negatively associated with physical frailty, suggesting that enhancing both aspects of social engagement may be beneficial.

The Japan Anti-Doping Agency aims to eliminate doping to protect athletes’ health. However, unintentional doping violations can occur when athletes unknowingly consume prohibited substances. As future professionals, student pharmacists are expected to learn about anti-doping measures, while sports science students must learn how to comply with regulations. However, comparative studies on anti-doping awareness among students from different faculties remain limited in Japan. In this study we surveyed students from Nihon University who took Introduction to Anti-doping in the College of Sports Sciences, 2023, and student pharmacists who took the Science of Health and Physical Fitness II course in the School of Pharmacy, 2024. A comparison of the responses for each question of the survey revealed a significant difference in knowledge content regarding medicines. However, there were no apparent differences between the two faculties of participants in terms of awareness of anti-doping measures. Next, using qualitative research by text mining, we also found differences in anti-doping awareness among students of each school. First, the student pharmacists responses consisted of comments like: “Supporting athletes as a pharmacist,” “An interest in becoming a sports pharmacist” and “Consideration for patients who are athletes.” On the other hand, the Sports Science students responses consisted of comments like “Necessary for coaching athletes,” “Attitude toward doping as an athlete” and “Acquisition of knowledge through lectures.” In this study, qualitative analysis using text mining revealed that both the sports science students and pharmacy students constructed faculty-dependent behavioral goals related to anti-doping, demonstrating the usefulness of these courses.

A woman in her 60 s presented with chest pain. The electrocardiography showed ST depressed in V3-V6, ST elevation in aVR, and negative T in I, II, aVL, and aVF. Laboratory examination revealed that creatinine kinase isoenzyme-MB and troponin I were elevated. Transthoracic echocardiography revealed moderate aortic regurgitation. Enhanced computed tomography did not show an aortic dissection. Acute coronary syndrome was suspected and cardiac catheterization was done. Aortography showed an intimal flap inside the Valsalva sinus. An emergency operation was performed. Surgical view: the intimal tear affected almost all the circumference of the aorta in the Valsalva sinus and the aortic dissection with a localized and moving intimal flap affected the coronary flow and the aortic dissection caused severe aortic regurgitation and decreased the coronary flow. An aortic root replacement was successfully performed, and the postoperative course was uneventful.

Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

Circulation is required for the delivery of oxygen and nutrition to tissues and organs, as well as waste collection. Therefore, the heart and vessels develop first during embryogenesis.The circulatory system consists of the heart, blood vessels, and blood cells, which originate from the mesoderm. The gene expression pattern required for blood vessel development is predetermined by the hierarchical and sequential regulation of genes for the differentiation of mesodermal cells. Herein, we review how blood vessels form distinctly in different tissues or organs of zebrafish and how vessel formation is universally or tissue-specifically regulated by signal transduction pathways and blood flow. In addition, the unsolved issues of mutual contacts and interplay of circulatory organs during embryogenesis are discussed.

Paroxysmal atrial fibrillation (pAf) is an arrhythmia that often occurs in the elderly. The quality of life often declines due to severe palpitations caused by pAf. We present a case of recurrent pAf that occurred on postoperative day 2 of coronary artery bypass grafting and pulmonary vein isolation for unstable angina pectoris and pAf. The patient was a 62-year-old man who complained of palpitations, which was consistent with pAf on the monitor ECG. During hospitalization, the patient was constantly wearing an ECG monitor. During pAf, the heart rate was around 120 bpm, and pAf could continue for up to and beyond 24 hours. Paroxysmal atrial fibrillation with strong palpitations was observed every day, even after starting beta-blockers and anticoagulants. After discharge, a Japanese Kampo medicine called shakanzoto was taken for a month, but there was no improvement. After that, it was changed to another Japanese Kampo medicine called saikokaryukotsuboreito, because abdominal examination revealed kyokyokuman (hypochondriac discomfort and distension (resistance)) and saiboki (brisk pulsation in the para-umbilical region). Palpitations quickly improved dramatically. It was speculated that not only palpitations but also pAf had been improved.

Circulation is required for the delivery of oxygen and nutrition to tissues and organs, as well as waste collection. Therefore, the heart and vessels develop first during embryogenesis.The circulatory system consists of the heart, blood vessels, and blood cells, which originate from the mesoderm. The gene expression pattern required for blood vessel development is predetermined by the hierarchical and sequential regulation of genes for the differentiation of mesodermal cells. Herein, we review how blood vessels form distinctly in different tissues or organs of zebrafish and how vessel formation is universally or tissue-specifically regulated by signal transduction pathways and blood flow. In addition, the unsolved issues of mutual contacts and interplay of circulatory organs during embryogenesis are discussed.

Background : Fungal mycotic aneurysm is rare ; however, special care and treatment are required for the deep fungal infection itself. Case : The patient was a 69-year-old man with a history of sepsis due to Candida albicans. He suffered from back pain and moderate fever. CT revealed saccular-form aneurysm at the infrarenal abdominal aorta. After emergent in situ bifurcated graft replacement of the infected aneurysm, antifungal treatment was attempted in reference to the antifungal drug sensitivity of C. albicans from intraoperative cultures and findings of fungal endophthalmitis in an ophthalmic examination. After an uneventful acute course, follow up CT images after 12 months postoperatively revealed pseudoaneurysm formation proximal to the site of graft anastomosis. Reoperation was planned with a trans-thoracic and transabdominal approach because of concerns about thoracoabdominal aortic infection. However, the reoperation displayed only inflammatory tissue around the graft and aortic tissue. Removal of the previous graft and reconstruction of the bilateral renal artery, and the pararenal abdominal aorta to the bilateral common iliac artery was performed. Intraoperative tissue cultures revealed no evidence of microorganisms. He returned home with oral antifungal treatment and is doing well at 8 months after the reoperation. Conclusions : Management of fungal mycotic aneurysms requires both surgical treatment and antifungal treatment. Antifungal agents should be selected based on the results of a susceptibility test and after examinations for metastatic comorbidities.

A 62-year-old man was referred to our hospital because of dyspnea. Electrocardiogram showed chronic atrial fibrillation and echocardiogram revealed severe tricuspid regurgitation. His history included a motorbike accident at age 17, and a heart murmur was pointed out in the following year. He developed paroxysmal atrial fibrillation when he was 45 years old. Heart failure was not controlled by medication and tricuspid valve repair was indicated. At surgery, the anterior leaflet of tricuspid valve was widely prolapsed due to chordal rupture. We performed chordal reconstruction with 4 expanded polytetrafluoroethylene (CV-5®) sutures, and ring annuloplasty. Furthermore, a small fenestration at the tricuspid annulus was noticed and was closed with a direct suture. The biatrial modified Maze procedure was performed subsequently. The patient is doing well without TR recurrence, and restored sinus rhythm is maintained. We report successful repair of traumatic tricuspid regurgitation.

Although the trunk segment shows well-coordinated movements in concert with the arms and legs during bipedal walking, little is understood about the neural mechanisms controlling the trunk muscles in response to sudden tactile sensations in the foot during walking. This study examined the cutaneous reflexes (CR) to shed light on the neural mechanisms underlying the regulation of the trunk muscles during walking and standing. Eleven healthy men participated in the study. Electromyographic (EMG) activities were recorded in the trapezius (TRAP), erector spinae (ES), and rectus abdominis (RA) muscles. To elicit CR, non-noxious electrical stimulation of the sural nerve at the ipsilateral lateral malleolus was applied during treadmill walking and tonic contraction of the test muscles during standing. During walking, cutaneous nerve stimulation in the foot gave rise to facilitatory CR in all the muscles, and the amplitude of the CR was strongly modulated in a phase-dependent manner. The amplitude of the background EMG and the amplitude of the CR showed a highly significant correlation in all the muscle tested during standing. However, this was true only in the ES during walking. In the RA, the inhibitory CR during standing changed to a facilitatory one during walking. In addition, reflex ratios were significantly larger during walking than standing. These findings suggest that common neural mechanisms in limb muscles could function in the TRAP and RA, however, in the ES disparate neural mechanisms play a crucial role in modulating cutaneous reflexes during walking and standing.