Objective: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant B.1.1.529 (Omicron) was first detected in Japan in November 2021. In Osaka, public health centres subsequently increased active case finding and encouraged self-isolation. This study investigated the effectiveness of these countermeasures. Methods: Cases targeted for analysis were persons who had neither recently travelled abroad nor had contact with foreign tourists but tested positive for SARS-CoV-2 between 24 November 2021 and 4 January 2022 and were suspected or confirmed to have the Omicron variant. We performed a descriptive analysis and calculated the reproduction number (R) for each generation using the branching process method. Genomic sequencing data were analysed to plot a haplotype network. Results: A total of 251 cases were analysed. The median age was 30 years, and 46% (115/251) were in their 20s or younger. The first Omicron case in Osaka was detected on 21 December 2021. Local public health centres conducted health monitoring and contact tracing. We analysed R, using information from six clusters, including 42 pairs with a clear relationship between the case and the infected contact (infector–infectee pairs); the clusters had 19, 21 and 2 cases in each subsequent generation. The basic R (t = 0) was estimated to be 3.2, and subsequent generations (t = 1, 2) of R decreased to 1.1 and 0.1, respectively. The haplotype network showed that these cases constituted a monophyletic group with others detected around Osaka, indicating that these case-related clusters had been contained and were not involved in the nationwide Omicron waves. Discussion: Active case finding and self-isolation were found to be effective in limiting the spread of an emerging novel variant.

Background/Aims: Serum leucine-rich alpha-2 glycoprotein (LRG) is a potential biomarker of Crohn’s disease (CD). This study aimed to evaluate the usefulness of LRG in predicting clinical relapse in patients in remission with CD. Methods: This retrospective observational study assessed the relationships among patient-reported outcome (PRO2), LRG, and other blood markers. The influence of LRG on clinical relapse was assessed in patients in remission with CD. Results: Data of 94 patients tested for LRG between January 2021 and May 2023 were collected. LRG level did not correlate with PRO2 score (ρ = 0.06); however, it strongly correlated with C-reactive protein (CRP) level (r=0.79) and serum albumin level (r=–0.70). Among 69 patients in clinical remission, relapse occurred in 22 patients (31.9%). In the context of predicting relapse, LRG showed the highest area under the curve, followed by CRP level, platelet count, and albumin level. Multivariate analysis revealed that only LRG (P= 0.02) was an independent factor for predicting clinical remission. The cumulative non-relapse rate was significantly higher in patients with LRG < 13.8 μg/mL than in patients in remission with LRG ≥ 13.8 μg/mL and normal CRP level (P= 0.002) or normal albumin level (P= 0.001). Cumulative non-relapse rate was also higher in patients with LRG < 13.8 μg/mL compared to those with LRG ≥ 13.8 μg/mL in patients with L3 or B2+B3 of Montreal calcification. Conclusions LRG is useful in predicting clinical relapse in patients with CD during biological remission. LRG is a useful biomarker for predicting prognosis, even in patients with intestinal stenosis, or previous/present fistulas.

Background/Aims: Serum leucine-rich alpha-2 glycoprotein (LRG) is a potential biomarker of Crohn’s disease (CD). This study aimed to evaluate the usefulness of LRG in predicting clinical relapse in patients in remission with CD. Methods: This retrospective observational study assessed the relationships among patient-reported outcome (PRO2), LRG, and other blood markers. The influence of LRG on clinical relapse was assessed in patients in remission with CD. Results: Data of 94 patients tested for LRG between January 2021 and May 2023 were collected. LRG level did not correlate with PRO2 score (ρ = 0.06); however, it strongly correlated with C-reactive protein (CRP) level (r=0.79) and serum albumin level (r=–0.70). Among 69 patients in clinical remission, relapse occurred in 22 patients (31.9%). In the context of predicting relapse, LRG showed the highest area under the curve, followed by CRP level, platelet count, and albumin level. Multivariate analysis revealed that only LRG (P= 0.02) was an independent factor for predicting clinical remission. The cumulative non-relapse rate was significantly higher in patients with LRG < 13.8 μg/mL than in patients in remission with LRG ≥ 13.8 μg/mL and normal CRP level (P= 0.002) or normal albumin level (P= 0.001). Cumulative non-relapse rate was also higher in patients with LRG < 13.8 μg/mL compared to those with LRG ≥ 13.8 μg/mL in patients with L3 or B2+B3 of Montreal calcification. Conclusions LRG is useful in predicting clinical relapse in patients with CD during biological remission. LRG is a useful biomarker for predicting prognosis, even in patients with intestinal stenosis, or previous/present fistulas.

We herein report a case of a 19-year-old male patient who presented with traumatic alopecia and was successfully treated with Kampo formulation saikoseikanto (Ikkando). This patient was referred to the Kampo outpatient department of Hoshi General Hospital from a neurosurgery hospital located near his workplace. The reason for the consultation was alopecia with subcutaneous hemorrhage that appeared several days after a blow to his parietal region. The patient presented with kyokyokuman on the right side along with chronic pharyngitis. We suspected that the alopecia was caused by folliculitis, so we prescribed saikoseikanto. The results of this medication were dramatic ; his alopecia and pharyngeal inflammation resolved within three months. His depressive mental state and his irritability improved significantly. We recognized that this Kampo formulation controlled both physical and mental disorders.

We herein report a case of a 72-year-old man who complained of recurrent hyperalgesia in the right big toe, which was successfully treated with the Kampo formulation ninjin’yoeito. The unusual pain felt like being cut with a utility knife whenever his skin was lightly scraped with a toothpick. There was mild tactile loss at this area, however, there were no other sensory disturbances in the sense of pain, cold, or vibration. This patient’s hobby was Iaido, a type of Kendo, which places stress on the soles of the feet. Therefore, we speculated that the clinical disorder in this case was related to his exercise. This patient exhibited a pattern of qi and blood deficiency with qi uprising, which suggested the use of ninjin’yoeito. After taking this Kampo formulation, his abnormal hyperalgesia with coldness in the big toe resolved. There have been no prior reports of ninjin’yoeito effectively treating unusual hyperalgesia.

We herein report the case of a 68-year-old female patient whose branch-type intraductal papillary mucinous neoplasm (IPMN) regressed during thirteen years of Kampo treatment. The Kampo treatment was not aimed at treating IPMN but rather at addressing her complex complaints, such as menopausal disorders, chronic headaches and abdominal pain. During this period, her IPMN was monitored by MRCP every year without any medication or surgical intervention. The regression of IPMN is extremely rare. Therefore, we report this case by presenting the course of MRCP images along with an overview of Kampo treatment over these thirteen years.

Background/Aims: Serum leucine-rich alpha-2 glycoprotein (LRG) is a potential biomarker of Crohn’s disease (CD). This study aimed to evaluate the usefulness of LRG in predicting clinical relapse in patients in remission with CD. Methods: This retrospective observational study assessed the relationships among patient-reported outcome (PRO2), LRG, and other blood markers. The influence of LRG on clinical relapse was assessed in patients in remission with CD. Results: Data of 94 patients tested for LRG between January 2021 and May 2023 were collected. LRG level did not correlate with PRO2 score (ρ = 0.06); however, it strongly correlated with C-reactive protein (CRP) level (r=0.79) and serum albumin level (r=–0.70). Among 69 patients in clinical remission, relapse occurred in 22 patients (31.9%). In the context of predicting relapse, LRG showed the highest area under the curve, followed by CRP level, platelet count, and albumin level. Multivariate analysis revealed that only LRG (P= 0.02) was an independent factor for predicting clinical remission. The cumulative non-relapse rate was significantly higher in patients with LRG < 13.8 μg/mL than in patients in remission with LRG ≥ 13.8 μg/mL and normal CRP level (P= 0.002) or normal albumin level (P= 0.001). Cumulative non-relapse rate was also higher in patients with LRG < 13.8 μg/mL compared to those with LRG ≥ 13.8 μg/mL in patients with L3 or B2+B3 of Montreal calcification. Conclusions LRG is useful in predicting clinical relapse in patients with CD during biological remission. LRG is a useful biomarker for predicting prognosis, even in patients with intestinal stenosis, or previous/present fistulas.

Objective：An inertial sensor-based motion capture system for rehabilitation therapy is feasible due to its simple measurement methods. However, a standard value must be used to evaluate or diagnose pathological gait kinematically. This study aimed to set a standard value by determining the averaged spatial-temporal parameter (STP) and range of motion (ROM) during gait in healthy participants.Methods：This study included 177 healthy individuals, who were grouped into six groups according to gender (male and female) and age (young, middle, and old). All participants walked under two speed conditions (NORMAL or FAST) and the gait was captured with an inertial sensor-based motion capture system. Eight types of STP and fourteen types of ROM were calculated.Results：Of the 132 variables (22 variables × 2 sexes × 3 ages), 123 variables for NORMAL and 112 variables for FAST followed the normal distribution. A main effect of age on walking velocity for FAST was noted but not for NORMAL. The middle and old ages depended on an increased cadence for maintaining walking velocity. Ankle and hip ROMs in the old were smaller than that in the young, and these differences were demonstrated more so during the FAST condition. There were gender differences in hip ROMs (men had greater internal-external rotation and women had greater flexion-extension).Conclusion：The standard value can be determined from variables in gait assessment, for young to elderly, and gender-specific.

Objective：An inertial sensor-based motion capture system for rehabilitation therapy is feasible due to its simple measurement methods. However, a standard value must be used to evaluate or diagnose pathological gait kinematically. This study aimed to set a standard value by determining the averaged spatial-temporal parameter (STP) and range of motion (ROM) during gait in healthy participants.Methods：This study included 177 healthy individuals, who were grouped into six groups according to gender (male and female) and age (young, middle, and old). All participants walked under two speed conditions (NORMAL or FAST) and the gait was captured with an inertial sensor-based motion capture system. Eight types of STP and fourteen types of ROM were calculated.Results：Of the 132 variables (22 variables × 2 sexes × 3 ages), 123 variables for NORMAL and 112 variables for FAST followed the normal distribution. A main effect of age on walking velocity for FAST was noted but not for NORMAL. The middle and old ages depended on an increased cadence for maintaining walking velocity. Ankle and hip ROMs in the old were smaller than that in the young, and these differences were demonstrated more so during the FAST condition. There were gender differences in hip ROMs (men had greater internal-external rotation and women had greater flexion-extension).Conclusion：The standard value can be determined from variables in gait assessment, for young to elderly, and gender-specific.

Purpose: Although patients with late-onset hypogonadism (LOH) often experience lower urinary tract symptoms (LUTS), LUTS are not generally included in LOH symptoms. No study has examined the direct relation of the Aging Males Symptoms rating scale (AMS) and the International Prostate Symptom Score (IPSS) with the quality of life (QOL) index. We analyzed the relation between the IPSS and QOL index and various factors including the AMS in patients with LOH syndromes. Materials and Methods: This study comprised 1,688 men with LOH symptoms who visited our hospital or affiliated clinic. Factors associated with the IPSS were assessed in terms of age, scores of several questionnaires including the AMS, endocrinological variables, and serum concentration of PSA. Among these same factors, those associated with the QOL index were also evaluated. Finally, the same analyses were repeated in 187 patients with low serum testosterone concentration (<3.0 ng/ mL). Results: In a multivariate analysis using the significant items from the univariate analysis, AMS, age, and Erection Hardness Score correlated significantly with the IPSS. A trend analysis using items other than the AMS as adjustment factors also confirmed the relationship between an increase in QOL index and an increase in AMS. Similar results were obtained in the analysis of patients with low serum testosterone concentration. Conclusions We revealed that the relation of IPSS with the QOL index for LUTS is closely associated with the AMS for LOH, regardless of testosterone level. When patients complain of LOH symptoms, a careful, detailed inquiry into LUTS is required.