Methods: This study included a total of 85 patients between 2016 and 2021. Nonsurgical treatments were provided by the respiratory medicine department. HU values for metastatic spinal lesions were evaluated upon diagnosis of spinal metastasis (baseline) and at 3, 6, and 12 months thereafter. Patients were then divided into two groups based on the median HU increase from baseline to 3 months. Overall survival was assessed using the Kaplan-Meier method. Results: Based on the median change in HU value (124), 42 and 43 patients were categorized into the HU responder and non-responder groups, respectively. The median overall survival was significantly longer in the HU responder group than in the HU non-responder group (13.7 months vs. 6.4 months, p <0.001). Multiple linear regression analysis revealed that the use of antiresorptive agents and molecularly targeted therapies were factors significantly associated with an increase in HU. Conclusions An increase in HU values for metastatic spinal lesions after 3 months of treatment was correlated with a significantly longer overall survival in patients with NSCLC. Thus, HU measurements may not only serve as an easy and quantitative approach for evaluating treatment response in metastatic spinal lesions but also predict overall survival.

Methods: This study included a total of 85 patients between 2016 and 2021. Nonsurgical treatments were provided by the respiratory medicine department. HU values for metastatic spinal lesions were evaluated upon diagnosis of spinal metastasis (baseline) and at 3, 6, and 12 months thereafter. Patients were then divided into two groups based on the median HU increase from baseline to 3 months. Overall survival was assessed using the Kaplan-Meier method. Results: Based on the median change in HU value (124), 42 and 43 patients were categorized into the HU responder and non-responder groups, respectively. The median overall survival was significantly longer in the HU responder group than in the HU non-responder group (13.7 months vs. 6.4 months, p <0.001). Multiple linear regression analysis revealed that the use of antiresorptive agents and molecularly targeted therapies were factors significantly associated with an increase in HU. Conclusions An increase in HU values for metastatic spinal lesions after 3 months of treatment was correlated with a significantly longer overall survival in patients with NSCLC. Thus, HU measurements may not only serve as an easy and quantitative approach for evaluating treatment response in metastatic spinal lesions but also predict overall survival.

Methods: This study included a total of 85 patients between 2016 and 2021. Nonsurgical treatments were provided by the respiratory medicine department. HU values for metastatic spinal lesions were evaluated upon diagnosis of spinal metastasis (baseline) and at 3, 6, and 12 months thereafter. Patients were then divided into two groups based on the median HU increase from baseline to 3 months. Overall survival was assessed using the Kaplan-Meier method. Results: Based on the median change in HU value (124), 42 and 43 patients were categorized into the HU responder and non-responder groups, respectively. The median overall survival was significantly longer in the HU responder group than in the HU non-responder group (13.7 months vs. 6.4 months, p <0.001). Multiple linear regression analysis revealed that the use of antiresorptive agents and molecularly targeted therapies were factors significantly associated with an increase in HU. Conclusions An increase in HU values for metastatic spinal lesions after 3 months of treatment was correlated with a significantly longer overall survival in patients with NSCLC. Thus, HU measurements may not only serve as an easy and quantitative approach for evaluating treatment response in metastatic spinal lesions but also predict overall survival.

[Introduction] In accordance with the 2018 revision of the Medical Care Act, prefectures have established career development programs for regional quota physicians aimed at both securing physicians committed to regional medical care and fostering their career development. We have surveyed and reviewed these programs across each prefecture.[Methods] The authors gathered information on the programs, which includes the acquisition of medical specialties, as well as the timing and duration of regional assignments, from the websites of each prefecture. The analysis of start timing and duration was limited to internal medicine.[Results] All prefectures have formulated programs. In more than 30% of the prefectures, regional quota physicians can choose any specialty from all available specialties. The regional assignment typically begins three years post-graduation, with a duration of four years in most cases.[Discussion] This nationwide trend provides a resource to evaluate the state of post-graduate education for regional quota physicians and to consider the future enhancement of these programs.

Methods: This study enrolled 60 patients who underwent corrective surgery and were followed up for >2 years postoperatively. AdIS was defined as adolescent idiopathic scoliosis in patients who had no history of corrective surgery, had a primary thoracolumbar/lumbar (TL/L) curve, and were ≥30 years old at the time of surgery. Results: The AdIS (n=23; mean age, 53.1 years) and de novo (n=37; mean age, 70.0 years) groups were significantly different in terms of the main thoracic and TL/L curves, sagittal vertical axis, thoracic kyphosis, and thoracolumbar kyphosis preoperatively. The scores in the self-image domain of the SRS-22r (before surgery/2 years after surgery [PO2Y]) were 2.2/4.4 and 2.3/3.7 in the AdIS and de novo groups, respectively, and PO2Y was significantly different between the two groups (p<0.001). Multivariate regression analysis revealed that AdIS was an independent factor associated with self-image at PO2Y (p=0.039). Conclusions AdIS, a spinal deformity pathology, was identified as a significant factor associated with the self-image domain of SRS-22r in patients who underwent corrective surgery. AdIS is not solely classified based on pathology but also differs in terms of the clinical aspect of self-image improvement following corrective surgery.

Methods: We investigated 154 foramina at L5–S1 in 77 patients. All the patients had degenerative lumbar disorders and had undergone both conventional MRI and 3D-MRI during the same visit. Differences between the FSRs calculated from conventional and 3D-MRI reconstructions and any correlations with the plain radiography findings were assessed. Results: In foramina that had a FSR of <50% on conventional MRI, the difference between the FSR obtained using conventional MRI and 3D-MRI was 5.1%, with a correlation coefficient of 0.777. For foramina with a FSR ≥50% on conventional MRI, the difference was 20.2%, with a correlation coefficient of 0.54. FSR obtained using 3D-MRI was significantly greater in patients who required surgery than in those who were successfully treated with conservative methods (88% and 42%, respectively). Segments with spondylolisthesis or lateral wedging showed higher FSRs than those without these conditions on both types of MRI. Conclusions FSRs <50% obtained using conventional MRI were sufficiently reliable; however, the results were inaccurate for FSRs ≥50%. Patients with high FSRs on 3D-MRI were more likely to require surgical treatment. Therefore, 3D-MRI is recommended in patients with suspected stenosis detected using conventional MRI or plain radiographs.

Methods: We investigated 154 foramina at L5–S1 in 77 patients. All the patients had degenerative lumbar disorders and had undergone both conventional MRI and 3D-MRI during the same visit. Differences between the FSRs calculated from conventional and 3D-MRI reconstructions and any correlations with the plain radiography findings were assessed. Results: In foramina that had a FSR of <50% on conventional MRI, the difference between the FSR obtained using conventional MRI and 3D-MRI was 5.1%, with a correlation coefficient of 0.777. For foramina with a FSR ≥50% on conventional MRI, the difference was 20.2%, with a correlation coefficient of 0.54. FSR obtained using 3D-MRI was significantly greater in patients who required surgery than in those who were successfully treated with conservative methods (88% and 42%, respectively). Segments with spondylolisthesis or lateral wedging showed higher FSRs than those without these conditions on both types of MRI. Conclusions FSRs <50% obtained using conventional MRI were sufficiently reliable; however, the results were inaccurate for FSRs ≥50%. Patients with high FSRs on 3D-MRI were more likely to require surgical treatment. Therefore, 3D-MRI is recommended in patients with suspected stenosis detected using conventional MRI or plain radiographs.

It is well known that eccentric exercise induces muscle damage that is characterized by a prolonged decrease in muscle strength and range of motion, development of delayed onset muscle soreness. The previous studies showed that hold-relax stretching (HRS) was effective for improving the decreases in range of motion and muscle soreness. In addition, modified proprioceptive neuromuscular facilitation stretching (mPNF) was an equally effective for HRS. However, it was unclear whether there are differences between acute effects of HRS and mPNF on muscle strength and muscle soreness in eccentrically damaged muscle. Therefore, the present study aimed to compare the acute effects of HRS with those of mPNF on muscle strength and soreness in eccentrically damaged muscle. The participants comprised 40 volunteers randomly assigned to either the HRS group (N = 20) or the mPNF group (N = 20). Initially, the participants of both groups performed 60 maximal eccentric contractions of the knee extensors. Two days after this exercise, each group performed either HRS or mPNF for 60 s at a time and repeated them six times for a total of 360 s. Muscle strength and soreness during stretching and contraction were measured before and immediately after HRS and mPNF. The results showed that the muscle soreness observed after eccentric contraction significantly decreased immediately after both HRS and mPNF. In addition, there were no significant changes in muscle strength immediately after both HRS and mPNF. These results suggest that while both HRS and mPNF can effectively decrease muscle soreness without reducing performance.