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.

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: Volunteers over 50 years of age underwent radiographic analysis. Radiographic parameters including pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), thoracic kyphosis, and sagittal vertical axis (SVA) were measured. The the three Scoliosis Research Society-Schwab sagittal modifiers (PT, SVA, PI–LL) were categorized and the KL grade was assessed. Differences in spinopelvic parameters and Oswestry Disability Index (ODI) scores among KL grades were evaluated. Results: A total of 396 volunteers (160 men, 236 women; mean age, 74.4 years) were analyzed. PI–LL and PT in KL4 were significantly higher compared to that in the other KL grades. However, there were no significant group differences in SVA. In women, but not in men, higher frequencies of the worst modifier grade (++) were observed for PI–LL and PT in the KL3 and KL4 groups compared to those for the other KL grades. In women, the ODI score in KL4 was worse compared to that in the other KL grades. Conclusions Individuals over 50 years of age with severe knee osteoarthritis had poor lumbo-pelvic sagittal alignment. Moreover, the progression severity of knee osteoarthritis had more impact onstronger relationship with lumbo-pelvic malalignment and disability-related low back pain in women than in men.

Since fiscal year 2015, our hospital has conducted regular hospital inspections by a medical engineer (ME). About 1 year after the start of this inspection, fungi and common bacteria were detected, so we searched for the cause and report here successful cleanup of the incubator. When the incubator was cleaned during a periodic inspection, the ME discovered that dirt mainly adhered to the fan and the bed rest. Also, fungi were detected from the fans, so the ME cleaned and disinfected all the fans and then switched to a process of washing the central supply room. Following this process, bacteria were no longer detected from inside the incubator, but they have been consistently detected from the fans. We have no reported cases of patient infection, and we believe this is because the ME is responsible for periodic cleaning against bacteria and for conducting inspections. This demonstrates that successful cleaning of the incubator led to control of the spread of infectious diseases.

Objective: Cervical dystonia (CD) is a clinically under-recognized symptom occurring at the later- to end-stages of Parkinson’s disease (PD). The frequency of CD and its influence on prognosis have not been well studied. Here, we conducted an in-depth examination of CD incidence and impact on disease progression in later-stage PD. Methods: We retrospectively reviewed the clinical features of 22 deceased patients with sporadic PD treated at a hospital in Japan from 1983 to 2008. Results: The most common cause of death in PD was pneumonia. CD, in particular retrocollis, was frequent in the later stages of the disease in elderly patients (9/22, 40.9%). Pneumonia incidence increased sharply in the later period with CD. There was a positive trend between CD duration and duration of pergolide use. Conclusion: Analysis revealed that CD increases markedly in late- to end-stage PD, which may be associated with aspiration pneumonia due to dysphagia. Pathological mechanisms underlying CD might be influenced by treatments including dopamine agonists. Prevention of CD may increase quality of life and prolong survival of PD patients.

Objective: The purpose of the present study was to clarify the efficacy of alendronate and raloxifene for preventing bone loss in patients with hip fracture by monitoring bone mineral densities (BMDs) and biochemical markers during the 9-month period after fracture. Patients and Methods: Eighty-two female hip fracture patients from 50 to 99 years old (mean ± SD: 81.6 ± 9.5) were randomly divided into two groups; there were 46 patients in the alendronate-treated group (group ALN) and 36 patients in the raloxifene-treated group (group RLX). Drugs were administered to patients six weeks after their operations. Lumbar spine BMD and neck, trochanter, Ward's and total BMDs of the contralateral proximal femur, serum intact osteocalcin (intact OC), bone-specific alkaline phosphatase (BAP) and urinary N-terminal telopeptide of type I collagen (NTX) were measured just before the start of drug administration and at 9 months thereafter. Results: Twenty-two out of 46 patients in group ALN and 23 out of 36 patients in group RLX completed the study. The most common reason for dropping out was the patient's failure to visit the outpatient clinic. Trochanter BMD in group ALN tended to increase by 8.4% compared with the baseline, and total hip BMD in group RLX showed a significant increase (5.7%), although neck BMD in both groups decreased during the 9 months of treatment (–8.7% for group ALN and –4.2% for group RLX compared with the baseline). Spine BMD did not change significantly in eithr group. Serum BAP and urinary NTX decreased significantly in both groups. Serum intact OC did not change significantly. Conclusions: Both alendronate and raloxifene have a favorable effect on trochanter and total BMDs of the contralateral proximal femur in the short period after hip fracture. However, both drugs could not prevent bone loss in the femoral neck during the 9 months of treatment.

We report the case of a 46-year-old man with hypertension whose blood pressure decreased due to saiko-karyukotsuboreito consumption.The patient also presented with some symptoms that suggested autonomic imbalance. After consuming 7.5g/day of a spray-dried powder of saikokaryukotsuboreito (Tsumura & Co.) for 3 months, his blood pressure measured at office was considerably lower. Twenty-four hour ambulatory blood pressure monitoring revealed that the surge in morning blood pressure, which is considered to be a risk factor for cerebrovascular disease, diminished in addition to the 24-hour mean blood pressure. A postural test revealed that his autonomic balance, which had been in a sympathetic dominant state, was inversely inclined to a parasympathetic dominant state.Our case report suggests that saikokaryukotsuboreito acts on the autonomic nervous system, which in turn exerts an antihypertensive effect, and that this effect is helpful in lowering the blood pressure in hypertensive patients whose autonomic balance is impaired due to stress.
Blood Pressure ; Assessment of balance ; Hour ; Effective ; Equilibrium