Coronavirus disease 2019 (COVID-19) has been spreading globally since 2019；however, comprehensive rehabilitation of elderly patients with COVID-19 pneumonia remains a challenge. A 76-year-old American woman with COVID-19 pneumonia was admitted to our hospital. Because her disease was complicated by acute respiratory distress syndrome (ARDS), she was treated with intensive care, including invasive ventilation and extracorporeal membrane oxygenation (ECMO). During and after intensive care, she exhibited physical symptoms such as weakness, pain, shortness of breath, and difficulty in movement and exercise. Furthermore, during approximately 3.5 months of hospitalization, she received swallowing and speech therapies along with physical therapy. These rehabilitation therapies enabled her to get home in the United States. Her rehabilitation schedule had to be carefully planned according to her symptoms and infectiousness of COVID-19. This paper highlights few important points regarding the difficulty in rehabilitation including that of physical function, mental health, and cognitive function of patients with COVID-19. Furthermore, this report provides a problem-solving approach for long-term rehabilitation in elderly patients with COVID-19 pneumonia.

The purpose of this study was to investigate the differences and effects of positional loading (arm position change) and image loading in Budo (martial arts) competitors, mainly kendo (Japanese fencing) masters. The microcirculatory responses were measured by differential digital photoplethys-mography (ΔDPG) using the characteristics of Budo mental attitude, experience and skill as para-meters.
The subjects were 7 kendo masters of the fifth grade or higher with mean experience of 29 years, 7 kendo athletes, 7 kyudo (Japanese archery) athletes, 5 karate athletes in university sports clubs and 9 middle-aged controls. Positional loading induced myogenic responses and image loading for examining sympathetic effects via the central nervous system on peripheral circulation were mea-sured in the subjects at rest in a sitting position. The following results were obtained
The increase in the . ΔPG-P wave height in response to positional loading was markedly larger in the kendo masters. In particular, the increase when raising the right arm was significantly higher in the kendo masters than in the kyudo and karate athletes (P<0.05) . The decrease in the ΔDPG-P wave height when lowering the right arm was smallest in the kendo masters. There were differences in the peripheral vascular responses between kinds of Budo and levels of skill, which were induced by differences at the time of arm raising.
The DPG-P wave height was significantly lower during stress imaging than before loading in all subjects. The effect of stress imaging was smallest in the kendo masters, and markedly large in the kyudo athletes (P<0.05) . During relaxation imaging, an increase in the ΔDPG-P wave height was observed in the kendo masters alone, and the occurrence of vascular dilation was confirmed.
These results suggest that arteriolar responses of kendo masters are flexible and stable despite their long training period ; and the control and regulation of muscle vascular tone is well-maintained via the central nerve-sympathetic and myogenic coupling.

AIMChromosome 13 is one of the most frequently altered chromosomes in prostate cancer. The present study was undertaken to examine the role of human chromosome 13 in the progression of prostate cancer.

METHODSHuman chromosome 13 was introduced into highly metastatic rat prostate cancer cells via microcell-mediated chromosome transfer.

RESULTSMicrocell hybrid clones containing human chromosome 13 showed suppression of metastasis to the lung without any suppression of tumorigenicity, except for one clone, which contained the smallest sized human chromosome 13 and did not show any suppression on lung metastasis. Expression of two known tumor suppressor genes, BRCA2 and RB1, which map to chromosome 13, was examined by reverse transcription- polymerase chain reaction analysis. BRCA2 was expressed only in the metastasis-suppressed microcell-hybrid clones, whereas RB1 was expressed in all clones.

CONCLUSIONHuman chromosome 13 contains metastasis suppressor gene(s) for prostate cancer derived from rat. Furthermore, the RB1 gene is unlikely to be involved in the suppression of metastasis evident in this system.

Animals ; Animals, Genetically Modified ; Cell Division ; genetics ; Chromosome Aberrations ; Chromosome Mapping ; Chromosomes, Human, Pair 13 ; Disease Progression ; Genetic Markers ; Humans ; In Situ Hybridization, Fluorescence ; Kinetics ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; genetics ; pathology ; prevention & control ; Rats ; genetics

AIMTo evaluate the occurrence and prevalence of microdeletions in the gamma chromosome of patients with azoospermia.

METHODSDNA from 29 men with idiopathic azoospermia was screened by polymerase chain reaction (PCR) analysis with a set of gamma chromosome specific sequence-tagged sites (STSs) to determine microdeletions in the gamma chromosome.

RESULTSDeletions in the DAZ (deleted in azoospermia) loci sgamma254 and sgamma255 were found in three patients with idiopathic azoospermia, resulting in an estimated frequency of deletions of 10.7% in idiopathic azoospermia men.

CONCLUSIONWe conclude that PCR analysis is useful for the diagnosis of microdeletions in the Y chromosome, which is important when deciding the suitability of a patient for assisted reproductive technology such as testicular sperm extracion-intracytoplasmic sperm injection (TESE-ICSI).

Adult ; Base Sequence ; Chromosomes, Human, Y ; DNA Primers ; Euchromatin ; genetics ; Follicle Stimulating Hormone ; blood ; Heterochromatin ; genetics ; Humans ; Luteinizing Hormone ; blood ; Male ; Oligospermia ; blood ; etiology ; genetics ; Polymerase Chain Reaction ; Prolactin ; blood ; Sequence Deletion ; genetics ; Sequence Tagged Sites ; Testosterone ; blood

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.

Primary cardiac tumors are comparatively rare. Primary cardiac angiosarcoma is the most common cardiac malignant tumor and the most common site of this tumor is in the right atrium. It is usually difficult to diagnose and treat this condition before death. The present case of primary cardiac angiosarcoma was located in the left atrium, which is very rare. A cardiac malignant tumor was suspected in this 56-year-old man based on chest MRI examination. The operation was performed successfully but its outcome was very poor.

An isolated huge unruptured aneurysm of the right coronary sinus of Valsalva was detected incidentally in a 47-year-old man. Echocardiography and aortograms revealed severe aortic insufficiency with moderate stenosis, and mild dilatation of the lower ascending aorta without annulo-aortic ectasia. At operation, a sclerotic bicuspid aortic valve was confirmed. These abnormal findings necessitated a reconstruction of the aortic root with a valved conduit and reimplantation of the coronary arteries (Bentall operation with the Carrel patch technique). Pathologic examination of the resected aortic wall showed diffuse sclerotic change and partial medial degeneration.

In order to synthesize biocompatible materials that are used for artificial organs, hybridization of materials with biologically active substances seems to be most effective. To prevent coagulation upon blood/materials contact, hybridization with the materials of the repressor of coagulation factors or platelet and the activator of fibrinolysis has been done. Simultaneous hybridization of two kinds of biologically active substances has also been found effective. Recently, cell/materials hybridization is particularly popular. For this type of hybridization composite materials have been developed that are convenient for cell lining or in vivo compatible with living cells. This method will lead to the control of cell functions with suitable materials and a future development is expected.

The persistent fifth aortic arch is rare vascular anomaly. To our knowledge, this is the 24th reported case of the persistent fifth aortic arch. This patient was a 31 days old male infant and had the persistent fifth aortic arch associated with atresia of the fourth aortic arch, patent ductus arteriosus, a double-outlet right ventricle, and a mesocardia. He underwent a fifth aortic arch division and an extended aortic arch anastomosis with a division of ductus arteriosus. There was no blood pressure gradient between upper and lower limbs after the repair. However, no weaning from a cardiopulmonary bypass after the subsequent radical operation for double-outlet right ventricle caused his death.