Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012–2013), 7 (2014–2015), and 8 (2016–2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0–10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61–0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50–0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57–0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35–0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34–0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain.

Methods: This study included 46 patients who underwent spinal reconstruction surgery for thoracolumbar osteoporotic vertebral fractures and kyphosis and were followed up for 1 year postoperatively. DJK was defined as an advanced kyphosis angle >10° between the LIV and one lower vertebra. The patients were divided into groups with and without DJK. The risk factors of the two groups, such as patient background, surgery-related factors, radiographic parameters, and clinical outcomes, were analyzed. Results: The DJK and non-DJK groups included 14 and 32 patients, respectively, without significant differences in patient background. Those with instability in the distal adjacent LIV disc had a significantly higher risk of DJK occurrence (28.6% vs. 3.2%, p=0.027). DJK occurrence significantly increased in those with the sagittal stable vertebra not included in the fixation range (57.1% vs. 18.8%, p=0.020). Other preoperative radiographic parameters were not significantly different. Instability in the distal adjacent LIV disc (adjusted odds ratio, 14.50; p=0.029) and the exclusion of the sagittal stable vertebra from the fixation range (adjusted odds ratio, 5.29; p=0.020) were significant risk factors for DJK occurrence. Conclusions Regarding spinal reconstruction surgery in patients with osteoporotic vertebral fractures, instability in the distal adjacent LIV disc and the exclusion of the sagittal stable vertebra from the fixation range were risk factors for DJK occurrence in the short term.

Methods: HFCs were obtained from patients with LSS who had undergone decompression surgery. The cells were stimulated with TGF-β and pretreated with either the p38 mitogen-activated protein (MAP) kinase inhibitor SB203580 or the p44/42 MAP kinase inhibitor FR180204. IL-6 secretion in the cell culture medium and IL-6 messenger RNA (mRNA) expression levels were analyzed using an enzyme-linked immunoassay and real-time polymerase chain reaction, respectively. Results: TGF-β administration resulted in a dose- and time-dependent stimulation of IL-6 release. Treatment with SB203580 and FR180204 markedly suppressed TGF-β–induced IL-6 secretion from HFCs. Moreover, these inhibitors suppressed IL-6 mRNA expression in response to TGF-β stimulation. Conclusions Our findings indicate that TGF-β induces IL-6 protein secretion and gene expression in HFCs through the activation of p38 or p44/42 MAP kinases. These results suggest a potential association between IL-6–mediated inflammatory response and tissue hypertrophy in LSS, and we provide insights into molecular targets for therapeutic interventions targeting LSS-related inflammation through our analysis of the MAP kinase pathway using HFCs.

This study aimed to evaluate the effects of ingesting yogurt fermented with Lactobacillus delbrueckii subsp. bulgaricus (OLL1073R-1) on the immune function of healthy university men track and field athletes. Study design Randomized, double-blind, placebo-controlled, parallel-group study. A total of 37 track and field athletes aged ≥18 years were randomly assigned into two groups. For 2 weeks, two bottles of yogurt fermented with OLL1073R-1 and Streptococcus thermophilus OLS3059 or placebo sour milk were ingested daily to the participants. During the intake period, a 1-week training camp was held and participants were subjected to strenuous exercise. Natural killer (NK) cell activity, which is the primary endpoint, was significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level of the yogurt group. The two-way repeated measures analysis of variance showed an interaction effect in the NK cell activity change (P=0.018) and a significant difference between the groups after the 2-week ingestion (P=0.015). Among the secondary endpoints, cytokines and chemokines levels involved in activating innate immunity maintained or enhanced only in the yogurt group. ALT, LDH, and CK significantly elevated only in the placebo group. Furthermore, amino acid levels were significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level in the yogurt group. Consuming yogurt fermented with OLL1073R-1 prevents the decline in immune function associated with strenuous exercise. Additionally, the yogurt may contribute to stable physical condition.

Methods: Five formalin-embalmed human cadavers were used. We assessed the proportion of segmental arteries and veins that intersected the IVD in the L2–L5 range and their course on the anterior part of the spinal column. Results: The segmental arteries and veins commonly intersect the anterior part of the IVD (artery, 28.1%; vein, 42.1%). Seven of 10 (70%) segmental arteries at L2 intersected the IVD, but only one artery intersected the IVD at L3 and L4. The proportions of segmental veins that intersected the IVD were 60%, 50%, and 16.7% at L2, L3, and L4, respectively. Conclusions The segmental arteries and veins frequently intersect the IVD in the anterior part of the spinal column. Therefore, it is necessary to consider these individual anatomical features to prevent vascular damage during lateral lumbar interbody fusion surgery.

We report a case of a 56-year-old woman. She had a history of emergent ascending aorta replacement due to type A dissection. Seven years later, aortic arch enlargement (55 mm) was detected on CT scan, and indicated secondary repair. Because of the existence of the aberrant right subclavian artery (ARSA), the safer surgical management needed to be discussed. Total arch replacement with the use of open stent-grafting technique and extra-anatomical reconstruction of ARSA was chosen for the treatment. In the operation, straight woven grafts (7 mm in diameter) were firstly anastomosed to the bilateral axillary arteries. Deep hypothermic circulatory arrest with antegrade cerebral perfusion through median sternotomy was established. The aortic arch was transected between the right and left subclavian arteries. The left subclavian artery was ligated at its origin, and an aortic open stent graft was inserted distally. An aortic reconstruction was performed between the left common carotid artery and the left subclavian artery with a 4 branched J-graft. The left carotid artery was reconstructed anatomically, and the tube grafts anastomosed to the bilateral axillary arteries were reconstructed in an extra-anatomical fashion. On the 11th postoperative days, coil-embolization of the ARSA was performed to complete the treatment. The patient had an uneventful post-operative recovery. Total arch replacement using an open stent-grafting technique was a feasible treatment option for the aortic arch aneurysm with ARSA.

Introduction: Vaccine policies have changed in recent years in Japan. In the present study, we assessed practices, recommendations, knowledge, and sources of information among primary care physicians (PCPs) regarding vaccinations in Japan. Methods: We conducted a nationwide cross-sectional study targeting PCPs in Japan. We used a web-based self-administered questionnaire targeting physicians that were members of the Japan Primary Care Association in 2019. We analyzed respondent administrations, recommendations, knowledge, and sources of information regarding vaccinations. Results: We received responses from 1,084 PCPs (20.1%) and invited 981 participants for the analysis. The rates at which physicians gave routine and voluntary vaccines in their own practices were 23.3-95.5% and 13.2-94.4%, respectively. The active recommendation rates for routine and voluntary vaccines were 41.6-92.0% and 13.6-75.5%, respectively. Furthermore, among routine vaccines, human papillomavirus vaccine was the least administered and recommended. PCPs working at clinics had the most accurate knowledge about vaccinations, and PCPs utilized academic organizations most readily as an information resource. Conclusion: We clarified practices, recommendations, knowledge, and sources of information regarding vaccinations among PCPs in Japan.

Novel coronavirus disease (COVID-19) spread worldwide. In Japan, From April 16 to May 25, 2020, a state of emergency was declared and people were “strongly requested to refrain from going out unnecessarily and thoroughly reduce contact with others.” As a result, the number of steps of all generations was expected to be lower than usual due to the novel coronavirus disease pandemic. This study investigated the weather walking steps decrease in the collegiate student due to COVID-19. A total of 221 collegiate students used their smartphones to enter the average number of steps taken every month from January to May. The number of steps taken by all students was 4,988±2,345 steps in January, 5182±2,516 steps in February, 5,118±2,291 steps in March, 3,281±1,689 steps in April, and 2,834±1,676 steps in May. A comparison between sex groups showed that the number of steps in April and May was significantly different (p<0.05), which means that the steps of women group was lower than that of men. These results suggest that the number of steps taken by students decreased with the outbreak of the novel coronavirus disease.

Methods: HFCs were obtained from patients with LSS who underwent surgery. HFCs were stimulated by tumor necrosis factor-α (TNF-α) and a p38 MAP kinase inhibitor, SB203580. Phosphorylation of the p38 MAP kinase was analyzed by western blotting. The concentration of interleukin-6 (IL-6) in the conditioned medium was measured by enzyme-linked immunoassay and IL-6 messenger RNA expression levels were determined by real-time polymerase chain reaction. Results: TNF-α induced the phosphorylation of p38 MAP kinase in a time-dependent manner, which was suppressed by the p38 MAP kinase inhibitor, SB203580. TNF-α also stimulated IL-6 release in both a time- and dose-dependent manner. On its own, SB203580 did not stimulate IL-6 secretion from HFCs; however, it dramatically suppressed the degree of IL-6 release stimulated by TNF-α from HFCs. Conclusions This is the first report suggesting that TNF-α stimulates the gene expression and protein secretion of IL-6 via p38 MAP kinase in HFCs. A noted association between tissue hypertrophy and inflammation suggests that the p38 MAP kinase inflammatory pathway may be a therapeutic molecular target for LSS.

We herein report a case of cardiac tumor resection through a right mini-thoracotomy. A 48-year-old man exhibited no symptoms. A mass was detected incidentally in the right atrium on computed tomography. We performed resection under cardiopulmonary bypass through a right mini-thoracotomy. Histopathological examination confirmed that this tumor was a lipoma. The patient's postoperative recovery was uneventful. He was discharged on postoperative day 6. As cardiac tumor resection through right mini-thoracotomy is minimally invasive, this approach may be useful for surgery in cases of benign cardiac tumors.