Intervertebral disc degeneration, a major cause of back pain, is characterized by a loss of nucleus pulposus (NP) cells and there is no effective treatment available to date. Recently, several regenerative strategies, including cellbased therapies to treat disc degeneration have been conducted. Dedifferentiated fat (DFAT) cells are multipotent mesenchymal stem cell-like cells prepared from mature adipocytes using a ceiling culture method. To explore the therapeutic potential of DFAT cells for intervertebral disc degeneration, NP cells were cocultured with DFAT cells in vitro, and cell proliferation and the expression of chondrogenic maker genes were examined. As the results, NP cell proliferation activity was enhanced when the cells were cocultured with DFAT cells. In addition, DFAT cells cocultured with NP cells increased expression of chondrogenic marker genes, i.e., glut-1, aggrecan, versican, collagen type I, and collagen type II, and sox9, suggesting differentiation into NP-like cells. Since DFAT cells can be easily prepared and expanded from elderly patients, these cells may represent an attractive source of cell-based therapy for intervertebral disc degeneration.

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Background: Malignant lymphoma is occasionally observed in chronic hepatitis B virus (HBV)-infected patients. The occurrence of HBV reactivation or acute exacerbation of chronic hepatitis B during and after chemotherapy and immunosuppressive therapies is a major issue. Case presentation: We reported a 65-year-old Japanese man with multiple nucleos(t)ide analogue (NUC)- resistant HBV infection and diffuse large B cell lymphoma (DLBCL), stage IV. The patient was treated with the addition of tenofovir disoproxil fumarate to entecavir and chemotherapy to control the HBV and treatment of lymphoma, respectively. Both diseases were safely controlled. Conclusion: Clinicians should pay careful attention to NUC-resistant HBV and select the proper NUCs to control the virus before and during the commencement of chemotherapy.

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In Japan, traumatic diaphragmatic hernias are caused by blunt trauma and tend to occur in the acute phase. Delayed-onset diaphragmatic hernia, as in this case, is rare. A 26-year-old female had been treated at another hospital four months previously for a stab wound. Lung injury and traumatic pneumothorax improved with conservative treatment. Two months after discharge, chest X-ray showed an elevated diaphragm with a mass-like shadow. By chest CT, the liver was shown to be protruding into the thoracic cavity at the top of the right diaphragm, suggesting traumatic diaphragmatic hernia. The diaphragmatic hernia was growing, and surgery was performed six months after the initial injury. A defect in the center of the diaphragm tendon and protrusion of the liver into the thoracic cavity were observed. The liver was repositioned in the abdominal cavity, and the diaphragm defect was sutured. On postoperative chest X-ray, the mass-like shadow on the diaphragm disappeared.

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An asymptomatic 72-year-old woman was referred by an orthopedist because of a mass on the aortic valve that was found during pre-operative examination of lumbar spinal canal stenosis. Transthoracic echocardiogram showed a 9 * 7 mm mobile mass attached to the non-coronary cusp of the aortic valve and no aortic regurgitation. In view of the potential risk of embolism of either the mass or the associated thrombus, elective surgical removal was performed. The patient made an uneventful recovery. Histological examination revealed the benign tumor and led to the diagnosis of papillary fibroelastoma. Primary cardiac tumor is rare and we report a case of cardiac papillary fibroelastoma with a review of the pertinent literature.

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Type A acute aortic dissection occurs suddenly, without any clinical sign and often takes the patient’s life before appropriate treatment can be provided. Herein, we report 12 patients who underwent computed tomography scan for assessment of other diseases less than 1 year before the onset of aortic dissection. We evaluated aortic diameter before the onset of aortic dissection. All patients had some risk of aortic dissection. The average maximum ascending aortic diameter was 44.3 ± 2.7 mm; range: 40 to 48 mm. Eleven patients underwent successful emergency surgery. However, 1 patient died before arrival at our hospital. Careful management is necessary for patients with aortic enlargement and risk of type A acute aortic dissection.

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