This study aimed to investigate the effect of yoga exercise on the increase of skeletal muscle mass and prevention of falling. We examined the change in muscle mass（whole body, trunk and limbs）, hamstring flexibility and balance ability in middle-aged and older people through our original yoga program. This study comprised 25 participants（average age 69.4 years old）. This yoga class was held once every other week for 3 months（6 sessions in total）. We measured muscle mass（whole body, trunk and limbs）, fat mass, Timed Up & Go test（TUG）, Straight Leg Raising test（SLR）and one-leg standing test with eyes open at the first and final sessions. We also collected and aggregated responses from the ADL test, Falls efficacy scale and POMS2 questionnaire at the second and fifth sessions. As a result, whole-body and trunk muscle mass increased and fat mass decreased significantly（p＜0.02, p＜0.01, respectively）and SLR increased significantly（p＜0.05）. Total Mood Disturbance scores（POMS-TMD）decreased during this study. In conclusion, our original yoga program contributed to increases in muscle mass and hamstring flexibility and had favorable psychological effects.

Objective: The number of dialysis patients has been increasing in recent years, and the introduction of dialysis among the elderly has been on the rise. We assessed recent trends in hemodialysis from the perspective of medical insurance treatment.

Methods: Referring to the “National Database（NDB）Open Data” and “Statistics by Social Medical Practice” published by the Ministry of Health, Labor and Welfare, we examined the annual changes in the number of total calculations and number of points calculated as “artificial kidney.”

Results: The number of calculations was 47,516,874 in fiscal year（FY）2020, thus representing an increase of 4,171,485（9.6%）times over the 6-year period, and the number of calculated points was 106,231,829,880 in FY2019, thus representing an increase of 12,809,022,095（13.7%）points over the 5-year period. However, 99,365,974,532 points were calculated in FY2020, which represented a decrease of 6.5% from the previous year. The peak age group was in the late 60s in FY 2014, gradually moving into the early 70s, indicating an aging trend. The number of calculated points in June 2019 was 9,233,060,015, thus showing an increasing trend, while the number of calculated points in June 2020 was 8,682,058,401, a decrease of 6.0% from the previous year. Additionally, 8,720,261,957 points were calculated in June 2021, thus showing an increase of 0.4% from the previous year.

Conclusion: The number of artificial kidney calculations and calculated points increased every year until 2019, but decreased in June 2020 compared to the previous year, suggesting that the reimbursement revisions and COVID-19 infection had an impact.

Purpose: Cardiac rehabilitation has been rapidly spreading in recent years; however, the recent outbreak of novel coronavirus infection has affected usual practice. In this study, we investigated the progress to date and the current status of cardiac rehabilitation from the perspective of insurance reimbursement.

Methods: I examined the number of calculations of "cardiac rehabilitation fees" and number of points from 2009 to 2021 using the social medical practice statistics published by the Ministry of Health, Labour and Welfare, and examined the annual change, percentage and annual change by age group, and annual change by non-hospitalization and hospitalization from 2019 to 2021.

Results: The number of cardiovascular disease rehabilitation charges was 99,865 in 2009 and 791,226 in 2019, an approximately eight-fold increase over 10 years. However, in 2020, the number was 651,118, down 18% from the previous year, and in 2021, it was 758,232（95.7% of the 2019 value）. The number of calculated points was 21,210,079 in 2009 and 186,409,625 in 2019, an approximately nine-fold increase over the previous 10 years, but in 2020 it was 157,369,680, a 16% decrease from the previous year. In 2021, the number was 181,145,440, 97.2% of the 2019 value. By age group, patients of ≥70 years and ≥85 years of age accounted for 78% and 32% of the total patients, respectively. The annual trend by age group shows that the rate of increase was highest among those in their early 80s. However, in 2020, there was a decrease in the 45-89 age group, which was mainly seen outside of hospitalization, with a particularly marked decrease in the late 70s, and only a slight decrease in hospitalization.

Conclusion: Cardiovascular disease rehabilitation reimbursement had been increasing until 2019, but decreased in 2020, probably due to the epidemic of novel coronavirus infection.

Introduction: Preimplantation genetic test for aneuploidy（PGT-A）has already been clinically recognized as a method for examining the condition of in vitro fertilized embryos. Cell-free DNA（cfDNA）in the spent culture medium can be used for assessing the status of embryos as an alternative to PGT-A.

Method: We fertilized mice eggs in vitro and cultured them for 5 days. We performed ethanol precipitation on the spent culture medium that contained the embryos, which were in the post-morula stage. Quantitative real-time PCR with the calibration curve method was performed using the mouse brain tissue DNA. Ethanol precipitation was also performed on controls.

Result: We measured the amount of cfDNA present in the spent culture medium. cfDNA was detected in some of the samples but not in all the samples. In the samples in which cfDNA was detected, the amount of cfDNA was approximately 900 pg on an average.

Discussion: We were able to obtain cfDNA from the spent culture medium that contained mice embryo by performing ethanol precipitation. We speculate that the spent culture medium contains cfDNA from few cells, and it was difficult to detect cfDNA in all the cultures due to the presence of a negligible amount. For the recovery of cfDNA from spent culture medium, it was considered necessary to select a purification method based on the subsequent analysis method.

One of the fertility preservation treatments is ovarian tissue cryopreservation and transplantation. Although orthotopic transplantation is the most common transplantation site following ovarian freezing, it has disadvantages such as the need for invasive surgical treatment. Therefore, in this study, we investigated the feasibility of ovarian tissue transplantation into the endometrium as a new target organ for ovarian tissue transplantation in mice, which was an ectopic transplantation. Eight-week-old ICR mice were used as recipients, and 7- to 10-day-old ICR mice were used as donors. Estrogen and progesterone were administered to the recipient mice under pituitary suppression, and the donor ovaries were implanted in the uterus. In the control group, 2 out of 12（16.6%）, in the estrogen group, 3 out of 9（33.0%）, and in the estrogen + progesterone group, 1 out of 11（9.1%）ovaries were successfully implanted. In addition, a developing follicle was observed in the successfully implanted ovarian tissue. Not only was the live attachment of the ovarian tissue to the endometrium confirmed, but it was also confirmed that the follicle was growing within the ovarian tissue that had grown. It is suggested that transplantation to the endometrium is feasible as a target site for ovarian transplantation after fertility preservation. Furthermore, it was shown that external control of the intrauterine environment during transplantation to the endometrium may improve the live-implantation rate.

A novel technique for fixation of fascia grafts for lower eyelid drooping is described. By use of a bi-pedicled periosteal flap created at the lateral canthus, easy adjustment of graft tension and easy and less traumatic fixation of the grafts with sutures was achieved in 2 patients without the need of an assistant surgeon. This technique can also be potentially useful in several plasties other than lower eyelid correction such as eyebrow lift by fascia suspension for facial nerve paralysis.

A woman in her 30s consulted our hospital complaining of abdominal pain. Height was 148 cm, weight was 50 kg, and body mass index was 22.8 kg/m². She was diagnosed as having a cecal volvulus by computed tomography and underwent endoscopic detorsion in the gastroenterology department of our hospital. She had undergone endoscopic detorsion for cecal torsion twice previously and had repeated recurrences, so she was referred to our department for surgical treatment. Laparoscopic observation revealed incomplete fixation with the retroperitoneum from the proximal 1/2 of the ascending colon to the cecum. To promote adhesion between the cecum and ascending colon and the retroperitoneum, we made a partial incision in the peritoneum and sutured the cecum and ascending colon at this area. Her postoperative course was uneventful, she resumed her diet on the 3rd postoperative day, and was discharged from hospital on the 8th postoperative day. She has been without recurrence for 4 years and 2 months postoperatively. Cecal volvulus is a relatively rare disease in Japan, accounting for 0.4% of cases of intestinal obstruction and 5.9% of colon volvulus. Onset occurs most commonly in the elderly, but we used laparoscopic cecal fixation to treat cecal volvulus that developed at a young age in the present patient.