PurposeAlthough chronic low back pain (CLBP) has profound effects on patients, society, and economy, its causes are difficult to identify. Psychogenic effects or social stress is known to affect CLBP; hence, investigation of its underlying causes requires a multifactorial approach. We determined the factors associated with CLBP by using an Internet-based survey. To prevent CLBP, we need to understand its cause and background.Patients and methodsA total of 1000 participants either with (+) or without (−) CLBP answered the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), which assesses five domains of CLBP: low back pain, lumbar function, walking ability, social life function and mental health. We also administered a new questionnaire for participants, that comprised five different domains: Body, Lifestyle, Emotion, Diet, and Social. To evaluate psychogenic effects on CLBP, we added two original factors, namely outshout and HIE, which have not yet been studied. HIE is a traditional concept (sense) of “feeling cold” or “chilly.” All participants completed both questionnaires.ResultsMultivariate logistic regression analysis extracted four factors (sleep, room temperature, outshout, and HIE) that were associated with CLBP. The mental health domain was assessed using the JOABPEQ for each of these factors. The factors outshout and HIE differed between CLBP (+) and CLBP (−) patients. CLBP (−) participants also showed a difference in Sleep and HIE factors.ConclusionAmong psychogenic effects, Emotion was common to all the four extracted factors. There was no common physical divisor. Therefore, we hypothesized that acute low back pain might develop into CLBP in the presence of psychological stress or other emotional factors such as outshout or HIE. Hence, we need to consider both physical and psychogenic effects in the prevention and treatment of CLBP. Furthermore, appropriate evaluation and treatment of psychological stress may be effective in reducing CLBP.

Balance between inflammatory and anti-inflammatory cytokines may be important in malaria presentation and outcome. To clarify cytokine interactions that produce pathology of malaria and control infection, C57BL/6 mice were infected with 10 4 parasitized RBCs from a non-lethal strain of Plasmodium yoelii. Kinetics was monitored showing the course of parasitemia, and cytokines were determined by RT-PCR from liver and spleen tissues. Inflammatory cytokines such as interferon-γ (IFNγ), interleukin (IL)-12, IL-6, tumor necrosis factor-α (TNFα) and anti-inflammatory cytokines, including IL-4 and IL-10, were investigated as key molecules that interact with immune cells in the activation of the immune responses. The production of IFNγ mRNA was found to be higher on day 7 than on day 21 after infection, and IL-12 and IL-6 showed higher expression in the liver than in the spleen. Though TNFα was highly expressed on day 14 after infection and on day 21 in the liver, such expression was decreased on day 21 in the spleen. Anti-inflammatory cytokines showed high expression in both the liver and spleen. The results suggest that a relative balance between inflammatory and anti-inflammatory cytokines is crucial and that the increase of inflammatory cytokine levels during the acute phase of malaria may reflect an early and effective immune response. The counteraction effect of anti-inflammatory cytokines is thought to play a role in limiting progression from uncomplicated malaria to severe life-threatening complications.

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The effect of repetitive mild hyperthermia on body temperature, the autonomic nervous system, and innate and adaptive immunity was investigated using a new hyperthermia treatment system, nanomist sauna (NMS). Six healthy volunteers participated and the concentration of catecholamines and cortisol, and the frequency and function of leukocytes in the peripheral blood were investigated before and after successive 7 days of hyperthermia treatment (20 min/day, 40°C, 100% relative humidity). After treatment, the blood level of adrenaline and cortisol on the 7th day was decreased compared with the 1st day, indicating the suppression of the sympathetic nervous system activity. Moreover, the frequency of CD56 + NK, CD56 + NKT and B cells on the 7th day tended to be increased compared with the 1st day. The frequency of HLA-DR-positive NK and NKT cells and expression of HLA-DR on B and T cells increased. The cytotoxicity of NK cells and proliferative response of B cells were also elevated. The results indicate that repetitive mild hyperthermia treatment might suppress excessive sympathetic dominance and modify immunity. Additionally, because it can provide the same effects as conventional hyperthermia treatments with minimal burden to the body, NMS may be a novel patient-and elderly-friendly hyperthermia treatment for health promotion.Many researchers have reported that hot springs, saunas and home baths give comfortable and appropriate hyperthermic stimulation. We have also reported a series of studies where systematic mild hyperthermia treatments could activate leukocyte, enhance immunity and treat various diseases (19,28). Thus conventional hyperthermia treatments might be effective for health promotion, including reports that hot-spring treatment is effective for the improvement of locomotive syndromes (14). However, Pilch et al. reported that wet hyperthermia is more stressful than dry hyperthermia for healthy males (22). Furthermore, it is not easy for frail people (especially children, older people and patients with locomotive disorders) to regularly take conventional hyperthermic treatments. For example, the water pressure of baths and the high temperatures (80-100°C) of dry saunas are sometimes stressful and dangerous to these individuals. In addition, conventional wet sauna has the problem of high humidity. Thus aspects of conventional hyperthermia treatments, such as high temperature, water pressure and humidity might induce stress. If such stresses could be lowered, hyperthermia treatment could be useful not only for patients and older people but also for caretakers. To pursue the further study of the effect of hyperthermia itself, we used nanomist sauna (NMS), a

The di-zhen (DZ) is an ancient type of acupuncture needle with a history dating back more than 2000 years. Unlike modern acupuncture needles, the DZ is not inserted subcutaneously, and is safely and commonly used at the bedside. The mechanisms underlying its effects are not known. In this study, we measured sublingual and cutaneous body temperature, pulse rate, oxygen pressure (PO 2 ), oxygen saturation (SO 2 ) and carbon dioxide pressure (PCO 2 ) before and after DZ application in 25 healthy male volunteers. Serum levels of catecholamines (adrenaline, noradrenaline and dopamine) and white blood cells (WBCs; ratio and number) were traced for one week. Soon after DZ application, pulse rate, body temperature, PO 2 and SO 2 all decreased. The serum levels of adrenaline and noradrenaline increased, indicating sympathetic dominance, and the number of granulocytes was elevated. One week after DZ application, the number of lymphocyte increased. We therefore suggest that DZ affects body temperature, pulse rate, catecholamine secretion and immune function by inducing transient sympathetic dominance via actions on the autonomic nervous system. These effects are similar to the effects observed with modern needles, which are inserted subcutaneously. Therefore, we consider DZ treatment to be advantageous and safe in modern clinical practice, especially in postsurgical and terminal care, as it avoids the issues with infection and tissue damage sometimes seen with modern acupuncture needles.