In 1999, the Japanese Orthopaedic Association decided to develop a new Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The final version of the JOACMEQ, comprising 24 questions and five domains (cervical spine function (CF); upper extremity function (UF); lower extremity function (LF); bladder function (BF); and quality of life (QOL)), was established after three nationwide investigations. The fourth investigation, reported in this paper, was performed to confirm the responsiveness of the questionnaire.
Methods
A total of 137 patients with cervical myelopathy were included in the study. Each patient was interviewed twice using the JOACMEQ before and after treatment. At the second interview, the patients self-rated their condition in five domains for “worse,” “somewhat worse,” “no change,” “somewhat better,” or “better,” and these scores were defined as the external assessment rating. The difference of the points in five domains between the first and the second interview was calculated against each external assessment. Based on the results, substantial clinical benefit (SCB) thresholds for the JOACMEQ were determined.
Results
The statistically significant median values of the acquired points were 17.5 for CF, 16.0 and 21.0 for UF, 27.0 and 20.5 for LF, 13.0 for BF, and 29.0 for QOL. After consideration of the results, the committee decided that an acquired point ≥20 could be interpreted as representing an SCB threshold for the JOACMEQ.
Conclusion
We have concluded that a treatment can be judged to be effective for a patient if 1) The patient give all answers for the questions necessary to calculate the functional score of a domain and an increase of ≥20 points is obtained for that score, or 2) The functional score after treatment is > 90 points even if the answer for the unanswered questions was supposed to be the worst possible choice. 相似文献
Endoscopic retrograde cholangiopancreatography(ERCP) is the preferred procedure for biliary and pancreatic drainage.While ERCP is successful in about 95% of cases,a small subset of cases are unsuccessful due to altered anatomy,peri-ampullary pathology,or malignant obstruction.Endoscopic ultrasound-guided drainage is a promising technique for biliary,pancreatic and recently gallbladder decompression,which provides multiple advantages over percutaneous or surgical biliary drainage.Multiple retrospective and some prospective studies have shown endoscopic ultrasoundguided drainage to be safe and effective.Based on the currently reported literature,regardless of the approach,the cumulative success rate is 84%-93% with an overall complication rate of 16%-35%.endoscopic ultrasoundguided drainage seems a viable therapeutic modality for failed conventional drainage when performed by highly skilled advanced endoscopists at tertiary centers with expertise in both echo-endoscopy and therapeutic endoscopy 相似文献
The current positron emission tomography (PET) design is aimed toward establishing an entire-body PET scanner. An entire-body PET scanner is a scanner whose axial field of view (FOV) covers the whole body of a patient, whereas whole-body PET scanner can be of any axial FOV length, but was designed for a whole-body scan. Despite its high production cost, an entire-body depth-of-interaction PET scanner offers many benefits, such as shorter and dynamic PET time acquisition, as well as higher sensitivity and count rate performance. This PET scanner may be cost-effective for clinical PET scanners with high scan throughput. In this work, we evaluated the sensitivity and count rate performance of a 2-m-long PET scanner with conventional data acquisition (DAQ) architecture, using Monte Carlo simulation, and we evaluated two ring diameters (60 and 80 cm) to reduce the scanner cost. From simulation of scanning with a 2-m axial FOV, the sensitivity for a 2-m-long PET scanner of 60 and 80-cm diameter is around 80 and 68 times higher, respectively, than that of the conventional PET scanner. In addition, for the 2-m-long PET scanner with 60-cm diameter, the peak noise equivalent count rate (NECR) was 843 kcps at 125 MBq, whereas the peak for the 80-cm diameter was 989 kcps at 200 MBq. This shows gains of 15.3 and 17.95, respectively, in comparison with that of the conventional PET scanner. The 2-m-long PET scanner with 60-cm ring diameter could not only reduce the number of detectors by 21 %, but also had a 17 % higher sensitivity compared to that with an 80-cm ring diameter. On the other hand, despite the higher sensitivity, the NECR of the 60-cm ring diameter was smaller than that of the 80-cm ring diameter. This results from the single data loss due to dead time, whereas grouping of axially stacked detectors was used in the conventional DAQ architecture. Parallelization of the DAQ architecture is therefore important for the 2-m-long PET scanner to achieve its optimal performance. 相似文献
Patients who have undergone bariatric surgery are at risk for gallstone formation. However, the incidence of gallstone formation after bariatric surgery has not been adequately studied in the Japanese population. We aimed to elucidate the incidence and risk factors for gallstone formation after laparoscopic sleeve gastrectomy (LSG) for Japanese patients with severe obesity.
Methods
We conducted a retrospective cohort study among patients with severe obesity treated with LSG between April 2017 and June 2020 at two institutions. Patients who had received previous cholecystectomy, had preoperative gallstones, and had received postoperative prophylactic ursodeoxycholic acid were excluded. Body weight, body mass index, and blood data were collected at each follow-up visit before and after the surgery. Follow-up abdominal ultrasonography was performed 6–12 months after surgery, and the incidence of gallstones was calculated. The association between the data and gallstone formation was evaluated.
Results
During the study period, we performed LSG for 98 patients. Of these, 61 cases remained by above conditions and were examined using abdominal ultrasonography over 6 months after surgery. The incidence of gallstones was 23.0% and that of symptomatic gallstones was 3.3%. Anti-Helicobacter pylori antibody seropositive and titer were the only factors that showed significant association with de novo gallstone formation after LSG.
Conclusions
Anti-Helicobacter pylori antibody seropositive may be associated with de novo gallstone formation after LSG for Japanese patients with severe obesity.
下载免费PDF全文