BackgroundThe Shoulder Pain and Disability Index (SPADI) is a simple disease specific questionnaire that is used to evaluate the impact of shoulder disorders. The purpose of this study was to translate the SPADI into Japanese (SPADI-Jp) and evaluate its reliability and validity in Japanese patients with shoulder disorders.MethodsCross-cultural adaptation of the SPADI was performed according to international guidelines. A total of 100 patients with shoulder disorders participated in this study. Each participant was asked to finish the SPADI-Jp, Disability of Arm, Shoulder and Hand (DASH), and the Short-Form 36 (SF-36) at the initial visit. Thirty-four patients repeated the SPADI-Jp to assess the test–retest reliability. The test–retest reliability was quantified using the interclass correlation coefficient (ICC), while Cronbach's alpha was calculated to assess the internal consistency. The construct validity was assessed using Spearman's rank correlation coefficients.ResultsInternal consistency in the SPADI-Jp was very high (0.969), as measured by the Cronbach's alpha. The ICC of the SPADI-Jp was 0.930. There was a strong, positive correlation between the DASH and the SPADI-Jp (r = 0.837, p < 0.001). The SPADI-Jp was significantly correlated with most of the SF-36 subscales. The correlations of the SPADI-Jp with physical subscales of the SF-36 were stronger than those with the other subscales.ConclusionsWe demonstrated that the SPADI-Jp is a reliable and valid self-assessment tool. Because cross-cultural adaptation, validation, and reliability of the disease-specific questionnaire for shoulder pain and disability have not been evaluated in Japan, the SPADI-Jp can be useful for evaluating such patients in the Japanese population. 相似文献
Clinical and Experimental Nephrology - Rituximab is conditionally approved in Japan for use in patients with refractory nephrotic syndrome. To meet the conditions of approval, an all-case... 相似文献
We examined the effect of GM1-ganglioside in combination with cholera toxin B, and synthetic α-sialyl cholesterol (α-SC) on neutral amino acid (tritiated α-aminoisobutyric acid, [3H]AIB) uptake, protein synthesis ([3H]leucine incorporation), and Na+, K+-ATPase activity in isolated superior cervical ganglia (SCG) and nodose ganglia (NG) from adult rats after aerobic incubation, usually for 2 h at 37°C in vitro. Cholera toxin B, that specifically masks the oligosaccharide chain of GM1-ganglioside, antagonized the GM1-induced changes in [3H]AIB uptake, [3H]leucine incorporation, and Na+, K+-ATPase activity almost completely in SCG, but partially in NG. Although cholesterol itself had little effect on either [3H]AIB uptake and Na+, K+-ATPase activity both in SCG and NG, α-SC caused considerable reduction of both amino acid uptake and the transport enzyme activity in each ganglia. However, cholesterol was more effective than α-SC in decreasing [3H]leucine incorporation in either ganglia. Whereas addition of EGTA markedly reduced either GM1-induced or α-SC-induced change in [3H]leucine incorporation into acid-insoluble fraction in both SCG and NG, application of Ca2+ ionophore produced considerable recovery of the protein synthesis from the inhibited level by Ca2+-deprivation. ATP and creatine phosphate contents in SCG were elevated by the presence of GM1 or α-SC, whereas [3H]AIB uptake and Na+, K+-ATPase activity were inhibited, suggesting that utilization for membrane transport was diminished as a result of GM1- or α-SC-induced decrease of ATPase activity. 相似文献
Many clinical reports have described vocal cord paralysis after general anaesthesia. In most cases, paralysis was attributed
to tracheal tube insertion. In this report we describe one patient in whom gastric tube insertion was strongly suspected as
the cause of paralysis. The patient was a 47-yr-old man who underwent left hepatic lobectomy. Just after the operation he
complained of hoarseness and a diagnosis of complete right vocal cord paralysis was made, from which he recovered after eight
weeks. In this patient, insertion of the gastric tube seemed to have injured the anterior ramus of the right recurrent laryngeal
nerve directly. Although there have been several reports of vocal cord paralysis induced by gastric tubes, none has noted
such an acute onset and direct nerve injury. Therefore we would like to report this rare case and elucidate the mechanism
of vocal cord paralysis. Careful attention should be paid in inserting a gastric tube to patients under general anaesthesia
and, sometimes, the use of the soft tube may be indicated.
Plusieurs publications portent sur la paralysie des cordes vocales après une anesthésie générale. Dans la plupart des cas,
on attribue la paralysie à l’insertion du tube endotrachéal. Ce compte-rendu se rapporte à un cas où l’insertion d’une sonde
gastrique est fortement mise en cause dans l’étiologie de la paralysie. Un patient de 47 ans subit une hépatectomie. Immédiatement
après l’intervention, il se plaint de raucité de la voix et une paralysie de la corde vocale droite est diagnostiquée. La
récupération s’effectue en huit semaines. Chez ce patient, la sonde gastrique semble avoir endommagé directement le rameau
antérieur du nerf récurrent laryngé. Bien que plusieurs observations identiques de paralysie des cordes vocales provoquée
par une sonde gastrique aient été publiées, aucune ne rapporte un début aussi soudain avec lésion nerveuse directe. Nous décrivons
ici ce cas rare et tenterons d’expliquer le mécanisme de la paralyse de la corde vocale. Il faut être très prudent lorsqu’on
insère un tube gastrique sous anesthésie générale et il est parfois préférable d’utiliser un tube mou. 相似文献
Background. Exact clinical staging before treatment of esophageal cancer has become increasingly important in the evaluation and comparison of the results of different treatment modalities, including surgery, chemotherapy, and radiotherapy.
Methods. The accuracy of preoperative tumor staging by using an esophagography, esophagoscopy, percutaneous and endoscopic ultrasonography, and computed tomography was assessed in 224 patients with resectable esophageal cancer. The results of tumor staging by these tests were compared prospectively with the pathologic stage of the esophagectomy specimens with respect to the T and N categories defined by the International Union Against Cancer TNM classification.
Results. For the T category, the overall accuracy was 80%. For the N category, overall accuracy was 72%, with a sensitivity of 78%, a specificity of 60%, and a positive predictive value of 78%. Overall, the accuracy of stage grouping was 56%.
Conclusions. Either the T or N categories can be predicted reliably by clinical staging techniques. However, the preoperative stage grouping might not be valid in resectable, localized esophageal cancer. 相似文献
Surgical treatment for aortic regurgitation (AR) caused by Behcet's disease is difficult due to the need to manipulate fragile, inflamed tissue. Valve detachment following aortic valve replacement (AVR) and suture detachment are serious postoperative complications. We investigated the surgical results in 11 patients. Between 1981 and July 1999, 11 patients, 9 males and 2 females, with AR caused by Behcet's disease underwent surgery. The age of these patients ranged from 33 to 60 years (mean, 45+/-8 years). The surgical procedures for AR were AVR in six patients and valved conduit operation in five patients. No patient died during the hospital stay. In a follow-up period ranging from 3 to 204 months (mean, 93+/-64 months) two patients died. Prosthetic valve detachment or suture detachment necessitating redo-operation occurred in four patients (36%) who then underwent a valved conduit procedure as a reoperation. Prosthetic valve detachment was higher in patients with AVR than in patients with a valved conduit operation. Valved conduit reconstruction is indicated in patients with AR caused by Behcet's disease in whom prevention of valve detachment is difficult even by current valve fixation methods. 相似文献
OBJECTIVE: The number of foreigners residing in Japan has increased during the past decade. The aim of this survey was to clarify the present situation and the disadvantages in the medical care for foreigners. METHODS: In October 1997, we mailed a questionnaire to all clinics and hospitals in Chiba City. The questionnaire included questions regarding the number of foreign patients who visited during the past three months, the proportion of patients who have any health insurance, procedures for handling foreign patients, and the disadvantages in medical care for them. RESULTS: Of the 210 respondents (183 clinics and 27 hospitals), 133 facilities (63.3%) provided medical care for foreign patients during the past three months, and 187 (89.0%) during the past year. In 102 facilities (76.7%), the number of foreign patients was fewer than 10 during the past three months. The mean number of foreign patients was 13.8 per facility (12.2 per clinic, and 23.5 per hospital). Of these foreign patients, 68.6% had any health insurance. In 172 facilities (81.9%), foreign patients were accepted in the same way as the Japanese. The main disadvantages in medical care for foreigners were difficulty in understanding because of communication problems, and default in payment of medical expenses for the foreigners with no health insurance. In 154 facilities (73.3%), no special preparation to communicate with foreign patients was provided, and few facilities could understand foreign languages except for English. In 20 facilities, fees for medical care had been left unpaid by foreign patients during the past year, and the total outstanding amount was about 23,800,000 yen. CONCLUSION: In Chiba City, many medical facilities provide medical care for foreign patients. This study suggests that support for communication with foreigners and compensation for default in medical expenses are necessary. 相似文献