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1.
Yohei Tomaru Hiroshi Kamada Yuta Tsukagoshi Shogo Nakagawa Kenta Tanaka Ryoko Takeuchi Yuki Mataki Shumpei Miyakawa Masashi Yamazaki 《Journal of orthopaedic science》2019,24(1):159-165
Background
On April 1, 2016, the Ministerial ordinance was enforced, and musculoskeletal examination of the extremities was made mandatory. From 2008, the University of us started musculoskeletal direct examination. To expand the examination, from 2016, we started to use the marksheet-type questionnaire. This study aimed to report the results of a musculoskeletal examination and investigate the association between musculoskeletal examination and age/gender and reports the reliability of the collected questionnaire data.Methods
Direct musculoskeletal examination was performed in K school by 7 orthopedic surgeons. A marksheet-type screening questionnaire was distributed to all the elementary and junior high school students in Tsukuba and Hitachiomiya cities. The rates of abnormal findings for scoliosis, standing flexion, full squatting with the heels on the floor, general joint laxity, and standing on one leg, torticollis, and flat feet were calculated. We compared the results of the questionnaire and direct examination and calculated sensitivity, specificity, and odds ratio.Results
A total of 1844 students in K school had direct examination, and 22,494 questionnaires were able to correct in Tsukuba and Hitachiomiya cities. The rates of abnormal findings in direct examination/questionnaire in scoliosis, standing flexion, full squat, general joint laxity, standing on one leg, torticollis and flat foot were 18.7% (344/1842)/5.1% (1094/21441), 20.2% (372/1841)/26.6% (5817/22078), 6.2% (114/1832)/6.9% (1516/22101), 7.5% (1648/22252), 4.9% (1100/22077), 2.2% (31/1844)/1.2% (272/21687), and 12.5% (231/1842)/8.7% (1785/20871), respectively. Sensitivities of the questionnaire for scoliosis, stand flexion, full squatting, torticollis, and flat feet were 16.8% (53/316), 67.9% (250/368), 48.2% (55/114), 18.9% (7/37), and 32.2% (65/202), respectively.Conclusion
We reported the result of musculoskeletal examination. Accuracy and reliability of this questionnaire were not satisfactory. To perform high quality musculoskeletal examinations, we will aim to increase the quality of screening methods. 相似文献2.
3.
Masayuki Tori Masaaki Nakahara Hiroki Akamatsu Shigeyuki Ueshima Masashi Shimizu Kazuyasu Nakao 《Journal of hepato-biliary-pancreatic sciences》2006,13(5):472-476
Even for patients with multiple pancreaticoduodenal aneurysms, successful treatment with noninvasive operative procedures can be employed, if intraoperative devices are considered. A 73‐year‐old man, without any symptoms, was admitted to our hospital and had computed tomography (CT) scanning to examine his liver for hepatitis C virus (HCV). Selective superior mesenteric artery (SMA) angiography confirmed multiple aneurysms in the anterior inferior pancreaticoduodenal artery (AIPDA), one aneurysm in the posterior inferior mesenteric artery (PIPDA), and another in the occluded celiac trunk, all with severe calcification. All of the aneurysms were thought to communicate with each other. With the celiac artery occlusion, the right hepatic artery (RHA) was revealed to be supplied by collateral arteries from the aneurysms in the AIPDA, and the left hepatic artery was shown to be supplied by collaterals from the left gastric artery. Intraoperative Doppler echography, at the time of the clamping of both IPDAs, demonstrated a marked decrease of blood velocity in all aneurysms (before clamping, >50 cm/s; after, <10 cm/s), although loss of pulsation and a marked decrease of flow in the RHA were inevitable. Therefore, each of these two IPDAs were ligated on the proximal side to the aneurysm, thus preserving the blood flow of the pancreas head fed by the PIPDA; bypass grafting from the AIPDA to the RHA, using the great saphenous vein, was done at the same time. After the creation of an anastomosis, the hepatic venous oxygen saturation (ShvO2) increased from 38% (at the time of ligation of the IPDAs) to 57% under ventilation. The patient's postoperative clinical course was uneventful. We describe and discuss our successful noninvasive operative management of multiple pancreaticoduodenal aneurysms, done while monitoring the blood flow and ShvO2, with some consideration of the literature. 相似文献
4.
Daisuke Kubota Chizuru Takishima Ken-ichi Ishii Takahiro Kawamura Tomoko Matsumoto Yasuhiro Itsui Eriko Okada Seishin Chin Shinya Oooka Kiichiro Tsuchiya Akihiro Araki Naoya Sakamoto Tatsuya Miyata Takanori Kanai Mamoru Watanabe 《Nihon Shokakibyo Gakkai zasshi》2006,103(9):1044-1049
A 23-year-old man was admitted for treatment of acute exacerbation of ileitis and perianal abscess caused by Crohn's disease. After incision and drainage of the abscess, coupled with antibiotic therapy, 6-mercaptopurine (6-MP) was commenced. His white blood cell (WBC) count on day 12 after initiation of 6-MP was not decreased. However, on day 24 he was re-admitted because of severe myelosuppression (WBC: 300/microl), which was complicated by the recurrence of the perianal abscess. Myelosuppression was prolonged and required the administration of granulocyte colony stimulating factor (G-CSF). G-CSF was continued for 17 days to achieve recovery of his WBC count to a normal level. 相似文献
5.
Toshio Imaizumi MD PhD Toshimi Honma MD PhD Yoshifumi Horita MD Ikuhide Kohama MD PhD Kei Miyata MD Maiko Kawamura MD Jun Niwa MD PhD 《Journal of neuroimaging》2006,16(3):236-242
BACKGROUND AND PURPOSE: Dot-like low intensity spots (dot-like hemosiderin spots: dotHSs) on gradient echo T2*-weighted MRI have been histologically diagnosed to represent old cerebral microbleeds associated with microangiopathies. They have also been correlated to the fragility of small vessels and the tendency to bleed. Therefore, a substantial number of dotHSs might be associated with a large-sized, deep intracerebral hematoma (ICH). On the other hand, dotHSs may reflect old microbleeds that did not enlarge to symptomatic size. METHODS: To investigate how dotHSs are related to the size (maximal diameter) of primary deep ICH, we analyzed the diameter and the number of dotHSs in 151 patients with deep ICH not associated with subarachnoid hemorrhage or intraventricular hemorrhage (75 males and 76 females, age ranged from 37 to 90 [65.7 +/- 11.3 years old] who were consecutively admitted to Hakodate Municipal Hospital. The hazard ratio (HR) for a maximal diameter of deep ICH < or =2 cm was estimated, using the number of dotHSs and risk factors for stroke. RESULTS: The number of dotHSs associated with the diameter < or =2 cm was 9.2 +/- 11.5, significantly larger than that with the diameter > or =2 cm (4.7 +/- 7.0, P= .012). Multivariate analysis revealed that a maximal diameter of deep ICH of < or =2 cm was found in patients with dotHS (HR, 3.7; 95% confidence interval [CI], 1.4-10.1; P= .009). CONCLUSION: Though small sample size limited the power of our analyses, these findings suggest that the number of dotHSs may be associated with a small diameter of deep ICH. 相似文献
6.
Kenichi Okubo Masashi Kobayashi Hiromasa Morikawa Eiichi Hayatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(7):268-272
Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer
with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal
node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral
to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted
of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients
underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical
findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy
after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion
to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal
nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior
to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p<
0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea
and makes the node dissection easier after induction chemoradiotherapy. 相似文献
7.
Daisuke Kubota Takanori Kanai Fumiro Yui Tomoko Matsumoto Takahiro Kawamura Yasuhiro Itsui Eriko Okada Seishin Chin Shinya Ooka Masakazu Nagahori Kiichiro Tsuchiya Akihiro Araki Naoya Sakamoto Tatsuya Miyata Mamoru Watanabe 《Nihon Shokakibyo Gakkai zasshi》2007,104(1):42-46
A 44-year-old women developed marked myopathy one year earlier, when she was treated with intravenous prednisolone for acute severe exacerbation of ulcerative colitis. When she was admitted to our hospital for another severe exacerbation, intravenous cyclosporine A was administered as monotherapy because she could not tolerate corticosteroid. The treatment was successful and she obtained complete remission. Cyclosporine A monotherapy is considered to be a valuable alternative to proctocolectomy for severe ulcerative colitis patients who cannot tolerate corticosteroid. 相似文献
8.
9.
Benign schwannoma of the pancreas 总被引:2,自引:0,他引:2
Labile Togba Soumaoro Kenichi Teramoto Tohru Kawamura Noriaki Nakamura Takahiro Sanada Kenichi Sugihara Shigeki Arii 《Journal of gastrointestinal surgery》2005,9(2):288-290
Reported cases of intrapancreatic schwannomas have recently increased in the literature. However, none of these cases were
diagnosed clearly as schwannoma preoperatively. We herein describe the clinicopathologic findings of a solitary benign schwannoma
occurring in the head of the pancreas. Additionally, the differential diagnosis versus other cystic- and solid-appearing pancreatic
masses is briefly discussed. 相似文献
10.
Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia 总被引:2,自引:0,他引:2
Shigeru Lee Harushi Osugi Taigo Tokuhara Masashi Takemura Masahiro Kaneko Yoshinori Tanaka Yushi Fujiwara Satoshi Nishizawa Hiroshi Iwasaki Shigefumi Suehiro 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):470-476
Objective Self-expandable metallic stent (EMS) placement has been the first choice for dysphagia because of the certainty over its safety,
low invasiveness, and immediate efficacy. However, there still remain some problems in relation to the EMS placement site
and anticancer therapies before and after EMS placement. Methods: Consecutive 78 patients in whom EMS was placed due to the unresectable malignant stricture in the esophagus or cardia from
July 1995 to August 2003 in our department were studied. Results: Gastroesophageal reflux was found in 5 of 8 patients after placement of conventional EMS for the stricture in the gastroesophageal
junction. Meanwhile, acid and bile reflux into the esophagus were not detected by pH and bilirubin monitoring, respectively,
in 6 patients after placement of the EMS with an anti-reflux mechanism for the stricture in the gastroesophageal junction.
The median survival period of all patients after EMS placement was 123 days. The median survival period of 7 patients with
radiotherapy only after EMS placement was 138 days and that of 17 patients with radiotherapy before EMS placement was 60 days,
which was shorter than that of the former (p<0.05). On the other hand, the median survival period after hospital admission
due to dysphagia of these 7 patients was longer than that of 17 patients with radiotherapy only before EMS placement, although,
the difference was not significant. Conclusion: EMS with an antireflux mechanism is not commercially available in Japan and approval is urgently required. The indication
of radiotherapy associated with EMS placement is to be studied further. 相似文献