PURPOSE : The purpose of this study is to compare sagittal spinal alignment and mobility among standing and sitting (which are fundamental postures in daily activities), and four point kneeling (FPK: the imitation of quadrupedal animal posture).METHODS : Fifty three healthy young men have participated in this study. Spinal alignment is measured using a non-invasive skin surface measurement device (Spinal Mouse®: Index Ltd, Japan). The spinal alignment is measured in 3 positions: upright, flexion, and extension, in each posture (standing, sitting, and FPK), and then the thoracic and lumbar curvature and sacral slope are analyzed.RESULTS : Even between 2 fundamental positions, upright standing and sitting, the lumbar lordosis is statistically different (17.1±8.9° at upright standing, 3.5±10.0° at upright sitting, p<0.001). But the sacral slope is not different between those 2 positions. The lumbo-pelvic rhythm (lumbar-hip or lumbar-pelvis flexion ratio) is also different among the 3 postures, especially in FPK posture. In this posture the lumbar spine and pelvis (sacrum) move to opposite direction each other; this phenomenon is not observed at standing and sitting postures. CONCLUSION : The spinal alignment and mobility are different in many segments among standing, sitting, and FPK.

　　This study was conducted to clarify the benefits of using cervical cytological examinations and human papilloma virus (HPV) testing in our cervical cancer screening program, which was carried out during the period from April 2012 through March 2013 in the Yuri-Honjo district of Akita Prefecture. A total of 772 women underwent this screening. About 11.3% (87/772) of the examinees tested positive for HPV, and of these 87 women, 64 were also positive for HPV DNA in the examinations subsequently conducted in the outpatient clinic. Of the HPV DNA-positive women who showed no sign of abnormalities in cytology, 67.6% had lesions cervical intraepithelial neoplasia (CIN) 1 and above, and five women had l CIN 2/3. Compared with the conventional cytology which detected nine women with CIN 2/3, our screening method with a combination of cytology and HPV testing found 14 women with CIN 2 or 3. To upgrade the cervical cancer screening, we recommend HPV testing should be used in combination with cervical cytology.

The purpose of this study was to determine the effects of supine floating on rectal temperature and cardiac autonomic nervous system activity after exercise. Seven healthy males volunteered for this study. Subjects performed supine position for 30 minutes in both control condition (C-condition) and water condition (W-condition) after exercise with a cycle ergometer for 15 minutes. Exercise intensity was high (80%VO₂max) and moderate (60%VO₂max). Water temperature was 30 degrees Celsius. Rectal temperature of post exercise showed no significant differences under the W-condition, as compared to the C-condition. Delta rectal temperature (point 0-0 was end of exercise) was significantly reduced (p<0.05) under the W-condition, as compared to the C-condition. Log HF was significantly increased (p<0.05) under the W-condition, as compared to the C-condition. These data suggested that supine floating after high and moderate intensity exercise could promote recovery of rectal temperature and increased in cardiac parasympathetic nervous system activity.

The purpose of this study was to examine the effects of anthropometric measures, including body height, body weight, body mass index (BMI), fat mass (FM), and lean body mass (LBM), on quantitative ultrasound (QUS) parameters of calcaneus in 358 Japanese university women. Ultrasonic bone densitometer (Achilles, Lunar corp.) was utilized to measure broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) of the right calcaneus. The average of SI in this study showed a slight lower value (84, 3±12.1, mean±SD) compared with that in age-matched university women as previously reported. The contradictive finding may suggest the need for a large-scale further investigation on SI in young women. Correlation analysis revealed that both BUA and SI are significantly correlated with all anthropometric measures. However SOS had only weak correlation with LBM. In consideration of the high colinearities of body weight and BMI with FM and LBM, the multiple liner regression analysis was conducted with BUA, SOS, and SI as dependent variables. Body height, FM, and LBM were then entered to a forward stepwise regression model. The analysis proved that the significant predictor of BUA, SOS, and SI is LBM. It also suggested BUA to be stronger correlated with LBM than the other QUS parameters, SOS and SI. In conclusion, our re sults support the view that QUS parameters appear to be influenced by anthropometric measures, especially by LBM in Japanese university women. It is conceivable that an increase in skeletal mus cle mass chiefly induced by physical exercise contributes to the improvement of bone mass as measured by QUS in young women.

The college years are an opportune timepoint of intervention in the primary prevention of osteoporosis. However, the effects of anthropometrical measures and lifestyle-related factors on the changes in bone mass during college years are unclear. The purpose of this study was thus to identify the determinants of the changes in calcaneal quantitative ultrasound (QUS) bone parameters (stiffness index: SI, speed of sound: SOS, broadband ultrasound attenuation: BUA) over 2 years in healthy Japanese college women (n=128). Correlation analysis revealed several significant relationships between the change rates in QUS parameters and anthropometry. Particularly, the changes in SI and BUA are highly correlated with the 2-year change in lean body mass (LBM). The subsequent multiple liner regression analysis also supported that the change in LBM was the significant predictor for the incremental rate of SI and BUA. All subjects then categorized into some grades, concerning about following lifestyle-related and physical variables during the last 2 years, living condition, sleeping time, alcohol consumption, smoking, meal skipping, dairy foods intake, instant foods intake, regular physical activity, regularity of menstruation, history of fracture, and history of dieting to reduce body weight. The incremental rates of all QUS parameters (i. e., SI, SOS, BUA) were positively associated with participation in regular physical activity. In addition, women who have continuously participated in regular physical activity from high school to college showed significant increases in SI and SOS compared with those who are not physically active or whose level of physical activity decline during college years. In conclusion, our study indicates that changes in QUS parameters in college-aged women were influenced by changes in anthropometric measures, especially LBM. It might suggest the importance of participation in regular physical activity to increase skeletal muscle mass. Our results also support the view that college women should maintain or increase regular physical activity before and after entering the college to maximize peak bone mass or lessen the age-related loss in bone mass in adulthood.

We investigated the effects on medical education of early exposure of undergraduate students to a summer camp for children with asthma. An objective evaluation by the editorial staff found final improvements in the following areas (in descending order of frequency): learning of basic medical behavior (91% of students); cooperative attitude of medical staff in general treatment with the patient and the patient's family (88%); understanding of childhood growth and development (80%); knowledge of childhood asthma (69%); and mastery of basic techniques for therapy and examination (41%). The differences in the ratio of improvement (%) before and after visiting the camp, were (in descending order of frequency): cooperative attitude of medical care staff in general medical treatment with the patient and the patient's family (47%); understanding of childhood growth and development (45%); knowledge of childhood asthma (38%); learning of basic medical manner (34%); and mastery of basic techniques for therapy and examination (25%). These findings suggest that a summer camp is useful for exposing undergraduate medical students to children with asthma and is effective for helping them understand patients and family-oriented pediatric medicine.

STUDY DESIGN: Retrospective and comparative study. PURPOSE: We assessed surgical treatment outcomes in patients with thoracic myelopathy due to ossification of the ligamentum flavum (OLF), and OLF combined with ossification of the posterior longitudinal ligament (OPLL) or vertebral fracture (VF) at the same level. OVERVIEW OF LITERATURE: OLF and OPLL cause severe thoracic myelopathy. Osteoporotic VF commonly occurs at the thoracolumbar junction. There have been no investigations of thoracic myelopathy due to OLF and VF. METHODS: Forty patients were divided among three groups: the OLF group (n=23): myelopathy due to OLF, the OLF+OPLL group (n=12): myelopathy due to OLF and OPLL, and the OLF+VF group (n=5): myelopathy due to OLF and VF. We recorded OLF, OPLL, and VF sites and operative procedures. Each patient’s neurological status, according to the Japanese Orthopaedic Association (JOA) score, and walking ability were evaluated pre- and postoperatively. RESULTS: Patients in the OLF+OPLL group were significantly younger than those in the other two groups. The preoperative JOA score was significantly lower in the OLF+VF than OLF group. The final JOA score was significantly lower in the OLF+VF than OLF and OLF+OPLL groups. The JOA score recovery rate was significantly lower in the OLF+VF than OLF group. Final walking ability was significantly worse in the OLF+OPLL and OLF+VF groups than in the OLF group and significantly worse in the OLF+VF than OLF+OPLL group. CONCLUSIONS: Thoracic myelopathy due to OLF+VF occurs primarily in older females, who also exhibit worse preoperative and postoperative neurological status, and worse walking ability, than patients with thoracic myelopathy due to OLF or OLF+OPLL.

Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in April 2013, as a national immunization program for girls aged 12–16 years, after an initial introduction in 2010 as a public-aid program for girls aged 13–16 years. The Yuri-Honjo district had the highest vaccine coverage among women aged 17–51 years in 2017, due to the original public-aid program. The aim of this study was to evaluate the differences in the vaccine types of HPV16/18 infections between 2008–2012 (pre-vaccine era) and 2013–2017 (vaccine era).Materials and Methods: We evaluated whether HPV vaccination was associated with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of HPV-associated cervical lesions. A total of 1,342 women aged 18–49 years, covering both the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent HPV genotype tests from June 2008 to December 2017 were compared.Results: Among women aged 18–24 years with higher vaccine coverage (68.2%), the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively, in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2− and grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to 36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did not significantly differ between the two eras.Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly decreased in women aged 18–24 years, most of whom were vaccinated. HPV vaccination effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.

Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.
Asian Continental Ancestry Group ; Colorectal Neoplasms ; Humans ; Japan ; Methods ; Traction

The indications of hachimijiogan formulation include lower limb pain, low back pain, edema, fatigue, coldness, and accompanying symptoms of hypertension. In this study, hachimijiogan was administered to patients who complained of symptoms of coldness, pain, etc., and the subsequent blood pressure was observed. Changes in hachimijiogan, a powder pill formulation of crude drugs, were observed in 12 patients aged 45 years or older, with an average age of 71 years. Various symptoms of jinkyo, blood pressure, and laboratory findings were examined. Coldness and pain improved significantly after 3 months. Of the 9 patients who wanted to take hachimijiogan for more than 9 months, 8 were treated with antihypertensive drugs. Among them, 4 underwent an antihypertensive dose reduction by 9 months, and 3 received angiotensin receptor antagonists, and 1 received a Ca antagonist. The systolic pressure before treatment with hachimijiogan averaged 127 mmHg, and after 9 months it was stable at 128 mmHg despite drug dose reduction. In patients with antihypertensive drugs, the long-term use of hachimijiogan may facilitate dose reduction and protection of the vascular endothelium protection. The usefulness of hachimijiogan in the aging society was suggested.