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.

The purpose of this study was to investigate the fluctuation of the recovery period of autonomic nervous activity (ANA) after isokinetic exercise. Sixteen male subjects participated in this study after they turned in their consent forms.The subjects performed isokinetic knee extension-flexion exercise using BIODEX. We obtained the electro-cardiogram during the entire experiment. We calculated their heart rate (HR) and power spectral of R-R interval (LF is low frequency component, and HF is high frequency component. Both indexes were converted to a logarithm transformation as to lnHF and lnLF.) from pre-exercise period (PRE) and post-exercise period (POST).Some researchers reported that ΔlnHF of POST was lower and ΔLF/HF of POST was higher than those of PRE immediately after aerobic exercise; however, this study's results were in complete contrast.In conclusion, we found that the recovery periods after aerobic and isokinetic exercises of ANA are entirely different.

The present study aimed to examine the change cold-induced vasodilation (CIVD) of finger between seven female alpine (AP group) and six female cross-country skiers (CC group) at different points in their training programs. The CIVD test was performed twice, once in spring period after ski-training, once in the summer period during physical-training.From the onset of ice-water immersion in each CIVD test, finger skin temperature in each group fell followed by an incline. Thereafter, finger skin temperature began to rise and fall in an attenuated fashion during ice-water immersion. The resistance index (RI) in summer (7.1±1.7) for AP group was significantly (P<0.01) higher than that in spring (4.6±1.1). However, that of CC group showed no difference between spring and summer.These results suggested that the physical training during summer period for AP group may influence on the improvement of CIVD.

The purpose of this study was to analyze the body characteristics of university soccer players, especially the hip joint and pelvis where chronic injuries frequently occur among soccer players.
Body characteristics of seventy male university soccer players were surveyed by an orthopedic medical check. The Micro FET value (MF) was used as the unique test for the potential stress on the pubic symphysis. MF was defined as the pressure value at which a subject claimed tenderness from compression on the pubic symphysis.
Among the various tests of the orthopedic medical check, trunk extension in the prone position and external rotation of the hip joint in the standing position correlated with MF. The same tendencies were observed in soccer players with pubic symphysitis.
Results indicate that these three simple tests : MF, trunk extension in the prone position and external rotation of the hip joint in the standing position, can be used as valuable indices for detecting pubic symphysitis in the early stages.

Kampo medicines have been used for treatment by an increasing number of doctors in recent years, and are becoming more frequently prescribed in combination with Western drugs. In the present study, we conducted a questionnaire of outpatients at the Kampo Clinic of Keio University Hospital in order to determine their perceptions and compliance regarding Kampo medicines.Ninety eight percent of patients used Kampo medicines in granular form, and approximately 30% of these patients reported difficulty in taking medicine due to reasons such as “bad taste”. Sixty percent of patients used Kampo medicines three times daily. Patients most often forgot to take afternoon doses, and so desired doses once daily. Furthermore, the same number of patients preferred Kampo medicines in tablet form as those who preferred Kampo medicines in granular form.The present findings clarified patients' perceptions toward Kampo medicines. Doctors and pharmacists must provide suitable treatment for patients by recognizing their perceptions of Kampo medicines.
Medicine, Kampo ; Clinic ; Use of ; percent ; therapeutic aspects

The system of the Japanese Board of Cardiovascular Surgery is changing. Since the last time, we have deliberated on the medical specialty board for U-40 column articles about the problems faced by young cardiovascular surgeons. This time, we conducted the second survey to U-40 members about the realities of becoming a board-certified cardiovascular surgeon. The results showed the circumstances and details on how to acquire the board certification. Moreover, we discussed about the current problems and future perspectives for the young cardiovascular surgeons.

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the oncological outcomes, including distant relapse, after en bloc spondylectomy (EBS) for spinal metastases in patients with a minimum of 2-year follow-up. OVERVIEW OF LITERATURE: Although EBS has been reported to be locally curative and extend survival in select patients with spinal metastases, detailed reports regarding the control of distant relapse after EBS are lacking. METHODS: We conducted a retrospective review of 18 consecutive patients (median age at EBS, 62 years; range, 40–77 years) who underwent EBS for spinal metastases between 1991 and 2015. The primary cancer sites included the kidney (n=7), thyroid (n=4), liver (n=3), and other locations (n=4). Survival rates were estimated using the Kaplan–Meier method, and groups were compared using the log-rank method. RESULTS: The median operative time and intraoperative blood loss were 767.5 minutes and 2,375 g, respectively. Twelve patients (66.7%) experienced perioperative complications. Five patients (27.8%) experienced local recurrence of the tumor at a median of 12.5 months after EBS, four of which had a positive resection margin status. Thirteen patients (72.2%) experienced distant relapse at a median of 21 months after EBS. The estimated median survival period after distant relapse was 20 months (95% confidence interval, 0.71–39.29 months). No association was found between resection margin status and distant relapse. Overall, the 2-year, 5-year, and 10-year survival rates after EBS were 72.2%, 48.8%, and 27.1%, respectively. Importantly, the era in which EBS was performed did not impact the oncological outcomes. CONCLUSIONS: Our results suggest that EBS by itself, even if margin-free, cannot prevent further dissemination, which occurred in >70% of patients at a median of 21 months after EBS. These results should be considered and conveyed to patients for clinical decision-making.
Clinical Decision-Making ; Follow-Up Studies ; Humans ; Kidney ; Liver ; Methods ; Neoplasm Metastasis ; Operative Time ; Recurrence ; Retrospective Studies ; Spine ; Survival Rate ; Thyroid Gland

Objective: In 2013, a cohort study aimed to clarify the positive and negative effects of introducing the human papillomavirus (HPV) testing for population-based cervical cancer screening has been launched in Japan. This study included four screenings during the subsequent 7-year follow-up period. We aim to describe the results of the first round of this study on cervical cancer screening here. Methods: This study began in September 2013 with recruitment completed in March 2016.Women aged 30–49 years were divided into 2 groups: those who received uterine cervical cytology alone in the first year (control group), or those who received a combination of cytology and HPV testing (intervention group), based on their age. After first screening, women with positive result of cytology or positive HPV test required referral. We summarized the results of the first round of cervical cancer screening. Results: Of the 25,074 women who were eligible for the study, 13,845 women (55.2%) were screened with cytology alone; 11,229 women (44.8%) received a combination of cytology and HPV testing. After screening, 407 women (2.9%) in the control group and 1,003 women (8.9%) in the intervention group required referral, respectively. Adding HPV testing increased referral rate significantly (p<0.001). Conclusion After first screening, introduction of HPV testing appears to contribute to significantly higher referral rates, suggesting that the number of colposcopies as a detailed examination may increase. These preliminary findings suggest that if HPV testing is introduced into screening, medical institutions need to be prepared for an increasing number of follow-up examinations.

A 81-year-old man underwent CABG for angina pectoris. The grafts were all patent in postoperative coronary angiography and he was discharged on postoperative day 24. Pericardial and pleural effusion appeared in 1 month after surgery. After pericardial and pleural effusion drainage, we started steroid therapy. However, his symptoms did not improve. We performed pericardiectomy under the diagnosis of constrictive pericarditis. Diastolic dysfunction improved after the surgery, and he was discharged on postoperative day 117.