1.The medical education of a student with a severe hearing impairment
Kazushi Taoda ; Teruyo Kitahara ; Hiroshi Matsuura
Medical Education 2012;43(4):299-307
Because changes in the Medical Practitioners’ Act in 2001 allowed persons with impaired hearing to obtain a physician’s license, medical education for hearing–impaired students has become necessary.
The Shiga University of Medical Science provided learning support for a student with severely impaired hearing who entered our university in 2001.
For class sessions, consideration was given to seating location, devices for taking notes, and distributed educational materials. However, difficulties often occurred in small–group sessions. Clinical training was made possible by taking measures in advance to compensate for the hearing impairment. Classmates viewed positively their learning with a severely hearing–impaired student.
We believe that a good understanding of hearing impairment by teachers and classmates and the selection of communication tools compensating for the impairment are essential for the medical education of hearing–impaired students.
2.Studies on Low Back Pain Caused by Agricultural Work in Flat Villages of South District in Akita Prefecture and by Work of Fisherman in a Fishing Village in Iwate Prefecture
Takeshi Sugaya ; Shigeki Hayashi ; Masato Hayashi ; Tomio Matsuoka ; Atsuro Yoshizumi ; Shinji Okubo ; Hiroshi Kitahara ; Kazuhiro Watanabe ; Yukio Ito ; Akira Kotanagi
Journal of the Japanese Association of Rural Medicine 1983;32(4):817-826
As regards to low back pain of agricultural worker, there are many problems still as to a syndrom of “Nofusho” in rural medicine, a disease in ocupational medicine and clinic of orthopedic.
Agricultural worker who complained of low back pain varies with their country and farm products, and it tend to increase with adding to their age. Further, the female rate of low back pain showed slightly high tendency than the made rate, 8.5-12.5 % of male, 6.5-13.4 % of female always complained of low back pain.
According to the findings of roentogenographic examination of back bone, the deformed vertebrae was found clearly, especially, low back pain caused by a trauma of soft tissue and iscogenic pain showed in farmers. Therefor, it is necessary to be improved working posture and condition.
In comparrison with non-farmer, it is located in order of truck drivers. bus drivers and repairmen.
3.Two Cases of Autoimmune Pancreatitis-Induced Obstructive Jaundice Treated with Inchinkoto
Hideyuki KITAHARA ; Tatsuya NOGAMI ; Hiroki MISAWA ; Sayuri ARAI ; Shigeru EBISAWA ; Hidetoshi WATARI ; Makoto FUJIMOTO ; Hiroshi FUJINAGA ; Hiroaki HIKIAMI ; Kozo TAKAHASHI ; Naotoshi SHIBAHARA ; Yutaka SHIMADA
Kampo Medicine 2014;65(3):202-209
We report two cases of inchinkoto treatment for obstructive jaundice via autoimmune pancreatitis (AIP). Case 1 : A 38-year-old male. After completion of treatment for Mikulicz disease, obstructive jaundice developed. A diagnosis of AIP was based on a high IgG 4 blood level and image views. T-Bil stayed above 20 mg/dl and there was no improvement by oral administration of prednisolone (PSL), ursodeoxycholic acid, or bilirubin adsorption therapy. Upon inchinkoto administration, T-Bil promptly fell to 3 mg/dL. Case 2 : A 77-year-old male. He suffered from itching and constipation, and blood data showed a pattern of obstructive jaundice. Image views suggested AIP, but a duodenal papillary biopsy could not provide a definitive diagnosis. Inchinkoto was administered, and the itching and constipation had mostly disappeared within 1 week. However, these symptoms recurred after one month. A definitive diagnosis of AIP was then reached based on a pancreas biopsy, and a PSL regimen was initiated. From these two cases, we consider that inchinkoto is useful for improving the symptoms of obstructive jaundice induced by AIP.
4.Three-Dimensional Evaluation of Innominate Bone Rotation in Female Patients with Developmental Dysplasia of the Hip
Noriaki SAKO ; Nobuhiro KAKU ; Yoshiki KITAHARA ; Yuta KUBOTA ; Hiroaki TAGOMORI ; Hiroshi TSUMURA
Clinics in Orthopedic Surgery 2022;14(2):196-204
Background:
Patients with developmental dysplasia of the hip (DDH) are known to have abnormal pelvic morphologies; however, rotation of innominate bone features remains unclear. Thus, we investigated innominate bone rotation in patients with DDH by measuring the associated angles and distances using three-dimensional (3D) computed tomography.
Methods:
We defined four straight lines in pelvic 3D models: from the anterior superior iliac spine to the posterior superior iliac spine, from the anterior inferior iliac spine to the posterior inferior iliac spine, from the pubic tubercle to the ischial spine, and from the pubic tubercle to the ischial tuberosity. Similarly, we measured the angles formed by these lines using the vertical axis of the anterior pelvic plane on the horizontal plane and the horizontal axis on the sagittal plane. Additionally, we measured the distances between the femoral head centers and the acetabular centers in the coronal plane.
Results:
The difference in internal rotation angle between the superior and inferior parts of the iliac bone was significantly lower, by approximately 1.7°, in the DDH group than in the control group (p = 0.007); the difference between the inferior and superior parts of the ischiopubic bone was significantly higher, by approximately 1.5°, in the DDH group (p< 0.001). In the sagittal plane, the sum of the superior aspect of the iliac bone and the inferior aspect of the ischium was significantly lower in the DDH group (p = 0.001) than in the control group. The distances between the femoral heads and the acetabula were significantly greater in the DDH group than in the control group (p = 0.03, p < 0.01, respectively).
Conclusions
Patients with DDH had a more internally rotated ilium and ischiopubic bone than normal individuals; however, it should be emphasized that internal rotation was reduced near the acetabulum, and the acetabulum was shifted laterally. Similarly, it was shown that patients with DDH had different rotations of the ilium and ischiopubic bone in the sagittal plane.