Among several manual examinations in cervical syndrome, there is a typical test called ‘Allen Test’ connected with hypertonus in the scalene muscles. We evaluated the clinical effectiveness of this test in cervical syndrome.
Both the positive group in the Allen test and the healthy group were examined with the plethysmogramm at the finger tips. As a result, in comparison with the healthy group, the positive group showed a low pulse wave. As their syndrome was improved clinically, their pulse wave heights were also improved.
It was thought that the Allen test was valuable to both the clinical test in cervical syndrome and the decisive test in a recovery from this syndrome.

A 64-year-old man with a history of abdominal aortic occlusion was admitted because of anterior chest pain. Angina pectoris with ischemic mitral regurgitation were diagnosed by transthoracic echocardiography and coronary artery angiography. He underwent coronary artery bypass grafting and mitral valve annuloplasty with a 26-mm Physio-ring. Because of difficulty in weaning from cardiopulmonary bypass, he required IABP support which was introduced via the ascending aorta. On the 2nd postoperative day, IABP was discontinued and the sternum was closed. His postoperative course thereafter was uneventful without any neurological complications. Postoperative echocardiogram showed good mitral valve function. He was discharged 16 days after surgery.

The human tooth with immature apex is a developing organ available for investigation. In this tooth, especially in the apical pulp, the proliferation and differentiation of various cells are activated to make a complete tooth. We investigated the notion that unique cells are included in the apical pulp of human tooth with immature apex. Human impacted third molars with immature apex freshly extracted for orthodontic reasons or treatment were obtained. Histological analyses revealed that BrdU-incorporating cells and cells positive for the mesenchymal stem cell markers SH2 and SH3 were located in the same region. The cells from the apical pulp of a human tooth with immature apex, designated here as apical pulp-derived cells (APDCs), can be cultured easily in vitro under ordinary serum-supplemented culture condition. The expression of surface markers of expanded APDCs is similar to that of bone marrow mesenchymal stem cells, except for CD49d (α4-integrin). APDCs differentiated into mineralized cells, adipocytes, chondroblasts and neural cells in vitro. APDCs have a high capacity for proliferation and multilineage potential in vitro. Our results indicate that human tooth with immature apex is a precious tissue source for the research of human adult stem cells and for the advancement of dental and regenerative medicine.

A 33-year-old woman underwent aortic root replacement for aortic regurgitation and an aneurysm of the ascending aorta due to annuloaortic ectasia. Ehlers-Danlos syndrome was diagnosed by skin biopsy when she was 23 years old. At operation, to avoid mechanical stress to the residual aorta, cardiopulmonary bypass was established via cannulation of the left femoral artery and we used the open distal anastomosis method under hypothermic circulatory arrest with selective cerebral perfusion. Moreover, the sutures of the aortic annulus were reinforced sewing the aortic wall together. Her postoperative course was uneventful. Despite the fragility of the cardiovascular tissues in Ehlers-Danlos syndrome, cardiac surgery could be performed safely with appropriate surgical procedures.

PURPOSE: The difficulty of femoral preparation with supine-position hip hemi-arthroplasty (HA) often leads to intra-operative fractures (IOFs). We aimed to clarify the incidence and types of IOFs in HA for hip fractures performed in the supine and lateral positions. MATERIALS AND METHODS: We retrospectively investigated cases of HA for acute femoral neck fractures from June 2013 to May 2018. We examined the incidence and types of IOFs according to different approaches. We defined supine-position in HA as the supine and hip-hyperextended (over-range) femoral preparation position, and lateral position as the lateral and hip-flexed femoral preparation position. We used a short tapered wedged stem. RESULTS: Supine-position HA was used in 46 patients (23.7%) and lateral-position HA in 148 patients (76.3%). IOFs in supine-position HA occurred in 8 patients (17.4%) and included five Vancouver AGT and three Vancouver B2 fractures. IOFs in lateral-position HA occurred in 3 patients (2.0%) and included one Vancouver AGT and two Vancouver B fractures. Supine-position HA was a risk factor for IOFs (adjusted odds ratio, 9.71; 95% confidence interval, 2.37–39.8; P < 0.01) CONCLUSION: Supine-position in HA is an IOF risk factor and significantly increases the incidence of great trochanter fractures of Vancouver type A.
Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; Femur ; Hemiarthroplasty ; Hip Fractures ; Hip ; Humans ; Incidence ; Minimally Invasive Surgical Procedures ; Odds Ratio ; Periprosthetic Fractures ; Retrospective Studies ; Risk Factors

A 28-year-old man was involved in a traffic accident that sandwiched his chest between a wall and a truck. Shortness of breath and other symptoms started to appear several years later. Echocardiography at that time showed severe tricuspid regurgitation due to a failed valve and ruptured chordae in the anterior leaflet. He was followed up with medication. Leg edema developed at the age of 62 years and worsening symptoms of heart failure over a period of 6 months indicated a need for surgery. Intraoperative findings revealed the ruptured chordae attached to the anterior leaflet and a scarred myocardium at the septomarginal trabeculation. The tricuspid valve was surgically repaired, the anterior leaflet chordae were surgically reconstructed, an annuloplasty ring was implanted to address the tricuspid regurgitation and atrial fibrillation was treated using the Maze procedure. Surgery 34 years after trauma has improved hemodynamic cardiac function and normalized the cardiac rhythm in this patient.

From April 1983 through March 1993, 10, 767 women underwent health examinations at the Health Care Center in Obihiro Kosei Hospital. Cervical smears were taken from theuterine cervix for cervical cancer screening. One hundred and six women had abnormal results, greater than class III. Those patients who were diagnosed as having carcinoma numbered 10 (0.09%). Of the cervical carcinomas found, 1 was frankly invasive (adenocarcinoma Ib); 3, microinvasive (2; squamous cell carcinoma and 1; co-existence of adenocarcinoma and squamous cell carcinoma); and 6, carcinomas in situ (squamous cell carcinoma).

Recently, interest has been forcused on the increasing incidence of bone fracture due to low bone mineral density (BMD) in some sportswomen. Therefore the present study attempted to elucidate important factors associated with an increase or decrease of BMD in sportswomen.
The results obtained were as follows;
(1) Ball games appeared to be the most desirable main sports. Also it appeared necessary to increase lean body mass (weight) by maintaining a higher activity of daily living (ADL) index.
(2) There were no clear nutritional factors that had a beneficial influence for increasing the BMD.
These results suggest that sufficient exercise, at least, is necessary in order to increase BMD.