The purpose of this study is to obtain more information about the occurrence of sports injury and through this to prevent injury in handball players.
Aquestionnaire was delivered to Japanese and Korean company handball players totaling 244 women (8 Japanese teams, 136 women and 7 Korean teames, 108 women), during the period from December, 1996 through March, 1997. The return rate was 88.9%. Injury rate in Korean teams was 73.2% and 71.7% in Japanese teams ; no statistical differences were found among these two countries. The injury rate was high on ankle joint, knee joint and lumbar in that order. Korean teams presented higher occurrence of jumper's knee and stress fracture.

A study was conducted to clarify the occurrence of injuries among Japanese and Korean handball players, their present condition, and the response to prescribed treatments. It was also ascertained whether players, after receiving proper treatment, were less susceptible to injury sequelae. A questionnaire was delivered to Japanese and Korean company handball players totaling 244 women (8 Japanese teams, 136 women ; 7 Korean teams, 108 women), during the period from December 1996 through March 1997.
The rate of injuries and the treatment situation during and after the period when the injury was sustained, and the occurrence of sequelae in the lower limbs after the player had joined the team, were examined, and a comparison between the two countries was made. The return rate was 88.9%.
1. The emergency treatment rate after injury was similar in the twe countries. However, Japanese players usually used taping and cooling, whereas Korea players used heat treatment. 2. Both Japanese and Korean players' injuries were diagnosed at hospital, although Koreans also went to bonesetters. 3. Japanese players resumed playing upon receiving their doctors' consent, whereas some Korean players were forced to resume playing before fully recovering ; there was a significant difference between the two countries. 4. Many players in both countries, resumed playing even though they felt pain in daily life. 5. Players who had undergone cooling treatment immediately after the injury, and who resumed activities upon their doctors' consent, and only after the pain had disappeared during daily life, had a lower incidence of sequelae.

We describe a 56-year-old man with relapsing sarcoidosis who presented with persistent hiccup responsive to steroid and clonazepam treatments. The patient also showed parkinsonism. The interval between the initial presentation and current symptoms was about 30 years. Brain MRI demonstrated foci of abnormal signal intensity in the cerebral white matter bilaterally, with decreased signal intensity on T1-weighted imaging and increased signal intensity on T2-weighted, diffusion-weighted, and FLAIR images. Gadolinium-enhanced MRI of the brain showed diffuse linear enhancement throughout the cerebral white matter with a confi guration suggesting perivascular infi ltration. Spinal MRI revealed spotty gadolinium-enhancing lesions from C2 to T3 segments. This case suggests that in some sarcoidosis patients intractable hiccup may be associated with high spinal cord lesions and parkinsonism with frontal white matter lesions.

We describe the first case of a patient with Japanese encephalitis suffering from central sleep apnea. The patient was a 58-year-old man who presented with high fever, semicomatose state, nuchal stiffness, and incontinence of feces. The patient had complication of severe pneumonia, and was ventilated with a respirator. After weaning from the respirator, desaturation of oxygen was observed during the night. Simplified polysomnography revealed a pure central apnea pattern. This case illustrates that Japanese encephalitis can result in central sleep apnea.

We report a case of unilateral tonic pupil in spinocerebellar ataxia without brainstem atrophy in a 42- year-old man. On neurological examination, he showed cerebellar symptoms and unilateral tonic pupil. Deep tendon reflexes were normal except for brisk patellar tendon reflexes. Brain MRI demonstrated cerebellar atrophy only. There was neither orthostatic hypotension nor bowel and bladder failure. The right pupil constricted from 5.0 mm to 1.7 mm 60 minutes after 0.125% pilocarpine administration, whereas the left pupil did not change, remaining at 3.7 mm. Although it is not proven that tonic pupil is causally related to spinocerebellar ataxia, physicians must remain aware of spinocerebellar ataxia as a disease that can demonstrate tonic pupil.

BACKGROUND: Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. METHODS: In this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging. RESULTS: The indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery. CONCLUSIONS: Although the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.
Analgesia ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Catheters ; Catheters, Indwelling ; Chronic Pain ; Humans ; Parturition ; Spine ; Thoracic Vertebrae ; Triiodobenzoic Acids

Our hospital is responsible for acute care as part of a regional-based integral medical care center and uses Diagnosis Procedure Combination (DPC). We attempt to increase patient discharge rates within period II in the DPC / Per-Diem Payment System (DPC/PDPS). However, hospitalization of cerebrovascular disease patients tends to be prolonged by reduced activities of daily living caused by disease and patient background. Thus, we surveyed factors related to extended hospitalization of patients with cerebral infarction, who are among the largest number of patients with cerebrovascular disease. In this survey, we retrospectively analyzed 109 hospitalized patients who underwent medical treatment from May 2016 to March 2017. Patients were divided into two groups (within period II, and period III and above). We performed univariate and multivariate analysis on factors contributing to prolonged hospitalization. Multivariate logistic regression analysis revealed that place of residence (pre- and posthospitalization) affected the hospitalization period. Among them, patients who were admitted from their homes and discharged to facilities other than their homes had the longest hospital stay. Interestingly, univariate analysis showed a significant difference (P<0.001) between the two groups in the National Institute of Health Stroke Scale (NIHSS) score on admission, while there was no significant difference (P = 0.65) with multivariate analysis. It implied that NIHSS score affected the decision about recuperation location after discharge, but not the hospitalization period. Based on our study, we identified key issues that need to be addressed: 1) the time to determine appropriate medical care after the acute phase, and 2) the waiting period for proper transfer. Therefore, to promptly discharge patients from hospital, we believe it is important to provide early intervention by ward nurses at the time of hospitalization, and to review our ongoing efforts to strengthen the system and enhance collaboration within our medical center.

Objective: Cervical dystonia (CD) is a clinically under-recognized symptom occurring at the later- to end-stages of Parkinson’s disease (PD). The frequency of CD and its influence on prognosis have not been well studied. Here, we conducted an in-depth examination of CD incidence and impact on disease progression in later-stage PD. Methods: We retrospectively reviewed the clinical features of 22 deceased patients with sporadic PD treated at a hospital in Japan from 1983 to 2008. Results: The most common cause of death in PD was pneumonia. CD, in particular retrocollis, was frequent in the later stages of the disease in elderly patients (9/22, 40.9%). Pneumonia incidence increased sharply in the later period with CD. There was a positive trend between CD duration and duration of pergolide use. Conclusion: Analysis revealed that CD increases markedly in late- to end-stage PD, which may be associated with aspiration pneumonia due to dysphagia. Pathological mechanisms underlying CD might be influenced by treatments including dopamine agonists. Prevention of CD may increase quality of life and prolong survival of PD patients.