We report a 30-year-old man with an extensive cerebral contusion. He presented with severe left upper and lower limb paralysis and mild right lower limb palsy. He was diagnosed with severe sleep apnea syndrome and was treated with nighttime nCPAP (nasal Continuous Positive Airway Pressure). Four years after the injury, he was able to walk with Lofstrand crutches. However, he gradually began to have difficulty standing, walking and driving his wheelchair because his spasticity developed markedly. He received ITB (intrathecal baclofen) therapy and noted a reduction in spasticity. He was once again able to drive his wheelchair and to walk with support. In addition, his respiratory function didn't show any deterioration. Spasticity is a common complication after cerebral or spinal cord injury, for which treatment has been difficult. ITB therapy can dramatically reduce spasticity, but has been demonstrated that it may also depress respiratory function in patients with respiratory insufficiency. This case suggests that ITB therapy may reduce spasticity without affecting respiratory function even in patients with a respiratory disorder.

During the last 7 years in Ogori Daiichi General Hospital, three cases of foreign bodies in the bladder and urethra are treated, two cases with transurethral removal and a case with transvesical removal. All of three cases are males. Two cases of transurethral removal were performed at out-patient-department and a case of transvesical removal was hospitalized for 33 days after the operation under lumber anethesia.
A statistical investigation clearly showed that transurethral removal became more common than transvesical removal owing to the recent advances of endourological procedures.

Between January 1986 and August 1989, four patients, whose urinary tuberculous cultures were positive, were treated in our hospital. They represented 0.66% of the total number of the new patiants who visited the outpatient department during this period. Also during the same period, two other patiants with unilateral old renal tuberculosis underwent nephrectomy.
Since the middle of this century, the development of chemotherapy has decreased the number of the patiants with urinary tuberculosis. However, there has been little decrease in recent several years, and our report supports this evidence. So, the possibility of urinary tuberculosis cannot be made light of in the urological examination, especially for the patiants with refractory urinary tract infection.

This study aimed to investigate the changes in physical function, fatigue, and psychiatric symptoms in patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sixty-two hospitalized patients with hematological malignancy undergoing chemotherapy and low-intensity exercise were recruited. At the time of exercise initiation and hospital discharge, grip strength, knee extension muscle strength, maximum walking speed, Eastern Cooperative Oncology Group (ECOG) performance status, a measure of functional independence, cancer fatigue pain, and hospital anxiety and depression were evaluated. When longitudinal data were analyzed in each group, changes in grip strength and knee extension muscle strength were unevenly distributed: some patients showed a decrease in knee extension strength. On the other hand, maximum walking speed, the measure of functional independence, and ECOG performance status were maintained or improved in more than 90% of the patients. Results of fatigue, anxiety, and depression tended to show an improvement in female patients, but not in male patients. In conclusion, physical function was maintained in nearly all patients with hematological malignancy undergoing chemotherapy and low-intensity exercise training. Sex differences were found in changes of fatigue, anxiety, and depression.

We report a successful staged repair of anomalous origin of right pulmonary artery from the ascending aorta in a neonate. A two-day-old girl, who suffered from severe circulatory failure, was admitted. In spite of all medical treatment, acidosis and systemic hypotension developed. Right pulmonary artery banding was performed in an emergency procedure, resulting in immediate elevation of systemic blood pressure. Definitive operation was subsequently performed on the 48th day after birth. The right pulmonary artery, which was de-banded and divided from aorta, was anastomosed directly to the pulmonary trunk in a side-to-end manner. The postoperative course was uneventful and the pulmonary artery pressure was within the normal range.

Methods: We retrospectively reviewed the medical records of 198 women aged 40–70 years who underwent mass screening for osteoporosis at our hospital between 2016 and 2019. The BMD values and the following data were collected: age, body mass index, fracture history, lower back pain, height loss, kyphosis, history of fragility fracture, family history of vertebral or hip fracture, and menopause. The reliability of each data point for the young adult mean <80% was calculated using discriminant analysis. Variables with large weight coefficients were selected and scored. This scoring tool was examined, and a cutoff score for predicting the young adult mean <80% was determined. Results: Sixty-four participants (32.3%) had a young adult mean <80%. According to the weight coefficients, the following five variables were scored as follows: age ≥60 years 3 points, body mass index <22 kg/m2 3 points, lower back pain 1 point, height loss (cm) 1 point, and menopause 1 point. The area under the receiver operating characteristic curve was 0.738 (95% confidence interval, 0.669–0.807). At cutoff scores of ≥5 and <5, the sensitivity was 82.8%, with specificity of 52.0%. Conclusions The scoring tool performed well for predicting young adult mean <80% among perimenopausal and postmenopausal women in Japan. This tool may be useful to screen for low BMD.

BACKGROUND/AIMS: Venous thromboembolism (VTE) is a major extraintestinal manifestation in inflammatory bowel disease (IBD), regarded as an independent risk factor for VTE according to reports from Western countries. However, the incidence and risk factors of VTE in Asian IBD patients are not fully understood. We aimed to reveal the incidence and risk factors of VTE in Japanese IBD inpatients. METHODS: The incidence of VTE in inpatients with IBD (n=340), gastrointestinal cancers (n=557), and other gastrointestinal diseases (n=569) treated at our hospital from 2009 to 2013 was retrospectively investigated. The characteristics and laboratory data of IBD inpatients with and without VTE were compared in univariate and multivariate analyses. Clinical courses of VTE in IBD were surveyed. RESULTS: VTE was detected in 7.1% of IBD inpatients, significantly higher than in gastrointestinal cancer inpatients (2.5%) and inpatients with other gastrointestinal diseases (0.88%). The incidence of VTE in ulcerative colitis (UC) patients (16.7%) was much higher than that in those with Crohn's disease (3.6%). In the univariate analysis, the risk factors were an older age, central venous catheter, prednisolone, surgery, low serum albumin, high serum C-reactive protein and D-dimer. According to a multivariate analysis, >50 years of age and surgery were the only risk factors. The in-hospital mortality rate of IBD inpatients with VTE was 4.2%. CONCLUSIONS: The incidence of VTE with IBD, especially UC, was found to be high compared with other digestive disease, which was almost equivalent to that of Western countries. The efficacy of prophylaxis needs to be investigated in Asian IBD patients.
Asian Continental Ancestry Group* ; C-Reactive Protein ; Central Venous Catheters ; Cohort Studies* ; Colitis, Ulcerative ; Crohn Disease ; Gastrointestinal Diseases ; Gastrointestinal Neoplasms ; Hospital Mortality ; Humans ; Incidence* ; Inflammatory Bowel Diseases* ; Inpatients* ; Multivariate Analysis ; Prednisolone ; Retrospective Studies* ; Risk Factors* ; Serum Albumin ; Venous Thromboembolism*