The HCV antibody positive rates of blood donors were studied in Yamaguchi Prefecture. C100-3 antibody was examined by the method of the 1st generation. The subjects were 146, 792 people who donated blood from Nov. 1989 to Dec. 1990. The average positive rate was 1.01% in Yamaguchi Prefecture. The positive rates of more than 3% were registered in four towns. In one town out of these four, the average positive rate was 22.0% It was extremely higher than the other three towns. Further study will be required to elucidate such regional differences in the HCV positive rate in the prefecture.

Shigyakusan, a traditional Japanese prescription, has been prescribed for chronic diseases including gastritis, upper respiratory tract infection, hepatitis, irritable colon and so on. The effectiveness of shigyakusan against pain, however, has only been rarely reported. Here we report that shigyakusan was effective on pain such as intractable chronic and acute pain in 26 patients. Shigyakusan is composed of 7.5 g (dry weight/day) : saiko, shakuyaku, kijitsu and kanzo. Shigyakusan and kososan mimic the composition of saikosokanto. Pain alleviation periods were 3-90 days (26 ± 19). Pains were recognized in various regions including side of the flank and the thorax, the back, the tongue, the perineum, the elbow joint, the head and plantar areas. Abdominal findings as tension of the rectus abdominis, kyokyokuman (discomfort of the hypochondrium area) and sinkahiko (tenderness of the hypochondrium area) were recognized 58%, 46% and 38%, respectively. All patients were recognized with depressive conditions. Shigyakusan alleviated acute and chronic pain that had not been improved with Western medicine. Therefore, shigyakusan may be considered for prescription in patients with incurable pain.

[Purpose] The effects of experimental osteoporosis on the trabecular bone structure of the mandible in cynomolgus monkeys were examined by radiological bone morphometric analysis. [Methods] Ovariectomy (OVX) was performed on twelve 10-year-old female cynomolgus monkeys, which were fed a controlled diet for 2 years. Twelve monkeys in a sham control group were fed under the same conditions. Using a microfocus tube and computed radiography, the removed mandibular bone samples were imaged by standardized magnification radiography, and two-dimensional digital imaging data were obtained. The structural parameters, such as skeletal area, perimeter, number, complexity, continuity and anisotropy, were measured using radiological bone morphometric analysis. The bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. The width of the cortical bone was measured using magnified radiographic images. [Results] There were no significant differences between the OVX and the sham control groups in the skeletal structure indicated by the skeletal volume, number, width, perimeter, complexity, continuity, separation and spacing. However, there were significant differences between the two groups in the BMD of the mandibular body, cortical bone width, anisotropy and some parameters of the skeletal continuity. Among these parameters, the difference in the thinning of the cortical bone was most significant. [Conclusions] Using two-dimensional digital radiographic image data, this study suggests that the cortical bone width is more useful than the trabecular bone structure as the morphologic parameter for diagnosis of osteoporosis in the mandibular body.

To investigate the effects of experimental osteoporosis on the trabecular structure of the mandibular condyle in cynomolgus monkeys by radiological bone morphometry, ovariectomy (OVX) was performed on 10-year-old female cynomolgus monkeys, which were fed a controlled diet for 2 years. Ten sham control groups were fed under the same conditions. Using a microfocus tube and computed radiography, the removed mandibular condyle samples were imaged by standardized magnification radiography. The structural parameters were measured using radiological bone morphometric analysis. The bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. The thickness of the cortical bone was measured using magnified radiographic images. The thickness of the cortical bone and the BMD in the OVX group were significantly lower than in the sham group. In the results of skeletal structure of the mandibular condyle, the trabecular structure of the mandibular condyle was markedly deteriorated in the OVX group. The trabecular structure of the mandibular condyle for the OVX group was significantly decreased, thus it was suggested that osteoporosis is a potential risk factor of osteoarthritis of the temporomandibular joint.

Celiac artery aneurysm (CAA) is very rare. We report a case of CAA with type IIIb aortic dissection (DA) which was treated surgically. A 60-year-old man who had an abnormal enlargement of the aorta on abdominal ultrasonography was admitted to our hospital. Angiography and CT scan revealed CAA with type IIIb DA. His general condition was stable and surgery was performed electively. The CAA was exposed through a median laparotomy. It was found to be about 3cm in diameter. As vascular reconstruction seemed difficult and the proper hepatic artery showed good pulsation after clamping the common hepatic artery, we decided to perform celiac artery aneurysmectomy without vascular reconstruction. Except for transient liver dysfunction, there was no other complication and he was discharged on the 24th postoperative day. During surgery for CAA, when collateral perfusion from the SMA to the liver is adequate, it seems that vascular reconstruction is not always necessary as shown by this case.

A 52-year-old man presented with a pulsatile mass in the right groin. He had undergone lumbar sympathectomy and aorto-right femoral artery bypass using an 8mm Microvel double velour graft, 14 years previously, for aortoiliac occlusive disease caused by thromboangiitis obliterans. Based on a clinical diagnosis of an anastomotic aneurysm, an operation was performed. When the aneurysm was incised, it was found that the anastomosis of the graft to the femoral artery was intact and that the graft itself had a defect, 3cm in size on the anterior wall, 1.5cm proximal to the distal anastomosis. The final diagnosis was a nonanastomotic false aneurysm due to prosthetic graft failure. The failed portion of the graft was resected, and a 10mm Hemashield Gold woven double velour graft was interposed between the old graft and the right femoral artery. Generally, arterial grafts below the groin are subject to high levels of mechanical stress, and graft failure is not uncommon. Vascular surgeons should keep in mind that graft failure is not rare in patients with long-standing prosthetic grafts.

Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures. Methods: This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results: We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge. Conclusion An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.

Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures. Methods: This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results: We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge. Conclusion An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.

Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures. Methods: This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results: We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge. Conclusion An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.

Background: This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures. Methods: This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes. Results: We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge. Conclusion An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.