1.COMPARISON OF THE GAIT OF WOMEN WITH A LOAD ON THEIR BELLY AND THAT OF PREGNANT WOMEN
HIROKI AOYAMA ; YOSUKE YAMADA ; MASAHIRO SHINYA ; HIDEAKI KUSUMOTO ; SHINGO ODA
Japanese Journal of Physical Fitness and Sports Medicine 2010;59(4):375-388
Gait analysis was conducted on 7 healthy pregnant women (pregnant group) and 6 non-pregnant women (pseudo-pregnant group) using a 3-D motion analysis system (VICON 460) and two forceplates (Kistlar 9286A). The data was collected at 8-9 months of gestation (pregnant condition) and 4-8 months postpartum (non-pregnant condition) in the pregnant group. In the pseudo-pregnant group, the participants walked with a 5kg-load on their belly (pregnant condition) and without any load (non-pregnant condition). Comparisons using two-way ANOVAs with repeated measures were conducted. Interaction of group × condition was not observed in the measured gait parameters except the angle of the maximum hip adduction. Main effect in the condition and the group was found in some parameters. In the pregnant condition, gait velocity was slower (pregnant group 68.7±8.6 m/min pseudo-pregnant group 63.8±4.8 m/min) than in the non-pregnant condition (pregnant group 75.5±3.2 m/min pseudo-pregnant group 69.8±8.7 m/min). The second vertical peak ground reaction force was smaller in the pregnant condition (pregnant group 105.4±4.8 % pseudo-pregnant group 108.4±6.3 % of body-weight) than in the non-pregnant condition (pregnant group 114.3±7.4 % pseudo-pregnant group 113.5±4.2 % of body-weight). These results demonstrated that pregnant condition changed kinetic and kinematic characteristics of the gait.
3.Feasibility of metronomic chemotherapy with tegafur-uracil, cisplatin, and dexamethasone for docetaxel-refractory prostate cancer
Hiroki Kubota ; Katsuhiro Fukuta ; Kenji Yamada ; Masahito Hirose ; Hiromichi Naruyama ; Yoshimasa Yanai ; Yasuyuki Yamada ; Hideki Watase ; Noriyasu Kawai ; Keiichi Tozawa ; Takahiro Yasui
Journal of Rural Medicine 2017;12(2):112-119
Objectives: To evaluate the efficacy of tegafur–uracil (UFT), a prodrug of 5-fluorouracil, plus cisplatin and dexamethasone in patients with docetaxel-refractory prostate cancers.
Methods: Twenty-five patients with docetaxel-refractory prostate cancer were administered oral UFT plus intravenous cisplatin (UFT-P therapy) and dexamethasone. Treatment responses were assessed monthly via prostate-specific antigen (PSA) level measurements. Treatment-related adverse events and overall survival were also assessed.
Results: UFT-P therapy resulted in decreased PSA levels in 14 (56%) patients and increased PSA levels in 11 (44%). In patients with increased PSA levels, 7 (64%) of the 11 patients displayed decreased PSA doubling times. The UFT-P therapy response rate was 84% (21/25 patients). Imaging studies revealed that tumor shrinkage during UFT-P therapy occurred in 1 patient in whom bilateral hydronephrosis caused by lymph node metastasis improved. The median survival time from docetaxel initiation was 36 months. In UFT-P-treated patients, the median PSA progression and overall survival times were 6 and 14 months, respectively. UFT-P treatment-related adverse events were mild diarrhea, general fatigue, and anorexia. Treatment was not discontinued for any of the patients. UFT-P therapy did not cause serious hepatic or renal dysfunction or pancytopenia.
Conclusions: UFT-P therapy is a safe and effective treatment for patients with docetaxel-refractory prostate cancer, although large-scale, multicenter, prospective studies are needed to validate these findings.
5.Cerebral air embolism associated with lung cancer invading the pulmonary vein, left atrium, and main bronchus
Hiroki Kuroda ; Masaru Yamada ; Toshihiro Kumabe
Neurology Asia 2020;25(2):221-223
Cerebral air embolism caused by lung cancer is extremely rare, especially if not associated with invasive
procedures such as needle biopsy. We describe the case of an 86-year-old man with squamous cell
lung carcinoma of the left lung. He developed a bad cough and subsequently suffered left hemiplegia.
Brain computed tomography (CT) on admission showed no abnormal findings. Diffusion-weighted
magnetic resonance (MR) imaging revealed high intensity lesions in the right frontal lobe and right
parietal lobes. Repeated brain CT revealed air densities around the high intensity lesions on previous
MR imaging, compatible with air embolism causing cerebral infarction. Chest CT confirmed a left
pulmonary hilar mass invading the left pulmonary vein, left atrium, and main bronchus. Air densities
were found in the left heart ventricle. These radiological findings were attributed to cerebral air embolism associated with advanced lung cancer. Shortly afterwards he died of progressive respiratory failure. Our case reveals two important aspects. First, cerebral air embolism can be caused by lung cancer invading the pulmonary vein, left atrium, and main bronchus without iatrogenic causes. Therefore, we should pay special attention to the etiology when the patients with lung cancer in the advanced stage developed cerebral infarction. Second, repeated CT is recommended if cerebral air embolism is suspected because initial head CT does not always reveal air bubbles.
6.Association between Pelvic Parameters and Vaginal Delivery
Tomohiro YAMADA ; Yu YAMATO ; Tomohiko HASEGAWA ; Go YOSHIDA ; Tatsuya YASUDA ; Tomohiro BANNO ; Hideyuki ARIMA ; Shin OE ; Yuki MIHARA ; Hiroki USHIROZAKO ; Koichiro IDE ; Yuh WATANABE ; Hironobu HOSINO ; Yukihiro MATSUYAMA
Asian Spine Journal 2022;16(2):248-253
Methods:
As part of a 2016 health screening, 320 female volunteers underwent whole-spine radiographs. Age-matched healthy women were grouped according to the number of vaginal deliveries (0, 1–2, or ≥3). Demographic variables and spinopelvic parameters were compared among the three groups.
Results:
Of the 320 volunteers, 213 were enrolled (mean age, 71.1±7.2 years). The mean number of vaginal deliveries was 2.2. The average pelvic incidence (PI) was 55.6°±11.1° and was significantly higher in the 90 women with three or more vaginal deliveries than in the other two groups (p<0.001). The average sacral slope was 33.4°±11.1° and was significantly higher in the women with three or more vaginal deliveries than in the 18 who did not deliver vaginally (p<0.001). The 105 women with one or two vaginal deliveries had significantly higher PIs and sacral slopes than did those who did not deliver vaginally (p<0.001).
Conclusions
This is the first study documenting an association between vaginal delivery and pelvic parameters. Bony birth canal realignment during vaginal delivery can affect postnatal PI. Our study helps in understanding the PI changes over a woman’s life span.
7.Revision Surgery for a Rod Fracture with Multirod Constructs Using a Posterior-Only Approach Following Surgery for Adult Spinal Deformity
Yu YAMATO ; Tomohiko HASEGAWA ; Go YOSHIDA ; Tomohiro BANNO ; Shin OE ; Hideyuki ARIMA ; Yuki MIHARA ; Hiroki USHIROZAKO ; Tomohiro YAMADA ; Yuh WATANABE ; Koichiro IDE ; Keiichi NAKAI ; Kenta KUROSU ; Yukihiro MATSUYAMA
Asian Spine Journal 2022;16(5):740-748
Methods:
We retrospectively reviewed the medical records of 404 patients who underwent corrective fusion surgery for ASD with a minimum 2-year follow-up. We studied cases of reoperation for postoperative rod fractures and investigated surgical procedure, intraoperative findings, clinical course, and rod refracture following revision surgery.
Results:
Rod fracture was observed in 88 patients (21.8%). Fifty-three patients (average age, 68.3 years; average blood loss, 502.2 mL [% estimated blood volume=16.4%]; and operation time, 203.3 minutes) who suffered from a rod fracture at an average of 28.3 months after the primary operation underwent reoperation. Surgical invasiveness had no significant differences in total or partial rod replacement; however, the procedures with and without an anterior bone graft significantly differed. The replaced rod refractured at an average of 35.3 months after the revision surgery of five patients. The rod also refractured at a level outside multiple rods in two patients and with traumatic episodes in three patients. Three patients had bone grafts in the anterior column.
Conclusions
Revision surgery involving a multirod with a posterior-only approach for a rod fracture that occurred after ASD was performed successfully. Bone grafting in the anterior column is unnecessary for patients without massive bone defects.
8.Selective Angiography to Detect Anterior Spinal Artery Stenosis in Thoracic Ossification of the Posterior Longitudinal Ligament
Go YOSHIDA ; Hiroki USHIROZAKO ; Tomohiko HASEGAWA ; Yu YAMATO ; Tatsuya YASUDA ; Tomohiro BANNO ; Hideyuki ARIMA ; Shin OE ; Yuki MIHARA ; Tomohiro YAMADA ; Koichiro IDE ; Yuh WATANABE ; Takasuke USHIO ; Yukihiro MATSUYAMA
Asian Spine Journal 2022;16(3):334-342
Methods:
This study prospectively examined nine T-OPLL patients who underwent posterior thoracic decompression with kyphosis correction and instrumented fusion at Hamamatsu University School of Medicine between 2017 and 2019. All underwent preoperative selective angiography to detect and evaluate the Adamkiewicz artery and ASA. Intraoperative neuromonitoring and Doppler ultrasonography were performed to analyze neurological complications and spinal cord blood flow.
Results:
All nine patients showed ASA stenosis in the area of T-OPLL. In all patients, the Adamkiewicz artery was located between T7 and L2 and the area of ASA stenosis corresponded to the level of T-OPLL and greatest spinal cord compression; intraoperative Doppler ultrasonography confirmed the ASA defect at the same spinal level. The number of spinal levels from the Adamkiewicz artery to the most compressive OPLL lesion was greater in the two patients who developed postoperative neurological deficit compared to those who did not (5.5 vs. 2.3, p=0.014).
Conclusions
This is the first study to report detection of ASA stenosis in patients with T-OPLL. Maintaining spinal cord blood flow is important in these patients to avoid neurological deterioration.
9.Peroral pancreatoscopy with videoscopy and narrow-band imaging in intraductal papillary mucinous neoplasms with dilatation of the main pancreatic duct
Yui KISHIMOTO ; Naoki OKANO ; Ken ITO ; Kensuke TAKUMA ; Seiichi HARA ; Susumu IWASAKI ; Kensuke YOSHIMOTO ; Yuto YAMADA ; Koji WATANABE ; Yusuke KIMURA ; Hiroki NAKAGAWA ; Yoshinori IGARASHI
Clinical Endoscopy 2023;56(2):261-261
10.Statistic Analysis About the Actual Situation of Crude Drug Prescription Based on the Survey Conducted by the Board of Crude Drug Materials of JSOM
Kyoko TAKAHASHI ; Hiroki UEDA ; Tetsuya HARIGAYA ; Kayoko SHIMADA-TAKAURA ; Takahiro YAMADA ; Denichiro YAMAOKA
Kampo Medicine 2019;70(4):399-408
The treatment by Kampo decoction is partly covered by National Health Insurance in Japan. However, this system is facing bankruptcy crisis because of rising prices of crude drugs in China, their main producer. The board of crude drug materials of the Japan Society for Oriental Medicine (JSOM) distributed questionnaires to 7416 JSOM member doctors, and performed statistical analysis (with JSOM approval) of 1877 answers to visualize the data. Twenty-six percent of respondents said that they had prescribed a decoction, and 29% of respondents said they had not, but wanted to prescribe a crude drug. Eighty-eight percent of doctors who prescribe decoctions offered medical treatment primarily to insured patients. Nine percent offered medical treatment at patients' own expense. The latter group prescribed decoctions more frequently. Many doctors were aware of the financial risk of prescribing crude drugs imposed by the drug price standard and rising crude drug import prices. Four hundred and fifty-five doctors explained when they were most inclined to prescribe a decoction. Thirty-five percent of these said they used decoctions when they couldn't treat patients with extracts. This result implies a necessity for decoctions. Many doctors said they prescribed decoctions for autoimmune or allergic diseases. Financial constraints were the most frequently cited barrier to treatment with decoctions. This survey made clear the financial difficulties clinics are facing. We therefore calculated the amount of crude drugs used for decoctions to validate the possibility of their domestic production.