A double-blind controlled test was performed to determine the analgesic effect of semiconductor laser irradiation (30mW, Ga-Al-As semiconductor laser) on various types of low back pain.
In the laser irradiated group, the improvement rate (including extremely effective and effective cases) of spontaneous pain was 61%, tenderness 61.8%, and locomotion pain 64% with an overall improvement rate of 73.5%. Significant differences from the control group were thus found in all types of pain (P<0.01).
No significant difference was found in the Lasegue sign and Deep Tendon Reflex (DTR) between the laser irradiated group and the control group and no organic change was found in the laser irradiated tissues.
Also, no significant difference was found between the laser irradiated group and control group blood test items with no side effect or degenerative changes. This confirmed that the laser irradiation was harmless to human tissues. The effectiveness and safety of the semiconductor low energy laser have been established. The authors therefore believe that the laser irradiation will be quite useful in treating low back pain in the future.

In this study, the author evaluated surgical results in 4 patients over 80 years old (3 males and one female) who were among 24 patients with ruptured abdominal aortic aneurysm (RAAA) who underwent operation at our medical center between November, 1985 and June, 1992. While three patients survived, one, who had preoperative profound shock, died due to mutiple organ failure. The post-operative course of two of the survivors was uneventful, and the other developed non-oliguric renal failure but recovered without hemodialysis. The Fitzgerald classification of the RAAA in the non-survivor was group 4 and that in the 3 survivors was group 2 or 3. The extent of preoperative shock and volume of blood loss were associated with increased operative risk. In conclusion, aggressive resection of RAAA should be performed not only in younger parients but also in elderly patients such as those over eighty years old.

The UBE woven 150cc WYK graft is a non-sealed graft that became available commercially in January 2005, and does not need to be preclotted before implantation. Subjects in this study comprised 50 patients with abdominal aortic aneurysms or common iliac arterial aneurysms, who received prosthetic Y grafts in our institution. Subjects were divided into 2 groups: the U group (n=26), with implantation of the UBE graft, and the I group (n=24) who received implantation of an INTERGARD^TM woven Y graft. Intraoperative bleeding, inflammatory response and duration of postoperative hospitalization were evaluated in each group. Significant differences were noted between C-reactive protein levels, frequency of recurrence of fever and duration of postoperative hospitalization. No differences were noted between intraoperative bleeding and time. The UBE woven 150cc WYK graft, compared with the INTERGARD^TM woven Y graft, required no extra time for implantation and appeared to offer advantages such reduced immunoreaction after surgery. However, follow-up for sufficient late-phase evaluation of the grafts is required.

During the past four years authors encountered a total of 25 tourists suffered from cerebral (CI: 14 cases) and acute myocardial infarction (AMI: 11 cases) while staying in Kusatsu Hot Spring. The subjects consisted of 13 males and 12 females, ranging from 49 to 85 years old (mean 68±9.5). Analytical study relating to the time of onset of diseases, bathing, drinking and others was performed in these patients. The results obtained were as follows.
1) Higher incidence was observed from May to October in CI, while from March to April and in September in AMI. A majority of the subjects suffered from CI or AMI within two days after arrival in Kusatsu. Attack occurred during bathing in one subject, within six hours after bathing in one, and from six to 24 hours after bathing in the others, respectively. Furthermore, a hourly distribution of the onset of disease showed the high incidence of CI between 3:00 and 9:00, and of AMI between 21:00 and 0:00.
2) Bathing was done one to four times within 24 hours before onset in all subjects. Meanwhile, drinking was in 56% of the subjects.
3) Out of 21 subjects investigated six cases were under medication with hypotensive drugs.
From the results above described, a role of bathing playing in pathogenetic mechanism in thrombotic diseases such as CI and AMI was briefly discussed.

We investigated the effects of artificial mineral bathing in water containing sodium sulfate and sodium bicarbonate on venous blood gas, blood pressure, heart rate, and deep body temperature in 10 patients with hypertension or history of hypertension. After a 10-minute bathing at 40°C, the parameters described above were carefully checked. The pH and P_O2 levels in venous blood increased and the P_CO2 level decreased after the artificial mineral bathing in comparison with plain water bathing. However, these changes were not statistically significant. The systolic blood pressure tended to decrease up to 10 hours after the artificial mineral bathing. The heart rate markedly reduced after the artificial mineral bathing and remained at a low level for 10 hours. The deep body temperature began to decrease 40 minutes after the artificial mineral bathing. However, it increased over the base-line level 6 hours later. From the above result, it is considered that artificial mineral bathing is useful for patients with hypertension.

Purpose: The purpose of the study was to determine the effect of cartilage degeneration at the patellofemoral joint on clinical outcomes after open wedge high tibial osteotomy and to investigate the predisposing factors for progressive patellofemoral cartilage degeneration. Methods: Seventy-two knees were evaluated on second-look arthroscopy in patients who opted for plate and screw removal at an average of 20.1 months after osteotomy. Cartilage degeneration at the patellofemoral joint was evaluated using the International Cartilage Repair Society grading system, with cases divided into progression and nonprogression groups. Radiographic parameters of the patellofemoral anatomy, knee range of motion, and clinical outcomes were evaluated from the preoperative baseline to the final follow up, on average 50 months after osteotomy. A contracture > 5° was considered a flexion contracture. Results: Cartilage degeneration progressed in 31 knees, and preoperative knee flexion contracture was significantly associated with progressive degeneration (P < 0.01). The Lysholm and Kujala scores were significantly lower in the progression group (87.9 and 85.3, respectively) than in the nonprogression group (91.6 and 93.6, respectively) (P < 0.05). The odds ratio of the flexion contracture resulting in progression of patellofemoral cartilage degeneration was 4.63 (95% confidence interval, 1.77–12.1). No association was detected between progressive degeneration and age, sex, body mass index, Kellgren-Lawrence grade, or radiographic parameters. Conclusions Flexion contracture may be associated with progression of cartilage degeneration at the patellofemoral joint and may negatively affect the clinical outcomes after open wedge, high tibial osteotomy.

Objective: The practices pertaining to hereditary breast and ovarian cancer (HBOC) in Japan have been rapidly changing owing to the clinical development of poly(ADP-ribose) polymerase inhibitors, the increasing availability of companion diagnostics, and the broadened insurance coverage of HBOC management from April 2020. A questionnaire of gynecologic oncologists was conducted to understand the current status and to promote the widespread standardization of future HBOC management. Methods: A Google Form questionnaire was administered to the members of the Japan Society of Gynecologic Oncology. The survey consisted of 25 questions in 4 categories: respondent demographics, HBOC management experience, insurance coverage of HBOC management, and educational opportunities related to HBOC. Results: A total of 666 valid responses were received. Regarding the prevalence of HBOC practice, the majority of physicians responded in the negative and required human resources, information sharing and educational opportunities, and expanded insurance coverage to adopt and improve HBOC practice. Most physicians were not satisfied with the educational opportunities provided so far, and further expansion was desired. They remarked on the psychological burdens of many HBOC managements. Physicians reported these burdens could be alleviated by securing sufficient time to engage in HBOC management, creating easy-to-understand explanatory material for patients, collaboration with specialists in genetic medicine, and educational opportunities. Conclusion Gynecologic oncologists in Japan are struggling to deal with psychological burdens in HBOC practice. To promote the clinical practice of HBOC management, there is an urgent need to strengthen human resources and improve educational opportunities, and expand insurance coverage for HBOC management.

Purpose: The purpose of the study was to determine the effect of cartilage degeneration at the patellofemoral joint on clinical outcomes after open wedge high tibial osteotomy and to investigate the predisposing factors for progressive patellofemoral cartilage degeneration. Methods: Seventy-two knees were evaluated on second-look arthroscopy in patients who opted for plate and screw removal at an average of 20.1 months after osteotomy. Cartilage degeneration at the patellofemoral joint was evaluated using the International Cartilage Repair Society grading system, with cases divided into progression and nonprogression groups. Radiographic parameters of the patellofemoral anatomy, knee range of motion, and clinical outcomes were evaluated from the preoperative baseline to the final follow up, on average 50 months after osteotomy. A contracture > 5° was considered a flexion contracture. Results: Cartilage degeneration progressed in 31 knees, and preoperative knee flexion contracture was significantly associated with progressive degeneration (P < 0.01). The Lysholm and Kujala scores were significantly lower in the progression group (87.9 and 85.3, respectively) than in the nonprogression group (91.6 and 93.6, respectively) (P < 0.05). The odds ratio of the flexion contracture resulting in progression of patellofemoral cartilage degeneration was 4.63 (95% confidence interval, 1.77–12.1). No association was detected between progressive degeneration and age, sex, body mass index, Kellgren-Lawrence grade, or radiographic parameters. Conclusions Flexion contracture may be associated with progression of cartilage degeneration at the patellofemoral joint and may negatively affect the clinical outcomes after open wedge, high tibial osteotomy.

Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

OBJECTIVEThe custom-homebuilding company, Cosmic Garden Co. Ltd., located in Okayama City, Japan was established in 1997 and uses specific natural ore powder (SNOP) in wall materials and surveys customers in order to improve allergic symptoms.

METHODSTo investigate the biological effects of SNOP, patients with a pollen allergy were recruited to stay in a room surrounded by cloth containing SNOP (CCSNOP), and their symptoms and various biological parameters were compared with those of individuals staying in a room surrounded by control non-woven cloth (NWC). Each stay lasted 60 min. Before and immediately after the stay, a questionnaire regarding allergic symptoms, as well as POMS (Profile of Mood Status) and blood sampling, was performed. Post-stay minus pre-stay values were calculated and compared between CCSNOP and NWC groups.

RESULTSResults indicated that some symptoms, such as nasal obstruction and lacrimation, improved, and POMS evaluation showed that patients were calmer following a stay in CCSNOP. Relative eosinophils, non-specific Ig E, epidermal growth factor, monocyte chemotactic protein-1, and tumor necrosis factor-α increased following a stay in CCSNOP.

CONCLUSIONThis ore powder improved allergic symptoms, and long-term monitoring involving 1 to 2 months may be necessary to fully explore the biological and physical effects of SNOP on allergic patients.

Adult ; Chemokine CCL2 ; immunology ; Clothing ; Female ; Geologic Sediments ; chemistry ; Humans ; Immunoglobulin E ; immunology ; Japan ; Male ; Pollen ; immunology ; Rhinitis, Allergic, Seasonal ; immunology ; therapy ; Tumor Necrosis Factor-alpha ; immunology