1.Status of Study Abroad Program Use at Chiba University School of Medicine
Ryohei Ono ; Kazuyo Yamauchi ; Daniel Salcedo ; Hiroshi Shirasawa ; Mayumi Asahina
Medical Education 2016;47(1):11-16
As globalization also influences medical education, Chiba University has provided extensive study abroad programs. This paper reports a medical student's methods to prepare for using such programs and improve his English level, and outlines his actual experience of studying abroad during a 6-year period. It also discusses the significance of medical study abroad, focusing on the following 3 points: meeting medical leaders in other countries; establishing friendships with international medical students of similar age groups, while comparing Japanese students' abilities with international standards; and taking full advantage of being a student, as one is allowed to flexibly develop global perspectives only in his/her school days before starting a long career as a medical professional, to provide guidance for medical students toward such experience and career development based on it.
2.Effects of electrical acupuncture to the stellate ganglion on carotid blood flow, deep tissue temperature, blood pressure and pulse rate in the humans.
Masaaki SHINOHARA ; Norihiro YAMAUCHI ; Kazuyo ARAKI ; Koichi KAMIMURA ; Toru SATO
Journal of the Japan Society of Acupuncture and Moxibustion 1985;34(3-4):225-230
Previously we reported effects of acupuncture to the stellate ganglion on measurements of skin electroconductivity by a Neurometer.
By using 8 healthy adults and 23 patients, we measured effects of electrical acupuncture to the stellate ganglion on carotid blood flow, deep tissue temperature, blood pressure and pulse rate in order to clarify the influence on functions of the autonomic nervous system.
After electrical acupuncture to the right stellate ganglion (SGA), the right and left carotid blood flow decreased with 4-9% and 7-12%, respectively. Deep tissue temperature of the right anterior forearm after SGA showed a little increase (with no significance), while the temperature increased with 0.4-0.7°C after the right stellate ganglion block (SGB). Deep tissue temperature of the left anterior forearm showed no significant change after SGA, while it increased with 0.1-0.3°C significantly after SGB. Systolic blood pressure increased with 2-4mmHg after SGA and this also increased with 9-11mmHg after SGB. Those increases were significant. While the pulse rate decreased (2bpm) significantly after SGA, it increased (4-6bpm) significantly after SGB.
Except the decreased pulse rate after SGA, the other data did not support a common hypothesis that electrical acupuncture to the stellate ganglion suppresses the sympathetic system as SGB.
3.The Time Course Changes in Bone Metabolic Markers after Administering the Anti-Receptor Activator of Nuclear Factor-Kappa B Ligand Antibody and Drug Compliance among Patients with Osteoporosis.
Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yoshihiro SAKUMA ; Go KUBOTA ; Yasuhiro OIKAWA ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2015;9(3):338-343
STUDY DESIGN: Retrospective study. PURPOSE: We conducted a study to investigate the time course changes in bone metabolic markers after the administration of the anti-receptor activator of nuclear factor-kappa B ligand (RANKL) antibody and to assess drug compliance among osteoporotic patients. OVERVIEW OF LITERATURE: The anti-RANKL antibody is expected to provide an improvement in those with a bone metabolism disorder. However there are only a few clinical reports available on the effect of treatment. METHODS: We included 40 post-menopausal osteoporotic patients who received the anti-RANKL antibody. To determine the time course changes in the bone metabolic markers, we measured the serum tartrate-resistant acid phosphatase 5b (TRACP 5b; a bone resorption marker) and the serum N-terminal propeptide of type 1 collagen (P1NP; a bone formation marker) levels prior to and 1 month after administrating the anti-RANKL antibody. To evaluable drug compliance, we assessed the dropout rate during treatment and at 6 months after treatment. RESULTS: The average TRACP 5b level significantly decreased from 574.8 mU/dL before treatment to 153.2 mU/dL 1 month after treatment (p<0.05). There was no significant difference in the average P1NP level, which was 56.9 microG/L and 35.1 microG/L before and 1 month after treatment, respectively (p>0.05). As for drug compliance, we did not have any dropouts during the treatment or after 6 months (dropout rate: 0%). CONCLUSIONS: Our study suggests that anti-RANKL antibody treatment suppresses bone resorption and maintains bone formation.
Acid Phosphatase
;
Bone Resorption
;
Collagen Type I
;
Compliance*
;
Humans
;
Metabolism
;
Osteogenesis
;
Osteoporosis*
;
Patient Dropouts
;
RANK Ligand
;
Retrospective Studies
4.Erratum: Correction of Figures. The Time Course Changes in Bone Metabolic Markers after Administering the Anti-Receptor Activator of Nuclear Factor-Kappa B Ligand Antibody and Drug Compliance among Patients with Osteoporosis.
Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yoshihiro SAKUMA ; Go KUBOTA ; Yasuhiro OIKAWA ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2015;9(6):999-1000
There were some mistakes in the numerical values of the graphs.
5.Elevated Levels of Serum Pentosidine Are Associated with Dropped Head Syndrome in Older Women
Yawara EGUCHI ; Toru TOYOGUCHI ; Kazuhide INAGE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Miyako SUZUKI ; Hirohito KANAMOTO ; Koki ABE ; Masaki NORIMOTO ; Tomotaka UMIMURA ; Masao KODA ; Takeo FURUYA ; Yasuchika AOKI ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Asian Spine Journal 2019;13(1):155-162
STUDY DESIGN: A retrospective observational study was performed. PURPOSE: We investigated the prevalence of sarcopenia in dropped head syndrome (DHS), and the relationship between biochemical markers, including major advanced glycation end products (AGEs), pentosidine, and DHS in older women. OVERVIEW OF LITERATURE: AGEs have been implicated in the pathogenesis of sarcopenia. METHODS: We studied 13 elderly women with idiopathic DHS (mean age, 77.2 years) and 20 healthy volunteers (mean age, 74.8 years). We used a bioelectrical impedance analyzer to analyze body composition, including appendicular skeletal muscle mass index (SMI; appendicular lean mass [kg]/[height (m)]2). Cervical sagittal plane alignment, including C2–C7 sagittal vertical axis (C2–C7SVA), C2–C7 angle, and C2 slope (C2S), was measured. Biochemical markers, such as serum and urinary pentosidine, serum homocysteine, 1, 25-dihydroxyvitamin D, and 25-hydroxyvitamin D, were measured. The level of each variable was compared between DHS and controls. The relationship between biochemical markers and DHS was examined. RESULTS: Sarcopenia (SMI < 5.75) was observed at a high prevalence in participants with DHS (77% compared to 22% of healthy controls). Height, weight, femoral bone mineral density, appendicular lean mass, total lean mass, and SMI all had significantly lower values in the DHS group. Serum and urinary pentosidine, and serum homocysteine were significantly higher in the DHS group compared to controls. Analysis of cervical alignment revealed a significant positive correlation of serum pentosidine with C2–C7SVA and C2S. CONCLUSIONS: Sarcopenia was involved in DHS, and high serum pentosidine levels are associated with severity of DHS in older women.
Aged
;
Biomarkers
;
Body Composition
;
Bone Density
;
Electric Impedance
;
Female
;
Glycosylation End Products, Advanced
;
Head
;
Healthy Volunteers
;
Homocysteine
;
Humans
;
Muscle, Skeletal
;
Neck Muscles
;
Observational Study
;
Prevalence
;
Retrospective Studies
;
Sarcopenia
6.Increase of TRPV1-Immunoreactivity in Dorsal Root Ganglia Neurons Innervating the Femur in a Rat Model of Osteoporosis.
Kensuke YOSHINO ; Miyako SUZUKI ; Yuya KAWARAI ; Yoshihiro SAKUMA ; Gen INOUE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Gou KUBOTA ; Yasuhiro OIKAWA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Junichi NAKAMURA ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Yonsei Medical Journal 2014;55(6):1600-1605
PURPOSE: Transient receptor potential vanilloid 1 (TRPV1) is a ligand-gated nonselective cation channel, which can be activated by capsaicin and other noxious stimuli. Recently, an association between bone pain and TRPV1 has been reported. However, the influence of osteoporosis on TRPV1 in the sensory system innervating the femur has not been reported. MATERIALS AND METHODS: TRPV1-immunoreactive (ir) in dorsal root ganglia (DRG) neurons labeled with neurotracer [Fluoro-Gold (FG)] innervating the femurs of Sprague Dawley rats were examined in control, sham, and ovariectomized (OVX) rats. We evaluated osteoporosis in the femurs and compared the proportion of TRPV1-ir DRG neurons innervating femur between the 3 groups of rats. RESULTS: OVX rats showed osteoporotic cancellous bone in the femur. FG labeled neurons were distributed from L1 to L6 DRG, but there was no significant difference in the proportion of labeled neurons between the 3 groups (p>0.05). The proportions of FG labeled TRPV1-ir DRG neurons were 1.7%, 1.7%, and 2.8% of DRG neurons innervating the femur, in control, sham-operated, and OVX rats, respectively. The proportion of TRPV1-ir neurons in DRG innervating the femur in OVX rats was significantly higher than that in control and sham-operated rats (p<0.05). CONCLUSION: Under physiological conditions, DRG neurons innervating femurs in rats contain TRPV1. Osteoporosis increases the numbers of TRPV1-ir neurons in DRG innervating osteoporotic femurs in rats. These findings suggest that TRPV1 may have a role in sensory perception of osteoporotic femurs.
Animals
;
Female
;
Femur/*innervation/*metabolism
;
Ganglia, Spinal/*metabolism
;
Lumbar Vertebrae/*innervation/physiopathology
;
Neurons
;
Osteoporosis/complications
;
Rats
;
Rats, Sprague-Dawley
;
Stilbamidines
;
TRPV Cation Channels/*metabolism
7.Interspinous Ligament Lidocaine and Steroid Injections for the Management of Baastrup's Disease: A Case Series.
Kentaro OKADA ; Seiji OHTORI ; Gen INOUE ; Sumihisa ORITA ; Yawara EGUCHI ; Junichi NAKAMURA ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Kazuhide INAGE ; Takeshi SAINOH ; Tomoaki TOYONE ; Kazuyo YAMAUCHI ; Kazuhisa TAKAHASHI
Asian Spine Journal 2014;8(3):260-266
STUDY DESIGN: Prospective study. PURPOSE: To examine the long-term effects of interspinous ligament injections of local anesthetics and steroids for the treatment of Baastrup's diseases. OVERVIEW OF LITERATURE: Baastrup's disease is associated with axial low back pains. Baastrup's disease has been more recently described as the "kissing spinous processes" disease. Several authors have reported methods for the diagnosis and treatment of the disease. However, there has been only one report of patients receiving interspinous ligament injections of agents for the treatment of Baastrup's disease. METHODS: Seventeen patients showed severe low back pains between spinous processes at L3-L4 or L4-L5. X-ray imaging, computed tomography, and magnetic resonance imaging revealed kissing spinous processes, consolidation of spinous process, or inflammation of an interspinous ligament. Pain reliefs after lidocaine and dexamethasone administration into interspinous ligament as therapy for low back pains were being examined and followed up. RESULTS: Low back pain scores significantly improved immediately after injection of the agents into interspinous ligaments. At final follow-up (1.4 year), low back pain scores significantly improved as compared with before the treatment. CONCLUSIONS: Findings from the current study indicate that lidocaine and dexamethasone administration into interspinous ligament in patients diagnosed with Baastrup's disease is effective for managing the pain associated with this disease.
Anesthetics, Local
;
Dexamethasone
;
Diagnosis
;
Follow-Up Studies
;
Humans
;
Inflammation
;
Lidocaine*
;
Ligaments*
;
Low Back Pain
;
Magnetic Resonance Imaging
;
Prospective Studies
;
Steroids
8.Classification of Chronic Back Muscle Degeneration after Spinal Surgery and Its Relationship with Low Back Pain.
Seiji OHTORI ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Yasuchika AOKI ; Junichi NAKAMURA ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Yasuhiro SHIGA ; Koki ABE ; Kazuki FUJIMOTO ; Hirohito KANAMOTO ; Gen INOUE ; Kazuhisa TAKAHASHI
Asian Spine Journal 2016;10(3):516-521
STUDY DESIGN: Retrospective case series. PURPOSE: To classify back muscle degeneration using magnetic resonance imaging (MRI) and investigate its relationship with back pain after surgery. OVERVIEW OF LITERATURE: Back muscle injury and degeneration often occurs after posterior lumbar surgery, and the degeneration may be a cause of back pain. However, the relationship between back muscle degeneration and back pain remains controversial. METHODS: A total of 84 patients (average age, 65.1 years; 38 men, 46 women) with lumbar spinal stenosis underwent posterior decompression surgery alone. MRI (1.5 tesla) was evaluated before and more than a year after surgery in all patients. Muscle on MRI was classified into three categories: low intensity in T1-weighted imaging, high intensity in T2-weighted imaging (type 1), high intensity in both T1- and T2-weighted images (type 2), and low intensity in both T1- and T2-weighted imaging (type 3). The prevalence of the types and their relationship with back pain (determined on a visual analog scale) were evaluated. RESULTS: MRI revealed muscle degeneration in all patients after surgery (type 1, 6%; type 2, 82%; and type 3, 12%). Type 2 was significantly more frequent compared with types 1 and 3 (p<0.01). Low back pain was significantly improved after surgery (p<0.01). Low back pain was not associated with any MRI type of muscle degeneration after surgery (p>0.05). CONCLUSIONS: Various pathologies of back muscle degeneration after posterior lumbar surgery were revealed. Type 2 (fatty) change was most frequent, and other patients had type 3 (scar) or type 1 (inflammation or water-like) changes. According to the Modic classification of bone marrow changes, Modic type 1 change is associated with inflammation and back pain. However, no particular type of back muscle degeneration was correlated with back pain after surgery.
Back Muscles*
;
Back Pain
;
Bone Marrow
;
Classification*
;
Decompression
;
Humans
;
Inflammation
;
Low Back Pain*
;
Magnetic Resonance Imaging
;
Male
;
Pathology
;
Prevalence
;
Retrospective Studies
;
Spinal Stenosis
9.Do Physical Symptoms Predict the Outcome of Surgical Fusion in Patients with Discogenic Low Back Pain?.
Seiji OHTORI ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Yasuchika AOKI ; Junichi NAKAMURA ; Masayuki MIYAGI ; Miyako SUZUKI ; Gou KUBOTA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Yasuhiro SHIGA ; Koki ABE ; Kazuki FUJIMOTO ; Hiroto KANAMOTO ; Gen INOUE ; Kazuhisa TAKAHASHI
Asian Spine Journal 2016;10(3):509-515
STUDY DESIGN: Retrospective case series. PURPOSE: To determine whether symptoms predict surgical outcomes for patients with discogenic low back pain (DLBP). OVERVIEW OF LITERATURE: Specific diagnosis of DLBP remains difficult. Worsening of pain on flexion is a reported symptom of DLBP. This study sought to determine whether symptoms predict surgical outcomes for patients with DLBP. METHODS: We investigated 127 patients with low back pain (LBP) and no dominant radicular pain. Magnetic resonance imaging was used to select patients with disc degeneration at only one level. If pain was provoked during discography, we performed fusion surgery (87 patients). Visual analogue scale score and responses to a questionnaire regarding symptoms including worsening of pain on flexion or extension were assessed. Symptom sites before surgery were categorized into LBP alone, or LBP plus referred inguinal or leg pain. We followed 77 patients (average 3.0 years) and compared symptoms before surgery with surgical outcome. RESULTS: Sixty-three patients with a good outcome showed postsurgical pain relief (≥60% pain relief) and 14 patients with a poor outcome did not (<60% pain relief). In patients with good outcomes, worsening of LBP was evident in 65% of cases on flexion and in 35% on extension. However, these findings were not significantly different from those in patients with poor outcomes. The percentage of patients with LBP alone was significantly lower and the percentage of patients with LBP plus referred inguinal or leg pain was significantly higher in the group with good surgical outcome compared with patients in the group with poor surgical outcome (p<0.05). CONCLUSIONS: Worsening of pain on extension may be a symptom of DLBP. Surgical outcomes were superior in patients with both LBP and either referred inguinal or leg pain compared with those having LBP alone.
Diagnosis
;
Humans
;
Intervertebral Disc
;
Intervertebral Disc Degeneration
;
Leg
;
Low Back Pain*
;
Magnetic Resonance Imaging
;
Retrospective Studies
10.Classification of Chronic Back Muscle Degeneration after Spinal Surgery and Its Relationship with Low Back Pain.
Seiji OHTORI ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Yasuchika AOKI ; Junichi NAKAMURA ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Yasuhiro SHIGA ; Koki ABE ; Kazuki FUJIMOTO ; Hirohito KANAMOTO ; Gen INOUE ; Kazuhisa TAKAHASHI
Asian Spine Journal 2016;10(3):516-521
STUDY DESIGN: Retrospective case series. PURPOSE: To classify back muscle degeneration using magnetic resonance imaging (MRI) and investigate its relationship with back pain after surgery. OVERVIEW OF LITERATURE: Back muscle injury and degeneration often occurs after posterior lumbar surgery, and the degeneration may be a cause of back pain. However, the relationship between back muscle degeneration and back pain remains controversial. METHODS: A total of 84 patients (average age, 65.1 years; 38 men, 46 women) with lumbar spinal stenosis underwent posterior decompression surgery alone. MRI (1.5 tesla) was evaluated before and more than a year after surgery in all patients. Muscle on MRI was classified into three categories: low intensity in T1-weighted imaging, high intensity in T2-weighted imaging (type 1), high intensity in both T1- and T2-weighted images (type 2), and low intensity in both T1- and T2-weighted imaging (type 3). The prevalence of the types and their relationship with back pain (determined on a visual analog scale) were evaluated. RESULTS: MRI revealed muscle degeneration in all patients after surgery (type 1, 6%; type 2, 82%; and type 3, 12%). Type 2 was significantly more frequent compared with types 1 and 3 (p<0.01). Low back pain was significantly improved after surgery (p<0.01). Low back pain was not associated with any MRI type of muscle degeneration after surgery (p>0.05). CONCLUSIONS: Various pathologies of back muscle degeneration after posterior lumbar surgery were revealed. Type 2 (fatty) change was most frequent, and other patients had type 3 (scar) or type 1 (inflammation or water-like) changes. According to the Modic classification of bone marrow changes, Modic type 1 change is associated with inflammation and back pain. However, no particular type of back muscle degeneration was correlated with back pain after surgery.
Back Muscles*
;
Back Pain
;
Bone Marrow
;
Classification*
;
Decompression
;
Humans
;
Inflammation
;
Low Back Pain*
;
Magnetic Resonance Imaging
;
Male
;
Pathology
;
Prevalence
;
Retrospective Studies
;
Spinal Stenosis