Injury of the anterior cruciate ligament (ACL) occurs frequently in female gymnasts and basketball players. However, there is no effective method for preventing ACL injury. Recently, a fatigue phenomenon of the ligament tissue has been considered to be the main causative factor in ACL injury.
The present study was done to investigate the relationship between knee laxity and general joint looseness in 34 female college basketball players at an orthopedic medical check-up.
Knee laxity was evaluated in terms of the anterior displacement (AD) value measured by a KT-2000 knee ligament arthrometer at 20 lb. General joint looseness was evaluated in terms of the general joint laxity (GL) score including six major joints and the spine.
There was a significant correlation between the AD value and GL score, the correlation coefficients being 0.48 (p<0.01) at the right knee and 0.54 (p<0.01) at the left knee.
The ACL of athletes with a higher AD would always be exposed to higher anterior stress than in athletes with a lower AD, thus possibly leading to a fatigue state. Therefore, we consider that athletes with a high AD are at greater risk of ACL injury. Our results suggest that the easy GL test is an effective screening method for differentiating those with a high AD and a greater risk of ACL injury.

Objective: To determine nurses’ and care workers’ role in caring for the dying on wards for recuperation under health insurance. Methods: The analysis was performed using semi-structured interviews involving 9 nurses and care workers working on wards for recuperation under health insurance and having experience of caring for dying patients. Results: As for nurses’ roles in caring for dying patients, 6 categories were extracted, including ‘support patients’ families to have a feeling that they were fully involved in the process of dying’. As for care workers’ roles in caring for dying patients, 5 categories were extracted, including ‘support nurse through the care worker activities’. Conclusion: In order to provide quality care for the dying, it is important to put the following points into practice: providing feedback and seculity on effects of daily life support, the provision of opportunities to enhance the independence of the care worker.

Background: The current study aimed to investigate factors associated with the prognosis of activities of daily living (ADL) in elderly patients with pneumonia who had undergone rehabilitation during their hospitalization.
Methods: The study included patients of age ≥65 years who were hospitalized due to pneumonia and had undergone rehabilitation for disuse syndrome at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL. The participants were divided into a high-recovery group (≥80%) and a low-recovery group (<80%) based on the FIM recovery rate score. Further, factors associated with the prognosis of ADL were evaluated using multivariate logistic regression analysis. Basic characteristics, consciousness, usual mode of transportation, FIM score, grip strength, range of motion, orthostatic hypotension, exercise tolerance (6-minutes walking distance), respiratory disorder (Hugh–Jones classification), constipation, malnutrition (mini-nutritional assessment), cognitive (mini-mental state examination), depression (geriatric depression scale), balance (functional balance scale), urinary incontinence, and pressure ulcers were included as the evaluation items.
Results: Among the 51 elderly patients with pneumonia (average age ± SD; 82.0 ± 11.3), 34 patients were classified in the high-recovery group and 17 in the low-recovery group. In multivariate logistic regression analysis, it was revealed that the number of days from the onset until the initiation of rehabilitation (days of inactivity) and nutritional status were factors associated with a high-recovery FIM score.
Conclusions: The study results suggest that days of inactivity and early management of nutritional status after hospitalization are important for elderly patients with pneumonia to return to their ADL.

The purpose of this study is to investigate the degenerative change of the cervical spine in American football (AF) players. The subjects were 27 collegiate AF players who had an annual radiological examination of the cervical spine. X-ray films of the lateral view were read by digital scanner and the anterior and posterior height of each spine (C 3-C 6) was measured. The subjects were divided into two groups based on experience of AF in high school (inexperienced and experienced) or the position played (lines and backs) .
Although the anterior height did not change from the first grade to fourth grade, the posterior height of C 4, C 5 and C6 significantly increased (P <0.05) . The experienced group showed a faster increase in the rate of posterior height than the inexperienced group. Also, the backs group showed a faster increase in the rate of posterior height than the lines group. The increased posterior height, which sometimes includes bony spur, results in kyphotic change of cervical alignment and impingement of the cervical nerve root. The faster growth rate in experienced or backs groups suggests that higher mechanical stress to the cervical spine and younger start of AF caused degeneration.

To clarify a mechanism of psychologic relaxation by artificial hot spring, the effect of hot spring bathing on psychologic sweating was studied in 11 healthy subjects (1 female and 10 males, age 26±5.7 years). After lying in the supine position for 5 minutes, the subjects were asked to take a bath with plain water or artificial hot spring for 5 minutes in the sitting position. The temperature of the bath was 40°C. To prepare the artificial hot spring, sodium sulfate tablet (Tsumura & Co.) was solved in 200L of plain water. For the measurement of psychologic sweating, Perspiro (Suzuken, Co. Ltd) was used. Sensor was attached to the first finger by biphasic adhesive tape. The psychologic sweating was induced by deep respiration, mental arithmetic, hand grip, blood pressure measurement and blood sampling. There were no statistical significant differences of CV value, heart rate, blood pressures, catecholamine values and serum β endorphin levels before and after the bathing. The psychologic sweating markedly decreased after the bathing (11.5±19.6 to 1.1±2.7 for plain water bathing, 14.9±21.9 to 1.6±5.1 for artificial hot spring, N. S.).
The decrease in psychologic sweating after bathing suggests the action of psychologic relaxation by bathing.

Background: In Japan, although clinicians have been extremely interested in conducting clinical research, the shortage of clinical researchers is a serious problem. Therefore, it is important to explore barriers to conducting clinical research.1) We mailed a cross-sectional survey to hospital managers asking about their interest in and barriers to conducting clinical research and training clinical researchers at their hospitals.2) Of 810 eligible hospital managers, 301 completed questionnaires (response rate: 37.2%).3) The managers of university hospitals and national medical centers were more interested in conducting clinical research than were managers of other hospitals.4) Furthermore, 60.6% of managers of university hospital and 18.8% of managers of other hospitals reported the need to employ physicians who specialized in clinical research. However, given public research grants, about 50% of hospital managers were willing to employ research residents.5) Our results suggest there are still barriers to conducting clinical research, such as a lack of time set aside for clinicians and specialists to teach clinical research. A substantial strategy is needed to address the shortage of clinical researchers in Japan.

To estimate the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis, all medical records in our clinic were retrospectively examined. Among 2,430 patients who took Kampo medicine containing Scutellaria baicalensis, liver blood tests were performed in 1,547 cases (63.7%). The possibility of liver injury related to Kampo medicine containing Scutellaria baicalensis could not be denied in 19 cases (1.2%) among the 1,547 cases. The clinical features of liver injury in 19 cases were not different from those in previous reports. In agreement with the previous literature, this study also suggests that the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis is about 1%.

A 47-year-old woman visited our clinic, and thereafter she had taken various Kampo medicines until she turned 58 years old. She took each medicine, containing 1-3.5 g/day of glycyrrhiza, for one or two months. Hypertension or edema was not observed in those days. From the age of 60, she took 7.5 g of tokishigyakukagoshuyushokyoto, containing 2 g of glycyrrhiza, day after day. Hypertension or edema was not observed for 35 months. However, when she was 63 years old, pseudoaldosteronism with headache, hypertension, edema,and hypopotassemia was observed for the first time. This case suggests that administration period or patient's age influences the development of pseudoaldosteronism.

A 56-year-old man felt something abnormal in his right upper leg and 2 weeks later, sudden severe pain occurred. He was admitted to our department, on the suspicion of peripheral artery aneurysm. Arteriography showed a right deep femoral artery aneurysm. We successfully treated him with transcatheter embolization. Selective angiography of the deep femoral artery after the embolization disclosed complete occlusion of the aneurysm. We concluded that this minimally invasive treatment by transcatheter embolization for aneurysm of the deep femoral artery may be the first treatment of choice rather than operative resection.

Objective : To examine the relation between psychoactive drugs and the outcome of dysphagia in patients with psychiatric disorders. Methods : We examined 53 inpatients who were prescribed speech therapy in the psychiatry ward of our hospital from January 2011 to April 2012. We categorized the patients into a poor outcome group and a good outcome group by the necessity for alternative nutrition at discharge and analyzed the number and kind of typical antipsychotic, atypical antipsychotic, hypnotic, antidepressant and mood stabilizer, total amount of typical antipsychotic, atypical antipsychotic used at admission and at discharge, sex, psychiatric disorder, central nervous system disease, aspiration pneumonia, duration of hospitalization, psychiatric disorder disease period, speech therapy intervention period and GAF scale at admission. Results : The outcome of dysphagia had a significant relation with the number and kind of antipsychotic used, especially typical antipsychotic used at admission. The good outcome group had a higher total amount of antipsychotic use, especially atypical antipsychotics. Conclusion : Long-term practical oral intake should not comprise antipsychotic polypharmacy, especially typical antipsychotics before onset of dysphagia, but should instead consist of a monopharmacy approach with atypical antipsychotics.