3.Studies on the Influence of National Examination for Physicians' License on Medical Education in the Japanese Medical Schools: Report from the Japan Society for Medical Education
Daizo USHIBA ; Motokazu HORI ; Fumio YAMASHITA ; Tetsuo ISHII ; Kenichi UEMURA ; Michio OKAJIMA ; Akitsugu OJIMA ; Osamu SAKAI ; Fumimaro TAKAKU ; Susumu TANAKA ; Masahiko HATAO ; Hidenobu MASHIMA
Medical Education 1984;15(4):237-252
4.Theory and practice of the pass level setting in the examination: Comparison between "MPL" and modified ebel's method.
DAIZO USHIBA ; MASAHIKO HATAO ; MOTOKAZU HORI ; FUMIO YAMASHITA ; TETSUO ISHII ; KENICHI UEMURA ; MICHIO OKAJIMA ; AKITSUGU OJIMA ; OSAMU SAKAI ; FUMIMARO TAKAKU ; SUSUMU TANAKA ; HIDENOBU MASHIMA
Medical Education 1985;16(3):175-182
5.A Case Report of Intrathecal Baclofen Therapy with Infusion Pump Implantation into the Antero-medial Thigh
Masakazu TAKEMITSU ; Kyohei MATSUDA ; Osamu UEMURA ; Yoshiyuki YATO
The Japanese Journal of Rehabilitation Medicine 2022;():21020-
Intrathecal baclofen (ITB) therapy is used to treat patients with spasticity. The pump that delivers baclofen to the intrathecal space of the thoracolumbar spine is generally implanted under the skin or fascia of the anterolateral abdomen. Here we present a case in which the pump was implanted in an alternative site, under the skin of the anteromedial thigh. The patient was a 61-year-old man who was 148 cm tall. He had spastic paraplegia (ASIA Impairment Scale grade B) caused by severe scoliosis related to dystrophic neurofibromatosis. No safety space for pump implantation existed in his abdomen because of a stoma, scars, and adhesions that resulted from surgeries for ileus and abdominal aortic aneurysms. The catheter ran from the lumbar spine to the anteromedial thigh via the point between the iliac crest and the great trochanter. The catheter and pump caused no trouble over 1 year of follow-up. This case demonstrates that the thigh can be an alternative site for ITB pump implantation in some patients with abdominal wall problems. This surgical modification may not be indicated for some patients with ambulators or frequent hip motion, who are at risk of catheter problems or pump migration.
6.A Case Report of Intrathecal Baclofen Therapy with Infusion Pump Implantation into the Antero-medial Thigh
Masakazu TAKEMITSU ; Kyohei MATSUDA ; Osamu UEMURA ; Yoshiyuki YATO
The Japanese Journal of Rehabilitation Medicine 2022;59(4):427-431
Intrathecal baclofen (ITB) therapy is used to treat patients with spasticity. The pump that delivers baclofen to the intrathecal space of the thoracolumbar spine is generally implanted under the skin or fascia of the anterolateral abdomen. Here we present a case in which the pump was implanted in an alternative site, under the skin of the anteromedial thigh. The patient was a 61-year-old man who was 148 cm tall. He had spastic paraplegia (ASIA Impairment Scale grade B) caused by severe scoliosis related to dystrophic neurofibromatosis. No safety space for pump implantation existed in his abdomen because of a stoma, scars, and adhesions that resulted from surgeries for ileus and abdominal aortic aneurysms. The catheter ran from the lumbar spine to the anteromedial thigh via the point between the iliac crest and the great trochanter. The catheter and pump caused no trouble over 1 year of follow-up. This case demonstrates that the thigh can be an alternative site for ITB pump implantation in some patients with abdominal wall problems. This surgical modification may not be indicated for some patients with ambulators or frequent hip motion, who are at risk of catheter problems or pump migration.
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