2.Inattention Behavioral Assessment conducted by the Family at Home : Validity of BAAD (Behavioral Assessment of Attentional Disturbance)
Minoru Toyokura ; Takashi Sugawara ; Tomomi Hayashi ; Youko Nishimura ; Rie Murayama
The Japanese Journal of Rehabilitation Medicine 2009;46(5):306-311
Attentional disturbance following brain damage is usually evaluated by several neuropsychological tests. In a rehabilitation setting, however, the primary concern is not task performance, but rather functional real-world behavior. To address this requirement, a new assessment system for attentional behavior, BAAD (Behavioral Assessment of Attentional Disturbance), has been developed. This assessment is generally completed by the patient's therapist (occupational therapist, OT) during therapy. The aim of this study was to investigate whether BAAD completed by the family at home (BAAD-FM) yields results that are comparable to BAAD completed by an OT during occupational therapy (BAAD-OT). The subjects were 53 patients with brain damage. BAAD consists of six items thought to be associated with attentional behaviors. Each item is rated (0 to 3) based on the frequency with which the problem behaviors appeared during daily living at home and daily sessions of occupational therapy. The intraclass-correlation coefficient of the total score between BAAD-FM and BAAD-OT was 0.89. The mean (SD) values of the total scores were 3.7 (3.7) and 3.7 (3.6), respectively. Similarly, there were no significant differences in any of the item scores between BAAD-FM and BAAD-OT. The coincidence rate between the two BAAD tests on an item-by-item basis was over 64% for all items but one (43%). In conclusion, the total BAAD-FM score seemed comparable to the total BAAD-OT score and valuable for detecting attentional disturbance.
3.A Case of Aneurysm of the Deep Femoral Artery Treated by Transcatheter Embolization
Naoki Kida ; Takashi Watanabe ; Hiroomi Murayama ; Takashi Yano ; Keiji Ohhara ; Atsukata Kobayashi
Japanese Journal of Cardiovascular Surgery 2006;35(5):278-280
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.
4.TYPE A bEHAVIOR PATTERN AND SPORTS INJURIES.
TAKASHI NIGORIKAWA ; KAZUO OISHI ; MICHIO YASUKAWA ; MAMI KAMIMURA ; MITSUYOSHI MURAYAMA ; NOBUAKI TANAKA
Japanese Journal of Physical Fitness and Sports Medicine 2003;52(4):359-367
This study was designed to investigate the relationships between the tendencies toward Type A behavior pattern (TABP) and sports injuries. A total of 2164 (1631 males and 533 females) athletes from several colleges in Japan, volunteered for this study. They were divided into two groups ; an injury group and a non-injury group. KG's Daily Life Questionnaire was used to investigate the tendency of TABP. Our hypothesis was that Type A individuals showed higher occurrences of sports injury than Type B individuals. Most of the results in this study supported our hypothesis. To put it concretely, the injury group showed higher TABP tendency than the non-injury group. And the higher TABP score group showed higher occurrence of injury experiences than those of low score group. Therefore, there was a possibility that TABP tendency of athletes might be one of the informations to prevent sports injuries.
5.Effects of Dialyzer Membrane Characteristics on Serum Total Protein and Albumin Concentration in Hemodialysis Patients
Maiko SATOH ; Wakako OOSHIMA ; Masaki MURAYAMA ; Takashi KATOH ; Katsumi YAMADA ; Shin HASEGAWA ; Gen KURAMOCHI
Journal of the Japanese Association of Rural Medicine 2009;58(1):13-20
Recent studies showed that high biocompatibility and reduction of uremic toxin contributed to the improvement of freatment outcome in hemodialysis patients.Therefore, a high-flux membrane dialyzer, especially polysulfone (PS) membrane, was generally used in dialysis. However, it was suggested that the higher efficiency of reduction in uremic toxins might cause an increase in the albumin leakage through the dialyzer membrane during dialysis, resulting in a decrease in serum albumin concentration. In this study, we used two different dialyzer membranes with high biocompatibility, namely, ethylenevinylalcohol (EVAL) membrane and improved PS membrane with a very lower leakage of serum albumin. After using these two types of mambrane of six straight months, we examined the effect of each dialyzer membrane characteristic on the serum total protein and albumin concentration. The reduction rates of each uremic solute and serum total protein concentration were significantly higher. The serum albumin concentration and its rate of change with the passing of time tended to increase in the case of the PS membrane. But in the case of EVAL membrane, these values tended to decrease. These results suggested that the differences in the changes in the serum total protein and albumin concentration might result from the differences in the efficiency of the reduction of uremic toxins. Therefore, it is necessary to consider the usage of the dialyzer membrane with a higher reduction of uremic solutes and a lower leakage of serum albumin to add to the higher biocompatibility specially in hemodialysis patients with hypoproteinemia.
Membranes
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Concentration
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Reduction (chemical)
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Serum Albumin
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Hemodialysis
6.Combination treatment of severe alcoholic hepatitis with continuous hemodiafiltration and steroid hormone: A case report and Literature review
Gen KURAMOCHI ; Wakako OHSHIMA ; Masaki MURAYAMA ; Takashi KATO ; Maiko SATO ; Kenji SHIMA ; Shin HASEGAWA ; Munehiro SATO ; Shinichi TAKEI ; Osamu ISOKAWA
Journal of the Japanese Association of Rural Medicine 2006;55(5):465-471
We experienced a case of severe alcoholic hepatitis. Combination treatment of continuous hemodiafiltration and steroid hormone was started immediately after admission. This treatment was very effective for severe alcoholic hepatitis, resulting in the shortening of the length of hospital stay. The reasons why this treatment was effective were; 1. The patient was younger, so the regeneration ability of liver cells was stronger. 2. The infection and bleeding of digestive organs except for acute renal failure were not found, resulting in the enhancement of the effectiveness for steroid hormone treatment. 3. The intensive blood purification treatment was started immediately. From this experience, we realized again that a fine collaboration of doctors, nurses and clinical engineers was very important in the intensive care of the severe diseases.
therapeutic aspects
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Steroid hormone, NOS
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Hepatitis, Alcoholic
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Combined
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Review [Publication Type]
7.Clinical Efficacy and Safety of Arbekacin against Pneumonia in Febrile Neutropenia: A Retrospective Study in Patients with Hematologic Malignancies
Takashi OHASHI ; Yukiyoshi FUJITA ; Hiroyuki IRISAWA ; Hidemasa NAKAMINAMI ; Takahiro ARAI ; Masumi TAKAHASHI ; Emi MOMIYAMA ; Naoya MURATA ; Kayoko MURAYAMA ; Taeko SAITO
Infection and Chemotherapy 2022;54(1):80-90
Background:
Arbekacin (ABK) is an aminoglycoside that exhibits anti-methicillin-resistant Staphylococcus aureus (MRSA) and anti-Pseudomonas aeruginosa activities. Therefore, for patients with febrile neutropenia (FN) and concurrent pneumonia suspected to be caused by MRSA, ABK may be sufficiently effective even as a single agent.
Materials and Methods:
Patients with hematologic malignancies treated with ABK who met the following criteria were included: 1) fever during neutropenia or functional neutropenia, 2) FN complicated by pneumonia, and 3) possible infection by antimicrobial-resistant Grampositive cocci.
Results:
This study encompassed 22 episodes involving 19 patients, of which, 15 (68.2%) were successfully treated with ABK. Of the nine episodes showing inadequate response to other anti-MRSA drugs, eight were successfully treated with ABK. Grade 2 or worse adverse events included acute kidney injury (13.6%) and increased transaminase levels (9.1%).
Conclusion
The present study demonstrated that ABK is effective and safe in patients with FN and concurrent pneumonia caused by antimicrobial-resistant Gram-positive cocci. ABK may also be effective in patients who are unresponsive to other anti-MRSA drugs. Therefore, ABK may be beneficial in the treatment of pneumonia caused by antimicrobial-resistant Gram-positive cocci in patients with FN.
8.Effects of Bone Cross-Link Bridging on Fracture Mechanism and Surgical Outcomes in Elderly Patients with Spine Fractures
Mitsuru FURUKAWA ; Kanehiro FUJIYOSHI ; Toshiki OKUBO ; Yoshihide YANAI ; Kohei MATSUBAYASHI ; Takashi KATO ; Yoshiomi KOBAYASHI ; Tsunehiko KONOMI ; Yoshiyuki YATO
Asian Spine Journal 2023;17(4):676-684
Methods:
We examined 242 patients (age >60 years) who underwent surgery for thoracic to lumbar spine fractures from 2010 to 2020. Subsequently, the maxVB was classified into three groups: maxVB (0), maxVB (2–8), and maxVB (9–18), and parameters, including fracture morphology (new Association of Osteosynthesis classification), fracture level, and neurological deficits were compared. In a sub-analysis, 146 patients with thoracolumbar spine fractures were classified into the three aforementioned groups based on the maxVB and compared to determine the optimal operative technique and evaluate surgical outcomes.
Results:
Regarding the fracture morphology, the maxVB (0) group had more A3 and A4 fractures, whereas the maxVB (2–8) group had less A4 and more B1 and B2 fractures. The maxVB (9–18) group exhibited an increased frequency of B3 and C fractures. Regarding the fracture level, the maxVB (0) group tended to have more fractures in the thoracolumbar transition region. Furthermore, the maxVB (2–8) group had a higher fracture frequency in the lumbar spine area, whereas the maxVB (9–18) group had a higher fracture frequency in the thoracic spine area than the maxVB (0) group. The maxVB (9–18) group had fewer preoperative neurological deficits but a higher reoperation rate and postoperative mortality than the other groups.
Conclusions
The maxVB was identified as a factor influencing fracture level, fracture type, and preoperative neurological deficits. Thus, understanding the maxVB could help elucidate fracture mechanics and assist in perioperative patient management.
9.Incidences and Risk Factors for Postoperative Non-Union after Posterior Lumbar Interbody Fusion with Closed-Box Titanium Spacers
Tsunehiko KONOMI ; Akimasa YASUDA ; Kanehiro FUJIYOSHI ; Yoshiyuki YATO ; Takashi ASAZUMA
Asian Spine Journal 2020;14(1):106-112
Methods:
PLIF using closed-box spacers without filling the autologous bone was performed in 78 (88 levels) consecutive patients. Surgical procedures included PLIF using traditional pedicle screw fixation (PLIF, n=37), PLIF using cortical bone trajectory screw fixation (CBT-PLIF, n=30), and transforaminal lumbar interbody fusion with traditional pedicle screw fixation (TLIF, n=11). Lateral dynamic radiography and computed tomography findings were investigated, and the relationship between the union status and variables that may be related to the risk of non-union was tested statistically.
Results:
The overall bone union rates at 12 and 24 months were 68.0% and 88.5%, respectively. Incidences of bone cyst formation, subsidence, and retropulsion of spacers were 33.3%, 47.4%, and 14.1%, respectively. Union rates at 24 months were 94.6% in PLIF, 80.0% in CBT-PLIF, and 90.9% in TLIF. Multivariate logistic regression analyses showed that at 12 months postoperatively, the risk factor for non-union was age >75 years (p =0.02). In contrast, no significant risk factor was observed at 24 months.
Conclusions
These findings demonstrated the efficacy of interbody closed-box spacers for PLIF without the need to fill the spacer with autologous bone. However, the risk of non-union should be considered in elderly patients, especially intra-operatively and during the early postoperative stage.
10.Effects of Modified Constraint-induced Movement Therapy without Constraints on the Unimpaired Side of the Lower Limb in Patients with Chronic Stroke
Kazuhiro MATSUZAWA ; Takashi MURAYAMA ; Tomoyoshi KOBARI ; Akiho SUZUKI ; Naohisa KIKUCHI ; Katsunori YOSHINAGA
The Japanese Journal of Rehabilitation Medicine 2019;():18021-
Constraint-induced movement therapy (CIMT) has been a well-established rehabilitative method for upper limb paralysis in patients post-stroke. In recent years, its application to lower limb paralysis (Lower limb CIMT, L-CIMT) has been reported. However, the reported intensive lower limb trainings do not seem enough to target behavioral modifications in an individual's daily life. In this study, we investigated the effects of L-CIMT including the transfer package to induce behavioral transformation in normal daily life of patients with lower limb paralysis. The L-CIMT including the transfer package was administered to three patients with chronic-phase stroke without any constraint on the healthy lower limb for 3.5 hours a day, 5 days a week for 3 weeks. As a result, standing balance and walking ability were improved immediately and within 6 months after the intervention, respectively. All three cases experienced increased daily opportunities for standing and walking. We believe that L-CIMT including the transfer package can bring both short- and long-term improvements in standing balance and walking ability. This can lead to an increase in the frequency of standing and walking in daily living, along with an expanded range of action in ADL and IADL in patients with chronic-phase stroke.