2.Creating Flowcharts of Eating and Swallowing
Hirotaka SHOJI ; Taizo YAMAMOTO ; Tomoko INOUE ; Chizuru OIKAWA ; Natsumi ADACHI ; Shuzo SHINTANI ; Taro HINO
Journal of the Japanese Association of Rural Medicine 2010;58(5):526-532
Purpose: To create flow charts of eating and swallowing that make it easy to identify the cases requiring professional treatment including dysphagia rehabilitation during oral intake.Subjects: 28 patients (mean age: 78.7±11.3 years) with dysphagia who underwent videofluorography (hereinafter “VF”).Methods: We conducted various tests such as Repetitive Salvia Swallowing Test (RSST), Modified Water Swallowing Test (MWST) and Food Test (FT), and studied relationships between VF findings and Fujishima's grade of eating and swallowing capability.Results: After the examination of th results of RSST (sensitivity: 0.83, specificity: 0.22), MWST (sensitivity: 0.56, specificity: 0.72), FT (sensitivity: 0.33, specificity: 0.75), VF and grade of eating and swallowing capability of Fujishima, the use of MWST and FT was appropriate. However, four cases in which the results of MWST and FT were over the cut-off value had misswallowed water and food. We created the flowcharts considering that all of those 4 cases are also the cases that suffered from the consequences of cerebral strokes.
4.Evaluation of the Association between Neck Pain and the Trapezius Muscles in Patients with Cervical Myelopathy Using Motor Evoked Potential: A Retrospective Study
Sadayuki ITO ; Yoshihito SAKAI ; Atsushi HARADA ; Kei ANDO ; Kazuyoshi KOBAYASHI ; Hiroaki NAKASHIMA ; Masaaki MACHINO ; Shunsuke KAMBARA ; Taro INOUE ; Tetsuro HIDA ; Kenyu ITO ; Naoki ISHIGURO ; Shiro IMAGAMA
Asian Spine Journal 2021;15(5):604-610
Methods:
The study included 100 patients with cervical myelopathy who underwent surgery at the National Center for Geriatrics and Gerontology in Obu, Japan from June 2010 to March 2013. Before the surgery, neck pain was evaluated using a Visual Analog Scale (a score ≥50 indicated neck pain and a score <50 indicated no neck pain). The preoperative cross-sectional areas of the trapezius muscles were measured with cervical magnetic resonance imaging sagittal T2-weighted images. Cranial stimulation under general anesthesia was used to derive the MEPs, enabling the measurement of latency and amplitude, using preoperative MEPs of the trapezius muscles.
Results:
The MEP of the trapezius muscle in patients with neck pain had significantly shorter latencies than those in patients who did not have neck pain. However, there was no significant difference in the amplitude between patients with and without neck pain. However, this tended to be greater in patients with neck pain as compared to that in those without neck pain. The cross-sectional area of the trapezius muscle in patients with neck pain was significantly smaller than that in those who did not have neck pain.
Conclusions
MEPs revealed electrophysiological abnormalities of the trapezius muscles in patients with neck pain, supporting a relationship of neck pain with the trapezius muscles.
5.Response to the Letter to the Editor: Evaluation of the Association between Neck Pain and the Trapezius Muscles in Patients with Cervical Myelopathy Using Motor Evoked Potential: A Retrospective Study
Sadayuki ITO ; Yoshihito SAKAI ; Atsushi HARADA ; Kei ANDO ; Kazuyoshi KOBAYASHI ; Hiroaki NAKASHIMA ; Masaaki MACHINO ; Shunsuke KAMBARA ; Taro INOUE ; Tetsuro HIDA ; Kenyu ITO ; Naoki ISHIGURO ; Shiro IMAGAMA
Asian Spine Journal 2024;18(1):160-161
6.Persistence of Denosumab Therapy among Patients with Osteoporosis
Kazuyoshi KOBAYASHI ; Kei ANDO ; Masaaki MACHINO ; Masayoshi MOROZUMI ; Shunsuke KANBARA ; Sadayuki ITO ; Taro INOUE ; Hidetoshi YAMAGUCHI ; Naoki ISHIGURO ; Shiro IMAGAMA
Asian Spine Journal 2020;14(4):453-458
Results:
The study included 101 patients (84 females) with a median follow-up period of 23.6±14.2 months. The persistence rate declined to 85.3%, 78.3%, 74.1%, 71.3%, and 69.3% at 12, 24, 36, 48, and 60 months, respectively. Age at the initiation of denosumab therapy differed significantly between non-persistent (n=31) and persistent (n=70) patients (81.3 vs. 72.8 years, p <0.01). Persistence was significantly lower in patients aged ≥80 years than in those aged <60 and 60–79 years (both p <0.01). The reasons for non-persistence of denosumab therapy were transfer to another hospital (n=13), interruption of outpatient visits (n=11), dental treatment (n=4), adverse events (n=2), and patient request (n=1).
Conclusions
Persistence was significantly lower in patients aged ≥80 years than in patients of other ages, and strategies promoting persistence are needed for these elderly patients.
7.Scoliosis Caused by Limb-Length Discrepancy in Children
Kazuyoshi KOBAYASHI ; Kei ANDO ; Hiroaki NAKASHIMA ; Masaaki MACHINO ; Masayoshi MOROZUMI ; Shunsuke KANBARA ; Sadayuki ITO ; Taro INOUE ; Hidetoshi YAMAGUCHI ; Kenichi MISHIMA ; Naoki ISHIGURO ; Shiro IMAGAMA
Asian Spine Journal 2020;14(6):801-807
Methods:
The subjects were 23 children with LLD ≥20 mm (range, 27–65 mm) treated at Nagoya University Hospital between 2007 and 2017. Whole spine posteroanterior standing radiographs and whole lower limb radiographs in a supine position were recorded. Data were collected for demographics, LLD, Cobb angle, pelvic obliquity, and Nash/Moe index. Scoliosis was defined as a Cobb angle ≥10°. Leg length was measured from the top of the femoral head to the middle of the tibial plafond, and LLD was defined as the difference between the left and right leg lengths.
Results:
The patients (nine males and 14 females) had a mean age of 14.0 years (range, 5–18 years). The average LLD was 44.3±17.2 mm, with LLDs of 20 to 39 mm, 40 to 59 mm, and ≥60 mm in 13, five, and five subjects, respectively. The average Cobb angle was 13.0°±7.0°, and 15 subjects (65%) had scoliosis. Convexity of the scoliosis was to the short leg side in all cases. The Cobb angle was significantly related to the severity of the LLD (R=0.736, p<0.01), pelvic obliquity (R=0.966, p<0.01), and Nash/Moe index (p<0.05).
Conclusions
LLD is a common pediatric condition that can cause scoliosis of the spine. Severe scoliosis may develop if the LLD is ≥30 mm. Long-term studies are needed to examine the effect of LLD resolution on the elimination of scoliosis.