1.Indication and Limitations of Speech-language Therapy for Foreign Language-speaking Patients
Tomoya HAMADA ; Chihiro IMAI ; Akane YAMASHITA
The Japanese Journal of Rehabilitation Medicine 2015;52(10):621-624
We reported our experiences with providing speech-language therapy to foreign language-speaking patients. The patients were English, Spanish, Chinese, Swahili and Persian speakers. The primary therapist was Japanese and had no experience in many of the target languages. Assessments were made and treatments were delivered to the patients with the assistance of interpreters and necessary information obtained from the Internet. Of the five patients reported, 3 patients were assessed as unimpaired or suffering only very mild aphasia and received no therapy, and 2 patients were assessed with severe aphasia and received speech-language therapy. It was indicated that the presence of an interpreter, the severity of aphasia and the accessibility to target language speech-language therapy information were the important factors in conducting foreign language therapy. In addition, arrangements need to be made to include a means to correct a patient's utterances, provide immediate feedback during therapy and translate all of the testing materials.
2.Fixation Strength of Caudal Pedicle Screws after Posterior Lumbar Interbody Fusion with the Modified Cortical Bone Trajectory Screw Method.
Hironobu SAKAURA ; Toshitada MIWA ; Tomoya YAMASHITA ; Yusuke KURODA ; Tetsuo OHWADA
Asian Spine Journal 2016;10(4):639-645
STUDY DESIGN: Clinical case series. PURPOSE: In the posterior lumbar interbody fusion (PLIF) procedure in our institute, the cephalad screw trajectory follows a mediolateral and caudocephalad directed path according to the original cortical bone trajectory (CBT) method. However, the starting point of the caudal screw is at the medial border of the pedicle on an articular surface of the superior articular process, and the trajectory takes a mediolateral path parallel to the cephalad endplate. The incidence of caudal screw loosening after PLIF with this modified CBT screw method was investigated, and significant risk factors for caudal screw loosening were evaluated. OVERVIEW OF LITERATURE: A biomechanical study of this modified caudal screw trajectory using the finite element method reported about a 20% increase in uniaxial yield pullout load compared with the traditional trajectory. However, there has been no clinical study concerning the fixation strength of this modified caudal screw trajectory. METHODS: The subjects were 193 consecutive patients who underwent single-level PLIF with modified CBT screw fixation. Caudal screw loosening was checked in computed tomography at 6 months after surgery, and screw loosening was defined as a radiolucency of 1 mm or more at the bone-screw interface. RESULTS: The incidence of caudal screw loosening after lumbosacral PLIF (46.2%) was significantly higher than that after floating PLIF (6.0%). No significant differences in sex, brand of the instruments, and diameter and length of the caudal screw were evident between patients with and without caudal screw loosening. Patients with caudal screw loosening were significantly older at the time of surgery than patients without caudal screw loosening. CONCLUSIONS: Fixation strength of the caudal screw after floating PLIF with this modified CBT screw technique was sufficiently acceptable. Fixation strength after the lumbosacral procedure was not.
Clinical Study
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Humans
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Incidence
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Methods*
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Pedicle Screws*
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Risk Factors
3.Gastric Xanthomas and Fundic Gland Polyps as Endoscopic Risk Indicators of Gastric Cancer
Kentaro YAMASHITA ; Ryo SUZUKI ; Toshiyuki KUBO ; Kei ONODERA ; Tomoya IIDA ; Mayuko SAITO ; Yoshiaki ARIMURA ; Takao ENDO ; Masanori NOJIMA ; Hiroshi NAKASE
Gut and Liver 2019;13(4):409-414
BACKGROUND/AIMS: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. METHODS: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. RESULTS: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. CONCLUSIONS: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
Gastroscopy
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Humans
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Polyps
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Prevalence
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Stomach Neoplasms
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Xanthomatosis
4.Frequency and clinical features of deficient mismatch repair in ovarian clear cell and endometrioid carcinoma
Tamaki TANAKA ; Kazuhiro TAKEHARA ; Natsumi YAMASHITA ; Mika OKAZAWA-SAKAI ; Kazuya KURAOKA ; Norihiro TERAMOTO ; Kenichi TAGUCHI ; Katsushige YAMASHIRO ; Hidenori KATO ; Tomoya MIZUNOE ; Rie SUZUKI ; Dan YAMAMOTO ; Arisa UEKI ; Toshiaki SAITO
Journal of Gynecologic Oncology 2022;33(5):e67-
Objective:
To clarify the frequency of deficient mismatch repair (dMMR) in Japanese ovarian cancer patients, we examined microsatellite instability (MSI) status and immunohistochemistry (IHC) subtypes, including endometrioid carcinoma (EMC), clear cell carcinoma (CCC), or a mixture of both (Mix).
Methods:
We registered 390 patients who were diagnosed with EMC/CCC/Mix between 2006 and 2015 and treated at seven participating facilities. For 339 patients confirmed eligible by the Central Pathological Review Board, MSI, IHC, and MutL homolog 1 methylation analyses were conducted. The tissues of patients with Lynch syndrome (LS)-related cancer histories, such as colorectal and endometrial cancer, were also investigated.
Results:
MSI-high (MSI-H) status was observed in 2/217 CCC (0.9%), 10/115 EMC (8.7%), and 1/4 Mix (25%). Additionally, loss of MMR protein expression (LoE-MMR) was observed in 5/219 (2.3%), 16/115 (14.0%), and 1/4 (25%) patients with CCC, EMC, and Mix, respectively. Both MSI-H and LoE-MMR were found significantly more often in EMC (p<0.001). The median (range) ages of patients with MMR expression and LoE-MMR were 54 (30–90) and 46 (22–76) (p=0.002), respectively. In the multivariate analysis, advanced stage and histological type were identified as prognostic factors.
Conclusion
The dMMR rate for EMC/CCC was similar to that reported in Western countries. In Japan, it is assumed that the dMMR frequency is higher because of the increased proportion of CCC.
5.Rimmed Vacuoles in Myositis Associated with Antimitochondrial Antibody
Rui SHIMAZAKI ; Akinori URUHA ; Hideki KIMURA ; Utako NAGAOKA ; Tomoya KAWAZOE ; Satoshi YAMASHITA ; Takashi KOMORI ; Kazuhito MIYAMOTO ; Shiro MATSUBARA ; Keizo SUGAYA ; Masahiro NAGAO ; Eiji SOZAKI
Journal of Clinical Neurology 2020;16(3):510-512