In recent years, the relationship between healthy life expectancy and exercise has been shown, and the same is also reported for the disabilities. However, we have not yet found any reports on the effects of exercise in children with lower extremity amputations. In this study, we had followed a seven-year-old boy who had undergone right knee rotationplasty for the Ewing's sarcoma, and studied the changes in his athletic abilities, bone density, and body composition with the use of a running-specific prosthesis (RSP). After becoming independent on walking with a daily-use prosthesis, he started using the RSP during exercise such as running. We measured the above parameters before the introduction of RSP, then again after one year use of the RSP. The results showed positive changes in all measurements: increased motor strength around hip, longer time on one leg standing test, increased one leg jump, faster walking speed, wider stride, improved bone density, and improved body compositions. The use of RSP's along with daily-use prostheses for children in their growth period may have favorable effects on their athletic abilities, bone densities, and body compositions.

In recent years, the relationship between healthy life expectancy and exercise has been shown, and the same is also reported for the disabilities. However, we have not yet found any reports on the effects of exercise in children with lower extremity amputations. In this study, we had followed a seven-year-old boy who had undergone right knee rotationplasty for the Ewing's sarcoma, and studied the changes in his athletic abilities, bone density, and body composition with the use of a running-specific prosthesis (RSP). After becoming independent on walking with a daily-use prosthesis, he started using the RSP during exercise such as running. We measured the above parameters before the introduction of RSP, then again after one year use of the RSP. The results showed positive changes in all measurements: increased motor strength around hip, longer time on one leg standing test, increased one leg jump, faster walking speed, wider stride, improved bone density, and improved body compositions. The use of RSP's along with daily-use prostheses for children in their growth period may have favorable effects on their athletic abilities, bone densities, and body compositions.

Methods: Consecutive patients diagnosed with OFs at Fujieda Heisei Memorial Hospital were divided into three groups: nonsurgical therapy, balloon kyphoplasty (BKP), and open surgery groups. The mOF score was calculated, and the levels of independence and posttreatment imaging data were compared between patients treated and not treated according to the mOF score-based treatment recommendation. Results: In total, 118 patients were included (nonsurgical therapy, n=57; BKP, n=48; open surgery, n=13), of whom 100 (85%) received treatment consistent with the mOF score-based treatment recommendation. In the BKP and open surgery groups, the mOF scorebased treatment recommendations were consistent with the actual treatment in 93% of the patients. However, in the nonsurgical group, the mOF score-based treatment recommendation was not consistent with the actual treatment in 25% of the patients. In this group, patients not treated according to the mOF score had significantly shorter vertebral body height, greater local kyphosis, and smaller sacral slope after treatment than patients treated according to the mOF score-based treatment recommendation. Conclusions In the BKP and open surgery groups, the mOF scores were consistent with actual clinical selection. In the nonsurgical therapy group, patients not treated according to the mOF score-based treatment recommendation exhibited severe vertebral body deformity and a less well-balanced spine shape after treatment. The mOF score may help in selecting suitable treatments for OFs.

There are few reports on the effects for children using the diagnostic method of Kampo medicine (called sho : pattern diagnosis). Therefore, we investigated the effects of combination therapy with Kampo medicines prescribed by specialists in this ancient form of medicine to children who were refractory to modern medicine. This was a retrospective observational study of 98 children (pre-school children (PS ; n = 21), elementary school students (ES ; n = 37) and junior high school students (JS ; n = 40)) younger than 16 years old at the first visit to our department of Chiba University hospital between April 2007 and April 2017. We collected the following information from their medical records : background, chief complaint, referral source, and efficacy of Kampo medicines. We evaluated efficacy for Kampo medicine as follows : Higher improvement (HI) (symptoms improved by 2/3 or more) ; Improvement (I) (symptoms improved by 1/3-2/3) ; Mild improvement (MI) (symptoms improved by 1/3 or less) ; constant ; aggravated ; and unknown or first visit only. Positive response (HI, I, and MI) due to Kampo medicines was observed in 76% (75/98) of patients. No aggravations were observed. The chief complaint by age was skin diseases in PS, digestive diseases in ES, and cardiovascular diseases in JS. Pediatrics was the primary referral in all ages, while 30% of JS were referred from psychiatry. Kampo medicine was significantly more effective for those in PS and ES compared to those in JS (p = 0.025). Combined use of Kampo medicine and modern medicine therapy is useful for children refractory to modern medicine.

In order to avoid the risk of COVID-19 among our clinic staffs, remote medical care using tablet-type devices was conducted in our fever outpatient clinic. In about 5 months, there were 87 patients with COVID-19 diagnosed by PCR test. Among them, 24 patients (15 men and 9 women, average age 36.2 years) were treated with Kampo medicine. Four of 24 patients required hospitalization. All patients, including those hospitalized cases, improved their symptoms during the observation period. We believe that Kampo medicine is effective in the early treatment of COVID-19. In addition, we consider that remote medical care using tablet-type devices is one of the useful methods in the treatment of highly contagious infectious diseases.

Purpose: This study examines the reliability and validity of an Interprofessional Competency Assessment Scale for Undergraduates (ICASU) in the staged evaluation of an interprofessional education (IPE) program.　Participants: Participants were 355 undergraduates of Sapporo Medical University, department of nursing, occupational therapy, and physical therapy.　Data collection: We developed the interprofessional competency assessment form with 28 items, each using a 5-point Likert scale, to ask participants about their achievement and learning opportunities.　Analysis: Deleting items that showed ceiling effects in the achievement, we performed a factor analysis. Repeating the deletions till the factor loads of all items became 0.4 or higher, 16 items were selected for the ICASU. We conducted an exploratory factor analysis on achievement and learning opportunities. Using principal factor analysis and Promax rotation, we calculated the Cronbach alpha coefficient.　Results: We collected 314 (89.2%) valid responses. Factor analyses of ICASU data on achievement showed three factors: six items for ‘Basic communication skills’, four items for ‘Understanding one’s own and other occupations’, and six items for ‘Interprofessional collaboration skills’. Three similar factors were extracted on learning opportunities, showing agreement among all items except one. The α coefficients of the ICASU on the achievement and learning opportunities were 0.8 or higher.　Conclusion: The findings suggest that the ICASU is composed of three factors that indicate staged interprofessional competency in undergraduates and verify the validity of concepts and internal consistency. The usefulness of this scale in the staged evaluation of IPE needs to be explored.

We investigated the number of drugs and pharmaceutical cost among 159 patients prescribed Western medicine and hospitalized from August 2006 to August 2015 in the Department of Oriental (Kampo) Medicine at Chiba University Hospital. The number of drugs used in Western medicine among improved patients significantly decreased from 5.6 ± 3.6 at hospitalization to 5.3 ± 3.5 at discharge, but the number of Kampo medicine drugs was not changed. The total number of drugs including both Western medicine and Kampo medicine significantly decreased from 7.0 ± 3.8 to 6.7 ± 3.6. The number of drugs used in Western medicine among nochanged patients decreased from 5.1 ± 3.4 at hospitalization to 5.0 ± 3.7 at discharge, but the number of Kampo medicine drugs significantly increased from 1.0 ± 0.0 at hospitalization to 1.3 ± 0.5. The total number of drugs including both Western medicine and Kampo medicine increased from 6.1 ± 3.4 to 6.3 ± 3.9. We thus conclude that a combination of Kampo medicine with Western medicine can be useful for reducing the number of drugs related to polypharmacy. To achieve these results, it is essential to use the concept of sho (a way of pattern recognition of a patient's symptoms in Kampo medicine).

BACKGROUND: Mizoribine (MZR) is an immunosuppressive drug used in Japan for treating patients with lupus nephritis and nephrotic syndrome and has been also reportedly effective in patients with immunoglobulin A (IgA) nephropathy. However, to date, few randomized control studies of MZR are performed in patients with IgA nephropathy. Therefore, this prospective, open-label, randomized, controlled trial aimed to investigate the efficacy and safety of adding MZR to standard treatment in these patients, and was conducted between April 1, 2009, and March 31, 2016, as a multicenter study. METHODS: Patients were randomly assigned (1:1) to receiving standard treatment plus MZR (MZR group) or standard treatment (control group). MZR was administered orally at a dose of 150 mg once daily for 12 months. RESULTS: Primary outcomes were the percentage reduction in urinary protein excretion from baseline and the rate of patients with hematuria disappearance 36 months after study initiation. Secondary outcomes were the rate of patients with proteinuria disappearance, clinical remission rate, absolute changes in estimated glomerular filtration rate from baseline, and the change in daily dose of prednisolone. Forty-two patients were randomly assigned to MZR (n = 21) and control groups (n = 21). Nine patients in MZR group and 15 patients in the control group completed the study. No significant differences were observed between the two groups with respect to primary and secondary outcomes. CONCLUSION: The addition of MZR to standard treatment has no beneficial effect on reducing urinary protein excretion and hematuria when treating patients with IgA nephropathy.
Glomerular Filtration Rate ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Immunoglobulins* ; Japan ; Lupus Nephritis ; Nephrotic Syndrome ; Prednisolone ; Prospective Studies ; Proteinuria

The present study examined the relationship between rate of abnormal menstrual cycles in women who participated in competitive sports and long-term fertility. Longitudinal menstrual data were collected over 25 years from 33 women who graduated from physical education collegesThe results were as follows:1)Among the 33 women surveyed, the number of pregnancies for each woman ranged from zero to eight; the total number of pregnancies was 85 (mean 2.6). Sixty-five (76.5%) of the 85 pregnancies were carried out to delivery times.2)The rate of spontaneous abortion was 15.3%. Four (12.1%) of the 33 women were infertile.3)In women with fertility-related problems such as infertility, spontaneous abortion, premature delivery, and stillbirth, the rate of abnormal menstrual cycles tended to be higher with increase of the fertility-related problems.4)In women with a high rate of abnormal menstrual cycles during college, the rate continued to be high after graduation.5)In women without fertility-related problems, the rate of abnormal menstrual cycles during college varied widely. Also, the rate of abnormal menstruation decreased less than 30% after graduation, excluding one woman. Conversely, in women with fertility-related problems, the rate of abnormal menstrual cycles was higher than in women without fertility problems both during college and after graduation.6)Changes in menstrual cycle length with age were more different than an individual. In women with fertility-related problems, abnormal menstrual cycles were observed between the ages of 18 and 42, and abnormal cycles were both longer and shorter than normal cycles.The results indicated that, in women who participated in competitive sports during their youth, abnormal menstrual cycles may remain long after retirement from sports. In addition, problems such as infertility and spontaneous abortion were observed to be associated with higher rates of abnormal menstrual cycles.