Keio University conducted practical training based on community diagnosis as part of an interprofessional education program involving three healthcare faculties: the School of Medicine, the Faculty of Nursing and Medical Care, and the Faculty of Pharmacy. This training took place in Wakkanai City (Hokkaido), Minakami Town (Gunma), and Mino City (Gifu). Students engaged in data collection, hypothesis setting, fieldwork-based hypothesis verification, and explored solutions to community issues. Through this process, they learned about the importance of experiencing residents' daily lives firsthand, the interconnectedness of various community factors, and collaborative approaches to problem-solving. The program offered students the opportunity to understand community dynamics and teamwork, while engaging in active trial-and-error learning that fostered independent learning and problem-solving skills.

Congenital fetal abnormalities, typically structural abnormalities, are found about 3-5% of all pregnancies. The prenatal detection of these abnormalities are especially important in providing optimal perinatal management for neonates. In many obstetric hospitals and clinics in Japan, fetal ultrasound screening is provided by obstetricians at regular pregnancy checkups. There were few reports on fetal ultrasound performed by medical technologists. Therefore, we conducted a retrospective investigation to determine the efficacy and accuracy of fetal ultrasound performed by medical technologists in our hospital. In total, 2,289 pregnancy women underwent fetal ultrasound screening. We excluded cases that were a second or subsequent scan, had gestational age of <22 weeks at the time of ultrasound screening, or had missing perinatal and neonatal outcomes. The remaining of 2,186 cases, including 65 cases of twins, were investigated. Abnormal findings were noted in 79 cases (3.6%): 31 for the heart, 14 for head, and 11 for urogenital organs. In those cases, congenital abnormalities were found in 39 neonates (1.8%). There were 95 cases (4.3%) in which abnormal finding were absent in fetal ultrasound screening but congenital abnormalities were diagnosed in neonates, including ventricular aneurysm, interruption of the vena cava, cerebellar medulloblastoma, atrial septal defect, and cleft palate. In conclusion, for detecting structural abnormalities, fetal ultrasound screening performed by medical technologists is an important alternative to ultrasound screenings performed by obstetricians. To increase the accuracy of fetal ultrasound screening, continuous improvement of fetal ultrasound skills is important.

A 60-year-old man underwent open surgery for chronic dissecting abdominal aorta accompanied with a horseshoe kidney. Through open laparotomy, the abdominal aortic aneurysm was exposed without revision of the horseshoe kidney. Cold ringer solution was infused to accessory renal arteries for renal protection. After supra-renal clamping, proximal anastomosis was then performed at the level just below the renal arteries. Abdominal cross clamp time at the level of the supra-renal arteries was 23 min. Median and right accessory arteries were reattached with an ischemic time of 73 and 103 min, respectively. Although serum creatine was elevated a preoperative level of 1.17 mg/dl to 3.63 mg/dl at postoperative day 2, that was gradually decreased to nearly preoperative level of 1.25 mg/dl at discharge. Postoperative enhanced CT demonstrated patency of the reattached accessory arteries. The patient was discharged without major complication on postoperative day 21. One year postoperatively, his follow-up course was uneventful without deterioration of renal function.

OBJECTIVES: This study aimed to characterize the skeletal muscles of patients who underwent total knee arthroplasty (TKA) using ultrasonography in order to investigate the effectiveness of ultrasonographic skeletal muscle assessment after TKA. METHODS: This study included 50 TKA patients (TKA group) and 41 residents with osteoarthritis who have not received TKA (non-TKA group). Ultrasonography was used to assess the characteristics of several different muscles. Various postoperative outcomes were evaluated. Muscle thickness (MT) and echo intensity (EI) results were compared among operated knees in the TKA group, nonoperated knees in the TKA group, and more severely affected knees in the non-TKA group. For the TKA group, multiple regression was conducted to examine the association between skeletal muscle characteristics of operated knees and postoperative outcomes. RESULTS: The MTs of the vastus medialis, vastus intermedius, and rectus femoris (RF) were significantly smaller and the RF-EI was significantly greater for both operated and nonoperated knees in the TKA group compared with the non-TKA group (P < 0.017). Several parameters of physical function were significantly poorer in the TKA group than in the non-TKA group (P < 0.05). Multiple regression demonstrated that RF-MT was associated with knee range of motion, knee strength, and physical functional performance in the TKA group (P < 0.05). CONCLUSIONS: The quantity and quality of skeletal muscles were lower in the TKA group than in the non- TKA group. Ultrasonography may be useful for assessing skeletal muscles in TKA patients because MT assessed with ultrasonography was associated with various parameters of physical function.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Humans ; Knee ; Muscle, Skeletal ; Muscles ; Osteoarthritis ; Quadriceps Muscle ; Range of Motion, Articular ; Ultrasonography

No abstract available.
Arthritis, Psoriatic* ; Macrophages* ; Scleroderma, Systemic*