Introduction: We evaluated a trainer for improving knot-tying skills using gummy candies (KTG; knot-tying trainer using gummy). To reveal its efficacy, the KTG was compared with a standard knot-tying board by evaluating construct and concurrent validities.　Method: The completion times for knot-tying with the both the trainers were recorded for 18 novices and 18 experts in our university hospital. The evaluation formula was published previously and comprised four items (accuracy, gap, slippage, and breakage) to calculate the total score.　Results: With the standard knot-tying board, the average score was 27.1±22.6 points in the novice group and 37.3±18.7 points in the expert group. There was no statistically significant difference between the groups. With the KTG, the average score was 12.3±20.6 points in the novice group and 36.7±18.3 points in the expert group, with a statistically significant difference (p<0.001).　Discussion: Using the KTG for knot-tying training, it may be possible to acquire knot-tying skills with proficiency-based training, which could improve knot-tying technique.

To treat the patient who developed post-dural puncture headache (PDPH) after the epidural anesthesia for painless delivery or spinal subarachnoid anesthesia for caesarean section, we provided a combination therapy with Kampo medicines goshuyuto and ryokeijutsukanto (39 patients), and a single therapy with goshuyuto (17 patients). We compared the patients based on the improvement rate and the average of the differences of Numerical Rating Scale (NRS) before and after taking Kampo medicines. Of 39 patients treated with combination therapy, 82.1% were effective in the improvement rate, and 74.4% were effective in NRS differences. Of 17 patients treated with goshuyuto alone, 58.8% was effective in the improvement rate, and 41.2% in NRS differences. In the improvement rate, it was insignificant (p=0.094). However, in the comparison of the average of the NRS differences, the combination therapy was significantly more effective than with from goshuyuto alone (p=0.032) (p<0.05). There was no significant difference depending on when the administration was started. It was suggested that a combination therapy with goshuyuto and ryokeijutsukanto is effective and convenient for PDPH.

The purpose of the present study was to examine characteristics of muscle anatomical cross-sectional area (CSA) for different regions from proximal to distal parts of each muscle of the hamstring muscles in high-level sprinters, and to examine the relationship with those and the sprint performance. The CSA of the semitendinosus (ST), semimembranosus (SM), biceps femoris long head (BFL) and biceps femoris short head (BFS) at the four different region of hamstring muscles for twenty sprinters (SPRINT) and twenty healthy male control subjects (CTRL) were measured by using B-mode ultrasonography. The measured regions were divided into four parts from proximal to distal parts (PRO1, PRO2, DIS2, DIS1). The results clearly showed that absolute CSA values in distal parts for all muscles together with PRO2 in ST were greater in SPRINT than in CTRL. When relative CSA values to the entire hamstrings muscles in each region were compared, only relative CSA at PRO1 in ST was greater in SPRINT than in CTRL, conversely, that at proximal regions in BFL and distal regions in BFS were smaller in SPRINT. In the relationships with sprint performance, the CSAs at PRO1 and PRO2 in ST and at PRO1 in SM were only related negatively. These results suggest that distal parts of hamstring muscles for SPRINT may be characteristics for sprint runners. However, the movements related to the specific hypertrophy (PRO1 and PRO2 in ST, PRO1in SM) may play important roles of the improvement of their sprint performance.

The purpose of the present study was to examine the importance of the agonist muscle activity of the post-impact 30 ms phase during drop jump (DJ) for effective rebound performance by comparing those of sprint runners and swimmers. The eight sprint runners (SPRINT) and twelve swimmers (SWIM) were participated in this study. They performed DJ from a 0.3-m height box with maximal rebound efforts. Electromyograms (EMG) of the lower leg muscles (medial gastrocnemius [MG], soleus [SOL] and tibialis anterior [TA]), and vertical ground reaction force together with kinematic data were measured simultaneously during DJ. In addition, the onsets of fascicle stretching of the MG and SOL muscles were measured by using high-speed ultrasonography (521Hz) during DJ. The onsets of the fascicle stretching of SOL during DJ were not significantly different between SPRINT and SWIM (15 ± 7 ms and 16 ± 6 ms, respectively). During DJ, SPRINT showed onset of the SOL EMG before the ground contact (-26 ± 19 ms). Meanwhile, SWIM showed the onset of the SOL EMG after the ground contact of DJ (16 ± 19 ms). These results suggest that the SOL muscles for SWIM cannot be fully-activated during the braking phase. Consequently, the rate of force development during the braking phase of DJ and subsequently rebound height could be reduced in SWIM.

A 42-year-old man with primary tongue cancer was admitted to our palliative care center for the control of pain due to multiple bone metastases. On 30th day after admission, he was suffering from pneumonia. And on 37th day, chest radiograph demonstrated pericardial emphysema, which developed to the pericardial abscess. Chest Computed Tomography showed lymph nodes metastases around the left main bronchus, and revealed that there was a fistula between the left main bronchus and the pericardium. The patient was faced to the difficulty in taking spine position because of excessive excretion of the sputum. Pericardiocentesis was then performed percutaneously and a tube for the drainage was placed. After the placement of drain tube, he restored good night sleep in the spine position and the complaints were reduced. Palliat Care Res 2008; 3(2): 321-325

Objective To evaluate the usefulness of Doppler micro-probe and rigid endoscope in aneurysm surgery. Methods From April 2005 to July 2006,Doppler micro-probe and rigid endoscope were applied to 96 patients with aneurysm.The number of aneurysm was 107.The diameter of the Doppler probe was 1.5 mm,with a frequency of 20 MHz.Endoscopes with 0,30 and 70 degree were used.Doppler and endoscope were employed before and/or after aneurysm clipping. Results In all the 107 aneurysms,there were 39 in which the endoscope provided information unavailable under the microscope.The clip was adjusted after endoscope and/or Doppler examination in 19 aneurysms,10 of which were due to incomplete clipping,while the other 9 compromise of small perforators. ConclusionDoppler and endoscope are useful in aneurysm surgery,and can be applied both before and/or after clipping.