Purpose: To focus on the effects of the presence of mesiodens on adjacent teeth and to investigate the timing of its safe removal. Materials and Methods: Cone-beam computed tomography examinations, obtained at Okayama University Hospital over a three-year period, were inspected. Data were recorded including the number of mesiodens; associated abnormalities; and the relationship with neighboring structures. Depending on multiple factors, the risk of developing complications due to early extraction of a mesiodens was divided into three categories: high, medium, and low risk. Results: A total of 5,958 cone-beam computed tomography exams were obtained, 460 patients aged 3-85 years were diagnosed with a total of 568 mesiodens, 382 (67.3%) of which were discovered in young patients (age <10 years), and 333 (87.2%) of these were associated with abnormalities. Regarding the risk categories, 11 (1.9%) were considered to be in the high-risk, five (0.9%) in the medium-risk and 552 (97.2%) in the low-risk categories. Moreover, eight out of 11 high-risk mesiodens were extracted and no post-operative complications have been seen. Conclusion As the results showed that no postoperative complications were seen in all the extracted cases of high-risk mesiodens, this indicates the possibility of safe extraction at an early age which could reduce related future complications.

Objective: Because patients with diabetes mellitus (DM) were forced to stay indoors during the state of emergency, resulting in stress and a lack of physical activity, concerns about their glycemic control were raised.Patients and Methods: The 165 patients’ glycated hemoglobin (HbA1c) levels were compared during the following periods: the 4 months that were selected as a representative condition 1 year before the COVID-19 pandemic (May 2018, March 2019, June 2019, and July 2019) and the latter 3 months as a 1-year follow-up during the COVID-19 pandemic (May 2019, March 2020, June 2020, and July 2020).Results: The patients’ HbA1c levels were 7.32 ± 1.23, 7.44 ± 1.20, 7.16 ± 1.06, 7.01 ± 1.05, 7.23 ± 1.06, 7.45 ± 1.18, 7.15 ± 10.7, and 7.11 ± 1.17 in May 2018, March 2019, June 2019, July 2019, May 2019, March 2020, June 2020, and July 2020, respectively (expressed as mean ± standard deviation).Conclusion: The analysis showed that HbA1c levels did not worsen during the self-restraint period.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.

STUDY DESIGN: Prospective study. PURPOSE: To examine the long-term effects of interspinous ligament injections of local anesthetics and steroids for the treatment of Baastrup's diseases. OVERVIEW OF LITERATURE: Baastrup's disease is associated with axial low back pains. Baastrup's disease has been more recently described as the "kissing spinous processes" disease. Several authors have reported methods for the diagnosis and treatment of the disease. However, there has been only one report of patients receiving interspinous ligament injections of agents for the treatment of Baastrup's disease. METHODS: Seventeen patients showed severe low back pains between spinous processes at L3-L4 or L4-L5. X-ray imaging, computed tomography, and magnetic resonance imaging revealed kissing spinous processes, consolidation of spinous process, or inflammation of an interspinous ligament. Pain reliefs after lidocaine and dexamethasone administration into interspinous ligament as therapy for low back pains were being examined and followed up. RESULTS: Low back pain scores significantly improved immediately after injection of the agents into interspinous ligaments. At final follow-up (1.4 year), low back pain scores significantly improved as compared with before the treatment. CONCLUSIONS: Findings from the current study indicate that lidocaine and dexamethasone administration into interspinous ligament in patients diagnosed with Baastrup's disease is effective for managing the pain associated with this disease.
Anesthetics, Local ; Dexamethasone ; Diagnosis ; Follow-Up Studies ; Humans ; Inflammation ; Lidocaine* ; Ligaments* ; Low Back Pain ; Magnetic Resonance Imaging ; Prospective Studies ; Steroids

BACKGROUND: Although non-thyroidal illness syndrome (NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine (fT3) levels in trauma patients requiring massive transfusion have not been reported. METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions (>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of fT3, free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation. RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial fT3 levels in group M (1.95±0.37 pg/mL) were significantly lower than those in group C (2.49±0.72 pg/mL;P<0.01) and remained low until 1 week after admission. Initial inter-group fT4 and TSH levels were not significantly different. TSH levels at 1 week (1.99±1.64 μIU/mL) were higher than at admission (1.48±0.5 μIU/mL) in group C (P<0.05). CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.

This study aimed to investigate the differences in the development of muscle thickness (MT) in the lower limbs with specific sports-event training. Furthermore, the relationship between MT of the lower limbs for weightlifters and sprinters and their competition performances (total weight lifted and 100m sprint times) was examined. Subjects were 64 males divided into 3 groups: weightlifters (n=20), sprinters (n=20), and untrained subjects as controls (n=24). The MT{relative to (body weight)^1/3}of knee extensors (KE), knee flexors (KF), plantar flexors (PF) and dorsi flexors (DF) was measured at 21 sites (proximal, middle and distal) along the length of the upper and lower leg by B-mode ultrasound. The MT of KE for weightlifters was significantly greater than that for sprinters and controls, while the MT of KF and PF for sprinters was significantly greater than that for weightlifters and controls. The MT of rectus femoris (RF), vastus intermedius (VI), vastus lateralis (VL) and vastus medialis (VM) for weightlifters was significantly greater than that for sprinters and controls, while the MT of RF and VM for sprinters was greater than that of controls. On the other hand, the MT of KE for weightlifters and sprinters (especially VM) correlated significantly with competition performances. These results indicated that squatting affected the MT of KE except for RF while sprinting affected the MT of KF and PF. It was also concluded that the MT of KE for weightlifters and sprinters (particularly VM) was related to their competition performances.

The purpose of this study was to investigate sex differences in the muscle volume (MV) of the iliopsoas, psoas major, and iliacus muscles, normalized by fat free mass (FFM), in the elderly. The subjects were 15 males and 15 females 65 years of age or over. Serial transverse 1.5T magnetic images (10 mm slice) of each subject were taken between the 12^th thoracic vertebrae and the lesser trochanter. FFM was measured with a bioelectrical impedance analyzer. The mean MV of each muscle on the right and left sides were calculated and used for regression analysis of the relationship between MV and FFM.A significant correlation was observed between MV and FFM of the iliacus in both sexes (p<0.01), but not between the MV and FFM of the psoas major. MV normalized by FFM and cross-sectional area (CSA) normalized by FFM^2/3 showed significantly greater values for the psoas major in the males than in the females (p<0.001), but there was no sex difference in the MV or CSA normalized by FFM of the iliacus.These results suggest that elderly males tend to have a greater muscle volume and cross-sectional area of the iliopsoas than elderly females, and that these sex differences are attributable to differences in the psoas major.

To compare the effectiveness of five different muscle training movements on the biceps brachii, latissimus dorsi and trapezius muscles, eight weight-trained men (age, 20.4±0.5 years) were asked to perform three repetitions, at 70% one repetition maximum, of upright rowing (UR) and bent-over rowing (BR) exercises using a barbell ; and seated rowing (SR), front lat pull-down (LPf) and back lat pull-down (LPb) exercises using a Universal Machine. The activities of the biceps brachii, latissimus dorsi, and trapezius during the elbow flexsion and elbow extension phases of each exercise were analyzed using integrated electromyography (EMG) and normalized I-EMG. The results were as follows :1. The mean nrmsEMG values for the biceps brachii were larger during UR and LPf exercises than during BR, SR, and LPb exercises, suggesting that UR and LPf are more effective than the other movements for training the biceps brachii. The mean nrmsEMG values for the latissimus dorsi were larger during SR, LPf, and LPb exercises, followed by BR and UR exercises (in descending order), suggesting that SR, LPf, and LPb exercises are more effective than the other movements for training the latissimus dorsi.2. The mean nrmsEMG values for the upper trapezius were larger during UR and BR exercises than during SR, LPf, and LPb exercises, suggesting that UR and BR exercises are more effective than the other movements for training the upper trapezius. The mean nrmsEMG values for the middle trapezius were larger during BR and SR exercises than during UR, LPf, and LPb exercises, suggesting that BR and SR exercises are more effective than the other movements for training the middle trapezius. The mean nrmsEMG values for the lower trapezius were larger during BR exercise than during other movements, suggesting that BR exercise is more effective than the other movements for training the lower trapezius.3. In all the exercises, each muscle showed a higher nrmsEMG value during the elbow flexsion phase than during the elbow extension phase. This observation suggests that the training method examined in this study should emphasize the elbow flexsion movement.The present results suggest that UR exercise is the most effective movement for training the biceps brachii and upper trapezius, BR is most effective for training the upper trapezius, middle trapezius and lower trapezius, SR is most effective for training the latissimus dorsi and middle trapezius, LPf is most effective for training the biceps brachii and latissimus dorsi, and LPb is most effective for training the latissimus dorsi.

Effects of 38°C 30-minute bathing on hemostatic function and autonomic nervous function were studied in 15 48-to-72-year-old patients with cerebral infarction. Blood samples were collected three times: immediately before the bathing, at the end of 30 minutes of bathing, and 30 minutes after the bathing. Hematocrit values and fibrinogen concentrations decreased during bathing and returned to the pre-bathing levels 30 minutes after bathing. This indicates that bathing caused hemodilution due to the fluid shift. During bathing, noradrenaline decreased at a rate significantly higher than that of hemodilution while the sympathetic nervous function, which was evaluated by spectral analysis of sequential variation in arterial blood pressure, was not suppressed. The autonomic nervous system seemed to be inactive in these patients. Coagulation time (PT and APTT) and platelet factor (β-TG and PF4) showed few changes. In the fibrinolytic system, however, tissue plasminogen activator (t-PA) antigen levels increased and plasminogen activator inhibitor type-1 (PAI-1) levels decreased after 30 minutes of bathing. This suggests that fibrinolytic activity was enhanced by 38°C bathing for 30 minutes. Thus, subthermal bathing with comfort may be useful in preventing cerebral infarction.

Studies on the effects of heating as well as the mineral components of hot spring water have been conducted to investigate the effects of balneotherapy. However, few studies have been conducted on the effects of hydrostatic pressure and buoyancy during water immersion. Therefore, we investigated the effect of water immersion up to the neck at thermoneutral temperature on hemostatic activity.
Nine healthy men aged 22 to 34 were immersed up to the neck in the standing position in thermoneutral water (34.0±0.5°C) for two hours. The heart rate decreased immediately after starting water immersion and remained low during the immersion. Hematocrit values (Ht) of the blood samples taken from the ante-cubital vein decreased by 3.4% in average. The decrease in Ht was more prominent in the blood samples taken from the earlobe (4.0%), suggesting that hemodilution due to fluid shift was stronger in the upper part of the body. The time until euglobulin clot lysis shortened immediately after starting the immersion. Although fibrinolytic activity was enhanced, the concentration of tissue plasminogen activator (t-PA) antigen in the blood decreased gradually during the immersion and tended to return to the original level 30 minutes after immersion. A larger decrease in the concentration of plasminogen activator inhibitor-1 (PAI-1) antigen in the blood was observed immediately after starting the immersion, and it remained low for 30 minutes after immersion. An increase in fibrinolytic activity due to the decrease in PAI-1, not in t-PA, was observed during water immersion at thermoneutral temperature and the activation of fibrinolytic system without activation of the coaguration system was also observed.