Background: In the Latarjet procedure, the subscapularis is divided at the superior two-thirds junction. It has been believed that this subscapularis split approach resulted in better internal rotation strength rather than an L-shaped subscapularis tenotomy. However, there are few studies demonstrating the preserved function of the subscapularis after the Latarjet procedure. The aim of the present study was to clarify the subscapularis activity using positron emission tomography (PET) in patients after the Latarjet procedure. Methods: Six men who had undergone the Latarjet procedure were enrolled. The internal rotation exercise with elastic bands was performed with the arm at 0° and 90° of abduction. After the exercises, the patients had an intravenous injection of fluorine 18 fluorodeoxyglucose ( 18 F FDG). Each PET image was fused to the corresponding computed tomography image to calculate the standardized uptake value (SUV). The internal rotation muscle strength was measured by a dynamometer. Results: At 0° of abduction, the subscapularis SUVs of the involved side were significantly lower than those of the uninvolved side (p = 0.010), although there was no significant difference at 90° of abduction. The SUVs of the involved subscapularis were significantly lower at 0° of abduction than at 90° (p = 0.034). The internal rotation strength of the involved side was 81.1% ± 12.1% of the uninvolved side at 0° of abduction. Conclusions After the Latarjet procedure with the subscapularis split approach, subscapularis activity was well preserved at 90° of abduction. However, internal rotation strength was reduced by 19%.

Background: In the Latarjet procedure, the subscapularis is divided at the superior two-thirds junction. It has been believed that this subscapularis split approach resulted in better internal rotation strength rather than an L-shaped subscapularis tenotomy. However, there are few studies demonstrating the preserved function of the subscapularis after the Latarjet procedure. The aim of the present study was to clarify the subscapularis activity using positron emission tomography (PET) in patients after the Latarjet procedure. Methods: Six men who had undergone the Latarjet procedure were enrolled. The internal rotation exercise with elastic bands was performed with the arm at 0° and 90° of abduction. After the exercises, the patients had an intravenous injection of fluorine 18 fluorodeoxyglucose ( 18 F FDG). Each PET image was fused to the corresponding computed tomography image to calculate the standardized uptake value (SUV). The internal rotation muscle strength was measured by a dynamometer. Results: At 0° of abduction, the subscapularis SUVs of the involved side were significantly lower than those of the uninvolved side (p = 0.010), although there was no significant difference at 90° of abduction. The SUVs of the involved subscapularis were significantly lower at 0° of abduction than at 90° (p = 0.034). The internal rotation strength of the involved side was 81.1% ± 12.1% of the uninvolved side at 0° of abduction. Conclusions After the Latarjet procedure with the subscapularis split approach, subscapularis activity was well preserved at 90° of abduction. However, internal rotation strength was reduced by 19%.

Background: In the Latarjet procedure, the subscapularis is divided at the superior two-thirds junction. It has been believed that this subscapularis split approach resulted in better internal rotation strength rather than an L-shaped subscapularis tenotomy. However, there are few studies demonstrating the preserved function of the subscapularis after the Latarjet procedure. The aim of the present study was to clarify the subscapularis activity using positron emission tomography (PET) in patients after the Latarjet procedure. Methods: Six men who had undergone the Latarjet procedure were enrolled. The internal rotation exercise with elastic bands was performed with the arm at 0° and 90° of abduction. After the exercises, the patients had an intravenous injection of fluorine 18 fluorodeoxyglucose ( 18 F FDG). Each PET image was fused to the corresponding computed tomography image to calculate the standardized uptake value (SUV). The internal rotation muscle strength was measured by a dynamometer. Results: At 0° of abduction, the subscapularis SUVs of the involved side were significantly lower than those of the uninvolved side (p = 0.010), although there was no significant difference at 90° of abduction. The SUVs of the involved subscapularis were significantly lower at 0° of abduction than at 90° (p = 0.034). The internal rotation strength of the involved side was 81.1% ± 12.1% of the uninvolved side at 0° of abduction. Conclusions After the Latarjet procedure with the subscapularis split approach, subscapularis activity was well preserved at 90° of abduction. However, internal rotation strength was reduced by 19%.

Background: In the Latarjet procedure, the subscapularis is divided at the superior two-thirds junction. It has been believed that this subscapularis split approach resulted in better internal rotation strength rather than an L-shaped subscapularis tenotomy. However, there are few studies demonstrating the preserved function of the subscapularis after the Latarjet procedure. The aim of the present study was to clarify the subscapularis activity using positron emission tomography (PET) in patients after the Latarjet procedure. Methods: Six men who had undergone the Latarjet procedure were enrolled. The internal rotation exercise with elastic bands was performed with the arm at 0° and 90° of abduction. After the exercises, the patients had an intravenous injection of fluorine 18 fluorodeoxyglucose ( 18 F FDG). Each PET image was fused to the corresponding computed tomography image to calculate the standardized uptake value (SUV). The internal rotation muscle strength was measured by a dynamometer. Results: At 0° of abduction, the subscapularis SUVs of the involved side were significantly lower than those of the uninvolved side (p = 0.010), although there was no significant difference at 90° of abduction. The SUVs of the involved subscapularis were significantly lower at 0° of abduction than at 90° (p = 0.034). The internal rotation strength of the involved side was 81.1% ± 12.1% of the uninvolved side at 0° of abduction. Conclusions After the Latarjet procedure with the subscapularis split approach, subscapularis activity was well preserved at 90° of abduction. However, internal rotation strength was reduced by 19%.

The aging population in Japan continues to grow, leading to the emergence of complex issues. To understand the current awareness of these issues among member pharmacies of the Fukuoka City Minami Ward Pharmaceutical Association and promote various initiatives, support tools such as the “Consultation Flowchart” and “Consultation Checklist” were distributed to share information about the elderly with the local comprehensive support center. A survey was conducted to assess the awareness of complex issues and support tools. The survey revealed that about half of the pharmacy pharmacists were aware of the complex issues themselves, but the Consultation Flowchart had a recognition rate of 35.34%, and the Consultation Checklist had a recognition rate of 31.03%. It was also found that pharmacies with higher participation in regional collaboration meetings and a greater number of visits for medication management counseling had higher awareness of complex issues and support tools. To enhance efforts in addressing complex issues, the Fukuoka City Minami Ward Pharmaceutical Association needs to approach pharmacies with limited participation in regional collaboration meetings and a lower number of visits for medication management counseling. Building visible relationships with diverse professions in the community is crucial for improvement initiatives related to complex issues.

A 74-year-old man having a right refractory foot ulcer was referred to our hospital with a diagnosis of arteriosclerosis obliterans. Angiography of the lower extremities showed occlusive lesions in the middle popliteal artery and lower-leg arteries. Preoperative examination revealed decreased cardiac function and severe stenosis of the left and right coronary arteries. Therefore, we first performed coronary artery bypass grafting, followed by revascularization of the lower limbs at a later date. Owing to the lack of suitable autologous vein grafts, our procedure of choice was popliteal endarterectomy via a posterior approach with short saphenous vein angioplasty. The patient's foot ulcer healed completely following surgery. His postoperative course was uneventful, and he remained symptom-free during a 1-year follow-up.

Spinal cord injury (SCI) is a main concern in patients who undergo thoracic endovascular therapy (TEVAR), because the blood flow of the vertebro-basilar artery may be reduced due to the left subclavian artery (LSA) occlusion. If the left vertebral artery originates directly from the aorta, which is called the isolated left vertebral artery (ILVA), a technical consideration for strategies regarding blood perfusion of the ILVA during TEVARs is required. We hereby aim to report three patients (No.1, No.2, and No.3) who underwent an ILVA translocation and TEVAR with Zone 2 landing for aortic dissection. The diameter of the ILVA was 4.2, 2.3, and 2.2 mm, respectively, and the right vertebral artery (RVA) was dominant in all cases. In Patient No.1 and No.2 (ILVA diameter: 4.2 and 2.3 mm, respectively), the ILVA was anastomosed directly to the left common carotid artery. In Patient No.2, the translocated ILVA was occluded resulting in SCI, but the SCI improved when blood pressure was augmented. In Patient No.3 (ILVA diameter: 2.2 mm), the saphenous vein graft was interposed between the ILVA and the bypass artery because the ILVA diameter was small, but postoperatively, the ILVA remained patent, and no paraplegia was observed. The occlusion of ILVA could cause SCI, even if the RVA is larger than the LVA. Reconstruction of the ILVA is a critical procedure to prevent postoperative SCIs in patients undergoing TEVARs.

Objective: Human papillomavirus subtypes are predictive indicators of cervical intraepithelial neoplasia (CIN) progression. While colposcopy is also an essential part of cervical cancer prevention, its accuracy and reproducibility are limited because of subjective evaluation. This study aimed to develop an artificial intelligence (AI) algorithm that can accurately detect the optimal lesion associated with prognosis using colposcopic images of CIN2 patients by utilizing objective AI diagnosis. Methods: We identified colposcopic findings associated with the prognosis of patients with CIN2. We developed a convolutional neural network that can automatically detect the rate of high-grade lesions in the uterovaginal area in 12 segments. We finally evaluated the detection accuracy of our AI algorithm compared with the scores by multiple gynecologic oncologists. Results: High-grade lesion occupancy in the uterovaginal area detected by senior colposcopists was significantly correlated with the prognosis of patients with CIN2. The detection rate for high-grade lesions in 12 segments of the uterovaginal area by the AI system was 62.1% for recall, and the overall correct response rate was 89.7%. Moreover, the percentage of high-grade lesions detected by the AI system was significantly correlated with the rate detected by multiple gynecologic senior oncologists (r=0.61). Conclusion Our novel AI algorithm can accurately determine high-grade lesions associated with prognosis on colposcopic images, and these results provide an insight into the additional utility of colposcopy for the management of patients with CIN2.

Ankle exercises are useful for preventing deep vein thrombosis, as they increase venous blood flow velocity. The cause for the increased venous blood flow velocity during ankle exercises may be the skeletal-muscle pump, but the mechanism is not clearly understood. The purpose of this study was to investigate the effects of the dorsiflexion angle and gastrocnemius muscle contraction on venous blood flow velocity during ankle exercises and to investigate the mechanism of the increase in venous blood flow velocity. The blood flow velocity in the popliteal vein, ankle joint angle, and surface electromyographic activity of the gastrocnemius muscle were measured at rest and during ankle exercises in the prone position in young healthy volunteers. The significant increase in venous blood flow velocity was observed during dorsiflexion phase, max dorsiflexion and during planter flexion phase. The peak venous blood flow velocity was different in each subject and classified into four types. The correlations of venous blood velocity to ankle joint angle and with the surface electromyographic activity of the gastrocnemius muscle were not statistically significant. These findings suggest that venous blood flow velocity increases not only during plantar flexion and dorsiflexion.

Objective: In order to ensure the safety of nursing home residents, it is very important to implement appropriate assistance to ensure compliance with necessary medication. The purpose of this study is to identify issues and to plan solutions for medication assistance.Design: We conducted a workshop involving care workers (CWs), nurses and pharmacists together.Methods: Using the KJ method, participants extracted problems related to medication assistance and planned solutions in a mixed group of CWs, nurses and pharmacists. Questionnaire surveys were conducted for the participants before, immediately after, and 3 months after the workshop.Results: A number of important and urgent issues related to medication assistance were identified. There were differences in the recognition patterns of the importance and urgency of the issues among the three categories of participants. In addition, many possible solutions were proposed. Among these solutions, 25% had been implemented by at least two participants. More than 75 % of participants felt that their awareness of the value of cooperation in medication assistance had been improved by participating in the workshop.Conclusion: These results suggest that a workshop with a group of CWs, nurses and pharmacists in one place is a useful approach for extracting problems and planning effective solutions related to cooperation in medication assistance.