We added Kampo medicine (Japanese traditional herbal medicine) to disease-­modifying anti-­rheumatic drugs (DMARDs) to treat rheumatoid arthritis (RA) in 41 patients. After 1 year, disease activity assessments showed improvement in the number of tender joints and DAS 28-­CRP, and Boolean remission increased from 3 cases to 6 cases. However, 16 of 41 patients had an insufficient therapeutic effect with Kampo medicine ; therefore, their DMARD treatment was strengthened. Disease activity in the 16 patients with strengthened DMARD therapy (Western group) was compared with that in the 25 patients who did not require strengthened DMARD therapy (Kampo group). The Western group had high disease activity at the beginning of Kampo medicine, and a year later CRP and DAS 28­-CRP improved. In the Kampo group, disease activity was relatively good at the beginning of Kampo medicine, and patient global assessment (PGA) improved. We believe that combination therapy, with DMARDs controlling synovitis and Kampo medicine improving PGA, is an effective way to achieve Boolean remission.

Abdominal draw-in is a functional transversus abdominal muscle exercise to acquire the contraction. However, it is difficult for even healthy subjects to selectively contract the deep transversus abdominal and internal oblique muscles without over-contraction of the superficial rectus abdominis and the external oblique muscles. This study examined whether the transversus abdominal muscle is selectively contracted by our taping method. The subjects were 20 healthy males. Using ultrasound, we compared the thickness of external oblique, internal oblique, and transversus abdominal muscle among no taping, kinesio taping and abdominal muscle activation taping in the standing position. The thickness of transversus abdominal muscle significantly increased in the activation taping more than the other methods. This study showed that abdominal musculature activation taping made it possible to contract the transversus abdominal muscle selectively.

Isolates of 24 enterococci, 5 Enterococcus casseliflavus and 19 Enterococcus gallinarum, possessing vanC genes and showing low-level resistance to vancomycin were obtained from mice from commercial mouse breeding companies. Since some of these isolates showed resistance to other antibiotics, the purpose of this study was to clarify the resistant profiles of these isolates. One E. casseliflavus isolate showed resistance to erythromycin with a minimal inhibitory concentration (MIC) of 8 μg/mL and also showed apparent resistance to fluoroquinolones with an MIC of 32 μg/mL for ciprofloxacin. The MICs of 2 other fluoroquinolone-resistant E. casseliflavus and E. gallinarum isolates were 3 and 6 μg/mL, respectively. These 3 resistant isolates showed an absence of macrolide- and fluoroquinolone-resistant genes, including amino acid substitutions in the quinolone resistance determining regions of DNA gyrase and topoisomerase IV. Resistance to tetracycline was detected in 2 E. gallinarum isolates that were highly resistant, exhibiting MICs of 48 and 64 μg/mL and possessing tet(O) genes. The results indicate that antibiotic-resistant enterococci are being maintained in some laboratory mouse strains that have never been treated with an antibiotic.
Amino Acid Substitution ; Animals ; Anti-Bacterial Agents ; Breeding ; Ciprofloxacin ; DNA Gyrase ; DNA Topoisomerase IV ; Drug Resistance, Microbial ; Enterococcus ; Erythromycin ; Fluoroquinolones ; Mice ; Tetracycline ; Vancomycin

PURPOSE: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. MATERIALS AND METHODS: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. RESULTS: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. CONCLUSIONS: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.
Asian Continental Ancestry Group ; Classification ; Humans ; Joints ; Knee Joint ; Knee ; Osteoarthritis ; Radiography

We describe a patient who underwent arthroscopic pullout fixation for a posterior cruciate ligament (PCL) avulsion fracture. A 46-year-old female, injured in a fall while riding a motorcycle, was diagnosed with a right knee PCL tibial attachment avulsion fracture and underwent arthroscopic osteosynthesis. A Kirschner wire was drilled to a point just medial to the medial border of the anterior tibial bony bed. A suture wire was folded into a loop and introduced into the posteromedial compartment via the bone tunnel. A fixation thread was inserted from the posteromedial portal, through the medial and lateral loop wires, and into the posteromedial compartment. The lateral and medial loop wires attached to the thread were pulled to the outside, and the thread was fixed onto the tibia. Three months post-surgery, she returned to her job. This procedure represents a minimally invasive method of treating avulsion fractures of the tibial attachment of the PCL.
Arthroscopy ; Female ; Humans ; Knee ; Methods ; Middle Aged ; Motorcycles ; Posterior Cruciate Ligament ; Sutures ; Tibia

STUDY DESIGN: Prospective study based on magnetic resonance (MR) imaging of the lumbar spinal root of the intervertebral foramen. PURPOSE: This study was to compare MR three-dimensional (3D) sequences for the evaluation of the lumbar spinal root of the intervertebral foramen. OVERVIEW OF LITERATURE: The diagnosis of spinal disorders by MR imaging is commonly performed using two-dimensional T1- and T2-weighted images, whereas 3D MR images can be used for acquiring further detailed data using thin slices with multi-planar reconstruction. METHODS: On twenty healthy volunteers, we investigated the contrast-to-noise ratio (CNR) of the lumbar spinal root of the intervertebral foramen with a 3D balanced sequence. The sequences used were the fast imaging employing steady state acquisition and the coherent oscillatory state acquisition for the manipulation of image contrast (COSMIC). COSMIC can be used with or without fat suppression (FS). We compared these sequence to determine the optimized visualization sequence for the lumbar spinal root of the intervertebral foramen. RESULTS: For the CNR between the nerve root and the peripheral tissue, these were no significant differences between the sequences at the entry of foramen. There was a significant difference and the highest CNR was seen with COSMIC-FS for the intra- and extra-foramen. CONCLUSIONS: In this study, the findings suggest that the COSMIC-FS sequences should be used for the internal or external foramen for spinal root disorders.
Diagnosis ; Healthy Volunteers ; Magnetic Resonance Imaging ; Prospective Studies ; Spinal Nerve Roots