Association between acromioclavicular joint pain and capsular bulging in adolescent baseball players.

Purpose: The purpose of this study was to investigate the association between acromioclavicular (AC) joint pain and superior capsular bulging assessed by ultrasound in adolescent baseball players.

Methods: One hundred and fifty players (1st-8th graders) were examined. All subjects underwent physical examinations, including assessment of tenderness on the AC joint and provocative tests (the Buchberger's test and the cross-body adduction stress test).

Reliability and validity of the Japanese version of the short questionnaire to assess health-enhancing physical activity (SQUASH) scale in older adults.

[Purpose] We tested the reliability and validity of the Japanese version of the Short Questionnaire to Assess Health-enhancing Physical Activity scale in asymptomatic older adults and sought to confirm discriminator validity in women with osteoarthritis. [Subjects] The participants included an asymptomatic comparison group (men and women) and women with knee or hip osteoarthritis. [Methods] The test-retest method was used to assess reliability.

Parastomal hernia repair with the Sugarbaker technique using e-PTFE mesh.

Purposes: Although surgery is commonly used to treat parastomal hernia, it is very difficult and has shown poor results. Recently, repair with prosthetic materials has been thought to be a more promising method.

Methods: The Sugarbaker technique with e-PTFE mesh (Dualmesh) performed via open surgery was adopted for seven patients with parastomal hernia.

[A case of huge advanced rectal cancer resected successfully after chemotherapy with mFOLFOX6].

The patient, a 75-year-old woman, who was referred to our hospital in April 2010 because of diarrhea and lower abdominal pain. Abdominal CT scan revealed a large tumor, over 8 cm in diameter within the pelvis, and colonoscopy detected rectal cancer. There was no obvious distant metastasis, although invasion to the uterus and regional lymph node metastasis was suspected.

A simple method to treat an ingrowing toenail with a shape-memory alloy device.

An ingrowing toenail has no definitive treatment. Previously, effective methods were complicated but easy ones had less effect. We show both an easy and an effective way with Cu-Al-Mn-based shape-memory alloys (SMAs).

Clinical observation of palatine tonsils with IgA nephropathy.

We have previously reported that clinical remission could be achieved by combination therapy consisting of steroid pulse therapy and tonsillectomy in patients with IgA nephropathy. However, there is no consensus as to the indications for tonsillectomy in IgA nephropathy (IgAN) patients. To clarify whether there is any correlation between characteristics of removed palatine tonsils and clinical remission rate, we evaluated the relationships between the remission rate of urinary abnormalities and characteristics of 186 IgAN patients (aged 11-65 years) with mild or moderate renal pathology and their tonsils.

[Two aged patients with chronic renal failure and chronic disseminated intravascular coagulation secondary to aortic aneurysms: effect of continuous subcutaneous heparin infusion therapy].

We describe here two cases of chronic disseminated intravascular coagulation(DIC) secondary to aortic aneurysms. The patients were 78- and 84-year-old males, who visited our hospital to receive hemodialysis therapy for chronic renal failure probably due to nephrosclerosis. They had mild bleeding tendency and thrombocytopenia(< 10 x 10(4)/microliter).

[A case of colonic cancer with multiple liver metastases effectively treated by intra-arterial chemotherapy].

A 36-year-old female underwent sigmoidectomy and insertion of an intra-hepatic arterial catheter for advanced sigmoid cancer with multiple liver metastases. After the operation, intra-hepatic arterial infusion of the chemotherapeutic agents that showed sensitivity in the histoculture drug response assay (HDRA) to the liver metastasis was done for one year. The metastatic liver lesions other than those in the lateral segment which were fed by an accessory artery decreased remarkably.

[Spinal anesthesia in a patient with spina bifida occulta].

A 32-year-old woman with spina bifida occulta was scheduled for hemorroidectomy under spinal anesthesia. Preoperatively, computed tomography and magnetic resonance imaging (MRI) were performed. The MRI demonstrated the conus medul laris reaching the L 3 level and a lipoma connected with conus medullaris intrathecally.

[Thymic carcinoid associated with ectopic ACTH syndrome].

A 63-year-old man was admitted to Sendai Red Cross Hospital complaining of chest and back pain associated with Cushing's syndrome. Based on the abnormally high levels of ACTH, cortisol, and CRH in plasma the patient was suspected of having ectopic ACTH syndrome. Histological examination of an extirpated rib and pleural tumor led to the diagnosis of atypical carcinoid tumor, with ribbon and festoon formation, immunoreactivity to ACTH, NSE, Chg-A, and argyrophilia in the tumor cells.

[Postoperative analgesic requirements after various operations].

The difference in postoperative analgesic requirements for operations involving 11 sites was assessed in 1100 patients. Pain relief was mainly attained by epidural administration of bupivacaine 0.25% on demand.

Expression of E- and P-selectins by vascular endothelial cells in human tonsils.

Selectins play an important role in the adhesion between vascular endothelial cells and leukocytes in immuno-inflammatory events. We investigated the immunohistochemical localization of E- and P-selectins in the human palatine tonsils at light and electron microscopic levels. E-selectin was expressed by high endothelial venules (HEV) in a linear pattern in heavily inflamed tonsils with focal infection and extensive neutrophilic infiltration, and much less in hypertrophic tonsils without focal infection.

Clinical study of chronic tonsillitis with IgA nephropathy treated by tonsillectomy.

Over the past 5 years, bilateral tonsillectomy has been performed in 104 patients (48 male and 56 female) with IgA nephropathy at the Department of Otolaryngology of Sendai Red Cross Hospital. We studied the relationship between remission rates as shown by urinary findings at one year after tonsillectomy and various clinical factors. Patients with mild or moderate renal pathology had higher postoperative remission rates of proteinuria than those with advanced renal pathology.

[A fluoroscopic analysis of the catheters abnormally placed in the epidural space].

In order to know how the catheters are placed abnormally in the epidural space, we inserted the epidural catheters under fluoroscopy. The catheter was placed straightly upward when the epidural puncture was done in the center of epidural space. When the puncture site was nearly close to the side wall of epidural space, we could not insert catheter at all.

[Effect of epinephrine added to spinal anesthesia with lidocaine and tetracaine].

The effect of epinephrine added to the solution of lidocaine and tetracaine for spinal anesthesia was investigated in patients undergoing elective surgery of lower extremities. Thirty patients received 3ml of 2% lidocaine and 0.4% tetracaine and 30 patients received the solution with 0.

[Combined spinal and epidural analgesia for caesarean section].

We compared the combined spinal and thoracic epidural analgesia with 2% lidocaine for caesarean section, with spinal analgesia using 2% lidocaine, tetracaine or dibucaine, and also with lumbar epidural analgesia. The analgesia at high thoracic level could be achieved with combined spinal and epidural analgesia more easily than with others. The frequency of side effects with the combined spinal and epidural analgesia, such as hypotension, decrease of fetal heart rate and so on, was less than that with others.

[Postoperative apnea in preterm infants after inguinal herniorrhaphy].

Preterm infants may become apneic during immediate postoperative period. We studied prospectively postoperative apneic attack in 167 preterm infants after inguinal herniorrhaphy with nitrous oxide-halothane anesthesia. Their mean gestational age was 30 +/- 3 weeks.

[Anesthetic induction of children with high concentrations of sevoflurane].

The induction and intubation with high concentrations of sevoflurane (4% or 6.4%) were investigated in 180 children with ages ranging from 1 to 6yr 12m. Average induction time (duration between the start of induction and loss of consciousness) with 4% sevoflurane was 56 sec and that with 6.

[A case of jejunal vein thrombosis due to medroxyprogesterone acetate].

The patient was a 68-year-old woman with advanced breast cancer which had been treated by modified radical mastectomy two years and nine months earlier. After the surgery, tamoxifen citrate (TAM) was orally administered in addition to various types of chemotherapy. Because the patient complained of nausea and weight loss, medroxyprogesterone acetate (MPA) was orally administered instead of TAM.

[The effect of preoperative oral administration of ranitidine on pH and volume of gastric juice].

The effect of ranitidine, administrated 2 or 4 hours prior to induction of anesthesia, on volume and pH of gastric juice was investigated in patients undergoing elective surgery. Three-hundred mg of ranitidine was administrated orally in 54 patients 2 hours prior to anesthesia and in 50 patients 4 hours prior to anesthesia. The volume and pH of gastric juice were measured immediately after induction of anesthesia.

[A case of advanced breast cancer effectively treated with tamoxifen].

A 69-year-old female with advanced breast cancer was daily administered 20 mg of tamoxifen. After 4 months, her left breast tumor decreased in size. Left breast tumor and metastatic lymph nodes disappeared completely (CR) 7 months later.

[The correct endotracheal tube size for infants and children].

The correct endotracheal tube size was assessed in 600 anesthetized infants and children. The correct tube size was determined by the airway pressure at which a gas leak around the endotracheal tube occurred, when the lungs were inflated with slowly increasing positive pressure. Endotracheal tube size correlated most with body length where the correlation coefficient was 0.