The Impact of High-Flow Nasal Oxygen Therapy on Swallowing Function and Aspiration in Patients and Healthy Adults: A Scoping Review.

High-flow nasal oxygen therapy (HFNO) is highly versatile and employed in varied situations, including after extubation, in cases of respiratory failure, and at the end of life. However, its impact on swallowing function is not yet elucidated. Therefore, this scoping review aimed to clarify how HFNO affects swallowing function and whether it poses a risk for aspiration pneumonia.

Study of the Responsiveness and Minimal Clinically Important Difference of the Trunk Impairment Scale in Patients With Acute Stroke.

Background: Trunk function is a prerequisite for functional activity; thus, it is crucial to carry out proper assessments and interventions. However, there is no clear indicator for trunk function evaluation in patients with stroke. To understand the effects of interventions over time, it is important to adopt responsive clinical indicators.

Comparison of a new EMG module, AF-201P, with acceleromyography using the post-tetanic counts during rocuronium-induced deep neuromuscular block: a prospective, multicenter study.

Recent advances in neuromuscular monitors have facilitated the development of a new electromyographic module, AF-201P™. The purpose of this study was to investigate the relationship between post-tetanic counts (PTCs) assessed using the AF-201P™ and the acceleromyographic TOF Watch SX™ during rocuronium-induced deep neuromuscular block. Forty adult patients consented to participate in this study.

The Utility of Virtual Patient Simulations for Clinical Reasoning Education.

Virtual Patient Simulations (VPSs) have been cited as a novel learning strategy, but there is little evidence that VPSs yield improvements in clinical reasoning skills and medical knowledge. This study aimed to clarify the effectiveness of VPSs for improving clinical reasoning skills among medical students, and to compare improvements in knowledge or clinical reasoning skills relevant to specific clinical scenarios. We enrolled 210 fourth-year medical students in March 2017 and March 2018 to participate in a real-time pre-post experimental design conducted in a large lecture hall by using a clicker.

Alexithymia and Somatosensory Amplification Link Perceived Psychosocial Stress and Somatic Symptoms in Outpatients with Psychosomatic Illness.

Background: Psychosomatic patients often complain of a variety of somatic symptoms. We sought to clarify the role of clinical predictors of complaints of somatic symptoms.

Methods: We enrolled 604 patients visiting a psychosomatic outpatient clinic.

Modified Lengthening Temporalis Myoplasty Involving an Extended Lazy-S Incision to Avoid Facial Scar Formation.

Background: Lengthening temporalis myoplasty is a faster and less invasive alternative to free muscle transfer for smile reconstruction. However, it requires a nasolabial fold incision, which leaves a midfacial scar. Based on esthetic considerations, a modified approach, involving an extended lazy-S (parotidectomy) incision instead of a nasolabial fold incision, was developed.

Intraoperative repositioning assessment using navigation system in zygomatic fracture.

Background: Intraoperative repositioning assessment in the zygomatic fracture operation is very important in achieving adequate facial symmetry. A navigation system that has been developed in neurosurgery has recently been applied in the otolaryngol, orthopedic, and maxillofacial surgeries. We used a navigation system (Stealth Station TREON; Medtronic) in zygomatic fracture operation, and found it useful in performing accurate reduction and confirming the symmetry.

Evaluation of Annuloaortic Ectasia by Angioscopy and IVUS "Report of 2 cases".

We attempted combined use of angioscopy and intravascular ultrasonography (IVUS) to localize the coronary ostia and determine the aortic segment to be replaced in patients with annuloaortic ectasia, because these preoperative informations are important for selection of an appropriate technique for reconstructing the coronary artery, to prevent complications, and also to postoperative follow-up. Two cases with annuloaortic ectasia underwent angioscopy and IVUS both pre- and post-operatively. Structure of aortic cusps, position of coronary ostia, the extent of ectasia with very thin wall were clearly observed by IVUS.

Angioscopic evaluation of stabilizing effects of bezafibrate on coronary plaques in patients with coronary artery disease.

Background Since long-term administrations of anti-hyperlipidemic agents result in reduction in % stenosis or increase in minimum lumen diameter (MLD) of stenotic coronary segments, it is generally believed that anti-hyperlipidemic agents stabilize vulnerable coronary plaques. However, recent pathologic and angioscopic studies revealed that vulnerability of coronary plaques is not related to severity of stenosis and the rims rather than top of the plaques disrupt, and therefore, angiography is not adequate for evaluation of vulnerability.Angioscopy enables macroscopic pathological evaluation of the coronary plaques.

Sacral adipofascial turn-over flap for the excisional defect of pilonidal sinus.

The aim of pilonidal sinus surgery includes complete resection of the lesion and filling of the resultant soft-tissue defect by some means; this has a major influence on whether a lesion will occur after surgical treatment. The creation of a sacral adipofascial turn-over flap for the excisional defect has been performed in seven cases of pilonidal sinus since November of 1992. During the postoperative follow-up period, which ranged from 10 months to 7 years 11 months (mean duration, 5 years 2 months), partial dehiscence of the wound as a result of fatlysis was observed and treated conservatively in one case; however, primary healing was obtained in the other cases.

Lateral intermuscular septum of the thigh and short head of the biceps femoris muscle: an anatomic investigation with new clinical applications.

An anatomic study was performed to reappraise the vasculature of the lateral intermuscular septum of the thigh and muscles associated with it using 12 preserved cadaver legs. Several possible new clinical applications of the lateral intermuscular septum and the short head of the biceps femoris were identified as follows: (1) short head of biceps femoris muscle or musculoseptal flap based on the second and/or third profunda perforating vessels, or based on the superior lateral genicular vessels, with or without the iliotibial tract and the deep fascia, and with or without the motor nerve of the short head; (2) transverse extension of the fascial portion of the tensor fasciae latae muscle or musculocutaneous flap to include the lateral intermuscular septum; (3) combination use of items 1 and 2, above; and (4) free septofascial graft using the lateral intermuscular septum and iliotibial tract. It is anticipated that the distally based short head of the biceps femoris muscle flap will be an additional option for repairing defects around the knee, and that a free short head of the biceps femoris muscle flap based on the profunda femoris perforating vessels will be useful in functional reconstruction such as reanimation of the paralyzed face.

Cytologic features of pleural effusion in apocrine sweat gland carcinoma. A case report.

Background: Carcinoma arising in the apocrine sweat glands is very rare, and there are few reports of the cytologic features. We encountered a case of metastatic apocrine carcinoma in a pleural effusion.

Case: A 46-year-old male had a dark reddish nodule in the right axillary region that was diagnosed as apocrine carcinoma of skin appendage origin.

Correction of pectus excavatum using a sternal elevator: preliminary report.

Operative procedures to correct the deformity caused by pectus excavatum are generally based on either sternal elevation or turnover. In either case, the operation is highly invasive. By considering the softness of the costal cartilages in early childhood, we have developed an endoscopically assisted procedure that applies external traction continuously in order to elevate the depressed sternum and costal cartilages.

Development of the local medical service network system. Integration of medical service with the network system between university hospital and other medical institutions.

Although every medical institution always make efforts to provide best services for the patients, it tends to be insufficient to send the patient's information and share them with other medical institutions. It is partly because in the Japanese medical care system there is no obligation to inform patients' medical information to other medical institutions. To provide effective and cost-effective medical service, we made a local network system between university hospital and other medical institutions.

Lateral calcaneal V-Y advancement flap for repair of posterior heel defects.

We obtained favorable results in reconstruction of the posterior heel with a lateral calcaneal V-Y advancement flap. This technique simplifies the operative procedure and eliminates the disadvantages of the original lateral calcaneal flap and its island version while retaining the advantages of these methods.

Combination latissimus dorsi and rectus abdominis musculocutaneous flap for primary repair of a large upper limb defect.

The usefulness of flap transfer in reconstructive surgery is well established, and various types of flaps have been reported. However, concomitant use of skin grafts or repair by plural flaps must be utilized for large defects. We have obtained satisfactory results in the primary repair of a large defect covering the entire length of the upper limb by using a combination flap consisting of latissimus dorsi and rectus abdominis musculocutaneous flaps.

The dorsal metacarpal flap for secondary digital artery flap donor sites.

The effective approach of the reverse digital artery flap for reconstruction of the distal phalanges, fingertips, and finger pulp is used widely in a clinical setting. However, the most potential problem is that digital artery flap donor sites cannot be closed primarily. We have used distally based dorsal metacarpal flaps to cover secondary digital artery flap donor sites in 12 patients.

The lateral thigh V-Y flap for the repair of ischial defects.

The lateral thigh fasciocutaneous flap described by Maruyama et al in 1984 is a useful method for the repair of ischial and trochanteric defects. We clinically re-evaluated the potential vascular territory of the nutrient artery for this flap, i.e.

Endoscopic osteosynthesis for frontal bone fracture.

Endoscopic surgery to repair a frontal bone fracture is described. This operation is less invasive than the conventional open technique, which is performed under direct vision through a bicoronal or eyebrow incision. Endoscopic surgery leaves no conspicuous scars in the forehead and is free from complications such as nerve or vascular injuries, and appears to be of significant clinical value.

Stepladder V-Y advancement flap for repair of postero-plantar heel ulcers.

Random fasciocutaneous flaps with bilateral adipofascial pedicles were elevated from the posterior heel and transferred distally to defects of the postero-plantar heel in 4 patients, using a stepped incision technique, in combination with the V-Y advancement principle. In all cases the flap was successfully transferred without any linear scar or scar contracture in the posterior heel. The absence of recurrence of ulcers during the postoperative follow-up between 1.

Cardiovascular effects of (2RS,3SR)- 2-aminomethyl-2,3,7,8-tetrahydro-2,3,5,8,8-pentamethyl-6H-furo- [2,3-e]indol-7-one hydrochloride (UK-1745), a novel cardiotonic agent with vasodilatory and antiarrhythmic properties.

The cardiovascular effects of (2RS,3SR)-2-aminomethyl-2,3,7,8- tetrahydro-2,3,5,8,8-pentamethyl-6H-furo[2,3-e]indol-7-one hydrochloride (CAS 170684-14-7, UK-1745), a novel cardiotonic agent, were investigated using in vitro and in vivo preparations. In paced left atria isolated from guinea pigs, both UK-1745 and vesnarinone (CAS 81840-15-5) showed a concentration-dependent positive inotropic effect. In spontaneously beating guinea pig right atria, both agents caused only a minimal chronotropic effect.

Use of endoscopic surgery for forehead recontouring.

Forehead recontouring in endoscopic surgery is presented. Eleven cases of protruded forehead deformity caused by benign tumor and one case of concave deformity caused by depressed frontal bone fracture were treated. All lesions were approached through incisions made in the hair-bearing area and operated on endoscopically.