Search

This paper describes the results of an experimental investigation on the drop off impact test on a range of sandwich panels. The magnesium alloy sandwich panels were fabricated with rolled sheets at different thickness by pressing and bonding method. Out-plane compression test was employed to obtain its basic deformation-force behavior. The impact experiments were carried out in which a steel cylinder was dropped off at various height levels, ranging from 0.5m to 1.5 cm to impact the panel. A high speed camera was employed to take pictures at 20 thousand frames per second and the low-velocity impact response on the sandwich panels is recorded with a dynamic force senor under the panel simultaneously. The shock response with time and the impact absorption energy were analyzed and compared. The results of this study proved that the magnesium alloy honeycomb sandwich panels have good impact energy absorption performance.

脳血管障害例の座位姿勢制御における視覚的垂直定位の影響を身体軸傾斜との関連から検討した。右麻痺7例，左麻痺8例，健常若年者9名及び健常高齢者4名に，視覚的垂直定位と，傾斜した視覚指標への身体軸傾斜を測定した。片麻痺例は身体軸傾斜が健常者より有意に小さく，麻痺側傾斜時にその傾向が著明であったが，運動麻痺の重症度と身体軸傾斜との間に有意な相関を認めなかった。視覚的垂直定位の標準偏差は左麻痺例で他の3群より有意に大きく，身体軸傾斜の標準偏差は左麻痺例の左傾斜時に大きい傾向を認めた。視覚的垂直定位の標準偏差は身体軸傾斜時の動揺に影響し，左麻痺例で顕著であると示唆された。

Summary Background: Epidermolysis bullosa simplex associated with muscular dystrophy is caused by plectin deficiency. Objective To report clinical, immunohistochemical, ultrastructural and molecular features of a 52-year-old Japanese patient affected with this disease, whose muscular disease had been followed-up for 27 years. Methods: We performed histopathological study, immunofluorescence, electron microscopic study and mutation detection analysis for plectin. Results: The patient developed blisters and erosions followed by nail deformity on the traumatized regions from birth. The skin lesions were continuously developed to date. The histopathological study showed subepidermal blister. Electron microscopic study showed blister formation inside the basal cells at the level just above the attachment plaque of hemidesmosome. Immunofluorescence showed complete loss of staining to plectin. The mutation analysis using protein truncation test and DNA sequencing revealed a C-to-T transition at nucleotide position 7006 of the plectin cDNA sequence, which lead a novel homozygous nonsense mutation (R2319X). Conclusion: From the above results, the diagnosis of epidermolysis bullosa simplex associated with muscular dystrophy was made. Slight muscular dystrophy was noticed at the age of 25 years. The muscular dystrophy gradually progressed and she could not walk at the age of 46 years. However, she can still breathe and swallow by herself. This is the patient of this disease with the longest follow-up, and may indicate the slow progress of muscular condition of this disease.

In 1997, the members of Japan Stroke Society presented the Japan Stroke Scale (JSS) for the acute stage, and in 2000 the Japan Stroke Scale of Motor (JSS-M) with the items of motor system required for the independence of activities of daily living (ADL). JSS-M consists of eight major items. We classified subjects with nine points or less into group A, with 10-19 points into group B and with 20 points or more into group C according to JSS scores for the acute stage at the baseline. In JSS scores, higher scores means more intense severity of disability. Subjects were 46 cases with cerebral hemorrhage and 63 cases with cerebral infarction, 109 cases in total. Age: cases with cerebral hemorrhage had a mean age of 58.3 ± 14.7, while those with cerebral infarction had a mean age of 69.2 ± 11.0: males 67, and females 42. The rate of improvement of cerebral hemorrhage was higher than that of cerebral infarction in groups A and B. The rate of improvement was the highest in Gait in groups A and B, and Dysphagia and Complex Movement followed in order after that; in group B the rate of improvement of Hand and Arm followed after Complex Movement. The mean rate of improvement of JSS was 98% in group A, 66.7% in group B, and 57.8% in group C. JSS-M is a very useful evaluation, but the study of evaluation methods of trunk and upper limb function required.

Evaluation of disorders constitutes an important part of work in rehabilitation medicine. But all of the objective evaluation methods for quantifying ADL have both advantages and disadvantages, and they are often difficult to use. Evaluation and judgment of ADL should be carried out in terms of movements simplified as much as possible. An ADL Score Study Group, consisting of medical co-workers, has been organized, and they have proposed a tentative plan for patients with paraplegia due to spinal cord injury. Method; ADL items were limited to 10, with sub-items limited to two to three per item, to simplify the ADL score as much as possible. The evaluation was carried out in accordance with the followings; 0 point, requiring full assistance, 1 point, partial assistance, 2 points, possible to do activities with insufficient perfectness, 3 points, possible to do activities independently, with a maximum of 99 points. Subjects were 35 patients with complete paralysis due to spinal cord injury. Thirty four persons were males and one was female. Results; Evaluation scores were 81 points for Group A (Spinal cord injury T1-7), 85 points for Group B (Spinal cord injury T8-L1), 95 points for Group C (Spinal cord injury L2 or lower). It was demonstrated that the evaluation of two items, reach and walking, was sufficient for independent patients with paraplegia due to spinal cord injury.

Making a functional prognosis for patients with traumatic incomplete spinal cord injuries is extremely important not only for the patients themselves, in attempting to achieve independence in activities of daily living and social rehabilitation, but also for medical co-workers, the family and almost everyone in the society. However, only very few reports deal with this subject, and rehabilitation is often conducted aimlessly. In the present study we tried at our department to summarize the functional prognosis of patients with spinal injuries and set up a preliminary standard for rehabilitation. The present study included 75 patients with Frankel class C, D, E, incomplete spinal injury who underwent rehabilitation training in the past ten years at our department. The level of the injury was the cervical cord in 53 patients and the thoracic or lumbar cord in 22 patients. The average age of the patients was 36.2 years. Seventy of the patients were male and 5 female. The time of the final evaluation after the injury was on the average 11.8 months (SD=5.9 months). When muscle power of the lower extremities three months after injury reached [4], patients accomplished independent walking 6.8 months after the injury. When muscle power of the lower extremities 6.5 months after injury reached [3-], patients accomplished semi-independent walking with the help of a wheelchair 8.7 months after the injury. Patients with a muscle power of more than [3-] in the upper extremities could walk independently. Among patients with incomplete injury of the cervical cord 64% gained independence in ADL 8.6 months after the injury, but patients with central paralysis or strong spasticity required assistance.

The early stage of colorectal cancer is divided into two morphological types polypoid and superficial. What percentage of advanced cancer is derived from the polypoid or superficial type is a matter of concern. The ratio of superficial variety among of ulcerated cancers was studied using those 2 cm or less in diameter, which often retain mucosal cancer. The existence of horizontal growing mucosal cancer at the marginal area of ulcerated cancer is a hallmark showing the lesion being of superficial origin. Eight (57 %) out of the 14 cases of ulcerated cancer, 2 cm or less, had this finding. This suggests that more than half of smaller colorectal cancers are of superficial origin. A zig-zag pattern (ZZP) was evident in 3 cases of superficial origin. No cases in the nonsuperficial group had the ZZP. The existence of circumferential ZZP during colonoscopic observation indicates that the cancer is of superficial origin.

Capsule endoscopy (CE) is used widely for determining the cause of obscure gastrointestinal bleeding (OGIB). However, negative findings still arise from CE examination. The aim of this study was to determine the factors associated with negative findings on CE in patients with OGIB.A total of 134 patients who underwent CE for overt (n = 104) or occult (n = 30) OGIB between October 2007 and April 2010 were included. The clinical backgrounds of the patients (age; sex; the use of anti-coagulant, anti-platelet drugs or NSAIDs; comorbidity and the timing of CE examination after bleeding) were noted.The overall diagnostic yield of CE in detecting the relevant findings was 50% (n = 67). Multivariate analysis revealed that the use of anti-platelet drug and the timing of CE (≥ 16 days) were predictive factors for negative findings on CE (odds ratio 2.69 [1.01-7.21], p = 0.048 and odds ratio 2.32 [1.01-5.33], p = 0.047, respectively). Among the patients with the use of low-dose aspirin (LDA, n = 28) as anti-platelet drug, cessation of it before CE was the only predictive factor for negative findings on CE (odds ratio 12.0 [1.72-83.5], p = 0.012).In the patients with OGIB, the use of LDA and the cessation of it before CE made it difficult to detect the cause of bleeding by CE. This might indicate that the source of OGIB related to LDA heals immediately after cessation of the drugs or is a very small lesion that could not be detected by CE.

42歳の女性。6ヵ月前より臍部に結節を生じ,月経時の出血と疼痛を認めるようになった。初診時,径20mm×高さ5mmの表面平滑の暗赤色のドーム状の結節を認めた。組織学的には真皮下層に子宮内膜円柱上皮細胞よりなる腺腔構造が認められ,臍部子宮内膜症と診断した。子宮,骨盤内に他病変は認めなかった。GnRHアゴニスト製剤による保存的治療を行い出血,疼痛の消失と結節の若干の縮小をみている。