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Background Silicosis is the most prevalent pneumoconiosis in Brazil. We aimed to estimate mortality rates and temporal trends for silicosis, and to identify areas of highest mortality. Methods Records of silicosis as the underlying (1980-2017) or contributory (2000-2017) cause of death in adults aged 20 years and older were retrieved from the Brazilian Mortality Database. Age-standardized mortality rates (ASMR) were calculated. The annual trend in ASMR was analyzed by joinpoint regression. Mortality rates per 100,000 person-years were calculated for each municipality. We analyzed temporal trends in municipalities where similar activities with exposure to silica were performed. Results There were 3164 death records (96.6% men) distributed over 14% of the municipalities. Mean age of death was 59.2 (SD 15.1) and mean ASMR was 0.085/100,000 (confidence interval 0.080-0.091). Joinpoint regression showed a significant increase in ASMR from 1980 to 2006 and a significant decrease after 2006 driven by a decline in deaths of individuals younger than 70 years. The highest mortality rate was 21.83/100,000 person-years, in a municipality with small mining operations for gems. Gold mining municipalities showed the highest composite death rate, 4.0/100,000 person-years. Tuberculosis was the main cause of death when silicosis was a contributing cause. Conclusions In contrast with developed countries, silicosis mortality in Brazil increased to 2006 and subsequently started to drop, mostly from a plateau or decrease in deaths occurring in municipalities which regulated economic activities. However, this decrease did not occur in the older age group nor in the unregulated sector, the latter being the main challenge for exposure control and surveillance.

The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000–2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers.

Background Several studies showed that sickness absenteeism has considerable impact on civil service given the increasing number of sick leaves granted to and days off work among employees. Health care workers, especially those in hospitals, represent one of the occupational groups at higher risk of absenteeism. Therefore, establishing the pattern of sickness absenteeism in this group is crucial to implement efficacious preventive measures against work-related diseases. Objective To characterize sickness absenteeism among the nursing and medical staff of a public hospital in Sao Paulo, Brazil, in the period from 2011 through 2013. Methods Cross-sectional descriptive study conducted in a large hospital in which we analyzed data from January 2011 to December 2013. Results Employees missed a total of 71,460 days of work along the analyzed period; 3,323 sick leave benefits were granted to 1,533 workers. Nursing assistants and workers in the adult emergency department accounted for the largest number of days off work to a total of 11,460. The most common reasons for sick leaves among emergency department employees were musculoskeletal diseases and mental and behavioral disorders. Conclusion We detected changes in the morbidity profile of the nursing and medical staff along the analyzed period, characterized by conditions which demand longer time for recovery and return to work.

In the original publication [...]

Objective: To analyze mortality from idiopathic pulmonary fibrosis (IPF) in Brazil over the period 1979-2014. Methods: Microdata were extracted from the Brazilian National Ministry of Health Mortality Database. Only deaths for which the underlying cause was coded as International Classification of Diseases version 9 (ICD-9) 515 or 516.3 (until 1995) or as ICD version 10 (ICD-10) J84.1 (from 1996 onward) were included in our analysis. Standardized mortality rates were calculated for the 2010 Brazilian population. The annual trend in mortality rates was analyzed by joinpoint regression. We calculated risk ratios (RRs) by age group, time period of death, and gender, using a person-years denominator. Results: A total of 32,092 deaths were recorded in the study period. Standardized mortality rates trended upward, rising from 0.24/100,000 population in 1979 to 1.10/100,000 population in 2014. The annual upward trend in mortality rates had two inflection points, in 1992 and 2008, separating three distinct time segments with an annual growth of 2.2%, 6.8%, and 2.4%, respectively. The comparison of RRs for the age groups, using the 50- to 54-year age group as a reference, and for the study period, using 1979-1984 as a reference, were 16.14 (14.44-16.36) and 6.71 (6.34-7.12), respectively. Men compared with women had higher standardized mortality rates (per 100,000 person-years) in all age groups. Conclusion: Brazilian IPF mortality rates are lower than those of other countries, suggesting underdiagnosis or underreporting. The temporal trend is similar to those reported in the literature and is not explained solely by population aging. Objetivo: Analisar a mortalidade por fibrose pulmonar idiopática (FPI) no Brasil ao longo período 1979-2014. Métodos: Os microdados foram extraídos do National National Banco de Dados de Mortalidade do Ministério da Saúde. Apenas os óbitos cuja causa básica foi codificado como Classificação Internacional de Doenças versão 9 (CID-9) 515 ou 516.3 (até 1995) ou como CID versão 10 (CID-10) J84.1 (de 1996 em diante) foram incluídos em nosso análise. As taxas de mortalidade padronizadas foram calculadas para a população brasileira de 2010. A tendência anual das taxas de mortalidade foi analisada por regressão joinpoint. Nós calculamos razões de risco (RRs) por faixa etária, período de tempo da morte e sexo, usando uma pessoa-ano denominador. Resultados: Foram registrados 32.092 óbitos no período do estudo. As taxas de mortalidade padronizadas apresentaram tendência ascendente, passando de 0,24/100.000 habitantes em 1979 para 1,10/100.000 habitantes em 2014. A tendência anual de aumento das taxas de mortalidade teve dois pontos de inflexão, em 1992 e 2008, separando três segmentos temporais distintos com crescimento anual de 2,2%, 6,8% e 2,4%, respectivamente. A comparação de RR para as faixas etárias, tendo como referência a faixa etária de 50 a 54 anos, e para o estudo período, usando 1979-1984 como referência, foram 16,14 (14,44-16,36) e 6,71 (6,34-7,12), respectivamente. Homens comparados com mulheres apresentaram taxas de mortalidade padronizadas mais altas (por 100.000 pessoas-ano) em todas as faixas etárias. Conclusão: As taxas brasileiras de mortalidade por FPI são inferiores aos de outros países, sugerindo subdiagnóstico ou subnotificação. O tendência temporal é semelhante às relatadas na literatura e não é explicada apenas por envelhecimento da população.

Resumo A Revista Brasileira de Saúde Ocupacional (RBSO) é o periódico científico do campo da Saúde do Trabalhador publicado pela Fundacentro desde 1973. O percurso histórico, o desempenho atual, os desafios e as perspectivas futuras da RBSO são discutidos a partir de análise documental. A história da revista pode ser dividida em três períodos, começando durante o governo militar. No início, se constituiu em veículo de difusão de conhecimentos e da política de prevenção de acidentes, na qual a Fundacentro desempenhava papel central. No início dos anos 80 abre-se espaço para publicações de caráter técnico científico, assim como o campo da Saúde do Trabalhador surge em suas páginas. Em 2005-6, um processo de reestruturação é implementado, assegurando política e estruturas editoriais independentes. Desde 2006, 139 artigos originais e nove dossiês temáticos foram publicados; a Revista está indexada em 9 bases; Qualis/CAPES B1 na área Interdisciplinar e B2 em Saúde coletiva, com tendência ascendente no Fator de Impacto SciELO e índice h5 no Google Scholar. Todavia, a relativa baixa produção científica no campo e o alto índice de rejeição de manuscritos podem colocar em risco a sobrevivência do “lócus principal” para publicações científicas no campo da Saúde do Trabalhador. Abstract The Revista Brasileira de Saúde Ocupacional (RBSO) - Brazilian Journal of Occupational Health - is an academic peer-reviewed journal in the field of Workers’ Health that has been published by Fundacentro since 1973. Its historical trajectory, current performance, challenges and future perspectives were approached, in this paper, from a documental analysis. The journal's history can be divided into three periods, starting during the military government. At the beginning, the journal was the official vehicle for the Brazilian occupational accidents prevention policy, in which Fundacentro played a central role. The early 1980s opens space for technical-scientific publications and the field of Workers’ Health emerges on the journal's pages. In 2005-6, a restructuring process is implemented, ensuring independent editorial policy and structures. Since 2006, 139 original papers and 9 thematic issues have been published. The journal is indexed in 9 bibliographic databases, has been ranked B1 in the field of interdisciplinary studies and B2 in the field of public health by CAPES, has an upward trend in the SciELO Impact Factor, and has an h-index of 5 in Google Scholar. Nevertheless, the low scientific production in the field and the high rate of rejection of manuscripts may jeopardize the survival of the journal, which is the main locus for scientific publications in the field of Workers’ Health.

SummaryObjectivesThe purpose of this study was to reveal the accurate prevalence and related factors to the presence of calcium pyrophosphate dihydrate (CPPD) crystal deposition in cadaveric knee joints.DesignControlled laboratory study.MethodsSix hundred and eight knees from 304 cadavers (332 male knees and 276 female knees, formalin fixed, Japanese anatomical specimens) were included in this study. The average age of the cadavers was 78.3 ± 10.7 years. Knees were macroscopically evaluated for the existence of CPPD, and the depth of cartilage degeneration of the femoro-tibial joint following the Outerbridge's classification. CPPD crystal was confirmed under Fourier transform infrared spectroscopy (FTIR) analysis using light microscopy. Statistical analysis was performed to reveal the correlation between the occurrence of CPPD deposition in the knee joint and gender, age, and the depth of cartilage degeneration of the femoro-tibial joint.ResultsThe prevalence of grossly visible CPPD crystal was 13% (79 knees). In all of these knees, CPPD crystal was confirmed under FTIR analysis. Statistical analysis showed significant correlation between the occurrence of CPPD deposition and gender (P

The purpose of this study was to reveal the prevalence of the subtypes of the meniscus using human cadaver knees. Four hundred and thirty-seven cadaveric knees in 219 subjects (formalin fixed, Japanese population) with a median age of 83 years (54–97) were included in this study. All soft tissues surrounding the knee, excluding the meniscus, were resected, and macroscopic assessment of the meniscus was performed. Meniscus subtypes were classified as: (1) normal meniscus, (2) complete discoid, (3) incomplete discoid, (4) ring-shaped, and (5) double-layered. All subtypes of the meniscus were observed in the lateral meniscus. Complete discoid lateral meniscus was observed in 27 knees (6.2 %), incomplete discoid lateral meniscus was observed in 139 knees (31.8 %), ring-shaped lateral meniscus was observed in 4 knees (0.9 %), and double-layered meniscus was observed in 2 knees (0.5 %). This study reports the accurate prevalence of ring-shaped and double-layered meniscus. None of the subtypes were detected in the medial meniscus in this study. For clinical relevance, the results of this study can be useful in assisting the diagnosis of meniscus tear in clinical situations.

In this study, we examined the therapeutic effect of photodynamic therapy (PDT) using the photosensitizer Na-Pheophorbide a (Na-Phde a) on osteomyelitis models in rats.Osteomyelitis is one of the most serious infectious problems in the orthopedic field. Recently, as a new clinical approach against septic arthritis, an experimental in vivo and in vitro model for the inactivation of methicillin-resistant-Staphylococcus aureus by PDT using Na-Phde a has been developed.Methicillin-sensitive Staphylococcus aureus (MSSA) was injected into the tibia of the rats to create osteomyelitis models (n = 10, 10 legs). A total of 560 μmol/l of Na-Phde a solution was injected into five of these tibial osteomyelitis models (five legs) 48 h after the initial MSSA infection. Sixty minutes after the Na-Phde a injection, a semiconductor laser (125 mW, 670 nm) was used to irradiate the models for 10 min with a total energy of 93.8 J/mm(2). As a control group, five rats (five legs) were treated with a phosphate buffered saline injection at 48 h after MSSA infection. Weight and leg perimeter changes were plotted. Bacterial growth, histological examination and radiological examination were evaluated at 14 days after initial treatment.PDT with Na-Phde a significantly prevented leg swelling. In the PDT group, bone destruction owing to osteomyelitis was inhibited not only histologically but also radiographically.The results in these experiments show that PDT using Na-Phde a improved osteomyelitis in rats. This suggests that PDT using Na- Phde a can be a useful treatment for osteomyelitis.

Intercondylar notch narrowing is a risk factor for anterior cruciate ligament (ACL) injuries, but it is unclear whether a narrow intercondylar notch correlates with bilateral ACL injuries.To determine whether a narrow intercondylar notch is associated with bilateral ACL knee injuries in athletes, using magnetic resonance imaging (MRI) and radiography to investigate the notch size.A retrospective case-control study.This was a comparative cohort study on 50 subjects of which 25 patients with sport trauma-associated bilateral ACL injuries, 30 with unilateral ACL injuries, and 20 healthy subjects. The notch width index (NWI) was measured as the ratio of the width of the intercondylar notch to the femoral condylar width on radiography and the MRI slice containing the region near the ACL attachment site on the femoral side (NWI-A) and on the following posterior slice (NWI-P).The mean NWI values on radiography were 0.257 (SD 0.040), 0.332 (SD 0.036), and 0.341 (SD 0.027) in the bilateral, unilateral, and control groups, respectively, with significant differences between the bilateral and unilateral groups and the bilateral and healthy groups. On MRI, the mean NWI-A values were 0.236 (SD 0.025), 0.243 (SD 0.048), and 0.266 (SD 0.030), respectively, with a significant difference between the bilateral and healthy groups. The mean NWI-P values were 0.239 (SD 0.021), 0.258 (SD 0.038), and 0.273 (SD 0.033), respectively, with significant differences between the bilateral and unilateral groups and the unilateral and healthy groups. A cutoff value of 0.25 for NWI-P gave an odds ratio of 22.667 for the risk of developing bilateral ACL knee injuries.The intercondylar notch was significantly narrower in subjects with bilateral ACL injuries than in healthy subjects. NWI measurement using coronal MRI is useful for judging intercondylar notch narrowing. The risk for ACL injuries is very high when NWI is ≤0.25. Preventive measures for the unaffected knee are required for patients with a narrow intercondylar notch.

Rehabilitation is one of the most critical points after anterior cruciate ligament (ACL) reconstruction. However, the recent trend of low-cost, short-term hospitalization makes sufficient rehabilitation after ACL reconstruction difficult.34 patients who underwent non-anatomical single bundle ACL reconstruction using a hamstring auto graft were evaluated. Twenty patients (12 males and 8 females) were transferred to a special rehabilitation hospital (RH hospital group) after operation and concentrated rehabilitation was performed up to 4 h per day. Fourteen (9 males and 5 females) patients performed clinic-based rehabilitation at a university hospital three times per week (clinic group). Strength of quadriceps and knee flexion muscles was assessed at 60 degrees /s using a Cybex II dynamometer (Lumex, Ronkonkoma, NY, USA) at 3, 6 and 9 months after ACL reconstruction. Anterior tibial translation (ATT) and pivot shift test were also evaluated.No significant difference in muscle recovery in the lower extremity was observed at any time point after ACL reconstruction between the clinic group and the RH hospital group. However, 3 months after operation, the average muscle strength of the RH hospital group tended to be higher than that of the clinic group. There was no significant difference in ATT or pivot shift (each group included 4 positive pivot shift subjects) in the patients who were tested between the clinic group and the RH hospital group.Concentrated rehabilitation at a rehabilitation hospital after ACL reconstruction has the potential to improve muscle strength in the lower extremities more dramatically in the early stages of post operation. However, the initial benefits of intensive physiotherapy disappear after 6 months.

The objective of this study was to investigate the accurate AM and PL tunnel positions in an anatomical double-bundle ACL reconstruction using human cadaver knees with an intact ACL. Fifteen fresh-frozen non-paired adult human knees with a median age of 60 were used. AM and PL bundles were identified by the difference in tension patterns. First, the center of femoral PL and AM bundles were marked with a K-wire and cut from the femoral insertion site. Next, each bundle was divided at the tibial side, and the center of each AM and PL tibial insertion was again marked with a K-wire. Tunnel placement was evaluated using a C-arm radiographic device. For the femoral side assessment, Bernard and Hertel's technique was used. For the tibial side assessment, Staubli's technique was used. After radiographic evaluations, all tibias' soft tissues were removed with a 10% NaOH solution, and tunnel placements were evaluated. In the radiographic evaluation, the center of the femoral AM tunnel was placed at 15% in a shallow-deep direction and at 26% in a high-low direction. The center of the PL bundle was found at 32% in a shallow-deep direction and 52% in a high-low direction. On the tibial side, the center of the AM tunnel was placed at 31% from the anterior edge of the tibia, and the PL tunnel at 50%. The ACL tibial footprint was placed close to the center of the tibia and was oriented sagittally. AM and PL tunnels can be placed in the ACL insertions without any coalition. The native ACL insertion site has morphological variety in both the femoral and tibial sides. This study showed, anatomically and radiologically, the AM and PL tunnel positions in an anatomical ACL reconstruction. We believe that this study will contribute to an accurate tunnel placement during ACL reconstruction surgery and provide reference data for postoperative radiographic evaluation.

To evaluate the efficacy of photodynamic therapy (PDT) against methicillin resistant-Staphylococcus aureus (MRSA) by selecting different light sources for irradiation and combining them with the photosensitizer Na-Pheophorbide a (Na-Phde a).The treatment of drug-resistant bacterial infection is a serious issue. Recently, as a new clinical approach against septic arthritis, an experimental in vivo and in vitro model for the inactivation of MRSA by PDT using the photosensitizer Na-Phde a has been developed.Na-Phde a solution (280 micromol/L) was mixed with MRSA strain bacterial inoculum. After 60 minutes, light was irradiated for 30 minutes using the following light sources: GaA1p semiconductor laser (300 mW, 670 nm), halogen lamp (75 W), xenon lamp (300 W) and fluorescent lamp (27 W). Bacterial growth was evaluated after 24 hours incubation in a blood agar culture.The semiconductor laser and halogen lamp groups showed perfect bactericidal effects after PDT. The xenon lamp and fluorescent lamp groups showed partial bactericidal effects.The results of this experiment showed that PDT using the combination of Na-Phde a with a semiconductor laser or halogen lamp showed a better bactericidal performance than with xenon or fluorescent lamps. These findings indicated that PDT using Na-Phde a could be a useful treatment for septic arthritis and soft tissue infection.

Attention has been focused on the importance of anatomical tunnel placement in anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare the effect of different tunnel positions for single-bundle (SB) ACL reconstruction on knee kinematics. Ten porcine knees were used for the following reconstruction techniques: three different anatomic SB [AM-AM (antero-medial), PL-PL (postero-lateral), and MID-MID] (n = 5 for each group), conventional SB (PL-high AM) (n = 5), and anatomic double-bundle (DB) (n = 5). Using a robotic/universal force-moment sensor testing system, an 89 N anterior load (simulated KT1000 test) at 30, 60, and 90 degrees of knee flexion and a combined internal rotation (4 N m) and valgus (7 N m) moment (simulated pivot-shift test) at 30 and 60 degrees were applied. Anterior tibial translation (ATT) (mm) and in situ forces (N) of reconstructed grafts were calculated. During simulated KT1000 test at 60 degrees of knee flexion, the PL-PL had significantly lower in situ force than the intact ACL (P0.01). In situ force of the MID-MID was higher than other SB reconstructions (at 30 degrees : 94.8 +/- 2.5 N; at 60 degrees : 85.2 +/- 5.3 N; and 90 degrees: 66.0 +/- 8.7 N). At 30 degrees of knee flexion, the PL-high AM had the lowest in situ values (67.1 +/- 19.3 N). At 60 and 90 degrees of knee flexion the PL-PL had the lowest in situ values (at 60 degrees : 60.8 +/- 19.9 N; 90 degrees : 38.4 +/- 19.2 N). The MID-MID and DB had no significant in situ force differences at 30 and 60 degrees of knee flexion. During simulated pivot-shift test at 60 degrees of knee flexion, the PL-PL and PL-high AM reconstructions had a significant lower in situ force than the intact ACL (P0.01). During simulated KT1000 test at 30, 60, and 90 degrees of knee flexion, the PL-PL and PL-high AM had significantly lower ATT than the intact ACL (P0.01). During simulated KT1000 test at 60 and 90 degrees, the MID-MID, AM-AM, and DB had significantly lower ATT than the ACL deficient knee (P0.01). During simulated KT1000 test at 90 degrees, every reconstructed knee had significantly higher ATT than the intact knee (P0.01). In conclusion, the MID-MID position provided the best stability among all anatomic SB reconstructions and more closely restored normal knee kinematics.

A novel iontophoretic system utilizing ion-exchange membranes is effective for selective transdermal delivery of ionized drugs. In the present study, we examined in vivo availability and safety of ion-exchange iontophoresis in the transdermal delivery of anionic diclofenac, a well known anti-inflammatory medication, to rat dorsal skin. While iontophoresis increased the plasma concentration of diclofenac sodium and skin injury was not observed, no anti-inflammatory effect was exerted. To enhance the efficiency of transdermal delivery of diclofenac sodium, iontophoresis was combined with topical application of one of three terpenes (menthol, nerolidol or geraniol) as chemical enhancers. By combining iontophoresis with geraniol, the plasma concentration of diclofenac sodium increased over 20-fold, and suppression of inflammation was achieved. Skin irritation was not seen even after 1.5 h iontophoresis. The enhancing effect of geraniol is attributed to increased penetration of the drug into the stratum corneum as well as enhanced transport across the anion-exchange membrane. Ion-exchange iontophoresis combined with geraniol is a highly effective transdermal delivery system.

Background There are limited data on mesothelioma mortality in industrializing countries, where, at present, most of the asbestos consumption occurs. Objectives To analyze temporal trends and to calculate mortality rates from mesothelioma and cancer of the pleura in Brazil from 2000 to 2012 and to estimate future mortality rates. Methods We retrieved records of deaths from mesothelioma (ICD-10C45) and cancer of the pleura (ICD-10C38.4) from 2000 to 2012 in adults aged 30 years and over. Crude and age-standardized mortality rates (ASMR) were calculated. Rate ratios of mean crude mortality for selected municipalities were compared to the Brazilian rate. A regression was carried out of the annual number of deaths against asbestos consumption using a Generalized Additive Model (GAM). The best model was chosen to estimate the future burden and peak period of deaths. Results There were 929C45 and 1379 C38.4 deaths. The ratio of men to women for C45 was 1.4. A positive trend in C45 numbers was observed in Brazil ( p =0.0012), particularly in Sao Paulo ( p =0.0004) where ASMRs presented an increasing linear trend ( p =0.0344). Selected municipalities harboring asbestos manipulation presented 3.7–11 fold rate ratios of C45 compared to Brazil. GAM presented best fits for latencies of 34 years or more. It is estimated that the peak incidence of C45 mortality will occur between 2021 and 2026. Conclusions The observed ASMRs and the gender ratio close to 1 suggest underreporting. Even so, deaths are increasing and mesothelioma clusters were identified. Compared to industrialized countries Brazil displays a 15–20 year lag in estimated peak mesothelioma mortality which is consistent with the lag of asbestos peak consumption in the country.

The Revista Brasileira de Saúde Ocupacional (RBSO) - Brazilian Journal of Occupational Health - is an academic peer-reviewed journal in the field of Workers' Health that has been published by Fundacentro since 1973. Its historical trajectory, current performance, challenges and future perspectives were approached, in this paper, from a documental analysis. The journal's history can be divided into three periods, starting during the military government. At the beginning, the journal was the official vehicle for the Brazilian occupational accidents prevention policy, in which Fundacentro played a central role. The early 1980s opens space for technical-scientific publications and the field of Workers' Health emerges on the journal's pages. In 2005-6, a restructuring process is implemented, ensuring independent editorial policy and structures. Since 2006, 139 original papers and 9 thematic issues have been published. The journal is indexed in 9 bibliographic databases, has been ranked B1 in the field of interdisciplinary studies and B2 in the field of public health by CAPES, has an upward trend in the SciELO Impact Factor, and has an h-index of 5 in Google Scholar. Nevertheless, the low scientific production in the field and the high rate of rejection of manuscripts may jeopardize the survival of the journal, which is the main locus for scientific publications in the field of Workers' Health.

We undertook a descriptive, observational study to determine the prevalence of the discoid lateral menisci. The relation between the lateral meniscal shapes and the incidence of meniscal tears were studied, and the gender differences in discoid lateral menisci and the similarities of the lateral meniscal shapes in bilateral knees were examined. A total of 602 knees from 306 cadavers were macroscopically analyzed. Altogether, 577 lateral menisci were classified into the following three types: normal type (NM); incomplete discoid type (ICDM); and complete discoid type (CDM). Each lateral meniscus was examined for meniscal tears. The prevalence of a discoid lateral meniscus and gender differences in its prevalence were examined, as were the presence of a meniscal tear for the three types of lateral meniscus. In all, there were 21 (3. 6%) CDM cases and 171 ICDM cases (29.6%). The prevalence of discoid lateral meniscus, including ICDM and CDM, in the female cadavers was significantly higher than that in the male cadavers, but there was no significant gender difference in the prevalence of CDM. It was found that the shape of the lateral meniscus was similar bilaterally. The incidence of meniscal tears for ICDM was significantly higher than that for NM.

健常成人女性9名に対してアイスパック，コールドパック，持続的冷却装置による3種類の寒冷療法を行い，皮膚温の変化について検討した。その結果，コールドパックと持続的冷却装置では，冷却開始直後の皮膚温低下はコールドパックの方が有意に低下したが，冷却終了時にはほぼ同値を示した。また，冷却終了後の皮膚温上昇も同様な経過を示した。アイスパックによる冷却では，持続的冷却装置およびコールドパックより有意な低下を示した。冷却終了直後の皮膚温上昇は他の冷却方法より大きかったが，30分以降は同様な経過を示した。各々の冷却特性や使用環境を考慮することにより，急性外傷に対する寒冷療法として有用と考えられた。

Background and aims: Our hospital has used LLLT in the treatment of athletes since 1990. We had a good result about LLLT for sports injuries. However, few articles have attempted to evaluate the efficacy of LLLT for sports injuries. The aims of this study was to evaluate the efficacy of LLLT for sports injuries. Materials (Subjects) and Methods: Forty one patients underwent LLLT in our hospital. These patients included 22 men and 19 women with an average age of 38.9 years old. Patients were irradiated by diode laser at points of pain and/or acupuncture points. Patients underwent LLLT a maximum treatment of 10 times (mean 4.1 times). We evaluated the efficacy of LLLT using a Pain relief score (PRS). A score of 2 to 5 after treatment was regarded as very good, 6 to 8 as good, and 9 to 10 as poor. A PRS score of less than 5 was regarded as effective. Results: The rate of effectiveness (PRS of 5 or less) after LLLT was 65.9% (27/41 patients). Discussion: In this study, the resulting rate of effectiveness was 65.9% for all sports injuries. However, we have a high rate of effectiveness for Jumper's knee, tennis elbow and Achilles tendinitis and cases that were irradiated laser by a physician. Conclusions: LLLT is an effective treatment for sports injuries, particularly jumper's knee, tennis elbow and Achilles tendinitis.

Nowadays practical antihypertensive therapy involves not only simple normalization of blood pressure but also a reduction of the risks of cardiovascular disease. In this multicenter open-label study, the long-term effects of doxazosin, an alpha 1-adrenergic receptor blocker, on serum lipids were prospectively investigated in 253 patients with essential hypertension. They were treated with doxazosin for 1 year. The averaged the blood pressure was maintained at levels lower than 150/90 mmHg throughout 1 year, but heart rate did not increase. After 3 months of doxazosin therapy, total and low density lipoprotein-cholesterol levels in serum were significantly reduced by 3.3% and 3.4%, respectively, and these levels were maintained throughout the study period. This effect of doxazosin on serum lipids was especially prominent in patients with hypercholesterolemia. In addition, the lipid profile of these patients was favorably altered even when other antihypertensive drugs or lipid-lowering drugs had already been used or were used concurrently. These results constitute useful information for physicians who treat hypertension with alpha 1-blockers to reduce the overall risk of cardiovascular disease.

The biological tissue is irradiated with laser light, and carbonization, incineration, evaporation, blood coagulation, protein denaturation, and photoactivation will arise in order of the strength of the reaction. LLLT is the application of those photoactivated biological effects. In this paper, effective pain relief, photoactivation effect on chondrocytes, and, PDT (photodynamic therapy) using photosensitizer are introduced.

本研究の目的は腰痛患者における体幹筋力の特性を明らかにすることである。等速性体幹筋力計(Cybex TEF)を用い、健常者92名(男性47、女性45)、腰痛患者61名(男性33，女性28)の等速性体幹筋力を測定し比較・検討した。測定速度は30・60・90・120・150deg/secの5種類とした。その結果、1)体幹伸筋筋力は腰痛患者において低値を示した。2)体幹屈筋筋力は測定速度が高速になると腰痛患者において低値を示した。3)角速度の増加による筋力減少は、体幹屈筋よりも体幹伸筋において大きかった。4)角速度の影響は男性よりも女性において著明であった。

Anterior cruciate ligament (ACL) graft impingement against the intercondylar roof has been postulated, but not thoroughly investigated. The roof impingement pressure changes with different tibial and femoral tunnel positions in ACL reconstruction. Anterior tibial translation is also affected by the tunnel positions of ACL reconstruction. The study design included a controlled laboratory study. In 15 pig knees, the impingement pressure between ACL and intercondylar roof was measured using pressure sensitive film before and after ACL single bundle reconstruction. ACL reconstructions were performed in each knee with two different tibial and femoral tunnel position combinations: (1) tibial antero-medial (AM) tunnel to femoral AM tunnel (AM to AM) and (2) tibial postero-lateral (PL) tunnel to femoral High-AM tunnel (PL to High-AM). Anterior tibial translation (ATT) was evaluated after each ACL reconstruction using robotic/universal force-moment sensor testing system. Neither the AM to AM nor the PL to High-AM ACL reconstruction groups showed significant difference when compared with intact ACL in roof impingement pressure. The AM to AM group had a significantly higher failure load than PL to High-AM group. This study showed how different tunnel placements affect the ACL-roof impingement pressure and anterior-posterior laxity in ACL reconstruction. Anatomical ACL reconstruction does not cause roof impingement and it has a biomechanical advantage in ATT when compared with non-anatomical ACL reconstructions in the pig knee. There is no intercondylar roof impingement after anatomical single bundle ACL reconstruction.

In this study, we examined the effect of photodynamic therapy (PDT) using Na-pheophorbide a (Na-Phde a) on normal joint tissue.The treatment of methicillin-resistant Staphylococcus aureus (MRSA) infection is a serious issue. Recently, an experimental in vivo and in vitro model for the inactivation of MRSA by PDT using a photosensitizer, Na-Phde a, has been developed.The knee joints of mice were injected with 560 or 280 micromol/L of Na-Phde a. Thirty minutes after injection, percutaneous laser irradiation was applied for 5 min using a semiconductor laser (power: 125 mW; wavelength: 664 nm; total energy: 12 J/cm2). The joint perimeter and body weight of the treated mice were monitored, and histological evaluation was also done.Joint swelling was observed up to 3 wk after PDT (p0.05). On histology 1 wk post-PDT, the treated knees were found to have inflammatory changes, primarily in synovial tissue. Eight weeks after PDT, the synovitis was no longer present. No significant effects were observed on cartilage, bone marrow, or menisci.The results of this experiment showed that PDT with Na-Phde a induced arthritis for a short time after treatment. However, this arthritis was reversible, and the PDT did not appear to induce osteoarthritic changes in normal joint tissue. These findings indicate that PDT using Na-Phde a caused minimal but reversible changes in joint tissue, suggesting that it would be a safe and useful treatment for bacterial septic arthritis.

本研究の目的は、等速性運動における角速度変化と体幹筋力の関係を知ることにある。等速性筋力計(TEF)を用い、健常成人43名(男性24名、女性19名)の体幹筋力を測定した。測定速度は、30・60・90・120・150deg/secの5種類で、体重に対するピークトルク値の割合(%BW)・体幹屈筋に対する伸筋の比(Ext/Flex比)・ピークトルクを発揮した角度(peak angle)について検討した。その結果、角速度の増加に伴う%BWの減少は伸筋に著明で、Ext/Flex比は減少した。伸筋群のpeak angleは、角速度の増加に伴い減少し伸展位に移行した。屈筋群のpeak angleは、角速度の変化にかかわらずほぼ一定であった。等速性運動における角速度変化の影響は体幹伸筋群に著明であった。

O potencial provocado visual (VEP) é uma resposta cortical registrável na superfície do couro cabeludo, que reflete a atividade dos neurônios de V1. É classificado, a partir da freqüência temporal de estimulação, em transiente ou de estado estacionário. Outras propriedades do estímulo parecem provocar uma atividade seletiva dos diversos grupos de neurônios existentes em V1. Desse modo, o VEP vem sendo usado para estudar a visão humana acromática e cromática. Diversos trabalhos usaram o VEP para estimar a sensibilidade ao contraste de luminância no domínio das freqüências espaciais. Mais recentemente, há estudos que empregaram o VEP para medir os limiares de discriminação de cores. O VEP transiente pode complementar as medidas psicofísicas de sensibilidade ao contraste espacial de luminância e de discriminação cromática, e constitui um método não invasivo para estudar a visão de indivíduos com dificuldades de realizar testes psicofísicos. The Visual Evoked Potential (VEP) is a cortical response obtainable on the scalp. It usually reflects the activity from V1 neurons. It is classified in transient or steady-state, according with the temporal frequency of stimulation. Other stimuli properties evoke a selective activity from different neuronal groups found in V1. This way, VEP have been used to study luminance and chromatic human vision. Several studies used VEP to estimate luminance contrast sensitivity in the spatial frequency domain. More recently, some studies used VEP to measure color discrimination thresholds. The transient VEP shows a good agreement with psychophysical measurements of spatial luminance contrast sensitivity and color discrimination, being a noninvasive method to study vision from subjects with difficulty to perform psychophysical tests. Le potenciel évoqué visuel (VEP) est une réponse corticale qui peut être enregistrée à la surface du cuir chevelu. Il reflète l'activité des neurones de V1 et est classifié, selon la fréquence de stimulation temporale, en transitoire ou stationnaire. D'autres propriétés du stimulus semblent provoquer une activité sélective des divers groupes de neurones existants dans V1. Ainsi, le VEP est utilisé pour étudier la vision humaine achromatique et chromatique. Divers travaux ont utilisé le VEP pour estimer la sensibilité au contraste de luminance dans le domaine des fréquences spatiales. Plus récemment, des études ont utilisé le VEP pour mesurer les seuils de discrimination des couleurs. Le VEP transitoire peut compléter les mesures psychophysiques de sensibilité au contraste spatial de luminance et de discrimination chromatique et constitue une méthode non envahissante pour étudier la vision des sujets avec des difficultés à réaliser les tests psychophysiques.