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Volume 58, Issue 4
Displaying 1-5 of 5 articles from this issue
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Original Contribution
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AKIO KATAOKA, SHOUKO HIRAKAWA, MANAMI IWAMOTO, YUMI SAKUMURA, RYOUTA Y ...2011 Volume 58 Issue 4 Pages 99-103
Published: April 30, 2012
Released on J-STAGE: July 27, 2012
JOURNAL FREE ACCESSTransvaginal hydrolaparoscopy (THL) has become a first-line procedure in infertile women, and THL by flexible fiberscope (THLF) is a less traumatic and a more suitable outpatient procedure than diagnostic laparoscopy. We performed THLF on infertile women based on four indications; (i) tubal obstruction and⁄or peritubal adhesion as suggested by hysterosalpingography (HSG); (ii) serum antibody against Chlamydia (C) positive for trachomatis; (iii) diagnosis of early stage endometriosis; and (iv) unexplained infertility. Seven women with a chief complaint of infertility were the subjects of the present study. Two of the 7 cases had a history of gynecological surgery. Six of 7 cases had a history of C. trachomatis infection. Four cases had abnormal findings of fallopian tubal patency in hysterosalpingography. Parafallopean tubal atresia and tubal obstruction were observed in 4 cases by THLF. In one case the bilateral ovaries were extremely small and atrophic. None of the cases had serious complications after THLF. After the THLF, six women were able to have a baby by assisted reproductive technology (ART) within two years.
As THL was developed using a solid scope, indications for THL have been limited, and have excluded cases with retroverted uterus or peritoneal surgical history. In the present study, THL using a fiberscope was carried out in infertile women with retroverted uterus, and in women with a history of peritoneal cavity surgery to examine the feasibility of extending the indications for THL. Findings on the THLF were given precedence in deciding further treatment strategies. We believe that THLF can be useful in helping patients with these indications to successfully achieve early pregnancy. This study is the first trial of THLF.View full abstractDownload PDF (696K) -
YUUKI MATSUMOTO, KOUJI TOYOMASU, NAOHISA UCHIMURA2011 Volume 58 Issue 4 Pages 105-115
Published: April 30, 2012
Released on J-STAGE: July 27, 2012
JOURNAL FREE ACCESSHealthy sleep habits entail not only sleeping for a sufficient period (quantity) but also regularity of the sleep cycle and getting sound sleep (quality). University students often have erratic schedules that cause irregular sleep patterns even though sleep durations remain relatively constant. This study compared the physical and mental health of 90 male university students with different sleep habits. We created sleep habit scales using the Tokyo Metropolitan Institute for Neuroscience life habits inventory (TMIN-LHI; Miyashita, 1994) by performing a factor analysis and classifying sleeping habits based on regularity, quality, and quantity. Four types of sleep habits were identified by cluster analysis; good sleep was characterized by regular and high quality sleep but of relatively short sleep duration; long sleep was regular and relatively long but of low quality; short sleep was of high quality but short and irregular, while poor sleep was irregular, of low quality, and relatively long. The good sleep group had a significantly lower average waist circumference, and lower systolic and diastolic blood pressure. The long and poor sleep groups, which both had low quality sleep, scored lower than the national standard on the mental component summary (MCS) calculated from the Social Functioning-36 (SF-36) short-form health survey. Furthermore, the average MCS score of the poor sleep group was significantly lower than that of any other sleep habit group. Subjects with poor sleep also scored lowest on the Self-rating Depression Scale (SDS). In addition, the short and poor sleep groups were prone to glucose or lipid metabolism disorders. Maintaining good physical and mental health without sound sleep and a regular sleep cycle is difficult, even if sleeping hours are kept constant. Therefore, we included the assessment of regularity and quality in addition to hours of sleep in order to develop appropriate sleep guidelines for improved physical and mental health.View full abstractDownload PDF (748K) -
MAU AMAKO, YOSHIAKI YAMAMOTO, KATSUMI NAKAMURA, SATORU TOBINAGA, EIJI ...2011 Volume 58 Issue 4 Pages 117-125
Published: April 30, 2012
Released on J-STAGE: July 27, 2012
JOURNAL FREE ACCESSTo improve our ability to visualize the Adamkiewicz artery (AKA), we developed a modified intravenous CT angiography technique, which we refer to as right atrial CT (RA-CT) angiography. In this study, AKA detection rate and visualization of the arterial continuity from the aorta to the anterior spinal cord artery (ASA) was evaluated using RA-CT angiography.
We performed RA-CT angiography in 110 patients with abdominal, thoracic descending, or thoracoabdominal aortic aneurysms. In RA-CT angiography, contrast medium with a high iodine concentration (370 mg⁄dl) was injected twice into the right atrium at a high injection rate (8.0 ml⁄sec), and two CT scans, starting at 20 sec after the first injection and at 35 sec after the second injection, respectively, were performed. All CT images were obtained using an 8- or 16-detector CT scanner at a slice thickness of 0.625 mm. The AKA was defined as the largest radiculomedullary artery with a characteristic hairpin turn, and with continuity from the aorta to the ASA.
The AKA with hairpin turn was detected in all patients (100%), and continuity from the aorta to the ASA was confirmed in 99 of the 110 patients (90.0%). The AKA arose between Th8 and L1 in 86 of these patients (86.8%), and originated from the left side in 71 patients (71.7%).
RA-CT angiography may be useful for visualizing the AKA and the arterial continuity from the aorta to the ASA in patients with aortic aneurysm, although the use of more advanced CT machines will provide safe and easy identification of the AKA and arterial continuity with a small amount of contrast medium and a single scan.View full abstractDownload PDF (22551K)
Case Report
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AKIO KATAOKA, SHOUKO HIRAKAWA, MANAMI IWAMOTO, YUMI SAKUMURA, RYOUTA Y ...2011 Volume 58 Issue 4 Pages 127-130
Published: April 30, 2012
Released on J-STAGE: July 27, 2012
JOURNAL FREE ACCESSLarge numbers of patients with deletions of the long arm of chromosome 13 have been described. However, only a few instances have been reported of monosomy 13 ⁄ r(13) mosaicism. A 31-year-old Japanese woman underwent an ultrasound tomographic screening, which detected a fetus with a nuchal translucency (NT) of ›5.8mm, indicating an increased risk of fetal chromosomal abnormality. An amniocentesis (AC) was performed, and the karyotype was 46,XX,r(13)(p11q33)[18] ⁄ 45XX[12]. Ultrasound showed echogenic skin edema. Phenotype of the fetus after delivery revealed some anomalies, including hyponasal bridge, hypertelorism, ambiguous genitalia with huge clitoris, low-set ear, neck edema and webbing.
Deletion of the long arm of chromosome 13 is associated with a wide spectrum of abnormalities, including retinoblastoma, mental and growth retardation, brain malformations, heart defects, distal limb deformities, and digestive, urogenital, and other abnormalities. The present case, however, had anomalies which were too faint to be detected by ultrasound tomography. Prenatal diagnosis of deletion 13q syndrome is rare. A number of reports have documented an association between increased NT and chromosomal defects. Ultrasound did not identify any major anomaly in this case, however amniocentesis was able to detect this rare abnormality.View full abstractDownload PDF (773K) -
HIROKI OHZONO, MASAFUMI GOTOH, YASUHIRO MITSUI, KATSUYA KANESAKI, TAKA ...2011 Volume 58 Issue 4 Pages 131-133
Published: April 30, 2012
Released on J-STAGE: July 27, 2012
JOURNAL FREE ACCESSFracture of the lesser tuberosity of the humerus often occurs concomitant with posterior shoulder dislocation or proximal humeral fracture, while isolated fractures are extremely rare. We report a case in which an isolated fracture of the lesser tuberosity of the humerus occurred due to a distinctive pathogenic mechanism. A 43-year-old male had his right shoulder forced into internal-rotation (i.e. back reach position) when he fell into a ditch approximately 70 cm wide and 1.5 m deep. Subcutaneous bleeding and tenderness were detected anteriorly in the shoulder, with restricted range of motion. Radiographs indicated a fracture of the lesser tuberosity of the humerus. Three-dimensional computed tomography (CT) confirmed an isolated fracture of the lesser tuberosity, which was displaced anteromedially by more than 5 mm from its previous anatomical position. During operation, the fractured fragment of the lesser tuberosity was reduced easily and fixed by a cancellous bone screw. At postoperative 2 years, the patient has recovered full range of motion with sufficient muscle strength, and has returned to work. The pathogenic mechanisms in this case were unique, differing from those that have been previously reported.View full abstractDownload PDF (720K)
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