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Nihon Seikeigeka Gakkai zasshi最新文献

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[Pain-induced gene expression in the nervous system]. [神经系统疼痛诱导的基因表达]。
Pub Date : 1996-01-01
E Senba
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引用次数: 0
[Variety in radicular symptoms and signs at the lumbosacral region]. 腰骶区神经根症状和体征的多样性。
Pub Date : 1996-01-01
M Hasue
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引用次数: 0
[Rotational acetabular osteotomy--long-term results]. [旋转髋臼截骨术-长期结果]。
Pub Date : 1996-01-01
S Ninomiya
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引用次数: 0
[Total health promotion plan for laborers--physical exercise and bone metabolism]. 【劳动者健康促进总体方案——体育锻炼与骨骼代谢】。
Pub Date : 1996-01-01
S Niwa, F Takayanagi
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引用次数: 0
[Biochemical and morphological studies on soft tissues in hip osteoarthrosis]. [髋关节骨关节病软组织的生化形态学研究]。
Pub Date : 1995-12-01
T Tsuchimochi

To investigate the pathogenesis of osteoarthrosis, we have performed biochemical and morphological studies, other than roentgenological examination, on the soft tissues. Biochemical analyses of collagen were performed on muscles (gluteus medius) in normal and in pathological cases. In the terminal stage of osteoarthrosis, we observed more immature collagen fibers in muscles, than in normal cases. In the preosteoarthrosis stage, immature collagen formation was inconsistent with various degrees of immaturity observed. Morphologically, irregularity in the muscle fibers and interfascicular-fibrosis was observed in the gluteus medius only at the terminal stage but not at the preosteoarthrosis stage. In some cases, we observed a predominance and/or grouping of type 1 fibers. Among the 20 cases with preosteoarthrosis, 3 cases (15%) showed marked biochemical changes in both quantity and quality of collagen fibers in the gluteus medius, as compared with cases at the terminal stage. These findings may be valuable in studying the onset and development of the pathophysiology of osteoarthrosis.

为了研究骨关节病的发病机制,除了x线检查外,我们还对软组织进行了生化和形态学研究。对正常和病理的臀中肌进行胶原蛋白的生化分析。在骨关节病终末期,我们观察到肌肉中未成熟的胶原纤维比正常病例多。在骨关节前阶段,未成熟的胶原形成与不同程度的不成熟不一致。形态学上,臀中肌纤维不规则和束间纤维化仅在骨关节病末期出现,而在骨关节病前期未出现。在一些病例中,我们观察到1型纤维的优势和/或分组。在20例骨关节前病变中,3例(15%)的臀中肌胶原纤维在数量和质量上均有明显的生化变化,与晚期病例相比。这些发现可能对研究骨关节病的发病和病理生理发展有价值。
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引用次数: 0
[Anatomical study of the ligaments in the occipito-atlantoaxial complex]. 枕寰枢韧带的解剖学研究。
Pub Date : 1995-12-01
K Okazaki

To investigate the role of the ligamentous complex in the stability of the atlanto-axial joint, the macroscopic anatomy of the occipito-atlanto-axial complex was studied in 44 cadavers involving the cruciate ligament of atlas, alar ligament, and the anterior atlanto-axial ligament (AADL). The transverse ligament (TL) had two layers, one was membranous tissue and the other was ligamentous. The mean length of the TL was 19.7 mm (range 14-25 mm). The TL was significantly longer in males than in females. The diameter of the TL was thinnest at the centre (mean 2.0 mm, range 1-5 mm). The thicker ligaments were significantly larger in diameter. The alar ligament (AL) was dissected and examined in all cadavers. The direction of the AL ran postero-laterally. This ligament was divided into five types according to the fiber orientation. Type 1 was separated type in its origin at the dens. Type 2 was partially connected type. Type 3 was totally connected with a covered dens tip. Type 4 was totally connected but did not cover the dens tip. Type 5 was a combined type of Type 3 covering Type 1. The fiber direction of the AL was divided into three types; caudocranial type, horizontal type, and craniocaudal type. The AADL was examined in 24 specimens (60%). This ligament existed bilaterally in 18 specimens (45%) and hemilaterally in 6 (15%). The right side only was examined in 2 specimens (5%) and the left side only in 4 specimens (10%). In 6 specimens, the orientations of this ligament was identified and the shape was found to be thin. From these results, it was considered that not only TL, but also the AL and AADLs played an important role in stabilizing the atlanto-axial complex.

为了探讨韧带复合体在寰枢关节稳定性中的作用,对44具尸体的寰枢交叉韧带、翼韧带和寰枢前韧带(AADL)进行了枕寰枢复合体的宏观解剖研究。横韧带分为两层,一层为膜组织,另一层为韧带组织。TL的平均长度为19.7 mm(范围14-25 mm)。雄性的TL明显长于雌性。TL的直径在中心最薄(平均2.0 mm,范围1-5 mm)。较厚的韧带直径明显较大。所有尸体均解剖并检查鼻翼韧带(AL)。AL的方向是后外侧的。该韧带根据纤维方向分为五种类型。1型为分离型,起源于齿槽处。类型2为部分连接型。第三型完全与有盖的齿尖有关。类型4完全连接,但没有覆盖齿尖。类型5是类型3覆盖类型1的复合类型。AL的纤维方向分为三种类型;尾颅型、水平型和颅侧型。检查24例(60%)AADL。该韧带在18例(45%)标本中存在双侧,6例(15%)标本中存在半侧。右侧2例(5%),左侧4例(10%)。在6个标本中,确定了该韧带的方向,发现其形状较薄。综上所述,认为除了TL外,AL和aadl在稳定寰枢椎复合体中也起着重要的作用。
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引用次数: 0
[Epidemiological study of osteoporosis]. [骨质疏松的流行病学研究]。
Pub Date : 1995-12-01
A Sudo, T Hineno, G Okada, Y Kasai, Y Ogihara, Y Ishigami

An epidemiological investigation of osteoporosis was carried out in a community in which fishing is the primary industry, and correlations were investigated between the bone mass and various risk factors for osteoporosis and biochemical findings. In 852, who could be examined directly, of the 3541 males and females aged 40 years or above living in Nansei Town, Watarai District, Mie Prefecture, the age, sex, height, body weight, years after menopause, married or unmarried, area of residence, daily activity, and intakes of milk, fish, and alcohol were studied by direct oral inquiry, and the serum calcium, inorganic phosphorus, alkaline phosphatase, and total protein were measured. The subjects were divided into a decreased bone mass group who showed grade I or more advanced loss in bone mass and a normal bone mass group who showed no or only slight loss in bone mass on the basis of microdensitometry (MD). Eighty-two subjects (9.6%) were classified as the decreased bone mass group. Items that showed a close correlation with sigma GS/D, which is an index of bone density, were age, years after menopause, serum alkaline phosphatase level, height, and body weight in females, age and serum alkaline phosphatase level in males. In the decreased bone mass group, 79 of the 82 subjects were females. Significant differences were observed between the decreased bone mass group and the normal bone mass group in age, years after menopause, serum alkaline phosphatase level, height, and body weight. From these results, a high age, being a female, low height, and a low body weight were found to be factors correlated with osteoporosis. Also, the bone mass was correlated with the serum alkaline phosphatase level and years after menopause.

在一个以渔业为主要产业的社区开展了骨质疏松症流行病学调查,并调查了骨量与骨质疏松症各种危险因素和生化结果之间的相关性。对居住在Mie县Watarai区南世镇40岁及以上的3541名可直接检查的852名男性和女性,采用直接口头询问的方法,研究了年龄、性别、身高、体重、停经年数、已婚或未婚、居住地区、日活动量、乳、鱼、酒的摄入量,并测定了血清钙、无机磷、碱性磷酸酶和总蛋白。研究对象被分为骨量减少组和正常骨量组,前者表现出I级或更严重的骨量损失,后者根据微密度测定(MD)显示没有或只有轻微的骨量损失。骨量减少组82例(9.6%)。与骨密度指标sigma GS/D密切相关的项目有女性的年龄、绝经年限、血清碱性磷酸酶水平、身高、体重,男性的年龄和血清碱性磷酸酶水平。在骨量减少组中,82名受试者中有79名是女性。骨量下降组与骨量正常组在年龄、绝经年限、血清碱性磷酸酶水平、身高、体重等指标上均有显著差异。从这些结果来看,高年龄、女性、低身高和低体重是骨质疏松症的相关因素。骨量与血清碱性磷酸酶水平及绝经年限相关。
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引用次数: 0
[MEPs by transcranical magnetic stimulation in experimental acute spinal cord injury]. [经颅磁刺激治疗实验性急性脊髓损伤的MEPs]。
Pub Date : 1995-12-01
H Kawakita, O Kameyama, R Ogawa, A Tsubura

The efficacy of motor evoked potentials (MEPs) induced by magnetic brain stimulation was investigated experimentally for assessing acute spinal cord injury. Twenty-five rabbits were employed for the acute spinal cord injury model. Following laminectomy under intravenous and intraperitoneal anesthesia, the spinal cord at the level of the fifth lumbar vertebra wsa injured by Allen's weight drop method. MEPs from the tibialis anterior muscle (M-MEP) were recorded using bipolar electrodes: prior to the injury; immediately after the injury; at 30 min, 1 hour, 3 hours, and at 5 hours after the injury. MEPs from the spinal cord (S-MEP) were recorded proximal to and distal from the injury site using epidural tube electrodes. Subjects were divided into two groups; complete and incomplete paralysis, according to the degree of motor dysfunction at 1 week after the injury. All the 13 subjects with incomplete paralysis had shown immediately after the trauma a prolongation in the M-MEP latency, with a polyphasic wave form seen in 5 of them. In 3 cases, the amplitude of the M-MEPs was decreased without any change in wave form. In others, there was some variation in the change of wave form, but there was no relationship found between the change of wave form and the degree of motor dysfunction in this group. Histopathologically, infiltration of the inflammatory cells and diffuse hemorrhaging were seen in the gray matter of the injured spinal cord in the incomplete paralysis group. In 7 of the 10 cases with complete paralysis, the M-MEP disappeared within 3 hours. Histopathologically, large areas of the nerve cells disappeared from the gray matter in this group. The S-MEP disappeared immediately after trauma in the group with complete paralysis as well as in those with incomplete paralysis. This study indicated that MEPs taken immediately after a trauma may predict the severity of a spinal cord injury and were useful for evaluating the prognosis of motor function during the acute phase of a spinal cord injury.

实验研究了脑磁刺激诱发的运动诱发电位(MEPs)在急性脊髓损伤评估中的作用。采用25只家兔建立急性脊髓损伤模型。在静脉和腹腔麻醉下行椎板切除术后,采用Allen's失重法损伤第5腰椎水平处的脊髓。使用双极电极记录胫骨前肌(M-MEP)的mep:损伤前;受伤后立即;损伤后30分钟、1小时、3小时和5小时。使用硬膜外管电极记录损伤部位近端和远端脊髓mep (S-MEP)。受试者被分为两组;根据损伤后1周运动功能障碍的程度,分为完全性和不完全性瘫痪。13例不完全瘫痪患者均在创伤后立即出现M-MEP潜伏期延长,其中5例出现多相波。3例中,M-MEPs的振幅下降,但波形没有变化。在其他组中,波形的变化有一定的变化,但在本组中波形的变化与运动功能障碍的程度没有关系。不完全瘫痪组损伤脊髓灰质可见炎性细胞浸润及弥漫性出血。10例完全瘫痪中有7例M-MEP在3小时内消失。在组织病理学上,这组灰质中大面积的神经细胞消失了。完全瘫痪组和不完全瘫痪组的S-MEP在创伤后立即消失。这项研究表明,创伤后立即采取的mep可以预测脊髓损伤的严重程度,并有助于评估脊髓损伤急性期运动功能的预后。
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引用次数: 0
[Triple osteotomy (modified Tönnis method) for advanced coxarthrosis]. [三联截骨术(改良Tönnis法)治疗晚期关节关节病]。
Pub Date : 1995-12-01
T Ohmura, Y Ohneda, S Tamai

The results of 79 triple osteotomies (modified Tönnis method) for advanced coxarthrosis in 76 patients, performed between 1986 and 1991 in our clinic, were evaluated. The operation was performed for 72 females and 4 males, with a mean age of 45.6 years, ranging from 20 to 59 years. The mean follow-up period was 4 years and 2 months, ranging from 1.6 to 9 years. The operative technique used was a modified Tönnis method originally described by Tönnis in 1981. Using a dorsal approach, the ischium is first osteotomized and then turning the patient to the supine position, the osteotomies of the pubis and ilium are performed through an anterior approach. The osteotomized acetabulum is rotated antero-laterally as much as possible to cover the femoral head sufficiently and is fixed with 4 or 5 Steinmann pins. For the clinical evaluation, we used the Japanese Orthopaedic Association Hip Score. The average score improved from 68 points preoperatively to 90 points postoperatively. The roentogenological evaluation confirmed the following results; excellent in 36 hips (46%) with good joint space and good joint congruity, fair in 35 hips (44%) with good joint space and fair joint congruity, and poor in 8 hips (10%) with narrowed joint space. The average CE angle at follow-up was 40.3 degrees in 36 hips with excellent result, 33.8 degrees in 35 hips with fair, and 32.4 degrees in 8 hips with poor (p < 0.01). Good remodelings are obtained, if the CE angle becomes more than 40 degrees postoperatively in acetabular rotational osteotomy for advanced coxarthrosis.

本文对1986年至1991年间在我院行79例晚期关节关节炎患者行三联截骨术(改良Tönnis法)的结果进行了评价。手术患者女性72例,男性4例,平均年龄45.6岁,年龄20 ~ 59岁。平均随访时间4年2个月,1.6 ~ 9年不等。使用的手术技术是一种改进的Tönnis方法,最初由Tönnis在1981年描述。采用背侧入路,首先对坐骨进行截骨,然后将患者转至仰卧位,耻骨和髂骨的截骨通过前入路进行。截骨后的髋臼尽可能向前外侧旋转以充分覆盖股骨头,并用4或5个Steinmann销固定。对于临床评估,我们使用了日本骨科协会髋关节评分。平均评分由术前68分提高到术后90分。肾源学评价证实了以下结果:关节间隙和关节一致性良好的36例(46%)为优等,关节间隙和关节一致性良好的35例(44%)为一般,关节间隙和关节一致性良好的8例(10%)为差。随访时CE角平均为40.3°,优者36髋,一般者35髋,33.8°,差者8髋,32.4°(p < 0.01)。在髋臼旋转截骨术治疗晚期关节关节病后,如果CE角大于40度,则可获得良好的重建。
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引用次数: 0
[Clinical study of cervical radiculopathy after laminoplasty for cervical myelopathy]. 颈椎病椎板成形术后颈神经根病的临床研究。
Pub Date : 1995-12-01
K Sasai, T Saito, S Akagi, H Watanabe

We have retrospectively determined the preoperative risk factors in cervical radiculopathy after laminoplasty for cervical myelopathy using preoperative neuroradiographical findings and electrophysiological studies. Of the 67 patients who underwent laminoplasty, 10 patients (14.9%) postoperatively showed cervical radioculopathy. The preoperative radiographical findings had included cervical lordosis, intraspinal cord centering, and anterior protrusion of the apex of the superior articular process. Needle electromyography, somatosensory evoked potentials (SEPs), sensory nerve action potentials (SNAP) were preoperatively examined in 42 cases. There was no relationship between the postoperative radiculopathy and the preoperative radiographical findings. Six (100%) of 6 cases preoperatively diagnosed as C5 radiculopathy (postganglionic type) with Erb-P 14 interpeak latency of dermatomal SEPs and SNAP, developed postoperative C5 radiculopathy. One (25%) of 4 cases preoperatively diagnosed as C6 radiculopathy developed postoperative C6 radiculopathy. No case preoperatively diagnosed as C7 or C8 radiculopathy developed postoperative radiculopathy. This study suggested that an important risk factor for postoperative radiculopathy was subclinical C5 radiculopathy (postganglionic type) that could be preoperatively evaluated using electrophysiological studies.

我们回顾性地确定了颈椎病椎板成形术后颈椎病的术前危险因素,利用术前神经影像学检查和电生理研究。67例行椎板成形术的患者中,10例(14.9%)术后出现颈椎放射性眼病。术前x线检查结果包括颈椎前凸,脊髓内居中,上关节突尖前突。术前检查42例患者的针肌电图、体感诱发电位(sep)、感觉神经动作电位(SNAP)。术后神经根病与术前影像学检查无关系。6例术前诊断为C5神经根病(节后型),伴有皮皮sep和SNAP的erb - p14峰间潜伏期,术后发生C5神经根病6例(100%)。术前诊断为C6神经根病的4例患者中有1例(25%)术后发展为C6神经根病。术前诊断为C7或C8神经根病的病例无术后发生神经根病。本研究提示,术后神经根病的一个重要危险因素是亚临床C5神经根病(神经节后型),可通过术前电生理研究进行评估。
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引用次数: 0
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Nihon Seikeigeka Gakkai zasshi
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