Nara Medical University Hospital
Global Institutional repository of Nara Medical UniversityNot a member yet
3071 research outputs found
Sort by
臼蓋形成不全の股関節に行った転子間骨切り術後症例に対するカスタムメイドセメントレスステムの術後10年以上の成績
Get PDFBackground: During fixation of total hip arthroplasty (THA) after osteotomy, it is difficult to obtain a good cement mantle with a cemented stem and to obtain good fit along the medullary canal with a ready-made stem. We developed a CT-based custom stem, which was inserted after osteotomy in THA. Methods: We investigated 32 hips in 28 patients. The mean patient age at surgery was 62 and the mean follow-up period was 13 years. The previous osteotomy was intertrochanteric varus femoral osteotomy in 14 hips, intertrochanteric valgus femoral osteotomy in 17, and Schanz osteotomy in one. CT studies were obtained with a 5 mm slice intervals and 2 mm slice width. We produced stems made of Ti-6Al-4V. The stems did not have collars and the proximal third was coated with a 400-μ. m-thick porous coating covered with 20-μ m-hydroxyapatite (HA) coating. Results: The Harris Hip Score improved from a preoperative mean of 49.9 points to a postoperative mean of 82.7 points. One patient complained of postoperative thigh pain. Fractures occurred in two hips. Dislocation occurred in three patients. To date. no patient has reqired revision of the stem due to aseptic loosening. There was bone-ingrown fixation in all hips. Severe stress shielding was found in 14 hips (44%) Conclusion: Stable fixation was achieved with the proximal press-fit of the custom stem. Although stress shielding was observed in 14 hips, excellent results were obtained over a follow-up period of 10 years with this custom stem system for hips after intertrochanteric femoral osteotomy.博士（医学）・乙第1419号・平成30年6月27
Self-Directed Learning for First Year Medical Students ; for Bridging the Gap Between Entrance Examinees and Beginners at Clinical Learning.
Get PDFIn recent years, more and more enthusiasm and pressure have been put into the selection of the candidates for medical schools in ]apan, and a larger gap has been witnessed between the preparatory study and the pre-service training in medical education. As a result, there is a requirement for a shift in the learning attitudes of first-year students at an earlier stage. In this article, from the point of view of studies of education, and especially from that of the understanding of learners, we focus on a case study of an educational practice; the course of “Self-Directed Learning". The Self-Directed Learning (SDL) model was developed as a learning model suited to adult learners' characteristics, at the opposite end to the Teacher Directed Learning (TDL) model. In the class, new medical students learn about TDL and SDL based on the ideas of adult education (andragogy), reflect on their learning histories using the two models as frameworks, and participate in the exercise of utilizing human resources (with M. Knowles's textbook: Self-Directed Learning; A Guide for Learners and Teachers). Then, they identify the image of the medical doctors they wish to become, try to draw up a feasible route to their goal, and visualize their learning objectives, the learning process and procedures on their own Learning Contract sheets. Working on their own Learning Contracts, they also gain a prospect on their future learning process through the graduate years. In the results of the text mining analysis of their reflection papers, we could see the significance of providing the learners with opportunities to make Leaning Contracts at the beginning of the pre-service training. Further analysis of the data, and the development of a follow-up educational scheme are left to the next stage of our studies
三角線維軟骨複合体損傷における尺側手根伸筋腱と遠位橈尺関節のMRI画像分析
Get PDFBACKGROUND: We compared the incidence of extensor carpi ulnaris (ECU) tendon and distal radioulnar joint (DRUJ) abnormalities using magnetic resonance imaging (MRI) between patients with triangular fibrocartilage complex (TFCC) tears and subjects without ulnar wrist pain. Additionally, we aimed to identify potential predictors of these MRI lesions. METHODS: The TFCC group comprised 70 consecutive patients with TFCC tears. The control group comprised 70 age- and sex-matched subjects without ulnar wrist pain. We evaluated the presence or absence of fluid collection in the DRUJ and ECU peritendinous area and longitudinal ECU tendon splitting. Dimensions of the fluid collection area around the ECU tendon were measured to evaluate the severity. The incidences of these abnormal MRI findings were compared between the two groups. We analyzed the correlation between the presence of ECU tendon and DRUJ lesions and variables including age, magnitude of ulnar variance, and type of TFCC tear. RESULTS: Significant differences were found between the two groups in the incidence of fluid collection of the DRUJ and ECU peritendinous area, and longitudinal ECU tendon splitting. Among the 70 patients with TFCC tears, age and the magnitude of ulnar variance were significantly correlated with the severity of fluid collection around the ECU tendon. The magnitude of ulnar variance in patients with DRUJ fluid collection was significantly larger than that in patients without fluid collection. There was a significant correlation between the presence of disc tears and DRUJ fluid collection. CONCLUSION: We found a higher incidence of accompanying abnormal MRI findings of the ECU tendon and DRUJ in patients with TFCC tears than in the control group. The presence of disc tears, the magnitude of ulnar variance, and age may be risk factors for these MRI lesions associated with TFCC tears.博士（医学）・甲第690号・平成30年11月30日Copyright © 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved
ヒト間葉系幹細胞はエオタキシン3/CCR3経路を介して前立腺癌細胞の浸潤能を増加させる
Get PDFThis study aimed to clarify the role of mesenchymal stem cells (MSCs) as a component of the cancer microenvironment. We investigated the homing-related chemokine expression levels of MSCs treated with a prostate cancer cell line (PC-3) -conditioned medium. Among several homing chemokines, an antibody array revealed that expression of eotaxin-3 (but not eotxin-1 and -2) was highly enhanced in MSCs treated with PC-3-conditioned medium. A gene expression array showed significantly increased expression of CCR3, a receptor of eotaxin-3, in PC-3. In a matrigel invasion assay, interferon-gamma, a specific inhibitor of eotaxin-related homing, significantly reduced the transmigration of PC-3 cells, under co-cultured condition with MSCs, in a dose-dependent manner (P < 0.05). Consistent with these results, anti-CCR3 antibody successfully reduced PC-3 migration under the co-cultured condition. These findings suggest that MSCs to modulation of the invasive potential of prostate cancer cells via the eotaxin-3/CCR3 axis.博士（医学）・乙第1424号・平成30年11月30日© 2018 Elsevier GmbH. All rights reserved
Analysis of Dimeric αβ Subunit Exchange between PEGylated and Native Hemoglobins (α 2 β 2 Tetramer) in an Equilibrated State by Intramolecular ββ-Cross-Linking.
No full textVarious chemical modifications of hemoglobin (Hb) including PEGylation have been investigated to produce red blood cell substitutes. Some of those modifications are designed on the premise that the α2β2 tetrameric structure of Hb is fundamentally stable and that it rarely dissociates into two αβ dimers in a physiological condition. However, in the present work using the “clipping” method we detected and quantitatively analyzed the considerable degree of exchange reaction of αβ subunits between β93Cys-bis-PEGylated and native Hbs through dissociation into αβ dimers and restructuring to α2β2 tetramer in a physiological condition. The equilibrium constant (Keq) of subunit exchange reactions increased from 0.82 to 2.86 with increasing molecular weight of PEG from 2 to 40 kDa, indicating that longer PEG chains enhanced such exchange reaction. The results suggest that the exchange might occur for other modified Hbs even at a practically high concentration for use as a red blood cell substitute.This document is the Accepted Manuscript version of a Published Work that appeared in final form in Biomacromolecules, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see https://doi.org/10.1021/acs.biomac.8b00728
