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Biomedical subjects

Yuichi Kasai

Publications and source records attributed to Yuichi Kasai.

15 recordsLinked to original sources
PubMed2006

A new evaluation method for lumbar spinal instability: passive lumbar extension test.

BACKGROUND AND PURPOSE: Although many studies have described clinical examination measures for the diagnosis of lumbar spinal instability, few of them have investigated the sensitivity and specificity of the measures that were used. The authors devised a passive lumbar extension (PLE) test for assessing lumbar spinal instability. The purpose of this study was to investigate the sensitivity, specificity, and positive likelihood ratio of this test. SUBJECTS AND METHODS: The PLE test as well as the instability catch sign, painful catch sign, and apprehension sign tests were done for 122 subjects with lumbar degenerative diseases. The subjects were divided into 2 groups-instability positive and instability negative-on the basis of findings on flexion-extension films of the lumbar spine. The sensitivity, specificity, predictive values, and positive likelihood ratio of each test were investigated. RESULTS: The sensitivity and specificity of the PLE test were 84.2% and 90.4%, respectively. These values were higher than those of other signs. The positive likelihood ratio of the PLE test was 8.84 (95% confidence interval=4.51-17.33). DISCUSSION AND CONCLUSION: The PLE test is an effective method for examining patients for lumbar spinal instability and can be performed easily in an outpatient clinic.

Adult↗
PubMed2006

Suicide during hospitalization in patients with spinal disease.

STUDY DESIGN: A retrospective study. OBJECTIVE: To examine the frequency and current status of the incidence of deaths by suicide of patients with spinal diseases during hospitalization. SUMMARY OF BACKGROUND DATA: It was reported that most cases of deaths by suicide during hospitalization were patients admitted to the psychiatric ward. There were no reports to the incidence of death by suicide during hospitalization in patients with spinal diseases. METHODS: Of 69,861 patients admitted to the Department of Orthopedics of 28 affiliated hospitals of our university between September 1997 and August 2002, 14,987 patients with spinal diseases were targeted for this study. We examined the number of deaths by suicide during hospitalization. RESULTS: Of the 14,987 patients with spinal diseases, there were 5 deaths (0.03%) by suicide during hospitalization. There were no deaths by suicide in 54,874 patients with orthopedic diseases other than spinal diseases. CONCLUSION: In the treatment of patients with spinal diseases, it seemed important for spinal surgeons to provide comprehensive treatment for the whole patient by paying attention to the relationship between a patient and a physician, in particular, by carefully observing the psychologic status of a patient.

Adult↗
PubMed2006

Effects of driving on low back pain.

BACKGROUND: Many previous studies have demonstrated that driving a car is a risk factor for low back pain (LBP). We have frequent contact with medical representatives who often drive cars for business, and have noticed that many of them suffer from LBP. AIMS: To investigate how driving affected the occurrence of LBP in medical representatives. METHODS: Questionnaire survey of all medical representatives working in Mie Prefecture (Japan). RESULTS: A total of 551 medical representatives replied (92%). We divided the subjects into Group A (with LBP) and Group B (without LBP). There was no significant difference in mean age, height, weight or duration of continuous employment between the two groups. Mean total mileage was 342 539 km in Group A and 251 945 km in Group B (P < 0.05). There was no significant difference in estimated daily mileage or estimated daily driving time between the two groups. As for backrest inclination, most of the respondents in Group A chose 105 degrees and the majority in Group B chose 120 degrees (P < 0.001). CONCLUSION: The total mileage was significantly higher in Group A than in Group B. We considered that the risk for LBP increased as the lumbar spine load accumulated day by day while driving a car almost every day without a holiday.

Adult↗
PubMed2006

[Quality of life in patients with metastatic spinal tumors].

The authors investigated the postoperative quality of life in 89 patients with metastatic spinal tumors. As the results of our study, it was found that spinal surgery could maintain or improve the quality of life, and then most of patients with poor quality of life had multiple spine/bone metastasis or brain/spinal cord metastasis.

Activities of Daily Living↗
PubMed2005

Pre-and postoperative psychological characteristics in mothers of patients with idiopathic scoliosis.

The purpose of the present study was to clarify changes in the psychological state of mothers of patients with idiopathic scoliosis, and to clarify relationships between the psychological states of the mothers and patients. The Maudsley personality inventory (MPI) was administered to 30 patients with idiopathic scoliosis who underwent surgery and their mothers preoperatively and at about 1 year postoperatively. We investigated the relationships between preoperative MPI scores and postoperative scores in patients and their mothers, respectively, and the relationships between MPI scores for patients and mothers. The results of the present study revealed that patients became more extroverted following surgery, while mothers displayed reduced neurotic tendencies. In conclusion, the mothers of patients who undergo corrective treatment for scoliosis may have experienced a substantial psychological burden before surgery, and doctors who treat patients with scoliosis should bear this point in mind.

Adult↗
PubMed2005

Solution structure of the C-terminal transcriptional activator domain of FixJ from Sinorhizobium meliloti and its recognition of the fixK promoter.

FixJ is a response regulator of the two-component signal transduction pathway involved in the transcriptional activation of nitrogen fixation genes of Sinorhizobium meliloti. Upon phosphorylation, FixJ transcriptionally activates the fixK and nifA promoters. We identified a FixJ recognition sequence of 16 bp in the high affinity binding site of the fixK promoter by means of a gel shift assay. In addition, the solution structure of the truncated C-terminal DNA binding domain of FixJ (FixJC) was solved by NMR spectroscopy. FixJC contains five alpha-helices that encode a typical helix-turn-helix motif as a potential DNA binding core with the highest structural similarity toward the C-terminal DNA binding domain of NarL. The addition of the DNA fragment containing the recognition sequence of the high affinity FixJ binding site resulted in intermediate to slow exchange interactions on the NMR time scale in the spectrum of FixJC, while the exchange was rapid in the case of control DNA. These spectral data suggest that more than one molecule of FixJC binds to the recognition sequence, although FixJC alone is present in monomeric form in solution. This result is consistent with a scenario in which a transcriptionally active species of FixJ is a homodimer of the phosphorylated form.

Amino Acid Sequence↗
PubMed2005

A case of idiopathic spinal cord herniation with duplicated dura mater.

The patient was a 48-year-old man in whom a slow progression in walking difficulty occurred over a year. Magnetic resonance imaging (MRI) and computed tomography myelography (CTM) revealed duplicated dura mater from T1 to T12 and spinal cord herniation in the inner layer of the dura at the T4-T5 level. Idiopathic spinal cord herniation with duplicated dura mater was diagnosed, and surgery was performed. Intraoperative findings were of an elliptical defect of about 1 cm in the inner layer of the dura at the T4-T5 level, into which the spinal cord was herniated. A 1.5-cm cephalocaudal incision was created in the inner layer of the dura, and the incarcerated spinal cord was released, resulting in resolution of gait disturbance and an excellent postoperative clinical course. We reviewed the reports of 11 cases of idiopathic spinal cord herniation with duplicated dura mater and summarized the clinical and imaging characteristics as follows: 1) A hernial orifice was found at the T4-T6 level, 2) cross-sectional MRI or CTM showed a "snowman-like" deformation of the spinal cord, and 3) symptoms were often improved by widening the hernia orifice.

Dura Mater↗
PubMed2005

Phosphoglyceride crystal deposition disease in the spine: a case report.

The authors report phosphoglyceride crystal deposition disease in the spine after a lumbar anesthetic given at the time of appendectomy. A 76-year-old Japanese woman with increasing lumbar pain was transported to our hospital in an ambulance. She had tumor-like lesions that had repeatedly appeared in injured soft tissues for >20 years. Osteolytic changes were detected by x-ray in the 12th thoracic vertebra and the 4th lumbar vertebra. Compression of the left L4 nerve root was detected by myelography, and a tumor corresponding to the left L3-L4 intervertebral foramen was determined by computed tomography. An operation to achieve posterior decompression and fusion was performed. The histopathologic tests on this coarse matter revealed a radial deposition of needle crystals and a strong foreign matter reaction in the periphery. Based on the above analyses, the deposited crystals were regarded as phosphoglyceride. Phosphoglyceride crystal deposition disease is characterized by the deposition of crystals of the phospholipid called phosphoglyceride in sites especially susceptible to invasion, such as surgical sites. To our best knowledge, only three cases of phosphoglyceride crystal deposition disease, including this one, have been reported.

Aged↗
PubMed2005

Assessment of gait and balance in patients with spinal diseases using the leg reposition test.

We devised a new leg reposition test, to assess gait and balance in patients with spinal diseases. This study included 344 patients who were scheduled to undergo spine surgery; 14 (4.1%) patients showed positive results. These 14 patients had worse gait status than leg reposition test-negative patients both preoperatively and postoperatively. The leg reposition test is a simple procedure, and requires no specialized equipment. This study showed that the leg reposition test has a strong relation with gait status, and therefore a high clinical significance regarding the assessment of preoperative gait and balance and prediction of postoperative gait status.

Adolescent↗
PubMed2003

A study of patients with spinal disease using Maudsley Personality Inventory.

We administered the Maudsley Personality Inventory (MPI) preoperatively to 303 patients with spinal diseases about to undergo surgery. Patients younger than 20 years, patients previously treated in the Department of Psychiatry, and patients with poor postoperative results were excluded. Patients with N-scores (neuroticism scale) of 39 points or greater or L-scores (lie scale) of 26 points or greater were regarded as "abnormal." Based on clinical definitions we identified 24 "problem patients" during the course and categorized them as "Unsatisfied," "Indecisive," "Doctor shoppers," or "Distrustful." Preoperative MPI categorized 26 patients as abnormal; 22 patients categorized as abnormal became problem patients ( p<0.001). MPI sensitivity and specificity was 84.6% and 99.3%, respectively. Preoperative MPI to patients with spinal disease was found to be useful in detecting problem patients.

Adult↗
PubMed2003

Metal concentrations in the serum and hair of patients with titanium alloy spinal implants.

STUDY DESIGN: A retrospective study of serum and hair metal concentrations in patients with titanium alloy spinal implants was performed. OBJECTIVE: To determine the incidence and possible causes of abnormal metal concentrations. SUMMARY OF BACKGROUND DATA: Several studies have demonstrated that metal debris are present in the tissues surrounding titanium alloy spinal implants. However, few studies suggest that metals dissolve, circulate in the body fluid, and accumulate in remote organs. METHODS: Titanium, aluminum, and vanadium concentrations in serum and hair were measured after surgery in 46 patients with titanium alloy spinal implants (12 patients in the implant failure group and 34 patients in the no implant failure group) and 20 patients without spinal implants (control group). All the subjects were examined again 1 year after the first examination or implant removal. RESULTS: Of the 46 patients with titanium alloy spinal implants, 16 patients (34.8%) exhibited abnormal serum metal concentrations and 11 patients (23.9%) exhibited abnormal hair metal concentrations. In the control group, three patients (15%) exhibited only abnormal serum and metal aluminum concentrations at the first examination. In both of the two patients who exhibited abnormal serum titanium concentrations and then had their spinal implants removed, the serum and hair titanium levels decreased to beneath the reference value limit in 1 year after the removal. Comparison of the implant failure and no implant failure groups showed no significant differences in the incidence of abnormal serum concentrations of titanium, aluminum, or both metals. Therefore, serum metal concentrations did not seem to be a useful indicator of hardware loosening or implant failure. CONCLUSIONS: Approximately one third of patients with titanium alloy spinal implants exhibited abnormal serum or hair metal concentrations at a mean time of mean 5.1 years after surgery. Titanium or aluminum may travel to distant organs after dissolution of metals from the spinal implants.

Adolescent↗
PubMed2003

Mixture ratios of local bone to artificial bone in lumbar posterolateral fusion.

There have been no reports on the effects of the mixture ratio of local bone graft to artificial bone on the outcome of intervertebral bone fusion. The purpose of this study was to determine whether the mixture ratio of local bone removed from laminae and spinous processes to apatite- and wollastonite-containing glass ceramic (AWGC) granules affected fusion rates in spinal fusion. Posterolateral lumbar fusion at two levels without spinal instrumentation was performed in 35 patients who were diagnosed with lumbar spinal canal stenosis. The patients were randomly divided into three groups, each of which received a different mixture ratio of local bone to AWGC granules: 2:1, 1:1, and 1:2. The total mass of grafted bone was 20 g in all three groups. The fusion rate was approximately 80% in all three groups. Our results indicate that lumbar posterolateral fusion can be successfully achieved even when the mixture ratio of local bone graft to AWGC granules is 1:2.

Aged↗
PubMed2002

Change of barometric pressure influences low back pain in patients with vacuum phenomenon within lumbar intervertebral disc.

The present study investigates whether changes in barometric pressure influence low back pain in patients with vacuum phenomenon within lumbar intervertebral discs. Twenty-four patients with low back pain were examined: 12 with vacuum phenomenon within the intervertebral discs (VP [+] group) and 12 without the vacuum phenomenon (VP [-] group). All patients consented to an evaluation of low back pain in a hyperbaric oxygen chamber. In the VP (+) group, low back pain became more severe in one patient when atmospheric pressure was elevated, and in eight patients when atmospheric pressure was decreased. In the VP (-) group, two patients experienced more severe low back pain when atmospheric pressure was decreased. Our study demonstrated that low back pain might be aggravated by atmosphere depression in patients with lumbar disease associated with the vacuum phenomenon.

Aged↗
PubMed2001

Length of the ribs in patients with idiopathic scoliosis.

There have been few reports of actual measurements of rib length in patients with idiopathic scoliosis. We measured the lengths of the 7th to 12th ribs in 28 patients with idiopathic scoliosis with right convex single thoracic curve. The measurements were performed by the multi-projection volume reconstruction method of computed tomography. A significant difference between the left and right side length (laterality) was observed in the 11th and 12th ribs. Laterality was not observed in the 7th, 8th, 9th, and 10th ribs. In this study, it appeared inadequate to conclude that the laterality of rib length caused the scoliosis. Since the 11th and 12th ribs were floating ribs, we speculated that, on the contrary, the scoliosis affected the laterality of the rib length.

Adolescent↗