Hemodialysis Treatment Influences Postoperative Activities of Daily Living Improvement for Patients with Hip Fractures.

Objectives: The aim of this study was to investigate the influences of hemodialysis (HD) on activities of daily living (ADL) in patients with hip fracture. Methods: This study included 28 patients (14 HD and 14 non-HD patients) with acute hip fracture. The effects of variables such as age, sex, surgical procedure, length of hospital stay, serum albumin, C-reactive protein (CRP), number of physical therapy units, and functional independence measure (FIM) were assessed. For each factor, a two-group comparison was conducted between the HD and non-HD groups. Multiple regression analysis was used to examine the factors affecting FIM efficacy (E-FIM). Results: For HD patients, total and motor FIM at discharge, E-FIM, and albumin level were significantly lower than in non-HD patients. Length of hospital stay was significantly longer for HD patients. Multiple regression analysis showed that HD had a negative effect on E-FIM. Conclusions: The results suggest that rehabilitation for HD patients with hip fractures require intervention that not only provides standard rehabilitation but also addresses aspects of renal rehabilitation.

Three-dimensional scanner with a modified evaluation method for measuring hand edema subtitle: an idea for accurate evaluation and preliminary fundamental and clinical validation.

Acute hand edema often results in loss of fine hand motor activities, especially without appropriate care. There is still no reliable and easy to use method to measure hand edema. In this study, we tested a handheld three-dimensional (3D) scanner on plastic male and female hand models using a whole hand measuring method (WM) and a modified method (MM) which excluded fingers. We evaluated the intra-rater reliability and inter-rater reliability and compared the measured volumes to computed tomography (CT) findings. Statistical analysis showed that the 3D scan method was valid and reliable for both WM and MM methods. In WM, intra-rater and inter-rater reliability were 0.97 and 0.84, with 95% confidence interval (CI) of 0.87-1.00 and 0.61-0.94, respectively. In MM, intra-rater and inter-rater reliability were 0.96 and 0.83, with 95% CI of 0.84-1.00 and 0.61-0.94, respectively. In comparison to the CT, the differences between 3D scan and CT in the male model volumes were 30.35 ± 2.70 cm3 (mean ± standard deviation) for WM and 11.60 ± 2.07 cm3 for MM. In the female model, the differences were 18.92 ± 2.66 cm3 and 11.18 ± 2.35 cm3, respectively. In both models, MM was significantly more accurate than WM (p < 0.001). When used in a clinical case, the scanner recorded changes in actual volume through the course of treatment. This cost-effective handheld 3D camera can be a reliable tool for evaluating hand edema even in cases of acute injury.

Epstein-Barr virus-positive ileal extraosseous plasmacytoma containing plasmablastic lymphoma components with CD20-positive lymph node involvement.

We report a case of Epstein-Barr virus (EBV)-positive ileal extraosseous plasmacytoma containing plasmablastic lymphoma components with CD20-positive lymph node involvement. A 34-year-old healthy Japanese male developed intussusception due to an ileal plasmacytoma. The lesion was positive for EBV-encoded small nuclear RNA in in situ hybridization, with the surrounding lymph nodes showing the expression of CD20. Tumor cells in the ileal and lymph node lesions contained high-grade malignant features compatible with plasmablastic lymphoma. Because his abdominal lymph nodes recurred 6 months after resection, he received six cycles of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), and had a complete remission. Although his case was complicated by acute promyelocytic leukemia, he has so far survived, recurrence-free, for more than 7.5 years after chemotherapy for extraosseous plasmacytoma.

Clinical application of double dorsal plates for the distal radius fractures.

The purpose of this study was to develop plates that fit the contour of the distal radius of the Japanese and can be inserted less invasively. Three-dimensional models of 36 radii of 18 volunteers were prepared. Using these models, the shape of the cortical bone on the radial margin of the distal radius and just below the dorsal fourth compartment of the wrist, to which the plates were expected to be applied, was measured, and the curves of the plates were determined. The functions of approximated curves of the plates were: [y = -2 x 10(-8) x5 - 2 x 10(-6) x(4) + 0.0006 x3 - 0.0312 x2 + 0.3274 x + 15.224 on the radial margin of the distal radius and [y = 7 x 10(-7) x5 - 0.0001 x4 + 0.0078 x3 - 0.2355 x2 + 3.1815 x - 5.6383 just below the fourth compartment. The clinical results of the application of double dorsal plates were satisfactory in clinical cases for the distal radius fractures.

Efficacy of etoposide, cyclophosphamide, and total body irradiation in allogeneic bone marrow transplantation for adult patients with hematological malignancies.

INTRODUCTION: A combination of fractionated total body irradiation (TBI) with etoposide (VP-16) and cyclophosphamide (CY) as a preconditioning regimen (VP/CY/TBI) has been reported to be safe and effective for both adults and children undergoing allogeneic bone marrow transplantation (allo-BMT). However, the reported doses of VP-16 were different. We evaluated the efficacy and safety of a VP-16 (at less than the usual dose)/CY/TBI regimen for adults with hematological malignancies who are required to receive allo-BMT. PATIENTS AND METHODS: Thirty-eight patients received VP-16, CY and TBI (VP/CY/TBI) as a preconditioning regimen for allo-BMT. Twenty-one patients were in first complete remission (1CR), six patients were in second remission (2CR) and 11 patients were in non-remission status (non-CR) before allo-BMT. These patients received allo-BMT from related donors (n=14) and unrelated donors (n=24). The preconditioning regimen consisted of VP-16 (15 mg/kg/d for 2 d), CY (60 mg/kg/d for 2 d) and 12 Gy TBI in six fractions for 3 d. RESULTS: Two patients died on day 30 after transplantation. The median follow-up period for all patients was 35.0 months (range 0.8-159.6 months). At the time of analysis, 10 patients had died. Seven of those 10 patients died because of relapse. The estimated 5-yr disease-free survival (DFS) rates for all cases and acute myelogenous leukemia and acute lymphoblastic leukemia cases were 73.6, 66.7 and 100%, respectively. The estimated 5-yr DFS rates for 1CR, 2CR and non-CR cases were 90.5, 83.3 and 40.9%, respectively (p < 0.05). CONCLUSION: Based on these findings, we suggest that a VP/CY/TBI regimen is effective and safe for adult patients with hematological malignancies in 1CR and 2CR.