著者

西尾 淳 緑川 孝二 柴田 陽三 城石 達光 江本 玄 緒方 公介

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.46, no.1, pp.13-18, 1997-03-25 (Released:2010-02-25)

参考文献数

6

---

We report a rare case of deltoid muscle contracture in an adult. The patient was a 40 year old female who visited our hospital complaining of pain and motion disturbance of both shoulder joints. She had received multiple intramuscular injections for migraine treatment for 5 years. Clinical examination revealed winging of the scapula and fibrous bands were seen in the intermediate part of the deltoid muscles. Strength of the deltoid muscles was normal. Adduction, external rotation and horizontal flexion of the shoulders were restricted, -25 degrees, 35 degrees, 90 degrees, respectively. Fibrous bands showed high echo images within low echo areas on ultrasonography and a low intensity area on MRI. In September 1995, surgery was performed on her right shoulder. The deltoid fascia and subcutaneous tissue were thoroughly and widely released. After resection of fibrous bands at the midpart of the deltoid muscle, range of abduction was improved during surgery. She is now able to touch the opposite shoulder with her right hand. No adductive disturbance was seen. The patient was satisfied with the surgical results and we plan on operating on her left shoulder.

著者

白井 佑 蓑川 創 南川 智彦 山崎 慎 秋吉 祐一郎 野村 智洋 原 純也 柴田 陽三

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.69, no.3, pp.561-564, 2020-09-25 (Released:2020-11-12)

参考文献数

13

---

反復性肩関節脱臼に対する烏口突起移行術は,Bristow法(B法)とLatarjet法(L法)があり,近年,術後移行骨片の骨吸収の報告が散見される.我々は,その骨形態変化が関節安定性に関与していると考え,両術式の術後成績とCTによる移行骨片の骨形態変化を関節面積に着目して検討した.6ヵ月以上経過観察できた34例35肩(平均22.7歳)を対象.B法11肩,L法24肩.両術式の術前と最終経過観察時の臨床成績,および両術式のCTによる移行骨片の骨形態変化を関節面積で評価した.各種臨床評価法を用いて,術前と最終経過観察時を比較し,両術式共に有意に改善したが,両群間に差はなかった.術直後と最終経過観察時のCTを比較では,L法は移行骨片の骨吸収のため,関節面積が縮小していた.一方B法は,移行骨片の関節窩接触部の増殖性変化のため増大していた.B法は関節窩接触部の増殖性変化のため,一度癒合が得られればL法に比し高い骨性支持が得られると推察した.

著者

柴田 陽三 緑川 孝二 内田 洋子 渡辺 伸彦 緒方 公介 伊崎 輝昌

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.21, no.2, pp.351-355, 1997-06-25

被引用文献数

1

著者

浜岡 秀明 伊賀崎 央 吉田 泰子 押川 達郎 村松 知佳 鶴澤 礼実 柴田 陽三

出版者

公益社団法人 日本理学療法士協会

雑誌

理学療法学Supplement

巻号頁・発行日

vol.46, pp.J-59_1-J-59_1, 2019

---

<p>【はじめに】18トリソミーは多彩な合併奇形を有し、重度の発達遅滞を呈する予後不良の疾患であり、大規模な調査に基づく生命予後は1年生存率5.5~8.4%、生存期間の中央値10~14.5日とされている。今回、急性呼吸器感染症を繰り返す18トリソミー女児を担当する機会を得た。母親は潰瘍性大腸炎に羅患し、定頚が不十分である児を常に抱っこすることが困難なため、児は1日の大半を臥位で過ごしていた。そこで、前傾クッションを作成し、坐位保持を導入したので報告する。</p><p>【症例紹介】1歳6ケ月、女児。原疾患は18トリソミーで、Fallot四徴症等を合併した重症心身障害児(発達指数DQ12)である。某日、咳嗽後の嘔吐が頻回となり急性呼吸器感染症で入院した。入院時、鼻カニューラにてO2:3L、SpO2:87%、咽頭発赤、湿性咳嗽、陥没呼吸を認めたがチアノーゼはなかった。動脈血ガス(ABG)はpH:7.45、PaCO2:45mmHg、PaO2:34mmHgであった。</p><p> </p><p>【経過】入院後抗菌薬にて治療開始。第12病日に高炭酸ガス血症に伴う意識障害を呈し、第14病日にてんかん発作が出現した。第15病日に呼吸リハ目的で理学療法開始となる。第16~18病日には無酸素発作出現、第19病日のABGはpH:7.25、PaCO2:79.0mmHg、PaO2:33.0mmHgであり、高炭酸ガス血症を認め高流量鼻カニューラ(以下NHF)を装着した。4時間後には、pH:7.45、PaCO2:47.0mmHg、PaO2:29.0mmHgへ改善し、第23病日にNHFを離脱し鼻カニューラに変更となる。第24病日、前傾クッションを作成し坐位訓練を開始。バイタル著変なく、第34病日、自宅退院となる。理学療法開始時、鼻カニューラにてO2:3L、SpO2:70%台で陥没呼吸がみられ、脈拍は110~120回/回であった。追視は可能で、吸引時に微弱ながら啼泣がみられた。粗大運動能力尺度(以下GMFM)は臥位と寝返り領域が5.8%であった。臥位は頭頸部、骨盤右回旋位、左股内旋位で、入院前は左側臥位まで寝返りが可能だったが、理学療法開始時は困難だった。坐位は定頸不十分、体幹低緊張、骨盤後傾、右回旋位、左股内旋位で保持が困難であった。以上の評価から筋緊張の改善や、呼吸が安定しやすい、前傾坐位を取り入れた。退院時、GMFMは臥位と寝返り領域が17.6%へ改善。日中、笑顔で過ごす時間が増え、前傾坐位は見守りで保持が可能となり、周囲への反応や頭頸部のコントロールが向上した。</p><p> </p><p>【考察】呼吸と姿勢は密接に関係し、背臥位より腹臥位や坐位が呼吸に適しているとされ、特に前傾坐位では、重力により胸郭が下方に広がりやすく、舌根沈下や下顎後退を防げるとされている。園田らは、姿勢ケアは安定性のもとに運動の自由度を増す設定にすることで児の隠れた能力を引き出し、それを日常生活場面で取り込むことが大切と述べている。本症例でも、前傾クッションを作成し呼吸が安定しやすい前傾坐位を導入したことで、骨盤、胸郭が安定し、頭頸部のコントロールが向上し、運動発達の一助となったと考えた。</p><p> </p><p>【倫理的配慮、説明と同意】ご家族には、本症例報告の主旨と個人情報の保護について十分に説明し、書面にて同意を得た。</p>

著者

柴田 陽三 藤永 隆志

出版者

The Japan Institute of Marine Engineering

雑誌

マリンエンジニアリング (ISSN:13461427)

巻号頁・発行日

vol.37, no.9, pp.647-653, 2002-09-01 (Released:2010-05-31)

参考文献数

9

---

The lack of power source capacity is one of the most fatal problems for the AUV spotlighted as a means of underwater survey and observation of the next generation, to be attacked for its practical use. To be free from such a problem, some long-term-cruising-AUVs employ with a large capacity power source like a closed cycle diesel engine or a fuel cell. On the other hand, if underwater recharging system for conventional batteries is developed, that will help us make the AUVs more practical without increasing its size, weight and cost. And such a new method of the AUV can be expected that the AUV is operated in combination with underwater bases or large submersibles.Now, we have carried out to develop such an AUV, called“MARINEBIRD”, that is capable of docking in an underwater station and recharging the battery. This kind of technologies have already been underwatertested in the U.S.A. and European countries, but our newly developed AUV is based on our original mechanism for docking, different from such ones.The MARINEBIRD succeeded the docking test in the dock trial, and demonstrated the excellence of its autonomous docking capability.The MARINEBIRD has the big advantage of charging batteries and receiving data at the underwater base without recovery by the surface support ship or such purposes as required in combination with a larger submersible, that will contribute to increase efficiency in underwater survey.

著者

宮﨑 弘太郎 野村 智洋 秋吉 祐一郎 南川 智彦 真田 京一 山﨑 裕太郎 橋野 悠也 柴田 陽三

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.67, no.3, pp.494-497, 2018

---

<p>【はじめに】高位脛骨骨切り術における骨切り面と膝窩動脈との距離・位置関係について検討を行った.【対象と方法】当院で2016年4月~2017年7月までに施行した膝MRI検査のうち3Dデーターが保存されMPR画像の再構成が可能であった症例を用いて検討を行った.内側開大式楔状高位脛骨骨切り術時の骨切りを想定し,内側関節面から3.5cm遠位の脛骨内側縁から腓骨頭へ向かう骨切り面のMRI画像の再構成を行い,脛骨後縁と膝窩動脈との最短距離および脛骨内側縁からの位置関係の評価を行った.【結果・考察】高位脛骨骨切り術における膝窩動脈損傷は非常に稀な合併症ではあるが,損傷時の治療は緊急手術を要する重篤な合併症の一つである.高位脛骨骨切り術における骨切り面と膝窩動脈との距離・位置関係に関して検討を行ったので若干の文献的考察を加え報告する.</p>

著者

柴田 陽三 竹下 満 高岸 直人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.36-40, 1986-07-28 (Released:2012-11-20)

---

Intra-articular pressure (1-A pressure) of the gleno-humeral joint (G-H Joint) was measured in order to elucidate the mechanism of shoulder joint. (Material and Method)Ten normal subjects were measured. Fluidfilled teflon tube, with two small perforations around tip, was inserted into the axillary pouch from anterior aspect of the shoulder joint. The end of tube was connected to a pressure transducer. Intra-articular pressure was measured during movement of the shoulder joint when subjects were sitting position.(Result) When none of saline was injected into the gleno-humeral joint, there was almost no change of intar-articular pressure. But, when 10 ml and 20 ml of saline were injected into G-H joint, I-A pressure rose at shoulder elevation. I-A pressure with 20 ml of saline was higher and rose more steeply at the same elevated position. It was demonstrated that 1-A pressure was highest at full elevation. The relationship of I-A pressure and joint position before and after full elevation demonstrated that the pressures were lower than for the same joint position before full elevation.There were peak pressures at the full internal rotated position and the full externa l rotated position, but latter was higher than the former. The lowest value of I-A pressure was showed at the slightly flexed, abducted and internal rotated position.And further measurements were done in the disease joints.

著者

伊崎 輝昌 緑川 孝二 柴田 陽三 緒方 公介 原 正文

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.5-11, 1994-09-01 (Released:2012-11-20)

参考文献数

12

---

PurposeBiceps labrum complex (BLC) lesions most commonly occur during sports activities in which the arm is frequently held in an overhead position. Among the available literature there are few histological studies about BLC. The purpose of this study was to demonstrate the anatomy of BLC and its attachment to the glenoid and to evaluate the results of our treatment for BLC lesions.Materials and MethodsAnatomical Study: Sixty shoulders from 30 cadavers were studied. We recorded the appearance of the glenoid labrum and the LHB. Then, we removed the glenoid process from the scapula leaving all of the capsular insertion intact. Sections were each cut along the cornal plane and along the sagittal plane at 200-300 p m thickness on a rotary milling saw, and then ground to a 20 p m thickness. The sections were stained with Cole's hematoxylin and eosin and examined via light and polarized light microscopy.Clinical Cases:Thirty shoulders of 29 patients with BLC lesions underwent arthroscopic debridement of the superior labrum.ResultsAnatomical Study: The LHB inserted directly to the superior glenoid and its attachment extended to the middle of the posterior glenoid. The LHB was firmly attached to the superior glenoid from the edge of the glenoid rim. The attachment was gradually loose toward the middle of the posterior glenoid. The LHB was attached to a large surface of the glenoid.Clinical Cases:All patients were able to return to competitive sports.DiscussionsBased on our anatomical study, the LHB has a larger attachment area on the glenoid than had been previously reported. Therefore, we believe debridement of the superior labrum for BLC lesions preserves the LHB functions.

著者

萩尾 友宣 柴田 陽三 篠田 毅 伊崎 輝晶

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.837-840, 2011 (Released:2011-12-21)

参考文献数

9

---

Proprioception was studied in rotator cuff tear and normal shoulder using active angle reproduction test. Subjects and methods: In cuff tear group(RCT), 33 cases (33 shoulders) were studied. They were 19 males and 14 females, their average age was 66.4 years.The average active elevation angle was 112.4° and the average external rotation angle was 51.4°. As a control group (C), 20 cases (20 shoulders) who had not had previous injury or disease in their shoulder were studied. Average elevation angle was 160.3° and average external rotation angle was 61.9°. The subjects were studied sitting on a chair and had a bandage put over their eyes. They rotate or elevate their shoulder to any angle. The difference absolute values between average of 3 times of reproduction of the angle and the target angle were studied. The target angles were 30° of internal rotation, 30° and 45° external rotation, 30°, 45° and 60° of elevation. In 30° of IR, error angle revealed 7.0° in RCT and 2.6° in C group (P<0.01). These were 4.6° and 2.5°(P<0.01) in 30° of ER, 3.6° and 2.5°(P=0.15) in 45° of ER. These were 4.0° and 2.1° in 30° of elevation (P<0.05), 4.1° and 1.9° in 45° of elevation (P<0.01), 4.8° and 2.4° in 60° of elevation(P<0.01). Proprioception of rotator cuff tear was lower than that of normal shoulder.