Radiographic Measurement of Joint Space Width Using the Fixed Flexion View in 1,102 Knees of Japanese Patients with Osteoarthritis in Comparison with the Standing Extended View

PURPOSE: The fixed flexion view (FFV) of the knee is considered useful for evaluating the joint space when assessing the severity of osteoarthritis (OA) of the knee. To clarify the usefulness of FFV for evaluation of the joint space and severity of knee OA, this study evaluated changes in the joint space on the FFV and standing extended view (SEV) in patients with knee OA. MATERIALS AND METHODS: The SEV and FFV images were acquired in 567 patients (1,102 knees) who visited the hospital with a chief complaint of knee joint pain. Medial joint space width (MJSW) and Kellgren-Lawrence (K-L) classification assessed using the SEV and FFV images were compared. RESULTS: Mean MJSW was significantly smaller when assessed on the FFV than on the SEV (3.02±1.55 mm vs. 4.31±1.30 mm; p<0.001). The K-L grade was the same or higher on the FFV than on the SEV. CONCLUSIONS: The FFV is more useful than the SEV for evaluating the joint space in OA knees. Treatment strategies in patients with knee OA should be determined based on routinely acquired FFV images.

How should Medical Students Be Allowed to Access and Utilize the Electronic Medical Recording System During the Bed-side Learning?: The Dilemma between Information Security and Educational Support / 医学教育

Medical students must be able to access electronic medical records and to utilize the information during bedside learning. However, there are no guidelines for using the electronic medical record system in undergraduate medical education. We created and implemented a written agreement regarding regulations for using the system. To ensure system security, users are authenticated with a fingerprint mouse. The patients' information can be retrieved from an Intranetbased reference database, and students' sheets are prepared for training in writing medical records. In conclusion, this method is a way of enhancing the authenticity of clinical education.

The salvage regimen for patients with advanced non-small cell lung cancer who failed prior chemotherapy: once-daily single oral agent Iressa / 中国肺癌杂志

<p><b>BACKGROUND</b>To summarize the effect of Iressa for refractory patients with advanced non small cell lung cancer (NSCLC) failed to prior chemotherapy.</p><p><b>METHODS</b>Thirty-one patients, with unresectable stage IIIB or IV NSCLC who had disease progression or relapse after prior chemotherapy using platinum-based regimen for at least 2 cycles, were admitted to the Osaka Prefectural Hobikino Hospital. Iressa 250 mg was administered once a day until disease progression was noted. Weekly chest x-ray and monthly CT scan were performed for response assessment each month.</p><p><b>RESULTS</b>Among the 31 patients, one complete response (CR) and 7 partial responses (PR) were observed. CR rate was 3.2% (95% confidence interval: 0-17%), PR rate 22.6% (95% confidence interval: 10%-41%), disease control rate including both tumor responses and stable disease was 80.6% (95% confidence interval: 52%-92%). The rate of symptoms relieves was 51.6% (95% confidence interval: 33%-70%), the most effective symptoms being cough and pain. The median time to improved symptoms was 14 days. The most common adverse events were grade I or II skin rash and diarrhea which were readily manageable and reversible. No patients were withdrawn due to the adverse events</p><p><b>CONCLUSIONS</b>Monotherapy using Iressa is effective and tolerable for the patients with advanced NSCLC who failed prior chemotherapy.</p>