ABSTRACT
Surgical procedures for atlantoaxial (C1–C2) fusion in young children are relatively uncommon. The purpose of this study was to report on a surgical treatment for a case of atlantoaxial instability caused by os-odontoideum in association with quadriparesis and respiratory paralysis in a 5-year-old girl. We present the patient's history, physical examination, and radiographic findings, describe the surgical treatment and a five year follow-up, and provide a literature review. The instability was treated by halo immobilization, followed by C1–C2 transarticular screw fixation using a computed tomography-based navigation system. At the five year follow-up, the patient had made a complete recovery with solid union. The authors conclude that C1–2 transarticular screw fixation is technically possible as in a case of atlantoaxial instability in a five-year-old child.
Subject(s)
Child , Child, Preschool , Female , Humans , Follow-Up Studies , Immobilization , Physical Examination , Quadriplegia , Respiratory ParalysisABSTRACT
1) In 2004, Shinshu University School of Medicine started a program for third-year medical students to experience nursing services during both the day and night shifts. The program included lectures on nursing sciences before practice and debriefing sessions after practice.2) Most students viewed this program favorably and felt that the night-shift training was particular meaningful. They also had favorable opinions about the nurses who taught them.3) Some practical issues remain to be solved, such as security during the night shift and the possible excessive burden upon nurses.
ABSTRACT
1) Medical students and students of the teacher-training course at Shinshu University were compared regarding their knowledge and understanding of heredity and genetics.<BR>2) Medical students' were better able to recognize terms related to genetics than were students of the teacher-training course, although medical students'understanding was not always correct.In both groups understanding was not related to whether the student had studied biology in high school.<BR>3) A standardized education system for clinical genetics for medical students is urgently needed in Japan.