Associations of self estimated workloads with musculoskeletal symptoms among hospital nurses.

OBJECTIVES: To investigate the prevalence of neck, shoulder, and arm pain (NSAP) as well as low back pain (LBP) among hospital nurses, and to examine the association of work tasks and self estimated risk factors with NSAP and LBP. METHODS: A cross sectional study was carried out in a national university hospital in Japan. Full time registered nurses in the wards (n = 314) were selected for analysis. The questionnaire was composed of items on demographic conditions, severity of workloads in actual tasks, self estimated risk factors for fatigue, and musculoskeletal pain in the previous month. Rate ratios (RRs) and 95% confidence intervals (95% CIs) were calculated by the Cox's proportional hazards model to study the association of pain with variables related to work and demographic conditions. RESULTS: The prevalences of low back, shoulder, neck, and arm pain in the previous month were 54.7%, 42.8%, 31.3%, and 18.6%, respectively. The prevalence of musculoskeletal symptoms among hospital nurses was higher than in previous studies. In the Cox's models for LBP and NSAP, there were no significant associations between musculoskeletal pain and the items related to work and demographic conditions. The RRs for LBP tended to be relatively higher for "accepting emergency patients" and some actual tasks. Some items of self estimated risk factors for fatigue tended to have relatively higher RRs for LBP and NSAP. CONCLUSIONS: It was suggested that musculoskeletal pain among hospital nurses may have associations with some actual tasks and items related to work postures, work control, and work organisation. Further studies, however, are necessary, as clear evidence of this potential association was not shown in the study.

Effects of box weight, vertical location and symmetry on lifting capacities and ratings on category scale in Japanese female workers.

The aim was to clarify the effects of box weight, vertical location and symmetry on the lifting capacities and subjective burden in Japanese female workers with manual material handling tasks. Sixteen healthy females were tested. They performed 12 different lifting tasks (three heights * two weights * two symmetries). It is difficult for Japanese women to exert dynamic force in lifting a 15-kg weight from the elbow to the shoulder level. A remarkable increase was observed in heart rate and category scale with ratio properties (CR-10) on large muscle group in lifting a 15-kg weight as compared with lifting a 10-kg one. Judging from calculation of the Recommended Weight Limit using the application manual by the National Institute for Occupational Safe and Health, it was also suggested that lifting the 15-kg weight from the elbow to the shoulder level was difficult for female workers. Not only peak force, but also the average upward acceleration and peak velocity were lower in asymmetric liftings than those in symmetric liftings. CR-10 for the left back and right thigh were also higher in 90 degrees right lateral plane lifting than in the mid-sagittal plane. Thus, asymmetric lifting was supposed to impose higher stress on the back contralaterally and thigh ipsilaterally to the location of the weight.

Leiomyoma of the parapharyngeal space.

A rare case of leiomyoma of the prestyloid parapharyngeal space is reported together with computed tomographic and magnetic resonance imaging findings. The tumor appeared as a well-circumscribed ovoid mass with some calcifications and lobulations. Because the attenuation, signal intensity, and shape of the mass were not specific and were similar to those of a pleomorhic adenoma, the most common tumor of the prestyloid parapharyngeal space, radiological differentiation of leiomyoma from pleomorphic adenoma of the prestyloid parapharyngeal space was difficult.

Adenoid cystic carcinoma of the external auditory canal: correlation between histological features and MRI appearances.

A rare case of adenoid cystic carcinoma of the external auditory canal with magnetic resonance imaging appearances is reported. Both T1 weighted and T2 weighted MR images showed the tumour as a hypointense mass, although there was marked contrast enhancement. Microscopic examination of the resected tumour showed a preponderance of solid tumour cell nests. According to previous reports, these pathological and radiological findings indicate a poor prognosis.

Serum Interleukin-6 Level is a Sensitive Parameter of Disease Activity in Rheumatoid Arthritis.

In rheumatoid synovium, interleukin-6 (IL-6) is the most abundantly expressed cytokine. Therefore, we investigated whether serum IL-6 levels could be clinically useful parameters of disease activity in rheumatoid arthritis (RA). The serum IL-6 levels were measured by enzyme-linked immunosorbent assay. The IL-6 levels were significantly higher in sera from patients with RA (n = 108, 13.3 +/- 14.0 pg/mL) than in those from the normal controls (n = 10, < 3.13 pg/mL). The IL-6 levels significantly correlated with conventional parameters, such as the Lansbury index, joint score, erythrocyte sedimentation rates, and C-reactive protein. In addition, the serum IL-6 level was useful to determine clinical remission. Advantages of serial measurement of IL-6 were observed in two cases. These findings suggested that the serum IL-6 level may be clinically useful as a sensitive parameter of disease activity in RA.

Effect of S-carboxymethylcysteine on the clearance of middle ear effusion. An experimental study.

The therapeutic effect of S-carboxymethylcysteine (S-CMC) on otitis media with effusion was investigated by use of immune-mediated otitis media with effusion (OME) induced in chinchillas. The S-CMC was administered daily to individuals in two different doses (100 mg/kg and 200 mg/kg) for 2 weeks after the induction of immune-mediated otitis media. The severity of OME was evaluated by observation of the tympanic membrane under a surgical microscope, by tympanogram, and by histologic findings of the middle ear mucosa. Results of the study showed that the oral administration of S-CMC at a dose of 200 mg/kg of body weight is more effective than at a dose of 100 mg/kg in the clearance of middle ear effusions in experimental OME. An autoradiographic study using 14C-S-CMC revealed that orally administered S-CMC is rapidly absorbed by the digestive tract and transported to the tubotympanum via the circulation. The uptake and excretion by secretory cells were apparently greater in activated secretory cells. However, S-CMC does not act on the infiltrating cells to prevent the release of chemical mediators such as histamine and prostaglandin E2. This finding suggests that prophylactic use of S-CMC may not be anticipated.

Congenital middle ear cholesteatoma: report of 3 cases.

In this report, we presented 3 cases of congenital middle ear cholesteatoma which occurred in a 12-year-old girl, a 4-year-old boy, and a 6-year-old boy. In all 3 cases, there was a whitish mass behind a normal tympanic membrane. Congenital middle ear cholesteatoma is not a rare disease. In the early stage, it is asymptomatic. But when it progresses, this disorder can destroy conductive systems of the middle ear and cause many symptoms. One patient (Case 1) had a complaint of hearing impairment. She underwent mastoidectomy and tympanoplasty; however, the cholesteatoma recurred. The other 2 patients had no symptoms. The abnormal appearance of their tympanic membrane was found by chance at their local otologists. We performed tympanotomies and removed cholesteatomas without aftereffects. When otologists note an abnormal appearance behind a normal tympanic membrane, with or without symptoms, tympanotomy should be done due to the possibility of congenital middle ear cholesteatoma.

[Therapeutic effects of cepharanthine on the experimental otitis media with effusion].

This study was designed to investigate the therapeutic efficacy of Cepharanthine for OME. Cepharanthine is a biscoclaurin type alkaloid, crude drug, and its main efficacy is to stabilize cell membranes. Experimental OME was induced in chinchillas by immunization with Keyhole Limpet Hemocyanin (KLH) into the right tympanic cavity following systemic sensitization. Forty-five chinchillas, weighing 350-600g, were used in this study. The animals were divided into 5 groups. Group A (N = 5), Group B (N = 5) and Group C (N = 5) were intraperitoneally given 1mg/kg, 2mg/kg or 5mg/kg dose of cepharanthine respectively, daily, after the induction of OME; Group D (N = 5) received no medicine as a control group; Group E (N = 17) received intraperitoneal administration of 2mg/kg of cepharanthine daily, for 7 days before the local antigenic challenge. The presence of middle ear effusion (MEE) was monitored daily by tympanometry and fiberscopic observation of the eardrum. At four days after experimental OME occurred, MEEs were aspirated aseptically through the eardrum and processed to biochemical analysis. The animals were then killed for the observation with autoradiography used by 3H-cepharanthine. Results demonstrated that the dose of 2mg/kg cepharanthine is more effective, compared with that of 1mg/kg or 5mg/kg of cepharanthine. It was clear that this drug was immediately transferred to the middle ear following intraperitoneal administration and diffusely distributed in the middle ear mucosa. Findings of this study suggest the efficacy of cepharanthine is prophylactic and restorative against experimental OME.