Pathophysiologic consideration of an intuitive “sense of alarm” / 日本プライマリ・ケア連合学会誌

<b><i>Abstract</i></b><br> Sometimes experienced doctors and nurses have an intuitive sense of alarm about an apparently stable patient, a sense which may be expressed as, for instance, ‘He/she seems seriously ill.’ However, this intuitive sense of alarm remains a rule of thumb, even though it is recognized as an important “diagnostic” indicator in clinical decision-making. In this review, we have attempted to clarify the meaning of the phrase by proposing a pathophysiologic/symptomatologic model that suggests that the sense of alarm is a premonitory sign of a homeostatic crisis characterized by acute systemic autonomic symptoms and acute sickness behavior. The model proposed here may help novices to avoid missing potentially critical diseases.

INJURIES OF WATER POLO PLAYERS / 体力科学

102 water polo players were interviewd about the injuries caused by water polo. 13% of the subjects had knee pain at least once a year. 73% of which were chronic cases. For 24 players, clinical examinations, including X-ray examination, A-P knee laxity measurement, isokinetic strength measurement of knee muscles, and photo analysis of the vertical egg beater kick motion were performed to elucidate the cause of knee pain.<BR>The summary of the results were as follows;<BR>1. The most common site of knee pain was the medial portion of the knee joint.<BR>2. Protrusion of the medial femoral epicondyle and sharpning of the tibial intercondylar eminentia as well as spur formation of the superior pole of the patella were observed in most subjects.<BR>3. Injured subjects had stiff knees and weak knee extensor muscles.<BR>4. The vertical egg beater kick motion must be the main factor of the painful knee.

Injuries of water polo players - In special regard to the knee joint / 体力科学

102 water polo players were interviewd about the injuries caused by water polo. 13% of the subjects had knee pain at least once a year. 73% of which were chronic cases. For 24 players, clinical examinations, including X-ray examination, A-P knee laxity measurement, isokinetic strength measurement of knee muscles, and photo analysis of the vertical egg beater kick motion were performed to elucidate the cause of knee pain.<BR>The summary of the results were as follows;<BR>1. The most common site of knee pain was the medial portion of the knee joint.<BR>2. Protrusion of the medial femoral epicondyle and sharpning of the tibial intercondylar eminentia as well as spur formation of the superior pole of the patella were observed in most subjects.<BR>3. Injured subjects had stiff knees and weak knee extensor muscles.<BR>4. The vertical egg beater kick motion must be the main factor of the painful knee.

Influence of the shoulder laxity on the shoulder lesion in several kinds of sports / 体力科学

The laxity of shoulder is one of main factors affecting shoulder lesions in athletes.<BR>To measure the anterior-posterior laxity of shoulder, a stress machine was arranged because the ordinary rentogenographic measurement is not suitable. The measurement of the anterior-posterior laxity was done with athletes in several kinds of sports in which shoulder joints are mainly used. The result was compared with those from clinical examinations and stress rentogenography. Conclusions :<BR>1. The anterior-posterior displacements of the affected side in baseball, volleyball and javelin players were significantly larger than that of the control side.<BR>2. For the anterior-posterior displacement of the shoulder joint, baseball, volleyball and javelin players showed significantly larger values than truck runners as the control whereas significantly smaller values were found in water polo players.<BR>3. There was no correlation between the anterior-posterior laxity and the inferior laxity.