Takashi Tanaka

JOA Back Pain Evaluation Questionnaire (JOABPEQ)/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007

1 Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan 2 Department of Orthopaedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan 3 Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan 4 Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan 5 Department of Orthopedic Surgery, Nippon Medical School, Tokyo, Japan 6 Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan 7 Department of Orthopaedic Surgery, Iwate Medical University School of Medicine, Morioka, Japan 8 Department of Orthopaedic Surgery, Saitama Medical School. Saitama, Japan 9 Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi, Japan 10 Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan 11 Department of Orthopaedics, Kochi Medical School, Kochi, Japan 12 Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Osaka, Japan 13 National Hospital Organization, Osaka-Minami Medical Center, Osaka, Japan 14 Department of Internal Medicine, Houai Hospital, Osaka, Japan 15 Department of Public Health, Osaka City University Faculty of Medicine, Osaka, Japan

Japanese Orthopaedic Association Back Pain Evaluation Questionnaire. Part 3. Validity study and establishment of the measurement scale

BackgroundThe Japanese Orthopaedic Association decided to revise the JOA score for low back pain and to develop a new outcome measure. In February 2002, the first survey was performed with a preliminary questionnaire consisting of 60 evaluation items. Based on findings of that survey, 25 items were selected for a draft of the JOA Back Pain Evaluation Questionnaire (JOABPEQ). The second survey was performed to confirm the reliability of the draft questionnaire. This article further evaluates the validity of this questionnaire and establishes a measurement scale.MethodsThe subjects of this study consisted of 355 patients with low back disorders of any type (201 men, 154 women; mean age 50.7 years). Each patient was asked to fill in a self-administered questionnaire. Superficial validity was checked in terms of the completion rate for filling out the entire questionnaire. Factor analysis was then performed to evaluate the validity of the questionnaire and establish a measurement scale.ResultsAs a result of the factor analysis, 25 items were categorized into five factors. The factors were named based on the commonality of the items: social function, mental health, lumbar function, walking ability, and low back pain. To establish a measurement scale for each factor, we determined the coefficient for each item so the difference between the maximum factor scores and minimum factor scores was approximately 100. We adjusted the formula so the maximum for each factor score was 100 and the minimum was 0.ConclusionsWe confirmed the validity of the JOA Back Pain Evaluation Questionnaire and est ablished a measurement scale.

JOA Back Pain Evaluation Questionnaire: initial report

BackgroundThere is no widely accepted objective evaluation for lumbar spine disorders. New outcome measures should be patient-oriented and should measure symptoms and self-reported functional status in multiple dimensions. The aim of this study was to identify items to be included in the disease-specific quality of life (QOL) questionnaire for the assessments of patients with lumbar spine disorders.MethodsThe draft of the QOL questionnaire that consisted of a total of 60 items, including 24 items derived from the Japanese version of the Roland Morris Disability Questionnaire (RDQ) and 36 items derived from the Japanese version of Short Form 36 (SF-36), were administered to patients and controls. After obtaining written informed consent, the following data were collected from the patient group (n = 328) and the control group (n = 213): (1) background characteristics, including age, diagnosis, Japanese Orthopaedic Association (JOA) score, and finger to floor distance; (2) responses to the questionnaire; (3) the identification rate by discrimination analysis to select the candidates for adoption and by adopting explanatory variables. The items to be excluded were determined by examining the explanatory variables, which were selected after the discrimination analysis, by setting the candidate to-be-excluded items as an objective variable.ResultsBased on the distribution of the responses, two items, RDQ-15 and RDQ-19, were excluded. From the results of the correlation coefficient calculation for each question in the patient group, 33 items were excluded and 27 candidate items were adopted. Based on the adoption explanatory variable used in the discrimination analysis, 25 of the 27 candidate items for adoption were accepted.ConclusionsThis study identified the 25 specific questionnaire items that should be included in the questionnaire to evaluate QOL of patients with various lumbar spine disorders.

Relationship between postrenal transplant osteonecrosis of the femoral head and gene polymorphisms related to the coagulation and fibrinolytic systems in Japanese subjects.

Background. Nontraumatic osteonecrosis of the femoral head (ONFH) is one of the complications that may occur after renal transplantation. We investigated the relationship between the incidence of ONFH and polymorphisms in the genes for plasminogen activator inhibitor (PAI)-1, which is one of the major regulatory proteins of the fibrinolytic system, and 5,10-methylenetetrahydrofolate reductase (MTHFR), which is associated with the plasma levels of homocysteine in Japanese subjects. Methods. Thirty-one patients with postrenal transplant ONFH and 106 patients without ONFH were selected. Genotypes of PAI-1 4G/5G and MTHFR C677T were determined by direct sequencing of genomic DNA. In addition, plasma PAI-1 antigen (Ag) levels and plasma total homocysteine (tHcy) levels at the steady state were measured. The relationships between the incidence of ONFH and these genotypes, as well as plasma levels of the gene products, were investigated. Results. Plasma PAI-1 Ag levels were the highest in patients with the 4G/4G genotype, and plasma tHcy levels were the highest in patients with TT genotypes of MTHFR C677T. However, the relationship between the incidence of ONFHH and PAI-1 4G/5G or MTHFR C677T was not observed. The relationship between the incidence of ONFH and plasma levels of PAI-1 Ag or tHcy was not observed. Conclusions. Genotypes of PAI-1 4G/5G and MTHFR C677T or plasma concentrations of PAI-1 Ag and tHcy had no effect on the incidence of ONFH in Japanese subjects, unlike the results of studies performed in white subjects. The effect of genetic background on the pathologic conditions that developed in patients with postrenal transplant ONFH may differ according to race.

JOA Back Pain Evaluation Questionnaire (JOABPEQ)/ JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) The report on the development of revised versions April 16, 2007: The Subcommittee of the Clinical Outcome Committee of the Japanese Orthopaedic Association on Low Back Pain and Cervical Myelopathy Evaluation

1 Laboratory of Statistics, Osaka City University Faculty of Medicine, Osaka, Japan 2 Department of Orthopaedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan 3 Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan 4 Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan 5 Department of Orthopedic Surgery, Nippon Medical School, Tokyo, Japan 6 Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan 7 Department of Orthopaedic Surgery, Iwate Medical University School of Medicine, Morioka, Japan 8 Department of Orthopaedic Surgery, Saitama Medical School. Saitama, Japan 9 Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi, Japan 10 Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan 11 Department of Orthopaedics, Kochi Medical School, Kochi, Japan 12 Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Osaka, Japan 13 National Hospital Organization, Osaka-Minami Medical Center, Osaka, Japan 14 Department of Internal Medicine, Houai Hospital, Osaka, Japan 15 Department of Public Health, Osaka City University Faculty of Medicine, Osaka, Japan

Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ): part 4. Establishment of equations for severity scores

BackgroundTo establish a patient-oriented outcome measure for cervical myelopathy, a subcommittee of the Japanese Orthopaedic Association (JOA) developed a new scoring system to evaluate the overall clinical status of patients, which could be completed by patients themselves. The subcommittee completed three large-scale studies to select and modify questions derived from various preexisting outcome measures including Short Form-36, and then finalized and validated the questionnaire, which comprised 24 questions.MethodsThe finalized questionnaire was administered to 369 patients with cervical myelopathy due to disc herniation, spondylosis, or ossification of posterior longitudinal ligament by randomly selected board-certified spine surgeons. Patients with different severities of myelopathy were included to insure accuracy and responsiveness of this questionnaire against patients’ different neurological status.ResultsData of 236 patients were employed and were subjected to rigorous statistical analyses. There was no question that was difficult to answer and distribution of answers for each question was not concentrated to one choice, indicating the appropriateness of all 24 questions. Results of factor analysis suggested that the 24 questions could be divided into five different factors or functional domains. The factors were defined as follows: factor 1, lower extremity function; factor 2, quality of life; factor 3, cervical spine function; factor 4, bladder function; and factor 5, upper extremity function. Finally, equations that would yield scores for the five factors were assembled. The score to be used to represent the degree of patients’ disability or status in each domain can be calculated by multiplying prefixed numbers of selected answers to questions by preassigned coefficients. Coefficients were defined to make the minimum score 0 and the maximum score 100.ConclusionsWe have successfully established a questionnaire that is able to demonstrate the status of patients suffering cervical myelopathy from five different aspects represented by five intuitive numerical scores. The final issue to be confirmed is the responsiveness of this questionnaire to changes in patients’ status after various surgical and nonsurgical treatments.

Evaluation of moisture content distribution in wood by soft X-ray imaging

A technique for nondestructive evaluation of moisture content distribution in Japanese cedar (sugi) during drying using a newly developed soft X-ray digital microscope was investigated. Radial, tangential, and cross-sectional samples measuring 100 × 100 × 10 mm were cut from green sugi wood. Each sample was dried in several steps in an oven and upon completion of each step, the mass was recorded and a soft X-ray image was taken. The relationship between moisture content and the average grayscale value of the soft X-ray image at each step was linear. In addition, the linear regressions overlapped each other regardless of the sample sections. These results showed that soft X-ray images could accurately estimate the moisture content. Applying this relationship to a small section of each sample, the moisture content distribution was estimated from the image differential between the soft X-ray pictures obtained from the sample in question and the same sample in the oven-dried condition. Moisture content profi les for 10-mm-wide parts at the centers of the samples were also obtained. The shapes of the profiles supported the evaluation method used in this study.

A PRELIMINARY STUDY ON ULTRASONIC TREATMENT EFFECT ON TRANSVERSE WOOD PERMEABILITY

Ultrasonic pre-treatment of small and pressure saturated Douglas-fir heartwood specimens at 20 kHz fixed frequency with an acoustic horn resulted in increased specific permeability coefficient in both radial and tangential directions. Statistical analysis revealed that there was a high correlation between ultrasonic treatment time and specific permeability coefficient. Improvement rate of permeability in both radial and tangential directions was nearly the same regardless of treatment time.

Air Permeability Of Sugi (Cryptomeria Japonica) Wood In The Three Directions

To investigate the air permeability of sugi (Cryptomeria japonica) and the effect of grain directions on it, the air permeabilities of air-dried sugi sapwood and heartwood were determined along the three material directions of wood. The value of the longitudinal permeability was the highest and that of the radial permeability was the lowest. The permeability of heartwood was about an order of magnitude less than the permeability of sapwood in the same direction. The ratio between the tangential and radial permeability was approximately 10, which was similar to softwoods that have impermeable rays. These results suggest that sugi has ray tissues that are either impermeable or have very low permeability. The radial permeability of sugi was much lower than that of Pinus, Sequoia, Juniperus, Abies, and Tsuga measured with gases reported in the literature, indicating that sugi is one of the least radially permeable softwoods. These findings explain the reasons for the difficulties encountered in the drying and chemical treatment of sugi (Cryptomeria japonica).

A new method for nondestructive evaluation of solid wood moisture content based on dual-energy X-ray absorptiometry

This paper presents a new method to determine the moisture content of solid wood based on the principle of dual-energy X-ray absorptiometry. The study investigates the theoretical relationship between X-ray wavelength and mass attenuation coefficients of wood, water, and reference substance. In accordance with this relationship, a theoretically obtained equation is proposed to calculate the moisture content in wood. The proposed equation is compared to experimental results using small blocks of sugi wood, which showed that the change in mass attenuation coefficient of wood with X-ray tube voltage increased with increasing moisture content as expected from the theoretical equation. A regression equation for moisture content estimation was determined based on the experimental results, and the standard error of estimate in the 0–120xa0% dry-basis moisture content range using the regression equation was determined to be 21.9xa0% with the most appropriate pair of tube voltages, 15 and 40xa0kVp. The accuracy of the method will be improved by reducing the duration of X-ray radiography and by increasing the disparity between paired tube voltages. This method has the potential to determine moisture content of solid wood using X-ray without oven-drying or assuming oven-dry density.