Post : HirotoShishido

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Thalamogeniculate artery vs lenticulostriate artery Thalamogeniculate → PCA

lenticulostriate → MCA
neurosurgery 国試   HirotoShishido

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HBV感染 再活性化の可能性を調べる検査 ☆HBc抗体
HBs抗原・抗体がともに（－）でも，過去に感染あるいはHBs抗原が変異（escape mutant）している場合には，HBc抗体は（＋）を示すことが多い．HBc抗体（＋）であれば，抗リウマチ薬の投与によりHBV活性化の可能性がありうる（de novo B型肝炎）．

HBV-DNA
まずHBc抗体を測定し，これが（＋）であればHBV-DNAの測定を考慮する．

HBe抗原、HBe抗体
HBs抗原・抗体とも（－）で，HBc抗体（＋），HBV-DNA（＋）ならば，測定する必要がある．
gastrointestinal infectious disease 国試   HirotoShishido

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WHO region Japan→ Western Pacific Region (WPRO)

African Region (AFRO)
Region of the Americas (PAHO)
South-East Asia Region (SEARO)
European Region (EURO)
Eastern Mediterranean Region (EMRO)
medu4 国試 public health   HirotoShishido

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treatment of Legg-Calvé-Perthes disease Conservative treatment: limited weight bearing, physical therapy
・Indicated in:
Young children (< 6 years of age)
Mostly undamaged femoral head
Lateral pillar A classification
・☆Casting and bracing can also be used until femoral head deformity develops or range of motion worsens.

Surgery: femoral osteotomy
Indicated in:
・Older children (≥ 6 years of age)
Extensive damage to the femoral head (> 50%)
Lateral pillar B/C class
・Hip arthroplasty can be considered in adults that develop OA
orthopedics 国試   HirotoShishido

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osteochondritis dissecans X-ray
Initial test
May be normal in early stages
More advanced lesions appear as a subchondral bony fragment surrounded by radiolucency.

MRI
Used for early diagnosis in patients with persistent symptoms and normal x-rays and for precise staging
May show articular cartilage thickening or partial detachment in early stages

Conservative therapy: first-line treatment
→ Initially, ☆rest and limited physical activity (4-6weeks)
orthopedics 国試   HirotoShishido

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