平成29年9月9日 ~ 平成29年10月31日まで、タイからPrakasit Chanasit 先生(ニックネームはMei)をclinical fellowとして迎えました。
Mei先生はタイの整形外科医で、肩、膝、スポーツを専門にとする35歳の先生です。英語が堪能な上に、今回の来日前に日本語を勉強してきたそうで、何とカタカナが読めちゃうスーパータイ人でした。今回は当科の三幡先生が考案した上方関節包再建術の手術手技や、リハビリなどを勉強するため、2か月弱の滞在でした。友好的な性格で肩の手術のコツのみならず日本語(生中、おかわり、もう一杯など)もどんどん吸収して最後は日本語でプレゼンテーションまでしてくれました。
Mei先生の今後の活躍とともに、これからも交流が続くことを期待しています。
(文責:長谷川 彰彦)
![](https://ort-ompu.com/wp-content/uploads/2017/11/81de119891b4596c31081b940072d9e8.jpg)
日本肩関節学会で(一番右がMei先生)
![](https://ort-ompu.com/wp-content/uploads/2017/11/761bcce5d0f93cc6f4b80d4c775d5b86.jpg)
日本語でプレゼンテーションをしたMei先生
My 2-month experience in Department of Orthopedic Surgery, Osaka Medical College.
Prakasit Chanasit MD FRCOST
Charoenkrung Pracharak Hospital
Bangkok, Thailand
I am Prakasit Chanasit MD. I am from Thailand. Before I came to Osaka Medical College(OMC), I worked at the municipal hospital in Bangkok named “CHAREONKRUNG PRACHARAK” hospital. I am specialized at shoulder and knee surgery with 6 years’ experience in this field.
Several years ago, I heard about “Superior capsular reconstruction”(SCR), the novel treatment for massive irreparable rotator cuff tendon tear. It was originated by Teruhisa Mihata MD PhD. It was very interesting concept and procedure for me. I have learned a lot from his publications. But, from the worldwide level, the result of this operation is not so good especially when do not perform by Dr. Mihata. I thought that there must be some details those influenced his good result.
So, I needed to know about that. First, I tried to find Dr. Mihata’s email from the internet. Fortunately, I could find it from the PubMed. I sent my proposal to him last year. And He accepted my proposal to observe his works for 2 months at OMC.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure1.jpg)
Figure 1 : SCR illustration
OMC is located in small city called TAKATSUKI. I never knew this name before. I really nervous about that. But, Dr. Mihata cordially appointed Akihiko Hasegawa MD PhD to take care of me. Dr. Hasegawa is very helpful and generous. He prepared the documentations, booked the hotel, and did everything that I might need to stay in Takatsuki. I would like to express my gratitude to him to made this good time for me.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure2.jpg)
Figure 2 : In front of OMC hospital
First day in OMC, Dr. Hasegawa took me to the department office. I met Dr. Mihata there. Dr. Hasegawa also introduced me to Prof. Neo and another department staff like Dr. Shima, Foot and ankle specialist, Dr. Nakano, Spine surgeon, etc. It was a warm welcome.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure3.jpg)
Figure 3 : OMC shoulder group & me
After that, Dr. Mihata introduced the research protocol for me to do in 2 months’ period. It was about the MRI evaluation of supraspinatus muscle after the SCR operation. Clinically, after SCR, the muscle power and range of motion is improved compare to preoperative. But, we still have no other evidence at this time. So, this is the main purpose for this study.
The clinical experience with Dr. Mihata is include the out-patient clinic, observe the operation, rehabilitation. I also had a good chance to scrub in and assist in the operation under Dr. Mihata supervision. It was my best experience, here. As mentioned earlier, my main purpose is to learn the SCR. Dr. Mihata showed me the presentation of concept and overview of SCR. So, I can understand more. Dr. Hasegawa also taught me how to harvest the Fascia Lata graft to use for the SCR. Different from the operation from another hospital, Dr. Mihata always use the Fascia Lata graft to reconstruction the superior capsule because of the good biomechanical property of the Fascia Lata.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure4.jpg)
Figure 4 : Assisting Dr. Mihata’s operation
After 2-week observation, I was allowed to assist the operation. I experienced to assist Dr.Mihata to do the shoulder arthroscopy including rotator cuff repair, anterior capsulolabral reconstruction and superior capsular reconstruction. I also harvested the Fascia Lata graft by myself under his supervision.
In the out-patient clinic, I observed Dr. Mihata follow up his patients. I was surprised every time that I saw the SCR patients can elevate their arm very well without any pain. That’s mean the operation has good outcome.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure5.jpg)
Figure 5 : Out-patient clinic
I also observed the surgery and the experiment of knee group in the hospital. Japanese surgeons always had the innovation for treatment. I saw the total knee arthroplasty using the implant that was made in Japan. And Dr. Otsuki’s experimental study about meniscal scaffold in rabbit model. Such innovative!!
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure6.jpg)
Figure 6 : Knee group surgery
Finally, I would like to express my gratitude to everyone contributing in creating the most joyful moment in my life. Friendships and happiness here will be forever-unforgettable memories. I really hope that one day in the future we will have a chance to meet again.
![](https://ort-ompu.com/wp-content/uploads/2017/11/Meis-OMC-in-short-review-Figure7.jpg)
Figure 7 : OMC Orthopaedics team & me
Mei先生の『My 2-month experience in Department of Orthopedic Sergery, Osaka Medical College.』は下記にて詳しくご覧いただけます。
↓↓↓
Mei’s OMC in short review_(PDFデータ)