Publications by authors named "Atsushi Yamamoto"

322 Publications

Endotoxins and Non-Alcoholic Fatty Liver Disease.

Front Endocrinol (Lausanne) 2021 29;12:770986. Epub 2021 Oct 29.

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. It occurs with a prevalence of up to 25%, of which 10-20% cases progress to nonalcoholic steatohepatitis (NASH), cirrhosis, and liver cancer. The histopathology of NASH is characterized by neutrophilic infiltration, and endotoxins from gram-negative rods have been postulated as a contributing factor. Elevations in endotoxin levels in the blood can be classified as intestinal and hepatic factors. In recent years, leaky gut syndrome, which is characterized by impaired intestinal barrier function, has become a significant issue. A leaky gut may prompt intestinal bacteria dysbiosis and increase the amount of endotoxin that enters the liver from the portal vein. These contribute to persistent chronic inflammation and progressive liver damage. In addition, hepatic factors suggest that liver damage can be induced by low-dose endotoxins, which does not occur in healthy individuals. In particular, increased expression of CD14, an endotoxin co-receptor in the liver, may result in leptin-induced endotoxin hyper-responsiveness in obese individuals. Thus, elevated blood endotoxin levels contribute to the progression of NASH. The current therapeutic targets for NASH treat steatosis and liver inflammation and fibrosis. While many clinical trials are underway, no studies have been performed on therapeutic agents that target the intestinal barrier. Recently, a randomized placebo-controlled trial examined the role of the intestinal barrier in patients with NAFLD. To our knowledge, this study was the first of its kind and study suggested that the intestinal barrier may be a novel target in the future treatment of NAFLD.
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http://dx.doi.org/10.3389/fendo.2021.770986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8586459PMC
October 2021

Reciprocal inhibition improves posterior shoulder tightness and shoulder range of motion in youth baseball players.

JSES Int 2021 Nov 19;5(6):978-982. Epub 2021 Aug 19.

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Background: The aim of this study was to evaluate the efficacy of reciprocal inhibition for posterior shoulder tightness (PST), internal rotation at 90° abduction (ABIR) limitation, and subacromial impingement in elementary and junior high school baseball players.

Methods: The present study included 290 elementary school and junior high school baseball players who were members of an organized baseball team and attended a medical checkup in 2014. Seventeen participants were excluded because they were left-handed. We applied a sit-up exercise as a tool of reciprocal inhibition to all participants. Before and after the sit-up exercise, we evaluated the shoulder range of motion (ROM) in external rotation at 90° abduction (ABER), ABIR, and horizontal flexion (HF) in both shoulders and the prevalence of subacromial impingement in the dominant shoulder. We defined PST as a ≧15°decrease in the HF angle of the dominant shoulder in comparison to the nondominant shoulder before the sit-up exercise and divided participants into two groups (the PST group and the non-PST groups). An independent -test was performed to compare the shoulder ROM, and a chi-squared test was performed to compare the prevalence of subacromial impingement between the two groups. A dependent -test was performed to compare intragroup changes in the shoulder ROM. The McNemar test was performed to compare intragroup changes in the prevalence of subacromial impingement.

Results: Fifty-six of 273 participants had PST in the initial examination. The initial examination revealed that the ROM of ABIR and HF in the dominant shoulder were significantly lower in the PST group than those in the non-PST group, whereas the ROM of ABER and total arc were significantly higher in the PST group. The prevalence of subacromial impingement in the PST group was significantly higher than that in the non-PST group. The sit-up exercise improved ABER, ABIR, total arc, HF, and the prevalence of subacromial impingement in both groups. However, the amount of ROM change did not differ between the two groups for any parameter with the exception of HF.

Conclusion: The presence of PST affects the prevalence of subacromial impingement but was not related to the loss of ABIR or the prevalence of pathological glenohumeral internal rotation deficit. The sit-up exercise, as reciprocal inhibition, can transiently improve the prevalence of subacromial impingement via the improvement of PST.
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http://dx.doi.org/10.1016/j.jseint.2021.06.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568802PMC
November 2021

N-ammonia positron emission tomography-derived left-ventricular strain in patients after heart transplantation validated using cardiovascular magnetic resonance feature tracking as reference.

Ann Nucl Med 2021 Oct 13. Epub 2021 Oct 13.

Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Objective: Heart transplant rejection leads to cardiac allograft vasculopathy (CAV). N-ammonia positron emission tomography (PET) can be useful in detecting CAV, as it can evaluate both epicardial vessels and microvasculature. In this study, we evaluated the regional wall motion in heart transplant patients using our PET-specific feature-tracking (FT) algorithm for myocardial strain calculation and validated it using a cardiovascular magnetic resonance (CMR) FT strain as a reference.

Methods: A total of 15 heart transplant patients who underwent both N-ammonia PET and CMR within 3 months were retrospectively enrolled. The same slice position of short-axis cine images of the middle slice of left ventricle (LV) and the same slice position of horizontal long-axis cine images were selected for the two modalities to measure the circumferential strain (CS) and longitudinal strain (LS), respectively. Based on the FT technique, time-strain curves were calculated by semi-automatic tracking of the endocardial contour on cine images throughout a cardiac cycle. The peak value in the time-strain curve was defined as the representative value. Correlations of CS and LS between PET and CMR were analyzed using Pearson correlation coefficients. The inter-modality error of strain measurements was evaluated using intraclass correlation coefficients (ICCs) with two-way random single measures.

Results: Excellent correlations of CS and LS between PET and CMR were observed (CS: r = 0.80; p < 0.01; LS: r = 0.87; p < 0.01). Excellent ICCs were observed (0.89 and 0.85) in CS and LS derived from PET.

Conclusions: We propose the first PET strain showing an excellent agreement with the CMR strain and high reproducibility in measurement.
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http://dx.doi.org/10.1007/s12149-021-01686-5DOI Listing
October 2021

Coronary flow quantification estimated by dynamic 320-detector CT angiography: validation by N ammonia PET myocardial flow reserve.

Br J Radiol 2021 Nov 29;94(1127):20201415. Epub 2021 Sep 29.

Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.

Objectives: Resting coronary flow index (rCFI) estimated by 320-detector low-dose dynamic coronary CT angiography (CCTA) is a direct flow quantification using intracoronary attenuation. We propose modified-rCFI from new protocol combining dynamic scan and standard CCTA using dose-modulation, and validate its consistency with quantitative values and ischemia depicted by N-ammonia PET (NH-PET).

Methods: 46 patients who underwent dynamic CCTA and NH-PET for coronary artery disease were evaluated using original rCFI in 21 patients and modified-rCFI in 25 patients. Two types of rCFI were calculated for three major coronary arteries. Myocardial blood flow (MBF) at rest and stress, myocardial flow reserve (MFR), and the presence or absence of ischemia for three major territories were depicted by NH-PET. Coronary territories were categorized as territories with MFR <2.0, ≥2.0, or with and without ischemia. Receiver operating characteristic analysis was performed to determine the optimal cut-off of rCFI to distinguish territories with MFR <2.0 or the presence of ischemia.

Results: rCFI and modified-rCFI had significant positive correlations with stress MBF and MFR. The optical cut-offs of rCFI and modified-rCFI of 0.39 and 0.61 could detect territories with MFR <2.0, with AUCs of 0.75 and 0.73, sensitivities of 48 and 34%, and specificities of 97 and 98%. Optimal cut-offs of rCFI and modified-rCFI distinguished ischemic segments from non-ischemic segments, with AUCs of 0.75 and 0.91, sensitivities of 53 and 50%, and specificities of 93 and 95%.

Conclusion: Two types of rCFI correlated with quantitative values from NH-PET, and were consistent with a high specificity in detecting functional ischemia.

Advances In Knowledge: rCFI can contribute as additional functional test over standard CCTA in clinical work-up.
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http://dx.doi.org/10.1259/bjr.20201415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553190PMC
November 2021

Risk Factors for Throwing-Related Shoulder and Elbow Pain in Adolescent Baseball Players: A Prospective Study of Physical and Developmental Factors.

Orthop J Sports Med 2021 Sep 17;9(9):23259671211017129. Epub 2021 Sep 17.

Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.

Background: Throwing-related shoulder and elbow pain continues to be reported among adolescent baseball players. Few prospective studies have specifically examined the association between throwing-related shoulder and elbow pain and physical and developmental changes.

Purpose: To evaluate the changes in physical and developmental characteristics during 1 year with respect to throwing-related shoulder and elbow pain in adolescent baseball players.

Study Design: Case-control study; Level of evidence, 3.

Methods: This 1-year prospective follow-up study investigated 164 baseball players aged 7 to 13 years. Player data (age, height, weight, field position, and pitch count), lower extremity muscle tightness, and range of motion (ROM) of the shoulder, elbow, and hip joints were assessed during the 2016 and 2017 preseason medical examinations. After the 2016 season, the participants completed questionnaires related to throwing-related shoulder and elbow pain, defined as an inability to play for ≥1 week because of elbow or shoulder difficulties. For study participants with and without throwing-related shoulder or elbow pain during the 2016 season, we conducted univariate and multivariate logistic regression analysis to identify risk factors for throwing-related shoulder or elbow pain.

Results: Overall, 21 players (12.8%) reported a shoulder pain episode, 56 players (34.1%) had an elbow pain episode, and 70 players (42.7%) reported having experienced shoulder and/or elbow pain during the 2016 season. In multivariate logistic regression analysis, (1) shoulder pain was associated with 2016 preseason height (odds ratio [OR], 1.06; 95% CI, 1.01-1.11; = .01) and change in dominant-side elbow extension ROM from 2016 to 2017 (OR, 1.12; 95% CI, 1.02-1.24; = .02); (2) elbow pain was associated with change in weight from 2016 to 2017 (OR, 1.21; 95% CI, 1.04-1.41; = .014); and (3) throwing-related shoulder and/or elbow pain was associated with greater 2016 preseason height (OR, 1.04; 95% CI, 1.003-1.68; = .03) and an increase in height from 2016 to 2017 (OR, 1.17; 95% CI, 1.01-1.35; = .03).

Conclusion: Our results indicated that adolescent baseball players who were taller in the preseason and those with an increase in height over the 1-year study period faced significant risks for developing throwing-related shoulder and/or elbow pain.
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http://dx.doi.org/10.1177/23259671211017129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8450620PMC
September 2021

[Eosinophilic granulomatosis with polyangiitis presenting with Guillain-Barré syndrome-like acute course. A case report].

Rinsho Shinkeigaku 2021 Sep 26;61(9):624-629. Epub 2021 Aug 26.

Department of Neurology, Kyoto Daini Red Cross Hospital.

A 57-years-old man with a history of bronchial asthma and pansinusitis developed acute progressive muscle weakness and sensory disturbance of the distal limbs after upper respiratory infection. On day 15 after onset of sensory disturbance and muscle weakness, the patient admitted to our hospital. A neurological examination revealed asymmetry weakness of both proximal and distal muscles, "glove and stocking type" hypoesthesia, and paresthesia without obvious pain. Blood tests and a nerve conduction study demonstrated eosinophilia and elevation of MPO-ANCA, axonal multiple mononeuropathy, respectively. The cerebrospinal fluid was normal. Eosinophilic granulomatosis with polyangiitis (EGPA) or Guillain-Barré syndrome (GBS) were suspected. So intravenous immunoglobulin therapy (IVIg) and high dose methylprednisolone pulse therapy (HDMP) followed by oral prednisolone were started. However, neurological symptoms did not improve. Sural nerve biopsy on day 31 revealed varying myelinating fiber loss at every nerve bundle and perivascular lymphocytic infiltration. The results did not fulfill the pathologic criteria for EGPA, but supported the changes of vasculitis. Cyclophosphamide (CPA) pulse therapy was administered for the additional therapy. Neurological symptoms did not improve and worsened again after decreasing oral prednisolone; therefore, combined therapy with IVIg, HDMP, and CPA was administered. Neurological symptoms then diminished gradually and the MPO-ANCA level and number of eosinophils normalized. This case suggests the importance of early nerve biopsy to obtain pathological findings supportive of EGPA diagnosis to allow introduction of aggressive immunosuppressive therapy such as CPA in a case with acute progressive motor-sensory neuropathy due to EGPA mimicking GBS.
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http://dx.doi.org/10.5692/clinicalneurol.cn-001601DOI Listing
September 2021

Neuroplasticity Caused by Peripheral Proprioceptive Deficits.

Med Sci Sports Exerc 2021 Aug 24. Epub 2021 Aug 24.

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.

Purpose: Proprioceptive feedback is crucial for motor control and stabilization of the shoulder joint in everyday life and sports. Shoulder dislocation causes anatomical and proprioceptive feedback damage that contributes to subsequent dislocations. Previous recurrent anterior shoulder instability (RSI) studies did not investigate functional neuroplasticity related to proprioception of the injured shoulder. Thus, we aimed to study the differences in neuroplasticity related to motor control between patients with RSI and healthy individuals, using functional magnetic resonance imaging, and assess the effects of peripheral proprioceptive deficits due to RSI on central nervous system (CNS) activity.

Methods: Using passive shoulder motion and voluntary shoulder muscles contraction tasks, we compared the CNS correlates of proprioceptive activity between patients having RSI (n = 13) and healthy controls (n = 12) to clarify RSI pathophysiology and the effects of RSI-related peripheral proprioceptive deficits on CNS activity.

Results: Decreased proprioception-related brain activity indicated a deficient passive proprioception in patients with RSI (P < 0.05 family-wise error, cluster level). Proprioceptive afferent-related right cerebellar activity significantly negatively correlated with the extent of shoulder damage (P = 0.001, r = -0.79). Functional magnetic resonance imaging demonstrated abnormal motor control in the CNS during voluntary shoulder muscles contraction.

Conclusion: Our integrated analysis of peripheral anatomical information and brain activity during motion tasks can be used to investigate other orthopedic diseases.
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http://dx.doi.org/10.1249/MSS.0000000000002775DOI Listing
August 2021

The Role of Leaky Gut in Nonalcoholic Fatty Liver Disease: A Novel Therapeutic Target.

Int J Mol Sci 2021 Jul 29;22(15). Epub 2021 Jul 29.

Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.

The liver directly accepts blood from the gut and is, therefore, exposed to intestinal bacteria. Recent studies have demonstrated a relationship between gut bacteria and nonalcoholic fatty liver disease (NAFLD). Approximately 10-20% of NAFLD patients develop nonalcoholic steatohepatitis (NASH), and endotoxins produced by Gram-negative bacilli may be involved in NAFLD pathogenesis. NAFLD hyperendotoxicemia has intestinal and hepatic factors. The intestinal factors include impaired intestinal barrier function (leaky gut syndrome) and dysbiosis due to increased abundance of ethanol-producing bacteria, which can change endogenous alcohol concentrations. The hepatic factors include hyperleptinemia, which is associated with an excessive response to endotoxins, leading to intrahepatic inflammation and fibrosis. Clinically, the relationship between gut bacteria and NAFLD has been targeted in some randomized controlled trials of probiotics and other agents, but the results have been inconsistent. A recent randomized, placebo-controlled study explored the utility of lubiprostone, a treatment for constipation, in restoring intestinal barrier function and improving the outcomes of NAFLD patients, marking a new phase in the development of novel therapies targeting the intestinal barrier. This review summarizes recent data from studies in animal models and randomized clinical trials on the role of the gut-liver axis in NAFLD pathogenesis and progression.
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http://dx.doi.org/10.3390/ijms22158161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347478PMC
July 2021

Prognostic effect of sarcopenia in colorectal cancer recurrence.

Nutrition 2021 Nov-Dec;91-92:111362. Epub 2021 Jun 2.

First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Objectives: Nutritional status significantly influences postoperative prognosis in gastrointestinal cancers. It has been evaluated using sarcopenia before treatments such as surgery and chemotherapy, despite constant changes in nutritional status. We consider that nutritional status at cancer recurrence is one of the important factors that affect treatment choice and intensity. This study evaluated the prognostic effects of improved postoperative nutritional status for people with colorectal cancer recurrence.

Methods: We enrolled 209 participants with pathologically confirmed stage II or III colorectal cancer who underwent radical resection. Sarcopenia was diagnosed using the psoas muscle index obtained from analysis of three-dimensional computed tomographic images. We adopted the cutoff value that was proposed by Hamaguchi et al. (psoas muscle index < 6.36 cm/m for men and < 3.92 cm/m for women). Evaluation was performed before surgery and at the time of recurrence. Participants with preoperative sarcopenia who relapsed were divided into two groups at the time of recurrence: sarcopenia continuation and sarcopenia improvement. We compared the prognosis of the two groups and examined the effect of postoperative nutritional improvement.

Results: Among the 209 participants, 81 (38.8%) had preoperative sarcopenia; this group had significantly lower overall survival than those without sarcopenia (P = 0.028). Colorectal cancer recurred in 48 participants. Of those 46, sarcopenia was evaluated at the time of recurrence; 19 of those 46 had preoperative sarcopenia. Preoperative sarcopenia did not affect the cancer recurrence ratio (sarcopenia, 23.5%; non-sarcopenia, 21.3%; P = 0.893). The sarcopenia-improvement group had higher overall survival than the sarcopenia-continuation group (P = 0.042).

Conclusions: Among participants with preoperative sarcopenia, the prognosis at the time of recurrence improved for the sarcopenia-improvement group compared to the sarcopenia-continuation group. In people with colorectal cancer and sarcopenia, nutritional management is important not only before but also after surgery.
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http://dx.doi.org/10.1016/j.nut.2021.111362DOI Listing
June 2021

Four-year trend in shoulder and elbow injuries in competitive-level high school baseball pitchers: a repeated cross-sectional survey.

JSES Int 2021 Jul 3;5(4):789-792. Epub 2021 May 3.

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Background: Shoulder and elbow injuries are the main cause of throwing disability among high school baseball pitchers. However, longitudinal studies on shoulder and elbow injuries among competitive-level high school baseball pitchers have been insufficient. This study aimed to investigate shoulder and elbow injuries in competitive-level high school baseball pitchers over a four-year period and elucidate the effects of implementing medical checkups on the incidence of shoulder and elbow injuries.

Methods: Five hundred fifty-two high school baseball pitchers, who received preseason medical checkups from February 2012 to February 2015, were enrolled in this study. Shoulder and elbow injuries occurring during the season after medical checkups were prospectively evaluated by a postseason questionnaire. Pitchers who were not able to pitch for >7 days owing to shoulder or elbow pain were defined as having shoulder and elbow injuries during the season. The incidence rates of shoulder and elbow injuries during the seasons were calculated and compared over the 4-year period.

Results: Ninety-six percent of medical checkup participants were included in the study. The mean questionnaire collection rate of the prospective study was 71.6% (range: 67.7-78.9%). The incidence of shoulder and elbow injuries significantly decreased from 20.0% in 2012 to 7.7% in 2015 ( = .013).

Conclusion: The four-year trend in the incidence of shoulder and elbow injuries in competitive-level high school baseball pitchers was evaluated. The incidence of shoulder and elbow injuries during the season significantly decreased with a linear downward trend during the survey period after the implementation of medical checkups.
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http://dx.doi.org/10.1016/j.jseint.2021.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245981PMC
July 2021

Risk factor for elbow symptom manifestation in young baseball players with asymptomatic medial elbow abnormalities: a prospective cohort study.

Sci Rep 2021 06 23;11(1):13119. Epub 2021 Jun 23.

Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.

Asymptomatic elbow abnormalities are relatively common in young baseball players, but the factors responsible are unclear. To prospectively identify risk factors related to symptom manifestation in asymptomatic elbow abnormalities, we recruited 573 baseball players (age: 7-14 years) at a pre-participation medical/physical examination in the preseason who were right-handed and had asymptomatic medial elbow abnormalities on ultrasound (US). Baseline preseason and postseason participant characteristics were assessed. A "symptomatic" elbow was defined as an elbow with medial elbow joint problems that prevented ball throwing for ≥ 8 days. After exclusions, 82 players were enrolled, of whom 22 (26.8%) developed a symptomatic elbow. In univariate analyses, the external and internal rotation strengths of the dominant shoulder were significantly greater in the symptomatic group than in the asymptomatic group (P = 0.021). Multivariate logistic regression analysis showed that the internal rotation strength of the dominant shoulder was a significant independent risk factor (odds ratio = 1.091, P = 0.027) for developing a symptomatic elbow. In young asymptomatic baseball players with abnormalities in the medial elbow region of the dominant arm on US, stronger preseason internal rotation strength of the dominant shoulder was a significant independent risk factor for the development of a "symptomatic" elbow.
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http://dx.doi.org/10.1038/s41598-021-92570-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222278PMC
June 2021

N-ammonia positron emission tomography-derived endocardial strain for the assessment of ischemia using feature-tracking in high-resolution cine imaging.

J Nucl Cardiol 2021 Jun 11. Epub 2021 Jun 11.

Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Background: Assessing endocardial strain using a single N-ammonia positron emission tomography (PET) scan would be clinically useful, given the association between ischemia and myocardial deformation. However, no software has been developed for strain analysis using PET. We evaluated the clinical potential of feature tracking-derived strain values measured using PET, based on associations with the myocardial flow reserve (MFR).

Methods And Results: This retrospective study included 95 coronary artery disease patients who underwent myocardial N-ammonia PET. Semi-automatic measurements were made using a feature-tracking technique during myocardial cine imaging, and values were calculated using a 16-segment model. Adenosine-stressed global circumferential strain (CS) and global longitudinal strain (LS) values were compared with global MFR values. Stressed and resting global strain values were also compared. Global strain values were significantly lower in 39 patients with abnormal MFRs [< 2.0] than in 56 patients with normal MFRs [≥ 2.0]. The global CS values in the stressed state were significantly decreased than the resting state values in patients with abnormal MFRs.

Conclusions: This study applied endocardial feature-tracking to N-ammonia PET, and the results suggested that blood flow and myocardial motility could be clinically assessed in ischemic patients using a single PET scan.
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http://dx.doi.org/10.1007/s12350-021-02677-9DOI Listing
June 2021

Risk stratification in coronary artery disease using NH-PET myocardial flow reserve and CAD-RADS on coronary CT angiography.

Int J Cardiovasc Imaging 2021 Nov 11;37(11):3335-3342. Epub 2021 Jun 11.

Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Myocardial flow reserve (MFR) derived from N-ammonia positron emission tomography (NH-PET) can predict the prognosis of patients with various heart diseases. Coronary computed tomography angiography (CCTA) is a non-invasive investigation for ischemic heart disease. The coronary artery disease reporting and data system (CAD-RADS) was established to standardize and facilitate the reporting of CCTA data regarding CAD. This study aimed to investigate the prognostic value of CAD-RADS and MFR. A total of 133 patients who underwent NH-PET and CCTA within 3 months were enrolled. Patients were divided into groups with CAD-RADS 0-2 and ≥ 3 and into groups with MFR ≥ 2.0 and < 2.0. The endpoint was major adverse cardiac events (MACE) comprising all-cause death, acute coronary syndrome, hospitalization due to heart failure, and cerebrovascular disease. The ability of CAD-RADS and MFR to predict MACE was analyzed using Kaplan-Meier analysis. There was no significant difference in MFR between patients with CAD-RADS 0-2 and ≥ 3 (2.3 ± 0.9 vs. 2.2 ± 0.7, p = 0.50). The MACE rate for patients with CAD-RADS 0-2 and ≥ 3 was equivalent (log-rank test, p = 0.64). Patients with MFR < 2.0 had a significantly higher MACE rate than those with MFR ≥ 2.0 (p = 0.017). In patients with CAD-RADS ≥ 3, patients with MFR < 2.0 had a significantly higher MACE rate than those with MFR ≥ 2.0 (p = 0.034). CAD-RADS did not contribute to MACE prediction. Conversely, MFR was useful in predicting MACE, allowing for further risk stratification in addition to CAD-RADS.
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http://dx.doi.org/10.1007/s10554-021-02312-1DOI Listing
November 2021

Exposure to Blood Components and Inflammation Contribute to Pancreatic Cancer Progression.

Ann Surg Oncol 2021 Dec 8;28(13):8263-8272. Epub 2021 Jun 8.

First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Chuo, Yamanashi, Japan.

Background: Pancreatectomy is a highly invasive procedure with extensive intraoperative blood loss (IBL) and high risk of postoperative pancreatic fistula (POPF). We conducted an experimental and retrospective clinical study to determine whether the malignant behaviors of pancreatic cancer cells were enhanced by exposure to blood components in vitro and to evaluate the oncological significance of high IBL and POPF in pancreatic cancer.

Methods: This study included 107 patients undergoing radical pancreatectomy in the University of Yamanashi Hospital between 2011 and 2017, classified into high (n = 29) and low (n = 78) IBL groups. In vitro experiments included functional analyses of Panc-1 pancreatic cancer and normal mesothelial cells exposed to patient blood components, and clinical data were used to assess the contribution of IBL and POPF to patient outcomes.

Results: The migration (p = 0.007), invasion (p < 0.001), and proliferation (p < 0.01) of Panc-1 cells were enhanced with platelet coculture. The ability of Panc-1 cells to adhere mesothelial cells was enhanced by plasma coincubation, especially in the presence of inflammation (p < 0.001). High IBL was associated with worse overall survival (p = 0.007) and increased locoregional recurrence (p = 0.003) in patients. POPF enhanced the negative prognostic significance of high IBL (p < 0.001 for overall survival, p = 0.001 for locoregional recurrence), indicating the oncological negative effects of high IBL and POPF.

Conclusions: Blood components, especially platelets, and inflammation enhance the malignant behaviors of pancreatic cancer cells, potentially contributing to poor prognosis for pancreatic cancer patients.
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http://dx.doi.org/10.1245/s10434-021-10250-4DOI Listing
December 2021

The Relationship Between Dynamic Balance Ability and Shoulder Pain in High School Baseball Pitchers.

Sports Health 2021 Jun 8:19417381211019682. Epub 2021 Jun 8.

Background: Dynamic balance is essential for pitching motion because pitching kinematics requires whole body coordination. The Star Excursion Balance Test (SEBT) and the Y balance test (YBT) evaluate dynamic balance quantitatively. There are some reports that investigated the relationship between SEBT/YBT and pain in upper and lower extremities, but there is no study among high school baseball pitchers.

Hypothesis: Dynamic balance deficiency is associated with shoulder pain among high school baseball pitchers.

Study Design: Cross-sectional study.

Level Of Evidence: Level 4.

Methods: A total of 259 male high school pitchers who participated in the preseason medical checkups were included in the study. YBT was used to measure their dynamic balance. The participants completed a questionnaire which asked if they were currently experiencing shoulder pain.

Results: Twenty-two pitchers had shoulder pain during the preseason medical checkups. In the YBT, the posterolateral balance while standing with the axis leg as well as the posteromedial and posterolateral balance while standing with the step leg were significantly lower in the pain group than in the nonpain group ( = 0.05, 0.04, and 0.001, respectively). A logistic regression analysis showed that posterolateral balance when standing with the step leg was an independent risk factor for current shoulder pain ( = 0.04, odds ratio 0.942, 95% CI 0.892-0.996).

Conclusion: The dynamic balance of high school baseball pitchers with shoulder pain was lower than that of participants without shoulder pain. In particular, posterolateral direction with the step leg standing was significantly related to shoulder pain.

Clinical Relevance: Among high school baseball pitchers, decreased dynamic balance was related to current shoulder pain. YBT maybe recommended in preseason medical checkups for high school baseball pitchers.
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http://dx.doi.org/10.1177/19417381211019682DOI Listing
June 2021

Enantioseparation of phenethylamines by using high-performance liquid chromatography column permanently coated with methylated β-cyclodextrin.

J Sep Sci 2021 Aug 15;44(15):2932-2940. Epub 2021 Jun 15.

School of Science, Tokai University, Hiratsuka, Japan.

Cyclodextrins and their derivatives have been used for chiral high-performance liquid chromatography selectors, while they are costly to use as mobile phase additives in high-performance liquid chromatography. Here, we report application of phenyl column coated permanently with methylated β-cyclodextrin for chiral high-performance liquid chromatography. A 0.1% (v/v) phosphoric acid solution containing 1 M NaCl and 0.5% (w/v) methylated β-cyclodextrin was subjected to a phenyl column at a flow rate of 0.5 mL/min at 30°C for 2 h. Using the precoating phenyl column, all the enantiomers of the four phenethylamines (norepinephrine, epinephrine, octopamine, and synephrine) were successfully separated simultaneously by high-performance liquid chromatography with a mobile phase without methylated β-cyclodextrin at a flow rate of 0.2 mL/min at 30°C. The enantioseparation ability was retained for successive analyses during 1 week. It is suggested that inclusion complex of methylated β-cyclodextrin with a phenyl group on the surface of the stationary phase could be formed and that the inclusion complex could form the ternary complex with the injected analytes. The longer retention time of (S)-enantiomers of analytes than corresponding (R)-enantiomers for high-performance liquid chromatography could be explained from the higher stability of the methylated β-cyclodextrin complexes with (S)-enantiomers, which were confirmed by capillary electrophoresis and H NMR spectroscopy experiments.
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http://dx.doi.org/10.1002/jssc.202100343DOI Listing
August 2021

An analysis of pre-season risk factors for low back injury in high-school baseball pitchers: a prospective study.

Sci Rep 2021 06 1;11(1):11415. Epub 2021 Jun 1.

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.

Pitching motion requires whole-body coordination; therefore, poor control of the lower extremities, pelvis and trunk may cause shoulder and elbow injuries. However, few studies have described the relationship between the shoulder joint function and low back injury in high-school baseball pitchers. A total of 128 healthy high school pitchers underwent pre-season medical checkups, where their shoulder range of motion and shoulder strength were measured. The participants completed a self-recorded daily questionnaire regarding the presence of low back pain. Pitchers were divided into injured and non-injured groups. Low back injury was observed in 13 participants (13.4%). In the injured group, horizontal adduction on the dominant shoulder was significantly less than in the non-injured group. A logistic regression analysis showed that horizontal adduction on the dominant side was a significant independent risk factor for low back injury during the season. It is important to recognize that restriction of the shoulder function not only causes shoulder and elbow injuries but can also risk low back injury.
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http://dx.doi.org/10.1038/s41598-021-90988-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169826PMC
June 2021

Prognostic impact of lymph node micrometastasis in patients with gastric cancer.

Surg Today 2021 May 22. Epub 2021 May 22.

First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan.

Purpose: The clinical significance of lymph node micrometastasis (LNMM) remains controversial in gastric cancer (GC). In this study, we investigated the prognostic impact of LNMM in patients with GC.

Methods: A total of 624 patients with pathologically lymph node metastasis-negative (pN0) and N1 status (pN1) who underwent gastrectomy between 2004 and 2018 were enrolled in this retrospective study. The diameter of tumor cell clusters in metastatic lymph nodes was measured in 120 patients with pN1 GC.

Results: Patients with lymph node tumors < 1500 μm in diameter (LNMM) had a significantly better prognosis than those with tumors ≥ 1500 μm in diameter (p = 0.012; log-rank test). Cox's proportional hazards model revealed that LNMM (p = 0.016), several dissected lymph nodes (p = 0.049), and the provision of adjuvant chemotherapy (p = 0.002) were independent prognostic factors for the overall survival of patients with pN1 GC. There was no significant difference in the overall survival between patients with LNMM who received chemotherapy and those who did not (p = 0.332).

Conclusions: LNMM is associated with a favorable prognosis and maybe an independent prognostic marker in patients with pN1 GC. LNMM in GC may be considered a factor preventing adjuvant chemotherapy.
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http://dx.doi.org/10.1007/s00595-021-02302-9DOI Listing
May 2021

Heterogeneous dynamics in the curing process of epoxy resins.

Sci Rep 2021 May 17;11(1):9767. Epub 2021 May 17.

Japan Synchrotron Radiation Research Institute/SPring-8, 1-1-1, Kouto, Sayo-cho, Sayo-gun, Hyogo, 679-5198, Japan.

Epoxy resin is indispensable for modern industry because of its excellent mechanical properties, chemical resistance, and excellent moldability. To date, various methods have been used to investigate the physical properties of the cured product and the kinetics of the curing process, but its microscopic dynamics have been insufficiently studied. In this study, the microscopic dynamics in the curing process of a catalytic epoxy resin were investigated under different temperature conditions utilizing X-ray photon correlation spectroscopy. Our results revealed that the temperature conditions greatly affected the dynamical heterogeneity and cross-linking density of the cured materials. An overview of the microscopic mechanism of the curing process was clearly presented through comparison with the measurement results of other methods, such as H-pulse nuclear magnetic resonance spectroscopy. The quantification of such heterogeneous dynamics is particularly useful for optimizing the curing conditions of various materials to improve their physical properties.
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http://dx.doi.org/10.1038/s41598-021-89155-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129072PMC
May 2021

Awake-induced increase of epileptiform discharges in a case with poststroke epilepsy.

Clin Neurophysiol Pract 2021 1;6:130-132. Epub 2021 Apr 1.

Department of Clinical Laboratory, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan.

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http://dx.doi.org/10.1016/j.cnp.2021.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091176PMC
April 2021

Pathological analysis of batch safety testing of veterinary vaccines using small laboratory animals.

J Toxicol Pathol 2021 Apr 25;34(2):137-146. Epub 2021 Feb 25.

National Veterinary Assay Laboratory, Ministry of Agriculture, Forestry and Fisheries, 1-15-1 Tokura, Kokubunji, Tokyo 185-8511, Japan.

Batch safety tests (BSTs) of veterinary vaccines are conducted using small laboratory animals to assure the safety of vaccines according to several criteria, including clinical signs and change in body weight. Although the latter is used as an evaluation index in BSTs, there have been no reports on the internal changes that affect body weight during the test period. Therefore, we analyzed BST via pathological examination of the tested animals. Here, BSTs were performed for 176 batches using mice and 126 batches using of guinea pigs. Most of the gross findings could be classified into four lesion types (nodules, adhesions, ascites, no apparent signs), with only one vaccine inducing lesions that could not be classified into any of these four types. Histopathological examination revealed that the reactions caused by BST were pyogenic and/or granulomatous inflammation. Nodular or adhesive lesions comprised more severe pyogenic granulomatous inflammation than ascites or cases with no apparent gross lesions. These nodular or adhesive lesions were more frequently induced by vaccines that contained an adjuvant than by vaccines that did not contain an adjuvant. The cases with "exceptional" gross findings histologically presented severe necrosis of the hematopoietic system. Additional testing showed that these "exceptional" lesions were induced when a specific type of light liquid paraffin was injected along with other vaccine additives. Our results show that body weight loss and/or lesions during BST were induced by proinflammatory properties of the tested vaccines and that BST is a sensitive method for detecting unexpected effects of vaccine components.
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http://dx.doi.org/10.1293/tox.2020-0078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100255PMC
April 2021

Asymptomatic Medial Elbow Ultrasound Abnormality in Youth Baseball Players Is an Independent Risk Factor for Elbow Injury: A Prospective Cohort Study.

Orthop J Sports Med 2021 Apr 14;9(4):2325967120986791. Epub 2021 Apr 14.

Investigation performed at the Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Background: Youth baseball players who experience elbow pain during the season frequently exhibit radiographic elbow abnormalities. However, it is unknown whether asymptomatic elbow abnormalities are risk factors for in-season elbow injuries.

Purpose: To determine whether the preseason presence of asymptomatic medial epicondyle apophysitis is a risk factor for in-season elbow injuries in youth baseball players.

Study Design: Cohort study; Level of evidence, 2.

Methods: Youth baseball players (N = 210; age range, 7-12 years) with no pain or history of injury in their throwing arms underwent preseason evaluations that included shoulder and elbow range of motion measurements, shoulder muscle strength testing, and ultrasound elbow scans with a multifrequency 13-MHz linear array transducer. Over 1 year of play, the players and their parents maintained daily elbow pain diaries. Elbow injuries were defined as medial elbow symptoms that prevented ball throwing for ≥8 days.

Results: The preseason ultrasound evaluation revealed medial epicondyle apophysitis in 59 players. In the year following, elbow injuries occurred in 17 (28.8%) players with preseason medial epicondyle apophysitis and 18 (11.9%) players without apophysitis. Independent predictors of elbow injuries were preseason medial epicondyle apophysitis (odds ratio [OR], 2.488; 95% confidence interval [CI], 1.152-5.376; = .02) and deficits of abduction (ABD) and external rotation of the dominant shoulder (OR, 0.963; 95% CI, 0.936-0.992; = .012).

Conclusion: Asymptomatic medial epicondyle apophysitis and ABD and external rotation deficits in the dominant shoulder were risk factors for elbow injuries in 7- to 12-year-old youth baseball players. These findings may aid in the design of programs to prevent elbow injuries in this population.
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http://dx.doi.org/10.1177/2325967120986791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050762PMC
April 2021

The formation process of button ulcers in pigs experimentally infected with a subgenotype 2.1 isolate of classical swine fever virus.

J Vet Med Sci 2021 Jul 19;83(6):990-993. Epub 2021 Apr 19.

National Veterinary Assay Laboratory, Ministry of Agriculture, Forestry and Fisheries, 1-15-1 Tokura, Kokubunji, Tokyo 185-8511, Japan.

We evaluated the role of classical swine fever virus (CSFV) in the formation of button ulcers in the mucosa of the gastrointestinal tract. Histopathological and immunohistochemical analyses of pigs experimentally infected with a subgenotype 2.1 isolate of CSFV, which was isolated in Japan in 2019, revealed follicular necrosis in the submucosal mucosa-associated lymphoid tissue and herniation of crypts as factors that contribute to the development of button ulcers during CSFV infection. These findings indicate that CSFV induces follicular necrosis and is one of the causative agents of button ulcers in pigs.
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http://dx.doi.org/10.1292/jvms.20-0654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267204PMC
July 2021

A case of simultaneous laparoscopic surgery for double cancer comprising multiple early gastric cancer and advanced sigmoid colon cancer after revascularization.

Surg Case Rep 2021 Apr 8;7(1):88. Epub 2021 Apr 8.

First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.

Background: Traditionally, the surgery for simultaneous double cancer of the stomach and colon required a large incision to the upper and lower region of the abdomen. In this case, an artificial blood vessel was located under the skin after revascularization. Considering ischemia due to graft compression by incision retractor during laparotomy, this was difficult to do. This is a report on laparoscopic surgery for simultaneous double cancer of the stomach and colon after revascularization.

Case Presentation: A 69-year-old man had early gastric cancer and advanced sigmoid colon cancer. He had suffered from thromboangitis obliterans and has undergone revascularization many times due to poor blood flow in his lower limbs. He had had some artificial blood vessels inserted under the skin, confirmed by blood vessel construction image by preoperative computed tomography (CT). There was a bypass vessel from the left axillary artery to the left femoral artery under the skin of the left thoracoabdominal. In addition, there were two bypass vessels from the left external iliac artery to the right femoral artery under the skin of the lower abdomen. One of the two bypasses was occluded. In the blood flow to the intestinal tract, the inferior mesenteric artery was already occluded. Peripheral blood flow in the common iliac artery depended on blood flow from the artificial blood vessel, and blood flow from the internal iliac artery to the rectum was poor. Laparoscopic Hartmann's operation was performed for Stage II B (UICC 8th Edition) sigmoid colon cancer. Because the blood flow in the intestinal tract on the anal side was poor, we thought that anastomosis was at a high risk for leakage. Laparoscopic total gastrectomy was also performed simultaneously for two Stage I (UICC 8th edition) gastric cancers in the cardia and body. The location of the port site and stoma was carefully determined preoperatively to prevent damage and infection to the artificial blood vessels. Minimal invasive surgery was performed using laparoscopic surgery.

Conclusions: Laparoscopic surgery with small incisions is useful for patients with double cancer who need an approach to the upper and lower abdomen. Furthermore, laparoscopic surgery has less interference on graft in patients with artificial blood vessels under the skin by intraperitoneal approach.
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http://dx.doi.org/10.1186/s40792-021-01161-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032834PMC
April 2021

Relationship between upper limb injuries and hip range of motion and strength in high school baseball pitchers.

J Orthop Surg (Hong Kong) 2021 Jan-Apr;29(1):23094990211003347

Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University Maebashi, Gunma, Japan.

We aimed to examine the relationship between hip range of motion (ROM) and abduction strength and throwing-related shoulder/elbow injuries in high school baseball pitchers. The study included 135 baseball pitchers. We asked them to fill out a questionnaire at the checkups, that included the dominant arm and the years of baseball experience. To avoid a confirmation bias, the examiners were blinded to the participants' hand dominance. All players underwent physical function measurements, such as height, weight, shoulder and hip strength, and shoulder and hip ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the patient had been aware of in the past 3 years. The results of injured and non-injured pitchers were compared. Eighty-five pitchers had experienced a shoulder or elbow injury in the past 3 years. The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation ROM on the dominant side, the hip abduction strength on the non-dominant side, and the hip abduction strength on the dominant side were significantly lower in the injured group than in the non-injured group. The results may contribute to reducing the incidence of these injuries.
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http://dx.doi.org/10.1177/23094990211003347DOI Listing
July 2021

Ankle dorsiflexion deficit in the back leg is a risk factor for shoulder and elbow injuries in young baseball players.

Sci Rep 2021 03 9;11(1):5500. Epub 2021 Mar 9.

Department of Orthopedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.

The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. Shoulder and elbow injuries were tracked during the season. Univariate and multivariate analyses were performed to identify risk factors for shoulder and elbow injuries among participants divided into non-injured and injured groups. Univariate analysis showed that age, height, weight, ROM of elbow flexion in the dominant arm, muscle strength ratio of shoulder abduction, and the likelihood of being a pitcher or a catcher were significantly greater in the injured group than in the non-injured group. ROM of shoulder abduction-external/internal rotation, shoulder total arc on the dominant arm, ankle joint dorsiflexion, and plantar flexion on the back (non-lead) and front (lead) legs were significantly less in the injured group than in the non-injured group. In conclusion, ROM dorsiflexion deficits in the back leg, shoulder abduction-external rotation in the dominant arm, ROM increase in elbow flexion on the dominant side, older age, and being a pitcher were significant independent risk factors for injury.
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http://dx.doi.org/10.1038/s41598-021-85079-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943763PMC
March 2021

Mucosa-associated lymphoid tissue lymphoma of the bladder: Case report.

Urol Case Rep 2021 Jul 4;37:101623. Epub 2021 Mar 4.

Department of Urology, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan.

We report the cases of patient with primary mucosa-associated lymphoid tissue (MALT) lymphoma of the bladder who successfully treated with local radiation therapy after transurethral resection of the bladder tumor. She maintains good activity of daily living without relapse. We recommend this strategy for localized MALT lymphoma of the bladder, because it provide better quality of life for elderly patients.
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http://dx.doi.org/10.1016/j.eucr.2021.101623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941202PMC
July 2021

Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET.

J Nucl Cardiol 2021 Jun 16;28(3):919-929. Epub 2021 Mar 16.

Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Background: We analyzed F-Fludeoxyglucose positron emission tomography (FDG-PET) and I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) performed for cardiac sarcoidosis (CS) patients taking prednisolone, identified recurrence by FDG-PET, and investigated BMIPP as a recurrence and prognostic factor in CS.

Methods And Results: CS patients who underwent BMIPP and FDG-PET within 2 months were enrolled. The recurrence-free group included patients with standardized uptake value (SUVmax) < 4 in the myocardium consecutively for ≥ 2 years. The total BMIPP SPECT defect score (BDS) was used to estimate myocardial damage. The predictability of the initial BDS and SUVmax for major adverse cardiac events (MACE) was analyzed using Kaplan-Meier analysis. Overall, 73 patients and 250 BMIPP and FDG-PET sets were analyzed retrospectively (mean follow-up, 3.5 years). The BDS was significantly greater for the recurrence group (N = 21) vs recurrence-free group (20 ± 13 vs 14 ± 12, P = 0.041). Patients with BDS ≥16 had a significantly higher MACE rate than patients with BDS < 16 (log-rank test, P = 0.016). However, MACE occurrence was comparable between patients with SUVmax ≥ 4 and < 4.

Conclusions: BDS is a predictive marker of recurrence and MACE. SUV is not related to MACE. Recurrence, defined by prednisolone treatment-induced SUV variability, was observed in approximately 30% of CS patients.
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http://dx.doi.org/10.1007/s12350-021-02567-0DOI Listing
June 2021

Relationship between the Lower Limb Function and Shoulder and Elbow Injuries in Elementary School Baseball Pitchers.

Prog Rehabil Med 2021 10;6:20210015. Epub 2021 Mar 10.

Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.

Objectives: We aimed to examine the relationship between the hip range of motion (ROM) and ankle ROM and throwing-related shoulder and elbow injuries in elementary school baseball pitchers.

Methods: This retrospective comparative study (Level of evidence: Level III) included 195 baseball pitchers (mean age 10.8±1.0 years, range 8-12 years). All pitchers underwent physical function measurements, including height, weight, shoulder strength, and hip and ankle ROM. Shoulder and elbow injury was defined as shoulder and elbow pain that the pitchers had been aware of in the past or at the time of medical checkups. The results for the injured and non-injured groups were then compared.

Results: The shoulder ROM and strength in the injured and non-injured groups did not differ to a statistically significant extent. The hip external rotation on the dominant side (injured vs. non-injured: 48.9±11.1° vs. 53.3±9.7°, P<0.01), the hip internal rotation on the non-dominant side (injured vs. non-injured: 36.6±12.0° vs. 40.9±11.0°, P=0.01), and ankle plantar flexion on the non-dominant side (injured vs. non-injured: 52.0±6.8° vs. 54.3±6.7°, P=0.02) were significantly smaller in the injured group than in the non-injured group.

Conclusions: The hip external rotation ROM on the dominant side and the hip internal rotation and ankle plantar flexion on the non-dominant side were significantly lower in the injured group than in the non-injured group. These results may suggest measures to reduce the incidence of elbow and shoulder injuries in elementary school baseball pitchers.
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http://dx.doi.org/10.2490/prm.20210015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952376PMC
March 2021
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