A higher intramuscular fat in vastus medialis is associated with functional disabilities and symptoms in early stage of knee osteoarthritis: a case-control study

[Background] The characteristics of muscle degeneration in individual quadriceps in early knee osteoarthritis (OA) and the association of muscle quantity and quality on knee dysfunction remain unclear. This study aimed to clarify the characteristics of muscle degeneration in individual quadriceps muscles in early knee OA and elucidate the association of muscle volume and intramuscular adipose tissue (intraMAT) with knee dysfunction, including functional disabilities, symptoms, and joint morphology. [Methods] Fifty participants were categorized into early knee OA and healthy control groups. 3.0 T magnetic resonance imaging (MRI) using T1-weighted and Dixon methods and 3D SPACE in the thigh muscle and knee joint regions was performed. Quadriceps muscle volume, intraMAT, and whole-organ MRI score (WORMS) were assessed. The Knee Society Score (KSS) was used to evaluate functional disabilities and knee symptoms. Univariate analysis of variance was conducted with covariates to clarify the differences in muscle volume and intraMAT between the two groups. Multiple linear regression analyses were performed using the KSS function and symptom subcategories and WORMS as dependent variables and muscle volume, intraMAT, and the presence of early knee OA as independent variables, such as potential confounders. [Results] The quadriceps intraMAT, especially in the vastus medialis (VM), was significantly higher in patients with early knee OA than in healthy controls. The VM intraMAT, not muscle volume, was significantly associated with KSS function [B =  − 3.47; 95% confidence interval [CI],  − 5.24 to − 1.71; p < 0.001] and symptom scores [B =  − 0.63; 95% CI,  − 1.09 to − 0.17; p = 0.008], but not with WORMS. [Conclusion] These findings suggest that higher VM intraMAT is characteristic of quadriceps muscle degeneration in early knee OA and its increase is associated with functional disabilities and symptoms

Age- and sex-related differences of muscle cross-sectional area in iliocapsularis: a cross-sectional study

[Background] This study aimed to determine in how many individuals the iliocapsularis muscle (IC) could be identified on magnetic resonance imaging (MRI) and whether age and sex are associated with the cross-sectional area (CSA) of the IC. [Methods] Thirty-seven healthy younger adults and 40 healthy older adults were assigned to four groups: 1) 20 younger men; 2) 17 younger women; 3) 20 older men; and 4) 20 older women. The CSAs of the IC, IP, the rectus femoris (RF) and the quadriceps (QUAD) were quantified on an axial MRI. [Results] The number of individuals with the identified IC was n = 17 (85.0%) of 20 younger men, n = 15 (88.2%) of 17 younger women, n = 18 (90.0%) of 20 older men, and 19 (95.0%) of 20 older women. Our results showed the main effect of sex, but not age, in the CSA of the IC. The men-groups had larger CSA of the IC than the women-groups; however, no difference in CSA of the IC was found between the younger and older groups. Meanwhile, the main effects of age and sex were found for the IP, RF, and QUAD; thus, younger or men groups have larger CSAs of the three muscles than the older or women groups. The IC muscle can be discriminated in 85% – 95% of healthy individuals. [Conclusion] Although sex and age are associated with the CSA of lower-limb muscles other than the IC, only sex is associated with the CSA of the IC

Predictors of Hypotension after Adrenalectomy for Pheochromocytoma

The management of blood pressure is a significant concern for surgeons and anesthesiologists performing adrenalectomy for pheochromocytoma. We evaluated clinical factors in pheochromocytoma patients to identify the predictors of postoperative hypotension. The medical records of patients who underwent adrenalectomy for pheochromocytoma between 2001 and 2017 were retrospectively reviewed and clinical and biochemical data were evaluated. Of 29 patients, 13 patients needed catecholamine support in the perisurgical period while 16 patients did not. There were significant differences in median age, tumor size, and blood pressure drop (maxmin) between the 2 groups (68 vs 53 years old, p=0.045; 50 vs 32 mm diameter, p=0.022; 110 vs 71 mmHg, p=0.015 respectively). In univariate logistic analysis, age > 65.5 years, tumor size > 34.5 mm, urine metanephrine > 0.205 mg/day and urine normetanephrine > 0.665 mg/day were significant predictors of prolonged hypotension requiring postoperative catecholamine support. Tumor size and urine metanephrine and urine normetanephrine levels were correlated with postoperative hypotension. These predictors may help in the safe perioperative management of pheochromocytoma patients treated with adrenalectomy

A Molecular Variant of the Angiotensinogen Gene and Hypertension in a Case-Control Study in Japanese

In order to examine the distribution of M235T (the substitution of threonine for 0methionine at position 235 codon) polymorphism genotypes of the angiotensinogen (AGT) gene and the relationship between M235T polymorphism of the AGT gene and hypertension, a descriptive study and a case-control study were performed among Japanese workers. The subjects were 2042 workers at an occupational site in Shimane Prefecture in Japan. The database was set up for the workers' regular health examination in 1998. The M235T polymorphism of the AGT gene for each worker was defined by the mutant allele specific amplification (MASA) method. The rates of M235M (MM), M235T (MT) and T235T (TT) genotypes were 3.9%, 30.7% and 65.5%, respectively. The odds ratios of MT and TT against MM for hypertension by univariate analysis were 0.77 [95% confidence interval (CI) 0.27-2.18] and 0.77 (95% CI 0.28-2.14), respectively. The odds ratios of MT and TT against MM for hypertension, adjusted for body mass index, fasting blood sugar, drinking habits, cigarette smoking and exercise in a logistic regression model, were 0.90 (95% CI 0.29-2.74) and 0.87 (95% CI 0.30-2.58), respectively. The data from this study suggests that there may be no relationship between the M235T polymorphism of the AGT gene and hypertension. Further prospective studies are needed to resolve this issue

Magnetic-Domain Structure Analysis of Nd-Fe-B Sintered Magnets Using XMCD-PEEM Technique

A combination of X-Ray Magnetic Circular Dichroism and PhotoEmission Electron Microscopy (XMCD-PEEM) was applied to the magnetic domain analysis of Nd-Fe-B sintered magnets. The XMCD-PEEM high-resolution images revealed both the magnetic domain structures and the microstructural morphologies. In the thermally demagnetized state, each grain in a polycrystalline sample exhibits a multidomain structure, which is magnetically coupled across grain boundaries. After the DC field-demagnetization, it changed to a single domain structure. The magnetization vector in each surface grain reversed to the negative direction during the field-demagnetization procedure because of the small coercivity in the surface region. In the present study, we observed this surface domain reversal for the first time by means of XMCD-PEEM imaging method, which is important in order to understand the surface phenomena of Nd-Fe-B magnets

Feasibility of Laparoscopic Radical Cystectomy in Elderly Patients: A Comparative Analysis of Clinical Outcomes in a Single Institution

Laparoscopic radical cystectomy (LRC) is a standard surgical treatment for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. LRC is a less invasive modality than conventional open surgery. Therefore, even elderly patients with invasive bladder cancer may be candidates for LRC. In this study, a comparative analysis of perioperative/oncological outcomes between elderly patients and younger patients who underwent LRC was performed to assess the feasibility of LRC in elderly patients. Sixty-eight consecutive patients who underwent LRC between October 2013 and March 2018 were enrolled and stratified into those younger than 75 years (n=37) and those ≥ 75 years old (n=31). The median follow-up period was 28.2 months. The preoperative and operative parameters and complications were similar in both groups. The 2-year overall survival (OS) was 64.4% in the younger vs. 76.4% in the elderly group (p=0.053), cancer-specific survival (CSS) was 79.3% vs. 81.7% (p=0.187), and recurrence-free survival (RFS) was 58.2% vs. 75.7% (p=0.174), respectively. No significant differences were observed in OS, CSS, or RFS between the groups. No significant differences were found between the groups with respect to peri-surgical/oncological outcomes. We conclude that LRC is feasible in elderly patients

Surgical Management of Unilateral Soft Tissue Swelling around the Proximal Interphalangeal Joint in an Adolescent: A Case Report of Pachydermodactyly

Pachydermodactyly (PDD) is a rare and benign acquired form of digital fibromatosis, characterized by asymptomatic fusiform soft tissue hypertrophy of the lateral aspect of the proximal interphalangeal (PIP) joints of the fingers. The etiology of PDD remains unknown, but it usually affects healthy males around the age of puberty. It can be misdiagnosed as inflammatory rheumatic diseases, especially as juvenile chronic arthritis. Here, we report a case of PDD in an 18-year-old man who had progressive fusiform swelling of the PIP joint on his left middle finger. Although he had no pain or functional limitation of movement, he chose to undergo surgical resection of the lesion to obtain a conclusive diagnosis and to rectify the deformity’s appearance. Histologically, the lesion was characterized by coarse fibrosis in the adipose tissue, peripheral nerve fibers, and eccrine glands; this is compatible with a diagnosis of PDD