ヒザ ノ イタミ コカンセツ ノ イタミ : ロコモティブ シンドローム ト カンセツ

“Locomotive syndrome” is the generic term for disability-free life expectancy and locomotive organ health in advanced people, in other words, becoming bedridden or demented and thus requiring nursing care. The main cause of locomotive syndrome has two reasons ; one is spontaneous disability related to aging and the other one is locomotive organ disease, such as joint disorders, spinal disorders, osteoporosis or rheumatoid arthritis. We describe the hip joint and the knee joint in this paper because these two joints are critical joints to stand and walk. Hip joint The hip joint is the biggest joint for human, and the most important part in supporting the body weight and walking smoothly. The hip join is the type of spheroidal or ball and socket joint where the femoral head and the acetabulum covered the cartilage tissue. The hip joint is supported by the ligaments, the tendons and muscles. Hip osteoarthritis is caused by deterioration of articular cartilage. Medications are one of the treatment with hip osteoarthritis for the mild cases. Total hip replacement is a surgical procedure which is the new acetabular and femoral components implanted for the severe cases. Knee joint The knee joint is between the femur and the tibia or between the femur and the patella. The knee joint is a hinge joint having flexion and extension motion. The ligaments surrounding the knee joint offer stability. The muscles are also supporting the body weight and walking smoothly. The knee pain frequently arises due to osteoarthritis. The causes of osteoarthritis are excessive motion and combination such as muscle weakness and overweight. Knee osteoarthritis treatments are aimed at decreasing pain, preserving or improving joint function, and limiting joint deformity and disability. Effective osteoarthritis treatments include medications, injections and joint surgery It is important that we aware of diseases of the locomotive organs, people require knowledge about how to keep those organs in good health

A Study on the Origin of Peroxisomes: Possibility of Actinobacteria Symbiosis

The origin of peroxisomes as having developed from the endoplasmic reticulum (ER) was proposed on the basis of the similarity between some peroxisomal proteins and ER proteins, and the localization of some peroxisomal proteins on the ER. To study the evolutionary distance between peroxisomes and ER and Prokaryotes, we carried out a phylogenetic analysis of CDC48 (cell division control 48) and its homologs, including ER-localized CDC48, CDC48 homologs in Prokaryotes and peroxisome-localized PEX1 and PEX6. A similarity search analysis of peroxisomal protein sequences to prokaryotic protein sequences using BLAST at several thresholds (E-values) was also done. We propose Actinobacteria symbiosis for the origin of peroxisomes based on the following evidence: (1) PEX1 and PEX6 are close in distance to CDC48 homologs in Actinobacteria, and these distances are closer than to ER-localized CDC48. (2) Actinobacteria proteins show the highest degree of similarity to peroxisomal proteins compared with other prokaryotes

Effective Use of Sacrificial Zinc Anode as a Suitable Repair Method for Severely Damaged RC Members Due to Chloride Attack

In many cases, the repair strategy by using sacrificial anodes for cathodic protection in real RC structures requires additional zinc anodes after several years due to the decreasing protective area. This experimental study evaluates the effectiveness of time lag application of sacrificial anode cathodic protection applied to RC beam specimens that deteriorated severely due to chloride attack. In the experiment, sacrificial anodes and cathodic protection (SACP) were applied to 41-year-old RC beam specimens exposed to natural marine environments in which the embedded steel bars were significantly corroded. The repair work was performed in three stages. Instant-off and rest potential tests of steel bars were conducted periodically to demonstrate the time-dependent depolarization value. In the first stage, a polymer-modified mortar as a patch repair material was cast to replace the concrete in the middle tensile part with small sacrificial anodes embedded in the mortar. After the protective current reaches an equilibrium state, the sacrificial anodes are disconnected from the steel bars for a year, defined as the second stage. During the one year in the second stage, the steel bar in the patch repair area remained passive, without any sign of corrosion. As for the third stage, additional sacrificial anodes were installed in the existing concrete part to protect the steel in it. From one year of observation after applying sacrificial anodes to old concrete parts, the time lag SACP application of both in patch and non-patch repair parts was clarified to be effective in stopping the corrosion of steel bar in both parts until 20–30 years based on the service life prediction. Doi: 10.28991/CEJ-2022-08-07-015 Full Text: PD

Proximal femoral rotational osteotomy

The Rotational osteotomy for femoral retroversion has been extremely rare despite the known association between femoral neck retroversion, hip pain, and osteoarthritis. Here, we describe a case of femoral neck retroversion for which proximal femoral rotation osteotomy. A 16-year-old boy with a past history of developmental dysplasia of the both hip treated conservatively presented with a complaint of pain in left hips. On physical examination, flexion of the left hip was limited to 90° with terminal pain. Internal rotation was also limited to 10°. Computed tomography (CT) showed -7.1° anteversion of the left femur. We performed rotational osteotomy to increase femoral anteversion because conservative treatment was not effective. The postoperative course was uneventful. At 12 postoperative months, his left hip pain was completely disappeared and femoral anteversion was 34° on CT scans. Retroversion of the femur is a distinct dynamic factor that should be considered in the evaluation of mechanical causes of hip pain. Restoring the normal rotational alignment of the hip resulted in cure of the impingement due to femoral retroversion

Anatomic evaluation of the insertional footprints of the iliofemoral and ischiofemoral ligaments : a cadaveric study

Background: An understanding of the insertional footprints of the capsular ligaments of the hip is important for preserving hip function and stability given the increasing number of minimally invasive hip surgeries being performed under a limited surgical view. However, it is difficult to detect these ligaments intraoperatively and many surgeons may not fully appreciate their complex anatomy. The aims of this study were to quantify the proximal and distal footprints of the iliofemoral ligament (ILFL) and ischiofemoral ligament (ISFL) and to estimate the location of the corresponding osseous landmarks on the proximal femur, which can be detected easily during surgery. Methods: Twelve hip joints from Japanese fresh frozen cadavers were used. All muscle, fascia, nerve tissue, and vessels were removed to expose the intact capsular ligaments of the hip. The length and width of the proximal and distal footprints of the ILFL and ISFL were measured and their relationship to osseous structures was evaluated, including the intertrochanteric line, femoral neck, and lesser trochanter. Results: The mean length of the distal medial arm of the ILFL footprint was 17.9 mm and the mean width was 9.0 mm. The mean length of the distal lateral arm of the ILFL footprint was 23.0 mm and the mean width was 9.7 mm. For the footprint of the medial arm, the insertion was in the distal third of the intertrochanteric line and that of the lateral arm was in the proximal 42% of this line. The mean distance from the lesser trochanter to the footprint of the medial arm was 24.6 mm. The mean length of the distal ISFL footprint was 11.3 mm and the mean width was 6.9 mm. The footprint of the distal ISFL was located forward of the femoral neck axis in all specimens. Conclusions: Understanding the size and location of each capsular ligament footprint in relation to an osseous landmark may help surgeons to manage the hip capsule intraoperatively even under a narrow surgical view. The findings of this study underscore the importance of recognizing that the distal ISFL footprint is located relatively forward and very close to the distal lateral arm footprint

Explicitly Multi-Modal Benchmarks for Multi-Objective Optimization

In multi-objective optimization, designing good benchmark problems is an important issue for improving solvers. Although many benchmark problems have been proposed and some of them became de facto standards, designing multimodal problems that have a controllable landscape is still an open problem especially for high-dimensional cases. We thus propose the Benchmark with Explicit Multimodality (BEM), which lets the benchmark designer specify the basins of attraction using a graph structure known as the reachability graph. In this article, we focus on the mathematical formulation of the BEM. We will see that the BEM has preferable characteristics such as (i) realizing user-specified local Pareto set, (ii) allowing high-dimensional design spaces and (iii) possessing nonseparability

Rotational and varus–valgus laxity affects kinematics of the normal knee : A cadaveric study

Purpose: The aim of this study was to evaluate the relationship between soft tissue laxity and kinematics of the normal knee using a navigation system. Methods: Fifteen cadaveric knees from 11 fresh frozen whole-body specimens were included in this study. The navigation system automatically recorded the rotation angle of the tibia as the internal–external (IE) kinematics and the coronal alignment of the lower limb as the varus–valgus (VV) kinematics. These measurements were made with the joint in maximal extension, at 10° intervals from 0° to 120° of flexion, and at maximal flexion during passive knee motion. For evaluation of laxity, the examiner gently applied maximum manual IE and VV stress to the knee at 0°, 30°, 60°, and 90° of flexion. Results: The measurements showed almost perfect reliability. The mean correlation coefficient between the intraoperative tibial rotation angle and the intermediate angle of IE laxity was 0.82, while that between the coronal alignment of the lower limb and the intermediate angle of the VV laxity was 0.96. There was a statistically significant correlation between kinematics and laxity at all degrees of knee flexion. Conclusion: The present study revealed that the rotation angle of the tibia was correlated to the intermediate angle of IE laxity at 0°, 30°, 60°, and 90° of knee flexion and the coronal alignment of the lower limb also correlated to the intermediate angle of VV laxity. These findings provide important reference data on soft tissue laxity and kinematics of the normal knee

Intraoperative knee kinematics

The aim of this cadaveric study was to evaluate the intraoperative kinematics of the native knee including two-dimensional translation of the femur using a navigation system. Eight native knees of 4 fresh-frozen whole-body cadavers were used for the study. The kinematics of each knee were analyzed intraoperatively using the navigation system. Although anterior-posterior translation could not be assessed directly, it could be calculated using a formula derived from the parameters in the navigation system. The native knee showed external rotation of the femur in early knee flexion, transient internal rotation in mid flexion, and gradual external rotation in late flexion. There was no marked change in the coronal rotation angle of the mechanical axis during knee flexion. The femoral center moved anteriorly in early knee flexion and posteriorly in late flexion. The distance moved in the medial-lateral direction was relatively smaller than that in the anterior-posterior direction. Two-dimensional translation of the surgical epicondylar axis showed a medial pivot-like motion. In this cadaveric study, the kinematics of the native knee, including two-dimensional translation of the femur, could be satisfactorily assessed intraoperatively using a navigation system. The intraoperative kinematics of the knee can be analyzed in more detail using this methodology

Induction of Tissue Factor Expression in Endothelial Cells by Basic Fibroblast Growth Factor and its Modulation by Fenofibric acid

BACKGROUND: Tissue factor (TF), expressed in endothelial cells (ECs) and enriched in human atherosclerotic lesions, acts as a critical initiator of blood coagulation in acute coronary syndrome. Basic fibroblast growth factor (bFGF) induces the proliferation and migration of ECs and plays a role in angiogenesis and restoration of endothelial integrity. As TF is implicated in angiogenesis, we studied the effect of bFGF on TF gene and protein expression. Methods: Human umbilical vein ECs (HUVECs) were exposed to bFGF. TF mRNA was assessed by Northern blot and TF protein was assessed by Western blot. TF promoter activity was assessed by transient transfection assay and transcription factor was identified by electro mobility shift assay. RESULTS: bFGF increased TF mRNA and protein expression in HUVECs. Increased TF mRNA was attenuated by inhibition of extracellular signal-regulated kinase kinase in human ECV304 cells. Transient transfection assays of the human TF promoter-luciferase construct (-786/+121 bp) demonstrated that bFGF induced transcription was dependent on the elements within the -197 to -176 bp relative to the transcription start site of the human TF gene. This region contains NF-κB like binding site. Electro mobility shift assay showed that bFGF increased nuclear translocation or DNA binding of NF-κB transcription factor to TF promoter. Nucleotide substitution to disrupt NF-κB like site reduced bFGF stimulated promoter activity. Fenofibric acid, an agonist ligand for the peroxisome proliferator activated receptor-α, reduced basal and bFGF stimulated TF expression. CONCLUSIONS: These results indicate that bFGF may increase TF production in ECs through activation of transcription at NF-κB binding site, and control coagulation in vessel walls. Fibrate can inhibit TF expression and therefore reduce the thrombogenecity of human atherosclerotic lesions