The intra-rater reliability of the supraspinatus cross-sectional area measurement using diagnostic ultrasound

The purpose of this study was to determine the intra-rater reliability between-scans and betweendays on measurements of the supraspinatus cross-sectional area of using diagnostic ultrasound. The subjects were five male volunteers(age range:19-23 years old). The diagnostic ultrasound images were acquired using the same 7.5MHz real time probe with an Aloka Echo Camera SSD-1000 system to all subjects. The section through the midpoint of the scapular spine was observed. Right shoulders were measured three times on the same day for between scan reliability and one time on the next day for between days reliability. The reliability of measuring the CSA of the supraspinatus using diagnostic ultrasound was high in this study. The intraclass correlation coefficients of this study were 0.83 for between three scans and 0.81 for between days. These findings support that the CSA of the supraspinatus can be used as a reliable clinical parameter if the examiner has experience in using diagnostic ultrasound.肩の様々な病態や、老化による棘上筋の萎縮が報告されている。棘上筋は肩関節の動的安定性に寄与する筋であり、この筋萎縮を検討することは臨床的に重要な指標となる。一般に筋の萎縮を測定するためにはMRI、CT、超音波画像を用いる方法がある。超音波画像はMRIやCTと比較して簡便に安全にくり返し検査を行うことができるが、画像を導出するプロ?べの大きさや、対象となる組織の音響抵抗などに影響を受けて、鮮明な画像をくり返し導出することが難しいとされている。本研究の目的は、超音波画像を用いた棘上筋断面積計測の再現性を同一検査者がくり返して測定することにより検討することにある。健常成人男性５名の右肩棘上筋の断面像計測を同一日に３回、異なる日に１回行い、同一日の３回の測定における級内相関係数および異なる日のそれぞれ１回目の測定における級内相関係数を検討した。同一日の３回の測定間の級内相関係数は0.83、異なる日の測定間のそれは0.81であった

The Variation in the Lumbar Facet Joint Orientation in an Adult Asian Population and Its Relationship with the Cross-Sectional Area of the Multifidus and Erector Spinae

Study DesignCross-sectional study of healthy volunteers.PurposeWe aimed to investigate the variation in the lumbar facet joint orientation in an adult Asian population. The relationship between the facet joint orientation and muscle cross-sectional area (CSA) of multifidus and erector spinae was also clarified.Overview of LiteratureSeveral studies have reported that lumbar pathologies, such as lumbar spondylolysis and degenerative spondylolisthesis, were related to the horizontally shaped lumbar facet joint orientation at the lower lumbar level. However, data regarding variations in the facet joint orientation in asymptomatic subjects have not been well documented.MethodsIn 31 healthy male adult Asian volunteers, the facet joint orientation and CSA of multifidus and erector spinae were measured using magnetic resonance imaging at the L4–5 and L5–S1 levels. Variation in the facet joint orientation was examined using coefficients of variation (CV). Pearson's product-moment coefficient was used to investigate the relationship between the facet joint orientation and CSA of multifidus and erector spinae.ResultsLumbar facet joint orientation had a wider range of variation at L5–S1 (CV=0.30) than at L4–5 (CV=0.18). The L4–5 facet joint orientation had a weak but significant correlation with the CSA of erector spinae (r=0.40; p=0.031). The CSA of the multifidus had no relationship with the facet joint orientation at the L4–5 (r=0.19; p=0.314) and the L5–S1 level (r=0.19; p=0.312).ConclusionsThe lumbar facet joint orientation was found to have a wide variation, particularly at the L5–S1 in the Asian adult population, and the facet joint orientation had a relationship with the CSA of the erector spinae at the L4–5

ヒト長腓骨筋内のコンパートメントを同定する肉眼解剖学的研究

Many skeletal muscles have been found to be composed of smaller portions of a muscle innervated by a primary muscle nerve branch called neuromuscular compartments. The purpose of this study was to identify the anatomical evidence for neuromuscular compartments of the human peroneus longus muscle. Eight legs from human cadavers donated were dissected. The architectural characteristics of muscle fiber direction and tendinous tissue were examined. The primary nerve branching pattern throughout the peroneus longus was also observed. The peroneus longus was found to have four distinct partitions. The superficial portion and deep portion within the muscle were separated by an aponeurosis that is continuous with the distal tendon. Furthermore, each of these both portions was partitioned into two portions by muscle fiber orientation. In addition, these architectural compartments of the muscle were congruent with compartments identified by innervation pattern. The present findings suggest that intramuscular compartments of the peroneus longus are anatomically defined. In future, this muscle\u27s partitioning will not only lead to an anatomical foundation for the physiological study to elucidate the functional multiplicity of the peroneus longus, but also provide a scientific rationale for establishment of more specific protocols for rehabilitation of patients with the dysfunctional muscle and muscle atrophy.近年、多くの骨格筋が神経筋コンパートメントと呼ばれる要素から構成され、これらの筋区画は機能的な要求に応じて選択的に活動することが確認されつつある。本研究では、ヒト長腓骨筋の筋内コンパートメントを肉眼解剖学的に同定することを目的とした。筋標本は解剖実習用固定屍体の下腿8肢を使用し、筋線維走行、腱組織の位置関係および筋内の神経分岐様式を観察した。その結果、長腓骨筋は独立した神経枝の支配を受ける４つの区画を有することが認められた。筋内の浅部および深部区画は、停止腱から続く腱膜によって分離される。さらに、これらの両区画の各々が筋線維の走行により前部と後部区画に区分される。今回試みた解剖学的な筋のコンパートメント化は、長腓骨筋内に存在する機能的分化を示唆する。また、筋機能不全や筋萎縮を呈する患者に対して、この筋内コンパートメントを指標として画像検査や筋電図学的評価を行うことは、効率の良い最適な理学療法プログラムの構築に寄与すると考えられる

RELATIONSHIP BETWEEN THE SHEAR ELASTIC MODULUS AND PASSIVE FORCE IN POSTERIOR SHOULDER CAPSULES: A CADAVERIC STUDY

Although shear wave elastography (SWE) has been used to indirectly measure passive force in muscle tissues, it is unknown whether SWE can be utilized to evaluate passive force in capsule tissues. This study investigated the relationship between the shear elastic modulus and passive force in posterior shoulder capsules using SWE. Four middle and four inferior posterior shoulder capsules were dissected from four fresh-frozen cadavers. Passive force (0-400 g in 25-g increments) was applied to each capsule, and elasticity was measured simultaneously using SWE. The relationship between elasticity and passive capsule force was highly linear for all tested capsules (coefficients of determination range: 0.853-0.963). SWE is a valid and useful method of evaluating indirectly and noninvasively the passive force of the posterior shoulder capsules

Clinical course and background of nasopharyngeal antibiotic-resistant bacteria carriers among preschool children hospitalized for lower respiratory tract infection

Abstract We investigated the nasopharyngeal microbiota in preschool patients hospitalized with lower respiratory tract infection to clarify the relationships between culturable nasopharyngeal bacteria and prognosis. From 2016 to 2018, nasopharyngeal culture was performed on inpatients under 6 years of age with a lower respiratory tract infection. Among the 1,056 study patients, 1,046 provided nasopharyngeal samples that yielded positive cultures, yielding 1,676 isolated strains. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, were isolated in 25%, 27%, and 31% of the samples, respectively, and were the major causes of respiratory tract infection in these children. The only factor associated with the isolation of antibiotic-resistant strains from the nasopharynx was daycare attendance, which did not affect clinical severity, such as duration of fever and hospitalization. This study demonstrated that resistant bacteria in the nasopharynx did not affect the severity of lower respiratory tract infection and supports the use of narrow-spectrum antimicrobial agents in accordance with published guidelines when initiating therapy for pediatric patients with community-acquired pneumonia

High energy electron observation by Polar Patrol Balloon flight in Antarctica

We accomplished a balloon observation of the high-energy cosmic-ray electrons in 10-1000GeV to reveal the origin and the acceleration mechanism. The observation was carried out for 13 days at an average altitude of 35km by the Polar Patrol Balloon (PPB) around Antarctica in January 2004. The detector is an imaging calorimeter composed of scintillating-fiber belts and plastic scintillation counters sandwiched between lead plates. The geometrical factor is about 600cm^2sr, and the total thickness of lead absorber is 9 radiation lengths. The performance of the detector has been confirmed by a test flight at the Sanriku Balloon Center and by an accelerator beam test using the CERN-SPS (Super Proton Synchrotron at CERN). The new telemetry system using the Iridium satellite, the power system supplied by solar panels and the automatic flight level control operated successfully during the flight. We collected 5.7×10^3 events over 100GeV, and selected the electron candidates by a preliminary data analysis of the shower images. We report here an outline of both detector and observation, and the first result of the electron energy spectrum over 100GeV obtained by an electronic counter

The effect of tibial rotation on the presence of instability in the anterior cruciate ligament deficient knee.

Context: The effects of tibial rotation after ACL injury have not yet been well determined. Objective: To show whether clinical outcomes such as the amount of tibial rotation can affect functional outcomes in normal and ACL deficient knees. Design: Case control study. Setting: Research laboratory. Participants: Twenty normal subjects (Control) and 20 subjects with ACL deficient knees (ACL). Main Outcome Measures: Tibial rotation at 30 and 90 degrees of knee flexion was measured using an inclinometer. One-legged hop, crossover hop, figure-of-eight running and 10-m running tests were used and determined the effect(s) of tibial rotation on the outcome of the functional tests. Results: There were significant between-group differences in internal and external rotation. The relationship between external tibial rotation and the figure-of-eight index was significantly negatively correlated. Conclusions: The amount of tibial rotation is greater in ACL ruptured knees than in uninjured knees, and these greater amounts of tibial rotation affected the figure-of-eight running index