Association between sarcopenia and low back pain in local residents prospective cohort study from the GAINA study

[Background] Low back pain (LBP) is one of the most common ailments that people experience in their lifetime. On the other hands, Sarcopenia also leads to several physical symptoms and contributes to reducing the quality of life of elderly people.The purpose of this study is to investigate the association between sarcopenia and low back pain among the general population. [Methods] The subjects included 216 adults (79 men and 137 women; mean age, 73.5 years) undergoing a general medical examination in Hino, Japan. Skeletal muscle index (SMI), The percentage of young adults’ mean (%YAM) of the calcaneal bone mass using with quantitative ultrasound (QUS) method and walking speed were measured, and subjects who met the criteria of the Asian Working Group for Sarcopenia were assigned to the sarcopenia group. Subjects with decreased muscle mass only were assigned to the pre-sarcopenia group, and all other subjects were assigned to the normal group. Then, we compared the correlations with low back pain physical finding. The Oswestry Disability Index (ODI) and the low back pain visual analogue scale (VAS) were used as indices of low back pain. Statistical analysis was performed among three groups with respect their characteristic, demographics, data of sarcopenia determining factor, VAS and ODI. We also analysed prevalence of LBP and sarcopenia. We investigated the correlations between ODI and the sarcopenia-determining factors of walking speed, muscle mass and grip strength. [Results] Sarcopenia was noted in 12 subjects (5.5%). The pre-sarcopenia group included 38 subjects (17.6%), and the normal group included 166 subjects (76.9%). The mean ODI score was significantly higher in the sarcopenia group (25.2% ± 12.3%; P < 0.05) than in the pre-sarcopenia group (11.2% ± 10.0%) and the normal group (11.9% ± 12.3%). %YAM and BMI were significantly lower in the sarcopenia group than in other groups (P < 0.05). A negative correlation existed between walking speed and ODI (r = −0.32, P < 0.001). [Conclusions] The results of this study suggested that decreased physical ability due to quality of life in residents with LBP may be related to sarcopenia

Successful Treatment with Denosumab of a Giant Cell Tumor of Bone in the Iliac Bone of an 84-Year-Old Man

We report a case of GCTB in an 84-year-old Japanese man who had a tumor in his left iliac bone and was treated safely with denosumab. The patient noticed a painful mass, with gradual enlargement, in his left low back next to the iliac region. Magnetic resonance imaging revealed that the tumor measured 94 × 66 × 90 mm and was located in the left iliac bone. Histologically, the tumor was composed of proliferative oval-shaped mononuclear cells, admixed with large number of osteoclast-like giant cells. Immunohistochemically, a strong positivity for histone 3.3 G34W mutant protein was observed in the nuclei of the mononuclear cells, confirming the diagnosis of GCTB. Because it was considered as unresectable tumor, the patient was treated with denosumab without any side effects

The Risk Factor of Worsening Low Back Pain in Older Adults Living in a Local Area of Japan: The GAINA Study

Background: Several factors, particularly osteoporosis, obesity, and a lack of exercise, contribute to low back pain (LBP). This observational longitudinal cohort study to identify the risk factors for worsening low back pain. Methods: We sent a self-administered questionnaire and a consent form for this study to 1,450 subjects aged > 40 years in Hino, Japan. Baseline assessments of 273 individuals undergoing medical check-ups were conducted from 2014 to 2016. The subjects were divided into Group A (no change or improvement in LBP) and Group B (worsening LBP). LBP was assessed using a visual analog scale; body mass index (BMI), bone mineral density, skeletal muscle index (SMI), standing posture, and habitual exercise frequency were also evaluated. We defined, habitual exercise as nontherapeutic exercise (e.g. swimming, walking, physical exercise and work out). Results: Overall, 81.2% subjects performed habitual exercise in Group A, a greater number of subjects than the 40.8% in Group B. BMI, SMI, and bone mineral density (BMD) were not significantly different between the two groups. Lack of exercise was a significant risk factor for worsening of LBP. On the other hand, the lack of osteoporosis treatment was significantly different between subjects with worsening LBP despite habitual exercise and those who did not perform habitual exercise. Conclusion: Although habitual exercise is useful to prevent LBP, it may not necessarily be useful for those with a lack of osteoporosis treatment. Although exercise is typically posited to prevent LBP, it may not be effective in preventing LBP associated with osteoporosis

Brachial Artery Dissection Caused by Closed Elbow Dislocation in a Snowboarder: A Case Report and Review of Literature

This report describes a rare case of brachial artery dissection associated with closed elbow dislocation caused by a snowboarding injury. After peripheral ischaemic findings in the right upper extremity were confirmed, urgent duplex-sonography was performed to diagnose the brachial artery injury. Urgent revascularisation surgery was promptly performed, and arterial dissection was diagnosed by intraoperative findings, in which the adventitia of the brachial artery was intact and the intima was disrupted. In this case, because there was no golden time window before undertaking urgent revascularisation surgery, duplex-sonography was very useful for making an emergency diagnosis. To diagnose arterial dissection, because the adventitia of the brachial artery is intact, it is necessary to perform arteriotomy to identify intimal disruption in the brachial artery. When diagnosing traumatic elbow dislocation, it is important to suspect arterial dissection

Analysis of the spatial distribution of galaxies in the numerical galaxy catalog

We examine the spatial distribution of galaxies in the Numerical Galaxy Catalog, which is based on a hierarchical clustering framework. This catalog is constructed from a semianalytic model of galaxy formation combined with high-resolution N-body simulations in a A-dominated flat cold dark-matter cosmological model. To quantify the spatial distribution of galaxies, we use a graph-theoretical approach, because it is one of the most powerful statistical ways of estimating spatial data. In particular, three types of graphs are adopted: the Delaunay graph, the minimal spanning tree, and the constellation graph. To quantify the galaxy distributions, we apply statistical measures suitable for each type. The mass distributions in the cold dark-matter universe are also examined to clarify differences in the spatial distribution of dark matter and galaxies. The spatial distribution of galaxies in the two-degree field (2dF) galaxy redshift survey is finally compared with that in the Numerical Galaxy Catalog. From our analysis, we definitely show that galaxy distributions in the Numerical Galaxy Catalog are different from the dark-matter distributions. We also find that the Numerical Galaxy Catalog considerably improves the theoretical prediction of spatial galaxy distributions, although it does not do enough to reproduce the 2dF galaxy redshift survey. Finally, we show that the constellation graph and the minimal spanning tree are convenient for quantifing the galaxy distributions in an objective manner

Response time differences during hand mental rotation

This study explored gender differences in correct response rates and response times on a task involving left or right arrow selection and another involving the transformation of mental rotation of the hand. We recruited 15 healthy, right-handed men (age 24.5 ± 6.4) and 15 healthy, right-handed women (age 21.3 ± 4.9). For the tasks, we used pictures of left and right arrows and 32 hand pictures (left and right, palm and back) placed in cons (each at 45° from 0° to 315°). Hand and arrow pictures alternated and were shown at random. Participants decided as quickly as possible whether each picture was left or right. To compare the time taken for the transformation of mental rotation of the hand, we subtracted the average arrow response time from that for the left and right hand pictures for each participant. Correct response rates did not differ significantly between men and women or left and right for either arrow or hand pictures. Regardless of gender, the response time was longer for the left arrow picture than right arrow picture. The response time for the hand picture was longest for both men and women for pictures at rotation angles that were most difficult to align with participants’ hands. While there was no difference between men’s responses for left and right hand pictures, the responses of women were longer for left than right hand pictures and also than those of men. These findings suggest that both men and women mainly perform the hand mental rotation task with implicit motor imagery. On the other hand, the gender difference in performance might be explained by the difference in balance with other strategies, such as visual imagery, and by cognitive, neurophysiological, and morphological differences

Significance of Stabilometry for Assessing Postoperative Body Sway in Patients with Cervical Myelopathy

[Study Design] Prospective study. [Purpose] To examine the changes in body sway using stabilometry in patients who underwent cervical laminoplasty for cervical myelopathy. [Overview of Literature] Although the patients of cervical myelopathy complain body sway there are few report to examine body sway objectively. [Methods] Patients who received treatment for cervical myelopathy between October 2010 and February 2013 were included. Twenty-one patients underwent cervical laminoplasty (myelopathy group). Body sway was assessed using stabilometry, wherein patients stood on a stabilometer with their eyes closed for 30 seconds. The Romberg ratio, outer peripheral area (OPA) with eyes closed (cm2), and total locus length per unit area (L/A) with eyes closed (/cm) were examined. Examinations were performed preoperatively (at baseline) and at 8 weeks postoperatively. Examination results of patients in the myelopathy group were compared with those of 17 healthy individuals (control group). Clinical symptoms were evaluated using the Japanese Orthopaedic Association scale score (JOA score) and the timed up and go (TUG) test. [Results] In the myelopathy and control groups, the mean baseline Romberg ratio, OPA, and L/A were 2.3±1.2, 8.9±5.5 cm2, and 14.2±5.3/cm and 1.4±1.0, 4.3±2.8 cm2, and 23.7±10.1/cm, respectively. Eight weeks after laminoplasty, only L/A showed significant improvement from baseline in the myelopathy group (23.2±10.1 to 16.8±7.9; p=0.03). The Romberg ratio and OPA showed improvement in the myelopathy group, but the changes were not statistically significant. JOA scores and TUG test results in this group significantly improved from baseline to 8 weeks after laminoplasty (12.7 to 13.4 and 10.8 to 8.0 seconds, respectively; both p<0.05). [Conclusions] L/A is a useful parameter for measuring body sway to assess the recovery of body sway after laminoplasty

Ossified Metaplastic Spinal Meningioma Without Psammomatous Calcification : A Case Report

Meningiomas constitute approximately 25% of primary spinal cord tumors, and 1% to 5% are calcified. Ossification is a rare event and the etiology of ossification in meningiomas is not well known. We present the case of a 29-year-old female with a rare case of ossified thoracic spinal metaplastic meningioma. The tumor was successfully resected, and pathology confirmed ossified metaplastic meningioma. On histopathological examination, only mature bone tissue and tumor cells were present in the region containing no psammoma bodies, suggesting that the tumor cells had transitioned to mature osteocytes

Utility of CD64 on Neutrophils in Orthopedic Infection

【Background】 Musculoskeletal infections are often seen in the daily practice of orthopedics. Several markers [white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)] have been used for diagnosing these infections. However, these markers may be elevated due to surgery or trauma, and may not be infection-related. These markers also show drug-dependent dynamics during infection that differ from its usual dynamics. Such situations make diagnosis of infections difficult, and Cluster of Differentiation 64 (CD64) has been brought to attention. This study aimed to clarify the utility of CD64 on neutrophils by comparing it with conventional infection markers (CRP, PCT) in musculoskeletal infection. 【Methods】 Forty-four patients who were suspected of having musculoskeletal infection between May 2010 and November 2013 in our hospital were enrolled in this study. Patients were divided into subgroups according to their culture results, antibiotics administration, measurement timing, and if they were immunocompromised. The measurements of the infection markers were compared between each group. In addition, the positive rates of each infection marker were compared between groups. 【Results】 There was no difference in the infection marker measurements between several groups. There was no statistically significant difference between groups for the positive rates of CD64, CRP, and PCT. 【Conclusion】 We evaluated the utility of CD64 on neutrophils in musculoskeletal infection. CD64 showed the utility that was equivalent to conventional infection markers in diagnoses of various musculoskeletal infections

Histological Evaluation of Lumbar Spine Changes in Rats with Collagen-induced Arthritis

【Background】 To histologically evaluate lumbar involvement in rheumatoid arthritis (RA) by investigating rats with collagen-induced arthritis (CIA) and to assess the potential effects of RA on the discovertebral joints and facet joints. 【Methods】 Seven-month-old female Sprague-Dawley rats were divided into groups with CIA and without CIA (control). All rats were sacrificed at 8 weeks after initial sensitization and the lumbar spine (L5/6) was harvested. Then the lumbar spine block specimens were stained with Villaneuva bone stain and sectioned in the midsagittal plane. The left facet joints were also sectioned in the midaxial plane. Specimens were studied under a microscope and infiltration of inflammatory cells was investigated. 【Results】 In the CIA group, lumbar lesions were observed in 13/18 rats (76%). Lymphocytes infiltrated into the anterior rim of the vertebral bodies only in 2 rats, while lymphocytes infiltrated the facet joints only in 4 rats. Both sites were involved in 7 rats. In addition, osteoclasts invaded the anterior rim of the vertebral bodies and formed cavities that also contained lymphocytes. Formation of pannus was seen in the facet joints in 11/18 rats. 【Conclusion】 In CIA rats, infiltration of inflammatory cells into the anterior rim of the vertebral bodies alone or into the facet joints alone was demonstrated in 2 rats and 4 rats, respectively, while both sites were involved in 7 rats. Therefore, lesions at the anterior rim of the vertebral body did not arise secondary to facet joint involvement, but were caused by CIA along with synovial lesions of the facet joints