Muscle Fiber Changes of the Vastus Medialis in Rheumatoid Patients

To study the pathology of muscle atrophy in rheumatoid arthritis (RA), we examined the vastus medialis in rheumatoid patients histologically. The relationship of the findings to their ambulatory ability and long-term steroid therapy was investigated. The muscles of the RA patients were also compared with those of patients with osteoarthritis (OA). Specimens of the vastus medialis were collected from 29 knees of 23 patients with RA and 16 knees of 13 patients with OA during total knee arthroplasty. Muscle fibers were classified according to their type, and the ratio between the area of single type I and type II fibers as well as the ratio between the total area of these fibers was calculated. The total area of type II fibers in the RA group was significantly greater than in the OA group (P &#60; 0.05). In the RA group, the mean proportion of the type II fibers relative to the total muscle fiber area tended to increase with the decline of ambulatory ability, while there was no such increase in the OA group. The proportion of type II fibers was increased significantly in RA patients on long-term steroid therapy when compared to those without therapy. In the ratio of the area of a single fiber, there was no clear relationship to ambulatory ability and long-term steroid therapy. It is considered that muscle atrophy in RA is not solely disuse atrophy, but also has a close relationship to steroid therapy and the pathology of the disease itself.</p

Pericardial Effusion in Association With Periodontitis: Case Report and Review of 8 Patients in Literature

Periodontal diseases are well-known background for infective endocarditis. Here, we show that pericardial effusion or pericarditis might have origin also in periodontal diseases. An 86-year-old man with well-controlled hypertension and diabetes mellitus developed asymptomatic increase in pericardial effusion. Two weeks previously, he took oral new quinolone antibiotics for a week because he had painful periodontitis along a dental bridge in the mandibular teeth on the right side and presented cheek swelling. The sputum was positive for Streptococcus species. He was healthy and had a small volume of pericardial effusion for the previous 5 years after drug-eluting coronary stents were inserted at the left anterior descending branch 10 years previously. The differential diagnoses listed for pericardial effusion were infection including tuberculosis, autoimmune diseases, and metastatic malignancy. Thoracic to pelvic computed tomographic scan demonstrated no mass lesions, except for pericardial effusion and a small volume of pleural effusion on the left side. Fluorodeoxyglucose positron emission tomography disclosed many spotty uptakes in the pericardial effusion. The patient denied pericardiocentesis, based on his evaluation of the risk of the procedure. He was thus discharged in several days and followed at outpatient clinic. He underwent dental treatment and pericardial effusion resolved completely in a month. He was healthy in 6 years until the last follow-up at the age of 92 years. We also reviewed 8 patients with pericarditis in association with periodontal diseases in the literature to reveal that periodontal diseases would be the background for developing infective pericarditis and also mediastinitis on some occasions

Spa therapy for patients with chronic obstructive lung disease

Thirty-six patients with chronic obstructive lung disease (34 cases with bronchial asthma, one case with chronic bronchiolitis and one case with pulmonary emphysema) have received spa therapy. Clinical effects of sa therapy on patients with bronchial asthma depended on patient age and asthma types classified by allergic reactions and clinical symptoms. Spa therapy was effective in the cases with ages more than 31 years and the cases with non-atopic type of bronchial asthma. Regarding asthma type classified by clinical symptoms, spa therapy was more effective in the cases with bronchiolar obstructive type and the cases with bronchospasm + hypersecretion type than in the cases with bronchospasm type of bronchial asthma

Chronic dislocation of proximal interphalangeal joint with mallet finger: A case report

We report a case of chronic dislocation of proximal interphalangeal joint with mallet finger

Effects of swimming training in the hot spring pool on ventilatory function in bronchial asthma

Effect of free swimming training in the hot spring pool (30℃) on ventilatory function were observed in nine patients with intractable asthma by measuring FVC, FEV(1.0), PEFR, MMF, V(50), V(25). 1. Swimming in the hot spring pool for three months allowed the reduction of glucocorticoid used for their asthma attack. 2. Although FVC was not affected by swimming training, EEV(1.0), PEFR, MMF, V(50), V(25) which represent obstructive ventilatory function were gradually improved by swimming training. The results show that free swimming training in the hot springpool is clinically available in intractable asthma

Influence of exercise on muscle fibers in rats with steroid myopathy.

The influence of mild exercise on skeletal muscle fibers was investigated histochemically to assess the effects of exercise on steroid myopathy and its efficacy for preventing this disease. Twenty male Wistar rats were divided into 4 groups of 5 each: group T, which received exercise alone; group S which received steroid alone; group ST which received both exercise and steroid; and group C, the control group. In groups S and ST, hydrocortisone was administered subcutaneously at a dose of 10 mg/kg/day for 4 weeks. In the exercise groups, the animals were made to run at a speed of 15 m/min for about 1 h/day for 5 days a week on a treadmill. After the completion of treadmill exercise and steroid administration for 4 weeks, the rats were anesthetized with Nembutal, the soleus muscle (SOL) and the extensor digitorum longus muscle (EDL) were removed and prepared for examinations. The area of type I fibers in the SOL was significantly larger in group ST than in group S. The area of type IIa fibers in the EDL was significantly larger in group ST than in group S. In group S, the proportion of type I fibers in the SOL was significantly lower than in the other three groups. There was little difference in fiber type distribution between groups ST and C. These results suggest that steroid myopathy can be prevented by even mild exercise.</p