Effects of trunk lean and foot lift exercises in sitting position on abdominal muscle activity and the contribution rate of transversus abdominis

Purpose: Abdominal hollowing exercise has been recommended to improve trunk stability. Trunk lean and foot lift exercises while sitting may easily promote abdominal muscle activity even in people who cannot perform abdominal hollowing consciously. The purpose of the present study was to examine the changes in abdominal muscle activity and contribution rate of the transversus abdominis muscle (TrA) when leaning the trunk and lifting the foot during sitting. Methods: The muscle stiffnesses (indicators of muscle activity) of the right rectus abdominis, external oblique, internal oblique, and TrA of 14 healthy men were measured during abdominal hollowing and the following nine sitting tasks: reference posture, 15° and maximal posterior trunk lean, 20° and maximal ipsilateral and contralateral trunk lean, and ipsilateral and contralateral foot lift. The TrA contribution rate was calculated by dividing the TrA stiffness by the sum of the abdominal muscles’ stiffnesses. Results: The TrA stiffness was significantly higher in abdominal hollowing than in reference posture, posterior and ipsilateral trunk lean, and ipsilateral foot lift, but not higher than in contralateral trunk lean and contralateral foot lift. There was no significant difference in the TrA contribution rates between abdominal hollowing and ipsilateral or contralateral foot lift. Conclusion: The contralateral trunk lean or contralateral foot lift could enhance TrA activity for people who cannot perform abdominal hollowing consciously. The contralateral foot lift could particularly be beneficial to obtain selective activity of TrA

Retroperitoneal hematoma associated with femoral neuropathy: a complication under antiplatelets therapy.

We report a case of retroperitoneal hematoma presenting as femoral nerve pulsy on antiplatelet therapy. The patient, a 78-year-old man who had undergone antiplatelet treatment using ticlopidine, was admitted to our hospital with complaints of sudden-onset low abdominal and back pain. Computed tomography showed an iso-density mass in the right retroperitoneum within the psoas muscle. We made a diagnosis of retroperitoneal hematoma compressing the femoral nerve and performed an operation to remove the hematoma in order to decompress the femoral neuropathy. Postoperatively, the patient rapidly recovered from the femoral neuropathy. In the particular case in which no antagonist against the ticlopidine is available, surgical decompression could produce a good outcome.</p

Experimental models of small intestinal transplantation in rats: orthotopic versus heterotopic model.

Two kinds of surgical models of small intestinal transplantation (SITx) in rats, namely heterotopic (HIT) and orthotopic transplantion (OIT), have been reviewed. In OIT, the small intestine of the recipient is removed and the transplanted intestine replaces it in continuity. On the other hand, in the HIT model, the small intestinal grafts are rendered dysfunctional without alimentary tract continuity. Histological evidence showed that acute rejection appeared earlier in HIT as compared to OIT. Hyperplasia and hypertrophy of the muscularis externa produced in the chronic rejection process were more pronounced in HIT allografts. The HIT grafts showed severe mucosal atrophy due to the lack of intraluminal trophic factors, because oral feedings can stimulate tropic hormones for mucosal growth, and provide nutrients for enterocytes. Intestinal permeability was consistently higher after HIT than after OIT. The HIT grafts demonstrated less contractility and less response to chemical stimulation than did OIT grafts. The OIT models are advantageous in studies of intraluminal nutrients, and intestinal secretions in these models might modulate the intestinal immune status and possibly delay rejection. The superior intestinal barrier function and the delayed onset of rejection in OIT rats suggest that nutrients and other factors in the succus entericus are important for the maintenance of intestinal graft function.</p

Creation and use of a composite polyurethane-expanded polytetrafluoroethylene graft for hemodialysis access.

The Thoratec (Vectra) polyurethane vascular access graft (TPVA) is among the most recent additions to the list of materials used to construct prosthetic grafts for vascular access during hemodialysis. We give the TPVA very high marks, and recognize the utility of such a graft for use in hemodialysis. However, the strong elasticity of this graft can lead to unexpected complications after suturing. We devised a new surgical method using a TPVA-ePTFE (expanded polytetrafluoroethylene) composite graft, substituting the anastomosis section of the TPVA with a portion of ePTFE graft material, and have been able to overcome most of the TPVA's potential problems. We herein describe the technique.</p

GPS and chemotherapy for elderly NSCLC

Background : Although platinum-combination chemotherapy is widely used to treat advanced non-small cell lung cancer (NSCLC), not all elderly patients benefit from this regimen. In this retrospective study, we aimed to evaluate whether the Glasgow Prognostic Score (GPS), an indicator of systemic inflammation and malnutrition, could predict the tolerability and efficacy of platinum-combination chemotherapy among elderly patients with NSCLC. Methods : The eligibility criteria included patients aged ≥ 70 years with NSCLC treated with first-line platinum-combination chemotherapy at Shimane University Hospital between January 2015 and December 2018. Results : Thirty-two patients with NSCLC (median age, 74 years) were included. The GPS scores were 0–1 for 19 patients and 2 for 13 patients. Four chemotherapy cycles were completed by 57.9% and 30.8% of patients in the GPS 0–1 and GPS 2 groups, respectively. The GPS 0–1 group experienced better outcomes than the GPS 2 group (response rate : 26% vs. 15%, P = 0.67 ; median progression-free survival : 4.1 vs. 2.1 months, P = 0.0026 ; median overall survival : 22.8 vs. 9.6 months, P = 0.0092). Conclusions : Platinum-combination chemotherapy demonstrated promising efficacy among elderly NSCLC patients with a GPS 0–1. Therefore, GPS may be crucial in determining whether treatments recommended for younger patients are suitable for older patients with NSCLC