Quantity and quality of antigravity muscles in patients undergoing living-donor lobar lung transplantation: 1-year longitudinal analysis using chest computed tomography images

Background: Skeletal muscle dysfunction is a common feature in patients with severe lung diseases. Although lung transplantation aims to save these patients, the surgical procedure and disuse may cause additional deterioration and prolonged functional disability. We investigated the postoperative course of antigravity muscle condition in terms of quantity and quality using chest computed tomography. Methods: 35 consecutive patients were investigated for 12 months after living-donor lobar lung transplantation (LDLLT). The erector spinae muscles (ESMs), which are antigravity muscles, were evaluated, and the cross-sectional area (ESMCSA) and mean attenuation (ESMCT) were analysed to determine the quantity and quality of ESMs. Functional capacity was evaluated by the 6-min walk distance (6MWD). Age-matched living donors with lower lobectomy were evaluated as controls. Results: Recipient and donor ESMCSA values temporarily decreased at 3 months and recovered by 12 months post-operatively. The ESMCSA of recipients, but not that of donors, surpassed baseline values by 12 months post-operatively. Increased ESMCSA (ratio to baseline ≥1) may occur at 12 months in patients with a high baseline ESMCT. Although the recipient ESMCT may continuously decrease for 12 months, the ESMCT is a major determinant, in addition to lung function, of the postoperative 6MWD at both 3 and 12 months. Conclusion: The quantity of ESMs may increase within 12 months after LDLLT in recipients with better muscle quality at baseline. The quality of ESMs is also important for physical performance; therefore, further approaches to prevent deterioration in muscle quality are required

Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair

Purpose: The impact of preoperative patent inferior mesenteric artery (IMA) on late outcomes following endovascular aneurysm repair (EVAR) remains unclear. This study aimed to investigate the specific influence of IMA patency on 7-year outcomes after EVAR. Materials and Methods: In this retrospective cohort study, 556 EVARs performed for true abdominal aortic aneurysm cases between January 2006 and December 2019 at our institution were reviewed. Endovascular aneurysm repairs performed using a commercially available device with no type I or type III endoleak (EL) during follow-up and with follow-up ≥12 months were included. A total of 336 patients were enrolled in this study. The cohort was divided into the patent IMA group and the occluded IMA group according to preoperative IMA status. The late outcomes, including aneurysm sac enlargement, reintervention, and mortality rates, were compared between both groups using propensity-score-matched data. Results: After propensity score matching, 86 patients were included in each group. The median follow-up period was 56 months (interquartile range: 32–94 months). The incidence of type II EL at discharge was 50% in the patent IMA group and 19% in the occluded IMA group (p<0.001). The type II EL from IMA and lumbar arteries was significantly higher in the patent IMA group than in the occluded IMA group (p<0.001 and p=0.002). The rate of freedom from aneurysm sac enlargement with type II EL was significantly higher in the occluded IMA group than in the patent IMA group (94% vs 69% at 7 years; p<0.001). The rate of freedom from reintervention was significantly higher in the occluded IMA group than in the patent IMA group (90% vs 74% at 7 years; p=0.007). Abdominal aortic aneurysm–related death and all-cause mortality did not significantly differ between groups (p=0.32 and p=0.34). Conclusions: Inferior mesenteric artery patency could affect late reintervention and aneurysm sac enlargement but did not have a significant impact on mortality. Preoperative assessment and embolization of IMA might be an important factor for improvement in late EVAR outcomes. Clinical Impact: The preoperative patency of the inferior mesenteric artery was significantly associated with a higher incidence of sac enlargement and reintervention with type II endoleak following endovascular aneurysm repair, even after adjustment for patient background. Preoperative assessment and embolization of inferior mesenteric artery might be an important factor for improvement in late EVAR outcomes.Ide T, Shimamura K, Kuratani T, et al. Impact of the Patency of Inferior Mesenteric Artery on 7-Year Outcomes After Endovascular Aneurysm Repair. Journal of Endovascular Therapy. 2022. Copyright © 2022 The Author(s). doi:10.1177/15266028221121748

立位における上肢運動時の腰部多裂筋深層線維および浅層線維の筋反応時間の検討

Based on the current literature, it remains unclear whether electromyographic onset of the deep fibers of the multifidus (DM) is dependent on the direction of shoulder movement and the position of the center of foot pressure (CFP). In the present study, we re-examined the electromyographic onset of the DM during shoulder flexion and extension and investigated the influence of the CFP position before arm movement. Intramuscular and surface electrodes recorded the electromyographic onset of the DM, superficial fibers of the multifidus (SM), rectus abdominis, and anterior and posterior deltoid. Eleven healthy participants performed rapid, unilateral shoulder flexion and extension in response to audio stimuli at three CFP positions: quiet standing, extreme forward leaning, and extreme backward leaning. It was found that the electromyographic onset of the DM and SM relative to the deltoid was dependent on the direction of arm movement. Additionally, of all electromyographic onsets recorded, only that of the DM occurred earlier in the extreme forward leaning position than in the extreme backward leaning position during shoulder flexion. These results suggest that the electromyographic onset of DM was influenced by the biomechanical disturbance such as shoulder movement and CFP position.首都大学東京, 2015-09-30, 博士（理学療法学）, 甲第619号首都大学東

Differences in gait kinetics and kinematics between patients with rotating hinge knee and cruciate-retaining prostheses : A cross-sectional study

東京都立大学Tokyo Metropolitan University博士（理学療法学）doctoral thesi

Integrated genetic and epigenetic analysis defines novel molecular subgroups in rhabdomyosarcoma.

横紋筋肉腫におけるゲノム・エピゲノム異常の全体図を解明 -横紋筋肉腫を4群に分類-. 京都大学プレスリリース. 2015-07-03.Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma in childhood. Here we studied 60 RMSs using whole-exome/-transcriptome sequencing, copy number (CN) and DNA methylome analyses to unravel the genetic/epigenetic basis of RMS. On the basis of methylation patterns, RMS is clustered into four distinct subtypes, which exhibits remarkable correlation with mutation/CN profiles, histological phenotypes and clinical behaviours. A1 and A2 subtypes, especially A1, largely correspond to alveolar histology with frequent PAX3/7 fusions and alterations in cell cycle regulators. In contrast, mostly showing embryonal histology, both E1 and E2 subtypes are characterized by high frequency of CN alterations and/or allelic imbalances, FGFR4/RAS/AKT pathway mutations and PTEN mutations/methylation and in E2, also by p53 inactivation. Despite the better prognosis of embryonal RMS, patients in the E2 are likely to have a poor prognosis. Our results highlight the close relationships of the methylation status and gene mutations with the biological behaviour in RMS

Movement patterns of the functional reach test do not reflect physical function in healthy young and older participants

東京都立大学Tokyo Metropolitan University博士（理学療法学）doctoral thesi

Precise asymmetric power‐splitter (1.7:1) by using nano‐pixel waveguide

Abstract Power‐splitter is one of the fundamental elements for photonic integrated circuits. Y‐junction, multi‐mode‐interference (MMI), and directional coupler may have been widely used as power splitter; however, the design theory to realize precise asymmetric splitting ratio is not well established. In addition, the device length is relatively long and less robustness in general. To realize a power splitter with a desired splitting ratio, the authors used a nano‐pixel structure. Nano‐pixel structures consist of an array of pixels in which the rectangular waveguide region is divided into many nano‐scale regions. The implemented devices were realized in an area of 3.2 μm × 3.4 μm. The device exhibited precise asymmetric splitting of 1.7:1 successfully at 1550 nm