Search

Cardiopulmonary function is usually assessed by cardiopulmonary exercise testing (CPX) using a cycle ergometer (CE-CPX) or a treadmill, which is difficult in patients with lower extremity motor dysfunction. A stepping and handshaking (SHS) exercise has been developed that can be performed safely and easily while sitting on a chair. This study compared peak oxygen uptake (peak V. O 2 ) between CE-CPX and SHS-CPX in healthy adults and investigated the safety and validity of SHS-CPX. Twenty young adults (mean age 27.8 ± 4.4 years) were randomly assigned to perform CE-CPX or SHS-CPX, with the other test to follow 1–2 weeks later. The peak V. O 2 , respiratory exchange ratio (RER), peak heart rate, blood pressure, and test completion time were compared between CE-CPX and SHS-CPX. All subjects completed the examination and met the criteria for peak V. O 2 . SHS-CPX and CE-CPX showed a strong correlation with peak V. O 2 (r = 0.85, p < 0.0001). The peak V. O 2 (40.4 ± 11.3 mL/min/kg vs. 28.9 ± 8.0 mL/min/kg), peak heart rate (190.6 ± 8.9 bpm vs. 172.1 ± 12.6 bpm), and test completion time (1052.8 ± 143.7 s vs. 609.1 ± 96.2 s) were significantly lower in the SHS-CPX (p < 0.0001). There were no adverse events. The peak V. O 2 with SHS-CPX was equivalent to about 70% of that with CE-CPX despite the exercise being performed in a sitting position, suggesting its suitability as a submaximal exercise test. [ABSTRACT FROM AUTHOR]

The aim of this study was to elucidate the interactive effect of central hypovolemia and plasma hyperosmolality on regulation of peripheral vascular response and AVP secretion during heat stress. Seven male subjects were infused with either isotonic (0.9%; NOSM) or hypertonic (3.0%; HOSM) NaC1 solution and then heated by perfusing 42[degrees]C (heat stress; HT) or 34.5[degrees]C water (normothermia; NT) through water perfusion suits. Sixty minutes later, subjects were exposed to progressive lower body negative pressure (LBNP) to -40 mmHg. Plasma osmolality ([P.sub.osmol]) increased by ~11 mosmol/kg[H.sub.2]O in HOSM conditions. The increase in esophageal temperature before LBNP was much larger in HT-HOSM (0.90 [+ or -] 0.09[degrees]C) than in HT-NOSM (0.30 [+ or -] 0.07[degrees]C) (P < 0.01) because of osmotic inhibition of therrnoregulation. During LBNP, mean arterial pressure was well maintained, and changes in thoracic impedance and stroke volume were similar in all conditions. Forearm vascular conductance (FVC) before application of LBNP was higher in HT than in NT conditions (P < 0.001) and was not influenced by [P.sub.osmol] within the thermal conditions. The reduction in FVC at -40 mmHg in HT-HOSM (-9.99 [+ or -] 0.96 units; 58.8 [+ or -] 4.1%) was significantly larger than in HT-NOSM (-6.02 [+ or -] 1.23 units; 44.7 [+ or -] 8.1%) (P < 0.05), whereas the FVC response was not different between NT-NOSM and NT-HOSM. Plasma AVP response to LBNP did not interact with [P.sub.osmol] in either NT or HT conditions. These data indicate that there apparently exists an interactive effect of [P.sub.osmol] and central hypovolemia on the peripheral vascular response during heat stress, or peripheral vasodilated conditions, but not in normothermia. plasma osmolality; baroreflexes; forearm vascular conductance; lower body negative pressure; arginine vasopressin

The bis(mu-oxo)dimanganese(III,III) complex [Mn(super II)(sub 2)(mu-oxo)2(TPA)2](super 2+) exhibits a high catechol oxidase activity. The reaction is very unique because the aerobic oxidation of catechols are catalyzed by a manganese complex through mononuclear Mn(II)-SQ and bis(mu-oxo-dimanganese(III,III) complexes.

Appropriate positioning of the inframammary fold (IMF) is essential for breast reconstruction. The purpose of this study was to quantitatively measure and evaluate the anthropometric position of the IMF in the thorax. A total of 145 Japanese women with unilateral breast cancer were analyzed. To indicate the superior-inferior position of the IMF on the non-diseased side, the distances from the sternal notch (SN) to the IMF along the midline (SN–IMFM) and from the SN to the umbilicus (UB) (SN–UB) were measured. A new index, the thorax anthropometric position (TAP) index for the IMF, was then defined as the ratio of SN–IMFM to SN–UB. The TAP index was calculated for each patient, and its correlations with demographic parameters, including age, body height, and body mass index, were statistically assessed. The TAP index was normally distributed and ranged from 0.500 to 0.704, with a mean of 0.590. Multivariate analysis revealed that age was an independent factor associated with a higher TAP index (p <.01). In addition, the paired t-test showed that the TAP index was significantly greater in the standing position than in the supine position (p <.001). The position of the IMF in the thorax could be objectively described by the TAP index, and it was suggested to become inferior with age and the standing position. The index, along with these findings, will provide useful information for the evaluation of the breast contour in an objective and simple manner. [ABSTRACT FROM AUTHOR]

Scleroderma renal crisis (SRC) is a severe complication of systemic sclerosis characterised by abrupt onset of arterial hypertension and rapid progression to renal failure. Angiotensin-converting enzyme inhibitor (ACEi) is widely used for the treatment of this disease. Although the prognosis of SRC can be improved by prompt initiation of ACEi, a considerable proportion of cases still require maintenance dialysis therapy. However, the clinical picture of SRC patients after introduction of haemodialysis has not been sufficiently investigated. Here, we describe a 69-year-old female patient who was receiving regular haemodialysis because of SRC for three months and who developed posterior reversible encephalopathy syndrome (PRES) or microangiopathic haemolytic anaemia (MAHA), accompanied by rapid elevation of blood pressure, shortly after discontinuation of ACEi. Resumption of ACEi quickly resulted in improvement of the patient's condition and allowed stable continuation of maintenance haemodialysis. As haemodialysis patients often develop hypotension during dialysis sessions, reduction of antihypertensive agents need to be considered. However, physicians must decide carefully whether antihypertensive drugs including ACEi should be discontinued in order to avoid complications such as PRES or MAHA related to blood pressure elevation during the management of patients receiving maintenance haemodialysis for SRC. [ABSTRACT FROM AUTHOR]

We have developed an advanced LTPS TFT technology in which top‐gate oxide TFTs are used in each pixel and CMOS LTPS TFTs are used in gate drivers and multiplexers in the peripheral circuits. Oxide TFTs have excellent Ids–Vgs characteristics with a small Vth shift under negative bias temperature illumination stress (NBTIS). [ABSTRACT FROM AUTHOR]

We propose an advanced LTPS TFT‐LCD technology in which top‐gate oxide TFTs are used in each pixel, whereas LTPS TFTs are used in the drivers and multiplexer in the frame areas. With this technology, we successfully developed a 538‐ppi TFT‐LCD prototype with 15‐Hz frame‐rate driving, a 0.5‐mm width side border, and lower gate driving voltages of +8.6/−8.0 V. Even after conducting a 500‐h driving test at 70 °C, no degradation was observed. [ABSTRACT FROM AUTHOR]

Background: Venous thromboembolism is one of the general complications following total hip arthroplasty, wherein various preventive treatments have been recommended. Several studies reported that venous thromboembolism incidence after total hip arthroplasty was similar in patients who were administered prophylaxis with a conventional mechanical procedure alone, and those who were administered pharmacological anticoagulation therapy. Therefore, the optimum methods of prophylaxis are still controversial. The purpose of this study was to investigate whether manual calf massage and passive ankle motion could lower the risk for venous thromboembolism after total hip arthroplasty.Methods: We retrospectively reviewed the data of 126 consecutive patients undergoing elective primary unilateral total hip arthroplasty wherein manual calf massage and passive ankle motion were performed after the surgery at our hospitals between January and October 2014. The 138 patients of the control group underwent total hip arthroplasty using the same surgical approach and pre- and postoperative protocols without this mechanical prophylaxis between January and December 2013. This mechanical prophylaxis was performed simultaneously 30 times during approximately 10 s; these procedures were repeated thrice immediately after total hip arthroplasty. Duplex ultrasonography was performed to observe the veins of both legs in all the patients on postoperative day 7.Results: The incidence of deep vein thrombosis was 6.52% and 0.79% in the control and manual calf massage and passive ankle motion groups, respectively. The odds ratio for the manual calf massage and passive ankle motion groups was 8.72. Performing this mechanical prophylaxis reduced the incidence of venous thromboembolism after total hip arthroplasty. This mechanical prophylaxis is not only simple and easy, but is also safe and inexpensive.Conclusions: We therefore recommend that manual calf massage and passive ankle motion be performed in patients who will undergo total hip arthroplasty, if deep vein thrombosis does not exist before the surgery. [ABSTRACT FROM AUTHOR]

Plasma D-dimer level is clinically useful for diagnosing patients with suspected deep vein thrombosis (DVT). However, the cut-off value for the D-dimer level remains controversial and undetermined with regard to total hip arthroplasty (THA). The objective of this study was to estimate the efficacy of an age- and D-dimer-based index for diagnosing DVTs in asymptomatic cases before THA. We enrolled 224 patients with no symptoms associated with DVT before THA. All the patients underwent ultrasonography, and the plasma D-dimer level was recorded about 1 month preoperatively. The optimal cut-off value was calculated using multiple logistic regression and receiver operating curve analyses. DVTs were detected in 13 patients (5.8%) using ultrasonography. Multiple logistic regression analysis demonstrated that age (odds ratio [OR]: 1.13; p = 0.007) and D-dimer value (OR: 1.74; p = 0.003) were related to the existence of preoperative DVT. A DVT index (0.12 × age + 0.45 × the D-dimer value) of 8.15 was the most reasonable cut-off value according to the receiver operating curve analysis. This value caused 100% sensitivity and 70.1% specificity, with an area under the curve (AUC) of 0.905 (range, 0.836–0.975). For age and D-dimer value, the AUCs were 0.828 (0.749–0.907) and 0.716 (0.522–0.910), respectively. This study demonstrated that age and D-dimer index can be useful in screening patients for DVTs before THA. This DVT index is also easy to calculate and may be clinically significant. [ABSTRACT FROM AUTHOR]

Background: While navigation systems have been developed to increase implantation accuracy in total hip arthroplasty (THA), they are not yet sufficiently versatile or commonly used. Therefore, to elevate the appeal of such systems, we have developed HipCOMPASS, a simple and effective mechanical angle indicator for use in supine THA. Questions/purposes: How accurate is the mean cup orientation [in terms of errors in radiographic anteversion (RA) and inclination (RI)] in cases where HipCOMPASS is used for intraoperative support? Does HipCOMPASS increase this cup orientation accuracy compared to THA cases without it? Does HipCOMPASS increase mean operation time? Methods: We measured cup orientation in 97 THA cases with HipCOMPASS and in 80 cases without it. Then we compared the angles determined in preoperative planning with the angles revealed by postoperative computed tomography (CT) for both groups. The discrepancy between them was defined as an error. Errors greater than 10° were considered outliers. Additionally, mean operative time with and without the Hip COMPASS were compared. Results: With the use of HipCOMPASS, the mean absolute error values in radiographic anteversion and inclination were 2.9° ± 2.3° (range 0°-12.8°) and 2.9° ± 2.1° (0.1°-7.7°), respectively. In contrast, without the use of HipCOMPASS, radiographic anteversion and inclination error values were 8.8° ± 5.8° (0.1°-25.4°) and 6.1° ± 4.5° (0.2°-21.0°), respectively. Outlier occurrence rates were 1.0 % with HipCOMPASS and 48.8 % without it. Mean operative times with and without HipCOMPASS use were 109.2 ± 23.8 min (74-199 min) and 137.6 ± 40.6 min (71-298 min), respectively. Conclusions: The study has found that HipCOMPASS dramatically increases implantation accuracy and it is also a simple and highly versatile tool that can be implemented quickly. Given its low cost in addition to its favourable accuracy, simple implementation, and short operative time, HipCOMPASS can be regarded as a very useful and effective THA support device. Level of evidence: Retrospective comparative study, Level 3. [ABSTRACT FROM AUTHOR]

In this study, we describe a 10.0-inch 1080 × 2880 capacitive curved-faced prototype liquid crystal display for automotive use, which has integrated in-cell touch panel technology. A sufficient signal-to-noise ratio of 100-160 was achieved with this display despite the 1.1-mm-thick cover glass. [ABSTRACT FROM AUTHOR]

In this paper a 12.2-inch 1920 × RGBW × 720 prototype LCD for automotive use which integrates an in-cell touch panel is described with some electrical and electro-optical characteristics. In addition, the prototype of a curved-faced and non-rectangular form of this cited LCD is described. [ABSTRACT FROM AUTHOR]

Abstract: In this study, we evaluated the hemostatic effects of tranexamic acid (TNA), an antifibrinolytic drug, by examining the timing of its administration during total hip arthroplasty. One hundred seven patients being treated for osteoarthritis of the hip joint were randomly divided into 5 groups based on the timing of TNA administration. The intraoperative blood loss, postoperative blood loss, and hemoglobin of these patients who received TNA at different times during the procedure were monitored. We found that the intraoperative blood loss in the preoperative TNA administration groups was significantly lower than both control and postoperative TNA administration groups. Furthermore, 1 g TNA 10 minutes before surgery and 6 hours after the first administration was most effective for the reduction of blood loss during total hip arthroplasty. [Copyright &y& Elsevier]

Beta-2-microglobulin-derived amyloidosis (Aβ2M amyloidosis) is a critical complication for patients undergoing long-term renal replacement therapy. Osteoarticular lesions, rather than visceral organs, are susceptible to this type of amyloidosis, and the visceral form seems to occur at a relatively late stage. Herein, we report a case of severe visceral Aβ2M amyloidosis without obvious joint symptoms or radiological findings in a chronic hemodialyzed patient who had received long-term treatment with glucocorticoid steroids for systemic lupus erythematosus. It should be noted that prominent visceral Aβ2M amyloidosis can develop without any osteoarticular symptoms or radiological abnormalities in dialyzed patients undergoing prolonged glucocorticoid therapy. [ABSTRACT FROM AUTHOR]

A 47-year-old woman demonstrated bilateral wrist joint pain during 4 weeks. Her status did not fulfill the ACR classification criteria for RA, and her symptoms had almost disappeared 4 weeks later. After about 1 year, she again complained of tenderness and swelling in the bilateral wrist joints. The laboratory data were as follows: ESR:61 mm/hour, CRP: 1.0 mg/dl, RF: 172 IU/ml, MMP-3: 178.7 ng/ml, and anti-cyclic citrullinated peptide antibodies (aCCP): 488 U/ml. Based on these findings, we diagnosed the patient as having RA. She was treated with several anti-rheumatic drugs, and joint symptoms decreased. This case was regarded as undifferentiated arthritis at the first visit. We later found the high titers of aCCP using her frozen sera after she fulfilled with ACR critera for RA, although aCCP was not checked at first time because its analysis was not covered by national health insurance in Japan. Thus, it is possible that this patient should have been treated as having RA from the first visit. In general, aCCP shows excellent specificity for RA diagnosis although sensitivity is lower. In contrast, it has demonstrated that aCCP is positive in about 40% of patients 1 year before the onset of RA. The clinical outcomes of patients with joint symptoms and positive aCCP analysis, but do not fulfill the ACR criteria for RA, should be assessed in plural patients. [ABSTRACT FROM AUTHOR]

Idiopathic osteonecrosis of the femoral head (ION) is a painful disease of the hip, the pathogenic mechanism of which is still unclear. The most common extraneous factor is steroid treatment. Steroids have inhibiting effects on bone formation and resorption. When bone regenerative treatments are indicated for ION patients who are exposed to steroids, we cannot ignore the effects of corticosteroid itself on bone healing. The aim of this study was to investigate the effects of glucocorticoid on bone regeneration after osteonecrosis of the femoral head in a rat model. Osteonecrosis was induced surgically on the left femoral heads of aged female rats (about 6 months old) on day 0. Methylprednisolone sodium succinate (MPSS) or normal saline was administrated at a dose of 100 mg/kg/day from day 7 to 11. Femoral heads were analyzed histologically. There were no pathological findings in the right femoral heads of the MPSS-treated and saline-treated rats, as control for the contralateral injury. The newly formed bone volume and the osteoclast number were significantly smaller in the MPSS-treated group. The normal bone marrow was regenerated in the saline-treated group, whereas most of the bone marrow space still contained fibroblast-like spindle-shaped cells in the MPSS-treated group on day 42. Alkaline phosphatase-positive cells were only seen in the areas around the regenerated bone marrow cavities. Thus, MPSS inhibits bone formation by suppressing osteoblast proliferation and resorption by suppressing the recruitment of osteoclast precursors. These findings may be useful when designing treatments for ION patients exposed to steroids. [ABSTRACT FROM AUTHOR]

We present three rheumatoid arthritis (RA) patients successfully treated with traditional herbal medicine (THM: Kampo). The treatment with THM resulted in a decrease in RA disease activity such as DAS28, as well as in the serum levels of anti-cyclic citrullinated peptide antibodies (anti-CCP) in 3 cases. These observations suggest that disease progression may be retarded in patients who respond to THM since anti-CCP is important for the prediction of disease severity and radiographic joint damage. Additionally, serial mesurements of anti-CCP titers may be a useful indicator in assessing this kind of treatment efficacy. [ABSTRACT FROM AUTHOR]