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1.
Pathol Int ; 74(3): 146-153, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38240415

ABSTRACT

A woman in her 60s with rheumatoid arthritis was admitted with fever and abdominal pain. Laparoscopic examination with the differential diagnosis of peritoneal neoplasm and infection revealed granulomatous phlebitis in the resected greater omentum. Amorphous eosinophilic deposits observed in the resected tissue exhibited focal, weak positivity for Congo red but were strongly positive for thioflavin S, confirming their focal amyloid properties. Marked degeneration of elastic fibers was also evident. Electron microscopy revealed deposits around the affected elastic fibers. Immunohistochemistry revealed the deposition of epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1) along with T-cell-predominant lymphocytic inflammation. The definitive diagnosis was granulomatous enterocolic lymphocytic phlebitis (ELP) associated with EFEMP1 deposition exhibiting focal amyloid properties (EFEMP1/AEFEMP1), supported by proteomics analysis. This type of vasculitis is similar to amyloid-ß-related angiitis of the central nervous system. Thus, we speculate that granulomatous ELP also results from an immune response that recognizes EFEMP1/AEFEMP1 deposits as foreign material and attempts to remove them. Confirmation of EFEMP1/AEFEMP1 deposition with Congo red staining is challenging, particularly in the presence of inflammation, and warrants comprehensive evaluation.


Subject(s)
Calcium-Binding Proteins , Epidermal Growth Factor , Phlebitis , Humans , Female , Congo Red , Inflammation , Extracellular Matrix Proteins/metabolism
2.
J Phys Ther Sci ; 35(9): 624-627, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37670757

ABSTRACT

[Purpose] This study aimed to develop a culturally adapted Japanese version of the Pain Understanding and Confidence Questionnaire (PUnCQ). The first-factor structure describes management from 12 perspectives for a case vignette of chronic pain and determines whether the management is based on a biomedical or biopsychosocial perspective. The second-factor structure evaluates the confidence level in management skills for the same case from 21 perspectives. [Participants and Methods] We conducted a cross-cultural adaptation based on five stages according to Beaton's guidelines (two forward translations, creation of an integrated forward translation version, two backward translations, creation of a provisional Japanese version, and a pilot test). In the pilot test, we asked 40 Japanese physical therapists to rate their understanding of the PUnCQ descriptions on a five-point Likert scale (1, not at all understandable; 5, completely understandable) and provide comments when they rated 1 to 3. We repeated revisions and pilot tests until less than 10% of the respondents rated 1 for all descriptions. [Results] By conducting two rounds of the pilot test, all items of descriptions satisfied the preestablished criteria. [Conclusion] A Japanese version of the PUnCQ was developed.

3.
PM R ; 15(8): 1012-1025, 2023 08.
Article in English | MEDLINE | ID: mdl-36152318

ABSTRACT

OBJECTIVE: The purpose of this systematic review with meta-analysis was to examine the effectiveness of exercise with behavior change techniques (BCTs) on core outcome sets in people with knee osteoarthritis. LITERATURE SURVEY: We searched randomized controlled trials (RCTs) in eight databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO, PEDro, ICTRP, and ClinicalTrials.gov) up to November 4, 2021. METHODOLOGY: Eligible participants were people with knee osteoarthritis. The intervention was exercise with BCTs. Primary outcomes included physical function, quality of life (QOL) 6 to 12 months after intervention, and adverse events. Secondary outcomes were knee pain, exercise adherence, mobility, and self-efficacy 3 months or more after intervention. The bias risk was assessed using the Risk of Bias 2 tool. The random-effects model was used for the meta-analysis. SYNTHESIS: We found 16 individual BCTs, and 37.7% of trials used a single BCT. For meta-analysis, we included 21 RCTs (n = 1623). Most outcomes had a very low certainty of evidence, and the risk of bias was the consistent reason for downgrading evidence levels. The standardized mean difference (SMD) with 95% confidence interval (95% CI) was 0.00 (-0.24, 0.24) in physical function, 0.33 (-0.51, 1.17) in exercise adherence, and 0.04 (-0.39, 0.47) in self-efficacy. The risk ratio (95% CI) of adverse events was 3.6 (0.79, 16.45). QOL was not pooled due to insufficient data (very low certainty of evidence). In contrast, the SMD (95% CI) for knee pain reduction and mobility improvement was -0.33 (-0.53, -0.13) and 0.21 (-0.05, 0.47) with moderate and low certainty of evidence, respectively. CONCLUSION: The evidence is inconclusive regarding the effectiveness of BCTs with exercises on core outcome sets. Further research should explore the effectiveness of BCTs with valid design. PROTOCOL REGISTRATION: PROSPERO (CRD42020212904).


Subject(s)
Osteoarthritis, Knee , Humans , Osteoarthritis, Knee/therapy , Exercise , Exercise Therapy/methods , Behavior Therapy , Pain
4.
J Phys Ther Sci ; 34(1): 13-17, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35035072

ABSTRACT

[Purpose] "Katakori" refers to a nonspecific symptom, including discomfort or dull pain, that is experienced around the occiput and that extends through the cervical spine to the acromion and scapular area. This study aimed to develop a patient-reported outcome measure of disability due to Katakori, namely the Katakori Disability Index, via evaluating patient comprehensibility and comprehensiveness. [Participants and Methods] We conducted a semi-structured interview among participants who had experienced Katakori consistently during the past month to examine patient comprehensibility and comprehensiveness; we particularly used the thinking-aloud method and cognitive debriefing to evaluate comprehensibility. [Results] We initially tested a provisional version of the Katakori Disability Index with 24 items using two 11-point numeric rating scales in a subset of 10 participants. Considering the issues identified concerning comprehensibility and comprehensiveness, we created a second draft of the Katakori Disability Index with two 6-point Likert scales, modified items, and four additional items. The second draft was tested in another subset of 10 participants. We eventually developed a 31-item Katakori Disability Index with modified instructions and items, two additional items, and a post-survey checklist; all these features addressed the concerns identified and suggestions obtained in the second round of interviews. [Conclusion] We developed a 31-item Katakori Disability Index with content validity.

5.
J Phys Ther Sci ; 33(9): 683-688, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34539074

ABSTRACT

[Purpose] To investigate the disturbed activities of daily living due to Katakori, a nonspecific symptom that includes discomfort or dull pain around the occiput through the cervical spine to the acromion and scapular area, by assessment of patients' values or perceptions. [Participants and Methods] Fifty participants with consistent Katakori during the last month were included. We used the patient-elicitation technique, in which the participants were asked to rate the 1) magnitude of disturbance to the elicited activities on an 8-point scale (0-7), and 2) the importance of each activity on an 11-point scale (0-10) in a semistructured interview. A score for each activity was calculated by multiplying the magnitude of the disturbance by its importance, and the score ranged from 0 to 70. [Results] Among the 186 disturbed activities evaluated in the patient-elicitation technique, 24 coding categories of disturbed activities were identified. The two most prevalent disturbed activities were using a personal computer (62%), and using a mobile phone or a tablet (52%). Taking care of children had the highest mean patient-elicitation technique score (66.5). [Conclusion] This study identified 24 conceptual structures of disturbed activities of daily living due to Katakori, which will serve as the foundation for future development of a patient-reported outcome measure for the disability caused by Katakori.

6.
Prog Rehabil Med ; 6: 20210034, 2021.
Article in English | MEDLINE | ID: mdl-34557605

ABSTRACT

OBJECTIVES: The Health Sciences Evidence-Based Practice (HS-EBP) questionnaire was recently developed for measuring five constructs of evidence-based clinical practice among Spanish health professionals by applying content and construct validity investigation. The current study aims to undertake a cross-cultural adaptation of the HS-EBP into Japanese and to investigate the internal consistency and test-retest reliability of the Japanese HS-EBP among undergraduate students of nursing and physical and occupational therapies. METHODS: Cross-cultural adaptation was undertaken by following Beaton's five-step process. Subsequently, the Japanese HS-EBP test-retest reliability was assessed with a 2-week interval. Participants were recruited from among third and fourth grade undergraduate students of nursing and physical and occupational therapies with clinical training experience. RESULTS: Pilot testing included 30 participants (11 nursing students, 11 physical therapy students, 8 occupational therapy students). Consequently, we developed the Japanese HS-EBP to be understandable for undergraduate students of nursing and physical and occupational therapies. Data from 52 participants who completed test-retest reliability questionnaires demonstrated adequate test-retest reliability in the total scores of Domains 1, 3, 4, and 5 [intraclass correlation coefficients were (ICC)=0.74, 0.70, 0.75, and 0.74, respectively]; the exception was Domain 2, which had an ICC of 0.66. Internal consistency (Cronbach's α) was adequate for Domains 1-5, for which α was 0.87, 0.94, 0.86, 0.93, and 0.95, respectively. CONCLUSIONS: This study developed the Japanese version of HS-EBP and provided preliminary evidence of adequate internal consistency and test-retest reliability in most domains for undergraduate students of nursing and physical and occupational therapies.

7.
Article in English | MEDLINE | ID: mdl-34068139

ABSTRACT

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.


Subject(s)
Head , Posture , Humans , Lumbosacral Region , Neck , Spine
8.
Sci Rep ; 10(1): 21109, 2020 12 03.
Article in English | MEDLINE | ID: mdl-33273542

ABSTRACT

Porphyromonas gingivalis, a periodontal pathogen, translocates many virulence factors including the cysteine proteases referred to as gingipains to the cell surface via the type IX secretion system (T9SS). Expression of the T9SS component proteins is regulated by the tandem signaling of the PorXY two-component system and the ECF sigma factor SigP. However, the details of this regulatory pathway are still unknown. We found that one of the T9SS conserved C-terminal domain-containing proteins, PGN_0123, which we have designated PorA, is involved in regulating expression of genes encoding T9SS structural proteins and that PorA can be translocated onto the cell surface without the T9SS translocation machinery. X-ray crystallography revealed that PorA has a domain similar to the mannose-binding domain of Escherichia coli FimH, the tip protein of Type 1 pilus. Mutations in the cytoplasmic domain of the sensor kinase PorY conferred phenotypic recovery on the ΔporA mutant. The SigP sigma factor, which is activated by the PorXY two-component system, markedly decreased in the ΔporA mutant. These results strongly support a potential role for PorA in relaying a signal from the cell surface to the PorXY-SigP signaling pathway.


Subject(s)
Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Bacterial Secretion Systems , Porphyromonas gingivalis/metabolism , Signal Transduction , Amino Acid Sequence , Bacterial Proteins/genetics , Bacterial Secretion Systems/drug effects , Cell Membrane/drug effects , Cell Membrane/metabolism , Gain of Function Mutation , Gingipain Cysteine Endopeptidases/pharmacology , Hemagglutination/drug effects , Lipopolysaccharides/metabolism , Models, Biological , Peptide Mapping , Pigmentation/drug effects , Porphyromonas gingivalis/drug effects , Protein Domains , Protein Transport/drug effects , Signal Transduction/drug effects
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