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2.
Prog Rehabil Med ; 8: 20230030, 2023.
Article in English | MEDLINE | ID: mdl-37736258

ABSTRACT

Objective: The aim of this study was to investigate the impact of untreated hand diseases on hand grip strength, a value that is commonly used as a diagnostic parameter for sarcopenia and frailty in geriatric populations. We hypothesized that individuals with untreated hand diseases would have lower grip strength than those without hand diseases. Methods: A total of 240 individuals aged at least 65 years were recruited and divided into two groups based on the presence or absence of typical hand diseases. Grip strength was compared between the two groups separately for men and women using a t-test, with each group consisting of 60 women or 60 men. Results: Both women and men in the hand disease group exhibited significantly lower grip strength than those in the control group. Conclusions: These findings suggest that untreated hand diseases have a negative impact on grip strength, and this may introduce bias in the screening or diagnosis of sarcopenia and frailty. It is essential to consider the presence of hand diseases when measuring hand grip strength in older adults.

3.
Respir Investig ; 61(5): 588-600, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37429072

ABSTRACT

BACKGROUND: Birth weight, as a measure of intrauterine growth, is commonly used in epidemiological studies and is reported to be associated with adult lung function. However, findings regarding this association in previous studies have been inconsistent. Furthermore, no studies have reported associations stratified by age or smoking status, or adjusted for eosinophil count or other parameters related to type 2 airway inflammation. METHODS: This cross-sectional study included 2632 men and 7237 women aged ≥20 years living in Miyagi Prefecture, Japan. Lung function was assessed based on spirometry. Birth weight data were obtained through a questionnaire survey. Analysis of covariance was used to evaluate the associations between birth weight and lung function, adjusting for potential confounders. Stratified analyses by age and smoking status were also conducted, together with a sub-analysis for low birth-weight participants. RESULTS: Birth weight was positively associated with forced expiratory volume in 1 s (FEV1) for both sexes and with vital capacity in women, after adjusting for height, age, smoking status, and parameters related to type 2 airway inflammation. The stratified analysis for smoking status revealed associations in never-smokers and ex-smokers. When stratified by age, the associations were confirmed in middle-aged participants. The effect of smoking status on the FEV1 of low birth-weight participants was not significant. CONCLUSIONS: Our analysis of a large, Japanese adult population showed that birth weight was independently and positively associated with adult lung function, even after adjustment for age, height, smoking status, and parameters related to type 2 airway inflammation.


Subject(s)
Lung , Smoking , Male , Middle Aged , Humans , Adult , Female , Cohort Studies , Birth Weight , Smoking/epidemiology , Cross-Sectional Studies , East Asian People , Forced Expiratory Volume , Vital Capacity , Spirometry , Inflammation
4.
J Orthop Sci ; 28(2): 446-452, 2023 Mar.
Article in English | MEDLINE | ID: mdl-34906401

ABSTRACT

BACKGROUND: In order to improve cancer care in Japan further, it is now required for orthopaedic surgeons to get actively involved in managing locomotive organs such as bones, muscles and nerves in cancer patients. In 2018, the Japanese Orthopaedic Association (JOA) conducted a questionnaire survey to investigate the current status of cancer treatment at the orthopaedic training facilities certified by the JOA. We analyzed the results of that questionnaire survey, focusing on the data from the core hospitals for cancer care (designated cancer hospitals), to clarify the involvement of orthopaedic surgeons in cancer treatment. MATERIALS AND METHODS: A nationwide survey was conducted in the orthopaedic training facilities certified by the JOA using an online questionnaire from March 15th to 31st, 2018. To clarify the involvement of orthopaedic surgeons in cancer treatment, we analyzed the results of that questionnaire survey, focusing on the data from the designated cancer hospitals in Japan. RESULTS: From the questionnaire survey, it became clear that 24% of the orthopaedic training facilities certified by the JOA are designated cancer hospitals. There were significant differences concerning cancer treatment and the prospect of orthopaedic surgeons' involvement in the treatment for bone metastases between institutions classified according to number of both certified orthopaedic surgeons by the JOA and specialists for bone and soft tissue tumors. In addition, in 45% of the designated cancer hospitals, orthopaedic surgeons treated bone metastases that occur in cancer patients, but in the rest of the institutions, orthopaedic surgeons did not yet adequately respond. CONCLUSION: In order to further improve the locomotive function and quality of life (QOL) in cancer patients, it was seemed to be necessary that all medical professionals engaged in cancer treatment, including orthopaedic surgeons, recognize the importance of locomotive management for cancer patients. In addition, the results of this study suggested that the presence of more than six certified orthopaedic surgeons by the JOA, including one or more specialists for bone and soft tissue tumors, may be able to create an environment conducive to the involvement of orthopaedic surgeons in cancer treatment at the facility.


Subject(s)
Musculoskeletal Diseases , Orthopedic Surgeons , Orthopedics , Soft Tissue Neoplasms , Humans , Japan , Orthopedics/methods , Quality of Life , Surveys and Questionnaires
5.
Mod Rheumatol ; 33(3): 617-622, 2023 Apr 13.
Article in English | MEDLINE | ID: mdl-35689559

ABSTRACT

OBJECTIVES: This study aimed to clarify the frequency-response relationship between exercise habits and locomotive syndrome (LS) in different age groups. METHODS: We analysed 8681 independent community dwellers who participated in a nationwide cross-sectional LS study. Participants were divided into young (20-39 years), middle (40-64 years), and old (≥ 65 years) groups. The presence of LS was evaluated using the LS risk tests. Exercise habits were assessed by exercise frequency (almost every day/sometimes/occasionally/never). The association between LS and exercise was assessed using the multiple logistic regression analysis adjusted for participant characteristics for each age category. RESULTS: Overall, 3528 (41%) participants had LS. In the old group, the risk of LS was lower with an increased exercise frequency. However, this dose-response relationship was not found in the young group. The proportion of LS was lower even in participants who occasionally exercised (1-3 days/month) than those who never exercise in the young and middle age groups. CONCLUSIONS: Regular exercise reduced the risk of LS not only in middle and older adults but also in young adults. Moreover, increasing exercise frequency may provide benefits for LS prevention, especially among older adults.


Subject(s)
Locomotion , Mobility Limitation , Middle Aged , Young Adult , Humans , Aged , Cross-Sectional Studies , Japan/epidemiology , Locomotion/physiology , Exercise , Syndrome
6.
J Orthop Sci ; 28(4): 758-764, 2023 Jul.
Article in English | MEDLINE | ID: mdl-35817666

ABSTRACT

BACKGROUND: Posterior cervical foraminotomy against anterior osteophyte is an indirect decompression procedure but less invasive compared to anterior cervical discectomy and fusion. Residual compression to the nerve root may lead to poor surgical outcomes. Although clinical results of posterior cervical foraminotomy for osteophytes are not considered better than those of disk herniation, osteophyte size and the association of the decompression area with poor surgical outcomes remain unclear. This study aimed to identify the limitations of minimally invasive posterior cervical foraminotomy for cervical radiculopathy and discuss the methods to improve surgical outcomes. METHODS: We analyzed 55 consecutive patients with degenerative cervical radiculopathy who underwent minimally invasive posterior cervical foraminotomy. Minimum postoperative follow-up duration was 1 year. We divided the patients into nonimproved and improved groups. The cutoff value between preoperative and postoperative Neck Disability Index scores was 30% improvement. Preoperative imaging data comprised disk height, local kyphosis, spinal cord compression, anterior osteophytes in the foramen, and anterior osteophytes of >50% of the intervertebral foramen diameter. Postoperative imaging data comprised craniocaudal length and lateral width of decompressed lamina, preserved superior facet width, and area of decompressed lamina. RESULTS: Fifty-five patients were divided into two groups: nonimproved (n = 19) and improved (n = 36). The presence of osteophytes itself was not significant; however, the presence of osteophytes of >50% of the foramen diameter increased in the nonimproved group (P = 0.004). Mean lateral width and mean area of decompressed lamina after surgery significantly increased in the improved group (P = 0.001, P = 0.03). CONCLUSION: The presence of anterior osteophytes >50% of the diameter of the foramen led to poor improvement of clinical outcomes in minimally invasive posterior cervical foraminotomy. However, the larger the lateral width and area of the decompressed lamina, the better the surgical outcome.


Subject(s)
Foraminotomy , Osteophyte , Radiculopathy , Humans , Foraminotomy/methods , Osteophyte/diagnostic imaging , Osteophyte/surgery , Radiculopathy/diagnostic imaging , Radiculopathy/etiology , Radiculopathy/surgery , Cohort Studies , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/surgery , Treatment Outcome , Diskectomy/methods , Decompression , Retrospective Studies
7.
J Orthop Sci ; 28(5): 1023-1026, 2023 Sep.
Article in English | MEDLINE | ID: mdl-36117033

ABSTRACT

BACKGROUND: Knowledge of the proximal edge of the germinal matrix is essential to avoid injuries in the germinal matrix. The previous index such as terminal tendon insertion is not visible from the body surface. The purpose of this study was to examine the relationship between the proximal edge of the germinal matrix and the body surface indexes by ultrasonographic measurements. METHODS: All participants underwent X-rays of the hand and were grouped based on the presence or absence of osteoarthritis in the distal interphalangeal (DIP) joint. The distance from the proximal edge of the germinal matrix to dorsal distal interphalangeal crease (parameter D1), and to ''DIP joint extension boundary line'' (parameter D2) were measured using ultrasonography. RESULTS: Thirty middle fingers of 24 patients were enrolled; 13 fingers were in control group and 17 fingers were in Heberden's node group. The average of parameter D1 was 6.17 mm (SD 1.12) in the control group (N = 13), and was 7.04 mm (SD 1.31) in Heberden's node group (N = 17) without significant difference. The DIP joint extension boundary line was not visible in 7 fingers with severe DIP joint osteoarthritis. The average of parameter D2 was 0.00 mm (SD 0.00) in the control group (N = 13), and was 0.04 mm (SD 0.13) in Heberden's node group (N = 10). CONCLUSIONS: We suggest that DIP joint extension boundary line and dorsal distal interphalangeal crease are valuable indexes to predict the proximal edge of the germinal matrix from the body surface. Though the DIP joint extension boundary line was not visible in some cases, once it has been sighted, the line shows where the germinal matrix exactly is.


Subject(s)
Finger Joint , Osteoarthritis , Humans , Finger Joint/diagnostic imaging , Osteoarthritis/diagnostic imaging , Fingers , Hand , Radiography
8.
BMJ Open ; 12(12): e065607, 2022 12 26.
Article in English | MEDLINE | ID: mdl-36572490

ABSTRACT

OBJECTIVES: Despite the possible large number of missing values on the 25-question Geriatric Locomotive Function Scale (GLFS-25), how we should treat them is unknown. In a simulation study, we investigated how to handle missing values in the GLFS-25. DESIGN, SETTING AND PARTICIPANTS: We used three datasets with different participant characteristics: community dwellers who could walk by themselves, outpatients of orthopaedics owing to pain, and patients who required surgery for total knee replacement or lumbar spinal canal stenosis. OUTCOME MEASURES: The missing items of the datasets were artificially created, and four statistical methods, complete case analysis, multiple imputation, single imputation using individual mean, and single imputation using individual domain average, were compared in terms of bias and mean squared error. Simulation studies were conducted to compare them under varying numbers of participants with missing values (5%-40%) and under varying numbers of missing items of GLFS-25 (4-16). RESULTS: Multiple imputation had the lowest root mean squared error. Complete case analysis showed the largest bias, and the performances of the single imputation were between those methods. The relative performances were similar across the three datasets. The absolute bias of the single imputation was<0.1. The bias and mean squared error of multiple imputation and single imputation were comparable when the number of missing items was less than or equal to eight. CONCLUSIONS: Multiple imputation is preferable, although single imputation using subject average/subject domain average can be used with practically negligible bias as long as the number of missing items is up to 8 out of 25 items in each individual of the population.


Subject(s)
Research Design , Walking , Humans , Aged , Computer Simulation , Bias
9.
J Orthop Surg (Hong Kong) ; 30(2): 10225536221103301, 2022.
Article in English | MEDLINE | ID: mdl-35722961

ABSTRACT

BACKGROUND: Ligament reconstruction and tendon interposition (LRTI) is currently the most performed procedure for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. In general, satisfactory outcomes are expected, although some patients complain of residual pain after LRTI. The objective of this study is to determine the factors associated with residual pain. METHOD: All patients with OA of the thumb CMC joint who underwent LRTI at our hospital between October 2013 and October 2018 and were regularly observed for at least 1 year were included. The following variables were extracted and included in the univariate analysis: sex, age, dominant hand, pain visual analog scale (VAS) score, Eaton classification, grip strength, pulp pinch strength, and metacarpophalangeal joint hyperextension angle were recorded as variables. Mann-Whitney U test or Fisher exact test was used for univariate analysis of the above factors, and then multivariate logistic regression analysis was performed to find out the factors associated with residual pain. RESULTS: The study included 60 thumbs of 53 patients. Eleven thumbs had postoperative residual pain. The surgery on the dominant hand was significantly associated with the presence of postoperative residual pain, especially in males. CONCLUSIONS: Dominant hand was associated with residual pain after LRTI for OA of the thumb CMC joint, although residual pain was minimal. Our findings will help in preoperative and postoperative counseling of patients. In the future, our results may also help select surgical procedures according to the patient's characteristics.


Subject(s)
Carpometacarpal Joints , Osteoarthritis , Arthroplasty/methods , Carpometacarpal Joints/surgery , Humans , Ligaments/surgery , Male , Osteoarthritis/surgery , Pain/surgery , Risk Factors , Tendons/surgery
11.
J Bone Miner Metab ; 40(4): 623-635, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35536512

ABSTRACT

INTRODUCTION: Locomotive syndrome (LOCOMO) is defined by the Japanese Orthopaedic Association (JOA) as a condition requiring nursing care due to a decline in mobility resulting from musculoskeletal disorders. In 2020, the JOA announced the new definition of LOCOMO stage 3 and revision of clinical decision limits in stages of LOCOMO. However, there are few reports on the epidemiological indices of LOCOMO. This prospective cohort study aimed to investigate the prevalence, incidence, and association of poor prognosis with LOCOMO stages. MATERIALS AND METHODS: The third survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study was conducted during 2012-2013, examining a population-based cohort of 1575 participants (513 men and 1062 women, mean age 65.6 years). Three LOCOMO risk tests were performed, and patients were classified into LOCOMO stages 0, 1, 2, and 3. They were followed up for 6 years, and identical examination of LOCOMO was performed in 3- and 6-year follow-ups. Data on patients' prognoses, including disability and death, were collected. RESULTS: The prevalence of LOCOMO stages 1, 2, and 3 was 41.3, 14.9, and 11.6%, respectively. The incidence of LOCOMO stages 1, 2, and 3 were 83.7, 23.0, and 18.6 per 1000 person-years, respectively. Compared with LOCOMO stage 0, logistic regression analysis showed that LOCOMO stage 3 significantly increased the risk of disability and mortality. In addition, each value of LOCOMO risk tests for LOCOMO stage 3 increased the risk of poor prognosis. CONCLUSION: LOCOMO stage 3 is a sensitive indicator of future disability and mortality.


Subject(s)
Osteoarthritis , Osteoporosis , Aged , Female , Follow-Up Studies , Humans , Japan/epidemiology , Male , Osteoarthritis/epidemiology , Prospective Studies , Syndrome
12.
Commun Biol ; 4(1): 1288, 2021 11 15.
Article in English | MEDLINE | ID: mdl-34782693

ABSTRACT

Lung function reflects the ability of the respiratory system and is utilized for the assessment of respiratory diseases. Because type 2 airway inflammation influences lung function, genome wide association studies (GWAS) for lung function would be improved by adjustment with an indicator of the inflammation. Here, we performed a GWAS for lung function with adjustment for exhaled nitric oxide (FeNO) levels in two independent Japanese populations. Our GWAS with genotype imputations revealed that the RNF5/AGER locus including AGER rs2070600 SNP, which introduces a G82S substitution of AGER, was the most significantly associated with FEV1/FVC. Three other rare missense variants of AGER were further identified. We also found genetic loci with three candidate genes (NOS2, SPSB2 and RIPOR2) associated with FeNO levels. Analyses with the BioBank-Japan GWAS resource revealed genetic links of FeNO and asthma-related traits, and existence of common genetic background for allergic diseases and their biomarkers. Our study identified the genetic locus most strongly associated with airway obstruction in the Japanese population and three genetic loci associated with FeNO, an indicator of type 2 airway inflammation in adults.


Subject(s)
Exhalation , Genotype , Nitric Oxide/metabolism , Pneumonia/genetics , Respiratory Function Tests , Adult , Aged , Biomarkers , Female , Genetic Loci , Genome-Wide Association Study , Humans , Japan , Lung/immunology , Male , Middle Aged
13.
BMC Geriatr ; 21(1): 651, 2021 11 19.
Article in English | MEDLINE | ID: mdl-34798834

ABSTRACT

BACKGROUND: Mobility decrease leading to disability can gradually develop during early life, however, its related factors are not well clarified. Therefore, we investigate the related factors of mobility decrease at various levels, using nationwide data in Japan. METHODS: In total, 8681 independent community dwellers aged 20-89 years were analysed (average age, 51.6 years; 58.5% women). Three stages of mobility decrease were based on the locomotive syndrome risk test: Stage 1, emerging; Stage 2, progressing; Stage 3, progressed to restrict social engagement. Age was analysed using a simple quadratic function model. RESULTS: The prevalence of Stages 1-3 was 31.6% (n = 2746), 5.8% (n = 504), and 3.2% (n = 278), respectively. On the multivariable logistic regression, increased age in participants aged ≥40 years (stage 1: odds ratio[OR] 1.05-1.20, stage 2: OR 1.04-1.22, stage 3: OR 1.05-1.22), female (stage 1: OR 2.28, 95% confidence interval [CI] 1.99-2.61, stage 2: OR 2.40, 95% CI 1.77-3.25, stage 3: OR 1.80, 95% CI 1.19-2.72), overweight status (stage 1: OR 1.56, 95% CI 1.34-1.82, stage 2: OR 3.19, 95% CI 2.38-4.27, stage 3: OR 2.87, 95% CI 1.90-4.32), hypertension (stage 1: OR 1.20, 95% CI 1.01-1.41, stage 2: OR 1.99, 95% CI 1.49-2.64, stage 3: OR 2.10, 95% CI 1.44-3.05), and diabetes mellitus (stage 1: OR 1.62, 95% CI 1.17-2.24, stage 2: OR 1.57, 95% CI 0.93-2.66, stage 3: OR 2.10, 95% CI 1.13-3.90) were positively associated. The frequency of physical activity/sports, even a few per month, was inversely associated with all stages (stage 1: OR 0.59-0.72, stage 2: OR 0.50-0.67, stage 3: 0.36-0.53). A one-year increase in age had a stronger impact on mobility decrease in older adults than in younger ones. Increased age in participants aged < 40 years and smoking were associated with Stage 1, while intake of various foods was inversely associated with Stages 1 and 2. CONCLUSION: Increased age (< 40 years) was associated with emerging mobility decrease, while that (≥ 40 years) was associated with any levels of mobility decrease. Female, lifestyle habits, including physical activities and overweight status, were associated with mobility decrease at every level.


Subject(s)
Disabled Persons , Mobility Limitation , Aged , Cross-Sectional Studies , Female , Humans , Japan/epidemiology , Life Style , Male
14.
BMC Musculoskelet Disord ; 22(1): 421, 2021 May 06.
Article in English | MEDLINE | ID: mdl-33957913

ABSTRACT

BACKGROUND: Isometric exercises for a flexed finger have been reported to be effective for treating trigger finger as the flexor tendon widens the space under the first annular (A1) pulley towards the palmar destination during the exercise. This study aimed to evaluate the structural changes during the A1 pulley stretch in healthy volunteers and patients with trigger finger using ultrasonography. METHODS: We enrolled 25 male and 14 female patients (39 middle fingers). The thickness of the subcutaneous tissue (parameter a), A1 pulley (parameter b), and the flexor tendon (parameter c) and the distance between the dorsal surface of the flexor tendon and the palmar surface of the metacarpal head (parameter d) were measured using ultrasonography of the metacarpophalangeal joint of the middle finger flexed at 45° at rest (pattern A) and under isometric contraction of the flexor tendon against an extension force of the proximal interphalangeal joint (pattern B). RESULTS: The average differences between patterns A and B in the healthy volunteers were 0.29 mm (parameter a; P = 0.02), 0.017 mm (parameter b; P = 0.63), 0.16 (parameter c; P = 0.26), and 0.41 (parameter d; P = 0.004), and those in patients with trigger finger were 0.22 mm (parameter a; P = 0.23), 0.019 mm (parameter b; P = 0.85), 0.03 mm (parameter c; P = 0.82), and 0.78 mm (parameter d; P < 0.001). The distance between the dorsal side of the A1 pulley and the palmar surface of the metacarpal head was also significantly increased by 0.57 mm (8.2%) in healthy volunteers (P < 0.001) and 0.81 mm (11%) in patients with trigger finger (P < 0.001). CONCLUSIONS: In this study, the space under the A1 pulley was expanded under isometric contraction of the flexor tendon. These findings support the effectiveness of pulley stretch exercises for the trigger finger condition.


Subject(s)
Trigger Finger Disorder , Female , Healthy Volunteers , Humans , Isometric Contraction , Male , Tendons/diagnostic imaging , Trigger Finger Disorder/diagnostic imaging , Trigger Finger Disorder/surgery , Ultrasonography
15.
J Hand Surg Am ; 46(9): 817.e1-817.e7, 2021 09.
Article in English | MEDLINE | ID: mdl-33726935

ABSTRACT

PURPOSE: This retrospective study aimed to analyze the initial clinical factors associated with surgical intervention for osteoarthritis of the thumb carpometacarpal (CMC) joint. METHODS: The study included patients who first visited our hand surgery clinic, were given the diagnosis of osteoarthritis of the thumb CMC joint between May 2012 and January 2015, and were observed for more than 3 years. Patients were classified into 2 groups according to whether they had undergone surgery during the follow-up period. The following variables were extracted and included in a bivariate analysis: sex, age, age at onset, disease duration, dominant hand, pain visual analog scale (VAS) scores at rest and during use, night pain, Eaton classification, use of an orthosis, number of injections, tender area, range of motion, grip strength, pinch strength, Kapandji abduction index, palmar abduction distance, grind test results, CMC joint shape on radiographs, dorsal subluxation ratio, volar tilt of the metacarpal, presence or absence of ossicles, and the surgeon who recommended the surgery. Variables with P values less than .05 in the bivariate analysis were included in a logistic regression model. RESULTS: The study included 80 thumbs of 48 patients. Pain scores at rest and during use, and the dorsal subluxation ratio were identified as factors significantly associated with surgical intervention in the bivariate analysis. The subsequent logistic regression analysis including these factors as explanatory variables also identified the VAS score at rest and dorsal subluxation ratio as significantly associated with surgical intervention. CONCLUSIONS: The VAS score at rest and the dorsal subluxation ratio at the first clinical visit were associated with the likelihood of future surgical intervention within 3 years in patients with osteoarthritis of the thumb CMC joint. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.


Subject(s)
Carpometacarpal Joints , Osteoarthritis , Carpometacarpal Joints/diagnostic imaging , Carpometacarpal Joints/surgery , Humans , Osteoarthritis/diagnostic imaging , Osteoarthritis/surgery , Range of Motion, Articular , Retrospective Studies , Thumb/diagnostic imaging , Thumb/surgery
17.
BMC Rheumatol ; 4: 1, 2020.
Article in English | MEDLINE | ID: mdl-32016169

ABSTRACT

BACKGROUND: Relapsing polychondritis (RPC) is a rare progressive autoimmune disease characterized by inflammation in the cartilage of multiple organs. Tracheobronchial involvement appears in nearly half of RPC patients during the course of their disease and represents the main cause of death. Localized tracheobronchial RPC is much rarer, and the pathogenesis remains unclear. Matrilin-1 is a non-collagenous cartilage matrix protein and has been suggested to be a potent autoantigen that induces the airway disease of RPC in animal models. However, the expression of matrilin-1 in tracheobronchial tissue in human remains unclear. Therefore, we examined the expression of matrilin-1 in the tracheal and auricular tissues in a localized tracheobronchial RPC patient. CASE PRESENTATION: A 62-year-old man with systemic sclerosis presented with cough and dyspnea on exertion. The lung function test showed an expiratory flow limitation and chest computed tomography showed diffuse thickness from the trachea to the bronchiole. No other tests showed abnormal findings. To evaluate further, bronchoscopy was performed and endobronchial ultrasonography showed thickness in the fourth-marginal echo layer suggesting inflammation of the cartilage. However, the tracheal biopsy showed no specific findings. The subsequent surgical tracheal biopsies showed inflammatory cell infiltration with destruction of the cartilage. Neither auricular nor nasal deformity, except for a tracheobronchial lesion, was detected. Biopsy from the left auricular cartilage also did not show any inflammatory changes. Finally, we diagnosed the patient with localized tracheobronchial RPC. To address the hypothesis that autoimmunity against matrilin-1 is involved in the pathogenesis of localized tracheobronchial RPC, we evaluated the expression level of matrilin-1 in a tracheal and auricular specimen from this patient. Immunohistochemical staining with anti-matrilin-1 antibody showed matrilin-1 in the tracheal but not in the auricular cartilage. CONCLUSIONS: We first demonstrated the expression of matrilin-1 in tracheal but not in auricular cartilage in a localized tracheobronchial RPC patient. This result supports the possibility that matrilin-1 is involved in the pathogenesis of localized tracheobronchial RPC. However, this is only one case report and further observations will be needed to confirm this result.

18.
BMC Cancer ; 18(1): 995, 2018 Oct 19.
Article in English | MEDLINE | ID: mdl-30340555

ABSTRACT

BACKGROUND: Ceritinib demonstrated a statistically significant effect on the progression-free survival versus chemotherapy in patients with advanced anaplastic lymphoma kinase (ALK) rearrangement in non-small cell lung cancer (NSCLC) as the first therapy or after previous treatment with crizotinib and one or two prior chemotherapy regimens in global phase 3 studies. However, some serious adverse effects related to ceritinib therapy were reported across these clinical studies. Among them, a grade 3 and 4 increase in hepatobiliary enzymes was one of the common adverse events related to treatment with ceritinib. However, the pathology remains unclear. Previously, increased Interleukin (IL)-18 was observed in both biliary duct disease and liver disease. Therefore, we hypothesized that IL-18 is involved in the pathology of hepatobiliary adverse effects related to treatment with ceritinib and evaluated the serum IL-18. CASE PRESENTATION: The patient was a 53-year-old Japanese woman that we previously reported as having severe hepatobiliary adverse effects related to ceritinib therapy. Laboratory data, CT and MRI were obtained at each time point. IL-18 was evaluated by ELISA method at each time point. Immunochemical staining of liver tissue was performed as a standard protocol using antibodies against IL-18. Our records showed that the levels of serum IL-18 increased from the early stage of hepatobiliary adverse effects related to the treatment with ceritinib and were became worse with an increase in hepatobiliary enzymes and the progression of imaging abnormalities in the bile duct. Furthermore, IL-18 positive cells were detected in the inflammatory sites around the interlobular bile duct of the liver tissue. CONCLUSION: Our case report shows that the increase of serum IL-18 had a positive correlation with the progression of severe hepatobiliary adverse effects related to treatment with ceritinib and the involvement of IL-18 in the hepatobiliary inflammation by pathological evaluation. These results suggest that IL-18 could be a useful surrogate marker for the hepatobiliary toxicity of ceritinib. However, this is only one case report and further prospective observations will complement our data in the future.


Subject(s)
Antineoplastic Agents/adverse effects , Biliary Tract Diseases/blood , Biliary Tract Diseases/chemically induced , Chemical and Drug Induced Liver Injury/blood , Interleukin-18/blood , Pyrimidines/adverse effects , Sulfones/adverse effects , Biliary Tract Diseases/diagnosis , Biomarkers/blood , Chemical and Drug Induced Liver Injury/diagnosis , Female , Humans , Middle Aged , Treatment Outcome
20.
J Orthop Sci ; 20(5): 888-95, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26008771

ABSTRACT

BACKGROUND: Motor dysfunction is a major reason why the elderly lose their independence in their daily lives. The concept of locomotive syndrome has been proposed to describe the risk of mobility dependence caused by various locomotive organ disorders. The preservation of locomotive organs is now socially important in the middle-aged and geriatric population. Therefore, it is important to establish a screening program to evaluate motor function and related quality of life in a wide range of ages. METHODS: We propose a new set of pre-existing scales (the Two-Step test, Stand-Up test, and 25-question Geriatric Locomotive Function Scale) as screening tools to identify the population at high risk for locomotive syndrome. We performed a preliminary survey on 777 subjects who had no apparent disorders related to motor function. We also examined the reliability of the Two-Step test and Stand-Up test. RESULTS: We found that each scale did not show ceiling or floor effects in various age groups. Because the correlations between the three scales were significant but weak, we assume that each scale covers different aspects of mobility. The test-retest reliability was found to be satisfactory for the Two-Step test and the Stand-Up test. CONCLUSION: Our results suggest that our "Short Test Battery for Locomotive syndrome" is a feasible and reliable tool for screening the adult population as a preventative strategy for locomotive syndrome in a super-aged society.


Subject(s)
Geriatric Assessment/methods , Locomotion/physiology , Mass Screening/methods , Mobility Limitation , Program Development , Quality of Life , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pilot Projects , Reproducibility of Results , Surveys and Questionnaires , Young Adult
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