Anterior-Posterior Center of Pressure Is Associated With Knee Extensor Moment During Landing After Anterior Cruciate Ligament Reconstruction.

CONTEXT: A reduced knee extensor moment (KEM) in the involved limb and asymmetry in the KEM during landing tasks are observed after anterior cruciate ligament reconstruction (ACLR). There is limited information about the association of kinetic and kinematic parameters with the KEM during landing after ACLR. This study investigated the association of the anterior-posterior center of pressure (AP-COP) position, vertical ground reaction force (VGRF), and lower limb joint angles with the KEM during landing in female athletes following ACLR. DESIGN: Cross-sectional study. METHODS: Twenty-two female athletes who underwent ACLR performed a drop vertical jump at 7.9 (1.7) months after surgery. We evaluated the KEM, AP-COP position, VGRF, and sagittal plane hip, knee, and ankle angles using a 3-dimensional motion analysis system with force plates. RESULTS: The peak KEM in the involved limb was significantly smaller than that in the uninvolved limb during landing (1.43 [0.33] N·m/kg/m vs 1.84 [0.41] Nm/kg/m, P = .001). The VGRF in the involved limb was significantly smaller than that in the uninvolved limb (11.9 [2.3] N/kg vs 14.6 [3.5] N/kg, P = .005). The limb symmetry index of the KEM was predicted by that of the VGRF (P < .001, R2 = .621, ß = 0.800). The KEM was predicted by the AP-COP position in the involved limb (P = .015, R2 = .227, ß = 0.513) and by the VGRF in the uninvolved limb (P = .018, R2 = .213, ß = 0.500). No significant correlation was noted between the KEM and the lower limb joint angles. CONCLUSIONS: The AP-COP position and VGRF were associated with the KEM during landing. Evaluating the VGRF and AP-COP position, not the lower limb joint angles, may contribute to understanding the KEM during double-leg landing after ACLR in the clinical setting.

Long-term safety of eldecalcitol in Japanese patients with osteoporosis: a retrospective, large-scale database study.

INTRODUCTION: This real-world study evaluated whether long-term use of eldecalcitol (ELD) increases the risk of adverse events (AEs), namely, hypercalcemia, acute kidney injury (AKI), and urolithiasis, and analyzed the ELD-induced risk of rare AEs such as osteonecrosis of the jaw (ONJ) and atypical femoral fracture (AFF). MATERIALS AND METHODS: Patient records were retrieved from Medical Data Vision (MDV) and Japan Medical Data Center (JMDC) databases. The ELD-treated osteoporosis patient cohort (ELD cohort) was analyzed to determine the incidence rate of the aforementioned AEs. The patient cohort that was prescribed active vitamin D3 other than ELD (AVD cohort) was analyzed as the reference. RESULTS: Incidence rates of hypercalcemia, AKI, and urolithiasis in the ELD cohort were 0.942, 0.517, 2.465 events per 100 person-years, respectively, in the MDV dataset, and 0.687, 0.155, 3.785, respectively, in the JMDC dataset. The incidence rates of these AEs in the ELD cohort remained relatively constant throughout ELD treatment. A small number of patients experienced ONJ or AFF during ELD or AVD treatment. The number of ONJ and AFF cases in the both cohorts decreased over time. The two cohorts showed no difference in the concomitant use of anti-bone resorptive agents such as bisphosphonates and denosumab. CONCLUSION: The risk of hypercalcemia and AKI associated with ELD use observed in this retrospective analysis is similar to that reported previously in the Japanese post-marketing surveillance of ELD. Furthermore, ELD, similar to AVD, may not increase the risk of ONJ and AFF.

Effects of gait training with a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), on quality of life in patients with neuromuscular disease, able to walk independently with aids.

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs.

Cutaneous pilomatrical carcinosarcoma: a case report with molecular analysis and literature review.

BACKGROUND: Cutaneous pilomatrical carcinosarcoma (CS) is a very rare biphasic tumor composed of admixed epithelial and mesenchymal malignant cells, with limited information on its pathogenesis. We report a case of pilomatrical CS of the scalp with comparative immunohistochemical and molecular analysis together with a review of the literature. CASE PRESENTATION: A 74-year-old woman presented with a rapidly growing long-standing tumor of the scalp. The tumor was surgically resected. Histologically, the tumor was 25 mm in diameter, and was composed of carcinoma showing a clear pilomatrical differentiation and sarcoma with pleomorphic spindle cells and giant cells. Both epithelial and mesenchymal components shared focal cytoplasmic and/or nuclear accumulation of ß-catenin based on immunohistochemical analysis, although a mutation of exon 3 of the CTNNB1 gene was not detected. Fluorescence in situ hybridization analysis revealed gains of chromosomes 9p21, 3, and 7 in both the epithelial and sarcomatous components. CONCLUSIONS: The current case demonstrated characteristic findings of pilomatricoma and further evidence of partial clonality between the carcinomatous and sarcomatous component, suggesting the possibility of malignant transformation of pilomatricoma. Rapid growth of a pilomatrical tumor should warrant the development of a malignant tumor, including CS.

Effects of different oral instructions on kinematic and kinetic parameters during drop vertical jump.

[Purpose] This study aimed to examine the impact of changing the drop vertical jump stance time on kinematic and kinetic parameters by ordering to high jump or quick jump for consistent stance time and a more accurate assessment of anterior cruciate ligament injury risk. [Participants and Methods] The participants were 20 healthy female students. The drop vertical jump was started by instructing the participants to stand on a 30-cm platform with both legs stationary. The task was performed while the participants were instructed to perform high jump or quick jump. [Results] Stance time was significantly shorter with quick jump than with high jump. Quick jump showed significantly higher knee abduction angles at initial contact and peak vertical ground reaction force, and lower hip flexion, knee flexion, and ankle dorsiflexion angles at the lowest point of the center of mass. Quick jump showed a significantly higher peak vertical ground reaction force. The knee abduction moment at initial contact was not significantly different between the 2 conditions. [Conclusion] Quick jump was better than high jump for making stance time consistent, and the differences in kinematic and kinetic characteristics by oral instructions should be considered when using drop vertical jump.

A preliminary study on the use of meconium for the assessment of prenatal exposure to heavy metals in Japan.

In recent years, there has been increasing interest in the relevance of environmental pollution to children's health. We investigated whether the concentrations of heavy metals in meconium can be used for the assessmet of prenatal exposure in Japan. Our study subjects were newborns whose mothers were hospitalized for childbirth at Tokai University Hospital between November 2010 and March 2011. The target compounds of this study were lead (Pb), cadmium (Cd) and arsenic (As). Meconium samples collected from 102 newborns were analyzed using ICPMS. The median concentrations of Pb and As in the meconium were 0.71 ppb and 0.03 ppb, respectively. The median concentration of Cd was below the limit of quantification. These concentration values are much lower than those used in previous studies. Further study is needed to compare the concentrations of heavy metals in biological samples and to investigate the availability of meconium for the assessment of exposure to heavy metals during pregnancy.

Pretreatment with nomifensine or nomifensine analogue 4-phenyl-1,2,3,4-tetrahydroisoquinoline augments methamphetamine-induced stereotypical behavior in mice.

Nomifensine is a dopamine/norepinephrine reuptake inhibitor. Nomifensine and some of its structural analogues produce behavioral effects indicative of indirect dopaminergic agonist properties, such as hyperlocomotion. By contrast, the deaminated and demethylated nomifensine analogue 4-phenyl-1,2,3,4-tetrahydroisoquinoline (PTIQ) is reported to have amphetamine-antagonistic properties, as demonstrated by inhibition of methamphetamine (METH)-induced dopamine release in the nucleus accumbens and METH-induced hyperlocomotion in rats. In the present study, we examined the effect of PTIQ (10mg/kg, i.p.) and nomifensine (3mg/kg, i.p.) on METH (5 or 10mg/kg, i.p.)-induced stereotypical behavior in mice in order to determine whether PTIQ and nomifensine inhibit and augment, respectively, METH-induced stereotypical behavior. Unexpectedly, our observations demonstrated that both PTIQ and nomifensine significantly augmented METH-induced stereotypical behavior and locomotion in mice. This augmentation is likely the result of additive effects on dopaminergic function by METH in combination with PTIQ or nomifensine. These results suggest that, contrary to some reports, PTIQ may display dopaminergic agonist properties in mice.

The effect of heavy metals on nicotinamideN-methyltransferase activityin vitro relating to Parkinson's disease.

OBJECTIVE: The aims of this study were to determine the effects of heavy metals such as manganese on nicotinamideN-methyltransferase (EC 2.1.1.1) (NNMT) activity and to consider the possibility of involvement of NNMT activation in the pathogenesis of heavy metal induced Parkinson's disease. METHODS: NNMT activity in supernatants separated from brain, liver and kidney homogenates of 5 elderly male Wistar rats by centrifugation were measured by high performance liquid chromatography system with fluorescence. NNMT activity under the conditon of 0.5 or 5.0 mM Mn(2+), Fe(2+), Cu(2+) or Cd(2+) was compared with control (no metal ion existence). RESULTS: NNMT activities in rat brain, liver and kidneys were significantly decreased by Cu(2+), and those in the liver and kidneys were significantly decreased by Cd(2+). Mn(2+) reduced NNMT activity only in the liver. Fe(2+) had no effect on NNMT activity. CONCLUSIONS: No metal increased NNMT activity in this study, contrary to our hypothesis. Further study is needed to clarify the reason why the effects of Mn(2+) and Fe(2+) which have a high relevance to Parkinson's disease on NNMT activity differ from those of Cu(2+) and Cd(2+).