Wiley Acta Medica Okayama 0902-0063 38 1 2023 Impact of changes in skeletal muscle mass and quality during the waiting time on outcomes of lung transplantation e15169 EN Akikazu Hagiyama Division of Physical Medicine and Rehabilitation, Okayama University Hospital Seiichiro Sugimoto Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin Tanaka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Matsubara Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kentaroh Miyoshi Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshimi Katayama Division of Physical Medicine and Rehabilitation, Okayama University Hospital Masanori Hamada Division of Physical Medicine and Rehabilitation, Okayama University Hospital Masuo Senda Division of Physical Medicine and Rehabilitation, Okayama University Hospital Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Introduction: The association of changes in skeletal muscle mass and quality during the waiting time with outcomes of lung transplantation (LT) remains unclear. We aimed to examine the association of changes in skeletal muscle mass and quality during the waiting time, as well as preoperative skeletal muscle mass and quality, with outcomes of LT.<br> Methods: This study included individuals who underwent LT from brain-dead donors. Skeletal muscle mass (cm2/m2) and quality (mean Hounsfield units [HU]) of the erector spinae muscle at the 12th thoracic level were evaluated using computed tomography. Preoperative skeletal muscle mass and quality, and their changes during the waiting time were calculated. We evaluated the associations among mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, 6-minute walk distance at discharge, and 5-year survival after LT.<br> Results: This study included 98 patients. The median waiting time was 594.5 days (interquartile range [IQR], 355.0–913.0). The median changes in skeletal muscle mass and quality were −4.4% (IQR, −13.3–3.1) and −2.9% (IQR, −16.0–4.1), respectively. Severe low skeletal muscle mass at LT was associated with prolonged ICU LOS (B = 8.46, 95% confidence interval [CI]: .51–16.42) and hospital LOS (B = 36.00, 95% CI: 3.23–68.78). Pronounced decrease in skeletal muscle mass during the waiting time was associated with prolonged MV duration (B = 7.85, 95% CI: .89–14.81) and ICU LOS (B = 7.97, 95% CI: .83–15.10).<br> Conclusion: Maintaining or increasing skeletal muscle mass during the waiting time would be beneficial to improve the short-term outcomes of LT. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 135 1 2023 第６回日本リハビリテーション医学会秋季学術集会報告 51 52 EN Masuo Senda Division of Physical Medicine and Rehabilitation, Okayama University Hospital No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 2 2023 Validity of the 30-Second Chair-Stand Test to Assess Exercise Tolerance and Clinical Outcomes in Patients with Esophageal Cancer: A Retrospective Study with Reference to 6-Minute Walk Test Results 193 197 EN Tomohiro Ikeda Department of Rehabilitation Medicine, Okayama University Kazuhiro Noma Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuki Okura Division of Rehabilitation, Akita University Graduate School of Medicine Sho Katayama Department of Rehabilitation Medicine, Okayama University Yusuke Takahashi Division of Rehabilitation, Akita University Graduate School of Medicine Naoaki Maeda Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shunsuke Tanabe Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akiyuki Wakita Department of Esophageal Surgery, Akita University Graduate School of Medicine Masanori Hamada Department of Rehabilitation Medicine, Okayama University Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masuo Senda Department of Rehabilitation Medicine, Okayama University Short Communication 10.18926/AMO/65149 This retrospective study aimed to investigate the validity of a 30-sec chair stand test (CS-30) as a simple test to assess exercise tolerance and clinical outcomes in 53 Japanese patients with esophageal cancer. There was a strong correlation between the results of CS-30 and the 6-min walk test (6MWT), the gold standard for assessing exercise tolerance (r=0.759). Furthermore, fewer patients whose CS-30 score was greater than 16 (the cutoff value defined based on 6MWT) experienced pneumonia in their postoperative course. These results suggest that exercise tolerance could be assessed using CS-30, and its cutoff value may be useful in predicting postoperative pneumonia risk. No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1471-2474 22 1 2021 Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome 882 EN Masato Ise Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Taichi Saito Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshimi Katayama Department of Rehabilitation Medicine, Okayama University Hospital Ryuichi Nakahara Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yasunori Shimamura Department of Sports Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masanori Hamada Department of Rehabilitation Medicine, Okayama University Hospital Masuo Senda Department of Rehabilitation Medicine, Okayama University Hospital Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background<br> Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS.<br> <br> Method<br> Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement.<br> <br> Results<br> The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, r = 0.67; 0–12 months, r = 0.60) and DASH (0–12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, r = − 0.33; 0–12 months, r = − 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below.<br> <br> Conclusion<br> NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2227-9032 9 5 2021 Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors 566 EN Masato Ise Department of Orthopaedic Surgery, Okayama University Hospital Eiji Nakata Department of Orthopaedic Surgery, Okayama University Hospital Yoshimi Katayama Department of Rehabilitation Medicine, Okayama University Hospital Masanori Hamada Department of Rehabilitation Medicine, Okayama University Hospital Toshiyuki Kunisada Department of Orthopaedic Surgery, Okayama University Hospital Tomohiro Fujiwara Department of Orthopaedic Surgery, Okayama University Hospital Ryuichi Nakahara Department of Orthopaedic Surgery, Okayama University Hospital Shouta Takihira Department of Orthopaedic Surgery, Okayama University Hospital Kohei Sato Department of Orthopaedic Surgery, Okayama University Hospital Yoshiteru Akezaki Division of Physical Therapy, Kochi Professional University of Rehabilitation Masuo Senda Department of Rehabilitation Medicine, Okayama University Hospital Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Hospital Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient's distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D >= 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 09492658 2020 Reference values for the locomotive syndrome risk test quantifying mobility of 8681 adults aged 20–89 years: A cross-sectional nationwide study in Japan EN Keiko Yamada Departments of Sensory & Motor System Medicine, Faculty of Medicine, The University of Tokyo Yoichi M. Ito Department of Statistical Data Science, The Institute of Statistical Mathematics Masao Akagi Department of Orthopedic Surgery, Kindai University Hospital Etsuo Chosa Department of Orthopaedic Surgery, University of Miyazaki Takeshi Fuji “Locomo Challenge!” Promotion Council Kenichi Hirano Hirano Orthopaedics Clinic Shinichi Ikeda Department of Orthopaedic Surgery, Oita University, Hideaki Ishibashi “Locomo Challenge!” Promotion Council Yasuyuki Ishibashi Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine Muneaki Ishijima “Locomo Challenge!” Promotion Council Eiji Itoi Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine Norimasa Iwasaki “Locomo Challenge!” Promotion Council Ryoichi Izumida “Locomo Challenge!” Promotion Council Ken Kadoya Department of Advanced Medicine for Locomotor System, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Masayuki Kamimura Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine Arihiko Kanaji “Locomo Challenge!” Promotion Council Hiroyuki Kato Department of Orthopaedic Surgery, Shinshu University School of Medicine Shunji Kishida “Locomo Challenge!” Promotion Council Naohiko Mashima Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine Shuichi Matsuda Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine Yasumoto Matsui Center for Frailty and Locomotive Syndrome, National Center for Geriatrics and Gerontology Toshiki Matsunaga Department of Rehabilitation Medicine, Akita University Hospital Naohisa Miyakoshi Department of Orthopedic Surgery, Akita University Graduate School of Medicine Hiroshi Mizuta Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University Yutaka Nakamura Saiseikai Shonan Hiratsuka Hospital Ken Nakata Medicine for Sports and Performing Arts, Osaka University Graduate School of Medicine Go Omori Department of Sports and Health, Faculty of Health and Science, Niigata University of Health and Welfare Koji Osuka Osuka Clinic Yuji Uchio Department of Orthopaedic Surgery, Shimane University Kazuteru Ryu Kanai Hospital Nobuyuki Sasaki Sasaki Orthopedic and Anesthesiology Clinic Kimihito Sato “Locomo Challenge!” Promotion Council Masuo Senda Okayama University Hospital, Division of Physical Medicine and Rehabilitation Akihiro Sudo Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Naonobu Takahira Department of Rehabilitation, Kitasato University School of Allied Health Sciences Hiroshi Tsumura Department of Orthopaedic Surgery Satoshi Yamaguchi “Locomo Challenge!” Promotion Council Noriaki Yamamoto Nigata Rehabilitation Hospital Kozo Nakamura “Locomo Challenge!” Promotion Council Ohe Takashi “Locomo Challenge!” Promotion Council, T Background<br/> The locomotive syndrome risk test was developed to quantify the decrease in mobility among adults, which could eventually lead to disability. The purpose of this study was to establish reference values for the locomotive syndrome risk test for adults and investigate the influence of age and sex.<br/> Methods<br/> We analyzed 8681 independent community dwellers (3607 men, 5074 women). Data pertaining to locomotive syndrome risk test (the two-step test, the stand-up test, and the 25-question geriatric locomotive function scale [GLFS-25]) scores were collected from seven administrative areas of Japan.<br/> Results<br/> The reference values of the three test scores were generated and all three test scores gradually decreased among young-to-middle-aged individuals and rapidly decreased in individuals aged over 60 years. The stand-up test score began decreasing significantly from the age of 30 years. The trajectories of decrease in the two-step test score with age was slightly different between men and women especially among the middle-aged individuals. The two physical test scores were more sensitive to aging than the self-reported test score.<br/> Conclusion<br/> The reference values generated in this study could be employed to determine whether an individual has mobility comparable to independent community dwellers of the same age and sex. No potential conflict of interest relevant to this article was reported.

Lippincott, Williams & Wilkins Acta Medica Okayama 0009-921X 477 8 2019 Temporary External External Fixation Can Stabilize Hip Transposition Arthroplasty After Resection of Malignant Periacetabular Bone Tumors 1892 1901 EN Toshiyuki Kunisada Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Tomohiro Fujiwara Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Joe Hasei Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Eiji Nakata Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Masuo Senda Department of Rehabilitation, Okayama University Hospital Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Background: The choice of reconstructive procedure to restore limb function is challenging after internal hemipelvectomy. Hip transposition arthroplasty, also known as resection arthroplasty, removes a malignant or aggressive tumor of the pelvis and acetabulum after which the remaining femoral head is moved proximally to the lateral surface side of the sacrum or the underside of the resected ilium after internal hemipelvectomy. It may provide reasonable functional results and have some advantages such as lowering the risk of an infected implant compared with other reconstructions because no foreign implants are used. Hip transposition is generally managed with prolonged bed rest or immobilization postoperatively to stabilize the soft tissue surrounding the remaining femur. Because enabling patients to be mobile while the soft tissues heal might be advantageous, we reviewed our experience with an external fixation for this procedure.<br/> Questions/purposes: (1) Does temporary external fixation facilitate postoperative physiotherapy in patients who undergo hip transposition arthroplasty? (2) What functional Musculoskeletal Tumor Society (MSTS) scores were achieved at short term in a small series of patients treated with hip transposition and temporary external fixation? (3) What were the complications of using external fixation in a small series of patients who received it for malignant tumors?<br/> Methods: Between 2008 and 2012, we treated seven patients (three men and four women; median age, 37 years; age range, 18-53 years) with acetabular resection for malignant bone tumors; all were managed with a hip transposition, initially stabilized using external fixation. No other types of procedures were used for this indication in this period. Minimum followup in this retrospective study was 45 months, except for one patient who died at 18 months (range of followup duration, 18-90 months; median followup, 57 months), and no patients were lost to followup. The pins for external fixation were inserted into the affected side of the femur and the healthy contralateral ilium. External fixation was removed 6 weeks postoperatively and weightbearing was started at that time. Preoperative chemotherapy was administrated in four patients, but postoperative chemotherapy was delayed since it was given after external fixation removal in three patients. The postoperative rehabilitation course and functional results were assessed by chart review, functional results were determined using MSTS scores, tallied by physiotherapists who were not part of the surgical team, and complications were ascertained through chart review. Major complications were defined as complications that were treated with additional operations, such as deep infection, or ones that could cause severe postoperative dysfunction, such as nerve injury.<br/> Results: With temporary external fixation, standing next to a bed was achieved in median 7 days (range, 6-9 days) postoperatively, transferring to a wheel chair in median 8 days (range, 6-28 days), and gait training using parallel bars in median 15 days (range, 7-48 days). At most recent followup, three patients could walk without a crutch or cane, three could walk with a cane, and one could walk with a crutch. The median MSTS score at most recent followup (median, 57 months) was 63%. Two patients had complications that resulted in reoperations; one had a wound dehiscence, and one had an abdominal herniation that gradually developed, and which was reconstructed using polypropylene mesh 2 years after pelvic resection. Two patients had nerve palsies that recovered by the end of the first year. All patients had pin tract infections that resolved with nonsurgical approaches.<br/> Conclusions: Hip transposition with temporary external fixation can stabilize the bone soft tissue after pelvic resection. Although we did not have a comparison group of patients, we believe that external fixation facilitates early postoperative physiotherapy and rehabilitation and provides good functional results without major surgical complications. Because it delays the resumption of chemotherapy, more patients with longer followup are needed to determine whether this will be associated with poorer oncologic results. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 124 3 2012 人工筋肉とリハビリテーション医学 211 216 EN Masuo Senda No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 66 3 2012 Statistical Analysis of Prognostic Factors for Survival in Patients with Spinal Metastasis 213 219 EN Masaki Kataoka Toshiyuki Kunisada Masato Tanaka Ken Takeda Satoru Itani Yoshihisa Sugimoto Haruo Misawa Masuo Senda Shinnosuke Nakahara Toshifumi Ozaki Original Article 10.18926/AMO/48560 There are a variety of treatment options for patients with spinal metastasis, and predicting prognosis is essential for selecting the proper treatment. The purpose of the present study was to identify the significant prognostic factors for the survival of patients with spinal metastasis. We retrospectively reviewed 143 patients with spinal metastasis. The median age was 61 years. Eleven factors reported previously were analyzed using the Cox proportional hazards model:gender, age, performance status, neurological deficits, pain, type of primary tumor, metastasis to major organs, previous chemotherapy, disease-free interval before spinal metastasis, multiple spinal metastases, and extra-spinal bone metastasis. The average survival of study patients after the first visit to our clinic was 22 months. Multivariate survival analysis demonstrated that type of primary tumor (hazard ratio [HR]＝6.80, p＜0.001), metastasis to major organs (HR＝2.01, p＝0.005), disease-free interval before spinal metastasis (HR＝1.77, p＝0.028), and extra-spinal bone metastasis (HR＝1.75, p＝0.017) were significant prognostic factors. Type of primary tumor was the most powerful prognostic factor. Other prognostic factors may differ among the types of primary tumor and may also be closely associated with primary disease activity. Further analysis of factors predicting prognosis should be conducted with respect to each type of primary tumor to help accurately predict prognosis. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 64 3 2010 Preoperative Time Required for the Timed "Up and Go" Test in Women with Hip Osteoarthritis Could Predict a Deep Venous Thrombosis Complication after Total Hip Arthroplasty 197 201 EN Kentaro Sasaki Masuo Senda Keiichiro Nishida Haruyuki Ota Original Article 10.18926/AMO/40012 We examined whether the preoperative time required for the Timed "Up and Go" (TUG) test could predict the risk for deep venous thrombosis (DVT) in patients with hip osteoarthritis after total hip arthroplasty (THA). Eighteen patients with DVT diagnosed by venography were selected, and 18 without DVT of the same age and sex and with the same operated side as the DVT group were selected as a control group. We evaluated the 5 preoperative factors that might affect the occurrence of DVT complications, as follows:disease duration, body mass index, serum total cholesterol, subjective pain evaluated by the visual analog scale, and TUG. The JOA hip score (pain, range of motion, walking ability, and daily life) was also evaluated before surgery. As a postoperative factor, we checked the postoperative day when weight-bearing was initiated. As a result, TUG (DVT, 18.4+/-4.0 sec vs. control, 15.0+/-3.2 sec;p0.01) was only significantly different between the 2 groups. The ROC curve revealed that the cut-off point of 15.3 sec in preoperative time for TUG was sensitive (83.3%) and specific (61.1%) for DVT after THA (odds ratio7.0;95% confidence interval, 1.6-30.8). These results suggested that low preoperative ambulatory ability in patients with hip osteoarthritis might be associated with DVT after THA. An improvement in TUG before surgery might contribute to a decrease in the occurrence of DVT after THA. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 64 2 2010 The effect of service dogs on the improvement of health-related quality of life 109 113 EN Mai Shintani Masuo Senda Tomoko Takayanagi Yoshimi Katayama Kazunari Furusawa Tamami Okutani Masaki Kataoka Toshifumi Ozaki Original Article 10.18926/AMO/32851 <p>To assess the effects of service dogs on health-related quality of life (HRQOL), we conducted a survey of 10 service dog owners using SF-36v2 (Medical Outcomes Study 36 Item Short-Form Health Survey Version 2.0) and compared it with a matched control group of people with physical disabilities who did not have service dogs but were eligible for one. The scores for mental health and role emotional of service dog owners were relatively high, and their mental component summary was higher than the general population norm. These results indicate that service dogs affect the mentality of their owners. The comparison with the control group indicated that service dogs alleviate the mental burden of daily activities, and subjectively improved the physical functioning of their owners. This study showed that service dogs have positive functional and mental effects on their disabled owners.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 54 2 2000 Measurement of fatigue in knee flexor and extensor muscles. 85 90 EN Yasuto Kawabata Masuo Senda Takahiro Oka Yukihisa Yagata Yasuhiro Takahara Hiroaki Nagashima Hajime Inoue Article 10.18926/AMO/32290 <p>In order to examine fatigue of the knee flexor and extensor muscles and to investigate the characteristics of muscular fatigue in different sports, a Cybex machine was used to measure muscle fatigue and recovery during isokinetic knee flexion and extension. Eighteen baseball players, 12 soccer players and 13 marathon runners were studied. Each subject was tested in the sitting position and made to perform 50 consecutive right knee bends and stretches at maximum strength. This was done 3 times with an interval of 10 min between each series. The peak torque to body weight ratio and the fatigue rate were determined in each case. In all subjects, the peak torque to body weight ratio was higher for extensors than flexors. Over the 3 trials, the fatigue rate of extensors showed little change, while that of flexors had a tendency to increase. In each subject, knee extensors showed a high fatigue rate but a quick recovery, while knee flexors showed a low fatigue rate but a slow recovery. As the marathon runners had the smallest fatigue rates for both flexors and extensors, we concluded that marathon runners had more stamina than baseball players and soccer players.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 58 2 2004 Talonavicular joint abnormalities and walking ability of patients with rheumatoid arthritis. 85 90 EN Noriyoshi Miyamoto Masuo Senda Masanori Hamada Yoshimi Katayama Atsushi Kinosita Kensuke Uchida Hajime Inoue Article 10.18926/AMO/32099 <p>Rheumatoid arthritis (RA) is often associated with deformities of the feet, and foot pain often arises in the talonavicular joint of patients with RA. The object of this study was to assess the relationship between magnetic resonance imaging (MRI) findings of the talonavicular joint and walking ability. The subjects were 35 RA patients (10 feet in 5 males and 56 feet in 30 females) aged 34-87 years (mean: 70 years +/- 12.1), with a disease duration from 1-54 years (mean: 14 years +/- 12.1). MRI findings were classified as follows: Grade 1, almost normal; Grade 2, early articular destruction; Grade 3, moderate articular destruction; Grade 4, severe articular destruction; and Grade 5, bony ankylosis dislocation. Walking ability was classified into one of 9 categories ranging from normal gait to bedridden status according to the system of Fujibayashi. As the grade of MRI images became higher the walking ability decreased, and these parameters showed a correlation by Spearman's rank correlation coefficient analysis (P = 0.003). Thus, in the present cohort group of patients with RA, the deterioration of walking ability increased with the severity of destruction of the talonavicular joint.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 58 4 2004 Relationship between postural balance and knee and toe muscle power in young women. 189 195 EN Yoshimi Katayama Masuo Senda Masanori Hamada Masaki Kataoka Mai Shintani Hajime Inoue Article 10.18926/AMO/32087 <p>Muscle power in the lower extremities and body sway were measured in 57 healthy young women volunteers in their 20's. Body sway was measured with a stabilimeter for 30 sec during two-leg standing, and for 10 sec during one-leg standing with the eyes open or closed, alternating between right and left legs (5 times each). The measured parameters of body sway were locus length per time unit, locus length per environmental area, environmental area, rectangle area, root mean square area, and the ratio of sway with eyes closed to sway with eyes open. Knee flexor and extensor power and toe flexor and abductor power were the measures representing lower extremity muscle power. The increase in sway with the eyes closed was more marked during one-leg standing than two-leg standing, as expected. We found that 36 of 57 subjects (62%) were unable to maintain one-leg standing with their eyes closed, and this failure correlated with marked body sway (P = 0.0086). Many subjects had one leg that was classified as stable and the other leg classified as unstable. Clearly, testing of both legs alternately with eyes closed is necessary to measure the full range of sway in subjects. Lower extremity muscle power did not appear to be the dominant factor in maintaining balance in these young subjects.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 59 5 2005 The relationship between ambulatory ability before surgery and the D-dimer value after total hip arthroplasty: the evaluation of ambulatory ability by the timed "Up & Go" test. 225 230 EN Kentaro Sasaki Masuo Senda Takashi Ishikura Haruyuki Ota Takeshi Mori Hisashi Tsukiyama Masanori Hamada Naofumi Shiota Article 10.18926/AMO/31970 <p>We examined whether ambulatory ability before surgery might influence the post-operative D-dimer level after total hip arthroplasty (THA). One hundred two patients with hip osteoarthritis receiving THA were included in the current study. The patients were all female, and their ages ranged from 45 to 81 (average 65.0 +- 9.3 years). Age, operated side, body mass index (BMI), disease duration before surgery, pre-operative pain evaluated by visual analogue scale (VAS), total cholesterol value, maximal circumference of the lower leg of the operated side, and timed &#34;Up &#38; Go&#34;test (TUG) before surgery, were retrospectively investigated to examine their relationship with D-dimer levels on post-operative day 7. Patients were divided into 2 groups according to the D-dimer value: over 10 microg/ml (Group D), and under (Group N). Patients in group D (N= 52)were older, had a higher BMI, and had less ambulatory ability than patients in group N (N= 50). As age showed a relationship with the D-dimer value on the 7th day and TUG results, patients in the 2 groups were further subdivided into 50's, 60's, and 70's age brackets. In the 50's bracket, patients in group D had higher BMI than patients in group N, but time for TUG was not significantly different. In the 60's and 70's bracket, patients in group D had less ambulatory ability than patients in group N, but the time for TUG was not directly correlated with the D-dimer value. The results suggest that pre-operative low ambulatory ability in patients with osteoarthritis over 60 years might influence the postoperative D-dimer after THA, indicating the potential risk for post-operative deep venous thrombosis.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 1 1999 Adequacy and Long-Term Prognosis of Endoscopic Carpal Tunnel Release 39 44 EN Hirooka Takahiro Hiroyuki Hashizume Masuo Senda Mitsuru Nagoshi Hajime Inoue Hiroaki Nagashima Article 10.18926/AMO/31644 <p>Forty-one hands of 37 patients with idiopathic carpal tunnel syndrome treated by endoscopic carpal tunnel release (ECTR) were followed up for more than one year after surgery. Surgical results were evaluated using Kelly's criteria, the Semmes-Weinstein test, the static and moving 2-point discrimination tests, tip-pinch strength, and motor and sensory nerve conduction studies. Clinical results, according to Kelly's criteria three months after surgery, were excellent or good in 36 hands, and fair or poor in five hands. No recovery was evident at six months and 12 months after surgery in fair and poor hands. Based on these findings, we conclude that a neurolysis of the median nerve and release of constriction of the thenar muscle branch should be performed using the conventional open technique for patients with poor results three months after ECTR if the patients are dissatisfied with ECTR results</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 2 1999 Ultrasonographic Analysis of Shoulder Rotator Cuff Tears 81 89 EN Shunji Masaoka Hiroyuki Hashizume Masuo Senda Keiichiro Nishida Mitsuru Nagoshi Hajime Inoue Article 10.18926/AMO/31628 <p>Seventy-nine shoulders suspected of rotator cuff tears were examined by ultrasonography (US) and forty-three received surgery. Long and short axis scans were performed and findings of each were separately classified according to a five-grade system, and the results were correlated with the actual extent of tear observed during surgery. Internal echogenicity and subacromial impingement were analyzed before and after surgery. A accuracy of US in detecting rotator cuff tears was analyzed. In addition, the correlation between cuff shape observed by US before surgery and actual shape observed during surgery was assessed. It was noted that cuff thinning and abnormalities in shape did not recover to normal after surgery. However, in the cases of discontinuities observed by US before surgery, US findings indicated that the torn cuff was anchored to the greater tuberosity and functional during active motion. Although post-operative US findings were not normal, clinical results were good in most cases. Sensitivity of US for detecting rotator cuff tear was 100% and specificity 94%. US is non-invasive, cost effective and allows the physician to examine the joint while it is in motion. Therefore, at this time, we use US as a screening method for detecting rotator cuff tears. Furthermore, US allows us to check for re-tears while the joint is in motion, which is essential for accurate diagnosis.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 6 1999 Influence of exercise on muscle fibers in rats with steroid myopathy. 265 270 EN Kie Nakago Masuo Senda Midori Touno Yasuhiro Takahara Hajime Inoue Article 10.18926/AMO/31621 <p>The influence of mild exercise on skeletal muscle fibers was investigated histochemically to assess the effects of exercise on steroid myopathy and its efficacy for preventing this disease. Twenty male Wistar rats were divided into 4 groups of 5 each: group T, which received exercise alone; group S which received steroid alone; group ST which received both exercise and steroid; and group C, the control group. In groups S and ST, hydrocortisone was administered subcutaneously at a dose of 10 mg/kg/day for 4 weeks. In the exercise groups, the animals were made to run at a speed of 15 m/min for about 1 h/day for 5 days a week on a treadmill. After the completion of treadmill exercise and steroid administration for 4 weeks, the rats were anesthetized with Nembutal, the soleus muscle (SOL) and the extensor digitorum longus muscle (EDL) were removed and prepared for examinations. The area of type I fibers in the SOL was significantly larger in group ST than in group S. The area of type IIa fibers in the EDL was significantly larger in group ST than in group S. In group S, the proportion of type I fibers in the SOL was significantly lower than in the other three groups. There was little difference in fiber type distribution between groups ST and C. These results suggest that steroid myopathy can be prevented by even mild exercise.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 4 1999 Measurement of the muscle power of the toes in female marathon runners using a toe dynamometer. 189 191 EN Masuo Senda Yasuhiro Takahara Yukihisa Yagata Kazushi Yamamoto Hiroaki Nagashima Hisashi Tukiyama Hajime Inoue Article 10.18926/AMO/31617 <p>The aim of this study was to investigate the relationship between the strength of the foot muscles that control the toes and disorders such as shin splint. In order to this, we designed and built a toe dynamometer to compare the muscle power exerted through the toes in top female marathon runners and age-matched women not involved in sports. The subjects were 12 top-level female marathon runners (Group A) and 37 student nurses who were not involved in sports (Group B). We devised a dynamometer to measure the total power exerted by the flexor muscles of the 5 toes of a single foot (total flexor power) and the combined power of the abductors of the big (1st) and little (5th) toes (abductor power). In Group A, the total flexor power was 14.3 +/- 5.3 kg in the right foot and 15.4 +/- 4.7 kg in the left foot. The abductor power was 1.9 +/- 1.8 kg in the right foot and 2.2 +/- 1.9 kg in the left foot. In Group B, total flexor power was 18.3 +/- 6.7 kg in the right foot, while the abductor power was 1.9 +/- 1.7 kg. The subjects from Group A with an arch index &#60; 1.0 (n = 8) or &#62; 1.0 (n = 4) were respectively classified as Group I and Group II. In Group I, total flexor power was 14.9 +/- 5.3 kg (right) and 15.5 +/- 5.2 kg (left), while the abductor power was 2.6 +/- 1.9 kg (right), and 3.1 +/- 1.7 kg (left). In Group II, the total flexor power was 13.2 +/- 5.8 kg (right) and 15.1 +/- 4.2 kg (left), while the abductor power was 0.7 +/- 0.6 kg (right) and 0.3 +/- 0.2 kg (left). The abductor power of toes was significantly lower in Group II than in Group I. The incidence of posteromedial shin pain was higher in Group II (75.0%) than in Group I (12.5%).</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 53 4 1999 Evaluation of Release Surgery for Idiopathic Carpal Tunnel Syndrome: Endoscopic Versus Open Method 179 183 EN Kenya Hasegawa Hiroyuki Hashizume Masuo Senda Akira Kawai Hajime Inoue Article 10.18926/AMO/31614 To evaluate the usefulness of endoscopic carpal tunnel release (ECTR) on patients with idiopathic carpal tunnel syndrome, multiple aspects of the results of 44 hands (42 patients) treated by ECTR and 40 hands (40 patients) treated by open carpal tunnel release (OCTR) were compared. Results of ECTR were compared with those of OCTR to study not only recovery rate and surgical safety but also cost-effectiveness. Although ECTR was much less invasive than OCTR, recovery of median nerve palsy in the ECTR group was not as good as that in the OCTR group one month after the surgery. Three months after surgery, the palsy of patients treated by ECTR had improved to almost the same extent as in those treated by OCTR. There were no major surgical complications in both ECTR and OCTR groups. The cost and time needed for ECTR treatment was 1/3 of those needed for OCTR. ECTR reduced both cost and treatment time, which is beneficial for both doctors and patients. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 3 1998 Evaluation of the thigh muscles after knee exercise on a Cybex II. 155 160 EN Masamichi Hayashi Shiro Hanakawa Masuo Senda Yasuhiro Takahara Article 10.18926/AMO/31325 <p>We investigated the degree of local heat and swelling of the thigh muscles produced by exercise. Eleven university athletes aged from 19 to 23 years old performed isokinetic exercise of the right knee on a Cybex II. Then serial determination of thigh circumference and thigh temperature (up to 120 min after exercise) as well as serial magnetic resonance (MR) imaging (up to 60 min after exercise) was performed on both thighs. The circumference of the right thigh peaked at 5.6 +/- 2.1 min after exercise and returned to normal at 38.6 +/- 9.2 min. The temperature of the right thigh peaked at 14.2 +/- 5.7 min after exercise and was not normalized after 120 min except in two subjects. T2-weighted MR images showed a marked increase in the signal intensity of the right knee flexor and extensor muscles. The signal intensity peaked immediately after exercise and subsequently decreased gradually but did not return to normal after 60 min in some muscles. Changes in the thigh circumference were closely correlated with changes in the MR findings. The changes in the thigh muscles after knee exercise could be demonstrated using MR imaging, thigh circumference, and thigh temperature data. These parameters may provide indicators for managing muscle fatigue and recovery.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 6 1998 Results of surgical treatment for ossification of the posterior longitudinal ligament of the thoracic spine. 319 323 EN Masuo Senda Yoshiaki Harada Kazuhiro Takeuchi Sinnosuke Nakahara Hajime Inoue Article 10.18926/AMO/31303 <p>Conservative treatment is ineffective for ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine, and surgical treatment is indicated for most cases, while such cases are not often experienced. In the present study, the results of surgical management involving mainly posterior decompression for this disease were evaluated clinically. The study included 9 patients (1 man and 8 women) who underwent surgical treatment for OPLL of the thoracic spine between 1984 and 1993. Laminectomy was performed in 5 patients, and laminectomy plus anterior decompression of the OPLL via the posterior approach based on Otsuka's method was performed in 2 patients. In 1 patient, laminoplasty for OPLL of the cervical spine was combined with laminectomy of the symptomatic lesion in the thoracic spine. One patient underwent anterior decompression and fusion. The results were evaluated using the Japanese Orthopaedic Association score (JOA score) and recovery rate. The postoperative follow-up period ranged from 1 year to 10 years and 3 months (mean, 4 years and 6 months). The mean JOA score was 4.8 before surgery and improved to 7.6 at the final examination. This was a mean recovery rate of 50.1%. Symptoms caused by OPLL in the thoracic spine can be alleviated by posterior decompression where OPLL extends from the upper to the middle thoracic spine or extends from the middle to the lower thoracic spine. It seems, however, that OPLL localized to the middle thoracic spine requires anterior decompression.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 52 4 1998 Evaluation of Rheumatoid Arthritis Using a Scoring System Devised from Magnetic Resonance Imaging of Rheumatoid Knees 211 224 EN Kazuhiro Takeuchi Hajime Inoue Yoshiki Yokoyama Masuo Senda Yusuke Ota Nobuhiro Abe Keiichiro Nishida Article 10.18926/AMO/31296 <p>We studied the magnetic resonance imaging (MRI) of 120 knees in 86 rheumatoid arthritis (RA) patients and of 14 unaffected knees in 12 control cases. We also developed a scoring system as a quantitative analysis method. We divided the MRI into 10 items, and classified the severity of the symptoms into 4 grades (score 0 to 3). The average total score increased according to the radiographic grade. Soft tissue lesions were clearly detected, even in the early stages of RA. Items such as synovial proliferation showed a high score even in the early stages, suggesting that it was the initial symptom of RA. The score also showed a correlation with the inflammatory signs. These results suggest that this scoring system is very sensitive and yields a good reflection of RA activity. We demonstrated that this system is simple and convenient for routine diagnostic use. We further demonstrated that it is useful for following the advancement of RA and for evaluating the response to treatment.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 51 5 1997 Muscle strength in rheumatoid elbow: quantitative measurement and comparison to Larsen's X-ray grade 267 274 EN Yukio Shigeyama Hajime Inoue Hiroyuki Hashizume Hiroaki Nagashima Masuo Senda Article 10.18926/AMO/30792 <p>Accurate assessment of elbow function is important to determine the total ability of the arm. The purpose of this study was to clarify the relationship between isometric muscle strength of the elbows of patients with rheumatoid arthritis (RA) and Larsen's X-ray evaluation. Fifty-six elbows of 45 RA patients aged 47 to 77 years (mean age, 63 years) were tested. Muscle strength was measured with an isometric torque-cell dynamometer. Test-retest reliability of the dynamometer was proven by measuring 12 elbows of 6 healthy young men. In RA patients, elbow flexion and extension strength decreased in proportion to increases in the severity of Larsen's grades from Grade 1 to 4. However, Grade 5 elbows had greater muscle strength than those in Grade 4. Forearm pronation and supination strength also decreased in proportion to increases in the severity of Larsen's grades from Grade 1 to 5. This quantitative study made it clear that the muscle strength of RA patients' elbows almost completely correlates to X-ray finding according to the grade of Larsen's evaluation based on X-rays. With regard to muscle strength of postoperative elbows, both flexion strength and supination strength after total elbow replacement (TER) were about two times greater than before TER, and after synovectomy it was as great as those in non-operative RA patients of Grade 2.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 51 6 1997 Lumbar spinal changes over 20 years after posterior fusion for idiopathic scoliosis 327 331 EN Masuo Senda Yoshiaki Harada Shinnosuke Nakahara Hajime Inoue Article 10.18926/AMO/30768 <p>Lumbar X-ray findings and clinical manifestations were investigated in 10 patients who underwent posterior fusion with or without Harrington instrumentation for idiopathic scoliosis between 1965 and 1975. The subjects were 4 men and 6 women, who ranged from 10 to 17 years of age at the time of surgery (mean, 12 years and 9 months). The postoperative follow-up period ranged from 20 to 30 years (mean, 24 years and 7 months). All patients were followed-up at our institution. Three patients received posterior fusion without instrumentation, and Harrington instrumentation was used in 7 from 1967 onwards. The distal end of the fusion was L2 in 4, L3 in 4, and L4 in 2 patients. Pain, evaluated by Moskowitz's criteria, was stage 1 in 5 and stage II in 5 patients (none of them had stage III or IV). In X-ray evaluation, graded according to Lawrence's classification, grade III changes were noted in 2 patients; one with thoracolumbar fusion with Harrington instrumentation to the L4 vertebra and the other patient was assessed at 30 years post-surgery. According to White-Panjabi's criteria, instability was noted in 1 patient with Harrington fixation including the L4 vertebra. Clinical manifestations and X-ray abnormalities were less severe than anticipated at 20 years plus post-surgery, although a tendency for deterioration was observed in patients with fusion including the L4 or patients followed up for more than 30 years post-surgery.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 60 1 2006 Body sway increases immediately after strabismus surgery. 13 24 EN Toshihiko Matsuo Akiko Narita Masuo Senda Satoshi Hasebe Hiroshi Ohtsuki Article 10.18926/AMO/30754 <p>The purposes of this study were to examine whether body sway is altered immediately after strabismus surgery in children and to find preoperative clinical factors associated with body sway. In a prospective study, body sway was measured on 1-3 days before surgery and on the third day after surgery; for the measurements, computerized static stabilometry was carried out on 28 consecutive patients with strabismus (age range: 3 to 12 years old; mean: 7.4) who underwent strabismus surgery under general anesthesia. The linear length of the sway path (cm), the linear length of the sway path in a particular unit of time (cm/second), and the area of the sway path (cm2), indicative of the extent of body sway, all increased significantly among a total of 28 patients in both conditions of the patient's eyes open and closed, as well as among those in a subgroup of 16 patients with exotropia, after they had undergone strabismus surgery (p &#60; 0.05, Wilcoxon signed ranks test). The center of pressure along the Y axis of orientation from the toe to the heel was found to deviate significantly toward the heel postoperatively, as compared with the preoperative center in the subgroup of 16 patients with exotropia (p &#60; 0.05). Before surgery, 15 patients with no stereoacuity exhibited a greater amount of body sway when their eyes were open than did 13 patients with measurable stereoacuity (p &#60; 0.05, Mann-Whitney U-test). In the subgroup of 16 patients with exotropia when their eyes open, 3 patients with abnormal head posture exhibited more extensive body sway than did 13 patients without abnormal head posture (p &#60; 0.05). Body sway was found to significantly increase immediately after strabismus surgery in children with strabismus. Stereoacuity and abnormal head posture are 2 clinical factors associated with preoperative postural instability.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 50 1 1996 Surgical Treatment for Metastatic Tumors of the Spine 29 35 EN Akira Kawai Yoshiaki Harada Masuo Senda Shinsuke Sugihara Hajime Inoue Article 10.18926/AMO/30517 <p>We report herein the results of anterior or posterior neural decompression with spinal stabilization in 16 patients with spinal metastases. Intractable back pain was relieved in 14 patients (87.5%) and 4 had complete pain relief. Neurologic recovery was observed in 8 out of 13 patients (61.5%) who had some neurologic deficits before surgery. The activities of daily living improved in 7 of 9 (77.7%), and 5 out of 8 patients (62.5%) who had been unable to walk before surgery became ambulatory after surgery. The average operation time was 3h 15 min with an average blood loss of 2150 ml. No patient died within 1 month after surgery and the median survival was 19.1 months. The results indicated that, if properly indicated, anterior or posterior neural decompression and spinal stabilization is a safe and effective treatment for patients with spinal metastases to improve the quality of life for the patients' remaining years.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 50 1 1996 Spinal schwannomas: a review of 42 cases. 25 28 EN Hiroshi Asahara Akira Kawai Yoshiaki Harada Masuo Senda Hajime Inoue Article 10.18926/AMO/30514 <p>&#60;P&#62;In this study, 42 cases of spinal schwannomas are reviewed. We analyzed the therapeutic results of patients with spinal schwannomas in order to investigate the factors which affect the clinical outcomes. Early diagnosis and treatment could help procure a good result for the patient. The delay in diagnosis and the subsequent duration of symptoms was significantly longer in cases of lumbar lesions compared to cervical and thoracic lesions. Tumor recurrence was rare, but in some cases where complete resection was not possible, close follow-up of the patients postoperatively with MRI was indicated.&#60;/P&#62;</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 50 3 1996 Muscle Fiber Changes of the Vastus Medialis in Rheumatoid Patients 157 164 EN Midori Touno Masuo Senda Kie Nakago Yoshiki Yokoyama Hajime Inoue Article 10.18926/AMO/30503 <p>To study the pathology of muscle atrophy in rheumatoid arthritis (RA), we examined the vastus medialis in rheumatoid patients histologically. The relationship of the findings to their ambulatory ability and long-term steroid therapy was investigated. The muscles of the RA patients were also compared with those of patients with osteoarthritis (OA). Specimens of the vastus medialis were collected from 29 knees of 23 patients with RA and 16 knees of 13 patients with OA during total knee arthroplasty. Muscle fibers were classified according to their type, and the ratio between the area of single type I and type II fibers as well as the ratio between the total area of these fibers was calculated. The total area of type II fibers in the RA group was significantly greater than in the OA group (P &#60; 0.05). In the RA group, the mean proportion of the type II fibers relative to the total muscle fiber area tended to increase with the decline of ambulatory ability, while there was no such increase in the OA group. The proportion of type II fibers was increased significantly in RA patients on long-term steroid therapy when compared to those without therapy. In the ratio of the area of a single fiber, there was no clear relationship to ambulatory ability and long-term steroid therapy. It is considered that muscle atrophy in RA is not solely disuse atrophy, but also has a close relationship to steroid therapy and the pathology of the disease itself.</p> No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 50 4 1996 Capillary Architecture in the Skeletal Muscles in the Rat Hind Limb 211 218 EN Yasuhiro Takahara Masuo Senda Hiroyuki Hashizume Yukihisa Yagata Hajime Inoue Article 10.18926/AMO/30474 <p>We observed differences in the capillary architecture of the skeletal muscles that have different fiber metabolism. The soleus, the vastus intermedius and the tibialis anterior muscles of adult Wistar rats were prepared using two different techniques. Samples for adenosine triphosphatase (ATPase) staining were prepared following Dubovitz's method, and the distributions of fiber type, Types 1, 2A and 2B, were analyzed. Then, corrosion casts of capillary architecture of these muscles prepared following Murakami's method were observed with a scanning electron microscope (SEM) and compared with the fiber distribution. The fiber type composition of the soleus muscle showed Type 1 (slow-twitch) dominance and that of the vastus intermedius and the tibialis anterior muscle showed Type 2 (fast-twitch) dominance. The capillaries of the soleus muscle were tortuous, and this was thought to be advantageous for blood supply. In contrast, the capillaries of the vastus intermedius and tibialis anterior muscles had a relatively parallel pattern. Additionally, two different patterns of capillary architecture that appeared to correspond to certain metabolic characteristic of different muscle fiber types were preserved with corrosion casting. In conclusion, comparative studies on capillary architecture of the skeletal muscles are useful for analyses of its function. </p> No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝医療センター Acta Medica Okayama 0918-7839 72 2002 RA患者のQOL ―　SF-36を用いて　― 71 73 EN Tadashi Yokoi Masuo Senda Fumihiro Mitsunobu Yasuhiro Hosaki Kozo Ashida Norikazu Nishida Hirofumi Tsugeno Makoto Okamoto Shingo Takata Yoshiro Tanizaki Hajime Inoue 10.18926/14885 近年QOLが重視されるようになってきている｡MOS short form 36 health survey (以下SF-36と略す)は,国際的レベルでの基準とされるべく開発された非疾患特異的HRQOL尺度である｡今回我々は当院でリハビリテーションをうけているRA患者を対象にSF-36を用いてQOL評価を行った｡SFl36の8項目をそれぞれ算出し,国民標準値との比較を行った. すべての項目において標準値を下回っていたが,特に,日常役割機能(身体),日常役割機能(精神),身体の痛み,身体横能において大きな開きを認めた｡また,PCSは平均35.8であり,MCSは平均49.1であった｡以上より,RA患者は身体に強い痛みを伴っているため精神健康面より身体横能面において制限を有していることが分かった｡ No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝医療センター Acta Medica Okayama 1348-1258 74 2004 温泉療法が腰痛症患者のQOLに及ぼす効果 48 50 EN Tadashi Yokoi Masuo Senda Masanori Hamada Fumihiro Mitsunobu Yasuhiro Hosaki Kozo Ashida Naofumi Iwagaki Takuya Nagata Makoto Fujii Shingo Takata Yoshiro Tanizaki Hajime Inoue 10.18926/14800 近年QOLが重視されるようになってきている。MOS short form 36 health survey（以下SF-36と略す）は，国際的レベルでの基準とされるべく開発された非疾患特異的HRQOL尺度である。今回，我々は当院でリハビリテーションをうけている腰痛症患者を対象に温泉療法のQOLに対する効果をSF−36を用いて調べた。SFL36の8項目をそれぞれ算出し，温泉療法前後での比較を行った。PCSは41.1から43.6へ, MCSは49.1から5l.0へ上昇したことより，身体・精神面ともに効果があると考えられた。 No potential conflict of interest relevant to this article was reported.

岡山大学医学部附属病院三朝医療センター Acta Medica Okayama 1348-1258 73 2003 温泉療法が骨関節症患者のQOLに及ぼす効果 72 74 EN Tadashi Yokoi Masuo Senda Fumihiro Mitsunobu Yasuhiro Hosaki Kozo Ashida Norikazu Nishida Hirofumi Tsugeno Makoto Okamoto Takuya Nagata Shingo Takata Yoshiro Tanizaki Hajime Inoue 10.18926/14770 近年QOLが重視されるようになってきている｡MOS short form 36 health survey(以下SF-36と略す)は,国際的レベルでの基準とされるべく開発された非疾患特異的HRQOL尺度である.今回,我々は当院でリハビリテーションをうけているOA患者を対象に温泉療法の効果をSF-36を用いてQOLの変化を調べたoSF-36の8項目をそれぞれ算出し,温泉療法前後でのQOLの比較を行った｡pCSは36.4から37.1へ,MCSは53.0から55.4へ上昇したことより,身体･健東面ともに効果があると考えられた｡ No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1987 下肢筋力の経年変化 (用手力量計による測定) EN No potential conflict of interest relevant to this article was reported.