The purpose of this study was to investigate the relationships between muscle mass or muscle power and bone mineral density in 43 postmenopausal women. Single photon absorptiometry was used to measure the bone mineral density and bone width of the calcaneuse. Isotonic muscle power of knee extensions (KE), knee flexions and incline squats (ISQ) were measured, using the power processor (VINE Co., Ltd.) . Statistical analysis demonstrated a significant positive correlation (p<0.05) between bone mineral density and lean body mass or muscle thickness. Although, bone mineral density was not significantly correlated with body mass index or fat mass, it was significantly corre-lated with leg muscle power. Further, the bone mineral density was also positively correlated with muscle contraction speed in the motion of KE (p<0.01) and ISQ (p<0.05), but not with muscle strength. This data suggest that the bone mineral density is closely related to the muscle power and/or speed rather than the muscle strength in postmenopausal women.

This study was performed to evaluate management of cancer pain in 322 patients who were treated in our pain clinic between January 1986 and December 1997. For this purpose, the change in the number of cancer patients and the annual morphine consumption during the period in our hospital were investigated. We found that as morphine consumption increased, the number of cancer patients visited the pain clinic decreased. Although 90% of them who visited the pain clinic underwent neural block therapy before 1996, the parcentage dropped to only 79% in 1996 and 50% in 1997. The increasing rate of morphine consumption in our hospital was on a par with the national average between 1986 and 1996. The use of adjuvant drugs did not change throughout the 12-year period.
We believe the consumption of morphine is not enough. It is necessary for us to become more skilled in using narcotics for relief of cancer pain along the guidelines of the World Health Organization.

In Japan, there are insufficient measures to ensure that women can maintain good health while working. In addition, many women have limited health literacy, making it difficult for them to access information on physical and mental health problems that are specific to them. In this context, it is essential for pharmacists to become the first point of contact for women seeking information about their physical health, as they are familiar with healthcare providers in the community. To address this issue, we organized a Women's Health Care Cafe for pharmacy students to provide them with an opportunity to learn about women's health.

The gastrocnemius muscles are composed predominantly of type II B and II A fibers while the soleus muscle is composed of type I fibers. However, the relationships between the calcaneal bone stiffness and the triceps surae muscles consisting of the different types of skeletal muscle fibers are unknown. The purpose of this study was to investigate the relationships between the calcaneal bone stiffness and the gastrocnemius or soleus muscle thickness in 73 postmenopausal women. We measured the speed of sound (SOS) and the broad band ultrasound attenuation (BUA), using a ultrasonic measurement of the calcaneal and the gastrocnemius or soleus muscle thickness used to measure the B-mode ultrasound anatomy. There was a significant differences in age between the high-and low-SOS groups. In the high-BUA group, the body mass index, the lower leg girth and the triceps surae muscle thickness were significantly higher than those in the low-BUA group. This data indicated that SOS is related to ageing and BUA is related to the body mass or the muscle thickness. The other side, stiffness and SOS were significantly correlated with the gastrocnemius muscle thickness, but not with the soleus muscle mass. Therefore, this study suggests that the calcaneal bone stiffness is closely related to the muscle thickness, which may be related especialy to the fast twitch muscle.

The purpose of this study was to develop prediction models of sarcopenia in 1,894 Japanese men and women aged 18-85 years. Reference values for sarcopenia (skeletal muscle index, SMI; appendicular muscle mass/height², kg/m²) in each sex were defined as values two standard deviations (2SD) below the gender-specific means of this study reference data for young adults aged 18-40 years. Reference values for predisposition to sarcopenia (PSa) in each gender were also defined as values one standard deviations (1SD) below. The subjects aged 41 years or older were randomly separated into 2 groups, a model development group and a validation group. Appendicular muscle mass was measured by DXA. The reference values of sarcopenia were 6.87 kg/m² and 5.46 kg/m², and those of PSa were 7.77 kg/m² and 6.12 kg/m². The subjects with sarcopenia and PSa aged 41 years or older were 1.7% and 28.8% in men and 2.7% and 20.7% in women. The whole body bone mineral density of PSa was significantly lower than in normal subjects. The handgrip strength of PSa was significantly lower than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference and age were independently associated with SMI in men; and BMI, handgrip strength and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between the DXA-measured and predicted SMI in men and women. This study proposed the reference values of sarcopenia in Japanese men and women. The prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.

INTRODUCTION: Recently, remnant-preserving anterior cruciate ligament (ACL) reconstruction has been increasingly performed to achieve revascularization, cell proliferation, and recovery of high-quality proprioception. However, poor arthroscopic visualization makes accurate socket placement during remnant-preserving ACL reconstruction difficult. This study describes a surgical technique used to create an anatomical femoral socket with a three-dimensional (3D) fluoroscopy based navigation system during technically demanding remnant-preserving ACL reconstruction. SURGICAL TECHNIQUE: After a reference frame was attached to the femur, an intraoperative image of the distal femur was obtained, transferred to the navigation system and reconstructed into a 3D image. A navigation computer helped the surgeon visualize the entire lateral wall of the femoral notch and lateral intercondylar ridge, even when the remnant of the ruptured ACL impeded arthroscopic visualization of the bone surface. When a guide was placed, the virtual femoral tunnel overlapped the reconstructed 3D image in real time; therefore, only minimal soft tissue debridement was required. MATERIALS AND METHODS: We treated 47 patients with remnant-preserving ACL reconstruction using this system. The center of the femoral socket aperture was calculated according to the quadrant technique using 3D computed tomography imaging. RESULTS: The femoral socket locations were considered to be an anatomical footprint in accordance with previous cadaveric studies. CONCLUSIONS: The 3D fluoroscopy-based navigation can assist surgeons in creating anatomical femoral sockets during remnant-preserving ACL reconstruction.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Reconstruction ; Cadaver ; Cell Proliferation ; Debridement ; Femur ; Fluoroscopy ; Humans ; Proprioception ; Surgery, Computer-Assisted

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

The purpose of this study was to develop prediction models of sarcopenia in 1,894 Japanese men and women aged 18-85 years. Reference values for sarcopenia (skeletal muscle index, SMI; appendicular muscle mass/height2, kg/m2) in each sex were defined as values two standard deviations (2SD) below the gender-specific means of this study reference data for young adults aged 18-40 years. Reference values for predisposition to sarcopenia (PSa) in each gender were also defined as values one standard deviations (1SD) below. The subjects aged 41 years or older were randomly separated into 2 groups, a model development group and a validation group. Appendicular muscle mass was measured by DXA. The reference values of sarcopenia were 6.87 kg/m2 and 5.46 kg/m2, and those of PSa were 7.77 kg/m2 and 6.12 kg/m2. The subjects with sarcopenia and PSa aged 41 years or older were 1.7% and 28.8% in men and 2.7% and 20.7% in women. The whole body bone mineral density of PSa was significantly lower than in normal subjects. The handgrip strength of PSa was significantly lower than in normal subjects. Stepwise regression analysis indicated that the body mass index (BMI), waist circumference and age were independently associated with SMI in men; and BMI, handgrip strength and waist circumference were independently associated with SMI in women. The SMI prediction equations were applied to the validation group, and strong correlations were also observed between the DXA-measured and predicted SMI in men and women. This study proposed the reference values of sarcopenia in Japanese men and women. The prediction models of SMI using anthropometric measurement are valid for alternative DXA-measured SMI in Japanese adults.