This study was performed to establish a simple method to evaluate knee joint proprioception by examining knee-bending angle, in which Lombard's Paradox phenomenon could be confirmed, in 8 extremities of 7 patients with ACL injured who were diagnosed with ACL rupture at a medical facility (ACL injured group) and 10 extremities of 10 healthy adults (control group). As a result, knee joint proprioception in the ACL injured group was significantly lower than that in the control group (P<0.05). Significantly more incidence of Lombard's Paradox phenomenon was confirmed at the knee-extension position in the ACL injured group (P<0.01), compared with the control group. Significant negative correlation was confirmed between the reproductive angle inaccuracy of joint position sensation, a marker of knee joint proprioception, and Lombard's Paradox phenomenon under the conditions of r=-0.58 and the risk rate of 5%. Based on the results of this study, it was suggested that the knee-bending angle, in which Lombard's Paradox phenomenon was confirmed, would be affected by knee joint proprioception through feedback from the ACL mechanoreceptors, and the angle might be used as a simple evaluation method for knee joint proprioception.

Japan has faced problems of declining birth rate and aging. Acupuncture has gained popularity among the various complementary medicines available and many go privately to have acupuncture while undergoing in vitro　fertilization(IVF). Although acupuncture has gained increasing popularity in the management of infertility, its effectiveness has remained controversial.Whether it is benetifical in terms of improvimg the live birth rate in IVF still remains subject to further well constructed randomized controlled studies.　Obesity, defined as an excess of body fat, is a growing public health crisis that is associated with the development of many disorders, including type 2 diabetes and cardiovascular disease . Menopause causes a deterioration of lipid metabolism and increases the tendency to obesity. Ovariectomized mice have been used to study changes in postmenopause metabolism and reported to gain weight due to changes in lipid metabolism, as do menopausal women. Alzheimer's disease is associated with the unprecedented aging tendency in　our world population and has become a significant health issue. In addition to a rapid acceleration of the aging progress, Alzheimer's disease is a severe affliction in patients and a heavy burden on their families and society.　Prevention of obesity and Alzheimer's disease becomes a largest matter of concern not only for medicine but also for health economics.We conclude that the partnership between acupuncture and conventional medicine is an effective treatment for obesity and Alzheimer's disease.

A 25-year-old woman, at 38 weeks of gestation, suddenly developed a left lumbar pain. Emergency cesarean section was performed to rescue the fetus since there was fetal bradycardia. At operation, a slight amount of retroperitoneal hematoma was observed, but was left without further examination. After the surgery, the patient complained of severe lumbar pain and fell into shock. A ruptured aneurysm of the left renal artery was suspected by computed abdominal tomography. At the second operation, a massive hematoma was observed in the retroperitoneal space, and a ruptured aneurysm of the left renal artery was confirmed after mobilization of the left kidney with the aid of manual hemostasis. Aneurysmectomy with arterial reconstruction was not considered feasible, and complete left nephrectomy was done because the patient was severely ill, in addition to the fact that the aneurysm was located at the trifurcation of the left main renal artery. The postoperative course was uneventful. On the surgical specimen the aneurysm measured 27mm in circular length, the lower half of which was ruptured. Histologically, the internal elastic lamina was torn, and the medial smooth muscle fibers were sporadically replaced with fibroblastic cells. The prognosis of ruptured aneurysm of a renal artery is often lethal. Therefore it is very important to suspect this lesion when we have to manage physical problems with patients in pregnancy so that we can make an early diagnosis with better results.

This study aimed to elucidate how body composition, force-generating capacity and jump performances are associated with 50-m sprint velocity in circumpubertal boys, in relation to sprint phases and maturation. One hundred thirty four circumpubertal boys were allocated to preadolescent or adolescent group on basis of the height at the peak height velocity of Japanese boys (154 cm) reported in literature: those with body heights over 154 cm as adolescent group and others as preadolescent group. Body composition was determined by bioelectrical impedance analysis. In addition to maximal voluntary isometric knee extension torque, the performances of counter movement jump (CMJ), rebound jump (RJ), standing long jump (SLJ) and standing 5-step jump (SFJ) were also measured. RJ-index was calculated by dividing height by contact time. The time of 50-m sprint was determined at 10-m intervals. Multiple regression analysis showed that in preadolescent boys, SFJ become a predictor for the sprint speed during acceleration phases, and SFJ, RJ-index and CMJ as predictors for the sprint speeds during maximal speed and deceleration phases. In the adolescent boys, age, CMJ, SLJ, and SFJ become a predictor for the sprint speed during acceleration phases, and torque relative to body mass, CMJ and SFJ were selected as predictors for the sprint speeds during maximal speed and deceleration phases. Thus, the current results indicate that force-generating capacity and jumping ability are determinants for sprint performance in circumpubertal boys, but the relative contribution of each of the two factors differs between preadolescent and adolescent stages and among the sprint phases.

This study aimed to determine the relationships between the torque generating capacity of the lower extremity muscles and either running or jump performance in primary and junior high school boys. A total of 102 primary and junior high school boys participated in this study. Muscle thicknesses (MTs) of the knee extensors and plantar flexors were determined using ultrasonography. Muscle volumes (MVs) of the knee extensors and plantar flexors were estimated using MTs and limb lengths. The isometric joint torques (TQs) for knee extensors and ankle plantar flexors were measured using myometer. MV and TQ were divided by body mass (MV/BM and TQ/BM, respectively). Running velocity was measured using a non-motorized treadmill. The counter movement jump (CMJ) and squat jump (SJ) were performed on a matswitch system. The flight time was measured and used to calculate the heights of CMJ and SJ using the following equation; height (cm) = g × (flight time)² /8/10. As the result of multiple regression analysis, age, MV/BM and TQ/BM were selected as predictors of running velocity in the primary school boys, whereas TQ and lean body mass in junior high school boys. In the primary school boys, TQ/BM and body fat mass was selected as significant contributors for SJ and CMJ performances, whereas, in the junior high school boys, TQ and the percent of body fat for SJ performance and MV/BM and TQ for CMJ performance. Thus, the present results indicate that the relationships between torque generating capacity of the lower extremity muscles and either running or jump performance differ between primary and junior high school boys. It may be assumed that, for running and jump performances, muscle mass and strength become determinant factors in junior high school boys, whereas their values relative to body mass in primary school boys.

We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke.
Aged ; Arteries* ; Basilar Artery* ; Carotid Artery, Internal ; Cerebral Angiography ; Cerebrum ; Consciousness ; Humans ; Infarction ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Quadriplegia ; Stroke* ; Thrombectomy ; Tissue Plasminogen Activator ; Unconsciousness ; Urokinase-Type Plasminogen Activator ; Vertebral Artery

BACKGROUND/AIMS: The administration of liquid nutrients to patients is often accompanied by complications such as gastroesophageal reflux. To prevent gastroesophageal reflux, high-viscosity liquid meals are used widely, however, it still remains controversial whether high-viscosity liquid meals have any effect on the rate of gastric emptying. The present study was conducted with the aim of determining whether high-viscosity liquid meals had any effect on the rate of gastric emptying and mosapride might accelerate the rate of gastric emptying of high-viscosity liquid meals. METHODS: Six healthy male volunteers underwent 3 tests at intervals of > 1 week. After fasting for > 8 hours, each subject received one of three test meals (liquid meal only, high-viscosity liquid meal [liquid meal plus pectin] only, or high-viscosity liquid meal 30 minutes after intake of mosapride). A 13C-acetic acid breath test was performed, which monitored the rate of gastric emptying for 4 hours. Using the Oridion Research Software (beta version), breath test parameters were calculated. The study parameters were examined for all the 3 test conditions and compared using the Freidman test. RESULTS: Gastric emptying was significantly delayed following intake of a high-viscosity liquid meal alone as compared with a liquid meal alone; however, intake of mosapride prior to a high-viscosity liquid meal was associated with a significantly accelerated rate of gastric emptying as compared with a high-viscosity liquid meal alone. CONCLUSIONS: This study showed that high-viscosity liquid meals delayed gastric emptying: however, mosapride recovered the delayed rate of gastric emptying by high-viscosity liquid meals.
Benzamides ; Breath Tests ; Cross-Over Studies ; Fasting ; Gastric Emptying ; Gastroesophageal Reflux ; Humans ; Male ; Meals ; Morpholines ; Pectins

BACKGROUND/AIMS: The gastrointestinal motility effects of endogenous incretin hormones enhanced by dipeptidyl peptidase-IV (DPP-IV) inhibitors have not yet been sufficiently investigated. The aim of this study was to determine whether single pre-prandial sitagliptin, the DPP-IV inhibitor, administration might have an effect on the rate of liquid gastric emptying using the 13C-acetic acid breath test. METHODS: Ten healthy male volunteers participated in this randomized, two-way crossover study. The subjects fasted for overnight and were randomly assigned to receive 50 mg sitagliptin 2 hours before ingestion of the liquid test meal (200 kcal per 200 mL, containing 100 mg 13C-acetate) or the test meal alone. Under both conditions, breath samples were collected for 150 minutes following the meal. Liquid gastric emptying was estimated by the values of the following parameters: the time required for 50% emptying of the labeled meal (T1/2), the analog to the scintigraphy lag time for 10% emptying of the labeled meal (Tlag), the gastric emptying coefficient and the regression-estimated constants (beta and kappa), calculated by using the 13CO2 breath excretion curve using the conventional formulae. The parameters between the 2 test conditions were compared statistically. RESULTS: No significant differences in the calculated parameters, including T1/2, Tlag, gastric emptying coefficient or beta and kappa, were observed between the 2 test conditions. CONCLUSIONS: The present study revealed that single-dose sitagliptin intake had no significant influence on the rate of liquid gastric emptying in asymptomatic volunteers.
Breath Tests ; Cross-Over Studies ; Eating ; Gastric Emptying ; Gastrointestinal Motility ; Humans ; Incretins ; Male ; Meals ; Pyrazines ; Triazoles ; Sitagliptin Phosphate

We report an extremely rare case of primary squamous cell carcinoma of the stomach. A 69-year-old man was admitted to our hospital with a 2-month history of dysphagia and tarry stools. Endoscopic examination revealed a cauliflower-shaped protruding mass along the lesser curvature of the gastric cardia. Biopsy of the lesion revealed squamous cell carcinoma of the stomach. Computed tomography revealed a thickened stomach wall and a mass protruding into the gastric lumen. Total gastrectomy with splenectomy, distal pancreatectomy, and Roux-en-Y reconstruction was performed, together with a lower thoracic esophagectomy via a left thoracotomy. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma of the stomach. Postoperative follow-up was uneventful for the first 18 months. However, multiple liver metastases and para-aortic lymph node metastasis developed subsequently. Despite systemic combination chemotherapy, the patient died because of progression of the recurrent tumors. Here, we review the characteristics of 56 cases of gastric squamous cell carcinoma reported in Japan.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Cardia ; Deglutition Disorders ; Drug Therapy, Combination ; Esophagectomy ; Follow-Up Studies ; Gastrectomy ; Humans ; Japan* ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Pancreatectomy ; Splenectomy ; Stomach Neoplasms ; Stomach* ; Thoracotomy

To investigate the effectiveness of Maobushisaishin-to (traditional Japanese herbal medicine; Tsumura TJ-127) in treating the common cold, a clinical comparison between Maobushisaishin-to and a general common cold drug was conducted using the sealed envelope method. The study involved 83 patients in the TJ-127 group and 88 patients in the general cold drug group. No differences in age, gender or the period from the onset of the disease to the beginning of treatment were observed between the two groups.
The results indicated greater than moderate improvement in 81.9% of the TJ-127 group, compared with 60.3% of the compound cold drug group (p<0.01). Further analysis of symptom diaries kept by the patients indicated that TJ-127 provided more rapid relief for symptoms such as fever, feeling feverish, coughing and phlegm than did the general cold drug. No side effects were observed for the TJ-127. These results suggest that TJ-127 is effective in the treatment of the common cold.