Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

Purpose: The impact of postoperative nutritional status on clinical outcomes and biomechanics following total knee arthroplasty remains largely unknown. This study aimed to assess this question using the prognostic nutritional index to evaluate the nutritional status of orthopedic participants. Methods: Patients with knee osteoarthritis who underwent total knee arthroplasty (n=49) in Japan were divided into two groups based on their 1-week postoperative prognostic nutritional index. Group L patients had a prognostic nutritional index <40, whereas Group H comprised patients with a prognostic nutritional index ≥40. Postoperative improvements in Knee Injury and Osteoarthritis Outcome Score were evaluated. The patients performed squats under single-fluoroscopic surveillance in the sagittal plane for biomechanical evaluation. A two-dimensional/three-dimensional registration technique was employed to measure the tibiofemoral kinematics. The axial rotation of the femoral component relative to the tibial component and the anteroposterior translation of the medial and lateral femorotibial contact points were measured. Results: Group H showed significantly higher pain scores than Group L at 12 and 36 months postoperatively and a significantly higher symptom score at 36 months postoperatively. The kinematic comparison revealed that the axial external rotation in Group L was larger than that in Group H from 70° to 80° with flexion. Moreover, in the medial anteroposterior translation, Group L was more anteriorly located than Group H, with flexion beyond 30°. Conclusion The results suggest that a high postoperative nutritional status significantly improved pain and other symptoms and was associated with better knee biomechanics following total knee arthroplasty.

We report a case of a hemodialysis patient with a calcified amorphous tumor (CAT) located in Left ventricular outflow tract. A 69-year-old female with chronic kidney disease on hemodialysis for 10 years complained about palpitation and chest tightness. Echocardiography and cardiac MRI revealed a mobile mass in the left ventricular outflow tract (LVOT). We had a follow-up 6 months after finding mass. We thought that as the mass had potential for embolism, we should remove it; we performed an operation, tumor resection without harming the aortic valve. Her clinical course was uneventful. Pathological examination showed that the mass contained calcified nodules and fibrotic tissue. These findings showed CAT.

Dry solid matter (rutin content: 51.6 mg/g; quercetin content: 72.2 mg/g) extracted from Tartary buckwheat boiled noodles using 70% methanol as the solvent was found to have α-glucosidase inhibitory activity. As for fractions fractionated by silica gel column chromatography, the fractions rich in quercetin and rutin showed remarkable α-glucosidase inhibitory activity. Tartary buckwheat boiled noodles used as samples in this study contained quercetin produced from rutin by the action of rutinase, suggesting that both rutin and quercetin contained were involved in the α-glucosidase inhibitory activity of the dry solid extract. Changes in postprandial blood glucose levels were compared for boiled noodles made from two types of buckwheat (i.e., Tartary buckwheat and common buckwheat), revealing that blood glucose elevation after eating Tartary buckwheat boiled noodles was suppressed. The blood glucose level 40 minutes after eating Tartary buckwheat boiled noodles was significantly low (p<0.05). It can be concluded that this might be caused by the α-glucosidase inhibitory activity of rutin (270.0 mg) and quercetin (330.5 mg), which correspond to a total amount of 935 mg of rutin equivalents, in the gastrointestinal tract. As a result, the digestion of carbohydrates contained in the samples consumed and their absorption by the intestine might be inhibited, resulting in the suppression of increases in blood glucose levels. The presence of a certain amount of quercetin was considered to be key to the suppression of blood glucose elevation. It is important to control rapid postprandial blood glucose increases to prevent diabetes from developing or becoming serious. This study suggests the potential for Tartary buckwheat boiled noodles to contribute to diabetes prevention.

Although the descriptions of shigyakukachotanto in “Waitaimiyaofang” and tsumyakushigyakukachotanjuto in “Songban Shanghanlun” are quite similar to each other, the specifications of the dosages of crude drugs and the water volume in the books were considerably different. Focused on the specified water volume to decoct these formulas, each reasonable decocting period was estimated, then the decoctions were prepared using hard water that was common in mainland China. The dosages of aconite root were 2­-fold different between these two formulas, but the contents of aconitine-­type diester alkaloids (ADA) in both decoctions were found in the range of 1.2—1.4­-fold. It was suggested that in order to control the efficacy and the safety of aconite, the decocting period was well regulated by the specification of water volume for decocting at this ancient era. Moreover, the dosages of aconite root and glycyrrhiza in bukuryoshigyakuto (BSGT) formula of “Songban Shanghanlun” are equal to those of shigyakuto (SGT) but the specified water volume to begin decocting is as about twice as that of SGT. When prepared using hard water, BSGT resulted to make the contents of ADA lower and those of non-­ester alkaloids higher compared with those of SGT decoction. It was suggested the spe­cific water volume for each formula prescribed in classical Chinese medicine had considerable significance to determine the dosages of chemical ingredients in the decoctions especially in the circumstances using hard water to prepare them.

Background: In Japan, in 2016, the School Health and Safety Act was revised and examination of extremities in addition to scoliosis became mandatory. Musculoskeletal examinations were subsequently started using a mark sheet-type questionnaire. In the present study, we aimed to analyze the relationship between physical findings and musculoskeletal problems and propose a preventive strategy for musculoskeletal injuries.Methods: In 2017, a total of 4,073 elementary and middle school students underwent direct musculoskeletal examination. In a direct examination, the following elements were included: torticollis; scoliosis; stiffness of the shoulder, elbow, hip, knee, and ankle; flexion and extension in standing position; flat foot; hallux valgus; and alignment of the upper and lower extremities. Of the 4,073 students who underwent direct examination in early 2017, only 3,754 were able to complete the mark sheet-type questionnaires in early 2018. A prospective longitudinal analysis of the data gathered was performed.Results: A total of 396 (11%) students had injuries. The ankle sprain/non-ankle sprain group comprised 119 (3%)/3,635 (97%) students, while the fracture/non-fracture group comprised 105 (2.8%)/3,650 (97.2%) students, respectively. Comparing the sprain group with the non-sprain group, ankle stiffness significantly correlated with ankle sprain in the univariable and multivariable analyses. Injuries occurred more frequently among boys, older students, students with stiff bodies, and students who were involved in sports activities of longer duration.Conclusion: Ankle stiffness was assumed to be a risk factor for ankle sprain. Stretching of the ankle might be effective for preventing ankle sprain. However, further interventional studies are needed to confirm this finding.

Objective: In 2016, Japan started conducting musculoskeletal examinations that included “limb status” of students as an essential item. Our institution implemented a unified musculoskeletal examination for all public elementary and junior high schools in T-city. In this study, we aimed to report the progress in the past 4 years.Patients and Methods: The Tsukuba Childhood Locomotive-Organ Screening Sheet (T-CLOSS), which is a questionnaire that includes some nationwide-recommended questions, was prepared and distributed to students. Results of the questionnaires were analyzed, and the orthopedic surgeon conducted examinations for the extracted items. From these questionnaires, the ratio of each item, rate of advisory for screening, and content of the advisory were investigated.Results: During 2016–2019, musculoskeletal examinations were conducted in every public schools, with nearly 20,000 students in T-city. The consultation advisory rate was 6.7% in 2019. Of the 524 students who received the third screening recommendation, the actual consultation rate was 248 (40.8%). After the third screening, the proportion of students requiring treatment and outpatient visits was 46.7% (n=248), which accounted for 1.2% of all elementary and junior high school students in the city.Conclusion: We reported the results of 4-year musculoskeletal examinations in a city. In our screening, we distributed a uniform questionnaire throughout the city, and orthopedic surgeons performed secondary examinations of identified students in all schools. This appears to be an advanced effort to prevent musculoskeletal impairment in students. We hope to conduct more sophisticated musculoskeletal examinations using our results, aiming at early detection, early treatment, and improvement of musculoskeletal function in elementary and junior high school students.