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Sugimoto T.,Hiroshima University | Ochi K.,Hiroshima University | Hosomi N.,Hiroshima University | Takahashi T.,Hiroshima University | And 6 more authors.
Journal of Neurology | Year: 2013

Demyelinating Charcot-Marie-Tooth disease (CMT) and chronic inflammatory demyelinating polyneuropathy (CIDP) are both demyelinating polyneuropathies. The differences in nerve enlargement degree and pattern at multiple evaluation sites/levels are not well known. We investigated the differences in nerve enlargement degree and the distribution pattern of nerve enlargement in patients with demyelinating CMT and CIDP, and verified the appropriate combination of sites/levels to differentiate between these diseases. Ten patients (aged 23-84 years, three females) with demyelinating CMT and 16 patients (aged 30-85 years, five females) with CIDP were evaluated in this study. The nerve sizes were measured at 24 predetermined sites/levels from the median and ulnar nerves and the cervical nerve roots (CNR) using ultrasonography. The evaluation sites/levels were classified into three regions: distal, intermediate and cervical. The number of sites/levels that exhibited nerve enlargement (enlargement site number, ESN) in each region was determined from the 24 sites/levels and from the selected eight screening sites/levels, respectively. The cross-sectional areas of the peripheral nerves were markedly larger at all evaluation sites in patients with demyelinating CMT than in patients with CIDP (p < 0.01). However, the nerve sizes of CNR were not significantly different between patients with either disease. When we evaluated ESN of four selected sites for screening from the intermediate region, the sensitivity and specificity to distinguish between demyelinating CMT and CIDP were 0.90 and 0.94, respectively, with the cut-off value set at four. Nerve ultrasonography is useful to detect nerve enlargement and can clarify morphological differences in nerves between patients with demyelinating CMT and CIDP. © 2013 Springer-Verlag Berlin Heidelberg. Source

Nanri K.,Tokyo Medical University | Niwa H.,Kariya Toyota General Hospital | Mitoma H.,Tokyo Medical University | Takei A.,Hokuyukai Neurology Hospital | And 6 more authors.
Cerebellum | Year: 2013

The majority of cases of anti-glutamic acid decarboxylase (GAD)-antibody-positive cerebellar ataxia are reported to have high levels of anti-GAD antibody, and the diagnostic value of low titers of anti-GAD antibody in a patient with cerebellar ataxia is still unknown. The purpose of this study was to verify the characteristics of low-titer-anti-GAD-antibody-positive cerebellar ataxia patients and the diagnostic value of low titers of anti-GAD antibody in patients with cerebellar ataxia. The subjects were six patients positive for low-titer GAD antibody (<100 U/mL). We examined them with MRI, including voxel-based morphometry, and with single-photon emission computed tomography and monitored the GAD antibody index in the cerebrospinal fluid. The levels of antineuronal, antigliadin, anti-SS-A, antithyroid antibodies, and of vitamins E, B1, and B12 were determined. Thoracic and abdominal CT scans were performed to exclude a paraneoplastic origin. We treated three patients with immunotherapy. All cases showed cortical cerebellar atrophy. The GAD antibody index in three of the five patients reviewed was >1.0. Two of the six patients were thyroid antibody-positive, and one was both antinuclear- and anti-SS-A antibody-positive. After the administration of immunotherapy to three patients, two showed clear effectiveness, and one, transient effectiveness. Effectiveness was greatest in the two patients with familial occurrence of the disease. In cerebellar ataxia, regardless of family history or isolated illness, it is critical to measure the GAD antibody level, and, even with a low titer level, if the result is positive, immunotherapy should be considered. © 2012 Springer Science+Business Media, LLC. Source

Muranaka H.,Hiroshima City General Rehabilitation Center
Nippon Hoshasen Gijutsu Gakkai zasshi | Year: 2010

PURPOSE: We evaluate radiofrequency (RF) heating of two kinds of hip joint implants of different sizes, shapes and materials. Temperature rises at various positions of each implant are measured and compared with a computer simulation based on electromagnetic-field analysis. METHODS: Two kinds of implants made of cobalt-chromium alloy and titanium alloy were embedded at a 2-cm depth of tissue-equivalent gel-phantom. The phantom was placed parallel to the static magnetic field of a 1.5 T MRI device. Scans were conducted at the specific absorption rate of 2.5 W/kg for 15 min, and temperatures were recorded with RF-transparent fiberoptic sensors. Temperatures of the implant surface were measured at 6 positions, from the tip to the head. Measured temperature rises were compared with the results of electromagnetic-field analysis. RESULTS: The maximum temperature rise was observed at the tip of each implant, and it was 9.0 degrees C for the cobalt- chromium implant and 5.3 degrees C for the titanium implant. The simulated heating positions with electromagnetic-field analysis accorded with experimental results. However, a difference in temperature rise was seen with the titanium implant. CONCLUSION: RF heating was confirmed to take place at both ends of the implants in spite of their different shapes. The maximum temperature rise was observed at the tip where there is large curvature. The value was found to depend on physical properties of the implant materials. The discrepancy between experimental and simulated temperature rises was presumed to be the result of an incomplete model for the titanium implant. Source

Tamura F.,The Nippon Dental University | Kikutani T.,The Nippon Dental University | Tohara T.,The Nippon Dental University | Yoshida M.,Hiroshima City General Rehabilitation Center | Yaegaki K.,The Nippon Dental University
Dysphagia | Year: 2012

Many elderly people under long-term care suffer from malnutrition caused by dysphagia, frequently leading to sarcopenia. Our hypothesis is that sarcopenia may compromise oral function, resulting in dysphagia. The objectives of this study were to evaluate sarcopenia of the lingual muscles by measuring the tongue thickness, and elucidate its relationship with nutritional status. We examined 104 elderly subjects (mean age = 80.3 ± 7.9 years). Anthropometric data, such as triceps skinfold thickness and midarm muscle area (AMA), were obtained. The tongue thickness of the central part was determined using ultrasonography. Measurement was performed twice and the mean value was obtained. The relationship between tongue thickness and nutritional status was analyzed by Pearson's correlation coefficient and Spearman's rank correlation coefficient. AMA and age were identified by multiple-regression analysis as factors influencing tongue thickness. The results of this study suggest that malnutrition may induce sarcopenia not only in the skeletal muscles but also in the tongue. © 2012 The Author(s). Source

Yoshida M.,Hiroshima City General Rehabilitation Center | Yoshida M.,Hiroshima University | Kikutani T.,The Nippon Dental University | Yoshikawa M.,Hiroshima University | And 3 more authors.
Geriatrics and Gerontology International | Year: 2011

Aim: The purpose of this study was to clarify the correlation between dental and nutritional status among community-dwelling elderly Japanese people. Methods: The subjects were 182 elderly individuals, aged 65-85years, who voluntarily participated in a health seminar at Kyoto Prefectural University of Medicine. These subjects were divided into two groups according to the occlusion. The subjects in the retained contact group were those who had retained molar occlusion with natural teeth. The lost contact group were those who retained molar occlusion with removable partial dentures. Anthropometric variables such as body mass index (BMI) were collected and dietary intake was assessed using a brief self-administered diet history questionnaire (BDHQ). Results: No statistical difference in BMI or intake of macronutrients was found between these two occlusal groups. The lost contact group reported significantly lower consumption of vegetables and higher consumption of confectionaries (foods rich in sugar) than did the retained contact group (P<0.05), and therefore had significantly lower intake of vitamin C and dietary fiber (P<0.05). Conclusion: It can be concluded that natural tooth contact loss in the posterior region affect the intake of vitamins and dietary fiber. Geriatr Gerontol Int 2011; 11: 315-319. © 2011 Japan Geriatrics Society. Source

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