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Niigata-shi, Japan

Omori G.,Niigata University | Koga Y.,Niigata Medical Center | Tanaka M.,Niigata Institute for Health and Sports Medicine | Nawata A.,Alcare Co. | And 3 more authors.
Journal of Orthopaedic Science | Year: 2013

Background: Knee osteoarthritis (OA) is a multifactorial disease and strongly affected by mechanical factors. The aims of the present study were to assess validity and reliability of a new muscle strength measuring device, the Quadriceps Training Machine (QTM) and evaluate the relationship between quadriceps strength measured by QTM and radiographic knee OA by epidemiological survey. Methods: The isometric knee extension muscle strength of QTM was compared with BIODEX in 24 healthy adults. Then, the relationship between radiographic knee OA and quadriceps strength using QTM was investigated with 2,032 knees in 1,016 subjects by an epidemiological survey (Matsudai Knee Osteoarthritis Survey). Results: Significant correlation was observed between QTM and BIODEX (r = 0.69, 0.82). In the Matsudai Knee Osteoarthritis Survey, the prevalence of radiographic OA (grade II or higher upon Kellgren-Lawrence classification) was: 13, 36.9, 67.8, and 86.5 %, regarding women in their fifties, sixties, seventies, and eighties, respectively, and was 1.7, 13.4, 33.5, and 66.2 % regarding men, respectively. Quadriceps muscle strength declined following 50 years of age, and significant decline was observed in the their sixties and seventies. Quadriceps muscle strength of the OA group (grades II, III and IV) was significantly declined compared with that of the Non-OA group (grade-0 and I). Furthermore, the tendency of the muscle strength level to decline with the progression of knee OA grade was particularly observed between grade 0 and grade I in both men and women and between grade I and grade II in men. Conclusion: The relationship between radiographic knee OA and quadriceps strength was quantitatively evaluated by an epidemiological survey, and we found a correlation between knee OA and the decline in quadriceps strength. Furthermore, it was suggested that the decline in quadriceps muscle strength may be more strongly related to the incidence of knee OA than to its progression. © 2013 The Japanese Orthopaedic Association.

Kudo H.,Niigata Medical Center
Japanese Journal of Plastic Surgery | Year: 2011

A 60-year-old man presented with adenoid cystic carcinoma of the skin of his lower leg. Adenoid cystic carcinoma (ACC) is uncommon but usually occurs from the salivary gland, mammary gland, bronchus, lacrimal gland, uterine cervix, prostate or ear canal. ACC of the skin is rare and is usually seen in the head and neck area, but only 1 case that occurred from the lower leg has been reported on examination of domestic and foreign literatures. He underwent a wide resection and the tissue defect was reconstructed with a distally based sural flap. As more than half of patients will develop local recurrence and some patients with distant metastasis are reported even after a long-term interval, we must be careful to prevent overlooking such cases for long periods of time.

The patient was a 78 year-old female with chronic hepatitis C and diagnosed with HCC. TAE was performed five times via the hepatic artery and PEIT three times. But no treatment effect was obtained and the hepatic artery was obstructed due to repeated TAE. Via the 11th intercostal artery which was an extrahepatic collateral feeding artery of HCC, doxorubicin 30 mg, mitomycin C 8 mg and lipiodol 1 ml were injected. After some time, redness and pain appeared in the right abdomen and back. Four weeks later, skin ulcer and necrosis developed. We suspected that the density of the anticancer drug in the vessel increased more than usual by the embolic material after the TAE via the 11th intercostal artery in the part where the microcirculation problem existed due to radiation, and a severe skin injury developed. We should keep in mind that anti-cancer drugs and embolic materials may cause skin injury after TAE via the intercostal artery especially in the part radiated repeatedly.

Kudo H.,Niigata Medical Center | Otsuka H.,Niigata Prefectural Central Hospital
Japanese Journal of Plastic Surgery | Year: 2012

The patient is a 76 year-old woman with a recurrent skin lesion on her left back and non NF-1. The tumor first appeared 22 years ago, and she had undergone 14 operations and local recurrences within a period of 18 years before visiting our clinic. The pathological diagnoses of the past 14 specimens were all neurofibroma with positive margin. Conservative excision was performed as the 15th operation and the pathological diagnosis was atypical neurofibroma with negative margin and no malignant transformation into MPNST. However, 9 months later, the tumor recurred and was excised as the 16th operation. Pathological diagnosis was MPNST. Wide resection was performed and the chest and abdominal wall defect was covered with a pedicled rectus abdominal musculocutaneous flap last year. She has had no recurrence or metastasis since then. Malignant transformation of sporadic neurofibroma with non NF-1 is very rare. And atypical neurofibroma was recognized in the course of the disease, which is usually seen adjacent to an area of blatant MPNST that is transformed from neurofibroma in NF1, and is not reported to recur and change into MPNST in the short term. We suspect that this unusual course and finding of malignant transformation is definitely due to repeatedly inadequate excision. Sporadic neurofibroma should be excised completely at the primary stage if possible even though it is a benign tumor because repeated excision may induce malignant transformation, and should be followed up carefully even though her MPNST is classified as relatively good prognosis.

Saitoh A.,Niigata University | Aizawa Y.,Niigata University | Sato I.,Yoiko no Syounika Sato Clinic | Hirano H.,Saiseikai Niigata Daini Hospital | And 2 more authors.
Vaccine | Year: 2015

As compared with standard intramuscular and subcutaneous vaccines, intradermal (ID) vaccines elicit a more potent immune response in both adults and children, with equivalent dosage or antigen dose sparing.Recently, various devices for ID injection have been developed; the length of needles ranges in 0.6-1.5. mm. However, skin thickness must be measured to determine optimal needle length for ID vaccines. Use of ID vaccines in infants and children is appealing because children require more vaccines than do adults; however, information on skin thickness in infants and children is limited. We used ultrasound echography to measure skin thickness in Japanese infants aged 2 months (. n=. 78) and adolescents aged 13-15 years (. n=. 82). Mean (range) deltoid and suprascapular skin thickness was 1.67. mm (1.16-2.39. mm) and 1.83. mm (1.24-2.60. mm), respectively, in infants and 1.81. mm (1.25-3.00. mm) and 2.43. mm (1.51-3.95. mm), respectively, in adolescents. Among infants who underwent re-measurement of skin thickness at age 6 months (. n=. 11), mean deltoid skin thickness (1.84. mm) was significantly greater than at age 2 months (1.60. mm) (. P<. 0.001). In contrast, no significant difference was observed in suprascapular skin thickness (1.79. mm vs. 1.67. mm, respectively; P=. 0.17). Gender was not associated with skin thickness in either age group. Skin thickness was positively correlated with body weight in adolescents (. r=. 0.43, P<. 0.001 in deltoid region; r=. 0.30, P=. 0.01 in suprascapular region). In conclusion, this is the first study to evaluate skin thickness in different age groups of children, including at age 2 months. Skin thickness gradually increased from age 2 months to age 13-15 years, but no consistent trend was noted in analysis stratified by measurement site, gender, or age. These findings suggest that an appropriate length of ID device needle for infants and children is likely to be less than 1.2. mm and a special device with shorter length of needle is warranted for infants and children. © 2015 Elsevier Ltd.

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