Association between sleep disturbance and new-onset subjective knee pain in Great East Japan Earthquake survivors: A prospective cohort study in the Miyagi prefecture

Background

The Great East Japan Earthquake (GEJE) and Tsunami devastated the northeastern coast of Japan on March 11, 2011. This study aimed to determine whether sociopsychological factors, such as sleep disturbance and psychological distress, influenced new-onset subjective knee pain in survivors during the post-disaster phase of the GEJE.

Downbeat positioning nystagmus is a common clinical feature despite variable phenotypes in an FHM1 family

Clinical examinations and mutational analyses were carried out in three patients of a Japanese familial hemiplegic migraine (FHM) pedigree. Each affected member demonstrated a broad clinical spectrum that included hemiplegic migraine with progressive cerebellar ataxia, migraine without aura, and episodic ataxia. Despite this variability, all members exhibited marked downbeat positioning nystagmus, and magnetic resonance images (MRI) all showed cerebellar atrophy predominantly of the cerebellar vermis. All affected members had a T666M missense mutation in the protein encoded by the CACNA1A gene (calcium channel, voltage-dependent, P/Q type, alpha 1A subunit). Although clinical features associated with the T666M CACNA1A mutation are highly variable, downbeat positioning nystagmus may be an important clinical feature of this disease.     

几种评价保湿产品无创性测试方法的相关性评价

目的:对测量皮肤角质层含水量和屏障功能的几种无创性皮肤测试方法进行相关性评价。方法:采用SKICON-200测定皮肤电导法、皮肤保水功能测定、TEWL测定、受试者主观评价的方法,比较某种保湿霜/精华素使用前、后皮肤角质层含水量和屏障功能的变化,并分析这些方法之间的相关性。结果:保湿霜的效果优于精华素,SKICON-200测定皮肤电导法、皮肤保水功能测定以及部分受试者临床症状和主观评价指标(如红斑、脱屑情况,皮肤滋润度的改善、皮肤细纹数量变化和皮肤弹性改善)有很好的平行关系。TEWL结果在本试验中变化不大,与上述指标没有平行关系。结论:SKICON-200测定皮肤电导法、皮肤保水功能测定适合用于保湿化妆品的功效评价。TEWL测定对于屏障功能受损的皮肤可能更敏感,对于健康皮肤使用前、后比较可作为参考指标。     

Validation and reliability of a Japanese version of the Shoulder Pain and Disability Index: A cross-sectional study

BackgroundThe Shoulder Pain and Disability Index (SPADI) is a simple disease specific questionnaire that is used to evaluate the impact of shoulder disorders. The purpose of this study was to translate the SPADI into Japanese (SPADI-Jp) and evaluate its reliability and validity in Japanese patients with shoulder disorders.MethodsCross-cultural adaptation of the SPADI was performed according to international guidelines. A total of 100 patients with shoulder disorders participated in this study. Each participant was asked to finish the SPADI-Jp, Disability of Arm, Shoulder and Hand (DASH), and the Short-Form 36 (SF-36) at the initial visit. Thirty-four patients repeated the SPADI-Jp to assess the test–retest reliability. The test–retest reliability was quantified using the interclass correlation coefficient (ICC), while Cronbach's alpha was calculated to assess the internal consistency. The construct validity was assessed using Spearman's rank correlation coefficients.ResultsInternal consistency in the SPADI-Jp was very high (0.969), as measured by the Cronbach's alpha. The ICC of the SPADI-Jp was 0.930. There was a strong, positive correlation between the DASH and the SPADI-Jp (r = 0.837, p < 0.001). The SPADI-Jp was significantly correlated with most of the SF-36 subscales. The correlations of the SPADI-Jp with physical subscales of the SF-36 were stronger than those with the other subscales.ConclusionsWe demonstrated that the SPADI-Jp is a reliable and valid self-assessment tool. Because cross-cultural adaptation, validation, and reliability of the disease-specific questionnaire for shoulder pain and disability have not been evaluated in Japan, the SPADI-Jp can be useful for evaluating such patients in the Japanese population.     

Youth baseball players with elbow and shoulder pain have both low back and knee pain: a cross-sectional study

Purpose

Serious arm injuries in youth baseball players have been increasing. Though a breakage in the kinetic chain could affect arm injuries, an association between arm injuries and insufficient support of the trunk and lower extremities is not well understood. The purpose of this study was to investigate the association of low back and knee pain with elbow and/or shoulder complaints among youth baseball players.

Methods

A self-administered questionnaire and document informed consent were mailed to youth athletes belonging to the Miyagi Amateur Sports Association. Multiple logistic regression analysis was used to examine the association of low back and knee pain with elbow and/or shoulder pain at the time of the questionnaire. Variables considered in the models were as follows: sex, age, BMI, years of athletic experience, position, team level, the amount of practice, participating day in team practice and game per week, frequency of participation in games, and practice intensity.

Results

The final study population was comprised 1582 youth baseball players (aged 6–15 years old, male 95.6 %) who had responded to the questionnaire. A total of 24.8 % (n = 381) had elbow and/or shoulder pain, whereas 8.5 % (n = 130) had low back pain and 13.1 % (n = 201) had knee pain. The prevalence of elbow and/or shoulder pain with concomitant low back and knee pain was 61.2 % (n = 82) and 51.9 % (n = 108) (p < 0.001), respectively. The presence of low back and knee pain was significantly associated with the prevalence of elbow and/or shoulder pain among youth baseball players [adjusted odds ratio (ORs): 4.31, 95 % confidence interval (95 % CI): 2.86–6.51, p < 0.001, and ORs: 2.92, 95 % CI: 2.09–4.09, p < 0.001, respectively]. For other variables, older age (10- and 11-year old: ORs: 1.73, 95 % CI 1.10–2.73, p = 0.018; 12–15 year old: ORs: 1.62, 95 % CI: 1.18–2.58, p = 0.006), pitcher (ORs: 1.46, 95 % CI: 1.10–1.94, p = 0.009), catcher (ORs: 1.69, 95 % CI: 1.24–2.31, p = 0.001,), and practice intensity (ORs: 1.58, 95 % CI: 1.22–2.06, p = 0.001) were significantly associated with elbow and/or shoulder pain.

Conclusion

Both low back and knee pain were significantly associated with elbow and/or shoulder pain in youth baseball players. Clinicians should check the complaints of the trunk and lower extremities as well as those of the elbow and shoulder for preventing severe injuries in youth baseball players. Level of Evidence III.

     

Portal blood flow and liver regeneration in auxiliary partial orthotopic liver transplantation in a canine model

Functional competition has been shown to lead to a detrimental outcome in auxiliary liver transplantation. We evaluated the interaction in auxiliary partial orthotopic liver transplantation between the native liver and the graft in terms of portal flow and regeneration. The need for diversion of the portal flow to the graft was also assessed. Reduced-size liver grafts were transplanted orthotopically after partial hepatectomy in beagles. There were two groups: the preserved group, where portal inflow to the native liver was preserved, and the ligated group, where it was interrupted. Portal flow was measured serially and liver regeneration was evaluated on postoperative day 5. Functional competition was not observed in the preserved group. On the other hand, ligation of the native liver portal vein had no obviously detrimental effects on the remnant native liver. This leads to the conclusion that the portal vein to the native liver can be safely ligated to prevent functional competition.     

A case of intra-articular fracture of the knee joint with three layers within lipohemarthrosis by ultrasonography and computed tomography

We report a case of intra-articular fracture of the knee joint showing three layers within lipohemarthrosis. Sagittal ultrasonography showed three layers (double fluid-fluid level): a superior hyperechoic layer of fat, an intermediate anechoic layer of serum, and an inferior hypoechoic layer of red blood cells. Horizontal computed tomography imaging demonstrated the same three layers. This is the first case of lipohemarthrosis in which three layers of joint effusion were confirmed by both ultrasonography and computed tomography.     

Soft‐shell technique using Viscoat® and Healon®5: a prospective,randomized comparison between a dispersive‐viscoadaptive and a dispersive‐cohesive soft‐shell technique

Purpose: To compare the efficacy of the dispersive‐viscoadaptive soft‐shell technique using Viscoat^® and Healon^®5 to the dispersive‐cohesive soft‐shell technique in reducing corneal endothelial cell damage during cataract surgery. Methods: In this prospective randomized study, 207 eyes of 171 cataract patients underwent phacoemulsification using the dispersive‐viscoadaptive soft‐shell technique (V‐group, 102 eyes) with Viscoat and Healon5 or the dispersive‐cohesive soft‐shell technique (C‐group, 105 eyes) with Viscoat and a cohesive agent (Opegan‐Hi^®). Each group was divided into two subgroups depending on the amount of ultrasound (%Min) used during phacoemulsification. Corneal endothelial cell density was examined preoperatively and 3 months postoperatively. The endothelial cell loss was compared between the two groups, and also between the subgroups. Results: The mean endothelial cell loss 3 months after surgery was 8.4 ± 5.6% standard deviation (SD) in the V‐group and 8.2 ± 6.2% in the C‐group (P = 0.787). In the subgroups with ultrasound of 10 %Min or less, the mean endothelial cell loss 3 months after surgery was 6.6 ± 4.6% in the V‐group and 5.5 ± 5.0% in the C‐group (P = 0.104). In the subgroups with ultrasound of over 10 %Min, this value was 10.6 ± 6.3% in the V‐group and 11.9 ± 5.7% in the C‐group (P = 0.413). The correlation coefficient of the endothelial cell loss rate and %Min was 0.245 (P = 0.0129) in the V‐group and 0.501 (P < 0.0001) in the C‐group. Conclusion: The dispersive‐viscoadaptive soft‐shell technique is as effective as the dispersive‐cohesive soft‐shell technique in protecting corneal endothelial cells during phacoemulsification regardless of the amount of ultrasound energy used.