Frequency features of mechanomyographic signals of human soleus muscle during quiet standing

The purpose of the present study was to determine whether the frequency features of the MMG signals during quiet standing reflect body sway as well as recurring muscle activity. Twenty healthy men maintained quiet standing in a barefoot position with their eyes open or closed. During quiet standing, MMG detected using uniaxial piezoresistive accelerometer and surface electromyogram (EMG) signals were recorded from the soleus (SOL) muscle, and the center of mass (CoM) displacement (CoMdis) in the anteroposterior direction was measured by a high-resolution laser displacement sensor. In addition, CoMdis was time-differentiated to yield CoM velocity (CoMvel). Cross-spectral analysis revealed that significant coherency spectra from MMG to CoMdis and from MMG to rectified EMG of SOL were observed below 2Hz and 8-12Hz frequency band, respectively. Furthermore, we revealed that the trajectories of MMG and the calculated dMMG/dt were significantly correlated to CoMdis and CoMvel, respectively. These results suggest that kinematic and physiological parameters of postural control during quiet standing can be quantified by frequency features of the MMG.     

Breast cancer in first-degree relatives and risk of lung cancer: assessment of the existence of gene sex interactions

BACKGROUND: Previous studies have shown the sex differences in lung cancer and the associations between estrogen-related genes and non-small cell lung cancer. In the present study, we assumed the existence of shared candidate genes that are common in lung and breast cancers, and examined whether women with a family history of breast cancer are at increased risk of lung cancer compared with men, especially adenocarcinoma, in a case-only study. METHODS: This case-only study was conducted based on the Lung Cancer Database Project at the National Cancer Center Hospital East. A total of 1566 patients with newly diagnosed primary lung cancer were consecutively recruited between 1999 and 2003. Information on their family history of cancer and smoking habit was obtained from a self-administered questionnaire. To assess an interactions between two factors, odds ratios for interaction (ORis) and 95% confidence intervals (CIs) were calculated by case-only contingency table. RESULTS: A statistically significant ORi was observed between a family history of breast cancer in first-degree relatives (parent and siblings, not including children) and the sex of a patient (ORi: 2.22, 95% CI: 1.02-4.81). A stratified analysis by histologic subtypes showed a statistically significant ORi only for adenocarcinoma (ORi: 3.27, 95% CI: 1.19-8.98). No other family history of cancer, such as stomach, colon and lung cancer, showed a statistically significant ORi. CONCLUSION: This study suggests the possibility of gene-sex interaction in lung cancer.     

Role of Tyr306 in the C-terminal fragment of Clostridium perfringens enterotoxin for modulation of tight junction

We previously reported that the C-terminal fragment of Clostridium perfringens enterotoxin (C-CPE) is a novel type of absorption enhancer that interacts with claudin-4 and that Tyr306 of C-CPE plays a role in ability of C-CPE to modulate barrier of tight junctions. In the current study, to investigate effects of Tyr306 on the C-CPE activity, we prepared some C-CPE mutants substituted Tyr306 with Trp (Y306W), Phe (Y306F) and Lys (Y306K). We found that Y306W and Y306F mutants of C-CPE had claudin-4 binding affinities and effects on the barrier function of tight junctions, whereas both of these properties were greatly reduced with the Y306K mutant. Finally, the Y306K but not the Y306F and Y306W mutants had reduced abilities to enhance absorption in rat jejunum. These results indicate that aromatic and hydrophobic properties, not hydrogen bonding potential, of Tyr306 are involved in the interaction of C-CPE with claudin-4 and in the modulation of the tight junction barrier function by C-CPE.     

Prospective analysis of depression and psychological distress before and after surgical resection of lung cancer

Objectives The psychological effects of surgery have received little attention in patients with lung cancer, so it is unclear how much psychological support is required by these patients. This study was done to assess the mental state of patients with lung cancer before and after surgery and to determine their need for psychological care. Methods A group of 165 patients with lung cancer scheduled for surgical treatment were included in this study. They were asked to complete the Profile of Mood States questionnaire before surgery and on discharge after completion of treatment. The data on mood from the questionnaires were analyzed. Results Tension-anxiety improved significantly after surgery, whereas the fatigue score increased significantly. The scores for depression-dejection and confusion were elevated before surgery and were unchanged afterward. Conclusions Patients with lung cancer were depressed before surgery and remained depressed after their operations, although postoperative tension-anxiety diminished. These results indicate that lung cancer patients need psychological support to alleviate depression during the perioperative period.     

Complications and risk factors of punch biopsy: A retrospective large-scale study

The authors analyzed the risk factors of punch biopsy by investigating the complications of the technique and their proportions. Patients who underwent punch biopsy in a dermatology clinic between November 2018 and November 2020 (n = 1294; mean age, 62.3 years; 540 men and 754 women) were enrolled in the current study. The most common complication was postoperative bleeding (0.9%). Wound infection (0.2%), surrounding skin damage (0.2%), and vagal reflex (0.1%) were also observed. The main risk factors for bleeding following biopsy were location of biopsy site outside of the trunk (odds ratio [OR], 4.60 [95% CI, 2.65–8.00]; p < 0.001) and platelet count lower than 150 000/μL (OR, 2.82 [95% CI, 1.69–4.73]; p < 0.001). When performing a punch biopsy, an adequate explanation of the risks and complications should be provided before obtaining informed consent. Further, blood sampling tests should be performed in advance and the types of cases that may require wound suture should be appropriately determined.     

Risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair

PURPOSE

We aimed to identify the risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair (EVAR).

METHODS

We retrospectively reviewed contrast-enhanced computed tomography (CT) images of 143 patients who were followed for ≥6 months after EVAR. Sac expansion was defined as an increase in sac diameter of 5 mm relative to the preoperative diameter. Univariate and multivariate analyses were performed to identify associated risk factors for late sac expansion after EVAR from the following variables: age, gender, device, endoleak, antiplatelet therapy, internal iliac artery embolization, and preprocedural variables (aneurysm diameter, proximal neck diameter, proximal neck length, suprarenal neck angulation, and infrarenal neck angulation).

RESULTS

Univariate analysis revealed female gender, endoleak, aneurysm diameter ≥60 mm, suprarenal neck angulation >45°, and infrarenal neck angulation >60° as factors associated with sac expansion. Multivariate analysis revealed endoleak, aneurysm diameter ≥60 mm, and infrarenal neck angulation >60° as independent predictors of sac expansion (P < 0.05, for all).

CONCLUSION

Our results suggest that patients with small abdominal aortic aneurysms (<60 mm) and infrarenal neck angulation ≤60° are more favorable candidates for EVAR. Intraprocedural treatments, such as prophylactic embolization of aortic branches or intrasac embolization, may reduce the risk of sac expansion in patients with larger abdominal aortic aneurysms or greater infrarenal neck angulation.The aim of endovascular abdominal aortic aneurysm repair (EVAR) is to prevent rupture of an abdominal aortic aneurysm (AAA) by depressurizing the aneurysm and excluding it from the systemic circulation using a stent-graft. Aneurysmal sac reduction is a reliable marker for the long-term prognosis after EVAR. Although most aneurysmal sacs shrink after EVAR, some sacs continue to expand. A relationship between aneurysm size and endoleaks was previously reported (1, 2). Most type II endoleaks spontaneously disappear over time, but 10%–25% persist for more than six months after EVAR (3–6). Persistent endoleaks with aneurysmal sac expansion are at high risk of rupture because of the continuously elevated intra-aneurysmal pressure and require a second intervention, such as embolization (7–11). However, it is difficult to predict sac expansion and persistent endoleak before performing EVAR. Although intraoperative intrasac thrombin injection and prophylactic embolization of aortic branches such as the inferior mesenteric artery and lumbar artery are reported to reduce the incidence of type II endoleak, the efficacy and clinical benefit of these procedures in terms of late postoperative aneurysm shrinkage have not been fully evaluated (12–15). Therefore, the purpose of this study was to identify the risk factors associated with late aneurysmal sac expansion after EVAR to determine possible indications for intrasac embolization and prophylactic embolization of aortic branches.