Effects of an Injury Prevention Program on Anterior Cruciate Ligament Injury Risk Factors in Adolescent Females at Different Stages of Maturation

The ideal timing to implement anterior cruciate ligament injury prevention programs with respect to maturation is unclear. The purpose of this study was to investigate the effects of an injury prevention program on knee mechanics in early-, late-, and post-pubertal females. In the study, 178 adolescent female basketball players were assigned to six groups: early-pubertal training, early-pubertal control, late-pubertal training, and late-pubertal control, post-pubertal training, and post-pubertal control. The training groups performed an injury prevention program for six months. Medial knee displacement, knee flexion range of motion, and the probability of high knee abduction moment were assessed before and after the training period. After the six-month training period, medial knee displacement was significantly increased in the early-pubertal control group whereas it was unchanged in the early-pubertal training group. Knee flexion range of motion was significantly decreased in the early-pubertal control group whereas it did not change in the early-pubertal training group. The probability of high knee abduction moment was increased in the early-pubertal control group whereas it was unchanged in the earl-pubertal training group. The probability of high knee abduction moment was also decreased in the post-pubertal training group whereas it did not change in the post-pubertal control group. The program limited the development of high-risk movement patterns associated with maturation in early puberty while improving the knee mechanics in post-pubertal adolescents. Therefore, an injury prevention program should be initiated in early puberty and continue through the post-puberty years.Key points

• An ACL injury prevention program limited the development of high-risk movement patterns associated with maturation in early puberty while it improved the knee mechanics in post-pubertal adolescents.
• An improvement through a program might not be obvious due to the natural development of the faulty movement patterns in early-pubertal adolescents, while significant improvement through the training program can be expected in post-pubertal adolescents.
• An ACL injury prevention program should be initiated in early puberty and continue through the post-puberty years.

Key words: Knee injuries, landing, neuromuscular control, puberty     

Potential of Reduction in Total Tumor Volume Measured with 3D‐MRI as a Prognostic Factor for Locally‐Advanced Breast Cancer Patients Treated with Primary Chemotherapy

Abstract: For accurate assessment of the response to primary chemotherapy (PCT) for locally advanced breast cancer, we measured reduction in total tumor volume (TTV) by using three‐dimensional magnetic resonance imaging (3D MRI), and examined the relationship between this reduction and patient prognosis. Fifty‐one patients with locally advanced breast cancer were treated with four cycles of docetaxel (60 mg/m²) before surgery. Tumor size was measured with calipers, ultrasonography (US) and conventional two‐dimensional (2D) MRI before and after chemotherapy. TTV was measured with 3D MRI. These and other clinicopathological parameters were statistically analyzed to determine the prognosis for the patients. Median follow‐up time was 46 months (1–64 months). Of the 51 patients, 25 developed distant recurrences. Patients whose TTV decreased by 75% or more after PCT showed significantly better prognosis than others, while tumor size measured with calipers, US and 2D MRI showed no significant relationship with patient prognosis. Of the clinicopathological parameters, only reduction in TTV and histological grade showed a significant association with distant recurrence‐free survival (p = 0.03 and 0.02, log‐rank test), while stepwise multivariate Cox’s proportional hazards analysis identified TTV as the strongest independent prognostic factor. Reduction in TTV measured with 3D MRI can be a useful prognostic factor for patients with locally advanced breast cancer treated with PCT.     

Successful surgical treatment of impending rupture of thoracoabdominal aortic aneurysm in an elderly patient with severe pulmonary emphysema

In a case of successful surgery for impending thoracoabdominal aortic aneurysmic rupture, an 83-year-old man with severe pulmonary emphysema was transferred to our hospital diagnosed with impending aneurysmic rupture. The aneurysm had been pointed out 2.5 years ago but surgical repair was not undertaken due to the patient’s severe pulmonary emphysema. After admission, computed tomography showed an enlarging saccular thoracoabdominal aortic aneurysm. Emergency surgery was conducted because of severe pain below the left costal margin. We resected the wall of the saccular aortic aneurysm and reconstructed the aorta with an on-lay patch under femoro-femoral bypass and selective visceral organ perfusion. Tracheostomy provided respiratory care on the day following surgery. The patient was weaned from respiratory support 6 days after surgery. Postoperative aortography showed that the reconstructed thoracoabdominal aorta functioned satisfactorily. The patient remains in good health 18 months after surgery.     

Usefulness and practical use of an automatic counter for scattering pollen in spring]

BACKGROUND: In this decade some automatic pollen counters have been developed and showed them useful in some reports. However, the results of automatic counting have not been established. METHOD: We have compared scattering cedar and cypress pollen counts with Durham pollen samplers and a newly developed automatic pollen counter (KH-3000) in the spring from 2000 to 2004 in Tokyo. RESULTS: The relationship between the data of the automatic counter and that of a Durham sampler method is so good that this automatic counter seems useful. The best relationship between two methods was seen from late February to early April in the season of high amounts of pollens scatters. The ratio of pollen counts measured with automatic counter and Durham sampler was about 3.5 on average in the period of enough cedar and cypress pollen dispersion. The avoidance of pollens seems possible with real-time pollen information because reliability of automatic counting is highly evaluated when enough pollens scatter. CONCLUSION: In future, the standardization of automatic counting should be necessary for the accurate evaluation of scattering pollens.     

Experimental studies on the effect of local irradiation on pulmonary metastasis

The enhancement of pulmonary metastasis by local irradiation of primary tumor was investigated using Lewis lung cancer (3LL) and C57BL mice. One million 3LL cells were implanted at foot pads of mice and 7 days after the tumor-bearing legs were irradiated locally (60 Gy). Seven days after irradiation, mice were sacrificed and pulmonary metastatic nodules were counted. So it was confirmed that the pulmonary metastasis of tumor-irradiation group was enhanced significantly compared with control group and sham radiation group. The tumor-bearing legs were amputated just after, 1 day and 3 days after irradiation and pulmonary metastatic nodules were counted 7 days after irradiation. The pulmonary metastasis of mice whose legs were amputated 3 days after irradiation were enhanced significantly compared with control, though in other 2 groups pulmonary metastasis was not enhanced. So it was speculated that the enhancement of pulmonary metastasis needs remaining of irradiated tumor in bodies of mice for a certain period. It was confirmed by Winn assay that spleen cells of mice bearing irradiated tumors had an enhancing effect on tumor cells. And by Winn assay with pretreatment of cyclophosphamide, it was speculated that the enhancing effect was originated from suppressor T lymphocytes. So it was speculated that an enhancement of pulmonary metastasis by tumor irradiation was resulted from induction of suppressor T lymphocytes.     

Changes in cholinergic markers following kainic acid lesion of the ventral globus pallidus in rat

Choline acetyltransferase (CAT) and glutamate decarboxylase (GAD) activities and [3H] quinuclidinyl benzilate ([3H]QNB) binding were determined in the rat frontal cortex following damage to the basal forebrain cholinergic system. Pre- and postsynaptic changes in the cholinergic system with the passage of time were also studied. After a unilateral injection of kainic acid into the right ventral globus pallidus, the GAD levels remained unaffected, but the CAT levels decreased to 63.4% after 7 days. After 12 weeks, the CAT levels had returned to 87% of the control value. The Bmax of [3H]QNB binding for the muscarinic receptor was higher in the ipsilateral cortex up to 4 weeks. On the other hand, the KD value at 12 weeks was higher without a change in the Bmax of the [3H]QNB binding. These findings might indicate an ongoing compensatory receptor mechanism of denervation supersensitivity as a response to early changes in presynaptic cholinergic activity and the production of postsynaptic effect with presynaptic cholinergic damage over a long period of time.     

Balloon angioplasty for pulmonary artery stenosis after lung transplantation

We report here a successful case of balloon angioplasty for a stenosis of the pulmonary artery after lung transplantation. A 49-year-old patient with end stage diffuse bronchiectasis with sinusitis underwent bilateral living donor lobar lung transplantation. After treatment of postoperative right pneumothorax, a perfusion lung scan revealed deficient perfusion in the left lung. Pulmonary angiography showed a severe stenosis in the left pulmonary artery just distal to the anastomosis. Percutaneous balloon angioplasty improved both pulmonary perfusion and respiratory function.