Sway of the center of gravity in patients with spinal canal stenosis

In this study the sway of the center of gravity was observed in patients with spinal canal stenosis, in order to observe the movement of the center of the gravity after the onset of claudication. In normal subjects the sway of the center of gravity was restricted to a small area, but in patients with spinal stenosis, the center of gravity was diverted to the left or right side. With claudication, the center of gravity moved forward. Following several rest periods, the center of gravity returned to the initial area. The time required to return to the initial area was longer than for a patient's subjective recovery from the symptoms.     

Autoimmune Pancreatitis as a New Clinical Entity (Three Cases of Autoimmune Pancreatitis with Effective Steroid Therapy)

The most common forms of chronic pancreatitisare related to alcohol ingestion, whereas the entity ofnon-alcohol-associated (idiopathic) pancreatitis ispoorly understood. Autoimmunity has been suggested as a possible etiologic factor of idiopathicchronic pancreatitis. A total of 362 Japanese patientsunderwent endoscopic retrograde pancreatography (ERP)for suspected pancreatic disease, and 161 were diagnosed with chronic pancreatitis. Among them, we foundthree cases (1.86% incidence) of unique chronicpancreatitis, in which ERP revealed diffuse narrowing ofthe main pancreatic duct with an irregular wall. We diagnosed these three patients as havingpancreatitis associated with an autoimmune mechanismmorphologically and biochemically and started them onsteroid therapy. The characteristics of the these three patients were as follows:hypergammaglobulinemia, eosinophilia, ultrasonographyshowing hypoehoic diffuse swelling in the pancreas(sausage-like appearance), ERP showing diffuse narrowingof the main pancreatic duct with irregular like thumbprintlike marks,reversible exocrine insufficiency, and positiveanti-carbonic anhydrase II antibody. After one month ofthe treatment with steroids, pancreatitis dramatically improved morphologically and enzymatically.Here we describe these cases of the suspected autoimmunechronic pancreatitis. We must recognize the concept andthe features of autoimmune pancreatitis in order to avoid unnecessary surgery as pancreaticcancer.     

Reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices for locomotive syndrome and associated disability: the second survey of the ROAD study

BackgroundWe established reference values for hand grip strength, muscle mass, walking time, and one-leg standing time as indices reflecting components of locomotive syndrome and associated disability using a large-scale population-based sample from the second survey of the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) cohort.MethodsWe measured the above-mentioned indices in 2,468 individuals ≥40 years old (826 men, 1,642 women; mean age 71.8 years) during the second visit of the ROAD study. Disability was defined as certified disability according to the long-term care insurance system through public health centres of each municipality.ResultsMean values for hand grip strength (weaker side), muscle mass of the thighs, walking time for 6 m at the usual pace, and the fastest pace for men were 32.7 kg, 7.0 kg, 5.6 s, and 3.7 s, respectively, and those for women were 20.8 kg, 5.2 kg, 5.9 s, and 4.1 s, respectively. The median values for one-leg standing time (weaker side) were 14 s for men and 12 s for women. The prevalence of disability in men aged 65–69, 70–74, 75–79, and ≥80 was 0.0, 1.0, 6.3, and 8.8%, respectively, and in women was 3.4, 3.5, 9.2, and 14.7%, respectively. There were significant associations between the presence of disability and walking time for 6 m at the usual pace and at the fastest pace, and between the presence of disability and walking speed.ConclusionsWe established reference values for indices reflecting components of locomotive syndrome, and identified significant associations between walking ability and disability.