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The Japanese Orthopaedic Association (JOA) introduced the concept of locomotive syndrome (LS), which indicates a decline in mobility function by musculoskeletal disorders with new 3-staged category. Additionally, sarcopenia indicates a decline in the quantity and/or quality of skeletal muscle. However, the relationship between low back pain (LBP) and LS or sarcopenia in older people has not been sufficiently understood. This study aimed to investigate the association between them through a cross-sectional locomotorium survey.A total of 302 participants were drawn from the aquatic exercise participants in a rural area of Japan. The body mass index, body fat percentage, skeletal muscle mass index (SMI), spinal inclination angle (SIA), grip strength, timed up-and-go test (TUG), and maximum stride of the participants were measured. LBP and LBP-related quality of life (QOL) were evaluated using the Oswestry Disability Index (ODI), visual analogue scale (VAS) of LBP, and the Short-Form 8 (SF-8). Associations between the investigating parameters and sarcopenia or LS were analyzed.There were no significant differences in the findings except grip strength between the non-sarcopenia and sarcopenia groups. However, the LS group showed significantly larger SIA, higher ODI, higher VAS of LBP, lower physical component score (PCS) of the SF-8, longer time in TUG, and lower value in maximum stride than the non-LS group. In addition, the ODI and PCS of the SF-8 significantly deteriorated as the LS stage progressed, and the GLFS-25 score was significantly correlated with ODI (r = 0.706, p 0.001) and PCS (r = -0.643, p 0.001) scores.LBP, LBP-related QOL, and physical performance were found to be significantly associated with LS, not sarcopenia, with LBP-related QOL and physical function being closely correlated with 3-stage categories of LS. Thus, these results suggested that LBP is a key factor for LS prevalence.

Intratracheal instillation is the introduction of a substance directly into the trachea. Intratracheal instillation has been used to investigate the lung toxicity of several chemicals and requires the suspension or dissolution of test material in a vehicle for even dispersal throughout the lung. Importantly, the toxicities of vehicles used in intratracheal instillation studies are generally considered to be insignificant. Hence, evaluating the influence of different vehicles on the lung due to intratracheal instillation is crucial. We examined the toxic effects of pure water, saline, phosphate buffered saline (PBS), 0.5% Kolliphor® P188 (KP188), 0.1% Tween 20 in saline, and 1.0% BSA in PBS. These vehicles were administered to male Crl:CD(SD) rats by a single intratracheal instillation. On day 3, broncho-alveolar lavage fluid (BALF) from the right lung was collected and processed for cell counting and biochemical analysis, while the left lung was used for histopathological examination. Accumulation of alveolar macrophages was observed in all vehicle-treated groups but was minimal in the group administered saline, somewhat higher in the groups administered pure water, PBS, 0.1% Tween 20, and 1% BSA, and notably higher in the group administered 0.5% KP188. The results from BALF analysis indicated that intratracheal instillation of 0.5% KP188 also induced alveolar damage. Additionally, administering pure water did not appear to cause tissue damage. Eosinophil infiltration in the interstitial regions was histopathologically observed. Altogether, the results of this study are helpful for the selection of appropriate vehicles for use in intratracheal instillation studies.

Background We assessed the morphological differences in the knee joint related to knee rotation angle in patients with hip dysplasia. These results may explain the anatomy of the knee in patients with hip dysplasia and aid in planning knee surgery. Methods We enrolled 73 women (146 legs, 35.6 ± 9.0 years) with bilateral hip dysplasia and 45 healthy women (90 legs, 49.0 ± 18.9 years) without lumbago, knee symptoms, or osteoarthritic findings of the knee or spine on plain radiographs. We examined the parameters affecting knee rotation angle, such as the condylar twist angle and femoral condyle measurements with a three-dimensional bone model using the correlation coefficients of each parameter. Results The condylar twist angle and the length of the posterior part of the lateral femoral condyle were statistically positively correlated with knee rotation angle in both the normal (condylar twist angle: r = 0.286, p = 0.007, posterolateral: r = 0.429, p

The Standard for Exchange of Nonclinical Data (SEND), adopted by the US Food and Drug Administration (FDA), is a set of regulations for digitalization and standardization of nonclinical study data; thus, related organizations have begun implementing processes in support of SEND. The Global Editorial and Steering Committee (GESC), which provides oversight of the International Harmonization of Nomenclature and Diagnostic Criteria (INHAND), has prepared the SEND Controlled Terminology (CT) for toxicologic pathology. SEND provides electronic data standards created by the Clinical Data Interchange Standards Consortium (CDISC), and CDISC also collaborates in the implementation of SEND. Furthermore, the Pharmaceutical Users Software Exchange (PhUSE), which includes members of the US FDA, has conducted various activities to promote realistic and effective methods to implement SEND. As we reported in 2015, there is a significant variation in the efficiency and quality of SEND data implementation across pharmaceutical companies and contractors (CROs) globally. To address this problem, the Global SEND Alliance (G-SEND) was established in August 2018 to facilitate the coordination and standardization of SEND datasets across CROs in Asia. This paper reports the first method for organizationally and jointly creating consistent SEND datasets between CROs using G-SEND.

Background: The natural course of scores of the Kihon Checklist, one of the promising tools used for frailty screening, is unknown. We aimed to analyze the 5-year natural course of frailty as assessed using the Kihon Checklist in community-dwelling older adults. Methods: We used the data from the postal Kihon Checklist survey conducted by the municipal government between 2011 and 2016. The sample of the current study consisted of 551 older adults (265 men and 286 women) aged 65-70 years in 2011, who responded to the postal Kihon Checklist both in 2011 and in 2016. A Kihon Checklist score of 0 to 3 was considered an indicator of robustness, 4 to 7 of prefrailty, and 8 or higher of frailty. Group comparisons were performed with significance set at p

Atypical femoral fracture is a low-energy stress fracture in the subtrochanteric region or the femoral shaft and is a complication of the long-term use of bisphosphonates. Histopathological findings of atypical femoral fractures have not been clarified. Herein, we report the case of a 61-year-old woman who fell while walking, which prompted her to visit our facility. She had a 7-year history of alendronate use to treat osteoporosis. A radiograph showed an atypical subtrochanteric femoral fracture, following which she underwent a primary surgery, where an intramedullary femoral nail was used. Implant breakage was discovered 8 weeks after the primary surgery. The patient underwent a revision surgery in which the entry point for the revised intramedullary hole was created to prevent varus position. The lag screw was successfully inserted into the center of the femoral head. Cancellous bone, isolated from the right ilium, was autogenously implanted into the fracture site. Fracture healing was promoted using low-intensity pulse ultrasonography. Callus formation was detected on a radiograph, and full weight-bearing was advised 12 weeks after the revision surgery. The fracture had healed completely at 13 months after the revision surgery. The patient was able to walk without support and could independently perform activities of daily life. Laboratory findings suggested that the concentrations of her bone formation markers were normal, while those of bone resorption markers were elevated. Iliac bone histomorphometry did not reveal severely suppressed bone turnover. In the cortex of fracture site, the lacunar density was markedly lower than the osteocyte density, and microcracks were detected, suggesting impaired osteocyte function and a low potential for fracture healing. This case is notable because it helps to clarify the histopathological findings of atypical femoral fractures.

Background: Many multidisciplinary approaches such as fracture liaison services (FLS) have been introduced in the United Kingdom and Japan and have reduced medical complications and secondary fractures. This study investigated patient outcomes following the introduction of FLS.Methods: Patients who were over 50 years old and experienced fragility hip fractures between January 1, 2015 and December 31, 2017, were enrolled in the study. We divided patients into a control group without FLS (94 patients; mean age: 83.8 years; 21 men and 73 women) and a FLS group (373 patients; mean age: 83.3 years; 69 men and 304 women).Results: The time from injury to surgery decreased significantly from 2.42 days to 1.83 days following the introduction of FLS (p = 0.003). The proportion of patients who underwent surgery within 36 hours of injury also increased significantly in the FLS group (p = 0.014). In the FLS group, a significant decrease was observed in the total number of cases with complications after admission (p = 0.004). Significantly more patients with a Barthel index (BI) of ≥80 were observed in the FLS group at 6 months, 12 months, and 24 months following injury (p = 0.046, 0.018, and 0.048, respectively). Multiple logistic regression analysis revealed that the BI at the time of injury, surgery within 36 hours of injury, and postoperative complications was associated with death within 12 or 24 months after the injury.Conclusions: Our results indicate that FLS contributed to earlier recovery and rehabilitation following surgery and accelerated the rehabilitation of medical complications following admission. Our FLS is expected to improve patient activity and decrease secondary hip fracture in patients who have undergone hip surgery.

Background: Many models of fracture liaison services (FLS) following hip fracture have been introduced in the United Kingdom and Japan, resulting in a reduction in medical complications and secondary fractures. This study investigated improvements in time to surgery, daily activity, and the rate of medical complications and secondary hip fractures following the introduction of FLS.Methods: Patients who were over 50 years old and experienced fragility hip fractures, including femoral neck and trochanteric fractures, between January 1, 2015 and December 31, 2017, were enrolled in the study. We divided patients into a control group without FLS (94 patients; mean age: 83.8 years; 21 men and 73 women) and an FLS group (373 patients; mean age: 83.3 years; 69 men and 304 women).Results: The time from injury to surgery decreased significantly from 2.42 days to 1.83 days following the introduction of FLS (p = 0.003). The proportion of patients who were able to undergo surgery within 36 hours of injury also increased significantly in the FLS group (p = 0.014). In the FLS group, a significant decrease was observed in the total number of cases with complications, including cardiovascular disease, pulmonary disease, and cerebrovascular disease, after admission (p = 0.009, 0.010, 0.043, respectively). Significantly more patients with a Barthel index (BI) of ≥80 were observed in the FLS group at 6 months, 12 months, and 24 months following injury (p = 0.046, 0.018, and 0.048, respectively). Multiple logistic regression analysis revealed that BI at the time of injury, surgery within 36 hours of injury, and postoperative complications were associated with death within 12 or 24 months after the injury.Conclusions: Our results indicate that FLS contributed to earlier recovery and rehabilitation following surgery, and accelerated rehabilitation of medical complications following admission. Our FLS is expected to improve patient activity and decrease secondary hip fracture in patients who have undergone hip surgery. Trial registration: University Hospital Medical Information Clinical Trials Registry, UMIN000041206. Registered 24th July 2020, https://upload.umin.ac.jp/cgi-in/ctr/ctr_view_reg.cgi?recptno=R000047054

Background:The anatomical sacral slope, considered an anatomical pelvic parameter independent of femoral head centers for measurement, was previously described to strongly correlate withpelvic incidenceon two-dimensional examination of normal healthy subjects. However, the associationbetween anatomical sacral slope and pelvic incidence was unclear in patients withdevelopmental dysplasia of the hip. Thecurrent study aimed to examine the association between anatomical sacral slope and other spinopelvic parameters on plain radiographs in female patients with developmental dysplasia of the hip. Methods:Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope, which was deemedthe angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane, were determined by plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and interrater intraclass correlation coefficients were evaluated forreliability.Results:A strong association was observed between pelvic incidence and anatomical sacral slope (r=0.725, pr=0.661, pr=0.554, pConclusions:We found that the strong association between anatomical sacral slope and pelvic incidence wasequal to that in normal,healthy subjects. The associationbetweenanatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient value foranatomical sacral slope was slightlyhigher than that forpelvic incidence. We thusconclude that anatomical sacral slope can be considered a helpful anatomical pelvic parameter that isasubstitute for pelvic incidence not only in normal subjectsbut also in patients with developmental dysplasia of the hip.

Background The anatomical sacral slope is considered as an anatomical pelvic parameter independent of femoral head centers for measurement of anatomical sacral slope and was previously described to strongly correlate with pelvic incidence on a two-dimensional examination of healthy subjects. However, the correlation between anatomical sacral slope and pelvic incidence was unclear in patients with developmental dysplasia of the hip. This study aimed to examine the correlation between anatomical sacral slope and other spinopelvic parameters by analyzing plain radiographs of female patients with developmental dysplasia of the hip. Methods Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope (the angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane) were determined by analyzing plain radiographs. The correlations were examined by Pearson’s correlation coefficients, and intra- and inter-rater intraclass correlation coefficients were evaluated for reliability. Results A strong correlation was observed between pelvic incidence and anatomical sacral slope (r = 0.725, p < 0.001). In addition, the correlation between anatomical sacral slope and lumbar lordosis was similar to that between pelvic incidence and lumbar lordosis (r = 0.661, p < 0.001, and r = 0.554, p < 0.001, respectively). The intra-rater intraclass correlation coefficient values were 0.869 and 0.824 for anatomical sacral slope and pelvic incidence, respectively. Furthermore, the inter-rater intraclass correlation coefficient values were 0.83 and 0.685 for anatomical sacral slope and pelvic incidence, respectively. Conclusions We observed that the strong correlation between anatomical sacral slope and pelvic incidence in patients with developmental dysplasia of the hip was equal to that in normal healthy subjects. The correlation between anatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient values for the anatomical sacral slope were slightly higher than those for pelvic incidence. Thus, we conclude that anatomical sacral slope can be considered as a helpful anatomical pelvic parameter that is a substitute for pelvic incidence not only in normal healthy subjects, but also in patients with developmental dysplasia of the hip.

Background It has been previously reported that manual calf massage and passive ankle motion after total hip arthroplasty could reduce the incidence of venous thromboembolism. However, a combination of chemical and mechanical prophylaxes was employed. In this study, we aimed to examine the effect of mechanical prevention without pharmacological antithrombotic intervention. Methods Of the 313 patients who underwent unilateral primary total hip arthroplasty and received passive ankle motion and calf massage postoperatively at our hospital between January 2015 and December 2019, 261 (58 men, 203 women; mean age 62.1 years) were included in this retrospective study. Pharmacological anticoagulation therapy was administered in 176 patients (combination group); 137 patients only underwent calf massage and passive ankle motion without anticoagulation therapy (single group). The study outcomes were operation time, the incidence of deep vein thrombosis, pulmonary thromboembolism, intraoperative bleeding, estimated actual blood loss, blood transfusion, and major bleeding. Results No significant differences were found in sex, age, side, platelet counts, activated partial thromboplastin time, prothrombin time, prothrombin time - International Normalized Ratio, intraoperative blood loss, estimated blood loss, and operation time. Moreover, the incidence of deep vein thrombosis, pulmonary thromboembolism, and intraoperative bleeding was not significantly different between the groups (deep vein thrombosis 4.0% vs. 6.3%, p = 0.244; pulmonary thromboembolism 0.7% vs. 0%, p = 0.548; and intraoperative bleeding 394 ± 173.6 ml vs. 365.4 ± 168.5 ml, p = 0.550). However, estimated actual blood loss and postoperative bleeding differed between the groups (eABL 996.6 ± 348.3 ml vs. 858.5 ± 269.6 ml, p = 0.003; postoperative bleeding 601.8 ± 330.0 ml vs. 492.1 ± 277.1 ml, p = 0.016), and both increased in the combination group. No major bleeding was noted in the two groups. Conclusion Postoperative anticoagulant therapy does not have to be routinely used if mechanical prophylaxis is performed in patients without deep vein thrombosis before total hip arthroplasty.

Background The purpose of this study is to measure pelvic morphology with respect to the pelvic incidence, pelvic tilt, and sacral slope using 3-dimensional measurement and to compare the pelvic morphology between the normal population and women with developmental dysplasia of the hip (center-edge angle, Methods We evaluated 61 healthy women without low back or knee pain and 71 patients with developmental dysplasia of the hip. We used the 3-dimensional pelvis model adjusted to the anterior pelvic plane and measured the pelvic parameters. To determine correlation, we used Pearson's coefficients. To evaluate variation, we used intraclass correlation coefficients. Results Pelvic incidence and anatomical pelvic tilt were significantly greater by 4° in the group with developmental dysplasia of the hip than in the normal group (p = 0.026 and 0.88. Conclusion Pelvic incidence and anatomical-pelvic tilt were significantly greater in patients with developmental dysplasia of the hip. We found a strong correlation between the pelvic incidence and anatomical sacral slope in both groups. Therefore, anatomical-sacral slope may be useful for estimating pelvic incidence because it is not easily measured, especially in patients with osteoarthritis of the hip joint.

Highlights • Unlike type 2, type 1 hallux interphalangeal joint dislocation is easy to miss. • Excision of the sesamoid bone is unnecessary. • External fixation for 3 weeks or K-wire fixation for 4 weeks is sufficient., Introduction The common treatment for hallux interphalangeal joint dislocation is closed reduction, but some cannot be reduced by interposition of the sesamoid or the plantar plate in the interphalangeal joint, and such cases need open reduction. Presentation of case In case 1, the patient was a 17-year-old boy who was injured when a motorcycle fell on his right hallux. X-ray revealed Miki type 2 IP joint dislocation. Because closed reduction failed, open reduction via the dorsal approach to the hallux IP joint was performed. In case 2, the patient was a 17-year-old boy who was hit by a car whilst walking. X-ray revealed Miki type 2 dorsal dislocation of the hallux IP joint. After closed reduction, X-ray and CT revealed that the IP joint dislocation changed from Miki type 2 to type 1. Open reduction was performed through the dorsal approach. Discussion Fifteen cases of Miki type 2 changed to type 1 after closed reduction, and type 1 dislocation is often overlooked, leading to some chronic cases. X-rays should be performed after repositioning, specifically in lateral and oblique views. Conclusion We experienced two cases of irreducible dislocation of the hallux IP joint. One of our cases was reclassified from Miki type 2 to type 1, but we did not overlook the failed closed reduction, as we performed CT. Hence, we recommend additional lateral-view X-rays and/or CT imaging.

Alpha-linolenic acid (ALA)-enriched diacylglycerol (DAG) oil is an edible oil enriched with DAG (>80%) and ALA (>50%). The present study investigated whether ALA-DAG oil promotes tumorigenesis in the tongue and gastrointestinal tract, using a rat medium-term multi-organ carcinogenesis bioassay model. Rats were treated with five genotoxic carcinogens to induce multi-organ tumorigenesis until week 4, and from 1 week after withdrawal, fed a semi-synthetic diet (AIN-93G) containing ALA-DAG oil at concentrations of 0, 13,750, 27,500, and 55,000 ppm. Rats fed AIN-93G containing 55,000 ppm ALA-triacylglycerol or a standard basal diet served as reference and negative control groups, respectively. Animals were euthanized at week 30. ALA-DAG oil was shown to have no effects on survival, general condition, body weight, food consumption, or organ weight. More discolored spots were observed in the stomachs of the 13,750- and 55,000-ppm ALA-DAG groups than in those of the control groups; however, there were no differences in the frequency of histopathological findings across groups. There were no meaningful increases in the incidence of pre-neoplastic and neoplastic lesions in the tongue and gastrointestinal tract among the groups. We therefore conclude that ALA-DAG oil does not promote tumor development in the digestive system.

Short-term alternatives to traditional 2-year carcinogenic studies in rodents are being actively pursued. Recently, a 26-week short-term carcinogenicity study using CB6F1-Tg rasH2@Jcl (rasH2) mice has become a worldwide standard for the evaluation of chemical carcinogenesis. However, an acceptable short-term carcinogenic study model for dermally applied products is still lacking. To investigate the suitability of using the rasH2 mouse to test carcinogenic potential, 1,2-dichloroethane (1,2-DCE) was dermally applied to rasH2 mice: 1,2-DCE is a known carcinogen that causes lung bronchiolo-alveolar adenomas and adenocarcinomas when administered topically, orally, or by inhalation exposure; 1,2-DCE at a dose level of 126 mg/mouse in 200 μl acetone or acetone alone (vehicle control) was applied to the dorsal skin of 10 mice of each sex 3 times a week for 26 weeks. As a positive control, 10 mice of each sex received a single intraperitoneal injection of 75 mg/kg of N-methyl- N-nitrosourea. Bronchiolo-alveolar adenomas and adenocarcinomas were significantly increased in 1,2-DCE-treated rasH2 mice of both sexes, and bronchiolo-alveolar hyperplasias were significantly increased in female mice. Overall, almost all mice of each sex developed adenomas and/or adenocarcinomas with 100% of female rasH2 mice developing bronchiolo-alveolar adenocarcinomas.

Highlights • An isolated fracture through the radial bicipital tuberosity is rare. • The posterior approach has lower complication and is suitable for this fracture. • IM nailing is not recommended in fractures through the radial bicipital tuberosity., Introduction Generally, anatomical reduction of shaft fractures through operative treatment is necessary to restore the anatomical relationship of the forearm bones. However, a number of nerves and vessels are located in the proximal radius, which complicates surgery. In this study, we aimed to reduce postoperative complications by using a posterior approach. Presentation of case We describe an isolated fracture through the radial bicipital tuberosity in a 69-year-old man caused by direct blunt force and our management of the fracture. The patient underwent an operation for the fracture under brachial plexus block. The injury was explored using the posterior approach, and plate fixation was performed after confirming the absence of obstacles to rotation on pronation and supination. One year later, the patient did not have any difficulties in activities of daily living. Discussion Since an isolated fracture through the radial bicipital tuberosity is more distal than the radial head and neck and more proximal than a common radius diaphysis fracture, we had to consider a different operative approach. The nerve and blood vessels of the forearm, such as the radial nerve and artery, run in a complicated fashion around the proximal radius; thus, we chose the posterior approach because of its simpler surgical technique and lower complication risk, compared with the anterior approach. Conclusion Surgeons can obtain a favorable treatment result using the posterior approach to the fracture and reduce complications by ensuring with rigid fixation using a locking plate.

BackgroundIt was previously reported that pelvises with developmental dysplasia of the hip are tilted anteriorly, which increases bony coverage of the femoral head. This study aimed to investigate the correlation between anatomical parameters of the pelvis such as pelvic incidence and anatomical pelvic tilt and functional parameters of the spine and pelvis such as tilt of the anterior pelvic plane.MethodsWe examined 84 female patients with bilateral developmental dysplasia of the hip who had undergone curved periacetabular osteotomy at author’s institution. Radiographs of the thoracic to lumbar spines and the pelvis were obtained in the standing position to measure spino-pelvic parameters before surgery. Morphological parameters of the acetabulum such as the anterior center-edge (CE) angle, posterior CE angle, lateral CE angle, and acetabular anteversion were measured using a preoperative three-dimensional pelvic model reconstructed from computed tomography images. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters.ResultsWith regard to correlations between pelvic incidence (PI) and other parameters, the sacral slope (SS) value (r = 0.666) was the highest among functional parameters and the anatomical-SS value (r = 0.789) was the highest among morphological parameters. There were moderate correlations of the anterior pelvic plane angle (APPA) with pelvic tilt (PT) (r = − 0.594) and anatomical-PT (r = 0.646). With regard to correlations between spino-pelvic parameters and bony morphological parameters of the acetabulum, there was a moderate correlation between anatomical-PT and acetabular anteversion (AA) (r = 0.424). There were moderate correlations of APPA with the anterior CE angle (r = − 0.478), posterior CE angle (r = 0.432), and AA (r = 0.565). APPA had a stronger correlation with anatomical-PT (r = 0.646) than with AA.ConclusionsThe tilt of the pelvis may be more dependent on anatomical-PT, a morphological parameter of the pelvis, than the lateral CE angle, anterior CE angle, posterior CE angle, and acetabular anteversion on bony coverage of the acetabulum. This study is the first to investigate the correlation between functional parameters of the pelvis and spine and morphological parameters of the pelvis and acetabulum besides PI.

Background Sagittal spinal balance and standing posture are affected by pelvic morphology, especially pelvic incidence (PI). However, it is not difficult to identify the hip center because of overlap of the pelvis, image contrast, and soft tissue artifacts. Measurements of PI are not always suitable in all patients, especially those with osteoarthritis of the hip joint whose femoral head is nonspherical, subluxed, or dislocated. We measured PI, pelvic tilt (PT), and sacral slope (SS) as anatomical parameters using a novel three-dimensional measurement in order to compare the pelvic morphology between normal, healthy men and women. Methods In this cross-sectional study, we evaluated 108 Japanese subjects (55 men, 53 women) without low back or knee pain. We used the three-dimensional pelvis model adjusted to the anterior pelvic plane and measured the pelvic parameters. The subjects were stratified by age ( 0.87. Conclusions We found a strong correlation between PI and anatomical-SS in men and women. This novel measurement concept may be useful to estimate PI from anatomical-SS because the measurements of PI are not always suitable in all patients, especially those with osteoarthritis of the hip joint whose femoral head is not spherical or whose femoral head is subluxed or dislocated. This is the first report to describe the relationship between PI, anatomical-PT, and anatomical-SS as morphologic parameters with a high interclass correlation coefficient for intraobserver and interobserver reliabilities.

Although the likelihood of exposure to leaking intermediate frequency magnetic fields (MFs) from electronic devices, such as induction-heating and wireless power transfer systems, has increased, biological data assessing the health risks associated with human exposure remain insufficient. We examined the carcinogenicity of a 20 kHz MF, a typical frequency produced by induction-heating cookers, using a transgenic rasH2 mouse model. Twenty-five male and female CByB6F1-Tg(HRAS)2Jic mice were exposed to a 0.20 mT, 20 kHz MF (22 h/day) or sham-exposed for 26 weeks. As a positive control, 10 male and female rasH2 mice from the same batch were administered a single intraperitoneal injection of 75 mg/kg N-methyl-N-nitrosourea. A blinded histopathological evaluation was performed, and the same experiments were conducted twice, independently, to confirm the reproducibility of the results. Histopathological examination revealed that spontaneous neoplastic lesions, such as splenic hemangiosarcomas and gastric squamous cell papillomas, were less (1-3 per group) in the MF- and sham-exposed groups. The frequency of the neoplastic lesions was not significantly different between the groups. Eight to ten mice in each positive-control group exhibited malignant lymphoma. The outcomes were consistent between duplicated experiments, which indicates lack of carcinogenicity of 20 kHz MF in the rasH2 mouse model. Bioelectromagnetics. © 2019 The Authors. Bioelectromagnetics Published by Wiley Periodicals, Inc.

In obese patients, malpositioning of the acetabular cup increases the risk of dislocation in total hip arthroplasty (THA). The aim of this study was to determine whether obesity affects the accuracy of acetabular cup positioning using a computed tomography (CT)-based navigation system.We retrospectively evaluated 226 consecutive patients who underwent cementless primary THAs assisted by the CT-based hip navigation system. We divided the patients into three groups according to body mass index (BMI) and examined the difference between preoperative planning and postoperative implantation angles from CT data.There was no significant correlation between BMI and both inclination and anteversion differences (R = 0.028 and R = 0.045, respectively). There were no significant differences among the BMI 25, 25 ≦ BMI 30, and BMI ≧ 30 groups (p value: 0.725, 0.934, respectively); between the BMI 25 and BMI ≧ 25 groups (p value: 0.542, 0.697, respectively); and between the BMI 30 and BMI ≧ 30 groups with regard to inclination and anteversion (p value: 0.859, 0.456, respectively). Moreover, similar findings were observed with regard to the distance between the preoperative planning and postoperative cup positioning for the transverse, anteroposterior, and craniocaudal axes of the pelvis.We found that the accuracy of acetabular cup placement using CT based-navigation in THA was not affected in obese patients. Therefore, THAs with a CT-based navigation system are considered useful in obese patients.

Background The kidney is a major target organ for systemic amyloidosis, which results in proteinuria and an elevated serum creatinine level. The clinical manifestations and precursor proteins of amyloid A (AA) and light-chain (AL) amyloidosis are different, and the renal damage due to amyloid deposition also seems to differ. Objectives The purpose of this study was to clarify haw the difference in clinical features between AA and AL amyloidosis are explained by the difference in the amount and distribution of amyloid deposition in the renal tissues. Methods A total of 119 patients participated: 58 patients with an established diagnosis of AA amyloidosis (AA group) and 61 with AL amyloidosis (AL group). We retrospectively investigated the correlation between clinical data, pathological manifestations, and the area occupied by amyloid in renal biopsy specimens. In most of the renal specimens the percentage area occupied by amyloid was less than 10%. For statistical analyses, the percentage area of amyloid deposition was transformed to a common logarithmic value (Log10%amyloid). Results The results of sex-, age-, and Log10%amyloid-adjusted analyses showed that systolic blood pressure (SBP) was higher in the AA group. In terms of renal function parameters, serum creatinine, creatinine clearance (Ccr) and estimated glomerular filtration rate (eGFR) indicated significant renal impairment in the AA group, whereas urinary protein indicated significant renal impairment in the AL group. Pathological examinations revealed amyloid was predominantly deposited at glomerular basement membrane (GBM) and easily transferred to the mesangial area in the AA group, and it was predominantly deposited at in the AL group. The degree of amyloid deposition in the glomerular capillary was significantly more severe in AL group. The frequency of amyloid deposits in extraglomerular mesangium was not significantly different between the two groups, but in AA group, the degree amyloid deposition was significantly more severe, and the deposition pattern in the glomerulus was nodular. Nodular deposition in extraglomerular mesangium leads to renal impairment in AA group. There are significant differences between AA and AL amyloidosis with regard to the renal function, especially in terms of Ccr, eGFR and urinary protein, even after Log10%amyloid was adjusted; showing that these inter-group differences in renal function would not be depend on the amount of renal amyloid deposits. Conclusions These differences could be explained by the difference in distribution and morphological pattern of amyloid deposition in the renal tissue. References [1] Kuroda T, et al. Significant association between renal function and area of amyloid deposition in kidney biopsy specimens in reactive amyloidosis associated with rheumatoid arthritis. Rheumatol Int. 2012;32:3155–3162. [2] Kuroda T, et al. Significant association between renal function and area of amyloid deposition in kidney biopsy specimens in both AA amyloidosis associated with rheumatoid arthritis and AL amyloidosis. Amyloid2017:14:1–8. Acknowledgements This work was supported by JSPS KAKENHI Grant Number 17 K09973. Disclosure of Interest None declared