Relationship between the floating toe and the center-of-pressure position in an upright posture among students.

[Purpose] The incidence of floating toes in children is increasing. Although the anteroposterior center of pressure in children is present posteriorly, its relationship with the floating toe is unclear. This study aimed to clarify the relationship between the position of the anteroposterior center of pressure and the floating toe in an upright posture in children. [Participants and Methods] In this cross-sectional study, a Win-Pod (Medicapteurs) platform was used to measure the position of the anteroposterior center of pressure in 208 boys and 195 girls from Japanese elementary schools. Using images of the plantar footprint, floating toes were assessed and the floating toe score was calculated. [Results] The anteroposterior center of pressure position was situated 32.3 ± 8.2% from the heel. The floating toe score of all the participants was 3.5 ± 2.4, with a very high rate of 98%. The floating toe score had a significant, moderate correlation with age, height, weight, and the anteroposterior center-of-pressure position. Multivariate analysis revealed an association between the floating toe score and the anteroposterior center-of-pressure position, height, and weight. [Conclusion] There is significant relationship between the anteroposterior center-of-pressure position and the floating toe score in an upright posture in Japanese elementary school students.

Effects of Competition Level on the Prevalence and Incidence of Lumbar Disk Degeneration in Japanese Collegiate Gymnasts.

Background: Lumbar disk degeneration (LDD) occurs frequently in athletes. Researchers have found that LDD occurs mainly in the lower disks (L4/L5 and L5/S1) in the general and athletic populations. However, a retrospective study showed a high prevalence of LDD in the upper lumbar disks (L1/L2), especially in elite gymnasts. Purpose: To investigate the effect of competition level on the prevalence and incidence of LDD in the upper lumbar disks (L1/L2). Study Design: Cross-sectional study; Level of evidence, 3; and cohort study; Level of evidence, 2. Methods: We conducted 2 studies to evaluate the effect of competition level on the prevalence and incidence of LDD in Japanese collegiate gymnasts. In study 1, a cross-sectional study of 298 collegiate gymnasts was conducted between 2011 and 2015. Competition levels were categorized as regional, national, and international, and T2-weighted magnetic resonance imaging (MRI) was used to evaluate LDD. Chi-square testing was applied to assess differences in the prevalence of LDD and spinal levels among the 3 competition levels. In study 2--a prospective cohort study--LDD progression and its related risk factors were investigated in 51 collegiate gymnasts. Baseline lumbar MRI scans and measurements of physical function (generalized joint laxity and finger-floor distance test) were performed in March 2014. Follow-up lumbar MRI scans were obtained 2 years later, in February 2016. Logistic regression analyses were performed to investigate the relationship between competition level and LDD progression. Results: In study 1, the prevalence of at least 1 degenerated disk in the regional, national, and international groups was 44.2% (19/43), 44.7% (98/219), and 52.8% (19/36), respectively (P = .655). The prevalence of LDD at L1/L2 in the international group was significantly higher than that in the other 2 groups (P = .018). In study 2, the presence of LDD at L1/L2 was associated significantly with international-level competition (adjusted odds ratio, 47.8; 95% CI, 2.75-830.50). Conclusion: In Japanese collegiate gymnasts, competing at the international level was found to be a risk factor for LDD at L1/L2.

Central Tendon Injury Impairs Regional Neuromuscular Activation of the Rectus Femoris Muscle.

We aimed to uncover which rectus femoris strain injury types affect regional activation within the rectus femoris. The rectus femoris has a region-specific functional role; the proximal region of the rectus femoris contributes more than the middle and distal regions during hip flexion. Although a history of strain injury modifies the region-specific functional role within the rectus femoris, it was not obvious which rectus femoris strain injury types affect regional activation within it. We studied 12 soccer players with a history of rectus femoris strain injury. Injury data were obtained from a questionnaire survey and magnetic resonance imaging. To confirm the region-specific functional role of the rectus femoris, surface multichannel electromyographic signals were recorded. Accordingly, eight legs had a history of central tendon injury, four had a history of myofascial junction injury, and four had a healed strain injury. When the injury was limited to the central tendon, the region-specific functional role disappeared. The region-specific functional role was confirmed when the injury was outside the central part. The neuromuscular function was also inhibited when the longitudinal range of the injured region was long. Our findings suggest that a central tendon injury with a long injury length impairs regional neuromuscular activation of the rectus femoris muscle.

Fabrication of GaN/Diamond Heterointerface and Interfacial Chemical Bonding State for Highly Efficient Device Design.

The direct integration of gallium nitride (GaN) and diamond holds much promise for high-power devices. However, it is a big challenge to grow GaN on diamond due to the large lattice and thermal-expansion coefficient mismatch between GaN and diamond. In this work, the fabrication of a GaN/diamond heterointerface is successfully achieved by a surface activated bonding (SAB) method at room temperature. A small compressive stress exists in the GaN/diamond heterointerface, which is significantly smaller than that of the GaN-on-diamond structure with a transition layer formed by crystal growth. A 5.3 nm-thick intermediate layer composed of amorphous carbon and diamond is formed at the as-bonded heterointerface. Ga and N atoms are distributed in the intermediate layer by diffusion during the bonding process. Both the thickness and the sp2 -bonded carbon ratio of the intermediate layer decrease as the annealing temperature increases, which indicates that the amorphous carbon is directly converted into diamond after annealing. The diamond of the intermediate layer acts as a seed crystal. After annealing at 1000 °C, the thickness of the intermediate layer is decreased to approximately 1.5 nm, where lattice fringes of the diamond (220) plane are observed.

The Effect of a Previous Strain Injury on Regional Neuromuscular Activation Within the Rectus Femoris.

The rectus femoris (RF) has a region-specific functional role; that is, the proximal region of the RF contributes more than the middle and distal regions during hip flexion. This study aimed to investigate whether RF strain injury affected the region-specific functional role of the muscle. We studied seven soccer players with a history of unilateral RF strain injury. Injury data were obtained from a questionnaire survey and magnetic resonance imaging (MRI). Multichannel surface electromyographic (SEMG) signals were recorded from the proximal to distal regions of the RF with 24 electrodes during isometric knee extension and hip flexion. The SEMG signals of each channel during hip flexion were normalised by those during knee extension for the injured and non-injured RF (HF/KE), and compared among the proximal, middle, and distal regions. Six RF strain injuries showed a low signal area in MRI. There was no significant difference in muscle strength between the injured and non-injured RF. While the HF/KE in the proximal region was significantly higher than those in the middle and distal regions in the non-injured RF, a difference in the HF/KE was seen only between the proximal and distal regions of the injured RF. Furthermore, the HF/KE of the most proximal channel in the injured RF was significantly lower than that in the non-injured RF. However, there was no significant difference between injured and non-injured areas in the HF/KE. Our findings suggest that the region-specific functional role of the RF muscle is partly affected by RF strain injury.

Association of COL11A1 4603C/T polymorphism with cervical disc degeneration in collegiate wrestlers.

BACKGROUND: The authors previously identified that COL11A1 gene polymorphism is not a susceptibility factor for lumbar disc degeneration (LDD) in athletes. However, the relationship between COL11A1 gene polymorphism and cervical disc degeneration (CDD) remains unclear. We hypothesized that significant associations between COL11A1 4603C/T gene polymorphism and CDD, but not LDD, in collegiate wrestlers exist. This study aims to examine the relationship between CDD, LDD, and COL11A1 4603C/T gene polymorphism in collegiate wrestlers. METHODS: The subjects enrolled in this study were 92 (Study-1) and 123 (Study-2) Japanese collegiate male wrestlers. Study-1 and Study-2 were conducted in 2010-2012 and 2012-2015, respectively. RESULTS: CDD and LDD prevalence among the wrestlers was 51.1% (47/92) and 43.9% (54/123), respectively. We found that COL11A1 4603C/T was significantly associated with CDD, but not with LDD. Using logistic regression analysis with concomitant confounding factors, we further confirmed that COL11A1 4603C/T was a significant risk factor for CDD (co-dominant genetic model [CC vs. CT+TT]: adjusted odds ratio [OR] 2.28; 95% CI: 1.13-4.59; dominant genetic model [CC+CT vs. TT]: adjusted OR 11.71; 95% CI: 1.36-101.06). CONCLUSIONS: Results suggest that COL11A1 4603C/T gene polymorphism is associated with an increased risk of CDD, but not LDD, in Japanese collegiate wrestlers.

Cervical Intervertebral Disc Degeneration and Low Cervical Extension Independently Associated With a History of Stinger Syndrome.

BACKGROUND: Stinger syndrome frequently occurs in athletes who compete in collision sports. Sharp pain and impairment of neck motion are major symptoms. Cervical intervertebral disc degeneration (CIDD) is also frequently observed in those who compete in collision sports. PURPOSE/HYPOTHESIS: To investigate whether CIDD and neck functionality are related to a history of stinger syndrome. The hypothesis was that a significant relationship exists between CIDD and neck motion and a history of stinger syndrome in Japanese collegiate football players. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 49 male Japanese collegiate football players (mean age, 20.0 ± 1.1 years; mean athletic experience, 3.8 ± 2.3 years; mean height, 172.3 ± 4.8 cm; mean weight, 83.1 ± 12.2 kg) were subdivided into athletes with stinger syndrome (stinger group) and those without (control group). Stinger syndrome was confirmed based on a questionnaire and interview. CIDD was assessed by using T2-weighted magnetic resonance imaging. Range of motion (ROM) and isometric muscle strength were measured for neck function testing. RESULTS: Thirty-nine percent (19/49) of athletes had at least 1 episode of stinger syndrome. The prevalence of CIDD was significantly higher in the stinger group (68%) than in the control group (30%) (P < .01). A statistically significant difference in cervical extension ROM was found between the stinger group (50.9° ± 11.1°) and the control group (60.2° ± 11.4°) (P < .01). Logistic regression analysis showed that CIDD and low cervical extension were independently associated with a history of stinger syndrome. CONCLUSION: Study results suggest that stinger syndrome is associated with CIDD and low cervical extension in collegiate football players.

Discovery of SMP-304, a novel benzylpiperidine derivative with serotonin transporter inhibitory activity and 5-HT1A weak partial agonistic activity showing the antidepressant-like effect.

We report the discovery of a novel benzylpiperidine derivative with serotonin transporter (SERT) inhibitory activity and 5-HT1A receptor weak partial agonistic activity showing the antidepressant-like effect. The 3-methoxyphenyl group and the phenethyl group of compound 1, which has weak SERT binding activity, but potent 5-HT1A binding activity, were optimized, leading to compound 35 with potent and balanced dual SERT and 5-HT1A binding activity, but also potent CYP2D6 inhibitory activity. Replacement of the methoxy group in the left part of compound 35 with a larger alkoxy group, such as ethoxy, isopropoxy or methoxy-ethoxy group ameliorated CYP2D6 inhibition, giving SMP-304 as a candidate. SMP-304 with serotonin uptake inhibitory activity and 5-HT1A weak partial agonistic activity, which could work as a 5-HT1A antagonist, displayed faster onset of antidepressant-like effect than a representative SSRI paroxetine in an animal model.

Asymmetrical and smaller size of trunk muscles in combat sports athletes with lumbar intervertebral disc degeneration.

BACKGROUND: Lumbar intervertebral disc degeneration (LDD) frequently occurs in athletes. Associations between LDD and trunk muscles still remain unclear. PURPOSE: This study examined whether there is an association between the prevalence of LDD and the symmetry and size of the cross-sectional areas (CSAs) of the trunk muscles in combat sports athletes. METHODS: Participants in this study were 151 collegiate male combat sports athletes. A total of 755 lumbar intervertebral discs from L1-2 to L5-S1 in 151 athletes were assessed using magnetic resonance imaging (MRI) and a comprehensive grading system of LDD (grades I-V). All 151 athletes were divided into 2 groups: LDD and non-LDD. CSAs of trunk muscles at the L3-4 disc level were measured using MRI. RESULTS: Sixty-nine athletes had LDD at 1 or more disc levels (45.7 %). The LDD grade for the lower 2 disc levels was significantly higher than that for the other disc levels (p < 0.001). The CSAs of the left and right sides in trunk muscles were significantly asymmetrical, independent of the LDD which was prevalent in the disc levels (obliques: p = 0.040; quadratus lumborum: p < 0.001). The relative CSAs of trunk muscles to their body weight in the LDD group were significantly smaller than those in the non-LDD group (rectus abdominis: p = 0.011; obliques: p = 0.024; quadratus lumborum: p = 0.006; lumbar erector spinae plus multifidus: p = 0.001). CONCLUSION: This study suggests that the prevalence of LDD is associated with asymmetrical and relatively smaller CSAs of trunk muscles in combat sports athletes.

Layer matching epitaxy of NiO thin films on atomically stepped sapphire (0001) substrates.

Thin-film epitaxy is critical for investigating the original properties of materials. To obtain epitaxial films, careful consideration of the external conditions, i.e. single-crystal substrate, temperature, deposition pressure and fabrication method, is significantly important. In particular, selection of the single-crystal substrate is the first step towards fabrication of a high-quality film. Sapphire (single-crystalline α-Al2O3) is commonly used in industry as a thin-film crystal-growth substrate, and functional thin-film materials deposited on sapphire substrates have found industrial applications. However, while sapphire is a single crystal, two types of atomic planes exist in accordance with step height. Here we discuss the need to consider the lattice mismatch for each of the sapphire atomic layers. Furthermore, through cross-sectional transmission electron microscopy analysis, we demonstrate the uniepitaxial growth of cubic crystalline thin films on bistepped sapphire (0001) substrates.

Evaluation of human epididymis protein 4 (HE4) and Risk of Ovarian Malignancy Algorithm (ROMA) as diagnostic tools of type I and type II epithelial ovarian cancer in Japanese women.

Human epididymis protein 4 (HE4) levels and the Risk of Ovarian Malignancy Algorithm (ROMA) have recently been shown to improve the sensitivity and specificity of epithelial ovarian cancer (EOC) diagnosis. We evaluated HE4 levels and ROMA as diagnostic tools of type I and type II EOC in Japanese women. Women who had a pelvic mass on imaging and were scheduled to undergo surgery were enrolled as ovarian mass patients. Serum levels of carbohydrate antigen 125 (CA125) and HE4 were tested in 319 women (131 benign, 19 borderline, 75 malignant, and 94 healthy controls). CA125, HE4, and ROMA were evaluated for sensitivity and by receiver operating characteristics (ROC) in type I and type II EOC. The results showed that, at 75% specificity, the sensitivity of CA125 and HE4 for type II was 92.1% for both markers and for type I was 51.5% and 78.8%, respectively. The sensitivities of ROMA (type I, 84.8% and type II, 97.4%) were better than those of CA125 and HE4. CA125, HE4, and ROMA were all highly accurate markers for type II. For type I, HE4 and ROMA showed better sensitivity than CA125. ROMA displayed the best diagnostic power for type I and type II including for the early stage of type I. In conclusion, HE4, CA125, and ROMA are valuable markers for type II EOC diagnosis. HE4 and ROMA analyses may improve differentiation between type I EOC and a benign mass. Measurement of combined HE4 and CA125 levels provides a more accurate method for EOC diagnosis.

Anterior Limbus Vertebra and Intervertebral Disk Degeneration in Japanese Collegiate Gymnasts.

BACKGROUND: Magnetic resonance imaging (MRI) studies have shown that gymnasts have a high prevalence of radiological abnormalities, such as intervertebral disk degeneration (IDD) and anterior limbus vertebra (ALV). These 2 abnormalities may coexist at the same spinal level. However, the relationship between IDD and ALV remains unclear. HYPOTHESIS: A significant relationship exists between IDD and ALV in Japanese collegiate gymnasts. STUDY DESIGN: Case-control study. METHODS: A total of 104 Japanese collegiate gymnasts (70 men and 34 women; age, 19.7 ± 1.0 years) with 11.8 ± 3.6 years of sporting experience participated. T1- and T2-weighted MRIs were used to evaluate ALV and IDD. RESULTS: The prevalence among the gymnasts of IDD and ALV was 40.4% (42/104) and 20.2% (21/104), respectively. The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test. Logistic regression analysis demonstrated a significant association between IDD and ALV (adjusted odds ratio [OR], 6.60; 95% confidence interval [CI], 2.14-20.35). IDD was further grouped by whether it was present in the upper lumbar region (L1-2, L2-3, and L3-4 disks) or in the lower lumbar region (L4-5 and L5-S1 disks). Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73). CONCLUSION: In Japanese collegiate gymnasts, ALV is a predictor of IDD, especially in the upper lumbar region. CLINICAL RELEVANCE: Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

Diagnosis and treatment of immunologically infertile women with sperm-immobilizing antibodies in their sera.

Detection of sperm-immobilizing antibodies in women may have relevance for diagnosis of immunological infertility. Infertile women in whom sperm-immobilizing antibodies are detected can be refractory to conventional treatments such as timed intercourse or intrauterine insemination (IUI) because the antibodies secreted in the female reproductive tract might impair sperm passage, inhibit fertilization, and prevent normal post-fertilization processes. Hence, manipulation of gametes and embryos from patients with sperm-immobilizing antibodies should be carried out with additional care to avoid fertilization failure resulting from the presence of antibodies during in vitro fertilization (IVF). Moreover, the reasons for the why majority of women do not develop sperm-immobilizing antibodies on exposure to sperm is not clear. The production of sperm-immobilizing antibodies is likely to occur in women with particular HLA haplotypes after repeated exposure to sperm. Characterization of sperm-immobilizing antibodies may help in the identification and characterization of sperm specific antigens that can be used as candidate antigens for the development of sperm based contraceptive vaccines.

Functional aspects of CD52 in reproduction.

CD52 is a GPI-anchored protein present in lymphocytes and male reproductive tissues (mrt) including mature sperm and seminal plasma. It has been shown that mrt-CD52 is synthesized in epithelial cells of the epididymis and vas deferens, but not in the testis. The mrt-CD52 is transported to mature sperm during sperm transition in the male reproductive tract. Lymphocyte CD52 functions to stimulate suppressor T cell induction, while mrt-CD52 is associated with seminogelin and involved in clot formation and liquefaction of semen. In a landmark study, a monoclonal antibody (Mab H6-3C4) from peripheral B lymphocytes of a patient with complement-dependent sperm-immobilizing antibody in the serum has been generated. Using Mab H6-3C4, the carbohydrate moiety of CD52 as an epitope for infertility-related antigen was identified. Mab H6-3C4 also shows strong complement-dependent sperm-immobilizing activity. This suggests CD52 may have a function in protecting sperm from complement activation. Indeed, purified mrt-CD52 from human sperm interferes with the classical pathway, but not lectin-binding or alternative pathways, of the complement systems. Recently, we found CD52 in ovulated cumulus cells from the female reproductive tissues (frt). The frt-CD52 is not recognized by Mab H6-3C4, suggesting that it harbors distinct carbohydrate antigenicity. Further studies are necessary to determine the molecular features and biological functions of CD52 in male and female reproductive tissues.

[Testicular tumor detected in a male infertility patient with prior orchiopexy].

A 37-year-old man was referred to our hospital with the chief complaint of infertility. Semen analysis at another clinic had demonstrated severe oligozoospermia and he had a history of bilateral orchiopexy for undescended testes. Scrotal ultrasonography revealed a hypoechoic heterogeneous mass (1.5 cm in diameter) within the left testis. With a provisional diagnosis of testicular tumor, left high orchiectomy was performed. Pathological examination of the tumor revealed seminoma. At 12 months after surgery, there has been no evidence of recurrence. Clinicians should be aware of the link between male infertility and testicular cancer, particularly following orchiopexy.

Harmful effects of anti-zona pellucida antibodies in folliculogenesis, oogenesis, and fertilization.

The zona pellucida (ZP) is an extracellular matrix that surrounds the mammalian oocyte and plays an important role in normal folliculogenesis and fertilization. Because of its strong immunogenicity and its possible relation with premature ovarian failure, we conducted the present study to examine whether or not anti-ZP antibodies impaired folliculogenesis. Mouse preantral follicles were cultured with anti-ZP antibodies to evaluate the effects on follicle growth and antral formation. The cultured follicles were also examined by electron microscope and assessed for oocyte maturation, fertilization capacity, and embryo development. The results showed that follicles cultured with anti-ZP antibodies had a smaller diameter than the controls. Also, these antibodies reduced antral formation, mucification, maturation of oocytes (metaphase II), and fertilization rates. Morphologically, ZP thickness was lower in the anti-ZP antibody groups. The quantity of granulosa cell microvillous processes that transverse the ZP was diminished in follicles cultured with anti-ZP antibodies. In conclusion, anti-ZP antibodies were harmful to the normal development of mouse follicles and oocytes in vitro. These antibodies may be a cause of premature ovarian failure syndrome because they disrupt the gap junctions between the oocyte and granulosa cells and, as a consequence, damage the bidirectional communication necessary for normal folliculogenesis.

A long-term user of cosmetic cream containing estrogen developed breast cancer and endometrial hyperplasia.

A 93-year-old woman was referred to our clinic for abnormal genital bleeding. It was found that she had endometrial hyperplasia and breast cancer. Her uterus was as large as that of a normal adult menstruating woman. She indicated that she had been applying cosmetic cream containing a low concentration of ethynylestradiol to her face and body three times a day for 75 years. It is possible that this long-term use of the ethynylestradiol-containing cream is related to the development of breast cancer and endometrial hyperplasia.

CD52 is synthesized in cumulus cells and secreted into the cumulus matrix during ovulation.

PROBLEM: Early studies have shown that an antibody to male reproductive tissue CD52 is a pathogenic factor of infertility. The molecule contains a unique carbohydrate antigen that induces antibodies interfering with sperm function. However, the characteristic properties of CD52 in female reproductive tissues are not known. We examined the expression and localization of CD52 in mature expanded cumulus masses. METHOD OF STUDY: Mouse cumulus oocyte complexes were collected from [C57B1/6; DBA/2] F1 female mice having a superovulation treatment. Human cumulus cells were obtained from infertile patients taking in vitro fertilization-embryo transfer treatment under informed consent. CD52 messenger RNA (mRNA) and protein were detected using RT-PCR, quantitative PCR, western blotting and immunohistochemical methods. RESULTS: CD52 mRNA was found both in the human and mouse cumulus cells. Mouse CD52 mRNA was detected in cumulus cells but not oocytes and significantly increased after ovulation. The expression of the molecule was also confirmed at the protein level. Immunostaining with anti CD52 peptide antibody revealed that CD52 is present in cumulus cells and the extracellular matrix. CONCLUSION: We first showed the expression of CD52 in human cumulus cells. CD52 has some functional roles around fertilization in females as well as in males.