Association between adductor pollicis muscle thickness and low skeletal muscle mass index in community-dwelling older women undergoing outpatient rehabilitation.

OBJECTIVE: The performance of sarcopenia diagnosis using adductor pollicis muscle thickness (APMT) has been reported. However, the relationship between APMT and low skeletal muscle mass index (SMI) is unclear. The purpose of this study is to investigate the relationship between APMT and low SMI and APMT performance to diagnose low SMI in community-dwelling older women undergoing outpatient rehabilitation. METHODS: This study included 65 older women (mean age: 86.4 years). Subjects were received outpatient rehabilitation one to three times a week. The main outcomes were low SMI as diagnosed using the Asian working group for sarcopenia 2019 and APMT. Logistic regression analysis was performed with low SMI as the dependent variable, APMT, and propensity score calculated using age, sex, number of medications, and updated Charlson comorbidity index as the independent variable. A receiver operating characteristic (ROC) curve of APMT for low SMI was created. A cut-off value was calculated using the Youden index. RESULTS: Among the 65 subjects, 45 (69.2 %) had low SMI. The results of the logistic regression analysis showed a significant association between APMT and low SMI (odds ratio: 0.482 {95 % confidence interval [CI]: 0.313-0.744}). The cut-off value of APMT calculated from the ROC curve was 13 mm. The sensitivity and specificity of this cut-off value were 0.800 (95 % CI: 0.654-0.904) (36 out of 45 subjects) and 0.850 (95 % CI: 0.621-0.968) (17 out of 20 subjects), respectively. The positive predictive value, negative predictive value, and area under the curve were 0.923 (95 % CI: 0.791-0.984), 0.654 (95 % CI: 0.443-0.828), and 0.843 (95 % CI: 0.731-0.955), respectively. The APMT cut-off value of 13 mm is good to identify low SMI. CONCLUSIONS: The results of this study show that APMT is associated with low SMI. Furthermore, the cut-off value of APMT for diagnosing low SMI was 13 mm. The APMT cut-off value of 13 mm is good to identify low SMI. Our findings indicate that measuring APMT is useful for diagnosing low SMI in community-dwelling older women undergoing outpatient rehabilitation.

Association between anorexia as assessed by simplified nutritional appetite questionnaire and sarcopenia in community-dwelling older adults using outpatient rehabilitation: A cross-sectional study.

OBJECTIVE: A previous study reported an association between sarcopenia and anorexia determined by the simplified nutritional appetite questionnaire (SNAQ) in community-dwelling older adults. However, it is unclear in the community-dwelling older adults who are using outpatient rehabilitation. The purpose of this study was to investigate the relationship between anorexia and sarcopenia as judged by SNAQ in community-dwelling older adults using outpatient rehabilitation. METHODS: This study included 120 older adults (72.5% female). Subjects were provided outpatient rehabilitation one to three times a week. The main outcome was sarcopenia as determined using the Asian working group for sarcopenia 2019. The simplified nutritional appetite questionnaire (SNAQ) was used to assess anorexia. The SNAQ total score range from 4 (worst) to 20 (best), with 13 score and lower considered to indicate anorexia. Statistical analysis was performed by forced-entry logistic regression analysis with sarcopenia as the dependent variable, body mass index (BMI), food intake level scale, anorexia, and propensity score calculated using age, sex, number of medications, updated Charlson comorbidity index as the independent variable. RESULTS: Sarcopenia was observed in 79 of 120 subjects (65.8%). Anorexia was observed in 28 subjects (23.3%). Logistic regression analysis revealed BMI (odds ratio: 0.71 [95% CI: 0.61-0.84]), anorexia (odds ratio: 5.35 [95% CI: 1.24-23.2]) were extracted as a significant variable. CONCLUSIONS: The results of this study show that anorexia as determined by the SNAQ is associated with sarcopenia in community-dwelling older adults using outpatient rehabilitation. This indicates the importance of understanding anorexia in assessing sarcopenia in community-dwelling older adults who are using outpatient rehabilitation.

Accuracy of determining sarcopenia using SARC-CalF in community-dwelling older adults aged 75 years and older.

OBJECTIVE: The accuracy of sarcopenia determination using SARC-CalF in community-dwelling older adults has been clarified in previous studies. However, this accuracy is unknown for subjects older than 75 years old. If this becomes clear, it will show the usefulness of using SARC-CalF in determining sarcopenia in community-dwelling older adults aged ≥75 years old. Thus, this study aimed to investigate the accuracy of sarcopenia determination using SARC-CalF in community-dwelling older adults aged ≥75 years old. METHODS: This study included 102 older adults aged ≥75 years old (74.5% female). Subjects were provided outpatient rehabilitation one to three times a week. The Asia Working Group for Sarcopenia 2019 standard was used to determine sarcopenia in participants. Logistic regression analysis was performed with sarcopenia as the dependent variable, and age, sex, and SARC-CalF as independent variables. When SARC-CalF was extracted as a significant variable, a receiver operating characteristic (ROC) curve was created. The cut-off value was calculated using the Youden index. RESULTS: Sarcopenia was observed in 65 of 102 subjects. Logistic regression analysis showed that only SARC-CalF was extracted as a significant variable (odds ratio: 1.18 [95% CI: 1.09-1.29]). The cut-off value calculated from the ROC curve was seven points. The sensitivity and specificity were 94.7% and 92.3%, respectively, and the area under the curve was 0.98. CONCLUSIONS: Our results indicate that SARC-CalF can accurately determine sarcopenia in older adults. A SARC-Calf cut-off value of seven may be more useful than 11 in determining sarcopenia in community-dwelling older adults aged ≥75 years old.

The effect of compound nasal surgery on obstructive sleep apnea syndrome.

BACKGROUND: Nasal surgery often fails to ameliorate the symptoms of obstructive sleep apnea syndrome (OSAS). We developed a compound nasal surgery (CNS) method that consists of septoplasty combined with submucosal inferior turbinectomy and posterior nasal neurectomy to ensure low nasal resistance during sleep. OBJECTIVE: To clarify the effect of CNS on OSAS, pre- and postoperative changes in sleep-related events were studied by using polysomnography, the Epworth sleepiness scale (ESS), the visual analog scale for snoring, and health-related quality of life (QOL). METHODS: Forty-five consecutive patients with OSAS and with nasal problems underwent CNS. Three months later, the postoperative effect on OSAS was assessed by using polysomnography findings, daytime sleepiness by the ESS, nasal allergy symptoms, and health-related QOL. Snoring was assessed by the family by using a visual analog scale. RESULTS: The indices of apnea, apnea-hypopnea, oxygen desaturation, and arousal; the ESS; allergic symptom score; health-related QOL; and snoring on a visual analog scale were all significantly improved. CONCLUSIONS: CNS improves OSAS events without any pharyngeal surgical procedure in selected patients. If high nasal resistance associated with OSAS is present, then CNS should thus be considered.

Nitrotyrosine in otitis media with effusion.

OBJECTIVES: Our purpose was to investigate mucosal cell injury due to the nitric oxide (NO)-superoxide system in otitis media with effusion. METHODS: We determined the levels of nitrotyrosine (NT) and NO and the activities of superoxide dismutase (SOD) and lactic dehydrogenase (LDH) in 90 middle ear fluid samples. RESULTS: The NT concentration was significantly higher in group A (<16 years old) than in group C (>50 years old; p < .05), and significantly higher in the acute group than in the chronic group (p < .05). The NO concentration did not show a significant difference among the groups. The activity of SOD showed significant correlations with the concentrations of NT and NO and with LDH activity (p < .05). The LDH activity was significantly greater in group A than in group C (p < .05). CONCLUSIONS: Our results indicate involvement of the NO-superoxide system in the pathogenesis of otitis media with effusion, showing evidence of protein and/or cell injury in the middle ear.

Determination of nitrotyrosine and related compounds in biological specimens by competitive enzyme immunoassay.

A gas mediator, nitric oxide is converted to peroxynitrite in the presence of superoxide anion. Peroxynitrite is a potent oxidant, which injures various tissues and organs by nitration of the tyrosine residues of proteins, and it enhances the late response of inflammation. The determination of nitrated tyrosine, nitrotyrosine, which is a stable final metabolite of peroxynitrite, provides an important indicator of tissue disorders caused by peroxynitrite. This paper reports a competitive solid-phase immunoassay for measuring nitrotyrosine in various biological specimens. In this study, peroxidase-conjugated nitrotyrosine was prepared by reaction of nitrotyrosine with 1,4-benzoquinone treatment, and then it was allowed to compete with nitrotyrosine on an anti-nitrotyrosine antibody-coated 96-well multiplate. No amino acids or related compounds tested in the experiments interfered with the immune reaction of nitrotyrosine, except cysteine, which only slightly inhibited the immune reaction at the concentrations higher than 1000 times the concentration of nitrotyrosine. The limit of detection of free nitrotyrosine was approximately 500 pg/mL (2 nM) at a competition ratio (B/B(o)%) of 80%. The newly developed enzyme immunoassay (EIA) method was used for assay of nitrotyrosine in biological specimens, with the following results: (i) Lipopolysaccharide (LPS) activation of RAW264.7 cells induced a significant increase in nitrotyrosine production compared to that with nonactivated cells. N(omega)-nitro-L-arginine methyl ester decreased nitrotyrosine production with either LPS-activated or nonactivated RAW cells. There is a relationship between nitrotyrosine production and nitrite ion. (ii) The nitrotyrosine level detected in the plasma specimens from healthy volunteers was 35.21 +/- 4.87 ng/mL (135.4 +/- 18.7 nM). (iii) The concentration of nitrotyrosine in the nasal lavage fluid of allergic rhinitis patients was 41.40 +/- 20.96 ng/mL (159.02 +/- 80.6 nM). Thus, the EIA method combines sensitivity and specificity with the ability to process a large number of specimens to quantify nitrotyrosine produced with in vivo and in vitro sources.