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1.
Medicine (Baltimore) ; 99(7): e19138, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049835

RESUMO

The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.Finally, the mean age of these women was 26.6 ±â€Š5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ±â€Š9.3 mm and the normal women from other study were 105.0 ±â€Š7.9 mm, the comparison showed a significant difference (P < .001).Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.


Assuntos
Nádegas/diagnóstico por imagem , Distocia/etiologia , Músculo Esquelético/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Adolescente , Adulto , Nádegas/patologia , Nádegas/fisiopatologia , Feminino , Fibrose , Humanos , Músculo Esquelético/fisiopatologia , Ossos Pélvicos/patologia , Gravidez , Síndrome , Adulto Jovem
2.
Anticancer Res ; 40(2): 1175-1181, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014971

RESUMO

BACKGROUND/AIM: This study aimed to evaluate the association of sarcopenia and Clinical Outcomes with esophageal cancer under neoadjuvant chemoradiotherapy (CRT). PATIENTS AND METHODS: A retrospective study assessing patients with esophageal cancer who underwent CRT between 2001 and 2014 was conducted in the medical center. Hospital patients' records on sarcopenia and treatment outcomes were statistically analyzed. RESULTS: The sarcopenia group had significantly lower body mass index than the non-sarcopenia group. CRT-related severe adverse events with mucositis, fever, and neutropenic fever were greater in the sarcopenia group. Overall survival and disease-free survival were significantly better in the non-sarcopenia group. Sarcopenic patients who received nutritional support with enteral access had less severe mucositis. There was no difference in mortality of sarcopenia patients with nutritional support via enteral access or without. Moreover, sarcopenia and advanced tumor stage were independent factors for mortality outcome. CONCLUSION: Sarcopenia before CRT may be associated with increased toxicities and worse overall survival/ disease-free survival in esophageal cancer patients.


Assuntos
Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/mortalidade , Sarcopenia/etiologia , Sarcopenia/mortalidade , Idoso , Composição Corporal , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Terapia Neoadjuvante/efeitos adversos , Terapia Neoadjuvante/métodos , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Sarcopenia/diagnóstico , Análise de Sobrevida , Resultado do Tratamento
3.
Adv Exp Med Biol ; 1213: 165-176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030670

RESUMO

Advancements in musculoskeletal analysis have been achieved by adopting deep learning technology in image recognition and analysis. Unlike musculoskeletal modeling based on computational anatomy, deep learning-based methods can obtain muscle information automatically. Through analysis of image features, both approaches can obtain muscle characteristics such as shape, volume, and area, and derive additional information by analyzing other image textures. In this chapter, we first discuss the necessity of musculoskeletal analysis and the required image processing technology. Then, the limitations of skeletal muscle recognition based on conventional handcrafted features are discussed, and developments in skeletal muscle recognition using machine learning and deep learning technology are described. Next, a technique for analyzing musculoskeletal systems using whole-body computed tomography (CT) images is shown. This study aims to achieve automatic recognition of skeletal muscles throughout the body and automatic classification of atrophic muscular disease using only image features, to demonstrate an application of whole-body musculoskeletal analysis driven by deep learning. Finally, we discuss future development of musculoskeletal analysis that effectively combines deep learning with handcrafted feature-based modeling techniques.


Assuntos
Osso e Ossos/diagnóstico por imagem , Aprendizado Profundo , Interpretação de Imagem Assistida por Computador , Músculo Esquelético/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Humanos
4.
J Comput Assist Tomogr ; 44(1): 20-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939877

RESUMO

OBJECTIVES: The purpose of this study was to evaluate whether quantitative analysis of lower leg muscle enhancement measured from dynamic computed tomographic angiography (dyn-CTA) could be used for diagnosis of peripheral arterial occlusive disease. METHODS: Patients (N = 35) with known peripheral arterial occlusive disease underwent the dyn-CTA of calves first. Five minutes later, standard CTA of the peripheral runoff from the diaphragm to the toes was performed. A runoff score was assigned by radiologists as a reference standard for each of 4 lower leg artery segments. The lower leg muscle enhancement measured from the dyn-CTA was analyzed by using quantitative kinetic parameters, including initial enhancement (E1), peak enhancement (Epeak), and enhancement ratio (ER) calculated from average time attenuation curves. In addition, histogram of lower leg muscle enhancement was evaluated by using the first enhanced phase images. RESULTS: Lower extremities were diagnosed as a normal group (n = 22) with each vessel segment score equals to 1 or lower and runoff score, 7 or lower, and otherwise as an ischemia group (n = 48). Average ± SD E1 is 91.4% ± 8.5% and 82.3% ± 10.7%, Epeak is 122.7% ± 10.4% and 115.6% ± 11.1%, and ER is 0.75 ± 0.05 and 0.72 ± 0.09 for normal and ischemia group, respectively. Statistical analysis showed that average E1 and Epeak for the ischemia group were significantly lower (P < 0.05) than the normal group. The histogram analysis demonstrated that mean and median of muscle enhancement in the ischemia group were significantly smaller (P < 0.05), and coefficient of variation (CV) was significantly larger (P < 0.05) than the normal group. There were weak negative correlations (r = -0.42, P < 0.05) between runoff scores and E1 and Epeak, and weak positive correlation (r = 0.40, P < 0.05) between runoff scores and CV. The receiver operating characteristics analysis between the 2 groups had area under the curve of 0.77 and 0.76 for E1 and CV, respectively. CONCLUSIONS: Lower leg muscle enhancement measured from the dyn-CTA could be assessed quantitatively to assist diagnosis of ischemia in clinical practice.


Assuntos
Arteriopatias Oclusivas/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Extremidade Inferior/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Doença Arterial Periférica/diagnóstico por imagem , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação
5.
Int J Sports Med ; 41(1): 3-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31791089

RESUMO

This study evaluated the morphological changes of the lower limb and associated hemodynamic responses to different lower-body compression pressures (COMPs) in physically active, healthy individuals at rest. Each of the 32 participants underwent three trials with three different degrees of lower-body compression applied: "Low" (2.2±1.4 mmHg), "Medium" (12.9±3.9 mmHg), and "High" (28.8±8.3 mmHg). In each COMP, a cross-sectional area of leg muscles (CSAmuscle), subcutaneous fat (CSAfat), superficial vessels (SupV), deep arteries (DA), and deep veins (DV) at the calf, knee, and thigh levels were measured using magnetic resonance imaging (MRI). Additionally, blood pressure (BP), heart rate (HR), cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) were measured using Doppler ultrasound (USCOM®). With High COMP, calf CSAmuscle and SupV were smaller (p<0.01), whereas DA and DV were larger (p<0.05). Calf CSAfat, however, was similar among all COMPs. There were no major changes in CSAmuscle and CSAfat at knee and thigh levels. CO (3.2±0.9 L/min) and SV (51.9±16.4 mL) were higher (p<0.05) only with High COMP, but other hemodynamic variables showed no significant changes across different COMPs. The High COMP at the lower limb induces leg morphological changes and increases associated hemodynamic responses of physically active healthy individuals at rest.


Assuntos
Hemodinâmica/fisiologia , Extremidade Inferior/fisiologia , Meias de Compressão , Artérias/diagnóstico por imagem , Artérias/fisiologia , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Feminino , Frequência Cardíaca/fisiologia , Humanos , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiologia , Volume Sistólico/fisiologia , Gordura Subcutânea/irrigação sanguínea , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/fisiologia , Ultrassonografia Doppler , Resistência Vascular/fisiologia , Veias/diagnóstico por imagem , Veias/fisiologia , Adulto Jovem
6.
J Cardiovasc Surg (Torino) ; 60(6): 672-678, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31603293

RESUMO

BACKGROUND: Sarcopenia, commonly determined by measuring skeletal muscle mass index (SMI) at the third lumbar level, has been identified as a predictor of clinical outcome in a variety of diseases. For patients with peripheral arterial occlusive disease (PAOD), we hypothesized that lower extremity SMI (LESMI) might be a more precise predictor of outcome and the extent of chronic ischemia than the systemic muscle mass at the L3 level. We investigated the association between complete muscle volume and muscle area derived with single-slice 2-dimensional measurements in the legs to identify at which level cross-sectional single-slice measurements are most representative of the muscle volume and investigated whether LESMI is associated with systemic sarcopenia and PAOD severity. METHODS: Muscle volumes and areas were semiautomatically segmented from computed tomography (CT) scans of the affected and contralateral legs of 50 PAOD patients with Fontaine stage IIb and 50 PAOD patients with Fontaine stage IV. The muscle mass was determined for the complete volumes of the upper and lower legs and for cross-sectional slices at 40%, 50%, and 60% of the length of the femur and tibia. Patients were determined as sarcopenic based on sex-specific cut-off values at the L3 spinal segment. Two observers segmented 20 randomly selected patients to determine the interobserver reliability with the intraclass correlation coefficient. RESULTS: The correlation between the LESMI of the complete muscle volume and the three cross-sectional slices in all 200 upper and 200 lower legs was moderately strong to strong. Interobserver reliability of cross-sectional slice segmentation was excellent. The LESMI, both measured volumetrically and cross-sectionally, were significantly lower in patients with sarcopenia compared to patients without sarcopenia. The LESMI was lower in patients with Fontaine stage IV compared to patients with Fontaine stage IIb for both volumetric and cross-sectional measurements. CONCLUSIONS: Segmentation of skeletal muscle mass from cross-sectional single-slice CT in the upper and lower leg can accurately and precisely substitute complete volume segmentations. These findings warrant the use of measurements based on cross-sectional single-slice CT for assessing the LESMI. Patients with systemic sarcopenia are also at increased risk for muscle mass loss in the lower extremities. In the current study, LESMI was lower in patients with Fontaine class IV PAOD compared to patients with Fontaine class IIb PAOD. Future studies should assess the predictive value of the LESMI on clinical outcomes in PAOD patients.


Assuntos
Composição Corporal , Isquemia/diagnóstico por imagem , Extremidade Inferior/irrigação sanguínea , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Doença Arterial Periférica/diagnóstico por imagem , Sarcopenia/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Feminino , Humanos , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Atrofia Muscular/fisiopatologia , Variações Dependentes do Observador , Doença Arterial Periférica/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sarcopenia/fisiopatologia , Índice de Gravidade de Doença
7.
J Shoulder Elbow Surg ; 28(10): 2007-2016, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31540726

RESUMO

BACKGROUND: The purpose of this study was to evaluate the different treatment strategies for posterolateral and posteromedial elbow dislocation. METHODS: The study enrolled 21 patients with unstable simple elbow dislocation including 16 cases of posterolateral dislocation (PLDL) and 5 cases of posteromedial dislocation (PMDL). In patients with PLDL, the medial side was evaluated and repaired first, followed by the lateral side. In patients with PMDL, the lateral side was repaired first, followed by the medial side according to residual instability. RESULTS: Among the 16 cases of unstable PLDL, 7 of 9 presenting with complex combined tear of the ulnar collateral ligament (UCL) and flexor muscle on magnetic resonance imaging showed abnormality on valgus stress testing and UCL repair. Three of 7 cases required additional lateral collateral ligament complex (LCLC) repair. Two of 9 cases showing medial complex dual lesions had normal findings on valgus stress testing and were treated only with LCLC repair. Seven of 16 cases without medial complex dual lesion had normal findings on valgus stress testing, and only LCLC repair was performed. All 5 cases of unstable PMDL showed distraction-type LCLC injury on magnetic resonance imaging and required no additional UCL repair after LCLC repair. There were no cases of recurrent instability following this treatment algorithm. CONCLUSIONS: In unstable elbow dislocation, PLDL and PMDL are caused by different mechanisms following damage to different structures. Therefore, different strategies are needed to ameliorate the dislocation and instability.


Assuntos
Ligamento Colateral Ulnar/cirurgia , Articulação do Cotovelo/cirurgia , Luxações Articulares/cirurgia , Instabilidade Articular/cirurgia , Adulto , Algoritmos , Ligamento Colateral Ulnar/diagnóstico por imagem , Ligamento Colateral Ulnar/lesões , Articulação do Cotovelo/diagnóstico por imagem , Feminino , Humanos , Luxações Articulares/diagnóstico por imagem , Instabilidade Articular/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões , Reoperação , Adulto Jovem
8.
NeuroRehabilitation ; 45(2): 213-220, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31498134

RESUMO

BACKGROUND: With increased practice of real-time ultrasound imaging in the physical therapy profession, it is essential to evaluate the utility of its use post stroke. OBJECTIVE: Evaluate relationship of spastic brachialis muscle architectural parameters with clinical measures of upper extremity function and spasticity. METHODS: Eleven post stroke individuals with spasticity of the upper limb had their brachialis muscle pennation angle and fascicle length measured in the affected and unaffected upper arm, at rest. Involved side upper extremity Fugl-Meyer, Modified Ashworth Scale, and grip strength were collected and compared to muscle architectural parameters of affected and unaffected brachialis muscles. RESULTS: Affected side brachialis pennation angle was significantly greater than the unaffected side, and affected fascile length was significantly shorter than the unaffected side. Function levels were found to be significantly higher in those with greater fascile lengths and lower pennation angles. Higher Fugl-Meyer scores of the affected upper extremity were inversely correlated with lower Modified Ashworth Scale scores. CONCLUSIONS: An objective method of quantifying spasticity can assist in determining if functional gains made post stroke are due to compensations in movement, or due to physiological changes. Ultrasound imaging may be used as an alternative to the Modified Ashworth score to quantify muscular parameters in spastic muscles post stroke.


Assuntos
Movimento , Espasticidade Muscular/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Ultrassonografia , Extremidade Superior/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/fisiopatologia , Projetos Piloto , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia
9.
J Urol ; 202(6): 1143-1149, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31483713

RESUMO

PURPOSE: Skeletal muscle and fat mass indexes have emerged as easily obtained, objective and useful tools to assess susceptibility to unfavorable postoperative outcomes. We examined the association between skeletal muscle and fat mass indexes, and the discharge disposition after radical cystectomy. MATERIALS AND METHODS: In a retrospectively collected, single institution cohort we studied patients who underwent radical cystectomy with pelvic lymphadenectomy of primary, nonmetastatic muscle invasive bladder cancer between 2009 and 2015. Included patients had undergone adequate axial computerized tomography at the L3 level within 90 days prior to surgery. Skeletal muscle and fat mass indexes were measured on preoperative computerized tomography and relationships to the outcomes of interest were analyzed. Multivariable logistic regression analysis was performed to assess the effect of the skeletal muscle and fat mass indexes on the discharge disposition while controlling for age, comorbidities, complications and previous neoadjuvant chemotherapy. RESULTS: A total of 136 patients met study inclusion criteria. The median skeletal muscle index among women and men in our study cohort was 36.4 and 47.6 cm2/m2, respectively. On multivariable logistic regression analysis a decreased skeletal muscle index (OR 0.94, 95% CI 0.90-0.98) and an increased fat mass index (OR 1.24, 95% CI 1.04-1.48) were associated with greater odds of discharge to a facility. Higher fat mass-to-skeletal muscle [corrected] index ratios were also associated with greater odds of discharge to a facility (OR 1.69, 95% CI 1.22-2.44). Study limitations include the retrospective design and unknown confounders. CONCLUSIONS: Low skeletal muscle and high fat compositions are independent predictors of discharge to a facility after radical cystectomy of nonmetastatic muscle invasive bladder cancer.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Cistectomia , Músculo Esquelético/diagnóstico por imagem , Alta do Paciente/estatística & dados numéricos , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Comorbidade , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias da Bexiga Urinária/patologia
10.
Muscle Nerve ; 60(6): 687-692, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31478199

RESUMO

INTRODUCTION: Nerve imaging has a limited role in axonal and muscle fiber loss. In this study, we sought to explore the utility of standardized muscle ultrasound (US) assessment in these clinical scenarios. METHODS: We performed a prospective study from March to August 2018 of patients attending the neuromuscular clinic. All patients underwent clinical evaluation and standardized muscle thickness measurement by US in seven muscles. RESULTS: The study cohort consisted of 114 participants, including patients with polyneuropathy, motor neuron disease, and myopathy. The smallest distal muscle thickness was found in patients with polyneuropathy, while the smallest proximal muscle thickness was found in patients with myopathy. Muscle thickness was strongly correlated with muscle strength (r 2 = 0.62), electrophysiological findings (r 2 : 0.44-0.55), and disability score (r 2 = 0.53). DISCUSSION: Standardized muscle thickness measured by US shows diagnostic usefulness in a spectrum of neuromuscular disorders and correlates with clinical and electrophysiological findings.


Assuntos
Músculo Esquelético/diagnóstico por imagem , Doenças Neuromusculares/diagnóstico por imagem , Potenciais de Ação/fisiologia , Adulto , Idoso , Esclerose Amiotrófica Lateral/diagnóstico por imagem , Esclerose Amiotrófica Lateral/patologia , Esclerose Amiotrófica Lateral/fisiopatologia , Eletromiografia , Feminino , Humanos , Masculino , Sintomas Inexplicáveis , Pessoa de Meia-Idade , Força Muscular , Músculo Esquelético/patologia , Músculo Esquelético/fisiopatologia , Atrofia Muscular Espinal/diagnóstico por imagem , Atrofia Muscular Espinal/patologia , Atrofia Muscular Espinal/fisiopatologia , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/patologia , Doenças Musculares/fisiopatologia , Condução Nervosa/fisiologia , Doenças Neuromusculares/patologia , Doenças Neuromusculares/fisiopatologia , Tamanho do Órgão , Polineuropatias/diagnóstico por imagem , Polineuropatias/patologia , Polineuropatias/fisiopatologia , Estudos Prospectivos , Radiculopatia/diagnóstico por imagem , Radiculopatia/patologia , Radiculopatia/fisiopatologia , Ultrassonografia
11.
Rinsho Shinkeigaku ; 59(9): 592-595, 2019 Sep 25.
Artigo em Japonês | MEDLINE | ID: mdl-31474639

RESUMO

A 72-year-old man presented with continuous hyperCKemia and intermittent claudication. He exhibited no calf muscle hypertrophy at that time or afterward. Other than an increased creatine kinase (CK) level (1,525 U/l), none of the laboratory tests was abnormal, including that for myositis-related autoantibodies. Electromyography showed neurogenic changes in the left gastrocnemius. Lumbar magnetic resonance imaging revealed spinal canal stenosis (L3/4, L4/5), left L4 radiculopathy, and bilateral S1 radiculopathy. T2-weighted and short tau inversion recovery images showed high signal intensity in the bilateral biceps femoris and gastrocnemius. Histopathological evaluation of a specimen obtained from the right gastrocnemius muscle revealed neurogenic changes. The patient was diagnosed with S1 radiculopathy caused by lumbar spinal canal stenosis with hyperCKemia. Although S1 radiculopathy with hyperCKemia is usually associated with calf muscle hypertrophy, we should consider S1 radiculopathy in patients with intermittent claudication and hyperCKemia even in the absence of calf muscle hypertrophy.


Assuntos
Creatina Quinase/sangue , Radiculopatia/diagnóstico , Radiculopatia/etiologia , Idoso , Imagem de Difusão por Ressonância Magnética , Humanos , Hipertrofia , Vértebras Lombares , Masculino , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Radiculopatia/diagnóstico por imagem , Estenose Espinal/complicações , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/etiologia
12.
Acta Med Indones ; 51(2): 95-101, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31383823

RESUMO

BACKGROUND: the use of bioelectrical impedance analysis (BIA) is affected by the population setting, the type of BIA, and the cut-off point being used. The aim of this study was to determine the diagnostic performance of BIA to measure muscle mass in Indonesian elderly outpatients aged 60 years or more. METHODS: a cross-sectional study was conducted at the Geriatric Clinic of Cipto Mangunkusumo Hospital from April to June 2018. The muscle mass was measured using BIA Tanita MC-780MA (Tokyo, Japan) with dual-energy x-ray absorptiometry (DXA) as the reference test. Analysis on the cut-off point was performed based on the Asian Working Group of Sarcopenia (AWGS) criteria and the new cut-off point. RESULTS: from 120 subjects, 74 were female (61.7%). The diagnostic performance of BIA based on AWGS criteria only showed sensitivity and specificity of 79.2% and 66.7%. The diagnostic performance of BIA based on the new cut-off point showed sensitivity and specificity of 75% and 92.7%. The new cut-off point using BIA was found to be <6.9 kg/m2 in males (sensitivity 70.6%; specificity 82.8%) and <5 kg/m2 in females (sensitivity 85.7%; specificity 97%). CONCLUSION: the diagnostic performance of BIA Tanita MC-780MA (Tokyo, Japan) was good to measure muscle mass in Indonesian elderly outpatients using a new cut-off point of <6.9 kg/m2 for males and <5 kg/m2 for females.


Assuntos
Absorciometria de Fóton/normas , Impedância Elétrica , Músculo Esquelético/diagnóstico por imagem , Sarcopenia/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Estudos Transversais , Feminino , Força da Mão , Humanos , Indonésia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Valores de Referência , Reprodutibilidade dos Testes , Sarcopenia/etnologia
13.
Muscle Nerve ; 60(5): 621-628, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31397906

RESUMO

INTRODUCTION: Golden retriever muscular dystrophy (GRMD) is a spontaneous X-linked canine model of Duchenne muscular dystrophy that resembles the human condition. Muscle percentage index (MPI) is proposed as an imaging biomarker of disease severity in GRMD. METHODS: To assess MPI, we used MRI data acquired from nine GRMD samples using a 4.7 T small-bore scanner. A machine learning approach was used with eight raw quantitative mapping of MRI data images (T1m, T2m, two Dixon maps, and four diffusion tensor imaging maps), three types of texture descriptors (local binary pattern, gray-level co-occurrence matrix, gray-level run-length matrix), and a gradient descriptor (histogram of oriented gradients). RESULTS: The confusion matrix, averaged over all samples, showed 93.5% of muscle pixels classified correctly. The classification, optimized in a leave-one-out cross-validation, provided an average accuracy of 80% with a discrepancy in overestimation for young (8%) and old (20%) dogs. DISCUSSION: MPI could be useful for quantifying GRMD severity, but careful interpretation is needed for severe cases.


Assuntos
Músculo Esquelético/diagnóstico por imagem , Distrofia Muscular Animal/diagnóstico por imagem , Animais , Modelos Animais de Doenças , Cães , Imagem por Ressonância Magnética , Músculo Esquelético/patologia , Distrofia Muscular Animal/patologia , Distrofia Muscular de Duchenne/diagnóstico por imagem , Distrofia Muscular de Duchenne/patologia , Índice de Gravidade de Doença
14.
Muscle Nerve ; 60(5): 549-557, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31397909

RESUMO

INTRODUCTION: This study assesses the burden, distribution, and evolution of muscle inflammation and damage on MRI among subtypes of idiopathic inflammatory myopathy (IIM). METHODS: Musculoskeletal MRIs performed in 66 patients with IIM and 10 patients with non-IIM between 2009 and 2016 were retrospectively graded for muscle edema, fatty replacement (FR), and atrophy. RESULTS: Immune-mediated necrotizing myopathy (IMNM) patients had severe and extensive lower limb muscle edema, FR, and atrophy. The pelvic muscles and adductors were significantly more affected than in patients with dermatomyositis and polymyositis. Inclusion body myositis (IBM) was characterized by marked anterior thigh involvement, which stabilized or progressed at follow-up imaging. Atrophy and FR grades improved over time in some non-IBM IIM patients. DISCUSSION: Patients with IMNM and IBM have characteristic patterns of muscle MRI abnormalities that may allow them to be differentiated radiologically from other IIM subtypes. Muscle damage in non-IBM IIM may be reversible.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Edema/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/diagnóstico por imagem , Miosite/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Dermatomiosite/diagnóstico por imagem , Feminino , Humanos , Inflamação/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Miosite de Corpos de Inclusão/diagnóstico por imagem , Polimiosite/diagnóstico por imagem
15.
J Dermatol ; 46(10): 886-897, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31418479

RESUMO

Patients with dermatomyositis positive for anti-aminoacyl tRNA synthetase (ARS) antibodies, also known as antisynthetase syndrome (ASS), frequently present with mechanic's hand and interstitial lung disease (ILD). We first screened the antibody profiles of 59 patients with dermatomyositis, and then examined the cutaneous, muscular and pulmonary manifestations characteristic for patients with ASS. The anti-ARS antibodies Jo-1, PL-7, PL-12, EJ and KS, along with antibodies to TIF1-γ, MDA5 and Mi-2, were examined. Among the 59 patients, 20, 21, 15 and three patients were classified into the ASS, non-ASS, myositis-specific antibody-negative and unknown groups, respectively. Five of 16 patients (31%) with ASS had six relatives with a history of collagen diseases, within the second degree of relationship, including two cases of dermatomyositis (vs the non-ASS group, P = 0.018). Patients with ASS more frequently presented with fever and arthralgia, and had elevated levels of C-reactive protein. Nine of the 11 finger lesions (82%) clinically diagnosed as mechanic's hands showed a psoriasiform tissue reaction. ILD was observed in 19 of 20 patients (95%) with ASS, and eight of 21 patients (38%) in the non-ASS group, in which six patients possessed anti-MDA5 antibody. Patients with ASS showed higher serum levels of muscle enzymes, and four of 12 patients (33%) had fasciitis-dominant myopathy, while only one of 11 patients (9%) in the non-ASS group had fasciitis-dominant myopathy. Patients with ASS often present with a psoriasiform tissue reaction in the hand lesions and fasciitis-dominant myopathy, and the relatives of those with ASS are at high risk for collagen diseases.


Assuntos
Aminoacil-tRNA Sintetases/imunologia , Autoanticorpos/sangue , Dermatomiosite/complicações , Doenças Pulmonares Intersticiais/diagnóstico , Miosite/diagnóstico , Psoríase/diagnóstico , Adulto , Idoso , Autoanticorpos/imunologia , Dermatomiosite/sangue , Dermatomiosite/imunologia , Feminino , Humanos , Pulmão/diagnóstico por imagem , Doenças Pulmonares Intersticiais/sangue , Doenças Pulmonares Intersticiais/imunologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Miosite/sangue , Miosite/imunologia , Psoríase/sangue , Psoríase/imunologia , Tomografia Computadorizada por Raios X
16.
Muscle Nerve ; 60(6): 739-744, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31449671

RESUMO

BACKGROUND: Hereditary motor and sensory neuropathy with proximal dominant involvement (HMSN-P) is characterized by adult onset, a slowly progressive course and autosomal dominant inheritance. It remains unclear whether myopathic changes occur histopathologically. METHODS: We encountered 2 patients in a family with a heterozygous p.P285L mutation in TRK-fused gene (TFG), which is known to cause HMSN-P. The affected individuals developed proximal-dominant muscle weakness in their 40s, which slowly progressed to a motor neuron disease-like phenotype. RESULTS: Muscle biopsy showed myopathic pathology including fiber size variability, increased internal nuclei, fiber splitting, and core-like structures, associated with neurogenic changes: large groups of atrophic fibers and fiber type-grouping. Immunohistochemistry revealed sarcoplasmic aggregates of TFG, TDP-43, and p62 without congophilic material. CONCLUSIONS: The present study demonstrates myopathic changes in HMSN-P. Although the mechanisms underlying the skeletal muscle involvement remain to be elucidated, immunohistochemistry suggests that abnormal protein aggregation may be involved in the myopathic pathology.


Assuntos
Neuropatia Hereditária Motora e Sensorial/patologia , Fibras Musculares Esqueléticas/patologia , Músculo Esquelético/patologia , Potenciais de Ação , Proteínas de Ligação a DNA/metabolismo , Feminino , Imunofluorescência , Neuropatia Hereditária Motora e Sensorial/diagnóstico por imagem , Neuropatia Hereditária Motora e Sensorial/genética , Neuropatia Hereditária Motora e Sensorial/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Atrofia Muscular/patologia , Condução Nervosa , Linhagem , Proteínas/genética , Proteínas de Ligação a RNA/metabolismo , Retículo Sarcoplasmático/metabolismo , Irmãos
17.
BMC Med Imaging ; 19(1): 69, 2019 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426754

RESUMO

BACKGROUND: Pocket-sized ultrasound devices are increasingly used in a variety of clinical situations, and perform well against standard ultrasound machines. We sought to investigate if a pocket-sized ultrasound device can assess muscle thickness and architecture in healthy volunteers. METHODS: Healthy male volunteers (n = 21) across a range of ages were recruited to the study. Laying supine, ultrasound images were taken from the right anterior and lateral thigh. Thickness of the rectus femoris (RFMT), vastus intermedius (VIMT), and the two combined (anterior thigh, AMT) were measured, along with thickness of vastus lateralis (VLMT), pennation angle (VLPA) and derived fascicle length (VLFL). These scans were performed initially using a pocket-sized ultrasound (VScan) and then using a standard device (Telemed Echoblaster 128). RESULTS: In all six variables, there was no significant difference between the two sets of measurements. Intra-class correlation co-efficients (ICC) for VLMT, VLPA, and AMT were all excellent (0.93, 0.89, 0.90 respectively) with the derived value of VLFL having an ICC of 0.84. All ICC values were statistically significant. Regression analysis demonstrated no evidence of proportional bias in any of the measured or derived variables. CONCLUSION: A pocket-sized ultrasound device gives similar measurements of lower limb muscle thickness and architecture as a standard device in healthy volunteers.


Assuntos
Músculo Esquelético/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Ultrassonografia/instrumentação , Adulto , Idoso , Equipamentos e Provisões , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Interpretação de Imagem Radiográfica Assistida por Computador , Decúbito Dorsal , Coxa da Perna/anatomia & histologia , Adulto Jovem
18.
Yonsei Med J ; 60(9): 876-881, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31433586

RESUMO

Architectural changes in healthy muscle after denervation have not yet been reported. This study aimed to investigate architectural changes in the medial head of the gastrocnemius muscle (GCM) after aesthetic tibial nerve ablation in healthy adults using ultrasonography (US). The effects of tibial nerve ablation were verified by visual observation and surface electromyography analysis. US images of medial GCMs were taken by one trained physician using B-mode and real-time US with a linear-array probe before nerve ablation, at 1 week after nerve ablation and at 3 months after nerve ablation in an anatomic standing position with the feet about shoulder-width apart in 19 healthy adults (17 females and 2 males). Muscle thickness was significantly reduced on the left side at 1 week and 3 months after the procedure and on the right side at 3 months after the procedure (p<0.050). Although fascicle length was not significantly changed, pennation angle was significantly reduced on both sides at 3 months after the procedure (p<0.050). Muscle thickness and pennation angle of the muscle fascicle were significantly reduced, although fascicle length was not significantly changed, after tibial nerve ablation in the medial GCM of healthy adults.


Assuntos
Denervação Muscular/efeitos adversos , Músculo Esquelético/anatomia & histologia , Nervo Tibial/cirurgia , Adulto , Eletromiografia , Feminino , Humanos , Terapia a Laser , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia
19.
J Hand Surg Asian Pac Vol ; 24(3): 311-316, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31438792

RESUMO

Background: Chronic exertional compartment syndrome (CECS) is a rare condition, which generally occurs in athletes. Few tools are available for diagnosis and treatment evaluation. We examined pre- and post- exertional forearm magnetic resonance imaging (MRI) before and after fasciotomy since 2013. The purpose of this study was to evaluate the efficacy of pre- and post-exertional MRI before and after fasciotomy. Methods: We treated 8 forearms of 5 patients diagnosed with CECS of the forearms since 2013, including 6 forearms of 3 motocross racers, 1 forearm of 1 baseball pitcher, 1 forearm of 1 manual laborer with a history of muscle contusion. We obtained pre- and post-exertional MRI before and after fasciotomy in all cases. Pre-exertional MRI was obtained when the patient was at rest without any symptom. Post-exertional MRI was obtained after the patients repeated "grip and release" using a hand gripper with maximum effort for approximately 10 minutes until symptoms occurred. We compared MRI findings before and after fasciotomy and evaluated the correlation with clinical outcome. Results: Symptoms disappeared completely in all 3 motocross racers after fasciotomy. MRI at rest showed no abnormal high signals in all cases both before and after fasciotomy. On post-exertional MRI, T2 high area presented mainly in flexor digitorum profundus (FDP) and brachioradialis (BR) and disappeared completely after surgery. Symptoms persisted in the pitcher and the laborer after fasciotomy. T2 high area presented mainly in FDP on post-exertional MRI before fasciotomy and remained on post-exertional MRI after fasciotomy in these two patients. These intensity changes correlated strongly with their symptoms. Conclusions: We performed pre- and post-exertional MRI before and after fasciotomy. The intensity change in T2-weighted images on post-exertional MRI correlated strongly with their symptoms. Post-exertional MRI is useful for diagnosis and treatment evaluation in CECS.


Assuntos
Síndromes Compartimentais/diagnóstico , Antebraço/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Exame Físico/métodos , Esforço Físico , Adulto , Síndromes Compartimentais/cirurgia , Fasciotomia , Humanos , Imagem por Ressonância Magnética , Masculino , Adulto Jovem
20.
Muscle Nerve ; 60(5): 582-585, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31443126

RESUMO

INTRODUCTION: Our aim in this work was to determine the safety and accuracy of the volar approach to the pronator quadratus (PQ) through cadaver dissection. METHODS: Twenty upper limbs from 10 fresh cadavers were investigated. At the level 3 cm proximal to the ulnar styloid process (USP), a needle was inserted just medial to the palmaris longus (PL) tendon. Distances of the median nerve (MN) and ulnar artery (UA) from the needle insertion point (IP) were measured using ultrasonography and cadaver dissection. RESULTS: The PQ was located at a depth of 10.8-19.9 mm from the skin and had a median thickness of 9.1 mm, measured 3 cm proximal to the USP. The median distances of the MN and UA from the IP were 7.6 and 13.4 mm, respectively. DISCUSSION: A needle insertion for the volar approach to the PQ was safe at 3 cm proximal to the USP, just medial to the PL tendon.


Assuntos
Pontos de Referência Anatômicos , Antebraço/anatomia & histologia , Nervo Mediano/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Artéria Ulnar/anatomia & histologia , Cadáver , Dissecação , Eletromiografia/métodos , Feminino , Antebraço/diagnóstico por imagem , Humanos , Masculino , Nervo Mediano/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Tendões , Artéria Ulnar/diagnóstico por imagem , Ultrassonografia
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