The measurement of skeletal muscle mass is essential for the diagnosis of sarcopenia. Muscle ultrasonography has emerged as a useful tool for evaluating sarcopenia because it can be used to assess ...muscle quality and quantity. This study investigated whether muscle ultrasonography is effective for estimating appendicular skeletal muscle mass (ASM) and screening for sarcopenia. This study prospectively enrolled 212 healthy volunteers aged 40-80 years. ASM was measured using the bioelectrical impedance analysis. Muscle thickness (MT) and echo-intensity (EI) were measured in four muscles (biceps brachii, BB; triceps brachii, TB; rectus femoris, RF; biceps femoris, BF) on the dominant hand. A hold-out cross-validation method was used to develop and validate the ASM prediction equation. In the model development group, the ASM prediction equations were deduced as follows: estimated ASM for men (kg) = 0.167 × weight (kg) + 0.228 × height (cm) + 0.143 × MT of BF (mm)- 0.822 × EI to MT ratio of BB- 28.187 (R2 = 0.830) and estimated ASM for women (kg) = 0.115 × weight + 0.215 × height (cm) + 0.139 × MT of RF-0.638 × EI to MT ratio of BB- 23.502 (R2 = 0.859). In the cross-validation group, the estimated ASM did not significantly differ from the measured ASM in both men (p = 0.775; intraclass correlation coefficient ICC = 0.948) and women (p = 0.516; ICC = 0.973). In addition, multiple logistic regression analysis revealed that the ratios of EI to MT in the BF and RF muscles in men and MT in the BB muscle in women could be valuable parameters for sarcopenia screening. Therefore, our study suggests that muscle ultrasound could be an effective tool for estimating ASM and screening sarcopenia.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Allodynia, which can be induced by paclitaxel administration, is the presence of pain as a result of a stimulus that does not usually provoke pain. Many studies have investigated the analgesic ...efficacy of acupuncture, including laser acupuncture (LA) and electroacupuncture (EA). Although pain-related diseases are relatively common, few studies have analyzed the analgesic effects and mechanisms of LA combined with EA. The purpose of this study was to investigate the therapeutic effect and mechanism of manual acupuncture (MA), EA, LA, and combined therapy (LA + EA) in a paclitaxel-induced allodynia rat model.
A total of 56 rats were classified into eight groups: a normal (Nor,
= 7), a control (Con,
= 7), an MA (
= 7), an EA (
= 7), a 650-nm LA (650LA,
= 7), an 830-nm LA (830LA,
= 7), a 650-nm LA combined with EA (650LA + EA,
= 7), and an 830-nm LA combined with EA group (830LA + EA,
= 7). Allodynia was induced by intraperitoneal injection of 2 mg/kg of paclitaxel every other day for a total of four times except the Nor group. Acupuncture treatments were conducted at the points of Jungwan (CV12) and Joksamni (ST36) once every other day for 6 min, for a total of nine times. Withdrawal response reaction times and force intensity of the foot were measured before the start of the experiment, after the 4th paclitaxel administration (day 8), and after the 9th and last treatment (day 15). On the 16th day, mRNA and protein expression in the spinal nerves was assessed, and a metabolome analysis of the animals' feces was performed.
Our analyses show that 650LA + EA treatment resulted in an upregulation of protein expression related to pain relief and nerve regeneration, whereas 830LA + EA treatment led to significant changes in metabolomes. This study demonstrates that a combination treatment of EA and LA can suppress allodynia and promote upregulation of protein expression related to nerve regeneration and is effective in changing the intestinal microbiome. Further large-scale research is required to assess the exact mechanism underlying the therapeutic effect of this combination treatment in pain-related diseases.
Diabetes mellitus (DM) has been proposed as a risk factor for carpal tunnel syndrome (CTS), but this remains controversial. We investigated the association between DM and CTS using both ...ultrasonography (US) and nerve conduction study (NCS) data.
We analyzed a prospectively recruited database of neuromuscular US and medical records of subjects who had undergone NCSs and electromyography for symptoms suggestive of CTS. Subjects were assigned to the follow groups: Group I, CTS with DM; Group II, CTS without DM; Group III, no CTS with DM; and Group IV, no CTS without DM. US cross-sectional area (CSA) and NCS measurements at the median nerve (MN) were compared among groups. We used a general linear mixed model to adjust for statistically significant covariates.
The 230 participants comprised 22, 83, 19, and 106 in Groups I-IV, respectively. In multivariate analyses, the MN action potential amplitude in females was the only variable that was significantly associated with DM (p<0.001). Groups with DM tended to have a longer latency, smaller amplitude, and lower conduction velocity in the NCSs compared to groups without DM. The measured US CSA values did not differ significantly among the groups.
NCS measurements of the MN tended to differ between DM and non-DM patients regardless of the presence or absence of CTS. However, US did not reveal any statistically significant relationship between CTS and DM.
•Shear wave elastography (SWE) and high-definition (HD) color provide useful supportive information for the evaluation of carpal tunnel syndrome (CTS).•SWE discriminated CTS severity, and detected ...CTS patients with normal nerve conduction study results.•50.12-kPa for median nerve (MN) stiffness at the wrist and 1.91 for the MN stiffness ratio are cutoff values for CTS diagnosis.
The diagnostic values of measuring median nerve (MN) stiffness and vascularity with shear wave elastography (SWE) and high-definition (HD) color were investigated in carpal tunnel syndrome (CTS).
Seventy patients (123 wrists) with CTS and thirty-five healthy volunteers (70 wrists) were enrolled. Based on nerve conduction studies (NCS), the patients were subdivided into NCS-negative, mild-to-moderate, and severe CTS groups. MN and abductor pollicis brevis (APB) SWE and MN HD color were performed on a longitudinal plane.
The mild-to-moderate and severe CTS groups showed increased MN stiffness at the wrist and MN stiffness ratio (wrist-to forearm) compared with the control (p < 0.001). The NCS-negative CTS group showed increased MN stiffness at the wrist (p = 0.022) and MN stiffness ratio (p = 0.032) compared with the control. The severe CTS group showed increased MN stiffness at the wrist compared with the mild-to-moderate CTS group (p = 0.034). The cutoff-values in diagnosing NCS-confirmed CTS were 50.12 kPa for MN stiffness at the wrist, 1.91 for MN stiffness ratio, and grade 1 for HD color.
SWE and HD color are good supportive tools in diagnosing and assessing severity in CTS.
SWE and HD color demonstrated that MN in CTS was associated with increased stiffness and hypervascularity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
A natural hybrid of a probable intergeneric mating between the striped shiner Pungtungia herzi and the stone morocco Pseudorasbora parva (Cypriniformes: Cyprinidae) was captured in the Geumho River, ...a tributary of the Nakdong River basin in Korea. Morphological characters and DNA sequences were analyzed to verify its hybrid state and identify the parentage of its parent species. The hybrid exhibited a phenotypic intermediacy between the two parent species in the number of vertebrae and the mouth shape. Out of 1,488 base pair (bp) positions of the nuclear recombination activating gene 1 gene (rag1), which has a biparental mode of inheritance, 41-bp substitutions were detected between the two parent species, whereas an electropherogram of the hybrid displayed polymorphic double peaks at all of the base positions, along with one additional one, strongly indicating its hybrid state. Meanwhile, sequence comparison of the mitochondrial cytochrome b gene (mt-cyb) (1,140 bp), which has a maternal mode of inheritance, showed only 5.22-bp differences (97.6.99.5% identities) between the hybrid and Pu. herzi, but as many as 158.168-bp differences (85.2.86.1% identities) between the hybrid and Ps. parva, clearly indicating Pu. herzi as the maternal species. Thus, combined analyses of independent data sets (i.e., morphology and nuclear and mitochondrial DNA sequences) offered convincing evidence for the hybrid state of a naturally occurring hybrid resulting from intergeneric mating between a female Pu. herzi and a male Ps. parva.
Appropriate evaluation and management of dysphagia are essential in neurological disorders. However, there is currently a lack of a simple yet reliable method for dysphagia evaluation.
This study ...aimed to investigate the usefulness of new dynamic M-mode ultrasonography (US) parameters of suprahyoid muscle (SHM) to evaluate dysphagia.
Prospective observational, cross-sectional study.
Inpatient setting at neurology department of tertiary medical center.
A total of 89 patients with dysphagia and 175 healthy volunteers were enrolled in the study. Patients were subdivided into mild and severe dysphagia groups depending on the need for dietary changes and disease classification, which included amyotrophic lateral sclerosis, peripheral neuromuscular diseases, and stroke.
Dynamic M-mode US was performed during swallowing to obtain the SHM thickness (the baseline thickness of the SHM), SHM displacement (peak-to-peak amplitude of SHM movement), SHM difference (SHM displacement - SHM thickness), SHM ratio (SHM displacement/SHM thickness), peak-to-peak time, and total duration. A videofluoroscopic swallowing study (VFSS) was performed.
Significant differences were found in SHM displacement and SHM difference according to dysphagia severity (P<0.001). The SHM ratio, total duration (P<0.001), and peak-to-peak time (P=0.001) differed significantly according to the patients' underlying diseases. The pharyngeal delay time and penetration-aspiration scale from the VFSS demonstrated significant negative correlations with SHM displacement and difference (P<0.001). By combining SHM difference and total duration, patients with dysphagia could be distinguished from healthy controls, with the highest negative predictive value of 95.6%.
Dynamic M-mode US of the SHM provided added value in evaluating the severity of dysphagia and differentiating swallowing mechanics of dysphagia related to underlying neurological disorders.
Dynamic M-mode US of the SHM can serve as a supportive tool for rapid screening and repetitive follow-up of patients with dysphagia, which would contribute to dysphagia rehabilitation in patients with various neurological disorders.
Visual evoked potentials (VEP), magnetic resonance imaging, and the optical coherence tomography (OCT) have been used to evaluate the functional and morphologic status of the afferent visual pathway. ...However, these utilities have some limitation to evaluate optic nerve pathology in the early stage. Recently transorbital ultrasound (US) has been introduced as a promising tool to evaluate optic bulb and nerve. We performed this study to assess the practical diagnostic value of US in patients with optic neuritis (ON).
Transorbital US, OCT, and VEP were performed in both eyes of patients with symptoms suggesting acute ON. The optic nerve diameter was measured using the US at point 3 mm posterior to eye globe with and without nerve sheath. The diameter was analyzed to see any correlation with parameters in VEP and OCT. All measured parameters were compared between affected and non-affected side.
Of 33 patients who were enrolled in this study, seven patients with the previous history of ON were excluded from analysis. Of 26 patients, nine patients were confirmed as the other disorder or no definite evidence of ON. Only data of 17 patients (9 men, median age 44.4 years) were finally included in the analysis. The median diameter of the optic nerve with and without sheath on the affected side (5.36 and 3.28 mm) was significantly larger compared to the non-affected side (5.22 and 3.08 mm; p = 0.018 and p = 0.003). However, the diameters of optic nerve with or without sheath were not correlated with VEP and OCT parameters on the same side.
Optic nerve diameter in the transorbital US was significantly increased in acute ON. US could be considered in patients with ON in the early stage as supportive tools for assessment of optic nerve.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Transorbital ultrasonography (TOUS) revealed thickening of the optic nerve sheath and optic nerve diameter with sheath on the affected side compared with the unaffected side.•Disease duration was ...inversely correlated with optic nerve diameter and retinal nerve fiber layer thickness (RNFL).•There were no clinically significant correlations or differences between US parameters and other diagnostic tools, including visual evoked potential, RNFL, and magnetic resonance image.
Because of limitations of conventional tools for diagnosing optic neuritis (ON), transorbital ultrasonography (TOUS) was introduced as a promising tool to evaluate the optic nerve. However, studies demonstrating its utility are scarce.
To assess the practical diagnostic value of TOUS in patients with ON along with other diagnostic tools such as visual evoked potential (VEP), MRI, and optical coherence tomography (OCT).
Seventeen patients with first-attack unilateral acute ON were enrolled. Clinical characteristics, visual acuity, TOUS, MRI, VEP, and OCT results were evaluated. Bilateral optic nerves were scanned using TOUS to obtain axial images showing the optic nerve and the disc in the longitudinal plane.
TOUS revealed thickening of the optic nerve sheath and optic nerve diameter with sheath on the affected side compared with the unaffected side (p = 0.002 and p = 0.003, respectively). Time since onset of initial symptoms was inversely correlated with optic nerve diameter (ρ = −0.517, p = 0.040) and retinal nerve fiber layer thickness (ρ = −0.831, p < 0.001).
TOUS could be a cost-effective tool for morphologically evaluating acute ON showing a significant thickening of the optic nerve and sheath, although only a limited retrobulbar area could be explored.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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