Mari Osaki

Effect of aging on oral and swallowing function after meal consumption.

Background/purpose Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs). Methods Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs) and 23 OA volunteers. Results There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow) was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption. Conclusion Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their efforts in mastication and swallowing.

Prostatic stromal sarcoma: case report and review of the literature.

We report a case of a 65‐year‐old man with rare prostatic stromal sarcoma in which suprapubital radical prostatectomy was performed, but neither chemotherapy nor radiation therapy were administered before or after the operation. The well‐circumscribed tumor, measuring 5 cm in diameter, showed a homogeneous white grayish cut surface with a hard consistency. Histopathologically, the tumor consisted mainly of medium‐sized rounded cells with a sarcomatous and epithelioid appearance intermingled with collagen fiber. Hyalinized foci were also noted in the tumor. Immunohistochemistry revealed that the tumor cells were diffusely positive for vimentin and focally positive for progesterone receptor and CD34, but not for EMA, cytokeratin or estrogen receptor. No recurrence or distant metastasis of the tumor has occurred in 8 years of follow up. The tumor was diagnosed as prostatic stromal sarcoma (PSS) showing epithelioid differentiation and of a progesterone‐dependent nature. Possible favorable nature of the PSS might be expected after complete resection.

Sarcopenia is a risk factor for falling in independently living Japanese older adults: A 2‐year prospective cohort study of the GAINA study

The purpose of the present study was to investigate whether sarcopenia was associated with future falls in the general Japanese older population.

Cytoplasmic maspin expression predicts poor prognosis of patients with soft tissue sarcomas

BackgroundMaspin is a 42 kDa protein known to act as a tumor suppressor. Although its function has not been fully elucidated, numerous reports have investigated the prognostic impact of maspin in patients with several types of cancer. However, there have been no reports on the association between maspin expression and the prognosis of patients with soft tissue sarcomas (STS). The aim of this study was thus to explore the association of maspin expression with the prognosis of patients with STS.MethodsOne-hundred and eight paraffin-embedded STS tissue samples were immunohistochemically analyzed using antibodies for maspin and Ki-67 antigen. The patients were followed up for 1 to 300 months (median: 33 months) and the prognostic value was evaluated by log-rank test and Coxs regression hazard model.ResultsCytoplasmic maspin expression was observed in 48.1% of specimens, and was significantly correlated with a higher FNCLCC grade (P = 0.002) and the presence of distant metastases (P = 0.001), and those with cytoplasmic maspin expression had both shorter disease-free survival (DFS) and overall survival (OS) by log-rank test (P <0.001, P = 0.001, respectively). By Coxs multivariate analysis, the presence of distant metastases was the only prognostic factor for DFS and OS.ConclusionsThis is the first report to reveal an association between maspin expression and the prognosis of patients with STS. Although further studies with a larger series of patients and a longer follow-up period will be needed, cytoplasmic maspin expression could be an indicator of unfavorable prognosis in patients with STS.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_205

Detailed analysis of a superficial CD34‑positive fibroblastic tumor: A case report and review of the literature

Superficial cluster of differentiation (CD)34-positive fibroblastic tumor (SCPFT) is a rare mesenchymal neoplasm of borderline malignancy. It is characterized by a superficial location, marked cellular pleomorphism, an extremely low incidence of mitotic figures, and strong CD34 immunohistochemical positivity. As SCPFT is a recently described neoplasm, its characteristics are yet to be fully elucidated. To the best of our knowledge, no detailed studies regarding the imaging findings and cytogenetic analyses of SCPFTs exist. The present study describes a typical case of an 18-year-old man who developed an SCPFT measuring 87×70×80 mm in the subcutaneous adipose tissue of his right thigh. Computed tomography (CT) revealed a well-marginated tumor without calcification, and the enhancement on CT was weak. The tumor demonstrated abnormal uptake on 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography (PET), with a maximum standardized uptake value of 2.57. Magnetic resonance imaging (MRI) revealed a clearly defined tumor that exhibited homogeneous low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging, with small lobulated structures. Histopathologically, the tumor was composed of irregular spindle-to-oval-shaped cells with eosinophilic glassy cytoplasm and hyperchromatic, bizarre and pleomorphic nuclei that frequently exhibited intranuclear pseudoinclusions. Immunohistochemically, the tumor cells were diffusely and strongly positive for CD34. The Mindbomb E3 ubiquitin protein ligase 1 labeling index was 8.6%. Ultrastructurally, the tumor cells exhibited irregular or convoluted nuclei with abundant euchromatin-prominent nucleoli. The cytoplasmic organelles consisted of scattered, abundant rough endoplasmic reticulum, mitochondria, lysosomes, ribosomal rosettes and aggregated lipid globules. Of 18 metaphase cells identified, 2 demonstrated translocation between chromosomes 2 and 5 in cytogenetic studies. To the best of our knowledge, this is the first study describing imaging data (CT, MRI and PET-CT) and chromosomal aberrations for SCPFT.

Comparison of Healthcare Workers Transferring Patients Using Either Conventional Or Robotic Wheelchairs: Kinematic, Electromyographic, and Electrocardiographic Analyses.

Objectives. The aim of this study was to compare the musculoskeletal and physical strain on healthcare workers, by measuring range of motion (ROM), muscle activity, and heart rate (HR), during transfer of a simulated patient using either a robotic wheelchair (RWC) or a conventional wheelchair (CWC). Methods. The subjects were 10 females who had work experience in transferring patients and another female adult as the simulated patient to be transferred from bed to a RWC or a CWC. In both experimental conditions, ROM, muscle activity, and HR were assessed in the subjects using motion sensors, electromyography, and electrocardiograms. Results. Peak ROM of shoulder flexion during assistive transfer with the RWC was significantly lower than that with the CWC. Values for back muscle activity during transfer were lower with the RWC than with the CWC. Conclusions. The findings suggest that the RWC may decrease workplace injuries and lower back pain in healthcare workers.

Automated stride assistance device improved the gait parameters and energy cost during walking of healthy middle-aged females but not those of young controls

[Purpose] The aim of this study was to clarify the effects of an automated stride assistance device on gait parameters and energy cost during walking performed by healthy middle-aged and young females. [Subjects and Methods] Ten middle-aged females and 10 young females were recruited as case and control participants, respectively. The participants walked for 3 minutes continuously under two different experimental conditions: with the device and without the device. Walking distance, mean walking speed, mean step length, cadence, walk ratio and the physiological cost index during the 3-minutes walk were measured. [Results] When walking with the stride assistance device, the step length and walk ratio of the middle-aged group were significantly higher than without it. Also, during walking without assistance from the device, the physiological cost index of the middle-aged group significantly increased; whereas during walking with assistance, there was no change. The intergroup comparison in the middle-aged group showed the physiological cost index was lower under the experimental condition with assistance provided, as opposed to the condition without the provision of assistance. [Conclusion] The results of this study show that the stride assistance device improved the gait parameters of the middle-aged group but not those of young controls.

Diagnotic Significance of Detection of Fusion Genes by Reverse Transcriptase-Polymerase Chain Reaction in Soft Tissue Tumors

軟部腫瘍の診断は，病理組織診断が最終診断となることが多いが，病理組織像が多彩で典型像を示さない例も多く，専門病理医でも診断に難渋する．近年，軟部腫瘍において多くの疾患特異的な融合遺伝子が同定され，診断へ応用されている．今回，RT-PCR法を用いた融合遺伝子の検出が軟部腫瘍の診断に有用であった症例を報告する．症例は滑膜肉腫2例，粘液型脂肪肉腫2例，悪性末梢神経鞘腫瘍1例，孤在性線維性腫瘍1例，類上皮肉腫1例であった．いずれも，臨床所見，術前生検の病理組織所見のみでは確定診断できなかった．滑膜肉腫，粘液型脂肪肉腫は特異的な融合遺伝子が検出された．悪性末梢神経鞘腫瘍，孤在性線維性腫瘍，類上皮肉腫は，特異的な融合遺伝子の存在は報告されていないが，鑑別診断となった融合遺伝子が存在する腫瘍を除外することで診断の補助となった．軟部腫瘍の診断において，融合遺伝子の検出は有用な手段となる．