Impact of sarcopenia on long-term prognosis of patients with esophageal cancer after surgery.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 118-118
Author(s):  
Tsutomu Hayashi ◽  
Soji Ozawa ◽  
Kenichi Kamachi ◽  
Akihito Kazuno ◽  
Eisuke Ito ◽  
...  

118 Background: Emerging evidence suggests that sarcopenia might have an adverse impact on the survival of patients with cancer. We herein investigated the impact of sarcopenia on the long-term outcome of patients with esophageal cancer after curative surgery by analyzing the muscle cross-sectional area using computed tomography (CT). Methods: Sarcopenia was assessed in 204 patients undergoing a macroscopic curative esophagectomy for the resection of esophageal cancer between January 2005, and December 2008 at Tokai University Hospital by measuring the cross-sectional area of the psoas muscle at the level of the third lumbar vertebra on CT images obtained before surgery. The measured total psoas area (TPA) was normalized according to the patient’s height. Sarcopenia was defined as a TPA of ≤525 mm/m2 for men, and ≤375 mm/m2 for women. The impact of sarcopenia was assessed after controlling for clinical factors using multivariate modeling. Results: The median follow-up period was 60 months. The median patient age was 64 years; 184 (90%) patients were male and 20 (10%) were female. The median TPA was 580 mm/m2 for the men and 386 mm/m2 for the women. Sixty-nine (34%) patients had sarcopenia (TPA ≤525 mm/m2 for men, 375 mm/m2 for women ). The overall five-year survival rates were 33% for the patients with sarcopenia, and 66% for those without sarcopenia. In a multivariate analysis, a low body mass index (BMI ≤ 18.5 kg/m2; hazard ratio [HR], 1.87 [P = 0.028]), pathological stage of disease (HR for stage I, 1.587 in stage II [P = 0.219], 4.146 in stage III [P < 0.001], and 6.712 in stage IV [P < 0.001]), tumor location (HR of upper thoracic for middle and lower thoracic, 2.350 [P = 0.002]), and sarcopenia (HR, 1.858 [P= 0.006]) were independently associated with the overall mortality. Conclusions: Sarcopenia is associated with an increased risk of overall mortality in esophageal cancer after curative surgery independent of tumor-specific factors and the BMI. The development of effective interventions for sarcopenia warrants further study to improve the prognosis of patients with esophageal cancer.

2013 ◽  
Vol 114 (8) ◽  
pp. 998-1008 ◽  
Author(s):  
Mette Hansen ◽  
Christian Couppe ◽  
Christina S. E. Hansen ◽  
Dorthe Skovgaard ◽  
Vuokko Kovanen ◽  
...  

Sex differences exist with regards to ligament and tendon injuries. Lower collagen synthesis has been observed in exercising women vs. men, and in users of oral contraceptives (OC) vs. nonusers, but it is unknown if OC will influence tendon biomechanics of women undergoing regular training. Thirty female athletes (handball players, 18–30 yr) were recruited: 15 long-term users of OC (7.0 ± 0.6 yr) and 15 nonusers (>5 yr). Synchronized values of patellar tendon elongation (obtained by ultrasonography) and tendon force were sampled during ramped isometric knee extensor maximum voluntary contraction to estimate mechanical tendon properties. Furthermore, tendon cross-sectional area and length were measured from MRI images, and tendon biopsies were obtained for analysis of tendon fibril characteristics and collagen cross-linking. Overall, no difference in tendon biomechanical properties, tendon fibril characteristics, or collagen cross-linking was observed between the OC users and nonusers, or between the different phases of the menstrual cycle. In athletes, tendon cross-sectional area in the preferred jumping leg tended to be larger than that in the contralateral leg ( P = 0.09), and a greater absolute ( P = 0.01) and normalized tendon stiffness ( P = 0.02), as well as a lower strain ( P = 0.04), were observed in the jumping leg compared with the contralateral leg. The results indicate that long-term OC use or menstrual phases does not influence structure or mechanical properties of the patellar tendon in female team handball athletes.


2018 ◽  
Vol 35 (2) ◽  
pp. 105-111
Author(s):  
Akram Asbeutah ◽  
Mohsen Dashti ◽  
Abdullah AlMajran ◽  
Aref Ghayyath

The objective was to evaluate the distribution of the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve (MN) in asymptomatic academic dentists using ultrasonography (US). Fifty academic dentists underwent US of the MN in transverse section at the pisiform bone level and the CSA (mm2) and FR were measured bilaterally. A CSA of <10 mm2 was considered normal. Paired t-test showed no statistical significance between either hand for CSA and FR ( P> .05). Two independent t-tests showed significant statistical differences ( P= .023) between males and females in the right dominant hand for CSA. Linear correlation analysis showed no significant correlation between CSA and FR for number of years of experience or number of working hours per day in either hand ( P>.05). The CSA was abnormal in the right dominant hand in 20 (40%) of the subjects. These male academic dentists were at increased risk of having an enlarged MN without symptoms.


2019 ◽  
Vol 11 (2) ◽  
pp. 149-159
Author(s):  
Ibnu Hajar ◽  
Tito Dias Fernando

PT. PLN (PERSERO) as a state-owned company responsible in the electricity sector is required to improve the quality of electricity transmission. In the transmission of electrical power to consumers will be got losses of power. Raising the voltage is an alternative to this problem but it creates new problems because the higher the voltage has increased the corona will occur. The impact of the corona in addition to damaging equipment, noise, and disturbing radio waves, the corona also causes power losses that are proportional to the length of the transmission line. This study uses a quantitative method, by calculating the corona power losses by comparing 4 different cross-sectional areas of the conductor and 4 different air temperatures. The results of this study found that the smaller the cross-sectional area of the conductor the power losses due to corona are smaller, conversely the greater the cross-sectional area the greater the power losses. At the smallest cross-sectional area of 282.6 mm2, the power losses that occurred were 2.013% and at the largest cross-sectional area of 378.7 mm2, the power losses were 5.251%. While the influence of air temperature, the lowest corona losses occur at 29 0C which are 1,223,886 kW and the biggest occur at 24 0C which are 1,373,419 kW, so the higher the air temperature the smaller the corona losses, conversely the lower the air temperature than the higher the corona losses that occur.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Mancusi ◽  
R Izzo ◽  
M A Losi ◽  
E Barbato ◽  
V Trimarco ◽  
...  

Abstract Background Increased intima media thickness (IMT) of common carotid artery (CA) is considered the hallmark of vascular hypertension-mediated target organ damage, even though vessel remodeling due to mechanical stress can be accompanied also by changes in diameter. Purpose We developed a method computing both diameter and IMT of CA, and assessed correlates and prognostic impact of carotid cross sectional area (CCSA) in a large registry of treated hypertensive patients. Methods We selected 7049 hypertensive patients of the Campania Salute Network registry free of overt cardiovascular (CV) disease and with available CA ultrasound (54±11 yrs; 57% male). CCSA was computed as: π × [((CA diameter + 2 × (mean IMT)) / 2)]2 − π × [((CA diameter) / 2)]2. Results CCSA was considered high if >90th percentile of the sex-specific distribution (>48 mm2 in men and >41 mm2 in women). Higher CCSA correlated with older age, male sex, higher pulse pressure (PP), higher total and LDL cholesterol and presence of diabetes (p<0.01 for all). During a median follow-up of 45 months (IQR 19–92), 324 incident composite major and minor CV events occurred. In Cox regression analysis high CCSA was associated with more than 100% increased risk of incident CV events (p<0.0001, figure), independently of the effect of older age, male sex, PP>60mmHg, presence of left ventricular hypertrophy (LVH), carotid plaque (CP), and less anti-RAS therapy (p<0.05 for all). Conclusions In treated hypertensive patients, increased CCSA is associated with worse metabolic and lipid profile and predict incident CV events, independently of high PP, presence of LVH and CP.


1978 ◽  
Vol 44 (3) ◽  
pp. 431-437 ◽  
Author(s):  
L. C. Maxwell ◽  
J. A. Faulkner ◽  
S. A. Mufti ◽  
A. M. Turowski

Fifty extensor digitorium longus muscles of 25 cats were autografted, 33 with and 17 without prior denervation. After 50 days, no significant differences were observed between predenervated and nonpredenervated autografts. Autografted muscles weighed 48% of the weight of control muscles. Few original muscle fibers survived and within 2 wk autografts contained regenerating muscle fibers. The mean cross-sectional area of muscle fibers in the autografts reached 125% of the value for control nontransplanted muscles. The mean percentage of fibers classified high oxidative in autografted muscles was 67% of values for control muscles. SDH activity of autografted muscle homogenates reached 55% of control values. Up to 60 days after surgery autografts had only fast-twitch fibers. At 170 days autografts remained 95% fast twitch in composition. Revascularization began within 4 days, but the capillary to fiber ratio of long term autografts reached only 60% of control values. Although fiber hypertrophy suggests that cats use autografted muscles, lower than control succinate dehydrogenase activity may result from altered recruitment.


1981 ◽  
Vol 48 (1) ◽  
pp. 35-54
Author(s):  
C.R. Shear

The effects of long-term muscle inactivity, throughout post-hatching development, have been examined. Continuous immobilization of the chicken posterior latissimus dorsi (PLD) muscle from the first hour after hatching for varying periods up to 330 days, resulted in a significantly greater decrease in myofibre size (40-64% less than control) than occurred when adult muscles were immobilized for similar periods (20-40% less than control). The myofibre atrophy resulting from long-term immobilization of adult muscle is reversible, after removal of the plaster cast. In contrast, the myofibres immobilized immediately after hatching, for similar periods of time, were unable to recover one the casts were removed. On the basis of myofibre cross-sectional area, 2 populations of cells were seen in muscles immobilized during postnatal development: small myofibres of 0.5-200 micron 2 and larger myofibres of 500–800 micron 2. The distribution of fibre cross-sectional area within immobilized adult muscles was similar to controls, suggesting a uniform response (i.e. atrophy) by all of the myofibres within the muscle. Immobilization in both newly hatched and adult PLD muscles did not appear to alter the pattern of motor endplate distribution within the muscle. Small, multiple motor endplates were observed associated with immobilized and control myofibres near their terminal ends. This finding suggests that the embryonic pattern of myofibre innervation is not entirely lost from all the fibres during postnatal development.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Aritomo Katsura ◽  
Yoshiyasu Minami ◽  
Kiyoshi Asakura ◽  
Masahiro Katamine ◽  
Ayami Kato ◽  
...  

Introduction: Factors for adverse cardiac events after drug-eluting stent (DES) implantation among patients with hemodialysis (HD) remain to be elucidated. Hypothesis: Suboptimal DES implantation is associated with the increased incidence of adverse events in patients with HD. Methods: A total of 109 consecutive patients with HD who underwent optical coherence tomography (OCT)-guided DES implantation were included. The impact of post-stent OCT findings on the incidence of device-oriented clinical endpoints (DoCE) at 1 year was investigated. DoCE included cardiac death, target vessel-related myocardial infarction, target lesion revascularization, and stent thrombosis. Results: There was no significant difference in baseline clinical characteristics and pre-stent lesion characteristics between patients with DoCE (n=15) and those without DoCE (n=94). Significant hazard ratio (HR) for the incidence of DoCE was not observed in the presence of edge dissection, irregular protrusion, or incomplete stent apposition (Panel A). In receiver operating characteristic curve analyses, the best cutoff of minimum stent cross-sectional area (MSA), %stent expansion [MSA / mean reference lumen cross-sectional area х 100], and eccentricity index (minimum stent diameter / maximum stent diameter) at MSA site for detecting DoCE was 3.4 (mm 2 ), 72.0 (%), and 0.71, respectively. Significant HR for the incidence of DoCE was observed in the presence of MSA< 3.4 (HR 3.58, 95% confidence interval [CI] 1.04 - 12.4, p=0.035) and eccentricity index< 0.71 (HR 6.68, 95% CI 1.94 - 23.0, p=0.001) (Panel B). Conclusions: Smaller stent area and eccentric expansion were associated with increased incidence of DoCE after DES implantation in patient with HD, although the presence of other post-stent suboptimal findings were not associated with the incidence of DoCE. The present results suggest the importance of larger stent area and concentric stent expansion in patients with HD.


2017 ◽  
Vol 41 (S1) ◽  
pp. S136-S137
Author(s):  
M. Gomez Revuelta ◽  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
M. Fernández Rodríguez ◽  
D. Abejas Díez ◽  
...  

IntroductionThe association between cannabis and psychosis makes crucial the intervention on cannabis use disorder at first episodes of psychosis (FEP), especially among young population. In this group of patients, the harmful potential of cannabis is more evident by its influence on neurodevelopment. However, the nature of the association cannabis-psychosis is not clearly described. It seems to represent a mediating factor for an increased risk of psychosis in healthy and high-risk populations, determining an earlier age of onset and worsening long term outcome.ObjectivesTo assess the impact of cannabis in terms of functional and clinical prognosis in patients recruited after a FEP.Material and methodsPAFIP is an early intervention program for early stages of psychosis. One hundred and sixty-three were included, followed-up at regular intervals of six months for three years with administration of clinical and functional scales (BPRS, SAPS, SANS, CDRS, GAF and Drake). Patients were divided into three groups: (1) those non-users neither before the onset nor during follow-up (nn) PEP, (2) consumers before the FEP and during follow-up (ss) and (3) consumers before the FEP that gave up consumption during follow-up (sn).ResultsNo statistically significant differences were observed in terms of functionality at three-year follow-up endpoint but a trend to a better-preserved functionality in the sn group. The sn group presented lower scores in scales for positive symptoms with respect to the comparison groups.ConclusionsThe interruption in cannabis use may have a beneficial effect on short-term clinical prognosis and functionality on long term.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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