Altered Joint Angle Strategy for Sprinting in Elite Sprinters with Chronic Ankle Instability

Hiroki Arakawa,Masamichi Okudaira,Satoru Tanigawa,Hirohiko Maemura,Takashi Fukuda 대한운동학회 2023 아시아 운동학 학술지 Vol.25 No.3

OBJECTIVES Individuals with chronic ankle instability (CAI) demonstrated altered not only ankle but also lower extremity joint angle during numerous dynamic movements compared to healthy controls. However, little is known about joint angles during sprinting, which is the most essential movement during explosive sports. We, therefore, investigated the lower extremity joint angle during sprinting between elite sprinters with CAI and healthy controls. Met hods Fourteen male college sprinters participated in this study, seven with CAI and seven healthy controls. Five-second steady speed running was performed on a treadmill at 7.5 m/s. Mean lower extremity joint angles were compared applying the statistical parametric mapping method. Results The CAI patients demonstrated significantly higher ankle dorsiflexion and knee flexion angles during the stance phase. Additionally, large between-group effect sizes would demonstrate higher ankle dorsiflexion and knee and hip flexion angle from the late swing phase to the late stance phase. Conclusions The altered lower extremity joint angles from the late swing phase to the late stance phase in CAI patients suggest greater joint stability for large external loads with feed-forward motor control programs.

Optimization of energy saving device combined with a propeller using real-coded genetic algorithm

Tomohiro Ryu,Takashi Kanemaru,Shiro Kataoka,Kiyoshi Arihama,Akira Yoshitake,Daijiro Arakawa,Jun Ando 대한조선학회 2014 International Journal of Naval Architecture and Oc Vol.6 No.2

This paper presents a numerical optimization method to improve the performance of the propeller with Turbo-Ring using real-coded genetic algorithm. In the presented method, Unimodal Normal Distribution Crossover (UNDX) and Minimal Generation Gap (MGG) model are used as crossover operator and generation-alternation model, respectively. Propeller characteristics are evaluated by a simple surface panel method “SQCM” in the optimization process. Blade sections of the original Turbo-Ring and propeller are replaced by the NACA66 a = 0.8 section. However, original chord, skew, rake and maximum blade thickness distributions in the radial direction are unchanged. Pitch and maximum camber distributions in the radial direction are selected as the design variables. Optimization is conducted to maximize the efficiency of the propeller with Turbo-Ring. The experimental result shows that the efficiency of the opti-mized propeller with Turbo-Ring is higher than that of the original propeller with Turbo-Ring.

Anococcygeal Raphe Revisited: A Histological Study Using Mid-Term Human Fetuses and Elderly Cadavers

Yusuke Kinugasa,Takashi Arakawa,Hiroshi Abe,Shinichi Abe,조백환,Gen Murakami,Kenichi Sugihara 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.4

Purpose: We recently demonstrated the morphology of the anococcygeal ligament. As the anococcygeal ligament and raphe are often confused, the concept of the anococcygeal raphe needs to be re-examined from the perspective of fetal development,as well as in terms of adult morphology. Materials and Methods: We examined the horizontal sections of 15 fetuses as well as adult histology. From cadavers,we obtained an almost cubic tissue mass containing the dorsal wall of the anorectum, the coccyx and the covering skin. Most sections were stained with hematoxylin and eosin or Masson-trichrome solution. Results: The adult ligament contained both smooth and striated muscle fibers. A similar band-like structure was seen in fetuses, containing: 1) smooth muscle fibers originating from the longitudinal muscle coat of the anal canal and 2) striated muscle fibers from the external anal sphincter (EAS). However, in fetuses, the levator ani muscle did not attach to either the band or the coccyx. Along and around the anococcygeal ligament, we did not find any aponeurotic tissue with transversely oriented fibers connecting bilateral levator ani slings. Instead, in adults, a fibrous tissue mass was located at a gap between bilateral levator ani slings; this site corresponded to the dorsal side of the ligament and the EAS in the immediately deep side of the natal skin cleft. Conclusion: We hypothesize that a classically described raphe corresponds to the specific subcutaneous tissue on the superficial or dorsal side of the anococcygeal ligament.

Female Longitudinal Anal Muscles or Conjoint Longitudinal Coats Extend into the Subcutaneous Tissue along the Vaginal Vestibule: A Histological Study Using Human Fetuses

Yusuke Kinugasa,Takashi Arakawa,Hiroshi Abe,Jose Francisco Rodríguez-Vázquez,Gen Murakami,Kenichi Sugihara 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3

Purpose: It is still unclear whether the longitudinal anal muscles or conjoint longitudinal coats (CLCs) are attached to the vagina, although such an attachment, if present, would appear to make an important contribution to the integrated supportive system of the female pelvic floor. Materials and Methods: Using immunohistochemistry for smooth muscle actin, we examined semiserial frontal sections of 1) eleven female late-stage fetuses at 28-37 weeks of gestation, 2) two female middle-stage fetus (2 specimens at 13 weeks), and, 3) six male fetuses at 12 and 37 weeks as a comparison of the morphology. Results: In late-stage female fetuses, the CLCs consistently (11/11) extended into the subcutaneous tissue along the vaginal vestibule on the anterior side of the external anal sphincter. Lateral to the CLCs, the external anal sphincter also extended anteriorly toward the vaginal side walls. The anterior part of the CLCs originated from the perimysium of the levator ani muscle without any contribution of the rectal longitudinal muscle layer. However, in 2 female middle-stage fetuses, smooth muscles along the vestibulum extended superiorly toward the levetor ani sling. In male fetuses, the CLCs were separated from another subcutaneous smooth muscle along the scrotal raphe (posterior parts of the dartos layer) by fatty tissue. Conclusion: In terms of topographical anatomy, the female anterior CLCs are likely to correspond to the lateral extension of the perineal body (a bulky subcutaneous smooth muscle mass present in adult women), supporting the vaginal vestibule by transmission of force from the levator ani.

Whipple disease mimicking inflammatory bowel disease

( Maiko Tatsuki ),( Takashi Ishige ),( Yoshiko Igarashi ),( Reiko Hatori ),( Akira Hokama ),( Junko Hirato ),( Aleixo Muise ),( Takumi Takizawa ),( Hirokazu Arakawa ) 대한장연구학회 2021 Intestinal Research Vol.19 No.1

Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acid-Schiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy. (Intest Res 2021;19:119-125)

Optimization of energy saving device combined with a propeller using real-coded genetic algorithm

Ryu, Tomohiro,Kanemaru, Takashi,Kataoka, Shiro,Arihama, Kiyoshi,Yoshitake, Akira,Arakawa, Daijiro,Ando, Jun The Society of Naval Architects of Korea 2014 International Journal of Naval Architecture and Oc Vol.6 No.2

This paper presents a numerical optimization method to improve the performance of the propeller with Turbo-Ring using real-coded genetic algorithm. In the presented method, Unimodal Normal Distribution Crossover (UNDX) and Minimal Generation Gap (MGG) model are used as crossover operator and generation-alternation model, respectively. Propeller characteristics are evaluated by a simple surface panel method "SQCM" in the optimization process. Blade sections of the original Turbo-Ring and propeller are replaced by the NACA66 a = 0.8 section. However, original chord, skew, rake and maximum blade thickness distributions in the radial direction are unchanged. Pitch and maximum camber distributions in the radial direction are selected as the design variables. Optimization is conducted to maximize the efficiency of the propeller with Turbo-Ring. The experimental result shows that the efficiency of the optimized propeller with Turbo-Ring is higher than that of the original propeller with Turbo-Ring.

Original Article : Ulcerative Colitis and Immunoglobulin G4

( Go Kuwata ),( Terumi Kamisawa ),( Koichi Koizumi ),( Taku Tabata ),( Seiichi Hara ),( Sawako Kuruma ),( Takashi Fujiwara ),( Kazuro Chiba ),( Hideto Egashira ),( Junko Fujiwara ),( Takeo Arakawa ),( The Editorial Office of Gut and Liver 2014 Gut and Liver Vol.8 No.1

Background/Aims: Ulcerative colitis (UC) is sometimes associated with autoimmune pancreatitis (AIP). Infiltration of immunoglobulin G4 (IgG4)-positive plasma cells is sometimes detected in the colonic mucosa of AIP or UC patients. This study aimed to clarify the relation between UC and IgG4. Methods: Associations with UC were reviewed in 85 AIP patients. IgG4 immunostaining was performed on biopsy specimens from the colonic mucosa of 14 AIP and 32 UC patients. Results: UC was confirmed in two cases (type 1 AIP, n=1, suspected type 2 AIP, n=1). Abundant infiltration of IgG4-positive plasma cells in the colonic mucosa was detected in the case of suspected type 2 AIP with UC and two cases of type 1 AIP without colitis. Abundant infiltration of IgG4-positive plasma cells was detected in 10 UC cases (IgG4-present, 31%). Although 72% of IgG4-absent UC patients showed mild disease activity, 70% of IgG4-present patients showed moderate to severe disease activity (p<0.05). Conclusions: UC is sometimes associated with AIP, but it seems that UC is not a manifestation of IgG4-related disease. Infiltration of IgG4-positive plasma cells is sometimes detectable in the colonic mucosa of UC patients and is associated with disease activity. (Gut Liver 2014,8:29-34)

Original Article : Differentiating Immunoglobulin G4-Related Sclerosing Cholangitis from Hilar Cholangiocarcinoma

( Taku Tabata ),( Terumi Kamisawa ),( Seiichi Hara ),( Sawako Kuruma ),( Kazuro Chiba ),( Go Kuwata ),( Takashi Fujiwara ),( Hideto Egashira ),( Koichi Koizumi ),( Junko Fujiwara ),( Takeo Arakawa ),( 대한간학회 2013 Gut and Liver Vol.7 No.2

Background/Aims: Few studies have differentiated immunoglobulin G (IgG) 4-related sclerosing cholangitis (IgG4-SC) from hilar cholangiocarcinoma (CC). Thus, we sought to investigate useful features for differentiating IgG4-SC from hilar CC. Methods: We retrospectively compared clinical, serological, imaging, and histological features of six patients with IgG4-SC and 42 patients with hilar CC. Results: In patients with hilar CC, obstructive jaundice was more frequent (p<0.01), serum total bilirubin levels were significantly higher (p<0.05), serum CA19-9 levels were significantly higher (p<0.01), and serum duke pancreatic monoclonal antigen type 2 levels were frequently elevated (p<0.05). However, in patients with IgG4-SC, the serum IgG (p<0.05) and IgG4 (p<0.01) levels were significantly higher and frequently elevated. The pancreas was enlarged in all IgG4-SC patients but only in 17% of hilar CC patients (p<0.01). Salivary and/or lacrimal gland swelling was detected in only 50% of IgG4-SC patients (p<0.01). Endoscopic retrograde cholangiography revealed that the hilar or hepatic duct was completely obstructed in 83% of hilar CC patients (p<0.01). Lower bile duct stenosis, apart from hilar bile duct stenosis, was more frequent in IgG4-SC patients (p<0.01). Bile duct wall thickening in areas without stenosis was more frequent in IgG4-SC patients (p<0.01). Conclusions: An integrated diagnostic approach based on clinical, serological, imaging, and histological findings is necessary to differentiate IgG4-SC from hilar CC. (Gut Liver 2013;7:234-238)

Organ Correlation in IgG4-Related Diseases

Satomi Koizumi,Terumi Kamisawa,Sawako Kuruma,Taku Tabata,Kazuro Chiba,Susumu Iwasaki,Go Kuwata,Takashi Fujiwara,Junko Fujiwara,Takeo Arakawa,Koichi Koizumi,Kumiko Momma 대한의학회 2015 Journal of Korean medical science Vol.30 No.6

IgG4-related disease (IgG4-RD) is a potentially multiorgan disorder. In this study, clinical and serological features from 132 IgG4-RD patients were compared about organ correlations. Underlying pathologies comprised autoimmune pancreatitis (AIP) in 85 cases, IgG4-related sclerosing cholangitis (IgG4-SC) in 12, IgG4-related sialadenitis (IgG4-SIA) in 56, IgG4-related dacryoadenitis (IgG4-DAC) in 38, IgG4-related lymphadenopathy (IgG4- LYM) in 20, IgG4-related retroperitoneal fibrosis (IgG4-RF) in 19, IgG4-related kidney disease (IgG4-KD) in 6, IgG4-related pseudotumor (IgG4-PT) in 3. Sixty-five patients (49%) had multiple IgG4-RD (two affected organs in 36 patients, three in 19, four in 8, five in 1, and six in 1). Serum IgG4 levels were significantly higher with multiple lesions than with a single lesion (P < 0.001). The proportion of association with other IgG4-RD was 42% in AIP, the lowest of all IgG4-RDs. Serum IgG4 level was lower in AIP than in other IgG4-RDs. Frequently associated IgG4-RDs were SIA (25%) and DAC (12%) for AIP; AIP (75%) for IgG4-SC; DAC (57%), AIP (38%) and LYM (27%) for IgG4-SIA; AIP (26%) and LYM (26%) for IgG4-DAC; SIA (75%), DAC (50%) and AIP (45%) for IgG4-LYM; SIA (58%), AIP (42%) and LYM (32%) for IgG4-RF; AIP (100%) and SIA (67%) for IgG4-KID; and DAC (67%) and SIA (67%) for IgG4-PT. Most associated IgG4-RD lesions were diagnosed simultaneously, but IgG4-SIA and IgG4-DAC were sometimes identified before other lesions. About half of IgG4-RD patients had multiple IgG4-RD lesions, and some associations were seen between specific organs.

Characteristic Findings of Endoscopic Retrograde Cholangiopancreatography in Autoimmune Pancreatitis

( Susumu Iwasaki ),( Terumi Kamisawa ),( Satomi Koizumi ),( Kazuro Chiba ),( Taku Tabata ),( Sawako Kuruma ),( Go Kuwata ),( Takashi Fujiwara ),( Koichi Koizumi ),( Takeo Arakawa ),( Kumiko Momma ),( 대한소화기학회 2015 Gut and Liver Vol.9 No.1

Background/Aims: Diffuse or segmental irregular narrowing of the main pancreatic duct (MPD), as observed by endoscopic retrograde cholangiopancreatography (ERCP), is a characteristic feature of autoimmune pancreatitis (AIP). Methods: ERCP findings were retrospectively examined in 40 patients with AIP in whom irregular narrowing of the MPD was detected near the orifice. The MPD opening sign was defined as the MPD within 1.5 cm from the orifice being maintained. The distal common bile duct (CBD) sign was defined as the distal CBD within 1.5 cm from the orifice being maintained. Endoscopic findings of a swollen major papilla and histological findings of specimens obtained from the major papilla were examined in 26 and 21 patients, respectively. Results: The MPD opening sign was detected in 26 of the 40 patients (65%). The distal CBD sign was detected in 25 of the 32 patients (78%), which showed stenosis of the lower bile duct. The patients who showed the MPD opening sign frequently showed the distal CBD sign (p=0.018). Lymphoplasmacytic infiltration, but not dense fibrosis, was histologically detected in biopsy specimens obtained from the major papilla. Conclusions: On ERCP, the MPD and CBD adjacent to the major papilla are frequently maintained in patients with AIP involving the pancreatic head. These signs are useful for diagnosing AIP on ERCP. (Gut Liver 2015;9:113-117)