Degenerative changes of the facet joints in patients with lumbar spondylolysis were more severe than those without spondylolysis.

Purpose To compare diffusion tensor imaging (DTI) parameters in healthy adult human lower leg muscles and to determine the correlation between DTI parameters and muscle power measurements among different types of muscle contraction. Materials and methods DTI measurements of the unilateral lower leg muscles having three different types of contraction (non-contraction state, isometric contraction, and soleus shortening) were obtained from 10 healthy adults using a 3-T MRI scanner. DTI parameters (λ1, λ2, λ3, mean diffusivity, and fractional anisotropy) were calculated. The values of the DTI parameters and correlation between the DTI parameters and muscle power measurements (maximum power and maximum amount of work) obtained from a dynamometer were statistically compared among the different types of contraction. Intra- and inter-class correlation coefficients were calculated for analysis of reproducibility. Results The λ1, λ2, λ3, and mean diffusivity of the soleus muscle are significantly lower in the non-contraction state as compared with isometric contraction and soleus shortening (p < 0.05). A positive correlation of the soleus muscle in the non-contraction state was seen between the maximum power and the λ1, λ2, and mean diffusivity. There was a positive correlation between the maximum amount of work and fractional anisotropy in the non-contraction state for the soleus muscle. A negative correlation for the tibialis anterior muscle in the non-contraction state was seen between the maximum amount of work and fractional anisotropy. Overall reproducibility of the DTI parameters was excellent. Conclusions DTI parameters were significantly changed depending on the ankle joint position and type of muscle contraction.

Background:In the daily clinical course, the liver uptake may seem to be increased in patients with renal failure. The purpose of this study was to investigate whether or not the FDG uptake of the liver, and the FDG uptake of blood pool which is generally used as a reference site as well as liver, is increased in patients with renal failure. Material and methods:We retrospectively analyzed 233 patients who underwent FDG positron emission tomography/computed tomography (PET/CT). Renal failure is defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 . We compared the FDG uptake in the liver and mediastinal blood pool of 67 patients with impaired renal function to that in 166 patients with a normal renal function (eGFR ≥ 60 mL/min/1.73 m 2 ). Correlations between the liver or mediastinal blood pool FDG uptake and the eGFR were also analyzed by Spearman's correlation test.Results: Maximum and mean standardized uptake values (SUV max and SUV mean , respectively) of the liver and the SUV mean of the mediastinal blood pool were 3.48 ± 0.57, 2.56 ± 0.37, and 1.90 ± 0.28 in the impaired renal function group, respectively, and 3.13 ± 0.45, 2.29 ± 0.33, and 1.66 ± 0.23, in the normal group, respectively. The SUV max and SUV mean of the liver and SUV mean of the mediastinal blood pool in the impaired renal function group were significantly higher than those in the normal group (p < 0.001, < 0.001, and < 0.001, respectively). The SUV max and SUV mean of the liver and SUV mean of the mediastinal blood pool of patients showed a significant negative correlation with the eGFR (Spearman's p = -0.25, -0.30, and -0.40, respectively, each p < 0.001).Conclusions: FDG uptake in both the liver and mediastinal blood pool was higher in patients with impaired renal function.

Progressive multifocal leukoencephalopathy (PML) is a devastating demyelinating disease caused by JC virus (JCV), predominantly affecting patients with impaired cellular immunity. PML is a non-reportable disease with a few exceptions, making national surveillance difficult. In Japan, polymerase chain reaction (PCR) testing for JCV in the cerebrospinal fluid (CSF) is performed at the National Institute of Infectious Diseases to support PML diagnosis. To clarify the overall profile of PML in Japan, patient data provided at the time of CSF-JCV testing over 10 years (FY2011–2020) were analyzed. PCR testing for 1537 new suspected PML cases was conducted, and 288 (18.7%) patients tested positive for CSF-JCV. An analysis of the clinical information on all individuals tested revealed characteristics of PML cases, including the geographic distribution, age and sex patterns, and CSF-JCV-positivity rates among the study subjects for each type of underlying condition. During the last five years of the study period, a surveillance system utilizing ultrasensitive PCR testing and widespread clinical attention to PML led to the detection of CSF-JCV in the earlier stages of the disease. The results of this study will provide valuable information not only for PML diagnosis, but also for the treatment of PML-predisposing conditions.

Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder, with its currently approved drugs, including riluzole and edaravone, showing limited therapeutic effects. Therefore, safe and effective drugs are urgently necessary. EPI-589 is an orally available, small-molecule, novel redox-active agent characterized by highly potent protective effects against oxidative stress with high blood-brain barrier permeability. Given the apparent oxidative stress and mitochondrial dysfunction involvement in the pathogenesis of ALS, EPI-589 may hold promise as a therapeutic agent. Objective This protocol aims to describe the design and rationale for the EPI-589 Early Phase 2 Investigator-Initiated Clinical Trial for ALS (EPIC-ALS). Methods EPIC-ALS is an explorative, open-labeled, single-arm trial that evaluates the safety and tolerability of EPI-589 in patients with ALS. This trial consists of 12-week run-in, 24-week treatment, and 4-week follow-up periods. Patients will receive 500 mg of EPI-589 3 times daily over the 24-week treatment period. Clinical assessments include the mean monthly change of Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised total score. The biomarkers are selected to analyze the effect on oxidative stress and neuronal damage. The plasma biomarkers are 8-hydroxy-2′-deoxyguanosine (8-OHdG), 3-nitrotyrosine (3-NT), neurofilament light chain (NfL), phosphorylated neurofilament heavy chain (pNfH), homocysteine, and creatinine. The cerebrospinal fluid biomarkers are 8-OHdG, 3-NT, NfL, pNfH, and ornithine. The magnetic resonance biomarkers are fractional anisotropy in the corticospinal tract and N-acetylaspartate in the primary motor area. Results This trial began data collection in September 2021 and is expected to be completed in October 2023. Conclusions This study can provide useful data to understand the characteristics of EPI-589. Trial Registration Japan Primary Registries Network jRCT2061210031; tinyurl.com/2p84emu6 International Registered Report Identifier (IRRID) DERR1-10.2196/42032