SUMMARY Preoperative risk assessment, particularly for patient frailty, remains largely subjective. This study evaluated the relationship between core muscle size and patient outcomes following esophagectomy for malignancy. Using preoperative computed tomography scans in 230 subjects who had undergone transhiatal esophagectomy for cancer between 2001 and 2010, lean psoas area (LPA), measured at the fourth lumbar vertebra, was determined. Cox proportional hazards regression was employed to analyze overall survival (OS) and disease-free survival (DFS) adjusted for age, gender, and stage, and the Akaike information criterion was used to determine each covariate contribution to OS and DFS. Univariate analysis demonstrated that increasing LPA correlated with both OS (P = 0.017) and DFS (P = 0.038). In multivariate analysis controlling for patient and tumor characteristics, LPA correlated with OS and DFS in patients who had not received neoadjuvant treatment (n = 64), with higher LPA associated with improved OS and DFS. Moreover, LPA was of equivalent, or slightly higher importance than pathologic stage. These measures were not predictive among patients (n = 166) receiving neoadjuvant chemoradiation. Core muscle size appears to be an independent predictor of both OS and DFS, as significant as tumor stage, in patients following transhiatal esophagectomy. Changes in muscle mass related to preoperative treatment may confound this effect. Assessment of core muscle size may provide an additional objective measure for risk stratification prior to undergoing esophagectomy.

We quantified reference values for lumbar and thoracic muscle CSA measures in a healthy US population. We defined the effect of IV contrast and different HU ranges for muscle. Combined, these results facilitate the extraction of clinically valuable data from the large numbers of existing scans performed for medical indications.

BACKGROUND: Daily life movements require balance ability. Good balance control is closely related to body stability and its development. Therefore, balance training is necessary for any age group. OBJECTIVE: This study proposes the combination of Kinect and virtual reality to build an information platform of interactive scenarios, for practice and evaluation of balance ability. Real-time monitoring of SpO2, pulse rate, velocity and reaction time during the training process is presented for the training activities of elderly physical function. METHODS: Based on the indicators of balance ability, this information platform sets out various training activities to improve balance ability, making the supposedly tedious process fun and vivid and leading to much better training results. RESULTS: The data (SpO2, pulse rate, velocity, reaction time) collected from this platform can be sorted and analysed, and the results used to evaluate the performance of balance training, and referenced for follow-up planning in the future. The real-time pulse rate and SpO2 measurement information indicating the training activities for the elderly to maintain physical function has a positive significance. A noninvasive and unconstrained real-time method to detect the pulse rate and SpO2 during exercises is presented. The results of balance assessment scale testing of BBS and TUG for the experimental group show that effective balance really improved. The difference between the experimental group and the control group was achieved by using paired t-test. The data were analysed by the descriptive statistics on significant level of P < 0.01. W.-M. Hsieh et al. / Virtual reality system based on Kinect for the elderly in fall preventionCONCLUSIONS: From the training results of the participants, we know that the information platform developed for enhancing balance ability is in line with practical needs. Furthermore, the fun and interesting game-like exercises it introduces are very helpful in improving balance ability, and certainly in preventing falls.