OBJECTIVETo explore the correlation between periodic limb movement index (PLMI) and the apnea-hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and lowest oxygen saturation (LSaO₂) in sixty-four children with sleep-disordered breathing (SDB).

METHODSBetween March 2008 and May 2009, sixty-four children suspected of OSAHS underwent overnight polysomnogram monitoring in our medicine sleep center. OSAHS was diagnosed according to the general criterion. Sixty-four children were divided into two groups. Thirty children were diagnosed as OSAHS and 34 children were diagnosed as primary snoring (PS, 32 children) or upper airway resistance syndrome (UARS, 2 children). The difference of PLMI and periodic limb movement index during sleep associated with arousals (PLMI-arousal) were compared between the two groups. Besides this, the correlation between PLMI, periodic limb movement index during sleep associated with arousals and AHI, AI, HI and LSaO₂ were also analyzed in all SDB children. Furthermore, all SDB children were divided into two groups according to PLMI (< 5 events/h vs ≥ 5 events/h). AHI, AI, HI, LSaO₂ and sleep structure were compared between the two groups.

RESULTS(1) The difference of PLMI and PLMI-arousal between the children with OSAHS and children with other SDB types (PS and UARS) were not significant (z value, -1.279, -1.490; P value, 0.201, 0.136, respectively). (2) The increased sleep stage I was significant as being compared between the two groups (< 5 events/h vs ≥ 5 events/h, t = -2.16, P < 0.05). However, other sleep stages and sleep efficiency were not significantly different (P value, all > 0.05). (3) The difference of HI, AI, AHI, arousals index (ArI) and LSaO₂ were not significant between the two groups (< 5 events/h vs ≥ 5 events/h, P value, all > 0.05). (4) PLMI and PLMI-arousal were not correlated with AHI, HI, AI, AHI and LSaO₂ (Spearman rank correlation analysis).

CONCLUSIONSPLMS may be independent of SDB and PLMS had a little influence on sleep structure.

Adolescent ; Child ; Child, Preschool ; Extremities ; physiopathology ; Female ; Humans ; Male ; Movement ; Polysomnography ; Sleep ; Sleep Apnea Syndromes ; physiopathology

OBJECTIVEThis review aims to illustrate the relationship between clinical features and the prognosis of patients with limb-shaking transient ischemic attack (LS-TIA).

DATA SOURCESRelevant articles published in two main Chinese medical periodical databases (China National Knowledge Infrastructure and China Science Periodical Database) from 1986 to June 2013 were identified with keywords "limb shaking" and "transient ischemic attack".

STUDY SELECTIONOriginal articles and case reports about LS-TIA were selected.

RESULTSA total of 63 cases collected from 19 articles were included in the pooled analysis. LS-TIA presented in two cerebrovascular diseases, of which atherosclerotic high-grade stenosis or occlusion in carotid artery system and moyamoya disease formed 95.2% and 4.8%, respectively. Of 63 patients, 11 (17.5%) were once misdiagnosed as epileptic and prescribed useless antiepilepsy drugs. The multivariable Logistic regression model showed a significant protective effect of patients with revascularization therapy on prognosis, compared with patients treated with drugs (odds ratio 0.20, 95% CI 0.05-0.74, P = 0.016).

CONCLUSIONSChronic carotid artery system hypoperfusion can induce limb(s) shaking, followed by high possibility of ischemic stroke in the same brain territorial. Revascularization of the responsible artery may work better than conservative drug-based therapy.

Aged ; Extremities ; physiopathology ; Female ; Humans ; Ischemic Attack, Transient ; pathology ; physiopathology ; Male ; Middle Aged ; Prognosis

AIMTo explore the role of femoral nerves section (FNS) on the protection of limb ischemic preconditioning (LIP) against cerebral ischemia/reperfusion injuries.

METHODSModel of brain ischemia induced by Four-vessel occlusion was used. LIP was performed by clamping the bilateral femoral arteries for 10 min 3 times in a interval of 10 min. Rats with vertebral arteries permanently occluded were divided into sham group, cerebral ischemic group, FNS + cerebral ischemic group, LIP + cerebral ischemic group, FNS + LIP + cerebral ischemic group. The changes of neural density (ND) in the CA1 hippocampus were observed 7d after the sham operation or brain ischemia under thionin staining. The expression of c-Fos in the CA1 hippocampus was measured 6 h after the sham operation or brain ischemia under immunohistochemistry method.

RESULTSThionin staining revealed that serious neuronal damage was visualized in the CA1 hippocampus in both cerebral ischemic group and FNS + cerebral ischemic group as compared with sham group. LIP attenuated the neuronal damage of the CA1 subfield induced normally by cerebral ischemia/reperfusion, and ND in LIP + cerebral ischemic group was significantly higher than that in cerebral ischemic group (P < 0.01). But obvious neuronal damage of the CA1 subfield was found in FNS+ LIP + cerebral ischemic group, and ND was significantly decreased as compared with LIP + cerebral ischemic group (P < 0.01). These results suggested that the protection of LIP against cerebral ischemia/reperfusion injuries might be cancelled by preceding section of femoral nerve. It was found that there was almost no c-Fos expression in the CA1 hippocampus in sham group. Changes of c-Fos expression in the CA1 subfield in cerebral ischemic group were similar to that in sham group. But in LIP + cerebral ischemic group, c-Fos expression in the CA1 subfield was markedly increased and the number of positive cells and optical density of c-Fos expression were significantly higher than those in sham and cerebral ischemic group. c-Fos expression in the CA1 subfield was again decreased in FNS + LIP + cerebral ischemic group, and the number of positive cells and optical density of c-Fos expression were significantly lower than those in LIP + cerebral ischemic group.

CONCLUSIONNeural pathway participated in the protective effect of LIP on brain, and increased c-Fos expression in the CA1 hippocampus by LIP after cerebral ischemia/reperfusion, might be a part of neural pathway by which LIP induced brain ischemic tolerance.

Animals ; Brain Ischemia ; physiopathology ; Extremities ; blood supply ; Ischemic Preconditioning ; methods ; Male ; Neural Pathways ; physiopathology ; Rats ; Rats, Wistar ; Reperfusion Injury ; physiopathology

This research was designed to illuminate the change in biomechanical parameters of soft tissue for bite marks on porker limb. The authors used a prefabricate nob to press perpendicularly on porket limb and so to establish bite mark under three forces: 100 N, 200 N and 300 N. After the procedure of biting, the stress-strain relationship and changes in extension of soft tissue were recorded. Meanwhile, the elasticity was measured with a press meter at nine time-points. When bite mark was formed, with the development of stress, the strain of soft tissue increased. But the speed of increment slowed down when stress exceeded some extent. After bite mark was formed, the extension and elasticity of soft tissue decreased with the increase of pressure.
Animals ; Animals, Newborn ; Biomechanical Phenomena ; Bite Force ; Bites, Human ; physiopathology ; Elasticity ; Extremities ; Humans ; Soft Tissue Injuries ; physiopathology ; Stress, Mechanical ; Swine

UNLABELLEDOBJECTIVE; To observe the effects of early acupuncture on motor function of the limb in the severe head injury patients.

METHODSNinety-six patients were randomly divided into an observation group and a control group, 48 cases in each group. The patient in the control group were treated by routine treatment of neurosurgical operation and drug treatment (Mannitol, Citioline Sodium, Cefeazidime, etc.). While the patient in the observation group were treated by the routine treatment and acupuncture treatment 48 h(-1) week after operation in different stages with different acupoints selected when the situation was stable. The selected main points were Neiguan (PC 6), Qu-chi (LI 11), Waiguan (TE 5), Hegu (LI 4), Binao (LI 14), Jianyu (LI 15), Fengshi (GB 31), Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taichong (LR 3), etc.. The limb motor function was evaluated with Fugl-Meyer Assessment (FMA) scale before treatment and after 10-week treatment.

RESULTSThere was a significant improvement in the FMA score in the two groups after the treatment (P < 0.01). The comparison between the two groups after the treatment showed that the improvement of FMA score in the observation group was significantly better than the control group (P < 0.05 or P < 0.01).

CONCLUSIONEarly acupuncture can improve the limb motor function in the severe head injury patients.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Craniocerebral Trauma ; physiopathology ; therapy ; Extremities ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Motor Activity

OBJECTIVETo study the effects of virtual reality (VR) training on the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

METHODSThirty-five children with spastic diplegia cerebral palsy were randomly assigned to VR training group (n=19) and conventional training group (n=16). The conventional training group received conventional physical therapy and occupational therapy for three months. The VR training group received VR training and occupational therapy for three months. Grip and visual-motor integration subtests in Peabody Developmental Motor Scales-2 were used to evaluate the fine movement in patients before and after treatment. The D and E domains of the 88-item version of the Gross Motor Function Measure (GMFM-88), Modified Ashworth Scale (MAS), and Berg Balance Scale (BBS) were used to evaluate the gross movement in patients before and after treatment.

RESULTSBefore treatment, there were no significant differences in grip, visual-motor integration, fine motor development quotient, scores of D and E domains of GMFM-88, MAS score, or BBS score between the two groups (P>0.05). After treatment, all the indices were significantly improved in the VR training group compared with the conventional training group (P<0.05).

CONCLUSIONSVR training can effectively improve the gross motor function of the lower limb and the fine motor function of the upper limb in children with spastic diplegia cerebral palsy.

Cerebral Palsy ; physiopathology ; therapy ; Child ; Child, Preschool ; Extremities ; physiopathology ; Female ; Humans ; Male ; Movement ; Virtual Reality Exposure Therapy

OBJECTIVE: To observe the changes of electrocardiogram and serum cardiac troponin I at the early stage of severe crush injury in rats. METHODS: Crush injury was produced in Sprague-Dawley rats. The changes of electrocardiogram were recorded with the standard II, the serum levels of cardiac troponin I were studied by automated chemiluminescence assay. RESULTS: The ST segment elevated considerably after crush injury and lasted 24 h, the levels of serum cTnI were much higher than those of the control groupes after 6 h of injury. CONCLUSION Cardiomyocyte injury was induced in the early phase of crush injury.
Animals ; Crush Syndrome/physiopathology* ; Electrocardiography ; Extremities/injuries* ; Female ; Heart Injuries/physiopathology* ; Male ; Rats ; Rats, Sprague-Dawley ; Troponin I/blood*

OBJECTIVE: To analyze and compare different methods for assessment of the limbs joints function and to discuss the rationality of the methods. METHODS: Eight hundred and six cases were collected from the Fujian Minzhong Forensic Appraisal Center from 2007 to 2010. These cases included injuries of large limbs joints with or without peripheral nerve injury. The loss of joint function was calculated according to the simple joint mobility method or the table method introduced in the book "Forensic Clinical Judicial Authentication Practice". The results of disability evaluation with different methods were analyzed and compared between different joints and injury patterns. RESULTS: In 642 cases of simple joint injuries without peripheral nerve injury, the results of disability evaluation based on simple joint mobility were the same as that based on the table. In 118 cases of joint injuries with peripheral nerve injury, all of them could be classified as disability, 33 cases (28.00%) had higher degree based on the table method than based on the simple joint mobility method. While 21 cases (17.80%) did not be evaluated as disabled based on the simple joint mobility method. CONCLUSION The evaluation for loss of limb function would be easier, more scientific and reasonable by the direct table method than the simple joint mobility method.
Accidents, Traffic ; Adult ; Arm Injuries/physiopathology* ; Disability Evaluation ; Extremities ; Female ; Forensic Medicine/methods* ; Humans ; Joints/physiopathology* ; Leg Injuries/physiopathology* ; Male ; Peripheral Nerve Injuries/physiopathology* ; Range of Motion, Articular/physiology* ; Trauma Severity Indices

Autonomic dysfunction commonly occurs in Parkinson's disease, but the pathogenesis of autonomic dysregulation remains uncertain. Autonomic functions regulating the cardiovascular system have been investigated in Parkinson's disease, but those involving the extremities has not been well demonstrated. To compare autonomic dysfunctions of the cardiovascular system with those of the extremities, we performed sympathetic skin response (SSR) and cardiovascular autonomic function tests (CAFT) - 30:15 ratio, E:I ratio, Valsalva ratio, isometric exercise test (IET) - in 37 patients with Parkinson's disease and 33 age- and sex-matched healthy controls. The patients were asked to stop antiparkinsonian medications for at least 12 hours prior to the tests. SSR was measured at the right hand and foot after electrical stimulation of the right median and posterior tibial nerves. Absent SSR at either one or both extremities and CAFT beyond normal ranges were regarded as abnormal. Abnormal SSR was observed in 59% of patients, while abnormal CAFT were found in the range of 32%-81%. Patients with abnormal SSR showed more frequent and severe CAFT abnormalities than did patients with normal SSR. Among the CAFT, IET was well correlated with the SSR. The results suggest that parkinsonian sympathetic dysfunction involving either the cardiovascular system or the extremities may have the same pathophysiology.
Adult ; Aged ; Aged, 80 and over ; Autonomic Nervous System/physiopathology* ; Cardiovascular System/innervation* ; Extremities/innervation ; Female ; Galvanic Skin Response/physiology* ; Human ; Male ; Middle Age ; Parkinson Disease/physiopathology*

Reflex movements have been reported to occur in up to 75% of brain-dead patients, but this issue has not been addressed in Korea. The patients admitted to our hospital who met the criteria for brain death were enrolled between March 2003 and February 2005. The frequency and type of reflex movements in these patients were evaluated prospectively using a standardized protocol. Brain death was determined according to the guideline of Korean Medical Association. Of 26 patients who were included, five (19.2%) exhibited reflex movements such as the pronation-extension reflex, abdominal reflex, flexion reflex, the Lazarus sign, and periodic leg movements. This finding suggests that the frequency of spinal reflex movements is not rare and the awareness of these movements may prevent delays in brain-dead diagnosis and misinterpretations.
Spinal Cord/physiopathology ; *Reflex ; Prospective Studies ; Physical Stimulation ; Organ Transplantation ; Movement ; Middle Aged ; Male ; Humans ; Female ; Extremities/physiopathology ; Brain Death/*pathology ; Adult