Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.

Methods: Thirty-one patients with multilevel cervical spondylotic myelopathy who required C6–C7 level decompression surgery were operated and followed up for 24 months. One group (15 patients) received C7 arcocristectomy without laminoplasty, and the other group (16 patients) received C7 laminoplasty. Flexion, neutral, and extension angles were measured using the Cobb method at C2–C7 to evaluate preoperative and postoperative radiographic parameters. Range of motion (ROM), ROM preservation rate of the cervical spine, C2–C7 sagittal vertical axis (SVA), and T1 slope were measured using C-spine lateral X-ray. The Visual Analog Scale (VAS) and modified Japanese Orthopedic Association (JOA) score were used to compare preoperative and postoperative clinical symptoms. Results: Flexion, neutral, extension angles of the cervical spine, C2–C7 SVA, T1 slope, ROM, ROM preservation rate, and modified JOA score were not significantly different between the two groups (p>0.05). In the C7 arcocristectomy group, the average postoperative VAS for axial neck pain was increased in 13.3% (2/15) of the patients, whereas in the C7 laminoplasty group, the average postoperative VAS was increased in 43.8% (7/16) of the patients (p=0.018). Conclusions C7 arcocristectomy, which preserves the C7 spinous process and posterior structures, is a useful technique for relieving axial neck pain.

PURPOSE: A laparoscopic colectomy in colorectal-cancer patients is usually associated with a high risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of injection of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist for the reduction of PONV in patients with colorectal cancer. METHODS: A total of 48 patients scheduled to undergo a laparoscopic colectomy for colorectal cancer were randomized in a double-blinded fashion. Patients were randomly allocated to 1 of 2 groups and assigned to receive either 0.3 mg of ramosetron intravenously (group A, n = 25) or 2 mL of normal saline (placebo) (group B, n = 22) immediately after the operation. The incidence of PONV, the nausea severity scale score, the visual analogue scale (VAS) score for pain, the total amount of patient-controlled analgesia used, the recovery of bowel function, and morbidities were assessed at 1 hour and at 24, 48, and 72 hours after surgery. RESULTS: The baseline and the operative characteristics were similar between the groups (P > 0.05). The number of cases without PONV (complete response) was higher for group A (ramosetron) than group B (normal saline): 24 hours after surgery, 92.0% (23 of 25) for group A versus 54.5% (12 of 22) for group B; 48 hours after surgery, 92% (23 of 25) for group A versus 81.8% (18 of 22) for group B (both P < 0.05). No serious adverse events occurred. CONCLUSION: Postoperative ramosetron injection is effective for the prevention of PONV after a laparoscopic colectomy in colorectal-cancer patients.
Analgesia, Patient-Controlled ; Colectomy ; Colorectal Neoplasms ; Humans ; Incidence ; Nausea ; Postoperative Nausea and Vomiting ; Serotonin ; Vomiting

The lateral septum (LS) is a forebrain structure that has been implicated in a wide range of behavioral and physiological responses to stress. However, the specific populations of neurons in the LS that mediate stress responses remain incompletely understood. Here, we show that neurons in the dorsal lateral septum (LSd) that express the somatostatin gene (hereafter, LSd Sst neurons) are activated by diverse stressors. Retrograde tracing from LSd Sst neurons revealed that these neurons are directly innervated by neurons in the locus coeruleus (LC), the primary source of norepinephrine well-known to mediate diverse stress-related functions in the brain. Consistently, we found that norepinephrine increased excitatory synaptic transmission onto LSd Sst neurons, suggesting the functional connectivity between LSd Sst neurons and LC noradrenergic neurons. However, optogenetic stimulation of LSd Sst neurons did not affect stress-related behaviors or autonomic functions, likely owing to the functional heterogeneity within this population. Together, our findings show that LSd Sst neurons are activated by diverse stressors and suggest that norepinephrine released from the LC may modulate the activity of LSd Sst neurons under stressful circumstances.

Background: and PurposePrevious studies have revealed various risk factors for carpal tunnel syndrome (CTS), but few large-scale studies have been conducted. We used data from the 11-year, longitudinal, nationwide population-based National Health Insurance Service–National Health Screening cohort to identify the actual risk factors for CTS. Methods: We collected patients with CTS newly diagnosed using electrodiagnostic studies while excluding radiculopathy, plexopathy, or polyneuropathy, which can be confused with CTS. The crude and standardized incidence rates of CTS were calculated. Univariate and multivariate Cox analyses and the incidence of CTS were used to identify the risk factors for newly diagnosed CTS. Results: The standardized incidence was 130.8/100,000 person-years based on the World Health Organization World Standard Population as a reference. Multivariate Cox analysis identified that the risk factors for CTS were being middle-aged, female, and obese, and having rheumatoid arthritis and Raynaud's syndrome, whereas gout and hypothyroidism were not risk factors. Diabetes and end-stage renal disease did not show a significant hazard ratio, although it is implicit that the durations of these diseases affect the development of CTS. Conclusions This study calculated the incidence of CTS and reappraised the associated risk factors found in previous studies. This information will be helpful for determining the pathophysiology of CTS, and hence aid the establishment of effective new public health policies.

Background: and PurposePrevious studies have revealed various risk factors for carpal tunnel syndrome (CTS), but few large-scale studies have been conducted. We used data from the 11-year, longitudinal, nationwide population-based National Health Insurance Service–National Health Screening cohort to identify the actual risk factors for CTS. Methods: We collected patients with CTS newly diagnosed using electrodiagnostic studies while excluding radiculopathy, plexopathy, or polyneuropathy, which can be confused with CTS. The crude and standardized incidence rates of CTS were calculated. Univariate and multivariate Cox analyses and the incidence of CTS were used to identify the risk factors for newly diagnosed CTS. Results: The standardized incidence was 130.8/100,000 person-years based on the World Health Organization World Standard Population as a reference. Multivariate Cox analysis identified that the risk factors for CTS were being middle-aged, female, and obese, and having rheumatoid arthritis and Raynaud's syndrome, whereas gout and hypothyroidism were not risk factors. Diabetes and end-stage renal disease did not show a significant hazard ratio, although it is implicit that the durations of these diseases affect the development of CTS. Conclusions This study calculated the incidence of CTS and reappraised the associated risk factors found in previous studies. This information will be helpful for determining the pathophysiology of CTS, and hence aid the establishment of effective new public health policies.

Manual therapy has been widely practiced in almost all countries worldwide. With its potential complications, there are contraindications for thrust technique. A 56-year-old woman diagnosed with athetoid cerebral palsy visited a local clinic due to a tingling sensation in right hand that lasted for a year and aggravated to both upper extremities. The patient underwent three sessions of cervical manual therapy including thrust technique. No evaluation was performed. The patient immediately felt weakness in all extremities after performing cervical thrust technique. Magnetic resonance imaging showed atlantoaxial instability and cervical myelopathy. Approximately one-third of adults with cerebral palsy reported chronic musculoskeletal pain and they often experience neck pain. Particularly in athetoid cerebral palsy, malalignment or instability of the cervical spine is prevalent and often results in myelopathy. Therefore, musculoskeletal evaluation is necessary to identify cervical instability in case of cervical thrust technique, and it should be performed by relevant medical professionals.