OBJECTIVETo evaluate the clinical effects of hyperbaric oxygention (HBO) in treating hypermyotonia caused by spinal cord injury (SCI).

METHODSFrom March 2009 to April 2011, 80 patients with hypermyotonia caused by SCI were divided into treatment group and control group, with 40 cases in each group. There were 49 males and 31 females with an average age of (34.12 +/- 6.61) years (ranged, 17 to 60) in the study. Course of disease was from 14 to 30 d with an average of (20.16 +/- 5.08) d. The patients of the treatment group were treated with HBO, rehabilitation exercise and baclofen medication. With pressure of HBO was 2ATA, the treatment project including mask oxygen-inspiration for 20 minutes and resting 5 min, repeating 3 circulations as once, once every day and 10 times as a course of treatment, a total of 6 courses. In the control group, the patients were only treated with rehabilitation exercise and baclofen medication. Course of treatment was same with treatment group. The muscular tensions of patients were evaluated according to method of Modified Ashworth scale (MAS) at 3 courses and 6 courses after treatment.

RESULTSAfter 3 courses of treatment,5 cases were effective in treatment group and 4 cases were effective in control group. There was no significant difference between two groups. After 6 courses of treatment, 24 cases were effective and 5 cases were obvious effective in treatment group; 14 cases were effective and 2 cases were obvious effective in control group. Clinical effect of treatment group was better than that of control group after 6 courses of treatment.

CONCLUSIONHBO was effective to controlling hypermyotonia caused by SCI, it can be used widely as a routine adjuvant therapy in clinic, but adequate course of treatment is necessary.

Adolescent ; Adult ; Cohort Studies ; Female ; Humans ; Hyperbaric Oxygenation ; Male ; Middle Aged ; Muscle Hypertonia ; etiology ; therapy ; Spinal Cord Injuries ; complications

Asian Continental Ancestry Group ; Cardiomyopathy, Hypertrophic ; genetics ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; LIM Domain Proteins ; genetics ; Male ; Muscle Hypertonia ; genetics ; Muscle Proteins ; genetics ; Mutation ; Young Adult

Botulinum toxins (BTX) have revolutionised the management of focal post-stroke spastic hypertonia. Published literature has supported the efficacy and safety of BTX in reducing spastic hypertonia but has not convincingly demonstrated the ability to enhance function. While clinicians and stroke survivors have reported impressive clinical outcomes, randomised, controlled trials (RCTs), have demonstrated only significant improvement in muscle tone but not functional changes. This paper will review the evidence supporting the efficacy of BTX for spastic hypertonia and discuss current clinical practice.
Botulinum Toxins, Type A ; administration & dosage ; therapeutic use ; Humans ; Muscle Hypertonia ; drug therapy ; etiology ; Neuromuscular Agents ; administration & dosage ; therapeutic use ; Recovery of Function ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo identify the correlation of the volume of residual urine (VRU) with the severity of bladder outlet obstruction (BOO) and detrusor contractility in patients with benign prostatic hyperplasia (BPH).

METHODSA total of 152 patients with clinically diagnosed BPH underwent ultrasonography for measurement of the prostate volume and RVU, free uroflowmetry, and urodynamic examination for the severity of BOO and detrusor contractility. Using the software SPSS20. 0, we analyzed the correlation between the ultrasonographic results and urodynamic parameters and compared the two sample means by the t-test.

RESULTSThe prostate volume was correlated positively with BOO severity (r = 0.432, P < 0.01) and detrusor contractility (r = 0.343 , P < 0.01) while Qmax negatively with BOO severity (r = 0.327, P < 0.01) but not significantly with detrusor contractility (r = 0.123, P > 0.05). VRU showed a significantly negative correlation with detrusor contractility when > 150 ml (r = -0.490, P < 0.01), even more significantly when > 300 ml (r = -0.717, P < 0.01), but exhibited no significant correlation with it when ≤ 150 ml (r = 0.041, P > 0.05).

CONCLUSIONVRU can somehow predict the detrusor function. For patients with VRU > 150 ml, especially for those with VRU > 300 ml, the detrusor function should be evaluated and urodynamic examination is recommended for exact assessment of BOO severity and detrusor contractility.

Aged ; Humans ; Male ; Muscle Contraction ; Muscle Hypertonia ; diagnostic imaging ; physiopathology ; Organ Size ; Prostate ; diagnostic imaging ; Prostatic Hyperplasia ; diagnostic imaging ; physiopathology ; Severity of Illness Index ; Ultrasonography ; Urinary Bladder Neck Obstruction ; diagnostic imaging ; physiopathology ; Urine ; Urodynamics

OBJECTIVETo study the relationship between the degree of bladder outlet obstruction (BOO), detrusor contractility and residual urine in patients suffering from benign prostatic hyperplasia (BPH).

METHODSIn 181 patients with BPH, degree of BOO, detrusor contractility, residual urine caculated from cathetering combined with the difference between the filling and the voiding were recorded and analysized statistically using urodynamic technique.

RESULTSResidual urine increased when the detusor contractility was weakened (F = 12.134, P = 0.001). In patients wih severe BOO, there was no significant difference in residual urine (F = 2.386, P = 0.071).

CONCLUSIONSIncreased residual urine is mainly resulted from decreased detrusor contractility. BOO has no significant influence on residual urine. Some patients with normal or weakened detrusor contractility may have more residual urine.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Muscle Contraction ; physiology ; Muscle Hypertonia ; physiopathology ; Prostatic Hyperplasia ; complications ; physiopathology ; Urinary Bladder ; physiopathology ; Urinary Bladder Neck Obstruction ; etiology ; physiopathology ; Urination Disorders ; etiology ; physiopathology ; Urodynamics ; physiology

PURPOSE: Anorectal manometry is an objective means of assessing the anorectal function through the anorectal sphincter muscles. The purpose of this study was to assess the usefulness of anorectal manometry. METHODS: Manometric findings of 1145 patients with anorectal diseases were analyzed. RESULTS: In hemorrhoids, the maximum resting pressure (MRP) was significantly decreased postoperatively (P<0.05), and the maximum squeezing pressure (MSP) was decreased postoperatively. The MRP was increased in hemorrhoids, internal sphincter hypertonia, and chronic anal fissure (CAF). The MRP and MSP were significantly decreased in CAF, anal fistula, and anal stricture postoperatively (P<0.05). In anal fistula, the high pressure zone length and sphincter length were significantly decreased postoperatively (P<0.05), and the vector symmetric index was decreased to 0.79 postoperatively. Fourteen of the 57 patients with fecal incontinence did not show rectoanal inhibitory reflex (RAIR). In 22 of the 25 patients were clinically suspected of congenital megacolon (CMC), unnecessary surgery was avoided with RAIR. Twelve of the 15 patients with CMC, who had undergone surgery, showed the RAIR. In patients treated by total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP), the MRP and MSP were decreased postoperatively, and the sensation of fullness (SOF) was significantly decreased postoperatively (P<0.05). In patients with rectal cancer treated by low anterior resection, the MRP, MSP, SOF, and compliance were significantly decreased until 12 months postoperatively (P<0.05). CONCLUSIONS: Manometry appears to be an important tool to evaluate anorectal function that enables adequate surgery or treatment for the most of anorectal diseases. Furthermore, it is a valuable tool in assessing functional recovery after surgeries associated with a sphincter injury.
Adenomatous Polyposis Coli ; Anal Canal ; Colitis, Ulcerative ; Compliance ; Constriction, Pathologic ; Fecal Incontinence ; Fissure in Ano ; Hemorrhoids ; Hirschsprung Disease ; Humans ; Manometry* ; Muscle Hypertonia ; Muscles ; Rectal Fistula ; Rectal Neoplasms ; Rectum ; Reflex ; Sensation ; Unnecessary Procedures

OBJECTIVETo explore the efficacy of partial resection of puborectalis combined with mutilation of internal anal sphincter(IAS) in the treatment of puborectalis syndrome with high anal pressure.

METHODSTwenty-five cases of puborectalis syndrome with high anal resting pressure in the preoperative examination received the operation of partial resection of puborectalis combined with mutilation of IAS in Zhongnan Hospital of Wuhan University between January 2013 and May 2015. The position of puborectalis was confirmed by touching with the exposure under the transfixion device, and a transverse incision was made by electrotome between 3 and 5 o'clock direction of puborectalis, then partial puborectalis was lifted by vessel clamp at 5 o'clock direction, and about 0.5 cm of muscular tissue was resected. Between 8 to 10 o'clock direction of anal tube, about 1 cm length of transverse incision was made by electrotome, then partial IAS was lifted by vessel clamp and cut off. Preoperative and postoperative 3-month anorectal manometry and defecography were carried out. Wexner constipation score and Cleveland Clinic incontinence score were implemented before surgery and 3, 6, 12 months after operation. This study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-ORB-16007695).

RESULTSOf the 25 cases, 18 were male and 7 were female, the average age was 55 years old and the average course of disease was 9 years. Compared with pre-operation, the postoperative 3-month anal resting pressure and maximal squeeze pressure were significantly decreased [(53.56±9.05) mmHg vs. (92.44±7.06) mmHg, (142.80±20.35) mmHg vs. (210.88±20.56) mmHg, respectively, both P=0.000]; anorectal angulation at resting state and forced defecation state increased significantly [(102.32±4.96)degree vs. (95.88±4.01)degree, (117.88±5.95)degree vs. (89.52±3.25)degree, respectively, both P=0.000]. Wexner constipation score of postoperative 3-month, 6-month, 12-month (8.28±3.91, 7.40±3.64 and 8.04±4.74) was significantly lower than the preoperative score (16.00±3.69, all P<0.05), while the score was not significantly different among 3 time points after operation (P>0.05). Cleveland Clinic incontinence score was 0 at postoperative 6 and 12 months, and revealed 20 cases were effective among all the surgical patients(80%).

CONCLUSIONPartial resection of puborectalis combined with mutilation of internal anal sphincter can effectively reduce anal pressure and improve symptoms of outlet obstruction, which is an effective method in the treatment of puborectalis syndrome with high anal pressure.

Anal Canal ; physiopathology ; surgery ; Constipation ; surgery ; Defecation ; Defecography ; Digestive System Surgical Procedures ; methods ; Female ; Gastrointestinal Diseases ; surgery ; Humans ; Male ; Manometry ; Middle Aged ; Muscle Hypertonia ; surgery ; Pelvic Floor ; physiopathology ; surgery ; Pressure ; Treatment Outcome

Infantile colic is a common self-limiting condition that causes significant distress to parents and caregivers. There is no clear cause, gold standard remedy or preventative action. The role of the family physician is to rule out sinister causes while providing counselling and reassurance for parents. The mainstay of management is parental support and reassurance while looking out for red flags in the baby such as fever, lethargy, distended abdomen and failure to thrive. This article provides a framework to approaching infantile colic and practical pointers to share with parents.
Caregivers ; Colic ; diagnosis ; therapy ; Crying ; Evidence-Based Medicine ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Muscle Hypertonia ; diagnosis ; Parenting ; Parents ; Pediatrics ; methods ; Physicians, Family ; Primary Health Care ; methods ; Professional-Patient Relations

No abstract available.
Muscle Spasticity*

Kinematics-based studies before and after selective tibial neurotomy (STN) gait have not been performed. It is very important for spastic patients before and after STN to evaluate quality of gait motion. We examined the quantitative changes in kinetic and kinematic parameters in the gait of a hemiplegic patient after STN. A patient with stroke-related hemiplegia who did not require aids to walk underwent a three-dimensional gait analysis (3DGA) before and after STN. 3DGA system was used to obtain spatiotemporal, kinetic and kinematic parameters of the lower extremities. Postoperative increases in walking speed and the single leg support ratio were detected in the paralyzed limb. Kinetic and kinematic analyses of the stance phase performed after STN detected dorsiflexion in the ankle, the appearance of generation power during plantar flexion, an extension of the range of hip movement during the gait cycle, and the disappearance of genu recurvatum. The acquisition of a normalized ankle joint gait pattern after STN might result in coordinated improvements in the kinetic and kinematic parameters of other joints. The measurement of spatiotemporal, kinetic, and kinematic gait parameters using 3DGA systems might aid decisions regarding the optimal post-STN rehabilitation strategies for spastic patients who hope to improve their gaits.
Muscle Spasticity