It is now commonly accepted that non-motor symptoms of Parkinson's disease often outweigh and sometimes even antedate the development of motor symptoms of PD. It can prove to be more disabling and more challenging to treat and it clearly impacts quality of life in PD. This article provides a concise review of non-motor features in Parkinson's disease as well as the pathophysiological mechanisms underlying each complication. Currently available management strategies will be outlined as well.

Amongst stroke patients, more than a third will develop spasticity, especially those that involve the paretic upper limbs. Despite establish intensive rehabilitaion programs in place, spasticity still affect a post-stroke patient's quality of life and create significant economic and caregiver burdens. The rationale for botulinum toxin type A (BoNT-A) use in spasticity is hinged on the toxin's ability to reduce muscle overactivity via a dual cholinergic blockede of extrafusal and intrafusal muscle. Efficacy and safety of BoNT-A in established post-stroke spasticity have been widely published, effectively establishing robustness of data and first line recommendation. Consensus guidelines and algorithms on the clinical use of BoNT-A for symptomatic upper limb spasticity are now also available. While BoNT-A has been universally shown to reduce muscle tone in spasticity, optimizing therapy requires judicious use of the toxin, while raising one's consciousness of adverse event, including muscle weakness, unwanted or desired in therapy. BoNT-A should not be administered alone in post-stroke spasticity, and its effects are best optimized in concert with a comprehensive neurorehabilitation program.

Pooled systematic studies that compare treatment stragegies for post-stroke spasticity prove that Botulinum toxin-A (BoNT-A) has superior efficacy and safety and has become the first line management in tandem with physiotherapy. The natural evolution of spasticity show that, not only are neural mechanisms of muscle hypertonus come into play, but that biomechanical forces may likely set in 3 months after stroke. Uses of BoNT-A have been driven by pre-defined goals in the established stage of spasticity (i.E. > 6 months from onset of stroke), as well as the practice of repeat cycle injections to reduce muscle tone. About 19-33% of patients develop spasticity within 3 months after the ictus. Early intervention with BoNT-A (i.e. < 3 months from onser stroke spasticity) can be aimed at preventing the increasing severity of spasticity and the contracture development. There are two randomiaed double blind placebo-controlled trials, and a one single blind comparator trial with a non-injected group, that have recently been performed as early BoNT-A intervention, in tandem with rehabilitation. All the 3 trials showed benefit in terms of reduction in muscle tone with BoNT-A, and one study showed improvement in function, in subanalysis of severely weak muscles at baseline. In the large double blind placebo controlled study, pain reduction was achieved and muscle tone had sustained reduction over the longitudinal observation of 24 weeks, despite a single cycle injection of BoNT-A. The combination of early nrurorehabilitation and early BoNT-A application is an appealing therapeutic approach for upper limb post-stroke spasticity. Neurorehabilitation by constraint-induced movement therapy, in tandem with BoNT-A have been proven to reduce muscle overactivity and improve motor control, but remains to be established in a setting of early spasticity.

No abstract available.
Factor X*

No abstract available.
Hypercholesterolemia* ; Lipoprotein-X* ; Lipoproteins*

No Abstract Available.
X-Ray Film*

Study 66 patients (mean age 45.9 years) diagnosed disseminated pulmonary tuberculosis. Results: patients often were in sub-acute and chronic types (83.3%), and their symptoms begin slowly (81.8%). Suggestive symptoms are afternoon fever, autonomic nervous disorder, crepitant rales in both sides, and combined extrapulmonary tuberculosis. In radiographic imagines, there were expansive lesions (74.2%), usually in the upper lobes, although pleural adhesion (16.7%) and thin border nodules (9.1%) weren’t common but very specific. Common X-ray syndromes are nodule syndrome (100%) and alveolus syndrome (72.7%).
Diagnosis ; X-rays ; Tuberculosis

The chemical composition of 56 urinary stone samples was studied by X-ray diffraction at Hue Central Hospital and Hue College Hospital. All of stone contain calcium. The rate of calcium stone was 67.9%, The rate of struvite stone was 3.5%. The rate of calcium stone was 28.6%. The acid uric stone and cystein stone were not found. The rate of crystal in calci oxalate stone was: whewellite 68% ; weddellite 32%. The rate of crystals in stone: whewellite 98.2%; weddellite 46.4%; bassanite 10.7%; calcium glycerophosphate1.8%; magnesium acetate hydrate 1.8%
Urinary Calculi ; X-Rays

Study on clinical characteristics, X-ray and tidal volume in 48 patients (mean age: 66.7 ± 7.32) have co-morbid chronic obstructive pulmonary disease and bronchiectasis at Bach Mai Hospital from February to September 2004. Male to female ratio was 15 to 1. 89.6% patients were smoker. 73% of patients have smoked over 15 packs per year. 34 patients (70.8%) had bronchiectasis after 5 years having chronic obstructive pulmonary disease. 23 patients (47.3%) had this condition after 6 to 10 years of chronic obstructive pulmonary disease. Symptoms were breathing difficulty in 100% patients, barre form thorax in 72.9% patients, change in diaphragm form in plain X-ray in 100% patients. RV,RV/TLC increased by more than 20% SLT in 100% patients. 81.2% patients had disease at degree III, IV
Bronchiectasis ; Diagnosis ; X-Rays

In duration of 11 months (12/1999-10/2000) 22 case of carotidocarvenous fistula (CCF) have been confirmed by angiography. 18 patients were treated by endovascular method with 17 procedures performed with detachable balloons. The remaining case was done using coils. Results of the 18 patients who underwent endovacular methods, caroticocavenous fistulae in 17 patients resolved completely. Two patients needed additional session which likewise showed good results. There is one failed case which is still awaiting for another interventive session.
X-Rays ; Fistula