No abstract available.
Pressure Ulcer*

OBJECTIVE: To investigate the shoulder disease patterns for the table-tennis (TT) and archery (AR) wheelchair athletes via ultrasonographic evaluations. METHODS: A total of 35 wheelchair athletes were enrolled, made up of groups of TT (n=19) and AR (n=16) athletes. They were all paraplegic patients and were investigated for their wheelchair usage duration, careers as sports players, weekly training times, the Wheelchair User's Shoulder Pain Index (WUSPI) scores and ultrasonographic evaluation. Shoulders were divided into playing arm of TT, non-playing arm of TT, bow-arm of AR, and draw arm of AR athletes. Shoulder diseases were classified into five entities of subscapularis tendinopathy, supraspinatus tendinopathy, infraspinatus tendinopathy, biceps long head tendinopathy, and subacromial-subdeltoid bursitis. The pattern of shoulder diseases were compared between the two groups using the Mann-Whitney and the chi-square tests RESULTS: WSUPI did not significantly correlate with age, wheelchair usage duration, career as players or weekly training times for all the wheelchair athletes. For the non-playing arm of TT athletes, there was a high percentage of subscapularis (45.5%) and supraspinatus (40.9%) tendinopathy. The percentage of subacromial-subdeltoid bursitis showed a tendency to be present in the playing arm of TT athletes (20.0%) compared with their non-playing arm (4.5%), even though this was not statistically significant. Biceps long head tendinopathy was the most common disease of the shoulder in the draw arm of AR athletes, and the difference was significant when compared to the non-playing arm of TT athletes (p<0.05). CONCLUSION: There was a high percentage of subscapularis and supraspinatus tendinopathy cases for the non-playing arm of TT wheelchair athletes, and a high percentage of biceps long head tendinopathy for the draw arm for the AR wheelchair athletes. Consideration of the biomechanical properties of each sport may be needed to tailor specific training for wheelchair athletes.
Arm ; Athletes* ; Bursitis ; Head ; Humans ; Pilot Projects* ; Shoulder Pain ; Shoulder* ; Sports ; Tendinopathy ; Ultrasonography ; Wheelchairs*

BACKGROUND/OBJECTIVES: In this randomized, placebo-controlled, double-blind study, we evaluated the antihypertensive effects of enzymatic hydrolysate from Styela clava flesh tissue in patients with type 2 diabetes mellitus (T2DM) and hypertension. SUBJECTS/METHODS: S. clava flesh tissue hydrolysate (SFTH) (n = 34) and placebo (n = 22) were randomly allocated to the study subjects. Each subject ingested two test capsules (500 mg) containing powdered SFTH (SFTH group) or placebo capsules (placebo group) during four weeks. RESULTS: In the SFTH group, systolic and diastolic blood pressure decreased significantly 4 weeks after ingestion by 9.9 mmHg (P < 0.01) and 7.8 mmHg (P < 0.01), respectively. In addition, the SFTH group exhibited a significant decrease in hemoglobin A1c with a tendency toward improvement in homeostasis model assessment of insulin resistance, triglyceride, apolipoprotein B and plasma insulin levels after 4 weeks. No adverse effects were observed in other indexes, including biochemical and hematological parameters in both groups. CONCLUSION: The results of our study suggested that SFTH exerts a regulatory, antihypertensive effect in patients with T2DM and hypertension.
Antihypertensive Agents ; Apolipoproteins ; Aquatic Organisms ; Blood Pressure ; Capsules ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Eating ; Homeostasis ; Humans ; Hypertension* ; Insulin ; Insulin Resistance ; Plasma ; Protein Hydrolysates ; Triglycerides

No abstract available.
Humans* ; Ligamentum Flavum*

OBJECTIVE: The authors performed instrumented anterior cervical fusion with either iliac autograft or fibular allograft for various clinical entities. The purposes of the study are to compare the fusion rate and the time to fusion according to graft material, and to identify the factors affecting fusion. METHOD:57 patients underwent instrumented anterior cervical fusion during 3 years between Jan. 1995 and Dec. 1997, among them 31 patients with iliac autograft(autograft group), and 26 patients with freeze-dried fibular allograft (allograft group). The clinical entities were trauma(n=0), soft disc herniation(n=), spondylotic radiculopathy(n=1), spondylotic myelopathy(n=6), and ossified posterior longitudinal ligament(n=). The method of fusion was either interbody fusion confined to disc space or strut fusion after corpectomy. Outcomes were assessed for fusion status and time to fusion, and comparison between autograft group versus allograft group. RESULT: Between autograft and allograft group there were no differences in distribution of perioperative clinical variables such as patients' age and gender, clinical entity, method of fusion, and length of fusion as determined by the number of disc space fused. Mean follow-up period was 19 months(range 10-28 months) in autograft group and 16 months(range 8-22 months) in allograft group. The fusion rate was 90% in autograft group and 85% in allograft group(p=.691). The median time to fusion was 7 months in autograft group and 15 months in allograft group(p<0.001). The perioperative variables affecting fusion, defined as those being significantly associated with the time to fusion, were the graft material(p=.000) and the length of fusion(p=.007). The rate of graft-related complications including donor-site morbidity was 41% in autograft group and 8% in allograft group. CONCLUSION: It is concluded that the use of freeze-dried fibular allograft in instrumented anterior cervical fusion is, though the time to fusion is delayed more than two times, as an effective way as the use of iliac autograft to achieve fusion, and is a better way to ameliorate graft-related complications.
Allografts* ; Autografts* ; Follow-Up Studies ; Humans ; Transplants

OBJECTIVE: To investigate whether transcranial direct current stimulation (tDCS) can improve dysarthria in stroke patients. METHOD: Twelve patients who developed dysarthria after acute middle cerebral artery (MCA) infarction were included in this study. In a prospective, double blinded, randomized case control study performed between January 2007 and December 2008, six patients were randomized to anodal tDCS application and conventional speech therapy, and six patients were randomized to the sham group which received only conventional speech therapy. tDCS was delivered for 30 minutes at 2 mA with 25cm2, five times/week, for a total two weeks. The effects were assessed in maximal phonation time (MPT), alternative motion rates (AMR)-Pa, AMR-Ta, AMR-Ka, and sequential motion rates (SMR)-PaTaKa using the Multi-Media Dimension Voice Program. RESULTS: Pre-treatment patient evaluation showed no significant difference between the two groups for all parameters. The MPT, AMR-Pa, AMR-Ta, AMR-Ka, and SMR-PaTaKa were improved pre- and post-treatment in the stimulation group, while MPT, SMR-PaTaKa were improved in the sham group (p<0.05). The AMR-Pa significantly improved in the stimulation group compared to the sham group (p<0.05). CONCLUSION: As these results demonstrated the beneficial effects of anodal tDCS on dysarthria, tDCS can successfully be used as a treatment modality for patients suffering from dysarthria after stroke.
Case-Control Studies ; Dysarthria ; Humans ; Infarction ; Middle Cerebral Artery ; Phonation ; Prospective Studies ; Salicylamides ; Speech Therapy ; Stress, Psychological ; Stroke ; Voice

STUDY DESIGN: Retrospective case analysis. PURPOSE: We retrospectively evaluated the clinical and radiological outcomes of posterior sublaminar wiring (PSLW) and/or transarticular screw fixation (TASF) for reducible atlantoaxial instability (AAI) secondary to os odontoideum. OVERVIEW OF LITERATURE: Limited information is available about the surgical outcomes of symptomatic os odontoideum with AAI. METHODS: We examined 23 patients (12 women and 11 men) with os odontoideum and reducible AAI. The average age of the patients at the time of the operation was 44.2 years. The average follow-up duration was 4.5 years. Thirteen patients with anterior AAI underwent PSLW alone, while 10 patients with combined (anterior+posterior) AAI underwent PSLW and TASF. An autogenous iliac bone graft was used for all patients. Nine patients complained of neck or suboccipital pain, and 14 complained of myelopathy. RESULTS: Angulational instability (preoperative 18.7°±8.9° vs. postoperative 2.1°±4.6°, p<0.001), translational instability (16.3±4.9 mm vs. 1.8±2.2 mm, p<0.001), and segmental angle of the C1–C2 joint (23.7°±7.2° vs. 28.4°±3.8°, p<0.05) showed significant improvement postoperatively. Neck Visual Analog Scale score (6.2±2.4 vs. 2.5±1.8, p<0.05) and the modified Japanese Orthopedic Association (9.1±3.1 vs. 13.2±2.6, p<0.05) score also improved, with a recovery rate of 51.8%. Among the three patients who developed nonunion and/or wire breakage, one underwent revision surgery with repeat PSLW and was finally able to achieve fusion. The final fusion rate was 91.3%. CONCLUSIONS: PSLW and/or TASF provided satisfactory clinical and radiological outcomes in reducible AAI secondary to os odontoideum without significant neurological complications. Our results suggest that PSLW and/or TASF can be considered a viable surgical option over segmental fixation in highly selected cases of os odontoideum with reducible AAI.
Asian Continental Ancestry Group ; Female ; Follow-Up Studies ; Humans ; Joints ; Neck ; Orthopedics ; Retrospective Studies ; Spinal Cord Diseases ; Transplants ; Visual Analog Scale

No abstract available.
Apoptosis ; Cell Aging ; Humans ; Keratinocytes ; Tretinoin

Systemic lupus erythematosus(SLE) is the prototypic immune complex disease which involves various organs. Chronic interstitial cystitis and protein-losing enteropathy are uncommon manifestations of SLE and have good response to steroid. Only one case of SLE associated with chronic interstitial cystitis and protein-losing enteropathy has been reported which was resistant to steroid treatment but dramatically responded to cyclophosphamide. We describe a case of a female patient who developed systemic lupus erythematosus associated with chylothorax, interstitial cystitis and protein-losing enteropathy with literature review. This case was initially resistant to steroid but with the addition of cyclophosphamide, chylothorax, chronic interstitial cystitis and protein-losing enteropathy markedly improved. This is the first case of SLE that developed chylothorax as well as chronic interstitial cystitis and protein-losing enteropathy.
Chylothorax* ; Cyclophosphamide ; Cystitis, Interstitial* ; Female ; Humans ; Immune Complex Diseases ; Lupus Erythematosus, Systemic* ; Protein-Losing Enteropathies*

BACKGROUND: A brief episode of global forebrain ischemia produces selective and often extensive neuronal loss in several vulnerable brain structures. This cell death does not occur immediately, but is delayed for hours to days. This process is termed delayed neuronal death (DND). Recently, several reports have suggested that an apoptotic process may be involved in DND. The most effective treatment at present is intraischemic hypothermia. Thus, we designed this study to investigate whether intraischemic mild hypothermia could inhibit apoptosis following transient forebrain ischemia in gerbils. METHODS: Twenty-four gerbils were divided into two groups based on intraischemic rectal temperature: 34 degrees C(n=12) and 37 degrees C(n=12). Two additional gerbils underwent a sham operation. Cerebral ischemia was produced by occluding both carotid arteries for 10 minutes. The DNA fragmentation in the gerbil hippocapal CA1 area was determined by using the TUNEL method, and the results for the normothermic and the hypothermic groups were compared at 1, 3, and 7 days following 10-min transient ischemia (n=4 for each time point, respectively). RESULTS: 1. Percent dead hippocampal neurons were significantly decreased in the hypothermic group compared with the normothermic group at 1, 3, and 7 days following transient ischemia (p<0.05). 2. In the intraischemic normothermic group, TUNEL positive cells were first detected in the hippocampal CA1 at 3 days (1.9+/-0.6 cells/section), and the number was larger at 7 days following transient ischemia (127.8+/-16.3 cells/section). 3. In the intraischemic hypothermic group, no TUNEL positive cells were detected in the hippocampal CA1 at 1, 3, and 7 days following transient ischemia. CONCLUSION: The data suggest that delayed neuronal death following transient ischemia is, in part, apoptotic and that intraischemic mild hypothermia affords significant neuronal protection and prevents DNA fragmentation.
Apoptosis* ; Brain ; Brain Ischemia ; Carotid Arteries ; Cell Death ; DNA Fragmentation ; Gerbillinae* ; Hypothermia* ; In Situ Nick-End Labeling ; Ischemia* ; Neurons ; Prosencephalon*