InLao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage,often at the village level, using a coverage target of one net per 2.5 (or fewer)persons in a given population. However, in villages that meet the target, notall households necessarily meet the target or utilize all available bednets. Thisstudy explored households that fell short of the target and household utilizationof bednets in villages that met the target of bednet coverage set by the NMCP. Thepersons per net ratio (PPNR), which is defined as the population divided by thenumber of available bednets in a household/village, was used to determine whethera household/village met the NMCP target. Using a household survey, we collectedand analyzed the data of 635 households in 17 villages in Xepon district in2012. Households that fell short of the target (households with a PPNR of >2.5 or no bednet) existed in every village. The proportion of these households differedgreatly among the villages, ranging from 3.4–50%, with some households fallingfar short. Of the 635 households, 275 (43.5%) had at least one bednet that wasnot being used on the night preceding the survey and 131 (20.6%) had at leasttwo. In conclusion, in villages that met the NMCP target, a considerable numberof households fell short of the target. Available bednets were not fullyutilized in many of the surveyed households.

In Lao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage, often at the village level, using a coverage target of one net per 2.5 (or fewer) persons in a given population. However, in villages that meet the target, not all households necessarily meet the target or utilize all available bednets. This study explored households that fell short of the target and household utilization of bednets in villages that met the target of bednet coverage set by the NMCP. The person per net ratio (PPNR), which is defined as the population divided by the number of available bednets in a household/village, was used to determine whether a household/village met the NMCP target. Using a household survey, we collected and analyzed the data of 635 households in 17 villages in Xepon district in 2012. Households that fell short of the target (households with a PPNR of > 2.5 or no bednet) existed in every village. The proportion of these households differed greatly among the villages, ranging from 3.4–50%, with some households falling far short. Of the 635 households, 275 (43.5%) had at least one bednet that was not being used on the night preceding the survey and 131 (20.6%) had at least two. In conclusion, in villages that met the NMCP target, a considerable number of households fell short of the target, and the available bednets were not fully utilized in many of the surveyed households.

A recurrent laryngeal nerve injury is known as a complication referring to an anterior cervical spine surgery. However, hypoglossal nerve injury is not well known yet. Herein we report a rare case of a 39-years-old male with a hypoglossal nerve injury after C3/4 osteophyte resection with Smith-Robinson approach. In this case there appeared difficulties of articulation and tongue movement with deviation of the tongue to the left side after the surgery and we diagnosed a hypoglossal nerve injury due to retraction against the nerve during the operation. During the operative approach to the upper cervical spine we had to retract the internal carotid artery and the soft tissue to reach the vertebrae. This retract was the cause of the hypoglossal nerve injury. A gently traction and intermittent release is important to avoid a hypoglossal nerve damage.
Carotid Artery, Internal ; Cervical Vertebrae ; Female ; Humans ; Hypoglossal Nerve ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve Injuries ; Male ; Osteophyte ; Recurrent Laryngeal Nerve Injuries ; Spine* ; Tongue ; Traction

No abstract available.
Hypoglossal Nerve* ; Spine*

STUDY DESIGN: Case series. PURPOSE: The objective of this study was to investigate the change in pulmonary function in adult patients with a spinal deformity who underwent spinal corrective surgery. OVERVIEW OF LITERATURE: Degenerative lumbar and/or thoraco-lumbar deformities are is often prominent in adult spinal deformity cases, whereas a thoracic deformity involving the chest wall is inconspicuous. A lumbar spine deformity could affect the pulmonary function; however, few reports have investigated pulmonary function in adult patients with a spinal deformity. METHODS: This study included 14 adult patients with a spinal deformity who underwent posterior corrective fusion (3 males, 11 females; mean age, 67.4 years). We measured percent vital capacity (%VC) and percent forced expiratory volume in 1 second (%FEV1) before surgery and six months after surgery. We investigated the change in pulmonary function after corrective surgery and the correlation between radiographic parameters and pulmonary function. RESULTS: Mean preoperative %VC and %FEV1 values were 99.9% and 79.3%, respectively. Two cases were diagnosed with restrictive impairment, and two cases were diagnosed with obstructive impairment before surgery. %VC improved in the restrictive impairment cases six months after surgery. However, %FEV1 did not improve significantly after surgery in the obstructive impairment cases. CONCLUSIONS: Restrictive impairment was improved in adult patients with a spinal deformity by corrective spinal surgery. However, spinal surgery did not improve obstructive impairment.
Adult ; Aged* ; Congenital Abnormalities ; Female ; Forced Expiratory Volume ; Humans ; Male ; Spine ; Thoracic Wall ; Vital Capacity

STUDY DESIGN: A prospective, randomized, controlled study. PURPOSE: The objective of this study was to evaluate the effectiveness of two techniques of skin preparation with povidone-iodine. OVERVIEW OF LITERATURE: Preoperative skin preparation is important for preventing surgical site infection by reducing the bacteria in the surgical area. Povidone-iodine is a commonly used agent for preoperative skin preparation, and further decrease in surgical site infections can be expected by understanding how to apply it more effectively. METHODS: Eighty-nine spine surgery patients were randomly allocated to two groups. In group A, povidone-iodine was applied to the surgical site just before starting the operation; in group B, povidone-iodine was applied several minutes prior to starting the operation and was allowed to dry. We collected samples from the wound edge before suturing, and we compared the rates of positive culture between the two groups. RESULTS: The rate of positive culture was 30.2% (13 out of 43 patients) in group A, and 6.5% (3 out of 46 patients) in group B. This indicates that there was a significant difference in postoperative infection rates between group A and group B. CONCLUSIONS: Because bacteria on the skin appeared significantly reduced by allowing povidone-iodine to dry for several minutes prior to surgery, we recommend this approach to reduce the incidence of postoperative infections.
Bacteria ; Humans ; Incidence ; Povidone-Iodine* ; Prospective Studies* ; Skin* ; Spine* ; Wounds and Injuries

STUDY DESIGN: Large cohort study. PURPOSE: To clarify spinal sagittal alignment and health-related quality of life (HRQOL) according to sex in volunteers aged >50 years with cervical deformity (CD). OVERVIEW OF LITERATURE: Adult spinal deformities, especially those associated with lumbosacral lesions, are more frequent in females; however, CD is observed to a greater extent in males. METHODS: We divided 656 volunteers (263 males, 393 females; age, 50–89 years [mean, 73 years]) as follows: males with CD (CDM; 82 patients); males without CD (NCDM, 181); females with CD (CDF, 36); and females without CD (NCDF, 357). CD was defined as C2–7 sagittal vertical axis (SVA) ≥40 mm. We measured pelvic tilt (PT), pelvic incidence minus lumbar lordosis (PI−LL), thoracic kyphosis, T1 slope, cervical lordosis, C7 SVA, and C2–7 SVA. HRQOL was evaluated using EuroQOL five dimensions questionnaire (EQ-5D). RESULTS: In CDM, NCDM, CDF, and NCDF groups, the respective parameters were as follows: PT: 15°, 14°, 26°, and 21°; PI−LL: 7°, 5°, 16°, and 10°; C2–7 SVA: 49, 24, 46, and 20 mm; C7 SVA: 61, 40, 75, and 47 mm; and EQ-5D: 0.82, 0.88, 0.78, and 0.81. PT and PI−LL were significantly greater in the CDF group than in the NCDF group (p < 0.05) but were not significantly different between CDM and NCDM groups. The CDF group already showed deterioration of spinopelvic alignment, although it was maintained in the CDM group. EQ-5D in showed significantly greater deterioration the CDM group than in the NCDM group; deterioration of lumbopelvic parameters had less influence in males (p < 0.05). CONCLUSIONS: Sagittal spinal deformity may have different mechanisms in males and females. The deterioration of spinal sagittal alignment in males may originate from the cervical spine, and CD may be associated with HRQOL.
Adult ; Animals ; Cohort Studies ; Congenital Abnormalities* ; Female* ; Humans ; Incidence ; Kyphosis ; Lordosis ; Male* ; Quality of Life* ; Sex Characteristics ; Spine ; Volunteers

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the relationship between tumor location and clinical characteristics. OVERVIEW OF LITERATURE: Hemangioblastoma is a rare disease that develops in the central nervous system. Magnetic resonance imaging (MRI) is useful to evaluate hemangioblastomas. Hemangioblastoma's location is designated as intramedullary, intramedullary+extramedullary, or extramedullary by MRI. METHODS: We analyzed 11 patients who underwent surgery for spinal hemangioblastoma. Using T1 contrast axial MRI data, the cases were divided into three groups (intramedullary, intramedullary+extramedullary, and extramedullary). Patient demographics, MRI findings, and preoperative neurological status were analyzed and compared for each group. RESULTS: The average age of patients with intramedullary, intramedullary+extramedullary, and extramedullary hemangioblastoma was 34.0, 64.4, and 67.5 years, respectively. Patients in the intramedullary hemangioblastoma group were younger than the other groups. Extramedullary cases had a smaller syrinx compared to the other groups. CONCLUSIONS: Age may play an important role in the hemangioblastoma tumor location and the subsequent diagnosis by an MRI.
Central Nervous System ; Demography ; Diagnosis ; Hemangioblastoma* ; Humans ; Magnetic Resonance Imaging ; Rare Diseases ; Retrospective Studies

AIM To study the chemical constituents from the twigs of Morus alba L..METHODS The 60％ ethanol extract from M.alba twigs was isolated and purified by ODS,sephadax LH-20 and semi-preparative column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and identified as 4'-O-β-D-glucopyranosyl-2'-hydroxyresveratrol 3-(6-O-β-D-glucopyanosyl-β-D-glucopyranoside) (1),3-O-β-D-glucopyranosyl-2'-hydroxyresveratrol 4'-(6-O-β-D-glucopyanosyl-β-D-glucopyranoside) (2),mulberroside A (3),mulberroside E (4),mulberroside F (5),transoxyresveratrol-4'-O-β-D-glucopyranoside (6),trans-oxyresveratrol 3-O-β-D-glucopyranoside (7),cis-mulberroside A (8),3,4-dimethoxyphenyl β-D-apiofuranosyl-(1→6)-β-D-glucopyranoside (9),kelampayoside A (10).CONCLUSION Compounds 9 and 10 are isolated from genus Morus for the first time,compounds 1,2,4-7 are first isolated from this plant.

STUDY DESIGN: Cross-sectional cohort study.PURPOSE: This study aimed to investigate the relationship between hypertension and spino-pelvic sagittal alignment in middle-aged and elderly individuals.OVERVIEW OF LITERATURE: Positive global sagittal alignment is associated with poor health-related quality of life. Hypertension is associated with tissue microcirculation disorders of the skeletal muscle. We hypothesized that hypertension may be involved in positive global sagittal alignment.METHODS: In this institutional review board-approved study, 655 participants (262 men and 393 women; mean age, 72.9 years; range, 50–92 years) who underwent musculoskeletal screening in Toei town, Aichi, Japan were included. Whole spine and pelvic radiographs were taken, and radiographic parameters (thoracic kyphosis, lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and sagittal vertical axis [SVA]) were measured using an image-analysis software. Hypertension was assessed using the standard criteria. The study participants were divided into three subgroups as per age (50–64 years, 65–74 years, and ≥75 years). We examined the differences in the radiographic parameters of those with and without hypertension in each age subgroup.RESULTS: In each age subgroup, there was no significant difference in the age and sex of those with and without hypertension. SVA was significantly shifted forward in the hypertension group than in the non-hypertension group in those aged 50–64 years old (32.4 mm vs. 16.0 mm, p=0.018) and in those aged 65–74 years old (42.7 mm vs. 30.6 mm, p=0.012). There was no significant difference between the hypertension and non-hypertension groups in terms of the alignment of the lumbar and thoracic spine in all the subgroups. In multivariate analysis, hypertension was a significant independent factor of forward-shifted SVA (standardized beta 0.093, p=0.015).CONCLUSIONS: This study showed that hypertension was associated with forward-shifted global sagittal alignment.
Aged ; Animals ; Cohort Studies ; Female ; Humans ; Hypertension ; Incidence ; Japan ; Kyphosis ; Lordosis ; Male ; Mass Screening ; Microcirculation ; Multivariate Analysis ; Muscle, Skeletal ; Quality of Life ; Spine