ABSTRACT
Objective : Scoliosis in cerebral palsy can seriously disturb the patient's daily life. To help alleviate this we developed a new original orthosis and named it the Dynamic Spinal Brace (DSB). In this study, we investigated the effectiveness of the DSB in daily life with patients and caregivers. Methods : We studied 222 cerebral palsy patients treated with the DSB. We carried out a questionnaire survey of the caregivers and measured X-ray results of the scoliosis deformities. Results: In the questionnaire, more than 80% of the patients improved in their sitting position and posture and more than 50 % of the patients improved in the transfer or ambulation assistance and meal assistance requirement by the caregivers. Higher age (over 18 years old) revealed improved muscle tonus. Breathing and muscle tonus showed improvement as scoliosis was advanced. Conclusion : DSB for scoliosis in cerebral palsy showed effectiveness in the sitting position, posture, transfer or ambulation assistance and meal assistance. DSB is also effective for muscle tonus in patients after growth maturity and breathing and muscle tonus in patients with severe scoliosis.
ABSTRACT
The mitral valve complex is consisted of annulus, leaflets, chordae tendineae, papillary muscle (PMs) and surrounding left ventricle. Functional mitral regurgitation (MR) results from left ventricular remodeling such as dilatation or distortion, which displaces the PMs and then tethers the mitral leaflets, restricting leaflet coaptation. Undersized annuloplasty, which has been widely accepted as a simple and effective procedure for functional MR, sometimes worsens the tethering of posterior leaflet and induces recurrent MR. In order to overcome such problems, several additional procedures to the simple annuloplasty have been produced. Three dimensional echocardiography plays an essential role to understand the geometry of mitral valve complex and contributes greatly to decision making of the surgical strategy in functional MR and its postoperative assessment.
Subject(s)
Chordae Tendineae , Decision Making , Dilatation , Echocardiography, Three-Dimensional , Heart Ventricles , Mitral Valve , Mitral Valve Insufficiency , Papillary Muscles , Ventricular RemodelingABSTRACT
PURPOSE: In cardiac 2-[F-18]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) examination, interpretation of myocardial viability in the low uptake region (LUR) has been difficult without additional perfusion imaging. We evaluated distribution patterns of FDG at the border zone of the LUR in the cardiac FDG-PET and established a novel parameter for diagnosing myocardial viability and for discriminating the LUR of normal variants. MATERIALS AND METHODS: Cardiac FDG-PET was performed in patients with a myocardial ischemic event (n = 22) and in healthy volunteers (n = 22). Whether the myocardium was not a viable myocardium (not-VM) or an ischemic but viable myocardium (isch-VM) was defined by an echocardiogram under a low dose of dobutamine infusion as the gold standard. FDG images were displayed as gray scaled-bull's eye mappings. FDG-plot profiles for LUR (= true ischemic region in the patients or normal variant region in healthy subjects) were calculated. Maximal values of FDG change at the LUR border zone (a steepness index; S(max) scale/pixel) were compared among not-VM, isch-VM, and normal myocardium. RESULTS: S(max) was significantly higher for n-VM compared to those with isch-VM or normal myocardium (ANOVA). A cut-off value of 0.30 in Smax demonstrated 100% sensitivity and 83% specificity for diagnosing n-VM and isch-VM. S(max) less than 0.23 discriminated LUR in normal myocardium from the LUR in patients with both n-VM and isch-VM with a 94% sensitivity and a 93% specificity. CONCLUSION: S(max) of the LUR in cardiac FDG-PET is a simple and useful parameter to diagnose n-VM and isch-VM, as well as to discriminate thr LUR of normal variants.