The Short Physical Performance Battery in Stroke Patients

OBJECTIVE: To determine the relationship and difference of the Short Physical Performance Battery (SPPB) between normal population and stroke patients, and to examine the relationship of the SPPB that used to assess lower extremity function in old, and Functional Independence Measure (FIM), Modified Barthel Index (MBI) in stroke patients. METHOD: One hundred and fifty nine stroke patients and 159 sex, age-matched normal population were included. All subjects were enrolled to interview and administer the SPPB and FIM, MBI. The SPPB included assessment of standing balance, a walking speed (timed 4 m walk), and chair stand (timed test of rising 5 times from a chair). RESULTS: The stroke patients showed significantly lower SPPB score than control group. The age, sex, direction of affection, and duration of stroke did not influence SPPB score respectively. In comparison of FIM and MBI, SPPB was significantly correlated with FIM and MBI, especially motor subtotal score of FIM. CONCLUSION: SPPB may be useful tool to assess and predict the physical function in stroke patients.

The upstream sequence of Mycobacterium leprae 18-kDa gene confers transcription repression activity in orientation-independent manner

In order to understand the role of the upstream region of the Mycobacterium leprae 18-kDa gene on the gene regulation, the region was divided into two at the -50 position from the first start codon of the gene and their effect on transcription was examined by using a LacZ transcriptional reporter gene assay. The presence of each of these two regions conferred transcription repression not only on its cognate M. lepraerae 18-kDa gene promoter, but also on a heterologous promoter such as the Mycobacterium bovis BCG hsp65 gene promoter. Moreover, it was found that these regions could confer transcription repression activity in both cases in an orientation-independent manner. Thus, these results indicate that the upstream region of the M. leprae 18-kDa gene harbors transcription repression responsive element(s) acting as an operator and can be further divided into two separately functional regions, suggesting a bipartite structure of the element(s). The identification of transcription repression activity of the upstream region in the M. leprae 18-kDa gene will contribute greatly for the understanding of the 18-kDa gene regulation mechanism, and provide also useful information for the manipulation of mycobacterium gene expression.

Heterologous Regulation of BCG hsp65 Promoter by M. leprae 18 kDa Transcription Repression Responsive Element

Among a number of antigens characterized in M. leprae, an etiological agent of Leprosy, the 18 kDa antigen, is unique to M. leprae. We have previously determined a sequence specific element in the 18 kDa gene of M. leprae, which confers transcriptional repression. In this report, we have examined if the element could be applied to genes other than the 18 kDa gene of M. leprae. To identify the roles of the regulatory sequence in heterologous promoter, we have constructed pB3 vector series, which contains BCG hsp65 promoter and the M. leprae 18 kDa transcription repression responsive element in tandem using LacZ gene as a reporter gene. Cloning of hsp65 promoters of M. bovis BCG or M. smegmatis in front of LacZ gene resulted in normal beta- galactosidase activity as expected. However, when the sequence element was placed between the promoter and the LacZ gene, beta-galactosidase activity was reduced 10-fold less. Also we have examined with pB3(-) vector, that harbors the transcription repression responsive element in a reversed orientation, the beta-galactosidase activity was found to be similar to pB3(+) vector. Thus, these results further confirm that M. leprae 18 kDa transcription repression responsive element could regulate BCG hsp65 heterologous promoter and that the element could act as an operator for the transcription of mycobacteria.

Evaluation of Epidural Injection with Modified Dallas Pain Questionnaire in Patients with Low Back Pain

OBJECTIVE: To evaluate the efficacy of epidural injections of steroid and local anesthetics with the modified Dallas pain questionnaire in the low back pain patients. METHOD: Before and after epidural injections with triamcinolone and local anesthetics, we examined the patients with modified Dallas pain questionnaire. The efficacy was assessed by paired t test to compare the results of this questionnaire. RESULTS: Four aspects of the patient's life (daily activity, work and leisure activity, anxiety- depression, and social interest) were significantly improved after epidural injection in low back pain patients. And their improvements were more definite in patients diagnosed with herniatied lumbar disc, relatively acute onset of symptom, and more serious findings in MRI. CONCLUSION: Epdiural injections of steroid and local anesthetics are effective for patients with low back pain, espercially for improving life quality of patients such as daily activity and work-leisure activity. It also decreases anxiety and increases social interest in some patients. However, validity of modified Dallas pain questionnaire must be proved in the future.

Efficacy of Epidural Injection of Hypertonic Saline, Steroid and Local Anesthetics in Patients with Low Back and Radiating Pain

OBJECTIVE: To evaluate the efficacy of epidural injections of hypertonic saline, steroid and local anesthetics in patients with low back pain and sciatica. METHOD: Retrospective study of 325 patients with low back pain and sciatica. Group I, 261 patients, were treated with epidural injection of steroid (Depo-medrol ) weekly for 2 weeks and local anesthetics (lidocaine and bupivacaine) daily via epidural catheter. Group II, 64 patients, were treated with epidural injection of hypertonic saline for three successive days and same method of group I via epidural catheter. The efficacy was assessed with Visual Analog Scale (VAS) on the day of pre- and post- (2weeks later) epidural injection. RESULTS: (1) VAS score changes from pre- to post-epidural injections were from 6.1+/-3.6 to 3.6+/-1.8 (p<0.05) in Group I and from 6.2+/-1.6 to 2.6+/-1.4 (p<0.05) in Group II. (2) VAS score decrease of Group II was more than that of Group I (p<0.05). CONCLUSION: Epidural injections of hypertonic saline, steroid and local anesthetics are effective for patients with low back pain and sciatica in the short term, and more effective than that of steroid and local anesthetics, but prospective long-term follow up studies will be necessary in the future.

A Survey of the Prevalence of the Physically Disabled in the Rural Community

The purpose of this study were to obtain the prevalence of the physically disabled order as a basic data for the planning of Community-Based Rehabilitation in a rural community and to evaluate the seventy of the physically disabled by according to the physical disability grade. The total residents in the community were surveyed to in May 1996. The prevalence of the physically disabled was 6.92% of the total population. The male: female ratio was 1:0.7. The most freguent age for the on set of physical disability was sixties and this group represented 35.5% of all physical disabilities. The majority of the physically disabled was graded an 10 th, 11 th, 12 th grade. The prevalence of the physically disabled in this study was higher than that a the previous study due to the inclurion of more mild disability groups were important in the prevalence of the physically disabled.