ABSTRACT
Paralytic condition is a kind of respiratory impairment, which mainly features global alveolar hypoventilation. This condition comprises spinal cord disorders and motor unit diseases, and may also include patients undergoing sedation. Although patients with paralytic and obstructive conditions are both candidates for comprehensive pulmonary rehabilitation, the approach used to treat either condition differs considerably. Patients with paralytic condition often lose their inspiratory and expiratory muscle strength. They need physical medicine respiratory aids, and they should be managed to maintain lung and chest wall compliance, cough ability sufficient enough to clear secretions, and ventilation. Noninvasive positive pressure ventilation and related aids are widespread in the treatment of these conditions. Appropriate use of these methods is very important in order to prolong and maintain quality of life. Impairment of bulbar function and intelligence, and disease progression should also be considered in rehabilitation for such individuals. Although establishing a system for the rehabilitation team is important, the present conditions locally are insufficient to provide this care. Several clinical guidelines have been published to spread information on the methods to treat patients. We are planning to develop new guidelines that include the necessary care required for paralytic condition patients, thereby hoping to spread this rehabilitation system.
ABSTRACT
This report illustrates a case of chronic inflammatory demyelinating polyneuropathy (CIDP) masquerading as neurofibromatosis caused by multifocal enlargements of spinal nerve roots. At age 73, the patient reported a 6-year history of numbness, weakness and pain in the hands and legs, but he could but he could walk independently with a cane. And although tremor was present, he could still draw. T2-weighted magnetic resonance imaging (MRI) through the cervical spine demonstrated spinal cord compression bilaterally at C 6-7, caused by neurofibroma-like cervical root tumors and enlargement of the spinal nerve roots and the brachial and lumbosacral nerve plexuses. Nerve conduction studies showed very little evoked response, with the exception of the median nerve which demonstrated prolonged distal latency and reduced compound muscle action potential with temporal dispersion, suggesting a diagnosis of demyelinating neuropathy. Somatosensory evoked potentials of the median nerve revealed prolonged latency, and motor evoked potentials obtained from the abductor pollicis brevis and abductor digiti minimi by transcranial magnetic stimulation demonstrated prolonged latency and temporal dispersion. Sural nerve biopsies showed segmental demyelination, remyelination (onion-bulb formation), axonal loss, and lymphocyte infiltration suggesting CIDP. The patient did not have a positive family history and declined further genetic studies. We could therefore not rule out the possibility of a hereditary hypertrophic neuropathy such as Charcot-Marie-Tooth disease.
ABSTRACT
Recently, interest has been forcused on the increasing incidence of bone fracture due to low bone mineral density (BMD) in some sportswomen. Therefore the present study attempted to elucidate important factors associated with an increase or decrease of BMD in sportswomen.<BR>The results obtained were as follows;<BR>(1) Ball games appeared to be the most desirable main sports. Also it appeared necessary to increase lean body mass (weight) by maintaining a higher activity of daily living (ADL) index.<BR>(2) There were no clear nutritional factors that had a beneficial influence for increasing the BMD.<BR>These results suggest that sufficient exercise, at least, is necessary in order to increase BMD.