Research on Self-tapping Performance Test of Self-tapping Bone Screws / 中国医疗器械杂志

OBJECTIVE@#To study the self-tapping performance test method of self-tapping bone screws based on the YY/T 1505 standard.@*METHODS@#With reference to the method of YY/T 1505, various factors affecting the self-tapping force test was optimised, and the self-tapping force judgment method was improved.@*RESULTS@#The experimental results showed that the self-tapping force obtained by the improved self-tapping force judgment method has good repeatability and high stability of the experimental data. At the same time, the test results of other influencing factors indicated that the manufacturer should fully consider the test material and the size of the pre-drilled hole.@*CONCLUSIONS@#An improved method for judging the self-tapping force is helpful for the repeatability and stability of the test data. This study has certain significance referring to the self-tapping performance test of self-tapping bone screws.

Mechanical Equation Verification and Mechanical Property Analysis of the TC4 Self-Tapping Bone Screw / 医用生物力学

Objective To test the validity for mechanical equation of the TC4 self-tapping bone screw and analyze the influence of bone screw parameters on its mechanical properties. Methods In order to derive the equation of self-tapping and pull-out for bone screw, the physical model of bone screw-polyurethane foam block was built. By reference of ASTMF543-07 standard specification and test method for metallic medical bone screw, the mechanical verification tests of selected conical head shallow thread locking bone screw (HAZ) and conical head deep thread locking bone screw (HBZ) with different diameters were performed on Instron E3000 mechanical testing machine, and the data of self-tapping force, self-tapping torque and pull-out force from 5 groups of bone screws were tested respectively. Results The calculated and measured values were basically the same, except for a few points with large individual errors. The average error of the two values was 11.02%, so the theoretical calculation formula was highly credible. The bone screw with a larger diameter or a higher tooth height would require greater self-tapping force and pull-out force. Conclusions The research results provide the calculation basis for mechanical properties of bone screw and the research direction for optimization and improvement of bone screw in future.

Tapping at acupoints along meridian combined with thunder-fire moxibustion for upper-limb hemiplegia after stroke / 中国针灸

OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.

A Clinical Study of Anterior Sylvian Point and Use of Anterior Sylvian Point For Surface Mapping of Frontal Horn For Intraoperative Emergency Ventricular Tapping

Introduction: Anterior sylvian point (ASyP) had a constant relationship with a point in the skull just posterior to the “H”-shapedpterion over the squamous suture called the anterior squamous point (ASqP).Objectives: The objectives of this study were as follows: (1) To confirm and establish the cisternal nature of ASyP and itsrelationship to other important neural and sulcal structures along the sylvian fissure. (2) To confirm the relationship of theAntSyP (ASyP) with the external cranial landmark ASqP for surface mapping of frontal horn for emergency ventricular tapping.Materials and Methods: Forty adult human brains (20 – right side and 20 – left side), both male and female, were observedduring surgery in Government Theni Medical College. Reliability of frontal horn tapping using the apex of Paine’s trianglefrom ASyP as the entry point was analyzed using the following steps. Exposure of pterion by the standard FTP trauma flapincision. Standard FTP craniotomy opening of the skull and dura mater and observing for ASyP relation to ASqP. A catheterwas introduced through the apex of the Paine’s triangle identified using the surgical tapes to form a 2.5 cm isosceles trianglefrom the ASyP. A study of the relationship of ASyP to the external cranial surface, middle cerebral artery (MCA) bifurcation,and frontal horn of ventricles was done.Conclusion: It could be safely concluded that ASqP is a reliable external cranial landmark for ASyP. ASyP can be the referencepoint for Paine’s triangle and hence Paine’s point. Hence, Paine’s point could be used to tap the frontal horn in emergentsituations. Furthermore, MCA bifurcation can be reached by ASyP cisternal dissection.

Knee Pain Presenting As Lumbar Radiculopathy: A Case Report

Background: Knee pain in general and if to be specific is the pain located anteriorly, and it is widespread among teenage, adults, and the old age population. Among the anterior knee pain etiologies, patellofemoral pain is one of the most common causes of knee pain. One of the significant issues with the patellofemoral pain is that most of the time it is misdiagnosed, or it is underrated for patients' problems, which in the long run lead to severe functional limitations and muscular atrophy. Right clinical diagnosis at an early phase in musculoskeletal conditions is vital. Case summary: The patient presented with chief complaints of diffused pain over right leg tracking it over to the lower back. She presented with a painful limping gait. No tenderness was noted over the lower back; the neural tension test was nonsignificant. Patellar compression test, Clark's test, eccentric step was positive. Severe disuse quadriceps muscular atrophy was noted over-involved limb. Tenderness over the retropatellar surface was significant. The patient was managed with cryotherapy at home, therapeutic ultrasound over the tender area along with Kinesio tapping, proprioception exercises, stretching, and strengthening exercises. Outcome measure: Pain, ROM, girth measurement, gait pattern. Significant improvement was noted in pain on NPS, ROM, and gait pattern in two weeks management. Conclusion: The Physiotherapy management in cases of anterior knee pain, specifically patellofemoral pain, mainly consisting of kinesiotaping, therapeutic ultrasound, cryotherapy, therapeutic exercises are very effective provided right clinical diagnosis, is made. The treatment outcome may be more fruitful if the correct clinical diagnosis is made at an early stage.

Neuropsychiatric manifestations in patient with normal pressure hydrocephalus improved with therapeutic lumbar tapping

Normal pressure hydrocephalus is a communicating hydrocephalus without evident obstruction of the normal pathway of CSF flow. Normal-pressure hydrocephalus is a common cause of reversible dementia and it can also present with various psychiatric symptoms. A 76-year old man was brought to psychiatry OPD with history suggestive of decreased need for sleep for 8 days, disinhibited behaviour, increased libido, increased activity and increased talk for 4 days. On examination patient was noticed to be having increased psychomotor activity with increased talk, mood reported to be happy with elated affect, no content or perceptual disturbances were elicited. Cognitive functions were within normal limits. Personal and social judgement was impaired with grade 0 insight. General physical and systematic examinations were within normal limits. MRI reports showed ventricular enlargement suggestive of normal pressure hydrocephalus. Patient underwent diagnostic and therapeutic lumbar tapping. There was significant improvement in patient’s behavioural symptoms following therapeutic lumbar tapping. Therapeutic lumbar tapping in this case of normal pressure hydrocephalus was effective in the management of manic symptoms. Early identification of organic cause in late onset psychiatric disorders is necessary. Prompt intervention of the organic cause was effective in the management of manic symptoms.

Clinical trials of treatment of post-stroke neurogenic bladder by plum-blossom needle tapping plus moxibustion / 针刺研究

OBJECTIVE: To observe the therapeutic effect of plum-blossom needle tapping plus moxibustion in the treatment of post-stroke neurogenic bladder(PSNB). METHODS: A total of 60 PSNB patients were equally randomized into control group (16 men and 14 women, 65.6±7.9 years in age, 10.1±6.3 months in the duration of disease) and treatment group (18 men and 12 women, 63.8±8.5 years in age, 9.8±6.5 months in the duration of disease). Patients of the control group were treated by asking the patients to make a pelvic muscular exercise and passive intermittent urethral catheterization. For patients of the treatment group, a plum-blossom needle was used to alternatively tap the bilateral Shenshu(BL23), Qihaishu(BL24), Guanyuanshu(BL26), Xiaochangshu(BL27), Pangguangshu(BL28), Huiyang(BL35), Shangliao(BL31), etc., followed by performing moxibustion over the skin of Shenque(CV8), Guanyuan(CV4), Qihai(CV6) and Zhongji(CV3), etc. about 15 min. In addition, patients without spontaneous urination were also received urethral catheterization as those in the control group. The treatment was given once every day except the weekends and for two months. The integrated symptom score was assessed. The frequencies of diurnal urination and urinary incontinence, and the urination volume every time were respectively recorded for consecutive 3 days before and after the treatment, and the residual urine volume was also measured. The therapeutic effect was evaluated based on the status and frequency of diurnal urination and residual urine volume each time. RESULTS: Of the two 30 cases in the control and treatment groups, 2(6.7%) and 5(16.7%) were cured, 8(26.7%) and 12(40.0%) experienced marked improvement in their symptoms, 13(43.3%) and 11(36.7%) were improved, 7(23.3%) and 2(6.7%) failed, with the effective rates being 76.7% and 93.3%, respectively. The effective rate of the treatment group was significantly higher than that of the control group(P<0.05). After the treatment, the integrated symptom score, residual urine volume, and frequencies of diurnal urination and urinary incontinence were significantly decreased, and the diurnal urination volume was obviously increased in comparison with their own pre-treatment in both groups(all P<0.05)． The therapeutic effect of the treatment group was significantly superior to that of the control group in reducing the integrated symptom score, residual urine volume, and frequencies of diurnal urination and urinary incontinence(P<0.05), and in increasing the diurnal urination volume(P<0.05). CONCLUSION: Plum-blossom needle tapping plus moxibustion is an effective option for the treatment of PSNB in improving symptoms, in reducing the residual urine volume and frequencies of diurnal urination and urinary incontinence, and in increasing the diurnal urination volume, deserving being promoted in primary care.

The Effect of Kinesio Taping Pre-intervention on Delayed Onset Muscle Soreness

PURPOSE: This examined the effect of Kinesio taping pre-intervention on the pain, tenderness, proprioceptive sensation, and muscle strength associated with delayed onset muscle soreness. METHODS: Thirty subjects were divided into a Kinesio taping application group of 15 subjects and a control non-taped group of 15 subjects, and the changes in individual variables were analyzed before taping and at 24, 48, and 72 hours after taping using two-way repeated ANOVA. Post-hoc t-tests were conducted in the cases with intergroup interactions, and the significance level α was set to α=0.01. RESULTS: The changes in pain during rest were significantly different only for the times, while the changes in pain during exercise were significantly different for the times, interactions between the times and groups, and intergroup changes (p<0.05). The changes in tenderness were significantly different for the times and for interactions between the times and groups (p<0.05). The changes in proprioceptive sensation were significantly different for the times, interactions between times and groups, and intergroup changes (p<0.05). The changes in muscle strength were significantly different only for the times (p<0.05). CONCLUSION: The application of Kinesio taping had positive effects on the pain, tenderness, and proprioceptive sensation of delayed onset muscle soreness. These results suggest that Kinesio taping can be a useful therapeutic factor in future studies and in clinical settings.

Clinical observation and psychological intervention of early postoperative inhalation of ambroxol hydrochloride combined with intermittent inhalation of sputum for postoperative expectoration of lung cancer / 中国生化药物杂志

Objective To investigate the effect of combined inhalation of ambroxol hydrochloride, intermittent tapping and sputum drainage and psychological intervention on postoperative lung cancer. Methods 68 cases of lung cancer patients treated in our hospital from January 2015 to March 2017 were selected, the control group received oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum at the early stage of the operation. The study group was treated with psychological intervention on the basis of the treatment of the control group. The postoperative pulmonary complications in two groups of patients with lung cancer were recorded. The data were input into SPSS statistical software and analyzed. Results The incidence rate of atelectasis and pulmonary infection in the study group (5.88％, 8.82％) were higher than those in the control group (The incidence of atelectasis was 32.35％, and the incidence of pulmonary infection was 38.24％) was significantly reduced, the difference was statistically significant (P<0.05). Conclusion On the basis of providing oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum for early postoperative lung cancer patients, the clinical prognosis can be significantly improved if psychological intervention is used.

Cerebrospinal Fluid Lumbar Tapping Utilization for Suspected Ventriculoperitoneal Shunt Under-Drainage Malfunctions

OBJECTIVE: The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. METHODS: We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device. We compared shunt valve opening pressure and CSF lumbar tapping pressure to check under-drainage. RESULTS: The mean pressure difference between valve opening pressure and CSF lumbar tapping pressure of all patients were 2.21±24.57 mmH₂O. The frequency of CSF lumbar tapping was 2.06±1.26 times. Eighty five times lumbar tapping of 41 patients showed that their VPS function was normal which was consistent with clinical improvement and decreased ventricle size on computed tomography scan. The mean pressure difference in these patients was −3.69±19.20 mmH₂O. The mean frequency of CSF lumbar tapping was 2.07±1.25 times. Fourteen cases of 10 patients revealed suspected VPS malfunction which were consistent with radiological results and clinical symptoms, defined as changes in ventricle size and no clinical improvement. The mean pressure difference was 38.07±23.58 mmH₂O. The mean frequency of CSF lumbar tapping was 1.44±1.01 times. Pressure difference greater than 35 mmH₂O was shown in 2.35% of the normal VPS function group (2 of 85) whereas it was shown in 64.29% of the suspected VPS malfunction group (9 of 14). The difference was statistically significant (p=0.000001). Among 10 patients with under-drainage, 5 patients underwent shunt revision. The causes of the shunt malfunction included 3 cases of proximal occlusion and 2 cases of distal obstruction and valve malfunction. CONCLUSION: Under-drainage of CSF should be suspected if CSF lumbar tapping pressure is 35 mmH₂O higher than the valve opening pressure and shunt malfunction evaluation or adjustment of the valve opening pressure should be made.

Estudio controlado, doble ciego, randomizado, multicéntrico, para evaluar la eficacia de la combinación fija tiocolchicósido más diclofenaco potásico en contracturas / Multicentered, randomized, double-blind and controlled study for the evaluation of efficacy of a set combination of thiocolchicoside plus potasium diclofenac in spams

Objetivo: determinar la eficacia y la tolerabilidad de la combinación a dosis fija, en una sola tableta, de tiocolchicósido 4 mg más diclofenaco potásico 50 mg en la reducción de la contractura muscular aguda estriada dolorosa comparado contra placebo y el uso de paracetamol tabletas de 500 mg como medicación de rescate. Métodos: fueron reclutados 97 pacientes de 2 ciudades ecuatorianas, Quito y Guayaquil, en tres centros de investigación, públicos y privados, con cervicalgia, dorsalgia y lumbalgia, principalmente de causa funcional. Los pacientes fueron asignados al azar en dos grupos: 1) grupo medicación activa, tiocolchicósido más diclofenaco potásico, 50 pacientes, 2) grupo placebo 47 pacientes. La eficacia en ambos grupos se evaluó por la reducción de la contractura muscular apreciada por inspección, palpación y reducción del dolor medido por una escala visual análoga, después de 5 días de tratamiento. Resultados: la evolución del grado de contractura muscular en el grupo medicación activa por evaluación visual pasó de un 100 por ciento con contractura visible con o sin actividad antiálgica fija a 96 por ciento sin signos visibles de contractura; de un 82 por ciento de contractura moderada a severa con o sin dolor evocado por palpación a un 74 por ciento de contractura leve sin dolor y 26 por ciento de ausencia de contractura. El promedio de dolor según la escala visual análoga disminuyó de 6,66 cm antes del tratamiento a 0,86 cm al finalizar el quinto día de tratamiento. Los efectos adversos fueron leves en el grupo tratado. Conclusiones: la combinación fija de tiocolchicósido 4 mg más diclofenaco potásico 50 mg en una sola tableta, administrado dos veces al día, es eficaz en el manejo de la contractura muscular aguda dolorosa de diversa etiología de manera estadísticamente significativa, bien tolerada y no altera el rendimiento psicomotor(AU)

Objective: to determine the efficacy and tolerability of a combination at a set dose in a single tablet of thiocolchicoside 4 mg plus potassium diclofenac 50 mg in the reduction of painful acute muscle spasm compared with the placebo and the use of 500 mg paracetamol as rescue medication. Methods: ninety seven patients from two Ecuador cities, named Quito and Guayaquil, were recruited in three research centers, both public and private. They suffered cervical pain, low back pain and dorsal pain, mainly of functional cause. The patients were randomly assigned in two groups 1) active medication group with 50 patients treated with thiocolchicoside plus potassium diclofenac and 2) placebo group with 47 patients. The efficacy of both groups was evaluated by the reduction of muscle spams observed in checking, palpation and pain reduction measured in an analogue visual scale after 5 days of treatment. Results: the progress of the muscle spasm degree in the active medication group according to visual evaluation went from 100 percent with visible spasm with or without fixed antialgic activity to 96 percent with no visible signs of spasm; from 82 percent of moderate spasm to severe with or without evoked pain by palpation to 74 percent of mild spasm without pain and 26 percent of spasm-free muscle. The pain average according to the visual scale decreased from 6.66 cm before treatment to 0,86 cm after the 5th day. The adverse effects were mild in t he treated group. Conclusions: the fixed combination of thiocolchicoside 4mg plus potassium diclofenac 50 mg in a single tablet, administered two times a day is efficacious in the painful acute muscle spasm of diverse etiology in a statistically significant way, well-tolerated and with no alteration of the psychomotor performance(AU)

Finger Tapping of Stroke Patients' Unaffected Hand Is Different from Healthy / 中国康复理论与实践

@#Objective To compare finger tapping of stroke patients' unaffected hands to the same hands of healthy people. Methods 40 stroke patients with left hemiplegia (25 males and 15 females), including 11 cases of cerebral hemorrhage and 29 cases of cerebral infarction, and other 40 healthy people were tested the finger tapping of right hand. Results The finger tapping was significantly lower in the stroke patients than in the healthy people (P<0.01). There was no difference in finger tapping between patients with cerebral hemorrhage and cerebral infarction (P<0.05). Conclusion Motor function of fingers in unaffected hands is injured in stroke patients.

CLINICAL APPLICATION OF MICRO -SCREW IMPLANT ANCHORAGE IN TREATMENT OF ANGLE'S CLASS II DIVISION 1 MALOCCLUSION WITH DEEP OVERBURDEN JAWS / 现代医院

Objective To assess theapplication values of self -tapping micro-screw implant anchorage in treatment of Angle's class II division 1 malocclusion with deep overburden jaws , compared with the traditional anchor-age.Micro-screw implantswere inserted in maxillary teeth of patients with Angle's class II division 1 malocclusion with deep overburden jaws tostrengthen anchorage .Changesin position of the maxillary incisor and the first molar were compared.Methods 68 cases of Angle's class II division 1 malocclusion with deep overburden jaws were selected and randomly divided into the research group and the control group .The research group wastreated with a self -tap-ping micro-screw implant as ananchorage .The control group was treated with Nance bow , transpalatal arch or in combination with face bow as strong anchorage .The total treatment time , line spacing and the angle differences be-tween the U1/SN of X-ray cephalometry before and after treatment were compared in two groups .Results ①The-self-tapping micro-screw implant kept stability without looseness .Thesoft tissue surrounding dental implants had no swellings or infections .Patients had no obvious discomfort .②The average periods of treatmentin the research group and the control group treatment were 20 months and 26 months, respectively.③The soft -tissue profilein the re-search group was improved significantly , with 4.26 mm and 4.54 mmof the adductions ofthe upper and lower lips rel-ative to aesthetic plane respectively .The angle of U1/SN was reduced 10.2°.Theadductionsof the upper and lower lipsin the control group relative to aesthetic plane were 2.88 mm and 3.01 mm respectively and there werestatistically significantdifferencesin two groups .There were no remarkableanteroposterior and verticalmovement after correction of maxillary first molars(p>0.05)but the anteroposterior incisor movement in the research group .The movements were statistically significant differences(p<0.01).Conclusion Compared with the traditional anchorage technique , mi-cro-screw implant anchorage can better control teeth movement and shorten the treatment time .

Another Understanding for Effects of Physical Stimuli on Modification of Autonomic Nerve System by Two Kinds of Stimuli on Feet / 日本温泉気候物理医学会雑誌

Background: In one series of studies, we observed the effects of acupuncture treatment (AT) on the autonomic nerve system (ANS). We experimented from various view-points. At last, we discovered a specific pattern for modifying ANS status, which showed that functions of the parasympathetic nerve increased while those of the sympathetic nerve decreased. To further study systematic modification of ANS balance, we focused on the lower body (feet). Moreover, two kinds of stimuli, tapping and vibration, were applied while measuring the value of finger floor distance (FFD) and heart rate (HR). Finally, the effects on ANS were discussed. Methods: Twenty healthy subjects participated in this study, and they were divided into two groups; the tapping group and the vibration group. The former received 50 taps on the feet, and the latter received vibrations for two minutes. In order to indicate ANS status the effects of these stimuli were evaluated by FFD values and a kinetic record of changes in HR. Results: Both groups showed improvement in FFD values, which was the same as the results for AT via modification of ANS. However, changes in HR showed a different pattern from AT; in this study sympathetic nerve) dominantly showed an increase without a decrease in parasympathetic nerve. Discussion and Conclusions: The reasons for differences in ANS modification may be found in the role, especially in an emergency, of the lower body. The lower body is heavy in skeletal muscles, which needs energy and blood to react during acute stress. The ANS, which controls blood distribution, may shift and concentrate system blood from the smooth muscles of the stomach (controlled by parasympathetic nerve) to the skeletal muscles of the legs and feet (controlled by sympathetic nerve). Thus, this study indicated that local stimuli of the foot induced systematic ANS modification.

Effects of two expectoration methods on pulmonary complications and hypoxemia in esophageal cancer patients having undergone radical resection with video-assisted thoracoscopic surgery / 现代临床护理

Objective To compare the effects of expectoration by high frequency back tapping with both hands and traditional expectoration by tapping back with a single hand on pulmonary complications in esophageal cancer patients having undergone radical resection with video-assisted thoracoscopic surgery (VATS). Methods Sixty patients after radical resection for esophageal cancer with VATS from May 2013 to January 2014 were set as the control group, in which expectoration by tapping the back with a single hand. Another 60 patients after radical resection for esophageal cancer with VATS from February 2014 to July 2014 were set as the observation group, in which the expectoration by high frequency tapping the back with both hands. The two groups were compared in terms of pulmonary complications. Result The incidence of atelectasis and pulmonary infection in the observation group were lower than those with a single hand in the control group (all P<0.05). Conclusion For the patients having undergone radical resection of esophageal carcinoma with VATS, the expectoration with high frequency back tapping with both hands is more effective in lowering atelectasis rate than that with a single hand.

Finger Tapping of Stroke Patients' Unaffected Hand Is Different from Healthy / 中国康复理论与实践

Objective To compare finger tapping of stroke patients' unaffected hands to the same hands of healthy people. Methods 40 stroke patients with left hemiplegia (25 males and 15 females), including 11 cases of cerebral hemorrhage and 29 cases of cerebral infarc-tion, and other 40 healthy people were tested the finger tapping of right hand. Results The finger tapping was significantly lower in the stroke patients than in the healthy people (P<0.01). There was no difference in finger tapping between patients with cerebral hemorrhage and cerebral infarction (P<0.05). Conclusion Motor function of fingers in unaffected hands is injured in stroke patients.

Another Understanding for Effects of Physical Stimuli on Modification of Autonomic Nerve System by Two Kinds of Stimuli on Feet / 日本温泉気候物理医学会雑誌

<b>Background:</b> In one series of studies, we observed the effects of acupuncture treatment (AT) on the autonomic nerve system (ANS). We experimented from various view-points. At last, we discovered a specific pattern for modifying ANS status, which showed that functions of the parasympathetic nerve increased while those of the sympathetic nerve decreased. To further study systematic modification of ANS balance, we focused on the lower body (feet). Moreover, two kinds of stimuli, tapping and vibration, were applied while measuring the value of finger floor distance (FFD) and heart rate (HR). Finally, the effects on ANS were discussed.<BR><b>Methods:</b> Twenty healthy subjects participated in this study, and they were divided into two groups; the tapping group and the vibration group. The former received 50 taps on the feet, and the latter received vibrations for two minutes. In order to indicate ANS status the effects of these stimuli were evaluated by FFD values and a kinetic record of changes in HR.<BR><b>Results:</b> Both groups showed improvement in FFD values, which was the same as the results for AT via modification of ANS. However, changes in HR showed a different pattern from AT; in this study sympathetic nerve) dominantly showed an increase without a decrease in parasympathetic nerve.<BR><b>Discussion and Conclusions:</b> The reasons for differences in ANS modification may be found in the role, especially in an emergency, of the lower body. The lower body is heavy in skeletal muscles, which needs energy and blood to react during acute stress. The ANS, which controls blood distribution, may shift and concentrate system blood from the smooth muscles of the stomach (controlled by parasympathetic nerve) to the skeletal muscles of the legs and feet (controlled by sympathetic nerve). Thus, this study indicated that local stimuli of the foot induced systematic ANS modification.

Spinal Subdural Hematoma Following Meningioma Removal Operation

Although blood contamination of cerebrospinal fluid (CSF) after an intracranial operation can occur, the development of a symptomatic spinal hematoma after craniotomy has been anecdotally reported and it is uncommon reported after a supratentorial meningioma removal operation. We report a case of spinal subdural hematoma following a supratentorial meningioma removal operation and discuss the mechanism of spinal subdural hematoma (SSDH) development. A 54-year-old woman presented with lumbago and radicular pain on both legs 4 days after a right parietooccipital craniotomy for meningioma removal. Only the straight leg raising sign was positive on neurologic examination but the magnetic resonance imaging (MRI) demonstrated a lumbosacral spinal subdural hematoma. The patient received serial lumbar tapping, after which her symptoms showed improvement.

Parámetros cinemáticos en la prueba de Tapping en pacientes con enfermedad de Parkinson / Cinematic parameters in the Tapping test in patients with Parkinson's disease

Motor slowness is the most characteristic motor deficit in Parkinson Disease (PD). The tapping test is a timed motor performance task which has been widely used in evaluation of PD. We study kinematics parameters of tapping test in PD and health control. Methods: Subjects consisted on 12 patients (2 women) with Parkinson's disease (PD) and 6 healthy control subjects (2 women). The mean age 63 +/- 9.7years PD and 64.8 +/- 13.3 years control. Duration of disease was 5.8 +/- 4.1 years. All patients were on levodopa medication. Procedures: All participants performed repetitive Hand/Arm movements between two points placed 25 cm apart horizontally for 20 successive taps ("as fast as possible"). The test was performed independently for each hand. Parkinson patients performed under the best ON condition. We assessed patients clinically using the motor section of the Unified Parkinson Disease Rating Scale (UPDRS). Informed consent was obtained. Apparatus: One standard video camera positioned perpendicularly from two target points recorded movement and referential xy system. A light reflective marker was attached to middle finger. The middle finger marker was manually digitized at a rate of 30 Hz using Kinematics Analysis software. Statistical analysis Kuskal-wallis one way analysis of variance, r spearman correlation. A p value < 0.05 was considered statistically significant. Results: Median Velocity in normal control was 94 +/- 11 cm/s and in PD was 67 +/- 15 cm/s (p < 0.001). Maximal velocity in normal control was 198 +/- 20 cm/s and in PD was 143 +/- 33 cm/s (p < 0.001). Median acceleration in normal control was 1630 +/- 331 cm/s2 in PD was 966 +/- 285 cm/s2 (p < 0.001). Median Movement amplitude in Y plane; in normal control was 28 +/- 5 cm and in PD was 21 +/- 8 cm (p < 0.01). Median Movement amplitude in Y plane correlated significantly with bradykinesia summary score (r = -0.59, p < 0.001)...

La bradicinecia es el déficit motor más característico de la enfermedad de Parkinson (EP), generalmente diagnosticado bajo diversos estudios como la prueba de tapping -ampliamente utilizada para determinar la enfermedad-, donde se mide la repetición de una tarea específica en un tiempo determinado. En el siguiente trabajo se estudiaron los parámetros cinemáticos del tapping en EP y controles. El estudio se realizó en 12 pacientes con EP con una edad media de 64,6 +/- 9,4 años -con duración promedio de la EP de 5,8 +/- 4,1 años. Todos los casos estaban en tratamiento con levodopa. Además, se estudiaron 7 controles en personas con una edad media de 64,8 +/- 12,8 años. Se les solicitó a todos que con los dedos de la mano tocaran en forma secuencial dos puntos separados por 25 cm. En el dedo medio se instaló una marca refractaria a la luz, utilizada como referencia para determinar la posición de la mano. El movimiento fue filmado mediante una cámara de video estándar con una velocidad de 30 cuadros por segundo. Los pacientes fueron evaluados clínicamente usando la escala unificada para la valoración de la enfermedad de Parkinson en su sección motora parte III (UPDRS-III). El análisis cinemático se realizó mediante un software especialmente diseñado para determinar la posición espacial de la marca en relación al sistema de referencia cartesiano. El análisis estadístico se realizó con Kurskal-Wallis test y correlaciones de Spearman. Se consideró significación estadística con p < 0,05. Resultados: La velocidad media en el control normal fue de 94 +/- 11 cm/seg y en la EP fue de 67 +/- 15 cm/seg (p <0,001). La velocidad máxima en el control normal fue de 198 +/- 20 cm /seg y en la EP fue de 143 +/- 33 cm/seg (p < 0,001). En el control de aceleración media normal fue 1.630 +/- 331 cm/seg² en la EP fue 966 +/- 285 cm/seg² (p < 0,001). Movimiento amplitud media en el plano Y, en el control normal fue de 28 +/- 5 cm y en la EP fue de 21 +/- 8 cm (p < 0,01)...

Influência do macheamento do orifício piloto nos parafusos cervicais anteriores / Influence of tapping the pilot hole in anterior cervical screws / Influencia del taladramiento del agujero piloto en tornillos cervicales anteriores

OBJETIVO: Analisar experimentalmente a influência do macheamento do orifício piloto nas propriedades mecânicas e na interface osso-implante do parafuso cervical anterior. MÉTODOS: Oito carneiros da raça Santa Inês deslanados foram utilizados no estudo. Nos segmentos vertebrais cervicais de C2-C7 foram realizados orifícios piloto de 2,5mm, de ambos os lados da vértebra. No lado direto da vértebra foi realizado o macheamento previamente a inserção do parafuso cortical de 3,5mm, e no lado esquerdo o implante foi colocado sem o macheamento do orifício piloto. Foram realizados ensaios mecânicos para avaliar a força de arrancamento dos implantes e estudo histomorfométrico da interface osso-implante na fase aguda e oito semanas após a colocação dos implantes. O torque de inserção foi mensurado durante a colocação dos implantes. RESULTADOS: O torque de inserção e a resistência ao arrancamento dos implantes foram maiores nos implantes colocados sem o macheamento do orifício piloto. A interface osso-implante apresentou maior área de contato ósseo e maior área óssea no interior da rosca do implante nos parafusos implantados sem o macheamento prévio. Não foi observado diferença na área óssea fora do passo de rosca do implante. CONCLUSÕES: O macheamento do orifício piloto reduz o torque de inserção e a resistência ao arrancamento do implante na fase aguda e crônica, e reduz a área de contato osso-implante e área de osso no interior do passo de rosca.

OBJECTIVE: Experimentally analyze the influence of the pilot hole tapping on the mechanical properties and the bone-implant interface of anterior cervical screw. METHODS: Eight shorn Santa Inês sheep were used in the study. In cervical segments C2-C7 of the column 2.5mm pilot holes were made on both sides of the vertebra. On the right side of the vertebra tapping was done before the insertion of the cortical screw of 3.5mm, and on the left side the implant was placed without tapping the pilot hole. Mechanical assays were performed to assess the strength of pullout as well as a histomorphometric study of bone-implant interface during the acute phase and eight weeks after implant placement. The insertion torque was measured during implant placement. RESULTS: The insertion torque and pullout strength were higher for implants placed without tapping the pilot hole. The bone-implant interface showed greater area of bone contact and greater bone area within the implant thread on the screws implanted without prior tapping. No differences were observed in the bone outside the thread pitch of the implant. CONCLUSIONS: Tapping the pilot hole reduces insertion torque and pullout strength of the implant in both acute and chronic phases, and reduces the area of bone-implant contact and the bone area within the thread pitch.

OBJETIVO: Para estudiar experimentalmente la influencia del taladramiento del agujero piloto sobre las propiedades mecánicas y la interfaz hueso-implante del tornillo cervical anterior. MÉTODOS: Ocho ovejas Santa Ines fueron utilizadas en el estudio. En los segmentos vertebrales cervicales C2-C7 se hicieron agujeros pilotos de 2,5 mm en ambos lados de la vértebra. En el lado derecho de la vértebra el taladramiento se hizo antes de la inserción del tornillo cortical de 3,5 mm, y en el lado izquierdo el implante fue colocado sin el taladramiento del agujero piloto. Se realizaron ensayos mecánicos para evaluar la fuerza de retirada y el estudio histomorfométrico de la interfase hueso-implante en la fase aguda y ocho semanas después de la colocación del implante. El torque de inserción se midió durante la colocación del implante. RESULTADOS: La fuerza de torsión de la inserción y la resistencia a la extracción fueron más altas en los implantes colocados sin el taladramiento del agujero piloto. La interfaz hueso-implante presentó mayor área de contacto con el hueso y mayor área de hueso dentro de la rosca del implante en los tornillos implantados sin taladramiento previo. No se observaron diferencias en el hueso fuera del paso de la rosca del implante. CONCLUSIONES: El taladramiento del agujero piloto reduce el par de torsión de inserción y la resistencia a la extracción del implante en las fases aguda y crónica, y reduce el área de contacto hueso-implante y el área ósea en el interior del paso de la rosca.