Preclinical Evaluation of an Everolimus-Eluting Bioresorbable Vascular Scaffold Via a Long-Term Rabbit Iliac Artery Model

BACKGROUND@#Biodegradable poly (l-lactic acid) (PLLA), a bio safe polymer with a large elastic modulus, is widely used in biodegradable medical devices. However, because of its poor mechanical properties, a PLLA strut must be made twice as thick as a metal strut for adequate blood vessel support. Therefore, the mechanical properties of a drug-eluting metal-based stents (MBS) and a bioresorbable vascular scaffolds (BVS) were evaluated and their safety and efficacy were examined via a long-term rabbit iliac artery model. @*METHODS@#The surface morphologies of the MBSs and BVSs were investigated via optical and scanning electron microscopy. An everolimus-eluting (EE) BVS or an EE-MBS was implanted into rabbit iliac arteries at a 1.1:1 stent-toartery ratio. Twelve months afterward, stented iliac arteries from each group were analyzed via X-ray angiography, optical coherence tomography (OCT), and histopathologic evaluation. @*RESULTS@#Surface morphology analysis of the EE coating on the MBS confirmed that it was uniform and very thin (4.7 lm). Comparison of the mechanical properties of the EE-MBS and EE-BVS showed that the latter outperformed the former in all aspects (radial force (2.75 vs. 0.162 N/mm), foreshortening (0.24% vs. 1.9%), flexibility (0.52 vs. 0.19 N), and recoil (3.2% vs. 6.3%). At all time points, the percent area restenosis was increased in the EE-BVS group compared to the EE-MBS group. The OCT and histopathological analyses indicate no significant changes in strut thickness. @*CONCLUSION@#BVSs with thinner struts and shorter resorption times should be developed. A comparable long-term safety/efficacy evaluation after complete absorption of BVSs should be conducted.

Three-dimensional evaluation of the pharyngeal airway space in patients with anterior open bite / 대한치과교정학회지

Objective@#This study aimed to three-dimensionally evaluate the pharyngeal airway space (PAS) of patients with anterior open bite (AOB) by using conebeam computed tomography (CBCT) and compare the findings with those obtained in individuals with normal occlusion. @*Methods@#The open bite group (OBG, n = 25) consisted of patients with an anterior overbite of –3 mm or less, while the control group (n = 25) consisted of age- and sex-matched individuals with an anterior overbite of 1–3 mm, Angle Class I malocclusion (1° ≤ point A-nasion-point B angle ≤ 4°), and a normodivergent profile (22° ≤ Frankfort mandibular plane angle ≤ 28°). After the CBCT data were reconstructed into a three-dimensional image, the PAS was segmented into four parts, and the volume of each part was measured. Pharyngeal airway length (PAL) and the area and transverse width of the part showing minimal constriction were also measured. Pearson’s correlation analysis was used to evaluate the correlation between changes in the PAS and the amount of anterior overbite. @*Results@#The OBG showed a significantly narrower airway space in the nasopharyngeal, hypopharyngeal, and total airway volumes. The OBG also showed a significantly smaller area and transverse width of the part with minimal constriction. The OBG showed a significantly longer PAL, but there was no correlation between the amount of anterior overbite and the changes in PAS. @*Conclusions@#The PAS was associated with AOB. Patients with AOB had a narrower PAS and a smaller part showing minimal constriction.

Biomechanical analysis for different mandibular total distalization methods with clear aligners: A finite element study / 대한치과교정학회지

Objective@#The purpose of this finite element method (FEM) study was to analyze the biomechanical differences and tooth displacement patterns according to the traction direction, methods, and sites for total distalization of the mandibular dentition using clear aligner treatment (CAT). @*Methods@#A finite element analysis was performed on four FEM models using different traction methods (via a precision cut hook or button) and traction sites (mandibular canine or first premolar). A distalization force of 1.5 N was applied to the traction site by changing the direction from –30 to +30° to the occlusal plane. The initial tooth displacement and von Mises stress on the clear aligners were analyzed. @*Results@#All CAT-based total distalization groups showed an overall trend of clockwise or counterclockwise rotation of the occlusal plane as the force direction varied. Mesiodistal tipping of individual teeth was more prominent than that of bodily movements. The initial displacement pattern of the mandibular teeth was more predominant based on the traction site than on the traction method. The elastic deformation of clear aligners is attributed to unintentional lingual tipping or extrusion of the mandibular anterior teeth. @*Conclusions@#The initial tooth displacement can vary according to different distalization strategies for CAT-based total distalization. Discreet application and biomechanical understanding of traction sites and directions are necessary for appropriate mandibular total distalization.

A Study on the Evaluation of Brainstem Dysfunction in Rapid Eye Movement Sleep Behavior Disorder Using Video Nystagmography

Background@#This study aimed to differentiate video nystagmography (VNG) characteristics, including the video head impulse test (vHIT), in patients with idiopathic rapid eye movement behavior disorder (RBD) from healthy controls, which is considered a precursor to degenerative diseases. @*Methods@#One hundred eighty-five patients underwent overnight polysomnography (PSG) and VNG. Based on overnight PSG, 27 patients with RBD or REM sleep without atonia (RWA) and AHI<15 were categorized into the RBD group, 34 patients with RBD/RWA and AHI≥15 were grouped into the combined group. Sixty patients with AHI≥15 and no RBD/RWA were included in the obstructive sleep apnea (OSA) group, and 64 negative participants were assigned to the control group. In VNG, we measured the gain of vHIT in each canal, with the latency, amplitude, and velocity of horizontal saccades and smooth pursuit. We compared the results between groups using ANOVA, after normalization and adjustment for age and sex. @*Results@#The gain of vHIT in the left horizontal canal was decreased in the RBD group, but it was more pronounced in the OSA group. Elevated gain of the left posterior canal was seen in the RBD group, but technical errors were attributable. The RBD group displayed prolonged latency of saccade on the left side and slowed saccade on the right side, but these were statistically insignificant. @*Conclusions@#The VNG study revealed differences between the sleep disorders, potentially reflecting brainstem function in each disorder. However, these differences lacked statistical significance. We anticipate that significant results could be obtained with more controlled conditions.

Palinacousis after Cerebral Venous Thrombosis in the Temporoparietal Lobe

Palinacousis is a rare auditory phenomenon characterized by the persistence of sounds beyond their actual duration. It has been associated with various brain conditions such as stroke, tumor, and seizure in the temporoparietal lobe. We present a case report of a 43-yearold man who developed palinacousis following cerebral venous thrombosis and seizure with lesions including the left auditory cortex. This case highlights the intriguing relationship between cerebral venous infarction, seizure, and the development of palinacousis in specific brain regions.

Comorbid Psychiatric Symptom Associated With Oppositional Defiant Symptom in Community School-Age Children

Objectives@#Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. This study aimed to investigate comorbid psychiatric symptoms and associated factors in elementary school children with symptoms of ODD. @*Methods@#The participants consisted of 205 mother-offspring pairs. Psychiatric symptoms were measured using the Diagnostic Predictive Scales and Korean Child Behavior Checklist. Psychiatric comorbid symptoms were compared between children with ODD symptom and those without ODD symptom. Multivariate logistic regression analysis was used to estimate the odds ratio of psychiatric symptom on ODD. @*Results@#ODD group had a significant association with internalizing and externalizing problem (p=0.001, p<0.001, respectively). ODD group were more comorbid with anxiety disorder, depressive disorder, attention-deficit/hyperactivity disorder, and conduct disorder. Among psychiatric disorder, generalized anxiety disorder (GAD) (adjusted odds ratio [AOR]=18.620, p<0.001) and conduct disorder (AOR=9.529, p=0.014) were associated with ODD symptom. @*Conclusion@#These findings suggest that children with ODD symptom had significantly higher rates of comorbid psychiatric symptoms. And GAD and conduct disorder are related to ODD symptom.

A Case of Sinochoanal Polyp Originating From the Ethmoid Sinus

A nasal polyp is a distinct mucosal pathology that obstructs the nasal cavity and paranasal sinuses, with various phenotypes and endotypes. Nasal polyps should be distinguished from inverted papillomas, squamous cell carcinomas, juvenile angiofibromas, lymphomas, and olfactory neuroblastomas. A choanal polyp is a solitary benign lesion that originates in the paranasal sinus and extends to the choana through the natural ostium of the sinus. Choanal polyps usually originate from the maxillary sinus; however, we recently experienced the case of 41-year old women with sinochoanal polyp originated from the ethmoid sinus. As choanal polyps can recur even after appropriate surgery, complete resection, including the surrounding mucosa at the site of origin, is required. Therefore, it is essential to consider anatomical differences in polypectomy. We recently diagnosed and successfully performed surgery on an ethmochoanal polyp; herein, we report our experience and present a literature review.

Reference Respiratory Muscle Strength Values and a Prediction Equation Using Physical Functions for Pulmonary Rehabilitation in Korea

Background@#In Korea, tests for evaluating respiratory muscle strength are based on other countries’ clinical experience or standards, which can lead to subjective evaluations. When evaluating respiratory function based on the standards of other countries, several variables, such as the race and cultures of different countries, make it difficult to apply these standards. The purpose of this study was to propose objective respiratory muscle strength standards and predicted values for healthy Korean adults based on age, height, weight, and muscle strength, by measuring maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak cough flow (PCF). @*Methods@#This cross-sectional study analyzed MIP, MEP, and PCF in 360 people, each group comprising 30 adult men and women aged 20–70, diagnosed as healthy after undergoing medical check-ups at a general hospital. Hand grip strength (HGS) and the five times sitto-stand test (FTSST) results were also recorded. Correlations among respiratory muscle strength, participant demographics, and overall muscle strength were evaluated using Pearson’s correlation analysis. The predicted values of respiratory muscle strength were calculated using multiple regression analysis. @*Results@#Respiratory muscle strength differed from the values reported in studies from other countries. In the entire samples, both MIP and MEP had the highest correlations with peak HGS (r= 0.643, r = 0.693; P < 0.05), while PCF had the highest correlation with forced expiratory volume in 1 s (r = 0.753; P < 0.05). Age, body mass index, peak HGS, and FTSST results were independent variables affecting respiratory muscle strength. A predictive equation for respiratory muscle strength was developed using the multiple regression equation developed in this study. @*Conclusion@#Respiratory muscle strength index may differ by country. For more accurate diagnoses, standard values for each country are required. This study presents reference values for Korea, and a formula for estimation is proposed when no respiratory muscle strength measurement equipment is available.Trial Registration: Clinical Research Information Service Identifier: KCT0006778

Surgical Techniques for Severe Liver Injury: A Comprehensive Review of Current Approaches and Advancements

In abdominal trauma, the liver is the most injured organ and treatment is usually determined by hemodynamics. Severe liver injury with extensive parenchymal injury and uncontrollable bleeding may rapidly evolve into the lethal triad of death (acidosis, hypothermia, and coagulopathy), requiring damage control surgery (DCS). Damage control resuscitation for trauma treatment reduces the need for DCS by enabling rapid control of massive bleeding. Thus, definitive surgery can be completed in one operation. Despite the systematic application of damage control resuscitation, definitive surgery cannot be achieved in severe, and extensive liver injuries. Therefore, understanding, and acquiring damage control surgical techniques is necessary to achieve DCS for severe liver injury. The Western Trauma Association and the World Society of Emergency Surgery have proposed algorithms for the nonoperative and operative management of blunt hepatic trauma. The algorithms list several surgical skills, including electrocautery or argon beam, manual compression, perihepatic packing, the Pringle maneuver, liver suture, omental packing, selective hepatic artery ligation, balloon tamponade, hepatic vascular isolation, and the shunt operation. These techniques require a multidisciplinary approach and individual honing of skills by the surgeon. Trauma surgeons, even hepatobiliary surgeons, must practice damage control techniques in severe liver injury models (animals or cadavers).

Analysis of clinical risk factors of failed electrical cardioversion in patients with persistent atrial fibrillation or atrial flutter

Background@#Although rhythm control could be the best for symptomatic atrial fibrillation (AF), some patients fail to achieve sinus rhythm (SR). This study aimed to identify clinical risk factors of failed electrical cardioversion (ECV). @*Methods@#A total of 248 patients who received ECV for persistent AF or atrial flutter (AFL) were retrospectivelyreviewed. Patients were divided into three groups: Group 1 maintained SR for > 1 year, group 2 maintained SR ≤ 1 yearafter ECV, and group 3 failed ECV. SR maintenance was assessed using regular electrocardiography or Holter monitoring. @*Results@#Patients were divided into group 1 (73, 29%), group 2 (146, 59%), and group 3 (29, 12%). The mean ageof patients was 60 ± 10 years, and 197 (79%) were male. Age, sex, and baseline characteristics were similar amonggroups. However, increased cardiac size, digoxin use, heart failure (HF), and decreased left ventricular ejection frac‑ tion (LVEF) were more common in group 3. Univariate analysis of clinical risk factors for failed ECV was increasedcardiac size [hazard ratio (HR) 2.14 (95% confidence interval [CI], 1.06–4.34, p = 0.030)], digoxin use [HR 2.66 (95% CI, 1.15–6.14), p = 0.027], HF [HR 2.60 (95% CI, 1.32–5.09), p = 0.005], LVEF < 40% [HR 3.45 (95% CI, 1.00–11.85), p = 0.038], and decreased LVEF [HR 2.49 (95% CI, 1.18–5.25), p = 0.012]. Among them, HF showed clinical significance only by multivariate analysis [HR 3.01 (95% CI, 1.13–7.99), p = 0.027]. @*Conclusions@#Increased cardiac size, digoxin use, HF, LVEF < 40%, and decreased LVEF were related to failed ECV for persistent AF or AFL. Among these, HF was the most important risk factor. Further multi-center studies including greater number of participants are planned.

Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study

Background/Aims@#This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract. @*Methods@#The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. @*Results@#UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. @*Conclusions@#The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.

Recurrence of Rathke’s Cleft Cyst Following Surgery and Histopathological Considerations for Recurrence: A Case Presentation

Recurrence of Rathke’s cleft cysts (RCC) following surgery is not uncommon. We present a 33-yearold male patient with chronic headache and visual disturbances whose MRI showed mostly cystic, suprasellar mass with peripheral enhancement. Endoscopic extended transsphenoidal approach and tumor resection was performed and RCC was pathologically confirmed postoperatively. Early recurrence was first suspected at 3 months following surgery, and his serial MRIs showed a recurred mass without associated clinical symptoms. Upon further histopathological study, extensive squamous metaplasia and high Ki-67 were seen. Also, in this study, we discuss important factors associated with cyst recurrence following surgery.

Nitric Oxide Signal Transduction and Its Role in Skin Sensitization

Nitric oxide (NO) is a signaling molecule that plays a crucial role in numerous cellular physiological processes. In the skin, NO is produced by keratinocytes, fibroblasts, endothelial cells, and immune cells and is involved in skin functions such as vasodilation, pigmentation, hair growth, wound healing, and immune responses. NO modulates both innate and adaptive immune responses. As a signaling molecule and cytotoxic effector, NO influences the function of immune cells and production of cytokines. NO is a key mediator that protects against or contributes to skin inflammation. Moreover, NO has been implicated in skin sensitization, a process underlying contact dermatitis. It modulates the function of dendritic cells and T cells, thereby affecting the immune response to allergens. NO also plays a role in contact dermatitis by inducing inflammation and tissue damage. NO-related chemicals, such as nitrofatty acids and nitric oxide synthase (NOS) inhibitors, have potential therapeutic applications in skin conditions, including allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). Further research is required to fully elucidate the therapeutic potential of NO-related chemicals and develop personalized treatment strategies for skin conditions.

The Use of High-Density Pedicle Screw Construct with Direct Vertebral Derotation of the Lowest Instrumented Vertebra in Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis: Comparison of Two Surgical Strategies

Methods@#We reviewed consecutive patients with Lenke 1 AIS who underwent STF from 2000 to 2017. The patients were divided into two groups based on the surgical strategy used: low-density (LD) construct without DVR of the LIV (LD group) versus HD construct with DVR of the LIV (HD group). We collected data on the patient’s demographic characteristics, skeletal maturity, operative data, and measured radiological parameters in the preoperative and final follow-up radiographs. The occurrence of adding-on (AO) and coronal decompensation was also determined. @*Results@#In this study, 72 patients (five males and 67 females) with a mean age of 14.1±2.3 years were included. No significant differences in the demographics, skeletal maturity, and Lenke type distribution were observed between the two groups; however, the follow-up duration was significantly longer in the LD group (64.3±25.7 months vs. 40.7±22.2 months, p <0.001). The HD group had significantly shorter fusion segments (7.1±1.3 vs. 8.5±1.2, p <0.001) and a more proximal LIV level (12.1±0.9 vs. 12.7±1.0, p =0.009). In the radiological measurements, the improvement of LIV+1 rotation (Nash–Moe scale) was significantly larger in the HD group (0.53±0.51 vs. 0.21±0.41, p =0.008). AO and decompensation occurred in 7 (9.7%) and 4 (5.6%) patients in the HD and LD groups, respectively, without any significant difference between the two groups. @*Conclusions@#In this study, the HD group had a significantly shorter fusion level and a more proximal LIV than the LD group; however, the two groups had similar curve correction and adverse radiological outcome rates.

The cover of an ear thermometer probe as a split-thickness skin graft mold in external auditory canal reconstruction

Maintaining the patency of the external auditory canal (EAC) during reconstruction is important because of its physiological role in hearing and immunological protective functions. The curved shape of the EAC presents a challenge when performing a skin graft. One of the key points for a successful skin graft is to ensure compression on the wound bed, and many novel methods, including prefabricated ear molds, have been reported for this purpose. In this study, we present a case of a skin graft performed to reconstruct a skin defect following excision of actinic keratosis in the EAC, using the cover of an ear thermometer probe as a mold for the graft to match the curvature of the EAC. This is an economical and practical method for secure compression dressing of a skin graft in the EAC.

Does the dominant hand’s use affect the complication rates in prosthetic breast reconstruction?

Background@#Numerous studies have investigated risk factors for unfavorable outcomes in prosthetic breast reconstruction, such as obesity, perioperative radiotherapy, and acellular dermal matrix use. However, no reports have explored whether the use of the dominant hand influences complications in breast reconstruction. To address this gap in the literature, analyzed complication rates between the dominant and non-dominant sides after reconstruction. @*Methods@#We retrospectively reviewed the charts of 160 patients (170 breasts) who underwent breast reconstruction from February 2017 to March 2022. We analyzed the complications between beasts on the dominant and non-dominant sides according to the reconstruction method. @*Results@#During prosthetic breast reconstruction, the drainage volume and duration on the dominant side exceeded those on the non-dominant side after reconstruction (duration: 9.79 days on the dominant side vs. 9.12 days on the non-dominant side, P=0.196; volume: 771.1 mL on the dominant side vs. 654.3 mL on the non-dominant side, P=0.027). The incidence of complications such as wound dehiscence, mastectomy flap necrosis, and infection was significantly higher in the dominant hand group (infection: 6 vs. 0, P=0.014; dehiscence: 15 vs. 4, P=0.009; flap necrosis: 13 vs. 4, P=0.024). @*Conclusions@#Complications including seroma, infection, and mastectomy skin flap necrosis following prosthetic reconstruction were common in breasts on the dominant-hand side. Therefore, meticulous management and restriction of shoulder movement can aid in preventing seroma-related complications in prosthetic breast reconstruction, especially on the side of the dominant hand.

The effects of curcumin on the fibrous envelope surrounding silicone implants in rats

Background@#Capsular contracture is the most common serious breast surgery complication. The cause of capsular formation remains unknown, but chronic inflammation is commonly considered to cause excessive fibrosis. Curcumin has anti-inflammatory effects and thus can relieve the symptoms of inflammatory diseases, as demonstrated in animal studies. This study aimed to evaluate the effects of curcumin on the fibrous envelope covering silicone implants in a rat model. @*Methods@#Two solid 1.8-cm oval-shaped silicone implants were placed beneath both sides of the back in 20 Sprague-Dawley rats. The control group included 10 rats that were fed a normal diet (group A), while the experimental group (group B) included the remaining 10 rats that were fed ground curcumin. En bloc excision was conducted at 8 postoperative weeks. Capsular thickness and inflammatory cell distribution were examined using a fixed tissue sample. @*Results@#Gross findings and histologic differences between the groups were observed. The experimental group had a significantly lower mean total capsular thickness than the control group (177.4±31.4 μm vs. 145.9±32.5 μm, P=0.007). A significant decreasing tendency was found in several inflammatory cells in the experimental group (7,070±744.3/mm2 vs. 2,640±301.7/mm2, P=0.001). @*Conclusions@#Curcumin significantly reduced the inflammatory reaction, and will help to lower the risk of capsular contracture. Long-term studies are required to determine whether this hypothesis can provide a basis for a viable therapeutic strategy to reduce capsular contracture.

The temporary abdominal closure techniques used for trauma patients: a systematic review and meta-analysis

Purpose@#The choice of temporary abdominal closure (TAC) method affects the prognosis of trauma patients. Previous studies on TAC are challenging to extrapolate due to data heterogeneity. We aimed to conduct a systematic review and comparison of various TAC techniques. @*Methods@#We accessed web-based databases for studies on the clinical outcomes of TAC techniques. Recognized techniques, including negative-pressure wound therapy with or without continuous fascial traction, skin tension, meshes, Bogota bags, and Wittman patches, were classified via a method of closure such as skin-only closure vs. patch closure vs.vacuum closure; and via dynamics of treatment like static therapy (ST) vs. dynamic therapy (DT). Study endpoints included in-hospital mortality, definitive fascial closure (DFC) rate, and incidence of intraabdominal complications. @*Results@#Among 1,065 identified studies, 37 papers comprising 2,582 trauma patients met the inclusion criteria. The vacuum closure group showed the lowest mortality (13%; 95% confidence interval [CI], 6%–19%) and a moderate DFC rate (74%; 95% CI, 67%–82%). The skin-only closure group showed the highest mortality (35%; 95% CI, 7%–63%) and the highest DFC rate (96%; 95% CI, 93%–99%). In the second group analysis, DT showed better outcomes than ST for all endpoints. @*Conclusion@#Vacuum closure was favorable in terms of in-hospital mortality, ventral hernia, and peritoneal abscess. Skinonly closure might be an alternative TAC method in carefully selected groups. DT may provide the best results; however, further studies are needed.

Epidemiology and Assessment of Traumatic Spinal Cord Injury With Concomitant Brain Injury: An Observational Study in a Regional Trauma Center

Objective@#To analyze the epidemiological information of patients with traumatic spinal cord injury (SCI) and concomitant traumatic brain injury (TBI) and to suggest points to be aware of during the initial physical examination of patients with SCI. @*Methods@#This study was a retrospective, observational study conducted in a regional trauma center. All the records of patients diagnosed with traumatic SCI between 2016 and 2020 were reviewed. A total of 627 patients with confirmed traumatic SCI were hospitalized. A retrospective study was conducted on 363 individuals. @*Results@#The epidemiological data of 363 individuals were investigated. Changes in American Spinal Injury Association Impairment Scale (AIS) scores in patients with SCI were evaluated. The initial evaluation was performed on average 11 days after the injury, and a follow-up examination was performed 43 days after. Fourteen of the 24 patients identified as having AIS A and SCI with concomitant TBI in the initial evaluation showed neurologic level of injury (NLI) recovery with AIS B or more. The conversion rate in patients with SCI and concomitant TBI exceeded that reported in previous studies in individuals with SCI. @*Conclusions@#Physical, cognitive, and emotional impairments caused by TBI present significant challenges in rehabilitating patients with SCI. In this study, the influence of concomitant TBI lesions could have caused the initial AIS assessment to be incorrect.

Effects of angiotensin peptides on colonic motility in rats

Purpose@#Renin-angiotensin system (RAS) is involved in the pathophysiology of colonic inflammation. The aim of this study was to investigate whether small angiotensins (Angs) peptides play a role in the regulation of colonic motility and their roles are modulated in colitis. @*Methods@#Experimental colitis was induced by an intake of 5% dextran sulfate sodium (DSS) dissolved in tap water for 7 days in Sprague-Dawley rats. After sacrifice, plasma hormone concentrations and messenger RNAs (mRNAs) for RAS were measured. Functional analysis of colonic motility in response to Angs peptides was performed using Taenia coli. @*Results@#DSS-treated colon showed an increased necrosis with massive infiltration of inflammatory cells. The mRNA level of colonic angiotensin II receptor type 2 (AT2R) in DSS-treated rats was higher than that in control rats whereas the mRNA levels of angiotensin II converting enzyme (ACE), ACE2, AT1R, AT4R, and Mars receptor were not different from those in control rats. Ang III, Ang IV, and Ang-(1-9) (1, 3 μM) increased the frequency of basal colonic motility. Ang-(1-7) did not cause any significant changes in frequency and amplitude of basal motility. The order of potency for an increased frequency of basal motility seems to be Ang II>>Ang IV>Ang III=Ang-(1-9). The increased frequency of basal motility by Ang-(1-9) but not Ang IV was significantly enhanced in DSS-treated rat colon. @*Conclusion@#In conclusion, these data suggest that small Angs peptides are partly involved in the pathophysiological regulation of colonic motility in experimental colitis.