Gene Expression Profile Changes in the Stimulated Rat Brain Cortex After Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation (rTMS) is gaining popularity as a research tool in neuroscience; however, little is known about its molecular mechanisms of action. The present study aimed to investigate the rTMS-induced transcriptomic changes; we performed microarray messenger RNA, micro RNA, and integrated analyses to explore these molecular events. Eight adult male Sprague-Dawley rats were subjected to a single session of unilateral rTMS at 1 Hz (n = 4) or sham (n = 4). The left hemisphere was stimulated for 20 minutes. To evaluate the cumulative effect of rTMS, eight additional rats were assigned to the 1-Hz (n = 4) or sham (n = 4) rTMS groups. The left hemisphere was stimulated for 5 consecutive days using the same protocol. Microarray analysis revealed differentially expressed genes in the rat cortex after rTMS treatment. The overrepresented gene ontology categories included the positive regulation of axon extension, axonogenesis, intracellular transport, and synaptic plasticity after repeated sessions of rTMS. A single session of rTMS primarily induced changes in the early genes, and several miRNAs were significantly related to the mRNAs.Future studies are required to validate the functional significance of selected genes and refine the therapeutic use of rTMS.

The Investigation of the Pain after the Orthotic Treatment in Adolescent Idiopathic Scoliosis

OBJECTIVE: To provide a perspective on the recent trends in the etiologies and levels of lower limb amputations in Korea. METHOD: Medical records of 284 patients discharged from Seoul National University Hospital between 1990 and 1999 who had amputation related procedure codes were reviewed. Data were used to calculate ratios of congenital anomaly, trauma related, tumor related, diabetes related, and vascular insufficiency related amputations, and ratios of each level of amputations. Trends over time were examined by comparing data from 1990 to 1994 with those from 1995 to 1999 using chi square tests. RESULTS: Dysvascular amputations accounts for 53.5% of lower limb loss in recent 10 years, and tumor (18.9%), congenital anomaly (14.5%), and trauma (6.1%) ranked the next common etiologies. The proportion of dysvascular amputations since 1995 was found to be significantly greater than the ratio before 1995 (p<0.05), and the ratio of amputations secondary to congenital anomaly was lower (p<0.05). There was no significant change in the level of amputations. CONCLUSION: Over recent 10 years, the risk of amputation secondary to dysvascular conditions has been increased, which warrants further investigations and efforts to improve our management of amputees.

Measurements of Lumbar Segmental Range of Motion with 3-dimensional Motion Analysis in Healthy Adults

OBJECTIVE: To measure the lumbar segmental range of motion (ROM) with 3-dimensional motion analysis system and compare the results with radiologic ROM measurements. METHOD: Ten healthy adult volunteers were included. We attached surface markers at the corresponding skin surface of each lumbar vertebral bodies and measured lumbar segmental ROM in flexion-extension, right bending, left bending, axial rotation with 3-D motion analysis. We compared some of the results with radiologic segmental ROM measurements. RESULTS: In 3-D motion analysis, segmental ROM of flexion and extension, right bending, left bending, right rotation, left rotation were, respectively: 10.1degrees, 45degrees, 3.5degrees, 1.7degrees and 1.9degrees(L1-L2); 17.9degrees, 6.2degrees, 5.1degrees, 1.4degrees and 1.1degrees (L2-L3); 15.0degrees, 7.2degrees, 4.9degrees, 2.1degrees and 1.1degrees (L3-L4); 14.9degrees, 5.8degrees, 4.6degrees, 1.7degree and 1.6degree (L4-L5); 10.6degrees, 4.9degrees, 3.8degree, 2.6degree and 0.8degree (L5-S1). There was no statistically significant difference in segmental ROM between 3-D motion analysis measurements and radiologic measurements except L5-S1 right bending, L2-L3 and L5-S1 left bending. No statistical significant difference in lumbar flexion and bending ROM was found between two methods. CONCLUSION: 3-D motion analysis is a useful method when measuring the lumbar segmental range of motion and it has an advantage to analyze segmental lumbar motion with three directions simultaneously.

Clinical Features of Lower Extremity Amputees in Hwa Sung Goon: One Korean County

OBJECTIVE: To evaluate the prevalence and prosthetic uses of lower extremity amputee in one Korean county. METHOD: We asked community health worker in Hwa Sung Goon to recruit lower extremity amputees. We contacted them by telephone and tried to know their prosthetic uses, adaptations and their behavior about prosthetic usage. Also, we recruited all lower extremity amputees in Hwa Sung Goon. RESULTS: In Hwa Sung Goon, the prevalence of lower extremity amputees was 35 persons per 100,000. 93.8% of them had prostheses, more than half of them were not satisfied with their prosthetic use. For last 10 years, they changed into new prosthesis per 2.3 years. CONCLUSION: In one Korean county, the prevalence of lower extremity amputees was 0.03%. Most of them used their prosthesis, and walked independently. Their compliances with rehabilitative intervention were very low.

Clinical Features and Long-term Outcome of Lower Extremity Amputees: A Follow-up Questionnaire Study in Three Regional Centers

OBJECTIVE: To evaluate the clinical features of lower extremity amputees and the process of prosthetic fitting and its use at follow up and to know the effects of prosthetic rehabilitation on adaptation to prosthesis and its long-term use. METHOD: One hundred and twenty four patients who underwent amputation surgery in 3 major hospitals in Korea from 1990 to 1997 were enrolled. They were evaluated by reviewing of medical records for anthropometry, level of amputation, causes of amputation, other coincidental medical problems, general physical states and followed up by telephone and mail questionnaire with respect to general outcome, prosthetic fitting, satisfaction of prosthesis, state of prosthetic use, functional state of prosthetic ambulation. RESULTS: The most common cause of amputation was trauma. The mean time to fit the prosthesis was 4.1 months and only 38 patients was supervised by rehabilitation programs. The patients who were supervised by rehabilitation program were fitted and able to ambulate significantly earlier than those who were not. They wore and used prosthesis significantly more often than those who were not supervised. The patients with above knee amputation who were supervised were significantly independent with walking aids. CONCLUSION: Rehabilitation training program enables amtupees to be fitted and walk earlier with prosthesis. Also, this program lowered the dependency on walking aids in above knee amputees.