Histopathological and Neurobehavioral Characterization in Adult Mice Exposed to Traumatic Brain Injury

PURPOSE: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Severity of the initial insult is one of the most significant factors affecting outcome following TBI. In order to investigate the mechanisms of cellular injury and develop novel therapeutic strategies for TBI, we designed a standardized animal TBI model and evaluated histological and functional outcomes according to the degree of impact severity. METHODS: Male adult C57Bl/6 mice underwent controlled cortical impact (CCI) at varying depths of deflection (1.0-2.0 mm). We performed hematoxylin and eosin staining at 7 days after recovery from TBI. Neurobehavioral characterization after TBI was analyzed by the Barnes maze test, passive avoidance test, open field test, rotarod test, tail suspension test, and light/dark test. RESULTS: We observed a graded injury response according to the degree of deflection depths tested (diameter, 3 mm; velocity, 3 m/s; and duration, 500 ms) compared to sham controls. In the Barnes maze test, the severe TBI (2 mm depth) group showed reduced spatial memory as compared with the sham and mild TBI (1 mm depth) groups at 7 days after TBI. There was a significant difference in the results of the open field test and light/dark test among the three groups. CONCLUSION: Our findings demonstrate that the graded injury responses following TBI resulted in differential histopathological and behavioral outcomes in a mouse experimental CCI model. Thus, a model of CCI with histologic/behavioral outcome analysis may offer a reliable and convenient design for preclinical TBI research involving mice.

Ischemic Compression After Trigger Point Injection Affect the Treatment of Myofascial Trigger Points

OBJECTIVE: To investigate the effects of trigger point injection with or without ischemic compression in treatment of myofascial trigger points in the upper trapezius muscle. METHODS: Sixty patients with active myofascial trigger points in upper trapezius muscle were randomly divided into three groups: group 1 (n=20) received only trigger point injections, group 2 (n=20) received trigger point injections with 30 seconds of ischemic compression, and group 3 (n=20) received trigger point injections with 60 seconds of ischemic compression. The visual analogue scale, pressure pain threshold, and range of motion of the neck were assessed before treatment, immediately after treatment, and 1 week after treatment. Korean Neck Disability Indexes were assessed before treatment and 1 week after treatment. RESULTS: We found a significant improvement in all assessment parameters (p<0.05) in all groups. But, receiving trigger point injections with ischemic compression group showed significant improvement as compared with the receiving only trigger point injections group. And no significant differences between receiving 30 seconds of ischemic compression group and 60 seconds of ischemic compression group. CONCLUSION: This study demonstrated the effectiveness of ischemic compression for myofascial trigger point. Trigger point injections combined with ischemic compression shows better effects on treatment of myofascial trigger points in the upper trapezius muscle than the only trigger point injections therapy. But the duration of ischemic compression did not affect treatment of myofascial trigger point.

Comparison of Manual Balance and Balance Board Tests in Healthy Adults

OBJECTIVE: To investigate the correlations of scores on the Timed Up and Go (TUG) test and the Single Leg Stance (SLS) test with stability scores on the Biodex Balance System (BBS) in healthy adults. METHOD: The postural balance of 73 participants was measured on the TUG and SLS tests and with the Overall Stability Index (OSI) on the BBS. The participants were divided into groups by age and by times on the TUG and SLS. The correlations between TUG or SLS and OSI scores were analyzed by groups. RESULTS: TUG scores were significantly correlated with OSI scores in age under 65 years, TUG over 10 seconds and SLS over 30 seconds groups (level 12). TUG scores were also correlated with OSI in total (level 10) and TUG under 10 seconds groups (level 2). However, there were no significant relationships between SLS and OSI scores. CONCLUSION: OSI scores on the BBS are significantly correlated with TUG scores, especially at the easy levels. According to the findings of present study, relatively easy BBS levels are considered to assess the postural balance in healthy adults.

The Effects of Neuromuscular Electrical Stimulation on Swallowing Function in Healthy Older Adults

OBJECTIVE: To evaluate the effects of neuromuscular electrical stimulation on the swallowing function in healthy older adults without clinical dysphagia. METHOD: The subjects were 18 healthy older adults aged >70 years and 10 young adults aged <30 years without symptoms or a history of dysphagia. Both groups were evaluated by the functional dysphagia scale (FDS) and pharyngeal transit time (PTT), using a videofluoroscopic swallowing study with semisolid material. Only the healthy older adults group received neuromuscular electrical stimulation (NMES) on suprahyoid and infrahyoid muscles, 60 min/day, 5 days/wk, for 2 weeks. The healthy older adults group was then re-evaluated by FDS and PTT. RESULTS: The average PTT in young adults was lower than in healthy older adults. FDS of the oral phase was larger in the older adults than in the young adults. After NMES for 2 weeks in older adults, there was a significant improvement in the averages for PTT and FDS. CONCLUSION: The results of this study showed that healthy older adults without clinical dysphagia had decreased swallowing function when they were compared with young adults. After NMES, the swallowing function, evaluated by FDS and PTT, was improved in healthy older adults.

Iatrogenic Rickets Myopathy: A case report

Gait disturbance in infants and toddlers results from various diseases, such as musculoskeletal, neuropathic, metabolic, and inherited disorders. These disorders lead to myopathies with muscle weakness. Nutritional deficiency can cause myopathy but it is very rare, because of early diagnosis and effective treatment. Vitamin D deficiency also can induce myopathy. Rickets, the clinical term of chronic vitamin D deficiency, results in secondary hyperparathyroidism that can show the characteristics of myopathy, such as muscle weakness, especially on the proximal muscles of lower extremities and the following waddling gait. We report a rare case of iatrogenic rickety myopathy.

Screening Test for Depression Using the SF-36 Health Survey in Patients with Chronic Musculoskeletal Pain

OBJECTIVE: To evaluate the usefulness of the mental component summary (MCS) from the short form 36-item health survey (SF-36) as a screening test for depression in patients with chronic musculoskeletal pain and identify the optimal cut-off value that predicts a positive depression score measured by the center for epidemiological study depression survey (CES-D). METHOD: This study was designed as a questionnaire survey. 502 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They completed the SF-36 and the CES-D. The correlation between the MCS score from the SF-36 and the CES-D was identified, and also the cut-off value of the MCS score was determined with ROC curves used the CES-D as the standard measure for depression. The MCS scores were compared according to age, sex, duration of diseases, diagnosis, and the presence of depression. RESULTS: The mean overall score of CES-D and the MCS score were 17.5+/-10.2, 52.2+/-16.4 respectively. The MCS scores negatively correlated with the CES-D (gamma=-0.879, p0.05). However, patients with depression had significantly lower MCS scores than patients without depression (p<0.05). The cut-off value was 42.4 with 88.1% of sensitivity and 92.6% of specificity. CONCLUSION: The MCS scores would be useful screening test for depression with cut-off value of 42.4 that predicts the closest result of the CES-D.

The Effect of Laterally Wedged Insoles on Standing Balance of Patients with Osteoarthritis in the Medial Compartment of Knees

OBJECTIVE: To investigate the effect of laterally wedged insole on static balance of patients with degenerative osteoarthritic knees. METHOD: Eighteen female patients were diagnosed with medial compartment knee degenerative osteoarthritis (OA) based on symptoms and simple X-rays. Patients were studied while they stood wearing shoes with the 5 degrees or 10 degrees lateral wedged insoles compared with a bare foot. Patients chose a comfortable stance with feet spread apart, slightly turned outwards, and were asked to look straight ahead at a fixed point in a quiet room. Postural sway and weight load asymmetry were recorded while the patients were standing on two adjacent force platforms during a 30 second trial. RESULTS: Postural sway and weight load asymmetry for 30 seconds were not significantly changed by wearing laterally wedged insoles with varying elevations (p>0.05). CONCLUSION: The degree of the postural sway and weight load asymmetry for 30 seconds with the insole were not affected by the tilt of the lateral wedge.

Analysis of Korean Internet Sites for 'Degenerative Osteoarthritis'

OBJECTIVE: To analyze and evaluate the quality of the Korean web sites of medical information about degenerative osteoarthritis. METHOD: The search term 'degenerative osteoarthritis' was entered into five popular Korean web search engines. The web sites for the first 20 matches generated by each search engine were grouped by author and evaluated by DISCERN instrument, certification standard of internet health information by Korean Academy of Medical Sciences (KAMS instrument), and guidelines and items for evaluation of internet health information by Chung and Park (Chung & Park Instrument). RESULTS: Of the 100 sites identified, only 44 were unique and included in the analysis. Eight sites were commercial and each 21, 5, 3, 7 sites were authored by physician, public institute, oriental medical doctor and others, respectively. By DISCERN instrument, there was a significant difference in total score, reliability of publication and overall quality rating. By KAMS instrument, there was a significant difference in total score, reliability, and content. By Chung & Park instrument, there was a significant difference in total score, objectivity, accuracy, credibility and authority. CONCLUSION: The quality of degenerative osteorarthritis information on the internet varied greatly. Web sites authored by public institutes and physicians were ranked higher than others.

Effect of a Unilateral Ankle Brace on Postural Sway and Limb Load Asymmetry

OBJECTIVE: This study was designed to evaluate the effect of ankle bracing (Aircast) on postural sway and limb load asymmetry (LLA) in normal adults. METHOD: 263 healthy subjects volunteered. These subjects were performed the balance test on three different conditions, 1st test fulfilled without ankle brace, 2nd test with aircast on one ankle and 3rd test with aircast on the other ankle. All subjects were divided into two groups; younger( or = 65 years) group. Postural sway and body weight distribution were recorded while the subjects were standing on two adjacent force platforms during 30 seconds trial. All subjects chose a comfortable stance with feet apart and asked to look straight ahead at a fixed point in a quiet room. RESULTS: There were significant differences not only in LLA but also in postural sway between younger and older group. The difference of postural sway and LLA in older group was more prominent that in younger group (p<0.05). CONCLUSION: The results indicated that ankle bracing improved postural sway irrespective of age. Moreover in older group, ankle bracing on one ankle that was in the absence of LLA improved postural sway by far.

Duchenne Muscular Dystrophy in a Girl with Turner Syndrome: A case report

Duchenne Muscular Dystrophy (DMD) is an X-linked, recessive disorder characterized by progressive muscular weakness, Gower sign, waddling gait and pseudohypertrophy of the calf muscles. Little is reported about DMD manifestations in females because of its' X-linked, recessive inheritance. The authors described a 12-year-old female with gait disturbance. Her symptoms were diminished muscle power, decreased deep tendon reflexes, Gower sign and pseudohypertrophy of calf muscle. Serum creatinine kinase level was elevated to 1, 674 U/ml. Electromyographic findings were compatible with myopathy. Histopathologic examination of the muscles confirmed the diagnosis of DMD. The result of karyotyping was 45X, but multiplex PCR (Polymerase Chain Reaction) analysis showed normal findings.

The Current Status of Cerebral Palsy Patients in Handicapped Residential Facility / 재활간호학회지

PURPOSE: The aim of this study is to evaluate the general status and prevalence of cerebral palsy, the complication and the activity of daily living in patients with cerebral palsy in Holt Ilsan Home. METHODS: Cross-sectional study was performed on 113 cerebral palsy patients in Holt Ilsan Home with the medical records review, the physical examination, and the Modified Barthel index for the independency of activities of daily living. RESULTS: The mean age of subjects was 28.1+/-12.7 years and the duration of residence was 22.9+/-12.8 years. The most common type of cerebral palsy according to the muscle tone abnormality was spastic type(53.1%). The most frequent condition in which extremities are involved were quadriplegia in 46.0%. The score of Modified Barthel index was significantly lower in mixed type for 16.9+/-24.0 and quadriplegic type for 14.8+/-25.5 compared with others. CONCLUSION: This study indicates that cerebral palsy patients in rehabilitation facility have severe medical problems such as musculoskeletal complications, visual and language problems, epilepsy and dependency in activities of daily living. Therefore more medical attention like long-term follow-up study and social supports is needed.

Clinical Trial on the Hypertensive Effect of Bunazosin

The clinical trial was carried out with Bunazosin in 31 patients with essential hypertension. The results were as follows : 1) Before and after 1, 2, 4, 6, and 8 weeks of medications, the overall average systolic and distolic blood pressure were 166.5+/-21.8/105.7+/-10.6, 152.7+/-17.2/99.8+/-11.1, 149.5+/-18.1/98.4+/-11.7, 148.5+/-16.9/97.3+/-11.3, 148.5+/-16.7/95.6+/-10.9 and 144.0+/-14.9/94.2+/-11.1mmHg. As a result, blood pressure significantly fell within 1week of medication, and marked and moderate degree of hypetensive effect was observed within 8weeks og medication in 45% of all cases. 2) Before and after 1, 2, 4, 6, and 8weeks of medication, the overall average heart rates were 79.7+/-10.1, 78.3+/-9.1, 79.4+/-7.4, 80.8+/-8.3, 79.2+/-8.9 and 80.1+/-8.3 beats/minute. There were no significant change in heart rates before and after medication. 3) There were no significant changes in values of complete blood counts, GOT, GDT, blood urea nitrogen, serum creatinine and total cholesterol before and after medication. On the basis of these results, we observed that Bunazosin was effective hypertensive drug.

Radionuclide Assessment of Cardiac Performance in Dilated Cardiomyopathy

It has been well known that dilated cardiomyopathy (D-CMP) has characterized by systolic dysfunction of left ventricle (LV). But there are few studies about LV diastolic and right ventricular (RV) dysfunction in D-CMP. The purpose of this study is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The purpose of this tudy is to assess the LV and RV systolic function as well as diastolic function in D-CMP. The gated blood pool scan (GBPS) was undertaken in 14 patients with D-CMP and 14 normal controls. The results are as follows : 1) Compared to normal controls, the global and regional ejection fraction of LV were significantly reduced (P<0.001) in D-CMP. But, there was no significant difference in LV ejection time between the two groups. 2) Peak filling rate and peak filling time were significantly reduced (P<0.001, P<0.05) in D-CMP 3) Global ejection fraction of RV was also significantly reduced in D-CMP compared to normal controls (P<0.001) But there was no significant difference in ejection rate of right ventricle between the two groups. 4) There was close correlation (R=0.802) between ejection fraction and filling rate of LV : filling rate was also reduced as ejection fraction decreased. And LV filling rate was also reduced with reduction of ejection rate. It is concluded that D-CMP shows diastolic impairment as well as systolic pumping failure and this systolic dysfunction is accounted for the diastolic impairment in D-CMP. And D-CMP shows also right ventricular dysfunction in almost all cases, as well as left ventricular dysfunction.