Plantar Pressure Reducing Effect of Diabetic Shoes with Different Rigid Rockers

OBJECTIVE: To determine the most effective type of rigid rocker bottom for prevention of diabetic foot complications according to the different rocker angles and axes of diabetic shoes. METHOD: Thirteen healthy volunteers participated in this study and the plantar peak pressure and pressure time integrals were measured by insole plantar pressure system for subjects either barefoot and wearing rigid rocker shoes with 12 kinds of different rocking angles and rocking points (15, 20, 25, 30degrees and 60, 65, 70% of shoe length). Evaluation was analyzed at M1 (hindfoot), M2 (midfoot), M3 (medial forefoot area), M4 (central forefoot area), M5 (lateral forefoot area), M6 (1st toe area), M7 (lesser toes area) zones respectively. RESULTS: Reduced pressure was observed in all kinds of rockers at central-metatarsal area (p<0.05). But pressure was not significantly changed at lateral metatarsal area in almost all types of rocker. With rocking point at 65 and 70%, pressure was increased at first and lesser toe area in all rocking angles. With rocking point at 60 and 70%, pressure was increased at midfoot area. CONCLUSION: Most effectively reduced pressure was observed with shoe of rocking point at 65% and rocking angle 30degress.

The Effect of Intrathecal Baclofen Injection on Muscle Stretch Reflex in Spinal Cord Injured Rabbit

OBJECTIVE: To develop an experimental model that is useful to evaluate the effect of antispastic medication administered intrathecally and to titrate the intrathecal baclofen effect quantitatively by using muscle stretch reflex. METHOD: Ten rabbits were laminectomized posteriorly and intrathecal catheter was inserted. Then the spinal cords were contused by 12.5 gx20 cm weight drop around 12th thoracic vertebra. After 8~12 days, muscle stretch reflex was measured before intrathecal baclofen injection (ITBI) and after ITBI 30 minutes, 60 minutes, and 120 minutes. Rabbits' triceps surae were dissected and stretched 5 mm at the rate of 2 mm/sec using a step motor. The change of muscle tension was graphed into the time (length)-tension curve. The slope in the time (length)-tension curve was defined as stiffness index (SI). RESULTS: The measurement of muscle stretch reflex was available in 5 of 10 spinal cord injured rabbits. The proportion of SI reduced significantly at 60 minutes and 120 minutes compared to baseline (p=0.005, p<0.001). CONCLUSION: Our data proved the antispastic effect of ITBI quantitatively by using muscle stretch reflex. We concluded that the quantitative measurement method of the antispastic effect of ITBI will be useful in evaluating antispastic effect by intrathecal administration of the other antispastic medications.

One Case of Subacute Sensory Ataxic Neuropathy Associated with Primary Sj gren's Syndrome: A case report

Sjogren's syndrome is an important but poorly recognized cause of peripheral neuropathy. Several forms of peripheral nerve dysfunction occur in Sjogren's syndrome, including trigeminal sensory neuropathy, mononeuropathy multiplex, distal sensorimotor polyneuropathy and pure sensory neuropathy. Rarely, chronic relapsing inflammatory polyneuropathy and multiple cranial neuropathies appear. This report described a patient with primary subacute pure sensory ataxic neuropathy associated with primary Sjogren's syndrome, who presented with ataxia and sensory loss of extremities. The possibility of subacute pure sensory ataxic neuropathy associated with Sjogren's syndrome should be considered in patient, especially middle aged women, who develop sensory neuropathy with ataxia and kinesthetic loss.

The Effect of Gabapentin on Muscle Stretch Reflex in Spinal Cord Injured Rabbit

OBJECTIVE: To document the anti-spastic effect and dose-response relationship of gabapentin (GBP) quantitatively using muscle stretch reflex in spinal cord injured rabbits. METHOD: Spinal cords of 25 rabbits were contused by 20 gx20 cm weight drop in the 11th thoracic spine. After 2 weeks, muscle stretch reflex was measured. Triceps surae was dissected and stretched for 5 mm at the rate of 2 mm/sec and the length-tension curve were obtained. The slope in the length-tension curve was defined as stiffness index (SI). After baseline measurement, group I (n=6) received 50 mg/kg GBP IM injection and group II (n=8) received 100 mg/kg GBP IM injection, but control group (n=5) did not. Muscle stretch reflex was measured again after 30 minutes and 60 minutes, and then after sciatic nerve section. Active tension was calculated by subtracting passive tension from total tension. Proportion of SI was calculated by dividing follow-up SI with baseline SI. RESULTS: The proportion of SI of active tension reduced significantly at 30 minutes and 60 minutes compared to baseline (p<0.001, p<0.001). The proportion of SI of active tension in both group I and group II reduced significantly than control group (p=0.041, p<0.001). The proportion of SI of active tension in group II reduced than group I, but it was not statistically significant (p=0.166). CONCLUSION: The GBP reduced significantly muscle stretch reflex in spinal cord injured rabbits and showed dose-response tendency.