Effects of rehabilitation program for an anatomical abnormality

Introduction : Spina bifida occulta (SBO) is a common malformation of lamina of the spine, most commonly occurring in the sacrum or lower lumbar spine. Athletes with anatomical abnormalities such as SBO may be vulnerable to discoordination of muscles and/or skeletal structures. Case Report : We present a case of a 15-year-old male adolescent who presented with persistent low back pain (LBP) associated with SBO at T11-L1 that had been overlooked for several years. He participated in karate as a top-level competitor at the nationallevel, but the LBP interfered with his play. Dynamic X-ray films showed limited range of motion (ROM) in his lower lumbar spine (L3-S1). Instead, the thoracolumbar junction compensated for the lack of ROM in the lumbar spine, enabling trunk flexion and extension. To restore normal coordination, he was treated with a 2-week rehabilitation program including flexibility and core conditioning for the trunk to improve coordination of spinal movement. Two weeks later, his LBP resolved. Conclusion : These results suggest that evaluation of the coordination of the muscles and skeletal structures has an important role in the treatment of cases with an anatomical abnormality such as SBO

Chronic irradiation with low-dose-rate ¹³⁷Cs-γ rays inhibits NGF-induced neurite extension of PC12 cells via Ca²⁺/calmodulin-dependent kinase II activation

Chronic irradiation with low-dose-rate ¹³⁷Cs-γ rays inhibits the differentiation of human neural progenitor cells and influences the expression of proteins associated with several cellular functions. We aimed to determine whether such chronic irradiation influences the expression of proteins associated with PC12 cells. Chronic irradiation at 0.027 mGy/min resulted in inhibition of NGF-induced neurite extension. Furthermore, irradiation enhanced the nerve growth factor (NGF)-induced increase in the phosphorylation of extracellular signal–regulated kinase (ERK), but did not affect the phosphorylation of NGF receptors, suggesting that irradiation influences pathways unassociated with the activation of ERK. We then examined whether irradiation influenced the Akt−Rac1 pathway, which is unaffected by ERK activation. Chronic irradiation also enhanced the NGF-induced increase in Akt phosphorylation, but markedly inhibited the NGF-induced increase in Rac1 activity that is associated with neurite extension. These results suggest that the inhibitory effect of irradiation on neurite extension influences pathways unassociated with Akt activation. As Ca²⁺ /calmodulin-dependent kinase II (CaMKII) is known to inhibit the NGF-induced neurite extension in PC12 cells, independent of ERK and Akt activation, we next examined the effects of irradiation on CaMKII activation. Chronic irradiation induced CaMKII activation, while application of KN-62 (a specific inhibitor of CaMKII), attenuated increases in CaMKII activation and recovered neurite extension and NGF-induced increases in Rac1 activity that was inhibited by irradiation. Our results suggest that chronic irradiation with low-dose-rate γ-rays inhibits Rac1 activity via CaMKII activation, thereby inhibiting NGF-induced neurite extension

Stand-to-sit motion in older women

Objectives : The aims of this study were to examine the biomechanics of StandTS movements in older adults and to identify their optimal StandTS motion by measuring sitting impact forces. Methods : Healthy older women (n = 17) and healthy young women (n = 18) were asked to perform SitTS and StandTS motions at a natural speed using a chair. We measured the ground reaction forces from the participants’ feet and the chair, the angle of the trunk and ankle, vertical velocity, and postural muscle activities using a force plate, motion analyzer, and electromyography, respectively. Results : Sitting impact force was significantly greater in the older women than in the young women during the StandTS motion. There was a significant difference between the trunk angle and the ankle angle during the StandTS motion and sitting impact force had a significant negative correlation with the ankle joint motion in the older women. Conclusions : The ankle joint strategy was characterized by body sway resembling a single-segment-inverted pendulum and suggests that this response is less developed in the older adult. These results indicate that the ankle joint strategy may be an important factor involved in the sitting impact force

Spectral analysis of erector spinae muscle surface electro-myography as an index of exercise performance in maximal treadmill running

Thirteen male athletes (mean 20.7 years) participated in the present study which investigated the relationship between mean power frequency (MPF) and exercise intensity determined from gas analysis during maximal treadmill running. All subjects performed two consecutive ramp exercise tests on the treadmill. Myoelectric signals from surface electrodes on the erector spinae muscles were digitized and MPF was calculated every ten seconds. Gas exchange data was collected using an automated breath-by-breath system, from which the anaerobic threshold (AT), respiratory gas exchange ratio (R=VCO2/VO2) and %VO2=VO2/VO2max were obtained. During loading, MPF showed a steady decrease, followed by a sudden fall to a base level in both tests. After loading, MPF recovered within 30 seconds in all subjects. The test-retest reliability coefficient of MPF and R at the point of sudden fall in MPF were0.757 (p=0.0018), and 0.808 (p=0.0004). These findings suggest that a sudden fall and a base level of MPF indicate local muscle fatigue, and the spectral analysis of trunk muscle surface EMG provides a reliable index of exercise performance in maximal treadmill running

MRI Changes of the Spinal Subdural Space after Lumbar Spine Surgeries: Report of Two Cases

Although magnetic resonance imaging (MRI) is frequently used to assess the lumbar spine, there are few reports in the medical literature that have evaluated using MRI immediately following spinal surgery. Furthermore, descriptions of the subdural changes after lumbar spine surgery are also infrequent. In this paper, we present two cases with subdural change seen on MRI immediately after lumbar surgery. Both the patients had mild symptoms that resolved spontaneously, and the follow-up MRI scans showed resolution of the subdural changes. Subdural changes should be considered as one of the possible causes of unexpected symptoms in patients following lumbar spinal surgery

Falls among Hospitalized Patients in an Acute Care Hospital : Analyses of Incident Reports

Falls cause injuries such as fractures, skin lacerations, bleeding, and head injury, and could result in more severe medical conditions in hospitalized patients. We retrospectively investigated the incidence and characteristics of falls among hospitalized patients in an acute care hospital from incident reports by hospital staff between January and June 2013. There were 154 falls in 135 patients, 2 of which resulted in fracture. The average age of patients who fell was 63.9 (range 0 to 91) years. Many falls occurred at the bedside (68.2%). Approximately half of all falls were related to elimination (46.6%). The most common time of discovery of falls was 2 : 00-2 : 59 AM (14/154 ; 9.1%), followed by early in the morning when patients would actively move. Fall rates in our hospital were 1.39 falls per 1,000 patient days. The department of respiratory medicine and rheumatology had the highest fall rate (3.08 falls per 1,000 patient days), followed by the departments of neurosurgery and neurology (2.98 falls per 1,000 patient days). This study revealed the characteristics of falls in an acute care hospital, and suggests that their notification in the hospital might help reduce the incidence of falls in hospitalized patients

Localized Immunoglobulin Light-Chain Amyloidosis of the Ulnar Nerve

Amyloidosis is a disorder caused by extracellular tissue deposition of insoluble fibrils. Amyloidosis can be divided into systemic or localized disease. Primary systemic amyloidosis is a multisystem disease caused by the deposition of amyloid in various tissues. Localized amyloidosis has different characteristics than those of systemic amyloidosis. In this paper, we present the case of a middle-aged woman who presented with worsening ulnar nerve palsy. Electrophysiological examination and MRI indicated a tumor surrounding the ulnar nerve in the forearm. However, the operative findings revealed that ulnar nerve fascicles were replaced with a yellow tissue, which was diagnosed as amyloid light-chain λ amyloidosis, based on histopathological examination. Systemic amyloidosis was ruled out after the screening examinations. This paper is the first report of the ulnar nerve as the sole site of localized immunoglobulin light-chain amyloidosis manifestation

Anterior thoracolumbar reconstruction surgery for late collapse following vertebroplasty : report of three cases

Although vertebroplasty (VP) using polymethylmethacrylate (PMMA) is thought to be an effective procedure for osteoporotic vertebral compression fractures, several complications have been reported. In this paper, we present three patients who developed local kyphotic deformity as a result of late collapse of the cemented vertebrae. In all patients we safely removed the PMMA block through an anterior approach and anterior reconstruction was performed successfully. In only one patient who had a three column unstable injury with fractured posterior elements was additional posterior spinal fixation needed. In conclusion, VP is thought to be an effective and minimal invasive technique to treat osteoporotic compression fractures in older patients. Once collapse or nonunion of the treated vertebral body occurs, however, removal of the cement and anterior reconstruction may be required to realign of the affected segments and reconstruct the spine

Ultrasonographic changes in quadriceps femoris thickness in women with normal pregnancy and women on bed rest for threatened preterm labor

This study aimed to evaluate the changes in quadriceps femoris muscle thickness during the pregnancy and postpartum periods and to elucidate the effect of bed rest for threatened preterm labor on muscle thickness. In 26 women with normal pregnancy, quadriceps femoris thickness was measured at 11–13, 26, 30, and 35 weeks’ gestation, and at 3–5 days and 1 month postpartum using ultrasonography. In 15 pregnant women treated with bed rest for threatened premature labor, quadriceps femoris thickness was measured at 30 and 35 weeks’ gestation and postpartum. In women with normal pregnancy, quadriceps femoris thickness increased, peaking at 35 weeks’ gestation, followed by a postpartum decrease. In women on bed rest, quadriceps femoris thickness showed no significant change during the pregnancy and postpartum periods, and the muscle was significantly thinner at 35 weeks’ gestation than that in women with normal pregnancy. In conclusion, a significant increase in quadriceps femoris muscle thickness during normal pregnancy was found using ultrasonography. Meanwhile, in pregnant women on bed rest treatment, the quadriceps femoris was significantly thinner in the late third trimester than that in normal pregnant women. Prolonged bed rest can affect normal changes in the quadriceps femoris muscle thickness during the pregnancy and postpartum periods