Citations
To determine the predictability of motor evoked potentials (MEP) in patients with putaminal hemorrhage (PH) according to the time of MEP from the onset of stroke.
Sixty consecutive patients with PH from January 2006 to November 2013 were retrospectively reviewed. Motor function of affected extremities was measured at onset time and at six months after the onset. Patients were classified into two groups according to the time of MEP from the onset of stroke: early MEP group (within 15 days from onset) and late MEP group (16-30 days from onset). Patients were also classified into two groups according to the presence of MEP on the affected abductor pollicis brevis (APB): MEP (+) group-patients (showing MEP in the affected APB) and MEP (-) group-patients (no MEP in the affected APB). Motor outcome was compared between the two early and late MEP groups or between the presence and absence of MEP in the affected APB groups.
For patients with MEP (+), a larger portion in the late MEP group showed good prognosis compared to the early MEP group (late MEP, 94.4%; early MEP, 80%). In contrast, in patients with MEP (-), a larger portion of patients in the late MEP group showed bad prognosis compared to the early MEP group (late MEP, 80%; early MEP, 71.4%). No significant improvement of MI between MEP (+) and MEP (-) was observed when MEP was performed early or late.
Our results revealed that the predictability of motor outcome might be better if MEP is performed late compared to that when MEP is performed early in patients with PH.
Citations
Neurogenic heterotopic ossification (NHO) is a process of benign bone formation and growth in soft tissues surrounding major synovial joints and is associated with central nervous system (CNS) injuries. It is a common complication in major CNS injuries, such as traumatic brain injury, spinal cord injury, and stroke. Here, we report the case of a 72-year-old male, who experienced a traumatic brain injury and painful chronic NHO around the left hip joint. Three applications of extracorporeal shock wave therapy (ESWT) were administered to the area of NHO, which resulted in pain relief and an improvement in the loss of motion in the left hip joint. Improvements were also noted in walking performance and activities of daily living, although the size of NHO remained unchanged. Therapeutic effects of ESWT lasted for 12 weeks.
Citations
Adrenomyeloneuropathy (AMN), one of the variants of X-linked adrenoleukodystrophy (ALD), is inherited peroxisomal disorder associated with the accumulation of very long chain fatty acids (VLCFA). AMN is characterized primarily by involvements of long ascending and descending tracts of the spinal cord and peripheral neuropathy, which leads to spastic paraparesis and urinary and erectile dysfunction. We experienced the AMN case of a 33-year-old man presenting bilateral progressive spastic paraparesis, impotence and urge incontinence with primary adrenal failures, as confirmed by increased serum of VLCFA concentrations. Considering that somatosensory evoked potentials in posterior tibial nerve was the only abnormal finding in electrophysiologic findings when compared with the severe spastic gait pattern shown, it is necessary to follow up with electrophysiologic studies.
Citations
To examine the effect of the posture of immobilization upon the tensile properties in injured Achilles tendon of rat for an initial period of immobilization.
Forty-two Sprague-Dawley rats were used in the present study. Eighteen rats received a total tenotomy of the right Achilles tendon to mimic total rupture and were divided into three groups comprising of 6 rats each. Ankles of group A were immobilized at 60° of plantarflexion. Ankles of group B were immobilized at neutral position. Whereas, those of group C were immobilized at 60° of dorsiflexion. Other 18 rats received hemitenotomy to mimic partial rupture and were divided into three groups. The remaining 6 rats were kept free as control. After 14 days, we dissected the tendons and analyzed maximum force, stiffness, and energy uptake during pulling of the tendons until they ruptured. The tendons of 6 rats in each group and control were reserved for histology. Picrosirius staining was done for the analysis of collagen organization.
In total tenotomy, tensile properties were significantly different between the control and the intervention groups (p<0.05). Group C showed relatively higher values than the groups A and B with respect to tensile properties (p>0.05). In partial tenotomy, tensile properties were significantly different between the control and the intervention groups (p<0.05). Group C showed significantly higher value than other intervention groups in terms of maximum force and energy uptake (p<0.05). The semiquantitative histologic grading scores were assigned for collagen organization. The scores for dorsiflexion posture were higher than the ones for plantarflexion.
Dorsiflexion posture in partial ruptured Achilles tendon showed better functional recovery than other immobilized postures. In total ruptured case, the tensile properties showed increasing tendency in dorsiflexion posture.
Citations
Central pontine myelinolysis is a rare neurologic disorder that is defined by demyelination of longitudinally descending tracts and transversly crossing fibers in the basis pontis. Frequently observed clinical manifestations of this disorder include sudden weakness, dysphagia, loss of consciouness and locked-in syndrome. However, there have been a few studies that reported a benign course of this disease, which include cerebellar signs, such as ataxia, intention tremor, and dysarthria. Here we report on a 53-year-old male with a history of liver cirrhosis who showed the cerebellar type of central pontine myelinolysis. The patient was diagnosed with central pontine myelinolysis based on clinical presentations and magnetic resonance imaging findings after a liver transplantation. Conventional magenetic resonance imaging (MRI) revealed the preservation of the corticospinal tract and abnormal pontocerebellar fibers. However, these findings were not sufficient to define the pathophysiology of our patient. Electrophysiologic analysis and diffusion tensor imaging (DTI) were performed to investigate cerebellar signs in this case. Delayed central motor conduction time (CMCT) to the tibialis anterior muscle with transcranial magnetic stimulation (TMS) was observed, which indicated demyelination of the corticospinal tract. Also, diffusion tensor imaging showed abnormal pontocerebellar fibers, which might have been caused by cerebellar dysfunction in our patient. A combination of TMS and DTI was also used to determine the pathophysiology of this disease.
Citations
To investigate Botulinum toxin type B (BNT-B) injection's effect and duration depending on dose for patients with brain lesion.
Twenty one patients with brain lesion and severe drooling were included and divided into three groups. All patients received conventional dysphagia therapy. Group A patients (n=7) received an injection of 1,500 units and group B patients (n=7) received an injection of 2,500 units of BNT-B in submandibular gland under ultrasound guidance. Group C patients (n=7) received conventional dysphagia therapy. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 2, 4, 8, and 12. The severity and frequency of drooling was assessed using the Drooling Quotient (DQ) by patients and/or caregivers.
Group A and B reported a distinct improvement of the symptoms within 2 weeks after BNT-B injection. Compared to the baseline, the mean amount of saliva decreased significantly throughout the study. However, there was no meaningful difference between the two groups. The greatest reductions were achieved at 2 weeks and lasted up to 8 weeks after BNT-B injection. Group C did not show any differences.
Local injection of 1,500 units of BNT-B into salivary glands under ultrasonic guidance proved to be a safe and effective dose for drooling in patient with brain lesion, as did 2,500 units.
Citations
Objective: The aims of this study were to know the effects of long time bed immobilization on the heart rate variability and to know the correlation between the heart rate variability and other anthropometric parameters.
Method: The subjects of this study were 60 normal sedentary persons as control group and 22 patients who had been immobilized for a long time because of musculoskeletal problems without any systemic diseases. The heart rate variabilities were measured through the R-R interval variation at rest, deep breathing and valsalva maneuver. These values were compared between control and patient group and were analysed for correlation with age, weight, height, body mass index (BMI), amounts of smoking (pack years), spans of immobilization and physical activity scale (PAS).
Results: The mean heart rate variability of patients were 0.132⁑0.072, 0.216⁑0.109, and 0.289⁑0.171 in rest, deep breathing and valsalva maneuver respectively which were lower than the corresponding 0.176⁑0.085, 0.314⁑0.146, and 0.322⁑0.174 of normal control group. The heart rate variabilities were negatively correlated with age, BMI and amounts of smoking but positively correlated with the height. The physical activity scale of preimmobilization state was negatively correlated with resting heart rate variability but was positively correlated with heart rate variability during deep breathing and valsalva maneuvering state.
Conclusion: The long bed immobilization significantly decreased the heart rate variability and the heart rate variability could be used as a useful tool to measure the effects of immobilization on the heart.
First
Prev
