The immediate effects of a shoulder brace on muscle activity and scapular kinematics in subjects with shoulder impingement syndrome and rounded shoulder posture: A randomized crossover design

BackgroundRound shoulder posture (RSP) is one of the potential risks for shoulder impingement syndrome (SIS) due to alignment deviation of the scapula. Evidence on how the characteristics of a shoulder brace affecting the degree of RSP, shoulder kinematics, and associated muscle activity during movements is limited.Research questionThe purposes of this study were (1) to compare the effects of a shoulder brace on clinical RSP measurements, muscle activities and scapular kinematics during arm movements in subjects with shoulder impingement syndrome (SIS) and RSP; and (2) to compare the effects of two configurations (parallel and diagonal) and two tensions (comfortable and forced tension) of the brace straps on muscle activities and scapular kinematics during arm movements in subjects with SIS and RSP.MethodsTwenty-four participants (12 males; 12 females) with SIS and RSP were randomly assigned into 2 groups (comfortable then forced, and forced then comfortable) with 2 strap configurations in each tension condition. The pectoralis minor index (PMI), acromial distance (AD) and shoulder angle (SA) were used to assess the degree of RSP. Three-dimensional electromagnetic motion analysis and electromyography were used to record the scapular kinematics and muscle activity during arm movements.ResultsAll clinical measurements with the brace were significantly improved (p < 0.05). Under forced tension, muscle activities were higher with the diagonal configuration than with the parallel configuration in the lower trapezius (LT) (1.2–2.3% MVIC, p < 0.05) and serratus anterior (SA) (2.3% MVIC, p = 0.015). For upward rotation and posterior tilting of the scapula, the diagonal configuration was larger than the parallel configuration (1.5°, p = 0.038; 0.4°–0.5°, p < 0.05, respectively).SignificanceDifferent characteristics of the straps of the shoulder brace could alter muscle activity and scapular kinematics at different angles during arm movement. Based on the clinical treatment preference, the application of a shoulder brace with a diagonal configuration and forced tension is suggested for SIS and RSP subjects.     

Round ligament varicosities diagnosed as inguinal hernia during pregnancy: A case report and series from two regional hospitals in Japan

IntroductionRound ligament varicosities (RLV) are not well-known and they are usually caused by pregnancy. Although the groin swelling of RLV mimics an inguinal hernia, it is difficult to distinguish between them through clinical examination alone, and there have been few published reports on this topic, especially from Asia.Case presentationA 37-year-old Japanese woman complained of left groin swelling for 2 weeks at her 28th week of gestation of her first pregnancy. According to a physical examination, she had a soft, painless swelling in the superficial inguinal ring of the left groin. An inguinal hernia was suspected and she was thus scheduled to undergo herniorrhaphy. However, since she had varicosities in the left labia majora, she first underwent color Doppler ultrasonography and a final diagnosis of round ligament varicosities was this made. Her symptoms resolved after delivery of her baby.DiscussionWe herein report 10 cases of RLV in pregnant Japanese women who were initially suspected of having an inguinal hernia. All of them were suspected to suffer from inguinal hernias after a clinical examination by their attending gynecologist. All of them were diagnosed using gray scale and color Doppler ultrasonography, treated with conservative management, and the symptoms resolved in all cases after the delivery.ConclusionThis is the largest report from Asia regarding RLV. To avoid unnecessary surgery in pregnant women, surgeons must be aware of this entity make an accurate diagnosis based of the findings of Doppler ultrasonography.     

Permeability of the round window membrane

Summary Cefmetazole sodium, a cephamycin antibiotic, was shown to pass through the round window membrane into the inner ear of the guinea pig. The concentration of the drug in the inner ear fluid indicated that a larger amount of the drug reached the inner ear through the round window membrane than when administered intraperitoneally.This study was supported by a Research Grant for Specific Diseases from the Ministry of Health and Welfare's Acute Profound Deafness Research Committee of Japan     

糖尿病足的治疗与新进展

糖尿病足是糖尿病的严重并发症,血管狭窄闭塞、神经病变和感染是主要的临床表现,本文复习了近年来的20余篇文献,主要从以下6个方面对糖尿病足的治疗进展进行总结。①糖尿病足的基础治疗;②血管狭窄闭塞和血栓的治疗,其中骨髓干细胞移植治疗糖尿病足取得了进展;③神经病变的治疗;④糖尿病足溃疡的处理;⑤抗菌素的使用原则;⑥祖国传统医学在糖尿病足治疗中的应用。糖尿病足的治疗是个系统工程,单一的方法难以治愈,并且早发现早治疗,可以起到事半功倍的效果。     

Mouse oocytes injected with cryopreserved round spermatids can develop into normal offspring

Purpose: This study was performed to determine whether frozen-thawed mouse round spermatids can fertilize oocytes and contribute to normal embryo development. Methods: Freshly collected mouse testicular cells were frozen in PBS containing 7.5% glycerol and 7.5% fetal bovine serum. After thawing and removal of the cryoprotectants, round spermatids were selected and injected individually into mature oocytes which had been previously activate with Sr ²⁺ -containing Ca ²⁺ -free medium. Results: After thawing, 75–85% of testicular cells were alive. About 90% of the oocytes were fertilized by intracytoplasmic injection of frozen-thawed round spermatids; 11% (17/150) of embryos transferred to foster mothers developed into normal offspring. Conclusions: Mouse round spermatids can be cryopreserved for production of normal offspring.     

Intracytoplasmic Injection Using Spermatids and Subsequent Pregnancies: Round Versus Elongated Spermatids

The purpose of this clinical trial study was to report the outcome of intracytoplasmic injection of round (RS) and elongated (ES) spermatids retrieved from the testis of nonobstructive men. Seven and three cycles using RS and ES injections were performed, respectively. Only one cycle utilizing the late stage of ES (Sd2) resulted in an on-going pregnancy. The remarkable low success rate following RS microinjection was established in this study.     

鼓室灌注地塞米松治疗难治性突发性感音神经性聋临床分析

目的观察和比较鼓膜穿刺、鼓膜置管和圆窗置管微泵灌注地塞米松3种方法治疗难治性突发性感音神经性聋的疗效。方法55例常规方法治疗无效的突聋患者作为研究对象,其中圆窗置管微泵灌注用药治疗21例(置管组),每次2.5mg/0.5ml,维持1小时,每天两次,连续给药7天,总剂量35mg;鼓膜穿刺注药23例(穿刺组),首次剂量为2.5mg,此后,每2天重复注药1次(每次2.5mg),共4次,总剂量10mg;鼓膜切开置管滴药11例(滴药组),首次剂量为0.5%地塞米松0.5ml,经通气管滴入鼓室,每天重复滴药2次(每次2.5mg),共7天,总剂量32.5mg。同期常规方法治疗无效的32例突聋患者,且拒绝鼓室用药者随访作为对照(对照组),比较各组听力恢复及并发症情况。4组治疗前听力无显著差异(P>0.05)。结果治疗完成后1月纯音测听检查:置管组、穿刺组和滴药组平均PTA分别提高9dB、8.6dB和1.7dB,前2组明显高于对照组1.4dB(P<0.05),置管组8例(38.1%)听力改善约15～56dB,无效13例;穿刺组8例(34.8%)听力改善约16～54dB,无效15例;滴药组1例(9.1%)听力改善约26dB,无效10例;对照组3例(9.4%)听力改善约15～36dB,无效29例。结论鼓室灌注地塞米松治疗难治性突聋方法安全有效,为用常规方法治疗无效的突聋患者,提供了再次治疗的机会。     

Pre- and postnatal exposure to ambient levels of urban particulate matter (PM2.5) affects mice spermatogenesis

This work characterizes the effects of ambient levels of urban particulate matter (PM_2.5) from the city of Sao Paulo on spermatogenesis using mice exposed during the embryo–fetal and/or postnatal phases of development. Parental generations (BALB/c mice) were exposed to air pollution in chambers with or without filtering PM_2.5 for 4 months. Animals were mated, and half of the 1-day-old offspring were moved between chambers, which yielded prenatal and postnatal groups. Remaining offspring comprised the non-exposed and pre+postnatal exposed groups. After 90 days, the animals were sacrificed for testis collection and weighing. Optical microscopy was used for the morphometric analyses of the cell counts, spermatogenic cycle, proliferation, and apoptosis. Prenatally exposed animals presented reduced body and testicular weight with an increased gonadosomatic index (GSI). Testicular volume also decreased, as well as the tubular diameter in testes of the same animals. Proliferation, apoptosis, and spermatogenic cycle analyses showed no significant differences among groups. However, the tubules at stage VII of pre- and postnatal animals presented a reduced number of elongated spermatids. Pre+postnatal group presented higher spermatid head retention at stages VIII–XII. These results show that ambient levels of PM_2.5 from Sao Paulo city affect spermatogenesis by damaging sperm production.     

介入治疗病人围手术期护理

介入放射学作为现代临床治疗中的第三大诊疗体系，正以其在医学影像导向下，集影像诊断与微创性治疗为一体的鲜明学科特点，得到学术界和广大患者的认同。因此针对不同疾病的特点，做好术前准备，术中配合及术后护理是介入术成功的关键之一。现将我院自2003年2月至2005年8月病人做介入术的护理特点及手术配合报告如下。