Insulin growth factors may explain relationship between spasticity and skeletal muscle size in men with spinal cord injury

The major objectives of this cross-sectional study were to (1) measure insulin-like growth factor-1 (IGF-1) in individuals with complete spinal cord injury (SCI) and spasticity and (2) determine the relationships between IGF-1 and cross-sectional areas (CSAs) of thigh skeletal muscle groups. Eight individuals with motor complete SCI underwent magnetic resonance imaging to measure the CSA of the whole thigh, knee extensor, and knee flexor skeletal muscle groups and dual-emission X-ray absorptiometry to measure fat-free mass. After participants fasted for 12 h, we measured their IGF-1 levels and determined spasticity using the Modified Ashworth Scale (MAS). Spearman rho correlations were used to test for the relationships among the tested variables, and independent t-tests were used to determine the difference in plasma IGF-1. Plasma IGF-1 was 44% greater in those with MAS scores of 2 or higher (p < 0.05). Plasma IGF-1 was positively related to knee extensor skeletal muscle CSA (r = 0. 83, p < 0.01). IGF-1 was strongly related to knee extensor and flexor spasticity (r = 0.88, p < 0.004). The findings suggest that IGF-1 is greater in SCI individuals with increased spasticity, and this may explain the strong positive relationships that were noted between spasticity and skeletal muscle CSA.     

TUBERCULOSIS IN KWANGTUNG ACCORDING TO AGE,SEX, OCCUPATION AND ECONOMIC CONDITION

Tuberculosis is the greatest single carise of death in China. This is only an opinion; yet it is hardly probable that anyone would care to qUestion it. .Fifty years ago it was''true for almost the whold world. Then 500 deaths annually from Wberculosis per 100,000 people was no unusual rate, and is probably. not far from the actual rate for COma today. In those countries where efforts have been macle to- combat it by raethods in harmony with knowledge of its etiology, epidemiology and treatment, there has been a consistent fall in the death rate. It is now reasonable to expect a death rate of 75 0r under. One statistician expresses the hope that within a decade it wiif be under 40. In New Zealand it is already below that figure.     

ACTIVITIF,S OF T.HE BUREAU OF PUBLIC HEALTH, CITY GOVERNMENT OF GREATER SHANGHAI.

Clty Government of Greater Shanghai. Greater Shanghai whicb meamres aprrroximately 17 x I2 miIes is located on the banks of the Whampo。 River at the mouth of the Yangtze River. It is sub-divided into two urban districts, Nantao and Chapei an.d fifteen suburban districts. The population according to the June, 1934 census was 2,015,966. The City Govemment is directIy under the control of the Executive Yuan of the National Government and is administered by a Mayor, while the activities of the govemment are carried out by eight bureaus: namely, Bureau of Public Safety, Bureau of Education, Bureau of Public Utility, Bureau of PubIic Works, Bureau of Land, Bureau of Finance, Bureau of Social Welfare and Bureau of Puhlic Health. The Government budget for the current year is approximately ten million dollars, about six per ccnt of which is being spent for public health work.     

Deep fungal and higher bacterial skin infections in Thailand: clinical manifestations and treatment regimens

BACKGROUND: Deep fungal and higher bacterial skin infections occur fairly frequently in Thailand. METHODS: Cases with a provisional diagnosis of deep fungal and higher bacterial infections were prospectively collected from 1994 to 1997 in the Granuloma Clinic, Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Demographic data, clinical manifestations, causative organisms, histologic features, treatment, and outcome were investigated. RESULTS: The total cases in a 4-year period numbered 27. The male to female ratio was approximately 1:1. Mycetoma was most common, followed by chromoblastomycosis. Actinomycetoma was similar in incidence to eumycetoma. The only causative organism that could be identified among the mycetoma cases was Cladosporium carrionii, which caused mycetoma of the buttock of an aplastic anemia patient at the site of bone marrow aspiration. Surgical treatment was recommended for eumycetoma. Chromoblastomycosis was caused by C. carrionii and F. compactum and responded well with itraconazole orally. Mycotic abscesses were found in four cases, basidiobolomycosis in two cases, and cutaneous nocardiosis in one case. Cotrimoxazole was recommended in the treatment of actinomycetoma, cutaneous nocardiosis, and basidiobolomycosis. CONCLUSIONS: Localized, chronic, slow, progressive, and usually asymptomatic were the main cutaneous manifestations of deep fungal and higher bacterial skin infections. A skin biopsy for histologic study and culture identification should be performed in every suspected case. The causative organisms were found in the histologic sections of every case, but only about one-third were found by culture.