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991.
Jens Jordan 《Clinical autonomic research》2007,17(6):331-333
Genes influencing the autonomic nervous system continue as a focus of research. Recent publications applied different methods
to identify genes influencing autonomic cardiovascular regulation in humans. Two reports relied on a candidate gene approach.
Common genetic polymorphisms in the promoter region of the tyrosine hydroxylase gene were shown to influence catecholamine
synthesis and blood pressure. The same group tested the hypothesis that the GTP cyclohydrolase 1 (GCH1) gene influences catecholamine
excretion and cardiovascular regulation. GCH1 affects tyrosine hydroxylase function indirectly. The authors concluded that
the GCH1 gene may influence cardiovascular autonomic regulation through changes in nitric oxide production rather than a change
in tyrosine hydroxylase activity. The third genetic study used a single nucleotide polymorphism chip to analyze 100,000 genetic
polymorphisms scattered throughout the genome in participants of the Framingham study. The authors identified several polymorphisms
that may influence QT interval duration, heart rate, and heart rate variability. The respective genes have not been identified
with certainty. Another study suggested that catecholamines may be released from phagocytes and regulate pulmonary inflammation
through alpha-2 adrenoreceptor activation in an autocrine or paracrine fashion. 相似文献
992.
Simple measurement of spinal cord evoked potential: a valuable data source in the rat spinal cord injury model. 总被引:1,自引:0,他引:1
Jong-Pil Park Ki-Jeong Kim Ji Hoon Phi Chul-Kee Park Jong-Hoon Kim Hyo Jin Kang Dohun Lee Kyu Hyun Han Kyu-Chang Wang Sun Ha Paek 《Journal of clinical neuroscience》2007,14(11):1099-1105
Measurement of spinal cord evoked potentials (SCEPs) is proposed as a means of predicting locomotion outcome in the rat spinal cord injury (SCI) model. Using 55 rats, three reproducible peak waves (waves I, II and III) were observed during stimulation at the C7 level with recording at the L1 epidural space. Hemisection at the T13 level showed three wave loss patterns: wave III loss only, loss of both wave II and III, and loss of all three waves. Defining an ideal SCI model as establishment of stable monoparesis or paraparesis, all animals in the wave II-III loss group showed favorable results. Histological data and electrophysiological properties allowed reasonable assumptions of wave origin: wave I from extrapyramidal tracts, wave II from the ventral corticospinal tract, and wave III from the dorsal corticospinal tract. Complete destruction of pyramidal tracts in both dorsal and ventral fibers was essential for long-term impairment of locomotion. 相似文献
993.
Intra-observer and inter-observer agreement of the manual examination of the lumbar spine in chronic low-back pain 总被引:1,自引:1,他引:0
Etienne Qvistgaard Jens Rasmussen Jes Lætgaard Steen Hecksher-Sørensen Henning Bliddal 《European spine journal》2007,16(2):277-282
Examination is a cornerstone in the manual procedures leading to mobilisation/manipulation of the low back. The observer variation of the more specific segmental tests remains to be investigated. Two skilled specialists in manual medicine examined the segmental changes in the lumbar spine. The patients were unknown to the examiners and no information of the case history was given. All test results were recorded by an observer present in the room who ensured that no conversation was allowed during the examination. The primary outcome measures were the kappa values for each test. The matching was defined as acceptable (acc) within two neighbouring levels and perfect (per) on the same level. Intra-observer variation (tested in 33 patients and 10 subjects without low-back pain): The agreement between first and second segmental diagnosis examination was 70% (per) and 82% (per + acc). Kappa values were: segmental diagnosis 0.60 (per) and 0.70 (per + acc), multifidus test 0.51 (per) and 0.60 (per + acc), sideflexion 0.57 (per) and 0.69 (per + acc), and ventral flexion 0.31 (per) and 0.45 (per + acc). Inter-observer variation (tested in 60 patients): The agreement for segmental diagnosis between the examiner A and B was 42% (per) and 75% (per + acc). Kappa values were: segmental diagnosis 0.21 (per) and 0.57 (acc), multifidus test 0.12 (per) and 0.48 (acc), sideflexion 0.22 (per) and 0.45 (acc), and ventralflexion 0.22 (per) and 0.44 (acc). By manual tests, skilled examiners seem to be able to diagnose segmental dysfunctions in the low back. The clinical implication of these dysfunctions remains to be clarified. 相似文献
994.
Modic changes following lumbar disc herniation 总被引:4,自引:3,他引:1
Only a small proportion (20%) of patients with LBP can be diagnosed based on a patho-anatomical entity. Therefore, the identification
of relevant subgroups, preferably on a patoanatomical basis, is strongly needed. Modic changes have been described by several
authors as being closely linked with LBP. The aims of this study were to describe the prevalence of Modic changes, their development
as well as their association to LBP, previous disc contour, and surgery in patients with previous severe sciatica. This is
a longitudinal cohort study where the patients were recruited from an RCT comparing two active conservative treatments, the
181 patients, who at baseline had radicular pain in or below the knee; all underwent a physical examination and MRI. MRI’s,
pain history and physical examination of 166 patients were obtained at follow-up 14 months later. The prevalence of Modic
changes type 1 increased from 9% at baseline to 29% at follow-up. At that time, a strong association between Modic changes
and non-specific LBP was noted. Apparently, Modic changes type 1 was more strongly associated with non-specific lumbar pain
than Modic changes type 2. The development of new Modic changes was closely related to the level of a previous disc herniation.
A lumbar disc herniation is a strong risk factor for developing Modic changes (especially type 1) during the following year.
Furthermore, Modic changes are strongly associated with LBP. 相似文献
995.
A prospective and controlled study of training after surgery for lumbar disc herniation (LDH). The objective was to determine
the effect of early neuromuscular customized training after LDH surgery. No consensus exists on the type and timing of physical
rehabilitation after LDH surgery. Patients aged 15–50 years, disc prolapse at L4–L5 or L5–S1. Before surgery, at 6 weeks,
4, and 12 months postoperatively, the following evaluations were performed: low back pain and leg pain estimated on a visual
analog scale, disability according to the Roland–Morris questionnaire (RMQ) and disability rating index (DRI). Clinical examination,
including the SLR test, was performed using a single blind method. Consumption of analgesics was registered. Twenty-five patients
started neuromuscular customized training 2 weeks after surgery (early training group=ETG). Thirty-one patients formed a control
group (CG) and started traditional training after 6 weeks. There was no significant difference in pain and disability between
the two training groups before surgery. Median preoperative leg pain was 63 mm in ETG and 70 mm in the CG. Preoperative median
disability according to RMQ was 14 in the ETG and 14.5 in the CG. Disability according to DRI (33/56 patients) was 5.3 in
the ETG vs. 4.6 in the CG. At 6 weeks, 4 months, and 12 months, pain was significantly reduced in both groups, to the same
extent. Disability scores were lower in the ETG at all follow-ups, and after 12 months, the difference was significant (RMQ
P=.034, DRI P=.015). The results of the present study show early neuromuscular customized training to have a superior effect on disability,
with a significant difference compared to traditional training at a follow-up 12 months after surgery. No adverse effects
of the early training were seen. A prospective, randomized study with a larger patient sample is warranted to ultimately demonstrate
that early training as described is beneficial for patients undergoing LDH surgery. 相似文献
996.
Akio Sakamoto Tatsuya Yoshida Hidetaka Yamamoto Yoshinao Oda Masazumi Tsuneyoshi Yukihide Iwamoto 《Journal of orthopaedic science》2007,12(4):361-365
Background Congenital pseudarthrosis of the tibia (CPT) is frequently, but not always, associated with neurofibromatosis type 1 (NF1).
Double inactivation of the NF1 gene has been reported to be the pathogenesis of CPT in NF1 cases.
Methods We analyzed the loss of heterozygosity (LOH) of the NF1 gene in cases of CPT with NF1 to examine whether double inactivation was seen in the case. In addition to morphological analysis,
immunoexpression of differentiation markers was examined.
Results and discussion The tibia tapered with the zone phenomenon from mature to immature bone with osteoblastic rimming, resembling osteofibrous
dysplasia. Osteosclerotic bowed bone with a small number of osteoclasts suggested dysfunction of bone remodeling. Fibrous
tissue at the site of pseudarthrosis was associated with the periosteum and demonstrated myofibroblastic differentiation accompanied
by massive cartilage formation, suggesting some misdirection during the differentiation of periosteum to myofibroblasts or
chondrocytes. LOH of the NF1 gene locus was not seen in fibrous tissue. This result suggests that CPT is not accompanied by double inactivation in every
NF1 case. 相似文献
997.
998.
Howard B. Yeon Jacob Weinberg Vincent Arlet Jean A. Ouelett Kirkham B. Wood 《European spine journal》2007,16(9):1379-1385
Fifteen skeletally immature patients with double major adolescent idiopathic scoliosis with large lumbar curves and notable L4 and L5 coronal plane obliquity were retrospectively studied. Seven patients who underwent anterior release and fusion of the lumbar curve with segmental anterior instrumentation and subsequent posterior instrumentation ending at L3 were compared with eight patients treated with anterior release and fusion without anterior instrumentation followed by posterior instrumentation to L3 or L4. At 4.5 years follow-up (range 2.5-7 years), curve correction, coronal balance and fusion rate were not statistically different between the two groups; however, the group with anterior instrumentation had improved coronal plane, near normalangulation in the distal unfused segment compared with the group without anterior instrumentation. In cases involving severe lumbar curvatures in the context of double major scoliosis, when as a first stage anterior release is chosen, the addition of instrumentation appears to restore normal coronal alignment of the distal unfused lumbar segment, and may in certain cases save a level compared with traditional fusions to L4. 相似文献
999.
Recessive dystrophic epidermolysis bullosa (RDEB) is an uncommon and severe disorder characterised by trauma-induced blisters, intractable skin ulcers, scarring, milia, and nail dystrophy. We report the good result of both surgical release of fingers allowing spontaneous epithelisation without skin grafting and post-operative meticulous skin care without splinting, followed-up for one year. 相似文献
1000.