A biomechanical study of fast throwing movements of the shoulder in baseball pitching.

OBJECTIVE: To define the biomechanic function of the shoulder in fast throwing movements in baseball pitching. METHODS: Using NAC high-speed video and PIAS LA-555 computer system, overhand pitching movements carried out by 12 healthy Japanese professional baseball pitchers were analyzed in three dimensions. The pitching motion was displayed as stick to sick figures dynamically. RESULTS: Pitching motion was a combination of translational and rotational movements. Acceleration and deceleration, being two typical motion patterns, worked sequentially through the anatomic link system from the pivot leg to the pitching hand. During the acceleration phase, the shoulder joint acted as a junction point and a fulcrum, supporting the rotational acceleration motion, shoulder forward flexion and elbow extension. According to the changing glenohumeral angles of the pitching shoulder, shearing force turned into tension force which worked on the anterior shoulder structures and then shifted to the posterior part of the joint. CONCLUSIONS: In fast throwing motion, the shoulder functions as an important fulcrum to support the pitching arm during the acceleration phase. Avoiding excessive stress and shearing force on the joint components and enhancing coordination of muscle action are important to a successful throwing motion and the prevention of shoulder injury.

Efficacy and safety of latanoprost eye drops for glaucoma treatment: a 1-year study in Japan.

PURPOSE: To evaluate the intraocular pressure (IOP)-lowering effect and safety of latanoprost, a prostaglandin analogue, in patients with primary open-angle glaucoma or ocular hypertension. METHOD: One hundred and twenty-four Japanese patients with primary open-angle glaucoma or ocular hypertension were enrolled in this open-labeled study and were treated with 0.005% latanoprost once daily for 1 year. RESULTS: At all follow-up visits there was a significant (P < .001) reduction in IOP compared with the baseline value. After 1 year, the IOP was reduced by 5.4 +/- 2.9 (mean +/- SD) mm Hg from a baseline value of 23.5 +/- 2.2 mm Hg. No evidence of an upward drift in the IOP was observed during the treatment period. The most frequently reported adverse ocular events were mild conjunctival hyperemia and iris pigmentation. Very few adverse systemic events were observed. CONCLUSIONS: Latanoprost eye drops showed a marked and stable IOP-lowering effect during the 1-year treatment period. Furthermore, latanoprost was well-tolerated and should be a valuable contribution to the management of glaucoma.

[Preventive effects of diclofenac ophthalmic solution on post-cataract-surgical cystoid macular edema].

Using eyes undergoing phacoemulsification followed by implantation of a foldable acrylic intraocular lens (IOL) designed for small-incision cataract surgery, a multi-center study was performed to compare a non-steroidal ophthalmic solution (0.1% diclofenac) to a steroidal ophthalmic solution (0.1% fluorometholone) in preventing cystoid macular edema (CME) and inducing disruption of the blood-aqueous barrier determined by laser flare cellmetry. The incidence of CME, noted in 3 out of 53 eyes (5.7%) receiving diclofenac and in 29 out of 53 eyes (54.7%) receiving fluorometholone, was significantly lower in the diclofenac group. The flare in the anterior chamber was also significantly lower in the diclofenac group; when compared between eyes with and without CME, the amount of flare was significantly higher in the former group. These findings suggest that diclofenac effectively prevents CME following cataract surgery and that CME is closely related to the breakdown of the blood-aqueous barrier.

[Predictive analysis of tumor response].

To select the best treatment modality for individual patient with cancer, the oncologist is subjected to consider various factors and parameters predictive of the outcome of therapy. A critical review is presented relating to the prognostic factors in the local control and/or long term survival rate in various kinds of malignant tumors. As predictors of response in cancer patients, it is attributed not only to physical characteristics of ionizing radiation and technical factors, but also tumor- and host-related factors such as gene amplification, DNA pattern, nuclear shape factor, histological grade, growth rate, glucose metabolic state, NMR spectroscopy, tumor marker levels, shape and location of tumor, in vitro sensitivity assay of tumor, age, general immunologic competence and psychological state of the patient. Most of the studies done sofar, are focused on the involvement of only one or two factors for each tumor, but importance of each factor as a predictor of tumor response is not clearly highlighted. It is emphasized that multivariate analysis of all these factors including potential predictors should be performed for each malignant tumor and for each treatment modality.

Contrast-enhanced MRI in spinal arteriovenous malformations and fistulae before and after embolisation therapy.

MRI was performed in six cases of spinal arteriovenous malformation (AVM) and arteriovenous fistula (AVF) before and after embolisation. Intramedullary and perimedullary AVMs showed marked vascular enhancement after embolisation. This was thought to reflect feeding vessel occlusion and correlated well with a favourable clinical outcome. In dural AVFs, contrast-enhanced studies were essential for the diagnosis, unenhanced images being nonspecific. After embolisation, enhancement of the spinal cord was reduced, although one case with a poor outcome showed persistent enhancement.

Type D dural carotid-cavernous fistula. Results of combined treatment with irradiation and particulate embolization.

PURPOSE: To assess the efficacy of irradiation combined with particulate embolization for treating type D dural carotid-cavernous fistulas, supplied by the meningeal branches of both external (ECA) and internal carotid arteries. MATERIAL AND METHODS: Nine patients were treated by particulate embolization via the ECA branches, followed by radiation therapy with doses of 30 Gy. One of these patients with recurrent symptoms received an additional 30 Gy one year after initial treatment, making a total dose of 60 Gy. RESULTS: In all cases, symptoms were improved immediately after the particulate embolizations. In 8 cases, complete resolution of symptoms were obtained in 4-19 months and an average of 8 months after treatment. In one case, chemosis was markedly improved and persisted minimally 41 months later. CONCLUSION: Particulate embolization is effective for immediate symptomatic improvement, and complete resolution of symptoms can usually be achieved by subsequent radiation therapy.