Dose Optimization Using a Deep Learning Tool in Various CT Protocols for Urolithiasis: A Physical Human Phantom Study.

Background and Objectives: We attempted to determine the optimal radiation dose to maintain image quality using a deep learning application in a physical human phantom. Materials and Methods: Three 5 × 5 × 5 mm3 uric acid stones were placed in a physical human phantom in various locations. Three tube voltages (120, 100, and 80 kV) and four current-time products (100, 70, 30, and 15 mAs) were implemented in 12 scans. Each scan was reconstructed with filtered back projection (FBP), statistical iterative reconstruction (IR, iDose), and knowledge-based iterative model reconstruction (IMR). By applying deep learning to each image, we took 12 more scans. Objective image assessments were calculated using the standard deviation of the Hounsfield unit (HU). Subjective image assessments were performed by one radiologist and one urologist. Two radiologists assessed the subjective assessment and found the stone under the absence of information. We used this data to calculate the diagnostic accuracy. Results: Objective image noise was decreased after applying a deep learning tool in all images of FBP, iDose, and IMR. There was no statistical difference between iDose and deep learning-applied FBP images (10.1 ± 11.9, 9.5 ± 18.5 HU, p = 0.583, respectively). At a 100 kV-30 mAs setting, deep learning-applied FBP obtained a similar objective noise in approximately one third of the radiation doses compared to FBP. In radiation doses with settings lower than 100 kV-30 mAs, the subject image assessment (image quality, confidence level, and noise) showed deteriorated scores. Diagnostic accuracy was increased when the deep learning setting was lower than 100 kV-30 mAs, except for at 80 kV-15 mAs. Conclusions: At the setting of 100 kV-30 mAs or higher, deep learning-applied FBP did not differ in image quality compared to IR. At the setting of 100 kV-30 mAs, the radiation dose can decrease by about one third while maintaining objective noise.

Effects of Log-Rolling Position on Hip-Abductor Muscle Activation During Side-Lying Hip-Abduction Exercise in Participants With Gluteus Medius Weakness.

CONTEXT: Weakness of the gluteus medius and gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergistic muscles that are not targeted should be considered when prescribing side-lying hip-abduction (SHA) exercises. Log-rolling positions may affect hip-abductor activity during SHA. OBJECTIVE: To determine the effects of log-rolling positions on gluteus medius, gluteus maximus, and tensor fasciae latae activity during SHA in participants with gluteus medius weakness. DESIGN: Controlled laboratory study. SETTING: University research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-one participants with gluteus medius weakness. INTERVENTION(S): Three types of SHA were performed: frontal-plane SHA in neutral position (SHA-neutral), frontal-plane SHA in anterior log-rolling position (SHA-anterior rolling), and frontal-plane SHA in posterior log-rolling position (SHA-posterior rolling). MAIN OUTCOME MEASURE(S): Surface electromyography was used to measure hip-abductor activity. One-way repeated-measures analysis of variance was calculated to assess the statistical significance of the muscle activity. RESULTS: The SHA-anterior rolling showed greater gluteus medius and gluteus maximus activation than the SHA-neutral (P = .003 and P < .001, respectively) and SHA-posterior rolling (P < .001 and P < .001, respectively). The SHA-neutral demonstrated greater gluteus medius and gluteus maximus activation than the SHA-posterior rolling (P < .001 and P = .001, respectively). The SHA-anterior rolling produced less tensor fasciae latae activation than the SHA-neutral (P < .001) and SHA-posterior rolling (P < .001). The SHA-neutral showed less tensor fasciae latae activation than the SHA-posterior rolling (P < .001). CONCLUSIONS: The SHA-anterior rolling may be an effective exercise for increasing activation of the gluteus medius and gluteus maximus while decreasing activation of the tensor fasciae latae in participants with gluteus medius weakness.

Four-week training involving self-ankle mobilization with movement versus calf muscle stretching in patients with chronic stroke: a randomized controlled study.

Background: In self-ankle mobilization with movement (S-MWM) therapy, a strap can be utilized to stabilize the posterior glide of the talus during ankle dorsiflexion movements.Objectives: Our objective was to compare the effects of 4-week self-mobilization with movement (S-MWM) with those of calf muscle stretching (CMS) on ankle dorsiflexion passive range of motion (DF-PROM), gait parameters, and fall risk in patients with chronic stroke with limited ankle dorsiflexion.Methods: Participants were randomized into the S-MWM (n = 19) and CMS groups (n = 19). Both groups received conventional physiotherapy for 30 minutes per session. In addition, S-MWM and CMS techniques were performed 3 times per week for 4 weeks and were performed by the participants themselves. Ankle DF-PROM, gait parameters, and fall risk were measured after 4 weeks of training.Results: After 4 weeks of training, both groups showed significant improvement in all outcome measures (p < .05). Furthermore, ankle DF-PROM, gait parameters (gait speed, cadence, and stride lengths on both sides), and fall risk showed greater improvement in the S-MWM group than in the CMS group (p < .05).Conclusions: This study shows that S-MWM training combined with conventional physiotherapy improved ankle DF-PROM, gait parameters, and fall risk in patients with chronic stroke.

The effects of three types of piriform muscle stretching on muscle thickness and the medial rotation angle of the coxal articulation.

[Purpose] The purpose of this study was three kinds of stretching methods and measured the change in the thickness of the piriform muscle in real time using ultrasound images and compared the medial rotation angle of the coxal articulation. [Subjects and Methods] Fourty-five subjects who attend B University in Cheonan, divided into three groups. The subjects in these three groups then underwent stretching with flexion of coxal articulation over 90°, stretching with flexion of coxal articulation under 90°, and muscle energy technique (MET) application. The main outcome measures were piriform muscle thickness and medial rotation angle of the coxal articulation. [Results] All groups showed decreased piriform muscle thickness and increased medial rotation angle of the coxal articulation. [Conclusion] Based on the above results, three kinds of piriform muscle stretching methods are effective of reduce muscle thickness and increase medial rotation angle of the coxal articulation.

Comparisons of shoulder stabilization muscle activities according to postural changes during flexi-bar exercise.

[Purpose] The purpose of this study was to compare shoulder stabilization muscle activities according to postural changes during flexi-bar exercise. [Subjects] The subjects included 18 students (10 males, 8 females) at B University. [Methods] The subjects performed the following flexi-bar exercises: 1) medio-lateral oscillation with the 90° shoulder abduction, with the hand in the neutral position; 2) dorso-ventral oscillation with 90° shoulder flexion, with the hand in the neutral position; 3) superior-inferior oscillation with 90° shoulder flexion, with the 80° hand pronation. [Results] The activity of the serratus anterior showed significant differences between each position; however, activities of the upper trapezius and middle trapezius were not significantly different. [Conclusion] The results of this study indicate that posture control is important for selective strengthening of the serratus anterior muscle during flexi-bar exercises.

The probiotic mixture IRT5 ameliorates age-dependent colitis in rats.

To investigate the anti-inflammatory effect of probiotics, we orally administered IRT5 (1×10(9)CFU/rat) for 8 weeks to aged (16 months-old) Fischer 344 rats, and measured parameters of colitis. The expression levels of the inflammatory markers' inducible NO synthase (iNOS), cyclooxygenase-2 (COX2), tumor necrosis factor (TNF)-α, and interleukin (IL)-1ß were higher in the colons of normal aged rats (18 months-old) than in the colons of normal young rats (6 months-old). Treatment with IRT5 suppressed the age-associated increased expression of iNOS, COX2, TNF-α, and IL-1ß, and activation of NF-κB and mitogen-activated protein kinases. In a similar manner, the expression of tight junction proteins in the colon of normal aged rats was suppressed more potently than in normal young rats, and treatment of aged rats with IRT5 decreased the age-dependent suppression of tight junction proteins ZO-1, occludin, and claudin-1. Treatment with IRT5 suppressed age-associated increases in expressions of senescence markers p16 and p53 in the colon of aged rats, but increased age-suppressed expression of SIRT1. However, treatment with IRT5 inhibited age-associated increased myeloperoxidase activity in the colon. In addition, treatment with IRT5 lowered the levels of LPS in intestinal fluid and blood of aged rats, as well as the reduced concentrations of reactive oxygen species, malondialdehyde, and C-reactive protein in the blood. These findings suggest that IRT5 treatment may suppress age-dependent colitis by inhibiting gut microbiota LPS production.

Comparison of the toxicity of aluminum oxide nanorods with different aspect ratio.

Aluminum oxide nanoparticles are listed among 14 high-priority nanomaterials published by the Organization for Economic Co-operation and Development, but limited information is available on their potential hazards. In this study, we compared the toxicity of two different aluminum oxide nanorods (AlNRs) commercially available in vivo and in vitro. Considering aspect ratio, one was 6.2 ± 0.6 (long-AlNRs) and the other was 2.1 ± 0.4 (short-AlNRs). In mice, long-AlNRs induced longer and stronger inflammatory responses than short-AlNRs, and the degree reached the maximum on day 7 for both types and decreased with time. In addition, in vitro tests were performed on six cell lines derived from potential target organs for AlNPs, HEK-293 (kidney), HACAT (skin), Chang (liver), BEAS-2B (lung), T98G (brain), and H9C2 (heart), using MTT assay, ATP assay, LDH release, and xCELLigence system. Long-AlNRs generally produced stronger toxicity than short-AlNRs, and HEK-293 cells were the most sensitive for both AlNRs, followed by BEAS-2B cells, although results from 4 kinds of toxicity tests conflicted among the cell lines. Based on these results, we suggest that toxicity of AlNRs may be related to aspect ratio (and resultant surface area). Furthermore, novel in vitro toxicity testing methods are needed to resolve questionable results caused by the unique properties of nanoparticles.

The effects of squat exercises in postures for toilet use on blood flow velocity of the leg vein.

[Purpose] The purpose of this study was to identify the effects of squat exercises performed in toilet-using postures on the blood flow velocity of the lower extremities for the prevention of deep vein thrombosis. [Subjects] The subjects were 28 students who were attending B University in Cheonan. They were divided into a group of 14 subjects of sitting toilet users and a group of 14 subjects of squat toilet users. [Methods] The subjects performed squat exercises in different toilet-using postures and we investigated the changes in blood flow velocity. [Results] The variations in blood flow velocities before and after the exercises showed significant differences in both groups but the differences between the two groups were not significant. [Conclusion] Based on the results of this study, we consider squat exercises are effective at improving the variation in lower-extremity blood flow velocity when using a toilet.

Comparison of Upper Trapezius, Anterior Deltoid, and Serratus Anterior Muscle Activity during Push-up plus Exercise on Slings and a Stable Surface.

[Purpose] The purpose of this study was to identify effects of push-up plus exercise on different support surfaces on upper extremity muscular activity. [Subjects] The subjects were 28 students (10 males, 18 females) at B University. [Methods] The subjects performed push-up plus exercises either on slings or on a fixed support. [Results] Push-up plus exercises on slings showed significant increases in the muscle activity of the trapezius (upper fiber), deltoid (anterior fiber), and serratus anterior muscles compared with stabilization exercises on a fixed support. [Conclusion] Based on these results, it is considered that performance of the push-up plus exercise on slings will increase scapular muscle activity.

Case report: Physiotherapy strategies for a woman with symphysis pubis diastasis occurring during labour.

This case report demonstrates a therapeutic exercise program as a noninvasive functional treatment for symphysis pubis diastasis (SPD) and reports its results. A 32-year-old primigravida with SPD during labour received a specific functional exercise program, which consisted of abdominal stabilization and strengthening of the pelvic floor muscles, hip adductors, and extensors; training for bed mobility; and walking training with suitable aids. The program was performed for 1-hour per session, twice a day, for 2 weeks. Before the intervention, the patient was totally dependent on others for performing her daily activities owing to severe pain in the pelvic region. After the 2-week intervention, however, the interpubic distance was reduced by 36% (from 22 mm to 14 mm), and pain and functional disability were remarkably improved. Moreover, the patient could walk independently for 30 m with a pelvic corset. Our results suggest that a systematically designed functional rehabilitation program may be beneficial in the functional recovery of patients suffering from SPD related to pregnancy.

Noninvasive treatment strategy for swallowing problems related to prolonged nonoral feeding in spinal muscular atrophy type II.

A 25-year-old patient with spinal muscular atrophy (SMA) type II was referred due to swallowing problems related to prolonged nonoral feeding. Restriction of jaw movement, neck stiffness, absence of oral food intake, and weakness of the oropharyngeal and laryngeal muscles were considered to be the main factors contributing to the deterioration of his swallowing function. Treatment comprised exercises to improve flexibility of the neck and temporomandibular joint, tactile oral stimulation, passive and active oropharyngolaryngeal exercises, and supraglottic swallowing maneuvers. Treatment was performed for 30 min per day, three times a week, for 7 months. On initial videofluoroscopic examination, the patient was unable to safely tolerate any per-oral nutrition. After 7 months of treatment, the patient's swallowing function had improved to the extent that he was able to resume oral intake of food under supervision, and aspiration was no longer evident. These findings suggest that noninvasive treatment is a possible strategy for enhancing the swallowing function of a patient with SMA type II presenting with swallowing difficulties related to prolonged nonoral feeding.

Watsu approach for improving spasticity and ambulatory function in hemiparetic patients with stroke.

BACKGROUND AND PURPOSE: This study reports the effect of Watsu as rehabilitation method for hemiparetic patients with stroke. METHOD: Watsu consisted of 40 treatment sessions for 8 weeks, delivered underwater or at water surface level, it applied in three patients. Outcome measures included tools for assessing spasticity and ambulatory function. RESULTS: All patients showed decreased scores in the TAS and RVGA after Watsu application. CONCLUSIONS: Watsu was helpful in controlling spasticity and improving ambulatory function of the patients with hemiparesis.

Antimicrobial activity of p-hydroxyphenyl acrylate derivatives.

To estimate the antimicrobial effect of p-hydroxyphenyl acrylate (H5) derivatives on the basis of their molecular structure, the hydroxy and acryl groups of p-hydroxyphenyl acrylate were modified. The antimicrobial activity of the resulting compounds was assessed against a Gram-positive bacterium (Staphylococcus aureus), a Gram-negative bacterium (Pseudomonas aeruginosa), and fungi (Aspergillus fumigatus and Penicillium pinphilum) by the halo zone and the shake flask test. The antimicrobial activity of H5 was ascribed mainly to the acryl group. Compounds with acryl or acryloxy groups bound to the phenyl moiety were found to exhibit particularly high antimicrobial activities. The activities of phenyl acrylate and phenyl vinyl ketone were excellent as compared to aliphatic acrylates such as cyclohexyl acrylate and hexyl acrylate, indicating that the stereoelectronic effect of the phenyl group was important to the antimicrobial activity.