Investigation of the Conditions Required for Acquiring ofSocks-handling Ability 5 Months after Total Hip Arthroplasty（Posterior Approach）with Consideration of the Functional Goals：A Longitudinal Study / The Japanese Journal of Rehabilitation Medicine

Objective：This study was aimed at investigating the acquirement of socks-handling ability with hip flex, abduction, and external rotation position (hip open position）in 5 months after the posterior approach to total hip arthroplasty (THA), with consideration of the functional goals by conducting a multicenter cooperative study.Methods：The study included 101 patients (104 hip joints) with hip osteoarthritis. We evaluated patient attribution；ranges of motion of the hip, knee and ankle；hip pain in socks-handling；and upper extremity length, which were evaluated before the operation, upon hospital discharge and at 5 months after the posterior approach to THA. The patients were classified into those who attained and did not attain socks-handling ability in open hip position until 5 months after THA. We investigated the factors for acquiring socks-handling ability by using a multiple logistic regression analysis.Results：We identified three factors that significantly correlated to socks-handling ability as follows：(1) socks-handling ability before the operation, (2) range of hip external rotation before operation, and (3) range of hip abduction before discharge. The goal to acquire socks-handling ability is 27.5° hip external rotation and 17.5° hip abduction.Conclusion：We suggest that socks-handling ability must be acquired before THA and that the target range of hip abduction and external rotation must be attained during the early post-THA stage.

Investigation of the Conditions Required for Acquiring of Socks-handling Ability 5 Months after Total Hip Arthroplasty（Posterior Approach）with Consideration of the Functional Goals：A Longitudinal Study / The Japanese Journal of Rehabilitation Medicine

Objective：This study was aimed at investigating the acquirement of socks-handling ability with hip flex, abduction, and external rotation position (hip open position) in 5 months after the posterior approach to total hip arthroplasty (THA), with consideration of the functional goals by conducting a multicenter cooperative study.Methods：The study included 101 patients (104 hip joints) with hip osteoarthritis. We evaluated patient attribution；ranges of motion of the hip, knee and ankle；hip pain in socks-handling；and upper extremity length, which were evaluated before the operation, upon hospital discharge and at 5 months after the posterior approach to THA. The patients were classified into those who attained and did not attain socks-handling ability in open hip position until 5 months after THA. We investigated the factors for acquiring socks-handling ability by using a multiple logistic regression analysis.Results：We identified three factors that significantly correlated to socks-handling ability as follows：(1) socks-handling ability before the operation, (2) range of hip external rotation before operation, and (3) range of hip abduction before discharge. The goal to acquire socks-handling ability is 27.5°hip external rotation and 17.5°hip abduction.Conclusion：We suggest that socks-handling ability must be acquired before THA and that the target range of hip abduction and external rotation must be attained during the early post-THA stage.

An Important Consideration when Using Botulinum Toxin Injections for Treating Claw Foot Deformity / The Japanese Journal of Rehabilitation Medicine

Objectives : In this study, we assessed the muscle contraction pattern of each toe by stimulating the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles in patients with claw foot deformity caused by spasticity in the lower extremity in order to increase the benefit of their botulinum toxin treatments. Subjects and Methods : Fifteen post-stroke patients (11 male and 4 female ; mean age, 62.3 years) were recruited for the study. In this observational study, the muscle contraction patterns of the hallux and digits on electrical stimulation of the FHL or FDL were examined by two doctors, and the data was then analyzed. In addition, the FHL and FDL were identified in 6 feet from 3 cadaver specimens below the ankle to near the end of each muscle on each toe. Results : In muscles that could be observed, muscle contraction was observed in the hallux in every subject and in the second digit in 92.3% subjects when the FHL was stimulated electrically. Muscle contraction was not observed in the second digit in 64.3% of the subjects when the FDL was stimulated electrically. In the cadaver dissections, the tendons of the FHL sent fibers to the FDL tendons in all 6 feet examined. Conclusion : In conclusion, when botulinum toxin is to be injected into the FHL or FDL muscle for treating claw foot deformity in patients with lower extremity spasticity, especially when the treatment target is the second digit, the injection should be performed not only in the FDL muscle, but also in the FHL muscle to increase the effectiveness of the treatment.

Study on gene mutations of single S region in immunoglobulin class switch recombination / 中国免疫学杂志

Objective:To investigate the gene rearrangements in immunoglobulin single switch(S) region during class switch recombination.Methods:An artificial substrate containing single S region(FS?-2) driven by tetracycline-responsive promoter was constructed and underwent CSR in a switch-inducible B lymphoma line was stimulated by cytokines,then the S region mutations and its dependent factors were detected by detected PCR and sequencing.Results:Gene rearrangements including deletions,insertions as well as point mutations could occur even in this single S region after cytokines stimulation;Furthermore,when the upstream promoter was suppressed by its inhibitor,CSR frequency was significantly decreased,indicating a transcription dependent S region recombination.Conclusion:Class switch recombination mechanism can exert a similar effect on single S region.