Pharmacopuncture and joint movement manual therapy for post-traumatic phalangeal osteoarthritis: A case report.

INTRODUCTION: Post-traumatic osteoarthritis (PTOA) is a type of osteoarthritis that develops after ligament injury, meniscus injury, or fracture. Currently, there is no specific treatment approved for PTOA. This report describes the case of a 38-year-old man who suffered from PTOA of the right second distal interphalangeal (DIP) joint after practicing judo. PATIENT CONCERNS: He visited the author's clinic at 3 months after the onset of symptoms. Symptoms included pain, limited motion, and joint enlargement of the right second DIP joint. DIAGNOSIS: Partial tear of the ulnar collateral ligament of the DIP was revealed by magnetic resonance imaging. As the symptoms appeared after the traumatic event, PTOA was diagnosed. INTERVENTIONS: Intra-articular hominis placenta pharmacopuncture and joint movement manual therapy were performed on each visit. Altogether, 10 sessions were performed until the symptoms improved remarkably. OUTCOMES: Visual analogue scale score (VAS) for pain; Quick Disabilities of the Arm, Shoulder, and Hand score (QuickDASH); joint circumference; and range of motion showed improvements at the end of the treatment. VAS decreased from 8.4 to 0.4, QuickDASH decreased from 44 to 13, joint circumference decreased from 5.5 to 5.4 cm, and range of motion was almost recovered, which was measured by the photographs. LESSONS: There are not enough studies on phalangeal joint PTOA and its treatment. This case suggests pharmacopuncture and joint movement manual therapy as treatment options for phalangeal PTOA.

Treatment of Poststroke Pathologic Laughing With Duloxetine: A Case Series.

OBJECTIVES: Pathologic laughing is characterized by episodes of uncontrollable laughter caused by underlying neurologic disturbances, such as stroke. Several types of medication, including selective serotonin reuptake inhibitors, have demonstrated only limited success at treating the condition. Duloxetine, a dual serotonin-norepinephrine reuptake inhibitor, is reportedly effective in treating the symptoms of mood disorders. We herein introduce a prospective consecutive sample of stroke patients with pathologic laughing treated with duloxetine. METHODS: We enrolled patients without a history of psychological illness who exhibited poststroke pathologic laughter. Duloxetine administration was commenced at an initial dose of 30 mg once daily. The dose was increased to 60 mg once daily within 2 weeks for all patients except 2. The effect of the treatment was assessed by means of the Pathological Laughter and Crying Scale. RESULTS: A total of 7 patients were included in the study. Improvements were observed within an average of 10 days after duloxetine administration. Pathological Laughter and Crying Scale score decreased after duloxetine administration in all patients, and 4 patients demonstrated a decrease in score of more than 50%. All patients reported subjective improvement of symptoms, and no adverse effects were observed. CONCLUSIONS: This case series demonstrates that duloxetine could attenuate pathologic laughing exhibited by stroke patients; however, further randomized controlled studies are necessary to validate our findings.

Local recurrence of brain metastasis reduced by intra-operative hyperthermia treatment.

PURPOSE: Brain metastasis is a common complication in cancer patients. Local recurrence after total resection of metastatic brain tumor has been frequently reported. In this study, we developed a new hyperthermia device and applied it to metastatic brain tumor patients intra-operatively to study if hyperthermia treatment could reduce local tumor recurrence. MATERIALS AND METHODS: A total of 63 metastatic brain patients were enrolled in the study with an informed consent obtained from every patient. After total resection of the tumor, the hyperthermia device was applied intra-operatively to the resection cavity. The surrounding brain tissue at 5 mm in depth from the tumor resection margin was raised to 42.5 °C for a total of 60 minutes (Clinical Research Information Service Registration Number: KCT0001308). RESULTS: A total of 10 local recurrences were observed in 63 patients who received hyperthermia treatment showing a local recurrence rate of 15.8%. It was significantly lower than the local recurrence rate of those who received conventional treatment (34%) when analyzed with one tailed z-test (p value: .001). Kaplan-Meier analysis also showed a significantly lower recurrence rate in the hyperthermia treatment group (p value: .0003). Complications included two cases of seizures and two cases of wound infection. CONCLUSIONS: Results of this study suggest that intra-operative hyperthermia treatment after total resection of metastatic brain tumor could reduce local recurrence of tumor. We believe that intra-operative hyperthermia treatment could be used as an adjuvant therapy to surgery and post-operative radiotherapy, or as a salvage treatment in patients who cannot receive further radiotherapy.

Development of a Cardiovascular Simulator for Studying Pulse Diagnosis Mechanisms.

This research was undertaken to develop a cardiovascular simulator for use in the study of pulse diagnosis. The physical (i.e., pulse wave transmission and reflection) and physiological (i.e., systolic and diastolic pressure, pulse pressure, and mean pressure) characteristics of the radial pulse wave were reproduced by our simulator. The simulator consisted of an arterial component and a pulse-generating component. Computer simulation was used to simplify the arterial component while maintaining the elastic modulus and artery size. To improve the reflected wave characteristics, a palmar arch was incorporated within the simulator. The simulated radial pulse showed good agreement with clinical data.

Study on the Depth, Rate, Shape, and Strength of Pulse with Cardiovascular Simulator.

Pulse diagnosis is important in oriental medicine. The purpose of this study is explaining the mechanisms of pulse with a cardiovascular simulator. The simulator is comprised of the pulse generating part, the vessel part, and the measurement part. The pulse generating part was composed of motor, slider-crank mechanism, and piston pump. The vessel part, which was composed with the aorta and a radial artery, was fabricated with silicon to implement pulse wave propagation. The pulse parameters, such as the depth, rate, shape, and strength, were simulated. With changing the mean pressure, the floating pulse and the sunken pulse were generated. The change of heart rate generated the slow pulse and the rapid pulse. The control of the superposition time of the reflected wave generated the string-like pulse and the slippery pulse. With changing the pulse pressure, the vacuous pulse and the replete pulse were generated. The generated pulses showed good agreements with the typical pulses.

Anti-obesity phenotypic screening looking to increase OBR cell surface expression.

The leptin receptor, OBR, is involved in the regulation of whole-body energy homeostasis. Most obese people are resistant to leptin and do not respond to the hormone. The prevention and reversal of leptin resistance is one of the major current goals of obesity research. We showed previously that increased OBR cell surface expression concomitantly increases cellular leptin signaling and prevents obesity development in mice. Improvement of OBR cell surface expression can thus be considered as an interesting anti-obesity therapeutic strategy. To identify compounds that increase the surface expression of OBR, we developed a cell-based, phenotypic assay to perform a high-content screen (HCS) against a library of 50,000 chemical compounds. We identified 67 compounds that increased OBR cell surface expression with AC50 values in the low micromolar range and no effect on total OBR expression and cellular toxicity. Compounds were classified into 16 chemical clusters, of which 4 potentiated leptin-promoted signaling through the JAK2/STAT3 pathway. In conclusion, development of a robust phenotypic screening approach resulted in the discovery of four new scaffolds that demonstrate the desired biological activity and could constitute an original therapeutic solution against obesity and associated disorders.

Cervical coupling motion characteristics in healthy people using a wireless inertial measurement unit.

Objective. The objectives were to show the feasibility of a wireless microelectromechanical system inertial measurement unit (MEMS-IMU) to assess the time-domain characteristics of cervical motion that are clinically useful to evaluate cervical spine movement. Methods. Cervical spine movements were measured in 18 subjects with wireless IMUs. All rotation data are presented in the Euler angle system. Amount of coupling motions was evaluated by calculating the average angle ratio and the maximum angle ratio of the coupling motion to the primary motion. Reliability is presented with intraclass correlation coefficients (ICC). Results. Entire time-domain characteristics of cervical motion were measured with developed MEMS-IMU system. Cervical range of motion (CROM) and coupling motion range were measured with high ICCs. The acquired data and calculated parameters had similar tendency with the previous studies. Conclusions. We evaluated cervical motion with economic system using a wireless IMU of high reliability. We could directly measure the three-dimensional cervical motion in degrees in realtime. The characteristics measured by this system may provide a diagnostic basis for structural or functional dysfunction of cervical spine. This system is also useful to demonstrate the effectiveness of any intervention such as conventional medical treatment, and Korean medical treatment, exercise therapy.