Psychological Stress Induced by Prone Positioning among Adults with Severe Cerebral Palsy.

The purpose of this study was to investigate the psychological impact of various positionings in subjects with cerebral palsy (CP). The participants were 17 individuals with severe motor and intellectual disability due to CP. They began in a sitting position in their wheelchair, and were placed consecutively in prone or supine positions, with no intervals between placements. Physiological observations were made in each position, and included salivary α-amylase activity, pulse, percutaneous oxygen saturation, respiratory rate, learance or not of airway secretions, and occurrence or not of adverse events. Salivary α-amylase activity values were higher in the prone position than in the baseline and supine positions (p<0.05). Clearance of airway secretions was significantly more prevalent in the prone position than in the baseline and supine positions (p <0.05). The participants' pulse was significantly lower in the supine and prone positions than in the baseline position (p<0.05). Greater prevalence of airway secretion clearance and significantly higher stress levels as indicated by saliva amylase were observed in the prone position than in the other two positions. Therefore, when such patients are placed in a prone position, close attention to airway management and the potential for psychological stress may be necessary.

Physical therapist-led swimming lessons for children with cerebral palsy: a report of 2 cases.

[Purpose] The purpose of this study was to report that a physical therapist qualified for swimming instruction can provide swimming instruction to children with spastic paraplegia due to cerebral palsy. We examined the role of the physical therapist in the support. [Participants and Methods] Two elementary school children with cerebral palsy participated in this study. The swimming program consisting of 6 sessions was performed over 6 months in an indoor swimming pool. Each session lasted for 30 minutes and was instructed by a trained physical therapist. The 5 categories for evaluation were motor function, muscle tone, activities of daily living, swimming skill, and satisfaction level. [Results] Case A showed improvement in streamline floating distance and 15-m time. Case B could not swim 15 m in the first session but completed 15 m within 102 s in the last session. The 3 other categories besides swimming skills did not improve. [Conclusion] With a skilled physical therapist's instruction, children with cerebral palsy may improve their swimming skills over a limited number of sessions without any adverse events.

Factors inducing falling in schizophrenia patients.

[Purpose] The purpose of this study is to investigate the factors causing falling among patients with schizophrenia hospitalized in psychiatric hospitals. [Subjects and Methods] The study subjects were divided into either those having experienced a fall within the past one year (Fall group, 12 patients) and those not having experienced a fall (Non-fall group, 7 patients), and we examined differences between the two groups. Assessment items measured included muscle strength, balance ability, flexibility, body composition assessment, Global Assessment of Functioning scale (GAF), the antipsychotic drug intake, and Drug Induced Extra-Pyramidal Symptoms Scale (DIEPSS). [Results] As a result, significant differences were observed in regard to One leg standing time with eyes open, Time Up and Go Test (TUGT), and DIEPSS Sialorrhea between the Fall group and the Non-fall group. [Conclusion] These results suggest that a decrease in balance ability was significantly correlated with falling in schizophrenia patients.

Factors Affecting Walking Speed in Schizophrenia Patients.

OBJECTIVE: This study investigated the factors affecting walking speed in schizophrenia patients who were inpatients at a psychiatric hospital. METHODS: The study subjects were 37 patients with schizophrenia who were hospitalized in a psychiatric hospital. The measured assessment items included age, duration of hospitalization, duration of disease, muscle strength (30-s chair stand test), balance ability (one-leg standing time with eyes open/closed, Functional Reach Test, and Timed Up & Go Test), flexibility (long sitting position toe-touching distance), walking speed (10-m maximum walking speed), and the antipsychotic drug intake. RESULTS: The walking speed was found to be correlated with the results of the 30-s chair stand test, the one-leg standing time with eyes open, the one-leg standing time with eyes closed, and the Timed Up & Go Test. Stepwise multiple regression analysis revealed that only the Timed Up & Go Test results affected walking speed. CONCLUSION: In schizophrenia patients, walking speed is influenced by balance and lower-limb muscle force, just as it is for patients without mental diseases. In schizophrenia patients, the dynamic balance ability has a strong influence on the walking speed.

[Three cases of drug-induced akathisia due to antiemetics during cancer palliative care].

Three cases of drug-induced akathisia during palliative care in terminal cancer patients were reported. Antiemetics (metoclopramide and prochlorperazine) possessing a central antidopaminergic effect were suspected to have caused the akathisia. Akathisia, as well as extrapyramidal symptoms, is a common and unpleasant complex neurobehavioral adverse effect of conventional antipsychotic drugs. But it is not widely recognized by general clinicians. This syndrome consists of subjective (feeling of inner restlessness, mental unease, or dysphoria and the urge to move) and objective components (restless movement, including rocking on one's feet, walking in position shuffling and tramping the legs,and crossing and uncrossing one's legs while sitting). In severe cases, patients constantly pace up and down in an attempt to relieve the sense of unrest. While the pathophysiology of drug-induced akathisia remains unknown, antagonism of the mesocortical and mesolimbic dopaminergic pathways is a plausible if not completely satisfactory hypothesis. The notion that dopaminergic blockade underlies the emergence of akathisia is supported by the PET studies. Since akathisia is a drug-induced adverse effect, optimal management involves its prevention rather than treatment. Drugs which have been found to have some efficacy in the treatment of akathisia are anticholinergics, beta-blockers, benzodiazepines and clonidine. Though a number of other treatments have been proposed, no trial-based evidences for treatment of akathisia have been available. It is important that akathisia is recognized and treated appropriately as an adverse reaction to drugs and a further increase in antipsychotic medication dosage may further exacerbate the condition.

Surgical correction of congenital lobar emphysema in a dog.

Massive lobar emphysema in the middle lobe of the right lung was observed in a dog brought to our clinic with sudden onset of tension pneumothorax, and lobectomy was performed to excise it. Pathological examination resulted in a diagnosis of congenital bronchiectasis associated with bronchial cartilage hypoplasia. Two cases of diagnosis and successful treatment of congenital lobar emphysema have been reported in dogs.

Growing porcine oocyte-granulosa cell complexes acquired meiotic competence during in vitro culture.

The aim of this study was to establish a culture system to improve the meiotic competence of porcine oocyte-granulosa cell complexes (OGCs) obtained from preantral or early antral follicles. Porcine OGCs were recovered from follicles with diameters of 230-300 (preantral follicles), 300-500, and 500-700 mum (early antral follicles) using scalpels. The OGCs were cultured for 2 weeks in culture medium. We examined the effects of the sizes of the follicles from which OGCs were recovered, the concentrations of polyvinylpyrrolidone (PVP, 0-8%) in the culture medium, and 2 types of culture dish (Falcon 3002 vs 1007) on formation of the antrum of OGCs. After culture, the oocytes were matured for 44 h to assess their meiotic competence. OGCs recovered from small follicles (230-500 microm) required longer (P<0.05) than larger follicles to form the antrum structure. The percentage of OGCs forming the antrum structure that were cultured in 2% PVP (31%) was higher (P<0.05) than for those cultured in other PVP concentrations (0-11%). The percentages of antrum-structure formation for OGCs cultured on Falcon 3002 (83% for 2% PVP and 60% for 4% PVP) were higher (P<0.05) than those cultured on Falcon 1007 (47% for 2% PVP and 9% for 4% PVP). Furthermore, all of the intact oocytes that were obtained from culture of OGCs and that formed an antrum were in the GV stage (n=28). When these immature oocytes were cultured for 44 h, the percentage of oocytes that reached the metaphase II stage (25%, n=68) was higher (P<0.0001) than that of oocytes matured without culture (0.7%, n=137). The results of the present study show that porcine OGCs obtained from preantral or early antral follicles acquire meiotic competence in vitro.