Enhancing Post-Surgical Rehabilitation Outcomes in Patients with Chronic Ankle Instability: Impact of Subtalar Joint Axis Balance Exercises Following Arthroscopic Modified Broström Operation.

Background and Objectives: This study aimed to evaluate the effects of subtalar joint axis-based balance exercises on the anterior talofibular ligament (ATFL) thickness, ankle strength, and ankle stability after an arthroscopic modified Broström operation (AMBO) for chronic ankle instability (CAI). Materials and Methods: The study included 47 patients diagnosed with CAI who underwent AMBO and were randomly divided into three groups: control (n = 11), general balance exercise (n = 17), and subtalar joint axis balance exercise (n = 19), regardless of the affected area. Participants in the exercise rehabilitation group performed exercises for 60 min twice a week for six weeks, starting six weeks after AMBO. ATFL thickness, ankle strength, and ankle dynamic stability were measured using musculoskeletal ultrasonography, Biodex, and Y-balance test, respectively, before and after treatment. Results: Compared with the remaining groups, the subtalar joint axis balance exercise group had reduced ATFL thickness (p = 0.000), improved ankle strength for eversion (p = 0.000) and inversion (p = 0.000), and enhanced ankle stability (p = 0.000). Conclusions: The study results suggest that subtalar joint axis-based balance exercises may contribute to the early recovery of the ankle joint after AMBO.

Nanocrystalline Composite Layer Realized by Simple Sintering Without Surface Treatment, Reducing Hydrophilicity and Increasing Thermal Conductivity.

The surface treatment for a polymer-ceramic composite is additionally performed in advanced material industries. To prepare the composite without a surface treatment, the simplest way to manufacture an advanced ceramic-particle is devised. The method is the formation of a nanocrystalline composite layer through the simple liquid-phase sintering. Using magnesia (MgO) which shows hydrophilicity, a nanocrystalline surface layer is realized by liquid-phase sintering. The amorphous matrix of nanocrystalline composite layer makes MgO hydrophobic and ensures miscibility with polymers, and the nanocrystalline MgO ensures high thermal conductivity. In addition, the liquid phase removes the open pores and makes the surface morphology smooth MgO with smooth surface (MgO-SM). Thermal interface materials (TIM) prepared with MgO-SM and epoxy show a high thermal conductivity of ≈7.5 W m-1 K-1 , which is significantly higher than 4.5 W m-1 K-1 of pure MgO TIM. Consequently, the formation process of a nanocrystalline surface layer utilizing simple liquid-phase sintering is proposed as a fabrication method for a next-generation ceramic-filler. In addition, it is fundamentally identified that the thermal conductivity of MgO depends on the Mg deficiency, and therefore a poly-crystal MgO-SM (produced at a low temperature) has a higher thermal conductivity than a single-crystal MgO (produced at a high temperature).

Effect of passive jaw opening on the electromyographic activity of the temporalis, masseter, digastric, and infrahyoid muscles in healthy adults.

OBJECTIVE: To investigate the surface electromyography (EMG) activity of the temporalis, masseter, digastric, and infrahyoid muscles during passive jaw opening in healthy adults. METHODS: The EMG activity of the masseter, temporalis, digastric anterior belly, and infrahyoid muscles on the right side was recorded during the four jaw-opening tasks: active opening to 20 mm (AO20); active opening to 40 mm (AO40); passive opening to 40 mm with a rubber mouth prop on the right posterior teeth (POR40); and passive opening to 40 mm with a mouth prop on the left posterior teeth (POL40). RESULTS: The EMG amplitude of the digastric anterior belly and infrahyoid muscles in either POL40 or POR40 was significantly less than that in AO20 or AO40, respectively. CONCLUSION: Passive jaw opening reduces the EMG activity of the digastric and infrahyoid muscles significantly and could help reduce the load on these muscles during prolonged mouth-opening conditions.

Microstructure and Texture Evolutions During Deep Drawing of Mg-Al-Mn Sheets at Elevated Temperatures.

Texture and microstructure evolution of ingot and twin-roll casted Mg-Al-Mn magnesium sheets were examined during deep drawing at elevated temperatures. The twin-roll casted sheets possessed smaller grain sizes and weaker basal intensity levels than the ingot-casted sheets. The strength and elongation at room temperature for the twin-roll casted sheets were greater than those of the ingot-casted sheets. At elevated temperatures, the ingot-casted sheets showed better elongation than the twin-roll casted sheets. Different size and density of precipitates were examined using transmission electron microscopy (TEM) for both ingot-casted and twin-roll-casted sheets. The deep drawing process was also carried out at various working temperatures and deformation rates, 225 °C to 350 °C and 30 mm/min to 50 mm/min, respectively. The middle wall part of cups were mainly tensile deformation, and the lower bent regions of drawn cups were most thinned region. Overall, the ingot-casted sheets revealed better deep drawability than the twin-roll casted sheets. Microstructure and texture evolution of the top, middle and lower parts of drawn cups were investigated using electron backscatter diffraction. Increased deformation rate is important to activate tensile twins both near the bent and flange areas. Ingot casted sheets revealed more tensile twins than twin-roll casted sheets. Increased working temperature is important to activate non-basal slips and produce the DRXed grain structure in the flange. Dynamic recrystallization were frequently found in the top flanges of the cups. Both tensile twins and non-basal slips contributed to occurrence of the dynamic recrystallization in the flange.

Repeatability of measurements of surface electromyographic variables during maximum voluntary contraction of temporalis and masseter muscles in normal adults.

This study evaluated the intraexaminer repeatability of measurements of surface electromyography (EMG) variables and functional indices of the myoelectric signals from the masseter and temporalis muscles bilaterally in 15 healthy men. The test was repeated on two different days without templates. The resting muscle activity was recorded once, and two kinds of maximum voluntary contraction (MVC) tasks were performed and recorded three times. The two MVC tasks involved clenching the teeth and biting down on two cotton rolls bilaterally with the posterior teeth. The intraclass correlation coefficient (ICC) of amplitude was >88% and that of frequency was >95% during the two MVC tasks but not under resting conditions. The ICC of the asymmetry and activity indices during the two MVC tasks was >76%. A Bland-Altman analysis revealed no significant difference in amplitude or frequency or in the two indices between the two days during the MVC tasks. In conclusion, the measurements of surface EMG variables and the indices obtained according to the study protocol were highly repeatable in healthy men. Additional studies using templates and intraexaminer measurement errors are warranted in both men and women for complete validation of these findings.

Baduk (the Game of Go) Improved Cognitive Function and Brain Activity in Children with Attention Deficit Hyperactivity Disorder.

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) symptoms are associated with the deficit in executive functions. Playing Go involves many aspect of cognitive function and we hypothesized that it would be effective for children with ADHD. METHODS: Seventeen drug naïve children with ADHD and seventeen age and sex matched comparison subjects were participated. Participants played Go under the instructor's education for 2 hours/day, 5 days/week. Before and at the end of Go period, clinical symptoms, cognitive functions, and brain EEG were assessed with Dupaul's ADHD scale (ARS), Child depression inventory (CDI), digit span, the Children's Color Trails Test (CCTT), and 8-channel QEEG system (LXE3208, Laxtha Inc., Daejeon, Korea). RESULTS: There were significant improvements of ARS total score (z=2.93, p<0.01) and inattentive score (z=2.94, p<0.01) in children with ADHD. However, there was no significant change in hyperactivity score (z=1.33, p=0.18). There were improvement of digit total score (z=2.60, p<0.01; z=2.06, p=0.03), digit forward score (z=2.21, p=0.02; z=2.02, p=0.04) in both ADHD and healthy comparisons. In addition, ADHD children showed decreased time of CCTT-2 (z=2.21, p=0.03). The change of theta/beta right of prefrontal cortex during 16 weeks was greater in children with ADHD than in healthy comparisons (F=4.45, p=0.04). The change of right theta/beta in prefrontal cortex has a positive correlation with ARS-inattention score in children with ADHD (r=0.44, p=0.03). CONCLUSION: We suggest that playing Go would be effective for children with ADHD by activating hypoarousal prefrontal function and enhancing executive function.

Microstructure characterization of ZK60 magnesium alloys using TEM and HR-EBSD.

ZK60 (Mg-Zn-Zr) alloys exhibited a variation in precipitates with aging, and their mechanical properties also changed. Microindentation tests were carried out on two types of ZK60 alloys of solid solution (T4) and peak aging (T6). Microstructure and texture evolution during indentation was investigated using electron backscatter diffraction. Twinning occurred near the indentation marks in most grains. It was found that tensile twinning was dominant, and two twin variants were usually observed. Texture and microstructure evolution by twinning and slip activation was further examined by uniaxial compression test with strain. The initial random orientation gradually changed into basal fibers with strain. Some grains with nonbasal orientations aligned with the loading direction easily underwent twinning followed by slip deformation. Other grains near basal orientations revealed only slip deformation.

Gastrocsoleus fascial release for correction of equinus deformity in residual or relapsed clubfoot.

BACKGROUND: Regardless of the mode of treatment, clubfoot has a strong tendency to relapse, especially hindfoot equinus. Because contraction or shortening of the Achilles tendon causes an equinus deformity of the ankle, release of this tendon is required to correct equinus deformity in patients with residual or relapsed clubfoot. This study assessed the effectiveness of the Vulpius technique in correcting equinus deformity in patients with residual or relapsed clubfoot. METHODS: Of the 80 idiopathic clubfeet treated conservatively using the Ponseti protocol, between March 2000 and July 2008, 32 were found to have residual or relapsed equinus deformity, with 22 feet in 17 patients undergoing Vulpius-type Achilles tendon lengthening. Mean age at the time of surgery was 29 (range, 6 to 52) months, and mean follow-up was 48 (range, 24 to 78) months. Clinical evaluation included the dorsiflexion angle of the ankle and radiographic evaluation included the talocalcaneal and tibiocalcaneal angles on dorsiflexion lateral views. RESULTS: All 22 feet showed satisfactory results at last follow-up, with significant improvements in mean ankle dorsiflexion angle, mean tibiocalcaneal angle, and mean lateral talocalcaneal angle (p < .05 each). CONCLUSION: The Vulpius procedure is an effective surgical procedure for correcting equinus deformity in residual and relapsed clubfeet.

Improving Pb2+ detection using DNAzyme-based fluorescence sensors by pairing fluorescence donors with gold nanoparticles.

For previously reported fluorescence Pb(2+) sensors, DNAzymes have lead to a significant increase in Pb(2+) detecting sensitivity and specificity. However, these sensors suffer from incomplete fluorescence quenching and require additional steps for annealing DNAzymes and substrates as well as for removing the uncoupled substrates. In this study, we successfully overcome these issues by immobilizing the substrate nucleic acids on gold nanoparticles through thiol linkages. The immobilization of the substrate molecules to the gold nanoparticles lead to almost-complete fluorescence quenching and fast Pb(2+) detection, without altering the Pb(2+) specificity of the DNAzymes. After optimizing the concentration of DNAzymes, reaction time and pH, we could detect Pb(2+) as low as 5 nM within 20 min without the preliminary and the post treatments. Considering the multi-color-fluorescence quenching capability of gold nanoparticles and the to-be-developed functional nucleic acids for other metal ions, this study could extend the application of DNAzymes to the detection of multiple heavy metal ions.

Improving immunobinding using oriented immobilization of an oxidized antibody.

Recent technical advances in biorecognition engineering and microparticle fabrication enabled us to develop a single-step purification process using magnetic particles (MPs). The process is simple, efficacious, easy to automate, and economical. The method immobilizes the ligand molecule in a particular orientation on commercial MPs that have surface carboxyl groups. Mouse IgG and anti-mouse IgG antibody were the model capture and ligand molecules for this study. The immunobinding efficacy of anti-mouse IgG antibody using "oriented immobilization" was compared with the efficacy of a conventional amine-coupling system that results in random orientation and of another standard method, the biotin-streptavidin system. The oriented immobilization was accomplished by oxidizing the sugar moiety in the CH(2) domain of the antibody's Fc and covalently conjugating the moiety to the hydrazine-coated MP. The specific binding affinity of the oriented immobilization process was about 2.5 times that of the amine-coupling system, and selectivity from a binary mixture was about 2 times greater for the oriented immobilization method. Results were nearly identical for the biotin-streptavidin system and the oriented immobilization system, matching the calculated binding stoichiometry between mouse IgG and anti-mouse IgG antibody. The binding improvement over the amine-coupling system shown by assay was confirmed by a separate surface plasmon resonance experiment. In summary, the oriented immobilization method was as effective as the streptavidin-biotin system, yet simpler and cost-effective.

Changes of glial Na+-K+ ATPase (alpha 1 subunit) immunoreactivity in the gerbil hippocampus after transient forebrain ischemia.

In the present study to evaluate the effects of ischemia on sodium-potassium adenosine triphosphatase (Na(+)-K+ ATPase) alpha1 subunit (alpha6F) expression in the glia, the immunodensities of both Na(+)-K+ ATPase and the glial fibrillary acidic protein in the hippocampus were measured and analyzed. In the sham hippocampus, alpha6F immunoreactivity was mainly observed in the both the molecular layer and the polymorphic layer of dentate gyrus. At 30 min after ischemic insult, the alpha6F immunoreactivity was markedly decreased in the molecular layer of the dentate gyrus, in contrast to the appearance of this immunoreactivity in the hilar neurons. Up to 12 h after ischemic insult, the alpha6F immunoreactivity was re-enhanced in the molecular layer of dentate gyrus. In addition, the alpha6F immunoreactivity appeared slightly in the glial components in the hippocampal region. Four days after ischemia-reperfusion, the intensity of alpha6F immunoreactivity in the glial cells was highest. At this time point, strong alpha6F immunoreactivity was colocalized with GFAP immunoreactivity in the strata radiatum of the CA1 and the molecular layer of the dentate gyrus. These results suggest that the enhancement of alpha6F immunoreactivity may be a compensatory response to regulate the ion homeostasis in the brain. In addition, the maintenance of Na(+)-K+ ATPase activity in the astrocytes may explain the resistant characteristics of these cells to ischemic insults.

[Intestinal Perforation Due To Infection Of Sparganum Mansoni]

In May 1974, authors encountered a 37 year old Korean male who was suffering from very serious condition of acute abdomen. On exploratory laparotomy, a ruptured granulomatous mass in the proximal portion of the ileum showing extensive inflammatory and gangrenous changes was found and about 4 ft. long of the bowel was resected. From the honey-combed fibrous capsules in the mass, four plerocercoid larvae, spargana, measuring about 3 to 7 cm in lengths were extirpated. The patient had a past history of having eaten the raw flesh of a snake as a tonic about 7 months prior to admission. Four cases of intra-abdominal sparganosis reported previously in Korea and the present case were discussed briefly. Snakes and frogs in Korea are very important second intermediate hosts for the 1arva, Sparganum stage. It is most preferable that the habitual ingestion of the raw fleshes of them should be avoided in this country.