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1.
Theranostics ; 14(4): 1325-1343, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38389833

RESUMO

Rationale: Non-invasive transcranial direct current stimulation (tDCS), a promising stimulation tool to modulate a wide range of brain disorders, has major limitations, such as poor cortical stimulation intensity and focality. We designed a novel electrode for tDCS by conjugating a needle to a conventional ring-based high-definition (HD) electrode to enhance cortical stimulation efficacy. Method: HD-tDCS (43 µA/mm2, charge density 51.6 kC/m2, 20 min) was administered to male C57BL/6J mice subjected to early-stage ischemic stroke. Behavioral tests were employed to determine the therapeutic effects, and the underlying mechanisms of HD-tDCS were determined by performing RNA sequencing and other biomedical analyses. Results: The new HD-tDCS application, showing a higher electric potential and spatial focality based on computational modeling, demonstrated better therapeutic effects than conventional HD-tDCS in alleviating motor and cognitive deficits, with a decrease in infarct volume and inflammatory response. We assessed different electrode configurations in the new HD electrode; the configurations variously showed potent therapeutic effects, ameliorating neuronal death in the peri-infarct region via N-methyl-D-aspartate-dependent sterol regulatory element-binding protein 1 signaling and related inflammatory factors, further alleviating motor and cognitive deficits in stroke. Conclusion: This new HD-tDCS application showed better therapeutic effects than those with conventional HD-tDCS in early-stage stroke via the amelioration of neuronal death in the penumbra. It may be applied in the early stages of stroke to alleviate neurological impairment.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Estimulação Transcraniana por Corrente Contínua , Masculino , Animais , Camundongos , Camundongos Endogâmicos C57BL , Acidente Vascular Cerebral/terapia , Eletrodos , Infarto
2.
J Clin Med ; 13(4)2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38398408

RESUMO

(1) Background: Unruptured intracranial aneurysm (UIA) occurs in 1-2% of the population and is being increasingly detected. Patients with UIA are treated with close observation, endovascular coiling or surgical clipping. The proportion of endovascular coiling has been rising. However, complications such as cerebral infarction (CI), intracranial hemorrhage (ICRH), and death remain crucial issues after coil treatment. (2) Methods: We analyzed the incidence and risk factors of complications after the use of coil in patients with UIA based on the patients' characteristics. We utilized the Health Insurance Review and Assessment (HIRA) database. Patients treated with coils for UIA between 1 January 2015 and 1 December 2021 were retrospectively analyzed. (3) Results: Of the total 35,140 patients, 1062 developed ICRH, of whom 87 died, with a mortality rate of 8.2%. Meanwhile, 749 patients developed CI, of whom 29 died, with a mortality rate of 3.9%. The overall mortality rate was 1.8%. In a univariate analysis of the risk factors, older age, males, a higher Charlson Comorbidity Index (CCI) score, and diabetes increase the risk of CI. Meanwhile, males with higher CCI scores and hemiplegia or paraplegia show increased ICRH risk. Older age, males and metastatic solid tumors relate to increased mortality risk. (4) Conclusions: This study is significant in that the complications based on the patient's underlying medical condition were analyzed.

3.
Anal Sci ; 40(5): 853-861, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38246930

RESUMO

To minimize background interference in electrochemical enzymatic biosensors employing electron mediators, it is essential for the electrochemical oxidation of electroactive interfering species (ISs), such as ascorbic acid (AA), to proceed slowly, and for the redox reactions between electron mediators and ISs to occur at a low rate. In this study, we introduce a novel combination of a working electrode and an electron mediator that effectively mitigates interference effects. Compared to commonly used electrodes such as Au, glassy carbon, and indium tin oxide (ITO), boron-doped diamond (BDD) electrodes demonstrate significantly lower anodic current (i.e., lower background levels) in the presence of AA. Additionally, menadione (MD) exhibits notably slower reactivity with AA compared to other electron mediators such as Ru(NH3)63+, 4-amino-1-naphthol, and 1,4-naphthoquinone, primarily due to the lower formal potential of MD compared to AA. This synergistic combination of BDD electrode and MD is effectively applied in three biosensors: (i) glucose detection using electrochemical-enzymatic (EN) redox cycling, (ii) glucose detection using electrochemical-enzymatic-enzymatic (ENN) redox cycling, and (iii) lactate detection using ENN redox cycling. Our developed approach significantly outperforms the combination of ITO electrode and MD in minimizing IS interference. Glucose in artificial serum can be detected with detection limits of ~ 20 µM and ~ 3 µM in EN and ENN redox cycling, respectively. Furthermore, lactate in human serum can be detected with a detection limit of ~ 30 µM. This study demonstrates sensitive glucose and lactate detection with minimal interference, eliminating the need for (bio)chemical agents to remove interfering species.


Assuntos
Boro , Diamante , Técnicas Eletroquímicas , Eletrodos , Glucose , Ácido Láctico , Vitamina K 3 , Diamante/química , Vitamina K 3/química , Boro/química , Glucose/análise , Glucose/química , Ácido Láctico/análise , Ácido Láctico/química , Técnicas Biossensoriais , Elétrons , Humanos , Oxirredução
4.
Biomed Eng Lett ; 13(3): 407-415, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37519870

RESUMO

Recently, we introduced a current limiter-based novel transcranial direct-current stimulation (tDCS) device that does not generate significant tDCS-induced electrical artifacts, thereby facilitating simultaneous electroencephalography (EEG) measurement during tDCS application. In this study, we investigated the neuromodulatory effect of the tDCS device using resting-state EEG data measured during tDCS application in terms of EEG power spectral densities (PSD) and brain network indices (clustering coefficient and path length). Resting-state EEG data were recorded from 10 healthy subjects during both eyes-open (EO) and eyes-closed (EC) states for each of five different conditions (baseline, sham, post-sham, tDCS, and post-tDCS). In the tDCS condition, tDCS was applied for 12 min with a current intensity of 1.5 mA, whereas tDCS was applied only for the first 30 s in the sham condition. EEG PSD and brain network indices were computed for the alpha frequency band most closely associated with resting-state EEG. Both alpha PSD and network indices were found to significantly increase during and after tDCS application compared to those of the baseline condition in the EO state, but not in the EC state owing to the ceiling effect. Our results demonstrate the neuromodulatory effect of the tDCS device that does not generate significant tDCS-induced electrical artifacts, thereby allowing simultaneous measurement of electrical brain activity. We expect our novel tDCS device to be practically useful in exploring the impact of tDCS on neuromodulation more precisely using ongoing EEG data simultaneously measured during tDCS application.

5.
J Cerebrovasc Endovasc Neurosurg ; 25(1): 69-74, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37006183

RESUMO

Subarachnoid hemorrhage (SAH) due to ruptured posterior cerebral artery (PCA) intracranial arterial dolichoectasia (IADE) is very rare. As these lesions are difficult to treat microsurgically, neurointervention is preferred because the dolichoectatic artery does not have a clear neck, and the surgical field of view was deep seated with the SAH. However, in some cases, neurointervention is difficult due to anatomical variation of the blood vessel to access the lesion. In this case, a 30-year-old male patient presented with a ruptured PCA IADE and an aortic arch anomaly. Aortic arch anomalies render it difficult to reach the ruptured PCA IADE via endovascular treatment. The orifice of the vertebral artery (VA) was different from the usual cases, so it was difficult to find the entrance. After only finding the VA and arriving at the lesion along the VA, trapping was performed. Herein, we report the PCA IADE with aortic arch anomaly endovascular treatment methods and results.

6.
Healthcare (Basel) ; 11(8)2023 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-37107902

RESUMO

Automatic age estimation using panoramic dental radiographic images is an important procedure for forensics and personal oral healthcare. The accuracies of the age estimation have increased recently with the advances in deep neural networks (DNN), but DNN requires large sizes of the labeled dataset which is not always available. This study examined whether a deep neural network is able to estimate tooth ages when precise age information is not given. A deep neural network model was developed and applied to age estimation using an image augmentation technique. A total of 10,023 original images were classified according to age groups (in decades, from the 10s to the 70s). The proposed model was validated using a 10-fold cross-validation technique for precise evaluation, and the accuracies of the predicted tooth ages were calculated by varying the tolerance. The accuracies were 53.846% with a tolerance of ±5 years, 95.121% with ±15 years, and 99.581% with ±25 years, which means the probability for the estimation error to be larger than one age group is 0.419%. The results indicate that artificial intelligence has potential not only in the forensic aspect but also in the clinical aspect of oral care.

8.
Clin Neurol Neurosurg ; 222: 107464, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36201897

RESUMO

OBJECTIVE: This study aimed to compare treatment outcomes between patients who received Stent-retriever thrombectomy (SRT) and those who received first stenting without retrieval (FRESH) for treating emergent large vessel occlusion (ELVO) due to underlying intracranial atherosclerotic stenosis (ICAS). METHODS: Consecutive patients with intracranial ELVO who underwent endovascular treatment at Yeungnam University Medical Center between January 2017 and December 2020 were retrospectively selected. ICAS-related ELVO was defined based on a remnant stenosis of > 70 % or a lesser degree of stenosis with a tendency toward reocclusion and/or flow impairment during endovascular treatment. The patients with ICAS-related ELVO were divided into two groups: SRT and FRESH. RESULTS: 62 consecutive patients with ELVO due to ICAS were enrolled in this study. Among the 62 patients, 32 (51.6 %) underwent SRT, whereas 30 (48.4 %) patients underwent FRESH. There were no significant intergroup differences in the rate of successful reperfusion. However, symptomatic intracranial hemorrhage was significantly more common in the SRT group than in the FRESH group (18.8 % vs. 0 %; odds ratio [OR]: 14.962, 95 % confidence interval [CI]: 0.804-278.311, p = 0.024). Favorable functional outcomes were significantly more frequent in the FRESH group (93.3 % vs. 40.6 %, OR: 20.462, 95 % CI: 4.137-101.21, p < 0.001). The multivariate logistic analysis showed that FRESH (OR: 7.243 [95 % CI: 1.095-47.91]; p = 0.040) was an independent predictor of favorable functional outcomes. CONCLUSION: FRESH could be a feasible solution when considering procedural simplicity and focusing on the cause of occlusion.


Assuntos
Procedimentos Endovasculares , Arteriosclerose Intracraniana , Acidente Vascular Cerebral , Humanos , Arteriosclerose Intracraniana/complicações , Arteriosclerose Intracraniana/cirurgia , Acidente Vascular Cerebral/terapia , Constrição Patológica/cirurgia , Constrição Patológica/etiologia , Estudos Retrospectivos , Trombectomia/efeitos adversos , Resultado do Tratamento , Stents/efeitos adversos , Procedimentos Endovasculares/efeitos adversos
9.
Sci Rep ; 12(1): 18036, 2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36302864

RESUMO

In this study, we presented flat-topped coherent supercontinuum lasers with tunable repetition rates and programmable spectral bandwidths. Supercontinuum sources with ultra-broadband and high-repetition-rate coverage can be achieved by merging nonlinearly broadened electro-optic optical frequency combs with optical line-by-line spectrum shaping. Spectral bandwidth programming is implemented by iterative spectrum shaping and input power control of highly nonlinear stages, whereas repetition rate tuning is performed by modulation speed control in optical frequency combs. Herein, we implemented a programmable and tunable flat-topped supercontinuum with a maximum bandwidth and repetition rate of 55 nm at 10 dB and 50 GHz, respectively. To clarify the coherence of the supercontinuum during tuning and programming, we performed a phase-noise analysis. We proposed a remarkably modified self-heterodyne method to measure the phase noise of each mode precisely by filtering specific supercontinuum taps in a Mach-Zehnder interferometer. With this method, it has been proved that the single-sideband spectra in each mode are almost similar to that of the RF clock, indicating that our programmable and tunable supercontinuum generation process added minimal degradation to the phase noise properties. This study shows possibilities for generating hundreds of programmable and tunable flat-topped optical carriers with robustness and coherence.

10.
Nutrients ; 14(17)2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36079772

RESUMO

Recently, a therapeutic method to stimulate the suprahyoid muscle using peripheral magnetic stimulation for dysphagia rehabilitation has been reported. However, clinical evidence, application protocol, and intervention method remain unclear. Therefore, a systematic review of the published literature is needed. The objective of this study was to systematically review clinical studies of peripheral magnetic stimulation applied for rehabilitation of dysphagia. Issues to be considered in future studies are also suggested. This systematic review performed a literature search of four databases (Medline, Embase, CINAHL, and Web of Science) to identify relevant studies published on the application of repetitive peripheral magnetic stimulation (rPMS) for swallowing-related muscles between 2010 and 2022. Seven studies were reviewed. Randomized controlled trials and one-group pre-post, case study designs were included. In the included studies, rPMS was applied to strengthen the submental suprahyoid muscles. The intervention regime varied. The rPMS was applied at a frequency of 30 Hz for 2 s. Rest time ranged from 8 s to 27-28 s. The number of intervention sessions ranged from 2-3 to 30. The intensity ranged from pain-inducing minimum intensity (90% of maximum stimulus output) to non-painful intensity (70-80% of maximum intensity). The rPMS on the suprahyoid muscles had positive effects on physiological changes in the swallowing function, such as displacement of the hyoid bone, muscle strength (cervical flexor, jaw-opening force), swallowing safety, swallowing performance, and swallowing-related quality of life. Participants also reported little pain and adverse reactions during rPMS. Although rPMS is a therapeutic option that can help improve the swallowing function as a non-invasive stimulation method in the rehabilitation of dysphagia, clinical evidence is needed for the development of clear stimulation protocols and guidelines.


Assuntos
Transtornos de Deglutição , Reabilitação do Acidente Vascular Cerebral , Deglutição , Transtornos de Deglutição/terapia , Humanos , Fenômenos Magnéticos , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral/métodos
11.
Healthcare (Basel) ; 9(12)2021 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-34946431

RESUMO

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653], p < 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003], p < 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909], p < 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients.

12.
Small Methods ; 5(7): e2100215, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34928005

RESUMO

The use of a conducting interlayer between separator and cathode is one of the most promising methods to trap lithium polysulfides (LiPSs) for enhancing the performance of lithium-sulfur (Li-S) batteries. Red phosphorus nanoparticles (RPEN )-coated carbon nanotube (CNT) film (RPEN @CF) is reported herein as a novel interlayer for Li-S batteries, which shows strong chemisorption of LiPSs, good flexibility, and excellent electric conductivity. A pulsed laser ablation method is engaged for the ultrafast production of RPEN of uniform morphology, which are deposited on the CNT film by a direct spinning method. The RPEN @CF interlayer provides pathways for effective Li+ and electron transfer and strong chemical interaction with LiPSs. The S/RPEN @CF electrode shows a superior specific capacity of 782.3 mAh g-1 (3 C-rate) and good cycling performances (769.5 mAh g-1 after 500 cycles at 1 C-rate). Density functional theory calculations reveal that the morphology and dispersibility of RPEN are crucial in enhancing Li+ and electron transfer kinetics and effective trap of LiPSs. This work demonstrates the possibility of using the RPEN @CF interlayer for the enhanced electrochemical performances of Li-S batteries and other flexible energy storage devices.

13.
J Cerebrovasc Endovasc Neurosurg ; 23(1): 35-40, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33494557

RESUMO

Cavernous sinus (CS) lesion is hard to access by surgical approach. With the development of endovascular technique, neurointerventional therapy is an alternative modality for CS lesions. This endovascular technique has been widely used for the past decade, avoiding the risks associated with surgical treatment. However, complications can still arise from coil embolization. Although immediate complication associate with embolic event or mass effect has been well described, but delayed (>1 year from treatment) nerve palsy after coil embolization is rare. We report two cases of delayed cranial nerve palsy after successful endovascular coil embolization in CS lesion.

14.
J Neurosurg ; 135(4): 1091-1099, 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33513579

RESUMO

OBJECTIVE: The optimal treatment for underlying intracranial atherosclerosis (ICAS) in patients with emergent large-vessel occlusion (ELVO) remains unclear. Reocclusion during endovascular treatment (EVT) occurs frequently (57.1%-77.3%) after initial recanalization with stent retriever (SR) thrombectomy in ICAS-related ELVO. This study aimed to compare treatment outcomes of the strategy of first stenting without retrieval (FRESH) using the Solitaire FR versus SR thrombectomy in patients with ICAS-related ELVO. METHODS: The authors retrospectively reviewed consecutive patients with acute ischemic stroke and intracranial ELVO of the anterior circulation who underwent EVT between January 2017 and December 2019 at Yeungnam University Medical Center. Large-vessel occlusion (LVO) of the anterior circulation was classified by etiology as follows: 1) no significant stenosis after recanalization (embolic group) and 2) remnant stenosis > 70% or lesser degree of stenosis with a tendency toward reocclusion and/or flow impairment during EVT (ICAS group). The ICAS group was divided into the SR thrombectomy group (SR thrombectomy) and the FRESH group. RESULTS: A total of 105 patients (62 men and 43 women; median age 71 years, IQR 62.5-79 years) were included. The embolic, SR thrombectomy, and FRESH groups comprised 66 (62.9%), 26 (24.7%), and 13 (12.4%) patients, respectively. There were no significant differences between the SR thrombectomy and FRESH groups in symptom onset-to-door time, but puncture-to-recanalization time was significantly shorter in the latter group (39 vs 54 minutes, p = 0.032). There were fewer stent retrieval passes but more first-pass recanalizations in the FRESH group (p < 0.001). Favorable functional outcomes were significantly more frequent in the FRESH group (84.6% vs 42.3%, p = 0.017). CONCLUSIONS: This study's findings suggest that FRESH, rather than rescue stenting, could be a treatment option for ICAS-related ELVO.

15.
J Cerebrovasc Endovasc Neurosurg ; 23(1): 1-5, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33086456

RESUMO

OBJECTIVE: If the size of an intracranial aneurysm is below 3 mm, clinicians rarely treat them because of the low risk of rupture. But subarachnoid hemorrhage (SAH) due to the rupture of very small intracranial aneurysm (VSIA) (saccular aneurysm sized less than 3 mm) may lead to many critical neurological complications. So we analyzed the characteristics and differences between the ruptured VSIA group and the ruptured non-VSIA group. METHODS: 421 saccular aneurysms from patients with SAH between January 2016 and December 2019 were included. Patient information including age, sex, and medical history and information about the aneurysm including location, size, aspect ratio, inflow angle, and height-width ratio were collected. And we compared the VSIA group with non-VSIA group about these characteristics. RESULTS: 12.1% (51/421) of the aneurysms were included in the VSIA group, while the non-VSIA group consisted of 87.9% of the aneurysms (370/421). The female predominance was significantly higher in the VSIA group than that in the non-VSIA group (p=0.011). No significant difference was observed in location, medical history, height-width ratio between the groups. The mean value of the inflow angle in the VSIA group was much lower than that in the non-VSIA group, but no statistically significant association between rupture risk and the inflow angle was observed. The average aspect ratio was significantly lower than that in the non-VSIA group. CONCLUSIONS: Ruptured VSIA group has higher percentage of females and lower aspect ratio than ruptured non-VSIA group. Further studies regarding the characteristics of ruptured and unruptured VSIA patients is required for assistance in clinical decision related to treatment of VSIA group before the aneurysmal sac rupture.

16.
J Craniofac Surg ; 32(1): e60-e62, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32858613

RESUMO

BACKGROUND: Decompressive craniectomy (DC) is the last-resort surgical procedure to reduce intracranial pressure and prevent secondary brain injury. Additional resection of the temporalis muscle and fascia can achieve a higher extracranial herniation volume compared to the standard DC technique at the expense of cosmetic problems for the patients. Various methods have been used to augment temporal fossa hollowing. METHODS: To improve the cosmetic outcome, the authors report a patient who had a skull defect restored using a precisely shaped implant engineered via a computer using the opposite temporalis muscle as a mirror image. Polyether-ether-ketone cranioplasty was performed for the 52-year-old man with temporal hollowing after DC with resection of the temporalis muscle and fascia, due to a ruptured cerebral arteriovenous fistula. RESULTS: The shape of the patient's surgical side was restored and not asymmetrical. The patient was very satisfied. CONCLUSION: In the case of cranioplasty (CP) in patients with DC with resection of the temporalis muscle, CP with implants that include the opposite muscle may increase patient satisfaction without the risk of additional complications.


Assuntos
Craniectomia Descompressiva , Implantes Dentários , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Procedimentos de Cirurgia Plástica , Estudos Retrospectivos , Crânio/cirurgia , Músculo Temporal/cirurgia , Resultado do Tratamento
17.
Dysphagia ; 36(1): 73-82, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32279120

RESUMO

Videofluoroscopic swallowing study (VFSS) is generally used to diagnose dysphagia and oropharyngeal aspiration during swallowing movement. Patients and bolus-feeding operators (such as occupational therapist and speech language pathologist) may undergo multiple VFSS procedure, placing them at risk for more radiation exposure due to increased scan time. The present study investigated the dose-area product, effective dose of various protocols, and summarized dose reports from various studies of VFSS. The PubMed database searched for relevant publications reporting radiation dose in the VFSS procedure. 13 articles were selected to be reviewed. This systematic review involved 13 peer-reviewed articles that reported the specific dose of the VFSS procedure. The articles were categorized into three types: operator radiation dose, adult patient radiation dose, and pediatric radiation dose. The operator dose reports showed that the operators' scattering exposure, equivalent dose (across the whole body, eyes, and hands), and annual effective dose were significantly lower than the annual dose limit of 20 mSv. Both adult and pediatric patient dose reports showed that the effective dose, which was estimated from recorded dose-area product, was significantly lower than the annual background exposure of 2.4 mSv in various protocols. The present literature review suggested that the radiation dose of VFSS by modified barium swallowing is acceptable in both operators and patients. However, various radiation protection strategies should be conducted during the procedure to reduce the risk of stochastic effect.


Assuntos
Transtornos de Deglutição , Exposição à Radiação , Adulto , Criança , Deglutição , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Fluoroscopia , Humanos , Doses de Radiação , Exposição à Radiação/efeitos adversos , Exposição à Radiação/análise
19.
J Shoulder Elbow Surg ; 30(7): 1527-1536, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33157240

RESUMO

BACKGROUND: Fractures of the anteromedial facet of the coronoid in posteromedial rotatory instability of the elbow are classified into 3 subtypes based on their location. The purpose of this study was to analyze the fracture morphology of anteromedial facet fractures in their 3 subtypes (anteromedial rim, anteromedial rim + tip, and anteromedial rim + sublime tubercle [±tip]). METHODS: Three-dimensional computed tomography remodeling was used to evaluate anteromedial facet fractures in a consecutive series of 40 patients, all of whom were affected by posteromedial rotatory instability of the elbow. Characteristics of the fractures, including the number of fragments, size of fragments, plane of the fracture line, and involvement of the sublime tubercle and radial notch, were measured for each subtype of the anteromedial facet fractures. RESULTS: Each subtype had a typical fracture pattern and distinct size. The fracture subtype 1 showed a single-fragment fracture, subtype 2 showed either a single- or dual-fragment fracture, and subtype 3 showed either a dual- or triple-fragment fracture. The angle between the fracture line and the coronal plane was greatest in subtype 3 fractures. The surface area of the fragment was largest in subtype 3 fractures. The percentages of articular involvement of the sublime tubercle were 0% in subtype 1, 47% in subtype 2, and 79% in subtype 3. The percentages of articular involvement of the radial notch were 0% in subtype 1, 7% in subtype 2, and 8% in subtype 3. CONCLUSION: Analysis with quantitative 3-dimensional computed tomography showed the characteristic morphology of each subtype of anteromedial facet fracture. Subtype 1 comprised 1 fragment with the smallest fragment size. Subtype 2 was a single- or dual-fragment fracture, the size of which should be considered in the treatment plan. Subtype 3 was a large fragment comprising the sublime tubercle. Our findings are significant because they highlight unique fracture morphology that may help surgeons to distinguish one fracture subtype from another in clinical practice.


Assuntos
Articulação do Cotovelo , Fraturas Ósseas , Fraturas da Ulna , Cotovelo , Articulação do Cotovelo/diagnóstico por imagem , Humanos , Tomografia Computadorizada por Raios X , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia
20.
Healthcare (Basel) ; 8(4)2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33086705

RESUMO

BACKGROUND: It has recently been shown that suprahyoid muscle exercise using kinesiology taping (KT) increases the activation of the suprahyoid muscle in healthy adults, suggesting a potential therapeutic clinical exercise for dysphagia rehabilitation. This study investigated the effect of dysphagia rehabilitation using KT in stroke patients with dysphagia. METHODS: Thirty subjects in South Korea were enrolled in this prospective placebo-controlled double-blind study. Participants were randomly assigned to the experimental and sham groups. In the experimental group, the tape was attached to the hyolaryngeal complex, pulled downward with approximately 70% tension, and then attached to the sternum and the clavicle bilaterally. In the sham group, the tape was applied similarly but without the tension. Both groups performed voluntary swallowing 50 times (10 times swallowing per set, times 5 sets) a day for 4 weeks with KT applied. Outcome measures were assessed using portable ultrasound equipment. The parameter measured was the change in thickness of the tongue muscle, mylohyoid muscle, and the anterior belly of the digastric muscle. RESULTS: The experimental group showed statistically significant changes in the thickness of the tongue muscle, mylohyoid muscle, and anterior belly of the digastric muscle than the sham group (p = 0.007, 0.002, and 0.001). CONCLUSION: Dysphagia rehabilitation using KT is a technique that may promote oropharyngeal muscle thickness in patients with dysphagia after stroke.

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