Purpose: To develop a continuous passive motion (CPM) device for the passive motion of the paretic ankle-foot and investigate the effect of continuous passive motion of bedridden, hemiparetic acute stroke patients. Me...Purpose: To develop a continuous passive motion (CPM) device for the passive motion of the paretic ankle-foot and investigate the effect of continuous passive motion of bedridden, hemiparetic acute stroke patients. Methods: 49 patients with stroke were investigated. Results in stroke patients (device group) were compared with those of 15 control subjects (manual group) also with stroke but not treated by device. The period of the treatment was 7 days;the duration was 30 minutes per day by CPM device in the device group. The efficacy of the device was evaluated by scales used in the clinical routine (6th item of National Institutes of Health Stroke Scale (NIHSS), Modified Ashworth Scale (MAS), modified Rankin Scale (mRS)). Ankle’s passive range of motion (PROM) and flexible equinovalgus deformitiy were measured every day with a goniometer. Results: 6th item of NIHSS score improved by -0.76 (SD = 0.56) points in the device group (p < 0.001) compared to the baseline values;the mean change in the manual group was -0.33 (SD = 0.62) points (p = 0.055). The mean of MAS decreased significantly by -0.53 (SD = 1.12) point in the device group (p < 0.001). The ankle’s mean plantar flexion PROM increased by 3.41 (SD = 5.19) degrees in the device group (p < 0.001). Significant improvement of the mean dorsiflexion in the PROM of the ankle was also detected (p = 0.019). The equinovalgus improved significantly by -5.12 (SD = 8.02) degrees (p < 0.001) in the device group. The scores of the mRS also improved significantly in the device group (p < 0.001). Conclusion: In the early phase of rehabilitation, ankle-foot continuous passive motion device treatment combined with manual therapy improved the ankle’s PROM better than manual therapy alone;in addition, device treatment decreased the foot’s equinovalgus, improved the 6th item NIHSS score, and decreased the severity of spasticity.展开更多
Background Despite the accepted utility of delayed enhancement MRI in identi fying irreversible myocardial injury,no study has yet assessed its role as a via bility tool exclusively in the setting of coronary artery b...Background Despite the accepted utility of delayed enhancement MRI in identi fying irreversible myocardial injury,no study has yet assessed its role as a via bility tool exclusively in the setting of coronary artery bypass surgery(CABG), and no study has repeated delayed enhancement MRI late after revascularization. In a clinical trial in which patients underwent CABG by either the off pump or on pump surgical technique, we hypothesized that(1) preoperative delayed enha ncement MRI would have high diagnostic accuracy in predicting viability and (2) the occurrence of perioperative myocardial necrosis would affect late regional w all motion recovery. Methods and Results Fifty two patients undergoing multive ssel CABG were studied by preoperative and early (day 6) and late (6 months) pos toperative cine MRI for global and regional functional assessment and delayed e nhancement MRI for assessment of irreversible myocardial injury. Preoperatively, 611 segments (21%) had abnormal regional function,whereas 421 segments (14%) showed evidence of hyperenhancement. At 6 months after revascularization, 57%(3 43 of 611) of dysfunctional segments improved contraction by at least 1 grade. W hen all preoperative dysfunctional segments were analyzed, there was a strong co rrelation between the transmural extent of hyper enhancement and the recovery in regional function at 6 months (P< 0.001). Of a total of 96 previously dysfunctional but nonenhancing or minimally hyperenhanci ng myocardial segments that did not improve regional function at 6 months, 35(36 %) demonstrated new perioperative hyperenhancement in the early postoperative M RI scan. Conclusions Delayed enhancement MRI is a powerful predictor of myocar dial viability after surgery, suggesting an important role for this technique in clinical viability assessment.展开更多
Mixed connective tissue disease (MCTD) is a rare systemic autoimmune disorder that damages multiple organs simultaneously and is associated with chronic inflammation, in which the signs of systemic sclerosis, systemic...Mixed connective tissue disease (MCTD) is a rare systemic autoimmune disorder that damages multiple organs simultaneously and is associated with chronic inflammation, in which the signs of systemic sclerosis, systemic lupus erythematosus, and polymyositis can co-occur. Its distinctive feature and the basis for the diagnosis of MCTD is the presence of an antibody against the uridine-rich RNP of the cell nucleus (Anti-U1-RNP). It has been observed that intercurrent infections can trigger autoimmune diseases, however, the fact that viral infections—such as SARS-CoV-2—induce them is currently poorly understood. The present study raises the etiological role of the SARS-CoV-2 virus in the development of the disease. Authors describe the case of a 38-year-old patient in good general condition, who was diagnosed with mixed connective tissue disease three months after COVID-19 infection.展开更多
This article focuses on the Israel-Palestine conflict from the Six Day War perspective. The authors try to make a clarification of the Six Day War impact on Israel and its role in the regional and international scenes...This article focuses on the Israel-Palestine conflict from the Six Day War perspective. The authors try to make a clarification of the Six Day War impact on Israel and its role in the regional and international scenes on the one hand, and the war＇s effect on the Arab states, including the Palestinian resistance against Israel, on the other hand. The war changed Israel＇s status from being a small state to becoming one of the most powerful regional powers. While the image of most Arab states was damaged and they lost their confidence among their peoples. The Six Day War changed the balance of power in the Middle East and intensified the Cold War following the end of the war. A climate of war was created and the individuals of both bearings, Israel and Arab countries, prepared for a new war.展开更多
文摘Purpose: To develop a continuous passive motion (CPM) device for the passive motion of the paretic ankle-foot and investigate the effect of continuous passive motion of bedridden, hemiparetic acute stroke patients. Methods: 49 patients with stroke were investigated. Results in stroke patients (device group) were compared with those of 15 control subjects (manual group) also with stroke but not treated by device. The period of the treatment was 7 days;the duration was 30 minutes per day by CPM device in the device group. The efficacy of the device was evaluated by scales used in the clinical routine (6th item of National Institutes of Health Stroke Scale (NIHSS), Modified Ashworth Scale (MAS), modified Rankin Scale (mRS)). Ankle’s passive range of motion (PROM) and flexible equinovalgus deformitiy were measured every day with a goniometer. Results: 6th item of NIHSS score improved by -0.76 (SD = 0.56) points in the device group (p < 0.001) compared to the baseline values;the mean change in the manual group was -0.33 (SD = 0.62) points (p = 0.055). The mean of MAS decreased significantly by -0.53 (SD = 1.12) point in the device group (p < 0.001). The ankle’s mean plantar flexion PROM increased by 3.41 (SD = 5.19) degrees in the device group (p < 0.001). Significant improvement of the mean dorsiflexion in the PROM of the ankle was also detected (p = 0.019). The equinovalgus improved significantly by -5.12 (SD = 8.02) degrees (p < 0.001) in the device group. The scores of the mRS also improved significantly in the device group (p < 0.001). Conclusion: In the early phase of rehabilitation, ankle-foot continuous passive motion device treatment combined with manual therapy improved the ankle’s PROM better than manual therapy alone;in addition, device treatment decreased the foot’s equinovalgus, improved the 6th item NIHSS score, and decreased the severity of spasticity.
文摘Background Despite the accepted utility of delayed enhancement MRI in identi fying irreversible myocardial injury,no study has yet assessed its role as a via bility tool exclusively in the setting of coronary artery bypass surgery(CABG), and no study has repeated delayed enhancement MRI late after revascularization. In a clinical trial in which patients underwent CABG by either the off pump or on pump surgical technique, we hypothesized that(1) preoperative delayed enha ncement MRI would have high diagnostic accuracy in predicting viability and (2) the occurrence of perioperative myocardial necrosis would affect late regional w all motion recovery. Methods and Results Fifty two patients undergoing multive ssel CABG were studied by preoperative and early (day 6) and late (6 months) pos toperative cine MRI for global and regional functional assessment and delayed e nhancement MRI for assessment of irreversible myocardial injury. Preoperatively, 611 segments (21%) had abnormal regional function,whereas 421 segments (14%) showed evidence of hyperenhancement. At 6 months after revascularization, 57%(3 43 of 611) of dysfunctional segments improved contraction by at least 1 grade. W hen all preoperative dysfunctional segments were analyzed, there was a strong co rrelation between the transmural extent of hyper enhancement and the recovery in regional function at 6 months (P< 0.001). Of a total of 96 previously dysfunctional but nonenhancing or minimally hyperenhanci ng myocardial segments that did not improve regional function at 6 months, 35(36 %) demonstrated new perioperative hyperenhancement in the early postoperative M RI scan. Conclusions Delayed enhancement MRI is a powerful predictor of myocar dial viability after surgery, suggesting an important role for this technique in clinical viability assessment.
文摘Mixed connective tissue disease (MCTD) is a rare systemic autoimmune disorder that damages multiple organs simultaneously and is associated with chronic inflammation, in which the signs of systemic sclerosis, systemic lupus erythematosus, and polymyositis can co-occur. Its distinctive feature and the basis for the diagnosis of MCTD is the presence of an antibody against the uridine-rich RNP of the cell nucleus (Anti-U1-RNP). It has been observed that intercurrent infections can trigger autoimmune diseases, however, the fact that viral infections—such as SARS-CoV-2—induce them is currently poorly understood. The present study raises the etiological role of the SARS-CoV-2 virus in the development of the disease. Authors describe the case of a 38-year-old patient in good general condition, who was diagnosed with mixed connective tissue disease three months after COVID-19 infection.
文摘This article focuses on the Israel-Palestine conflict from the Six Day War perspective. The authors try to make a clarification of the Six Day War impact on Israel and its role in the regional and international scenes on the one hand, and the war＇s effect on the Arab states, including the Palestinian resistance against Israel, on the other hand. The war changed Israel＇s status from being a small state to becoming one of the most powerful regional powers. While the image of most Arab states was damaged and they lost their confidence among their peoples. The Six Day War changed the balance of power in the Middle East and intensified the Cold War following the end of the war. A climate of war was created and the individuals of both bearings, Israel and Arab countries, prepared for a new war.
