OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)...OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)and to explore factors that influence treatment effect.METHODS:A total of 55 patients with degenerative scoliosis received 4 weeks of SM.After treatment,patients were divided into two groups:the remission group(VAS score<40 mm)and the non-remission group(VAS score≥40 mm).Pre-versus post-treatment VAS scores,Cobb angles,SVA,and AVR were compared in each group and in the total population.Baseline data(sex,age,symptom characteristics,duration of symptoms,VAS score,Cobb angle,SVA,and AVR)were compared between groups.Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS:No changes were found in the Cobb angle(P=0.722)or AVR(P=0.424)after intervention in the overall population.However,the SVA(P<0.001)and VAS score(P=0.000)changed significantly after treatment.Similar changes were observed in the remission group(n=29).Multiple linear regression revealed that the only factors influencing treatment effect were symptom characteristics,SVA,and VAS score.CONCLUSION:SM relieved pain and improved sagittal imbalance in patients with degenerative scoliosis.It did not lessen the severity of coronal curvature or vertebral rotation.Factors influencing the effect of SM included symptom characteristics,VAS score,and SVA.A larger randomized trial is needed to further confirm our results.展开更多
Scoliosis is a musculoskeletal disorder manifested as a three-dimensional spinal deformity. It affects 2% - 3% of the adolescent population. The conventional method to diagnose scoliosis is to measure the Cobb angle f...Scoliosis is a musculoskeletal disorder manifested as a three-dimensional spinal deformity. It affects 2% - 3% of the adolescent population. The conventional method to diagnose scoliosis is to measure the Cobb angle from posteroante-rior radiograph. Since radiation exposure is not desirable for patients, other non-ionizing methods have been explored. Among all the non-ionization methods, ultrasound (US) is a potential cost-effective method. However, our understand-ing of US interaction with the vertebrae or the spine is limited. The purpose of this study was to demonstrate the ability of US to identify bony landmarks for measuring spinal deformity. This study used a phased array US system with a 5 MHz transducer and a position encoder. In-vitro experiment on a cadaver vertebra and a pilot clinical study were carried out. The in-vitro experimental results showed that the lamina and spinous process were strong reflectors from the single vertebra. Less than 4% of error occurred on the dimension measurements. The pilot study was performed on a healthy subject and a scoliotic patient. The results indicated the lamina and spinous process could be identified and the curvature of the spine could be estimated using the reflectors. The difference of the curvature angle of the spine measured from the radiograph and the US images was 2?. These results have illustrated that US is a promising tool to measure curvature of spinal deformity and study scoliosis.展开更多
Objective To introduce a novel Cobb protractor and assess its reliability and rapidity for measuring Cobb angle in scoliosis patients. Methods The novel Cobb protractor had two endplate markers. A measurement was perf...Objective To introduce a novel Cobb protractor and assess its reliability and rapidity for measuring Cobb angle in scoliosis patients. Methods The novel Cobb protractor had two endplate markers. A measurement was performed just to align the two markers to each endplate of the curve. The Cobb angle on the posteroanterior radiographs of 24 patients clinically diagnosed with adolescent idiopathic scoliosis was measured by three orthopedic surgeons with both standard Cobb method and the new technique, and the time of measurement was recorded. Intraclass correlation coefficients(ICCs) were calculated to assess the reliability of the new method. Results The time for a measurement with the new tool was approximately 10 seconds less than the time that used to finish a measurement with the standard method(P<0.05). The overall mean Cobb angle for the major curve of the 24 patients was 47.8°. The mean overall intraobserver and interobserver ICC was 0.971 and 0.971 for the Cobb method group, while the overall intraobserver ICC and the interobserver was 0.985 and 0.979 for the new tool group. Conclusions The novel Cobb protractor could perform quick measurement and measure almost all forms of radiographs. The Cobb protractor might be an ideal instrument to measure the Cobb angle.展开更多
AIM To find accompanying anomalies of typical and atypical Scheuermann's disease(SD) is reported in the present study. METHODS Study included 20 patients(16 men and 4 women) who had radiological imaging radiograph...AIM To find accompanying anomalies of typical and atypical Scheuermann's disease(SD) is reported in the present study. METHODS Study included 20 patients(16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging(MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI.RESULTS Age of the patients ranged from 11.0 to 23.0(mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2(mean 55.5 ± 8.7) in typical Scheuermann's patients and 24.7-49.9(mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8(mean 5.3 ± 1.6) and 7-9(mean 8.2 ± 0.8) in typical and atypical Scheuermann's patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs(mean 4.1 ± 1.7) in typical patients and 5-10 discs(mean 7.6 ± 1.9) in atypical patients.CONCLUSION SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases,herniations and cord pathologies such as syringomyelia can accompany SD(albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.展开更多
To investigate the effects ofMoringa oleifera leaf meal （MOLM） on the performance and haematology of broiler finisher using 120 Cobb chicks of 4 weeks old broiler chicks. The birds were assigned randomly into four d...To investigate the effects ofMoringa oleifera leaf meal （MOLM） on the performance and haematology of broiler finisher using 120 Cobb chicks of 4 weeks old broiler chicks. The birds were assigned randomly into four dietary treatments containing MOLM at 0, 6%, 8%, and 10% （treatments 1, 2, 3 and 4） inclusion levels, respectively, in a complete randomized design experiment. The effect of the dietary treatments on the growth performance and blood parameters of the broiler finisher was determined. MOLM at a rate of 6% （T2）, 8% （T3）, and 10% （T4） of the diets （as fed basis） to replace 3.2%, 5.6% and 8.6% of the crude protein （CP） of the control diet. The daily feed, dry matter and CP intake of the chicks fed MOLM diets were higher （p〈0.05） than those fed the control diet. Average weight gain （AWG） of birds fed MOLM diets reduced as inclusion levels increases 09〈0.05） than those fed the control diet. Chicks fed T2 showed higher （p〈0.05） AWG than those on T3 and T4. Feed conversion ratios （FCR, weight gain/g and feed intake） were higher for chicks fed MOLM. MOLM showed minimal deleterious effects in birds. However, birds fed T2 （6%） diets recorded significantly （p〈0.05） the highest body weight gain. There were significant differences （p〈0.05） among groups in packed cell volume （PVC） of birds. The haemoglobin （Hb）, mean corpuscular volume （MCV）, mean corpuscular haemoglobin （MCH） and mean corpuscular haemoglobin concentration （MCHC） counts showed no significant difference （p〉0.05） among treatments. The results indicated that at 10% in the diets of broiler finisher chick, MOLM could be substituted with expensive conventional protein sources without any deleterious effects on performance and blood parameters of broiler finisher chicken.展开更多
Cobb syndrome, also known as cutaneo-meningospinal angiomatosis, is a rare clinical entity characterized by the combination of a vascular skin nevus and an angioma in the spinal canal at the same metamere. 1 It was f...Cobb syndrome, also known as cutaneo-meningospinal angiomatosis, is a rare clinical entity characterized by the combination of a vascular skin nevus and an angioma in the spinal canal at the same metamere. 1 It was first described by Berenbruch in 1890 and did not receive recognition until Cobb’s description 2 in 1915. Only few documents about this disease had been reported. 1 We present two cases here and review the other reported cases.展开更多
This study aims to evaluate and compare the fertilizing effects of fish-breeding water and river water combined or not with composted poultry manure on the growth and production of okra and lettuce crops. Thus, a samp...This study aims to evaluate and compare the fertilizing effects of fish-breeding water and river water combined or not with composted poultry manure on the growth and production of okra and lettuce crops. Thus, a sample of 2000 Nile tilapia Oreochromis niloticus fry and a sample of 100 Cobb 500 strain chicks were reared and monitored for six months and fifteen days. Poultry manure and fish-breeding water were then collected and used to fertilize and water okra and lettuce crops. Two systems were used for the crops (okra and lettuce) tested in an elementary plot design with replicates for each treatment (T1: fish-breeding water alone;T2: river water alone;T3: fish-breeding water combined with manure;T4: river water combined with manure). Morphometric parameters and phenological traits of okra and lettuce crops as well as the total harvest weight and production yield were evaluated and compared between treatments. The results reveal better growth and higher yields (0.67 kg/m<sup>2</sup> vs. 0.45 kg/m<sup>2</sup>) of okra crops that received treatment T1 compared to T2. The best growth and yields of lettuce were obtained with treatments T3 (3.34 kg/m<sup>2</sup>) and T1 (1.89 kg/m<sup>2</sup>) compared to T4 (1.23 kg/m<sup>2</sup>) and T2 (1.20 kg/m<sup>2</sup>). These results show that fish-breeding water combined with poultry manure can boost okra and lettuce production and would be a real asset to stimulate local agricultural development. Thus, the adoption of such an agro-ecological approach integrating fish farming and animal husbandry could increase local production and provide food of good nutritional quality.展开更多
AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language a...AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language articles fulfilled the criteria for inclusion to the study and based on the contents on these articles a management strategy was formulated. Age at presentation ranged from 42 to 80 years with no sex or racial predisposition. Most patients with IMH have no systemic disease but a higher incidence had been reported in patients with diabetes mellitus, myotonic dystrophy, chronic obstructive pulmonary disease (COPD) and several other systemic and ophthalmic co-morbidities. Most patients remained asymptomatic until they experienced a sudden blurring of vision due to a hyphaema. Some patients only develop a self-limiting single episode of hyphaema and therefore the laser or surgical photocoagulation of iris should be reserved for the cases complicated with recurrent hyphaema. In some patients, several laser photoco-agulation sessions may be needed and the recurrent iris vascular tufts may require more aggressive treatment. Iris fluorescein angiography (IFA) is useful in identifying the true extent of the disease and helps to improve the precision of the laser treatment. Surgical excision (iridectomy) should only be considered in patients who fail to respond to repeated laser treatment. In some cases IMHs has been initially misdiagnosed as amaurosis fugax, iritis and Posner-Schlossman syndrome.CONCLUSION: Owing to its scarcity, there is no good quality scientific evidence to support the management of IMH. The authors discuss the various treatment options and present a management strategy based on the previous literature for the management for this rare condition and its complications.展开更多
Cobb syndrome is a rare entity characterized by cutaneous vascular lesions and arteriovenous malformations in the spine, both in the same metamere. This syndrome is also known as cutaneous vertebral medullary angiomat...Cobb syndrome is a rare entity characterized by cutaneous vascular lesions and arteriovenous malformations in the spine, both in the same metamere. This syndrome is also known as cutaneous vertebral medullary angiomatosis, cutaneomeningospinal angiomatosis, and spinal arterial metameric disorder. We report the case of a male infant diagnosed with Cobb syndrome who was treated surgically. The presence of a cutaneous vascular lesion in this patient prompted subsequent imaging for spinal angioma or AVM in the same dermatome. Early recognition in this patient was shown to be life-changing, as patients with Cobb syndrome who have undergone early intervention have shown to be without neurologic deficit or have a halt in progression of symptoms.展开更多
基金Supported by the Special Subject for the Construction of the National Traditional Chinese Medicine Clinical Research Base Effect of Spinal Manipulation on Degenerative Scoliosis and Factors Influencing Treatment Effect(JDZX2015271)Basic Scientific Research Project of Chinese Academy of Traditional Chinese Medicine Clinical and Experimental Study on Delaying The Degeneration of Bone and Joint(ZZ10-022)。
文摘OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)and to explore factors that influence treatment effect.METHODS:A total of 55 patients with degenerative scoliosis received 4 weeks of SM.After treatment,patients were divided into two groups:the remission group(VAS score<40 mm)and the non-remission group(VAS score≥40 mm).Pre-versus post-treatment VAS scores,Cobb angles,SVA,and AVR were compared in each group and in the total population.Baseline data(sex,age,symptom characteristics,duration of symptoms,VAS score,Cobb angle,SVA,and AVR)were compared between groups.Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS:No changes were found in the Cobb angle(P=0.722)or AVR(P=0.424)after intervention in the overall population.However,the SVA(P<0.001)and VAS score(P=0.000)changed significantly after treatment.Similar changes were observed in the remission group(n=29).Multiple linear regression revealed that the only factors influencing treatment effect were symptom characteristics,SVA,and VAS score.CONCLUSION:SM relieved pain and improved sagittal imbalance in patients with degenerative scoliosis.It did not lessen the severity of coronal curvature or vertebral rotation.Factors influencing the effect of SM included symptom characteristics,VAS score,and SVA.A larger randomized trial is needed to further confirm our results.
文摘Scoliosis is a musculoskeletal disorder manifested as a three-dimensional spinal deformity. It affects 2% - 3% of the adolescent population. The conventional method to diagnose scoliosis is to measure the Cobb angle from posteroante-rior radiograph. Since radiation exposure is not desirable for patients, other non-ionizing methods have been explored. Among all the non-ionization methods, ultrasound (US) is a potential cost-effective method. However, our understand-ing of US interaction with the vertebrae or the spine is limited. The purpose of this study was to demonstrate the ability of US to identify bony landmarks for measuring spinal deformity. This study used a phased array US system with a 5 MHz transducer and a position encoder. In-vitro experiment on a cadaver vertebra and a pilot clinical study were carried out. The in-vitro experimental results showed that the lamina and spinous process were strong reflectors from the single vertebra. Less than 4% of error occurred on the dimension measurements. The pilot study was performed on a healthy subject and a scoliotic patient. The results indicated the lamina and spinous process could be identified and the curvature of the spine could be estimated using the reflectors. The difference of the curvature angle of the spine measured from the radiograph and the US images was 2?. These results have illustrated that US is a promising tool to measure curvature of spinal deformity and study scoliosis.
文摘Objective To introduce a novel Cobb protractor and assess its reliability and rapidity for measuring Cobb angle in scoliosis patients. Methods The novel Cobb protractor had two endplate markers. A measurement was performed just to align the two markers to each endplate of the curve. The Cobb angle on the posteroanterior radiographs of 24 patients clinically diagnosed with adolescent idiopathic scoliosis was measured by three orthopedic surgeons with both standard Cobb method and the new technique, and the time of measurement was recorded. Intraclass correlation coefficients(ICCs) were calculated to assess the reliability of the new method. Results The time for a measurement with the new tool was approximately 10 seconds less than the time that used to finish a measurement with the standard method(P<0.05). The overall mean Cobb angle for the major curve of the 24 patients was 47.8°. The mean overall intraobserver and interobserver ICC was 0.971 and 0.971 for the Cobb method group, while the overall intraobserver ICC and the interobserver was 0.985 and 0.979 for the new tool group. Conclusions The novel Cobb protractor could perform quick measurement and measure almost all forms of radiographs. The Cobb protractor might be an ideal instrument to measure the Cobb angle.
文摘AIM To find accompanying anomalies of typical and atypical Scheuermann's disease(SD) is reported in the present study. METHODS Study included 20 patients(16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging(MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI.RESULTS Age of the patients ranged from 11.0 to 23.0(mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2(mean 55.5 ± 8.7) in typical Scheuermann's patients and 24.7-49.9(mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8(mean 5.3 ± 1.6) and 7-9(mean 8.2 ± 0.8) in typical and atypical Scheuermann's patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs(mean 4.1 ± 1.7) in typical patients and 5-10 discs(mean 7.6 ± 1.9) in atypical patients.CONCLUSION SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases,herniations and cord pathologies such as syringomyelia can accompany SD(albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.
文摘To investigate the effects ofMoringa oleifera leaf meal （MOLM） on the performance and haematology of broiler finisher using 120 Cobb chicks of 4 weeks old broiler chicks. The birds were assigned randomly into four dietary treatments containing MOLM at 0, 6%, 8%, and 10% （treatments 1, 2, 3 and 4） inclusion levels, respectively, in a complete randomized design experiment. The effect of the dietary treatments on the growth performance and blood parameters of the broiler finisher was determined. MOLM at a rate of 6% （T2）, 8% （T3）, and 10% （T4） of the diets （as fed basis） to replace 3.2%, 5.6% and 8.6% of the crude protein （CP） of the control diet. The daily feed, dry matter and CP intake of the chicks fed MOLM diets were higher （p〈0.05） than those fed the control diet. Average weight gain （AWG） of birds fed MOLM diets reduced as inclusion levels increases 09〈0.05） than those fed the control diet. Chicks fed T2 showed higher （p〈0.05） AWG than those on T3 and T4. Feed conversion ratios （FCR, weight gain/g and feed intake） were higher for chicks fed MOLM. MOLM showed minimal deleterious effects in birds. However, birds fed T2 （6%） diets recorded significantly （p〈0.05） the highest body weight gain. There were significant differences （p〈0.05） among groups in packed cell volume （PVC） of birds. The haemoglobin （Hb）, mean corpuscular volume （MCV）, mean corpuscular haemoglobin （MCH） and mean corpuscular haemoglobin concentration （MCHC） counts showed no significant difference （p〉0.05） among treatments. The results indicated that at 10% in the diets of broiler finisher chick, MOLM could be substituted with expensive conventional protein sources without any deleterious effects on performance and blood parameters of broiler finisher chicken.
文摘Cobb syndrome, also known as cutaneo-meningospinal angiomatosis, is a rare clinical entity characterized by the combination of a vascular skin nevus and an angioma in the spinal canal at the same metamere. 1 It was first described by Berenbruch in 1890 and did not receive recognition until Cobb’s description 2 in 1915. Only few documents about this disease had been reported. 1 We present two cases here and review the other reported cases.
文摘This study aims to evaluate and compare the fertilizing effects of fish-breeding water and river water combined or not with composted poultry manure on the growth and production of okra and lettuce crops. Thus, a sample of 2000 Nile tilapia Oreochromis niloticus fry and a sample of 100 Cobb 500 strain chicks were reared and monitored for six months and fifteen days. Poultry manure and fish-breeding water were then collected and used to fertilize and water okra and lettuce crops. Two systems were used for the crops (okra and lettuce) tested in an elementary plot design with replicates for each treatment (T1: fish-breeding water alone;T2: river water alone;T3: fish-breeding water combined with manure;T4: river water combined with manure). Morphometric parameters and phenological traits of okra and lettuce crops as well as the total harvest weight and production yield were evaluated and compared between treatments. The results reveal better growth and higher yields (0.67 kg/m<sup>2</sup> vs. 0.45 kg/m<sup>2</sup>) of okra crops that received treatment T1 compared to T2. The best growth and yields of lettuce were obtained with treatments T3 (3.34 kg/m<sup>2</sup>) and T1 (1.89 kg/m<sup>2</sup>) compared to T4 (1.23 kg/m<sup>2</sup>) and T2 (1.20 kg/m<sup>2</sup>). These results show that fish-breeding water combined with poultry manure can boost okra and lettuce production and would be a real asset to stimulate local agricultural development. Thus, the adoption of such an agro-ecological approach integrating fish farming and animal husbandry could increase local production and provide food of good nutritional quality.
文摘AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language articles fulfilled the criteria for inclusion to the study and based on the contents on these articles a management strategy was formulated. Age at presentation ranged from 42 to 80 years with no sex or racial predisposition. Most patients with IMH have no systemic disease but a higher incidence had been reported in patients with diabetes mellitus, myotonic dystrophy, chronic obstructive pulmonary disease (COPD) and several other systemic and ophthalmic co-morbidities. Most patients remained asymptomatic until they experienced a sudden blurring of vision due to a hyphaema. Some patients only develop a self-limiting single episode of hyphaema and therefore the laser or surgical photocoagulation of iris should be reserved for the cases complicated with recurrent hyphaema. In some patients, several laser photoco-agulation sessions may be needed and the recurrent iris vascular tufts may require more aggressive treatment. Iris fluorescein angiography (IFA) is useful in identifying the true extent of the disease and helps to improve the precision of the laser treatment. Surgical excision (iridectomy) should only be considered in patients who fail to respond to repeated laser treatment. In some cases IMHs has been initially misdiagnosed as amaurosis fugax, iritis and Posner-Schlossman syndrome.CONCLUSION: Owing to its scarcity, there is no good quality scientific evidence to support the management of IMH. The authors discuss the various treatment options and present a management strategy based on the previous literature for the management for this rare condition and its complications.
文摘Cobb syndrome is a rare entity characterized by cutaneous vascular lesions and arteriovenous malformations in the spine, both in the same metamere. This syndrome is also known as cutaneous vertebral medullary angiomatosis, cutaneomeningospinal angiomatosis, and spinal arterial metameric disorder. We report the case of a male infant diagnosed with Cobb syndrome who was treated surgically. The presence of a cutaneous vascular lesion in this patient prompted subsequent imaging for spinal angioma or AVM in the same dermatome. Early recognition in this patient was shown to be life-changing, as patients with Cobb syndrome who have undergone early intervention have shown to be without neurologic deficit or have a halt in progression of symptoms.
