In this prospective study, the effectiveness and biomechanical factors of spinal orthoses in the treatment of moderate adolescent idiopathic scoliosis (AIS) patients were investigated. In the first 20 months of orthotic treatment, the values of standing AP Cobb's angle, apical vertebral rotation, lumbar lordosis as well as thoracic kyphosis showed significant reduction (P<0.05), however, the angle of trunk inclination and trunk listing did not. The values of those reducible parameters reached their lowest values within the first 12 months of orthotic treatment and then the values gradually increased but they were still below the pre-brace values. The mean pressure of The pressure pads was found to be 7.09 +/- 1.77 kPa (53.2 +/- 13.3 mmHg) while the mean tension of the straps was 26.8 +/- 5.2N. The standing AP Cobb's angle strongly correlated with the pad pressure (correlation coefficient=0.931, p<(.05) and strap tension (correlation coefficient=0.914, p<0.05). The strap tension and pad pressure strongly correlated and the correlation coefficient was 0.873 (p<0.05). This suggests that in the consideration of biomechanical function of spinal orthoses, the focus may be upon how tightly the orthosis was fastened and if the location and direction of the pressure pads are the correct. Therefore, for enhancing independent standard tension should be set in each strap, and regular and close monitoring is needed.
The possibility of using learned physiological responses in control of progressive adolescent idiopathic scoliosis (AIS) was investigated. Sixteen (16) AIS patients with progressing or high-risk curves (Cobb's angle between 25 degrees and 35 degrees at start and reducible by lateral bending) were fitted with a device with tone alarm for poor posture. In the first 18 months of application, 3 patients defaulted and 4 showed curve progression > 10 degrees (2 changed to rigid spinal orthoses and 2 underwent surgery). The curves for the other 9 patients were kept under control (within +/- 5 degrees of Cobb's angle) and 5 of them have reached skeletal maturity and terminated the application. The remaining 4 patients were still using the devices until skeletal maturity or curve progression. The curve control rate was 69%. A long-lasting active spinal control could be achieved through the patient's own spinal muscles. Nevertheless, before the postural training device could become a treatment modality, a long-term study for more AIS patients was necessary. This project is ongoing in the Duchess of Kent Children's Hospital, Sandy Bay, Hong Kong.
To satisfy the demand for more high energy, high brightness x-ray sources at the Advanced Light Source (ALS), a plan is in place to replace three 1.3 Tesla normal conducting bending magnets with three 5 Tesla superconducting magnets (Superbends) in the year 2001. This will result in 12 new x-ray beam lines (four from each superbend) for users. The Superbend sources will be an order of magnitude higher in x-ray brightness and flux at 12 keV than the conventional 1.3 Tesla bending magnets. The Superbend project is a major upgrade to the ALS where the 3 superconducting magnets will be an integral part of the machine lattice. In this paper we discuss the current status of the Superbend projectas well as precomissioning studies prior to the 2001 installation for users.
This is a preliminary investigation to detect the body sway and postural changes of patients with AIS under different spatial images. Two pairs of low-power prismatic eye lenses (Fresnel prisms) with 5 dioptre and 10 dioptre were used. In the experiment, the apices of the prisms were orientated randomly at every 22.5° from 0° to 360° to test changes. Four patients with mean age of 11 and Cobb's angle of 30° were recruited and the results showed that the low-power prisms at specific orientations (157.5° and 180°) could cause positive postural changes (2.1° -2.7° reduction of angle of trunk mis-alignment) measured by 3-D motion analysis. This might be used for controlling their scoliotic curves by induced visual bio-feedback. Apart from this laboratory test, a longitudinal study is necessary to investigate the long-term effect of the prisms at different powers and orientations (under both static and dynamic situations) on the patient's posture, spinal muscular activities, vision, eyehand coordination, psychological state and other daily activities before it becomes an alternative management of AIS.
The tear stability and tear volume of 55 asymptomatic Hong Kong-Chinese were assessed before soft contact lens (Hydron Zero 6) were and repeated on three visits over 28 weeks of lens wear. Soft lens wear caused a significant initial transient decrease in the non-invasive tear break-up time (NITBUT), but no change in tear volume as assessed by the self-prepared cotton thread test (SP-CTT) and phenol red thread (PRT) test. After 28 weeks, the subjects were classified according to the length of time they could wear their lenses without dry eye related signs and symptoms. The NITBUT and PRT tests were unable to predict the success of soft contact lens wear. However, the SP-CTT gave a sensitivity and specificity of 88.5 and 52.4%, respectively, in the prediction of subjects most likely to be successful wearers. The positive and negative predictive values at the chosen cut-off point were 69.7 and 78.6%, respectively. Wetting values, that is, combinations of NITBUT and SP-CTT values or NITBUT and PRT values, did not predict success in soft contact lens wear.
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