Disruption of the cervical lordotic curve can cause undesirable symptoms such as neck pain, and cord compression. The purpose of this study was to investigate the biomechanics of loss of cervical lordosis by measuring the cross-sectional area (CSA) of the cervical muscles using magnetic resonance imaging (MRI), and to determine the relationship between cervical lordosis angle and cervical muscle status. The cervical lordosis angle was measured on standing lateral plain radiography using the posterior tangent technique in patients who complained of neck pain. The CSAs of the cervical flexor muscles including the longus cervicis and longus capitis, the cervical extensor muscles including the splenius capitis and semispinalis capitis, and the sternocleidomastoid muscle, were measured at the maximum levels by axial T1-weighted MRI. We compared neck muscle CSAs between the two groups, the correlation with cervical lordosis angle, and muscle status including CSA and imbalance. The CSA of the semispinalis capitis was significantly lower in the loss of cervical lordosis group, and the ratio of cervical flexor to extensor was significantly different between the two groups (P < 0.05). Partial correlation analysis revealed that the cervical lordotic angle was significantly positively correlated with the ratio of flexor to extensor muscle CSAs (P < 0.05). There is a significant relationship between cervical muscle imbalance, including extensor muscle weakness, and loss of cervical lordosis. An exercise program focusing on cervical extensor muscle strengthening and restoring the balance of flexor and extensor muscles is recommended for patients with loss of cervical lordosis. Clin. Anat. 31:710-715, 2018. © 2018 Wiley Periodicals, Inc.
The protective effects of physical activity (PA) against Parkinson disease (PD) development have been suggested; however, the association of PA with mortality in PD has rarely been investigated. OBJECTIVETo evaluate the association between PA and mortality in individuals with PD and determine how the amount and maintenance of PA are associated with mortality. DESIGN, SETTING, AND PARTICIPANTS This nationwide population-based cohort study used
Objectives: To evaluate the effects of methylphenidate on cerebral glucose metabolism in patients with impaired consciousness after acquired brain injury.Methods: Fourteen patients with impaired consciousness after acquired brain injury were enrolled in our study. We evaluated the level of consciousness with the Glasgow Coma Scale upon initial evaluation and at the 6-week follow-up after methylphenidate medication (0.3 mg/kg per day, which was administered twice daily). Positron emission tomography was performed before and after 6 weeks of medication, and the effects of methylphenidate on cerebral glucose metabolism were analyzed using statistical parametric mapping. Results:The statistical parametric mapping analysis indicated that significant increases of the cerebral glucose metabolism after methylphenidate therapy, compared with the initial positron emission tomographic image, were most evident in the left precuneus, the right posterior cingulated and the right retrosplenial cortices, and the right inferior parietal cortex (P G 0.001). In addition, cerebral glucose metabolism was significantly increased in the right precuneus, the right superior and middle temporal gyri, and bilateral middle occipital gyri (P G 0.005). In the correlation analysis, improvement of the Glasgow Coma Scale scores after methylphenidate medication was significantly associated with increased cerebral glucose metabolism in the bilateral precuneus, the bilateral middle occipital gyri, and right middle frontal gyrus.Conclusions: Our findings suggest that the posteromedial parietal cortex, which is part of the neural network for consciousness, may be the relevant structure for the pharmacological response to methylphenidate treatment in patients with impaired consciousness after acquired brain injury.
Study Design. Case-control study. Objective. To quantify risk factors for cervical ossification of the posterior longitudinal ligament (OPLL) using a large nationwide cohort in Korea, a country with a high prevalence of OPLL. Summary of Background Data. OPLL is a pathological calcification of the posterior longitudinal ligament of the spine. OPLL progression can cause spinal cord injury that results in disability. Considering neurologic deficits and disability caused by OPLL, identifying OPLL risk factors for early prediction have important health benefits. Methods. The nationwide population-based matched cohort study was conducted using the Korean National Health Insurance Service cohort data. We selected patients with a primary diagnosis of OPLL involving cervical lesion (International Classification of Diseases-10 code: M48.82, M48.83). A matched cohort without cervical OPLL was enrolled by randomly matching patients by sex, age, year of diagnosis, and residential area to the OPLL group with a ratio of 1:9. Logistic regression analyses were performed to identify risk associated with OPLL development using odds ratios (OR) and 95% confidence intervals (CI). Results. Comorbidities, such as hypertension (OR = 1.283, 95% CI 1.071–1.538), ischemic stroke (OR = 1.386, 95% CI 1.017–1.889), diabetes mellitus (OR = 1.331, 95% CI 1.098–1.615), hypothyroidism (OR = 1.562, 95% CI 1.165–2.094), and osteoporosis (OR = 1.456, 95% CI 1.151–1.842), were significantly associated with the prospective development of OPLL, with low predictive value. Conclusion. OPLL was significantly associated with comorbidities such as hypertension, ischemic stroke diabetes mellitus, hypothyroidism, and osteoporosis. Our findings can provide helpful information for OPLL prediction and offer important health benefits. Level of Evidence: 3
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