Publications by authors named "Soo Y Kim"

34 Publications

Examining assessment methods of scapular motion: Comparing results from planar elevations and functional task performance.

Clin Biomech (Bristol, Avon) 2020 12 24;80:105203. Epub 2020 Oct 24.

School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Canada. Electronic address:

Background: Scapular kinematics of breast cancer survivors are most often evaluated during arm elevation. However, known compensations exist during functional task performance. The purpose of this study was to determine if scapular kinematics of breast cancer survivors during arm elevation are related to scapular kinematics during functional task performance.

Methods: Scapular kinematics of 25 non-cancer controls and 25 breast cancer survivors (split by presence of impingement pain) during arm elevation in 3 planes and 3 reaching and lifting functional tasks were measured. Scapular upward rotation and scapulohumeral rhythm (SHR) at 30° increments of arm elevation were calculated. Between-group differences of upward rotation during arm elevation were evaluated with one-way ANOVAs (p < 0.05). The association of upward rotation angle and SHR during arm elevation and functional tasks was tested with Pearson correlations (p < 0.05).

Findings: Scapular upward rotation was reduced for the breast cancer survivor with pain at lower levels of arm elevation in each plane by up to 7.1° (p = .014 to 0.049). This is inconsistent with functional task results, in which upward rotation decrements occurred at higher levels of arm elevation. Upward rotation angles and SHR during arm elevation had an overall weak-to-moderate relationship (r = 0.003 to 0.970, p = .001 to 0.048) to values from functional tasks. Arm elevation during sagittal plane elevation demonstrated scapular upward rotation that was most closely associated to upward rotation during functional task performance.

Interpretation: Inconsistent relationships suggests that clinical evaluations should adopt basic functional movements for scapular motion assessment to complement simple arm elevations.
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http://dx.doi.org/10.1016/j.clinbiomech.2020.105203DOI Listing
December 2020

Managing the Rehabilitation Wave: Rehabilitation Services for COVID-19 Survivors.

Arch Phys Med Rehabil 2020 12 22;101(12):2243-2249. Epub 2020 Sep 22.

Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD; The Johns Hopkins Hospital, Baltimore, MD. Electronic address:

The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on the provision of medical care. As the curve progresses and patients are discharged, the rehabilitation wave brings a high number of postacute COVID-19 patients suffering from physical, mental, and cognitive impairments threatening their return to normal life. The complexity and severity of disease in patients recovering from severe COVID-19 infection require an approach that is implemented as early in the recovery phase as possible, in a concerted and systematic way. To address the rehabilitation wave, we describe a spectrum of interventions that start in the intensive care unit and continue through all the appropriate levels of care. This approach requires organized rehabilitation teams including physical therapists, occupational therapists, speech-language pathologists, rehabilitation psychologists or neuropsychologists, and physiatrists collaborating with acute medical teams. Here, we also discuss administrative factors that influence the provision of care during the COVID-19 pandemic. The services that can be provided are described in detail to allow the reader to understand what services may be appropriate locally. We have been learning and adapting real time during this crisis and hope that sharing our experience facilitates the work of others as the pandemic evolves. It is our goal to help reduce the potentially long-lasting challenges faced by COVID-19 survivors.
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http://dx.doi.org/10.1016/j.apmr.2020.09.372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506328PMC
December 2020

Estimating Muscle Forces for Breast Cancer Survivors During Functional Tasks.

J Appl Biomech 2020 Sep 22:1-8. Epub 2020 Sep 22.

University of Waterloo.

Breast cancer survivors have known scapular kinematic alterations that may be related to the development of secondary morbidities. A measure of muscle activation would help understand the mechanisms behind potential harmful kinematics. The purpose of this study was to define muscle force strategies in breast cancer survivors. Shoulder muscle forces during 6 functional tasks were predicted for 25 breast cancer survivors (divided by impingement pain) and 25 controls using a modified Shoulder Loading Analysis Module. Maximum forces for each muscle were calculated, and 1-way analysis of variance (P < .05) was used to identify group differences. The differences between maximum predicted forces and maximum electromyography were compared with repeated-measures analysis of variance (P < .05) to evaluate the success of the model predictions. Average differences between force predictions and electromyography ranged from 7.3% to 31.6% but were within the range of previously accepted differences. Impingement related pain in breast cancer survivors is associated with increased force of select shoulder muscles. Both pectoralis major heads, upper trapezius, and supraspinatus peak forces were higher in the pain group across all tasks. These force prediction differences are also associated with potentially harmful kinematic strategies, providing a direction for possible rehabilitation strategies.
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http://dx.doi.org/10.1123/jab.2020-0047DOI Listing
September 2020

Surgical repair of the supraspinatus: architectural changes in the muscle pre- and postoperatively.

Singapore Med J 2020 08 17. Epub 2020 Aug 17.

School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Introduction: Shortening of the tendon and muscle is recognised as a strong predictor for surgical failure of supraspinatus tendon tears. Changes in muscle architecture following repair have not been thoroughly investigated. We aimed to compare the architecture of the supraspinatus pre- and postoperatively.

Methods: We recruited eight participants with full-thickness supraspinatus tears. Images of the supraspinatus were captured preoperatively (pre-op) and postoperatively at one (post-op1), three (post-op2) and six (post-op3) months in relaxed and contracted states (0° and 60° glenohumeral abduction). Fibre bundle length (FBL), pennation angle (PA) and muscle thickness (MT) were quantified. Self-reported function, and maximal isometric abduction and external rotation strengths were assessed.

Results: Mean FBL increased from pre-op to post-op1 (p = 0.001) in the relaxed state and from pre-op to post-op2 (p = 0.002) in the contracted state. Decrease in FBL was observed from post-op2 to post-op3 in the relaxed state. Mean PA decreased from pre-op to post-op1 (p < 0.001) in the relaxed state, but increased from post-op2 to post-op3 in both relaxed (p = 0.006) and contracted (p = 0.004) states. At post-op3, external rotation (p = 0.009) and abduction (p = 0.005) strengths were greater than at post-op2. Overall function increased by 47.67% from pre-op to post-op3.

Conclusion: Lengthening of the supraspinatus occurs with surgery, altering the length-tension relationship of the muscle, which can compromise muscle function and lead to inferior surgical outcomes. These findings may guide clinicians to optimise loads, velocities and shoulder ranges for effective postoperative rehabilitation.
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http://dx.doi.org/10.11622/smedj.2020123DOI Listing
August 2020

Sub-regional activation of supraspinatus and infraspinatus muscles during activities of daily living is task dependent.

J Electromyogr Kinesiol 2020 Oct 17;54:102450. Epub 2020 Jul 17.

Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada. Electronic address:

The supraspinatus and infraspinatus muscles each have multiple sub-regions that may activate differentially in activities of daily living. Awareness of these differential demands critically informs rehabilitation of rotator cuff muscle following injury, particularly if centered on recovering and strengthening the rotator cuff to perform daily tasks. This study quantified muscle activation of supraspinatus and infraspinatus sub-regions during the performance of six activities of daily living. Twenty-three participants (mean: 22.6 ± 2.6 years) completed the following tasks: opening a jar, reaching at shoulder height, overhead reaching, pouring water from a pitcher, eating with a spoon, and combing hair. Indwelling electromyography was collected from the anterior and posterior supraspinatus and superior, middle, and inferior infraspinatus. Tasks requiring high arm elevations (e.g. reaching at shoulder and overhead height) activated anterior supraspinatus between 21 and 28% MVC. The posterior supraspinatus consistently activated between 10 and 30% MVC across all tasks. All sub-regions of infraspinatus activated highly (between 18 and 25% MVC) in tasks requiring high arm elevations in flexion. These findings may be leveraged to define effective measures to increase rotator cuff function in daily tasks.
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http://dx.doi.org/10.1016/j.jelekin.2020.102450DOI Listing
October 2020

The ability of surface electromyography to represent supraspinatus anterior and posterior partition activity depends on elevation angle, hand load and plane of elevation.

J Biomech 2020 01 18;99:109526. Epub 2019 Nov 18.

Department of Kinesiology, University of Waterloo, Waterloo, Canada. Electronic address:

This study examined relationships between electromyography recorded from indwelling electrodes of the anterior and posterior supraspinatus and a surface supraspinatus electrode. Twenty male and twenty female participants completed full range humeral elevations in three planes of elevation (0/40/90°) and three hand loads (unloaded/20%/40% of maximal elevation strength). EMG activation was combined with motion capture to determine activation at instantaneous activation angles, and linear regressions of anterior and posterior indwelling electrodes relative to the surface electrode determined relationships between these signals. Regressions between surface and indwelling signals were affected by plane of elevation, elevation angle, load intensity and participant sex, but no interactions existed. Surface signals underestimated activation at low elevation angles for both regions, and up to 45% in the anterior supraspinatus (p < 0.01), then overestimated activation at higher elevation angles. Surface EMG underestimated indwelling signals by up to 15% in unloaded conditions, while overestimating the posterior region by up to 17% in the 40% load condition (p < 0.01). Sex effects showed increased overestimation by surface signals in the posterior region in males by 21% (p < 0.01). Better agreement existed for the anterior region than the posterior region across postures, but postural relationships should be considered when choosing electrodes for this muscle.
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http://dx.doi.org/10.1016/j.jbiomech.2019.109526DOI Listing
January 2020

Impingement pain affects kinematics of breast cancer survivors in work-related functional tasks.

Clin Biomech (Bristol, Avon) 2019 Dec 19;70:223-230. Epub 2019 Oct 19.

School of Rehabilitation Science, College of Medicine, University of Saskatchewan, Canada. Electronic address:

Background: Breast cancer survivors may encounter upper limb morbidities post-surgery. It is currently unclear how these impairments affect arm kinematics, particularly during functional task performance. This investigation examined upper body kinematics during functional tasks for breast cancer survivors and an age-matched control group.

Methods: Fifty women (aged 35-65) participated: 25 breast cancer survivors who had undergone mastectomy and 25 age-range matched controls. Following basic clinical evaluation, including shoulder impingement tests, motion of the torso and upper limbs were tracked during six upper limb-focused functional tasks from which torso, scapular, and thoracohumeral angles were calculated. Between-group differences were evaluated with independent t-tests (p < .05). The breast cancer group was then divided based upon impingement tests and differences between the three new groups were tested with one-way ANOVAs (p < .05).

Findings: Breast cancer survivors had higher disability scores, lower range of motion, and lower performance scores. The largest kinematic differences existed between the breast cancer survivors with impingement pain and the two non-pain groups. During overhead tasks, right peak scapular upward rotation was significantly reduced (d = 0.80-1.11) in the breast cancer survivors with impingement pain. This group also demonstrated trends of decreased peak humeral abduction and internal rotation at extreme postures (d = 0.54-0.78). These alterations are consistent with kinematics considered high risk for rotator cuff injury development.

Interpretation: Impingement pain in breast cancer survivors influences functional task performance and may be more important to consider than self-reported disability when evaluating pain and potential injury development.
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http://dx.doi.org/10.1016/j.clinbiomech.2019.10.001DOI Listing
December 2019

Verification of intramuscular electromyography electrode placement for neuromuscular partitions of infraspinatus.

J Electromyogr Kinesiol 2019 Dec 9;49:102354. Epub 2019 Sep 9.

University of Toronto, Department of Surgery, Division of Anatomy, Toronto, Ontario, Canada.

The infraspinatus muscle is composed of three neuromuscular partitions: superior, middle and inferior. Although methods for fine-wire EMG electrode insertion into these partitions have been developed and used, it has yet to be verified. The purpose of this cadaveric EMG needle placement study was to assess the accuracy and reproducibility of a protocol used to target the three partitions of infraspinatus. On seven shoulder specimens, two investigators inserted needles into each superior, middle and inferior partition according to a previously developed protocol. Each was blinded to the other's insertion sites. The specimens were dissected and the location of each needle was digitized and modeled in 3D. Of the 42 needles that were inserted, 32 were placed in the targeted partition. The highest accuracy rate occurred for the middle partition (100%), followed by the inferior (71.4%) and then the superior (57.1%). When the needles were not placed in the targeted partition, they were located in the neighboring partition within infraspinatus or the teres minor muscle. The current study showed the middle partition could be targeted accurately, whereas the superior and inferior partitions were more challenging. Ultrasound guidance may be necessary to ensure accurate placement into all parts of infraspinatus.
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http://dx.doi.org/10.1016/j.jelekin.2019.102354DOI Listing
December 2019

Flexibility exercise training for adults with fibromyalgia.

Cochrane Database Syst Rev 2019 Sep 2;9:CD013419. Epub 2019 Sep 2.

School of Rehabilitation Science, University of Saskatchewan, Health Sciences Building, 104 Clinic Place, Room 3410, Saskatoon, SK, Canada, S7N 2Z4.

Background: Exercise training is commonly recommended for adults with fibromyalgia. We defined flexibility exercise training programs as those involving movements of a joint or a series of joints, through complete range of motion, thus targeting major muscle-tendon units. This review is one of a series of reviews updating the first review published in 2002.

Objectives: To evaluate the benefits and harms of flexibility exercise training in adults with fibromyalgia.

Search Methods: We searched the Cochrane Library, MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database), Thesis and Dissertation Abstracts, AMED (Allied and Complementary Medicine Database), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and ClinicalTrials.gov up to December 2017, unrestricted by language, and we reviewed the reference lists of retrieved trials to identify potentially relevant trials.

Selection Criteria: We included randomized trials (RCTs) including adults diagnosed with fibromyalgia based on published criteria. Major outcomes were health-related quality of life (HRQoL), pain intensity, stiffness, fatigue, physical function, trial withdrawals, and adverse events.

Data Collection And Analysis: Two review authors independently selected articles for inclusion, extracted data, performed 'Risk of bias' assessments, and assessed the certainty of the body of evidence for major outcomes using the GRADE approach. All discrepancies were rechecked, and consensus was achieved by discussion.

Main Results: We included 12 RCTs (743 people). Among these RCTs, flexibility exercise training was compared to an untreated control group, land-based aerobic training, resistance training, or other interventions (i.e. Tai Chi, Pilates, aquatic biodanza, friction massage, medications). Studies were at risk of selection, performance, and detection bias (due to lack of adequate randomization and allocation concealment, lack of participant or personnel blinding, and lack of blinding for self-reported outcomes). With the exception of withdrawals and adverse events, major outcomes were self-reported and were expressed on a 0-to-100 scale (lower values are best, negative mean differences (MDs) indicate improvement). We prioritized the findings of flexibility exercise training compared to land-based aerobic training and present them fully here.Very low-certainty evidence showed that compared with land-based aerobic training, flexibility exercise training (five trials with 266 participants) provides no clinically important benefits with regard to HRQoL, pain intensity, fatigue, stiffness, and physical function. Low-certainty evidence showed no difference between these groups for withdrawals at completion of the intervention (8 to 20 weeks).Mean HRQoL assessed on the Fibromyalgia Impact Questionnaire (FIQ) Total scale (0 to 100, higher scores indicating worse HRQoL) was 46 mm and 42 mm in the flexibility and aerobic groups, respectively (2 studies, 193 participants); absolute change was 4% worse (6% better to 14% worse), and relative change was 7.5% worse (10.5% better to 25.5% worse) in the flexibility group. Mean pain was 57 mm and 52 mm in the flexibility and aerobic groups, respectively (5 studies, 266 participants); absolute change was 5% worse (1% better to 11% worse), and relative change was 6.7% worse (2% better to 15.4% worse). Mean fatigue was 67 mm and 71 mm in the aerobic and flexibility groups, respectively (2 studies, 75 participants); absolute change was 4% better (13% better to 5% worse), and relative change was 6% better (19.4% better to 7.4% worse). Mean physical function was 23 points and 17 points in the flexibility and aerobic groups, respectively (1 study, 60 participants); absolute change was 6% worse (4% better to 16% worse), and relative change was 14% worse (9.1% better to 37.1% worse). We found very low-certainty evidence of an effect for stiffness. Mean stiffness was 49 mm to 79 mm in the flexibility and aerobic groups, respectively (1 study, 15 participants); absolute change was 30% better (8% better to 51% better), and relative change was 39% better (10% better to 68% better). We found no evidence of an effect in all-cause withdrawal between the flexibility and aerobic groups (5 studies, 301 participants). Absolute change was 1% fewer withdrawals in the flexibility group (8% fewer to 21% more), and relative change in the flexibility group compared to the aerobic training intervention group was 3% fewer (39% fewer to 55% more). It is uncertain whether flexibility leads to long-term effects (36 weeks after a 12-week intervention), as the evidence was of low certainty and was derived from a single trial.Very low-certainty evidence indicates uncertainty in the risk of adverse events for flexibility exercise training. One adverse effect was described among the 132 participants allocated to flexibility training. One participant had tendinitis of the Achilles tendon (McCain 1988), but it is unclear if the tendinitis was a pre-existing condition.

Authors' Conclusions: When compared with aerobic training, it is uncertain whether flexibility improves outcomes such as HRQoL, pain intensity, fatigue, stiffness, and physical function, as the certainty of the evidence is very low. Flexibility exercise training may lead to little or no difference for all-cause withdrawals. It is also uncertain whether flexibility exercise training has long-term effects due to the very low certainty of the evidence. We downgraded the evidence owing to the small number of trials and participants across trials, as well as due to issues related to unclear and high risk of bias (selection, performance, and detection biases). While flexibility exercise training appears to be well tolerated (similar withdrawal rates across groups), evidence on adverse events was scarce, therefore its safety is uncertain.
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http://dx.doi.org/10.1002/14651858.CD013419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718217PMC
September 2019

Regional activation of supraspinatus and infraspinatus sub-regions during dynamic tasks performed with free weights.

J Electromyogr Kinesiol 2019 May 11:102308. Epub 2019 May 11.

University of Saskatchewan, College of Medicine, School of Rehabilitation Science, Saskatoon, Saskatchewan, Canada. Electronic address:

Growing evidence supports the existence of distinct anatomical sub-regions within supraspinatus and infraspinatus, but only recently has attention turned to exploring their potential functional differences. Using indwelling fine-wire electromyography, muscle activity was investigated from these sub-regions in 15 participants (mean 34 yr, 170 cm, 71.9 kg) during dynamic external rotation (ER), abduction, flexion, and scaption tasks with and without free weights corresponding to 50% and 75% of the participant's five repetition maximum. Electromyography data were normalized to isometric and isokinetic maximal voluntary contractions and activation ratios for each sub-region compared. Differences in mean regional activation ratios for supraspinatus and infraspinatus varied by arm posture, but were not influenced by load. Relative activation of posterior supraspinatus was greater during an ER task performed in side lying compared to an ER task performed with 90° of humeral elevation in seated and prone postures. Relative activation of superior infraspinatus was greater during an ER task in prone and side lying postures compared to flexion and scaption. Similar results were found when comparing regional muscle activation ratios for infraspinatus between tasks regardless of normalization method employed. These findings may impact exercise selection in the non-operative management of rotator cuff tears.
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http://dx.doi.org/10.1016/j.jelekin.2019.05.009DOI Listing
May 2019

The utility of the acromion marker cluster (AMC) in a clinical population.

J Electromyogr Kinesiol 2019 Apr 15:102298. Epub 2019 Apr 15.

Department of Kinesiology, Faculty of Applied Health Sciences, University of Waterloo, Canada.

Introduction: The acromion marker cluster (AMC) is a non-invasive scapular motion tracking method. However, it lacks testing in clinical populations, where unique challenges may present. This investigation resolved the utility of the AMC approach in a compromised clinical population.

Methods: The upper body of breast cancer survivors (BCS) and controls were tracked via motion capture and scapular landmarks palpated and recorded using a digitizer at static neutral to maximum elevation postures. The AMC tracked the scapula during dynamic maximum arm abduction. Both single (SC) and double calibration (DC) methods were applied to calculate scapular angles. The influences of calibration method, elevation, and group on mean and absolute error with two-way fixed ANOVAs with interactions (p < 0.05). Root mean square errors (RMSE) were calculated and compared.

Results: DC improved AMC estimation of palpated scapular orientation over SC, especially at higher arm elevations; RMSE averaged 11° higher for SC than DC at maximum elevation, but the methods were only 2.2° different at 90° elevation. DC of the AMC yielded mean error values of ∼5-10°. These approximate errors reported for AMC with young, lean adults.

Conclusions: The AMC with DC is a non-invasive method with acceptable error for measuring scapular motion of BCS and age-matched controls.
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http://dx.doi.org/10.1016/j.jelekin.2019.04.002DOI Listing
April 2019

Arm posture influences on regional supraspinatus and infraspinatus activation in isometric arm elevation efforts.

J Electromyogr Kinesiol 2019 Feb 15;44:108-116. Epub 2018 Dec 15.

University of Waterloo, Faculty of Applied Health Sciences, Department of Kinesiology, Digital Industrial Ergonomics and Shoulder Evaluation Laboratory (DIESEL), Waterloo, Ontario, Canada. Electronic address:

This study aimed to evaluate the effect of arm posture on activation of the anterior and posterior regions of supraspinatus and the superior and middle regions of infraspinatus during resisted isometric arm elevations. Thirty-one healthy participants performed 18 isometric resistance exertions against a force cube in three elevation planes (flexion, scaption, abduction) and three elevation angles (30°, 90°, 150°) in maximal and sub-maximal resistance conditions. EMG data were obtained using four pairs of fine wire electrodes. The mean activation of each region and the activation ratios were compared across postures using ANOVAs. Supraspinatus anterior was significantly more active during abduction and scaption, and in higher elevation angles, while the posterior region showed similar activation levels across postures. Infraspinatus regions were more active during flexion with more relative activation of the infraspinatus superior at 90° flexion. The results suggest that regional activation of supraspinatus and infraspinatus should be considered for assessment and rehabilitation purposes. In any clinical setting where it is important to reduce the stress on the supraspinatus anterior, isometric flexion exercises performed with arm in low elevation angles could provide the opportunity to strengthen the posterior region of supraspinatus with limited stress on the anterior region. Beside external rotation exertions, resisted flexion tests may be useful for evaluation of infraspinatus regions.
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http://dx.doi.org/10.1016/j.jelekin.2018.12.005DOI Listing
February 2019

Maximal voluntary isometric contraction tests for normalizing electromyographic data from different regions of supraspinatus and infraspinatus muscles: Identifying reliable combinations.

J Electromyogr Kinesiol 2018 Aug 25;41:19-26. Epub 2018 Apr 25.

University of Waterloo, Faculty of Applied Health Sciences, Department of Kinesiology, Digital Industrial Ergonomics and Shoulder Evaluation Laboratory (DIESEL), Waterloo, Ontario, Canada. Electronic address:

This study aimed to identify optimal sets of maximal voluntary isometric contractions (MVICs) for normalizing EMG data from anterior and posterior regions of the supraspinatus, and superior, middle and inferior regions of the infraspinatus. 31 right-handed young healthy individuals (15 males, 16 females) participated. EMG activity was obtained from two regions of supraspinatus and three regions of infraspinatus muscles via fine wire electrodes. Participants performed 15 MVIC tests against manual resistance. The EMG data were normalized to the maximum values. Optimal sets of MVIC combinations, defined as those which elicited >90% MVIC activation in the muscles of interest in >80% and >90% of the population, were obtained. EMG data from the inferior region of infraspinatus were removed from analysis due to technical problem. No single test achieved maximal activation of both regions of either the supraspinatus or infraspinatus. Instead, a combination of 6-8 MVICs were required to reach >90% MVIC activation in both parts of those muscles. In all regions of the rotator cuff muscles, the optimal combination was obtained with 8-10 MVICs. The proposed combinations can reduce inter-participant variability in generating maximal activation from different regions of the supraspinatus and infraspinatus muscles.
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http://dx.doi.org/10.1016/j.jelekin.2018.04.007DOI Listing
August 2018

Biomechanical and physiological age differences in a simulated forward fall on outstretched hands in women.

Clin Biomech (Bristol, Avon) 2018 02 3;52:102-108. Epub 2018 Feb 3.

School of Physical Therapy, College of Medicine, Suite 3400, 104 Clinic Place, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada. Electronic address:

Background: Falling on the outstretched hands, a protective mechanism to arrest the body and avoid injury, requires upper limb and trunk motor control for effective body descent. Older women are particularly susceptible to injury from a forward fall, but the biomechanical and physiological (e.g., muscle strength) factors related to this increased risk are poorly understood. Determining age differences in the modifiable neuromuscular factors related to a forward fall landing and descent could help to inform injury prevention strategies. The purpose was to investigate age related differences in upper extremity strength and fall arrest strategy differences during a simulated fall and to evaluate the relationships between muscle strength and biomechanical variables.

Methods: Nineteen younger (mean age 23.0 yrs., SD 3.8) and 16 older (mean age 68.2 yrs., SD 5.3) women performed five trials of simulated falls. Biomechanical measures and electromyographic muscle activity were recorded during the descents. Concentric, isometric and eccentric strength of the non-dominant upper limb was measured via a dynamometer using a customized protocol.

Findings: Older women demonstrated lower concentric elbow extension strength compared to younger women (p = 0.002). Landing strategies differed where younger women had significantly greater elbow joint angle (p = 0.006) and velocity (p = 0.02) at impact. Older women demonstrated diminished capacity to absorb energy and control descent on outstretched hands compared to younger women (p = 0.001).

Interpretation: The landing strategy used by older women along with decreased energy absorption may increase risk of fall-related injury and increase the likelihood of trunk or head impact with the ground.
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http://dx.doi.org/10.1016/j.clinbiomech.2018.01.018DOI Listing
February 2018

Whole body vibration exercise training for fibromyalgia.

Cochrane Database Syst Rev 2017 Sep 26;9:CD011755. Epub 2017 Sep 26.

Norwegian Institute of Public Health, PO Box 4404 Nydalen, Oslo, Norway, 0403.

Background: Exercise training is commonly recommended for adults with fibromyalgia. We defined whole body vibration (WBV) exercise as use of a vertical or rotary oscillating platform as an exercise stimulus while the individual engages in sustained static positioning or dynamic movements. The individual stands on the platform, and oscillations result in vibrations transmitted to the subject through the legs. This review is one of a series of reviews that replaces the first review published in 2002.

Objectives: To evaluate benefits and harms of WBV exercise training in adults with fibromyalgia.

Search Methods: We searched the Cochrane Library, MEDLINE, Embase, CINAHL, PEDro, Thesis and Dissertation Abstracts, AMED, WHO ICTRP, and ClinicalTrials.gov up to December 2016, unrestricted by language, to identify potentially relevant trials.

Selection Criteria: We included randomized controlled trials (RCTs) in adults with the diagnosis of fibromyalgia based on published criteria including a WBV intervention versus control or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events.

Data Collection And Analysis: Two review authors independently selected trials for inclusion, extracted data, performed risk of bias assessments, and assessed the quality of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences.

Main Results: We included four studies involving 150 middle-aged female participants from one country. Two studies had two treatment arms (71 participants) that compared WBV plus mixed exercise plus relaxation versus mixed exercise plus relaxation and placebo WBV versus control, and WBV plus mixed exercise versus mixed exercise and control; two studies had three treatment arms (79 participants) that compared WBV plus mixed exercise versus control and mixed relaxation placebo WBV. We judged the overall risk of bias as low for selection (random sequence generation), detection (objectively measured outcomes), attrition, and other biases; as unclear for selection bias (allocation concealment); and as high for performance, detection (self-report outcomes), and selective reporting biases.The WBV versus control comparison reported on three major outcomes assessed at 12 weeks post intervention based on the Fibromyalgia Impact Questionnaire (FIQ) (0 to 100 scale, lower score is better). Results for HRQL in the control group at end of treatment (59.13) showed a mean difference (MD) of -3.73 (95% confidence interval [CI] -10.81 to 3.35) for absolute HRQL, or improvement of 4% (11% better to 3% worse) and relative improvement of 6.7% (19.6% better to 6.1% worse). Results for withdrawals indicate that 14 per 100 and 10 per 100 in the intervention and control groups, respectively, withdrew from the intervention (RR 1.43, 95% CI 0.27 to 7.67; absolute change 4%, 95% CI 16% fewer to 24% more; relative change 43% more, 95% CI 73% fewer to 667% more). The only adverse event reported was acute pain in the legs, for which one participant dropped out of the program. We judged the quality of evidence for all outcomes as very low. This study did not measure pain intensity, fatigue, stiffness, or physical function. No outcomes in this comparison met the 15% threshold for clinical relevance.The WBV plus mixed exercise (aerobic, strength, flexibility, and relaxation) versus control study (N = 21) evaluated symptoms at six weeks post intervention using the FIQ. Results for HRQL at end of treatment (59.64) showed an MD of -16.02 (95% CI -31.57 to -0.47) for absolute HRQL, with improvement of 16% (0.5% to 32%) and relative change in HRQL of 24% (0.7% to 47%). Data showed a pain intensity MD of -28.22 (95% CI -43.26 to -13.18) for an absolute difference of 28% (13% to 43%) and a relative change of 39% improvement (18% to 60%); as well as a fatigue MD of -33 (95% CI -49 to -16) for an absolute difference of 33% (16% to 49%) and relative difference of 47% (95% CI 23% to 60%); and a stiffness MD of -26.27 (95% CI -42.96 to -9.58) for an absolute difference of 26% (10% to 43%) and a relative difference of 36.5% (23% to 60%). All-cause withdrawals occurred in 8 per 100 and 33 per 100 withdrawals in the intervention and control groups, respectively (two studies, N = 46; RR 0.25, 95% CI 0.06 to 1.12) for an absolute risk difference of 24% (3% to 51%). One participant exhibited a mild anxiety attack at the first session of WBV. No studies in this comparison reported on physical function. Several outcomes (based on the findings of one study) in this comparison met the 15% threshold for clinical relevance: HRQL, pain intensity, fatigue, and stiffness, which improved by 16%, 39%, 46%, and 36%, respectively. We found evidence of very low quality for all outcomes.The WBV plus mixed exercise versus other exercise provided very low quality evidence for all outcomes. Investigators evaluated outcomes on a 0 to 100 scale (lower score is better) for pain intensity (one study, N = 23; MD -16.36, 95% CI -29.49 to -3.23), HRQL (two studies, N = 49; MD -6.67, 95% CI -14.65 to 1.31), fatigue (one study, N = 23; MD -14.41, 95% CI -29.47 to 0.65), stiffness (one study, N = 23; MD -12.72, 95% CI -26.90 to 1.46), and all-cause withdrawal (three studies, N = 77; RR 0.72, 95% CI -0.17 to 3.11). Adverse events reported for the three studies included one anxiety attack at the first session of WBV and one dropout from the comparison group ("other exercise group") due to an injury that was not related to the program. No studies reported on physical function.

Authors' Conclusions: Whether WBV or WBV in addition to mixed exercise is superior to control or another intervention for women with fibromyalgia remains uncertain. The quality of evidence is very low owing to imprecision (few study participants and wide confidence intervals) and issues related to risk of bias. These trials did not measure major outcomes such as pain intensity, stiffness, fatigue, and physical function. Overall, studies were few and were very small, which prevented meaningful estimates of harms and definitive conclusions about WBV safety.
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http://dx.doi.org/10.1002/14651858.CD011755.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483692PMC
September 2017

Aerobic exercise training for adults with fibromyalgia.

Cochrane Database Syst Rev 2017 06 21;6:CD012700. Epub 2017 Jun 21.

Norwegian Institute of Public Health, PO Box 4404 Nydalen, Oslo, Norway, 0403.

Background: Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with fibromyalgia that will replace the "Exercise for treating fibromyalgia syndrome" review first published in 2002.

Objectives: • To evaluate the benefits and harms of aerobic exercise training for adults with fibromyalgia• To assess the following specific comparisons ० Aerobic versus control conditions (eg, treatment as usual, wait list control, physical activity as usual) ० Aerobic versus aerobic interventions (eg, running vs brisk walking) ० Aerobic versus non-exercise interventions (eg, medications, education) We did not assess specific comparisons involving aerobic exercise versus other exercise interventions (eg, resistance exercise, aquatic exercise, flexibility exercise, mixed exercise). Other systematic reviews have examined or will examine these comparisons (Bidonde 2014; Busch 2013).

Search Methods: We searched the Cochrane Library, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), Thesis and Dissertation Abstracts, the Allied and Complementary Medicine Database (AMED), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and the ClinicalTrials.gov registry up to June 2016, unrestricted by language, and we reviewed the reference lists of retrieved trials to identify potentially relevant trials.

Selection Criteria: We included randomized controlled trials (RCTs) in adults with a diagnosis of fibromyalgia that compared aerobic training interventions (dynamic physical activity that increases breathing and heart rate to submaximal levels for a prolonged period) versus no exercise or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events.

Data Collection And Analysis: Two review authors independently selected trials for inclusion, extracted data, performed a risk of bias assessment, and assessed the quality of the body of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences between groups.

Main Results: We included 13 RCTs (839 people). Studies were at risk of selection, performance, and detection bias (owing to lack of blinding for self-reported outcomes) and had low risk of attrition and reporting bias. We prioritized the findings when aerobic exercise was compared with no exercise control and present them fully here.Eight trials (with 456 participants) provided low-quality evidence for pain intensity, fatigue, stiffness, and physical function; and moderate-quality evidence for withdrawals and HRQL at completion of the intervention (6 to 24 weeks). With the exception of withdrawals and adverse events, major outcome measures were self-reported and were expressed on a 0 to 100 scale (lower values are best, negative mean differences (MDs)/standardized mean differences (SMDs) indicate improvement). Effects for aerobic exercise versus control were as follows: HRQL: mean 56.08; five studies; N = 372; MD -7.89, 95% CI -13.23 to -2.55; absolute improvement of 8% (3% to 13%) and relative improvement of 15% (5% to 24%); pain intensity: mean 65.31; six studies; N = 351; MD -11.06, 95% CI -18.34 to -3.77; absolute improvement of 11% (95% CI 4% to 18%) and relative improvement of 18% (7% to 30%); stiffness: mean 69; one study; N = 143; MD -7.96, 95% CI -14.95 to -0.97; absolute difference in improvement of 8% (1% to 15%) and relative change in improvement of 11.4% (21.4% to 1.4%); physical function: mean 38.32; three studies; N = 246; MD -10.16, 95% CI -15.39 to -4.94; absolute change in improvement of 10% (15% to 5%) and relative change in improvement of 21.9% (33% to 11%); and fatigue: mean 68; three studies; N = 286; MD -6.48, 95% CI -14.33 to 1.38; absolute change in improvement of 6% (12% improvement to 0.3% worse) and relative change in improvement of 8% (16% improvement to 0.4% worse). Pooled analysis resulted in a risk ratio (RR) of moderate quality for withdrawals (17 per 100 and 20 per 100 in control and intervention groups, respectively; eight studies; N = 456; RR 1.25, 95%CI 0.89 to 1.77; absolute change of 5% more withdrawals with exercise (3% fewer to 12% more).Three trials provided low-quality evidence on long-term effects (24 to 208 weeks post intervention) and reported that benefits for pain and function persisted but did not for HRQL or fatigue. Withdrawals were similar, and investigators did not assess stiffness and adverse events.We are uncertain about the effects of one aerobic intervention versus another, as the evidence was of low to very low quality and was derived from single trials only, precluding meta-analyses. Similarly, we are uncertain of the effects of aerobic exercise over active controls (ie, education, three studies; stress management training, one study; medication, one study) owing to evidence of low to very low quality provided by single trials. Most studies did not measure adverse events; thus we are uncertain about the risk of adverse events associated with aerobic exercise.

Authors' Conclusions: When compared with control, moderate-quality evidence indicates that aerobic exercise probably improves HRQL and all-cause withdrawal, and low-quality evidence suggests that aerobic exercise may slightly decrease pain intensity, may slightly improve physical function, and may lead to little difference in fatigue and stiffness. Three of the reported outcomes reached clinical significance (HRQL, physical function, and pain). Long-term effects of aerobic exercise may include little or no difference in pain, physical function, and all-cause withdrawal, and we are uncertain about long-term effects on remaining outcomes. We downgraded the evidence owing to the small number of included trials and participants across trials, and because of issues related to unclear and high risks of bias (performance, selection, and detection biases). Aerobic exercise appears to be well tolerated (similar withdrawal rates across groups), although evidence on adverse events is scarce, so we are uncertain about its safety.
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http://dx.doi.org/10.1002/14651858.CD012700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481524PMC
June 2017

Persistence Length and Cooperativity Estimation of Single Stranded DNA using FCS Combined with HYDRO Program.

J Fluoresc 2017 Jul 3;27(4):1373-1383. Epub 2017 Apr 3.

Department of Physics, Korea Advanced Institute of Science and Technology, Daejeon, 305-701, South Korea.

Translational diffusion properties of single-stranded DNA (ssDNA) and G-quadruplexes were studied to determine the persistence length and cooperativity of G-quadruplex formation using FCS combined with HYDRO in which wormlike chain (WLC)-based Monte Carlo simulation are implemented. The presence of a guanine instead of a thymine shortened the contour length of nucleic acids and increased the vulnerability to ion screening. For cooperativity estimation, the telomeric sequence HT was assumed to undergo 27 intermediate states, which can be classified as ssDNA, single-G-quadruplex, double-G-quadruplex, and three consecutive G-quadruplexes. Each state type was modeled using a series of beads and appropriate bond lengths, which were obtained from the WLC model. Using the HYDRO program, we calculated diffusion times for each species, and these were used to calculate simulated HT diffusion times for mixtures of species in arbitrary KCl concentrations. By comparison between simulated and experimental diffusion properties, we obtained a positive cooperativity of C = 200 from FCS combined with HYDRO.
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http://dx.doi.org/10.1007/s10895-017-2072-8DOI Listing
July 2017

Induction of Nuclear Enlargement and Senescence by Sirtuin Inhibitors in Glioblastoma Cells.

Immune Netw 2016 Jun 17;16(3):183-8. Epub 2016 Jun 17.

College of Pharmacy and Research Institute of Life Sciences, Gyeongsang National University, Jinju 52828, Korea.

Sirtuin family members with lysine deacetylase activity are known to play an important role in anti-aging and longevity. Cellular senescence is one of the hallmarks of aging, and downregulation of sirtuin is reported to induce premature senescence. In this study, we investigated the effects of small-molecule sirtuin inhibitors on cellular senescence. Various small molecules such as tenovin-1 and EX527 were employed for direct sirtuin activity inhibition. U251, SNB-75, and U87MG glioblastoma cells treated with sirtuin inhibitors exhibited phenotypes with nuclear enlargement. Furthermore, treatment of rat primary astrocytes with tenovin-1 also increased the size of the nucleus. The activity of senescence-associated β-galactosidase, a marker of cellular senescence, was induced by tenovin-1 and EX527 treatment in U87MG glioblastoma cells. Consistent with the senescent phenotype, treatment with tenovin-1 increased p53 expression in U87MG cells. This study demonstrated the senescence-inducing effect of sirtuin inhibitors, which are potentially useful tools for senescence research.
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http://dx.doi.org/10.4110/in.2016.16.3.183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917402PMC
June 2016

Angelman syndrome: A review highlighting musculoskeletal and anatomical aberrations.

Clin Anat 2016 Jul 17;29(5):561-7. Epub 2015 Nov 17.

School of Physical Therapy, University of Saskatchewan, Saskatoon, Canada.

Angelman's syndrome (AS) is a genetic neurodevelopment disorder. The cause is a known abnormality involving the maternal inherited ubiquitin-protein ligase (UBE3A) gene. Clinical characteristics universal to the disorder are well documented in the literature and include developmental delay, seizures, ataxia, altered tone, severely impaired speech and intellect, as well as an overall happy demeanor, frequent bouts of laughter, and hypermotoric behavior. Associated with this disorder are several musculoskeletal aberrations. To date, a review of case studies reporting on these musculoskeletal changes has not been carried out. Thus, the purpose of this paper was to provide an overview of the musculoskeletal changes present in individuals with AS. In our review of 21 case reports from 1965-2013, the most consistently reported anatomical changes were of the craniofacial region. These include microcephaly, brachycephaly, a palpable occipital groove, prognathism, and wide spaced teeth. Other musculoskeletal abnormalities less frequently reported in the literature include scoliosis, excessive lumbar lordosis, and pes planus. Given that the majority of the case reports reviewed was of young children, the possibility of underreporting musculoskeletal changes which may manifest in the later years of life may be present. Early diagnosis and interventions to minimize secondary complications are crucial to maintain quality of life. An overall multidisciplinary approach is emphasized to maximize developmental potential for these individuals. Future prospective studies that follow patients into adulthood are needed to better understand the prevalence and development of secondary musculoskeletal changes, which in turn can inform intervention techniques and preventative measures. Clin. Anat. 29:561-567, 2016. © 2015 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/ca.22659DOI Listing
July 2016

Change in the Pathologic Supraspinatus: A Three-Dimensional Model of Fiber Bundle Architecture within Anterior and Posterior Regions.

Biomed Res Int 2015 27;2015:564825. Epub 2015 Aug 27.

Department of Anatomy and Cell Biology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5.

Supraspinatus tendon tears are common and lead to changes in the muscle architecture. To date, these changes have not been investigated for the distinct regions and parts of the pathologic supraspinatus. The purpose of this study was to create a novel three-dimensional (3D) model of the muscle architecture throughout the supraspinatus and to compare the architecture between muscle regions and parts in relation to tear severity. Twelve cadaveric specimens with varying degrees of tendon tears were used. Three-dimensional coordinates of fiber bundles were collected in situ using serial dissection and digitization. Data were reconstructed and modeled in 3D using Maya. Fiber bundle length (FBL) and pennation angle (PA) were computed and analyzed. FBL was significantly shorter in specimens with large retracted tears compared to smaller tears, with the deeper fibers being significantly shorter than other parts in the anterior region. PA was significantly greater in specimens with large retracted tears, with the superficial fibers often demonstrating the largest PA. The posterior region was absent in two specimens with extensive tears. Architectural changes associated with tendon tears affect the regions and varying depths of supraspinatus differently. The results provide important insights on residual function of the pathologic muscle, and the 3D model includes detailed data that can be used in future modeling studies.
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http://dx.doi.org/10.1155/2015/564825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4564630PMC
July 2016

Fiber type composition of the human quadratus plantae muscle: a comparison of the lateral and medial heads.

J Foot Ankle Res 2014 13;7(1):54. Epub 2014 Dec 13.

Current Address: School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, Saskatchewan S7N 0W3 Canada.

Background: The human quadratus plantae muscle has been attributed a variety of functions, however no consensus has been reached on its significance to foot functioning. The architecture of the human quadratus plantae consists of an evolutionarily conserved lateral head, and a medial head thought to be unique to Man. Surveys of human anatomy have demonstrated the absence of either the medial or lateral head in 20% of the population, which may have implications for foot functioning if each muscle head performs a discrete function.

Methods: We investigated the quadratus plantae from eleven formalin-embalmed specimens with a mean age of 84 ± 9 years. Immunohistochemical methods were used to determine the percentage of Type I and Type II muscle fibers in the medial and lateral heads of the quadratus plantae from these specimens.

Results: Results showed striking homogeneity in fiber type composition within an individual, with an average difference in Type I fiber content of 4.1% between lateral and medial heads. Between individuals, however, the ratio of fiber types within the quadratus plantae was highly variable, with Type I fiber percentages ranging from 19.1% to 91.6% in the lateral head, and 20.4% to 97.0% within the medial head.

Conclusions: Our finding of similar fiber type composition of lateral and medial heads within an individual supports the hypothesis that the two heads have a singular function.
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http://dx.doi.org/10.1186/s13047-014-0054-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271414PMC
December 2014

Investigation of supraspinatus muscle architecture following concentric and eccentric training.

J Sci Med Sport 2015 Jul 27;18(4):378-82. Epub 2014 May 27.

School of Physical Therapy, University of Saskatchewan, Canada.

Objectives: To investigate the effects of concentric or eccentric abduction strength training on supraspinatus fiber bundle architecture and strength.

Design: A pre-post single-subject design.

Methods: Thirteen participants were randomized to concentric (n=6) or eccentric (n=7) training groups. Participants completed an eight week shoulder abduction training program in the scapular plane using an isokinetic dynamometer. Resistance training, requiring maximal effort on contraction, consisted of 4 sets of 8 reps at 60°/s in weeks 1-4, and 6 sets of 6 reps at 60°/s in weeks 5-8 with a frequency of 3×/week. Primary outcome measures included fiber bundle length, pennation angle, and muscle thickness of supraspinatus and these were quantified using ultrasound. Secondary outcome measures included isometric, eccentric and concentric abduction strength and these were evaluated using the isokinetic dynamometer.

Results: Mean fiber bundle length in the relaxed (p=0.033) and contracted (p=0.036) states significantly decreased with concentric training but remained unchanged with eccentric training. A significant increase in pennation angle, muscle thickness, and peak torque were found with training but no significant differences were detected between concentric and eccentric groups.

Conclusions: Training mode has a significant impact on fiber bundle length changes of the supraspinatus. Eccentric training of shoulder abduction leads to similar strength gains as concentric, but it may also have the added advantages of maintaining fiber bundle lengths and promoting tendon healing. Study is needed to confirm fiber bundle changes in a clinical population which would further support the use of eccentric abduction strength training in rehabilitation settings.
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http://dx.doi.org/10.1016/j.jsams.2014.05.007DOI Listing
July 2015

Pico-force optical exchange (pico-FOX): utilizing optical forces applied to an orthogonal electroosmotic flow for particulate enrichment from mixed sample streams.

Anal Chem 2013 Sep 4;85(18):8647-53. Epub 2013 Sep 4.

National Research Council Post-Doctoral Fellow, Washington, D.C., United States.

Results are reported from a combined optical force and electrokinetic microfluidic device that separates individual particulates from molecular components in a mixed sample stream. A pico-Newton optical force was applied to an orthogonal electroosmotic flow carrying a hydrodynamically pinched, mixed sample, resulting in the separation of the various particles from the sample stream. Different combinations of polystyrene, PMMA, and silica particles with a commercially available dye were utilized to test the different separation modes available, from purely optical force to combined optical and electrophoretic forces. The impact of various particle properties on particle separation and separation efficiency were explored, including size (2, 6, 10 μm), refractive index, and electrophoretic mobility. Particle addressability was achieved by moving particles to different outlets on the basis of particle size, refractive index, and electrophoretic differences. Separations of 6 and 10 μm polystyrene particles led to only 3% particle contamination in the original sample stream and interparticle type enrichment levels >80%. The unique addressability of three different particle materials (polystyrene, PMMA, and silica) of the same size (2 μm) led to each being separated into a unique outlet without measurable contamination of the other particle types using optical force and electrophoretic mobility. In addition to particle separation, the device was able to minimize dye diffusion, leading to >95% dye recovery. This combined platform would have applications for noninvasive sample preparation of mixed molecular/particulate systems for mating with traditional analytics as well as efficient removal of harmful, degrading components from complex mixtures.
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http://dx.doi.org/10.1021/ac401369hDOI Listing
September 2013

Epigallocatechin-3-gallate suppresses IGF-I-induced lipogenesis and cytokine expression in SZ95 sebocytes.

J Invest Dermatol 2012 Dec 5;132(12):2700-8. Epub 2012 Jul 5.

Department of Dermatology, College of Medicine, Chungnam National University, Daejeon, Korea.

Acne vulgaris is the most common disease of the pilosebaceous unit. The pathogenesis of this inflammatory disease is complex, involving increased sebum production and perifollicular inflammation. To identify effective agents for factors that induce acne vulgaris, we explored the pharmacological potential of epigallocatechin-3-gallate (EGCG), which has been widely investigated as an anti-proliferative and anti-inflammatory agent. In this study, we demonstrated that topical application of EGCG to rabbit auricles reduced the size of the sebaceous glands. When applied to cultured human SZ95 sebocytes, EGCG strongly suppressed cell proliferation and lipogenesis. These actions of EGCG were reproduced in IGF-I-differentiated SZ95 sebocytes. To investigate the anti-inflammatory potential of EGCG, we evaluated pro-inflammatory cytokine synthesis in IGF-I-differentiated SZ95 sebocytes and found that expression of IL-1, IL-6, and IL-8 was decreased. These results provide early evidence that EGCG is an effective candidate for acne therapy whose mechanisms of action in IGF-I-differentiated SZ95 sebocytes include the inhibition of lipogenesis and inflammation.
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http://dx.doi.org/10.1038/jid.2012.202DOI Listing
December 2012

Laparoscopic repair of colonic anastomotic leak in an elderly patient.

JSLS 2011 Oct-Dec;15(4):555-7

Department of Surgery, Abington Memorial Hospital, Abington, PA, USA.

Background: Laparoscopy to repair iatrogenic colonoscopic perforation of the colon has proven to be a safe, effective, and reproducible means to treat these potentially devastating emergencies. The use of the laparoscope provides exceptional diagnostic yield, and under the hand of a trained surgeon, produces excellent therapeutic results while minimizing recovery time for the patient.

Methods: We report the case of an 86-year-old man who underwent emergent laparoscopic repair of a postoperative anastomotic leak following sigmoid colectomy.

Results: The patient underwent laparoscopic oversewing of a colonic anastomotic leak, omental patch, and diverting loop ileostomy. The patient recovered fully from his emergency procedure without any further complications.

Conclusion: Laparoscopic surgery can be extended to a wider variety of colorectal emergencies in a carefully selected group of patients, including the elderly.
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http://dx.doi.org/10.4293/108680811X13176785204553DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340970PMC
August 2012

Musculotendinous architecture of pathological supraspinatus: a pilot in vivo ultrasonography study.

Clin Anat 2013 Mar 19;26(2):228-35. Epub 2012 Mar 19.

School of Physical Therapy, University of Saskatchewan, Saskatoon, Canada.

Architectural changes associated with tendon tears of the supraspinatus muscle (SP) have not been thoroughly investigated in vivo with the muscle in relaxed and contracted states. The purpose of this study was to quantify the geometric properties within the distinct regions of SP in subjects with full-thickness tendon tears using an ultrasound protocol previously developed in our laboratory, and to compare findings with age/gender matched normal controls. Twelve SP from eight participants (6 male/2 female), mean age 57 ± 6.0 years, were investigated. Muscle geometric properties of the anterior region (middle and deep parts) and posterior region (deep part) were measured using image analysis software. Along with whole muscle thickness, fiber bundle length (FBL) and pennation angle (PA) were computed for architecturally distinct regions and/or parts. Pathologic SP was categorized according to the extent of the tear in the tendon (with or without retraction). In the anterior region, mean FBL of the pathologic SP was similar with normal controls; however, mean PA was significantly smaller in pathologic SP with retraction compared with normal controls, in the contracted state (P < 0.05). Mean FBL in the posterior region in both relaxed and contracted states was significantly shorter in the pathologic SP with retraction compared with normal controls (P < 0.05). Findings suggest FBL changes associated with tendon pathology vary between the distinct regions, and PA changes are related to whether there is retraction of the tendon. The ultrasound protocol may provide important information on architectural changes that may assist in decision making and surgical planning.
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http://dx.doi.org/10.1002/ca.22065DOI Listing
March 2013

NDRG2 expression decreases with tumor stages and regulates TCF/beta-catenin signaling in human colon carcinoma.

Carcinogenesis 2009 Apr 23;30(4):598-605. Epub 2009 Feb 23.

Stem Cell Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 305-333, Republic of Korea.

NDRG (N-Myc downstream-regulated gene)-2 is a member of the NDRG family. Although it has been suggested that NDRG2 is involved in cellular differentiation and tumor suppression, its intracellular signal and regulatory mechanism are not well known. Here, we show the differential expression of NDRG2 in human colon carcinoma cell lines and tissues by reverse transcription-polymerase chain reaction and immunohistochemical analyses with monoclonal antibody against NDRG2. NDRG2 was strongly expressed in normal colonic mucosa and colonic adenomatous tissues (25 of 25) but not in all invasive cancer tissues [44 of 99 (44%)]. Most distinctive results indicated that the high expression level of NDRG2 has a positive correlation with tumor differentiation and inverse correlation with tumor invasion depth and Dukes' stage of colon adenocarcinoma. To investigate the roles of NDRG2 in tumorigenesis, we used in vitro cell culture system. SW620 colon cancer cell line with a low level of intrinsic NDRG2 protein was transfected with NDRG2-expressing plasmid. TOPflash luciferase reporter assay showed that the transcriptional activity of T-cell factor (TCF)/lymphoid enhancer factor (LEF) was reduced by NDRG2 introduction, but not by the introduction of mutant NDRG2 generated by deletion or site-directed mutagenesis. Intracellular beta-catenin levels were slightly reduced in the NDRG2-transfected SW620 cells and this regulation of beta-catenin stability and TCF/LEF activity were mediated through the modulation of glycogen synthase kinase-3beta activity by NDRG2 function. Our results suggest that NDRG2 might play a pivotal role as a potent tumor suppressor by the attenuation of TCF/beta-catenin signaling for the maintenance of healthy colon tissues.
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http://dx.doi.org/10.1093/carcin/bgp047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664458PMC
April 2009

Deterministic loading of individual atoms to a high-finesse optical cavity.

Phys Rev Lett 2007 Jun 8;98(23):233601. Epub 2007 Jun 8.

School of Physics, Georgia Institute of Technology, Atlanta, Georgia 30332-0430, USA.

Individual laser-cooled atoms are delivered on demand from a single atom magneto-optic trap to a high-finesse optical cavity using an atom conveyor. Strong coupling of the atom with the cavity field allows simultaneous cooling and detection of individual atoms for time scales exceeding 15 s. The single atom scatter rate is studied as a function of probe-cavity detuning and probe Rabi frequency, and the experimental results are in qualitative agreement with theoretical predictions. We demonstrate the ability to manipulate the position of a single atom relative to the cavity mode with excellent control and reproducibility.
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http://dx.doi.org/10.1103/PhysRevLett.98.233601DOI Listing
June 2007

Three-dimensional study of the musculotendinous architecture of supraspinatus and its functional correlations.

Clin Anat 2007 Aug;20(6):648-55

Division of Anatomy, Department of Surgery, University of Toronto, Ontario, Canada.

The supraspinatus is most frequently involved in shoulder pathology. However, the musculotendinous architecture of the supraspinatus has not been well documented. Therefore, the purpose of this study is to investigate the detailed three-dimensional architecture of the supraspinatus throughout its volume. Ten male formalin embalmed cadaveric specimens (mean age 61.9 +/- 16 years) without any evidence of rotator cuff pathology were used. Three-dimensional coordinates (x, y, and z) of the tendon and muscle fiber bundles were collected in situ, using serial dissection and digitization. The data was reconstructed into a three-dimensional model using Maya. Fiber bundle lengths, pennation angles (PA), muscle volumes, and tendon dimensions for each architecturally distinct area were computed and then analyzed using paired t-tests and ANOVA (P < 0.05). The supraspinatus was found to consist of anterior and posterior regions, which were each further subdivided into superficial, middle, and deep parts. Mean PA were found to be significantly different between the distinct parts of the anterior region of the muscle. Medial PA was also found be significantly different between the superficial and middle, and superficial and deep parts of the posterior region. These results provide insight into the normal function of the muscle and its possible contribution to the initiation and progression of supraspinatus tendon tears.
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http://dx.doi.org/10.1002/ca.20469DOI Listing
August 2007

The role of endogenous growth hormone-releasing hormone in acromegaly.

J Clin Endocrinol Metab 2006 Jun 14;91(6):2185-90. Epub 2006 Mar 14.

Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan 48109, USA.

Context: Some indirect evidence suggests hypothalamic control of GH secretion in acromegaly.

Objective: The objective of the study is to examine whether GH secretion in acromegaly is dependent on endogenous GHRH.

Patients And Study Design: We studied eight patients with untreated acromegaly due to a GH-producing pituitary tumor. All patients received an iv infusion of normal saline for 24 h and GHRH-antagonist (GHRH-ant) at 50 microg/kg x h for 7 d. GH was measured every 10 min for 24 h during the normal saline infusion and on the last day of the GHRH-ant infusion. A group of nine different patients with untreated acromegaly served as the control group and underwent blood sampling for GH every 10 min for two 24-h periods to assess the day-to-day variability of GH secretion.

Setting: The study was set in a university referral center.

Main Outcome Measure: Twenty-four-hour mean GH was the main outcome measured.

Results: In six of eight subjects treated with GHRH-ant, 24-h mean GH decreased by 5.8-30.0% during iv GHRH-ant and, in three subjects, the change in the 24-h mean GH was greater than the upper limit of the 95% confidence interval of the spontaneous day-to-day variability of the mean GH in patients with acromegaly. Based on the binomial distribution, the probability of this magnitude of change to occur in three of eight subjects by chance alone is 0.0008.

Conclusion: In some patients with acromegaly due to a pituitary adenoma, GH secretion is under partial control by endogenous GHRH.
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http://dx.doi.org/10.1210/jc.2005-2398DOI Listing
June 2006