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PURPOSE Evaluation of the incidence of a midline sternal foramen, as a developmental anomaly, in order to avoid fatal complications following sternal puncture of sternal acupuncture treatment. MATERIAL AND METHODS 100 chest computed tomograms were evaluated in reference to the incidence of this anomaly and its various features. RESULTS The variety of CT aspects ranged from very incomplete types with only sandglass-like retraction of sternal cortex, to a complete foraminal defect. The incidence of midline sternal foramen in a feature bearing a risk of complication, is approximately 6%. CONCLUSION We conclude that--if sternal acupuncture is planned in the region of corpus--previous radiographs should be done to rule out this anomaly. Furthermore, we strongly recommend the acupuncture technique of the "Wiener Schule", which prescribes a safe superficial-oblique approach to the sternum.

Objectives Asymptomatic hyperuricemia (AHU) is elevated serum uric acid (UA) without symptoms. This study aimed to determine the effects of AHU treatment with allopurinol on selected hypertension-mediated organ damage (HMOD) indices in patients with uncomplicated essential arterial hypertension (AH). Methods Patients aged 30-70 years with AHU and AH grade 1-2 with adequate blood pressure (BP) control, without previous urate-lowering therapy (ULT), were divided into two groups: (a) ULT (receiving allopurinol) and (b) control (age- and sex-matched patients without ULT). Both received a UA-lowering diet. BP (office, 24 h and central), echocardiographic parameters, carotid intima-media thickness (IMT) and lab tests [high-sensitivity C-reactive protein (hs-CRP)] were measured at baseline and at 6 months follow-up. Results Of 100 participants, 87 (44 ULT, 43 controls) completed the study. At 6 months follow-up, there was a greater reduction in serum UA concentration in the ULT group than in the control group. Patients receiving allopurinol had significant reductions in office systolic and diastolic BP, central systolic BP, pulse pressure, IMT (0.773 ± 0.121 vs. 0.752 ± 0.13 mm, P = 0.044) and hs-CRP (3.36 ± 2.73 vs. 2.74 ± 1.91 mg/L, P = 0.028) compared to controls. Multivariate regression analysis revealed the independent relationship between reduction in IMT and UA lowering (P < 0.026). Conclusion In patients with AH and AHU, treatment with allopurinol leads to improvement in BP control and reduction in HMOD intensity, in particular IMT. The decrease in hs-CRP concentration associated with ULT may have a beneficial effect on a patient's long-term prognosis.

Electroneurographic signals were intraoperatively recorded from the S3 sacral nerve root in two SCI patients. The aim of this study was to record afferent nerve signals in response to mechanical stimulation of the urinary bladder, rectum, and dermatome. Such signals could be used in an implantable neuroprosthesis to treat neurogenic detrusor overactivity. In both patients a neural response was recorded from the dermatome and the rectum, but from the bladder only in one patient. The results were consistent with results from animal and other human studies. Further studies are however, needed because the number of subjects investigated remains low.

The aims of the present study were to investigate whether temporal summation of the nociceptive withdrawal reflex depends on the stimulation site on the sole of the human foot, and to characterize the reflex receptive fields (RRF) of lower limb muscles to repetitive stimulation. The cutaneous RRFs were assessed in 15 subjects in sitting position by recording the EMG from five lower leg muscles and the kinematic responses (ankle, knee, and hip joints) to repetitive painful electrical stimulation. The stimulus consisted of a series of five stimuli (frequency: 3 Hz) delivered randomly at 10 different sites on the sole of the foot. The size of the reflexes increased generally between the first and the second stimulus, however, the increment depended on the stimulation site. In tibialis anterior, the RRF covered the distal sole of the foot and gradually expanded during the stimulus train. No expansion toward the heel area was detected. In soleus, the reflexes were facilitated after the second stimulus at all sites and remained in this state until the last stimulus. In vastus lateralis, biceps femoris, and iliopsoas a gradual expansion of the RRF was seen, resulting in RRFs covering the lateral, distal foot, and part of the proximal foot (iliopsoas). Knee and hip flexion were evoked at all sites. Ankle dorsiflexion was evoked at the distal foot, while ankle plantarflexion was evoked at the heel. The enlargement of the RRF reflects spinal temporal summation leading to gradually stronger reflex responses. The degree of temporal summation was dependent on stimulation site. The facilitation of the withdrawal reflex responses due to repetitive stimulation might have potential applications in the rehabilitation engineering field, where these reflexes could be used to assist gait of patients with central nervous system injuries.