Search

This study presents an objective evaluation of both scapular upward and axial rotational tilts in shoulder impingement syndrome, using a scapular spine line defined on antero-posterior (AP) radiographs of the shoulder as the referential line. Twenty-seven patients with unilateral shoulder motion pain, who were diagnosed as having chronic shoulder impingement syndrome, were enrolled in the study. Scapular upward and axial rotational tilts were compared between the affected and contralateral shoulders. AP radiographs were obtained at shoulder abduction angles of 0 degrees, 45 degrees, and 90 degrees, and the X-ray films were digitized by computer. The upward and axial rotational tilts of the scapula were then evaluated on the digital images. In shoulder impingement syndrome, both upward and axial external rotations of the scapula were impaired at the painful arc angle of abduction. This tended to be more apparent for the axial rotation of the scapula than for the upward rotation. These reductions in scapular rotations reduce available clearance for the rotator cuff and humeral greater tuberosity as the shoulder is abducted.

We studied the effects of denervation on the energy metabolism and peripheral circulation dynamics of rat hindlimb muscles during and after exercise. The sciatic nerves of male Wistar rats were cut to produce denervation. Energy metabolism was assessed by phosphorus-31 magnetic resonance spectroscopy (MRS), and circulation by fluorine-19 MRS. Exercise of rat hindlimb muscles was induced by electrical stimulation at 40 Hz. The inorganic phosphate (Pi) / ¿Pi + phosphocreatine (PCr)¿ ratio, an indicator of the energy level, was 0.795 immediately after denervation. The ratios 4 and 8 weeks after denervation were 0.870 and 0.853, respectively. The intracellular pH during the 4 min after initiation of stimulation was significantly reduced 4 and 8 weeks after denervation compared with the value immediately after denervation. The signal strength of the research perfluoro-carbon (FC-43; perfluorotributylamine) a measure of circulation dynamics, increased to 167% in controls during exercise, but an increase of only 134% was seen in rats 8 weeks after denervation. These results showed that the energy supply and circulation dynamics in denervated atrophic muscles decreased during exercise compared with findings in control muscles.

We reviewed 95 consecutive patients with cervical spinal cord injury admitted within 2 days of injury and treated nonoperatively, to elucidate the relationship between neurological deterioration and the white blood cell count in the first 4 days after injury. The count for 14 patients who had neurological deterioration was 13.2 +/- 3.2 x 10(9)/l, and that for 81 patients who had no deterioration was 11.0 +/- 3.1 x 10(9)/l. None of 19 patients whose highest white blood cell count was less than 9 x 10(9)l deteriorated, while 14 of 76 patients whose count was 9 x 10(9)/l or more deteriorated. These results suggest that the white blood cell is important in the secondary pathological changes after mechanical injury to the spinal cord.

The mechanism of muscle fatigue was studied by 31P-MRS. During tetanic contraction for 2 minutes(min), the tension measured with a strain gauge and Phosphocreatine(PCr)/Inorganic phosphate(Pi)+ Phosphomonoester(PME) ratio decreased to 31.5 +/- 4.4% of the control value and 0.6 +/- 0.1, respectively. The intracellular pH(pH) also decreased to 6.62 +/- 0.04. Toward the end of the stimulation, the tension decreased to 25.3 +/- 1.9% of the control value. However, during 20min stimulation, the PCr/(Pi+PME) ratio increased to 2.5 +/- 0.5 and the pH to 6.91 +/- 0.04. These results show that muscular fatigue is ascribable not to a decreased level of high energy metabolites required for actomyosin ATPase, but to an increase in the threshold intensity of excitation in excitation-contraction coupling.