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Objectives This study aimed to evaluate the histological and mechanical features of tendon healing in a rabbit model with second-harmonic-generation (SHG) imaging and tensile testing. Materials and Methods A total of eight male Japanese white rabbits were used for this study. The flexor digitorum tendons in their right leg were sharply transected, and then were repaired by intratendinous stitching. At four weeks post-operatively, the rabbits were killed and the flexor digitorum tendons in both right and left legs were excised and used as specimens for tendon healing (n = 8) and control (n = 8), respectively. Each specimen was examined by SHG imaging, followed by tensile testing, and the results of the two testing modalities were assessed for correlation. Results While the SHG light intensity of the healing tendon samples was significantly lower than that of the uninjured tendon samples, 2D Fourier transform SHG images showed a clear difference in collagen fibre structure between the uninjured and the healing samples, and among the healing samples. The mean intensity of the SHG image showed a moderate correlation (R2 = 0.37) with Young’s modulus obtained from the tensile testing. Conclusion Our results indicate that SHG microscopy may be a potential indicator of tendon healing.

The application of motor learning is important for the rehabilitation of patients with motor disorders. Although the exercise method of motor learning consists of constant exercise, variable exercise or both, these methods have not yet been verified adequately with regard to the postural control during standing. To investigate the effect of different exercises with visual feed-back information on postural control, we examined the motor performance with regard to the center of pressure (COP) during the standing target-tracking task in six healthy young males. The visual feed-back information of COP from the force plate was provided to subjects by the monitor display. Subjects were asked to move their body in a forward or backward direction to fit and track their own projected COP to the target on the display. The constant exercise group had a scale with the same rate between the COP displacement on the force plate and the COP displacement displayed in the monitor, and the variable exercise group had two scales with different rates. The retention tests were performed after completing the exercises, on the following day, and one week later. The COP data acquired during the tracking task in retention tests were measured, and the gain, the root-mean-square error (RMSE) and the phase shift for the tracking target were computed. In comparison to the constant exercise group, the motor performance of the variable exercise group was better and maintained these effects for a week after the exercise. The findings of this study suggest that differences in exercise methods affect motor performance and/or the retention of motor performance, and that the application of variable exercise for balance training may therefore be beneficial for fall prevention., ＜和文要約＞運動障害をもつ患者のリハビリテーションに運動学習の応用は重要である。運動学習の練習方法には一定練習と多様性練習があるが、異なる練習方法がその後の立位時の姿勢制御に与える影響については十分に明らかにされていない。本研究は視覚的フィードバック情報を用いた練習方法の違いが立位での目標追跡課題の成績に与える影響について健常若年者6名を対象に行なった。目標追跡課題は床反力計上で直立位をとり、モニター画面上に表示された自身の足圧中心（COP）と追跡目標を一致させる視覚誘導型の随意的追跡運動とした。練習方法の違いは床反力計の情報からモニター画面上に表示されるフィードバック情報への割合の違いとした。一定練習は床反力計上のCOP移動量をモニター画面上に同じ大きさで表示し、多様性練習は２種類の異なる割合でモニター画面上にCOPの移動量を表示した。多様性練習群の成績は一定練習群に比べ良好であり、その練習効果は1週間後においても維持されていた。 本研究より、練習方法の違いは立位での随意的運動課題の成績及び効果の持続に影響を与え、転倒予防を目的としたバランス訓練への多様性の応用は有効である可能性が示唆される。

[Purpose] To understand stair ascent and descent motions, we examined the muscle activities of the vastus medialis (VM) and vastus lateralis (VL) and the ground reaction force (GRF) in the supporting leg of eight young healthy males. We also compared these data with level walking data. [Result] The muscle activities of VM and VL during the ascent motion were the highest among the three tasks. The muscle activity ratios of VM and VL during ascending and descending differed from that during level walking. The VM contribution increased in the ascent and descent tasks compared with level walking. There was no significant difference for the vertical GRF among the tasks. Although the anterior-posterior GRF during the ascent motion was similar to that during level walking, the anteriorposterior GRF during the descent motion was different from that of the ascent motion and level walking. Further, the medial-lateral GRF during ascending and descending were different from that during level walking. [Conclusion] The results of this study suggest that the increased VM contribution of the supporting leg may be related to the change of medial-lateral GRF during ascent and descent. This finding will add knowledge to the rehabilitation and physical therapy of ascent and descent motions for elderly people and patients with motor disorders., 〔目的〕段差昇降時の支持脚の大腿四頭筋（内側広筋と外側広筋）と床反力の関係について筋電図計と床反力計を用いて測定した。〔対象〕若年健康男性8 名とした。〔結果〕内側広筋と外側広筋の筋活動は昇段動作で最も大きな値を示していた。内側広筋と外側広筋の筋活動の比率は歩行に比べ段差昇降動作で大きな値を示し，内側広筋の活動の関与を高めていた。垂直方向の床反力の値は動作間で差はみられなかったが，昇降動作時の外側方向の分力は歩行に比べ有意に低い値を示していた。内側方向の分力に動作間の差がみられなかったことから，相対的に内側方向への力が増大し，内側広筋の筋活動の増大に関連している可能性が示唆される。〔結語〕段差昇降では身体の内外側方向の安定化に内側広筋の活動が寄与していることが明らかとなり，昇降動作の理学療法ではこれらのことに考慮して行う必要がある。

Osteomyelitis caused by Candida glabrata is rare and its optimal treatment is unknown. Here we report a case of osteomyelitis caused by C. glabrata in the distal phalanx in a 54-year-old woman. Despite partial resection of the nail and administering a 1-month course of antibiotics for paronychia, the local swelling remained and an osteolytic lesion was found. C. glabrata osteomyelitis of the distal phalanx was later diagnosed after curettage. Thereafter, the patient was treated with antifungal agents for 3 months. The infection eventually resolved, and radiological healing of the osteolytic lesion was achieved. Antifungal susceptibility testing should be performed in the case of osteomyelitis caused by nonalbicans Candida species, due to their resistance to fluconazole.

A 32-year-old man underwent radiofrequency thermal annuloplasty (TA) with percutaneous endoscopic discectomy (PED) under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ) in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc.