The purpose of this study is to investigate the efficacy of exercise to prevent disuse osteoporosis in femurs of rats. The jump exercise was selected in this study because it had been reported as one of the most effective resistance training to gain bone mass. Twenty-four of 6 month-old, F 344, female rats were divided into three groups equally; control group (CONT), hindlimb suspension group (HS), and hindlimb suspension with jump exercise group (HS+EX). A Kirschner wire that was attached to the ceiling of the cage penetrated each tail of HS and HS+EX rat, and then her hindlimbs were unloaded from gravity. HS+EX rats were taken off from tail suspension and forced to jump during the exercise. When HS+EX rats jump up, they grasped the top of the 30cm height with their forelimbs and climbed up to the top. After each jump, they were replaced gently to the bottom by hands in preparation for the next jump so as to exclude the impact made by dropping down. HS+EX rats were suspended again when they finished 50 jumps a day, which were held on 5 days a week. All groups of the rats were fed for 8 weeks, and then their femurs were harvested. Bone mineral densities, mechanical bone properties, and morphological analysis of all femurs were measured. The femurs of HS rats showed a significant decrease in bone mineral density and maximum bending load compared with the control ones, but the femurs of HS+EX rats showed almost the same degree of these parameters as those of the CONT rats. The same tendencies were observed in the bone length and diameter. So we concluded that the dynamic resistance training like our jump exercise was thought to be effective for preventing disuse osteoporosis.

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The purpose of this study was to investigate relationship between newborn's behavior patterns as measured by the Neonatal Behavioral Assessment Scale (NBAS) and long-term cerebral palsy (CP) as a neurological outcome among low birthweight infants. The subjects of this case-control study were low birthweight infants admitted to the NICU at the Nagasaki University Hospital between 1988 and 1994. The study subject consisted of 292 infants, with mean gestational age of 32.6 weeks and mean birth weight of 1648.6 grams. These infants were examined using NBAS at 36 weeks, at 40 weeks and at 44 weeks post-conceptional age (PCA). Each of infants was examined at five years of age again to measure its development status on standardized assessments. Logistic regression analysis was performed to examine the relationship between newborn's behavioral patterns in NBAS cluster scores and developmental status at five years. At five years of age, 148 infants were categorized within the normal range, 46 were categorized borderline and mental retardation, 14 died and 15 were diagnosed as having CP. The remaining 69 could not be contacted. The NBAS cluster scores of the 15 infants who were diagnosed CP were compared with the NBAS scores of the normal infants. NBAS cluster scores in the 15 newborn infants diagnosed as having CP five years later were significantly lower than in normal on Mann-Whitney U Tests. In the logistic regressions analysis, Motor (p<0.01) and Autonomic (p<0.04) clusters at 36-38 weeks PCA, Motor (p<0.00) and Reflexes (p<0.02) clusters at 40-42 weeks and Reflex cluster (p<0.01) at 44 weeks, was significantly related to indicated characteristics of CP. Sensitivity and specificity at the NBAS examinations were very high (85.6-93.3% and 96.6-96.9%, respectively) in discriminate analysis. The results of the study would confirm the usefulness of the NBAS as a predictor of CP and the validity of prediction using NBAS as a diagnostic tool for identifying the early indicators of CP. The results may suggest that the NBAS, when used serially in the postnatal period, not only can help identify neonates who are at risk for CP but it can help clinicians develop a management protocol for infants with cerebral palsy.

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The patient, a 25-year-old woman, was admitted to our hospital for comprehensive rehabilitation 7 years after traumatic spinal cord injury. On the 7th day after admission she lost consciousness. The physical examination revealed tachycardia, tachypnea and a pan-systolic murmur on the left sternal border between the 4th and 5th rib. The white blood cell count was 11, 310/μl and serum LDH was 5, 26IU/l. Arterial blood gases revealed 39mmHg. Chest X-ray revealed moderate cardiomegaly without evidence of pulmonary congestion. Ultrasonography showed marked right hypertrophy. Doppler flow study showed that systolic pulmonary artery pressure was 50mmHg. Swan-Ganz catheterization showed that pulmonary artery pressure was 45/22 (mean 31) mmHg. Thus, based on three findings the diagnosis of pulmonary embolism was established. We treated her with intravenous heparin. On the 3rd day from onset, she recovered her consciousness and pulmonary artery pressure normalized. Three weeks after the, onset, ^99mTc-pulmonary perfusion scan showed a perfusion defect over S⁹ of the right lobe. To the best of our knowledge, there has been no report of a patient developing pulmonary infarction after such a long time after spinal cord injury.

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