Abstract-We present the case of a 24 yr old male who was diagnosed with gluteal compartment syndrome and was subsequently found to have developed lumbosacral radiculoplexopathy and complex regional pain syndrome. The patient's gluteal compartment syndrome was diagnosed within 24 h of presentation to the emergency room, and he underwent emergent compartment release. While recovering postoperatively, persistent weakness was noted in the right lower limb. Results of electrodiagnostic testing were consistent with a lumbosacral radiculoplexopathy. After admission to inpatient rehabilitation, the patient complained of pain, burning sensation, and numbness in the distal right lower limb. Based on clinical findings, he was diagnosed with complex regional pain syndrome type II, or causalgia, and was referred for a lumbar sympathetic block under fluoroscopic guidance. Sympathetic block resulted in relief of the patient's symptoms. He was discharged home with good pain control on oral medications.

Participants: 327 persons with SCI presenting for their annual evaluation in 2012 and 2013. Interventions: Using a validated algorithm, each case was classified as asymptomatic bacteriuria (ASB), urinary tract infection (UTI) or neither. Main Outcome Measures: Urinalysis results (levels of pyuria, presence of nitrates, presence of leukocyte esterase) and urine culture results (colony forming unit count and organisms). Results: The patients were predominantly male (95%), white (60%) and used intermittent catheterization (43%). Of the 327 clinic visits, 271 (83%) had a UA obtained, and 249 (76%) had a UC. 171 (69%) of the cultures were positive. 76 (44%) of the cultures grew urease producing organisms. The vast majority (149, 87%) of the positive cultures represented ASB, and 22 cases (13%) represented UTI. Nitrates were positive in 11 (50%) of the UTI cases and 91 (61%) of the ASB cases. Leukocyte esterase was positive in 21 (95%) of the UTI cases and 133 (89%) of the ASB cases. There was no difference in the mean level of pyuria in the ASB and UTI cases (115, SD 311 and 115, SD 148, respectively). Conclusions: Distinguishing between ASB and UTI poses a diagnostic challenge, as the presenting signs and symptoms of UTI in persons with SCI can be non-specific. Urinalysis and urine culture results can be difficult to interpret in the setting of chronic catheter use.

with initial RCSPA . Mean RCSPA was found to improve in all subgroups of subjects following insole fitting. Moreover, in children younger than 7 years, RCSPA improved greatly from the insole fitting compared to the children aged 7 years old and older. This indicates that the younger the children are, the more prominent the effectiveness of the insole is. Moreover, it was found that the initial RCSPA increased with increasing age of children. Conclusion: The insole has proven to be effective in all population aged younger than 13. However, there may be a hidden effect of normal structural pedal alignment during growth accompanied with bony maturation and developmental process. Controversy still exists whether the treatment of flexible flatfoot is necessary in the vast majority of cases or simple observation and advice to parents is sufficient. Further study might be performed to compare subjects with insole fitting and without and to see what is going to happen between two groups. Objective: To test hypothesis that lumbar multifidus muscles are more vulnerable to physiological muscle fatigue than thoracic erector spinae muscles in the continuous stooped posture at work place. Design: Quasi-experiment Setting: Biomechanics laboratory with wireless surface electromyography (EMG) monitoring system. Participants: Eighteen male subjects, 18-32 years of age. Interventions: We performed static tests to subjects keeping continuous stooped posture for 10 minutes. Each subject was asked to bend forward while maintaining straight legs. Their flexion angle of T12-S1 vertebra was controlled at 40 degree. Wireless surface EMG data were recorded from bilateral lumbar multifidus and thoracic erector spinae muscles from each subject during the whole task. Main Outcome Measures: Mean frequency (MNF) of surface EMG data was calculated by the sum of product of the EMG power spectrum and the frequency divided by the total sum of the power spectrum. The decline of MNF was analyzed by linear regression. Visual analog scale (VAS) on back pain was recorded at task discontinuation. Results or Clinical Course: Sixteen of 18 subjects discontinued stooping task before 10 minutes due to excessive back pain and fatigue. Mean VAS score was 7.3(range, 6-9) points. Mean and minimum task duration was 385 and 224 seconds respectively. We analyzed EMG data during initial 224 seconds from 16 subjects who has fulfilled quality criteria. Consistent decline of MNF values was demonstrated only in lumbar multifidus muscles. The coefficients of determination from linear regression model were above 0.5 in 7 subjects. In thoracic erector spinae muscles, there is no tendency of MNF decline. Conclusion: In the stooped posture both lumbar multifidus and thoracic erector spinae muscles were activated, but there is a tendency of earlier fatigability in lumbar multifidus. Endurance of lumbar multifidus may be a limiting factor for maintenance of stooped posture.Case Description: An otherwise healthy 37-year-old male patient presented with a 3-day history of acute-o...

We report a case of a patient who underwent Living Donor Liver Transplantation (LDLT) while being continued on his dual antiplatelet regimen of clopidigrel and aspirin perioperatively. The patient had two drug eluting stents for coronary artery disease placed eight months prior to surgery. Preoperative thromboelastography and platelet mapping showed normal clot formation. Based on these tests it was determined that preoperative platelet transfusion was not necessary. The surgery proceeded relatively uneventfully. The patient received 1 unit of packed red blood cells intraoperatively and continued on aspirin during the postoperative period with no evidence of bleeding or cardiac ischemia.