To investigate the effect of intravenous infusion of peripheral blood mononuclear cells (mPBMC) mobilized by granulocyte-colony stimulating factor (G-CSF) on upper extremity function in children with cerebral palsy (CP).
Fifty-seven children with CP were enrolled. Ten patients were excluded due to follow-up loss. In total, 47 patients (30 males and 17 females) were analyzed. All patients' parents provided signed consent before the start of the study. After administration of G-CSF for 5 days, mPBMC was collected and cryopreserved. Patients were randomized into two groups 1 month later. Twenty-two patients were administered mPBMC and 25 patients received normal saline as placebo. Six months later, the two groups were switched, and administered mPBMC and placebo, respectively. Quality of Upper Extremity Skills Test (QUEST) and the Manual Ability Classification System (MACS) were used to evaluate upper motor function.
All subdomain and total scores of QUEST were significantly improved after mPBMC and placebo infusion, without significant differences between mPBMC and placebo groups. A month after G-CSF, all subdomain and total scores of QUEST were improved. The level of MACS remained unchanged in both mPBMC and placebo groups.
In this study, intravenously infused mPBMC showed no significant effect on upper extremity function in children with CP, as compared to placebo. The effect of mPBMC was likely masked by the effect of G-CSF, which was used in both groups and/or G-CSF itself might have other neurotrophic potentials in children with CP.
Citations
Objective: To evaluate long-term prognosis of postoperative femoral neuropathy.
Method: 15 patients who confirmed as femoral neuropathy by electrodiagnostic study after renal transplantation or abdominal hysterectomy were included in this study. Retrospective chart review and telephone interview of 12 available patients were performed at 36 months on average after operation. Second telephone interview were available in 4 out of 12 patients one year after first telephone interview. After the second telephone interview, we evaluated muscle strength and gait function of them in our labaratory.
Results: At immediate postoperative stage (average 16.8 days), knee extensor strength was less than grade III in 8 out of 12 patients. In gait function evaluation, six patients were unable to walk on flat surface. At first interveiw, recovery of muscle strength was excellent in five patients, good in five and fair in two. In gait function, all could walk without walking aids for more than 30 minutes and 9 could run and mount up the stairs. The second follow-up showed functional improvement even after 24 months of onset. The findings of physical examination correlated well with telephone interview.
Conclusion: Almost all patients who diagnosed as postoperative femoral neuropathy regained near normal motor strength and functional ambulation in the long-term follow- up. (J Korean Acad Rehab Med 2002; 26: 550-554)
Objective: To investigate the character of peripheral neuropathy associated with end-stage liver disease and the effect of liver transplantation on peripheral neuropathy.
Method: Twenty five patients admitted for a liver transplantation were involved in this study. All patients underwent nerve conduction study before liver transplantation and 6 months after liver transplantation. Based on results of this study, motor amplitude (MAS), motor velocity (MVS), sensory amplitude (SAS), and sensory velocity score (SVS) were calculated. Neuropathy symptom score (NSS), and neuropathy disability score (NDS) were estimated. The scores from the nerve conduction study were compared with NSS and NDS to find out the correlation between them. The changes in nerve conduction study, NSS and NDS after liver transplantation were evaluated.
Results: All patients had abnormalities on their nerve conduction study preoperatively, but 10 patients (40%) showed normal findings 6 months after transplantation. Only SAS disclosed significant correlation with NDS preoperatively. SAS, SVS, and MVS showed significant correlation with NDS after transplantation. SAS and MVS substantially increased after transplantation.
Conclusion: Nerve conduction study showed the improvement both in sensory and motor nerve after liver transplantation. The correlation between the nerve conduction study and clinical estimates after liver transplantation was closer than before the transplantation.
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