Difference of motor overflow depending on the impaired or unimpaired hand in stroke patients

The aim of this study was to investigate the patterns of contralateral motor overflow (i.e. mirror movement) between the homologous body parts on the right and left side, in stroke patients during single-finger and multi-finger maximum force production tasks. Forty subjects, including stroke (n=20) and normal subjects (n=20), participated in this study. The stroke subjects maximally pressed force sensors with their fingers in a flexed position using a single (index, middle, ring, or little) or all fingers (all 4 fingers) using the impaired (IH) or unimpaired (UIH) hand, while the non-patient subjects used their right hands for the same tasks. The maximal voluntary forces in the ipsilateral and unintended pressing forces of each contralateral finger were recorded during the tasks. The magnitude of motor overflow to the contralateral side was calculated using the index of contralateral independence (CI). During the single finger tasks, the finger CI was significantly decreased in the UIH (91%) compared with that in the IH (99%) or normal hands (99%). Likewise, the multiple finger tasks showed that the CI was significantly lower in the UIH (84%) compared with that in the IH (96%) or normal hands (99%). However, the maximal forces were significantly lower in the IH relative to those in the UIH and normal hands. These data demonstrate that stroke patients have greater motor overflow from the UIH to the IH.

Comparison of the effects of water- and land-based exercises on the physical function and quality of life in community-dwelling elderly people with history of falling: a single-blind, randomized controlled trial

PURPOSE

The purpose of this study was to identify the effects of water-based exercises on the physical functions and quality of life (QOL) in community-dwelling elderly people with history of falling.

MATERIALS AND METHODS

Participants were randomly assigned to the water-based exercise group (n=34) or land-based exercise groups (n=32). To identify the effects on physical functions, muscle strength, flexibility, and mobility were measured. QOL and fear of falling were evaluated using the Short Form 36-item questionnaire and the modified falls efficacy scale (M-FES). The measurements were performed before and after the 10-week training period.

RESULTS

Within-group analysis indicated that hip abduction and adduction strength improved significantly in both groups (p=0.005; p=0.007). However, no statistically significant within-group differences were found in the back scratch test (p=0.766) and chair sit-and-reach test (p=0.870). QOL was significantly different in both groups (health transition: p=0.014, physical functioning: p<0.001, role physical: p<0.001, role emotional: p=0.002, bodily pain: p<0.001, vitality: p<0.001, and mental health: p<0.001). There was a significant difference in the M-FES in both groups (p=0.040).

CONCLUSIONS

These results indicate that water-based exercises are beneficial to improve the QOL, as well as physical activities, of community-dwelling elderly compared with land-based exercise. Water-based exercises would be useful to improve physical and psychological health in the elderly people with history of falling.

The effect of stroke on motor selectivity for force control in single- and multi-finger force production tasks

BACKGROUND

The stroke patients have difficulties in both voluntary muscle contraction and individual movements. However, there is a lack of quantitative analysis focusing on decreased finger control in stroke patients.

OBJECTIVES

The purpose of the study was to identify the changes in motor selectivity in stroke patients during a finger force production task.

METHODS

Fifteen stroke patients and fifteen control subjects were asked to perform maximum voluntary force (MVF) production during single- and multi-finger force tasks. Finger interaction indices such as force independence (FI) and force sharing deviation (FSD) were analyzed using measured individual finger forces.

RESULTS

MVF analysis in the impaired hand of stroke patients showed that they produced 31% or 41% lower force than their unimpaired hand or the control hand, respectively. For the finger interaction indices, the stroke patients' impaired hand had lower FI and higher FSD than their unimpaired hand or the normal subjects' hand.

CONCLUSION

The lower FI and higher FSD show that stroke patients have a limited ability to produce force independently and to synchronize produced multi-finger force, respectively. These results have a negative impact on the selectivity of their motor control. In terms of rehabilitation, we expect that the finger interaction indices used in the present study can quantify motor selectivity in the damaged central nervous system.

Homologous expression and quantitative analysis of T3SS-dependent secretion of TAP-tagged XoAvrBs2 in Xanthomonas oryzae pv. oryzae induced by rice leaf extract

Xanthomonas oryzae pv. oryzae (Xoo) produces a putative effector, XoAvrBs2. We expressed XoAvrBs2 homologously in Xoo with a TAP-tag at the C-terminus to enable quantitative analysis of protein expression and secretion. Addition of rice leaf extracts from both Xoo-sensitive and Xoo-resistant rice cultivars to the Xoo cells induced expression of the XoAvrBs2 gene at the transcriptional and translational levels, and also stimulated a remarkable amount of XoAvrBs2 secretion into the medium. In a T3SS-defective Xoo mutant strain, secretion of the TAPtagged XoAvrBs2 was blocked. Thus, we elucidated the transcriptional and translational expressions of the XoAvrBs2 gene in Xoo was induced in vitro by the interaction with rice and the induced secretion of XoAvrBs2 was T3SSdependent. It is the first report to measure the homologous expression and secretion of XoAvrBs2 in vitro by rice leaf extract. Our system for the quantitative analysis of effector protein expression and secretion could be generally used for the study of host-pathogen interactions.

Differences in microstructural alterations of the hippocampus in Alzheimer disease and idiopathic normal pressure hydrocephalus: a diffusion tensor imaging study

BACKGROUND AND PURPOSE

DTI can be used to assess the degradation of WM tracts by measuring the FA and MD. Decreased FA/increased MD values in the AD hippocampus have been reported by many studies. In contrast, only a few studies reported on hydrocephalus by using the DTI technique. In elderly patients with dementia and with dilated ventricles, it is often difficult to differentiate iNPH from AD with visual measurements on MR imaging. The aim of this study was to investigate the changes of microstructural integrity of the hippocampus in iNPH by using DTI and determining whether this method could be a new diagnostic tool to differentiate iNPH from AD.

MATERIALS AND METHODS

We recruited 43 participants (15 healthy controls, 15 patients with AD, and 13 patients with iNPH). The FA and MD values were measured by using the region-of-interest method in the hippocampal head, body, and tail on both sides. Clinical history, neurologic examination, and neuropsychological assessment were included.

RESULTS

The FA values were the lowest in the patients with AD, the patients with iNPH, and the healthy controls in this order. The MD values were the highest in the same order. These findings were consistent in the 3 subdivisions of the bilateral hippocampal regions. Hippocampal volume was not different between patients with iNPH and AD.

CONCLUSIONS

The microstructural alterations of the hippocampus were more sensitive than the volumetric changes in AD and iNPH. DTI analysis might be a useful tool for discriminating AD from iNPH.

Lumbar spine stability for subjects with and without low back pain during one-leg standing test

STUDY DESIGN

An experimental design comparing kinematic changes in the lumbar spine axis in subjects with and without low back pain (LBP) while standing on one leg with and without visual feedback.

OBJECTIVE

The purpose of this study was to evaluate the lumbar stability index, which includes relative holding time (RHT) and relative standstill time (RST), in subjects with and without LBP.

SUMMARY OF BACKGROUND DATA

Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with LBP, lumbar spine stability has not been examined for abnormal postural responses with visual feedback.

METHODS

All participants were asked to maintain the stork test position (standing on one leg with the contra lateral hip flexed 90 degrees) for 25 seconds. The outcome measures included RHT and RST for the axes of the core spine and lumbar spine. Independent t tests were used to compare the differences between groups. Two-way repeated measure analysis of variance was used to compare the differences for both axes. The age variable was used as a covariate to control confounding effects for the data analyses.

RESULTS

The RHT was longer for the lumbar spine axis in subjects without LBP than those with LBP, especially without visual feedback. There was also significant interaction in RST between subjects with and without LBP (F = 7.18, P = 0.01). For the core axis of the trunk, significant differences existed based on the main effect of side (F = 9.07, P = 0.004), trunk rotation (F = 24.30, P = 0.001), and both of these interactions (F = 8.93, P = 0.004). However, there was a lack of significant interaction with age for the lumbar and core spine axes (F = 0.06, P = 0.81).

CONCLUSION

Although the control group included slightly younger volunteers compared with the LBP group, the stability index of the core spine significantly decreased in RHT and RST, especially when visual feedback was blocked for subjects with LBP. The interaction between visual feedback and trunk rotation indicated that core spine stability is critical in coordinating balance control. A trunk muscle imbalance may contribute to unbalanced postural activity, which could prompt a decreased, uncoordinated bracing effect in subjects with LBP. As a result, core spine training could be used in the prevention of postural instability in such subjects.

Endometrial stromal sarcomas: A retrospective analysis of 28 patients, single center experience for 20 years

16053

Background: Little is known about the pathogenesis, risk factors, optimal therapy or outcomes of endometrial stromal sarcoma (ESS). The aim of this study is to evaluate the behavior of ESS in relation to its clinical and pathogenic features and to find the better treatment strategy. Methods: A retrospective analysis was performed of 28 patients with histologically proven ESS treated at our institution between 1987 and 2006. Results: The median follow-up time was 54.7±63.1 months and 5-year survival rate was 82.0%. 16 (57.1%) patients were referred to our institution from private clinics for further treatment of the ESS. They were previously undergone either hysterectomy, myomectomy, or hysteroscopy for presumed benign gynecological conditions. 22 patients (81.5%) showed low grade and 5 patients (18.5%) showed high grade disease. A univariate analysis revealed that histologic grade according to mitotic count is associated with longer survival (p=0.004). However, among those with low grade tumor, 5/20 patients (25%) had recurrence and 2/21 (9.5%) had distant metastasis during the follow-up period. Except for 2 cases, 26 patients with ESS had hysterectomy for their primary treatment. Adjuvant treatment after surgery was performed in 14/26 cases (53.8%). Hormone therapy by progesterone, chemotherapy and/or radiotherapy individually did not influence the overall survival of the patients. However, postoperative adjuvant therapy group regardless of the treatment modality was associated with relatively increased overall survival when compared to the surgery only group (p=0.054). Conclusions: Differential diagnosis of ESS from other benign gynecologic diseases before surgery is a difficult problem. Furthermore, it is advised that postoperative adjuvant therapy should be performed after hysterectomy to prevent recurrence or distant metastasis.

No significant financial relationships to disclose.

Instability driven fragmentation of nanoscale fractal islands

Formation and evolution of fragmentation instabilities in fractal islands, obtained by deposition of silver clusters on graphite, are studied. The fragmentation dynamics and subsequent relaxation to the equilibrium shapes are controlled by the deposition conditions and cluster composition. Sharing common features with other materials' breakup phenomena, the fragmentation instability is governed by the length-to-width ratio of the fractal arms.

Preventive effect of germanium dioxide on the inhibition of gap junctional intercellular communication by TPA

Gap junctional intercellular communication (GJIC) is thought to be essential for maintaining cellular homeostasis and growth control. In order to detect any protective agent against tumor formation, we examined the anticarcinogenic effect of a germanium dioxide (GeO(2)) using a model system of GJIC in F344 rat liver epithelial cells, named WB cells. 12-O-tetradecanoylphorbol-13-acetate (TPA), known as tumor promoters, inhibited GJIC in the epithelial cells as determined by the scrape loading/dye transfer (SL/DT) assay. And GeO(2) recovered this inhibition of GJIC. Immunostaining of connexin 43 (Cx43) protein in WB cells indicated that TPA caused a loss of Cx43 protein from the cell membranes. However, GeO(2) treatment showed re-appearance of Cx43 protein on the membrane. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blots were analyzed to determine whether the test compounds might have altered the steady-state levels of gap junction mRNA and/or connexin protein levels or phosphorylation. The inhibition of GJIC by TPA in WB cells was correlated with the hyperphosphorylation of Cx43 as measured by mobility shifts of the western blot bands of Cx43. TPA induced hyperphosphorylation of Cx43 protein, while GeO(2) appeared to partially block this hyperphosphorylation. Here, we showed that pre- and co-incubation with GeO(2) in TPA-treated WB-cells abolished down-regulation of GJIC by TPA. These data suggest that GeO(2) may inhibit tumor promotion by enhancing GJIC.

The expression of pseudogene cyclin D2 mRNA in the human ovary may be a novel marker for decreased ovarian function associated with the aging process

PURPOSE

Our purpose was to investigate the expression pattern of cyclin D2 and pseudogene cyclin D2 mRNA in the human ovary with age.

METHODS

After extraction of the total RNA from ovarian tissues of 23 premenopausal patients, cyclin D2 and pseudogene cyclin D2 mRNAs were measured by the reverse transcription-polymerase chain reaction technique using cyclin D2 and pseudogene cyclin D2 specific primers. Analysis of the cyclin D2 and pseudogene cyclin D2 mRNA expression pattern with age and correlation analysis were carried out.

RESULTS

A 489-bp cyclin D2 band and a 441-bp pseudogene cycin D2 mRNA band were detected in the human ovarian tissue. While cyclin D2 mRNA expression showed a decreasing tendency with age (P = 0.17), pseudogene cyclin D2 mRNA expression increased with age (P < 0.05). Pseudogene cyclin D2 mRNA expression showed a negative correlation with cyclin D2 mRNA (R = -0.35, P < 0.03).

CONCLUSION

The expression of pseudogene cyclin D2 mRNA in the human ovary increases with age, which may be a novel marker for decreased ovarian function associated with the aging process.

Changes in gallbladder motility in gastrectomized patients

OBJECTIVES

Gastric resection may predispose gallstone formation. However, the mechanism has not been clearly understood. To evaluate the relationship between gastric resection and gallstone formation, we compared gallbladder(GB) motility in gastrectomized patients and control subjects.

METHODS

We compared the GB volume and ejection fraction of the 46 gastrectomized patients with 37 healthy controls using real time ultrasonography.

RESULTS

GB volume increased significantly in the gastrectomized group in fasting (30.2 +/- 13.9 ml). The GB volume after a fatty meal was greater in the gastrectomized group (12.6 +/- 6.4 ml) than in the control group (4.3 +/- 3.3 ml) (p < 0.01). A significant reduction of ejection fraction was found in gastrectomized patients (56.9 +/- 13.0%) in comparison with the control group (75.5 +/- 16.1%) (p < 0.01). The GB ejection fraction had a poor correlation to the postoperative period (r = 0.232).

CONCLUSION

A gastrectomy appears to be a risk factor of GB dysmotility, which may play a major role in gallstone formation in gastrectomized patients.

Detection and differentiation of Listeria spp. by a single reaction based on multiplex PCR

The iap gene encodes the protein p60, which is common to all Listeria species. A previous comparison of the DNA sequences indicated conserved and species-specific gene portions. Based on these comparisons, a combination consisting of only five different primers that allows the specific detection and differentiation of Listeria species with a single multiplex PCR and subsequent gel analysis was selected. One primer was derived from the conserved 3' end and is specific for all Listeria species; the other four primers are specific for Listeria monocytogenes, L. innocua, L. grayi, or the three grouped species L. ivanovii, L. seeligeri, and L. welshimeri, respectively. The PCR method, which also enables the simultaneous detection of L. monocytogenes and L. innocua, was evaluated against conventional biotyping with 200 food hygiene-relevant Listeria strains. The results indicated the superiority of this technique. Thus, this novel type of multiplex PCR may be useful for rapid Listeria species confirmation and for identification of Listeria species for strains isolated from different sources.

Analysis of mesocarb analogues in urine and plasma of rats by high-performance liquid chromatography and thermospray liquid chromatography-mass spectrometry

The pharmacokinetics and metabolism of synthetic 2-hydroxymesocarb and 4-methyl-2-hydroxymesocarb analyzed by HPLC-DAD and thermospray LC-MS were studied in rats. Multistep liquid-liquid extraction (LLE) was used with diethyl ether at pH 7.0. The major metabolites of 2-hydroxymesocarb in both urine and plasma of the rat were the p-hydroxylated derivative of the phenylcarbamoyl group of the parent drug. The metabolites of 4-methyl-2-hydroxymesocarb in urine of rats may be the oxidized forms at the phenylcarbamoyl group of the parent drug. Absorption (ka) and elimination (ke) rate constants in plasma of 2-hydroxy-mesocarb were 0.0300 and 0.00485 min-1, respectively; those of 4-methyl-2-hydroxymesocarb were 0.0546 and 0.00797 min-1, respectively. The half-lives (t1/2) of 2-hydroxymesocarb and 4-methyl-2-hydroxymesocarb in plasma were 144 and 86 min, respectively.

Elephantiasis-like appearance of upper and lower extremities in Graves' dermopathy

Graves' dermopathy, affecting upper as well as lower extremities, is reported in a 50-year-old male patient addicted to multiple narcotic drugs. The narcotic drug administration routes include subcutaneous and intravenous injection in all limbs over a period of 29 years. The combination of drug injection trauma and Graves' dermopathy produced elephantiasis-like appearance of upper and lower limbs with impairment of their function; the left hand required amputation. Other features of Graves' disease, ie, hyperthyroidism and ophthalmopathy were severe and required multiple modes of therapy. Although the pathogenesis of Graves' dermopathy is unclear, it is surmised that trauma to skin might exacerbate it and preventive measures for trauma might be helpful in the management of dermopathy.