Discriminative and predictive validity of the short-form activities-specific balance confidence scale for predicting fall of stroke survivors.

[Purpose] The present study aimed to investigate the discriminative validity of the short-form activities-specific balance confidence scale (ABC scale) in predicting falls, and its validity. [Subjects and Methods] 43 stroke survivors were identified as a group with a history of multiple falls (faller group) and a group without or with a history of one falls (non-faller group). The balance confidence was examined using the ABC scale and the short-form ABC scale. Functional abilities were examined with Fugl-Meyer assessment, sit-to-stand test, and Berg balance scale. [Results] The area under the curve of the ABC scale and the short-form ABC scale in predicting fall was>0.77. This result indicates that both examination tools have discriminative validity in predicting falls. Although both tools showed an identical predictable specificity of 72% in the non-faller and faller groups, the short-form ABC scale exhibited a predictable sensitivity of 86% in the faller group, which is higher than that of the ABC scale (71%). [Conclusion] Results of this study showed that the short-form ABC scale is an efficient clinical tool to evaluate and predict the balance confidence of stroke survivors.

Clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors.

[Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4-0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (FES), 2-min step test (2mST), and 6-min walk test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for FES, >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except FES had moderate accuracy according to the area under the curve of 0.76-0.88 (70-93%). [Conclusion] Clinical measures (except FES) have moderate validity in predicting the level of community ambulation of stroke survivors.

Predictive factors of hypertonia in the upper extremity of chronic stroke survivors.

[Purpose] Muscle tone is known to predict the motor function of the upper extremity within 12 months after onset in stroke survivors. The aim of this study was to investigate whether motor function of the upper extremity can predict the risk of hypertonia in chronic stroke survivors, and to analyze the correlation between the two variables to determine the predictive validity. [Subjects and Methods] Forty-three chronic stroke survivors were assessed using the Modified Ashworth Scale (MAS) for elbow flexor tone, the Fugl-Meyer assessment of the upper extremity (FM-UE), and the Action Research Arm Test (ARAT) for upper extremity motor recovery and function. [Results] Elbow flexor tone (MAS≥1(+)) increased by 0.246 compared with the baseline muscle tone even at month 12 and appeared to negatively affect the motor function of the upper extremity. The cutoff value for predicting muscle tone (MAS≥1(+)) was 24 for FM-UE and 15.5 for ARAT. FM-UE had the biggest impact on elbow flexor tone (MAS≥1(+)), and the risk of elbow flexor hypertonia (MAS≥1(+)) increased 0.764-fold for a cutoff value of FM-UE≤24 compared with a cutoff value of FM-UE>24. [Conclusion] The results show that the most important variable for predicting muscle tone of the elbow flexor in stroke survivors is the FM assessment of the upper extremity.

Influence of light touch using the fingertips on postural stability of poststroke patients.

[Purpose] The purpose of this study was to investigate the influence of fingertip light touch on the postural control in poststroke patients. [Subjects] In the study, the subjects were recruited through a rehabilitation hospital, and 21 patients were screened from among 30 volunteers. [Methods] The subjects participated in an experiment that measured postural sway during the static standing posture without light touch and postural sway during the static standing posture with light touch as follows: visual information not blocked without light touch, visual information blocked without light touch, visual information blocked with light touch using fingertips, and visual information not blocked with light touch using fingertips. The measurements were performed using a force platform. The variables measured by the force platform included sway velocities of the COP in the anterior and posterior directions and, medial and lateral directions and sway velocity moments. [Results] In the results of the study, there were significant differences between the state without light touch and state with light touch in terms of the postural sway velocity and velocity moment under all conditions. The rate of decease of the sway velocity and moment velocity under the eyes closed condition were higher compared with those under the eyes open condition. [Conclusion] Through this study, we confirmed the influence of fingertip light touch on the decrease in postural sway. The results show that active light touch may be supplemental means of improving postural sway in stroke patients.

Serendipitous discovery of 2-((phenylsulfonyl)methyl)-thieno[3,2-d]pyrimidine derivatives as novel HIV-1 replication inhibitors.

We identified a novel class of 2-((phenylsulfonyl)methyl)-thieno[3,2-d]pyrimidine compounds as potent HIV-1 replication inhibitors serendipitously during the process of evaluation of triazolothienopyrimidine (TTPM) compounds. Herein, we report synthesis and biological evaluation of 2-((phenylsulfonyl)methyl)-thieno[3,2-d]pyrimidine compounds using a cell-based full replication assay to identify thienopyrimidines 6 and 30, which could be further utilized as viable lead compounds.

Effect of whole body vibration exercise in the horizontal direction on balance and fear of falling in elderly people: a pilot study.

[Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies.

Identification of a series of 1,3,4-trisubstituted pyrazoles as novel hepatitis C virus entry inhibitors.

In this report we describe the identification of novel pyrazole analogs as potent hepatitis C virus (HCV) entry inhibitor. The pyrazoles were identified by our phenotypic high-throughput screening using infectious HCV. A series of pyrazole derivatives was synthesized and evaluated for inhibitory activity against HCV in the infectious cell culture system. Through evaluation of selected compounds we observed that the pyrazoles did not interfere with HCV RNA replication but with viral entry as shown by experiments with HCV replicons and HCV pseudo particles, respectively.

Synthesis and biological evaluation of triazolothienopyrimidine derivatives as novel HIV-1 replication inhibitors.

We identified a novel class of triazolothienopyrimidine (TTPM) compounds as potent HIV-1 replication inhibitors during a high-throughput screening campaign that evaluated more than 200,000 compounds using a cell-based full replication assay. Herein, we report the optimization of the antiviral activity in a cell-based assay system leading to the discovery of aryl-substituted TTPM derivatives (38, 44, and 45), which exhibited significant inhibition of HIV-1 replication with acceptable safety margins. These novel and potent TTPMs could serve as leads for further development.

Discovery and characterization of a novel 7-aminopyrazolo[1,5-a]pyrimidine analog as a potent hepatitis C virus inhibitor.

We describe a novel 7-aminopyrazolo[1,5-a]pyrimidine (7-APP) derivative as a potent hepatitis C virus (HCV) inhibitor. A series of 7-APPs was synthesized and evaluated for inhibitory activity against HCV in different cell culture systems. The synthesis and preliminary structure-activity relationship study of 7-APP are reported.

Study on the immunomodulation effect of Isodon japonicus extract via splenocyte function and NK anti-tumor activity.

Here we investigated the potential immune-enhancing activity of Isodon japonicus on murine splenocyte and natural-killer (NK) cells in vitro. The ethanol extract of I. japonicus significantly enhanced the proliferation of splenocyte and induced the significant enhancement of NK cells' activity against tumor cells (YAC-1). In addition, I. japonicus increased the production of interferon (IFN)-γ and tumor necrosis factor (TNF)-α, suggesting that the increase in NK cell cytotoxicity could be due to the enhancement of the NK cell production of both cytokines. Taken together, I. japonicus extract inhibited the growth of human leukemia cells (K562) by 74%. Our observation indicated that the anti-tumor effects of I. japonicus may be attributed to its ability to serve as a stimulant of NK anti-tumor activity. In addition, our results support the development of functional food studies on I. japonicus.

Inhibition effects of the classical pathway complement of three Sorghum bicolor from South Korea.

The present study evaluated the anti-complement effects from organic solvent extracts of three varieties (Hwanggeumchal Sorghum, Chal Sorghum, and Heuin Sorghum) from Sorghum bicolor in classical pathway complement system. We have evaluated organic solvent extract from Sorghum bicolor varieties with regard to its anti-complement activity. Chal Sorghum ethyl acetate extract showed inhibitory activity against complement system with 50% inhibitory concentrations (IC(50)) values of 38.7 µg/mL. This is the first report of anti-complement activity from Sorghum bicolor varieties.

Development of the Korean Academy of Medical Sciences Guideline for rating the impairment in the brain injured and brain diseased persons with motor dysfunction.

To develop an objective and scientific method to evaluate the brain injured and brain diseased persons with motor dysfunction, American Medical Association's Guides to the Evaluation of Permanent Impairment was used as an exemplar. After the motor dysfunction due to brain injury or brain disease was confirmed, active range of motion and muscle strength of affected extremities were measured. Also, the total function of extremities was evaluated through the assessment of activities of daily living, fine coordination of hand, balance and gait. Then, the total score of manual muscle test and functional assessment of impaired upper and lower extremity were added, respectively. Spasticity of upper and lower extremity was used as minus factors. Patients with movement disorder such as Parkinson's disease were assessed based on the degree of dysfunction in response to medication. We develop a new rating system based on the concept of total score.

The Application of Three-Dimensional Printed Finger Splints for Post Hand Burn Patients: A Case Series Investigation.

The application of three-dimensional (3D) printing is growing explosively in the medical field, and is especially widespread in the clinical use of fabricating upper limb orthosis and prosthesis. Advantages of 3D-printed orthosis compared to conventional ones include its lower cost, easier modification, and faster fabrication. Hands are the most common body parts involved with burn victims and one of the main complications of hand burns are finger joint contractures. Applying orthotic devices such as finger splints are a well-established essential element of burn care. In spite of the rapid evolution of the clinical use of 3D printing, to our knowledge, its application to hand burn patients has not yet been reported. In this study, the authors present a series of patients with hand burn injuries whose orthotic needs were fulfilled with the application of 3D-printed finger splints.

Antimicrobial activity of NO-releasing compounds against periodontal pathogens.

This study describes the successful synthesis of nitric oxide (NO)-releasing compounds with biodegradable and injectable properties and demonstrates that the kinetics of NO release vary according to the type of NO donor. The antimicrobial activity of NO-releasing compounds against three common periodontal pathogens, i.e., Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Actinomyces israelii, was investigated using a susceptibility assay. Human gingival fibroblasts were treated with NO-releasing compounds at the minimum concentrations required for bacterial growth and cytotoxicity was evaluated using the MTT cell proliferation assay. Our results suggest that NO-releasing compounds can be used topically to treat both gram-negative and gram-positive periodontal pathogens. Comparison of the antimicrobial activity and cytotoxicity assay results between the NO-releasing compounds revealed that an NO donor comprising a macromolecule without surface charge, a lower instantaneous NO concentration, and an adequate supply of NO were associated with a strong bactericidal effect and low cytotoxicity. NO-releasing compounds with these properties may be suitable for treatment of periodontitis.

Diagnosis of Ilioinguinal Nerve Injury Based on Electromyography and Ultrasonography: A Case Report.

Being located in the hypogastric area, the ilioinguinal nerve, together with iliohypogastric nerve, can be damaged during lower abdominal surgeries. Conventionally, the diagnosis of ilioinguinal neuropathy relies on clinical assessments, and standardized diagnostic methods have not been established as of yet. We hereby report the case of young man who presented ilioinguinal neuralgia with symptoms of burning pain in the right groin and scrotum shortly after receiving inguinal herniorrhaphy. To raise the diagnostic certainty, we used a real-time ultrasonography (US) to guide a monopolar electromyography needle to the ilioinguinal nerve, and then performed a motor conduction study. A subsequent US-guided ilioinguinal nerve block resulted in complete resolution of the patient's neuralgic symptoms.

Characterization and structure-activity relationship study of iminodipyridinopyrimidines as novel hepatitis C virus inhibitor.

Upon high-throughput screening of synthetic small molecule libraries with the infectious hepatitis C virus (HCV) cell culture system, we identified an iminodipyridinopyrimidine (IDPP) scaffold. IDPP did not inhibit HCV replication, but exhibited very potent inhibitory activity on early and late steps of HCV life cycle. Applying an intensive structure-activity relationship (SAR) study, a promising IDPP Lead compound (12c) with excellent potency (EC50 = 10 nM), high safety margin (SI > 2000), and an acceptable stability in human and rat liver microsomes (t1/2 >60 min) was identified. Overall, our results suggest that the IDPP scaffold could be used for the development of novel HCV interventions.

Dissociable modulating effect of repetitive transcranial magnetic stimulation on sensory and pain perception.

The effects of high frequency repetitive transcranial magnetic stimulation on sensory perception and the pain tolerance thresholds were investigated applying both motor cortex stimulation and medial frontal cortex stimulation in normal study participants. Both the sensory perception and pain tolerance thresholds were significantly increased in the motor cortex stimulation, whereas the pain tolerance thresholds, but not the sensory perception was significantly decreased in the medial frontal cortex stimulation. These results suggest the dissociable modulating effects of sensory and pain perception by the high frequency repetitive transcranial magnetic stimulation on the medial pain regulating system, but not the lateral pain regulating system.

Diagnostic Value of the Second Lumbrical-Interosseous Distal Motor Latency Comparison Test in Severe Carpal Tunnel Syndrome.

OBJECTIVE: To examine the usefulness of the second lumbrical-interosseous (2L-INT) distal motor latency (DML) comparison test in localizing median neuropathy to the wrist in patients with absent median sensory and motor response in routine nerve conduction studies. METHODS: Electrodiagnostic results from 1,705 hands of patients with carpal tunnel syndrome (CTS) symptoms were reviewed retrospectively. All subjects were evaluated using routine nerve conduction studies: median sensory conduction recorded from digits 1 to 4, motor conduction from the abductor pollicis brevis muscle, and the 2L-INT DML comparison test. RESULTS: Four hundred and one hands from a total of 1,705 were classified as having severe CTS. Among the severe CTS group, 56 hands (14.0%) showed absent median sensory and motor response in a routine nerve conduction study, and, of those hands, 42 (75.0%) showed an abnormal 2L-INT response. CONCLUSION: The 2L-INT DML comparison test proved to be a valuable electrodiagnostic technique in localizing median mononeuropathy at the wrist, even in the most severe CTS patients.

Steamed and Fermented Ethanolic Extract from Codonopsis lanceolata Attenuates Amyloid-ß-Induced Memory Impairment in Mice.

Codonopsis lanceolata (C. lanceolata) is a traditional medicinal plant used for the treatment of certain inflammatory diseases such as asthma, tonsillitis, and pharyngitis. We evaluated whether steamed and fermented C. lanceolata (SFC) extract improves amyloid-ß- (Aß-) induced learning and memory impairment in mice. The Morris water maze and passive avoidance tests were used to evaluate the effect of SFC extract. Moreover, we investigated acetylcholinesterase (AChE) activity and brain-derived neurotrophic factor (BDNF), cyclic AMP response element-binding protein (CREB), and extracellular signal-regulated kinase (ERK) signaling in the hippocampus of mice to determine a possible mechanism for the cognitive-enhancing effect. Saponin compounds in SFC were identified by Ultra Performance Liquid Chromatography-Quadrupole-Time-of-Flight Mass Spectrometry (UPLC-Q-TOF-MS). SFC extract ameliorated amyloid-ß-induced memory impairment in the Morris water maze and passive avoidance tests. SFC extract inhibited AChE activity and also significantly increased the level of CREB phosphorylation, BDNF expression, and ERK activation in hippocampal tissue of amyloid-ß-treated mice. Lancemasides A, B, C, D, E, and G and foetidissimoside A compounds present in SFC were determined by UPLC-Q-TOF-MS. These results indicate that SFC extract improves Aß-induced memory deficits and that AChE inhibition and CREB/BDNF/ERK expression is important for the effect of the SFC extract. In addition, lancemaside A specifically may be responsible for efficacious effect of SFC.

Myotonic Dystrophy Type 1 Complicated With Peripheral Arterial Occlusive Disease: A Case Report.

Myotonic dystrophy (MD) is the most common adult muscular dystrophy characterized by multi-systemic clinical manifestations involving the brain, smooth muscle, cardiovascular and endocrine systems. However, peripheral arterial occlusive disease (PAOD) is an uncommon presentation of MD type 1 (DM1), which has not been reported in recent literature. A 53-year-old female, previously confirmed as DM1, presented with vague claudication of both lower limbs. The diagnosis of PAOD based on results of ankle-brachial index, ultrasonography, and abdominal computed tomography angiography studies was followed by aortobifemoral artery bypass surgery. Although the arterial patency was restored after the operation, she did not recover from post-operative respiratory complications. Screening of PAOD is necessary for DM1 with general risk factors of occlusive arteriopathy. However, surgery should be reserved for the most severe cases.