Cumulative effect of transcranial direct current stimulation in patients with partial refractory epilepsy and its association with phase lag index-A preliminary study.

There is an urgent need for alternative treatments for refractory epilepsy. We investigated the effect of two courses of cathodal transcranial direct current stimulation (tDCS) in nine patients with partial refractory epilepsy. A two-course treatment (1 month per course, with six sessions of stimulation per course within the first 2 weeks by 2-mA cathodal tDCS for 20 min) was administered to each patient. After the first course of tDCS, the average seizure frequency had decreased by 37.8 ±â€¯21.9% compared with baseline (p = 0.001). After the second course, the average seizure frequency had decreased by 48.9 ±â€¯31.2% compared with baseline (p = 0.002). Only seven of the nine patients maintained the same state of wakefulness in three electroencephalogram (EEG) recordings. We analyzed the EEG recordings of these seven patients on day 0 immediately posttreatment and on days 4 and 9 in the first course of tDCS. When compared with baseline, no significant change in the number of epileptiform discharges was observed. The day 9 phase lag index (PLI) decreased in five patients with seizure reduction after tDCS but increased in two patients without seizure reduction after tDCS. A significant negative correlation was observed between the day 9 PLI of alpha band and first-course seizure reduction (R2 = 0.6515) (p = 0.028). The results revealed that tDCS may be considered as an alternative treatment option for patients with refractory epilepsy, and its effect might be cumulative after repeated stimulations and associated with a decrease in PLI.

[The Management of Itching in Burn Patients During the Rehabilitation Stage].

Pruritus, a distressing symptom that affects burn patients, not only interferes with activities of daily living but also causes disturbed sleep, which has been associated with anxiety, depression, and other types of negative moods. Furthermore, the uncontrolled scratching that often accompanies pruritus causes tissue damage and may damage or destroy the skin graft. In this paper, the authors first describe the definition and mechanism of pruritus and next use itching-assessment tools to identify the triggering factors. Finally, the authors propose a multifaceted approach to treating pruritus that includes using medication, topical emollients, massage therapy, skin moisture, relaxation techniques, and combined coping to relieve patient discomfort. The authors hope that this paper deepens and broadens the knowledge of health professionals on this issue and improves the quality of care that is available for burn patients who are in the rehabilitation stage.

The BiP molecular chaperone plays multiple roles during the biogenesis of torsinA, an AAA+ ATPase associated with the neurological disease early-onset torsion dystonia.

Early-onset torsion dystonia (EOTD) is a neurological disorder characterized by involuntary and sustained muscle contractions that can lead to paralysis and abnormal posture. EOTD is associated with the deletion of a glutamate (ΔE) in torsinA, an endoplasmic reticulum (ER) resident AAA(+) ATPase. To date, the effect of ΔE on torsinA and the reason that this mutation results in EOTD are unclear. Moreover, there are no specific therapeutic options to treat EOTD. To define the underlying biochemical defects associated with torsinAΔE and to uncover factors that might be targeted to offset defects associated with torsinAΔE, we developed a yeast torsinA expression system and tested the roles of ER chaperones in mediating the folding and stability of torsinA and torsinAΔE. We discovered that the ER lumenal Hsp70, BiP, an associated Hsp40, Scj1, and a nucleotide exchange factor, Lhs1, stabilize torsinA and torsinAΔE. BiP also maintained torsinA and torsinAΔE solubility. Mutations predicted to compromise specific torsinA functional motifs showed a synthetic interaction with the ΔE mutation and destabilized torsinAΔE, suggesting that the ΔE mutation predisposes torsinA to defects in the presence of secondary insults. In this case, BiP was required for torsinAΔE degradation, consistent with data that specific chaperones exhibit either pro-degradative or pro-folding activities. Finally, using two independent approaches, we established that BiP stabilizes torsinA and torsinAΔE in mammalian cells. Together, these data define BiP as the first identified torsinA chaperone, and treatments that modulate BiP might improve symptoms associated with EOTD.

Applying the transtheoretical model to promote functional fitness of community older adults participating in elastic band exercises.

AIMS: The transtheoretical model was applied to promote behavioural change and test the effects of a group senior elastic band exercise programme on the functional fitness of community older adults in the contemplation and preparation stages of behavioural change. BACKGROUND: Forming regular exercise habits is challenging for older adults. The transtheoretical model emphasizes using different strategies in various stages to facilitate behavioural changes. DESIGN: Quasi-experimental design with pre-test and post-tests on two groups. METHODS: Six senior activity centres were randomly assigned to either the experimental or control group. The data were collected during 2011. A total of 199 participants were recruited and 169 participants completed the study (experimental group n = 84, control group n = 85). The elastic band exercises were performed for 40 minutes, three times per week for 6 months. The functional fitness of the participants was evaluated at baseline and at the third and sixth month of the intervention. Statistical analyses included a two-way mixed design analysis of variance, one-way repeated measures analysis of variance and an analysis of covariance. RESULTS: All of the functional fitness indicators had significant changes at post-tests from pre-test in the experimental group. The experimental group had better performances than the control group in all of the functional fitness indicators after three months and 6 months of the senior elastic band exercises. CONCLUSION: The exercise programme provided older adults with appropriate strategies for maintaining functional fitness, which improved significantly after the participants exercising regularly for 6 months.

Experiences and preferences of truth-telling in families of children with cancer: A phenomenological study.

Objective: The delivery of bad news is an unpleasant but necessary medical procedure. However, few studies have addressed the experiences and preferences of the families of school-aged children with cancer when they are informed of the children's condition. This study aimed to explore families of school-age children with cancer for their preferences and experiences of truth-telling. Methods: This descriptive phenomenological qualitative research was conducted using focus group interviews and semistructured interview guidelines were adopted for in-depth interviews. Fifteen families participated in the study. The data were analyzed using Colaizzi's analysis. Data were collected from August 2019 to May 2020. Results: The study identified two major themes: "caught in a dilemma" and "kind and comprehensive team support." The first major theme focused on families' experiences with cancer truth-telling. Three sub-themes emerged: (1) cultural aspects of cancer disclosure, (2) decision-making regarding informing pediatric patients about their illness, and (3) content of disclosure after weighing the pros and cons. The second major theme, which revealed families' preferences for delivering bad news, was classified into three sub-themes: (1) have integrity, (2) be realistic, and (3) be supportive. Conclusions: This study underscores the dilemma encountered by the families of children with cancer after disclosure and their inclination toward receiving comprehensive information and continuous support. Health care personnel must improve their truth-telling ability in order to better address the needs of such families and to provide continuous support throughout the truth-telling process.

Development and Validation of the Osteoporosis Knowledge, Attitude, and Behaviors Questionnaire for Female Osteoporosis Patients in Taiwan: A Mediation Model.

This research develops the Osteoporosis Knowledge, Attitude and Behaviors Questionnaire (OKABQ) with the intent to evaluate the levels of osteoporosis knowledge, attitude and behavior change by developing and validating the OKABQ while establishing a mediation model of the research. A quantitative, descriptive and instrumental study was conducted in two phases: Phase I-development of the scale through Delphi Method by osteoporosis experts; and Phase II-evaluation of the validity and reliability of the scale and construction of a mediation model using SmartPLS. In Phase I, the content validity index (CVI) of the questionnaire was higher than 0.96 and the inter-rater reliability (IRR) kappa was 1.00. In Phase II, exploratory factor analysis showed that two predominating factors of attitude as a mediation were addressed by the 26-item OKABQ. The indirect effect results from the estimated model indicate that attitude mediates the relationship between knowledge and behaviors (ß = 0.114, t = 2.627, p < 0.001), which is positive and statistically significant. We concluded that the OKABQ is a valid measure of osteoporosis knowledge, attitudes and behaviors for women with osteoporosis. These assessment results could assist healthcare providers in mitigating insufficiency in health education and help patients better adapt to a more active bone-healthy lifestyle.

Mozart k.545 mimics mozart k.448 in reducing epileptiform discharges in epileptic children.

Mozart K.448 has been shown to improve cognitive function, leading to what is known as the Mozart Effect. Our previous work reveals positive effects of Mozart K.448 in reducing epileptiform discharges in epileptic children. In this study, we evaluated the effect of Mozart K.545 and compared the effects with those of Mozart K.448 on epileptiform discharges in children with epilepsy. Thirty-nine epileptic children with epileptiform discharges were included in the study. They received electroencephalogram examinations before, during, and after listening to Mozart K.448 and K.545, one week apart, respectively. The frequencies of epileptiform discharges were compared. There was a significant decrease in the frequency of epileptiform discharges during and right after listening to Mozart K.448 and K.545 (reduced by 35.7 ± 32.7% during Mozart K.448 and 30.3 ± 44.4% after Mozart K.448; and 34.0 ± 39.5% during Mozart K.545 and 31.8 ± 39.2% after Mozart K.545). Spectrogrammatic analysis of the two pieces of music demonstrated that both share similar spectrogrammatic characteristics. Listening to Mozart K.448 and K.545 decreased the epileptiform discharges in epileptic children. This suggests that Mozart K.448 is not the only piece of music to have beneficial effects on children with epilepsy. Other music with lower harmonics may also decrease epileptiform discharges in epileptic children.

Intensive Care Unit Nurses' Perceptions of and Coping Strategies for Motherhood Experiences: A Qualitative Study.

This qualitative study explored the perception of intensive care unit nurses in relation to their motherhood experiences and coping strategies. Ten intensive care unit nurses (aged 28-37 years) with children under 3 years old were recruited. In-depth 90-min interviews were conducted, and the contents of the audio recordings were translated into verbatim transcripts. From the results of the research analysis, three themes were identified: challenges and conflicts of motherhood, dilemma in life and work balance, and maternal engagement. The "challenges and conflicts of motherhood" and "dilemma in life and work" represent the maternal experiences, while "maternal engagement" is the coping strategy used. To establish a friendly working environment and policies, nursing managers should consider improving the friendliness of work units and encourage co-workers to support each other in the hospital.

The long-term effect of listening to Mozart K.448 decreases epileptiform discharges in children with epilepsy.

Mozart's Sonata for Two Pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart Effect. Our previous work revealed that epileptiform discharges in children with epilepsy decrease during and right after listening to Mozart K.448. However, the duration of the effect was not studied. In the study described here, we evaluated the long-term effect of Mozart K.448 on epileptiform discharges in children with epilepsy. Eighteen children with epilepsy whose seizures were clinically well controlled with antiepileptic drugs were included. For each child, EEGs had revealed persistent epileptiform discharges for at least 6 months. These patients listened to Mozart K.448 for 8 minutes once a day before bedtime for 6 months. Epileptiform discharges were recorded and compared before and after 1, 2, and 6 months of listening to Mozart K.448. All of the children remained on the same antiepileptic drug over the 6 months. Relationships between number of epileptiform discharges and foci of discharges, intelligence, epilepsy etiology, age, and gender were analyzed. Epileptiform discharges significantly decreased by 53.2±47.4, 64.4±47.1, and 71.6±45.8%, respectively, after listening to Mozart K.448 for 1, 2, and 6 months. All patients except those with occipital discharges showed a significant decrease in epileptiform discharges. Patients with normal intelligence and idiopathic epilepsy had greater decreases than those with mental retardation and symptomatic epilepsy. Age and gender did not affect the results. We conclude that long-term listening to Mozart K.448 may be effective in decreasing epileptiform discharges in children with epilepsy in a chronologically progressive manner.

Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy.

Mozart's Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness <50%; unmodified or worsened seizure frequency). The average seizure reduction was 53.6 ± 62.0%. There were no significant differences in seizure reduction with IQ, etiology, or gender. We conclude that Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy.

Suppression of bamboo mosaic virus accumulation by a putative methyltransferase in Nicotiana benthamiana.

Bamboo mosaic virus (BaMV) is a 6.4-kb positive-sense RNA virus belonging to the genus Potexvirus of the family Flexiviridae. The 155-kDa viral replicase, the product of ORF1, comprises an N-terminal S-adenosyl-l-methionine (AdoMet)-dependent guanylyltransferase, a nucleoside triphosphatase/RNA 5'-triphosphatase, and a C-terminal RNA-dependent RNA polymerase (RdRp). To search for cellular factors potentially involved in the regulation of replication and/or transcription of BaMV, the viral RdRp domain was targeted as bait to screen against a leaf cDNA library of Nicotiana benthamiana using a yeast two-hybrid system. A putative methyltransferase (PNbMTS1) of 617 amino acid residues without an established physiological function was identified. Cotransfection of N. benthamiana protoplasts with a BaMV infectious clone and the PNbMTS1-expressing plasmid showed a PNbMTS1 dosage-dependent inhibitory effect on the accumulation of BaMV coat protein. Deletion of the N-terminal 36 amino acids, deletion of a predicted signal peptide or transmembrane segment, or mutations in the putative AdoMet-binding motifs of PNbMTS1 abolished the inhibitory effect. In contrast, suppression of PNbMTS1 by virus-induced gene silencing in N. benthamiana increased accumulation of the viral coat protein as well as the viral genomic RNA. Collectively, PNbMTS1 may function as an innate defense protein against the accumulation of BaMV through an uncharacterized mechanism.

A New Method of Diagnosing Attention-Deficit Hyperactivity Disorder in Male Patients by Quantitative EEG Analysis.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders of childhood. Diagnosis of ADHD is based on core symptoms and checklists. However, these are both subjective, which can lead to the problems of overdiagnosis and underdiagnosis. Elevated theta/beta ratio (TBR) of EEG band has been approved by the US Food and Drug Administration as a tool to assist in the diagnosis of ADHD. However, several recent studies have demonstrated that there are no significant differences in TBR between people with and without ADHD. In this study, we attempted to develop a new method for differentiating between male with and without ADHD by analyzing EEG features. Thirty boys with ADHD combined type (aged 8 years 5 months ± 1 year 11 months) and 30 age-matched controls (aged 8 years 5 months ± 1 year 8 months) were enrolled in this study. A classification analysis-based approach comprising training and classification phases was developed for classifying each subject's EEG features as ADHD or non-ADHD. Eight crucial feature descriptors were selected and ranked based on the t test. Compared with TBR in our study, the developed method had a higher area under the curve (87.78%), sensitivity (80.0%), and specificity (80.0%). Our method is more precise than using TBR in the diagnosis of ADHD. This newly developed method is a useful tool in identifying patients with ADHD and might reduce the possibility of overdiagnosis and underdiagnosis.

Entropy-Based Quantitative Electroencephalogram Analysis for Diagnosing Attention-Deficit Hyperactivity Disorder in Girls.

Diagnosis of attention-deficit hyperactivity disorder (ADHD) is currently based on core symptoms or checklists; however, the inevitability of practitioner subjectivity leads to over- and underdiagnosis. Although the Federal Drug Administration has approved an elevated theta/beta ratio (TBR) of the electroencephalogram (EEG) band as a tool for assisting ADHD diagnosis, several studies have reported no significant differences of the TBR between ADHD and control subjects. This study detailed the development of a method based on approximate entropy (ApEn) analysis of EEG to compare ADHD and control groups. Differences between ADHD presentation in boys and girls indicate the necessity of separate investigations. This study enrolled 30 girls with ADHD and 30 age-matched controls. The results revealed significantly higher ApEn values in most brain areas in the control group than in the ADHD group. Compared with TBR-related feature descriptors, ApEn-related feature descriptors can produce the higher average true positive rate (0.846), average true negative rate (0.814), average accuracy (0.817), and average area under the receiver operating characteristic curve value (0.862). Therefore, compared with TBR, ApEn possessed the better potential for differentiating between girls with ADHD and controls.

Novel method using Hjorth mobility analysis for diagnosing attention-deficit hyperactivity disorder in girls.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric disorder. Diagnosis of ADHD is based on core symptoms or checklists; however, practitioner subjectivity inevitably results in instances of over- or under-diagnosis. Although an elevated theta/beta ratio (TBR) of the electroencephalography (EEG) band has been approved by the Food and Drug Administration as a factor that may be used in diagnosis of ADHD, several studies have reported no significant differences between the TBR of patients with ADHD and controls. PURPOSE: In this study, a method was developed based on Hjorth Mobility (M) analysis of EEG to compare patients with ADHD and controls. METHODS: Differences in the presentations of ADHD between boys and girls are well established; therefore, separate investigations are required. The present study enrolled 30 girls with ADHD and 30 age-matched controls. RESULTS: The results revealed that the control group had significantly higher Hjorth M values in most brain areas in EEG readings compared with the values for the ADHD group. Compared with TBR, our method revealed a greater number of more significant differences between the girls in the ADHD group and the controls. Moreover, our method can produce the higher average sensitivity (0.796), average specificity (0.796), average accuracy (0.792), and average area under the curve of receiver operating characteristic curve (AUC) value (0.885). Therefore, compared with TBR, Hjorth M possessed the better potential for differentiating between girls with ADHD and controls. CONCLUSION: The proposed method was more accurate than the TBR in diagnosing ADHD. Therefore, Hjorth M may be a promising tool for differentiating between children with ADHD and controls.

The effects of a Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults living in long-term care facilities: a single group design with multiple time points.

BACKGROUND: Studies support the positive effects that Tai Chi has on the physical health of older adults. However, many older adults residing in long-term care facilities feel too weak to practice traditional Tai Chi, and a more simplified style is preferred. OBJECTIVE: To test the effects of a newly-developed, Simplified Tai-Chi Exercise Program (STEP) on the physical health of older adults who resided in long-term care facilities. DESIGN: A single group design with multiple time points: three pre-tests, one month apart; four post-tests at one month, two months, three months, and six months after intervention started. SETTINGS: Two 300-400 bed veteran homes in Taiwan. PARTICIPANTS: The 51 male older adults were recruited through convenience sampling, and 41 of them completed six-month study. Inclusion criteria included: (1) aged 65 and over; (2) no previous training in Tai Chi; (3) cognitively alert and had a score of at least eight on the Short Portable Mental Status Questionnaire; (4) able to walk without assistance; and (5) had a Barthel Index score of 61 or higher. Participants who had dementia, were wheel-chair bound, or had severe or acute cardiovascular, musculoskeletal, or pulmonary illnesses were excluded. METHODS: The STEP was implemented three times a week, 50 min per session for six months. The outcome measures included cardio-respiratory function, blood pressure, balance, hand-grip strength, lower body flexibility, and physical health actualization. RESULTS: A drop in systolic blood pressure (p=.017) and diastolic blood pressure (p<.001) was detected six months after intervention started. Increase in hand-grip strength from pre to post intervention was found (left hand: p<.001; right hand: p=.035). Participants also had better lower body flexibility after practicing STEP (p=.038). CONCLUSIONS: Findings suggest that the STEP be incorporated as a floor activity in long-term care facilities to promote physical health of older adults.

Quantitative EEG findings and response to treatment with antiepileptic medications in children with epilepsy.

BACKGROUND: Epilepsy is a common chronic disorder in pediatric neurology. Nowadays, a variety of antiepileptic drugs (AEDs) are available. A scientific method designed to evaluate the effectiveness of AEDs in the early stage of treatment has not been reported. PURPOSE: In this study, we try to use quantitative EEG (QEEG) analysis as a biomarker to evaluate therapeutic effectiveness. METHODS: 20 epileptic children were enrolled in this study. Participants were classified as effective if they achieved a reduction in seizure frequency over 50%. Ineffective was defined as a reduction in seizure frequency less than 50%. Eleven participants were placed in the effective group, the remaining 9 participants were placed in the ineffective group. EEG segments before and after 1-3months of antiepileptic drugs start/change were analyzed and compared by QEEG analysis. The follow-up EEG segments after the 2nd examinations were used to test the accuracy of the analytic results. RESULTS: Six crucial EEG feature descriptors were selected for classifying the effective and ineffective groups. Significantly increased RelPowAlpha_avg_AVG, RelPowAlpha_snr_AVG, HjorthM_avg_AVG, and DecorrTime_snr_AVG values were found in the effective group as compared to the ineffective group. On the contrary, there were significantly decreases in DecorrTime_std_AVG, and Wavelet_db4_EnergyBand_5_avg_AVG values in the effective group as compared to the ineffective group. The analyses yielded a precision rate of 100%. When the follow-up EEG segments were used to test the analytic results, the accuracy was 83.3%. CONCLUSION: The developed method is a useful tool in analyzing the effectiveness of antiepileptic drugs. This method may assist pediatric neurologists in evaluating the efficacy of AEDs and making antiepileptic drug adjustments when managing epileptic patients in the early stage.

A feasible method to enhance and maintain the health of elderly living in long-term care facilities through long-term, simplified tai chi exercises.

Practicing Tai Chi offers the potential to enhance the physical and mental health of older adults. Identifying a feasible way to encourage regular Tai Chi practice is essential if Tai Chi is to be promoted as a long-term, daily activity for elderly care facility residents. The purpose of this study was to test the effectiveness and feasibility of using an audiovisual, simplified Tai Chi exercise module to enhance and maintain the health of long-term care facility residents. A quasi-experimental, one-group, time-series design was used. Data were collected six times (twice before the intervention; four times after intervention started) at three-month intervals. Fifty-one elderly male subjects were recruited by convenience sampling. A 50-minute Simplified Tai-Chi Exercise Program (STEP) was implemented in two small groups three times a week for 12 months. During the first six-month period, participants received guidance from an actual instructor. During the second six-month period, guidance was delivered via a video tape and displayed on a television screen. Results indicated that participants' physical health (cardio-respiratory function, lower body flexibility, and hand-gripping strength) and mental health (quality of sleep) had both improved significantly six months after intervention started, with improvements maintained throughout the end of the 12-month study (all p values < .05). Instructor-led STEP training followed by practice using appropriate audiovisual aids represents a feasible and effective method to implement a long-term activity program in long-term elderly care facilities.

Classification Preictal and Interictal Stages via Integrating Interchannel and Time-Domain Analysis of EEG Features.

The life quality of patients with refractory epilepsy is extremely affected by abrupt and unpredictable seizures. A reliable method for predicting seizures is important in the management of refractory epilepsy. A critical factor in seizure prediction involves the classification of the preictal and interictal stages. This study aimed to develop an efficient, automatic, quantitative, and individualized approach for preictal/interictal stage identification. Five epileptic children, who had experienced at least 2 episodes of seizures during a 24-hour video EEG recording, were included. Artifact-free preictal and interictal EEG epochs were acquired, respectively, and characterized with 216 global feature descriptors. The best subset of 5 discriminative descriptors was identified. The best subsets showed differences among the patients. Statistical analysis revealed most of the 5 descriptors in each subset were significantly different between the preictal and interictal stages for each patient. The proposed approach yielded weighted averages of 97.50% correctness, 96.92% sensitivity, 97.78% specificity, and 95.45% precision on classifying test epochs. Although the case number was limited, this study successfully integrated a new EEG analytical method to classify preictal and interictal EEG segments and might be used further in predicting the occurrence of seizures.

Modulation of 5-fluorouracil cytotoxicity through thymidylate synthase and NF-kappaB down-regulation and its application on the radiolabelled iododeoxyuridine therapy on human hepatoma cell.

The inhibition of thymidylate synthase (TS) by 5-fluorouracil (5-FU) was known to increase the incorporation of radiolabelled iododeoxyuridine (IdUrd) into DNA. The relatively non-toxic compounds such as thiol-containing antioxidant pyrrolidinodithiocarbamte (PDTC) or aromatic fatty acid phenylbutyrate (PB) had been reported to enhance the cytotoxic efficacy of 5-FU. We designed a novel strategy through triplet combination of PB, PDTC and 5-FU to increase the radiolabelled IdUrd uptake and investigated the underlying mechanisms. The growth inhibition and [(125)I]IdUrd-DNA incorporation by PB, PDTC, 5-FU in different combinations were tested on parent or p21(Waf1) transfected Hep3B cells. The combination of PB and PDTC was more effective in enhancing 5-FU cytotoxicity than either drug alone. The combination of PB/PDTC and 5-FU blocked cells in S-phase and resulted in 8.5-fold increase of radiolabelled IdUrd-DNA incorporation. The transfection of p21(Waf1) did not change the general pattern of enhancement. Intriguingly, the combination of PB and PDTC effectively down-regulated NF-kappaB and TS and prevented their up-regulation from 5-FU treatment than either drug alone through a p21(Waf1)-independent mechanism. Based on this strategy, the 3-drug combination offered potential for improved radiolabelled IdUrd molecular radiotherapy for hepatoma treatment.

Early evaluation of the therapeutic effectiveness in children with epilepsy by quantitative EEG: a model of Mozart K.448 listening--a preliminary study.

PURPOSE: There are many treatments being developed for patients with epilepsy, including anti-epileptic drugs, ketogenic diet and vagus nerve stimulation. To date, there is a lack of valid methods to predict at an early stage the therapeutic effects on patients with epilepsy who receive one of these treatments. Our previous studies revealed that epileptiform discharges which were observed in patients with epilepsy were significantly decreased while listening to Mozart K.448. In this study, we attempted to develop a useful marker by utilizing a quantitative electroencephalogram (qEEG) method in analyzing the features of EEG to early evaluate the effect of the music on children with epilepsy, even without epileptiform discharges. METHODS: EEG segments from 19 Taiwanese children who were selected from a large screen study of music effect (eight boys and 11 girls) diagnosed with epilepsy were analyzed. EEG examinations were performed in two parallel periods in each patient; before, and while listening to Mozart K.448's first movement (8 min 22s) and EEG data were compared by qEEG. EEG segments were classified into music effective/ineffective group. The term "effective" was defined as patient exposure to music resulting in over a 25% reduction in epileptiform discharges. On the contrary, the term "ineffective" was defined as patient exposure to music resulting in less than a 5% reduction in epileptiform discharges. RESULTS: There were four global feature descriptors selected for the music effective/ineffective classification. Two descriptors, DecorrTime_avg_AVG and DecorrTime_std_AVG, were related to the EEG feature "decorrelation" whereas the other two descriptors, RelPowGamma_avg_SNR and RelPowGamma_std_SNR, were related to "relative power of gamma." There were significantly higher RelPowGamma_std_SNR (0.190±0.133 vs. -0.026±0.119, p=0.0029), DecorrTime_std_AVG (0.005±0.004 vs. 0.0003±0.0016, p=0.0055), DecorrTime_avg_AVG (0.005±0.005 vs. -0.002±0.008, p=0.0179), and RelPowGamma_avg_SNR (0.176±0.219 vs. -0.078±0.244, p=0.0222) in the effective group than in the ineffective group. The precision rate of classification was 0.953. CONCLUSIONS: Using qEEG, we have developed a useful model for predicting therapeutic effectiveness of music in patients with epilepsy. Among the limited number of patients, the tool is of potential to predict the effectiveness in patients even without epileptiform discharges. It is worthwhile in the application of other therapeutic model.