Immediate effects of transcutaneous electrical nerve stimulation on gait patterns in chronic stroke survivors: A single group, pretest-posttest clinical trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) has been used to reduce muscle spasticity and improve locomotion in stroke survivors. We speculate that acute changes in gait performance after TENS mediate functional improvement in the long-term. However, no previous study has investigated the effect of TENS on ankle kinetics and kinematics during walking in stroke survivors. PURPOSE: We aimed to investigate whether TENS applied over the paretic leg could rapidly improve the plantar flexion moment and ankle kinematics in chronic stroke survivors with lower limb paresis. METHODS: Twenty chronic stroke survivors were recruited. They underwent 30 min of TENS over the area innervated by the common peroneal nerve on the paretic leg. Three-dimensional (3D) motion capture was performed and ankle plantar flexor spasticity was assessed before and immediately after stimulation. Ankle kinematics and kinetic and spatiotemporal data were collected using 3D motion capture. Ankle plantar flexor spasticity was assessed using the Modified Tardieu Scale. PRINCIPAL RESULTS: A significant increase in the ankle plantar flexion moment of the paretic side during the pre-swing phase was observed immediately after stimulation (p = 0.009, maximal mean difference = 0.035, 95%CI = 0.0125 to 0.0575). The step length of the paretic limb also increased significantly after stimulation (p = 0.023, mean difference = -0.02, 95%CI = -0.04 to -0.004). TENS had no immediate effect on paretic ankle spasticity, as measured by the Modified Tardieu Scale, or on other temporo-spatial parameters. CONCLUSION: The findings support the use of TENS to improve the motor function and gait pattern in chronic stroke survivors. The study indicated that the application of TENS to the paretic leg before gait training might improve rehabilitation outcomes. Future studies investigating the effects of TENS on functional outcomes, the optimal stimulation duration, and assessing spasticity using more sensitive measures are warranted.

Curcumin interrupts the interaction between the androgen receptor and Wnt/ß-catenin signaling pathway in LNCaP prostate cancer cells.

Recently, studies have investigated the significance of the Wnt/ß-catenin pathway in prostate cancer. The transcriptional activity of the androgen receptor (AR) is modulated by interaction with coregulators, one of which is ß-catenin. Curcumin, a dietary yellow pigment of Curcuma longa, has emerged as having a chemopreventive role. Although curcumin has been shown to inhibit AR expression, its molecular mechanism has not been fully elucidated. In this study, whether curcumin mediates the Wnt/ß-catenin signaling pathway with regard to AR/ß-catenin interactions was studied. Curcumin was shown to induce significant inhibition of AR expression in a dose-dependent manner. Marked curcumin-induced suppression of ß-catenin was shown in the nuclear and cytoplasmic extracts as well as whole cell lysates. Further analysis revealed that phosphorylation of Akt and glycogen synthase kinase-3ß were attenuated, but phosphorylated ß-catenin was increased after curcumin treatment. Finally, cyclin D1 and c-myc, the target gene of the ß-catenin/T-cell factor transcriptional complex, were also decreased. These findings suggest that curcumin modulates the Wnt/ß-catenin signaling pathway and might have a significant role in mediating inhibitory effects on LNCaP prostate cancer cells.

Mechanism of tuberothalamic infarction.

BACKGROUND AND PURPOSE: The tuberothalamic artery (TTA), one of the arteries supplying the paramedian thalamic area, is peculiar because it originates from the posterior communicating artery (p-comA), which connects the vertebrobasilar and carotid systems. METHODS: From Stroke Registry, 23 consecutive patients with an acute infarction involving the TTA were selected. We investigated the mechanism of TTA infarction. RESULTS: Fourteen of 23 patients (61%) had coexisting infarctions outside the TTA territory (carotid in three, vertebrobasilar in seven, and both carotid and vertebrobasilar arteries in four patients). Coexisting lesions were most common in the posterior thalamoperforating arterial territory (seven patients). Eleven out of 14 patients (79%) with coexisting lesions had embolic sources from the heart or proximal atherosclerotic arteries, and cardioembolism was the most common mechanism. However, eight of the nine patients with isolated tuberothalamic lesions were classified as small vessel occlusions. More patients with embolic sources had visible p-comA or fetal-type posterior cerebral arteries. The vertebrobasilar arterial system played a more dominant role in developing tuberothalamic infarction than the carotid arterial system. CONCLUSIONS: Isolated TTA infarctions are rare and mostly because of small vessel occlusion. Patients with coexisting infarctions outside TTA territory usually have an embolic source, predominantly vertebral artery atherosclerosis.

High-intensity focused ultrasound therapy for clinically localized prostate cancer.

The efficacy of high-intensity focused ultrasound (HIFU) used for the treatment of localized prostate cancers has been demonstrated over the past decade. We present our early results after HIFU used as a single session in patients with clinically localized prostate cancer. A total of 58 patients were treated using the Ablatherm HIFU device with or without transurethral resection of the prostate (TURP). HIFU failure was defined as the presence of a cancer remnant on repeated biopsies or three consecutive increases in the prostate-specific antigen (PSA) >/=1.0 ng/ml. The mean follow-up was 14 months (range, 6-21 months). After HIFU treatment, 78% of patients had a decreased PSA level to <0.5 ng/ml within 3 months. The median value of the last PSA was 0.6 ng/ml and the median nadir PSA was 0.2 ng/ml. The success rates of HIFU were 85, 77 and 47% in low-, intermediate- and high-risk groups, respectively. The HIFU failure rate was closely associated with clinical stage, presence of cancer on TURP chips and nadir PSA on univariate analysis. However, the only significant predictor for HIFU failure was the nadir PSA value by multivariate Cox regression analysis. The operation-related complications were minimal. Although both the period and number of patients were limited to evaluate the clinical efficacy, HIFU appears to be a safe and effective treatment option in selected patients with prostate cancer.

Change of spontaneous reaction of glue and lipiodol mixture during embolization after the addition of tungsten powder: in vitro study.

BACKGROUND AND PURPOSE: We have noted that glue-Lipiodol mixtures harden prematurely in the catheter during embolization of brain arteriovenous malformations. However, we observed that hardening of this embolic material does not occur when tungsten powder is added to the glue mixture. In order to clarify the effect of tungsten powder on the glue mixture, we evaluated the reaction time and hardness of the glue mixture in vitro after the addition of tungsten powder. We also measured the pH of the tungsten solution. METHODS: Six lots of Lipiodol and three lots of Histoacryl Blue were mixed in a 5-cc bottle with a 50% to 25% glue concentration (glue:Lipiodol = 1:1 to 1:3) and this mixture was observed for 2 weeks. The hardness of the polymerized glue mixture was categorized as liquid, gel, semi-solid, or solid. Various series of experiments were performed after the addition of tungsten powder (0.2 g) and blood (a drop) into the glue mixture. We also separately mixed tungsten and tantalum powder in tubes, each with 5 mL of distilled water, and then measured the pH of these three times. The mixed amounts of tungsten and tantalum ranged from 0.1 to 0.5 mg. RESULTS: In a 50% glue concentration, the glue mixture turned into a solid cast within 48 hours. In a 25% concentration, the glue mixture turned into gel within 24 hours. The casts became solid in the 50% and gelled in the 25% concentration, and solid or gel in 28% and 33% glue mixture concentrations. The addition of tungsten powder to 50% and 25% glue mixture concentrations caused the glue mixtures to remain in a liquid state for 2 weeks regardless of the Lipiodol products used. Measurement of acidity achieved using a pH meter in 5 cc of distilled water with tungsten powder (0.1 to 0.5 g) revealed a change of pH from 3.5 to 2.6 according to the amount of tungsten added. Tantalum revealed weak acidity, with a pH range from 6.4 to 5.7. The addition of blood immediately caused the mixture to become solid in 50% and semi-solid in 25% glue concentrations. CONCLUSION: The reaction time of the glue mixture differed according to the lot number of the Lipiodol. The addition of tungsten powder appeared to prevent premature cast formation by decreasing the pH with a mechanism similar to that of adding acetic acid.

Application of flow injection--chemiluminescence to the study of radical scavenging activity in plants.

Chemiluminescence (CL) was observed during the oxidation of luminol (2 mg/L). mediated by 0.06% hydrogen peroxide (H(2)O(2)) and cytochrome c (10 mg/L). CL intensity was decreased by the presence of radical scavengers and the reduction was linearly proportional to the concentration and ability of scavengers; butylated hydroxytoluene (BHT), caffeic acid and gallic acid. The order of effectiveness as radical scavengers was gallic acid > caffeic acid > BHT, which shows that the number of hydroxyl groups (OH) in the B-ring of flavonoids plays a key role in a good radical scavenging activity. Of eight catechins obtained from green tea extracts, (-)-catechin was the least effective and (-)-epigallocatechin gallate (EGCg) showed the strongest activity. This result indicates that the stereoscopic structure between the C-3 group and the B ring of flavonoids as well as substituents at the C-3 position make a contribution to radical scavenging activity. Of the tested Chinese herbal ingredients, five species of ingredients represented more than 90% of the radical scavenging activity.

Successful management with glue injection of arterial rupture seen during embolization of an arteriovenous malformation using a flow-directed catheter: a case report.

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed microcatheter, was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superselective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recognition and closure of the perforation site is essential for good prognosis.

A case of rectal cancer with sternal metastasis as initial presentation.

Colorectal cancer with bone metastasis as initial manifestation is a very rare event. We have reported a case of rectal cancer presenting with sternal metastasis. A 30 year-old man was evaluated due to pain in the sternal area with a bulging mass. History and physical examination did not suggest any specific disease. A radionuclide bone scan revealed increased uptake in the sternal area, right 6th rib, and sacrum. Microscopic examination of a biopsy specimen from the sternum showed metastatic adenocarcinoma. A barium enema and CT scan of the pelvis suggested carcinoma of the upper rectum. Adenocarcinoma of the rectosigmoid junction area was demonstrated by colonoscopic examination with biopsy. He received palliative transverse colostomy for obstruction without further treatment.

Estrone sulfate sulfohydrolase in the developing brain and pituitary of rat, mouse and guinea pig.

The pattern of estrone sulfate sulfohydrolase (estrogen sulfatase) development in the brain of rat, mouse and guinea pig has been established by assaying whole homogenates. Activity was measurable in each species from the fetal state to adulthood. Maximum brain content was reached at about 20 days of age in rat, 14 days in mouse and 15 days in guinea pig. A considerable decrease occurred between 14 days and adulthood in mouse and lesser decreases were seen in rat and guinea pig. The subcellular distribution of enzyme in rat and mouse brain appeared to change from the immature to the adult state. No major differences in enzyme activity occurred between the sexes at any age. Tissue concentration of enzyme in the hypothalamic-preoptic area of rat and mouse was similar to that in the remainder of the brain. In guinea pig the brain concentration was slightly lower than that of the hypothalamic-preoptic region. Sulfatase content of the pituitary was low in all 3 species but the tissue concentration was considerably higher than that of brain, particularly in rat and mouse. Apparent Km values for brain sulfatase were in the range 6-17 microM, with no striking sex difference. Apparent Km's for pituitary sulfatase of immature rat and guinea pig were similar to those for brain in the same animals but that for mouse pituitary (0.9 microM) was much lower. It is unlikely that brain or pituitary sulfatase is by itself, a major factor in making available potentially active estrogen for use during differential sex development in these species.