Cauda equina syndrome caused by the application of DuraSealTM in a microlaminectomy surgery: A case report.

BACKGROUND: The management of dural tears is important. While a massive dura can be repaired with absorbable suture lines, cerebrospinal fluid leakage can be attenuated by dural sealant when an unintended tiny durotomy occurs intraoperatively. DuraSeal is often used because it can expand to seal tears. This case emphasizes the need for caution when DuraSeal is used as high expansion can cause complications following microlaminectomy. CASE SUMMARY: A 77-year-old woman presented with L2/3 and L3/4 lateral recess stenosis. She underwent microlaminectomy, foraminal decompression, and disk height restoration using an IntraSPINE® device. A tiny incident durotomy occurred intraoperatively and was sealed using DuraSealTM. However, decreased muscle power, urinary incontinence, and absence of anal reflexes were observed postoperatively. Emergent magnetic resonance imaging revealed fluid collection causing thecal sac indentation and central canal compression. Surgical exploration revealed that the gel-like DuraSeal had entrapped the hematoma and, consequently, compressed the thecal sac and nerve roots. While we removed all DuraSealTM and exposed the nerve root, the patient's neurological function did not recover postoperatively. CONCLUSION: DuraSeal expansion must not be underestimated. Changes in neurological status require investigation for cauda equina syndrome due to expansion.

Effectiveness of an adapted physical activity intervention for weight management in adolescents with intellectual disability: A randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a 9-month school-based adapted physical activity (APA) program for reducing weight among adolescents with intellectual disability (ID). METHODS: In this randomized controlled trial, adolescents with ID, aged 12-18 years, who were overweight/or with obesity were randomly assigned into intervention and control groups. The APA intervention consisted of aerobic and resistance exercises with an overall moderate intensity and was delivered at a frequency of two sessions per week for 9 months. Changes in body mass index (BMI, primary outcome) and changes in BMIz, weight, percent body fat, waist circumference and waist-to-height ratio (secondary outcomes) were examined using general linear models. RESULTS: In total 61 subjects (39 in the intervention and 22 in the control) completed the study and were included in the analyses. At 9 months, the intervention group exhibited a reduced BMI of -0.66 kg/m2 (95% CI -1.06 to -0.25 kg/m2 , p = 0.002), while a significant increase in BMI was observed in the control group. A significant post-intervention between-group difference in change in BMI (-1.31 kg/m2 [95% CI -1.99 to -0.63], p < 0.01) was found in favour of the intervention group. Similar results were also observed for all secondary outcomes. CONCLUSIONS: This study provides evidence that a 9-month APA intervention induced clinically meaningful effects on weight loss in adolescents with ID.

Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study.

BACKGROUND: Osteoporosis with vertebral compression fractures is increasingly common in the elderly population. Cement augmentation is one of the effective surgical treatments for these patients. Currently, there are several different types of cement augmentation treatments. No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures; thus, we retrospectively compared vertebroplasty, balloon kyphoplasty, and kyphoplasty with SpineJack or an intravertebral expandable pillar. AIM: To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures. METHODS: We retrospectively analyzed 354 patients with acute vertebral compression fractures, defined as signal changes in the T1 weighted magnetic resonance imaging, and randomly divided the patients into five groups. Their visual analog scale scores for pain, kyphotic angle, average body height, rate of cement leakage, and occurrence of adjacent vertebral compression fractures were followed for 1 year. One-way analysis of variance, the post hoc Bonferroni test, and Fisher exact probability test were used for statistical analyses. RESULTS: All pain scores significantly improved 12 mo postoperatively; however, there was no significant difference between the groups (P = 0.325). Kyphoplasty with SpineJack significantly reduced the kyphotic angle (P = 0.028) and restored the height of the vertebral body (P = 0.02). The rate of adjacent compression fractures was the highest in the vertebroplasty group, with a statistically significant difference according to the Fisher exact probability test (P = 0.02). The treatment with the lowest cement leakage rate cannot be identified because of the small sample size; however, kyphoplasty with SpineJack, an IVEP, and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty. CONCLUSION: Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration. Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.

Application of the IntraSPINE® interlaminar device in patients with osteoporosis and spinal stenosis: two case reports.

Osteoporosis is a rising concern in the aging population and should be considered before performing spinal surgery for older patients. Nonfusion surgery using interlaminar or interspinous devices is gradually gaining acceptance because adjacent segment disease seldom occurs postoperatively; however, other complications may occur. This report discusses the surgical outcomes of two women with osteoporosis treated by laminectomy and interlaminar device (IntraSPINE®) placement. Both patients had experienced low back pain for several years and had developed vertebral compression fractures. Several conservative treatments, including rehabilitation and local injections, were ineffective. Their bone mineral density levels were -3.0 and -2.8, indicating severe osteoporosis according to the definition established by the World Health Organization. They chose to undergo nonfusion surgery with IntraSPINE® interlaminar device placement. Their pain significantly decreased postoperatively, and their visual analog scale scores decreased from 8 to 2 and 3. Their extremity numbness and back pain resolved within 3 months. Both patients were satisfied with the surgical outcomes. No complications had occurred by 1 year postoperatively. These cases indicate that osteoporosis may not be an absolute contraindication for nonfusion spinal surgery. This report suggests a possible alternative surgical treatment for patients with osteoporosis that is refractory to conservative treatments.

Isolated distal ulnar bone metastasis from lung squamous cell carcinoma: an extremely rare case report.

Bone metastases commonly occur in patients with lung cancer. However, metastasis from primary lung carcinoma to the bone below the knee and elbow is rarely encountered. We herein describe a man who developed an isolated distal ulnar bone metastasis originating from lung squamous cell carcinoma. A 68-year-old man presented to our orthopedic outpatient clinic for evaluation of a rapidly progressing tumor over his right wrist area. Tenderness with increased local temperature was noted, and the tumor was firm in consistency, oval-shaped, and 7 × 5 cm in size. Magnetic resonance imaging and radiographic imaging revealed an osteolytic tumor in his distal ulnar shaft. A 99m Tc-phosphate bone scan showed that this tumor was isolated and newly observed compared with the previous bone scan findings during initial diagnosis. Bone tumor biopsy confirmed metastatic squamous cell carcinoma. Segmental tumor resection with cementation was subsequently performed. This rare case report of an isolated ulnar metastasis includes detailed descriptions of the clinical, radiographic, and pathological features of the tumor.

Rare Episode of Cement Leakage During Vesselplasty in a Case of Vertebral Compression Fracture.

BACKGROUND: Osteoporosis has become an important issue owing to the increasing elderly population. It is the most common cause of vertebral compression fracture. Conservative treatment is often ineffective, whereas surgical treatment has a vital role in compression fracture. Vesselplasty is a new surgical alternative to traditional vertebroplasty and kyphoplasty. It uses a polyethylene terephthalate balloon that functions as both a vertebral body expander and a bone cement container. We present a rare but catastrophic case of cement leakage during vesselplasty resulting in devastating neurologic compromise. This case highlights the need for awareness of vesselplasty safety and the importance of using a low-temperature bone cement. CASE DESCRIPTION: A 77-year-old woman presented with debilitating back pain owing to acute T6 compression fracture as detected by magnetic resonance imaging. Under biplanar fluoroscopy, vesselplasty using a polyethylene terephthalate balloon container was performed at the T6 vertebrae. During cement injection, balloon rupture and cement leakage occurred compromising the spinal canal. Emergent laminectomy and cement removal were performed. Paraplegia developed postoperatively. CONCLUSIONS: Though vesselplasty is claimed to be safe, cement leakage related to balloon rupture occurred in our case. Furthermore, thermal effects were difficult to observe during polymethyl methacrylate polymerization. Heat not only might cause irreversible complications but also might make the balloon rupture more easily.

Physical-Activity-Related Injuries and Risk Factors among Secondary School Students in Hong Kong.

Increase in physical activity (PA) might elevate risks for physical-activity-related injuries (PARIs). This study aimed to investigate the incidence rate and risk factors for PARIs among secondary school students in Hong Kong. All eligible students from three secondary schools were invited to participate in the study from November to December 2014. Information on PARI occurrences in the past 12 months, PA participation, and sociodemographics was collected. Multivariate and hierarchical logistic regression models were performed to estimate the risk of potential factors for PARIs. In total, 1916 students in forms 1-6 (aged 14.3 ± 1.7 years) completed valid questionnaires, with an overall yearly PARI incidence rate of 32.1% (boys: 34.3%; girls: 29.3%). There were sex differences in the risk factors identified, except that family size was associated with PARIs for all participants. Longer duration and higher intensity of PA increased the risk for PARI occurrences in both sexes. In conclusion, PARIs were prevalent among secondary school students in Hong Kong, and different sexes had different PARI incidence rates and were influenced by different risk factors. There is an urgent call for effective sex-specific interventions to prevent PARIs in this population.

Optical manipulation of nematic colloids at the interfaces in azo-dye-doped liquid crystals.

This study demonstrates the optical manipulation of colloids dispersed in azo-dye-doped liquid crystals (DDLCs) where the accumulation occurs at the interfaces of the phase domains. We explain the mechanism related to the formation of the domains and the movement of the colloids in DDLCs with respect to the isomerization of azo-dye molecules via the illumination of laser beams. The colloids are dragged to the interfaces of the isotropic/nematic domain and the air bubble/isotropic domain by molecular interaction and Marangoni flows.

Fabrication of optical vortex lattices based on holographic polymer-dispersed liquid crystal films.

This Letter demonstrates optical vortex lattices based on holographic polymer-dispersed liquid crystal (HPDLC) films. The fabrication method uses a phase-only reflective spatial light modulator with numerically calculated phase profiles loaded on it to simplify multi-helical-wave interference. The beam profiles of the diffraction beams are simulated using the Fourier transform and compared with experimental results. The topological charges of the 1st-order diffraction beams reconstructed from the HPDLC films are examined using a Michelson interferometer.

Subchondral mesenchymal stem cells from osteoarthritic knees display high osteogenic differentiation capacity through microRNA-29a regulation of HDAC4.

Subchondral bone deterioration and osteophyte formation attributable to excessive mineralization are prominent features of end-stage knee osteoarthritis (OA). The cellular events underlying subchondral integrity diminishment remained elusive. This study was undertaken to characterize subchondral mesenchymal stem cells (SMSCs) isolated from patients with end-stage knee OA who required total knee arthroplasty. The SMSCs expressed surface antigens CD29, CD44, CD73, CD90, CD105, and CD166 and lacked CD31, CD45, and MHCII expression. The cell cultures exhibited higher proliferation and greater osteogenesis and chondrogenesis potencies, whereas their population-doubling time and adipogenic lineage commitment were lower than those of bone marrow MSCs (BMMSCs). They also displayed higher expressions of embryonic stem cell marker OCT3/4 and osteogenic factors Wnt3a, ß-catenin, and microRNA-29a (miR-29a), concomitant with lower expressions of joint-deleterious factors HDAC4, TGF-ß1, IL-1ß, TNF-α, and MMP3, in comparison with those of BMMSCs. Knockdown of miR-29a lowered Wnt3a expression and osteogenic differentiation of the SMSCs through elevating HDAC4 translation, which directly regulated the 3'-untranslated region of HDAC4. Likewise, transgenic mice that overexpressed miR-29a in osteoblasts exhibited a high bone mass in the subchondral region. SMSCs in the transgenic mice showed a higher osteogenic differentiation and lower HDAC4 signaling than those in wild-type mice. Taken together, high osteogenesis potency existed in the SMSCs in the osteoarthritic knee. The miR-29a modulation of HDAC4 and Wnt3a signaling was attributable to the increase in osteogenesis. This study shed an emerging light on the characteristics of SMSCs and highlighted the contribution of SMSCs in the exacerbation of subchondral integrity in end-stage knee OA. KEY MESSAGES: Subchondral MSCs (SMSCs) from OA knee expressed embryonic stem cell marker Oct3/4. The SMSCs showed high proliferation and osteogenic and chondrogenic potencies. miR-29a regulated osteogenesis of the SMSCs through modulation of HDAC4 and Wnt3a. A high osteogenic potency of the SMSCs existed in mice overexpressing miR-29a in bone. Aberrant osteogenesis in SMSCs provides a new insight to subchondral damage in OA.

Histone demethylase UTX counteracts glucocorticoid deregulation of osteogenesis by modulating histone-dependent and -independent pathways.

Excess glucocorticoid administration impairs osteogenic activities, which raises the risk of osteoporotic disorders. Epigenetic methylation of DNA and histone regulates the lineage commitment of progenitor cells. This study was undertaken to delineate the actions of histone lysine demethylase 6a (UTX) with regard to the glucocorticoid impediment of osteogenic differentiation. Osteogenic progenitor cells responded to supraphysiological glucocorticoid by elevating CpG dinucleotide methylation proximal to transcription start sites within Runx2 and osterix promoters and Wnt inhibitor Dickkopf-1 (Dkk1) expression concomitant with low UTX expression. 5'-Aza-deoxycystidine demethylation of Runx2 and osterix promoters abolished the glucocorticoid inhibition of mineralized matrix accumulation. Gain of UTX function attenuated the glucocorticoid-induced loss of osteogenic differentiation, whereas UTX silencing escalated adipogenic gene expression and adipocyte formation. UTX sustained osteogenic gene transcription through maintaining its occupancy to Runx2 and osterix promoters. It also mitigated the trimethylation of histone 3 at lysine 27 (H3K27me3), which reduced H3K27me3 enrichment to Dkk1 promoter and thereby lowered Dkk1 transcription. Modulation of ß-catenin and Dkk1 actions restored UTX signaling in glucocorticoid-stressed cells. In vivo, UTX inhibition by exogenous methylprednisolone and GSK-J4 administration, an effect that disturbed H3K27me3, ß-catenin, Dkk1, Runx2, and osterix levels, exacerbated trabecular microarchitecture loss and marrow adiposity. Taken together, glucocorticoid reduction of UTX function hindered osteogenic differentiation. Epigenetic hypomethylation of osteogenic transcription factor promoters and H3K27 contributed to the UXT alleviation of Dkk1 transcription and osteogenesis in glucocorticoid-stressed osteogenic progenitor cells. Control of UTX action has an epigenetic perspective of curtailing glucocorticoid impairment of osteogenic differentiation and bone mass. KEY MESSAGES: UTX attenuates glucocorticoid deregulation of osteogenesis and adipogenesis. UTX reduces Runx2 promoter methylation and H3K27me3 enrichment in the Dkk1 promoter. ß-catenin and Dkk1 modulate the glucocorticoid inhibition of UTX signaling. UTX inhibition exacerbates bone mass, trabecular microstructure and fatty marrow. UTX signaling is indispensable in fending off glucocorticoid-impaired osteogenesis.

Anti-inflammatory and burn injury wound healing properties of the shell of Haliotis diversicolor.

BACKGROUND: The shell of Haliotis diversicolor, or shijueming (SJM), is a type of traditional Chinese medicine. The SJM has appeared in historical records as early as the third and fourth centuries. Historical records have revealed that SJM had mainly been used to treat eye diseases. After the Qing Dynasty (1757), records had emerged, detailing the use of SJM for treating skin injuries, particularly for treating poorly managed ulcers or traumatic wounds. Furthermore, in our anti-inflammation-screening system, SJM significantly inhibited the expression of pro-inflammatory proteins. Previous studies have yet to adopt an animal model to verify the phenomenon and described in the historical records regarding the efficacy of SJM in promoting wound healing. Besides, the mechanism of wound healing effect of SJM is also not clear. METHODS: This study applied in vitro and in vivo models, tissue section analysis, and western blotting to evaluate the effect of SJM on wound healing. The RAW 264.7 cells were used in anti-inflammatory activity assay and phagocytic assay. Male Wistar rats were used to evaluate the effect of SJM on burn injury healing. A copper block (2 × 2 cm, 150 g) preheated to 165 °C in a dry bath was used to contact the skin area for 10 s, thus creating a full-thickness burn injury. The results were analyzed by hematoxylin and eosin staining, picrosirius red staining and Western blotting. RESULTS: The results revealed that in the in vitro model, the presence of SJM decreased the inducible nitric oxide synthase (iNOS) expression and enhanced the functions of macrophages. The results of the rat burn injury model revealed that SJM decreased neutrophil infiltration, promoted wound healing, thus increasing the collagen I content and promoting the expression of transforming growth factor-beta 1 (TGF-ß1) protein. We speculate that the effect and mechanism of SJM on promoting wound healing is related to macrophage activation. In the inflammation phase, SJM alleviates inflammation by inhibiting iNOS expression and removing neutrophils through phagocytosis. Furthermore, SJM induces the secretion of TGF-ß1, converting collagen during the tissue remodeling phase. CONCLUSIONS: According to our review of relevant literature, this is the first study that applied an evidence-based method to verify that SJM alleviates inflammation, enhances phagocytosis, and triggers wound healing after burn injury. The study findings reveal that SJM provides a promising therapeutic option for treating burn injury.

Independent Manipulation of Topological Charges and Polarization Patterns of Optical Vortices.

We present a simple and flexible method to generate various vectorial vortex beams (VVBs) with a Pancharatnam phase based on the scheme of double reflections from a single liquid crystal spatial light modulator (SLM). In this configuration, VVBs are constructed by the superposition of two orthogonally polarized orbital angular momentum (OAM) eigenstates. To verify the optical properties of the generated beams, Stokes polarimetry is developed to measure the states of polarization (SOP) over the transverse plane, while a Shack-Hartmann wavefront sensor is used to measure the OAM charge of beams. It is shown that both the simulated and the experimental results are in good qualitative agreement. In addition, polarization patterns and OAM charges of generated beams can be controlled independently using the proposed method.

Smart electro-optical iris diaphragm based on liquid crystal film coating with photoconductive polymer of poly(N-vinylcarbazole).

This study develops a light shutter whose transmittance can be tuned electro-optically. The liquid crystal (LC) film applies the photoconductive material of poly(N-vinylcarbazole) (PVK) based on twisted nematic (TN) liquid crystals (LCs). The hole-transport layer of PVK could reduce the built-in electric field of the LC film under the exposure of UV light. The driving voltage is considerably decreased with the aid of UV light exposure. The repeating optical switching is performed under sunlight illumination with an external bias of electric field ∼5 V. Further, it could be operated under a parallel/cross-polarizer to change the light beam/ring as an iris and used to automatically block the UV light to protect an optical integrated system.

4-(Phenylsulfanyl)butan-2-One Suppresses Melanin Synthesis and Melanosome Maturation In Vitro and In Vivo.

In this study, we screened compounds with skin whitening properties and favorable safety profiles from a series of marine related natural products, which were isolated from Formosan soft coral Cladiella australis. Our results indicated that 4-(phenylsulfanyl)butan-2-one could successfully inhibit pigment generation processes in mushroom tyrosinase platform assay, probably through the suppression of tyrosinase activity to be a non-competitive inhibitor of tyrosinase. In cell-based viability examinations, it demonstrated low cytotoxicity on melanoma cells and other normal human cells. It exhibited stronger inhibitions of melanin production and tyrosinase activity than arbutin or 1-phenyl-2-thiourea (PTU). Also, we discovered that 4-(phenylsulfanyl)butan-2-one reduces the protein expressions of melanin synthesis-related proteins, including the microphthalmia-associated transcription factor (MITF), tyrosinase-related protein-1 (Trp-1), dopachrome tautomerase (DCT, Trp-2), and glycoprotein 100 (GP100). In an in vivo zebrafish model, it presented a remarkable suppression in melanogenesis after 48 h. In summary, our in vitro and in vivo biological assays showed that 4-(phenylsulfanyl)butan-2-one possesses anti-melanogenic properties that are significant in medical cosmetology.

Spiral phase plate based on polymer dispersed liquid crystal for wide visible band applications.

This study demonstrates helical wave fronts via a spiral phase plate based on polymer dispersed liquid crystals (PDLCs). Because the PDLC is electric tunable, the plate can be used in a wide visible band. In addition, if the probe beam deviates from the center of the sample, some of the light propagates out of the sectors. We propose some of the applications for the results.

The occurrence of core muscle fatigue during high-intensity running exercise and its limitation to performance: the role of respiratory work.

This study investigated the occurrence of core muscle fatigue during high-intensity running exercise and its limitation to exercise performance. A secondary aim was to investigate whether respiratory muscle work performed during intense running periods, would contribute to core muscle fatigue. Nine male recreational runners were recruited for two reasons; (1) to perform a continuous treadmill run at 85% VO2max with and without core muscle fatigue in the CR_F and CR trials, respectively; and (2) to mimic the treadmill run-induced respiratory response recorded in the CR trial while subjects were free of whole-body exercise (Mimic trial). The changes in global core muscle function with fatigue in this study were evaluated by performing a sport-specific endurance plank test (SEPT), and the associated influence on running performance was examined by comparing the time to exhaustion during the treadmill run between the CR and CR_F trials. Subsequent to the treadmill run in the CR trial, SEPT (255.7 ± 85.3 vs 177.3 ± 80.6 s) was reduced from baseline in all runners. The reduction correlated (r = 0.67) with the concomitant decline in inspiratory muscle function revealed by maximal inspiratory mouth pressure (PImax: 151.3 ± 18.2 vs 133.3 ± 17.2 cmH2O, p < 0.05). In the Mimic trial, similar results in SEPT (212.3 ± 90.2 s), PImax (129.0 ± 26.7 cmH2O), and correlation (r = 0.77, p < 0.05) were observed following voluntary hyperpneic activity. With the preceded fatigued core muscle workout in the CR_F trial, the running capacity was impaired significantly (10.7 ± 4.5 vs 6.5 ± 2.0 min, p < 0.05). The impairment was correlated (r=0.72) to the SEPT reduction resulting from the workout. The results suggest that a high-intensity maximum run may induce core muscle fatigue in runners. The core muscle fatigue, which may be partly attributed to the corresponding respiratory work, may limit their running endurance. Inspiratory muscle function appears to be essential for core stabilization during the intense running. Key pointsA high-intensity maximum run may induce core muscle fatigue in runners. The core muscle fatigue, which may be partly attributed to the corresponding respiratory work, may limit their running endurance.In support of previous notion, inspiratory muscles may share the work of core stabilization during intense exercise, while simultaneously increasing the demand for breathing.Inspiratory muscle training incorporated into a running specific-core training regime potentially enhances the training effect on the core muscles in a functional manner to deal with the challenges faced during intense exercise.

Optical filter with tunable wavelength and bandwidth based on phototunable cholesteric liquid crystals.

An optical filter with tunable wavelength and bandwidth is demonstrated using two phototunable cholesteric liquid crystals (CLCs) configured in a reflection mode. In this mode, incident light is first reflected by one Azo-chiral-doped CLC and then by another one. The tuning mechanism, which is based on the pitch modulation of the CLCs that contain an Azo-chiral dopant, can be controlled by two pumping laser beams. The central wavelength can be tuned from 510 to 628 nm, and the bandwidth can be changed from 13 to 79 nm.

Sport-specific endurance plank test for evaluation of global core muscle function.

OBJECTIVE: To examine the validity and reliability of a sports-specific endurance plank test for the evaluation of global core muscle function. DESIGN: Repeated-measures study. SETTING: Laboratory environment. PARTICIPANTS: Twenty-eight male and eight female young athletes. MAIN OUTCOME MEASURES: Surface electromyography (sEMG) of selected trunk flexors and extensors, and an intervention of pre-fatigue core workout were applied for test validation. Intraclass correlation coefficient (ICC), coefficient of variation (CV), and the measurement bias ratio */÷ ratio limits of agreement (LOA) were calculated to assess reliability and measurement error. RESULTS: Test validity was shown by the sEMG of selected core muscles, which indicated >50% increase in muscle activation during the test; and the definite discrimination of the ∼30% reduction in global core muscle endurance subsequent to a pre-fatigue core workout. For test-retest reliability, when the first attempt of three repeated trials was considered as familiarisation, the ICC was 0.99 (95% CI: 0.98-0.99), CV was 2.0 ± 1.56% and the measurement bias ratio */÷ ratio LOA was 0.99 */÷ 1.07. CONCLUSION: The findings suggest that the sport-specific endurance plank test is a valid, reliable and practical method for assessing global core muscle endurance in athletes given that at least one familiarisation trial takes place prior to measurement.

Cytotoxicity of (-)-vitisin B in human leukemia cells.

Vitis thunbergii var. taiwaniana (VTT) is an indigenous Taiwanese wild grape and is used as a folk medicine in Taiwan. VTT is rich in polyphenols, especially quercetin and resveratrol derivatives, which were demonstrated to exhibit inhibitory activities against carcinogenesis and prevent some neurodegenerative diseases. (-)-Vitisin B is one of the resveratrol tetramers extracted from VTT. In this study, we investigated the mechanisms of (-)-vitisin B on the induction of apoptosis in human HL-60 promyelocytic leukemia cells. First, (-)-vitisin B significantly inhibited cell proliferation through inducing cell apoptosis. This effect appeared to occur in a time- and dose-dependent manner. Cell-cycle distribution was also examined, and we found that (-)-vitisin B significantly induced a sub-G1 population in a dose-dependent manner. In addition, (-)-vitisin B exhibited stronger inhibitory effects on cell proliferation than resveratrol. Second, (-)-vitisin B dose dependently induced apoptosis-related protein expressions, such as the cleavage form of caspase-3, caspase-8, caspase-9, poly(ADP ribose) polymerase, and the proapoptotic Bax protein. Third, (-)-vitisin B treatment also resulted in increases in c-Jun N-terminal kinase (JNK) phosphorylation and Fas ligand (FasL) expression. Moreover, the (-)-vitisin B-induced FasL expression and caspase-3 activation could be reversed by a JNK inhibitor. These results suggest that (-)-vitisin B-induced apoptosis of leukemia cells might be mediated through activation of JNK and Fas death-signal transduction.