The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke.

OBJECTIVE: To examine the clinimetric characteristics of the Trunk Impairment Scale (TIS). This newly developed scale evaluates motor impairment of the trunk after stroke. The TIS scores, on a range from 0 to 23, static and dynamic sitting balance as well as trunk co-ordination. It also aims to score the quality of trunk movement and to be a guide for treatment. DESIGN: Two physiotherapists observed each patient simultaneously, but scored independently. Each patient was re-examined by one of the therapists. SUBJECTS: Twenty-eight patients in a rehabilitation setting. RESULTS: Kappa and weighted kappa values for item per item reliability ranged for all but two, from 0.62 to 1. All percentages of agreement exceeded 81%. Intraclass correlations (ICC) for the summed scores of the different subscales were between 0.85 and 0.99. Test-retest and interobserver reliability for the TIS total score (ICC) was 0.96 and 0.99, respectively. The 95% limits of agreement for the test-retest and interexaminer measurement error were -2.90, 3.68 and -1.84, 1.84, respectively. Cronbach alpha coefficients for internal consistency ranged from 0.65 to 0.89. Content validity was defined. Spearman rank correlations with the Barthel Index (r = 0.86) and the Trunk Control Test (r = 0.83) was used to examine construct and concurrent validity, respectively. CONCLUSIONS: Analysis of different clinimetric parameters support the use of the TIS in both clinical use and future stroke research. Guidelines for treatment and level of quality of trunk activity can be derived from the assessment.

Phase II study of teniposide in patients with AIDS-related Kaposi's sarcoma.

Antitumour activity of cytotoxic agents, evaluated in patients with AIDS-related Kaposi's sarcoma (KS), is about 30-80%. However, responses are mostly partial and short. Experience with etoposide is similar. Teniposide has a longer elimination half-life and superior antitumour activity compared with etoposide in some experimental models. Thus a phase II trial was done in 25 patients with AIDS-related KS. Teniposide was given by 60-min infusion at 360 mg/m2 every 3 weeks. 10 (40%) showed a partial response, median duration of 9 (6-20) weeks. The main side-effects were leukopenia, thrombocytopenia, nausea and vomiting, alopecia and mucositis.

[The diagnosis of posttraumatic neuroma via sonography and CT]. / Diagnostik posttraumatischer Neurome mittels Sonographie und CT.

The sonographic CT and myelographic findings in three peripheral amputation neuromas are described, as well as a cauda equina neuroma following a tear of the lumbar plexus. Sonographically, the peripheral neuromas produced low intensity echoes with sharp differentiation from their highly echogenic surroundings. On CT the neuromas were hypodense, compared with muscle, measuring between 40 and 60 HU and showing only minimal enhancement after contrast. The cauda equina neuroma was shown on myelography as an intradural filling defect situated on the cranial aspect of a traumatic pseudomeningocoele. In view of their characteristic appearances, and the possibility of identifying trigger points, sonography appears to be the method of choice in the diagnosis of peripheral neuromas.

Functional characterization of the uncoupler-insensitive Na+ pump of the halotolerant bacterium, Ba1.

Respiration initiates Na+ efflux from Na+-preloaded cells of the halotolerant bacterium, Ba1. This efflux can take place against the concentration and electrochemical gradients. Since it is not inhibited by carbonylcyanide-p-trifluoromethoxyphenyl-hydrazone or N'N'-dicyclohexylcarbodiimide, it seems unlikely that either delta p (electrochemical potential difference of H+ across the membrane) generated by the primary proton pump or ATP play a role in the transduction of the energy supplied by electron transport. The electrogenic extrusion of Na+ causes passive counterflow of protons and/or simultaneous flux of permeant anions. In the absence of permeant anions the charge compensation attained by influx of protons is not complete. The membrane potential which persists in this case is inside negative and insensitive to uncoupler. The influx of protons builds up a delta pH of reversed sign (more acid inside), which is insensitive to uncoupler. The simultaneous efflux of Na+ and permeant anions diminishes the intracellular salt content and, as a corollary, causes volume contraction. Thus, the respiration-linked, uncoupler-insensitive Na+ pump may play a role in the regulation of the intracellular salt content.