Asymmetry of peak plantar pressure in transfemoral amputees during indoor and outdoor walking.

This study investigates the differences in peak plantar pressure between the amputated and intact limbs of transfemoral amputees when walking outdoors. Ten non-amputees (aged 24.4 ± 2.0 years, 176.9 ± 2.5 cm, 72.3 ± 7.9 kg) and six transfemoral amputees (48.5 ± 6.3 years, 173.8 ± 4.2 cm, 82.0 ± 11.9 kg) participated in the study. Over approximately 1.6 km, the participants encountered various obstacles, including stairs, uneven surfaces, hills, and level ground, both indoors and outdoors. Throughout the walking session, the peak plantar pressure in both feet was monitored using wearable insole sensors. For all terrains, the percentage asymmetry was determined. Significant changes in peak plantar pressure asymmetry were found between the intact and amputated limbs, particularly when walking on level ground indoors, uneven terrains, descending stairs, and on steep slopes outdoors (all p < 0.05). These findings highlight the greater peak plantar pressure asymmetry in transfemoral amputees when walking outside. In addition, this study revealed that not all terrains contribute uniformly to this asymmetry.

Determination of Gait Events and Temporal Gait Parameters for Persons with a Knee-Ankle-Foot Orthosis.

Gait event detection is essential for controlling an orthosis and assessing the patient's gait. In this study, patients wearing an electromechanical (EM) knee-ankle-foot orthosis (KAFO) with a single IMU embedded in the thigh were subjected to gait event detection. The algorithm detected four essential gait events (initial contact (IC), toe off (TO), opposite initial contact (OIC), and opposite toe off (OTO)) and determined important temporal gait parameters such as stance/swing time, symmetry, and single/double limb support. These gait events were evaluated through gait experiments using four force plates on healthy adults and a hemiplegic patient who wore a one-way clutch KAFO and a pneumatic cylinder KAFO. Results showed that the smallest error in gait event detection was found at IC, and the largest error rate was observed at opposite toe off (OTO) with an error rate of -2.8 ± 1.5% in the patient group. Errors in OTO detection resulted in the largest error in determining the single limb support of the patient with an error of 5.0 ± 1.5%. The present study would be beneficial for the real-time continuous monitoring of gait events and temporal gait parameters for persons with an EM KAFO.

Effect of Core Balance Training on Muscle Tone and Balance Ability in Adult Men and Women.

(1) Background: The amount of physical activity most adults perform is less than the recommended amount, and the resulting decrease in physical strength makes them vulnerable to various diseases. A decrease in muscle size and strength due to damage caused by disease or aging negatively affects functional strength. Muscle evaluation in adults can yield results that are predictive indicators of aging and unexpected disability. In addition, balance ability is essential to prevent falls and injuries in daily life and maintain functional activities. It is important to develop and strengthen balance in the lower extremities and core muscles to maintain and enhance overall body balance. This study aimed to analyze the effects of core balance training on muscle tone and balance ability in adults. (2) Methods: The participants of this study were 32 adult male and female university students (male: mean age = 21.3 ± 1.9 years, weight = 74.2 ± 12.6 kg, BMI = 23.4 + 2.5, n = 14; female: mean age = 21.0 ± 1.4 years, weight = 64.6 + 1.2 kg, BMI = 22.4 ± 2.4, n =18). Thirty-two adults (training group: 16, control group: 16; male: 16, female: 16) participated in the Myoton PRO (gastrocnemius lateral/medial, tibialis anterior), Pedalo balance system, and Y-balance test. (3) Results: The following results were obtained for muscle elasticity, stiffness, and dynamic/static balance ability after 10 weeks of core balance training. 1. There was no significant difference in muscle elasticity (gastrocnemius lateral/medial, tibialis anterior) (p < 0.05). 2. Muscle stiffness (gastrocnemius lateral/medial, tibialis anterior) significantly increased (p < 0.05). 3. Dynamic/static balance ability significantly increased (p < 0.05). (4) Conclusions: In future, data for the age and sex of various participants, should be accumulated by recruiting participants to study muscle characteristics, such as muscle elasticity and stiffness. Estimating the appropriate injury range and optimal exercise capacity is possible through follow-up studies. The findings can then be used as a basis for predicting injuries or determining and confirming the best time to resume exercise.

Development and validation of bioimpedance prediction equations for fat-free mass in unilateral male amputees.

BACKGROUND: Metabolic disease due to increased fat mass is observed in amputees (APTs), thereby restricting their activity. Systemic health management with periodic body composition (BC) testing is essential for healthy living. Bioelectrical impedance analysis (BIA) is a non-invasive and low-cost method to test BC; however, the APTs are classified as being exempted in the BIA. OBJECTIVE: To develop segmental estimated regression equations (sEREs) for determining the fat-free mass (FFM, kg) suitable for APTs and improve the accuracy and validity of the sERE. METHODS: Seventy-five male APTs participated in this cross-sectional study. Multiple regression analysis was performed to develop highly accurate sEREs of BIA based on independent variables derived from anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and BIA parameters. The difference in validity between the predicted DXA and sum of the segmentally-predicted FFM values by sEREs (Sum_sEREs) values was evaluated using bivariate linear regression analysis and the Bland-Altman plot. RESULTS: The coefficient of determination (R2 ) and total error (TE) between DXA and Sum_sEREs were 71% and 5.4 (kg) in the cross-validation analysis. CONCLUSIONS: We confirmed the possibility of evaluating the FFM of APTs through the sEREs developed in this study. We also identified several independent variables that should be considered while developing such sEREs. Further studies are required to determine the validity of our sEREs and the most appropriate BIA frequencies for measuring FFM in APTs.

Effect of Gait Training Program with Mechanical Exoskeleton on Body Composition of Paraplegics.

PURPOSE: To identify the effect of a 52-weeks gait training program with an exoskeletal body-powered gait orthosis on the body composition of paraplegics. PATIENTS AND METHODS: Ten subjects with spinal cord injury at the thoracolumbar spine level for more than 2 years participated and were divided into exercise (n=5) and nonexercise (n=5) groups. A gait training program comprising stages 1-6 with customized exoskeletal body-powered gait orthosis was conducted for 52-weeks. A six-stage gait training program was conducted to manage the body composition and prevent obesity, and the changes in the body composition before and after the program were determined through bioelectrical impedance analysis. RESULTS: No significant changes in weight, fat-free mass (kg), lean body mass (kg), and percent fat mass (%) are seen in the exercise group before and after the 52-weeks program. However, fat-free mass (pre = 47.3± 6.5, post = 44.3 ± 5.4, kg), lean body mass (pre = 45.2 ± 6.3, post = 42.3±5.2, kg), and percent fat mass (pre = 30.1 ± 12.1, post = 40.9 ± 9.1, kg) show significant changes (p < 0.05) in the nonexercise group. In the nonexercise group, among lean body mass changes over 52-weeks in the upper limbs (-31%), trunks (-9.7%), and lower limbs (-8.6%), upper limbs exhibit the most significant decrease (p < 0.05). CONCLUSION: The gait training program with exoskeletal body-powered gait orthosis has a positive effect on fat management in the whole body and lean body mass loss in paraplegics. Furthermore, it is effective in preventing continuous muscle loss and in maintaining health by reducing body fat. Body composition measurements with bioelectrical impedance analysis for paraplegics can be applied in various clinical areas and can be combined with various arbitration methods such as rehabilitation program.

Between-day reliability of MyotonPRO for the non-invasive measurement of muscle material properties in the lower extremities of patients with a chronic spinal cord injury.

Measuring the muscle properties of patients with spinal cord injuries (SCIs) is important to better understand their biomechanical features. In this study, we sought to evaluate the between-day reliability of MyotonPRO, a handheld device that can measure muscle mechanical properties, and assess whether it is reliable to measure muscle properties over time in patients with SCI. Thirteen men with complete SCIs (age 53.9 ±â€¯6.3 years, height 171.0 ±â€¯5.2 cm, weight 66.1 ±â€¯5.8 kg), and injury levels ranging from L1 to T12, were enrolled. Oscillation frequency; logarithmic decrement; dynamic stiffness; mechanical stress relaxation time; and creep of the biceps femoris, medial and lateral gastrocnemius, rectus femoris, tibialis anterior, and Achilles tendon were measured on consecutive days using MyotonPRO. The intraclass coefficient for most muscles and the Achilles tendon ranged from 0.53 to 0.99 for all parameters. The percentage standard error of the measurement for many parameters in most muscles and the Achilles tendon was less than 10%. Bland-Altman analysis showed a high agreement for all mechanical properties. No significant differences were observed in any muscle or Achilles tendon properties between days (all p > 0.05). These results indicate that the MyotonPRO is reliable for between-day measurements of the mechanical properties of lower limb muscles and Achilles tendon in patients with SCI.

Study of gait using weighted vests on balance with paraplegic patients.

The aims of this study were to identify static and dynamic balance with the addition of weighted vests for the rehabilitation of paraplegic patients. The study was conducted using weighted vest exercises with applied optimal weight ratios. Ten paraplegic patients who use custom orthosis were enrolled for experiments including static standing and dynamic gait with a weighted vest. We set weight ratios as 0%, 10%, and 15% of the patients' weight. A plantar pressure device was used for static balance tests for excursion and velocity of center of pressure and we identified dynamic balance through the tool of Timed Up and Go (TUG) test. The results of static and dynamic balance in 0%, 10%, and 15% weight ratios did not have statistically significant differences, but we found an increasing tendency of sway excursion from nonweight (0%) to weight ratios (10%, 15%) in static balance when weight is applied. Sway excursion in anteroposterior direction is greater than mediolateral sway. In dynamic balance, the TUG results showed a more delayed time when weight ratios were applied. In conclusion, we have to focus on balance training with anteroposterior direction to upgrade a patient's balance and prevent falls. Exercises with weighed vests are more useful than nonweighted but there is no difference between 10% and 15% weight ratios. Weighted vest exercises may play a role in the rehabilitation of balance in those with paraplegia.

Variations in gait features in elderly adults during walking considering their balance.

The aim of this study was to evaluate the influence of balance on the spatiotemporal features, lower-limb kinematics, and center of mass (COM) of the non-faller elderly during walking. In this study, 20 healthy elderly women (age, 76.2 ± 5.6 years; height, 150.1 ± 3.2 cm; weight, 55.8 ± 9.0 kg) were enrolled. Based on the Berg balance scale (BBS), the elderly were classified into two groups: poor balance (PB; BBS scores <46; n = 10; 43.8 ± 1.8) and good balance (GB; BBS scores ≥46; n = 10; 50.4 ± 2.5). The two groups had no differences in terms of the spatiotemporal features and range of motion (ROM) of the vertical COM (all p > 0.05). The ROM of the mediolateral COM was greater in PB than in GB. Hip transversal movements in the two groups were different. The impairment of the lateral balance function might contribute to an increase in the incidence of fall events in the elderly with poor balance.

DNA Topoisomerase Inhibitory Activity of Constituents from the Flowers of Inula japonica.

Fourteen compounds were isolated from the flowers of Inula japonica THUNB. (Asteraceae), including two new compounds, (1S,2S,4S,5S,8S,10R)-2-acetoxy-4,3-dihydroxy-pseudoguai-7(11)-en-12,8-olide (1) and (1S,2S,4S,5S,8S,10R)-2,4,13-trihydroxy-pseudoguai-7(11)-en-12,8-olide (2), and twelve known compounds, budlein B (3), 6ß-hydroxytomentosin (4), 6-deacetoxybritanin (5), 4-epipulchellin (6), britanin (7), tomentosin (8), (+)-dihydroquercetin (9), (-)-syringaresinol (10), quercetagetin 3,4'-dimethyl ether (11), luteolin (12), britanin G (13) and inuchinenolide C (14). Structures of 1 and 2 were determined based on one and two dimensional (1D)- and (2D)-NMR data and Mosher's esterification method. Compounds 9 and 12 showed inhibitory activities toward DNA topoisomerase I with IC50 values of 55.7 and 37.0 µM, respectively, compared to camptothecin (CPT) with an IC50 of 24.5 µM. Compounds 7-9 and 11-14 exhibited more potent inhibitory activity against topoisomerases II with IC50 values of 6.9, 3.8, 3.0, 6.9, 10.0, 14.7 and 13.8 µM, respectively, than that of etoposide (VP-16) with an IC50 of 26.9 µM. Compounds 4-7 and 10-14 exhibited weak cytotoxicities to the selected cancer cell lines.

Effects of balance ability and handgrip height on kinematics of the gait, torso, and pelvis in elderly women using a four-wheeled walker.

AIM: Numerous elderly individuals use the four-wheeled walker (FWW) as a gait-assistive device. The walker's handgrip height is important for correct use. However, few clinical studies have investigated the biomechanical effects of the FWW's handgrip height on balance. Therefore, the present study assessed kinematic features of the gait, torso and pelvis during use of the FWW at two levels of handgrip height (48% vs 55% of the subject's height) while assessing balance in older adults. METHODS: A total of 20 older adults were allocated into two groups according to the Berg Balance Scale (BBS): good balance (GB; BBS≥46) versus poor balance (PB; BBS<45). Participants walked with the FWW at 48% or 55% handgrip height for 10 m. RESULTS: Our study showed that the double-support period and stance phase significantly increased at 55% handgrip height, but the swing phase significantly decreased in the GB group. In the PB group, velocity and stride length significantly increased at 55% handgrip height. Tilt angle of the torso in the GB group was significantly lower at 55% than at 48% handgrip height, but no differences were observed in the PB group. In the pelvis, initial contact and toe-off angles of tilt were lower in the GB group at 55% handgrip height, but no differences were observed in the PB group. CONCLUSIONS: These results showed that kinematic features of the gait, torso, and pelvis in older adults using the FWW might be dependent on the handgrip height of the FWW and the patient's balance. Additionally, greater than 48% of the body height might be appropriate for older adults with poor balance.

Assessment of forearm and plantar foot load in the elderly using a four-wheeled walker with armrest and the effect of armrest height.

BACKGROUND: Patients with hand and/or wrist pathology are recommended to have a four-wheeled walker with an arm rest (FWW-AR) rather than a standard walker or a standard four-wheeled walker (FWW). However, only a few quantitative studies have been performed to compare upper and lower extremity weight bearing. The aim of this study was to evaluate forearm and foot weight bearing using a FWW-AR and the effect of the armrest height. METHODS: Eleven elderly women (mean age 80.1±5.3 years; mean height 148.5±4.0 cm; mean weight 51.2±9.0 kg) were enrolled. The subjects walked with an FWW-AR, with the elbow in either 90 degree (D90) or 130 degree (D130) flexion, for a distance of 10 m. Surface electromyographic signals were recorded for the upper, middle, and lower trapezius, anterior deltoid, and erector spinae muscles; walking velocity was measured with the subjects weight bearing on their feet and forearms while walking. Simultaneously, the maximum plantar and forearm loads during walking with an FWW-AR were measured. RESULTS: The normalized foot plantar loads were lower at D90 than at D130, while the normalized forearm load was higher at D90 than at D130 (all P<0.05; left foot, 7.9±0.1 N/kg versus 8.8±0.1 N/kg; right foot, 8.6±0.2 N/kg versus. 9.6±0.1 N/kg; left forearm, 1.8±0.5 N/kg versus 0.8±0.2 N/kg; and right forearm, 2.0±0.5 N/kg versus 1.0±0.2 N/kg, respectively). The surface electromyographic activity of the muscles involved in shoulder elevation and the walking velocity were both lower with the elbow at D90 than at D130 (all P<0.05; left upper trapezius, 98.7%±19.5% versus 132.6%±16.9%; right upper trapezius, 83.4%±10.6% versus 108.1%±10.5%; left anterior deltoid, 94.1%±12.8% versus 158.6%±40.4%; right anterior deltoid, 99.1%±15.0% versus 151.9%±19.4%; and velocity, 0.6±0.1 m/sec versus 0.7±0.1 m/sec, respectively). CONCLUSION: Weight bearing on the lower extremities is significantly reduced when the upper extremities are supported during walking with an FWW-AR. Furthermore, the weight bearing profile is dependent on the armrest height.

Predictors of unfavorable disease after radical prostatectomy in patients at low risk by D'Amico criteria: role of multiparametric magnetic resonance imaging.

PURPOSE: We identified risk factors predicting unfavorable pathological outcomes after radical prostatectomy in patients with low risk prostate cancer. We also evaluated the role of magnetic resonance imaging. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1,262 patients who underwent 12-core biopsy, preoperative magnetic resonance imaging and radical prostatectomy at a single center between September 2007 and June 2012. A total of 382 men with low risk prostate cancer by the D'Amico criteria were included in study. Multivariate logistic regression analysis was used to identify factors predicting unfavorable pathological outcomes. RESULTS: Median patient age was 65 years and median preoperative prostate specific antigen was 4.6 ng/ml. Gleason sum was upgraded in 212 patients (55.5%). In 249 patients (65.1%) prostate cancer was identified on 3 Tesla T2-weighted and diffusion-weighted magnetic resonance imaging without dynamic contrast imaging. The lesion was in the anterior and posterior of the prostate in 42.9% and 57.0% of cases, respectively. Unfavorable pathological results were found postoperatively in 29.6% of patients. Multivariate analysis revealed that older age (OR 1.072, p<0.001), number of positive cores (OR 1.373, p<0.001) and an anterior index tumor site on magnetic resonance imaging (OR 2.121, p=0.017) were significant predictors of unfavorable final pathological results (pT3 or greater, or tumor upgrading to Gleason 3+4 plus tumor volume 15% or greater, or upgrading to Gleason 4+3 or greater). CONCLUSIONS: An anterior site of cancer on magnetic resonance imaging was useful for predicting Gleason sum upgrading or an unfavorable pathological outcome after radical prostatectomy in patients with low risk prostate cancer.

Incremental value of magnetic resonance imaging for clinically high risk prostate cancer in 922 radical prostatectomies.

PURPOSE: We investigated the incremental value of magnetic resonance imaging in addition to clinical variables for predicting pathological outcomes and disease recurrence in patients with clinically high risk prostate cancer. MATERIALS AND METHODS: A total of 922 consecutive patients with clinically high risk prostate cancer underwent magnetic resonance imaging before radical prostatectomy. We created multivariate logistic regression and Cox proportional hazards models with clinical variables only or combined with magnetic resonance imaging data to predict pathological outcomes and biochemical recurrence. The models were compared using ROC curves and the Harrell concordance index. RESULTS: The proportion of patients with pathological extracapsular extension, seminal vesicle invasion and lymph node metastasis was 57.5%, 12.7% and 6.3%, respectively. The sensitivity and specificity of extracapsular extension, seminal vesicle invasion and lymph node metastasis detection were 43% and 84.2%, 34.9% and 93.8%, and 14.0% and 96.9%, respectively. The area under the ROC curve of the model with clinical variable and magnetic resonance imaging data was greater than that of the model with clinical variables alone to predict extracapsular extension and seminal vesicle invasion (0.734 vs 0.697, p=0.001 and 0.750 vs 0.698, p<0.001, respectively). The 5-year biochemical recurrence-free survival rate was 56.1%. To predict biochemical recurrence the concordance index of the multivariate model with clinical variables only and with clinical variables plus magnetic resonance imaging data was 0.563 and 0.599, respectively (p=0.003). CONCLUSIONS: Magnetic resonance imaging findings have incremental value in addition to clinical variables for predicting pathological outcomes and disease recurrence.

Is there a treatment advantage when paclitaxel and lovastatin are combined to dose anaplastic thyroid carcinoma cell lines?

BACKGROUND: Anaplastic thyroid carcinoma (ATC) is the most aggressive type of thyroid carcinoma. The purpose of this study was to evaluate the combined cytotoxic effects of paclitaxel and lovastatin in ATC cell lines. METHODS: ATC cells were treated with paclitaxel and lovastatin, separately or together, and the cytotoxicity of the compounds was determined by quantifying cell viability and apoptosis. We conducted an isobologram analysis to investigate the combined effect of the two drugs. RESULTS: In 8505C cells, cellular viability was inhibited by lovastatin and paclitaxel in a concentration-dependent manner (p = 0.002 and p = 0.020, respectively). The IC(50) of lovastatin was 3.53 µM and that of paclitaxel was 5.98 nM. In BHT-101 cells, cellular viability was also inhibited in a concentration-dependent manner by lovastatin and paclitaxel (p = 0.020 and p = 0.032, respectively). The IC(50) of lovastatin was 17.13 µM and that of paclitaxel was 35.26 nM. In 8505C cells, paclitaxel and lovastatin alone induced apoptosis in a concentration-dependent manner. However, both an isobologram analysis on inhibition of viability and an analysis of apoptosis demonstrated antagonism between paclitaxel and lovastatin. In BHT-101 cells, however, neither drug had an apoptotic effect when used individually. There was a variable effect when used in combination, depending on the drug concentrations. CONCLUSIONS: Paclitaxel and lovastatin were cytotoxic in two ATC cell lines and increased apoptosis in 8505C cells. However, in these cells, the combination of drugs resulted in antagonism that affected both the cytotoxicity of the compounds and the apoptosis of 8505C cells. The combination of paclitaxel and lovastatin did not enhance the treatment effect in ATC cell lines.

Imaging findings of primitive neuroectodermal tumors of the kidney.

PURPOSE: This study was designed to present the radiological imaging findings of a renal primitive neuroectodermal tumor (PNET). MATERIALS AND METHODS: The study included 10 patients with pathologically proven renal PNETs. We assessed the size, margin, internal architecture, enhancement pattern, vein thrombosis, and presence of a metastasis of the tumors on multidetector-row computed tomography and magnetic resonance imaging. RESULTS: The mean age of the patients was 31 years. Patients were predominantly male (males-females, 8:2). The mean diameter of a renal PNET was 12.7 cm. All masses were well defined with a lobulated contour. Necrosis and hemorrhage were detected in 9 cases, respectively. All of the masses showed weak heterogeneous enhancement with multiple irregular septumlike structures. Eight of the masses had renal vein thrombosis, and 4 masses had extension into inferior vena cava. A lymph node metastasis was detected in 3 patients. A lung metastasis was detected in 4 patients, and 2 of the patients also had a bone metastasis. CONCLUSIONS: A renal PNET usually appears as a weakly enhanced large mass with multiple septumlike structures, peripheral hemorrhage, venous thrombosis, and accompanied with a distant metastasis in a young adult.

Relative apparent diffusion coefficient: determination of reference site and validation of benefit for detecting metastatic lymph nodes in uterine cervical cancer.

PURPOSE: To determine the reference site for relative apparent diffusion coefficient (rADC) and to evaluate the benefit of rADC for detecting metastatic lymph nodes in uterine cervical cancer. MATERIALS AND METHODS: Two observers independently measured ADCs in the spleen, liver, renal cortex, lumbar spine, lumbar spinal cord, and gluteus maximus on diffusion-weighted images (b value, 0 and 1000 mm/sec(2)) in 50 patients. The reference site for rADC was determined using the intra- and interobserver coefficient of variation (CV) of ADC in these organs. rADC was calculated by ADC(lesion)/ADC(reference site). The benefit of rADC over ADC was validated by comparing the area under the receiver operating curve for identifying metastatic lymph nodes in uterine cervical cancer in 130 patients. RESULTS: The renal cortex was determined to be the reference site for rADC, as its CVs (intraobserver, 5%-7%; interobserver, 5%) were less than those of the other organs (P < 0.05). The ADC and rADC of metastatic lymph nodes (n = 29, ADC, 0.7483 x 10(-3) mm(2)/sec; rADC, 0.3832) were less than those of nonmetastatic lymph nodes (n = 229, ADC, 0.9960 x 10(-3) mm(2)/sec; rADC, 0.5383) (P < 0.05). The area under the receiver operating characteristics curve for differentiating metastatic from nonmetastatic lymph nodes was greater for rADC (0.914; 95% confidence interval [CI], 0.872-0.945) than for ADC (0.872; 95% CI, 0.825-0.910) (P = 0.007). CONCLUSION: The renal cortex is an appropriate reference site for rADC and rADC may improve the accuracy for diagnosing metastatic lymph nodes in uterine cervical cancer.

Gene delivery to the rat liver using cationic lipid emulsion/DNA complex: comparison between intra-arterial, intraportal and intravenous administration.

OBJECTIVE: To compare the efficiency of intra-arterial, intraportal, and intravenous administration of cationic lipid emulsion/DNA complex, as used for gene transfer to rat liver. MATERIALS AND METHODS: DNA-carrier complex for the in-vivo experiment was prepared by mixing DNA and a cationic lipid emulsion. According to the administration route used (intra-arterial, intraportal, or intravenous), the animals were assigned to one of three groups. The heart, lung, liver, spleen and kidneys were removed and assayed for total protein and luciferase concentration. RESULTS: The cationic lipid emulsion/DNA complex used successfully transfected the various organs via the different administration routes employed. Luciferase activity in each organ of untreated animals was negligible. Liver luciferase values were significantly higher in the groups in which intra-arterial or intraportal administration was used. CONCLUSION: The intra-arterial or intraportal administration of cationic lipid emulsion/DNA complex is superior to intravenous administration and allows selective gene transfer to the liver.