Gait velocity control using projection mapping for children with spastic diplegia cerebral palsy.

BACKGROUND: Gait characteristics in children with cerebral palsy vary according to their individual walking speed. As such, establishing methods to maintain a consistent gait velocity are necessary to evaluate specific intervention effects in this clinical population. Our study aim was to validate the accuracy of projection mapping for guiding gait velocity to a control gait velocity. METHODS: This was a cross-sectional study of 13 children with cerebral palsy (mean age [standard deviation] of 12.42 [2.31] years). The target velocity was calculated from the average speed obtained across three trials of self-selected walking speed. A virtual reality system with four projectors was used to project an image onto the floor to guide children to match two gait conditions: 100% and 125% velocity of the average speed. Participants completed three gait trials at each velocity under image guidance. Gait velocity was quantified using a 3-dimensional motion capture system. Bland-Altman plots were used to analyze systematic errors and the limits of agreement calculated. FINDINGS: The results indicated the limits of agreement were acceptable for 0.10 m/s for 100% velocity and 0.12 m/s for 125% velocity. Therefore, projection mapping was effective in guiding children to adjust their gait to the intended velocity. INTERPRETATION: Projection mapping is a novel method for guiding children with cerebral palsy to walk at a controlled target velocity that may improve the reliability of gait analysis.

Evaluating a frailty education program implemented through barbershops/salons in Japan: A preliminary study.

Although frailty has detrimental physical and psychological effects on elderly people, it is potentially reversible. In this study, we aim to evaluate the effectiveness of a pilot frailty education program implemented through barbershops/salons in Japan. In January 2018, we selected five barbershops/salons in Japan where customers were educated on frailty, which was classified as "normal," "prefrail," and "frail." We developed a web-based assessment tool to reduce the workload for barbers/stylists. Participants included 45 customers (82% women), with a median (interquartile range) age of 53.0 (47.5-57.5) years, and a mean ± SD BMI of 22.3 ± 2.7. Frailty scores indicated that 35% of participants were normal, 58% were prefrail, and 7% were frail. Frailty status scores reflected no significant differences after the intervention. Customers classified as frail were advised to visit the regional comprehensive support center for further professional frailty assessment. Participants, especially those aged over 65 years, found the web-based assessment difficult to use. In conclusion, a frailty education program implemented through barbershops/salons is possible because barbers/stylists can provide information on and assessment of frailty. Females and highly educated customers are more likely to be interested in participating. Nevertheless, a simple intervention is essential to expand the program nationwide.

Analysis of center of mass and center of pressure displacement in the transverse plane during gait termination in children with cerebral palsy.

BACKGROUND: While gait termination is challenging for children with spastic cerebral palsy (CCP), few studies have quantitatively assessed this issue. RESEARCH QUESTION: What are the characteristics of center of mass (COM) and center of pressure (COP) displacement during gait termination in CCP, and how do they compare with those in children with typical development (CTD)? METHODS: This cross-sectional study included 13 adults with typical development (19.85 ± 0.52 years), 12 CTD (10.41 ± 2.98 years), and 16 CCP (11.15 ± 2.71 years). Participants were instructed to immediately stop walking when a stop sign appeared on a screen, which was placed at the end of an 8-m walkway. COM and COP were determined via 3-dimensional motion analysis and force plate data. Differences between the groups were assessed using the two sample t-test or Wilcoxon rank sum test. The level of statistical significance was set at P < 0.05. RESULTS: The normalized time for stopping in CCP (4.556 ± 0.602) was higher than that in CTD (3.617 ± 0.545, P < 0.001). The normalized COP displacement (P < 0.001) and divergence between COM and COP (P < 0.001) in the mediolateral (ML) direction were significantly higher in CCP than CTD. However, the normalized divergence between COM and COP in the anteroposterior (AP) direction in CCP was lower than that in CTD (P = 0.034). SIGNIFICANCE: The more minor divergence between COM and COP in the AP direction and the more significant COP displacement in the ML direction cause difficulty to exert braking force during gait termination. Thus, CCP require a longer time for gait termination. This finding may facilitate the development of interventions for improving gait in CCP.

Inhibition of Hsp90 and 70 sensitizes melanoma cells to hyperthermia using ferromagnetic particles with a low Curie temperature.

BACKGROUND: Heat shock protein (Hsp) 90 is a key regulator of various oncogene products and cell-signaling molecules, while Hsp70 protects against heat-induced apoptosis. We previously described a system in which hyperthermia was produced using thermosensitive ferromagnetic particles (FMPs) with a Curie temperature (T c) of 43 °C to mediate automatic temperature control, and demonstrated its antitumor effect in a mouse melanoma model. In the present study, the antitumor effects of combining Hsp90 inhibitor (17DMAG) and Hsp70 inhibitor (quercetin) with FMP-mediated hyperthermia were examined. METHODS: Expressions of Hsp90/70 and Akt were evaluated using Western blotting in vitro. In an in vivo study, melanoma cells were subcutaneously injected into the backs of C57BL/6 mice. FMPs were then injected into the resultant tumors, and the mice were divided into groups treated with quercetin and/or 17DMAG with/without hyperthermia. When exposed to a magnetic field, the temperature of tissues containing FMPs increased and stabilized at the T c. The TUNEL method was used to determine whether hyperthermia induced apoptosis within tumors. RESULTS: In the group pretreated with hyperthermia + quercetin + 17DMAG, Akt expression was reduced in vitro, the incidence of apoptosis within tumors was greater, and tumor growth was significantly suppressed 20 days after FMP injection in vivo, compared with other treatment groups. The survival rates among tumor-bearing mice observed for a period of 40 days were significantly higher in the hyperthermia + quercetin + 17DMAG group. CONCLUSION: Combining Hsp90/70 inhibition with hyperthermia appears to increase their antitumor effects. Thus, the combination of FMP-mediated, self-regulating hyperthermia with Hsp90/70 inhibition has important implications for cancer treatment.

Features of the Vision of Elderly Pedestrians when Crossing a Road.

The present study clarifies the mechanism by which an accident occurs when an elderly pedestrian crosses a road in front of a car, focusing on features of the central and peripheral vision of elderly pedestrians who are judging when it is safe to cross the road. For the pedestrian's central visual field, we investigated the effect of age on the timing judgment using an actual car. The results for daytime conditions indicate that the elderly pedestrians tended to make later judgments of when they crossed the road from the right side of the driver's view at high car velocities. At night, for a car with its headlights on high beam, the average car-pedestrian distances of elderly pedestrians on the left side of the driver's view were significantly longer than those of young pedestrians at velocities of 20 and 40 km/h. The eyesight of the elderly pedestrians during the day did not affect the timing judgment of crossing a road. At night, for a car with its headlights on either high or low beam, the average car-pedestrian distances of elderly pedestrians having good eyesight were longer than those of elderly pedestrians having poor eyesight, for all car velocities. The color of the car body in the central visual field did not affect the timing judgment of elderly pedestrians crossing the road. Meanwhile, the car-body color in the elderly pedestrian's peripheral vision strongly affected the pedestrian's awareness of the car.

[An attempt to evaluate postural control with a magnetic motion capture system].

Measurement of the body sway can be useful in the assessment of the ability to maintain posture. It is, however, difficult to quantitatively evaluate the chronological changes in the equilibrium function in the elderly. Although it is considered that not only sway movement of body center of gravity but also head movement should be measured for essential assessment of postural control, few methods are suitable for a clinical test. In this study, we investigated the head and trunk movement in elderly subjects standing upright, using a magnetic motion capture system to substantiate its usefulness. Seven subjects aged 66 to 83 years old were instructed to stand with their feet close together on the stabilometer with eyes open and then eyes closed for periods of 30 seconds each, while the movement of the head, cervix and lumbar region (MH, MC and ML) were monitored three-dimensionally with the magnetic motion capture system. The obtained data were compared with the movement of the body's center of gravity (MCG). The results were as follows: The MH was the largest, followed by MC and ML, and the ML trace was similar to that of the MCG. MH, MC, ML and the ratio of the MH to ML increased with age, and they were considered to be a valid index for assessment of postural control. A magnetic motion capture system, which can record the movements of the head, cervix and lumbar region accurately and conveniently, is seen as potentially and clinically useful apparatus for evaluation of postural control in dizzy patients, especially the elderly.

Inhibition of heat shock protein 90 sensitizes melanoma cells to thermosensitive ferromagnetic particle-mediated hyperthermia with low Curie temperature.

Heat shock protein (Hsp) 90 is a key regulator of a variety of oncogene products and cell-signaling molecules, and the therapeutic benefit of its inhibition in combination with radiation or chemotherapy has been investigated. In addition, hyperthermia has been used for many years to treat various malignant tumors. We previously described a system in which hyperthermia was induced using thermosensitive ferromagnetic particles (FMP) with a Curie temperature (Tc = 43 degrees C) low enough to mediate automatic temperature control, and demonstrated its antitumor effect in a mouse melanoma model. In the present study, we examined the antitumor effects of combining a Hsp90 inhibitor (geldanamycin; GA) with FMP-mediated hyperthermia. In cultured B16 melanoma cells, GA exerted an antitumor effect by increasing the cells' susceptibility to hyperthermia and reducing expression of Akt. In an in vivo study, melanoma cells were subcutaneously injected into the backs of C57BL/6 mice. FMP were then injected into the resultant tumors, and the mice were divided into four groups: group I, no treatment (control); group II, one hyperthermia treatment; group III, GA alone; and group IV, GA with hyperthermia. When exposed to a magnetic field, the temperature of tissues containing FMP increased and stabilized at the Tc. In group IV, complete regression of tumors was observed in five of nine mice (56%), whereas no tumor regression was seen in groups I-III. Our findings suggest that inhibition of Hsp90 with hyperthermia increases its antitumor effect. Thus, the combination of FMP-mediated, self-regulating hyperthermia with Hsp90 inhibition has important implications for the treatment of cancer.

Self-regulating hyperthermia induced using thermosensitive ferromagnetic material with a low Curie temperature.

Hyperthermia has been used for many years to treat a variety of malignant tumors. The Curie temperature (Tc) is a transition point at which magnetic materials lose their magnetic properties, causing a cessation of current and thus heat production. The Tc enables automatic temperature control throughout a tumor as a result of the self-regulating nature of the thermosensitive material. We have developed a method of magnetically-induced hyperthermia using thermosensitive ferromagnetic particles (FMPs) with low Tc (43 degrees C), enough to mediate automatic temperature control. B16 melanoma cells were subcutaneously injected into the backs of C57BL/6 mice, after which tumors were allowed to grow to 5 mm in diameter. FMPs were then injected into the tumors, and the mice were divided into three groups: group I (no hyperthermia, control); group II (one hyperthermia treatment); and group III (hyperthermia twice a week for 4 weeks). When exposed to a magnetic field, the FMPs showed a sharp rise in heat production, reaching the Tc in tissue within 7 min, after which the tissue temperature stabilized at approximately the Tc. In groups I and II, all mice died within 30-45 days. In group III, however, 6 of 10 mice remained alive 120 days after beginning treatment. Our findings suggest that repeated treatment with magnetically-induced self-regulating hyperthermia, mediated by FMPs with a low Tc, is an effective means of suppressing melanoma growth. A key advantage of this hyperthermia system is that it is minimally invasive, requiring only a single injection for repeated treatments with automatic temperature control.

Noninvasive temperature measurement method for hyperthermia treatment using ferromagnetic implant with low curie temperature.

Induction heating using 'ferromagnetic implant with low Curie temperature (FILCT)' is one of the heating methods for hyperthermia. However, a lot of energy is needed to heat malignant tumors; the heating efficiency has to be improved. In order to address this problem, we propose using FILCT as a probe for temperature. A non-invasive temperature measurement system was developed based on this approach. A key advantage of this system is that it can noninvasively distinguish whether the temperature of FILCT has reached the Curie temperature or not. As a result, materials with high heating efficiency may be used.

Imaging of epithelial cancer in sub-terahertz electromagnetic wave.

We used sub-terahertz (THz) imaging to exam two cross sections of epithelial cancer tissue embedded in paraffin using a 0.19 THz electromagnetic wave. The sub-THz imaging system was constructed with a tunnel injection transit time (TUNNETT) diode, a Schottky barrier diode detector and a X-Z stage. We examined the difference between a sub-THz wave absorption in melanoma and nevus tissue.