Motor imagery beyond the motor repertoire: Activity in the primary visual cortex during kinesthetic motor imagery of difficult whole body movements.

To elucidate the neural substrate associated with capabilities for kinesthetic motor imagery of difficult whole-body movements, we measured brain activity during a trial involving both kinesthetic motor imagery and action observation as well as during a trial with action observation alone. Brain activity was assessed with functional magnetic resonance imaging (fMRI). Nineteen participants imagined three types of whole-body movements with the horizontal bar: the giant swing, kip, and chin-up during action observation. No participant had previously tried to perform the giant swing. The vividness of kinesthetic motor imagery as assessed by questionnaire was highest for the chin-up, less for the kip and lowest for the giant swing. Activity in the primary visual cortex (V1) during kinesthetic motor imagery with action observation minus that during action observation alone was significantly greater in the giant swing condition than in the chin-up condition within participants. Across participants, V1 activity of kinesthetic motor imagery of the kip during action observation minus that during action observation alone was negatively correlated with vividness of the kip imagery. These results suggest that activity in V1 is dependent upon the capability of kinesthetic motor imagery for difficult whole-body movements. Since V1 activity is likely related to the creation of a visual image, we speculate that visual motor imagery is recruited unintentionally for the less vivid kinesthetic motor imagery of difficult whole-body movements.

2D electron temperature diagnostic using soft x-ray imaging technique.

We have developed a two-dimensional (2D) electron temperature (T(e)) diagnostic system for thermal structure studies in a low-aspect-ratio reversed field pinch (RFP). The system consists of a soft x-ray (SXR) camera with two pin holes for two-kinds of absorber foils, combined with a high-speed camera. Two SXR images with almost the same viewing area are formed through different absorber foils on a single micro-channel plate (MCP). A 2D Te image can then be obtained by calculating the intensity ratio for each element of the images. We have succeeded in distinguishing T(e) image in quasi-single helicity (QSH) from that in multi-helicity (MH) RFP states, where the former is characterized by concentrated magnetic fluctuation spectrum and the latter, by broad spectrum of edge magnetic fluctuations.

Thermal injury in the elderly: when is comfort care the right choice?

The factors contributing to a higher mortality rate in elderly thermal injury victims are not well delineated. The purpose of this study is to determine the impact of the initial injury, medical comorbidities, and burn size on patient outcome and to determine a level of injury in this population when comfort care is an appropriate first choice. Individual medical records of patients over 65 years of age admitted to our burn center over a 10-year interval were reviewed for patient demographics, mechanism of injury, total body surface area (TBSA) burned, medical comorbidities, use of Swan-Ganz catheters, evidence of inhalation injury, level of support, and patient outcome. The mechanisms of thermal injury were flame (68%), scald (21%) and electrical or chemical contact (11%). Twenty-six preventable bathing, cooking, and smoking-related injuries were seen (33%). The average TBSA was 25 per cent. Average length of stay varied depending on outcome. The overall mortality rate for this group was 45 per cent. Patients older than 80 years with 40 per cent or greater TBSA burned had a 100 per cent mortality rate despite aggressive treatment. Burn wound size correlated better with probability of poor outcome than age. Thermal injuries in the elderly are becoming more important with the aging of our population. Underlying medical problems--specifically chronic obstructive pulmonary disease--do play a role in increased patient morbidity and mortality. This study shows that age greater than 80 years in combination with burns greater than 40 per cent TBSA are uniformly fatal despite aggressive therapy. We believe that delaying the start of comfort-only measures in this situation only prolongs the pain and suffering for the patient, the family, and the physician.

Multifactorial analyses in the diagnosis of pneumonia arising in the surgical intensive care unit.

The diagnosis of ventilator-associated pneumonia in the surgical intensive care unit continues to be problematic. The majority of intensive care units use clinical criteria based on chest x-ray; fever; leukocytosis; alterations in the pulse oximeter observations; the need to alter modes and amounts of ventilatory support; and more specific microbiologic studies, such as appropriate sputum, Gram stain, and culture to identify pneumonia. Diagnosing pneumonia based on clinical criteria alone is often difficult and inaccurate, which may lead to inappropriate use and choice of antibiotics. Invasive diagnostic techniques, such as protected specimen brush and bronchoalveolar lavage, provide an important microbiologic diagnosis. However, the cost and inconvenience limit broad usage. Furthermore, those results that return positive are often too late to dictate the need for, or direction of, therapy. Our use of a "pneumonia grid" may help identify patients likely to have a poor outcome. Until a readily available and cost-effective diagnostic study for pneumonia is developed, clinical criteria remain vital in routine practice.

Purification and characterization of phenylacetaldehyde reductase from a styrene-assimilating Corynebacterium strain, ST-10.

A novel phenylacetaldehyde reductase was purified about 50-fold to homogeneity from Corynebacterium sp. strain ST-10, which can assimilate gaseous styrene as the sole carbon and energy source. The enzyme was inductively synthesized when grown on gaseous styrene and had an important role in styrene metabolism in vivo. The enzyme had a molecular weight of 155,000 and was composed of four identical subunits (molecular weight, 42,000). The enzyme catalyzed the reduction of not only phenylacetaldehyde but also various aldehydes and ketones; however, it did not catalyze the reverse reaction, the dehydrogenation of 2-phenylethanol. The enzyme required NADH as a cofactor and showed no activity with NADPH; therefore, it was defined as an NADH-dependent phenylacetaldehyde reductase. The enzyme stereospecifically produced (S)-(-)-1-phenylethanol from acetophenone; therefore, it would be useful as a biocatalyst.

Characterization of Styrene Oxide Isomerase, a Key Enzyme of Styrene and Styrene Oxide Metabolism in Corynehacterium sp.

Styrene oxide isomerase (SOI) [EC 5.3.99.7], most probably located in the cell wall, was partially purified from Coiynebacterium sp. AC-5 cells grown in a styrene gas atmospheres. The enzyme catalyzed the isomerization reaction to give phenylacetaldehyde, but did not catalyze its reverse reaction. The optimum pH of the reaction was around 7.0, and the enzyme was unstable below pH 6.0. The Km toward styrene oxide was very low (7.7 × 10(-5) m), indicating its high affinity for styrene oxide. The enzyme showed strict substrate specificity, and epoxide compounds other than styrene oxide did not serve as substrates. (S)-Styrene oxide was preferentially converted by the enzyme, compared with the (R)-isomer. The possible application of SOI as a biocatalyst is also discussed.

[A case of recurrent hepatocellular carcinoma after hepatic resection surviving over five years by hepatic arterial infusion of lipiodol-anticancer drug suspension].

A 63-year-old male with four intrahepatic recurrences of surgically resected hepatocellular carcinoma was admitted to our hospital in June 1985. He underwent lateral segmentectomy of the liver in November 1983. Pathologic finding of Edmondson II with liver cirrhosis had been confirmed by the operative specimen. Sizes of four recurrent tumors were assessed by CT as 3.5 x 2.2 cm, 2.6 x 2.2 cm, 2.2 x 2.2 cm and 2.2 x 2.2 cm, respectively. During five years until July 1990, the patient was treated with hepatic arterial infusion of Lipiodol-anticancer drug suspension eight times (total 5-FU 900 mg, ADM 77 mg, MMC 73 mg, and Lipiodol 36 ml) and hepatic arterial chemoembolization of MMC microcapsules one time. In addition, two hepatic arterial infusions of CDDP (total 70 mg) were given and 5-FU (total 10 g) was administered intravenously. Partial response (PR) was obtained for 19 months. Hepatic arterial infusion of Lipiodol-anticancer drug suspension was given only once every 6 months, and he maintained a good quality of life for over four and half years. The man died in July 1990. In general, multiple intrahepatic recurrence of surgical resected hepatocellular carcinoma has a poor prognosis. Therefore it was considered that hepatic arterial infusion of this drug brought about the relatively long survival of more than five years.

[Thermochemotherapy of cancer of the stomach]. / Termokhimioterapiia raka zheludka.

Short-term results of chemo-hyperthermia of gastric carcinoma were reported. Complete regression was noted in 15%, partial regression in 42% of cases.

[Pre-operative endoscopic infusions of an adsorbent containing mitomycin C (MMC-CH44) in stomach cancer].

Small charcoal particles adsorbing Mitomycin C (MMC-CH) were used in the treatment of lymphnode metastasis of gastric cancer. Immediately after injection of MMC-CH into the gastric wall, lymph capillaries and regional lymphnodes were stained in black and the high concentration of MMC was delivered with charcoal particles. MMC-CH was injected preoperatively using endoscope into the gastric wall of 20 patients with gastric cancer. MMC-CH was observed in 70% of metastatic regional lymphnodes. Systemic side effect was not noted at all. Erosion and shallow ulcers were observed at the site of injection but no perforation occurred.