A new method for detecting unilateral spatial neglect with tracing tasks using the Rey-Osterrieth complex figure: a pilot study.

PURPOSE: To explore efficacy of the "Rey-Osterrieth complex figure (ROCF) tracing task" as a new test to detect unilateral spatial neglect (USN). METHODS: Subjects were 40 healthy control (HC) and 20 right brain-damaged patients with (USN + , n = 10) or without USN (USN - , n = 10). After the ROCF copying task, the tracing task was performed under conditions that did not leave any tracing lines on the sample figure. Evaluation used the conventional 36-point scoring system, laterality index (LI) as the ratio of the left and right structure scores, and the number of overlaps for each of the left and right structures scored. RESULTS: In the tracing task, USN + showed a lower LI than HC. Furthermore, left-sided neglect was sometimes more evident than in the copying task. Regarding the total overlapping score, USN + showed a greater score than HC. The right-sided overlapping scores in USN + and USN - were also greater than that in HC. In the right brain-damaged subjects, clinically meaningful correlations were not found between evaluations in the ROCF tracing task and in conventional USN screening tests. Receiver-operating-characteristic analysis to test the power of detection showed moderate performance for the tracing LI (AUC = 0.76, 95% CI = 0.54-0.97), which was greater than that of other tests. Further, the total overlapping score in the tracing task showed sensitivity 0.9 (highest among the tests performed), specificity 0.5, and AUC 0.68 (95% CI = 0.43-0.92). CONCLUSION: The ROCF tracing task might be a convenient method to detect USN and to reveal the extent of spatial working memory impairment.

Immediate Effects of Electrical Stimulation on Oropharyngeal Structure and Laryngeal Vestibular Closure: A Pilot Study in Healthy Subjects.

Objectives: This study examined the immediate effects of neuromuscular electrical stimulation (NMES) on the dynamics of oropharyngeal structure and laryngeal vestibular closure (LVC) in healthy subjects. Methods: Ten healthy male volunteers participated in this controlled, before-and-after, videofluoroscopic swallowing pilot study. The study was conducted in four phases (each performed twice): (1) saliva swallow (SS) before evaluation (BEFORE), (2) NMES while at rest with no SS (NMES AT REST), (3) SS during NMES (DURING NMES), and (4) SS to examine the aftereffects of NMES (AFTER). We measured distances that oropharyngeal structures moved in the NMES AT REST phase, and we analyzed the kinematics of saliva swallowing primarily in the BEFORE and AFTER phases. Results: Four changes in the morphology of the oropharyngeal structure caused by NMES AT REST were statistically significant: anterior-upward displacement of the hyoid bone and larynx, stretch of the laryngeal vestibule, and posterior ridge of the tongue root. Regarding the kinematics measured during SS, although there was no significant change in LVC reaction times, LVC duration in the AFTER phase was significantly longer than BEFORE. Regarding maximal displacement of the hyoid bone, there was significantly greater movement AFTER than BEFORE. As additional exploratory outcomes, the velocity of hyoid bone movement was significantly slower, and the hyoid-to-larynx approximation was significantly smaller, DURING NMES than AFTER. Conclusions: Longer duration of LVC might be caused by adaptive learning with NMES-induced structural changes in the oropharynx. Further clinical studies are warranted to determine whether this approach improves dysphagia, which impairs LVC.

Pharmacokinetic analysis of a combined chemoendocrine treatment with paclitaxel and toremifene for metastatic breast cancer.

BACKGROUND: Multidrug resistance protein could be a target for improving the efficacy of paclitaxel (PXL). Toremifene (TOR) may moderate P-gp-related drug resistance in vitro. Some P-gp moderators may change the pharmacokinetic parameters of PXL in vivo. A pharmacokinetic (PK) study in metastatic breast cancer patients (MBC) was conducted to determine the safety and efficacy of PXL and TOR. METHOD AND PATIENTS: Fifteen patients received 80 mg/m(2) PXL (i.v.) weekly and 120 mg/body TOR (p.o.) daily. For the pharmacokinetic study, PXL was administered on days 1, 8, 15, 32, and 39; TOR was given from day 18 to the end of study. On days 1, 8, 15, 18, 32, and 39, blood samples were collected from the patients who received either PXL alone or PXL + TOR, and these were analyzed by high-performance liquid chromatography. RESULTS: Among the 15 patients enrolled in the study, one showed a partial response, and eight had a stable disease. TOR caused no specific adverse events that were greater than grade 3, and its toxicity profile in combination with PXL was similar to that of PXL monotherapy. The PK profile of PXL was similar with or without TOR. The PK parameters of PXL indicated no inter- or intra-patient variability in previously treated patients with MBC. No increased PXL toxicity was observed. CONCLUSION: The PK profile of combined PXL and TOR was similar to that of PXL monotherapy. The addition of TOR to PXL in previously treated patients with MBC appears safe.

Gene transfection into HeLa cells by vesicles containing cationic peptide lipid.

Lipid vesicles are potentially useful as microcapsules for drug and/or gene delivery. We developed cationic lipid vesicles consisting mainly of sorbitan monooleate (Span 80) and cationic peptide lipid (CPL), and evaluated the CPL vesicles as gene transfection vectors. The optimum CPL concentration for gene transfection into HeLa cells was found to be 20 wt % of total lipid, and such CPL vesicles did not exhibit significant cytotoxicity. Co-culture of Poly-L-lysine and plasmids prior to making CPL vesicle-plasmid complexes was effective. Lipofection using LipofectAMINE was suppressed in 10% serum-supplemented medium. The transfection efficiency of 20 wt % CPL vesicles, however, was not affected by serum in the medium when plasmids were treated with poly-L-lysine.