Effects of High-Speed Power Training on Neuromuscular and Gait Functions in Frail Elderly with Mild Cognitive Impairment Despite Blunted Executive Functions: A Randomized Controlled Trial.

BACKGROUND: Physical frailty and impaired executive function of the brain show similar pathophysiology. Both of these factors lead to dysfunction of neuromuscular and abilities in elderly. High-speed power training (HSPT) has been determined to have positive effects on neuromuscular function and gait performance, as well as executive function in the elderly. OBJECTIVES: The purpose of this study was to investigate the effects of 8-week HSPT on neuromuscular, gait and executive functions in frail elderly with mild cognitive impairment (MCI). DESIGN, SETTING AND PARTICIPANTS: We performed a randomized controlled trial of frail elderly from community and medical center in republic of Korea. Forty-two physically frail elderly with MCI were randomly allocated to control (n=22, age=74.22±4.46) and intervention groups (n=18, age=73.77±4.64). The intervention group was subjected to HSPT, 3 times weekly for 8 weeks. MEASUREMENTS: Isometric contraction of knee extension and flexion with electromyography (EMG) was measured to determine the neuromuscular function such as knee extensor strength, rate of torque development, movement time, pre-motor time, motor time, rate of EMG rise, and hamstrings antagonist co-activation. Additionally, the 4.44-meter gait and timed up-and-go (TUG) test were administered to assess gait performance. A frontal assessment battery was measured in this study. RESULTS: The 8-week HSPT regimen improved the knee extensor strength from 1.13±0.08 to 1.25±0.07 (p<0.05), the 200-ms RTD from 3.01±0.3 to 3.55±0.24 (p<0.05) and the rate of EMG rise from 166.48±13.31 to 197.94±11.51 (p<0.05), whereas the movement time and motor time were statistically decreased from 921.69±40.10 to 799.51±72.84, and 271.40±19.29 to 181.15±38.08 (p<0.05), respectively. The 4.44-m gait speed and TUG significantly decreased from 6.39±0.25 to 5.5±0.24, and 11.05±0.53 to 9.17±0.43 respectively (p<0.05). CONCLUSION: The findings of this study suggest the favorable effects of 8-week HSPT on the neuromuscular function and the gait performance in the frail elderly with MCI without increase in the executive function.

JWA regulates TRAIL-induced apoptosis via MARCH8-mediated DR4 ubiquitination in cisplatin-resistant gastric cancer cells.

Platinum chemotherapeutics are widely used to treat solid malignant tumors, including gastric cancer (GC). Drug resistance to platinum compounds may result in cancer relapse and decreased survival. The identification and development of novel agents to reactivate apoptosis pathways in platinum-resistant cancer cells is therefore necessary. Here we report that cisplatin-resistant human GC cells (BGC823/DDP and SGC7901/DDP) but not their parental cells (BGC823 and SGC7901) exhibit high sensitivity to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) as a result of overexpression of death receptor 4 (DR4). Furthermore, we found that JWA, a molecule that promotes cisplatin-induced apoptosis in GC cells, suppressed TRAIL-induced apoptosis via negative regulation of DR4. Mechanistically, JWA promoted the ubiquitination of DR4 at K273 via upregulation of the ubiquitin ligase membrane-associated RING-CH-8 (MARCH8). In human GC tissues, JWA and DR4 protein levels were negatively correlated. Thus TRAIL may serve as an auxiliary treatment for cisplatin-resistant GC, and JWA may be a potential predictive marker of TRAIL sensitivity and may improve personalized therapeutics for treating human GC.

Transition probability/Markov chain analyses of DNAPL source zones and plumes.

At sites where a dense nonaqueous phase liquid (DNAPL) was spilled or released into the subsurface, estimates of the mass of DNAPL contained in the subsurface from core or monitoring well data, either in the nonaqueous or aqueous phase, can be highly uncertain because of the erratic distribution of the DNAPL due to geologic heterogeneity. In this paper, a multiphase compositional model is applied to simulate, in detail, the DNAPL saturations and aqueous-phase plume migration in a highly characterized, heterogeneous glaciofluvial aquifer, the permeability and porosity data of which were collected by researchers at the University of Tübingen, Germany. The DNAPL saturation distribution and the aqueous-phase contaminant mole fractions are then reconstructed by sampling the data from the forward simulation results using two alternate approaches, each with different degrees of sampling conditioning. To reconstruct the DNAPL source zone architecture, the aqueous-phase plume configuration, and the contaminant mass in each phase, one method employs the novel transition probability/Markov chain approach (TP/MC), while the other involves a traditional variogram analysis of the sampled data followed by ordinary kriging. The TP/MC method is typically used for facies and/or hydraulic conductivity reconstruction, but here we explore the applicability of the TP/MC method for the reconstruction of DNAPL source zones and aqueous-phase plumes. The reconstructed geometry of the DNAPL source zone, the dissolved contaminant plume, and the estimated mass in each phase are compared using the two different geostatistical modeling approaches and for various degrees of data sampling from the results of the forward simulation. It is demonstrated that the TP/MC modeling technique is robust and accurate and is a preferable alternative compared to ordinary kriging for the reconstruction of DNAPL saturation patterns and dissolved-phase contaminant plumes.

RAPD based DNA markers linked to anthracnose disease resistance in Sorghum bicolor ( L.) Moench.

Anthracnose caused by Colletotrichum graminicola is one of the major diseases of sorghum. The locus for disease resistance in sorghum [Sorghum biocolor (L.) Moench] accession G73 was found to segregate as a simple recessive trait in a cross to susceptible cultivar HC136. In order to identify molecular markers linked to the locus for disease resistance, random amplified polymorphic DNA (RAPD) analysis was coupled with bulk segregant analysis. DNA from the parental cultivars and the bulks were, screened by PCR amplification with 114 RAPD primers. Three RAPD primers amplified a sequence that consegregated with the recessive resistance allele, while another three amplified a band linked to the susceptible allele. The six disease linked markers were screened with individual resistant and susceptible genotypes to observe degree of linkage of identified RAPD markers with the gene for resistance. Two primer sequences (OPI 16 and OPD 12) were found to be closely linked to the locus for disease resistance.

Clinics in diagnostic imaging (56). Cavernous vascular malformation with intracerebral haematoma.

A 28-year-old woman presented following a seizure. Physical and neurological examinations showed no significant abnormality except a drowsy mental state. Routine laboratory studies were normal. Emergency MR imaging showed a rounded, high signal intensity lesion with a focal eccentric heterogeneous signal focus in the right frontal lobe. The heterogeneous focus revealed an irregular low signal rim on T1- and T2-weighted images. Mild surrounding parenchymal oedema was noted. The eccentric focus showed some central enhancement. The diagnosis of cavernous vascular malformation with intracerebral haematoma was confirmed at surgery. The combination of typical MR imaging findings, with clinical and family histories consistent with cavernous angiomata provides sufficient conclusive evidence.

Obstructive jejunal adenocarcinoma in the Muir-Torre syndrome.

A young male patient was referred for endoscopic resection of a recto-sigmoid polyp and abdominal complaints. His medical history revealed a sebaceous adenoma resection from his back and a tubular adenoma excision from his right upper eyelid. After disclosure of a jejunal tumour on a small bowel enema and given the remarkable family history characterized by the frequent occurrence of bowel cancer, the diagnosis of Muir-Torre syndrome was established. This syndrome pertains to the combination of sebaceous gland tumours/adenomas in combination with gastrointestinal or genitourinary tract tumours. Inheritance takes place in an autosomal dominant manner. It usually occurs in males at an early age. Given its low malignancy potential, early detection of the syndrome renders a favourable prognosis. Careful examination and follow-up also involving the small intestine are mandatory for patients and relatives.

Detection of measles, mumps, and rubella antibodies in saliva using antibody capture radioimmunoassay.

Antibody capture radioimmunoassays were developed for detecting virus specific IgM (MACRIA) and IgG (GACRIA) to measles, mumps, and rubella and used to investigate saliva as an alternative specimen to serum for diagnosis. Saliva was collected from 63 patients with measles, 19 with mumps, and 150 with rubella, which were all clinically diagnosed and serologically confirmed. Virus specific IgM was detected in 92% of measles, 75% of mumps, and 100% of rubella saliva samples collected during the first week of illness. Between 1 and 5 weeks after onset virus specific IgM was detected in 100% of saliva specimens. After the 5th week the proportion of reactive specimens declined. The specificity of the MACRIA tests was established by testing saliva samples collected from blood donors for measles (88), mumps (88), and rubella IgM (91). All of the saliva specimens tested for measles and rubella specific IgM were unreactive, 1/88 specimens tested for mumps specific IgM contained significant reactivity. Saliva specimens collected from acute cases of MMR were tested in all 3 MACRIAs. A small proportion of saliva samples contained detectable IgM of more than one virus infection. Rubella and measles specific IgG was detected in the saliva of all cases from the 4th or 5th day of illness, respectively. Detection of mumps specific IgG was less successful. We have demonstrated that virus specific IgM can be reliably detected in saliva samples collected from acute cases of measles, mumps, and rubella and identified 1-5 weeks after onset of illness as the optimum time for collection of samples.

Admission to hospital with gastroenteritis.

A prospective study over a one year period examined preadmission illness and its treatment, social characteristics and referral patterns, and inpatient illness progression in 1148 children admitted with a primary diagnosis of gastroenteritis. Admissions were predominantly from socially disadvantaged families: 712 (62%) from social classes IV and V. Approximately a quarter were referred with minimal symptoms, only 12 (1%) with moderate to severe dehydration, and eight (less than 1%) with hypernatraemia. One hundred and ninety two of 1101 (17%) had not seen their general practitioner during the acute illness. One third had received no treatment and one third inappropriate antibiotics, antidiarrhoeals, antiemetics, or changes of milk. Gastroenteritis is a less severe illness than formerly but remains a significant cause of paediatric morbidity. Suboptimal treatment is common. Improved local district hospital and community based resources are needed.

Diagnosis of hepatitis A and B by testing saliva.

The use of salivary samples to diagnose acute viral hepatitis was investigated. Tests for IgM antibody to hepatitis A virus (anti-HAV) on 29 acute-phase samples from serologically confirmed cases of hepatitis A were strongly reactive. Follow-up samples indicated that IgM anti-HAV persisted at moderate levels for 2-4 months and was not usually detectable thereafter. The ratio of IgM to IgG anti-HAV (RIA index) correlated closely with the interval from onset of infection. Significant levels of IgM anti-HAV were not detected in the saliva of 103 IgG anti-HAV positive and 102 IgG anti-HAV negative individuals nor of 4 individuals with hepatitis B. Similarly, IgM anti-HBc was present in the saliva of acute cases of hepatitis B, but not in the saliva of 25 IgG anti-HBc positive and 85 IgG anti-HBc negative individuals, nor of 24 individuals with recent hepatitis A. It is concluded that saliva is a convenient and satisfactory alternative to serum for the diagnosis of hepatitis A infection.

Clinical and diagnostic features of pulmonary valve endocarditis in the setting of congenital cardiac malformations.

We studied the clinical and diagnostic features of 5 cases of pulmonary valve endocarditis where morphologic documentation was available. All patients had congenital cardiac disease as the predisposing factor and the infectious process involved only the pulmonary valve. None of the patients was addicted to drugs. Absence of systemic emboli, lack of pulmonary symptoms, acute course and high frequency of sterile cultures made the clinical recognition difficult and was possible only in three cases. The clinical picture of pulmonary valve endocarditis was characterised by fever, right-sided congestive cardiac failure and pulmonary incompetence. Echocardiography assumes a specific diagnostic role in such cases and cross-sectional echocardiography provides more information than M-mode echocardiography. Pulmonary valve endocarditis carries a high mortality and 3 patients died. Two patients underwent successful surgery of their underlying defect and excision of the pulmonary valve. Staphylococcus aureus was the organism grown from autopsy or surgical material in 3 cases.

Tissue distribution of lymphocytes in rheumatic heart valves as defined by monoclonal anti-T cell antibodies.

Fresh cardiac valvular tissues and atrial appendages removed from 106 Indian patients with rheumatic heart disease at the time of corrective cardiac surgery were examined to determine the characteristics of valvular interstitial lymphocytic infiltrates using conventional histologic staining along with indirect immunofluorescent techniques. Precise identification of the phenotypic profiles of inflammatory mononuclear cells was attempted using anti-IgG, anti-Ia, and monoclonal mouse hybridoma reagents identifying T cells (OKT3) as well as T cell subsets (OKT4 helper/inducer and OKT8 suppressor/cytotoxic cells). A similar group of 21 patients undergoing cardiac valvular resection in Albuquerque was studied. The mean age of Indian patients providing valve tissues was 27.7, whereas in those in Albuquerque, it was 52 years. Twenty-five percent of rheumatic heart valves in Indian patients showed significant interstitial lymphoid infiltrates, and one third of the rheumatic valves from patients in Albuquerque showed similar mononuclear cell collections. Lymphoid infiltrates contained a predominance of T cells (70 to 80 percent) and only occasional B cells. Most of the T cells were OKT4-positive, with only a minor representation of suppressor/cytotoxic OKT8-positive T cells. In many instances, OKT4-positive helper T cell collections were closely juxtaposed to fibroblasts and collagen fibrils. These findings suggest that the chronic rheumatic scarring process may involve helper/inducer T cells as an ancillary factor in the indolent contracture and fibrosis of deformed cardiac valvular structures. Attempts to demonstrate residual streptococcal antigens by indirect immunofluorescence using a wide panel of heterologous rabbit F(ab')2 reagents with specificity for group A streptococcal membranes, cell wall mucopeptide, or group A carbohydrate gave negative results.

Superior mesenteric artery embolism after resection of left ventricular aneurysm.

A rare complication of superior mesenteric embolism following resection of a ventricular aneurysm is reported. A 45-year-old male patient underwent left ventricular aneurysm resection under cardiopulmonary bypass. Thirty-six hours after surgery the patient developed an acute superior mesenteric artery embolus with a gangrenous small bowel; this necessitated resection of more than 90% of the small intestine. To the best of our knowledge, the successful outcome of a superior mesenteric embolization following resection of the ventricular aneurysm under cardiopulmonary bypass is here recorded for the first time.