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Investigation of a practical assessment index to capture the clinical presentation of cachexia in patients with lung cancer. Jpn J Clin Oncol 2024; 54:305-311. [PMID: 38213068 DOI: 10.1093/jjco/hyad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE Cancer cachexia constitutes a poor prognostic factor in patients with lung cancer. However, the factors associated with cancer cachexia remain unclear. This study aimed to identify factors that influence cancer cachexia in patients with lung cancer. METHODS In this retrospective observational study conducted at the Kansai Medical University, 76 patients with lung cancer were evaluated for physical function, nutritional status (Mini Nutritional Assessment-Short Form) and physical activity (International Physical Activity Questionnaire-Short Form) at the first visit to the rehabilitation outpatient clinic. The patients were divided into cachexia and noncachexia groups. The log-rank tests and Cox proportional hazards model were used to investigate the relationship between cachexia and prognosis. To examine the factors that influence cachexia, multivariate regression analysis with significant (P < 0.05) variables in the univariate logistic regression analysis was performed. Spearman's correlation analysis was performed to investigate the association between International Physical Activity Questionnaire-Short Form and performance status. RESULTS Overall, 42 patients (55.2%) had cachexia associated with survival time since their first visit to the outpatient rehabilitation clinic, even after confounders adjustment (hazard ratio: 3.24, 95% confidence interval: 1.12-9.45, P = 0.031). In the multivariate analysis, Mini Nutritional Assessment-Short Form (odds ratio: 20.34, 95% confidence interval: 4.18-99.02, P < 0.001) and International Physical Activity Questionnaire-Short Form (odds ratio: 4.63, 95% confidence interval: 1.20-17.89, P = 0.026) were identified as independent factors for cachexia. There was no correlation between International Physical Activity Questionnaire-Short Form and performance status (r = 0.155, P = 0.181). CONCLUSION Malnutrition and low physical activity were associated with cachexia in patients with lung cancer. The International Physical Activity Questionnaire-Short Form may be a useful indicator of physical activity in cachexia. Regularly assessing these factors and identifying suitable interventions for cachexia remain challenges to be addressed in the future.
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Diverse plantarflexor module characteristics influence immediate effects of plastic ankle-foot orthosis on gait performance in patients with stroke: A cross-sectional study. Arch Phys Med Rehabil 2024:S0003-9993(24)00848-7. [PMID: 38458374 DOI: 10.1016/j.apmr.2024.02.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/21/2023] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the immediate effects of plastic ankle foot orthosis (AFO) on locomotor performance in patients with stroke and determine how such effects might undergo alteration when distinct plantarflexor (PF) module subtypes are considered. DESIGN Cross-sectional study. SETTING Two university hospitals. PARTICIPANTS Fifty-two stroke patients and twenty-one healthy controls. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Motor modules were identified through non-negative matrix factorization, and participants were classified into three groups: independent-normal-timing, independent-altered-timing, and merged PF modules. To assess the effects of the AFO, gait measurements reflecting locomotor performance were obtained with and without the presence of the plastic AFO for each group. RESULTS The independent-altered-timing group had increased paretic propulsion, greater non-paretic step length, and faster walking speed after the administration of the plastic AFO; however, these significant changes were not observed in the independent-normal-timing and merged PF module groups. Notably, patients in the independent-normal-timing and merged PF module groups exhibited longer paretic stance times. CONCLUSION This study suggests that the immediate effects of plastic AFO depend on the PF module subtype. These findings can potentially guide clinical decision-making regarding AFO selection for stroke rehabilitation in patients with diverse gait control characteristics.
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Protective effect of the tunneling nanotube-TNFAIP2/M-sec system on podocyte autophagy in diabetic nephropathy. Autophagy 2023; 19:505-524. [PMID: 35659195 PMCID: PMC9851239 DOI: 10.1080/15548627.2022.2080382] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Podocyte injury leading to albuminuria is a characteristic feature of diabetic nephropathy (DN). Hyperglycemia and advanced glycation end products (AGEs) are major determinants of DN. However, the underlying mechanisms of podocyte injury remain poorly understood. The cytosolic protein TNFAIP2/M-Sec is required for tunneling nanotubes (TNTs) formation, which are membrane channels that transiently connect cells, allowing organelle transfer. Podocytes express TNFAIP2 and form TNTs, but the potential relevance of the TNFAIP2-TNT system in DN is unknown. We studied TNFAIP2 expression in both human and experimental DN and the renal effect of tnfaip2 deletion in streptozotocin-induced DN. Moreover, we explored the role of the TNFAIP2-TNT system in podocytes exposed to diabetes-related insults. TNFAIP2 was overexpressed by podocytes in both human and experimental DN and exposre of podocytes to high glucose and AGEs induced the TNFAIP2-TNT system. In diabetic mice, tnfaip2 deletion exacerbated albuminuria, renal function loss, podocyte injury, and mesangial expansion. Moreover, blockade of the autophagic flux due to lysosomal dysfunction was observed in diabetes-injured podocytes both in vitro and in vivo and exacerbated by tnfaip2 deletion. TNTs allowed autophagosome and lysosome exchange between podocytes, thereby ameliorating AGE-induced lysosomal dysfunction and apoptosis. This protective effect was abolished by tnfaip2 deletion, TNT inhibition, and donor cell lysosome damage. By contrast, Tnfaip2 overexpression enhanced TNT-mediated transfer and prevented AGE-induced autophagy and lysosome dysfunction and apoptosis. In conclusion, TNFAIP2 plays an important protective role in podocytes in the context of DN by allowing TNT-mediated autophagosome and lysosome exchange and may represent a novel druggable target.Abbreviations: AGEs: advanced glycation end products; AKT1: AKT serine/threonine kinase 1; AO: acridine orange; ALs: autolysosomes; APs: autophagosomes; BM: bone marrow; BSA: bovine serum albumin; CTSD: cathepsin D; DIC: differential interference contrast; DN: diabetic nephropathy; FSGS: focal segmental glomerulosclerosis; HG: high glucose; KO: knockout; LAMP1: lysosomal-associated membrane protein 1; LMP: lysosomal membrane permeabilization; MAP1LC3/LC3: microtubule-associated protein 1 light chain 3; PI3K: phosphoinositide 3-kinase; STZ: streptozotocin; TNF: tumor necrosis factor; TNFAIP2: tumor necrosis factor, alpha-induced protein 2; TNTs: tunneling nanotubes; WT: wild type.
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Use of the reliable change index to evaluate the effect of a multicomponent exercise program on physical functions. Aging Clin Exp Res 2022; 34:3033-3039. [PMID: 36057083 DOI: 10.1007/s40520-022-02241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022]
Abstract
AIMS Using the reliable change index (RCI), we aimed to examine the effect of a multicomponent exercise program on the individual level. METHODS Overall, 270 adults (mean age, 78 years) completed a multicomponent physical exercise program (strength, aerobic, gait, and balance) for 40 min, 1-2 times per week, continued up to 1 year at a daycare center. Effectiveness was assessed using grip, ankle, knee, and hip strength; Timed Up & Go (TUG); Berg Balance Scale (BBS); gait speed; and 6-min walking distance. These were measured at baseline and every 3 months thereafter. We calculated the RCI using the data between two-time points (baseline and at 3, 6, 9, or 12 months) in each participant and then calculated the mean RCI value across the participants. A paired t-test was also employed to evaluate the effect of the intervention as an average-based statistics. RESULTS The highest mean RCI values were on ankle plantar-flexion strength, followed by gait speed, hip abduction strength, BBS, knee extensor strength, 6-min walk distance, grip strength, and finally TUG. Paired t-test also revealed significant improvement with moderate effect sizes for ankle plantar-flexion strength (0.504), gait speed (0.413), hip abduction strength (0.374), BBS (0.334), knee extensor strength (0.264), and 6-min walk distance (0.248). Significant but small effect size was seen on TUG (0.183). CONCLUSION The RCI is a convenient method of comparing the effect between different assessments, especially at an individual level. This index can be applied to the use of personal feedback.
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How to Decide the Number of Gait Cycles in Different Low-Pass Filters to Extract Motor Modules by Non-negative Matrix Factorization During Walking in Chronic Post-stroke Patients. Front Hum Neurosci 2022; 16:803542. [PMID: 35463923 PMCID: PMC9019077 DOI: 10.3389/fnhum.2022.803542] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
The motor modules during human walking are identified using non-negative matrix factorization (NNMF) from surface electromyography (EMG) signals. The extraction of motor modules in healthy participants is affected by the change in pre-processing of EMG signals, such as low-pass filters (LPFs); however, the effect of different pre-processing methods, such as the number of necessary gait cycles (GCs) in post-stroke patients with varying steps, remains unknown. We aimed to specify that the number of GCs influenced the motor modules extracted in the consideration of LPFs in post-stroke patients. In total, 10 chronic post-stroke patients walked at a self-selected speed on an overground walkway, while EMG signals were recorded from the eight muscles of paretic lower limb. To verify the number of GCs, five GC conditions were set, namely, 25 (reference condition), 20, 15, 10, and 5 gate cycles with three LPFs (4, 10, and 15 Hz). First, the number of modules, variability accounted for (VAF), and muscle weightings extracted by the NNMF algorithm were compared between the conditions. Next, a modified NNMF algorithm, in which the activation timing profiles among different GCs were unified, was performed to compare the muscle weightings more robustly between GCs. The number of motor modules was not significantly different, regardless of the GCs. The difference in VAF and muscle weightings in the different GCs decreased with the LPF of 4 Hz. Muscle weightings in 15 GCs or less were significantly different from those in 25 GCs using the modified NNMF. Therefore, we concluded that the variability extracted motor modules by different GCs was suppressed with lower LPFs; however, 20 GCs were needed for more representative extraction of motor modules during walking in post-stroke patients.
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Corrigendum to 'Novel gait training using a dual-belt treadmill in older adults: a randomized controlled trial' [Archives of Gerontology and Geriatrics 98 Jan-Feb (2021) 104573]. Arch Gerontol Geriatr 2022; 99:104596. [PMID: 34864476 DOI: 10.1016/j.archger.2021.104596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Longitudinal effects of physical exercise on health-related outcomes based on frailty status in community-dwelling older adults. Geriatr Gerontol Int 2022; 22:213-218. [PMID: 35080094 DOI: 10.1111/ggi.14346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/02/2021] [Accepted: 12/27/2021] [Indexed: 12/23/2022]
Abstract
AIM To clarify the difference in the longitudinal effects of physical exercise on health-related outcomes according to the baseline frailty status (frail or non-frail) in community-dwelling older adults. METHODS Participants included 177 adults aged ≥65 years who carried out multicomponent physical exercises (strength, aerobic, gait and balance) for 40 min, one to three times per week, for 1 year at a day-care center. Bodyweight, comfortable walking speed, 6-min walking distance and Mini-Mental State Examination were measured at baseline and every 3 months. For longitudinal trend, we analyzed the change in scores from baseline for each outcome using the linear mixed effects model. Fixed effects included "group" (frail or non-frail), "time" (4 time points every 3 months, from 3 to 12 months) and "interaction between group and time." RESULTS The effect sizes from baseline showed almost all positive values for each outcome. The linear mixed effects model showed significant effects on "interaction between group and time" in changes in bodyweight (P = 0.033), "group" in changes in walking speed (P = 0.013) and "time" in changes in the Mini-Mental State Examination (P < 0.001). Bodyweight showed a decreasing trend in the non-frail group after 3 months, unlike in the frail group. For walking speed, moderate effect sizes (d = 0.67-0.74) were sustained over time in the frail group, as did lesser effect sizes (d = 0.26-0.40) in the non-frail group. CONCLUSIONS Exercise-based multicomponent interventions were effective for both groups. The longitudinal effects on walking speed and bodyweight were greater in the frail group. Geriatr Gerontol Int 2022; ••: ••-••.
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Current perspectives on quantitative gait analysis for patients with hemiparesis. JAPANESE JOURNAL OF COMPREHENSIVE REHABILITATION SCIENCE 2022; 13:1-3. [PMID: 37859851 PMCID: PMC10545024 DOI: 10.11336/jjcrs.13.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 10/21/2023]
Abstract
Hase K. Current perspectives on quantitative gait analysis for patients with hemiparesis. Jpn J Compr Rehabil Sci 2022; 13: 1-3.
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Novel gait training using a dual-belt treadmill in older adults: A randomized controlled trial. Arch Gerontol Geriatr 2022; 98:104573. [DOI: 10.1016/j.archger.2021.104573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/25/2021] [Accepted: 11/04/2021] [Indexed: 11/02/2022]
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A Cross-Sectional Study on the Association between Body Mass Index and Frailty According to Sex in Elderly Patients with Disabilities from an Elderly Day-Care Center. Geriatrics (Basel) 2021; 7:geriatrics7010007. [PMID: 35076496 PMCID: PMC8788289 DOI: 10.3390/geriatrics7010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/12/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022] Open
Abstract
The association between body mass index (BMI) and frailty in elderly patients with disabilities is unclear. We aimed to investigate the association between BMI and frailty in the elderly with disabilities according to sex. This cross-sectional study included 280 elderly patients with disabilities from an elderly daycare center. BMI classification for the Asian population was used to categorize the patients into four groups: underweight, normal, overweight, and obese. Frailty score was based on the phenotypic definition of frailty and consisted of five criteria derived from the revised Japanese version of the Cardiovascular Health Study. Those who had three or more criteria were considered frail. Logistic regression models were constructed to investigate the associations between frailty and BMI in each group (males and females). In females, being underweight was significantly associated with frailty after adjusting for confounders (age and Mini-Mental State Examination score); after adding medical history as a confounder, the aforementioned association was not significant. In males, BMI was not significantly associated with frailty. The association between BMI and frailty differed according to sex among the elderly with disabilities. This finding provides important information regarding frailty risk to workers in daycare facilities.
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Long-term effects of combined botulinum toxin treatment and rehabilitation on upper limb muscle spasms: a case report. J Phys Ther Sci 2021; 33:307-311. [PMID: 33814721 PMCID: PMC8012200 DOI: 10.1589/jpts.33.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/01/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We report our experience with a patient with a central spinal cord injury who
showed improved finger and upper limb functions after long-term treatment with a
combination of rehabilitation and botulinum toxin type A. [Participants and Methods] The
patient had spasms and pain that gradually became more profound and was given botulinum
toxin type A at 1 year 3 months after sustaining a spinal cord injury. We administered 14
botulinum toxin type A injections periodically for 7 years 4 months after the injury. We
administered the injections at an average interval of 5.6 months. Splints that allowed
extension and improved finger muscle tone and contracture were made for the patient.
[Results] The patient experienced gradual alleviation of the spasms in the proximal upper
limb muscles and improved range of motion after receiving five doses of botulinum toxin
type A. The spasms and range of motion in the fingers gradually improved around 4 years
after the injury through splint therapy and a combination of botulinum toxin type A
administration and rehabilitation. [Conclusion] The combination of botulinum toxin type A,
splint, and rehabilitation therapies can lead to positive improvements in finger
spasticity and range of motion and is recommended for hypertonia cases with severe
contractures.
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Prognostic and predictive values of tumour budding in stage IV colorectal cancer. BJS Open 2020; 4:693-703. [PMID: 32472647 PMCID: PMC7397347 DOI: 10.1002/bjs5.50300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/22/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Tumour budding is an important prognostic feature in early-stage colorectal cancer, but its prognostic significance in metastatic disease has not been fully investigated. METHODS Patients with stage IV disease who had primary colorectal tumour resection without previous chemotherapy or radiotherapy from January 2000 to December 2018 were reviewed retrospectively. Budding was evaluated at the primary site and graded according to the criteria of the International Tumor Budding Consensus Conference (ITBCC) (BD1, low; BD2, intermediate; BD3, high). Patients were categorized by metastatic (M1a, M1b) and resectional (R0/R1, R2/unresected) status. Subgroups were compared for overall (OS) and recurrence-free (RFS) survival in R0/R1 subgroups; R2/unresected patients were evaluated for the rate of tumour progression, based on change in tumour size from baseline. RESULTS Of 371 patients observed during the study, 362 were analysed. Patients with BD3 had a lower 5-year OS rate than those with BD1 + BD2 (18·4 versus 40·5 per cent; P < 0·001). Survival analyses according to metastatic and resection status also showed that BD3 was associated with shorter OS than BD1 + BD2. In multivariable analysis, BD3 (hazard ratio (HR) 1·51, 95 per cent c.i. 1·11 to 2·10; P = 0·009), T4 status (HR 1·39) and R2/unresected status (HR 3·50) were associated with decreased OS. In the R0/R1 subgroup, the 2-year RFS rate was similar for BD3 and BD1 + BD2 according to metastatic status. There was no significant difference between BD3 and BD1 + BD2 for change in tumour size in the R2/unresected subgroup (P = 0·094). Of 141 patients with initially unresectable metastases who had chemotherapy, 35 achieved conversion from unresectable to resectable status. The conversion rate was significantly higher for BD1 + BD2 than for BD3 (36 versus 18 per cent; P = 0·016). CONCLUSION Stage IV colorectal cancer with high-grade tumour budding according to ITBCC criteria correlates with poor prognosis.
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Novel characterization of subjective visual vertical in patients with unilateral spatial neglect. Neurosci Res 2020; 163:18-25. [PMID: 32084447 DOI: 10.1016/j.neures.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 10/25/2022]
Abstract
Visual vertical (VV), visually perceived direction of gravity, is widely measured to assess the vestibular function and visuospatial cognition. VV has been assessed by comparing orientation and variability of measured values separately between subject groups. However, changes in orientation and variability often differ in patients with unilateral spatial neglect (USN). Here, we developed a novel classification of VV that combines orientation and variability and characterized the effects of USN on VV. Forty-three subacute stroke patients with or without USN (USN+, n = 17; USN-, n = 26) and 33 age-matched controls were included in the study. In darkness, a luminous line, initially tilted at 30° either to the left or right, gradually rotated towards the vertical. The VV was defined as the deviation of the subjectively-perceived vertical from the true vertical. The new classification demonstrated that, while the majority of USN + patients (14/17) exhibited large variability, nine showed normal orientation and five showed greater contra-lesional deviation of orientation, suggesting different underlying mechanisms for orientation and variability. Further analyses revealed VV deviation to the initial tilt in all groups. However, the deviation in USN + was larger and more variable, indicating attentional disorders. Such characterization would contribute to individually specified clinical rehabilitation.
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Predictive immunohistochemical features for tumour response to chemoradiotherapy in rectal cancer. BJS Open 2020; 4:301-309. [PMID: 32026629 PMCID: PMC7093790 DOI: 10.1002/bjs5.50251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/21/2019] [Indexed: 01/02/2023] Open
Abstract
Background Reduced expression of cluster of differentiation (CD) 133 and cyclo‐oxygenase (COX) 2, and increased density of CD8+ tumour‐infiltrating lymphocytes, are associated with a favourable tumour response to preoperative chemoradiotherapy (CRT). This study aimed to evaluate these markers in relation to tumour response after preoperative CRT in two rectal cancer cohorts. Methods Patients with low rectal cancer who underwent radical resection and preoperative short‐term CRT in 2001–2007 (retrospective cohort) and long‐term CRT in 2011–2017 (prospective cohort) were analysed. Pretreatment biopsies were stained immunohistochemically using antibodies to determine CD133 and COX‐2 expression, and increased CD8+ density. Outcome measures were tumour regression grade (TRG), tumour downstaging and survival. Results For 95 patients in the retrospective cohort, the incidence of TRG 3–4 was 67 per cent when two or three immunohistochemistry (IHC) features were present, but only 20 per cent when there were fewer features (P < 0·001). The incidence of tumour downstaging was higher in patients with at least two IHC features (43 versus 22 per cent with fewer features; P = 0·029). The 49 patients in the prospective cohort had similar rates to those in the retrospective cohort (TRG 3–4: 76 per cent for two or more IHC features versus 25 per cent with fewer features, P < 0·001; tumour downstaging: 57 versus 25 per cent respectively, P = 0·022). Local recurrence‐free survival rates in patients with more or fewer IHC features were similar in the retrospective and prospective cohort (P = 0·058 and P = 0·387 respectively). Conclusion Assessment of CD133, COX‐2 and CD8 could be useful in predicting a good response to preoperative CRT in patients with lower rectal cancer undergoing neoadjuvant therapy. Further studies are needed to validate the results in larger cohorts and investigate a survival benefit.
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S1-4. Training of cognitive function and higher brain function using mixed reality. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.06.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Acquisition of Practical Communication by Introducing a New Input Method for Locked-In Syndrome in an Older Adult: A Case Report. PM R 2019; 11:562-565. [PMID: 30609233 DOI: 10.1002/pmrj.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 11/28/2018] [Indexed: 11/11/2022]
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Potential of muscles to accelerate the body during late-stance forward progression in individuals with knee osteoarthritis. Hum Mov Sci 2018; 61:109-116. [DOI: 10.1016/j.humov.2018.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/03/2018] [Accepted: 07/24/2018] [Indexed: 11/15/2022]
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O-2-17. Influence of different types of orthoses on muscle synergy control during gait in stroke patients with hemiparesis. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.02.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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P1-2-07. Relationship between Saccadic Eye Movements and Higher Brain Function in the elderly. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.02.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Randomized phase III study of adjuvant chemotherapy with S-1 versus capecitabine in patients with stage III colorectal cancer: Updated results of Japan Clinical Oncology Group study (JCOG0910). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Validity and reliability of a performance evaluation tool based on the modified Barthel Index for stroke patients. BMC Med Res Methodol 2017; 17:131. [PMID: 28841846 PMCID: PMC6389202 DOI: 10.1186/s12874-017-0409-2] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023] Open
Abstract
Background The Barthel Index (BI) is a measure of independence in activities of daily living (ADL). In the modified Barthel Index (MBI), a five-point system replaced the original two or three or four point rating system. Based on this modified measure, the performance evaluation tool MBI (PET-MBI) was developed in Japan. Although the reliability and validity of PET-MBI have been verified for older people, the use of this tool in stroke patients has not been evaluated. This study investigated the validity and reliability of PET-MBI for stroke patients. Methods Ten raters independently determined the BI and PET-MBI scores of stroke patients by direct observation. These patients’ ADL were videotaped, and 10 other raters then evaluated the videos privately and assigned PET-MBI scores twice, one month apart. The criterion-related validity of the PET-MBI against the BI was evaluated using the correlation coefficients for their total scores. Furthermore, to assess inter- and intra-rater reliabilities from the results of the first and second sessions, Fleiss’ intraclass correlation coefficients (ICCs) were calculated for the total scores, with the lower limits of the 95% confidence interval (95%CI), along with weighted kappa (κw) coefficients for agreement in individual tasks of this evaluation tool. ICC and κw coefficients of 0.81–1.00 were considered to be “almost perfect” agreement. Results The mean age of the 30 patients (23 men, 7 women) was 71.9 (standard deviation 10.5) years. One patient had diplegia, 14 had right hemiplegia, and 15 had left hemiplegia. For the total scores obtained by direct evaluation, Pearson’s and Spearman’s correlation coefficients of the BI versus the PET-MBI were both 0.95 (lower limit of the 95%CI, 0.90). The ICC representing inter-rater reliability for the first session was 0.99 (lower limit of the 95%CI, 0.98]. For intra-rater reliability, the mean value of the ICCs was 0.99 (range, 0.99–1.00). For individual tasks of the PET-MBI, inter-rater κw coefficients for the first session ranged from 0.77 to 0.94, with intra-rater κw coefficients from 0.85 to 0.96. Conclusions PET-MBI showed strong criterion-related validity against the BI, with high reliabilities. This scoring system may become a convenient tool allowing anyone to assess ADL.
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Influence of age and comorbidity on prognosis and application of adjuvant chemotherapy in elderly Japanese patients with colorectal cancer: A retrospective multicentre study. Eur J Cancer 2017. [DOI: 10.1016/j.ejca.2017.05.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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428. Inframesocolic superior mesenteric artery first approach as an introductory procedure of radical antegrade modular pancreatosplenectomy for distal pancreatic cancer. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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MON-P061: Influences of AD Libitum Feeding of a Low Carbohydrate-High Fat Diet on Host Response to Gut Ischemia Reperfusion in Mice. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30695-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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FRI0631-HPR A New Impulse Response Method To Assess Early Knee Osteoarthritis Differences between Young and Elderly Women. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Preoperative chemoradiation therapy for esophageal cancer is a risk factor for the elevation of high mobility group box-1, leading to an increase in postoperative severe pulmonary complications. Dis Esophagus 2016; 29:70-8. [PMID: 25139532 DOI: 10.1111/dote.12261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We herein clarified the time course of changes in the serum high mobility group box chromosomal protein-1 (HMGB-1) concentrations in esophageal cancer patients after esophagectomy, and investigated whether the perioperative serum HMGB-1 levels correlate with the administration of neoadjuvant chemoradiation therapy (NACRT) and the postoperative clinical course, especially the occurrence of pulmonary complications, in such patients. Sixty patients who underwent right transthoracic esophagectomy for esophageal cancer were enrolled in this study. The relationship between the perioperative serum HMGB-1 levels and NACRT, and the postoperative severe pulmonary complications were evaluated. Patients with severe pulmonary complications (n = 44) tended to have undergone NACRT more often than those without severe pulmonary complications (n = 16). The preoperative and postoperative day 7 serum HMGB-1 concentrations were significantly higher in patients with severe pulmonary complications than those in patients without severe pulmonary complications. In the univariate and multivariate analyses, the use of NACRT and the preoperative elevations in the serum HMGB-1 levels (>4.2 ng/mL) were found to be significantly associated with pulmonary dysfunction. Furthermore, the response to NACRT was found to be significantly associated with the preoperative serum HMGB-1 levels. The use of NACRT contributes to preoperative serum HMGB-1 elevation, and these were risk factors for the occurrence of severe postoperative pulmonary complications in patients with esophageal cancer after thoracic esophagectomy.
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SUN-PP224: The Influence of Short-Term Low Carbohydratehigh Fat Diet on Survival After Gut Ischemia Reperfusion in Mice. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30375-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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MON-PP065: Semi-Elemental Diet Maintains Peyer Patch Lymphocyte Number and Immunoglobulin a Levels in Mouse Small Intestine as well as a Normal Diet. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The AURKA/TPX2 axis drives colon tumorigenesis cooperatively with MYC. Ann Oncol 2015; 26:935-942. [PMID: 25632068 DOI: 10.1093/annonc/mdv034] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 01/15/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The MYC oncogene has long been established as a central driver in many types of human cancers including colorectal cancer. However, the realization of MYC-targeting therapies remains elusive; as a result, synthetic lethal therapeutic approaches are alternatively being explored. A synthetic lethal therapeutic approach aims to kill MYC-driven tumors by targeting a certain co-regulator on the MYC pathway. PATIENTS AND METHODS We analyzed copy number and expression profiles from 130 colorectal cancer tumors together with publicly available datasets to identify co-regulators on the MYC pathway. Candidates were functionally tested by in vitro assays using colorectal cancer and normal fibroblast cell lines. Additionally, survival analyses were carried out on another 159 colorectal cancer patients and public datasets. RESULTS Our in silico screening identified two MYC co-regulator candidates, AURKA and TPX2, which are interacting mitotic regulators located on chromosome 20q. We found the two candidates showed frequent co-amplification with the MYC locus while expression levels of MYC and the two genes were positively correlated with those of MYC downstream target genes across multiple cancer types. In vitro, the aberrant expression of MYC, AURKA and TPX2 resulted in more aggressive anchorage-independent growth in normal fibroblast cells. Furthermore, knockdown of AURKA or TPX2, or treatment with an AURKA-specific inhibitor effectively suppressed the proliferation of MYC-expressing colorectal cancer cells. Additionally, combined high expression of MYC, AURKA and TPX2 proved to be a poor prognostic indicator of colorectal cancer patient survival. CONCLUSIONS Through bioinformatic analyses and experiments, we proposed TPX2 and AURKA as novel co-regulators on the MYC pathway. Inhibiting the AURKA/TPX2 axis would be a novel synthetic lethal therapeutic approach for MYC-driven cancers.
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Potential Causes of Stage Migration and Their Prognostic Implications in Colon Cancer: A Nationwide Survey of Specialist Institutions in Japan. Jpn J Clin Oncol 2014; 44:547-55. [DOI: 10.1093/jjco/hyu043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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31
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Polymyxin B-immobilized fiber hemoperfusion therapy improves sepsis-related immunosuppression. Crit Care 2014. [PMCID: PMC4069416 DOI: 10.1186/cc13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Comparison of three instruments to assess changes of motor impairment in acute hemispheric stroke: the Stroke Impairment Assessment Set (SIAS), the National Institute of Health Stroke Scale (NIHSS) and the Canadian Neurological Scale (CNS). Disabil Rehabil 2013; 36:1549-54. [DOI: 10.3109/09638288.2013.854840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Differential Clinical Benefits of 5-Fluorouracil-based Adjuvant Chemotherapy for Patients with Stage III Colorectal Cancer According to CD133 Expression Status. Jpn J Clin Oncol 2013; 44:42-8. [DOI: 10.1093/jjco/hyt168] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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LB008-MON THE INFLUENCES OF OBSTRUCTIVE JAUNDICE ON PEYER'S PATCH LYMPHOCYTE NUMBERS AND SUBPOPULATIONS IN MICE. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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THU0128 The extra-low-dose methotrexate treatment facilitates the intracellular accumulation of longer chain subgroups of methotrexate polyglutamates. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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The effect of active pedaling combined with electrical stimulation on spinal reciprocal inhibition. J Electromyogr Kinesiol 2013; 23:190-4. [DOI: 10.1016/j.jelekin.2012.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 08/09/2012] [Accepted: 08/12/2012] [Indexed: 11/29/2022] Open
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State of intracortical inhibitory interneuron activity in patients with chronic stroke. Clin Neurophysiol 2012; 124:364-70. [PMID: 22955029 DOI: 10.1016/j.clinph.2012.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 07/22/2012] [Accepted: 08/09/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Few studies have assessed short intracortical inhibition (SICI) in the affected hemisphere (AH) in a large number of patients with chronic stroke. In this study, SICI was assessed in chronic stroke patients with severe hemiparesis, and its relationship to clinical parameters was examined. METHODS The participants were 72 patients with chronic hemiparetic stroke. SICI of both the AH and the unaffected hemisphere (UH) was assessed. The relationships between SICI and the location of lesion, time from onset, and finger function were studied. Motor function of the paretic finger was assessed with the Stroke Impairment Assessment Set (SIAS) and the Fugl-Meyer test upper extremity motor score. To compare the results with those of healthy subjects, SICI was assessed in seven age-matched control subjects. RESULTS MEPs of the UH were evoked in all 72 subjects, and MEPs of the AH were evoked in 24 subjects. SICI of the AH was inversely correlated with paretic finger motor function and time from stroke onset. SICI of the UH was not correlated with either one. SICI of the UH was higher in the cortical lesion group than in the control group. CONCLUSIONS The state of intracortical inhibitory neuron activity depends on the state of motor function and lesion site even in chronic stroke patients with severe hemiparesis. SIGNIFICANCE The inhibitory system of the AH is involved in functional recovery of the paretic hand even in the chronic stage of stroke.
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Evaluation of the seventh edition of the tumour, node, metastasis (TNM) classification for colon cancer in two nationwide registries of the United States and Japan. Colorectal Dis 2012; 14:1065-74. [PMID: 22176600 DOI: 10.1111/j.1463-1318.2011.02917.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM The new TNM classification is currently being implemented. We evaluated the TNM-7 staging system based on the two nationwide colon cancer registries in the United States and Japan to clarify whether this system better stratifies patients' prognoses than the TNM-6 did and to determine whether stratification can be effectively simplified. METHODS The Surveillance, Epidemiology, and End Results population-based data from 1988 to 2001 for 50139 colon cancer patients and the multi-institutional registry data from the Japanese Society for Cancer of the Colon and Rectum from 1984 to 1994 for 10754 patients were analysed. We devised a modified version of the TNM-7 staging system to allow simpler classification of the TN categories and compared the TNM-6, TNM-7, modified TNM-7, and the Dukes staging system based on survival curves and objective statistical tests such as likelihood ratio χ(2) tests, Akaike's information criterion, and Harrell's c-index. RESULTS The TNM-7 was superior to the TNM-6 in all objective statistical tests in the United States (c-index; 0.700 vs 0.696, P<0.001) as well as in the Japan data sets (0.732 vs 0.729, P=0.035). The modified TNM-7 is much simpler, but it nevertheless showed similar values to those of the original TNM-7 (c-index; the United States 0.702, Japan 0.733). CONCLUSIONS The new TNM-7 is complicated but better at stratifying patients than the TNM-6 in the United States and Japan, and could be effectively simplified.
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Comparison of the After-Effects of Transcranial Direct Current Stimulation Over the Motor Cortex in Patients With Stroke and Healthy Volunteers. Int J Neurosci 2012; 122:675-81. [DOI: 10.3109/00207454.2012.707715] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Trajectory planning of a robot for lower limb rehabilitation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:1259-63. [PMID: 22254545 DOI: 10.1109/iembs.2011.6090296] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We introduce a method for lower-limb physical rehabilitation by means of a robot that applies preliminary defined forces to a patient's foot while moving it on a preliminary defined trajectory. We developed a special musculoskeletal model that takes into consideration the generated muscle forces of 27 musculotendon actuators and joint stiffness of the leg and allows the calculation of the motion trajectory of the robot and the forces that the robot needs to apply to the foot in each moment of the therapeutic exercise. Robotic treatment programs are customized for the individual patient by using a genetic algorithm (GA) that refers to the musculoskeletal model and calculates the parameters of the spline curves of the motion trajectory of the robot and forces acting on the foot.
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Contraction level-related modulation of corticomuscular coherence differs between the tibialis anterior and soleus muscles in humans. J Appl Physiol (1985) 2012; 112:1258-67. [DOI: 10.1152/japplphysiol.01291.2011] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The sensorimotor cortex activity measured by scalp EEG shows coherence with electromyogram (EMG) activity within the 15- to 35-Hz frequency band (β-band) during weak to moderate intensity of isometric voluntary contraction. This coupling is known to change its frequency band to the 35- to 60-Hz band (γ-band) during strong contraction. This study aimed to examine whether such contraction level-related modulation of corticomuscular coupling differs between muscles with different muscle compositions and functions. In 11 healthy young adults, we quantified the coherence between EEG over the sensorimotor cortex and rectified EMG during tonic isometric voluntary contraction at 10–70% of maximal voluntary contraction of the tibialis anterior (TA) and soleus (SOL) muscles, respectively. In the TA, the EEG-EMG coherence shifted from the β-band to the γ-band with increasing contraction level. Indeed, the magnitude of β-band EEG-EMG coherence was significantly decreased, whereas that of γ-band coherence was significantly increased, when the contraction level was above 60% of maximal voluntary contraction. In contrast to the TA, the SOL showed no such frequency changes of EEG-EMG coherence with alterations in the contraction levels. In other words, the maximal peak of EEG-EMG coherence in the SOL existed within the β-band, irrespective of the contraction levels. These findings suggest that the central nervous system regulates the frequency of corticomuscular coupling to exert the desired levels of muscle force and, notably, that the applicable rhythmicity of the coupling for performing strong contractions differs between muscles, depending on the physiological muscle compositions and functions of the contracting muscle.
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Effects of Therapeutic Gait Training Using a Prosthesis and a Treadmill for Ambulatory Patients With Hemiparesis. Arch Phys Med Rehabil 2011; 92:1961-6. [DOI: 10.1016/j.apmr.2011.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 07/01/2011] [Accepted: 07/07/2011] [Indexed: 10/14/2022]
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Between-subject variance in the magnitude of corticomuscular coherence during tonic isometric contraction of the tibialis anterior muscle in healthy young adults. Neurosci Res 2011. [DOI: 10.1016/j.neures.2011.07.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Author's reply: Optimal margins and lymphadenectomy in colonic cancer surgery ( Br J Surg 2011; 98: 1171–1178). Br J Surg 2011. [DOI: 10.1002/bjs.7666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Prism adaptation therapy enhances rehabilitation of stroke patients with unilateral spatial neglect: a randomized, controlled trial. Neurorehabil Neural Repair 2011; 25:711-20. [PMID: 21700922 DOI: 10.1177/1545968311407516] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND and objective. Unilateral spatial neglect (USN) can interfere with rehabilitation processes and lead to poor functional outcome. The purpose of this study was to determine whether prism adaptation (PA) therapy improves USN and functional outcomes in stroke patients in the subacute stage. METHODS . A multicenter, double-masked, randomized, controlled trial was conducted to evaluate the effects of a 2-week PA therapy on USN assessed with the Behavioral Inattention Test (BIT), the Catherine Bergego Scale (CBS), and activities of daily living (ADL) as evaluated with the Functional Independence Measure (FIM). A total of 38 USN patients with right-brain damage were divided into prism (n = 20) and control (n = 18) groups. Patients were divided into mild and severe USN groups according to BIT behavioral test (mild ≥ 55 and severe<55). The prism group performed repetitive pointing with prism glasses that induce rightward optical shift twice daily, 5 days per week, for 2 weeks, whereas the control group performed similar pointing training with neutral glasses. RESULTS . The FIM improved significantly more in the prism group. In mild USN patients, there was significantly greater improvement of BIT and FIM in the prism group. CONCLUSIONS . PA therapy can significantly improve ADL in patients with subacute stroke.
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Effectiveness of Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy in Patients With Subacute Stroke. Neurorehabil Neural Repair 2011; 25:830-7. [DOI: 10.1177/1545968311408917] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background and objective. Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy was devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The aim of this study is to assess the effectiveness of HANDS therapy for patients with subacute stroke. Methods. The participants were 24 inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Patients were randomly assigned to 2 groups. The HANDS group (n = 12) used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group (n = 12) wore a wrist splint alone. All patients received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL). Results. In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in distal (wrist/hand) portion of the FMA ( P < .01) and improvement of the ARAT ( P < .05). The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted. Conclusion. HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation.
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Between-subject variance in the magnitude of corticomuscular coherence during tonic isometric contraction of the tibialis anterior muscle in healthy young adults. J Neurophysiol 2011; 106:1379-88. [PMID: 21653712 DOI: 10.1152/jn.00193.2011] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Oscillatory activity of the sensorimotor cortex has been reported to show coherence with muscle activity in the 15- to 35-Hz frequency band (β-band) during weak to moderate intensity of isometric contraction. The present study examined the variance of the magnitude of the corticomuscular coherence across a large number of subjects. We quantified the coherence between EEG over the sensorimotor cortex and rectified electromyogram (EMG) from the tibialis anterior muscle during tonic isometric contraction at 30% of maximal effort in 100 healthy young individuals. We estimated the maximal peak of EEG-EMG coherence (Cohmax) and the ratio of the sum of the autopower spectral density function within the β-band to that of all frequency ranges for both EEG (EEGβ-PSD) and EMG (EMGβ-PSD) signals. The frequency histogram of Cohmax across all subjects showed a broad bell-shaped continuous distribution (range, 0.048-0.816). When the coherence was thresholded at the estimated significance level of P < 0.05 (0.114), 46 out of 100 subjects showed significant EEG-EMG coherence. Cohmax occurred within the β-band in the majority of subjects who showed significant EEG-EMG coherence (n = 43). Furthermore, Cohmax showed significant positive correlations with both EEGβ-PSD (r = 0.575, P < 0.001) and EMGβ-PSD (r = 0.606, P < 0.001). These data suggest that even during simple tonic isometric contraction, the strength of oscillatory coupling between the sensorimotor cortex and spinal motoneurons varies among individuals and is a contributory factor determining muscle activation patterns such as the degree of grouped discharge in muscle activity within the β-band for each subject.
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P19.3 Transcranial direct current stimulation modulates the spinal plasticity induced with patterned electrical stimulation. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Adaptation process for standing postural control in individuals with hemiparesis. Disabil Rehabil 2011; 33:2567-73. [DOI: 10.3109/09638288.2011.579226] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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50
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Optimal margins and lymphadenectomy in colonic cancer surgery. Br J Surg 2011; 98:1171-8. [DOI: 10.1002/bjs.7518] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2011] [Indexed: 12/13/2022]
Abstract
Abstract
Background
A standard management policy has not yet been established with respect to the extent of lymphadenectomy for colonic cancer.
Methods
A total of 914 consecutive patients who underwent potentially curative surgery for T2–T4 colonic cancer were reviewed retrospectively. The number of lymph nodes (LNs) examined and the potential contributions to the staging accuracy of the distinct area were analysed. The survival benefit of dissection was compared for pericolic (local), mesocolic (intermediate) and main arterial trunk (main) LN.
Results
Removal of the pericolic LNs within 5 cm of the tumour and intermediate LNs resulted in a mean LN number of 15·9, a sensitivity for overall node positivity of 97·5 per cent, and a survival benefit calculated as a therapeutic value index of 31·4 points. The additional removal of LNs more than 5 cm from the tumour and main LNs did not improve the staging accuracy, while adding only 3·4 points to the survival benefit.
Conclusion
Current guidelines may encourage needlessly extensive surgery. Clinical trials to establish the optimal extent of lymphadenectomy are warranted.
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