Rehabilitation of stroke patients with gait disturbance

Abstract Most stroke patients who have lost the ability to walking hope to recover this walking ability. In such cases, generation of adaptive gait patterns and development of realistic walking systems could aid in the performance of various activities. It is reported that the adaptive gait control patterns are generated by various neural domains, including the cerebral cortex, brainstem, and spinal cord, and are modurated by the basal ganglia and cerebellum. Walking dysfunctions after stroke are caused by abnormal reactivity, perception, cognition, plan for the locomotion and its constitution, muscle tone, and attitudinal reflexes. These abnormalities adversely affect posture and movement pattern, and give rise to dysrhythmia. Additionally, stroke patients suffer from disorders of higher brain functions. Thus, it is more difficult to generate adaptive gait patterns in such patients. However, there are few studies on concrete rehabilitation programs for patients with adaptive gait disturbance. In this paper, we introduce constitutive treatment methods for the recovery of walking function in our clinical setting and the task-oriented rehabilitation strategies for adaptation of realistic walking systems.     

Gastric cancer with choriocarcinoma and yolk sac tumor components: case report

Choriocarcinoma- and yolk sac tumor-like differentiation have rarely been reported in gastric cancers. We report a case of gastric adenocarcinoma, concurrently possessing choriocarcinoma and yolk sac tumor components, of a 74-year-old man. A hemorrhagic, 11 × 8 × 3 cm, tumor with ulceration was located in the body and pre-pylorus of the stomach. Histological examination of the resected specimens demonstrated intermingled proliferation of three different components, namely, adenocarcinoma, choriocarcinoma and yolk sac tumor, which were immunoreactive for carcinoembryonic antigen (CEA), beta-subunit of human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP), respectively. Gastric cancers with germ cell tumor components are uncommon and this is the second reported case of gastric cancer with choriocarcinoma and yolk sac tumor components.     

Therapeutic effect of nicotine in a mouse model of intracerebral hemorrhage

Intracerebral hemorrhage (ICH) resulting from the leakage of blood into the brain parenchyma triggers severe tissue damage involving neurodegeneration and inflammation. Increasing lines of evidence indicate that the stimulation of central nicotinic acetylcholine receptors affords neuroprotection against various insults and also suppresses the proinflammatory activation of microglia. Therefore, the present study aimed to determine whether the administration of nicotine modifies the pathological consequences of ICH, using a mouse model of ICH induced by intrastriatal injection of collagenase. Daily intraperitoneal administration of nicotine (2 mg/kg), starting from 3 h after the induction of ICH, inhibited apoptosis and decreased the number of remaining striatal neurons at 3 days after the insult. We also found that nicotine administration increased the relative expression level of the antiapoptotic protein B cell lymphoma-2 versus that of the proapoptotic protein Bax in the brain. In addition, nicotine administration attenuated the activation of microglia/macrophages, infiltration of neutrophils, and increases in oxidative stress associated with ICH, without affecting hematoma expansion and brain edema. It is noteworthy that mice treated with nicotine exhibited improved sensorimotor performance and a marked increase in survival rate after ICH. These results indicate that nicotinic acetylcholine receptors may serve as a novel target for emergency therapy for ICH.     

Effects of selegiline on antioxidant systems in the nigrostriatum in rat

Summary. Selegiline, a therapeutic agent of Parkinson’s disease, is known to have neuroprotective properties that may involve its regulatory effects on antioxidant enzymes. We evaluated effects of selegiline on activities of catalase (CAT), Cu,Zn-superoxide dismutase (SOD1) and Mn-SOD (SOD2) in the striatum, cortex and hippocampus of 8- and 25-week-old rats, and on SOD activities and glutathione levels in mesencephalic slice cultures. Selegiline (2 mg/kg) significantly increased CAT and SOD2 activities in the striatum, but not in the cortex and hippocampus, of 25-week-old rats. In contrast, selegiline failed to increase CAT and SOD activities in three brain regions of 8-week-old rats, whereas L-dopa significantly increased SOD1 activity in the striatum. In slice cultures, selegiline increased SOD1 and SOD2 activities with a maximal effective concentration of 10⁻⁸ and 10⁻¹⁰ M, respectively. Moreover, selegiline significantly increased glutathione level. These results suggest that selegiline can decrease oxidative stress in nigrostriatum by augmenting various antioxidant systems, each of which responds optimally to different concentrations of selegiline.     

Withdrawal of thiopurines in Crohn’s disease treated with scheduled adalimumab maintenance: a prospective randomised clinical trial (DIAMOND2)

Journal of Gastroenterology - The risk:benefit ratio of concomitant use of thiopurines with scheduled adalimumab (ADA) maintenance therapy for Crohn’s disease is controversial. The aim of...     

Small renal cell carcinoma presented with pleural metastasis and multiple bone metastasis ; a case report

The patient is a 69-year-old male. His chief complaint was chest pain. Because imaging studies suggested pleural mesothelioma associated with multiple bone metastases, right pleural tumor resection was performed. Pathological diagnosis was metastatic pleural tumor, and renal cell carcinoma (RCC) was suspected as its origin. Dynamic computed tomography showed a small tumor in the right kidney. The tumor was 15 mm in diameter and consistent with RCC. Laparoscopic radical nephrectomy was performed for the right kidney. Pathological diagnosis was RCC, clear cell carcinoma with sarcomatoid component, T1aN0M1, stage IV. Sorafenib therapy was started 46 days after the operation as a systemic therapy, and stable disease has been maintained. Generally, small RCC is assumed to have a good prognosis. However, a small percentage of patients with small RCC have distant metastasis at the time of diagnosis, and the prognosis is reported to be poor. We report this case, and a review of the literature.     

Increment of hypothalamic 2-arachidonoylglycerol induces the preference for a high-fat diet via activation of cannabinoid 1 receptors

The aim of the present study is to examine the relationship between preference for HFD and 2-arachidonoylglycerol (2-AG), endogenous cannabinoid. The 3-day HFD intake induced preference for HFD, which was suppressed by CB1 antagonist, O-2050. Moreover, hypothalamic 2-AG was increased after 3-day HFD intake. Our results show that preference for HFD is induced by activation of CB1 receptors via an increment of 2-AG in hypothalamus.