Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation

OBJECTIVE: To study the utility and functional benefits of an implanted functional electrical stimulation (FES) system for hand grasp and release in adolescents with tetraplegia secondary to spinal cord injuries. DESIGN: Intervention study with before-after trial measurement with each subject as his or her own control. SETTING: Nonprofit pediatric orthopedic rehabilitation facility specializing in spinal cord injury. PARTICIPANTS: A convenience sample of five adolescents between 16 and 18 years of age with C5 or C6 level tetraplegia at least 1 year after traumatic spinal cord injury. Key muscles for palmar and lateral grasp and release were excitable by electrical stimulation. INTERVENTIONS: A multichannel stimulator/receiver and eight electrodes were surgically implanted to provide stimulated palmar and lateral grasp and release. In conjunction with implantation of the FES hand system, surgical reconstruction in the form of tendon transfers, tendon lengthenings and releases, and joint arthrodeses was performed to augment stimulated hand function. Rehabilitation of the tendon transfers and training in the use of the FES hand system were provided. MAIN OUTCOME MEASURES: Measurements of pinch and grasp force, the Grasp and Release Test (GRT), and an assessment of six activities of daily living (ADL) were administered before implantation of the FES hand system and at regular follow-up intervals. Results of the stimulated response of individual muscles and surgical reconstruction were evaluated using standard and stimulated muscle testing techniques and standard assessment of joint range of motion. All subjects completed followup testing. RESULTS: Lateral and palmar forces were significantly greater than baseline forces (p = .043). Heavy objects on the GRT could only be manipulated with FES, and FES increased the level of independence in 25 of 30 ADL comparisons (5 subjects, 6 activities) as compared to baseline. After training, FES was preferred in 21 of 30 comparisons over the typical means of task completion. Of the 40 electrodes implanted, 37 continue to provide excellent stimulated responses and all of the implanted stimulators have functioned without problems. The surgical reconstruction procedures greatly enhanced FES hand function by either expanding the workspace in which to utilize FES (deltoid to triceps transfer), stabilizing the wrist (brachioradialis to wrist extensor transfer), or stabilizing joints (intrinsic tenodesis transfer, FPL split transfer). CONCLUSION: For five adolescents with tetraplegia, the combination of FES and surgical reconstruction provided active palmar and lateral grasp and release. Laboratory-based assessments demonstrated that the FES system increased pinch force, improved the manipulation of objects, and typically increased independence in six standard ADL as compared to pre-FES hand function. The study also showed that the five adolescents generally preferred FES for most of the ADL tested. Data on the benefits of the implanted FES hand system outside of the laboratory are needed to understand the full potential of FES.     

Low-temperature unit-cell parameters of La1−x Pr x CaBaCu3O7 compounds

The suppression of the superconductivity by praseodymium in La_1−x Pr _x CaBaCu₃O₇ may be explained in terms of the difference in the electronic or crystal structure between these compounds. Three compositions with x=0.0, 0.5, 1.0 were, therefore, investigated by X-ray diffraction in order to determine the unit-cell dimensions at room temperature as well as at lower temperatures down to 5 K. The results showed no considerable changes in the orthorhombic unit-cell dimensions on decreasing the temperature to 5 K. Unit-cell volumes at low temperatures were 0.99 of the room temperature values. The intensity sequence of reflections in the diffraction pattern was the same for all samples throughout the range of temperature studied.     

Involvement of regional lymph nodes after penetration of Schistosoma mansoni cercariae in naive and infected mice

The very low density lipoprotein receptor (VLDL-r) is a cell-surface molecule specialized for the internalization of multiple diverse ligands, including apolipoprotein E (apoE)-containing lipoprotein particles, via clathrin-coated pits. Its structure is similar to the low-density lipoprotein receptor (LDL-r), although the two have substantially different systemic distributions and regulatory pathways. The present work examines the distribution of VLDL-r in the central nervous system (CNS) and in relation to senile plaques in Alzheimer disease (AD). VLDL-r is present on resting and activated microglia, particularly those associated with senile plaques (SPs). VLDL-r immunoreactivity is also found in cortical neurons. Two exons of VLDL-r mRNA are differentially spliced in the mature receptor mRNA. One set of splice forms gives rise to receptors containing (or lacking) an extracellular O-linked glycosylation domain near the transmembrane portion of the molecule. The other set of splice forms appears to be brain-specific, and is responsible for the presence or absence of one of the cysteine-rich repeat regions in the binding region of the molecule. Ratios of the receptor variants generated from these splice forms do not differ substantially across different cortical areas or in AD. We hypothesize that VLDL-r might contribute to metabolism of apoE and apoE/A beta complexes in the brain. Further characterizations of apoE receptors in Alzheimer brain may help lay the groundwork for understanding the role of apoE in the CNS and in the pathophysiology of AD.     

MC-CDMA with exponential power profile in Nakagami fading channel

A refined study of multi-carrier code division multiple access transmission over a Nakagami fading channel is proposed. The channel power is modeled with an exponential power profile rather than the uniform profile prevalent in other papers. An expression for the bit error rate (BER) is then derived. Numerical results show that MC-CDMA performances depend on the power dispersion of interferers around the desired user power.     

Synergistic antimycobacterial activity between ethambutol and the beta-lactam drug cefepime

The contributions of (+/-)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and gamma-aminobutyric acid (GABA[A]) receptors in the induction of long-term potentiation (LTP) have been studied in the CA1 region of the rat hippocampus. The results suggest that: (1) in physiological conditions, AMPARs are necessary for the induction of N-methyl-D-aspartate receptor (NMDAR)-dependent LTP since LTP cannot be elicited in the presence of the AMPAR antagonist, 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX). Although a NMDAR-dependent LTP occurs in the presence of a GABA(A) antagonist and high concentrations of divalents cations, blockade of AMPARs leads to a voltage-dependent calcium channels (VDCC)-dependent LTP since its induction is blocked by nifedipine and not by APV. (2) The bicarbonate-induced GABA(A) receptor-mediated depolarizing response is not necessary in the induction of NMDAR-dependent or VDCC-dependent LTP since induction of these two types of LTP were not blocked by acetazolamide or in a nominally bicarbonate-free solution.     

New mechanisms in photo-assisted MOVPE of II-VI semiconductors

The first detailed comparison has been made of the metalorganic vapor phase epitaxy growth rates of CdTe, ZnTe, and ZnSe, measured in situ with laser reflectometry. The comparison also includes the photo-assisted growth with visible radiation from an argon ion laser. Using a standard Group II precursor (DMCd or DMZn.TEN) partial pressure of 1.5 × 10⁻⁴ atm, VI/II ratio of 1 and DIPM (M = Te, Se) the maximum growth rates are in the region of 10 to 15 AU/ s. Decrease in growth rates of ZnTe at higher temperatures or higher laser powers have been attributed to the desorption from the substrate of unreacted Te precursor. The behavior of DTBSe is quite different from DIPSe for both pyrolytic and photo-assisted growth. The maximum growth rate is around 1 AU/ s with very little photo-enhancement, except at 300°C. Secondary ion mass spectroscopy analysis of hydrogen concentration in the ZnSe layers shows high concentrations, up to 5.9 × 10¹⁹ atoms cm⁻³ for DTBSe grown ZnSe under pyrolytic conditions. These results show that the growth kinetics play an important part in the incorporation of hydrogen and passivation of acceptor doped material.