Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report

Context: We sought to describe our experience with the Hybrid Assistive Limb® (HAL®) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury.

Findings: A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient’s manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees.

Conclusion/clinical relevance: Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.     

Substance P- and calcitonin gene-related peptide-immunofluorescent nerves in the repair of experimental bone defects

Summary Healing of an experimental bony defect in the rat's tibia was studied with an immunofluorescent technique to clarify when and where substance P (SP) and calcitonin gene-related peptide (CGRP) would develop. The normal tibia showed a few SP- and CGRP-immunofluorescent nerve fibres. In the experimental tibia, the number of these fibres increased on the 6th day after operation, reached a peak of proliferation on the 15th day and reverted to normal after the 24th day. The changes were associated with the development and decay of callus tissue suggesting that harmful stimuli from the injured site in a bone could be mediated by sensory nerves throughout the repair period. Most of the SP- and CGRP-immunofluorescence was seen near the vessels, frequently in the same nerve fibres. The SP- and CGRP-immunofluorescent nerves seemed to take part jointly in callus formation through the enhancement of local blood flow.

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Résumé Le procesus de guérison d'une perte de substance osseuse expérimentale a été étudié sur le tibia du rat par immunofluorescence afin de déterminer quand et où la substance P (SP) et la calcitonine peptide d'origine génique (CGRP) se développeraient. Le tibia normal ne montre qu'un petit nombre de fibres nerveuses immunofluorescentes SP et CGRP. Dans le tibia d'expérimentation, les fibres nerveuses immunofluorescentes SP et CGRP augmentent en nombre à partir du 6ème jour, atteignent leur maximum de prolifération le 15ème jour et reviennent à l'état normal après le 24ème jour post-opératoire. Ces modifications sont étroitement associées au développement et à la disparition du cal, suggérant ainsi que les stimuli nocifs provenant de la lésion osseuse pourraient être inactivés par les nerfs sensitifs durant la période de réparation. En outre, la plus grande partie de l'immunofluorescence SP et CGRP a été observée à proximité des vaisseaux, souvent dans les mêmes fibres nerveuses. Il semble que les nerfs immunofluorescents SP et CGRP participent conjointement à la formation du cal en augmentant la vascularisation locale.

     

Malignant fibrous histiocytoma arising from a calcifying enchondroma – a case report

Summary. A man, 79 years of age, developed a malignant fibrous histiocytoma which arose in relation to a calcifying enchondroma of the distal femur. Radiographs showed a fracture through an intensely calcified bony tumour with no bony destruction. The clinical diagnosis was a dedifferentiated chondrosarcoma. Histology showed an anaplastic sarcoma with calcified tissue showing extensive areas of necrosis and degeneration. No chondrosarcomatous foci were found.

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Resumé. Nous rapportons le cas d’un homme de 79 ans, qui a développé un histiocytofibrome malin à partir d’un enchodrome calcifié du fémur distal. L’examen radiologique a montré une fracture au sein d’une tumeur très calcifiée sans association de destruction osseuse. Cette lésion apparaissait cliniquement être un chondrosarcome dédifférencié. Mais l’étude histologique a montré un sarcome anaplasique avec un tissu cartilagineux calcifié présentant des plages étendues de nécrose et de dégénérescence. Il n’y avait pas de foyer chondrosarcomateux visible.

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Accepted: 9 November 1996     

Familial Juvenile Nephronophthisis in Two Siblings — Histological Findings at an Early Stage —

We present two female siblings with familial juvenile nephronophthisis (FJN) which was diagnosed at the early stage of renal failure. Diagnosis was made during the investigation of anemia in case 1 and by a subsequent family survey in case 2. Most patients with FJN are not identified until the terminal stage of renal failure and such cases have rarely been reported in Japan. Case 2 had a reduction in the maximum urinary concentration ability but no azotemia, and among the FJN patients reported in Japan so far she has the least advanced renal disease. Histological examination of the renal biopsy in case 1 showed typical findings of FJN, such as thickening and lamination of the tubular basement membrane (TBM), interstitial fibrosis, and round cell infiltration of the interstitium. In case 2, renal biopsy revealed an irregular marked thickening of the TBM with trivial interstitial changes and a normal glomerular appearance. The histology of these two cases suggests that the TBM may be the primary site affected in FJN.     

A case-control study of breast cancer among Japanese women: with special reference to family history and reproductive and dietary factors

Summary To study the effects of family history and reproductive, anthropometric, and dietary factors on the risk of breast cancer among low risk populations, we conducted a hospital-based case-control study involving 908 patients with breast cancer and their matched controls, in Japan. A positive family history of breast cancer significantly increased the risk of breast cancer (odds ratio = 1.52, 95% confidence interval: 1.14–2.03). The risk further increased with increasing number of family members affected. Obesity, single marital status, fewer births, a late childbirth, and less consumption of green-yellow vegetables and dairy products were also associated with an increased risk of breast cancer. These associations were independent in multivariate analyses. There was no increase in risk associated with consumption of high fat foods. When analyzed by menopausal status, the association with family history of breast cancer, especially in the first degree of relatives, was more evident for premenopausal breast cancer. The associations with obesity and lower consumption of dairy products were more pronounced for postmenopausal breast cancer, while those with lower parity and single marital status were stronger for premenopausal breast cancer.     

F213I突变型高雪氏病分子伴侣治疗方法的研究

目的 研究高雪氏病新的分子治疗方法。方法 用β-葡萄糖脑昔脂酶(β-glucocerebrosidase，β-Glc)(EC3．2．1．45)的底物类似物(glucocerebroside analogue，GCA)作为分子伴侣，处理体外培养的不同突变型的高雪氏病患者皮肤成纤维细胞，采用荧光酶学手段测定β-Glc活性；Western印迹杂交技术分析该酶蛋白表达的量；细胞双染确定β-Glc在细胞内的定位；薄层层析法分析葡萄糖脑苷脂的降解情况。结果 该酶的底物类似物GCA可以提高体外培养的F213I突变型患者成纤维细胞内β-Glc活性；增加该酶蛋白的表达量；促进该酶蛋白向溶酶体内转运，加速底物葡萄糖脑苷脂(glucocerebroside，GlcCer)的降解。结论低分子量的GCA作为一种分子伴侣可能为F213I突变型高雪氏病的治疗开辟一条新的途径。     

The synthesis of dicarboxylie acids containing oxadiazole rings and polyamides derived from them

Novel dicarboxylic acids containing one or two 1,3,4-oxadiazole rings in a molecule were synthesized by the reaction between orthoesters and acid hydrazides These dicarboxylic acids have the following structures: and where R represents a phenylene or an alkylene group and n = 1-4. The polyamides from p-xylylenediamine with these dicarboxylic acids were also prepared. The polymers are generally insoluble in m-cresol but soluble in conc. sulfuric acid. The melting points were estimated at above 350°C. Copolyamides of high molecular weights with aliphatic polyamides were obtained.     

Anatomy of the iliolumbar ligament

Information is lacking in the literature on the precise anatomy of the iliolumbar ligament and its individual differences. The morphologic pattern, length, and width of the iliolumbar ligament were determined in 56 embalmed lumbosacral spines from human cadavers. It was possible to classify the iliolumbar ligament into two groups: Type A (74 ligaments), in which anterior and posterior ligaments had separate courses; and Type B (32 ligaments), in which anterior and posterior ligaments moved together as one band. The angle of the posterior iliolumbar ligament in Type A was oriented significantly more posteriorly than that in Type B. The posterior iliolumbar ligament was significantly shorter and oriented more posteriorly in male anatomic specimens than in female ones.     

Trastuzumab-mediated antibody-dependent cellular cytotoxicity against esophageal squamous cell carcinoma.

PURPOSE: In the present study, we investigated the degree of protein expression and gene amplification of HER-2 in esophageal squamous cell carcinoma (SCC) cell lines and freshly isolated tumors, and trastuzumab-mediated biological activity, in particular antibody-dependent cellular cytotoxicity (ADCC) against HER-2-expressing esophageal SCC cell lines. EXPERIMENTAL DESIGN: Ten different SCC cell lines with various levels of HER-2 status evaluated by flow cytometry, immunocytochemistry (HercepTest), and fluorescence in situ hybridization were evaluated for ADCC, growth inhibitory, or apoptosis-inducing activities mediated by trastuzumab. RESULTS: Trastuzumab induced ADCC against HER-2-expressing esophageal SCC and the activities reflected the degree of HER-2 expression analyzed by flow cytometric analysis, but not by HercepTest nor fluorescence in situ hybridization analysis. Furthermore, trastuzumab-mediated ADCC against transforming growth factor-beta-producing SCC was enhanced by the treatment with SB-431542, which is a selective inhibitor of the phosphorylation induced by transforming growth factor-beta. There were very marginal effects of anti-proliferative or apoptosis-inducing activities mediated by trastuzumab for HER-2-expressing esophageal SCC. CONCLUSION: HER-2-expressing esophageal SCC cells could be killed by trastuzumab-mediated ADCC and the activity reflected the degree of HER-2 expression detected by flow cytometry.     

Elevation of serum thrombopoietin precedes thrombocytosis in acute infections

To clarify the mechanisms underlying thrombocytosis secondary to infections, we longitudinally studied serum levels of thrombopoietin (TPO) and interleukin (IL)-6 in 15 infants and young children with prominent thrombocytosis (platelets >700 x 10(9)/l) following acute infections and 116 age-matched controls using an enzyme-linked immunosorbent assay. The subjects included nine patients with bacterial infections, three with viral infections and three with non-determined pathogens. TPO values in the controls were 2.24 +/- 0.87 fmol/ml (mean +/- SD) with a 95% reference interval of 0.85-4.47 fmol/ml. In the first week of infection, platelet counts were normal, but TPO values increased (approximately 10.73 fmol/ml). TPO levels peaked on day 4 +/- 2 at 6.44 +/- 2.37 fmol/ml and then fell gradually. When platelet counts peaked in the second and third weeks, TPO levels were similar to the controls. IL-6 levels in the first week rose and dropped more rapidly than TPO. Serum TPO values were significantly correlated with C-reactive protein levels (r = 0.688, P < 0.001) and IL-6 levels (r = 0.481, P = 0.027). These results suggest that TPO contributes to thrombocytosis following infections in conjunction with IL-6, arguing for additional regulatory mechanisms of blood TPO levels.