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Sebastian Rutkowski, 1 Anna Rutkowska, 1 Paweł Kiper, 2 Dariusz Jastrzebski, 3 Henryk Racheniuk, 1 Andrea Turolla, 2 Jan Szczegielniak, 1 Richard Casaburi 4 1Institute of Physiotherapy, Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland; 2Laboratory of Neurorehabilitation Technologies, Fondazione Ospedale San Camillo IRCCS, Venice, Italy; 3School of Medicine with the Division of Dentistry, Department of Lung Diseases and Tuberculosis, Medical University of Silesia, Zabrze, Poland; 4Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USACorrespondence: Sebastian RutkowskiInstitute of Physiotherapy, Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, PolandTel +48 507027792Fax +48 77 449 80 00Email s.rutkowski@po.opole.plPurpose: This study compared the effects of inpatient-based rehabilitation program of patients with chronic obstructive pulmonary disease (COPD) using non-immersive virtual reality (VR) training with a traditional pulmonary rehabilitation program. The aims of this study were to determine 1) whether rehabilitation featuring both VR as well as exercise training provides benefits over exercise training (ET) alone and 2) whether rehabilitation featuring VR training instead of exercise training provides equivalent benefits.Patients and Methods: The study recruited 106 patients with COPD to a 2-week high-intensity, five times a week intervention. Randomized into three groups, 34 patients participated in a traditional pulmonary rehabilitation program including endurance exercise training (ET), 38 patients participated in traditional pulmonary rehabilitation, including both endurance exercise training and virtual reality training (ET+VR) and 34 patients participated in pulmonary rehabilitation program including virtual reality training but no endurance exercise training (VR). The traditional pulmonary rehabilitation program consisted of fitness exercises, resistance respiratory muscle and relaxation training. Xbox 360® and Kinect® Adventures software were used for the VR training of lower and upper body strength, endurance, trunk control and dynamic balance. Comparison of the changes in the Senior Fitness Test was the primary outcome. Analysis was performed using linear mixed-effects models.Results: The comparison between ET and ET+VR groups showed that ET+VR group was superior to ET group in Arm Curl (p< 0.003), Chair stand (p< 0.008), Back scratch (p< 0.002), Chair sit and reach (p< 0.001), Up and go (p< 0.000), 6-min walk test (p< 0.011). Whereas, the comparison between ET and VR groups showed that VR group was superior to ET group in Arm Curl (p< 0.000), Chair stand (p< 0.001), 6-min walk test (p< 0.031).Conclusion: Results suggest that pulmonary rehabilitation program supplemented with VR training is beneficial intervention to improve physical fitness in patients with COPD.Keywords: virtual reality, COPD, pulmonary rehabilitation, physical activity, exercise

The role of the central nervous system in enteroenteric motor reflexes remains controversial. Our aims were as follows: 1) to evaluate colorectal, rectocolic, gastrocolonic, and gastrorectal reflex responses in patients with cervical spinal cord injury (SCI) and 2) to compare these responses with those in healthy subjects. In six patients with SCI (5 male, 42 [+ or -] 4 yr) and six healthy control subjects (5 male, 36 [+ or -] 5 yr), 2-min phasic distensions were performed randomly via dual-barostat balloons in the colon and rectum. Continuous colonic and rectal balloon volumes were recorded during distensions and after a 1,000-kcal liquid meal. Mean balloon volumes were recorded before, during, and after phasic distensions and over 60 min postprandially. The colorectal response was similar in control subjects and SCI patients (rectal volume reduction = 28 [+ or -] 11% and 15 [+ or -] 5% in SCI patients and healthy subjects, respectively); the rectocolic response was variable. The gastrocolonic response was present in all subjects (colonic volume reduction = 49 [+ or -] 4% and 44 [+ or -] 3% in SCI patients and healthy subjects, respectively), with a time effect in the first 30 min (P < 0.0001) and a group effect in the second 30 rain (P < 0.004). The gastrorectal response was present in four SCI patients and five healthy subjects (rectal volume reduction = 38 [+ or -] 4% and 41 [+ or -] 3% in SCI patients and healthy subjects, respectively), with a time effect in the first 30 min (P < 0.0001) but no group effect in the second 30 min. Intact neural transmission between the spinal cord and higher centers is not essential for normal colorectal motor responses to feeding and distension; however, a degree of central nervous system and neurobormonal modulation of these responses is likely. gastrocolonic; gastrorectal; rectocolic; colon; spinal injury

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Thermoluminescence (TL), optical absorption, and electron paramagnetic resonance (EPR) have been used to characterize point defects in Mg-doped stoichiometric LiNbO[sub 3]. A broad TL emission, peaking at 440 nm, is observed near 94 K when these crystals are irradiated at 77 K and then rapidly warmed. X rays and below-band-gap lasers (325 and 355 nm) are equally effective in producing the TL peak. During excitation, holes are trapped on oxygen ions adjacent to lithium vacancies and electrons are trapped on niobium ions at regular lattice sites. These defects both have characteristic EPR spectra, and the trapped electron center has an optical absorption band peaking at 1200 nm. Upon warming, the electrons become thermally unstable near 94 K and migrate to the trapped-hole sites where radiative recombination occurs. We suggest that the near-edge charge-transfer absorption band from Fe[sup 3+] impurities, nominally present, provides the mechanism by which below-band-gap light initially produces the separately trapped holes and electrons. [ABSTRACT FROM AUTHOR]

Background: Intracranial peripheral primitive neuroectodermal tumors (P-PNET) are extremely rare. They can be easily misdiagnosed as central nervous system primitive neuroectodermal tumors (CNS-PNET) or meningiomas. Little is known about the optimal treatment and prognosis of these tumors.Patients and Methods: We evaluated the treatment and outcome of 17 patients with intracranial, nonmetastatic, genetically confirmed P-PNET. Three patients were treated at our institutions. Thirteen other cases providing sufficient treatment and follow-up information were extracted from the literature.Results: The median age at diagnosis was 17 years. All patients underwent initial surgery. Complete resection was achieved in 9 of the 17 cases (53 %). Combined adjuvant treatment consisting of radiotherapy (focal, n = 10; craniospinal, n = 1) and chemotherapy was administered to 11 of the 17 patients (59 %). The median follow-up time was 1.4 years. In 8 of the 17 patients (47 %), the disease progressed; 4 of the 17 patients (24 %) died. The 2-year progression-free and overall survival rates were 64 % and 76 %, respectively.Conclusion: The differential diagnosis for intracranial, meningeal-based, small, round-cell tumors should include P-PNET. It is highly probable that complete resection has a positive impact on survival--as previously reported for extracranial P-PNET--but this cannot be shown by our data. Intensive adjuvant treatment consisting of radiotherapy and chemotherapy seems to be essential. A statistically grounded recommendation for the appropriate target volume and radiation dose is not yet possible. However, in most case reports of primary intracranial P-PNET published to date, patients were treated with focal irradiation. The optimal chemotherapy regimen has yet to be established, with both the Ewing tumor and CNS-PNET protocols being promising candidates for effective treatment. [ABSTRACT FROM AUTHOR]

Study design:Cohort of incident cases from 1955 to 2006.Objectives:To analyse acute and long-term mortality, estimate life expectancy and identify survival patterns of individuals experiencing traumatic spinal cord injury (SCI).Setting:Specialised SCI unit in Australia.Methods:Data for patients with traumatic SCI admitted to a spinal unit in Sydney, Australia between January 1955 and June 2006 were collated and deaths confirmed. Cumulative survival probability was estimated using life-table techniques and mortality rates were calculated from the number of deaths and aggregate years of exposure. Standardised mortality ratios (SMRs) were estimated from the ratio of observed to expected number of deaths. Life expectancy was then estimated using adjusted attained age-specific mortality rates.Results:From 2014 persons, 88 persons with tetraplegia (8.2%) and 38 persons with paraplegia (4.1%) died within 12 months of injury, most often with complete C1-4 tetraplegia. Among first-year survivors, overall 40-year survival rates were 47 and 62% for persons with tetraplegia and paraplegia, respectively. The most significant increases in mortality were seen in those with tetraplegia and American Spinal Injury Association Impairment Scale (AIS) grades A-C lesions, with SMRs between 5.4 and 9.0 for people 50 years, reducing with advancing attained age. Estimated life expectancies from 25 to 65 years ranged between 69-64%, 74-65%, 88-91% and 97-96% for C1-4 AIS A-C, C5-8 A-C, T1-S5 A-C and all AIS D lesions, respectively.Conclusion:Survival related strongly to extent of neurological impairment. Future research should focus on identifying contextual factors, personal or environmental, that may contribute to the reduced life expectancy after SCI. [ABSTRACT FROM AUTHOR]

Background:Tumours are responsive to temozolomide (TMZ) if they are deficient in O6-methylguanine-DNA methyltransferase (MGMT), and mismatch repair (MMR) proficient.Methods:The effect of TMZ on medulloblastoma (MB) cell killing was analysed with clonogenic survival assays. Expression of DNA repair genes and enzymes was investigated using microarrays, western blot, and immunohistochemistry. DNA sequencing and promoter methylation analysis were employed to investigate the cause of loss of the expression of MMR gene MLH1.Results:Temozolomide exhibited potent cytotoxic activity in D425Med (MGMT deficient, MLH1 proficient; IC50=1.7 μM), moderate activity against D341Med (MGMT proficient, MLH1 deficient), and DAOY MB cells (MGMT proficient, MLH1 proficient). MGMT inhibitor O6-benzylguanine sensitised DAOY, but not D341Med cells to TMZ. Of 12 MB cell lines, D341Med, D283Med, and 1580WÜ cells exhibited MMR deficiency due to MLH1 promoter hypermethylation. DNA sequencing of these cells provided no evidence for somatic genetic alterations in MLH1. Expression analyses of MMR and MGMT in MB revealed that all patient specimens (n=74; expression array, n=61; immunostaining, n=13) are most likely MMR proficient, whereas some tumours had low MGMT expression levels (according to expression array) or were totally MGMT deficient (3 out of 13 according to immunohistochemistry).Conclusion:A subset of MB may respond to TMZ as some patient specimens are MGMT deficient, and tumours appear to be MMR proficient. [ABSTRACT FROM AUTHOR]

Objective:To determine whether Methenamine Hippurate (MH) or cranberry tablets prevent urinary tract infections (UTI) in people with neuropathic bladder following spinal cord injury (SCI).Study design:Double-blind factorial-design randomized controlled trial (RCT) with 2 year recruitment period from November 2000 and 6 month follow-up.Setting:In total, 543 eligible predominantly community dwelling patients were invited to participate in the study, of whom 305 (56%) agreed.Methods:Eligible participants were people with SCI with neurogenic bladder and stable bladder management. All regimens were indistinguishable in appearance and taste. The dose of MH used was 1 g twice-daily. The dose of cranberry used was 800 mg twice-daily. The main outcome measure was the time to occurrence of a symptomatic UTI.Results:Multivariate analysis revealed that patients randomized to MH did not have a significantly longer UTI-free period compared to placebo (HR 0.96, 95% CI: 0.68–1.35, P=0.75). Patients randomized to cranberry likewise did not have significantly longer UTI-free period compared to placebo (HR 0.93, 95% CI: 0.67–1.31, P=0.70).Conclusion:There is no benefit in the prevention of UTI from the addition of MH or cranberry tablets to the usual regimen of patients with neuropathic bladder following SCI.Spinal Cord (2007) 45, 542–550; doi:10.1038/sj.sc.3101974; published online 17 October 2006 [ABSTRACT FROM AUTHOR]

Study Design:Cross-sectional study with repeated measurements.Objectives:To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL).Setting:Australia.Methods:A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients’ subjective evaluation of pre- and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time.Results:A significant difference was found between perception of pre- and postmorbid function on composite Cognitive (t=5.99, df=62, P<0.001), Physical (t=11.56, df=62, P<0.001), and QOL (t=7.16, df=62, P<0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (P<0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2=0.20, P<0.001); emotional (R 2=0.13, P<0.004); and of QOL (R 2=0.22, P<0.001) functioning. With the exception of a decrease in happiness (P<0.01), there were no significant changes in any measures over the 6 month time period.Conclusions:There are significant changes in patients’ perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys.Spinal Cord (2007) 45, 429–436; doi:10.1038/sj.sc.3102022; published online 16 January 2007 [ABSTRACT FROM AUTHOR]