Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the methods that have been used to quantify 18 F-FDG uptake in the lungs using dynamic PET; (2) discuss the interpretation of the outcomes from these methods; and (3) provide suggested considerations on quantification of 18 F-FDG uptake in the lungs for future studies.

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Background: Pelvic instability is a common occurrence during standing and walking post stroke. Inappropriate muscle activation and poor movement control around the pelvis lead to difficulty in mobility and daily functioning. Purpose: The purpose of the study was to examine the effects of pelvic stability training on the movement performance of trunk and lower limb, hip muscles strength, walking speed and daily activities after stroke. Methods: This randomized controlled trial involved 34 patients aged 56 (11) years with the post stroke duration being 31 (22) weeks. Patients with medical stability, an ability to follow verbal instructions, independent sitting balance and supervised walking capacity were included. The experimental group (n = 13) underwent the pelvic stability training and the control group (n = 13) were subjected to standard physiotherapy for 1 h a day, 3 times a week for over 6 weeks in a stroke rehabilitation setting. Trunk Impairment Scale 2.0 (TIS 2.0), Fugl Meyer Assessment of Lower Extremity (FMA-LE), hip muscles strength (lb.), gait speed, pelvic tilt and modified Barthel Index (MBI) were the outcome measures. Results: All the measures between both groups were similar at baseline except TIS 2.0 and FMA-LE. Following training, pelvic stability group showed statistically significant improvement (p < 0.05) except MBI and substantial mean changes in the measures of TIS 2.0 (2.12), FMA-LE (5.12), hip strength (lb.) for flexors (4.6), extensors (2.8), abductors (2.58), adductors (2.9), gait speed (0.05 m/s) and MBI (7.74) as against standard physiotherapy group. Conclusion: Pelvic stability training was found to be beneficial in improving the trunk and lower extremity movement control, hip muscles strength, gait speed and daily activities in stroke.

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BackgroundAn inflammatory reaction in the airways and lung parenchyma, comprised mainly of neutrophils and alveolar macrophages, is present in some patients with chronic obstructive pulmonary disease (COPD). Thoracic fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) has been proposed as a promising imaging biomarker to assess this inflammation. We sought to introduce a fully quantitative analysis method and compare this with previously published studies based on the Patlak approach using a dataset comprising 18F-FDG PET scans from COPD subjects with elevated circulating inflammatory markers (fibrinogen) and matched healthy volunteers (HV). Dynamic 18F-FDG PET scans were obtained for high-fibrinogen (>2.8 g/l) COPD subjects (N = 10) and never smoking HV (N = 10). Lungs were segmented using co-registered computed tomography images and subregions (upper, middle and lower) were semi-automatically defined. A quantitative analysis approach was developed, which corrects for the presence of air and blood in the lung (qABL method), enabling direct estimation of the metabolic rate of FDG in lung tissue. A normalised Patlak analysis approach was also performed to enable comparison with previously published results. Effect sizes (Hedge’s g) were used to compare HV and COPD groups.ResultsThe qABL method detected no difference (Hedge’s g = 0.15 [−0.76 1.04]) in the tissue metabolic rate of FDG in the whole lung between HV (μ = 6.0 ± 1.9 × 10−3 ml cm−3 min−1) and COPD (μ = 5.7 ± 1.7 × 10−3 ml cm−3 min−1). However, analysis with the normalised Patlak approach detected a significant difference (Hedge’s g = −1.59 [−2.57 −0.48]) in whole lung between HV (μ = 2.9 ± 0.5 × 10−3 ml cm−3 min−1) and COPD (μ = 3.9 ± 0.7 × 10−3 ml cm−3 min−1). The normalised Patlak endpoint was shown to be a composite measure influenced by air volume, blood volume and actual uptake of 18F-FDG in lung tissue.ConclusionsWe have introduced a quantitative analysis method that provides a direct estimate of the metabolic rate of FDG in lung tissue. This work provides further understanding of the underlying origin of the 18F-FDG signal in the lung in disease groups and helps interpreting changes following standard or novel therapies.Electronic supplementary materialThe online version of this article (doi:10.1186/s13550-017-0291-2) contains supplementary material, which is available to authorized users.

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Ulmus wallichiana Planchon (Family: Ulmaceae), a traditional medicinal plant, was used in fracture healing in the folk tradition of Uttarakhand, Himalaya, India. The present study investigated the cardioprotective effect of ethanolic extract (EE) and butanolic fraction (BF) of U. wallichiana in isoprenaline (ISO) induced cardiac hypertrophy in Wistar rats. Cardiac hypertrophy was induced by ISO (5 mg/kg/day, subcutaneously) in rats. Treatment was performed by oral administration of EE and BF of U. wallichiana (500 and 50 mg/kg/day). The blood pressure (BP) and heart rate (HR) were measured by non-invasive blood pressure measurement technique. Plasma renin, Ang II, NO, and cGMP level were estimated using an ELISA kit. Angiotensin converting enzyme activity was estimated. BP and HR were significantly increased in ISO group (130.33 ± 1.67 mmHg vs. 111.78 ± 1.62 mmHg, p < 0.001 and 450.51 ± 4.90 beats/min vs. 347.82 ± 6.91 beats/min, respectively, p < 0.001). The BP and HR were significantly reduced (EE: 117.53 ± 2.27 mmHg vs. 130.33 ± 1.67 mmHg, p < 0.001, BF: 119.74 ± 3.32 mmHg vs. 130.33 ± 1.67 mmHg, p < 0.001); HR: (EE: 390.22 ± 8.24 beats/min vs. 450.51 ± 4.90 beats/min, p < 0.001, BF: 345.38 ± 6.79 beats/min vs. 450.51 ± 4.90 beats/min, p < 0.001) after the treatment of EE and BF of U. wallichiana, respectively. Plasma renin, Ang II, ACE activity was decreased and NO, cGMP level were increased. The EE and BF of U. wallichiana down regulated the expression of ANP, BNP, TNF-α, IL-6, MMP9, β1-AR, TGFβ1 and up regulated NOS3, ACE2 and Mas expression level, respectively. Thus, this study demonstrated that U. wallichiana has cardioprotective effect against ISO induced cardiac hypertrophy.