BackgroundThe combination of voluntary effort and functional electrical stimulation (ES) appears to have a greater potential to induce plasticity in the motor cortex than either electrical stimulation or voluntary training alone. However, it is not clear whether the motor commands from the central nervous system, the afferent input from peripheral organs, or both, are indispensable to induce the facilitative effects on cortical excitability. To clarify whether voluntary motor commands enhance corticospinal tract (CoST) excitability during neuromuscular ES, without producing voluntary muscular contraction (VMC), we examined the effect of a combination of motor imagery (MI) and electrical muscular stimulation on CoST excitability using transcranial magnetic stimulation (TMS).MethodsEight neurologically healthy male subjects participated in this study. Five conditions (resting, MI, ES, ES + MI [ESMI], and VMC) were established. In the ES condition, a 50-Hz stimulus was applied for 3 to 5 s to the first dorsal interosseous (FDI) while subjects were relaxed. In the MI condition, subjects were instructed to imagine abducting their index finger. In the ESMI condition, ES was applied approximately 1 s after the subject had begun to imagine index finger abduction. In the VMC condition, subjects modulated the force of index finger abduction to match a target level, which was set at the level produced during the ES condition. TMS was applied on the hotspot for FDI, and the amplitude and latency of motor evoked potentials (MEPs) were measured under each condition.ResultsMEP amplitudes during VMC and ESMI were significantly larger than those during other conditions; there was no significant difference in MEP amplitude between these 2 conditions. The latency of MEPs evoked during MI and VMC were significantly shorter than were those evoked during rest and ES.ConclusionsMEP acutely reinforced in ESMI may indicate that voluntary motor drive markedly contributes to enhance CoST excitability, without actual muscular contraction.

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Twelve different prosthetic feet were tested by 10 male subjects with right below-knee amputations. Level walking with each prosthetic foot was investigated using a pair of force plates. Five parameters were selected to compare the functional characteristics of the feet: 1) step length, 2) walking velocity on the sound side in relation to the prosthetic side, 3) depth of valley in the pattern of the vertical component of the floor reaction force, 4) efficiency of the deceleration and acceleration by the prosthetic foot, and 5) irregular patterns in the wave form of the fore and aft components of the floor reaction force. Each of the above parameters was rated numerically. The total score of the objective evaluation attained by analysing the five parameters showed some coincidence to the results of subjective evaluation. However, a good correlation existed between the objective negative score and the subjective negative rating (p < 0.05). Non-axial feet developed recently, such as the SAFE II and Seattle Light feet achieved higher scores in the older age group, while single-axis feet, such as the LAPOC and Otto Bock feet achieved higher scores in the younger age group (p < 0.05).

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Few clinical reports exist regarding the effects of phosphodiesterase III inhibitors on cerebral arteries. Therefore we used a [99mTc]-ECD brain SPECT and an ultrasound method to quantitatively evaluate cerebral and systemic flow dynamics after the administration of olprinone, a phosphodiesterase III inhibitor. In 15 patients (65 +/- 8 years, M/F = 13/2) with no abnormalities on a brain computed tomography (CT), cerebral blood flow and cardiac output were measured using [99mTc]-ECD brain SPECT and Doppler echocardiography, respectively. Measurements were repeated at baseline and after the administration of olprinone. Significant increases in cerebral blood flow (p = 0.0007) and cardiac output (p = 0.001) were observed, and systolic blood pressure (p = 0.02) and systemic vascular resistance (p = 0.002) significantly decreased. No significant correlation between the increase in cerebral blood flow and the increase in cardiac output was observed. The data indicate that olprinone has a direct vasodilator effect on the cerebral artery, which was little related to the increase in cardiac output in patients who had not experienced stroke.

The results indicate that acyl ghrelin stimulates gastric acid secretion via a mechanism involving activation of the vagus nerve and histamine release and synthesis and that desacyl ghrelin has no action on gastric acid secretion. Furthermore, the results demonstrate synergism between gastrin and acyl ghrelin in terms of gastric acid secretion via a mechanism involving histamine release and synthesis.

A case of an 81-year-old woman with a left ventricular diverticulum who underwent myocardial contrast echocardiography is reported. After administration of the contrast agent, a pulsed Doppler flow measurement clearly revealed the biphasic waveform of the ejection flow in the pre-systolic and systolic phase at the ostium of the diverticular cavity. A harmonic power Doppler image showed that part of the diverticulum wall had similar acoustic properties to the ventricular septal wall. Intracardiac blood flow and myocardial perfusion could be clearly evaluated and a ventricular diverticulum was correctly diagnosed using contrast echocardiography.