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BACKGROUND: People with stroke excessively move their trunk, when reaching and grasping objects. OBJECTIVE: To determine if the addition of trunk restraint to modified constraint-induced movement therapy (mCIMT) was better than mCIMT alone in improving strength, function, and quality of life after stroke. METHODS: A pilot randomized double-blinded clinical trial was conducted. Twenty-two participants with chronic stroke were randomly assigned to an experimental group that received mCIMT plus trunk restraint, or a control group (only mCIMT). Primary outcomes were the amount of use and quality of movement of the paretic upper limb (UL), determined by the Motor Activity Log (MAL) scores. Secondary outcomes included the observed performance of the paretic UL during unimanual and bimanual tasks, kinematics of reaching, strength, and quality of life. RESULTS: Both groups demonstrated significant improvements in the MAL scores and in the time to perform bimanual activities immediately after the interventions. However, no between-group differences were observed. CONCLUSIONS: The addition of trunk restraint to mCIMT resulted in no additional benefits, compared with mCIMT alone with stroke individuals with mild to moderate impairments. Unimanual and bimanual improvements were observed after mCIMT, regardless of trunk restraint, and the intervention did not adversely affect their reaching patterns.

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Stroke is a leading cause of morbidity and mortality worldwide. Recovery of motor function after stroke can be modified by post-injury experience, but most of surviving patients exhibit persistence of the motor dysfunctions even after rehabilitative therapy. In this study we investigated if skilled and unskilled training induce different motor recovery and brain plasticity after experimental focal ischemia. We tested this hypothesis by evaluating the motor skill relearning and the immunocontent of Synapsin-I, PSD-95 and GFAP (pre and post-synaptic elements, as well as surrounding astroglia) in sensorimotor cortex of both hemispheres 6 weeks after endothelin-1-induced focal brain ischemia in rats. Synapsin-I and PSD-95 levels were increased by skilled training in ischemic sensorimotor cortex. The content of GFAP was augmented as a result of focal brain ischemia in ischemic sensorimotor cortex and that was not modified by rehabilitation training. Unexpectedly, animals remained permanently impaired at the end of motor/functional evaluations. Significant modifications in protein expression were not observed in undamaged sensorimotor cortex. We conclude that skilled motor activity can positively affect brain plasticity after focal ischemia despite of no functional improvement in conditions here tested.

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The most disabling aspect of human peripheral nerve injuries, the majority of which affect the upper limbs, is the loss of skilled hand movements. Activity-induced morphological and electrophysiological remodeling of the neuromuscular junction has been shown to influence nerve repair and functional recovery. In the current study, we determined the effects of two different treatments on the functional and morphological recovery after median and ulnar nerve injury. Adult Wistar male rats weighing 280 to 330 g at the time of surgery (N = 8-10 animals/group) were submitted to nerve crush and 1 week later began a 3-week course of motor rehabilitation involving either "skilled" (reaching for small food pellets) or "unskilled" (walking on a motorized treadmill) training. During this period, functional recovery was monitored weekly using staircase and cylinder tests. Histological and morphometric nerve analyses were used to assess nerve regeneration at the end of treatment. The functional evaluation demonstrated benefits of both tasks, but found no difference between them (P > 0.05). The unskilled training, however, induced a greater degree of nerve regeneration as evidenced by histological measurement (P < 0.05). These data provide evidence that both of the forelimb training tasks used in this study can accelerate functional recovery following brachial plexus injury.

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The most disabling aspect of human peripheral nerve injuries, the majority of which affect the upper limbs, is the loss of skilled hand movements. Activity-induced morphological and electrophysiological remodeling of the neuromuscular junction has been shown to influence nerve repair and functional recovery. In the current study, we determined the effects of two different treatments on the functional and morphological recovery after median and ulnar nerve injury. Adult Wistar male rats weighing 280 to 330 g at the time of surgery (N = 8-10 animals/group) were submitted to nerve crush and 1 week later began a 3-week course of motor rehabilitation involving either "skilled" (reaching for small food pellets) or "unskilled" (walking on a motorized treadmill) training. During this period, functional recovery was monitored weekly using staircase and cylinder tests. Histological and morphometric nerve analyses were used to assess nerve regeneration at the end of treatment. The functional evaluation demonstrated benefits of both tasks, but found no difference between them (P > 0.05). The unskilled training, however, induced a greater degree of nerve regeneration as evidenced by histological measurement (P < 0.05). These data provide evidence that both of the forelimb training tasks used in this study can accelerate functional recovery following brachial plexus injury.

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INTRODUÇÃO: O Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA) é composto por tarefas padronizadas, representando atividades da vida diária e avalia a função do membro superior (MS) de pessoas com alteração motora. Além da medida do tempo e da graduação funcional, o instrumento propõe uma análise das tarefas executadas. OBJETIVO: Os objetivos do estudo foram: traduzir e adaptar para a língua portuguesa o formulário e o manual de administração do TEMPA; avaliar a confiabilidade teste reteste e interobservadores e a validade para pacientes com hemiparesia. MÉTODOS: Participaram deste estudo 23 pacientes (61±13 anos) com hemiparesia (30±29 meses) e 23 controles (60±12 anos). A confiabilidade interobservadores foi testada comparando o resultado de dois observadores, em avaliações realizadas no mesmo dia. A confiabilidade teste reteste foi testada comparando o resultado das avaliações, repetidas no intervalo de uma semana. A validade para hemiparéticos foi avaliada por meio da correlação com a escala de Fugl-Meyer (EFM). RESULTADOS: Os resultados mostram adequada confiabilidade interobservadores (coeficiente de correlação intraclasse - CCI=0,93) e teste reteste (CCI=0,99) para os escores totais. Nos pacientes com comprometimento motor moderado a grave (EFM<50), todos os itens mostraram adequada confiabilidade teste reteste e interobservadores (CCI entre 0,70 e 1,00). Nos pacientes com comprometimento motor leve (EFM>50), a confiabilidade para a velocidade na execução assim como para o escore funcional total (interobservadores, ICC=0,79 e teste-reteste, ICC=0,78), foi adequada. A correlação do TEMPA com a EFM foi de r=-0,85 (p=0,001). CONCLUSÕES: Os resultados sugerem adequada confiabilidade para a versão brasileira do TEMPA e validade para pacientes com hemiparesia.

INTRODUCTION: The Test d'Évaluation des Membres Supérieurs de Personnes Âgées (TEMPA) is composed of standardized tasks that represent activities of daily living. This test evaluates upper limb function in individuals with motor deficits. In addition to measuring time and functional level, this instrument also provides analysis of the tasks performed. OBJECTIVE: The aims were: to translate and to adapt the TEMPA form and administration manual to the Portuguese language; and to assess interrater and test-retest reliability and the validity of TEMPA for patients with hemiparesis. METHODS: Twenty-three patients (61±13 years) with hemiparesis (30±29 months) and 23 controls (60±12 years) participated in this study. The interrater reliability was tested by comparing the results from two examiners, in evaluations on the same day. The test-retest reliability was tested by comparing the results from evaluations repeated within a one-week interval. The validity of TEMPA for hemiparetics was assessed by correlation with the Fugl-Meyer scale (FMS). RESULTS: The results showed adequate interrater reliability (intraclass correlation coefficient - ICC=0.93) and test-retest reliability (ICC=0.99) for the total scores. In patients with moderate to severe motor deficits (FMS<50), all the items showed adequate test-retest and interrater reliability (ICC between 0.70 and 1.00). In patients with mild motor deficits (FMS>50), the reliability regarding speed of execution and total functional score (interrater, ICC=0.79 and test-retest, ICC=0.78) was adequate. The correlation of TEMPA with FMS was r=-0.85 (p=0.001). CONCLUSIONS: The results suggest that the Brazilian version of TEMPA is reliable and that it is valid for patients with hemiparesis.

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BACKGROUND AND PURPOSE: Reaching movements made with the affected arm in hemiparetic patients are often accompanied by compensatory trunk or shoulder girdle movements, which extend the reach of the arm. We investigated the effects of the suppression of these compensatory movements on reaching ability in hemiparetic individuals. METHODS: Eleven healthy and 11 hemiparetic individuals participated. Three-dimensional kinematic analysis was used to quantify reaches made to a close and a distant target (near the limit of arm's length). Unrestrained reaches were compared with those in which shoulder girdle and trunk movements were restrained by a harness. RESULTS: During unrestrained reaching, abnormal trunk recruitment and limitations in elbow and shoulder movements were correlated with the degree of clinical stroke severity (r=-0.91 to -0.96) in hemiparetic patients. During trunk restraint, ranges of elbow and shoulder joint movement increased in both groups. In addition, elbow and shoulder interjoint coordination improved. This was caused by increases in the range of joint motion as well as by a better dynamic temporal relation between joints. CONCLUSIONS: Trunk restraint allowed patients with hemiparetic stroke to make use of arm joint ranges that are present but not normally recruited during unrestrained arm-reaching tasks. Thus, the underlying "normal" patterns of movement coordination may not be entirely lost after stroke. Appropriate treatments, such as trunk restraint, may be effective in uncovering latent movement patterns to maximize arm recovery in hemiparetic patients.

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BACKGROUND: The Long-Evans cinnamon (LEC) rat has a mutation homologous to the human Wilson's disease gene, leading to copper-induced hepatotoxicity. The mechanism of how excess copper damages the liver or what chemical form of copper is toxic is still unclear. RESULTS: In liver cytosol, copper levels were highest just before the onset of hepatitis and declined thereafter. In cytosol, total copper was bound to metallothionein (MT). Considerable amounts of both copper and iron accumulated in lysosomes with increasing age and development of liver damage. Lysosomal levels of presumably reactive non-MT-bound copper were increased. In severely affected livers, large amounts of copper were associated with insoluble material of high density which, upon ultrastructural information, was found to be derived from the lysosomes of Kupffer cells. This copper-rich material is considered to consist of polymeric degradation products of copper-MT. CONCLUSION: We suggest that chronic copper toxicity in LEC rats involves the uptake of copper-loaded MT into lysosomes, where it is incompletely degraded and polymerizes to an insoluble material containing reactive copper. This copper, together with iron, initiates lysosomal lipid peroxidation, leading to hepatocyte necrosis. Subsequent to phagocytosis by Kupffer cells, the reactive copper may amplify liver damage either directly or through stimulation of these cells.

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OBJECTIVE: In this paper we present an attempt at noninvasive imaging of distributed myocardial electrical activity in patients suffering from myocardial infarction and in healthy subjects. Although advances have been made, noninvasive three-dimensional imaging of cardiac electrophysiological activity is still in its infancy and extending our knowledge of cardiac electrophysiological properties may be a valuable guide in the treatment of patients with coronary artery disease. METHODS: Magnetic field mapping data formed the input for an inverse solution that is based on a multiple dipole model. The lead field normalized minimum norm least square criterion was applied to predefined myocardial source geometry. Current density distributions were calculated for the left ventricle during ventricular depolarization. Images from two patients with previous myocardial infarction were compared to images from two healthy subjects. RESULTS: Low regional and global current density was found in the infarction patients. Regions of low current density corresponded to infarcted segments. The images of the healthy subjects displayed less marked areas of low current density. CONCLUSION: The proposed multiple dipole model may be able to distinguish viable from scarred myocardium. A prospective clinical study should be undertaken to investigate the spatial resolution and the diagnostic performance of this method.

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Top loin (TLS), top sirloin (TSS), and eye of round (EYS) steaks, and loin end (LRR) and blade end (BRR) rib, and eye of round (EYR) roasts were used to determine the effect of USDA quality grade, Choice or Select, external fat trim level, and internal temperature endpoint on sensory, chemical and cooking characteristics. Cuts cooked with external fat required slightly greater cooking times and had higher fat content in the lean than cuts cooked without external fat (p < 0.05). Regardless of quality grade or external fat trim, increasing internal temperature endpoint resulted in tougher, drier cuts with longer cooking times and greater cooking loss (p < 0.05). Choice TLS, TSS and LRR were higher (p < 0.05) in palatability than Select, but quality grade did not affect palatability of BRR, EYS or EYR.

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Long-Evans Cinnamon (LEC) rats aged 16 +/- 4 weeks with histopathological alterations of liver and kidney, exhibited elevated Cu levels in liver, kidney and spleen which were 52, 27 and 5 times higher than those of the respective tissues of age-matched Wistar rats. About 61% of hepatic and about 38% of renal Cu was recovered in the cytosolic fraction. Metallothionein (MT) levels were found to correlate with the cytosolic Cu concentrations in liver and kidney. According to differential MT analysis, about 68 and 82% of hepatic and renal MT was loaded with Cu. The portion of MT which binds Cu was negatively correlated with the ratio of cytosolic Zn/Cu in all organs investigated. Despite high MT levels and the high percentage of Cu binding to MT, particularly in liver and kidney, considerable amounts of Cu remained unbound to MT. This non-MT bound Cu showed good correlation with the total cytosolic Cu content, and might play a crucial role in the pathogenesis of Cu toxicosis.

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Scalp-recorded direct current (DC) potentials and their topographical distribution (F3, F4, C3, C4 and Pz) were investigated at the transition from wakefulness to sleep, and during NREM-REM sleep and REM-NREM sleep transitions in 11 healthy men during normal sleep. Changes in endexpiratory CO2 partial pressure (ETCO2), scalp temperature and polysomnographic data were simultaneously measured. The transition to sleep was associated with a negative potential shift reaching significance bilaterally at frontal and central sites 5 to 10 minutes after sleep onset (p < 0.05). Largest shifts were found at frontal locations 10 to 15 minutes after sleep onset averaging (mean +/- SEM) -512 +/- 103 mu V. Negative DC potential shifts also occurred at the transitions from NREM to REM sleep and from REM to NREM sleep, but were, however, less pronounced. The negative DC shift at NREM-REM sleep transitions preceded the REM sleep onset (assessed conventionally by polysomnographic criteria) by about 1.5 minutes. Changes in temperature, ETCO2 and eye movements were ruled out as factors significantly contributing to the generation of these shifts. Assuming a neuronal origin of the DC potential, the negative shifts at the wake--sleep transition and between NREM and REM sleep suggest a temporary phase of increased cortical excitability.

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Micellar electrokinetic capillary chromatography (MECC) using sodium dodecyl sulphate (SDS) and sodium cholate have been used for analyses of 30 dansylated (Dns) amino acids. The influences of sample preparation, Dns/amino acid ratio, sample solvent composition, and separation conditions including voltage, temperature, pH and buffer composition were investigated. Complete separations of acidic and neutral amino acids were obtained within 45 min in the SDS system. The efficiency expressed as number of theoretical plates for the applied capillary 0.52 m long were between 210,000 and 343,000, and the repeatability was very good with relative standard deviations on relative migration times between 0.09 and 0.70% and on relative normalised peak areas (RNPAs) between 0.85 and 3.41%. The linearity studies gave correlation coefficients between 0.9957 and 0.9993 for RNPAs against concentration. Detection limits were between 3 and 6 fmol or approximately 2 pg of each amino acid. Basic amino acids were separated in a MECC system using sodium cholate. Procedures and problems using Dns derivatisation for amino acids analysed by the MECC methods are described. Finally, examples of analyses of hydrolysates of real complex samples show, that this method can be applied to determine the amino acid composition of proteins in feedstuffs and skin.

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High-performance capillary electrophoresis (HPCE) was adapted for the determination of Kunitz soybean trypsin inhibitor, Bowman Birk inhibitor from soybean and protein-type proteinase inhibitors from pea (Pisum sativum L.). The method was developed for the determination and characterization of the inhibitors, the enzymes trypsin and chymotrypsin and the monoclonal antibodies (mAbs) raised against the inhibitors, and also the inhibitor-enzyme and inhibitor-mAb association complexes. The results from studies involving the use of various types of buffers revealed the advantages of having zwitterions such as trimethylammoniumpropyl sulphonate (AccuPure) or taurine included in the buffer. The use of capillaries dynamically coated with zwitterions efficiently reduced the interactions of the proteins with the silica capillary surface, which was important for the analyses for trypsin, chymotrypsin and mAbs and their association complexes with the inhibitors. The influence of temperature, voltage, pH and buffer type on migration times, resolution, peak areas and number of theoretical plates was investigated for the proteins studied. The proposed HPCE method is very suitable for studies of proteinase inhibitors compared with traditional inhibitor studies, and it gives efficient protein separations with the possibility of 245,000 plates/m.

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Capillary electrophoresis based on cetyltrimethylammonium bromide micellar electrokinetic capillary chromatography (MECC) was developed for the separation and determination of glycosaminoglycan (GAG) disaccharide units without derivatization. The influence of changes in several separation conditions was studied, and the separation mechanisms are discussed. Tests of repeatability and linearity were performed for qualitative and quantitative evaluation of the method. The described procedure gives a rapid and efficient determination of GAG disaccharides. Samples of chondroitin sulphates and mink skin were treated with proteases, and the extent of protein cleavage was followed by free zone capillary electrophoresis. The result of the chondroitinase ABC treatment following the protease treatment was evaluated by the MECC method.

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