Index Of Recovery Research Articles

Flexible Reorganization of Human Prefrontal Cortex Following Stroke

Flexible Reorganization of Human Prefrontal Cortex Following Stroke

Nishinomiya Built Environment Database and its Findings

We introduce the Nishinomiya Built Environment Database (NBED), which archives digital data on the disaster process from immediately after earthquake through recovery following the 1995 Hanshin-Awaji Earthquake Disaster. Using this database, we discuss findings obtained from analysis of the disaster process: (1) effectiveness of the Building Standard Law, (2) comparison of building damage assessment results, (3) the relationship between fatalities and building collapse, (4) collapse factors among wooden houses, and (5) monument construction process as an index of community recovery. We also demonstrate two applications – (1) the support tool for seismic risk assessment and (2) the training system for building damage assessment for issuing victim certificates. The NBED exhibits that it enables to use to simulate earthquake disaster and social reactions by those responding to disaster in local government and it contributes to establish countermeasures for disaster reduction.

Clinical Validity of Longitudinal Pre-Ejectional Myocardial Velocity for Identifying the Transmural Extent of Viable Myocardium Early After Reperfusion of an Infarct-Related Coronary Artery

Positive longitudinal pre-ejectional velocity (+PEVL) was recently reported to be a reliable index of myocardial recovery early after successful revascularization in myocardial infarction (MI); that is, it recognizes the transmural extent of viable myocardium. The applicability of PEVL in the real-world clinical setting for identifying the transmural extent of viable myocardium in reperfused recent MI was assessed. Using tissue Doppler imaging, the resting basal and mid myocardial PEVLs were determined within 3 days after revascularization in 41 consecutive patients with recent MI. Infarct thickness was semi-quantified using delayed gadolinium-enhanced magnetic resonance imaging (MRI) at baseline and at 6-month follow up to differentiate transmural from nontransmural MI. The proportion of segments showing the presence of +PEVL was not significantly changed as infarct thickness increased (p=0.2), with 66.2% having +PEVL even in segments involving >75% transmural infarction. Moreover, +PEVL was found in a large fraction of segments with akinesia (70.4%). Specificity and negative predictive value of +PEVL for assessing infarct nontransmurality were disappointingly low (32.0% and 26.9%, respectively). All of these results were not altered when the 6-month follow-up MRI was done. +PEVL cannot be regarded as a reliable marker for predicting the transmural extent of viable myocardium in recent MI.

Can Bacterial Translocation Be a Beneficial Event?

Infection is a major concern in intestinal transplant recipients. Bacterial migration to extraintestinal sites is a central component of the gut hypothesis of sepsis. However, some studies have cited the beneficial effects of bacterial translocation (BT) on the host acquired immune system. We evaluated the role of previous BT on a subsequent BT challenge, examined the BT index in organs as well as changes in white blood cell (WBC) count in mesenteric lymph and blood for correlation with outcomes. Wistar rats ( n = 60) were divided into a BT group ( n = 20), which underwent inoculation of 10 mL of 10 10 CFU/mL Escherichra coli R-6 confined to the small intestine as opposed to a BT1-14 group ( n = 20), which underwent the BT procedure on days 1 and 14 or a S1-BT14 group ( n = 20) that received 10 mL of saline on day 1 and the BT procedure on day 14. Half of the animals were killed 2 hours following the BT procedure. Samples from different compartments were collected for culture. Mesenteric lymph and peripheral blood were examined for WBC counts. The other half of the hosts was subjected to outcome evaluation concerning weight gain and mortality. Animals undergoing double BT showed a significantly lower index of bacterial recovery (liver, spleen, and blood) compared with those having a single BT ( P < .05). The WBC count of mesenteric lymph cells after double BT was similar to naïve animals, but significantly lower than the single BT group ( P < .05). The outcome was unchanged among double BT versus other groups. A previous BT challenge was efficient to generate a host-defense mechanism against a second BT episode induced by intestinal overgrowth with the same bacterial strain.

The Clinical Strategies Implementation Scale to Measure Implementation of Treatment in Mental Health Services

The authors describe the development of the Clinical Strategies Implementation Scale (CSI), an instrument designed to help providers measure the extent to which evidence-based strategies have been implemented in the treatment of persons with schizophrenia spectrum disorders. Nine ordinal scales were devised to measure key aspects of treatment strategies that have been associated with clinical and social recovery from schizophrenia: goal- and problem-oriented assessment, medication strategies, assertive case management, mental health education, caregiver-based problem solving, living skills training, psychological strategies for residual problems, crisis prevention and intervention, and booster sessions. A study of interrater reliability was conducted with 15 trained raters from participating centers in Athens, Auckland, Bonn, Budapest, Gothenburg, and Tokyo who assessed 54 cases. Each treatment strategy was weighted according to its effect size in clinical trials. Correlation analyses were conducted to explore associations between the total CSI score and ratings of clinical, social, and caregiver outcomes each year over four years of continued treatment of 51 patients. Interrater reliability ranged from .93 to .99. Four annual total CSI ratings were significantly correlated with impairment, disability, functioning, work activity, and an index of recovery. Most correlations were stronger in years 3 and 4 than in years 1 and 2. Reliable and valid assessment of the implementation of evidence-based strategies in clinical practice is feasible. The quality of integrated program implementation may be associated with improved clinical and social recovery from schizophrenic disorders.

Recovery of sexual function after nerve-sparing radical retropubic prostatectomy: is cavernous nitric oxide level a prognostic index?

The preservation of NANC nerve fibers (producing nitric oxide, NO) is necessary for erection recovery after retropubic radical prostatectomy (RRP). Yet, it is impossible to establish when and if a patient will recover erections; therefore, we investigate the prognostic value of cavernous blood NO levels on this parameter. Nerve-sparing RRP was performed on 14 patients for localized prostate cancer. We evaluated all patients 3 months after surgery by IIEF score: no patients had erections. A cavernous blood sample was also taken to determine NO levels (as nitrite). Patients were evaluated again 18 months after surgery. In six cases, erectile function was compromised, whereas in seven cases, potency was restored. Statistical analysis showed a relationship between nitrite levels in cavernous blood 3 months after surgery and the recovery or erectile function at 18 months. We propose that cavernous NO blood levels are a prognostic index of erection recovery.

Reductions in interhemispheric motor cortex functional connectivity after muscle fatigue

Muscle fatigue has been known to differentially affect the activation level of the primary motor cortices (MIs) of the brain's two hemispheres. Whether this fatigue-related decoupling influence on the motor cortical signals extends beyond the motor action to the after-fatigue-task resting state is unknown. This question can be addressed by analyzing functional connectivity (FC) of low-frequency oscillations of resting-state functional MRI (fMRI) signals of the MIs. Low-frequency oscillations (<0.08 Hz) have been detected in many fMRI studies and appear to be synchronized between functionally related areas. These patterns of FC have been shown to differ between normal and various pathological states. The purpose of this study was to examine muscle fatigue-induced resting-state interhemispheric motor cortex FC changes in healthy subjects. We hypothesized that muscle fatigue would create a temporary “disrupted state” in the brain, and would decrease resting state interhemispheric motor cortical FC. Ten healthy subjects performed repetitive unilateral handgrip contractions that induced significant muscle fatigue, with resting state fMRI data collected before and after the task. After excluding two subjects due to gross head motion, interhemispheric motor cortex FC was assessed by cross-correlating the MI fMRI signal time courses. We found that the number of significant interhemispheric correlations in the MI fMRI signals decreased significantly after the performance of the fatigue task. These results suggest that resting state interhemispheric motor cortex FC may be used as an index of recovery from fatigue.

Effects of immediate post-game recovery procedures on muscle soreness, power and flexiblity levels over the next 48 hours

This study investigated whether or not immediate post-game recovery procedures could enhance the rate of recovery in Australian football players in the first 48 hr after a game. Control, stretch, pool walking and hot/cold recoveries were trialled. Typical next day recovery training (25 min of pool exercise) was also performed after each game. Muscle soreness ratings and measures of flexibility (sit and reach) and power (6-s cycling sprint and vertical jump) were obtained 45 hr pre-game (Thursdays) (baseline), 15 hr post-game (Sundays, prior to "next day" recovery) and 48 hr post-game (Mondays). Performance ratios (Sunday and Monday scores divided respectively by the Thursday score) were used as the primary index of recovery. Muscle soreness was significantly greater (p<0.01) than baseline on both Sunday and Monday in all conditions, but no differences between the three recoveries and control were evident. On Sunday, vertical jump and 6-s work and power scores were only significantly lower than baseline values in control and performance ratios recorded two significant differences (vertical jump: pool walking > control, p<0.01; 6-s power: stretch > control, p<0.01) and moderate to large effect sizes (>0.3). No differences were found between the three experimental recoveries. On Monday no significant differences were recorded in performance between the recoveries and the effect sizes were of lower magnitude. In conclusion, recovery of muscle soreness, flexibility and power at 48 hr post-game was not significantly enhanced by performing an immediate post-game recovery beyond that achieved by performing only next day recovery training.

End-tidal carbon dioxide monitoring indicates recovery from cardiogenic shock in patients receiving percutaneous cardiopulmonary support

The aim of this study was to examine the prognostic value of monitoring end-tidal carbon dioxide (ETCO(2)) levels for patients in cardiogenic shock undergoing percutaneous cardiopulmonary support (PCPS). Fifteen patients in whom PCPS was used to treat cardiogenic shock were enrolled in this study. For hemodynamic measurements, a thermodilution catheter was inserted into the pulmonary artery and an infrared absorption sensor was placed in the main stream of exhaled air between the respiration tube and the respirator to measure ETCO(2) levels. Nine patients (group II, 60%) died of multiple organ failure. In the six survivors (group I), there was a significant increase in average ETCO(2) level from 8.8 +/- 3.9 mmHg before treatment to 20.5 +/- 2.1 mmHg 24 h after the start of PCPS compared with values in group II patients (8.8 +/- 3.9 mmHg, P = 0.0411). Also, serum lactate concentrations fell significantly in group I patients (group I 2.8 +/- 0.47 mmol/l, group II 9.0 +/- 2.31 mmol/l, P = 0.0435). The mean ETCO(2) level in group I patients gradually returned to 23 mmHg, which was within the normal healthy range; these patients were successfully weaned from PCPS. These results suggest that, in cardiogenic shock patients, ETCO(2) level is a possible index of cardiac recovery during PCPS support.

Monument Construction as an Index of Community Recovery from the Hanshin-Awaji earthquake disaster

Monument Construction as an Index of Community Recovery from the Hanshin-Awaji earthquake disaster

A Study of the Process of Gold Recovery from a Slag Melt into the Bottom Phase in Fire Assay

Procedures have been proposed to estimate the recovery of gold from a slag melt into the bottom phase without using a lead collector and the size of particles settling naturally to the bottom phase. It is shown that the processes of coalescence of gold particles and their settling to the bottom phase make a substantial contribution to the overall index of gold recovery in fire assay.

Liver-targeted doxorubicin: effects on rat regenerating hepatocytes.

The conjugate of doxorubicin (DOXO) with lactosaminated human albumin (L-HSA) has the potential of improving DOXO efficacy in the treatment of hepatocellular carcinomas (HCCs) expressing the asialoglycoprotein receptor (ASGP-R). In view of an adjuvant chemotherapy with L-HSA-DOXO after the surgical removal of the tumour, in the present experiments we verified whether DOXO accumulation produced by the conjugate can impair the liver regeneration following hepatic resection in non-cirrhotic liver. Using saline-injected hepatectomised rats as controls, we studied the effects of the conjugate on the ultrastructure of regenerating hepatocytes and evaluated [3H]thymidine incorporation, mitotic index and rate of DNA recovery in the liver remnant. L-HSA-DOXO caused a selective drug accumulation in liver remnant, with low DOXO levels in extra-hepatic tissues. It did not change the ultrastructure of hepatocytes and did not increase serum alanine aminotransferase. It decreased [3H]thymidine incorporation and mitotic index, causing a moderate delay in hepatic DNA recovery. The experiments indicate a substantial resistance of rat regenerating hepatocytes to high intracellular concentrations of DOXO. They support the possibility of using L-HSA-DOXO in an adjuvant chemotherapy after the surgical removal of HCCs which maintain the ASGP-R.

Mismatch Negativity Brain Response as an Index of Speech Perception Recovery in Cochlear-Implant Recipients

Speech-discrimination performance and the mismatch negativity (MMN) response elicited by vowel changes were used to track vowel-perception improvement of 5 adult cochlear-implant (CI) recipients. The MMN was recorded several times during the first 3 years after CI activation. Artefacts, presumably caused by CI, contaminated most of the brain responses until 1 year after CI activation. We found that speech discrimination improved over time and the MMN, observed in all patients after 2.5 years of CI use, was first seen for the larger vowel difference and later for the smaller one.

EPR oximetry in the beating heart: myocardial oxygen consumption rate as an index of postischemic recovery.

Oxygen plays a critical role in the pathophysiology of myocardial injury during both ischemia and subsequent reperfusion (I/R). Thus, oxygen concentration is an important variable to measure during I/R. In the present work, electron paramagnetic resonance (EPR)-based oximetry was used to measure the oxygen concentration during a series of I/R episodes and oxygenation levels were correlated with the contractile and hemodynamic functions of the heart. A custom-developed electronically tunable surface coil resonator working at 1.1 GHz was used to determine tissue pO(2) in the beating heart. Microcrystalline particulate of lithium phthalocyanine was used as an EPR oximetry probe. Isolated and perfused rat hearts were subjected to 1 or 3 hr durations of preischemic perfusion, followed by 15-min I/R cycles. In hearts perfused for 3 hr prior to 15-min I/R cycles, the myocardial pO(2) decreased gradually on subsequent reperfusions of three successive I/R cycles. However, in hearts perfused for 1 hr there was almost 100% recovery of myocardial pO(2) in all three I/R cycles. The extent of oxygenation recovered in each reperfusion cycle correlated with the recovery of hemodynamic and contractile function. The results also showed that the oxygen consumption rate of the heart at the end of each I/R episode decreased in direct proportion to the functional recovery. In summary, it was observed that the amount of myocardial oxygen consumption during I/R could provide a reliable index of functional impairment in the heart.

Mitogen-activated protein kinases regulate COX-2 and mucosal recovery in ischemic-injured porcine ileum.

Mitogen-activated protein kinase (MAPK) pathways transduce signals from a diverse array of extracellular stimuli. The three primary MAPK-signaling pathways are the extracellular regulated kinases (ERK1/2), p38 MAPK, and c-Jun NH(2)-terminal kinase (JNK). Previous research in our laboratory has shown that COX-2-elaborated prostanoids participate in recovery of mucosal barrier function in ischemic-injured porcine ileum. Because COX-2 expression is regulated in part by MAPKs, we postulated that MAPK pathways would play an integral role in recovery of injured mucosa. Porcine mucosa was subjected to 45 min of ischemia, after which tissues were mounted in Ussing chambers, and transepithelial electrical resistance (TER) was monitored as an index of recovery of barrier function. Treatment of tissues with the p38 MAPK inhibitor SB-203580 (0.1 mM) or the ERK1/2 inhibitor PD-98059 (0.1 mM) abolished recovery. Western blot analysis revealed that SB-203580 inhibited upregulation of COX-2 that was observed in untreated ischemic-injured mucosa, whereas PD-98059 had no effect on COX-2 expression. Inhibition of TER recovery by SB-203580 or PD-98059 was overcome by administration of exogenous prostaglandin E(2) (1 microM). The JNK inhibitor SP-600125 (0.1 mM) significantly increased TER and resulted in COX-2 upregulation. COX-2 expression appears to be positively and negatively regulated by the p38 MAPK and the JNK pathways, respectively. Alternatively, ERK1/2 appear to be involved in COX-2-independent reparative events that remain to be defined.

Tolerance of Mycelium of Different Genotypes of Phytophthora infestans to Freezing Temperatures for Extended Periods

ABSTRACT Mycelium of Phytophthora infestans, the causal agent of potato late blight, can initiate crop infections over successive years by overwintering in infected potato tubers that survive as seed in fields or within cull piles. This study used four different genotypes of P. infestans to evaluate the influence of freezing temperatures on survival of mycelium in vitro. Sporangium-free mycelium of P. infestans US1, US8, US11, and US14 growing on rye agar plates was exposed to temperatures ranging from -20 and 0 degrees C (experiment A) for different periods up to 24 h and from -5 and 0 degrees C (experiment B) for periods up to 5 days. Cultures were incubated at 12 degrees C after exposure, and survival of the cultures was estimated after 28 days by a digital image analysis technique that measured the average reflectance intensity (ARI) of images of the mycelium of temperature-treated cultures. The ARI values of treated cultures were compared with the growth of mycelium in negative controls (mycelium not present) and positive controls (mycelium exposed to 12 degrees C for an equivalent period), and determination of recovery was based on statistical differences from the controls. There were significant differences in ARI values among genotypes, temperature treatment, and exposure periods in all experiments. An index of recovery was calculated for each genotype at all treatment temperatures and exposure periods for both experiments. In experiment A, exposure of mycelium of P. infestans (all genotypes) to -20 and -10 degrees C proved lethal for exposure periods of more than 1 h. All genotypes showed some degree of recovery up to 24-h exposure at -5 and -3 degrees C. In both experiments, exposure of mycelium of P. infestans to 0 degrees C was not lethal to any genotype tested for any exposure period. In experiment B, all of the genotypes survived exposure up to 3 days at -3 degrees C to some degree, but at -5 degrees C, exposure of 1 day was lethal to all genotypes. Tolerance of freezing temperatures by mycelium of P. infestans may be an ecologically important survival mechanism and the increased tolerance of US8 and US14 may explain their predominance in cooler climates such as north-central United States.

Peripheral nerve ischemia: reperfusion injury and fiber regeneration

We continued our studies of ischemia–reperfusion (IR) injury, extending the reperfusion duration to 42 days to capture the fiber regeneration process. We used a rat model for IR injury produced by ligation and release of nooses around supplying vessels to the sciatic nerve. Fifty-six rats were used. One group (control N = 8) underwent sham ischemia; the other six groups ( N = 8 each) underwent complete hind limb ischemia for 4 h followed by reperfusion durations of 0 h (ischemia alone), 3 h, 7 days, 14 days, 28 days, and 42 days. Behavioral and electrophysiological data were obtained immediately before euthanasia. Pathologically, three phases were identifiable: Phase 1 (0–3 h)—minimal pathological changes, minimal edema; phase 2 (7 days, 14 days)—prominent fiber degeneration, endoneurial edema; phase 3 (28 days, 42 days)—abundant small regenerating fiber clusters, minimal edema. Compound muscle action potential (CMAP) was the most sensitive index of neural deficits and recovery, showing progressive recovery beyond 14 days. Severe functional deficits developed immediately and persisted with a trend to recovery at the 42-day time-point. It was concluded that reperfusion, by oxidative injury, worsened nerve function and aggravated fiber degeneration, but in the longer time frame, permitted fiber regeneration to occur.

Experiments on the effect of different intensities of desiccation on bryophyte survival, using chlorophyll fluorescence as an index of recovery

Chlorophyll fluorescence provides a non-invasive and non-destructive method to follow various aspects of the photosynthetic function of bryophytes under relatively natural conditions, which is easy to use and can be applied to small amounts of material. Some of its potentialities (and potential pitfalls) for bryophyte desiccation physiology are outlined. Data are presented on the responses of eleven desiccation-tolerant bryophytes to drying at –41, –114, –218 and –412 MPa for periods up to ~240 days. Recovery was assessed from FV/FM after 20 min and 24 h re-wetting, and from the mean FM value after 24 h. For the more desiccation-tolerant species, Grimmia pulvinata, Syntrichia ruralis, Andreaea rothii, Racomitrium lanuginosum, R. aquaticum, Leucodon sciuroides, Pleurochaete squarrosa and Ulota crispa, long-term survival (>30–120 d) was generally best at ~–100 to –200 MPa (20–45% r.h.). The moderately desiccation-tolerant Anomodon viticulosus, Porella platyphylla and P. obtusata survived best at the highest humidity used, –41 MPa (74% r.h.).

Raloxifene analog LY117018 enhances the regeneration of sciatic nerve in ovariectomized female mice

The aim of this study was to examine the effects of LY117018, a selective estrogen receptor modulator, on peripheral nerve regeneration, using a model of sciatic nerve crush injury in mice. Sciatic functional index, an index of functional recovery, was significantly higher in LY117018 treated mice throughout regeneration. Analysis of semi-thin sections revealed a significant increase in both the total number of regenerating nerve fibers at day 7, and the mean axonal area of myelinated fibers at 7, 14, and 21 days after injury, in LY117018 treated mice. Analysis of axonal transport through retrograde labeling of motor neurons showed that LY117018 increased transport, and ICI 182,780 blocked the effects of LY117018, delineating estrogen receptors as its target. Our study suggests that LY117018 may markedly accelerate peripheral nerve regeneration and functional recovery through activation of estrogen receptors.

Use of reversal agents in day care procedures (with special reference to postoperative nausea and vomiting)

There is some confusion about the contribution of reversal of residual paralysis to the occurrence of postoperative nausea and vomiting. The aim of this review is to discuss whether antagonism of residual paralysis is a cause of postoperative nausea and vomiting, and to assess the risk of residual paralysis if the reversal is omitted. Data from a meta-analysis published before 1998 were considered, along with trials published after that date to assess the influence of reversal of residual paralysis on postoperative nausea and vomiting, and the likelihood of harm when antagonism was omitted. Moreover, an overview of pathophysiological consequences, incidence and clinical consequences of residual paralysis is given and the actual criteria of the adequacy of neuromuscular recovery presented. When emetic outcomes are combined across all trials and all different neostigmine doses, there is no beneficial effect from omitting neostigmine on postoperative nausea and vomiting, but there is some evidence of a dose-responsiveness with neostigmine; higher doses may have emetic properties. However, omitting reversal introduces a non-negligent risk of residual paralysis. An improved understanding of the pathological consequences of residual paralysis (i.e. impaired laryngeal and pharyngeal muscle function, alterations in hypoxic ventilatory control, reduced margin of safety) led to establishment of more rigorous criteria for defining adequacy of neuromuscular recovery. A train-of-four ratio of ≥0.9 is now accepted as the index of adequate recovery of neuromuscular function. Applying this new definition, residual paralysis becomes a frequent adverse side-effect. Neuromuscular recovery should therefore be routinely monitored in ambulatory patients and residual paralysis prevented by reversing neuromuscular block.