Abstract

Training-induced Recovery of Manual Dexterity after
a Lesion in the Motor Cortex

Noriyuki Higo

Cerebral injury, such as stroke, cause functional deficits; however some functions can recover with postlesion rehabilitative training. Several recent studies using rodents and monkeys have reported the effects of postlesion training on functional recovery after brain injury. We present herein an overview of recent animal experimental studies on the effects of postlesion motor training on brain plasticity and motor recovery. Our study in the macaque monkey reported the effects of hand motor training on motor recovery after lesioning of the primary motor cortex (M1). In monkeys that had undergone intensive daily training after the lesion, manual dexterity recovered to previous levels. Relatively independent digit movements, including those of precision grip, were restored in the trained monkeys. While hand movements recovered to some extent in the monkeys without postlesion training, these monkeys frequently used alternative grips to grasp a small object instead of the precision grip. These findings suggest that recovery after M1 lesions includes both training-dependent and training-independent processes, and that recovery of precision grip requires intensive postlesion training. Recent results of both brain imaging and gene expression analyses suggest that functional and structural changes may occur in uninjured motor areas during recovery of hand function after M1 lesions. In particular, our preliminary results suggest that structural changes in ventral premotor cortex neurons may participate in functional compensation of precision grip.

Why Japanese Advanced Medical Treatment Never Go Ahead?! -The Doctor Flees Abroad to the United States. Where is the Compassion to Rescue Japanese Patients?

Nobuyo Hatanaka, Shinichi Matsumoto, Yuji Tanaka and Masahiro Kami

Islet cell transplantation is a minimal invasive procedure and effectively controls blood glucose for type 1 diabetic patients but it is considered as experimental. A dramatic improvement was achieved by the Edmonton group in 2000. After islet transplantation, all type 1 diabetic patients became insulin free at 1 year with stable glycemic control. However, only stable glycemic control was maintained for long-term but not insulin free status. In 2004, the Kyoto University performed the Japanese first islet transplantation. Of note, due to lack of enough cadaveric donors in Japan, the same group performed the world first success case of living donor islet transplantation in 2005. Both patients achieved insulin free however, as the Edmonton protocol; only excellent glycemic control can be maintained for prolonged period. Unfortunately both patients have not been satisfied well. Islet cell transplantation is the treatment for improving quality of life (QOL) and only the patients themselves can evaluate their QOL. Therefore, it is mandatory that patients themselves think the effect of the treatment on their lives after transplantation carefully and decide whether they will receive the treatment or not (Autonomy). Lacking the autonomy might be the one of the reasons for the not satisfied result. Even the series of the islet transplantation at the Kyoto University showed promising results, the leading scientist Shinichi Matsumoto gave up for continuing the research in Japan and fled to the United States. This is because it is extremely difficult to make the newly developed treatment as the standard therapy in Japan.

New Aspects of Lymph Vessel Research

Toshio Ohhashi

In this lecture, I would like to talk about (1) current topics of active pump mechanisms of lymph vessels with heart-like contractions, (2) concentration mechanisms of albumin in lymph through lymph vessel walls or lymph nodes, (3) molecular mechanisms involved in suitable environment for micrometastasis in sentinel lymph node (SLN) and (4) recanalization of collecting lymph vessels after surgical dissection of lymph node or the afferent lymph vessel. With these talking, I would like to discuss the possibility that new lymphology combined with cardiovascular medicine, oncology, and innate immunology may be established. Thus, I emphasize current physiological and pharmacological topics of the regulating mechanisms of active lymph transport, i.e., lower oxygen tension in lymph, endogeneous nitric oxide and ATP-sensitive potassium channels. I also demonstrate slow movement and concentration of plasma albumin through the lymphatic system, which may play a key role in the regulation of innate immunity. I demonstrate the effects of supernatants cultured with MDA-MB-231 and MCF-7 on the expression of adhesion molecules on human cultured lymphatic endothelial cells (LECs) and then investigate whether the expressed adhesion molecules accelerate the attachment of carcinoma cells to LECs. I address the possibility that we may design new drugs to diagnose and/or treat the micrometastasis of carcinoma cells in SLN. Finally I will discuss the possibility of reconstructive treatment of lymph vessels for secondary lymph edema in patients with breast cancers.