Human airway trypsin-like protease (HAT) is a serine protease found in sputum of patients with chronic airway diseases and is an agonist of protease-activated receptor-2 (PAR-2). Results from this study show that HAT treatment also enhances mucus production by the airway epithelial cell line NCI-H292 in vitro. Histologic examination showed that HAT enhances mucous glycoconjugate synthesis, whereas the PAR-2 agonist peptide (PAR-2 AP) has no such effect. HAT, but not PAR-2 AP, enhances MUC2 and MUC5AC gene expression 23-fold and 32-fold, respectively. The proteolytic activity of HAT is required to enhance MUC5AC gene expression; the addition of the inhibitors of trypsin-like protease activity of HAT, aprotinin and leupeptin, abolishes its enhancing effect. AG1478, anti-epidermal growth factor receptor (anti-EGFR)-neutralizing antibody, and anti-amphiregulin (AR)-neutralizing antibody all inhibited the stimulatory effect of HAT. Furthermore, HAT increases AR gene expression and subsequent AR protein release, whereas PAR-2 AP shows no such effects. These results indicate that HAT enhances mucin gene expression through an AR-EGFR pathway, and PAR-2 is not sufficient for or does not directly cause HAT-induced mucin gene expression. Thus, HAT might be a possible therapeutic target to prevent excessive mucus production in patients with chronic airway diseases.

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Objective: To determine the efficacy of intense constraint-induced movement therapy (CIMT) for patients who cannot achieve finger extension due to a severe plegic hand after stroke. Design: Pre-post, pre-1 month follow-up, singleblinded, multi-baseline case. Participants: Fifteen participants who were all >12 months post-stroke. Interventions: Two weeks of CIMT including restraint of the nonparetic upper extremity and 6 hours of training each day. Outcome: There was a statistically significant effect of CIMT on upper extremity motor impairment assessed by the Fugl-Meyer Motor Assessment (FMA), the Motor Activity Log for low functioning patients (Grade 5 MAL) and Active Range of Motion (AROM). Post hoc analysis showed significant differences between pre-and post-treatment motor impairment scores, and the improvements in these scores were maintained at 1 month after completion of treatment. Improvements were mostly in the use of the involved upper extremity for bimanual activities. Conclusions: Intense CIMT conferred significant changes in objective measures in subjects with chronic severe plegic hand after stroke. Additional studies of the long-term benefits of this treatment on post-stroke motor impairments and related functional disabilities are warranted.

Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.