Botulinum toxin A (BTX-A) was used in adult cerebral palsy patients for chronic pain treatment. Five patients (quadriplegia 3, diplegia 1, and athetosis 1 with an average age of 47) were all classified as GMFCS level IV. As a treatment for neck and trunk muscle pain, BTX-A injections were administered with a total dose below 6 units per kilogram of body weight. To investigate the efficacy of BTX-A, the Visual Analogue Scale and Modified Tsui Scale were used to evaluate the patients before and at regular monthly follow-ups after their injections. We found significant improvement in the Visual Analogue Scale scores at 1 month after initial injection and also found the same difference at the second injection. Also, although we found improvement in the Modified Tsui Scale scores at 1 month after injection, these improvements did not last as long as the Visual Analogue Scale improvements. BTX-A has been used in a growing number of indications for the treatment of muscle spasticity including blepharospasm, facial spasm and spasmodic torticollis. We found that BTX-A may also be useful in treating patients with cerebral palsy suffering from chronic pain.

Auto-transplantation of adipose tissue is commonly used for the treatment of tissue defects in plastic surgery. The survival of the transplanted adipose tissue is not always constant, and one of reasons is the accelerated apoptosis of the implanted preadipocytes. We have recently established highly homogeneous preadipocytes, named ccdPAs. The aim of the current study was to evaluate the regulation of the potency of platelet-rich plasma (PRP) on the apoptosis of ccdPAs in vitro. PRP stimulated the proliferation of the preadipocytes in a dose-dependent manner, and the stimulatory activity of 2% PRP was significantly higher than that of 2% FBS or 2% platelet-poor plasma (PPP). The presence of 2% PRP significantly inhibited serum starvation- or TNF-alpha/cycloheximide-induced apoptosis in comparison to 2% FBS or 2% PPP. DAPK1 and Bcl-2-interacting mediator of cell death (BIM) mRNAs were reduced in the preadipocytes cultured with 2% PRP in comparison to those cultured in 2% FBS. The gene expression levels were significantly higher in cells cultured without serum in comparison to cells cultured with 2% FBS, and the levels in the cells with 2% PRP were reduced to 5-10% of those in the cells without serum. These results indicated that ccdPAs exhibit anti-apoptotic activities, in addition to increased proliferation, when cultured in 2% PRP in comparison to the same concentration of FBS, and that this was accompanied with reduced levels of DAPK1 and BIM mRNA expression in in vitro culture. PRP may improve the outcome of transplantation of adipose tissue by enhancing the anti-apoptotic activities of the implanted preadipocytes.
Adipocytes/*cytology ; Adipose Tissue/cytology/metabolism ; Apoptosis/*physiology ; Apoptosis Regulatory Proteins/antagonists & inhibitors/metabolism ; Calcium-Calmodulin-Dependent Protein Kinases/antagonists & inhibitors/metabolism ; Cell Culture Techniques/*methods ; *Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Gene Expression Regulation ; Humans ; Membrane Proteins/antagonists & inhibitors/metabolism ; *Platelet-Rich Plasma/metabolism/physiology ; Proto-Oncogene Proteins/antagonists & inhibitors/metabolism ; Tissue Transplantation