「寝たきり後期高齢者」の超音波骨量指標の現状について

　This study was designed to be investigated the existing of QUS parameters of the calcaneus in the immobile Japanese elderly aged 75 and over（ Patients G:N hospital）. 　The subjects were 10 men aged76-97 （mean age 82.12±6.24） and 24 wemen aged75-99（88.76±6.70）. They were all ranked level in Ⅳ - Ⅴ on Care need grades and immbobiled periods were 3.88±2.79 years in men and 2.76±2.39 years in wemen.In this case,only women’s deta was used to compare with the normal samed aged women in this study Higashimurayama City （EHMC,n=72,61-89years）.In body size,body weight was shown low level （under 12kg than EHMC）.BMI score were 17.78±2.79 in Patient G and 23.12±3.42 in EHMC G.Al in Blood was 3.51±0.34g/d（l normalrange;3.8-5.3g/dl）.In QUS parameters,Stiff ness were 35.67±13.81（in Patients）and 61.43 ±11.32 （in EHMC）,BUA were 66.08±10.84dB/Mhz（in P） and 91.10±11.21 dB/Mhz.These parameters showed signifi cantly decreased than EMHC Group.These decrememts were due to decrease of mechanical stress with prolonged immobilized states

入院高齢者における栄養アセスメント追跡調査

【目的】近年、高齢者の低栄養問題が注目されている。これまで、集団を対象とした、ある一時点における横断的調査の結果が多数報告された。一方で、長期間にわたり同じ栄養摂取状態が継続された同一人物を追跡した縦断的調査はほとんどない。本研究では、4年前に栄養状態の調査を行った長期入院中の高齢者を対象として追跡調査を行い、栄養状態、自立度、介護度および認知症度の推移について検討を行った。【方法】C 県C 市N医学生物学研究所付属病院に入院している11名（男性2 名、女性9 名、年齢81.8±6.4歳、入院期間平均6.0±1.7年、2012年3 月）を対象とし、身体計測、栄養状態調査、自立度（寝たきり度）、要介護度、認知症度、および栄養素摂取調査を行った。また、血液を採取し、生化学的検査を行った。調査は2012年2 ～ 8 月に実施し、2008年1 ～ 4 月に行った調査のデータを利用して縦断的な比較を行った。また、栄養摂取方法の違いの比較も行った。【結果】対象入院患者の推定栄養素摂取量は、約4年間で減少する傾向が見られた。血液・生化学検査の結果からは、加齢に伴う栄養状態の低下が観察された。ビタミン類に関しては、栄養剤から栄養素を摂取している経腸栄養患者の方が、食事を通じて栄養素をしている経口栄養患者と比べて血中の値が良好であり、また加齢に伴う低下度は小さかった。亜鉛は縦断的な比較はできなかったが、2012年の調査では11名中10名が基準値未満であった。【考察】長期入院高齢者においては、ビタミン、ミネラル類に関しては、経腸栄養群の方が経口栄養群よりも栄養状態が良かった。しかし、経腸栄養剤に十分含まれていない栄養素に関しては不足していた。これより、経腸栄養患者に対しては、ビタミンばかりではなく、亜鉛をはじめとするミネラル類の含有量も配慮された経腸栄養剤に変更する、または使用中の栄養剤と併用して、ミネラル類の摂取量を上げることが望まれる。また、経口栄養患者に対しても、給食に加えて栄養補助食品やサプリメントなどを利用して、不足している微量栄養素の補給を行うことが望ましいと考えられる

Experimental Hypoglycemic Neuropathy in Rat: Nerve Blood Flow and Nerve Conduction Study

Abstract Severe hypoglycemia causes peripheral neuropathy. The role of ischemia in the development of hypoglycemic neuropathy has been postulated, although its underlying mechanism is uncertain. We, therefore, measured the blood flow of sciatic nerve in hypoglycemic rat. Severe hypoglycemia was induced for 3 h by insulin injection. Nerve blood flow ῌNBF῍ was measured using a laser Doppler flowmeter at midand lower thigh levels of sciatic nerve, and nerve vascular resistance ῌNVR῍ was calculated. NBF was significantly decreased and NVR was significantly increased in sciatic nerve during 3 h of hypoglycemia. Nerve conduction velocity in sciatic nerve was significantly slowed after 3 h of hypoglycemia. These results suggest that ischemia is implicated in the underlying mechanism of hypoglycemic neuropathy

Statistical Power Modeling of GPU Kernels Using Performance Counters

Abstract—We present a statistical approach for estimating power consumption of GPU kernels. We use the GPU performance counters that are exposed for CUDA applications, and train a linear regression model where performance counters are used as independent variables and power consumption is the dependent variable. For model training and evaluation, we use publicly available CUDA applications, consisting of 49 kernels in the CUDA SDK and the Rodinia benchmark suite. Our regression model achieves highly accurate estimates for many of the tested kernels, where the average error ratio is 4.7%. However, we also find that it fails to yield accurate estimates for kernels with texture reads because of the lack of performance counters for monitoring texture accesses, resulting in significant underestimation for such kernels. I

Clinical screening of autonomic dysfunction in multiple sclerosis

Background and Purpose: Multiple sclerosis (MS) can affect the autonomic nervous system. Although exercise may be beneficial for people with MS, those with autonomic dysfunction may have altered heart rate responses to exercise. We investigated the hypothesis that the pattern of increase in heart rate on commencement of a simple cycle test would be different in those participants with MS who had been shown to have autonomic dysfunction on laboratory testing compared with both control participants and MS participants not exhibiting autonomic involvement. Method: A controlled cohort study with a volunteer sample of 31 adults with MS (26 women, 5 men) with a mean age of 46 ± 8.00 years (32-60 years), a median Expanded Disability Severity Scale of 3 (1-6) and a mean duration since diagnosis of 10.3 years (0.1-39 years). Thirty-one age-matched, non-disabled, sedentary but healthy adults (26 women, 5 men) with a mean age of 45 ± 9.5 years (24-57) comprised the control group. Autonomic function was evaluated using continuous heart rate and blood pressure responses to rhythmical deep breathing, the Valsalva manoeuvre, passive postural change and a simple cycle test. Results: There were no significant differences in age, height or weight (p < 0.05) between the two groups or on any of the autonomic test results (p < 0.05). Five participants with MS (16%) had abnormal autonomic function on laboratory testing, two of whom demonstrated an abnormal heart rate response to the cycle test. Conclusions: It is suggested that physiotherapists monitor the heart rate response to a dynamic exercise test in people with MS prior to prescribing an exercise programme to ensure patients' safety. Should the response appear delayed or attenuated, referral for more formal autonomic laboratory testing is recommended.14 page(s

Efficacy of nonviral gene transfer of human hepatocyte growth factor (HGF) against ischemic-reperfusion nerve injury in rats.

Ischemic neuropathy is common in subjects with critical limb ischemia, frequently causing chronic neuropathic pain. However, neuropathic pain caused by ischemia is hard to control despite the restoration of an adequate blood flow. Here, we used a rat model of ischemic-reperfusion nerve injury (IRI) to investigate possible effects of hepatocyte growth factor (HGF) against ischemic neuropathy. Hemagglutinating virus of Japan (HVJ) liposomes containing plasmids encoded with HGF was delivered into the peripheral nervous system by retrograde axonal transport following its repeated injections into the tibialis anterior muscle in the right hindlimb. First HGF gene transfer was done immediately after IRI, and repeated at 1, 2 and 3 weeks later. Rats with IRI exhibited pronounced mechanical allodynia and thermal hyperalgesia, decreased blood flow and skin temperature, and lowered thresholds of plantar stimuli in the hind paw. These were all significantly improved by HGF gene transfer, as also were sciatic nerve conduction velocity and muscle action potential amplitudes. Histologically, HGF gene transfer resulted in a significant increase of endoneurial microvessels in sciatic and tibial nerves and promoted nerve regeneration which were confirmed by morphometric analysis. Neovascularization was observed in the contralateral side of peripheral nerves as well. In addition, IRI elevated mRNA levels of P2X3 and P2Y1 receptors, and transient receptor potential vanilloid receptor subtype 1 (TRPV1) in sciatic nerves, dorsal root ganglia and spinal cord, and these elevated levels were inhibited by HGF gene transfer. In conclusion, HGF gene transfer is a potent candidate for treatment of acute ischemic neuropathy caused by reperfusion injury, because of robust angiogenesis and enhanced nerve regeneration

Therapeutic Effect of Exendin-4, a Long-Acting Analogue of Glucagon-Like Peptide-1 Receptor Agonist, on Nerve Regeneration after the Crush Nerve Injury

Glucagon-like peptide-1 (GLP-1) is glucose-dependent insulinotropic hormone secreted from enteroendocrine L cells. Its long-acting analogue, exendin-4, is equipotent to GLP-1 and is used to treat type 2 diabetes mellitus. In addition, exendin-4 has effects on the central and peripheral nervous system. In this study, we administered repeated intraperitoneal (i.p.) injections of exendin-4 to examine whether exendin-4 is able to facilitate the recovery after the crush nerve injury. Exendin-4 injection was started immediately after crush injury and was repeated every day for subsequent 14 days. Rats subjected to sciatic nerve crush exhibited marked functional loss, electrophysiological dysfunction, and atrophy of the tibialis anterior muscle (TA). All these changes, except for the atrophy of TA, were improved significantly by the administration of exendin-4. Functional, electrophysiological, and morphological parameters indicated significant enhancement of nerve regeneration 4 weeks after nerve crush. These results suggest that exendin-4 is feasible for clinical application to treat peripheral nerve injury