Relationship between Pressure Ulcers in Elderly People and Physiological Indices of the Skin

This study examined the relationship between skin physiological indices and pressure ulcers in elderly people. The subjects were 55 bedridden elderly Japanese patients with a median age of 85 years. The following parame-ters were measured using non-invasive devices: skin surface temperature, moisture content in the stratum corneum, moisture content in the dermis, transepidermal water loss as an index of skin barrier function, skin erythema and skin elasticity. The sacral and 2 heel areas were observed as sites predisposed to pressure ulcers. Within one month after measuring the skin physiological indices, we confirmed pressure ulcers of National Pressure Ulcer Advisory Panel classification Stage II or worse based on medical records. Among the 55 patients, 4 (7.3%) prospectively developed a total of 5 pressure ulcers within 16 days. Only the skin erythema score was significantly higher with than without pressure ulcers (p < 0.001). We performed a binary logistic regression analysis and confirmed a significant relationship between pressure-ulcer development and the level of erythema (odds ratio = 1.026; 95% confidence interval: 1.011-1.042). Skin erythema increased before the development of pressure ulcers. Taken together, our results show that the high skin erythema score can be a predictive indicator of pressure ulcers

Development of 3D clinostat synchronized irradiation systems to analyze the combined effects on radiation under simulated microgravity for space biosciences

学位記番号：医博甲1611

Clusters die hard: Time-correlated excitation in the Hamiltonian Mean Field model

The Hamiltonian Mean Field (HMF) model has a low-energy phase where $N$ particles are trapped inside a cluster. Here, we investigate some properties of the trapping/untrapping mechanism of a single particle into/outside the cluster. Since the single particle dynamics of the HMF model resembles the one of a simple pendulum, each particle can be identified as a high-energy particle (HEP) or a low-energy particle (LEP), depending on whether its energy is above or below the separatrix energy. We then define the trapping ratio as the ratio of the number of LEP to the total number of particles and the ``fully-clustered'' and ``excited'' dynamical states as having either no HEP or at least one HEP. We analytically compute the phase-space average of the trapping ratio by using the Boltzmann-Gibbs stable stationary solution of the Vlasov equation associated with the $N \to \infty$ limit of the HMF model. The same quantity, obtained numerically as a time average, is shown to be in very good agreement with the analytical calculation. Another important feature of the dynamical behavior of the system is that the dynamical state changes transitionally: the ``fully-clustered'' and ``excited'' states appear in turn. We find that the distribution of the lifetime of the ``fully-clustered'' state obeys a power law. This means that clusters die hard, and that the excitation of a particle from the cluster is not a Poisson process and might be controlled by some type of collective motion with long memory. Such behavior should not be specific of the HMF model and appear also in systems where {\it itinerancy} among different ``quasi-stationary'' states has been observed. It is also possible that it could mimick the behavior of transient motion in molecular clusters or some observed deterministic features of chemical reactions.Comment: 14 pages, 5 figure

Russian Comfreyの窒素化合物

Russian comfrey の新鮮葉100g 風乾葉10g に水， 10%食塩水， 70% アルコーノレ液， 3.3%苛性ソーダ溶液， 0.3% 苛性ソーダ60% アノレコーノレ液を順次10 倍量宛加え，同じ操作を3回繰返しその合一＊液について窒素を測定した.各種溶剤可溶の窒素総量は全室奈量に対し新鮮葉は60%，風乾葉は47%で稿少ない.また試料の風乾lとより各種溶剤可溶窒素は総量lこ対し， 10%食境水可溶窒素量はその割合を減少するが， 0.3% 苛性ソーダ可溶窒素量はその割合を増加lする.純蛋白質においても同様の傾向がみられる. これは乾燥のため蛋白質に変性をきたしたもので試料保取の時期を異にしても同様な結果を示す.なおアンモニア態，硝酸態，アミノ態，アミド態，ペプチド態窒素をも測定し，特に硝酸と家畜Methemoglobinemia との関係を検討した.The nitrogen content which is soluble in many kinds of solvents, in fresh and dried leaves of Russian comfrey was investigated. Harvest periods of Russian comfrey are in the latter part of May and in the early part of September. Ratios of H 20 and 0.3% NaOH soluble nitrogen are increased and 10% NaCl soluble nitrogen decreased in dried leaves compared to fresh leaves. These tendencies are observed in protein nitrogen fraction of dried leaves. The variation of solubility is considered to be caused by denaturation of protein. NH3-N, N03-N, NH 2-N, Amide-N, and Peptide-N are determined in dried leaves, and some considerations of these nitrogenous compounds, especially nitrate poisoning effect on livestock, are issued

アミノ酸のX線回折

　X線回折による研究は，今日まで無機化合物，粘上鉱物， 岩石鉱物などにおいて多く行われている.有機化合物はその数夥しく，また本来の性質から回折図形が複雑になることが多く， ASTMカードに集録されている数値の数も極めて少ない.しかし同族化合物，関連化合物について必準となる図形や数値が求められているならば，無機化合物と同織に定性分析を，さらに図形の回折によって定量分析を行なうことができる.したがって有機化合物のX線回折による基礎的関形作製はその有機化合物を含有する製品の品質管理や鑑定に資するところが大きいということができる. 本実験は数純のアミノ酸のX 線回折を行ない基礎的図形を作製すると共に，アミノ般を含有する調味料の回折図形について検討したものである

Rhabdomyolysis with Multiple Electrolyte Imbalances under Proton Pump Inhibitor Treatment after Total Thyroidectomy

A 90-year-old man presented with muscle weakness, difficulty concentrating, and dysphagia. About eighteen months prior to presentation, lansoprazole had been initiated to prevent stress ulcers; he also had a history of total thyroidectomy due to papillary thyroid cancer ten years prior. Laboratory findings were as follows: K 2.4 mEq/L, Ca 3.7 mg/dL, Mg 1.3 mg/dL, CK 5386 U/L, and intact PTH (iPTH) 14 pg/mL. Rhabdomyolysis with multiple electrolyte imbalances under proton pump inhibitor (PPI) treatment was diagnosed. We initiated intravenous hydration and electrolyte supplementation with discontinuation of PPI. After discontinuing PPI, the patient’s serum magnesium, potassium, and calcium levels normalised with oral vitamin D and calcium supplementation. PPIs can cause hypocalcaemia and hypokalaemia via hypomagnesemia; hypocalcaemia is also a common postoperative complication of thyroidectomy. Careful monitoring of electrolyte levels is required in patients with long-term PPI treatment, especially in post-thyroidectomy cases

Autonomic Dysreflexia during a Bowel Program in Patients with Cervical Spinal Cord Injury.

The purpose of the present study was to investigate the relationship between bowel maneuvers and autonomic dysreflexia (AD) in patients with cervical spinal cord injuries (CSCI). Fifteen consecutive, clinically stable patients with CSCI participated. We evaluated changes in blood pressure (BP), pulse rate (PR) and classic symptoms of AD before, during and after a bowel program involving the manual removal of stool in lateral recumbency. The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation. Furthermore, the manual removal of stool induced AD, with maximal increases of systolic BP (169.1(+-)19.5 mmHg, mean(+-)SD). However, the insertion of a finger into the anus after the end of stool flow did not cause a further increase in systolic BP. Systolic BP recovered to pre-program values within 5 min after defecation. Our study demonstrated that the combined effects of rectal and/or anal sphincter distension and uninhibited rectal contraction in response to the manual removal of stool might induce AD. We recommend avoiding, if at all possible, the manual removal of stool in order to prevent AD in patients with CSCI

Clinical Efficacy of Capecitabine and Cyclophosphamide (XC) in Patients with Metastatic Breast Cancer

Combined low-dose therapy of oral capecitabine (Xeloda) and cyclophosphamide (XC) has been demonstrated to be useful for long-term control of lesions in patients with metastatic breast cancer (MBC) and is aimed at symptomatic alleviation and prolongation of survival. Here, a retrospective review was conducted of MBC patients administered XC at the Okayama University Hospital (OUH), to evaluate responses to XC, adverse events and time to progression (TTP). Twenty patients with MBC received XC between 2006 and 2009. With the exception of 2 elderly patients who were over the age of 70 at the initial examination, all of the patients had received prior treatment with an anthracycline and/or a taxane. No complete response (CR) cases were observed, but partial response (PR) was achieved in 6 patients (30%) and SD in 9 (45%), of whom 5 (20%) sustained SD status for >12 months. The median TTP was 6 months (range:3-27 mo.). Three patients developed Grade 3 adverse events (diarrhea, nausea and stomatitis), but no other patients developed adverse reactions causing interruption of the therapy. XC was safe even in previously treated and elderly MBC patients;moreover, it yielded remarkable clinical responses