ペグボード課題の運動調整：運搬から挿入における障害物回避動作の分析

Background : Clinical assessment using the pegboard task has been quantitatively evaluated in terms of time required and amount of work, but it has not been qualitatively evaluated from the movement of the upper limb and fingers. The purpose of this study was to clarify the required ability for motion adjustments of the upper limb and fingers when transport-to-insertion task is performed. Methods : A total of 51 healthy volunteers (aged 22.3±3.8) were studied. They performed tasks involving pulling a peg from a near-side hole and inserting it into a far-side hole under three conditions : no obstacle, obstacle on the lateral side, and obstacle on the front side. The motion of upper limb and fingers were measured with a three-dimensional ultrasound motion analyzer, and 15 parameters were measured. Ability of motion adjustment was evaluated by factor analysis of related parameters in each condition. Results : In the no-obstacle condition, the important factors were adjustments of finger motion at transport phase (TP), wrist and finger motion at insertion phase (IP), vertical trajectories, timing and speed of the task. When obstacles were present, in addition to factors that were required in the no-obstacle condition, additional adjustments of the wrist motion at TP and horizontal amplitude were required. Conclusion : In the transport-to-insertion task, different ability of motion adjustment was required depending on the task conditions. The results of this study may provide useful basic data for assessment of dexterity from the qualitative aspect using the pegboard task. 【背景】ペグボードを用いた臨床評価は、作業量や所要時間という量的側面からの評価が多 く、上肢手指の動き方に関する質的側面からは評価されていない。本研究の目的は、ペグ ボード課題（運搬・挿入課題）に要求される上肢手指の運動調整能力を明らかにすること である。 【方法】対象は健常成人ボランティア51名（22.3±3.8歳）とした。課題はペグ１本を手前の ボード穴から抜いて奥のボード穴に挿入することとした。課題条件は、ペグボードを想定 した障害物なし、障害物側方、障害物前方の３条件とした。上肢手指の動きは超音波式三 次元動作解析装置を用いて測定し、15項目の測定値を算出した。測定値の条件間の比較と 因子分析から、各条件で必要とされる運動調整能力を検討した。 【結果】障害物なしの条件では、運搬相の手指による調整、挿入相の手指・手関節による調 整、垂直軌道の調整、タイミングの調整、そして速さの調整が必要であった。障害物があ ると、障害物なしの条件に加え、運搬相の手関節による調整、水平軌道の調整が必要と なった。 【結論】本研究より、運搬・挿入課題は条件により異なる運動調整能力が要求されることが 明らかになった。本研究は、ペグボードを用いて巧緻性の質的側面を評価する際の基礎的 データとして有用である。Thesis of Riho Nakajima / 中嶋 理帆 博士論文 金沢大学医薬保健学総合研究科（保健学専攻

Clinical and genetic aspects of mild hypophosphatasia in Japanese patients

Background: Hypophosphatasia (HPP) is a rare inborn error of metabolism that results from a dysfunctional tissue non-specific alkaline phosphatase enzyme (TNSALP). Although genotype-phenotype correlations have been described in HPP patients, only sparse information is currently available on the genetics of mild type HPP. Methods: We investigated 5 Japanese patients from 3 families with mild HPP (patients 1 and 2 are siblings; patient 4 is a daughter of patient 5) who were referred to Fujita Health University due to the premature loss of deciduous teeth. Physical and dental examinations, and blood, urine and bone density tests were conducted. Genetic analysis of the ALPL gene was performed in all patients with their informed consent. Results: After a detailed interview and examination, we found characteristic symptoms of HPP in some of the study cases. Mobile teeth or the loss of permanent teeth were observed in 2 patients, and 3 out of 5 patients had a history of asthma. The serum ALP levels of all patients were 30% below the lower limit of the age equivalent normal range. ALPL gene analysis revealed compound heterozygous mutations, including Ile395Val and Leu520Argfs in family 1, Val95Met and Gly491Arg in family 2, and a dominant missense mutation (Gly456Arg) in family 3. The 3D-modeling of human TNSALP revealed three mutations (Val95Met, Ile395Val and Gly456Arg) at the homodimer interface. Severe collisions between the side chains were predicted for the Gly456Arg variant. Discussion: One of the characteristic findings of this present study was a high prevalence of coexisting asthma and a high level serum IgE level. These characteristics may account for the fragility of tracheal tissues and a predisposition to asthma in patients with mild HPP. The genotypes of the five mild HPP patients in our present study series included 1) compound heterozygous for severe and hypomorphic mutations, and 2) dominant-negative mutations. All of these mutations were at the homodimer interface, but only the dominant-negative mutation was predicted to cause a severe collision effect between the side chains. This may account for varying mechanisms leading to different effects on TNSALP function

Simple Orchestration Application Framework to Control "Burning Plasma Integrated Code"

We have developed the Simple Orchestration Application Framework (SOAF) on a grid infrastructure to control cooperative and multiple execution of simulation codes on remote computers from a client PC. SOAF enables researchers to generate a scenario of their cooperative and multiple executions by only describing a configuration file which includes the information of execution codes and file flows among them. SOAF does not need substantial modification of the simulation codes. We have applied SOAF to the "Burning Plasma Integrated Code" which consists of various plasma simulation codes. In order to predict and interpret the behavior of fusion burning plasma, it is necessary to cooperatively and concurrently execute various simulation codes to understand complex plasma phenomena with wide temporal and spatial ranges. Those codes exist on distributed heterogeneous computers located in different sites such as universities and institutes. By using SOAF, we succeeded to cooperatively and concurrently execute four plasma simulation codes without substantial modification as described in the configuration file

Reducing variability among treatment machines using knowledge‐based planning for head and neck, pancreatic, and rectal cancer

PURPOSE: This study aimed to assess dosimetric indices of RapidPlan model-based plans for different energies (6, 8, 10, and 15 MV; 6- and 10-MV flattening filter-free), multileaf collimator (MLC) types (Millennium 120, High Definition 120, dual-layer MLC), and disease sites (head and neck, pancreatic, and rectal cancer) and compare these parameters with those of clinical plans. METHODS: RapidPlan models in the Eclipse version 15.6 were used with the data of 28, 42, and 20 patients with head and neck, pancreatic, and rectal cancer, respectively. RapidPlan models of head and neck, pancreatic, and rectal cancer were created for TrueBeam STx (High Definition 120) with 6 MV, TrueBeam STx with 10-MV flattening filter-free, and Clinac iX (Millennium 120) with 15 MV, respectively. The models were used to create volumetric-modulated arc therapy plans for a 10-patient test dataset using all energy and MLC types at all disease sites. The Holm test was used to compare multiple dosimetric indices in different treatment machines and energy types. RESULTS: The dosimetric indices for planning target volume and organs at risk in RapidPlan model-based plans were comparable to those in the clinical plan. Furthermore, no dose difference was observed among the RapidPlan models. The variability among RapidPlan models was consistent regardless of the treatment machines, MLC types, and energy. CONCLUSIONS: Dosimetric indices of RapidPlan model-based plans appear to be comparable to the ones based on clinical plans regardless of energies, MLC types, and disease sites. The results suggest that the RapidPlan model can generate treatment plans independent of the type of treatment machine

Serum Apolipoprotein M Levels are Correlated with Biomarkers of Coagulation

Background:Apolipoprotein M (ApoM) is bound to high-density lipoprotein (HDL) in plasma, and HDL has anticoagulation effects. However, the association between ApoM and biomarkers of coagulation was unclear. Therefore, we investigated relationships between ApoM and biomarkers of coagulation. Methods: Serum samples from 233 Japanese participants including with diabetes mellitus, hypertension, dyslipidemia, or healthy controls were analyzed. Serum ApoM levels were measured using Enzyme-Linked Immuno-Sorbent Assay(ELISA). Results:Analysis of all 233 participants showed that ApoM levels were positively correlated with age (r＝0.284, p＜0.001), total cholesterol (TC;r＝0.477, p＜0.001), HDL-cholesterol (HDL-C;r＝0.234, p＜0.001) and lowdensity lipoprotein cholesterol (LDL-C;r＝0.331, p＜0.001). Higher ApoM levels were correlated with shorter activated partial thromboplastin time(APTT;r＝－0.226,p＝0.001) and prothrombin time(PT,％;r＝0.326,p＜ 0.001). Separate analysis of the 115 healthy controls showed that ApoM levels were positively correlated with age, TC, HDL-C and LDL-C, and higher ApoM levels were correlated with shorter PT. Conclusion:Serum levels of ApoM may influence biomarkers of coagulation

Serum lipoprotein lipase mass: Clinical significance of its measurement

金沢大学大学院医学系研究科Lipoprotein lipase (LPL) is a lipolytic enzyme involved in catalyzing hydrolysis of triglycerides (TG) in chylomicrons and very low-density lipoprotein (VLDL) particles. Over the last decade, increasing attention has been paid to the clinical significance of measuring serum LPL protein mass without heparin injection to the study subjects. In earlier studies, this marker was utilized to classify LPL deficient subjects, which is an extremely rare metabolic disorder with a frequency of one in one million. Later, researchers paid more attention to the clinical significance of measuring this parameter in more common metabolic disorders. Studies have shown that pre-heparin plasma or serum LPL mass has significant relationships with serum lipids and lipoproteins, visceral fat area, insulin resistance, and even the development of coronary atherosclerosis in cross-sectional studies, although this might be a metabolic surrogate marker with almost no catalytic activities, which does not appear to be involved in catalyzing hydrolysis of TG in TG-rich lipoproteins. Recently, a prospective study has demonstrated that low serum LPL concentration predicts future coronary events. Taken together, we suggest that pre-heparin LPL mass in plasma or sera provide us with useful and important information on the development of metabolic disorders leading to atherosclerotic disease. © 2006 Elsevier B.V. All rights reserved

Atherogenic lipoproteins in subclinical hypothyroidism and their relationship with hepatic lipase activity: Response to replacement treatment with levothyroxine

Background: Qualitative lipoprotein changes, such as an increase in fasting remnants, are reported in subclinical hypothyroidism (SCH). It was hypothesized that such changes are due to reduced hepatic lipase (HL) activity in SCH: HL is an enzyme regulated by thyroid hormones, and is involved in the degradation of triglyceride (TG)-rich remnants. This study aimed to quantify remnant-like lipoproteins (RLP), small dense LDL (sdLDL), and HL activity in women with SCH, and to assess these parameters after levothyroxine replacement therapy. Methods: This was an observational cross-sectional study with a subsequent longitudinal follow-up. Findings in women with thyrotropin levels >4.5 mIU/L (SH group) were compared with age- and body mass index (BMI)-matched euthyroid women (control group). In addition, a subgroup analysis was undertaken in SCH women who chose to receive levothyroxine treatment (0.9 μg/kg/day) for 6 months. RLP was quantified by measuring cholesterol (RLP-C) and triglycerides (RLP-TG) after immunoaffinity chromatography, and sdLDL by automated standardized methods; HL activity was measured in post-heparin plasma. Results: The SCH group included 37 women; 29 women were included in the control group. In addition, 22 women with SCH were included in the subgroup analysis (levothyroxine treatment). Significantly higher RLP values were observed in the SCH group than in the control group: RLP-C (median [range], mg/dL): 20.3 (5.8-66.8) versus 10.2 (2.7-36.3), p = 0.005; RLP-TG (mg/dL): 26.3 (3.2-123.3) versus 12.1 (2.5-61.6), p = 0.033. HL activity (mean ± standard deviation [SD], μmol free fatty acid/mL post-heparin plasma.h) - 9.83 ± 4.25 versus 9.92 ± 5.20, p = 0.707 - and sdLDL levels (mg/dL) - 23.1 ± 10.7 versus 22.6 ± 8.4, p = 0.83 - were similar. After levothyroxine, RLP-C decreased - 21.5 (5.8-66.8) versus 17.2 (4.1-45.6), p = 0.023 - and HL increased - 9.75 ± 4.04 versus 11.86 ± 4.58, p = 0.012 - in the subgroup of SCH women. No changes in sdLDL were observed. Conclusions: Women with SCH have higher RLP levels than matched controls do, but their RLP-C levels decrease significantly following levothyroxine therapy. Furthermore, HL activity also increases after levothyroxine therapy and can be interpreted as a possible explanation for the decrease in RLP-C.Fil: Brenta, Gabriela. Unidad Asistencial Doctor César Milstein; ArgentinaFil: Berg, Gabriela Alicia. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Miksztowicz, Verónica Julieta. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lopez, Graciela Ines. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lucero, Diego Martín. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Faingold, María Cristina. Unidad Asistencial Doctor César Milstein; ArgentinaFil: Murakami, Masami. Gunma University Graduate School Of Medicine; JapónFil: Machima, Tetsudo. Gunma University Graduate School Of Medicine; JapónFil: Nakajima, Katsuyuki. Graduate School Of Health Sciences, Gunma University; JapónFil: Schreier, Laura Ester. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Bioquímica Clínica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Regulation of Epithelial Sodium Transport via Epithelial Na+ Channel

Renal epithelial Na+ transport plays an important role in homeostasis of our body fluid content and blood pressure. Further, the Na+ transport in alveolar epithelial cells essentially controls the amount of alveolar fluid that should be kept at an appropriate level for normal gas exchange. The epithelial Na+ transport is generally mediated through two steps: (1) the entry step of Na+ via epithelial Na+ channel (ENaC) at the apical membrane and (2) the extrusion step of Na+ via the Na+, K+-ATPase at the basolateral membrane. In general, the Na+ entry via ENaC is the rate-limiting step. Therefore, the regulation of ENaC plays an essential role in control of blood pressure and normal gas exchange. In this paper, we discuss two major factors in ENaC regulation: (1) activity of individual ENaC and (2) number of ENaC located at the apical membrane