Psycho-physiological Studies for Attendance of the Persons with Wheelchairs (Second Report)

本報では，介助の実際を市街地において行った時の介助者―障害者間の生理心理的負担に ついて検討し，前報に引き続き安全で心地よい車いす介助のあり方を検討することを目的と する。 協力者は，前報同様，障害者４名，健常者10名である。 前報で示した形状の異なる車いすＡ，Ｂを用いた健常者同士（介助者及び介助協力者）の 介助と実際の障害者における介助で，大阪府立大学キャンパスの外周およそ3.5 km を車い すで押してもらった。 介助者，介助協力者及び障害者には，携帯用心拍記録装置を装着させ，介助中の心拍数を 記録した。また，介助前後には，STAI テストを測定した。 介助者の平均心拍数は，いずれの介助協力者の場合でも，車椅子Ａに比べて車椅子Ｂの方 が，高い値を示した。また介助時の心拍数，及び介助時間は，車椅子の形状及び介助協力者 によって，異なる結果を示した。介助前後の状態不安は，介助前に比べて介助後の方が低か った。 介助協力者の心拍数は，車椅子Ａ，Ｂ共に，いずれの協力者においても，介助中の心拍の 変動幅は少なく示された。しかし，協力者によっては，心拍数平均値からみて車椅子Ａより Ｂの方が低値を示した者や，逆に高値を示す者がおり，車椅子の機能や形状によって，介助 協力者の生理反応も異なることが示された。各介助協力者の状態不安は，車椅子Ａ，Ｂ共に 介助協力者間で異なる傾向を示した。 障害者を対象とした車椅子介助時における平均心拍数は，介助経験者に比べ未経験者の方 が有意(p0.05) に高かった。また，障害者の平均心拍数についても，未経験者介助時の方 が有意(p0.05) に高かった。 障害者を介助した時の介助者の状態不安は，介助経験者および未経験者共にいずれも介助 前に比べ介助後に減少し，介助経験による差は認められなかった。障害者の状態不安は，介 助未経験者による介助では介助後に増加し，介助経験者では，減少した。 以上のことから，身体障害者に対する介助経験の差が，介助者と身体障害者のいずれにも 生理心理的影響を及ぼすことが明らかとなった。今後の課題として，車椅子を押す簡単と思 われる介助についても，介助を受ける身体障害者の立場に立った視点での介助経験者の育成 が急務と考えられる。departmental bulletin pape

Studies on children’s lifestyle circumstances and health (First report)

In this first report we aimed to clarify the factors of life environments which affect children’s health. Our subjects were the guardians of 93 elder (6 years-old) male and female preschoolers of K nursery school in Tokyo met. (abbreviated as KNS) and Y nursery school in Yamaguchi pref. (abbreviated as YNS). Questionnaires regarding the life environments of the preschoolers covered 29 items concerning fundamental life habits including their wake-up time, bedtime, and sleeping period, dietary habits, activity habits, and circumstances of playing. In both preschools more than 80％ of preschoolers live with parents, and the number of preschoolers living with only their mothers was less than 15％, therefore no significant difference of family constitution was observed between YNS and KNS. The average wake-up time of preschoolers attending YNS was significantly earlier (p＜0.01) than that of KNS. The average bedtime of KNS was significantly later (p＜0.001) than that of YNS. The average sleeping period of YNS was significantly longer (p＜0.001) than that of KNS. The means of going to school showed much difference between the two schools. The percentage taken by car was greater in YNS than KNS, while the percentages of being taken by bicycle or walking were greater in KNS than YNS. All means of transportation to school had significant difference of rates (p＜0.05) between YNS and KNS. Results of this study clarified that the preschool located in the city area is characterized by life habits such as short sleeping period, late wake-up time and bedtime, and the preschool located in the mountain area is characterized by longer sleeping period, early wake-up time and bedtime. However, the location of playing spaces did not show significant difference, probably because of the social backgrounds including TV games rather than environmental factors. Considering the health of preschoolers, emphasis on physical activities by playing outside and ensuring sufficient sleep are important factorsdepartmental bulletin pape

Association of Plasma Retinol-Binding Protein 4, Adiponectin, and High Molecular Weight Adiponectin with Insulin Resistance in Non-Diabetic Hypertensive Patients

∙The authors have no financial conflicts of interest. Purpose: The aim of this study was to determine whether retinol-binding protein 4 (RBP4), adiponectin and high molecular weight (HMW) adiponectin are associated with insulin resistance (IR) and metabolic parameters in non-diabetic hypertensive patients. Also, we sought to compare the predictive values of these adipocytokines for IR in non-diabetic hypertensive patients. Materials and Methods: Analyses of RBP4, adiponectin, and HMW adiponectin were performed on 308 non-diabetic hypertensives (148 males, age 58 ± 10 years, 189 non-metabolic syndrome and 119 metabolic syndrome). The homeostasis model assessment (HOMA) index for IR, lipid profiles, and anthropometric measure-ments were assessed. Results: There was no significant difference in RBP4 levels according to the presence of metabolic syndrome, although adiponectin and HMW adiponectin were significantly lower in metabolic syndrome. Correlation analysis of log RBP4 with IR and metabolic indices revealed that there was no significant correlation of RBP4 with wais

Development of the Korean Medicine Core Outcome Set for Facial Palsy: herbal medicine treatment of patients with facial palsy in primary clinics

IntroductionFacial palsy (FP) significantly affects the quality of life of patients and poses a treatment challenge in primary healthcare settings. This study aimed to develop a Korean medicine (KM) core outcome set (COS) for FP, with a focus on evaluating the effectiveness of herbal medicine (HM) treatments in KM primary clinics.MethodsOutcomes and effect modifiers related to FP treatments were initially identified through related review articles. Subsequently, experts in the field took part in three rounds of modified Delphi consensus exercises to refine and prioritize these outcomes and effect modifiers. Additionally, primary KM clinicians were involved in a Delphi consensus round to assess the suitability and feasibility of the proposed COS in real-world clinical settings.ResultsThe initial review of related literature identified 44 relevant studies, resulting in an initial selection of 23 outcomes and 10 effect modifiers. The expert consensus process refined these to 8 key outcomes and 6 effect modifiers, which established the foundation of the COS-FP-KM. Subsequently, primary KM clinicians confirmed the practicality and applicability of the COS, endorsing its suitability for use in KM primary clinics.ConclusionThe COS-FP-KM establishes a standardized approach for assessing HM treatment effectiveness in FP patients in KM primary clinics. The COS-FP-KM encourages consistent outcome reporting and enhances patient care quality. Future work should aim to integrate broader stakeholder perspectives to refine and validate the COS further

Effect of FIXed-dose combination of ARb and statin on adherence and risk factor control: The randomized FIXAR study

Background: The efficacy of fixed-dose combinations (FDCs) in improving adherence and risk factor control for cardiovascular disease has not been reported consistently. Here, we compared adherence and efficacy between an olmesartan/rosuvastatin FDC and the usual regimen. Methods: In this 6-month, open-label, randomized, active-control study, we screened 154 patients; of these, 150 were randomly assigned to receive either olmesartan/rosuvastatin FDC or the usual regimen with separate angiotensin receptor blockers and statins. In total, 135 patients completed the study (median age: 68 years; male: 68.9%). The primary outcome was patients’ adherence; the secondary outcomes were changes in blood pressure (BP) and lipid parameters. Results: During follow-up, adherence in both groups was high and similar between the groups (98.9% and 98.3% in the FDC and usual regimen groups, respectively, p = 0.328). Changes in systolic (–8 and –5 mmHg, respectively, p = 0.084) and diastolic BP (–5 and –2 mmHg, p = 0.092) did not differ significantly, although they were numerically greater in the FDC group. Changes in low-density lipoprotein cholesterol (LDL-C) were greater in the FDC group (–13 and –4 mg/dL, respectively, p = 0.019), whereas changes in other lipid parameters were similar between the groups. The test drugs were well tolerated, showing no difference in safety between the groups. Conclusions: Patients’ adherence was excellent and similar in the groups, whereas the reduction in the LDL-C level was greater in the FDC group. We provide comprehensive information on the adherence and efficacy of an FDC compared to the usual regimen in Korean patients with high cardiovascular risk

Dual oxidase 1 and NADPH oxidase 2 exert favorable effects in cervical cancer patients by activating immune response

Background Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived reactive oxygen species (ROS) not only can promote cancer progression, but also they have recently emerged as mediators of the mucosal immune system. However, the roles and clinical relevance of the collective or individual NADPH oxidase (NOX) family genes in cervical cancer have not been studied. Methods We investigated the clinical significance of the NOX family genes using data from 307 patients with cervical cancer obtained from The Cancer Genome Atlas. Bioinformatics and experimental analyses were performed to examine NOX family genes in cervical cancer patients. Results Dual Oxidase1 (DUOX1) and Dual Oxidase 2 (DUOX2) mRNA levels were upregulated 57.9- and 67.5-fold, respectively, in cervical cancer patients. The protein expression of DUOX1, DUOX2, and NOX2 also identified in cervical squamous cell carcinoma tissues. Especially, DUOX1 and DUOX2 mRNA levels were significantly increased in patients infected with human papillomavirus (HPV) 16. Moreover, high DUOX1 mRNA levels were significantly associated with both favorable overall survival and disease-free survival in cervical cancer patients. High NOX2 mRNA levels was significantly associated with favorable overall survival. Gene set enrichment analyses revealed that high DUOX1 and NOX2 expression was significantly correlated with the enrichment of immune pathways related to interferon (IFN)-alpha, IFN-gamma, and natural killer (NK) cell signaling. Cell-type identification by estimating relative subsets of known RNA transcript analyses indicated that the fraction of innate immune cells, including NK cells, monocytes, dendritic cells, and mast cells, was elevated in patients with high DUOX1 expression. Conclusions DUOX1 and NOX2 expression are associated with mucosal immunity activated in cervical squamous cell carcinoma and predicts a favorable prognosis in cervical cancer patients.This work was supported by a grant from Korea Institute of Oriental Medicine (K18123), National Research Foundation of Korea funded by the Korean government (NRF-2017R1C1B1004924) and Bio & Medical Technology Development Program of the National Research Foundation (NRF) & funded by the Korean government (NRF-2019M3E5D1A02068557). The funding bodies had no involvement in the design of the study, collection, analysis, and interpretation of data and in writing the manuscript

Endothelial Nitric Oxide Synthase Glu298Asp Gene Polymorphism is Associated with Hypertensive Response to Exercise in Well-Controlled Hypertensive Patients

PURPOSE: Hypertensive response to exercise (HRE) is known to be an adverse prognostic factor for future cardiovascular events and may be associated to endothelial dysfunction. Previous studies regarding endothelial nitric oxide synthase (eNOS) Glu298Asp polymorphism focused upon its relation to hypertension. In this study, we hypothesize that the polymorphism may be associated with inherent difference in endothelial response to exercise. PATIENTS AND METHODS: Two hundred sixty nine patients who underwent treadmill test were enrolled in this study; 77 patients (mean age 55.8 +/- 9.4 years) had hypertensive response (peak systolic BP of > or = 210 mmHg in men and > or = 190 mmHg in women). Pulse wave velocity (PWV) was measured on 153 patients of them. The Glu298Asp exchange in exon 7 was determined by the methods of single base extension with amplifying primers and probes for TaqMan. RESULTS: The percentages of the GG, GT and TT genotypes were 81.0, 18.6 and 0.4 %, respectively. The presence of GT or TT genotype was independently associated with prevention of HRE when controlled for age, sex, baseline systolic BP and homeostatic model assessment (HOMA) index (OR=0.35, p=0.016). Subgroup analysis showed that preventive effect for HRE of T allele was significant in females (p < 0.001) and patients without insulin resistance (p=0.009). CONCLUSION: In our study, eNOS Glu298Asp polymorphism was significantly associated with HRE. This result suggests that the presence of T allele of the Glu298Asp polymorphism may be a favorable factor to in preventing HRE, especially in female and patients without insulin resistance.ope