一般高齢者の介護予防運動プログラムとその評価指標に関する文献レビュー

目的　 一次予防を目的とした介護予防教室の運動プログラム実施に関する文献をレビューして①プログラムの内容②効果指標の二点について明らかにすることを目的とした。方法　 医中誌web ver.5を使用して、検索された17件について、研究デザイン、参加対象者の属性、プログラム内容と効果・評価指標などについて検討した。結果　 プログラム内容は会場での運動のみ、あるいは自宅での運動課題を組み合わせたものが多く、運動機能の評価指標が多く用いられていた。開催頻度は週5 回～週1 回、評価測定は3 か月ごとに行っているものが多かった。教室の効果として、運動機能の向上、活動・運動量の拡大・増加、身体的状態・自覚症状の維持・改善が多くみられた。結論　 評価指標としてTUG、開眼片足立ち、握力が多く用いられ、他の取り組みとの比較による評価にも有用であること、運動機能の向上のためには、週1回以上の実施、あるいは自宅での毎日の運動の実施が望ましいことが示された。介護予防の視点を念頭に置き、運動機能に加えて、認知機能の評価、栄養状態の評価などを選択して用いていく必要性が示された

Anterior meniscus extrusion is associated with anterior tibial osteophyte width in knee osteoarthritis – The Bunkyo Health Study

Background: In knee osteoarthritis (OA), medial meniscus extrudes both medially and anteriorly. We reported that full-length width of medial tibial osteophyte, which comprises cartilage and bone parts, is directly associated with medial meniscus extrusion in early-stage knee OA and hypothesized that anterior tibial osteophyte (ATO) is also associated with anterior meniscus extrusion (AME). Thus, we aimed to examine their prevalence and relationship. Methods: Elderly subjects (638 females and 507 males; average 72.9 years old) in the Bunkyo Health Study cohort were enrolled. MRI-detected OA changes were evaluated according to the Whole Organ Magnetic Resonance Imaging Score. ATO was evaluated using the method which can assess both cartilage and bone parts of osteophyte by pseudo-coloring images of proton density-weighted fat-suppressed MRI. Results: Most subjects showed the Kellgren-Lawrence grade 1/2 of the medial knee OA (88.1%), AME (94.3%, 3.7 ​± ​2.2 ​mm), and ATO (99.6%, 4.2 ​± ​1.5 ​mm). Among the OA changes, AME was most closely associated with full-length width of ATO (multivariable β ​= ​0.877, p ​< ​0.001). The area under the receiver operating characteristic curve for determining the presence of AME as evaluated by ATO width was 0.75 (95% confidence interval 0.60–0.84, p ​< ​0.001). The odds ratio for the presence of AME as evaluated by ATO width at 2.9 ​mm was 7.16 (4.23–12.15, p ​< ​0.001, age, gender, BMI, and K-L adjusted). Conclusions: AME and ATO were inevitably observed in the elderly subjects and AME was closely associated with full-length width of ATO. Our study provides the first evidence on the close relationship between AME and ATO in knee OA

Medial meniscus extrusion is invariably observed and consistent with tibial osteophyte width in elderly populations: The Bunkyo Health Study

Abstract We reported that the full-length width of medial tibial osteophytes comprising cartilage and bone parts correlates with medial meniscus extrusion (MME) in early-stage knee osteoarthritis (OA). However, no data exist on the prevalence of MME and its relationship with osteophytes in the elderly population. 1191 elderly individuals (females 57%; 72.9 years old on average) in the Bunkyo Health Study underwent standing plain radiograph and proton density-weighted MRI on knee joints. MRI-detected OA changes were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. A new method of assessing the cartilage and bone parts of osteophytes was developed using pseudo-coloring images of proton density-weighted fat-suppressed MRI. Most subjects showed Kellgren-Lawrence grade 1 or 2 radiographic medial knee OA (88.1%), MME (98.7%, 3.90 ± 2.01 mm), and medial tibial osteophytes (99.3%, 3.27 ± 1.50 mm). Regarding OA changes, MME was closely associated with the full-length width of medial tibial osteophytes (β = 1.114; 95% CI 1.069–1.159; p < 0.001) in line with osteophyte width (intraclass correlation coefficient, 0.804; 95% CI 0.783–0.823). Our data revealed that MME and medial tibial osteophytes are observed in the elderly and demonstrate that the degree of MME is consistent with the full-length width of medial tibial osteophytes, suggesting that osteophytes might be implicated in MME

Combined effects of exercise training and D‐allulose intake on endurance capacity in mice

Abstract This study investigated the combined effects of exercise training and D‐allulose intake on endurance capacity in mice. Male C57BL/6J mice were fed either a control diet (Con) or a 3% D‐allulose diet (Allu) and further divided into the sedentary (Sed) or exercise training (Ex) groups (Con‐Sed, Con‐Ex, Allu‐Sed, Allu‐Ex, respectively; n = 6–7/group). The mice in the Ex groups were trained on a motor‐driven treadmill 5 days/week for 4 weeks (15–18 m/min, 60 min). After the exercise training period, all mice underwent an exhaustive running test to assess their endurance capacity. At 48 h after the running test, the mice in the Ex groups were subjected to run at 18 m/min for 60 min again. Then the gastrocnemius muscle and liver were sampled immediately after the exercise bout. The running time until exhaustion tended to be higher in the Allu‐Ex than in the Con‐Ex group (p = 0.08). The muscle glycogen content was significantly lower in the Con‐Ex than in the Con‐Sed group and was significantly higher in the Allu‐Ex than in the Con‐Ex group (p < 0.05). Moreover, exercise training increased the phosphorylation levels of adenosine monophosphate‐activated protein kinase (AMPK) in the muscle and liver. The phosphorylation levels of acetyl coenzyme A carboxylase (ACC), a downstream of AMPK, in the muscle and liver were significantly higher in the Allu‐Ex than in the Con‐Sed group (p < 0.05), suggesting that the combination of exercise training and D‐allulose might have activated the AMPK‐ACC signaling pathway, which is associated with fatty acid oxidation in the muscle and liver. Taken together, our data suggested the combination of exercise training and D‐allulose intake as an effective strategy to upregulate endurance capacity in mice. This may be associated with sparing glycogen content and enhancing activation of AMPK‐ACC signaling in the skeletal muscle

Corneal Regeneration by Deep Anterior Lamellar Keratoplasty (DALK) Using Decellularized Corneal Matrix.

The purpose of this study is to demonstrate the feasibility of DALK using a decellularized corneal matrix obtained by HHP methodology. Porcine corneas were hydrostatically pressurized at 980 MPa at 10°C for 10 minutes to destroy the cells, followed by washing with EGM-2 medium to remove the cell debris. The HHP-treated corneas were stained with H-E to assess the efficacy of decellularization. The decellularized corneal matrix of 300 μm thickness and 6.0 mm diameter was transplanted onto a 6.0 mm diameter keratectomy wound. The time course of regeneration on the decellularized corneal matrix was evaluated by haze grading score, fluorescein staining, and immunohistochemistry. H-E staining revealed that no cell nuclei were observed in the decellularized corneal matrix. The decellularized corneal matrices were opaque immediately after transplantation, but became completely transparent after 4 months. Fluorescein staining revealed that initial migration of epithelial cells over the grafts was slow, taking 3 months to completely cover the implant. Histological sections revealed that the implanted decellularized corneal matrix was completely integrated with the receptive rabbit cornea, and keratocytes infiltrated into the decellularized corneal matrix 6 months after transplantation. No inflammatory cells such as macrophages, or neovascularization, were observed during the implantation period. The decellularized corneal matrix improved corneal transparency, and remodelled the graft after being transplanted, demonstrating that the matrix obtained by HHP was a useful graft for corneal tissue regeneration