特定健診受診者を対象としたメンタルヘルスと睡眠の質及び特定健診測定値の検討

　特定健診・特定保健指導は生活習慣病（糖尿病，脂質異常症，高血圧）の対策として行われているが，メンタルヘルスや睡眠について十分な検討や対策は出来ていない．今回，我々は特定健診受診者の健診結果とメンタルヘルス及び睡眠について詳細を明らかにすることを目的に本研究を行った．本研究への参加を書面にて同意頂いた特定健診受診者76名（女性41名，男性35名）を対象に研究を行った．対象者には健診受診時に日本語版ピッツバーグ睡眠質問票（Pittsburgh Sleep Quality Index, PSQI）及び一般健康調査票（General Health Questionnaire, GHQ）-12 項目版の回答を求めた．調査項目はPSQI とGHQ-12の及び特定健診の測定項目，精神健康の指標World Health Organization Well-being Index （WHO）-5を含む健診問診票の結果を対象とした．PSQI のスコアを6点以上と未満とで分け特定健診測定値を比較した結果は有意差を認めなかった．GHQ-12とPSQI のスコアはSpearman の順位相関係数で有意な相関を認めた （r=0.63, p<0.01）．また，GHQ-12とPSQI の7つの要素と性別及び年齢で多変量解析を用いて検討した結果GHQ-12は睡眠の質 （β=0.32, t=2.96, p<0.01） と日中の眠気 （β=0.37, t=3.93, p<0.01） で有意な関連を示した．GHQ-12の代わりにWHO-5を用いた結果でも同様であった．今回の検討では特定健診受診者において睡眠の状態とメンタルヘルスに相関を認め，特に熟眠感の欠如と日中の眠気がメンタルヘルスにとって重要な症状であることを示唆した．　Specific Health Checkups and Specific Health Guidance are enforced for the prevention of lifestyle-related diseases. However, mental health and sleep condition are not comprehensively considered in this checkup. We conducted the present study to evaluate the relationship of health checkup data with mental health and sleep condition. Seventy six participants (41 women and 35 men) from Specific Health Checkups were enrolled in this study. All participants provided written consent for study participation. They completed the Japanese version of Pittsburgh Sleep Quality Index (PSQI) and 12-item General Health Questionnaire (GHQ-12). In addition, World Health Organization Well-Being Index (WHO)-5 as well as health checkup data were investigated. The values of health checkup data in two groups were not different when the participants were divided by a PSQI of 6. The GHQ-12 value and PSQI score were significantly correlated, as observed using Spearman’s rank correlation coefficient. The relationship with GHQ-12 and seven component scores of the PSQI was assessed by multiple regression analysis. Sleep quality and daytime dysfunction were associated with the GHQ-12 value after adjustment for age and sex. Furthermore, the WHO-5 and PSQI component showed the same results. The present study reveals a significant association between sleep and mental health and suggests that sleep quality and daytime dysfunction are particularly important for mental health

Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report

<p>Abstract</p> <p>Background</p> <p>Robotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation.</p> <p>Methods</p> <p>The study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared.</p> <p>Results</p> <p>The hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit.</p> <p>Conclusions</p> <p>Although the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.</p

The Effect of Enzymatically Polymerised Polyphenols on CD4 Binding and Cytokine Production in Murine Splenocytes

High-molecular weight polymerised polyphenols have been shown to exhibit anti-influenza virus, anti-HIV, and anti-cancer activities. The purpose of this study was to evaluate the immunomodulating activities of enzymatically polymerised polyphenols, and to clarify the underlying mechanisms of their effects. The cytokine-inducing activity of the enzymatically polymerised polyphenols derived from caffeic acid (CA), ferulic acid (FA), and p-coumaric acid (CoA) was investigated using murine splenocytes. Polymerised polyphenols, but not non-polymerised polyphenols, induced cytokine synthesis in murine splenocytes. Polymerised polyphenols induced several cytokines in murine splenocytes, with interferon-γ (IFN-γ) and granulocyte-macrophage colony-stimulating factor (GM-CSF) being the most prominent. The underlying mechanisms of the effects of the polymerised polyphenols were then studied using neutralising antibodies and fluorescent-activated cell sorting (FACS) analysis. Our results show that polymerised polyphenols increased IFN-γ and GM-CSF production in splenocytes. In addition, the anti-CD4 neutralised monoclonal antibody (mAb) inhibited polymerised polyphenol-induced IFN-γ and GM-CSF secretion. Moreover, polymerised polyphenols bound directly to a recombinant CD4 protein, and FACS analysis confirmed that interaction occurs between polymerised polyphenols and CD4 molecules expressed on the cell surface. In this study, we clearly demonstrated that enzymatic polymerisation confers immunoactivating potential to phenylpropanoic acids, and CD4 plays a key role in their cytokine-inducing activity

Site-specific isotope labeling of long RNA for structural and mechanistic studies

A site-specific isotope labeling technique of long RNA molecules was established. This technique is comprised of two simple enzymatic reactions, namely a guanosine transfer reaction of group I self-splicing introns and a ligation with T4 DNA ligase. The trans-acting group I self-splicing intron with its external cofactor, ‘isotopically labeled guanosine 5′-monophosphate’ (5′-GMP), steadily gave a 5′-residue-labeled RNA fragment. This key reaction, in combination with a ligation of 5′-remainder non-labeled sequence, allowed us to prepare a site-specifically labeled RNA molecule in a high yield, and its production was confirmed with 15N NMR spectroscopy. Such a site-specifically labeled RNA molecule can be used to detect a molecular interaction and to probe chemical features of catalytically/structurally important residues with NMR spectroscopy and possibly Raman spectroscopy and mass spectrometry

Three cases of Asymptomatic Gastric Anisakiasis during health check-ups

　本邦での胃アニサキス症の報告例は多く，健康診断（以下：健診）や人間ドック診療において偶然発見される無症候性の胃アニサキス症の報告例も散見される．我々は，当施設の人間ドックで発見された胃アニサキス症３例を経験したので報告する．症例は58歳女性，66歳男性，73歳男性．自覚症状は全例で無症状であった．診断時期は12月から２月の冬季で，全例で検査数日前に鯖，イカ等の魚介類の生ものの摂食歴があった．血液検査所見では，白血球数は全例で正常範囲であり， CRP は２例で軽度の上昇を認めた（0.02 mg/dl，0.41 mg/dl，0.91 mg/dl）．好酸球数は２例で前回値より軽度の上昇を認めた（181/μl から322/μl，379/μl から540/μl）．胃内視鏡所見については，穿入部の発赤，浮腫，びらんを全例で認め，２例で非萎縮粘膜領域に虫体が穿入していた．背景胃粘膜所見は「胃炎の京都分類」で評価すると１例が萎縮やびまん性発赤等の所見のないH. pylori未感染胃相当であり，２例は除菌後の症例（木村・竹本分類：C2 type）であった．過去の報告例と同様，当院で診断した３症例は，全例が無症状で発見され，２例で好酸球数の上昇が認められた．健診・人間ドック診療において胃アニサキス症を検査前に強く疑うことは困難であるが，この疾患を念頭に入れ，無症状であっても十分な問診や内視鏡観察を行うことが重要である．　There are several reports of gastric anisakiasis, and some reports of asymptomatic gastric anisakiasis observed during health check-ups in Japan. We are reporting three cases of gastric anisakis found in health check-up in our hospital. These cases presented in a 58-year-old woman, a 66-year-old man, and a 73-year-old man. All the three cases were asymptomatic in nature. All the cases were observed during the winter season from December to February. The patients consumed fish such as mackerel, tuna, and squid before the examination. White Blood Cell (WBC) counts on blood tests was stable in all cases, whereas two cases exhibited a slight increase in C-reactive Protein (CRP) levels (0.41 mg/dl, 0.91 mg/ dl). Eosinophil count were slightly higher than the previous values in two cases (from 181/μl to 322/μl, and 379/μl to 540/μl). Endoscopic findings in the area invaded by the parasite showed redness, edema, and swelling. In addition to this, parasites penetrated the non-atrophic mucosal area in two cases. According to evaluation by the“Kyoto classification of gastritis”, one case was non-H. pylori infected stomach and 2 cases were post-eradication. All cases depicted asymptomatic gastric anisakiasis in our institutions and two cases indicated an increase in the eosinophil count. Even if it is asymptomatic, the eosinophil count may increase due to the effects of gastric anisakiasis. It is challenging to diagnose gastric anisakiasis before the examination in health check-ups. However, it is imperative to pay attention to this disease and to opt for endoscopic evaluations despite the absence of symptoms