Relationship between progressive improvement in gait ability one year after discharge and skeletal muscle characteristics of stroke survivors.

BACKGROUND: The clinical importance of skeletal muscle characteristics for improving gait ability of stroke survivors is increasing. We aimed to examine the association between muscle quantity and quality at discharge and changes in gait independence at the time of 1 year after discharge in patients with stroke. METHODS: This prospective observational study included 100 patients with stroke who were admitted to a convalescent rehabilitation ward. We defined muscle quantity and quality operationally as muscle thickness and echo intensity observed in ultrasonography images, respectively, and measured quadriceps muscle on the paretic and non-paretic sides at the time of discharge. The outcome measured in our study was changes in gait independence 1 year after discharge, as assessed by the Functional Independence Measure gait assessment tool score. RESULTS: Among the study participants, 23 (23.0 %) were assessed to have reduced gait independence, while 77 (77.0 %) were evaluated to have improved or maintained gait independence. Our multivariate logistic regression analysis revealed that only muscle quantity on the paretic side was significantly associated with an improvement or maintenance of gait independence (odds ratios 3.32; 95 % confidence interval 1.01-10.95; p = 0.049). CONCLUSIONS: Our findings revealed that an improvement in gait independence 1 year after discharge was influenced by quadriceps muscle quantity on the paretic side at the time of discharge in patients with subacute stroke. This finding highlights the importance of lower limb muscle quantity on the paretic side as a clinically significant factor that influences the improvement in gait ability after hospital discharge.

[Survey on healthcare provider awareness of cosmetic therapy for older adults of in-and-out geriatric hospital departments].

AIM: This study aimed to determine the perceptions among healthcare providers of the clinical need for cosmetic therapy among older adults. METHODS: A questionnaire was distributed to 190 medical staff regarding their perceptions of cosmetic therapy for older adults. The survey included questions on occupation, sex, age, cosmetic therapy in older adults, and acceptable cosmetic treatments. Nurses answered questions regarding the type of ward in which they worked. RESULTS: Completed questionnaires were collected from 121 people (mean age 33.3±9.4; men n=42). The participants included nurses (n=55), physical therapists (n=25), occupational therapists (n=15), and other occupations (n=26). Most participants believed that makeup improves the quality of life of older adults; however, many participants first became aware of the existence of cosmetic therapy through this survey. Half of the participants were interested in participating in cosmetic therapy, and a high number of women and nurses were interested. Most cosmetic treatments were acceptable to those caring for outpatients, while those caring for hospitalized patients showed low acceptance rates for treatments other than skin care. The acceptance rates tended to be particularly high for participants who worked in rehabilitation wards. CONCLUSION: Many participants believed cosmetic therapy to be effective in improving the quality of life; however, only about half of all subjects were interested in participating in cosmetic therapy. The acceptance rate of cosmetic treatments differed by work environment. This study provided valuable data contributing to the spread of cosmetic therapy.

Evaluation of the physical properties of a newly developed denture adhesive for patients with dry mouth.

PURPOSE: Elderly individuals with dry mouth wearing dentures require an appropriate denture adhesive. The purpose of this study was to evaluate the in vitro properties of a newly developed denture adhesive for patients with dry mouth and compare these with those of a currently available adhesive and oral moisturizing agent. METHODS: We developed a new gel-type denture adhesive with physical properties suitable for patients with dry mouth (DM). We subsequently performed in vitro comparisons among DM, New Poligrip (NP), and Biotene Oralbalance Gel (BT) with regard to the following properties: retention force, resistance to squeezing, and ease of removal. In accordance with the standards of the International Organization for Standardization (ISO10873:2010), the retention force was measured for dry samples (no water exposure, severe dry mouth model) and for samples exposed to water for 10min (normal model) and 1min (moderate dry mouth model). The resistance to squeezing was evaluated by pushing the samples out of syringes, while the ease of removal was evaluated by measuring the time required to wash the material from a polymethyl methacrylate plate. RESULTS: In the severe dry mouth model, DM exhibited greater retention force than did NP and BT. Moreover, the resistance to squeezing was significantly lower for DM than for NP. Both BT and DM showed better ease of removal than did NP. NP was the most difficult to wash out with water. CONCLUSIONS: Our findings suggest that the newly developed denture adhesive DM is suitable for use in patients with dry mouth.

A new oral care gel to prevent aspiration during oral care.

AIM: Although oral care is important in the prevention of aspiration pneumonia, the different institutions and practitioners employ various oral care methods, some of which are associated with the risk of aspiration. We have developed a new gel with the physical properties needed for waterless oral care. In the present study, we evaluated and investigated the properties and effectiveness of this gel. METHODS: The physical properties of the trial gel and commercial moisturizing gels were compared using a VAS scale. The effects of plaque elimination were evaluated in healthy volunteers. Brushing was carried out by a dental hygienist using the gel and water. The number of throat suctions performed during brushing was also counted, and the difference was evaluated. RESULTS: In the evaluation of physical characteristics, trial Gel B showed a significantly higher rating than the other gels. In plaque elimination, the rate of decrease in a modified PCR was significantly greater with the gel trial. Suctioning was also performed significantly fewer times with the trial gel. CONCLUSIONS: Good results were obtained with the newly developed trial Gel B with regard to the physical properties and the sensory evaluations. Its effectiveness was also confirmed in plaque elimination and in the evaluated risk of aspiration. The use of Gel B may have the potential to decrease the risk of aspiration during oral care and reduce the occurrence of aspiration pneumonia.

Function of desiccate in gustatory sensilla of drosophila melanogaster.

Desiccate (Desi), initially discovered as a gene expressing in the epidermis of Drosophila larvae for protection from desiccation stress, was recently found to be robustly expressed in the adult labellum; however, the function, as well as precise expression sites, was unknown. Here, we found that Desi is expressed in two different types of non-neuronal cells of the labellum, the epidermis and thecogen accessory cells. Labellar Desi expression was significantly elevated under arid conditions, accompanied by an increase in water ingestion by adults. Desi overexpression also promoted water ingestion. In contrast, a knockdown of Desi expression reduced feeding as well as water ingestion due to a drastic decrease in the gustatory sensillar sensitivity for all tested tastants. These results indicate that Desi helps protect insects from desiccation damage by not only preventing dehydration through the integument but also accelerating water ingestion via elevated taste sensitivities of the sensilla.

Interaction effects between rehabilitation and discharge destination on inpatients' functional abilities.

A patient's functional ability after hospital discharge may be influenced by in-hospital rehabilitation and discharge destination. However, we know very little about how in-hospital rehabilitation intervention interacts with the type of discharge destination or how this interaction influences patients' functional abilities. Thus, how an interaction between in-hospital rehabilitation and discharge destination influences a patient's subsequent functional ability was examined. This was a cross-sectional study whose participants were inpatients who underwent rehabilitation between February 2008 and December 2010 at a hospital in Japan (n = 835). Participants were categorized into three condition groups (i.e., stroke, orthopedic, disuse syndrome). Then, interaction effects between the rehabilitation therapy and the type of discharge destination on a patient's subsequent functional ability were estimated by hierarchical linear regression analysis in each of the three subgroups. In models where the dependent variable was Functional Independence Measure (FIM) score at 3 mo after hospital discharge, a significant interaction between rehabilitation potential (a measure based on the FIM effectiveness measure) and discharge destination (home or other) was observed in the stroke and orthopedic patients (both p < 0.001). These findings may be useful in deciding on discharge destinations for patients.

Psychiatrist characteristics related to patient outcome in Japan.

We evaluated psychiatric care in terms of the relationship between patient outcome (length of stay, Global Assessment of Functioning (GAF) at discharge, GAF difference, and GAF change per day) and psychiatrist characteristics (gender and years in psychiatric practice) in patients with schizophrenia, schizotypal, or delusional disorders (ICD-10 codes F20-F29) and in those with mood disorders (ICD-10 codes F30-F39). The sample consisted of inpatients discharged from an institute in Japan between April 2007 and March 2008. Multivariate analyses were performed to identify patient and psychiatrist characteristics related to outcome. We found that psychiatrist characteristics, such as gender and years in practice, were associated with GAF-related outcomes in patients in the F20-F29 and F30-F39 code groups (P < 0.05, P < 0.001, respectively). Patient characteristics and clinical factors such as GAF at admission, ward type, arrival by ambulance, admission type, seclusion, restraint, diagnosis, and patient age, were associated with outcome in both diagnostic groups. These findings show that gender and years in psychiatric practice had a significant effect on psychiatric patient outcome. Further studies in multiple institutes using a follow-up design are necessary to verify these findings.

Identification of Ca2+-dependent calmodulin-binding proteins in rat spermatogenic cells as complexes of the heat-shock proteins.

Ca2+-calmodulin (CaM)-binding proteins in rat testes were characterized by assays for CaM-binding activity using the CaM-overlay method on transblots of electrophoresed gels and purification by gel-filtration, ion exchange, and adsorption chromatographies. A major CaM-binding protein complex (CaMBP) was identified and found to be comprised of three proteins with molecular masses 110, 100, and 70 kDa. Amino acid sequence analyses of lysylendopeptidase digests from these proteins indicated that all of the constituents of CaMBP are very similar to the members of the heat-shock protein family, i.e., the 110-kDa protein is similar to the APG-2/94 kDa rat ischemia-responsive protein, the 100-kDa protein is similar to the rat counterpart of the mouse APG-1/94 kDa osmotic stress protein, and the 70-kDa protein is similar to the rat testis-specific major heat-shock protein (HSP70). Immunohistochemistry using anti-CaMBP and anti-CaM antibodies demonstrated that CaMBP was co-localized with CaM in the cytoplasm of pachytene spermatocytes and nuclei of round spermatids. In addition, CaMBP, but not CaM, was localized at a high level in the residual bodies of elongated spermatids. The possible relevance of CaMBP to regulation of cell cycle progression and spermatogenesis is discussed in this paper.

Heart formative factor(s) is localized in the anterior endoderm of early Xenopus neurula.

To elucidate the mechanisms of early heart morphogenesis in Xenopus laevis, we examined the effect of endoderm on heart morphogenesis in the early Xenopus neurula. Explants of anterior ventral (presumptive heart) mesoderm from early neurula were cultured alone or in combination with endoderm dissected from various regions. Heart formation was scored by an original heart index based on morphology. These explant studies revealed that anterior ventral endoderm plays a critical role in heart morphogenesis. Furthermore, we found that it was possible to confer this heart-forming ability on posterior ventral endoderm by the injection of poly(A)+ RNA from stage 13 anterior endoderm. These results imply that the heart formative factor(s) is localized in the anterior endoderm of the early neurula and that at least part of this activity is encoded by mRNA(s).

Immunoelectron Microscopic Localization of Sperm-specific Nuclear Basic Proteins during Spermatogenesis in Anuran Amphibians: (Immuno-electron microscopy/Protamines/Spermatogenesis/Anuran amphibians).

Antisera were raised in rabbits against sperm-specific nuclear basic proteins (SPs) of Bufo japonicus and Xenopus laevis. The localizations of these proteins in spermatogenic cells were then studied by electron microscopy with colloidal gold labeled antibodies as probes. The numbers of gold particles counted on ultra-thin sections of cells at various spermatogenic stages were corrected for the density per unit area, on the basis of areas determined with a digitizer. No grains were deposited during early nuclear elongation stages. Grains appeared on nuclei at the beginning of chromatin granulation, and their density increased first gradually and then sharply at the last step of spermiogenesis. Recalculation of grain counts according to the estimated nuclear volumes of Bufo spermatogenic cells also indicated a sharp increase in the amount of SPs per nucleus in the last step of spermiogenesis. No significant localization of grains in the cytoplasm was observed at any stage of spermatogenesis.