Juntendo Iji Zasshi最新文献

Objectives: Infants with fetal growth restriction (FGR) are at a risk of developing metabolic syndromes in adulthood. We hypothesized that skeletal muscle degeneration by nutrition-restricted FGR results in abnormal insulin signaling and epigenetic changes.

Material and methods: To develop a protein-restricted FGR model, rats were fed a low-protein diet (7% protein) during the gestational period; rats fed a normal diet (20% protein) were used as controls. At 8 and 12 weeks of age, the pups were subjected to oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) to evaluate insulin resistance. At 12 weeks, the mRNA and protein levels of insulin signaling pathway molecules in the skeletal muscles were examined. DNA methylation of promoters was detected. DNA extracted from skeletal muscles was used as a template for methylation-specific PCR analysis of GLUT4.

Results: The body weight of FGR rats from birth to 8 weeks was significantly lower than that of the controls; no significant difference was observed between the groups at 12 weeks. In the OGTT and ITT, the incremental area under the curve (iAUC) was significantly higher in FGR rats than in the controls at 12 weeks. The mRNA and protein levels of Akt2 and GLUT4 in the plantar muscles were significantly lower in FGR rats than in the controls. GLUT4 methylation was comparable between the groups.

Conclusions: Protein-restricted FGR rats showed insulin resistance and altered insulin signaling in skeletal muscles after 12 weeks. However, we could not demonstrate the involvement of DNA methylation in this model.

Neutrophils serve as the frontline defenders in the host's response to infections. However, the available methods for assessing the activated status of neutrophils are still limited. The immature cells that appear during sepsis are large with complex cytoplasmic components and rich nucleic acids, making them diagnosable by cell population data analysis using the automated cell counter. The changes are expressed as increased forward scattered light, side fluorescence light, and side fluorescence distribution width. Additionally, changes in side fluorescence light may indicate the neutrophil extracellular trap formation and can be useful for the diagnosis of sepsis-associated disseminated intravascular coagulation.

Dementia is one of the most significant global challenges in medical and social care in the 21st century. It affects not only the patients themselves, but also their families, caregivers, and society in general, causing physical, psychological, and socioeconomic effects. As of 2020, there are approximately 6 million people in Japan aged 65 or older with dementia, and this number is expected to increase to around 7 million by 2025, meaning that one out of every five elderly people will have dementia. To prevent the onset and progression of dementia, it is crucial to have a proper understanding of its risks and adopt a healthy lifestyle. Leading an active life from an early stage can also aid in delaying or preventing the onset of dementia. Livingston has identified 12 risks that can lead to dementia, including physical inactivity, smoking, excessive alcohol consumption, air pollution, head injury, social isolation, poor educational history, obesity, hypertension, diabetes, depression, and hearing loss. Modifying one's lifestyle and leading an active life can be crucial in reducing these risks. The Mediterranean diet is gaining attention as a good practice for dementia prevention due to its diversity, richness in omega-3 fatty acids and vitamins. Exercise has been shown to prevent dementia on biological, behavioral, and socio-psychological levels. Repetitive transcranial magnetic stimulation is a non-invasive brain stimulation method that can alter brain plasticity and is being studied for clinical applications as a non-drug therapy for preventing dementia progression.

The glycocalyx serves as the covering layer of the luminal surface of vascular endothelial cells, comprising proteoglycans, glycosaminoglycans, and adherent plasma proteins. This intricate structure is crucial in promoting antithrombogenicity, controlling vascular permeability, regulating vascular tone, and managing leukocyte/platelet adhesion. However, during sepsis, the glycocalyx undergoes significant degradation through inflammatory mechanisms; this process can be further facilitated by treatment for sepsis and septic shock. Therefore, it is crucial to exercise careful management to avoid damage to the glycocalyx during sepsis treatment.

Sepsis is frequently associated with disseminated intravascular coagulation (DIC) and multiple organ damage. It is widely accepted that DIC is not merely a complication but also plays a role in the development of organ dysfunction. Thrombus formation in the microvasculature leads to impaired tissue perfusion and organ damage. Activated neutrophils interacting with platelets, endothelial injury, and an imbalance of coagulation and fibrinolysis are the essence of thromboinflammation induced in sepsis-associated DIC. The above mechanisms are typically seen in sepsis-associated acute kidney injury (AKI), and the development of AKI is known to be strongly associated with the severity of sepsis. It is important to recognize the pathway of this mechanism in the context of sepsis management.

Objectives: This study presents the multifaceted effects of candidate loci identified by genome-wide association studies on parameters such as educational background and the clinical symptoms of Japanese patients with schizophrenia along with detailed psychological measurements. This study aimed to investigate whether gene mutations that affect cognitive dysfunction are (1) related to the onset of schizophrenia and (2) also affect cognitive dysfunction in patients with schizophrenia.

Design: Case-control study.

Methods: This study evaluated 12 single-nucleotide polymorphisms (SNPs) (rs10189857, rs2175263, rs9398171, rs12670234, rs6466056, rs11156875, rs2018916, rs11663602, rs11885093, rs9404453, rs2473938, and rs4275659) that are common in Japanese individuals and demonstrated a relationship with schizophrenia and educational attainment in a previous genome-wide study. We included 640 Japanese patients (schizophrenia group) and 640 healthy participants (control group). Both groups were investigated for the relationship between the SNPs and educational attainment as well as psychometric evaluations of cognitive function.

Results: The 12 SNPs were not identified as genetic risk factors for schizophrenia. However, rs9404453 was associated with a decline in educational achievement, educational performance, Japanese Adult Reading Test (JART100) score, and Wechsler Adult Intelligence Scale-Revised (WAIS-R) (full-scale intelligence quotient [FSIQ]) score in patients with schizophrenia, SNP rs6466056 was associated with a decline in the WAIS-R (FSIQ) score, and SNP rs11663602 was associated with a decline in the JART100 score.

Conclusion: The SNPs rs9404453, rs6466056, and rs11663602 may be associated with academic performance or cognitive decline in patients with schizophrenia, although the overall findings from psychological tests did not show the expected consistency.

Objective: In Japan, there is an urgent need to strengthen efforts to retain nurses and prevent high turnover. The Japan Nurses Association has set the goal of creating a supportive work environment for nurses to work with peace of mind and improve outcomes throughout their lives. Against this background, we examined the relationship between nurses' health and productivity management and their work engagement (WE) in Japanese hospital organizations.

Design: A cross-sectional design was used.

Methods: A web-based survey was administered to full-time employed nurses working in Japanese hospitals with 100 or more beds.

Results: Total WE scores were analyzed as the objective variable; WE crude odds ratios (ORs) were significantly higher in the high group than in the low group for all indicator items related to a healthy workplace culture. For adjusted ORs, propensity scores were calculated from gender, age, years of service, years of experience, job title, marital status, work shift, frequency of exercise per week, and hours worked per week and used as moderator variables. The results showed that the adjusted ORs for the high group were significantly higher than the adjusted ORs for the low group for all items except "participation of the person in charge from the planning stage of the initiative" and "reflection of the person in charge's opinion in the planning of the initiative."

Conclusions: This study suggests that health and productivity management initiatives in hospital organizations may positively impact nurses' WE. Furthermore, it suggests that these initiatives may contribute to improving nurse retention and preventing turnover.

Objectives: This study aimed to investigate Japan's service sector employees to determine whether employee creativity is associated with the provision of a fitness program (that encourages employees to perform physical exercise) or a health and productivity management (H&PM) program at the workplace.

Design: This was a cross-sectional study.

Methods: A nationwide online survey was conducted using stratified sampling. Data were obtained for respondents' demographic characteristics, subjective health, exercise frequency, and organizational wellness support. Workplace creativity, psychological safety, and leadership were evaluated using standardized scales. A binary logistic regression was performed to examine the relationship between organizational wellness support programs and workplace creativity.

Results: Respondents were 1,955 full-time employees in private-sector organizations (979 men and 976 women; mean age 40.30 ± 10.85). Workplace creativity was significantly more likely respondents whose employers provided a fitness program (adjusted OR = 1.86, 95% CI = 1.39-2.48, p<.001) or an H&PM program (adjusted OR = 2.07, 95% CI = 1.53-2.80, p<.001). Furthermore, workplace creativity was significantly more likely in employees who perceived themselves as rather healthy or healthy. Employees who exercised frequently over the past year were more likely to display creativity than those never exercised.

Conclusions: Workplace creativity was associated with good subjective health, high exercise frequency, and organizational wellness support programs offered by employers. Human resource management for employees' fitness and health is crucial for cultivating the productivity and innovation necessary for business success.

Objective: Due to the lack of information on the effects of nutritional guidance focused on leucine intake in patients undergoing maintenance cardiac rehabilitation, this study investigated on plasma leucine concentrations, lean body mass, and muscle strength.

Methods: Nutritional guidance, focused on leucine (intervention group) or general nutritional guidance (control group), was provided for six months to patients participating in cardiac rehabilitation. Body composition, grip strength, hematological test results, and diet of both groups were compared before and after the intervention.

Results: Seven patients in the intervention group (53.2 ± 18.2 years) and 7 patients in the control group (58.6 ± 15.3 years) were included. Dietary survey results showed that the six-month intervention significantly (p < 0.05) increased protein intake and estimated leucine intake only in the intervention group. There was no significant difference in the rate of change in plasma leucine concentration between the two groups. The rate of change in lean body mass was significantly higher in the intervention group compared to the control group (p = 0.035). The rate of change in plasma leucine concentration and that in lean body mass was positively correlated only in the intervention group (r = 0.777, p = 0.040), and the rate of change in plasma leucine concentration was also positively correlated with the rate of change in grip strength (ρ = 0.857, p = 0.014).

Conclusions: In the patients undergoing maintenance cardiac rehabilitation, increased plasma leucine concentration by nutritional guidance focused on leucine increased lean body mass without any increasing the training load.

Daily health management and exercise are important for staying healthy and avoiding the need for long-term care. However, it is not easy to maintain regular exercise. Therefore, exercise needs to be done efficiently. In recent years, due to the aging population and increasing severity of illness, older patients often experience a significant decline in physical function, even with minimal rest, which often interferes with their daily life after discharge from the hospital. Frailty not only affects ADLs, but also strongly influences prognosis, including the development of atherosclerotic disease and rehospitalization. This perspective is a summary of the 51st Metropolitan Public Lecture held on June 17, 2023, and discusses exercise-based rehabilitation programs that can be delivered at home to prevent physical frailty and avoid hospitalization-related disability.