Skin fragility in obese diabetic mice: possible involvement of elevated oxidative stress and upregulation of matrix metalloproteinases.

The purpose of this study was to test the hypothesis that obese diabetic mice exhibit marked skin fragility, which is caused by increased oxidative stress and increased matrix metalloproteinase (MMP) gene expression in the subcutaneous adipose tissue. Scanning electron microscopy of skin samples from Tsumura-Suzuki obese diabetic (TSOD) mice revealed thinner collagen bundles, and decreased density and convolution of the collagen fibres. Furthermore, skin tensile strength measurements confirmed that the dorsal skin of TSOD mice was more fragile to tensile force than that of non-obese mice. The mRNA expressions of heme oxygenase 1 (Hmox1), a marker of oxidative stress, Mmp2 and Mmp14 were increased in the adipose tissue of TSOD mice. Antioxidant experiments were subsequently performed to determine whether the changes in collagen fibres and skin fragility were caused by oxidative stress. Strikingly, oral administration of the antioxidant dl-α-tocopherol acetate (vitamin E) decreased Hmox1, Mmp2 and Mmp14 mRNA expressions, and improved the skin tensile strength and structure of collagen fibres in TSOD mice. These findings suggest that the skin fragility in TSOD mice is associated with dermal collagen damage and weakened tensile strength, and that oxidative stress and MMP overexpression in the subcutaneous adipose tissue may, at least in part, affect dermal fragility via a paracrine pathway. These observations may contribute to novel clinical interventions, such as dietary supplementation with antioxidants or application of skin cream containing antioxidants, which may overcome skin fragility in obese patients with diabetes.

Development of a Daily Life Support System for Elderly Persons with Dementia in the Care Facility.

Taking care for dementia persons with BPSD is burdening on caregivers. To reduce caregivers' burdens and improve dementia persons' quality of life, monitoring and communication intervention system has been proposed. A part of the system, wandering and falling down detection system has been developed. It is designed based on the requirement of the caregivers working in the care facility. Functional test was carried out and had positive impressions from the caregivers.

Development of an upper limb patient simulator for physical therapy exercise.

Physical therapist plays an important role to help people to regain the social life from disease and physical handicap. However, they can obtain their skills only from their practical experiences. The physical therapist trainee can enrich is experience only from the clinical practical training and this opportunity is limited. Therefore, we have been developing the upper limb patient simulator, which reproduce the stiffness of elbow joint to allow trainees to increase the opportunities to obtain the practical exercise of the physical therapy. The system reproduces the diseases by generating stiffness of the elbow joint, when the trainee tries to flex the elbow joint of the patient. We developed a mechanical part and a control system to realize the patient conditions and the full system has been evaluated by veteran physical therapists.

Observation of capillary flow in human skin during tissue compression using CCD video-microscopy.

Recent technological advances of the CCD video-camera have made microscopes more compact and greatly improved their sensitivity. We newly designed a compact capillaroscopy which was composed with a CCD video-probe equipped a contact-type objective lens and illuminator. In the present study, we evaluated usefulness of the instrument for a bed-side human capillaroscopy to observe the capillary flow in various dermal regions. The influences of tissue compression on the dermal capillary blood flow were also investigated to confirm the utility for clinical applications. Our capillaroscopy visualized the nutritional capillary blood flow in almost all parts of skin surface. Our observations showed that a level of vertical stress similar to arterial pressure was required to stop the capillary flow. From these demonstrations the present CCD video-probe based capillaroscopy would be useful for clinical applications as a bed-side human capillaroscopy.

Upper limb neurorehabilitation in patients with stroke using haptic device system: reciprocal bi-articular muscle activities reflect as a result of improved circle-drawing smoothness.

PURPOSE: Muscular co-contraction resulted in corrected elbow and shoulder joint stiffness; however, this correction neither ameliorated endpoint oscillation nor assisted in the execution of smooth two-joint arm movements. We hypothesised that the reacquisition of smooth arm movements became synonymous with the restoration of time-domain reciprocal electromyographic (EMG) activities in biarticular arm muscles. The purpose of this study was to investigate whether or not the restored reciprocal EMG activities in biarticular arm muscles reflected improved smooth motor performance in patients with stroke after 10 days of two-joint arm-movement training. METHODS: Three male patients with sub-acute stroke with left-arm paralysis performed circle-drawing tasks using a haptic device system for upper limb neuromuscular rehabilitation. RESULTS: After the training, the movement velocities and achievement periods increased with the enhancement of the reciprocal EMG activities in biarticular arm muscles, and there was less jerkness in movement after training for the same duration. CONCLUSIONS: Patients with stroke could achieve smooth motor performance with the restoration of the reciprocal EMG activities in biarticular arm muscles. Therefore, the reciprocal EMG activities in biarticular arm muscles in response to circle drawing would be an index for the progressive improvements of smooth motor functions in the upper limbs.

Automatic detection method of muscle fiber movement as revealed by ultrasound images.

The objective of this study was to develop a method of muscle structure measurement based on the automatic analysis of muscle fibers, proximal fascias, and distal aponeurosis movements as revealed by a time-series of ultrasound images. This method was designed to detect changes in the length of muscle fiber movements, and its validity was demonstrated in a time-series of muscle movement, slow ankle dorsiflexion (10 degrees/s), by comparison to manual measurement. The results showed that, when this method was used, the changes in the length of the muscle fiber under slow muscle movement were smaller than those in manual operations by novice individuals. However, with the proposed method, it was possible to obtain a sufficient degree of validity and reliability for the changes in the length of the muscle fiber length compared with those in manual operations, since the correlation coefficients exceeded 0.8 which was tested by the linear regression. The proposed method suggests that automation reduces the errors caused by manual operations and makes the processing of data possible in an acceptable amount of time.

Somatosensory graviception inhibits soleus H-reflex during erect posture in humans as revealed by parabolic flight experiment.

The purpose of this study was to investigate how gravity level affects the excitability of the soleus muscle (SOL) motoneuron pool to Ia afferent input while erect posture is maintained in humans. Three healthy male subjects participated in an experiment whereby three different gravity conditions [microgravity (MG), normal gravity (NG), and hypergravity (HG)] were imposed using a parabolic flight procedure. The SOL H-reflex was evoked every 2 s while the subjects kept an erect posture. The stimulus intensity was controlled automatically on a real-time basis by personal computer to induce the constant amplitude of M-wave (10+/-5% of maximal M-wave amplitude). The background electromyographic activity (BGA) of the SOL was largest during HG, while it was almost absent during MG. The SOL H-reflex amplitude was significantly larger during HG and MG than during NG ( P<0.05). During NG and HG, there was a linear relationship between the BGA and the H-reflex amplitude; the difference in the SOL H-reflex amplitude between both gravity conditions could be explained in terms of the BGA level. However, during MG, despite the absence of BGA, the SOL H-reflex amplitude was larger than that during NG. Furthermore, when the subjects voluntarily activated the SOL by applying a load to the lower limb joints and spine by pulling a handle upward, this H-reflex enhancement almost disappeared. These results suggest that the somatosensory systems detecting a load at the lower limbs and/or vertebral column might play a role in reducing the excitability of the SOL motoneuron pool to Ia afferent inputs by presynaptic inhibition.