Risk factors for heavy burden among family caregivers in a rural town in Hokkaido

OBJECTIVE: The present study was conducted in order to investigate risk factors for heavy burden of family caregivers. STUDY DESIGN: Cross-sectional study. PARTICIPANTS: 51 pairs of the frail elderly and their family caregivers in one town in Hokkaido. RESULTS: Compared to those with a lighter burden, family caregivers with heavier burden looked after the frail elderly with more behavior disturbances due to dementia. They cared for the elderly longer and had less time to go out without accompanying their charges than less burdened caregivers. On the other hand, the elderly had similar activities of daily living and degree of need of care between the two groups. In addition, physical caring time did not differ between the two groups. These findings suggest that the psychological burden may be more important than the physical burden. In addition, caregivers used only 30-40% of services they had the right to use with long-term care insurance. These findings suggest that more convenient services for users should be provided.     

Induction of hepatitis B virus surface antigen‐specific cytotoxic T lymphocytes can be up‐regulated by the inhibition of indoleamine 2, 3‐dioxygenase activity

Cytotoxic T lymphocytes (CTLs) are thought to be major effectors involved in viral clearance during acute infections, including hepatitis B virus (HBV) infection. A persistent HBV infection is characterized by a lack of or a weak CTL response to HBV, which may be reflective of tolerance to HBV. Efficient induction of HBV‐specific CTLs leads to the clearance of HBV in patients with a chronic HBV infection. Previously, we reported that α‐galactosylceramide (α‐GalCer), a specific natural killer T (NKT) cell agonist, enhanced the induction of HBV surface antigen (HBsAg)‐specific CTLs. In the present study, we found that inhibition of indoleamine 2,3‐dioxygenase (IDO) activity enhanced the induction of HBsAg‐specific CTLs after immunization with HBsAg and α‐GalCer. The administration of HBsAg and α‐GalCer increased the production of interleukin‐2 and interleukin‐12b, which are crucial for the induction of HBsAg‐specific CTLs. The production of these cytokines was more strongly enhanced in IDO knockout mice compared with wild‐type mice. In addition, α‐GalCer induced the production of IDO in CD11b⁺ cells, and these cells inhibited proliferation of HBsAg‐specific CTLs. Our results lead to strategies for improving the induction of HBsAg‐specific CTLs.     

Teeth clenching reduces arm abduction force

It has been reported that the 90° arm abduction force counteracting external adduction loads appeared to be smaller under teeth clenching condition than under non-clenching condition. To elucidate the physiological mechanism underlying the possible inhibitory effect of teeth clenching on the arm abduction, we have attempted to quantify the difference in the force induced against the fast and slow ramp load between the arm abductions under teeth non-clenching and clenching conditions. When the load of adduction moment was linearly increased, the abductor force increased to a maximal isometric contraction force (MICF) and further increased to a maximal eccentric contraction force (MECF) with forced adduction. The MICF measured under teeth clenching was significantly lower than that under non-clenching, despite no significant difference in the MECF between the two conditions. The reduction in MICF caused by teeth clenching was enhanced by increasing the velocity of the load. These results suggest that clenching inhibits abduction force only during isometric contraction phase. The invariability of MECF would indicate the lack of involvement of fatigue in such inhibitory effects of clenching. To discover the source of the inhibition, we have examined the effects of teeth clenching on the stretch reflex in the deltoid muscle. The stretch reflex of deltoid muscles was inhibited during clenching, contrary to what was expected from the Jendrassik maneuver. Taken together, our results suggest that the teeth clenching reduced the MICF by depressing the recruitment of deltoid motoneurones presumably via the presynaptic inhibition of spindle afferent inputs onto those motoneurones.