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- 저자 : Kota Tanaka (검색결과 4 건)
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Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke Tanaka,Hidenori Ohkubo,Atsushi Yamamoto,Kota Takahashi,Yuki Kasai,Anna Ozaki,Michihiro Iwaki,Takashi Kobayashi,Tsutomu Yoshihara,Noboru Misawa,Akiko Fuyuki,Shingo Kato,Takuma Higurashi,Kunihiro 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.3
Background/AimsNatural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients. MethodsFrom October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course. ResultsForty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2, 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care. ConclusionCIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.
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Dynamic splitting of light trails for increasing throughput in light trail networks
Yukinobu Fukushima,Kota Tanaka,Wenjie Chen,Tokumi Yokohira 대한전자공학회 2009 ITC-CSCC :International Technical Conference on Ci Vol.2009 No.7
As a promising medium access control method in light trail networks, ART MAC based on token passing has been proposed. In order to increase throughput of ART MAC, we propose a dynamic light trail splitting method. Our method increases throughput of a light trail by splitting a light trail into two trails at the token holding node and enabling simultaneous data transmission on both trails. Simulation results show that our method achieves 23-32 % higher throughput than a light trail without splitting.
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Sato, Masanobu,Toshimoto, Kota,Tomaru, Atsuko,Yoshikado, Takashi,Tanaka, Yuta,Hisaka, Akihiro,Lee, Wooin,Sugiyama, Yuichi American Society for Pharmacology and Experimental 2018 Drug metabolism and disposition: the biological fa Vol.46 No.5
<P>Bosentan is a substrate of hepatic uptake transporter organic anion-transporting polypeptides (OATPs), and undergoes extensive hepatic metabolism by cytochrome P450 (P450), namely, CYP3A4 and CYP2C9. Several clinical investigations have reported a non-linear relationship between bosentan doses and its systemic exposure, which likely involves the saturation of OATP-mediated uptake, P450-mediated metabolism, or both in the liver. Yet, the underlying causes for the nonlinear bosentan pharmacokinetics are not fully delineated. To address this, we performed physiologically based pharmacokinetic (PBPK) modeling analyses for bosentan after its intravenous administration at different doses. As a bottom-up approach, PBPK modeling analyses were performed using in vitro kinetic parameters, other relevant parameters, and scaling factors. As top-down approaches, three different types of PBPK models that incorporate the saturation of hepatic uptake, metabolism, or both were compared. The prediction from the bottom-up approach (models 1 and 2) yielded blood bosentan concentration-time profiles and their systemic clearance values that were not in good agreement with the clinically observed data. From top-down approaches (models 3, 4, 5-1, and 5-2), the prediction accuracy was best only with the incorporation of the saturable hepatic uptake for bosentan. Taken together, the PBPK models for bosentan were successfully established, and the comparison of different PBPK-models identified the saturation of the hepatic uptake process as a major contributing factor for the nonlinear pharmacokinetics of bosentan.</P>
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Yano Yudai,Iwata Eiichiro,Sada Takuya,Ueno Yuki,Hyakuda Yoshinobu,Kawasaki Sachiko,Okuda Akinori,Shigematsu Hideki,Uematsu Kota,Yajima Hiroshi,Tanaka Yasuhito 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.6
Study Design: Retrospective cohort study.Purpose: We propose a method for screening for low bone mineral density (BMD) among perimenopausal and postmenopausal women using a self-reported questionnaire.Overview of Literature: Osteoporosis is a major health problem worldwide. However, it is not cost-effective to evaluate BMD in all patients. Although several tools for predicting osteoporosis have been established, they do not focus much on low BMD prior to the development of osteoporosis.Methods: We retrospectively reviewed the medical records of 198 women aged 40–70 years who underwent mass screening for osteoporosis at our hospital between 2016 and 2019. The BMD values and the following data were collected: age, body mass index, fracture history, lower back pain, height loss, kyphosis, history of fragility fracture, family history of vertebral or hip fracture, and menopause. The reliability of each data point for the young adult mean <80% was calculated using discriminant analysis. Variables with large weight coefficients were selected and scored. This scoring tool was examined, and a cutoff score for predicting the young adult mean <80% was determined.Results: Sixty-four participants (32.3%) had a young adult mean <80%. According to the weight coefficients, the following five variables were scored as follows: age ≥60 years 3 points, body mass index <22 kg/m2 3 points, lower back pain 1 point, height loss (cm) 1 point, and menopause 1 point. The area under the receiver operating characteristic curve was 0.738 (95% confidence interval, 0.669–0.807). At cutoff scores of ≥5 and <5, the sensitivity was 82.8%, with specificity of 52.0%.Conclusions: The scoring tool performed well for predicting young adult mean <80% among perimenopausal and postmenopausal women in Japan. This tool may be useful to screen for low BMD.
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