Relationship Between Performance Improvement in Activities of Daily Living and Energy Intake in Older Patients With Hip Fracture Undergoing Rehabilitation

Hiroki Umezawa,Yoji Kokura,Satoko Abe,Chieko Suzuki,Akiko Nishida,Yoshie Uchiyama,Keisuke Maeda,Hidetaka Wakabayashi,Ryo Momosaki 대한재활의학회 2019 Annals of Rehabilitation Medicine Vol.43 No.5

Objective To analyze whether sufficient energy intake (EI) improves performance of activities of daily living (ADL) in patients with hip fracture admitted to rehabilitation hospitals. The adequate amount of EI for improving performance of ADL in patients with hip fracture remains unknown. Methods This retrospective cohort study included all patients with hip fracture (n=234) admitted to rehabilitation hospitals in Japan. The inclusion criteria for this study were age >65 years and body mass index <30.0 kg/m2. Patients who were transferred to an acute hospital and those with missing case data were excluded. According to the amount of EI, the patients were classified into energy sufficiency and shortage groups (EI/total energy expenditure ≥1.0 and <1.0, respectively). The Functional Independence Measure (FIM) and FIM gain were used to evaluate the patient disability level and change in patient status in response to rehabilitation. Finally, FIM gain was calculated as the discharge FIM score minus the admission FIM score. Results The final analysis targeted 202 patients—53 (26.2%) were in the energy shortage group and 149 (73.8%) were in the energy sufficiency group. The energy sufficiency group had a greater FIM gain than the energy shortage group (mean, 25.1±14.2 vs. 19.7±16.4; p=0.024). Furthermore, sufficient EI in the first week since admission (β=0.165; 95% confidence interval, 0.392–5.230; p=0.023) was an independent factor of FIM gain. Conclusion Among elderly patients with hip fracture admitted to rehabilitation hospitals in Japan, the amount of EI during the first week after admission was an independent factor of FIM gain.

Development of Dilated Esophagus, Sigmoid Esophagus, and Esophageal Diverticulum in Patients With Achalasia: Japan Achalasia Multicenter Study

Hiroki Sato,Yusuke Fujiyoshi,Hirofumi Abe,Hironari Shiwaku,Junya Shiota,Chiaki Sato,Hiroyuki Sakae,Masaki Ominami,Yoshitaka Hata,Hisashi Fukuda,Ryo Ogawa,Jun Nakamura,Tetsuya Tatsuta,Yuichiro Ikebuchi 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.2

Background/AimsPatients with achalasia-related esophageal motility disorders (AEMDs) frequently present with dilated and sigmoid esophagus, and develop esophageal diverticulum (ED), although the prevalence and patients characteristics require further elucidation. MethodsWe conducted a multicenter cohort study of 3707 patients with AEMDs from 14 facilities in Japan. Esophagography on 3682 patients were analyzed. ResultsStraight (n = 2798), sigmoid (n = 684), and advanced sigmoid esophagus (n = 200) were diagnosed. Multivariate analysis revealed that long disease duration, advanced age, obesity, and type I achalasia correlate positively, whereas severe symptoms and integrated relaxation pressure correlate negatively with development of sigmoid esophagus. In contrast, Grade II dilation (3.5-6.0 cm) was the most common (52.9%), while grade III dilation (≥ 6 cm) was rare (5.0%). We found early onset, male, obesity, and type I achalasia correlated positively, while advanced age correlated negatively with esophageal dilation. Dilated and sigmoid esophagus were found mostly in types I and II achalasia, but typically not found in spastic disorders. The prevalence of ED was low (n = 63, 1.7%), and non-dilated esophagus and advanced age correlated with ED development. Patients with right-sided ED (n = 35) had a long disease duration (P = 0.005) with low integrated relaxation pressure values (P = 0.008) compared with patients with left-sided ED (n = 22). Patients with multiple EDs (n = 6) had lower symptom severity than patients with a single ED (P = 0.022). ConclusionsThe etiologies of dilated esophagus, sigmoid esophagus, and ED are considered multifactorial and different. Early diagnosis and optimal treatment of AEMDs are necessary to prevent these conditions.

Neurotropin protects rotator cuff tendon cells from lidocaineinduced cell death

Ryunosuke Abe,Hiroki Ohzono,Masafumi Gotoh,Yosuke Nakamura,Hirokazu Honda,Hidehiro Nakamura,Shinichiro Kume,Takahiro Okawa,Naoto Shiba 대한견주관절의학회 2021 대한견주관절의학회지 Vol.24 No.4

Background: Local anesthetics often are used in rotator cuff tears as therapeutic tools, although some cases have reported that they have detrimental effects. Neurotropin (NTP) is used widely in Japan as a treatment for various chronic pain conditions and is shown to have protective effects on cartilage and nerve cells. In this study, we investigated the protective effect of NTP against lidocaine-induced cytotoxicity. Methods: Tenocytes from rotator cuff tendons were incubated with lidocaine, NTP, lidocaine with NTP, and a control medium. Cell viability was evaluated using the WST-8 assay. Cell apoptosis was detected via annexin V staining using flow cytometry. The expression of BCL-2 and cytochrome c, which are involved in the intrinsic mitochondrial pathway of apoptosis, was evaluated via Western blotting and immunohistochemical staining. Results: In the cell viability assay, lidocaine decreased cell viability in a dose-dependent manner, and NTP did not affect cell viability. Moreover, NTP significantly inhibited the cytotoxic effect of lidocaine. The flow cytometry analysis showed that lidocaine significantly induced apoptosis in tenocytes, and NTP considerably inhibited this lidocaine-induced apoptosis. Western blotting experiments showed that lidocaine decreased the protein expression of BCL-2, and that NTP conserved the expression of BCL-2, even when used with lidocaine. Immunohistochemical staining for cytochrome c showed that 0.1% lidocaine increased cytochrome c-positive cells, and NTP suppressed lidocaine-induced cytochrome c expression. Conclusions: NTP suppresses lidocaine-induced apoptosis of tenocytes by inhibiting the mitochondrial apoptotic pathway. Intra-articular/bursal injection of NTP with lidocaine could protect tenocytes in rotator cuff tendons against lidocaine-induced apoptosis.

How should we treat acute kidney injury caused by renal congestion?

( Masanori Abe ),( Seiichiro Hemmi ),( Hiroki Kobayashi ) 대한신장학회 2023 Kidney Research and Clinical Practice Vol.42 No.4

Decreased kidney function is associated with increased risk of cardiovascular events and mortality, and heart failure (HF) is a well-known risk factor for renal dysfunction. Acute kidney injury (AKI) in patients with HF often is attributed to prerenal factors, such as renal hypoperfusion and ischemia as a result of decreased cardiac output. Another such factor is reduction of absolute or relative circulating blood volume, with the decrease in renal blood flow leading to renal hypoxia followed by a decrease in the glomerular filtration rate. However, renal congestion is increasingly being recognized as a potential cause of AKI in patients with HF. Increased central venous pressure and renal venous pressure lead to increased renal interstitial hydrostatic pressure and a reduction of the glomerular filtration rate. Both decreased kidney function and renal congestion have been shown to be important prognostic factors of HF, and adequate control of congestion is important for improving kidney function. Loop and thiazide diuretics are recommended as standard therapies to reduce volume overload. However, these agents are associated with worsening renal function even though they are effective for improving congestive symptoms. There is growing interest in tolvaptan, which can improve renal congestion by increasing excretion of free water and decreasing the required dose of loop diuretic, thereby improving kidney function. This review summarizes renal hemodynamics, the pathogenesis of AKI due to renal ischemia and renal congestion, and diagnosis and treatment options for renal congestion.

Comparison of Wireless Communication Technologies in Remote Monitoring Systems

Tong Li,Hiroki Abe,Shigeyuki Tateno,Yuriko Hachiya 제어로봇시스템학회 2018 제어로봇시스템학회 국제학술대회 논문집 Vol.2018 No.10

Nowadays, remote monitoring systems based on wireless communication technologies, are used in elderly care facilities and child day-care centers. In these systems, a ZigBee network with advantages of low energy consumption, flexibility and large network capacity has been used. Previous researchers proposed a system with XBee modules that are made by Digi international Inc. and widely used in the ZigBee network. Moreover, the XBee module can support not only the original ZigBee network but also a special DigiMesh network. These two networks have different performance in network construction and data transmission. Therefore, it should be compared to ensure the system stability that which network is better in network construction speed and packet loss rate. In this paper, several experiments under different environment have been designed to evaluate the performance of the remote monitoring system on the ZigBee network and the DigiMesh network.

Subtype of Achalasia and Integrated Relaxation Pressure Measured Using the Starlet High-resolution Manometry System: A Multicenter Study in Japan

Tetsuya Tatsuta,Hiroki Sato,Yusuke Fujiyoshi,Hirofumi Abe,Akio Shiwaku,Junya Shiota,Chiaki Sato,Masaki Ominami,Yoshitaka Hata,Hisashi Fukuda,Ryo Ogawa,Jun Nakamura,Yuichiro Ikebuchi,Hiroshi Yokomichi 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.4

Background/Aims ManoScan and Sandhill high-resolution manometry (HRM) systems are used worldwide; however, the diagnosis of achalasia on the Starlet HRM system is not fully characterized. Furthermore, the impact of calcium channel blockers and nitrites in treating achalasia has not been investigated using HRM. Management of recurrent cases is a priority issue, although few studies have examined patient characteristics. Methods We conducted a multicenter, large-scale database analysis. First, the diagnosis of treatment-naive achalasia in each HRM system was investigated. Next, patient characteristics were compared between type I-III achalasia, and the impact of patient characteristics, including calcium channel blocker and nitrite use for integrated relaxation pressure (IRP) values, were analyzed. Finally, patient characteristics with recurrent achalasia were elucidated. Results The frequency of type I achalasia with Starlet was significantly higher than that with ManoScan and Sandhill HRM systems. In achalasia, multivariate analysis identified male sex, advanced age, long disease duration, obesity, type I achalasia, and sigmoid type as risk factors related to normal IRP values (< 26 mmHg). Calcium channel blockers and nitrites use had no significant impact on the IRP values, although achalasia symptoms were indicated to be alleviated. In recurrent cases, the IRP value was significantly lower, and advanced age, long disease duration, and sigmoid type were more common than in treatment-naive patients. Conclusions We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making.

Numerical Study of Slow-wave Instabilities in an Oversized Coaxial Slow-wave Structure

Kazuo Ogura,Shingo Abe,Hiroki Kimura,Kazumasa Yamamoto,Kiyoyuki Yambe,Ruhul Amin 한국물리학회 2011 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.59 No.61

In this paper, slow-wave instabilities in oversized coaxial SWSs are numerically analyzed. An infinitesimally thin annular beam with transverse perturbations and guided by a finite axial magnetic field is considered as the energy source for creating the instabilities. The coaxial SWSs consist of an outer oversized hollow waveguide and a central conductor and have sinusoidal corrugations. An electromagnetic slow-wave is generated by the inner corrugation and is called inner surface wave (ISW). The ISW is a cylindrical surface wave and can exist even if the outer conductor is removed. The higher-order modes are produced by the outer waveguide. The annular beam interacts with the ISW and higher-order modes. Slow cyclotron instability occurs due to the transversely modulated beam boundary, in addition to the conventional Cherenkov instability. The slow-wave instabilities are able to be controlled by the beam radius and the relative position of inner and outer corrugations.

Application of Real-Time Tumor-Tracking and Gated Rdiotherapy System for Unresectable Pancreatic Cancer

안용찬,Shinichi Shimizu,Hiroki Shirato,Takayuki Hashimoto,Yasuhiro Osaka,Xiao-Qing Zhang,Tatsuya Abe,Masao Hosokawa,Kazuo Miyasaka 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.4

Herein is reported our experience of radiation therapy using a real-time tumor-tracking and gated radiotherapy (RTRT) system for inoperable pancreatic cancer. Three unresectable pancreatic cancer patients were treated with intraoperative electron beam radiation therapy, at the time of open biopsy, and postoperative external beam radiation therapy using an RTRT system with a 2.0mm diameter gold ball implanted into the pancreas. The total BED'sα/β=10 was intended to be equivalent to that of delivering 60 Gy by 2.0Gy/fraction, while the actual dose schedules were individualized. The movement of the pancreas was analyzed based on the 3-dimensional marker positions during the RTRT. The side effects and tumor responses were evaluated. During the RTRT course, the average movement of markers in the x (left to right), y (cranial to caudal) and z (dorsal to ventral) directions were 3.0mm (1.7-5.2mm), 5.2mm (3.5-6.8mm) and 3.5mm (2.7-5.1 mm), respectively. During and after the course of postoperative radiation therapy, no acute side effects of RTOG grade II or higher were detected. The objective tumor responses, as evaluated by CT scans 3 months after the treatment, were 2 partial responses and no response in one patient. Using the RTRT technique the margin of treatment planning and the possible errors in target localization were reduced, and the 3-dimensional movement of the internal marker implanted in the pancreas was able to be analyzed.

Virtual Monochromatic Imaging in Dual-source and Dual-energy CT for Visualization of Acute Ischemic Stroke

Hidetake Hara,Hiroshi Muraishi,Hiroki Matsuzawa,Toshiyuki Inoue,Yasuo Nakajima,Hitoshi Satoh,Shinji Abe 한국물리학회 2015 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.67 No.1

We have recently developed a phantom that simulates acute ischemic stroke. We attempted to visualize an acute-stage cerebral infarction by using dual-energy Computed tomography (DECT) to obtain virtual monochromatic images of this phantom. Virtual monochromatic images were created by using DECT voltages from 40 to 100 keV in steps of 10 keV and from 60 to 80 keV in steps of 1 keV, under three conditions of the tube voltage with thin (Sn) filters. Calculation of the CNR values allowed us to evaluate the visualization of acute-stage cerebral infarction. The CNR value of a virtual monochromatic image was the highest at 68 keV under 80 kV / Sn 140 kV, at 72 keV under 100 kV / Sn 140 kV, and at 67 keV under 140 kV / 80 kV. The CNR values of virtual monochromatic images at voltages between 65 and 75 keV were significantly higher than those obtained for all other created images. Therefore, the optimal conditions for visualizing acute ischemic stroke were achievable.

Effect of Supplemental Fish Meal on Milk Yield and Milk Composition of Holstein Cows during Early Lactation

Adachi, N.,Suzuki, K.,Kasai, K.,Hiroki, M.,Kume, S.,Nonaka, I.,Abe, A. Asian Australasian Association of Animal Productio 2000 Animal Bioscience Vol.13 No.3

Data of 15 multiparous Holstein cows kept at Ibaraki Prefectural Animal Experiment Station were collected from 10 weeks prepartum to 20 weeks postpartum. Cows were assigned randomly to a soybean meal (S8M) diet or a fish meal (FM) diet from 4 weeks before expected calving date to 20 weeks postpartum. Each diet was formulated to contain similar amounts of CP, ADF, and NDF. In the FM diet, 2.5 and 5% of fish meal were supplemented as total mixed rations in prepartum and postpartum periods, respectively. Compared to the SBM diet, undegraded intake protein (UIP) and Met were higher in the FM diet, but Lys was low. Body weight and dry matter intake were not affected by supplemental FM, and dry matter intake increased by 6 weeks postpartum and maintained constant after 7 weeks postpartum. Cows in the FM diet remained high milk production during the experimental period, but milk yield in the SBM diet decreased gradually after 6 weeks postpartum. Supplemental FM increased milk yield and protein yield from 10 to 20 weeks postpartum when FM intake was 1.19 kg/d, although milk protein was not improved. There were no significance differences in fat content and fat yield between FM and SBM diets. Supplemental FM had no effect on plasma glucose and urea-N at parturition and 7 weeks postpartum. Thus, the increased milk and protein yield may be due to the combination of carryover effect of supplemental UIP or Met in FM from 4 weeks prepartum to 10 weeks postpartum and direct effect of supplemental FM.