1.Energy Expenditure of Stroke Patients during the Rehabilitation Phase
Michiyuki KAWAKAMI ; Meigen LIU ; Ayako WADA ; Atsuko HORIE ; Tomoyoshi OOTSUKA
The Japanese Journal of Rehabilitation Medicine 2011;48(9):623-627
Objective : Little is known about the energy demands of stroke patients in the rehabilitation phase, information essential to both appropriate clinical and nutritional management. The aims of this study were to determine the resting energy expenditure (REE) of stroke patients in the rehabilitation phase, and to evaluate whether REE estimation using the Harris-Benedict equation (HBE) requires the addition of a “stress factor” to capture possible additional REE imposed by stroke. Method : We measured REE with a portable calorimeter, MetavinTR, and compared it with basal energy expenditure (BEE) calculated with HBE in 76 stroke patients admitted to a rehabilitation ward. We then analyzed its relationship with sex, stroke type, paretic side, severity of paralysis, the Functional Independence Measure (FIM) score and dysphagia. Results : Mean REE and REE/BEE (%) were 1231.3±245.7 kcal/day and 104.3±16.4%. A comparison showed no significant difference. Sex, stroke type, paretic side, severity of paralysis, FIM and dysphagia were not significantly related with REE/BEE (%). Conclusion : The REE of stroke patients was not significantly different from that predicted with HBE. This information would be useful in planning appropriate nutritional management.
2.Effects of hindlimb suspension on patterns of myosin isoforms in rat soleus muscle.
TADASHI OKUMOTO ; AYAKO SAITOH ; SHIGERU KATSUTA ; SHIGEMITSU NIIHATA ; KUNIO KIKUCHI ; MASANOBU WADA
Japanese Journal of Physical Fitness and Sports Medicine 1997;46(3):279-287
Using several electrophoretic techniques, this study examined the effects of 3 weeks hindlimb suspension on the patterns of isomyosins, myosin heavy chain (HC) isoforms and myosin light chain (LC) isoforms in the soleus muscle of the rat. The suspended soleus showed a shift in the HC isoform distribution with a marked increase in fast HC isoforms and a commensurate decrease in HCI. In addition, the change in the fast HC isoforms consisted of the expression of HCIId and HC IIb absent in the normal soleus. In contrast to HC isoforms, suspension did not lead to appreciable changes in LC isoform distribution. Analyses of electrophoresis under nondenaturing conditions demonstrated that the normal soleus expressing HCI and HCIIa isoforms contained two isomyooins. Although, of the two isomyosins observed in the normal soleus, the faster migrating band most likely represented the HCIIa-based one (FMas), its mobility was not identical with that of the HCIIa-based isomyosin (FMaf) found in fast-twitch muscles, migrating in the order FMaf>FMas. FMas was designated as intermediate isomyosin (IM) . Some of the suspended soleus contained slow isomyosin (SM) and IM whereas the others comprised FM 3 and/or FM 2 as well as SM and IM. In spite of the expression of HCIIb and HCIId in the suspended soleus, FM 3 and FM 2 observed in these muscles exhibited distinct mobilities from either HCIId-based or HCIIb-based isomyosins comprised in fast-twitch muscles. These results suggest that some of newly expressed HCIId and/or HCIIb isoforms in the suspended soleus are associated with not only fast but also slow LC isoforms and function as a constitutive element of the myosin molecule.
3.Qualitative Study of Outpatients’ Eating-related Distress and Struggle in Cancer Center Hospital
Yasutaka Kimura ; Makiko Murase ; Tamae Hiramatu ; Mayumi Tsukagoshi ; Chihoko Wada ; Yoichi Shimizu ; Ayako Mori ; Miki Hosoya ; Kyoko Toju ; Yuko Shimizu ; Maki Obana ; Misae Maruguchi
Palliative Care Research 2017;12(2):239-249
Purpose: The purpose of this study was to clarify the state of eating -related distress and struggle in the daily lives of cancer outpatients in cancer center hospital. Methods: Cancer outpatients who consented to participate in the study filled out self-administered questionnaires regarding eating distress and the means of coping with them. The data were qualitatively analyzed via content analysis method. Results: Data from 176 patients who responded that they experienced eating difficulties were analyzed. A total of 222 codes were extracted for eating-related distress, and these were classified into five categories, which included eating-related symptoms accompanying the disease and its treatment, difficulties related to food preparation, and concerns about eating outside food. A total of 224 codes were extracted for eating-related struggle made by the patients, and these were classified into eight categories, which included adjusting eating methods to make food easier to eat, controlling one’s feelings when unable to eat certain foods, and adjustments related to food preparation. Conclusions: The study results suggested that cancer outpatients require care not only at early stages after treatment for eating-related symptoms but also related to food preparation and concerns when eating outside food.
4.Initiatives for the Establishment of the Network of Regional Medical Institutions regarding Palliative Care at the National Cancer Center in Japan
Ayako SATO ; Madoka YAMAZAKI ; Tomomi SANO ; Emi TAKEUCHI ; Yutaka MATSUOKA ; Saho WADA
Palliative Care Research 2025;20(1):81-87
Background: The National Cancer Center Institute for Cancer Control has trained regional palliative care coordinators to disseminate personnel promoting collaboration between cancer hospitals and regional institutions. We examined the effectiveness of the training. Methods: A questionnaire survey was conducted in February 2022 among facilities participating in the training sessions from 2016 to 2021. Results: One-hundred sixteen facilities responded. The results were classified as ‘positive change (78%)’ and ‘negative change (0%)’. Regarding ‘factors inhibiting the smooth transition of terminal cancer patients from hospital to home,’ ‘patients’ social background (e.g., living alone, old age, etc.) interferes with the transition to home care (88%)’ and ‘patients’ anxiety about home care (83%)’ were the most common factors. Conclusion: Nearly 80% of participants reported positive changes, indicating that the training has had a certain effect. With regard to inhibiting factors, we plan to consider how training should be conducted so that it can address the individual issues in each region.