1.Effects of high phosphorous intake and jump training on the developing rat tibia
Guodong Wang ; Akiko Honda ; Takamasa Mizuno ; Kenji Harada ; Naota Sogo ; Yoshihisa Umemura
Japanese Journal of Physical Fitness and Sports Medicine 2015;64(3):295-303
The extensive use of food additives has increased the phosphorous content of the modern diet, while calcium intake has remained similar to past levels according to the national standards of nutrient intake. Although exercise increase bone mineral content, the intake of phosphorus may change the exercise effect. The purpose of this study was to examine the effects of jump exercise on bone and phosphate-calcium metabolism in rats consuming high levels of dietary phosphorous. Forty-two male Wistar rats aged 8 weeks were fed either a high-phosphorus diet with a 2.0 P/Ca ratio or a normal diet with a 1.0 P/Ca ratio. Rats from each dietary group were then further assigned to undergo 8 weeks of jump exercise or to be sedentary controls. Two-way analysis of variance (ANOVA) revealed that the bone mineral content (P<0.001), strength (P<0.001), transverse thickness (P<0.001), and longitudinal thickness (P<0.001) of the tibial diaphysis were increased by jump exercise in both dietary groups. The concentrations of serum inorganic phosphorus (P<0.001), FGF23 (P<0.001), and 1-25 (OH) vitamin D (P<0.001) were increased by a high phosphorus diet, and the concentrations of serum total calcium (P<0.05) and 1-25 (OH) vitamin D (P<0.05) were increased by jump exercise in both groups. In conclusion, exercise is important to increase bone mass and bone strength in a high phosphorus intake state.
2.Graft Replacement of an Abdominal Aortic Aneurysm Previously Treated by Endovascular Stent Grafting in Two Cases
Toshiro Ito ; Nobuyoshi Kawaharada ; Yoshihiko Kurimoto ; Kenji Kuwaki ; Ryou Harada ; Yousuke Kuroda ; Kiyohumi Morishita ; Tetsuya Higami
Japanese Journal of Cardiovascular Surgery 2007;36(3):141-144
Ninety patients with abdominal aortic aneurysm underwent endovascular stent grafting in our hospital between 2001 and 2006 and two patients required graft replacement of abdominal aortic aneurysms during the late postoperative phase. Case 1 was a 77-year-old man for whom endovascular stent grafting for an abdominal aortic aneurysm and thoracic aortic aneurysm had been performed concomitantly. Six months later, because the abdominal aortic aneurysm had expanded from 68mm to 75mm in diameter, due to a type I endoleak which was detected postoperatively, he underwent open surgery. An occlusion balloon was inflated at the proximal site of the celiac artery until the stent graft was extracted. After positioning the aortic clamp below the origin of the renal arteries, a bifurcated graft was implanted. The postoperative course was uneventful. Case 2 was an 86-year-old woman who had undergone endovascular stent grafting for an abdominal aortic aneurysm. The endovascular procedure was successful and no endoleak was detected postoperatively. However, 13 months later, a community hospital admitted her in a state of shock due to ruptured abdominal aortic aneurysm. She was transferred to our hospital and underwent an emergency operation. Because insertion of an occlusion balloon into the brachial artery failed, we primarily performed supravisceral aortic cross clamping. After opening the aneurysm sac, the stent graft was removed and a bifurcated graft was implanted. After declamping, we found that the right common iliac artery was occluded, and therefore aorto-right external iliac bypass grafting was then also performed. The postoperative course was uneventful.
3.Suggestions and recommendations from health care professionals involved in regional palliative care program
Tatsuya Morita ; Chizuru Imura ; Yoshiko Nozue ; Satoshi Suzuki ; Mie Shibuya ; Hiroya Kinoshita ; Kumiko Harada ; Yutaka Shirahige ; Mika Hirayama ; Kenji Eguchi
Palliative Care Research 2012;7(1):163-171
The aim of this study is to collect the suggestions and recommendations of health care professionals involved in the regional palliative care program (OPTIM-study). A total of 101 multidisciplinary health care professionals who participated in the intervention program were interviewed, and 107 meaningful units were obtained from 89 valid interviews. The responses were categorized into “suggestions regardless of profession” (n=59), including “Participate in a multi-disciplinary conference to expand the network of people”, “Try to understand the situation of others”, “Seek support from others when you cannot solve the problem by yourself”, “Pursue all possibilities before giving up”, and “Do not try too hard”. As suggestions to those engaged in each profession, “Suggestions to community pharmacies” and “Suggestions to care managers” are frequently described. An examination of suggestions by the participants in the regional palliative care program could provide some insights to improve community palliative care.
4.What is the greatest impact of the regional palliative care program?: the OPTIM-study
Tatsuya Morita ; Chizuru Imura ; Yoshiko Nozue ; Satoshi Suzuki ; Mie Shibuya ; Hiroya Kinoshita ; Kumiko Harada ; Yutaka Shirahige ; Mika Hirayama ; Kenji Eguchi
Palliative Care Research 2012;7(2):209-217
The purpose of this study was to identify the greatest impact of the regional palliative care program on community health care professionals. Interviews were conducted involving 101 people who became involved in the intervention program implemented in 4 areas across Japan, and 96 valid responses were collected. The following were cited as the greatest impact: [I developed a network of people, and realized the importance of collaboration] (n=61; “I was able to develop an interpersonal relationship” and “Now I understand the significance of collaboration”), [My knowledge and skills regarding palliative care were improved] (n=18; “Knowledge and support helped me respond to patients with confidence” and “I have come to think that there is more to palliative care than terminal care”), [I rediscovered my role through a wide variety of experiences] (n=10), [Both collaboration and palliative knowledge/skills meant a lot to me] (n=4), [What I experienced in this program will help me play my role] (n=2), and [Patients and their families became satisfied] (n=1). The community palliative care program was most effective in facilitating collaboration, and helped participants develop knowledge and skills concerning palliative care.
5.Abdominal Aortic Aneurysm Repair in Patients with Ischemic Heart Disease.
Hiroshi Urayama ; Kenji Kawakami ; Fuminori Kasashima ; Yuhshi Kawase ; Takeshi Harada ; Yasushi Matsumoto ; Hirofumi Takemura ; Naoki Sakakibara ; Michio Kawasuji ; Yoh Watanabe
Japanese Journal of Cardiovascular Surgery 1995;24(1):31-35
Ischemic heart disease (IHD) poses a major complicating factor for abdominal aortic aneurysm (AAA) repair. To identify patients with IHD, we evaluated patients scheduled to undergo AAA repair with dipyridamole-thallium scintigraphy (DTS) and coronary angiography (CAG). If indicated, coronary revascularization was performed. Finally, an assessment of the effectiveness of these preventive measures was made. One hundred and ten patients scheduled to undergo AAA repair were identified and treated accordingly over a 20-year period. As the pre-operative evaluation and prophylactic surgical revascularization strategies were instituted in 1983, the patients were divided into 2 groups: 25 patients between 1973-1982 (group A) and 85 patients between 1983-1992 (group B). The mean age of patients in group A was 65.3 years. The male/female ratio within this group was 21:4. One patient in the group had a history of IHD and 9 had hypertention. The mean age of patients in group B was 67.7 years. The male/female ratio within this group was 77:8. Fourteen patients in this group had a history of IHD and 27 had hypertension. Screening and treatment of IHD in group B was as follows. All patients with a history of IHD underwent CAG. Of the 32 patients with cardiac risk factors, including hypertension and hyperlipidemia, or ECG abnormalities who underwent DTS, 8 were referred for CAG. Thirty-nine patients with no risk factors and a normal ECG proceeded to AAA repair without further workup. Perioperative myocardial infarction occurred in 2 patients in grouzp A, leading to death in 1 patient. Coronary revascularization was performed in 5 patients in group B. No perioperative myocardial infarction occurred in this group. Pre-operative identification of high-risk cases with DTS, CAG, and coronary revascularization in patients with IHD may prevent cardiovascular complications in patients undergoing AAA repair.
6.Current Status in the Treatment of Acute Cholecystitis Patients Receiving Antithrombotic Therapy: Is Endoscopic Drainage Feasible?- A Systematic Review
Ryota SAGAMI ; Kenji HAYASAKA ; Hidefumi NISHIKIORI ; Hideaki HARADA ; Yuji AMANO
Clinical Endoscopy 2020;53(2):176-188
The bleeding complication risk of surgery or percutaneous transhepatic gallbladder drainage (PTGBD) may increase in patients with acute cholecystitis receiving antithrombotic therapy (ATT). Endoscopic gallbladder drainage (EGBD) may be recommended for such patients. English articles published between 1991 and 2018 in peer-reviewed journals that discuss cholecystectomy, PTGBD, and EGBD in patients with ATT or coagulopathy were reviewed to assess the safety of the procedures, especially in terms of the bleeding complication. There were 8 studies on cholecystectomy, 3 on PTGBD, and 1 on endoscopic transpapillary gallbladder drainage (ETGBD) in patients receiving ATT. With respect to EGBD, 28 studies on ETGBD (including 1 study already mentioned above) and 26 studies on endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) were also analyzed. The overall bleeding complication rate in patients with ATT who underwent cholecystectomy was significantly higher than that in patients without ATT (6.5% [23/354] vs. 1.2% [26/2,224], p<0.001). However, the bleeding risk of cholecystectomy and PTGBD in patients receiving ATT was controversial. The overall technical success, clinical success, and bleeding complication rates of ETGBD vs. EUS-GBD were 84% vs. 96% (p<0.001), 92% vs. 97% (p<0.001), and 0.65% vs. 2.1% (p=0.005), respectively. One patient treated with ETGBD experienced bleeding complication among 191 patients with bleeding tendency. ETGBD may be an ideal drainage procedure for patients receiving ATT from the viewpoint of bleeding, although EUS-GBD is also efficacious.
7.mFOLFOX6 therapy could control ascites caused by peritonitis carcinomatosis in a patient with recurrent colorectal cancer. A case report
Masakazu Sugimoto ; Masateru Matsui ; Masanori Harada ; Yumiko Yamauchi ; Nao Moriyama ; Kanae Ando ; Makoto Yamamoto ; Hisayo Yamaoka ; Chiemi Ono ; Tamuro Hayama ; Keiji Matsuda ; Toshiaki Watanabe ; Kenji Eguchi ; Keiko Yamaoka
Palliative Care Research 2008;3(2):316-320
We performed combination therapy with modified oxaliplatin/l-LV/5-FU (mFOLFOX) in a patient with recurrent colorectal cancer who had peritonitis carcinomatosis. In this patient, mFOLFOX therapy resulted in disappearance of ascites and a decrease in carbohydrate antigen 19-9 (CA19-9), and improved quality of life (QOL) of the patient. This 62-year-old man was diagnosed with ascending colon cancer and metastatic cancer of the liver. Right hemicolectomy and right hepatic lobectomy were performed. We had started to treat with TS-1 in ambulatory care, however, he had peritonitis carcinomatosis with massive ascite reservoir on CT and peritoneal dissemination after a half year postoperatively. Furthermore, his ECOG Performance Status (PS) was rated as level 3. Therefore, we performed puncture of ascites and palliative mFOLFOX6 therapy. After ten courses, ascites and abdominal induration had disappeared and PS recovered to level 1. At present, CPT-11/l-LV/5-FU (FOLFIRI) are being administered for peripheral neuropathy and metastatic tumor associated with mFOLFOX6. The patient is spending his daily life satisfactory after FOLFIRI without abdominal swelling or ascites, and thus mFOLFOX6 may be an option for palliative therapy against massive ascites in patients with advanced colorectal cancer. The usefulness of palliative mFOLFOX6 therapy for patients with massive ascites should be evaluated in a well-designed clinical trial.Palliat Care Res 2008; 3(2): 316-320
8.A New Technique of Endoscopic Transpapillary Gallbladder Drainage Combined with Intraductal Ultrasonography for the Treatment of Acute Cholecystitis
Ryota SAGAMI ; Kenji HAYASAKA ; Tetsuro UJIHARA ; Ryotaro NAKAHARA ; Daisuke MURAKAMI ; Tomoyuki IWAKI ; Satoshi SUEHIRO ; Yasushi KATSUYAMA ; Hideaki HARADA ; Yuji AMANO
Clinical Endoscopy 2020;53(2):221-229
Background/Aims:
Endoscopic transpapillary gallbladder drainage (ETGBD) is useful for the treatment of acute cholecystitis; however, the technique is difficult to perform. When intraductal ultrasonography (IDUS) is combined with ETGBD, the orifice of the cystic duct in the common bile duct may be more easily detected in the cannulation procedure. The aim of this study was to evaluate the efficacy of ETGBD with IDUS compared with that of ETGBD alone.
Methods:
A total of 100 consecutive patients with acute cholecystitis requiring ETGBD were retrospectively recruited. The first 50 consecutive patients were treated using ETGBD without IDUS, and the next 50 patients were treated using ETGBD with IDUS. Through propensity score matching analysis, we compared the clinical outcomes between the groups. The primary outcome was the technical success rate.
Results:
The technical success rate of ETGBD with IDUS was significantly higher than that of ETGBD without IDUS (92.0% vs. 76.0%, p=0.044). There was no significant difference in procedure length between the two groups (74.0 min vs. 66.7 min, p=0.310). The complication rate of ETGBD with IDUS was significantly higher than that of ETGBD without IDUS (6.0% vs. 0%, p<0.001); however, only one case showed an IDUS technique-related complication (pancreatitis).
Conclusions
The assistance of IDUS may be useful in ETGBD.
9.Evaluation of Observable Items of Gait Abnormality in Patients with Knee Osteoarthritis:Criterion-related Validity Using Three-dimensional Gait Analysis and Test-retest Reliability
Shunsuke YAMASHINA ; Kazuhiro HARADA ; Shinya ONO ; Masumi ADACHI ; Kazuya MIYAKE ; Kenji KAWAMURA
The Japanese Journal of Rehabilitation Medicine 2019;():19002-
Objective:We aimed to examine the criterion-related validity of observable items of gait abnormality in patients with knee osteoarthritis (OA) using three-dimensional gait analysis and to assess the test-retest reliability.Methods:The items of gait abnormality were pooled from a prior study and rated using a 3-point scale. Content validity was examined by four experts in knee OA research and accepted when there was an agreement among at least three experts. Correlation between abnormality rating and three-dimensional gait analysis data was examined. The test-retest reliability of the agreement rate was then assessed in the same subject twice.Results:Eleven items were pooled, and all met the criterion of content validity. Eight items showed adequate correlation with the three-dimensional gait analysis data and had test-retest reliability exceeding 0.61.Conclusion:In patients with knee OA, observable items of gait abnormality had good test-retest reliability and criterion-related validity according to the three-dimensional gait analysis data.
10.Evaluation of Observable Items of Gait Abnormality in Patients with Knee Osteoarthritis:Criterion-related Validity Using Three-dimensional Gait Analysis and Test-retest Reliability
Shunsuke YAMASHINA ; Kazuhiro HARADA ; Shinya ONO ; Masumi ADACHI ; Kazuya MIYAKE ; Kenji KAWAMURA
The Japanese Journal of Rehabilitation Medicine 2019;56(12):1032-1043
Objective:We aimed to examine the criterion-related validity of observable items of gait abnormality in patients with knee osteoarthritis (OA) using three-dimensional gait analysis and to assess the test-retest reliability.Methods:The items of gait abnormality were pooled from a prior study and rated using a 3-point scale. Content validity was examined by four experts in knee OA research and accepted when there was an agreement among at least three experts. Correlation between abnormality rating and three-dimensional gait analysis data was examined. The test-retest reliability of the agreement rate was then assessed in the same subject twice.Results:Eleven items were pooled, and all met the criterion of content validity. Eight items showed adequate correlation with the three-dimensional gait analysis data and had test-retest reliability exceeding 0.61.Conclusion:In patients with knee OA, observable items of gait abnormality had good test-retest reliability and criterion-related validity according to the three-dimensional gait analysis data.