We have started to hold regular conferences with patients on walking rounds in order to listen to their problems as much as possible and to make it easy to obtain informed consent from our patients. To sound our patients' opinions about our approach, we distributed questionnaires to a total of 332 patients between August and December 1994. The survey found the 103 patients joined the conferences for more than one week. Ninety-eight patients commented favorably foward the conferences and about 90% said that they have become able to reveal their thoughts and ask the physicians and nurse what they wanted to ask. A lotal of 82 patients said that they understood the purpose of their therapy, while 27 patients said that they had difficulty speaking to us at beside in the presence of other patients in the same room. With these results, we attained our purpose of sharing in their problems and making it easy to obtain informed consent. However, we feel a need to take measures to assure the privacy of the patients.

This study aimed to explore the association of breakfast (BF) dietary patterns with physical activity (PA) and fitness in elementary school children. This study enrolled 242 school children of 5th and 6th grade. BF dietary patterns were evaluated by questionnaires on whether the child consumes the following food categories: staple, main dish, side dish, soup, milk or dairy products, and fruit. Individual PA levels were categorized into high and low PA groups using a PA scale for children. The measured 8 assessments of physical fitness scores were converted to Z-scores normalized for sex, age and height as previously reported. High PA group had significantly higher scores in running and muscle strength as well as in the total score of physical fitness. The frequency of eating BF (with or without BF omission) and the level of PA were not significantly related in both sexes. However, in girl children, BF, including staple, main dish, side dish, and soup, was significantly more prevalent in high PA group than low PA group (55.9% vs. 32.1%; χ2 = 5.638, p = 0.018). A similar tendency was observed in girls who had BF, including staple, main dish, and side dish (49.0% vs. 31.1%; χ2 = 3.720, p = 0.054). No associations between dietary patterns and PA were observed in boys. The results suggested that the frequency of eating BF was not associated with PA levels, which was significantly related to physical fitness in Japanese 5th and 6th grade elementary school children. In contrast, the results indicated that a high-quality BF dietary pattern, such as a meal including staple, main dish, side dish, and soup, might be associated with a physically active girl child.

Water exercise has various health benefits. However, effects of low-intensity water exercise program, frequently conducted as a health promotion activity, on high frequency component of heart rate variability (HF, an index of cardiovagal activity and a predictor of future cardiovascular disease) has been unexplored. To investigate acute effects of a low-intensity water exercise program on cardiovagal activity, 35 young healthy men participated in this study as a part of the water exercise group (15 min of walking, 10 min of jogging, and 10 min of supine floating) or the control group (35 min of sitting at rest on land). Heart rate during walking, jogging, and floating in water were 88±13, 104±19, and 73±14 bpm, respectively. Ratings of perceived exertion (Borg’s 6—20 scale) were 9±2, 10±2, and 7±2, respectively. Before the low-intensity water exercise program or 35-min sitting rest, there were no intergroup differences in natural logarithm of HF (lnHF), the ratio of low to high frequency component of heart rate variability (LF/HF), heart rate, blood pressure, sublingual temperature, and salivary amylase activity. An interaction between time and group was found in lnHF (P = 0.01); lnHF was greater 15 min and 30 min after versus before the program in the water exercise group, whereas there were no differences in the control group. There were no interactions in LF/HF, heart rate, blood pressure, sublingual temperature, and salivary amylase activity. These results suggest that the low-intensity water exercise program consists of walking, jogging, and supine floating acutely enhances cardiovagal activity.

We investigated the impact of Bazett (B) and Fridericia (F) correction formulas on the evaluation of QT prolongation in patients during methadone administration and to explore the relationship between heart rate and corrected QT interval (QTc) according to both correction formulas. This study was conducted as a single-center, retrospective observational study. Subjects were cancer patients who underwent electrocardiographic evaluation for methadone therapy at our institute from April 1, 2013, to August 31, 2023. The study assessed the incidence of QT prolongation and analyzed the correlation between heart rate and QTc derived from the B and F formulas. The mean QTc of 430.3±25.8 msec for the B formula and 409.2±20.8 msec for the F formula. The incidence of QT prolongation was significantly lower with the F formula (8.4%) compared to the B formula (27.7%), indicating a 19.3% reduction in QT prolongation cases (p<0.001). Additionally, the difference in QTc between the two formulas increased with an increase in heart rate (p<0.001). These results suggest that the F formula for QT interval correction in methadone therapy potentially expands the eligible patients for this therapy.

Intracranial germ cell tumor is more common in Asian countries, including Japan, than in Western countries. The disease is characterized by juvenile onset with a mean age at diagnosis of 18 years. Most patients with intracranial germ cell tumors in the basal ganglia manifest paralytic symptoms, but few of these patients have been reported to have long-term progression of motor paralysis and rehabilitation interventions.A young male patient was diagnosed as having right basal ganglia germinoma and left hemiplegia at the age of 10 years. He received intervention and long-term follow-up for upper limb function. He underwent hybrid assistive neuromuscular dynamic stimulation therapy at the age of 14 years and modified constraint-induced movement therapy (modified CI therapy) at the age of 20 years. With such a gradual neurorehabilitation intervention, the Fugl-Meyer assessment score for the upper limb improved from 41 to 58 points, and the frequency of use of the paralyzed hand also improved. We hope that this report will provide guidance when considering treatment options for similar diseases in the future.

Intracranial germ cell tumor is more common in Asian countries, including Japan, than in Western countries. The disease is characterized by juvenile onset with a mean age at diagnosis of 18 years. Most patients with intracranial germ cell tumors in the basal ganglia manifest paralytic symptoms, but few of these patients have been reported to have long-term progression of motor paralysis and rehabilitation interventions.A young male patient was diagnosed as having right basal ganglia germinoma and left hemiplegia at the age of 10 years. He received intervention and long-term follow-up for upper limb function. He underwent hybrid assistive neuromuscular dynamic stimulation therapy at the age of 14 years and modified constraint-induced movement therapy (modified CI therapy) at the age of 20 years. With such a gradual neurorehabilitation intervention, the Fugl-Meyer assessment score for the upper limb improved from 41 to 58 points, and the frequency of use of the paralyzed hand also improved. We hope that this report will provide guidance when considering treatment options for similar diseases in the future.