1.Effects of salt intake on the body in exercise.
HIROSHI TOYAMA ; HIROYUKI TANAKA
Japanese Journal of Physical Fitness and Sports Medicine 1985;34(3):141-149
This study was to examine the effects of quantity of taking salt diet on the body during exercise. The subjects were made to do endurance exercise on each after intake of the moderate-salt diet, the much-salt diet and a little-salt diet in a fixed duration.
The results were obtained as follows:
1) Under the much-salt diet intake, responce of systolic blood pressure and heart rate showed small increment during the exercise.
2) Under a little-salt diet intake, the CK-MB/CK ratio showed large increment during exercise.
3) Under the much-salt diet intake, serum BUN values were decreased compared with under the other diets. Under a little-salt diet intake, serum BUN, Uric Acid and Triglycerides values were increased, on the contrary serum Glucose values were decreased in resting condition. Especially, under a little-salt diet intake, serum BUN values were increased during the exercise.
4) The value of urinary sodium excretion was varied in response to the intake of salt. The value of urinary potassium excretion showed no change under the much-salt diet intake. But it showed decrease under a little-salt diet intake.
5) Under a little-salt diet intake, the creatinine clearance values were decreaced during and after the exercise.
The above mentioned findings suggested that the change of salt intake itself may become a stressor to the body and it is necessary to pay much attention when we exercise under these condition.
4.Aortic Surgery in Dialysis Patients
Hiroshi TANAKA ; Koichi MATSUO
Japanese Journal of Cardiovascular Surgery 2021;50(5):5-xxv-5-xxix
5.Efficacy of Kampo Formula Tokishigyakukagoshuyushokyoto for Cold Syndrome Evaluated with a Novel Clinical Method using a Patient-based Questionnaire Database
Yoko KIMURA ; Akira TANAKA ; Hiroshi SATO
Kampo Medicine 2012;63(5):299-304
Objectives : Persistent coldness is a common complaint for which Kampo, traditional Japanese herbal medicine, is often tried, because there is no definition or objective measure of subjective coldness in Western medicine. The aim of this study was to evaluate the efficacy of a common Kampo agent, tokishigyakukagoshuyushokyoto, and to identify key symptoms that would predict positive treatment outcomes for coldness.
Design : A retrospective cohort study.
Setting : 181 patients who complained of coldness without any organic abnormalities self-surveyed their health using a Kampo questionnaire database system on their first visit. Another 28 patients were assigned to verify the discriminatory predictability of treatment efficacy.
Interventions : Patients were treated with extract product, 7.5 grams a day for a month.
Outcome measures : Treatment efficacy as a binary response.
Results : Frequency and severity scales (0 to 4) for coldness decreased from 3.2 ± 0.7 to 2.1 ± 0.1 (p < 0.01)and from 3.1 ± 0.7 to 2.2 ± 0.9 (p < 0.01), respectively. Improvements in both frequency and severity of coldness were observed in 74.0% of patients. The status of tenderness in the iliac region, without upset stom ach or depression, was obtained as an appropriate model for the prediction of treatment effect, and its discrimi natory predictability was calculated as 84.4%. The predictive accuracy of the model was validated with 82.1% for the 28 new patients.
Conclusions : Coldness susceptible to tokishigyakukagoshuyushokyoto was very frequently accompanied by tenderness in iliac region, without upset stomach or depression.
6.Indicators for Treatment of Coldness with Tokishakuyakusan and Kamishoyosan
Yoko KIMURA ; Akira TANAKA ; Hiroshi SATO
Kampo Medicine 2013;64(4):205-211
Objectives : We evaluated the efficacy of tokishakuyakusan and kamishoyosan for patients who complained of feeling cold, and identified key symptoms that would predict positive treatment outcomes for coldness with these medicines.
Design : A retrospective cohort study
Subjects and Methods : The subjects were 188 patients who reported feeling cold. They were treated with tokishakuyakusan or kamishoyosan according to their Sho for more than one month. The relationships between improvement of cold sensation and 62 factors, including other symptoms noted at the first medical examination, were evaluated by means of cross-sectional analysis, followed by logistic regression.
Results : The factors of coldness of the abdomen (odds ratio, 5.0), vertigo (7.7), dimness of sight (16) and blushing (5.6), without anger (0.11) or tinnitus (0.025), were found to be predictors of a positive effect with tokishakuyakusan treatment (p < 0.001). The factors of hot flushes (14), without coldness of the whole body (0.099), and faint feeling (0.21) were significant for kamishoyosan (p < 0.001). This suggests that kamishoyosan can improve subjective coldness of the extremities (AIC -8.64), especially of the legs (-2.23).
Conclusions : Coldness in the abdomen was an important indicator for treatment with tokishakuyakusan, while coldness in the legs, but not in the whole body, was important in the case of kamishoyosan.
7.Signal Detection of Adverse Drug Reactions through LASSO Logistic Regression Using an Electronic Health Records Database:A Case-Control Study
Hiroshi HAYASHI ; Tatsuo HIRAMATSU ; Daisuke KOIDE ; Katsuya TANAKA ; Kazuhiko OHE
Japanese Journal of Pharmacoepidemiology 2017;21(2):51-62
Objective:The objective of this study was to apply Least Absolute Shrinkage and Selection Operator (LASSO)logistic regression to detection of adverse drug reaction (ADR) signals using an electronic health records database as a comprehensive and quantitative method to supplement the current pharmacovigilance activities in Japan.
Design:case-control study
Methods:We analyzed data from 40767 inpatients using a single-institution hospital database and identified two ADRs, suspected pancreatitis and thrombocytopenia, using abnormal laboratory test results. LASSO logistic regression analysis was applied to detect ADR signals with adjustment for age, sex, comorbidities and medical procedures. The positive predictive value (PPV) was calculated using reference standard of known drug-ADR associations based on drug product labels.
Results:The number of case group was 6735 for suspected pancreatitis and 11561 for thrombocytopenia. The number of ADR signals detected using LASSO logistic regression was 27 for suspected pancreatitis and 40 for thrombocytopenia. The calculated PPV was 3.7% for suspected pancreatitis and 55.0% for thrombocytopenia.
Conclusion:LASSO logistic regression analysis efficiently detects ADR signals by adjusting for confounding factors such as comorbidities and medical procedures. The false positive signals may contain unknown signals and further signal assessment will be needed.
8.Assessment of Types of Menstrual Migraine Treated with Periodical Application of Goreisan in Combination with Goshuyuto
Yoko KIMURA ; Akira TANAKA ; Hiroshi SATO ; Takashi ITO
Kampo Medicine 2017;68(1):34-39
Background : Menstrual migraine is more resistant to treatment than that of nonmenstrual episodes. Hormonal progesterone changes may cause sui (water/fluid) disturbance, in Kampo medicine terms. We therefore treated patients with menstrual migraine in which goshuyuto was ineffective, with the combination of goreisan and goshuyuto.
Subjects & Methods : Subjects were 37 female patients with coldness (mean age 37 years, age range 23-48 years), whose migraine during their intra-menstrual periods was successfully treated with goshuyuto for 3 months. In order to treat migraine in the menstrual period, goreisan was added to goshuyuto from 1 week before onset, until the end of their menstrual period. Results : Among 37 patients, the treatment was effective in 26 patients (70%). Significant variables were found to be dull headache (p = 0.003), edema (p = 0.006), vertigo (p = 0.014) and oliguria (p = 0.014) during attacks, as well as worsening before rain (p = 0.004). Conclusion : The periodical combination of goreisan and goshuyuto seems to be effective in patients with menstrual migraine who report symptoms of sui disturbance, such as dull headache and oliguria during their attacks.
9.The Concentration of Artificial CO2 Warm Water Bathing and the Skin Blood Flow
Masaharu MAEDA ; Hiroshi NAGASAWA ; Shinobu SHIMIZU ; Koji YORIZUMI ; Katsura TANAKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2003;66(3):180-184
A comparative study was made on bathing-induced changes in body temperature, blood pressure, pulse rate and tissue blood flow of 12 healthy adults using tap water and artificial CO2 water at 37°C to clarify the physiological effects of CO2 at various concentrations of 0, 100, 300, 600, 800 and 1000ppm. There was no change in body temperature during bathing in either water, whereas blood pressure and pulse rate were similarly decreased during bathing, but either of these decreases was not significantly different between tap water and CO2-water. Therefore, it seemed that the decrease in blood pressure due to vasodilation during bathing would be controlled through some regulatory system like autonomic nerve system not so as to result in too much decrease. But, tissue blood flow was more increased during bathing in CO2-water than tap water, suggesting that blood circulation in the tissue near skin surface would have been more enhanced by bathing in hot CO2-water, resulting in a decrease of blood pressure.
Since the increase in tissue blood flow during bathing was dependent on the concentration of CO2, it seemed that an improvement of tissue circulation and metabolism would have resulted from venous return increase associated to venous dilatation, one of dose-dependent CO2 effects.
10.Causes of Spinal Cord Injury and Effects of the Great East Japan Earthquake Disaster in Our Hospital
Kuniaki AMANO ; Hiroshi AKAOGI ; Arata WATANABE ; Haruka TANAKA ; Yousuke SHIBAO
Journal of the Japanese Association of Rural Medicine 2014;63(2):93-98
It is often reported that the number of cases of cervical spinal cord injury without fracture resulting from falls have increased in recent years with a aging population. We reviewed the cases of cervical spinal cord injury in the patients who were admitted within two days after the injury to our department between January 2006 and December 2012, The subjects of this study numbered 167 cases;129 males and 38 females. The frequency of occurrence of cervical spinal cord injury, according to reports by the fire departments in the southwestern part of Ibaraki Prefecture is 32.0 per million individuals per year. In our cases under review, fractures were noted in 72 individuals, whereas 95 had no fractures. As to the causes of injury, traffic accidents topped the list with 38.9%, followed by falls with 28.7%, stumbles with 20.4%, and other factors with 12.0%. Cervical spinal cord injury account for 75% of all the cases of spinal cord injury with an incident of 30-40 cases per 100 million individuals per year. In 2011, the incidence of cervical spinal cord injuries resulting from traffic accidents decreased, while that of injuries related to falls increased. Six cases of injury resulting from falls happened during repairs on the damaged houses in the aftermath of the Great East Japan Earthquake of March 2013.