1.Relationship Between Exercise Hyperpnea and Exercise Tolerance in Patients on Chronic Hemodialysis.
KAZUO TSUYUKI ; HIROYOSHI YANO ; ATSUO KASUGAI ; YASUO KIMURA ; SHINICHI WATANABE ; HIROKI HASE ; KUNIO EBINE ; KWANGCHOL CHANG
Japanese Journal of Physical Fitness and Sports Medicine 2001;50(2):255-258
2.Effects of physical training on the ventilatory response to exercise in patients on chronic hemodialysis.
KAZUO TSUYUKI ; KOHTETSU CHOH ; HIROKI HASE ; YASUO KIMURA ; ATSUO KASUGAI ; KOUICHI CHIASHI ; KENJI NINOMIYA ; SHINICHI WATANABE ; KUNIO EBINE
Japanese Journal of Physical Fitness and Sports Medicine 2002;51(4):377-384
This study examined the effects of physical training on exercise hyperpnea (EH) in patients on hemodialysis (HD) . In baseline, 17 (trained group) and 12 (control group) patients on HD performed symptom limited exercise test using a treadmill. Trained group, but not control group, exercised 2 to 3 times weekly on non-dialysis days under medical supervision. Exercise testing was repeated 20 weeks after the baseline. Ventilatory response to exercise was evaluated using the regression slope relating minute ventilation (VE) to carbon dioxide output (VCO2 ) during incremental exercise (VE/VCO2 slope) below the point of respiratory compensation. In trained group, VE, oxygen uptake ( VO2) and VCO2 at peak exercise increased and VE/VO2 and VE/VCO2 decreased after physical training, respectively. No change was observed in control group. VO2 at the anaerobic threshold increased in trained group, but not in control group. The post training VE/VCO2 slope (33.9±5.0) was significantly (p<0.05) lower than the pre-training slope (38.0± 4.8) and remained constant in control group. In trained group, changes in the VE/VCO2 slope correlated with those in peak VO2 (p<0.05) . These results suggest that physical training decreases EH in patients on HD and that it correlates with changes in exercise tolerance.
3.Contribution of Visceral Fat Accumulation to Metabolic and Vascular Complications in Obesity.
Tsuneo OHNO ; Keisuke ITOH ; Wataru MURAMATSU ; Tomomitsu TANI ; Fuminori OKUMURA ; Yoshiaki YAMADA ; Kunio KASUGAI ; Toshiaki SHIGEYASU ; Takashi MONOE ; Kouji NAGAHARA
Journal of the Japanese Association of Rural Medicine 1995;44(4):592-596
In patients with the visceral fat type obesity, there is a high incidence of glucose and lipid metabolic abnormalities and hypertension. We obtained the following results from a study of the relationship between the degree of visceral fat obesity and metabolic and vascular complications in 98 obese patients with various complications.
1. Viceral fat obesity (V/S ratio ≥ 0.4) was found in 74% of the subjects. The incidence was higher in males than females. The highest incidence was observed in both men and women in thier 40s, and there was no increase with age.
2. The V/S ratio was high in patients with hyperlipidemia, diabetes, and fatty liver in that order. In the V/S ≥ 0.4 group, there was a higher incidence of hyperlipidemia and ischemic heart disease than in the V/S<0.4 group.
3. The V/S ratio was higher in the patients with two or more metabolic and vascular complications than in those with only one complication.
4. A questionnaire survey showed that there were many individuals who did almost no exercise and had a long history of obesity in the V/S ≥ 0.4 group.
5. The V/S ≥ 0.4 group had high triglyceride levels. There was a positive correlation between the V/ S ratio or V value and the trigyceride level, but no correlation between S value and triglyceride level.
4.How to Interpret a Functional or Motility Test: Slow Nutrient Drinking Test.
Akihito IIDA ; Hiroshi KANEKO ; Toshihiro KONAGAYA ; Kunio KASUGAI
Journal of Neurogastroenterology and Motility 2012;18(3):332-335
The gastric barostat study is the gold standard method for evaluating gastric perception and accommodation. This technique has serious drawbacks, such as expense and invasiveness. Several drinking tests have been developed as noninvasive methods. Such tests are easily performed without special instruments and are well tolerated. We have reported that (1) a threshold volume inducing mild bloating in the slow nutrient drinking test might be an alternative parameter of gastric accommodation volume as determined by the barostat method and (2) the maximum satiety volume in the drinking test correlated positively with the pressure to induce severe discomfort in healthy volunteers, indicating that the slow nutrient drinking test may be useful for evaluating accommodation volume and the threshold to induce severe discomfort. However, the correlation between the maximum satiety drinking volume and accommodation volume as measured by the barostat study has been controversial. Therefore, validation of a certain nutrient drink test for measuring gastroduodenal function might be recommended in each institution.
Drinking
5.Overlap Between Constipation and Gastroesophageal Reflux Disease in Japan: Results From an Internet Survey
Naotaka OGASAWARA ; Yasushi FUNAKI ; Kunio KASUGAI ; Masahide EBI ; Yasuhiro TAMURA ; Shinya IZAWA ; Makoto SASAKI
Journal of Neurogastroenterology and Motility 2022;28(2):291-302
Background/Aims:
Detailed evaluations of overlapping constipation and gastroesophageal reflux disease (GERD) have not been conducted in Japan. The REACTION-J2 study examined the overlap of these diseases in Japan.
Methods:
This internet-based survey recruited participants from general public survey panels. Questions included demographic and medical data and assessments based on validated measures for constipation and GERD. Associations between background factors affecting constipation/GERD overlap, disease measures, and treatment were also evaluated.
Results:
Among 10 000 survey responses received, functional constipation (Rome IV diagnostic criteria) was reported by 439 participants; chronic constipation (Japanese guidelines) by 3804 participants; and subjective constipation symptoms by 2563 participants. The number of participants with constipation/GERD overlap ranged from 73 to 1533 depending on the criteria used. Regardless of the definition used, all GERD groups had significantly higher odds of being constipated than non-GERD participants: the OR (95% CI) for all 9 combinations of definitions ranged between 1.56 (1.21, 2.01) and 2.67 (2.44, 2.92) (all P ≤ 0.001). Straining, hard stools, and sensations of incomplete evacuation and anorectal obstruction/blockage, according to chronic constipation criteria, were common.Participants with constipation/GERD overlap had poorer quality of life (P < 0.001) and worse GERD symptom scores (P < 0.001). The frequency of abnormal stools was highest (P < 0.001) in the constipation/GERD overlap group. In the overlap group, 52.4% and 26.0% used gastric and constipation medication, respectively.
Conclusion
Individuals with constipation/GERD overlap tend to have worsened symptoms and quality of life.
6.Predictive Factors for Intractability to Endoscopic Hemostasis in the Treatment of Bleeding Gastroduodenal Peptic Ulcers in Japanese Patients.
Naotaka OGASAWARA ; Mari MIZUNO ; Ryuta MASUI ; Yoshihiro KONDO ; Yoshiharu YAMAGUCHI ; Kenichiro YANAMOTO ; Hisatsugu NODA ; Noriko OKANIWA ; Makoto SASAKI ; Kunio KASUGAI
Clinical Endoscopy 2014;47(2):162-173
BACKGROUND/AIMS: Despite improvements in endoscopic hemostasis and pharmacological therapies, upper gastrointestinal (UGI) ulcers repeatedly bleed in 10% to 20% of patients, and those without early endoscopic reintervention or definitive surgery might be at a high risk for mortality. This study aimed to identify the risk factors for intractability to initial endoscopic hemostasis. METHODS: We analyzed intractability among 428 patients who underwent emergency endoscopy for bleeding UGI ulcers within 24 hours of arrival at the hospital. RESULTS: Durable hemostasis was achieved in 354 patients by using initial endoscopic procedures. Sixty-nine patients with Forrest types Ia, Ib, IIa, and IIb at the second-look endoscopy were considered intractable to the initial endoscopic hemostasis. Multivariate analysis indicated that age > or =70 years (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.07 to 4.03), shock on admission (OR, 5.26; 95% CI, 2.43 to 11.6), hemoglobin <8.0 mg/dL (OR, 2.80; 95% CI, 1.39 to 5.91), serum albumin <3.3 g/dL (OR, 2.23; 95% CI, 1.07 to 4.89), exposed vessels with a diameter of > or =2 mm on the bottom of ulcers (OR, 4.38; 95% CI, 1.25 to 7.01), and Forrest type Ia and Ib (OR, 2.21; 95% CI, 1.33 to 3.00) predicted intractable endoscopic hemostasis. CONCLUSIONS: Various factors contribute to intractable endoscopic hemostasis. Careful observation after endoscopic hemostasis is important for patients at a high risk for incomplete hemostasis.
Asian Continental Ancestry Group*
;
Emergencies
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Endoscopy
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Hematemesis
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Hemorrhage*
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Hemostasis
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Hemostasis, Endoscopic*
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Humans
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Melena
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Mortality
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Multivariate Analysis
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Peptic Ulcer*
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Risk Factors
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Serum Albumin
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Shock
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Ulcer
7.Application of low-crystalline carbonate apatite granules in 2-stage sinus floor augmentation: a prospective clinical trial and histomorphometric evaluation
Takayuki NAKAGAWA ; Keiko KUDOH ; Naoyuki FUKUDA ; Shohei KASUGAI ; Noriko TACHIKAWA ; Kiyoshi KOYANO ; Yasuyuki MATSUSHITA ; Masanori SASAKI ; Kunio ISHIKAWA ; Youji MIYAMOTO
Journal of Periodontal & Implant Science 2019;49(6):382-396
PURPOSE: The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO₃Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens.METHODS: Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared.RESULTS: Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO₃Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO₃Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO₃Ap were 33.8%±15.1% and 15.3%±11.9%, respectively.CONCLUSIONS: In this first demonstration, low-crystalline CO₃Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO₃Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.
Apatites
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Biopsy
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Bone Substitutes
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Carbon
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Dental Implants
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Giant Cells, Foreign-Body
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Humans
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Individuality
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Prospective Studies
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Sinus Floor Augmentation
8.Internet Survey of Japanese Patients With Chronic Constipation: Focus on Correlations Between Sleep Quality, Symptom Severity, and Quality of Life
Sayuri YAMAMOTO ; Yurika KAWAMURA ; Kazuhiro YAMAMOTO ; Yoshiharu YAMAGUCHI ; Yasuhiro TAMURA ; Shinya IZAWA ; Hiroaki NAKAGAWA ; Yoshinori WAKITA ; Yasutaka HIJIKATA ; Masahide EBI ; Yasushi FUNAKI ; Wataru OHASHI ; Naotaka OGASAWARA ; Makoto SASAKI ; Masato MAEKAWA ; Kunio KASUGAI
Journal of Neurogastroenterology and Motility 2021;27(4):602-611
Background/Aims:
Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population.
Methods:
This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor).Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors.
Results:
The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (allP < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep.
Conclusions
Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.
9.Internet Survey of Japanese Patients With Chronic Constipation: Focus on Correlations Between Sleep Quality, Symptom Severity, and Quality of Life
Sayuri YAMAMOTO ; Yurika KAWAMURA ; Kazuhiro YAMAMOTO ; Yoshiharu YAMAGUCHI ; Yasuhiro TAMURA ; Shinya IZAWA ; Hiroaki NAKAGAWA ; Yoshinori WAKITA ; Yasutaka HIJIKATA ; Masahide EBI ; Yasushi FUNAKI ; Wataru OHASHI ; Naotaka OGASAWARA ; Makoto SASAKI ; Masato MAEKAWA ; Kunio KASUGAI
Journal of Neurogastroenterology and Motility 2021;27(4):602-611
Background/Aims:
Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population.
Methods:
This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor).Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors.
Results:
The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (allP < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep.
Conclusions
Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.