1.A BATTERY OF FIELD TESTS FOR PREDICTING THE GENERAL PHYSICAL FITNESS LEVEL OF MALE PARAPLEGICS IN ACTIVE DAILY LIFE
NOBUYUKI TANAKA ; KENSUKE IWAOKA ; MASAHIRO YAMASAKI
Japanese Journal of Physical Fitness and Sports Medicine 2010;59(1):131-142
Purpose: To investigate the factorial structure of physical fitness of male paraplegics with thoracic or lumbar spinal cord injury and to develop a battery of field tests for predicting their general physical fitness level.Methods: Fifty-three active male paraplegics with spinal cord injury (PSCI) (age range: 18-54; spinal cord injury level: T4 to L4) were examined. Thirteen feasible variables were selected using physical fitness components based on the International Committee for the Standardization of Physical Fitness Tests and previous PSCI studies. Factor analysis was applied to 14 variables; 13 of these involved physical fitness tests stratified by age to determine the factorial structure of physical fitness variables. Multiple regression analysis was performed to obtain a linear regression equation using a representative variable for each factor in the factorial structure as an independent variable. A first principal component score was obtained by principal component analysis using each variable as a dependent variable.Results: For factorial structure, wheelchair driving ability (3-minute shuttle run), body composition (sebum thickness), respiratory function (vital capacity) and shoulder joint extension force factors were obtained. The results of multiple regression analysis involved 5 variables (the 4 above-mentioned variables plus age); and the first principal component score of each subject from all variables provided a significant linear regression equation (r = 0.934, P <0.01) when the body composition factor was excluded.Conclusions: The representative measurement variables obtained from the factorial structure allowed for the development of a battery of field tests for predicting general physical fitness level of PSCI.
2.Acupuncture Treatment for the Patient with Spinal Cord Stimulation
Tadashi TANAKA ; Hiroshi TOYODA ; Hidekazu RYO ; Masahiro SANNOMIYA ; Minoru WATANUKI
Kampo Medicine 2004;55(3):343-346
We experienced a case of chronic pain responding to electrical acupuncture therapy while on spinal cord stimulation. A 35 year-old male presented with chronic neck pain. At 16 years of age, he had neck pain due to traffic accident with stellate ganglion block and epidural block. At 29 years of age, he sensed radiating pain in the 3rd to 5th digits of the left hand during epidural block. At 33 years of age, nerve root injury occurred after insertion of an epidural catheter, resulting in epidural abscess. Although the abscess resolved after antibiotic treatment, he had stiff fingers in the left hand together with neck pain and restricted range of motion of the neck. At 34 years of age, a spinal cord stimulation device was inserted which improved the stiff fingers in the left hand, but not the neck pain and restricted neck motion. He therefore visited our institute. At presentation, neck pain together with dysphagia and mastication pain were observed, and the patient was on a liquid diet. He was given electrical acupuncture treatment in additional to trigger point block and stellate ganglion laser. After two treatments, he was able to resume a normal diet. With reduced neck pain, he also undergo rehabilitation mainly through voluntary neck movements. This case demonstrates that electrical acupuncture treatment may be safe and effective for patients fitted with spinal cord stimulation device.
3."Brain Activation Study by Acupuncture"
Masahiro UMEDA ; Ichiro SHIMOYAMA ; Tomoaki KIMURA ; Chuzo TANAKA
Journal of the Japan Society of Acupuncture and Moxibustion 2004;54(5):686-697
In this paper we introduce recent developments in the studies of brain activation during somatosensory stimulationexploiting new technologies. Somatosensory stimulation such as acupuncture, inauces tocai activation in tne central nervous system. The electroencephalogram is a popular method to investigate this activation, however, it is difficult to identify the exact location of the activation site. Recent new technologies may provide more accurate localization. Besides magnetoencephalography (MEG), which recognizes the activated brain areas by an evoked magnetic field with induced current, two other methodologies, which take advantage of physiological phenomena occurring during brain activation, were used in this functional study. Following excitation of neurons, brain tissue is supplied with oxygen from oxyhemoglobin causing oxyhemoglobin to turn into deoxyhemoglobin. As a consequence deoxyhemoglobin increases in the brain tissue. In the near-infrared spectrum, the deoxyhemoglobin absorption peak shows higher signal intensity than that of oxyhemoglobin, for which reason activated brain areas can be identified by absorption maps. In functional magnetic resonance imaging (fMRI) activated area can be revealed with high spatial resolution due to the change in magnetic susceptibility of deoxygeneated blood. This paper describes fMRI studies employing these three methods for the evaluation of experiments using acupuncture for focal brain activation.
4.Reliability and validity of a simple endurance test for the elderly; shuttle stamina walk test(SSTw).
MISAKA KIMURA ; YASUKO OKAYAMA ; YASUHITO TANAKA ; MASAHIRO KANEKO
Japanese Journal of Physical Fitness and Sports Medicine 1998;47(4):401-410
To develop a simple test of endurance capacity in the elderly, we evaluated the reliability and validity of the shuttle stamina walk test (SSTw), in which the running in the shuttle stamina test (SST : 3-minute shuttle running along a 10-meter course) was changed to walking.
We found that: 1) The walking distance in the SSTw was correlated with Vo2max (r=0.827), 2) the walking distance showed a correlation between the first test and a re-test (r=0.853), 3) the mean peak heart rate during the test was 86.3% of the estimated maximum heart rate with no difference according to age or sex, 4) subjective evaluation of the intensity of exercise was expressed as“fairly light”or“somewhat hard”by 73.7% of the subjects, 5) the results of the SSTw reflected the subjects' self-evaluation of endurance capacity, and 6) the age-related percentage reduction of the walking distance in the SSTw was similar to that in V2max in subjects aged 40 years and above.
These results suggest that the SSTw, a simple test of endurance capacity that can be performed safely over a wide range of middle-aged to elderly people including those in late old age and those with a low fitness level, has sufficient reliability and validity.
5.PENDULAR MOTION EFFICIENCY DURING VARIOUS WALKING SPEEDS IN ELDERLY WOMEN
HIKARU TANAKA ; TAKAFUMI FUCHIMOTO ; MISAKA KIMURA ; MASAHIRO KANEKO
Japanese Journal of Physical Fitness and Sports Medicine 2003;52(5):621-630
In the context of energetics related to a pendular model, the mechanical power (W) and ‘pendular motion efficiency’ (PME) were determined during walking of the subjects who consist of 37 healthy elderly women (65-85 years) and 21 young women (18-25 years) . Using a force plate, the potential and kinetic energies of the body's centre of mass were measured at various constant speeds. Walking speeds were selected and controlled by a newly devised pace-maker. PME, which is equivalent to ‘% recovery’ by Cavagna (1976), indicates a sort of efficiency in transforming potential energy into kinetic energy and vice versa. The external power to accelerate the body (Wext ), which is thought to be supplied by muscles, increased with walking speed, and the rate of increase in Wext tended to be greater in the elderly than in the young subjects. It was noted that the maximal PME values at the optimum speed in both age groups were comparable, but PME values in the elderly decreased more markedly than in the young subjects as walking speed deviated from the optimum. This fact suggests that an adaptability to different walking speeds reduced in the elderly population.
6.A Combination of a Modification of Bentall's Procedure, the Elephant Trunk Method and Aortic Arch Replacement for Marfan's Syndrume Using Cardioplegia.
Tsuneo Tanaka ; Yasuhide Ohkawa ; Masahiro Toyama ; Masaki Hashimoto ; Koji Matsumoto
Japanese Journal of Cardiovascular Surgery 2000;29(2):91-93
A 44-year-old woman with Marfan's syndrome presented complaining of severe back pain. Angiography revealed annulo aortic ectasia, aortic regurgitation, acute aoric dissection (DeBakey IIIb) and distal aortic arch aneurysm. One month after admission, she underwent cardiopulmonary bypass was established through the femoral artery, the superior and inferior vena cava. The heart was arrested by aortic cross clamping and retrograde cold (20°C) cardioplegia. At first, a modified Bentall's procedure was done in addition to a Carrel patch procedure. After this procedure, the heart was perfused continuously (300ml/min) with warm (37°C) blood until the end of the cardiopulmonary bypass. The heart recovered a sinus rhythm spontaneously. Subsequently, aortic arch replacement and the elephant trunk method was done with the aid of deep hypothermia and circulatory arrest. The patients is well 1 year after the operation. This technique is useful for patients who require prolonged aortic cross clamping time.
7.Graft-versus-Leukemia Effect of Nonmyeloablative Stem Cell Transplantation.
Masahiro IMAMURA ; Junji TANAKA
The Korean Journal of Internal Medicine 2009;24(4):287-298
Nonmyeloablative stem cell transplantation (NST) is increasingly used with beneficial effects because it can be applied to older patients with hematological malignancies and those with various complications who are not suitable for conventional myeloablative stem cell transplantation (CST). Various conditioning regimens differ in their myeloablative and immunosuppressive intensity. Regardless of the type of conditioning regimen, graft-versus- host disease (GVHD) in NST occurs almost equally in CST, although a slightly delayed development of acute GVHD is observed in NST. Although graft-versus-hematological malignancy effects (i.e., graft-versus-leukemia effect, graft-versus-lymphoma effect, and graft-versus-myeloma effect) also occur in NST, completely eradicating residual malignant cells through allogeneic immune responses is insufficient in cases with rapidly growing disease or uncontrolled progressive disease. Donor lymphocyte infusion (DLI) is sometimes combined to support engraftment and to augment the graft-versus-hematological malignancy effect, such as the graft-versus-leukemia effect. DLI is especially effective for controlling relapse in the chronic phase of chronic myelogenous leukemia, but not so effective against other diseases. Indeed, NST is a beneficial procedure for expanding the opportunity of allogeneic hematopoietic stem cell transplantation to many patients with hematological malignancies. However, a more sophisticated improvement in separating graft-versus-hematological malignancy effects from GVHD is required in the future.
Antigen-Presenting Cells/physiology
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Graft vs Host Disease/etiology
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*Graft vs Leukemia Effect
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Hematopoietic Stem Cell Transplantation/*adverse effects
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Humans
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Leukemia/therapy
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Lymphocyte Transfusion
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Lymphoma, Non-Hodgkin/therapy
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Multiple Myeloma/therapy
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*Transplantation Conditioning
8.A Clinical Study of Beclomethasone Dipropionate Inhalation Therapy with a Large Spacer.
Yoshiaki WATANABE ; Masahiro OGAWA ; Hitoshi TANAKA ; Hitoshi KANAYAMA ; Hiroshi SANO ; Katsumoto KATO
Journal of the Japanese Association of Rural Medicine 1995;44(2):89-92
Since April 1992 we have introduced a beclomethasone dipropionate (BDP) inhalation therapy with a large spacer for patients with bronchial asthma who were admitted to the internal medicine department of our hospital because of the exacerbation of asthma.
To find out the effect of this BDP inhalation therapy, we investigated the number of emergency room visits by the patients with bronchial asthma who had been admitted to our hospital with asthmatic attacks before and after the introduction of the new therapy.
From April 1991 to March 1994, the proportion of asthma patients decreased significantly (p<0.05): from April 1991 to March 1992 (before the introduction of the BDP inhalation therapy) 10.4±3.0%; from April 1992 to March 1993 5.3±1.4%, from April 1993 to March 1994 3.7±1.4%.
We checked the inhalation technique of 21 patients who visited our hospital regularly during the same period. The BDP therapy could decrease the number of emergency-room visits by 10 patients whose inhalation technique was imperfect, as well as by the other 11 patients whose inhalation technique was perfect.
9.Comparative Analysis of Faculty Development in Japanese Medical Schools from 2003 through 2005
Nobuo NARA ; Masaaki ITO ; Eiji GOTOH ; Nobuhiko SAITO ; Yujiro TANAKA ; Masahiro TANABE ; Osamu FUKUSHIMA ; Saburo HORIUCHI
Medical Education 2007;38(4):275-278
1) The faculty development at each medical school from 2003 through 2005 was analysed.
2) The major themes in faculty development were problem based learning, tutorial, computer based testing, and clinical training.
3) Faculty development is considered an effective way to enhance the contributions of faculty members to medical education.
10.Pregnancy outcome following first trimester exposure to Terbinafine Hydrochloride : A case series survey
MASAHIRO HAYASHI ; RITSUKO YAMANE ; MASA TANAKA ; KAYOKO HISHINUMA ; KAYOKO OGAWA ; IKUKO YOKOO ; HIROAKI KITAGAWA
Japanese Journal of Drug Informatics 2009;11(1):31-34
Objective: Treatment of tinea unguium with topical drugs alone is difficult, and medication with oral terbinafine hydrochloride is necessary in many cases. Since Trychophyton infects the nails in not only men but also women at a reproductive age, the influence on a fetus of the drug ingested during early pregnancy is a matter of concern of many women. The objective of this study was to investigate the influence of oral terbinafine hydrochloride on fetuses.
Methods: The outcomes were investigated in pregnant women who ingested terbinafine hydrochloride and visited the ‘Outpatient Services for Consultation on Pregnancy and Drugs (Teratology Information Services)’ of Toranomon Hospital, and cases were collected.
Results: Fifteen pregnant women ingested the drug during the organogenic period, in which the teratogenic risk is the highest. All 15 pregnant women gave birth to healthy babies.
Conclusion: This is the first survey concerning newborns delivered by women who ingested terbinafine hydrochloride during pregnancy in Japan. All investigated women gave birth to healthy babies, and the incidence of congenital abnormalities did not markedly exceed that in the general population. Since the number of cases was small, it is necessary to perform a cohort study to investigate details of the safety for fetuses.