Although it is common to assess visceral adipose tissue (VAT) by CT and MRI with a single slice at the umbilicus or the fourth and fifth lumbar vertebrae (L4-L5), recent studies reported that this single-slice method for determining an individual’s VAT may be inaccurate. Therefore, VAT accumulation should be based on total volume and determined with multiple slices rather than by cross-sectional area. However, obtaining multiple slices is burdensome for both subjects and analysts and lacks versatility despite its accuracy. The purpose of this study was to develop a new equation model for predicting VAT volume while maintaining the measurement accuracy of the multiple-slice method. We analyzed data from 214 Japanese male adults (48.5±9.3 years) and developed multiple, stepwise, linear regressions with VAT volume as a dependent variable and age, BMI, waist circumference and VAT areas (the standard L4-L5 measurement site 0 cm, +5 cm, +10 cm) as independent variables. From these results, we determined the best prediction equation for VAT volume as follows: VAT volume = (30.4×BMI) + (17.9×VAT area at L4-L5+10 cm) – 501.5. The model explained 93.1% of VAT variance and the predicted VAT volume significantly correlated with the measured VAT volume (r=0.97). This study developed a new VAT assessment method with a high level of accuracy. The method is significantly less burdensome in measurement and analysis than the multiple-slice method. Researchers can use this equation when they require an accurate evaluation of VAT accumulation. However, they should bear in mind that this equation was derived from data acquired from middle-aged, overweight and obese male subjects.

Obesity and increasing of arterial stiffness are known as independent risk factors for cardiovascular disease. Previously, we demonstrated that dietary modification or aerobic exercise training can decrease arterial stiffness in obese individuals. However, it has not been compared the effect of dietary modification and/or aerobic exercise training on arterial stiffness in obese men. We compared the effect of three patterns of lifestyle modification (i.e., dietary modification, aerobic exercise training or combined them) on arterial stiffness in obese men. Fifty-three obese men completed the 12-week lifestyle modification program, dietary modification (D), aerobic exercise training (E) or combined D and E (DE). Before and after the program, all participants were measured central, peripheral, and systemic arterial stiffness (measured by carotid-femoral pulse wave velocity [cfPWV], femoral-ankle PWV [faPWV] and brachial-ankle PWV [baPWV]). We demonstrated that the degree of decrease in BMI was the greatest after DE, and that was greater after D than E. The level of decrease in baPWV after DE was the greatest among three interventions. On the other hand, the level of decrease in baPWV in D group was similar to E group. These results suggested that systemic arterial stiffness may be decreased by different mechanisms between D and E groups. We demonstrated that dietary modification decreased central and systemic arterial stiffness, and aerobic exercise training decreased central, systemic, and peripheral arterial stiffness in obese individuals. We also showed an additional effect of decreasing systemic arterial stiffness by combining dietary modification and aerobic exercise training in obese individuals.

Moderate to vigorous physical activity is associated with improving insulin resistance in overweight and obese adults. However, effect of light physical activity on insulin resistance remains to be fully elucidated. The purpose of this study was to investigate the effect of light physical activity on insulin resistance in overweight and obese men. Thirty-seven overweight and obese middle-aged men (28.9 ± 1.8 kg/m², 51.0 ± 8.8 years) participated in this study. They took part in the lifestyle intervention (calorie restricted diet and exercise) for 12 weeks. Anthropometric parameters, fasting glucose, HbA1c, fasting insulin, and HOMA-IR were assessed at baseline and post intervention. Physical activity was objectively measured using a triaxial accelerometer at baseline and during intervention. Light physical activity (+17.7 min/day) and moderate-vigorous physical activity (+33.2 min/day) increased significantly, while body weight (-12.4 kg), fasting glucose (-9.5 mg/ml), fasting insulin (-4.2 μU/ml), and HOMA-IR (-1.1) decreased significantly. The change in light physical activity from baseline to during intervention were inversely related to change in fasting insulin (r = 0.18, P = 0.02) and change in HOMA-IR (r = -0.16, P = 0.03), after adjustment for several confounders. These results suggest that an increase of light physical activity improves insulin resistance in overweight and obese men.

BACKGROUND: /OBJECTIVE: Centella asiatica, also known as Gotu kola, is a tropical medicinal plant native to Madagascar, Southeast Asia, and South Africa. It is well known to have biological activities, including wound healing, anti-inflammatory, antidiabetic, cytotoxic, and antioxidant effects. The purpose of this study was to determine the efficacy of extracts of C. asiatica against age-related eye degeneration and to examine their physiological activities.MATERIALS/METHODS: To determine the effects of CA-HE50 (C. asiatica 50% EtOH extract) on retinal pigment cells, we assessed the cytotoxicity of CoCl2 and oxidized-A2E in ARPE- 19 cells and observed the protective effects of CA-HE50 against N-methyl-N-nitrosourea (MNU)-induced retinal damage in C57BL/6 mice. In particular, we measured factors related to apoptosis and anti-oxidation and the protein levels of rhodopsin/opsin. We also measured glucose uptake to characterize glucose metabolism, a major factor in cell protection. RESULTS: Induction of cytotoxicity with CoCl2 and oxidized-A2E inhibited decreases in the viability of ARPE-19 cells when CA-HE50 was administered, and promoted glucose uptake under normal conditions (P < 0.05). In addition, CA-HE50 inhibited degeneration/apoptosis of the retina in the context of MNU-induced toxicity (P < 0.05). In particular, CA-HE50 at 200 mg/kg inhibited the cleavage of pro-caspase-3 and pro-poly (ADP-ribose)-polymerase and maintained the expressions of nuclear factor erythroid 2-related factor 2 and heme oxygenase-1 similar to normal control levels. Rhodopsin/opsin expression was maintained at a higher level than in normal controls. CONCLUSION A series of experiments confirmed that CA-HE50 was effective for inhibiting or preventing age-related eye damage/degeneration. Based on these results, we believe it is worthwhile to develop drugs or functional foods related to age-related eye degeneration using CA-HE50.

OBJECTIVE: To plan the goals of the rehabilitation management after stroke, it was important to know functional prognosis of the patients. The purpose of this article was to predict functional outcomes of stroke patients by means of an analysis of the well-known prognostic factors of function at admission. METHOD: This study was performed retrospectively on 102 patients with acute stroke who were admitted to Department of Rehabilitation Medicine. The inpatients, clinical and functional evaluation were carried out at admission. Functional abilities were measured with the use of the Functional Ambulatory Category (FAC) and the modified Barthel Index (MBI). RESULTS: The significant prognostic factors of FAC improvement rate were age, National Institute of Health Stroke Scale (NIHSS), Morticity Index, MBI, Mini-Mental State Examination (MMSE), aphasia and Trunk Control Test (TCT) (p<0.01). The most valuable single factor of FAC improvement rate was TCT. The significant prognostic factors of MBI improvement rate were age, NIHSS, Morticity Index, MMSE, aphasia and TCT (p<0.01). The most valuable single factor of MBI improvement rate was TCT. CONCLUSION: We concluded that TCT could be the most valuable prognostic factor in rehabilitation management outcome of stroke.
Aphasia ; Humans ; Inpatients ; Prognosis ; Rehabilitation ; Retrospective Studies ; Stroke*

PURPOSE: The prevalence and treatment patterns of abdominal aortic aneurysm (AAA) vary according to ethnicity and region. This study analyzed nationwide data on the epidemiology, practice patterns, and mortality rates of AAA in Korea.MATERIALS AND METHODS: Data from patients treated for AAA from 2012 to 2016 were extracted from the Korean Health Insurance Review and Assessment (HIRA) database.RESULTS: A total of 30,766 patients in Korea had treatment codes for AAA and 2,618 patients were treated for ruptured AAA. Of the 6,356 patients treated surgically, 1,849 and 4,507 underwent open surgical aneurysmal repairs (OSAR) or endovascular aneurysmal repairs (EVAR), respectively. The number of surgical treatments performed annually for AAA increased from 1,129 cases in 2012 to 1,501 cases in 2016. The number of EVAR cases increased from 753 to 1,109 during these five years, while the number of OSAR cases remained similar, at 376 and 392, respectively. The 30-day mortality rates after EVAR and OSAR were 4.2% and 10.6%, respectively. The mortality rates were significantly higher in patients with hypertension, dyslipidemia, chronic renal disease, diabetes mellitus, and congestive heart failure. There were significant differences in the prevalence, proportion of EVAR, and mortality rates according to the regional area.CONCLUSION: The prevalence of AAA and the proportion of EVAR in Korea increased in the past 5 years, while the rupture rate and the proportion of OSAR remained similar. To minimize mortality and regional discrepancies, nationwide registry and treatment standardization are needed.
Aneurysm ; Aortic Aneurysm, Abdominal ; Cross-Sectional Studies ; Diabetes Mellitus ; Dyslipidemias ; Epidemiologic Studies ; Epidemiology ; Heart Failure ; Humans ; Hypertension ; Insurance, Health ; Korea ; Mortality ; National Health Programs ; Prevalence ; Renal Insufficiency, Chronic ; Rupture

OBJECTIVE: To determine whether insufficient weight-bearing on the hemiparetic side has a correlation with the degree of stiff-knee gait in hemiplegic patients. METHOD: Fifty hemiplegic patients were included. In all patients, 3-dimensonal gait analysis and static and dynamic foot pressure measurements were taken. The degree of stiff-knee gait was evaluated using the peak knee flexion angle and the knee flexion slope at toe-off in hemiplegic limb. The degree of weight-bearing was evaluated using the percentage of hemiplegic foot pressure and pressure-time integration on the non-hemiplegic side. RESULTS: The static and dynamic mean pressure ratios and pressure-time integration ratio were statistically correlated with peak knee flexion angle and knee flexion slope (p<0.01). CONCLUSION: As a result, insufficient weight-bearing had a correlation with the degree of stiff-knee gait in hemiplegic patients. Insufficient weight-bearing should be further investigated to determine whether it is one of the characteristic findings of stiff-knee gait, or another cause of stiff-knee gait.
Extremities ; Foot ; Gait* ; Hemiplegia ; Humans ; Knee ; Weight-Bearing*

Although research on physical fitness science in Japan has developed along with occupational health issues, the role of researchers in this area has been reduced by technological advancements. Nowadays, the automation and mechanization of manual tasks have created new occupational problems. These new problems affecting workers, such as prolonged occupational sitting and a decline in cardiorespiratory fitness (CRF), have been shown to increase the risk of several diseases (i.e., diabetes, obesity, heart diseases, and mortality), and further studies are needed to clarify this issue. Furthermore, in response to changes in the social structure due to the “low birthrate, aging society, and shrinking population”, a workforce with a different form than that from the postwar period is required. Therefore, the need to consider how we can avert this national crisis with the new role of researchers in the field of physical fitness science is once again drawing attention. In this article, we introduce the research being conducted by the National Institute of Occupational Safety and Health in Japan to meet the needs of “healthy and long working” and discuss this research in the context of future issues. Specifically, we introduce the development of a tool (the Worker’s Living Activity-time Questionnaire) to assess workers’ sitting time and epidemiological research using it. Finally, we describe the efforts to develop a new index for evaluating workers’ CRF and social implementation experiments to make the workplace a base for health promotion.

This study described 1-year changes in body weight and metabolic syndrome components in middle-aged obese Japanese men participating in a 6-month weight loss program. This study comprised two phases: 6-month weight loss program and 12-month weight maintenance. Data were collected at Tsukuba, between July 2009 and February 2011. Overweight or obese Japanese men aged 40-64 years without any cardiovascular disease history participated. The primary outcome was the 18-month weight change. Secondary outcomes were 18-month changes in metabolic syndrome components. Primary analyses included all participants who had provided baseline data, and all missing follow-up values were replaced with their baseline data. Of the 58 participants, 39 (67.2%) completed all measurement visits. Their body weight decreased significantly immediately after the 6-month weight loss program (-8.0 kg; 95% confidence interval [CI]: -10.2 kg, -5.8 kg). However, it increased significantly, by 3.7 kg (95% CI: 1.4 kg, 6.0 kg), at Month 18 (a year after the program ended). The 18-month weight loss was 4.3 kg (95% CI: 2.1 kg, 6.5 kg). Among the metabolic syndrome components, visceral fat area, systolic blood pressure, and high-density lipoprotein cholesterol levels improved significantly at Month 18. The other components did not improve over the 18 months. In this study, the obese, middle-aged Japanese men experienced modest weight regains after its substantial reduction. Unlike other ethnicities, factors associated with long-term weight loss maintenance remain understudied among Japanese adults. Therefore, accumulating evidence from Japanese studies with longer follow-up is necessary in the future.