1.Acceleration of the Effects of Forearm Bathing by L-Arginine Ingestion
Mitsuru KOKUSHO ; Tadashi OSHIGE ; Nobuyuki TANAKA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2009;72(3):201-206
In this study, we investigated the effects of L-Arginine, which increases the production of nitricoxide (NO) with vasodilative actions, on forearm bathing. The subjects were 12 healthy adult males with 24±1 years old. We compared the changes of blood pressure, heart rate, deep/superficial temperatures, and dermal blood flow by forearm batlmg with or without the oral ingestion of 2000mg L-Arginine. After a 30-minute rest following ingestion, the subjects took a forearm bathing ; immersion of the right forearm below the elbow in 41°C hot water for 15 minutes. There were no significant differences neither in blood pressure, heart rate, nor sublingual temperature between the changes by L-Arginine and water ingestion. Although the superficial temperature of the left toe was significarttly increased 15 minutes after the start of bathing regardless of the presence or absence of L-Arginine (p<0.01), the increase with L-Argilline ingestion was significantly greater (p<0.01) than that without L-Arginine. Furthemore, an increase in left dorsal skin blood flow after 10 to 15 minutes bathing with L-Arginine was more marked than that without L-Arginine. The increasing ratio of blood flow after 15 minutes of right forearm bathing against pre-bathing value was significantly higher (p<0.05) in case with L-Argitme than that in its absence. These results suggest that the oral administration of L-Arginine accelerates thermal vasodilative effects during forearm bathing.
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.Resident Training in U.S.A.
Ryo TANAKA ; Hiroshi NAKAJIMA ; Keizo HIRAYAMA ; Tadashi HINOHARA
Medical Education 1971;2(3):199-208
4.Exercise attenuates oxidative stress in patients with stroke
Nagatoshi Kihoin ; Kazunari Tanaka ; Masaaki Okuno ; Tadashi Okamoto ; Ryuichi Saura
Neurology Asia 2016;21(1):7-16
In stroke patients, excessive oxidative stress impairs brain nerve cells and leads to arteriosclerosis. On
the other hand, rehabilitative exercise is necessary for the functional improvement and maintenance
after stroke, and exercises themselves increase reactive oxygen species production simultaneously.
Therefore, it is essential to elucidate how exercises influence oxidative stress in stroke patients. We
assessed the effects of exercises on 29 Japanese subacute-phase stroke patients (exercise group, 20;
control group, 9), in terms of oxidative stress by examining changes in reactive oxygen metabolite
(ROM) level (i.e., oxidative stress) and biological antioxidant potential (BAP) level (i.e., antioxidant
capacity) in blood plasma. The exercise group performed two sets of 1-hour exercises 6 days/week for
56 days. The control group performed the same 1-hour exercises, but only on days 1 and 56. ROM and
BAP levels in blood plasma in both groups were measured immediately before and after the exercises
and at rest on days 1 and 56. ROM level significantly decreased and BAP level significantly increased
at rest from days 1 to 56 in the exercise group. However, no significant change was observed in these
levels in the control group.
Conclusion: Regular rehabilitative exercise can improve antioxidant capacity and attenuate oxidative
stress even in stroke patients.
Oxidative Stress
;
Stroke
;
Arteriosclerosis
5.Effects of 9 months mild aerobic training on serum lipids and lipoprotein concentrations in older than 65 years men and women with hypertension.
MITSUGI MOTOYAMA ; TAKASHI IRIE ; TADASHI IRIE ; YOSHIYUKI SUNAMI ; JUN SASAKI ; AKIRA KIYONAGA ; HIROAKI TANAKA ; MUNEHIRO SHINDO
Japanese Journal of Physical Fitness and Sports Medicine 1992;41(5):559-566
In the present study, we instiuted a long-term mild aerobic training program for older patients with hypertension and investigated its effects on serum lipids and lipoprotein concentrations. The intensity of exercise in mild aerobic training was adjusted to the lactate threshold level (LT), i, e., the level at which the blood lactate concentration began to increase nonlinearly with increasing work intensity. The training group (15 patients, 7 men and 8 women) and control group (15 patients, 7 men and 8 women) were 65-83 year-old patients with mean ages of 75.5±5.6 and 73.7±4.4 (mean±S.D), respectively, who had never exercised regularly up to that time. Treadmill training at the LT was carried out for 30min/day 3-6 times/week and continued for 9 months under the supervision of exercise physiology specialists.
In the training group, LT speed significantly increased from 3.43±0.65 km/h to 3.73±0.67 km/h (9.0%) in men, and from 2.75±0.57 km/h to 3.05±0.61 km/h (11.8%) in women (both P<0.05) . HDL-c was significantly increased 9 months after training both in men (19.2%) and women (20.9%) (both P<0.05) . The TC/HDL-c ratio, an atherogenetic index, was significantly (P<0.05) decreased by training in women but not in men. The other serum lipid and lipoprotein profiles were unchanged in both men and women. In the control group, all serum lipid and lipoprotein profiles were unchanged in both men and women.
The HDL-c level in the training group was higher than in the control group after 9 months in both men and women (both P<0.02) . The TC/HDL-c ratio in the training group was lower only in women (P<0.02) . There were no significant differences in other values between the training group and the control group in either men or women.
These results suggest that mild aerobic training at the LT is an effective method of improving the level of serum HDL-c, the TC/HDL-c ratio and aerobic capacity in the older patients with hypertension.
6.Coronary Artery Bypass with Free Internal Mammary Artery Grafts.
Yasunobu HARUTA ; Tadashi TASHIRO ; Ko TANAKA ; Masahiko NAGATA ; Masanao NAKAMURA ; Kageshige TODO
Japanese Journal of Cardiovascular Surgery 1992;21(6):529-533
We experienced 26 cases of free internal mammary artery (IMA) grafting for coronary artery bypass (CABG) during past 44 months. There were 3, 6 distal anastomoses per patient and 1.6 distal anastomoses per patient were performed with free IMA. The early mortality rate (within 1 month after surgery) was 3.8%. The surgical complications were 0 in mediastintis requiring operation, 0 in reoperation for bleeding and 1; phrenic nerve paralysis with respiratory dysfunction, the patency rate at 1 month after surgery were 97.2% in free IMA and were 96.1% in in-situ IMA. Conclusion was as followed that the use of free IMA for CABG provided excellent result in early period and we would anticipate to expand the use of IMA.
7.Attitudes of Medical Students Toward Oriental Medicine before and after Lecture Course.
Jiro IMANISHI ; Satoko WATANABE ; Hiroko KURIYAMA ; Hachiro HOSONO ; Kunio TANAKA ; Tadashi YANO ; Toyofumi HOSOKAWA
Kampo Medicine 2002;53(6):669-674
In order to examine the attitudes of medical students toward oriental medicine before and after lecture course, self-administered questionnaires were given the medical students of Kyoto Prefectural University of Medicine. Eighteen percent of the students had some experience with the prescription of Kampo medicine by doctors; 53% had used Kampo medicine purchased in pharmacies, and 13% had been treated with acupuncture and moxibustion. Eighty-four percent of the students were interested in oriental medicine; 82% thought that oriental medicine was worth learning; 76% thought that oriental medicine was essential in contemporary medicine and 54% wanted to introduce oriental medicine into their clinical practice in the future. These percentages increased after the lecture course to 92%, 85%, 87% and 62%, respectively.
8.Assessment of Surgical Training for First-Year Postgraduate Trainees; Analysis of Interrater Disagreements.
Yoshiaki SUGIURA ; Yutaka YOSHIZUMI ; Yuichi OZEKI ; Satoshi AIKO ; Tomokazu MATSUYAMA ; Tadashi MAEHARA ; Susumu TANAKA
Medical Education 2002;33(3):157-162
We investigated causes of interrater disagreements in the observational assessment of clinical training for first-year postgraduate trainees. In 1998 25 first-year postgraduates rotated through the Second Department of Surgery for 3 months, including 1 month in cardiovascular surgery, thoracic surgery, and upper-gastrointestinal surgery. Each trainee cared for several patients at most with a senior resident under the supervision of senior staff members. Nine attending physicians (staff members), 3 doctor-course graduates, and 2 chief residents assessed the trainees at the end of the rotation with special reference to clinical, social, and supervisory abilities. Trainees were given scores of “Good, ” “Fair, ” “Pass, ” or “Fail” for each ability. Interrater disagreements often involved responsibility and activeness, which reflected social abilities, and rapid patient consultations, orderly arrangement of laboratory examinations and procedures, and avoiding ordering of unnecessary laboratory examinations and medications, which reflected supervisory abilities. Assessments of poorly performing trainees often disagreed. Some interrater disagreements were seen among 4 of 14 attending physicians, but disagreements were fewer among the 3 doctor-course graduates and 2 chief residents who were graduates of the college. Both the proper training of assessors and a good relationship between assessors and rotators are necessary to make appropriate evaluations that might affect the career of postgraduates trainees.
9.Effects of Self-Planning and Human-Relations Training for Medical Students
Megumi NISHIKAWA ; Chisako MITUISHI ; Mari SUZUKI ; Hiromi WATANABE ; Hiroaki HORIKAWA ; Tadashi AOKI ; Akemi TANAKA ; Toshiko TAKEMIYA
Medical Education 2004;35(6):395-405
At Tokyo Women's Medical University, our curriculum for first-year students is designed to teach the dynamics and etiquette of human relations. During the third year, medical students are expected to anticipate and plan effective therapeutic communication and interaction with patients. A discussion group of 6 students and a member of the human-relations committee first clarify the purpose and develop the training; students then independently participate in human-relations training during the summer vacation. After training, experiences are discussed during class. Although this curriculum has been used for some 10 years, its benefits have been assumed but not validated. We used student reports and questionnaires to examine the effects of this curriculum. The results clearly show that planning and training give the students an opportunity to learn how to establish an effective physician-patient relationship.
10.Understanding Postpartum Healthcare Services and Exploring the Challenges and Motivations of Maternal Health Service Providers in the Philippines: a Qualitative Study
Tadashi Yamashita ; Sherri Ann Suplido ; Cecilia Llave ; Maria Teresa R. Tuliao ; Yuko Tanaka ; Hiroya Matsuo
Tropical Medicine and Health 2015;43(2):123-130
Background: Given the shortage of medical professionals in the Philippines, Barangay Health Workers (BHWs) may play a role in providing postpartum healthcare services. However, as there are no reports regarding BHW activities in postpartum healthcare, we conducted this study to understand postpartum healthcare services and to explore the challenges and motivations of maternal health service providers. Methods: Focus group interview (FGI) of 13 participants was conducted as qualitative research methodology at Muntinlupa City. The results were analyzed according to the interview guide. The proceedings of the FGI were transcribed verbatim, and researchers read and coded the transcripts. The codes were then used to construct categories. Results: Four important activities were highlighted among 11 analysis codes. These activities were “Assessment of postpartum women’s conditions,” “Recommendation to visit a health facility,” “Measurement of blood-pressure and vitamin intake,” and “Providing postpartum health information.” Among five analysis codes, we identified three challenges that BHWs face, which were “No current information regarding postpartum care,” “Some postpartum women do not want to receive healthcare services from BHW,” and “Too many assigned postpartum women.” Among five analysis codes, we identified two reasons for continuing BHW activities, which were “Hospitality to help postpartum women and their family in the community” and “Performance of mission in providing BHW services.” Conclusion: This study is the first to evaluate BHW activities in postpartum healthcare services. Our results indicate that BHWs play a potentially important role in evaluating postpartum women’s physical and mental conditions through home-visiting services. However, several difficulties adversely affected their activities, and these must be addressed to maximize the contributions of BHWs to the postpartum healthcare system.