4.The Application and Pitfalls for Registering New Japanese Board of Cardiovascular Surgery
Hironobu NISHIORI ; Takahiro ITO ; Kohei TONAI ; Rihito TAMAKI ; Yukika KAMEDA ; Yuta KITAGATA ; Taisuke SHIBUYA ; Takao MIKI ; Go MIYAZAKI ; Kaori MORI ; Misato TOKIOKA
Japanese Journal of Cardiovascular Surgery 2023;52(6):6-U1-6-U6
The first examination of the new board of the Japanese cardiovascular surgery took place in 2022. As it is a transitional period for the new system, many doctors are not familiar with the changes and details of the new system, and some have their concerns. Here, we held a round-table discussion with doctors who actually took the new board of the Japanese cardiovascular surgery under the new system, and we summarized their opinion.
5.A Case of Decreased Swallowing Function Due to Cardiac Myxoma
Sumiyo AKAZAWA ; Seiko MIURA ; Yasuhiro NAGAYOSHI ; Junya FUKUSHIMA ; Takahiro NISHINO ; Hiroji NAGATA ; Taigo NAGAYAMA ; Kazuaki NISHIKI ; Taishi FUJII ; Daisuke SAKAMOTO ; Tetsuya MINAMI ; Taketsugu TSUCHIYA ; Hidetaka URAMOTO ; Shigeru KUDOH ; Tamaki TAKANO ; Takaki MIWA ; Michihiko KITAYAMA ; Shigeru SKAMOTO
An Official Journal of the Japan Primary Care Association 2022;45(1):31-35
The case was a 77-year-old man. He had dizziness and dysphagia for 2 years, and underwent detailed screening at the internal medicine department for general malaise and bloody sputum. He was hospitalized for aspiration pneumonia due to dysphagia of unknown origin. This time, he visited a local doctor with palpitations and shortness of breath. Echocardiography indicated a left atrial tumor involving the mitral valve and arrhythmia. Emergency surgery was performed to remove the left atrial myxoma and close the patch at our hospital's cardiovascular surgery department. After the excision, swallowing function was restored, and the patient was diagnosed with postoperative Ortner's syndrome. We report a case where echocardiography was considered important as a detailed investigation of the cause of swallowing dysfunction and dizziness.
6.Measurement of the Calf Muscle Circumference is Useful for Diagnosing Sarcopenia in Older Adults Requiring Long-Term Care
Ryo SATO ; Yohei SAWAYA ; Tamaki HIROSE ; Takahiro SHIBA ; Lu YIN ; Shuntaro TSUJI ; Masahiro ISHIZAKA ; Tomohiko URANO
Annals of Geriatric Medicine and Research 2025;29(1):58-65
Background:
Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia.
Methods:
A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient.
Results:
Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80.
Conclusions
Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.
7.Measurement of the Calf Muscle Circumference is Useful for Diagnosing Sarcopenia in Older Adults Requiring Long-Term Care
Ryo SATO ; Yohei SAWAYA ; Tamaki HIROSE ; Takahiro SHIBA ; Lu YIN ; Shuntaro TSUJI ; Masahiro ISHIZAKA ; Tomohiko URANO
Annals of Geriatric Medicine and Research 2025;29(1):58-65
Background:
Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia.
Methods:
A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient.
Results:
Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80.
Conclusions
Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.
8.Measurement of the Calf Muscle Circumference is Useful for Diagnosing Sarcopenia in Older Adults Requiring Long-Term Care
Ryo SATO ; Yohei SAWAYA ; Tamaki HIROSE ; Takahiro SHIBA ; Lu YIN ; Shuntaro TSUJI ; Masahiro ISHIZAKA ; Tomohiko URANO
Annals of Geriatric Medicine and Research 2025;29(1):58-65
Background:
Calf muscle circumference is a potential alternative for measuring skeletal muscle mass. However, the association between calf muscle circumference and sarcopenia and the reliability of sarcopenia diagnosis based on calf muscle circumference have not been well reported. In this study, we aimed to determine the usefulness of calf muscle circumference measurement in the diagnosis of sarcopenia.
Methods:
A cross-sectional study was conducted using data collected from 63 older adults (40 male and 23 female; mean age, 79.7±6.5 years) using day-care rehabilitation. Sarcopenia was defined according to the guidelines of the 2019 Asian Working Group for Sarcopenia (AWGS 2019). The association between sarcopenia and calf muscle circumference was determined using multiple regression analysis, and the reliability of sarcopenia diagnosis based on calf muscle circumference was determined using the kappa coefficient.
Results:
Overall, 36.5% (30.4% female and 40.0% male) of the participants had sarcopenia. Calf muscle circumference was independently associated with sarcopenia. The best cutoff points for calf muscle circumference to identify older adults at risk of low skeletal muscle mass were 28.7 cm and 31.1 cm for female and male participants, respectively. Furthermore, the kappa coefficient between sarcopenia diagnosed using calf muscle circumference and that diagnosed using the AWGS 2019 criteria was 0.80.
Conclusions
Calf muscle circumference is independently and significantly associated with sarcopenia in older adults requiring long-term care. Calf muscle circumference is a surrogate for skeletal muscle mass and thus may be used to diagnose sarcopenia.
9.Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions
Seigo NAKATANI ; Kosuke OKUWAKI ; Masafumi WATANABE ; Hiroshi IMAIZUMI ; Tomohisa IWAI ; Takaaki MATSUMOTO ; Rikiya HASEGAWA ; Hironori MASUTANI ; Takahiro KUROSU ; Akihiro TAMAKI ; Junro ISHIZAKI ; Ayana ISHIZAKI ; Mitsuhiro KIDA ; Chika KUSANO
Clinical Endoscopy 2024;57(1):89-95
Background/Aims:
In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs).
Methods:
In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA’s diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs.
Results:
The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture.
Conclusions
Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.
10.Associations between trunk-to-peripheral fat ratio and cardiometabolic risk factors in elderly Japanese men: baseline data from the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study.
Katsuyasu KOUDA ; Yuki FUJITA ; Kumiko OHARA ; Takahiro TACHIKI ; Junko TAMAKI ; Akiko YURA ; Jong-Seong MOON ; Etsuko KAJITA ; Kazuhiro UENISHI ; Masayuki IKI
Environmental Health and Preventive Medicine 2021;26(1):35-35
BACKGROUND:
Body mass-independent parameters might be more appropriate for assessing cardiometabolic abnormalities than weight-dependent indices in Asians who have relatively high visceral adiposity but low body fat. Dual-energy X-ray absorptiometry (DXA)-measured trunk-to-peripheral fat ratio is one such body mass-independent index. However, there are no reports on relationships between DXA-measured regional fat ratio and cardiometabolic risk factors targeting elderly Asian men.
METHODS:
We analyzed cross-sectional data of 597 elderly men who participated in the baseline survey of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study, a community-based single-center prospective cohort study conducted in Japan. Whole-body fat and regional fat were measured with a DXA scanner. Trunk-to-appendicular fat ratio (TAR) was calculated as trunk fat divided by appendicular fat (sum of arm and leg fat), and trunk-to-leg fat ratio (TLR) as trunk fat divided by leg fat.
RESULTS:
Both TAR and TLR in the group of men who used ≥ 1 medication for hypertension, dyslipidemia, or diabetes ("user group"; N = 347) were significantly larger than those who did not use such medication ("non-user group"; N = 250) (P < 0.05). After adjusting for potential confounding factors including whole-body fat, both TAR and TLR were significantly associated with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, fasting serum insulin, and the insulin resistance index in the non-user group and non-overweight men in the non-user group (N = 199).
CONCLUSION
The trunk-to-peripheral fat ratio was associated with cardiometabolic risk factors independently of whole-body fat mass. Parameters of the fat ratio may be useful for assessing cardiometabolic risk factors, particularly in underweight to normal-weight populations.
Absorptiometry, Photon
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Adiposity/physiology*
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Aged
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Aged, 80 and over
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Biomarkers/metabolism*
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Cardiometabolic Risk Factors
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Cross-Sectional Studies
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Humans
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Intra-Abdominal Fat/diagnostic imaging*
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Japan
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Male
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Osteoporosis/etiology*
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Prospective Studies
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Risk Assessment
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Risk Factors
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Thorax/diagnostic imaging*