1.Development of a physical fitness evaluation method that accounts for individual growth status in 6-17 year old students using data obtained in 2009
Shigeru Obara ; Sachio Usui ; Akira Tamagawa ; Hiroaki Tanaka ; Yousuke Matsumoto
Japanese Journal of Physical Fitness and Sports Medicine 2012;61(4):403-414
Evaluation of the physical fitness level of children and adolescents must include consideration of individual growth rates. This study evaluates the relationship between height and physical fitness in a large sample of 6-17 yr students. Physical fitness test scores were calculated for every 1 cm height group and used to generate quadratic regression equations. Physical fitness data reported by the Ministry of Education, Culture, Sports, Science and Technology in Japan (MEXT) were compared with estimated values obtained using our regression equations. The differences between the values reported by MEXT and our estimated values were very small. Comparison of physical fitness T-scores calculated based on school grade averages with T-scores based on means calculated using our regression equations indicated that shorter height students had lower T-scores if school grade averages were used for the calculation. In conclusion, in elementary and junior high school students, it is important to evaluate physical fitness level relative to individual physical growth.
2.Quantitative Measurement of Blood Glucose Disposition Rate by Intravenous Glucose Infusion and the Effects of Warm Water Bathing
Nobuyuki TANAKA ; Mitsuru KOKUSHO ; Yousuke OHKATSU ; Megumi SHIMODOZONO ; Kazumi KAWAHIRA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2010;73(2):122-128
Blood glucose disposition rate after intravenous glucose infusion is considered to reflect mainly the rate of cellular glucose uptake, the rate of glucose degradation process and gluconeogenesis. excluding the influense of glucose absorption.
When it is hypothesized that the elevated blood glucose is disposed by constant rate (one-compartment theory), the following formula will be realized.
Ct = A (1— k)t Ct = blood glucose level at t-minutes after infusion
A = initial glucose level after infusion
k = constant glucose disposition index / min
log Ct = log A (1—k) t= log A + t log (1 — k)
This formula demonstrates that logarithm of blood glucose concentration (Ct) is a one-dimensional (linear) function of time t with a slope log (1 — k), and blood glucose disposition index k can be calculated from this slope.
To examine the validity of this hypothesis, 1.5 ml / kg of 20% glucose (0.3g / kg) was infused at rest within 3 minutes into an antecubital vein and plasma glucose was determinned at 1, 3, 5, 10, 15, 20, 30 and 40 min after the cessation of infusion.
In 10 healthy subjects, linear regression coefficient between logarithm of plasma glucose and time t was significantly higher (r= 0.992 ± 0.006, p<0.001) during 5 to 40 min. Calculated k index ranged from 0.78 to 4.54% / min and the correlation between the 1st and the 2nd measurements (n=5) within a week was also significantly high (0.92±0.06, p<0.01). These results highly support the validity of basic formula (one-compartment theory) and practical procedure to measure k index.
The effects of warm water bathing (42 C, 10min) was examined in 7 subjects keeping warmth by blankets. After bathing, k value remained in nearly the same in 4 subjects, decreased in 2 and increased in 1. Although more detailed studies are needed, the effect of single bathing on glucose disposition seems to be not so significant.
3.Causes of Spinal Cord Injury and Effects of the Great East Japan Earthquake Disaster in Our Hospital
Kuniaki AMANO ; Hiroshi AKAOGI ; Arata WATANABE ; Haruka TANAKA ; Yousuke SHIBAO
Journal of the Japanese Association of Rural Medicine 2014;63(2):93-98
It is often reported that the number of cases of cervical spinal cord injury without fracture resulting from falls have increased in recent years with a aging population. We reviewed the cases of cervical spinal cord injury in the patients who were admitted within two days after the injury to our department between January 2006 and December 2012, The subjects of this study numbered 167 cases;129 males and 38 females. The frequency of occurrence of cervical spinal cord injury, according to reports by the fire departments in the southwestern part of Ibaraki Prefecture is 32.0 per million individuals per year. In our cases under review, fractures were noted in 72 individuals, whereas 95 had no fractures. As to the causes of injury, traffic accidents topped the list with 38.9%, followed by falls with 28.7%, stumbles with 20.4%, and other factors with 12.0%. Cervical spinal cord injury account for 75% of all the cases of spinal cord injury with an incident of 30-40 cases per 100 million individuals per year. In 2011, the incidence of cervical spinal cord injuries resulting from traffic accidents decreased, while that of injuries related to falls increased. Six cases of injury resulting from falls happened during repairs on the damaged houses in the aftermath of the Great East Japan Earthquake of March 2013.
4.Effect of Edaravone on Cerebral Protection during Aortic Arch Surgery
Yousuke Kitanaka ; Haruo Makuuchi ; Hiroshi Murakami ; Makoto Ono ; Takashi Ando ; Kayoko Tanaka ; Shigeko Onuma
Japanese Journal of Cardiovascular Surgery 2011;40(2):48-53
Edaravone is an agent developed as a free radical scavenger, and is useful in functional recovery of the brain after cerebral infarction. However, to the best of our knowledge no experimental studies have been made regarding the effect of edaravone on cerebral protection during aortic arch surgery. We investigated the pharmacological effect of edaravone experimentally, through selective cerebral perfusion under deep hypothermia. Twelve adult dogs (body weight 14.8±2.0 kg) were used, and selective cerebral perfusion was performed under hypothermic circulatory arrest of 20°C for 120 min at 5 mg/kg/min, which was half the usual flow volume of cerebral perfusion. Group E (n=6) received 3 mg/kg edaravone for 30 min at the start of both selective cerebral perfusion and rewarming of the body, while Group C (n=6) received no drugs. Somatosensory evoked potential (SEP) was measured, and so were blood pressure, body temperature, pH level, oxygen partial pressure, and blood flow in the cerebral tissue. Histopathological investigations were also performed. In Group E, complete SEP recovery was observed in all dogs, while in Group C, complete SEP recovery was observed in only 2 dogs (33%) (p=0.014). A statistically significant difference was also observed in cerebral tissue pressure (p=0.014), but not in pH level, oxygen partial pressure, or cerebral tissue blood flow. On histopathological investigation, Group C demonstrated reduced staining of Nissl granules in neurons of the cerebral cortex, and many of them presented the appearance of acute circulatory impairment while Group E demonstrated no reduction in staining of Nissl granules. In the present experimental study of selective cerebral perfusion under deep hypothermia below the safety threshold flow, edaravone was effective in cerebral protection.
5.Impact of Hospital Integration on Emergency Surgery Patients with Stanford Type A Acute Aortic Dissection
Hidekazu NAKAI ; Hidetaka WAKIYAMA ; Makoto KUSAKIZAKO ; Daiki KATO ; Ryota TAKAHASHI ; Yousuke TANAKA ; Ayako MARUO ; Hidehumi OBO
Japanese Journal of Cardiovascular Surgery 2024;53(2):49-55
Objective: Hospitals throughout Japan are being integrated and reorganized under the government's regional medical care plan. However, the effects on cardiovascular surgery practice remain unknown. In the year 2016, our institution employed hospital integration; we report its effects on patients with type A acute aortic dissection who underwent emergency surgery. Methods: This study included 89 patients who underwent emergency surgery for type A acute aortic dissection from May 2012 to December 2020. Evaluation items included preoperative patient factors, number of surgeries, surgical mortality, referral rate, patient transport time, transport distance, number of surgeries performed by young cardiovascular surgeons, and overtime work for surgery. Patients were categorized into pre-(group P: 29 patients) and post-integration (group A: 60 patients) groups, which were retrospectively compared. Results: Preoperative factors were not significantly different between the two groups. Operations accounted for 29 and 60 in groups P and A, respectively; they increased significantly after integration (p=0.005). Surgical mortality was 27.6 and 15% in groups P and A, respectively, with no significant difference (p=0.2). The referral rate was 17 (58.6%) and 21 (35%) patients in groups P and A, respectively; group A displayed a significantly lower referral rate (p=0.04). The interval from the onset of symptoms to arrival at the surgery cite was significantly reduced (p=0.01) in group A (112±140 min) compared to group P (206±201 min). There was no significant difference in the transfer distance between groups P (13.9±14.8 km) and A (13.5±16.2 km). The number of surgeries performed by young surgeons increased in 9 cases (31%) in group P and 34 cases (56.7%) in group A (p=0.02). Overtime work was substantially reduced:446±154 min in group P and 349±112 min in group A. Conclusion: Hospital integration resulted in increased number of acute aortic dissection surgeries and decreased interval time from the onset of symptoms to arrival at the surgery cite. The young surgeons performed more surgeries and reduced their overtime work.