1.Therapeutic Impact on Quality of Life in Adult Patients With Chronic Intestinal Pseudo-obstruction: A Multicenter, Cohort Study
Kota TAKAHASHI ; Takaomi KESSOKU ; Hidenori OHKUBO ; Yo ISHIHARA ; Kosuke TANAKA ; Tomoki OGATA ; Tsumugi JONO ; Atsushi YAMAMOTO ; Anna OZAKI ; Yuki KASAI ; Michihiro IWAKI ; Akiko FUYUKI ; Takayuki KATO ; Yasunari SAKAMOTO ; Takeo KURIHASHI ; Hirotoshi EBINUMA ; Atsushi NAKAJIMA
Journal of Neurogastroenterology and Motility 2026;32(2):244-253
Background/Aims:
To evaluate the quality of life (QOL) of patients with chronic intestinal pseudo-obstruction (CIPO) before and after treatment.
Methods:
This study enrolled 50 adult patients diagnosed with CIPO at 4 institutions, of whom 42 underwent therapy.Patient background, body mass index, treatment, palliative care intervention, numerical rating scale for abdominal pain or bloating, the medical outcomes study 36-item short-form health survey (SF-36) and summary scores (physical component summary, mental component summary, and role/social component summary), Japanese version of the Patient Assessment of Constipation Quality of Life (JPAC-QOL) and subscales (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction), and Patient Assessment of Constipation Symptoms (PAC-SYM) and subscales (stool, rectal, and abdominal symptoms) were prospectively sampled and collected.
Results:
The patients (n = 50; 35 females and 15 males) had an average age of onset of 44.7 years and, body mass index of 17.3 kg/m², and 38 (76%) required palliative care intervention. Effective therapeutic interventions included intestinal sterilization (19/42), decompression therapy with percutaneous endoscopic gastrojejunostomy (PEG-J) (6/42), and dietary restriction (6/42). The numerical rating scale for abdominal distension and pain decreased significantly after treatment. All SF-36 summary scores showed improvements. The JPAC-QOL and PAC-SYM both showed improvement overall and in all subscales.
Conclusions
Patients with CIPO have a lower physical, psychological and social QOL, which is equivalent to or lower than that of adult patients with inflammatory bowel disease or psychiatric disorders. Sterilization of the intestinal tract and PEG-J decompression effectively improve the QOL of patients.
2.Mechanical characteristics of different braiding methods used in canine self-expanding tracheal stents
Akiko UEMURA ; Masashi TANAKA ; Tomohiko YOSHIDA
Journal of Veterinary Science 2026;27(1):e14-
Objective:
This study compared the mechanical properties of two self-expanding nitinol tracheal stents with different braided patterns—a conventional cross-braided design and a cross-and-hook braided design—to assess their mechanical characteristics and potential suitability for use in dogs.
Methods:
Mechanical testing was performed on two commercial veterinary tracheal stents: a cross-braided stent and a cross-and-hook braided stent (Fauna stent; M.I.TECH. Co. Ltd, Korea).The flexural stiffness was assessed using a three-point bending test, while the radial and axial mechanical strengths were evaluated using compression and tensile tests, respectively.
Results:
The cross-and-hook braided stent showed greater bending flexibility and slightly higher radial stiffness than the cross-braided stent. Both stents showed comparable tensile resistance within the physiological deformation ranges. The cross-and-hook structure also retained its cell geometry under compression and resisted permanent deformation more effectively.
Conclusions
and Relevance: The cross-and-hook braided stent showed trends toward improved mechanical properties relevant to the clinical performance in dogs, with possible benefits in reducing stent fatigue and rupture. These findings highlight its potential suitability for managing tracheal collapse in dogs and may help guide future development of veterinary and human stents.
3.Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke TANAKA ; Hidenori OHKUBO ; Atsushi YAMAMOTO ; Kota TAKAHASHI ; Yuki KASAI ; Anna OZAKI ; Michihiro IWAKI ; Takashi KOBAYASHI ; Tsutomu YOSHIHARA ; Noboru MISAWA ; Akiko FUYUKI ; Shingo KATO ; Takuma HIGURASHI ; Kunihiro HOSONO ; Masato YONEDA ; Takeo KURIHASHI ; Masataka TAGURI ; Atsushi NAKAJIMA ; Kok-Ann GWEE ; Takaomi KESSOKU
Journal of Neurogastroenterology and Motility 2023;29(3):378-387
Background/Aims:
Natural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients.
Methods:
From October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course.
Results:
Forty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2 , 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care.
Conclusion
CIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.
4.Surgical outcomes in dogs with tracheal collapse treated with a novel crossand-hook braided endoluminal stent
Akiko UEMURA ; Yusuke OZAI ; Lina HAMABE ; Tomohiko YOSHIDA ; Ryou TANAKA
Journal of Veterinary Science 2022;23(3):e46-
Background:
Stenting is an effective treatment option for tracheal collapse in dogs. Crossbraided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs.
Objectives:
To evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs.
Methods:
The medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically.
Results:
Twenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs.
Conclusions
Compared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse.
5.Clip ligation for treatment of patent ductus arteriosus occlusion in three cats
Yusuke OZAI ; Akiko UEMURA ; Ryou TANAKA ; Aki TAKEUCHI ; Lina HAMABE ; Kazumi SHIMADA ; Aimi YOKOI ; Miki HIROSE ; Momoko WATANABE ; Katsumi UEHARA
Journal of Veterinary Science 2022;23(4):e39-
Patent ductus arteriosus (PDA) is a rare congenital cardiovascular anomaly in cats. Due to their small body, intercostal thoracotomy is the most common option to close the PDA.However, few reports detail the surgical technique for ligating PDA in kittens. In this case report, three cats weighing 1.4 kg, 1.2 kg, and 2.9 kg were diagnosed PDA. Clip ligation via left fourth intercostal thoracotomy was performed and the cats were successfully treated.Postoperative echocardiography showed no residual flow in any of the cases. This case report highlights clip occlusion for small cats with PDA could be safe and effective.
6.What lifestyles are risk factors for low well-being of healthy elderlies dwelled in a local city in super-aging Japan? ―Kizugawa cohort study―
Akiko HOSHINO ; Nobuhito ISHIKAWA ; Mai TANAKA ; Kanae USUI ; Michiko KOMATA ; Miho SHIZAWA ; Toshiki KATSURA
Journal of Rural Medicine 2020;15(3):73-84
The purpose of this cohort study is to clarify the risk factors of low well-being of elderly people who residing in a local city of a super-aging country, Japan.Subjects are people, who have selected randomly from healthy elderly people resided in Kizugawa City, Kyoto Prefecture, in 2010, followed until 2015. Question survey was conducted in both year, and questionnaire consisted of items such as basic attributes, lifestyles (health practices, consultation behaviors, social activities and so on) and well-being (WHO-5). In analysis we made multi-logistic regression analysis using lifestyle variables as an independent variable and well-being as a dependent variable.The results were as follows.1. Risk factors were not to exercise, knowledge of appropriate diet, subjective feeling of stress for at least a month, not to participate in voluntary activities, age and bad subjective feeling of health.2. Risk factors in regard to changes of lifestyles using good-good lifestyles as a reference were sustainment of having no time for hobby or relaxation, sustainment or deterioration of subject feeling of stress for at least a month, sustainment or deterioration of having no time for relaxation and deterioration of having no activities with pleasure or aim. A factor promoting well-being is to have more frequencies for going out home.This study shows that in a longevity society it is important for community-dwelling elderly Japanese to have good health practices, appropriate consultation behaviors and good social activities for the purpose of keeping good well-being, and that these results are contributed to health promotion policy for community-dwelling elderly people.
7.Characteristics of Socially Isolated Elderly People in a Rural Area According to a New Classification System Based on Intentionality in Social Choices
Mai TANAKA ; Toshiki KATSURA ; Shinji ISHIKAWA ; Akiko HOSHINO ; Miho SHIZAWA ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2020;68(6):773-
The aim of this study was to analyze the relationships among various characteristics such as personal attributes, health status, and social functioning in socially isolated elderly people according to a new classification based on intentionality in social choices, and to clarify the characteristics and issues of these individuals living in the community. We conducted a questionnaire survey of all healthy elderly people in Town A, which is located in a rural area. We classified respondents as non-socially isolated, intentionally socially isolated, or accidentally socially isolated. We then compared the three groups. Correspondence analysis was used to examine relationships among personal attributes and physical, mental, social functioning in the three groups. Valid responses were received from 1,284 respondents. Results showed that intentional social isolation was associated with living alone and poor physical functioning but not with medical history. Thus, intentional social isolation requires interventions for improving lifestyle, physical activity, nutrition, and oral care to prevent frailty among elderly people living in the community. Accidental social isolation was associated with depression and cognitive decline, and therefore requires mental health intervention. In addition, the accidentally socially isolated elderly tended to have low socioeconomic status, so it is necessary to create a mechanism for the early identification of high-risk individuals during monitoring and intervention provided by health and welfare professionals in various fields.
8.Clinical and MRI Characteristics of Uterine Cervical Adenocarcinoma: Its Variants and Mimics
Tsukasa SAIDA ; Akiko SAKATA ; Yumiko Oishi TANAKA ; Hiroyuki OCHI ; Toshitaka ISHIGURO ; Masafumi SAKAI ; Hiroaki TAKAHASHI ; Toyomi SATOH ; Manabu MINAMI
Korean Journal of Radiology 2019;20(3):364-377
Adenocarcinoma currently accounts for 10–25% of all uterine cervical carcinomas and has a variety of histopathological subtypes. Among them, mucinous carcinoma gastric type is not associated with high-risk human papillomavirus (HPV) infection and a poor prognosis, while villoglandular carcinoma has an association with high-risk HPV infection and a good prognosis. They show relatively characteristic imaging findings which can be suggested by magnetic resonance imaging (MRI), though the former is sometimes difficult to be distinguished from lobular endocervical glandular hyperplasia. Various kinds of other tumors including squamous cell carcinoma should be also differentiated on MRI, while it is currently difficult to distinguish them on MRI, and HPV screening and pathological confirmation are usually necessary for definite diagnosis and further patient management.
Adenocarcinoma
;
Adenocarcinoma, Mucinous
;
Carcinoma, Squamous Cell
;
Diagnosis
;
Humans
;
Hyperplasia
;
Magnetic Resonance Imaging
;
Mass Screening
;
Prognosis
;
Uterine Cervical Neoplasms
;
Uterus
9.Unruptured right sinus of Valsalva aneurysm in a Maltese dog: a case report
Akiko UEMURA ; Ryou TANAKA ; Telma Mary NAKATA ; Ryousuke NAMIKI ; Takashi TANAKA ; Katsuhiro MATSUURA ; Tomohiko YOSHIDA
Journal of Veterinary Science 2019;20(3):e20-
A rare case of an unruptured sinus of Valsalva aneurysm (SVA) in a 2-month-old male Maltese terrier weighing 1.0 kg with a heart murmur is presented. A right SVA and a ventricular septal defect (VSD) were diagnosed by echocardiography and cardiac catheterization. The dog died due to a worsening of his condition. The necropsy revealed the sinus of Valsalva to have a diameter of 7 mm and a VSD hole was on the opposite surface. This report is the first to describe an unruptured SVA in the right coronary cusp of a small dog.
Aneurysm
;
Animals
;
Cardiac Catheterization
;
Cardiac Catheters
;
Dogs
;
Echocardiography
;
Heart Defects, Congenital
;
Heart Murmurs
;
Heart Septal Defects, Ventricular
;
Humans
;
Infant
;
Male
;
Sinus of Valsalva
10.Hybrid balloon dilation treatment for cor triatriatum dexter in a small breed puppy
Akiko UEMURA ; Tomohiko YOSHIDA ; Katsuhiro MATSUURA ; Zeki YILMAZ ; Ryou TANAKA
Journal of Veterinary Science 2019;20(5):e49-
The authors encountered a 4-month-old, female Shiba dog weighing 4.0 kg, who had been exhibiting abdominal distension and increasing ascites for 2 months. She was brought for further examination and treatment with the chief complaints of ascites and dyspnoea during sleep. The dog was diagnosed with ascites caused by cor triatriatum dexter based on the physical and imaging findings. Under general anaesthesia, she was treated with hybrid balloon dilation under transoesophageal echocardiography guidance. Her postoperative recovery was quite rapid and uneventful. This method appears to be a useful, new, and less-invasive treatment option for cor triatriatum dexter.
Animals
;
Ascites
;
Cor Triatriatum
;
Dogs
;
Echocardiography
;
Echocardiography, Transesophageal
;
Female
;
Heart Defects, Congenital
;
Humans
;
Infant
;
Methods


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