start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=160 end-page=173 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202601 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Long-Term Safety and Effectiveness of Durvalumab in Unresectable Stage III NSCLC in Japan: A Multicenter Prospective Study (AYAME) en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: Based on the PACIFIC trial results, durvalumab after chemoradiotherapy (CRT) is the standard of care for unresectable stage III NSCLC. However, few large-scale studies have prospectively evaluated its long-term effectiveness and safety, including subsequent treatment.
Methods: This multicenter, noninterventional study (AYAME) enrolled patients who were prescribed durvalumab for unresectable stage III NSCLC after CRT (July 2019?December 2020; 52 sites; Japan). Patients received durvalumab for a maximum of 12 months and were prospectively followed up for 3 years, including the post-durvalumab treatment period. Primary end points were real-world progression-free survival (rwPFS), the incidence of interstitial lung disease (ILD), and adverse events of special interest (AESIs).
Results: Of the 529 enrolled patients, 512 received durvalumab and 511 comprised the safety analysis population. The median time to onset of the first presentation or occurrence of ILD was 45.0 days. ILD of any grade occurred in 387 patients (75.7%) over the 3-year study period: grade 3, 57 (11.2%); grade 4, none (0.0%); and grade 5, 9 (1.8%). The most common AESIs of any grade during durvalumab treatment were thyroid dysfunction (12.5%), hepatic dysfunction (7.2%), and colitis (2.0%). No durvalumab treatment-related ILD or AESIs occurred during the post-treatment period. The median [95% confidence interval] rwPFS was 23.2 [18.2, 27.2] months in the effectiveness analysis population (n = 495). rwPFS rates were 62.5%, 54.6%, 49.4%, and 40.4% at 12, 18, 24, and 36 months, respectively.
Conclusions: This first and largest prospective, observational study demonstrated the long-term safety and effectiveness of durvalumab for unresectable stage III NSCLC after CRT in a real-world clinical setting.
Clinical Trial Registration: UMIN000037090 and NCT03995875 en-copyright= kn-copyright= en-aut-name=KenmotsuHirotsugu en-aut-sei=Kenmotsu en-aut-mei=Hirotsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoYoshinobu en-aut-sei=Saito en-aut-mei=Yoshinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NinomiyaKiichiro en-aut-sei=Ninomiya en-aut-mei=Kiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UematsuShinya en-aut-sei=Uematsu en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AkdemirBurak en-aut-sei=Akdemir en-aut-mei=Burak kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FukuiAyako en-aut-sei=Fukui en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KotoRyo en-aut-sei=Koto en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=FujiwaraMasakazu en-aut-sei=Fujiwara en-aut-mei=Masakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwaoChikako en-aut-sei=Iwao en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KitagawaHiroshi en-aut-sei=Kitagawa en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YoshinoIchiro en-aut-sei=Yoshino en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=GemmaAkihiko en-aut-sei=Gemma en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MitsudomiTetsuya en-aut-sei=Mitsudomi en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=YamamotoNobuyuki en-aut-sei=Yamamoto en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Division of Thoracic Oncology, Shizuoka Cancer Center kn-affil= affil-num=2 en-affil=Department of Respiratory Medicine, Nippon Medical School, Musashi Kosugi Hospital kn-affil= affil-num=3 en-affil=Center for Comprehensive Genomic Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Oncology Medical, AstraZeneca K.K. kn-affil= affil-num=5 en-affil=Oncology Medical, AstraZeneca K.K. kn-affil= affil-num=6 en-affil=Evidence and Observational Research, Medical, AstraZeneca K.K. kn-affil= affil-num=7 en-affil=Evidence and Observational Research, Medical, AstraZeneca K.K. kn-affil= affil-num=8 en-affil=Evidence and Observational Research, Medical, AstraZeneca K.K. kn-affil= affil-num=9 en-affil=Oncology Medical, AstraZeneca K.K. kn-affil= affil-num=10 en-affil=Oncology Medical, AstraZeneca K.K. kn-affil= affil-num=11 en-affil=Department of Thoracic Surgery, International University of Health and Welfare Narita Hospital kn-affil= affil-num=12 en-affil=Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School kn-affil= affil-num=13 en-affil=Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine and Faculty of Medicine & Hospital kn-affil= affil-num=14 en-affil=Internal Medicine III, Wakayama Medical University kn-affil= en-keyword=Durvalumab kn-keyword=Durvalumab en-keyword=Chemoradiotherapy kn-keyword=Chemoradiotherapy en-keyword=Interstitial lung disease kn-keyword=Interstitial lung disease en-keyword=Real-world evidence kn-keyword=Real-world evidence en-keyword=Unresectable stage III NSCLC kn-keyword=Unresectable stage III NSCLC END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=8 article-no= start-page=e106715 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202608 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Study protocol for a phase II clinical trial evaluating the safety and efficacy of favipiravir injection combined with oseltamivir in influenza treatment en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction Older adults are at an increased risk of influenza-related hospitalisation and mortality due to a combination of risk factors. Severe influenza and excess mortality in this population remain major public health concerns, underscoring the need for novel treatment strategies.
Methods and analysis This multicentre, investigator-initiated, randomised, double-blind clinical trial evaluated the efficacy and safety of the investigational drug favipiravir injection (T-705IV) in combination with oseltamivir phosphate, compared with oseltamivir monotherapy in hospitalised patients with influenza aged ?65 years. Both T-705IV and oseltamivir phosphate will be administered for 5?days. The primary endpoint is time from randomisation to recovery within 15 days. Recovery is defined as either actual hospital discharge or sustained clinical status permitting discharge for 3 consecutive days. Clinical status will be assessed using a 7-point ordinal scale based on hospitalisation status and oxygen requirement. The primary analysis employs a Bayesian Cox proportional hazards model with a non-informative prior to estimate the posterior probability that the HR exceeds 1.0. The secondary endpoints include the distribution of 7-point scale scores over a 29-day period; rates of clinical worsening at days 15 and 29; duration of fever; all-cause mortality; intensive care unit admission within 29 days; pneumonia complication rate at 15 days; and changes in viral titre and viral RNA load on days 1, 2, 3 and 7. Safety will be assessed through the collection of adverse events (AEs) up to day 29. Pharmacokinetic evaluation will include measurement of plasma favipiravir concentrations on day 3. The planned sample size is 80 patients (40 per group).
Ethics and dissemination Written informed consent will be obtained from all participants. This study was approved by the Center Hospital of the National Center for Global Health and Medicine Institutional Review Board (approval number: NCGM-I-022-24a) and registered in the Japan Registry of Clinical Trials. Study findings will be disseminated through peer-reviewed publications and/or presentations at academic conferences.
Trial registration number jRCT2031240586, en-copyright= kn-copyright= en-aut-name=HikidaSayaka en-aut-sei=Hikida en-aut-mei=Sayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NomotoHidetoshi en-aut-sei=Nomoto en-aut-mei=Hidetoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UemuraYukari en-aut-sei=Uemura en-aut-mei=Yukari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SuzukiTadaki en-aut-sei=Suzuki en-aut-mei=Tadaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IzumikawaKoichi en-aut-sei=Izumikawa en-aut-mei=Koichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OhgeHiroki en-aut-sei=Ohge en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamatoMasaya en-aut-sei=Yamato en-aut-mei=Masaya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KatoYasuyuki en-aut-sei=Kato en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HaseRyota en-aut-sei=Hase en-aut-mei=Ryota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AoyagiTetsuji en-aut-sei=Aoyagi en-aut-mei=Tetsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NukuiYoko en-aut-sei=Nukui en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=YamamotoKazuko en-aut-sei=Yamamoto en-aut-mei=Kazuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TakesueYoshio en-aut-sei=Takesue en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SawadaKota en-aut-sei=Sawada en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=ShimizuYosuke en-aut-sei=Shimizu en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MiyamotoSho en-aut-sei=Miyamoto en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=TamuraNamiko en-aut-sei=Tamura en-aut-mei=Namiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=TakahashiKozue en-aut-sei=Takahashi en-aut-mei=Kozue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=SaitoSho en-aut-sei=Saito en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=MiyazakiKazuki en-aut-sei=Miyazaki en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=MorinoEriko en-aut-sei=Morino en-aut-mei=Eriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=TokitaDaisuke en-aut-sei=Tokita en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=OhmagariNorio en-aut-sei=Ohmagari en-aut-mei=Norio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= affil-num=1 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= affil-num=2 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= affil-num=3 en-affil=Laboratory of Biostatistics, Department of Data Science, Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=4 en-affil=Department of Infectious Disease Pathology, National Institute of Infectious Diseases, Japan Institute for Health Security kn-affil= affil-num=5 en-affil=Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences kn-affil= affil-num=6 en-affil=Project Research Center for Nosocomial Infectious Diseases, Hiroshima University kn-affil= affil-num=7 en-affil=Infectious Diseases Center, Rinku General Medical Center kn-affil= affil-num=8 en-affil=Department of Infectious Diseases, International University of Health and Welfare Narita Hospital kn-affil= affil-num=9 en-affil=Department of Infectious Diseases, Japanese Red Cross Narita Hospital kn-affil= affil-num=10 en-affil=Department of Clinical Microbiology and Infection, Tohoku University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Infectious Diseases, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Infection Control & Laboratory Medicine, Kyoto Prefectural University of Medicine kn-affil= affil-num=13 en-affil=First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine kn-affil= affil-num=14 en-affil=Chita Peninsula General Medical Organization, Rinku Hospital kn-affil= affil-num=15 en-affil=Laboratory of Biostatistics, Department of Data Science, Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=16 en-affil=Laboratory of Biostatistics, Department of Data Science, Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=17 en-affil=Department of Infectious Disease Pathology, National Institute of Infectious Diseases, Japan Institute for Health Security kn-affil= affil-num=18 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= affil-num=19 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= affil-num=20 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= affil-num=21 en-affil=Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=22 en-affil=Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=23 en-affil=Center for Clinical Sciences, Japan Institute for Health Security kn-affil= affil-num=24 en-affil=Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security kn-affil= END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=10 article-no= start-page=489 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260923 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficacy and Safety of Switching from Nalfurafine to Difelikefalin in Hemodialysis Patients with Refractory Pruritus en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Hemodialysis-associated pruritus is common and can substantially impair quality of life. Given its heterogeneous pathophysiology and variable treatment response, individualized therapeutic strategies are needed. This study investigated the prevalence and severity of pruritus and clinical outcomes after switching from nalfurafine to difelikefalin. Methods: Clinical data from 108 maintenance hemodialysis patients whose pruritus severity was assessed using the Numerical Rating Scale (NRS) were retrospectively reviewed. Ten patients with persistent moderate-to-severe pruritus (NRS ? 3) despite treatment with nalfurafine were switched to difelikefalin in routine clinical practice, of whom eight completed the 16-week follow-up and were included in the switch group. Eight patients matched for age, sex, dialysis vintage, and baseline NRS served as controls. Changes in NRS scores at weeks 4 and 16, as well as adverse events, were evaluated. Results: Among 108 patients, 21 (20%) had no pruritus, while 20 (18.5%), 47 (43.5%), and 20 (18.5%) had mild, moderate, and severe pruritus, respectively. Of 14 patients receiving nalfurafine, 13 (92.9%) had persistent moderate-to-severe pruritus. In the switch group, mean NRS decreased from 5.9 亇 1.7 at baseline to 2.3 亇 2.3 at week 4 and 2.0 亇 0.9 at week 16 (p = 0.0156 and p = 0.0078, respectively), with no meaningful change in controls. No serious adverse events strongly related to difelikefalin were identified. Conclusions: Pruritus was highly prevalent in this cohort. Switching to difelikefalin was associated with rapid and sustained improvement in patients inadequately responsive to nalfurafine, with favorable tolerability, supporting its potential role as an individualized treatment option. en-copyright= kn-copyright= en-aut-name=SakurabuYoshimasa en-aut-sei=Sakurabu en-aut-mei=Yoshimasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TokunagaKumiko en-aut-sei=Tokunaga en-aut-mei=Kumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OgisoYuko en-aut-sei=Ogiso en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MotoieMiwako en-aut-sei=Motoie en-aut-mei=Miwako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YoshitakeMegumi en-aut-sei=Yoshitake en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SugimotoTaro en-aut-sei=Sugimoto en-aut-mei=Taro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Sugimoto Clinic kn-affil= affil-num=4 en-affil=Sugimoto Clinic kn-affil= affil-num=5 en-affil=Sugimoto Clinic kn-affil= affil-num=6 en-affil=Sugimoto Clinic kn-affil= affil-num=7 en-affil=Sugimoto Clinic kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=hemodialysis-associated pruritus kn-keyword=hemodialysis-associated pruritus en-keyword=difelikefalin kn-keyword=difelikefalin en-keyword=kappa-opioid receptor agonist kn-keyword=kappa-opioid receptor agonist en-keyword=refractory pruritus kn-keyword=refractory pruritus en-keyword=nalfurafine kn-keyword=nalfurafine END start-ver=1.4 cd-journal=joma no-vol=31 cd-vols= no-issue=6 article-no= start-page=979 end-page=988 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260416 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficacy of bepotastine compared with hydroxyzine in preventing rituximab-induced infusion-related reactions in non-hodgkin lymphoma patients: a phase II, double-blind, multicenter, and randomized trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background This study evaluated the efficacy of hydroxyzine and bepotastine, first- and second-generation H1 receptor antagonists (H1RA), as pretreatments to prevent infusion-related reactions (IRRs) during the initial rituximab infusion in patients with non-Hodgkin lymphoma.
Methods In this double-blind, multicenter, randomized phase II study, 40 patients received hydroxyzine or bepotastine with acetaminophen 30 min before rituximab infusion. Primary endpoint was incidence of???grade 2 IRRs based on the National Cancer Institute Common Terminology Criteria for Adverse Events. Secondary endpoints included IRRs severity, time to IRR onset, and H1RA-induced drowsiness.
Results Incidence of???grade 2 IRRs was 52.4% and 31.6% for the hydroxyzine (n?=?21) and bepotastine (n?=?19) groups, respectively (P?=?0.184). Distribution of initial and maximum IRR grades in the two groups was not statistically significant (P?=?0.846 and 0.555). Median time (range) to IRR onset in the two groups was 67 (12?112) and 62 (10?119) min, respectively (P?=?0.981). Median visual analog scale score (range and 75th percentile) for drowsiness was 37 (0?100, 46) and 12 (0?100, 29) mm in the two groups, respectively (P?=?0.138). Incidence of???grade 2 IRRs in the absence of bone marrow infiltration was 43.8% and 14.3% in the two groups, respectively (P?=?0.118), and no group differences were observed with bone marrow infiltration.
Conclusions Bepotastine did not show significant superiority over hydroxyzine in preventing rituximab-induced IRRs due to the small sample size. Nevertheless, this exploratory study provides insight for further confirmatory studies.
Trial registration number and date of registration jRCTs051220169; February 14, 2023. en-copyright= kn-copyright= en-aut-name=KitahiroYumi en-aut-sei=Kitahiro en-aut-mei=Yumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MinamiHironobu en-aut-sei=Minami en-aut-mei=Hironobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamamotoKazuhiro en-aut-sei=Yamamoto en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YakushijinKimikazu en-aut-sei=Yakushijin en-aut-mei=Kimikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KurataKeiji en-aut-sei=Kurata en-aut-mei=Keiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SakaiRina en-aut-sei=Sakai en-aut-mei=Rina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SaekiMiki en-aut-sei=Saeki en-aut-mei=Miki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Okazoe-HirakawaYuri en-aut-sei=Okazoe-Hirakawa en-aut-mei=Yuri kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IidaKotaro en-aut-sei=Iida en-aut-mei=Kotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MuraseNatsuko en-aut-sei=Murase en-aut-mei=Natsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HarimaIsamu en-aut-sei=Harima en-aut-mei=Isamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KitamuraNaoko en-aut-sei=Kitamura en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=ItoharaKotaro en-aut-sei=Itohara en-aut-mei=Kotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=OmuraTomohiro en-aut-sei=Omura en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SugimotoTakeshi en-aut-sei=Sugimoto en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=TakakuraHidetomo en-aut-sei=Takakura en-aut-mei=Hidetomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=KitaoAkihito en-aut-sei=Kitao en-aut-mei=Akihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=TakahashiMasako en-aut-sei=Takahashi en-aut-mei=Masako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=ShimoyamaManabu en-aut-sei=Shimoyama en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=OkunoMamoru en-aut-sei=Okuno en-aut-mei=Mamoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=YanoIkuko en-aut-sei=Yano en-aut-mei=Ikuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= affil-num=1 en-affil=Department of Pharmacy, Kobe University Hospital kn-affil= affil-num=2 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=5 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=6 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=7 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=8 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=9 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=10 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=11 en-affil=Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine kn-affil= affil-num=12 en-affil=Department of Pharmacy, Kobe University Hospital kn-affil= affil-num=13 en-affil=Department of Pharmacy, Kobe University Hospital kn-affil= affil-num=14 en-affil=Department of Pharmacy, Kobe University Hospital kn-affil= affil-num=15 en-affil=Department of Hematology and Oncology, Kita-Harima Medical Center kn-affil= affil-num=16 en-affil=Department of Hematology and Oncology, Kita-Harima Medical Center kn-affil= affil-num=17 en-affil=Department of Hematology and Oncology, Kita-Harima Medical Center kn-affil= affil-num=18 en-affil=Department of Pharmacy, Kita-Harima Medical Center kn-affil= affil-num=19 en-affil=Department of Hematology and Oncology, Kohnan Medical Center kn-affil= affil-num=20 en-affil=Department of Pharmacy, Kohnan Medical Center kn-affil= affil-num=21 en-affil=Department of Pharmacy, Kobe University Hospital kn-affil= en-keyword=Rituximab kn-keyword=Rituximab en-keyword=Infusion-related reactions kn-keyword=Infusion-related reactions en-keyword=Non-Hodgkin lymphoma kn-keyword=Non-Hodgkin lymphoma en-keyword=Bepotastine kn-keyword=Bepotastine en-keyword=Hydroxyzine kn-keyword=Hydroxyzine en-keyword=Drowsiness kn-keyword=Drowsiness END start-ver=1.4 cd-journal=joma no-vol=17 cd-vols= no-issue=1 article-no= start-page=e77709 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250120 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association Between Dinner-to-Bed Time and Gastroesophageal Reflux-Related Diseases in Children en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: Gastroesophageal reflux disease (GERD) is characterized by esophageal mucosal injury due to the reflux of gastroduodenal contents. Typical symptoms include heartburn and acid regurgitation. In addition, gastroesophageal reflux (GER) can influence conditions such as otitis media, rhinitis, and asthma. This study aimed to examine the association between dinner-to-bed time and GER-related diseases, such as otitis media, allergic rhinitis, and asthma.
Methods: This was a longitudinal cohort study using secondary data. Data were collected from a large-scale birth cohort study conducted in Japan including babies born in 2001 and 2010. Dinner-to-bed time was categorized as 乬longer dinner-to-bed time" (>120 minutes), 乬shorter dinner-to-bed time" (?120 minutes or less), and 乬irregular dinner-to-bed time.乭 Modified Poisson regression with robust variance was used to estimate risk ratios (RRs).
Results: A total of 60,392 children were included in this study. Children with shorter dinner-to-bed time had a higher risk of asthma (adjusted RR (aRR)?=?1.10; 95% confidence interval (CI), 1.03-1.18) than those with longer dinner-to-bed time. However, no significant association was observed between shorter dinner-to-bed time and otitis media or allergic rhinitis. Furthermore, supplementary analyses revealed that the risk of asthma was significantly higher in children born in 2001 (aRR?=?1.13; 95% CI, 1.04-1.22).
Conclusion: This study showed that dinner-to-bed time within 120 minutes after dinner increases the risk of developing asthma. This underscores the importance of considering lifestyle modifications, as certain pediatric asthma cases may be influenced by behaviors that promote GER. en-copyright= kn-copyright= en-aut-name=UraguchiKensuke en-aut-sei=Uraguchi en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoNaomi en-aut-sei=Matsumoto en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MakiharaSeiichiro en-aut-sei=Makihara en-aut-mei=Seiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AndoMizuo en-aut-sei=Ando en-aut-mei=Mizuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Otolaryngology- Head and Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=acute otitis media kn-keyword=acute otitis media en-keyword=allergic rhinitis (ar) kn-keyword=allergic rhinitis (ar) en-keyword=gastroesophageal reflux symptoms kn-keyword=gastroesophageal reflux symptoms en-keyword=pediatric asthma kn-keyword=pediatric asthma en-keyword=public health kn-keyword=public health END start-ver=1.4 cd-journal=joma no-vol=27 cd-vols= no-issue=1 article-no= start-page=35 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20251210 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Oral health care during pregnancy to prevent preterm birth and low birth weight: study protocol for a randomized controlled trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Periodontal disease during pregnancy has been associated with an increased risk of preterm birth (PTB) and low birth weight (LBW). However, most previous interventional studies have reported that scaling and root planing (SRP), a form of basic periodontal treatment, is insufficient to effectively prevent PTB and LBW. Recent systematic reviews and meta-analyses suggest that combining SRP with routine use of chlorhexidine gluconate (CHG) mouthwash may reduce the risk of these adverse birth outcomes by approximately half. This study will be among the first randomized controlled trials (RCTs) to evaluate the potential synergistic effects of this combined approach on improving birth outcomes.
Methods This multi-center, three-arm RCT will be conducted at two hospitals in Dhaka and Bogura, Bangladesh, between April 2025 and September 2026. A total of 480 pregnant women less than 20 weeks乫 gestation attending antenatal checkups will be recruited. Participants diagnosed with periodontal disease will be randomly assigned to either an intervention group or a positive control group. Participants without periodontal disease will be assigned to a negative control group. The intervention consists of SRP combined with continued use of CHG mouthwash throughout pregnancy. The primary outcome will be the rate of PTB. Secondary outcomes include the birth weight of the newborn baby, maternal periodontal status, and oral health-related quality of life (OHRQoL). Effectiveness will be assessed by comparing outcomes across the study groups.
Discussion The oral health intervention is expected to improve both birth outcomes and maternal oral health. Demonstrating its effectiveness in a real-world setting may support the integration of oral health care into broader maternal, neonatal, and child health strategies, particularly in resource-limited settings.
Trial registration UMIN Clinical Trials Registry. UMIN000057519. Registered on April 4, 2025. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000065719. en-copyright= kn-copyright= en-aut-name=YasuokaJunko en-aut-sei=Yasuoka en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakeshitaYohei en-aut-sei=Takeshita en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkadaShunsuke en-aut-sei=Okada en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AlamProdhan MD Rubayet en-aut-sei=Alam en-aut-mei=Prodhan MD Rubayet kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShibanumaAkira en-aut-sei=Shibanuma en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NanishiKeiko en-aut-sei=Nanishi en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SatoYoko en-aut-sei=Sato en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HossainMd. Zahid en-aut-sei=Hossain en-aut-mei=Md. Zahid kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=AmanMusfiqa en-aut-sei=Aman en-aut-mei=Musfiqa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KarimFahmida en-aut-sei=Karim en-aut-mei=Fahmida kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=RaziaSultana en-aut-sei=Razia en-aut-mei=Sultana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=RezwanaRifat en-aut-sei=Rezwana en-aut-mei=Rifat kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=RahmanMd Mahmudur en-aut-sei=Rahman en-aut-mei=Md Mahmudur kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=Jahan KhanNusrat en-aut-sei=Jahan Khan en-aut-mei=Nusrat kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=NakashimaNaoki en-aut-sei=Nakashima en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=IslamRafiqul en-aut-sei=Islam en-aut-mei=Rafiqul kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=KikuchiKimiyo en-aut-sei=Kikuchi en-aut-mei=Kimiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Division of Global Health Sciences, Graduate School of Public Health, St. Luke乫s International University kn-affil= affil-num=2 en-affil=Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Oral and Maxillofacial Radiology, Medical Development Field, Okayama University kn-affil= affil-num=4 en-affil=Department of Orthodontics, Dental Unit, TMSS Medical College & Rafatullah Community Hospital kn-affil= affil-num=5 en-affil=Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo kn-affil= affil-num=6 en-affil=Office of International Academic Affairs, Graduate School of Medicine, The University of Tokyo kn-affil= affil-num=7 en-affil=Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=8 en-affil=Department of Periodontology and Oral Pathology, Holy Family Red Crescent Medical College Hospital kn-affil= affil-num=9 en-affil=Department of Periodontology, Dental Unit, TMSS Medical College & Rafatullah Community Hospital kn-affil= affil-num=10 en-affil=Department of Obstetrics & Gynecology, Holy Family Red Crescent Medical College Hospital kn-affil= affil-num=11 en-affil=Department of Obstetrics & Gynecology, TMSS Medical College & Rafatullah Community Hospital kn-affil= affil-num=12 en-affil=Department of Molecular and Cellular Biochemistry, Division of Oral Health, Brain Health and Total Health, Faculty of Dental Science, Kyushu University kn-affil= affil-num=13 en-affil=Global Communication Center, Grameen Communications kn-affil= affil-num=14 en-affil=Global Communication Center, Grameen Communications kn-affil= affil-num=15 en-affil=Department of Medical Informatics, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=16 en-affil=Division of Healthcare Digital Transformation, Kyushu University kn-affil= affil-num=17 en-affil=Department of Research Promotion, Institute for Asian and Oceanian Studies, Kyushu University kn-affil= en-keyword=Preterm birth kn-keyword=Preterm birth en-keyword=Low birth weight kn-keyword=Low birth weight en-keyword=Oral health kn-keyword=Oral health en-keyword=Periodontal treatment kn-keyword=Periodontal treatment en-keyword=Chlorhexidine gluconate mouthwash kn-keyword=Chlorhexidine gluconate mouthwash en-keyword=Randomized controlled trial kn-keyword=Randomized controlled trial en-keyword=Bangladesh kn-keyword=Bangladesh END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=23 article-no= start-page=5732 end-page=5738 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250602 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Ultrafast Protein Dynamics Prior to Retinal Photoisomerization in Microbial Rhodopsins en-subtitle= kn-subtitle= en-abstract= kn-abstract=Rhodopsins, an important group of photoreceptor proteins, possess a retinal chromophore. It has long been believed that the photoisomerization of the chromophore is the initial event triggering its photocycle. However, we recently reported that protein structural changes around the chromophore precede photoisomerization in bacteriorhodopsin (BR). In this study, we performed deep-ultraviolet femtosecond stimulated Raman measurements for H+-pump rhodopsin (RxR) and photosensor rhodopsin (NpSRII) to investigate whether these ultrafast protein dynamics are common among rhodopsins. We observed that the protein structural changes occur within 0.2 ps after photoexcitation and precede the chromophore photoisomerization, similar to the case for BR. This strongly indicates that the protein structural change precedes the photoisomerization in rhodopsins, regardless of the difference in their origins and functions. Furthermore, we found that only limited protein changes occur on the time scale of the photoisomerization, suggesting that the protein environment is already optimized for the structural change of the chromophore. These observations raise the possibility that the ultrafast protein change arranges the environment around the chromophore to facilitate the photoisomerization. en-copyright= kn-copyright= en-aut-name=TaharaShinya en-aut-sei=Tahara en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KuriharaRika en-aut-sei=Kurihara en-aut-mei=Rika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KojimaKeiichi en-aut-sei=Kojima en-aut-mei=Keiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KuramochiHikaru en-aut-sei=Kuramochi en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakeuchiSatoshi en-aut-sei=Takeuchi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SudoYuki en-aut-sei=Sudo en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TaharaTahei en-aut-sei=Tahara en-aut-mei=Tahei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Molecular Spectroscopy Laboratory, RIKEN kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Molecular Spectroscopy Laboratory, RIKEN kn-affil= affil-num=5 en-affil=Molecular Spectroscopy Laboratory, RIKEN kn-affil= affil-num=6 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Molecular Spectroscopy Laboratory, RIKEN kn-affil= END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue= article-no= start-page=rbae144 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=2025 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Optimizing 兝-TCP with E-rhBMP-2-infused fibrin for vertical bone regeneration in a mouse calvarium model en-subtitle= kn-subtitle= en-abstract= kn-abstract=Effective reconstruction of large bone defects, particularly in thickness, remains one of the major challenges in orthopedic and dental fields. We previously produced an Escherichia coli-based industrial-scale GMP-grade recombinant human bone morphogenetic protein-2 (E-rhBMP-2) and showed that the combination of E-rhBMP-2 with beta-tricalcium phosphate (兝-TCP/E-rhBMP-2) can effectively promote bone reconstruction. However, the limited mechanical strength and poor morphology retention of 兝-TCP granules are key points that need optimization to obtain more effective grafts and further expand its clinical applications. Therefore, we combined 兝-TCP/E-rhBMP-2 with fibrin gel to enhance its mechanical properties and usability for vertical bone regeneration. We investigated the mechanical properties and vertical bone regeneration effects of the materials applied, with or without fibrin containing E-rhBMP-2, in a calvarial defect model in mice. Compression tests were conducted to assess the initial stability of the materials. Scanning electron microscopy and Fourier transform infrared spectroscopy were conducted to characterize the presence of fibrin on the scaffold. After 4 and 12?weeks of implantation, micro-computed tomography and histological and immunofluorescent analyses were performed to assess the morphology and volume of the newly formed bone. The fibrin-containing groups had significantly higher initial mechanical strength and higher ability to maintain their morphology in vivo compared to the counterparts without fibrin. However, fibrin gel alone suppressed the bone formation ability of 兝-TCP/E-rhBMP-2 whereas the presence of high doses of E-rhBMP-2 in fibrin gel resulted in material resorption and enhanced new bone formation. In conclusion, fibrin gel significantly improved the mechanical strength and surgical manageability of the 兝-TCP/E-rhBMP-2 scaffold, and the addition of E-rhBMP-2 to the fibrin gel further enhanced the vertical bone regeneration and initial structural integrity of the scaffold. en-copyright= kn-copyright= en-aut-name=ZhaoKun en-aut-sei=Zhao en-aut-mei=Kun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OnoMitsuaki en-aut-sei=Ono en-aut-mei=Mitsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MuXindi en-aut-sei=Mu en-aut-mei=Xindi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WangZiyi en-aut-sei=Wang en-aut-mei=Ziyi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=XieShichao en-aut-sei=Xie en-aut-mei=Shichao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YonezawaTomoko en-aut-sei=Yonezawa en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkadaMasahiro en-aut-sei=Okada en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MatsumotoTakuya en-aut-sei=Matsumoto en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KubokiTakuo en-aut-sei=Kuboki en-aut-mei=Takuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OohashiToshitaka en-aut-sei=Oohashi en-aut-mei=Toshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Division of Dental Biomaterials, Tohoku University Graduate School of Dentistry kn-affil= affil-num=8 en-affil=Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=BMP-2 kn-keyword=BMP-2 en-keyword=fibrin kn-keyword=fibrin en-keyword=vertical bone regeneration kn-keyword=vertical bone regeneration en-keyword=biocompatible materials kn-keyword=biocompatible materials END start-ver=1.4 cd-journal=joma no-vol=80 cd-vols= no-issue=3 article-no= start-page=185 end-page=193 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202606 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Reducing Hesitation in Resuscitation: Educational Effects of a Female-Appearing Simulator in Basic Life Support Training en-subtitle= kn-subtitle= en-abstract= kn-abstract=Women are less likely than men to receive timely defibrillation during out-of-hospital cardiac arrest. We investigated whether using a simulator that is visually modified to resemble a female affects learners乫 attitudes, knowledge, and performance in basic life support (BLS) training. In a BLS simulation training, first-year medical students (n=220) used a standard gender-neutral simulator (control group) or a modified simulator with a female-like appearance (intervention group). Pre- and post-training questionnaires concerning attitudes and knowledge plus a post-training skills evaluation assessed the students乫 training outcomes. The intervention group initiated chest compressions significantly faster than the control group (33.1 vs. 39.8 sec, p<0.01) and achieved a significantly higher rate of correct AED pad placement (64.2% vs. 38.5%, p<0.01). While performing the resuscitation on the female-appearing manikin, the intervention group showed significantly greater increases in self-efficacy (p<0.01) and larger decreases in discomfort about removing the patient乫s clothes (p<0.01). They were also significantly more likely to recognize that chest compressions can be performed (p=0.016) and AED pads can be applied (p=0.015) without removing the patient乫s underwear. Using a female-appearing simulator in BLS training was thus associated with faster chest compression initiation, more accurate AED pad placement, and improved gender-sensitive attitudes and knowledge. en-copyright= kn-copyright= en-aut-name=KuboTakuya en-aut-sei=Kubo en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsukaharaKohei en-aut-sei=Tsukahara en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HongoTakashi en-aut-sei=Hongo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ObaraTakafumi en-aut-sei=Obara en-aut-mei=Takafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KosakiYoshinori en-aut-sei=Kosaki en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NojimaTsuyoshi en-aut-sei=Nojima en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=resuscitation kn-keyword=resuscitation en-keyword=basic life support kn-keyword=basic life support en-keyword=female simulator kn-keyword=female simulator en-keyword=medical education kn-keyword=medical education en-keyword=gender bias kn-keyword=gender bias END start-ver=1.4 cd-journal=joma no-vol=47 cd-vols= no-issue=3 article-no= start-page=104848 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202605 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Predictors of therapeutic response and pain after near-infrared photoimmunotherapy in head and neck cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective: Near-infrared photoimmunotherapy (NIR-PIT) has been approved by the Japanese national health insurance for approximately five years, and clinical experience has steadily accumulated. However, reports analyzing treatment outcomes and pain-related factors remain limited. This study aimed to identify predictors of therapeutic response and pain following NIR-PIT.
Methods: This retrospective cohort study included 25 patients who underwent NIR-PIT for head and neck cancer between January 2021 and June 2025. Lesion diameter and thickness were evaluated in relation to complete response (CR), and the frequency and predictors of post-treatment pain were assessed.
Results: Among 22 evaluable patients, eight achieved CR. Lesions with a shorter longest diameter and thinner thickness were significantly associated with higher CR rates (p = 0.011 and p = 0.024). Moderate-to-severe pain (Numerical Rating Scale ?4) occurred in 18 of 48 treatment cycles (37.5%) but was significantly less frequent in patients with a history of reconstructive surgery (p = 0.017).
Conclusions: NIR-PIT demonstrated particularly favorable efficacy for short, thin lesions, suggesting that early introduction of treatment may be associated with improved therapeutic outcomes. A history of reconstructive surgery was associated with reduced post-treatment pain, highlighting the importance of individualized treatment and pain management strategies in head and neck cancer patients undergoing NIR-PIT. en-copyright= kn-copyright= en-aut-name=MatsumotoJunya en-aut-sei=Matsumoto en-aut-mei=Junya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MakinoTakuma en-aut-sei=Makino en-aut-mei=Takuma kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NaoiYuto en-aut-sei=Naoi en-aut-mei=Yuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=FujimotoShohei en-aut-sei=Fujimoto en-aut-mei=Shohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AndoMizuo en-aut-sei=Ando en-aut-mei=Mizuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Near-infrared photoimmunotherapy kn-keyword=Near-infrared photoimmunotherapy en-keyword=Head and neck cancer kn-keyword=Head and neck cancer en-keyword=Treatment response kn-keyword=Treatment response en-keyword=Tumor size kn-keyword=Tumor size en-keyword=Tumor thickness kn-keyword=Tumor thickness en-keyword=Pain kn-keyword=Pain END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=3 article-no= start-page=643 end-page=650 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=2026 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Post Hoc Analysis of Frailty and Tracheostomy Risk in Older Patients Intubated and in an Intensive Care Unit in Japan: An Inverse Association in Older Patients with Advanced Age en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: This post hoc analysis of a prospectively collected intensive care unit (ICU) cohort examined the association between frailty and the likelihood of tracheostomy in older Japanese patients (aged ?65 years). Frailty, a condition of increased vulnerability to stressors, is common among older patients in the ICU and may influence clinical decision-making and outcomes. We aimed to explore whether baseline frailty is associated with the likelihood of receiving tracheostomy in older patients in the ICUs.
Methods: We analyzed data from a multicenter prospective study conducted from November 2019 to April 2020 at 17 hospitals in Japan. Patients aged ?65 years, admitted directly from the emergency department, and requiring mechanical ventilation, were included. After excluding early deaths (?5 days) or treatment-limit cases, 363 patients with intubation remained. Frailty was assessed using the Clinical Frailty Scale (CFS), with primary cutoff CFS ?4. The primary outcome was the occurrence of tracheostomy during ICU stay. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using generalized linear models with a Poisson distribution, adjusted for age, sex, Charlson Comorbidity Index, and Acute Physiology and Chronic Health Evaluation II score.
Results: Among 363 patients, patients with frailty (CFS ?4) had a significantly lower adjusted risk of having tracheostomy than did those with less frailty (CFS <4) (adjusted RR: 0.40; 95% CI: 0.27-0.61). In patients aged ?75 years, the adjusted RR for CFS ?4 was 0.32 (95% CI: 0.20-0.50), indicating a pronounced reduction in tracheostomy use among patients with frailty.
Conclusions: Frailty (CFS ?4) was independently associated with a lower likelihood of tracheostomy, particularly in patients aged ?75 years. en-copyright= kn-copyright= en-aut-name=UmedaTakehide en-aut-sei=Umeda en-aut-mei=Takehide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HongoTakashi en-aut-sei=Hongo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InabaMototaka en-aut-sei=Inaba en-aut-mei=Mototaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AriyasuYoshinori en-aut-sei=Ariyasu en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil= affil-num=2 en-affil= kn-affil= affil-num=3 en-affil= kn-affil= affil-num=4 en-affil= kn-affil= affil-num=5 en-affil= kn-affil= affil-num=6 en-affil= kn-affil= en-keyword=frailty kn-keyword=frailty en-keyword=respiration kn-keyword=respiration en-keyword=tracheostomy kn-keyword=tracheostomy en-keyword=critical care outcomes kn-keyword=critical care outcomes en-keyword=aged kn-keyword=aged END start-ver=1.4 cd-journal=joma no-vol=52 cd-vols= no-issue=5 article-no= start-page=e70314 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202605 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Survey to Document the Adverse Reactions After Human Papillomavirus Vaccination Among Japanese Female Youth at a University en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aim: Concerns about possible adverse events remain a critical barrier in implementing human papillomavirus (HPV) vaccination among Japanese youth. This study aimed to understand the time course of adverse events experienced by HPV vaccine recipients.
Methods: An online questionnaire survey was given to students, faculty, and staff aged 18?26?years, at Okayama University Hospital, who received the HPV vaccine. The survey gathered information on the number of HPV vaccine doses received, prevaccination health conditions, adverse reactions within 2?h and between 2?h and 7?days postvaccination, menstrual irregularities after vaccination, reasons for getting vaccinated, feelings before and after vaccination, and factors providing reassurance during vaccination. Prevalence of symptoms was expressed as numbers and percentages, and analyses were performed using Chi-squared or Fisher's exact tests.
Results: Responses were obtained from 299 participants, yielding a 75% response rate. Approximately 60% participants reported local pain, 30% swelling, and 4% fever. Most symptoms resolved on the vaccination day itself or the following day, although some persisted for 3?7?days. Over 80% participants rated their pain between 0 and 3 on numerical rating scale of 0?10. While 60% experienced anxiety before vaccination, 90% reported no anxiety afterward.
Conclusions: Our study presents one of the first comprehensive accounts of post-HPV vaccination adverse events and their time course, and underpins the importance of disseminating detailed information about vaccine-associated adverse reactions to encourage greater vaccine uptake. en-copyright= kn-copyright= en-aut-name=HiguchiChigusa en-aut-sei=Higuchi en-aut-mei=Chigusa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OgawaChikako en-aut-sei=Ogawa en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MasuyamaHisashi en-aut-sei=Masuyama en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Educational and Research Management Field, Health Management Department, Okayama University kn-affil= affil-num=2 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=1Educational and Research Management Field, Health Management Department, Okayama University kn-affil= affil-num=4 en-affil=Department of Infectious Diseases, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine kn-affil= en-keyword=anxiety kn-keyword=anxiety en-keyword=human papillomavirus vaccine kn-keyword=human papillomavirus vaccine en-keyword=Japanese youth kn-keyword=Japanese youth en-keyword=questionnaire kn-keyword=questionnaire en-keyword=survey kn-keyword=survey END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=6 article-no= start-page=e0350803 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A multicenter, randomized, parallel-group confirmatory study protocol to evaluate the efficacy of Soft Protector CPC, a novel oral mucosal protectant, in preventing oral mucositis and alleviating pain in patients with breast cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=Oral mucositis is a frequent and debilitating adverse event observed in patients undergoing chemotherapy or radiotherapy. Current management strategies are limited in duration, require frequent application, and fail to address the mechanical irritation from teeth. A novel device, Soft Protector CPC, was developed to overcome these limitations. This multicenter, randomized, two-arm, open-label, confirmatory trial aims to evaluate the efficacy and safety of Soft Protector CPC in patients with breast cancer undergoing chemotherapy. A total of 154 participants will be randomly assigned in a 1:1 ratio to receive either oral care with Soft Protector CPC or oral care alone. The primary endpoint will be oral mucositis as assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v3.0 during the comparative treatment period. The secondary endpoints will include CTCAE v3.0 during the continuous treatment period, oral mucositis, pain (CTCAE v5.0), quality of life (Patient Reported Outcomes-CTCAE version 1.0 [PRO-CTCAE v1.0], the 15-item oral health questionnaire of the European Organization For Research And Treatment Of Cancer [EORTC QLQ-OH15], and the pain Numeric Rating Scale), onset and site of mucositis, completion of chemotherapy, use of rescue medications, technical feasibility, and patient preference. The safety endpoints will include adverse events, device malfunction, and laboratory tests. This trial is expected to establish the clinical utility of the Soft Protector CPC for the prevention and management of oral mucositis, with the potential to improve the patients乫 quality of life and adherence to cancer therapy. This study was approved by the Clinical Research Review Board and registered with the Japan Registry of Clinical Trials, jRCTs062250005, on April 18, 2025. en-copyright= kn-copyright= en-aut-name=OmoriKazuhiro en-aut-sei=Omori en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurukawaKohei en-aut-sei=Furukawa en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UsubuchiMasatoshi en-aut-sei=Usubuchi en-aut-mei=Masatoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HamadaTomofumi en-aut-sei=Hamada en-aut-mei=Tomofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShienTadahiko en-aut-sei=Shien en-aut-mei=Tadahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YoshidaMichihiro en-aut-sei=Yoshida en-aut-mei=Michihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakatsukaYuki en-aut-sei=Nakatsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HottaKatsuyuki en-aut-sei=Hotta en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IbaragiSoichiro en-aut-sei=Ibaragi en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TakashibaShogo en-aut-sei=Takashiba en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Dentistry and Oral Surgery, Shikoku Cancer Center kn-affil= affil-num=3 en-affil=Department of Dentistry, Miyagi Cancer Center kn-affil= affil-num=4 en-affil=Department of Dentistry and Oral Surgery, Sagara Hospital kn-affil= affil-num=5 en-affil=Department of Breast and Endocrine Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=8 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue=1 article-no= start-page=ra.2025-0153 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=2026 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Current Status of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: An International Perspective Including Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) is gaining global prevalence as a minimally invasive treatment aimed at serving as an adjunct to or method of avoiding surgery; however, its optimal positioning remains unclear. This study outlines the current status of MMAE in Japan, Germany, and the United States based on nationwide survey reports, recently published consensus guidelines, and meta-analyses including randomized controlled trials (RCTs) reported in the New England Journal of Medicine (NEJM; EMBOLISE, STEM, and MAGIC-MT) and examines its efficacy and limitations. Real-world clinical data from Japan, Germany, and the United States indicate that MMAE is primarily used as an adjunctive therapy following surgery for older and high-risk or recurrent cases, or as a stand-alone therapy in selected cases to safely reduce the risk of recurrence and reoperation. While a multidisciplinary consensus statement takes a cautious stance that limits MMAE to recurrent or inoperable cases such as those at high risk associated with interrupting antithrombotic medication, the Society of Vascular and Interventional Neurology guidelines published after the RCTs strongly recommend the concurrent use of MMAE with standard therapy in de novo cases. Meta-analyses integrating the 3 NEJM trials and other RCTs showed that MMAE suppressed recurrence and reoperation versus standard treatment, with particularly pronounced effects in the nonsurgical (conservative treatment) group; however, the additive effect was limited in the surgical adjunct group. No improvement in functional outcomes (modified Rankin Scale score) was observed. Cost-effectiveness analyses suggest that, while MMAE reduces reoperations, routine implementation for all cases is difficult to justify economically because of high procedural costs, indicating the need to narrow the indication to populations at high risk of recurrence. In conclusion, although MMAE is an effective treatment option, the current evidence does not support its uniform introduction in all patients with CSDH. Thus, it is necessary to individualize and adapt the indications for specific patient subgroups, such as those at high risk of recurrence or those for whom surgery is difficult. Finally, we propose a pragmatic treatment strategy for MMAE stratified by disease stage (de novo vs. recurrent) and clinical severity to guide the individualized selection of adjunctive and stand-alone embolization. en-copyright= kn-copyright= en-aut-name=KawakamiMasato en-aut-sei=Kawakami en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HiramatsuMasafumi en-aut-sei=Hiramatsu en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HarumaJun en-aut-sei=Haruma en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KimuraRyu en-aut-sei=Kimura en-aut-mei=Ryu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SoutomeYuta en-aut-sei=Soutome en-aut-mei=Yuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=FujitaJuntaro en-aut-sei=Fujita en-aut-mei=Juntaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HirataYuichi en-aut-sei=Hirata en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=BabaFukiko en-aut-sei=Baba en-aut-mei=Fukiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TanakaShota en-aut-sei=Tanaka en-aut-mei=Shota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=middle meningeal artery embolization kn-keyword=middle meningeal artery embolization en-keyword=chronic subdural hematoma kn-keyword=chronic subdural hematoma en-keyword=current status kn-keyword=current status END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260519 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Incidence of B-cell Malignancies in Patients with Lung Cancer Receiving PD-1 Blockade Therapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: Many patients with various cancer types have received immune checkpoint inhibitors (ICI) worldwide since their approval, and novel unexpected complications from their long-term use are apparent. We identified some cases of B-cell lymphoma occurring during PD-1 blockade therapy as such unexpected complications. In this study, we aimed to evaluate the incidence of hematologic malignancies in patients with lung cancer receiving PD-1 blockade therapy and to elucidate the mechanisms underlying the progression of these malignancies.
Experimental Design: We performed IHC staining on the clinical samples from patients with B-cell lymphoma that developed during PD-1 blockade therapy and analyzed large-scale real-world datasets. We further investigated the underlying mechanisms through in vitro and in vivo experiments.
Results: A higher incidence of B-cell malignancies has been observed in patients with lung cancer treated with PD-1 blockade therapies based on large-scale real-world data analyses (n = 15,670). The identified lymphomas had a large amount of CD4+ T follicular helper (TFH) cell infiltration. In addition, PD-1 blockade activated PD-1+ TFH cells, which promoted lymphoma proliferation via the IL4/IL4R, IL21/IL21R, and CD40L/CD40 axes. Notably, the lymphomas exhibited high expression of IL4R, IL21R, and CD40.
Conclusions: Our findings highlight the need for careful monitoring and consideration of the potential B-cell malignancy complications in clinical settings in which ICIs are used. en-copyright= kn-copyright= en-aut-name=NinomiyaToshifumi en-aut-sei=Ninomiya en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FangCaiyang en-aut-sei=Fang en-aut-mei=Caiyang kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HamanoHirofumi en-aut-sei=Hamano en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MorinagaTeruya en-aut-sei=Morinaga en-aut-mei=Teruya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ZhouWenhao en-aut-sei=Zhou en-aut-mei=Wenhao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KoyamaToshihiro en-aut-sei=Koyama en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MikiSakura en-aut-sei=Miki en-aut-mei=Sakura kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ZhuLi en-aut-sei=Zhu en-aut-mei=Li kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NaoiYusuke en-aut-sei=Naoi en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=EnnishiDaisuke en-aut-sei=Ennishi en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KatsutaTomoya en-aut-sei=Katsuta en-aut-mei=Tomoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OhashiKadoaki en-aut-sei=Ohashi en-aut-mei=Kadoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MorizaneShin en-aut-sei=Morizane en-aut-mei=Shin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=Ohki-IkedaTomoka en-aut-sei=Ohki-Ikeda en-aut-mei=Tomoka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=NishiTatsuya en-aut-sei=Nishi en-aut-mei=Tatsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=UedaYouki en-aut-sei=Ueda en-aut-mei=Youki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=IshinoTakamasa en-aut-sei=Ishino en-aut-mei=Takamasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=MaedaYoshinobu en-aut-sei=Maeda en-aut-mei=Yoshinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=OkamotoIsamu en-aut-sei=Okamoto en-aut-mei=Isamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=ZamamiYoshito en-aut-sei=Zamami en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=NagasakiJoji en-aut-sei=Nagasaki en-aut-mei=Joji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=TogashiYosuke en-aut-sei=Togashi en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= affil-num=1 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Pharmacy, Okayama University Hospital, Okayama University kn-affil= affil-num=4 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Pharmaceutical Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=11 en-affil=Department of Respiratory Medicine, Ehime Prefectural Central Hospital kn-affil= affil-num=12 en-affil=Department of Respiratory Medicine, Okayama University Hospital, Okayama University kn-affil= affil-num=13 en-affil=Department of Dermatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=14 en-affil=Department of Pathology, Okayama University Hospital, Okayama University kn-affil= affil-num=15 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=16 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=17 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=18 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=19 en-affil=Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=20 en-affil=Department of Pharmacy, Okayama University Hospital, Okayama University kn-affil= affil-num=21 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=22 en-affil=Department of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=2 article-no= start-page=170 end-page=181 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260205 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Development of Linear Interpolation System for SMK Model Parameters Evaluated from Cellular-Scale Simulation (LISMEC) and its application to BNCT dosimetry en-subtitle= kn-subtitle= en-abstract= kn-abstract=Boron neutron capture therapy (BNCT) utilizes high linear energy transfer (LET) 兛-particles and 7Li ions generated through the 10B(n, 兛)7Li reaction. Precise dosimetry is essential for maximizing therapeutic efficacy while minimizing normal tissue adverse events, considering the microscopic distribution of 10B and cellular structures. Recently, the photon isoeffective dose (DisoE) has been proposed as a more appropriate metric for BNCT treatment planning and can be evaluated using the stochastic microdosimetric kinetic (SMK) model. However, clinical implementation of the SMK model remains challenging due to the difficulty of evaluating its input parameters, which requires computationally intensive radiation transport simulations at the cellular scale. To address this issue, we developed LISMEC (Linear Interpolation System for Stochastic Microdosimetric Kinetic model parameters Evaluated from Cellular-scale simulation), a rapid estimation framework based on precomputed cellular-scale PHITS (Particle and Heavy Ion Transport code System) simulations covering various cell geometries and boron distributions. By applying a linear interpolation algorithm, LISMEC enables the retrieval of SMK model parameters without the need for computationally intensive cellular-scale simulations. The utility of LISMEC, in conjunction with PHITS, was demonstrated through simulations of various irradiation scenarios in reactor-based BNCT. The results showed that DisoE values ranged from 7.4 to 32.7 Gy, even under a fixed macroscopic 10B concentration of 60 ppm. These findings emphasize the importance of incorporating a microscopic distribution of 10B and cellular structures into BNCT treatment planning. en-copyright= kn-copyright= en-aut-name=ShigehiraTakafumi en-aut-sei=Shigehira en-aut-mei=Takafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeTubasa en-aut-sei=Watanabe en-aut-mei=Tubasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SuzukiMinoru en-aut-sei=Suzuki en-aut-mei=Minoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HirataYuho en-aut-sei=Hirata en-aut-mei=Yuho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OgawaTatsuhiko en-aut-sei=Ogawa en-aut-mei=Tatsuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujimuraAtsushi en-aut-sei=Fujimura en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SakuraiYoshinori en-aut-sei=Sakurai en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SatoTatsuhiko en-aut-sei=Sato en-aut-mei=Tatsuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Particle Radiation Oncology Research Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University kn-affil= affil-num=2 en-affil=Particle Radiation Oncology Research Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University kn-affil= affil-num=3 en-affil=Particle Radiation Oncology Research Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University kn-affil= affil-num=4 en-affil=Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center , Japan Atomic Energy Agency (JAEA) kn-affil= affil-num=5 en-affil=Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center , Japan Atomic Energy Agency (JAEA) kn-affil= affil-num=6 en-affil=Department of Cellular Physiology, Neutron Therapy Research Center, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Particle Radiation Oncology Research Center, Institute for Integrated Radiation and Nuclear Science, Kyoto University kn-affil= affil-num=8 en-affil=Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center , Japan Atomic Energy Agency (JAEA) kn-affil= en-keyword=BNCT kn-keyword=BNCT en-keyword=microdosimetry kn-keyword=microdosimetry en-keyword=borondistribution kn-keyword=borondistribution en-keyword=cellmorphology kn-keyword=cellmorphology END start-ver=1.4 cd-journal=joma no-vol=80 cd-vols= no-issue=2 article-no= start-page=99 end-page=107 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Consistent Clinical Outcomes of Anteroinferior Minimally Invasive Plate Osteosynthesis for Midshaft Clavicle Fractures Across AO/OTA Fracture Types en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although the performance of minimally invasive plate osteosynthesis (MIPO) via the anteroinferior approach is increasingly adopted for midshaft clavicle fractures, the influence of fracture morphology on clinical outcomes under a standardized protocol is unclear. We retrospectively analyzed the cases of 54 patients who underwent anteroinferior MIPO for an acute midshaft clavicle fracture (AO/OTA types B1, B2, B3) performed by a single surgeon across three affiliated institutions (2009-2022). We evaluated the clinical outcomes, i.e., the surgical time, incision length, radiographic union, reduction accuracy, range of motion, pain (visual analog scale [VAS]), and complications and compared them among the three AO/OTA subtypes. The mean incision length (3.4 cm) and surgical time (71-79 min) were similar among the groups (both p>0.2). All fractures achieved radiographic union at a mean of 3.5 months. Postoperative alignment and clavicular length were maintained (length reduction ?1.0亇2.2 mm [B1], ?0.5亇2.0 mm [B2], ?0.6亇1.8 mm [B3]; p=0.825; angulation ?0.8亇3.4亱, ?1.1亇3.1亱, ?0.3亇3.3亱; p=0.888). At 3 months, shoulder elevation and abduction were 169亱-175亱 (p=0.079) and 164亱-175亱 (p=0.324). Pain was minimal (100-mm VAS: ?1 mm; p=0.782). One plate-fatigue failure occurred; no supraclavicular-nerve symptoms were recorded. Anteroinferior MIPO yielded consistent outcomes across AO/OTA types, with excellent union rates, functional recovery, and few complications, indicating that this technique is safe and reproducible for the surgical management of midshaft clavicle fractures. en-copyright= kn-copyright= en-aut-name=Nguyen Trung Thanh en-aut-sei=Nguyen Trung Thanh en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakamichiRyo en-aut-sei=Nakamichi en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShimamuraYasunori en-aut-sei=Shimamura en-aut-mei=Yasunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SaitoTaichi en-aut-sei=Saito en-aut-mei=Taichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IshiharaTakeshi en-aut-sei=Ishihara en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FurutaniTomoki en-aut-sei=Furutani en-aut-mei=Tomoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ShitozawaHisakazu en-aut-sei=Shitozawa en-aut-mei=Hisakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NodaTomoyuki en-aut-sei=Noda en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Kousei Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Kawasaki Medical School General Medical Center kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=clavicle fracture kn-keyword=clavicle fracture en-keyword=minimally invasive plate osteosynthesis kn-keyword=minimally invasive plate osteosynthesis en-keyword=anteroinferior plating kn-keyword=anteroinferior plating en-keyword=AO/OTA classification kn-keyword=AO/OTA classification END start-ver=1.4 cd-journal=joma no-vol=80 cd-vols= no-issue=2 article-no= start-page=85 end-page=97 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of Nonsurgical Periodontal Treatment on Bacterial and Clinical Parameters in Down Syndrome Patients Based on 16S rRNA Gene Amplicon Sequencing en-subtitle= kn-subtitle= en-abstract= kn-abstract=Individuals with Down syndrome (DS) are more susceptible to periodontal disease; however, microbial changes following treatment remain insufficiently understood. This study evaluated the effects of nonsurgical periodontal therapy on clinical outcomes and oral microbiome dynamics in 6 patients with DS using 16S rRNA gene amplicon sequencing. Bacterial diversity, composition, network structure, and predicted functional pathways were analyzed using dental plaque samples. Bleeding on probing decreased significantly (p=0.047) after treatment, with a trend toward reduction in periodontal inflamed surface area (p=0.05). The abundance of Fusobacteria at the class level decreased significantly after treatment. The abundance of Mogibacterium timidum was higher in the pretreatment group than in the posttreatment group. M. timidum was positively correlated with Treponema denticola and associated with multiple bacterial taxa in the network during pretreatment. Predicted functional pathways related to aromatic compound degradation were more abundant in posttreatment samples than in pretreatment samples. An increase in the abundance of Fusobacterium and the positive correlation between T. denticola and M. timidum, together with their associations with other periodontal pathogens before treatment, may contribute to the development of periodontitis in individuals with DS. Nonsurgical periodontal therapy produces measurable clinical improvement and promotes microbial shifts in patients with DS. en-copyright= kn-copyright= en-aut-name=ShibaTakahiko en-aut-sei=Shiba en-aut-mei=Takahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakamoriMitsuhito en-aut-sei=Takamori en-aut-mei=Mitsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KatagiriSayaka en-aut-sei=Katagiri en-aut-mei=Sayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KobayashiRyota en-aut-sei=Kobayashi en-aut-mei=Ryota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KawauchiAki en-aut-sei=Kawauchi en-aut-mei=Aki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OhsugiYujin en-aut-sei=Ohsugi en-aut-mei=Yujin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=LinPeiya en-aut-sei=Lin en-aut-mei=Peiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=EkuniDaisuke en-aut-sei=Ekuni en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=EgusaMasahiko en-aut-sei=Egusa en-aut-mei=Masahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=IwataTakanori en-aut-sei=Iwata en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MaedaShigeru en-aut-sei=Maeda en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=2 en-affil=Department of Oral Physiology, Graduate School of Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=4 en-affil=Department of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=5 en-affil=Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=6 en-affil=Department of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=7 en-affil=Department of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=8 en-affil=Department of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=The center for Special Needs Dentistry, Medical Development Field, Okayama University kn-affil= affil-num=10 en-affil=Department of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= affil-num=11 en-affil=Department of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo kn-affil= en-keyword=Down Syndrome kn-keyword=Down Syndrome en-keyword=16S rRNA Gene Amplicon Sequencing kn-keyword=16S rRNA Gene Amplicon Sequencing en-keyword=periodontitis kn-keyword=periodontitis en-keyword=nonsurgical periodontal treatment kn-keyword=nonsurgical periodontal treatment en-keyword=oral microbiome kn-keyword=oral microbiome END start-ver=1.4 cd-journal=joma no-vol=27 cd-vols= no-issue=1 article-no= start-page=bbag021 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202601 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=SGCRNA: spectral clustering-guided co-expression network analysis without scale-free constraints for multi-omic data en-subtitle= kn-subtitle= en-abstract= kn-abstract=Weighted gene co-expression network analysis (WGCNA) is among the most widely employed methods in bioinformatics. WGCNA enables the identification of gene clusters (modules) exhibiting correlated expression patterns, the association of these modules with traits, and the exploration of candidate biomarker genes by focusing on hub genes within the modules. WGCNA has been successfully applied in diverse biological contexts. However, conventional algorithms manifest three principal limitations: the assumption of scale-free topology, the requirement for parameter tuning, and the neglect of regression line slopes. These limitations are addressed by SGCRNA. SGCRNA provides Julia functions for the analysis of co-expression networks derived from various types of biological data, such as gene expression data. The Julia packages and their source code are freely available at https://github.com/C37H41N2O6/SGCRNAs.jl. en-copyright= kn-copyright= en-aut-name=OsoneTatsunori en-aut-sei=Osone en-aut-mei=Tatsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakaoTomoka en-aut-sei=Takao en-aut-mei=Tomoka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtakeShigeo en-aut-sei=Otake en-aut-mei=Shigeo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakaradaTakeshi en-aut-sei=Takarada en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=co-expression network analysis kn-keyword=co-expression network analysis en-keyword=multi-omics kn-keyword=multi-omics en-keyword=spectral clustering kn-keyword=spectral clustering END start-ver=1.4 cd-journal=joma no-vol=6 cd-vols= no-issue= article-no= start-page=1 end-page=6 dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260331 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The effects of cold compresses on itching in patients with atopic dermatitis: A cross-over controlled pilot trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=This cross-over controlled trial aimed to evaluate the effectiveness and safety of two types of cold compresses (towels and ice packs) in alleviating itching among patients with atopic dermatitis. The study recruited 19 participants diagnosed with atopic dermatitis and suffering from chronic itching for over 6 months. Each participant received both types of cold compress interventions. Itching sensations were assessed repeatedly using a visual analogue scale before and after the application of the cold compress. The mean and standard deviation of itching scores for the towel intervention were 16.9 亇 19.1 (baseline) and 11.4 亇 16.1 (post-application). For the ice pack intervention, the scores were 13.6 亇 14.7 (baseline) and 6.2 亇 9.8 (post-application). Although there was a reduction in mean itching scores following the application of cold compresses, the differences were not statistically significant for either intervention. Despite the lack of statistical significance, this study suggests that cold compresses, which are user-friendly and inexpensive, may safely reduce subjective itching in patients with atopic dermatitis without causing pain or discomfort. However, further research with a larger sample size is needed to confirm these findings. en-copyright= kn-copyright= en-aut-name=HIRAMIYuki en-aut-sei=HIRAMI en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HARADANahoko en-aut-sei=HARADA en-aut-mei=Nahoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ONOMiho en-aut-sei=ONO en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KODAMasahide en-aut-sei=KODA en-aut-mei=Masahide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FUKAIKiyoko en-aut-sei=FUKAI en-aut-mei=Kiyoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Former Department of Nursing, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Nursing Science, Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University kn-affil= affil-num=3 en-affil=Department of Nursing, Faculty of Health, Kagawa Prefectural University of Health Sciences kn-affil= affil-num=4 en-affil=Co-learning Community Healthcare Re-innovation Office, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Professor Emeritus, Okayama University, Graduate School of Nursing, The Jikei University School of Medicine kn-affil= en-keyword=Atopic Dermatitis kn-keyword=Atopic Dermatitis en-keyword=Pruritus kn-keyword=Pruritus en-keyword=Cryotherapy kn-keyword=Cryotherapy en-keyword=Quality of Life kn-keyword=Quality of Life en-keyword=Skin Temperature kn-keyword=Skin Temperature END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=6 article-no= start-page=1128 end-page=1136 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250531 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Surgery for Older Cancer Patients: Cross乚Organ Review and Good Practice Statement by the Japanese Geriatric Oncology Guideline Committee en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Although the number of older people is increasing, there is a lack of evidence and insufficient consensus regarding postoperative complications and survival in older cancer patients. In this study, we conducted a literature search and systematic review focusing on the outcomes after surgery for older cancer patients.
Methods: Literature focusing on surgical treatment for older cancer patients was extracted from Japanese clinical practice guidelines for gastric cancer, lung cancer, colorectal cancer, liver cancer, and gynecological cancers (uterine body, uterine cervix, ovary, and external genitalia and vagina). Outcomes were reviewed, and committee members determined the strength of evidence on a four-point scale (A to D), with A being the highest and D being the lowest.
Results: Older cancer patients tend to have a higher incidence of postoperative complications and postoperative syndromes, and their expected survival is generally shorter compared to non-older patients. When extensive surgeries such as para-aortic lymph node dissection and/or resection with other organs are performed for older cancer patients, the postoperative mortality rates tend to increase compared to non-older patients.
Conclusion: Surgical treatments for older cancer patients tend to result in higher morbidity even when the patients are in good health status. Nevertheless, there is still a possibility that a certain fraction of the patients achieve treatment outcomes comparable to those of non-older patients. Therefore, surgical indication and procedure for older cancer patients should be carefully determined based on surgical invasiveness and patient tolerability. en-copyright= kn-copyright= en-aut-name=TanakaChie en-aut-sei=Tanaka en-aut-mei=Chie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OfuchiTakashi en-aut-sei=Ofuchi en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NinomiyaKiichiro en-aut-sei=Ninomiya en-aut-mei=Kiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueDaisuke en-aut-sei=Inoue en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SugimotoKen en-aut-sei=Sugimoto en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MurofushiKeiko en-aut-sei=Murofushi en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkuyamaToru en-aut-sei=Okuyama en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WatanukiShigeaki en-aut-sei=Watanuki en-aut-mei=Shigeaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ImamuraChiyo en-aut-sei=Imamura en-aut-mei=Chiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SakaiDaisuke en-aut-sei=Sakai en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SakuraiNaomi en-aut-sei=Sakurai en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WatanabeKiyotaka en-aut-sei=Watanabe en-aut-mei=Kiyotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TamuraKazuo en-aut-sei=Tamura en-aut-mei=Kazuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SaekiToshiaki en-aut-sei=Saeki en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=IshiguroHiroshi en-aut-sei=Ishiguro en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Surgery, Kyushu University Beppu Hospital kn-affil= affil-num=3 en-affil=Center for Comprehensive Genomic Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Obstetrics and Gynecology, University of Fukui kn-affil= affil-num=5 en-affil=Department of General Geriatric Medicine, Kawasaki Medical School kn-affil= affil-num=6 en-affil=Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital kn-affil= affil-num=7 en-affil=Department of Psychiatry/Palliative Care Center, Nagoya City University West Medical Center kn-affil= affil-num=8 en-affil=National Center for Global Health and Medicine, National College of Nursing kn-affil= affil-num=9 en-affil=Advanced Cancer Translational Research Institute, Showa University kn-affil= affil-num=10 en-affil=Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Cancer Solutions Co. Ltd kn-affil= affil-num=12 en-affil=Division of Medical Oncology, Department of Medicine, School of Medicine, Teikyo University kn-affil= affil-num=13 en-affil=NPO Clinical Hematology/Oncology Treatment Study Group kn-affil= affil-num=14 en-affil=Breast Oncology Service, Saitama Medical University International Medical Center kn-affil= affil-num=15 en-affil=Breast Oncology Service, Saitama Medical University International Medical Center kn-affil= en-keyword=cancer kn-keyword=cancer en-keyword=older patients kn-keyword=older patients en-keyword=surgery kn-keyword=surgery END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue= article-no= start-page=20250037 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=2025 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Reliability and Validity of the Japanese Perme ICU Mobility Score: An Initial Psychometric Evaluation en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objectives : The Perme ICU Mobility Score is widely used to assess functional status, but no version of this assessment tool has been validated for use in Japan. This study aimed to translate the Perme Score into Japanese and evaluate its reliability and validity.
Methods : Following forward?backward translation, the Japanese Perme Score was tested at ICU discharge. Inter-rater reliability was examined using weighted kappa coefficient. Construct validity was assessed through correlations with the Medical Research Council Sum Score (MRC-SS), Functional Status Score for the ICU (FSS-ICU), and ICU Mobility Scale (IMS). Predictive validity for activities of daily living (ADL) independence (Barthel Index ??85) and discharge destination was evaluated using Receiver operating characteristic (ROC) analysis. Floor and ceiling effects were also analyzed.
Results : In 69 patients, the Japanese Perme Score showed high inter-rater reliability (內=0.83). It showed moderate correlation with FSS-ICU (rho=0.61) and IMS (rho=0.73), and it showed weak correlation with MRC-SS (rho=0.36). Predictive validity for ADL independence and home discharge yielded AUCs of 0.76 and 0.73, respectively. A ceiling effect was noted in 10% of cases, with no floor effect.
Conclusions: The Japanese Perme Score is a reliable, valid instrument for evaluating physical function at ICU discharge. en-copyright= kn-copyright= en-aut-name=KatayamaSho en-aut-sei=Katayama en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaTomohiro en-aut-sei=Ikeda en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakanishiNobuto en-aut-sei=Nakanishi en-aut-mei=Nobuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KatsukawaHajime en-aut-sei=Katsukawa en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NawaRicardo Kenji en-aut-sei=Nawa en-aut-mei=Ricardo Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=PermeChristiane en-aut-sei=Perme en-aut-mei=Christiane kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SatoIkumi en-aut-sei=Sato en-aut-mei=Ikumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HirohataSatoshi en-aut-sei=Hirohata en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University kn-affil= affil-num=4 en-affil=Department of Scientific Research, Japanese Society for Early Mobilization kn-affil= affil-num=5 en-affil=Department of Critical Care Medicine, Hospital Israelita Albert Einstein kn-affil= affil-num=6 en-affil=Department of Rehabilitation Services, Houston Methodist Hospital kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=9 en-affil=Academic Field of Health Science, Okayama University kn-affil= affil-num=10 en-affil=Academic Field of Health Science, Okayama University kn-affil= en-keyword=critical illness kn-keyword=critical illness en-keyword=intensive care unit kn-keyword=intensive care unit en-keyword=outcome assessment kn-keyword=outcome assessment en-keyword=physical function kn-keyword=physical function en-keyword=rehabilitation kn-keyword=rehabilitation END start-ver=1.4 cd-journal=joma no-vol=445 cd-vols= no-issue= article-no= start-page=134071 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=20260215 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Cardiac characteristics of Fabry disease from baseline enrolment data in a nationwide prospective Japanese registry en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Fabry disease (FD) is an important disease in the cardiovascular field because a significant proportion of patients with FD die from cardiac lesions.
Methods: A multicenter prospective registration study of patients with FD throughout Japan was designed. The baseline clinical characteristics of 175 patients are presented here.
Results: The mean ages at enrolment and at diagnosis were 52 亇 16 and 43 亇 18 years, respectively, with men accounting for 38 % of the patients. In the cohort, 24 % of the patients had the classical hemizygote male type, whereas 14 % had the late-onset male type, and 62 % had the heterozygote female type. On electrocardiography data at enrolment in 92 patients with left ventricular hypertrophy (LVH) (maximum LV wall thickness > 12 mm), 12 % showed a short PQ interval (< 120 msec), and 33 % had a short PendQ interval (? 40 msec). The Sokolow-Lyon voltage was high (6.1 亇 13.1 mv). Regarding the distribution of LVH patterns, 77 % of the patients showed concentric diffuse LVH, 16 % of the patients had asymmetric septal hypertrophy, and 1 % of the patients had hypertrophy confined to the LV apex. With regard to implantation of cardiac devices, permanent pacemakers had been implanted in 5 % of the patients and defibrillators had been implanted in 12 patients (7 %), for primary prevention in nine patients and for secondary prevention in three patients.
Conclusion: As the first large-scale prospective registry of FD patients in Japan, this study has provided valuable baseline data for the cardiac features and management of FD. en-copyright= kn-copyright= en-aut-name=KuboToru en-aut-sei=Kubo en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MaekawaYuichiro en-aut-sei=Maekawa en-aut-mei=Yuichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HongoKenichi en-aut-sei=Hongo en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamamotoSaori en-aut-sei=Yamamoto en-aut-mei=Saori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IzumiyaYasuhiro en-aut-sei=Izumiya en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamakawaHiroyuki en-aut-sei=Yamakawa en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YanoToshiyuki en-aut-sei=Yano en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HiguchiKoji en-aut-sei=Higuchi en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KuramotoYuki en-aut-sei=Kuramoto en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NakagawaNaoki en-aut-sei=Nakagawa en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=AmanoMasashi en-aut-sei=Amano en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YamadaYu en-aut-sei=Yamada en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OikawaMasayoshi en-aut-sei=Oikawa en-aut-mei=Masayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IidaYuichiro en-aut-sei=Iida en-aut-mei=Yuichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TsujitaKenichi en-aut-sei=Tsujita en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=MatsueYuya en-aut-sei=Matsue en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=IzawaHideo en-aut-sei=Izawa en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=SuzukiAtsushi en-aut-sei=Suzuki en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=NagatomoYuji en-aut-sei=Nagatomo en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=NagaiToshiyuki en-aut-sei=Nagai en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=KidaKeisuke en-aut-sei=Kida en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=NakamuraKazuto en-aut-sei=Nakamura en-aut-mei=Kazuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=NakamuraKazufumi en-aut-sei=Nakamura en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=IkenagaHiroki en-aut-sei=Ikenaga en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=KandaTakahiro en-aut-sei=Kanda en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=KinugasaYoshiharu en-aut-sei=Kinugasa en-aut-mei=Yoshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= en-aut-name=ItoHiromasa en-aut-sei=Ito en-aut-mei=Hiromasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=27 ORCID= en-aut-name=OnoueKenji en-aut-sei=Onoue en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=28 ORCID= en-aut-name=KanamoriHiromitsu en-aut-sei=Kanamori en-aut-mei=Hiromitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=29 ORCID= en-aut-name=KitaokaHiroaki en-aut-sei=Kitaoka en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=30 ORCID= affil-num=1 en-affil=Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University kn-affil= affil-num=2 en-affil=Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine kn-affil= affil-num=3 en-affil=Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine kn-affil= affil-num=5 en-affil=Department of Cardiovascular Medicine, Osaka Metropolitan University, Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Cardiology, Keio University School of Medicine kn-affil= affil-num=7 en-affil=Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine kn-affil= affil-num=8 en-affil=Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University kn-affil= affil-num=9 en-affil=Department of Cardiovascular Medicine, The University of Osaka Graduate School of Medicine kn-affil= affil-num=10 en-affil=Division of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University kn-affil= affil-num=11 en-affil=Department of Heart Failure and Transplantation, National Cerebral and Cardiovascular Center kn-affil= affil-num=12 en-affil=Department of Cardiology, Institute of Medicine, University of Tsukuba kn-affil= affil-num=13 en-affil=Department of Cardiovascular Medicine, Fukushima Medical University kn-affil= affil-num=14 en-affil=Department of Cardiovascular Medicine, Kitasato University School of Medicine kn-affil= affil-num=15 en-affil=Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University kn-affil= affil-num=16 en-affil=Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine kn-affil= affil-num=17 en-affil=Department of Cardiology, Fujita Health University kn-affil= affil-num=18 en-affil=Department of Cardiology, Tokyo Women's Medical University kn-affil= affil-num=19 en-affil=Department of Cardiology, National Defense Medical College kn-affil= affil-num=20 en-affil=Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University kn-affil= affil-num=21 en-affil=Department of Pharmacology, St. Marianna University School of Medicine kn-affil= affil-num=22 en-affil=Department of Cardiovascular Medicine, University of Yamanashi, Faculty of Medicine kn-affil= affil-num=23 en-affil=Center for Advanced Heart Failure, Okayama University Hospital kn-affil= affil-num=24 en-affil=Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences kn-affil= affil-num=25 en-affil=Department of Internal Medicine, Division of Cardiology, Hamamatsu Red Cross Hospital kn-affil= affil-num=26 en-affil=Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University kn-affil= affil-num=27 en-affil=Department of Cardiology, Mie University Hospital kn-affil= affil-num=28 en-affil=Department of Cardiovascular Medicine, Nara Medical University kn-affil= affil-num=29 en-affil=Department of Cardiology, Gifu University Graduate School of Medicine kn-affil= affil-num=30 en-affil=Department of Cardiology and Geriatrics, Kochi Medical School, Kochi University kn-affil= en-keyword=Fabry disease kn-keyword=Fabry disease en-keyword=Prospective study kn-keyword=Prospective study en-keyword=Left ventricular hypertrophy kn-keyword=Left ventricular hypertrophy en-keyword=Treatment kn-keyword=Treatment END start-ver=1.4 cd-journal=joma no-vol=51 cd-vols= no-issue=11 article-no= start-page=e70112 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202511 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Short乚Term Impacts of Japan's 2024 Physician Working乚Hour Limits on Labor Conditions, Self乚Directed Professional Development, and Happiness Among Obstetrician乚Gynecologists en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective: To examine the short-term impacts of Japan's newly implemented physician working-hour limits (April 2024) on working conditions, self-directed professional development (SDPD), defined as activities undertaken outside working hours to enhance one's professional skills, and work-related happiness among obstetrician-gynecologists (OB-GYNs).
Methods: An online survey was conducted between July 8 and July 31, 2024, targeting 867 Japan Society of Obstetrics and Gynecology members. Five hundred and fourteen full-time practitioners who had not changed workplaces around April 2024 and had no missing data were analyzed. Participants were stratified by regulation levels (A, B, C, discretionary labor system, those who don't know their own level), and their working hours, anticipated income, SDPD satisfaction, and happiness (0?10 scale) were assessed. We used multivariate linear regression to evaluate the influence of labor condition changes on happiness and explored interactions involving unpaid overtime, income changes, and SDPD satisfaction.
Results: Compared with level A (up to 960?h of overtime per year), participants at levels B and C (up to 1860?h of overtime per year) reported significantly lower happiness (p? Conclusions: The new working-hour limits had minimal impact on labor conditions in the short run. However, satisfaction with SDPD was positively associated with happiness, whereas anticipated decreases in income were correlated with lower happiness. en-copyright= kn-copyright= en-aut-name=MaedaYuto en-aut-sei=Maeda en-aut-mei=Yuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakagawaSatoru en-aut-sei=Nakagawa en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakanishiKentaro en-aut-sei=Nakanishi en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueEri en-aut-sei=Inoue en-aut-mei=Eri kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=InoueDaisuke en-aut-sei=Inoue en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KidoSaki en-aut-sei=Kido en-aut-mei=Saki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KidoMichiko en-aut-sei=Kido en-aut-mei=Michiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KogaKaori en-aut-sei=Koga en-aut-mei=Kaori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SuzukiShunji en-aut-sei=Suzuki en-aut-mei=Shunji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SuzukiYukio en-aut-sei=Suzuki en-aut-mei=Yukio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HaragaJunko en-aut-sei=Haraga en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MasuyamaHisashi en-aut-sei=Masuyama en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=YamamotoEiko en-aut-sei=Yamamoto en-aut-mei=Eiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=UmazumeTakeshi en-aut-sei=Umazume en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=YokoyamaYoshihito en-aut-sei=Yokoyama en-aut-mei=Yoshihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=IwaseAkira en-aut-sei=Iwase en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=IkedaTomoaki en-aut-sei=Ikeda en-aut-mei=Tomoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YoshidaYoshio en-aut-sei=Yoshida en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=KudoYoshiki en-aut-sei=Kudo en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=SugiyamaTakashi en-aut-sei=Sugiyama en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=MiuraKiyonori en-aut-sei=Miura en-aut-mei=Kiyonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=YahataHideaki en-aut-sei=Yahata en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=UnnoNobuya en-aut-sei=Unno en-aut-mei=Nobuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=KurasawaKentaro en-aut-sei=Kurasawa en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=MaenakaTakahide en-aut-sei=Maenaka en-aut-mei=Takahide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=MiyagiEtsuko en-aut-sei=Miyagi en-aut-mei=Etsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= en-aut-name=KatoKiyoko en-aut-sei=Kato en-aut-mei=Kiyoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=27 ORCID= en-aut-name=KatoYasuhito en-aut-sei=Kato en-aut-mei=Yasuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=28 ORCID= affil-num=1 en-affil=Department of Public Health, Institute of Science Tokyo kn-affil= affil-num=2 en-affil=Department of Obstetrics and Gynecology, Osaka University kn-affil= affil-num=3 en-affil=Department of Obstetrics and Gynecology, Asahikawa Medical University kn-affil= affil-num=4 en-affil=Aiiku Maternal and Child Health Center, Aiiku Hospital kn-affil= affil-num=5 en-affil=Department of Obstetrics and Gynecology, University of Fukui kn-affil= affil-num=6 en-affil=Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=7 en-affil=Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center kn-affil= affil-num=8 en-affil=Department of Obstetrics and Gynecology, Reproductive Medicine Chiba University kn-affil= affil-num=9 en-affil=Department of Obstetrics and Gynecology, Nippon Medical School kn-affil= affil-num=10 en-affil=Department of Gynecology, Kanagawa Cancer Center kn-affil= affil-num=11 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Healthcare Administration, Nagoya University Graduate School of Medicine kn-affil= affil-num=14 en-affil=Department of Obstetrics and Gynecology, Hokkaido University kn-affil= affil-num=15 en-affil=Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine kn-affil= affil-num=16 en-affil=Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine kn-affil= affil-num=17 en-affil=Saiseikai Matsusaka General Hospital kn-affil= affil-num=18 en-affil=Department of Obstetrics and Gynecology, University of Fukui kn-affil= affil-num=19 en-affil=Department of Obstetrics and Gynecology, Hiroshima University kn-affil= affil-num=20 en-affil=Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine kn-affil= affil-num=21 en-affil=Department of Obstetrics and Gynecology, Nagasaki University kn-affil= affil-num=22 en-affil=Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=23 en-affil=Center for Perinatal Medicine, JCHO Sagamino Hospital kn-affil= affil-num=24 en-affil=Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine kn-affil= affil-num=25 en-affil=Department of Obstetrics and Gynecology, Higashiosaka City Medical Center kn-affil= affil-num=26 en-affil=Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine kn-affil= affil-num=27 en-affil=Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=28 en-affil=Department of Obstetrics and Gynecology, Asahikawa Medical University kn-affil= en-keyword=gynecologists kn-keyword=gynecologists en-keyword=happiness kn-keyword=happiness en-keyword=obstetrician kn-keyword=obstetrician en-keyword=work style reform kn-keyword=work style reform en-keyword=working-hour limits kn-keyword=working-hour limits END start-ver=1.4 cd-journal=joma no-vol=32 cd-vols= no-issue=2 article-no= start-page=103274 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2026 dt-pub=202602 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Optimization of the reconstruction kernel for temporal bone imaging using photon-counting detector CT: A combined physical and visual evaluation en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: Photon-counting detector CT (PCD-CT) offers superior spatial resolution and noise characteristics compared to conventional CT. However, optimal reconstruction parameters for temporal bone imaging, especially kernel selection, remain unclear. This study aimed to identify the optimal reconstruction kernel using both objective physical image quality metrics and subjective expert assessments.
Methods: In phantom experiments, the system performance function (SPF) based on the task-based transfer function (TTF) and noise power spectrum (NPS) was calculated across 11 reconstruction kernels (Hr60?Hr98). Based on the results of the physical evaluation and clinical considerations from clinical practice, a subset of kernels was selected for visual assessment. For clinical images, two diagnostic radiologists evaluated three fine anatomical structures (i.e., stapes footplate, incudomalleolar joint, and cochlea) and overall image quality using both a ranking method and a 5-point Likert scale.
Results: TTF analysis indicated that Hr96 had the highest spatial resolution, while Hr60 showed the lowest noise in the NPS. SPF analysis identified Hr72 as providing the optimal balance between resolution and noise. Visual assessment using four reconstruction kernels (Hr60, Hr72, Hr76, and Hr84) showed that Hr76 consistently received the highest preference for overall image quality and visualization of fine structures. Statistically significant differences were observed among the kernels, with Hr60 consistently rated the lowest (p < 0.05).
Conclusion: The kernel Hr76 was found suitable for middle and inner ear diagnoses using PCD-CT, providing a good balance between spatial resolution and image noise. This finding provides a foundation for standardized reconstruction protocols in high-resolution temporal bone imaging.
Implications for practice: These findings support the use of Hr76 as a standard kernel for high-resolution temporal bone imaging and may contribute to protocol optimization in clinical PCD-CT practice. en-copyright= kn-copyright= en-aut-name=NishiiS. en-aut-sei=Nishii en-aut-mei=S. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AsaharaT. en-aut-sei=Asahara en-aut-mei=T. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorimitsuY. en-aut-sei=Morimitsu en-aut-mei=Y. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KajisakiS. en-aut-sei=Kajisaki en-aut-mei=S. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AkagiN. en-aut-sei=Akagi en-aut-mei=N. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HondaM. en-aut-sei=Honda en-aut-mei=M. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HayashiH. en-aut-sei=Hayashi en-aut-mei=H. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SugayaA. en-aut-sei=Sugaya en-aut-mei=A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MunetomoK. en-aut-sei=Munetomo en-aut-mei=K. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HigakiF. en-aut-sei=Higaki en-aut-mei=F. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HirakiT. en-aut-sei=Hiraki en-aut-mei=T. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=IguchiT. en-aut-sei=Iguchi en-aut-mei=T. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Radiological Technology, Faculty of Health Sciences, Okayama University kn-affil= affil-num=3 en-affil=Division of Radiological Technology, Medical Support Department, Okayama University Hospital kn-affil= affil-num=4 en-affil=Division of Radiological Technology, Medical Support Department, Okayama University Hospital kn-affil= affil-num=5 en-affil=Division of Radiological Technology, Medical Support Department, Okayama University Hospital kn-affil= affil-num=6 en-affil=Division of Radiological Technology, Medical Support Department, Okayama University Hospital kn-affil= affil-num=7 en-affil=College of Transdisciplinary Sciences for Innovation, Kanazawa University kn-affil= affil-num=8 en-affil=Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Radiology, Medical Development Field, Okayama University kn-affil= affil-num=10 en-affil=Department of Radiology, Medical Development Field, Okayama University kn-affil= affil-num=11 en-affil=Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of Radiological Technology, Faculty of Health Sciences, Okayama University kn-affil= en-keyword=Photon-counting CT kn-keyword=Photon-counting CT en-keyword=Temporal bone imaging kn-keyword=Temporal bone imaging en-keyword=Reconstruction kernel kn-keyword=Reconstruction kernel en-keyword=Image quality kn-keyword=Image quality END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=12 article-no= start-page=2351 end-page=2363 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20251024 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Multicenter, Prospective, Observational, and Single-Arm Interventional Study of Mirogabalin in Diabetic Peripheral Neuropathic Pain: Rationale and Design of Dia-NeP en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background/Objectives: The exact prevalence of and recent changes in diabetic polyneuropathy (DPN) and diabetic peripheral neuropathic pain (DPNP) in Japan are unclear. The oral gabapentinoid, mirogabalin besylate (mirogabalin), is effective with a good safety profile for DPNP with moderate-to-severe pain (numerical rating scale [NRS] scores???4). However, clinical evidence for mild pain (NRS scores???3) is unclear. The Dia-NeP study aims to examine: (1) the prevalences of DPN and DPNP and background factors in patients with type 2 diabetes mellitus (T2DM); and (2) the efficacy and safety of mirogabalin in patients with DPNP, including those with mild pain.
Methods: The Dia-NeP study is a multicenter, prospective study consisting of two parts, a baseline survey and an interventional study, to be conducted from March 2025 to August 2026 in patients with T2DM in Japan. The baseline survey is the observational study investigating the epidemiology of DPN and DPNP, and the interventional study is an exploratory, single-arm, open-label study of 12-week mirogabalin treatment. Of patients with T2DM enrolled in the baseline survey, those diagnosed with DPNP who have an NRS score for pain???1 will be included in the interventional study. The target sample size is 1000 to 3000 patients for the baseline survey and 100 for the interventional study.
Planned Outcomes: The primary endpoint is the change from baseline in the NRS score at week 12 in the interventional study. The safety endpoint is adverse events. This study will not only show the latest prevalence of DPN and DPNP in Japan, but is also the first study to investigate the efficacy and safety of mirogabalin in patients with DPNP having mild pain, as well as moderate-to-severe pain, and is expected to provide useful evidence for future DPN and DPNP treatment.
Trial Registration: Japan Registry of Clinical Trials (jRCTs031240623, registered 20/January/2025, https://jrct.mhlw.go.jp/en-latest-detail/jRCTs031240623). en-copyright= kn-copyright= en-aut-name=KamiyaHideki en-aut-sei=Kamiya en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SuzukiRyo en-aut-sei=Suzuki en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=DeguchiTakahisa en-aut-sei=Deguchi en-aut-mei=Takahisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HimenoTatsuhito en-aut-sei=Himeno en-aut-mei=Tatsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamamotoShuhei en-aut-sei=Yamamoto en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ToyamaTaiki en-aut-sei=Toyama en-aut-mei=Taiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NakamuraJiro en-aut-sei=Nakamura en-aut-mei=Jiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine kn-affil= affil-num=2 en-affil=Department of Diabetes, Metabolism and Endocrinology, Tokyo Medical University kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=4 en-affil=Department of Diabetes, Metabolism and Endocrinology, Kagoshima University Graduate School of Medical and Dental Sciences kn-affil= affil-num=5 en-affil=Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine kn-affil= affil-num=6 en-affil=Data Intelligence Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=7 en-affil=Primary Medical Science Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=8 en-affil=Division of Diabetes, Department of Internal Medicine, Aichi Medical University School of Medicine kn-affil= en-keyword=Diabetic peripheral neuropathic pain kn-keyword=Diabetic peripheral neuropathic pain en-keyword=Diabetic polyneuropathy kn-keyword=Diabetic polyneuropathy en-keyword=Epidemiological survey kn-keyword=Epidemiological survey en-keyword=Exploratory study kn-keyword=Exploratory study en-keyword=Mirogabalin kn-keyword=Mirogabalin en-keyword=Quality of life kn-keyword=Quality of life END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=436 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241127 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficacy of Pericapsular Nerve Group (PENG) block in preoperative rehabilitation (Prehabilitation) for patients with femoral neck fractures: study protocol for a randomized, placebo-controlled, double-blinded trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Despite surgery intervention for femoral neck fractures is recommended within 48 h of admission, achieving timely surgery presents challenges for patients with severe comorbidities, or in resource-limited settings. Preoperative rehabilitation (prehabilitation) reduces bedridden time, enhances mobility, and improves postoperative outcomes for patients scheduled for hip arthroplasty due to femoral neck fractures. However, prehabilitation is hindered by insufficient pain control. The pericapsular nerve group (PENG) block provides effective analgesia while preserving motor function. We designed a study to assess the efficacy of PENG block in facilitating prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty.
Methods This prospective randomized placebo-controlled double-blinded trial aims to enroll 100 patients with Garden 3 or 4 femoral neck fractures who are scheduled for hip arthroplasty. Participants will be randomly assigned to receive a PENG block with 0.375% ropivacaine (PENG group) or with normal saline (placebo group) before the initial prehabilitation session. The prehabilitation program comprises five items: Bed-sitting, Edge-sitting, Stand-up, Maintaining-standing, and Wheelchair-transfer, performed with the assistance of a single physical therapist. The primary outcome is the percentage of patients completing the entire prehabilitation program. Secondary outcomes during the initial prehabilitation session are the achievement of each program item and the Numerical Rating Scale (NRS) pain score. Other secondary outcomes include intraoperative bleeding amounts, thromboembolic events during postoperative day 0 to 7, postoperative 3-day cumulative Cumulated Ambulation Score (CAS), and discharge destination. The postoperative outcomes will be compared between subgroups of patients undergoing surgery within 48 h of admission and those undergoing surgery more than 48 h of admission.
Discussion This is the first study aiming to assess the efficacy of PENG block in prehabilitation for patients with femoral neck fractures who are scheduled for hip arthroplasty. PENG block could be beneficial, especially for patients facing delayed surgery, providing a potential treatment option during the waiting period.
Trial registration Japan Registry of Clinical Trials, jRCT1031220294, registered on August 26, 2022. en-copyright= kn-copyright= en-aut-name=JinZhuan en-aut-sei=Jin en-aut-mei=Zhuan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaDaisuke en-aut-sei=Sugiyama en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HigoFumiya en-aut-sei=Higo en-aut-mei=Fumiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HirataTakahiro en-aut-sei=Hirata en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KobayashiOsamu en-aut-sei=Kobayashi en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UedaKenichi en-aut-sei=Ueda en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Anesthesiology, Kameda Medical Center kn-affil= affil-num=3 en-affil=Department of Rehabilitation, Kameda Medical Center kn-affil= affil-num=4 en-affil=Department of Rehabilitation, Kameda Medical Center kn-affil= affil-num=5 en-affil=Department of Anesthesiology, Kameda Medical Center kn-affil= affil-num=6 en-affil=Department of Anesthesiology and Resuscitology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Anesthesiology, Kameda Medical Center kn-affil= en-keyword=Femoral neck fracture kn-keyword=Femoral neck fracture en-keyword=Hip fracture kn-keyword=Hip fracture en-keyword=PENG block kn-keyword=PENG block en-keyword=Pericapsular nerve group block kn-keyword=Pericapsular nerve group block en-keyword=Prehabilitation kn-keyword=Prehabilitation en-keyword=Preoperative mobilization kn-keyword=Preoperative mobilization en-keyword=Preoperative rehabilitation kn-keyword=Preoperative rehabilitation en-keyword=Randomized controlled trial kn-keyword=Randomized controlled trial en-keyword=Study protocol kn-keyword=Study protocol END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=1 article-no= start-page=468 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250929 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The safety and efficacy of finasteride for transgender men with androgenetic alopecia: a case series en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Testosterone replacement therapy is commonly used in transgender men for masculinization. One of the most common adverse effects of testosterone replacement therapy is androgenetic alopecia. In Japan, finasteride is approved exclusively for cisgender men and is not indicated for transgender men. The aim of this clinical trial was to evaluate the safety and efficacy of finasteride in transgender men with androgenetic alopecia.
Case presentation This study included three transgender men (assigned female at birth, identifying as male), aged 44, 43, and 29 years. All participants were of Asian ethnicity. A clinical trial was conducted from October 2021 to December 2023. Transgender men aged 20?60 years who had not undergone hysterectomy, were undergoing testosterone replacement therapy, and who had been diagnosed with stage???II androgenetic alopecia on the basis of the Norwood?Hamilton scale were recruited. The participants initiated treatment with 0.2 mg of finasteride per day for 3 months (phase 1). If no adverse events above grade 2 occurred, the dose was increased to 1.0 mg per day for an additional 3 months (phase 2). The primary endpoints were the incidence of treatment-related adverse events at 1 week, 1 month, and 3 months, as well as the rate of participants continuing treatment at 3 months. None of the patients experienced serious adverse events at 3 months, and all the patients extended their treatment to a total of 6 months. Improvements of at least one stage on the N?H scale were observed, but two participants experienced resumption of menstruation.
Conclusion Finasteride appears to be a safe and effective treatment for androgenetic alopecia in transgender men undergoing testosterone replacement therapy. However, its potential for reducing some of the effects of testosterone replacement therapy warrants further investigation. Trial registration: jRCT, jRCTs061210040, registered 7 October 2021, https://jrct.mhlw.go.jp/latest-detail/jRCTs061210040. en-copyright= kn-copyright= en-aut-name=TominagaYusuke en-aut-sei=Tominaga en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KobayashiTomoko en-aut-sei=Kobayashi en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MatsumotoYuko en-aut-sei=Matsumoto en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakoTomoko en-aut-sei=Sako en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MoriwakeTakatoshi en-aut-sei=Moriwake en-aut-mei=Takatoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HoriiSatoshi en-aut-sei=Horii en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KatayamaSatoshi en-aut-sei=Katayama en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwataTakehiro en-aut-sei=Iwata en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=BekkuKensuke en-aut-sei=Bekku en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=EdamuraKohei en-aut-sei=Edamura en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Urology, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=5 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=8 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=12 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=13 en-affil=Center for Innovative Clinical Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=14 en-affil=Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= en-keyword=Finasteride kn-keyword=Finasteride en-keyword=Dihydrotestosterone kn-keyword=Dihydrotestosterone en-keyword=Transgender men kn-keyword=Transgender men en-keyword= Androgenetic alopecia kn-keyword= Androgenetic alopecia en-keyword=Resumption of menstruation kn-keyword=Resumption of menstruation END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=5 article-no= start-page=369 end-page=379 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202510 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Blood Pressure and Heart Rate Patterns Identified by Unsupervised Machine Learning and Their Associations with Subclinical Cerebral and Renal Damage in a Japanese Community: The Masuda Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (? 12 mg/g) of the mean value from ?2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage. en-copyright= kn-copyright= en-aut-name=HisamatsuTakashi en-aut-sei=Hisamatsu en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KinutaMinako en-aut-sei=Kinuta en-aut-mei=Minako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MunetomoSosuke en-aut-sei=Munetomo en-aut-mei=Sosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=FukudaMari en-aut-sei=Fukuda en-aut-mei=Mari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KojimaKatsuhide en-aut-sei=Kojima en-aut-mei=Katsuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TaniguchiKaori en-aut-sei=Taniguchi en-aut-mei=Kaori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakahataNoriko en-aut-sei=Nakahata en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KandaHideyuki en-aut-sei=Kanda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Environmental Medicine and Public Health, Izumo, Shimane University Faculty of Medicine kn-affil= affil-num=7 en-affil=Department of Health and Nutrition, The University of Shimane Faculty of Nursing and Nutrition kn-affil= affil-num=8 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=blood pressure kn-keyword=blood pressure en-keyword=heart rate kn-keyword=heart rate en-keyword=subclinical disease kn-keyword=subclinical disease en-keyword=uniform manifold approximation and projection kn-keyword=uniform manifold approximation and projection en-keyword=unsupervised machine learning kn-keyword=unsupervised machine learning END start-ver=1.4 cd-journal=joma no-vol=18 cd-vols= no-issue=1 article-no= start-page=e70149 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202501 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Impacts of Minimally Invasive Transperineal Abdominoperineal Resection in Crohn's Disease: A Retrospective Analysis en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.
Methods: A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (n?=?11) or APR (n?=?8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.
Results: The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223?mL vs. 533?mL, p?=?0.04) and a lower incidence of SSI rates (36.4% vs. 75%, p?=?0.07). Operative time and hospital stay were comparable between groups.
Conclusion: Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings. en-copyright= kn-copyright= en-aut-name=KondoYoshitaka en-aut-sei=Kondo en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KanayaNobuhiko en-aut-sei=Kanaya en-aut-mei=Nobuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShojiRyohei en-aut-sei=Shoji en-aut-mei=Ryohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InokuchiToshihiro en-aut-sei=Inokuchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HiraokaSakiko en-aut-sei=Hiraoka en-aut-mei=Sakiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YoshidaYusuke en-aut-sei=Yoshida en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MatsumiYuki en-aut-sei=Matsumi en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShigeyasuKunitoshi en-aut-sei=Shigeyasu en-aut-mei=Kunitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TeraishiFuminori en-aut-sei=Teraishi en-aut-mei=Fuminori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Research Center for Intestinal Health Science, Okayama University kn-affil= affil-num=5 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Crohn's disease kn-keyword=Crohn's disease en-keyword=intraoperative blood loss kn-keyword=intraoperative blood loss en-keyword=minimally invasive surgery kn-keyword=minimally invasive surgery en-keyword=surgical site infection (SSI) kn-keyword=surgical site infection (SSI) en-keyword=transperineal abdominoperineal resection (TpAPR) kn-keyword=transperineal abdominoperineal resection (TpAPR) END start-ver=1.4 cd-journal=joma no-vol=65 cd-vols= no-issue=9 article-no= start-page=396 end-page=406 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250915 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Real-world Experience of Embolization for Intracranial Tumors in Japan: Analysis of 2,756 Cases from Japanese Registry of NeuroEndovascular Therapy 4 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Embolization of intracranial tumors is predominantly performed in Japan, primarily before neurosurgical resection. The Japanese Registry of NeuroEndovascular Therapy (JR-NET) Study Group, established in 2005, aims to clarify the factors influencing the outcomes of neuroendovascular treatment. Japanese Registry of NeuroEndovascular Therapy 4 is a nationwide, multicenter retrospective observational study that evaluates real-world data on intracranial tumor embolization in Japan. Japanese Registry of NeuroEndovascular Therapy 4 is based on data collected from 166 neurosurgical centers in Japan between January 2015 and December 2019. Of 63,230 patients, 2,664 (4.2%) with intracranial tumors underwent embolization. The primary endpoint was the proportion of patients with a modified Rankin scale (mRS) score of 0-2 at 30 days post-procedure. Secondary endpoints included procedure-related complications. Among the 2,664 patients, 61 records lacked sufficient data, leaving 2,603 patients (1,612 females, median age: 61 years [interquartile range 51-71]). The proportion of patients with mRS scores ?2 at 30 days after the procedure was 86.9%. The overall incidence of procedure-related complications was 4.8%, with 1.8% hemorrhagic, 2.0% ischemic, and 1.0% classified as other complications. In the multivariate analysis, general anesthesia and embolization of vessels other than the external carotid artery were identified as risk factors for the development of complications. Meningioma cases had a complication rate of 4.3%, with major complications occurring in 3.5%. Hemangioblastoma cases had a 14.9% complication rate, with major complications at 9.9%. Japanese Registry of NeuroEndovascular Therapy 4 provides comprehensive real-world data on intracranial tumor embolization in Japan, identifying risk factors to inform and improve the safe practice of intracranial tumor embolization in neuroendovascular therapy. en-copyright= kn-copyright= en-aut-name=HARUMAJun en-aut-sei=HARUMA en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SUGIUKenji en-aut-sei=SUGIU en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HISHIKAWATomohito en-aut-sei=HISHIKAWA en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SOUTOMEYuta en-aut-sei=SOUTOME en-aut-mei=Yuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=EBISUDANIYuki en-aut-sei=EBISUDANI en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KIMURARyu en-aut-sei=KIMURA en-aut-mei=Ryu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=EDAKIHisanori en-aut-sei=EDAKI en-aut-mei=Hisanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KAWAKAMIMasato en-aut-sei=KAWAKAMI en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MURAISatoshi en-aut-sei=MURAI en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HIRAMATSUMasafumi en-aut-sei=HIRAMATSU en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TANAKAShota en-aut-sei=TANAKA en-aut-mei=Shota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SATOWTetsu en-aut-sei=SATOW en-aut-mei=Tetsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=IIHARAKoji en-aut-sei=IIHARA en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IMAMURAHirotoshi en-aut-sei=IMAMURA en-aut-mei=Hirotoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ISHIIAkira en-aut-sei=ISHII en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=MATSUMARUYuji en-aut-sei=MATSUMARU en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=SAKAIChiaki en-aut-sei=SAKAI en-aut-mei=Chiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YOSHIMURAShinichi en-aut-sei=YOSHIMURA en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=SAKAINobuyuki en-aut-sei=SAKAI en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=Japanese Registry of Neuroendovascular Therapy (JR-NET) Investigators en-aut-sei=Japanese Registry of Neuroendovascular Therapy (JR-NET) Investigators en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurosurgery, Kawasaki Medical School kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurosurgery, Kawasaki Medical School kn-affil= affil-num=10 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Neurosurgery, Kindai University kn-affil= affil-num=13 en-affil=Department of Neurosurgery, National Cerebral and Cardiovascular Center kn-affil= affil-num=14 en-affil=Department of Neurosurgery, National Cerebral and Cardiovascular Center kn-affil= affil-num=15 en-affil=Department of Neurosurgery, Juntendo University Graduate School of Medicine kn-affil= affil-num=16 en-affil=Department of Neurosurgery, Institute of Medicine, University of Tsukuba kn-affil= affil-num=17 en-affil=Department of Neurosurgery, Kyoto University kn-affil= affil-num=18 en-affil=Department of Neurosurgery, Hyogo Medical University kn-affil= affil-num=19 en-affil=Department of Neurological Surgery, Shimizu Hospital kn-affil= affil-num=20 en-affil= kn-affil= en-keyword=complication kn-keyword=complication en-keyword=intracranial tumor kn-keyword=intracranial tumor en-keyword=embolization kn-keyword=embolization en-keyword=Japanese registry kn-keyword=Japanese registry END start-ver=1.4 cd-journal=joma no-vol=4 cd-vols= no-issue=3 article-no= start-page=e70167 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250728 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Occupational therapist乚guided exercise increased white blood cell and neutrophil counts during clozapine treatment: A case report en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Moderate exercise increases white blood cells and neutrophils. However, there are no reports on the relationship between exercise intensity and these cells. We observed a patient taking clozapine whose white blood cell and neutrophil counts were borderline. Supervised exercise therapy with an occupational therapist stabilized these counts.
Case Presentation: A 50-year-old woman with treatment-resistant schizophrenia was prescribed clozapine. By Day 63, the clozapine dosage had been increased to 450?mg/day. Additionally, she was advised to perform a 30-min walking exercise program 1 h before blood tests. Exercise therapy supervised by an occupational therapist was performed eight times, and self-training was performed five times. Exercise intensity was monitored using the Borg Scale for subjective evaluation and the Karvonen formula for objective evaluation. Supervised exercise therapy with an occupational therapist resulted in greater increases on the Borg Scale and Karvonen formula than did self-training. It also induced increases in white blood cells and neutrophils. Her psychiatric symptoms improved, and she was discharged on Day 71. A blood test taken after discharge revealed that her white blood cell and neutrophil counts were within the normal range and she continued to take clozapine for 2 years. She has since been able to enjoy a calm and relaxed life at home.
Conclusion: Exercise involving subjective and objective evaluation by an occupational therapist effectively increased white blood cells and neutrophils during clozapine treatment. Supervised exercise therapy by an occupational therapist is important when self-exercise is insufficient for continuing clozapine treatment. en-copyright= kn-copyright= en-aut-name=HinotsuKenji en-aut-sei=Hinotsu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakamotoShinji en-aut-sei=Sakamoto en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawaiHiroki en-aut-sei=Kawai en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OhyaYoshio en-aut-sei=Ohya en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YokodeAkiyoshi en-aut-sei=Yokode en-aut-mei=Akiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AsadaTakahiro en-aut-sei=Asada en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkahisaYuko en-aut-sei=Okahisa en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakakiManabu en-aut-sei=Takaki en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Neuropsychiatry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=clozapine kn-keyword=clozapine en-keyword=exercise kn-keyword=exercise en-keyword=leukopenia kn-keyword=leukopenia en-keyword=neutropenia kn-keyword=neutropenia en-keyword=occupational therapist kn-keyword=occupational therapist END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue=2 article-no= start-page=156 end-page=167 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250602 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Metaverse Support Groups for LGBTQ+ Youth: An Observational Study on Safety, Self-Expression, and Early Intervention en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study explored whether metaverse-based support groups could address social isolation and suicide risks among LGBTQ+ youths by providing enhanced anonymity, avatar-based self-expression, and improved accessibility. Over one year, 53 individuals aged 14?23 participated in regular online sessions facilitated via the "cluster" metaverse platform by a non-profit LGBTQ+ organization. Each 90-minute session included voice and text-based interactions within a specially designed single-floor virtual space featuring conversation areas and a designated "safe area" for emotional regulation. Post-session questionnaires (5-point Likert scales) captured demographics, avatar preferences, self-confidence, and perceived safety, self-expression, and accessibility; responses were analyzed with Pearson's chi-squared test and Mann?Whitney U tests (兛=0.05). Results indicated that 79.2% of participants selected avatars aligned with their gender identity, reporting high satisfaction (mean = 4.10/5) and minimal discomfort (mean = 1.79/5). Social confidence was significantly higher in the metaverse compared with real-world settings (p<0.001), particularly among those with lower real-world confidence, who exhibited an average gain of 2.08 points. Approximately half of all first-time participants were aged 16 years or younger, which suggested the platform乫s value for early intervention. Additionally, the metaverse environment was rated significantly higher in safety/privacy (3.94/5), self-expression (4.02/5), and accessibility (4.21/5) compared with the real-world baseline, and 73.6% reported they felt more accepted virtually. However, some participants who had high confidence offline experienced mild adaptation challenges (mean decrease of 0.58 points), which highlighted that metaverse-based support may be more effective as a complement to in-person services rather than a replacement. Overall, these findings demonstrate that metaverse-based support groups can reduce psychological barriers for LGBTQ+ youth by facilitating safe and affirming virtual environments. The metaverse may help alleviate emotional distress and prevent further severe outcomes, such as suicidal ideation by providing early intervention, especially for adolescents unable to access conventional in-person services. Further research should examine its integration with existing clinical, community, and educational resources to ensure comprehensive, long-term support. en-copyright= kn-copyright= en-aut-name=HaseiJoe en-aut-sei=Hasei en-aut-mei=Joe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoYosuke en-aut-sei=Matsumoto en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawaiHiroki en-aut-sei=Kawai en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkahisaYuko en-aut-sei=Okahisa en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakakiManabu en-aut-sei=Takaki en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Okayama University kn-affil= affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Science of Functional Recovery and Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceu-tical Sciences, Okayama University kn-affil= en-keyword=LGBTQ+ Youth kn-keyword=LGBTQ+ Youth en-keyword=Social Isolation kn-keyword=Social Isolation en-keyword=Suicide Prevention kn-keyword=Suicide Prevention en-keyword=Avatar-Based Interventions kn-keyword=Avatar-Based Interventions END start-ver=1.4 cd-journal=joma no-vol=32 cd-vols= no-issue=5 article-no= start-page=567 end-page=579 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250501 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=ChatGPT Responses to Clinical Questions in the Japan Atherosclerosis Society Guidelines for Prevention of Atherosclerotic Cardiovascular Disease 2022 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims: Artificial intelligence is increasingly used in the medical field. We assessed the accuracy and reproducibility of responses by ChatGPT to clinical questions (CQs) in the Japan Atherosclerosis Society Guidelines for Prevention Atherosclerotic Cardiovascular Diseases 2022 (JAS Guidelines 2022).
Methods: In June 2024, we assessed responses by ChatGPT (version 3.5) to CQs, including background questions (BQs) and foreground questions (FQs). Accuracy was assessed independently by three researchers using six-point Likert scales ranging from 1 (乬completely incorrect乭) to 6 (乬completely correct乭) by evaluating responses to CQs in Japanese or translated into English. For reproducibility assessment, responses to each CQ asked five times separately in a new chat were scored using six-point Likert scales, and Fleiss kappa coefficients were calculated.
Results: The median (25th?75th percentile) score for ChatGPT乫s responses to BQs and FQs was 4 (3?5) and 5 (5?6) for Japanese CQs and 5 (3?6) and 6 (5?6) for English CQs, respectively. Response scores were higher for FQs than those for BQs (P values 亙0.001 for Japanese and English). Similar response accuracy levels were observed between Japanese and English CQs (P value 0.139 for BQs and 0.586 for FQs). Kappa coefficients for reproducibility were 0.76 for BQs and 0.90 for FQs.
Conclusions: ChatGPT showed high accuracy and reproducibility in responding to JAS Guidelines 2022 CQs, especially FQs. While ChatGPT primarily reflects existing guidelines, its strength could lie in rapidly organizing and presenting relevant information, thus supporting instant and more efficient guideline interpretation and aiding in medical decision-making. en-copyright= kn-copyright= en-aut-name=HisamatsuTakashi en-aut-sei=Hisamatsu en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukudaMari en-aut-sei=Fukuda en-aut-mei=Mari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KinutaMinako en-aut-sei=Kinuta en-aut-mei=Minako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KandaHideyuki en-aut-sei=Kanda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Autonomic intelligence kn-keyword=Autonomic intelligence en-keyword=ChatGPT kn-keyword=ChatGPT en-keyword=Accuracy kn-keyword=Accuracy en-keyword=Reproducibility kn-keyword=Reproducibility en-keyword=Guidelines kn-keyword=Guidelines END start-ver=1.4 cd-journal=joma no-vol=54 cd-vols= no-issue=8 article-no= start-page=afaf224 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Oestrogen replacement combined with resistance exercise in older women with knee osteoarthritis: a randomised, double-blind, placebo-controlled clinical trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Interventions targeting physical function decline in older women with knee osteoarthritis (KOA) are vital for healthy ageing. The additive benefits of combining oestrogen replacement therapy (ERT) with resistance exercise remain unclear.
Objective: To evaluate the additive effect of low-dose ERT on physical performance when combined with a muscle resistance exercise programme (MREP) in older women with KOA.
Design: This is a placebo-controlled, double-blind, randomised clinical trial.
Subjects: The subjects were community-dwelling women aged ?65 years with chronic knee pain and KOA diagnosis.
Methods: Participants completed a 3-month MREP and were randomised to receive daily low-dose transdermal ERT (oestradiol 0.54 mg/day) or placebo. Outcomes were assessed at baseline, postintervention and 12 months later. The primary outcome was change in 30-second chair stand test (CS-30) score. Secondary outcomes included muscle mass, knee extension strength, walking performance, metabolic indicators, knee pain scale and 12-item short-form health survey (SF-12). Between-group differences in CS-30 changes were analysed using a linear regression model based on the intention-to-treat principle.
Results: Among 168 individuals screened, 75 participants (mean age 73.8 years, SD 5.8) were enrolled and randomised into an ERT group (n?=?37) or a placebo group (n?=?38). Baseline CS-30 scores were 14.81 (SD 3.95) in the ERT group and 15.58 (SD 3.48) in the placebo group. At 3 months, mean changes were 2.59 (SD 2.58) and 1.79 (SD 2.28) repetitions, respectively. The primary analysis showed no statistically significant between-group difference [regression coefficient: 0.81 (95% CI: ?0.31, 1.92); P?=?.16]. Post hoc subgroup and sensitivity analyses suggested that benefits may exist among early-stage KOA participants. SF-12 mental health scores also improved significantly in the ERT group. No serious adverse events occurred.
Conclusions: ERT did not confer significant additive benefits to resistance exercise overall but may improve outcomes in early-stage KOA and mental health domains. These exploratory findings warrant further investigation. en-copyright= kn-copyright= en-aut-name=MitomaTomohiro en-aut-sei=Mitoma en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OobaHikaru en-aut-sei=Ooba en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakahashiKasumi en-aut-sei=Takahashi en-aut-mei=Kasumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KondoTsunemasa en-aut-sei=Kondo en-aut-mei=Tsunemasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IkedaTomohiro en-aut-sei=Ikeda en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SakamotoYoko en-aut-sei=Sakamoto en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MakiJota en-aut-sei=Maki en-aut-mei=Jota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Medical Development Field, Center for Innovative Clinical Medicine, Okayama University kn-affil= affil-num=2 en-affil=Medical Development Field, Center for Innovative Clinical Medicine, Okayama University kn-affil= affil-num=3 en-affil=Obstetrics and Gynecology, Ochiai Hospital kn-affil= affil-num=4 en-affil=Obstetrics and Gynecology, Ochiai Hospital kn-affil= affil-num=5 en-affil=Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil=Medical Development Field, Center for Innovative Clinical Medicine, Okayama University kn-affil= affil-num=7 en-affil=Medical Development Field, Center for Innovative Clinical Medicine, Okayama University kn-affil= affil-num=8 en-affil=Medical Development Field, Center for Innovative Clinical Medicine, Okayama University kn-affil= en-keyword=oestrogen replacement therapy kn-keyword=oestrogen replacement therapy en-keyword=muscle resistance exercise kn-keyword=muscle resistance exercise en-keyword=knee osteoarthritis kn-keyword=knee osteoarthritis en-keyword=physical performance kn-keyword=physical performance en-keyword=randomised controlled trial kn-keyword=randomised controlled trial en-keyword=older people kn-keyword=older people END start-ver=1.4 cd-journal=joma no-vol=27 cd-vols= no-issue=3 article-no= start-page=121 end-page=127 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=2024 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association Between Early Mobilization and Postoperative Pneumonia Following Robot-assisted Minimally Invasive Esophagectomy in Patients with Thoracic Esophageal Squamous Cell Carcinoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective: The objective of this study was to confirm that early mobilization (EM) could reduce pneumonia in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE) for thoracic esophageal squamous cell carcinoma (TESCC). Methods: Postoperative pneumonia was defined as physician-diagnosed pneumonia using the Esophagectomy Complications Consensus Group definition of pneumonia with a Clavien?Dindo classification grade II?V on postoperative day (POD) 3?5. EM was defined as achieving an ICU Mobility Scale (IMS) ?7 by POD 2. Patients were divided into EM (n = 36) and non-EM (n = 35) groups. Barriers to EM included pain, orthostatic intolerance (OI), and orthostatic hypotension. Results: The overall incidence of postoperative pneumonia was 12.7%, with a significant difference between the EM (2.8%) and non-EM (22.9%) groups (P = 0.014). The odds ratio was 0.098 in the EM group compared to the non-EM group. A significant difference was found between the two groups in terms of the barriers to EM at POD 2 only for OI, with a higher incidence in the non-EM group. Multivariate logistic regression analysis showed that patients with OI were more likely to be unable to achieve EM than those without OI (odds ratio, 7.030; P = 0.006). Conclusion: EM within POD 2 may reduce the incidence of postoperative pneumonia in patients undergoing RAMIE for TESCC. Furthermore, it was suggested that OI can have a negative impact on the EM after RAMIE. en-copyright= kn-copyright= en-aut-name=NOZAWAYasuaki en-aut-sei=NOZAWA en-aut-mei=Yasuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HARADAKazuhiro en-aut-sei=HARADA en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NOMAKazuhiro en-aut-sei=NOMA en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KATAYAMAYoshimi en-aut-sei=KATAYAMA en-aut-mei=Yoshimi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HAMADAMasanori en-aut-sei=HAMADA en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OZAKIToshifumi en-aut-sei=OZAKI en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital kn-affil= affil-num=2 en-affil=Graduate School of Health Science Studies, Kibi International University kn-affil= affil-num=3 en-affil=Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital kn-affil= affil-num=5 en-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital kn-affil= affil-num=6 en-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital kn-affil= en-keyword=Early mobilization kn-keyword=Early mobilization en-keyword=Postoperative pneumonia kn-keyword=Postoperative pneumonia en-keyword=Orthostatic intolerance kn-keyword=Orthostatic intolerance en-keyword=Thoracic esophageal squamous cell carcinoma kn-keyword=Thoracic esophageal squamous cell carcinoma en-keyword=Robot-assisted minimally invasive esophagectomy kn-keyword=Robot-assisted minimally invasive esophagectomy END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250102 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Health-related quality of life, work productivity, and persisting challenges in treated ulcerative colitis patients: a Japanese National Health and Wellness Survey en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background/Aims Despite available treatments for ulcerative colitis (UC), unmet needs persist among patients in Japan. This study explored the health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), indirect cost, and unmet needs among treated UC patients in Japan.
Methods This cross-sectional, observational study utilized data from the online 2017, 2019, and 2021 Japan National Health and Wellness Survey. Respondents were aged ? 18 years and had undergone or were on UC treatment (5-aminosalicylic acid, steroids, immunomodulators/immunosuppressants, biologics/Janus kinase inhibitors [JAKi]). Demographic, general health, and clinical characteristics, medication adherence, HRQoL, WPAI, and indirect cost were collected and analyzed.
Results Among 293 treated UC patients, 83.6% were non-biologic/JAKi users, 29.0% had UC ? 15 years, 34.8% had moderate-to-severe disease severity, 55.3% experienced ? 1 persisting UC symptom, and 91.5% reported UC as bothersome to an extent. Patients reported EuroQoL visual analog scale score of 68.1 and ? 35% reported anxiety and depression. Mean work productivity loss was 29.3%, resulting in an annual mean indirect loss of 1.1 million JPY (45.3 thousand USD) per person. Higher WPAI (impairment) was associated with being male, moderate-to-severe disease severity, and low treatment adherence (P<0.05). Biologics/JAKi users had higher work impairment, and IM/IS users had higher activity impairment than 5-aminosalicylic acid users (P<0.05).
Conclusions Despite treatment, Japanese UC patients experienced high disease burden and persistent disease-related challenges. Overall HRQoL were lower than the mean healthy population and work productivity impairment led to high indirect costs. The findings suggest the importance of new interventions for optimizing UC outcomes. en-copyright= kn-copyright= en-aut-name=HiraokaSakiko en-aut-sei=Hiraoka en-aut-mei=Sakiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HuangZhezhou en-aut-sei=Huang en-aut-mei=Zhezhou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=QinFei en-aut-sei=Qin en-aut-mei=Fei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=Nathan ArokianathanFatima Megala en-aut-sei=Nathan Arokianathan en-aut-mei=Fatima Megala kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=Dav?Kiran en-aut-sei=Dav? en-aut-mei=Kiran kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShahShweta en-aut-sei=Shah en-aut-mei=Shweta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KimHyunchung en-aut-sei=Kim en-aut-mei=Hyunchung kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Gastroenterology, Okayama University kn-affil= affil-num=2 en-affil=Cerner Enviza kn-affil= affil-num=3 en-affil=Cerner Enviza kn-affil= affil-num=4 en-affil=Oracle Life Sciences kn-affil= affil-num=5 en-affil=Bristol Myers Squibb kn-affil= affil-num=6 en-affil=Bristol Myers Squibb kn-affil= affil-num=7 en-affil=Bristol Myers Squibb kn-affil= en-keyword=Quality of life kn-keyword=Quality of life en-keyword=Presenteeism kn-keyword=Presenteeism en-keyword=Absenteeism kn-keyword=Absenteeism en-keyword=Ulcerative colitis kn-keyword=Ulcerative colitis en-keyword=Japan kn-keyword=Japan END start-ver=1.4 cd-journal=joma no-vol=145 cd-vols= no-issue=1 article-no= start-page=64 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241218 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Medial meniscus posterior root tears with advanced osteoarthritis or subchondral insufficiency fracture are good indications for unicompartmental knee arthroplasty at a minimum 2-year follow-up en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction The outcomes of unicompartmental knee arthroplasty (UKA) in the presence and absence of medial meniscus posterior root tears (MMPRTs) have not been compared. This study compared the characteristics and clinical outcomes of patients undergoing UKA with and without MMPRTs.
Materials and methods This study analyzed 68 patients. The presence or absence of MMPRTs was evaluated using preoperative magnetic resonance imaging. Patient characteristics, clinical scores before surgery and at the final evaluation, and imaging findings were compared between patients with and without MMPRTs. Multiple regression analysis was conducted on postoperative visual analog scale (VAS)-pain scores.
Results MMPRTs were present in 64.7% (44/68) of patients. Patients with MMPRTs were significantly younger (67.8?亇?8.2 vs. 75.0?亇?7.1 years, p? Conclusions Patients undergoing UKA with MMPRTs were younger with less radiographic osteoarthritic changes compared to those without MMPRTs, and their postoperative VAS-pain scores were significantly superior. The duration from the development of symptoms to the time of surgery significantly influenced postoperative pain in patients undergoing UKA. en-copyright= kn-copyright= en-aut-name=KawadaKoki en-aut-sei=Kawada en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YokoyamaYusuke en-aut-sei=Yokoyama en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TamuraMasanori en-aut-sei=Tamura en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Unicompartmental knee arthroplasty kn-keyword=Unicompartmental knee arthroplasty en-keyword=Meniscus kn-keyword=Meniscus en-keyword=Posterior root tear kn-keyword=Posterior root tear en-keyword=Subchondral insufficiency fracture kn-keyword=Subchondral insufficiency fracture en-keyword=Osteoarthritis kn-keyword=Osteoarthritis END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=4 article-no= start-page=293 end-page=297 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202508 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effectiveness of Pallidal Stimulation for Dystonic Storm and Subsequent Ssevere Posterior Reversible Encephalopathy Syndrome in a Patient with GNAO1 Variant en-subtitle= kn-subtitle= en-abstract= kn-abstract=GNAO1 variant affects primarily the brain and neurodevelopment, leading to a range of motor disorders including seizures beginning in infancy and involuntary movements such as dyskinesia and dystonia. Our patient, a 15-year-old Japanese female, began exhibiting involuntary movements at age 4. A de novo missense mutation (NM_020988.3: c.228C>G, NP_066268.1: p.(Asn76Lys)) in the GNAO1 gene was identified when the patient was 15, and during the same year she developed influenza pneumonia, accompanied by dystonic storm. She required intensive care with mechanical ventilation and underwent a tracheostomy. She also developed posterior reversible encephalopathy syndrome. Globus pallidal stimulation was administered, leading to an improvement in the dystonic storm. Early consideration of globus pallidal stimulation is recommended when treating difficult-to-manage dystonic storms. en-copyright= kn-copyright= en-aut-name=KawaiKoji en-aut-sei=Kawai en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SasakiTatsuya en-aut-sei=Sasaki en-aut-mei=Tatsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TanimotoShun en-aut-sei=Tanimoto en-aut-mei=Shun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SaijoTomoya en-aut-sei=Saijo en-aut-mei=Tomoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SasadaSusumu en-aut-sei=Sasada en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AkiyamaTomoyuki en-aut-sei=Akiyama en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HiraideTakuya en-aut-sei=Hiraide en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SaitsuHirotomo en-aut-sei=Saitsu en-aut-mei=Hirotomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TanakaShota en-aut-sei=Tanaka en-aut-mei=Shota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Pediatric Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Biochemistry, Hamamatsu University School of Medicine kn-affil= affil-num=8 en-affil=Department of Biochemistry, Hamamatsu University School of Medicine kn-affil= affil-num=9 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=GNAO1 variant kn-keyword=GNAO1 variant en-keyword=dystonic storm kn-keyword=dystonic storm en-keyword=globus pallidal stimulation kn-keyword=globus pallidal stimulation en-keyword=posterior reversible encephalopathy syndrome kn-keyword=posterior reversible encephalopathy syndrome END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=4 article-no= start-page=244 end-page=254 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202408 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A novel brief questionnaire using a face rating scale to assess dental anxiety and fear en-subtitle= kn-subtitle= en-abstract= kn-abstract=PURPOSE This study aimed to evaluate the reliability and validity of a four-item questionnaire using a face rating scale to measure dental trait anxiety (DTA), dental trait fear (DTF), dental state anxiety (DSA), and dental state fear (DSF).
MATERIALS AND METHODS Participants were consecutively selected from patients undergoing scaling (S-group; n = 47) and implant placement (I-group; n = 25). The S-group completed the questionnaire both before initial and second scaling, whereas the I-group responded on the pre-surgery day (Pre-day), the day of implant placement (Imp-day), and the day of suture removal (Post-day).
RESULTS The reliability in the S-group was evaluated using the test-retest method, showing a weighted kappa value of DTA, 0.61; DTF, 0.46; DSA, 0.67; DSF, 0.52. Criterion-related validity, assessed using the State-Trait Anxiety Inventory乫s trait anxiety and state anxiety, revealed positive correlations between trait anxiety and DTA/DTF (DTA, 兿 = 0.30; DTF, 兿 = 0.27, 兿: correlation coefficient) and between state anxiety and all four items (DTA, 兿 = 0.41; DTF, 兿 = 0.32; DSA, 兿 = 0.25; DSF, 兿 = 0.25). Known-group validity was assessed using the initial data and Imp-day data from the S-group and I-group, respectively, revealing significantly higher DSA and DSF scores in the I-group than in the S-group. Responsiveness was gauged using I-group data, showing significantly lower DSA and DSF scores on post-day compared to other days.
CONCLUSION The newly developed questionnaire has acceptable reliability and validity for clinical use, suggesting its usefulness for research on dental anxiety and fear and for providing patient-specific dental care. en-copyright= kn-copyright= en-aut-name=MinoTakuya en-aut-sei=Mino en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=Kimura-OnoAya en-aut-sei=Kimura-Ono en-aut-mei=Aya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ArakawaHikaru en-aut-sei=Arakawa en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokumotoKana en-aut-sei=Tokumoto en-aut-mei=Kana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KurosakiYoko en-aut-sei=Kurosaki en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsukaYoshizo en-aut-sei=Matsuka en-aut-mei=Yoshizo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MaekawaKenji en-aut-sei=Maekawa en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KubokiTakuo en-aut-sei=Kuboki en-aut-mei=Takuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University kn-affil= affil-num=7 en-affil=Department of Removable Prosthodontics and Occlusion, Osaka Dental University kn-affil= affil-num=8 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Dental anxiety kn-keyword=Dental anxiety en-keyword=Anxiety disorders kn-keyword=Anxiety disorders en-keyword=Surveys kn-keyword=Surveys en-keyword=Questionnaires kn-keyword=Questionnaires en-keyword=Validation study kn-keyword=Validation study en-keyword=Phobia kn-keyword=Phobia END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=2 article-no= start-page=e70262 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202504 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical outcomes following medial meniscus posterior root repairs: A minimum of 5乚year follow乚up study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: This study assessed the clinical outcomes of the FasT-Fix dependent modified Mason-Allen suture (F-MMA) and two simple stitches (TSS) on mid-term postoperative outcomes following medial meniscus (MM) posterior root repair.
Methods: Forty-three patients who underwent transtibial pullout repair for MM posterior root tear (PRT) between November 2016 and September 2018 were initially enrolled. Patients with a femorotibial angle ? 180亱, Kellgren?Lawrence grade of 0?2, and modified Outerbridge grade I or II cartilage lesions were included. The Lysholm, Tegner activity, International Knee Documentation Committee score, pain visual analogue scale and Knee injury and Osteoarthritis Outcome scores were assessed as clinical outcomes. Conversion surgery to knee arthroplasty was considered as the endpoint. Surgeries other than second-look arthroscopy and plate or screw removal were also recorded.
Results: The mean follow-up period was 5.9 years. All evaluated 5-year postoperative clinical outcomes were significantly improved compared to the preoperative outcomes (p? Conclusion: Both F-MMA and TSS pullout repairs yielded satisfactory clinical outcomes in patients with MMPRT with a mean follow-up of 5.9 years, and no conversion to knee arthroplasty was required. Further follow-up is warranted to assess long-term survival rates.
Level of Evidence: Level III. en-copyright= kn-copyright= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiuKazuhisa en-aut-sei=Sugiu en-aut-mei=Kazuhisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KamatsukiYusuke en-aut-sei=Kamatsuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TamuraMasanori en-aut-sei=Tamura en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KawadaKoki en-aut-sei=Kawada en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HasegawaTsubasa en-aut-sei=Hasegawa en-aut-mei=Tsubasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama Saiseikai General Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=clinical outcome kn-keyword=clinical outcome en-keyword=medial meniscus posterior root tear kn-keyword=medial meniscus posterior root tear en-keyword=mid乚term follow乚up kn-keyword=mid乚term follow乚up en-keyword=survival rate kn-keyword=survival rate en-keyword=transtibial pullout repair kn-keyword=transtibial pullout repair END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=10 article-no= start-page=3332 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250510 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Experience of High Tibial Osteotomy for Patients with Rheumatoid Arthritis Treated with Recent Medication: A Case Series en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: High tibial osteotomy (HTO) was generally not indicated in patients with rheumatoid arthritis (RA) because synovial inflammation may exacerbate joint damage postoperatively. Recently, joint destruction in RA has dramatically changed with the introduction of methotrexate (MTX) and biological disease-modifying antirheumatic drugs (bDMARDs). This study aimed to investigate the clinical outcomes of HTO for patients with RA treated with recent medication. Methods: In this study, patients with RA who underwent HTO between 2016 and 2020 were retrospectively reviewed. Patients whose follow-up period was <2 years and those whose onset of RA occurred after HTO were excluded. Clinical outcomes were investigated using the Japanese orthopedic Association (JOA) and visual analog scale (VAS) scores. Results: Seven patients (two males and five females, mean age 72.0 亇 6.2 years, mean body mass index 24.0 亇 2.9 kg/m2) were included in this study. The mean follow-up period was 62.1 亇 21.4 months. Open-wedge and hybrid closed-wedge HTO were performed in two and five cases, respectively. MTX was used for all cases. The bDMARDs were used in six cases (golimumab and tocilizumab in four and two cases, respectively). JOA scores significantly improved from 63.6 亇 10.7 preoperatively to 90.7 亇 5.3 postoperatively (p = 0.0167 Wilcoxon rank test). VAS scores significantly decreased from 48.6 亇 12.2 preoperatively to 11.4 亇 6.9 postoperatively (p = 0.017 Wilcoxon rank test). None of the patients underwent total knee arthroplasty. Conclusions: This study showed seven RA patients who underwent HTO treated with recent medication. The prognosis of RA, including joint destruction, has dramatically improved with induction of MTX and bDMARDs. HTO may be one of effective joint preservation surgeries even for patients with RA. To achieve the favorable outcomes, surgeons should pay attention to timing and indication of surgery. en-copyright= kn-copyright= en-aut-name=TakaharaYasuhiro en-aut-sei=Takahara en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakashimaHirotaka en-aut-sei=Nakashima en-aut-mei=Hirotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UchidaYoichiro en-aut-sei=Uchida en-aut-mei=Yoichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatoHisayoshi en-aut-sei=Kato en-aut-mei=Hisayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ItaniSatoru en-aut-sei=Itani en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IwasakiYuichi en-aut-sei=Iwasaki en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Nippon Kokan Fukuyama Hospital kn-affil= en-keyword=high tibial osteotomy kn-keyword=high tibial osteotomy en-keyword=rheumatoid arthritis kn-keyword=rheumatoid arthritis en-keyword=methotrexate kn-keyword=methotrexate en-keyword=biologic diseasemodifying antirheumatic drugs kn-keyword=biologic diseasemodifying antirheumatic drugs en-keyword=knee surgery kn-keyword=knee surgery en-keyword=joint preservation kn-keyword=joint preservation END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue= article-no= start-page=e60943 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250729 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Usefulness of Interventions Using a Smartphone Cognitive Behavior Therapy Application for Children With Mental Health Disorders: Prospective, Single-Arm, Uncontrolled Clinical Trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: The prevalence of mental health disorders among children in Japan has increased rapidly, and these children often show depressive symptoms and reduced quality of life (QOL). We previously developed a smartphone-based self-monitoring app to deliver cognitive behavioral therapy (CBT), implemented it in healthy children, and reported its effectiveness for health promotion.
Objective: This study aims to examine the usefulness of the CBT app for improvement in depressive symptoms and QOL in children with mental health disorders.
Methods: The participants were 115 children with mental health disorders (eg, school refusal, orthostatic hypotension, eating disorders, developmental disorders, among others) and aged 12乚18 years. The CBT app?based program comprised 1 week of psychoeducation followed by 1 week of self-monitoring. After reading story-like scenarios, participants created a self-monitoring sheet with 5 panels: events, thoughts, feelings, body responses, and actions. All participants received regular mental health care from physicians in addition to the app-based program. To evaluate the participants乫 depressive symptoms and QOL, Patient Health Questionnaire for Adolescents (PHQ-9A), Depression Self-Rating Scale for Children (DSRS-C), and Pediatric Quality of Life Inventory (PedsQL) were measured at the beginning of the intervention, and at 2 and 6 months thereafter. Questionnaire for Triage and Assessment with 30 items (QTA30), and Rosenberg Self-Esteem Scale (RSES) were also used to measure their health and self-esteem. Participants were divided into 4 groups on the basis of the PHQ-9A score (above or below the cutoff; PHQ-9A?5 or PHQ-9A<5) and completion or noncompletion of the CBT app?based program (app [+] or app [-]). The primary outcome was improvement in the DSRS-C score, and secondary outcomes were improvement in other psychometric scales including PedsQL, QTA30, and RSE. A paired-samples t test was used for statistical analysis. The Medical Ethics Committee of Fukuoka University Faculty of Medicine (approval U22-05-002) approved the study design.
Results: There were 48, 18, 18, and 7 participants in the PHQ-9A?5 app (+), PHQ-9A?5 app (-), PHQ-9A<5 app (+), and PHQ-9A<5 app (-) groups, respectively. A total of 24 participants dropped out. No improvement in the DSRS-C score was observed in all groups. However, PedsQL scores improved significantly at 2 and 6 months in the PHQ-9A<5 app (+) group (t17=6.62; P<.001 and t17=6.11; P<.001, respectively). There was a significant positive correlation between the PHQ-9A scores and the number of self-monitoring sheets completed.
Conclusions: The CBT app was useful for improving PedsQL scores of children with mental health disorders. However, a higher-intensity CBT program is necessary for more severely depressed children.
Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000046775; center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053360 en-copyright= kn-copyright= en-aut-name=NagamitsuShinichiro en-aut-sei=Nagamitsu en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkadaAyumi en-aut-sei=Okada en-aut-mei=Ayumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SakutaRyoichi en-aut-sei=Sakuta en-aut-mei=Ryoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IshiiRyuta en-aut-sei=Ishii en-aut-mei=Ryuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KoyanagiKenshi en-aut-sei=Koyanagi en-aut-mei=Kenshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HabukawaChizu en-aut-sei=Habukawa en-aut-mei=Chizu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KatayamaTakashi en-aut-sei=Katayama en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ItoMasaya en-aut-sei=Ito en-aut-mei=Masaya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KanieAyako en-aut-sei=Kanie en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtaniRyoko en-aut-sei=Otani en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=InoueTakeshi en-aut-sei=Inoue en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KitajimaTasuku en-aut-sei=Kitajima en-aut-mei=Tasuku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MatsubaraNaoki en-aut-sei=Matsubara en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TanakaChie en-aut-sei=Tanaka en-aut-mei=Chie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=ShigeyasuYoshie en-aut-sei=Shigeyasu en-aut-mei=Yoshie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MatsuokaMichiko en-aut-sei=Matsuoka en-aut-mei=Michiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=KakumaTatsuyuki en-aut-sei=Kakuma en-aut-mei=Tatsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=HorikoshiMasaru en-aut-sei=Horikoshi en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= affil-num=1 en-affil=Department of Pediatrics, Faculty of Medicine, Fukuoka University kn-affil= affil-num=2 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=4 en-affil=Department of Pediatrics & Child Health, Kurume University, School of Medicine kn-affil= affil-num=5 en-affil=Nagasaki Prefectural Center of Medicine and Welfare for Children kn-affil= affil-num=6 en-affil=Department of Pediatric Allergy, Minami Wakayama Medical Center kn-affil= affil-num=7 en-affil=L2B Inc kn-affil= affil-num=8 en-affil=National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry kn-affil= affil-num=9 en-affil=National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry kn-affil= affil-num=10 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=11 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=12 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=13 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=14 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=17 en-affil=Department of Neuropsychiatry, Kurume University School of Medicine kn-affil= affil-num=18 en-affil=Biostatistics Center, Kurume University kn-affil= affil-num=19 en-affil=National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry kn-affil= en-keyword=smartphone kn-keyword=smartphone en-keyword=cognitive behavioral therapy kn-keyword=cognitive behavioral therapy en-keyword=application kn-keyword=application en-keyword=adolescent kn-keyword=adolescent en-keyword=youth kn-keyword=youth en-keyword=teen kn-keyword=teen en-keyword=pediatric kn-keyword=pediatric en-keyword=mental health kn-keyword=mental health en-keyword=psychoeducation kn-keyword=psychoeducation en-keyword=self-monitoring kn-keyword=self-monitoring en-keyword=questionnaire kn-keyword=questionnaire en-keyword=depressive symptoms kn-keyword=depressive symptoms en-keyword=effectiveness kn-keyword=effectiveness en-keyword=Japan kn-keyword=Japan en-keyword=statistical analysis kn-keyword=statistical analysis en-keyword=single-arm uncontrolled study kn-keyword=single-arm uncontrolled study en-keyword=mobile phone kn-keyword=mobile phone END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=551 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240827 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Body weight and eating attitudes influence improvement of depressive symptoms in children and pre-adolescents with eating disorders: a prospective multicenter cohort study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Pediatric patients with eating disorders in a multicenter joint study on 11 facilities were enrolled and prospectively investigated to determine whether improvement in body weight, eating attitudes, and psychosocial factors in children with eating disorders would also improve depressive symptoms.
Methods In this study, 91 patients were enrolled between April 2014 and March 2016. The severity of underweight was assessed using the body mass index-standard deviation score (BMI-SDS), eating behavior was assessed using the children's eating attitude test (ChEAT26), the outcome of childhood eating disorders was assessed using the childhood eating disorder outcome scale, and depressive symptoms were assessed using the Children's Depression Inventory (CDI) score.
Results After 12 months of treatment, depressive symptoms were evaluated in 62 of the 91 cases where it was evaluated at the initial phase. There was no difference in background characteristics between the included patients and the 29 patients who dropped out. A paired-sample t-test revealed a significant decrease in CDI scores after 12 months of treatment (p? Conclusions Depressive symptoms in children with eating disorders improved with therapeutic intervention on body weight and eating attitudes.
Trial registration The Clinical Trial Number for this study is UMIN000055004. en-copyright= kn-copyright= en-aut-name=SuzukiYuichi en-aut-sei=Suzuki en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NagamitsuShinichiro en-aut-sei=Nagamitsu en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=EshimaNobuoki en-aut-sei=Eshima en-aut-mei=Nobuoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueTakeshi en-aut-sei=Inoue en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OtaniRyoko en-aut-sei=Otani en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SakutaRyoichi en-aut-sei=Sakuta en-aut-mei=Ryoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IguchiToshiyuki en-aut-sei=Iguchi en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IshiiRyuta en-aut-sei=Ishii en-aut-mei=Ryuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=UchidaSoh en-aut-sei=Uchida en-aut-mei=Soh kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OkadaAyumi en-aut-sei=Okada en-aut-mei=Ayumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KitayamaShinji en-aut-sei=Kitayama en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KoyanagiKenshi en-aut-sei=Koyanagi en-aut-mei=Kenshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SuzukiYuki en-aut-sei=Suzuki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SumiYoshino en-aut-sei=Sumi en-aut-mei=Yoshino kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TakamiyaShizuo en-aut-sei=Takamiya en-aut-mei=Shizuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=FukaiYoshimitsu en-aut-sei=Fukai en-aut-mei=Yoshimitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Pediatrics, Fukushima Medical University School of Medicine kn-affil= affil-num=2 en-affil=Department of Pediatrics, Fukuoka University Faculty of Medicine kn-affil= affil-num=3 en-affil=Department of Pediatrics, Kurume University School of Medicine kn-affil= affil-num=4 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=5 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=6 en-affil=Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center kn-affil= affil-num=7 en-affil=Department of Pediatrics, Hoshigaoka Maternity Hospital kn-affil= affil-num=8 en-affil=Department of Pediatrics and Child Health, Kurume University School of Medicine kn-affil= affil-num=9 en-affil=Karamun`S Forest Children`S Clinic kn-affil= affil-num=10 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Himeji City Center for the Disabled kn-affil= affil-num=12 en-affil=Nagasaki Prefectural Center of Medicine and Welfare for Children kn-affil= affil-num=13 en-affil=Department of Pediatrics, National Hospital Organization Mie National Hospital kn-affil= affil-num=14 en-affil=Mental and Developmental Clinic for Children 乬Elm Tree乭 kn-affil= affil-num=15 en-affil=Takamiya Psychiatry Clinic kn-affil= affil-num=16 en-affil=Department of Pediatrics/Child Psychosomatic Medicine, Okayama University Hospital kn-affil= affil-num=17 en-affil=Department of Pediatrics, St. Luke乫s International Hospital kn-affil= en-keyword=Eating disorders kn-keyword=Eating disorders en-keyword=Anorexia nervosa kn-keyword=Anorexia nervosa en-keyword=Body mass index-standard deviation score kn-keyword=Body mass index-standard deviation score en-keyword=Eating attitudes kn-keyword=Eating attitudes en-keyword=Children乫s depression inventory kn-keyword=Children乫s depression inventory END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue= article-no= start-page=115 end-page=119 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20251231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Safety of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Interim Results of a Single-center, Single-arm Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of this single-center, single-arm study was to evaluate the safety of adenosine-assisted clipping surgery for unruptured cerebral aneurysms. Five patients underwent aneurysmal clipping during adenosine-induced hypotension at ?60 mmHg. The mean age of patients was 63.4亇8.5 years, and the mean aneurysm size was 5.3亇1.1 mm. The prevalence of patients with modified Rankin Scale scores of zero 30 days after surgery was 100%. The degree of aneurysm obliteration was complete in 4 patients and residual dome in 1 patient. The mean total dosage of adenosine was 37.4亇18.8 mg. The mean duration of systolic blood pressure at ?60 mmHg was 64.2亇28.3 secs. No patients exhibited paroxysmal atrial fibrillation within 24 hours after adenosine administration or elevation of high-sensitivity cardiac troponin T on postoperative day 1. There was no reduction in either motor-evoked or somatosensory-evoked potential amplitude during surgery. Adenosine-induced hypotension is a safe procedure in clipping surgery for unruptured cerebral aneurysms. en-copyright= kn-copyright= en-aut-name=HISHIKAWATomohito en-aut-sei=HISHIKAWA en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MURAISatoshi en-aut-sei=MURAI en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HIRAMATSUMasafumi en-aut-sei=HIRAMATSU en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HARUMAJun en-aut-sei=HARUMA en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=EBISUDANIYuki en-aut-sei=EBISUDANI en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YASUHARATakao en-aut-sei=YASUHARA en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SUGIUKenji en-aut-sei=SUGIU en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SHIMIZUKazuyoshi en-aut-sei=SHIMIZU en-aut-mei=Kazuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NAKAGAWAKoji en-aut-sei=NAKAGAWA en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KIMURA-ONOAya en-aut-sei=KIMURA-ONO en-aut-mei=Aya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HOTTAKatsuyuki en-aut-sei=HOTTA en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MORIMATSUHiroshi en-aut-sei=MORIMATSU en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=DATEIsao en-aut-sei=DATE en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurosurgery, Kawasaki Medical School kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=11 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=12 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=adenosine kn-keyword=adenosine en-keyword=clipping kn-keyword=clipping en-keyword=safety kn-keyword=safety en-keyword=unruptured cerebral aneurysm kn-keyword=unruptured cerebral aneurysm END start-ver=1.4 cd-journal=joma no-vol=23 cd-vols= no-issue= article-no= start-page=6699 end-page=6703 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=2025 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=One-pot synthesis of trans-2,3-diaminoindolines through 2,3-diamination of electrophilic indolines en-subtitle= kn-subtitle= en-abstract= kn-abstract=Despite recent advances in the synthesis of 2,3-diaminoindole derivatives, construction of 2,3-diaminoindolines, whose two amine moieties on each molecule differ from one another has yet to be achieved. In this work, we developed a concise one-pot protocol for differentiated diamination involving reacting a C2,C3-electrophilic indole reagent with amines to access a variety of previously inaccessible 2,3-diaminoindolines. Furthermore, the synthetic utility of this protocol was demonstrated by a successful gram-scale reaction and further transformation of the 2,3-diaminoindolines. en-copyright= kn-copyright= en-aut-name=KoboriYuito en-aut-sei=Kobori en-aut-mei=Yuito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokushigeKeisuke en-aut-sei=Tokushige en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AbeTakumi en-aut-sei=Abe en-aut-mei=Takumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficacy of transcatheter patent foramen ovale closure for drug-resistant migraine: initial experience in Japan and long-term outcome en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study evaluates the efficacy and safety of transcatheter patent foramen ovale (PFO) closure for the treatment of drug-resistant migraine in Japan. Previous studies have suggested a potential benefit for migraine with aura, although large-scale trials in the United States and Europe have failed to confirm efficacy as a primary endpoint. The study included 27 patients (mean age 36.4 years, 15 female, 21 with aura) who had more than two migraine attacks per month despite medication. All had PFO confirmed by transesophageal echocardiography and underwent transcatheter closure with the Amplatzer PFO Occluder. Patients were followed up to 12 months with migraine severity monitored by headache specialist. The procedure was successful and without complications in all cases. One patient required a larger occluder (35 mm) due to the size of PFO. At 12 months, 22 of 27 (81%) patients reported either complete resolution or improvement of migraine. Specifically, 10 of 21 (48%) patients with aura experienced complete resolution of migraine at one year. Patients without aura had a lower response rate, with only one case of complete resolution. Despite limitations such as the lack of a control group and potential patient selection bias, the study demonstrated that PFO closure may provide significant relief for patients with drug-resistant migraine, particularly those with aura. These findings support further investigation to better define its clinical indications and potential benefits. en-copyright= kn-copyright= en-aut-name=AkagiTeiji en-aut-sei=Akagi en-aut-mei=Teiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakayaYoichi en-aut-sei=Takaya en-aut-mei=Yoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MikiTakashi en-aut-sei=Miki en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakayamaRie en-aut-sei=Nakayama en-aut-mei=Rie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakagawaKoji en-aut-sei=Nakagawa en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakashimaMitsuki en-aut-sei=Nakashima en-aut-mei=Mitsuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakahashiYoshiaki en-aut-sei=Takahashi en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YuasaShinsuke en-aut-sei=Yuasa en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Patent foramen ovale kn-keyword=Patent foramen ovale en-keyword=Migraine kn-keyword=Migraine en-keyword=Headache kn-keyword=Headache en-keyword=Stroke kn-keyword=Stroke en-keyword=Catheter kn-keyword=Catheter END start-ver=1.4 cd-journal=joma no-vol=17 cd-vols= no-issue=6 article-no= start-page=e85680 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250610 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Whole-Eye Radiation for the Local Control of Choroidal Lymphoma in Primary Central Nervous System Lymphoma: A 14-Year Case Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Involved-site radiation therapy is effective for curative and palliative treatments of cancers, including lymphoma. This case study describes the use of whole-eye radiation for primary intraocular lymphoma occurring during primary central nervous system lymphoma. The patient, a 68-year-old man, developed personality changes and apathy two weeks after cataract surgery combined with vitrectomy for vitreous opacity in the left eye. Magnetic resonance imaging revealed a mass lesion in the left frontal lobe, and biopsy by craniotomy confirmed diffuse large B-cell lymphoma. He underwent chemotherapy using rituximab combined with high-dose methotrexate and high-dose cytarabine in association with intrathecal methotrexate and cytarabine injections, leading to complete remission. At age 75, he noticed forgetfulness, and fluorodeoxyglucose positron emission tomography and magnetic resonance imaging revealed a relapse of lymphoma in the splenium of the corpus callosum. He underwent chemotherapy using rituximab combined with high-dose methotrexate, followed by monthly rituximab monotherapy for one year and then rituximab monotherapy every two months for one year. He maintained complete remission with no treatment until age 78, when he developed subretinal choroidal lesions in the left eye and underwent whole-eye radiation at 40 Gy. One year later, he developed subretinal choroidal lesions in the right eye and underwent whole-eye radiation at 40 Gy. At age 81, he had lower limb weakness with disorientation. Magnetic resonance imaging showed a relapse of lymphoma in the right frontal to temporal lobe. The brain lesions showed a marked response to four weeks of oral tirabrutinib as a salvage therapy, but the lesions regrew, and the patient died seven months later. Throughout the treatment, he maintained a visual acuity of 0.7 (decimal scale) in both eyes. In conclusion, whole-eye radiation should be considered as a treatment option for the local control of active intraocular lymphoma, especially choroidal lesions, for patients with primary central nervous system lymphoma with no active brain lesions and without systemic treatment. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YanoTomofumi en-aut-sei=Yano en-aut-mei=Tomofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YoshioKotaro en-aut-sei=Yoshio en-aut-mei=Kotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TanakaTakehiro en-aut-sei=Tanaka en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishimuraHirotake en-aut-sei=Nishimura en-aut-mei=Hirotake kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsuokaKen-ichi en-aut-sei=Matsuoka en-aut-mei=Ken-ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University kn-affil= affil-num=2 en-affil=Department of Internal Medicine, Okayama Rosai Hospital kn-affil= affil-num=3 en-affil=Department of Radiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Pathology, Kawasaki Medical School kn-affil= affil-num=6 en-affil=Department of Hematology and Oncology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=brain biopsy kn-keyword=brain biopsy en-keyword=bruton tyrosine kinase (btk) inhibitor kn-keyword=bruton tyrosine kinase (btk) inhibitor en-keyword=chemotherapy kn-keyword=chemotherapy en-keyword=diffuse large b-cell lymphoma kn-keyword=diffuse large b-cell lymphoma en-keyword=fluorodeoxyglucose positron emission tomography kn-keyword=fluorodeoxyglucose positron emission tomography en-keyword=primary central nervous system lymphoma kn-keyword=primary central nervous system lymphoma en-keyword=primary intraocular (vitreoretinal) lymphoma kn-keyword=primary intraocular (vitreoretinal) lymphoma en-keyword=radiation therapy (radiotherapy) kn-keyword=radiation therapy (radiotherapy) en-keyword=tirabrutinib kn-keyword=tirabrutinib en-keyword=whole-eye radiation kn-keyword=whole-eye radiation END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=2 article-no= start-page=93 end-page=100 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202504 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Lower Work Engagement Is Associated with Insomnia, Psychological Distress, and Neck Pain among Junior and Senior High School Teachers in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=School teachers are subject to both physical and mental health problems. We examined cross-sectional relationships between work engagement and major health outcomes among junior and senior high school teachers in Japan via a nationwide survey in 2019-2020. A total of 3,160 respondents were included in the analyses (19.9% response rate). Work engagement was assessed with the Utrecht Work Engagement Scale-9 (UWES-9), and we thus divided the teachers into quartiles according to their UWES-9 scores. Based on validated questionnaires, we assessed insomnia, psychological distress, and neck pain as health outcomes. A binomial logistic regression adjusted for age, gender, school type, teacher乫s roles, involvement in club activities, division of duties, employment status, and whether they lived with family demonstrated that the teachers with lower UWES-9 scores had higher burdens of insomnia, psychological distress, and neck pain (odds ratios [95% confidence intervals] in 4th vs. 1st quartile, 2.92 (2.34-3.65), 3.70 (2.81-4.88), and 2.12 (1.68-2.68), respectively; all trend p<0.001). There were no significant differences in these associations between full-time and part-time teachers. Our findings indicate that low work engagement may contribute to physical and mental health issues among junior and senior high school teachers, thus providing insights for preventing health problems in this profession. en-copyright= kn-copyright= en-aut-name=TsuchieRina en-aut-sei=Tsuchie en-aut-mei=Rina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukudaMari en-aut-sei=Fukuda en-aut-mei=Mari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsumuraHideki en-aut-sei=Tsumura en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KinutaMinako en-aut-sei=Kinuta en-aut-mei=Minako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HisamatsuTakashi en-aut-sei=Hisamatsu en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KandaHideyuki en-aut-sei=Kanda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Psychology, Graduate School of Technology, Industrial and Social Sciences, Tokushima University kn-affil= affil-num=4 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=work engagement kn-keyword=work engagement en-keyword=school teachers kn-keyword=school teachers en-keyword=insomnia kn-keyword=insomnia en-keyword=psychological distress kn-keyword=psychological distress en-keyword=neck pain kn-keyword=neck pain END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=2 article-no= start-page=75 end-page=80 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202504 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Potential for Radiation Dose Reduction in Temporal Bone CT Imaging Using Photon-Counting Detector CT en-subtitle= kn-subtitle= en-abstract= kn-abstract=Temporal bone computed tomography (CT) is frequently performed for pediatric patients with ear diseases. Advances in CT technology have improved diagnostic imaging quality, but reduction of radiation exposure remains a goal. We evaluated the potential for radiation dose reduction in temporal bone CT examinations using porcine ear ossicles and a photon-counting detector CT system. Three scans of the bilateral temporal bone were performed on each of three pig cadaver heads. In each of seven successive imaging sessions, the radiation dose was reduced by an additional one-seventh of the recommended dose (RD). Two board-certified radiologists independently scored the resulting images on a scale of 1 to 5 points, where 5 represented the image quality at the RD. Images scoring ?4.5 points were considered acceptable. Noise was assessed in a 2-cm-diameter region near the ear ossicles, and standard deviation was measured for each of the seven decrements from the RD. As the radiation dose decreased, the noise progressively increased, and visual assessment scores progressively decreased. Acceptable image scores were obtained at six-sevenths (4.9), five-sevenths (4.8), four-sevenths (4.7), and three-sevenths (4.6) of the RD. Thus, acceptable porcine temporal bone CT images were obtained with a radiation dose reduction of approximately 50%. en-copyright= kn-copyright= en-aut-name=HigakiFumiyo en-aut-sei=Higaki en-aut-mei=Fumiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MorimitsuYusuke en-aut-sei=Morimitsu en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HwangSung Il en-aut-sei=Hwang en-aut-mei=Sung Il kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KitayamaTakahiro en-aut-sei=Kitayama en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakahashiYuka en-aut-sei=Takahashi en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AkagiNoriaki en-aut-sei=Akagi en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SugayaAkiko en-aut-sei=Sugaya en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Radiological Technology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Radiological Technology, Faculty of Health Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Radiology, Seoul National University Bundang Hospital kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Radiological Technology, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Otolaryngology-Head and Neck Surgery, Okayama University Hospital kn-affil= affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=computed tomography kn-keyword=computed tomography en-keyword=photon-counting detector computed tomography kn-keyword=photon-counting detector computed tomography en-keyword=ear ossicle kn-keyword=ear ossicle en-keyword=energy-integrating detector computed tomography kn-keyword=energy-integrating detector computed tomography END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250317 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Novel Therapeutic Algorism in Patients With Anterior Cutaneous Nerve Entrapment Syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Anterior cutaneous nerve entrapment syndrome (ACNES) is often overlooked as a cause of chronic abdominal pain. Trigger point injections (TPIs) serve as both a diagnostic and therapeutic tool. Although neurectomy is frequently chosen for patients with severe ACNES, its surgical outcomes remain unclear.
Aim: This study aims to evaluate both the short- and long-term outcomes for neurectomy and propose a novel therapeutic algorithm.
Methods: A cohort of postoperative patients presenting with ACNES between 2016 and 2023 was retrospectively evaluated. Patients received a single diagnostic TPI. When the pain subsided, an anterior neurectomy was performed using either an anterior or laparoscopic approach. Pain scores were assessed using the numeric rating scale (NRS).
Results: Among 37 patients (60% females, mean age 33.8?亇?3.4?years), 29 patients (78.4%) experienced pain recurrence following initial neurectomy. Of these, 22 patients underwent repeat neurectomies, resulting in complete remission in 15 patients and no benefit in 7 patients. Long-term outcomes showed that 62.2% achieved clinical remission (NRS?=?0), whereas 8.1% reported reduced but persistent pain (NRS 1?2). Preoperative TPI effectiveness was a strong predictor of surgical success, with patients achieving post-TPI NRS (0?1) significantly more likely to attain remission (p?=?0.0074). Older age was also associated with higher remission rates (p?=?0.0476).
Conclusion: TPI is critical for predicting neurectomy success. These findings support the integration of preoperative TPI evaluation and tailored surgical strategies to optimize outcomes for patients with ACNES. en-copyright= kn-copyright= en-aut-name=KondoYoshitaka en-aut-sei=Kondo en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KanayaNobuhiko en-aut-sei=Kanaya en-aut-mei=Nobuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KobayashiAmi en-aut-sei=Kobayashi en-aut-mei=Ami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ArakawaKyosuke en-aut-sei=Arakawa en-aut-mei=Kyosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MatsuokaYoshikazu en-aut-sei=Matsuoka en-aut-mei=Yoshikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MimataYudai en-aut-sei=Mimata en-aut-mei=Yudai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KakiuchiYoshihiko en-aut-sei=Kakiuchi en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShigeyasuKunitoshi en-aut-sei=Shigeyasu en-aut-mei=Kunitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurology, Brigham and Women's Hospital, Harvard Medical School kn-affil= affil-num=4 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine kn-affil= affil-num=5 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=anterior cutaneous nerve entrapment syndrome (ACNES) kn-keyword=anterior cutaneous nerve entrapment syndrome (ACNES) en-keyword=neurectomy kn-keyword=neurectomy en-keyword=trigger point injections (TPIs) kn-keyword=trigger point injections (TPIs) END start-ver=1.4 cd-journal=joma no-vol=7 cd-vols= no-issue= article-no= start-page=1543543 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250225 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Empowering pediatric, adolescent, and young adult patients with cancer utilizing generative AI chatbots to reduce psychological burden and enhance treatment engagement: a pilot study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Pediatric and adolescent/young adult (AYA) cancer patients face profound psychological challenges, exacerbated by limited access to continuous mental health support. While conventional therapeutic interventions often follow structured protocols, the potential of generative artificial intelligence (AI) chatbots to provide continuous conversational support remains unexplored. This study evaluates the feasibility and impact of AI chatbots in alleviating psychological distress and enhancing treatment engagement in this vulnerable population.
Methods: Two age-appropriate AI chatbots, leveraging GPT-4, were developed to provide natural, empathetic conversations without structured therapeutic protocols. Five pediatric and AYA cancer patients participated in a two-week intervention, engaging with the chatbots via a messaging platform. Pre- and post-intervention anxiety and stress levels were self-reported, and usage patterns were analyzed to assess the chatbots' effectiveness.
Results: Four out of five participants reported significant reductions in anxiety and stress levels post-intervention. Participants engaged with the chatbot every 2-3 days, with sessions lasting approximately 10 min. All participants noted improved treatment motivation, with 80% disclosing personal concerns to the chatbot they had not shared with healthcare providers. The 24/7 availability particularly benefited patients experiencing nighttime anxiety.
Conclusions: This pilot study demonstrates the potential of generative AI chatbots to complement traditional mental health services by addressing unmet psychological needs in pediatric and AYA cancer patients. The findings suggest these tools can serve as accessible, continuous support systems. Further large-scale studies are warranted to validate these promising results. en-copyright= kn-copyright= en-aut-name=HaseiJoe en-aut-sei=Hasei en-aut-mei=Joe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HanzawaMana en-aut-sei=Hanzawa en-aut-mei=Mana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NaganoAkihito en-aut-sei=Nagano en-aut-mei=Akihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MaedaNaoko en-aut-sei=Maeda en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshidaShinichirou en-aut-sei=Yoshida en-aut-mei=Shinichirou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EndoMakoto en-aut-sei=Endo en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YokoyamaNobuhiko en-aut-sei=Yokoyama en-aut-mei=Nobuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OchiMotoharu en-aut-sei=Ochi en-aut-mei=Motoharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IshidaHisashi en-aut-sei=Ishida en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KatayamaHideki en-aut-sei=Katayama en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=FujiwaraTomohiro en-aut-sei=Fujiwara en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NakataEiji en-aut-sei=Nakata en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Medical Information and Assistive Technology Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Gifu University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Pediatrics, NHO National Hospital Organization Nagoya Medical Center kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Tohoku University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=8 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Palliative and Supportive Care, Okayama University Hospital kn-affil= affil-num=11 en-affil=Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=generative AI chatbot kn-keyword=generative AI chatbot en-keyword=large language model kn-keyword=large language model en-keyword=pediatric cancer kn-keyword=pediatric cancer en-keyword=adolescent and young adult (AYA) kn-keyword=adolescent and young adult (AYA) en-keyword=psychological support kn-keyword=psychological support END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=4 article-no= start-page=1055 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250207 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Natural Course and Long-Term Outcomes of Gastric Subepithelial Lesions: A Systematic Review en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background/Objectives: Gastric subepithelial lesions (SELs) are often incidentally detected during endoscopic examinations, with most patients being asymptomatic and lesions measuring <20 mm. Despite their generally indolent nature, certain SELs, such as gastrointestinal stromal tumors, require resection. Current guidelines recommend periodic surveillance; however, the natural course and long-term outcomes of gastric SELs have not been sufficiently investigated. This systematic review aimed to synthesize evidence on the progression, growth rate, and risk factors associated with gastric SELs to inform clinical management strategies. Methods: A comprehensive search of PubMed was conducted for peer-reviewed studies published between January 2000 and November 2024. Eligible studies included original studies on the follow-up and progression of gastric SELs. Non-English articles, reviews, case reports, and unrelated topics were excluded. In total, 277 articles were screened, with 15 additional articles identified through manual screening. Ultimately, 41 articles were included in the analysis. The study protocol is registered in PROSPERO (CRD42024614865). Results: Large-scale studies reported low growth rates of 2.0-8.5% over 2.0-5.0 years, while smaller studies reported a broader range of growth rates of 5.4-28.4%. The factors contributing to these discrepancies include patient selection, follow-up duration, and growth criteria. Risk factors for lesion size increase include larger initial lesion size, irregular margins, heterogeneous echo patterns, and certain tumor locations. Conclusions: These findings underscore the need for individualized management strategies based on lesion size, imaging characteristics, and risk factors. The close monitoring of high-risk lesions is crucial for timely intervention. Standardized growth criteria and optimized follow-up protocols are essential for improving clinical decision making and patient outcomes. en-copyright= kn-copyright= en-aut-name=IwamuroMasaya en-aut-sei=Iwamuro en-aut-mei=Masaya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtsukaMotoyuki en-aut-sei=Otsuka en-aut-mei=Motoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital kn-affil= affil-num=3 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=esophagogastroduodenoscopy kn-keyword=esophagogastroduodenoscopy en-keyword=gastric lesions kn-keyword=gastric lesions en-keyword=gastrointestinal stromal tumor kn-keyword=gastrointestinal stromal tumor en-keyword=subepithelial lesion kn-keyword=subepithelial lesion en-keyword=submucosal tumor kn-keyword=submucosal tumor END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=4 article-no= start-page=1391 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250219 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Course of General Fatigue in Patients with Post-COVID-19 Conditions Who Were Prescribed Hochuekkito: A Single-Center Exploratory Pilot Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: After the start of the COVID-19 pandemic, general fatigue in patients with long COVID and post-COVID-19 conditions (PCC) became a medical issue. Although there is a lack of evidence-based treatments, Kampo medicine (traditional Japanese medicine) has gained attention in Japan. At an outpatient clinic in Japan specializing in long COVID, 24% of all prescriptions were Kampo medicines, and 72% of Kampo medicine prescriptions were hochuekkito. However, there has been no prospective, quantitative study on the course of fatigue in patients with long COVID and PCC who were prescribed hochuekkito. The aim of this study was to clarify the course of fatigue in those patients. Methods: This study included patients aged 18 years or older with general fatigue who visited the long COVID specialized outpatient clinic at Okayama University Hospital and consented to participate after being prescribed hochuekkito. We reviewed the backgrounds of the patients, and we evaluated the patients' fatigue assessment scale in person or online. Results: Twenty patients were enrolled in this study from September to December in 2023. The average age of the patients was 42.9 years (SD: 15.8 years) and 12 patients (60%) were female. After hochuekkito administration, the fatigue assessment scale score decreased from 35.9 (SD: 5.9) at the initial visit to 31.2 (SD: 9.4) after 8 weeks, indicating a trend for improvement in fatigue (difference: 4.7; 95% CI: 0.5-8.9). Conclusions: A trend for improvement in fatigue was observed in patients with long COVID and PCC who were prescribed hochuekkito, indicating a potential benefit of hochuekkito for general fatigue in such patients. General fatigue in patients with long COVID or PCC can be classified as post-infectious fatigue syndrome and is considered a condition of qi deficiency in Kampo medicine, for which hochuekkito is appropriately indicated. en-copyright= kn-copyright= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsukiNobuyoshi en-aut-sei=Matsuki en-aut-mei=Nobuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtsukaYuki en-aut-sei=Otsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakamotoYoko en-aut-sei=Sakamoto en-aut-mei=Yoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UedaKeigo en-aut-sei=Ueda en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsudaYui en-aut-sei=Matsuda en-aut-mei=Yui kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SakuradaYasue en-aut-sei=Sakurada en-aut-mei=Yasue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HasegawaToru en-aut-sei=Hasegawa en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TakaseRyosuke en-aut-sei=Takase en-aut-mei=Ryosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OmuraDaisuke en-aut-sei=Omura en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=11 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=13 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=fatigue assessment scale (FAS) kn-keyword=fatigue assessment scale (FAS) en-keyword= general fatigue kn-keyword= general fatigue en-keyword= hochuekkito kn-keyword= hochuekkito en-keyword= kampo medicine kn-keyword= kampo medicine en-keyword= long COVID kn-keyword= long COVID en-keyword= post-COVID-19 condition kn-keyword= post-COVID-19 condition END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue=1 article-no= start-page=12 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Voice analysis and deep learning for detecting mental disorders in pregnant women: a cross-sectional study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction Perinatal mental disorders are prevalent, affecting 10-20% of pregnant women, and can negatively impact both maternal and neonatal outcomes. Traditional screening tools, such as the Edinburgh Postnatal Depression Scale (EPDS), present limitations due to subjectivity and time constraints in clinical settings. Recent advances in voice analysis and machine learning have shown potential for providing more objective screening methods. This study aimed to develop a deep learning model that analyzes the voices of pregnant women to screen for mental disorders, thereby offering an alternative to the traditional tools.
Methods A cross-sectional study was conducted among 204 pregnant women, from whom voice samples were collected during their one-month postpartum checkup. The audio data were preprocessed into 5000 ms intervals, converted into mel-spectrograms, and augmented using TrivialAugment and context-rich minority oversampling. The EfficientFormer V2-L model, pretrained on ImageNet, was employed with transfer learning for classification. The hyperparameters were optimized using Optuna, and an ensemble learning approach was used for the final predictions. The model's performance was compared to that of the EPDS in terms of sensitivity, specificity, and other diagnostic metrics.
Results Of the 172 participants analyzed (149 without mental disorders and 23 with mental disorders), the voice-based model demonstrated a sensitivity of 1.00 and a recall of 0.82, outperforming the EPDS in these areas. However, the EPDS exhibited higher specificity (0.97) and precision (0.84). No significant difference was observed in the area under the receiver operating characteristic curve between the two methods (p = 0.759).
Discussion The voice-based model showed higher sensitivity and recall, suggesting that it may be more effective in identifying at-risk individuals than the EPDS. Machine learning and voice analysis are promising objective screening methods for mental disorders during pregnancy, potentially improving early detection.
Conclusion We developed a lightweight machine learning model to analyze pregnant women's voices for screening various mental disorders, achieving high sensitivity and demonstrating the potential of voice analysis as an effective and objective tool in perinatal mental health care. en-copyright= kn-copyright= en-aut-name=OobaHikaru en-aut-sei=Ooba en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MakiJota en-aut-sei=Maki en-aut-mei=Jota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MasuyamaHisashi en-aut-sei=Masuyama en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Perinatal mental disorders kn-keyword=Perinatal mental disorders en-keyword=Voice analysis kn-keyword=Voice analysis en-keyword=Machine learning kn-keyword=Machine learning en-keyword=Screening kn-keyword=Screening en-keyword=Pregnant women kn-keyword=Pregnant women END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=1 article-no= start-page=9 end-page=19 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202502 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Gastrectomy Causes an Imbalance in the Trunk Muscles en-subtitle= kn-subtitle= en-abstract= kn-abstract=Muscle loss negatively affects gastrectomy prognosis. However, muscle loss is recognized as a systemic change, and individual muscle function is often overlooked. We investigated changes in the muscle volume of individual muscles after gastrectomy to identify clues for prognostic factors and optimal rehabilitation programs. Patients who underwent R0 gastrectomy for Stage I gastric cancer at our hospital from 2015 to 2021 were retrospectively selected to minimize the effects of malignancy and chemotherapy. Trunk muscle volume was measured by computed tomography to analyze body composition changes. Statistical analysis was performed to identify risk factors related to body composition changes. We compared the preoperative and 6-month postoperative conditions of 59 patients after gastrectomy. There was no difference in the psoas major muscle, a conventional surrogate marker of sarcopenia. There were significant decreases in the erector spinae (p=0.01) and lateral abdominal (p=0.01) muscles, and a significant increase in the rectus abdominis muscle (p=0.02). No significant correlation was found between these muscle changes and nutritional status. Body composition imbalance may serve as a new indicator of the general condition of patients after gastrectomy. Rehabilitation to correct this imbalance may improve prognosis after gastrectomy. en-copyright= kn-copyright= en-aut-name=IkeyaNanami en-aut-sei=Ikeya en-aut-mei=Nanami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkitaAtsushi en-aut-sei=Okita en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HashidaShinsuke en-aut-sei=Hashida en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamamotoSumiharu en-aut-sei=Yamamoto en-aut-mei=Sumiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IkedaHirokuni en-aut-sei=Ikeda en-aut-mei=Hirokuni kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TsukudaKazunori en-aut-sei=Tsukuda en-aut-mei=Kazunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ToyookaShinichi en-aut-sei=Toyooka en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Surgery, Okayama City Hospital kn-affil= affil-num=3 en-affil=Department of Surgery, Okayama City Hospital kn-affil= affil-num=4 en-affil=Department of Surgery, Okayama City Hospital kn-affil= affil-num=5 en-affil=Department of Surgery, Okayama City Hospital kn-affil= affil-num=6 en-affil=Department of Surgery, Okayama City Hospital kn-affil= affil-num=7 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=sarcopenia kn-keyword=sarcopenia en-keyword=skeletal muscle kn-keyword=skeletal muscle en-keyword=gastric cancer kn-keyword=gastric cancer en-keyword=gastrectomy kn-keyword=gastrectomy en-keyword=erector spinae muscle kn-keyword=erector spinae muscle END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=4 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250116 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Maternal smoking during infancy increases the risk of allergic diseases in children: a nationwide longitudinal survey in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background The incidence of allergic diseases has been increasing in Japan. In particular, a serious decline in the age of onset of allergic rhinitis has been observed. Passive smoking from parental smoking has a significant impact on children乫s health; however, it is difficult to restrict smoking in the home. While various studies have previously reported on the relationship between passive smoking and the development of allergic diseases in children. However, there have been no reports on passive smoking and allergic diseases on a national scale.
Methods Using Japanese national longitudinal survey data (n?=?38,444) for newborns born between May 10 and 24, 2010, we assessed parental smoking habits when their children were 6 months old and investigated the association with the development of allergic diseases until the age of 5.5 years. The risk ratios and 95% confidence intervals for the development of different allergic diseases were analyzed after adjusting for potential confounders using Poisson regression with a robust error variance.
Results The risk ratio for developing allergic rhinitis/allergic conjunctivitis (AR/AC) in children was significantly higher in the maternal smoking groups (?亝?10 cigarettes/day; RR 1.15, 95% CI 1.02?1.30; 亞11 cigarettes/day; RR 1.16, 95% CI 0.93?1.44). Furthermore, associations were found between the maternal smoking group in the presence of paternal smoking and the risk of developing bronchial asthma (?亝?10, RR 1.33 95% CI 1.17?1.52; 亞11, RR 1.71 95% CI 1.38?2.1), food allergy (?亝?10, RR 1.36 95% CI 1.12?1.63; 亞11, RR 1.25 95% CI 0.84?1.86), atopic dermatitis (?亝?10, RR 1.42 95% CI 1.22?1.66; 亞11, RR 1.6 95% CI 1.2?2.13), and AR/AC (?亝?10, RR 1.21 95% CI 1.07?1.36; 亞11, RR 1.35 95% CI 1.09?1.67).
Conclusions Maternal smoking during infancy increases the risk of developing AR/AC in children. Considering paternal smoking, maternal smoking further increased the risk of developing allergic diseases in children, suggesting that reducing parental smoking at home may reduce the risk of developing allergic diseases in children. en-copyright= kn-copyright= en-aut-name=ShigeharaKenji en-aut-sei=Shigehara en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoNaomi en-aut-sei=Matsumoto en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsugeMitsuru en-aut-sei=Tsuge en-aut-mei=Mitsuru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UdaKazuhiro en-aut-sei=Uda en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SaitoYukie en-aut-sei=Saito en-aut-mei=Yukie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YashiroMasato en-aut-sei=Yashiro en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IkedaMasanori en-aut-sei=Ikeda en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Pediatric Acute Diseases, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Allergic rhinitis kn-keyword=Allergic rhinitis en-keyword=Bronchial asthma kn-keyword=Bronchial asthma en-keyword=Atopic dermatitis kn-keyword=Atopic dermatitis en-keyword=National cohort study kn-keyword=National cohort study en-keyword=Passive smoking kn-keyword=Passive smoking END start-ver=1.4 cd-journal=joma no-vol=25 cd-vols= no-issue=1 article-no= start-page=39 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250109 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effectiveness of professional-identity-formation and clinical communication-skills programs on medical students' empathy in the COVID-19 context: comparison between pre-pandemic in-person classes and during-pandemic online classes en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Enhancing students' empathy is critical in medical school education. The COVID-19 pandemic necessitated a shift from in-person to online classes. However, the effectiveness of online classes for enhancing medical students' empathy has not been investigated sufficiently and the evidence is limited. This study compared the effectiveness of enhancing empathy between pre-pandemic in-person classes and during-pandemic online classes among medical students in Japan using pre-pandemic and during-pandemic data.
Methods This is a retrospective observational study. This study measured students' empathy using the Japanese translation of the Jefferson Scale of Empathy-Student Version (JSE-S) before and after the special programs for professional identity formation and clinical communication among first- and second-year students who matriculated from 2015-2021. This study categorized the matriculation year groups as "pre-pandemic" and "during-pandemic" groups for the first- and second-year students. This study estimated the adjusted mean score differences of the JSE-S and 95% confidence intervals (CIs) from the pre- to post-program between the pre-pandemic and during-pandemic groups in the first and second years using linear regression analysis.
Results This study's participants included 653 first-year students and 562 second-year students. In the first year, the during-pandemic group had a significantly higher mean score difference from the pre- to post-program compared to the pre-pandemic group. The adjusted regression coefficient (95% CI) was 7.6 (5.7 - 9.5), with the pre-pandemic group as the reference. In the second year, there were no significant differences between the two groups.
Conclusions The results suggest that online classes are not inferior to in-person classes or even slightly better in enhancing medical students' empathy, which should be clarified by further studies. This study's findings have important implications for medical education and implementing hybrid class formats to enhance students' empathy. en-copyright= kn-copyright= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokinobuAkiko en-aut-sei=Tokinobu en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=2 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=3 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=4 en-affil=Division of Kidney, Diabetes and Endocrine Diseases, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=COVID-19 pandemic kn-keyword=COVID-19 pandemic en-keyword=Empathy kn-keyword=Empathy en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Medical students kn-keyword=Medical students en-keyword=Online class kn-keyword=Online class END start-ver=1.4 cd-journal=joma no-vol=101 cd-vols= no-issue=5 article-no= start-page=1030 end-page=1037.e5 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202505 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Short- and longer-term learning effects from virtual scale endoscopy videos: a useful tool for colorectal lesion size estimation (with videos) en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background and Aims: Accurate assessment of colorectal polyp size is crucial for determining treatment and surveillance policies. However, visual estimation of lesion diameter is often inaccurate, making simple and effective educational tools essential. We aimed to evaluate the learning effects of virtual scale endoscopy (VSE).
Methods: Thirty-three endoscopists first watched prelearning videos for SET1. They then estimated the diameters of 20 lesions and referred to instructional videos with VSE for self-study. Subsequently, they watched the postlearning videos for SET2 and estimated the lesion diameters. The error between the estimated and correct lesion sizes of both sets was compared. To evaluate longer-term learning effects, participants answered SET3 and SET4, which consisted of the same questions as SET2 and SET1, respectively, but 2 to 3 months later without watching the instructional video for SET2.
Results: The error in the participants乫 estimation of the correct lesion diameter improved from SET1 to SET2 (34.7 亇 6.6 mm vs 30.7 亇 7.7 mm, P = .048), with a significant learning effect and error improvement specifically among nonexperts (35.2 亇 5.3 mm vs 30 亇 6.8 mm, P = .028). In SET3 and SET4, participants乫 errors indicated that the learning effect was well maintained (SET2 vs SET3: 30.7 亇 7.7 mm vs 28.6 亇 7.2 mm [P = .1]; SET1 vs SET4: 34.7 亇 6.6 mm vs 31.7 亇 7.1 mm [P = .025]).
Conclusions: VSE videos are a valuable learning tool for estimating lesion diameter, particularly for novice endoscopists, both in the short and longer term. en-copyright= kn-copyright= en-aut-name=HiraiRyosuke en-aut-sei=Hirai en-aut-mei=Ryosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KinugasaHideaki en-aut-sei=Kinugasa en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IshiguroMikako en-aut-sei=Ishiguro en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ToyosawaJunki en-aut-sei=Toyosawa en-aut-mei=Junki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AoyamaYuki en-aut-sei=Aoyama en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IgawaShoko en-aut-sei=Igawa en-aut-mei=Shoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamasakiYasushi en-aut-sei=Yamasaki en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=InokuchiToshihiro en-aut-sei=Inokuchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TakaharaMasahiro en-aut-sei=Takahara en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KawanoSeiji en-aut-sei=Kawano en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HiraokaSakiko en-aut-sei=Hiraoka en-aut-mei=Sakiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OtsukaMotoyuki en-aut-sei=Otsuka en-aut-mei=Motoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=25 cd-vols= no-issue=1 article-no= start-page=48 end-page=53 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241209 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effectiveness of oral health care intervention for stroke patients following the introduction of Oral Health Assessment Tool en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aim: This study aimed to evaluate the effectiveness of oral health assessment tools in facilitating oral health care interventions by dental care providers for acute stroke patients within 48?h of admission, following a reform of the nursing system.
Methods: Data were gathered from a retrospective cohort study conducted at a stroke center, comparing 10?months before and after the implementation of the reformed system, with a 2-month interval. Parameters assessed included stroke type, severity measured using the National Institutes of Health Stroke Scale, stroke history, stroke-related factors, number of teeth, hospitalization cost and duration, occurrence of fever and pneumonia, stroke treatment, days from admission to dental intervention, and intervention frequency.
Results: Implementation of the new system significantly reduced the time before dental intervention (P? Conclusions: Although the frequency and duration of fevers increased slightly, this approach, incorporating oral health assessment tools, made it possible to provide early dental intervention, particularly for patients with severe strokes. Geriatr Gerontol Int 2025; 25: 48?53. en-copyright= kn-copyright= en-aut-name=MatsunagaKazuyuki en-aut-sei=Matsunaga en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=Yoshida乚TsuboiAyaka en-aut-sei=Yoshida乚Tsuboi en-aut-mei=Ayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InoharaKen en-aut-sei=Inohara en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshidaYasuko en-aut-sei=Yoshida en-aut-mei=Yasuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakahamaKanako en-aut-sei=Nakahama en-aut-mei=Kanako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SasakiKazuki en-aut-sei=Sasaki en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SoudaFumie en-aut-sei=Souda en-aut-mei=Fumie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TerasawaYuka en-aut-sei=Terasawa en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ShimoeYutaka en-aut-sei=Shimoe en-aut-mei=Yutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=Takeuchi乚HatanakaKazu en-aut-sei=Takeuchi乚Hatanaka en-aut-mei=Kazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YamamotoTadashi en-aut-sei=Yamamoto en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OmoriKazuhiro en-aut-sei=Omori en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KohriyamaTatsuo en-aut-sei=Kohriyama en-aut-mei=Tatsuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TakashibaShogo en-aut-sei=Takashiba en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital kn-affil= affil-num=3 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=4 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=5 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=6 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=7 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=8 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=9 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=10 en-affil=Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital kn-affil= affil-num=11 en-affil=The Center for Graduate Medical Education (Dental Division), Okayama University Hospital kn-affil= affil-num=12 en-affil=Department of Pathophysiology ? Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=13 en-affil=Brain Attack Center, Ota Memorial Hospital kn-affil= affil-num=14 en-affil=Department of Pathophysiology ? Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=acute stroke kn-keyword=acute stroke en-keyword=dental intervention kn-keyword=dental intervention en-keyword=medical and dental cooperation kn-keyword=medical and dental cooperation en-keyword=oral health assessment tool kn-keyword=oral health assessment tool en-keyword=severity kn-keyword=severity END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page=cmad074 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230719 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of 2-week postpartum check-ups on screening positive for postpartum depression: a population-based cohort study using instrumental variable estimation in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Postpartum depression is experienced by approximately 10% of women and affects the health and development of their children. Although it is recommended that all mothers have the opportunity for early detection and intervention for postpartum depression, it is unclear whether early postpartum check-ups help to reduce postpartum depression.
Objective: The aim of this study was to assess the effect of 2-week postpartum check-ups on screening positive for postpartum depression in Japan.
Methods: This was a population-based cohort study that used the administrative database of Tsuyama, Japan. Participants were women who received postpartum home visits from a public health nurse in Tsuyama during the fiscal years 2017?2019. Data were obtained on participant乫s attendance at a 2-week postpartum check-up and their responses on the Edinburgh Postpartum Depression Scale. Owing to the initiation of a publicly funded postpartum check-up programme, participants were pseudo-randomly assigned to receive/not receive a 2-week postpartum check-up. We conducted instrumental variable estimation to assess the causal effects of the check-up on screening positive for postpartum depression.
Results: The characteristics of the 1,382 participants did not differ by fiscal year of childbirth. We found a 6.7% (95% confidence interval 2.2?11.2) reduction in the prevalence of screening positive for postpartum depression as an effect of 2-week postpartum check-ups among women received 1-month postpartum home visits.
Conclusion: The results suggest that 2-week postpartum check-ups are effective in reducing the prevalence of screening positive for postpartum depression among 1-month postpartum women. Despite some limitations, early postpartum care could reduce postpartum depression. en-copyright= kn-copyright= en-aut-name=NakamuraNaoko en-aut-sei=Nakamura en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakashimaYasuko en-aut-sei=Nakashima en-aut-mei=Yasuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsumotoNaomi en-aut-sei=Matsumoto en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Health Promotion Division, Tsuyama City Department of Children乫s Health kn-affil= affil-num=4 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=community health planning kn-keyword=community health planning en-keyword=diagnostic screening programmes kn-keyword=diagnostic screening programmes en-keyword=home visits kn-keyword=home visits en-keyword=postpartum depression kn-keyword=postpartum depression en-keyword=postnatal care kn-keyword=postnatal care en-keyword=quasi-experimental study kn-keyword=quasi-experimental study END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=2 article-no= start-page=e202400552 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241217 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Potassium tert-Butoxide-Mediated Ring-Opening of Indolines: Concise Synthesis of 2-Vinylanilines en-subtitle= kn-subtitle= en-abstract= kn-abstract=A concise and metal-free procedure has been developed for the synthesis of 2-vinylanilines. Reactions of indolines with tert-BuOK in DMSO afford the decorated 2-vinylanilines in yields up to 92?%. In addition, the 2, or 3-substituted indolines could be converted to trisubstituted alkenes. Also, the protocol can be scaled to afford gram quantities of the decorated 2-vinylanilines. en-copyright= kn-copyright= en-aut-name=TokushigeKeisuke en-aut-sei=Tokushige en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AsaiShota en-aut-sei=Asai en-aut-mei=Shota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AbeTakumi en-aut-sei=Abe en-aut-mei=Takumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=School of Pharmacy, Shujitsu University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=2-vinylanilines kn-keyword=2-vinylanilines en-keyword=indolines kn-keyword=indolines en-keyword=Potassium tert-butoxide kn-keyword=Potassium tert-butoxide en-keyword=Elimination kn-keyword=Elimination en-keyword=Ring-opening kn-keyword=Ring-opening END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=1 article-no= start-page=195 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241111 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between discontinuity of care and patient trust in the usual rheumatologist among patients with systemic lupus erythematosus: a cross-sectional study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Patient trust plays a central role in the patient-physician relationship. This study aimed to determine whether the number of outpatient visits with a covering rheumatologist is associated with patient trust in their usual rheumatologist.
Methods Japanese adults with systemic lupus erythematosus (SLE) who met the 1997 revised classification criteria of the American College of Rheumatology and had outpatient visits with a covering rheumatologist in the past year were included.
We used the 11-item Japanese version of the modified Trust in Physician Scale (range 0?100) to assess patient trust. A general linear model with cluster-robust variance estimation was used to evaluate the association between the number of outpatient visits with covering rheumatologists and the patient乫s trust in their usual rheumatologist.
Results Of the 515 enrolled participants, 421 patients with SLE were included in our analyses. Patients were divided into groups according to the number of outpatient visits with a covering rheumatologist in the past year as follows: no visits (59.9%; reference group), one to three visits (24.2%; low-frequency group), and four or more visits (15.9%; high-frequency group). The median Trust in Physician Scale score was 81.8 (interquartile range: 72.7?93.2). Both the low-frequency group (mean difference: -3.03; 95% confidence interval [CI] -5.93 to -0.80) and high-frequency group (mean difference: -4.17; 95% CI -7.77 to -0.58) exhibited lower trust in their usual rheumatologist.
Conclusion This study revealed that the number of outpatient visits with a covering rheumatologist was associated with lower trust in a patient乫s usual rheumatologist. en-copyright= kn-copyright= en-aut-name=KatayamaYu en-aut-sei=Katayama en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyawakiYoshia en-aut-sei=Miyawaki en-aut-mei=Yoshia kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShidaharaKenta en-aut-sei=Shidahara en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NawachiShoichi en-aut-sei=Nawachi en-aut-mei=Shoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AsanoYosuke en-aut-sei=Asano en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KatsuyamaEri en-aut-sei=Katsuyama en-aut-mei=Eri kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KatsuyamaTakayuki en-aut-sei=Katsuyama en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Takano-NarazakiMariko en-aut-sei=Takano-Narazaki en-aut-mei=Mariko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MatsumotoYoshinori en-aut-sei=Matsumoto en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OguroNao en-aut-sei=Oguro en-aut-mei=Nao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YajimaNobuyuki en-aut-sei=Yajima en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=IshikawaYuichi en-aut-sei=Ishikawa en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SakuraiNatsuki en-aut-sei=Sakurai en-aut-mei=Natsuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=HidekawaChiharu en-aut-sei=Hidekawa en-aut-mei=Chiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=YoshimiRyusuke en-aut-sei=Yoshimi en-aut-mei=Ryusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=OhnoShigeru en-aut-sei=Ohno en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=IchikawaTakanori en-aut-sei=Ichikawa en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=KishidaDai en-aut-sei=Kishida en-aut-mei=Dai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=ShimojimaYasuhiro en-aut-sei=Shimojima en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=SadaKen-Ei en-aut-sei=Sada en-aut-mei=Ken-Ei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=ThomDavid H. en-aut-sei=Thom en-aut-mei=David H. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=KuritaNoriaki en-aut-sei=Kurita en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Division of Rheumatology, Department of Medicine, Showa University School of Medicine kn-affil= affil-num=11 en-affil=Division of Rheumatology, Department of Medicine, Showa University School of Medicine kn-affil= affil-num=12 en-affil=The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health kn-affil= affil-num=13 en-affil=Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine kn-affil= affil-num=14 en-affil=Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine kn-affil= affil-num=15 en-affil=Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine kn-affil= affil-num=16 en-affil=Centre for Rheumatic Disease, Yokohama City University Medical Centre kn-affil= affil-num=17 en-affil=Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University kn-affil= affil-num=18 en-affil=Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine kn-affil= affil-num=19 en-affil=Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine kn-affil= affil-num=20 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=21 en-affil=Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=22 en-affil=Department of Medicine, Stanford University School of Medicine kn-affil= affil-num=23 en-affil=Division of Rheumatology, Department of Medicine, Showa University School of Medicine kn-affil= en-keyword=Systemic lupus erythematosus kn-keyword=Systemic lupus erythematosus en-keyword=Patient-physician relationship kn-keyword=Patient-physician relationship en-keyword=Outpatient visits kn-keyword=Outpatient visits en-keyword=Patient trust kn-keyword=Patient trust en-keyword=Discontinuity of care kn-keyword=Discontinuity of care END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=10 article-no= start-page=382 end-page=386 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=2024 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Important Notes for Preventing Entrapment of Distal Filter-based Embolic Protection Device in Carotid Artery Stenting en-subtitle= kn-subtitle= en-abstract= kn-abstract=Failure to retrieve a distal filter-based embolic protection device (EPD) is a potential complication of carotid artery stenting. This may be caused by trapping of the proximal marker of the EPD within the stent tip marker. Maintaining an adequate distance between the two can prevent this. We examined the behavior of several stent-filter-based EPD combinations, focusing on their propensity to become trapped or disengage in vitro. Four physicians subjectively rated the force required to result in trapping using a 5-point scale. Moreover, the force required to disengage trapped devices was evaluated. The Casper stent & horbar;Spider FX EPD combination was difficult to disengage when entrapment occurred, which suggested that this phenomenon tended to occur with this combination. The stent tip marker of the closed-cell stents advanced as they shortened, which may be a unique feature of closed-cell stents. Although trapping is uncommon, it can cause serious complications. To prevent these complications, device characteristics should be well understood before they are used in patients. en-copyright= kn-copyright= en-aut-name=FUJITAJuntaro en-aut-sei=FUJITA en-aut-mei=Juntaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HIROTSUNENobuyuki en-aut-sei=HIROTSUNE en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MATSUDAYuki en-aut-sei=MATSUDA en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HAMASAKIOsamu en-aut-sei=HAMASAKI en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FUKUDAShoichi en-aut-sei=FUKUDA en-aut-mei=Shoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OKADAYoshihiro en-aut-sei=OKADA en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KOBASHIAiko en-aut-sei=KOBASHI en-aut-mei=Aiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NISHIGAKIShohei en-aut-sei=NISHIGAKI en-aut-mei=Shohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MAKINOKeigo en-aut-sei=MAKINO en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TOMITAYusuke en-aut-sei=TOMITA en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KIDANINaoya en-aut-sei=KIDANI en-aut-mei=Naoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MURAOKAKenichiro en-aut-sei=MURAOKA en-aut-mei=Kenichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NISHINOShigeki en-aut-sei=NISHINO en-aut-mei=Shigeki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=3 en-affil=Department of Neurosurgery, Miyoshi Central Hospital kn-affil= affil-num=4 en-affil= Department of Neurosurgery, Miyoshi Central Hospital kn-affil= affil-num=5 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=6 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=7 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=8 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=9 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=10 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=11 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=12 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=13 en-affil=Department of Neurosurgery and Neuroendovascular Surgery, Hiroshima City Hiroshima Citizens Hospital kn-affil= en-keyword=carotid artery stenting kn-keyword=carotid artery stenting en-keyword=distal filter-based embolic protection device kn-keyword=distal filter-based embolic protection device en-keyword=complication kn-keyword=complication END start-ver=1.4 cd-journal=joma no-vol=103 cd-vols= no-issue=32 article-no= start-page=e39113 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240809 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Insomnia among patients with chronic pain A retrospective study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Insomnia can coexist with chronic pain and is a major cause of rapidly increasing medical expenses. However, insomnia has not been fully evaluated in patients with chronic pain. This retrospective study aimed to identify the risk factors for insomnia in patients with chronic non-cancer pain. A total of 301 patients with chronic non-cancer pain were enrolled. Patients with the Athens insomnia scale scores >= 6 and < 6 were classified into insomnia (+) and insomnia (-) groups, respectively. All patients completed self-report questionnaires as part of their chronic pain treatment approach. Univariate and multivariate analyses were performed to predict insomnia. We found that 219 of 301 (72.8%) patients met the AIS criteria for insomnia. Significant differences were depicted between patients with and without insomnia in terms of body mass index, numeric rating scale, pain catastrophizing scale, hospital anxiety, and depression scale (HADS), pain disability assessment scale, EuroQol 5 dimension (EQ5D), and pain self-efficacy questionnaire. Multiple regression analysis identified the numeric rating scale, HADS, and EQ5D scores as factors related to insomnia in patients with chronic non-cancer pain. Anxiety, depression, and disability were associated with a greater tendency toward insomnia. HADS and EQ5D scores are useful screening tools for preventing insomnia in patients with chronic non-cancer pain. en-copyright= kn-copyright= en-aut-name=UedaMasataka en-aut-sei=Ueda en-aut-mei=Masataka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TetsunagaTomoko en-aut-sei=Tetsunaga en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TetsunagaTomonori en-aut-sei=Tetsunaga en-aut-mei=Tomonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakatoriRyo en-aut-sei=Takatori en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShitozawaHisakazu en-aut-sei=Shitozawa en-aut-mei=Hisakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UotaniKoji en-aut-sei=Uotani en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShinoharaKennsuke en-aut-sei=Shinohara en-aut-mei=Kennsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OdaYoshiaki en-aut-sei=Oda en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University kn-affil= affil-num=3 en-affil=Department of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Division of Chronic Pain Medicine and Division of Comprehensive Rheumatology, Locomotive Pain Center, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University kn-affil= affil-num=8 en-affil=Department of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=AIS kn-keyword=AIS en-keyword=cognitive-behavioral therapy kn-keyword=cognitive-behavioral therapy en-keyword=EQ5D kn-keyword=EQ5D en-keyword=HADS kn-keyword=HADS en-keyword=insomnia kn-keyword=insomnia en-keyword=pain-liaison outpatient clinic kn-keyword=pain-liaison outpatient clinic en-keyword=sleep disorders kn-keyword=sleep disorders END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=14 article-no= start-page=4099 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240713 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Importance of Blood Glucose Measurement for Predicting the Prognosis of Long COVID: A Retrospective Study in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: The present study aimed to clarify the effects of a hyperglycemic condition on the clinical consequences of long COVID. Methods: Among 643 patients who visited the outpatient clinic of our hospital from February 2021 to September 2023, long COVID patients were classified into a hyperglycemic (HG) group with casual blood glucose levels above 140 mg/dL and a normoglycemic (NG) group. The patients' backgrounds, clinical symptoms, health status including the QOL evaluation scale (EQ-5D-5L), self-rating depression scale (SDS), and F-scale questionnaire (FSSG), blood test data, and recovery periods were analyzed. Results: The NG group included 607 patients with long COVID and the HG group included 36 patients with long COVID. Patients in the HG group were older than those in the NG group (55 vs. 41 years; p < 0.001) and included a larger percentage of males (67% vs. 44%; p = 0.009). The HG group had a larger percentage of patients with moderate-to-severe conditions in the acute infection phase (28% vs. 12%; p = 0.008), a higher BMI (25 vs. 22 kg/m(2); p < 0.001), higher blood pressure (138/81 vs. 122/72 mmHg; p < 0.001), and a larger percentage of patients with an alcohol drinking habit (53% vs. 34%; p = 0.031). Long COVID symptoms and self-rated scales were not differed between the two groups; however, the laboratory data showed that liver and renal functions and metabolic data were significantly worse in the HG group. Although there was no apparent difference between the two groups in duration from the infection to the first visit, the HG group had a significantly longer period of recovery from long COVID (median period of 421 vs. 294 days; p = 0.019). Conclusion: A hyperglycemic state associated with other lifestyle-related diseases is associated with the prolongation of recovery from long COVID. en-copyright= kn-copyright= en-aut-name=YokoyamaSho en-aut-sei=Yokoyama en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OtsukaYuki en-aut-sei=Otsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SakuradaYasue en-aut-sei=Sakurada en-aut-mei=Yasue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MatsudaYui en-aut-sei=Matsuda en-aut-mei=Yui kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SunadaNaruhiko en-aut-sei=Sunada en-aut-mei=Naruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HasegawaToru en-aut-sei=Hasegawa en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TakaseRyosuke en-aut-sei=Takase en-aut-mei=Ryosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OmuraDaisuke en-aut-sei=Omura en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SoejimaYoshiaki en-aut-sei=Soejima en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=UedaKeigo en-aut-sei=Ueda en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=blood glucose kn-keyword=blood glucose en-keyword=diabetes mellitus kn-keyword=diabetes mellitus en-keyword=long COVID kn-keyword=long COVID en-keyword=omicron variant kn-keyword=omicron variant en-keyword=post-COVID-19 condition kn-keyword=post-COVID-19 condition END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240325 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=PRO-CTCAE傪婎偵偟偨symptom illustration scale偺奐敪偲擕娻姵幰偵偍偗傞専徹 kn-title=Development and validation of a symptom illustration scale from the patient-reported outcome common terminology criteria for adverse events for patients with breast cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=SUZUKIYoko en-aut-sei=SUZUKI en-aut-mei=Yoko kn-aut-name=楅栘梲巕 kn-aut-sei=楅栘 kn-aut-mei=梲巕 aut-affil-num=1 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 END start-ver=1.4 cd-journal=joma no-vol=28 cd-vols= no-issue=7 article-no= start-page=847 end-page=859 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230509 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review en-subtitle= kn-subtitle= en-abstract= kn-abstract=Breast reconstruction (BR) aims to improve the satisfaction and quality of life (QOL) of breast cancer survivors. Clinical studies using patient-reported outcomes (PROs) can therefore provide relevant information to the patients and support decision-making. This scoping review was conducted to analyze recent trends in world regions, methods used, and factors investigated. The literature search was conducted in August 2022. Databases of PubMed, MEDLINE, and CINAHL were searched for relevant English-language studies published from 2017 to 2022. Studies involving women with breast cancer who underwent BR after mastectomy and investigated PROs after BR using BR-specific scales were included. Data on the country, publication year, study design, PRO measures (PROMs) used, time points of surveys, and research themes were collected. In total, 147 articles met the inclusion criteria. BREAST-Q was the most widely used, contributing to the increase in the number and diversification of studies in this area. Such research has been conducted mainly in North America and Europe and is still developing in Asia and other regions. The research themes involved a wide range of clinical and patient factors in addition to surgery, which could be influenced by research methods, time since surgery, and even cultural differences. Recent BR-specific PROMs have led to a worldwide development of research on factors that affect satisfaction and QOL after BR. PRO after BR may be influenced by local cultural and social features, and it would be necessary to accumulate data in each region to draw clinically useful conclusion. en-copyright= kn-copyright= en-aut-name=SaigaMiho en-aut-sei=Saiga en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakagiriRyoko en-aut-sei=Nakagiri en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MukaiYuko en-aut-sei=Mukai en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsumotoHiroshi en-aut-sei=Matsumoto en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KimataYoshihiro en-aut-sei=Kimata en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Plastic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Plastic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Plastic Surgery, Okayama Rosai Hospital kn-affil= affil-num=4 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Patient-reported outcomes kn-keyword=Patient-reported outcomes en-keyword=Breast reconstruction kn-keyword=Breast reconstruction en-keyword=Breast cancer kn-keyword=Breast cancer en-keyword=Quality of life kn-keyword=Quality of life en-keyword=Satisfaction kn-keyword=Satisfaction END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=6 article-no= start-page=476 end-page=485 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240415 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Perioperative and Postoperative Continuous Nutritional Counseling Improves Quality of Life of Gastric Cancer Patient Undergoing?Gastrectomy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Post-gastrectomy syndrome (PGS) and body weight loss (BWL) decrease quality of life (QOL) and survival of the patient undergoing gastrectomy. We have introduced perioperative and post-discharge continuous nutritional counseling (CNC) to prevent BWL and improve QOL after gastrectomy. In the present study, we evaluated the effect of CNC on QOL using the Post-gastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Eighty-three patients with gastric cancer (GC) who underwent curative gastrectomy between March 2018 and July 2019 were retrospectively analyzed. Patients received either pre-discharge nutritional counseling alone (control group, n?=?45) or CNC (CNC group, n?=?38) after gastrectomy. QOL at 12?months after gastrectomy was compared between the two groups. In QOL assessment, change in body weight (?7.98% vs. ?12.77%, p?=?0.0057), ingested amount of food per meal (7.00 vs. 6.07, p?=?0.042) and ability for working (1.89 vs. 2.36, p?=?0.049) were significantly better in CNC group than control group. Multiple regression analysis showed that CNC was a significantly beneficial factor for abdominal pain subscale (p?=?0.028), diarrhea subscale (p?=?0.047), ingested amount of food per meal (p?=?0.012), Ability for working (p?=?0.031) and dissatisfaction at the meal (p?=?0.047). Perioperative and postoperative CNC could improve QOL in the patient undergoing gastrectomy in addition to preventing postoperative BWL. en-copyright= kn-copyright= en-aut-name=HanzawaShunya en-aut-sei=Hanzawa en-aut-mei=Shunya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KikuchiSatoru en-aut-sei=Kikuchi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ShojiRyohei en-aut-sei=Shoji en-aut-mei=Ryohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KashimaHajime en-aut-sei=Kashima en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsumiYuki en-aut-sei=Matsumi en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakahashiAyako en-aut-sei=Takahashi en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KakiuchiYoshihiko en-aut-sei=Kakiuchi en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TakagiKosei en-aut-sei=Takagi en-aut-mei=Kosei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Clinical Nutrition, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Clinical Nutrition, Okayama University Hospital kn-affil= affil-num=14 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=25 cd-vols= no-issue=1 article-no= start-page=251 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparison of early clinical outcome in carpal tunnel release - mini-open technique with palmar incision vs. endoscopic technique with wrist crease incision- en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background The purpose of this study was to examine two techniques for Carpal Tunnel Syndrome, mini-Open Carpal Tunnel Release (mini-OCTR) and Endoscopic Carpal Tunnel Release (ECTR), to compare their therapeutic efficacy.
Methods Sixteen patients who underwent mini-OCTR in palmar incision and 17 patients who underwent ECTR in the wrist crease incision were included in the study. All patients presented preoperatively and at 1, 3, and 6 months postoperatively and were assessed with the Visual Analogue Scale (VAS) and the Disabilities of Arm, Shoulder and Hand Score (DASH). We also assessed the pain and cosmetic VAS of the entire affected hand or surgical wound, and the patient's satisfaction with the surgery.
Results In the objective evaluation, both surgical techniques showed improvement at 6 months postoperatively. The DASH score was significantly lower in the ECTR group (average = 3 months: 13.6, 6 months: 11.9) than in the mini-OCTR group (average = 3 months: 27.3, 6 months: 20.6) at 3 and 6 months postoperatively. Also, the pain VAS score was significantly lower in the ECTR group (average = 17.1) than in the mini-OCTR group (average = 36.6) at 3 months postoperatively. The cosmetic VAS was significantly lower in the ECTR group (average = 1 month: 15.3, 3 months: 12.2, 6 months: 5.41) than in the mini-OCTR group (average = 1 month: 33.3, 3 months: 31.2, 6 months: 24.8) at all time points postoperatively. Patient satisfaction scores tended to be higher in the ECTR group (average = 3.3) compared to the mini-OCTR group (average = 2.7).
Conclusions ECTR in wrist increase incision resulted in better pain and cosmetic recovery in an early postoperative phase compared with mini-OCTR in palmar incision. Our findings suggest that ECTR is an effective technique for patient satisfaction. en-copyright= kn-copyright= en-aut-name=NakamichiRyo en-aut-sei=Nakamichi en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoTaichi en-aut-sei=Saito en-aut-mei=Taichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShimamuraYasunori en-aut-sei=Shimamura en-aut-mei=Yasunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Sports Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Sports Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Sports Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Sports Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= en-keyword=Carpal tunnel syndrome kn-keyword=Carpal tunnel syndrome en-keyword=Mini-open kn-keyword=Mini-open en-keyword=Endoscopy kn-keyword=Endoscopy en-keyword=Patient-oriented evaluation kn-keyword=Patient-oriented evaluation END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=2 article-no= start-page=e0297347 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Japan-epiretinal membrane (J-ERM) registry: A prospective cohort study protocol investigating the surgical outcome of epiretinal membrane en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Epiretinal membrane (ERM) causes visual impairment such as reduction in visual acuity and metamorphopsia due to retinal traction. With the improvement of optical coherence tomography (OCT) and microincision vitrectomy surgery (MIVS), the surgery of ERM has significantly advanced. However, there have been no large-scale studies on the following: (1) how to evaluate visual impairment in ERM, (2) the relationship between OCT findings and visual function, (3) when is the optimal timing of surgery, and (4) the relationship between the surgical instruments as well as techniques and prognosis. The purpose of this study was to obtain evidence regarding these ERM surgeries.
Methods and design
This is a prospective, multicenter cohort study of ERM surgery in Japan from March 1, 2023, to March 31, 2027 (UMIN000048472, R-3468-2). Patients who underwent ERM surgery during the study period and agreed to participate in this study will be included. The goal is to have a total of 5,000 eyes surgically treated for ERM. The following data will be collected: age, gender, medical history, subjective symptoms, visual function before and 6 and 12 months after surgery, clinical findings, OCT data, surgical technique, instruments used in surgery, and complications.
Discussion
The results of this study will support the surgical decisions and procedures in ERM practices. en-copyright= kn-copyright= en-aut-name=KanzakiYuki en-aut-sei=Kanzaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatobaRyo en-aut-sei=Matoba en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IshiharaKenji en-aut-sei=Ishihara en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MoritaTetsuro en-aut-sei=Morita en-aut-mei=Tetsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MuraokaYuki en-aut-sei=Muraoka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KimuraShuhei en-aut-sei=Kimura en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KotoTakashi en-aut-sei=Koto en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawasakiRyo en-aut-sei=Kawasaki en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=BabaTakayuki en-aut-sei=Baba en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OkamotoFumiki en-aut-sei=Okamoto en-aut-mei=Fumiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=InoueMakoto en-aut-sei=Inoue en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SakamotoTaiji en-aut-sei=Sakamoto en-aut-mei=Taiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TsujikawaAkitaka en-aut-sei=Tsujikawa en-aut-mei=Akitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MorizaneYuki en-aut-sei=Morizane en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine kn-affil= affil-num=8 en-affil=Division of Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Ophthalmology, Graduate School of Medicine, Nippon Medical School kn-affil= affil-num=11 en-affil=Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine kn-affil= affil-num=12 en-affil=Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences kn-affil= affil-num=13 en-affil=Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine kn-affil= affil-num=14 en-affil=Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=257 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240315 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Long-term, patient-centered, frailty-based outcomes of older critical illness survivors from the emergency department: a post hoc analysis of the LIFE Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Evidence indicates frailty before intensive care unit (ICU) admission leads to poor outcomes. However, it is unclear whether quality of life (QOL) and activities of daily living (ADL) for survivors of critical illness admitted to the ICU via the emergency department remain consistent or deteriorate in the long-term compared to baseline. This study aimed to evaluate long-term QOL/ADL outcomes in these patients, categorized by the presence or absence of frailty according to Clinical Frailty Scale (CFS) score, as well as explore factors that influence these outcomes.
Methods This was a post-hoc analysis of a prospective, multicenter, observational study conducted across Japan. It included survivors aged 65 years or older who were admitted to the ICU through the emergency department. Based on CFS scores, participants were categorized into either the not frail group or the frail group, using a threshold CFS score of Results Of 514 candidates, 390 participants responded to the EQ-5D-5L questionnaire, while 237 responded to the Barthel Index. At six months post-admission, mean EQ-5D-5L values declined in both the not frail and frail groups (0.80 to 0.73, p?=?0.003 and 0.58 to 0.50, p?=?0.002, respectively); Barthel Index scores also declined in both groups (98 to 83, p? Conclusions Regardless of frailty, older ICU survivors from the emergency department were more likely to experience reduced QOL and ADL six months after ICU admission compared to baseline. en-copyright= kn-copyright= en-aut-name=HongoTakashi en-aut-sei=Hongo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InabaMototaka en-aut-sei=Inaba en-aut-mei=Mototaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TaitoShunsuke en-aut-sei=Taito en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=the LIFE Study Investigators en-aut-sei=the LIFE Study Investigators en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Clinical Practice and Support, Hiroshima University Hospital kn-affil= affil-num=5 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=ADL kn-keyword=ADL en-keyword=Clinical frailty scale kn-keyword=Clinical frailty scale en-keyword=Critical illness kn-keyword=Critical illness en-keyword=Emergency department kn-keyword=Emergency department en-keyword=Intensive care kn-keyword=Intensive care en-keyword=QOL kn-keyword=QOL END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=1 article-no= start-page=4190 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240220 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Assessing the efficacy of simulation-based education for paramedics in extended focused assessment with sonography for trauma under physician guidance en-subtitle= kn-subtitle= en-abstract= kn-abstract=We investigated the effectiveness of simulation-based education in Focused Assessment with Sonography for Trauma (FAST) to increase the number of Emergency Medical Technicians (EMTs) capable of performing ultrasound examinations in vehicles under the guidance of a physician. Twenty-eight paramedics watched a 14-min video on the features of the ultrasound system, its use, and the scanning method for each part of the body. Each participant performed four FAST examinations using a portable ultrasound device, and the task performance was rated using the Task Specific Checklist (TSC) and Global Rating Scale (GRS). The time required for visualizing each examination site and each FAST was assessed. The mean time required for the first and fourth FAST was 144.6?亇?52.4 s and 90.5?亇?31.0 s, respectively. The time required for each test significantly decreased with repeated testing (p? Methods: In this open-label, non-inferiority, parallel, individually randomized clinical trial, patients who underwent elective LG for gastric cancer were randomized 1:1 to receive either EDA or PCIA after surgery. The primary endpoint was pain score using the Numerical Rating Scale at rest 24 h after surgery, analysed both according to the intention-to-treat (ITT) principle and per protocol. The non-inferiority margin for pain score was set at 1. Secondary outcomes were postoperative parameters related to recovery and adverse events related to analgesia.
Results: Between 3 July 2017 and 29 September 2020, 132 patients were randomized to receive either EDA (n = 66) or PCIA (n = 66). After exclusions, 64 patients were included in the EDA group and 65 patients in the PCIA group for the ITT analysis. Pain score at rest 24 h after surgery was 1.94 (s.d. 2.07) in the EDA group and 2.63 (s.d. 1.76) in the PCIA group (P = 0.043). PCIA was not non-inferior to EDA for the primary endpoint (difference 0.69, one side 95% c.i. 1.25, P = 0.184) in ITT analysis. Postoperative parameters related to recovery were similar between groups. More EDA patients (21 (32.8%) versus 1 (1.5%), P < 0.001) developed postoperative hypotension as an adverse event.
Conclusions: PCIA was not non-inferior to EDA in terms of early-phase pain relief after LG. Registration number: UMIN000027643 (https://www.umin.ac.jp/ctr/index-j.htm). Conclusions: PCIA was not non-inferior to EDA in terms of early-phase pain relief after LG.Registration number: UMIN000027643 (https://www.umin.ac.jp/ctr/index-j.htm). en-copyright= kn-copyright= en-aut-name=KikuchiSatoru en-aut-sei=Kikuchi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsusakiTakashi en-aut-sei=Matsusaki en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KashimaHajime en-aut-sei=Kashima en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakataNobuo en-aut-sei=Takata en-aut-mei=Nobuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MitsuiEma en-aut-sei=Mitsui en-aut-mei=Ema kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KakiuchiYoshihiko en-aut-sei=Kakiuchi en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=UmedaYuzo en-aut-sei=Umeda en-aut-mei=Yuzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=2 article-no= start-page=e12636 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231229 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Trends in childhood obesity in Japan: A nationwide observational study from 2012 to 2021 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The persistent ascension of childhood obesity on a global scale constitutes a significant quandary. The prevalence of childhood obesity in Japan peaked in the early 2000s and has been reported to have declined since then, but recent data and its trend including the novel coronavirus disease 2019 (COVID-19) pandemic era are not available. Moreover, there is a dearth of studies examining the correlation between the trend in childhood obesity and exercise habits over the past decade. This study aims to examine the changes in the prevalence of obesity, physical fitness, and exercise habits over the past 10?years in Japanese children. We investigated the prevalence of childhood obesity in Japan, using the School Health Statistics Survey data from 2012 to 2021. The dataset has a sample size representative of children nationwide and includes variables for obesity, such as height, weight, and age. Data were classified into groups by sex and age (6?8, 9?11, and 12?14?years age). Children weighing 20% or more of the standard body weight are classified as obese. The annual percentage changes and average annual percentage changes were estimated using the joinpoint regression model. We also examined the trends in the physical fitness test score and exercise time. Average annual percentage changes of boys increased, especially in the 6- to 8-year age group (3.4%?4.6%). For girls, average annual percentage changes had increased in 6- to 8-year (2.5%?4.0%) and 9- to 11-year (0.9%?2.2%) age groups. Since the late 2010s, significantly increasing annual percentage changes were observed in 12- to 14-year age boys (6.7%?8.9%) and girls of many age groups (2.6%?8.6%). The physical fitness test score and exercise time showed decreasing trends since the late 2010s. Childhood obesity may have generally risen in Japan, in the last decade. Encouraging healthy eating and physical activity through school policies and curricula is necessary. en-copyright= kn-copyright= en-aut-name=FujiwaraShintaro en-aut-sei=Fujiwara en-aut-mei=Shintaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HaradaKo en-aut-sei=Harada en-aut-mei=Ko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KoyamaToshihiro en-aut-sei=Koyama en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HasegawaKosei en-aut-sei=Hasegawa en-aut-mei=Kosei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Pediatrics, NHO Okayama Medical Center kn-affil= affil-num=2 en-affil=Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Pharmaceutical Biomedicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=childhood obesity kn-keyword=childhood obesity en-keyword=epidemiology kn-keyword=epidemiology en-keyword=joinpoint regression analysis kn-keyword=joinpoint regression analysis en-keyword=paediatrics kn-keyword=paediatrics en-keyword=trend analysis kn-keyword=trend analysis END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue= article-no= start-page=100507 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Treatment patterns and clinician stress related to care of out-of-hospital cardiac arrest patients with a do not attempt resuscitation order en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective: This research investigated treatment patterns for out-of-hospital cardiac arrest patients with Do Not Attempt Resuscitation orders in Japanese emergency departments and the associated clinician stress.
Methods: A cross-sectional survey was conducted at 9 hospitals in Okayama, Japan, targeting emergency department nurses and physicians. The questionnaire inquired about the last treated out-of-hospital cardiac arrest patient with a Do Not Attempt Resuscitation. We assessed emotional stress on a 0?10 scale and moral distress on a 1?5 scale among clinicians.
Results: Of 208 participants, 107 (51%) had treated an out-of-hospital cardiac arrest patient with a Do Not Attempt Resuscitation order in the past 6 months. Of these, 65 (61%) clinicians used a 乬slow code乭 due to perceived futility in resuscitation (42/65 [65%]), unwillingness to terminate resuscitation upon arrival (38/65 [59%]), and absence of family at the time of patient乫s arrival (35/65 [54%]). Female clinicians had higher emotional stress (5 vs. 3; P = 0.007) and moral distress (3 vs. 2; P = 0.002) than males. Nurses faced more moral distress than physicians (3 vs. 2; P < 0.001). Adjusted logistic regression revealed that having performed a 乬slow code乭 (adjusted odds ratio, 5.09 [95% CI, 1.68?17.87]) and having greater ethical concerns about 乬slow code乭 (adjusted odds ratio, 0.35 [95% CI, 0.19?0.58]) were associated with high stress levels.
Conclusions: The prevalent use of 乬slow code乭 for out-of-hospital cardiac arrest patients with Do Not Attempt Resuscitation orders underscores the challenges in managing these patients in clinical practice. en-copyright= kn-copyright= en-aut-name=TanabeRyo en-aut-sei=Tanabe en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HongoTakashi en-aut-sei=Hongo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ObaraTakafumi en-aut-sei=Obara en-aut-mei=Takafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NojimaTsuyoshi en-aut-sei=Nojima en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ElmerJonathan en-aut-sei=Elmer en-aut-mei=Jonathan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Emergency Medicine, University of Pittsburgh kn-affil= affil-num=7 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Do not attempt resuscitation kn-keyword=Do not attempt resuscitation en-keyword=Out-of-hospital cardiac arrest kn-keyword=Out-of-hospital cardiac arrest en-keyword=Emergency department kn-keyword=Emergency department en-keyword=Clinicians kn-keyword=Clinicians en-keyword=Slow code kn-keyword=Slow code en-keyword=Stress kn-keyword=Stress END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=22 article-no= start-page=7187 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231120 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Effectiveness of Rehabilitation after Open Surgical Release for Trigger Finger: A Prospective, Randomized, Controlled Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal its effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercises. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. At final follow-up, the DASH score, grip strength, and ROM were significantly improved in the rehabilitation group compared to that preoperatively. At final follow-up, pain was significantly improved in both groups from that preoperatively. There were no significant differences in the results, including the DASH score, grip strength, ROM and pain-VAS between the control and rehabilitation groups at the final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms >12 months between the control and rehabilitation groups at the final follow-up. en-copyright= kn-copyright= en-aut-name=SaitoTaichi en-aut-sei=Saito en-aut-mei=Taichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakamichiRyo en-aut-sei=Nakamichi en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=hand surgery kn-keyword=hand surgery en-keyword=rehabilitation kn-keyword=rehabilitation en-keyword=open surgical release kn-keyword=open surgical release en-keyword=trigger finger kn-keyword=trigger finger END start-ver=1.4 cd-journal=joma no-vol=32 cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=2023 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Safety and Clinical Effects of a Muse Cell-Based Product in Patients With Amyotrophic Lateral Sclerosis: Results of a Phase 2 Clinical Trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of motor neurons. Multilineage-differentiating stress-enduring (Muse) cells are unique endogenous stem cells that show therapeutic effects on motor function in ALS mouse models. We conducted a single-center open phase II clinical trial to evaluate the safety and clinical effects of repeated intravenous injections of an allogenic Muse cell-based product, CL2020, in patients with ALS. Five patients with ALS received CL2020 intravenously once a month for a total of six doses. The primary endpoints were safety and tolerability, and the secondary endpoint was the rate of change in the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) score. In addition, serum tumor necrosis factor-兛 (TNF-兛), interleukin-6 (IL-6), sphingosine-1-phosphate (S1P), cerebrospinal fluid chitotriosidase-1 (CHIT-1), and neurofilament light chain (NfL) levels were evaluated. The CL2020 treatment was highly tolerated without serious side effects. The ALSFRS-R score change trended upward at 12 months post-CL2020 treatment compared with that at 3 months pre-administration, but the difference was not statistically significant. Among five patients diagnosed with ALS, three exhibited a decrease in the rate of ALSFRS-R score change, one demonstrated an increase, and another showed no change. In addition, the patients乫 serum IL-6 and TNF-兛 levels and cerebrospinal fluid CHIT-1 and NfL levels increased for up to 6 months post-treatment; however, their serum S1P levels continuously decreased over 12 months. These findings indicate a favorable safety profile of CL2020 therapy. In the near future, a double-blind study of a larger number of ALS patients should be conducted to confirm the efficacy of ALS treatment with CL2020. en-copyright= kn-copyright= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakanoYumiko en-aut-sei=Nakano en-aut-mei=Yumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SasakiRyo en-aut-sei=Sasaki en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TadokoroKoh en-aut-sei=Tadokoro en-aut-mei=Koh kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OmoteYoshio en-aut-sei=Omote en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YunokiTaijun en-aut-sei=Yunoki en-aut-mei=Taijun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KawaharaYuko en-aut-sei=Kawahara en-aut-mei=Yuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MatsumotoNamiko en-aut-sei=Matsumoto en-aut-mei=Namiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TairaYuki en-aut-sei=Taira en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MatsuokaChika en-aut-sei=Matsuoka en-aut-mei=Chika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MoriharaRyuta en-aut-sei=Morihara en-aut-mei=Ryuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=amyotrophic lateral sclerosis kn-keyword=amyotrophic lateral sclerosis en-keyword=clinical trial kn-keyword=clinical trial en-keyword=CL2020 kn-keyword=CL2020 en-keyword=multilineage-differentiating stress-enduring (Muse) cells kn-keyword=multilineage-differentiating stress-enduring (Muse) cells en-keyword=intravenous administration kn-keyword=intravenous administration END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=727 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Increased quadriceps muscle strength after medial meniscus posterior root repair is associated with decreased medial meniscus extrusion progression en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background丂This study aimed to assess quadriceps muscle strength after medial meniscus (MM) posterior root repair and determine its relationship with clinical scores and MM extrusion (MME).
Methods丂Thirty patients who underwent pullout repair for MM posterior root tear and were evaluated for quadriceps muscle strength preoperatively and at 1 year postoperatively were included in this study. Quadriceps muscle strength was measured using the Locomo Scan-II instrument (ALCARE, Tokyo, Japan). MME and clinical scores (i.e., Knee Injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee score, Lysholm score, Tegner score, and visual analog scale pain score) were evaluated preoperatively and at 1 year postoperatively, and second-look arthroscopy was performed at 1 year postoperatively. Wilcoxon ' s signed-rank test was used to compare each measure pre-and postoperatively. Pearson ' s correlation coefficient was used to assess the correlation with quadriceps muscle strength values. Multiple regression analysis was performed to identify factors associated with the change in MME (.MME).
Results丂Second-look arthroscopy confirmed continuity of the posterior root in all patients. The quadriceps muscle strength measured at 1 year postoperatively (355.1 +/- 116.2 N) indicated significant improvement relative to the quadriceps muscle strength measured preoperatively (271.9 +/- 97.4 N, p < 0.001). The MME at 1 year postoperatively (4.59 +/- 1.24 mm) had progressed significantly relative to the MME preoperatively (3.63 +/- 1.01 mm, p < 0.001). The clinical scores at 1 year postoperatively were improved significantly relative to the scores preoperatively (p < 0.001). The postoperative quadriceps muscle strength was correlated with.MME (correlation coefficient = -0.398, p = 0.030), and the change in quadriceps muscle strength was correlated with the KOOS-Quality of Life (correlation coefficient = 0.430, p = 0.018). Multiple regression analysis showed that the postoperative quadriceps muscle strength had a significant effect on.MME even when the body mass index and time from injury to surgery were included.
Conclusions丂After MM posterior root repair, patients with greater quadriceps muscle strength showed less MME progression. In addition, patients with greater improvement in quadriceps muscle strength had better clinical scores; therefore, continued rehabilitation aimed at improving quadriceps muscle strength after MM posterior root repair is recommended. en-copyright= kn-copyright= en-aut-name=KawadaKoki en-aut-sei=Kawada en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FukubaMikao en-aut-sei=Fukuba en-aut-mei=Mikao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TamuraMasanori en-aut-sei=Tamura en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HigashiharaNaohiro en-aut-sei=Higashihara en-aut-mei=Naohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YokoyamaYusuke en-aut-sei=Yokoyama en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KatayamaYoshimi en-aut-sei=Katayama en-aut-mei=Yoshimi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Clinical score kn-keyword=Clinical score en-keyword=Medial meniscus kn-keyword=Medial meniscus en-keyword=Medial meniscus extrusion kn-keyword=Medial meniscus extrusion en-keyword=Muscle strength kn-keyword=Muscle strength en-keyword=Posterior root tear kn-keyword=Posterior root tear en-keyword=Quadriceps kn-keyword=Quadriceps END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=5 article-no= start-page=491 end-page=497 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Participation in the Setouchi Triennale and the Health of Residents in Naoshima: A Cross-Sectional Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Arts festivals have become increasingly popular in various parts of Japan in recent years. The purpose of this study was to investigate the relationships between arts festival activities participation at the Setouchi Triennale and the health of residents in the town of Naoshima. This was a cross-sectional study. Questionnaires were distributed to all residents of Naoshima who were 20 years old or older (n=2,588). We analyzed responses from 708 people. The associations between arts festival activities participation and health (measured by self-rated health) were analyzed using logistic regression analysis as the primary outcome. Kessler乫s psychological distress scale scores were also analyzed in the same manner as the primary outcome. The participating group had an adjusted odds ratio of 1.86 (95% confidence interval: 1.03-3.33) for higher self-rated health compared with those who did not participate. Kessler乫s psychological distress scale results showed that the participating group had an adjusted odds ratio of 3.23 (95% confidence interval: 1.19-8.81) for lower psychological distress compared with those who did not participate. In conclusion, arts festival activities participation was associated with higher self-rated health and lower psychological distress. However, caution must be taken in regard to generalizability and causality when interpreting these results. en-copyright= kn-copyright= en-aut-name=HabuHiroshi en-aut-sei=Habu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiyajiChikara en-aut-sei=Miyaji en-aut-mei=Chikara kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsumotoNaomi en-aut-sei=Matsumoto en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AooKen en-aut-sei=Aoo en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NishitaYosuke en-aut-sei=Nishita en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TsuriMasao en-aut-sei=Tsuri en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Graduate School of Humanities and Social Sciences, Okayama University kn-affil= affil-num=6 en-affil=Graduate School of Humanities and Social Sciences, Okayama University kn-affil= affil-num=7 en-affil=Faculty of Economics, Musashi University kn-affil= affil-num=8 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=art kn-keyword=art en-keyword=arts in public health kn-keyword=arts in public health en-keyword=arts festival kn-keyword=arts festival en-keyword=self-rated health kn-keyword=self-rated health en-keyword=Setouchi Triennale kn-keyword=Setouchi Triennale END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=5 article-no= start-page=479 end-page=490 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Childcare and Child Development in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this 乬myth of the first three years乭 in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment. en-copyright= kn-copyright= en-aut-name=MurataAkiko en-aut-sei=Murata en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoNaomi en-aut-sei=Matsumoto en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiyajiChikara en-aut-sei=Miyaji en-aut-mei=Chikara kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=乬myth of the first three years乭 kn-keyword=乬myth of the first three years乭 en-keyword=childcare kn-keyword=childcare en-keyword=child development kn-keyword=child development en-keyword=problem behavior kn-keyword=problem behavior en-keyword=educational attainment kn-keyword=educational attainment END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=5 article-no= start-page=471 end-page=478 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Low Patient Weight and Long Intubation Time Are Key Factors for Pain during Colonoscopy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although the clinical usefulness of colonoscopy has been established, the procedure remains painful for many patients. This study was designed to clarify the factors predicting colonoscopy-related pain. We evaluated 283 consecutive patients who completed a first-ever, total colonoscopy without sedatives or analgesics. The severity of pain symptoms was evaluated by a numeric rating scale (NRS) in a questionnaire immediately after the colonoscopy. Patient backgrounds and endoscopic findings were analyzed to evaluate their association with pain. Out of 283 patients, 53 scored their pain 0-1 on the NRS while 48 scored it 6-10. We defined the colonoscopies of the former and latter patients as painless and painful, respectively, and compared the two. Multivariate analyses revealed that low body weight (OR 4.95, 95%CI 1.89-12.99) and longer intubation time (OR 3.63, 95%CI 1.46-9.03) were significant risk factors for painful colonoscopy. To identify factors contributing to the increased intubation time, we divided subjects into short- and long-intubation-time groups based on a median insertion time of 7 min. Older age (OR 2.28, 95%CI 1.31-3.98), previous abdominal surgery (OR 1.93, 95%CI 1.13-3.32) and findings of invasive cancer (OR 10.90, 95%CI 1.34-88.90) were significant factors for longer intubation time. en-copyright= kn-copyright= en-aut-name=OkaShohei en-aut-sei=Oka en-aut-mei=Shohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HaradaKeita en-aut-sei=Harada en-aut-mei=Keita kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamamotoShumpei en-aut-sei=Yamamoto en-aut-mei=Shumpei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YasutomiEriko en-aut-sei=Yasutomi en-aut-mei=Eriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IgawaShoko en-aut-sei=Igawa en-aut-mei=Shoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OhmoriMasayasu en-aut-sei=Ohmori en-aut-mei=Masayasu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HiraiMami en-aut-sei=Hirai en-aut-mei=Mami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamasakiYasushi en-aut-sei=Yamasaki en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=InokuchiToshihiro en-aut-sei=Inokuchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KinugasaHideaki en-aut-sei=Kinugasa en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TakaharaMasahiro en-aut-sei=Takahara en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HiraokaSakiko en-aut-sei=Hiraoka en-aut-mei=Sakiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=colonoscopy kn-keyword=colonoscopy en-keyword=colonoscopy-related pain kn-keyword=colonoscopy-related pain en-keyword=comfortable colonoscopy kn-keyword=comfortable colonoscopy END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=4 article-no= start-page=345 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220817 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of bacterium in the malignant wounds of soft tissue sarcoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=Malignant wounds (MWs) are rare skin lesions, which accompany ulceration, necrosis and infection caused by infiltration or damage by malignant tumor. The present study aimed to investigate the bacterial etiology implicated in MW in soft tissue sarcoma (STS), and the effectiveness of culture?guided perioperative antibacterial administration. A retrospective evaluation was conducted on medical records of patients who presented with MW between 2006 and 2020. A total of seven patients were included in the present study, in whom all tumors were relatively large (>5 cm) and high?grade. Subsequently, five patients underwent limb?sparing surgery, and three patients had distant metastases with a 5?year overall survival of 71%. Preoperative microbiological sampling from the wound identified 11 different bacterial strains in five patients. The infections were polymicrobial with an average of 2.6 strains isolated per patient (1 aerobic, 1.6 anaerobic bacteria). They were predominantly methicillin?sensitive Staphylococcus aureus. Patients with MWs from STS reported symptoms, including bleeding (71%), exudation (71%) and malodorous wound (43%) at the initial presentation; these completely resolved after surgery. All but one patient reported pain at the MW site with an average numeric rating scale of 4.4 at presentation that decreased to 1.4 (P=0.14) and 0.6 (P=0.04) one and two weeks after surgery, respectively. The patients had elevated C?reactive protein (71%), anemia (57%), low albumin (86%) and renal/liver dysfunction (14?29%). One patient was diagnosed with sepsis. Surgical resection afforded symptomatic relief and resolution of abnormal laboratory values. Although selected antibiotics were administered in four patients based on the preoperative antibiotic sensitivity test, surgical site infection (SSI) occurred in three patients. Therefore, the effectiveness of the selected antibiotics based on the results of the preoperative culture in preventing SSI needs to be investigated in the future. In conclusion, physicians should keep in mind that although surgical resection can improve the symptoms and abnormal values in laboratory examination form MW, it is accompanied with a high rate of SSI and poor prognosis. en-copyright= kn-copyright= en-aut-name=NakataEiji en-aut-sei=Nakata en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiwaraTomohiro en-aut-sei=Fujiwara en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KatayamaHaruyoshi en-aut-sei=Katayama en-aut-mei=Haruyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ItanoTakuto en-aut-sei=Itano en-aut-mei=Takuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= en-keyword=malignant wounds kn-keyword=malignant wounds en-keyword=soft tissue sarcoma kn-keyword=soft tissue sarcoma en-keyword=microbiological analysis kn-keyword=microbiological analysis en-keyword=surgical site infection kn-keyword=surgical site infection en-keyword=prognosis kn-keyword=prognosis END start-ver=1.4 cd-journal=joma no-vol=18 cd-vols= no-issue=1 article-no= start-page=599 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230814 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Results of resection of forearm soft tissue sarcoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose丂Soft tissue sarcomas (STS) of the forearm are rare. We aim to assess their oncological and functional outcomes.
Methods丂We retrospectively evaluated 34 patients who underwent surgical excision for forearm STS at our institution between 1993 and 2020. We analyzed postoperative Musculoskeletal Tumor Society rating scale (MSTS) and local recurrence-free survival (LRFS), metastasis-free survival, and overall survival (OS) rates. The significance of the following variables was determined: age, sex, histology, tumor size, Federation Nationale des Centres de Lutte contre le Cancer grade, American Joint Committee on Cancer stage, surgical margin, unplanned excision, metastases upon initial presentation, receipt of chemotherapy, and radiotherapy (RT).
Results丂The postoperative median MSTS score was 28. Bone resection or major nerve palsy was the only factor that influenced MSTS scores. The median MSTS scores in patients with or without bone resection or major nerve palsy were 24 and 29, respectively (P < 0.001). The 5-year LRFS rates was 87%. Univariate analysis revealed that the histological diagnosis of myxofibrosarcoma was the only factor that influenced LRFS (P = 0.047). The 5-year MFS rates was 71%. In univariate analysis, no factors were associated with MFS. The 5-year OS rates was 79%. Age was the only factor that influenced OS (P = 0.01).
Conclusion丂In the treatment of forearm STS, reconstruction of the skin and tendon can compensate for function, while bone resection and major nerve disturbance cannot. Careful follow-up is important, especially in patients with myxofibrosarcoma, due to its likelihood of local recurrence. en-copyright= kn-copyright= en-aut-name=NakataEiji en-aut-sei=Nakata en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiwaraTomohiro en-aut-sei=Fujiwara en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatayamaHaruyoshi en-aut-sei=Katayama en-aut-mei=Haruyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ItanoTakuto en-aut-sei=Itano en-aut-mei=Takuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= en-keyword=Soft tissue sarcomas kn-keyword=Soft tissue sarcomas en-keyword=Forearm kn-keyword=Forearm en-keyword=Function kn-keyword=Function en-keyword=Prognosis kn-keyword=Prognosis END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=14 article-no= start-page=4737 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230718 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Utility of Serum Ferritin for Predicting Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Patients with Long COVID en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective: The most common symptom of post-acute coronavirus disease 2019 (COVID-19) is fatigue, and it potentially leads to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); however, a specific prognosticator is lacking. We aimed to elucidate the clinical characteristics of patients who developed ME/CFS after COVID-19. Methods: In this retrospective observational study, patients who visited Okayama University Hospital for long COVID between February 2021 and March 2022 were investigated. Results: Of the 234 patients, 139 (59.4%) had fatigue symptoms. Fifty patients with fatigue symptoms (21.4%) met the criteria for ME/CFS (ME/CFS group), while the other 89 patients did not (non-ME/CFS group); 95 patients had no fatigue complaints (no-fatigue group). Although the patients乫 backgrounds were not significantly different between the three groups, the ME/CFS group presented the highest scores on the self-rating symptom scales, including the Fatigue Assessment Scale (FAS), EuroQol, and the Self-Rating Depression Scale (SDS). Furthermore, serum ferritin levels, which were correlated with FAS and SDS scores, were significantly higher in the ME/CFS group (193.0 兪g/L, interquartile range (IQR): 58.8?353.8) than in the non-ME/CFS group (98.2 兪g/L, 40.4?251.5) and no-fatigue group (86.7 兪g/L, 37.5?209.0), and a high serum ferritin level was prominent in female patients. Endocrine workup further showed that the ME/CFS group had higher thyrotropin levels but lower growth hormone levels in serum and that insulin-like growth factor-I levels were inversely correlated with ferritin levels (R = ?0.328, p < 0.05). Conclusions: Serum ferritin level is a possible predictor of the development of ME/CFS related to long COVID, especially in female patients. en-copyright= kn-copyright= en-aut-name=YamamotoYukichika en-aut-sei=Yamamoto en-aut-mei=Yukichika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OtsukaYuki en-aut-sei=Otsuka en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SunadaNaruhiko en-aut-sei=Sunada en-aut-mei=Naruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SakuradaYasue en-aut-sei=Sakurada en-aut-mei=Yasue kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HasegawaToru en-aut-sei=Hasegawa en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=COVID-19 kn-keyword=COVID-19 en-keyword=ferritin kn-keyword=ferritin en-keyword=insulin-like growth factor-I (IGF-I) kn-keyword=insulin-like growth factor-I (IGF-I) en-keyword=long COVID kn-keyword=long COVID en-keyword=myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) kn-keyword=myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) END start-ver=1.4 cd-journal=joma no-vol=143 cd-vols= no-issue=4 article-no= start-page=393 end-page=404 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Awareness about the Establishment of Clinical Evidence among Community Pharmacists: A Large-scale Survey among Members of the Okayama Pharmaceutical Association kn-title=曐尟栻嬊栻嵻巘偵偍偗傞僄價僨儞僗憂弌偵懳偡傞堄幆丗壀嶳導栻嵻巘夛夛堳偵懳偡傞戝婯柾幚懺挷嵏 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Community pharmacists in Japan participate in many important clinical cases involving drug therapies. This involvement should be researched and widely publicized to promote evidence-based medicine (EBM). However, the awareness level about the establishment of clinical evidence among community pharmacists remains unknown. Therefore, this large-scale questionnaire survey was conducted among members of the Okayama Pharmaceutical Association to clarify the awareness about the establishment of clinical evidence among community pharmacists to determine the major factors affecting their awareness. Questionnaires requiring open-ended responses were developed in Google Forms. Finally, 366 valid answers were obtained and statistically analyzed based on three aspects: academic conference presentation, research article publication, and research conduct. More than 50% of the participants agreed that they must engage in the establishment of clinical evidence. However, they were unwilling to engage in it by themselves. Additionally, the awareness about the establishment of clinical evidence among participants aged <40 years, who underwent a 6-year course, and with presentation experience was greater than that among participants aged ?40 years, who underwent a 4-year course and without presentation experience. Thus, age, course duration, and presentation experience are important factors influencing awareness about the establishment of clinical evidence. Further, >70% of the participants did not have enough time to engage in the establishment of clinical evidence, suggesting that reducing workload and ensuring adequate time are necessary for such engagements. Our novel findings may increase the establishment of clinical evidence by community pharmacists, improve community pharmacists乫 social standing, and promote EBM in Japan. en-copyright= kn-copyright= en-aut-name=MatsumotoJun en-aut-sei=Matsumoto en-aut-mei=Jun kn-aut-name=徏杮弝 kn-aut-sei=徏杮 kn-aut-mei=弝 aut-affil-num=1 ORCID= en-aut-name=ItanoMadoka en-aut-sei=Itano en-aut-mei=Madoka kn-aut-name=斅栰墌崄 kn-aut-sei=斅栰 kn-aut-mei=墌崄 aut-affil-num=2 ORCID= en-aut-name=IwataNaohiro en-aut-sei=Iwata en-aut-mei=Naohiro kn-aut-name=娾揷捈戝 kn-aut-sei=娾揷 kn-aut-mei=捈戝 aut-affil-num=3 ORCID= en-aut-name=OroMasafumi en-aut-sei=Oro en-aut-mei=Masafumi kn-aut-name=戝楥恀巎 kn-aut-sei=戝楥 kn-aut-mei=恀巎 aut-affil-num=4 ORCID= en-aut-name=KitakazeChikako en-aut-sei=Kitakaze en-aut-mei=Chikako kn-aut-name=杒晽抭壚巕 kn-aut-sei=杒晽 kn-aut-mei=抭壚巕 aut-affil-num=5 ORCID= en-aut-name=HirotaAyuko en-aut-sei=Hirota en-aut-mei=Ayuko kn-aut-name=淎揷偁備巕 kn-aut-sei=淎揷 kn-aut-mei=偁備巕 aut-affil-num=6 ORCID= en-aut-name=MakinoKatsuhiko en-aut-sei=Makino en-aut-mei=Katsuhiko kn-aut-name=隊栰崕旻 kn-aut-sei=隊栰 kn-aut-mei=崕旻 aut-affil-num=7 ORCID= en-aut-name=TatenoTomoyuki en-aut-sei=Tateno en-aut-mei=Tomoyuki kn-aut-name=棫栰朁巙 kn-aut-sei=棫栰 kn-aut-mei=朁巙 aut-affil-num=8 ORCID= en-aut-name=TeraiRyohei en-aut-sei=Terai en-aut-mei=Ryohei kn-aut-name=帥堜棾暯 kn-aut-sei=帥堜 kn-aut-mei=棾暯 aut-affil-num=9 ORCID= en-aut-name=KenmotsuHideo en-aut-sei=Kenmotsu en-aut-mei=Hideo kn-aut-name=娔暔塸抝 kn-aut-sei=娔暔 kn-aut-mei=塸抝 aut-affil-num=10 ORCID= en-aut-name=DateMotohide en-aut-sei=Date en-aut-mei=Motohide kn-aut-name=埳払尦塸 kn-aut-sei=埳払 kn-aut-mei=尦塸 aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil=壀嶳戝妛妛弍尋媶堾堛帟栻妛堟 affil-num=2 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=3 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=4 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=5 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=6 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=7 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=8 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=9 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=10 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 affil-num=11 en-affil=Okayama Pharmaceutical Association kn-affil=壀嶳導栻嵻巘夛 en-keyword=community pharmacists kn-keyword=community pharmacists en-keyword=questionnaire survey kn-keyword=questionnaire survey en-keyword=research kn-keyword=research en-keyword=academic conference presentation kn-keyword=academic conference presentation en-keyword=article publication kn-keyword=article publication END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=3 article-no= start-page=263 end-page=272 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202306 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Early Fluid Balance Is Associated with 90-Day Mortality in Patients Receiving Continuous Renal Replacement Therapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Continuous renal replacement therapy (CRRT) is widely used to control fluid balance, but the optimal fluid balance to improve the prognosis of patients remains debated. Appropriate fluid management may depend on hemodynamic status. We investigated the association between 90-day mortality and fluid balance/mean arterial pressure (MAP) in patients receiving CRRT. This single-center retrospective study was conducted between May 2018 and March 2021. Based on the cumulative fluid balance at 72 h after initiation of CRRT, the cases were divided into negative (< 0 mL) and positive (> 0 mL) fluid balance groups. Ninety-day mortality was higher in the positive fluid balance group (p=0.009). At 4 h before and after CRRT initiation, the mean MAP was lower in the positive fluid balance group (p<0.05). After multivariate cox adjustment, 72-h positive fluid balance was independently associated with 90-day mortality (p=0.004). In addition, the cumulative fluid balance was associated with 90-day mortality (p<0.05) in cases without shock, high APACHE II score, sepsis, dialysis dependence, or vasopressor use. A 72-h positive fluid balance was associated with 90-day mortality in patients receiving CRRT. en-copyright= kn-copyright= en-aut-name=GuoYusheng en-aut-sei=Guo en-aut-mei=Yusheng kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KosakaJunko en-aut-sei=Kosaka en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=fluid management kn-keyword=fluid management en-keyword=continuous renal replacement therapy kn-keyword=continuous renal replacement therapy en-keyword=mortality kn-keyword=mortality en-keyword=mean arterial pressure kn-keyword=mean arterial pressure en-keyword=daily cumulative fluid balance kn-keyword=daily cumulative fluid balance END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=1 article-no= start-page=5433 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230403 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of frailty on long-term mortality in older patients receiving intensive care via the emergency department en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of this study was to evaluate whether frailty was associated with 6-month mortality in older adults who were admitted to the intensive care unit (ICU) with an illness requiring emergency care. The investigation was a prospective, multi-center, observational study conducted among the ICUs of 17 participating hospitals. Patients >= 65 years of age who were admitted to the ICU directly from an emergency department visit were assessed to determine their baseline Clinical Frailty Scale (CFS) scores before the illness and were surveyed 6 months after admission. Among 650 patients included in the study, the median age was 79 years old, and overall mortality at 6 months was as low as 21%, ranging from 6.2% in patients with CFS 1 to 42.9% in patients with CFS >= 7. When adjusted for potential confounders, CFS score was an independent prognostic factor for mortality (one-point increase in CFS, adjusted risk ratio with 95% confidence interval 1.19 [1.09-1.30]). Quality of life 6 months after admission worsened as baseline CFS score increased. However, there was no association between total hospitalization cost and baseline CFS. CFS is an important predictor of long-term outcomes among critically ill older patients requiring emergent admission. en-copyright= kn-copyright= en-aut-name=InabaMototaka en-aut-sei=Inaba en-aut-mei=Mototaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakamichiChikaaki en-aut-sei=Nakamichi en-aut-mei=Chikaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MaeyamaHiroki en-aut-sei=Maeyama en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IshikawaHideki en-aut-sei=Ishikawa en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ShimeNobuaki en-aut-sei=Shime en-aut-mei=Nobuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UemoriSadayori en-aut-sei=Uemori en-aut-mei=Sadayori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IshiharaSatoshi en-aut-sei=Ishihara en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TakaokaMakoto en-aut-sei=Takaoka en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OhtsukaTsuyoshi en-aut-sei=Ohtsuka en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HaradaMasahiro en-aut-sei=Harada en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NozakiSatoshi en-aut-sei=Nozaki en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KohamaKeisuke en-aut-sei=Kohama en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SakuraiRyota en-aut-sei=Sakurai en-aut-mei=Ryota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=SatoShuho en-aut-sei=Sato en-aut-mei=Shuho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MuramatsuShun en-aut-sei=Muramatsu en-aut-mei=Shun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YamashitaKazunori en-aut-sei=Yamashita en-aut-mei=Kazunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=MayumiToshihiko en-aut-sei=Mayumi en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=AitaKaoruko en-aut-sei=Aita en-aut-mei=Kaoruko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=the LIFE Study Investigators en-aut-sei=the LIFE Study Investigators en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Advanced Emergency and Critical Care Center, National Hospital Organization, Nagasaki Medical Center kn-affil= affil-num=5 en-affil=Emergency and Critical Care Center, Tsuyama Chuo Hospital kn-affil= affil-num=6 en-affil=Trauma and Resuscitation Center, Teikyo University Hospital kn-affil= affil-num=7 en-affil=Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University kn-affil= affil-num=8 en-affil=Department of Emergency, Yodogawa Christian Hospital kn-affil= affil-num=9 en-affil=Department of Emergency and Critical Care, Hyogo Emergency Medical Center kn-affil= affil-num=10 en-affil=Acute Care Division, Harima-Himeji General Medical Center kn-affil= affil-num=11 en-affil=Emergency Department, National Hospital Organization Yokohama Medical Center kn-affil= affil-num=12 en-affil=Department of Emergency and Critical Care, National Hospital Organization Kumamoto Medical Center kn-affil= affil-num=13 en-affil=Emergency Department, Okayama Saiseikai General Hospital kn-affil= affil-num=14 en-affil=Department of Emergency, Disaster, and Critical Care Medicine, Hyogo College of Medicine kn-affil= affil-num=15 en-affil=Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University kn-affil= affil-num=16 en-affil=Emergency Medical Center, Saiseikai Senri Hospital kn-affil= affil-num=17 en-affil=Emergency Department, Japanese Red Cross Medical Center kn-affil= affil-num=18 en-affil=Acute and Critical Care Center, Nagasaki University Hospital kn-affil= affil-num=19 en-affil=Department of Emergency Medicine, University of Occupational and Environmental Health Hospital kn-affil= affil-num=20 en-affil=Uehiro Division, Center for Death and Life Studies and Practical Ethics, Graduate School of Humanities and Sociology, University of Tokyo kn-affil= affil-num=21 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=22 en-affil= kn-affil= END start-ver=1.4 cd-journal=joma no-vol=28 cd-vols= no-issue=5 article-no= start-page=1060 end-page=1067 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230908 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The stability of repaired meniscal root can affect postoperative cartilage status following medial meniscus posterior root repair en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Transtibial pullout repair yields beneficial clinical outcomes in patients with medial meniscus (MM) posterior root tear. However, the relationship between repaired meniscal root healing status and postoperative clinical outcomes remains unclear. We aimed to evaluate changes in articular cartilage damage and clinical scores after pullout repair using two simple stitches (TSS).

Methods
Thirty-three patients who underwent pullout repair using TSS were assessed. Healing status was assessed by a semi-quantitative second-look arthroscopic scoring system comprising three evaluation criteria (width of bridging tissues, stability of the repaired root, and synovial coverage), 1 year postoperatively. MM medial extrusion (MMME) and cartilage damage were assessed preoperatively and 1 year postoperatively. The medial compartment was divided into 8 zones (A-H) for comparison of preoperative and 1-year postoperative cartilage damage. Clinical outcomes were evaluated using the Knee Injury and Osteoarthritis Outcome score, Lysholm score, International Knee Documentation Committee scores, and visual analogue scale pain score.

Results
Although cartilage damage did not aggravate significantly in most medial compartment areas, MMME progressed at 1 year postoperatively. No statistical differences were observed in cartilage damage between the central-to-medial area of the medial femoral condyle and the medial tibial plateau area at 1 year postoperatively. Regarding semi-quantitative healing scores, the stability score was significantly correlated with the International Cartilage Repair Society grade at 1 year postoperatively. All 1-year and 2-year clinical scores significantly improved compared with the preoperative scores.

Conclusion
Regarding TSS repair, stability of repaired meniscal root negatively correlated with cartilage damage in the medial compartment loading area. All 1-year and 2-year clinical scores significantly improved than those of the preoperative scores. Achieving MM stability is crucial for suppressing cartilage degeneration.

Level of evidence
IV case series study. en-copyright= kn-copyright= en-aut-name=ZhangXiming en-aut-sei=Zhang en-aut-mei=Ximing kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=XueHaowei en-aut-sei=Xue en-aut-mei=Haowei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KintakaKeisuke en-aut-sei=Kintaka en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MiyazawaShinichi en-aut-sei=Miyazawa en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=2 article-no= start-page=193 end-page=197 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202304 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Validity of the 30-Second Chair-Stand Test to Assess Exercise Tolerance and Clinical Outcomes in Patients with Esophageal Cancer: A Retrospective Study with Reference to 6-Minute Walk Test Results en-subtitle= kn-subtitle= en-abstract= kn-abstract=This retrospective study aimed to investigate the validity of a 30-sec chair stand test (CS-30) as a simple test to assess exercise tolerance and clinical outcomes in 53 Japanese patients with esophageal cancer. There was a strong correlation between the results of CS-30 and the 6-min walk test (6MWT), the gold standard for assessing exercise tolerance (r=0.759). Furthermore, fewer patients whose CS-30 score was greater than 16 (the cutoff value defined based on 6MWT) experienced pneumonia in their postoperative course. These results suggest that exercise tolerance could be assessed using CS-30, and its cutoff value may be useful in predicting postoperative pneumonia risk. en-copyright= kn-copyright= en-aut-name=IkedaTomohiro en-aut-sei=Ikeda en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkuraKazuki en-aut-sei=Okura en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KatayamaSho en-aut-sei=Katayama en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakahashiYusuke en-aut-sei=Takahashi en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MaedaNaoaki en-aut-sei=Maeda en-aut-mei=Naoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WakitaAkiyuki en-aut-sei=Wakita en-aut-mei=Akiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SendaMasuo en-aut-sei=Senda en-aut-mei=Masuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Rehabilitation Medicine, Okayama University kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Division of Rehabilitation, Akita University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Rehabilitation Medicine, Okayama University kn-affil= affil-num=5 en-affil=Division of Rehabilitation, Akita University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Esophageal Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Rehabilitation Medicine, Okayama University kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Rehabilitation Medicine, Okayama University kn-affil= en-keyword=esophageal cancer kn-keyword=esophageal cancer en-keyword=exercise tolerance kn-keyword=exercise tolerance en-keyword=rehabilitation kn-keyword=rehabilitation END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230327 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prevalence of transthyretin amyloidosis among heart failure patients with preserved ejection fraction in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims Heart failure with preserved ejection fraction (HFpEF), which is caused by wide various conditions, has become a major public health problem. Transthyretin amyloid cardiomyopathy (ATTR-CM), which is thought to be an underdiagnosed disease, can cause HFpEF. Non-invasive diagnosis using 99mTechnetium (Tc)-pyrophosphate (PYP) scintigraphy enables accurate diagnosis of ATTR-CM. The aim of this study was to clarify the prevalence and characteristics of ATTR-CM among Japanese patients with HFpEF.
Methods and results This study was a multicentre, prospective, observational study conducted in Japan. We enrolled 373 patients with HFpEF [left ventricular (LV) ejection fraction ?50%] aged ?65 years who were admitted to the department of cardiology from September 2018 to January 2022. A 99mTc-PYP scintigraphy scan was performed during admission in all eligible patients. Cardiac 99mTc-PYP retention was graded according to a previously reported visual scale ranging from 0 to 3 points. The scan was considered positive when it revealed moderate-to-severe 99mTc-PYP uptake (Grade 2?3) in both ventricles. Patients were divided into ATTR-CM and non-ATTR-CM patients according to positive (Grade 2?3) or negative (Grade 0?1) 99mTc-PYP scintigraphy, respectively. Medical history, blood tests, electrocardiogram, echocardiography, and magnetic resonance imaging in the two groups of patients were compared. Among the 373 patients with HFpEF, 53 patients (14.2%; 95% confidence interval: 10.7?17.7) showed positive uptake on 99mTc-PYP scintigraphy. An endomyocardial biopsy was performed in 32 patients and confirmed amyloidosis in all cases. There were no significant differences between the two groups in age, severity of heart failure as assessed by the New York Heart Association (NYHA) functional classification, renal function values, left ventricular ejection fraction, and tricuspid regurgitant pressure gradient (ATTR-CM, n = 53 vs. non-ATTR-CM, n = 320). Patients in the ATTR-CM group had a higher N-terminal pro-brain natriuretic peptide level [2314 (1081?3398) vs. 900 (415?1828), P < 0.001], higher sensitive troponin T level (0.074 亇 0.049 vs. 0.035 亇 0.038, P < 0.001), and higher mean LV maximal wall thickness [12.5 (11?14) vs. 10.5 (9.5?11.5), P < 0.001].
Conclusions ATTR-CM is an underdiagnosed disease with a significant prevalence in Japanese patients with HFpEF. This study showed that results of examinations for ATTR-CM patients appear to be worse than those for non-ATTR-CM patients, but clinical severities of heart failure as assessed by the NYHA functional classification are similar in ATTR-CM and non-ATTR-CM patients, and the clinical overlap between ATTR-CM and non-ATTR-CM is high. en-copyright= kn-copyright= en-aut-name=NaitoTakanori en-aut-sei=Naito en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakamuraKazufumi en-aut-sei=Nakamura en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AbeYukio en-aut-sei=Abe en-aut-mei=Yukio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeHiroyuki en-aut-sei=Watanabe en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SakuragiSatoru en-aut-sei=Sakuragi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KatayamaYusuke en-aut-sei=Katayama en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KiharaHajime en-aut-sei=Kihara en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OkizakiAtsutaka en-aut-sei=Okizaki en-aut-mei=Atsutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KawaiYusuke en-aut-sei=Kawai en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YoshikawaMasaki en-aut-sei=Yoshikawa en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TakaishiAtsushi en-aut-sei=Takaishi en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=FujioHideki en-aut-sei=Fujio en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OtsukaHiroaki en-aut-sei=Otsuka en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=OguraSoichiro en-aut-sei=Ogura en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ItoHiroshi en-aut-sei=Ito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=ATTR HFpEF Registry Investigators en-aut-sei=ATTR HFpEF Registry Investigators en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Cardiology, Osaka City General Hospital kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Tokyo Bay Urayasu Ichikawa Medical Center kn-affil= affil-num=5 en-affil=Department of Cardiovascular Medicine, National Hospital Organization Iwakuni Clinical Center kn-affil= affil-num=6 en-affil=Department of Cardiovascular Medicine, National Hospital Organization Iwakuni Clinical Center kn-affil= affil-num=7 en-affil=Department of Internal Medicine, Kihara Cardiovascular Clinic kn-affil= affil-num=8 en-affil=Department of Radiology, Asahikawa Medical University kn-affil= affil-num=9 en-affil=Department of Cardiovascular Medicine, Okayama City Hospital kn-affil= affil-num=10 en-affil=Department of Cardiovascular Medicine, Fukuyama City Hospital kn-affil= affil-num=11 en-affil=Department of Cardiology, Mitoyo General Hospital kn-affil= affil-num=12 en-affil=Department of Cardiovascular Medicine, Japanese Red Cross Society Himeji Hospital kn-affil= affil-num=13 en-affil=Department of Cardiovascular Medicine, National Hospital Organization Iwakuni Clinical Center kn-affil= affil-num=14 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil= kn-affil= en-keyword=Transthyretin amyloidosis kn-keyword=Transthyretin amyloidosis en-keyword=Heart failure kn-keyword=Heart failure en-keyword=Scintigraphy kn-keyword=Scintigraphy en-keyword=Left ventricular hypertrophy kn-keyword=Left ventricular hypertrophy END start-ver=1.4 cd-journal=joma no-vol=134 cd-vols= no-issue=1 article-no= start-page=22 end-page=27 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Developing a scale to measure nurses' difficulty related to the treatment of gender dysphoric patients kn-title=娕岇巘偺惈暿堘榓傊偺娭傢傝偵偔偝偵偮偄偰偺広搙嶌惉 en-subtitle= kn-subtitle= en-abstract= kn-abstract=丂This study aimed to develop a scale to measure the perceived difficulty experienced by nurses in treating and caring for patients diagnosed with gender dysphoria and examine its reliability and validity. We developed a 26-item preliminary scale through discussions with experts in gender dysphoria treatment. We administered a questionnaire including this scale to 1,010 nurses working at Okayama University Hospital and analyzed the data of 346 nurses who had been involved in the treatment of gender dysphoria and had no missing responses.
丂A total of 20 items consisting of two factors, 乬relationship building乭 and 乬negative emotion for gender dysphoria,乭 were extracted by exploratory factor analysis, and we used them in the final version of the scale. Cronbach's alpha coefficient for the entire scale was 0.879, indicating a high degree of internal consistency.
丂However, the correlations with a communication skills scale (ENDCOREs) and the Scale of Gender Conception were limited, and the external validity could not be proven. This scale may be useful for evaluating nursing practice and educational support for nurses; however, there is room for further study on the scale validation. en-copyright= kn-copyright= en-aut-name=MiyakeMaki en-aut-sei=Miyake en-aut-mei=Maki kn-aut-name=嶰戭杻婓 kn-aut-sei=嶰戭 kn-aut-mei=杻婓 aut-affil-num=1 ORCID= en-aut-name=OshimaYoshitaka en-aut-sei=Oshima en-aut-mei=Yoshitaka kn-aut-name=戝搰媊岶 kn-aut-sei=戝搰 kn-aut-mei=媊岶 aut-affil-num=2 ORCID= en-aut-name=NambaShihoko en-aut-sei=Namba en-aut-mei=Shihoko kn-aut-name=擄攇巙曚巕 kn-aut-sei=擄攇 kn-aut-mei=巙曚巕 aut-affil-num=3 ORCID= en-aut-name=MatsumotoYosuke en-aut-sei=Matsumoto en-aut-mei=Yosuke kn-aut-name=徏杮梞曘 kn-aut-sei=徏杮 kn-aut-mei=梞曘 aut-affil-num=4 ORCID= en-aut-name=HoriuchiMakiko en-aut-sei=Horiuchi en-aut-mei=Makiko kn-aut-name=杧撪恀婓巕 kn-aut-sei=杧撪 kn-aut-mei=恀婓巕 aut-affil-num=5 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name=嶳揷椆巑 kn-aut-sei=嶳揷 kn-aut-mei=椆巑 aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Nursing, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂娕岇晹 affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂惛恄壢恄宱壢 affil-num=3 en-affil=Department of Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂怴堛椕尋媶奐敪僙儞僞乕 affil-num=4 en-affil=Department of Gender Center, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂僕僃儞僟乕僙儞僞乕 affil-num=5 en-affil=Department of Medical Support, Clinical Psychology section, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂堛椕媄弍晹丂椪彴怱棟晹栧 affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=壀嶳戝妛妛弍尋媶堾堛帟栻妛堟丂惛恄恄宱昦懺妛 en-keyword=惈暿堘榓 (gender dysphoria) kn-keyword=惈暿堘榓 (gender dysphoria) en-keyword=娭傢傝偵偔偝 (difficulty in relating) kn-keyword=娭傢傝偵偔偝 (difficulty in relating) en-keyword=僐儈儏僯働乕僔儑儞 (communication) kn-keyword=僐儈儏僯働乕僔儑儞 (communication) en-keyword=惈嵎娤 (gender conception) kn-keyword=惈嵎娤 (gender conception) END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=3 article-no= start-page=2926 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Expression of Acetabular Labral Vascular Endothelial Growth Factor and Nerve Growth Factor Is Directly Associated with Hip Osteoarthritis Pain: Investigation by Immunohistochemical Staining en-subtitle= kn-subtitle= en-abstract= kn-abstract=The acetabular labrum enhances hip joint stability and plays a key role in osteoarthritis (OA) progression. Labral nerve endings contribute to hip OA pain. Moreover, vascular endothelial growth factor (VEGF) and nerve growth factor (NGF) are associated with pain. Consequently, we analysed VEGF and NGF expression levels in the labrum and their roles in OA. Labra obtained from OA patients were stained immunohistochemically, and labral cells were cultured and subjected to a reverse transcription (RT)-polymerase chain reaction (PCR) to analyse VEGF and NGF mRNA expression. VEGF and NGF expression were compared in each region of the labrum. Correlations between VEGF and NGF expression and age, body mass index, Kellgren-Lawrence grade, Harris Hip Score, the visual analogue scale (VAS), and Krenn score were analysed, and the RT-PCR confirmed the findings. VEGF and NGF expression were high on the labral articular side, negatively correlated with the Krenn score, and positively correlated with the VAS in early OA. VEGF and NGF mRNA expression increased significantly in patients with severe pain and decreased significantly in severely degenerated labra. In early OA, VEGF and NGF expression in the acetabular labrum was associated with the occurrence of hip pain; therefore, these factors could be effective targets for pain management. en-copyright= kn-copyright= en-aut-name=SatoYoshihiro en-aut-sei=Sato en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TetsunagaTomonori en-aut-sei=Tetsunaga en-aut-mei=Tomonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamadaKazuki en-aut-sei=Yamada en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KawamuraYoshi en-aut-sei=Kawamura en-aut-mei=Yoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshidaAki en-aut-sei=Yoshida en-aut-mei=Aki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Intelligent Orthopaedic System, Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Medical Materials for Musculoskeletal Reconstruction, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=hip osteoarthritis (OA) kn-keyword=hip osteoarthritis (OA) en-keyword=acetabular labrum kn-keyword=acetabular labrum en-keyword=vascular endothelial growth factor (VEGF) kn-keyword=vascular endothelial growth factor (VEGF) en-keyword=nerve growth factor (NGF) kn-keyword=nerve growth factor (NGF) en-keyword=immunochemical staining kn-keyword=immunochemical staining END start-ver=1.4 cd-journal=joma no-vol=8 cd-vols= no-issue= article-no= start-page=4826 end-page=4834 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230125 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Detection of Membrane Potential-Dependent Rhodopsin Fluorescence Using Low-Intensity Light Emitting Diode for Long-Term Imaging en-subtitle= kn-subtitle= en-abstract= kn-abstract=Microbial rhodopsin is a family of photoreceptive membrane proteins that commonly consist of a seven-transmembrane domain and a derivative of vitamin-A, retinal, as a chromophore. In 2011, archaeorhodopsin-3 (AR3) was shown to exhibit voltage-dependent fluorescence changes in mammalian cells. Since then, AR3 and its variants have been used as genetically encoded voltage indicators, in which mostly intense laser stimulation (1-1000 W/cm(2)) is used for the detection of dim fluorescence of rhodopsin, leading to high spatiotemporal resolution. However, intense laser stimulation potentially causes serious cell damage, particularly during long-term imaging over minutes. In this study, we present the successful detection of voltage-sensitive fluorescence of AR3 and its high fluorescence mutant Archon1 in a variety of mammalian cell lines using low-intensity light emitting diode stimulation (0.15 W/cm2) with long exposure time (500 ms). The detection system enables real-time imaging of drug-induced slow changes in voltage within the cells for minutes harmlessly and without fluorescence bleaching. Therefore, we demonstrate a method to quantitatively understand the dynamics of slow changes in membrane voltage on long time scales. en-copyright= kn-copyright= en-aut-name=KawanishiShiho en-aut-sei=Kawanishi en-aut-mei=Shiho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KojimaKeiichi en-aut-sei=Kojima en-aut-mei=Keiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShibukawaAtsushi en-aut-sei=Shibukawa en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakamotoMasayuki en-aut-sei=Sakamoto en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SudoYuki en-aut-sei=Sudo en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Optical Neural and Molecular Physiology, Graduate School of Biostudies kn-affil= affil-num=5 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences and Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=23 cd-vols= no-issue=1 article-no= start-page=81 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Eleven years of data on the Jefferson Scale of Empathy - medical student version: Japanese norm data and tentative cutoff scores en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
More and more studies investigate medical students' empathy using the Jefferson Scale of Empathy (JSE). However, no norm data or cutoff scores of the JSE for Japanese medical students are available. This study therefore explored Japanese norm data and tentative cutoff scores for the Japanese translation of the JSE-medical student version (JSE-S) using 11 years of data obtained from matriculants from a medical school in Japan.

Methods
Participants were 1,216 students (836 men and 380 women) who matriculated at a medical school in Japan from 2011 to 2021. The JSE-S questionnaire was administered to participants prior to the start of the program. Data were summarized using descriptive statistics and statistical tests were performed to show the norm data and tentative cutoff scores for male and female students separately.

Results
The score distributions of the JSE-S were moderately skewed and leptokurtic for the entire sample, with indices -0.75 and 4.78, respectively. The mean score (standard deviation) for all participants was 110.8 (11.8). Women had a significantly higher mean score (112.6) than men (110.0; p < 0.01). The effect size estimate of gender difference was 0.22, indicating a small effect size. The low and high cutoff scores for men were <= 91 and >= 126, respectively, and the corresponding scores for women were <= 97 and >= 128, respectively.

Conclusions
This study provides JSE-S norm data and tentative cutoff scores for Japanese medical school matriculants, which would be helpful in identifying those who may need further training to enhance their empathy. en-copyright= kn-copyright= en-aut-name=KataokaHitomi U. en-aut-sei=Kataoka en-aut-mei=Hitomi U. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokinobuAkiko en-aut-sei=Tokinobu en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=2 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=3 en-affil= Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=4 en-affil=Division of Kidney, Diabetes and Endocrine Diseases, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Norm data kn-keyword=Norm data en-keyword=Cutoff scores kn-keyword=Cutoff scores en-keyword=Medical students kn-keyword=Medical students en-keyword=Empathy kn-keyword=Empathy END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=19 article-no= start-page=12523 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of Yoga and Mindfulness Programs on Self-Compassion in Medical Professionals during the COVID-19 Pandemic: An Intervention Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Stress among healthcare workers (HCWs) increased during the coronavirus disease 2019 pandemic. We aimed to determine whether a yoga and mindfulness program could alleviate burnout and other psychological and physical distress in HCWs, and how this might affect their empathy for patients. A weekly one-hour yoga and mindfulness program was conducted for three months in 2021. Participants were 18 consenting HCWs and, the final analysis included 13 participants. They responded to online questionnaires before and after the program. We measured salivary cortisol levels before and after the program on the first and last days. Self-measured pulse rates (PRs) were taken before and after each session, which decreased significantly in both cases (before, after the first program: 72, 65 bpm, p < 0.05; before, after the last program: 75, 66, p < 0.05), but salivary cortisol levels did not change. No significant changes were observed in Patient Health Questionnaire-9, Maslach Burnout Inventory, Sense of Coherence, Connor-Davidson Resilience Scale, Self-compassion Scale, or Jefferson Scale of Empathy. However, common humanity, a subscale of self-compassion, increased significantly (before the first program: 5.6, after the last program: 6.5, p < 0.05), and over-identification decreased significantly (7.9, 6.7, p < 0.01). Yoga and mindfulness programs may help improve the sense of common humanity and reduce over-identification in HCWs. en-copyright= kn-copyright= en-aut-name=MiyoshiTomoko en-aut-sei=Miyoshi en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IdaHiromi en-aut-sei=Ida en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishimuraYoshito en-aut-sei=Nishimura en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AkoSoichiro en-aut-sei=Ako en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=stress kn-keyword=stress en-keyword=burnout kn-keyword=burnout en-keyword=yoga kn-keyword=yoga en-keyword=mindfulness kn-keyword=mindfulness en-keyword=stress in healthcare workers kn-keyword=stress in healthcare workers en-keyword=self-compassion kn-keyword=self-compassion en-keyword=the COVID-19 pandemic kn-keyword=the COVID-19 pandemic END start-ver=1.4 cd-journal=joma no-vol=101 cd-vols= no-issue=39 article-no= start-page=e30802 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Factors influencing caregiver burden in chronic pain patients: A retrospective study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Chronic pain coexists with disability, anxiety, depression, and sleep disturbances, which are factors of pain chronicity in the fear-avoidance model. Self-efficacy for managing pain plays a protective role against pain chronicity. For chronic pain sufferers, social support from caregivers is important. However, such caregivers face enormous physical and mental burdens. This study aimed to assess how self-efficacy and factors related to the fear-avoidance model affect caregiver burden. Participants were 135 chronic pain patients and their caregivers who visited our outpatient pain special clinic. In clinical assessments, numeric rating scale (NRS), pain catastrophizing scale (PCS), hospital anxiety and depression scale (HADS), Athens insomnia scale (AIS), pain disability assessment scale (PDAS), pain self-efficacy questionnaire (PSEQ) for the patients and Zarit Burden Interview (ZBI) for their caregivers were evaluated. Participants were divided into 2 groups (L group ZBI < 24 points and H group ZBI >= 24 points) and compared. Regression analyses were conducted to identify factors correlated with the ZBI scores. Compared to L group, H group showed significantly higher NRS and HADs depression scores, and lower PSEQ scores. In univariate regression analysis, ZBI scores were significantly correlated with NRS, PCS, HADS anxiety, HADS depression, PDAS and PSEQ. Multiple linear regression analysis revealed that ZBI scores were significantly correlated with PSEQ. The caregivers who perceived high caregiver burden had significantly higher patients' pain intensity, depression, and lower self-efficacy than those who perceived low caregiver burden. Caregiver burden correlated with the pain intensity, pain catastrophizing, anxiety, depression, disability, and self-efficacy of chronic pain patients. Among these factors, self-efficacy was the most negatively correlated with caregiver burden. Treatments focused on increasing self-efficacy for managing pain have the potential to reduce caregiver burden. en-copyright= kn-copyright= en-aut-name=TsujiHironori en-aut-sei=Tsuji en-aut-mei=Hironori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TetsunagaTomoko en-aut-sei=Tetsunaga en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TetsunagaTomonori en-aut-sei=Tetsunaga en-aut-mei=Tomonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MisawaHaruo en-aut-sei=Misawa en-aut-mei=Haruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OdaYoshiaki en-aut-sei=Oda en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakaoShinichiro en-aut-sei=Takao en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= Department of Orthopedic Surgery, Okayama Red Cross Hospital kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=caregiver burden kn-keyword=caregiver burden en-keyword=chronic pain kn-keyword=chronic pain en-keyword=fear-avoidance model kn-keyword=fear-avoidance model en-keyword=self-efficacy kn-keyword=self-efficacy en-keyword=Zarit Burden Interview kn-keyword=Zarit Burden Interview END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=9 article-no= start-page=1392 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220827 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effectiveness of Cement Augmentation on Early Postoperative Mobility in Patients Treated for Trochanteric Fractures with Cephalomedullary Nailing: A Prospective Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Fixation using cephalomedullary nails (CMNs) with additional cement augmentation (CA) was developed as a novel treatment option for the osteosynthesis of osteoporotic trochanteric fractures, though the effectiveness of CA on early postoperative mobility remains uncertain. This multicenter prospective cohort study aimed to estimate the effectiveness of CA on early postoperative mobility in patients with trochanteric fractures. We enrolled patients with femoral trochanteric fractures aged >60 years who were able to walk independently before the injury. The primary outcome was the postoperative 3-day cumulated ambulation score (CAS); the secondary outcome was the visual analog scale (VAS) pain score at rest and during movement on postoperative days 1-3. The outcomes of the patients treated using CMNs with or without CA were compared. Sixty-three eligible patients were categorized into CA (n = 32) and control (n = 31) groups. In univariate analysis, the CA group had significantly higher CAS values, lower VAS scores at rest on day 1 postoperatively, and lower VAS scores during movement on day 3. In multivariable linear regression analyses, the CA group had significantly higher CAS values (beta, 2.1; 95% confidence interval, 0.5 to 3.6; p = 0.01). The CA group had a negative adjusted beta value in their VAS scores during movement. This study indicated that CA was associated with a high CAS value in patients with geriatric trochanteric fractures. However, CA was not associated with pain reduction at rest and during movement during the initial postoperative days. en-copyright= kn-copyright= en-aut-name=MochizukiYusuke en-aut-sei=Mochizuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoNorio en-aut-sei=Yamamoto en-aut-mei=Norio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiTatsuya en-aut-sei=Fujii en-aut-mei=Tatsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TomitaYosuke en-aut-sei=Tomita en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Kaneda Hospital kn-affil= affil-num=2 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Matsue Hospital kn-affil= affil-num=4 en-affil=Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare kn-affil= en-keyword=cement augmentation kn-keyword=cement augmentation en-keyword=trochanteric fracture kn-keyword=trochanteric fracture en-keyword=intertrochanteric fracture kn-keyword=intertrochanteric fracture en-keyword=hip fracture kn-keyword=hip fracture en-keyword=proximal femoral fracture kn-keyword=proximal femoral fracture en-keyword=cumulated ambulation score kn-keyword=cumulated ambulation score en-keyword=mobility kn-keyword=mobility en-keyword=ambulance kn-keyword=ambulance en-keyword=ADL kn-keyword=ADL en-keyword=pain kn-keyword=pain END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=4 article-no= start-page=439 end-page=446 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Social Capital and Post-traumatic Stress Disorder among Heavy Rainfall and Flood Victims in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study examined the relationship between cognitive/structural social capital and post-traumatic stress disorder (PTSD) among victims of heavy rain and flood. Participants were individuals aged?18 years affected by the July 2018 heavy rainfall in the cities of Kurashiki and Soja, Japan, and living in temporary housing. We distributed five copies of a questionnaire to 1,991 households and received responses from 1,927 individuals (907 men, 1,008 women, 12 respondents of unspecified sex) in 1,029 households (51.7%). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between high (vs. low) social capital and PTSD or other outcomes. After covariate adjustment, the odds of having PTSD were lower in participants with high cognitive social capital than those with low cognitive social capital (OR=0.346, 95%CI: 0.263-0.456). Elderly women with higher structural social capital tended to have lower PTSD odds than those with lower structural social capital (OR=0.671, 95%CI: 0.431-1.046). The opposite pattern was observed for elderly men (OR=1.315, 95%CI: 0.792-2.183). Cognitive social capital is a protective factor that may reduce PTSD or promote a favorable PTSD prognosis after heavy rainfall and flood events. The associations between structural social capital and PTSD differ by age and sex. en-copyright= kn-copyright= en-aut-name=MiyajiChikara en-aut-sei=Miyaji en-aut-mei=Chikara kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NoguchiMasayuki en-aut-sei=Noguchi en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkazakiTsubasa en-aut-sei=Okazaki en-aut-mei=Tsubasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SatoShunsuke en-aut-sei=Sato en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Okayama Prefectural Mental Health and Welfare Center kn-affil= affil-num=4 en-affil=Okayama Prefectural Mental Health and Welfare Center kn-affil= affil-num=5 en-affil=Okayama Prefectural Mental Health and Welfare Center kn-affil= affil-num=6 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=social capital kn-keyword=social capital en-keyword=post-traumatic stress disorder kn-keyword=post-traumatic stress disorder en-keyword=disaster kn-keyword=disaster en-keyword=flooding kn-keyword=flooding END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=4 article-no= start-page=391 end-page=398 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of Tanden Breathing on Constipation: A Randomized Controlled Trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Tanden breathing, an ancient health technique, involves expiratory abdominal pressure breathing is practiced in Japan. In this study we examined the ability of Tanden breathing to relieve constipation. The study was designed as a stratified-block randomized controlled trial enrolling 20 participants. Nineteen were female and one was male, none were elderly. During the 6-week intervention period, the participants performed video-guided Tanden breathing about 10 min once day. We evaluated constipation using the Constipation Assessment Scale (CAS). There were significant differences in the mean CAS score between time points (baseline, 3 weeks after baseline, 6 weeks after baseline), groups (intervention and control), and their interaction (time亊group) using repeated-measures analysis of variance. The control group showed no change in the mean CAS score; the mean CAS scores of the intervention group changed from 7.2 at baseline to 3.9 at 3 weeks and 3.1 at 6 weeks after baseline. A regression analysis of the difference in the mean CAS between baseline and 6 weeks later showed that the CAS of the intervention group was 4.3 points lower than that of the control group (95% confidence interval, 2.5-6.1). The results suggested that Tanden breathing is effective in relieving constipation among young women. en-copyright= kn-copyright= en-aut-name=HabuHiroshi en-aut-sei=Habu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TokinobuAkiko en-aut-sei=Tokinobu en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Tanden breathing kn-keyword=Tanden breathing en-keyword=Dantian kn-keyword=Dantian en-keyword=breathing exercises kn-keyword=breathing exercises en-keyword=constipation kn-keyword=constipation en-keyword=mind?body therapy kn-keyword=mind?body therapy END start-ver=1.4 cd-journal=joma no-vol=30 cd-vols= no-issue=2 article-no= start-page=10225536221117903 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220807 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose We investigated objective and patient-reported outcomes after resection arthroplasty or shortening oblique osteotomy (SOO) of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal (MTP) joint for severe rheumatoid forefoot deformities. Methods 17 feet from 14 women (mean age, 67.8 years) underwent resection arthroplasty of the lesser metatarsal heads (MTH resection group), while 13 feet from nine women and two men (mean age, 68.7 years) underwent SOO of the lesser metatarsals (MTH preservation group). Arthrodesis of the first MTP joint was performed in all cases. Mean follow-up in the MTH resection and preservation groups was 25.0 and 21.3 months, respectively. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q) scores. Results Mean total JSSF scale significantly improved from 53.4 to 76.4 in the MTH resection group (p < .001) and from 50.1 to 74.2 in the MTH preservation group (p = .002). Pain and pain-related and shoe-related SAFE-Q subscale scores significantly improved after surgery in both groups. In the MTH resection group, recurrence of painful callosities and claw toe deformity was observed in four and three feet, respectively. In the MTH preservation group, one patient experienced recurrence of painful callosities and one underwent revision surgery for IP joint dislocation. Conclusion Resection arthroplasty or SOO of the lesser metatarsals combined with arthrodesis of the first MTP joint achieved significant improvement with respect to pain relief, deformity correction, and footwear comfort. en-copyright= kn-copyright= en-aut-name=HoritaMasahiro en-aut-sei=Horita en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NasuYoshihisa en-aut-sei=Nasu en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SaigaKenta en-aut-sei=Saiga en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=forefoot surgery kn-keyword=forefoot surgery en-keyword=arthrodesis kn-keyword=arthrodesis en-keyword=shortening oblique osteotomy kn-keyword=shortening oblique osteotomy en-keyword=patient-reported outcome kn-keyword=patient-reported outcome en-keyword=rheumatoid arthritis kn-keyword=rheumatoid arthritis END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220707 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Arthroscopic Meniscal Healing following Medial Meniscus Posterior Root Repair: A Comparison between Two Suture Materials en-subtitle= kn-subtitle= en-abstract= kn-abstract=Recently, transtibial pullout repair of the medial meniscus (MM) posterior root tear (PRT) has become widely accepted and provides satisfactory clinical outcomes. Widening after cyclic loading or ultimate failure load using different suture materials and configurations has been studied. However, no study has compared the clinical outcomes using different suture materials. This study aimed to evaluate the clinical outcomes after performing MMPRT pullout repair using different suture materials. We hypothesized that better clinical outcomes would be achieved using ultra-high molecular weight polyethylene (UHMWPE) tape compared with a normal polyester suture. Thirty-seven patients who underwent MM posterior root repair between November 2019 and May 2020 were retrospectively investigated. Pullout repair was performed using a hollow no. 0 polyester suture (n?=?14) and UHMWPE tape (n?=?23). Clinical outcomes were assessed preoperatively and at 1 year postoperatively, using the Lysholm knee score, Knee Injury and Osteoarthritis Outcome Score, and visual analogue scale (VAS) pain score. The meniscal healing status was assessed using an arthroscopic scoring system (range: 0?10). All clinical scores were improved significantly in both groups. However, significantly higher meniscal healing scores and decreased VAS pain scores were observed in the UHMWPE group (7.3?亇?0.9 and 7.7?亇?11.3, respectively) than in the polyester group (5.6?亇?2.1 and 18.4?亇?18.6, respectively; p?<?0.01). Suture cut-out and loss of the root continuity were observed in some cases (three cases [21.4%] in the polyester suture group and one case [4.3%] in the UHMWPE tape group). Both suture materials led to satisfactory clinical outcomes at 1 year postoperatively, whereas the UHMWPE tape was useful for obtaining good meniscal healing and decreasing the VAS pain score. en-copyright= kn-copyright= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ZhangXiming en-aut-sei=Zhang en-aut-mei=Ximing kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KintakaKeisuke en-aut-sei=Kintaka en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HigashiharaNaohiro en-aut-sei=Higashihara en-aut-mei=Naohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TamuraMasanori en-aut-sei=Tamura en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KamatsukiYusuke en-aut-sei=Kamatsuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=clinical outcome kn-keyword=clinical outcome en-keyword=medial meniscus kn-keyword=medial meniscus en-keyword=meniscal healing kn-keyword=meniscal healing en-keyword=posterior root tear kn-keyword=posterior root tear en-keyword=suture material kn-keyword=suture material END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=1 article-no= start-page=98 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220408 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between timing of speech and language therapy initiation and outcomes among post-extubation dysphagia patients: a multicenter retrospective cohort study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Post-extubation dysphagia (PED) is recognized as a common complication in the intensive care unit (ICU). Speech and language therapy (SLT) can potentially help improve PED; however, the impact of the timing of SLT initiation on persistent PED has not been well investigated. This study aimed to examine the timing of SLT initiation and its effect on patient outcomes after extubation in the ICU. Methods We conducted this multicenter, retrospective, cohort study, collecting data from eight ICUs in Japan. Patients aged >= 20 years with orotracheal intubation and mechanical ventilation for longer than 48 h, and those who received SLT due to PED, defined as patients with modified water swallowing test scores of 3 or lower, were included. The primary outcome was dysphagia at hospital discharge, defined as functional oral intake scale score < 5 or death after extubation. Secondary outcomes included dysphagia or death at the seventh, 14th, or 28th day after extubation, aspiration pneumonia, and in-hospital mortality. Associations between the timing of SLT initiation and outcomes were determined using multivariable logistic regression. Results A total of 272 patients were included. Of them, 82 (30.1%) patients exhibited dysphagia or death at hospital discharge, and their time spans from extubation to SLT initiation were 1.0 days. The primary outcome revealed that every day of delay in SLT initiation post-extubation was associated with dysphagia or death at hospital discharge (adjusted odds ratio (AOR), 1.09; 95% CI, 1.02-1.18). Similarly, secondary outcomes showed associations between this per day delay in SLT initiation and dysphagia or death at the seventh day (AOR, 1.28; 95% CI, 1.05-1.55), 14th day (AOR, 1.34; 95% CI, 1.13-1.58), or 28th day (AOR, 1.21; 95% CI, 1.07-1.36) after extubation and occurrence of aspiration pneumonia (AOR, 1.09; 95% CI, 1.02-1.17), while per day delay in post-extubation SLT initiation did not affect in-hospital mortality (AOR, 1.04; 95% CI, 0.97-1.12). Conclusions Delayed initiation of SLT in PED patients was associated with persistent dysphagia or death. Early initiation of SLT may prevent this complication post-extubation. A randomized controlled study is needed to validate these results. en-copyright= kn-copyright= en-aut-name=HongoTakashi en-aut-sei=Hongo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoRyohei en-aut-sei=Yamamoto en-aut-mei=Ryohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=LiuKeibun en-aut-sei=Liu en-aut-mei=Keibun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YaguchiTakahiko en-aut-sei=Yaguchi en-aut-mei=Takahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=DoteHisashi en-aut-sei=Dote en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SaitoRyusuke en-aut-sei=Saito en-aut-mei=Ryusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MasuyamaTomoyuki en-aut-sei=Masuyama en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NakatsukaKosuke en-aut-sei=Nakatsuka en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=WatanabeShinichi en-aut-sei=Watanabe en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KanayaTakahiro en-aut-sei=Kanaya en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YamaguchiTomoya en-aut-sei=Yamaguchi en-aut-mei=Tomoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University kn-affil= affil-num=3 en-affil=Critical Care Research Group, Faculty of Medicine, University of Queensland, The Prince Charles Hospital kn-affil= affil-num=4 en-affil=Department of Intensive Care Medicine, Kameda Medical Center kn-affil= affil-num=5 en-affil=Department of Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital kn-affil= affil-num=6 en-affil=Department of Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital kn-affil= affil-num=7 en-affil= Department of Emergency, Misato Kenwa Hospital kn-affil= affil-num=8 en-affil=Department of Anesthesiology, Okayama Rosai Hospital kn-affil= affil-num=9 en-affil=Department of Rehabilitation, Nagoya Medical Center, NHO kn-affil= affil-num=10 en-affil=Department of Rehabilitation, Hokkaido Medical Center, NHO kn-affil= affil-num=11 en-affil=Division of Critical Care Medicine, Nara Prefecture General Medical Center kn-affil= affil-num=12 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Post-extubation dysphagia kn-keyword=Post-extubation dysphagia en-keyword=Speech and language therapy kn-keyword=Speech and language therapy en-keyword=Intensive care kn-keyword=Intensive care en-keyword=Dysphagia kn-keyword=Dysphagia en-keyword=Aspiration pneumonia kn-keyword=Aspiration pneumonia END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=2 article-no= start-page=195 end-page=202 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202204 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Safety and Effectiveness of Perospirone in Comparison to Risperidone for Treatment of Delirium in Patients with Advanced Cancer: A Multicenter Prospective Observational Study in Real-World Psycho-Oncology Settings en-subtitle= kn-subtitle= en-abstract= kn-abstract=The clinical benefit of perospirone for treatment of delirium in patients with advanced cancer is not sufficiently clear. The objective of this study was to compare the safety and effectiveness of perospirone to those of risperidone for the treatment of delirium in patients with advanced cancer. This is a secondary analysis of a multicenter prospective observational study in nine psycho-oncology consultation services in Japan. The study used the Delirium Rating Scale (DRS) Revised-98 to measure effectiveness and the CTCAE (Common Terminology Criteria for Adverse Events) version 4 to assess safety. Data from 16 patients who received perospirone and 53 patients who received risperidone were analyzed. The mean age was 70 years in the perospirone group and 73 years in the risperidone group. Both groups showed a significant decrease in the total score of DRS-R-98 after three days of treatment (perospirone: 11.7 (7.9-15.4) to 7.0 (3.3-10.7), difference ?4.7, effect size=0.72, p=0.003; risperidone: 15.5 (13.6-17.4) to 12.2 (10.1-14.2), difference ?3.3, effect size=0.55, p=0.00). The risperidone group showed significant improvements in sleep-wake cycle disturbance, orientation, attention, and visuospatial ability. In the perospirone group, there was a significant improvement of sleep-wake cycle disturbance. The median daily dose of perospirone was 4 mg/day. There were fewer episodes of somnolence as an adverse event in the perospirone group. Low-dose perospirone was thus found to be effective for the treatment of delirium in patients with advanced cancer and may be associated with fewer episodes of over-sedation as an adverse event. en-copyright= kn-copyright= en-aut-name=InoueShinichiro en-aut-sei=Inoue en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MaedaIsseki en-aut-sei=Maeda en-aut-mei=Isseki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OgawaAsao en-aut-sei=Ogawa en-aut-mei=Asao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshiuchiKazuhiro en-aut-sei=Yoshiuchi en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TeradaSeishi en-aut-sei=Terada en-aut-mei=Seishi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Palliative Care, Senri-Chuo Hospital kn-affil= affil-num=3 en-affil=Department of Psycho-Oncology Service, National Cancer Center Hospital East kn-affil= affil-num=4 en-affil=Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo kn-affil= affil-num=5 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=delirium kn-keyword=delirium en-keyword=cancer kn-keyword=cancer en-keyword=perospirone kn-keyword=perospirone en-keyword=risperidone kn-keyword=risperidone END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=2 article-no= start-page=187 end-page=193 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202204 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between the Remifentanil Dose during Anesthesia and Postoperative pain en-subtitle= kn-subtitle= en-abstract= kn-abstract=Remifentanil is an ultra-short-acting opioid that sometimes causes opioid-induced hyperalgesia, which has led to controversy regarding the association between intraoperative remifentanil administration and postoperative pain. This study aimed to assess the effects of the intraoperative remifentanil dose on postoperative pain. Patients undergoing esophageal, gastric/hepatobiliary, or intestinal/colon surgery and using postoperative patient-controlled epidural analgesia were analyzed. The patients were divided into two groups based on the average intraoperative remifentanil dose (high-dose remifentanil [HR] group: ?0.1 兪g/kg/min; low-dose remifentanil [LR] group: <0.1 兪g/kg/min). In all, 406 patients met the inclusion criteria. A significant difference in the average dose of remifentanil was seen between the groups during the anesthesia period (0.14亇0.05 vs. 0.07亇0.02 兪g/kg/min). However, no significant difference was seen in pre- or intraoperative patient characteristics. Numerical rating scale (NRS) scores on postoperative day 1 were similar between the groups (HR: 1.7亇2.0; LR: 1.7亇2.0; p=0.74). The incidence of poor pain control (NRS > 3/10) was also similar between the groups (HR: 14%; LR: 16%; p=0.57). Older age (> 60 years) and type of surgery (esophageal surgery) were associated with worse postoperative NRS scores. No significant association was seen between the intraoperative remifentanil dose and postoperative NRS scores following thoracoabdominal surgery with postoperative epidural pain management. en-copyright= kn-copyright= en-aut-name=RenWanxu en-aut-sei=Ren en-aut-mei=Wanxu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsusakiTakashi en-aut-sei=Matsusaki en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Abugri Osman Bright en-aut-sei=Abugri Osman Bright en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=high-dose remifentanil kn-keyword=high-dose remifentanil en-keyword=postoperative numerical rating scale kn-keyword=postoperative numerical rating scale en-keyword=type of surgery kn-keyword=type of surgery en-keyword=epidural block kn-keyword=epidural block END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=2 article-no= start-page=137 end-page=143 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202204 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Changes in Plasma Clozapine Levels after Smoking Cessation in Japanese Inpatients with Schizophrenia: A Retrospective Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although reported for Caucasians, changes in plasma clozapine levels after smoking cessation in East Asians remain unclear. We here investigated plasma clozapine levels before and after smoking cessation in Japanese inpatients with schizophrenia. We conducted a retrospective chart review of 14 inpatients with schizophrenia who were being treated with clozapine between June 1, 2019, and July 31, 2019 and who were smokers as of July 1, 2019, the day on which a smoking ban was instituted in the tertiary public psychiatric hospital. The primary outcome was individual differences in plasma clozapine levels between before and after the smoking ban, which were compared using paired t-tests. The mean plasma clozapine level was significantly increased, by 213.4 ng/mL (95% CI 119.9-306.8; p<0.01) or 53.2%. Four of the 14 inpatients experienced clinically significant side effects, such as myoclonus, drooling, and amnesia, due to the development of high plasma clozapine levels. Our findings indicated that close monitoring of plasma clozapine levels before and after smoking cessation and prior dose adjustment of clozapine may be necessary, to prevent a significant risk of developing high plasma clozapine levels, even in Japanese patients. en-copyright= kn-copyright= en-aut-name=TsukaharaMasaru en-aut-sei=Tsukahara en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SoRyuhei en-aut-sei=So en-aut-mei=Ryuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YadaYuji en-aut-sei=Yada en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KodamaMasafumi en-aut-sei=Kodama en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KishiYoshiki en-aut-sei=Kishi en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Psychiatry, Okayama Psychiatric Medical Center kn-affil= affil-num=2 en-affil=Department of Psychiatry, Okayama Psychiatric Medical Center kn-affil= affil-num=3 en-affil=Department of Psychiatry, Okayama Psychiatric Medical Center kn-affil= affil-num=4 en-affil=Department of Psychiatry, Okayama Psychiatric Medical Center kn-affil= affil-num=5 en-affil=Department of Psychiatry, Okayama Psychiatric Medical Center kn-affil= affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Asian kn-keyword=Asian en-keyword=clozapine kn-keyword=clozapine en-keyword=schizophrenia kn-keyword=schizophrenia en-keyword=smoking kn-keyword=smoking END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=2 article-no= start-page=146 end-page=154 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Development of Scaled-Up Synthetic Method for Retinoid X Receptor Agonist NEt-3IB Contributing to Sustainable Development Goals en-subtitle= kn-subtitle= en-abstract= kn-abstract=Abstract Small-molecular drugs, which are generally inexpensive compared with biopharmaceuticals and can often be taken orally, may contribute to the Sustainable Development Goals (SDGs) adopted by the United Nations. We previously reported the retinoid X receptor (RXR) agonist 4-(ethyl(3-isobutoxy-4-isopropylphenyl)amino)benzoic acid (NEt-3IB, 1) as a small-molecular drug candidate to replace biopharmaceuticals for the treatment of inflammatory bowel disease. The previous synthetic method to 1 required a large amount of organic solvent and extensive purification. In line with the SDGs, we aimed to develop an environmentally friendly, inexpensive method for the large-scale synthesis of 1. The developed method requires only a hydrophobic ether and EtOH as reaction and extraction solvents. The product was purified by recrystallization twice to afford 99% pure 1 at 100?mmol scale in about 30% yield. The optimized process showed a 35-fold improvement of the E-factor (an index of environmental impact) compared to the original method. This work, which changes the solvent used to environmentally preferable ones based on the existing synthetic method for 1, illustrates how synthetic methods for small-molecular drugs can be adapted and improved to contribute to the SDGs. en-copyright= kn-copyright= en-aut-name=TakamuraYuta en-aut-sei=Takamura en-aut-mei=Yuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MorishitaKen-ichi en-aut-sei=Morishita en-aut-mei=Ken-ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KikuzawaShota en-aut-sei=Kikuzawa en-aut-mei=Shota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMasaki en-aut-sei=Watanabe en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KakutaHiroki en-aut-sei=Kakuta en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Division of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Division of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Division of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Division of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Division of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=7 cd-vols= no-issue=2 article-no= start-page=111 end-page=119 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=2016127 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Thrombolysis with Low-Dose Tissue Plasminogen Activator 3?4.5?h After Acute Ischemic Stroke in Five Hospital Groups in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Clinical data from Japan on the safety and real-world outcomes of alteplase (tPA) thrombolysis in the extended therapeutic window are lacking. The aim of this study was to assess the safety and real-world outcomes of tPA administered within 3-4.5 h of stroke onset. The study comprised consecutive acute ischemic stroke patients (n = 177) admitted across five hospitals between September 2012 and August 2014. Patients received intravenous tPA within <3 or 3-4.5 h of stroke onset. Endovascular therapy was used for tPA-refractory patients. In the 3-4.5 h subgroup (31.6 % of patients), tPA was started 85 min later than the <3 h group (220 vs. 135 min, respectively). However, outcome measures were not significantly different between the <3 and 3-4.5 h subgroups for recanalization rate (67.8 vs. 57.1 %), symptomatic intracerebral hemorrhage (2.5 vs. 3.6 %), modified Rankin Scale score of 0-1 at 3 months (36.0 vs. 23.4 %), and mortality (6.9 vs. 8.3 %). We present data from 2005 to 2012 using a therapeutic window <3 h showing comparable results. tPA following endovascular therapy with recanalization might be superior to tPA only with recanalization (81.0 vs. 59.1 %). Compared with administration within 3 h of ischemic stroke onset, tPA administration within 3-4.5 h of ischemic stroke onset in real-world stroke emergency settings at multiple sites in Japan is as safe and has the same outcomes. en-copyright= kn-copyright= en-aut-name=MoriharaRyuta en-aut-sei=Morihara en-aut-mei=Ryuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KonoSyoichiro en-aut-sei=Kono en-aut-mei=Syoichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=DeguchiKentaro en-aut-sei=Deguchi en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ManabeYasuhiro en-aut-sei=Manabe en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TakaoYoshiki en-aut-sei=Takao en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KashiharaKenichi en-aut-sei=Kashihara en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=InoueSatoshi en-aut-sei=Inoue en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KiriyamaHideki en-aut-sei=Kiriyama en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil= kn-affil= affil-num=5 en-affil=epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=epartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Okayama National Hospital Medical Center kn-affil= affil-num=9 en-affil=Okayama National Hospital Medical Center kn-affil= affil-num=10 en-affil=Okayama National Hospital Medical Center kn-affil= affil-num=11 en-affil=Okayama National Hospital Medical Center kn-affil= affil-num=12 en-affil=Okayama National Hospital Medical Center kn-affil= affil-num=13 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Acute stroke kn-keyword=Acute stroke en-keyword=edaravone kn-keyword=edaravone en-keyword=endovascular treatment kn-keyword=endovascular treatment en-keyword=intracerebral hemorrhage kn-keyword=intracerebral hemorrhage en-keyword=recanalization kn-keyword=recanalization en-keyword=tissue-type plasminogen activator kn-keyword=tissue-type plasminogen activator END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=1 article-no= start-page=2185 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220209 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Current status of delirium assessment tools in the intensive care unit: a prospective multicenter observational survey en-subtitle= kn-subtitle= en-abstract= kn-abstract=Delirium is a critical challenge in the intensive care unit (ICU) or high care unit (HCU) setting and is associated with poor outcomes. There is not much literature on how many patients in this setting are assessed for delirium and what tools are used. This study investigated the status of delirium assessment tools of patients in the ICU/HCU. We conducted a multicenter prospective observational study among 20 institutions. Data for patients who were admitted to and discharged from the ICU/HCU during a 1-month study period were collected from each institution using a survey sheet. The primary outcome was the usage rate of delirium assessment tools on an institution- and patient-basis. Secondary outcomes were the delirium prevalence assessed by each institution's assessment tool, comparison of delirium prevalence between delirium assessment tools, delirium prevalence at the end of ICH/HCU stay, and the relationship between potential factors related to delirium and the development of delirium. Result showed that 95% of institutions used the Intensive Care Delirium Screening Checklist (ICDSC) or the Confusion Assessment Method for the ICU (CAM-ICU) to assess delirium in their ICU/HCU, and the remaining one used another assessment scale. The usage rate (at least once during the ICU/HCU stay) of the ICDSC and the CAM-ICU among individual patients were 64.5% and 25.1%, and only 8.2% of enrolled patients were not assessed by any delirium assessment tool. The prevalence of delirium during ICU/HCU stay was 17.9%, and the prevalence of delirium at the end of the ICU/HCU stay was 5.9%. In conclusion, all institutions used delirium assessment tools in the ICU/HCU, and most patients received delirium assessment. The prevalence of delirium was 17.9%, and two-thirds of patients had recovered at discharge from ICU/HCU. en-copyright= kn-copyright= en-aut-name=IshiiKenzo en-aut-sei=Ishii en-aut-mei=Kenzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KurodaKosuke en-aut-sei=Kuroda en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TokuraChika en-aut-sei=Tokura en-aut-mei=Chika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MichidaMasaaki en-aut-sei=Michida en-aut-mei=Masaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SugimotoKentaro en-aut-sei=Sugimoto en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SatoTetsufumi en-aut-sei=Sato en-aut-mei=Tetsufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IshikawaTomoki en-aut-sei=Ishikawa en-aut-mei=Tomoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HagiokaShingo en-aut-sei=Hagioka en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ManabeNobuki en-aut-sei=Manabe en-aut-mei=Nobuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KurasakoToshiaki en-aut-sei=Kurasako en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=GotoTakashi en-aut-sei=Goto en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KimuraMasakazu en-aut-sei=Kimura en-aut-mei=Masakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SunamiKazuharu en-aut-sei=Sunami en-aut-mei=Kazuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=InoueKazuyoshi en-aut-sei=Inoue en-aut-mei=Kazuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TsukijiTakashi en-aut-sei=Tsukiji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=YasukawaTakeshi en-aut-sei=Yasukawa en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=NogamiSatoshi en-aut-sei=Nogami en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=TsukiokiMitsunori en-aut-sei=Tsukioki en-aut-mei=Mitsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=OkabeDaisuke en-aut-sei=Okabe en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=TaninoMasaaki en-aut-sei=Tanino en-aut-mei=Masaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Anesthesia, Kagawa Rosai Hospital kn-affil= affil-num=4 en-affil=Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School General Medical Center kn-affil= affil-num=5 en-affil=Department of Anesthesia, Chikamori Hospital kn-affil= affil-num=6 en-affil=Department of Anesthesia and Intensive Care, National Cancer Center Hospital kn-affil= affil-num=7 en-affil=Department of Anesthesia, Okayama Red Cross General Hospital kn-affil= affil-num=8 en-affil=Department of Anesthesia, Tsuyama Chuo Hospital kn-affil= affil-num=9 en-affil=Department of Anesthesia, Saiseikai Imabari Hospital kn-affil= affil-num=10 en-affil=Department of Anesthesiology, Japanese Red Cross Society Himeji Hospital kn-affil= affil-num=11 en-affil=Department of Anesthesia, Hiroshima City Hiroshima Citizens Hospital kn-affil= affil-num=12 en-affil=Department of Anesthesia, Okayama City Hospital kn-affil= affil-num=13 en-affil=Department of Internal Medicine, Okayama Kyoritsu Hospital kn-affil= affil-num=14 en-affil=Department of Anesthesia, Kagawa Prefectural Central Hospital kn-affil= affil-num=15 en-affil=Department of Anesthesia, Takasago Municipal Hospital kn-affil= affil-num=16 en-affil=Department of Anesthesia, Okayama Kyokuto Hospital kn-affil= affil-num=17 en-affil=Department of Anesthesia, National Hospital Organization Okayama Medical Center kn-affil= affil-num=18 en-affil=Department of Anesthesia, Onomichi Municipal Hospital kn-affil= affil-num=19 en-affil=Department of Anesthesia, Himeji St. Mary乫s Hospital kn-affil= affil-num=20 en-affil=Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School Hospital kn-affil= affil-num=21 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=1 article-no= start-page=25 end-page=32 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Development and Evaluation of a Short-time Imaging Method for the Clinical Study of the Apparent Diffusion Coefficient Subtraction Method en-subtitle= kn-subtitle= en-abstract= kn-abstract=The apparent diffusion coefficient subtraction method (ASM) was developed as a new restricted diffusionweighted imaging technique for magnetic resonance imaging (MRI). The usefulness of the ASM has been established by in vitro basic research using a bio-phantom, and clinical research on the application of the ASM for the human body is needed. Herein, we developed a short-time sequence for ASM imaging of the heads of healthy volunteers (n=2), and we investigated the similarity between the obtained ASM images and diffusion kurtosis (DK) images to determine the utility of the ASM for clinical uses. This study appears to be the first to report ASM images of the human head. We observed that the short-time sequence for the ASM imaging of the head can be scanned in approx. 3 min at 1.5T MRI. The noise reduction effect of median filter processing was confirmed on the ASM images scanned by this sequence. The obtained ASM images showed a weak correlation with the DK images, indicating that the ASM images are restricted diffusion-weighted images. The new shorttime imaging sequence could thus be used in clinical studies applying the ASM. en-copyright= kn-copyright= en-aut-name=SugimotoKohei en-aut-sei=Sugimoto en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KurodaMasahiro en-aut-sei=Kuroda en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YoshimuraYuuki en-aut-sei=Yoshimura en-aut-mei=Yuuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HamadaKentaro en-aut-sei=Hamada en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KhasawnehAbdullah en-aut-sei=Khasawneh en-aut-mei=Abdullah kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=BarhamMajd en-aut-sei=Barham en-aut-mei=Majd kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TekikiNouha en-aut-sei=Tekiki en-aut-mei=Nouha kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KonishiKohei en-aut-sei=Konishi en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IshizakaHinata en-aut-sei=Ishizaka en-aut-mei=Hinata kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=ShimizuYudai en-aut-sei=Shimizu en-aut-mei=Yudai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NakamitsuYuki en-aut-sei=Nakamitsu en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=Al-HammadWlla E. en-aut-sei=Al-Hammad en-aut-mei=Wlla E. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KamizakiRyo en-aut-sei=Kamizaki en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=AsaumiJunichi en-aut-sei=Asaumi en-aut-mei=Junichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=2 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=3 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=4 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=9 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Radiological Technology, Graduate School of Health Sciences, Okayama University kn-affil= affil-num=14 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=apparent diffusion coefficient kn-keyword=apparent diffusion coefficient en-keyword=apparent diffusion coefficient subtraction method kn-keyword=apparent diffusion coefficient subtraction method en-keyword=diffusion kurtosis imaging kn-keyword=diffusion kurtosis imaging en-keyword=restricted diffusion kn-keyword=restricted diffusion en-keyword=short-time imaging kn-keyword=short-time imaging END start-ver=1.4 cd-journal=joma no-vol=23 cd-vols= no-issue=1 article-no= start-page=20 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220207 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Identification of targetable kinases in idiopathic pulmonary fibrosis en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Tyrosine kinase activation plays an important role in the progression of pulmonary fibrosis. In this study, we analyzed the expression of 612 kinase-coding and cancer-related genes using next-generation sequencing to identify potential therapeutic targets for idiopathic pulmonary fibrosis (IPF). Methods Thirteen samples from five patients with IPF (Cases 1-5) and eight samples from four patients without IPF (control) were included in this study. Six of the thirteen samples were obtained from different lung segments of a single patient who underwent bilateral pneumonectomy. Gene expression analysis of IPF lung tissue samples (n = 13) and control samples (n = 8) was performed using SureSelect RNA Human Kinome Kit. The expression of the selected genes was further confirmed at the protein level by immunohistochemistry (IHC). Results Gene expression analysis revealed a correlation between the gene expression signatures and the degree of fibrosis, as assessed by Ashcroft score. In addition, the expression analysis indicated a stronger heterogeneity among the IPF lung samples than among the control lung samples. In the integrated analysis of the 21 samples, DCLK1 and STK33 were found to be upregulated in IPF lung samples compared to control lung samples. However, the top most upregulated genes were distinct in individual cases. DCLK1, PDK4, and ERBB4 were upregulated in IPF case 1, whereas STK33, PIM2, and SYK were upregulated in IPF case 2. IHC revealed that these proteins were expressed in the epithelial layer of the fibrotic lesions. Conclusions We performed a comprehensive kinase expression analysis to explore the potential therapeutic targets for IPF. We found that DCLK1 and STK33 may serve as potential candidate targets for molecular targeted therapy of IPF. In addition, PDK4, ERBB4, PIM2, and SYK might also serve as personalized therapeutic targets of IPF. Additional large-scale studies are warranted to develop personalized therapies for patients with IPF. en-copyright= kn-copyright= en-aut-name=HigoHisao en-aut-sei=Higo en-aut-mei=Hisao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OhashiKadoaki en-aut-sei=Ohashi en-aut-mei=Kadoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TomidaShuta en-aut-sei=Tomida en-aut-mei=Shuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkawaSachi en-aut-sei=Okawa en-aut-mei=Sachi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamamotoHiromasa en-aut-sei=Yamamoto en-aut-mei=Hiromasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SugimotoSeiichiro en-aut-sei=Sugimoto en-aut-mei=Seiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SenooSatoru en-aut-sei=Senoo en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MakimotoGo en-aut-sei=Makimoto en-aut-mei=Go kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NinomiyaKiichiro en-aut-sei=Ninomiya en-aut-mei=Kiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NakasukaTakamasa en-aut-sei=Nakasuka en-aut-mei=Takamasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NishiiKazuya en-aut-sei=Nishii en-aut-mei=Kazuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TaniguchiAkihiko en-aut-sei=Taniguchi en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KuboToshio en-aut-sei=Kubo en-aut-mei=Toshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IchiharaEiki en-aut-sei=Ichihara en-aut-mei=Eiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=HottaKatsuyuki en-aut-sei=Hotta en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=MiyaharaNobuaki en-aut-sei=Miyahara en-aut-mei=Nobuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MaedaYoshinobu en-aut-sei=Maeda en-aut-mei=Yoshinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=ToyookaShinichi en-aut-sei=Toyooka en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=KiuraKatsuyuki en-aut-sei=Kiura en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= affil-num=1 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Center for Comprehensive Genomic Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=5 en-affil=Department of Thoracic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Organ Transplant Center, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=8 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=12 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=13 en-affil=Center for Clinical Oncology, Okayama University Hospital kn-affil= affil-num=14 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=15 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=16 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=17 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=18 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=19 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= en-keyword=Idiopathic pulmonary fibrosis kn-keyword=Idiopathic pulmonary fibrosis en-keyword=RNA sequencing kn-keyword=RNA sequencing en-keyword=Molecular therapeutic target kn-keyword=Molecular therapeutic target en-keyword=Personalized therapy kn-keyword=Personalized therapy END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=5 article-no= start-page=567 end-page=574 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Manifestations of Patients with Influenza Differ by Age : A Prospective, Multi-centered Study in the Setouchi Marine Area en-subtitle= kn-subtitle= en-abstract= kn-abstract=Influenza potentially has a high mortality rate when it affects the elderly. We aimed to examine the differences in clinical manifestations in patients with influenza according to their age. This multicenter prospective study was performed in six medical institutions in Okayama and Kagawa prefectures (Japan). Between December 1, 2019 and March 31, 2020, we collected data on adult patients diagnosed with influenza type A, who were strat-ified into younger (20-49 years), middle-aged (50-64 years), and older groups (? 65 years). We compared the presence or absence of fever, respiratory symptoms, and extrapulmonary symptoms according to age group. In total, 203 patients (113, younger; 51, middle-aged; and 39, older) were eligible for the analysis. The maxi-mum body temperature and temperature at first physician visit in the older group were significantly lower than those in the younger group. The incidence of respiratory symptoms was not different among the three groups. Chills, muscle pain, and arthralgia as systemic symptoms were noted significantly more frequently in the younger (80.9%) and middle-aged (75.5%) groups than in the older group (51.3%) (p = 0.002). Fever and sys-temic symptoms were less likely to appear in older patients, possibly resulting in the delaying of hospital visits among older adults. en-copyright= kn-copyright= en-aut-name=TakaseRyosuke en-aut-sei=Takase en-aut-mei=Ryosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UedaKeigo en-aut-sei=Ueda en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=influenza, kn-keyword=influenza, en-keyword=elderly kn-keyword=elderly en-keyword= fever kn-keyword= fever en-keyword=respiratory symptom kn-keyword=respiratory symptom END start-ver=1.4 cd-journal=joma no-vol=156 cd-vols= no-issue= article-no= start-page=e300 end-page=e306 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210921 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparative Study of Bilateral Dual Sacral-Alar-Iliac Screws versus Bilateral Single Sacral-Alar-Iliac Screw for Adult Spine Deformities en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective
To evaluate the feasibility of O-arm navigation of bilateral dual sacral-alar-iliac (SAI) screws compared with conventional bilateral single SAI and S1 pedicle screws for pelvic anchors in cases of adult spinal deformity.
Methods
This retrospective, comparative study included 39 patients who underwent corrective fusion using SAI screws from T10 to the pelvis. Patients were divided into 2 groups according to the number of SAI screws placed during adult spinal deformity surgery: single SAI screw (group S, 17 cases) and dual SAI screws (group D, 22 cases). The incidence of rod breakage, proximal junctional kyphosis, screw loosening, reoperation, and global alignment in each group was estimated. Postoperative patient-reported outcomes were measured using the Oswestry Disability Index, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, and visual analog scale.
Results
The incidence of SAI screw loosening was significantly lower in group D than in group S (23% vs. 65%, P?= 0.011). The rod breakage incidence was 0% and 12% in groups D and S, respectively (P?= 0.17). There were no significant differences in the postoperative global alignment and clinical outcomes between the 2 groups.
Conclusions
Dual SAI screws were associated with a significantly reduced incidence of screw loosening compared with single SAI screws. The bilateral dual SAI screws technique for pelvic anchors is feasible for the treatment of patients with adult spinal deformity. en-copyright= kn-copyright= en-aut-name=UotaniKoji en-aut-sei=Uotani en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SonawaneSumeet en-aut-sei=Sonawane en-aut-mei=Sumeet kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=RuparelSameer en-aut-sei=Ruparel en-aut-mei=Sameer kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujiwaraYoshihiro en-aut-sei=Fujiwara en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamauchiTaro en-aut-sei=Yamauchi en-aut-mei=Taro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MisawaHaruo en-aut-sei=Misawa en-aut-mei=Haruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=3 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=6 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=7 en-affil=Department of Orthopaedic surgery, Okayama Rosai Hospital kn-affil= affil-num=8 en-affil=Department of Orthopaedic surgery, Okayama University Hospital kn-affil= en-keyword=dual SAI screws kn-keyword=dual SAI screws en-keyword= adult spine deformity kn-keyword= adult spine deformity en-keyword= spinopelvic fixation kn-keyword= spinopelvic fixation en-keyword=navigation surgery kn-keyword=navigation surgery END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=104 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210916 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between emergency medical service transport time and survival in patients with traumatic cardiac arrest: a Nationwide retrospective observational study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Patients with traumatic cardiac arrest (TCA) are known to have poor prognoses. In 2003, the joint committee of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma proposed stopping unsuccessful cardiopulmonary resuscitation (CPR) sustained for > 15 min after TCA. However, in 2013, a specific time-limit for terminating resuscitation was dropped, due to the lack of conclusive studies or data. We aimed to define the association between emergency medical services transport time and survival to demonstrate the survival curve of TCA.
Methods
A retrospective review of the Japan Trauma Data Bank. Inclusion criteria were age >= 16, at least one trauma with Abbreviated Injury Scale score (AIS) >= 3, and CPR performed in a prehospital setting. Exclusion criteria were burn injury, AIS score of 6 in any region, and missing data. Estimated survival rate and risk ratio for survival were analyzed according to transport time for all patients. Analysis was also performed separately on patients with sustained TCA at arrival.
Results
Of 292,027 patients in the database, 5336 were included in the study with 4141 sustained TCA. Their median age was 53 years (interquartile range (IQR) 36-70), and 67.2% were male. Their median Injury Severity Score was 29 (IQR 22-41), and median transport time was 11 min (IQR 6-17). Overall survival after TCA was 4.5%; however, survival of patients with sustained TCA at arrival was only 1.2%. The estimated survival rate and risk ratio for sustained TCA rapidly decreased after 15 min of transport time, with estimated survival falling below 1%.
Conclusion
The chances of survival for sustained TCA declined rapidly while the patient is transported with CPR support. Time should be one reasonable factor for considering termination of resuscitation in patients with sustained TCA, although clinical signs of life, and type and severity of trauma should be taken into account clinically. en-copyright= kn-copyright= en-aut-name=NaitoHiromichi en-aut-sei=Naito en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NojimaTsuyoshi en-aut-sei=Nojima en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamamotoHirotsugu en-aut-sei=Yamamoto en-aut-mei=Hirotsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamadaTaihei en-aut-sei=Yamada en-aut-mei=Taihei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TsukaharaKohei en-aut-sei=Tsukahara en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=InabaMototaka en-aut-sei=Inaba en-aut-mei=Mototaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NishimuraTakeshi en-aut-sei=Nishimura en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=UeharaTakenori en-aut-sei=Uehara en-aut-mei=Takenori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Dentistry and Pharmaceutical Sciences, Department of Epidemiology, Okayama University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=5 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=8 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= en-keyword=Mortality kn-keyword=Mortality en-keyword=Trauma care kn-keyword=Trauma care en-keyword=Cardiac arrest kn-keyword=Cardiac arrest en-keyword=Time-to-treatment kn-keyword=Time-to-treatment END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=4 article-no= start-page=495 end-page=503 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of Tablet Size and Head Posture on Drug Swallowing: A Preliminary Examination Using Endoscopy in Healthy Subjects en-subtitle= kn-subtitle= en-abstract= kn-abstract=Tablet size and head posture have been reported to affect swallowing of medications, but no previous studies have evaluated their effects in detail. Our aim was to investigate for the first time the effect of tablet size and head posture on drug swallowing by endoscopic evaluation in healthy subjects. Round tablets (7 , 10 , 12, and 14 mm in diameter) were swallowed by 15 healthy adults with an endoscope inserted in the neutral, head flex-ion, and head extension positions. Evaluation of swallowing difficulty using a numeric rating scale (NRS), presence or absence of pharyngeal residue and its location, and tablet oral transit time (TOTT) were recorded. In the neutral position, the NRS score was higher with the 14 mm tablets than with the 7 mm tablets. The TOTT with the 7 mm tablets was significantly shorter in the head extension than in the neutral position. Swallowing difficulty increased when the tablet diameter was more than 7 mm. Residues were found in the epi-glottis, pyriform sinus, and tongue base. These findings suggest that head extension shortens the TOTT and assists oral-pharyngeal transport. en-copyright= kn-copyright= en-aut-name=SugiyamaShuntaro en-aut-sei=Sugiyama en-aut-mei=Shuntaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IidaTakatoshi en-aut-sei=Iida en-aut-mei=Takatoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorimotoYoshinari en-aut-sei=Morimoto en-aut-mei=Yoshinari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamazakiYuki en-aut-sei=Yamazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MikuzukiLou en-aut-sei=Mikuzuki en-aut-mei=Lou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HayashiMegumi en-aut-sei=Hayashi en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Kanagawa Dental University Hospital Graduate School of Dentistry kn-affil= affil-num=2 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Kanagawa Dental University Hospital Graduate School of Dentistry kn-affil= affil-num=3 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Kanagawa Dental University Hospital Graduate School of Dentistry kn-affil= affil-num=4 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Pharmacy, Kanagawa Dental University Hospital kn-affil= affil-num=5 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Kanagawa Dental University Hospital Graduate School of Dentistry kn-affil= affil-num=6 en-affil=Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Kanagawa Dental University Hospital Graduate School of Dentistry kn-affil= en-keyword=tablet size kn-keyword=tablet size en-keyword=head posture kn-keyword=head posture en-keyword=swallowing kn-keyword=swallowing en-keyword=endoscopy kn-keyword=endoscopy en-keyword=pharyngeal residue kn-keyword=pharyngeal residue END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=4 article-no= start-page=415 end-page=421 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Cell Cycle Checkpoint Gene, RAD17 rs1045051, Is Associated with Prostate Cancer Risk en-subtitle= kn-subtitle= en-abstract= kn-abstract=Human RAD17, as an agonist of checkpoint signaling, plays an essential role in mediating DNA damage. This hospital-based case-control study aimed to explore the association between RAD17 rs1045051, a missense sin-gle nucleotide polymorphism (SNP), and prostate cancer risk. Subjects were 358 prostate cancer patients and 314 cancer-free urology patients undergoing treatment at the Zhujiang Hospital of Southern Medical University in China. RAD17 gene polymorphism rs1045051 was evaluated by the SNaPshot method. Compared with the RAD17 gene polymorphism rs1045051 AA genotype, there was a higher risk of prostate cancer for the CC gen-otype (adjusted odds ratio [AOR] = 1.731, 95% confidence interval [95%CI] = 1.031?2.908, p = 0.038). Compared with the A allele, the C allele was significantly associated with the disease status (AOR = 1.302, 95%CI = 1.037?1.634, p = 0.023). All these findings indicate that in the SNP rs1045051, both the CC genotype and C allele may have a substantial influence on the prostate cancer risk. en-copyright= kn-copyright= en-aut-name=SunJingkai en-aut-sei=Sun en-aut-mei=Jingkai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=LinWenfeng en-aut-sei=Lin en-aut-mei=Wenfeng kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WangQixu en-aut-sei=Wang en-aut-mei=Qixu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakaiAkiko en-aut-sei=Sakai en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=XueRuizhi en-aut-sei=Xue en-aut-mei=Ruizhi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=LiuChunxiao en-aut-sei=Liu en-aut-mei=Chunxiao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=XuAbai en-aut-sei=Xu en-aut-mei=Abai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HuangPeng en-aut-sei=Huang en-aut-mei=Peng kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Urology, Zhujiang Hospital, Southern Medical University kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Zhujiang Hospital, Southern Medical University kn-affil= affil-num=4 en-affil=Department of Molecular Genetics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Zhujiang Hospital, Southern Medical University kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Urology, Zhujiang Hospital, Southern Medical University kn-affil= affil-num=11 en-affil=Department of Urology, Zhujiang Hospital, Southern Medical University kn-affil= en-keyword=prostate cancer kn-keyword=prostate cancer en-keyword=single-nucleotide polymorphisms kn-keyword=single-nucleotide polymorphisms en-keyword=cell cycle checkpoint kn-keyword=cell cycle checkpoint en-keyword=rs1045051 kn-keyword=rs1045051 en-keyword=RAD17 kn-keyword=RAD17 END start-ver=1.4 cd-journal=joma no-vol=61 cd-vols= no-issue=7 article-no= start-page=393 end-page=396 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=2021 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol en-subtitle= kn-subtitle= en-abstract= kn-abstract=The effectiveness of adenosine-induced flow arrest in surgical clipping for the cerebral aneurysms with difficulties in temporary clip placement to the proximal main trunk has been reported. This is the first clinical trial to evaluate the safety and feasibility of adenosine-assisted clipping surgery for unruptured cerebral aneurysms (UCAs) in Japan. The inclusion criteria are as follows: patients over 20 years old, patients who agree to be enrolled in this study after providing informed consent, patients who undergo clipping surgery for UCA in our institute, and patients in whom the surgeons (T.H. or I.D.) judge that decompression of the aneurysm is effective. The primary endpoint is a modified Rankin Scale (mRS) score 30 days after surgery. We plan to enroll 10 patients in this study. The original protocol of adenosine administration was established in this trial. Herein, we present the study protocol. en-copyright= kn-copyright= en-aut-name=HishikawaTomohito en-aut-sei=Hishikawa en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MuraiSatoshi en-aut-sei=Murai en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HiramatsuMasafumi en-aut-sei=Hiramatsu en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HarumaJun en-aut-sei=Haruma en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishiKazuhiko en-aut-sei=Nishi en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EbisudaniYuki en-aut-sei=Ebisudani en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SatoYu en-aut-sei=Sato en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YasuharaTakao en-aut-sei=Yasuhara en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=ShimizuKazuyoshi en-aut-sei=Shimizu en-aut-mei=Kazuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KobayashiMotomu en-aut-sei=Kobayashi en-aut-mei=Motomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NakagawaKoji en-aut-sei=Nakagawa en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=Kimura-OnoAya en-aut-sei=Kimura-Ono en-aut-mei=Aya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=HottaKatsuyuki en-aut-sei=Hotta en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=14 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=15 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=adenosine kn-keyword=adenosine en-keyword=clipping kn-keyword=clipping en-keyword=unruptured cerebral aneurysm kn-keyword=unruptured cerebral aneurysm END start-ver=1.4 cd-journal=joma no-vol=57 cd-vols= no-issue=61 article-no= start-page=7493 end-page=7496 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Synthesis of 兛-substituted indolylacetamide using acetonitriles as acetamide enolate equivalents through O-transfer reactions en-subtitle= kn-subtitle= en-abstract= kn-abstract=We introduce readily available ammonium hemiaminals as O-transfer reagents and commercially available acetonitriles as a primary amide enolate precursor. The combination serves as an amide enolate equivalent, thereby providing one-pot access to alpha-substituted indolylacetamides. A broad substrate scope and good functional group tolerance as well as gram-scale synthesis make this protocol highly attractive. Mechanistic experiments suggest that the cyano group is trapped by a hydroxy group of hemiaminals en route to the desired primary amides under metal-free conditions. en-copyright= kn-copyright= en-aut-name=AbeTakumi en-aut-sei=Abe en-aut-mei=Takumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NodaKenta en-aut-sei=Noda en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SawadaDaisuke en-aut-sei=Sawada en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=164 cd-vols= no-issue=2 article-no= start-page=517 end-page=523 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=2021619 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study.
Methods
We retrospectively evaluated 98 consecutive patients who underwent endovascular surgery for rVADA from 2000 to 2018 at our institution or five affiliated hospitals. When each patient was initially transported to the local affiliated hospitals, neuroendovascular surgeons traveled directly to the affiliated hospital from the flagship center in order to treat the patient there. Clinical outcomes using modified Rankin Scale at 6 months after treatment, radiological results, and procedure-related complications were reviewed to justify our mobile endovascular strategy.
Results
All aneurysms were cured successfully by internal trapping. Favorable outcome was achieved in 61 patients (62.2%) even though 53 patients (54.1%) had presented with severe subarachnoid hemorrhage. Overall mortality rate, treatment-related mortality rate, and treatment related complication rate were 18.4% (18/98), 0%, and 16% (16/98), respectively. There were no differences in clinical and radiological outcomes between the patients treated in the flagship center and those who treated in the affiliated hospitals. Treatment in the affiliated hospital was not a predictive factor of unfavorable outcome in our multivariate analysis, and elderly age (>= 60) was negatively associated with favorable outcome.
Conclusions
Our results prove the efficacy and safety of mobile endovascular therapy for the treatment of rVADA in the ultra-acute stage. Mobile endovascular therapy may work well in the acute treatment of rVADAs in the certain circumstance. en-copyright= kn-copyright= en-aut-name=KidaniNaoya en-aut-sei=Kidani en-aut-mei=Naoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TerasakaKaoru en-aut-sei=Terasaka en-aut-mei=Kaoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakashimaHiroyuki en-aut-sei=Nakashima en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TokunagaKoji en-aut-sei=Tokunaga en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KobayashiKazuki en-aut-sei=Kobayashi en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KambaraHirokazu en-aut-sei=Kambara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HishikawaTomohito en-aut-sei=Hishikawa en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HiramatsuMasafumi en-aut-sei=Hiramatsu en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurosurgery, Kure Kyosai Hospital kn-affil= affil-num=4 en-affil=Department of Neurosurgery, Okayama Kyokuto Hospital kn-affil= affil-num=5 en-affil=Department of Neurosurgery, Okayama City Municipal Hospital kn-affil= affil-num=6 en-affil=Department of Neurosurgery, Tsuyama Chuo Hospital kn-affil= affil-num=7 en-affil=Department of Neurosurgery, Japanese Red Cross Okayama Hospital kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=316 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The effect of Humanitude care methodology on improving empathy: a six-year longitudinal study of medical students in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Empathy, which involves understanding another person's experiences and concerns, is an important component for developing physicians' overall competence. This longitudinal study was designed to test the hypothesis that medical students' empathy can be enhanced and sustained by Humanitude Care Methodology, which focuses on perception, emotion and speech.

Methods
This six-year longitudinal observational study examined 115 students who entered Okayama University Medical School in 2013. The study participants were exposed to two empathy-enhancing programs: (1) a communication skills training program (involving medical interviews) and (2) a Humanitude training program aimed at enhancing their empathy. They completed the Jefferson Scale of Empathy (JSE) seven times: when they entered medical school, before participation in the first program (medical interview), immediately after the first program, before the second program (Humanitude exercise), immediately after the second program, and in the 5th and 6th year (last year) of medical school. A total of 79 students (69% of the cohort) completed all seven test administrations of the JSE.

Results
The mean JSE scores improved significantly after participation in the medical interview program (p<0.01) and the Humanitude training program (p=0.001). However, neither program showed a sustained effect.

Conclusions
The Humanitude training program as well as medical interview training program, had significant short-term positive effects for improving empathy among medical students. Additional reinforcements may be necessary for a long-term sustained effect. en-copyright= kn-copyright= en-aut-name=FukuyasuYusuke en-aut-sei=Fukuyasu en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KataokaHitomi U. en-aut-sei=Kataoka en-aut-mei=Hitomi U. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HondaMiwako en-aut-sei=Honda en-aut-mei=Miwako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IwaseToshihide en-aut-sei=Iwase en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SatoMasaru en-aut-sei=Sato en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=DeSantisJennifer en-aut-sei=DeSantis en-aut-mei=Jennifer kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HojatMohammadreza en-aut-sei=Hojat en-aut-mei=Mohammadreza kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=GonnellaJoseph S. en-aut-sei=Gonnella en-aut-mei=Joseph S. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Okayama University Hospital Center for Diversity and Inclusion kn-affil= affil-num=3 en-affil=Geriatric Research Division, National Hospital Organization Tokyo Medical Center kn-affil= affil-num=4 en-affil=Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Primary Care and Medical Education, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Okayama University Hospital Center for Diversity and Inclusion kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University kn-affil= affil-num=11 en-affil=Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University kn-affil= affil-num=12 en-affil=Department of Psychiatry and Human Behavior, Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University kn-affil= en-keyword=Empathy kn-keyword=Empathy en-keyword=Humanitude kn-keyword=Humanitude en-keyword=Medical education kn-keyword=Medical education END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=3 article-no= start-page=315 end-page=322 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Validity and Reliability of the Japanese Version of the 12-item Self-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in Patients with Schizophrenia en-subtitle= kn-subtitle= en-abstract= kn-abstract=It is necessary to assess functional impairment when treating schizophrenia. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been adopted as a measure of functional disability in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This study was a secondary analysis from a cross-sectional study of health-related behaviors among patients with schizophrenia. We examined the validity and reliability of the Japanese version of the 12-item WHODAS 2.0 when self-administered by such patients. Participants were 350 outpatients with schizophrenia from a psychiatric hospital. The standard six-factor structure of the WHODAS 2.0 showed a good fit for these participants. The Cronbach乫s alpha coefficient was 0.858, showing good internal consistency. The WHODAS 2.0 showed moderate correlations with the modified Global Assessment of Functioning and Kessler 6 scales (r=?0.434 and 0.555, respectively). The results of this study show that the Japanese version of the 12-item self-administered WHODAS 2.0 has good internal consistency and convergent validity among patients with schizophrenia. Further exploration of the usefulness of WHODAS 2.0 in clinical settings is needed. en-copyright= kn-copyright= en-aut-name=WadaRiho en-aut-sei=Wada en-aut-mei=Riho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiwaraMasaki en-aut-sei=Fujiwara en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamadaYuto en-aut-sei=Yamada en-aut-mei=Yuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakayaNaoki en-aut-sei=Nakaya en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujimoriMaiko en-aut-sei=Fujimori en-aut-mei=Maiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SoRyuhei en-aut-sei=So en-aut-mei=Ryuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KodamaMasafumi en-aut-sei=Kodama en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HiguchiYuji en-aut-sei=Higuchi en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KakedaKyoko en-aut-sei=Kakeda en-aut-mei=Kyoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=UchitomiYosuke en-aut-sei=Uchitomi en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=InagakiMasatoshi en-aut-sei=Inagaki en-aut-mei=Masatoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Health Sciences, Saitama Prefectural University kn-affil= affil-num=5 en-affil=Division of Health Care Research, Behavioral Sciences and Survivorship Research Group, National Cancer Center kn-affil= affil-num=6 en-affil=Okayama Psychiatric Medical Center kn-affil= affil-num=7 en-affil=Okayama Psychiatric Medical Center kn-affil= affil-num=8 en-affil=Care of Your Mind, Taiyo Hills Hospital kn-affil= affil-num=9 en-affil=Department of Neuropsychiatry, Kochi Medical School, Kochi University kn-affil= affil-num=10 en-affil=Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital kn-affil= affil-num=11 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Psychiatry, Faculty of Medicine, Shimane University kn-affil= en-keyword=disability kn-keyword=disability en-keyword=schizophrenia kn-keyword=schizophrenia en-keyword=validity kn-keyword=validity en-keyword=reliability kn-keyword=reliability en-keyword=WHODAS 2.0 kn-keyword=WHODAS 2.0 END start-ver=1.4 cd-journal=joma no-vol=22 cd-vols= no-issue=11 article-no= start-page=5582 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210525 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Management of Cirrhotic Ascites under the Add-on Administration of Tolvaptan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Tolvaptan is a recently available diuretic that blocks arginine vasopressin receptor 2 in the renal collecting duct. Its diuretic mechanism involves selective water reabsorption by affecting the water reabsorption receptor aquaporin 2. Given that liver cirrhosis patients exhibit hyponatremia due to their pseudo-aldosteronism and usage of natriuretic agents, a sodium maintaining agent, such as tolvaptan, is physiologically preferable. However, large scale studies indicating the patients for whom this would be effective and describing management under its use have been insufficient. The appropriate management of cirrhosis patients treated with tolvaptan should be investigated. In the present review, we collected articles investigating the effectiveness of tolvaptan and factors associated with survival and summarized their management reports. Earlier administration of tolvaptan before increasing the doses of natriuretic agents is recommended because this may preserve effective arterial blood volume. en-copyright= kn-copyright= en-aut-name=AdachiTakuya en-aut-sei=Adachi en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakeuchiYasuto en-aut-sei=Takeuchi en-aut-mei=Yasuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakakiAkinobu en-aut-sei=Takaki en-aut-mei=Akinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OyamaAtsushi en-aut-sei=Oyama en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WadaNozomu en-aut-sei=Wada en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OnishiHideki en-aut-sei=Onishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ShirahaHidenori en-aut-sei=Shiraha en-aut-mei=Hidenori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=tolvaptan kn-keyword=tolvaptan en-keyword=liver cirrhosis kn-keyword=liver cirrhosis en-keyword=ascites kn-keyword=ascites END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=5 article-no= start-page=566 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210501 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors en-subtitle= kn-subtitle= en-abstract= kn-abstract=Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient's distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D >= 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain. en-copyright= kn-copyright= en-aut-name=IseMasato en-aut-sei=Ise en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakataEiji en-aut-sei=Nakata en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KatayamaYoshimi en-aut-sei=Katayama en-aut-mei=Yoshimi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujiwaraTomohiro en-aut-sei=Fujiwara en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakihiraShouta en-aut-sei=Takihira en-aut-mei=Shouta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SatoKohei en-aut-sei=Sato en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AkezakiYoshiteru en-aut-sei=Akezaki en-aut-mei=Yoshiteru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SendaMasuo en-aut-sei=Senda en-aut-mei=Masuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=10 en-affil=Division of Physical Therapy, Kochi Professional University of Rehabilitation kn-affil= affil-num=11 en-affil=Department of Rehabilitation Medicine, Okayama University Hospital kn-affil= affil-num=12 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= en-keyword=psychological distress kn-keyword=psychological distress en-keyword=distress and impact thermometer kn-keyword=distress and impact thermometer en-keyword=bone and soft tissue tumor kn-keyword=bone and soft tissue tumor en-keyword=surgery kn-keyword=surgery END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=1 article-no= start-page=181 end-page=186 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080101 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Appearance of Multidrug-Resistant Opportunistic Bacteria on the Gingiva During Leukemia Treatment en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Dentists generally recognize the importance of periodontal treatment inpatients with leukemia, with the most attention paid to preventing the development of odontogenic infection. For physicians, the worst type of infection is one caused by multidrug-resistant bacteria. Here, we report a patient with an abnormal increase in multidrug-resistant opportunistic bacteria in the gingiva during hematopoietic cell transplantation (HCT).

Methods: A 53-year-old woman receiving HCT for leukemia had an insufficient blood cell count for invasive periodontal treatment before HCT. Even brushing caused difficulties with hemostasis. Therefore, frequent pocket irrigation and local minocycline administration were performed.

Results: The multidrug-resistant opportunistic bacterium Stenotrophomonas maltophilia was detected first in phlegm 2 days before HCT, and it was detected in a gingival smear and a blood sample 7 and I I days after HCT, respectively. The patient developed sepsis on day I I and died 14 days after HCT. Frequent irrigation and local antibiotic application were ineffective against S. maltophilia on the gingiva. Inflammatory gingiva without scaling and root planing showed bleeding tendency, and this interfered with the eradication of this bacterium.

Conclusions: The gingiva in patients undergoing leukemia treatment acts as sites of proliferation and reservoirs for multidrug-resistant opportunistic bacteria. Severe systemic infection by multidrug-resistant bacteria in such patients with leukemia also may involve the gingiva. To prevent abnormal increases in such bacteria on the gingiva, scaling and/or root planing before chemotherapy, which reduces bleeding on brushing during the neutropenic period caused by chemotherapy, may contribute to infection control in such patients, although it was impossible in this case. en-copyright= kn-copyright= en-aut-name=SogaYoshihiko en-aut-sei=Soga en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoTakashi en-aut-sei=Saito en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishimuraFusanori en-aut-sei=Nishimura en-aut-mei=Fusanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IshimaruFumihiko en-aut-sei=Ishimaru en-aut-mei=Fumihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MineshibaJunji en-aut-sei=Mineshiba en-aut-mei=Junji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MineshibaFumi en-aut-sei=Mineshiba en-aut-mei=Fumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakayaHirokazu en-aut-sei=Takaya en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SatoHideaki en-aut-sei=Sato en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KudoChieko en-aut-sei=Kudo en-aut-mei=Chieko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KokeguchiSusumu en-aut-sei=Kokeguchi en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=FujiiNobuharu en-aut-sei=Fujii en-aut-mei=Nobuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TanimotoMitsune en-aut-sei=Tanimoto en-aut-mei=Mitsune kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TakashibaShogo en-aut-sei=Takashiba en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Global Health and Environmental Sciences ? Oral Microbiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Pathophysiology ? Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=bacteria kn-keyword=bacteria en-keyword=drug resistance kn-keyword=drug resistance en-keyword=gingiva kn-keyword=gingiva en-keyword=leukemia kn-keyword=leukemia en-keyword=opportunistic infections kn-keyword=opportunistic infections END start-ver=1.4 cd-journal=joma no-vol=23 cd-vols= no-issue=1 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS). Methods This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of >= 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use. Results Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (beta coefficient = - 2.54 [95% confidence interval - 4.48 to - 0.60], P = 0.01). Conclusions Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health. en-copyright= kn-copyright= en-aut-name=MiyawakiYoshia en-aut-sei=Miyawaki en-aut-mei=Yoshia kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShimizuSayaka en-aut-sei=Shimizu en-aut-mei=Sayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OgawaYusuke en-aut-sei=Ogawa en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SadaKen-Ei en-aut-sei=Sada en-aut-mei=Ken-Ei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatayamaYukitoshi en-aut-sei=Katayama en-aut-mei=Yukitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AsanoYosuke en-aut-sei=Asano en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HayashiKeigo en-aut-sei=Hayashi en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamamuraYuriko en-aut-sei=Yamamura en-aut-mei=Yuriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=Hiramatsu-AsanoSumie en-aut-sei=Hiramatsu-Asano en-aut-mei=Sumie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OhashiKeiji en-aut-sei=Ohashi en-aut-mei=Keiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MorishitaMichiko en-aut-sei=Morishita en-aut-mei=Michiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WatanabeHaruki en-aut-sei=Watanabe en-aut-mei=Haruki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=Takano-NarazakiMariko en-aut-sei=Takano-Narazaki en-aut-mei=Mariko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MatsumotoYoshinori en-aut-sei=Matsumoto en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=YajimaNobuyuki en-aut-sei=Yajima en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=YoshimiRyusuke en-aut-sei=Yoshimi en-aut-mei=Ryusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=ShimojimaYasuhiro en-aut-sei=Shimojima en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=OhnoShigeru en-aut-sei=Ohno en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=KajiyamaHiroshi en-aut-sei=Kajiyama en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=IchinoseKunihiro en-aut-sei=Ichinose en-aut-mei=Kunihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=SatoShuzo en-aut-sei=Sato en-aut-mei=Shuzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=FujiwaraMichio en-aut-sei=Fujiwara en-aut-mei=Michio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=YamazakiHajime en-aut-sei=Yamazaki en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=YamamotoYosuke en-aut-sei=Yamamoto en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=FukuharaShunichi en-aut-sei=Fukuhara en-aut-mei=Shunichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Institute for Health Outcome & Process Evaluation Research (i-Hope International) kn-affil= affil-num=3 en-affil=Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Ushimado Marine Institute, Faculty of Science, Okayama University kn-affil= affil-num=6 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=13 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=15 en-affil=Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University kn-affil= affil-num=16 en-affil=Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine kn-affil= affil-num=17 en-affil=Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine kn-affil= affil-num=18 en-affil=Center for Rheumatic Diseases, Yokohama City University Medical Center kn-affil= affil-num=19 en-affil=Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University kn-affil= affil-num=20 en-affil=Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences kn-affil= affil-num=21 en-affil=Department of Rheumatology, Fukushima Medical University School of Medicine kn-affil= affil-num=22 en-affil=Department of Rheumatology, Yokohama Rosai Hospital kn-affil= affil-num=23 en-affil=Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University kn-affil= affil-num=24 en-affil=Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University kn-affil= affil-num=25 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=26 en-affil=Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University kn-affil= en-keyword=Systemic lupus erythematosus kn-keyword=Systemic lupus erythematosus en-keyword=Glucocorticoid kn-keyword=Glucocorticoid en-keyword=Emotional health kn-keyword=Emotional health en-keyword=Patient-reported outcome kn-keyword=Patient-reported outcome en-keyword=Depression kn-keyword=Depression en-keyword=Anxiety kn-keyword=Anxiety en-keyword=Cross-sectional study kn-keyword=Cross-sectional study END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=1 article-no= start-page=380 end-page=388 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210131 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A comparison of colorimetric and visual methods for the assessment of masticatory performance with color-changeable chewing gum in older persons en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background/purpose
Color-changeable chewing gum is used for the evaluation of masticatory performance. However, it is currently unclear whether colorimetric and visual assessment methods yield consistent results. This study aimed to clarify the consistency between colorimetric and visual methods used for the evaluation of color changes in color-changeable chewing gum.
Materials and methods
The sample comprised 644 older persons (mean age, 75.4?亇?6.4 years). The chewing gum was masticated 60 times at the participant's own chewing rate and then expectorated. The color of the chewing gum was evaluated with the 儮E values and a? values, measured using a colorimeter, and the 10 Color Shades (10CSh) and 5 Color Scales (5CSc), using visual evaluation. Spearman's correlation analysis was performed to examine the correlation between the results obtained by the four methods. The significance level was set at 兛?=?0.05.
Results
The 儮E values, a? values, 10CSh scores, and 5CSc scores were all significantly correlated. The highest correlation coefficient (0.979) was between the 儮E values and a? values. The lowest correlation coefficient (0.847) was between the a? values and 5CSc scores. Decreased masticatory performance was observed with increased age.
Conclusion
Significant correlations were found for all four methods used in the assessment of masticatory performance with color-changeable chewing gum. While visually based assessments are valid, colorimetric methods are more sensitive to smaller changes in masticatory performance. en-copyright= kn-copyright= en-aut-name=KugimiyaYoshihiro en-aut-sei=Kugimiya en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeYutaka en-aut-sei=Watanabe en-aut-mei=Yutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShirobeMaki en-aut-sei=Shirobe en-aut-mei=Maki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MotohashiYoshiko en-aut-sei=Motohashi en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MotokawaKeiko en-aut-sei=Motokawa en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EdahiroAyako en-aut-sei=Edahiro en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OharaYuki en-aut-sei=Ohara en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=RyuMasahiro en-aut-sei=Ryu en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IgarashiKentaro en-aut-sei=Igarashi en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HoshinoDaichi en-aut-sei=Hoshino en-aut-mei=Daichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NakajimaJunko en-aut-sei=Nakajima en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=UedaTakayuki en-aut-sei=Ueda en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TaniguchiYu en-aut-sei=Taniguchi en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=OgawaToru en-aut-sei=Ogawa en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=MaekawaKenji en-aut-sei=Maekawa en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=TamakiKatsushi en-aut-sei=Tamaki en-aut-mei=Katsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=KubokiTakuo en-aut-sei=Kuboki en-aut-mei=Takuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=KitamuraAkihiko en-aut-sei=Kitamura en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=ShinkaiShoji en-aut-sei=Shinkai en-aut-mei=Shoji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=HiranoHirohiko en-aut-sei=Hirano en-aut-mei=Hirohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College kn-affil= affil-num=2 en-affil=Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University kn-affil= affil-num=3 en-affil=The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care kn-affil= affil-num=4 en-affil=Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=5 en-affil=Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=6 en-affil=Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=7 en-affil=Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=8 en-affil=Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College kn-affil= affil-num=9 en-affil=Removable Prosthodontics, Nihon University School of Dentistry at Matsudo kn-affil= affil-num=10 en-affil=Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University kn-affil= affil-num=11 en-affil=Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College kn-affil= affil-num=12 en-affil=Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College kn-affil= affil-num=13 en-affil=Center for Health and Environmental Risk Research, National Institute for Environmental Studies kn-affil= affil-num=14 en-affil=Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry kn-affil= affil-num=15 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Critical Care Medicine and Dentistry, Division of Prosthodontic Dentistry for Function of TMJ and Occlusion, Graduate School of Dentistry, Kanagawa Dental University kn-affil= affil-num=17 en-affil=Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=18 en-affil=Research Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=19 en-affil=Social Sciences and Human Care, Tokyo Metropolitan Institute of Gerontology kn-affil= affil-num=20 en-affil=Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology kn-affil= en-keyword=Aged kn-keyword=Aged en-keyword=Chewing gum kn-keyword=Chewing gum en-keyword=Colorimetry kn-keyword=Colorimetry en-keyword=Color kn-keyword=Color en-keyword=Mastication kn-keyword=Mastication END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210321 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Intravesical Therapy in Patients with Intermediate-risk Non?muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis of Disease Recurrence en-subtitle= kn-subtitle= en-abstract= kn-abstract=Context
Patients with intermediate-risk non?muscle-invasive bladder cancer (NMIBC) may pose a clinical dilemma without an agreed evidence-based decision tree for personalized treatment.
Objective
To perform a systematic review and network meta-analysis (NMA) to summarize available evidence on the oncologic outcomes of intravesical therapy in patients with intermediate-risk NMIBC.
Evidence acquisition
The MEDLINE, EMBASE, and ClinicalTrials.gov databases were searched in October 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they reported on oncologic outcomes in patients with intermediate-risk NMIBC treated with transurethral resection of bladder tumor with and without intravesical chemotherapy or bacillus Calmette-Gu?rin (BCG) immunotherapy.
Evidence synthesis
Twelve studies were included in a qualitative synthesis (systematic review); three were deemed eligible for a quantitative synthesis (NMA). An NMA of five different regimens was conducted for the association of treatment with the 5-yr recurrence risk. Chemotherapy with maintenance was associated with a lower likelihood of 5-yr recurrence than chemotherapy without maintenance (odds ratio [OR] 0.51, 95% credible interval [CI] 0.26?1.03). Immunotherapy, regardless of whether a full- or reduced-dose regimen, was not associated with a significantly lower likelihood of 5-yr recurrence when compared with chemotherapy without maintenance (OR 0.90, 95% CI 0.39?2.11 vs OR 0.93, 95% CI 0.40?2.19). Analysis of the treatment ranking revealed that chemotherapy with maintenance had the lowest 5-yr recurrence risk (P score 0.9666).
Conclusions
Our analysis indicates that chemotherapy with a maintenance regimen confers a superior oncologic benefit in terms of 5-yr recurrence risk compared to chemotherapy without maintenance in patients with intermediate-risk NMIBC. Regardless of the dose regimen, immunotherapy with BCG does not appear to be superior to chemotherapy in patients with intermediate-risk NMIBC in term of disease recurrence. However, owing to the lack of comparative studies, there is an unmet need for well-designed, large-scale trials to validate our findings and generate robust evidence on disease recurrence and progression.
Patient summary
A maintenance schedule of chemotherapy reduces the rate of long-term recurrence of bladder cancer that has not invaded the bladder muscle. Chemotherapy inserted directly into the bladder and immunotherapy without maintenance schedules seem to have limited benefit in preventing cancer recurrence. en-copyright= kn-copyright= en-aut-name=LaukhtinaEkaterina en-aut-sei=Laukhtina en-aut-mei=Ekaterina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AbufarajMohammad en-aut-sei=Abufaraj en-aut-mei=Mohammad kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Al-AniAbdallah en-aut-sei=Al-Ani en-aut-mei=Abdallah kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AliMustafa Rami en-aut-sei=Ali en-aut-mei=Mustafa Rami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MoriKeiichiro en-aut-sei=Mori en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MoschiniMarco en-aut-sei=Moschini en-aut-mei=Marco kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=QuhalFahad en-aut-sei=Quhal en-aut-mei=Fahad kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Sari MotlaghReza en-aut-sei=Sari Motlagh en-aut-mei=Reza kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=PradereBenjamin en-aut-sei=Pradere en-aut-mei=Benjamin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SchuettfortVictor M. en-aut-sei=Schuettfort en-aut-mei=Victor M. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MostafaeiHadi en-aut-sei=Mostafaei en-aut-mei=Hadi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KatayamaSatoshi en-aut-sei=Katayama en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=GrossmannNico C. en-aut-sei=Grossmann en-aut-mei=Nico C. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=FajkovicHarun en-aut-sei=Fajkovic en-aut-mei=Harun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SoriaFrancesco en-aut-sei=Soria en-aut-mei=Francesco kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=EnikeevDmitry en-aut-sei=Enikeev en-aut-mei=Dmitry kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=ShariatShahrokh F. en-aut-sei=Shariat en-aut-mei=Shahrokh F. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=2 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=3 en-affil=Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan kn-affil= affil-num=4 en-affil=Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan kn-affil= affil-num=5 en-affil=Department of Urology, The Jikei University School of Medicine kn-affil= affil-num=6 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=7 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=8 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=9 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=10 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=11 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=14 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=15 en-affil=Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino kn-affil= affil-num=16 en-affil=Institute for Urology and Reproductive Health, Sechenov University kn-affil= affil-num=17 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= en-keyword=Non?muscle-invasive bladder cancer kn-keyword=Non?muscle-invasive bladder cancer en-keyword=Bladder cancer kn-keyword=Bladder cancer en-keyword=Intermediate risk kn-keyword=Intermediate risk en-keyword=Intravesical therapy kn-keyword=Intravesical therapy en-keyword=Network meta-analysis kn-keyword=Network meta-analysis END start-ver=1.4 cd-journal=joma no-vol=58 cd-vols= no-issue=8 article-no= start-page=1081 end-page=1085 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190415 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Improving Anxiety in Subacute Myelo-optico-neuropathy (SMON) after an Automated Telephone Call Service en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective We evaluated the clinical effects of a telephone call service for psychological symptoms such as anxiety, depression or apathy in subacute myelo-optico-neuropathy (SMON) patients living alone or with a single caregiver.
Methods Up to 16 SMON patients (4 men, 12 women) and 32 control subjects were evaluated by the geriatric depression scale (GDS), apathy scale (AS) and state and trait anxiety inventory (STAI) forms X-I, including the P and A values for depression, apathy and state anxiety including disturbed peace of mind and enhanced anxiety, respectively, before (pre) and three months after (post) the telephone call service.
Results The SMON patients, especially women, had significantly worse baseline scores in GDS (depression), AS (apathy) and STAI (state anxiety) than control subjects. The automated telephone call service significantly improved the high baseline STAI scores, including the P and A scores (disturbed peace of mind and enhanced anxiety), of SMON patients but not the GDS or AS scores.
Conclusion SMON patients, especially women, living alone or with a single caregiver showed higher baseline depression, apathy and anxiety scores than the control subjects. The present automated telephone call service proved to be a useful care tool for improving the anxiety of SMON patients with high STAI P and A scores. en-copyright= kn-copyright= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakemotoMami en-aut-sei=Takemoto en-aut-mei=Mami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=DoutareShinji en-aut-sei=Doutare en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Doutare Medical Clinic kn-affil= affil-num=7 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=anxiety kn-keyword=anxiety en-keyword=SMON kn-keyword=SMON en-keyword=STAI kn-keyword=STAI en-keyword=telephone call service kn-keyword=telephone call service END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue=1 article-no= start-page=53 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210114 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=What impact does postgraduate clinical training have on empathy among Japanese trainee dentists? en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients乫 medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees乫 empathy from cognitive, behavioral, and patients乫 perspective.
Methods
This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees乫 communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.
Results
No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85?134] vs. 108.34 [range, 69?138]; p?=?0.643). Considering the results according to gender, male scored 104.06 (range, 88?118) vs. 101.06 (range, 71?122; p?=?0.283) and female 109.17 (range, 85?134) vs. 111.20 (range, 69?138; p?=?0.170). Similarly, there was no difference in the SPs乫 evaluation of trainees乫 communication (10.73 vs. 10.38, p?=?0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p?=?0.000).
Conclusions
Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists乫 empathy levels. Providing regular education support in this area may help trainees foster their empathy. en-copyright= kn-copyright= en-aut-name=YoshidaToshiko en-aut-sei=Yoshida en-aut-mei=Toshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WatanabeSho en-aut-sei=Watanabe en-aut-mei=Sho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KonoTakayuki en-aut-sei=Kono en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TaketaHiroaki en-aut-sei=Taketa en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShiotsuNoriko en-aut-sei=Shiotsu en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShiraiHajime en-aut-sei=Shirai en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakaiYukie en-aut-sei=Nakai en-aut-mei=Yukie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ToriiYasuhiro en-aut-sei=Torii en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Center for Education in Medicine and Health Sciences (Dental Education), Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=3 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=4 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=5 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=6 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Dental Hygiene, University of Shizuoka, Junior College kn-affil= affil-num=8 en-affil=Comprehensive Dental Clinic, Okayama University Hospital kn-affil= en-keyword=Empathy kn-keyword=Empathy en-keyword=Trainee dentists kn-keyword=Trainee dentists en-keyword=Clinical training kn-keyword=Clinical training en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Roter interaction analysis system kn-keyword=Roter interaction analysis system en-keyword=Simulated patients kn-keyword=Simulated patients END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=1 article-no= start-page=1 end-page=8 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202102 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Characteristics of Low Androgen Status in Males with Type 2 Diabetes Mellitus en-subtitle= kn-subtitle= en-abstract= kn-abstract=To determine the clinical characteristics of low androgen status in adult males with diabetes, we retrospectively analyzed the medical records of patients with type 2 diabetes mellitus in whom serum free testosterone (FT) levels were examined for 1 year. Among the 46 patients (56 亇 1.5 years old), decreases in serum FT levels to < 8.5 pg/ml (indicating the occurrence of late-onset hypogonadism [LOH]) were detected in 18 (39%). The per-centages of patients with low FT levels were high in the ? 50 years age group (83%), the HbA1c < 7% group (67%), and the 25 ? BMI < 30 kg/m2 group (56%). The serum FT levels tended to decrease age-dependently. The level of HbA1c was significantly correlated with the Heinemann Aging Male Symptoms (AMS) score (R = 0.47). The low-FT group had decreased levels of hemoglobin. Of note, the serum FSH level (R = ?0.32) was negatively correlated with the serum FT level, whereas the serum TSH level (R = 0.36) was positively correlated with the serum FT level. Collectively, these results revealed that many diabetic males may have low FT levels and that the AMS score is related to the HbA1c level. A slightly anemic condition, thyroid dysfunction, and obesity (class 1) might be involved in LOH in middle-aged diabetic males. en-copyright= kn-copyright= en-aut-name=HamaharaJun en-aut-sei=Hamahara en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamamotoKoichiro en-aut-sei=Yamamoto en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokumasuKazuki en-aut-sei=Tokumasu en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UedaKeigo en-aut-sei=Ueda en-aut-mei=Keigo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=androgen kn-keyword=androgen en-keyword=diabetes mellitus kn-keyword=diabetes mellitus en-keyword=late-onset hypogonadism kn-keyword=late-onset hypogonadism en-keyword=testosterone kn-keyword=testosterone en-keyword=thyroid function kn-keyword=thyroid function END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=11 article-no= start-page=e0242223 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201112 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Short-term and long-term comparisons of laparoscopy-assisted proximal gastrectomy with esophagogastrostomy by the double-flap technique and laparoscopy-assisted total gastrectomy for proximal gastric cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Although proximal gastrectomy (PG) is a recognized surgical procedure for early proximal gastric cancer, total gastrectomy (TG) is sometimes selected due to concern about severe gastroesophageal reflux. Esophagogastrostomy by the double-flap technique (DFT) is an anti-reflux reconstruction after PG, and its short-term effectiveness has been reported. However, little is known about the long-term effects on nutritional status and quality of life (QOL).
Methods
Gastric cancer patients who underwent laparoscopy-assisted PG (LAPG) with DFT or laparoscopy-assisted TG (LATG) between April 2011 and March 2014 were retrospectively analyzed. Body weight (BW), body mass index (BMI), and prognostic nutritional index (PNI) were reviewed to assess nutritional status, and the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45 was used to assess QOL.
Results
A total of 36 patients (LATG: 17, LAPG: 19) were enrolled. Four of 17 LATG patients (24%) were diagnosed with Stage ?II after surgery, and half received S-1 adjuvant chemotherapy. BW and PNI were better maintained in LAPG than in LATG patients until 1-year follow-up. Seven of 16 LATG patients (44%) were categorized as 乬underweight (BMI<18.5 kg/m2)乭 at 1-year follow-up, compared to three of 18 LAPG patients (17%; p = 0.0836). The PGSAS-45 showed no significant difference in all QOL categories except for decreased BW (p = 0.0132). Multivariate analysis showed that LATG was the only potential risk factor for severe BW loss (odds ratio: 3.03, p = 0.0722).
Conclusions
LAPG with DFT was superior to LATG in postoperative nutritional maintenance, and can be the first option for early proximal gastric cancer. en-copyright= kn-copyright= en-aut-name=TsumuraTomoko en-aut-sei=Tsumura en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KurodaShinji en-aut-sei=Kuroda en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishizakiMasahiko en-aut-sei=Nishizaki en-aut-mei=Masahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KikuchiSatoru en-aut-sei=Kikuchi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KakiuchiYoshihiko en-aut-sei=Kakiuchi en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakataNobuo en-aut-sei=Takata en-aut-mei=Nobuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ItoAtene en-aut-sei=Ito en-aut-mei=Atene kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WatanabeMegumi en-aut-sei=Watanabe en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KuwadaKazuya en-aut-sei=Kuwada en-aut-mei=Kazuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue=21 article-no= start-page=6016 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201023 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Diagnosis of Occlusal Tooth Wear Using 3D Imaging of Optical Coherence Tomography Ex Vivo en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of this study was to assess the utility of 3D imaging of optical coherence tomography (OCT) for the diagnosis of occlusal tooth wear ex vivo. Sixty-three extracted human molars with or without visible tooth wear were collected to take digital intraoral radiography and 3D OCT images. The degree of tooth wear was evaluated by 12 examiners and scored using 4-rank scale: 1-slight enamel wear; 2-distinct enamel wear; 3-tooth wear with slight dentin exposure; 4-tooth wear with distinct involvement of dentin. The degree of tooth wear was validated by the histological view of confocal laser scanning microscopy (CLSM). The sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic analysis were calculated. Diagnostic accuracy was compared with the agreement with CLSM observation using weighted kappa. The results were statistically analyzed at a significance level of alpha = 0.05. Three-dimensional OCT showed significantly higher sensitivity (p < 0.05) for all the diagnostic thresholds of enamel wear and dentin exposure than digital radiography (0.82, 0.85, and 0.79 vs. 0.56, 0.52, and 0.57, respectively). Three-dimensional OCT showed higher AUC and kappa coefficients than digital radiography (p < 0.05), where mean AUC and Kappa values were 0.95 and 0.76 for OCT and 0.92 and 0.47 for radiography, respectively. No significant difference of specificity was observed (p > 0.05). Three-dimensional OCT could visualize and estimate the degree of tooth wear and detect the dentin exposure at the tooth wear surface accurately and reproducibly. Consequently, a new guideline for tooth wear assessment can be proposed using OCT. en-copyright= kn-copyright= en-aut-name=KashiwaMisa en-aut-sei=Kashiwa en-aut-mei=Misa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShimadaYasushi en-aut-sei=Shimada en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SadrAlireza en-aut-sei=Sadr en-aut-mei=Alireza kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshiyamaMasahiro en-aut-sei=Yoshiyama en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SumiYasunori en-aut-sei=Sumi en-aut-mei=Yasunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TagamiJunji en-aut-sei=Tagami en-aut-mei=Junji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University kn-affil= affil-num=2 en-affil=Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University kn-affil= affil-num=4 en-affil=Department of Operative Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Center of Advanced Medicine for Dental and Oral Diseases, Department for Advanced Dental Research, National Center for Geriatrics and Gerontology kn-affil= affil-num=6 en-affil=Department of Cariology and Operative Dentistry Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University kn-affil= en-keyword=occlusal tooth wear kn-keyword=occlusal tooth wear en-keyword=erosive tooth wear kn-keyword=erosive tooth wear en-keyword=SS-OCT kn-keyword=SS-OCT en-keyword=3D imaging kn-keyword=3D imaging en-keyword=enamel thickness kn-keyword=enamel thickness en-keyword=dentin exposure kn-keyword=dentin exposure en-keyword=demineralization kn-keyword=demineralization END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=1 article-no= start-page=18616 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201029 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Capabilities of multi-pinhole SPECT with two stationary detectors for in vivo rat imaging en-subtitle= kn-subtitle= en-abstract= kn-abstract=We aimed to investigate the image quality of the U-SPECT5/CT E-Class a micro single-photon emission computed tomography (SPECT) system with two large stationary detectors for visualization of rat hearts and bones using clinically available Tc-99m-labelled tracers. Sensitivity, spatial resolution, uniformity and contrast-to-noise ratio (CNR) of the small-animal SPECT scanner were investigated in phantom studies using an ultra-high-resolution rat and mouse multi-pinhole collimator (UHR-RM). Point source, hot-rod, and uniform phantoms with Tc-99m-solution were scanned for high-count performance assessment and count levels equal to animal scans, respectively. Reconstruction was performed using the similarity-regulated ordered-subsets expectation maximization (SROSEM) algorithm with Gaussian smoothing. Rats were injected with similar to 100 MBq [Tc-99m]Tc-MIBI or similar to 150 MBq [Tc-99m]Tc-HMDP and received multi-frame micro-SPECT imaging after tracer distribution. Animal scans were reconstructed for three different acquisition times and post-processed with different sized Gaussian filters. Following reconstruction, CNR was calculated and image quality evaluated by three independent readers on a five-point scale from 1="very poor" to 5="very good". Point source sensitivity was 567 cps/MBq and radioactive rods as small as 1.2 mm were resolved with the UHR-RM collimator. Collimator-dependent uniformity was 55.5%. Phantom CNR improved with increasing rod size, filter size and activity concentration. Left ventricle and bone structures were successfully visualized in rat experiments. Image quality was strongly affected by the extent of post-filtering, whereas scan time did not have substantial influence on visual assessment. Good image quality was achieved for resolution range greater than 1.8 mm in bone and 2.8 mm in heart. The recently introduced small animal SPECT system with two stationary detectors and UHR-RM collimator is capable to provide excellent image quality in heart and bone scans in a rat using standardized reconstruction parameters and appropriate post-filtering. However, there are still challenges in achieving maximum system resolution in the sub-millimeter range with in vivo settings under limited injection dose and acquisition time. en-copyright= kn-copyright= en-aut-name=JanssenJan P. en-aut-sei=Janssen en-aut-mei=Jan P. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HoffmannJan V. en-aut-sei=Hoffmann en-aut-mei=Jan V. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KannoTakayuki en-aut-sei=Kanno en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NoseNaoko en-aut-sei=Nose en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=GrunzJan-Peter en-aut-sei=Grunz en-aut-mei=Jan-Peter kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OnoguchiMasahisa en-aut-sei=Onoguchi en-aut-mei=Masahisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ChenXinyu en-aut-sei=Chen en-aut-mei=Xinyu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=LapaConstantin en-aut-sei=Lapa en-aut-mei=Constantin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=BuckAndreas K. en-aut-sei=Buck en-aut-mei=Andreas K. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nuclear Medicine, University Hospital W?rzburg kn-affil= affil-num=2 en-affil=Department of Nuclear Medicine, University Hospital W?rzburg kn-affil= affil-num=3 en-affil=Comprehensive Heart Failure Centre, University Hospital W?rzburg kn-affil= affil-num=4 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Diagnostic and Interventional Radiology, University Hospital W?rzburg kn-affil= affil-num=6 en-affil=Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University kn-affil= affil-num=7 en-affil=Comprehensive Heart Failure Centre, University Hospital W?rzburg kn-affil= affil-num=8 en-affil=Nuclear Medicine, Medical Faculty, University of Augsburg kn-affil= affil-num=9 en-affil=Department of Nuclear Medicine, University Hospital W?rzburg kn-affil= affil-num=10 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Biomarkers kn-keyword=Biomarkers en-keyword=Diagnostic markers kn-keyword=Diagnostic markers en-keyword=Medical research kn-keyword=Medical research en-keyword=Preclinical research kn-keyword=Preclinical research en-keyword=Translational research kn-keyword=Translational research END start-ver=1.4 cd-journal=joma no-vol=28 cd-vols= no-issue=11 article-no= start-page=3416 end-page=3425 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20191128 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Transtibial fixation for medial meniscus posterior root tear reduces posterior extrusion and physiological translation of the medial meniscus in middle-aged and elderly patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose
To investigate changes in meniscal extrusion during knee flexion before and after pullout fixation for medial meniscus posterior root tear (MMPRT) and determine whether these changes correlate with articular cartilage degeneration and short-term clinical outcomes.
Methods
Twenty-two patients (mean age 58.4?亇?8.2 years) diagnosed with type II MMPRT underwent open magnetic resonance imaging preoperatively, 3 months after transtibial fixation and at 12 months after surgery, when second-look arthroscopy was also performed. The medial meniscus medial extrusion (MMME) and the medial meniscus posterior extrusion (MMPE) were measured at knee 10亱 and 90亱 flexion at which medial meniscus (MM) posterior translation was also calculated. Articular cartilage degeneration was assessed using International Cartilage Research Society grade at primary surgery and second-look arthroscopy. Clinical evaluations included Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee subjective knee evaluation form, Lysholm score, Tegner activity level scale, and pain visual analogue scale.
Results
MMPE at 10亱 knee flexion was higher 12 months postoperatively than preoperatively (4.8?亇?1.5 vs. 3.5?亇?1.2, p?=?0.01). MMPE at 90亱 knee flexion and MM posterior translation were smaller 12 months postoperatively than preoperatively (3.5?亇?1.1 vs. 4.6?亇?1.3, 7.2?亇?1.7 vs. 8.9?亇?2.0, p? Conclusions
MMPRT transtibial fixation suppressed the progression of MMPE and cartilage degeneration and progressed MMME minimally in knee flexion position at 1 year. However, in the knee extension position, MMME progressed and correlated with cartilage degeneration of medial femoral condyle. MMPRT transtibial fixation contributes to the dynamic stability of the MM in the knee flexion position. en-copyright= kn-copyright= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MasudaShin en-aut-sei=Masuda en-aut-mei=Shin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkazakiYoshiki en-aut-sei=Okazaki en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KamatsukiYusuke en-aut-sei=Kamatsuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyazawaShinichi en-aut-sei=Miyazawa en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YasumitsuMasaharu en-aut-sei=Yasumitsu en-aut-mei=Masaharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Iwakuni Clinical Center kn-affil= affil-num=10 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= en-keyword=Medial meniscus kn-keyword=Medial meniscus en-keyword=Posterior root tear kn-keyword=Posterior root tear en-keyword=Transtibial fixation kn-keyword=Transtibial fixation en-keyword=Meniscus extrusion kn-keyword=Meniscus extrusion en-keyword=Open magnetic resonance imaging kn-keyword=Open magnetic resonance imaging END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=1 article-no= start-page=191 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200526 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Short-term outcomes of mirogabalin in patients with peripheral neuropathic pain: a retrospective study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the 兛2兟 subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the 兛2兟-1 and 兛2兟-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin.
Methods
We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests.
Results
The mean age of the patients was 72.3?years (range, 30?94?years), and the mean duration of disease was 37?months (range, 3?252?months). After treatment with mirogabalin for 1?week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8?weeks, NRS scores improved by ??30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin.
Conclusions
The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain. en-copyright= kn-copyright= en-aut-name=TetsunagaTomoko en-aut-sei=Tetsunaga en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TetsunagaTomonori en-aut-sei=Tetsunaga en-aut-mei=Tomonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MisawaHaruo en-aut-sei=Misawa en-aut-mei=Haruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamaneKentaro en-aut-sei=Yamane en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TsujiHironori en-aut-sei=Tsuji en-aut-mei=Hironori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakeiYoshitaka en-aut-sei=Takei en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Orthopedic Surgery, Kurashiki Municipal Hospital kn-affil= affil-num=9 en-affil=Department of Orthopedic Surgery, Okayama University Hospital kn-affil= en-keyword=Peripheral neuropathic pain kn-keyword=Peripheral neuropathic pain en-keyword=Mirogabalin kn-keyword=Mirogabalin en-keyword=Pregabalin kn-keyword=Pregabalin en-keyword=Adverse event kn-keyword=Adverse event END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=1 article-no= start-page=282 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200228 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Transversus Abdominis Plane Block Reduced Early Postoperative Pain after Robot-assisted Prostatectomy: a Randomized Controlled Trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Analgesic effect of transversus abdominis plane block (TAP block) in lower major abdominal laparoscopic surgery with about 5 cm of maximum surgical scar has been controversial. We hypothesized that TAP block has benefits, so the analgesic effect of TAP block after robot-assisted laparoscopic prostatectomy (RALP) was evaluated. One hundred patients were enrolled in this prospective, double-blinded, randomized study. Standardized general anesthesia with wound infiltration on camera port and fentanyl dose limit of 3 mu g/kg was provided. Ultrasound-guided, single-shot subcostal TAP block with either 0.375% ropivacaine (Ropivacaine group, 48 patients) or normal saline (Control group, 52 patients) was performed by anesthesiologist in charge (34 anesthesiologists) after surgical procedure. Pain score using numerical rating scale (NRS) and postoperative intravenous fentanyl were evaluated for the first 24 postoperative hours. Median values (interquartile range) of NRS scores when the patients were transferred to post-anesthesia care unit (PACU) were 5 (2-7) in Ropivacaine group and 6 (4-8) in Control group at rest (P = 0.03), 5 (2-8) in Ropivacaine group and 7 (5-8) in Control group during movement (P < 0.01). These significant differences disappeared at the time of discharging PACU. Fentanyl doses for the first 24 postoperative hours were 210 mu g (120-360) in Ropivacaine group and 200 mu g (120-370) in Control group (P = 0.79). These results indicated that subcostal TAP block by anesthesiologists of varied level of training reduced postoperative pain immediate after RALP. TAP block had fundamental analgesic effect, but this benefit was too small to reduce postoperative 24-hour fentanyl consumption. en-copyright= kn-copyright= en-aut-name=TaninishiHideki en-aut-sei=Taninishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsusakiTakashi en-aut-sei=Matsusaki en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=3 article-no= start-page=430 end-page=434 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200704 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=High body mass index is a risk factor for unfavorable clinical outcomes after medial meniscus posterior root repair in well-aligned knees en-subtitle= kn-subtitle= en-abstract= kn-abstract=BackgroundSevere chondral lesions and varus knee alignment are associated with poor outcomes following transtibial pullout repair for medial meniscus posterior root tears and meniscus tear is strongly associated with body mass index. The prognostic factors in well-aligned knees (femorotibial angle? MethodsWe retrospectively reviewed the files of 28 patients who had undergone pullout repair of medial meniscus posterior root tears between October 2016 and December 2017. We recorded the baseline characteristics (age, gender, height, weight, and body mass index) and the time between injury and surgery. We recorded the International Knee Documentation Committee scores, Knee injury and Osteoarthritis Outcome Scores, and pain visual analog scale scores. Using magnetic resonance imaging preoperatively and 1 year after surgery, we measured the medial meniscus body width and absolute and relative medial meniscus extrusion. Pearson correlation and multivariate linear regression analyses were used to assess potential associations between these factors and clinical outcomes.
ResultsAge positively correlated (coefficient?=?0.49, P? ConclusionsBody mass index?>?30?kg/m(2) is a risk factor for unfavorable clinical outcomes following pullout repair of medial meniscus posterior root tears in well-aligned knees. Level of evidenceIII, Comparative retrospective study. en-copyright= kn-copyright= en-aut-name=ZhangXiming en-aut-sei=Zhang en-aut-mei=Ximing kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=XueHaowei en-aut-sei=Xue en-aut-mei=Haowei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkazakiYoshiki en-aut-sei=Okazaki en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=3 article-no= start-page=209 end-page=214 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Clinical Study Evaluating an Aspiration-type Semi-Automatic Cutting Biopsy Needle (SCIRO-1702) en-subtitle= kn-subtitle= en-abstract= kn-abstract=An aspiration-type semi-automatic cutting biopsy needle enables tissue cutting during application of negative pressure, which is expected to contribute to a larger amount of specimen. The aim of the present study was to evaluate this novel needle in a clinical setting. Patients who underwent image-guided percutaneous biopsy for lung or renal masses were enrolled. Cutting biopsy was performed with and without aspiration during each procedure. The specimens were weighed using an electronic scale. The weights were compared between specimens obtained with and without aspiration using a paired t-test. The data from 45 lung and 30 renal biopsy procedures were analyzed. In lung biopsy, the mean亇standard deviation weights of specimens obtained with and without aspiration were 2.20亇1.05 mg and 2.24亇1.08 mg, respectively. In renal biopsy, the mean weights were 6.52亇2.18 mg and 6.42亇1.62 mg, respectively. The weights were not significantly different between specimens obtained with and without aspiration either in lung (p=0.799) or renal (p=0.789) biopsies. The application of negative pressure with the aspiration-type semi-automatic cutting biopsy needle did not contribute to an increase in the amount of the specimen obtained in lung and renal biopsies. en-copyright= kn-copyright= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakuraiJun en-aut-sei=Sakurai en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MasaokaYoshihisa en-aut-sei=Masaoka en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=GobaraHideo en-aut-sei=Gobara en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Center for Innovative Clinical Medicine kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Division of Medical Informatics, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=biopsy kn-keyword=biopsy en-keyword=cutting needle kn-keyword=cutting needle en-keyword=aspiration kn-keyword=aspiration en-keyword=clinical study kn-keyword=clinical study END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue=6 article-no= start-page=1659 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200317 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Diagnosis of Occlusal Caries with Dynamic Slicing of 3D Optical Coherence Tomography Images en-subtitle= kn-subtitle= en-abstract= kn-abstract=Detecting the extent of occlusal caries is a clinically important but challenging task required for treatment decision making. The aim of this study was to assess the diagnostic power of 3D swept-source optical coherence tomography (OCT) for evaluation of occlusal caries in comparison with X-ray radiography. Extracted human molars not exhibiting American Dental Association (ADA) criteria advanced caries were mounted in a silicone block and digital dental radiographs were captured from the buccal side. Subsequently, occlusal surfaces were scanned with a prototype Yoshida Dental OCT. Thirteen examiners evaluated the presence and extent of caries on radiographs and dynamically sliced 3D OCT video images, using a 4 level scale-0: intact; 1: enamel demineralization without cavitation; 2: enamel caries with cavitation; 3: dentin caries with or without cavitation. Sensitivity, specificity and area under operating characteristic curves (Az) were statistically analyzed (alpha = 0.05). Reliability analysis showed an excellent agreement among the 13 examiners for both methods. The OCT presented a significantly higher sensitivity and Az value for the detection of caries compared to radiographs (p < 0.05). Radiography showed especially low sensitivity for dentin caries (0-2 versus 3). Dynamic slicing of 3D OCT volumes is a powerful adjunct tool to visual inspection to diagnose the dentin occlusal caries in vitro. en-copyright= kn-copyright= en-aut-name=LuongMinh N. en-aut-sei=Luong en-aut-mei=Minh N. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShimadaYasushi en-aut-sei=Shimada en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ArakiKazuyuki en-aut-sei=Araki en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshiyamaMasahiro en-aut-sei=Yoshiyama en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TagamiJunji en-aut-sei=Tagami en-aut-mei=Junji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SadrAlireza en-aut-sei=Sadr en-aut-mei=Alireza kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Restorative Dentistry, University of Washington kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry kn-affil= affil-num=4 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University kn-affil= affil-num=6 en-affil=Department of Restorative Dentistry, University of Washington kn-affil= en-keyword=dentin kn-keyword=dentin en-keyword=enamel kn-keyword=enamel en-keyword=optical coherence tomography kn-keyword=optical coherence tomography en-keyword=radiograph kn-keyword=radiograph en-keyword=receiver operating characteristic (ROC) analysis kn-keyword=receiver operating characteristic (ROC) analysis en-keyword=hidden caries kn-keyword=hidden caries en-keyword=dentino-enamel junction DEJ kn-keyword=dentino-enamel junction DEJ END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=6 article-no= start-page=830 end-page=846 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Icodextrin Versus Glucose Solutions for the Once-Daily Long Dwell in Peritoneal Dialysis: An Enriched Systematic Review and Meta-analysis of Randomized Controlled Trials en-subtitle= kn-subtitle= en-abstract= kn-abstract=Rationale & Objective
The efficacy and safety of icodextrin versus glucose-only peritoneal dialysis (PD) regimens is unclear. The aim of this study was to compare once-daily long-dwell icodextrin versus glucose among patients with kidney failure undergoing PD.
Study Design
Systematic review of randomized controlled trials (RCTs), enriched with unpublished data from investigator-initiated and industry-sponsored studies.
Setting & Study Populations
Individuals with kidney failure receiving regular PD treatment enrolled in clinical trials of dialysate composition.
Selection Criteria for Studies
Medline, Embase, CENTRAL, Ichushi Web, 10 Chinese databases, clinical trials registries, conference proceedings, and citation lists from inception to November 2018. Further data were obtained from principal investigators and industry clinical study reports.
Data Extraction
2 independent reviewers selected studies and extracted data using a prespecified extraction instrument.
Analytic Approach
Qualitative synthesis of demographics, measurement scales, and outcomes. Quantitative synthesis with Mantel-Haenszel risk ratios (RRs), Peto odds ratios (ORs), or (standardized) mean differences (MDs). Risk of bias of included studies at the outcome level was assessed using the Cochrane risk-of-bias tool for RCTs.
Results
19 RCTs that enrolled 1,693 participants were meta-analyzed. Ultrafiltration was improved with icodextrin (medium-term MD, 208.92 [95% CI, 99.69-318.14] mL/24 h; high certainty of evidence), reflected also by fewer episodes of fluid overload (RR, 0.43 [95% CI, 0.24-0.78]; high certainty). Icodextrin-containing PD probably decreased mortality risk compared to glucose-only PD (Peto OR, 0.49 [95% CI, 0.24-1.00]; moderate certainty). Despite evidence of lower peritoneal glucose absorption with icodextrin-containing PD (medium-term MD, ?40.84 [95% CI, ?48.09 to ?33.59] g/long dwell; high certainty), this did not directly translate to changes in fasting plasma glucose (?0.50 [95% CI, ?1.19 to 0.18] mmol/L; low certainty) and hemoglobin A1c levels (?0.14% [95% CI, ?0.34% to 0.05%]; high certainty). Safety outcomes and residual kidney function were similar in both groups; health-related quality-of-life and pain scores were inconclusive.
Limitations
Trial quality was variable. The follow-up period was heterogeneous, with a paucity of assessments over the long term. Mortality results are based on just 32 events and were not corroborated using time-to-event analysis of individual patient data.
Conclusions
Icodextrin for once-daily long-dwell PD has clinical benefit for some patients, including those not meeting ultrafiltration targets and at risk for fluid overload. Future research into patient-centered outcomes and cost-effectiveness associated with icodextrin is needed. en-copyright= kn-copyright= en-aut-name=GoossenK?the en-aut-sei=Goossen en-aut-mei=K?the kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=BeckerMonika en-aut-sei=Becker en-aut-mei=Monika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MarshallMark R. en-aut-sei=Marshall en-aut-mei=Mark R. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=B?hnStefanie en-aut-sei=B?hn en-aut-mei=Stefanie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=BreuingJessica en-aut-sei=Breuing en-aut-mei=Jessica kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FiranekCatherine A. en-aut-sei=Firanek en-aut-mei=Catherine A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HessSimone en-aut-sei=Hess en-aut-mei=Simone kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NariaiHisanori en-aut-sei=Nariai en-aut-mei=Hisanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SloandJames A. en-aut-sei=Sloand en-aut-mei=James A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YaoQiang en-aut-sei=Yao en-aut-mei=Qiang kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ChangTae Ik en-aut-sei=Chang en-aut-mei=Tae Ik kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ChenJinBor en-aut-sei=Chen en-aut-mei=JinBor kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=PaniaguaRam?n en-aut-sei=Paniagua en-aut-mei=Ram?n kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TakatoriYuji en-aut-sei=Takatori en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=PieperDawid en-aut-sei=Pieper en-aut-mei=Dawid kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=2 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=3 en-affil=Baxter Healthcare (Asia) Pte Ltd kn-affil= affil-num=4 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=5 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=6 en-affil=Baxter Healthcare International kn-affil= affil-num=7 en-affil=nstitute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=8 en-affil=Baxter Japan Ltd kn-affil= affil-num=9 en-affil=Baxter Healthcare International kn-affil= affil-num=10 en-affil=Baxter (China) Investment Co. Ltd kn-affil= affil-num=11 en-affil=Department of Internal Medicine, NHIS Medical Center kn-affil= affil-num=12 en-affil=Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine kn-affil= affil-num=13 en-affil=Research Unit, Unidad de Investigaci?n M?dica en Enfermedades Nefrol?gicas, Centro M?dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS) kn-affil= affil-num=14 en-affil=Internal Medicine, Rijinkai Medical Foundation, Socio-Medical Corporation, Kohsei General Hospital kn-affil= affil-num=15 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=nstitute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=131 cd-vols= no-issue=3 article-no= start-page=139 end-page=143 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20191202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Efficacy of Helicobacter pylori eradication followed by the administration of a proton pump inhibitor (PPI) or PPI plus a prokinetic in H. pylori-positive patients with dyspepsia kn-title=僨傿僗儁僾僔傾徢忬傪慽偊傞僿儕僐僶僋僞乕丒僺儘儕姶愼堓墛偵懳偡傞彍嬠帯椕偲丆僾儘僩儞億儞僾慾奞嵻丆徚壔娗塣摦婡擻夵慞嵻偺慻傒崌傢偣帯椕偵傛傞徢忬夵慞岠壥偺専摙 en-subtitle= kn-subtitle= en-abstract= kn-abstract=To investigate whether treatment comprised of Helicobacter pylori eradication followed by the administration of a proton pump inhibitor (PPI) alone and a dual treatment with a PPI plus a prokinetic agent helps relieve symptoms, we treated 26 patients with H. pylori infection and dyspepsia with the sequential treatment and assessed their symptoms. Scores for gastroesophageal reflux disease (GERD) and dyspepsia in a modified F-scale were significantly improved after the eradication of H. pylori, and symptoms were completely relieved in 13 patients. The remaining 13 patients received 4-week treatment with the PPI rabeprazole, and their GERD scores significantly improved after the treatment. The symptoms of five patients completely disappeared ; the other eight patients required dual treatment with a PPI plus the prokinetic acotiamide. Early satiety tended to be relieved after the dual treatment, but the improvement was not significant. Thus, in patients with dyspepsia and an H. pylori infection, the H. pylori should be eradicated first. The administration of a PPI is useful in patients with GERD symptoms, and a PPI+ acotiamide may be beneficial for residual symptoms of early satiety. en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=嶰塝岞 kn-aut-sei=嶰塝 kn-aut-mei=岞 aut-affil-num=1 ORCID= en-aut-name=IwamuroMasaya en-aut-sei=Iwamuro en-aut-mei=Masaya kn-aut-name=娾幒夒栫 kn-aut-sei=娾幒 kn-aut-mei=夒栫 aut-affil-num=2 ORCID= en-aut-name=ToyokawaTatsuya en-aut-sei=Toyokawa en-aut-mei=Tatsuya kn-aut-name=朙愳払栫 kn-aut-sei=朙愳 kn-aut-mei=払栫 aut-affil-num=3 ORCID= en-aut-name=TakenakaRyuta en-aut-sei=Takenaka en-aut-mei=Ryuta kn-aut-name=抾拞棿懢 kn-aut-sei=抾拞 kn-aut-mei=棿懢 aut-affil-num=4 ORCID= en-aut-name=InoueMasafumi en-aut-sei=Inoue en-aut-mei=Masafumi kn-aut-name=堜忋夒暥 kn-aut-sei=堜忋 kn-aut-mei=夒暥 aut-affil-num=5 ORCID= en-aut-name=ItoMamoru en-aut-sei=Ito en-aut-mei=Mamoru kn-aut-name=埳摗庣 kn-aut-sei=埳摗 kn-aut-mei=庣 aut-affil-num=6 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name=壀揷桾擵 kn-aut-sei=壀揷 kn-aut-mei=桾擵 aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Internal Medicine, Tsuyama Chuo Hospital kn-affil=捗嶳拞墰昦堾丂撪壢 affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Phamaceutical Sciences kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 affil-num=3 en-affil=Department of Gastroenterology, Fukuyama Medical Center kn-affil=暉嶳堛椕僙儞僞乕丂徚壔婍撪壢 affil-num=4 en-affil=Department of Internal Medicine, Tsuyama Chuo Hospital kn-affil=捗嶳拞墰昦堾丂撪壢 affil-num=5 en-affil=Department of Gastroenterology, Okayama Red Cross Hospital kn-affil=壀嶳愒廫帤昦堾丂徚壔婍撪壢 affil-num=6 en-affil=Department of Internal Medicine, Okayama Saiseikai General Hospital kn-affil=壀嶳嵪惗夛憤崌昦堾丂撪壢 affil-num=7 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Phamaceutical Sciences kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 en-keyword= 婡擻惈僨傿僗儁僾僔傾 (functional dyspepsia) kn-keyword= 婡擻惈僨傿僗儁僾僔傾 (functional dyspepsia) en-keyword=僿儕僐僶僋僞乕丒僺儘儕 (Helicobacter pylori) kn-keyword=僿儕僐僶僋僞乕丒僺儘儕 (Helicobacter pylori) en-keyword=僾儘僩儞億儞僾慾奞嵻 (proton pomp inhibitor) kn-keyword=僾儘僩儞億儞僾慾奞嵻 (proton pomp inhibitor) en-keyword=徚壔娗塣摦婡擻夵慞嵻 (acotiamide) kn-keyword=徚壔娗塣摦婡擻夵慞嵻 (acotiamide) END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=1 article-no= start-page=65 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20191106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association of Japan Coma Scale score on hospital arrival with in-hospital mortality among trauma patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND: The Japan Coma Scale (JCS) score has been widely used to assess patients' consciousness level in Japan. JCS scores are divided into four main categories: alert (0) and one-, two-, and three-digit codes based on an eye response test, each of which has three subcategories. The purpose of this study was to investigate the utility of the JCS score on hospital arrival in predicting outcomes among adult trauma patients.
METHODS: Using the Japan Trauma Data Bank, we conducted a nationwide registry-based retrospective cohort study. Patients 16?years old or older directly transported from the trauma scene between January 2004 and December 2017 were included. Our primary outcome was in-hospital mortality. We examined outcome prediction accuracy based on area under the receiver operating characteristic curve (AUROC) and multiple logistic regression analysis with multiple imputation.
RESULTS: A total of 222,540 subjects were included; their in-hospital mortality rate was 7.1% (n =?15,860). The 10-point scale JCS and the total sum of Glasgow Coma Scale (GCS) scores demonstrated similar performance, in which the AUROC (95% CIs) showed 0.874 (0.871-0.878) and 0.878 (0.874-0.881), respectively. Multiple logistic regression analysis revealed that the higher the JCS score, the higher the predictability of in-hospital death. When we focused on the simple four-point scale JCS score, the adjusted odds ratio (95% confidence intervals [CIs]) were 2.31 (2.12-2.45), 4.81 (4.42-5.24), and 27.88 (25.74-30.20) in the groups with one-digit, two-digit, and three-digit scores, respectively, with JCS of 0 as a reference category.
CONCLUSIONS: JCS score on hospital arrival after trauma would be useful for predicting in-hospital mortality, similar to the GCS score. en-copyright= kn-copyright= en-aut-name=YumotoTetsuya en-aut-sei=Yumoto en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NaitouHiromichi en-aut-sei=Naitou en-aut-mei=Hiromichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AokageToshiyuki en-aut-sei=Aokage en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujisakiNoritomo en-aut-sei=Fujisaki en-aut-mei=Noritomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama kn-affil= affil-num=4 en-affil=Department of Geriatric Emergency Medicine, Okayama University Graduate School of Medicine,Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Glasgow coma scale kn-keyword=Glasgow coma scale en-keyword=Japan Coma Scale kn-keyword=Japan Coma Scale en-keyword=Mortality kn-keyword=Mortality en-keyword=Trauma kn-keyword=Trauma en-keyword=Traumatic brain injury kn-keyword=Traumatic brain injury END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1 article-no= start-page=73 end-page=76 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Surgical Instructor Training Course for the Next Generation en-subtitle= kn-subtitle= en-abstract= kn-abstract= In 2016, Gunma University Hospital乫s Medical Accident Investigation Committee released a report reiterating the necessity of medical education and the need for surgeons to master non-technical skills. We designed a 17-h training course for surgical instructors, designed to teach participants how to sufficiently educate surgeon trainees and encourage their professional identity formation. A post-training survey showed that participants improved their awareness, and their behavioral changes led to favorable team performances. We then began offering a 3-h workshop focusing on the participants乫 experiences. We propose that the training course using participant narratives is required and effective to establish surgeons乫 self-reflection and professional identity as surgeons. en-copyright= kn-copyright= en-aut-name=YamaneMasaomi en-aut-sei=Yamane en-aut-mei=Masaomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=Mandai Yasuhiro en-aut-sei=Mandai en-aut-mei= Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InoHideo en-aut-sei=Ino en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsukawaAkihiro en-aut-sei=Matsukawa en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ToyookaShinichi en-aut-sei=Toyooka en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Pathology and Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=professional identity kn-keyword=professional identity en-keyword=instructor training kn-keyword=instructor training en-keyword=narrative kn-keyword=narrative END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1 article-no= start-page=33 end-page=40 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Relevance of Blood Glucose and Gastroesophageal Reflux Symptoms to Depressive Status in Patients with Type 2 Diabetes Mellitus en-subtitle= kn-subtitle= en-abstract= kn-abstract= A relationship between diabetes and depression is apparent. To clarify the clinical relevance of diabetic patients乫 gastroesophageal symptoms to their psychological status, we retrospectively analyzed the data from a Selfrating Depression Scale (SDS) and a Frequency Scale for Symptoms of Gastroesophageal reflux disease (FSSG) among 143 type 2 diabetic patients who visited a general medicine department. Among the 45 Japanese patients enrolled, the group with relatively high SDS scores (? 36) showed higher (FSSG) dysmotility symptom scores versus the low-SDS (< 36) group, although the 2 groups乫 characteristics and laboratory data were not significantly different. Positive correlations of postprandial plasma glucose (PPG) levels with FSSG scores (R=0.321, p<0.05), particularly with reflux scores (R=0.455, p<0.01) were revealed. PPG and HbA1c levels were not correlated with SDS scores. The patients乫 SDS scores were significantly correlated with their FSSG scores (R=0.41, p<0.01), suggesting that depressive status is linked to GERD-related manifestations. Considering that the patients乫 PPG levels were correlated with GERD-related symptoms, diabetic patients乫 blood glucose levels are associated with depressive status. Collectively, key symptoms related to GERD and glucose level values would be helpful en-copyright= kn-copyright= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HamaharaJun en-aut-sei=Hamahara en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OgawaHiroko en-aut-sei=Ogawa en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=blood glucose kn-keyword=blood glucose en-keyword= type 2 diabetes mellitus kn-keyword= type 2 diabetes mellitus en-keyword=gastroesophageal reflux kn-keyword=gastroesophageal reflux en-keyword=depressive status kn-keyword=depressive status en-keyword=postprandial plasma glucose kn-keyword=postprandial plasma glucose END start-ver=1.4 cd-journal=joma no-vol=61 cd-vols= no-issue=1 article-no= start-page=133 end-page=139 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190328 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The level of salivary lactate dehydrogenase as an indicator of the association between gingivitis and related factors in Japanese university students en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of this study was to investigate the association between the presence of gingivitis estimated using the salivary level of lactate dehydrogenase (LD) and related factors in young Japanese adults. Data from 1,915 participants (21.4 亇 2.5 years) were analyzed. Unstimulated saliva was collected from each participant and the salivary LD level was evaluated using a commercially available test kit with an integer scale ranging from 1 to 10. Gingivitis was defined as the LD level of ?8. The number of permanent teeth, the simplified oral hygiene index (OHI-S), the presence of partially erupted molars and body mass index were recorded. Additionally, participants answered a questionnaire. The percentage of male participants, the number of permanent teeth, the OHI-S and the presence of partially erupted molars were higher, whereas the proportion receiving dental check-ups was lower in the gingivitis group (n = 88, 4.6%) than in the healthy group. Logistic regression analysis showed that gingivitis was significantly associated with OHI-S (OR: 2.68, 95% CI: 1.94-3.69) and receiving dental checkups (OR: 0.31, 95% CI: 0.10-0.99). The present findings indicated that the OHI-S and receiving dental checkups were significantly associated with gingivitis, as assessed by the salivary LD level, in this cohort. en-copyright= kn-copyright= en-aut-name=Taniguchi-TabataAyano en-aut-sei=Taniguchi-Tabata en-aut-mei=Ayano kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=EkuniDaisuke en-aut-sei=Ekuni en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AzumaTetsuji en-aut-sei=Azuma en-aut-mei=Tetsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YonedaToshiki en-aut-sei=Yoneda en-aut-mei=Toshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=Yamane-TakeuchiMayu en-aut-sei=Yamane-Takeuchi en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KataokaKota en-aut-sei=Kataoka en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MizunoHirofumi en-aut-sei=Mizuno en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyaiHisataka en-aut-sei=Miyai en-aut-mei=Hisataka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MoritaManabu en-aut-sei=Morita en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Community Oral Health, Asahi University School of Dentistry kn-affil= affil-num=4 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Health Service Center, Okayama University kn-affil= affil-num=10 en-affil=Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=lactate dehydrogenase kn-keyword=lactate dehydrogenase en-keyword=gingivitis; screening kn-keyword=gingivitis; screening en-keyword=young adults kn-keyword=young adults en-keyword=cross-sectional study kn-keyword=cross-sectional study END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=6 article-no= start-page=566 end-page=573 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190227 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical characteristics of elderly depressive patients with low metaiodobenzylguanidine uptake en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND:
Recently, depression with Lewy body pathology before the appearance of parkinsonism and cognitive dysfunction has been drawing attention. Low cardiac metaiodobenzylguanidine (MIBG) uptake is helpful for early differentiation of Lewy body disease (LBD) from late-onset psychiatric disorders even before parkinsonism or dementia appears. In this study, we used MIBG uptake as a tool in suspected LBD, and evaluated the relationship of MIBG results to clinical characteristics and depressive symptoms.
METHODS:
Fifty-two elderly inpatients with depression were included in this study. The Hamilton Depression Rating Scale (HDRS) was administered at admission, and 123 I-MIBG cardiac scintigraphy was performed. Of 52 patients, 38 had normal and 14 had reduced MIBG uptake.
RESULTS:
Correlation analyses of the late phase heart-to-mediastinum (H/M) ratio on the MIBG test and each item of the HDRS revealed that the H/M ratio was significantly correlated with scores of 'agitation', 'anxiety-somatic', and 'retardation' on the HDRS. Mean HDRS composite scores of 'somatic and psychic anxiety (Marcos)' and 'somatic anxiety/somatization factor (Pancheri)' were higher in the low uptake group than in the normal uptake group.
CONCLUSION:
Elderly patients with depression who manifested an obvious somatic anxiety tend to show low MIBG uptake, and are more likely to have Lewy body pathology. en-copyright= kn-copyright= en-aut-name=TakenoshitaShintaro en-aut-sei=Takenoshita en-aut-mei=Shintaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TeradaSeishi en-aut-sei=Terada en-aut-mei=Seishi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OshimaEtsuko en-aut-sei=Oshima en-aut-mei=Etsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamaguchiMegumi en-aut-sei=Yamaguchi en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HayashiSatoshi en-aut-sei=Hayashi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HinotsuKenji en-aut-sei=Hinotsu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=EsumiSatoru en-aut-sei=Esumi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShinyaTakayoshi en-aut-sei=Shinya en-aut-mei=Takayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Pediatric Radiology, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=depression kn-keyword=depression en-keyword=elderly kn-keyword=elderly en-keyword=Lewy body disease kn-keyword=Lewy body disease en-keyword=metaiodobenzylguanidine kn-keyword=metaiodobenzylguanidine en-keyword=somatic anxiety kn-keyword=somatic anxiety END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=6 article-no= start-page=479 end-page=486 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Correlations between Depressive Condition and Gastroesophageal Reflux Symptoms in Patients Visiting a Department of General Medicine en-subtitle= kn-subtitle= en-abstract= kn-abstract= To clarify the potential relevance of patients乫 chief complaints at a general medicine department to their self-rating depression scale (SDS) and frequency scale for symptoms of gastroesophageal reflux disease (GERD) (FSSG) scores, we analyzed data of 478 patients who visited our general medicine department. The chief complaints (553 symptoms of 447 patients) were categorized into major symptom-based groups: respiratory (31%), circulatory (3%), gastrointestinal (GI) tract (26%), neurology (8%), orthopedic and skin (10%), and systemic (22%) symptoms. The SDS score tended to be higher in females and younger patients. The FSSG score did not differ by gender but was higher in younger patients. The patients receiving social welfare had higher SDS and FSSG scores. A close inter-relationship between the FSSG (including both degrees of reflux and dysmotility) and SDS was observed in all patients. Although the averages of the SDS and FSSG scores were not significantly different among the symptom-based categories, we observed significantly positive correlations between the FSSG and SDS in each category, suggesting that depressive status may be closely related to GERD-related symptoms regardless of the patients乫 chief complaints. An initial checkup of patients乫 psychological condition and/or GERD-like symptoms could help screen for latent disorders in outpatients with uncertain complaints. en-copyright= kn-copyright= en-aut-name=SuganamiYu en-aut-sei=Suganami en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkaKosuke en-aut-sei=Oka en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HondaHiroyuki en-aut-sei=Honda en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HamaharaJun en-aut-sei=Hamahara en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KariyamaKazuya en-aut-sei=Kariyama en-aut-mei=Kazuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=chief complaints kn-keyword=chief complaints en-keyword=frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) kn-keyword=frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) en-keyword=self-rating depression scale (SDS) kn-keyword=self-rating depression scale (SDS) en-keyword=welfare kn-keyword=welfare END start-ver=1.4 cd-journal=joma no-vol=43 cd-vols= no-issue=5 article-no= start-page=1239 end-page=1245 dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=20180801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Arthroscopic scoring system of meniscal healing following medial meniscus posterior root repair en-subtitle= kn-subtitle= en-abstract= kn-abstract=PURPOSE:
Medial meniscus posterior root tear (MMPRT) leads to a rapid degradation of articular cartilage. In the treatment of MMPRT, transtibial pullout repair demonstrates a high clinical survival rate. However, there is no reliable method to evaluate the meniscal healing after surgery. We propose an arthroscopic scoring system for evaluating the meniscal healing status. The aim of this study was to investigate the correlations between second-look arthroscopic scores and clinical outcomes after transtibial pullout repair.
METHODS:
Twenty patients who had MMPRTs underwent transtibial pullout repairs. Clinical outcomes were assessed using the Japanese Knee Injury and Osteoarthritis Outcome Score (KOOS) and pain score evaluated by visual analogue scale at preoperatively and 1 year postoperatively. The healing status of repaired MM was assessed at one year post-operatively using a semi-quantitative arthroscopic scoring system (total, 10 points) composed of three evaluation criteria: (i) anteroposterior width of bridging tissues, (ii) stability of the MM posterior root, and (iii) synovial coverage of the sutures. Linear regression analysis was used to assess the correlation between second-look arthroscopic scores and clinical outcomes.
RESULTS:
Transtibial pullout repairs of MMPRTs significantly improved clinical evaluation scores at one year post-operatively. A median of second-look arthroscopic scores was 6.5 (5.75-8). A good correlation was observed between the arthroscopic score and KOOS quality of life (QOL) subscale. A moderate negative correlation between the arthroscopic score and pain score was observed.
CONCLUSIONS:
This study demonstrated that our semi-quantitative scoring system of meniscal healing correlated with the KOOS QOL subscale following MMPRT transtibial pullout repair. Our results suggest that the second-look arthroscopic score using this system may be a useful scale to determine and compare the healing status of the MM posterior root. en-copyright= kn-copyright= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyazawaShinichi en-aut-sei=Miyazawa en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiMasataka en-aut-sei=Fujii en-aut-mei=Masataka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TanakaTakaaki en-aut-sei=Tanaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Hospital kn-affil= en-keyword=Arthroscopic scoring kn-keyword=Arthroscopic scoring en-keyword=Medial meniscus kn-keyword=Medial meniscus en-keyword=Meniscal healing kn-keyword=Meniscal healing en-keyword=Posterior root tear kn-keyword=Posterior root tear en-keyword=Transtibial pullout repair kn-keyword=Transtibial pullout repair END start-ver=1.4 cd-journal=joma no-vol=41 cd-vols= no-issue=11 article-no= start-page=1001 end-page=1007 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20191005 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Yoga-plus exercise mix promotes cognitive, affective, and physical functions in elderly people en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objectives:
Increased attention is being paid to Asian medicine in balanced total health care. We investigated the effects of mixed exercise including yoga ('Yoga-plus') among elderly individuals.
Methods:
A total of 385 subjects (72 males and 313 females, 75.5 亇 8.7 years old) participated in a 12-month (M) exercise program at a health and welfare center, a day service center, and a nursing home. Cognitive, affective, and physical functions, and activities of daily living (ADL), were compared at baseline (0M), 6M and 12M of exercise intervention.
Results:
Mean scores on the frontal assessment battery, clock drawing test, cube copying test, letter fluency, and category fluency significantly improved after the Yoga-plus intervention, while mini-mental state examination, Hasegawa dementia score-revised, and trail-making test performance were relatively stable. Affective scores on the geriatric depression scale (GDS), apathy scale (AS) and Abe's behavioral and psychological symptoms of dementia were not significantly affected by exercise therapy, but subgroups with higher baseline GDS (GDS ? 5) and AS (AS ? 16) scores showed a significant improvement after intervention. One-leg standing time and 3-m timed up and go test performance significantly improved after 12M intervention.
Discussion:
Yoga-plus improved cognitive, affective, ADL, and physical functions in a local elderly population, particularly among below-baseline individuals, indicating the benefits of dementia prevention among elderly individuals. en-copyright= kn-copyright= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakahashiYoriko en-aut-sei=Takahashi en-aut-mei=Yoriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FukuiYusuke en-aut-sei=Fukui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokuchiRyo en-aut-sei=Tokuchi en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FurusawaJunichi en-aut-sei=Furusawa en-aut-mei=Junichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakemotoMami en-aut-sei=Takemoto en-aut-mei=Mami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Education, Nippon Ayurveda School kn-affil= affil-num=3 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Occupational Therapy, Okayama Institute for Medical and Technical Sciences kn-affil= affil-num=5 en-affil=Department of Occupational Therapy, Mizunaga Rehabilitation Hospital kn-affil= affil-num=6 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil= Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Affective function kn-keyword=Affective function en-keyword=cognitive function kn-keyword=cognitive function en-keyword=elderly population kn-keyword=elderly population en-keyword=physical function kn-keyword=physical function en-keyword=yoga exercise kn-keyword=yoga exercise END start-ver=1.4 cd-journal=joma no-vol=19 cd-vols= no-issue=1 article-no= start-page=123 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201904 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Validation of Addenbrooke's cognitive examination III for detecting mild cognitive impairment and dementia in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND:Early detection of mild cognitive impairment (MCI) and dementia is very important to begin appropriate treatment promptly and to prevent disease exacerbation. We investigated the screening accuracy of the Japanese version of Addenbrooke's Cognitive Examination III (ACE-III) to diagnose MCI and dementia.
METHODS:The original ACE-III was translated and adapted to Japanese. It was then administered to a Japanese population. The Hasegawa Dementia Scale-revised (HDS-R) and Mini-mental State Examination (MMSE) were also applied to evaluate cognitive dysfunction. In total, 389 subjects (dementia?=?178, MCI?=?137, controls?=?73) took part in our study.
RESULTS:The optimal ACE-III cut-off scores to detect MCI and dementia were 88/89 (sensitivity 0.77, specificity 0.92) and 75/76 (sensitivity 0.82, specificity 0.90), respectively. ACE-III was superior to HDS-R and MMSE in the detection of MCI or dementia. The internal consistency, test-retest reliability, and inter-rater reliability of ACE-III were excellent.
CONCLUSIONS:ACE-III is a useful cognitive test to detect MCI and dementia. ACE-III may be widely useful in clinical practice. en-copyright= kn-copyright= en-aut-name=TakenoshitaShintaro en-aut-sei=Takenoshita en-aut-mei=Shintaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TeradaSeishi en-aut-sei=Terada en-aut-mei=Seishi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YoshidaHidenori en-aut-sei=Yoshida en-aut-mei=Hidenori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamaguchiMegumi en-aut-sei=Yamaguchi en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YabeMayumi en-aut-sei=Yabe en-aut-mei=Mayumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ImaiNao en-aut-sei=Imai en-aut-mei=Nao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HoriuchiMakiko en-aut-sei=Horiuchi en-aut-mei=Makiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MikiTomoko en-aut-sei=Miki en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YokotaOsamu en-aut-sei=Yokota en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YamadaNorihito en-aut-sei=Yamada en-aut-mei=Norihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Addenbrooke乫s cognitive examination kn-keyword=Addenbrooke乫s cognitive examination en-keyword=Cognitive screening kn-keyword=Cognitive screening en-keyword=Diagnosis dementia kn-keyword=Diagnosis dementia en-keyword=Diagnosis mild cognitive impairment kn-keyword=Diagnosis mild cognitive impairment en-keyword=Mild cognitive impairment kn-keyword=Mild cognitive impairment END start-ver=1.4 cd-journal=joma no-vol=60 cd-vols= no-issue=24 article-no= start-page=1562 end-page=1565 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190613 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficient and practical synthesis of N-acetyl enamides from ketoximes by unique iron catalytic system en-subtitle= kn-subtitle= en-abstract= kn-abstract= A new procedure for the iron-catalyzed synthesis of enamides from ketoximes was developed, and its mechanism was proposed. A unique reduction system, with the concerted use of KI and Na2S2O4, was involved. The reaction exhibited a wide substrate scope and gave good yields in a short reaction time. The procedure is operationally simple and also applicable for the large-scale synthesis. en-copyright= kn-copyright= en-aut-name=Kunishige Takahiro en-aut-sei=Kunishige en-aut-mei= Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=Sawada Daisuke en-aut-sei=Sawada en-aut-mei= Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Ketoxime kn-keyword=Ketoxime en-keyword=Enamide synthesis kn-keyword=Enamide synthesis en-keyword=Iron catalyst kn-keyword=Iron catalyst en-keyword=One-electron reduction kn-keyword=One-electron reduction END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=2 article-no= start-page=337 end-page=341 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201903 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mini-open excision of osteoid osteoma using intraoperative O-arm/Stealth navigation en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Although osteoid osteomas have traditionally been treated by surgical excision, radiofrequency ablation (RFA) has gained favor as a less invasive procedure. However, RFA is contraindicated for osteoid osteomas close to the skin or crucial neurovascular structures, and is not covered by national health insurance in Japan. The aim of the present study was to evaluate the efficacy of surgical excision of osteoid osteomas using intraoperative navigation.
Methods
We performed a retrospective review of five patients with osteoid osteoma who underwent a mini-open excision using O-arm/Stealth navigation at our institution. The osteoid osteomas were excised using a cannulated cutter or curetted out with the assistance of navigation.
Results
Complete excision was achieved in all patients, which was confirmed by pathological examination. The mean skin incision was 2.1 cm (range, 1.5 to 3.0 cm) and the mean duration required for setup three-dimensional image was 15 min (range, 12 to 20 min). Although the mean visual analog scale score was 7 (range, 4 to 8) before surgery, all patients experienced relief from their characteristic pain immediately after surgery, with the mean scores of 2.2 (range, 1 to 3) and 0 at 2 days and 4 weeks after surgery, respectively. There was no intra-operative complication related to the navigation and no recurrence was observed during the mean follow-up period of 25 months (range, 13 to 33 months).
Conclusions
Mini-open excision using intraoperative O-arm/Stealth navigation is a safe and accurate procedure for patients with osteoid osteoma, which could cover the limitation of RFA. en-copyright= kn-copyright= en-aut-name=FujiwaraTomohiro en-aut-sei=Fujiwara en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakedaKen en-aut-sei=Takeda en-aut-mei=Ken kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HaseiJoe en-aut-sei=Hasei en-aut-mei=Joe kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakataEiji en-aut-sei=Nakata en-aut-mei=Eiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MochizukiYusuke en-aut-sei=Mochizuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KiyonoMasahiro en-aut-sei=Kiyono en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YoshidaAki en-aut-sei=Yoshida en-aut-mei=Aki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=3 article-no= start-page=223 end-page=228 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201906 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Post-traumatic Articular Cartilage Lesions Increase at Second-look Arthroscopy Following Primary Anterior Cruciate Ligament Reconstruction en-subtitle= kn-subtitle= en-abstract= kn-abstract= Anterior cruciate ligament (ACL) reconstruction (ACLR) after ACL rupture improves the instability of the knee joint and decreases mechanical stress to the meniscus and articular cartilage. However, there are reports that post-traumatic osteoarthritis (PTOA) is observed over time following ACLR. In this study, we assessed changes in cartilage lesions by arthroscopic findings following anatomical double-bundle ACLR and at post-operative second-look arthroscopy about 14 months later. We retrospectively evaluated 37 knees in cases with patients <40 years of age who had undergone an anatomical double-bundle ACL reconstruction <1 year after ACL rupture injury from March 2012 to December 2016. Clinical results and arthroscopic cartilage/meniscal lesion were evaluated and compared between a cartilage lesion-detected group and intact-cartilage group. Surgery improved anteroposterior laxity and other clinical measures; however, cartilage lesions were detected at 11 sites during ACLR and at 54 sites at second-look arthroscopy. The periods from injury to second-look arthroscopy and from ACLR to second-look arthroscopy were significantly longer in the cartilage-lesion group (n=23) than in the intact-cartilage group (n=14). Conversely, 96% of meniscal damage observed during ACLR was cured at the time of second-look arthroscopy. Knee articular cartilage lesions after ACL rupture cannot be completely suppressed, even using the anatomical ACL reconstruction technique. This study suggested that articular cartilage lesions can progress to a level that can be confirmed arthroscopically at approximately 17 months after ACL injury. Therefore, in ACLR patients, the possibility of developing knee articular cartilage lesions and PTOA should be considered. en-copyright= kn-copyright= en-aut-name=SugiuKazuhisa en-aut-sei=Sugiu en-aut-mei=Kazuhisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FurumatsuTakayuki en-aut-sei=Furumatsu en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KodamaYuya en-aut-sei=Kodama en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KamatsukiYusuke en-aut-sei=Kamatsuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OkazakiYoshiki en-aut-sei=Okazaki en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkazakiYuki en-aut-sei=Okazaki en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HiranakaTakaaki en-aut-sei=Hiranaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=anterior cruciate ligament reconstruction kn-keyword=anterior cruciate ligament reconstruction en-keyword=post-traumatic osteoarthritis kn-keyword=post-traumatic osteoarthritis en-keyword=meniscal lesion kn-keyword=meniscal lesion en-keyword=cartilage lesions kn-keyword=cartilage lesions en-keyword=second-look arthroscopy kn-keyword=second-look arthroscopy END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=1 article-no= start-page=81 end-page=84 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201902 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparison of Two Electrosurgical Modes for Endoscopic Submucosal Dissection of Superficial Colorectal Neoplasms: A Prospective Randomized Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= Endoscopic submucosal dissection (ESD) is reportedly one of the standard treatment strategies for large superficial colorectal neoplasms in Japan because of its high en bloc resection rate. A few technical issues regarding ESD should be considered, one of which is the selection of the Endo-cut I mode versus the Swift-coagulation mode as the electrosurgical unit mode setting during submucosal dissection. We seek to determine which of these two modes is more suitable for submucosal dissections of colorectal tumors with regard to procedure time and safety. en-copyright= kn-copyright= en-aut-name=SugiharaYuusaku en-aut-sei=Sugihara en-aut-mei=Yuusaku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HaradaKeita en-aut-sei=Harada en-aut-mei=Keita kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkaShohei en-aut-sei=Oka en-aut-mei=Shohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YasutomiEriko en-aut-sei=Yasutomi en-aut-mei=Eriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamasakiYasushi en-aut-sei=Yamasaki en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=InokuchiToshihiro en-aut-sei=Inokuchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KinugasaHideaki en-aut-sei=Kinugasa en-aut-mei=Hideaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakaharaMasahiro en-aut-sei=Takahara en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HiraokaSakiko en-aut-sei=Hiraoka en-aut-mei=Sakiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Division of Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=endoscopic submucosal dissection kn-keyword=endoscopic submucosal dissection en-keyword=electrosurgical mode kn-keyword=electrosurgical mode en-keyword=colorectal tumor kn-keyword=colorectal tumor END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=4 article-no= start-page=440 end-page=445 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Cognitive and affective benefits of combination therapy with galantamine plus cognitive rehabilitation for Alzheimer's disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIM: The aim of the present study was to compare the effects of a galantamine only therapy and a combination therapy with galantamine plus ambulatory cognitive rehabilitation for Alzheimer's disease patients. METHODS: For this retrospective cohort study, we enrolled 86 patients with Alzheimer's disease, dividing them into two groups - a galantamine only group (group G, n = 45) and a combination with galantamine plus ambulatory rehabilitation group (group G + R, n = 41). The present cognitive rehabilitation included a set of physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. We compared the Mini-Mental State Examination and Frontal Assessment Battery for cognitive assessment, and Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia score for affective assessment in two groups over 6 months. RESULTS: The baseline Mini-Mental State Examination score was 20.2 and 18.7 in groups G and G + R, respectively. Other baseline data (Frontal Assessment Battery, Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia) were not different between the two groups. Although group G kept all the scores stable until 6 months of the treatment, the Apathy Scale score showed a significant improvement in group G + R as early as 3 months, followed by the Mini-Mental State Examination and Frontal Assessment Battery improvements at 6 months (*P = 0.04 and *P = 0.02, respectively). The Geriatric Depression Scale and Abe's Behavioral and Psychological Symptoms of Dementia did not show any changes. CONCLUSION: The combination therapy of galantamine plus ambulatory cognitive rehabilitation showed a superior benefit both on cognitive and affective functions than galantamine only therapy in Alzheimer's disease patients. en-copyright= kn-copyright= en-aut-name=TokuchiRyo en-aut-sei=Tokuchi en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MatsuzonoKosuke en-aut-sei=Matsuzono en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakaoYoshiki en-aut-sei=Takao en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WakutaniYosuke en-aut-sei=Wakutani en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KonoSyoichiro en-aut-sei=Kono en-aut-mei=Syoichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=DeguchiKentaro en-aut-sei=Deguchi en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Neurology, Kurashiki Heisei Hospital kn-affil= affil-num=5 en-affil=Department of Neurology, Kurashiki Heisei Hospital kn-affil= affil-num=6 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=8 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Neurology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= en-keyword=Alzheimer's disease kn-keyword=Alzheimer's disease en-keyword=affective function kn-keyword=affective function en-keyword=cognitive function kn-keyword=cognitive function en-keyword=combination therapy kn-keyword=combination therapy en-keyword=galantamine kn-keyword=galantamine END start-ver=1.4 cd-journal=joma no-vol=17 cd-vols= no-issue=5 article-no= start-page=722 end-page=729 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201705 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical features of incidental mild cognitive impairment and dementia in a population-based study en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIM: The number of people with dementia is rapidly increasing as populations around the world age. It is important to grasp the characteristic features of mild cognitive impairment (MCI) for early detection and prevention of dementia. METHODS: We examined 408 individuals recruited from a health checkup for metabolic syndrome, which comprised three groups: normal (n?=?325), MCI (n?=?55) and apparent cognitive decline (ACD; n?=?28). We compared cognitive/affective functions and exercise/hobby habits with assessments of vascular risk factors and results from computerized touch-panel tests. RESULTS: Among the 408 individuals, 93.1% showed normal scores on the Mini-Mental State Examination, and 6.9% had ACD. Among the normal Mini-Mental State Examination participants, 14.5% had MCI (13.5% of all participants). The three groups of participants showed significant differences in age, education, systolic blood pressure, glycosylated hemoglobin and high-density lipoprotein cholesterol level. Even within the normal range, those in the MCI group showed significantly lower cognitive function than those in the normal group. Scores on the Geriatric Depression Scale were greater in the MCI group, and "day-night reversal" was worse in the ACD group. Scores on touch-panel screening tests were significantly worse in the MCI and ACD groups than in the normal group. Participants showed better cognitive and affective function if they exercised regularly or had hobbies. CONCLUSIONS: Incidental MCI and ACD had prevalences of 13.5% and 6.9%, respectively, in the population-based study. Participants with these conditions showed cognitive/affective decline and impairment on computerized touch-panel tests in relation to vascular risk factors and exercise/hobbies. Geriatr Gerontol Int 2017; 17: 722-729. en-copyright= kn-copyright= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukuiYusuke en-aut-sei=Fukui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=apparent cognitive decline kn-keyword=apparent cognitive decline en-keyword=cognitive/affective functions kn-keyword=cognitive/affective functions en-keyword=general population kn-keyword=general population en-keyword=mild cognitive impairment kn-keyword=mild cognitive impairment en-keyword=risk factors kn-keyword=risk factors END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=4 article-no= start-page=458 end-page=465 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Characteristic features of cognitive, affective and daily living functions of late-elderly dementia en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIMS: The world is rapidly aging, and is facing an increase of late-elderly dementia patients. It is important to investigate the characteristic features of late-elderly dementia in a super-aged country. METHODS: We examined 1554 patients with cognitive decline in Department of Neurology, Okayama University Hospital, Okayama, Japan, divided into three subgroups according to the age: young-elderly (age ?64 years), middle-elderly (age 65-74 years) and late-elderly (age 75 years), and investigated the cognitive, affective and activities of daily living functions (ADL), especially in late-elderly patients compared with young-elderly and middle-elderly patients. RESULTS: Among 1554 patients, Alzheimer's disease dominated at 62%, and age-dependently increased up to 69% in the late-elderly group. The total scores of four cognitive tests were significantly worse with aging for specific subscales of orientation, recall, visual retention, word fluency and so on. In contrast, total scores of the affective tests showed only an increase in the apathy scale in the late-elderly group. Each subgroup showed depressive/depression in 63.2-55.2%, and apathy in 44.2-54.8%. Furthermore, instrumental ADL items significantly deteriorated in the late-elderly group, which statistically correlated with Mini-Mental State Examination score. CONCLUSIONS: These results show that the late-elderly group is characterized by significant cognitive declines, increasing apathy, and instrumental ADL decrease. The cognitive decline may be related to such affective and ADL declines. en-copyright= kn-copyright= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FukuiYusuke en-aut-sei=Fukui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KonoSyoichiro en-aut-sei=Kono en-aut-mei=Syoichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=DeguchiKentaro en-aut-sei=Deguchi en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=affective functions kn-keyword=affective functions en-keyword=cognitive function kn-keyword=cognitive function en-keyword=daily living function kn-keyword=daily living function en-keyword=late-elderly dementia kn-keyword=late-elderly dementia en-keyword=super-aged country kn-keyword=super-aged country END start-ver=1.4 cd-journal=joma no-vol=17 cd-vols= no-issue=11 article-no= start-page=1991 end-page=1999 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201711 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Different clinical effect of four antidementia drugs for Alzheimer's disease patients depending on white matter severity en-subtitle= kn-subtitle= en-abstract= kn-abstract=AIM:To examine the clinical effect of four antidementia drugs (donepezil, galantamine, rivastigmine and memantine) in Alzheimer's disease patients who were divided into subgroups based on their periventricular hyperintensity (PVH) severity. METHODS: A total of 551 Alzheimer's disease patients (201 men and 350 women) were divided into four subgroups based on their PVH severity (0-III). They received monotherapy for 12 months. We compared the clinical effects at the baseline, and at 3, 6 and 12 months after initiation. RESULTS: The baseline age became higher with PVH grades, and the Mini-Mental State Examination and Hasegawa Dementia Scale-Revised showed a decrease that was dependent on white matter severity. Although the PVH 0 subgroup showed stable cognitive, affective and ADL functions until 12 months in all four drug groups, the PVH I subgroup showed an improved Apathy Scale from the baseline in response to memantine at 3 and 9 months (P < 0.05), and galantamine at 9 months (P < 0.01). In the PVH II subgroup, the Mini-Mental State Examination showed a significant improvement from the baseline in response to galantamine (P < 0.05) at 9 months and Hasegawa Dementia Scale-Revised (P < 0.05) at 3 months. In the PVH III subgroup, cognitive and affective functions were preserved in all four drug groups until 12 months, but activities of daily living deteriorated in the riverstigmine group at 6 and 12 months (P < 0.05). CONCLUSIONS: The present study shows that these four drugs showed sensitivity dependent on white matter severity that clinically affected cognitive, affective and activities of daily living functions. Geriatr Gerontol Int 2017; 17: 1991-1999. en-copyright= kn-copyright= en-aut-name=FukuiYusuke en-aut-sei=Fukui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HishikawaNozomi en-aut-sei=Hishikawa en-aut-mei=Nozomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IchinoseJin en-aut-sei=Ichinose en-aut-mei=Jin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SatoKota en-aut-sei=Sato en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakanoYumiko en-aut-sei=Nakano en-aut-mei=Yumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MoriharaRyuta en-aut-sei=Morihara en-aut-mei=Ryuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OhtaYasuyuki en-aut-sei=Ohta en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamashitaToru en-aut-sei=Yamashita en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Alzheimer's disease kn-keyword=Alzheimer's disease en-keyword=antidementia drug kn-keyword=antidementia drug en-keyword=magnetic resonance imaging kn-keyword=magnetic resonance imaging en-keyword=periventricular hyperintensity kn-keyword=periventricular hyperintensity en-keyword=white matter lesions kn-keyword=white matter lesions END start-ver=1.4 cd-journal=joma no-vol=129 cd-vols= no-issue=2 article-no= start-page=93 end-page=99 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=20170801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The development of a scale to measure stress recognition during the treatment of diabetes patients kn-title=摐擜昦姵幰偺乽帯椕偵敽偆僗僩儗僗擣抦広搙乿偺奐敪 en-subtitle= kn-subtitle= en-abstract= kn-abstract=丂The purpose of this study was to establish a measurement scale for "stress recognition in receiving treatment" in patients with diabetes. A self-completed questionnaire was distributed to 149 type-2 diabetes outpatients in March-May 2015 after authorization from Okayama Prefectural University and the ethics committee of the hospital. 丂The "stress recognition in receiving treatment" scale was designed as a second-order factor model consisting of 14 items and the following four factors : the respondent's sense of (1) the burden of being sick, (2) the burden on interpersonal relationships, (3) the burden of treatment, and (4) the burden of medical expenses. 丂Stress recognition in treatment means recognition of being stressed in the burdens related to the illness, interpersonal relationships, treatment and medical expenses. 丂The suitability of the questionnaire data was then evaluated with a structural equation model. The suitability of the factor model to the data satisfied the statistically acceptable standards as Comparative Fit Index (CFI) 亖0.931, Root Mean Square Error of Approximation (RMSEA) 亖0.096, Tucker-Lewis Index (TLI) 亖0.946. 丂As the construct validity was not examined by the scale created in this study or by existing scale, it was verified by using the degrees of mental healthiness and HbA1c that were proved to be associated with the sense of burden. 丂In addition, the construct validity of the questionnaire was supported by a significant correlation between the Japanese version of the WHO-Five Well-being Index (S-WHO-5-J) and the patients' HbA1c levels. The use of this measure is expected to contribute to the early detection of a decline in a diabetic patient's activities of daily living and to the early confirmation of patients' support status. en-copyright= kn-copyright= en-aut-name=SumiyoshiKazuko en-aut-sei=Sumiyoshi en-aut-mei=Kazuko kn-aut-name=廧媑榓巕 kn-aut-sei=廧媑 kn-aut-mei=榓巕 aut-affil-num=1 ORCID= en-aut-name=KawataChieko en-aut-sei=Kawata en-aut-mei=Chieko kn-aut-name=愳揷抭宐巕 kn-aut-sei=愳揷 kn-aut-mei=抭宐巕 aut-affil-num=2 ORCID= en-aut-name=OkamotoTatsuo en-aut-sei=Okamoto en-aut-mei=Tatsuo kn-aut-name=壀杮扖晇 kn-aut-sei=壀杮 kn-aut-mei=扖晇 aut-affil-num=3 ORCID= en-aut-name=OhashiMutsuko en-aut-sei=Ohashi en-aut-mei=Mutsuko kn-aut-name=戝嫶杛巕 kn-aut-sei=戝嫶 kn-aut-mei=杛巕 aut-affil-num=4 ORCID= en-aut-name=MikaneSakae en-aut-sei=Mikane en-aut-mei=Sakae kn-aut-name=泬嬥塰 kn-aut-sei=泬嬥 kn-aut-mei=塰 aut-affil-num=5 ORCID= en-aut-name=TakabayashiNoriko en-aut-sei=Takabayashi en-aut-mei=Noriko kn-aut-name=崅椦斖巕 kn-aut-sei=崅椦 kn-aut-mei=斖巕 aut-affil-num=6 ORCID= en-aut-name=FutoyuYoshiko en-aut-sei=Futoyu en-aut-mei=Yoshiko kn-aut-name=懢搾岲巕 kn-aut-sei=懢搾 kn-aut-mei=岲巕 aut-affil-num=7 ORCID= en-aut-name=KimWoesook en-aut-sei=Kim en-aut-mei=Woesook kn-aut-name=嬥奜廼 kn-aut-sei=嬥 kn-aut-mei=奜廼 aut-affil-num=8 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name=榓揷弤 kn-aut-sei=榓揷 kn-aut-mei=弤 aut-affil-num=9 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name=巐曽尗堦 kn-aut-sei=巐曽 kn-aut-mei=尗堦 aut-affil-num=10 ORCID= en-aut-name=NakajimaKazuo en-aut-sei=Nakajima en-aut-mei=Kazuo kn-aut-name=拞搱榓晇 kn-aut-sei=拞搱 kn-aut-mei=榓晇 aut-affil-num=11 ORCID= affil-num=1 en-affil=Faculty of Health and Welfare Science, Okayama Prefectural University kn-affil=壀嶳導棫戝妛丂曐寬暉巸妛晹 affil-num=2 en-affil=Health and Nursing Sciences Masters Program, Wakayama Medical University kn-affil=榓壧嶳導棫堛壢戝妛丂戝妛堾曐寬娕岇妛尋媶壢 affil-num=3 en-affil=Ryobi General Research Institute of Community Care kn-affil=椉旛抧堟働傾憤崌尋媶強 affil-num=4 en-affil=Department of Nursing, Okayama University Hospital kn-affil=壀嶳戝妛昦堾娕岇晹 affil-num=5 en-affil=Faculty of Health and Welfare Science, Okayama Prefectural University kn-affil=壀嶳導棫戝妛丂曐寬暉巸妛晹 affil-num=6 en-affil=Faculty of Health and Welfare Science, Okayama Prefectural University kn-affil=壀嶳導棫戝妛丂曐寬暉巸妛晹 affil-num=7 en-affil=School of Health Science and Social Welfare, Kibi International University kn-affil=媑旛崙嵺戝妛丂曐寬堛椕暉巸妛晹 affil-num=8 en-affil=College of Nursing Art and Science, University of Hyogo kn-affil=暫屔導棫戝妛丂娕岇妛晹 affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂恡丒柶塽丒撪暘斿戙幱撪壢妛 affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil=壀嶳戝妛昦堾丂怴堛椕尋媶奐敪僙儞僞乕 affil-num=11 en-affil=Ryobi General Research Institute of Community Care kn-affil=椉旛抧堟働傾憤崌尋媶強 en-keyword=摐擜昦姵幰 (diabetes patients) kn-keyword=摐擜昦姵幰 (diabetes patients) en-keyword=帯椕 (treatment) kn-keyword=帯椕 (treatment) en-keyword=僗僩儗僗擣抦 (stress recognition) kn-keyword=僗僩儗僗擣抦 (stress recognition) en-keyword=広搙奐敪 (development of a scale) kn-keyword=広搙奐敪 (development of a scale) END start-ver=1.4 cd-journal=joma no-vol=37 cd-vols= no-issue=6 article-no= start-page=1258 end-page=1266 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201512 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Exploring autistic-like traits relating to empathic attitude and psychological distress in hospital pharmacists en-subtitle= kn-subtitle= en-abstract= kn-abstract=BACKGROUND: Pharmacists are expected to play a key role in modern cancer care. Research suggests that an empathic approach and attitude in medical staff improves the quality of patient care. An empathic attitude and psychological distress are thought to be associated with autistic-like traits, but little is known about such traits. OBJECTIVE: In this study, we aimed to clarify the associations among autistic-like traits, empathic attitude in a medical context, and psychological health in hospital pharmacists. SETTING: Eligibility criteria for inclusion were certified pharmacists working at hospitals for patient care who returned their questionnaires. METHOD: Eight hundred and twenty-three hospital pharmacists completed a number of self-administered questionnaires anonymously by mail. MAIN OUTCOME MEASURES: Scores were obtained on the Autism-Spectrum Quotient, the Jefferson Scale of Empathy, the General Health Questionnaire-12, and subscales of the Interpersonal Reactivity Index (Perspective Taking, IRI-Empathic Concern, IRIPersonal Distress). We performed correlation and mediation analyses to confirm that the empathy and general health questionnaires were associated with autism-spectrum quotient scores, and with each IRI subscale. RESULTS: Complete responses were obtained from 379 pharmacists comprising 151 males (39.8 %) with a mean age of 37.7 亇 10.8 years (missing data, n = 13) and a median of 11 years after qualification as a pharmacist. Autism-Spectrum Quotient scores were inversely correlated with empathy (r = -0.22, p < 0.001) and positively correlated with general health scores (r = 0.40, p < 0.001). In the models with mediation, the inverse correlation between autism-spectrum quotient and empathy scores was mediated indirectly by IRI-Perspective Taking and IRI-Empathic Concern, and the positive correlation between autism-spectrum quotient and general health was mediated indirectly by IRI-Personal Distress. There were also direct effects, with significant effects of autism-spectrum quotient on empathy and general health scores. CONCLUSION: Our findings suggest that autistic-like traits affect both empathic attitude in a medical context and the psychological health of pharmacists. We recommend that to improve empathy in those with high levels of autistic-like traits, we may need to develop specialized interventions, such as improving communication skills training. en-copyright= kn-copyright= en-aut-name=HiguchiYuji en-aut-sei=Higuchi en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchitomiYosuke en-aut-sei=Uchitomi en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujimoriMaiko en-aut-sei=Fujimori en-aut-mei=Maiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KoyamaToshihiro en-aut-sei=Koyama en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KitamuraYoshihisa en-aut-sei=Kitamura en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SendoToshiaki en-aut-sei=Sendo en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=InagakiMasatoshi en-aut-sei=Inagaki en-aut-mei=Masatoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of NeuropsychiatryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Innovation Center for Supportive, Palliative and Psychosocial CareNational Cancer Center kn-affil= affil-num=3 en-affil=Center for Suicide Prevention, National Institute of Mental HealthNational Center for Neurology and Psychiatry kn-affil= affil-num=4 en-affil=Department of Clinical PharmacyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Primary Care and Medical EducationOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Clinical PharmacyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Clinical PharmacyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of NeuropsychiatryOkayama University Hospital kn-affil= en-keyword=Empathy kn-keyword=Empathy en-keyword= Hospital pharmacist kn-keyword= Hospital pharmacist en-keyword= Japan kn-keyword= Japan en-keyword= Pharmaceutical care kn-keyword= Pharmaceutical care END start-ver=1.4 cd-journal=joma no-vol=29 cd-vols= no-issue=5 article-no= start-page=2150 end-page=2156 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=20170302 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Real-Time, in Situ Monitoring of the Oxidation of Graphite: Lessons Learned en-subtitle= kn-subtitle= en-abstract= kn-abstract= Graphite oxide (GO) and its constituent layers (i.e., graphene oxide) display a broad range of functional groups and, as such, have attracted significant attention for use in numerous applications. GO is commonly prepared using the 乬Hummers method乭 or a variant thereof in which graphite is treated with KMnO4 and various additives in H2SO4. Despite its omnipresence, the underlying chemistry of such oxidation reactions is not well understood and typically affords results that are irreproducible and, in some cases, unsafe. To overcome these limitations, the oxidation of graphite under Hummers-type conditions was monitored over time using in situ X-ray diffraction and in situ X-ray absorption near edge structure analyses with synchrotron radiation. In conjunction with other atomic absorption spectroscopy, UV?vis spectroscopy and elemental analysis measurements, the underlying mechanism of the oxidation reaction was elucidated, and the reaction conditions were optimized. Ultimately, the methodology for reproducibly preparing GO on large scales using only graphite, H2SO4, and KMnO4 was developed and successfully adapted for use in continuous flow systems. en-copyright= kn-copyright= en-aut-name=MorimotoNaoki en-aut-sei=Morimoto en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SuzukiHideyuki en-aut-sei=Suzuki en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakeuchiYasuo en-aut-sei=Takeuchi en-aut-mei=Yasuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KawaguchiShogo en-aut-sei=Kawaguchi en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KunisuMasahiro en-aut-sei=Kunisu en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=BielawskiChristopher W. en-aut-sei=Bielawski en-aut-mei=Christopher W. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NishinaYuta en-aut-sei=Nishina en-aut-mei=Yuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Division of Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Research Core for Interdisciplinary Sciences, Okayama University kn-affil= affil-num=3 en-affil=Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Division of Pharmaceutical Sciences, Okayama Universit kn-affil= affil-num=4 en-affil=Japan Synchrotron Radiation Research Institute (JASRI), SPring-8 kn-affil= affil-num=5 en-affil=Toray Research Center, Inc., Surface Science Laboratories kn-affil= affil-num=6 en-affil=Center for Multidimensional Carbon Materials (CMCM), Institute for Basic Science (IBS) kn-affil= affil-num=7 en-affil=Research Core for Interdisciplinary Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=6 article-no= start-page=477 end-page=483 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201612 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot en-subtitle= kn-subtitle= en-abstract= kn-abstract=The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Japanese Society of Surgery of the Foot (JSSF) standard rating system for the RA foot and ankle scale improved significantly from 59.6 points preoperatively to 88.3 points postoperatively (p亙0.001). Twenty-four feet (89 ) were free from metatarsalgia and symptomatic callosities at the lesser MTP joint after surgery. Our present findings showed satisfactory early clinical outcomes of the shortening oblique osteotomy of the metatarsal bone with screw fixation for RA forefoot. en-copyright= kn-copyright= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MachidaTakahiro en-aut-sei=Machida en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HoritaMasahiro en-aut-sei=Horita en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HashizumeKenzo en-aut-sei=Hashizume en-aut-mei=Kenzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NasuYoshihisa en-aut-sei=Nasu en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OhashiHideki en-aut-sei=Ohashi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SaigaKenta en-aut-sei=Saiga en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Rehabilitation, Japan Labour Health and Welfare Organization, Okayama Rosai Hospital kn-affil= affil-num=5 en-affil=Department of Musculoskeletal Traumatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=shortening oblique osteotomy kn-keyword=shortening oblique osteotomy en-keyword=rheumatoid arthritis kn-keyword=rheumatoid arthritis en-keyword=forefoot kn-keyword=forefoot en-keyword=screw fixation kn-keyword=screw fixation END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=6 article-no= start-page=449 end-page=453 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201612 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Neurological Recovery after Posterior Spinal Surgery in Patients with Metastatic Epidural Spinal Cord Compression en-subtitle= kn-subtitle= en-abstract= kn-abstract=Metastatic epidural spinal cord compression (MESCC) is a common complication in patients with a malignant tumor, but it is difficult to decide the proper time to perform the necessary surgery. Here we analyzed the prognostic factors for postoperative walking ability. We retrospectively reviewed the cases of 112 MESCC patients treated surgically at our institute and divided them into ambulatory (n亖 88) and non-ambulatory (n亖24) groups based on their American Spinal Injury Association (ASIA) Impairment Scale grades at the final follow-up. We also classified the patients preoperatively using the revised Tokuhashi score. We assessed the correlation between preoperative or intraoperative factors and postoperative walking ability in both groups. Of the 10 patients classified preoperatively as grade A or B, 2 (20 ) were ambulatory at the final follow-up. Of the 102 patients classified preoperatively as grade C, D or E, 86 (84 ) were ambulatory at the final follow-up (p亙0.001). There were no significant differences between the groups in the average total Tokuhashi score. Our analysis revealed that the severity of paralysis significantly affects neurological recovery in patients with MESCC. Patients with MESCC should receive surgery before the preoperative ASIA Impairment Scale grade falls below grade C. en-copyright= kn-copyright= en-aut-name=WatanabeNoriyuki en-aut-sei=Watanabe en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MazakiTetsuro en-aut-sei=Mazaki en-aut-mei=Tetsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AratakiShinya en-aut-sei=Arataki en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakigawaTomoyuki en-aut-sei=Takigawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KataokaMasaki en-aut-sei=Kataoka en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=metastatic epidural spinal cord compression kn-keyword=metastatic epidural spinal cord compression en-keyword=American Spinal Injury Association Impairment Scale kn-keyword=American Spinal Injury Association Impairment Scale en-keyword=Tokuhashi score kn-keyword=Tokuhashi score en-keyword=walking ability kn-keyword=walking ability en-keyword=prognostic factor kn-keyword=prognostic factor END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=2 article-no= start-page=119 end-page=130 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201604 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Diminished Gastric Resection Preserves Better Quality of Life in Patients with Early Gastric Cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=Using the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, we compared the surgical outcomes and the quality of life (QOL) between patients undergoing limited gastrectomies and those undergoing conventional gastrectomies. In Oomoto Hospital between January 2004 and December 2013, a total of 124 patients who met the eligibility criteria were enrolled. Using the main outcome measures of PGSAS-45, we compared 4 types of limited gastrectomy procedures (1/2 distal gastrectomy [1/2DG] in 21 patients; pylorus-preserving gastrectomy [PPG] in 15 patients; segmental gastrectomy [SG] in 26 patients; and local resection [LR] in 13 patients) with conventional gastrectomy (total gastrectomy [TG] in 24 patients and 2/3 or more distal gastrectomy [WDG] in 25 patients). The TG group showed the worst QOL in almost all items of the main outcome measures. The 1/2DG, PPG, and SG groups showed better QOL than the WDG group in many of the main outcome measures, including the body weight ratio, total symptom score, ingested amount of food per meal, and the dissatisfaction for daily life subscale. The LR group showed a better intake of food than the 1/2DG, PPG, and SG groups. The body weight ratio of the LR group was better than that of the SG group. Diminished gastric resection preserved better QOL in patients with early gastric cancer. en-copyright= kn-copyright= en-aut-name=IsozakiHiroshi en-aut-sei=Isozaki en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoSasau en-aut-sei=Matsumoto en-aut-mei=Sasau kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MurakamiShigeki en-aut-sei=Murakami en-aut-mei=Shigeki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakamaTakehiro en-aut-sei=Takama en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShoTatuo en-aut-sei=Sho en-aut-mei=Tatuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IshiharaKiyohiro en-aut-sei=Ishihara en-aut-mei=Kiyohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SakaiKunihiko en-aut-sei=Sakai en-aut-mei=Kunihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakedaMasanori en-aut-sei=Takeda en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakadaKoji en-aut-sei=Nakada en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=2 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=3 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=4 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=5 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=6 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=7 en-affil= kn-affil=Department of Surgery, Oomoto Hospital affil-num=8 en-affil= kn-affil=Department of Surgery, Watanabe Hospital affil-num=9 en-affil= kn-affil=Department of Surgery, The Jikei University School of Medicine affil-num=10 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=limited gastrectomy kn-keyword=limited gastrectomy en-keyword=early gastric cancer kn-keyword=early gastric cancer en-keyword=function preserving gastrectomy kn-keyword=function preserving gastrectomy en-keyword=quality of life kn-keyword=quality of life en-keyword=postgastrectomy syndrome kn-keyword=postgastrectomy syndrome END start-ver=1.4 cd-journal=joma no-vol=127 cd-vols= no-issue=2 article-no= start-page=117 end-page=121 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=20150803 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Successful laparoscopic resection of a cecal tumor in a 95-year-old man kn-title=挻崅楊幰乮95嵨乯偺恑峴栍挵娻偵懳偟偰暊峯嬀壓夞栍晹愗彍傪巤峴偟偨1椺 en-subtitle= kn-subtitle= en-abstract= kn-abstract=We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials 乮RCTs乯 revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients. en-copyright= kn-copyright= en-aut-name=WatanabeAyako en-aut-sei=Watanabe en-aut-mei=Ayako kn-aut-name=搉绯嵤巕 kn-aut-sei=搉绯 kn-aut-mei=嵤巕 aut-affil-num=1 ORCID= en-aut-name=InadaRyo en-aut-sei=Inada en-aut-mei=Ryo kn-aut-name=堫揷椓 kn-aut-sei=堫揷 kn-aut-mei=椓 aut-affil-num=2 ORCID= en-aut-name=NagasakaTakeshi en-aut-sei=Nagasaka en-aut-mei=Takeshi kn-aut-name=塱嶁妜巌 kn-aut-sei=塱嶁 kn-aut-mei=妜巌 aut-affil-num=3 ORCID= en-aut-name=YagiTomohiko en-aut-sei=Yagi en-aut-mei=Tomohiko kn-aut-name=敧栘挬旻 kn-aut-sei=敧栘 kn-aut-mei=挬旻 aut-affil-num=4 ORCID= en-aut-name=MatsumotoHijiri en-aut-sei=Matsumoto en-aut-mei=Hijiri kn-aut-name=徏杮惞 kn-aut-sei=徏杮 kn-aut-mei=惞 aut-affil-num=5 ORCID= en-aut-name=ToshimaToshiaki en-aut-sei=Toshima en-aut-mei=Toshiaki kn-aut-name=屗搱弐柧 kn-aut-sei=屗搱 kn-aut-mei=弐柧 aut-affil-num=6 ORCID= en-aut-name=KikuchiSatoru en-aut-sei=Kikuchi en-aut-mei=Satoru kn-aut-name=媏抮妎師 kn-aut-sei=媏抮 kn-aut-mei=妎師 aut-affil-num=7 ORCID= en-aut-name=KurodaShinshi en-aut-sei=Kuroda en-aut-mei=Shinshi kn-aut-name=崟揷怴巑 kn-aut-sei=崟揷 kn-aut-mei=怴巑 aut-affil-num=8 ORCID= en-aut-name=KondoYoshitaka en-aut-sei=Kondo en-aut-mei=Yoshitaka kn-aut-name=嬤摗婌懢 kn-aut-sei=嬤摗 kn-aut-mei=婌懢 aut-affil-num=9 ORCID= en-aut-name=MoriYoshiko en-aut-sei=Mori en-aut-mei=Yoshiko kn-aut-name=曣棦廼巕 kn-aut-sei=曣棦 kn-aut-mei=廼巕 aut-affil-num=10 ORCID= en-aut-name=KishimotoHiroyuki en-aut-sei=Kishimoto en-aut-mei=Hiroyuki kn-aut-name=娸杮峗峴 kn-aut-sei=娸杮 kn-aut-mei=峗峴 aut-affil-num=11 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name=摗尨弐媊 kn-aut-sei=摗尨 kn-aut-mei=弐媊 aut-affil-num=12 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=8 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=9 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=10 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=11 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 affil-num=12 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢 en-keyword=挻崅楊幰乮extremely elderly patient乯 kn-keyword=挻崅楊幰乮extremely elderly patient乯 en-keyword=戝挵娻乮colorectal cancer乯 kn-keyword=戝挵娻乮colorectal cancer乯 en-keyword=暊峯嬀庤弍乮laparoscopic surgery乯 kn-keyword=暊峯嬀庤弍乮laparoscopic surgery乯 END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue= article-no= start-page=9 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=20131212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of repeated Waon therapy on exercise tolerance and pulmonary function in patients with chronic obstructive pulmonary disease: a pilot controlled clinical trial en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: Controlled clinical trials evaluating the efficacy of repeated Waon therapy for patients with chronic obstructive pulmonary disease (COPD) have yet to be conducted. The purpose of the present study was to evaluate whether repeated Waon therapy exhibits an adjuvant effect on conventional therapy for COPD patients. Patients and methods: This prospective trial comprised 20 consecutive COPD patients who satisfied the criteria of the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines, stages 1?4. They were assigned to either a Waon or control group. The patients in the Waon group received both repeated Waon therapy and conventional therapy, including medications, such as long-acting inhaled 兝2 agonists, long-acting anticholinergics and xanthine derivatives, and pulmonary rehabilitation. The Waon therapy consisted of sitting in a 60亱C sauna room for 15 minutes, followed by 30 minutes of being warmed with blankets once a day, 5 days a week, for a total of 20 times. The patients in the control group received only conventional therapy. Pulmonary function and the 6-minute walk test were assessed before and at 4 weeks after the program. Results: The change in vital capacity (0.30 亇 0.4 L) and in peak expiratory flow (0.48 亇 0.79 L/s) in the Waon group was larger than the change in the vital capacity (0.02 亇 0.21 L) (P=0.077) and peak expiratory flow (?0.11 亇 0.72 L/s) (P=0.095) in the control group. The change in forced expiratory flow after 50% of expired forced vital capacity in the Waon group, 0.08 (0.01?0.212 L/s), was larger than that in the control group, ?0.01 (?0.075?0.04 L/s) (P=0.019). Significant differences were not observed in the change in any parameters in the 6-minute walk test. Data are presented as means 亇 standard deviation or median (25th?75th percentile). Conclusion: The addition of repeated Waon therapy to conventional therapy for COPD patients can possibly improve airway obstruction. en-copyright= kn-copyright= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShiozawaNobuyoshi en-aut-sei=Shiozawa en-aut-mei=Nobuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=2 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=3 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=4 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med affil-num=5 en-affil= kn-affil=Okayama Univ Hosp, Misasa Med Ctr, Div Med en-keyword=modified Borg scale kn-keyword=modified Borg scale en-keyword=airway obstruction kn-keyword=airway obstruction en-keyword=6-minute walk test kn-keyword=6-minute walk test en-keyword=quality of life kn-keyword=quality of life END start-ver=1.4 cd-journal=joma no-vol=39 cd-vols= no-issue=9 article-no= start-page=844 end-page=849 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=201209 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effects of self-efficacy on oral health behaviours and gingival health in university students aged 18- or 19-years-old en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aim Although self-efficacy is known to affect various health-related practises, few studies have clearly examined how self-efficacy correlates with oral health behaviors or the oral health condition. We examined the relationship between gingivitis, oral health behaviors and self-efficacy in university students. Material & Methods A total of 2,111 students (1,197 males, 914 females) aged 18 and 19 years were examined. The degree of gingivitis was expressed as the percentage of bleeding on probing (%BOP). Additional information was collected via a questionnaire regarding oral health behaviors (daily frequency of tooth-brushing, use of dental floss and regular check-up). Self-efficacy was assessed using the Self-Efficacy Scale for Self-care (SESS). Path analysis was used to test pathways from self-efficacy to oral health behaviors and %BOP. Results In the final structural model, self-efficacies were related to each other, and they affected oral health behaviors. Good oral health behaviors reduced dental plaque and calculus, and lower levels of dental plaque and calculus resulted in lower %BOP. Conclusion Higher self-efficacy correlated with better oral health behaviours and gingival health in university students. Improving self-efficacy may be beneficial for maintaining good gingival health in university students. To prevent gingivitis, the approach of enhancing self-efficacy in university students would be useful. en-copyright= kn-copyright= en-aut-name=MizutaniShinsuke en-aut-sei=Mizutani en-aut-mei=Shinsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=EkuniDaisuke en-aut-sei=Ekuni en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FurutaMichiko en-aut-sei=Furuta en-aut-mei=Michiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TomofujiTakaaki en-aut-sei=Tomofuji en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IrieKoichiro en-aut-sei=Irie en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AzumaTetsuji en-aut-sei=Azuma en-aut-mei=Tetsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KojimaAzusa en-aut-sei=Kojima en-aut-mei=Azusa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NagaseJun en-aut-sei=Nagase en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MoritaManabu en-aut-sei=Morita en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=2 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=3 en-affil= kn-affil=Kyushu Univ, Fac Dent Sci, Div Oral Hlth Growth & Dev, Sect Prevent & Publ Hlth Dent affil-num=4 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=5 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=6 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=7 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=8 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci affil-num=9 en-affil= kn-affil=Okayama Univ, Hlth Serv Ctr affil-num=10 en-affil= kn-affil=Okayama Univ, Dept Prevent Dent, Grad Sch Med Dent & Pharmaceut Sci en-keyword=behavioral science kn-keyword=behavioral science en-keyword=cross-sectional studies kn-keyword=cross-sectional studies en-keyword=gingivitis kn-keyword=gingivitis en-keyword=path analysis kn-keyword=path analysis en-keyword=self-efficacy kn-keyword=self-efficacy en-keyword=university students kn-keyword=university students END start-ver=1.4 cd-journal=joma no-vol=8 cd-vols= no-issue=10 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=20131017 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Type D Personality Is Associated with Psychological Distress and Poor Self-Rated Health among the Elderly: A Population-Based Study in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=We investigated the association between Type D personality, psychological distress, and self-ratings of poor health in elderly Japanese people. In August 2010, questionnaires were sent to all residents aged >= 65 in three municipalities (n = 21232) in Okayama Prefecture, Japan, and. 13929 questionnaires were returned (response rate: 65.6%). To assess mental and physical health outcomes, we used the Kessler Psychological Distress Scale and a single item question regarding perceived general health. We analyzed 9759 questionnaires to determine odds ratios (ORs) and 95% confidence intervals (CIs) for several health outcomes, adjusting for sex, age, smoking status, frequency of alcohol consumption, overweight status, educational attainment, socioeconomic status, and number of cohabiters. The multiple imputation method was employed for missing data regarding Type D personality. The prevalence of Type D personality in our sample was 46.2%. After adjusting for covariates, we found that participants with Type D personality were at 4-5 times the risk of psychological distress, and twice the risk of poor self-rated health. This association was stronger in participants aged 65-74 years (psychological distress; OR: 5.80, 95% CI: 4.96-6.78, poor self-rated health; OR: 2.84, 95% CI: 2.38-3.38) than in those aged over 75 years (psychological distress; OR: 4.54, 95% CI: 3.96-5.19, poor self-rated health; OR: 2.05, 95% CI: 1.79-2.34). Type D personality is associated with adverse health status among Japanese elderly people in terms of mental and physical risk; therefore, further research into the implications of this personality type is warranted. en-copyright= kn-copyright= en-aut-name=KasaiYosuke en-aut-sei=Kasai en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SuzukiEtsuji en-aut-sei=Suzuki en-aut-mei=Etsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IwaseToshihide en-aut-sei=Iwase en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=DoiHiroyuki en-aut-sei=Doi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci affil-num=2 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci affil-num=3 en-affil= kn-affil=Okayama Univ, Grad Sch Med Dent & Pharmaceut Sci, Support Ctr Med Cooperat Human Resource Placement affil-num=4 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci affil-num=5 en-affil= kn-affil=Okayama Univ, Dept Epidemiol, Grad Sch Med Dent & Pharmaceut Sci END start-ver=1.4 cd-journal=joma no-vol=126 cd-vols= no-issue=1 article-no= start-page=45 end-page=48 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=A patient with primary malignant melanoma of the esophagus who underwent esophagectomy kn-title=怘摴尨敪埆惈崟怓庮偺侾愗彍椺 en-subtitle= kn-subtitle= en-abstract= kn-abstract=丂We report the case of a 61-old-man with a primary malignant melanoma of the esophagus, an extremely rare and highly aggressive malignancy. He presented with dysphagia, and we performed an upper gastrointestinal endoscopy that detected a tumor in the thoracic part of the esophagus. The biopsy showed malignant melanoma. PET/CT, endoscopy and an esophagogram showed that a 70-mm scaled type 2+1 tumor in the thoracic esophagus and no metastases. We diagnosed a cT3cN0cM0 cStage II tumor. We then performed a subtotal esophagectomy with two-field lymph node dissection and esophagogastrostomy via a retrosternal route. The pathological examination of the resected specimens confirmed that the type 2+1 tumor was PMME (pT2N0M0 pStage II). We administered six courses of postoperative adjuvant chemotherapy with dacarbazine, and the patient has had no recurrence for 17 months after the surgery. en-copyright= kn-copyright= en-aut-name=MaedaNaoaki en-aut-sei=Maeda en-aut-mei=Naoaki kn-aut-name=慜揷捈尒 kn-aut-sei=慜揷 kn-aut-mei=捈尒 aut-affil-num=1 ORCID= en-aut-name=ShirakawaYasuhiro en-aut-sei=Shirakawa en-aut-mei=Yasuhiro kn-aut-name=敀愳桋攷 kn-aut-sei=敀愳 kn-aut-mei=桋攷 aut-affil-num=2 ORCID= en-aut-name=KoujimaTakeshi en-aut-sei=Koujima en-aut-mei=Takeshi kn-aut-name=殸晎搰寬 kn-aut-sei=殸晎搰 kn-aut-mei=寬 aut-affil-num=3 ORCID= en-aut-name=OharaToshiaki en-aut-sei=Ohara en-aut-mei=Toshiaki kn-aut-name=戝尨棙復 kn-aut-sei=戝尨 kn-aut-mei=棙復 aut-affil-num=4 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name=揷绮弐曘 kn-aut-sei=揷绮 kn-aut-mei=弐曘 aut-affil-num=5 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name=栰娫榓峀 kn-aut-sei=栰娫 kn-aut-mei=榓峀 aut-affil-num=6 ORCID= en-aut-name=SakuramaKazuhumi en-aut-sei=Sakurama en-aut-mei=Kazuhumi kn-aut-name=烴娫嫵暥 kn-aut-sei=烴娫 kn-aut-mei=嫵暥 aut-affil-num=7 ORCID= en-aut-name=FujiwaraToshiyosi en-aut-sei=Fujiwara en-aut-mei=Toshiyosi kn-aut-name=摗尨弐媊 kn-aut-sei=摗尨 kn-aut-mei=弐媊 aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=8 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 en-keyword=怘摴乮esophagus乯 kn-keyword=怘摴乮esophagus乯 en-keyword=埆惈崟怓庮乮malignant melanoma乯 kn-keyword=埆惈崟怓庮乮malignant melanoma乯 END start-ver=1.4 cd-journal=joma no-vol=126 cd-vols= no-issue=1 article-no= start-page=39 end-page=43 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Complete response of primary esophageal endocrine cell carcinoma resected after neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil kn-title=弍慜DCF椕朄偑挊岠偟偨怘摴尨敪撪暘斿嵶朎娻偺侾愗彍椺 en-subtitle= kn-subtitle= en-abstract= kn-abstract=丂Esophageal endocrine cell carcinoma is extremely rare. We report a case of esophageal endocrine cell carcinoma showing histological complete response to neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil (DCF). A 66-year-old man had been experiencing epigastralgia, and a type 2 tumor in the thoracic part of esophagus was detected by upper endoscopy. The biopsy showed endocrine cell carcinoma. PET/CT, endoscopy and an esophagogram showed that the patient had a 70-mm scaled type 2 tumor in the middle thoracic esophagus, and they also revealed lymph node metastases (no. 106recR). We diagnosed a cT3cN1cM0 cStage III tumor. With two courses of DCF treatment, both the primary tumor and lymph node metastases showed a partial response. We performed a subtotal esophagectomy with three-field lymph node dissection. The pathological examination of the resected specimens revealed no malignant cells in the esophagus or lymph nodes, and we concluded that the pathological effect of the DCF treatment was Grade 3. en-copyright= kn-copyright= en-aut-name=MaedaNaoaki en-aut-sei=Maeda en-aut-mei=Naoaki kn-aut-name=慜揷捈尒 kn-aut-sei=慜揷 kn-aut-mei=捈尒 aut-affil-num=1 ORCID= en-aut-name=ShirakawaYasuhiro en-aut-sei=Shirakawa en-aut-mei=Yasuhiro kn-aut-name=敀愳桋攷 kn-aut-sei=敀愳 kn-aut-mei=桋攷 aut-affil-num=2 ORCID= en-aut-name=KoujimaTakeshi en-aut-sei=Koujima en-aut-mei=Takeshi kn-aut-name=殸晎搰寬 kn-aut-sei=殸晎搰 kn-aut-mei=寬 aut-affil-num=3 ORCID= en-aut-name=OharaToshiaki en-aut-sei=Ohara en-aut-mei=Toshiaki kn-aut-name=戝尨棙復 kn-aut-sei=戝尨 kn-aut-mei=棙復 aut-affil-num=4 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name=揷绮弐曘 kn-aut-sei=揷绮 kn-aut-mei=弐曘 aut-affil-num=5 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name=栰娫榓峀 kn-aut-sei=栰娫 kn-aut-mei=榓峀 aut-affil-num=6 ORCID= en-aut-name=SakuramaKazuhumi en-aut-sei=Sakurama en-aut-mei=Kazuhumi kn-aut-name=烴娫嫵暥 kn-aut-sei=烴娫 kn-aut-mei=嫵暥 aut-affil-num=7 ORCID= en-aut-name=FujiwaraToshiyosi en-aut-sei=Fujiwara en-aut-mei=Toshiyosi kn-aut-name=摗尨弐媊 kn-aut-sei=摗尨 kn-aut-mei=弐媊 aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 affil-num=8 en-affil= kn-affil=壀嶳戝妛昦堾丂徚壔娗奜壢 en-keyword=怘摴娻乮esophageal cancer乯 kn-keyword=怘摴娻乮esophageal cancer乯 en-keyword=撪暘斿嵶朎娻乮endocrine cell carcinoma乯 kn-keyword=撪暘斿嵶朎娻乮endocrine cell carcinoma乯 en-keyword=DCF椕朄乮DCF treatment乯 kn-keyword=DCF椕朄乮DCF treatment乯 END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=5 article-no= start-page=277 end-page=283 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relationship between Orthodontic Expertise and Perception of Need for Orthodontic Treatment for Mandibular Protrusion in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aims of this study were to investigate how the Peer Assessment Rating (PAR index) predicts the perceived need for orthodontic treatment of mandibular protrusion in Japanese subjects, and to elucidate whether the perceived need for treatment was affected by the raters? orthodontic expertise. The subjects were 110 dental students and 32 orthodontists. We showed them casts of 10 untreated mandibular protrusion cases and gave them a questionnaire in which they had to describe their perceptions of the orthodontic treatment needs using a 10-point visual analog scale (VAS). The PAR index was used for cast evaluation. The PAR index scores showed significant correlations with the VAS scores. In casts with a low PAR score, there were no differences in the VAS scores between orthodontists and students. In casts with a PAR score greater than 23, the orthodontists perceived a significantly greater treatment need than did the students;for scores of 22, 28, and 29, students who had received orthodontic treatment themselves were more likely to perceive the treatment need. The PAR index is a good clinical predictor for assessing the perceived treatment needs for mandibular protrusion. Perception of the need for orthodontic treatment for mandibular protrusion depended on the degree of orthodontic expertise in Japanese subjects. en-copyright= kn-copyright= en-aut-name=MurakamiTakashi en-aut-sei=Murakami en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FujiiAkihito en-aut-sei=Fujii en-aut-mei=Akihito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawabataYuya en-aut-sei=Kawabata en-aut-mei=Yuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakakuraHiroaki en-aut-sei=Takakura en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamaueRie en-aut-sei=Yamaue en-aut-mei=Rie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=Tarek Abdulsamad Ali Balam en-aut-sei=Tarek Abdulsamad Ali Balam en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KurodaShingo en-aut-sei=Kuroda en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawanabeNoriaki en-aut-sei=Kawanabe en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KamiokaHiroshi en-aut-sei=Kamioka en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YamashiroTakashi en-aut-sei=Yamashiro en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=YA dental clinic affil-num=3 en-affil= kn-affil=Undergraduate student, Dental School, Okayama University affil-num=4 en-affil= kn-affil=Undergraduate student, Dental School, Okayama University affil-num=5 en-affil= kn-affil=Undergraduate student, Dental School, Okayama University affil-num=6 en-affil= kn-affil=Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Orthodontics and Dentofacial Orhtopedics, The University of Tokusima Graduate School of Oral Sciences affil-num=8 en-affil= kn-affil=Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=orthodontic expertise kn-keyword=orthodontic expertise en-keyword=treatment need kn-keyword=treatment need en-keyword=PAR index kn-keyword=PAR index en-keyword=mandibular protrusion kn-keyword=mandibular protrusion END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=4 article-no= start-page=253 end-page=258 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201308 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Septic Pulmonary Embolism Induced by Dental Infection en-subtitle= kn-subtitle= en-abstract= kn-abstract=Dental infection can be an important source for septic pulmonary embolism (SPE), but only a few cases of SPE accompanying dental infection have been reported. The aim of this study was to characterize the clinical features of SPE induced by dental infection. Patients who fulfilled the diagnostic criteria described in the text were recruited in a retrospective fashion. All 9 patients were men, with a median age of 59 years (range:47 to 74 years). Eight patients had chest pain (88.9%), 5 had a preceding toothache (55.6%) and 3 had preceding gingival swelling (33.3%). Blood cultures obtained from 7 patients were negative. Periodontitis was found in all of the cases, periapical periodontitis in 5 cases, and gingival abscess in 3 cases. The median duration of hospitalization was 15 days, and symptoms were mild in some cases. In addition to antimicrobial therapy, tooth extraction was performed in 3 cases, tooth scaling in 6. SPE induced by dental infection has prominent clinical characteristics such as male preponderance, chest pain, preceding toothache, and mild clinical course. en-copyright= kn-copyright= en-aut-name=ShiotaYutaro en-aut-sei=Shiota en-aut-mei=Yutaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TaniguchiAkihiko en-aut-sei=Taniguchi en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YuzurioSyota en-aut-sei=Yuzurio en-aut-mei=Syota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HoritaNaokatsu en-aut-sei=Horita en-aut-mei=Naokatsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HosokawaShinobu en-aut-sei=Hosokawa en-aut-mei=Shinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WatanabeYoichi en-aut-sei=Watanabe en-aut-mei=Yoichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TohmoriHidetoshi en-aut-sei=Tohmori en-aut-mei=Hidetoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OnoTetsuya en-aut-sei=Ono en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Department of Respiratory Diseases, Kure Kyosai Hospital affil-num=2 en-affil= kn-affil=Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Respiratory Diseases, Kure Kyosai Hospital affil-num=4 en-affil= kn-affil=Department of Respiratory Diseases, Kure Kyosai Hospital affil-num=5 en-affil= kn-affil=Department of Respiratory Diseases Okayama Red Cross General Hospital affil-num=6 en-affil= kn-affil=Department of Respiratory Diseases Okayama Red Cross General Hospital affil-num=7 en-affil= kn-affil=Department of Dentistry and Oral Surgery, Kure Kyosai Hospital affil-num=8 en-affil= kn-affil=Department of Internal Medicine, Kure Kyosai Hospital en-keyword=bacteremia kn-keyword=bacteremia en-keyword=chest pain kn-keyword=chest pain en-keyword=multiple nodular shadows kn-keyword=multiple nodular shadows en-keyword=periodontitis kn-keyword=periodontitis en-keyword=septic pulmonary embolism kn-keyword=septic pulmonary embolism END start-ver=1.4 cd-journal=joma no-vol=66 cd-vols= no-issue=6 article-no= start-page=499 end-page=502 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=201212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Surgical Treatment for Congenital Kyphosis Correction Using Both Spinal Navigation and a 3-dimensional Model en-subtitle= kn-subtitle= en-abstract= kn-abstract=An 11 year-old girl had 66 degrees of kyphosis in the thoracolumbar junction. For the purpose of planning for kyphosis correction, we created a 3-D, full-scale model of the spine and consulted spinal navigation. Three-dimensional models are generally used as tactile guides to verify the surgical approach and portray the anatomic relations specific to a given patient. We performed posterior fusion from Th10 to L3, and vertebral column resection of Th12 and L1. Screw entry points, directions, lengths and diameters were determined by reference to navigation. Both tools were useful in the bone resection. We could easily detect the posterior element to be resected using the 3D model. During the anterior bony resection, navigation helped us to check the disc level and anterior wall of the vertebrae, which were otherwise difficult to detect due to their depth in the surgical field. Thus, the combination of navigation and 3D models helped us to safely perform surgery for a patient with complex spinal deformity. en-copyright= kn-copyright= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakaharaRyuichi en-aut-sei=Nakahara en-aut-mei=Ryuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MisawaHaruo en-aut-sei=Misawa en-aut-mei=Haruo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KunisadaToshiyuki en-aut-sei=Kunisada en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=2 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=3 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=4 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=5 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital affil-num=6 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Hospital en-keyword=congenital scoliosis kn-keyword=congenital scoliosis en-keyword=kyphosis kn-keyword=kyphosis en-keyword=navigation kn-keyword=navigation en-keyword=3-dimensional models kn-keyword=3-dimensional models END start-ver=1.4 cd-journal=joma no-vol=66 cd-vols= no-issue=6 article-no= start-page=469 end-page=473 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=201212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Recovery of Motor Function in Patients with Subaxial Cervical Spine Injury Relevant to the Fracture Pattern en-subtitle= kn-subtitle= en-abstract= kn-abstract=In this study, we studied the relationship between fracture patterns and motor function recovery in 70 consecutive patients with cervical spinal cord injury. Fractures were categorized into 6 fracture types and subdivided into stages according to the Allen-Ferguson classification system:compressive flexion (CF), distractive flexion (DF), compressive extension (CE), distractive extension (DE), vertical compression (VC) and lateral flexion (LF). Paralysis was evaluated using the American Spinal Injury Association (ASIA) impairment scale at the time of injury and 3 months afterwards. The residual rate of complete motor palsy (ASIA grade A or B) at the final examination was higher in those patients with DE fractures than those with CF, DF or CE. The final outcomes were as follows. Of the 14 patients who were classified with CF fractures, residual palsy was frequently seen in patients who had stage 5 injury. Of the 27 patients with DF fractures, residual palsy occurred in about half of the patients who had stage 4 or 5 injury. Of the 18 patients with CE fractures, residual palsy occurred in half of the patients with stage 3 injury or higher. Finally, of the 7 patients with DE fractures, the rate of residual palsy was high even for the stage 1 and 2 cases;indeed, all DE patients who had complete motor palsy at the first examination had residual palsy at the final examination. Accordingly, we conclude that motor recovery may be related to fracture pattern. en-copyright= kn-copyright= en-aut-name=ShiozakiYasuyuki en-aut-sei=Shiozaki en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ItoYasuo en-aut-sei=Ito en-aut-mei=Yasuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugimotoYoshihisa en-aut-sei=Sugimoto en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TomiokaMasao en-aut-sei=Tomioka en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShimokawaTetsuya en-aut-sei=Shimokawa en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MazakiTetsuro en-aut-sei=Mazaki en-aut-mei=Tetsuro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KoshimuneKoichiro en-aut-sei=Koshimune en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TanakaMasato en-aut-sei=Tanaka en-aut-mei=Masato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OzakiToshifumi en-aut-sei=Ozaki en-aut-mei=Toshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Gracuate School of Medicine, Dentistry, and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Orthopaedic Surgery, Kobe Red Cross Hospital affil-num=3 en-affil= kn-affil=Department of Orthopaedic Surgery, Kobe Red Cross Hospital affil-num=4 en-affil= kn-affil=Department of Orthopaedic Surgery, Hyogo Emergency Medical Center affil-num=5 en-affil= kn-affil=Department of Orthopaedic Surgery, Kobe Red Cross Hospital affil-num=6 en-affil= kn-affil=Department of Orthopaedic Surgery, Kobe Red Cross Hospital affil-num=7 en-affil= kn-affil=Department of Orthopaedic Surgery, Kobe Red Cross Hospital affil-num=8 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Gracuate School of Medicine, Dentistry, and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Orthopaedic Surgery, Okayama University Gracuate School of Medicine, Dentistry, and Pharmaceutical Sciences en-keyword=cervical spinal cord injury kn-keyword=cervical spinal cord injury en-keyword=motor function recovery kn-keyword=motor function recovery en-keyword=fracture patterns kn-keyword=fracture patterns END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=22 article-no= start-page=3306 end-page=3309 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=2009 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Fabricating small-scale, curved, polymeric structures with convex and concave menisci through interfacial free energy equilibrium en-subtitle= kn-subtitle= en-abstract= kn-abstract=Polymeric curved structures are widely used in imaging systems including optical fibers and microfluidic channels. Here, we demonstrate that small-scale, poly(dimethylsiloxane) (PDMS)-based, curved structures can be fabricated through controlling interfacial free energy equilibrium. Resultant structures have a smooth, symmetric, curved surface, and may be convex or concave in form based on surface tension balance. Their curvatures are controlled by surface characteristics (i.e., hydrophobicity and hydrophilicity) of the molds and semi-liquid PDMS. In addition, these structures are shown to be biocompatible for cell culture. Our system provides a simple, efficient and economical method for generating integrateable optical components without costly fabrication facilities. en-copyright= kn-copyright= en-aut-name=ChengChao-Min en-aut-sei=Cheng en-aut-mei=Chao-Min kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsuuraKoji en-aut-sei=Matsuura en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WangI-Jan en-aut-sei=Wang en-aut-mei=I-Jan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KurodaYuka en-aut-sei=Kuroda en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=LeDucPhilip R. en-aut-sei=LeDuc en-aut-mei=Philip R. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NaruseKeiji en-aut-sei=Naruse en-aut-mei=Keiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Departments of Mechanical and Biomedical Engineering and Biological Sciences, Carnegie Mellon University affil-num=2 en-affil= kn-affil=Research Core for Interdisciplinary Sciences, Okayama University affil-num=3 en-affil= kn-affil=Departments of Mechanical and Biomedical Engineering and Biological Sciences, Carnegie Mellon University affil-num=4 en-affil= kn-affil=Research Core for Interdisciplinary Sciences, Okayama University affil-num=5 en-affil= kn-affil=Departments of Mechanical and Biomedical Engineering and Biological Sciences, Carnegie Mellon University affil-num=6 en-affil= kn-affil=Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University END start-ver=1.4 cd-journal=joma no-vol=52 cd-vols= no-issue=6 article-no= start-page=775 end-page=781 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=20111122 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Study of the Response of Superoxide Dismutase in Mouse Organs to Radon Using a New Large-scale Facility for Exposing Small Animals to Radon en-subtitle= kn-subtitle= en-abstract= kn-abstract=We examined dose?dependent or dose rate?dependent changes of superoxide dismutase (SOD) activity using a new large-scale facility for exposing small animals to radon. Mice were exposed to radon at a concentration of 250, 500, 1000, 2000, or 4000 Bq/m³ for 0.5, 1, 2, 4, or 8 days. When mice were exposed to radon at 2000 day?Bq/m³, activation of SOD activities in plasma, liver, pancreas, heart, thymus, and kidney showed dose?rate effects. Our results also suggested that continuous exposure to radon increased SOD activity, but SOD activity transiently returned to normal levels at around 2 days. Moreover, we classified the organs into four groups (1. plasma, brain, lung; 2. heart, liver, pancreas, small intestine; 3. kidney, thymus; 4. stomach) based on changes in SOD activity. Thymus had the highest responsiveness and stomach had lowest. These data provide useful baseline measurements for future studies on radon effects. en-copyright= kn-copyright= en-aut-name=KataokaTakahiro en-aut-sei=Kataoka en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakodaAkihiro en-aut-sei=Sakoda en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IshimoriYuu en-aut-sei=Ishimori en-aut-mei=Yuu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ToyotaTeruaki en-aut-sei=Toyota en-aut-mei=Teruaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishiyamaYuichi en-aut-sei=Nishiyama en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TanakaHiroshi en-aut-sei=Tanaka en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=YamaokaKiyonori en-aut-sei=Yamaoka en-aut-mei=Kiyonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University affil-num=2 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University affil-num=3 en-affil= kn-affil=Ningyo-toge Environmental Engineering Center, Japan Atomic Energy Agency affil-num=4 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University affil-num=5 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University affil-num=6 en-affil= kn-affil=Ningyo-toge Environmental Engineering Center, Japan Atomic Energy Agency affil-num=7 en-affil= kn-affil=Misasa Medical Center, Okayama University Hospital affil-num=8 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University en-keyword=Radon kn-keyword=Radon en-keyword=Superoxide dismutase kn-keyword=Superoxide dismutase en-keyword=Dose kn-keyword=Dose en-keyword=Dose rate kn-keyword=Dose rate en-keyword=Large-scale facility kn-keyword=Large-scale facility END start-ver=1.4 cd-journal=joma no-vol=124 cd-vols= no-issue=1 article-no= start-page=41 end-page=45 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=20120401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Current state and challenges of Japanese medical education kn-title=堛椕恖堢惉偺尰嫷偲壽戣 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KataokaHitomi U en-aut-sei=Kataoka en-aut-mei=Hitomi U kn-aut-name=曅壀恗旤 kn-aut-sei=曅壀 kn-aut-mei=恗旤 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂抧堟堛椕恖嵽堢惉 en-keyword=堛妛嫵堢 kn-keyword=堛妛嫵堢 en-keyword=抧堟堛椕嫵堢 kn-keyword=抧堟堛椕嫵堢 en-keyword=彈惈堛巘巟墖 kn-keyword=彈惈堛巘巟墖 en-keyword=僾儘僼僃僢僔儑僫儕僘儉 kn-keyword=僾儘僼僃僢僔儑僫儕僘儉 en-keyword=empathy kn-keyword=empathy END start-ver=1.4 cd-journal=joma no-vol=37 cd-vols= no-issue=5 article-no= start-page=907 end-page=913 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=201107 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Long-term exposure to methylmercury and psychiatric symptoms in residents of Minamata, Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: It is well-known that prenatal or postnatal exposure to methylmercury can produce neurological signs in adults and children, exemplified by a case of large-scale poisoning in Minamata, Japan, in the 1950s. However, evidence regarding whether pre- or postnatal exposure to methylmercury causes psychiatric symptoms (e.g., impairment of intelligence and mood and behavioral dysfunction) is still limited-excluding cases of fetal Minamata disease patients. Methods: We evaluated the effects of pre- or postnatal exposure to methylmercury on psychiatric symptoms using data derived from a 1971 population-based survey in Minamata and neighboring communities. We adopted residential areas as an exposure indicator and psychiatric symptoms as the outcome. Then, we estimated the adjusted prevalence odds ratio (POR) and confidence interval (Cl) of psychiatric symptoms in relation to residential area. Results: There were 904 participants in Minamata (high exposure area), 1700 in Goshonoura (middle exposure area), and 913 in Ariake (low exposure area). Compared to the Ariake area, participants in the Minamata area manifested psychiatric symptoms more frequently: PORs for impairment of intelligence and mood and behavioral dysfunction were 5.2 (95% Cl: 3.7-7.3) and 4.4 (95% Cl: 2.9-6.7), respectively. Furthermore, participants with psychiatric symptoms in the Minamata area more frequently had neurological signs. Peaks in prevalence of psychiatric symptoms occurred around age 20 and in older age adults in the area. These findings did not change when we excluded those who had been officially certified as Minamata disease patients by that time. Conclusions: The present study suggests a relationship between pre- or postnatal exposure to methylmercury and psychiatric symptoms among the general population in Minamata even after excluding officially certified patients. en-copyright= kn-copyright= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsudaToshihide en-aut-sei=Tsuda en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InoueSachiko en-aut-sei=Inoue en-aut-mei=Sachiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakaoSoshi en-aut-sei=Takao en-aut-mei=Soshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HaradaMasazumi en-aut-sei=Harada en-aut-mei=Masazumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Environmental Epidemiology, Okayama University Graduate School of Environmental Science affil-num=3 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=Environmental pollution kn-keyword=Environmental pollution en-keyword=Epidemiological studies kn-keyword=Epidemiological studies en-keyword=Methylmercury compounds kn-keyword=Methylmercury compounds en-keyword=Minamata disease kn-keyword=Minamata disease en-keyword=Prenatal exposure delayed effects kn-keyword=Prenatal exposure delayed effects en-keyword=Psychiatric disorders kn-keyword=Psychiatric disorders END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=3 article-no= start-page=197 end-page=201 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Preoperative Time Required for the Timed "Up and Go" Test in Women with Hip Osteoarthritis Could Predict a Deep Venous Thrombosis Complication after Total Hip Arthroplasty en-subtitle= kn-subtitle= en-abstract= kn-abstract=We examined whether the preoperative time required for the Timed "Up and Go" (TUG) test could predict the risk for deep venous thrombosis (DVT) in patients with hip osteoarthritis after total hip arthroplasty (THA). Eighteen patients with DVT diagnosed by venography were selected, and 18 without DVT of the same age and sex and with the same operated side as the DVT group were selected as a control group. We evaluated the 5 preoperative factors that might affect the occurrence of DVT complications, as follows:disease duration, body mass index, serum total cholesterol, subjective pain evaluated by the visual analog scale, and TUG. The JOA hip score (pain, range of motion, walking ability, and daily life) was also evaluated before surgery. As a postoperative factor, we checked the postoperative day when weight-bearing was initiated. As a result, TUG (DVT, 18.4+/-4.0 sec vs. control, 15.0+/-3.2 sec;p0.01) was only significantly different between the 2 groups. The ROC curve revealed that the cut-off point of 15.3 sec in preoperative time for TUG was sensitive (83.3%) and specific (61.1%) for DVT after THA (odds ratio7.0;95% confidence interval, 1.6-30.8). These results suggested that low preoperative ambulatory ability in patients with hip osteoarthritis might be associated with DVT after THA. An improvement in TUG before surgery might contribute to a decrease in the occurrence of DVT after THA. en-copyright= kn-copyright= en-aut-name=SasakiKentaro en-aut-sei=Sasaki en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SendaMasuo en-aut-sei=Senda en-aut-mei=Masuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishidaKeiichiro en-aut-sei=Nishida en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OtaHaruyuki en-aut-sei=Ota en-aut-mei=Haruyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Department of Physical Therapy, Kinjo University affil-num=2 en-affil= kn-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital affil-num=3 en-affil= kn-affil=Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Division of Physical Medicine and Rehabilitation, Okayama University Hospital en-keyword=preoperative Timed 乬Up and Go乭 test kn-keyword=preoperative Timed 乬Up and Go乭 test en-keyword=deep venous thrombosis kn-keyword=deep venous thrombosis en-keyword=total hip arthroplasty kn-keyword=total hip arthroplasty en-keyword=hip osteoarthritis kn-keyword=hip osteoarthritis END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=1 article-no= start-page=39 end-page=47 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Influencing Factors for Dietary Behaviors of Patients with Diabetic Nephropathy en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The aim of this study was to clarify the factors influencing the dietary behavior of patients with diabetic nephropathy. One hundred twenty-two patients with type 2 diabetes were recruited from the outpatients of Okayama University Hospital in Okayama, Japan. We performed a cross-sectional study using a questionnaire including 206 items among 18 categories as follows:background factors, coping behavior (coping scale), degree of uncertainty in illness (uncertainty scale), and dietary behavior. The data were analyzed by correlation analysis, t-test, one-way analysis of variance, Pearson correlation analysis, and multiple regression analysis. We found that those patients with microalbuminuria alone tended to recognize more mild about their kidney status than those with macroalbuminuria and chronic renal failure. We also found that common factors influencing the dietary behavior of diabetic patients with and without nephropathy are as follows:1. coping with the problem (beta0.342, p0.01);2. anxiety about prognosis (beta0.344, p0.01);3. sex (beta0.234, p0.05);4. uncertainty regarding treatment (beta0.377, p0.01);5. negative coping (beta0.354, p0.01);and 6. employment status (beta0.367, p0.01). Coping and uncertainty in illness had a significant relation to positive support and lack of support. To maintain appropriate dietary behavior in diabetic patients, medical staff need to determine what the social supports are important for the patient, and also to ensure good communication among healthcare personnel as well as positive support for patients and families.

en-copyright= kn-copyright= en-aut-name=SumiyoshiKazuko en-aut-sei=Sumiyoshi en-aut-mei=Kazuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawataChieko en-aut-sei=Kawata en-aut-mei=Chieko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences affil-num=2 en-affil= kn-affil=Mejiro Unibersity Graduate School of Nursing affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences en-keyword=diabetic nephropathy kn-keyword=diabetic nephropathy en-keyword=dietary behavior kn-keyword=dietary behavior en-keyword=coping kn-keyword=coping en-keyword=uncertainty in illness kn-keyword=uncertainty in illness en-keyword=social support kn-keyword=social support END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=1 article-no= start-page=9 end-page=17 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200902 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Nutrition and Depressive Symptoms in Community-dwelling Elderly Persons in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=

A cross-sectional study was conducted to evaluate the association between dietary intake and depressivesymptoms in community-dwelling elderly persons. Five-hundred elderly persons aged 65 to 75 years were randomly selected from the population of O city in Okayama Prefecture, Japan. Among 401 respondents (response rate, 80.0%), data from 279 (133 males, 146 females) who completed the questionnaire concerning dietary intake and depressive state were analyzed using logistic regression. Each of 17 dietary intakes was classified into tertiles:high intake, moderate intake, and low intake. The Center for Epidemiology Studies Depression scale (CES-D) was used. Among males, the observed odds ratios (the 95% confidence intervals) for the depressive state were 0.36 (95% CI:0.13-0.98) in the highest tertile of carotene intake, 0.33 (95% CI:0.12-0.93) in the highest tertile of vitamin C intake, 0.29 (95% CI:0.10-0.85) in the highest tertile of carbohydrate intake, and 0.33 (95% CI:0.12-0.92) in the medium tertile of vitamin E intake. Among females, similar results were observed, but these results were not statistically significant. The results suggested that carbohydrate, carotene, and vitaminC intakes are associated with lowering depressive symptoms among elderly persons dwelling in communities in Japan.

en-copyright= kn-copyright= en-aut-name=OishiJunko en-aut-sei=Oishi en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=DoiHiroyuki en-aut-sei=Doi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawakamiNorito en-aut-sei=Kawakami en-aut-mei=Norito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Mental Health, Graduate School of Medicine and Faculty of Medicine, the University of Tokyo en-keyword=dietary intake kn-keyword=dietary intake en-keyword=depressive symptoms kn-keyword=depressive symptoms en-keyword=elderly persons kn-keyword=elderly persons en-keyword=cross-sectional study kn-keyword=cross-sectional study en-keyword=gender kn-keyword=gender END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=2 article-no= start-page=83 end-page=91 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=200804 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Job strain and smoking cessation among Japanese male employees: a two-year follow-up study en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The purpose of the present study was to assess the association between job strain and smoking cessation among Japanese male employees. In 1997, a baseline questionnaire was given to 2,625 (2,113 males and 512 females) employees of an electronics firm in Gifu Prefecture, Japan. The self-administered questionnaire was a set of questions on smoking habits and consisted of items on socio-demographic variables and smoking habits, including the Japanese version of the Job Content Questionnaire (JCQ). The JCQ consists of scales of job control, job demand, supervisory support, coworker support, job insecurity, physical demands, and isometric load. A total of 733 male smokers were then followed for 2 years, with 446 completing a follow-up questionnaire in 1999 (follow-up rate, 61%). Logistic regression analyses were performed to examine associations between job strain and smoking cessation. Among the 446 participants, 38 had quit smoking. After adjusting for age ((odds ratio: OR) = 0.38, 95% (contidence interval: CI) = 0.15-0.94), men with a high level of physical demands at baseline showed a lower smoking cessation rate at follow-up than did those with a low level. However, when adjustments were made for age and other socio-demographic variables, the odds ratio of smoking cessation showed marginal significance (OR = 0.45, 95% CI = 0.16-1.29). There was no significant association between other job strain variables and smoking cessation at the 2-year follow-up. No significant association was found between job strain and change in the number of smoked cigarettes per day. The present study did not support the hypothesis that higher levels of job stressors are associated with a lower rate of smoking cessation among men.

en-copyright= kn-copyright= en-aut-name=FukuokaEtsuko en-aut-sei=Fukuoka en-aut-mei=Etsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HirokawaKumi en-aut-sei=Hirokawa en-aut-mei=Kumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawakamiNorito en-aut-sei=Kawakami en-aut-mei=Norito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsuchiyaMasao en-aut-sei=Tsuchiya en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HarataniTakashi en-aut-sei=Haratani en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KobayashiFumio en-aut-sei=Kobayashi en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ArakiShunichi en-aut-sei=Araki en-aut-mei=Shunichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=DoiHiroyuki en-aut-sei=Doi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Hygiene and Preventive Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Psychology, Fukuyama University affil-num=3 en-affil= kn-affil=Department of Mental Health, Graduate School of Medicine, and Faculty of Medicine, the University of Tokyo affil-num=4 en-affil= kn-affil=Hygiene and Preventive Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Japan National Institute of Occupational Safety and Health affil-num=6 en-affil= kn-affil=Department of Hygiene and Preventive Medicine, Aichi Medical University affil-num=7 en-affil= kn-affil=Japan National Institute of Occupational Safety and Health affil-num=8 en-affil= kn-affil=Hygiene and Preventive Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=job strain kn-keyword=job strain en-keyword=smoking kn-keyword=smoking en-keyword=worksite support kn-keyword=worksite support en-keyword=physical demands kn-keyword=physical demands en-keyword=prospective cohort study kn-keyword=prospective cohort study END start-ver=1.4 cd-journal=joma no-vol=51 cd-vols= no-issue=1 article-no= start-page=33 end-page=37 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=199702 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical effect of low-dose, long-term roxithromycin chemotherapy in patients with chronic sinusitis en-subtitle= kn-subtitle= en-abstract= kn-abstract=

We studied the clinical efficacy of roxithromycin (RXM) administered at the daily dosage of one tablet (150mg) for 3 months in 30 patients with chronic sinusitis. The effectiveness of this drug was evaluated on a four-point scale. Subjective and objective symptoms disappeared or decreased markedly, especially postnasal drip and nature of discharge in 80 percent or more of the patients. All symptoms significantly decreased (P < 0.001; headache P < 0.05), except for the sensation of foul odor. Symptoms improved even in those cases in which Haemophilus influenzae was detected. It is suggested that RXM produces some clinically beneficial effect through an immunological and or anti-inflammatory mechanisms in addition to its antibiotic effect.

en-copyright= kn-copyright= en-aut-name=KimuraNobuhiko en-aut-sei=Kimura en-aut-mei=Nobuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NishiokaKeiko en-aut-sei=Nishioka en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishizakiKazunori en-aut-sei=Nishizaki en-aut-mei=Kazunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OgawaTeruhiro en-aut-sei=Ogawa en-aut-mei=Teruhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NaitouYoshihiro en-aut-sei=Naitou en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MasudaYu en-aut-sei=Masuda en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Hiroshima City Hospital affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University en-keyword=roxithromycin kn-keyword=roxithromycin en-keyword=clinical evaluation kn-keyword=clinical evaluation en-keyword=chronic sinusitis kn-keyword=chronic sinusitis en-keyword=long-term kn-keyword=long-term en-keyword=low-dose administration kn-keyword=low-dose administration END start-ver=1.4 cd-journal=joma no-vol=121 cd-vols= no-issue=2 article-no= start-page=109 end-page=112 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=20090803 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The Japanese guidelines for management of gastric ulcer kn-title=堓捵釃恌椕偺僈僀僪儔僀儞 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=InoueMasafumi en-aut-sei=Inoue en-aut-mei=Masafumi kn-aut-name=堜忋夒暥 kn-aut-sei=堜忋 kn-aut-mei=夒暥 aut-affil-num=1 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name=壀揷桾擵 kn-aut-sei=壀揷 kn-aut-mei=桾擵 aut-affil-num=2 ORCID= en-aut-name=KawaharaYoshiro en-aut-sei=Kawahara en-aut-mei=Yoshiro kn-aut-name=壨尨徦楴 kn-aut-sei=壨尨 kn-aut-mei=徦楴 aut-affil-num=3 ORCID= en-aut-name=KawanoSeiji en-aut-sei=Kawano en-aut-mei=Seiji kn-aut-name=愳栰惤巌 kn-aut-sei=愳栰 kn-aut-mei=惤巌 aut-affil-num=4 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name=嶳杮榓廏 kn-aut-sei=嶳杮 kn-aut-mei=榓廏 aut-affil-num=5 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 affil-num=2 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 affil-num=3 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 affil-num=4 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 affil-num=5 en-affil= kn-affil=壀嶳戝妛戝妛堾堛帟栻妛憤崌尋媶壢丂徚壔婍丒娞憻撪壢妛 END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue= article-no= start-page=43 end-page=49 dt-received= dt-revised= dt-accepted= dt-pub-year=1996 dt-pub=199611 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=壏愹椕朄偵傛傞婥娗巟歜懅姵幰偺怱棟揑忈奞偺夵慞 kn-title=Improvement of psychological disorders by spa therapy in patients with asthma en-subtitle= kn-subtitle= en-abstract=婥娗巟歜懅偵懳偡傞壏愹椕朄(1-2儢寧)偵傛傞怱棟揑忈奞偺夵慞傪昡壙偡傞偨傔偵,3庬椶偺怱棟妛揑挷嵏:CMI(Cornel Medical Index),SDS(Selfrationg Depression Scale),CAI(Comprehensive Asthma Inventory)傪,婥娗巟歜懅姵幰37椺傪懳徾偲偟偰,擖堾帪偲戅堾帪偵幚巤偟斾妑偟偨@CMI偱偼,恎懱揑帺妎徢,屇媧婍宯徢忬偍傛傃CIJ徢忬偑,壏愹椕朄屻偵桳堄偵夵慞偟偨ASDS抣偑40埲忋偺徢椺偵偍偄偰,壏愹椕朄屻,暯嬒抣偼45.7偐傜37.5傊桳堄偵尭彮偟偨BCAI偺庬乆偺怱棟妛揑崁栚偵傛傝昡壙偟偨怱棟揑忈奞偼,壏愹椕朄屻偵桳堄偵夵慞偟偨e怱棟崁栚偺暯嬒抣偱偁傞CAI僗僐傾偼,帯椕屻,37.1偐傜27.8傊桳堄偵掅壓偟偨眰陚鐐虒媺蕚﹤�,婥娗巟歜懅姵幰偵娤嶡偝傟傞怱棟揑忈奞偼,壏愹椕朄偵傛傝夵慞偡傞偙偲偑帵嵈偝傟偨� kn-abstract=To evaluate improvement of mental disorders by spa therapy for 1-2 months, three kinds of psychological examinations, CMI (Cornel Medical Index), SDS (Selfrating Depression Scale) and CAI (Comprehensive Asthma Inventory) tests, were performed in 37 patients with asthma before and after spa therapy. 1. In CMI test, the scores of physical symptoms, respiratory symptoms, and CIJ symptoms significantly decreased after spa therapy. The score of psychical symptoms tended to decrease after the therapy, however, this was not significant. 2. The mean score of the subjects over 40 points in SDS test significantly decreased from 45.7 points before spa therapy to 37.5 after the therapy. 3. Mental disorders evaluated by various categories in CAI test were significantly improved after spa therapy. The average score in CAI test significantly decreased from 37.1 to 27.8 after the therapy. These results demonstrate that psychological disorders in patients with asthma are improved by spa therapy. en-copyright= kn-copyright= en-aut-name=YokotaSatoshi en-aut-sei=Yokota en-aut-mei=Satoshi kn-aut-name=墶揷憦 kn-aut-sei=墶揷 kn-aut-mei=憦 aut-affil-num=1 ORCID= en-aut-name=MifuneTakashi en-aut-sei=Mifune en-aut-mei=Takashi kn-aut-name=屼鋞彯巙 kn-aut-sei=屼鋞 kn-aut-mei=彯巙 aut-affil-num=2 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=岝墑暥桾 kn-aut-sei=岝墑 kn-aut-mei=暥桾 aut-affil-num=3 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=曐嶈懽峅 kn-aut-sei=曐嶈 kn-aut-mei=懽峅 aut-affil-num=4 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=埌揷峩嶰 kn-aut-sei=埌揷 kn-aut-mei=峩嶰 aut-affil-num=5 ORCID= en-aut-name=TsugenoHirofumi en-aut-sei=Tsugeno en-aut-mei=Hirofumi kn-aut-name=捬栰峗巎 kn-aut-sei=捬栰 kn-aut-mei=峗巎 aut-affil-num=6 ORCID= en-aut-name=TakeuchiKazuaki en-aut-sei=Takeuchi en-aut-mei=Kazuaki kn-aut-name=抾撪堦徍 kn-aut-sei=抾撪 kn-aut-mei=堦徍 aut-affil-num=7 ORCID= en-aut-name=NawaYuichiro en-aut-sei=Nawa en-aut-mei=Yuichiro kn-aut-name=柤榓桼堦榊 kn-aut-sei=柤榓 kn-aut-mei=桼堦榊 aut-affil-num=8 ORCID= en-aut-name=TanizakiYoshiro en-aut-sei=Tanizaki en-aut-mei=Yoshiro kn-aut-name=扟嶈彑楴 kn-aut-sei=扟嶈 kn-aut-mei=彑楴 aut-affil-num=9 ORCID= en-aut-name=TadaShinya en-aut-sei=Tada en-aut-mei=Shinya kn-aut-name=懡揷怲栫 kn-aut-sei=懡揷 kn-aut-mei=怲栫 aut-affil-num=10 ORCID= en-aut-name=HaradaMine en-aut-sei=Harada en-aut-mei=Mine kn-aut-name=尨揷幚崻 kn-aut-sei=尨揷 kn-aut-mei=幚崻 aut-affil-num=11 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=8 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=9 en-affil= kn-affil=壀嶳戝妛堛妛晹晬懏昦堾嶰挬暘堾撪壢 affil-num=10 en-affil= kn-affil=壀嶳戝妛堛妛晹戞擇撪壢 affil-num=11 en-affil= kn-affil=壀嶳戝妛堛妛晹戞擇撪壢 en-keyword=婥娗巟歜懅 (Bronchial asthma) kn-keyword=婥娗巟歜懅 (Bronchial asthma) en-keyword=壏愹椕朄 (Spa therapy) kn-keyword=壏愹椕朄 (Spa therapy) en-keyword=怱棟僥僗僩乮CMI, SDS, CAI) (CMI test, SDS test, CAI test) kn-keyword=怱棟僥僗僩乮CMI, SDS, CAI) (CMI test, SDS test, CAI test) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=31 end-page=34 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Spa therapy for patient with postherpetic neuralgia丗A case report kn-title=懷忬醰怾屻恄宱捝偵懳偡傞壏愹傪棙梡偟偨儕僴價儕僥乕僔儑儞偺宱尡 en-subtitle= kn-subtitle= en-abstract=We report a case who had a favorable outcome with spa therapy for postherpetic neuralgia. A 72-year-old woman had shingles with rash in the right leg. Pain was severe even after the rash healed. After six months of the onset of shingles, she was admitted to this hospital for rehabilitation with the use of a hot spring. She presented with allodynia in the right leg and thermohyperesthesia . We provided thermotherapy mainly with tepid bath and therapeutic exercise mainly with active-assistive exercise of the right leg. The pain was alleviated with spa therapy, allowing her to walk with a cane. Spa therapy , with fewer adverse effects , appears likely to become one of the treatment choices for postherpetic neuralgia. kn-abstract=懷忬醰怾屻恄宱捝偵懳偟偰, 壏愹椕朄傪峴偄, 椙岲側寢壥偑摼傜傟偨徢椺偵偮偄偰曬崘偡傞�72嵥, 彈惈. 塃壓巿偺旂怾偵偰懷忬醰怾傪敪徢偟偨鐞]偑帯桙偟偨屻傕醬捝偑嫮偐偭偨瓘菙紨N屻, 壏愹傪棙梡偟偨儕僴價儕僥乕僔儑儞栚揑偵偰, 摉堾偵擖堾偟偨E壓巿偵偼傾儘僨傿僯傾偑偁傝窊x妎夁晀偑偁偭偨鲏窏亗饞啇S偲偟偨壏擬椕朄偲塃壓巿偺帺摦夘彆塣摦傪拞怱偲偟偨塣摦椕朄傪峴偭偨. 壏愹椕朄偵傛傝醬捝寉尭偟駮鄭s偑壜擻偲側偭偨窅驐脰@偼暃嶌梡傕彮側偔懷忬醰怾屻恄宱捝偺帯椕偺慖戰巿偺堦偮偵側傞偲峫偊傞� en-copyright= kn-copyright= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=郷揷慡婭 kn-aut-sei=郷揷 kn-aut-mei=慡婭 aut-affil-num=1 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=岝墑暥桾 kn-aut-sei=岝墑 kn-aut-mei=暥桾 aut-affil-num=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=曐嶈懽峅 kn-aut-sei=曐嶈 kn-aut-mei=懽峅 aut-affil-num=3 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=埌揷峩嶰 kn-aut-sei=埌揷 kn-aut-mei=峩嶰 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=娾奯彯巎 kn-aut-sei=娾奯 kn-aut-mei=彯巎 aut-affil-num=5 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=崅揷恀屷 kn-aut-sei=崅揷 kn-aut-mei=恀屷 aut-affil-num=6 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=媏抮岹 kn-aut-sei=媏抮 kn-aut-mei=岹 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕儕僴價儕僥乕僔儑儞壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕撪壢 en-keyword=Chronic obstructive pulmonary disease (枬惈暵嵡惈攛幘姵) kn-keyword=Chronic obstructive pulmonary disease (枬惈暵嵡惈攛幘姵) en-keyword=Spa therapy (壏愹椕朄) kn-keyword=Spa therapy (壏愹椕朄) en-keyword=Six-minute walk test (俇暘娫曕峴帋尡) kn-keyword=Six-minute walk test (俇暘娫曕峴帋尡) en-keyword=Borg scale (儃儖僌僗働乕儖) kn-keyword=Borg scale (儃儖僌僗働乕儖) en-keyword=Ventilatory function (屇媧婡擻) kn-keyword=Ventilatory function (屇媧婡擻) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=24 end-page=30 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=枬惈暵嵡惈攛幘姵姵幰偵偍偗傞壏愹椕朄偺俇暘娫曕峴偵懳偡傞岠壥 kn-title=Effects of spa therapy on the six-minute walk test in patients with chronic obstructive pulmonary disease en-subtitle= kn-subtitle= en-abstract=変乆偼壏愹椕朄偑枬惈暵嵡惈攛幘姵姵幰偵懳偟偰, 屇媧婡擻夵慞岠壥傪桳偡傞偙偲傪曬崘偟偰偒偨駢鋪X偼枬惈暵嵡惈攛幘姵姵幰傪懳徾偵壏愹椕朄偺俇暘娫曕峴帋尡偵媦傏偡塭嬁偵偮偄偰専摙偟偨枆@擖堾拞偺枬惈暵嵡惈攛幘姵姵幰10椺(抝惈俋椺, 彈惈侾椺) 傪懳徾偲偟偰, 壏愹僾乕儖悈拞塣摦, 峼揇幖晍椕朄, 儓乕僪僝儖媧擖椕朄摍偵傛傞暋崌壏愹椕朄傪4廡娫巤峴偟, 偦偺娫偺屇媧婡擻, 俇暘娫曕峴帋尡偵偍偗傞曕峴嫍棧, 摦柆寣巁慺朞榓搙, 廋惓Borg僗働乕儖偺曄壔傪斾妑専摙偟偨膵z婡擻専嵏偱偼, 攛妶検, 侾昩検摍偺夵慞孹岦偑擣傔傜傟偨U暘娫曕峴嫍棧, 摦柆寣巁慺朞榓搙偼忋徃孹岦偵偁偭偨C惓Borg僗働乕儖偼桳堄偵掅壓孹岦偟偨窅驐脰@偵傛傝屇媧婡擻偺夵慞偑摼傜傟, 偙傟偵傛傝摦柆寣巁慺朞榓搙媦傃俇暘娫曕峴嫍棧偑忋徃偟偨偲峫偊傜傟偨窅驐脰@偑枬惈暵嵡惈攛幘姵偺帯椕偵桳梡偱偁傞偙偲偑帵嵈偝傟偨� kn-abstract=Our previous studies have shown that subjective symptoms and ventilatory function are improved by spa therapy in patients with chronic obstructive pulmonary disease (COPD). In the present study, we investigated the effects of spa therapy on six-minute walk distance in patients with COPD . Subjects were 10 patients with chronic obstructive pulmonary disease (9 males and 1 female) admitted to our hospital to undergo pulmonary rehabilitation. All patients had complex spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therapy) for 4 weeks. Ventilatory function, six-minute walk distance, oxygen saturation and Borg scale were measured. Vital capacity, forced expiratory volume in one second, sixminute walk distance and oxygen saturation increased, but not significantly. Significant decreases were observed for Borg scale. We found that spa therapy improved ventilatory dysfunction and six-minute walk distance in patients with COPD. The results demonstrated that spa therapy may lead to better disease control and exercise tolerance in patients with COPD. en-copyright= kn-copyright= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=崅揷恀屷 kn-aut-sei=崅揷 kn-aut-mei=恀屷 aut-affil-num=1 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=埌揷峩嶰 kn-aut-sei=埌揷 kn-aut-mei=峩嶰 aut-affil-num=2 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=曐嶈懽峅 kn-aut-sei=曐嶈 kn-aut-mei=懽峅 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=郷揷慡婭 kn-aut-sei=郷揷 kn-aut-mei=慡婭 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=娾奯彯巎 kn-aut-sei=娾奯 kn-aut-mei=彯巎 aut-affil-num=5 ORCID= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=媏抮岹 kn-aut-sei=媏抮 kn-aut-mei=岹 aut-affil-num=6 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=岝墑暥桾 kn-aut-sei=岝墑 kn-aut-mei=暥桾 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕儕僴價儕僥乕僔儑儞壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕撪壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 en-keyword=Chronic obstructive pulmonary disease (枬惈暵嵡惈攛幘姵) kn-keyword=Chronic obstructive pulmonary disease (枬惈暵嵡惈攛幘姵) en-keyword=Spa therapy (壏愹椕朄) kn-keyword=Spa therapy (壏愹椕朄) en-keyword=Six-minute walk test (俇暘娫曕峴帋尡) kn-keyword=Six-minute walk test (俇暘娫曕峴帋尡) en-keyword=Borg scale (儃儖僌僗働乕儖) kn-keyword=Borg scale (儃儖僌僗働乕儖) en-keyword=Ventilatory function (屇媧婡擻) kn-keyword=Ventilatory function (屇媧婡擻) END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue= article-no= start-page=18 end-page=23 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080301 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Examination about the effectiveness of thermal therapy on exercise tolerance and pulmonary function for patients with chronic obstructive pulmonary disease kn-title=枬惈暵嵡惈攛幘姵姵幰偺塣摦懴梕擻丒攛婡擻偵懳偡傞壏擬椕朄偺桳岠惈偵偮偄偰偺専摙丂亅pilot study亅 en-subtitle= kn-subtitle= en-abstract=We have reported the effectiveness of the complex spa therapy (swimming training in a hot spring pool, fango therapy, and inhalation of iodine salt solution) for patients with chronic obstructive pulmonary disease (COPD). In present study, we examined the effectiveness of thermal therapy for COPD patients. Fourteen patients with COPD were classified into two groups丟 group A (俇 males and 1 female, 68-81 years) and group B (俈 males , 68-81 years) . For group A , we underwent the thermal therapy which warms the whole body in a sitting posture at 60亷 for 15 minutes with dry system farinfrared sauna 5 times a week, in addition to medication therapy and lung physiotherapy. On the other hand, we carried out only medication therapy and lung physiotherapy for group B. All subjects were treated for 4 weeks. The pulmonary function test and 6 minute-walk test were performed before and after these therapies. In the pulmonary function test, vital capacity (VC) and forced expiratory volume in one second (FEV1) after the therapy improved more than those before therapy in both A and B groups. The FEV1 value after 4 weeks tended to increase more in group A compared with group B. However, no changes were observed in the VC value. In 6 minute-walk test, distance value, oxygen saturation value and Borg Scale value improved more than those before therapy in both A and B groups. These three parameters after 4 weeks tended to improve more in group A compared with group B. In particular, the statistically significant difference was observed in Borg Scale value before and after therapy (p<0.01). It is suggested that the thermal therapy could improve pulmonary function and exercise tolerance, and be helpful in the therapy of COPD patients. kn-abstract=変乆偼尰嵼傑偱, 枬惈暵嵡惈攛幘姵(COPD丟chronic obstructive pulmonary disease)姵幰偵懳偡傞暋崌壏愹椕朄(壏愹僾乕儖塣摦梺, 峼揇幖晍椕朄, 儓乕僪媧擖) 偺桳岠惈傪曬崘偟偰偒偨�, 壏擬椕朄偺桳岠惈傪柧傜偐偵偡傞偙偲傪栚揑偲偟偰, 壏擬椕朄傪廬棃偺帯椕偵暪梡偟, 塣摦懴梕擻偍傛傃攛婡擻偵懳偡傞岠壥傪専摙偟偨`孮俈椺(68乣79嵨丒抝惈俇椺, 彈惈侾椺) 偍傛傃俛孮俈椺(63乣81嵨丒慡椺抝惈), 寁14椺偺COPD姵幰傪懳徾偲偟偨`孮偵偮偄偰偼, 栻暔丒攛棟妛椕朄偺懠偵, 壏擬椕朄傪廡俆夞偱係廡娫巤峴偟偨� 壏擬椕朄偲偟偰, 姡幃墦愒奜慄幃僒僂僫傪梡偄偨60亷, 15暘娫偺僒僂僫梺(嵗埵) 傪巤峴偟偨屻, 夌埵偱30暘娫慡恎傪栄晍偱曪傫偱埨惷曐壏偟偨a孮偼, 栻暔丒攛棟妛椕朄偺傒係廡懕偗偨脩O屻偱攛婡擻偍傛傃俇暘娫曕峴帋尡傪巤峴偟斾妑専摙偟偨紝Q偲傕, 帯椕奐巒係廡屻偵偼俇暘娫曕峴偱偺曕峴嫍棧, 巁慺朞榓搙(俽pO2), 廋惓Borg scale偵偰夵慞傪擣傔, 攛婡擻偵偍偄偰傕攛妶検(VC丟vital capacity), 堦昩検(FEV1.0丟forced expiratory volume in one second) 偼忋徃偟偨紝Q娫偺斾妑偱偼, 俇暘娫曕峴帋尡偱忋婰俁崁栚偺夵慞棪偼偄偢傟傕俙孮偼俛孮傪椊夗偟, 俙孮偑桪埵偵塣摦懴梕擻偺岦忋傪擣傔偨`孮偱廋惓 Borg scale偺帯椕係廡娫屻偺夵慞棪偼桳堄嵎(p亙0.01) 傪擣傔偨軅綌x婡擻偱偼, 係廡娫屻偱VC忋徃棪偼傎傏晄曄偱偁偭偨偑FEV1.0偱偼俙孮偑桪埵偵忋徃偟偨葟銈虒媺蕚鎮鑹窋M椕朄偑COPD帯椕偵桳岠偱偁傞壜擻惈偑帵嵈偝傟偨� en-copyright= kn-copyright= en-aut-name=KikuchiHiroshi en-aut-sei=Kikuchi en-aut-mei=Hiroshi kn-aut-name=媏抮岹 kn-aut-sei=媏抮 kn-aut-mei=岹 aut-affil-num=1 ORCID= en-aut-name=HosakiYasuhiro en-aut-sei=Hosaki en-aut-mei=Yasuhiro kn-aut-name=曐嶈懽峅 kn-aut-sei=曐嶈 kn-aut-mei=懽峅 aut-affil-num=2 ORCID= en-aut-name=AshidaKozo en-aut-sei=Ashida en-aut-mei=Kozo kn-aut-name=埌揷峩嶰 kn-aut-sei=埌揷 kn-aut-mei=峩嶰 aut-affil-num=3 ORCID= en-aut-name=HamadaMasanori en-aut-sei=Hamada en-aut-mei=Masanori kn-aut-name=郷揷慡婭 kn-aut-sei=郷揷 kn-aut-mei=慡婭 aut-affil-num=4 ORCID= en-aut-name=IwagakiNaofumi en-aut-sei=Iwagaki en-aut-mei=Naofumi kn-aut-name=娾奯彯巎 kn-aut-sei=娾奯 kn-aut-mei=彯巎 aut-affil-num=5 ORCID= en-aut-name=TakataShingo en-aut-sei=Takata en-aut-mei=Shingo kn-aut-name=崅揷恀屷 kn-aut-sei=崅揷 kn-aut-mei=恀屷 aut-affil-num=6 ORCID= en-aut-name=MitsunobuFumihiro en-aut-sei=Mitsunobu en-aut-mei=Fumihiro kn-aut-name=岝墑暥桾 kn-aut-sei=岝墑 kn-aut-mei=暥桾 aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=2 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=3 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=4 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕儕僴價儕僥乕僔儑儞壢 affil-num=5 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 affil-num=6 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕撪壢 affil-num=7 en-affil= kn-affil=壀嶳戝妛堛妛晹丒帟妛晹晬懏昦堾嶰挬堛椕僙儞僞乕丂撪壢 en-keyword=COPD (Chronic obstructive pulmonary disease) kn-keyword=COPD (Chronic obstructive pulmonary disease) en-keyword=暋崌壏愹椕朄 (Complex spa therapy) kn-keyword=暋崌壏愹椕朄 (Complex spa therapy) en-keyword=壏擬椕朄 (Thermal therapy) kn-keyword=壏擬椕朄 (Thermal therapy) en-keyword=攛棟妛椕朄 (Lung physiotherapy) kn-keyword=攛棟妛椕朄 (Lung physiotherapy) en-keyword=廋惓Borg scale (6 minute- walk test, Pulmonary function test) kn-keyword=廋惓Borg scale (6 minute- walk test, Pulmonary function test) END