Ohno Memorial Hospital
Ohno Memorial Hospital
Sakamoto R.,Ohno Memorial Hospital |
Sakamoto R.,Kobe University |
Miura Y.,Kobe University
Journal of Physical Therapy Science | Year: 2016
[Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. © 2016 The Society of Physical Therapy Science.
Koyama H.,Osaka City University |
Fukuda S.,Osaka City University |
Shoji T.,Osaka City University |
Inaba M.,Osaka City University |
And 12 more authors.
Clinical Journal of the American Society of Nephrology | Year: 2010
Background and objectives: Despite potential significance of fatigue and its underlying components in the occurrence of cardiovascular diseases, epidemiologic data showing the link are virtually limited. This study was designed to examine whether fatigue symptoms or fatigue's underlying components are a predictor for cardiovascular diseases in high-risk subjects with ESRD. Design, setting, participants, & measurements: 788 volunteer patients under hemodialysis therapy (506 male, 282 female) completed the survey between October and November 2005, with the follow-up period up to 26 months to monitor occurrence of fatal or nonfatal cardiovascular events. The questionnaire consisted of 64 questions, and promax rotation analysis of the principal component method conceptualized eight fatigue-related factors: fatigue itself, anxiety and depression, loss of attention and memory, pain, overwork, autonomic imbalance, sleep problems, and infection. Results: 14.7% of the patients showed fatigue scores higher than twice the SD of the mean for healthy volunteers. These highly fatigued patients exhibited a significantly higher risk for cardiovascular events (hazard ratio: 2.17; P < 0.01), with the relationship independent of the well-known risk factors, including age, diabetes, cardiovascular disease history, and inflammation and malnutrition markers. Moreover, comparisons of the risk in key subgroups showed that the risk of high fatigue score for cardiovascular events was more prominent in well-nourished patients, including lower age, absence of past cardiovascular diseases, higher serum albumin, and high non-HDL cholesterol. Conclusions: Fatigue can be an important predictor for cardiovascular events in patients with ESRD, with the relationship independent of the nutritional or inflammatory status. Copyright © 2010 by the American Society of Nephrology.
Naganuma T.,Osaka City University |
Takemoto Y.,Osaka City University |
Shoji T.,Osaka City University |
Shima H.,Osaka City University |
And 3 more authors.
Nephrology | Year: 2012
Aim: Cerebral white matter hyperintensities (WMHs), comprising periventricular hyperintensity (PVH) and deep and subcortical white matter hyperintensity (DSWMH) on magnetic resonance imaging (MRI), have been reported to be markers of ischaemic cerebral small-vessel disease and risk factors for future stroke, cognitive impairment and dementia in the general population. However, there have been only a few reports describing WMHs in haemodialysis (HD) patients and these previous studies have been relatively small population studies with little investigation on prevalence and risk factors according to the regional subtypes of WMHs. Methods: Cranial MRI was performed on 179 HD patients and 58 healthy control subjects and we investigated the prevalence of WMHs (PVH and/or DSWMH) and the clinical factors associated with the presence of WMHs. Results: The prevalence of WMHs was significantly higher in the HD patients than in the healthy subjects. In the HD patients, multiple logistic regression analysis showed that independent and significant factors associated with the presence of PVH were age, female gender and systolic blood pressure and those associated with the presence of DSWMH were age, female gender, systolic blood pressure and body mass index. Conclusions: These findings indicated a high prevalence of WMHs in HD patients. Older age, female gender and high blood pressure were strong factors associated with the presence of both PVH and DSWMH. Moreover, excess body weight was a significant factor associated with the presence of DSWMH only, indicating that there may be differences in risk factors according to the subtype of WMHs. This study demonstrates factors associated with cerebral white matter hyperintensities (WMH) on MRI in a relatively large cohort of HD patients. Among the risk factors that the authors described, female gender is a new finding as a risk factor of WMH. © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.
Nagami Y.,Osaka City University |
Tominaga K.,Osaka City University |
Machida H.,Machida Gastrointestinal Hospital |
Nakatani M.,Minamiosaka Hospital |
And 14 more authors.
American Journal of Gastroenterology | Year: 2014
OBJECTIVES:The usefulness of non-magnifying endoscopy with narrow-band imaging (NBI; NM-NBI) in the screening of early esophageal squamous cell carcinoma (SCC) and high-grade intraepithelial neoplasia (HGIN) remains unclear. Here, we aimed to compare NM-NBI and chromoendoscopy with iodine staining (CE-Iodine) in terms of the diagnostic performance, and to evaluate the usefulness of NM-NBI in detecting early esophageal SCC.METHODS:We prospectively enrolled 202 consecutive patients (male/female=180/22; median age, 67 years) with high-risk factors for esophageal SCC. All patients received endoscopic examination with NM-NBI and CE-Iodine to screen for early esophageal SCC or HGIN. We conducted the examinations sequentially, and calculated the accuracy, sensitivity, and specificity through a per-lesion-based analysis. A propensity score matching analysis was performed to reduce the effects of selection bias, and we compared the respective outcomes according to NM-NBI and CE-Iodine after matching.RESULTS:The accuracy, sensitivity, and specificity of NM-NBI were 77.0, 88.3, and 75.2%, respectively, and those for unstained areas by CE-Iodine were 68.0, 94.2, and 64.0, respectively. The accuracy and specificity of NM-NBI were superior to those of CE-Iodine (P=0.03 and P=0.01, respectively). However, the sensitivity did not significantly differ between NM-NBI and CE-Iodine (P=0.67). The accuracy and specificity of NM-NBI before matching were superior to those of CE-Iodine after matching (P=0.04 and P=0.03).CONCLUSIONS:NM-NBI was useful and reliable for the diagnosis of esophageal SCC and can be a promising screening strategy for early esophageal SCC. © 2014 by the American College of Gastroenterology.
PubMed | Ohno Memorial Hospital, Minamiosaka Hospital, Osaka City University and Machida Gastrointestinal Hospital
Type: Comparative Study | Journal: The American journal of gastroenterology | Year: 2014
The usefulness of non-magnifying endoscopy with narrow-band imaging (NBI; NM-NBI) in the screening of early esophageal squamous cell carcinoma (SCC) and high-grade intraepithelial neoplasia (HGIN) remains unclear. Here, we aimed to compare NM-NBI and chromoendoscopy with iodine staining (CE-Iodine) in terms of the diagnostic performance, and to evaluate the usefulness of NM-NBI in detecting early esophageal SCC.We prospectively enrolled 202 consecutive patients (male/female=180/22; median age, 67 years) with high-risk factors for esophageal SCC. All patients received endoscopic examination with NM-NBI and CE-Iodine to screen for early esophageal SCC or HGIN. We conducted the examinations sequentially, and calculated the accuracy, sensitivity, and specificity through a per-lesion-based analysis. A propensity score matching analysis was performed to reduce the effects of selection bias, and we compared the respective outcomes according to NM-NBI and CE-Iodine after matching.The accuracy, sensitivity, and specificity of NM-NBI were 77.0, 88.3, and 75.2%, respectively, and those for unstained areas by CE-Iodine were 68.0, 94.2, and 64.0, respectively. The accuracy and specificity of NM-NBI were superior to those of CE-Iodine (P=0.03 and P=0.01, respectively). However, the sensitivity did not significantly differ between NM-NBI and CE-Iodine (P=0.67). The accuracy and specificity of NM-NBI before matching were superior to those of CE-Iodine after matching (P=0.04 and P=0.03).NM-NBI was useful and reliable for the diagnosis of esophageal SCC and can be a promising screening strategy for early esophageal SCC.
PubMed | Ohno Memorial Hospital, Osaka City University and Machida Gastrointestinal Hospital
Type: | Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver | Year: 2017
Endoscopic submucosal dissection (ESD) is a widely accepted procedure for superficial esophageal squamous cell neoplasia (ESCN) because of a high complete resection rate. However, there were a few reports about the long-term outcomes of these patients due to short follow-up periods.We aimed to evaluate the 5-year survival after ESD for superficial ESCN.This was a retrospective cohort study performed at a single institution. Between 2006 and 2009, 94 patients with superficial ESCN underwent ESD. Eighty-three patients (93.3%) who had completed an extended period of observation of at least 5 years were enrolled. The main outcomes were the 5-year survival rates. The secondary outcomes were the cumulative incidence rate of metachronous ESCN, and the clinical outcomes.The 5-year relative overall survival rate was 99.0%, whereas the cause specific survival rate was 100% during 72.9 months of median follow up period. Subgroup analysis showed that the 5year survival of patients with EP/LPM and MM/SM1 (submucosal invasion 200m) were 100% and 89.0%, respectively. The cumulative incidence rate of metachronous ESCN at 5 years was 16.8%.ESD for superficial ESCN is a curative treatment with a favorable 5-year survival rate.
PubMed | Okada Clinic, Shirasagi Hospital, Kumamoto University, Hyogo College of Medicine and 6 more.
Type: Journal Article | Journal: PloS one | Year: 2015
Fatigue is a predictor of cardiovascular events in patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment. We hypothesized that multinutritional support would improve quality of life, fatigue symptoms, and potential quantitative measures including endocrine, immune and autonomic functions in patients with ESRD undergoing hemodialysis.Two hundred and two hemodialysis patients were randomly assigned to receive active treatment (containing vitamin B1, vitamin B2, niacin, vitamin B6, vitamin B12, folic acid, vitamin C, carnitine, coenzyme Q10, nave galacto-oligosaccharide, and zinc) or placebo after each dialysis session for 12 weeks. The patients and attending physicians were blinded to the treatment, and 172 patients (86 in each group) completed the study. Fatigue was evaluated via fatigue questionnaire at 0, 4, and 12 weeks. To assess human herpes virus (HHV) 6 and 7 reactivation, numbers of viral DNA copies were determined in saliva by polymerase chain reaction at weeks 0 and 12. Autonomic function was determined via measurement of beat-to-beat variation by using acceleration plethysmography.Clinical characteristics, changes in fatigue, quality of life score, endocrine functions, and laboratory data did not differ significantly between the two groups. Several parameters of heart rate variability significantly increased after nutritional treatment compared to placebo. Nutritional drink for 12 weeks significantly suppressed HHV7 DNA copy numbers. Similarly, HHV6 DNA copy numbers tended to be decreased by treatment but without reaching statistical significance.Nutritional supplementation may modulate immune and autonomic dysfunction in ESRD patients undergoing hemodialysis.
Mizuyama Y.,Ohno Memorial Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2013
A 47-year-old woman had undergone breast-conserving treatment for right breast cancer (T3, N1, M0, Stage IIIA, human epidermal growth factor receptor[ HER]-2 enriched subtype) after primary systemic chemotherapy with trastuzumab. Pathological examination revealed a quasi-pathological complete response( CR) in the breast tumor and no axillary nodal involvement. The patient then received conventional breast irradiation and adjuvant trastuzumab therapy. However, adjuvant anti- HER2 therapy was discontinued in the 19th week because of a decreased left ventricular ejection fraction( approximately 50%). A left adrenal tumor was detected by abdominal computed tomography (CT) 2 years after surgery. Positron emission tomography( PET) scans showed strong accumulation in the left adrenal gland and in the lymph node near the adrenal tumor. No other obvious lesion was detected on meticulous examination. Laparoscopic adrenalectomy was performed for diagnosis and treatment. Pathological examination of the resected specimen revealed that the tumor was a metastatic adenocarcinoma with overexpression of the HER2 protein but without expression of hormonal receptors. The patient received 12 cycles of chemotherapy with paclitaxel and trastuzumab, which was followed by trastuzumab monotherapy. However, trastuzumab monotherapy could not be continued because the left ventricular ejection fraction decreased to 50% at 24 weeks after initiation of chemotherapy. The patient has been observed since the cessation of trastuzumab, without the administration of anticancer therapy, and she continues to have a good performance status without relapse. Herein, we report a case of solitary adrenal metastasis from breast cancer, an extremely rare condition, and review the relevant literature.