著者

Akio Kodama Akio Koyama Masayuki Sugimoto Kiyoaki Niimi Hiroshi Banno Kimihiro Komori

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0369, (Released:2017-08-23)

参考文献数

32

被引用文献数

36

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Background:Most patients with critical limb ischemia (CLI) exhibit severe comorbidities accompanied by frailty. This study assessed and risk-stratified mortality after infrainguinal bypass (IB) in CLI and investigated the effects of frailty.Methods and Results:The study retrospectively reviewed 107 consecutive CLI patients who had undergone de novo IB due to atherosclerotic disease. Data regarding patient age, comorbidities, laboratory data, and functional status were collected; functional status was evaluated using the Barthel index (BI) and nutritional status was evaluated using albumin concentrations and body mass index (BMI). Mean (±SD) BI and BMI were 75±16 and 22±4 kg/m2, respectively. BI (hazard ratio [HR] 0.96; 95% confidence interval [CI] 0.94–0.99, P=0.004), BMI (HR 0.85; 95% CI 0.75–0.95, P=0.003), atrial fibrillation (AF; HR 5.31; 95% CI 2.12–13.30, P<0.001), and ejection fraction (EF; HR 0.94; 95% CI 0.91–0.98, P=0.003) were independent predictors of mortality. Patients were divided into 2 groups based on BI (BI >75, n=71; and BI <70, n=36). Survival after IB was significantly lower for the lower BI group (P<0.001, log-rank test). After propensity score matching, post-IB survival remained significantly lower in the lower BI group (P=0.02).Conclusions:BI, BMI, AF, and EF were independently associated with all-cause mortality after IB for CLI. BI and BMI may be useful in identifying and optimizing treatment for high-risk frail patients.

著者

小山 昭雄 Akio Koyama

出版者

学習院大学経済学会

雑誌

學習院大學經濟論集 = The journal of Faculty of Economics, Gakushuin University (ISSN:00163953)

巻号頁・発行日

vol.16, no.3, pp.3-27, 1980-03

著者

Mari Sugiyama Takuya Katsube Akio Koyama Hiroyuki Itamura

出版者

一般社団法人 園芸学会

雑誌

The Horticulture Journal (ISSN:21890102)

巻号頁・発行日

pp.OKD-053, (Released:2017-01-19)

被引用文献数

9

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The aim of this study was to determine the best time to harvest mulberry (Morus alba L.) leaves for optimal yields of functional components. Mulberry leaves were analyzed to determine the seasonal changes in the concentrations of functional components, including flavonols, chlorogenic acid, and 1-deoxynojirimycine (DNJ). During the experimental period (May 26–October 16), the ranges of flavonols, chlorogenic acid, and DNJ contents were 1134–2230 mg/100 g dry weight (DW), 616–1014 mg/100 g DW, and 53–199 mg/100 g DW, respectively. There were high flavonols contents in mulberry leaves from late May to early July, from early to mid-August, and after late September. There were high chlorogenic acid contents from late May to early July, and after late September. From late September, the flavonols contents increased over time, and showed the highest level on October 16, the last day of the experimental period. The increased flavonols contents after late September were due to the synergistic effects of solar radiation and lower temperatures. The DNJ content showed a bell-shaped curve, peaking in mid-August, and the DNJ content was strongly correlated with total temperature. The flavonols and chlorogenic acid contents in mulberry leaves were higher after late September when the temperatures decreased and there was still high solar radiation, while the DNJ content peaked in August when temperatures were highest. The results indicated that August is the best time to harvest mulberry leaves to obtain optimal yields of beneficial functional components. If mulberry leaves are harvested twice per year, then the first harvest should be in July to August when temperatures and solar radiation hours are high, and the second harvest should be completed by the end of September.