著者

Yohei Tsuchikawa Yoshiyuki Tokuda Hideki Ito Miho Shimizu Shinya Tanaka Kazuki Nishida Daichi Takagi Akimasa Fukuta Natsuki Takeda Hiromasa Yamamoto Masaya Hori Yoshihiro Nishida Masato Mutsuga

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0416, (Released:2022-11-10)

参考文献数

20

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Background: The effect of delayed ambulation on the outcome of coronary artery bypass grafting (CABG) remains to be clarified.Methods and Results: The long-term and in-hospital outcomes of 887 patients who underwent isolated CABG (455 off-pump cases, 135 urgent cases) were evaluated, with a focus on the timing of first ambulation. In-hospital mortality cases were excluded. Early ambulation (first ambulation within 3 days after operation) was achieved in 339 (38%) patients. In the multivariable logistic regression analysis, longer operation time and urgent case, EuroSCORE II, re-thoracotomy, and respiratory time were associated with delayed (≥4 days) ambulation. Delayed ambulation was associated with a high incidence of postoperative complications, such as pneumonia, and stroke (P<0.01). Following discharge, 22.2% of patients experienced major cardiac events and 13.8% died during the follow-up period (median follow-up 60 months). Cox hazards analysis revealed that delayed ambulation was associated with long-term adverse events (hazard ratio 1.04 per day, P<0.001). With adjustment for preoperative factors, the estimated future risk of adverse events was found to be increased day-by-day during the delay until initial ambulation.Conclusions: In isolated CABG patients, delayed ambulation was associated with poor outcomes, even in the long-term period. The results support the current guideline recommending early ambulation protocol after cardiac surgery.

著者

Kazuya Tanaka Tomoaki Atomi Yasuhiro Kawahara Miho Shimizu Yoriko Atomi

出版者

International Society of Exercise Sciences

雑誌

Journal of Internationl Exercise Sciences (ISSN:27580105)

巻号頁・発行日

vol.2, no.1, pp.19-25, 2023 (Released:2023-06-30)

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[Purpose] The trunk is extremely important for postural control because it has the largest body mass ratio. This study aimed to clarify the relationship between upper body center of mass (UCoM) control, including the trunk, and one-leg standing balance. [Methods] Ten healthy adult males were subjected to a left-right one-leg standing task. The center of mass total locus length (CoM-TLL), center of pressure total locus length (CoP-TLL), CoP-frequency (CoP-Freq), UCoM deviation (UCoM-Dev), trunk lateral flexion angle of the stance leg side, and hip abduction angle of the stance leg side were analyzed. Pearson's correlation analysis was performed on each parameter to examine the relationship. [Results] ​​Significant correlations were found between the CoM-TLL and UCoM-Dev (r = 0.53, p = 0.02), the CoM-TLL and lateral trunk flexion angle to the stance side (r = 0.47, p = 0.04), CoM-TLL and hip abduction angle (r = 0.45, p = 0.04), and CoP-Freq and trunk lateral flexion angle to the stance side (r = −0.64, p = 0.002) in the one-leg standing position.​ [Conclusion] In postural control, some postural parameters were associated with CoM and CoP sway. Postural parameters that contribute to CoM deviation were found to be related to the amount of body sway. Postural parameters that decrease CoM deviance were found to be related to decreases in the amount of body sway and body sway frequency. Therefore, these suggested that different upper body segmentation and mass control strategies were associated with CoM and CoP.

著者

Eri Ohto-Fujita Nozomi Hatakeyama Aya Atomi Shunsuke Yasuda Shoki Kodama Tomoaki Atomi Kazuya Tanaka Noboru Hirose Kenji Harada Yoshihide Asano Toshiyuki Watanabe Yukio Hasebe Miho Shimizu Yoriko Atomi

出版者

The Society of Fiber Science and Technology, Japan

雑誌

Journal of Fiber Science and Technology (ISSN:21897654)

巻号頁・発行日

vol.77, no.10, pp.258-265, 2021 (Released:2021-10-23)

参考文献数

49

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Chicken eggshell membrane (ESM) is a two-layered insoluble sheet located between the eggshell and the albumen and is composed of fibrous proteins. Naturally occurring composite material, such as ESM have various ameliorative effects for osteoarthritis of the knee, joint, and connective tissue when ingested and absorbed as supplements. The physiological effects by oral ESM intake, especially on respiratory function,remain unclear. We have recently reported that tritium-labeled ESM powder can be digested and absorbed by mice and distributed in tissues throughout the body. We have also reported that the application of hydrolyzed water-soluble ESM to human skin significantly improved skin elasticity, which declines with aging, in a before and after comparison at 3 months, and significantly reduced wrinkles at the corners of the eyes compared to controls. In the present double-blind, placebo-controlled study, we examined breathing, skin, and body functions, such as zigzag walking, after ESM ingestion compared to controls. We hypothesized this to improve physical functions by improving the extracellular matrix (ECM) within the range of homeostasis. Among 20 healthy subjects (age: 21–68 years), the group given ESM supplementation for 8 weeks showed significantly increased rate of change in arm skin elasticity, respiratory function (forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC)), and zigzag walking speed compared to controls. There was a significant correlation between the rate of change in FEV1/FVC and that of zigzag walking after 8 weeks compared to the initial values. These functional improvements observed in skin elasticity, lung function, and motor function with oral intake of ESM suggest that maintaining elasticity in the cellular environment can support overall health and activity levels.

著者

Yuki Kato Miho Shimizu Shinsuke Hori Kenta Ushida Yoshinori Yamamoto Ken Muramatsu Ryo Momosaki

出版者

THE JAPANESE ASSOCIATION OF RURAL MEDICINE

雑誌

Journal of Rural Medicine (ISSN:1880487X)

巻号頁・発行日

vol.17, no.2, pp.73-78, 2022 (Released:2022-04-06)

参考文献数

19

被引用文献数

2

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Objectives: This study aimed to determine the relationship between the number of board-certified physiatrists and the amount of inpatient rehabilitation delivered.Materials and Methods: We analyzed open data from 2017 in the National Database of Health Insurance Claims and Specific Health Checkups of Japan and compared the volume of inpatient rehabilitation services between prefectures to examine regional disparities. We also examined the relationship between the volume of rehabilitation services provided and the number of board-certified physiatrists.Results: The population-adjusted number of inpatient rehabilitation units per prefecture ranged from a maximum of 659,951 to a minimum of 172,097, a disparity of 3.8-fold. The population-adjusted number of board-certified physiatrists was 4.8 in the highest region and 0.8 in the lowest region, a disparity of 5.8-fold. The population-adjusted number of board-certified physiatrists was significantly correlated with the population-adjusted total number of inpatient rehabilitation units (r=0.600, P<0.001). Correlations were between the number of board-certified physiatrists and the number of rehabilitation units in cerebrovascular and orthopedic services, but not in cardiovascular, respiratory, or oncology services.Conclusion: Large regional disparities manifested in the amount of inpatient rehabilitation provided in Japan. An association was found between the number of board-certified physiatrists and rehabilitation units delivered. It may be necessary to train more BCPs in regions with fewer units to eliminate these disparities.

著者

Kengo Furuichi Miho Shimizu Akinori Hara Tadashi Toyama Takashi Wada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.57, no.23, pp.3345-3350, 2018-12-01 (Released:2018-12-01)

参考文献数

23

被引用文献数

3 20

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Diabetic kidney disease is the main cause of end-stage kidney disease. However, the clinical manifestations of diabetic kidney disease are diverse. Therefore, the clinical classification of diabetic kidney disease is clinically important and valuable. In Japan, two clinical staging systems divided by the estimated glomerular filtration rate (eGFR) and albuminuria can be used for diabetic kidney disease: the chronic kidney disease (CKD) risk classification and the Japanese classification of diabetic nephropathy. The Japanese classification of diabetic nephropathy and the CKD risk classification are similar; however, these two classification systems show different frequencies of outcomes. For example, the frequency of the kidney outcomes in stage 4 of the Japanese classification of diabetic nephropathy was found to be higher than that in the red stage of the CKD risk classification (composite kidney events: stage 4=32.0/100 person-years, red =14.5/100 person-years). However, there were no marked differences in the speed or rate of decline in the kidney function (speed: stage 4=6.8 mL/min/1.73 m2/year, red =5.8 mL/min/1.73 m2/year; rate: stage 4=38.8%/year, red =34.3%/year) or in the pathological changes between the two classifications. These data indicate that each stage of these clinical classification systems has characteristic clinical and pathological features. Therefore, it is important to understand each characteristic feature and use each classification system appropriately.