著者

Satoru Ebihara Toru Naito

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.256, no.1, pp.1-17, 2022 (Released:2022-01-28)

参考文献数

194

被引用文献数

3

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Recent advances in dysphagia treatment have given us many methods of stimulating swallowing function, but no attempt has been made to systematically classify them all. In this review, we provide an exhaustive description of all the techniques and stimulatory substances that stimulate swallowing that have so far been reported in the scientific literature, irrespective of their level of evidence, and we have tried to classify them with the objective of encouraging the future development of research in this direction. The Preferred Reporting Items for Systematic Reviews and Meta-analysis were followed for retrieval of relevant research. A total of 237 records were screened for this literature review. One record was excluded for being published in a language other than English, and 59 articles were excluded for having no original data. Of the 177 records that were assessed for eligibility in this review, 31 were excluded for reasons related to other inclusion and exclusion criteria. Finally, 146 records were classified. We found stimuli related to swallowing published in the literature could be divided into physical and chemical stimuli. Each stimulus had both peripheral and central stimuli when we assessed the main site of action. Physical stimuli included electric, magnetic and thermal stimulations and acupuncture. Chemical stimuli included spices activating transient receptor potential channels, several categories of medications, taste and flavor, and olfactory stimulants. Medications modifying substance P and the dopaminergic system are thought to be peripheral and central stimuli, respectively. This classification may pave the way to discover means to improve swallowing.

著者

Satoru Ebihara Midori Miyagi Yuta Otsubo Hideki Sekiya Takae Ebihara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.6576-20, (Released:2020-12-07)

参考文献数

12

被引用文献数

1

著者

Harumi Morioka Kiyoko Murata Tatsuki Sugisawa Mari Shibukawa Junya Ebina Masahiro Sawada Sayori Hanashiro Junpei Nagasawa Masaru Yanagihashi Takehisa Hirayama Masayuki Uchi Kiyokazu Kawabe Satoru Ebihara Yoshitaka Murakami Takashi Nakajima Osamu Kano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.61, no.10, pp.1479-1484, 2022-05-15 (Released:2022-05-15)

参考文献数

28

被引用文献数

4

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Objective To assess the long-term effects of hybrid assistive limb (HAL) treatment on gait in patients with amyotrophic lateral sclerosis (ALS). Methods Three courses of treatment with HAL were administered to three women with ALS. Each course had a four- to five-week duration, during which the treatment was performed nine times, with a rest period of at least two months between each course. Gait ability (2-minutes-walk and 10-m-walk tests), ALS Functional Rating Scale-Revised, and respiratory function tests were performed before and after each treatment course. Patients Patients diagnosed with ALS, according to the updated Awaji criteria, by board-certified neurologists in the Department of Neurology and Department of Rehabilitation Medicine, Toho University Omori Faculty of Medicine between January and December 2019 were recruited. Results The average time from the start to the end of the 3 courses was 319.7±33.7 days. A multiple regression analysis was performed for the 2-minutes-walk and 10-m-walk tests, using the baseline value, each participant's ID, and time point as covariates. Changes after each course were considered outcomes. Following the 3 treatment courses, the 2-minutes walk distance improved by 16.61 m (95% confidence interval, -9.33-42.54) compared with the baseline value, but this improvement was not statistically significant (p=0.21). However, cadence significantly improved by 1.30 steps (95% confidence interval, 0.17-2.42; p=0.02). Conclusion Long-term, repetitive HAL treatments may help patients with ALS maintain their gait.

著者

Takashi Ohrui Hidenori Takahashi Satoru Ebihara Toshifumi Matsui Katsutoshi Nakayama Hidetada Sasaki

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.192, no.1, pp.81-86, 2000 (Released:2005-04-21)

参考文献数

11

被引用文献数

16 16

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This report presents the cases of two patients with rapidly progressive hypoxemia associated with influenza A(H3N2) virus infection, who were diagnosed with influenza related acute pulmonary microthromboembolism by serum D-dimer, lung perfusion and ventilation scans and computed-tomography scan of the chest, and were successfully treated by anti-coagulant therapy. The present cases suggest that acute onset pulmonary microthromboembolism should be considered in some patients with sudden, unexplained dyspnea during an outbreak of influenza infection and prompt diagnosis is essential to save the patient from acute death associated with influenza.

著者

Masaru Yanagihashi Tatsuki Sugisawa Masaaki Fuchimoto Yuuichi Saotome Keiko Onozawa Yukinori Matsumoto Kota Bokuda Junya Ebina Mari Shibukawa Takehisa Hirayama Yoshitaka Murakami Naohiro Washizawa Satoru Ebihara Osamu Kano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.60, no.10, pp.1519-1524, 2021-05-15 (Released:2021-05-15)

参考文献数

14

被引用文献数

4

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Objective The coronavirus disease 2019 (COVID-19) pandemic has resulted in a shortage of medical resources, including ventilators, personal protective equipment, medical staff, and hospital beds. We investigated the impact of COVID-19 in amyotrophic lateral sclerosis (ALS) patients, their families, caregivers, and medical experts. Methods We conducted a nationwide ALS webinar about COVID-19 in May 2020 and sent a questionnaire to those enrolled. Results A total of 135 participants (31 ALS patients; 23 families and caregivers of ALS patients; 81 medical experts) responded to this cross-sectional self-report questionnaire. The results showed that tracheostomy and invasive ventilation (TIV) was used in 22.6% of ALS patients, whereas 77.4% of ALS patients were not under TIV. Among non-TIV patients (n=24), 79.2% did not want TIV in the future. However, 47.4% of non-TIV patients not wanting a tracheostomy in advanced stages replied that they would want an emergency tracheostomy if they developed COVID-19-related pneumonia. These results suggest that ALS patients may be receptive to emergency treatments for reasons other than ALS. In addition, approximately half of the ALS patients agreed with the policy of not ventilating the elderly or ALS patients in case of a ventilator shortage. Furthermore, compared with medical experts, few ALS patients reported that the chance for ALS patients to obtain work was higher due to the increasing availability of remote work. Conclusions This survey indicates that the COVID-19 pandemic might be associated with increased distress about access to care and work, inducing contradictory responses and potential hopelessness among ALS patients.

著者

Satoru Ebihara Masahiro Kohzuki Yasunori Sumi Takae Ebihara

出版者

The Japanese Pharmacological Society

雑誌

Journal of Pharmacological Sciences (ISSN:13478613)

巻号頁・発行日

vol.115, no.2, pp.99-104, 2011 (Released:2011-02-18)

参考文献数

37

被引用文献数

33 44

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Morbidity and mortality from aspiration pneumonia continues to be a major health problem in the elderly. A swallowing disorder, such as a delayed triggering of the swallowing reflex, exists in patients with aspiration pneumonia. We found that the swallowing reflex in elderly people was temperature-sensitive. The swallowing reflex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature difference increases. The improvement of swallowing reflex by temperature stimuli could be mediated by the temperature-sensitive transient receptor potential (TRP) channel. The administration of a pastille with capsaicin as an agonist stimulus of TRPV1, a warm-temperature receptor, decreased the delay in swallowing reflex. Food with menthol, an agonist of TRPM8, a cold-temperature receptor, also decreased the delay in swallowing reflex. Olfactory stimulation such as black pepper was useful to improve the swallowing reflex for people with low activity of daily living (ADL) levels or with decreased consciousness. Oral care also shortened the latent time of swallowing reflex presumably due to stimulating the nociception of the oral cavity. A combination of these sensory stimuli may improve the swallowing disorders and prevent aspiration pneumonia.

著者

Mitsutoshi Munakata Kaori Kobayashi Junko Niisato-Nezu Souichiro Tanaka Yosuke Kakisaka Takae Ebihara Satoru Ebihara Kazuhiro Haginoya Shigeru Tsuchiya Akira Onuma

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.214, no.4, pp.327-332, 2008 (Released:2008-04-26)

参考文献数

15

被引用文献数

18 24

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Patients with severe neurological disorders often require enteral nutrition (EN). Since long-term EN can cause multiple complications, reinstating the oral intake of food is beneficial. Olfactory stimulation using black pepper oil (BPO), a strong appetite stimulant, was reported to facilitate swallowing in older people. Therefore, the effects of olfactory stimulation with BPO were investigated in pediatric patients receiving long-term EN due to neurological disorders. The effects of scenting with BPO for 1 min immediately before every meal were evaluated in ten patients: 4 boys and 6 girls, aged 19-97 months (51 ± 26 months). The neurological disorders included periventricular leukomalacia (3 patients), hypoxic ischemic encephalopathy (3), Costello syndrome (1), Russell-Silver syndrome (1), Miller-Dieker syndrome (1), and cerebral palsy of unknown etiology (1). In eight of these patients, BPO intervention was continued for 3 months. Five of these eight patients showed increases in the amount of oral intake with desirable effects including facilitated swallowing movement, although complete elimination of the need for EN was not achieved. In the other three patients, BPO intervention was not effective; severe cerebral tissue loss, profound malformation or intractable seizures seemed to reduce the efficacy of BPO. In two cases, BPO intervention was discontinued due to cough or because the odor of BPO was unbearable to the family. In conclusion, olfactory stimulation with BPO facilitated oral intake in a subset of patients on long-term EN. BPO stimulation may be useful for facilitating oral intake when used in combination with conventional methods.

著者

Hiroyuki Arai Mutsuo Yamaya Takashi Ohrui Satoru Ebihara Takae Ebihara Kazushi Nakajo Hidetada Sasaki

出版者

The Japan Society of Logopedics and Phoniatrics

雑誌

The Japan Journal of Logopedics and Phoniatrics (ISSN:00302813)

巻号頁・発行日

vol.43, no.4, pp.467-472, 2002-10-20 (Released:2010-06-22)

参考文献数

19

被引用文献数

1 2

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誤嚥性肺炎を発症する高齢者では, 高率に脳血管障害, 特に大脳基底核領域に脳梗塞が見出される.この場合の脳梗塞は, 新しいものであっても陳旧性のものであっても, また症候性であっても無症候性であっても構わない.このような患者では, 嚥下反射と咳反射の両者の低下により, 誤嚥特に夜間の不顕性誤嚥により肺炎の成立にいたると考えられる.嚥下反射と咳反射は, 少なくとも2つの神経伝達物質, すなわちドーパミンとサブスタンス-Pによって支えられている.進行したアルツハイマー病患者も大脳基底核障害などにより誤嚥性肺炎を発症する.進行したアルツハイマー病患者において, major tranquilizerの使用と無症候性脳梗塞の合併は誤嚥性肺炎を誘発する危険因子であるため問題行動に対するmajor tranquilizerの使用には細心の注意が要求される.塩酸アマンタジン, ACE阻害薬, 抗血小板剤の使用また歯ブラシなどによる簡便な口腔ケアは肺炎の予防に役立つばかりでなく高齢者医療費削減にも貢献すると思われる.