著者

Hideki Origuchi Haruki Itoh Shin-ichi Momomura Ryuji Nohara Hiroyuki Daida Takashi Masuda Masahiro Kohzuki Shigeru Makita Kenji Ueshima Masatoshi Nagayama Kazuto Omiya Hitoshi Adachi Yoichi Goto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0650, (Released:2020-02-08)

参考文献数

21

被引用文献数

17

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Background:There is little evidence regarding the effect of outpatient cardiac rehabilitation (CR) on exercise capacity or the long-term prognosis in patients after coronary artery bypass graft surgery (CABG). This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort.Methods and Results:We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2–3 weeks) and late (3–6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart failure. Peak oxygen uptake at 3–5 months from baseline was significantly more increased in Active than in Non-Active patients (+26±24% vs. +19±20%, respectively; P<0.05), and the MACE rate was significantly lower in Active than Non-Active patients (3.4% vs. 10.5%, respectively; P=0.02). Multivariate Cox proportional hazard analysis showed that participation in outpatient CR was a significant prognostic determinant of MACE (P=0.03).Conclusions:This unique study showed that a multicenter cohort of patients who underwent CABG and actively participated in outpatient CR exhibited greater improvement in exercise capacity and better survival without cardiovascular events than their counterparts who did not participate.

著者

Shinya Tanaka Kentaro Kamiya Nobuaki Hamazaki Ryota Matsuzawa Kohei Nozaki Takeshi Nakamura Masashi Yamashita Emi Maekawa Chiharu Noda Minako Yamaoka-Tojo Atsuhiko Matsunaga Takashi Masuda Junya Ako

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.9, pp.1860-1867, 2019-08-23 (Released:2019-08-23)

参考文献数

33

被引用文献数

20 24

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Background:Evidence for the prognostic value of gait speed is largely based on a single measure at baseline, so we investigated the prognostic significance of change in gait speed in hospitalized older acute heart failure (AHF) patients.Methods and Results:This retrospective study was performed in a cohort of 388 AHF patients ≥60 years old (mean age: 74.8±7.8 years, 228 men). Routine geriatric assessment included gait speed measurement at baseline and at discharge. The primary outcome of this study was all-cause death. Gait speed increased from 0.74±0.25 m/s to 0.98±0.27 m/s after 13.5±11.0 days. Older age, shorter height and lower hemoglobin level at admission, prior HF admission, and higher baseline gait speed were independently associated with lesser improvement in gait speed. A total of 80 patients died and 137 patients were readmitted for HF over a mean follow-up period of 2.1±1.9 years. In multivariate analyses, change in gait speed showed inverse associations with all-cause death (hazard ratio [HR] per 0.1 m/s increase: 0.83; 95% confidence interval [CI]: 0.73 to 0.95; P=0.006) and with risk of readmission for HF (HR: 0.91; 95% CI: 0.83 to 0.99; P=0.036).Conclusions:Short-term improvement in gait speed during hospitalization was associated with reduced risks of death and readmission for HF in older patients with AHF.

著者

品川 高廣 河野 健二 益田 隆司 Takahiro Shinagawa Kenji Kono Takashi Masuda 東京農工大学工学部情報コミュニケーション工学科 電気通信大学情報工学科:科学技術振興事業団さきがけ21 電気通信大学情報工学科 Department of Computer Information and Communication Sciences Faculty of Engineering Tokyo University of Agriculture & Technology Department of Computer Science University of Electro-Communications:PRESTO Japan Science and Technology Corporation Department of Computer Science University of Electro-Communications

出版者

日本ソフトウェア科学会

雑誌

コンピュータソフトウェア (ISSN:02896540)

巻号頁・発行日

vol.21, no.2, pp.107-113, 2004-03-25

参考文献数

11

被引用文献数

1

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本論文では,UNIXシステムにおけるsetuidプログラムのバグを利用したroot権限の不正取得に対処するために,setuidプログラム中のroot権限で動作するコードを最小化する手法について述べる.この手法では,我々が提案している細粒度保護ドメインを利用することでsetuidプログラム中の最小限必要なコードのみをroot権限で動作させ,root権限が不要なコードに含まれるバグによるroot権限の不正取得を防止することができる.

著者

Kazue ITOH Katsumi IMAI Takashi MASUDA Shimako ABE Misuzu TANAKA Ririko KOGA Hitomi ITOH Toshitaka MATSUYAMA Motoomi NAKAMURA

出版者

The Japanese Society of Hypertension

雑誌

Hypertension Research (ISSN:09169636)

巻号頁・発行日

vol.25, no.6, pp.881-886, 2002 (Released:2003-06-30)

参考文献数

30

被引用文献数

31 44

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Insulin resistance is thought to raise blood pressure. Recently, a significant positive relationship between mean blood pressure and plasma leptin levels, but there have been no reports dealing with the relationship between blood pressure and either insulin resistance or serum leptin levels after weight loss. In the present work, we attempted to clarify the relationship between changes in blood pressure and either the serum leptin level or the insulin level in 102 moderately obese females (mean body mass index (BMI), 29.5±0.5 kg/m2; age, 47.0±0.9) during a 3 month period. No differences in age, fat-mass, homeostasis model assessment (HOMA), the summation of insulin (ΣIRI), plasma renin activity (PRA) or 24 h norepinephrine excretion (24hU-NE) were observed between the hypertensive (HT) group (n =31) and normotensive (NT) group (n =71) before weight loss, but the basal serum leptin was significantly higher in the HT (16.8±1.1 ng/ml) than in the NT group (15.2±0.8 ng/ml), after adjusting for abdominal total fat. After a 3 month weight reduction program, the total abdominal fat, serum leptin and ΣIRI significantly decreased in both groups. The systolic blood pressure (SBP)/diastolic blood pressure (DBP) significantly decreased from 144/84 to 130/77 mmHg only in the HT but not in the NT group. The PRA decreased in both groups, while the 24hU-NE significantly decreased only in the HT group. The changes in the leptin level were significantly correlated with the changes in both ΣIRI and HOMA after weight loss in the two groups, respectively. Finally, a statistically significant positive correlation was observed between the changes in the leptin and the changes in the mean blood pressure (MBP) (r =0.412, p <0.05) only in the HT group. Multiple regression analysis revealed that the changes in MBP were independently associated with the changes in 24hU-NE and the changes in either ΣIRI or HOMA in all subjects. However, a statistically significant positive correlation was observed between the changes in MBP and the changes in leptin levels even after adjusting for the total abdominal fat, 24hU-NE and either ΣIRI or HOMA (both expressed as a percentage of the baseline value) in a multiple regression analysis only in the HT group. These results suggest that leptin may play a role in the pathophysiology of obese hypertension. (Hypertens Res 2002; 25: 881-886)

著者

Hideki Origuchi Haruki Itoh Shin-ichi Momomura Ryuji Nohara Hiroyuki Daida Takashi Masuda Masahiro Kohzuki Shigeru Makita Kenji Ueshima Masatoshi Nagayama Kazuto Omiya Hitoshi Adachi Yoichi Goto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.3, pp.427-435, 2020-02-25 (Released:2020-02-25)

参考文献数

21

被引用文献数

17

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Background:There is little evidence regarding the effect of outpatient cardiac rehabilitation (CR) on exercise capacity or the long-term prognosis in patients after coronary artery bypass graft surgery (CABG). This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort.Methods and Results:We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2–3 weeks) and late (3–6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart failure. Peak oxygen uptake at 3–5 months from baseline was significantly more increased in Active than in Non-Active patients (+26±24% vs. +19±20%, respectively; P<0.05), and the MACE rate was significantly lower in Active than Non-Active patients (3.4% vs. 10.5%, respectively; P=0.02). Multivariate Cox proportional hazard analysis showed that participation in outpatient CR was a significant prognostic determinant of MACE (P=0.03).Conclusions:This unique study showed that a multicenter cohort of patients who underwent CABG and actively participated in outpatient CR exhibited greater improvement in exercise capacity and better survival without cardiovascular events than their counterparts who did not participate.

著者

Shuhei Yamamoto Atsuhiko Matsunaga Guoqin Wang Keika Hoshi Kentaro Kamiya Chiharu Noda Masahiko Kimura Minako Yamaoka-Tojo Takashi Masuda

出版者

一般社団法人 インターナショナル・ハート・ジャーナル刊行会

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.14-017, (Released:2014-08-04)

被引用文献数

3 11

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The purpose of this study was to clarify the effect of standing balance training on walking speed (short-term outcome) and cardiac events (long-term outcome) in elderly ischemic heart disease (IHD) patients. This was a retrospective cohort study. Ninety-two elderly (≥ 65 years) IHD patients who underwent an inpatient cardiac rehabilitation program were assigned to two groups: a balance group that received standing balance training in addition to conventional (aerobic and resistance) training and a conventional group. Standing balance was assessed by one-leg standing time and a postural stability index reflecting dynamic balance, and normal walking speed was measured at baseline and hospital discharge. Patients were followed for up to 3 years or until a cardiac event occurred. There were no significant differences in clinical characteristics between the groups. Both groups showed a significant change in normal walking speed from baseline to hospital discharge (P < 0.001, respectively), and normal walking speed was significantly higher in the balance group compared to the conventional group (P = 0.001). The postural stability index improved significantly only in the balance group (P = 0.005). Multivariable analyses using Cox proportional hazards model confirmed that standing balance training (hazard ratio [HR]: 0.408; 95% confidence interval [CI]: 0.162-1.029; P = 0.058) and fast walking speed (HR: 0.362; 95% CI: 0.137-0.957; P = 0.041) were associated with cardiac events. These findings show that standing balance training improves walking speed and reduces cardiac events, and suggests that such training can be an effective intervention for elderly IHD patients.

著者

Kazuki Hotta Kentaro Kamiya Ryosuke Shimizu Misako Yokoyama Misao Nakamura-Ogura Minoru Tabata Daisuke Kamekawa Ayako Akiyama Michitaka Kato Chiharu Noda Atsuhiko Matsunaga Takashi Masuda

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.54, no.2, pp.59-63, 2013 (Released:2013-04-03)

参考文献数

31

被引用文献数

13 33

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The purpose of this study was to clarify the acute effects of a single session of stretching exercises on vascular endothelial function and peripheral circulation in patients with acute myocardial infarction. This study evaluated 32 patients (mean age, 66 ± 9 years) who received phase I cardiac rehabilitation after acute myocardial infarction. Five types of stretching exercises were performed on the floor: wrist dorsiflexion, close-legged trunk flexion, open-legged trunk flexion, open-legged lateral trunk bending, and cross-legged trunk flexion. Each exercise entailed a 30-second stretching followed by a 30-second relaxation, and was repeated twice. Low- and high-frequency components (LF and HF) of heart rate variability (LF, 0.04-0.15 Hz; HF, 0.15-0.40 Hz) were analyzed, and HF and LF/HF were used as indices of parasympathetic and sympathetic nervous activities, respectively. Reactive hyperemia peripheral arterial tonometry (RH-PAT) index was measured and used as a parameter for vascular endothelial function. Transcutaneous oxygen pressure (tcPO2) on the right foot and chest was also measured, and the Foot-tcPO2/Chest-tcPO2 ratio was used as a parameter for peripheral circulation. The HF, RH-PAT index, and Foot-tcPO2/Chest-tcPO2 ratio were significantly higher after the exercises than before (P < 0.05, P < 0.01, and P < 0.05, respectively). There was no significant difference in the LF/HF ratio measured before and after stretching exercises. These findings demonstrate that stretching exercises improve vascular endothelial function and peripheral circulation in patients with acute myocardial infarction.