Search

Atsushi Kimura,1 Kohei Yamaguchi,2 Haruka Tohara,2 Yusuke Sato,3 Naoko Sawada,3 Yasuhide Nakagawa,3 Yukako Matsuda,4,5 Motoharu Inoue,5 Yuji Wada,6 Kazuhiro Tamaki3,4 1College of Risk Management, Nihon University, Tokyo, Japan; 2Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan; 3Geriatric Health Services Facility Nanohana, Medical Corporation Kanjinkai, Tokyo, Japan; 4Nanohana Dentistry Clinic, Medical Corporation Kanjinkai, Tokyo, Japan; 5Department of Dysphagia Rehabilitation, Nihon University of Dentistry, Tokyo, Japan; 6College of Gastronomy Management, Ritsumeikan University, Shiga, JapanCorrespondence: Atsushi Kimura, College of Risk Management, Nihon University, Setagaya-ku, Tokyo, 1548513, Japan, Tel +81 3 6453 1600, Fax +81 3 6453 1630, Email kimura.atsushi@nihon-u.ac.jp Kazuhiro Tamaki, Geriatric Health Services Facility Nanohana, Medical Corporation Kanjinkai, Nishitama-Gun, Tokyo, 1901212, Japan, Tel +81 42 568 5111, Fax +81 42 568 5127, Email tamakikazuhiro@g.kanjinkai.netPurpose: Past research has shown that exposure to the image of a slim person reduces food consumption among young adults. However, it remains unknown whether this paradigm could be adapted and applied to increase food intake among older adults with dementia by exposing them to the image of a higher-weight person to mitigate weight loss and malnutrition. The present study explored whether weight-related visual cues affect the amount of food consumed by older adults with dementia.Participants and Methods: In the experiment, twenty-one elderly people with dementia living in a nursing home were visually exposed to one of four conditions (a cartoon image of a normal-weight chef, a higher-weight chef, a flower or no image) during real-life daily lunch situations over the course of four weeks, during which each condition was presented for one week.Results: Results demonstrate that participants finished their meals more frequently when they were exposed to the image of the higher-weight chef than when they were not exposed to any images.Conclusion: These results suggest that exposure to a cartoon chef character representing a stereotyped social group related to body weight activates the stereotype and increases stereotype-consistent behavior in older adults with dementia. The present findings will contribute to understanding the effect of visual information on eating behavior and to designing eating environments which facilitate sufficient nutrition intake among older adults with dementia.Keywords: nudge, body weight, dementia, food consumption, dining environment

Miharu Inoue,1 Jiro Takeuchi,2 Mio Sakuma,2 Tsukasa Nakamura,3 Takeshi Morimoto2 1Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan; 2Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan; 3Department of Infectious Diseases, Shimane Prefectural Central Hospital, Izumo, JapanCorrespondence: Takeshi Morimoto, Department of Clinical Epidemiology, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan, Tel +81-798-45-6879, Fax +81-798-45-6920, Email morimoto@kuhp.kyoto-u.ac.jpPurpose: Low total protein (TP) is associated with mortality among patients with specific diseases, but its association was uncertain among general patients. We evaluated the effects of low TP on in-hospital mortality among general inpatients.Patients and Methods: We used data from the Japan Adverse Drug Events study series. We enrolled adult inpatients (≥ 16 years) admitted to a tertiary care hospital between September 1 and November 30, 2013. We excluded patients with multiple myeloma, pregnant women, and bone marrow graft donors. Patient data were extracted from electronic medical records. All patients were stratified into those with and without malignancy and divided into the low and normal TP groups. Low TP was defined as < 6.5 g/dL. We compared the in-hospital mortality of the low and normal TP groups stratified by the presence of malignancy.Results: Among the 2235 enrolled patients (mean age, 67.8 years), the TP value was lower in 516 patients with malignancy than in 1719 patients without malignancy (6.6 g/dL vs 6.8 g/dL, P = 0.0002). Among patients without or with malignancy, 27% (462/1719) and 35% (183/516) were in the low TP group, respectively. Mortality was higher in the low TP group among patients without malignancy (23.2% vs 10.2%, P < 0.0001). Likewise, among patients with malignancy, mortality was higher in the low TP group (34.7% vs 11.3%, P = 0.0029). The adjusted hazard ratio of the low TP group was 1.75 (95% confidence interval, 1.04– 2.96) in patients without malignancy and 2.45 (95% confidence interval, 1.12– 5.37) in patients with malignancy, but the interaction was not significant (P = 0.23).Conclusion: Low TP values were associated with higher in-hospital mortality among general inpatients, and this association was observed among patients with and those without malignancy. Routinely measured TP should be utilized to risk stratification on admission.Keywords: admission, general patients, historical cohort study, mortality, total protein

Mutsuko Kato, Michie Namba, Sachika Shimoyama, Mayumi Inoue, Chihiro Ouchi, Takehiro Shimizu Department of Ophthalmology, Japan Red Cross Okayama Hospital, Okayama, JapanCorrespondence: Mutsuko KatoDepartment of Ophthalmology, Japan Red Cross Okayama Hospital, 2-1-1 Aoe, Kita-ward, Okayama, 700-8607, JapanTel +81 86 222 8811Fax +81 86 222 8841Email mutsukato@okayama-med.jrc.or.jpPurpose: To report our modified simple technique for optic capture and the clinical results of intrascleral IOL fixation preserving the lens capsule, without vitrectomy, in cases of cataract with insufficient zonular support to stabilize the intraocular lens (IOL).Patients and Methods: In 37 eyes of 25 patients with phacodonesis and two or more risk factors for progressive zonular insufficiency, we inserted a CTR to support the capsule and zonules during cataract surgery and IOL fixation; an optic was inserted into the lens capsule, and a haptic was fixed in the scleral tunnel without vitrectomy. In all cases, anterior or total vitrectomy was not needed.Results: The postoperative mean (± standard deviation) tilt and decentration of the implanted IOL did not change from 6 to 12 months (6.77 ± 3.15° to 6.33 ± 3.38° and 0.60 ± 0.30 to 0.61 ± 0.35 mm, respectively). We encountered no late IOL dislocation and no retinal complications, including retinal breaks or cystoid macular oedema, postoperatively (follow-up = 21.1 ± 5.2 months).Conclusion: Our modified techniques preclude the need for vitrectomy. If the lens capsule can be preserved using a CTR, our modified technique can be used to stabilize IOL.Keywords: insufficient zonular support, phacodonesis, lens capsule, capsular tension ring, intrascleral IOL fixation

We present the measured spin correlation coefficient C y , y for p- 3 He elastic scattering at 100 MeV at the angles θ c. m. = 46. 9 ∘ – 149. 2 ∘ in the center of mass system. The experiment was performed using a 100 MeV polarized proton beam in conjunction with the polarized 3 He target. Proton beams were injected to the target, and scattered protons were detected by using E- Δ E detectors which consisted of plastic and NaI(Tl) scintillators. The data are compared with rigorous numerical calculations based on realistic NN potentials as well as with the Δ -isobar excitation. The obtained results indicate that the C y , y expands the knowledge of the nuclear interactions with Δ -isobar or those including 3NFs that are masked in nucleon-deuteron elastic scattering. [ABSTRACT FROM AUTHOR]

Atsushi Kimura,1 Kohei Yamaguchi,2,3 Haruka Tohara,3 Yusuke Sato,4 Naoko Sawada,4 Yasuhide Nakagawa,4 Yukako Matsuda,2,5 Motoharu Inoue,2,5 Kazuhiro Tamaki2,4 1College of Risk Management, Nihon University, Setagaya-ku, Tokyo, Japan; 2Dentistry Nanohana Clinic, Medical Corporation Kanjinkai, Nishitama-gun, Tokyo, Japan; 3Department of Gerodontology and Oral Rehabilitation, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; 4Geriatric Health Services Facility Nanohana, Medical Corporation Kanjinkai, Nishitama-gun, Tokyo, Japan; 5Department of Dysphasia Rehabilitation, Nihon University of Dentistry, Chiyoda-Ku, Tokyo, JapanCorrespondence: Atsushi KimuraCollege of Risk Management, Nihon University, 3-34-1 Shimouma, Setagaya-ku, Tokyo 154-8513, JapanTel +81 3 6453 1600Fax +81 3 6453 1630Email kimura.atsushi@nihon-u.ac.jpKazuhiro TamakiGeriatric Health Services Facility Nanohana, Medical Corporation Kanjinkai, 454 Tonogaya, Mizuho-machi, Nishitama-gun, Tokyo 190-1212, JapanTel +81 42 568 5111Fax +81 42 568 5127Email tamakikazuhiro@g.kanjinkai.netPurpose: The previous study demonstrated that the addition of a sauce is an effective means of influencing the consumption of finger foods among French elderly people with dementia. However, it is unclear the relative importance of low-level sensory factors such as flavor and a semi-solid nature and high-level cognitive factors such as memory stimulation and familiarity to the effect of the addition of sauce on food intake. The present study investigated whether the addition of sauce affects finger-snack intake among Japanese elderly people with dementia who were not familiar with sauce dipping.Patients And Methods: A total of 21 patients with dementia who were recruited in a nursing home in Tokyo received a plate of cut baumkuchen (a very thinly layered German roll cake), which had pieces of baumkuchen both with and without sauce, at their afternoon snack time. The amount of food intake and the first choice between options were measured for each participant. We used chocolate (in Experiment 1, n = 21) and agave (Experiment 2, n =14) syrups as sauce samples.Results: Results of both experiments demonstrate that snack consumption was greater for the with-sauce options than for the without-sauce options. A 90.5% of the participants in Experiment 1 and 64.3% of participants in Experiment 2 ate more snacks with sauce than without sauce.Conclusion: These findings imply that low-level sensory factors such as flavor and a semi-solid nature contribute relatively more strongly to the enhancement of food consumption with the addition of sauce than do high-level cognitive factors such as memory stimulation and familiarity, because Japanese elderly people are not always familiar with the custom of wiping up the sauce with food.Keywords: food consumption, dementia, under nutrition, food improvement, sauce

Maiko Maruyama-Inoue, Shimpei Sato, Shin Yamane, Kazuaki Kadonosono Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, JapanCorrespondence: Maiko Maruyama-InoueDepartment of Ophthalmology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, JapanTel +81 45 261 5656Fax +81 45 253 8490Email maicoo@urahp.yokohama-cu.ac.jpPurpose: To report the results of 9-year follow-up examinations and predictive factors for visual acuity outcome after intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents to treat retinal angiomatous proliferation (RAP).Methods: We conducted a retrospective observational study of 85 treatment-naïve eyes in 61 patients (21 men, 40 women; age range, 70–95 years; mean age, 84.0 years) treated with intravitreal injections of anti-VEGF agents. All patients received three consecutive monthly injections as an induction treatment. During the maintenance phase, the patients received intravitreal injections as needed or fixed dosing. The primary outcome measures were best-corrected visual acuity (BCVA) during the follow-up period. Furthermore, we investigated potential predictive factors of improvement in visual acuity. The proportion of patients who developed specific complications were also analyzed.Results: The mean BCVA gradually decreased from 0.58 at baseline to 0.70 at 36 months (P = 0.146), 0.82 at 48 months (P = 0.004), and 0.92 at 108 months (P = 0.021). Improvement in visual acuity at the final visits was associated with baseline visual acuity and central foveal thickness. Massive subretinal hemorrhage, fibrotic scars, and macular atrophy developed in 4 (4.7%), 9 (10.6%), and 50 (56.8%) eyes, respectively, at the final visits, and were all significantly associated with final visual acuity (P = 0.013, P < 0.001, and P = 0.001, respectively).Conclusion: Long-term stabilization of vision in patients with RAP, regardless of treatment modality, was difficult to achieve by using intravitreal injections of anti-VEGF agents. Earlier detection and treatment are important to maintain visual acuity in patients with RAP.Keywords: ranibizumab, aflibercept, retinal angiomatous proliferation, age-related macular degeneration, intravitreal injection

Tempei Otsubo,1 Yoshinori Watanabe,2,3 Seiji Hongo,3 Mikichika Inoue,4 Kimiko Akimoto,4 Ken Murakami,5 Ryutaro Takahashi,6 Toshiaki Kikuchi7 1Department of Psychiatry, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan; 2Himorogi Psychiatric Institute, Tokyo, Japan; 3Nanko Clinic of Psychiatry, Shirakawa, Japan; 4Ikebukuro Internal Medicine, Tokyo, Japan; 5Murakami Hospital, Tokyo, Japan; 6Takahashi Clinic, Tokyo, Japan; 7Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Aim: To assess the effectiveness and safety of switching the antidepressant formulation from immediate-release (IR) to controlled-release (CR) paroxetine in patients with major depressive disorder (MDD). Patients and methods: A total of 113 outpatients with MDD diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and treated with a stable dose of IR paroxetine for at least 6 months were enrolled. Patients were then switched to CR paroxetine for 8 weeks. Effectiveness was evaluated by scores on the Himorogi Self-Rating Depression/Anxiety Scales (HSDS/HSAS) and the Clinical Global Impression – Severity (CGI-S). Safety was evaluated based on the reported adverse drug reactions (ADRs). Medication satisfaction and preference were assessed based on questionnaire responses using Likert-type scales. Results: The overall patient HSDS/HSAS scores significantly improved after switching from IR to CR paroxetine (P

Both proxy and model studies conducted to understand anthropogenic warming have revealed historical variations in sea‐surface temperature (SST) since the industrial revolution. However, because of discrepancies between observations and models in the late nineteenth century, the timing and degree of anthropogenic warming remain unclear. In this study, we reconstructed a 237‐year‐long record of SST and salinity using a coral core collected from Bicol, southern Luzon, Philippines, which is located at the northern edge of the western Pacific warm pool. The SST record showed volcanic cooling after several volcanic eruptions, including the 1815 Tambora eruption, but the pattern of change differed. Decadal SST variations at Bicol are connected to Pacific Decadal Variability (PDV). Therefore, it is suggested that the PDV conditions at the time of the eruption may have influenced marine conditions, such as the degree and duration of cooling and/or salinity, after the eruptions. Although there were discrepancies in SST variations among the modeled, observed, and proxy SST data from the late nineteenth to early twentieth centuries, SST data from the late twentieth century showed globally coherent anthropogenic warming, especially after 1976. In particular, summer SST in the northwestern Pacific has become more sensitive to anthropogenic forcing since 1976. Plain Language Summary: Global warming is a growing concern worldwide, and model studies play an important role in predicting climate change. To improve the accuracy of the model, a comparison with observed data is critical. However, continuous observed data are spatially inadequate, and sometimes there is a discrepancy between the model and observed data. Therefore, proxy data, such as coral skeletons, were used to understand climate variability. In this study, we measured geochemical tracers in a coral skeleton collected from Bicol, southern Luzon, Philippines, and reconstructed the sea surface temperature (SST) and salinity data for more than 200 years. The SST record shows several cooling events due to volcanic eruptions, such as the Tambora eruptions in 1815. Overall SST variations at Bicol are likely to be connected to Pacific Decadal Variability. The SST profile in the modeled, observed, and proxy data from the late nineteenth to early twentieth centuries showed discrepancies. However, the anthropogenic warming indicated by the SST data of the late twentieth century was globally coherent, especially after 1976. Key Points: Coral geochemical data from the Philippines show volcanic cooling only during the nineteenth centuryThe decadal variation in sea‐surface temperature in this study showed a close relationship with the Pacific decadal variabilityThe warming trend observed in the late twentieth century suggests that recent warming was globally synchronous [ABSTRACT FROM AUTHOR]

Background/Objectives: Epidemiologic evidence on the relationship between antioxidant vitamin intake and stroke is limited. We aimed to investigate the association between dietary intake of antioxidant vitamins and the incidence of total stroke and ischemic stroke. Subjects/Methods: The subjects were 82 044 Japanese men and women aged 45-74 years under the Japan Public Health Center-based Prospective Cohort Study. Between 1995 and 1997, dietary assessment was done using a food frequency questionnaire. During 983 857 person-years of follow-up until the end of 2009 we documented 3541 incident total strokes and 2138 ischemic strokes. Results: Dietary intakes of [alpha]-carotene, [beta]-carotene, [alpha]-tocopherol and vitamin C were not inversely associated with the incidence of total stroke and ischemic stroke adjustment for cardiovascular risk factors and selected lifestyle variables. When stratified by current smoking status, the inverse association between dietary vitamin C intake and incidence of total stroke observed among non-smokers but not smokers, with respective multivariable hazard ratios for the highest versus lowest quintiles of vitamin C of 0.81 (95% confidence interval (CI), 0.68-0.96; P-trend=0.03) among non-smokers; and 1.03 (0.84-1.25; P-trend=0.55) among smokers. As for ischemic stroke, the corresponding multivariable hazard ratios were 0.76 (0.60-0.96; P-trend=0.02) among non-smokers; and 1.00 (0.78-1.28; P-trend=0.61) among smokers. Conclusions: Dietary vitamin C intake was inversely associated with the incidence of total stroke and ischemic stroke among non-smokers., Author(s): S Uesugi [sup.1] , J Ishihara [sup.2] , H Iso [sup.3] , N Sawada [sup.4] , R Takachi [sup.5] , M Inoue [sup.4] [sup.6] , S Tsugane [sup.4] , [...]

Toshio Kamimura,1 Kazutaka Kida,1 Masashi Takeda,1 Shunsuke Sato,1 Masato Fujii,1 Masahiro Inoue,1 Hiromasa Tsukino,1 Shoichiro Mukai,1 Atsushi Nanashima,2 Kunihide Nakamura,2 Toshiyuki Kamoto1 1Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan Abstract: Clear cell renal cell carcinoma (ccRCC) shows extreme hypervascularity, which may cause significant bleeding during surgery. For this reason, control of arterial blood supply is an important factor in the choice of operative procedure and in avoiding perioperative complications. This case series reports the successful dissection of renal artery in the preliminary stage of laparoscopic procedure in three ccRCC patients with inferior vena cava (IVC) extension. Patient 1 had right renal cell carcinoma (RCC) with level I tumor thrombus through two renal veins, and the renal artery was successfully dissected by retroperitonealscopic approach. Patient 2 had right invasive, immobilized RCC with significant infiltration to IVC and liver. Ligation of renal artery was performed by transperitoneal laparoscopic procedure. Patient 3 had left RCC with level III tumor thrombus and lung metastasis. Ligation of left renal artery and mobilization of peritoneal organs and kidney were performed by transperitoneal laparoscopic surgery. These cases suggest that combined laparoscopic-open surgery for RCC with IVC extension may facilitate early control of arterial blood supply. Keywords: renal cell carcinoma, IVC extension, combined laparoscopic-open surgery

Akira Arakawa,1,2 Maiko Inoue,2 Shimpei Sato,2 Shin Yamane,2 Kazuaki Kadonosono2 1Department of Ophthalmology, St Marianna University School of Medicine, Yokohama City Seibu Hospital, 2Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan Purpose: To evaluate the efficacy of intravitreal aflibercept therapy in treatment-naïve Japanese patients with polypoidal choroidal vasculopathy (PCV) using Early Treatment Diabetic Retinopathy Study (ETDRS) letter scores.Subjects and methods: This study was a prospective, nonrandomized, interventional exploratory clinical trial performed in an institutional setting. Patients with PCV were treated with intravitreal aflibercept 2 mg/0.05 mL every 2 months after 3 initial monthly doses, for 1 year. Visual acuity test using the ETDRS chart and indocyanine green angiography was performed at baseline and at 6 and 12 months after initiating the treatment, in addition to routine examinations performed at each visit. The main outcome measure was the proportion of patients who achieved

BACKGROUND: Focal intestinal perforation (FIP) is a devastating complication of premature birth, and extremely low birth weight (ELBW) infants are at highest risk. This study aimed to evaluate the relationship of the superior mesenteric artery (SMA) and portal vein (PV) blood flow velocities to investigate the association between intestinal blood flow and FIP. In addition, the herbal formula Daikenchuto (TJ-100) is expected to improve intestinal blood flow disorders; therefore, we evaluated its effect. METHODS: We conducted a prospective cohort study of 15 ELBW infants from January 2020 to August 2021. Measured variables included birth weight, 5-minute Apgar score, time of oral feeding initiation, ductus arteriosus (PDA) closure (percent), diastolic and systolic blood pressure, SMA and PV blood flow velocity, and FIP onset data. Fifteen infants were divided into three groups: a non-surgery group (Group I; 6), a surgery group with FIP (Group II; 4), and a TJ-100 administration group (Group III; 5). The main outcome parameters included SMA and PV blood flow velocities with TJ-100. RESULTS: SMA and PV blood flow differed significantly for the SMA of Group I and the SMA and PV of Group III (P < 0.01, P = 0.01, and P = 0.04, respectively). There was a correlation between SMA and PV in Group III (P = 0.03). CONCLUSION: TJ-100 may increase SMA and PV blood flow and improve intestinal blood flow in ELBW infants at risk of FIP. Therefore, the effects of TJ-100 should undergo further study. [ABSTRACT FROM AUTHOR]

Background/Objectives: Although vitamin D has been experimentally reported to inhibit tumorigenesis, cell growth and prostate cancer invasion, epidemiologic data regarding prostate cancer risk are inconsistent, and some studies have suggested positive but nonsignificant associations. Further, the impact of vitamin D on prostate cancer between Western and Japanese populations may differ due to different plasma vitamin D levels. Subjects/Methods: We performed a nested case-control study within the Japan Public Health Center-based Prospective (JPHC) Study in 14,203 men (40-69 years) who answered a self-administered questionnaire at baseline (1990-1994) and gave blood samples, and were followed until 2005. We identified 201 prostate cancers which are newly diagnosed during follow-up (mean 12.8 years). We selected two matched controls for each case from the cohort. We used a conditional logistic regression model to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for prostate cancer with respect to levels of 25-hydroxy vitamin D (25(OH)D) in plasma. Results: We did not observe statistically significant association between 25(OH)D level and total prostate cancer (multivariate OR=1.13 (95%CI=0.66-1.94, P.sub.trend=0.94) for the highest versus lowest tertile) However, 25(OH) levels were slightly positively associated with advanced cancer. The results remained substantially unchanged after stratification by intake of fish or calcium intake. Conclusions: 25(OH)D level showed no association with overall prostate cancer among Japanese men in this large cohort., Author(s): N Sawada [sup.1] , M Inoue [sup.1] [sup.2] , M Iwasaki [sup.1] , T Yamaji [sup.1] , T Shimazu [sup.1] , S Sasazuki [sup.1] , S Tsugane [sup.1] , [...]