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Due to a more physiological reproduction of the in vivo situation, liver‐on‐a‐chip devices in recent studies have shown higher sensitivity and accuracy for hepatotoxicity testing compared to traditional in vitro liver models. In this context, this work presents an original microfluidic device mimicking 3D hepatic cords organized radially, like in the liver lobule. Ten cell‐culture chambers seeded at a high density are disposed with a parallelized flow that emulates blood flow from the portal triad to the central vein in the liver lobule. Using this device, on‐chip differentiation of human HepaRG‐Hepatoblast (HepaRG‐HB) to HepaRG‐Hepatocytes (HepaRG‐HC) has been studied in terms of self‐organization capabilities, bile canaliculi formation and albumin expression. Our results indicate that due to the design of the cell culture chamber, which mechanically constrains tissue proliferation, and the physiologically relevant microfluidic flow condition used during tissue development, the HepaRG‐HBs in the device can proliferate, self‐organize, and spontaneously differentiate in a DMSO free medium forming long, directional bile canaliculi. On the contrary, under the same conditions, differentiated HepaRG‐HC is observed to aggregate without long bile canaliculi and form tissues resembling traditional HepaRG‐HC cultures. © 2024 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Introduction: Accumulation of β2-microglobulin (B2M) in dialysis patients contributes to several comorbidities of end-stage kidney disease (ESKD). The LIXELLE® device adsorbs B2M from blood using sorbent bead technology. Studies in Japan showed that LIXELLE treatment during hemodialysis (HD) at blood flow rates up to 250 mL/min removes B2M above HD alone and is well tolerated. We investigated tolerance for LIXELLE treatment during HD at higher HD blood flow rates standard in the USA. Methods: A prospective, open-label, non-randomized, single-arm, early-feasibility study (EFS) assessed tolerance and safety of LIXELLE treatment during HD at blood flow rates up to 450 mL/min. ESKD patients (40–75 years old) on thrice weekly outpatient HD were eligible. After a 1-week HD run-in, patients received LIXELLE plus HD at a blood flow rate of 250 mL/min (1 week), followed by LIXELLE plus HD at a blood flow rate up to 450 mL/min (1 week). These blood flow rates were tested with three LIXELLE column sizes in sequence (treatment = 6 weeks). B2M removal was assessed for each combination. Results: Ten patients with a historic intradialytic hypotension (IDH) rate of 0.42 events/HD session/patient were enrolled. Nine patients completed all combinations without IDH events (treatment IDH rate: 0.56 events/HD session/patient). No treatment-emergent serious adverse events or significant changes in red blood cell, platelet, or complement indices except haptoglobin were reported. B2M reduction ratios and removal of select proteins (<40 kDa) increased with escalating column size and blood flow rate. Conclusion: LIXELLE plus HD across all column sizes was safe and well tolerated at blood flow rates up to 450 mL/min. Extent of B2M removal corresponded to column size-blood flow rate combinations. This EFS provides a risk profile to guide further studies of LIXELLE in ESKD patients at US-standard blood flow rates. [ABSTRACT FROM AUTHOR]

Local low‐frequency vibration promotes blood flow and wound healing in hard‐to‐heal diabetic foot ulcers (DFUs). However, vibration treatment is challenging in patients with DFUs due to wound management difficulties and low adherence. Consequently, developing wearable self‐care devices becomes imperative for effective wound healing. This study introduces a wearable vibration dressing and assesses its impact on wound healing in hyperglycemic rats. Low‐frequency vibration at 52 Hz was applied to the wound for 40 min/day in awake rats. Relative wound areas on post‐wounding days (PWDs) 4–7 were significantly smaller and the wound closure rate was significantly higher in the vibration group than in the control group (p < 0.05, respectively). The total haemoglobin at baseline and after vibration on post‐wounding day 7 was significantly larger in the vibration group than in the control group (p < 0.05). On PWD 7, the thickness of the granulation tissue was significantly higher in the vibration group than in the control group (p < 0.05). Moreover, the number of blood vessels at the wound site and vascular endothelial growth factor A protein expression were significantly higher in the vibration group than in the control group (p < 0.05, respectively). The ratio of (CD68+/iNOS+)/(CD163+) macrophages in the vibration group was significantly lower than that in the control group (p < 0.05). These results indicate the potential of wearable vibration dressings as new self‐care devices that can promote angiogenesis and blood flow, improve inflammation, and enhance wound healing in DFUs. [ABSTRACT FROM AUTHOR]

Level 3 automated driving mandates the installation of a driver monitoring system that monitors the driver's condition, such as drowsiness. Conventional drowsiness detection has been hampered by the mental and physical burden of wearing equipment and the time required for detection. In this study, we applied sparse coding to facial images captured with near‐infrared light to extract features of facial skin blood flow information related to drowsiness and to estimate drowsiness. As a result, skin blood flow features related to drowsiness were extracted in the nasal area and other areas, and drowsiness was estimated with 74.6% accuracy. © 2023 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Background/Objective: Stagnant blood (oketsu in Japanese) is considered a severe pathological condition in traditional Chinese and Japanese medicine. Kummerowia striata is known as a weed in Japan; however, in traditional Chinese medicines, it is used for detoxification and for treating colds, fevers, and bruises. To the best of our knowledge, there is no record of this plant, or its parts, being used as an anti-blood stasis agent. Herein, we demonstrated the effect of the 35% ethanol extract (KS) of the aerial part of K. striata on stagnant blood flow (BF) in the peripheral circulation using an in vivo assay. Methods: Hen-egg white lysozyme (HEL) was injected into the tail vein of mice to induce stagnant BF, the pathology of which is similar to that of oketsu ; then, the changes in BF were observed. Results: The oral administration of KS (200 mg/kg) significantly improved HEL-induced BF decrease, suggesting that KS can improve blood stasis. Bioassay-guided fractionation of KS resulted in the isolation of 14 flavone and flavonol derivatives. As apigenin (1) and luteolin (2) reportedly have activity in this assay, here, the effects of isovitexin (3), vitexin (5), rhoifolin (12), and vicenin-1 (14) were examined. Compounds 5, 12, and 14 (20 µmol/kg) more effectively inhibited HEL-induced stagnant BF than 1, which was used as a positive control. Conclusion: The aerial part of K. striata could be useful in the discovery of new leads for the prevention of stagnant blood syndrome. [ABSTRACT FROM AUTHOR]

Purpose: It has previously been found that imposing positive defocus changes axial length and choroidal thickness after only 30 min. In the present study, we investigated whether these changes may result from an altered choroidal blood flow. Methods: Eighteen young adult subjects watched a movie from a large screen (65 in.) in a dark room at 2 m distance. A 15-min wash-out period was followed by 30 min of watching the movie with a monocular positive defocus (+ 2.5D). Changes in axial length and ocular blood flow were measured before and after the defocus, by using low-coherent interferometer (LS 900, Haag-Streit, Switzerland) and a laser speckle flowgraphy (LSFG) RetFlow unit (Nidek Co., LTD, Japan), respectively. Three regions were analyzed: (1) the macular area, where choroidal blood flow can be measured, (2) the optic nerve head (ONH), and (3) retinal vessel segments. Results: Changes in choroidal blood flow were significantly and negatively correlated with changes in axial length that followed positive defocus in exposed eyes (R = − 0.67, p < 0.01). The absolute values of changes in choroidal blood flow in the defocused eyes were significantly larger than in the fellow control eyes (2.35 ± 2.16 AU vs. 1.37 ± 1.44 AU, respectively, p < 0.05). ONH and retinal blood flow were not associated with the induced changes in axial length. Conclusions: Positive defocus selectively alters choroidal, but not retinal or ONH blood flow in young human subjects after short-term visual exposure. The results suggest that blood flow modulation is involved in the mechanism of choroidal responses to optical defocus. [ABSTRACT FROM AUTHOR]

Background: The original formula name for daikenchuto (DKT) was written in 'Jin Gui Yao Lue (Kinkiyōryaku in Japanese)'. DKT as used in Japan consists of four types of crude drug. Key findings: Although there are few examples of its use in Chinese classical records, it has begun to be used extensively in modern Japan for intestinal obstruction after laparotomy. Furthermore, to prove its usefulness, many clinical trials on DKT for intestinal obstruction have been conducted since the 1990s. Although the efficacy of DKT in preventing or improving intestinal obstruction was controversial, a meta‐analysis of nine studies reported in recent years showed that DKT significantly reduced the incidence of intestinal obstruction after gastrointestinal cancer surgery, suggesting its effectiveness. Related knowledge of irritable bowel syndrome has also been accumulated through case reports. DKT has been shown to be involved in the promotion of gastrointestinal motility, inhibition of excessive gastrointestinal motility, secretion of gastrointestinal hormones, and improvement of gastrointestinal blood flow, and to have anti‐inflammatory effects. In addition to drug rash, serious adverse events include hepatic dysfunction and interstitial pneumonia, but there have been relatively few reports. Conclusion: DKT has been used in many cases in Japan, but it is often used without considering the 'pattern (shō)'. Since it was originally formulated for the treatment of chills (hie), it would be more effective if its target (pattern) were taken into consideration. Overall, DKT is a safe prescription with a wide range of applications. [ABSTRACT FROM AUTHOR]

This study aimed to identify the clinical characteristics associated with spontaneous isolated dissection of superior mesenteric artery/celiac artery (SIDSMA/SIDCA). This observational study, conducted at Toranomon Hospital, Japan between 2009 and 2020, analyzed consecutive SIDSMA/SIDCA cases based on radiology data. The study compared clinical characteristics between symptomatic and asymptomatic patients with SIDSMA/SIDCA and investigated factors related to future vessel dilatation. Among 57 cases (44 SIDSMA, 17 SIDCA, and 4 both), the majority were male (87.7%), nearly half having hypertension (43.9%) and smokers (48.9%). Of those, 17 cases (29.8%) were symptomatic; abdominal pain (94.1%), back pain (23.5%), nausea (17.6%) and fever (5.9%). The symptomatic group was younger (52.6 ± 9.4 versus 67.2 ± 7.9 years, P < 0.001), had higher systolic and mean blood pressure (142.6 ± 20.0 versus 129.5 ± 16.5 mmHg, P = 0.017; 96.1 ± 14.6 versus 88.2 ± 17.7 mmHg, P = 0.038), a higher white blood cell count (9975 ± 5032 versus 6268 ± 1991 /µL, P = 0.012), and a higher LDL cholesterol level at diagnosis (129.7 ± 21.7 versus 87.2 ± 25.6 mg/dL, P = 0.002) than the asymptomatic group. The factors associated with future vessel dilatation included the presence of pseudo-lumen flow in the dissection vessel (73.9% versus 41.4%, p = 0.019) and a larger vessel diameter (13.5 ± 2.4 mm versus 11.5 ± 2.1 mm, p = 0.005) at diagnosis after multiple adjustments, pseudo-lumen flow was a predictor of future vessel dilatation (odds ratio, 4.80; 95% confidence interval, 1.11–20.75; p = 0.036). The study revealed that only 30% of SIDSMA/SIDCA cases were symptomatic. Symptomatic cases were generally younger and exhibited higher blood pressure and elevated white blood cell counts. These findings offer valuable insights for the acute diagnosis of SIDSMA/SIDCA. [ABSTRACT FROM AUTHOR]

Background: The Japanese Society for Dialysis Therapy (JSDT) published in 2013 inaugural hemodialysis (HD) guidelines. Specific targets include 1.4 for single-pool Kt/V (spKt/V) with a minimum dose of 1.2, minimum dialysis session length of 4 hours, minimum blood flow rate (BFR) of 200 mL/min, fluid removal rate no more than 15 mL/kg/hr, and hemodiafiltration (HDF) therapy for certain identified symptoms. We evaluated the effect of these guidelines on actual practice in the years spanning 2005 - 2018.Methods: Analyses were carried out to describe trends in the above HD prescription practices from December 2005 to April 2013 (before guideline publication) to August 2018 based on prevalent patient cross-sections from approximately 60 randomly selected HD facilities participating in the Japan Dialysis Outcomes and Practice Patterns Study.Results: From April 2006 to August 2017 continual rises occurred in mean spKt/V (from 1.35 to 1.49), and percent of patients having spKt/V>1.2 (71% to 85%). Mean BFR increased with time from 198.3 mL/min (April 2006) to 218.4 mL/min (August 2017) , along with percent of patients with BFR >200 ml/min (65% to 85%). HDF use increased slightly from 6% (April 2006 and August 2009) to 8% by April 2013, but increased greatly thereafter to 23% by August 2017. In contrast, mean HD treatment time showed little change from 2006-2017, whereas mean UFR declined from 11.3 in 2006 to 8.4 mL/Kg/hour in 2017.Conclusions: From 2006 - 2018 Japanese HD patients experienced marked improvement in reaching the spKt/V target specified by the 2013 JSDT guidelines. This may have been due to moderate increase in mean BFR even though mean HD session length did not change much. In addition, HDF use increased dramatically in this time period. Other HD delivery changes during this time, such as increased use of super high flux dialyzers, also merit study. While we cannot definitively conclude a causal relationship between the publication of the guidelines and the subsequent practice changes in Japan, those changes moved practice closer to the recommendations of the guidelines. [ABSTRACT FROM AUTHOR]

Application of exposure to 50/60 Hz magnetic fields (MFs) has been conducted in the treatment of muscle pain and fatigue mainly in Japan. However, whether MFs could increase blood flow leading to muscle fatigue recovery has not been sufficiently tested. We investigated the acute effects of a 50 Hz sinusoidal MF at Bmax 180 mT on hemodynamics, electrocardiogram, and vascular endothelial function in healthy young men. Three types of regional exposures to a 50 Hz MF, i.e., forearm, upper arm, or neck exposure to MF were performed. Participants who received three types of real MF exposures had significantly increased ulnar arterial blood flow velocity compared to the sham exposures. Furthermore, after muscle loading exercise, MF exposure recovered hemoglobin oxygenation index values faster and higher than sham exposure from the loading condition. Moreover, participants who received real MF exposure in the neck region had significantly increased parasympathetic high-frequency activity relative to the sham exposure. The MF exposure in the upper arm region significantly increased the brachial artery flow-mediated dilation compared to the sham exposure. Computer simulations of induced in situ electric fields indicated that the order-of-magnitude estimates of the peak values were 100–500 mV/m, depending on the exposure conditions. This study provides the first evidence that a 50 Hz MF can activate parasympathetic activity and thereby lead to increase vasodilation and blood flow via a nitric oxide-dependent mechanism. Trial registration: UMIN Clinical Trial Registry (CTR) UMIN000038834. The authors confirm that all ongoing and related trials for this drug/intervention are registered. [ABSTRACT FROM AUTHOR]

BACKGROUND: Blood flow restriction training, as an emerging training method, can effectively increase muscle cross-sectional area and improve muscular function, providing a new way for sports intervention of dyskinesia. However, there are many controversies in the field from mechanism to application. OBJECTIVE: To explore the current research hotspots and main contents in the application of blood flow restriction training, and to provide new ideas and directions for future research and development in this field. METHODS: A total of 441 articles regarding blood flow restriction training published from 2009 to 2019 were retrieved from the Web of Science Core Collection database for a visual analysis using CiteSpace 5.6.R3. Based on key literatures, the analysis was performed by integration of mapping and data. RESULTS AND CONCLUSION: The research on blood flow restriction training has been on an upward trend since the 21st century, mainly published by the United States, Japan and their institutions with more achievements and higher influence. The development of the research theme has gradually changed from the impact on local tissues and organs to the impact on body functions, from the training and application in general populations to intervention therapy in special populations. Hot keywords are blood flow restriction, strength, skeletal muscle, muscle hypertrophy, growth hormone, and adaptation; its research hotspots mainly include different physiological adaptation mechanisms, training methods that influence variables, rehabilitation for people with dyskinesia, effects on cardiovascular function, etc. Low-intensity blood flow restriction training as an effective exercise intervention is mainly used in the clinical treatment and rehabilitation of musculoskeletal, cardiovascular, metabolic, and neurological diseases. Future research can focus on long-term exercise benefits, physiological adaptation mechanisms, application effects in different populations, and safety of training methods. [ABSTRACT FROM AUTHOR]

This review provides a comprehensive update on emerging ROCK inhibitors as an innovative treatment option for lowering intraocular pressure (IOP) in glaucoma and aims to describe the structure, mechanism of action, pharmaceutical characteristics, desirable ocular effects, including side effects for each agent. A literature review was conducted using PubMed, Scopus, clinicaltrials.gov, ARVO journals, Cochrane library and Selleckchem. Databases were searched using "investigational Rho kinase inhibitors," and "glaucoma" as keywords. In addition to this building block strategy, successive fractions were employed to further refine the results. Of the several ROCK inhibitors discovered, only two drugs are currently approved for glaucoma treatment; Netarsudil in the USA and Ripasudil in Japan and China. We identified and reviewed 15 agents currently in laboratory or clinical trials. These agents lower IOP mainly by decreasing outflow resistance through pharmacologic relaxation of the trabecular meshwork (TM) cells and reducing episcleral venous pressure. They have an optimistic safety profile; however, conjunctival hyperemia, conjunctival hemorrhage, pain on instillation, and corneal verticillata are common. Other properties such as neuroprotection (enhancing optic nerve blood flow and promoting axonal regeneration), anti-fibrotic activity, and endothelial cell proliferation may improve the visual prognosis and surgical outcomes in glaucoma. In addition, these agents have the potential to work synergistically with other topical glaucoma medications. [ABSTRACT FROM AUTHOR]

This paper presents the noninvasive determination of cardiac output by peripheral electrical bioimpedance. We validate our approach first with small animals and then with human. We established an experimental protocol that allowed us to perform the measurements of several cardiovascular parameters by two methods, echocardiography and bioimpedance. For the rats, we used a group of 19 Wistar rats. Peripheral bioimpedance allowed us to obtain the blood flow index at the level of the rat's tail without sacrificing it. The objective being the determination of the cardiac output, a correlation with the measurements of the cardiac output by ultrasound has been established. The correlation obtained '0.83' can be considered satisfactory and comparable to those obtained in similar human studies. For humans, a group of 32 healthy women, (age 21.3 ± 1.5 years) has participated in this study. Peripheral bioimpedance allowed us to obtain the index of blood flow at the patient's left arm and echocardiography allowed us to obtain the cardiac output. Then, we established a linear correlation between the two methods. The strength of the correlation obtained is '0.89' and can be considered very satisfactory. The mean percentage of error in estimating cardiac output by the proposed method is 5.6%. © 2020 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Choreito (CRT), a traditional Japanese (Kampo) medicine, is widely used for the treatment of overactive bladder (OAB) and other lower urinary tract symptoms in Japan. This study aimed to identify the effects and therapeutic mechanism of CRT on the improvement of detrusor overactivity (DO) using an experimental rat model. Forty‐five female Sprague‐Dawley rats were equally divided into three groups: intravesical saline instillation with normal food (normal group), intravesical acetic acid (AA) instillation with normal food (AA group), and intravesical AA instillation with CRT (AA with CRT group). To induce a decrease in bladder capacity, instillation of 0.2% AA was used based on prior studies. Cystometric investigation was employed to clarify the effects of AA and CRT. Microcirculation was performed using a laser blood flowmeter, and the localization of hypoxia‐inducible factor 1α (HIF1α) was assessed by immunohistochemistry. The bladder capacities of the normal, AA, and AA with CRT groups were 1.2 ± 0.3 mL, 0.4 ± 0.1 mL, and 0.8 ± 0.1 mL, respectively. CRT significantly attenuated AA irritation of the urinary bladder and exerted protective effects on basal pressure, micturition pressure, micturition interval, and micturition volume. Furthermore, CRT could prevent the excess blood flow and edematous change under the urothelium induced by intravesical AA instillation. No obvious changes in immunohistochemical HIF1α staining were observed among the groups. CRT attenuated DO induced by intravesical AA instillation in a rat experimental model. CRT might impart therapeutic effects on OAB via the mitigation of urothelial damage and regulation of excess blood flow. [ABSTRACT FROM AUTHOR]

Brown adipose tissue (BAT) is responsible for non-shivering thermogenesis and is an attractive therapeutic target for combating obesity and related diseases. Human BAT activity has been evaluated by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) under acute cold exposure, but the method has some serious limitations, including radiation exposure. Infrared thermography (IRT) may be a simple and less-invasive alternative to evaluate BAT activity. In the present study, to establish an optimal condition for IRT, using a thermal imaging camera, skin temperature was measured in the supraclavicular region close to BAT depots (Tscv) and the control chest region (Tc) in 24 young healthy volunteers. Their BAT activity was assessed as the maximal standardized uptake value (SUVmax) by 18FDG-PET/CT. Under a warm condition at 24–27°C, no significant correlation was found between the IRT parameters (Tscv, Tc,, and the difference between Tscv and Tc,, Δtemp) and SUVmax, but 30–120 min after cold exposure at 19°C, Tscv and Δtemp were significantly correlated with SUVmax (r = 0.40–0.48 and r = 0.68–0.76). Δtemp after cold exposure was not affected by mean body temperature, body fatness, and skin blood flow. A lower correlation (r = 0.43) of Δtemp with SUVmax was also obtained when the participant’s hands were immersed in water at 18°C for 5 min. Receiver operating characteristic analysis revealed that Δtemp after 30–60 min cold exposure can be used as an index for BAT evaluation with 74% sensitivity, 92% specificity, and 79% diagnostic accuracy. Thus, IRT may be useful as a simple and less-invasive method for evaluating BAT, particularly for large-scale screening and longitudinal repeat studies. [ABSTRACT FROM AUTHOR]

Twin to twin transfusion syndrome (TTTS) is a major complication of monochorionic diamniotic (MD) twins, and its onset is known to be associated with placental vascular anastomoses and blood flow imbalance. In a typical case of TTTS, the recipient develops polyhydramnios, weight gain, cardiomegaly and hydrops fetalis in the uterus. In contrast, the donor develops oligohydramnios and intrauterine growth restriction. Recently, the significance of the renin-angiotensin-aldosterone system (RAAS) that transfers from the donor to the recipient has attracted interest in the fetal circulation of TTTS. The donor has decreased renal blood flow due to decreased circulating blood volume. For this reason, the secretion of RAAS hormones is augmented in the fetal kidneys of the donor. In TTTS, these RAAS hormones from the donor transfer to the recipient through the anastomosed vessels. In addition to excess preload, the recipient heart is exposed to excess afterload due to systemic vasoconstriction through RAAS hormones. Commonly occurring complications in the recipient include myocardial hypertrophy, atrioventricular valve regurgitation, and pulmonary valve stenosis or pulmonary atresia. Fetoscopic laser photocoagulation (FLP) has been introduced recently because neither mortality nor neurological morbidity have been satisfactorily improved with conventional treatment. FLP is a curative method that may improve the prognosis of TTTS. In Japan, this procedure has been performed frequently, and positive neurological outcomes have been achieved. [ABSTRACT FROM AUTHOR]

The use of color Doppler ultrasound (CD) for distinguishing between benign and malignant breast lesions remains controversial. This study (JABTS BC-04 study) was aimed at confirming the usefulness of our CD diagnostic criteria. We evaluated ultrasound images of 1408 solid breast masses from 16 institutions in Japan (malignant: 839, benign: 569). Multivariate analysis indicated that vascularity (amount of blood flow), vascular flow pattern ("surrounding marginal flow" or "penetrating flow") and the incident angle of penetrating flow were significant findings for distinguishing between benign and malignant lesions. However, the sensitivity and specificity of B-mode alone did not improve significantly with CD addition (97.6% → 97.9%, 38.3% → 41.5%, respectively). We explored the causes of these negative results and found that age should have been considered when evaluating vascularity. Simulation experiments suggested that specificity is significantly improved when age is taken into consideration (38.3% → 46.0%, p < 0.001) and we thereby improved our diagnostic criteria. [ABSTRACT FROM AUTHOR]

Abstract Background Although non-IgE-mediated gastrointestinal food allergy has increased rapidly in Japan, a small number of reports has evaluated B-mode and Doppler ultrasonographic findings in the acute phase of infantile gastrointestinal milk allergy. The aim of the present study was to compare the diagnostic utility of ultrasonographic findings and laboratory allergic data in non-IgE-mediated infantile gastrointestinal milk allergy. Methods Sixteen cases of active non-IgE-mediated infantile gastrointestinal milk allergy, diagnosed by food elimination tests and oral food challenge tests (OFCTs) (group A), 15 cases of acute viral gastroenteritis (AGE) (group B), and 15 controls (group C) were enrolled. 1) B-mode abdominal ultrasound findings, 2) laboratory allergic data including eosinophil counts (Eos), serum IgE, and the antigen-specific lymphocyte proliferation test (ALPT) against milk protein, and 3) vessel density (VD) indirectly quantified by gastrointestinal Doppler flow at jejunum, ileum, and sigmoid colonic mucosae were evaluated and compared among the groups. Results In the small intestine, wall thickening, dilation, mesenteric thickening, and poor peristalsis were found in 100%, 62.5%, 93.7%, and 100%, respectively, in group A. Eos, IgE, ALPT, and VD were positive in 25.0%, 0%, 87.5%, and 100%, respectively, in group A. Small intestinal VD was significantly greater in group A than in groups B (jejunum p <.001; ileum p <.001) and C (jejunum p <.001; ileum p <.001), with no significant differences between groups B and C (jejunum: p =.74; ileum: p =.73). Conclusions Abdominal Doppler ultrasonography and small intestinal VD at symptomatic state can support the diagnosis and evaluation of non-IgE-mediated infantile gastrointestinal milk allergy with symptoms of vomiting, diarrhea, and failure to thrive. [ABSTRACT FROM AUTHOR]

Aim: The present study was conducted in order to clarify the effects of a warm hand bath at 40°C for 10 min on the blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort in healthy women. Methods: The study's participants were 40 healthy adult women who were randomly assigned to either a structured hand bath first and no hand bath second (Group A) or to no hand bath first and a hand bath second (Group B). The blood flow in the shoulder, skin and deep body temperature, autonomic nervous activity, and subjective comfort then were recorded in all the participants. Results: A repeated‐measures ANOVA revealed no significant difference in the blood flow in the right shoulder or deep body temperature between groups. The skin temperature of the hands, forearms, and arms was significantly increased, but not of the face and upper back. The skin temperature of the forearms was maintained at 0.5°C–1°C higher for 30 min in the hand bath group, compared with the no hand bath group. The hand bath group had a significantly higher heart rate while bathing and a significantly lower parasympathetic nerve activity level during bathing. No significant difference was seen in the sympathetic activity level between groups. The hand bath group had a significantly higher subjective comfort level. Conclusion: Hand baths can improve the level of subjective comfort and increase the heart rate and might affect autonomic nervous activity. The skin temperature of the forearms was maintained for 30 min in the hand bath group. [ABSTRACT FROM AUTHOR]

Objective: The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection. Method: Clinical symptoms, ankle-brachial pressure index (ABPI) and SPP were assessed to evaluate the condition of each foot ulcer. Every foot ulcer was treated as independent, even if a participant had multiple ulcers. All ulcers for which we measured SPP were subject to the analysis. All ulcers were purely ischaemic in nature and were exclusively located on the foot or toes. Results: Data were collected from 117 foot ulcers on 91 toes and feet from 65 patients. Almost all SPP values in healed cases were > 27 mmHg. There were three patients whose ulcers failed to heal by conservative treatments were complicated with severe infection. However, no effect of DM on the relationship between SPP values and prognosis was observed. Logistic regression analysis of all ulcers except for the 5 cases complicated with infection revealed that those with 30 mmHg or lower SPP values are likely to heal by conservative treatment with 23% or lower probability, whereas any ulcer with more than 50 mmHg SPP value and without severe infection may heal without the need for further operations with 80% or higher probability. Conclusion: The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM. Declaration of interest: Nothing to declare. [ABSTRACT FROM AUTHOR]

Purpose: It has previously been found that imposing positive defocus changes axial length and choroidal thickness after only 30 minutes. In the present study, we investigated whether these changes may result from an altered choroidal blood flow. Methods: Eighteen young adult subjects watched a movie from a large screen (65 inch) in a dark room at 2 m distance. A fifteen‐minute wash‐out period was followed by 30 minutes of watching the movie with a monocular positive defocus (+2.5D). Changes in axial length and ocular blood flow were measured before and after the defocus, by using low‐coherent interferometer (LS 900, Haag‐Streit, Switzerland) and a laser speckle flowgraphy (LSFG) RetFlow unit (Nidek Co., LTD, Japan), respectively. Three regions were analysed: (1) the macular area, where choroidal blood flow can be measured, (2) the optic nerve head (ONH), and (3) retinal vessel segments. Results: Changes in choroidal blood flow were significantly and negatively correlated with changes in axial length that followed positive defocus in exposed eyes (R = −0.67, p < 0.01). The absolute values of changes in choroidal blood flow in the defocused eyes were significantly larger than in the fellow control eyes. ONH and retinal blood flow were not associated with the induced changes in axial length. Conclusions: Positive defocus selectively alters choroidal, but not retinal or ONH blood flow in young human subjects after short‐term visual exposure. The results suggest that blood flow modulation is involved in the mechanism of choroidal responses to optical defocus. [ABSTRACT FROM AUTHOR]

Background: Japanese patients undergoing dialysis have an extremely low mortality rate compared with those in the United States and Europe. As shown in the Dialysis Outcomes & Practice Patterns Study (DOPPS), certain features of dialysis treatment, such as single treatment time and amount of blood flow, are unique to Japan, but factors contributing to the low mortality risk are unclear. Although DOPPS is a multi-country prospective cohort study, the study results may not entirely reflect the real trend in Japan because the number of Japanese institutions participating in the study is small. Summary: In this article, we review the data reported for Japan and other countries and reveal country-specific differences, particularly in patient age distribution and duration of dialysis. Key Messages: The mean age of prevalent dialysis patients is rising every year in Japan, and the proportion of patients undergoing dialysis for long periods of time is also increasing. In addition, the proportion of dialysis patients with diabetes, one of the primary diseases, has increased to a level similar to that observed in Western countries. However, no significant decline in the crude death rate among prevalent dialysis patients has been observed in Japan, presumably because of technological advances in dialysis treatment, but further studies are needed to elucidate the contributing factors. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle–brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO2): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO2 ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO2 < 10 mmHg (Group C). Heel blood flow was monitored using tcPO2 sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO2 for the first 10 min, and change in tcPO2 after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO2 for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO2 after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO2 < 10 mmHg might be necessary after loading. [ABSTRACT FROM PUBLISHER]

Background and Aim: Although mucoprotective agents are commonly used against gastric and duodenal lesions in Japan, their availability as agents for non-steroidal anti-inflammatory drug (NSAID)-induced gastrointestinal damage has not been clarified. To investigate the effect of irsogladine maleate (IM) on gastric mucosal blood flow (GMBF) reduction induced by diclofenac sodium, a NSAID commonly used in Japan, by laser Doppler flowmetry (LDF) and ultrasonography (US) in canine stomach. Methods: GMBF was measured by LDF and contrast-enhanced US in 15 beagles. US was performed employing real-time harmonic imaging under low acoustic power after intravenous contrast injection using Definity™ (60 mg/kg). 60 min after insertion of a diclofenac sodium suppository (1.0 mg/kg) into the rectum, LDF and contrast-enhanced US were repeated. The examination was done in a crossover, single-blinded fashion. Results: The mean extent of the change in GMBF in the IM group and in the placebo group was +29.3 and –38%, respectively. Conclusions: IM alleviates the reduction of GMBF induced by diclofenac sodium. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To examine changes in blood flow in the corpus luteum throughout the luteal phase and during early pregnancy. Design: Longitudinal and cross-sectional prospective studies. Setting: University hospital and city general hospital. Patient(s): Sixty-one women with normal menstrual cycles and normal luteal function, 13 women with hCG-induced ovulatory cycle, 10 women with luteal phase defect, six women with luteinized unruptured follicle (LUF), and 17 pregnant women (4-10 weeks of gestation). Intervention(s): Blood-flow impedance in the corpus luteum was assessed by transvaginal color-pulsed Doppler ultrasound. Main Outcome Measures: Resistance index (RI) in the corpus luteum. Result(s): In the normal menstrual cycle, the RI of the preovulatory follicle was high and significantly decreased after ovulation. Luteal-RI further decreased during the early to midluteal phase but significantly increased during the late luteal phase. Those changes in luteal-RI were similar to those of the hCG-induced ovulatory cycle. Luteal-RI during the midluteal phase was significantly higher in the patients with luteal phase defect than in women with normal luteal function. Luteal-RI of the LUF patients remained high throughout the luteal phase. In pregnant women, luteal-RI remained at the midluteal phase level until 7 weeks of gestation and significantly increased thereafter. Conclusion(s): The change in luteal-RI was associated with corpus luteum development and corpus luteum regression. Luteal-RI was closely associated with luteal function. [ABSTRACT FROM AUTHOR]

It is well known that a rotary blood pump (RP) is effective as a small ventricular assist device (VAD). It might be still more effective if pulsation was available. The undulation pump (UP), which is a type of small RP, can also produce pulsation. In Japan, a development project for an implantable type UP ventricular assist device (UPVAD) is now advanced. Six universities and some companies together have been in charge of the development project for 5 years. In this study, the influence which the UP under development has on circulation in internal organs was investigated. Goats with the same weight as an average Asian person were used for the experiment. The left chest cavity was opened after resection of the fourth rib and the heart was approached. A cannula was inserted in the left ventricle from the apex. An outflow cannula was inserted into the left descending aorta. Heart muscle was excised using a newly developed puncher. The UPVAD was implanted using a left-heart bypass system. The myocardial blood flow, carotid arterial blood flow, and the kidney blood flow were recorded together with an electrocardiogram, blood pressure, and the flow rate. In these animal experiments, the blood circulation dynamic state was stabilized and sufficient support of the left heart was observed. Myocardial blood flow, carotid arterial flow, and a kidney blood flow increase resulting from UPVAD support was observed. Often the problem of multiple organ failure is important at the time of clinical application of a ventricular assist device. Assisting circulation to internal organs is important for prevention of multiple organ failure. It was concluded that the UPVAD might be useful for prevention of multiple organ failure. [ABSTRACT FROM AUTHOR]

Objective: To clarify the prevalence and major risk factors of reduced flow volume in lower extremities with normal ankle-brachial index (ABI) in Japanese patients with type 2 diabetes.Research Design and Methods: We recruited 208 consecutive type 2 diabetic patients and 33 age-matched nondiabetic subjects (control group) admitted to our hospital. Thirty-two of the patients had low ABI (<0.90) and intermittent claudication (peripheral arterial disease [PAD] group), and 176 patients had normal ABI (>0.9) (non-PAD group). We evaluated flow volume and resistive index, as an index of arterial resistance to blood flow, at the popliteal artery using gated two-dimensional cine-mode phase-contrast magnetic resonance imaging.Results: Simple linear regression analysis showed a negative correlation between resistive index and total flow volume in the non-PAD group (r = -0.714, P < 0.001). We defined the means +/- 2 SD of these parameters in the control group as the normal range; abnormal resistive index was >1.017, and abnormal flow volume was <50.8 ml/min. The non-PAD group was divided according to the levels of these parameters: 80 patients had both normal resistive index and normal flow volume (normal group); of 96 patients with higher resistive index, 63 had normal flow volume (borderline group) and 33 had reduced flow volume (reduced group). Multiple regression analysis demonstrated that the major risk factors for reduced flow volume were age, hypertension, and diabetic nephropathy (r(2) = 0.303, P < 0.001).Conclusions: The prevalence of patients without PAD with reduced flow volume in the lower extremities was 16% (n = 33) and comparable with that of patients with PAD with intermittent claudication (n = 32), suggesting that increase in arterial resistance to blood flow may be one of the major causes of lower extremity arterial disease in Japan. [ABSTRACT FROM AUTHOR]

Editorial. Highlights the 9th Japanese Congress of the Rotary Blood Pump Society on April 6, 2001 in Tokyo, Japan. Focus on the clinical applications of continuous flow pumps; Application of the continuous devices in heart transplantation; Advantages of the continuous flow devices over pulsatile blood pumps.

Examines the use of radiofrequency ablation therapy and blood flow for the treatment of hepatocellular carcinoma in Japan. Complications of local ablation treatment; Influence of blood flow on the size and shape of ablated lesion; Control of the needle array temperature at 100 to 105 degrees Celsius.

HTLV-I was first described as a pathogenic human retrovirus that causes adult T-cell leukemia (ATL). Soon after the discovery of HTLV-I, an association of this virus with a slowly progressive neurological disorder was found independently in Japan and Caribbean islands, and this new clinical entity (HTLV-I-associated myelopathy with tropical spastic paraparesis) was named HAMJTSP. Autopsy findings clarified the chronic inflammatory nature of the disease. Detailed neuropathological analysis demonstrated: (i) T-cell-dominant mononuclear cell infiltration; (ii) diffuse and symmetrical degeneration of the anterolateral and inner portion of the posterior columns involving both myelin and axons; (iii) the presence of cytotoxic T cells and apoptosis of helper/inducer T cells; (iv) in vivo localization of HTLV-I provirus in the perivascular infiltrated T cells; and (v) accentuation of inflammatory lesions at the site with slow blood flow. From these findings it is suggested that a T-cell-mediated chronic inflammatory process targeting the HTLV-I-infected T cells is the primary pathogenic mechanism of HAM/TSP. [ABSTRACT FROM AUTHOR]

Objective: To find out whether an increased rate of portal venous blood flow after oral intake of glucose could be used to estimate liver function. Design: Prospective study. Setting: University hospital, Japan. Subjects: Sixty patients, of whom 23 had hepatocellular carcinoma and liver cirrhosis, 21 had tumours metastatic to normal liver, and 16 had obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD). Intervention: Portal flow was measured after oral intake of glucose 75g using pulsed-Doppler ultrasonography. Results: The ratio of portal flow 30 minutes after glucose intake to that before intake (PVFR30) was significantly lower in cirrhotic patients than in those with metastases and a normal liver. A PVFR30 of less than 1.5 indicated impaired hepatic function assessed by the Child-Pugh scores, indocyanine green clearance test, prothrombin time, and hepaplastin test. It also indicated less reduction in total bilirubin concentrations in the first week after PTBD. Conclusions: Results suggest that PVFR30 can be used to estimate liver function and predict outcome after PTBD. [ABSTRACT FROM AUTHOR]

Purpose: Although many studies have investigated the optimal anastomotic procedure for the end-to-side (ETS) procedure with a free flap, no study has focused on the size of the arteriotomy. Some surgeons have recently described the effectiveness of ETS with wide arteriotomy, but the postoperative haemodynamics remains unclear for free flaps created using this technique. The aim of this study was to use ultrasonography to evaluate the postoperative blood flow distribution after ETS with a wide arteriotomy in extremity free flap surgery., Methods: We evaluated 20 free flaps in 18 consecutive patients who received an ultrasonographic examination after free flap surgery using the ETS technique with wide arteriotomy for arterial anastomosis. All flaps were examined after surgery and blood flow was calculated for the flap and recipient vessels., Results: All 20 flaps survived, but one flap developed asymptomatic arterial thrombosis and 19 flaps were analysed. For the ETS technique with wide arteriotomy, peripheral circulation was well preserved in all flaps. Comparison of flap types showed that blood flow was significantly higher in myocutaneous flaps than in fasciocutaneous flaps, but there was no significant difference according to the size of the arteriotomy., Conclusions: Given the range of arteriotomy performed using the ETS with a wide arteriotomy technique, the blood flow volume in the flap depended on the type of flap but not on the size of the arteriotomy. A steal phenomenon related to the creation of a wide window in the receipt artery was not found in the analysed retrospective cohort., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

From the measurement of a reflected voltage waveform from a biological body for a step-like voltage waveform, the frequency characteristics of the complex relative permittivity are studied and the following results are obtained: (1) if the blood flow and sweating are normal, the value of tank in the mouth is 4 – 6 at about 10 MHz because electrochemical materials are contained in a large quantity. At frequencies below 100 MHz, the value is larger than those at the face, upper arms, legs and torso and its decrease with respect to frequency is larger. The back of the foot and the thenar have relative permittivities and tanδ's lower than other parts and hence are suitable for measurement of emotion functions; (2) in a physical exercise which causes a change in blood condition without sweating, the value of tanδ in the moving part increases as the number of motions is increased. In addition, the frequency characteristics below 1 GHz change significantly. The value of tanδ in the portion not related to the motion increases even after termination of the motion. Hence, the effect of the exercise can be evaluated from tanδ; and (3) as sweating progresses, the reduction of the permittivity becomes significant at frequencies below 100 MHz while the increase of tanδ is significant below 1 GHz. Hence, the sweating activity can be evaluated from the complex relative permittivity. [ABSTRACT FROM AUTHOR]

Purpose Right ventricular (RV) failure remains a major concern in heart failure (HF) patients undergoing LVAD surgery. We aimed to measure flow kinetic energy (KE) of the RV outflow tract (OT) - a new marker of RV global systolic function - and assess its relationship to well-established echocardiographic and hemodynamic parameters of RV performance in heart failure (HF) and LVAD pts. Methods Twenty-one subjects were prospectively enrolled: 12 HF pts (2 NYHA Class II and 10 Class IV), 3 HeartMate II (HMII) and 6 healthy controls (C). Echocardiographic parameters of RV function (TAPSE, St', Et', IVA, MPI) and RV inflow-outflow color Doppler images were recorded on all pts. Invasive hemodynamic parameters of RV function and RV failure risk score (RVFRS) were collected in all Class IV pts. KE-RVOT was derived from color Doppler images using a vector flow mapping proprietary software, Echo VFM® (Cardio Flow Design, Tokyo, Japan) (Figure). Kruskal-Wallis test was performed for comparison of each group. Correlation between KE-RVOT and echocardiographic/hemodynamic parameters as well as RVFRS was assessed by linear regression analysis. Results KERVOT (Median ± IQR) was higher in C (56.98 [37.63 to 97.21] mW/m) than in Class II HF (26.60 [26.14 to 27.05] mW/m, p <0.05) and further declined in Class IV HF (7.45 [4.87 to 10.46] mW/m, p <0.05)). LVAD therapy partially restored KE-RVOT (23.17 [9.77 to 25.03] mW/m, p <0.05)) to levels similar to Class II HF (Figure). KE-RVOT was significantly related to TAPSE, St', CVP/PCWP, and PAPi (r = 0.5887, 0.6671, -0.6942, and 0.7899, respectively, all p <0.05) but not to RVFRS. Conclusion KE-RVOT, a novel noninvasive measure of RV function, strongly correlates with well-established markers of RV performance. The utility of KE-RVOT in prediction of RV failure post LVAD requires further study. [ABSTRACT FROM AUTHOR]

Predictive modeling of blood flow and pressure have numerous applications ranging from non-invasive assessment of functional significance of disease to planning invasive procedures. While several such predictive modeling techniques have been proposed, their use in the clinic has been limited due in part to the significant time required to perform virtual interventions and compute the resultant changes in hemodynamic conditions. We propose a fast hemodynamic assessment method to aid in interventional planning based on first constructing an exploration space of geometries, tailored to each patient, and subsequently building a physics driven reduced order model in this space. We demonstrate that this method can predict fractional flow reserve derived from coronary computed tomography angiography in response to changes to a patient-specific lumen geometry in real time while achieving high accuracy when compared to computational fluid dynamics simulations. We validated this method on over 1300 patients that received a coronary CT scan and demonstrated a correlation coefficient of 0.98 with an error of 0. 005 ± 0. 015 (95% CI: (-0.020, 0.031)) as compared to three-dimensional blood flow calculations. This technology is implemented in a product that has received clearance by the U.S. Food and Drug Administration and is being used clinically to enable physicians to predict changes in blood flow resulting from removal of coronary stenoses as might occur with percutaneous coronary interventions. This technology is also cleared for use in Japan and pending regulatory approval in Europe. • A patient-specific reduced order model (PSROM) was developed and validated. • The method was demonstrated to be equivalent to CFD simulations. • The method is implemented in a product that is cleared by the FDA. • Good comparison was demonstrated against invasive clinical data. [ABSTRACT FROM AUTHOR]

CLBS12 (autologous, mobilized peripheral blood derived selected CD34 cells) has previously been studied for the treatment of No-Option Critical Limb Ischemia (NOCLI) in Phase 1 and 2 studies in Japan and the United States. These studies demonstrated statistically significant improvement in key outcome measures including reduced Rutherford category, improved walking distance, reduction in pain, improvement in blood flow and tissue oxygenation, reduction in size and number of ulcers, and improved amputation-free survival. In one of the Japan studies, more than 80% of subjects treated with a single administration of CD34 cells became CLI-free and maintained this status through 4 years of observation. The promising results of these studies led to discussions with the PMDA regarding the design of a confirmatory study that, with a favorable outcome, could support registration of CLBS12 in Japan for NOCLI under the new regenerative medicine regulations. The study is a prospective, randomized clinical trial in subjects with arteriosclerosis obliterans (ASO; n=30) or Buerger's Disease (BD; n=5). All patients receive standard-of-care treatment (SOC). The study calls for randomization of 30 subjects with ASO to receive either CLBS12 or to continue with SOC alone. Additionally, 5 subjects with BD were to be allocated to a sub-study and receive CLBS12 while continuing SOC treatment. The primary endpoint for the study is ability to achieve a continuous CLI-free state. Other key measures include progression-free, amputation-free, and overall survival; Rutherford category; tissue oxygenation; blood flow; ulcer size, depth, and infection; pain; and quality-of-life. For preparation of CLBS12, subjects are mobilized with GCSF 5 µg/day for 5 days, then undergo apheresis to collect a mononuclear cell fraction. CD34 cells are separated using a magnetic separation method. CLBS12 is formulated as a cell suspension in proprietary media in a 10 mL volume for administration as a series of 20 intramuscular injections in one affected limb. The study was initiated in December 2017 and is expected to be completed in 2020. The BD sub-study has enrolled 6 subjects and half have achieved a continuous CLI-free state. Interim data from the trial will be presented. [ABSTRACT FROM AUTHOR]

Background: During aging, a significant loss of muscle mass, strength, and power is associated with a decline in daily functional capacities. Traditionally, resistance training is prescribed to prevent or reverse the skeletal muscle weakness, but the required training intensity may be too demanding for older people with poor physical performance. Resistance exercise with blood flow moderation (KAATSU training), originally developed in Japan, combines resistance exercise with blood flow restriction. It has been reported that KAATSU training enhances muscle hypertrophy in many populations. However, few studies have evaluated the effects of resistance exercises with blood flow restriction in elderly people and how this affects vascular structure and function. Objective: The aim of this study was to evaluate (1) the acute and chronic effects of resistance exercise with blood flow restriction on vascular health in elderly people with low gait speed and (2) whether low-load resistance training with blood flow restriction elicits similar strength and gait speed gains to those elicited by conventional resistance training without blood flow restriction. Methods: This is an ongoing randomized controlled trial in elderly people with low gait speed. Overall, two study arms of 13 participants each perform resistance exercise with and without blood flow restriction. The 2 groups are as follows: the control group will perform conventional resistance exercise (60% of 1 repetition maximum) and the KAATSU group will perform the low-load resistance exercise with blood flow restriction (20% of 1 repetition maximum) for 12 weeks. Pulse wave velocity, venous occlusion plethysmography, and flow-mediated dilation are used to assess arterial stiffness, muscle blood flow, and endothelial function, respectively. The secondary outcomes are gait speed, strength, and quality of life. All measures will be performed before and after the training program. Results: This research study is in progress. Recruitment has started, and data collection is expected to finish in August 2020. Conclusions: The findings of this study will have important implications for the rehabilitation of elderly people. Trial Registration: ClinicalTrials.gov NCT03272737; https://clinicaltrials.gov/ct2/show/NCT03272737 International Registered Report Identifier (IRRID): DERR1-10.2196/14691 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Background: Diverticula in the internal auditory canal (IAC) have been reported in ears with otosclerosis., Objective: We evaluated hearing levels and vascular activity in ears with otosclerosis with and without IAC diverticula and clarify the significance of IAC diverticula., Materials and Methods: Sixty-one ears from 54 patients who underwent stapes surgery for otosclerosis [fenestral (48 ears) and retrofenestral (13 ears) groups] were included in the present study. Preoperative hearing levels on pure tone audiometry (PTA) and intraoperative measurements of blood flow were compared between the groups., Results: A total of 24 of 61 ears (39.3%) showed IAC diverticula, significantly higher than the frequency in ears without otosclerosis (3.7%). No significant differences in air- and bone-conduction thresholds on PTA were evident between ears with and without IAC diverticula in each group. Ears without IAC diverticula tended to show higher blood flow in the area anterior to the oval window than ears with IAC diverticula, but the difference was not significant., Conclusions: The incidence of the IAC diverticula in otosclerosis was significantly higher than in cases without otosclerosis. The existence of IAC diverticula was not evidently related to the severity of the disease from the perspective of hearing level and vascular activity.

Purpose: To investigate the relationship between the choroidal thickness and choroidal blood flow in healthy young subjects. Design: Retrospective, cross-sectional study. Methods: We examined 25 eyes of 25 healthy young Japanese subjects. The subfoveal choroidal thickness was measured by enhanced depth imaging optical coherence tomography (EDI-OCT). The total choroidal blood flow and subfoveal choroidal blood flow were evaluated by pulsatile ocular blood flow using Langham OBF computerized tonometry and the choroidal blood flow using laser Doppler flowmetry. The refractive error, intraocular pressure, and axial length were also measured. Results: The mean refractive error was −3.4 ± 3.1 diopters, mean intraocular pressure 15.3 ± 1.7 mm Hg, and axial length 25.4 ± 2.0 mm. The subfoveal choroidal thickness was correlated positively (r = 0.785, P < .01) with the refractive error and negatively (r = −0.735, P < .001) with the axial length. No significant correlation was found between the subfoveal choroidal thickness and the pulsatile ocular blood flow or choroidal blood flow. Conclusion: Our results suggested that there were no significant correlations between the subfoveal choroidal thickness and the total choroidal blood flow and the subfoveal choroidal blood flow in healthy young subjects; however, decreased subfoveal choroidal thickness was associated with decreased refractive error and axial length. [ABSTRACT FROM AUTHOR]

The article offers information on a study conducted by Noriaki Harada of the Department of Hygiene at the Yamaguchi University School of Medicine in Ube, Japan regarding digital circulation in palmar and dorsal skin that have been induced by short-term vibration. It indicates the measurement of the finger blood flow (FBF) and finger skin temperature from the palmar and dorsal regions. The study shows the different impact of vibration on the digital circulation in palmar and dorsal skin.