405 results on '"Masahiro Kohzuki"'
Search Results
2. Factors associated with quality of life in patients receiving lung transplantation: a cross-sectional study
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Ryo Takahashi, Tamao Takahashi, Yoshinori Okada, Masahiro Kohzuki, and Satoru Ebihara
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Respiration Disorders ,Lung Transplantation ,Quality of Life ,Respiratory Function Tests ,Exercise Tolerance ,Dyspnea ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background With improved prognosis after lung transplantation (LTx), improving health-related quality of life (HRQL) in patients who have undergone LTx is a key goal. Although HRQL is improved significantly after transplantation, it is poorer than that in ordinary healthy people. However, the factors associated with poor HRQL remain unclear. This cross-sectional study aimed to identify the factors associated with poor HRQL in patients who have undergone LTx. Methods Between December 2018 and May 2022, 80 patients who had undergone LTx completed St. George’s Respiratory Questionnaire (SGRQ) as a disease-specific quality of life measure, the Short Form-12 (SF-12) as a generic quality of life measure, and modified Medical Research Council (mMRC) scale of dyspnea. The groups were assigned according to the median SGRQ-total score and the Japanese population standard for SF-12, and those with good HRQL were compared with those with poor HRQL. Independent factors were evaluated using multivariate analysis. Results With regard to the SGRQ, there were significant differences in the forced expiratory volume in 1 s (FEV1) (P = 0.041), use of bronchodilators (P = 0.026), 6-min walk distance (6MWD) (P
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- 2023
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3. Recovery of physical function in lung transplant recipients with sarcopenia
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Etsuhiro Nikkuni, Takashi Hirama, Kazuki Hayasaka, Sakiko Kumata, Shinichi Kotan, Yui Watanabe, Hisashi Oishi, Hiromichi Niikawa, Masahiro Kohzuki, and Yoshinori Okada
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Lung transplant ,Sarcopenia ,Erector spine muscle (ESM) ,Hand-grip ,Six-min walk distance (6MWD) ,Muscle ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background Lung transplant (LTX) can provide a survival benefit and improve physical function for selected patients with advanced pulmonary disease. Sarcopenia is a systemic muscle-failure that can be found in a variety of life stages and disabilities. In this study, we follow the evolution of each variable defined in sarcopenia and the outcomes in LTX recipients with post-transplant sarcopenia. Methods Patients who underwent LTX at Tohoku University Hospital between 2013 and 2018 were consecutively included in the retrospective cohort study, with follow-up to 2019. Sarcopenia was defined by low muscle mass (the cross-sectional area (CSA) of erector spinae muscle (ESM) in thoracic CT with a threshold
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- 2021
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4. Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study
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Kumi Watanabe, Yuka Kamijo, Mai Yanagi, Yoshitaka Ishibashi, Taku Harada, and Masahiro Kohzuki
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Osteoporosis ,Physical function ,Physical activity ,Fall prevention ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD. Methods Stable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared. Results There was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results. Conclusions Home-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD. Trial registration UMIN Clinical Trials Registry, UMIN000041678 . Registered September 4, 2020; retrospectively registered.
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- 2021
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5. Gliding performance is affected by cranial movement of abdominal organs
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Naoki Yoshida, Hideki Ota, Satoshi Higuchi, Yusuke Sekiguchi, Takaaki Kakihana, Haruka Sato, Tomoyoshi Kimura, Shin-Ichi Izumi, and Masahiro Kohzuki
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Medicine ,Science - Abstract
Abstract Swimming is an extremely popular sport around the world. The streamlined body position is a crucial and foundational position for swimmers. Since the density of lungs is low, the center of buoyancy is always on the cranial side and the center of gravity is always on the caudal side. It has been reported that the greater the distance between the centers of buoyancy and gravity, the swimmer’s legs will sink more. This is disadvantageous to swimming performance. However, the way to reduce the distance between the centers of buoyancy and gravity is yet to be elucidated. Here we show that swimmers with high gliding performance exhibit different abdominal cavity shapes in the streamlined body position, which causes cranial movement of the abdominal organs. This movement can reduce the distance between the centers of buoyancy and gravity, prevent the legs from sinking, and have a positive effect on gliding performance.
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- 2020
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6. Prediction of the development of delirium after transcatheter aortic valve implantation using preoperative brain perfusion SPECT
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Masashi Takeuchi, Hideaki Suzuki, Yasuharu Matsumoto, Yoku Kikuchi, Kentaro Takanami, Toshihiro Wagatsuma, Jun Sugisawa, Satoshi Tsuchiya, Kensuke Nishimiya, Kiyotaka Hao, Shigeo Godo, Tomohiko Shindo, Takashi Shiroto, Jun Takahashi, Kiichiro Kumagai, Masahiro Kohzuki, Kei Takase, Yoshikatsu Saiki, Satoshi Yasuda, and Hiroaki Shimokawa
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Medicine ,Science - Abstract
Objectives Delirium is an important prognostic factor in postoperative patients undergoing cardiovascular surgery and intervention, including transcatheter aortic valve implantation (TAVI). However, delirium after transcatheter aortic valve implantation (DAT) is difficult to predict and its pathophysiology is still unclear. We aimed to investigate whether preoperative cerebral blood flow (CBF) is associated with DAT and, if so, whether CBF measurement is useful for predicting DAT. Methods We evaluated CBF in 50 consecutive patients before TAVI (84.7±4.5 yrs., 36 females) using 99mTc ethyl cysteinate dimer single-photon emission computed tomography. Preoperative CBF of the DAT group (N = 12) was compared with that of the non-DAT group (N = 38) using whole brain voxel-wise analysis with SPM12 and region of interest-based analysis with the easy-Z score imaging system. Multivariable logistic regression analysis with the presence of DAT was used to create its prediction model. Results The whole brain analysis showed that preoperative CBF in the insula was lower in the DAT than in the non-DAT group (PConclusions These results suggest that preoperative CBF in the insula is associated with DAT and may be useful for its prediction.
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- 2022
7. Exercise Training Ameliorates Renal Oxidative Stress in Rats with Chronic Renal Failure
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Seiko Yamakoshi, Takahiro Nakamura, Lusi Xu, Masahiro Kohzuki, and Osamu Ito
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exercise ,chronic renal failure ,oxidative stress ,NADPH oxidase ,xanthine oxidase ,Microbiology ,QR1-502 - Abstract
In patients with chronic kidney disease, exercise training with moderate intensity protects renal function and improves mortality. However, the mechanisms of the renal protective effects of exercise training in chronic kidney disease have not been clarified. This study investigated the effects of exercise training on renal NADPH oxidative and xanthine oxidase, which are major sources of reactive oxygen species, in rats with chronic renal failure. Six-week-old, male Sprague–Dawley rats were divided into the sham operation, 5/6 nephrectomy (Nx)+ sedentary, and Nx+ exercise training groups. The Nx+ exercise training group underwent treadmill running. After 12 weeks, systolic blood pressure, renal function, malondialdehyde, renal NADPH oxidase, and xanthine oxidase were examined. Nx induced hypertension, proteinuria, and renal dysfunction, and exercise training attenuated these disorders. Although the plasma levels of malondialdehyde were not different among the group, urinary levels were increased by Nx and decreased by exercise training. Renal activity and expression of NADPH oxidase and xanthine oxidase were increased by Nx and decreased by exercise training. These results indicate that exercise training attenuates hypertension and renal dysfunction and ameliorates NADPH oxidase and xanthine oxidase in rats with chronic renal failure, suggesting that the reduction of reactive oxygen species generation may be involved in the renal protective effects of exercise training.
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- 2022
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8. Clinical practice guideline for renal rehabilitation: systematic reviews and recommendations of exercise therapies in patients with kidney diseases
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Kunihiro Yamagata, Junichi Hoshino, Hitoshi Sugiyama, Norio Hanafusa, Yugo Shibagaki, Yasuhiro Komatsu, Tsuneo Konta, Naohiko Fujii, Eiichiro Kanda, Tadashi Sofue, Kiyonobu Ishizuka, Masashi Kitagawa, Keiji Kono, Norikazu Hinamoto, Takayuki Miyai, Kiyomi Koike, Susumu Toda, Jumpei Hasegawa, Masayuki Yamanouchi, Ryuichi Yoshimura, Ryota Ishii, Shunsuke Goto, Hiroo Kawarazaki, Kentaro Takase, Fumika Taki, Mimiko Matsumura, Yoshihiko Raita, Satoko Sakurai, Tatsuya Shimizu, Suguru Yamanoto, Takehiko Kawaguchi, Hideyo Oguchi, Makoto Tsujita, Masahiko Yazawa, Akiko Uchida, Yasuhiro Ando, Satoru Kaneko, Atsuhiko Matsunaga, Taku Harada, Osamu Ito, and Masahiro Kohzuki
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Renal rehabilitation ,Exercise therapy ,CKD ,Dialysis ,Transplantation ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract In recent years, a concept of renal rehabilitation has become widely known among nephrology specialists, dialysis specialists, kidney transplantation specialists, rehabilitation specialists, nutrition specialists, guideline specialists, nurses, physiotherapists, and representatives of patients. Therefore, in order to make it clear the definition, methods, and effectiveness of renal rehabilitation in Japan, we launched Renal Rehabilitation Guideline Preparation Committee in 2016 as a part of works in the Japanese Society of Renal Rehabilitation, and created a guideline in accordance to the “Minds Handbook for Clinical Practice Guideline Development 2014”. Here, we report systematic reviews and recommendations of exercise therapies in patients with kidney diseases based on the guideline preparation committee works. Six recommendations for the condition of each kidney disorder, groups addressing nephritis/nephrosis, chronic kidney diseases, dialysis therapy, and kidney transplantation were created. All the recommendation grades were determined by a consensus conference participated in by representatives of patients and various professionals. The purpose of this report is to provide an evidence-based, best practice summary to optimize the quality, safety and efficacy, and availability of renal rehabilitation service, and to provide care for maximum patient prognosis, quality of life, and satisfaction.
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- 2019
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9. The area under curve for time-course analysis parameters is associated with abdominal aortic aneurysms and the severity of peripheral artery disease in men
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Nao Konno, Taku Harada, Daijirou Akamatsu, Hitoshi Goto, Takashi Miki, Takashi Kamei, and Masahiro Kohzuki
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Flow-mediated vasodilation ,Nitroglycerin-mediated vasodilation ,Peripheral artery disease ,Abdominal aortic aneurysm ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Abdominal aortic aneurysm (AAA) and peripheral artery disease (PAD) are associated with vascular endothelial dysfunction. To date, flow-mediated vasodilatation (FMD) and nitroglycerin-mediated vasodilatation (NMD) have been used to evaluate vascular function. Recently, parameters of time-course analysis have been proposed as useful evaluations for arteriosclerotic diseases. In this study, the correlation between the parameters of time-course analysis, to the degree of vascular endothelial damage in AAA and PAD, together with their applicability as a vascular function test, was investigated. Methods: Brachial artery vasoreactivity was assessed in male patients with AAA (n = 150) and PAD (n = 50). The percentage change in peak diameters (ΔFMD and ΔNMD), the time to diameter change, the time to peak diameter from the diameter change, the blood flow decay time constant, the area under the curve (AUC), the maximum dilation rate and the extended time constant were measured. Results: Among the groups of aneurysm diameter in AAA, the FMD-AUC was highly different (p = .01), while the ΔFMD was not significantly different (p = .36). Among the Fontaine stages in PAD, the FMD-AUC was inversely associated with severity (p = .01) although the ΔFMD was not significantly different (p = .71). Among the Fontaine stages, the NMD-AUC was also inversely associated with severity (p = .03) although the ΔNMD was not significantly different (p = .11). Conclusion: This study suggests that FMD-AUC and NMD-AUC are useful for estimating vascular endothelial and vascular smooth muscle dysfunction, serving as supplementary markers for the diagnosis and evaluation of PAD and AAA.
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- 2021
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10. Effects of Adachi Rehabilitation Programme on older adults under long-term care: A multi-centre controlled trial.
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Yoshihiko Baba, Chika Ooyama, Yasushi Tazawa, and Masahiro Kohzuki
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Medicine ,Science - Abstract
ObjectivesWe developed the Adachi Rehabilitation Programme (ARP), a community rehabilitation program. Under the supervision of professional caregivers, older adults cleaned and planted flowers in the park and they walked and shopped in the community. We examined the effects of ARP on individuals receiving small-group multifunctional at-home care at community facilities.MethodsThis was a multi-centre controlled trial at thirteen small multifunctional at-home care facilities in Adachi, Tokyo. The primary outcomes of the study were daily step counts and timed up & go (TUG). Secondary outcomes included gait speed, step length, Barthel Index for Activities of Daily Living, Functional Independence Measure, Mini-Mental State Examination (MMSE) and EuroQOL 5 Dimension.ResultsNinety-six individuals at thirteen small multifunctional at-home care facilities were recruited for participation in December 2017. They were allocated to intervention (38) and control (40) groups. The average daily step count of the control group decreased from 852 to 727, but it increased by approximately 650 steps, from 990 to 1635, for the intervention group. Average TUG decreased from 16.1 s to 14.0 s and MMSE score increased from 15.9 to 16.3 for the intervention group, but a significant interaction was not found. On non-intervention home days, the daily step counts of the intervention group increased significantly from 908 steps to 1485 steps, while those of the control group decreased from 865 steps to 722 steps.ConclusionsARP may have effectively increased the physical activity of older adults under long-term care by increasing motivation and changing behaviour.
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- 2021
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11. Effects of exercise training on physical activity in heart failure patients treated with cardiac resynchronization therapy devices or implantable cardioverter defibrillators
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Hidetoshi Yanagi, Harumi Konishi, Saori Yamada, Kazufumi Kitagaki, Michio Nakanishi, Taku Harada, and Masahiro Kohzuki
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exercise ,defibrillator ,heart failure ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Objective: This study elucidated the effects of exercise training on physical activity, 6-min walk distance, and all-cause hospitalization rates in patients with chronic heart failure, and evaluated factors contributing to changes in physical activity. Design: Prospective cohort observational study. Patients and methods: Patients (n =62) who completed an exercise training programme after implantable cardioverter-defibrillator or cardiac resynchronization therapy treatment between May 2017 and May 2018 were included. Patients exercised for 20–50 min 3–5 times weekly for 3 months and were assigned to the active (≥ 10 min/day) or non-active (
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- 2020
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12. Combination of Exercise Training and SOD Mimetic Tempol Enhances Upregulation of Nitric Oxide Synthase in the Kidney of Spontaneously Hypertensive Rats
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Pengyu Cao, Osamu Ito, Daisuke Ito, Rong Rong, Yang Zheng, and Masahiro Kohzuki
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Both exercise training (Ex) and superoxide dismutase (SOD) mimetic tempol have antihypertensive and renal protective effects in rodent models of several hypertensions. We recently reported that Ex increases nitric oxide (NO) production and the expression levels of endothelial and neuronal NO synthase (eNOS and nNOS) in the kidney and aorta of the spontaneously hypertensive rats (SHR) and normotensive Wistar–Kyoto rats (WKY). We also found that endogenous hydrogen peroxide (H2O2) upregulates the expression levels of eNOS and nNOS in SHR. To elucidate the mechanism of the Ex-upregulated NO system in the kidney, we examined the additive effect of Ex and tempol on the renal NO system in SHR and WKY. Our data showed that, in SHR, both Ex and tempol increase the levels of H2O2 and nitrate/nitrite (NOx) in plasma and urine. We also observed an increased renal NOS activity and upregulated expression levels of eNOS and nNOS with decreased NADPH oxidase activity. The effects of the combination of Ex and tempol on these variables were cumulate in SHR. On the other hand, we found that Ex increases these variables with increased renal NADPH oxidase activity, but tempol did not change these variables or affect the Ex-induced upregulation in the activity and expression of NOS in WKY. The SOD activity in the kidney and aorta was activated by tempol only in SHR, but not in WKY; whereas Ex increased SOD activity only in the aorta in both SHR and WKY. These results indicate that Ex-induced endogenous H2O2 produced in the blood vessel and other organs outside of the kidney may be carried to the kidney by blood flow and stimulates the NO system in the kidney.
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- 2020
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13. Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial
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Misa Miura, Aki Hirayama, Shigeru Oowada, Akihito Nishida, Chie Saito, Kunihiro Yamagata, Osamu Ito, Yo Hirayama, and Masahiro Kohzuki
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Elderly hemodialysis patients ,Lower limb electrical stimulation ,Aerobic exercise ,Hemodialysis sessions ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Decreased physical activity in hemodialysis (HD) patients causes various structural, metabolic, and functional abnormalities due to uremic changes in skeletal muscles. Electrical stimulation (ES) of the lower limbs was found to be effective in patients with cardiac insufficiency for exercise tolerance. This study compared the effects of ES and variable load ergometers on the lower limbs in HD patients. Methods We performed a prospective, double-center, open-label, randomized controlled trial. Eligible patients were aged over 65 years, had end-stage renal disease, and underwent maintenance HD. The primary endpoint was muscle power, and the secondary endpoints included changes in dialysis efficiency, serum phosphorus, and inflammatory markers. Thirty HD outpatients were randomly assigned to the following groups: exercise (EX), ES, or control (SED). In EX and ES groups, patients were instructed to exercise twice a week for 12 weeks, depending on their physical capabilities. The safety and efficacy of aerobic training and ES during HD were confirmed when a sudden decrease in blood pressure or any other side effects did not occur. A repeated measures analysis of variance was performed as the principal method to evaluate time (baseline vs. 12 weeks) and group (EX vs. ES vs. SED) comparisons for the experimental outcomes. Results The efficiency of HD significantly increased in the ES and EX groups (p ≤ 0.02). Moreover, the ES group experienced a significant increase in muscle power (p = 0.01) and the weight bearing index (p = 0.04) and a significant decrease in serum phosphorus level (p = 0.04) and tumor necrosis factor-alpha (TNF-α) level (p = 0.04) from baseline to 12 weeks. Furthermore, there was a significant increase in serum TNF-α level (p ≤ 0.03) over time in both the EX and SED groups. Conclusion The safety and efficacy of aerobic training and ES during HD were confirmed when a sudden decrease in blood pressure or any other side effects did not occur. Therefore, ES may improve the patient’s condition, similar to lower limb exercises, and ES should be considered as an option for rehabilitation programs in HD patients. Trial registration UMIN Clinical Trials Registry (UMIN-CTR R 000032202); retrospectively registered on April 11, 2018
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- 2018
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14. Association between physical activity and change in renal function in patients after acute myocardial infarction.
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Toshimi Sato, Masahiro Kohzuki, Masahiro Ono, Mitsuru Muto, Taku Osugi, Keiichi Kawamura, Wakako Naganuma, Masayuki Sato, and Namiko Shishito
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Medicine ,Science - Abstract
BackgroundCombined renal dysfunction worsens the subsequent prognosis in patients after acute myocardial infarction (AMI). Therefore, establishing a therapeutic modality to maintain or improve renal function in AMI patients is necessary. This study aimed to elucidate the association between physical activity level and change in renal function in such patients.DesignProspective and observational study.MethodsWe enrolled 41 patients (35 men; average age, 67.5 ± 12.6 years) after AMI onset. Blood biochemistry, urinalysis, and physical function tests were conducted at discharge and 3 months after discharge. Renal function was evaluated based on cystatin C based-estimated glomerular filtration rate (eGFRcys). The number of steps was recorded for 3 months post-discharge. Generalized estimating equations (GEE) was used to test the association between physical activity level and within-patient changes in eGFRcys.ResultsPatients were stratified into low (n = 21; number of steps, 2335 ± 1219 steps/day) and high groups (n = 20; number of steps, 7102 ± 2365 steps/day). eGFRcys significantly increased from baseline to after 3 months in the high group (76.5 ± 13.8 to 83.2 ± 16.0 mL/min/1.73 m2, q = 0.004), whereas no significant change was observed in the low group (65.1 ± 15.9 to 62.2 ± 20.2 mL/min/1.73 m2, q = 0.125). Result of GEE adjusted for potential confounding variables showed a significant positive association between physical activity level and within-patient changes in eGFRcys (p = 0.003). Changes in eGFRcys was -2.9 mL/min/1.73 m2 among low group versus +6.7 mL/min/1.73 m2 among high group.ConclusionsPhysical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI.
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- 2019
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15. Cost-Effectiveness of Cardiac Rehabilitation in Patients with Coronary Artery Disease: A Meta-Analysis
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Tomoyuki Takura, Nozomi Ebata-Kogure, Yoichi Goto, Masahiro Kohzuki, Masatoshi Nagayama, Keiko Oikawa, Teruyuki Koyama, and Haruki Itoh
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background. Medical costs associated with cardiovascular disease are increasing considerably worldwide; therefore, an efficacious, cost-effective therapy which allows the effective use of medical resources is vital. There have been few economic evaluations of cardiac rehabilitation (CR), especially meta-analyses of medical cost versus patient outcome. Methods. The target population in this meta-analysis included convalescent and comprehensive CR patients with coronary artery disease (CAD), the status most commonly observed postmyocardial infarction (MI). Here, we evaluated medical costs, quality-adjusted life year (QALY), cost-effectiveness, mortality, and life year (LY). Regarding cost-effectiveness analysis, we analyzed medical costs per QALY, medical costs per LY, and the incremental cost-utility ratio (ICUR). We then examined the differences in effects for the 2 treatment arms (CR vs. usual care (UC)) using the risk ratio (RR) and standardized mean difference (SMD). Results. We reviewed 59 studies and identified 5 studies that matched our selection criteria. In total, 122,485 patients were included in the analysis. Meta-analysis results revealed that the CR arm significantly improved QALY (SMD: −1.78; 95% confidence interval (CI): −2.69, −0.87) compared with UC. Although medical costs tended to be higher in the CR arm compared to the UC arm (SMD: 0.02; 95% CI: −0.08, 0.13), cost/QALY was significantly improved in the CR arm compared with the UC arm (SMD: −0.31; 95% CI: −0.53, −0.09). The ICURs for the studies (4 RCTs and 1 model analysis) were as follows: −48,327.6 USD/QALY; −5,193.8 USD/QALY (dominant, CR is cheaper and more effective than UC); and 4,048.0 USD/QALY, 17,209.4 USD/QALY, and 26,888.7 USD/QALY (
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- 2019
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16. Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial
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Min-Ji Kim, Chang-Wan Han, Kyoung-Youn Min, Chae-Yoon Cho, Chae-Won Lee, Yoshiko Ogawa, Etsuro Mori, and Masahiro Kohzuki
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Alzheimer’s disease ,Physical activity ,Nonpharmacologic treatment ,Cognition ,Neurology. Diseases of the nervous system ,RC346-429 ,Geriatrics ,RC952-954.6 - Abstract
Aims: This study aimed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program (MCP) on the cognitive function of older adults with moderate to severe Alzheimer's disease (AD). Methods: We included 33 participants with AD in a 6-month randomized controlled trial. The intervention group participated in physical exercise and received a MCP. The control group received only the MCP. Before and after the intervention, cognitive outcomes were assessed using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog), Mini-Mental State Examination, and the Clock Drawing Test. Physical performance was evaluated by exercise time, the number of pedal rotation, total load, grip strength, and the Berg Balance Scale (BBS). Results: In all cognitive measures, there were no significant improvements between the two groups after 6 months in the baseline value-adjusted primary analysis. However, the ADAS-cog score was significantly lower between the two groups in secondary analysis adjusted for baseline value, age, sex, and education years. All physical outcomes were significantly higher in the intervention group except for total load compared with baseline measurements. Conclusion: This study indicates that it is possible to improve cognitive function in older adults with moderate to severe AD through 6-month physical exercise with a multicomponent cognitive intervention.
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- 2016
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17. Music Attenuated a Decrease in Parasympathetic Nervous System Activity after Exercise.
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Tiantian Jia, Yoshiko Ogawa, Misa Miura, Osamu Ito, and Masahiro Kohzuki
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Medicine ,Science - Abstract
Music and exercise can both affect autonomic nervous system activity. However, the effects of the combination of music and exercise on autonomic activity are poorly understood. Additionally, it remains unknown whether music affects post-exercise orthostatic tolerance. The aim of this study was to evaluate the effects of music on autonomic nervous system activity in orthostatic tolerance after exercise. Twenty-six healthy graduate students participated in four sessions in a random order on four separate days: a sedentary session, a music session, a bicycling session, and a bicycling with music session. Participants were asked to listen to their favorite music and to exercise on a cycle ergometer. We evaluated autonomic nervous system activity before and after each session using frequency analysis of heart rate variability. High frequency power, an index of parasympathetic nervous system activity, was significantly increased in the music session. Heart rate was increased, and high frequency power was decreased, in the bicycling session. There was no significant difference in high frequency power before and after the bicycling with music session, although heart rate was significantly increased. Additionally, both music and exercise did not significantly affect heart rate, systolic blood pressure or also heart rate variability indices in the orthostatic test. These data suggest that music increased parasympathetic activity and attenuated the exercise-induced decrease in parasympathetic activity without altering the orthostatic tolerance after exercise. Therefore, music may be an effective approach for improving post-exercise parasympathetic reactivation, resulting in a faster recovery and a reduction in cardiac stress after exercise.
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- 2016
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18. Cognitive Dysfunction and Malnutrition Are Independent Predictor of Dysphagia in Patients with Acute Exacerbation of Congestive Heart Failure.
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Junichi Yokota, Yoshiko Ogawa, Shinsuke Yamanaka, Yoshimi Takahashi, Hiroshi Fujita, Nobuhiro Yamaguchi, Noriko Onoue, Takeshi Ishizuka, Tsuyoshi Shinozaki, and Masahiro Kohzuki
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Medicine ,Science - Abstract
Early detection and intervention for dysphagia is important in patients with congestive heart failure (CHF). However, previous studies have focused on how many patients with dysphagia develop CHF. Studies focusing on the comorbidity of dysphagia in patients with CHF are rare. Additionally, risk factors for dysphagia in patients with CHF are unclear. Thus, the aim of this study was to clarify risk factors for dysphagia in patients with acute exacerbation of CHF. A total of 105 patients, who were admitted with acute exacerbation of CHF, were enrolled. Clinical interviews, blood chemistry analysis, electrocardiography, echocardiography, Mini-Mental State Examination (MMSE), exercise tolerance tests, phonatory function tests, and evaluation of activities of daily living (ADL) and nutrition were conducted on admission. After attending physicians permitted the drinking of water, swallowing screening tests were performed. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (non-DG) based on Functional Oral Intake Scale level. Among the 105 patients, 38 had dysphagia. A greater number of patients had history of aspiration pneumonia and dementia, and there was a higher age, N-terminal pro-B-type natriuretic peptide level in the DG compared with the non-DG. MMSE scores, exercise tolerance, phonatory function, status of ADL, nutrition, albumin, and transthyretin were lower in the DG compared with the non-DG. In multivariate analysis, after adjusting for age and sex, MMSE, BI score, and transthyretin was independently associated with dysphagia. Comorbidity of dysphagia was 36.1% in patients with acute exacerbation of CHF, and cognitive dysfunction and malnutrition may be an independent predictor of dysphagia.
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- 2016
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19. Sensory Stimulation to Improve Swallowing Reflex and Prevent Aspiration Pneumonia in Elderly Dysphagic People
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Satoru Ebihara, Masahiro Kohzuki, Yasunori Sumi, and Takae Ebihara
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Therapeutics. Pharmacology ,RM1-950 - Abstract
Morbidity and mortality from aspiration pneumonia continues to be a major health problem in the elderly. A swallowing disorder, such as a delayed triggering of the swallowing reflex, exists in patients with aspiration pneumonia. We found that the swallowing reflex in elderly people was temperature-sensitive. The swallowing reflex was delayed when the temperature of the food was close to body temperature. The actual swallowing time shortened when the temperature difference increases. The improvement of swallowing reflex by temperature stimuli could be mediated by the temperature-sensitive transient receptor potential (TRP) channel. The administration of a pastille with capsaicin as an agonist stimulus of TRPV1, a warm-temperature receptor, decreased the delay in swallowing reflex. Food with menthol, an agonist of TRPM8, a cold-temperature receptor, also decreased the delay in swallowing reflex. Olfactory stimulation such as black pepper was useful to improve the swallowing reflex for people with low activity of daily living (ADL) levels or with decreased consciousness. Oral care also shortened the latent time of swallowing reflex presumably due to stimulating the nociception of the oral cavity. A combination of these sensory stimuli may improve the swallowing disorders and prevent aspiration pneumonia. Keywords:: elderly, olfactory stimulation, swallowing reflex, drug delivery system, aspiration pneumonia
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- 2011
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20. Chronic Running Exercise Alleviates Early Progression of Nephropathy with Upregulation of Nitric Oxide Synthases and Suppression of Glycation in Zucker Diabetic Rats.
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Daisuke Ito, Pengyu Cao, Takaaki Kakihana, Emiko Sato, Chihiro Suda, Yoshikazu Muroya, Yoshiko Ogawa, Gaizun Hu, Tadashi Ishii, Osamu Ito, Masahiro Kohzuki, and Hideyasu Kiyomoto
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Medicine ,Science - Abstract
Exercise training is known to exert multiple beneficial effects including renal protection in type 2 diabetes mellitus and obesity. However, the mechanisms regulating these actions remain unclear. The present study evaluated the effects of chronic running exercise on the early stage of diabetic nephropathy, focusing on nitric oxide synthase (NOS), oxidative stress and glycation in the kidneys of Zucker diabetic fatty (ZDF) rats. Male ZDF rats (6 weeks old) underwent forced treadmill exercise for 8 weeks (Ex-ZDF). Sedentary ZDF (Sed-ZDF) and Zucker lean (Sed-ZL) rats served as controls. Exercise attenuated hyperglycemia (plasma glucose; 242 ± 43 mg/dL in Sed-ZDF and 115 ± 5 mg/dL in Ex-ZDF) with increased insulin secretion (plasma insulin; 2.3 ± 0.7 and 5.3 ± 0.9 ng/mL), reduced albumin excretion (urine albumin; 492 ± 70 and 176 ± 11 mg/g creatinine) and normalized creatinine clearance (9.7 ± 1.4 and 4.5 ± 0.8 mL/min per body weight) in ZDF rats. Endothelial (e) and neuronal (n) NOS expression in kidneys of Sed-ZDF rats were lower compared with Sed-ZL rats (p
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- 2015
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21. Chronic Kidney Disease is a New Target of Cardiac Rehabilitation
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Masahiro Kohzuki and Osamu Ito
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Chronic heart failure is increasingly prevalent worldwide and is associated with significant morbidity and mortality. The Cochrane review demonstrated that cardiac rehabilitation (CR) resulted in improvements in QOL and a reduction in long-term mortality. Chronic kidney disease (CKD) is another worldwide public health problem. This review focuses on the importance and efficacy of rehabilitation for CKD patients as a new target of CR. Patients with CKD on hemodialysis (HD) have a high mortality rate, with cardiovascular diseases, such as chronic heart failure. A new systematic review and meta-analysis of randomized controlled trials reported that exercise-based renal rehabilitation improved aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and QOL in CKD patients with HD. Moreover, exercise training may have renal protective effects, not only in some animal models of pre-HD CKD, but also in pre-HD CKD patients. Exercise therapy could be an effective clinical strategy in improving renal function, lowering the need for renal replacement therapy, such as HD, and reducing renal transplant risk in pre-HD CKD patients. This led the Ministry of Health, Labor and Welfare of Japan to extend renal rehabilitation partial coverage to stage 4 pre-HD CKD patients for the first time in the world in 2016.
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- 2017
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22. PS-BPB06-4: EXERCISE TRAINING AMELIORATES RENAL OXIDATIVE STRESS IN RATS WITH CHRONIC KIDNEY DISEASE
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Seiko Yamakoshi, Takahiro Nakamura, Nobuyoshi Mori, Masahiro Kohzuki, Takefumi Mori, and Osamu Ito
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Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
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23. Lower-limb Aerobic Exercises Improve Physical Function in Frail Older Adults
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Chaeyoon CHO, Chaewon LEE, and Masahiro KOHZUKI
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General Medicine - Published
- 2023
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24. Overview:Diabetes Mellitus, Disability, and Rehabilitation Medicine
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Masahiro Kohzuki
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General Medicine - Published
- 2022
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25. Rehabilitation for Multimorbidity and Multiple Disabilities(MMD)
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Masahiro Kohzuki
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General Medicine - Published
- 2022
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26. Rehabilitation Medicine in Renal Transplantation
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Keisuke Obata and Masahiro Kohzuki
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- 2022
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27. Effects of Exercise Training on the Renin–Angiotensin System in the Kidneys of Dahl Salt-Sensitive Rats
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AKIHIRO SAKUYAMA, YOSHIKO OGAWA, LUSI XU, MIWA KOMATSU, TAKAHIRO MIURA, ASAKO NAMAI-TAKAHASHI, MASAHIRO KOHZUKI, and OSAMU ITO
- Subjects
Male ,Renin-Angiotensin System ,Rats, Inbred Dahl ,Physical Conditioning, Animal ,Hypertension ,Angiotensinogen ,Animals ,Blood Pressure ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,Kidney ,Rats - Abstract
Exercise training (Ex) has antihypertensive and renal protective effects; however, the precise mechanisms remain unclear. The renal renin-angiotensin system (RAS) plays a vital role in renal function and pathology. Therefore, we investigated the effects of Ex on the renal RAS components in Dahl salt-sensitive (Dahl-S) rats.Male Dahl-S rats were divided into four groups: normal salt diet + sedentary, normal salt diet + Ex, high-salt diet (HS, 8% NaCl) + sedentary, and HS + Ex. Treadmill running was performed for 8 wk in the Ex groups.Ex attenuated the HS-induced renal dysfunction and glomerular injury without causing blood pressure alterations. HS increased urinary excretion of both total and intact angiotensinogen. Ex decreased the HS-induced increased urinary excretion of total angiotensinogen. However, it did not change the HS-induced urinary excretion of intact angiotensinogen, indicating reduced intact angiotensinogen cleaving. Ex restored the HS-induced increased angiotensinogen and angiotensin II type 1 receptor expressions in the outer medulla and the HS-induced increased angiotensin-converting enzyme expression in the cortex. Ex restored the HS-induced decreased renin expression in the cortex and outer medulla, and the HS-induced decreased angiotensin-converting enzyme 2, angiotensin II type 2 receptor, and Mas receptor expressions in the outer medulla.Ex attenuates HS-induced renal dysfunction, glomerular injury, and renal RAS dysregulation in Dahl-S rats.
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- 2022
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28. JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease
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Shigeru, Makita, Takanori, Yasu, Yoshihiro J, Akashi, Hitoshi, Adachi, Hideo, Izawa, Shunichi, Ishihara, Yoshitaka, Iso, Hideo, Ohuchi, Kazuto, Omiya, Yusuke, Ohya, Koichi, Okita, Yutaka, Kimura, Akira, Koike, Masahiro, Kohzuki, Shinji, Koba, Masataka, Sata, Kazunori, Shimada, Tomoki, Shimokawa, Hirokazu, Shiraishi, Naokata, Sumitomo, Tetsuya, Takahashi, Tomoyuki, Takura, Hiroyuki, Tsutsui, Masatoshi, Nagayama, Emiko, Hasegawa, Yoshihiro, Fukumoto, Yutaka, Furukawa, Shin-Ichiro, Miura, Satoshi, Yasuda, Sumio, Yamada, Yuichiro, Yamada, Dai, Yumino, Toshiko, Yoshida, Takuji, Adachi, Toshimi, Ikegame, Kazuhiro P, Izawa, Takeshi, Ishida, Neiko, Ozasa, Naohiko, Osada, Hiroaki, Obata, Naoya, Kakutani, Yusuke, Kasahara, Masaaki, Kato, Kentaro, Kamiya, Shintaro, Kinugawa, Yuji, Kono, Yasuyuki, Kobayashi, Teruyuki, Koyama, Kazuhiro, Sase, Shinji, Sato, Tatsuhiro, Shibata, Norio, Suzuki, Daisuke, Tamaki, Minako, Yamaoka-Tojo, Michio, Nakanishi, Eisaku, Nakane, Mari, Nishizaki, Taiki, Higo, Kanta, Fujimi, Tasuku, Honda, Yasuharu, Matsumoto, Noriko, Matsumoto, Ikuko, Miyawaki, Makoto, Murata, Shusuke, Yagi, Masanobu, Yanase, Midori, Yamada, Miho, Yokoyama, Noboru, Watanabe, Haruki, Ito, Takeshi, Kimura, Syunei, Kyo, Yoichi, Goto, Ryuji, Nohara, and Ken-Ichi, Hirata
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- 2022
29. Rehabilitation for Visceral Impairment:Update
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Masahiro Kohzuki
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medicine.medical_specialty ,Rehabilitation ,Physical medicine and rehabilitation ,business.industry ,medicine.medical_treatment ,medicine ,business - Published
- 2021
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30. Genomics and Internal Medicine & Rehabilitation Science
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Masahiro Kohzuki and Naoki Yoshida
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Medical education ,Rehabilitation ,business.industry ,medicine.medical_treatment ,medicine ,Genomics ,business - Published
- 2021
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31. Evaluation of ADL in Patients with Respiratory and Cardiovascular Disease
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Masahiro Kohzuki and Ryo Takahashi
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,In patient ,Disease ,Respiratory system ,business - Published
- 2021
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32. Exercise intensity of real-time remotely delivered yoga via videoconferencing: Comparison with in-person yoga
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Hisako Miura, Takahiro Miura, Masahiro Kohzuki, Tamao Takahashi, Mina Akizuki, and Satoru Ebihara
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History ,Polymers and Plastics ,Complementary and alternative medicine ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2023
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33. Chronic Exercise Protects against the Progression of Renal Cyst Growth and Dysfunction in Rats with Polycystic Kidney Disease
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Yoichi Sato, Masahiro Kohzuki, Osamu Ito, Takahiro Miura, Lusi Xu, and Jiahe Qiu
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medicine.medical_specialty ,Vasopressin ,CYST GROWTH ,Urinary system ,Physical Exertion ,RENAL PROTECTION ,Renal function ,Physical Therapy, Sports Therapy and Rehabilitation ,Rats, Sprague-Dawley ,Excretion ,Internal medicine ,medicine ,Polycystic kidney disease ,Animals ,Humans ,Orthopedics and Sports Medicine ,Cyst ,Cell Proliferation ,Polycystic Kidney Diseases ,Kidney ,Basic Sciences ,business.industry ,POLYCYSTIC KIDNEY DISEASE ,PCK RATS ,medicine.disease ,Rats ,Disease Models, Animal ,Endocrinology ,medicine.anatomical_structure ,Disease Progression ,CHRONIC EXERCISE ,business ,Kidney disease - Abstract
Introduction Polycystic kidney disease (PKD) is a genetic disorder characterized by the progressive enlargement of renal epithelial cysts and renal dysfunction. Previous studies have reported the beneficial effects of chronic exercise on chronic kidney disease. However, the effects of chronic exercise have not been fully examined in PKD patients or models. The effects of chronic exercise on the progression of PKD were investigated in a polycystic kidney (PCK) rat model. Methods Six-week-old male PCK rats were divided into a sedentary group and an exercise group. The exercise group underwent forced treadmill exercise for 12 weeks (28 m/min, 60 min/day, 5 days/week). After 12 weeks, renal function and histology were examined, and signaling cascades of PKD progression including arginine vasopressin (AVP) were investigated. Results Chronic exercise reduced the excretion of urinary protein, liver-type fatty acid-binding protein, plasma creatinine, urea nitrogen, and increased plasma irisin and urinary AVP excretion. Chronic exercise also slowed renal cyst growth, glomerular damage, and interstitial fibrosis, and led to reduced Ki-67 expression. Chronic exercise had no effect on cAMP content but decreased the renal expression of B-Raf and reduced the phosphorylation of extracellular signal-regulated kinase (ERK), mammalian target of rapamycin (mTOR), and S6. Conclusion Chronic exercise slows renal cyst growth and damage in PCK rats, despite increasing AVP, with down-regulation of the cAMP/B-Raf/ERK and mTOR/S6 pathways in the kidney of PCK rats.
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- 2021
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34. Peak exercise oxygen uptake and changes in renal function in patients after acute myocardial infarction
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Toshimi Sato, Shinichiro Morishita, Masahiro Ono, Yoshinari Funami, Keishi Hayao, Daichi Kusano, and Masahiro Kohzuki
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Pulmonary and Respiratory Medicine ,Oxygen ,Exercise Tolerance ,Oxygen Consumption ,Myocardial Infarction ,Exercise Test ,Humans ,Longitudinal Studies ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,Kidney ,Retrospective Studies - Abstract
The impact of exercise tolerance on renal function change after acute myocardial infarction (AMI) is not clear.The present study aimed to elucidate the effect of peak exercise oxygen uptake (VOThis retrospective longitudinal study enrolled 198 AMI patients. Symptom-limited cardiopulmonary exercise testing was performed at completion of early Phase II cardiac rehabilitation, and peak VOPatients were stratified into tertile groups (Low group, 12.3 ± 1.3 mL/kg/min; Mid group, 15.3 ± 0.7 mL/kg/min; and High group, 19.1 ± 2.3 mL/kg/min) according to peak VOThere was a significant effect of lower peak VO
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- 2022
35. Metformin slows liver cyst formation and fibrosis in experimental model of polycystic liver disease
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Osamu Ito, Takuo Hirose, Jiahe Qiu, Masahiro Kohzuki, Takahiro Miura, Yoichi Sato, and Yasunori Sato
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Male ,medicine.medical_specialty ,Time Factors ,endocrine system diseases ,Physiology ,Enzyme Activators ,AMP-Activated Protein Kinases ,Liver Cirrhosis, Experimental ,Cholangiocyte ,Fibrosis ,Physiology (medical) ,Internal medicine ,medicine ,Animals ,Phosphorylation ,Liver cysts ,Cell Proliferation ,Hepatology ,Cysts ,Activator (genetics) ,Cell growth ,business.industry ,Liver Diseases ,Polycystic liver disease ,digestive, oral, and skin physiology ,Gastroenterology ,nutritional and metabolic diseases ,AMPK ,medicine.disease ,Metformin ,Rats ,Enzyme Activation ,Endocrinology ,Liver ,Disease Progression ,business ,Signal Transduction ,medicine.drug - Abstract
Polycystic liver disease (PLD) is a hereditary liver disease in which the number of cysts increases over time, causing various abdominal symptoms and poor quality of life. Although effective treatment for PLD has not been established, we recently reported that long-term exercise ameliorated liver cyst formation and fibrosis with the activation of AMP-activated protein kinase (AMPK) in polycystic kidney (PCK) rats, a PLD model. Therefore, the aim of this study was to investigate whether metformin, an indirect AMPK activator, was effective in PCK rats. PCK rats were randomly divided into a control (Con) group and a metformin-treated (Met) group. The Met group was treated orally with metformin in drinking water. After 12 wk, liver function, histology, and signaling cascades of PLD were examined in the groups. Metformin did not affect the body weight or liver weight, but it reduced liver cyst formation, cholangiocyte proliferation, and fibrosis around the cyst. Metformin increased the phosphorylation of AMPK and tuberous sclerosis complex 2 and decreased the phosphorylation of mammalian target of rapamycin, S6, and extracellular signal-regulated kinase and the expression of cystic fibrosis transmembrane conductance regulator, aquaporin I, transforming growth factor-β, and type 1 collagen without changes in apoptosis or collagen degradation factors in the liver. Metformin slows the development of cyst formation and fibrosis with the activation of AMPK and inhibition of signaling cascades responsible for cellular proliferation and fibrosis in the liver of PCK rats.
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- 2021
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36. Beneficial effects of exercise training on physical performance in patients with vasospastic angina
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Yasuhiko Sakata, Tomohiko Shindo, Koichi Sato, Masashi Takeuchi, Hideki Ota, Satoshi Tsuchiya, Hiroaki Shimokawa, Mina Akizuki, Shohei Ikeda, Shoko Ohura, Yasuharu Matsumoto, Akira Suda, Yoku Kikuchi, Kei Takase, Kensuke Nishimiya, Masahiro Kohzuki, Takashi Shiroto, Kiyotaka Hao, Jun Sugisawa, Satoshi Miyata, Jun Takahashi, and Kazuma Ohyama
- Subjects
Angina Pectoris, Variant ,medicine.medical_specialty ,Coronary Vasospasm ,Vasodilation ,Perfusion scanning ,030204 cardiovascular system & hematology ,Coronary Angiography ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,parasitic diseases ,medicine ,Humans ,030212 general & internal medicine ,Exercise ,Beneficial effects ,Vasospastic angina ,business.industry ,Blood flow ,Physical Functional Performance ,medicine.disease ,Coronary Vessels ,Coronary arteries ,medicine.anatomical_structure ,Coronary vasospasm ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
In vasospastic angina (VSA), coronary vasomotion abnormalities could develop not only in epicardial coronary arteries but also in coronary microvessels, where calcium channel blockers (CCBs) have limited efficacy. However, efficacy of exercise training for VSA remains to be elucidated. We thus aimed to examine whether vasodilator capacity of coronary microvessels is impaired in VSA patients, and if so, whether exercise exerts beneficial effects on the top of CCBs.We performed 2 clinical protocols. In the protocol 1, we measured myocardial blood flow (MBF) using adenosine-stress dynamic computed tomography perfusion (CTP) in 38 consecutive VSA patients and 17 non-VSA controls. In the protocol 2, we conducted randomized controlled trial, where 20 VSA patients were randomly assigned to either 3-month exercise training group (Exercise group) or Non-Exercise group (n= 10 each).In the protocol 1, MBF on CTP was significantly decreased in the VSA group compared with the Non-VSA group (138 ± 6 vs 166 ± 10 ml/100 g/min, P = 0.02). In the protocol 2, exercise capacity was significantly increased in the Exercise group than in the Non-Exercise group (11.5 ± 0.5 to 15.4 ± 1.8 vs 12.6 ± 0.7 to 14.0 ± 0.8 ml/min/kg, P 0.01). MBF was also significantly improved after 3 months only in the Exercise group (Exercise group, 145 ± 12 to 172 ± 8 ml/100 g/min, P 0.04; Non-Exercise group, 143 ± 14 to 167 ± 8 ml/100 g/min, P = 0.11), although there were no significant between-group differences.These results provide the first evidence that, in VSA patients, exercise training on the top of CCBs treatment may be useful to improve physical performance, although its effect on MBF may be minimal.
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- 2021
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37. Rehabilitation for Heart Failure Patients with Multimorbidity and Multiple Disabilities(MMD)
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Masahiro Kohzuki
- Subjects
medicine.medical_specialty ,Physical medicine and rehabilitation ,Rehabilitation ,Multiple disabilities ,business.industry ,Heart failure ,medicine.medical_treatment ,medicine ,General Medicine ,medicine.disease ,business - Published
- 2020
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38. Effects of exercise training on renal interstitial fibrosis and renin–angiotensin system in rats with chronic renal failure
- Author
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Masahiro Kohzuki, Osamu Ito, Nobuyoshi Mori, Chihiro Suda, Seiko Yamakoshi, and Takahiro Nakamura
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Male ,medicine.medical_specialty ,Physiology ,medicine.medical_treatment ,Renal cortex ,Urology ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,urologic and male genital diseases ,Rats, Sprague-Dawley ,Renin-Angiotensin System ,03 medical and health sciences ,0302 clinical medicine ,Renin–angiotensin system ,Internal Medicine ,medicine ,Animals ,030212 general & internal medicine ,Receptor ,Proteinuria ,business.industry ,Glomerulosclerosis ,medicine.disease ,Fibrosis ,Angiotensin II ,Nephrectomy ,Rats ,medicine.anatomical_structure ,Kidney Failure, Chronic ,Kidney Diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective To clarify the mechanisms of the renal protective effects of exercise training, we examined the effects of exercise training on the renal interstitial fibrosis and renin-angiotensin system (RAS) in rats with chronic renal failure. Methods Six-week-old male Sprague-Dawley rats were divided into three groups: sham operation; 5/6 nephrectomy + sedentary; 5/6 nephrectomy + exercise training. The 5/6 nephrectomy + exercise training group underwent treadmill running (20 m/min, 60 min/day, 5 days/week). After 12 weeks, renal function, histology and protein expression of collagen type I, transforming growth factor-β1 (TGF-β1), matrix metalloproteinase (MMP), tissue inhibitors of metalloproteinase (TIMP) and RAS components in the renal cortex were examined. Results Exercise training ameliorated the 5/6 nephrectomy-induced hypertension, proteinuria, renal dysfunction, glomerular sclerosis and renal interstitial fibrosis. 5/6 Nephrectomy increased the expression of collagen type I, TGF-β1, MMP-2, MMP-9, TIMP-1, angiotensinogen, angiotensin-converting enzyme (ACE), (pro)renin receptor and angiotensin II type 1 receptor, and exercise training inhibited the 5/6 nephrectomy-increased expression of collagen type I, TGF-β1, TIMP-1, angiotensinogen and ACE expressions. 5/6 Nephrectomy decreased the expression of renin, ACE2, angiotensin II type 2 receptor and Mas receptor, and exercise training inhibited the 5/6 nephrectomy-decreased expressions. Conclusion These results indicated that exercise training attenuates the progression of glomerular sclerosis and renal interstitial fibrosis in chronic renal failure rats. The renal protective effects of exercise training may be mediated by ameliorating the renal collagen turnover and the exacerbation of renal RAS.
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- 2020
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39. Osteosarcopenic Obesity Associated with Poor Physical Performance in the Elderly Chinese Community
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Wen Zhang, Qi Guo, Masahiro Kohzuki, Yixuan Ma, and Peipei Han
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business.industry ,General Medicine ,Timed Up and Go test ,medicine.disease ,Obesity ,Osteopenia ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Sarcopenia ,Medicine ,Population study ,Sarcopenic obesity ,030212 general & internal medicine ,Geriatrics and Gerontology ,business ,Bioelectrical impedance analysis ,030217 neurology & neurosurgery ,Demography - Abstract
Objective The aims of this study were to investigate the association between osteosarcopenic obesity (OSO) and physical performance in Chinese elderly communities. Methods Our study population is comprised of residents of the Township Central Hospital in the suburban of Tianjin, China. Participants (n=303; percent body fat (PBF): ≥25% for men and ≥32% for women) were assessed using the direct segmental multi-frequency bioelectrical impedance analysis (BIA) for body composition. Sarcopenia was defined as the lower 20th percentile of appendicular skeletal muscle mass/height2 (ASMI). A quantitative ultrasound scan of each participants' calcaneus with a T score≤-1.0 was used to identify the prevalence of osteopenia/osteoporosis (OP). We divided people into four groups: obesity only (O), osteopenic obesity (OO), sarcopenic obesity (SO), and osteosarcopenic obesity (OSO). We assessed the physical performance by grip strength, 4-m walk test (WS) and timed up and go test (TUGT). Results A total of 303 participants had completed data (89 men, 214 women; mean age of 68.8±6.0 years). The prevalence of OSO was 10.2% (men: 15.70%, women: 7.9%). After multiple adjustments, WS was significantly declined in OSO group when compared with the O group in men (mean value 95% CI was 0.84 (0.69, 0.99)) and women (mean value 95% CI was 0.93 (0.84, 1.02)). TUGT was significantly poorer in men (mean value 95% CI was 13.3 (10.6, 15.9)) and women (mean value 95% CI was 12.4 (11.2, 13.7)) with OSO when compared with the O group. Furthermore, the OSO group in women also had a significantly poorer TUGT compared with the OO group. The result of grip strength decreased significantly in women SO and OSO groups when compared with the O group (mean value 95% CI was 16.4 (14.5, 18.2) and 16.1 (13.9, 18.3)). But the results of grip strength in men showed no significant differences in any of the group. Conclusion In Chinese community-dwelling elderly, slower WS and lower balance function were associated with OSO in men and women. Lower grip strength was associated with SO and OSO in women.
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- 2020
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40. Dysphagia worsens short-term outcomes in patients with acute exacerbation of heart failure
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Noriko Onoue, Tsuyoshi Shinozaki, Nobuhiro Yamaguchi, Junichi Yokota, Yoshimi Takahashi, Masahiro Kohzuki, and Yoshiko Ogawa
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Male ,medicine.medical_specialty ,Time Factors ,Exacerbation ,030204 cardiovascular system & hematology ,Risk Assessment ,Severity of Illness Index ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Swallowing ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Medical history ,Hospital Mortality ,Longitudinal Studies ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Heart Failure ,business.industry ,Stroke Volume ,Length of Stay ,medicine.disease ,Dysphagia ,Deglutition ,Cardiac surgery ,Heart Disease Risk Factors ,Heart failure ,Propensity score matching ,Disease Progression ,Female ,medicine.symptom ,Deglutition Disorders ,Cardiology and Cardiovascular Medicine ,business ,Body mass index - Abstract
Dysphagia, defined as a dysfunction in any stage or process of eating, is common in patients with acute exacerbation of heart failure (HF). In some diseases, dysphagia worsens in-hospital mortality, length of hospital stay, and discharge disposition. However, it remains unclear whether dysphagia is associated with poor short-term outcomes in HF patients. The objective of the present study was to determine whether dysphagia affects short-term outcomes in patients with acute exacerbation of HF. A total of 327 patients hospitalized with acute exacerbation of HF were eligible for the study. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (NDG) based on results of the functional oral intake scale (FOIS), which evaluates a patient's ability of eating and swallowing. FOIS is a 7-point scale, with a level of ≤ 5 indicating dysphagia. Following the withdrawal of 16 patients, short-term outcomes such as in-hospital mortality, length of hospital stay, and discharge disposition, of 311 patients were analyzed. All indexes of short-term outcomes were significantly worse in the DG than in the NDG. After propensity score matching, which was performed to adjust for baseline characteristics such as age, sex, height, weight, body mass index, medical history, complications, HF severity, ejection fraction, and biochemical data excluding nutritional status, all short-term outcomes remained significantly worse in the DG than in the NDG. Multivariate analysis showed that FOIS was an independent predictor of in-hospital survival, length of hospital stay, and discharge to home. The present study suggested that dysphagia affected short-term outcomes in patients with acute exacerbation of HF. Therefore, early detection and intervention of dysphagia in HF patients are important.
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- 2020
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41. Risk and Benefits of Exercise Training in Patients with Renal Impairment
- Author
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Masahiro Kohzuki
- Subjects
medicine.medical_specialty ,business.industry ,Training (meteorology) ,Physical therapy ,medicine ,In patient ,business - Published
- 2020
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42. Active Participation in Outpatient Cardiac Rehabilitation Is Associated With Better Prognosis After Coronary Artery Bypass Graft Surgery ― J-REHAB CABG Study ―
- Author
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Haruki Itoh, Masatoshi Nagayama, Takashi Masuda, Kenji Ueshima, Hitoshi Adachi, Ryuji Nohara, Masahiro Kohzuki, Kazuto Omiya, Yoichi Goto, Shigeru Makita, Hideki Origuchi, Shin Ichi Momomura, and Hiroyuki Daida
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Health Status ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Ambulatory Care ,medicine ,Clinical endpoint ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Coronary Artery Bypass ,Aged ,Retrospective Studies ,Cardiac Rehabilitation ,Exercise Tolerance ,Unstable angina ,business.industry ,VO2 max ,Recovery of Function ,General Medicine ,Middle Aged ,medicine.disease ,Exercise Therapy ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Heart failure ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,business ,Mace ,Artery - Abstract
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
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- 2020
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43. Development of the Disability Awareness Program (DAP) scale;
- Author
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Masahiro Kohzuki, Changwan Han, Mamiko Ota, and Haejin Kwon
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Scale (ratio) ,Applied psychology ,Scale development ,Content validity ,General Medicine ,Psychology - Published
- 2020
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44. Effect of Partial Foot Amputation Level on Gait Independence in Patients With Chronic Lower Extremity Wounds: A Retrospective Analysis of a Japanese Multicenter Database
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Yuma Sonoda, Noriaki Maeshige, Mikiko Uemura, Shinsuke Imaoka, Nobuhide Kawabe, Hisae Hayashi, Miki Fujii, Yoriko Tsuji, Masahide Furukawa, Masahiro Kohzuki, and Hiroto Terashi
- Subjects
Surgery ,General Medicine - Abstract
Partial foot amputation (PFA) is generally planned to minimize the amputation level; nonetheless, the effect of PFA levels on gait independence in amputees remains unclear. This study aimed to investigate the impact of PFA levels of the forefoot on gait independence in patients with chronic lower extremity (LE) wounds. This multicenter retrospective cohort study included 232 hospitalized Japanese patients treated and rehabilitated for chronic LE wounds. A multivariate analysis based on PFA levels was conducted for gait independence at discharge, with age and comorbidities as independent variables. Patients with Lisfranc amputation had significantly less independent gait than patients with more distal amputation and those without amputation (40%; P = .027; Fisher's exact test). Logistic regression analysis revealed that Lisfranc amputation (odds ratio [OR]: 0.257, P = .047), age (OR: 0.559, P = .043), and chronic limb-threatening ischemia (OR: 0.450, P = .010) were independent factors associated with gait independence. Additionally, the regression model confirmed discrimination performance using the C index (0.691, P
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- 2023
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45. PS-B07-2: EXERCISE TRAINING PREVENTS HIGH FRUCTOSE-INDUCED HYPERTENSION AND RENAL DAMAGES IN DAHL SALT-SENSITIVE RATS
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Lusi Xu, Gaizun Hu, Masahiro Kohzuki, and Osamu Ito
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Physiology ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
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46. Febuxostat ameliorates high salt intake-induced hypertension and renal damage in Dahl salt-sensitive rats
- Author
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Yoshiko Ogawa, Jiahe Qiu, Asako Namai-Takahashi, Osamu Ito, Akihiro Sakuyama, Lusi Xu, Masahiro Kohzuki, and Takahiro Miura
- Subjects
Male ,medicine.medical_specialty ,Physiology ,Thiobarbituric acid ,medicine.medical_treatment ,Urinary system ,Blood Pressure ,medicine.disease_cause ,Kidney ,Excretion ,chemistry.chemical_compound ,Febuxostat ,Internal medicine ,Internal Medicine ,Medicine ,Animals ,Sodium Chloride, Dietary ,Rats, Inbred Dahl ,business.industry ,Hydrogen Peroxide ,Malondialdehyde ,Rats ,Blood pressure ,Endocrinology ,chemistry ,Hypertension ,Diuretic ,Cardiology and Cardiovascular Medicine ,business ,Oxidative stress ,medicine.drug - Abstract
OBJECTIVE Several clinical studies have reported that xanthine oxidoreductase inhibitors have antihypertensive and renal protective effects but their mechanisms have not been fully determined. This study aims to clarify these mechanisms by examining the effects of febuxostat, which is a novel selective xanthine oxidoreductase inhibitor, in Dahl salt-sensitive rats. METHODS Eight-week-old male Dahl salt-sensitive rats were fed a normal salt (0.6% NaCl) or high salt (8% NaCl) diet for 8 weeks. A portion of the rats that were fed high salt diet were treated with febuxostat (3 mg/kg per day) simultaneously. Additionally, acute effects of febuxostat (3 mg/kg per day) were examined after high salt diet feeding for 4 or 8 weeks. RESULTS Treatment with febuxostat for 8 weeks attenuated high salt diet-induced hypertension, renal dysfunction, glomerular injury, and renal interstitial fibrosis. Febuxostat treatment reduced urinary excretion of H2O2 and malondialdehyde and renal thiobarbituric acid reactive substances content. High salt diet increased xanthine oxidoreductase activity and expression in the proximal tubules and medullary interstitium. Febuxostat completely inhibited xanthine oxidoreductase activity and attenuated the high salt diet-increased xanthine oxidoreductase expression. Febuxostat transiently increased urine volume and Na+ excretion without change in blood pressure or urinary creatinine excretion after high salt diet feeding for 4 or 8 weeks. CONCLUSION Febuxostat ameliorates high salt diet-induced hypertension and renal damage with a reduction of renal oxidative stress in Dahl salt-sensitive rats. The antihypertensive effect of febuxostat may be mediated in part by diuretic and natriuretic action.
- Published
- 2021
47. Belt Electrode-Skeletal Muscle Electrical Stimulation in Older Hemodialysis Patients with Reduced Physical Activity: A Randomized Controlled Pilot Study
- Author
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Midori Homma, Misa Miura, Yo Hirayama, Tamao Takahashi, Takahiro Miura, Naoki Yoshida, Satoshi Miyata, Masahiro Kohzuki, and Satoru Ebihara
- Subjects
General Medicine ,electrical muscle stimulation ,hemodialysis ,older ,chronic kidney disease ,frailty ,6 min walk test ,short physical performance battery - Abstract
Background: Although patients receiving hemodialysis are more likely to develop metabolic disorders and muscle weakness at an earlier stage than healthy individuals, many older dialysis patients have difficulty establishing exercise habits to prevent these problems. Therefore, we evaluated the use of belt electrode-skeletal muscle electrical stimulation (B-SES), which can stimulate a wider area than conventional electrical muscle stimulation (EMS), to examine its application and safety in older hemodialysis patients as a means to improve lower extremity function without voluntary effort. Methods: This study was a randomized controlled trial (RCT) involving 20 older dialysis patients (>65 years old) with reduced physical activity. The control group received 12 weeks of routine care only and the intervention group received 12 weeks of B-SES during hemodialysis in addition to routine care. The primary endpoint was the 6 min walk test (6MWT) distance, while the Short Physical Performance Battery (SPPB), body composition, Functional Independence Measure (FIM), biochemistry test, and blood pressure/pulse measurements were used as secondary endpoints. Results: As a result of the 12-week B-SES intervention, no increase in creatine kinase or C-reactive protein levels was observed after the intervention in either group, and no adverse events attributed to the B-SES intervention were observed in the intervention group. Furthermore, the intervention group showed a significant improvement in the 6MWT and SPPB scores after the intervention. Conclusions: The results of this study suggest that a 12-week B-SES intervention during hemodialysis sessions safely improves 6MWT distance and SPPB scores in older patients with a reduced level of physical activity.
- Published
- 2022
- Full Text
- View/download PDF
48. High Fructose-Induced Hypertension and Renal Damage Are Exaggerated in Dahl Salt-Sensitive Rats via Renal Renin-Angiotensin System Activation
- Author
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Takahiro Miura, Masahiro Kohzuki, Osamu Ito, Jiahe Qiu, Yixuan Ma, Lusi Xu, Yuxuan Fan, and Gaizun Hu
- Subjects
0301 basic medicine ,Dahl Salt-Sensitive Rats ,Male ,medicine.medical_specialty ,renin‐angiotensin system ,Kidney Glomerulus ,Tetrazoles ,renal damage ,Blood Pressure ,Fructose ,030204 cardiovascular system & hematology ,Peptidyl-Dipeptidase A ,urologic and male genital diseases ,Receptor, Angiotensin, Type 1 ,Renin-Angiotensin System ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Enalapril ,Internal medicine ,Renin–angiotensin system ,Renin ,Medicine ,Animals ,Antihypertensive Agents ,Original Research ,Rats, Inbred Dahl ,business.industry ,Renal damage ,Biphenyl Compounds ,Sodium, Dietary ,glomerular hyperfiltration ,biochemical phenomena, metabolism, and nutrition ,equipment and supplies ,Rats ,carbohydrates (lipids) ,030104 developmental biology ,Endocrinology ,chemistry ,Hypertension ,High fructose ,bacteria ,Benzimidazoles ,Cardiology and Cardiovascular Medicine ,business ,Glomerular hyperfiltration - Abstract
Background High‐fructose diet (HFr) induces hypertension and renal damage. However, it has been unknown whether the HFr‐induced hypertension and renal damage are exaggerated in subjects with salt sensitivity. We tested impacts of HFr in Dahl salt‐sensitive (DS) and salt‐resistant (DR) rats. Methods and Results Male DS and DR rats were fed control diet or HFr (60% fructose) with normal‐salt content. After 12 weeks, plasma and urinary parameters, renal histological characteristics, and renal expression of renin‐angiotensin system components were examined. Furthermore, effects of renin‐angiotensin system inhibitors were also examined in DS rats fed the HFr. HFr elevated blood pressure in DS rats but not in DR rats. HFr increased urinary albumin and liver type fatty acid binding protein excretions in both rats, but the excretions were exaggerated in DS rats. HFr increased plasma lipids and uric acid in both rats, whereas HFr increased creatinine clearance in DS rats but not DR rats. Although HFr decreased plasma renin activity in DS rats, HFr‐induced glomerular injury, afferent arteriolar thickening, and renal interstitial fibrosis were exaggerated in DS rats. HFr increased renal expression of angiotensinogen, renin, (pro)renin receptor, angiotensin‐converting enzyme, and angiotensin II type 1 receptor in DS rat, whereas HFr increased only angiotensin‐converting enzyme expression and decreased renin and angiotensin II type 1 receptor expressions in DR rats. Enalapril and candesartan attenuated the HFr‐induced hypertension, albuminuria, glomerular hyperfiltration, and renal damage in DS rats. Conclusion HFr‐induced hypertension and renal damage are exaggerated in DS rats via renal renin‐angiotensin system activation, which can be controlled by renin‐angiotensin system inhibitors.
- Published
- 2021
49. Effect of Weight Loss and Exercise Therapy on Obesity-related Respiratory Disorders
- Author
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Masahiro Kohzuki and Tamao Takahashi
- Subjects
medicine.medical_specialty ,business.industry ,Sleep apnea ,Exercise therapy ,General Medicine ,medicine.disease ,Obesity ,Weight loss ,Internal medicine ,medicine ,Cardiology ,medicine.symptom ,Respiratory system ,business - Published
- 2019
- Full Text
- View/download PDF
50. Renal rehabilitation in PAD patients
- Author
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Masahiro Kohzuki
- Subjects
medicine.medical_specialty ,Rehabilitation ,National health insurance ,business.industry ,Family medicine ,medicine.medical_treatment ,medicine ,business - Published
- 2019
- Full Text
- View/download PDF
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