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Mochizuki M, Uchiyama Y, Domen K, Koyama T. Clinical applicability of automated tractography for stroke rehabilitation: Z-score conversion of fractional anisotropy. J Phys Ther Sci 2024; 36:319-324. [PMID: 38694010 PMCID: PMC11060757 DOI: 10.1589/jpts.36.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/08/2024] [Indexed: 05/03/2024] Open
Abstract
[Purpose] To expand the applicability of diffusion-tensor tractography fractional anisotropy for stroke rehabilitation, this study aimed to provide references for representative neural tracts from non-lesioned hemispheres. Therefore, we applied the assessment of neural integrity to representative stroke patients using Z-score conversion. [Participants and Methods] Fractional anisotropy values were assessed in neural tracts, including the corticospinal tract, inferior fronto-occipital fasciculus, uncinate fasciculus, and anterior thalamic radiation, of stroke patients receiving acute care. [Results] Data were collected from 60 patients for the non-lesioned right hemisphere and 68 patients for the non-lesioned left hemisphere. Mean fractional anisotropy values in the corticospinal tract and inferior fronto-occipital fasciculus were notably elevated, reaching approximately 0.6 and 0.5, respectively. The mean fractional anisotropy values for other neural tracts were approximately 0.4, and, the overall standard deviations were approximately 0.04. In two typical stroke patients assessed using Z-scores, the scores in the corticospinal tract corresponded to the severity of the hemiparesis. The scores in the anterior thalamic radiation and inferior fronto-occipital fasciculus were associated with more significant brain dysfunction, including inattention and aphasia. [Conclusion] In this study, the Z-score findings related to stroke symptoms align with those reported in the literature, indicating the appropriateness of the methodology used and its potential in future applications.
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Affiliation(s)
- Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Japan
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Kakuda W, Nakajima M, Oki K, Koyama T, Oyama N, Koga M, Hayase M, Ohta T, Iguchi Y, Fujimoto S, Omori T, Matsumoto K, Hashimoto Y, Itabashi R, Niimi M, Ashiga H, Tajima F, Ogasawara K. Evidence and Recommendations for Acute Stroke Rehabilitation from the Japan Stroke Society: Abridged Secondary Publication of the Japanese-language Version. Prog Rehabil Med 2024; 9:20240015. [PMID: 38660472 PMCID: PMC11038992 DOI: 10.2490/prm.20240015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Objectives In Japan, acute stroke rehabilitation has been expanding more steadily than previously with the nationwide establishment of primary stroke centers. However, Japan previously had no established guidelines for the rehabilitation. Consequently, rehabilitation programs and the provision systems for acute stroke varied among the facilities. To equalize and standardize acute stroke rehabilitation in Japan, it is necessary to develop clinical recommendations for rehabilitation. Therefore, the rehabilitation project team of the Japan Stroke Society aimed to develop the first recommendations for acute stroke rehabilitation in Japan. Methods The recommendations are based on the results of a survey on the current status of acute stroke rehabilitation at primary stroke centers in Japan, which was completed in 2022, and on a literature review conducted by the rehabilitation project team. Results The recommendations consist of 19 clinical questions regarding the following topics of acute stroke rehabilitation: (1) head elevation and mobilization training, (2) acute complications, (3) training time and frequency for acute stroke rehabilitation, (4) dysphagia in the acute phase, and (5) acute rehabilitation during pandemics of novel and re-emerging infections, particularly novel coronavirus disease 2019 (COVID-19). The team members agreed on all answers for these 19 clinical questions. Conclusions These recommendations suggest broad principles of rehabilitative intervention in the acute phase of stroke. In the near future, it is expected that the dissemination of these recommendations will result in an increase in the quality of acute stroke rehabilitation in Japan.
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Affiliation(s)
- Wataru Kakuda
- Department of Rehabilitation Medicine, International
University of Health and Welfare School of Medicine, Narita, Japan
| | - Makoto Nakajima
- Department of Neurology, Graduate School of Medical
Sciences, Kumamoto University, Kumamoto, Japan
| | - Koichi Oki
- Department of Neurology, Stroke Center, Tokyo Saiseikai
Central Hospital, Tokyo, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Nishinomiya, Japan
| | - Naoki Oyama
- Department of Stroke Medicine, Kawasaki Medical School,
Kurashiki, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral
and Cardiovascular Center, Osaka, Japan
| | - Makoto Hayase
- Department of Neurosurgery, National Hospital Organization
Kyoto Medical Center, Kyoto, Japan
| | - Tsuyoshi Ohta
- Department of Neurosurgery, Kobe City Medical Center General
Hospital, Kobe, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of
Medicine, Tokyo, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi
Medical University, Tochigi, Japan
| | - Tomohiro Omori
- Division of Rehabilitation Medicine, International
University of Health and Welfare Narita Hospital, Narita, Japan
| | - Koichi Matsumoto
- Division of Rehabilitation Medicine, Tokyo General
Hospital, Tokyo, Japan
| | | | - Ryo Itabashi
- Stroke Center, Division of Neurology and Gerontology,
Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka,
Japan
| | - Masachika Niimi
- Department of Rehabilitation Medicine, Nihon University
School of Medicine, Tokyo, Japan
| | - Hirokazu Ashiga
- Department of Speech and Hearing Sciences, School of Health
Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | | | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University School
of Medicine, Morioka, Japan
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Kubo T, Sunami K, Koyama T, Kitami M, Fujiwara Y, Kondo S, Yonemori K, Noguchi E, Morizane C, Goto Y, Maejima A, Iwasa S, Hamaguchi T, Kawai A, Namikawa K, Arakawa A, Sugiyama M, Ohno M, Yoshida T, Hiraoka N, Yoshida A, Yoshida M, Nishino T, Furukawa E, Narushima D, Nagai M, Kato M, Ichikawa H, Fujiwara Y, Kohno T, Yamamoto N. The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology. ESMO Open 2024; 9:102981. [PMID: 38613908 PMCID: PMC11033064 DOI: 10.1016/j.esmoop.2024.102981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP. MATERIALS AND METHODS A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response. RESULTS Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively). CONCLUSION Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.
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Affiliation(s)
- T Kubo
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo
| | - K Sunami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Division of Genome Biology, National Cancer Center Research Institute, Tokyo
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo
| | - M Kitami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - Y Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi
| | - S Kondo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - K Yonemori
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - E Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - Y Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - A Maejima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo; Department of Urology, National Cancer Center Hospital, Tokyo
| | - S Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Hamaguchi
- Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama
| | - A Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo
| | - A Arakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Sugiyama
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo
| | - T Yoshida
- Department of Genetic Services and Medicine, National Cancer Center Hospital, Tokyo
| | - N Hiraoka
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - A Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - M Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - T Nishino
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - E Furukawa
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - D Narushima
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Nagai
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Kato
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - H Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - Y Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - N Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo.
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Nakada J, Matsushita T, Koyama T, Hatano K, Matsuoka K. Synthetic assembly of α-O-linked-type GlcNAc using polymer chemistry affords sugar clusters, which effectively bind to lectins. Bioorg Med Chem Lett 2024; 99:129616. [PMID: 38216097 DOI: 10.1016/j.bmcl.2024.129616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/31/2023] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
Fischer's glycoside synthesis was applied to linker precursor alcohols of two different lengths having appropriate alkane chains to obtain the corresponding α-glycoside and it was found to be applicable with moderate yields. Water-soluble glycomonomers were systematically prepared from N-acetyl-d-glucosamine (GlcNAc) by introducing two kinds of alcohols having different methylene lengths. Typical radical polymerizations of the glycomonomers with acrylamide as a modulator for control of the distance between carbohydrate residues in water in the presence of ammonium persulfate (APS)-N,N,N',N'-tetramethylethylenediamine (TEMED) gave a series of glycopolymers with various α-glycoside-type GlcNAc residue densities. Fluorometric analysis of the interaction of wheat germ agglutinin (WGA) with the glycopolymers was performed and the results showed unique binding specificities based on structural differences.
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Affiliation(s)
- Jyuichi Nakada
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Takahiko Matsushita
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan.
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Nakajima M, Oki K, Omori T, Koyama T, Oyama N, Koga M, Hayase M, Ohta T, Matsumoto K, Iguchi Y, Fujimoto S, Kakuda W, Ogasawara K. A nationwide survey for the provision of acute stroke rehabilitation in Japan: initial dose and weekend/holiday rehabilitation. J Stroke Cerebrovasc Dis 2024; 33:107550. [PMID: 38142566 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 12/26/2023] Open
Abstract
OBJECTIVES The early initiation of acute stroke rehabilitation with a sufficient dose, including at weekends/holidays, is important to improve functional outcome. We investigated the status of acute stroke rehabilitation in Japan by using a nationwide survey. MATERIALS AND METHODS Facility features, rehabilitation dose provided in the first week in each stroke subtype, and weekend/holiday rehabilitation were investigated by using the results of a web-based survey among primary stroke centers. The relationships between facility features and weekend/holiday rehabilitation were also analyzed. RESULTS A total of 639 stroke centers (66.6%) completed the questionnaire. The overall median dose was 2.0 (interquartile range, 1.7-3.0) U/day (1U = 20 min). After 7 days, the overall median dose increased to 4.0 (2.0-5.4) U/day. Almost 50% of facilities replied that they could not provide a sufficient dose of rehabilitation; the main reason was a lack of therapists (31%). For rehabilitation on long weekends, no rehabilitation was provided on 3-day weekends in 19% of facilities, and in 5% of facilities on ≥4-day weekends. The mean number of therapists was almost 50% less in the facilities that provided no rehabilitation on 3-day weekends compared to those that provided daily rehabilitation (19.4 vs. 36.2 therapists, respectively, p < 0.001). CONCLUSIONS In this survey, the provision of acute stroke rehabilitation, including non-working days, was clarified. According to the results, prospective interventional or observational studies are needed to design more effective rehabilitation programs to improve outcome. In particular, it is important to determine the optimal dose and intensity of acute stroke rehabilitation.
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Affiliation(s)
- Makoto Nakajima
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
| | - Koichi Oki
- Department of Neurology, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
| | - Tomohiro Omori
- Division of Rehabilitation Medicine, International University of Health and Welfare Narita Hospital, Japan.
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Hyogo, Japan.
| | - Naoki Oyama
- Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Makoto Hayase
- Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
| | - Tsuyoshi Ohta
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Hyogo, Japan.
| | - Koichi Matsumoto
- Division of Rehabilitation Medicine, General Tokyo Hospital, Japan.
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
| | - Wataru Kakuda
- Rehabilitation Medicine, International University of Health and Welfare Narita Hospital, Chiba, Japan.
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan.
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Koyama T, Mochizuki M, Uchiyama Y, Domen K. Outcome Prediction by Combining Corticospinal Tract Lesion Load with Diffusion-tensor Fractional Anisotropy in Patients after Hemorrhagic Stroke. Prog Rehabil Med 2024; 9:20240001. [PMID: 38223334 PMCID: PMC10782178 DOI: 10.2490/prm.20240001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
Objectives The objective of this study was to evaluate the predictive precision of combining the corticospinal tract lesion load (CST-LL) with the diffusion-tensor fractional anisotropy of the corticospinal tract (CST-FA) in the lesioned hemispheres regarding motor outcomes. Methods Patients with putaminal and/or thalamic hemorrhage who had undergone computed tomography (CT) soon after onset in our hospital were retrospectively enrolled. The CST-LL was calculated after registration of the CT images to a standard brain. Diffusion-tensor imaging was performed during the second week after onset. Standardized automated tractography was employed to calculate the CST-FA. Outcomes were assessed at discharge from our affiliated rehabilitation facility using total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor total; null to full, 0 to 25). Multivariate regression analysis was performed with CST-LL and CST-FA as explanatory variables and SIAS-motor total as a target value. Results Twenty-five patients participated in this study. SIAS-motor total ranged from 0 to 25 (median, 17). CST-LL ranged from 0.298 to 7.595 (median, 2.522) mL, and the lesion-side CST-FA ranged from 0.211 to 0.530 (median, 0.409). Analysis revealed that both explanatory variables were detected as statistically significant contributory factors. The estimated t values indicated that the contributions of these two variables were almost equal. The obtained regression model accounted for 63.9% of the variability of the target value. Conclusions Incorporation of the CST-LL with the lesion-side CST-FA enhances the precision of the stroke outcome prediction model.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Nishinomiya, Japan
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
| | - Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, School of Medicine,
Hyogo Medical University, Nishinomiya, Japan
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Iwasa S, Uchiyama Y, Tauchi Y, Koyama T, Domen K. Impact of functional independence and sociodemographic factors on post-stroke discharge destination in a super-aged rural community in Japan. J Rural Med 2024; 19:33-39. [PMID: 38196805 PMCID: PMC10774001 DOI: 10.2185/jrm.2023-033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/23/2023] [Indexed: 01/11/2024] Open
Abstract
Objective: This study aimed to clarify the factors influencing the discharge destination of stroke patients in a super-aged rural community in Japan, focusing on functional independence and sociodemographic factors. Patients and Methods: We enrolled patients recovering from stroke with supratentorial lesions who were admitted to our convalescent rehabilitation hospital. The motor components of the Functional Independence Measure (FIM-motor) were assessed for each patient at admission and discharge as explanatory variables. An increase in the FIM-motor scores during hospitalization was also recorded. Additionally, sociodemographic data such as sex, age, and clinical characteristics, such as type of stroke, history of stroke, days from stroke onset to transfer to our convalescent rehabilitation hospital, total duration of hospital stay including acute care, number of co-resident household members, living with a spouse, and number of children were collected. As target values, discharge outcomes were categorized into two groups: returning home and going to a nursing home. Logistic regression analysis was performed. Results: The study sample comprised 160 patients (mean age ± standard deviation, 74.80 ± 12.19 years). Of these, 114 were discharged to their homes, and 46 were transferred to nursing homes. The results of multivariate logistic regression analysis indicated that higher FIM-motor scores at discharge, greater number of co-resident household members, and living with one's spouse were the most powerful predictors of a higher probability of returning home. Conclusion: This study demonstrated that functional independence levels and the number of co-resident household members were crucial factors in predicting the discharge destination of patients after stroke in a super-aged rural community in Japan. These findings imply that for older patients with lower functional independence, supportive social networks are essential for home discharge, offering clues for providing long-term healthcare in super-aged rural communities worldwide.
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Affiliation(s)
- Saya Iwasa
- Department of Rehabilitation Medicine, Sasayama Medical Center, Hyogo Medical University, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
| | - Yuta Tauchi
- Department of Rehabilitation Medicine, Sasayama Medical Center, Hyogo Medical University, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical University, Japan
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8
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Koyama T, Mochizuki M, Uchiyama Y, Domen K. Applicability of fractional anisotropy from standardized automated tractography for outcome prediction of patients after stroke. J Phys Ther Sci 2023; 35:838-844. [PMID: 38075519 PMCID: PMC10698312 DOI: 10.1589/jpts.35.838] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/14/2023] [Indexed: 03/22/2024] Open
Abstract
[Purpose] Diffusion-tensor fractional anisotropy has been used for outcome prediction in stroke patients. We assessed the clinical applicability of the two major fractional anisotropy methodologies-fractional anisotropy derived from segmentation maps in the standard brain (region of interest) and fractional anisotropy derived from standardized automated tractography-in relation to outcomes. [Participants and Methods] The study design was a retrospective survey of medical records collected from October 2021 to September 2022. Diffusion-tensor imaging was conducted in the second week after stroke onset. Outcomes were assessed using the total score of the motor component of the Stroke Impairment Assessment Set (null to full, 0 to 25). Correlations between fractional anisotropy and the outcomes were then assessed. [Results] Fourteen patients with hemorrhagic stroke were sampled. The fractional anisotropy from standardized automated tractography of the corticospinal tract on the lesion side (mean ± standard deviation, 0.403 ± 0.070) was significantly and tightly correlated (r=0.813) with the outcomes (13.4 ± 9.2), whereas the fractional anisotropy from a region of interest set in the cerebral peduncle on the lesion side (0.548 ± 0.064) was not significantly correlated with the outcomes (r=0.507). [Conclusion] The findings suggest that fractional anisotropy derived from standardized automated tractography can be more applicable to outcome prediction than that derived from a region of interest defined in the standard brain.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
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9
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Mochizuki M, Uchiyama Y, Domen K, Koyama T. Automated Tractography for the Assessment of Aphasia in Acute Care Stroke Rehabilitation: A Case Series. Prog Rehabil Med 2023; 8:20230041. [PMID: 38024960 PMCID: PMC10661235 DOI: 10.2490/prm.20230041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Aphasia is a common disorder among stroke patients. Assessment of aphasia is essential for scheduling appropriate rehabilitative treatment. Although this is conventionally accomplished using neuropsychological test batteries, these tests are not always accessible because of attention and/or consciousness disturbances during acute care. To overcome this issue, we have introduced a newly developed automated tractography known as XTRACT. Cases Diffusion-tensor images were acquired from three patients on days 10-14. Brain images were processed by XTRACT, which automatically extracts neural tracts using standardized protocols. Fractional anisotropy (FA) values were then bilaterally evaluated in the following neural tracts associated with aphasia: arcuate fasciculus, inferior fronto-occipital fasciculus, middle longitudinal fasciculus, inferior longitudinal fasciculus, and uncinate fasciculus. Case 1 had word-finding difficulty on admission. FA values in the lesioned left hemisphere were not decreased in all tracts and this patient fully recovered during acute care. Case 2 had reduced spontaneous speech and a low FA value in the left arcuate fasciculus. Rehabilitative treatment was scheduled to improve the verbal output of sentences and word recall. Case 3 could not complete the conventional aphasia test battery because of attention disturbance. He had low FA values in all tracts in the left hemisphere. Rehabilitative treatment was designed to focus on both speaking and auditory comprehension. Discussion Automated tractography enables quantitative assessment of the neural damage associated with aphasia, even in patients with attention and/or consciousness disturbances. This modality can aid in the assessment of aphasia and allows the planning of appropriate rehabilitative treatment.
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Affiliation(s)
- Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
- Department of Rehabilitation Medicine, Hyogo Medical University, Nishinomiya, Japan
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10
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Matsushita T, Nozaki M, Sunaga M, Koyama T, Hatano K, Matsuoka K. Preparation of N-Linked-Type GlcNAc Monomers for Glycopolymers and Binding Specificity for Lectin. ACS Omega 2023; 8:37329-37340. [PMID: 37841120 PMCID: PMC10568714 DOI: 10.1021/acsomega.3c05151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023]
Abstract
Glycomonomers having N-glycosidic linkages were prepared from a known glycosyl amine, N-acetyl-d-glucosamine (GlcNAc). Radical polymerization of the glycomonomers gave a series of glycopolymers displaying various sugar densities, which were models of the core structure of Asn-linked-type glycoproteins. In addition, fluorometric analyses of wheat germ agglutinin (WGA) against the glycopolymers were carried out, and the results showed unique binding specificities on the basis of flexibility of sugar moieties.
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Affiliation(s)
- Takahiko Matsushita
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Momoka Nozaki
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Mio Sunaga
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Science and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
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11
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Ishimaru Y, Moteki T, Suzuki M, Koyama T, Matsushita T, Hatano K, Matsuoka K. Preparation of a Water-Soluble Glycopolymer Bearing Porphyrin Skeletons and Its Biological Properties. ACS Omega 2023; 8:37451-37460. [PMID: 37841131 PMCID: PMC10568584 DOI: 10.1021/acsomega.3c05581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023]
Abstract
A known tetraphenyl porphyrin (TPP) having an amino functional group [5-(4-aminophenyl)-10,15,20-(triphenyl)porphyrin] was converted into the corresponding monomer by means of condensation with acryloyl chloride. Simple radical polymerization of the porphyrin monomer and a glycosyl monomer in the presence of acrylamide as a regulator monomer in order to avoid steric interference gave a water-soluble glycopolymer bearing porphyrin moieties. Spectroscopic analyses suggested incorporation of porphyrin moieties in the glycopolymer. The physical properties of the water-soluble glycopolymer bearing porphyrin moieties were examined in aqueous media, and the results also indicated the incorporation of TPP moieties in the polymer. Uptake of the polymer into HeLa cells was observed, and the cytotoxicity of the polymer was confirmed by microscopic analyses. The glycopolymer bearing porphyrin moieties is promising not only for photodynamic therapy but also as an anti-cancer reagent.
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Affiliation(s)
- Yoshihiro Ishimaru
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tomohide Moteki
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Miho Suzuki
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Takahiko Matsushita
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
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12
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Matsushita T, Yamochi H, Omiya S, Koyama T, Hatano K, Matsuoka K. Proteolytic polymer: polyacrylamides functionalized with amino acids cleave bovine and human serum albumins. Bioorg Med Chem 2023; 92:117422. [PMID: 37523791 DOI: 10.1016/j.bmc.2023.117422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
Polyacrylamides with various compositions of serine, aspartic acid, and histidine, which are the amino acids involved in the catalytic triad of natural serine protease chymotrypsin, were synthesized and their protein cleavage activity was investigated. SDS-PAGE analysis showed that some of the synthesized ternary copolymers showed cleavage activity against bovine and human serum albumins. Polyacrylamides incorporating a single type of amino acid were also able to cleave the protein substrates. These homopolymers exhibited unique cleavage profiles and pH and temperature sensitivities that differed from those of α-chymotrypsin. The results indicate the potential of polymers functionalized with amino acids as proteolytic artificial enzymes.
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Affiliation(s)
- Takahiko Matsushita
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Hinako Yamochi
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Shinzo Omiya
- Applied Chemistry Program, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan.
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13
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Loong HH, Shimizu T, Prawira A, Tan AC, Tran B, Day D, Tan DSP, Ting FIL, Chiu JW, Hui M, Wilson MK, Prasongsook N, Koyama T, Reungwetwattana T, Tan TJ, Heong V, Voon PJ, Park S, Tan IB, Chan SL, Tan DSW. Recommendations for the use of next-generation sequencing in patients with metastatic cancer in the Asia-Pacific region: a report from the APODDC working group. ESMO Open 2023; 8:101586. [PMID: 37356359 PMCID: PMC10319859 DOI: 10.1016/j.esmoop.2023.101586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 06/27/2023] Open
Abstract
INTRODUCTION Next-generation sequencing (NGS) diagnostics have shown clinical utility in predicting survival benefits in patients with certain cancer types who are undergoing targeted drug therapies. Currently, there are no guidelines or recommendations for the use of NGS in patients with metastatic cancer from an Asian perspective. In this article, we present the Asia-Pacific Oncology Drug Development Consortium (APODDC) recommendations for the clinical use of NGS in metastatic cancers. METHODS The APODDC set up a group of experts in the field of clinical cancer genomics to (i) understand the current NGS landscape for metastatic cancers in the Asia-Pacific (APAC) region; (ii) discuss key challenges in the adoption of NGS testing in clinical practice; and (iii) adapt/modify the European Society for Medical Oncology guidelines for local use. Nine cancer types [breast cancer (BC), gastric cancer (GC), nasopharyngeal cancer (NPC), ovarian cancer (OC), prostate cancer, lung cancer, and colorectal cancer (CRC) as well as cholangiocarcinoma and hepatocellular carcinoma (HCC)] were identified, and the applicability of NGS was evaluated in daily practice and/or clinical research. Asian ethnicity, accessibility of NGS testing, reimbursement, and socioeconomic and local practice characteristics were taken into consideration. RESULTS The APODDC recommends NGS testing in metastatic non-small-cell lung cancer (NSCLC). Routine NGS testing is not recommended in metastatic BC, GC, and NPC as well as cholangiocarcinoma and HCC. The group suggested that patients with epithelial OC may be offered germline and/or somatic genetic testing for BReast CAncer gene 1 (BRCA1), BRCA2, and other OC susceptibility genes. Access to poly (ADP-ribose) polymerase inhibitors is required for NGS to be of clinical utility in prostate cancer. Allele-specific PCR or a small-panel multiplex-gene NGS was suggested to identify key alterations in CRC. CONCLUSION This document offers practical guidance on the clinical utility of NGS in specific cancer indications from an Asian perspective.
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Affiliation(s)
- H H Loong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - T Shimizu
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
| | - A Prawira
- Cancer Trials and Research Unit, Prince of Wales Hospital, Sydney, Australia
| | - A C Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - B Tran
- Department of Oncology, Peter MacCallum Cancer Centre, Melbourne
| | - D Day
- Department of Oncology, Monash Health and Monash University, Australia
| | - D S P Tan
- Department of Haematology-Oncology, National University Cancer Institute, Singapore
| | - F I L Ting
- Department of Medicine, Dr. Pablo O. Torre Memorial Hospital, Bacolod, Philippines
| | - J W Chiu
- Department of Medicine, The University of Hong Kong, HKSAR, Pok Fu Lam, Hong Kong, China
| | - M Hui
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, Australia
| | - M K Wilson
- Department of Medical Oncology, Auckland City Hospital, Auckland, New Zealand
| | - N Prasongsook
- Division of Medical Oncology, Phramongkutklao Hospital, Bangkok, Thailand
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - T Reungwetwattana
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - T J Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - V Heong
- Department Medical Oncology, Tan Tock Seng Hospital, Singapore
| | - P J Voon
- Radiotherapy and Oncology Department, Hospital Umum Sarawak, Kuching, Malaysia
| | - S Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - I B Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - S L Chan
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, China
| | - D S W Tan
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
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14
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Oki K, Nakajima M, Koyama T, Oyama N, Koga M, Hayase M, Ohta T, Omori T, Matsumoto K, Iguchi Y, Fujimoto S, Kakuda W, Ogasawara K. Timing of Initiation of Acute Stroke Rehabilitation and Management Corresponding to Complications at Primary Stroke Centers in Japan: A Nationwide Cross-Sectional Web-Based Questionnaire Survey. Cerebrovasc Dis 2023; 53:125-135. [PMID: 37399792 DOI: 10.1159/000530873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/22/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION Many guidelines now recommend early rehabilitation for acute stroke patients. However, evidence remains lacking regarding the specific timings for initiation of various rehabilitation steps and management when complications are encountered in acute stroke rehabilitation. This survey aimed to investigate actual clinical situations in acute stroke rehabilitation in Japan and to improve the medical systems for rehabilitation and plan further studies. METHODS This nationwide, cross-sectional, web-based questionnaire survey was administered between February 7, 2022, and April 21, 2022, targeting all primary stroke centers (PSCs) in Japan. Among several components of the survey, this paper focused on the timing of the initiation of three rehabilitation steps (passive bed exercise; head elevation; and out-of-bed mobilization), along with the management of rehabilitation (continued or suspended) in the event of complications during acute stroke rehabilitation. We also investigated the influence of facility features on these contents. RESULTS Responses were obtained from 639 of the 959 PSCs surveyed (response rate: 66.6%). In cases of ischemic stroke and intracerebral hemorrhage, most PSCs initiated passive bed exercise on day 1, head elevation on day 1, and out-of-bed mobilization on day 2 (with day of admission defined as day 1). In cases with subarachnoid hemorrhage, rehabilitation steps were delayed compared to other stroke subtypes or showed wide variation depending on the facility. Passive bed exercise was accelerated by the presence of protocols for rehabilitation and weekend rehabilitation. Out-of-bed mobilization was accelerated by the presence of a stroke care unit. Facilities with board-certified rehabilitation doctors were cautious regarding the initiation of head elevation. Most PSCs suspended rehabilitation training in the event of symptomatic systemic/neurological complications. CONCLUSION Our survey revealed the actual situation of acute stroke rehabilitation in Japan and indicated that some facility features appear to influence early increases in physical activity levels and early mobilization. Our survey provides fundamental data to improve the medical systems for acute stroke rehabilitation in the future.
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Affiliation(s)
- Koichi Oki
- Department of Neurology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Makoto Nakajima
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Naoki Oyama
- Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Makoto Hayase
- Department of Neurosurgery, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - Tsuyoshi Ohta
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomohiro Omori
- Division of Rehabilitation Medicine, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Koichi Matsumoto
- Division of Rehabilitation Medicine, General Tokyo Hospital, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Wataru Kakuda
- Department of Rehabilitation Medicine, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
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15
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Taketa T, Uchiyama Y, Kodama N, Koyama T, Domen K. ICU-Acquired Weakness Complicated With Bilateral Foot Drop After Severe COVID-19: Successful Rehabilitation Approach and Long-Term Follow-Up. Cureus 2023; 15:e36566. [PMID: 37102034 PMCID: PMC10123525 DOI: 10.7759/cureus.36566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/28/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is associated with muscle and nerve injuries as a consequence of prolonged critical illness. We report here a case of intensive care unit-acquired weakness (ICU-AW) with bilateral peroneal nerve palsy after COVID-19. A 54-year-old male with COVID-19 was transferred to our hospital. He was treated by mechanical ventilation and veno-venous extracorporeal membrane oxygenation (VV-ECMO), from which he was successfully weaned. However, by day 32 of ICU admission, he had developed generalized muscle weakness with bilateral foot drop and was diagnosed with intensive care unit-acquired weakness complicated with bilateral peroneal nerve palsy. Electrophysiological examination showed a denervation pattern in the tibialis anterior muscles, indicating that the foot drop was unlikely to recover immediately. Gait training with customized ankle-foot orthoses (AFO) and muscle-strengthening exercises were started as part of a regimen that included a stay in a convalescent rehabilitation facility and outpatient rehabilitation. Seven months after onset, he returned to work, and 18 months after onset, he had improved to the same level of activities of daily living (ADLs) as before onset. Outcome prediction by electrophysiological examination, appropriate prescription of orthoses, and continuous rehabilitative treatment that focused on locomotion contributed to the successful outcome in this case.
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Affiliation(s)
- Tomoyo Taketa
- Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, JPN
| | - Yuki Uchiyama
- Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, JPN
| | - Norihiko Kodama
- Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, JPN
| | - Tetsuo Koyama
- Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, JPN
| | - Kazuhisa Domen
- Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, JPN
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16
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Adachi R, Matsushita T, Koyama T, Hatano K, Matsuoka K. Synthetic assembly of a series of glycopolymers having sialyl α2-3 lactose moieties connected with longer spacer arms. Bioorg Med Chem 2023; 81:117209. [PMID: 36787684 DOI: 10.1016/j.bmc.2023.117209] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
Glycopolymers having sialyl α2-3 lactose moieties via longer spacer arms were systematically prepared from the corresponding glycomonomers. Radical polymerization of glycomonomers gave a series of glycopolymers displaying various sugar densities. Fluorometric analyses of wheat germ agglutinin (WGA) against the glycopolymers were conducted and the results showed unique binding specificities on the basis of sugar densities.
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Affiliation(s)
- Ryota Adachi
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Takahiko Matsushita
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Area for Health Science, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Area for Health Science, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan; Area for Health Science, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan.
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17
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Uchiyama Y, Domen K, Koyama T. Brain regions associated with Brunnstrom and functional independence measure scores in patients after a stroke: a tract-based spatial statistics study. J Phys Ther Sci 2023; 35:211-216. [PMID: 36866011 PMCID: PMC9974314 DOI: 10.1589/jpts.35.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/06/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] We aimed to assess diffusion tensor fractional anisotropy to outline the brain regions associated with the long-term motor and cognitive functional outcomes of patients with stroke. [Participants and Methods] Eighty patients from our previous study were enrolled. Fractional anisotropy maps were acquired on days 14-21 after stroke onset, and tract-based spatial statistics were applied. Outcomes were scored using the Brunnstrom recovery stage and Functional Independence Measure motor and cognition components. Fractional anisotropy images were assessed in relation to outcome scores using the general linear model. [Results] For both the right (n=37) and left (n=43) hemisphere lesion groups, the corticospinal tract and the anterior thalamic radiation were most strongly associated with the Brunnstrom recovery stage. In contrast, the cognition component involved large regions encompassing the anterior thalamic radiation, superior longitudinal fasciculus, inferior longitudinal fasciculus, uncinate fasciculus, cingulum bundle, forceps major, and forceps minor. The results for the motor component were intermediate between those for the Brunnstrom recovery stage and those for the cognition component. [Conclusion] Motor-related outcomes were associated with fractional anisotropy decreases in the corticospinal tract, whereas cognitive outcomes were related to broad regions of association and commissural fibers. This knowledge will help scheduling appropriate rehabilitative treatments.
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Affiliation(s)
- Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan,Corresponding author. Yuki Uchiyama (E-mail: )
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo Medical
University: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan, Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital, Japan
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18
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Adachi R, Matsushita T, Koyama T, Hatano K, Matsuoka K. Use of a Longer Aglycon Moiety Bearing Sialyl α(2→3) Lactoside on the Glycopolymer for Lectin Evaluation. Polymers (Basel) 2023; 15:polym15040998. [PMID: 36850281 PMCID: PMC9959589 DOI: 10.3390/polym15040998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
A polymerizable alcohol having 9 PEG repeats was prepared in order to mimic an oligosaccharide moiety. Sialyl α(2→3) lactose, which is known as a sugar moiety of GM3 ganglioside, was also prepared, and the polymerizable alcohol was condensed with the sialyl α(2→3) lactose derivative to afford the desired glycomonomer, which was further polymerized with or without acrylamide to give water-soluble glycopolymers. The glycopolymers had higher affinities than those of glycopolymers having sialyl lactose moieties with shorter aglycon moieties.
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Affiliation(s)
- Ryota Adachi
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Takahiko Matsushita
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
- Correspondence: ; Tel.: +81-7088194601
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19
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Mochizuki M, Uchiyama Y, Domen K, Koyama T. Applicability of automated tractography during acute care stroke rehabilitation. J Phys Ther Sci 2023; 35:156-162. [PMID: 36744203 PMCID: PMC9889207 DOI: 10.1589/jpts.35.156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/22/2022] [Indexed: 02/04/2023] Open
Abstract
[Purpose] To assess the clinical applicability of a novel automated tractography tool named XTRACT during acute stroke rehabilitation. [Participants and Methods] Three patients with left hemisphere stroke were sampled. Diffusion tensor images were acquired on the second week, and automated tractography was then applied. Tractography images and fractional anisotropy (FA) values in the corticospinal tract (CST) and arcuate fasciculus (AF) were assessed in relation to hemiparesis and aphasia. [Results] Patient 1 was nearly asymptomatic; FA in the left CST was 0.610 and that in the AF was 0.509. Patient 2 had severe hemiparesis and mild motor aphasia. Tractography images of the CST and AF were blurred; FA in the left CST was 0.295 and that in the AF was 0.304. Patient 3 showed no hemiparesis or aphasia at initial assessment. Tractography image of the CST was intact but that of the AF was less clear; FA in the left CST was 0.586 and that in the AF was 0.338. Considering the less clear images of the AF and lower FA value in Patients 2 and 3, further examinations for aphasia were performed, which revealed agraphia. [Conclusion] Visualization and quantification of neural fibers using automated tractography promoted planning acute care rehabilitative treatment in patients with stroke.
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Affiliation(s)
- Midori Mochizuki
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan,Corresponding author. Midori Mochizuki (E-mail: )
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu
Neurosurgical Hospital: 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan, Department of Rehabilitation Medicine, Hyogo Medical
University, Japan
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20
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Kondo S, Koyama T, Kawazoe A, Iwasa S, Yonemori K, Shitara K, Nakamura Y, Saori M, Yamamoto N, Sato J, Sahara T, Hayata N, Yamamuro S, Kimura T, Dutta L, Tamai T, Ikeda M. 401P A phase Ib study of E7386, a CREB-binding protein (CBP)/β-catenin interaction inhibitor, in combination with lenvatinib in patients (pts) with advanced solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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21
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Matsushita T, Maruyama N, Koyama T, Hatano K, Matsuoka K. Modification of Fab Fragments by Dibromopyridazinediones Carrying Mono- and Double-Biotin Functionalities. ACS Omega 2022; 7:34554-34562. [PMID: 36188280 PMCID: PMC9520716 DOI: 10.1021/acsomega.2c04379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
To verify the potencies of dibromopyridazinediones with mono- and double-biotin groups, the functions as cysteine-selective biotinylation reagents were evaluated through conjugation with a goat anti-mouse IgG Fab fragment as a functional protein model. The starting Fab was reduced with tris(2-carboxyethyl)phosphine to cleave the disulfide bond and then treated with the reagents. These reagents simultaneously introduced biotin groups into the reduced Fab and re-bridged the disulfide moiety. Furthermore, we demonstrated that the biotin-labeled Fabs were reactive to an antigen and streptavidin.
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Affiliation(s)
- Takahiko Matsushita
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Naoto Maruyama
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Koji Matsuoka
- Area
for Molecular Function, Division of Material Science, Graduate School
of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
- Medical
Innovation Research Unit (MiU), Advanced Institute of Innovative Technology
(AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
- Health
Sciences and Technology Research Area, Strategic Research Center, Saitama University, Sakura, Saitama 338-8570, Japan
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22
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Doi T, Patel M, Falchook G, Koyama T, Friedman C, Piha-Paul S, Gutierrez M, Abdul-Karim R, Awad M, Adkins D, Takahashi S, Kadowaki S, Cheng B, Ikeda N, Laadem A, Yoshizuka N, Qian M, Dosunmu O, Arkenau HT, Johnson M. 453O DS-7300 (B7-H3 DXd antibody-drug conjugate [ADC]) shows durable antitumor activity in advanced solid tumors: Extended follow-up of a phase I/II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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23
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Ware L, Koyama T, Nguyen J, Swain S, Kukreja J, Dhillon G, Weigt S, Singer J, Matthay M. Randomized Trial of Protective Lung Ventilation in Organ Donors. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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24
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Matsuoka K, Nakagawa M, Koyama T, Matsushita T, Hatano K. Systematic synthesis of a series of glycopolymers having N-acetyl-D-glucosamine moieties that can be used for evaluations of lectin—carbohydrate interactions. Eur Polym J 2022. [DOI: 10.1016/j.eurpolymj.2022.111101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Kanata Y, Ito T, Yoshida T, Koyama T, Mikami Y, Domen K. Prosthetic walking after bilateral transfemoral amputation in a patient with dilated cardiomyopathy: a case report. Prosthet Orthot Int 2022; 46:195-198. [PMID: 35412526 DOI: 10.1097/pxr.0000000000000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 11/01/2021] [Indexed: 02/03/2023]
Abstract
In this study, we present a case of a 14-year-old adolescent boy who developed rhabdomyolysis and underwent bilateral transfemoral amputation after cardiopulmonary resuscitation for cardiac arrest because of dilated cardiomyopathy (DCM). Patients with bilateral transfemoral amputation have slower walking velocity and greater oxygen consumption during walking. Rehabilitation of such patients may be demanding especially if they have DCM, one of the major causes of advanced heart failure. The patient was admitted to our hospital on postoperative day (POD) 206. At first, we started with residuum compression. Simultaneously, resistance training and range-of-motion exercise were performed. He started the walking training with short stubbies prostheses on POD 262. Then, we used two types of knee joint prostheses, microprocessor-controlled prosthetic knee (MPK) and non-MPK. We chose MPK for his bilateral knee joints because it was easier for him to walk with MPK than with non-MPK. MPK also has the advantage of high stability and less burden on the heart. He achieved to walk with the prosthesis using T-canes with both hands on POD 374. Furthermore, he was able to return to school after discharge. In patients with transfemoral amputations and DCM with exercise restrictions, MPK is preferred because it reduces cardiac load during physical activity.
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Affiliation(s)
- Yoshihiro Kanata
- Department of Rehabilitation Medicine, Hyogo College of Medicine Sasayama Medical Center, Tanbasasayama, Hyogo, Japan
| | - Tomoyuki Ito
- Department of Rehabilitation Medicine, Kyoto Tanabe Memorial Hospital, Kyotanabe, Kyoto, Japan
| | - Takuya Yoshida
- Department of Rehabilitation Medicine, Kyoto Tanabe Memorial Hospital, Kyotanabe, Kyoto, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan
| | - Yasuo Mikami
- Department of Rehabilitation Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan
| | - Kazuhiza Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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26
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Taketa T, Uchiyama Y, Kodama N, Koyama T, Domen K. Rehabilitation Management for a Patient with Bilateral Pneumothorax after Surgery for Esophageal Cancer. Prog Rehabil Med 2022; 7:20220017. [PMID: 35434404 PMCID: PMC8983873 DOI: 10.2490/prm.20220017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Tomoyo Taketa
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Norihiko Kodama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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27
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Uchiyama Y, Domen K, Katsutani M, Koyama T. Relationship between the independence level of individual motor-related functional independence measure items and its total score in patients after hip fracture: an ordinal logistic modelling study. J Phys Ther Sci 2022; 34:404-409. [PMID: 35527845 PMCID: PMC9057680 DOI: 10.1589/jpts.34.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/17/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan
| | - Masashi Katsutani
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Rehabilitation Hospital, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya City, Hyogo 663-8501, Japan
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28
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Uchiyama Y, Domen K, Koyama T. Outcome Prediction of Patients with Intracerebral Hemorrhage by Measurement of Lesion Volume in the Corticospinal Tract on Computed Tomography. Prog Rehabil Med 2021; 6:20210050. [PMID: 34963905 PMCID: PMC8652345 DOI: 10.2490/prm.20210050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: This study investigated the potential utility of computed tomography for outcome prediction in patients with intracerebral hemorrhage. Methods: Patients with putaminal and/or thalamic hemorrhage for whom computed tomography images were acquired in our hospital emergency room soon after onset were retrospectively enrolled. Outcome measurements were obtained at discharge from the convalescent rehabilitation ward of our affiliated hospital. Hemiparesis was evaluated using the total score of the motor component of the Stroke Impairment Assessment Set (SIAS-motor; null to full, 0 to 25), the motor component of the Functional Independence Measure (FIM-motor; null to full, 13 to 91), and the total length of hospital stay. After registration of the computed tomography images to the standard brain, the volumes of the hematoma lesions located in the corticospinal tract were calculated. The correlation between the corticospinal tract lesion volumes and the outcome measurements was assessed using Spearman’s rank correlation test. Results: Thirty patients were entered into the final analytical database. Corticospinal tract lesion volumes ranged from 0.002 to 4.302 ml (median, 1.478). SIAS-motor scores ranged from 0 to 25 (median, 20), FIM-motor scores ranged from 15 to 91 (median, 80.5), and the total length of hospital stay ranged from 31 to 194 days (median, 106.5). All correlation tests were statistically significant (P <0.01). The strongest correlation was for SIAS-motor total (R=–0.710), followed by FIM-motor (R=–0.604) and LOS (R=0.493). Conclusions: These findings suggest that conventional computed tomography images may be useful for outcome prediction in patients with intracerebral hemorrhage.
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Affiliation(s)
- Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
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29
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Zhang J, Koyama T, Matsushita T, Hatano K, Matsuoka K. Preparation of lauryl thioglycoside of N-glycolylneuraminic acid (Neu5Gc) as a useful glycosyl donor for assembly of an oligosaccharide containing Neu5Gc. Tetrahedron Lett 2021. [DOI: 10.1016/j.tetlet.2021.153403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Kage H, Sunami K, Naito Y, Amano T, Ennishi D, Imai M, Kanai M, Kenmotsu H, Komine K, Koyama T, T. M, Morita S, Saigusa Y, Sakai D, Yamanaka T, Kohsaka S, Tsuchihara K, Yoshino T. 519MO Concordance analysis of treatment recommendations between central consensus and multidisciplinary tumor boards. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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31
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Kojima Y, Shimizu T, Yonemori K, Koyama T, Matsui N, Kamikura M, Tomatsuri S, Okuma H, Shimoi T, Noguchi E, Sudo K, Hirakawa A, Sadachi R, Okita N, Nakamura K, Yamamoto N, Fujiwara Y. 1521O A phase II biomarker-driven study evaluating the clinical efficacy of an MDM2 inhibitor, milademetan, in patients with intimal sarcoma, an ultra-rare cancer with highly life-threatening unmet medical needs (NCCH1806/MK004). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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32
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Komine K, Sunami K, Naito Y, Amano T, Ennishi D, Imai M, Kage H, Kanai M, Kenmotsu H, Koyama T, T. M, Morita S, Sakai D, Kohsaka S, Tsuchihara K, Saigusa Y, Yamanaka T, Yoshino T. 551P Chronological improvement in precision oncology implementation in Japan. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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33
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Kitada T, Kadoba K, Watanabe R, Koyama T, Nakayama Y, Taki M, Yukawa S, Odani K, Morinobu A. Listeriosis presenting with fever, arthralgia, elevated liver enzymes, and hyperferritinaemia in pregnancy: a critical mimicker of adult-onset Still's disease. Scand J Rheumatol 2021; 51:78-80. [PMID: 34152237 DOI: 10.1080/03009742.2021.1923149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- T Kitada
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,These authors contributed equally to this work
| | - K Kadoba
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,These authors contributed equally to this work
| | - R Watanabe
- Department of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Koyama
- Department of Rheumatology and Clinical Immunology, Kyoto University Hospital, Kyoto, Japan.,Department of Infectious Diseases, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Y Nakayama
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Taki
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S Yukawa
- Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan
| | - K Odani
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - A Morinobu
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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34
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Uchida K, Uchiyama Y, Domen K, Koyama T. Outcome Prediction for Patients With Ischemic Stroke in Acute Care: New Three-Level Model by Eating and Bladder Functions. Ann Rehabil Med 2021; 45:215-223. [PMID: 34126671 PMCID: PMC8273726 DOI: 10.5535/arm.20226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/11/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To develop a new prediction model by combining independence in eating and bladder management functions, and to assess its utility in an acute care setting. METHODS Patients with ischemic stroke who were admitted in our acute stroke care unit (n=250) were enrolled in this study. Functional Independence Measure (FIM) scores for eating and bladder management on the initial day of rehabilitative treatment (median, 3 days) were collected as predictive variables. These scores were divided into low (<5) and high (≥5) and categorized as values 0 and 1, respectively. From the simple summation of these two-level model values, we derived a three-level model that categorized the scores as values 0, 1, and 2. The FIM-motor scores at discharge (median, 14 days) were collected as outcome measurements. The three-level model was assessed by observing the distribution patterns of the outcome FIM-motor scores and logistic regression analyses. RESULTS The median outcome FIM-motor score was 19 (interquartile range [IQR],13.8-45.3) for the value 0 category (n=14), 66.5 (IQR, 59.5-81.8) for the value 1 category (n=16), and 84 (IQR, 77-89) for the value 2 category (n=95) in the three-level model. Data fitting by logistic regression for FIM-motor scores of 41.3 and 61.4 reached 50% probability of values 1 and 2, respectively. CONCLUSION Despite the simplicity of the three-level model, it may be useful for predicting outcomes of patients with ischemic stroke in acute care.
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Affiliation(s)
- Kensaku Uchida
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan.,Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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35
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Uchiyama Y, Sasanuma N, Nanto T, Fujita K, Takahashi M, Iwasa S, Koyama T, Kodama N, Domen K. COVID-19 Patient Returned to Work after Long Hospitalization and Follow-up: A Case Report. Prog Rehabil Med 2021; 6:20210025. [PMID: 34164586 PMCID: PMC8190587 DOI: 10.2490/prm.20210025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/25/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) causes severe respiratory dysfunction and
post-intensive care syndrome (PICS), which can significantly affect the return to work
after discharge from the hospital. This report describes the first case of a patient
with severe COVID-19 at our institution during the first wave of the COVID-19 pandemic
(February to June 2020) who returned to work following rehabilitation management. Case: A 48-year-old female nurse was admitted with COVID-19 and underwent mechanical
ventilation (MV). Respiratory and anti-gravity training was conducted as physical
therapy; however, the patient developed PICS, muscle weakness, delirium, and
psychological problems. After the withdrawal of MV, muscle strengthening activities,
activities of daily living (ADL) training, family visits, and occupational and speech
therapy were started. On day 60 post-admission, the patient was able to perform ADL
independently and was discharged; however, she continued to experience shortness of
breath during exertion. Post-discharge, follow-up assessments for symptoms, respiratory
function, and exercise capacity were continued. On day 130, she returned to work as a
nurse. Discussion: The PICS noted during hospitalization in this patient improved, but at discharge, the
patient had difficulty completing the practical tasks involved in a nurse’s workload.
Follow-up assessments of symptoms, respiratory function, and exercise capacity after
discharge helped to determine whether the patient could return to work.
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Affiliation(s)
- Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Naoki Sasanuma
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Japan
| | - Tomoki Nanto
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Japan
| | - Kouhei Fujita
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Japan
| | - Miyako Takahashi
- Department of Nursing, Hyogo College of Medicine College Hospital, Nishinomiya, Japan
| | - Saya Iwasa
- Department of Rehabilitation, Hyogo College of Medicine College Hospital, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Norihiko Kodama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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Yoshida T, Hashimoto M, Murakami K, Murata K, Nishitani K, Watanabe R, Koyama T, Uehara R, Tanaka M, Ito H, Matsuda S. POS1482-HPR PAIN CATASTROPHIZING IS ASSOCIATED WITH RESIDUAL PAIN AFTER REACHING IMPROVED CONDITIONS OF SWOLLEN/TENDER JOINTS AND SERUM C-REACTIVE PROTEIN LEVEL. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:It has long been recognized that immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA), are prone to coexist with depression due to the effects of cytokines, and that these two illnesses lead to an elevation in patients’ pain. However, we often encounter patients with RA who suffer from residual pain despite an improvement in disease activity and inflammation. The specific psychological factors associated with residual pain have not yet been clarified. In addition to the traditional psychological factors, such as depression and anxiety, we focused on pain catastrophizing due to the distortion of pain perception and explored its association with residual pain.Objectives:To examine whether psychological factors, such as pain catastrophizing, depression, and anxiety, are associated with self-reported pain visual analogue scale (pain-VAS) scores in RA patients with 1 or less on 28joints- swollen/tender counts (SJC/TJC) and CRP.Methods:This was a cross-sectional study of 290 RA outpatients (85% of whom were women) with scores of less than 1 on SJC, TJC, and CRP, with a median (IQR) age of 66 (57–73) years. The participants completed questionnaires, including pain VAS (0–100 mm), Pain Catastrophizing Scale (PCS, 0–52 scale), and Hospital Depression and Anxiety Scale (HADS, 0–42 scale). Using linear regression analyses, we analysed whether PC (PCS ≥30), depression (HADS-D ≥11), and anxiety (HADS-A ≥11) (independent variables) were associated with pain VAS scores (dependent variable). After univariate regression analysis, multivariate analysis adjusted for confounding factors was performed.Results:Patients reported a wide range of pain severity with a median (range) pain VAS score of 9 (0–96mm). The prevalence of anxiety and depression were 5.5% and 5.9%, respectively. Meanwhile, 24.1% of the patients experienced pain catastrophizing. Pain catastrophizing was associated with pain VAS scores in univariate and multivariate analyses (Table 1). The presence of anxiety and depression was not associated with pain VAS scores in any model. Multivariate analysis of other covariates showed that age, disease duration, and presence of SJC/TJC of joints other than the 28 joints were positively correlated with pain VAS scores.Table 1.Univariate and multivariate regression analysis for independent variables associated with pain-VAS scoresUnivariateMultivariate independent variablesModel 1*Model 2**Pain catastrophizingEstimate3.74.13.695%CI 0.7 to 6.61.1 to 7.00.5 to 6.6p-value0.0150.0060.021AnxietyEstimate3.74.40.595%CI -1.9 to 9.2 -1.0 to 9.9 -3.5 to 7.9p value0.1980.1080.453DepressionEstimate3.54.23.995%CI -1.9 to 8.9 -1.1 to 9.5 -1.9 to 8.7p-value0.2040.1190.210The covariates in multivariate analysis are as follows: age, sex, body mass index, disease duration, Steinbrocker’s Stage, prednisolone dosage, biologic agents use, and presence of swollen joint counts/tender joint counts of joints other than the 28 joints.*Model 1: each psychological independent variable and the above covariates.**Model 2: all psychological independent variables and the above covariates.Conclusion:Pain catastrophizing was associated with pain VAS scores in RA patients with 1 or less on 28joints-SJC/TJC and CRP, emphasising that residual pain in the patients should be treated in a biopsychosocial framework focussing on pain catastrophizing.Disclosure of Interests:Tamami Yoshida: None declared, Motomu Hashimoto Speakers bureau: Mitsubishi Tanabe Pharma Corporation; Bristol-Myers Squibb; Eisai Co., Ltd.; and Eli Lilly and Company., Grant/research support from: Mitsubishi Tanabe Pharma Corporation; Bristol-Myers Squibb; Eisai Co., Ltd.; and Eli Lilly and Company., Kosaku Murakami Speakers bureau: Eisai Co., Ltd.; Chugai Pharmaceutical Co., Ltd.; Pfizer Inc.; Bristol-Myers Squibb; Mitsubishi Tanabe Pharma Co; UCB Japan Co., Ltd.; Daiichi Sankyo Co., Ltd.; and Astellas Pharma Inc., Consultant of: Eisai Co., Ltd.; Chugai Pharmaceutical Co., Ltd.; Pfizer Inc.; Bristol-Myers Squibb; Mitsubishi Tanabe Pharma Co; UCB Japan Co., Ltd.; Daiichi Sankyo Co., Ltd.; and Astellas Pharma Inc., Koichi Murata Speakers bureau: Eisai Co., Ltd. and Astellas Pharma Inc., Consultant of: Eisai Co., Ltd. and Astellas Pharma Inc., Kohei Nishitani Grant/research support from: Asahi-Kasei Pharma., Ryu Watanabe Speakers bureau: Mitsubishi Tanabe Pharma Co; Pfizer Inc.; Sanofi S.A.; AbbVie GK; Asahi Kasei Pharma; Eisai Co., Ltd.; Eli Lilly and Company; Bristol-Myers Squibb; and Janssen Pharmaceutical K.K., Teruhide Koyama: None declared, Ritei Uehara: None declared, Masao Tanaka Speakers bureau: AbbVie GK, Asahi Kasei Pharma., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Pfizer Inc., Taisyo Pharma., Ltd., UCB Japan Co., Ltd., Grant/research support from: AbbVie GK, Asahi Kasei Pharma., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Pfizer Inc., Taisyo Pharma., Ltd., UCB Japan Co., Ltd., Hiromu Ito Grant/research support from: Bristol-Myers Squibb, Eisai Co, Taisyo Pharma., and Mochida., Shuichi Matsuda: None declared
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Iwasa S, Uchiyama Y, Kodama N, Koyama T, Domen K. Regaining Gait Using an Early Postoperative Hip Prosthesis: A Case Report of an Elderly Woman. Prog Rehabil Med 2021; 6:20210011. [PMID: 33598585 PMCID: PMC7882425 DOI: 10.2490/prm.20210011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 01/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Hip prostheses are generally avoided in elderly patients because of cognitive decline and/or reduced muscle strength. The present report describes the case of an elderly woman who regained gait using a prosthesis prescribed during the early postoperative phase following hip disarticulation. Case: A 78-year-old woman suffered from a pathological fracture caused by liposarcoma of the left thigh. Before hospitalization, the patient was fully independent in her activities of daily living, including gait. The right and left handgrip strengths were 12.9 and 14.2 kg, respectively, and the patient had no signs of cognitive decline. Radical treatment involving hip disarticulation was scheduled. Before surgery, the possibility of fitting a hip prothesis that would allow the patient to walk was discussed, to which she consented. On postoperative day 23, the patient was fitted with a hip prosthesis and began gait training. On day 31, she was able to walk using a fixed walker and, eventually, using a crutch. Discussion: The present case demonstrated the successful reacquisition of gait using a hip prothesis prescribed during the early postoperative phase after amputation, suggesting that the applicability of hip prostheses may be widely considered even for elderly patients.
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Affiliation(s)
- Saya Iwasa
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Norihiko Kodama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
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Yasukawa T, Koyama T, Uchiyama Y, Iwasa S, Saito J, Takahashi J, Kiritani N, Domen K. Outcome prediction in patients with putaminal hemorrhage at admission to a convalescent rehabilitation ward based on hemorrhage volume assessed with computed tomography during acute care. J Phys Ther Sci 2021; 33:27-31. [PMID: 33519070 PMCID: PMC7829568 DOI: 10.1589/jpts.33.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/02/2020] [Indexed: 11/30/2022] Open
Abstract
[Purpose] The aim of this study was to assess the usefulness of computed tomography for
outcome prediction in patients with putaminal hemorrhage at admission to a convalescent
rehabilitation ward. [Participants and Methods] Patients admitted to our convalescent
rehabilitation ward after transfer from acute care hospitals were included in this study.
Multiple regression analyses were performed using the score in the motor component of the
Functional Independence Measure at discharge as the target value. Hemorrhage volume
assessed with computed tomography during acute care and age were set as the explanatory
variables. The motor component of the Functional Independence Measure score at admission
and the time (days) from onset were also recorded. Correlation analyses between all the
possible pairs of explanatory variables were then performed. [Results] Hemorrhage volume
and age were both significant contributors to the motor component of the Functional
Independence Measure score at discharge. However, the contribution of hemorrhage volume
disappeared when the time from onset and motor component of the Functional Independence
Measure score at admission were added. Hemorrhage volume significantly correlated with the
time from onset and motor component of the Functional Independence Measure score at
admission. [Conclusion] The present findings suggest that computed tomography may be
useful for outcome prediction from the acute stage in stroke patients with putaminal
hemorrhage. However, because of multicollinearity, its predictive power was reduced when
the patients were transferred to a convalescent rehabilitation ward.
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Affiliation(s)
- Toshiki Yasukawa
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.,Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Saya Iwasa
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Saito
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Jun Takahashi
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Naoko Kiritani
- Department of Rehabilitation Medicine, Rakusai Shimizu Hospital, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine: 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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Pasalic D, Barocas D, Zhao Z, Huang L, Koyama T, Tang C, Penson D, Hoffman K. Patient-Reported Outcomes through Five Years following External Beam Radiotherapy or External Beam Radiotherapy with Low-Dose-Rate Brachytherapy Boost for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Oka T, Kamada R, Kunimasa K, Oboshi M, Nishikawa T, Yasui T, Shioyama W, Miyashita Y, Koyama T, Kumagai T, Fujita M. Pathological assessment of osimertinib-associated cardiotoxicity in EGFR-mutated non-small cell lung cancer patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Osimertinib, a third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), inhibits both EGFR-TKI sensitizing mutations and resistant T790M mutations detected in non-small cell lung cancer (NSCLC) patients. Cardiac adverse events (AEs) induced by osimertinib are infrequent; however, cases of severe associated cardiac dysfunction have been reported and remain poorly understood.
Purpose
To assess pathogenesis of osimertinib-associated cardiac AEs, we analyzed myocardial specimens of three NSCLC cases with osimertinib-associated cardiac dysfunction.
Results
Analysis of LVEF prior to and after osimertinb administration in 36 NSCLC patients showed significant decrease of LVEF from 69% to 63%. Within this cohort, right ventricular (RV) biopsy was performed in 2 cases to further understand the pathophysiology of cardiac dysfunction. Case 1 was 78-year-old female with advanced NSCLC harboring an EGFR L858R mutation was treated with osimertinib as second line therapy. After 3 moths of osimetinib treatment, she presented with dyspnea, high NT-proBNP and troponin I, and significantly decreased left ventricular ejection fraction (LVEF) at 28%. RV biopsy showed moderate cardiomyocyte hypertrophy without inflammatory cell infiltration. Case 2 was 52-year-old female with advanced NSCLC harboring L858R mutation. She was treated with osimertinib as first line therapy. After 2 weeks of osimertinib, screening echocardiography revealed a reduction of LVEF from 63% to 41% without cardiac symptom. RV biopsy showed mild cardiomyocyte hypertrophy with infiltration of a few inflammatory cells in interstinum. We further analyzed death case of NSCLC. Case 3 was 63-year-old female with advanced NSCLC harboring EGFR ex. 19 del. and T790M mutations. After 6 months of osimertinib, she suffered from severe respiratory failure and severely reduced LVEF at 27%. She died on the 44th day after admission. Pathological autopsy revealed mild to moderate cardiomyocyte hypertrophy without inflammatory cell infiltration in both ventricles. These pathological findings may indicate neither myocyte injury nor myocarditis was induced by osimertinib in myocardium.
Conclusion
Although additional data collection of advanced NSCLC patients will be important in understanding the pathophysiology of cardiac AEs with osimertinib, osimertinib-associated cardiotoxicity may result from functional inhibition of myocyte contractility by osimertinib without induction of cell death or inflammation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Oka
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - R Kamada
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - K Kunimasa
- Osaka International Cancer Institute, Department of Thoracic Oncology, Osaka, Japan
| | - M Oboshi
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - T Nishikawa
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - T Yasui
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - W Shioyama
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
| | - Y Miyashita
- Yamanashi Prefectural Central Hospital, Department of Pneumology, Kofu, Japan
| | - T Koyama
- Yamanashi Prefectural Central Hospital, Department of Pathology, Kofu, Japan
| | - T Kumagai
- Osaka International Cancer Institute, Department of Thoracic Oncology, Osaka, Japan
| | - M Fujita
- Osaka International Cancer Institute, Department of Onco-Cardiology, Osaka, Japan
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Uchida K, Uchiyama Y, Domen K, Koyama T. Item Difficulties of the FIM-Motor Subscale in Patients with Ischemic Stroke during Acute Care: An Ordinal Logistic Modeling Study. Prog Rehabil Med 2020; 5:20200022. [PMID: 32999943 PMCID: PMC7516197 DOI: 10.2490/prm.20200022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/15/2020] [Indexed: 01/01/2023] Open
Abstract
Objective: The aim of the current study was to assess the item difficulties of the motor subscales of the Functional Independence Measure (FIM-motor) in patients with ischemic stroke during acute care. Methods: FIM scores were assessed for each patient on admission to, and discharge from, acute care. The relationship between individual FIM-motor items (target variables) and the total FIM-motor score (explanatory variable) was assessed by ordinal logistic modeling. The total FIM-motor scores that corresponded to a 50% probability of independence level 5 (supervision or setup) for each FIM-motor item were assessed. Results: A total of 250 patients (155 men, 95 women) were included in the analytical database. The median age was 74 (interquartile range [IQR], 66–81) years and the median length of hospital stay was 14 (IQR, 10–24) days. Ordinal logistic modeling was successfully performed for all 13 FIM-motor items. The total FIM-motor scores that corresponded to a 50% probability of independence level 5 for individual FIM-motor items were as follows: eating, 34.1; bowel management, 42.2; bladder management, 43.4; grooming, 51.0; toileting, 62.0; dressing the lower body, 64.5; transfer to bed/chair/wheelchair, 65.5; transfer to toilet, 65.9; bathing, 70.3; dressing the upper body, 73.6; locomotion, 74.2; transfer to tub/shower, 80.0; and stair climbing, 89.2. Conclusions: These results revealed that eating, grooming, and bowel and bladder management were relatively easy, whereas gait-related items such as locomotion and stair climbing were difficult. Items such as transfer to bed/chair/wheelchair and toileting had intermediate difficulty. These results should facilitate efficient rehabilitative treatments during acute care.
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Affiliation(s)
- Kensaku Uchida
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
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Matsuoka K, Suzuki Y, Koyama T, Matsushita T, Hatano K. Fluorogenic glycopolymers available for determining the affinity of lectins by intermolecular FRET. Bioorg Med Chem Lett 2020; 30:127024. [PMID: 32098722 DOI: 10.1016/j.bmcl.2020.127024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/31/2020] [Accepted: 02/09/2020] [Indexed: 10/25/2022]
Abstract
A convenient assembly of fluorogenic glycopolymers having various polymer compositions was accomplished from the corresponding glycomonomer and dansyl monomer by means of radical polymerization, and the water-soluble glycopolymers gave typical fluorescence spectroscopic profiles due to the dansyl moieties on the glycopolymer in aqueous media. Biological evaluation of the polymer against wheat germ agglutinin (WGA) was accomplished on the basis of fluorescence changes due to tryptophan residues on WGA, and the affinities between the glycopolymers and WGA were estimated to be 4.7 × 105 to 9.3 × 105 M-1. In order to apply the fluorogenic glycopolymers for further biological measurements, efficient resonance energy transfer from tryptophan moieties on WGA to dansyl moieties on the fluorogenic glycopolymers was examined. FRET profiles of both fluorophores were similar compared to the binding profiles on the basis of fluorescence changes of tryptophan residues. This approach is applicable for the determination of an affinity constant between a carbohydrate and a lectin in which no fluorophore exists near the binding site.
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Affiliation(s)
- Koji Matsuoka
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan.
| | - Yuya Suzuki
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Tetsuo Koyama
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan
| | - Takahiko Matsushita
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
| | - Ken Hatano
- Area for Molecular Function, Division of Material Science, Graduate School of Science and Engineering, Saitama University, Sakura, Saitama 338-8570, Japan; Medical Innovation Research Unit (MiU), Advanced Institute of Innovative Technology (AIIT), Saitama University, Sakura, Saitama 338-8570, Japan
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Koyama T, Uchiyama Y, Domen K. Outcome in Stroke Patients Is Associated with Age and Fractional Anisotropy in the Cerebral Peduncles: A Multivariate Regression Study. Prog Rehabil Med 2020; 5:20200006. [PMID: 32789274 PMCID: PMC7365210 DOI: 10.2490/prm.20200006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/23/2020] [Indexed: 01/16/2023] Open
Abstract
Objectives: Diffusion tensor fractional anisotropy (FA) in the corticospinal tracts has been used
to assess the long-term outcome in stroke patients. Patient age and the type of stroke
may also affect outcomes. In this study, we investigated the associations of age, type
of stroke, and FA in the ipsilesional and contralesional cerebral peduncles with stroke
outcomes. Methods: This study involved 80 patients with stroke (40 hemorrhagic, 40 ischemic) that we had
investigated previously. Diffusion tensor FA images were obtained between 14 and 21 days
post-stroke. FA values in the ipsilesional and contralesional cerebral peduncles were
extracted and their ratio (rFA) was calculated. Outcome was assessed using the
Brunnstrom stage, the motor component of the Functional Independence Measure (FIM-motor)
at discharge, and the length of stay until discharge from rehabilitation. Using forward
stepwise multivariate regression, we assessed the associations of rFA, contralesional
FA, age, and type of stroke with outcome measures. Results: rFA and contralesional FA were included in the final model for the Brunnstrom stage in
the upper limbs. There was a strong association between hemorrhagic stroke and poorer
lower extremity function. rFA, contralesional FA, and age were included in the final
model for FIM-motor and length of stay. The effect of rFA on all outcome measures was
stronger than that of contralesional FA. The effect of age on FIM-motor was as strong as
that of rFA. Conclusions: Neural damage in the corticospinal tracts (indicated by rFA) had the strongest effect
on outcome measures, whereas the level of disability (measured by FIM-motor) was
associated with a broader range of factors, including age.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan.,Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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Imamura Y, Kiyota N, Suzuki C, Koyama T, Kimbara S, Shinomiya H, Otsuki N, Hasegawa T, Toyoda M, Funakoshi Y, Akashi M, Sasaki R, Nibu K, Minami H. Prognostic value of the modified Glasgow Prognostic Score for head and neck cancer in the era of immunotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sato J, Shimizu T, Fujiwara Y, Yonemori K, Koyama T, Shimomura A, Tamura K, Iwasa S, Kondo S, Sudo K, Ikezawa H, Nomoto M, Nakajima R, Miura T, Yamamoto N. 17O A first-in-human phase I study of MORAb-202 in patients with folate receptor alpha-positive advanced solid tumors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Imamine R, Okumura A, Ito H, Yamamoto Y, Ishizaka Y, Sakata E, Okumura N, Koyama T. Abstract No. 588 Success rate and complications of indocyanine green and lipiodol mixture with fat emulsion for computed tomography–guided pulmonary marking before video-assisted thoracic surgery: a retrospective comparison with short hook wire. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Matsushita T, Danyel MN, Koyama T, Hatano K, Matsuoka K. Neuraminidase-triggered activation of prodrug-type substrate of 4-nitroaniline. Bioorg Med Chem Lett 2020; 30:126883. [DOI: 10.1016/j.bmcl.2019.126883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/27/2019] [Accepted: 12/01/2019] [Indexed: 11/26/2022]
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Baron P, Cornet S, Collins E, DeAngelis G, Del Cul G, Fedorov Y, Glatz J, Ignatiev V, Inoue T, Khaperskaya A, Kim I, Kormilitsyn M, Koyama T, Law J, Lee H, Minato K, Morita Y, Uhlíř J, Warin D, Taylor R. A review of separation processes proposed for advanced fuel cycles based on technology readiness level assessments. Progress in Nuclear Energy 2019. [DOI: 10.1016/j.pnucene.2019.103091] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yamazaki K, Koyama T, Shimizu T, Takahashi T, Watanabe J, Tanaka Y, Myobudani H, Yamamoto N. Phase I study of BI 836880, a VEGF/Ang2-blocking nanobody®, as monotherapy and in combination with BI 754091, an anti-PD-1 antibody, in Japanese patients (pts) with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Koyama T, Uchiyama Y, Domen K. Comparison of Fractional Anisotropy from Tract-Based Spatial Statistics with and without Lesion Masking in Patients with Intracerebral Hemorrhage: A Technical Note. J Stroke Cerebrovasc Dis 2019; 28:104376. [PMID: 31530481 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/27/2019] [Accepted: 08/26/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diffusion-tensor fractional anisotropy (FA) is an index of neural-fiber damage in patients following stroke. To better characterize FA, tract-based spatial statistics (TBSS) is frequently used, which involves spatial transformation into the standard brain space. Despite its utility, this technique is susceptible to space-occupying hematoma in patients with intracerebral hemorrhage. To correct this, "lesion making" has been proposed. Here, FA values from TBSS without lesion masking and TBSS with lesion masking were compared, and the clinical utility was evaluated. METHODS Forty patients from our previously published work were entered into the study. Diffusion-tensor imagings were acquired 14-21 days after onset and FA maps were generated. Lesion masks were produced in reference with nondiffusion (b = 0) brain images. Two types (with or without lesion masking) of TBSS were then performed. For both types, using individual data we extracted mean FA values within for the corticospinal tract (CST) and the superior longitudinal fasciculus (SLF). FA ratio (rFA) between the lesioned hemisphere and the unaffected hemisphere was then calculated. The two sets of the data were then compared by assessing residuals of mean root sum square error (RMSE). RESULTS Although rFA obtained from TBSS with lesion masking tended to be slightly smaller, the estimated RMSE was .025 for both the CST and the SLF. CONCLUSIONS The estimated FA differences between the two sets of TBSS were very small. Considering the time for manual labor for producing lesion masks, regular TBSS without lesion masking may be sufficient in terms of clinical utility.
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Affiliation(s)
- Tetsuo Koyama
- Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan; Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
| | - Yuki Uchiyama
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Kazuhisa Domen
- Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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