A Food Intake Estimation System Using an Artificial Intelligence-Based Model for Estimating Leftover Hospital Liquid Food in Clinical Environments: Development and Validation Study.


Accuracy of an Artificial Intelligence-Based Model for Estimating Leftover Liquid Food in Hospitals: Validation Study.

An accurate evaluation of the nutritional status of malnourished hospitalized patients at a higher risk of complications, such as frailty or disability, is crucial. Visual methods of estimating food intake are popular for evaluating the nutritional status in clinical environments. However, from the perspective of accurate measurement, such methods are unreliable. The accuracy of estimating leftover liquid food in hospitals using an artificial intelligence (AI)-based model was compared to that of visual estimation. The accuracy of the AI-based model (AI estimation) was compared to that of the visual estimation method for thin rice gruel as staple food and fermented milk and peach juice as side dishes. A total of 576 images of liquid food (432 images of thin rice gruel, 72 of fermented milk, and 72 of peach juice) were used. The mean absolute error, root mean squared error, and coefficient of determination (R) were used as metrics for determining the accuracy of the evaluation process. Welch t test and the confusion matrix were used to examine the difference of mean absolute error between AI and visual estimation. The mean absolute errors obtained through the AI estimation approach were 0.63 for fermented milk, 0.25 for peach juice, and 0.85 for the total. These were significantly smaller than those obtained using the visual estimation approach, which were 1.40 (P<.001) for fermented milk, 0.90 (P<.001) for peach juice, and 1.03 (P=.009) for the total. By contrast, the mean absolute error for thin rice gruel obtained using the AI estimation method (0.99) did not differ significantly from that obtained using visual estimation (0.99). The confusion matrix for thin rice gruel showed variation in the distribution of errors, indicating that the errors in the AI estimation were biased toward the case of many leftovers. The mean squared error for all liquid foods tended to be smaller for the AI estimation than for the visual estimation. Additionally, the coefficient of determination (R) for fermented milk and peach juice tended to be larger for the AI estimation than for the visual estimation, and the R value for the total was equal in terms of accuracy between the AI and visual estimations. The AI estimation approach achieved a smaller mean absolute error and root mean squared error and a larger coefficient of determination (R) than the visual estimation approach for the side dishes. Additionally, the AI estimation approach achieved a smaller mean absolute error and root mean squared error compared to the visual estimation method, and the coefficient of determination (R) was similar to that of the visual estimation method for the total. AI estimation measures liquid food intake in hospitals more precisely than visual estimation, but its accuracy in estimating staple food leftovers requires improvement.


The role of medical informatics in the management of medical information

With progress in information and communication technology, medical information has been converted to digital formats and stored and managed using computer systems. The construction, management, and operation of medical information systems and regional medical liaison systems are the main components of the clinical tasks of medical informatics departments. Research using medical information accumulated in these systems is also a task for medical informatics department. Recently, medical real-world data (RWD) accumulated in medical information systems has become a focus not only for primary use but also for secondary uses of medical information. However, there are many problems, such as standardization, collection, cleaning, and analysis of them. The internet of things and artificial intelligence are also being applied in the collection and analysis of RWD and in resolving the above problems. Using these new technologies, progress in medical care and clinical research is about to enter a new era. J. Med. Invest. 67 : 27-29, February, 2020.

The Journal of Medical Investigation : JMI


Accelerated organ region segmentation by the revised radial basis function network using a graphics processing unit.

This study aimed to accelerate the segmentation of organs in medical imaging with the revised radial basis function (RBF) network, using a graphics processing unit (GPU). We segmented the lung and liver regions from 250 chest x-ray computed tomography (CT) images and 160 abdominal CT images, respectively, using the revised RBF network. We compared the time taken to segment images and their accuracy between serial processing by a single-core central processing unit (CPU), parallel processing using four CPU cores, and GPU processing. Segmentation times for lung and liver organ regions shortened to 57.80 and 35.35 seconds for CPU parallel processing and 20.16 and 11.02 seconds for GPU processing, compared to 211.03 and 124.21 seconds for CPU serial processing, respectively. The concordance rate of the segmented region to the normal region in slices excluding the upper and lower ends (173 lung and 111 liver slices) was 98% for lung and 96% for liver. The use of CPU parallel processing and GPU shortened the organ segmentation time in the revised RBF network without compromising segmentation accuracy. In particular, segmentation time was shortened to less than 10%with GPU. This processing method will contribute to workload reduction in imaging analysis. J. Med. Invest. 66 : 86-92, February, 2019.


Matrix changes in articular cartilage in the knee of patients with rheumatoid arthritis after biological therapy: 1-year follow-up evaluation by T2 and T1ρ MRI quantification.

Decreasing cartilage thickness and matrix changes appeared in the MFC after 1 year of treatment with bDMARDs. Microstructural damage of the cartilage at baseline is a predictor for further cartilage damage in the knee joint, even if treatment with bDMARDs is effective.


PERK-mediated translational control is required for collagen secretion in chondrocytes.

mice displayed reduced collagen in articular cartilage but no differences in chondrocyte proliferation or apoptosis compared to the findings in wild-type mice. PERK inhibition increases misfolded protein levels in the ER, which largely hinder ER-to-Golgi transport. These results suggest that the translational control mediated by PERK is a critical determinant of ECM secretion in chondrocytes.


Validation of Each Category of Kihon Checklist for Assessing Physical Functioning, Nutrition and Cognitive Status in a Community-Dwelling Older Japanese Cohort


This study clarified that the fibrocartilage-like repair tissue appeared on the articular surface of the medial compartment after HCO as evidenced by MRI T1 and T2 mapping.Cite this article: H. Nishioka, E. Nakamura, J. Hirose, N. Okamoto, S. Yamabe, H. Mizuta. MRI T1 and T2 mapping for the assessment of articular cartilage changes in patients with medial knee osteoarthritis after hemicallotasis osteotomy. Bone Joint Res 2016;5:294-300. DOI: 10.1302/2046-3758.57.BJR-2016-0057.R1.


Combined arteriosclerotic assessment of ankle-brachial index and maximum intima-media thickness via CCTA is useful for predicting coronary artery stenosis in patients with type 2 diabetes.

We developed a novel formula to predict coronary artery stenosis using five predictive factors. This formula is useful for determining whether computed tomography (CT) examination is necessary, even in clinical settings without CCTA equipment. Early detection of coronary artery stenosis in patients with DM may also lead to better health outcomes.

A prediction formula was developed based on a multivariate analysis of common factors in patients with ⩾50% coronary artery stenosis in a cohort of 327 patients with type 2 DM who underwent CCTA between 2007 and 2009, and cutoff values were calculated (derivation study). The validity of the optimal cutoff value was confirmed in a separate cohort of 317 patients with type 2 DM who underwent CCTA between 2010 and 2011 (validation study).


Validity of E-PASS System for Postoperative Morbidity of Spinal Surgery.

The E-PASS system correctly predicted morbidity. The predictive ability of CRS was good for overall morbidity. The E-PASS system is useful for the accurate prediction of the risk for in-hospital morbidity in individual patients scheduled for spinal surgery.

Journal of Spinal Disorders & Techniques


Evaluation of the utility of the Estimation of Physiologic Ability and Surgical Stress score for predicting post-operative morbidity after orthopaedic surgery.

The E-PASS scoring system showed some utility in predicting post-operative morbidity after general orthopaedic surgery. However, creating a new risk score that is more suitable for orthopaedic surgery will be challenging.

The incidence of post-operative complications (n = 274) significantly increased with an increase in E-PASS scores (p < 0.001). The areas under the curve for the comprehensive risk score of the E-PASS scoring system for overall and non-surgical site complications were 0.777 and 0.794, respectively.


Evaluation of the relationship between T1 and T2 values and patella cartilage degeneration in patients of the same age group.

Our study confirmed that T1 and T2 mapping can quantitatively evaluate the degree of patella cartilage degeneration in patients within the same age group.


Endoplasmic reticulum stress-induced apoptosis contributes to articular cartilage degeneration via C/EBP homologous protein.

Our results indicate that Chop plays a direct role in chondrocyte apoptosis and that Chop-mediated apoptosis contributes to the progression of cartilage degeneration in mice.

In vivo, the degree of ER stress was similar in Chop(-/-)- and Chop(+/+) mice. However, in Chop(-/-) mice apoptosis and cartilage degeneration were lower by 26.4% and 42.4% at 4 weeks, by 26.8% and 44.9% at 8 weeks, and by 26.9% and 32.3% at 12 weeks after surgery than Chop(+/+) mice, respectively. In vitro, the degree of ER stress induction by TM was similar in Chop(-/-)- and Chop(+/+) chondrocytes. On the other hand, apoptosis was 55.3% lower and the suppression of collagen type II and aggrecan mRNA was 21.0% and 23.3% less, and the increase of matrix metalloproteinase-13 mRNA was 20.0% less in Chop(-/-)- than Chop(+/+) chondrocytes.


The long-term outcome of open-wedge osteotomy of the proximal tibia with hemicallotasis.

We report the long-term outcome of 33 patients (37 knees) who underwent proximal tibial open-wedge osteotomy with hemicallotasis (HCO) for medial osteoarthritis of the knee between 1995 and 2000. Among these, 29 patients with unilateral HCO were enrolled and 19 were available for review at a mean of 14.2 years (10 to 15.7) post-operatively. For these 19 patients, the mean Hospital for Special Surgery knee score was 60 (57 to 62) pre-operatively and 85 (82 to 87) at final follow-up (p < 0.001; paired t-test). The femorotibial angle and tibial inclination angle (IA) were measured at short-term follow-up, one to four years post-operatively, and showed no significant subsequent changes. The clinical scores and radiological measurements showed little change over time. One patient required conversion to total knee replacement during this time. These results suggest that the coronal angle achieved at operation is maintained at long-term follow up after HCO without alteration of the IA, providing a good long-term clinical outcome.


Predictive value of E-PASS and POSSUM systems for postoperative risk assessment of spinal surgery.

As E-PASS predicted morbidity more correctly than POSSUM, it is useful for estimating the postoperative risk of patients considered for spinal surgery.


Articular cartilage lesions increase early cartilage degeneration in knees treated by anterior cruciate ligament reconstruction: T1 mapping evaluation and 1-year follow-up.

Using T1 mapping to detect minimal changes, our study demonstrated that cartilage lesions are related to progressive degenerative cartilage changes during the early phase after ACLR.


Detecting ICRS grade 1 cartilage lesions in anterior cruciate ligament injury using T1 and T2 mapping.

Our study demonstrated that the T1 and T2 values were significantly higher for ICRS grade 1 cartilage lesions than for normal cartilage and that the two mappings were able to non-invasively detect ICRS grade 1 cartilage lesions in the ACL-injured knee with a higher detectability than were 3D WATS images.


Intracellular accumulation of advanced glycation end products induces apoptosis via endoplasmic reticulum stress in chondrocytes.

Mammalian cells attempt to maintain their homeostasis under endoplasmic reticulum (ER) stress. If the stress cannot be alleviated, cells are led to apoptosis through induction of C/EBP homologous protein (CHOP). ER stress is provoked in osteoarthritis chondrocytes, and intracellular accumulation of advanced glycation end products (AGEs) in chondrocytes is a possible cause. To clarify the role of intracellular AGE accumulation in chondrocytes, the present study investigated the effect of intracellular AGE accumulation on ER stress and apoptosis by in vitro and in vivo analysis. Intracellular AGE accumulation induced by AGE precursors caused apoptosis, induced expression of ER stress markers, and led to co-localization of AGEs with glucose-regulated protein 78, leading to formation of high-molecular-weight complexes in cultured chondrocytes. These reactions were inhibited by an AGE formation inhibitor. CHOP deletion inhibited apoptosis induced by intracellular AGE accumulation. In vivo intracellular AGE accumulation induced by intra-articular injection of AGE precursors caused ER stress and apoptosis in chondrocytes and led to degradation of articular cartilage. Additionally, intracellular AGE accumulation increased the degree of cartilage degradation in an osteoarthritis model. These data indicate that intracellular accumulation of AGEs induces modification of unfolded protein response-related protein by AGEs and apoptosis via ER stress in chondrocytes. Moreover, the in vivo study showed that intracellular AGE accumulation in chondrocytes is involved in the occurrence and progression of osteoarthritis through ER stress. Thus, research on mechanisms of apoptosis via ER stress induced by intracellular AGE accumulation in chondrocytes will lead to a new understanding of osteoarthritis pathology.


Endoplasmic reticulum stress mediates nitric oxide-induced chondrocyte apoptosis.

Nitric oxide (NO) is one of the most important mediators of chondrocyte apoptosis, which is a notable feature of cartilage degeneration. While apoptosis of chondrocytes is induced by p53, NO can also induce endoplasmic reticulum (ER) stress, which may be involved in the process of NO-induced chondrocyte apoptosis. The aims of this study were to determine whether NO-induced ER stress (ERS) leads to apoptosis of chondrocytes and to investigate the temporal relationship between the expression of C/EBP-homologous protein (CHOP), an ERS-associated apoptotic molecule, and the expression of p53 during apoptosis in NO-stimulated chondrocytes. Rat chondrocytes were stimulated by sodium nitroprusside (SNP), a NO donor. Real-time polymerase chain reaction (PCR) was performed to analyze the mRNA expression of CHOP, glucose-regulated protein (GRP78) and p53. Apoptosis of chondrocytes was quantified using an enzyme-linked immunosorbent assay (ELISA). SNP-treated chondrocytes showed an increase in CHOP and GRP78 mRNA expression and underwent apoptosis. Sodium 4-phenylbutyrate (PBA), an ERS inhibitor, reduced CHOP and GRP78, as well as SNP-stimulated apoptosis of chondrocytes, without affecting the SNP-dependent generation of NO. In addition, the blockade of CHOP following siRNA transfection reduced SNP-induced apoptosis of chondrocytes. The CHOP expression increased after apoptosis was detected in the SNP-treated chondrocytes, whereas the p53 expression increased prior to apoptosis. These data demonstrated that NO-induced ERS leads chondrocytes to apoptosis, although this effect appears to be limited to persistent impairment of NO stimulation. These findings may provide insight into the pathology of cartilage degeneration.


T1 and T2 mapping of the proximal tibiofibular joint in relation to aging and cartilage degeneration.

We document that the T(1) and T(2) values of PTFJ cartilage were not affected by aging or cartilage degeneration in the FTJ. The T(1) value of the PTFJ may represent a useful internal standard reference for evaluating early degeneration of the FTJ.


T1 and T2 mapping reveal the in vivo extracellular matrix of articular cartilage.

The present study demonstrated that T(1) and T(2) values reflect the GAG content of the cartilage and can indicate cartilage degeneration in vivo. Use of these parameters can facilitate the noninvasive diagnosis and evaluation of cartilage degeneration.

Journal of Magnetic Resonance Imaging : JMRI


Enhanced apoptotic and reduced protective response in chondrocytes following endoplasmic reticulum stress in osteoarthritic cartilage.

Endoplasmic reticulum (ER) stress has been shown to participate in many disease pathologies. Although recent reports have demonstrated that ER stress in chondrocytes is present in human osteoarthritis (OA), its role in the pathology of cartilage degeneration, such as chondrocyte apoptosis, remains unclear. In the present study, we investigated the expression of phosphorylated PERK (pPERK), ubiquitin (Ub), GRP78, CHOP, phosphorylated JNK (pJNK) and cleaved caspase-3 (C-CASP3) and the mRNA splicing of XBP1 (XBP1 splicing) in human OA cartilage by immunohistochemistry and RT-PCR. Additionally, human chondrocytes were treated with several concentrations of tunicamycin, an ER stress inducer, to assess the impact of ER stress on the mRNA expression of CHOP, XBP1 splicing and apoptosis, as determined by real-time PCR, RT-PCR and ELISA analyses respectively. In human OA cartilage, the number of chondrocytes expressing pPERK, Ub, CHOP and pJNK positively correlated with cartilage degeneration and the number of C-CASP3-positive chondrocytes. XBP1 splicing and GRP78 expression in severe OA containing the greatest number of C-CASP3-positive chondrocytes were similar to the levels in mild OA, however, XBP1 splicing was higher in moderate OA than in mild and severe OA. Tunicamycin dose dependently increased CHOP expression and apoptosis of cultured chondrocytes. Although tunicamycin upregulated XBP1 splicing in cultured chondrocytes, its impact on XBP1 splicing was weakened at higher concentrations. In conclusion, the present results indicate that ER stress may contribute to chondrocyte apoptosis along with OA progression, which was closely associated with an enhanced apoptotic response and a reduced protective response by the cells.

International Journal of Experimental Pathology


Painful heterotopic pacinian corpuscle in the hand: a report of three cases.

Severe pain in the finger caused by an abnormal Pacinian corpuscle is a rare condition. We have recently encountered three patients diagnosed with a heterotopic Pacinian corpuscle, based on histopathological findings. When making a differential diagnosis of unexplained severe pain in the finger, abnormal Pacinian corpuscles must be taken into account in addition to glomus tumour and other types of painful soft-tissue tumour.


Immunohistochemical distribution of advanced glycation end products (AGEs) in human osteoarthritic cartilage.

Advanced glycation end products (AGEs) may be associated with osteoarthritis (OA), because the accumulation of AGEs in articular cartilage are among the most striking age-related changes. AGEs modify the tissue protein structure and function and stimulate the cellular responses mediated by a specific receptor for AGEs (RAGE). This study investigated the localization of AGEs in degenerated cartilage using newly identified epitope-specific antibodies to determine the linkage between the distribution of AGEs and the development and progression of OA. Osteochondral specimens of the tibial plateau from OA patients were immunostained by specific antibodies against N()-(carboxymethyl)lysine (CML), N()-(carboxyethyl)lysine (CEL), pentosidine, GA-pyridine, and RAGE. The immunohistochemical distribution of these epitopes was evaluated during cartilage degeneration. The immunoreactivity (IR) of AGEs and RAGE was stronger in cells rather than in the extracellular matrix. Higher IR of cellular CML and CEL was observed in both mild and severe OA cartilage in comparison to macroscopically intact cartilage. There was a strong association between GA-pyridine and RAGE in the pattern of increasing IR with the OA grade. These IR patterns of AGEs varying with cartilage degeneration indicate that AGE modified proteins are associated with cartilage degeneration. The coincidental up-regulation of GA-pyridine and RAGE suggests that GA-pyridine is the most significant AGE for cartilage degeneration via the RAGE pathway.


Contribution of HLA-DRB1*04 alleles and anti-cyclic citrullinated antibodies to development of resistance to disease-modifying antirheumatic drugs in early rheumatoid arthritis.

This study was intended to evaluate HLA-DRB1 alleles and antibodies against anti-cyclic citrullinated peptides (anti-CCP Abs) for their value in predicting patient responses to treatment with disease-modifying antirheumatic drugs (DMARDs) in early rheumatoid arthritis (RA). The subjects were 124 Japanese patients who had received their first treatment with DMARDs, usually methotrexate, within 1 year of disease onset and who had been followed-up for 2 years subsequently. Approximately 40% of patients developed DMARD resistance and accordingly required anti-tumor necrosis factor (TNF) therapy during the 2-year period. DMARD resistance was strongly associated with the carriage of SE-positive HLA-DRB1*04 alleles, especially the *0405 allele (OR, 3.92; 95%CI, 1.83-8.41; p = 0.0003). In contrast, the SE-positive allele HLA-DRB1*0101 was less potent in contributing to DMARD resistance. The rate of anti-CCP Ab-positive patients was significantly higher in the DMARD-resistant group (OR, 6.62; 95%CI, 1.45-30.24; p = 0.008). Multivariate logistic regression analysis confirmed the strong association of DMARD resistance with the presence of SE-positive *04 alleles (OR, 2.89; 95%CI, 1.28-6.53; p = 0.011) and anti-CCP Abs (OR, 6.31; 95%CI, 1.23-32.34; p = 0.027), yielding an area under the receiver operating characteristic curve of 0.76 (95% CI, 0.68-0.84; p = 0.000). After stratification, the highest rate of DMARD resistance was observed in patients having both SE-positive *04 alleles and anti-CCP Abs. These observations show that the presence of SE-positive *04 alleles in combination with anti-CCP Abs is the strongest predictor for development of DMARD resistance and eventual need of anti-TNF agents in patients with early RA.


Prediction of postoperative ambulatory status 1 year after hip fracture surgery.

In candidates for hip fracture surgery, the E-PASS scores exhibited a good correlation with the patients' functional and survival prognoses, and the algorithm including E-PASS scores and dementia status can accurately estimate the ambulatory status at discharge and 1 year after surgery.

Archives of Physical Medicine and Rehabilitation


New equations for predicting postoperative risk in patients with hip fracture.

Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

Clinical Orthopaedics and Related Research


The effects of fibroblast growth factor-2 on rotator cuff reconstruction with acellular dermal matrix grafts.

The application of FGF-2 may result in improved histologic characteristics and biomechanical strength in ADM graft constructs in humans.

Arthroscopy : the Journal of Arthroscopic & Related Surgery


The effect of a local application of fibroblast growth factor-2 on tendon-to-bone remodeling in rats with acute injury and repair of the supraspinatus tendon.

The initial tendon-to-bone remodeling was accelerated by a local application of FGF-2. This may represent a clinically important improvement in rotator cuff repair.


Reconstruction of large rotator-cuff tears with acellular dermal matrix grafts in rats.


E-PASS for predicting postoperative risk with hip fracture: a multicenter study.


An anatomic study of the subscapularis insertion to the humerus: the subscapularis footprint.

The precise anatomic measurements presented here are useful for the evaluation and repair of tears of the subscapularis.


Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients.

These results suggest that E-PASS may be useful for predicting postoperative risk and estimating medical expense for surgical cases with hip fracture.

Archives of Orthopaedic and Trauma Surgery


Arthroscopic repair of traumatic combined rotator cuff tears involving the subscapularis tendon.

Arthroscopic repair with use of the suture anchor technique is a safe and effective procedure for the treatment of combined rotator cuff tears involving the subscapularis tendon; it can alleviate shoulder pain and improve function and the range of motion. The postoperative integrity of the repair correlates with the clinical results. Patient age and the degree of tendon retraction can affect the integrity of the repair.

The Journal of Bone and Joint Surgery. American Volume


Healing of full-thickness defects of the articular cartilage in rabbits using fibroblast growth factor-2 and a fibrin sealant.

We have investigated in vitro the release kinetics and bioactivity of fibroblast growth factor-2 (FGF-2) released from a carrier of fibrin sealant. In order to evaluate the effects of the FGF-2 delivery mechanism on the repair of articular cartilage, full-thickness cylindrical defects, 5 mm in diameter and 4 mm in depth, which were too large to undergo spontaneous repair, were created in the femoral trochlea of rabbit knees. These defects were then filled with the sealant. Approximately 50% of the FGF-2 was released from the sealant within 24 hours while its original bioactivity was maintained. The implantation of the fibrin sealant incorporating FGF-2 successfully induced healing of the surface with hyaline cartilage and concomitant repair of the subchondral bone at eight weeks after the creation of the defect. Our findings suggest that this delivery method for FGF-2 may be useful for promoting regenerative repair of full-thickness defects of articular cartilage in humans.

The Journal of Bone and Joint Surgery. British Volume


Up-regulated expression of cartilage intermediate-layer protein and ANK in articular hyaline cartilage from patients with calcium pyrophosphate dihydrate crystal deposition disease.

CILP and ANK mRNA expression correlates with chondrocyte ePPi accumulation around CPPD and OA chondrocytes, and all respond similarly to growth factor stimulation. These findings suggest that up-regulated CILP and ANK expression contributes to higher ePPi accumulation from CPPD crystal-forming cartilage.


Effects of a hydroxyl radical scavenger, EPC-K1, and neutrophil depletion on reperfusion injury in rat skeletal muscle.

Oxygen free radicals (OFR) and neutrophils are potent sources of reperfusion injury. We compared the effect of EPC-K1, a new OFR scavenger, and neutrophil depletion on the reperfusion injury in skeletal muscle, using an ischemic revascularized hindlimb model in rats. Warm ischemia, produced by vascular pedicle clamping, was sustained for 4 h. After 24 h of reperfusion, muscle function and damage were evaluated in 4 groups: a sham operation group, a control study group, a group treated by EPC-K1 (EPC group), and a group that received nitrogen mustard to induce neutropenia (NM group). Both the EPC and NM groups had limited muscle damage compared to the control group. The EPC group preserved muscle function significantly better than the control group and the mean isometric tetanic tension in the EPC group appeared to be higher than that in the NM group. Furthermore, levels of lipid peroxides in muscle and serum, and muscle edema in the EPC group, were significantly lower than in the NM group. Histological examinations supported these results. These findings suggest that limiting OFR generation by EPC-K1 in the early phase of reoxygenation is more potent than depletion of neutrophils in reducing reperfusion injury.


Increased ischemia-reperfusion blood flow impairs the skeletal muscle contractile function.

Reperfusion blood flow increased time dependently until 3 h of warm ischemia. Hyperemia deteriorated skeletal muscle contractile function, although it was well preserved by l-NMMA infusion to restrict the postischemic hyperemia.


Expression of cartilage intermediate layer protein/nucleotide pyrophosphohydrolase parallels the production of extracellular inorganic pyrophosphate in response to growth factors and with aging.

These results provide evidence that CILP/NTPPH expression and ePPi elaboration are concomitantly stimulated by TGFbeta1 and down-regulated by IGF-1, especially in adult chondrocytes, implicating CILP/NTPPH as a functional participant in ePPi elaboration. Increased CILP/NTPPH mRNA expression in chondrocytes derived from aged animals compared with young animals might promote the formation of calcium pyrophosphate dihydrate crystals in aged cartilage.


Reduced reperfusion injury in muscle. A comparison of the timing of EPC-K1 administration in rats.

EPC-K1, a phosphate diester of alpha-tocopherol and ascorbic acid, is a new hydroxyl radical scavenger. We examined the effects of EPC-K1 according to differences in the timing of its administration. Warm ischemia, produced by vascular pedicle clamping, was sustained for 4 hours. After 24 hours of reperfusion, muscle injury was evaluated in 4 groups: the first group received a sham operation, the second group was treated with an intravenous injection of EPC-K1 prior to ischemia, the third group was treated with EPC-K1 prior to reperfusion, and the fourth group was controls. Compared with the control group, both the preischemic and pre-reperfusion EPC-K1-treated groups showed a statistically significant amelioration in the reduction of isometric muscle contraction. There were also significant reductions in the muscle and serum levels of thiobarbituric acid reactive substances (TBA-RS) and muscle damage, indicated by the biochemical and histological study. A comparison of the timing of EPC-K1 administration revealed that only the muscle TBA-RS level in the pre-reperfusion EPC-K1-treated group was significantly higher than that in the preischemic EPC-K1-treated group. These observations indicate that EPC-K1 not only by preischemic but also by pre-reperfusion administration acted effectively on reperfusion injury in muscle, thereby improving muscle function.


Reduced ischemia-reperfusion injury in muscle. Experiments in rats with EPC-K1, a new radical scavenger.

L-ascorbic acid 2-[3,4-dihydro-2,5,7,8-tetramethyl- 2-(4,8,12-trimethyltridecyl)-2H-1-benzopyran-6-yl hydrogen phosphate] potassium salt (EPC-K1), a phosphate diester of alpha-tocopherol and ascorbic acid, is a potent antioxidant. We examined the effects of EPC-K1 on ischemia-reperfusion injury in the skeletal muscle of rats, using an ischemic revascularized hind limb model. Warm ischemia (25 degrees C), produced by vascular pedicle clamping, was sustained for 4 hours. After 24 hours of reperfusion, skeletal muscle injury was evaluated in 2 groups: one group treated by intravenous injection of EPC-K1 (10 mg/kg) prior to ischemia, and a group of controls. The EPC-K1-treated group showed a statistically significant amelioration in the reduction of the isometric muscle contraction, inhibition of the elevation of the muscle wet- to dry-weight ratio, limitation of the muscle level of thiobarbituric acid reactive substances and the serum levels of creatine phosphokinase, lactate dehydrogenase and mitochondrial glutamic oxaloacetic transaminase, and reduction of the extent of muscle injury according to the histological findings. These observations indicate that EPC-K1 acted effectively on ischemia-reperfusion injury in the rat skeletal muscle and thereby improved muscle function.


Predictability of postoperative recurrence on hepatocellular carcinoma through data mining method.

Hepatocellular carcinoma (HCC) is a highly lethal tumor and the majority of postoperative patients experience recurrence. In the present study, we focus on the predictability of postoperative recurrence on HCC through the data mining method. In total, 323 patients with HCC who underwent hepatic resection were included in the present study, 156 of whom suffered from cancer recurrence. Clinicopathological data including prognosis were analyzed using the data mining method for the predictability of postoperative recurrence on HCC. The resulting alternating decision tree (ADT) was described using data mining method. This tree was validated using a 10-fold cross validation process. The average and standard deviation of the accuracy, sensitivity, and specificity were 69.0 8.2, 59.7 14.5 and 77.7 10.2%, respectively. The identified postoperative recurrence factors were age, viral hepatitis, stage, GOT and T-cholesterol. Data mining method could identify the factors associated at different levels of significance with postoperative recurrence of HCC. These factors could help to predict the postoperative recurrence of HCC.


Collecting Electrocardiographic Information and Healthcare by IoT

第23回日本医療情報学会春季学術大会【大会企画セッション3】IoTによる生体情報の収集とヘルスケアに向けた取り組み∼心電情報の管理と活用∼

[セッション抄録]

 Society5.0で創出される新たな価値として，健康促進や最適治療の発展が期待されている．その中で，IoTを用いた生体情報のモニタリングやデータ活用に向けたシステム構築は，ヘルスケア充実のために必要な課題である．心電波形は，血圧や心拍数とともに循環器領域の日常診療で広く普遍的に実施されている検査の一つだが，日常生活におけるリアルタイム波形の可視化や心電情報の二次利用という点ではまだこれからである．

 従来の医療用電極を用いた心電図計測は，長時間の連続使用に不向きである．しかし，導電性の繊維素材を電極としてシャツに配置したことで，着るだけで繰り返し心電情報の所得が可能となったシャツ型ウェアラブルが開発されている．TRIARTは，ミツフジの提供するウェアラブル製品と小型トランスミッターを用い，大量の生体情報の収集と蓄積，解析を可能とするサービスの提供を目指している．また，セキュアなP2Pブロックチェーン技術を応用した分散コンピューティングおよびストレージ環境を最適化し，バイタルデータの研究開発用プラットフォームを開発中である．

 心電情報を有効活用していくためには，心電機器メーカーを問わない伝送規格や心電波形記述の標準化が今後ますます必要になってくるであろう．Precision medicineとして，予防・治療・ケアといった総合的なヘルスケアサポートを目指し，熊本大学，TRIART，およびミツフジが共同で取り組んでいる生体情報収集とデータ活用のためのシステム構築について，またデジタル化された心電情報の二次利用とその可能性について紹介したい．