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Unsedated transnasal small-caliber esophagogastroduoden oscopy in elderly and bedridden patients

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World Journal of Gastroenterology 2009年第44期15卷 5586-5591页

作者： Mika Yuki Yuji Amano Yoshinori Komazawa Hiroyuki Fukuhara Toshihiro Shizuku Shun Yamamoto Yoshikazu Kinoshita Division of Internal Medicine Izumo-City General Medical Center613 Nadabunn-choIzumo-shi Shimane 693-0003Japan Division of Endoscopy Shimane University Hospital89-1 Enya-choIzumo-shiShimane 693-8501Japan Division of Internal Medicine Unnan Municipal General Hospital96-1 Iida-choUnnan-shiShimane 699-1221Japan Second Department of Internal Medicine Shimane UniversitySchool of Medicine89-1 Enya-choIzumo-shiShimane 693-8501Japan

AIM： To evaluate the safety of unsedated transnasal small-caliber esophagogastroduodenoscopy （EGD） for elderly and critically ill bedridden patients. METHODS： One prospective randomized comparative study and one crossover comparative study between transnasal small-caliber EGD and transoral conventional EGD was done （Study 1）. For the comparative study, we enrolled 240 elderly patients aged 〉 65 years old. For the crossover analysis, we enrolled 30 bedridden patients with percutaneous endoscopic gastrostomy （PEG）（Study 2）, We evaluated cardiopulmonary effects by measuring arterial oxygen saturation （SpO2） and calculating the rate-pressure product （RPP）（pulse rate x systolic blood pressure/100） at baseline, 2 and 5 min after endoscopic intubation in Study 1. To assess the risk for endoscopy-related aspiration pneumonia during EGD, we also measured blood leukocyte counts and serum C-reactive protein （CRP） levels before and 3 d after EGD in Study 2. RESULTS： In Study 1, we observed significant decreases in SpO2 during conventional transoral EGD, but not during transnasal small-caliber EGD （0.24% vs -0.24% after 2 min, and 0.18% vs -0.29% after 5 min, P = 0.034, P = 0.044）. Significant differences of the RPP were not found between conventional transoral and transnasal small-caliber EGD. In Study 2, crossover analysis showed statistically significant increases of the RPP at 2 min after intubation and the end of endoscopy （26.8 and 34.6 vs 3.1 and 15.2, P = 0.044, P = 0.046）, and decreases of SpO2 （-0.8% vs -0.1%, P = 0.042） during EGD with transoral conventional in comparison with transnasal small-caliber endoscopy. Thus, for bedridden patients with PEG feeding, who were examined in the supine position, transoral conventional EGD more severely suppressed cardiopulmonary function than transnasal small-caliber EGD. There were also significant increases in the markers of inflammation, blood leukocyte counts and serum CRP values, in bedridden patients after transoral co

关键词： Aged Aspiration pneumonia Gastrointestina endoscopy Critical illness

Relationships of loneliness and mobile phone dependence with Internet addiction in Japanese medical students

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Open Journal of Preventive Medicine 2013年第6期3卷 407-412页

作者： Satoko Ezoe Masahiro Toda Department of Pharmacology Osaka Dental University Osaka Japan shimane university Health Service Center Izumo Shimane Japan

We investigated factors contributing to Internet addiction in 105 Japanese medical students. The subjects were administered by a self-reporting questionnaire designed to evaluate demographic factors, Internet addiction, loneliness, health-related lifestyle factors, depressive state, patterns of behavior, and mobile phone dependence. Results of multivariate logistic regression analysis indicated that loneliness and mobile phone dependence were positively related to degree of addiction. Our findings suggest that Internet addiction is associated with loneliness and mobile phone dependence in Japanese students.

关键词： Internet Addiction Mobile Phone Dependence Loneliness Depression Medical Students

Relationship of Smartphone Dependence to General health Status and Personality Traits among university Students

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Open Journal of Preventive Medicine 2016年第10期6卷 215-221页

作者： Masahiro Toda Satoko Ezoe Kanae Mure Tatsuya Takeshita Graduate School of Human Life Sciences Notre Dame Seishin University Okayama Japan Department of Public health Wakayama Medical University Wakayama Japan shimane university health service center izumo Shimane Japan

We investigated associations between smartphone dependence and general health status or personality traits. To 197 medical university students, we administered a set of self-reporting questionnaires designed to evaluate these parameters. For males, smartphone dependence positively correlated with somatic symptoms, anxiety and insomnia, and emotional instability, and negatively correlated with agreeableness. For females, smartphone dependence positively correlated with somatic symptoms, severe depression, and extraversion, and negatively correlated with social dysfunction. These findings suggest that smartphone dependence may be associated with general health status or personality traits and that there may be a gender difference in these associations.

关键词： Dependence General health Status Personality Traits Smartphone university Students Wakayama Smartphone-Dependence Scale (WSDS)

Multifactorial study of mobile phone dependence in medical students: Relationship to health-related lifestyle, Type A behavior, and depressive state

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Open Journal of Preventive Medicine 2013年第1期3卷 99-103页

作者： Masahiro Toda Satoko Ezoe Department of Pharmacology Osaka Dental University Osaka Japan shimane university Health Administration Center Izumo Shimane Japan

We investigated factors contributing to mobile phone dependence. To 139 medical students, we administered a self-reporting questionnaire designed to evaluate mobile phone dependence, health-related lifestyle, patterns of behavior, and depressive state. Multivariate logistic regression analysis revealed that scores for poor health-related lifestyle, Type A behavior pattern, and presence of depression are independently associated with degree of mobile phone dependency. These findings suggest that persons with an unhealthy lifestyle, Type A behavior traits, or depression might benefit from mobile phone use guidance.

关键词： Mobile Phone Dependence health-Related Lifestyle Patterns of Behavior Depressive State Medical Students

Characteristics of Geriatric health service Facilities Designated as Sites of Death

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health 2015年第10期7卷 1275-1282页

作者： Mitsumi Ono Hideyuki Kanda Yuko Takeda Sachiko Hara Department of Community health and Gerontological Nursing Faculty of Medicine Shimane University Izumo Japan Department of Environmental Medicine and Public health Faculty of Medicine Shimane University Izumo Japan

There are many deaths occurring among the aged population in Japan. Geriatric health service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was to clarify the characteristics and related factors, including physical signs first noticed by staff at the end-of-life period, in GHSFs designated as sites of death, using a nationwide survey in Japan. We administered a questionnaire to 3971 GHSFs in Japan. Eligible responses for the study were obtained from 854 GHSFs. We found that GHSFs designated as sites of death were more likely to have basic policies and documented preferences regarding end-of-life care. We also found that staff members in GHSFs designated as sites of death were less likely to first notice physical signs of pain. We found that GHSFs designated as sites of death tended to identify earlier symptoms, such as reduced oral intake and less vigor. Our results would enable elderly persons, their families, and staff in GHSFs to prepare for the elderly’s death more efficiently though earlier identification of the end-of-life period. We hope that GHSFs have an important role to play in end-of-life care provision to elderly persons in Japan, through the strengthening of these intermediate facilities.

关键词： Geriatric health service Facility End-of-Life Care Basic Policy Preference Documented Physical Signs

Effects of Psychological Stress from a National License Examination on the Urine 8-Hydroxy-Deoxyguanosine Levels in Young Female Students, Taking into Account the Menstrual Cycle

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Open Journal of Preventive Medicine 2018年第2期8卷 21-31页

作者： Tadayuki Iida Yasuhiro Ito Hiroaki Ishikawa Miho Kanazashi Ryoji Teradaira Asami Tatsumi Satoko Ezoe Department of Physical Therapy Faculty of Health and Welfare Prefectural University of Hiroshima Mihara City Japan School of health Sciences Fujita Health University Toyoake Japan Department of Nursing Hamamatsu University School of Medicine Hamamatsu Japan health service center izumo Shimane University Izumo Japan

Objective: Urine 8-hydroxy-deoxyguanosine (U8-OHdG) was a marker of oxidative stress-induced DNA damage;it was increased by psychological stress. Since the menstrual cycle may confound or modify the association between psychological stress and U8-OHdG. The aim of this study was to verify the effect of psychological stress from a national license examination on levels of U8-OHdG, which is a biomarker of oxidative stress. And the effects of women’s menstrual cycles, which should be considered in mental and physical assessments, on U8-OHdG, were evaluated. Methods: The subjects were 18 female university students at a medical university in whom Self-rating Depression Scale (SDS) scores, State-Trait Anxiety Inventory (STAI) scores, and U8-OHdG levels were measured in 3 phases of the menstrual cycle, the follicular phase, ovulatory phase, and luteal phase. The mean values were taken for the group during a time of classroom learning. The same measurements were also made one week before and the day after a national license examination and the measurements were compared among the three periods. Results and Conclusion: State anxiety and U8-OHdG levels were significantly higher in those with a week before the national license examination than in those with classroom lecture (State anxiety: p = 0.002, U8-OHdG levels: p = 0.007). The menstrual cycle did not show a significant correlation with U8-OHdG levels. This study demonstrated that levels of the oxidative stress biomarker U8-OHdG are not affected by changes in the menstrual cycle. It also showed that U8-OHdG levels increased with the psychological stress of a national license examination.

关键词： 8-OHdG Oxidative Stress Menstrual Cycles Psychological Stress

Development of Japanese Version of Smartphone Dependence Scale

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Open Journal of Preventive Medicine 2016年第7期6卷 179-185页

作者： Satoko Ezoe Tadayuki Iida Ken Inoue Masahiro Toda health service center izumo Shimane University Shimane Japan Department of Physical Therapy Faculty of Health and Welfare Prefectural University of Hiroshima Hiroshima Japan Department of Public health Gunma University Graduate School of Medicine Gunma Japan 4Graduate School of Human Life Sciences Notre Dame Seishin University Okayama Japan

We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p university students who may be at risk of developing smartphone dependence.

关键词： Smartphone Dependence Japanese Version of Smartphone Dependence Scale Internet Addiction Reliability Validity Factor Analysis university Students

New simulation model for bone formation markers in osteoporosis patients treated with once-weekly teriparatide

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Bone Research 2014年第4期2卷 252-258页

作者： Sakae Tanaka Taiji Adachi Tatsuhiko Kuroda Toshitaka Nakamura Masataka Shiraki Toshitsugu Sugimoto Yasuhiro Takeuchi Mitsuru Saito John P Bilezikian Department of Orthopaedic Surgery Faculty of MedicineUniversity of TokyoTokyoJapan Department of Biomechanics Institute for Frontier Medical SciencesKyoto UniversityKyotoJapan Medical Affairs Department Asahi Kasei Pharma CorporationTokyoJapan National center for Global health and Medicine TokyoJapan Research Institute and Practice for Involutional Diseases NaganoJapan Internal Medicine 1 Shimane University Faculty of MedicineIzumoJapan Toranomon Hospital Endocrine center TokyoJapan Department of Orthopaedic Surgery Jikei University School of MedicineTokyoJapan Metabolic Bone Diseases Program Division of EndocrinologyDepartment of MedicineCollege of Physicians and SurgeonsColumbia UniversityNew YorkUSA

Daily 20-mg and once-weekly 56.5-mg teriparatide（parathyroid hormone 1–34） treatment regimens increase bone mineral density（BMD） and prevent fractures, but changes in bone turnover markers differ between the two regimens. The aim of the present study was to explain changes in bone turnover markers using once-weekly teriparatide with a simulation model. Temporary increases in bone formation markers and subsequent decreases were observed during once-weekly teriparatide treatment for 72 weeks. These observations support the hypothesis that repeated weekly teriparatide administration stimulates bone remodeling, replacing old bone with new bone and leading to a reduction in the active remodeling surface. A simulation model was developed based on the iterative remodeling cycle that occurs on residual old bone. An increase in bone formation and a subsequent decrease were observed in the preliminary simulation. For each fitted time point, the predicted value was compared to the absolute values of the bone formation and resorption markers and lumbar BMD. The simulation model strongly matched actual changes in bone turnover markers and BMD. This simulation model indicates increased bone formation marker levels in the early stage and a subsequent decrease. It is therefore concluded that remodeling-based bone formation persisted during the entire treatment period with once-weekly teriparatide.

关键词： bone New simulation model for bone formation markers in osteoporosis patients treated with once-weekly teriparatide BMD

A Multicenter Cohort Study for XELOX (Capecitabine, Leucovorin plus Oxaliplatin) Therapy as First-Line Treatment in Elderly Patients with Unresectable Colorectal Cancer

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Journal of Cancer Therapy 2015年第2期6卷 153-162页

作者： Tetsu Yamamoto Ryoji Hyakudomi Shinichi Sugimoto Atsuo Tokuka Yoshitoshi Sato Satoshi Nagai Hikota Hayashi Masahikoo Igarashi Kenji Takubo Yoshitsugu Tajima Department of Digestive and General Surgery Faculty of Medicine Shimane University Izumo Japan Department of Surgery Shimane Prefectural Central Hospital Izumo Japan Department of Gastroenterological Surgery Matsue Red Cross Hospital Matsue Japan Department of Surgery National Hospital Organization Hamada Medical Center Hamada Japan Department of Surgery Masuda Medical Association Hospital Masuda Japan

Oxaliplatin-based chemotherapy with bevacizumab is now widely used for colorectal cancer patients. This study evaluated the efficacy and tolerability of XELOX (capecitabine + oxaliplatin + leucovorin combined) therapy with or without bevacizumab in elderly patients. One hundred and seven patients, consisting of 52 elderly (>70 years of age) and 55 non-elderly, with unresectable colorectal cancer were enrolled in this multicenter cooperative group study using a database between October 2009 and March 2012. We evaluated the outcomes in terms of the median time to treat failure (TTF), overall response rate (ORR), disease control rate (DCR) and tolerability in both age groups. The median TTF for the XELOX + bevacizumab regimen was 7.1 months in the non-elderly group and 8.1 months in the elderly group (p = 0.838). There was no significant difference in TTF between the two groups. The ORR and DCR in the non-elderly group were 30.8% and 73.1%, respectively. In the elderly group, the ORR was 40.0% and the overall DCR was 90.0%. No severe or uncontrollable adverse events were observed in the two groups. These data indicated that the XELOX chemotherapy with or without bevacizumab has an equivalent efficacy in both groups, without increasing the adverse events even in the elderly population.

关键词： Colorectal Cancer Oxaliplatin Capecitabine Bevacizumab Elderly Patients