Analytical simulation on experimental seismic response of headed anchors embedded in reinforced concrete

This paper deal with a series of dynamic response analyses, carried out to give numerical correlation of hysteretic behavior of cast-in-place anchorages obtained by the static loading and shake table tests. Specimens for the analyses are reinforced concrete rectangular blocks with embedded headed anchors. Failure modes expected are the steel bolt failure and the concrete cone failure, associated with the respective embedment depth. Initial flexural cracks presumed seismic damage on the concrete block is developed with bending loading. In the analytical model, nonlinear hysteretic behavior of the anchorage is idealized by translational and rotational springs in which properties estimated from the hysteretic loops of the static loading tests. It was shown that the overall force and displacement performance under dynamic loads are well simulated based on the analytical models presented herein

維持血液透析患者に対する受動的下肢拳上の検討

Background: Passive leg raising （PLR） has been widely used for stabilizing decreased blood pressure during hemodialysis（HD） sessions. However, the detailed effects have not been well documented. The purpose of this study was to investigate changes in hemodynamic parameters during PLR to determine whether the technique stabilizes those parameters in patients undergoing an HD session. Method: PLR was performed in 7 patients（mean age 72.7±10.7 years） for 3 minutes after lying in a supine position for 3 minutes during an HD session. Systolic blood pressure（SBP） and diastolic blood pressure （DBP） were measured at 1-minute intervals, and heart rate （HR）, stroke volume （SV）, cardiac output （CO）, cardiac index （CI）, and total peripheral resistance （TPR） were monitored using impedance cardiography （Physioflow, Manatec Biomedical Co., France） at a frequency of 0.2 Hz in 7 patients. Data for each parameter measured in the supine position were averaged to obtain baseline data. SBP and DBP measurements obtained during the interval in which the highest SBP value was obtained were compared with those at baseline. Sampled data for HR, SV, CO, CI, and TPR during PLR were converted to relative values and compared with the baseline values. Results: SBP during PLR （155.1 ± 19.7mmHg） was significantly higher （p＜0.05） than the baseline （140.2±13.1）, while there was no significant change in DBP. The relative value for TPR （12.3%） was also significantly higher than that at the baseline, while the relative values for HR, CO, and CI （3.6%, 6.7%, and 6.8%, respectively） were significantly lower than the baseline values. There was no significant change in SV. Conclusions: Our results suggest that PLR increases SBP during an HD session, while TPR may contribute to that increase

地域在住高齢透析患者の活動範囲を規定する因子の検討

Background: Physical inactivity in elderly people deteriorates their physical capacity and quality of life and increases their mortality risk. However, a sedentary lifestyle is highly prevalent among elderly hemodialysis （HD） patients. This study aimed to explore the clinical characteristics of lifespace mobility-related factors such as muscle mass, nutritional status, and cardiac function in elderly HD patients.Method: Life-space mobility for 158 community-dwelling outpatients （aged ≥65 years） who were undergoing maintenance HD thrice a week was surveyed using the Life-Space Assessment（ LSA）. Parameters such as muscle mass, nutritional status, cardiac function, anemia, inflammation, and obesity were compared between male（ n = 85） and female groups（ n = 73）, and the association between the LSA score and the parameters was investigated using multiple regression analysis in all subjects and the two groups.Results: The mean age of the patients was 73.7±5.8 years. LSA score, psoas muscle index（ PMI）, and serum creatinine（ Cr） levels in the male group were significantly higher than those in the female group. Left ventricular ejection fraction was higher in the female group than in the male group. Using multiple regression analysis, the LSA score in all subjects was independently associated with Cr levels, male gender, and serum albumin levels. Furthermore, in the male group, the LSA score was associated with PMI, while in the female group, the LSA score was associated with serum albumin levels and diabetes mellitus.Conclusions: Our results suggested that higher life-space mobility was associated with higher muscle mass in the male group and with higher nutritional status and absence of diabetes mellitus in the female group. Further comprehensive studies with larger sample sizes are required to investigate additional factors such as physical function and psychosocial and environmental variables

Hemodynamic response to orthostatic stress immediately after dialysis session in chronic hemodialysis patients

Abstract Orthostatic hypotension is a risk factor for falls among chronic hemodialysis (HD) patients. This study aimed to investigate the hemodynamic response to orthostatic stress immediately after an HD session. Twenty-one HD patients (mean age, 70.2 ± 8.1 years; HD duration, 7.5 ± 6.4 years) participated in this study. Each 5-min hemodynamic monitoring was performed in the supine, semi-recumbent, and sitting positions immediately after an HD session. Hemodynamic variables were measured using a noninvasive beat-to-beat monitoring device during the test. Patients were divided into an intradialytic hypotension (IDH) group and a non-IDH group according to the presence or absence of IDH on the day of the measurements, and intra- and intergroup comparisons were performed. In the IDH group, the nadir values of systolic blood pressure in the semi-recumbent and sitting positions were significantly lower than those in the supine position and the last systolic blood pressure in the semi-recumbent position. The nadir of stroke volume in the sitting position was significantly lower than that in the supine position. There were no statistically significant intergroup differences in the changes for any positions. These results suggest that patients with IDH require special attention when getting out of bed to prevent post-dialytic falls