The Traditional Japanese Medicine (Kampo) Boiogito has a Dual Benefit in Cardiorenal Syndrome: A Pilot Observational Study

Article信州医学雑誌 62(2):89-97(2014)journal articl

Impact of Ambulation Status in Patients with End-stage Renal Disease on Hemodialysis due to Diabetic Nephropathy : The PREDICT Study

Article信州医学雑誌 68(3): 131-138(2020)journal articl

分割表解析における対称性のモデリングと尺度

東京理科大学201

Measure of Departure from Conditional Symmetry Based on Cumulative Probabilities for Square Contingency Tables

For the analysis of square contingency tables with ordered categories, a measure was developed to represent the degree of departure from the conditional symmetry model in which there is an asymmetric structure of the cell probabilities with respect to the main diagonal of the table. The present paper proposes a novel measure for the departure from conditional symmetry based on the cumulative probabilities from the corners of the square table. In a given example, the proposed measure is applied to Japanese occupational status data, and the interpretation of the proposed measure is illustrated as the departure from a proportional structure of social mobility

Two-Dimensional Index of Departure from the Symmetry Model for Square Contingency Tables with Nominal Categories

In the analysis of two-way contingency tables, the degree of departure from independence is measured using measures of association between row and column variables (e.g., Yule’s coefficients of association and of colligation, Cramér’s coefficient, and Goodman and Kruskal’s coefficient). On the other hand, in the analysis of square contingency tables with the same row and column classifications, we are interested in measuring the degree of departure from symmetry rather than independence. Over past years, many studies have proposed various types of indexes based on their power divergence (or diversity index) to represent the degree of departure from symmetry. This study proposes a two-dimensional index to measure the degree of departure from symmetry in terms of the log odds of each symmetric cell with respect to the main diagonal of the table. By measuring the degree of departure from symmetry in terms of the log odds of each symmetric cell, the analysis results are easier to interpret than existing indexes. Numerical experiments show the utility of the proposed two-dimensional index. We show the usefulness of the proposed two-dimensional index by using real data

Two-Dimensional Index of Departure from the Symmetry Model for Square Contingency Tables with Nominal Categories

In the analysis of two-way contingency tables, the degree of departure from independence is measured using measures of association between row and column variables (e.g., Yule’s coefficients of association and of colligation, Cramér’s coefficient, and Goodman and Kruskal’s coefficient). On the other hand, in the analysis of square contingency tables with the same row and column classifications, we are interested in measuring the degree of departure from symmetry rather than independence. Over past years, many studies have proposed various types of indexes based on their power divergence (or diversity index) to represent the degree of departure from symmetry. This study proposes a two-dimensional index to measure the degree of departure from symmetry in terms of the log odds of each symmetric cell with respect to the main diagonal of the table. By measuring the degree of departure from symmetry in terms of the log odds of each symmetric cell, the analysis results are easier to interpret than existing indexes. Numerical experiments show the utility of the proposed two-dimensional index. We show the usefulness of the proposed two-dimensional index by using real data

Nudging patients with chronic kidney disease at screening to visit physicians: A protocol of a pragmatic randomized controlled trial

Background/Aims: Strategies for an effective intervention after chronic kidney disease (CKD) screening have not been well examined. We describe the rationale and design of a protocol of a pragmatic randomized controlled trial (RCT) to test the effect of a behavioral intervention using the nudge approach in behavioral economics on CKD patients’ visiting behaviors to physicians and change in their kidney function after CKD screening. Methods: The RCT will include CKD patients (N = 4500) detected at screening (estimated glomerular filtration rate [eGFR] <60 mL/min/1.74 m2 or urine protein ≥1+), aged 40–63 years. The two intervention groups will receive a “usual letter” and “nudge-based letter, ” while the control group will only receive a conventional follow-up. Our primary outcome is proportion of patients’ visiting physicians for 6 months after the intervention; the secondary outcome is change in the eGFR at 2 years after the intervention. Results: We developed an efficient intervention program after CKD screening and designed the pragmatic RCT to assess its effectiveness in the real world. Our trial is unique in that it investigates the effect of the nudge approach in behavioral economics. By the end of 2018, we have enrolled 1, 692 participants, and randomized 677 participants into the usual letter group, 677 participants into the nudge-based letter group, and 338 participants into the control group. We have confirmed that health checkup data could identify a large number of eligible participants. Conclusion: The trial's results will contribute to filling in the gap between screening and subsequent medical interventions for preventing CKD progression

Unique angiographic findings in a patient with myocardial ischemia and immunoglobulin G4-related disease

Immunoglobulin G4-related disease characteristically involves multiple organs including the heart and coronary arteries. Immunoglobulin G4-related coronary artery disease is thought to be due to periarteritis and histopathologically is characterized by marked thickening of the adventitia and periarterial fat with infiltration of immunoglobulin G4-positive plasma cells. Although comprehensive diagnostic criteria require a biopsy for a definite or probable diagnosis of immunoglobulin G4-related disease, obtaining a coronary artery biopsy is difficult and risky. However, imaging findings including coronary angiography and intravascular ultrasound might be useful tools to establish a diagnosis of immunoglobulin G4-related coronary artery disease. We report a case of a 63-year-old man with a history of immunoglobulin G4-related disease who presented with exertional chest pain. We found unique angiographic and intravascular ultrasound features of immunoglobulin G4-related coronary artery disease that distinguished it from those of arteriosclerotic coronary artery disease and suggest that coronary angiography and intravascular ultrasound might be useful tools in the diagnosis of immunoglobulin G4-related coronary artery disease

Utility of Fine-Gauge Balloon Catheter for EUS-Guided Hepaticogastrostomy

Background and Purpose: During endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), tract dilation is one of the most important steps, and the placement of conventional metal stents with 8.5 Fr delivery devices is difficult due to the large outer shape of the device. Fine-gauge balloon catheters have become popular because of their stricture penetration ability and ease of dilation. This study aimed to evaluate the utility of fine-gauge balloon catheters. Patients and Methods: This retrospective study involved 38 patients who underwent conventional metal stent placement. The patients were classified into two groups: those who underwent dilation with a fine-gauge balloon catheter before initial metal stenting (balloon dilation group) and those who underwent bougie dilation only (non-balloon dilation group). We evaluated the stenting success rate after initial dilation and adverse events. Results: Seventeen and twenty-one patients were included in the balloon dilation and non-balloon dilation groups, respectively. The stenting success rate after initial dilation was 100% (17/17) in the balloon dilation group and 71.4% (15/21) in the non-balloon dilation group (p = 0.024). As adverse events, peritonitis was observed in one case (4.8%) in the balloon dilation group, and in three cases (14.3%) in the non-balloon dilation group (p = 0.613). Conclusions: Dilation using a fine-gauge balloon catheter before conventional metal stent with 8.5 Fr delivery device placement is considered effective in EUS-HGS