Quantitative and qualitative evaluation of sequential PET/MRI using a newly developed mobile PET system for brain imaging

[Purpose]To evaluate the clinical feasibility of a newly developed mobile PET system with MR-compatibility (flexible PET; fxPET), compared with conventional PET (cPET)/CT for brain imaging.[Methods]Twenty-one patients underwent cPET/CT with subsequent fxPET/MRI using 18F-FDG. As qualitative evaluation, we visually rated image quality of MR and PET images using a four-point scoring system. We evaluated overall image quality for MR, while we evaluated overall image quality, sharpness and lesion contrast. As quantitative evaluation, we compared registration accuracy between two modalities [(fxPET and MRI) and (cPET and CT)] measuring spatial coordinates. We also examined the accuracy of regional 18F-FDG uptake.[Results]All acquired images were of diagnostic quality and the number of detected lesions did not differ significantly between fxPET/MR and cPET/CT. Mean misregistration was significantly larger with fxPET/MRI than with cPET/CT. SUVmax and SUVmean for fxPET and cPET showed high correlations in the lesions (R = 0.84, 0.79; P < 0.001, P = 0.002, respectively). In normal structures, we also showed high correlations of SUVmax (R = 0.85, 0.87; P < 0.001, P < 0.001, respectively) and SUVmean (R = 0.83, 0.87; P < 0.001, P < 0.001, respectively) in bilateral caudate nuclei and a moderate correlation of SUVmax (R = 0.65) and SUVmean (R = 0.63) in vermis.[Conclusions]The fxPET/MRI system showed image quality within the diagnostic range, registration accuracy below 3 mm and regional 18F-FDG uptake highly correlated with that of cPET/CT

Effects of Rolipram and Cilostamide on Renal Functions and Cyclic AMP Release in Anesthetized Dogs 1

ABSTRACT The present study was undertaken to examine whether phosphodiesterases III and IV regulate renal cAMP level and whether inhibition of these enzymes influences renal functions in anesthetized dogs. The intrarenal arterial infusion of rolipram (0.1, 0.3, and 1 g/kg/min), a selective phosphodiesterase IV inhibitor, increased renal blood flow, glomerular filtration rate, urine flow rate, and urinary Na ϩ excretion with elevating arterial and renal venous plasma cAMP concentrations and urinary cAMP excretion. However, cilostamide (0.1, 0.3, and 1 g/kg/min), a selective phosphodiesterase III inhibitor, did not affect the values of these parameters. Indomethacin (3 mg/kg i.v. bolus and 1 mg/kg/min i.v. infusion), a cyclooxygenase inhibitor, reduced the basal arterial and renal venous plasma cAMP concentrations and blunted the rolipram-induced elevation of cAMP concentrations and urinary cAMP excretion. The effects of rolipram on renal hemodynamics and urine formation were attenuated in the presence of indomethacin. These results suggest that in the dog kidney in vivo, 1) phosphodiesterase IV, but not phosphodiesterase III, participates in degradation of cAMP and 2) the inhibition of phosphodiesterase IV enhances glomerular filtration and urinary Na ϩ excretion, the responses of which depend in part on indomethacin-susceptible (prostaglandin-mediated, probably) control of basal cAMP level

Effect of Simultaneous Dual-Task Training on Regional Cerebral Blood Flow in Older Adults with Amnestic Mild Cognitive Impairment

東京都立大学Tokyo Metropolitan University博士（理学療法学）doctoral thesi

ケイド ノ ヨウカイゴ コウレイシャ ニ タイスル テイキテキ ナ ウンドウ シドウ ノ コウカ

本研究の目的は、軽度の要介護高齢者に対して、虚弱高齢者向け運動プログラムを定期的に指導することによって、身体的(運動機能)、社会的(日常生活活動量)、心理的(運動意欲)な効果について検討することであった。対象は、M県内の通所介護・居宅介護支援施設Aを利用している要支援から要介護2に該当する69歳～91歳の高齢者5名であり、12週間、全12回、週1回の頻度で運動指導を行った。運動指導前後で、形態計測(身長、体重、BMI、左右の大腿前部の筋厚)と運動機能測定(握力、椅子座り立ち時間、開眼片足立ち時間、ファンクショナルリーチ、足関節底・背屈角度)を実施した結果、対象者の形態及び運動機能測定値に有意な変化は認められず、廃用性の筋萎縮や運動機能低下を防げることが確認された。個別にみると、5名中4名に左右の大腿前部における筋厚の増加と足関節底屈・背屈角度の拡大、椅子座り立ち時間の短縮がみられたことから、運動指導の頻度と期間をさらに増やせば、日常での身体活動量が少ない軽度の要介護高齢者の運動機能維持だけでなく、機能向上も期待できる可能性が示唆された。さらに、身体活動量が少なく、運動に不慣れな軽度の要介護高齢者に対して、定期的な運動指導をおこなう際には、自立した高齢者以上に運動に対する意欲を維持・向上させるための支援が必要であることが示唆された。The purpose of this study is to examine the effectiveness of introducing an instructed routine exercise program (originally designed for the frail elderly) to improve the physical, social, and psychological well-being (measured by motor function, the level of activities of daily living, and willingness to exercise, respectively) of elderly persons requiring support. The participants were five elderly people between the ages of 69 to 91, who were requiring support or long-term care up to level 2, and all of them were users of Outpatient or In-Home Long-Term Care Support Facility A in M Prefecture. They took the instructed exercise once a week, and had 12 sessions in total.for 12 weeks Before they had the first exercise session, and after the last session, body measurements (body height, weight, BMI, and left and right thigh front muscles) and motor function measurements (grip, chair sitting and standing time, one-leg standing time with eyes open, functional reach, and angles of plantar and dorsal flexion) were carried out. The results showed no significant changes in the participants\u27 body measurements and motor function, and it was confirmed that disuse muscle atrophy and deterioration of motor function were prevented. When the results were looked into individually, four participants out of five increased mass of left and right thigh front muscles, and expanded angles of plantar and dorsal flexion, reduced chair sitting and standing time. It was suggested from the results that if the instructed exercise program is offered more frequently, not only maintenance but also improvement of motor function of the elderly persons requiring support can be expected.The results also suggest that when an instructed routine exercise program is offered to elderly persons requiring support whose general level of physical activity is limited and who are not familiar with exercising, such persons need even more support than self-reliant elderly persons to maintain and improve their willingness to exercise

Relationship between care dependency and behavioral symptoms among elderly in-patients with Alzheimer’s disease in Japan and the Netherlands

Objective: This study investigates the influence of personal characteristics and health-related variables on the care dependency status among elderly in-patients with clinically diagnosed Alzheimer’s disease in two countries. Methods: A descriptive cross-cultural survey was administered to a convenience sample of 137 elderly in-patients. Patients were recruited from a hospital in Japan (N = 77) and from a nursing home in the Netherlands (N = 60). Results: In both countries, almost all participants are assessed on the severity level of care dependency in the range of “completely care dependent” (Japan: 35.1%; the Netherlands: 20.0%), or “to a great extent care dependent” (Japan: 24.7%; the Netherlands: 45.0%), to “partially care dependent” (Japan: 22.1%; the Netherlands: 21.7%). Conclusion: This study demonstrates that there is no interdependence between the severity level of care dependency and personal characteristics of patients with Alzheimer’s disease in both countries. Regarding the interplay of health-related variables on the severity level of care dependency, a difference was found between countries

Factors Associated with Increased Caregiver Burden of Informal Caregivers during the COVID-19 Pandemic in Japan

This study’s objective was to explore the association between various factors and the increased caregiver burden of informal caregivers during the COVID-19 pandemic. On February, 2021, 700 informal caregivers completed an online survey. We assessed the change in caregiver burden during the COVID-19 pandemic. Among all caregiver participants, 287 (41.0%) complained of an increased caregiver burden due to the COVID-19 pandemic. The factors associated with increased caregiver burden were depressive symptoms in caregivers [odds ratio (OR), 2.20; 95% confidence interval (CI), 1.50–3.23], dementia (OR, 2.48; 95%CI, 1.07–5.73) and low Barthel Index scores (OR, 2.01; 95%CI, 1.39–2.90) in care receivers, care days (OR, 1.09; 95%CI, 1.01–1.17) and times (OR, 1.06; 95%CI, 1.01–1.10), and use of home care service (OR, 1.46; 95%CI, 1.01–2.10) and visiting care service (OR, 1.71; 95%CI, 1.20–2.45). These findings suggest we need to pay attention to the physical and mental health of both the care receivers and caregivers