Physical Activity and Chronic Pulmonary Diseases - Pulmonary Rehabilitation in Hospital

Prema definiciji, plućna rehabilitacija niz je personaliziranih intervencija kod kroničnih plućnih bolesnika na osnovi kojih se određuju individualna terapija vježbanja, ali i edukacija o bolesti te promjeni ponašanja, a sve radi poboljšanja fizičkog i psihičkog stanja bolesnika s kroničnom plućnom bolesti. Vježbanje je esencijalna komponenta programa plućne rehabilitacije. Opća načela vježbanja bolesnika s kroničnom plućnom bolesti ne razlikuju se od onih zdravih pojedinaca ili čak sportaša. Da bi program vježbanja bio djelotvoran, ukupno opterećenje treninga mora biti prilagođeno pojedinačnim specifičnim zahtjevima i prelaziti opterećenja u svakodnevnom životu radi poboljšanja aerobnog kapaciteta i snage mišića uz poboljšanje kapaciteta vježbanja u određenom razdoblju. Optimalan tip vježbanja za bolesnike s kroničnim plućnim bolestima nije utvrđen i može se razlikovati od pojedinca do pojedinca. Najčešće se primjenjuje trening izdržljivosti u obliku vožnje stacionarnog bicikla ili hodanja po pokretnoj stazi. Nordijsko hodanje sa štapovima tijekom jednog sata na dan pokazalo se vrlo uspješno u povećanju dnevne hodne pruge i dnevnih aktivnosti. Za vrijeme provedbe programa svakog bolesnika valja pratiti i reagirati na simptome povezane s netolerancijom napora, povišenim krvnim tlakom, povećanim brojem otkucaja srca, padom saturacije. Program treba biti nadziran i personaliziran te prilagođen mogućnostima i ograničenjima pojedinog bolesnika. U sklopu programa mora se preporučiti i vježbanje kod kuće. Pritom valja definirati realne ciljeve za bolesnika da bi on vidio napredak i bio motiviran. Bolesnik treba i nakon završena programa nastaviti vježbati, promijeniti životne navike i povećati fizičku aktivnost, a sve radi što bolje kvalitete života.According to the definition, pulmonary rehabilitation programme for chronic pulmonary patients provides a range of personalized interventions used to determine individual exercise therapy, as well as education on the disease and behavioural change, for the purpose of improving physical and mental condition of patients with chronic pulmonary disease. Exercise is an essential component of the pulmonary rehabilitation programme. General principles of exercising in individuals with chronic pulmonary disease do not differ from the principles in healthy individuals or even athletes. For the exercise programme to be effective, the overall training workload has to suit specific individual requirements and exceed everyday workload in order to increase aerobic capacity and muscle strength, with an improvement of exercise capacity over a period of time. Optimal type of exercise for patients with chronic pulmonary diseases has not been established and may vary from individual to individual. Most commonly used mode of exercise is endurance training in the form of cycling on a stationary bike or walking on a treadmill. Nordic walking for one hour per day has proved to be a very successful type of training for an increase in the daily walking distance and overall daily activity. Each patient’s reactions to symptoms associated with exertion intolerance, increased blood pressure, increased heart rate or decrease in saturation are monitored throughout the programme. The programme is supervised and personalized, and it is individually tailored to the capabilities and limitations of each patient. Patient’s visible progress and continued motivation require recommended home exercise and reasonable goals set as part of the programme. After completing the programme, the patient should continue exercising, change lifestyle and increase physical activity for the purpose of improving the quality of life

Backward multiplex coherent anti-Stokes Raman (CARS) spectroscopic imaging with electron-multiplying CCD (EM-CCD) camera

A multiplex CARS imaging system, equipped with an EM-CCD camera, was developed to improve the sensitivity of backward CARS imaging in biological analysis using an inverted microscope. The signal-to-noise ratio was improved by a factor of ca. 3 compared to a conventional CCD mode through the use of EM gain. When imaging epithelial cells in the backward CARS configuration, intracellular organelles such as lipid droplets and nuclei were spectroscopically identified with an exposure time of only 100 ms/pixel.</p

Group-theoretical analysis of two-dimensional hexagonal materials

金沢大学理工研究域数物科学系Two-dimensional hexagonal materials such as graphene and silicene have highly symmetric crystal structures and Dirac cones at the K point, which induce novel electronic properties. In this report, we calculate their electronic structures by using density functional theory and analyze their band structures on the basis of the group theory. Dirac cones frequently appear when the symmetry at the K point is high; thus, two-dimensional irreducible representations are included. We discuss the relationship between symmetry and the appearance of the Dirac cone. © 2017 The Japan Society of Applied Physics.Embargo Period 12 month

Sarcopenia, intramuscular fat deposition, and visceral adiposity independently predict the outcomes of hepatocellular carcinoma

Background & AimsObesity defined by body mass index (BMI) significantly increases the risk of hepatocellular carcinoma (HCC). In contrast, not only obesity but also underweight is associated with poor prognosis in patients with HCC. Differences in body composition rather than BMI were suggested to be true determinants of prognosis. However, this hypothesis has not been demonstrated conclusively.MethodsWe measured skeletal muscle index (SMI), mean muscle attenuation (MA), visceral adipose tissue index, subcutaneous adipose tissue index, and visceral to subcutaneous adipose tissue area ratios (VSR) via computed tomography in a large-scale retrospective cohort of 1257 patients with different stages of HCC, and comprehensively analyzed the impact of body composition on the prognoses.ResultsAmong five body composition components, low SMI (called sarcopenia), low MA (called intramuscular fat [IMF] deposition), and high VSR (called visceral adiposity) were significantly associated with mortality, independently of cancer stage or Child-Pugh class. A multivariate analysis revealed that sarcopenia (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.18–1.96; p=0.001), IMF deposition (HR, 1.34; 95% CI, 1.05–1.71; p=0.020), and visceral adiposity (HR, 1.35; 95% CI, 1.09–1.66; p=0.005) but not BMI were significant predictors of survival. The prevalence of poor prognostic body composition components was significantly higher in underweight and obese patients than in normal weight patients.ConclusionsSarcopenia, IMF deposition, and visceral adiposity independently predict mortality in patients with HCC. Body composition rather than BMI is a major determinant of prognosis in patients with HCC

Management of Hepatocellular Carcinoma in Japan : JSH Consensus Statements and Recommendations 2021 Update

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC

BAG-6 is essential for selective elimination of defective proteasomal substrates

The ubiquitin-like protein BAG-6 protects cells from newly synthesized misfolded proteins by tethering them to the proteasome

Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC

Degenerative changes in the appendicular joints of ancient human populations from the Japan Islands

Degenerative changes in six major limb joints were investigated to compare their prevalence among five ancient skeletal populations from the Japan Islands. The populations assessed in this study consisted of the farmers in the northern Kyushu/Yamaguchi area and the foragers from the northwestern Kyushu area from the Yayoi period (5th century BC to 3rd century AD); the Okhotsk (5th to 12th centuries AD) foragers from Hokkaido and Sakhalin; the common people from medieval Kamakura (12th to 14th centuries AD) in Kanto, central Japan; and the early-modern farmers (17th to 19th centuries AD) from Kumejima, in the southernmost island chain (Ryukyu Islands). Crude prevalence comparisons showed that the shoulder and hip joints were principally affected in early-modern Kumejima and medieval Kamakura, which contrasted with the high prevalence of elbow and knee joint changes in the Okhotsk people. The heavy dependence on marine mammals and fish for dietary protein intake probably required flexion and extension movements of the most severely degenerated joints in the Okhotsk people. The northern Kyushu/Yamaguchi and northwestern Kyushu Yayoi peoples were more affected by degeneration in the wrist joints than others, possibly due to their use of innovative tools such as stone or shell knives and harpoons. A multivariate logistic regression analysis, adjusted for age, region, and sex as the predictor variables for degenerative changes in joints, was applied to only the two samples from Kumejima and Kamakura (including previously reported spine data) because of their better preservation. This revealed differences in the prevalence of changes in some joints; for example, age-related changes were recognized. The Kumejima people were more commonly affected by hip and knee joint changes, whereas the Kamakura people were more commonly affected by changes to apophyseal joints. Because a stable isotope analysis indicated that the trophic levels of the two populations were almost the same, the pattern of degenerative changes would have reflected differences in their specific workloads, such as wet rice cultivation using a peculiar hoe by the Kumejima people. This study, combining multivariate logistic regression analysis of degenerative joint changes and stable isotope analyses, uses large skeletal populations to add clarity to the actual rigors of ancient life. © 2015 Elsevier Ltd and INQUA