Publications by authors named "Tsunoda R"

Background: Reduction of spontaneous nystagmus by fixation, a characteristic feature of peripheral nystagmus, is important for differentiating between peripheral and central vestibular disorders. In the emergency room, Frenzel goggles are recommended to observe spontaneous nystagmus for the differential diagnosis of acute vestibular syndrome. We developed a portable loupe with a Fresnel lens to observe nystagmus.

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The billing database of the universal healthcare system in Japan potentially includes large-cohort data of patients with immunoglobulin A nephropathy, diagnosis codes aimed at billing should not be directly used for clinical research because of the risk of misdiagnosis. To solve this problem, we aimed to develop a novel method for identifying patients with immunoglobulin A nephropathy from billing data using machine learning. The medical records and bills of 3,743 patients who consulted nephrologists at a single center were extracted.

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Background: Iron deficiency is a major contributor to anaemia in chronic kidney diseases. The association of anaemia and iron deficiency with health-related quality of life in Japanese patients with non-dialysis chronic kidney disease has not been examined. In this study, we evaluated anaemia and iron deficiency in patients with chronic kidney disease G3b-5 and examined their associations with health-related quality of life.

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  • The study investigates the link between physical activity and outcomes in advanced chronic kidney disease (CKD) patients in Japan, focusing on those with eGFR < 45 ml/min.
  • Results show that active patients in CKD stage G3b have a lower risk of renal decline, while physical activity is also associated with reduced mortality, particularly for non-diabetic patients across stages G3b to G5.
  • Overall, the findings indicate that exercise can improve survival and renal health in advanced CKD, emphasizing its importance for both diabetic and non-diabetic patients, especially those in earlier stages.
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  • Subclinical leaflet thrombosis (SLT) can lead to failure of transcatheter heart valves (THV) after TAVI, prompting this study to investigate its formation and related thrombotic factors.
  • In a study of 26 patients treated with edoxaban for atrial fibrillation undergoing TAVI, SLT was observed in 16.7% of patients at one week, decreasing to 5.9% by three months.
  • It was found that patients with SLT at one week had reduced maximal leaflet thickness, while thrombogenicity initially dropped but began to rise again by three months post-TAVI, indicating complex dynamics in thrombus formation in the early recovery phase.
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Background: The subjective visual vertical (SVV) test can evaluate otolith function and spatial awareness and is performed in dedicated vertigo centers using specialized equipment; however, it is not otherwise widely used because of the specific equipment and space requirements. An SVV test smartphone app was developed to easily perform assessments in outpatient facilities.

Objective: This study aimed to verify whether the SVV test smartphone app with commercially available virtual reality goggles can be used in a clinical setting.

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  • The study investigates the mechanisms behind decreased kidney function in autosomal dominant polycystic kidney disease (ADPKD), finding that specific hemodynamic changes occur in patients over time.
  • Although kidney cyst enlargement is understood, the link between total kidney volume and renal dysfunction remains unclear, prompting detailed examination of glomerular hemodynamics in ADPKD progression.
  • Results show that over two years, total kidney volume increased, while glomerular filtration rate and renal plasma flow decreased, revealing an inverse correlation between baseline kidney volume and filtration rate, but not with other hemodynamic parameters.
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  • The study evaluated the health-related quality of life (QOL) in 10-year survivors of chronic kidney disease (CKD) in Japan, highlighting the impact of CKD and cardiovascular disease (CVD) on their well-being.
  • Data was collected from 1,473 participants using the EQ-5D-5L instrument, with a response rate of 38.2%, revealing a mean QOL score of 0.893 and demonstrating variations based on treatment status and CVD presence.
  • Significant factors influencing QOL included baseline age, blood pressure, and a history of hyperuricemia, indicating that CKD complications substantially impact long-term survivors' quality of life.
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Background: Dizziness is a common complaint of patients treated by primary care physicians. It is predominantly caused by peripheral vestibular disorders; however, central nervous system disorders should be excluded. Examination of the eye movements and nystagmus can help differentiate the disorders of the central nervous system from the peripheral vestibular disorders; however, it is often not performed appropriately.

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Background: Persistent postural-perceptual dizziness (PPPD) is a relatively new disease entity, with diagnostic criteria published by the Bárány Society. PPPD is often preceded by a peripheral or central vestibular disorder. It is not clear how coexisting deficits due to preceding vestibular disorders affect PPPD symptoms.

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Objectives: This study investigated the effects of a supervised home-based vestibular rehabilitation program using a booklet on gait function and dizziness in patients with chronic peripheral vestibular hypofunction.

Methods: This was a non-blinded, randomized, controlled trial. Patients (n=42) with chronic peripheral vestibular hypofunction were randomly divided into the vestibular rehabilitation group (VR group; n=20) or the control group (n=22).

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  • Obesity and its impact on mortality in chronic kidney disease (CKD) patients is debated, with a lack of clear evidence regarding the role of exercise in improving outcomes.
  • In a study involving 685,889 individuals aged 40-74 from Japan, obese CKD patients who gained weight showed significantly higher death rates compared to those who maintained their weight.
  • Additionally, those who lost exercise habits had a greater risk of mortality than those who continued exercising, suggesting that weight management and regular physical activity are crucial for the health of obese CKD patients.
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The demand for the privacy-preserving survival analysis of medical data integrated from multiple institutions or countries has been increased. However, sharing the original medical data is difficult because of privacy concerns, and even if it could be achieved, we have to pay huge costs for cross-institutional or cross-border communications. To tackle these difficulties of privacy-preserving survival analysis on multiple parties, this study proposes a novel data collaboration Cox proportional hazards (DC-COX) model based on a data collaboration framework for horizontally and vertically partitioned data.

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Objective: This study aimed to investigate the prevalence of sarcopenia and factors associated with sarcopenia in patients with dizziness.

Study Design: This is a cross-sectional study.

Patients: A total of 162 patients 65 years or older with the chief complaint of dizziness or vertigo (dizziness group) and 132 community-dwelling elderly (control group) were recruited during their visit to the otolaryngology clinic between May 2020 and October 2021.

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[Purpose] This study aimed to compare the effects of different intervention frequencies on walking ability and balance in patients with chronic unilateral vestibular hypofunction. [Participants and Methods] Participants included in this case-control study were assigned to one of two groups: the multiple-intervention (once a week) and single-intervention groups. Results for the Timed Up and Go test, Dynamic Gait Index, Functional Gait Assessment, and Activities-specific Balance Confidence scale were determined at baseline and four weeks after initiating the vestibular rehabilitation program.

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Background: The paradoxical association of obesity with mortality, named the "obesity paradox", has been inconsistent, possibly due to a difference between body mass index (BMI) and central obesity, estimated by waist circumference (WC) as patterns of adiposity.

Subjects/methods: We enrolled 8513 participants from the Kumamoto Intervention Conference Study, a multicenter registry that included consecutive patients undergoing percutaneous coronary intervention (PCI) at 18 centers between 2008 and 2017 in Japan. Patients were divided into quartiles in ascending order of the BMI or WC.

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Background: Statins are generally used for patients with coronary artery disease. However, the impact of statins in patients with vasospastic angina (VSA) is not fully understood.

Methods: In a multicenter registry study of the Japanese Coronary Spasm Association (n = 1429), patients with or without statins were compared.

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Objectives: Determinants showing plasmid-mediated quinolone resistance, which usually leads to antimicrobial ineffectiveness, have become an emerging clinical problem. In our previous study in the Philippines, a high prevalence of qnr determinants was found in clinical samples and food-producing animals and their food products. However, no qnr-carrying plasmids have been investigated in animals or animal-derived foods.

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  • The study focuses on how factors influencing vestibular rehabilitation outcomes are linked to patient quality of life, especially regarding dizziness.
  • The research involved 47 patients undergoing therapist-supervised rehab sessions, analyzing various health indicators.
  • Findings revealed that higher confidence in balance (measured by the Activity-Specific Balance Confidence Scale) significantly correlated with better improvements in dizziness-related quality of life.
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Background: The numbers of patients treated with hemodialysis (HD) in Japan are currently quantified by manual survey. As this method requires much effort from medical institutions and cannot achieve 100% response, a more practical method is required. We aimed to establish a novel method for determining the static and dynamic numbers of patients treated with HD.

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Background: Practice facilitation program by multidisciplinary care for primary care physicians (PCPs) is expected to improve chronic kidney disease (CKD) outcomes, but there is no clear evidence of its long-term effectiveness. We have previously performed a cluster-randomized controlled trial for 3.5 years (the Frontier of Renal Outcome Modifications in Japan (FROM-J) study) with two arms-group A without the program and group B with the program.

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Background: The pedicle sign is a radiographic indicator of spinal metastases. However, it is not only the pedicle sign that is important in radiographic diagnosis of bone metastases. In the present study, the radiological features of symptomatic spinal metastases in patients without the pedicle sign were retrospectively examined.

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Background: In recent years, transthyretin amyloid cardiomyopathy (ATTR-CM) has received increasing attention; however, the epidemiology of ATTR-CM in Japan is not yet understood. In the Kumamoto Cardiac Amyloid Survey, we evaluated the current incidence, clinical characteristics, diagnostic approaches, and treatment strategies for ATTR-CM and compared tafamidis-prescription hospitals with regional hospitals.

Methods: We conducted a retrospective multicenter observational cohort study.

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Objective: To investigate the utilization and demographic characteristics of in-hospital rehabilitation for patients with acute vestibular neuritis using the Japan Medical Data Center (JMDC) database.

Methods: We gathered information on patients that were at least 20 years of age who were admitted with a diagnosis of VN (ICD-10 code: H81.2).

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Cardiovascular and cerebrovascular diseases are considered the principal cause of morbidity and mortality worldwide; the effect of stroke-induced cardiac manifestations is well recognized; however, not enough clinical data have been found about the impact of stroke with underlying cardiac disease. This study's objective is to assess the impact of stroke on the prognosis of patients with underlying IHD, who underwent PCI treatment. This was a multicenter, 1-year observational study in patients undergoing PCI in one of the 17 participating centers across Japan.

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