Improvement in prescriptions while maintaining overall health outcomes: a prospective observational study conducted in Japanese facilities for older people.

Background: Improvements in the use of polypharmacy or potentially inappropriate medication (PIM) may reduce medication costs in Japan. We aimed to evaluate the impact of improvement in prescription on both overall health outcomes and medication costs in Japanese facilities for older people.

Methods: Residents in Japanese facilities for older people between March 2019 and March 2020 were included in this study.

[A Giant Right Coronary Artery Aneurysm:Report of a Case].

We report the case of a 49-year-old woman with a giant atherosclerotic thrombus-filled aneurysm of the right coronary artery. She was referred to our hospital because of abnormal finding of the chest X-ray. Echocardiography revealed a large cystic mass adjacent to the right atrium and computed tomography revealed a giant aneurysm of middle segment of the right coronary artery.

Impact of the Severity of Alzheimer's Disease on the Quality of Life, Activities of Daily Living, and Caregiving Costs for Institutionalized Patients on Anti-Alzheimer Medications in Japan.

Background: Alzheimer's disease (AD) increases societal costs and decreases the activities of daily living (ADL) and quality of life (QoL) of the affected individuals.

Objective: We assess the impact of AD severity on ADL, QoL, and caregiving costs in Japanese facilities for the elderly.

Methods: Patients with AD in facilities for the elderly were included (47 facilities, N = 3,461).

Effect of walking on depression prevalence for diabetes using information communication technology: Prospective study.

Aim: This study aimed to evaluate the prevention of diabetic depression and its impact on medical costs through the implementation of a step count monitoring system using information and communication technology.

Methods: This study carried out a longitudinal analysis of a prospective cohort. A total of 296 participants were enrolled in the intervention group and 882 participants in the control group.

An increase in the deoxygenated hemoglobin concentration induced by a working memory task during the refractory period in the hemodynamic response in the human cerebral cortex.

In activated brain regions, the deoxygenated hemoglobin (deoxy-Hb) concentration decreases despite an increase in oxygen consumption. This is attributed to the fact that the cerebral blood flow (CBF) induced by neuronal activation exceeds the accompanying increase in the cerebral metabolic rate of oxygen (CMRO). The discrepancy between large CBF and disproportionately small CMRO responses provides the basis for detecting the hemodynamic correlates of neuronal activities by functional magnetic resonance imaging (fMRI).

Corrosion Generation and Cleaning Effect on Surgical Instruments with Attached Radiofrequency Identification Tags in Long-Term Usage.

Faulty cleaning of surgical instruments may lead to corrosion damage and a higher risk of surgical site infection. We have developed a method in which each instrument has an attached radiofrequency identification (RFID) tag for individual management. However, because of the structure of the instruments, a risk of corrosion from poor cleaning exists; therefore, observation during long-term usage is necessary.

Improvements in lower-limb muscle strength and foot pressure distribution with foot care in frail elderly adults: a randomized controlled trial from Japan.

Background: Abnormalities in the feet and toenails are common among the elderly and may increase the risk of falls. This study aimed to investigate the changes in toe-gap force, knee-gap force, foot pressure distribution, the ability to perform activities of daily living, subjects' feelings and behaviors, and physical function resulting from daily lifestyle modification and foot care.

Methods: The study participants included 74 elderly adults (mean age 80.

[Thoracic Aortic Stent Graft for Patent Ductus Arteriosus with Residual Shunt after Surgical Repair;Report of a Case].

We report a case of a 75-year-old woman with residual shunt of patent ductus arteriosus after initial surgical repair. She was successfully treated by thoracic aortic stent graft and residual shunt disappeared. Re-surgical repair for residual shunt of patent ductus arteriosus is very invasive and challenging procedure.

[A case of late-onset paraphrenia in a very elderly patient receiving home medical care].

A 94 year old woman with a late-onset paraphrenia was referred to our clinic from a community care center. The patient showed symptoms of paranoia and auditory hallucination. The patient was in conflict with her neighbors regarding noise-related problems and was experiencing loss of appetite.

Coronary plaque characteristics in computed tomography and 2-year outcomes: The PREDICT study.

Background: Coronary computed tomography angiography (CCTA) not only provides information regarding luminal stenoses but also allows for visualization of mural atheromatous changes (coronary plaques).

Objective: We sought to elucidate whether plaques seen on CCTA enable prediction of 2-year outcomes in patients with suspected and known coronary artery disease (CAD).

Methods: Of 3015 patients who underwent CCTA, the images and 2-year clinical courses of 2802 patients were independently analyzed.

[Coronary Computed Tomography Angiography for Patients with Atrial Fibrillation: Feasibility of Prospective Electrocardiography-gated Diastolic Acquisition with a Manual Exposure-termination Technique].

Coronary computed tomography angiography (CCTA) was performed in 283 patients with atrial fibrillation (Af) using a prospective electocardiogeaphic gated scanning with a manual exposure-termination technique. When preparatory 5-beat scanning contained at least one RR interval longer than 800 ms, 5-beat diastolic scanning (R+800 ms protocol) was selected. When no RR interval longer than 800 ms was observed, 2-beat scanning starting at end-systolic phase (R+210 ms to R protocol) was chosen.

Incremental Prognostic Value of Coronary Computed Tomography Angiography: High-Risk Plaque Characteristics in Asymptomatic Patients.

Aim: Coronary computed tomography angiography (CCTA) findings of positive remodeling (index ＞1.1) and low-attenuation plaque (＜30 Hounsfield units) are recognized as CT-verified high-risk plaque (CT-HRP). Therefore, we investigated the incremental prognostic value of evaluation of plaque characteristics using CCTA in asymptomatic patients.

[Pacemaker-induced Metallic Artifacts in Coronary Computed Tomography Angiography: Clinical Feasibility of Single Energy Metal Artifact Reduction Technique].

Background: Coronary computed tomography angiography (CCTA) in patients with pacemaker suffers from metallic lead-induced artifacts, which often interfere with accurate assessment of coronary luminal stenosis. The purpose of this study was to assess a frequency of the lead-induced artifacts and artifact-suppression effect by the single energy metal artifact reduction (SEMAR) technique.

Methods: Forty-one patients with a dual-chamber pacemaker were evaluated using a 320 multi-detector row CT (MDCT).

Single injection protocol for coronary and lower extremity CT angiographies in patients suspected for peripheral arterial disease.

To evaluate the feasibility of a single injection protocol for coronary CT angiography (CTA) and lower extremity CTA in patients suspected for peripheral arterial disease (PAD).This prospective observational study included a total of 103 patients who showed an ankle brachial index ≤0.9 and underwent the single injection protocol for coronary and lower extremity CTA.

Independent predictors of retrograde failure in CTO-PCI after successful collateral channel crossing.

Objectives: To evaluate factors for predicting retrograde CTO-PCI failure after successful collateral channel crossing.

Background: Successful guidewire/catheter collateral channel crossing is important for the retrograde approach in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).

Methods: A total of 5984 CTO-PCI procedures performed in 45 centers in Japan from 2009 to 2012 were studied.

[The Minimum Values of (RR-PQ) for High Quality Coronary CT Angiogram in Half, Automatic Patient's Motion Correction (APMC) and Full Reconstruction Using 320-ADCT (0.275 s/r)].

Background: A clear coronary CT angiography (CCTA) can be obtained when temporal resolution (TR) is shorter than slow filling (SF) duration. The SF duration was calculated by the following equation: SF=-443+0.742 (RR-PQ).

[Quadricuspid Aortic Valve with Aortic Regurgitation;Report of a Case].

A 65-year-old woman was admitted due to electrocardiographic abnormality and exertional dyspnea. Transthoracic echocardiography revealed quadricuspid aortic valve malformation with severe aortic regurgitation. All 4 cusps were of equal size, and the quadricuspid valve was classified as type a by Hurwitz classification.

Comparison of percutaneous coronary intervention for chronic total occlusion outcome according to operator experience from the Japanese retrograde summit registry.

Objectives: This study was performed to evaluate the acute outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) based on operator experience.

Background: Despite developments in both technology and techniques, PCI procedures for CTO's remain challenging.

Methods: A total of 3,229 eligible subjects who underwent CTO-PCI were enrolled from 56 centers by a retrograde summit using a web registry system.

Coronary Whole-heart MR Angiography: Feasibility of Breath-hold Chasing with Diaphragmatic Navigation.

We propose a simple but novel data acquisition technique for whole-heart coronary magnetic resonance angiography (CMRA). In this technique, the breath-hold chasing MRA, data are collected during breath-hold intervals, with the navigation window manually adjusted to the diaphragmatic level. Compared with the conventional free breathing MRA, this method provided 33% reduction of acquisition time and improved visibility of right coronary artery in 18 normal subjects without any additional software or hardware requirements.

Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease.

Purpose: To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD).

Materials And Methods: Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis.

Assessment of coronary in-stent restenosis: value of subtraction coronary computed tomography angiography.

In conventional coronary computed tomography angiography (CCTA), metal artifacts are frequently observed where stents are located, making it difficult to evaluate in-stent restenosis. This study was conducted to investigate whether subtraction CCTA can improve diagnostic accuracy in the evaluation of in-stent restenosis. Subtraction CCTA was performed using 320-row CT in 398 patients with previously placed stents who were able to hold their breath for 25 s and in whom mid-diastolic prospective one-beat scanning was possible.

Complications during retrograde approach for chronic coronary total occlusion: Sub-analysis of Japanese multicenter registry.

Objectives: This study was performed to determine the complications occurring during retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) based on analysis of the multicenter, prospective, nonrandomized Retrograde Summit registry.

Background: Retrograde PCI for CTO has improved treatment success rates, but several complications related to the retrograde approach have been reported, including collateral channel injury and donor artery injury due to their use as retrograde roots.

Methods: This registry included data from 1,166 patients who underwent retrograde PCI for CTO in 28 Japanese centers between January 2009 and December 2011.

Incremental predictive value for obstructive coronary artery disease by combination of Duke Clinical Score and Agatston score.

Aims: Recent study suggests that algorithms such as the Duke Clinical score (DCS) may overestimate the pretest probability. The Agatston score representing the grade of coronary artery calcification can be simply calculated from low-radiation exposure ECG-gated plain CT. In this study, we investigated whether or not more superior diagnostic performance for obstructive coronary artery disease (CAD) can be obtained by combining DCS with the Agatston score.