Kousaku Saotome

Effects of a Low-Volume Aerobic-Type Interval Exercise on V˙O2max and Cardiac Mass

PURPOSE The aim of this study was to compare the effects of time-efficient, low-volume interval exercises on cardiorespiratory capacity and left ventricular (LV) mass with traditional continuous exercise in sedentary adults. METHODS Forty-two healthy but sedentary male subjects (age 26.5 ± 6.2 yr) participated in an 8-wk, five times per week, supervised exercise intervention. They were randomly assigned to one of three exercise protocols: sprint interval training (SIT, 5 min, 100 kcal), high-intensity interval aerobic training (HIAT, 13 min, 180 kcal), and continuous aerobic training (CAT, 40 min, 360 kcal). Cardiorespiratory capacity (V˙O2max) and LV mass (3T-MRI) were measured preintervention and postintervention. RESULTS We observed significant (P < 0.01) increases in V˙O2max in all three groups, and the effect of the HIAT was the greatest of the three (SIT, 16.7% ± 11.6%; HIAT, 22.5% ± 12.2%; CAT, 10.0% ± 8.9%; P = 0.01). There were significant changes in LV mass, stroke volume (SV), and resting HR in both the SIT (LV mass, 6.5% ± 8.3%; SV, 5.3% ± 8.3%; HR, -7.3% ± 11.1%; all P < 0.05) and HIAT (LV mass, 8.0% ± 8.3%; SV, 12.1% ± 9.8%; HR, -12.7% ± 12.2%; all P < 0.01) but not in the CAT (LV mass, 2.5% ± 10.1%; SV, 3.6% ± 6.6%; HR, -2.2% ± 13.3%; all P > 0.05). CONCLUSIONS Our study revealed that V˙O2max improvement with the HIAT was greater than with the CAT despite the HIAT being performed with a far lower volume and in far less time than the CAT. This suggests that the HIAT has potential as a time-efficient training mode to improve V˙O2max in sedentary adults.

Evaluation of ventriculomegaly using diffusion tensor imaging: correlations with chronic hydrocephalus and atrophy

OBJECT Ventriculomegaly is a common imaging finding in many types of conditions. It is difficult to determine whether it is related to true hydrocephalus or to an atrophic process by using only imaging procedures such as MR imaging after traumatic injury, stroke, or infectious disease. Diffusion tensor (DT) imaging can distinguish the compression characteristics of white matter, indicating that increased diffusion anisotropy may be related to white matter compression. In this preliminary study, the authors compared the DT imaging findings of ventriculomegaly with those of chronic hydrocephalus or atrophy to clarify the potential of diffusion anisotropy in the identification of hydrocephalus. METHODS Ten patients with chronic hydrocephalus, 8 patients with atrophy (defined by conventional devices and surgical outcome), and 14 healthy volunteers underwent DT imaging. Images were acquired before and after shunting or once in cases without shunting. The fractional anisotropy (FA) values at many points around the lateral ventricle were evaluated. RESULTS The FA patterns around the lateral ventricle in the chronic hydrocephalus and atrophy groups were different. Especially in the caudate nucleus, FA was increased in the chronic hydrocephalus group compared with the atrophy group. Furthermore, the FA values returned to normal levels after shunt placement. CONCLUSIONS Assessment of the FA value of the caudate nucleus may be an important, less invasive method for distinguishing true hydrocephalus from ventriculomegaly. Further research in a large number of patients is needed to verify the diagnostic ability of this method.

Best single-slice measurement site for estimating visceral adipose tissue volume after weight loss in obese, Japanese men

BackgroundAlthough the measurement site at L4–L5 for visceral adipose tissue (VAT) has been commonly accepted, some researchers suggest that additional upper sites (i.e., L1–L2 and L2–L3) are useful for estimating VAT volume. Therefore, determining the optimum measurement site remains challenging and has become important in determining VAT volume. We investigated the influence of a single-slice measurement site on the prediction of VAT volume and changes in VAT volume in obese Japanese men.MethodsTwenty-four men, aged 30–65 years with a mean BMI of 30 kg/m2, were included in a 12-week weight loss program. We obtained continuous T1-weighted abdominal magnetic resonance images from T9 to S1 with a 1.5-T system to measure the VAT area. These VAT areas were then summed to determine VAT volume before and after the program.ResultsSingle-slice images at 3–11 cm above L4–L5 had significant and high correlations with VAT volume at baseline (r = 0.94–0.97). The single-slice image with the highest correlation coefficient with respect to VAT volume was located at 5 cm above L4–L5 (r = 0.97). The highest correlation coefficient between the individual changes in VAT area and changes in VAT volume was located at 6 cm above L4–L5 (r = 0.90).ConclusionsIndividual measurement sites have different abilities to estimate VAT volume and changes in VAT volume in obese Japanese men. Best zone located at 5–6 cm above L4–L5 may be a better predictor of VAT volume than the L4–L5 image in terms of both baseline and changes with weight loss.

Multiple-slice magnetic resonance imaging can detect visceral adipose tissue reduction more accurately than single-slice imaging.

Background/Objective:Imaging methods by magnetic resonance imaging are being increasingly used to quantify visceral adipose tissue (VAT), but there is no clear consensus as to a standardized protocol. We compared the ability of two commonly used imaging protocols (multiple slice versus single slice) to detect changes in VAT with diet or exercise.Subjects/Methods:We utilized data from the participants who completed our diet (n=22) or exercise (n=35) based weight-loss interventions. The intervention mainly comprised of weekly dietary modification sessions or aerobic exercise sessions over 12 weeks. Multiple-slice images obtained from T9 to S1 and a single-slice image at L4–L5 were compared using the effect size of the VAT change. In addition, we calculated the sample size needed to compare the two imaging protocols’ ability to detect significant changes in VAT.Results:VAT and subcutaneous adipose tissue volumes and areas, and other anthropometry decreased significantly after both the diet and exercise interventions. For VAT, a single-slice image had a lower effect size (diet: 1.23; exercise: 0.49) than the multiple-slice images (diet: 1.81; exercise: 0.90). The sample size required for multiple slice was substantially lower than for the single-slice with both weight-loss interventions.Conclusions:The different image protocols may lead to different results in relative VAT changes. Furthermore, single-slice imaging required a substantially larger sample size than multiple-slice imaging, and for researchers to detect smaller changes in VAT with single-slice imaging, a larger sample size would be needed. Thus, multiple-slice imaging has advantages for assessing VAT change in future clinical research.

Elevated diffusion anisotropy in gray matter and the degree of brain compression

OBJECT For several decades, clinicians have predicted intraparenchymal brain pressure or brain tissue compression indirectly based on the degree of distortion of the midline structures (midline shift) and ventricle wall (ventriculomegaly) observed on conventional MRI. However, this method has several limitations. Diffusion tensor imaging (DTI) is a novel MRI technique that can provide information about the microstructural properties of compressed tissue. In this study, the authors evaluated whether DTI can precisely define the degree of tissue compression in patients with chronic subdural hematoma (CSDH). METHODS The study sample consisted of 18 patients (mean age 71 years, 10 men and 8 women) with unilateral CSDH and 12 age-matched volunteers. Diffusion tensor imaging results were acquired before and after the surgical irrigation in the CSDH group. Subdural pressure during the operation was also measured. Fractional anisotropy (FA) values were evaluated at several locations, including the gray matter. RESULTS The FA values of the gray matter, especially in the caudate nucleus and putamen, were increased in the patients with CSDH compared with the control group. The change in FA data before and after surgery (ΔFA) correlated with the degree of tissue compression evaluated by measurement of the subdural pressure. Furthermore, the increased FA values in patients with CSDH decreased after surgery. CONCLUSIONS These findings indicate that FA values of the gray matter, especially in the caudate nucleus and putamen, may be important markers of tissue compression. The assessment of FA values of the gray matter will result in a new, less-invasive diagnostic technique to evaluate the degree of brain compression.

Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study

Context: Patients with complete quadriplegia after high cervical spinal cord injury are fully dependent with activities of daily living. Assistive technology can improve their quality of life. We examined the use of a hybrid assistive limb for single joints (HAL-SJ) in a 19-year-old man with complete C4 quadriplegia due to chronic spinal cord injury to restore function of active elbow flexion. This is the first report on the use of the HAL-SJ in a patient with spinal cord injury. Findings: The HAL-SJ intervention for each elbow was administered in 10 sessions. Clinical assessment using surface EMG was conducted to evaluate muscle activity of the trapezius, biceps brachii, infraspinatus, and triceps brachii muscle before, and during the 2nd, 3rd, 6th, and 9th interventions. Surface electromyography (EMG) before intervention showed no contraction in the upper arms, but in the bilateral trapezius. The HAL-SJ used motion intention from the right trapezius for activation. After the 6th and 7th session, respectively, biceps EMG showed that voluntary contraction and right elbow flexion could be performed by motion intention from the right biceps. After the 10th session, voluntary bicep contraction was possible. HAL-SJ treatment on the left elbow was performed using the same protocol with a similar outcome. After completing treatment on both upper extremities, both biceps contracted voluntarily, and he could operate a standard wheelchair for a short distance independently. Conclusion: HAL-SJ intervention is feasible and effective in restoring elbow flexor function in a patient with C4 chronic spinal cord injury and complete quadriplegia.

Muscle activity during gait-like motion provided by MRI compatible lower-extremity motion simulator

This paper describes an evaluation of muscle activity of volunteers while they undergo gait-like motion in their dorsal position supported by our lower-extremity motion simulator (LoMS) that is magnetic resonance imaging (MRI) compatible. Our LoMS is designed to provide gait-like motion for a wearer in his/her dorsal position while a functional MRI measures his/her brain activity. A purpose of providing gait-like motion by LoMS is to enable a wearer in the dorsal posture to move his/her lower extremities like gait. LoMS is controlled with torque control based on predictive control method to convert the gravity effect of the dorsal posture into the caudal posture. The performance providing gait-like motion is evaluated from two viewpoints of muscle activities: bioelectrical potential (BEP) transition and inhibition of musculus soleus during the motion. There were correlation of BEP transition at iliopsoas, quadriceps femoris, musculus tibialis anterior, and musculus soleus. The inhibition during the gait-like motion provided by LoMS was similar to the inhibition during treadmill gait. The inhibition is modulated by a level of cerebellum, brainstem and spinal. Therefore, it is considered that LoMS induces the motor sensation in the level of cerebellum, brainstem, and spinal by providing the gait-like motion. Graphical Abstract

MRI compatibility of lower-extremity motion simulator: LoMS

This paper describes a magnetic resonance imaging (MRI) compatibility assessment of our lower-extremity motion simulator called LoMS which provides gait-like motion for a wearer within his/her lying posture during functional MRI (fMRI) imaging. We confirmed that the existence and the movement of LoMS do not decrease the fMRI image quality when the distance between LoMS and the head coil of MRI is practical distance (more than 400 mm). We also confirmed that LoMS can operate properly in MRI environment, which is to measure own joint angle avoiding the noise from fMRI imaging. Then we show that the brain activity related to gait motion can be imaged during gait-like motion.

Development of an MRI-powered robotic system for cryoablation.

This study proposes a novel MRI-powered robotic system controlled with the magnetic field generated by a magnetic resonance imaging (MRI) scanner. In the proposed system, we use an MRI-powered actuator unit proposed in the previous study and a spherical positioning mechanism. The actuator unit contains a ferromagnetic sphere, which acts as a power source and is used to control the positioning unit inside the MRI environment. These elements enable the development of a remote needle tip positioning system for use within the MRI scanner. Potential applications of the developed system include the automation of procedures during under MRI inspections, especially the cryoablation of breast cancer. In this paper, we report on the performance evaluation and the MR-safety of the proposed system and describe the newly developed spherical positioning mechanism, which can be activated by the actuator units.

Development of MRI-powered modular robotic system.

This study proposes a novel robotic system controlled by the magnetic forces generated from Magnetic Resonance Imaging (MRI) scanner. In the proposed system, ferromagnetic particles are used to actuate the device, while all other parts are made of nonmagnetic materials. The possible range of motion for the particles is investigated by using the common sequence which is usually available for MR imaging. We then designed a mechanism that extends the observed pendular motion to rotational movement. By using the designed mechanism, we realized a MRI-powered multiaxial robotic system. The potential application of this system covers the automation for under MRI inspections such as esthesiometry and needle biopsy. In this paper, we described the fundamental principle of the MRI-powered robotic system and also report on the performance evaluation of the robotic system.