Estimation of Gait Independence Using a Tri-Axial Accelerometer in Stroke Patients.

The purpose of this study was to clarify whether a gait analysis using an accelerometer could estimate gait independence. Eighty-six stroke patients and 21 healthy control subjects participated in this study. Stroke patients were identified as dependent or independent based on their gait ability. The acceleration of the trunk and bilateral thigh was measured using three wireless sensors during walking. The root mean square, gait regularity, and symmetry were calculated from the acceleration to estimate gait quality. ANCOVA showed that gait regularity of the trunk and bilateral thigh were significantly lowest in the dependent group, regardless of gait velocity. A logistic regression analysis showed that the regularity and root mean square of the anteroposterior acceleration of the unaffected thigh were the key factors for estimating gait independence. This study suggests that an acceleration-based gait analysis facilities gait independence estimation, and is a useful tool during the rehabilitation of stroke patients.

The effects of olanzapine treatment on brain regional glucose metabolism in neuroleptic-naive first-episode schizophrenic patients.

OBJECTIVE: The current study examined metabolic alterations associated with a positive response to olanzapine and identified brain regions associated with treatment-related improvement of symptoms in neuroleptic-naive first-episode schizophrenic patients using [18 F]fluoro-deoxy-glucose positron emission tomography analysis. METHODS: Neuroleptic-naive first-episode schizophrenic patients who showed good or poor clinical responses to olanzapine were assessed using the Positive and Negative Syndrome Scale. Data were analyzed using statistical nonparametric mapping. RESULTS: Before treatment, responders showed significantly increased metabolism in the superior temporal gyrus and cerebellum compared with healthy controls. Glucose metabolism in responders was significantly increased after treatment in the left precentral gyrus, left postcentral gyrus, and left paracentral lobule, and significantly decreased in the left hypothalamus. An analysis of the Positive and Negative Syndrome Scale symptoms associated with olanzapine treatment revealed that "suspiciousness/persecution" scores were positively correlated with metabolic changes in the right superior frontal gyrus. CONCLUSIONS: These findings provide evidence of the neural mechanisms underlying the effects of olanzapine on metabolism in the early stages of schizophrenia.

A gait abnormality measure based on root mean square of trunk acceleration.

BACKGROUND: Root mean square (RMS) of trunk acceleration is seen frequently in gait analysis research. However, many studies have reported that the RMS value was related to walking speed. Therefore, the relationship between the RMS value and walking speed should be considered when the RMS value is used to assess gait abnormality. We hypothesized that the RMS values in three sensing axes exhibit common proportions for healthy people if they walk at their own preferred speed and that the RMS proportions in abnormal gait deviate from the common proportions. In this study, we proposed the RMS ratio (RMSR) as a gait abnormality measure and verified its ability to discriminate abnormal gait. METHODS: Forty-seven healthy male subjects (24-49 years) were recruited to examine the relationship between walking speed and the RMSR. To verify its ability to discriminate abnormal gait, twenty age-matched male hemiplegic patients (30-48 years) participated as typical subjects with gait abnormality. A tri-axial accelerometer was attached to their lower back, and they walked along a corridor at their own preferred speed. We defined the RMSR as the ratio between RMS in each direction and the RMS vector magnitude. RESULTS: In the healthy subjects, the RMS in all directions related to preferred walking speed. In contrast, RMSR in the mediolateral (ML) direction did not correlate with preferred walking speed (rs = -0.10, p = 0.54) and represented the similar value among the healthy subjects. Moreover, the RMSR in the ML direction for the hemiplegic patients was significantly higher than that for the healthy subjects (p < 0.01). CONCLUSIONS: These results suggest that the RMSR in the ML direction exhibits a common value when healthy subjects walk at their own preferred speed, even if their preferred walking speed were different. For subjects with gait abnormality, the RMSR in the ML direction deviates from the common value of healthy subjects. The RMSR in the ML direction may potentially be a quantitative measure of gait abnormality.

Different clinical phenotypes in siblings with a presenilin-1 P264L mutation.

BACKGROUND: Mutations in the presenilin-1 gene (PSEN1) have been identified in autosomal dominant early-onset cases of Alzheimer's disease (AD). AIMS: To investigate different clinical phenotypes of siblings possessing the same heterozygous P264L mutation in the PSEN1 gene. METHODS: We evaluated clinical features, neuroimaging results, and neuropsychological examinations. The PSEN1 gene and other dementia-related gene mutations were screened. RESULTS: We clinically diagnosed the proband as atypical AD with frontotemporal dementia features and diagnosed the elder brother of the proband as typical AD, based on neuropsychological symptoms and a brain imaging examination including amyloid imaging data. A heterozygous P264L mutation in the PSEN1 gene was identified in both siblings. CONCLUSION: This study is one of few reports of AD siblings possessing the same mutation but exhibiting different clinical phenotypes in a Japanese family possessing a P264L mutation in the PSEN1 gene. The current results suggest that unknown modifiers, including both genetic and epigenetic factors, may alter the pathological and clinical phenotypes of a genetically predetermined disease.

Metabolic changes in the brain of patients with late-onset major depression.

Positron emission tomography (PET) with fluorodeoxyglucose-F18 was used to examine glucose metabolism in patients with late-onset major depression, all hospitalized non-responders to antidepressant medication. The three-dimensional stereotactic surface projection (3D-SSP) method provided 3D-SSP images and relative metabolic values with minimal partial volume effects. The 3D-SSP score map showed decreased relative metabolism in the prefontal, cingulate and parietal regions in both hemispheres, and in the temporal region on the right, and increased relative metabolism in the occipital pole, vermis, cerebellum, dorsal-frontal, central convexity areas and basal ganglia in both hemispheres in patients compared with controls. The ratio of the parietal to occipital values in right plus left hemispheres was significantly decreased. Correlation coefficients of the anterior cingulate-primary sensorimotor, posterior cingulate-primary sensorimotor and occipital-media frontal in both hemispheres, of the frontal-primary sensorimotor, occipital-parahippocampal, primary visual-medial frontal and parahippocampal-amygdala in the right, and the frontal-vermis, parietal-thalamus, temporal-vermis, occipital-putamen, primary visual-putamen, thalamus-vermis and thalamus-cerebellum in the left were significantly different in patients compared with controls. Patients with late-onset depression who were treatment non-responders showed alterations not only in limbic-cortical circuits, but also in a wider network of thalamo-cortical circuits.

Changes in glucose metabolism due to aging and gender-related differences in the healthy human brain.

Using [(18)F]fluoro-deoxy-glucose-PET, we studied relative metabolic changes due to age- and gender-related differences in the brain of 126 healthy subjects from their twenties to seventies. We used a data-extraction technique, the three-dimensional stereotactic surface projections (3D-SSP) method, to measure metabolic changes with fewer effects of regional anatomic variances. Simple regression analysis revealed significant age-related increases in relative metabolic values in the parahippocampal and amygdala regions in both sexes in their twenties to forties, and significant age-related decreases in both sexes in their fifties to seventies. Relative values in the frontal lobe showed significant age-related decreases in both sexes in their twenties to forties, but these effects were not seen in subjects in their fifties to seventies. Significant gender differences in correlation coefficients of relative values with age were shown in the parahippocampal, primary sensorimotor, temporal, thalamus and vermis regions in subjects in their 20s to 40s, but disappeared in subjects in their twenties to forties, but were not apparent in subjects in their fifties to seventies except in the vermis. Males in their twenties to sixties and females in their fifties showed significant laterality in relative values in the temporal lobes. Our study demonstrated age- and gender-related differences in glucose metabolism in healthy subjects.

Abnormal glucose metabolism in the anterior cingulate cortex in patients with schizophrenia.

Changes in glucose metabolism were studied in the brains of schizophrenic patients treated with neuroleptics, using [(18)F]fluoro-deoxy-glucose positron emission tomography (FDG-PET). Fourteen male and eight female patients in their thirties and forties were studied in a resting state. Data from FDG-PET were processed with an anatomic standardization method, three-dimensional stereotactic surface projections (3D-SSP), which provided relative glucose metabolic values that mitigated the contamination of brain atrophy. Z-score maps indicating metabolic differences between the patient and control groups were also acquired. Metabolic values in 19 regions were evaluated in the right and left hemispheres. Patients showed decreased values in the frontal cortex, primary sensory regions and anterior cingulate cortex, more in the rostral affective subdivision than the dorsal cognitive subdivision in both hemispheres, and increased metabolic values in left and right basal ganglia, left temporal and right medial parietal regions. Values were more decreased in both anterior cingulate regions, and more increased in the right thalamus in male than female patients, suggesting gender-related dysfunction in the anterior cingulate and thalamus in schizophrenia. FDG-PET demonstrated that schizophrenia may be a disorder with a dysfunction of fronto-striatal-thalamic circuitry including the cingulate cortex.

Improving the accuracy of pedometer used by the elderly with the FFT algorithm.

PURPOSE: The aim of this study was to investigate and improve the accuracy of accelerometer-type pedometers used by the elderly with slow walking speeds, with or without gait disorders, who do or do not use a cane. METHODS: Eighteen subjects walked with a cane (5 males, 13 females; age, 80.9 +/- 7.7 yr; height, 148.1 +/- 7.7 cm; weight, 51.8 +/- 8.8 kg (mean +/- SD); nine had impaired gait), and 31 subjects walked without a cane (7 males, 24 females; age, 80.9 +/- 7.7 yr; height, 148.1 +/- 7.7 cm; weight, 51.8 +/- 8.8 kg; 15 had impaired gait). Subjects walked for approximately 20 m (10 m in each direction and a turning arc) at their own speed. We determined the number of steps by pedometer (PM), by visually counting the actual number of steps (RM), and by the triaxial acceleration signals. The power spectrum of the accelerometer in each direction calculated by fast Fourier transform (FFT) for a 4-s temporal window was normalized with the maximum power of each window. It was composited, and the frequency at maximum power was considered as the cadence. The number of steps taken (FM) was determined by summing all the estimated steps in each window. RESULTS: PM was significantly less than the RM (P < 0.05), and the error of PM was 53.2 +/- 34.1% of RM. FM did not differ from the RM, and the average error of FM was -0.7 +/- 7.9% of RM (absolute value: 5.8 +/- 5.3%). CONCLUSION: We suggest that our FFT method is suitable for estimating the number of steps during walking in this population.

Determination of hemispheric language dominance using functional magnetic resonance imaging and the Shiritori (Japanese word chain) task in patients with epilepsy: Comparison with the Wada test.

PURPOSE: The Wada test has been the gold standard for determining hemispheric language dominance (HLD) in the presurgical evaluation of patients scheduled for neurosurgical procedures. As it poses inherent risks associated with intra-arterial catheter techniques and as it occasionally fails to indicate language dominance, an alternative reliable test is needed. We quantitatively assessed the results of functional magnetic resonance imaging (fMRI) using the Shiritori task, a Japanese word chain, to identify the threshold for correctly predicting HLD. METHODS: The subjects were 28 patients with intractable epilepsy scheduled to undergo the Wada test and focus resection. We set the region of interest (ROI) on the bilateral Brodmann areas 44 and 45 (BA 44 and 45). To compare the functional activity at both ROIs we calculated the language laterality index (LI) using the formula: [VL-VR]/[VL+VR]×100, where VL and VR indicated the number of activated voxels in the left and right ROIs, respectively. RESULTS: As 2 patients were excluded due to the lack of activation in either ROI, the final study population consisted of 26 patients. By the Wada test, HLD was left in 20, right in 3, and equivocal in 3. At a cut-off of LI+50, the predictive sensitivity and specificity for left HLD were 85% (17/20) and 100%; right HLD was predicted in a single patient (sensitivity 33.3%, specificity 100%). CONCLUSION: The fMRI using the Shiritori task showed good activation in ROI of BA 44 and 45. At a cut-off of LI+50, LI of BA 44 and 45 predicted HLD identified by the Wada test with high specificity.

Sex Differences in Gamma Band Functional Connectivity Between the Frontal Lobe and Cortical Areas During an Auditory Oddball Task, as Revealed by Imaginary Coherence Assessment.

We studied sex-related differences in gamma oscillation during an auditory oddball task, using magnetoencephalography and electroencephalography assessment of imaginary coherence (IC). We obtained a statistical source map of event-related desynchronization (ERD) / event-related synchronization (ERS), and compared females and males regarding ERD / ERS. Based on the results, we chose respectively seed regions for IC determinations in low (30-50 Hz), mid (50-100 Hz) and high gamma (100-150 Hz) bands. In males, ERD was increased in the left posterior cingulate cortex (CGp) at 500 ms in the low gamma band, and in the right caudal anterior cingulate cortex (cACC) at 125 ms in the mid-gamma band. ERS was increased in the left rostral anterior cingulate cortex (rACC) at 375 ms in the high gamma band. We chose the CGp, cACC and rACC as seeds, and examined IC between the seed and certain target regions using the IC map. IC changes depended on the height of the gamma frequency and the time window in the gamma band. Although IC in the mid and high gamma bands did not show sex-specific differences, IC at 30-50 Hz in males was increased between the left rACC and the frontal, orbitofrontal, inferior temporal and fusiform target regions. Increased IC in males suggested that males may acomplish the task constructively, analysingly, emotionally, and by perfoming analysis, and that information processing was more complicated in the cortico-cortical circuit. On the other hand, females showed few differences in IC. Females planned the task with general attention and economical well-balanced processing, which was explained by the higher overall functional cortical connectivity. CGp, cACC and rACC were involved in sex differences in information processing and were likely related to differences in neuroanatomy, hormones and neurotransmitter systems.

Fractal dynamics of body motion in patients with Parkinson's disease.

In this paper, we assess the complexity (fractal measure) of body motion during walking in patients with Parkinson's disease. The body motion of 11 patients with Parkinson's disease and 10 healthy elderly subjects was recorded using a triaxial accelerometry technique. A triaxial accelerometer was attached to the lumbar region. An assessment of the complexity of body motion was made using a maximum-likelihood-estimator-based fractal analysis method. Our data suggest that the fractal measures of the body motion of patients with Parkinson's disease are higher than those of healthy elderly subjects. These results were statistically different in the X (anteroposterior), Y (lateral) and Z (vertical) directions of body motion between patients with Parkinson's disease and the healthy elderly subjects (p < 0.01 in X and Z directions and p < 0.05 in Y direction). The complexity (fractal measure) of body motion can be useful to assess and monitor the output from the motor system during walking in clinical practice.

Discrimination of walking patterns using wavelet-based fractal analysis.

In this paper, we attempted to classify the acceleration signals for walking along a corridor and on stairs by using the wavelet-based fractal analysis method. In addition, the wavelet-based fractal analysis method was used to evaluate the gait of elderly subjects and patients with Parkinson's disease. The triaxial acceleration signals were measured close to the center of gravity of the body while the subject walked along a corridor and up and down stairs continuously. Signal measurements were recorded from 10 healthy young subjects and 11 elderly subjects. For comparison, two patients with Parkinson's disease participated in the level walking. The acceleration signal in each direction was decomposed to seven detailed signals at different wavelet scales by using the discrete wavelet transform. The variances of detailed signals at scales 7 to 1 were calculated. The fractal dimension of the acceleration signal was then estimated from the slope of the variance progression. The fractal dimensions were significantly different among the three types of walking for individual subjects (p < 0.01) and showed a high reproducibility. Our results suggest that the fractal dimensions are effective for classifying the walking types. Moreover, the fractal dimensions were significantly higher for the elderly subjects than for the young subjects (p < 0.01). For the patients with Parkinson's disease, the fractal dimensions tended to be higher than those of healthy subjects. These results suggest that the acceleration signals change into a more complex pattern with aging and with Parkinson's disease, and the fractal dimension can be used to evaluate the gait of elderly subjects and patients with Parkinson's disease.

Development of a network system combined with ambulatory and non-conscious physiological measurements for supporting challenged kids - a new proposal of a gait monitoring system for use in rehabilitation.

Various physiological measurement techniques have been developed to support healthcare and daily living of adult including elderly. However, in light of the rapid growth of the declining birth rate, promotion in care and life support for children are not enough. Especially in rehabilitation for disabled children, i.e., challenged kids, it is important for therapist to evaluate the efficacy of rehabilitation and the health condition. Share of these information with educational, welfare, and government institutions are also needed for accurate life support. Therefore, the quantitative data of the activities and daily health status are helpful. From these viewpoints, we are developing a new network system for monitoring the activities and the health status of children using ambulatory and non-conscious physiological measurements as well as data browse at anytime and anywhere. Firstly, we propose a wearable gait monitoring system to support evaluation for the efficacy of rehabilitation. In this study, the present system can successfully detect the characteristics of postural changes in children with disorder of movement, demonstrating its usefulness and availability to the evaluation for the effect of the brace attached to the subject's lower limb.

Dysfunctional cortical connectivity during the auditory oddball task in patients with schizophrenia.

BACKGROUND: We studied the imaginary coherence (IC) of gamma frequency oscillations between brain regions of male schizophrenia patients during an auditory oddball task using magnetoencephalography (MEG) and electroencephalography (EEG). METHODS: Subjects were 10 right-handed male schizophrenia patients, evaluated by the positive and negative symptom scale (PANSS), and 10 healthy controls. Functional connectivity during the auditory oddball task was reconstructed in low (30-50 Hz) and high (50-100 Hz) gamma bands, and represented by imaginary coherence (IC) based on significant oscillatory power changes. We calculated correlations between PANSS scores and IC. RESULTS: In the high gamma band, IC between left occipital and right prefrontal lobe areas during the time window 750-1000 ms from stimulus onset showed negative correlations with total negative scores, total positive scores, the sum of positive and negative scores in PANSS, conceptual disorganization, and social avoidance scores. In the low gamma band, IC between the same areas from 250-500 ms also showed a negative correlation with the conceptual disorganization score. In the same time window, IC between left occipital and right frontoparietal lobe areas in the low gamma band showed a positive correlation with hallucinatory behavior; IC between right temporal pole and left prefrontal lobe areas showed a positive correlation with delusion scores, although these ICs were decreased relative to controls. CONCLUSIONS: Functional disconnection of high and low gamma bands in auditory oddball task may play an important role in the auditory processing in schizophrenia patients.

Changes in Event-Related Desynchronization and Synchronization during the Auditory Oddball Task in Schizophrenia Patients.

OBJECTIVE: We studied differences in the spatiotemporal dynamics of cortical oscillation across brain regions of patients with schizophrenia and normal subjects during the auditory oddball task using magnetoencephalography (MEG) and electroencephalography (EEG). METHODS: Ten right-handed male schizophrenia patients were studied. We used a newly developed adaptive spatial filtering algorithm optimized for robust source time-frequency reconstruction of MEG and EEG data, and obtained consecutive images in functional maps of event-related desynchronization (ERD) and synchronization (ERS) in theta, lower alpha (8-10 Hz), upper alpha (10-13 Hz), and beta bands. RESULTS: Beta ERD power at 750-1000 ms in patients was significantly increased in large right upper temporal and parietal regions and small upper portions of bilateral dorsal frontal and dorsal-medial parietal regions. Theta ERS power in schizophrenic patients during the oddball task was significantly increased in the left temporal pole at 250-500 ms, and was significantly increased in dorsal, medial frontal, and anterior portions of the anterior cingulate cortex in both hemispheres, and the left portion of lateral temporal regions at 500-750 ms, compared to the control group (family-wise error correction p<0.05). Lower alpha ERS power was significantly decreased in the right occipital region at 500-750 ms and in the right midline parietal and bilateral occipital regions at 750-1000 ms. Upper alpha ERS power was significantly decreased in right midline parietal and left occipital regions at 750-1000 ms. CONCLUSIONS: ERD/ERS changes were noted in the left temporal pole and midline frontal and anterior cingulate cortex in theta ERS, occipital lobe in alpha ERS, and right temporal-frontal-parietal, midline frontal, and anterior cingulate cortex in beta ERD. These findings may reflect disturbances in interaction among active large neuronal groups and their communication with each other that may be related to abnormal cognitive and psychopathological function. SIGNIFICANCE: Study of ERD and ERS by time-frequency analyses using MEG is useful to clarify data processing dysfunction in schizophrenia.

Effectiveness of interval training compared with endurance training in cardiac rehabilitation.

Anaerobic endurance training (AET) can improve sympathomimetic hyperactivity, and anaerobic interval training (AIT) is recommended for patients who cannot exercise due to exertional breathlessness and leg fatigue. However, the difference in sympathetic nerve activation (SNA) and parasympathetic nerve activation (PNA) during AIT and AET is unclear. The aim of this study is to investigate the differences between endurance and interval trainings. We studied three patients (63-73 years) assigned to AIT which exercise/pause phase is 60/120 seconds (AIT120) and AET of 10 minutes duration. Systolic blood pressure, heart rate (HR), and rate pressure product (as an index of SNA) and oxygen uptake, tidal volume, respiratory rate, and minute ventilation were measured. As a result, these parameters in AET were increased compared with those of AIT120 among the subjects. While, high frequency component of frequency distribution in HR (HF) in AET was decrease compared with that in AIT120 among subject. We concluded that AIT inhibited SNA more effectively compared with AET and AIT may be safe for cardiac rehabilitation.

Development of a ubiquitous healthcare monitoring system combined with non-conscious and ambulatory physiological measurements and its application to medical care.

The demand for ubiquitous healthcare monitoring has been increasingly raised for prevention of lifestyle-related diseases, acute life support or chronic therapies for inpatients and/or outpatients having chronic disorder and home medical care. From these view points, we developed a non-conscious healthcare monitoring system without any attachment of biological sensors and operations of devices, and an ambulatory postural changes and activities monitoring system. Furthermore in this study, in order to investigate those applicability to the ubiquitous healthcare monitoring, we have developed a new healthcare monitoring system combined with the non-conscious and the ambulatory measurements developed by us. In patients with chronic cardiovascular disease or stroke, the daily health conditions such as pulse, respiration, activities and so on, could be continuously measured in the hospital, the rehabilitation room and subject's own home, using the present system. The results demonstrated that the system appears useful for the ubiquitous healthcare monitoring not only at medical facility, but also during daily living at home.

Associations between liver (18)F fluoro-2-deoxy-D-glucose accumulation and various clinical parameters in a Japanese population: influence of the metabolic syndrome.

PURPOSE: Liver demonstrates a heterogeneous (18)F fluoro-2-deoxy-D: -glucose ((18)F-FDG) uptake pattern and sometimes shows an abnormally increased uptake even when there is no malignant tissue. The aim of this study was to evaluate the relationships of liver (18)F-FDG uptake as related to physical factors, fatty liver, blood glucose (BG), and other biochemical data. METHODS: (18)F-FDG positron emission tomography (PET) imaging was performed in 101 consecutive subjects for cancer screening. Multiple stepwise regression analysis was used to define the best predictors of the liver standardized uptake value (SUV) among height, weight, waist circumference, body mass index (BMI), systolic and diastolic blood pressure, BG and other biochemical data, i.e., aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, total cholesterol, high-density lipoprotein cholesterol, triglycerides, total protein, total bilirubin, and alkaline phosphatase. Furthermore, we evaluated the association between liver (18)F-FDG uptake and the metabolic syndrome. RESULTS: The independent factors for increased liver (18)F-FDG uptake (mean SUV > or = 2) were BMI (P < 0.0001), triglycerides (P = 0.0007), and high-density lipoprotein cholesterol (P = 0.0013). Other factors were not significantly associated with liver (18)F-FDG uptake. In addition, the liver (18)F-FDG uptake of metabolic syndrome subjects was significantly higher than that of a non-metabolic syndrome subjects. CONCLUSIONS: BMI was the strongest determinant of liver (18)F-FDG uptake, and the liver (18)F-FDG uptake of metabolic syndrome subjects was significantly higher than that of non-metabolic syndrome subjects. This result suggests that a subject with a high liver (18)F-FDG uptake should be screened for the metabolic syndrome.

Role of gastric distention with additional water in differentiating locally advanced gastric carcinomas from physiological uptake in the stomach on 18F-fluoro-2-deoxy-D-glucose PET.

PURPOSE: In this study, we investigated the role of gastric distention with additional water to determine whether it is beneficial for the differentiation of locally advanced gastric carcinomas from physiological 18F-fluoro-2-deoxy-D-glucose (FDG) uptake in the stomach and to characterize the FDG uptake of gastric carcinomas by relating it to the histopathological properties of the tumours. METHODS: Sixteen patients with locally advanced gastric carcinomas and 20 control patients were studied by FDG-PET. After whole-body PET imaging, the patients drank 400 ml of water and then spot imaging with additional water of the stomach was performed. The final diagnosis was determined from the results of surgery. The gastric areas were divided into the upper, middle, and lower parts. The degree of FDG uptake in the stomach was qualitatively evaluated by visual grading into three degrees. For quantitative analysis, the regional tumour uptake was measured by mean standardized uptake values using a region of interest technique. RESULTS: In visual analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET without additional water ingestion were 100, 50, 62, 100 and 72%, respectively, and those of PET with additional water ingestion were 88, 100, 100, 91 and 94%, respectively. Using spot imaging under the condition with additional water ingestion, four gastric carcinomas were depicted more clearly. CONCLUSION: Gastric distention as a result of patients drinking a glass of water is a simple and noninvasive method for improving the diagnostic accuracy of FDG-PET in patients with locally advanced gastric carcinoma.

A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation.

Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.