Aug. 2025
Japanese Society of Pressure Ulcers, Outstanding Paper Award (Oura Award)
Exploring diagnostic indicators based on the theory of multi-circulatory disorders in early pressure injury
En Takashi

Feb. 2024
2024 Annual Conference（USA）, Poster Award
Applicability of Early Detection Model of Pressure Ulcer Deterioration Using Artificial Intelligence (AI)
Sakakibara U;Jerelyn C;Malana GM;Takashi E;Kamijo A.

Mar. 2021
NPIAP 2021 Annual Conference, USA, Best Overall Award (Poster Presenter)
Artificially Inducing Local Torpor-Like State Protects Skin from Pressure Injury, United States, International society
En Takashi;Akio Kamijo;Jian Lu;Lan Zhang;Daiji Miura;Akio Kitayama
【Purpose】
Pressure injury (PI) is local skin ischemia primarily caused by pressure, which accelerates metabolism of residual glucose in anaerobic condition and causes rapid depletion, and leads to necrosis as a result of the loss of energy sources. Mammal hibernation is a mean of maintaining life over long time with limited energy during winter when food is scarce. This torpor-like state is used for extracorporeal storage of skin graft for transplantation. Using this biomedical approach, we tried to decrease temperature of local skin to mimic torpor-like state in vivo and observed its effects on PI.
【Methods】
The PI model was established by exposing dorsal skin of 4 hairless rats to pressure between 2 circular neodymium magnets (4 kg attraction) for 4 hours. The PIs on left and right side were respectively categorized as a torpor and control group (each n=8). Skin temperature of the torpor group was decreased to 1-10℃ and that of the control group was 29.3±1.0℃. The rectal temperature was also monitored during the entire process. After the pressure release, macroscopic observation was performed to evaluate ulcer formations and a spectral colorimeter was used to measure an erythema index of redness. The experiment followed the protocols approved by the Animal Experiment Ethics Committee of Nagano College of Nursing.
【Results】
In the control group, 50% (n=4) of the PI deteriorated to ulcer formations in 12 hours and 75% (n = 6) did in 2 days. In contrast, no ulcer formation was observed in the torpor group. Even though both groups showed strong redness immediately after the pressure release, the erythema index of the torpor group rapidly decreased from 8.5±2.1% to 3.5±0.9% in 1.5 hour while the control group had only slight reduction from 10.4±0.9% to 7.6±1.7% (p<0.05 vs torpor group). The rectal temperature was 34.2±0.8℃.
【Conclusion】
The artificial induction of local torpor-like state protected the skin from the PI. This result may indicate that ischemic skin prolonged its survival without blood perfusion by adjusting metabolic demand under low temperature.

Aug. 2019

Sep. 2018

Sep. 2016

Establishment of the multi-circulatory disorders theory in early pressure injury and its significance in diagnosis and treatment
En Takashi
Bull, Nagano Coll Nurs, Jul. 2025, [Invited]

Development of a Printed Sensor and Wireless Measurement System for Urination Monitoring
Lan Zhang; En Takashi; Jian Lu; Sohei Matsumoto
Sensors, 08 May 2025, [Reviewed]
The development of reliable and efficient sensors is essential for advances in health monitoring technologies. This study focused on the fabrication and evaluation of a multichannel printed sensor electrode designed for long-term stability and effective data acquisition. Using rapid printing technology, we created a urine sensor array with extended electrodes for the measurement of urine volume and frequency. The ultrathin design of the sensor electrode, with an average thickness of only 30 microns, ensures both user comfort and measurement accuracy. The sensor electrode dimensions were meticulously designed, measured, and optimized through successful trial manufacturing of the sensor electrode and sensor array. Comprehensive evaluation of the fabricated sensor demonstrated excellent performance, including a high response speed of ≤1 s and long-term stability exceeding 5 weeks. In addition, wireless transmission capabilities and user interfaces were developed for field experiments. Finally, animal experiments were performed to evaluate the field performance of the fabricated sensor. Accordingly, we are confident that the sensor developed herein will contribute to enhancing healthcare in an aging society.

Clarification of the Clinical Characteristics of Autoimmune Disease-Related Ulcers to Improve Treatment Outcomes: A Retrospective Study.
Min Wei; Dongyun Xia; En Takashi; Yansen Qiu; Li Huang; Zhen Sun; Yajuan Weng
The international journal of lower extremity wounds, 17 Mar. 2025
AimTo clarify the clinical characteristics of autoimmune disease (AID)-related ulcers to improve treatment outcomes.Materials and MethodsThe medical records of 189 patients treated for AID-related ulcers at two tertiary hospitals in Nanjing, China, from January 1, 2018 to December 31, 2022 were retrospectively reviewed. The relevant clinical data included diagnosis, type and severity of wounds, and prescribed medications.ResultsOf the 189 patients with AID-related ulcers, 146 (77.25%) were female and 43 (22.75%) were male. The top four immunological diagnoses were rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, and vasculitis. The four most common wound sites were the lower limb, foot, hand, and upper limb. Regarding the number of wounds, 81 (42.86%) patients had one ulcer, 43 (22.75%) had two, 30 (15.87%) had three, and 35 (18.52%) had four or more. More than half of the patients (54%, 102/189) were previously treated for AID-related ulcers. Of these 102 patients, 27 (26.47%) had one previous diagnosis, 49 (40.83%) had two, and 26 (25.49%) had three or more. Among all 189 patients, 142 (75%) had clinical symptoms of local infection. Of these 142 patients, bacteria cultures were conducted for 70 (49.30%), of which 63 (90.00%) were positive. The most commonly detected bacteria were Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae. The median (interquartile range) duration of AID-related ulcers was 55 (39, 90) days. Most patients (87.3%, 165/189) received systemic therapy with immunosuppressants and hormones.ConclusionsThe most common clinical characteristics of AID-associated ulcers were spontaneous rupture, long duration, multiple wounds, bacterial infection, and recurrence. Clarification of the clinical characteristics of AID-associated ulcers can improve treatment outcomes.

Local skin ventilation reduces pressure injuries in rats through oxygen supply and improving the microclimate
Kamijo Akio; Mao Xin’E; Chen Hongmei; Miura Daiji; Kitayama Akio; Ten Hirotomo; Takashi En
Journal of wellness and health care, 01 Feb. 2025, [Reviewed]

早期褥瘡の多循環障害説に基づく診断指標の探索
Oct. 2024, [Reviewed]

早期褥瘡における病理機序の再考と最新の知見に基づく診断デバイスの開発　　　　　　　　　　　　　　　
Aug. 2024

Topical Skin Application of Small-Molecule Antiplatelet Agent against Pressure Injury in Rat Models.
Yuan Yuan; En Takashi; Ping Hou; Akio Kamijo; Daiji Miura; Hirotomo Ten
International journal of molecular sciences, 29 Jan. 2024, [Reviewed]
Due to prolonged forced positioning, the incidence of intraoperative pressure injuries is high. This study aimed to explore the impact of small-molecule antiplatelet drugs on pressure injuries by locally applying them before an injury occurs. In the first part of this study, water-soluble tracers with different molecular weights were applied to normal and early-stage pressure-injured skin. Through digital cameras, spectrophotometers, and histological observations, the penetration of tracers into the epidermis was clarified. In the second part of this study, a water-soluble antiplatelet drug called Trapidil (molecular weight = 205 Da) was applied to the left side of the back of a rat before, during, and after compression, and the contralateral side served as a non-intervention control group. The differences in pressure injuries between the two groups were observed through a digital camera, an ultraviolet camera, and temperature measurement, and skin circulation and perfusion were assessed via an intravenous injection of Evans Blue. The first part of this study found that water-soluble tracers did not easily penetrate normal skin but could more easily penetrate pressure-damaged skin. The smaller the molecular weight of the tracer, the easier it penetrated the skin. Therefore, in the next step of research, water-soluble drugs with smaller molecular weights should be selected. The second part of this study found that, compared with the control group, the occurrence rates and areas of ulcers were lower, the gray value was higher, and the skin temperature was lower in the Trapidil group (p < 0.05). After the intravenous Evans Blue injection, skin circulation and perfusion in the Trapidil group were found to be better. In conclusion, this study found that the topical skin application of a small-molecule antiplatelet agent may have significant effects against pressure injuries by improving post-decompression ischemia, providing new insights into the prevention and treatment of intraoperative pressure injuries.

Psychosocial markers of pre-hospital delay in patients with diabetic foot: A cross-sectional survey.
Huiwen Xu; Chen Wu; Shengxiao Xiang; Shuang Qiu; Yan Chen; En Takashi; Kiyoko Yanagihara; Ping Xie
Nursing open, Jan. 2024
AIM: This study aimed to determine the psychosocial markers associated with pre-hospital delay among patients with diabetic foot (DF). DESIGN: This study has a cross-sectional design. METHODS: The participants completed a questionnaire including pre-hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale-14. Bivariate and multivariate analyses were conducted to explore independent associations with pre-hospital delay. RESULTS: Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self-management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. PATIENT OR PUBLIC CONTRIBUTION: This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China.

Fluctuations in Detection Indicators and Their Significance for the Diagnosis of Early Pressure Injury in Rat Models
Ping Hou; Lu Chen; En Takashi; Akio Kamijo; Huiwen Xu; Daiji Miura; Hirotomo Ten; Akio Kitayama; Jianglin Fan
Journal of Wound, Ostomy & Continence Nursing, Jan. 2024, [Reviewed]
PURPOSE:

The aim of this study was to identify the most meaningful diagnostic indicator for distinguishing blanchable erythema (BE) and stage 1 pressure injury (early PI) in an in vivo (rat) model.

DESIGN:

A prospective case-control design was used to complete a horizontal and vertical comparison of detection indicators during the process of fading of BE or the deterioration of early PI into ulcer in rat models.

MATERIALS AND SETTING:

The sample comprised 5 hairless rats with 20 injuries, of which 10 were BE and the other 10 were early PI. Data were collected at Nagano College of Nursing in 2020 in Nagano, Japan.

METHODS:

The BE and PI rat models were established by subjecting the dorsal skin of a hairless rat to compression between 2 neodymium magnets for 45 minutes and 3.45 hours, respectively. The affected skin was observed based on the following: (1) photography, (2) hardness, (3) temperature, (4) moisture, and (5) spectrophotometric (a* value and ultraviolet [UV] reflectance) measurements. All measurements of BE were performed at the beginning to 60 minutes after decompression, and those for early PI were performed until 48 hours after decompression.

RESULTS:

Multiple BE factors, such as the degree of erythema (macroscopy and a* value), hardness, temperature, and moisture, were found to have unstable fluctuations. Only UV reflectance gradually decreased from 6 hours and decreased significantly at 48 hours after decompression (P = .001 vs 1 hour). In contrast to early PI, erythema in BE obviously faded within 10 minutes.

CONCLUSIONS:

Study findings indicate that a continuous decrease in UV reflectance can reflect the worsening of hemorrhage in early (stage 1) PI. In contrast, other indicators including photography, skin hardness, temperature, and moisture fluctuated and did not prove predictive for PI progression. The obvious fading of erythema in BE a short time after decompression can be used for clinical observations.

A comprehensive analysis of multi-circulatory disorders in early pressure injury and their diagnostic significance in rat models.
Lu Chen; En Takashi; Akio Kamijo; Daiji Miura; Jian Lu; Lan Zhang; Hirotomo Ten; Jianglin Fan
Scientific reports, 07 Nov. 2023, [Reviewed]
Early pressure injury (PI) progression is associated with multi-circulatory disorders and they interplay with each other, resulting in a lack of a satisfactory diagnostic method. We generated early PI and blanchable erythema hairless rat models. Transparent disc method and capillary refilling time test (CRTT) results were recorded with ultraviolet camera to capture the dynamics changes, and the blanching index and refilling index were set for comprehensive analysis. The deteriorated areas of early PI showed non-blanchable erythema (NBE) and an increase in erythema at 0.5 and 6 h with the transparent disc method. CRTT showed a marked refilling delay at 12 h. The comprehensive analysis of blanching index and refilling index showed a significant change in erythema from NBE at 0.5 h and ischemia progressing to hemorrhage at 18 h. There was also a marked difference in the deteriorating and improving areas within the same erythema. Pathological analysis showed inflammatory cell infiltration, with marked edema accompanied by increased hemorrhage and tissue necrosis. Furthermore, small arteries and veins with thrombosis and microthrombi were observed. Consistent ischemia after decompression and subsequent hemorrhage are important indicators, and comprehensive analysis can help increase the positive diagnosis rate over that for other circulatory disorders alone.

実験的早期褥瘡における複雑な循環障害の総合解析およびその診断意義
Aug. 2023

Thermal preconditioning can reduce the incidence of intraoperatively acquired pressure injuries.
Ping Hou; Huiping Xue; Shuwen Chang; Ping Xie; Yajie Chen; Yanwei Wang; Daiji Miura; Jianglin Fan; Jingyan Liang; Akio Kitayama; Fang Fang; Haijuan Yuan; Xiaoling Wu; Xiaolin Zhang; Jing Wang; Ning Ding; Can Zhang; Xiuyun Sun; En Takashi
Journal of thermal biology, Jul. 2023
Intraoperatively acquired pressure injuries (IAPIs) occur frequently among patients who undergo surgical procedures that last longer than 3 h. Several studies indicated that heat shock proteins (HSPs) play an important role in the protection of stress-induced damages in skin tissues. Hence, the aim of this study was to investigate the potential preventive effect of thermal preconditioning (TPC) on IAPIs in surgical patients and rats and to identify the differentially expressed HSP genes in response to the above treatment. TPC was performed on one group of hairless rats before the model of pressure injuries was established. Subsequently, the size of skin lesions was measured and the expression levels of mRNA and protein of HSPs of the pressured skin were detected by real-time polymerase chain reaction (RT-PCR), western blot, and immunohistochemical staining. For human studies, 118 surgical patients were randomly divided into the TPC group (n = 59) and the control group (n = 59), respectively. The temperature and pressure of sacral skin, as well as the incidence of pressure injury (PI) were detected and compared. In animal studies, TPC significantly reduced both the size and incidence of PI in rats on the second, third and fourth days post treatment. In addition, the expression levels of both mRNA and protein of HSP27 were increased in the TPC group, compared with the control group. Immunohistochemical staining showed that HSP27 was distributed in various types of dermal cells and increased in basal cells. In human studies, a significant reduction (75%) of IAPIs was observed among the patients in the TPC group. TPC can reduce the incidence of PI in rats and humans, and the upregulation of HSP27 may play an important role in this biological progress. Further studies are warranted to explore the molecular mechanism of the preventive effect in PI mediated by HSP27.

Exploring the relationship between lateral violence and nursing professionalism through the mediating effect of professional identity: A cross-sectional questionnaire study.
Huiwen Xu; Mengxin Xue; En Takashi; Akio Kitayama; Pingting Zhu; Yongbing Liu
Nursing open, May 2023
AIM: This study aimed to investigate the prevalence of lateral violence (LV) experienced by nursing students during their internship, explore the difference between professional identity and professionalism among nursing students who had or had not experienced LV and analyse the mediating effect of professional identity on the relationship between LV and professionalism. DESIGN: A cross-sectional survey was used. METHODS: An online anonymous survey was distributed to nursing students (N = 298) in Jiangsu province, China from June to July 2021. The questionnaire consisted of sections on lateral violence, professional identity and nursing professionalism. RESULTS: Approximately 49.7% of the nursing students experienced LV behaviour during the internship period. Students who experienced LV had lower professional identity and professionalism than those who did not. Among the students, LV was negatively correlated with professional identity (r = -0.333, p < 0.001) and professionalism (r = -0.418, p < 0.001). The relationship effect of LV on nursing professionalism was partly mediated by professional identity. CONCLUSION: Nearly half of the nursing students suffered from LV in the workplace, and this condition remarkably influenced nursing professionalism through professional identity. Both quantitative and qualitative studies are needed to investigate the factors that influence LV development in detail.

Rapid Manufacturing Approach of an Ultrathin Moisture Sensor for Health Monitoring.
Lan Zhang; Jian Lu; En Takashi; Sohei Matsumoto
Sensors (Basel, Switzerland), 25 Apr. 2023
This study developed a rapid manufacturing approach for a moisture sensor based on contactless jet printing technology. A compact measurement system with ultrathin and flexure sensor electrodes was fabricated. The proposed sensor system focuses on continuous urine measurement, which can provide timely information on subjects to ensure efficient diagnosis and treatment. The obtained results verify that the proposed sensor system can exhibit a typical responsivity of up to -7.76 mV/%RH in the high-sensitivity range of 50-80 %RH. A preliminary field experiment was conducted on a hairless rat, and the effectiveness of the proposed ultrathin moisture sensor was verified. This ultrathin sensor electrode can be fabricated in the micrometer range, and its application does not affect the comfort of the user. The ultrathin electrode sensors can be printed directly on the diaper or undergarment of the user for in situ urine health monitoring, particularly of infants and the elderly.

Elucidation of Ischemic Mechanisms of Early Pressure Injury during Post-Decompression and Detecting Methods
Lu Chen; En Takashi; Ping Hou; Akio Kamijo; Daiji Miura; Jianglin Fan
Diagnostics, 09 Sep. 2022, [Reviewed]
Background: Pressure injuries (PIs) generally result from prolonged ischemia through localized skin compression, and ischemia persists and exacerbates damage even post-decompression. The mechanisms of ischemia post-decompression are still unclear, and appropriate methods for detection are lacking. Methods: We used blanchable erythema (BE) and early PI rat models. We assessed the perfusion using Evans Blue (EB) and thrombus formation under a light microscope. Furthermore, we performed a capillary refill time test (CRTT) to detect ischemia after depression coupled with the transparent disk method using a spectrophotometer. Results: Compared with the BE group, the early PI group showed significantly slow and insufficient perfusion, as determined by EB staining (p < 0.001). Histological observations revealed that ischemia during post-decompression of early PI was caused by a greater amount of thrombi. The CRTT results showed that although both groups exhibited varying degrees of insufficient refilling volume, the early PI group had significantly slower refilling than the BE group (p < 0.001), which persisted during the deterioration or disappearance of erythema. Conclusions: Our results showed that persistent ischemia caused by thrombi is an important cause of early PI deterioration post-decompression. Therefore, the performance of CRTT coupled with the transparent disc method may become a promising method for detecting ischemia post-decompression.

Effect of Heat Shock Preconditioning on Pressure Injury Prevention via Hsp27 Upregulation in Rat Models.
Huiwen Xu; En Takashi; Jingyan Liang; Yajie Chen; Yuan Yuan; Jianglin Fan
International journal of molecular sciences, 11 Aug. 2022
Pressure injury (PI) prevention is a huge industry and involves various interventions. Temperature and moisture are important factors for wound healing; however, the active mechanism by which “moist heat” affects PI prevention has not yet been clarified. Thus, we explored the protective and therapeutic effects of hydrotherapy on PI based on the preconditioning (PC) principle, which might be useful for clinical practice. This study aimed to investigate the preventive mechanisms of heat shock preconditioning on PIs in rat models. The experiment was performed in the basic medical laboratory of Nagano College of Nursing in Japan. Ten rats were divided into two groups, with five rats in each group. Rats in the control group were not bathed. Rats in the preconditioning group (PC group) were bathed with hot tap-water. Bathing was conducted thrice a week. After bathing for 4 weeks, the PI model was constructed on the rats’ dorsal skin. The skin temperature, skin moisture, and area of ulcers were compared between the two groups. In vitro, we investigated the expression of heat shock protein 27 (Hsp27) in 6, 12, and 24 h after the PI model was constructed through Western blot analysis. Ulcers occurred in the control group 24 h after the PI model constructed, wheras the PC group exhibited ulcers after 36 h. The ulcer area was larger in the control group than that in the PC group after 24 h (all p < 0.05). The temperatures of PI wounds in the control group decreased and were lower than those in the PC group after 1, 6, 12, 36, and 48 h (all p < 0.05). However, the skin moisture levels of PI wounds increased in the control group and were higher than those in the PC group at the same time (all p < 0.05). Using Western blot analysis, hydrotherapy preconditioning showed the potential to increase Hsp27 expression after pressure was released (p < 0.05). We determine that heat shock preconditioning had a preventive effect on PIs in rat models, a result that may be associated with their actions in the upregulation of Hsp27.

通気デバイスを用いて湿度調整した空気の送風が圧迫性皮膚傷害に及ぼす影響
01 Aug. 2022, [Reviewed]

Establishing an Appropriate Pressure for the Transparent Disc Method to Distinguish Early Pressure Injury and Blanchable Erythema.
Lu Chen; Yuan Yuan; En Takashi; Akio Kamijo; Jingyan Liang; Jianglin Fan
Diagnostics (Basel, Switzerland), 25 Apr. 2022, [Reviewed]
BACKGROUND: Non-blanchable erythema is used as a diagnostic indicator for stage 1 pressure injury (early PI); it is distinguished from blanchable erythema (BE) by the application of "light pressing". Considering the low of the accuracy of the degree of pressure applied, it is difficult to use this method in clinical settings. METHODS: We constructed models of BE and early PI in order to determine the most appropriate pressure values using the transparent disc method. We observed erythema by using a Dermo-camera to quantify the gray and a* values of the wound area along with a spectrophotometer. RESULTS: BE started to fade at 50 mmHg, while the gray values became statistically significant when the pressure was increased to 100 mmHg (p < 0.05). However, erythema remained even when the pressure was increased to 150 mmHg soon after decompression. By contrast, the early PI was showed to be non-blanchable for the longest time under a pressure of 150 mmHg, but by 18 h it had decreased and the erythema faded more obviously after applying pressure. CONCLUSIONS: We proposed that a pressure of 50-100 mmHg was more appropriate for light pressure, but this may vary when different instruments are used. Variations may occur in either BE or early PI, therefore, careful attention should be paid during observations.

酸素局所供給による皮膚圧迫性傷害の発症予防効果
Feb. 2022, [Reviewed]

Preventive effect of topical oxygen supply on skin pressure injury
Kamijo Akio; Takizawa Shiori; Takashi En; Lu Jian; Zhang Lan; Miura Daiji; Kitayama Akio; Morikami Sachie
Journal of wellness and health care = Journal of wellness and health care, 01 Feb. 2022, [Reviewed]
褥瘡とは，「寝たきりなどによって体重で圧迫されている場所の血流が悪くなったり滞ることで，皮膚の一部が赤い色味をおびたり，ただれたり，傷ができてしまうこと」とされ，長時間の圧迫等により皮膚の細胞に十分な酸素や栄養が行き渡らなくなることにより発症する。一方で，皮膚の細胞は必要な酸素の一部を外気から吸収しているため，圧迫部に対して外部から酸素を供給することで褥瘡発生に予防的な効果を得られることが考えられる。本研究ではヘアレスラットを用いて圧迫部皮膚に局所的に外部から空気または酸素濃度１００ % 濃度の気体（純酸素）を供給することで皮膚細胞の酸素不足を軽減し，褥瘡予防に対する効果を検討した。 本研究においては空気，純酸素を供給した群では無通気群よりも圧迫部における発赤面積，潰瘍発生率が低く，圧迫部に対する通気は褥瘡予防に効果的であることが示唆された。特に純酸素を供給した群において潰瘍は発生せず，発赤消失までの時間も短時間であった。 過剰な量の酸素投与は細胞に対する毒性が報告されている。しかしながら本研究においては純酸素投与が褥瘡予防に最も効果的な結果を示した。手術等で姿勢が固定されている際にも圧迫部に対し通気を行うことで褥瘡予防へ繋がる可能性が考えられる。今後より効果的な酸素濃度や臨床への応用についてもさらなる検討を重ねていきたい。
Pressure injuries consist of redness, ulceration and wounds caused by the obstructionof blood flow due to sustained mechanical load and the deformation of soft tissue. Onemechanism of pressure injuries is a lack of oxygen and nutrition supply due to theblocking of peripheral blood flows. Skin cells can absorb oxygen from the air; therefore,it is considered that a preventive effect on the development of pressure injuries can beobtained by supplying oxygen topically to the compressed area. In this study, we discusspressure injury prevention via the supply of oxygen (room air or 100% oxygen) to thecompressed skin of a hairless rat for the purpose of preventing a lack of oxygen in theskin cells. As a result, the area of redness and incidence rate of pressure ulcers in the compressedareas were smaller in the room air group and 100% oxygen group, when compared to acontrol group. In particular, in the 100% oxygen group, there was no ulcer incidence andthe period of sustained skin redness was shorter. Although it is reported that excessive oxygen supply produces a toxic effect on humancells, the pure oxygen group showed the most effective results in the present study. Ifposture is to be fixed for a long time, e.g. for an operation, topical oxygen supply to thecompressed skin area may be effective. We hope to discuss the most effective oxygenconcentration and clinical application in a future study.

Psychological Impact and Compliance with Staying at Home of the Public to COVID-19 Outbreak during Chinese Spring Festival.
Huiwen Xu; Lin Liu; Luming Zhao; En Takashi; Akio Kitayama; Yan Zou
International journal of environmental research and public health, 14 Jan. 2022
In December 2019, COVID-19 was reported in Wuhan, China. Most of the studies related to the psychological impact and compliance with staying at home due to COVID-19 focused on ten days or one month after the initial "stay-at-home" phase of the COVID-19 pandemic. The early psychological impact and behavior change to COVID-19 during the Chinese Spring Festival (the start time for recommendations to stay at home) is uncertain. In this study, people from 23 provinces in China were recruited to participate in an online survey, using Credamo. Psychological impact and compliance with staying at home were evaluated by a self-designed and validated questionnaire. The results indicated that anxiety was the most often reported feeling (mean: 3.69), followed by sadness (mean: 3.63). Participants employed in foreign-owned companies were most likely to express anxiety and sadness. Overall, 61.8% of participants reported hardly going out, whereas 2.4% said they frequently went out during the initial "stay-at-home" phase of the COVID-19 pandemic. Participants with higher levels of anxiety and sadness were most likely to stay at home against the spread of COVID-19, as were female gender. This survey is an important study of the first reaction to staying at home during the initial "stay-at-home" phase coinciding with Chinese Spring Festival. Our findings identified factors associated with higher level of psychological impact and better compliance with staying at home recommendations during Chinese Spring Festival. The findings can be used to formulate precaution interventions to improve the mental health of vulnerable groups and high uptake of policy during the COVID-19 epidemic.

Reliability and validity of the Chinese version of Oldenburg Burnout Inventory for Chinese nurses.
Huiwen Xu; Yuan Yuan; Weijuan Gong; Jingyi Zhang; Xinyi Liu; Pingting Zhu; En Takashi; Akio Kitayama; Xiaojuan Wan; Jianhui Jiao
Nursing open, Jan. 2022
AIM: This study aims to develop a reliable and validate Chinese version of Oldenburg Burnout Inventory (OLBI). DESIGN: A cross-sectional validation design was adopted in this study. METHODS: After obtaining the copyright by contacting with the author, the original English OLBI was developed to Chinese by forward translation, back-translation, cultural adaptation and a pre-test (20 nurses). The Chinese OLBI and Maslach Burnout Inventory (MBI) were administered to 641 clinical nurses during July and August, 2020. Internal consistency (Cronbach's α coefficient), split reliability (split half coefficient), construct validity (confirmatory factor analysis) and criterion validity (comparison with MBI, using Pearson correlation analysis) were assessed. RESULTS: The Chinese OLBI included 16 items. Exploratory factor analysis extracted two factors with a cumulative contribution of 62.245%. Two-dimensional structure (exhaustion and disengagement) was confirmed. It has good internal consistency (Cronbach's α coefficient values of 0.905, 0.933 and 0.876 for the total questionnaire, exhaustion dimension and disengagement dimension, respectively), split half reliability (split half coefficient = 0.883, p < .01) and criterion validity (r = 0.873, p < .01). Pearson coefficients between 16 items and the scale varied from 0.479-0.765. An acceptable model fit (χ2 /df = 2.49, RMSEA = 0.068, TLI = 0.906, CFI = 0.922, SRMR = 0.061) was achieved.

Demand analysis of telenursing among empty-nest elderly individuals with chronic diseases based on the Kano model.
Yuan Yuan; Chunhua Tao; Ping Yu; Yanwei Wang; Akio Kitayama; En Takashi; Kiyoko Yanagihara; Jingyan Liang
Frontiers in public health, 2022
AIM: The increase in empty-nest elderly individuals with chronic diseases poses a major challenge to the provision of public health services in China. Telenursing can effectively relieve the pressure of public health services to a certain extent. This study aims to explore the telenursing needs of empty-nest elderly individuals with chronic diseases based on the Kano model to provide references for improving the quality of telenursing. METHODS: Participants were selected from five rural communities and five urban communities in Yangzhou and Nantong, Jiangsu Province, China. A total of 348 empty-nest elderly individuals with chronic diseases were included. The participants received a sociodemographic characteristics questionnaire, and their telenursing needs were surveyed and analyzed based on the Kano model. RESULTS: Of the 15 quality attributes evaluated by the participants, 3 telenursing services were categorized as "must-be quality", 5 were categorized as "one-dimensional quality", 5 were categorized as "attractive quality", and 2 were categorized as "indifferent quality". The proportion of individuals who desired telenursing services ranged from 47.41 to 83.62%, the better values (satisfaction) ranged from 35.29-83.98%, and the worse values (dissatisfaction) ranged from 10.91 to 63.27%. There were no significant differences in any items of telenursing needs for between participants in Yangzhou and Nantong (all P > 0.05), and there were also no significant differences in all items between rural and urban communities (all P > 0.05). CONCLUSION: Based on the Kano model, it was found that empty-nest elderly individuals with chronic diseases had a positive attitude toward telenursing and that they had different levels of need for different telenursing services. These findings provided a theoretical basis for medical decision-makers to formulate medical policies and provided a scientific foundation for nursing managers to improve telenursing services to meet the needs of the empty-nest elderly individuals with chronic diseases.

The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases.
Yuan Yuan; Hui-Wen Xu; Song Zhang; Ying Wang; Akio Kitayama; En Takashi; Wei-Juan Gong; Jing-Yan Liang
Nursing open, Nov. 2021
AIM: To explore whether self-efficacy has any positive or negative mediating effects between family functioning and quality of life among elders with chronic diseases. DESIGN: A cross-sectional study. METHODS: Questionnaires were collected from 516 community-dwelling elderly individuals with chronic diseases using a convenience sampling method. The questionnaires included the Self-efficacy for Managing Chronic Disease Six-Item Scale, the Family Adaptation Partnership Growth Affection Resolve Index and the MOS 36-Item Short Form Health Survey. RESULTS: Family functioning and self-efficacy impacted the quality of life of community-dwelling elderly individuals with chronic diseases. Family functioning was mediated by self-efficacy and had an indirect impact on quality of life. The mediating effect accounted for 62.50% of the total effect.

酸素の局所投与による皮膚圧迫性傷害に対する発症予防効果
Aug. 2021

動物皮膚圧迫創における早期褥瘡の悪化予測法の検討
Aug. 2021

Impacts of different degrees of pressure on erythema and progression of early pressure injury in rat models
Jul. 2021, [Reviewed]

Predicting the different progressions of early pressure injury by ultraviolet photography in rat models.
Huiwen Xu; Yanwei Wang; En Takashi; Akio Kamijo; Daiji Miura; Kunie Karasawa; Akio Kitayama; Jian Lu; Lan Zhang
International wound journal, May 2021, [Reviewed]
Early pressure injury (PI) can result in either spontaneous healing (SH) or deterioration into ulcer (DU). However, determining whether PI will progress into SH or DU on the basis of non-blanchable erythema only is difficult. In this study, we constructed two animal PI models to mimic SH and DU injuries and observed haemorrhage by using ultraviolet (UV) photography to develop potential clinical indicators for predicting the progression of early PI. Macroscopy, UV photography, and skin temperature observations were obtained. In the SH group, macroscopic observation showed the erythema was obvious at 0.5 hours after decompression and faded gradually had almost disappeared at 72 hours. In the DU group, the erythema persisted, and an erosion appeared at 24 hours after decompression and expanded at 36 hours. The erythema developed into an obvious ulcer at 48 hours and enlarged at 72 hours. The obvious ulcer found at 48 hours through macroscopic observation was clearly visible at 36 hours with UV photography, and a significant difference in grey values between the two groups was found at as early as 18 hours (P < .05). This study provided evidence showing that UV photography can predict the different progression stages of early PI. Additionally, when combined with the transparent disc method, UV photography also can be used to identify the circulatory disorders of early PI, such as haemorrhage or hyperaemia and even congestion.

Demand Analysis of Telenursing for Community-Dwelling Empty-Nest Elderly Based on the Kano Model.
Yuan Yuan; Yulu Liu; Lei Gong; Hongmei Chen; Song Zhang; Akio Kitayama; En Takashi; Jingyan Liang
Telemedicine journal and e-health : the official journal of the American Telemedicine Association, Apr. 2021
Background: In recent years, the increasing number of empty-nest elderly has become a significant global social problem, and the rapid development of medical technology and information technology has improved the feasibility of telenursing. However, few studies have been conducted on needs of telenursing among the empty-nest elderly. The aim of this study is to explore the needs of telenursing for community-dwelling empty-nest elderly who are completely independent in activities of daily living (ADL), or who are mildly disabled, and to provide a reference for improving the remote care quality. Methods: A questionnaire survey aiming to explore telenursing needs of the elderly was conducted among 268 community-dwelling empty-nest elderly who were selected using random sampling and then data were analyzed based on the Kano Model. Results: Chi-square goodness-of-fit test showed that there were significant differences between actual and expected counts for each item of telenursing needs (p < 0.01 for all), indicating that the sample had specific individual preference for the Kano category. The desired degree of telenursing service ranged from 48.37% to 80.86%, the better values (satisfaction) were between 57.09% and 67.56%, and the worse values (dissatisfaction) were between 11.92% and 37.93%. The items, remote one-button emergency caller and remote emergency assistance arrangement, were considered to be one-dimensional qualities by empty nesters and the rest were attractive qualities. In the quadrant analysis diagram, all the remote care services were categorized as attractive qualities. Discussion: The community-dwelling empty-nest elderly with ADL independence or mild impairment have positive attitudes toward telenursing services, especially the needs of remote first aid nursing. Medical policy makers and nursing managers can provide targeted telenursing services according to empty nesters' requirements, thus improving nursing care quality and satisfaction of the elderly.

物理的諸性状の比較による褥瘡の早期発見法の探索
Aug. 2020

褥瘡モデルラットにおける凍り豆腐経口摂取の褥瘡治癒促進効果
Sep. 2019, [Reviewed]

分光測定法による圧迫性皮膚傷害の解析と褥瘡の早期診断に対する意義
Jul. 2019

Investigation of the effects of warm baths on Pressure Skin Injuries
Bulletin, Nagano College of Nursing, 31 Mar. 2019, [Reviewed]
温泉には様々な医学的作用があり，古くから皮膚に対して温泉（温浴）が良いと言われている．こ のことから，温浴が褥瘡に対して効果があると考えられる．本研究では，温浴が褥瘡の発症予防や重症化抑制に 効果が認められるのかを検討することとした． 磁石でラットの皮膚に圧迫を行い，圧迫性皮膚障害を作成した．対照群，温水群，温泉群の3群に分け，各種 測定を行った．圧迫解除後36時間から12日目まで，いずれの時点でも温水群と温泉群は対照群よりも有意に創 スコアが低かった．圧迫性皮膚障害の最大発生率は，対照群では70.0％であったのに対し，温水群では12.5％， 温泉群では7.1％と著明に低下した．最大潰瘍面積は，対照群では14.9mm2であったのに対し，温水群では 6.5mm2，温泉群では4.1mm2と低下した．温浴した群において明らかな潰瘍の発症予防と重症化抑制の効果が得 られた．また，温泉浴では温水浴を行うよりもその効果がより増加する可能性が示唆された． 以上より，温浴を行うことにより，圧迫性皮膚障害の発症予防や重症化抑制に対して効果があることが示され た．
identifier:40021986624

褥瘡早期診断に用いるガラス板圧診法の適正圧力の検証
Sep. 2018

iPhone/スマートフォンのカメラを活用した褥瘡早期診断装置の開発
Aug. 2017

紫外線を用いた褥瘡の早期診断法の開発 発赤所見の先は予測可能か
Aug. 2016

Carbonate ion-enriched hot spring water promotes skin wound healing in nude rats.
Jingyan Liang; Dedong Kang; Yingge Wang; Ying Yu; Jianglin Fan; En Takashi
PloS one, 2015
Hot spring or hot spa bathing (Onsen) is a traditional therapy for the treatment of certain ailments. There is a common belief that hot spring bathing has therapeutic effects for wound healing, yet the underlying molecular mechanisms remain unclear. To examine this hypothesis, we investigated the effects of Nagano hot spring water (rich in carbonate ion, 42°C) on the healing process of the skin using a nude rat skin wound model. We found that hot spring bathing led to an enhanced healing speed compared to both the unbathed and hot-water (42°C) control groups. Histologically, the hot spring water group showed increased vessel density and reduced inflammatory cells in the granulation tissue of the wound area. Real-time RT-PCR analysis along with zymography revealed that the wound area of the hot spring water group exhibited a higher expression of matrix metalloproteinases-2 and -9 compared to the two other control groups. Furthermore, we found that the enhanced wound healing process induced by the carbonate ion-enriched hot spring water was mediated by thermal insulation and moisture maintenance. Our results provide the evidence that carbonate ion-enriched hot spring water is beneficial for the treatment of skin wounds.

Interleukin-8, cyclo-oxygenase-2, and trefoil factor family 1 gene expression and their association with Helicobacter pylori infection in the remnant stomach.
Chengzhong Xing; Shunji Kato; Norio Matsukura; Noriko Matsuda; Huimian Xu; En Takashi; Nobutaka Yamada; Zenya Naito; Takashi Tajiri
Surgery today, 2005, [Reviewed]
PURPOSE: The risk factors for secondary stomach carcinogenesis after distal gastrectomy have not been evaluated in detail. METHODS: Using gastrointestinal endoscopy, we examined 112 patients who had undergone gastrectomy. Biopsy specimens were taken from the stoma and the upper corpus mucosa in the remnant stomach to examine the associations among Helicobacter pylori (H.pylori) infection, bile reflux, and the expressions of interleukin-8 (IL-8), cyclo-oxygenase-2 (COX-2), and trefoil factor family 1 (TFF1) genes in the stomach mucosa. RESULTS: The IL-8 levels in the corpus mucosa were significantly higher in the H.pylori-positive patients than in the H.pylori-negative patients (P = 0.015). The IL-8 levels were significantly higher in the stomal mucosa than in the corpus mucosa in the H.pylori-positive patients (P = 0.047). The COX-2 levels in the corpus mucosa tended to be higher in the H.pylori-positive patients, but these levels were not significantly different in the stoma mucosa. The COX-2 levels in the corpus were significantly higher after Billroth II (BII) anastomosis than after Billroth I (BI) anastomosis (P = 0.041). TFF1 expression in the stoma was higher in the H.pylori-positive patients than in the H.pylori-negative patients, but the difference was not significant. CONCLUSIONS: Both H.pylori infection and bile reflux increased IL-8 levels after BI anastomosis. Furthermore, COX-2 levels were higher after BII than after BI anastomosis. These indicators will become useful not only as biomarkers to predict the degree of inflammation in the stomach mucosa, but also as surrogate biomarkers to predict the risk of secondary stomach carcinogenesis in the remnant stomach mucosa.

Contradictory effects of short- and long-term hyperglycemias on ischemic injury of myocardium via intracellular signaling pathway.
Guang Xu; En Takashi; Mitsuhiro Kudo; Toshiyuki Ishiwata; Zenya Naito
Experimental and molecular pathology, Feb. 2004, [Reviewed]
Although clinical diabetes mellitus is obviously a high risk factor for myocardial infarction, there is disagreement about the sensitivity of ischemic injury of an infarcted myocardium in experimental studies. The present study evaluated the influences of different durations of hyperglycemia on ischemic and reperfusion injuries of the myocardium, and focused on extracellular signal-regulated kinase 1/2 (ERK1/2), which plays an important role in the intracellular signaling pathway and is reported to be associated with myocardial protection against heart injury. Short- and long-term hyperglycemias were induced in rats by streptozotocin (STZ) injection and the rats were examined 4 (4WDM) and 20 weeks (20WDM) after the treatment. Ischemia and reperfusion were induced by occlusion and reperfusion (I/R) of the left coronary artery (LCA). I/R-induced infarct size was determined using triphenyltetrazolium chloride (TTC) staining. After 20 weeks of STZ treatment (20WDM+I/R), the infarct size in the rat heart increased by 65.2 +/- 4.3%, whereas after 4 weeks of STZ treatment (4WDM+I/R), the infarct size decreased compared with the time-matched I/R group (43.1 +/- 3.6% and 59.5 +/- 5.6%, respectively). The number of dead myocytes including necrotic and apoptotic cells was determined using horseradish peroxidase (HRP) and terminal deoxynucleotide nick-end labeling (TUNEL) methods. The number of dead myocytes decreased in the 4WDM+I/R group, while the number of dead myocytes increased markedly in the 20WDM+I/R group, compared with the time-matched I/R group. The increment of ERK1/2 phosphorylation in the 4WDM group and the slight enhancement of this phosphorylation by I/R treatment were observed by western blotting. However, in the 20WDM group, the level of ERK1/2 phosphorylation reduced by approximately 1/3 compared with the time-matched control group; moreover, I/R treatment did not enhance the phosphorylation level. This study demonstrated that short- and long-term hyperglycemias exert opposite influences on ischemic myocardial injury, and these contradictory influences may depend on an ERK1/2-mediated intracellular signaling pathway.

Different influences of hyperglycemic duration on phosphorylated extracellular signal-regulated kinase 1/2 in rat heart.
Zenya Naito; En Takashi; Guang Xu; Toshiyuki Ishiwata; Kiyoshi Teduka; Munehiro Yokoyama; Nokutaka Yamada; Yuichi Sugisaki; Goro Asano
Experimental and molecular pathology, Feb. 2003, [Reviewed]
Extracellular signal-regulated kinase (ERK) 1/2 is an important intracellular proteinase associated with myocardial protection against heart injury. Hyperglycemia was also reported to be highly involved in heart injury by the formation of advanced glycation end products (AGEs) in myocardial protein, resulting in its altered structure and function. However, the effect of this glycation on mitogen-activated protein kinases, particularly ERK1/2, in the myocardium is largely unclarified. In this study, we investigated whether the glycation of an intracellular protein, ERK1/2, would result in ERK1/2-AGEs formation that adversely affects ERK1/2 activation in the rat heart under hyperglycemia. Hyperglycemia was induced by injection of streptozotocin (STZ) and hearts were examined 4 and 20 weeks after STZ treatment. By immunohistochemical staining and Western blotting, it was determined that the level of phosphorylated ERK1/2 in the rat heart under hyperglycemia 20 weeks after STZ treatment decreased markedly by about 50% of that of the time-matched control group, whereas in the case of 4 weeks after STZ treatment, it increased by about 2.7-fold that of the time-matched group. The level of deposition of AGEs in proteins of the myocardium increased significantly depending on the duration of hyperglycemia. Twenty weeks after STZ treatment, two clear bands corresponding to 44- and 42-kDa AGEs were detected by Western blotting: these corresponded to protein sizes of ERK1/2. The immunoprecipitation method further confirmed the formation and the increased intensity of ERK1/2-AGEs in the rat heart under hyperglycemia for 20 weeks. These results demonstrate that long-term hyperglycemia may inhibit ERK1/2 phosphorylation in the myocardium, whereas a short-term (4 weeks) hyperglycemia enhances its phosphorylation. The ERK1/2 phosphorylation under long-term hyperglycemia is very different from that under short-term hyperglycemia. In addition, this inhibition of ERK1/2 activation appears to be dependent on the formation of ERK1/2-AGEs under long-term hyperglycemia, which may be related in part to the etiology of diabetic cardiomyopathy. It also suggests that the formation of AGEs in intracellular enzymes and proteins under hyperglycemia could play important roles in the development of diabetes complications.

Pathologic Assessment of Myocardial Cell Necrosis and Apoptosis after Ischemia and Reperfusion with Molecular and Morphological Markers
En Takashi; Muhammad Ashraf
Journal of Molecular and Cellular Cardiology, Feb. 2000, [Reviewed]

Activation of mitochondrial KATP channel elicits late preconditioning against myocardial infarction via protein kinase C signaling pathway
E Takashi; YG Wang; M Ashraf
Circulation Research, Dec. 1999, [Reviewed]

Ultrastructural study of the mechanism of perineural extension in pancreatic cancer
Chengxue Dang; En Takashi; Fang Guo; Zenya Naito; Munehiro Yokoyama; Goro Asano; Zongzheng Ji; Zhaoyin Qin
Medical Molecular Morphology, 1998, [Reviewed]

Effect of vitamin E on vascular integrity in cholesterol-fed guinea pigs.
Y Qiao (E Takash)i; M Yokoyama; K Kameyama; G Asano
Arteriosclerosis and Thrombosis: A Journal of Vascular Biology, Dec. 1993, [Reviewed]
This study was designed to clarify the effects of vitamin E on the alterations in proteoglycan distribution and vascular permeability, which were examined by immunohistochemical and ultrastructural techniques in the aortas of cholesterol-fed guinea pigs. The animals were divided into three groups: a control group, a cholesterol group, and a vitamin E group. Serum levels of cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, and thiobarbituric acid-reactive substances were measured. An increase in thiobarbituric acid-reactive substances was observed in the cholesterol group compared with control and vitamin E groups. Intimal atheromatous lesions of the aorta were significantly decreased in the vitamin E group compared with the cholesterol group. Histochemically, an increased distribution of proteoglycans such as chondroitin, dermatan, and heparan sulfates and ruthenium red reaction products in the intima; decreased glycocalyx on the endothelial surface; and increased permeability to horseradish peroxidase were revealed in the cholesterol group compared with the vitamin E group. Hypercholesterolemia, resulting in superoxide production, may have contributed to the endothelial damage and increased permeability to plasma proteins and lipids in the vascular wall of the cholesterol group. However, vitamin E administration inhibited lipid deposition and development of this abnormal permeability associated with an irregular distribution of proteoglycan. These results suggest that vitamin E preserves the morphological and functional integrity of the vascular wall and may contribute to the inhibition of atherogenesis in cholesterol-fed guinea pigs.

早期褥瘡における病理機序の再考と最新の知見に基づく診断デバイスの開発
2024

実験的早期褥瘡における複雑な循環障害の総合解析およびその診断意義
2023

早期圧迫性皮膚傷害に対するブルーライト診断装置の開発と検証
Jul. 2019

水素水浴によるドライスキンの紫外線(UV-B)傷害の軽減効果　　　　　　　　　　　　　　　
Oct. 2017

分子病理学的手法を用いた天然温泉の皮膚治癒遅延創治癒促進作用の機序解明
Feb. 2016

スマートフォンを光学顕微鏡へ接続させるアダプターの開発と組織病理学実習への活用　　　　　　　　　　　　　　　
Sep. 2015

蓼科三室源泉のドライスキンに対する保湿効果
Nov. 2014

天然温泉の泉質の違いが皮膚治癒遅延創に及ぼす影響の比較　　　　　　　　　　　　　　　
Dec. 2012

天然温泉浴による難治性皮膚創の治癒促進に関するMMPsの動態変化
Nov. 2012

血液を用いる解剖生理学実習の新たな試み 血球形態及び浸透圧による影響の同時観察　　　　　　　　　　　　　　　
Aug. 2012

異なる部位の皮膚創におけるMMPsの変化と炭酸水素塩泉浴による影響　　　　　　　　　　　　　　　
Mar. 2012

異なる部位の皮膚創におけるMMPsの変化と炭酸水素塩泉浴による影響　　　　　　　　　　　　　　　
Dec. 2011

天然温泉浴による難治性皮膚創傷のMMPs遺伝子発現の動態変化
Nov. 2011

病理学実習におけるデジタルカメラ-プリンターの活用　　　　　　　　　　　　　　　
Aug. 2011

簡易で安価な接続器具の開発と光学顕微鏡のリアルな観察システム確立への応用　　　　　　　　　　　　　　　
Aug. 2011

病理学演習におけるコンパクトデジタルカメラの活用について
Mar. 2011

皮膚の治癒遅延創におけるMMPs遺伝子の発現動態 1次治癒創との比較について　　　　　　　　　　　　　　　
Dec. 2010

組織病理学実習におけるポータブルデジタルカメラの併用による示教効果の改善について　　　　　　　　　　　　　　　
Aug. 2010

異なる湯温における天然温泉浴の難治性皮膚創に対する影響について　　　　　　　　　　　　　　　
Dec. 2009

人工温泉の難治性皮膚創に対する治癒促進作用 天然温泉との比較について　　　　　　　　　　　　　　　
Dec. 2009

難治性皮膚創に対する炭酸水素塩泉浴の治癒促進作用
Nov. 2009

ヘアレスラットの皮膚自然治癒遅延創 簡便な難治性皮膚潰瘍動物モデルの確立とその発生機序
Aug. 2009

炭酸水素塩泉浴によるラット難治性皮膚創傷の治癒促進について
Aug. 2009

炭酸温泉浴による皮膚創傷治癒の促進効果　　　　　　　　　　　　　　　
Dec. 2008

足場の形成障害による皮膚創傷治癒遅延モデルの確立とその治癒過程の経時的観察
Aug. 2008

Keratinocyte Growth Factor Receptor(KGFR)とKGFの胃癌における役割の検討　　　　　　　　　　　　　　　
Apr. 2006

大腸癌組織におけるnestinによる新生血管の評価と予後の検討　　　　　　　　　　　　　　　
Apr. 2006

新生児に発症したLangerhans cell histiocytosis(LCH)の一剖検例　　　　　　　　　　　　　　　
Apr. 2006

ヒト膵癌におけるKGF/KGFR,VEGFの発現と肝転移に関する検討　　　　　　　　　　　　　　　
Apr. 2006

高血糖によるERK1/2活性化の変化と虚血心筋細胞のapoptosis
Aug. 2004

高血糖状態による虚血再灌流傷害と心筋細胞のアポトーシス 細胞内伝達情報経路の関与
Dec. 2003

Pathogenesis and Protection of Ischemia and Reperfusion Injury in Myocardium
Goro Asano; En Takashi; Toshiyuki Ishiwata; Munehiko Onda; Munehiro Yokoyama; Zenya Naito; Muhammad Ashraf; Yuhichi Sugisaki
Journal of Nippon Medical School, Oct. 2003

加齢心筋におけるリン酸化ERK1/2の減少とAGEsの形成　　　　　　　　　　　　　　　
May 2002

高血糖ラットの虚血再灌流傷害モデルにおける心筋のERK 1/2の活性化と細胞内グリケーション
Feb. 2002

長期間高血糖ラットにおける心筋細胞ERK1/2の活性低下とグリケーションによる細胞内ERK1/2-AGEの形成
Dec. 2001

高血糖状態におけるグリケーションと心筋細胞内ERK1/2のリン酸化に及ぼす影響
Sep. 2001

高血糖状態の虚血再灌流傷害進展への影響,特に分子形態マーカーによる形態学的観察
Feb. 2001

虚血後心筋細胞傷害の形態学的評価とその予防法の開発
Dec. 2000

高血糖状態の虚血再灌流傷害進展への影響,特に分子形態マーカーによる形態学的観察　　　　　　　　　　　　　　　
Aug. 2000

心臓における虚血・再灌流障害の進展についての実験的研究　　　　　　　　　　　　　　　
Mar. 2000

新しい心筋虚血-再灌流動物モデルの開発 心筋梗塞病態解明の試み　　　　　　　　　　　　　　　
Dec. 1997

内耳蝸牛と迷路動脈の加齢変化 特に微細構造変化を中心に　　　　　　　　　　　　　　　
Aug. 1995

高脂肪食負荷動物における冠状動脈と心筋細胞の微細構造的変化　　　　　　　　　　　　　　　
Aug. 1994

エンドトキシンショック時の心不全の発生機序 特にフリーラジカルとCa++ ATPaseの関連性　　　　　　　　　　　　　　　
Aug. 1994

高脂食負荷大動脈病変に対するVitamin E投与の影響　　　　　　　　　　　　　　　
Apr. 1992

高脂血症モルモットに見られた内耳平衡斑およびその支配血管の微細構造変化
Nov. 1990

動脈硬化病変成立ちの上での関門としての内皮細胞の役割
Aug. 1990

動脈硬化症病変成立ちの上での関門としての内皮細胞の役割　　　　　　　　　　　　　　　
Dec. 1989

From NBE to NRR, the redefinition of stage 1 pressure injury based on the current experimental and clinical evidences
Takashi En
The 3rd International Nursing Sumit Form, 03 Nov. 2025, [Invited]

Development and Enhancement Track of an Early Pressure Ulcers Diagnosis Device
Lan Zhang; Jian Lu; En Takashi
16th Japan-China-Korea Joint Conference on MEMS/NEMS (JCK MEMS/NEMS, 07 Jul. 2025

Clinical verification of the multi-circulatory disorders theory and its significance for early detection of stage 1 pressure injury　　　　　　　　　　　　　　　
En Takashi; Ping Hou; Fangfang Zhu; Jiaxin You
NPIAP; 2025 Annual Conference, USA

早期褥瘡における多循環障害の総合的な解析と診断デバイスの開発
02 Nov. 2024

バイオ研究のすすめ
02 Nov. 2024, [Invited]

局所へのブドウ糖と酸素の供給による圧迫性皮膚傷害に対する予防効果
07 Sep. 2024

Evaluating Ischemia in Early Pressure Injury with Transparent Disc Method and CRTT in Rat Model　　　　　　　　　　　　　　　
En Takashi; Lu Chen; Akio Kamijo; Daiji Miura; Akio Kitayama; Jian Lu; Lan Zhang
NPIAP;2022 Annual Conference, 17 Mar. 2022

酸素の局所投与による 皮膚圧迫性傷害に対する 発症予防効果　　　　　　　　　　　　　　　
10 Sep. 2021

動物皮膚圧迫創における早期褥瘡の悪化予測法の検討　　　　　　　　　　　　　　　
10 Sep. 2021

Apr. 2017 - Present
看護理工学会　　　　　　　　　　　　　　　

Sep. 2016 - Present
NPIAP(USA)　　　　　　　　　　　　　　　

Jan. 2006 - Present
Japanese Society of Pressure Ulcers

Apr. 1995 - Present
Japan Mibyou Association

人工知能を活用した褥瘡早期自動診断機の製品開発と臨床検証
Apr. 2025 - Mar. 2029

要介護者に適した排尿パターンセンサ及び排尿トラブル診断システムの開発
01 Apr. 2024 - 31 Mar. 2027

最先端のAI認証とセンシング技術を活用した褥瘡早期診断システムの開発
01 Apr. 2021 - 31 Mar. 2025

最先端のAI認証とセンシング技術を活用した褥瘡早期診断システムの開発
Apr. 2021 - Mar. 2025

Development of an early detection method for pressure injury at home care by fusing new polymer material rubber sensor and and remote communication means
Grant-in-Aid for Scientific Research (C)
Nagano College of Nursing
Apr. 2018 - Mar. 2021
In this study, we used our developed animal early pressure injury model (magnet compression) to verify the appropriate pressure of the "transparent disc method" with precision measuring equipment. Then, using a new polymer rubber sensor (Provided from collaborator, Tokyo University of Science), we have established a method for photographing and observing early pressure injury under constant pressure in combination with a commercially available damo-camera (DZ-D100). In addition, the image information of early pressure injury taken by the dermo-camera can be sent to the server via a Wifi router, enabling remote diagnosis by specialists such as doctors or nurses. On the other hand, using the UV function of the dermo-camera, it was found that early pressure injury could be photographed to accurately evaluate the hemorrhage, and the severity could be determined, that cannot be seen clearly through macroscopy from the surface of skin.

Development of total care network system for people with dimentia by the most advanced ICT in a local city
Grant-in-Aid for Scientific Research (A)
Nagano College of Nursing
01 Apr. 2016 - 31 Mar. 2020
Our research outcomes are as follows:
1) Development of a monitoring system (monitoring by non-camera, non-contact type Doppler (24 GHz microwave) sensor) and Vital Data (body temperature, blood pressure, heart rate) collecting & monitoring system for elderly people with dementia at home 2) Development of a dementia prevention and early detection system (SalusTalk) based on conversation records closely related to daily life 3) Establishment of a total care network system for dementia on A dementia hub hospital. During the study period, a small-scale demonstration test was conducted for a limited number of subjects and for a limited period in A hospital, and the effectiveness of the monitoring system and the benefit of prevention and early detection for elderly people with dementia were suggested.

Development and evaluation of the community-based total care program for dementia in a super aging society
Grant-in-Aid for Scientific Research (B)
Nagano College of Nursing
01 Apr. 2012 - 31 Mar. 2017
In this study we implemented and evaluated the program to improve the quality of care for situations encompassing features from dementia prevention to end of life care. It was established that maintaining and improving physical functions, particularly the ability to walk is important.
The program was effective in sustaining the mental functioning of participants involved for 5 years or longer. The frequencies of consultation as requested by family caregivers were mostly for patients at moderate stages of dementia, suggesting the need to establish and create a consultation framework for patients who are at the early stages of dementia. The quality of care provided for patients at the facilities varied depending on the career and specialties of care managers employed, suggesting the necessity to involve nurses with long career. As the individual elderly patients have specific hopes and intentions for the terminal lives, it is important to provide care by respecting such intentions.

Development of telecare system for people in the disaster area in Satoyama (hilly and mountainous areas)
Grant-in-Aid for Scientific Research (A)
Nagano College of Nursing
01 Apr. 2012 - 31 Mar. 2016
The outcome in this study was as follows;1.To file for trademark registration of the telecare system "Salus" as "Salus Vision", 2.To grasp the needs for ICT utility among the aged, 3.To develop the PDA for watch over the homecare provided aged for 24 hours, 4.To develop the e-mail system for safety confirmation of the aged at the time of disaster, 5.To develop the PDA information system shared with medical malti-experts, 6.To develop the touch type display oriented to the aged, 7.To apply Salus to the Live Surgery, 8.To promote the business model of Salus, and so on.
In this study we succeeded in setting up the innovative network which supported the total life of the aged in Satoyama (hilly and mountainous areas). As some issues remain unsolved, further study should be carried out.