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Positive relationships between annual changes in salt intake and plasma B-type natriuretic peptide levels in the general population without hypertension and heart diseases
Get PDFExcessive salt intake causes hypertension and heart diseases. B-type natriuretic peptide (BNP) is a surrogate marker of heart disease, and a slightly elevated BNP level is associated with a poor prognosis. Our previous cross-sectional study demonstrated that plasma BNP has a significant positive association with daily salt intake in the general population. However, the relationship between changes in salt intake and changes in plasma BNP remains unknown.
We recruited 3051 participants without hypertension or electrocardiogram abnormalities who underwent annual health check-ups for two consecutive years. Clinical parameters, including plasma BNP, were obtained, and daily salt intake was evaluated using urinary samples. Annual changes in these parameters were calculated.
The median plasma BNP level was 12.9pg/mL, and the daily salt intake was 8.73±1.89g. The annual changes in plasma BNP and daily salt intake were 4.79±36.38% and 2.01±21.80%, respectively. Participants in the highest quartile of annual changes in daily salt intake showed the largest annual changes in plasma BNP. Annual changes in plasma BNP indicated a significant positive association with daily salt intake. Moreover, multiple linear regression analyses revealed that annual changes in plasma BNP showed a significant positive association with daily salt intake after adjustments.
Our study showed a significant positive relationship between annual changes in plasma BNP and annual changes in daily salt intake. The suppression of plasma BNP is therefore induced by salt intake restriction. The monitoring of plasma BNP while reducing salt intake may therefore prevent heart diseases and lead to improved prognoses in the general population without heart diseases.journal articl
Detection of highly abundant small molecules in the stratum corneum of healthy young women using desorption electrospray ionization-mass spectrometry imaging
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Expression of FLRT2 in postnatal central nervous system development and after spinal cord injury
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Plasma globotriaosylsphingosine level as a primary screening target for Fabry disease in patients with left ventricular hypertrophy
Get PDF浜松医科大学博士（医学）doctoral医学系研究科Background: Although previous studies have suggested a certain prevalence of Fabry disease (FD) in left ventricular hypertrophy (LVH) patients, the screening of FD is difficult because of its wide-ranging clinical phenotypes. We aimed to clarify the utility of combined measurement of plasma globotriaosylsphingosine (lyso-Gb3) concentration and α-galactosidase A activity (α-GAL) as a primary screening of FD in unexplained LVH patients.
Methods and Results: Between 2014 and 2016, both lyso-Gb3 and α-GAL were measured in 277 consecutive patients (male 215, female 62, age 25?79 years) with left ventricular wall thickness >12 mm on echocardiogram: 5 patients (1.8%) screened positive (2 (0.7%) showed high lyso-Gb3 and 4 (1.4%) had low α-GAL levels). Finally, 2 patients (0.7%) were diagnosed with clinically significant FD. In 1 case, a female heterozygote with normal α-GAL levels had genetic variants of unknown significance and was diagnosed as FD by endomyocardial biopsy. The other case was a male chronic renal failure patient requiring hemodialysis, and he had a p.R112H mutation. In both cases there were high lyso-Gb3 levels.
Conclusions: The serum lyso-Gb3 level can be relevant for clinically significant FD, and combined measurement of lyso-Gb3 and α-GAL can provide better screening of FD in unexplained LVH patients.doctoral thesi
Investigation on toxicological usefulness of synovial fluids, as an alternative matrix; postmortem distribution/redistribution of triazolam and its predominant metabolite α-hydroxytriazolam in human body fluids
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A negative pressure-based visualization technique for abdominal Veress needle insertion
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Transient Neonatal Myasthenia Gravis Born to a Mother with Systemic Myasthenia Gravis Being Treated with Eculizumab in Pregnancy : A Case Report
Get PDF重症筋無力症 (myasthenia gravis : MG) の母体から出生した児の10-20％が新生児一過性筋無力症 (transient neonatal myasthenia gravis : TNMG) を発症する. TNMGは母体が有する神経筋接合部シナプスに対する自己抗体が経胎盤移行し, 児の神経筋接合部シナプスに作用することで発症し, 症状は移行抗体の減少とともに自然軽快する. 妊娠中の使用薬剤は制限されるが, ヒトモノクローナル抗体エクリズマブは妊娠中の使用が可能である. 今回妊娠中にエクリズマブを使用した母体から出生し, TNMGを発症した新生児例を経験した. 母体は妊娠分娩による症状増悪はなく, 児はTNMGを発症したが,症状は自然消退し早産や先天奇形等の薬剤による有害事象はなかった. 本症例は母体管理におけるエクリズマブ使用の安全性を支持する結果であり, 児においても有害事象は認めなかった. 妊娠中の使用によるTNMGへの影響については報告数も少なく, 今後さらなる症例蓄積が望まれる.journal articl
Development and validation of the optimal circumferential resection margin in pathological T3 esophageal cancer: A multicenter retrospective study
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This study reported that the circumferential resection margin of 600 μm, set between the Royal College of Pathologists criteria and the College of American Pathologists criteria, is optimal to predict locoregional recurrence for pathological T3 esophageal squamous cell carcinoma.Background: The clinical significance of circumferential resection margin (CRM) in esophageal squamous cell carcinoma (ESCC) remains unclear. Optimal CRM for predicting the recurrence of pathological T3 ESCC was investigated.
Methods: Seventy-three patients were retrospectively investigated in the development cohort. Patients were divided into CRM-negative and CRM-positive groups, and clinicopathological factors and survival outcomes were compared between the groups. The cut-off value was validated in another validation cohort (n=99).
Results: Receiver operating characteristic analysis in the development cohort showed the cut-off value of CRM was 600 μm. In the validation cohort, patients in the CRM-positive 10 group showed a significantly higher rate of locoregional recurrence (p=0.006) and worse recurrence-free survival (RFS) (p<0.001) than those in the CRM-negative group. Multivariate analysis identified positive CRM as an independent predictive factor for poor RFS (hazard ratio, 2.695; 95% confidence interval, 1.492–4.867; p=0.001). The predictive value of our criteria of positive CRM for RFS was higher than that of the Royal College of Pathologists (RCP) and the College of American Pathologists (CAP) criteria. Stratified analysis in the neoadjuvant chemotherapy groups also revealed that the rate of locoregional recurrence was higher in the CRM-positive group than in the CRM-negative group both in the pathological N0 and N1–3 subgroups.
Conclusions: CRM of 600 μm can be the optimal cut-off value rather than the RCP and CAP criteria for predicting locoregional recurrence after esophagectomy. These results may support the impact of perioperative locoregional control of locally advanced ESCC.journal articl
Disc degeneration could be recovered after chemonucleolysis with condoliase. −1 year clinical outcome of condoliase therapy−
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Condoliase-induced chemonucleolysis is a less-invasive alternative treatment for lumbar disc herniation (LDH); however, its long-term clinical outcome is still unclear. This study aimed to investigate 1-year clinical outcomes and assess radiographs after chemonucleolysis with condoliase.
Methods
We enrolled patients with LDH who received condoliase injection with a follow-up period of>1 year. Sixty patients (37 men, 23 women; mean age, 44.5 ± 18.9 years; mean follow-up period, 22.0 ± 6.0 months) were analyzed. Changes in disc height and degeneration were evaluated using magnetic resonance imaging. Visual analog scale (VAS) scores for leg and back pain and the Oswestry disability index (ODI) were obtained. All data were assessed at baseline, 1-month, 3-month, and 1-year follow-up.
Results
Surgical treatment was subsequently required in 8 patients (12.5%) after condoliase therapy. Their ODI and VAS scores for leg pain and back pain significantly improved at 1 year, as in those who received condoliase therapy only. On MRI, progression of Pfirrmann grade was observed in 23 patients (44.2%) at 3 months; however, 8 patients recovered to baseline at 1 year. The mean disc height decreased at 3 months; however, it recovered at 1 year. Disc height recovery (disc recovery rate>50%) was observed in 30.8% of the patients. Patients with disc height recovery were significantly younger than those without. Patients with longer symptom duration (≥1 year) showed significantly lower rates of effectiveness compared with those with shorter symptom durations (<1 year).
Conclusions
Chemonucleolysis with condoliase is a safe and minimally invasive treatment. Disc degeneration induced by chemonucleolysis could be recovered, particularly in younger patients. Prolonged symptom duration had adverse effects on outcome; thus, therapeutic intervention at the optimal time is needed.journal articl