著者
Michihiro Satoh Takahisa Murakami Kei Asayama Takuo Hirose Masahiro Kikuya Ryusuke Inoue Megumi Tsubota-Utsugi Keiko Murakami Ayako Matsuda Azusa Hara Taku Obara Ryo Kawasaki Kyoko Nomura Hirohito Metoki Koichi Node Yutaka Imai Takayoshi Ohkubo
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1227, (Released:2018-06-09)
参考文献数
30

Background:N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point.Methods and Results:We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened.Conclusions:NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
著者
Masashi SHIMAHARA Yasunori ARIYOSHI Yutaka IMAI Harumi MIZUKI Jun SHIMADA Kiyofumi FURUSAWA Syosuke MORITA Yoshiya UEYAMA
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
Japanese Journal of Oral and Maxillofacial Surgery (ISSN:00215163)
巻号頁・発行日
vol.53, no.10, pp.594-602, 2007-10-20 (Released:2011-04-22)
参考文献数
20
被引用文献数
13 6

Bisphosphonates are used for the management of bone metastatic disease and hypercalcemia caused by malignancy, as well as the treatment of osteoporosis. Recently, a number of patients with bisphosphonate-associated osteomyelitis and osteonecrosis of the jaws have been reported in the English-language literature. This report describes patients with bisphosphonate-related osteomyelitis and osteonecrosis of the jaws in Japan. The subjects were enrolled using questionnaires sent to 239 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons in 2006. Thirty patients (4 men and 26 women) from 18 different institutions (mean age at diagnosis, 66.9 years) were studied. As for local features, pain with or without swelling was the most common symptom and sign. The mandible was affected in 22 patients, the maxilla in 6, and both jaws in 2. Twenty patients received intravenous bisphosphonates, 8 received only oral bisphosphonates, and 1 received both types of treatment. The reasons for bisphosphonate treatment were bone metastasis from breast carcinoma (13 patients), multiple myelomas (6 patients), osteoporosis (8 patients), and hypercalcemia related to malignancy. More than 50 % of the patients underwent oral surgery including tooth extraction just before or during treatment with bisphosphonates, while 5 patients received no dental treatment. In addition to antibiotic therapy, surgery, including sequestrectomy and curettage, was performed. As for outcome, 8 of the patients were completely cured, while 17 patients remained under treatment at the time of this writing.
著者
Shiro Oguma Itiro Ando Takuo Hirose Kazuhito Totsune Hiroshi Sekino Hiroshi Sato Yutaka Imai Masako Fujiwara
出版者
東北ジャーナル刊行会
雑誌
The Tohoku Journal of Experimental Medicine (ISSN:00408727)
巻号頁・発行日
vol.227, no.3, pp.217-223, 2012 (Released:2012-07-07)
参考文献数
27
被引用文献数
5 6

Patients with renal failure undergoing hemodialysis often have muscle cramps during and after the dialysis therapy. Muscle cramps are defined as the sudden onset of a prolonged involuntary muscle contraction accompanied with severe pain, resulting in early termination of a HD session and inadequate dialysis. The etiology of the cramps is unknown and effective anti-cramp medicine is not available. We have hypothesized that water-soluble vitamins are deficient in HD patients. Accordingly, we administrated biotin to 14 patients who had frequent muscle cramps during HD sessions. Oral administration of 1 mg/day biotin promptly reduced the onset and the severity of cramps in 12 patients both during and after HD. Then, the plasma biotin levels were measured by an enzyme-linked immunosorbent assay method (ELISA) in HD patients, including 14 patients with cramps and 13 patients without cramps, and 11 healthy volunteers. Plasma biotin levels were elevated in 27 HD patients at baseline compared with healthy volunteers [451 (377 - 649) vs. 224 (148 - 308) ng/l, median (lower-upper quartiles); p < 0.0001]. Unexpectedly, among the 14 cramp patients, the biotin levels were significantly higher in biotin-ineffective 7 patients than biotin-effective 7 patients [1,064 (710 - 1,187) vs. 445 (359 - 476) ng/l; p < 0.001]. Thus, the biotins measured by ELISA may consist of not only intact biotin but also its metabolites that do not function as a vitamin. In conclusion, biotin administration is one choice to relieve HD patients from muscle cramps regardless of their elevated plasma biotin levels.