Recurrent Cerebrovascular Complications under Enzyme Replacement Therapy in a Patient with Fabry Disease on Peritoneal Dialysis.

Fabry disease is an X-linked lysosomal storage disorder due to mutations in the alpha-galactosidase A gene, which leads to the accumulation of globotriaosylceramide in various organs. In Fabry disease with end-stage renal disease (ESRD), cerebrovascular events are lethal, even with enzyme replacement therapy (ERT). However, the utility of biomarkers to evaluate the ERT response is unclear.

Association between Occupation and Cervical Disc Degeneration in 1211 Asymptomatic Subjects.

Magnetic resonance imaging (MRI) system has frequently observed degenerative changes in the cervical discs of healthy subjects. Although there are concerns regarding the link between an individual's occupation and intervertebral disc degeneration (IDD) in the cervical spine, whether the occupation affects IDD is still not clear. This study aimed to evaluate the occupation and IDD interplay using cervical spine MRI among a cohort of healthy individuals, and to evaluate any association between the type of labor and IDD.

Cardiopulmonary exercise responses in patients with non-ischemic heart failure and a mildly reduced ejection fraction.

The cardiopulmonary response to exercise in patients with heart failure exhibiting a mildly reduced ejection fraction (41% ≤ EF ≤ 49%) remains unclear. A total of 193 consecutive patients with heart failure (excluding those with coronary artery disease) who underwent cardiopulmonary exercise (CPX) tests were examined. CPX variables were compared among patients with reduced, mildly reduced, and preserved EF.

Metabolic syndrome reduces spinal range of motion: The Yakumo study.

Background: Excess visceral fat can accumulate owing to lack of exercise. The relationship between metabolic syndrome (MetS) and spinal range of motion (ROM) is not clear. The purpose of this study was to investigate the relationship between MetS and spinal alignment and ROM.

Trends in the numbers of spine surgeries and spine surgeons over the past 15 years.

The purpose of this study is to examine trends in spine surgeries at ten facilities over 15 years, and to analyze relationships with the number of spine surgeons at these facilities. The subjects were patients who underwent spine surgery at the ten facilities from 2003 to 2017. Data were collected every year via a questionnaire designed to obtain clinicopathological and surgical information.

Cervical disc degeneration is associated with a reduction in mobility: A cross-sectional study of 1211 asymptomatic healthy subjects.

The aim of this study was to establish the age-related changes and gender-specific differences of cervical disc degeneration using magnetic resonance image (MRI) and to evaluate the correlation between the severity of cervical disc degeneration and mobility in asymptomatic subjects. A total of 1,211 relatively healthy volunteers (606 males and 605 females, mean age 49.5 years) without neurological symptoms underwent MRI.

Long-Term Outcomes in Elderly Patients After Deferral of Coronary Revascularization Guided by Fractional Flow Reserve.

Background: Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).

Methods and results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or <75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR).

Herpes zoster meningitis in a rheumatoid arthritis patient treated with tofacitinib.

A man in his 70s with rheumatoid arthritis presented with seizures and coma and was transferred to our emergency department. Two months prior to admission, he started to take tofacitinib 10 mg/day. On admission, we noted a rash with a blister on the forehead, and herpes zoster was diagnosed.

Thrombotic Risk and Cardiovascular Events in Patients With Revascularization Deferral After Fractional Flow Reserve Assessment.

Objectives: The aim of this study was to evaluate the impact of thrombotic risk on the occurrence of cardiovascular events in patients with coronary artery disease with deferred revascularization after fractional flow reserve (FFR) measurements.

Background: Deferral of revascularization on the basis of FFR is generally considered to be safe, but after deferral, some patients have cardiovascular events over time.

Methods: From J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), 1,263 patients with deferral of revascularization on the basis of FFR were evaluated.

Five-Year Outcomes After Fractional Flow Reserve-Based Deferral of Revascularization in Chronic Coronary Syndrome: Final Results From the J-CONFIRM Registry.

Background: Little large-scale data is available about the long-term (beyond 3 years) clinical outcomes after fractional flow reserve (FFR)-based deferral of revascularization in clinical practice. We sought to assess the 5-year outcomes after deferral of revascularization based on FFR.

Methods: The J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry) prospectively enrolled 1263 patients with 1447 lesions in whom revascularization was deferred based on FFR from 28 Japanese centers.

Association of guideline-directed medical therapy adherence with outcomes after fractional flow reserve-based deferral of revascularization.

Aims: Guideline-directed medical therapy (GDMT) is essential to prevent future cardiovascular events in chronic coronary syndrome (CCS) patients. However, whether achieving optimal GDMT could improve clinical outcomes in CCS patients with deferred lesions based on fraction flow reserve (FFR) remains thoroughly investigated. We sought to evaluate the association of GDMT adherence with long-term outcomes after FFR-based deferral of revascularization in a real-world registry.

Importance of ultrasound examination: A case of peritoneal catheter tunnel infection.

Some peritoneal dialysis catheter infections cannot be detected via a physical examination. Ultrasound of the PD catheter tunnel should be performed in cases of suspected infection or clinical abnormality at the catheter tunnel site.

Poor local control of ulcerative T1 glottic cancer treated with 2.25-Gy per fraction radiotherapy.

The Tokai Study Group for Therapeutic Radiology and Oncology (TOSTRO) started managing T1 glottic cancer using 2.25 Gy/fraction radiotherapy in 2011. The aim was to evaluate the local control (LC) rate and toxicity with 2.

Unexpected postmortem diagnoses in cases of clinically diagnosed amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a motor neuron disease that is clinically and pathologically characterized by impairment of the upper and lower motor neurons. The clinical diagnosis of ALS is not always straightforward because of the lack of specific biomarkers and clinical heterogeneity. This review presents the clinical and pathological findings of four autopsied cases that had been diagnosed with ALS before death.

[The Role of Pharmacists in AST in Large Hospitals and Their Training].

Since 1997, Chubu Rosai Hospital has been establishing the proper use of various antibacterial drugs through the activities of an infection control team (ICT), introduction of a notification system for specific antibacterial drug use, and intervention of ward pharmacists for individual cases. There is no infectious disease department, and we have been working closely with each other on multiple occupations. As an initiative, we established the Nagoya Southern Infection Countermeasures Meeting in 2006 and conducted antimicrobial use and resistance (AUR) surveys to promote the proper use of antimicrobial agents within the area.

Pelvic incidence affects postoperative dislocation rate in total hip arthropalsty patients with spinal fusion.

Purpose: The purpose of this study was to compare the clinical outcome of total hip arthroplasty (THA) with and without spinal fusion (SF), and to evaluate the radiographic characteristics of patients with dislocation after THA.

Methods: A case-controlled study of 53 patients (67 hips) who underwent both THA and SF was performed. The control group was matched to the SF group by age, gender and body mass index, and 106 patients (134 hips) were selected.

Clinical characteristics of non-radiographic versus radiographic axial spondyloarthritis in Asia and non-radiographic axial spondyloarthritis in other regions: results of the cross-sectional ASAS-COMOSPA study.

Objectives: To delineate characteristics of non-radiographic axial spondyloarthritis (nr-axSpA) in Asia versus non-Asian regions, and compare radiographic axSpA (r-axSpA) with nr-axSpA within Asia.

Methods: Data were collected from the Assessment of SpondyloArthritis international Society-COMOrbidities in SPondyloArthritis database. Categorising patients by region, we compared clinical characteristics between nr-axSpA from Asia vs elsewhere (Europe, the Americas and Africa).

Pericostal tuberculosis in a patient with systemic sclerosis:The relationship of two rare diseases.

Regardless of immunosuppressant use, physicians should be aware of pulmonary and extra-pulmonary tuberculosis in patients with autoimmune disease including systemic sclerosis, especially if they follow unusual clinical courses.

Associations Between Neck and Shoulder Pain and Neuropathic Pain in a Middle-aged Community-living Population.

Study Design: A cross-sectional study.

Objective: The present study aimed to investigate the prevalence of NeP in subjects suffering from NSP to reveal the impact of NeP on the health-related QOL (HRQOL) in middle-aged and elderly people with NSP in a health checkup.

Summary Of Background Data: No previous studies have established the relationship between NSP and NeP as potential risk factors contributing to a decreased QOL in the general population.

The Level of Conus Medullaris in 629 Healthy Japanese Individuals.

The conus medullaris typically terminates at the L1 level; however, variations in its level and the factors associated with the conus medullaris level are unclear. We investigated the level of conus medullaris on magnetic resonance imaging in healthy volunteers. In total, 629 healthy adult volunteers (≥50 individuals of each sex and in each decade of age from 20 to 70) were enrolled.

Age-related degenerative changes and sex-specific differences in osseous anatomy and intervertebral disc height of the thoracolumbar spine.

The aim of this study was to determine age-related changes and sex-specific differences in sagittal alignment, range of motion (ROM), and intervertebral disc height of the thoracolumbar spine in healthy subjects. Lateral neutral and flexion-extension radiographs of the thoracolumbar spine of 627 asymptomatic subjects (307 males and 320 females; average age, 49.6 ± 16.

[Epiconus Syndrome and Conus Syndrome].

The most caudal part of the spinal cord shows special anatomical characteristics and it contains epiconus (L4-S2 segments), the conus medullaris (S3-S5 segments), and surrounding nerve roots. Lesions of the thoracolumbar junction cause epiconus or conus syndrome. Epiconus syndrome is characterized by segmental muscular weakness and atrophy of one or both lower extremities, often accompanied by foot drop.

Lumbar Thecal Sac Dimensions and Axial Spinal Cord Areas on Magnetic Resosnace Imaging in 626 Healthy Subjects.

Study Design: A cross-sectional study.

Objective: The aim of this study was to investigate the lumbar thecal sac dimensions and spinal cord area on magnetic resonance (MR) imaging in healthy volunteers.

Summary Of Background Data: There are few reports regarding lumbar spine MRI in healthy subjects, and the difference in spinal canal dimensions by age remains unclear.