Successful Treatment of Hemi-Retinal Vein Occlusion with Macular Edema following Spinal Surgery Using Intravitreal Aflibercept and Retinal Photocoagulation: A Case Report.

Introduction: Perioperative visual loss (POVL) owing to hemi-retinal vein occlusion (HRVO) following prone positioning during spinal surgery is rare. Here, we report a case of HRVO with macular edema (ME) after spinal surgery that was successfully treated with intravitreal aflibercept (IVA) injections and retinal photocoagulation (RP).

Case Presentation: A 63-year-old Japanese man underwent spinal surgery for lumbar spinal canal stenosis.

Herpes zoster in the context of immune reconstitution inflammatory syndrome in patients with rheumatic diseases: a single-center retrospective study.

Immune reconstitution inflammatory syndrome (IRIS) experienced in rheumatology practice is diverse and includes opportunistic infections such as herpes zoster (HZ). This study aimed to explore the risk of HZ in patients with rheumatic diseases in the perspective of IRIS. The study retrospectively reviewed the clinical courses of 20 patients with HZ and investigated the IRIS triggers such as the reduction or discontinuation of immunosuppressive drugs within 3 months and coronavirus disease 2019 (COVID-19) vaccination within 4 weeks prior to HZ development.

Neurohormonal Activation and Renal Chloride Avidity in Acute Heart Failure: Clinical Evidence Supporting the "Chloride Theory".

Introduction: Heart failure (HF) progression according to changes in the serum chloride concentration ([sCl-]) was recently proposed as the "chloride (Cl) theory" for HF pathophysiology. The present study examined the association of neurohormones and renal Cl avidity to determine their contribution to acute HF and their involvement to the "Cl theory."

Methods: Data from 29 patients with acute HF (48% men; 80.

A simple score for malnutrition-inflammation complex syndrome (MICS) is associated with the risk of mortality in Japanese patients undergoing maintenance hemodialysis.

Introduction: Malnutrition-inflammation complex syndrome (MICS) is highly prevalent in patients undergoing hemodialysis. We determined the prognostic value of the Simple MICS score, calculated using a combination of age, body mass index, and serum concentrations of albumin, creatinine, and C-reactive protein.

Methods: We retrospectively recruited 218 Japanese patients undergoing maintenance hemodialysis.

Estimation of Plasma Renin Activity on the Basis of Serum and Urinary Chloride Concentrations versus Sodium Concentrations.

Introduction: The present study examined the possible estimation of plasma renin activity (PRA) by serum and urinary concentrations of chloride versus sodium in acute and chronic heart failure (HF).

Methods: Data from 29 patients with acute HF (48% men; 80.3 ± 12 years) and 26 patients with recovery of HF after decongestive therapy (50% men; 81.

Simplified geriatric nutritional risk index for assessing nutritional status and stratifying mortality risk in patients receiving maintenance hemodialysis.

Introduction: The geriatric nutritional risk index (GNRI) is a widely used tool for nutritional assessment in patients receiving hemodialysis. The simplification of the GNRI calculation would be more useful for easier screening of malnutrition and for providing an intuitive stratification of mortality risk.

Methods: We retrospectively evaluated 218 Japanese patients receiving maintenance hemodialysis at two hemodialysis centers.

Mechanistic insights into chloride-related heart failure progression according to the plasma volume status.

Aims: Two types of heart failure (HF) progression were recently proposed on the basis of an increased vs. non-increased serum chloride concentration. The applicability of this concept to real-world HF pathophysiology requires further investigation.

Chloride in Heart Failure Syndrome: Its Pathophysiologic Role and Therapeutic Implication.

Until recently, most studies of heart failure (HF) focused on body fluid dynamics through control of the sodium and water balance in the body. Chloride has remained largely ignored in the medical literature, and in clinical practice, chloride is generally considered as an afterthought to the better-known electrolytes of sodium and potassium. In recent years, however, the important role of chloride in the distribution of body fluid has emerged in the field of HF pathophysiology.

Arginine Vasopressin as an Important Mediator of Fluctuations in the Serum Creatinine Concentration Under Decongestion Treatment in Heart Failure Patients.

The mechanism underlying serum creatinine (SCr) fluctuations in heart failure (HF) patients remains unclear. This study examined mediators of SCr fluctuations under diuretic treatment in HF patients. Data from 26 HF patients were analyzed.

Effusion-Serum Chloride Gradient in Heart Failure-Associated Pleural Effusion - Pathophysiologic Implications.

There is scant clinical data of electrolyte analyses in the pleural fluid under heart failure (HF) pathophysiology. This study retrospectively analyzed data from 17 consecutive patients who presented with pleural effusion and underwent thoracentesis. A diagnosis of worsening HF was established by clinical criteria (presentation, echocardiography, serum B-type natriuretic peptide, and response to therapy).

Proposal for New Classification and Practical Use of Diuretics According to Their Effects on the Serum Chloride Concentration: Rationale Based on the "Chloride Theory".

Currently, diuretic therapy for heart failure (HF) pathophysiology is primarily focused on the sodium and water balance. Over the last several years, however, chloride (Cl) has been recognized to have an important role in HF pathophysiology, as both a prognostic marker and a possible central factor regulating the body fluid status. I recently proposed a unifying hypothesis for HF pathophysiology, called the "chloride theory", during HF worsening and recovery, as follows.

Enhancement of the serum chloride concentration by administration of sodium-glucose cotransporter-2 inhibitor and its mechanisms and clinical significance in type 2 diabetic patients: a pilot study.

Background: Chloride is a key electrolyte that regulates the body fluid distribution. Accordingly, manipulating chloride kinetics by selecting a suitable diuretic could be an attractive strategy for correcting body fluid dysregulation. Therefore, this study examined the effects and contributing factors of a sodium-glucose cotransporter-2 inhibitor (SGLT2i) on the serum chloride concentration in type 2 diabetic (T2DM) patients without heart failure (HF).

Comparison of Changes in Plasma Volume and Renal Function between Acetazolamide and Conventional Diuretics: Understanding the Mechanical Differences according to the "Chloride Theory".

Objective: We compared the effects of the chloride-regaining diuretic acetazolamide with those of conventional diuretics on plasma volume, serum electrolytes, and renal function in acutely decompensated heart failure (HF) patients.

Methods: A retrospective analysis was performed on the data of 13 patients treated with acetazolamide (Group A) and 13 patients with conventional diuretics (Group B) matched based on diuresis-induced weight reduction (≥1 kg) during resolution of worsening HF. Changes in plasma volume (Strauss formula), renal function, and serum electrolytes under treatment were determined by peripheral blood tests.

Acetazolamide as a potent chloride-regaining diuretic: short- and long-term effects, and its pharmacologic role under the 'chloride theory' for heart failure pathophysiology.

According to the "chloride theory" for heart failure (HF) pathophysiology, manipulation of the serum chloride concentration is an important therapeutic target. This study determined the short- and long-term effects of acetazolamide (Diamox), a potential chloride-regaining diuretic, on peripheral blood, serum electrolytes, and renal function. Effects of low-dose Diamox (250-500 mg/day) were evaluated in 30 HF patients for whom Diamox was added as de-novo/add-on decongestion therapy for acutely worsening HF (n = 18) or as modification therapy for serum hypochloremia in stable HF ( < 100 mEq/L; n = 12).

Vasopressin antagonist-like effect of acetazolamide in a heart failure patient: a case report.

Background: Hyponatraemia is easily corrected by treatment with an oral vasopressin antagonist, but these medications are costly and their use at outpatient clinics is restricted by government-managed insurance in Japan. Acetazolamide could be an alternative diuretic to a vasopressin antagonist.

Case Summary: An 83-year-old dyspnoeic male patient was emergently admitted to the hospital due to decompensated heart failure (HF), hypotension, and hyperkalaemia-associated sinus arrest with a junctional escape rhythm.

Dynamic changes in serum chloride concentrations during worsening of heart failure and its recovery following conventional diuretic therapy: A single-center study.

Background And Aims: Few data are available regarding the dynamic changes in the serum chloride concentrations in heart failure (HF) pathophysiology. The aim of the present study was to investigate changes in the serum chloride concentration under worsening HF and its recovery following conventional diuretic therapy.

Methods: Blood test data, including measurements of serum albumin/solutes and b-type natriuretic peptide, at both worsening and recovery of HF status, were obtained from 47 patients with definite HF.

[Basic Evaluation of the Acoustic Lens Narrow Aperture Method Devised for Improving Elevational Resolution of Ultrasonic Probe].

In general probe, the focal length in the elevational direction and resolution are fixed by the acoustic lens, so that sufficient resolution cannot be obtained in the region other than the focal point, except for special ultrasonic probes. Therefore, to improve the elevational resolution in the very shallow region, we devised the "narrow aperture method" for attaching a tape slit to an acoustic lens, and verified the method and its effect. The result of the study, for the slit, use Transpore™ tape overlaid on three layers and set the slit width to 1 mm.

Biochemical Determinants of Changes in Plasma Volume After Decongestion Therapy for Worsening Heart Failure.

Background: Optimal vascular volume is required to avoid organ dysfunction during decongestive therapy for worsening heart failure (HF). This study investigated the relation between changes in serum substance(s) and the vascular volume after diuresis in HF patients.

Methods And Results: Data from 47 patients with HF undergoing conventional diuretic therapy were analyzed.

Treatment of hypochloremia with acetazolamide in an advanced heart failure patient and importance of monitoring urinary electrolytes.

Chloride was recently recognized to play an important role in the pathophysiology of heart failure (HF). Chloride manipulation, including the use of acetazolamide, may be a requisite therapeutic target in HF treatment. An 87-year-old male patient with advanced HF and hypertrophic cardiomyopathy was admitted to the hospital due to hypochloremia (94 mEq/L) and hyponatremia (134 mEq/L) under diuretic treatment with azosemide, spironolactone, and tolvaptan.