High-sensitivity C-reactive protein and white blood cell count equally predict development of the metabolic syndrome in a Japanese health screening population.

To compare high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC) as a predictor of metabolic syndrome (MetS). Hazard ratios (HRs) adjusted for age, smoking, and other confounding covariates and areas under receiver operating characteristic curve (AUCs) of hs-CRP and WBC for developing MetS were calculated in 1,463 men and 920 women from a Japanese health screening population who were free from MetS, diabetes, histories of coronary heart disease, and stroke at baseline and followed through 3 years. The adjusted HRs (95% confidence interval-CI; p value) of MetS for each 1 SD increases in log hs-CRP, and log WBC were 1.

Metabolic syndrome is a poor predictor of diabetes in a Japanese health screening population.

Objective: Although metabolic syndrome (MS) is considered to be a predictor of diabetes and cardiovascular disease, its value for predicting diabetes beyond the levels of fasting glucose (FG) and hemoglobin A1c (HbA1c) remains questionable. In this study, we evaluated the usefulness of MS and Japanese MS (JMS) as predictors of diabetes.

Methods: This study is a longitudinal study using data for 2,034 subjects who visited our Medical Check-up Center in both 2008 and 2011 and were free from diabetes at baseline.

Atrial fibrillation (AF) and complete right bundle branch block (RBBB) are independently associated with increased hemoglobin levels in apparently healthy subjects.

Objective: The associations between atrial fibrillation (AF) or complete right bundle branch block (RBBB) and other laboratory tests have not been examined sufficiently in healthy populations.

Methods: These associations were examined with multivariable logistic regression analyses using data from 6,381 apparently healthy subjects including 46 subjects with AF and 100 subjects with RBBB.

Results: The mean age, body mass index (BMI), hemoglobin, the prevalence of male sex and a history of coronary heart disease (CHD) were significantly higher in subjects with AF or RBBB than without.

Pacing lead-induced granuloma in the atrium: a foreign body reaction to polyurethane.

We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells.

Total bilirubin is inversely associated with metabolic syndrome but not a risk factor for metabolic syndrome in Japanese men and women.

Serum total bilirubin (TB) is a potent antioxidant and inversely associated with metabolic syndrome (MetS) in Asian populations. However, there has been no study which is aimed to investigate whether TB is a risk factor for MetS or not. We investigated cross-sectional and longitudinal associations between TB and MetS in 2,435 Japanese men and 1,436 Japanese women.

The association between obesity and acute myocardial infarction is age- and gender-dependent in a Japanese population.

Controversies concerning the association between obesity and acute myocardial infarction (AMI) are still ongoing in Japan. We investigated the association between obesity defined by body mass index of 25 kg/m(2) or higher and AMI by a case-control study using data from 1199 AMI cases and 4056 apparently healthy controls. The analysis was performed in age- and sex-matched samples of 621 case-control pairs younger than 80 years and in crude samples aged 40-79 years divided into 10-year age groups.

Hypobilirubinemia might be a possible risk factor of end-stage kidney disease independently of estimated glomerular filtration rate.

Background/aims: The relationship between serum total bilirubin (TB) and estimated glomerular filtration rate (eGFR) is controversial and there is no report on the association between TB and end-stage kidney disease (ESKD).

Methods: We examined the cross-sectional association between TB and eGFR and investigated whether TB can predict ESKD with multivariable logistic regression adjusted for age, sex, and baseline eGFR using hospital-based data.

Results: The geometric mean TB of patients with eGFR ≥ 90 mL/min/1.

Renal Dysfunction was an Independent Predictor of In-Hospital Death and Ventricular Rupture in Patients With Acute Myocardial Infarction.

Background: Apart from the severity of myocardial infarction and coronary artery disease, several predictors of in-hospital death (In-HD) are suggested in patients with acute myocardial infarction (AMI).

Methods: We investigated predictors of In-HD and ventricular rupture (VR) including ventricular septal rupture (VSR) and free wall rupture (FWR) with stepwise multivariable logistic regressions in 1,042 patients admitted to our Cardiovascular Center within 48 hours from symptom onset for the first attack of AMI.

Results: In-HD, VSR, and FWR were observed in 78 cases (7.

Smoking was a Possible Negative Predictor of Incident Hypertension After a Five-Year Follow-up Among a General Japanese Population.

Backgrounds: The association between cigarette smoking and hypertension is controversial. The aim of this study is to investigate the association between smoking and incident hypertension.

Methods: This is a post-hoc five-year follow-up study in a general Japanese population.

[Single-stage procedure for multiple dissected aortic aneurysms with coagulopathy in an elderly patient].

An 86-year-old man was admitted for abdominal pain. Dissected descending thoracic aortic aneurysm and infrarenal abdominal aortic aneurysm were observed under computed tomographic (CT) scan. Hematologic studies revealed low platelet count and an increase in fibrin degradation products (FDP), and disseminated intravascular coagulation( DIC) associated with dissecting aortic aneurysm was highly suspected.

Metabolic syndrome: its history, mechanisms, and limitations.

In late twentieth century, Ruderman and Reaven showed that insulin resistance might be fundamental to metabolic syndrome (MetS) which means a constellation of obesity-related metabolic derangements predisposing to type 2 diabetes and cardiovascular disease. In 2001, user-friendly National Cholesterol Education Program (NCEP) criteria of MetS were proposed. In 2005, the International Diabetes Federation (IDF) and the Examination Committee for Criteria of Metabolic Syndrome in Japan issued different criteria of MetS where abdominal obesity is a necessary component.

Lymphocyte count was significantly associated with hyper-LDL cholesterolemia independently of high-sensitivity C-reactive protein in apparently healthy Japanese.

The aim of this study was to investigate the association between leukocyte subtype counts and hyper-LDL cholesterolemia, hypertriglyceridemia, and hypo-HDL cholesterolemia. Logistic regressions using hyper-LDL cholesterolemia, hypertriglyceridemia, and hypo-HDL cholesterolemia as a dependent variable and total leukocyte, basophil, eosinophil, neutrophil, lymphocyte, and monocyte counts as an independent variable were calculated adjusting for age, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), smoking, drinking, and physical activity in apparently healthy Japanese men (1,803) and women (1,150). The odds ratio (OR) of hyper-LDL cholesterolemia for total leukocyte, eosinophil, and lymphocyte counts, the OR of hypertriglyceridemia for total leukocyte, eosinophil, neutrophil, and lymphocyte counts, and the OR of hypo-HDL cholesterolemia for total leukocyte, neutrophil, and lymphocyte counts were significant in men, and the OR of hyper-LDL cholesterolemia, for lymphocyte count, and the OR of hypo-HDL cholesterolemia for eosinophil count were significant in women.

A modified infarct exclusion repair of posterior postinfarction ventricular perforation: triple-patch technique for postinfarction ventricular septal perforation in 2 female patients.

We describe a new technique for the early surgical repair of a posterior postinfarction ventricular septal perforation (VSP) in two consecutive female patients. The occurrence of a posterior VSP is rare, and its repair is technically difficult because the posteromedial papillary muscle is located adjacent to the intraventricular septum. This modification appears to prevent leaks to the right ventricle through the VPS with a single direct patch and the use of two equine pericardial patches to form a single endocardial pouch.

High-density lipoprotein cholesterol is positively associated with hypertension in apparently healthy Japanese men and women.

Among five components of metabolic syndrome, high-density lipoprotein (HDL) cholesterol is unique because it is not significantly associated with blood pressure. This study looks at cross-sectional relationships between HDL cholesterol and hypertension using medical check-up data from 1803 apparently healthy Japanese men aged 49.9 +/- 9.

A possible cross-sectional association of serum total bilirubin with coronary heart disease and stroke in a Japanese health screening population.

Bilirubin is a potent antioxidant, and serum total bilirubin (TB) is reported to be negatively associated with cardiovascular disease (CVD). There has been no report on the association between TB and CVD prevalence in Japanese. The aim of the study is to examine the association between TB and CVD prevalence in a Japanese health screening population.

Bilirubin is negatively associated with hemoglobin a(1c) independently of other cardiovascular risk factors in apparently healthy Japanese men and women.

Background: Serum total bilirubin (TB) is a potent antioxidant and may be a negative risk factor of cardiovascular disease. In non-diabetic adults, hemoglobin A(1c) (HbA(1c)), but not fasting plasma glucose, is an independent risk factor of cardiovascular disease.

Methods And Results: Linear regression using TB as a dependent variable and cardiovascular risk factors, including HbA(1c), as independent variables, linear regression using HbA(1c) as a dependent variable and other cardiovascular risk factors, including TB, as independent variables, and logistic regression using the highest decile (≥ 5.

Comparison among body mass index (BMI), waist circumference (WC), and percent body fat (%BF) as anthropometric markers for the clustering of metabolic risk factors in Japanese.

Objective: To compare body mass index (BMI), waist circumference (WC), and percent body fat (%BF) as markers for the clustering of metabolic risk factors in Japanese.

Methods: Age-adjusted correlation coefficients (Rs) were calculated between the three anthropometric markers of obesity and metabolic risk factors in 2,444 men and 1,442 women among Japanese. Areas under receiver operating characteristic curves (AUCs) of BMI, WC, and %BF were calculated for diagnosing the clustering of 1 or more, 2 or more, 3 or more, and 4 risk factors among increased blood pressure, impaired fasting glucose, increased triglycerides, and decreased HDL cholesterol and for the clustering of 1 or more, 2 or more, 3 or more, 4 or more, 5 or more, and 6 risk factors among the upper four risk factors as well as increased high-sensitivity C-reactive protein and increased LDL cholesterol.

Antituberculosis treatment for a patient with massive ascites: the role of f-18-fluorodeoxyglucose positron emission tomography.

Background: The diagnosis of peritoneal tuberculosis (TB) is difficult, and the condition is often misdiagnosed as advanced ovarian cancer. The clinical discrimination is important to avoid both unnecessary surgery and a delay in anti-TB treatment.

Case: A 66-year-old woman presented with abdominal distension.

[Assessment of pulse wave velocity as a marker of post-operative cardiovascular risk in off-pump coronary artery bypass grafting patients].

Objective: Pulse wave velocity is widely used as an index of arterial stiffness. The aim of this study is to assess the usefulness of pulse wave velocity as a risk factor in patients who underwent off-pump coronary artery bypass grafting (CABG) [OPCAB].

Methods And Results: Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and the ratio of patient's baPWV to age-matched normal value was calculated in 90 OPCAB patients.

Body mass index is more strongly associated with hypertension than waist circumference in apparently healthy Japanese men and women.

Obesity is associated with hypertension. However, it is controversial which obesity index, body mass index (BMI) or waist circumference (WC), is more strongly associated with hypertension. We compared the cross-sectional associations of BMI and WC with hypertension.

Reproducibility of high-sensitivity C-reactive protein as an inflammatory component of metabolic syndrome in Japanese.

Background: Cutoff points for high-sensitivity C-reactive protein (hs-CRP) as a component of metabolic syndrome (MetS) in Japanese have been proposed as 0.40-0.45 mg/L for men and 0.

Low-density lipoprotein (LDL) cholesterol is cross-sectionally associated with preclinical chronic kidney disease (CKD) in Japanese men.

Background: Low-density lipoprotein (LDL) cholesterol and chronic kidney disease (CKD) are both well-known risk factors for cardiovascular disease. However, few studies have examined the associations between LDL cholesterol and CKD.

Methods: In the present study, we investigated the associations between LDL cholesterol and CKD using medical check-up data from 2,449 Japanese men and 1,448 Japanese women.

Severe aortic regurgitation resulting from a downward displacement of anterior aortic annulus and fibrous strands in the bicuspid aortic valve.

Aortic regurgitation is occasionally caused by fibrous strands and more rarely by downward displacement of the aortic annulus. The present report describes an 18-year-old man with aortic regurgitation resulting from an anterior-posterior type of bicuspid aortic valve with fibrous strands and downward displacement of the anterior aortic annulus. A pair of fibrous strands at the anterior cusp of the bicuspid valve lifted the free margin of the cusp, and the anterior cusp originated from the intraventricular septum.