Brachial-Ankle Pulse Wave Velocity Versus Its Stiffness Index β-Transformed Value as Risk Marker for Cardiovascular Disease.

Background The difference in the predictive ability of the brachial-ankle pulse wave velocity (baPWV) and its stiffness index β-transformed value (β-baPWV, ie, baPWV adjusted for the pulse pressure) for the development of pathophysiological abnormalities related to cardiovascular disease or future occurrence of cardiovascular disease was examined. Methods and Results In study 1, a 7-year prospective observational study in cohorts of 3274 men and 3490 men, the area under the curve in the receiver operator characteristic curve analysis was higher for baPWV than for β-baPWV for predicting the development of hypertension (0.73, 95% CI=0.

N-Terminal Pro-B-Type Natriuretic Peptide Is a Predictor of Chronic Kidney Disease in an Asian General Population - The Ohasama Study.

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is known to increase in heart failure patients. Given that no reports have described the association between NT-proBNP and chronic kidney disease (CKD) incidence in Asian populations, we investigated this association in the Japanese population. We followed up 867 participants without CKD from the general population of Ohasama, Japan.

Trends in sepsis care in Japan: comparison of two sepsis cohort studies conducted by the Japanese Association for Acute Medicine.

Our analysis showed that improved compliance with sepsis bundles was associated with lower in-hospital mortality over a 7-year period in Japan, confirming that the SSC has been executed correctly in our country.

Cesarean section under spinal anesthesia in acquired complete atrioventricular block without a pacemaker: A case report.

Pregnancy with complete atrioventricular block is rare, and its perioperative management is controversial. We successfully managed cesarean section in a pregnancy with acquired complete atrioventricular block under spinal anesthesia without a pacemaker. Asymptomatic pregnant women with acquired complete atrioventricular block can tolerate cesarean section under spinal anesthesia without a pacemaker.

Age-Related Trends in Home Blood Pressure, Home Pulse Rate, and Day-to-Day Blood Pressure and Pulse Rate Variability Based on Longitudinal Cohort Data: The Ohasama Study.

Background Home blood pressure is a more accurate prognosticator than office blood pressure and allows the observation of day-to-day blood pressure variability. Information on blood pressure change during the life course links the prediction of blood pressure elevation with age. We prospectively assessed age-related trends in home blood pressure, home pulse rate, and their day-to-day variability evaluated as a coefficient of variation.

Community-Wide Dissemination of Bystander Cardiopulmonary Resuscitation and Automated External Defibrillator Use Using a 45-Minute Chest Compression-Only Cardiopulmonary Resuscitation Training.

Background Little is known about whether cardiopulmonary resuscitation ( CPR ) training can increase bystander CPR in the community or the appropriate target number of CPR trainings. Herein, we aimed to demonstrate community-wide aggressive dissemination of CPR training and evaluate temporal trends in bystander CPR . Methods and Results We provided CPR training (45-minute chest compression-only CPR plus automated external defibrillator use training or the conventional CPR training), targeting 16% of residents.

Anti-interleukin 5 antibody is effective for not only severe asthma and eosinophilic pneumonia but also eosinophilic bronchiolitis.

A 60-year-old female with severe bronchial asthma developed persistent dyspnoea and an abnormal lung shadow. High-resolution computed tomography (HRCT) demonstrated patchy ground-glass opacities and diffuse, small nodular shadows. Elevated percentages of eosinophils were observed in the blood and bronchoalveolar lavage fluid.

Daclatasvir and asunaprevir improves health-related quality of life in Japanese patients infected with hepatitis C virus.

Aims: Interferon-free direct-acting antiviral agent (DAA) regimens for chronic hepatitis C virus (HCV) patients have improved their health-related quality of life (HRQOL). Currently, there are no published data assessing the impact of DAAs regimens without sofosbuvir on HRQOL. The aim of this study was to investigate the improvement of HRQOL in Japanese HCV patients treated with a protease inhibitor and a nonstructural protein 5A inhibitor.

Non-alcoholic fatty liver disease in patients with autoimmune hepatitis.

Background And Aim: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing all over the world. NAFLD develops in patients with liver disease, including patients with autoimmune hepatitis (AIH). NAFLD and AIH have some similar laboratory and histological findings.

Gamma Glutamyltransferase Reduction Is Associated With Favorable Outcomes in Pediatric Primary Sclerosing Cholangitis.

Adverse clinical events in primary sclerosing cholangitis (PSC) happen too slowly to capture during clinical trials. Surrogate endpoints are needed, but no such validated endpoints exist for children with PSC. We evaluated the association between gamma glutamyltransferase (GGT) reduction and long-term outcomes in pediatric PSC patients.

Patients Refusing Transcatheter Aortic Valve Replacement Even Once Have Poorer Clinical Outcomes.

Background Although transcatheter aortic valve replacement ( TAVR ) is the least invasive treatment for patients with symptomatic aortic stenosis, some patients hesitate to undergo the procedure. We investigated the clinical impact of treatment delay after patient refusal of TAVR . Methods and Results We used the Japanese OCEAN (Optimized Catheter valvular intervention) regsitry data of 1542 patients who underwent TAVR .

A survey on infection control in emergency departments in Japan.

Aim: Infection control in the emergency department is important for hospital risk management; however, few clinical guidelines have been established. This study aimed to determine whether hospitals in Japan have infection control manuals, and investigate the contents of manuals, consulting systems, and isolation facilities for emergency departments.

Methods: A total of 517 hospitals certified as educational institutions for board-certified acute care physicians in Japan were requested between March and May 2015 to provide a written evaluation of the infection control in the emergency department.

Lemierre's syndrome presented with acute pancreatitis.

Case: Lemierre's syndrome is a rare clinical condition that is characterized by infected internal jugular vein thrombosis with metastatic septicemia. The most common causative agent is . A previously healthy 37-year-old woman presented to our emergency department with nausea, vomiting, and diarrhea.

A case of pulmonary cyst and pneumothorax after bronchial thermoplasty.

Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma using thermal energy to reduce smooth muscle in the bronchial wall. A 47-year-old man underwent BT for uncontrolled severe asthma despite maximal pharmacological treatment. After a third procedure, he experienced hypoxaemia because of complete bilateral upper lobe atelectasis.

Effectiveness of dispatcher training in increasing bystander chest compression for out-of-hospital cardiac arrest patients in Japan.

Aim: The Japanese government has developed a standardized training program for emergency call dispatchers to improve their skills in providing oral guidance on chest compression to bystanders who have witnessed out-of-hospital cardiac arrests (OHCAs). This study evaluated the effects of such a training program for emergency call dispatchers in Japan.

Methods: The analysis included all consecutive non-traumatic OHCA patients transported to hospital by eight emergency medical services, where the program was implemented as a pilot project.

Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan.

Aims: Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.

Methods: Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013.

Spontaneous formation of neutrophil extracellular traps in serum-free culture conditions.

Neutrophils play a critical role in the innate immune response. Recently, a new neutrophilic biological defense mechanism, termed neutrophil extracellular traps (NETs), has been attracting attention. Neutrophils have been observed to release both lysosomal enzymes and their nuclear contents, including unfolded chromatin, which together trap and inactivate bacteria.

Effectiveness of a One-minute Self-retraining for Chest Compression-only Cardiopulmonary Resuscitation: Randomized Controlled Trial.

Objectives: Although cardiopulmonary resuscitation (CPR) skills decay after training, little is known about appropriate retraining methods. Our aim was to evaluate the effectiveness of a 1-minute self-retraining (with automated assessment and feedback) at 3 months after the initial 45-minute chest compression-only CPR training in a simulated randomized controlled trial.

Methods: After the initial 45-minute chest compression-only CPR training, participants were randomly assigned to either a 1-minute self-retraining group or a control group.

11-1 Isolated from Rice Bran Pickles Activated Innate Immunity and Improved Survival in a Silkworm Bacterial Infection Model.

Lactic acid bacteria (LAB) have high immune system-stimulating activity and are considered beneficial for human health as probiotics in the gut. The innate immune system is highly conserved between mammals and insects. Microbe-associated molecular patterns (e.

Red cell and platelet distribution widths in patients with angina pectoris and acute myocardial infarction.

Aim: We aimed to determine the relationship of red cell and platelet distribution widths with the onset of acute myocardial infarction, to enable the early detection and prevention of acute myocardial infarction.

Methods: Red cell and platelet distribution widths were retrospectively determined in 46 patients with stable angina pectoris and 140 patients with acute myocardial infarction who were brought to the emergency department of our institution. Red cell and platelet distribution widths were determined with an automatic blood cell analyzer, and the results were compared between the acute myocardial infarction and angina pectoris groups.

A case of invasive Langerhans cell histiocytosis localizing only in the lung and diagnosed as pneumothorax in an adolescent female.

In infants, Langerhans cell histiocytosis (LCH) is associated with poor clinical outcomes as Langerhans cells invade and damage multiple organs, a presentation that is different from that in adults. Here, we present a case of a 15-year-old female who visited ourclinic complaining of right chest pain and dyspnea. She was diagnosed with right pneumothorax by chest X-ray.

Factors affecting layperson confidence in performing resuscitation of out-of-hospital cardiac arrest patients in Japan.

Aim: Bystander cardiopulmonary resuscitation including automated external defibrillator use increases the chance of survival after out-of-hospital cardiac arrest. However, bystanders may be distressed by witnessing out-of-hospital cardiac arrest and may hesitate to initiate cardiopulmonary resuscitation. The present study examined factors associated with layperson confidence in carrying out resuscitation of out-of-hospital cardiac arrest patients.

Impact of serum glucose levels on disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis.

Aim: To determine whether glycemic abnormality and pre-existing diabetes are associated with disease severity and mortality in patients with severe sepsis.

Methods: Six hundred and nineteen patients with severe sepsis were grouped into four categories according to their blood glucose levels (<100, 100-199, 200-299, and ≥300 mg/dL). We compared disease severity and mortality between glycemic categories.

Role of varicocele repair for male infertility in the era of assisted reproductive technologies.

Varicocele is an abnormal condition characterized by dilatation of the pampiniform plexus veins draining the testis and is present in 15 % of men. Varicoceles have an adverse effect on spermatogenesis and are the most common cause of male infertility. Approximately 35 % of infertile men and more than 70 % of men with secondary infertility were reported to have varicoceles.

Gene expression analysis of TREM1 and GRK2 in polymorphonuclear leukocytes as the surrogate biomarkers of acute bacterial infections.

Objective: In the acute stage of infectious diseases such as pneumonia and sepsis, sequelae hypercytokinemia and cytokine storm are often observed simultaneously. During bacterial infections, activated polymorphonuclear leukocytes (PMNs) cause inflammation and organ dysfunction in severely ill patients. Gene expression of the triggering receptor on myeloid cells (TREM)-1 and G-coupled-protein receptor kinase (GRK)-2 in PMNs isolated from patients was analysed to identify genes correlated with the severity of pathophysiological conditions.