Hamamatsu, Japan
Hamamatsu, Japan

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Takase H.,Enshu Hospital | Kimura G.,Asahi Rosai Hospital | Dohi Y.,Nagoya City University
Journal of Human Hypertension | Year: 2014

We tested the hypothesis that uric acid levels predict new-onset hypertension in the Japanese general population. Normotensive individuals who visited our hospital for a yearly health checkup (n=8157, men=61.0% and age=50.7±12.2 years) were enrolled in the present study. After baseline evaluation, participants were followed up for a median of 48.3 months (range 4.9-101.0 months), with the endpoint being the development of hypertension, defined as systolic blood pressure (BP) ≥140 mm Hg, diastolic BP ≥90 mm Hg or the use of antihypertensive medication. The impact of uric acid and other cardiovascular risk factors at baseline on future BP and development of hypertension was assessed. During follow-up, 19.0% of women (n=605) and 29.5% of men (n=1 469) participants developed hypertension. Incident hypertension was increased across the quartiles for baseline uric acid levels (P<0.0001), and multivariate Cox proportional hazards analysis revealed a significant and independent association between the uric acid level and the onset of hypertension in both men and women participants (P<0.05). Furthermore, uric acid was independently and positively correlated with future BP (P<0.05). Thus, uric acid is an independent predictor of new-onset hypertension in both women and men. © 2014 Macmillan Publishers Limited.


Ohishi T.,Enshu Hospital | Takahashi M.,Juzen Hospital | Matsuyama Y.,Hamamatsu University School of Medicine
Knee | Year: 2014

A large osteochondral fragment trapped in the posterolateral compartment of a knee was removed from a posteromedial portal through the trans-septal portal and fixed on an osteochondral defect of the lateral femoral condyle in a 16. year-old boy. When a free body in the posterolateral compartment is so large that enlargement of the portal site is required for removal, doing so from a posteromedial portal is safer and easier than from a posterolateral portal. © 2013 Elsevier B.V.


Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University
European Journal of Clinical Investigation | Year: 2014

Background: B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are useful biomarkers in the management of heart failure. Both peptides are secreted into the circulation after cleavage of their precursor proBNP and excreted from the kidney in the active form or as metabolites. We investigated effects of kidney function on the levels and association of these peptides. Materials and methods: Plasma concentrations of BNP and serum concentrations of NT-proBNP were measured in 229 outpatients of our cardiology department (male/female = 138/91, mean age= 68 years) and 53 hospital outpatients on chronic haemodialysis (30/23, 68 years). Kidney function in nondialysed patients was assessed by estimated glomerular filtration rate (eGFR; mL/min/1·73 m2) and categorised across five stages. Effects of kidney function on BNP, NT-proBNP and their relationship were investigated. Results: Deterioration in kidney function increased BNP and NT-proBNP levels, as well as the NT-proBNP/BNP ratio, and these values were highest in patients on haemodialysis. The eGFR inversely correlated with BNP (r = -0·472), NT-proBNP (r = -0·579), and the NT-proBNP/BNP ratio (r = -0·454, all P < 0·0001). A significant correlation was observed between BNP and NT-proBNP at all stages of kidney function including patients on haemodialysis, but the correlation was significantly affected by kidney function. Conclusions: Although circulating levels of both BNP and NT-proBNP increased with deteriorating kidney function, the impact of kidney function on NT-proBNP was much more pronounced than that on BNP. Kidney function should be taken into account when interpreting data on BNP, NT-proBNP and their relationship. © 2013 Stichting European Society for Clinical Investigation Journal Foundation.


Sonoda H.,Nagoya City University | Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University | Kimura G.,Nagoya City University
American Journal of Nephrology | Year: 2011

Aims: Increased uric acid levels are associated with kidney dysfunction. We tested the hypothesis that uric acid level predicts future development of chronic kidney disease (CKD) in the general population. Methods: For this study, we enrolled 7,078 consecutive subjects with normal estimated glomerular filtration rates (eGFR; ≥60 ml/min/1.73 m 2) who visited our hospital for a yearly health checkup (age: 52.8 ± 10.7 years; female: 35.8%). Subjects underwent a routine physical examination and laboratory assessment of cardiovascular disease risk factors at enrollment, and were followed up for 1,694 days (median) with the endpoint being the development of CKD (eGFR <60 ml/min/1.73 m 2). The impact of uric acid and other cardiovascular risk factors at baseline on the future development of CKD were assessed. Results: During the follow-up period, 417 male (9.2%) and 151 female subjects (6.0%) developed CKD. Univariate logistic regression analysis revealed a significant association between the onset of CKD and age, male gender, body mass index, blood pressure, fasting plasma glucose, dyslipidemia and uric acid. Multiple logistic regression analysis revealed that new-onset CKD was independently correlated with the baseline uric acid level after adjustment for possible factors. Subanalysis showed similar results in subjects with normal uric acid levels (male: ≤7.0 mg/dl; female: ≤6.0 mg/dl; n = 6,223). Conclusion: Uric acid is an independent predictor of future development of CKD. Whether preventing an increase in uric acid levels reduces the incidence of CKD must be clarified by prospective follow-up studies. Copyright © 2011 S. Karger AG, Basel.


Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University | Toriyama T.,Enshu Hospital | Okado T.,Enshu Hospital | And 3 more authors.
Journal of Hypertension | Year: 2012

Objectives: The present study tested the hypothesis that glomerular filtration rate can predict the onset of hypertension in individuals with normal blood pressure in the general population. Methods: Normotensive individuals (n = 7684) who visited our hospital for a routine physical examination were enrolled in the study (4907 men; mean age 52.1 ± 11.1 years) and were followed up with the endpoint being the development of hypertension. The relationship between estimated glomerular filtration rate at baseline and the incidence of hypertension was evaluated. Results: During the follow-up period (median 4.0 years; actual follow-up 30 624 person-years), hypertension developed in 2031 participants (66.3 per 1000 person-years). After adjustment for possible risk factors, the hazard ratio of incident hypertension (first tertile as reference) in the second and third tertiles was 1.03 (95% confidence interval 0.92-1.16) and 1.40 (95% confidence interval 1.26-1.57), respectively. Multivariate Cox proportional hazard regression analysis, in which estimated glomerular filtration rate was taken as a continuous variable and adjustments were made for known risk factors, also indicated that baseline estimated glomerular filtration rate independently predicted the onset of hypertension (P < 0.0001). Furthermore, multiple regression analysis revealed that a longitudinal increase in SBP was significantly associated with baseline estimated glomerular filtration rate after adjustment for known risk factors (P < 0.01). Conclusion: Estimated glomerular filtration rate in normotensive individuals is a good predictor of the onset of hypertension in the general population. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University | Okado T.,Enshu Hospital | Hashimoto T.,Enshu Hospital | And 2 more authors.
European Journal of Clinical Investigation | Year: 2012

Background Although visceral obesity, a key abnormality in the metabolic syndrome, is an important risk for cardiovascular diseases, reduction in visceral fat is hard to achieve despite intensive efforts directed at lifestyle modification. The present study was designed to investigate whether ezetimibe, an inhibitor of intestinal cholesterol absorption through its binding to Niemann-Pick C1-like 1, reduces visceral fat in patients with metabolic syndrome. Materials and Methods Seventy-eight outpatients (63·7±10·4years old) with metabolic syndrome were enroled and randomly assigned to receive either ezetimibe (10mg/day) or nothing for 6months. Changes in visceral fat were assessed by computed tomography. Results Treatment with ezetimibe significantly improved lipid profiles. Visceral fat was decreased 7·2%, from 161·3±58·6cm2 to 148·4±52·7cm2 (P<0·05), and adiponectin was increased 7·7%, from 3·61±3·10μg/mL to 3·86±3·62μg/mL (P<0·05), after ezetimibe therapy; these beneficial effects were not observed in the control group. The increase in the adiponectin level was correlated with the reduction in visceral fat after ezetimibe treatment. Furthermore, ezetimibe reduced fasting insulin levels (P<0·05) and improved the homoeostasis model assessment of insulin resistance (HOMA-IR) (P<0·05). Conclusions Ezetimibe reduces visceral fat with beneficial effects on adiponectin and insulin resistance in patients with metabolic syndrome, suggesting a new therapeutic approach in such patients. © 2012 Stichting European Society for Clinical Investigation Journal Foundation.


Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University | Kimura G.,Nagoya City University
Hypertension Research | Year: 2013

Central blood pressure is more closely associated with cardiovascular events and target organ damage than peripheral blood pressure measured over the brachium using a conventional method. This study was designed to investigate the distribution of central systolic blood pressure values estimated by Omron HEM-9000AI in the Japanese general population. A cross-sectional study were performed in 10 756 subjects without overt cardiovascular disease (male=6574; mean age 55.3±12.5 years, range 20-91 years). Of these, 7348 subjects received no antihypertensive, antidiabetic or lipid-lowering drug treatment, and were used for the present analysis. Estimated central systolic blood pressure was higher than brachial systolic blood pressure and was significantly correlated with age and brachial blood pressure. The central systolic blood pressure values obtained from subjects without cardiovascular risk factors other than hypertension were 125.8±37.2 (mean±2 s.d., n=3760) mm Hg. The values obtained from subjects with no cardiovascular risk factors were 112.6±19.2 (n=1975) mm Hg for optimal and 129.2±14.9 mm Hg for normal brachial blood pressure categories (n=697). This study is the first to show the distribution of central systolic blood pressure values estimated using the Omron HEM-9000AI, marking an important step toward implementing the clinical use of central blood pressure in the diagnosis and management of hypertension. © 2013 The Japanese Society of Hypertension All rights reserved.


Ohishi T.,Enshu Hospital | Ito T.,Hamamatsu University School of Medicine | Suzuki D.,Enshu Hospital | Banno T.,Enshu Hospital | Honda Y.,Enshu Hospital
Archives of Orthopaedic and Trauma Surgery | Year: 2012

Method We investigated the incidence of occult hip and pelvic fractures and associated muscle injuries around the hip. Patients A total of 113 patients aged 60-102 years with suspected hip fracture but negative plain radiographs underwent further examination by magnetic resonance imaging (MRI) within 2 days after an X-ray examination. Coronal and axial T1 and T2 or short tau inversion recovery sequences of MRI of the hip including the sacrum were obtained. Results One hundred and two cases (90.2%) had bone or soft-tissue abnormalities and 83 cases (73.5%) had fractures of the hip and/or pelvis. The frequency of hip fracture and pelvic fracture was almost the same. More than half of the patients among those with pelvic fractures sustained occult sacral fractures; therefore, it was important to determine if a sacral fracture was involved when occult hip fracture was suspected. Muscles located at the lateral aspect of the hip, such as gluteus maximus, gluteus medius, gluteus minimus and quadratus femoris, were frequently injured in cases with intertrochanteric and greater trochanter fracture, suggesting that direct impact may be associated with fractures of the trochanteric region. However, hip rotator and adductor muscles such as obturator internus, obturator externus and adductor brevis were commonly injured in cases with pelvic fracture, indicating indirect force mediated by these muscles may be associated with pelvic fracture. Conclusion Occult hip and pelvic fractures were almost equally seen among 113 cases with suspected hip fracture but were negative on plain radiography. different patterns of associated muscle injuries in cases of occult hip fracture and pelvic fracture suggest that the mechanism of hip fracture and pelvic fracture is possibly different. © Springer-Verlag 2011.


Sonoda H.,Nagoya City University | Takase H.,Enshu Hospital | Dohi Y.,Nagoya City University | Kimura G.,Nagoya City University
Journal of Human Hypertension | Year: 2012

The present study investigated factors that modify or affect arterial stiffness as assessed by brachial-ankle pulse wave velocity (baPWV) in the general population. Subjects had previously participated in a physical checkup program (n=911), and baPWV and urinary albumin and sodium excretion were also measured. Urine albumin was expressed as the ratio of urine albumin to urine creatinine. Individual salt intake was assessed by estimating 24-h urinary salt excretion and expressed as the ratio of estimated salt intake to body weight. The mean blood pressure and baPWV were 127.1±15.2/77.0±9.5 mm Hg and 15.9±3.3 m s-1, respectively. Univariate analysis demonstrated that baPWV correlated with various factors including age, blood pressure, electrocardiogram voltage (SV 1 +RV 5), urine albumin and salt intake. Multivariate regression analysis revealed that electrocardiogram voltage (P<0.001), systolic blood pressure (P<0.0001), urine albumin (P<0.001) and salt intake (P<0.001), independently correlated with baPWV after adjustment for other possible factors. Similar results were obtained for participants not taking any medication. These results suggest that the baPWV value is independently associated with individual salt intake and cardiac and renal damage, and could be a useful procedure for identifying individuals with concealed risk of cardiovascular disease. © 2012 Macmillan Publishers Limited. All rights reserved.


Benign prostatic hyperplasia (BPH) is an extremely common and chronic condition that can lead to bladder outlet obstruction (BOO) in elderly men. Although pressure-flow studies are considered the most reliable method for evaluating BOO, they are invasive and complicated. Transrectal ultrasonography (TRUS) is a promising alternative because of its minimal invasiveness. Recently, TRUS imaging has been shown capable of measuring the resistive index, a useful parameter for evaluating BOO and for determining proper medical intervention in patients suffering from BPH. © 2011 Springer Science+Business Media, LLC.

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