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1. A single dose of oral nattokinase accelerates skin temperature recovery after cold water immersion: A double-blind, placebo-controlled crossover study

Author

Noriko Nara, Yuko Kurosawa, Sayuri Fuse-Hamaoka, Miyuki Kuroiwa, Tasuki Endo, Riki Tanaka, Ryotaro Kime, and Takafumi Hamaoka

Subjects
Blood pressure, Cardiac output, Cold water immersion, Peripheral circulation, Sympathetic nervous activity, Visual analogue scale, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Nattokinase (NK) intake may improve blood flow; however, its effects on skin temperature, which is predominantly controlled by skin surface blood flow, are unknown. The purpose of this study was to determine the effects of a single dose of NK on changes in skin temperature after cold water immersion. A double-blinded, placebo-controlled, crossover intervention study was performed on nine healthy men. The participants were randomised to receive either a single dose of 2,000 fibrinolytic units (FU) of NK or a placebo with subsequent crossover. Two hours after supplementation, the participants immersed both hands in a water bath maintained at 10 °C for 1 min. Skin temperature, perceived coldness, cardiac output, and sympathetic nervous activity were measured before, during, and after water immersion. Two-way analysis of variance showed a significant effect of treatment interaction on the skin temperature of the middle finger, palm, and back of the right hand (p

Published
2023
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2. Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study

Author

Kazunari Murakami, Shiro Ohno, Kouichi Mashiba, Fumio Otsuka, Masashi Yamanouchi, Akira Ukimura, Noriko Nara, Keito Torikai, Kenichiro Akazawa, Fujiko Mitsumoto, Hiroyuki Morita, Shoichi Senda, Susumu Tazuma, Jun Hayashi, Koji Yamamoto, Yoshio Ohyama, Nobuhiko Mishima, Kenji Kanazawa, Masafumi Mizooka, and Toshio Naito

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Epidemiology, Research, INTERNAL MEDICINE, Familial Mediterranean fever, Retrospective cohort study, General Medicine, Disease, medicine.disease, Procalcitonin, Polymyalgia rheumatica, Medicine, Fever of unknown origin, Differential diagnosis, business
Abstract

Objective Fever of unknown origin (FUO) can be caused by many diseases, and varies depending on region and time period. Research on FUO in Japan has been limited to single medical institution or region, and no nationwide study has been conducted. We identified diseases that should be considered and useful diagnostic testing in patients with FUO. Design A nationwide retrospective study. Setting 17 hospitals affiliated with the Japanese Society of Hospital General Medicine. Participants This study included patients ≥18 years diagnosed with ‘classical fever of unknown origin’ (axillary temperature ≥38°C at least twice over a ≥3-week period without elucidation of a cause at three outpatient visits or during 3 days of hospitalisation) between January and December 2011. Results A total of 121 patients with FUO were enrolled. The median age was 59 years (range 19–94 years). Causative diseases were infectious disease in 28 patients (23.1%), non-infectious inflammatory disease in 37 (30.6%), malignancy in 13 (10.7%), other in 15 (12.4%) and unknown in 28 (23.1%). The median interval from fever onset to evaluation at each hospital was 28 days. The longest time required for diagnosis involved a case of familial Mediterranean fever. Tests performed included blood cultures in 86.8%, serum procalcitonin in 43.8% and positron emission tomography in 29.8% of patients. Conclusions With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO.

Published
2013

3. Abstracts

Author

Cristina Hurtado, John Bradley, Andrew R. Burns, Keyvan Karkouti, Rob Anderson, Simon D. Abrahamson, C. David Mazer, O. R. Hung, L. Comeau, Joseph A. Fisher, Janet Tessler, Joshua Rucker, Alix Mathicu, Sara Murray-Foster, Chou Tz-Chong, Li Chi-Yuan, Takako Tsuda, Akihiko Tabuchi, Hiroshi Sasano, Masanobu Kiriyama, Akinori Okada, Junichiro Hayano, Akinori Takeuchi, Hirotada Katsuya, Claude P. Tousignant, Elizabeth Ling, Ramiro Arellano, N. Dowd, J. Karski, D. Cheng, J. Carroll-Munro, D. K. Rose, C. O. Mazer, M. M. Cohen, D. Wigglesworth, William P. S. McKay, Robert J. Teskey, Julio Militzer, Guy Kember, Travis Blanchet, Peter H. Gregson, Steven R. Howells, James A. Robblee, Terrance W. Breen, Laura Dierenfield, Tacie McNeil, Donna J. Nicholson, Stephen E. Kowalski, G. Andrew Hamilton, Michael P. Meyers, Carl Serrette, Peter C. Duke, Ingrid Custeau, Rend Martin, Sonia Larabée, Martine Pirlet, Madeleine Pilote, Jean-Pierre Tetrault, Ban C. H. Tsui, Sunil Gupta, Brendan Finucane, Mitchell J. Weisbrod, Vincent W. S. Chan, Z. Kaszas, C. Dragomir, M. R. Cohen, M. Gandhi, A. S. Clanachan, B. A. Finegan, Lisa Isaac, William M. Splinter, L. A. Hall, H. M. Gould, E. J. Rhine, Lyne Bergeron, Michel Girard, Pierre Drolet, Hong Hanh Le Truong, Carl Boucher, Daniel Vézina, Martin R. Lessard, Marie Gourdeau, Claude A. Trépanier, Theresa Yang, Alison Macarthur, P. Chouinard, F. Fugère, M. Ruel, Pekka Tarkkila, Marja Silvasti, Marjatta Tuominen, Nils Svartling, Per H. Rosenberg, David M. Bond, John F. Rudan, Michael A. Adams, Brian K. Tsang, Wanda Keahey, Lucia Gagliese, Marla Jackson, Paul Ritvo, Adarose Wowk, Alan N. Sandler, Joel Katz, J. G. Laffey, J. F. Boylan, Neal H. Badner, Wendy E. Komar, R. A. Cherry, S. M. Spadafora, R. J. Butler, Fiona McHardy, Joanne Fortier, Frances Chung, Scott Marshall, Ananthan Krishnathas, Jean Wong, Ewan Ritchie, Andrew Meikle, Nicole Avery, Janet van Vlymen, Joel L. Parlow, David Sinclair, Gabor Mezei, Fengling Jin, Andrew Norris, Tharini Ganeshram, Bernard A. MacLeod, Aliréza Azmudéh, Luigi G. Franciosi, Craig R. Ries, Stephan K. W. Schwarz, William PS McKay, Benjamin W. S. McKay, Pascal Meuret, Vincent Bonhomme, Gilles Plourde, Pierre Fiset, Stevens B. Backman, Alex Vesely, Leeor Sommer, Joel Greenwald, Elana Lavine, Steve Iscoe, George Volgyesi, Ludwik Fedorko, Joseph Fisher, Emilio B. Lobato, Cheri A. Sulek, Laurie K. Davies, Peter F. Gearen, François Bellemare, François Donati, Jacques Couture, Hwan S. Joo, Sunil Kapoor, Shahriar Shayan, Kenneth M. LeDez, Jim Au, John H. Tucker, Edwin B. Redmond, V. Gadag, Catherine Penney, Gregory M. T. Hare, Timothy D. G. Lee, Gregory M. Hirsch, Fan Yang, Eric Troncy, Gilbert Blaise, Yoshiyuki Naito, Shoji Arisawa, Masahiro Ide, Susumu Nakano, Kazuo Yamazaki, Takae Kawamura, Noriko Nara, Reiji Wakusawa, Katsuya Inada, Robert J. Hudson, Karanbir Singh, Gary A. Harding, Blair T. Henderson, Ian R. Thomson, Christopher G. Wherrett, Donald R. Miller, Alan A. Giachino, Michelle A. Turek, Kelly Rody, H. Vaghadia, V. Chan, S. Ganapathy, A. Lui, J. McKenna, K. Zimmer, William D. Regan, Ross G. Davidson, Krista Nevin, Sergio Escobedo, E. Mitmaker, M. J. Tessler, K. Kardash, S. J. Kleiman, M. Rossignol, L. Kahn, F. Baxter, A. Dauphin, C. Goldsmith, P. Jackson, J. McChesney, J. Miller, L. Takeuchi, E. Young, Kristine Klubien, Edith Bandi, Franco Carli, Kathleen Dattilo, Doris Tong, Mohit Bhandari, Louise Mazza, Linda Wykes, L. Z. Sommer, J. Rucker, A. Veseley, E. Levene, Y. Greenwald, G. Volgyesi, L. Fedorko, S. Iscoe, J. A. Fisher, Guo-Feng Tian, Andrew J. Baker, F. X. Reinders, A. J. Baker, R. J. Moulton, J. I. M. Brown, L. Schlichter, Laurence Van Tulder, Stéphane Carignan, Julie Prénovault, Jean-Paul Collet, Stan Shapiro, Jean-Gilles Guimond, Louis Blait, Thierry Ducruet, Martin Francœur, Marc Charbonneau, Guy Cousineau, Daniel R. Wong, Michele McCall, Fergus Walsh, Regina Kurian, Mary Keith, Michael J. Sole, Kursheed N. Jeejeebhoy, E. Whitten, P. H. Norman, J. A. Aucar, L. A. Coveler, Rodney M. Solgonick, Y. Bastien, Bruce Mazer, Koji Lihara, Beverley A. Orser, Michael Tymianski, Brendan T. Finucane, Nuzhat Zaman, Ibrahim Kashkari, Soheir Tawfik, Yun K. Tarn, Peter D. Slinger, Karen McRae, Timothy Winton, Alan N. Sandier, J. E. Zamora, Mary Jane Salpeter, Donglin Bai, John F. MacDonald, Kelly Mayson, Ed Gofton, Keith Chambers, Susan E. Belo, J. Colin Kay, Sean R. R. Hall, Louie Wang, Brian Milne, Chris Loomis, Zhi He, Wichai Wougchanapai, Ing K. Ho, John H. Eichhorn, Tangeng Ma, Wichai Wongchanapai, John H. Eicnhorn, Damian B. Murphy, M. B. Murphy, Steven B. Backman, Reuben D. Stein, Brian Collier, Canio Polosa, Chi-Yuan Li, Tz-Chong Chou, Jia-Yi Wang, John Fuller, Ronald Butler, Salvatore Spadafora, Neil Donen, Laurence Brownell, Sandy Shysh, Keith Carter, Chris Eagle, Isabella Devito, Stephen Halpern, J. Hugh Devitt, Doreen A. Yee, John L. deLacy, Donald C. Oxorn, Gary F. Morris, Raymond W. Yip, M. G. Gregoret-Quinn, R. F. Seal, LJ. Smith, A. B. Jones, C. Tang, B. J. Gallant, L. A. Nadwidny, Gerald V. Goresky, Tara Cowtan, Hilary S. Bridge, Carolyne J. Montgomery, Ross A. Kennedy, Pamela M. Merrick, M. Yamashita, K. Wada, Sylvie LeMay, Jean-François Hardy, Pamela Morgan, Steven Halpern, Jana Evers, P. Ronaldson, F. Dexter, Desmond Writer, Holly Muir, Romesh Shukla, Rob Nunn, John Scovil, Jeremy Pridham, Ola Rosaeg, Allan Sandier, Patricia Morley-Foster, Simon Lucy, Lesley-Ann Crone, Karen Zimmer, Deborah J. Wilson, Robert Heid, M. Joanne Douglas, Dan W. Rurak, Anna Fabrizi, Chantal T. Crochetière, Louise Roy, Edith Villeneuve, Louise Lortie, Sandra Katsiris, Barbara Leighton, Donna Wilson, Jean Kronberg, Leszek Swica, Janet Midgley, Robert Nunn, Bruce Smith, Michael E. Rooney, David C. Campbell, Celina M. Riben, Ray W. Yip, Jo MacDonell, and Tracey Levine

Subjects
Sevoflurane, Anesthesiology and Pain Medicine, Morphine, Total Knee Arthroplasty, Pulmonary Capillary Wedge Pressure, Ropivacaine, General Medicine, Article
Published
1998

4. Differential Regulation of Plasma Copeptin Levels in Patients with Heart Failure: A Single-Center Prospective Study.

Author

Natsuko Iwashita, Noriko Nara, Ryosuke Sato, Tomoyori Nakatogawa, Shunichi Kobayashi, Sayuri Zama, Mitsuo Mita, Shigeru Hishinuma, and Masaru Shoji

Abstract

Elevated levels of arginine vasopressin (AVP) have been reported to be involved in the pathogenesis of heart failure (HF). Recent evidence has shown the role of copeptin, the C-terminal fragment of pro-AVP, as a biomarker in patients with HF. However, the relevant information is still limited. Therefore, we evaluated 39 Japanese patients admitted for HF between 2013 and 2015 (23 males and 16 females with an average age of 79.2 years). They were treated according to the Japanese acute HF guideline. Plasma copeptin levels were measured on admission and about 1 week later. The median plasma copeptin levels on admission were 0.5 (0.1-50.6) pmol/L, higher than the normal values (0.24 ± 0.06 pmol/L). Despite the similar clinical severity on admission, the patients showed great variability in plasma copeptin levels. They were divided into three groups (13 patients/group) according to plasma copeptin levels on admission: highest (> 30.8 pmol/L), midrange, and lowest (< 0.2 pmol/L) groups. Initial treatment improved HF symptoms in 37 of 39 patients, with the two unresponsive patients in the lowest group. Notably, plasma copeptin responses to initial treatment were different, depending on admission copeptin levels. The initial treatment significantly decreased copeptin levels in the highest group, but increased copeptin levels in the lowest group. By contrast, patients in the midrange group showed no significant changes. Thus, the treatment appears to restore the plasma copeptin levels. In conclusion, HF is a complex syndrome with the differential integration of stimulatory and inhibitory inputs to the AVP/copeptin secretory system. [ABSTRACT FROM AUTHOR]

Published
2016
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5. Diagnostic workup for fever of unknown origin: a multicenter collaborative retrospective study.

Author

Toshio Naito, Masafumi Mizooka, Fujiko Mitsumoto, Kenji Kanazawa, Keito Torikai, Shiro Ohno, Hiroyuki Morita, Akira Ukimura, Nobuhiko Mishima, Fumio Otsuka, Yoshio Ohyama, Noriko Nara, Kazunari Murakami, Kouichi Mashiba, Kenichiro Akazawa, Koji Yamamoto, Shoichi Senda, Masashi Yamanouchi, Susumu Tazuma, and Jun Hayashi

Abstract

Objective: Fever of unknown origin (FUO) can be caused by many diseases, and varies depending on region and time period. Research on FUO in Japan has been limited to single medical institution or region, and no nationwide study has been conducted. We identified diseases that should be considered and useful diagnostic testing in patients with FUO. Design: A nationwide retrospective study. Setting: 17 hospitals affiliated with the Japanese Society of Hospital General Medicine. Participants: This study included patients =18 years diagnosed with 'classical fever of unknown origin' (axillary temperature ≥38°C at least twice over a ≥3-week period without elucidation of a cause at three outpatient visits or during 3 days of hospitalisation) between January and December 2011. Results: A total of 121 patients with FUO were enrolled. The median age was 59 years (range 19-94 years). Causative diseases were infectious disease in 28 patients (23.1%), non-infectious inflammatory disease in 37 (30.6%), malignancy in 13 (10.7%), other in 15 (12.4%) and unknown in 28 (23.1%). The median interval from fever onset to evaluation at each hospital was 28 days. The longest time required for diagnosis involved a case of familial Mediterranean fever. Tests performed included blood cultures in 86.8%, serum procalcitonin in 43.8% and positron emission tomography in 29.8% of patients. Conclusions: With the widespread use of CT, FUO due to deep-seated abscess or solid tumour is decreasing markedly. Owing to the influence of the ageing population, polymyalgia rheumatica was the most frequent cause (9 patients). Four patients had FUO associated with HIV/AIDS, an important cause of FUO in Japan. In a relatively small number of cases, cause remained unclear. This may have been due to bias inherent in a retrospective study. This study identified diseases that should be considered in the differential diagnosis of FUO. [ABSTRACT FROM AUTHOR]

Published
2013
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