高齢夜間頻尿患者における夜間尿産生に対する閉塞性睡眠時無呼吸症候群の影響

OBJECTIVE: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on night-time secretion of brain natriuretic peptide (BNP) and antidiuretic hormone (ADH) in older men with nocturia accompanied by nocturnal polyuria. MATERIALS AND METHODS: One hundred six men with nocturia aged ≥ 60 years underwent full-night polysomnography to determine whether they had OSAS. Blood count, standard chemistry panel, BNP, urinary ADH, urinary creatinine (u-Cre), and urinary osmolarity were measured at 6:00 AM, and a frequency volume chart was recorded on the same day that polysomnography was performed. RESULTS: We evaluated 83 patients after excluding 18 with mild OSAS and 5 with nocturnal polyuria index <0.35. Participants with OSAS had higher apnea-hypopnea index (P < .0001) than those without OSAS. Body mass index and systolic blood pressure were higher in OSAS patients than those in the control group. BNP was higher in the OSAS patients than in the control patients (48.6 ± 41.4 vs 30.7 ± 31.5; P = .0006). On urinalysis, OSAS patients showed higher urinary sodium and u-Cre secretion than controls (24.7 ± 11.3 vs 16.2 ± 5.1; P <.0001). Urine osmolarity was also higher in OSAS patients than in the control patients (616 ± 172 vs 516 ± 174; P = .0285). There was no significant difference in urinary ADH and u-Cre (6.7 ± 10.4 vs 6.8 ± 7.8; P = .3617) between the 2 groups. CONCLUSION: Our results indicated that older men with nocturnal polyuria and OSAS did not compensate their fluid imbalance presented with decreased secretion of ADH but increased BNP level.博士（医学）・乙第1349号・平成26年12月3日Copyright © 2014 Elsevier Inc. All rights reserved

Ab initio\textit{Ab initio} Materials Design of Superconductivity in d9d^9 Nickelates

Motivated by the recent theoretical materials design of superconducting $d^9$ nickelates for which the charge transfer from the NiO$_2$ to the block layer is completely suppressed [M. Hirayama $\textit{et al.}$, Phys. Rev. B $\textbf{101}$, 075107 (2020)], we perform a calculation based on the dynamical vertex approximation and obtain the phase diagram of RbCa$_2$NiO$_3$ and $A_2$NiO$_2$Br$_2$ where $A$ is a cation with a valence of 2.5+. We show that the phase diagram of these nickelates exhibits the same essential features as those found in cuprates. Namely, superconductivity appears upon hole-doping into an antiferromagnetic Mott insulator, and the superconducting transition temperature shows a dome-like shape. This demonstrates that the electron correlations play an essential role in nickelate superconductors and we can control them by changing block layers.Comment: 7 pages, 6 figure

Recovery of flow-mediated vasodilatation after repetitive measurements is involved in early vascular impairment: comparison with indices of vascular tone.

In repetitive measurements of flow-mediated dilatation (FMD), the duration of the interval between measurements remains controversial. In this pilot study, we conducted three sequential measurements of low-flow-mediated constriction (L-FMC), FMD and flow-mediated total dilation (FMTD; L-FMC+ FMD) at baseline and intervals of 15 and 60 min in 30 healthy males. FMD15, L-FMC15, and FMTD15 were significantly lower than the respective first measurements, but all indices showed full recovery at 60 min in all subjects. The baseline diameter was slightly increased at 15 min and restored at 60 min, but the maximum diameter, and the baseline and reactive flow velocity unchanged. We examined the relationship between recovery rate of FMTD at 15 min (FMTD-R) and cardio-ankle vascular index (CAVI). Univariate analysis showed moderate correlation between FMTD-R, and CAVI and L-FMC0. Patients were divided according to FMTD-R value; the low-FMTD-R group [below the median value (-26.2%)] included a significantly higher proportion of smokers and higher CAVI values than the high-FMTD-R group. The reproducibility of FMTD and FMTD-R was evaluated in another group of 25 healthy subjects. The range of variation across measurements was 1.1% for FMTD and 4.6% for FMTD-R; with intraclass correlation coefficients of 0.93 and 0.95, respectively. The present study demonstrated blunted recovery of FMD within 15 min, suggesting the need for selection of a more adequate interval between measurements to avoid underestimation of FMD in subsequent measurements. The findings demonstrated the reproducibility of FMTD-R and FMTD measurements, and that FMTD-R might be involved in arterial stiffness and early vascular impairment in the healthy subjects

Brachial artery characteristics.

<p>Values are mean ± SD.</p><p>p<0.01, compared with the respective baseline measurement.</p

Correlation between FMTD-R and other FMD-related indices.

<p>Although a significant correlation between FMTD-R and L-FMC was confirmed (A), no relationship was found between FMTD-R and FMD (B) or FMTD (C). Notably, FMTD-R correlated significantly with CAVI (D).</p

Values of FMD-related indices and CAVI in the healthy subjects divided into the poor and good recovery groups based on the median FMTD-R value (-26.2%).

<p>No significant difference was observed in FMD (A), FMTD (B), and L-FMC (C) values between the two groups. CAVI values were significantly higher in the poor recovery group.</p

Clinical characteristics of the patient population divided according to FMTD-R.

<p>Values are mean ± SD or percentage of patients.</p><p>*p<0.004, compared with the good FMTD-R group (Fisher's exact probability test).</p

FMTD and FMTD-R measurements in consecutive FMD procedures in healthy volunteers.

<p>Correlation analysis for FMTD (A) and FMTD-R (B) (p<0.01, respectively.). Bland-Altman Plots for FMTD (C) and FMTD-R (D). The dotted lines represent 1.96 ± SD.</p