SIADH induced by pneumonia in a patient with Shy-Drager syndrome

Patients with Shy-Drager syndrome have impaired baroreceptor-mediated vasopressin release when inan upright position. We report a case of Shy-Drager syndrome in which the syndrome of inappropriate secretionof antidiuretic hormone (SIADH) developed with pneumonia. It has been speculated that pneumonia-induced SIADH is caused by baroreceptor-mediated vasopressin release. Our case presents the possibilitythat pneumonia-induced SIADH is caused by non-baroreceptor-mediated ADH release

A case in which water intoxication due to excessive water ingestion did not inhibit the secretion of arginine vasopressin

We experienced a case of water intoxication due to excessive water ingestion that was complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 60-year-old Japanese woman with nervous depression drank too much lemon tea within several hours, vomited ten times, and developed disturbed consciousness and dysarthria. Her plasma arginine vasopressin (AVP) concentration was not inhibited,although her plasma osmolality was low. Nausea and/or stress may stimulate AVP secretion regardless of the hypo-osmolality. We believe that dilatation of her stomach due to excessive liquid ingestion and cerebral edema due to hypo-osmolality brought on her nausea. Stress induced by a psychiatric problem and/or admission to a hospital may also stimulate AVP secretion by the central nervous system. Treatingnausea and stress may help reduce AVP secretion and resolve hyponatremia

テイNa ケッショウ ノ ビョウタイ セイリ

日常診療において低Na 血症は最も頻回に遭遇する電解質異常である.その治療には,ヒトの体液恒常性維持のメカニズムと,低Na 血症となる病態の正確な理解が必要不可欠である.本稿では低Na 血症の概説と,その代表的疾患であるSIADH について詳しく述べる.最新の知見を紹介しながらSIADH の鑑別診断にも触れる.Hyponatremia is a most common electrolyte abnormalityin routine practice. It is extremely necessary to understandboth the mechanism of maintaining fluid homeostasis of humanbody and the true pathophysiology of hyponatremia. Ifyou meet a male patient who needs fluid management, youmust choose appropriate fuild content or he might causeiatrogenic hyponatremia, even though he is not a patientwith hyponatremia. We tried to summarize hyponatremiaand SIADH as a review in this manuscript

Solvent Extraction of Ruthenium from Hydrochloric Acid Solutions with Primary Amines

Ru(III) chlorocomplexes are poorly extracted into organic solvents, which is due to the charge of the complex as well as those inert character in chloride solutions, that is, formation of RuCl6-n(H2O)n(3-n)- (n=0-6). Therefore, it is difficult to extract Ru(III) by solvent extraction, and Ru(III) is currently separated and purified by the oxidative distillation method. If Ru can be separated and recovered from chloride solutions by solvent extraction, an efficient separation and recovery process for PGMs can be established. Therefore, it is important to investigate the solvent extraction of Ru(III) from chloride solutions. The authors have previously studied solvent extraction of Ru(III) with 2-ethylhexylamine (EHA), which is a primary amine extractant, from chloride solutions and shown that the extraction of Ru(III) with EHA from chloride solutions without the addition of Sn (II)was high. However, the stripping of Ru(III) was difficult. In the present study, extractions of Ru from hydrochloric acid solutions with EHA and octylamine (OA), which are primary amines, were tested to clarify the extraction of Ru and the stripping of Ru with various stripping solutions. The extraction efficiency of Ru with EHA and OA from hydrochloric acid solutions without the addition of Sn (II) was high. And also, it was found that Ru could be easily stripped from EHA with sodium sulfate solutions

Implementation and costs of housing adaptations among older adults with different functional limitations in Japan

BackgroundAccessible housing is crucial to maintain a good quality of life for older adults with functional limitations, and housing adaptations are instrumental in resolving accessibility problems. It is unclear to what extent older adults, who have a high risk of further functional decline, use housing adaptation grants acquired through the long-term care (LTC) insurance systems. This study aimed to examine the utilization of housing adaptation grants in terms of implementation and costs, for older adults with different types of functional limitations related to accessibility problems.MethodsThe study sample included individuals from a suburban city in the Tokyo metropolitan area who were certified for care support levels (indicative of the need for preventive care) for the first time between 2010 and 2018 (N = 10,372). We followed the study participants over 12 months since the care needs certification. We matched and utilized three datasets containing the same individual’s data: 1) care needs certification for LTC insurance, 2) insurance premium levels, and 3) LTC insurance claims. We conducted a multivariable logistic regression analysis to estimate the likelihood of individuals with different functional limitations of having housing adaptations implemented. Afterward, we conducted a subgroup analysis of only older adults implementing housing adaptation grants to compare costs between groups with different functional limitations using the Mann–Whitney U and Kruskal–Wallis tests.ResultsHousing adaptations were implemented among 15.6% (n = 1,622) of the study sample, and the median cost per individual was 1,287 USD. Individuals with lower extremity impairment or poor balance were more likely to implement housing adaptations (adjusted odds ratio (AOR) = 1.290 to AOR = 2.176), while those with visual impairment or lower cognitive function were less likely to implement housing adaptations (AOR = 0.553 to AOR = 0.861). Costs were significantly lower for individuals with visual impairment (1,180 USD) compared to others (1,300 USD).ConclusionOlder adults with visual or cognitive limitations may not receive appropriate housing adaptations, despite their high risk of accessibility problems. Housing adaptation grants should include various types of services that meet the needs of older people with different disabilities, and the results indicate there may be a need to improve the system