[Measurement of Nicotine, Tobacco-Specific Nitrosamines, and Additives in the Filler and Gas from Japanese Brand Snuff].

OBJECTIVE: The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) reported that understanding the use and impact of smokeless tobacco (SLT) products is complicated by product diversity. Many different SLT products with different characteristics are used worldwide. ZERO STYLE STIX(TM) (sold by Japan Tobacco Inc.) is a brand of snuff, a type of smokeless tobacco. Our objective was to determine the constituents of the gas from SLT and analyze the ingredients in tobacco fillers. METHODS: ZERO STYLE STIX smokeless tobacco was released in the Japanese market in 2010. Nicotine, menthol, and tobacco-specific nitrosamines in the smokeless tobacco fillers were determined by gas chromatography-mass spectrometry (GC/MS) and liquid chromatography-tandem mass spectrometry (LC/MS/MS). The gaseous compounds were collected by a smoking machine using two smoking protocols, i.e., the ISO and Health Canada Intense methods. Nicotine and menthol in the gas were determined by GC/MS. RESULTS: Nicotine, menthol, and the total tobacco-specific nitrosamines were detected in the tobacco fillers. The level of menthol in the snuff was more than ten times that of nicotine. The determined levels of the two components of the gas from the snuff were higher when using the Health Canada Intense protocol than when using the ISO protocol. In addition, flavors other than menthol were emitted from the smokeless tobacco. CONCLUSION: The new type of snuff introduced in the Japanese market in 2010 contained added flavors, and was attractive smokeless tobacco. Flavors in tobacco products need to regulate on the basis of FCTC 9 and 10 in JAPAN.

Maximum ventricular dyssynchrony predicts clinical improvement and reverse remodeling during cardiac resynchronization therapy.

BACKGROUND: Tissue synchronization imaging (TSI) and tissue tracking imaging (TTI) might facilitate the evaluation of ventricular dyssynchrony. METHODS: In 22 patients, TSI and TTI were performed before and < 1 month after onset of cardiac resynchronization therapy (CRT). With TSI guidance, maximum left ventricular (LV) intraventricular conduction delay (IVCDmax) was the greatest difference in time-to-peak velocity between septum and lateral wall. IVCD between the basal septum and lateral wall (IVCDbase) was also measured. Using TTI, the mean peak myocardial displacement of the basal septal and lateral walls (PMDbase), and the temporal coefficient of variation of the PMD in six LV regions (CV-PMDLV) were measured. The patients were divided into responders (whose LV end-systolic volume decreased by >/= 15% during a 27 +/- 9 months follow-up) and nonresponders. RESULTS: Before CRT, IVCDbase was similar in both groups, and remained unchanged within the 1st month of CRT in both groups. However, before CRT, IVCDmax was greater in responders than in nonresponders (P < 0.05), and decreased only in the responders during CRT (P < 0.05). No significant difference was observed in PMDbase or CV-PMDLV between the two groups, before or during CRT. CONCLUSIONS: TSI was useful to measure IVCDmax. A greater IVCDmax before CRT that decreased shortly after onset of CRT may predict long-term clinical improvement in CRT recipients.