start-ver=1.4 cd-journal=joma no-vol=135 cd-vols= no-issue=13 article-no= start-page=e172988 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250513 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=LAG3 regulates antibody responses in a murine model of kidney transplantation en-subtitle= kn-subtitle= en-abstract= kn-abstract=Lymphocyte activation gene 3 (LAG3) is a coinhibitory receptor expressed by various immune cells. Although the immunomodulatory potential of LAG3 is being explored in cancer and autoimmunity, there is no information on its role after organ transplantation. Our study investigated the functions of LAG3 in a mouse model of renal allograft rejection. LAG3?/? recipients rapidly rejected MHC-mismatched renal allografts that were spontaneously accepted by WT recipients, with graft histology characteristic of antibody-mediated rejection. Depletion of recipient B cells but not CD8+ T cells significantly extended kidney allograft survival in LAG3?/? recipients. Treatment of WT recipients with an antagonistic LAG3 antibody enhanced anti-donor immune responses and induced kidney damage associated with chronic rejection. The studies of conditional LAG3?/? recipients and mixed bone marrow chimeras demonstrated that LAG3 expression on either T or B cells is sufficient to regulate anti-donor humoral immunity but not to induce acute allograft rejection. The numbers and proinflammatory functions of graft-infiltrating NK cells were markedly increased in LAG3?/? recipients, suggesting that LAG3 also regulates the effector stage of antibody-mediated rejection. These findings identified LAG3 as a regulator of immune responses to kidney allografts and a potential therapeutic target for antibody-mediated rejection prevention and treatment. en-copyright= kn-copyright= en-aut-name=NicosiaMichael en-aut-sei=Nicosia en-aut-mei=Michael kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=FanRan en-aut-sei=Fan en-aut-mei=Ran kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=LeeJuyeun en-aut-sei=Lee en-aut-mei=Juyeun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AllGabriella en-aut-sei=All en-aut-mei=Gabriella kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=GorbachevaVictoria en-aut-sei=Gorbacheva en-aut-mei=Victoria kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ValenzuelaJos? I. en-aut-sei=Valenzuela en-aut-mei=Jos? I. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamamotoYosuke en-aut-sei=Yamamoto en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=BeaversAshley en-aut-sei=Beavers en-aut-mei=Ashley kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=DvorinaNina en-aut-sei=Dvorina en-aut-mei=Nina kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=BaldwinWilliam M. en-aut-sei=Baldwin en-aut-mei=William M. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ChuluyanEduardo en-aut-sei=Chuluyan en-aut-mei=Eduardo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=GaudetteBrian T. en-aut-sei=Gaudette en-aut-mei=Brian T. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=FairchildRobert L. en-aut-sei=Fairchild en-aut-mei=Robert L. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=MinBooki en-aut-sei=Min en-aut-mei=Booki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=ValujskikhAnna en-aut-sei=Valujskikh en-aut-mei=Anna kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=2 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=3 en-affil=Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=4 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=5 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=6 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=7 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=8 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=9 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=10 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=11 en-affil=Universidad de Buenos Aires, Consejo Nacional de Investigaciones Cient?ficas y T?cnicas, Centro de Estudios Farmacol?gicos y Bot?nicos (CEFYBO), Facultad de Medicina kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=14 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=15 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= affil-num=16 en-affil=Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic kn-affil= END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=6 article-no= start-page=1711 end-page=1720 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dotinurad Treatment for Patients With Hyperuricemia Complicating CKD en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: The management of hyperuricemia is important to reduce cardiovascular risk and the progression of renal injury in chronic kidney disease (CKD). This study aimed to assess the efficacy and safety of dotinurad, a novel urate transporter-1 inhibitor, in patients with hyperuricemia and CKD.
Methods: In a nonrandomized, parallel interventional study, patients were grouped based on their estimated glomerular filtration rate (eGFR) at baseline. The starting dotinurad dose was 0.5 mg/d and titrated to a final dose of 2 mg/d to 4 mg/d. The primary end point was the noninferiority of the change in serum uric acid (UA) levels between the G1/G2 and G3/G4 groups at week 24. The main secondary end points were changes in eGFR and UA clearance-to-creatinine clearance ratio (CUA/CCr). Reported adverse events were also investigated.
Results: Ninety-eight patients continued the dose titration. The mean percentage reduction in serum UA level at week 24 were 47.2% and 42.8% for the G1/G2 and G3/G4 groups, respectively; the between-group difference was ?4.3% (95% confidence interval [CI], ?9.5% to 0.9%, noninferiority P = 0.0321), validating the noninferiority of treatment in the G3/G4 group to the G1/G2 group. eGFR tended to increase slightly through to week 24, suggesting that spontaneous eGFR decline was counteracted. Mean CUA/CCr generally increased over time from week 4 to week 24. No new safety issues of particular concern were identified; and there were no marked changes in urinary pH.
Conclusion: Dotinurad therapy may be well-tolerated in patients with hyperuricemia and may have efficacy comparable with existing standard treatment in patients with CKD stages G3/G4. Randomized controlled trials in larger patient groups are needed. en-copyright= kn-copyright= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ItabashiNaoki en-aut-sei=Itabashi en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KatayamaAkihiro en-aut-sei=Katayama en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakamuraAkihiko en-aut-sei=Nakamura en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OhbayashiHiroyuki en-aut-sei=Ohbayashi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WatanabeKyoko en-aut-sei=Watanabe en-aut-mei=Kyoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MaruyamaKeisuke en-aut-sei=Maruyama en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HosoyaTakeshi en-aut-sei=Hosoya en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OkadaShinichi en-aut-sei=Okada en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Nunoue Clinic kn-affil= affil-num=3 en-affil=Itabashi Diabetes and Dermatology Medical Clinic kn-affil= affil-num=4 en-affil=NHO Okayama Medical Center kn-affil= affil-num=5 en-affil=Osafune Clinic kn-affil= affil-num=6 en-affil=Tohno Chuo Clinic kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Japanese Red Cross Okayama Hospital kn-affil= affil-num=9 en-affil=Okayama Saiseikai Outpatient Center Hospital kn-affil= affil-num=10 en-affil=Hosoya Clinic kn-affil= affil-num=11 en-affil=Okada Medical Clinic kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=dotinurad kn-keyword=dotinurad en-keyword=efficacy kn-keyword=efficacy en-keyword=hyperuricemia kn-keyword=hyperuricemia en-keyword=safety kn-keyword=safety en-keyword=serum uric acid kn-keyword=serum uric acid END start-ver=1.4 cd-journal=joma no-vol=79 cd-vols= no-issue=3 article-no= start-page=147 end-page=155 dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=202506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Immunometabolic Regulation of Innate Immunity in Systemic Lupus Erythematosus en-subtitle= kn-subtitle= en-abstract= kn-abstract=Pathogens or their components can induce long-lasting changes in the behavior of innate immune cells, a process analogous to “training” for future threats or environmental adaptation. However, such training can sometimes have unintended consequences, such as the development of autoimmunity. Systemic lupus erythematosus (SLE) is a chronic and heterogeneous autoimmune disease characterized by the production of autoantibodies and progressive organ damage. Innate immunity plays a central role in its pathogenesis, contributing through impaired clearance of apoptotic cells, excessive type I interferon production, and dysregulated formation of neutrophil extracellular traps. Recent studies have revealed that metabolites and nucleic acids derived from mitochondria, a crucial energy production site, directly regulate type I interferon and anti-inflammatory cytokine production. These insights have fueled interest in targeting metabolic pathways as a novel therapeutic approach for SLE, offering promise for improving long-term patient outcomes. en-copyright= kn-copyright= en-aut-name=WatanabeHaruki en-aut-sei=Watanabe en-aut-mei=Haruki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsumotoYoshinori en-aut-sei=Matsumoto en-aut-mei=Yoshinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=systemic lupus erythematosus kn-keyword=systemic lupus erythematosus en-keyword=interferon kn-keyword=interferon en-keyword=tricarboxylic acid cycle kn-keyword=tricarboxylic acid cycle en-keyword=innate immune memory kn-keyword=innate immune memory en-keyword=trained immunity kn-keyword=trained immunity END start-ver=1.4 cd-journal=joma no-vol=20 cd-vols= no-issue=3 article-no= start-page=e0320482 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250325 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Serum uric acid level is associated with renal arteriolar hyalinosis and predicts post-donation renal function in living kidney donors en-subtitle= kn-subtitle= en-abstract= kn-abstract=Major guidelines for living-donor kidney transplantation underscore the need for pre-donation evaluation of renal function, hypertension, obesity, diabetes mellitus, and albuminuria to minimize the risk of donation from marginal donors. However, validity is yet to be established. We retrospectively investigated the relationship between clinical characteristics and histological indices in baseline renal biopsies (0-h biopsies) and whether these parameters could predict renal function in living kidney donors one year post-donation. Seventy-six living kidney donors were recruited for this study. In histological analyses, glomerulosclerosis, arteriosclerosis, arteriolosclerosis, arteriolar hyalinosis, and interstitial fibrosis and tubular atrophy scores/indices were evaluated. Post-donation serum creatinine levels in kidney donors with arteriolar hyalinosis were significantly higher than those in individuals without arteriolar hyalinosis. There was a significant correlation between baseline serum uric acid levels and the arteriolar hyalinosis index, with baseline uric acid level identified as an independent factor for hyalinosis in multiple regression analysis. Additionally, the serum uric acid level was a significant prognostic factor for post-donation serum creatinine after adjustment for baseline clinical parameters. These data demonstrate that pre-donation serum uric acid levels are associated with arteriolar hyalinosis in the kidney and could predict a decline in renal function during the first year after donation in living kidney donors. en-copyright= kn-copyright= en-aut-name=KanoYuzuki en-aut-sei=Kano en-aut-mei=Yuzuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamanoiTomoaki en-aut-sei=Yamanoi en-aut-mei=Tomoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YoshinagaKasumi en-aut-sei=Yoshinaga en-aut-mei=Kasumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=BekkuKensuke en-aut-sei=Bekku en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Medicine, Kawasaki Medical School General Medical Center and Department of Medical Care Work, Kawasaki College of Health Professions kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=6 article-no= start-page=2485 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250311 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Vesicular Glutamate Transporter 3 Is Involved in Glutamatergic Signalling in Podocytes en-subtitle= kn-subtitle= en-abstract= kn-abstract=Glomerular podocytes act as a part of the filtration barrier in the kidney. The activity of this filter is regulated by ionotropic and metabotropic glutamate receptors. Adjacent podocytes can potentially release glutamate into the intercellular space; however, little is known about how podocytes release glutamate. Here, we demonstrated vesicular glutamate transporter 3 (VGLUT3)-dependent glutamate release from podocytes. Immunofluorescence analysis revealed that rat glomerular podocytes and an immortal mouse podocyte cell line (MPC) express VGLUT1 and VGLUT3. Consistent with this finding, quantitative RT-PCR revealed the expression of VGLUT1 and VGLUT3 mRNA in undifferentiated and differentiated MPCs. In addition, the exocytotic proteins vesicle-associated membrane protein 2, synapsin 1, and synaptophysin 1 were present in punctate patterns and colocalized with VGLUT3 in MPCs. Interestingly, approximately 30% of VGLUT3 colocalized with VGLUT1. By immunoelectron microscopy, VGLUT3 was often observed around clear vesicle-like structures in differentiated MPCs. Differentiated MPCs released glutamate following depolarization with high potassium levels and after stimulation with the muscarinic agonist pilocarpine. The depletion of VGLUT3 in MPCs by RNA interference reduced depolarization-dependent glutamate release. These results strongly suggest that VGLUT3 is involved in glutamatergic signalling in podocytes and may be a new drug target for various kidney diseases. en-copyright= kn-copyright= en-aut-name=NishiiNaoko en-aut-sei=Nishii en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawaiTomoko en-aut-sei=Kawai en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YasuokaHiroki en-aut-sei=Yasuoka en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AbeTadashi en-aut-sei=Abe en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TatsumiNanami en-aut-sei=Tatsumi en-aut-mei=Nanami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HaradaYuika en-aut-sei=Harada en-aut-mei=Yuika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MiyajiTakaaki en-aut-sei=Miyaji en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=LiShunai en-aut-sei=Li en-aut-mei=Shunai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TsukanoMoemi en-aut-sei=Tsukano en-aut-mei=Moemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TakeiKohji en-aut-sei=Takei en-aut-mei=Kohji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=YamadaHiroshi en-aut-sei=Yamada en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Cell Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neuroscience, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neuroscience, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Neuroscience, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Genomics and Proteomics, Advanced Science Research Center, Okayama University kn-affil= affil-num=7 en-affil=Department of Genomics and Proteomics, Advanced Science Research Center, Okayama University kn-affil= affil-num=8 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=9 en-affil=Central Research Laboratory, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Neuroscience, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Neuroscience, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=VGLUT3 kn-keyword=VGLUT3 en-keyword=glutamate kn-keyword=glutamate en-keyword=podocyte kn-keyword=podocyte en-keyword=glutamatergic transmission kn-keyword=glutamatergic transmission END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=1 article-no= start-page=21 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241225 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Gut-Kidney Axis in Chronic Kidney Diseases en-subtitle= kn-subtitle= en-abstract= kn-abstract=The gut-kidney axis represents the complex interactions between the gut microbiota and kidney, which significantly impact the progression of chronic kidney disease (CKD) and overall patient health. In CKD patients, imbalances in the gut microbiota promote the production of uremic toxins, such as indoxyl sulfate and p-cresyl sulfate, which impair renal function and contribute to systemic inflammation. Mechanisms like endotoxemia, immune activation and oxidative stress worsen renal damage by activating pro-inflammatory and oxidative pathways. Insights into these mechanisms highlight the impact of gut-derived metabolites, bacterial translocation, and immune response changes on kidney health, suggesting new potential approaches for CKD treatment. Clinical applications, such as dietary interventions, prebiotics, probiotics and fecal microbiota transplantation, are promising in adjusting the gut microbiota to alleviate CKD symptoms and slow disease progression. Current research highlights the clinical relevance of the gut-kidney axis, but further study is essential to clarify these mechanisms' diagnostic biomarkers and optimize therapeutic interventions. This review emphasizes the importance of an integrated approach to CKD management, focusing on the gut microbiota as a therapeutic target to limit kidney injury. en-copyright= kn-copyright= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaNaruhiko en-aut-sei=Uchida en-aut-mei=Naruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NakanohHiroyuki en-aut-sei=Nakanoh en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HaraguchiSoichiro en-aut-sei=Haraguchi en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=gut-kidney axis kn-keyword=gut-kidney axis en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=uremic toxin kn-keyword=uremic toxin en-keyword=dysbiosis kn-keyword=dysbiosis en-keyword=gut microbiota kn-keyword=gut microbiota END start-ver=1.4 cd-journal=joma no-vol=25 cd-vols= no-issue=1 article-no= start-page=39 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2025 dt-pub=20250109 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effectiveness of professional-identity-formation and clinical communication-skills programs on medical students' empathy in the COVID-19 context: comparison between pre-pandemic in-person classes and during-pandemic online classes en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background Enhancing students' empathy is critical in medical school education. The COVID-19 pandemic necessitated a shift from in-person to online classes. However, the effectiveness of online classes for enhancing medical students' empathy has not been investigated sufficiently and the evidence is limited. This study compared the effectiveness of enhancing empathy between pre-pandemic in-person classes and during-pandemic online classes among medical students in Japan using pre-pandemic and during-pandemic data.
Methods This is a retrospective observational study. This study measured students' empathy using the Japanese translation of the Jefferson Scale of Empathy-Student Version (JSE-S) before and after the special programs for professional identity formation and clinical communication among first- and second-year students who matriculated from 2015-2021. This study categorized the matriculation year groups as "pre-pandemic" and "during-pandemic" groups for the first- and second-year students. This study estimated the adjusted mean score differences of the JSE-S and 95% confidence intervals (CIs) from the pre- to post-program between the pre-pandemic and during-pandemic groups in the first and second years using linear regression analysis.
Results This study's participants included 653 first-year students and 562 second-year students. In the first year, the during-pandemic group had a significantly higher mean score difference from the pre- to post-program compared to the pre-pandemic group. The adjusted regression coefficient (95% CI) was 7.6 (5.7 - 9.5), with the pre-pandemic group as the reference. In the second year, there were no significant differences between the two groups.
Conclusions The results suggest that online classes are not inferior to in-person classes or even slightly better in enhancing medical students' empathy, which should be clarified by further studies. This study's findings have important implications for medical education and implementing hybrid class formats to enhance students' empathy. en-copyright= kn-copyright= en-aut-name=KataokaHitomi en-aut-sei=Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokinobuAkiko en-aut-sei=Tokinobu en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=2 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=3 en-affil=Center for Diversity and Inclusion, Okayama University Hospital kn-affil= affil-num=4 en-affil=Division of Kidney, Diabetes and Endocrine Diseases, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=COVID-19 pandemic kn-keyword=COVID-19 pandemic en-keyword=Empathy kn-keyword=Empathy en-keyword=Jefferson Scale of Empathy kn-keyword=Jefferson Scale of Empathy en-keyword=Medical students kn-keyword=Medical students en-keyword=Online class kn-keyword=Online class END start-ver=1.4 cd-journal=joma no-vol=78 cd-vols= no-issue=6 article-no= start-page=429 end-page=437 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202412 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers. en-copyright= kn-copyright= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=BekkuKensuke en-aut-sei=Bekku en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KatayamaSatoshi en-aut-sei=Katayama en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IwataTakehiro en-aut-sei=Iwata en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EdamuraKohei en-aut-sei=Edamura en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KobayashiTomoko en-aut-sei=Kobayashi en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=hypertension kn-keyword=hypertension en-keyword=nephrectomy kn-keyword=nephrectomy en-keyword=proteinuria kn-keyword=proteinuria END start-ver=1.4 cd-journal=joma no-vol=106 cd-vols= no-issue=5 article-no= start-page=972 end-page=984 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202411 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A randomized, open-label, clinical trial examined the effects of canagliflozin on albuminuria and eGFR decline using an individual pre-intervention eGFR slope en-subtitle= kn-subtitle= en-abstract= kn-abstract=Demonstrating drug efficacy in slowing kidney disease progression requires large clinical trials when targeting participants with an early stage of chronic kidney disease (CKD). In this randomized, parallel-group, open-labeled trial (CANPIONE study), we assessed the effect of the sodium-glucose cotransporter 2 (SGLT2) inhibitor canagliflozin using the individual’s change in estimated glomerular filtration rate (eGFR) slope before (pre-intervention slope) and during treatment (chronic slope). We randomly assigned (1:1) participants with type 2 diabetes, urinary albumin-to-creatinine ratio (UACR) of 50 to under 300 mg/g, and an eGFR of at least 45 ml/min/1.73m2 to receive canagliflozin or guideline-recommended treatment except for SGLT2 inhibitors (control). The first and second primary outcomes were the geometric mean percentage change from baseline in UACR and the change in eGFR slope, respectively. Of 98 randomized participants, 96 received at least one study treatment. The least-squares mean change from baseline in log-transformed geometric mean UACR was significantly greater in the canagliflozin group than the control group (between group-difference, ?30.8% (95% confidence interval ?42.6 to ?16.8). The between-group difference (canagliflozin group ? control group) of change in eGFR slope (chronic ? pre-intervention) was 4.4 (1.6 to 7.3) ml/min/1.73 m2 per year, which was more pronounced in participants with faster eGFR decline. In summary, canagliflozin reduced albuminuria and the participant-specific natural course of eGFR decline in participants with type 2 diabetes and microalbuminuria. Thus, the CANPIONE study suggests that the within-individual change in eGFR slope may be a novel approach to determine the kidney protective potential of new therapies in early stages of CKD. en-copyright= kn-copyright= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HeerspinkHiddo J.L. en-aut-sei=Heerspink en-aut-mei=Hiddo J.L. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=de ZeeuwDick en-aut-sei=de Zeeuw en-aut-mei=Dick kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakamotoKota en-aut-sei=Sakamoto en-aut-mei=Kota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshidaMichihiro en-aut-sei=Yoshida en-aut-mei=Michihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ToyodaMasao en-aut-sei=Toyoda en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SuzukiDaisuke en-aut-sei=Suzuki en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HatanakaTakashi en-aut-sei=Hatanaka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakamuraTohru en-aut-sei=Nakamura en-aut-mei=Tohru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KameiShinji en-aut-sei=Kamei en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MuraoSatoshi en-aut-sei=Murao en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HidaKazuyuki en-aut-sei=Hida en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=AndoShinichiro en-aut-sei=Ando en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=AkaiHiroaki en-aut-sei=Akai en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TakahashiYasushi en-aut-sei=Takahashi en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KitadaMunehiro en-aut-sei=Kitada en-aut-mei=Munehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=SuganoHisashi en-aut-sei=Sugano en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=NakamuraAkihiko en-aut-sei=Nakamura en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=SasakiMotofumi en-aut-sei=Sasaki en-aut-mei=Motofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=NakatouTatsuaki en-aut-sei=Nakatou en-aut-mei=Tatsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=FujimotoKei en-aut-sei=Fujimoto en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=KawanamiDaiji en-aut-sei=Kawanami en-aut-mei=Daiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=WadaTakashi en-aut-sei=Wada en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=KuramotoHiromi en-aut-sei=Kuramoto en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=27 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen kn-affil= affil-num=3 en-affil=Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen kn-affil= affil-num=4 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil=Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine kn-affil= affil-num=7 en-affil=Suzuki Diadetes Clinic kn-affil= affil-num=8 en-affil=Department of Diabetes and Endocrinology, National Hospital Organization Fukuyama Medical Center kn-affil= affil-num=9 en-affil=Diabetes Internal Medicine, Sumitomo Besshi Hospital kn-affil= affil-num=10 en-affil=Department of Diabetic Medicine, Kurashiki Central Hospital kn-affil= affil-num=11 en-affil=Department of Diabetes and Endocrinology, Takamatsu Hospital kn-affil= affil-num=12 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=13 en-affil=Department of Internal Medicine Diabetic Center, Okayama City Hospital kn-affil= affil-num=14 en-affil=Division of Diabetes and Metabolism, Faculty of Medicine, Tohoku Medical and Pharmaceutical University kn-affil= affil-num=15 en-affil=Department of Diabetes, Ochiai General Hospital kn-affil= affil-num=16 en-affil=Department of Diabetology and Endocrinology, Kanazawa Medical University kn-affil= affil-num=17 en-affil=Department of Diabetes and Endocrinology, Kochi Health Sciences Center kn-affil= affil-num=18 en-affil=Nunoue Clinic kn-affil= affil-num=19 en-affil=Internal Medicine, Osafune Clinic kn-affil= affil-num=20 en-affil=Department of Diabetes and Endocrinology, Matsue City Hospital kn-affil= affil-num=21 en-affil=Diabetes Center, Okayama Saiseikai General Hospital kn-affil= affil-num=22 en-affil=Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University Kashiwa Hospital kn-affil= affil-num=23 en-affil=Department of Endocrinology and Diabetes, Fukuoka University School of Medicine kn-affil= affil-num=24 en-affil=Department of Nephrology and Laboratory Medicine, Graduate School of Medical Sciences, Kanazawa University kn-affil= affil-num=25 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=26 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=27 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= en-keyword=canagliflozin kn-keyword=canagliflozin en-keyword=CANPIONE study kn-keyword=CANPIONE study en-keyword=chronic kidney disease microalbuminuria kn-keyword=chronic kidney disease microalbuminuria en-keyword=preintervention eGFR slope kn-keyword=preintervention eGFR slope en-keyword=sodium-glucose cotransporter 2 inhibitor kn-keyword=sodium-glucose cotransporter 2 inhibitor END start-ver=1.4 cd-journal=joma no-vol=33 cd-vols= no-issue=4 article-no= start-page=294 end-page=301 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202307 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Role of lymphadenectomy during primary surgery for kidney cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose of review
Lymph node dissection (LND) during radical nephrectomy (RN) for renal cell carcinoma (RCC) is not considered as a standard. The emergence of robot-assisted surgery and effective immune checkpoint inhibitors (ICI) in recent years may change this and lymph node (LN) staging has become easier and has a clinical impact. In this review, we aimed to reconsider the role of LND today.

Recent findings
Although the extent of LND has still not been well established, removal of more LN seems to provide better oncologic outcomes for a select group of patients with high-risk factors such as clinical T3-4. Adjuvant therapy using pembrolizumab has been shown to improve disease free survival if complete resection of metastatic lesions as well as the primary site is obtained in combination. Robot assisted RN for localized RCC has been widespread and the studies regarding LND for RCC has been recently appeared.

Summary
The staging and surgical benefits and its extent of LND during RN for RCC remains unclear, but it is becoming increasingly important. Technologies that allow an easier LND and adjuvant ICI that improve survival in LN-positive patients are engaging the role of LND, a procedure that was needed, but almost never done, is now indicated sometimes. Now, the goal is to identify the clinical and molecular imaging tools that can help identify with sufficient accuracy who needs a LND and which LNs to remove in a targeted personalized approach. en-copyright= kn-copyright= en-aut-name=BekkuKensuke en-aut-sei=Bekku en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawadaTatsushi en-aut-sei=Kawada en-aut-mei=Tatsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YanagisawaTakafumi en-aut-sei=Yanagisawa en-aut-mei=Takafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KarakiewiczPierre I. en-aut-sei=Karakiewicz en-aut-mei=Pierre I. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShariatShahrokh F. en-aut-sei=Shariat en-aut-mei=Shahrokh F. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= affil-num=4 en-affil=Cancer Prognostic and Health Outcomes Unit, Division of Urology, University of Montreal Health Center kn-affil= affil-num=5 en-affil=Department of Urology, Comprehensive Cancer Center, Medical University of Vienna kn-affil= en-keyword=lymph node dissection kn-keyword=lymph node dissection en-keyword=lymph node metastasis kn-keyword=lymph node metastasis en-keyword=lymphadenectomy kn-keyword=lymphadenectomy en-keyword=lymphadenopathy kn-keyword=lymphadenopathy en-keyword=Renal cell carcinoma kn-keyword=Renal cell carcinoma END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=11 article-no= start-page=359 end-page=366 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202411 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Intravitreal Fluconazole Injection for Fungal Endophthalmitis as Treatment Option in a Patient With End-Stage Liver and Kidney Diseases en-subtitle= kn-subtitle= en-abstract= kn-abstract=Endogenous endophthalmitis is an infectious disease of the intraocular tissue that is a consequence of bloodstream infection. The efficacy of intravitreal fluconazole injection to assist low-dose oral fluconazole in fungal endophthalmitis remains unknown in older adults with advanced liver and renal disease. In this case report, a 78-year-old man with hepatitis C virus-related liver cirrhosis and hepatocellular carcinoma who also had end-stage renal disease with temporary nephrostomy noticed blurred vision and showed a large retinal infiltrate with vitreous opacity in the right eye. In the clinical diagnosis of endogenous fungal endophthalmitis, he had an intravitreal injection of 0.1% fluconazole in 0.2 - 0.3 mL every 2 weeks four times in total, in addition to a minimum dose of oral fluconazole. One month before the ophthalmic presentation, he developed a fever and computed tomography scan showed ureterolithiasis with hydronephrosis on the right side, indicating that the renal pelvic stone fell into the ureter. He underwent nephrostomy tube insertion on the right side in the diagnosis of obstructive urinary tract infection. In the course, a potassium hydroxide (KOH) preparation of the urine sediments which were obtained from the nephrostomy tube showed yeast-like fungi, suggestive of Candida, 1 week before the development of eye symptoms. One week after the ophthalmic presentation, the nephrostomy tube at 14 Fr (French gauge) which had been inserted 1 month previously was replaced with a new tube with a larger size at 16 Fr because urine excretion from the tube was reduced. Immediately after the exchange of the nephrostomy tube, a large volume of urine was excreted from the tube. In a week, he had no systemic symptoms and serum C-reactive protein became low. In the meantime, the retinal infiltrate became inactive and vitreous opacity resolved. Intravitreal fluconazole injection is a treatment option for fungal endophthalmitis in the case that a patient cannot undergo vitrectomy and cannot take a maximum dose of fluconazole because of poor renal function. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshiokaNaoko en-aut-sei=Yoshioka en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakahashiYasushi en-aut-sei=Takahashi en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IguchiYasutaka en-aut-sei=Iguchi en-aut-mei=Yasutaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil=Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Gastroenterology and Hepatology, Kawasaki Medical School kn-affil= affil-num=5 en-affil=Department of Internal Medicine, Ochiai Hospital kn-affil= affil-num=6 en-affil=Department of Internal Medicine, Ochiai Hospital kn-affil= en-keyword=Fungal endophthalmitis kn-keyword=Fungal endophthalmitis en-keyword=Intravitreal injection kn-keyword=Intravitreal injection en-keyword=Fluconazole kn-keyword=Fluconazole en-keyword=Nephrostomy kn-keyword=Nephrostomy en-keyword=Urinary tract infection kn-keyword=Urinary tract infection en-keyword=Ureterolithiasis kn-keyword=Ureterolithiasis END start-ver=1.4 cd-journal=joma no-vol=18 cd-vols= no-issue=1 article-no= start-page=19 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240929 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Assessment of the renal function of patients with anorexia nervosa en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr- eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.
Methods The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.
Results When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.
Conclusions Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN. en-copyright= kn-copyright= en-aut-name=MiyaharaHiroyuki en-aut-sei=Miyahara en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShigeyasuYoshie en-aut-sei=Shigeyasu en-aut-mei=Yoshie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiiChikako en-aut-sei=Fujii en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TanakaChie en-aut-sei=Tanaka en-aut-mei=Chie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ManaHanzawa en-aut-sei=Mana en-aut-mei=Hanzawa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SugiharaAkiko en-aut-sei=Sugihara en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkadaAyumi en-aut-sei=Okada en-aut-mei=Ayumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Clinical Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=6 en-affil=Clinical Psychology Section, Department of Medical Support, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Pediatrics, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= en-keyword=Anorexia nervosa kn-keyword=Anorexia nervosa en-keyword=Dehydration kn-keyword=Dehydration en-keyword=Glomerular filtration rate estimated using creatinine kn-keyword=Glomerular filtration rate estimated using creatinine en-keyword=Glomerular filtration rate estimated using cystatin-C kn-keyword=Glomerular filtration rate estimated using cystatin-C en-keyword=Hypokalemia kn-keyword=Hypokalemia en-keyword=Low free triiodothyronine syndrome kn-keyword=Low free triiodothyronine syndrome END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=10 article-no= start-page=e70865 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20241004 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Presumed Choroidopathy of IgG4-Related Disease Discovered During 16-Year Follow-Up of a Patient With Polycystic Kidney Disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=Immunoglobulin G4 (IgG4)-related disease is characterized by infiltration with IgG4-producing plasma cells in different organs and the elevation of serum IgG4. We present a patient with polycystic kidney disease in long-term follow-up who developed bilateral lacrimal gland enlargement and presumed IgG4-related choroidopathy at different time points. A 45-year-old woman developed bilateral upper eyelid swelling. Head MRI showed bilateral lacrimal gland enlargement, and the resection on both sides revealed foci of infiltration with lymphocytes and plasma cells in bilateral lacrimal glands. The IgG4-immunostaining did not satisfy the diagnostic criteria. She had been taking oral valsartan 40 mg daily for hypertension with polycystic kidney disease.

The patient was well until the age of 49 years, when she noticed yellowish vision in the right eye compared to the left eye. The right eye showed multiple yellowish spotty lesions in the deep retina to choroid with a mildly hyperemic optic disc, while the left eye showed the normal fundus. No inflammation was noted in the anterior segments of both eyes. Fundus angiography demonstrated early-phase no-filling with late-phase leakage by fluorescein dye and both early-phase and late-phase no-filling by indocyanine green dye, leading to the diagnosis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). She began to have oral prednisolone tapered from 30 mg daily and discontinued in a year. At the age of 52 years, she switched to candesartan 8 mg daily and began to have tolvaptan (a selective competitive vasopressin receptor 2 (V2) antagonist) 90 mg daily for polycystic kidney disease with liver cysts. At that time, the lesions in the right eye had mild degeneration.

The patient was followed once a year ophthalmologically to maintain good vision. At 57 years, serum IgG4, which was measured for the first time on suspicion of IgG4-related disease, was elevated to 269.6 mg/dL. In the following four years to the latest visit at 61 years, she kept stable but high levels of serum IgG4 around 300 mg/dL. Serum IgG4 measurement is helpful to make a clinical diagnosis and, hence, a clinical decision since the spectrum of IgG4-related disease remains obscure. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanakaTakehiro en-aut-sei=Tanaka en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Ophthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University kn-affil= affil-num=2 en-affil=Pathology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Nephrology, Okayama University Hospital kn-affil= en-keyword=acute posterior multifocal placoid pigment epitheliopathy kn-keyword=acute posterior multifocal placoid pigment epitheliopathy en-keyword=choroidopathy kn-keyword=choroidopathy en-keyword=uveitis kn-keyword=uveitis en-keyword=lacrimal gland tumor kn-keyword=lacrimal gland tumor en-keyword=igg4-related disease kn-keyword=igg4-related disease END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=1 article-no= start-page=1099 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240916 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Histological differences related to autophagy in the minor salivary gland between primary and secondary types of Sj?gren's syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=Some forms of Sj?gren’s syndrome (SS) follow a clinical course accompanied by systemic symptoms caused by lymphocyte infiltration and proliferation in the liver, kidneys, and other organs. To better understand the clinical outcomes of SS, here we used minor salivary gland tissues from patients and examine their molecular, biological, and pathological characteristics. A retrospective study was performed, combining clinical data and formalin-fixed paraffin-embedded (FFPE) samples from female patients over 60 years of age who underwent biopsies at Okayama University Hospital. We employed direct digital RNA counting with nCounter? and multiplex immunofluorescence analysis with a PhenoCycler? on the labial gland biopsies. We compared FFPE samples from SS patients who presented with other connective tissue diseases (secondary SS) with those from stable SS patients with symptoms restricted to the exocrine glands (primary SS). Secondary SS tissues showed enhanced epithelial damage and lymphocytic infiltration accompanied by elevated expression of autophagy marker genes in the immune cells of the labial glands. The close intercellular distance between helper T cells and B cells positive for autophagy-associated molecules suggests accelerated autophagy in these lymphocytes and potential B cell activation by helper T cells. These findings indicate that examination of FFPE samples from labial gland biopsies can be an effective tool for evaluating molecular histological differences between secondary and primary SS through multiplexed analysis of gene expression and tissue imaging. en-copyright= kn-copyright= en-aut-name=Ono-MinagiHitomi en-aut-sei=Ono-Minagi en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NohnoTsutomu en-aut-sei=Nohno en-aut-mei=Tsutomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakabatakeKiyofumi en-aut-sei=Takabatake en-aut-mei=Kiyofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TanakaTakehiro en-aut-sei=Tanaka en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatsuyamaTakayuki en-aut-sei=Katsuyama en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiyawakiKohta en-aut-sei=Miyawaki en-aut-mei=Kohta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IbaragiSoichiro en-aut-sei=Ibaragi en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IidaSeiji en-aut-sei=Iida en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YoshinoTadashi en-aut-sei=Yoshino en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NagatsukaHitoshi en-aut-sei=Nagatsuka en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SakaiTakayoshi en-aut-sei=Sakai en-aut-mei=Takayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OhuchiHideyo en-aut-sei=Ohuchi en-aut-mei=Hideyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Cytology and Histology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Cytology and Histology, Okayama University Medical School kn-affil= affil-num=3 en-affil=Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Pathology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Hospital kn-affil= affil-num=6 en-affil=Division of Precision Medicine, Kyushu University School of Medicine kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=8 en-affil=Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Pathology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of Rehabilitation for Orofacial Disorders, Osaka University Graduate School of Dentistry kn-affil= affil-num=13 en-affil=Department of Cytology and Histology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Autoimmune disease kn-keyword=Autoimmune disease en-keyword=Xerostomia kn-keyword=Xerostomia en-keyword=Multiplex immunostaining kn-keyword=Multiplex immunostaining en-keyword=Spatial analysis kn-keyword=Spatial analysis en-keyword=Autophagy kn-keyword=Autophagy END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=15 article-no= start-page=4384 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240726 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of Serum Indoxyl Sulfate on One-Year Adverse Events in Chronic Kidney Disease Patients with Heart Failure en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background/Objectives: Indoxyl sulfate, a uremic toxin, is associated with mortality and cardiovascular events in patients with chronic kidney disease (CKD). This study aimed to evaluate the prognostic implications of serum indoxyl sulfate levels in patients with heart failure and CKD. Methods and Results: This was a prospective multicenter observational study. Overall, 300 patients with chronic heart failure with a previous history of hospitalization and an estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m2 or less (CKD stage G3b to G5) without dialysis were analyzed. The primary outcome assessed in a time-to-event analysis from the measurement of indoxyl sulfate was a composite of all-cause death, hospitalization for heart failure, nonfatal myocardial infarction, and nonfatal stroke. Clinical events were followed-up to one year after indoxyl sulfate measurement. The median patient age was 75 years, and 57% of the patients were men. We divided the cohort into low and high indoxyl sulfate categories according to a median value of 9.63 mg/mL. The primary outcome occurred in 27 of 150 patients (18.0%) in the low indoxyl sulfate group and 27 of 150 patients (18.0%) in the high indoxyl sulfate group (hazard ratio, 1.00; 95% confidence interval, 0.58 to 1.70, p = 0.99). In the post hoc exploratory analyses, the results were consistent across age, sex, body mass index, left ventricular ejection fraction, eGFR, and N-terminal pro b-type natriuretic peptide. Conclusions: Among heart failure patients with CKD stages G3b to 5G, serum indoxyl sulfate concentrations were not significantly associated with the subsequent occurrence of cardiovascular events. en-copyright= kn-copyright= en-aut-name=IwasakiKeiichiro en-aut-sei=Iwasaki en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyoshiToru en-aut-sei=Miyoshi en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UrabeChikara en-aut-sei=Urabe en-aut-mei=Chikara kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakuragiSatoru en-aut-sei=Sakuragi en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KawaiYusuke en-aut-sei=Kawai en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FukeSoichiro en-aut-sei=Fuke en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=DoiMasayuki en-aut-sei=Doi en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakaishiAtsushi en-aut-sei=Takaishi en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OkaTakefumi en-aut-sei=Oka en-aut-mei=Takefumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TokunagaNaoto en-aut-sei=Tokunaga en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ItoHiroshi en-aut-sei=Ito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Iwakuni Clinical Center kn-affil= affil-num=5 en-affil=Department of Cardiovascular Medicine, Okayama City Hospital kn-affil= affil-num=6 en-affil=Department of Cardiovascular Medicine, Japanese Red Cross Okayama Hospital kn-affil= affil-num=7 en-affil=Department of Cardiology, Kagawa Prefectural Central Hospital kn-affil= affil-num=8 en-affil=Department of Cardiology, Mitoyo General Hospital kn-affil= affil-num=9 en-affil=Department of Cardiology, Tsuyama Chuo Hospital kn-affil= affil-num=10 en-affil=Department of Cardiology, Ibara City Hospital kn-affil= affil-num=11 en-affil=Department of General Internal Medicine 3, Kawasaki Medical School kn-affil= en-keyword=heart failure kn-keyword=heart failure en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=indoxyl sulfate kn-keyword=indoxyl sulfate END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue= article-no= start-page=1383309 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240606 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Late-onset renal variant Fabry disease with R112H mutation and mild increase in plasma globotriaosylsphingosine: a case report en-subtitle= kn-subtitle= en-abstract= kn-abstract=Fabry disease (FD) is an X-linked disorder resulting in a deficiency of alpha-galactosidase A (GLA) activity. The R112H mutation of GLA is relatively common in Japanese FD patients, characterized by a late-onset phenotype, almost normal to mild lyso-Gb3 elevation, and mild clinical symptoms, despite low GLA activity. This is due to the structural features of the R112H GLA protein. We herein report the case of a 42-year-old male patient with late-onset FD with a R112H mutation. The patient exhibited only renal involvement with no other organ damage and was successfully treated with galactosidase beta and subsequent migalastat for approximately 10 years. Especially, migalastat was clinically effective in normalizing plasma lyso-Gb3 levels and inhibiting the progression of renal damage associated with FD. Therefore, the use of migalastat in the FD patients with R112H mutation is highly recommended based on this case report. en-copyright= kn-copyright= en-aut-name=TanakaKeiko en-aut-sei=Tanaka en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorinagaHiroshi en-aut-sei=Morinaga en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OnishiAkifumi en-aut-sei=Onishi en-aut-mei=Akifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MaruyamaHiroki en-aut-sei=Maruyama en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=2 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=3 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=4 en-affil=Department of Nephrology, Fukuyama City Hospital kn-affil= affil-num=5 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=6 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= affil-num=7 en-affil=Department of Clinical Nephroscience, Niigata University Graduate School of Medical and Dental Sciences kn-affil= affil-num=8 en-affil=Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University kn-affil= en-keyword=Fabry disease kn-keyword=Fabry disease en-keyword=R112H mutation kn-keyword=R112H mutation en-keyword=migalastat kn-keyword=migalastat en-keyword=proteinuria kn-keyword=proteinuria en-keyword=chronic kidney disease kn-keyword=chronic kidney disease END start-ver=1.4 cd-journal=joma no-vol=78 cd-vols= no-issue=3 article-no= start-page=245 end-page=250 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202406 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Impact of Reduced Skeletal Muscle Mass on Patients with Knee Osteoarthritis en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although several studies have suggested a possible association between sarcopenia and knee osteoarthritis (OA) in the elderly, there remains no definitive evidence. Recently, however, the serum creatinine/cystatin C ratio (sarcopenia index: SI) was reported to correlate with skeletal muscle mass. The present retrospective study therefore investigated the impact of reduced skeletal muscle mass on advanced knee OA using SI. In 55 individuals scheduled for knee osteotomy or knee arthroplasty, correlations between SI and patient-reported outcomes such as the Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were explored. Significant associations were found between SI and the KSS functional activity score (β=0.37; p=0.022), KOOS subscale for activities of daily living (β=0.42; p=0.0096), and OKS (β=0.42; p=0.0095). This study underscores the role of reduced muscle mass in functional outcomes and introduces SI as a valuable marker for assessing muscle loss in knee OA patients. en-copyright= kn-copyright= en-aut-name=AkagawaManabu en-aut-sei=Akagawa en-aut-mei=Manabu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoHidetomo en-aut-sei=Saito en-aut-mei=Hidetomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakahashiYasuhiro en-aut-sei=Takahashi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IwamotoYosuke en-aut-sei=Iwamoto en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IidaJunpei en-aut-sei=Iida en-aut-mei=Junpei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YoshikawaTakayuki en-aut-sei=Yoshikawa en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=AbeToshiki en-aut-sei=Abe en-aut-mei=Toshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SaitoKimio en-aut-sei=Saito en-aut-mei=Kimio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KijimaHiroaki en-aut-sei=Kijima en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KasukawaYuji en-aut-sei=Kasukawa en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HongoMichio en-aut-sei=Hongo en-aut-mei=Michio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MiyakoshiNaohisa en-aut-sei=Miyakoshi en-aut-mei=Naohisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=2 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=4 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=5 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=6 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=7 en-affil=Department of Orthopedic Surgery, Omagari Kousei Medical Center kn-affil= affil-num=8 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=9 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=11 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= affil-num=12 en-affil=Department of Orthopedic Surgery, Akita University Graduate School of Medicine kn-affil= en-keyword=knee osteoarthritis kn-keyword=knee osteoarthritis en-keyword=sarcopenia index kn-keyword=sarcopenia index en-keyword=reduced muscle mass kn-keyword=reduced muscle mass en-keyword=activities of daily living kn-keyword=activities of daily living en-keyword=functional activity kn-keyword=functional activity END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=3 article-no= start-page=e004237 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202405 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3) en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction ACE cleaves angiotensin I (Ang I) to angiotensin II (Ang II) inducing vasoconstriction via Ang II type 1 (AT1) receptor, while ACE2 cleaves Ang II to Ang (1-7) causing vasodilatation by acting on the Mas receptor. In diabetic kidney disease (DKD), it is still unclear whether plasma or urine ACE2 levels predict renal outcomes or not.
Research design and methods Among 777 participants with diabetes enrolled in the Urinary biomarker for Continuous And Rapid progression of diabetic nEphropathy study, the 296 patients followed up for 9 years were investigated. Plasma and urinary ACE2 levels were measured by the ELISA. The primary end point was a composite of a decrease of estimated glomerular filtration rate (eGFR) by at least 30% from baseline or initiation of hemodialysis or peritoneal dialysis. The secondary end points were a 30% increase or a 30% decrease in albumin-to-creatinine ratio from baseline to 1 year.
Results The cumulative incidence of the renal composite outcome was significantly higher in group 1 with lowest tertile of plasma ACE2 (p=0.040). Group 2 with middle and highest tertile was associated with better renal outcomes in the crude Cox regression model adjusted by age and sex (HR 0.56, 95% CI 0.31 to 0.99, p=0.047). Plasma ACE2 levels demonstrated a significant association with 30% decrease in ACR (OR 1.46, 95% CI 1.044 to 2.035, p=0.027) after adjusting for age, sex, systolic blood pressure, hemoglobin A1c, and eGFR.
Conclusions Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD.Trial registration number UMIN000011525. en-copyright= kn-copyright= en-aut-name=UenoAsami en-aut-sei=Ueno en-aut-mei=Asami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiseKoki en-aut-sei=Mise en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamaguchiSatoshi en-aut-sei=Yamaguchi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KannoAyaka en-aut-sei=Kanno en-aut-mei=Ayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NojimaIchiro en-aut-sei=Nojima en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HiguchiChigusa en-aut-sei=Higuchi en-aut-mei=Chigusa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=HidaKazuyuki en-aut-sei=Hida en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KatayamaAkihiro en-aut-sei=Katayama en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=NakatoTatsuaki en-aut-sei=Nakato en-aut-mei=Tatsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=ToneAtsuhito en-aut-sei=Tone en-aut-mei=Atsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=TeshigawaraSanae en-aut-sei=Teshigawara en-aut-mei=Sanae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=MatsuokaTakashi en-aut-sei=Matsuoka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=KameiShinji en-aut-sei=Kamei en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=MurakamiKazutoshi en-aut-sei=Murakami en-aut-mei=Kazutoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=ShimizuIkki en-aut-sei=Shimizu en-aut-mei=Ikki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=MiyashitaKatsuhito en-aut-sei=Miyashita en-aut-mei=Katsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=AndoShinichiro en-aut-sei=Ando en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= affil-num=1 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=14 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=15 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=16 en-affil=Department of Internal Medicine, Okayama Saiseikai General Hospital kn-affil= affil-num=17 en-affil=Department of Internal Medicine, Okayama Saiseikai General Hospital kn-affil= affil-num=18 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=19 en-affil=Department of Diabetic Medicine, Kurashiki Central Hospital kn-affil= affil-num=20 en-affil=Department of Diabetic Medicine, Kurashiki Central Hospital kn-affil= affil-num=21 en-affil=Department of Diabetic Medicine, Kurashiki Central Hospital kn-affil= affil-num=22 en-affil=Sakakibara Heart Institute of Okayama kn-affil= affil-num=23 en-affil=Japanese Red Cross Okayama Hospital kn-affil= affil-num=24 en-affil=Okayama City General Medical Center kn-affil= affil-num=25 en-affil=Nunoue Clinic kn-affil= affil-num=26 en-affil=Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=9 article-no= start-page=1261 end-page=1267 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=20240501 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Severe Cytokine Release Syndrome and Immune Effector Cell-associated Neurotoxicity Syndrome in a Man Receiving Immune Checkpoint Inhibitors for Lung Cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=A 55-year-old man with stage IV lung adenocarcinoma was treated with cisplatin, pemetrexed, nivolumab, and ipilimumab. Approximately 100 days after treatment initiation, he became disoriented and presented to the emergency department with a high fever. Blood tests revealed liver and kidney dysfunctions. Subsequently, the patient developed generalized convulsions that required intensive care. He was clinically diagnosed with cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Organ damage was gradually controlled with immunosuppressive drugs, including steroids, and the patient was discharged. Successful treatment is rare in patients with CRS, including ICANS, during immune checkpoint inhibitor treatment for solid tumors. en-copyright= kn-copyright= en-aut-name=TanakaTakaaki en-aut-sei=Tanaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TaokaMasataka en-aut-sei=Taoka en-aut-mei=Masataka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MakimotoGo en-aut-sei=Makimoto en-aut-mei=Go kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NinomiyaKiichiro en-aut-sei=Ninomiya en-aut-mei=Kiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HigoHisao en-aut-sei=Higo en-aut-mei=Hisao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujiiMasanori en-aut-sei=Fujii en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IchiharaEiki en-aut-sei=Ichihara en-aut-mei=Eiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OhashiKadoaki en-aut-sei=Ohashi en-aut-mei=Kadoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HottaKatsuyuki en-aut-sei=Hotta en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TabataMasahiro en-aut-sei=Tabata en-aut-mei=Masahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MaedaYoshinobu en-aut-sei=Maeda en-aut-mei=Yoshinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Center for Comprehensive Genomic Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Respiratory Medicine, Okayama University Hospital kn-affil= affil-num=9 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=10 en-affil=Center for Clinical Oncology, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=immune checkpoint inhibitor kn-keyword=immune checkpoint inhibitor en-keyword=nivolumab kn-keyword=nivolumab en-keyword=ipilimumab kn-keyword=ipilimumab en-keyword=cytokine release syndrome kn-keyword=cytokine release syndrome en-keyword=immune effector cell-associated neurotoxicity syndrome kn-keyword=immune effector cell-associated neurotoxicity syndrome END start-ver=1.4 cd-journal=joma no-vol=42 cd-vols= no-issue=3 article-no= start-page=319 end-page=325 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20231014 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prospective evaluation of core number of biopsy for renal tumor: are multiple cores preferable? en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose This single-center, single-arm, prospective, open-label study was conducted to evaluate the optimal number of cores (single or multiple) in renal tumor biopsy.
Materials and methods Forty-four biopsies of 44 tumors (mean diameter, 2.7?±?1.0 cm; range, 1.6?5.0 cm) were included. Biopsy was performed under ultrasound or computed tomography fluoroscopy guidance using an 18-gauge cutting needle and the co-axial method. Two or more specimens were obtained, which were divided into first and subsequent specimens. “First specimen” and “all specimens” were histologically evaluated (i.e., appropriateness of specimen, histological diagnosis, subtype, and Fuhrman grade of renal cell carcinoma [RCC]) blindly and independently by two board-certified pathologists.
Results Multiple specimens were successfully and safely obtained in all the biopsies. All tumors were histologically diagnosed; 40 malignancies included 39 RCCs and 1 solitary fibrous tumor, and 4 benign lesions included 2 angiomyolipomas, 1 oncocytoma, and 1 capillary hemangioma. In all RCCs, the subtype could be determined (32 clear cell RCCs, 4 chromophobe RCCs, and 3 papillary RCCs), and the Furman grade was determined in 38 RCCs. When only the first specimen was evaluated, 22.7% of the specimens were inappropriate for diagnosis, and 34 (77.3%) were histologically diagnosed. The diagnostic yield was significantly lower than that of all specimens (P?=?0.0044). Univariate analysis revealed that smaller lesions were a significant predictor of diagnostic failure (P?=?0.020).
Conclusion Biopsy with multiple cores significantly improved diagnostic yield. Thus, operators should obtain multiple cores during renal tumor biopsy. en-copyright= kn-copyright= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TojiTomohiro en-aut-sei=Toji en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SakuraiJun en-aut-sei=Sakurai en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TomitaKoji en-aut-sei=Tomita en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UmakoshiNoriyuki en-aut-sei=Umakoshi en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawabataTakahiro en-aut-sei=Kawabata en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MunetomoKazuaki en-aut-sei=Munetomo en-aut-mei=Kazuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Biopsy kn-keyword=Biopsy en-keyword=Kidney kn-keyword=Kidney en-keyword=Tumor kn-keyword=Tumor en-keyword=Computed tomography kn-keyword=Computed tomography en-keyword=Ultrasound kn-keyword=Ultrasound END start-ver=1.4 cd-journal=joma no-vol=78 cd-vols= no-issue=2 article-no= start-page=135 end-page=142 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202404 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Photon-Counting Detector CT: Potential for 75% Reduction in Contrast Medium Amount: A Phantom Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study aimed to evaluate the potential reduction in contrast medium utilization using photon-counting detector computed tomography (PCD-CT). One PCD-CT scan (CT1) and three conventional (non-PCD-CT) CT scans (CT2-CT4) were performed using a multi-energy CT phantom that contained eight rods with different iodine concentrations (0.2, 0.5, 1, 2, 5, 10, 15, and 20 mg/ml). The CT values of the seven groups (CT1 for 40, 50, 60, and 70 keV; and CT2-4) were measured. Noise and contrast-to-noise ratio (CNR) were assessed for the eight rods at various iodine concentrations. CT2 and CT1 (40 keV) respectively required 20 mg/ml and 5 mg/ml of iodine, indicating that a comparable contrast effect could be obtained with approximately one-fourth of the contrast medium amount. The standard deviation values increased at lower energy levels irrespective of the iodine concentration. The CNR exhibited a decreasing trend with lower iodine concentrations, while it remained relatively stable across all iodine levels (40-70 keV). This study demonstrated that virtual monochromatic 40 keV images offer a similar contrast effect with a reduced contrast medium amount when compared to conventional CT systems at 120 kV. en-copyright= kn-copyright= en-aut-name=HigakiFumiyo en-aut-sei=Higaki en-aut-mei=Fumiyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MorimitsuYusuke en-aut-sei=Morimitsu en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SaitoHayato en-aut-sei=Saito en-aut-mei=Hayato kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakakiHaruhiko en-aut-sei=Takaki en-aut-mei=Haruhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NakagoshiAyako en-aut-sei=Nakagoshi en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WadaMaki en-aut-sei=Wada en-aut-mei=Maki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=AkagiNoriaki en-aut-sei=Akagi en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Radiological Technology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Radiological Technology, Faculty of Health Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Radiological Technology, Okayama University Medical School kn-affil= affil-num=5 en-affil=Department of Radiological Technology, Okayama University Medical School kn-affil= affil-num=6 en-affil=Department of Radiological Technology, Okayama University Medical School kn-affil= affil-num=7 en-affil=Department of Radiological Technology, Okayama University Medical School kn-affil= affil-num=8 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Radiological Technology, Okayama University Hospital kn-affil= affil-num=10 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=11 en-affil=Department of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=photon-counting detector CT kn-keyword=photon-counting detector CT en-keyword=energy integrating detector CT kn-keyword=energy integrating detector CT en-keyword=computed tomography kn-keyword=computed tomography en-keyword=contrast medium amount kn-keyword=contrast medium amount en-keyword=reduction kn-keyword=reduction END start-ver=1.4 cd-journal=joma no-vol=53 cd-vols= no-issue=7 article-no= start-page=595 end-page=603 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230404 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Venetoclax plus low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia ineligible for intensive chemotherapy: an expanded access study in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: In a Phase 3 international clinical trial (VIALE-C), venetoclax plus low-dose cytarabine improved the response rate and overall survival versus placebo plus low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia who were ineligible for intensive chemotherapy. After the enrollment period of VIALE-C ended, we conducted an expanded access study to provide preapproval access to venetoclax in combination with low-dose cytarabine in Japan.
Methods: Previously, untreated patients with acute myeloid leukemia who were ineligible for intensive chemotherapy were enrolled according to the VIALE-C criteria. Patients received venetoclax (600 mg, Days 1?28, 4-day ramp-up in Cycle 1) in 28-day cycles and low-dose cytarabine (20 mg/m2, Days 1?10). All patients took tumor lysis syndrome prophylactic agents and hydration. Safety endpoints were assessed.
Results: Fourteen patients were enrolled in this study. The median age was 77.5 years (range = 61?84), with 78.6% over 75 years old. The most common grade ? 3 treatment-emergent adverse event was neutropenia (57.1%). Febrile neutropenia was the most frequent serious adverse event (21.4%). One patient developed treatment-related acute kidney injury, leading to discontinuation of treatment. Two patients died because of cardiac failure and disease progression that were judged not related to study treatment. No patients developed tumor lysis syndrome.
Conclusions: The safety outcomes were similar to those in VIALE-C without new safety signals and were well managed with standard medical care. In clinical practice, more patients with severe background disease are expected, in comparison with in VIALE-C, suggesting that it is important to carefully manage and prevent adverse events. en-copyright= kn-copyright= en-aut-name=AsadaNoboru en-aut-sei=Asada en-aut-mei=Noboru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AndoJun en-aut-sei=Ando en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakadaSatoru en-aut-sei=Takada en-aut-mei=Satoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshidaChikashi en-aut-sei=Yoshida en-aut-mei=Chikashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UsukiKensuke en-aut-sei=Usuki en-aut-mei=Kensuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShinagawaAtsushi en-aut-sei=Shinagawa en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IshizawaKenichi en-aut-sei=Ishizawa en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyamotoToshihiro en-aut-sei=Miyamoto en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IidaHiroatsu en-aut-sei=Iida en-aut-mei=Hiroatsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=DobashiNobuaki en-aut-sei=Dobashi en-aut-mei=Nobuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=OkuboSumiko en-aut-sei=Okubo en-aut-mei=Sumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HondaHideyuki en-aut-sei=Honda en-aut-mei=Hideyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SoshinTomomi en-aut-sei=Soshin en-aut-mei=Tomomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=NishimuraYasuko en-aut-sei=Nishimura en-aut-mei=Yasuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TsutsuiAtsuko en-aut-sei=Tsutsui en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=MukaiHarumi en-aut-sei=Mukai en-aut-mei=Harumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=YamamotoKazuhito en-aut-sei=Yamamoto en-aut-mei=Kazuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Hematology and Oncology, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Hematology, School of Medicine, Juntendo University kn-affil= affil-num=3 en-affil=Leukemia Research Center, Gunma Saiseikai Maebashi Hospital kn-affil= affil-num=4 en-affil=Department of Hematology, National Hospital Organization Mito Medical Center kn-affil= affil-num=5 en-affil= kn-affil= affil-num=6 en-affil=Department of Internal Medicine, Hitachi General Hospital kn-affil= affil-num=7 en-affil=Department of Internal Medicine III, Yamagata University Faculty of Medicine kn-affil= affil-num=8 en-affil=Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences kn-affil= affil-num=9 en-affil=Department of Hematology, National Hospital Organization Nagoya Medical Center kn-affil= affil-num=10 en-affil=Division of Clinical Oncology/Hematology, The Jikei University Daisan Hospital kn-affil= affil-num=11 en-affil=Department of Hematology and Cell Therapy, AbbVie GK kn-affil= affil-num=12 en-affil=Department of Hematology and Cell Therapy, AbbVie GK kn-affil= affil-num=13 en-affil=Department of Hematology and Cell Therapy, AbbVie GK kn-affil= affil-num=14 en-affil=Department of Hematology and Cell Therapy, AbbVie GK kn-affil= affil-num=15 en-affil=Department of Hematology and Cell Therapy, AbbVie GK kn-affil= affil-num=16 en-affil=Department of Hematology and Cell Therapy, Abbvie Inc. kn-affil= affil-num=17 en-affil=Department of Hematology and Cell Therapy, Aichi Cancer Center kn-affil= en-keyword=acute myeloid leukemia kn-keyword=acute myeloid leukemia en-keyword=venetoclax kn-keyword=venetoclax en-keyword=low-dose cytarabine kn-keyword=low-dose cytarabine en-keyword=expanded access study kn-keyword=expanded access study en-keyword=tumor lysis syndrome kn-keyword=tumor lysis syndrome END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=2 article-no= start-page=240 end-page=246 dt-received= dt-revised= dt-accepted= dt-pub-year=2024 dt-pub=202403 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Long-term outcomes of lung transplantation requiring renal replacement therapy: A single-center experience en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
Life-long immunosuppressive therapy after lung transplantation (LT) may lead to end-stage renal disease (ESRD), requiring renal replacement therapy (RRT). We aimed to investigate the characteristics and long-term outcomes of patients undergoing LT and requiring RRT.

Methods
This study was a single-center, retrospective cohort study. The patients were divided into the RRT (n = 15) and non-RRT (n = 170) groups. We summarized the clinical features of patients in the RRT group and compared patient characteristics, overall survival, and chronic lung allograft dysfunction (CLAD)-free survival between the two groups.

Results
The cumulative incidences of ESRD requiring RRT after LT at 5, 10, and 15 years were 0.8 %, 7.6 %, and 25.2 %, respectively. In the RRT group, all 15 patients underwent hemodialysis but not peritoneal dialysis, and two patients underwent living-donor kidney transplantation. The median follow-up period was longer in the RRT group than in the non-RRT group (P < 0.001). The CLAD-free survival and overall survival did not differ between the two groups. The 5-year survival rate even after the initiation of hemodialysis was 53.3 %, and the leading cause of death in the RRT group was infection.

Conclusions
Favorable long-term outcomes can be achieved by RRT for ESRD after LT. en-copyright= kn-copyright= en-aut-name=TomiokaYasuaki en-aut-sei=Tomioka en-aut-mei=Yasuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugimotoSeiichiro en-aut-sei=Sugimoto en-aut-mei=Seiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShiotaniToshio en-aut-sei=Shiotani en-aut-mei=Toshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsubaraKei en-aut-sei=Matsubara en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ChoshiHaruki en-aut-sei=Choshi en-aut-mei=Haruki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IshiharaMegumi en-aut-sei=Ishihara en-aut-mei=Megumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TanakaShin en-aut-sei=Tanaka en-aut-mei=Shin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyoshiKentaroh en-aut-sei=Miyoshi en-aut-mei=Kentaroh kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtaniShinji en-aut-sei=Otani en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=ToyookaShinichi en-aut-sei=Toyooka en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Thoracic Surgery and Organ Transplant Center, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Lung transplantation kn-keyword=Lung transplantation en-keyword=Dialysis kn-keyword=Dialysis en-keyword=Living-donor kidney transplantation kn-keyword=Living-donor kidney transplantation en-keyword=End -stage renal disease kn-keyword=End -stage renal disease en-keyword=Renal replacement therapy kn-keyword=Renal replacement therapy END start-ver=1.4 cd-journal=joma no-vol=5 cd-vols= no-issue=12 article-no= start-page=100733 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Rationale & Objective: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the corticomedullary region. However, the role of VMC and the clinical significance of VMC variants are poorly understood. In the present study, we investigated kidney prognostic values of VMC variants.
Study Design: Retrospective cohort study.
Setting & Participants: Among 808 patients who underwent a kidney biopsy from 2011 to 2019, 246 patients whose kidney biopsy specimens contained VMC were enrolled.
Predictors: VMC variants; inflammatory-VMC (an infiltration of ?80 inflammatory cells/mm2-VMC area) and VMC hypertrophy (hyper-VMC, a VMC average width ?850 μm), and the interstitial fibrosis/tubular atrophy (IFTA) score.
Outcomes: A decline in estimated glomerular filtration rate (eGFR) ?40% from the baseline or commencement of kidney replacement therapy.
Analytical Approach: Cox proportional hazards model.
Results: Among 246 patients with data on VMC, mean baseline eGFR was 56.0±25.6 ml/min per 1.73 m2; 80 had high inflammatory-VMC, and 62 had VMC hypertrophy. There were 51 kidney events over median follow-up of 2.5 years. We analyzed 2 VMC variants. Multivariable logistic regression analysis revealed that eGFR negatively correlated with the presence of both inflammatory-VMC and hyper-VMC. A Cox proportional hazards analysis revealed that inflammatory-VMC (but not hyper-VMC) was independently associated with the primary outcome after adjustments for known risk factors of progression, including proteinuria, eGFR, and the interstitial fibrosis/tubular atrophy (IFTA) score (hazard ratio, 1.97; 95% confidence interval, 1.00-3.91).
Limitations: Single-center study and small sample size.
Conclusions: Assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. en-copyright= kn-copyright= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakanohHiroyuki en-aut-sei=Nakanoh en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakahashiKensaku en-aut-sei=Takahashi en-aut-mei=Kensaku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MoritaTakafumi en-aut-sei=Morita en-aut-mei=Takafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SangYizhen en-aut-sei=Sang en-aut-mei=Yizhen kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=Matsuoka-UchiyamaNatsumi en-aut-sei=Matsuoka-Uchiyama en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=18 article-no= start-page=2893 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230909 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=MicroRNAs as Biomarkers and Therapeutic Targets for Acute Kidney Injury en-subtitle= kn-subtitle= en-abstract= kn-abstract=Acute kidney injury (AKI) is a clinical syndrome where a rapid decrease in kidney function and/or urine output is observed, which may result in the imbalance of water, electrolytes and acid base. It is associated with poor prognosis and prolonged hospitalization. Therefore, an early diagnosis and treatment to avoid the severe AKI stage are important. While several biomarkers, such as urinary L-FABP and NGAL, can be clinically useful, there is still no gold standard for the early detection of AKI and there are limited therapeutic options against AKI. miRNAs are non-coding and single-stranded RNAs that silence their target genes in the post-transcriptional process and are involved in a wide range of biological processes. Recent accumulated evidence has revealed that miRNAs may be potential biomarkers and therapeutic targets for AKI. In this review article, we summarize the current knowledge about miRNAs as promising biomarkers and potential therapeutic targets for AKI, as well as the challenges in their clinical use. en-copyright= kn-copyright= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakanohHiroyuki en-aut-sei=Nakanoh en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=microRNA kn-keyword=microRNA en-keyword=acute kidney injury kn-keyword=acute kidney injury en-keyword=biomarker kn-keyword=biomarker en-keyword=mesenchymal stem cell kn-keyword=mesenchymal stem cell END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=6 article-no= start-page=595 end-page=605 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202312 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Concomitant Use of Multiple Nephrotoxins including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity: Combined Retrospective Analyses of Two Real-World Databases en-subtitle= kn-subtitle= en-abstract= kn-abstract=There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ?2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN. en-copyright= kn-copyright= en-aut-name=BandoTakashi en-aut-sei=Bando en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ChumaMasayuki en-aut-sei=Chuma en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HamanoHirofumi en-aut-sei=Hamano en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NiimuraTakahiro en-aut-sei=Niimura en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OkadaNaoto en-aut-sei=Okada en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KondoMasateru en-aut-sei=Kondo en-aut-mei=Masateru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IzumiYuki en-aut-sei=Izumi en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IshidaShunsuke en-aut-sei=Ishida en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YoshiokaToshihiko en-aut-sei=Yoshioka en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AsadaMizuho en-aut-sei=Asada en-aut-mei=Mizuho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ZamamiYoshito en-aut-sei=Zamami en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TakechiKenshi en-aut-sei=Takechi en-aut-mei=Kenshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=GodaMitsuhiro en-aut-sei=Goda en-aut-mei=Mitsuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MiyataKoji en-aut-sei=Miyata en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=YagiKenta en-aut-sei=Yagi en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=Izawa-IshizawaYuki en-aut-sei=Izawa-Ishizawa en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=AzumaMomoyo en-aut-sei=Azuma en-aut-mei=Momoyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YanagawaHiroaki en-aut-sei=Yanagawa en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=TasakiYoshikazu en-aut-sei=Tasaki en-aut-mei=Yoshikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=IshizawaKeisuke en-aut-sei=Ishizawa en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=2 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=3 en-affil=Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences kn-affil= affil-num=4 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=5 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=6 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=7 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=8 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=9 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=10 en-affil=Department of Medical Molecular Informatics, Meiji Pharmaceutical University kn-affil= affil-num=11 en-affil=Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences kn-affil= affil-num=12 en-affil=Department of Drug Information Analysis, College of Pharmaceutical Sciences, Matsuyama University kn-affil= affil-num=13 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=14 en-affil=Department of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical Sciences kn-affil= affil-num=15 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=16 en-affil=Department of Pharmacology, Tokushima University Graduate School of Biomedical Sciences kn-affil= affil-num=17 en-affil=Department of Infection Control and Prevention, Tokushima University Hospital kn-affil= affil-num=18 en-affil=Department of Nursing, Faculty of Health and Welfare, Tokushima Bunri University kn-affil= affil-num=19 en-affil=Department of Hospital Pharmacy and Pharmacology, Asahikawa Medical University kn-affil= affil-num=20 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= en-keyword=vancomycin-associated nephrotoxicity kn-keyword=vancomycin-associated nephrotoxicity en-keyword=polypharmacy kn-keyword=polypharmacy en-keyword=nephrotoxin kn-keyword=nephrotoxin en-keyword=spontaneous adverse event reporting database kn-keyword=spontaneous adverse event reporting database en-keyword=electronic medical records kn-keyword=electronic medical records END start-ver=1.4 cd-journal=joma no-vol=40 cd-vols= no-issue=11 article-no= start-page=1201 end-page=1209 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220621 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Percutaneous cryoablation for clinical T3a renal cell carcinoma ( Materials and methods　Sixteen cryoablation sessions were performed in 14 patients (10 men; mean age, 69.8?±?10.5 years; range, 49?90 years) with 14 clear cell T3a RCCs (mean, 3.3?±?0.9 cm; range, 1.9?5.2 cm). One patient was on dialysis. Transcatheter arterial embolization was performed before cryoablation in 15 sessions. The primary endpoint was the technique efficacy rate. The secondary endpoints included feasibility, safety, renal function, and survival.
Results　Cryoablation was technically successful in all RCC cases. In two RCCs, cryoablation was performed twice because of local tumor progression. No major adverse events were observed. All patients were alive without metastases, with a median follow-up of 45 months (6?93 months). Complete response was achieved by cryoablation in 11 RCCs (78.6%). The primary and secondary technique efficacy rates were 77.1% and 84.4% at 1 year, 57.9% and 73.9% at 3 years, and 57.9% and 73.9% at 5 years, respectively. One patient underwent dialysis given a total contralateral nephrectomy due to another RCC 1 month after initial cryoablation and a total ipsilateral nephrectomy 46 months after initial cryoablation due to local progression. Except for two dialysis patients, of the 12 patients with a median follow-up of 41 months (6?93 months), none were on dialysis.
Conclusion　Cryoablation was safe and effective in T3a RCC, which mainly involved the renal venous branches and may represent an alternative treatment for inoperable patients. en-copyright= kn-copyright= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkawaNanako en-aut-sei=Okawa en-aut-mei=Nanako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TomitaKoji en-aut-sei=Tomita en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UmakoshiNoriyuki en-aut-sei=Umakoshi en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MunetomoKazuaki en-aut-sei=Munetomo en-aut-mei=Kazuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=GobaraHideo en-aut-sei=Gobara en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=2 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=3 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=4 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=5 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=6 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=7 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=8 en-affil=Division of Medical Informatics, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Urology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= affil-num=10 en-affil=Department of Radiology, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine kn-affil= en-keyword=Kidney neoplasms kn-keyword=Kidney neoplasms en-keyword=Cryosurgery kn-keyword=Cryosurgery en-keyword=Image-guided kn-keyword=Image-guided END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=5 article-no= start-page=527 end-page=536 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202310 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Characteristics of Retroperitoneal Fibrosis Patients at a Tertiary Hospital in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=Retroperitoneal fibrosis (RPF) is a rare cause of hydronephrosis and progressive renal dysfunction with unidentified origin. RPF is categorized into idiopathic RPF with/without immunoglobulin G4 (IgG4)-related disease (IgG4-RD), and secondary RPF. Identifying the underlying cause is challenging and often associated with delayed diagnosis or therapeutic interventions. We investigated RPF’s clinical characteristics based on different etiologies and factors that may help distinguish the underlying causes. We analyzed the cases of 49 patients with RPF that was radiographically diagnosed at our institution (2008-2022). The cohort was 77.6% males; 75.5% had idiopathic RPF and 24.5% had secondary RPF. Among the idiopathic patients, 54.1% had IgG4-RD. The patients were likely to have abdominal pain, lower back pain/lumbago, and constitutional symptoms including generalized fatigue and fever. The idiopathic patients were likely to have higher serum IgG4 and IgG levels and lower serum C3 levels compared to secondary RPF. The IgG4-RPF patients were likely to have higher serum IgG4 levels and lower serum C-reactive protein, ferritin, and C3 levels compared to the idiopathic RPF patients without IgG4-RD. These findings might reflect underlying systemic inflammatory responses. Comprehensive laboratory testing, including serum inflammatory markers and immunological panels, is recommended for radiologically diagnosed RPF patients. en-copyright= kn-copyright= en-aut-name=AndoMiho en-aut-sei=Ando en-aut-mei=Miho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishimuraYoshito en-aut-sei=Nishimura en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=retroperitoneal fibrosis kn-keyword=retroperitoneal fibrosis en-keyword=IgG4-related disease kn-keyword=IgG4-related disease en-keyword=malignancy kn-keyword=malignancy END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=1 article-no= start-page=13770 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230823 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A population-based longitudinal study on glycated hemoglobin levels and new-onset chronic kidney disease among non-diabetic Japanese adults en-subtitle= kn-subtitle= en-abstract= kn-abstract=Chronic kidney disease (CKD) is a major global public health problem. Recent studies reported that diabetes and prediabetes are risk factors for developing CKD; however, the exact glycated hemoglobin (HbA1c) cut-off value for prediabetes remains controversial. In this study, we aimed to examine the relationship between HbA1c levels and subsequent CKD development in greater detail than previous studies. Longitudinal data of annual checkups of 7176 Japanese non-diabetic people (male: 40.4%) from 1998 to 2022 was analyzed. HbA1c values were categorized into < 5.0%, 5.0-5.4%, 5.5-5.9%, and 6.0-6.4%. CKD was defined as an estimated glomerular filtration rate < 60 ml/min/1.73 m(2). The descriptive statistics at study entry showed that higher HbA1c values were associated with male, older, overweight or obese, hypertensive, or dyslipidemic people. During a mean follow-up of 7.75 person-years, 2374 participants (male: 40.0%) developed CKD. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated. The adjusted time ratios of developing CKD for HbA1c levels of 5.5-5.9% and 6.0-6.4% compared with 5.0-5.4% were 0.97 (95% confidence interval: 0.92-1.03) and 1.01 (95% confidence interval: 0.90-1.13), respectively. There was no association between HbA1c in the prediabetic range and subsequent CKD development. en-copyright= kn-copyright= en-aut-name=OkawaYukari en-aut-sei=Okawa en-aut-mei=Yukari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SuzukiEtsuji en-aut-sei=Suzuki en-aut-mei=Etsuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsudaToshihide en-aut-sei=Tsuda en-aut-mei=Toshihide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YorifujiTakashi en-aut-sei=Yorifuji en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University kn-affil= affil-num=5 en-affil=Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=7 article-no= start-page=1190 end-page=1202 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220421 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Reduction in the magnitude of serum potassium elevation in combination therapy with esaxerenone (CS‐3150) and sodium?glucose cotransporter?2 inhibitor in patients with diabetic kidney disease: Subanalysis of two phase?III studies en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims/Introduction: We evaluated the effect of co-administration of esaxerenone and a sodium?glucose cotransporter?2 (SGLT2) inhibitor on the magnitude of serum potassium elevation in Japanese patients with diabetic kidney disease.
Materials and Methods: We carried out a prespecified subanalysis of data from two phase?III studies: a multicenter, randomized, double-blind, placebo-controlled trial in patients with type?2 diabetes and microalbuminuria (J308); and a multicenter, single-arm, open-label trial in patients with type?2 diabetes and macroalbuminuria (J309). Changes in serum potassium levels during the studies and other measures were evaluated according to SGLT2 inhibitor use.
Results: In both studies, time-course changes in serum potassium levels, and incidence rates of serum potassium elevation were lower in patients with co-administration of SGLT2 inhibitor in both the placebo and esaxerenone groups than those without the inhibitor. In contrast, time-course changes and mean percentage changes from baseline in urinary albumin-to-creatinine ratio, the proportion of patients with albuminuria remission and time-course changes in blood pressure did not change with or without SGLT2 inhibitor, whereas the albumin-to-creatinine ratio and blood pressure were reduced with esaxerenone. The blood glucose-lowering effect of SGLT2 inhibitor was not affected by esaxerenone.
Conclusions: In Japanese patients with type?2 diabetes and albuminuria treated with esaxerenone, concomitant use of SGLT2 inhibitor reduced the magnitude of serum potassium elevation without any change of its antihypertensive and albuminuria-suppressing effects. Co-administration of esaxerenone and SGLT2 inhibitor might be a beneficial treatment option for patients with diabetic kidney disease. en-copyright= kn-copyright= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ItoSadayoshi en-aut-sei=Ito en-aut-mei=Sadayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KashiharaNaoki en-aut-sei=Kashihara en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NangakuMasaomi en-aut-sei=Nangaku en-aut-mei=Masaomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WadaTakashi en-aut-sei=Wada en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkudaYasuyuki en-aut-sei=Okuda en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SawanoboriTomoko en-aut-sei=Sawanobori en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SugimotoKotaro en-aut-sei=Sugimoto en-aut-mei=Kotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University School of Medicine kn-affil= affil-num=3 en-affil=Department of Nephrology and Hypertension, Kawasaki Medical School kn-affil= affil-num=4 en-affil=Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo kn-affil= affil-num=5 en-affil=Department of Nephrology and Laboratory Medicine, Kanazawa University kn-affil= affil-num=6 en-affil=Department of Nephrology and Laboratory Medicine, Kanazawa University kn-affil= affil-num=7 en-affil=Clinical Development Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=8 en-affil=Primary Medical Science Department, Daiichi Sankyo Co., Ltd. kn-affil= en-keyword=Esaxerenone kn-keyword=Esaxerenone en-keyword=Potassium kn-keyword=Potassium en-keyword=Sodium-glucose transporter 2 inhibitor kn-keyword=Sodium-glucose transporter 2 inhibitor END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue= article-no= start-page=1261330 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230907 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=In vivo tracking transplanted cardiomyocytes derived from human induced pluripotent stem cells using nuclear medicine imaging en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: Transplantation of human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) is a promising treatment for heart failure. Information on long-term cell engraftment after transplantation is clinically important. However, clinically applicable evaluation methods have not yet been established.
Methods: In this study, to noninvasively assess transplanted cell engraftment, human SLC5A5, which encodes a sodium/iodide symporter (NIS) that transports radioactive tracers such as 125I, 18F-tetrafluoroborate (TFB), and 99mTc-pertechnetate (99mTcO4?), was transduced into human induced pluripotent stem cells (iPSCs), and nuclear medicine imaging was used to track engrafted human iPSC-CMs.
Results: To evaluate the pluripotency of NIS-expressing human iPSCs, they were subcutaneously transplanted into immunodeficient rats. Teratomas were detected by 99mTcO4? single photon emission computed tomography (SPECT/CT) imaging. NIS expression and the uptake ability of 125I were maintained in purified human iPSC-CMs. NIS-expressing human iPSC-CMs transplanted into immunodeficient rats could be detected over time using 99mTcO4? SPECT/CT imaging. Unexpectedly, NIS expression affected cell proliferation of human iPSCs and iPSC-derived cells.
Discussion: Such functionally designed iPSC-CMs have potential clinical applications as a noninvasive method of grafted cell evaluation, but further studies are needed to determine the effects of NIS transduction on cellular characteristics and functions. en-copyright= kn-copyright= en-aut-name=SaitoYukihiro en-aut-sei=Saito en-aut-mei=Yukihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NoseNaoko en-aut-sei=Nose en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IidaToshihiro en-aut-sei=Iida en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AkazawaKaoru en-aut-sei=Akazawa en-aut-mei=Kaoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KannoTakayuki en-aut-sei=Kanno en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujimotoYuki en-aut-sei=Fujimoto en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SasakiTakanori en-aut-sei=Sasaki en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AkehiMasaru en-aut-sei=Akehi en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AkagiSatoshi en-aut-sei=Akagi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=YoshidaMasashi en-aut-sei=Yoshida en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MiyoshiToru en-aut-sei=Miyoshi en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=ItoHiroshi en-aut-sei=Ito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=NakamuraKazufumi en-aut-sei=Nakamura en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Cardiovascular Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Molecular Imaging Project of RECTOR Program, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Molecular Imaging Project of RECTOR Program, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Molecular Imaging Project of RECTOR Program, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=7 en-affil=Okayama Medical Innovation Center, Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Okayama Medical Innovation Center, Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Molecular Imaging Project of RECTOR Program, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=11 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=13 en-affil=Department of General Internal Medicine 3, Kawasaki Medical School kn-affil= affil-num=14 en-affil=Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=sodium/iodide symporter kn-keyword=sodium/iodide symporter en-keyword=human induced pluripotent stem cell-derived cardiomyocytes kn-keyword=human induced pluripotent stem cell-derived cardiomyocytes en-keyword=single photon emission computed tomography kn-keyword=single photon emission computed tomography en-keyword=cell-based therapy kn-keyword=cell-based therapy en-keyword=in vivo imaging kn-keyword=in vivo imaging END start-ver=1.4 cd-journal=joma no-vol=24 cd-vols= no-issue=8 article-no= start-page=1429 end-page=1438 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220518 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Rationale, design and baseline characteristics of the effect of canagliflozin in patients with type 2 diabetes and microalbuminuria in the Japanese population: The CANPIONE study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aim: To evaluate the effect of canagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor, on albuminuria and the decline of estimated glomerular filtration rate (eGFR) in participants with type 2 diabetes and microalbuminuria.
Methods: The CANPIONE study is a multicentre, randomized, parallel-group and open-labelled study consisting of a unique 24-week preintervention period, during which the rate of eGFR decline before intervention is estimated, followed by a 52-week intervention and a 4-week washout period. Participants with a geometric mean urinary albumin-to-creatinine ratio (UACR) of 50 and higher and less than 300?mg/g in two consecutive first-morning voids at two different time points, and an eGFR of 45?ml/min/1.73m2 or higher, are randomly assigned to receive canagliflozin 100?mg daily or to continue guideline-recommended treatment, except for SGLT2 inhibitors. The first primary outcome is the change in UACR, and the second primary outcome is the change in eGFR slope.
Results: A total of 258 participants were screened and 98 were randomized at 21 sites in Japan from August 2018 to May 2021. The mean baseline age was 61.4?years and 25.8% were female. The mean HbA1c was 7.9%, mean eGFR was 74.1?ml/min/1.73m2 and median UACR was 104.2?mg/g.
Conclusions: The CANPIONE study will determine whether the SGLT2 inhibitor canagliflozin can reduce albuminuria and slow eGFR decline in participants with type 2 diabetes and microalbuminuria. en-copyright= kn-copyright= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HeerspinkHiddo J. L. en-aut-sei=Heerspink en-aut-mei=Hiddo J. L. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=de ZeeuwDick en-aut-sei=de Zeeuw en-aut-mei=Dick kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ToyodaMasao en-aut-sei=Toyoda en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SuzukiDaisuke en-aut-sei=Suzuki en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HatanakaTakashi en-aut-sei=Hatanaka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakamuraTohru en-aut-sei=Nakamura en-aut-mei=Tohru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KameiShinji en-aut-sei=Kamei en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MuraoSatoshi en-aut-sei=Murao en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HidaKazuyuki en-aut-sei=Hida en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=AndoShinichiro en-aut-sei=Ando en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=AkaiHiroaki en-aut-sei=Akai en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TakahashiYasushi en-aut-sei=Takahashi en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KoyaDaisuke en-aut-sei=Koya en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=KitadaMunehiro en-aut-sei=Kitada en-aut-mei=Munehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=SuganoHisashi en-aut-sei=Sugano en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=NakamuraAkihiko en-aut-sei=Nakamura en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=SasakiMotofumi en-aut-sei=Sasaki en-aut-mei=Motofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=NakatouTatsuaki en-aut-sei=Nakatou en-aut-mei=Tatsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=FujimotoKei en-aut-sei=Fujimoto en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=KawanamiDaiji en-aut-sei=Kawanami en-aut-mei=Daiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=WadaTakashi en-aut-sei=Wada en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=YoshidaMichihiro en-aut-sei=Yoshida en-aut-mei=Michihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= en-aut-name=the CANPIONE study Investigators en-aut-sei=the CANPIONE study Investigators en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=27 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen kn-affil= affil-num=3 en-affil=Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen kn-affil= affil-num=4 en-affil=Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine kn-affil= affil-num=5 en-affil=Suzuki Diadetes Clinic kn-affil= affil-num=6 en-affil=Department of Diabetes and Endocrinology, National Hospital Organization Fukuyama Medical Center kn-affil= affil-num=7 en-affil=Diabetes Internal Medicine, Sumitomo Besshi Hospital kn-affil= affil-num=8 en-affil=Department of Diabetic Medicine, Kurashiki Central Hospital kn-affil= affil-num=9 en-affil=Department of Diabetes and Endocrinology, Takamatsu Hospital kn-affil= affil-num=10 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=11 en-affil=Department of Internal Medicine Diabetic Center, Okayama City Hospital kn-affil= affil-num=12 en-affil=Division of Diabetes and Metabolism, Faculty of Medicine, Tohoku Medical and Pharmaceutical University kn-affil= affil-num=13 en-affil=Department of Diabetes, Ochiai General Hospital kn-affil= affil-num=14 en-affil=Department of Diabetology and Endocrinology, Kanazawa Medical University kn-affil= affil-num=15 en-affil=Department of Diabetology and Endocrinology, Kanazawa Medical University kn-affil= affil-num=16 en-affil=Department of Diabetes and Endocrinology, Kochi Health Sciences Center kn-affil= affil-num=17 en-affil=Nunoue Clinic kn-affil= affil-num=18 en-affil=Internal Medicine, Osafune Clinic, Setouchi kn-affil= affil-num=19 en-affil=Department of Diabetes and Endocrinology, Matsue City Hospital kn-affil= affil-num=20 en-affil=Diabetes Center, Okayama Saiseikai General Hospital kn-affil= affil-num=21 en-affil=Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University Kashiwa Hospital kn-affil= affil-num=22 en-affil=Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine kn-affil= affil-num=23 en-affil=Department of Nephrology and Laboratory Medicine, Graduate School of Medical Sciences, Kanazawa University kn-affil= affil-num=24 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=25 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=26 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=27 en-affil= kn-affil= en-keyword=canagliflozin kn-keyword=canagliflozin en-keyword=CANPIONE study kn-keyword=CANPIONE study en-keyword=diabetic kidney disease kn-keyword=diabetic kidney disease en-keyword=eGFR slope kn-keyword=eGFR slope en-keyword=SGLT2 inhibitor kn-keyword=SGLT2 inhibitor en-keyword=urinary albumin-to-creatinine ratio kn-keyword=urinary albumin-to-creatinine ratio END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=4 article-no= start-page=582 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230326 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction: While chronic kidney disease (CKD) is one of the most important contributors to mortality from non-communicable diseases, the number of nephrologists is limited worldwide. Medical cooperation is a system of cooperation between primary care physicians and nephrological institutions, consisting of nephrologists and multidisciplinary care teams. Although it has been reported that multidisciplinary care teams contribute to the prevention of worsening renal functions and cardiovascular events, there are few studies on the effect of a medical cooperation system. Methods: We aimed to evaluate the effect of medical cooperation on all-cause mortality and renal prognosis in patients with CKD. One hundred and sixty-eight patients who visited the one hundred and sixty-three clinics and seven general hospitals of Okayama city were recruited between December 2009 and September 2016, and one hundred twenty-three patients were classified into a medical cooperation group. The outcome was defined as the incidence of all-cause mortality, or renal composite outcome (end-stage renal disease or 50% eGFR decline). We evaluated the effects on renal composite outcome and pre-ESRD mortality while incorporating the competing risk for the alternate outcome into a Fine-Gray subdistribution hazard model. Results: The medical cooperation group had more patients with glomerulonephritis (35.0% vs. 2.2%) and less nephrosclerosis (35.0% vs. 64.5%) than the primary care group. Throughout the follow-up period of 5.59 +/- 2.78 years, 23 participants (13.7%) died, 41 participants (24.4%) reached 50% decline in eGFR, and 37 participants (22.0%) developed end-stage renal disease (ESRD). All-cause mortality was significantly reduced by medical cooperation (sHR 0.297, 95% CI 0.105-0.835, p = 0.021). However, there was a significant association between medical cooperation and CKD progression (sHR 3.069, 95% CI 1.225-7.687, p = 0.017). Conclusion: We evaluated mortality and ESRD using a CKD cohort with a long-term observation period and concluded that medical cooperation might be expected to influence the quality of medical care in the patients with CKD. en-copyright= kn-copyright= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MaeshimaYohei en-aut-sei=Maeshima en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkuyamaYuka en-aut-sei=Okuyama en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OtakaNozomu en-aut-sei=Otaka en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=UjikeHaruyo en-aut-sei=Ujike en-aut-mei=Haruyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TanakaKeiko en-aut-sei=Tanaka en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MorinagaHiroshi en-aut-sei=Morinaga en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KinomuraMasaru en-aut-sei=Kinomura en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=OtaKosuke en-aut-sei=Ota en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MaruyamaKeisuke en-aut-sei=Maruyama en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=HiramatsuMakoto en-aut-sei=Hiramatsu en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=OshiroYoshiyuki en-aut-sei=Oshiro en-aut-mei=Yoshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=MoriokaShigeru en-aut-sei=Morioka en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=TakiueKeiichi en-aut-sei=Takiue en-aut-mei=Keiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=OmoriKazuyoshi en-aut-sei=Omori en-aut-mei=Kazuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=FukushimaMasaki en-aut-sei=Fukushima en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=GamouNaoyuki en-aut-sei=Gamou en-aut-mei=Naoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=HirataHiroshi en-aut-sei=Hirata en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= en-aut-name=SatoRyosuke en-aut-sei=Sato en-aut-mei=Ryosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=26 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=27 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=28 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Japanese Red Cross Society Himeji Hospital kn-affil= affil-num=5 en-affil=Kagawa Prefectural Central Hospital kn-affil= affil-num=6 en-affil=Kagawa Prefectural Central Hospital kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=National Hospital Organization Okayama Medical Center kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=14 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=National Hospital Organization Okayama Medical Center kn-affil= affil-num=17 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=18 en-affil=Okayama Saiseikai General Hospital, kn-affil= affil-num=19 en-affil=Kawasaki Medical School General Medical Center kn-affil= affil-num=20 en-affil=Okayama Central Hospital kn-affil= affil-num=21 en-affil=Okayama City Hospital kn-affil= affil-num=22 en-affil=Shigei Medical Research Hospital kn-affil= affil-num=23 en-affil=Shigei Medical Research Hospital kn-affil= affil-num=24 en-affil=Japanese Red Cross Okayama Hospital kn-affil= affil-num=25 en-affil=Akebono Clinic kn-affil= affil-num=26 en-affil=Sato Clinic kn-affil= affil-num=27 en-affil=Okayama University kn-affil= affil-num=28 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=chronic kidney disease (CKD) kn-keyword=chronic kidney disease (CKD) en-keyword=medical cooperation kn-keyword=medical cooperation en-keyword=patient care team kn-keyword=patient care team en-keyword=OCKD-NET kn-keyword=OCKD-NET END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=2 article-no= start-page=221 end-page=225 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202304 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Withdrawal from Hemodialysis in a Patient with IgD Type Multiple Myeloma: A Case-based Review en-subtitle= kn-subtitle= en-abstract= kn-abstract=Several previous case reports have shown that patients with immunoglobulin D (IgD) multiple myeloma (MM) can be withdrawn from hemodialysis, however, the characteristics that can predict withdrawal in these patients have not yet been elucidated. A 57-year-old Japanese woman required hemodialysis because of renal dysfunction due to IgD-λ and Bence Jones protein-λ MM. Bortezomib-based chemotherapy nine days after admission led to her withdrawal from hemodialysis on Day 50. In our case-based review, younger age and early initiation of bortezomib-based chemotherapy emerged as possible predictors of successful hemodialysis withdrawal. en-copyright= kn-copyright= en-aut-name=IriyoshiHiroki en-aut-sei=Iriyoshi en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SadaKen-ei en-aut-sei=Sada en-aut-mei=Ken-ei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiyauchiAtsushi en-aut-sei=Miyauchi en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamamotoHirotaka en-aut-sei=Yamamoto en-aut-mei=Hirotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HashimotoDaisuke en-aut-sei=Hashimoto en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NojimaShigeru en-aut-sei=Nojima en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamanakaShingo en-aut-sei=Yamanaka en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawamuraMasafumi en-aut-sei=Kawamura en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OkaSatoshi en-aut-sei=Oka en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=2 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=3 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=4 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=5 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=6 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=7 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=8 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= affil-num=9 en-affil=Department of Internal Medicine, Kochi Prefectural Hata-Kenmin Hospital kn-affil= en-keyword=IgD-type multiple myeloma kn-keyword=IgD-type multiple myeloma en-keyword=acute renal dysfunction kn-keyword=acute renal dysfunction en-keyword=urinary protein kn-keyword=urinary protein en-keyword=hemodialysis kn-keyword=hemodialysis en-keyword=bortezomib kn-keyword=bortezomib END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=2 article-no= start-page=139 end-page=145 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202304 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prolonged Sedentary Bouts Are Critically Involved in All-Cause Mortality in Patients on Chronic Hemodialysis: A Prospective Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=We investigated the link between prolonged sedentary bouts and all-cause mortality in patients on chronic hemodialysis, using a prospective cohort. A total of 104 outpatients on chronic hemodialysis from 2013 to 2019, aged 71.4±11.4 years, were enrolled. Prolonged sedentary bouts (? 30 min and ?60 min) (min and bouts) and relative prolonged sedentary bouts (? 30 min and ? 60 min) (%) on the patients’ non-hemodialysis days were measured by a tri-accelerometer, and we also analyzed the patients’ clinical parameters. The relationship between prolonged sedentary bouts and all-cause mortality was evaluated by a survival analysis and the Cox proportional hazard model. Thirty-five patients died during the follow-up period. A Kaplan-Meier analysis detected significant differences in the survival rate between two groups stratified by the median for all prolonged sedentary-bout parameters. After the adjustment for confounding factors, all of the prolonged sedentary-bout parameters were determinant factors for all-cause mortality. These results indicate that prolonged sedentary bouts on non-hemodialysis days were closely related to all-cause mortality in the patients on hemodialysis. en-copyright= kn-copyright= en-aut-name=NamioKeiichi en-aut-sei=Namio en-aut-mei=Keiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KondoTakashi en-aut-sei=Kondo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HishiiShuhei en-aut-sei=Hishii en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishiHiroyuki en-aut-sei=Nishi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KatayamaAkihiko en-aut-sei=Katayama en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UjikeKazuhiro en-aut-sei=Ujike en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SuzukiHiromi en-aut-sei=Suzuki en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KoumotoKiichi en-aut-sei=Koumoto en-aut-mei=Kiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=2 en-affil=Innoshima General Hospital kn-affil= affil-num=3 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=4 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=5 en-affil=Innoshima General Hospital kn-affil= affil-num=6 en-affil=Faculty of Social Studies, Shikokugakuin University kn-affil= affil-num=7 en-affil=Innoshima General Hospital kn-affil= affil-num=8 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=9 en-affil=Innoshima General Hospital kn-affil= en-keyword=sedentary bout kn-keyword=sedentary bout en-keyword=mortality kn-keyword=mortality en-keyword=hemodialysis kn-keyword=hemodialysis en-keyword=survival analysis kn-keyword=survival analysis END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=2 article-no= start-page=121 end-page=129 dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=202304 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Complications of Percutaneous Cryoablation for Renal Tumors and Methods for Avoiding Them en-subtitle= kn-subtitle= en-abstract= kn-abstract=Percutaneous cryoablation of renal tumors is widely used because of its high efficacy and safety. This high safety can be attributed, at least in part, to the visibility of the ablated area as an “ice ball”. This therapy has fewer complications (incidence, 0-7.2%) and is less invasive than surgery. Minor bleeding is inevitable in most kidney-related procedures, and indeed the most common complication of this therapy is bleeding (hematoma and hematuria). However, patients require treatment such as transfusion or transarterial embolization in only 0-4% of bleeding cases. Various other complications such as ureteral or collecting system injury, bowel injury, nerve injury, skin injury, infection, pneumothorax, and tract seeding also occur, but they are usually minor and asymptomatic. However, operators should know and avoid the various complications associated with this therapy. This study aimed to summarize the complications of percutaneous cryoablation for renal tumors and provide some techniques for achieving safe procedures. en-copyright= kn-copyright= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TomitaKoji en-aut-sei=Tomita en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UmakoshiNoriyuki en-aut-sei=Umakoshi en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KawabataTakahiro en-aut-sei=Kawabata en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MunetomoKazuaki en-aut-sei=Munetomo en-aut-mei=Kazuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NagataShoma en-aut-sei=Nagata en-aut-mei=Shoma kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Radiology, Okayama University Hospital kn-affil= en-keyword=cryosurgery kn-keyword=cryosurgery en-keyword=kidney neoplasms kn-keyword=kidney neoplasms en-keyword=carcinoma kn-keyword=carcinoma en-keyword=renal cell kn-keyword=renal cell en-keyword=complication kn-keyword=complication END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue=4 article-no= start-page=669 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2023 dt-pub=20230210 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association between Urinary Creatinine Excretion and Hypothyroidism in Patients with Chronic Kidney Disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=While hypothyroidism increases serum creatinine (Cr) levels, it is uncertain whether the elevation is mediated via a decline in the glomerular filtration rate (GFR) or the reflection of enhanced Cr production from the muscles or both. In the present study, we explored an association between urinary Cr excretion rate (CER) and hypothyroidism. A total of 553 patients with chronic kidney disease were enrolled in a cross-sectional study. Multiple linear regression analysis was performed to explore the association between hypothyroidism and urinary CER. The mean urinary CER was 1.01 +/- 0.38 g/day and 121 patients (22%) had hypothyroidism. The multiple linear regression analysis revealed explanatory variables with urinary CER, including age, sex, body mass index, 24 h Cr clearance (24hrCcr), and albumin while hypothyroidism was not considered an independent explanatory variable. In addition, scatter plot analysis with regression fit line representing the association between estimated GFR calculated using s-Cr (eGFRcre) and 24hrCcr revealed that eGFRcre and 24hrCcr had strong correlations with each other in hypothyroid patients as well as euthyroid patients. Collectively, hypothyroidism was not considered an independent explanatory variable for urinary CER in the present study and eGFRcre is a useful marker to evaluate kidney function regardless of the presence of hypothyroidism. en-copyright= kn-copyright= en-aut-name=Matsuoka-UchiyamaNatsumi en-aut-sei=Matsuoka-Uchiyama en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakahashiKensaku en-aut-sei=Takahashi en-aut-mei=Kensaku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=InagakiKenichi en-aut-sei=Inagaki en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UchidaHaruhito A. A. en-aut-sei=Uchida en-aut-mei=Haruhito A. A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=hypothyroidism kn-keyword=hypothyroidism en-keyword=kidney function kn-keyword=kidney function en-keyword=urinary creatinine excretion kn-keyword=urinary creatinine excretion END start-ver=1.4 cd-journal=joma no-vol=478 cd-vols= no-issue=8 article-no= start-page=1779 end-page=1790 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20221226 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Significance of UGT1A6, UGT1A9, and UGT2B7 genetic variants and their mRNA expression in the clinical outcome of renal cell carcinoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=UDP-glucuronosyltransferase (UGT) metabolizes a number of endogenous and exogenous substrates. Renal cells express high amounts of UGT; however, the significance of UGT in patients with renal cell carcinoma (RCC) remains unknown. In this study, we profile the mRNA expression of UGT subtypes (UGT1A6, UGT1A9, and UGT2B7) and their genetic variants in the kidney tissue of 125 Japanese patients with RCC (Okayama University Hospital, Japan). In addition, we elucidate the association between the UGT variants and UGT mRNA expression levels and clinical outcomes in these patients. The three representative genetic variants, namely, UGT1A6 541A > G, UGT1A9 i399C > T, and UGT2B7-161C > T, were genotyped, and their mRNA expression levels in each tissue were determined. We found that the mRNA expression of the three UGTs (UGT1A6, UGT1A9, and UGT2B7) are significantly downregulated in RCC tissues. Moreover, in patients with RCC, the UGT2B7-161C > T variant and high UGT2B7 mRNA expression are significantly correlated with preferable cancer-specific survival (CSS) and overall survival (OS), respectively. As such, the UGT2B7-161C > T variant and UGT2B7 mRNA expression level were identified as significant independent prognostic factors of CSS and CSS/OS, respectively. Taken together, these findings indicate that UGT2B7 has a role in RCC progression and may, therefore, represent a potential prognostic biomarker for patients with RCC. en-copyright= kn-copyright= en-aut-name=MatsumotoJun en-aut-sei=Matsumoto en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NishimotoAnzu en-aut-sei=Nishimoto en-aut-mei=Anzu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WatariShogo en-aut-sei=Watari en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UekiHideo en-aut-sei=Ueki en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShiromizuShoya en-aut-sei=Shiromizu en-aut-mei=Shoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IwataNaohiro en-aut-sei=Iwata en-aut-mei=Naohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakedaTatsuaki en-aut-sei=Takeda en-aut-mei=Tatsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UshioSoichiro en-aut-sei=Ushio en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KajizonoMakoto en-aut-sei=Kajizono en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=FujiyoshiMasachika en-aut-sei=Fujiyoshi en-aut-mei=Masachika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KoyamaToshihiro en-aut-sei=Koyama en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WadaKoichiro en-aut-sei=Wada en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=ZamamiYoshito en-aut-sei=Zamami en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=AriyoshiNoritaka en-aut-sei=Ariyoshi en-aut-mei=Noritaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Urology, National Hospital Organization Okayama Medical Center kn-affil= affil-num=4 en-affil=Department of Urology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Pharmacy, Tottori University Hospital kn-affil= affil-num=11 en-affil=Department of Pharmaceuticals Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=12 en-affil=Department of Urology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=13 en-affil=Department of Urology, Faculty of Medicine, Shimane University kn-affil= affil-num=14 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=15 en-affil=Department of Urology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=16 en-affil=Department of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Genetic variant kn-keyword=Genetic variant en-keyword=Polymorphism kn-keyword=Polymorphism en-keyword=Renal cell carcinoma kn-keyword=Renal cell carcinoma en-keyword=Survival kn-keyword=Survival en-keyword=UDP-glucuronosyltransferase kn-keyword=UDP-glucuronosyltransferase END start-ver=1.4 cd-journal=joma no-vol=13 cd-vols= no-issue= article-no= start-page=1048863 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20221108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Masked CKD in hyperthyroidism and reversible CKD status in hypothyroidism en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction
While it is well known that thyroid function may affect kidney function, the transition of the chronic kidney disease (CKD) status before and after treatment for thyroid disorders, as well as the factors affecting this change, remains to be explored. In the present study, we focused on the change in kidney function and their affecting factors during the treatment for both hyperthyroidism and hypothyroidism.

Methods
Eighty-eight patients with hyperthyroidism and fifty-two patients with hypothyroidism were enrolled in a retrospective and longitudinal case series to analyze the changes in kidney function and their affecting factors after treatment for thyroid disorders.

Results
Along with the improvement of thyroid function after treatment, there was a significant decrease in estimated glomerular filtration rate (eGFR) in hyperthyroidism (an average Delta eGFR of -41.1 mL/min/1.73 m(2)) and an increase in eGFR in hypothyroidism (an average Delta eGFR of 7.1 mL/min/1.73 m(2)). The multiple linear regression analysis revealed that sex, eGFR, free thyroxine (FT4) and free triiodothyronine (FT3) could be considered independent explanatory variables for Delta eGFR in hyperthyroidism, while age, eGFR, and FT3 were detected as independent explanatory variables in hypothyroidism. In addition, the stratification by kidney function at two points, pre- and post-treatment for thyroid disorders, revealed that 4.5% of the participants with hyperthyroidism were pre-defined as non-CKD and post-defined as CKD, indicating the presence of "masked" CKD in hyperthyroidism. On the other hand, 13.5% of the participants with hypothyroidism presented pre-defined CKD and post-defined non-CKD, indicating the presence of "reversible" CKD status in hypothyroidism.

Conclusions
We uncovered the population of masked CKD in hyperthyroidism and reversible CKD status in hypothyroidism, thereby re-emphasizing the importance of a follow-up to examine kidney function after treatment for hyperthyroidism and the routine evaluation of thyroid function in CKD patients as well as the appropriate hormone therapy if the patient has hypothyroidism. en-copyright= kn-copyright= en-aut-name=Uchiyama-MatsuokaNatsumi en-aut-sei=Uchiyama-Matsuoka en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ItohYoshihiko en-aut-sei=Itoh en-aut-mei=Yoshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NishiyamaYuki en-aut-sei=Nishiyama en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MorimotoEisaku en-aut-sei=Morimoto en-aut-mei=Eisaku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=FujisawaSatoshi en-aut-sei=Fujisawa en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TerasakaTomohiro en-aut-sei=Terasaka en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HaraTakayuki en-aut-sei=Hara en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=Ogura-OchiKanako en-aut-sei=Ogura-Ochi en-aut-mei=Kanako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=InagakiKenichi en-aut-sei=Inagaki en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Academic field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=masked CKD kn-keyword=masked CKD en-keyword=reversible CKD kn-keyword=reversible CKD en-keyword=hyperthyroidism kn-keyword=hyperthyroidism en-keyword=hypothyroidism kn-keyword=hypothyroidism en-keyword=eGFR kn-keyword=eGFR END start-ver=1.4 cd-journal=joma no-vol=58 cd-vols= no-issue=11 article-no= start-page=1529 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20221026 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Beneficial Effect of Personalized Lifestyle Intervention in Chronic Kidney Disease Follow-Up Project for National Health Insurance Specific Health Checkup: A Five-Year Community-Based Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background and Objectives: Mimasaka city is a relatively small city with a population of 28,381, and an aging rate (>= 65 years old) of 38.9%, where only one nephrology clinic is available. Since 2013, the city has conducted its own unique lifestyle intervention for the participants of the National Health Insurance specific medical health checkup, aiming to prevent the progression of chronic kidney disease (CKD) severity. Materials and Methods: The persons in National Health Insurance specific medical health checkup (40-74 years old) conducted in Mimasaka city in 2013, with eGFR less than 50 mL/min/1.73 m(2) or 50-90 mL/min/1.73 m(2) with urine dipstick protein 1+ or more, were registered for the CKD follow-up project, as high-risk subjects for advanced renal dysfunction. Municipal workers directly visited the subjects' homes to provide individual health guidance and encourage medical consultation. We aimed to examine the effect of home-visit intervention on the changes of renal function and related factors until 2017. Results: The number of the high-risk subjects who continuously received the health checkup until 2017 was 63, and only 23 (36.5%) visited a medical institution in the first year. The eGFR decreased by only 0.4 mL/min/1.73 m(2)/year, and the subjects with urinary protein 1+ or higher decreased significantly from 20 (31.7%) to 9 (14.3%) (p = 0.034) in the high-risk subjects. The changes in eGFR and urinary protein was almost in the same fashion regardless of their medical institution visits. Next, we examined the effects of various factors on Delta eGFR, the changes of eGFR from 2013 to 2017, by multivariate linear regression analysis. The effects of medical institution visit were not significant, and the degree of urinary protein (coefficient B: 4.503, beta: 0.705, p < 0.001), age (coefficient B: 4.753, beta: 0.341, p = 0.004), and smoking (coefficient B: 5.878, beta: 0.295, p = 0.031) had independent significant effects, indicating that they were the factors exacerbating the decrease in eGFR from the baseline. Conclusions: The personalized lifestyle intervention by home-visit in CKD follow-up project showed the possibility of beneficial effects on the deterioration of renal function. This may be an efficient method to change behavior in a small community with limited medical resources. en-copyright= kn-copyright= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KatayamaKatsuyoshi en-aut-sei=Katayama en-aut-mei=Katsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=Matsuoka-UchiyamaNatsumi en-aut-sei=Matsuoka-Uchiyama en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OkamotoShugo en-aut-sei=Okamoto en-aut-mei=Shugo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OkuyamaYuka en-aut-sei=Okuyama en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UmebayashiRyoko en-aut-sei=Umebayashi en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MiyajiKodai en-aut-sei=Miyaji en-aut-mei=Kodai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KaiAkiko en-aut-sei=Kai en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MatsumotoIzumi en-aut-sei=Matsumoto en-aut-mei=Izumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TaniguchiKeiko en-aut-sei=Taniguchi en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=YamashitaFukiko en-aut-sei=Yamashita en-aut-mei=Fukiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=EmiTsutomu en-aut-sei=Emi en-aut-mei=Tsutomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=9 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=10 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=11 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=12 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=13 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=14 en-affil=Department of Health and Welfare, Division of Health Promotion, Mimasaka City Health Center kn-affil= affil-num=15 en-affil=Kawasaki Medical School General Medical Center kn-affil= affil-num=16 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry, and Pharmaceutical Science kn-affil= en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=specific medical health check-up kn-keyword=specific medical health check-up en-keyword=home-visit type lifestyle intervention kn-keyword=home-visit type lifestyle intervention en-keyword=CKD exacerbation kn-keyword=CKD exacerbation END start-ver=1.4 cd-journal=joma no-vol=14 cd-vols= no-issue=2 article-no= start-page=205 end-page=220 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20221029 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Suramin prevents the development of diabetic kidney disease by inhibiting NLRP3 inflammasome activation in KK-Ay mice en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims/Introduction Nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasomes produce IL-18 upon being activated by various stimuli via the P2 receptors. Previously, we showed that serum and urine IL-18 levels are positively associated with albuminuria in patients with type 2 diabetes, indicating the involvement of inflammasome activation in the pathogenesis of diabetic kidney disease (DKD). In the present study, we investigated whether the administration of suramin, a nonselective antagonist of the P2 receptors, protects diabetic KK.Cg-A(y)/TaJcl (KK-Ay) mice against DKD progression. Materials and Methods Suramin or saline was administered i.p. to KK-Ay and C57BL/6J mice once every 2 weeks for a period of 8 weeks. Mouse mesangial cells (MMCs) were stimulated with ATP in the presence or absence of suramin. Results Suramin treatment significantly suppressed the increase in the urinary albumin-to-creatinine ratio, glomerular hypertrophy, mesangial matrix expansion, and glomerular fibrosis in KK-Ay mice. Suramin also suppressed the upregulation of NLRP3 inflammasome-related genes and proteins in the renal cortex of KK-Ay mice. P2X4 and P2X7 receptors were significantly upregulated in the isolated glomeruli of KK-Ay mice and mainly distributed in the glomerular mesangial cells of KK-Ay mice. Although neither ATP nor suramin affected NLRP3 expression in MMCs, suramin inhibited ATP-induced NLRP3 complex formation and the downstream expression of caspase-1 and IL-18 in MMCs. Conclusions These results suggest that the NLRP3 inflammasome is activated in a diabetic kidney and that inhibition of the NLRP3 inflammasome with suramin protects against the progression of early stage DKD. en-copyright= kn-copyright= en-aut-name=OdaKaori en-aut-sei=Oda en-aut-mei=Kaori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KoderaRyo en-aut-sei=Kodera en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=3 en-affil=Osafune Clinic kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism kn-affil= affil-num=5 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= en-keyword=Diabetic kidney disease kn-keyword=Diabetic kidney disease en-keyword=Inflammasomes kn-keyword=Inflammasomes en-keyword=Suramin kn-keyword=Suramin END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=19 article-no= start-page=5589 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220923 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Impact of Different KDIGO Criteria on Clinical Outcomes for Early Identification of Acute Kidney Injury after Non-Cardiac Surgery en-subtitle= kn-subtitle= en-abstract= kn-abstract=The Kidney Disease Improving Global Outcomes (KDIGO) guidelines are currently used in acute kidney injury (AKI) diagnosis and include both serum creatinine (SCR) and urine output (UO) criteria. Currently, many AKI-related studies have inconsistently defined AKI, which possibly affects the comparison of their results. Therefore, we hypothesized that the different criteria in the KDIGO guidelines vary in measuring the incidence of AKI and its association with clinical outcomes. We retrospectively analyzed that data of patients admitted to the intensive care unit after non-cardiac surgery in 2019. Three different criteria used to define AKI were included: UOmean, mean UO < 0.5 mL/kg/h over time; UOcont, hourly UO < 0.5 mL/kg/h over time; or SCR, KDIGO guidelines SCR criteria. A total of 777 patients were included, and the incidence of UOmean-AKI was 33.1%, the incidence of UOcont-AKI was 7.9%, and the incidence of SCR-AKI was 2.0%. There were differences in the length of ICU stay and hospital stay between AKI and non-AKI patients under different criteria. We found differences in the incidence and clinical outcomes of AKI after non-cardiac surgery when using different KDIGO criteria. en-copyright= kn-copyright= en-aut-name=FuJingwen en-aut-sei=Fu en-aut-mei=Jingwen kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KosakaJunko en-aut-sei=Kosaka en-aut-mei=Junko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=acute kidney injury kn-keyword=acute kidney injury en-keyword=KDIGO definition kn-keyword=KDIGO definition en-keyword=serum creatine kn-keyword=serum creatine en-keyword=urine output kn-keyword=urine output en-keyword=early identification kn-keyword=early identification END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202297 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Efficacy and Safety of Esaxerenone in Hypertensive Patients with Diabetic Kidney Disease: A Multicenter, Open-Label, Prospective Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction
Clinical data of esaxerenone in hypertensive patients with diabetic kidney disease (DKD) are lacking. We evaluated the efficacy and safety of esaxerenone in patients with DKD and an inadequate response to blood pressure (BP)-lowering treatment.

Methods
In this multicenter, open-label, prospective study, patients were divided into urinary albumin-to-creatinine ratio subcohorts (UACR?
Results
In total, 113 patients were enrolled. Morning home SBP/DBP significantly decreased from baseline to EOT in the total population (??11.6/??5.2 mmHg, both p?
Conclusion
Esaxerenone demonstrated a BP-lowering effect and improved albuminuria. The effects were consistent regardless of the severity of albuminuria without clinically relevant serum potassium elevation and eGFR reduction. en-copyright= kn-copyright= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakajimaHirofumi en-aut-sei=Nakajima en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HashimotoMasami en-aut-sei=Hashimoto en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakamuraAkihiko en-aut-sei=Nakamura en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MurakamiKazuharu en-aut-sei=Murakami en-aut-mei=Kazuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HosoyaTakeshi en-aut-sei=Hosoya en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KomotoKiichi en-aut-sei=Komoto en-aut-mei=Kiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TaguchiTakashi en-aut-sei=Taguchi en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=AkasakaTakaaki en-aut-sei=Akasaka en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ShiosakaiKazuhito en-aut-sei=Shiosakai en-aut-mei=Kazuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SugimotoKotaro en-aut-sei=Sugimoto en-aut-mei=Kotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Internal Medicine, Nakashima Hospital kn-affil= affil-num=3 en-affil=Hashimoto Kidney Clinic kn-affil= affil-num=4 en-affil=Osafune Clinic kn-affil= affil-num=5 en-affil=Nunoue Clinic kn-affil= affil-num=6 en-affil=Murakami Clinic kn-affil= affil-num=7 en-affil=Hosoya Clinic kn-affil= affil-num=8 en-affil=Innoshima General Hospital kn-affil= affil-num=9 en-affil=Primary Medical Science Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=10 en-affil=Primary Medical Science Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=11 en-affil=Data Intelligence Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=12 en-affil=Primary Medical Science Department, Daiichi Sankyo Co., Ltd. kn-affil= affil-num=13 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=1 article-no= start-page=14999 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220902 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The association between hypothyroidism and proteinuria in patients with chronic kidney disease: a cross-sectional study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Hypothyroidism is known to be correlated with kidney function and nephrotic range proteinuria. However, it is uncertain whether non-nephrotic proteinuria is associated with hypothyroidism. This study aimed to evaluate the association of proteinuria and hypothyroidism in chronic kidney disease (CKD) patients. We conducted a cross-sectional study composed of 421 CKD patients in a single hospital with measurements of 24-h urine protein excretion (UP) and thyroid function tests. Spearman correlation analysis revealed that 24-h Cr clearance (24hrCcr) was positively (r = 0.273, p < 0.001) and UP was negatively (r = - 0.207, p < 0.001) correlated with free triiodothyronine. Frequency distribution analysis stratified by CKD stage and UP for hypothyroidism revealed that the prevalence of hypothyroidism was higher among participants with higher CKD stage and nephrotic range proteinuria. Multivariate logistic regression analysis revealed that 24hrCcr and UP were significantly correlated with hypothyroidism (24hrCcr/10 mL/min decrease: odds ratio [OR], 1.29; 95% confidence interval [CI], 1.18-1.41; UP/1 g increase: OR, 1.10; 95% CI, 1.03-1.17). In addition, nephrotic range proteinuria, but not moderate UP (UP: 1.5-3.49 g/day), was significantly correlated with hypothyroidism compared to UP < 0.5 g/day. In summary, decreased kidney function and nephrotic range proteinuria, not non-nephrotic proteinuria, are independently associated with the hypothyroidism. en-copyright= kn-copyright= en-aut-name=Matsuoka-UchiyamaNatsumi en-aut-sei=Matsuoka-Uchiyama en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SangYizhen en-aut-sei=Sang en-aut-mei=Yizhen kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakahashiKensaku en-aut-sei=Takahashi en-aut-mei=Kensaku kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=InagakiKenichi en-aut-sei=Inagaki en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=4 article-no= start-page=429 end-page=437 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Association between Preoperative Blood Pressure Elevations and Postoperative Adverse Outcomes after Non-cardiac Surgery: A Single-center Retrospective Observational Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Blood pressure (BP) often rises before surgery. This study investigated whether BP elevation immediately before surgery was associated with adverse outcomes. Medical records of 11,732 patients (average age: 61 years; male: 47.4%) who underwent non-cardiac elective inpatient surgery under general anesthesia at Kagawa University Hospital between January 2011 and June 2019 were reviewed. Differences between the first BP values measured on the day before surgery and the first BP values in the operating room were defined as Δ systolic BP (ΔSBP) and Δ diastolic BP (ΔDBP). The relationships between ΔSBP/ΔDBP and 30-day mortality, 30-day readmission, and over-the-standard length of hospital stay (OSLOS) were assessed. OSLOS was defined as a hospital stay longer than mean+2 standard deviations and was calculated using the Japanese Diagnosis Procedure Combination data. In univariate analysis, the differences in ΔSBP and ΔDBP between the OSLOS and standard LOS groups were both 2 mmHg. In multivariate logistic regression analysis, only ΔDBP was associated with OSLOS. The adjusted odds ratio (95% confidence interval) for the largest quartile was 1.31 (1.02-1.69) (p<0.05). ΔDBP was associated with OSLOS; however, there may be little need to worry about large ΔSBPs and ΔDBPs in clinical practice. en-copyright= kn-copyright= en-aut-name=YamadoriYusuke en-aut-sei=Yamadori en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HiraoTomohiro en-aut-sei=Hirao en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Nlandu R. Ngatu en-aut-sei=Nlandu R. Ngatu en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KandaKanae en-aut-sei=Kanda en-aut-mei=Kanae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=Syed Mahfuz Al Hasan en-aut-sei=Syed Mahfuz Al Hasan en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MurakamiAkitsu en-aut-sei=Murakami en-aut-mei=Akitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MashimaYukinori en-aut-sei=Mashima en-aut-mei=Yukinori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ShirakamiGotaro en-aut-sei=Shirakami en-aut-mei=Gotaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Anesthesiology, Faculty of Medicine, Kagawa University kn-affil= affil-num=2 en-affil=Department of Public Health, Faculty of Medicine, Kagawa University kn-affil= affil-num=3 en-affil=Department of Public Health, Faculty of Medicine, Kagawa University kn-affil= affil-num=4 en-affil=Department of Public Health, Faculty of Medicine, Kagawa University kn-affil= affil-num=5 en-affil=Department of Public Health, Faculty of Medicine, Kagawa University kn-affil= affil-num=6 en-affil=Department of Anesthesiology, Faculty of Medicine, Kagawa University kn-affil= affil-num=7 en-affil=Department of Public Health, Faculty of Medicine, Kagawa University kn-affil= affil-num=8 en-affil=Department of Anesthesiology, Faculty of Medicine, Kagawa University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=4 article-no= start-page=359 end-page=371 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Therapeutic Approaches Targeting miRNA in Systemic Lupus Erythematosus en-subtitle= kn-subtitle= en-abstract= kn-abstract=Systemic lupus erythematosus (SLE) is a potentially fatal systemic autoimmune disease, and its etiology involves both genetic and environmental factors such as sex hormone imbalance, genetic predisposition, epigenetic regulation, and immunological factors. Dysregulation of microRNA (miRNA) is suggested to be one of the epigenetic factors in SLE. miRNA is a 22-nucleotide single-stranded noncoding RNA that contributes to post-transcriptional modulation of gene expression. miRNA targeting therapy has been suggested to be useful for the treatment of cancers and other diseases. Gene knockout and miRNA targeting therapy have been demonstrated to improve SLE disease activity in mice. However, these approaches have not yet reached the level of clinical application. miRNA targeting therapy is limited by the fact that each miRNA has multiple targets. In addition, the expression of certain miRNAs may differ among cell tissues within a single SLE patient. This limitation can be overcome by targeted delivery and chemical modifications. In the future, further research into miRNA chemical modifications and delivery systems will help us develop novel therapeutic agents for SLE. en-copyright= kn-copyright= en-aut-name=Hiramatsu-AsanoSumie en-aut-sei=Hiramatsu-Asano en-aut-mei=Sumie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=systemic lupus erythematosus kn-keyword=systemic lupus erythematosus en-keyword=miRNA kn-keyword=miRNA en-keyword=miRNA targeting therapy kn-keyword=miRNA targeting therapy END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=8 article-no= start-page=1117 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220814 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Edaravone Attenuated Angiotensin II-Induced Atherosclerosis and Abdominal Aortic Aneurysms in Apolipoprotein E-Deficient Mice en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: The aim of the study was to define whether edaravone, a free-radical scavenger, influenced angiotensin II (AngII)-induced atherosclerosis and abdominal aortic aneurysms (AAAs) formation. Methods: Male apolipoprotein E-deficient mice (8-12 weeks old) were fed with a normal diet for 5 weeks. Either edaravone (10 mg/kg/day) or vehicle was injected intraperitoneally for 5 weeks. After 1 week of injections, mice were infused subcutaneously with either AngII (1000 ng/kg/min, n = 16-17 per group) or saline (n = 5 per group) by osmotic minipumps for 4 weeks. Results: AngII increased systolic blood pressure equivalently in mice administered with either edaravone or saline. Edaravone had no effect on plasma total cholesterol concentrations and body weights. AngII infusion significantly increased ex vivo maximal diameters of abdominal aortas and en face atherosclerosis but was significantly attenuated by edaravone administration. Edaravone also reduced the incidence of AngII-induced AAAs. In addition, edaravone diminished AngII-induced aortic MMP-2 activation. Quantitative RT-PCR revealed that edaravone ameliorated mRNA abundance of aortic MCP-1 and IL-1 beta. Immunostaining demonstrated that edaravone attenuated oxidative stress and macrophage accumulation in the aorta. Furthermore, edaravone administration suppressed thioglycolate-induced mice peritoneal macrophages (MPMs) accumulation and mRNA abundance of MCP-1 in MPMs in male apolipoprotein E-deficient mice. In vitro, edaravone reduced LPS-induced mRNA abundance of MCP-1 in MPMs. Conclusions: Edaravone attenuated AngII-induced AAAs and atherosclerosis in male apolipoprotein E-deficient mice via anti-oxidative action and anti-inflammatory effect. en-copyright= kn-copyright= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakatsukaTetsuharu en-aut-sei=Takatsuka en-aut-mei=Tetsuharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HadaYoshiko en-aut-sei=Hada en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=UmebayashiRyoko en-aut-sei=Umebayashi en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SubramanianVenkateswaran en-aut-sei=Subramanian en-aut-mei=Venkateswaran kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=DaughertyAlan en-aut-sei=Daugherty en-aut-mei=Alan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=Saha Cardiovascular Research Center, University of Kentucky kn-affil= affil-num=8 en-affil=Saha Cardiovascular Research Center, University of Kentucky kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=edaravone kn-keyword=edaravone en-keyword=angiotensin II kn-keyword=angiotensin II en-keyword=abdominal aortic aneurysm kn-keyword=abdominal aortic aneurysm en-keyword=atherosclerosis kn-keyword=atherosclerosis END start-ver=1.4 cd-journal=joma no-vol=27 cd-vols= no-issue=9 article-no= start-page=753 end-page=757 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220628 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Simulation for ultrasound‐guided renal biopsy using boiled egg en-subtitle= kn-subtitle= en-abstract= kn-abstract=Real-time ultrasound-guided renal biopsy is generally applied to diagnose multiple kidney diseases. A practical simulation model is desired since it is an invasive technique with higher risks of complications such as bleeding. We developed a simple simulation tool for ultrasound-guided renal biopsy using boiled eggs. Boiled chicken eggs were embedded in the agar, and a biopsy simulation was performed using a real-time ultrasound-guided technique as the renal biopsy simulator by trainees and biopsyproficient nephrologists, and the feedback from the participants was obtained. The ultrasonographic evaluation revealed a clear contrast between egg yolk and white, which clearly mimicked the kidney cortex and medulla region. In addition, we observed the needle entering the egg white under needle penetration, and we obtained the biopsy core consisting of egg white. As for the simulations, all the participants succeeded in obtaining the appropriate samples. A total of 92% of the trainees agreed that the simulation could reduce their fears of performing renal biopsies in patients. In addition, all the trainees and biopsy-proficient nephrologists recommend using the simulator for trainees before conducting renal biopsies on patients. The total cost of the simulator was low (< USD 1/simulator). Collectively, our simulation tool using boiled eggs may be a good candidate for practical simulation models of renal biopsy. en-copyright= kn-copyright= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama Japan kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama Japan kn-affil= affil-num=3 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama Japan kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama Japan kn-affil= en-keyword=Renal biopsy kn-keyword=Renal biopsy en-keyword=clinical nephrology kn-keyword=clinical nephrology en-keyword=ultrasound kn-keyword=ultrasound END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue= article-no= start-page=892356 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220502 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Potential Strategies for Kidney Regeneration With Stem Cells: An Overview en-subtitle= kn-subtitle= en-abstract= kn-abstract=Kidney diseases are a major health problem worldwide. Despite advances in drug therapies, they are only capable of slowing the progression of kidney diseases. Accordingly, potential kidney regeneration strategies with stem cells have begun to be explored. There are two different directions for regenerative strategies, de novo whole kidney fabrication with stem cells, and stem cell therapy. De novo whole kidney strategies include: 1) decellularized scaffold technology, 2) 3D bioprinting based on engineering technology, 3) kidney organoid fabrication, 4) blastocyst complementation with chimeric technology, and 5) the organogenic niche method. Meanwhile, stem cell therapy strategies include 1) injection of stem cells, including mesenchymal stem cells, nephron progenitor cells, adult kidney stem cells and multi-lineage differentiating stress enduring cells, and 2) injection of protective factors secreted from these stem cells, including growth factors, chemokines, and extracellular vesicles containing microRNAs, mRNAs and proteins. Over the past few decades, there have been remarkable step-by-step developments in these strategies. Here, we review the current advances in the potential strategies for kidney regeneration using stem cells, along with their challenges for possible clinical use in the future. en-copyright= kn-copyright= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=kidney regeneration kn-keyword=kidney regeneration en-keyword=stem cell kn-keyword=stem cell en-keyword=de novo kidney kn-keyword=de novo kidney en-keyword=cell therapy kn-keyword=cell therapy en-keyword=CKD kn-keyword=CKD END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=2 article-no= start-page=155 end-page=165 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202204 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinicopathological Features and Surgical Outcomes of Small Bowel Metastasis from Renal Cell Carcinoma en-subtitle= kn-subtitle= en-abstract= kn-abstract=Small bowel metastasis from renal cell carcinoma (RCC) is rare, and its clinicopathological characteristics are unclear; thus, we revisited the concept of this tumor and reviewed its diagnostic and treatment modalities. We filtered MEDLINE searches of articles published in English between 1950 and 2019, and identified 100 patients who had undergone treatment, including 1 patient from our clinic. We extracted patient characteristics, treatment, and prognostic data, resulting in clinicopathological data on 100 patients (83 men, 17 women). Mean age was 63 years (range, 16-86 years). Tumor sites were duodenum, jejunum, ileum, and multiple sites in 30, 37, 25, and 7 patients, respectively. The 1-, 3-, and 5-year overall survival rates after diagnosis were 53.0%, 36.0%, and 36.0%. Curative resection patients showed 62.1% 5-year survival after surgery, vs. 27.5% in noncurative surgical management cases. Good prognoses can be expected if these tumors are identified early for complete removal. Surgery is the only curative option. To determine the best management strategy and improve prognostic accuracy, we continue to collect and analyze epidemiological and pathological data. Although this condition is rare, surgery should be considered if curative resection is expected. Prognosis after curative resection is not poor, but recurrence is not unlikely. en-copyright= kn-copyright= en-aut-name=KimuraJiro en-aut-sei=Kimura en-aut-mei=Jiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OkabayashiTakehiro en-aut-sei=Okabayashi en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SuiKenta en-aut-sei=Sui en-aut-mei=Kenta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TabuchiMotoyasu en-aut-sei=Tabuchi en-aut-mei=Motoyasu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=IwataJun en-aut-sei=Iwata en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HataYasuhiro en-aut-sei=Hata en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IiyamaTatsuo en-aut-sei=Iiyama en-aut-mei=Tatsuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OnoNoriaki en-aut-sei=Ono en-aut-mei=Noriaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Gastroenterological Surgery, National Center for Global Health and Medicine kn-affil= affil-num=2 en-affil=Department of Gastroenterological Surgery, National Center for Global Health and Medicine kn-affil= affil-num=3 en-affil=Department of Gastroenterological Surgery, National Center for Global Health and Medicine kn-affil= affil-num=4 en-affil=Department of Gastroenterological Surgery, National Center for Global Health and Medicine kn-affil= affil-num=5 en-affil=Department of Diagnostic Pathology, National Center for Global Health and Medicine kn-affil= affil-num=6 en-affil=Department of Radiology, National Center for Global Health and Medicine kn-affil= affil-num=7 en-affil=Department of Biostatistics, National Center for Global Health and Medicine kn-affil= affil-num=8 en-affil=Department of Urology, Kochi Health Sciences Center kn-affil= en-keyword=renal cell carcinoma kn-keyword=renal cell carcinoma en-keyword=small bowel metastasis kn-keyword=small bowel metastasis en-keyword=intestine kn-keyword=intestine en-keyword=tumor kn-keyword=tumor END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=2 article-no= start-page=113 end-page=119 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202204 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relation between Prolonged Sedentary Bouts and Health-Related Quality of Life in Patients on Chronic Hemodialysis en-subtitle= kn-subtitle= en-abstract= kn-abstract=This study aimed to investigate the link between prolonged sedentary bouts and health-related quality of life (QOL) in patients on chronic hemodialysis (CHD). A total of 84 outpatients on CHD, aged 71.6±11.8 years, were enrolled in this cross-sectional study. Parameters for prolonged sedentary bouts [i.e., ≧ 30 min (% and bout) and ≧ 60 min (% and bout)] were measured using a triaxial accelerometer. Health-related QOL (HRQOL) was evaluated by the Euro-QOL (EQ-5D). Clinical parameters were obtained from medical records. Relatively prolonged sedentary bouts (%) were 44.0±18.2 (≧ 30 min) and 29.8±16.5 (≧ 60 min) for total days. Prolonged sedentary bouts (bouts) were 6.2±2.7 (≧ 30 min) and 2.7±1.6 (≧ 60 min) for total days. EQ-5D scores were 0.728±0.220. All prolonged sedentary bout parameters were negatively correlated with EQ-5D scores, except for prolonged sedentary bouts (≧ 60 min) (min) and relatively prolonged sedentary bouts (%) on hemodialysis days. Multiple regression analysis showed that prolonged sedentary bout parameters were an important factor in EQ-5D scores even after adjusting for confounding factors for total and non-hemodialysis days. Our results suggested that prolonged sedentary bouts were closely associated with HRQOL in patients on CHD, especially on non-hemodialysis days. en-copyright= kn-copyright= en-aut-name=NamioKeiichi en-aut-sei=Namio en-aut-mei=Keiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HishiiShuhei en-aut-sei=Hishii en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KondoTakashi en-aut-sei=Kondo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishiHiroyuki en-aut-sei=Nishi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KatayamaAkihiko en-aut-sei=Katayama en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UjikeKazuhiro en-aut-sei=Ujike en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KoumotoKiichi en-aut-sei=Koumoto en-aut-mei=Kiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SuzukiHiromi en-aut-sei=Suzuki en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HashimotoHiroo en-aut-sei=Hashimoto en-aut-mei=Hiroo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=2 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=3 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=4 en-affil=Innoshima General Hospital kn-affil= affil-num=5 en-affil=Innoshima General Hospital kn-affil= affil-num=6 en-affil=Faculty of Social Studies, Shikokugakuin University kn-affil= affil-num=7 en-affil=Innoshima General Hospital kn-affil= affil-num=8 en-affil=Innoshima General Hospital kn-affil= affil-num=9 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=10 en-affil=Innoshima General Hospital kn-affil= en-keyword=prolonged sedentary bouts kn-keyword=prolonged sedentary bouts en-keyword=hemodialysis kn-keyword=hemodialysis en-keyword=EQ-5D kn-keyword=EQ-5D en-keyword=QOL kn-keyword=QOL END start-ver=1.4 cd-journal=joma no-vol=2022 cd-vols= no-issue= article-no= start-page=3157841 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20220110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Association of Postprandial Triglyceride Variability with Renal Dysfunction and Microalbuminuria in Patients with Type 2 Diabetic Mellitus: A Retrospective and Observational Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective. We examined whether or not day-to-day variations in lipid profiles, especially triglyceride (TG) variability, were associated with the exacerbation of diabetic kidney disease. Methods. We conducted a retrospective and observational study. First, 527 patients with type 2 diabetes mellitus (DM) who had had their estimated glomerular filtration rate (eGFR) checked every 6 months since 2012 for over 5 years were registered. Variability in postprandial TG was determined using the standard deviation (SD), SD adjusted (Adj-SD) for the number of measurements, and maximum minus minimum difference (MMD) during the first three years of follow-up. The endpoint was a & GE;40% decline from baseline in the eGFR, initiation of dialysis or death. Next, 181 patients who had no micro- or macroalbuminuria in February 2013 were selected from among the 527 patients for an analysis. The endpoint was the incidence of microalbuminuria, initiation of dialysis, or death. Results. Among the 527 participants, 110 reached a & GE;40% decline from baseline in the eGFR or death. The renal survival was lower in the higher-SD, higher-Adj-SD, and higher-MMD groups than in the lower-SD, lower-Adj-SD, and lower-MMD groups, respectively (log-rank test p=0.0073, 0.0059, and 0.0195, respectively). A lower SD, lower Adj-SD, and lower MMD were significantly associated with the renal survival in the adjusted model (hazard ratio, 1.62, 1.66, 1.59; 95% confidence intervals, 1.05-2.53, 1.08-2.58, 1.04-2.47, respectively). Next, among 181 participants, 108 developed microalbuminuria or death. The nonincidence of microalbuminuria was lower in the higher-SD, higher-Adj-SD, and higher-MMD groups than in the lower-SD, lower-Adj-SD, and lower-MMD groups, respectively (log-rank test p=0.0241, 0.0352, and 0.0474, respectively). Conclusions. Postprandial TG variability is a novel risk factor for eGFR decline and the incidence of microalbuminuria in patients with type 2 DM. en-copyright= kn-copyright= en-aut-name=Matsuoka-UchiyamaNatsumi en-aut-sei=Matsuoka-Uchiyama en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkamotoShugo en-aut-sei=Okamoto en-aut-mei=Shugo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatayamaKatsuyoshi en-aut-sei=Katayama en-aut-mei=Katsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=Tsuchida-NishiwakiMariko en-aut-sei=Tsuchida-Nishiwaki en-aut-mei=Mariko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakemotoRika en-aut-sei=Takemoto en-aut-mei=Rika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HadaYoshiko en-aut-sei=Hada en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=UmebayashiRyoko en-aut-sei=Umebayashi en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KurookaNaoko en-aut-sei=Kurooka en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=NakajimaHirofumi en-aut-sei=Nakajima en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Nakashima Hospital kn-affil= affil-num=15 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=16 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=2 article-no= start-page=87 end-page=92 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=2022 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Confirmation of efficacy, elucidation of mechanism, and new search for indications of radon therapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Indications of radon therapy include various diseases related to respiratory, painful, digestive, chronic degenerative, senile, etc. derived from reactive oxygen species, but most are based on empirical prescriptions. For this reason, we have evaluated the relation between the biological response caused by radon and the tissue/organ absorbed dose more quantitatively, and have promoted the elucidation of mechanisms related to the indication and searching newly. As a result, as a mechanism, a series of moderate physiological stimulative effects accompanying a small amount of oxidative stress by radon inhalation are being elucidated. That is, hyperfunction of anti-oxidation/immune regulation/damage repair, promotion of anti-inflammation/circulating metabolism/hormone secretion, induction of apoptosis/heat shock protein, etc. Also, new indications include inflammatory/neuropathic pain, hepatic/renal injury, colitis, type 1 diabetes, complication kidney injury, hyperuricemia, transient cerebral ischemia, and inflammatory edema. Furthermore, we examined the combined antioxidant effect of radon inhalation and antioxidants or therapeutic agents. As a result, it was clear that any combination treatment could enhance the suppression effect of disease. It can be expected that radon therapy can be used effectively by applying it in addition to usual treatment, since reduction in its dosage can also be expected by concomitant use for drugs with strong side effects. en-copyright= kn-copyright= en-aut-name=YamaokaKiyonori en-aut-sei=Yamaoka en-aut-mei=Kiyonori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KataokaTakahiro en-aut-sei=Kataoka en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil=Health Sciences, Institute of Academic and Research, Okayama University kn-affil= affil-num=2 en-affil=Health Sciences, Institute of Academic and Research, Okayama University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=1 article-no= start-page=63 end-page=70 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Chidamide and Decitabine in Combination with a HAG Priming Regimen for Acute Myeloid Leukemia with TP53 Mutation en-subtitle= kn-subtitle= en-abstract= kn-abstract=We analyzed the treatment effects of chidamide and decitabine in combination with a HAG (homoharringtonine, cytarabine, G-CSF) priming regimen (CDHAG) in acute myeloid leukemia (AML) patients with TP53 mutation. Seven TP53 mutated AML patients were treated with CDHAG. The treatment effects were assessed using hemogram detection and bone marrow aspirate. The possible side effects were evaluated based on both hematological and non-hematological toxicity. Four of the seven patients were classified as having achieved complete remission after CDHAG treatment; one patient was considered to have achieved partial remission, and the remaining two patients were considered in non-remission. The overall response rate (ORR) to CDHAG was 71.4%. Regarding the side effects, the hematological toxicity level of the seven patients ranged from level III to level IV, and infections that occurred at lung, blood, and skin were recorded. Nausea, vomiting, liver injury, and kidney injury were also detected. However, all side effects were attenuated by proper management. The CDHAG regimen clearly improved the ORR (71.4%) of TP53-mutated AML patients, with no severe side effects. en-copyright= kn-copyright= en-aut-name=ZhangBei en-aut-sei=Zhang en-aut-mei=Bei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=PeiZhixin en-aut-sei=Pei en-aut-mei=Zhixin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WangHongxia en-aut-sei=Wang en-aut-mei=Hongxia kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WuHuimin en-aut-sei=Wu en-aut-mei=Huimin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WangJunjie en-aut-sei=Wang en-aut-mei=Junjie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=BaiJunjun en-aut-sei=Bai en-aut-mei=Junjun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SongQinglin en-aut-sei=Song en-aut-mei=Qinglin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=2 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=3 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=4 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=5 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=6 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= affil-num=7 en-affil=Department of Hematology, Jiaozuo People’s Hospital kn-affil= en-keyword=acute myeloid leukemia kn-keyword=acute myeloid leukemia en-keyword=chidamide kn-keyword=chidamide en-keyword=decitabine kn-keyword=decitabine en-keyword=HAG kn-keyword=HAG en-keyword=TP53 mutation kn-keyword=TP53 mutation END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=1 article-no= start-page=41 end-page=49 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Urinary Protein-to-creatinine Ratios Predict Recurrence in Pediatric and Young Adult Cases of Minimal Change Nephrotic Syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=High-dose steroids are required for the treatment of minimal change nephrotic syndrome (MCNS), especially for episodes of recurrence. Predicting and avoiding recurrence can help reduce the steroid dose, but prediction is currently difficult. We herein examined whether changes in laboratory data, especially the urinary protein- to-creatinine ratio (UTP/UCr), can predict clinical recurrence. We also assessed differences in clinical features between children and young adults. We included 36 patients with MCNS; for each case, we retrospectively studied laboratory data during stable remission and pre-recurrence, with the “stable” period defined as all but the 6 weeks before recurrence, and pre-recurrence defined as the 4±2 weeks before recurrence. UTP/UCr, serum albumin, etc. were measured every 5 years during stable periods. We divided patients into cohorts by age at recurrence, < 15 years and ? 15 years, and compared stable and pre-recurrence values for the two groups. UTP/UCr values during stable periods tended to be higher in younger patients. UTP/UCr and serum albumin showed statistically significant changes during pre-recurrence periods, but only in those aged ? 15 years. Thus, clinical features of recurrence differed depending on age. Signs of recurrence can be confirmed via UTP/UCr or serum albumin several weeks before recurrence in patients ? 15 years. en-copyright= kn-copyright= en-aut-name=MiyaharaHiroyuki en-aut-sei=Miyahara en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyaiTakayuki en-aut-sei=Miyai en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AyaKunihiko en-aut-sei=Aya en-aut-mei=Kunihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Pediatrics, Okayama University Hospital kn-affil= affil-num=4 en-affil=Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=minimal change nephrotic syndrome kn-keyword=minimal change nephrotic syndrome en-keyword=recurrence kn-keyword=recurrence en-keyword= urinary protein to creatinine ratio kn-keyword= urinary protein to creatinine ratio END start-ver=1.4 cd-journal=joma no-vol=76 cd-vols= no-issue=1 article-no= start-page=7 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=202202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Aging-related Characteristics of Subclinical Hypothyroidism Detected in General Practice en-subtitle= kn-subtitle= en-abstract= kn-abstract=Subclinical hypothyroidism (SCH) is diagnosed when serum thyrotropin (TSH) is elevated despite a normal thyroxine level and is known to increase the risk of metabolic disorders. This study was conducted to identify potential laboratory markers suspicious for latent SCH. We retrospectively reviewed 958 outpatients in whom thyroid functions had been examined. Eighty-five (9.1%) of the 939 analyzed subjects had SCH (73% females). In the SCH group, median serum TSH and FT4 levels were 5.04 μU/ml and 1.19 ng/dl, respectively, and auto-thyroid antibodies were detected in 53.8% of patients. SCH group patients were significantly older than patients in the euthyroid group, while there was no intergroup difference in BMI. However, 56.5% of the SCH patients were asymptomatic. In the SCH group, serum aspartate aminotransferase and low-density lipoprotein cholesterol (LDL-C) levels were significantly higher, and the estimated glomerular filtration rate (eGFR) was significantly lower than in the euthyroid group. Among patients less than 65 years of age, SCH patients tended to have lower eGFR and higher LDL-C than euthyroid patients. Age-dependent reductions of red blood cells and serum albumin were more prominent in the SCH than the euthyroid group. Biochemical changes with aging are useful as potential clues for suspecting latent SCH. en-copyright= kn-copyright= en-aut-name=TakamiMasao en-aut-sei=Takami en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoKoichiro en-aut-sei=Yamamoto en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakanoYasuhiro en-aut-sei=Nakano en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ObikaMikako en-aut-sei=Obika en-aut-mei=Mikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=FurukawaMasanori en-aut-sei=Furukawa en-aut-mei=Masanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Laboratory Medicine, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=aging kn-keyword=aging en-keyword=renal function kn-keyword=renal function en-keyword=cholesterol kn-keyword=cholesterol en-keyword=subclinical hypothyroidism kn-keyword=subclinical hypothyroidism en-keyword=thyroid function kn-keyword=thyroid function END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue= article-no= start-page=1 end-page=10 dt-received= dt-revised= dt-accepted= dt-pub-year=2022 dt-pub=20221 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Diffuse Large B-Cell Lymphoma 18 Years After Bilateral Lacrimal Gland IgG4-Related Disease: Case Report and Literature Review en-subtitle= kn-subtitle= en-abstract= kn-abstract=IgG4-related disease is a recently established clinical entity. The disease might serve as the background for later development of systemic lymphoma. This study aims to confirm the diagnosis of IgG4-related disease by re-staining lacrimal gland lesions diagnosed previously with low-grade lymphoma in a patient who developed systemic diffuse large B-cell lymphoma (DLBCL) 18 years later. A 53-year-old man developed bilateral lacrimal gland swelling and right submandibular gland swelling and was diagnosed by excision as low-grade lymphoma. In follow-up, positron emission tomography showed high uptake in the median hyoid 11 years later but no malignancy was detected by laryngeal submucosal biopsy. He was well with no treatment until 18 years later when he had palatal swelling and was diagnosed with DLBCL by oral floor biopsy. He had systemic lymphadenopathy, infiltration in paranasal sinuses, hypopharynx, small intestine, kidney, and prostate. He underwent 8 courses of R-CHOP and 3 courses of high-dose methotrexate and achieved complete remission with no relapse for 1 year thereafter. Re-immunostaining of paraffin blocks of bilateral lacrimal gland lesions showed IgG and IgG4-positive lymphocytes and plasma cells among lymphoid follicles separated by fibrous bundles, with 10 or more IgG4-positive cells in high-power field. The IgG4/IgG-positive cell ratio was 100% and the number of κ chain-positive cells and λ chain-positive cells was the same. The bilateral lacrimal lesions were thus re-diagnosed as IgG4-related disease. In conclusion, systemic DLBCL occurred approximately 20 years after lacrimal gland IgG4-related disease. Literature review revealed 12 patients with IgG4-related disease, including the present patient, who later developed lymphoma in the other organs. en-copyright= kn-copyright= en-aut-name=MatsuoToshihiko en-aut-sei=Matsuo en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanakaTakehiro en-aut-sei=Tanaka en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NotoharaKenji en-aut-sei=Notohara en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkadaKazuya en-aut-sei=Okada en-aut-mei=Kazuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems kn-affil= affil-num=2 en-affil=Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Pathology, Kurashiki Central Hospital kn-affil= affil-num=4 en-affil=Department of Hematology/Oncology, Kurashiki Central Hospital kn-affil= en-keyword=IgG4-related disease kn-keyword=IgG4-related disease en-keyword=lacrimal gland kn-keyword=lacrimal gland en-keyword=diffuse large B-cell lymphoma kn-keyword=diffuse large B-cell lymphoma en-keyword=re-immunostaining kn-keyword=re-immunostaining en-keyword=literature review kn-keyword=literature review END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=10 article-no= start-page=e04922 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20211006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Celiac artery dissection in polycystic kidney disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=Autosomal-dominant polycystic kidney disease (ADPKD) is rarely complicated by celiac artery dissection. Dissection of the aorta and its major branches should be carefully differentiated in ADPKD patients with acute-onset abdominal pain. en-copyright= kn-copyright= en-aut-name=YamamotoKoichiro en-aut-sei=Yamamoto en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HasegawaKou en-aut-sei=Hasegawa en-aut-mei=Kou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkaKosuke en-aut-sei=Oka en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=autosomal-dominant polycystic kidney disease kn-keyword=autosomal-dominant polycystic kidney disease en-keyword=hypertension and mesenteric artery dissection kn-keyword=hypertension and mesenteric artery dissection END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=5 article-no= start-page=585 end-page=593 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Factors for Acute Kidney Injury Following Total Arch Replacement and Association with Temperature Management During Cardiopulmonary Bypass: A Single-center Retrospective Observational Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Many patients develop acute kidney injury (AKI) after vascular surgery. In this retrospective observational study, we investigated the risk factors for AKI defined using the Kidney Disease Improving Global Outcomes criteria after total arch replacement (TAR). Additionally, we investigated the influence of temperature manage-ment during cardiopulmonary bypass (CPB) on postoperative renal function by propensity score-matched anal-ysis. We retrospectively analyzed 161 consecutive patients who underwent TAR between 2016 and 2019. Postoperative AKI occurred in 48.7% of the patients. In the multivariate analysis, male sex (odds ratio [OR] 3.95, 95% confidence interval [95%CI] 1.56-8.27, p = 0.002), ACE inhibitors/ARB medication (OR 3.19, 95%CI 1.49-6.82, p = 0.003), preoperative chronic kidney disease (OR 2.47, 95%CI 1.17-5.23, p = 0.02), pro-longed CPB time (OR 2.36, 95%CI 1.05-5.34, p = 0.04), and lower body ischemic time during CPB (OR 2.20, 95%CI 1.05-4.46, p = 0.04) were identified as independent risk factors for AKI. Propensity score-matched anal-ysis showed no significant difference in the risk of AKI following TAR between mild hypothermia or normo-thermia and moderate hypothermia (37.2% vs. 41.9%, p = 0.83). In conclusion, modifiable risk factors for AKI included prolonged CPB time and lower body ischemic time. Temperature management during CPB had no clear effect on outcomes. en-copyright= kn-copyright= en-aut-name=OmiyaHiroki en-aut-sei=Omiya en-aut-mei=Hiroki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakatoriMakoto en-aut-sei=Takatori en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YunokiKeiji en-aut-sei=Yunoki en-aut-mei=Keiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MorimatsuHiroshi en-aut-sei=Morimatsu en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Anesthesiology and Critical Care Medicine, Hiroshima Citizens Hospital kn-affil= affil-num=2 en-affil=Department of Anesthesiology and Critical Care Medicine, Hiroshima Citizens Hospital kn-affil= affil-num=3 en-affil=Department of Cardiovascular Surgery, Hiroshima Citizens Hospital kn-affil= affil-num=4 en-affil=Department of Anesthesiology and Resuscitation, Okayama University Hospital kn-affil= en-keyword=acute kidney injury kn-keyword=acute kidney injury en-keyword=total arch replacement kn-keyword=total arch replacement en-keyword=cardiopulmonary bypass kn-keyword=cardiopulmonary bypass en-keyword=lower body ischemic time kn-keyword=lower body ischemic time END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=1 article-no= start-page=3394 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210209 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Novel urinary glycan profiling by lectin array serves as the biomarkers for predicting renal prognosis in patients with IgA nephropathy en-subtitle= kn-subtitle= en-abstract= kn-abstract=In IgA nephropathy (IgAN), IgA1 molecules are characterized by galactose deficiency in O-glycans. Here, we investigated the association between urinary glycosylation profile measured by 45 lectins at baseline and renal prognosis in 142 patients with IgAN. The primary outcome was estimated glomerular filtration rate (eGFR) decline (>4 mL/min/1.73 m(2)/year), or eGFR >= 30% decline from baseline, or initiation of renal replacement therapies within 3 years. During follow-up (3.4 years, median), 26 patients reached the renal outcome (Group P), while 116 patients were with good renal outcome (Group G). Multivariate logistic regression analyses revealed that lectin binding signals of Erythrina cristagalli lectin (ECA) (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.11-7.28) and Narcissus pseudonarcissus lectin (NPA) (OR 2.32, 95% CI 1.11-4.85) adjusted by age, sex, eGFR, and urinary protein were significantly associated with the outcome, and they recognize Gal(beta 1-4)GlcNAc and high-mannose including Man(alpha 1-6)Man, respectively. The addition of two lectin-binding glycan signals to the interstitial fibrosis/tubular atrophy score further improved the model fitness (Akaike's information criterion) and incremental predictive abilities (c-index, net reclassification improvement, and integrated discrimination improvement). Urinary N-glycan profiling by lectin array is useful in the prediction of IgAN prognosis, since ECA and NPA recognize the intermediate glycans during N-glycosylation of various glycoproteins. en-copyright= kn-copyright= en-aut-name=KawakitaChieko en-aut-sei=Kawakita en-aut-mei=Chieko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiseKoki en-aut-sei=Mise en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OnishiYasuhiro en-aut-sei=Onishi en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshidaMichihiro en-aut-sei=Yoshida en-aut-mei=Michihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YamadaMasao en-aut-sei=Yamada en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil=GlycoTechnica Ltd kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=1 article-no= start-page=14990 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210722 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Association of blood pressure and renal outcome in patients with chronic kidney disease; a post hoc analysis of FROM-J study en-subtitle= kn-subtitle= en-abstract= kn-abstract=It is well-known that hypertension exacerbates chronic kidney disease (CKD) progression, however, the optimal target blood pressure (BP) level in patients with CKD remains unclear. This study aimed to assess the optimal BP level for preventing CKD progression. The risk of renal outcome among different BP categories at baseline as well as 1 year after, were evaluated using individual CKD patient data aged between 40 and 74 years from FROM-J [Frontier of Renal Outcome Modifications in Japan] study. The renal outcome was defined as >= 40% reduction in estimated glomerular filtration rate to<60 mL/min/1.73 m(2), or a diagnosis of end stage renal disease. Regarding baseline BP, the group of systolic BP (SBP) 120-129 mmHg had the lowest risk of the renal outcome, which increased more than 60% in SBP130 mmHg group. A significant increase in the renal outcome was found only in the group of diastolic BP >= 90 mmHg. The group of BP<130/80 mmHg had a benefit for lowering the risk regardless of the presence of proteinuria, and it significantly reduced the risk in patients with proteinuria. Achieving SBP level<130 mmHg after one year resulted in a 42% risk reduction in patients with SBP level >= 130 mmHg at baseline. Targeting SBP level<130 mmHg would be associated with the preferable renal outcome.Clinical Trial Registration-URL: https://www.umin.ac.jp/ctr/. Unique identifier: UMIN000001159 (16/05/2008). en-copyright= kn-copyright= en-aut-name=Tsuchida-NishiwakiMariko en-aut-sei=Tsuchida-Nishiwaki en-aut-mei=Mariko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NishiwakiNoriyuki en-aut-sei=Nishiwaki en-aut-mei=Noriyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MaeshimaYohei en-aut-sei=Maeshima en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SaitoChie en-aut-sei=Saito en-aut-mei=Chie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NaritaIchiei en-aut-sei=Narita en-aut-mei=Ichiei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WatanabeTsuyoshi en-aut-sei=Watanabe en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=MatsuoSeiichi en-aut-sei=Matsuo en-aut-mei=Seiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=HishidaAkira en-aut-sei=Hishida en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=YamagataKunihiro en-aut-sei=Yamagata en-aut-mei=Kunihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=4 en-affil=Department of Gastroenterological Surgery Transplant and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=6 en-affil=Department of Nephrology, Faculty of Medicine, University of Tsukuba kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=9 en-affil=Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science kn-affil= affil-num=10 en-affil=Tokyo-Kita Medical Center kn-affil= affil-num=11 en-affil=Nagoya University kn-affil= affil-num=12 en-affil=Okayama University kn-affil= affil-num=13 en-affil=Yaizu City Hospital kn-affil= affil-num=14 en-affil=Department of Nephrology, Faculty of Medicine, University of Tsukuba kn-affil= END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=3 article-no= start-page=397 end-page=402 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Case of Metastatic Fumarate Hydratase-Deficient?like Renal Cell Carcinoma Successfully Managed by Ipilimumab plus Nivolumab en-subtitle= kn-subtitle= en-abstract= kn-abstract=We report a 62-year-old male with metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) without fumarate hydratase (FH) mutation (FH-deficient?like RCC). The International Metastatic RCC Database Consortium risk score was intermediate, and immunotherapy with nivolumab and ipilimumab (Ipi/ Nivo) was initiated. Four cycles of Ipi/Nivo and 5 cycles of nivolumab resulted in a complete response of the metastases. Hypophysitis occurred as an immune-related adverse event after four cycles of Ipi/Nivo. The prognosis of patients with FH-deficient RCC is generally poor. Few reports of FH-deficient RCC successfully treated with Ipi/Nivo have been published. Ipi/Nivo can be effective for treating FH-deficient RCC. en-copyright= kn-copyright= en-aut-name=SekitoTakanori en-aut-sei=Sekito en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TakamotoAtsushi en-aut-sei=Takamoto en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MitsuiMasao en-aut-sei=Mitsui en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=WatariShogo en-aut-sei=Watari en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=IwataTakehiro en-aut-sei=Iwata en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=EdamuraKohei en-aut-sei=Edamura en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SakoTomoko en-aut-sei=Sako en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=WatanabeToyohiko en-aut-sei=Watanabe en-aut-mei=Toyohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=ShibataRei en-aut-sei=Shibata en-aut-mei=Rei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=EnnishiDaisuke en-aut-sei=Ennishi en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Kurashiki Medical Center kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Pathology, Okayama University Hospital kn-affil= affil-num=16 en-affil=Department of Hematology and Oncology, Okayama University Hospital kn-affil= affil-num=17 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=fumarate hydratase kn-keyword=fumarate hydratase en-keyword=fumarate hydratase-deficient renal cell carcinoma kn-keyword=fumarate hydratase-deficient renal cell carcinoma en-keyword=renal cell carcinoma kn-keyword=renal cell carcinoma en-keyword=ipilimumab kn-keyword=ipilimumab en-keyword=nivolumab kn-keyword=nivolumab END start-ver=1.4 cd-journal=joma no-vol=8 cd-vols= no-issue= article-no= start-page=668059 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210524 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Novel Urinary Glycan Biomarkers Predict Cardiovascular Events in Patients With Type 2 Diabetes: A Multicenter Prospective Study With 5-Year Follow Up (U-CARE Study 2) en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Although various biomarkers predict cardiovascular event (CVE) in patients with diabetes, the relationship of urinary glycan profile with CVE in patients with diabetes remains unclear. Methods: Among 680 patients with type 2 diabetes, we examined the baseline urinary glycan signals binding to 45 lectins with different specificities. Primary outcome was defined as CVE including cardiovascular disease, stroke, and peripheral arterial disease. Results: During approximately a 5-year follow-up period, 62 patients reached the endpoint. Cox proportional hazards analysis revealed that urinary glycan signals binding to two lectins were significantly associated with the outcome after adjustment for known indicators of CVE and for false discovery rate, as well as increased model fitness. Hazard ratios for these lectins (+1 SD for the glycan index) were UDA (recognizing glycan: mixture of Man5 to Man9): 1.78 (95% CI: 1.24-2.55, P = 0.002) and Calsepa [High-Man (Man2-6)]: 1.56 (1.19-2.04, P = 0.001). Common glycan binding to these lectins was high-mannose type of N-glycans. Moreover, adding glycan index for UDA to a model including known confounders improved the outcome prediction [Difference of Harrel's C-index: 0.028 (95% CI: 0.001-0.055, P = 0.044), net reclassification improvement at 5-year risk increased by 0.368 (0.045-0.692, P = 0.026), and the Akaike information criterion and Bayesian information criterion decreased from 725.7 to 716.5, and 761.8 to 757.2, respectively]. Conclusion: The urinary excretion of high-mannose glycan may be a valuable biomarker for improving prediction of CVE in patients with type 2 diabetes, and provides the rationale to explore the mechanism underlying abnormal N-glycosylation occurring in patients with diabetes at higher risk of CVE. en-copyright= kn-copyright= en-aut-name=MiseKoki en-aut-sei=Mise en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ImamuraMariko en-aut-sei=Imamura en-aut-mei=Mariko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamaguchiSatoshi en-aut-sei=Yamaguchi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HiguchiChigusa en-aut-sei=Higuchi en-aut-mei=Chigusa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KatayamaAkihiro en-aut-sei=Katayama en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=HidaKazuyuki en-aut-sei=Hida en-aut-mei=Kazuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NakatoTatsuaki en-aut-sei=Nakato en-aut-mei=Tatsuaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=ToneAtsuhito en-aut-sei=Tone en-aut-mei=Atsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TeshigawaraSanae en-aut-sei=Teshigawara en-aut-mei=Sanae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=MatsuokaTakashi en-aut-sei=Matsuoka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KameiShinji en-aut-sei=Kamei en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=MurakamiKazutoshi en-aut-sei=Murakami en-aut-mei=Kazutoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=ShimizuIkki en-aut-sei=Shimizu en-aut-mei=Ikki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=MiyashitaKatsuhiro en-aut-sei=Miyashita en-aut-mei=Katsuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=AndoShinichiro en-aut-sei=Ando en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=NunoueTomokazu en-aut-sei=Nunoue en-aut-mei=Tomokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=YoshidaMichihiro en-aut-sei=Yoshida en-aut-mei=Michihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=YamadaMasao en-aut-sei=Yamada en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Diabetes Center, Okayama University Hospital kn-affil= affil-num=7 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center kn-affil= affil-num=12 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=13 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=14 en-affil=Okayama Saiseikai General Hospital kn-affil= affil-num=15 en-affil=Kurashiki Central Hospital kn-affil= affil-num=16 en-affil=Kurashiki Central Hospital kn-affil= affil-num=17 en-affil=Kurashiki Central Hospital kn-affil= affil-num=18 en-affil=The Sakakibara Heart Institute of Okayama kn-affil= affil-num=19 en-affil=Japanese Red Cross Okayama Hospital kn-affil= affil-num=20 en-affil=Okayama City General Medical Center kn-affil= affil-num=21 en-affil=Nunoue Clinic kn-affil= affil-num=22 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=23 en-affil=GlycoTechnica Ltd. kn-affil= affil-num=24 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=25 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=cardiovascular event kn-keyword=cardiovascular event en-keyword=diabetes kn-keyword=diabetes en-keyword=lectins kn-keyword=lectins en-keyword=N-glycans kn-keyword=N-glycans en-keyword=urinary biomarkers kn-keyword=urinary biomarkers END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=12 article-no= start-page=6105 end-page=6119 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210407 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Current and future perspectives on functional molecular imaging in nephro-urology: theranostics on the horizon en-subtitle= kn-subtitle= en-abstract= kn-abstract=In recent years, a paradigm shift from single-photon-emitting radionuclide radiotracers toward positron-emission tomography (PET) radiotracers has occurred in nuclear oncology. Although PET-based molecular imaging of the kidneys is still in its infancy, such a trend has emerged in the field of functional renal radionuclide imaging. Potentially allowing for precise and thorough evaluation of renal radiotracer urodynamics, PET radionuclide imaging has numerous advantages including precise anatomical co-registration with CT images and dynamic three-dimensional imaging capability. In addition, relative to scintigraphic approaches, PET can allow for significantly reduced scan time enabling high-throughput in a busy PET practice and further reduces radiation exposure, which may have a clinical impact in pediatric populations. In recent years, multiple renal PET radiotracers labeled with C-11, Ga-68, and F-18 have been utilized in clinical studies. Beyond providing a precise non-invasive read-out of renal function, such radiotracers may also be used to assess renal inflammation. This manuscript will provide an overview of renal molecular PET imaging and will highlight the transformation of conventional scintigraphy of the kidneys toward novel, high-resolution PET imaging for assessing renal function. In addition, future applications will be introduced, e.g. by transferring the concept of molecular image-guided diagnostics and therapy (theranostics) to the field of nephrology. en-copyright= kn-copyright= en-aut-name=ToyamaYoshitaka en-aut-sei=Toyama en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WernerRudolf A. en-aut-sei=Werner en-aut-mei=Rudolf A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=Ruiz-BedoyaCamilo A. en-aut-sei=Ruiz-Bedoya en-aut-mei=Camilo A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OrdonezAlvaro A. en-aut-sei=Ordonez en-aut-mei=Alvaro A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakaseKei en-aut-sei=Takase en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=LapaConstantin en-aut-sei=Lapa en-aut-mei=Constantin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=JainSanjay K. en-aut-sei=Jain en-aut-mei=Sanjay K. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=PomperMartin G. en-aut-sei=Pomper en-aut-mei=Martin G. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=RoweSteven P. en-aut-sei=Rowe en-aut-mei=Steven P. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nuclear Medicine, University Hospital Wuerzburg kn-affil= affil-num=2 en-affil=Department of Nuclear Medicine, University Hospital Wuerzburg kn-affil= affil-num=3 en-affil=Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine kn-affil= affil-num=4 en-affil=Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine kn-affil= affil-num=5 en-affil=Department of Diagnostic Radiology, Tohoku University kn-affil= affil-num=6 en-affil=Nuclear Medicine, Medical Faculty, University of Augsburg kn-affil= affil-num=7 en-affil=Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine kn-affil= affil-num=8 en-affil=Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine kn-affil= affil-num=9 en-affil=Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine kn-affil= affil-num=10 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Glomerular filtration rate kn-keyword=Glomerular filtration rate en-keyword=renal kn-keyword=renal en-keyword=kidney kn-keyword=kidney en-keyword=renal function kn-keyword=renal function en-keyword=positron emission tomography kn-keyword=positron emission tomography en-keyword=nephrology kn-keyword=nephrology en-keyword=urology kn-keyword=urology en-keyword=molecular imaging kn-keyword=molecular imaging en-keyword=theranostics kn-keyword=theranostics END start-ver=1.4 cd-journal=joma no-vol=18 cd-vols= no-issue=8 article-no= start-page=1831 end-page=1839 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=20210222 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Artificial intelligence supported anemia control system (AISACS) to prevent anemia in maintenance hemodialysis patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=Anemia, for which erythropoiesis-stimulating agents (ESAs) and iron supplements (ISs) are used as preventive measures, presents important difficulties for hemodialysis patients. Nevertheless, the number of physicians able to manage such medications appropriately is not keeping pace with the rapid increase of hemodialysis patients. Moreover, the high cost of ESAs imposes heavy burdens on medical insurance systems. An artificial-intelligence-supported anemia control system (AISACS) trained using administration direction data from experienced physicians has been developed by the authors. For the system, appropriate data selection and rectification techniques play important roles. Decision making related to ESAs poses a multi-class classification problem for which a two-step classification technique is introduced. Several validations have demonstrated that AISACS exhibits high performance with correct classification rates of 72%-87% and clinically appropriate classification rates of 92%-98%. en-copyright= kn-copyright= en-aut-name=OharaToshiaki en-aut-sei=Ohara en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaHiroshi en-aut-sei=Ikeda en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SugitaniYoshiki en-aut-sei=Sugitani en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SuitoHiroshi en-aut-sei=Suito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HuynhViet Quang Huy en-aut-sei=Huynh en-aut-mei=Viet Quang Huy kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KinomuraMasaru en-aut-sei=Kinomura en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HaraguchiSoichiro en-aut-sei=Haraguchi en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SakuramaKazufumi en-aut-sei=Sakurama en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Pathology & Experimental Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Internal Medicine, Shigei Medical Research Hospital kn-affil= affil-num=3 en-affil=Advanced Institute for Materials Research, Tohoku University kn-affil= affil-num=4 en-affil=Advanced Institute for Materials Research, Tohoku University kn-affil= affil-num=5 en-affil=Advanced Institute for Materials Research, Tohoku University kn-affil= affil-num=6 en-affil=Division of Hemodialysis and Apheresis, Okayama University Hospital kn-affil= affil-num=7 en-affil=Kobayashi Medicine Clinic kn-affil= affil-num=8 en-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=anemia kn-keyword=anemia en-keyword=artificial intelligence kn-keyword=artificial intelligence en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=erythropoiesis-stimulating agents kn-keyword=erythropoiesis-stimulating agents en-keyword=hemodialysis kn-keyword=hemodialysis en-keyword=iron kn-keyword=iron END start-ver=1.4 cd-journal=joma no-vol=46 cd-vols= no-issue=9 article-no= start-page=1773 end-page=1786 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20190530 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The next era of renal radionuclide imaging: novel PET radiotracers en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although single-photon-emitting radiotracers have long been the standard for renal functional molecular imaging, recent years have seen the development of positron emission tomography (PET) agents for this application. We provide an overview of renal radionuclide PET radiotracers, in particular focusing on novel 18F-labelled and 68Ga-labelled agents. Several reported PET imaging probes allow assessment of glomerular filtration rate, such as [68Ga]ethylenediaminetetraacetic acid ([68Ga]EDTA), [68Ga]IRDye800-tilmanocept and 2-deoxy-2-[18F]fluorosorbitol ([18F]FDS)). The diagnostic performance of [68Ga]EDTA has already been demonstrated in a clinical trial. [68Ga]IRDye800-tilmanocept shows receptor-mediated binding to glomerular mesangial cells, which in turn may allow the monitoring of progression of diabetic nephropathy. [18F]FDS shows excellent kidney extraction and excretion in rats and, as has been shown in the first study in humans. Further, due to its simple one-step radiosynthesis via the most frequently used PET radiotracer 2-deoxy-2-[18F]fluoro-d-glucose, [18F]FDS could be available at nearly every PET centre. A new PET radiotracer has also been introduced for the effective assessment of plasma flow in the kidneys: Re(CO)3-N-([18F]fluoroethyl)iminodiacetic acid (Re(CO)3([18F]FEDA)). This compound demonstrates similar pharmacokinetic properties to its 99mTc-labelled analogue [99mTc](CO)3(FEDA). Thus, if there is a shortage of molybdenum-99, Re(CO)3([18F]FEDA would allow direct comparison with previous studies with 99mTc. The PET radiotracers for renal imaging reviewed here allow thorough evaluation of kidney function, with the tremendous advantage of precise anatomical coregistration with simultaneously acquired CT images and rapid three-dimensional imaging capability. en-copyright= kn-copyright= en-aut-name=WernerRudolf A. en-aut-sei=Werner en-aut-mei=Rudolf A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ChenXinyu en-aut-sei=Chen en-aut-mei=Xinyu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=LapaConstantin en-aut-sei=Lapa en-aut-mei=Constantin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KoshinoKazuhiro en-aut-sei=Koshino en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=RoweSteven P. en-aut-sei=Rowe en-aut-mei=Steven P. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=PomperMartin G. en-aut-sei=Pomper en-aut-mei=Martin G. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=JavadiMehrbod S. en-aut-sei=Javadi en-aut-mei=Mehrbod S. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Nuclear Medicine/Comprehensive Heart Failure Center, University of Wuerzburg kn-affil= affil-num=2 en-affil=Department of Nuclear Medicine/Comprehensive Heart Failure Center, University of Wuerzburg kn-affil= affil-num=3 en-affil=Department of Nuclear Medicine/Comprehensive Heart Failure Center, University of Wuerzburg kn-affil= affil-num=4 en-affil=Department of Biomedical Imaging, National Cardiovascular and Cerebral Center kn-affil= affil-num=5 en-affil=Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine kn-affil= affil-num=6 en-affil= kn-affil= affil-num=7 en-affil=Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine kn-affil= affil-num=8 en-affil=Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School kn-affil= en-keyword=Kidney kn-keyword=Kidney en-keyword=Positron emission tomography kn-keyword=Positron emission tomography en-keyword=PET kn-keyword=PET en-keyword=[18F]Fluorodeoxysorbitol kn-keyword=[18F]Fluorodeoxysorbitol en-keyword=GFR kn-keyword=GFR en-keyword=ERPF kn-keyword=ERPF END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=1 article-no= start-page=45 end-page=53 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=202102 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Possible Protective Effect of Remote Ischemic Preconditioning on Acute Kidney Injury Following Elective Percutaneous Coronary Intervention: Secondary Analysis of a Multicenter, Randomized Study en-subtitle= kn-subtitle= en-abstract= kn-abstract=Remote ischemic preconditioning (RIPC) is a promising strategy for protecting against ischemic reperfusion injury. This study is a secondary analysis of a randomized study that aimed to evaluate the effect of RIPC on the early increase in serum creatinine (SCr) following percutaneous coronary intervention (PCI), which is associ-ated with contrast-induced acute kidney injury. Patients with stable angina undergoing elective PCI were assigned to control, RIPC, and continuous infusion of nicorandil (nicorandil) groups. The endpoint of this study was the incidence of the early increase in SCr, a predictor of contrast-induced acute kidney injury, which was defined as either a > 20% or absolute increase by 0.3 mg/dl of SCr levels after 24 h of PCI. This study included 220 patients for whom a dataset of SCr values was available. The incidence of the early increase in SCr was significantly lower in the RIPC than in the control (1.3% vs 10.8%, p = 0.03) group, but was not significantly different between the nicorandil and control groups. In multivariate analysis, RIPC remained a significant fac-tor associated with a reduction in the incidence of early increase in SCr. RIPC reduces the incidence of early increase in SCr in patients with stable angina following elective PCI. en-copyright= kn-copyright= en-aut-name=OtsukaHiroaki en-aut-sei=Otsuka en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyoshiToru en-aut-sei=Miyoshi en-aut-mei=Toru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=EjiriKentaro en-aut-sei=Ejiri en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KohnoKunihisa en-aut-sei=Kohno en-aut-mei=Kunihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakahamaMakoto en-aut-sei=Nakahama en-aut-mei=Makoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=DoiMasayuki en-aut-sei=Doi en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MunemasaMitsuru en-aut-sei=Munemasa en-aut-mei=Mitsuru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MurakamiMasaaki en-aut-sei=Murakami en-aut-mei=Masaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NakamuraKazufumi en-aut-sei=Nakamura en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=ItoHiroshi en-aut-sei=Ito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Cardiology, Fukuyama City Hospital kn-affil= affil-num=6 en-affil=Department of Cardiology, Kagawa Prefectural Central Hospital kn-affil= affil-num=7 en-affil=Department of Cardiology, Okayama Medical Center kn-affil= affil-num=8 en-affil=Department of Cardiology, Okayama Heart Clinic kn-affil= affil-num=9 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences kn-affil= en-keyword=remote ischemic preconditioning kn-keyword=remote ischemic preconditioning en-keyword=stable angina kn-keyword=stable angina en-keyword=serum creatinine kn-keyword=serum creatinine en-keyword=acute kidney injury kn-keyword=acute kidney injury END start-ver=1.4 cd-journal=joma no-vol=11 cd-vols= no-issue=2 article-no= start-page=325 end-page=332 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200517 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prevalence of albuminuria and renal dysfunction, and related clinical factors in Japanese patients with diabetes: The Japan Diabetes Complication and its Prevention prospective study 5 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims/Introduction
To clarify the prevalence of albuminuria and renal dysfunction, and related factors in Japanese patients with diabetes, we analyzed the baseline data of the Japan Diabetes Complication and its Prevention prospective study.
Materials and Methods
We used the data of 355 patients with type 1 diabetes and 5,194 patients with type 2 diabetes to evaluate the prevalence of albuminuria and renal dysfunction, and related factors. A binomial logistic regression analysis was used to investigate independent contributing factors for estimated glomerular filtration rate <60 mL/min/1.73 m2 or albuminuria.
Results
The prevalence of microalbuminuria and macroalbuminuria was 15.2% (54/355) and 3.1% (11/355) in type 1 diabetes patients, and 25.0% (1,298/5,194) and 5.1% (265/5,194) in type 2 diabetes patients, respectively. The proportion of renal dysfunction (estimated glomerular filtration rate <60 mL/min/1.73 m2) was 9.9% (35/355) in type 1 diabetes patients, and 15.3% (797/5,194) in type 2 diabetes patients. The proportion of patients with renal dysfunction with normoalbuminuria was 7.3% (26/355) for type 1 diabetes patients, and 9.0% (467/5,194) for type 2 diabetes patients. The factors related to albuminuria in type 2 diabetes patients were glycated hemoglobin, hypertension, age, duration of diabetes, body mass index and estimated glomerular filtration rate. In contrast, factors to related renal dysfunction were age, duration of diabetes, dyslipidemia, hypertension, body mass index, male sex and albuminuria.
Conclusions
We showed the recent prevalence of albuminuria and renal dysfunction, and related factors in Japanese type 1 and type 2 diabetes patients using the baseline data of the Japan Diabetes Complication and its Prevention prospective study. The current results suggest that renal disease in patients with type 2 diabetes is heterogeneous, and different mechanisms might be involved in albuminuria and deterioration of renal function. en-copyright= kn-copyright= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KoderaRyo en-aut-sei=Kodera en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UtsunomiyaKazunori en-aut-sei=Utsunomiya en-aut-mei=Kazunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KoyaDaisuke en-aut-sei=Koya en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishimuraRimei en-aut-sei=Nishimura en-aut-mei=Rimei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TajimaNaoko en-aut-sei=Tajima en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=the JDCP study group en-aut-sei=the JDCP study group en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=The Japan Diabetes Society kn-affil= affil-num=3 en-affil=The Japan Diabetes Society kn-affil= affil-num=4 en-affil=The Japan Diabetes Society kn-affil= affil-num=5 en-affil=The Japan Diabetes Society kn-affil= affil-num=6 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=7 en-affil=The Japan Diabetes Society kn-affil= affil-num=8 en-affil= kn-affil= en-keyword=Diabetic nephropathy kn-keyword=Diabetic nephropathy en-keyword=Diabetic kidney disease kn-keyword=Diabetic kidney disease en-keyword=Japan Diabetes Complication and its Prevention study kn-keyword=Japan Diabetes Complication and its Prevention study END start-ver=1.4 cd-journal=joma no-vol=59 cd-vols= no-issue=11 article-no= start-page=1345 end-page=1350 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200601 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Clinical Characteristics and Risk Factors for Rebleeding in Patients with Obscure Gastrointestinal Bleeding en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objective With the advent of capsule endoscopy (CE) and double-balloon endoscopy (DBE), the diagnosis and treatment of obscure gastrointestinal bleeding (OGIB) have markedly progressed. However, rebleeding sometimes occurs and is difficult to diagnose and treat. The aim of the present study was to investigate the clinical features of OGIB and risk factors for rebleeding in our hospital.
Methods A total of 195 patients who underwent CE and/or DBE for OGIB in our hospital from January 2009 to July 2016 were included in the present study. We analyzed 168 cases of small intestinal OGIB, after excluding 27 cases of extra small intestinal bleeding. The clinical characteristics and risk factors related to rebleeding were retrospectively studied.
Results Among the 168 patients who were included in the analysis, 95 patients (56.5%) were male. The mean age was 64.5 years (range, 8 to 87 years). Hypertension (31.0%) was the most frequent comorbidity, followed by chronic kidney disease (19.0%). The final diagnoses were ulcerative lesions (n=50, 29.8%), vascular lesions (n=30, 17.9%), tumors (n=7, 4.2%), and diverticula (n=2, 1.2%). The bleeding source was undetermined in the remaining 79 cases (47.0%). Rebleeding was confirmed in 29 cases (17.3%). In a univariate analysis, chronic kidney disease, vascular lesions, and overt previous bleeding were significantly associated with the risk of rebleeding. A multivariate analysis showed that chronic kidney disease, vascular lesion, and overt previous bleeding were significantly associated with the risk of rebleeding.
Conclusion Patients with OGIB with overt previous bleeding, vascular lesions, and/or chronic kidney disease had a higher risk of rebleeding. en-copyright= kn-copyright= en-aut-name=BabaYuki en-aut-sei=Baba en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawanoSeiji en-aut-sei=Kawano en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KonoYoshiyasu en-aut-sei=Kono en-aut-mei=Yoshiyasu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InokuchiToshihiro en-aut-sei=Inokuchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KanzakiHiromitsu en-aut-sei=Kanzaki en-aut-mei=Hiromitsu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=IwamuroMasaya en-aut-sei=Iwamuro en-aut-mei=Masaya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HaradaKeita en-aut-sei=Harada en-aut-mei=Keita kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KawaharaYoshiro en-aut-sei=Kawahara en-aut-mei=Yoshiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=obscure gastrointestinal bleeding kn-keyword=obscure gastrointestinal bleeding en-keyword=overt previous bleeding kn-keyword=overt previous bleeding en-keyword=vascular lesions kn-keyword=vascular lesions en-keyword=chronic kidney disease kn-keyword=chronic kidney disease END start-ver=1.4 cd-journal=joma no-vol=30 cd-vols= no-issue=3 article-no= start-page=1342 end-page=1349 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=20191126 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Robotic CT-guided out-of-plane needle insertion: comparison of angle accuracy with manual insertion in phantom and measurement of distance accuracy in animals en-subtitle= kn-subtitle= en-abstract= kn-abstract=Objectives
To evaluate the accuracy of robotic CT-guided out-of-plane needle insertion in phantom and animal experiments.
Methods
A robotic system (Zerobot), developed at our institution, was used for needle insertion. In the phantom experiment, 12 robotic needle insertions into a phantom at various angles in the XY and YZ planes were performed, and the same insertions were manually performed freehand, as well as guided by a smartphone application (SmartPuncture). Angle errors were compared between the robotic and smartphone-guided manual insertions using Student’s t test. In the animal experiment, 6 robotic out-of-plane needle insertions toward targets of 1.0 mm in diameter placed in the kidneys and hip muscles of swine were performed, each with and without adjustment of needle orientation based on reconstructed CT images during insertion. Distance accuracy was calculated as the distance between the needle tip and the target center.
Results
In the phantom experiment, the mean angle errors of the robotic, freehand manual, and smartphone-guided manual insertions were 0.4°, 7.0°, and 3.7° in the XY plane and 0.6°, 6.3°, and 0.6° in the YZ plane, respectively. Robotic insertions in the XY plane were significantly (p < 0.001) more accurate than smartphone-guided insertions. In the animal experiment, the overall mean distance accuracy of robotic insertions with and without adjustment of needle orientation was 2.5 mm and 5.0 mm, respectively.
Conclusion
Robotic CT-guided out-of-plane needle insertions were more accurate than smartphone-guided manual insertions in the phantom and were also accurate in the in vivo procedure, particularly with adjustment during insertion. en-copyright= kn-copyright= en-aut-name=KomakiToshiyuki en-aut-sei=Komaki en-aut-mei=Toshiyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KamegawaTetsushi en-aut-sei=Kamegawa en-aut-mei=Tetsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MatsunoTakayuki en-aut-sei=Matsuno en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SakuraiJun en-aut-sei=Sakurai en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MatsuuraRyutaro en-aut-sei=Matsuura en-aut-mei=Ryutaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YamaguchiTakuya en-aut-sei=Yamaguchi en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SasakiTakanori en-aut-sei=Sasaki en-aut-mei=Takanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MitsuhashiToshiharu en-aut-sei=Mitsuhashi en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OkamotoSoichiro en-aut-sei=Okamoto en-aut-mei=Soichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=UkaMayu en-aut-sei=Uka en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MatsuiYusuke en-aut-sei=Matsui en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=GobaraHideo en-aut-sei=Gobara en-aut-mei=Hideo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=2 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=3 en-affil=Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University kn-affil= affil-num=4 en-affil=Graduate School of Natural Science and Technology, Okayama University kn-affil= affil-num=5 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=6 en-affil=Graduate School of Health Sciences, Okayama University Medical School kn-affil= affil-num=7 en-affil=Division of Radiology, Department of Medical Technology, Okayama University Hospital kn-affil= affil-num=8 en-affil=Collaborative Research Center for OMIC, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=11 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=12 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=13 en-affil=Department of Radiology, Okayama University Medical School kn-affil= affil-num=14 en-affil=Division of Medical Informatics, Okayama University Hospital kn-affil= affil-num=15 en-affil=Department of Radiology, Okayama University Medical School kn-affil= en-keyword=Robotics kn-keyword=Robotics en-keyword=Interventional radiology kn-keyword=Interventional radiology en-keyword=Animal experiments kn-keyword=Animal experiments END start-ver=1.4 cd-journal=joma no-vol=127 cd-vols= no-issue=6 article-no= start-page=851 end-page=873 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200409 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Recent advances in radiotracers targeting norepinephrine transporter: structural development and radiolabeling improvements en-subtitle= kn-subtitle= en-abstract= kn-abstract=The norepinephrine transporter (NET) is a major target for the evaluation of the cardiac sympathetic nerve system in patients with heart failure and Parkinson's disease. It is also used in the therapeutic applications against certain types of neuroendocrine tumors, as exemplified by the clinically used 123/131I-MIBG as theranostic single-photon emission computed tomography (SPECT) agent. With the development of more advanced positron emission tomography (PET) technology, more radiotracers targeting NET have been reported, with superior temporal and spatial resolutions, along with the possibility of functional and kinetic analysis. More recently, fluorine-18-labelled NET tracers have drawn increasing attentions from researchers, due to their longer radiological half-life relative to carbon-11 (110 min vs. 20 min), reduced dependence on on-site cyclotrons, and flexibility in the design of novel tracer structures. In the heart, certain NET tracers provide integral diagnostic information on sympathetic innervation and the nerve status. In the central nervous system, such radiotracers can reveal NET distribution and density in pathological conditions. Most radiotracers targeting cardiac NET-function for the cardiac application consistent of derivatives of either norepinephrine or MIBG with its benzylguanidine core structure, e.g. 11C-HED and 18F-LMI1195. In contrast, all NET tracers used in central nervous system applications are derived from clinically used antidepressants. Lastly, possible applications of NET as selective tracers over organic cation transporters (OCTs) in the kidneys and other organs controlled by sympathetic nervous system will also be discussed. en-copyright= kn-copyright= en-aut-name=ChenXinyu en-aut-sei=Chen en-aut-mei=Xinyu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KudoTakashi en-aut-sei=Kudo en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=LapaConstantin en-aut-sei=Lapa en-aut-mei=Constantin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=BuckAndreas en-aut-sei=Buck en-aut-mei=Andreas kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HiguchiTakahiro en-aut-sei=Higuchi en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Nuclear Medicine, University Hospital of W?rzburg kn-affil= affil-num=2 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Department of Nuclear Medicine, University Hospital of W?rzburg kn-affil= affil-num=4 en-affil=Department of Nuclear Medicine, University Hospital of W?rzburg kn-affil= affil-num=5 en-affil=Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=Norepinephrine transporter kn-keyword=Norepinephrine transporter en-keyword=Benzylguanidine kn-keyword=Benzylguanidine en-keyword=Phenethylguanidine kn-keyword=Phenethylguanidine en-keyword=Antidepressant kn-keyword=Antidepressant en-keyword=Organic cation transporter kn-keyword=Organic cation transporter END start-ver=1.4 cd-journal=joma no-vol=134 cd-vols= no-issue=20 article-no= start-page=2771 end-page=2787 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201030 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Inhibition of interleukin-6 signaling attenuates aortitis, left ventricular hypertrophy and arthritis in interleukin-1 receptor antagonist deficient mice en-subtitle= kn-subtitle= en-abstract= kn-abstract=The aim of the present study was to examine whether inhibition of Interleukin (IL)-6 signaling by MR16-1, an IL-6 receptor antibody, attenuates aortitis, cardiac hypertrophy, and arthritis in IL-1 receptor antagonist deficient (IL-1RA KO) mice. Four weeks old mice were intraperitoneally administered with either MR16-1 or non-immune IgG at dosages that were adjusted over time for 5 weeks. These mice were stratified into four groups: MR16-1 treatment groups, KO/MR low group (first 2.0 mg, following 0.5 mg/week, n=14) and KO/MR high group (first 4.0 mg, following 2.0 mg/week, n=19) in IL-1RA KO mice, and IgG treatment groups, KO/IgG group (first 2.0 mg, following 1.0 mg/week, n=22) in IL-1RA KO mice, and wild/IgG group (first 2.0 mg, following 1.0 mg/week, n=17) in wild mice. Aortitis, cardiac hypertrophy and arthropathy were histologically analyzed. Sixty-eight percent of the KO/IgG group developed aortitis (53% developed severe aortitis). In contrast, only 21% of the KO/MR high group developed mild aortitis, without severe aortitis (P<0.01, vs KO/IgG group). Infiltration of inflammatory cells, such as neutrophils, T cells, and macrophages, was frequently observed around aortic sinus of the KO/IgG group. Left ventricle and cardiomyocyte hypertrophy were observed in IL-1RA KO mice. Administration of high dosage of MR16-1 significantly suppressed cardiomyocyte hypertrophy. MR16-1 attenuated the incidence and severity of arthritis in IL-1RA KO mice in a dose-dependent manner. In conclusion, blockade of IL-6 signaling may exert a beneficial effect to attenuate severe aortitis, left ventricle hypertrophy, and arthritis. en-copyright= kn-copyright= en-aut-name=HadaYoshiko en-aut-sei=Hada en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MukaiTomoyuki en-aut-sei=Mukai en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KojimaFumiaki en-aut-sei=Kojima en-aut-mei=Fumiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshidaMasashi en-aut-sei=Yoshida en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TakeuchiHidemi en-aut-sei=Takeuchi en-aut-mei=Hidemi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KakioYuki en-aut-sei=Kakio en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=OtakaNozomu en-aut-sei=Otaka en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MoritaYoshitaka en-aut-sei=Morita en-aut-mei=Yoshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=3 en-affil=Department of Rheumatology, Kawasaki Medical School kn-affil= affil-num=4 en-affil=Department of Pharmacology, Kitasato University School of Allied Health Sciences kn-affil= affil-num=5 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= affil-num=9 en-affil=Department of Rheumatology, Kawasaki Medical School kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science kn-affil= en-keyword= MR16-1 kn-keyword= MR16-1 en-keyword=interleukin-1 receptor antagonist kn-keyword=interleukin-1 receptor antagonist en-keyword=aortitis kn-keyword=aortitis en-keyword=arthritis kn-keyword=arthritis en-keyword=LV hypertrophy kn-keyword=LV hypertrophy END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=6 article-no= start-page=545 end-page=550 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202012 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Delayed Methotrexate Elimination after Administration of a Medium Dose of Methotrexate in a Patient with Genetic Variants Associated with Methotrexate Clearance en-subtitle= kn-subtitle= en-abstract= kn-abstract=Polymorphisms in methotrexate transporter pathways have been associated with methotrexate toxicities and clearance. Recent genome-wide association studies have revealed that the SLCO1B1 T521C variant is associated with methotrexate elimination. We present a case of a pediatric patient with acute lymphoblastic leukemia who suffered from persistently high plasma methotrexate concentrations and acute kidney injuries after the admin-istration of a medium dose of methotrexate. Subsequent genetic analysis showed that he was a carrier of dys-functional genetic variants associated with methotrexate clearance. This case highlights that polymorphisms of methotrexate transporter pathways can adversely affect methotrexate elimination in a clinically significant manner. en-copyright= kn-copyright= en-aut-name=TatebeYasuhisa en-aut-sei=Tatebe en-aut-mei=Yasuhisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KanamitsuKiichiro en-aut-sei=Kanamitsu en-aut-mei=Kiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KanzakiHirotaka en-aut-sei=Kanzaki en-aut-mei=Hirotaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IshidaHisashi en-aut-sei=Ishida en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujiwaraKaori en-aut-sei=Fujiwara en-aut-mei=Kaori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WashioKana en-aut-sei=Washio en-aut-mei=Kana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KitamuraYoshihisa en-aut-sei=Kitamura en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=SendoToshiaki en-aut-sei=Sendo en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=ShimadaAkira en-aut-sei=Shimada en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=2 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= affil-num=3 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= affil-num=7 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=8 en-affil=Department of Pharmacy, Okayama University Hospital kn-affil= affil-num=9 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of pediatrics, Okayama University Hospital kn-affil= en-keyword=methotrexate kn-keyword=methotrexate en-keyword=polymorphism kn-keyword=polymorphism en-keyword=drug elimination kn-keyword=drug elimination en-keyword=acute kidney injury kn-keyword=acute kidney injury en-keyword=acute lymphoblastic leukemia kn-keyword=acute lymphoblastic leukemia END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=10 article-no= start-page=1026 end-page=1032 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202010 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Concomitant vancomycin and piperacillin/tazobactam treatment is associated with an increased risk of acute kidney injury in Japanese patients en-subtitle= kn-subtitle= en-abstract= kn-abstract=Introduction
Recent studies have corroborated that the co-administration of vancomycin (VCM) and piperacillin/tazobactam (PT) is correlated with an increased incidence of acute kidney injury (AKI). However, evidence directed at the Japanese population is scarce. Therefore, we conducted a retrospective study to compare the occurrence of AKI among Japanese patients who received VCM with PT (VP therapy) and VCM with another β-lactams (VA therapy).
Methods
The present study, performed at Tsuyama Chuo Hospital between June 2012 and December 2018, included adult patients who received VCM and β-lactam antibiotics for ?48 h. We defined the primary outcome as the incidence of AKI based on the risk, injury, failure, loss, and end-stage kidney disease criteria. Patients' clinical characteristics and outcomes were reviewed and compared between the two groups with univariate and multivariate logistic regression analyses. Subgroup analysis was conducted by stratifying the patients’ baseline hospital admittance status, as intensive care unit or general wards.
Results
We analyzed 272 patients (92 V P therapy and 180 VA therapy). Univariate analysis revealed a significant difference in AKI development between VP and VA therapy (25.0% vs 12.2%; p < 0.01). A multivariate analysis demonstrated that VP therapy and VCM initial trough levels ?15 μg/mL were associated with an incidence of AKI. Patients at general wards, rather than those admitted at an intensive care unit, developed AKI with VP therapy (p = 0.02).
Conclusion
VP therapy was associated with an increased risk of AKI compared to that with VA therapy among the Japanese population. en-copyright= kn-copyright= en-aut-name=HarukiYuto en-aut-sei=Haruki en-aut-mei=Yuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HarukiMai en-aut-sei=Haruki en-aut-mei=Mai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueYuta en-aut-sei=Inoue en-aut-mei=Yuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SugiyamaTetsuhiro en-aut-sei=Sugiyama en-aut-mei=Tetsuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= affil-num=1 en-affil=Department of Pharmacy, Tsuyama Chuo Hospital kn-affil= affil-num=2 en-affil=Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Pharmacy, Tsuyama Chuo Hospital kn-affil= affil-num=4 en-affil=Department of Pharmacy, Tsuyama Chuo Hospital kn-affil= affil-num=5 en-affil=Department of Pharmacy, Tsuyama Chuo Hospital kn-affil= en-keyword=Acute kidney injury kn-keyword=Acute kidney injury en-keyword=β-lactams kn-keyword=β-lactams en-keyword=Piperacillin/tazobactam kn-keyword=Piperacillin/tazobactam en-keyword=Vancomycin kn-keyword=Vancomycin END start-ver=1.4 cd-journal=joma no-vol=34 cd-vols= no-issue=12 article-no= start-page=16449 end-page=16463 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20201017 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dynamin 1 is important for microtubule organization and stabilization in glomerular podocytes en-subtitle= kn-subtitle= en-abstract= kn-abstract=Dynamin 1 is a neuronal endocytic protein that participates in vesicle formation by scission of invaginated membranes. Dynamin 1 is also expressed in the kidney; however, its physiological significance to this organ remains unknown. Here, we show that dynamin 1 is crucial for microtubule organization and stabilization in glomerular podocytes. By immunofluorescence and immunoelectron microscopy, dynamin 1 was concentrated at microtubules at primary processes in rat podocytes. By immunofluorescence of differentiated mouse podocytes (MPCs), dynamin 1 was often colocalized with microtubule bundles, which radially arranged toward periphery of expanded podocyte. In dynamin 1-depleted MPCs by RNAi, alpha-tubulin showed a dispersed linear filament-like localization, and microtubule bundles were rarely observed. Furthermore, dynamin 1 depletion resulted in the formation of discontinuous, short acetylated alpha-tubulin fragments, and the decrease of microtubule-rich protrusions. Dynamins 1 and 2 double-knockout podocytes showed dispersed acetylated alpha-tubulin and rare protrusions. In vitro, dynamin 1 polymerized around microtubules and cross-linked them into bundles, and increased their resistance to the disassembly-inducing reagents Ca(2+)and podophyllotoxin. In addition, overexpression and depletion of dynamin 1 in MPCs increased and decreased the nocodazole resistance of microtubules, respectively. These results suggest that dynamin 1 supports the microtubule bundle formation and participates in the stabilization of microtubules. en-copyright= kn-copyright= en-aut-name=LaThe Mon en-aut-sei=La en-aut-mei=The Mon kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TachibanaHiromi en-aut-sei=Tachibana en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=LiShun-Ai en-aut-sei=Li en-aut-mei=Shun-Ai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AbeTadashi en-aut-sei=Abe en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SeirikiSayaka en-aut-sei=Seiriki en-aut-mei=Sayaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NagaokaHikaru en-aut-sei=Nagaoka en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakashimaEizo en-aut-sei=Takashima en-aut-mei=Eizo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TakedaTetsuya en-aut-sei=Takeda en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MakinoShin-Ichi en-aut-sei=Makino en-aut-mei=Shin-Ichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=AsanumaKatsuhiko en-aut-sei=Asanuma en-aut-mei=Katsuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TianXuefei en-aut-sei=Tian en-aut-mei=Xuefei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=IshibeShuta en-aut-sei=Ishibe en-aut-mei=Shuta kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SakaneAyuko en-aut-sei=Sakane en-aut-mei=Ayuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=SasakiTakuya en-aut-sei=Sasaki en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=TakeiKohji en-aut-sei=Takei en-aut-mei=Kohji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=YamadaHiroshi en-aut-sei=Yamada en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= affil-num=1 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=3 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=5 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=6 en-affil=Division of Malaria Research, Proteo-Science Center, Ehime University kn-affil= affil-num=7 en-affil=Division of Malaria Research, Proteo-Science Center, Ehime University kn-affil= affil-num=8 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=10 en-affil=Department of Nephrology, Graduate School of Medicine, Chiba University kn-affil= affil-num=11 en-affil=Department of Nephrology, Graduate School of Medicine, Chiba University kn-affil= affil-num=12 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=13 en-affil=Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine kn-affil= affil-num=14 en-affil=Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine kn-affil= affil-num=15 en-affil=Department of Biochemistry, Tokushima University Graduate School of Medical Sciences kn-affil= affil-num=16 en-affil=Department of Biochemistry, Tokushima University Graduate School of Medical Sciences kn-affil= affil-num=17 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=18 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= affil-num=19 en-affil=Department of Neuroscience, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University kn-affil= en-keyword=dynamin kn-keyword=dynamin en-keyword=microtubules kn-keyword=microtubules en-keyword=podocyte kn-keyword=podocyte en-keyword=primary process kn-keyword=primary process END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=1 article-no= start-page=14928 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dysfunction of CD8+PD-1+T cells in type 2 diabetes caused by the impairment of metabolism-immune axis en-subtitle= kn-subtitle= en-abstract= kn-abstract=The metabolic changes and dysfunction in CD8+T cells may be involved in tumor progression and susceptibility to virus infection in type 2 diabetes (T2D). In C57BL/6JJcl mice fed with high fat-high sucrose chow (HFS), multifunctionality of CD8+splenic and tumor-infiltrating lymphocytes (TILs) was impaired and associated with enhanced tumor growth, which were inhibited by metformin. In CD8+splenic T cells from the HFS mice, glycolysis/basal respiration ratio was significantly reduced and reversed by metformin. In the patients with T2D (DM), multifunctionality of circulating CD8+PD-1+T cells stimulated with PMA/ionomycin as well as with HLA-A*24:02 CMV peptide was dampened, while metformin recovered multifunctionality. Both glycolysis and basal respiration were reduced in DM, and glycolysis was increased by metformin. The disturbance of the link between metabolism and immune function in CD8+PD-1+T cells in T2D was proved by recovery of antigen-specific and non-specific cytokine production via metformin-mediated increase in glycolytic activity. en-copyright= kn-copyright= en-aut-name=NojimaIchiro en-aut-sei=Nojima en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=EikawaShingo en-aut-sei=Eikawa en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TomonobuNahoko en-aut-sei=Tomonobu en-aut-mei=Nahoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HadaYoshiko en-aut-sei=Hada en-aut-mei=Yoshiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KajitaniNobuo en-aut-sei=Kajitani en-aut-mei=Nobuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TeshigawaraSanae en-aut-sei=Teshigawara en-aut-mei=Sanae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ToneAtsuhito en-aut-sei=Tone en-aut-mei=Atsuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=UdonoHeiichiro en-aut-sei=Udono en-aut-mei=Heiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Hematology/Oncology, Hess Cancer Institute, Icahn School of Medicine At Mount Sinai kn-affil= affil-num=3 en-affil=Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Internal Medicine, Diabetes Center, Okayama City Hospital kn-affil= affil-num=6 en-affil=Diabetes Center, Okayama S kn-affil=italama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=7 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=8 en-affil=Diabetes Center, Okayama Saiseikai General Hospital kn-affil= affil-num=9 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=13 en-affil=Department of Immunology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=Cytokines kn-keyword=Cytokines en-keyword=Diabetes kn-keyword=Diabetes en-keyword=Endocrine system and metabolic diseases kn-keyword=Endocrine system and metabolic diseases en-keyword=Immunology kn-keyword=Immunology en-keyword=Tumour immunology kn-keyword=Tumour immunology END start-ver=1.4 cd-journal=joma no-vol=12 cd-vols= no-issue=2 article-no= start-page=207 end-page=216 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200808 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Randomized trial of an intensified, multifactorial intervention in patients with advanced‐stage diabetic kidney disease: Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) en-subtitle= kn-subtitle= en-abstract= kn-abstract=Aims/Introduction
We evaluated the efficacy of multifactorial intensive treatment (IT) on renal outcomes in patients with type 2 diabetes and advanced‐stage diabetic kidney disease (DKD).
Materials and Methods
The Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) is a multicenter, open‐label, randomized controlled trial with a 5‐year follow‐up period. We randomly assigned 164 patients with advanced‐stage diabetic kidney disease (urinary albumin‐to‐creatinine ratio ?300 mg/g creatinine, serum creatinine level 1.2?2.5 mg/dL in men and 1.0?2.5 mg/dL in women) to receive either IT or conventional treatment. The primary composite outcome was end‐stage kidney failure, doubling of serum creatinine or death from any cause, which was assessed in the intention‐to‐treat population.
Results
The IT tended to reduce the risk of primary end‐points as compared with conventional treatment, but the difference between treatment groups did not reach the statistically significant level (hazard ratio 0.69, 95% confidence interval 0.43?1.11; P = 0.13). Meanwhile, the decrease in serum low‐density lipoprotein cholesterol level and the use of statin were significantly associated with the decrease in primary outcome (hazard ratio 1.14; 95% confidence interval 1.05?1.23, P < 0.001 and hazard ratio 0.53, 95% confidence interval 0.28?0.998, P < 0.05, respectively). The incidence of adverse events was not different between treatment groups.
Conclusions
The risk of kidney events tended to decrease by IT, although it was not statistically significant. Lipid control using statin was associated with a lower risk of adverse kidney events. Further follow‐up study might show the effect of IT in patients with advanced diabetic kidney disease. en-copyright= kn-copyright= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HanedaMasakazu en-aut-sei=Haneda en-aut-mei=Masakazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NinomiyaToshiharu en-aut-sei=Ninomiya en-aut-mei=Toshiharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KoyaDaisuke en-aut-sei=Koya en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SuzukiYoshiki en-aut-sei=Suzuki en-aut-mei=Yoshiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SuzukiDaisuke en-aut-sei=Suzuki en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=IshidaHitoshi en-aut-sei=Ishida en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AkaiHiroaki en-aut-sei=Akai en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TominoYasuhiko en-aut-sei=Tomino en-aut-mei=Yasuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=UzuTakashi en-aut-sei=Uzu en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=NishimuraMotonobu en-aut-sei=Nishimura en-aut-mei=Motonobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=MaedaShiro en-aut-sei=Maeda en-aut-mei=Shiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) collaborative group en-aut-sei=the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) collaborative group en-aut-mei= kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=2 en-affil=Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University kn-affil= affil-num=3 en-affil=Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University kn-affil= affil-num=4 en-affil=Department of Diabetology & Endocrinology, Kanazawa Medical University kn-affil= affil-num=5 en-affil=Health Administration Center, Niigata University kn-affil= affil-num=6 en-affil=Suzuki Diabetes Clinic kn-affil= affil-num=7 en-affil=Research Center for Health Care, Nagahama City Hospital kn-affil= affil-num=8 en-affil=Division of Metabolism and Diabetes, Tohoku Medical and Pharmaceutical University kn-affil= affil-num=9 en-affil=Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine kn-affil= affil-num=10 en-affil=Division of Nephrology, Department of Medicine, Nippon Life Hospital kn-affil= affil-num=11 en-affil=Department of Diabetes and Endocrinology, National Hospital Organization Chiba‐East National Hospital kn-affil= affil-num=12 en-affil=Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus kn-affil= affil-num=13 en-affil=Okayama Diabetes and Neurology Clinic kn-affil= affil-num=14 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=15 en-affil=Okayama University kn-affil= affil-num=16 en-affil= kn-affil= en-keyword=Diabetic kidney disease kn-keyword=Diabetic kidney disease en-keyword=Diabetic nephropathy kn-keyword=Diabetic nephropathy en-keyword=Diabetic Nephropathy Remission and Regression Team Trial in Japan kn-keyword=Diabetic Nephropathy Remission and Regression Team Trial in Japan END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=4 article-no= start-page=365 end-page=370 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202008 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Successful Vancomycin Dose Adjustment in a Sepsis patient with Bacterial Meningitis Using Cystatin C en-subtitle= kn-subtitle= en-abstract= kn-abstract=Cystatin C-guided vancomycin (VCM) dosing is useful in critically ill patients. Its usefulness in septic patients with bacterial meningitis remains unknown, as there are no published reports. In this study, we sought to clarify its benefit. Cystatin C was used to guide VCM dosing in a septic bacterial meningitis patient with normal kidney function, according to therapeutic drug monitoring (TDM). Using cystatin C, the Bayesian method-based TDM made optimal VCM dosing possible, and decreased the predicted error (4.85 mg/L) compared to serum creatinine (16.83 mg/L). We concluded TDM of VCM using cystatin C can be considered in sepsis patients with bacterial meningitis with normal kidney function. en-copyright= kn-copyright= en-aut-name=ChumaMasayuki en-aut-sei=Chuma en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KondoMasateru en-aut-sei=Kondo en-aut-mei=Masateru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ZamamiYoshito en-aut-sei=Zamami en-aut-mei=Yoshito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakechiKenshi en-aut-sei=Takechi en-aut-mei=Kenshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=GodaMitsuhiro en-aut-sei=Goda en-aut-mei=Mitsuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkadaNaoto en-aut-sei=Okada en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ShibataAkitomo en-aut-sei=Shibata en-aut-mei=Akitomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AsadaMizuho en-aut-sei=Asada en-aut-mei=Mizuho kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OtoJun en-aut-sei=Oto en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YanagawaHiroaki en-aut-sei=Yanagawa en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=IshizawaKeisuke en-aut-sei=Ishizawa en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= affil-num=1 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=2 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=3 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=4 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=5 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=6 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= affil-num=7 en-affil=Department of Pharmacy, Saiseikai Kumamoto Hospital kn-affil= affil-num=8 en-affil=Department of Pharmacy, Medical Hospital, Tokyo Medical and Dental University kn-affil= affil-num=9 en-affil=Department of Emergency and Critical Care Medicine, Tokushima University Graduate School of Biomedical Sciences kn-affil= affil-num=10 en-affil=Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital kn-affil= affil-num=11 en-affil=Department of Pharmacy, Tokushima University Hospital kn-affil= en-keyword=vancomycin, kn-keyword=vancomycin, en-keyword=therapeutic drug monitoring kn-keyword=therapeutic drug monitoring en-keyword=cystatin C kn-keyword=cystatin C en-keyword=bacterial meningitis kn-keyword=bacterial meningitis en-keyword=sepsis kn-keyword=sepsis END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=4 article-no= start-page=335 end-page=343 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202008 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Recurrence of Solitary Fibrous Tumor/Hemangiopericytoma Could Be Predicted by Ki-67 Regardless of Its Origin en-subtitle= kn-subtitle= en-abstract= kn-abstract=Since the discovery of the NAB2-STAT6 gene fusion in 2013, solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) have been considered the same disease. STAT6 nuclear stain is approved as a highly sensitive and specific marker to diagnose SFT/HPC from other tumors with similar histology. As the next step, detection of fusion variants that may predict clinical malignancy of SFT/HPC has been attempted. However, no fusion variants with a clear relation to malignancy have been identified. In this study, the clinical and histological backgrounds of 23 Japanese patients diagnosed with SFT/HPC from 2000 to 2019 at Kochi University Hospital were examined to identify factors potentially related to recurrence. A significant relationship to recurrence was detected for mitosis ? 1/10 HPF (400×), necrosis, and Ki-67>5%. These findings indicate that a deliberate investigation of histological features such as mitosis and necrosis is crucial for the clinical observation of SFT/ HPC patients. In addition, Ki-67 was revealed to be a useful parameter to predict recurrence in SFT/HPC patients. en-copyright= kn-copyright= en-aut-name=YamamotoYumiko en-aut-sei=Yamamoto en-aut-mei=Yumiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HayashiYoshihiro en-aut-sei=Hayashi en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MurakamiIchiro en-aut-sei=Murakami en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Diagnostic Pathology, Kochi University kn-affil= affil-num=2 en-affil=Department of Equipment of Support Planning Office, Kochi University kn-affil= affil-num=3 en-affil=Department of Diagnostic Pathology, Kochi University kn-affil= en-keyword=solitary fibrous tumor kn-keyword=solitary fibrous tumor en-keyword=hemangiopericytoma kn-keyword=hemangiopericytoma en-keyword=Ki-67 kn-keyword=Ki-67 en-keyword=NAB2-STAT6 kn-keyword=NAB2-STAT6 en-keyword=WHO classification kn-keyword=WHO classification en-keyword=WHO grading criteria kn-keyword=WHO grading criteria en-keyword=Marseille Grading System kn-keyword=Marseille Grading System END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=4 article-no= start-page=293 end-page=299 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202008 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Preoperative Use of Alpha-1 Receptor Blockers in Male Patients Undergoing Extracorporeal Shock Wave Lithotripsy for a Ureteral Calculus en-subtitle= kn-subtitle= en-abstract= kn-abstract=In this retrospective single-center cohort study, we investigated the impact of preoperative use of an alpha-1 adrenergic receptor (AR) blocker on the outcome of single-session extracorporeal shock wave lithotripsy (SWL) in 193 male patients who underwent SWL for a single ureteral calculus between 2006 and 2016. We reviewed their medical records to obtain the data on the preoperative use of alpha-1 AR blockers. The primary outcome was treatment success after single-session SWL. We performed a multivariable logistic regression analysis adjusting for clinically important confounders to examine the association between preoperative use of alpha-1 AR blockers and the treatment success of SWL. Among the 193 patients, 15 (7.8%) were taking an alpha-1 AR blocker preoperatively. A multivariable analysis showed that preoperative use of an alpha-1 AR blocker was a significant negative predictor for treatment success of SWL (adjusted odds ratio 0.17; 95% confidence intervals, 0.04-0.74). Our findings suggest that the preoperative use of an alpha-1 AR blocker was a negative predictor of treatment success of SWL in male patients with a single ureteral calculus. Clinicians should pay more attention to the preoperative drug use in determining an appropriate stone therapy modality. en-copyright= kn-copyright= en-aut-name=YoshiokaTakashi en-aut-sei=Yoshioka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OmaeKenji en-aut-sei=Omae en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KawadaTatsushi en-aut-sei=Kawada en-aut-mei=Tatsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=InoueYosuke en-aut-sei=Inoue en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OedaTadashi en-aut-sei=Oeda en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UeharaShinya en-aut-sei=Uehara en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=FukuharaShunichi en-aut-sei=Fukuhara en-aut-mei=Shunichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University kn-affil= affil-num=2 en-affil=Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University kn-affil= affil-num=3 en-affil=Department of Urology, Onomichi Municipal Hospital kn-affil= affil-num=4 en-affil=Department of Urology, Onomichi Municipal Hospital kn-affil= affil-num=5 en-affil=Department of Urology, Onomichi Municipal Hospital kn-affil= affil-num=6 en-affil=Department of Urology, Onomichi Municipal Hospital kn-affil= affil-num=7 en-affil=Department of Urology, Kawasaki Medical School General Medical Center kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University kn-affil= en-keyword=urolithiasis kn-keyword=urolithiasis en-keyword=extracorporeal shockwave therapy kn-keyword=extracorporeal shockwave therapy en-keyword=adrenergic alpha-1 receptor antagonists kn-keyword=adrenergic alpha-1 receptor antagonists END start-ver=1.4 cd-journal=joma no-vol=15 cd-vols= no-issue=1 article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200124 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Podocyte autophagy is associated with foot process effacement and proteinuria in patients with minimal change nephrotic syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=Autophagy is a cellular mechanism involved in the bulk degradation of proteins and turnover of organelle. Several studies have shown the significance of autophagy of the renal tubular epithelium in rodent models of tubulointerstitial disorder. However, the role of autophagy in the regulation of human glomerular diseases is largely unknown. The current study aimed to demonstrate morphological evidence of autophagy and its association with the ultrastructural changes of podocytes and clinical data in patients with idiopathic nephrotic syndrome, a disease in which patients exhibit podocyte injury. The study population included 95 patients, including patients with glomerular disease (minimal change nephrotic syndrome [MCNS], n = 41; idiopathic membranous nephropathy [IMN], n = 37) and 17 control subjects who underwent percutaneous renal biopsy. The number of autophagic vacuoles and the grade of foot process effacement (FPE) in podocytes were examined by electron microscopy (EM). The relationships among the expression of autophagic vacuoles, the grade of FPE, and the clinical data were determined. Autophagic vacuoles were mainly detected in podocytes by EM. The microtubule-associated protein 1 light chain 3 (LC3)-positive area was co-localized with the Wilms tumor 1 (WT1)-positive area on immunofluorescence microscopy, which suggested that autophagy occurred in the podocytes of patients with MCNS. The number of autophagic vacuoles in the podocytes was significantly correlated with the podocyte FPE score (r = -0.443, p = 0.004), the amount of proteinuria (r = 0.334, p = 0.033), and the level of serum albumin (r = -0.317, p = 0.043) in patients with MCNS. The FPE score was a significant determinant for autophagy after adjusting for the age in a multiple regression analysis in MCNS patients (p = 0.0456). However, such correlations were not observed in patients with IMN or in control subjects. In conclusion, the results indicated that the autophagy of podocytes is associated with FPE and severe proteinuria in patients with MCNS. The mechanisms underlying the activation of autophagy in association with FPE in podocytes should be further investigated in order to elucidate the pathophysiology of MCNS. en-copyright= kn-copyright= en-aut-name=Ogawa-AkiyamaAyu en-aut-sei=Ogawa-Akiyama en-aut-mei=Ayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TanakaKeiko en-aut-sei=Tanaka en-aut-mei=Keiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KanoYuzuki en-aut-sei=Kano en-aut-mei=Yuzuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiseKoki en-aut-sei=Mise en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OtakaNozomu en-aut-sei=Otaka en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MorinagaHiroshi en-aut-sei=Morinaga en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KinomuraMasaru en-aut-sei=Kinomura en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Division of Medical Informatics,Okayama University Hospital kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=21 cd-vols= no-issue= article-no= start-page=113 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=20200331 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Pembrolizumab-induced hypothyroidism caused reversible increased serum creatinine levels: a case report en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
The advent of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of patients with advanced malignancies. On the other hand, these drugs might cause immune-related adverse events (irAEs) including endocrinopathies and nephropathies. Thyroid dysfunction is one of the most common irAEs. For ICIs-induced nephropathies, most cases are due to tubulointerstitial nephritis, which might require steroid treatment. Here, we report a patient with non-small cell lung cancer treated with ICI who developed increased serum creatinine (s-Cr) levels due to ICIs-induced hypothyroidism.
Case presentation
A 57-year-old Asian man with refractory non-small cell lung cancer under ICIs therapy (pembrolizumab, an anti-programmed cell death-1 monoclonal antibody) developed increased s-Cr levels 5 months after the pembrolizumab initiation. His laboratory data, renal biopsy, and Gallium-67 scintigraphy findings denied pembrolizumab-induced tubulointerstitial nephritis. His renal function was correlated with thyroid function. Despite the increase of s-Cr levels, serum cystatin C levels were normal, which could be explained by the hypothyroidism. Levothyroxine treatment improved renal function as well as thyroid function. Then pembrolizumab was resumed, and both his thyroid and renal function remained normal level. Ultimately, we concluded that the increased s-Cr levels were caused by pembrolizumab-induced hypothyroidism.
Conclusion
All clinicians involved in ICI treatment need to recognize the possible increase in s-Cr levels caused by ICIs-induced hypothyroidism, and we propose monitoring serum cystatin C levels to differentiate ICIs-induced hypothyroidism from tubulointerstitial nephritis before invasive renal biopsies or steroid treatment, which are recommended by the prescribing information for pembrolizumab, are performed. en-copyright= kn-copyright= en-aut-name=MatsuokaNatsumi en-aut-sei=Matsuoka en-aut-mei=Natsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IchiharaEiki en-aut-sei=Ichihara en-aut-mei=Eiki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=HaraTakayuki en-aut-sei=Hara en-aut-mei=Takayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TomaKishio en-aut-sei=Toma en-aut-mei=Kishio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=InagakiKenichi en-aut-sei=Inagaki en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Hematology, Oncology, Allergy and Respiratory Medicine,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences kn-affil= en-keyword=Pembrolizumab kn-keyword=Pembrolizumab en-keyword=Hypothyroidism kn-keyword=Hypothyroidism en-keyword=Creatinine kn-keyword=Creatinine en-keyword=Cystatin C kn-keyword=Cystatin C END start-ver=1.4 cd-journal=joma no-vol=75 cd-vols= no-issue=6 article-no= start-page=830 end-page=846 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202006 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Icodextrin Versus Glucose Solutions for the Once-Daily Long Dwell in Peritoneal Dialysis: An Enriched Systematic Review and Meta-analysis of Randomized Controlled Trials en-subtitle= kn-subtitle= en-abstract= kn-abstract=Rationale & Objective
The efficacy and safety of icodextrin versus glucose-only peritoneal dialysis (PD) regimens is unclear. The aim of this study was to compare once-daily long-dwell icodextrin versus glucose among patients with kidney failure undergoing PD.
Study Design
Systematic review of randomized controlled trials (RCTs), enriched with unpublished data from investigator-initiated and industry-sponsored studies.
Setting & Study Populations
Individuals with kidney failure receiving regular PD treatment enrolled in clinical trials of dialysate composition.
Selection Criteria for Studies
Medline, Embase, CENTRAL, Ichushi Web, 10 Chinese databases, clinical trials registries, conference proceedings, and citation lists from inception to November 2018. Further data were obtained from principal investigators and industry clinical study reports.
Data Extraction
2 independent reviewers selected studies and extracted data using a prespecified extraction instrument.
Analytic Approach
Qualitative synthesis of demographics, measurement scales, and outcomes. Quantitative synthesis with Mantel-Haenszel risk ratios (RRs), Peto odds ratios (ORs), or (standardized) mean differences (MDs). Risk of bias of included studies at the outcome level was assessed using the Cochrane risk-of-bias tool for RCTs.
Results
19 RCTs that enrolled 1,693 participants were meta-analyzed. Ultrafiltration was improved with icodextrin (medium-term MD, 208.92 [95% CI, 99.69-318.14] mL/24 h; high certainty of evidence), reflected also by fewer episodes of fluid overload (RR, 0.43 [95% CI, 0.24-0.78]; high certainty). Icodextrin-containing PD probably decreased mortality risk compared to glucose-only PD (Peto OR, 0.49 [95% CI, 0.24-1.00]; moderate certainty). Despite evidence of lower peritoneal glucose absorption with icodextrin-containing PD (medium-term MD, ?40.84 [95% CI, ?48.09 to ?33.59] g/long dwell; high certainty), this did not directly translate to changes in fasting plasma glucose (?0.50 [95% CI, ?1.19 to 0.18] mmol/L; low certainty) and hemoglobin A1c levels (?0.14% [95% CI, ?0.34% to 0.05%]; high certainty). Safety outcomes and residual kidney function were similar in both groups; health-related quality-of-life and pain scores were inconclusive.
Limitations
Trial quality was variable. The follow-up period was heterogeneous, with a paucity of assessments over the long term. Mortality results are based on just 32 events and were not corroborated using time-to-event analysis of individual patient data.
Conclusions
Icodextrin for once-daily long-dwell PD has clinical benefit for some patients, including those not meeting ultrafiltration targets and at risk for fluid overload. Future research into patient-centered outcomes and cost-effectiveness associated with icodextrin is needed. en-copyright= kn-copyright= en-aut-name=GoossenK?the en-aut-sei=Goossen en-aut-mei=K?the kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=BeckerMonika en-aut-sei=Becker en-aut-mei=Monika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MarshallMark R. en-aut-sei=Marshall en-aut-mei=Mark R. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=B?hnStefanie en-aut-sei=B?hn en-aut-mei=Stefanie kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=BreuingJessica en-aut-sei=Breuing en-aut-mei=Jessica kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FiranekCatherine A. en-aut-sei=Firanek en-aut-mei=Catherine A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HessSimone en-aut-sei=Hess en-aut-mei=Simone kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NariaiHisanori en-aut-sei=Nariai en-aut-mei=Hisanori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SloandJames A. en-aut-sei=Sloand en-aut-mei=James A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=YaoQiang en-aut-sei=Yao en-aut-mei=Qiang kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=ChangTae Ik en-aut-sei=Chang en-aut-mei=Tae Ik kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=ChenJinBor en-aut-sei=Chen en-aut-mei=JinBor kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=PaniaguaRam?n en-aut-sei=Paniagua en-aut-mei=Ram?n kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TakatoriYuji en-aut-sei=Takatori en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=PieperDawid en-aut-sei=Pieper en-aut-mei=Dawid kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= affil-num=1 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=2 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=3 en-affil=Baxter Healthcare (Asia) Pte Ltd kn-affil= affil-num=4 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=5 en-affil=Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=6 en-affil=Baxter Healthcare International kn-affil= affil-num=7 en-affil=nstitute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= affil-num=8 en-affil=Baxter Japan Ltd kn-affil= affil-num=9 en-affil=Baxter Healthcare International kn-affil= affil-num=10 en-affil=Baxter (China) Investment Co. Ltd kn-affil= affil-num=11 en-affil=Department of Internal Medicine, NHIS Medical Center kn-affil= affil-num=12 en-affil=Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine kn-affil= affil-num=13 en-affil=Research Unit, Unidad de Investigaci?n M?dica en Enfermedades Nefrol?gicas, Centro M?dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS) kn-affil= affil-num=14 en-affil=Internal Medicine, Rijinkai Medical Foundation, Socio-Medical Corporation, Kohsei General Hospital kn-affil= affil-num=15 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=nstitute for Research in Operative Medicine, Faculty of Health, Department of Medicine, Witten/Herdecke University kn-affil= END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1 article-no= start-page=53 end-page=58 dt-received= dt-revised= dt-accepted= dt-pub-year=2020 dt-pub=202002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Robotic Renal Autotransplantation: A Feasibility Study in a Porcine Model en-subtitle= kn-subtitle= en-abstract= kn-abstract= We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci? robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort? and irrigated on ice with Ringer’s solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery. en-copyright= kn-copyright= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaKoichiro en-aut-sei=Wada en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KawamuraKasumi en-aut-sei=Kawamura en-aut-mei=Kasumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MaruyamaYuki en-aut-sei=Maruyama en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MitsuiYosuke en-aut-sei=Mitsui en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AriyoshiYuichi en-aut-sei=Ariyoshi en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=IwataTakehiro en-aut-sei=Iwata en-aut-mei=Takehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=TakamotoAtsushi en-aut-sei=Takamoto en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SakoTomoko en-aut-sei=Sako en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=EdamuraKohei en-aut-sei=Edamura en-aut-mei=Kohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=KanoYuzuki en-aut-sei=Kano en-aut-mei=Yuzuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=WatanabeToyohiko en-aut-sei=Watanabe en-aut-mei=Toyohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=17 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=18 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=19 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=20 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=21 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=22 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=renal autotransplantation kn-keyword=renal autotransplantation en-keyword=robotic kn-keyword=robotic en-keyword=porcine model kn-keyword=porcine model en-keyword=transplantation kn-keyword=transplantation END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=6 article-no= start-page=475 end-page=477 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201912 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Aging Population and Research into Treatments for Abdominal Aortic Aneurysms en-subtitle= kn-subtitle= en-abstract= kn-abstract= Abdominal aortic aneurysms (AAAs) usually expand asymptomatically until the occurrence of a life-threatening event such as aortic rupture, which is closely associated with high mortality. AAA and aortic dissection are ranked among the top 10 causes of death in Japan. The major risk factors for AAA are age over 65 years, male gender, family history, and smoking. Thus, for prevention, smoking cessation is the most important lifestyle-intervention. For treatment, since AAA generally affects elderly people, less invasive treatment is preferable. However, the only established treatment for AAA is open repair and endovascular repair. This review describes potential medical treatments to slow aneurysm growth or prevent AAA rupture. en-copyright= kn-copyright= en-aut-name=UmebayashiRyoko en-aut-sei=Umebayashi en-aut-mei=Ryoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJunzo en-aut-sei=Wada en-aut-mei=Junzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=abdominal aortic aneurysms kn-keyword=abdominal aortic aneurysms en-keyword=medical treatment kn-keyword=medical treatment en-keyword=anti-platelet drugs kn-keyword=anti-platelet drugs END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=433 end-page=440 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relationship between Intracellular Signaling of the (Pro)renin Receptor and the Pathogenesis of Preeclampsia en-subtitle= kn-subtitle= en-abstract= kn-abstract= An association between preeclampsia and (pro)renin was recently reported. Intracellular signaling of the (pro) renin receptor [(P)RR] increases the expressions of TGF-β and PAI-1. In this study we sought to clarify the involvement of (pro)renin in the pathogenesis of preeclampsia via the intracellular signaling of (P)RR on preeclampsia placentas. Activated (pro)renin plasma concentrations were compared between pregnant women with (n=15) and without (n=28) preeclampsia. The placentas were immunohistochemically evaluated with anti-HIF-1α and anti-(P)RR antibodies. HTR-8/SVneo cells were cultured under hypoxic conditions and treated with human recombinant (pro)renin. The mRNA expressions of HIF-1α, (P)RR, PAI-1, TGF-β, and ET-1 were also examined by real-time RCR. The activated (pro)renin plasma concentration was significantly higher in the third vs. the second trimester in the preeclampsia patients. HIF-1α and (P)RR expressions were significantly increased in the preeclampsia placentas. The mRNA expressions of PAI-1, TGF-β, and ET-1 were significantly increased in the experiments using recombinant (pro)renin vs. hypoxic conditions. (P)RR expression in preeclampsia placentas is increased by persistent hypoxia through the second and third trimesters, and PAI-1, TGF-β, and ET-1 production is increased via (P)RR. Our results suggest that ET-1 production via the intracellular signaling of (P)RR is important in the pathogenesis of preeclampsia. en-copyright= kn-copyright= en-aut-name=TamadaShoko en-aut-sei=Tamada en-aut-mei=Shoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MitsuiTakashi en-aut-sei=Mitsui en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OhiraAkiko en-aut-sei=Ohira en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TaniKazumasa en-aut-sei=Tani en-aut-mei=Kazumasa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MakiJota en-aut-sei=Maki en-aut-mei=Jota kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EguchiTakeshi en-aut-sei=Eguchi en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=EtoEriko en-aut-sei=Eto en-aut-mei=Eriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HayataKei en-aut-sei=Hayata en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MasuyamaHisashi en-aut-sei=Masuyama en-aut-mei=Hisashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=preeclampsia kn-keyword=preeclampsia en-keyword=(pro)renin kn-keyword=(pro)renin en-keyword=(pro)renin receptor kn-keyword=(pro)renin receptor en-keyword=endothelin-1 kn-keyword=endothelin-1 en-keyword=HTR-8/SVneo kn-keyword=HTR-8/SVneo END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=5 article-no= start-page=419 end-page=425 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201910 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Relationship between Sedentary Behavior and All-cause Mortality in Japanese Chronic Hemodialysis Patients: A Prospective Cohort Study en-subtitle= kn-subtitle= en-abstract= kn-abstract= We investigated the relationship between sedentary behavior and all-cause mortality in patients undergoing hemodialysis. A total of 71 patients (39 men, 32 women, aged 72.1±11.7 years) were enrolled in this longitudinal study. Their sedentary behavior was measured using a tri-accelerometer that provides relative values per daily wearing time. We classified the sedentary behavior time into 2 groups (under the median: short-sedentary behavior (SB) group; over the median: long-SB group) and compared the groups’ clinical parameters. We compared the groups’ survival rates by using Kaplan-Meier curves and the log-rank test, and we performed multivariate analyses by a Cox-proportional hazard model to evaluate the relationship between the sedentary behavior and the survival rate. Twenty patients (28.2%) died during the observation period. The survival rate of the short-SB group was significantly higher than that of the long-SB group. Sedentary behavior was thus an important factor for all-cause mortality even after adjusting for confounding factors by a Cox-proportional hazard model. Sedentary behavior is closely linked to all-cause mortality, especially total days and non-hemodialysis days, and reducing sedentary behavior may be beneficial to reduce the all-cause mortality of patients on chronic hemodialysis. en-copyright= kn-copyright= en-aut-name=HishiiShuhei en-aut-sei=Hishii en-aut-mei=Shuhei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MiyatakeNobuyuki en-aut-sei=Miyatake en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishiHiroyuki en-aut-sei=Nishi en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KatayamaAkihiko en-aut-sei=Katayama en-aut-mei=Akihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=UjikeKazuhiro en-aut-sei=Ujike en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KoumotoKiichi en-aut-sei=Koumoto en-aut-mei=Kiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SuzukiHiromi en-aut-sei=Suzuki en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HashimotoHiroo en-aut-sei=Hashimoto en-aut-mei=Hiroo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=2 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=3 en-affil=Innoshima General Hospital kn-affil= affil-num=4 en-affil=Faculty of Social Studies, Shikokugakuin University kn-affil= affil-num=5 en-affil=Innoshima General Hospital kn-affil= affil-num=6 en-affil=Innoshima General Hospital kn-affil= affil-num=7 en-affil=Department of Hygiene, Faculty of Medicine, Kagawa University kn-affil= affil-num=8 en-affil=Innoshima General Hospital kn-affil= en-keyword=sedentary behavior kn-keyword=sedentary behavior en-keyword=hemodialysis kn-keyword=hemodialysis en-keyword=mortality kn-keyword=mortality en-keyword=physical activity kn-keyword=physical activity END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=4 article-no= start-page=367 end-page=372 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201908 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Patient with Type 3 Autoimmune Polyglandular Syndrome who Developed Systemic Lupus Erythematosus 8 years after the Diagnosis of Autoimmune Hepatitis en-subtitle= kn-subtitle= en-abstract= kn-abstract= Eight years prior to her present admission, a 61-year-old Japanese woman was diagnosed with autoimmune hepatitis, slowly progressive insulin-dependent diabetes mellitus, and chronic thyroiditis; she had been treated with oral prednisolone (PSL). After she suddenly discontinued PSL, she newly developed systemic lupus erythematosus. A combination therapy of oral PSL and intravenous cyclophosphamide resulted in remission. She was finally diagnosed with autoimmune polyglandular syndrome (APS) type 3 (3A ,3B, 3D), complicated with four different autoimmune diseases. Since patients with type 3 APS may present many manifestations over a long period of time, they should be carefully monitored. en-copyright= kn-copyright= en-aut-name=Mifune-MoriokaTomoyo en-aut-sei=Mifune-Morioka en-aut-mei=Tomoyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=A. UchidaHaruhito en-aut-sei=A. Uchida en-aut-mei=Haruhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FukushimaKazuhiko en-aut-sei=Fukushima en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=WatanabeMayu en-aut-sei=Watanabe en-aut-mei=Mayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OuchiChihiro en-aut-sei=Ouchi en-aut-mei=Chihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=MiseKoki en-aut-sei=Mise en-aut-mei=Koki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KawakitaChieko en-aut-sei=Kawakita en-aut-mei=Chieko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KanoYuzuki en-aut-sei=Kano en-aut-mei=Yuzuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OnishiAkifumi en-aut-sei=Onishi en-aut-mei=Akifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TomaKishio en-aut-sei=Toma en-aut-mei=Kishio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WadaNozomu en-aut-sei=Wada en-aut-mei=Nozomu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SasakiErika en-aut-sei=Sasaki en-aut-mei=Erika kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=SuganamiYu en-aut-sei=Suganami en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KishidaMasayuki en-aut-sei=Kishida en-aut-mei=Masayuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=OkadaHiroyuki en-aut-sei=Okada en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of General Internal Medicine and Endocrinology, Okayama City Hospital kn-affil= affil-num=15 en-affil=Department of General Internal Medicine and Endocrinology, Okayama City Hospital kn-affil= affil-num=16 en-affil=Department of General Internal Medicine and Endocrinology, Okayama City Hospital kn-affil= affil-num=17 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=18 en-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=19 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=autoimmune polyglandular syndrome type 3 kn-keyword=autoimmune polyglandular syndrome type 3 en-keyword=systemic lupus erythematosus kn-keyword=systemic lupus erythematosus en-keyword=autoimmune hepatitis kn-keyword=autoimmune hepatitis en-keyword=slowly progressive insulin-dependent diabetes mellitus kn-keyword=slowly progressive insulin-dependent diabetes mellitus en-keyword=chronic thyroiditis kn-keyword=chronic thyroiditis END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=4 article-no= start-page=285 end-page=297 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201908 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dynamic Reorganization of Microtubule and Glioma Invasion en-subtitle= kn-subtitle= en-abstract= kn-abstract= Gliomas are characterized as highly diffuse infiltrating tumors, and currently available treatments such as surgery, radiation and chemotherapy are unfeasible or show limited efficacy against these tumors. Recent genetic and epigenetic analyses of glioma have revealed increasing evidence of the role of driver genetic alterations in glioma development and led to the identification of prognostic factors. Despite these findings, the survival rates of glioma patients remain low, and alternative treatments and novel targets are needed. Recent studies identified neural stem cells as the possible origin of gliomas, and some evidence has revealed shared functions and mechanisms between glioma cells and neurons, also supporting their similarity. The cytoskeleton plays important roles in the migration of normal cells as well as cancer cells. Recent reports have described a role for microtubules, a component of the cytoskeleton, in glioma invasion. Notably, several factors that regulate microtubule functions, such as microtubule-associated proteins, plus-end tracking proteins, or motor proteins, are upregulated in glioma tissues compared with normal tissue, and upregulation of these factors is associated with high invasiveness of glioma cells. In this review, we describe the mechanism of microtubules in glioma invasion and discuss the possibility of microtubule-targeted therapy to inhibit glioma invasion. en-copyright= kn-copyright= en-aut-name=OtaniYoshihiro en-aut-sei=Otani en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IchikawaTomotsugu en-aut-sei=Ichikawa en-aut-mei=Tomotsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KurozumiKazuhiko en-aut-sei=Kurozumi en-aut-mei=Kazuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil=Department of Neurosurgery, The University of Texas Health Science Center at Houston kn-affil= affil-num=2 en-affil=Department of Neurosurgery, Kagawa Prefectural Central Hospital kn-affil= affil-num=3 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=glioma kn-keyword=glioma en-keyword=cytoskeletons kn-keyword=cytoskeletons en-keyword=invasion kn-keyword=invasion en-keyword=microtubules kn-keyword=microtubules END start-ver=1.4 cd-journal=joma no-vol=73 cd-vols= no-issue=3 article-no= start-page=269 end-page=272 dt-received= dt-revised= dt-accepted= dt-pub-year=2019 dt-pub=201906 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Contrast-enhanced Computed Tomography-Guided Percutaneous Cryoablation of Renal Cell Carcinoma in a Renal Allograft: First Case in Asia en-subtitle= kn-subtitle= en-abstract= kn-abstract= Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up. en-copyright= kn-copyright= en-aut-name=TsuboiIchiro en-aut-sei=Tsuboi en-aut-mei=Ichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=FujiwaraHiroyasu en-aut-sei=Fujiwara en-aut-mei=Hiroyasu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IguchiToshihiro en-aut-sei=Iguchi en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HirakiTakao en-aut-sei=Hiraki en-aut-mei=Takao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ArichiNaoko en-aut-sei=Arichi en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KawamuraKasumi en-aut-sei=Kawamura en-aut-mei=Kasumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MaruyamaYuki en-aut-sei=Maruyama en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MitsuiYosuke en-aut-sei=Mitsui en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SakoTomoko en-aut-sei=Sako en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=TakamotoAtsushi en-aut-sei=Takamoto en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=WadaKoichiro en-aut-sei=Wada en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=WatanabeToyohiko en-aut-sei=Watanabe en-aut-mei=Toyohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=YanaiHiroyuki en-aut-sei=Yanai en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=22 ORCID= en-aut-name=ShiinaHiroaki en-aut-sei=Shiina en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=23 ORCID= en-aut-name=KanazawaSusumu en-aut-sei=Kanazawa en-aut-mei=Susumu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=24 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=25 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil= kn-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=4 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=5 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=6 en-affil=Department of Urology, Shimane University, Faculty of Medicine kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=17 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=18 en-affil=Department of Pathology, Okayama University Hospital kn-affil= affil-num=19 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=20 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=21 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=22 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=23 en-affil=Department of Urology, Shimane University, Faculty of Medicine kn-affil= affil-num=24 en-affil=Department of Radiology, Okayama University Hospital kn-affil= affil-num=25 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=cryoablation kn-keyword=cryoablation en-keyword=partial nephrectomy kn-keyword=partial nephrectomy en-keyword=renal cell carcinoma kn-keyword=renal cell carcinoma en-keyword=renal allograft kn-keyword=renal allograft en-keyword=renal transplantation kn-keyword=renal transplantation END start-ver=1.4 cd-journal=joma no-vol=72 cd-vols= no-issue=5 article-no= start-page=535 end-page=538 dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=201810 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Effect of Zinc Acetate Dihydrate (NobelzinR) Treatment on Anemia and Taste Disorders in Patients with Chronic Kidney Disease with Hypozincemia en-subtitle= kn-subtitle= en-abstract= kn-abstract= Some patients with chronic kidney disease (CKD) receiving hemodialysis develop erythropoietin-resistant anemia, possibly due to zinc deficiency. The frequency of zinc deficiency in CKD (stages 1-5 and 5D) and CKD improvement via zinc supplementation are not completely verified. Here 500 CKD patients (Stage 1/2, n=100; Stage 3, n=100; Stage 4, n=100, Stage n=5, 100; Stage 5D, n=100) will be recruited to determine the frequency of serum zinc deficiency at each CKD stage. Patients with serum zinc concentrations <80 μg/dL will be treated with zinc acetate dihydrate (NobelzinR) to evaluate its effects on hypozincemia, taste disturbances, and anemia. en-copyright= kn-copyright= en-aut-name=SatoDaisuke en-aut-sei=Sato en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=GohdaTomohito en-aut-sei=Gohda en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KiharaMasao en-aut-sei=Kihara en-aut-mei=Masao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KanaguchiYasuhiko en-aut-sei=Kanaguchi en-aut-mei=Yasuhiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KobayashiTakashi en-aut-sei=Kobayashi en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=ManoSatoshi en-aut-sei=Mano en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SasakiYu en-aut-sei=Sasaki en-aut-mei=Yu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NoharaNao en-aut-sei=Nohara en-aut-mei=Nao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MurakoshiMaki en-aut-sei=Murakoshi en-aut-mei=Maki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NakataJunichiro en-aut-sei=Nakata en-aut-mei=Junichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SuzukiHitoshi en-aut-sei=Suzuki en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=UedaSeiji en-aut-sei=Ueda en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=HorikoshiSatoshi en-aut-sei=Horikoshi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=SuzukiYusuke en-aut-sei=Suzuki en-aut-mei=Yusuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=2 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=3 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=4 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=5 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=6 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=7 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=8 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=9 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=10 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=11 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=12 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=13 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= affil-num=14 en-affil=Department of Nephrology, Juntendo University Faculty of Medicine kn-affil= en-keyword=zinc acetate dihydrate kn-keyword=zinc acetate dihydrate en-keyword=anemia kn-keyword=anemia en-keyword=chronic kidney disease kn-keyword=chronic kidney disease END start-ver=1.4 cd-journal=joma no-vol=72 cd-vols= no-issue=3 article-no= start-page=301 end-page=307 dt-received= dt-revised= dt-accepted= dt-pub-year=2018 dt-pub=201806 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=IgA Nephropathy Complicated with X-linked Thrombocytopenia en-subtitle= kn-subtitle= en-abstract= kn-abstract= Renal involvement is occasionally observed in Wiskott-Aldrich syndrome (WAS) and X-linked thrombocytopenia (XLT). It has been reported that galactose-deficient IgA is a closely linked to IgA nephropathy (IgAN), suggesting that patients with XLT/WAS associated with reduced galactosylation on serum IgA are susceptible to IgAN. It is necessary to pay more attention to patients with IgAN due to the potential complication with XLT/WAS. We here present a patient of XLT complicated with mild IgAN who underwent tonsillectomy combined with steroid pulse therapy to achieve complete clinical remission. en-copyright= kn-copyright= en-aut-name=KakioYuki en-aut-sei=Kakio en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=A. UchidaHaruhito en-aut-sei=A. Uchida en-aut-mei=Haruhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ArataYuka en-aut-sei=Arata en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KatoAyako en-aut-sei=Kato en-aut-mei=Ayako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=Inoue-ToriiAkiko en-aut-sei=Inoue-Torii en-aut-mei=Akiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=HinamotoNorikazu en-aut-sei=Hinamoto en-aut-mei=Norikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Ogawa-AkiyamaAyu en-aut-sei=Ogawa-Akiyama en-aut-mei=Ayu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=epartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=IgAN nephropathy kn-keyword=IgAN nephropathy en-keyword=Wiskott-Aldrich syndrome kn-keyword=Wiskott-Aldrich syndrome en-keyword=X-linked thrombocytopenia kn-keyword=X-linked thrombocytopenia en-keyword=galactose-deficient IgA1 kn-keyword=galactose-deficient IgA1 END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=9 article-no= start-page=e107934 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140925 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Exacerbation of diabetic renal alterations in mice lacking vasohibin-1 en-subtitle= kn-subtitle= en-abstract= kn-abstract= Vasohibin-1 (VASH1) is a unique endogenous inhibitor of angiogenesis that is induced in endothelial cells by pro-angiogenic factors. We previously reported renoprotective effect of adenoviral delivery of VASH1 in diabetic nephropathy model, and herein investigated the potential protective role of endogenous VASH1 by using VASH1-deficient mice. Streptozotocin-induced type 1 diabetic VASH1 heterozygous knockout mice (VASH1(+/-)) or wild-type diabetic mice were sacrificed 16 weeks after inducing diabetes. In the diabetic VASH1(+/-) mice, albuminuria were significantly exacerbated compared with the diabetic wild-type littermates, in association with the dysregulated distribution of glomerular slit diaphragm related proteins, nephrin and ZO-1, glomerular basement membrane thickening and reduction of slit diaphragm density. Glomerular monocyte/macrophage infiltration and glomerular nuclear translocation of phosphorylated NF-κB p65 were significantly exacerbated in the diabetic VASH1(+/-) mice compared with the diabetic wild-type littermates, accompanied by the augmentation of VEGF-A, M1 macrophage-derived MCP-1 and phosphorylation of IκBα, and the decrease of angiopoietin-1/2 ratio and M2 macrophage-derived Arginase-1. The glomerular CD31(+) endothelial area was also increased in the diabetic VASH1(+/-) mice compared with the diabetic-wild type littermates. Furthermore, the renal and glomerular hypertrophy, glomerular accumulation of mesangial matrix and type IV collagen and activation of renal TGF-β1/Smad3 signaling, a key mediator of renal fibrosis, were exacerbated in the diabetic VASH1(+/-) mice compared with the diabetic wild-type littermates. In conditionally immortalized mouse podocytes cultured under high glucose condition, transfection of VASH1 small interfering RNA (siRNA) resulted in the reduction of nephrin, angiopoietin-1 and ZO-1, and the augmentation of VEGF-A compared with control siRNA. These results suggest that endogenous VASH1 may regulate the development of diabetic renal alterations, partly via direct effects on podocytes, and thus, a strategy to recover VASH1 might potentially lead to the development of a novel therapeutic approach for diabetic nephropathy. en-copyright= kn-copyright= en-aut-name=HinamotoNorikazu en-aut-sei=Hinamoto en-aut-mei=Norikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MaeshimaYohei en-aut-sei=Maeshima en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YamasakiHiroko en-aut-sei=Yamasaki en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NasuTatsuyo en-aut-sei=Nasu en-aut-mei=Tatsuyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SaitoDaisuke en-aut-sei=Saito en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=WatataniHiroyuki en-aut-sei=Watatani en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=UjikeHaruyo en-aut-sei=Ujike en-aut-mei=Haruyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MasudaKana en-aut-sei=Masuda en-aut-mei=Kana kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=ArataYuka en-aut-sei=Arata en-aut-mei=Yuka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SatoYasufumi en-aut-sei=Sato en-aut-mei=Yasufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil= kn-affil= affil-num=12 en-affil=Department of Vascular Biology, Institute of Development, Aging, and Cancer, Tohoku University kn-affil= affil-num=13 en-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=26 cd-vols= no-issue=5 article-no= start-page=730 end-page=737 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=20160311 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Comparison of severity classification in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study en-subtitle= kn-subtitle= en-abstract= kn-abstract=OBJECTIVE: To compare disease severity classification systems for six-month outcome prediction in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: Patients with newly diagnosed AAV from 53 tertiary institutions were enrolled. Six-month remission, overall survival, and end-stage renal disease (ESRD)-free survival were evaluated. RESULTS: According to the European Vasculitis Study Group (EUVAS)-defined disease severity, the 321 enrolled patients were classified as follows: 14, localized; 71, early systemic; 170, generalized; and 66, severe disease. According to the rapidly progressive glomerulonephritis (RPGN) clinical grading system, the patients were divided as follows: 60, grade I; 178, grade II; 66, grade III; and 12, grade IV. According to the Five-Factor Score (FFS) 2009, 103, 109, and 109 patients had ?1, 2, and ?3 points, respectively. No significant difference in remission rates was found in any severity classification. The overall and ESRD-free survival rates significantly differed between grades I/II, III, and IV, regardless of renal involvement. Severe disease was a good predictor of six-month overall and ESRD-free survival. The FFS 2009 was useful to predict six-month ESRD-free survival but not overall survival. CONCLUSIONS: The RPGN grading system was more useful to predict six-month overall and ESRD-free survival than the EUVAS-defined severity or FFS 2009. en-copyright= kn-copyright= en-aut-name=SadaKen-ei en-aut-sei=Sada en-aut-mei=Ken-ei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HarigaiMasayoshi en-aut-sei=Harigai en-aut-mei=Masayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=AmanoKoichi en-aut-sei=Amano en-aut-mei=Koichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=AtsumiTatsuya en-aut-sei=Atsumi en-aut-mei=Tatsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=FujimotoShouichi en-aut-sei=Fujimoto en-aut-mei=Shouichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YuzawaYukio en-aut-sei=Yuzawa en-aut-mei=Yukio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=TakasakiYoshinari en-aut-sei=Takasaki en-aut-mei=Yoshinari kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=BannoShogo en-aut-sei=Banno en-aut-mei=Shogo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=SugiharaTakahiko en-aut-sei=Sugihara en-aut-mei=Takahiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=KobayashiMasaki en-aut-sei=Kobayashi en-aut-mei=Masaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=UsuiJoichi en-aut-sei=Usui en-aut-mei=Joichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=YamagataKunihiro en-aut-sei=Yamagata en-aut-mei=Kunihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=HommaSakae en-aut-sei=Homma en-aut-mei=Sakae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=DobashiHiroaki en-aut-sei=Dobashi en-aut-mei=Hiroaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TsuboiNaotake en-aut-sei=Tsuboi en-aut-mei=Naotake kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=IshizuAkihiro en-aut-sei=Ishizu en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=OkadaYasunori en-aut-sei=Okada en-aut-mei=Yasunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=ArimuraYoshihiro en-aut-sei=Arimura en-aut-mei=Yoshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=MatsuoSeiichi en-aut-sei=Matsuo en-aut-mei=Seiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=21 ORCID= affil-num=1 en-affil= Department of Nephrology, Rheumatology, Endocrinology and Metabolism , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Rheumatology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University kn-affil= affil-num=3 en-affil=Department of Rheumatology and Clinical Immunology , Saitama Medical Center, Saitama Medical University kn-affil= affil-num=4 en-affil=Division of Rheumatology, Endocrinology and Nephrology at the Graduate School of Medicine , Hokkaido University kn-affil= affil-num=5 en-affil=Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine , Miyazaki University kn-affil= affil-num=6 en-affil=Department of Nephrology , Fujita Health University School of Medicine kn-affil= affil-num=7 en-affil=Department of Internal Medicine and Rheumatology , Juntendo University School of Medicine kn-affil= affil-num=8 en-affil=Division of Rheumatology and Nephrology, Department of Internal Medicine , Aichi Medical University School of Medicine kn-affil= affil-num=9 en-affil=Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology kn-affil= affil-num=10 en-affil=Department of Nephrology , Tokyo Medical University Ibaraki Medical Center kn-affil= affil-num=11 en-affil=Department of Nephrology, Faculty of Medicine , University of Tsukuba kn-affil= affil-num=12 en-affil=Department of Nephrology, Faculty of Medicine , University of Tsukuba kn-affil= affil-num=13 en-affil=Department of Respiratory Medicine , Toho University Omori Medical Center kn-affil= affil-num=14 en-affil=Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine , Kagawa University kn-affil= affil-num=15 en-affil=Department of Nephrology, Internal Medicine , Nagoya University Graduate School of Medicine kn-affil= affil-num=16 en-affil=Faculty of Health Sciences , Hokkaido University kn-affil= affil-num=17 en-affil=Department of Chronic Kidney Disease and Peritoneal Dialysis , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=18 en-affil=Department of Pathology , Keio University School of Medicine kn-affil= affil-num=19 en-affil=Nephrology and Rheumatology, First Department of Internal Medicine , Kyorin University School of Medicine kn-affil= affil-num=20 en-affil=Department of Nephrology, Internal Medicine , Nagoya University Graduate School of Medicine kn-affil= affil-num=21 en-affil=Okayama University Hospital kn-affil= en-keyword=Antineutrophil cytoplasmic antibody-associated vasculitis kn-keyword=Antineutrophil cytoplasmic antibody-associated vasculitis en-keyword=Eosinophilic granulomatosis with polyangiitis kn-keyword=Eosinophilic granulomatosis with polyangiitis en-keyword=Granulomatosis with polyangiitis kn-keyword=Granulomatosis with polyangiitis en-keyword=Inception cohort kn-keyword=Inception cohort en-keyword=Microscopic polyangiitis kn-keyword=Microscopic polyangiitis END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=4 article-no= start-page=351 end-page=355 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=201708 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Robotic Renal Autotransplantation: First Case Outside of North America en-subtitle= kn-subtitle= en-abstract= kn-abstract= A 38-year-old woman with a 2.7-cm left ureteral stenosis requiring chronic ureteral stent exchange elected to undergo robotic renal autotransplantation. Left ureteropelvic junction obstruction (UPJO) was also suspected. Robotic donor nephrectomy contributed to the fine dissection for desmoplastic changes. The kidney was removed through a Gelport and examined on ice. UPJO was not seen. An end-to-side robotic anastomosis was created between the renal and external iliac vessels. The console time was 507 min, and the warm ischemia time was 4 min 5 sec. She became stent-free. Robotic renal autotransplantation is a new, minimally invasive approach to renal preservation. en-copyright= kn-copyright= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WadaKoichiro en-aut-sei=Wada en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuiYosuke en-aut-sei=Mitsui en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SadahiraTakuya en-aut-sei=Sadahira en-aut-mei=Takuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NishimuraShingo en-aut-sei=Nishimura en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=YoshiokaTakashi en-aut-sei=Yoshioka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=AriyoshiYuichi en-aut-sei=Ariyoshi en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=FujioKei en-aut-sei=Fujio en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=TakamotoAtsushi en-aut-sei=Takamoto en-aut-mei=Atsushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SugimotoMorito en-aut-sei=Sugimoto en-aut-mei=Morito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=SasakiKatsumi en-aut-sei=Sasaki en-aut-mei=Katsumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=EbaraShin en-aut-sei=Ebara en-aut-mei=Shin kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=TaninishiHideki en-aut-sei=Taninishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= en-aut-name=AmanoHiroyuki en-aut-sei=Amano en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=16 ORCID= en-aut-name=InuiMasashi en-aut-sei=Inui en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=17 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=18 ORCID= en-aut-name=WatanabeToyohiko en-aut-sei=Watanabe en-aut-mei=Toyohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=19 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=20 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=13 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=15 en-affil=Department of Anesthesiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=16 en-affil=Amano Clinic kn-affil= affil-num=17 en-affil=Department of Urology, Tokyo Women’s Medical University Yachiyo Medical Center kn-affil= affil-num=18 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=19 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=20 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=robotic surgery kn-keyword=robotic surgery en-keyword=renal autotransplantation kn-keyword=renal autotransplantation en-keyword=ureteral stenosis kn-keyword=ureteral stenosis en-keyword=laparoscopic surgery kn-keyword=laparoscopic surgery en-keyword=renal transplantation kn-keyword=renal transplantation END start-ver=1.4 cd-journal=joma no-vol=129 cd-vols= no-issue=2 article-no= start-page=101 end-page=105 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=20170801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The perception of chronic kidney disease in a general population in Okayama, Japan : 2015 kn-title=岡山県健診受診者の慢性腎臓病（CKD）認知度〜 2015年度〜 en-subtitle= kn-subtitle= en-abstract= kn-abstract=　Public education programs about chronic kidney disease (CKD) have been performed in Okayama, Japan for the past 10 years. The present study investigated the perception of CKD in a general population in Okayama. In October and November 2015, a questionnaire survey was distributed by 12 medical centers in five medical districts in Okayama prefecture. A total of 7,022 respondents who underwent their physical checkup at these centers answered the questionnaire. In response to a questionnaire item asking about the respondent's familiarity with the term "CKD," only 4% of the respondents answered "know it well" and 10% answered "unfamiliar." In contrast, in response to a questionnaire item asking about the respondent's familiarity with "chronic kidney disease," 27% answered "know it well" and 38% answered "unfamiliar." The leading avenue by which the respondents learned about CKD/chronic kidney disease was television, followed by newspapers, magazines, and a family doctor or nurse. The leading component which the respondents considered essential for the diagnosis of CKD/chronic kidney disease was proteinuria. A stratified analysis demonstrated a higher recognition of “CKD" or “chronic kidney disease" in the medical districts in northern Okayama prefecture compared to southern Okayama prefecture. These results indicated that the awareness of CKD in Okayama prefecture is still inadequate. Many people did not appear to realize that the term “CKD" represents "chronic kidney disease". Further continuous public education efforts are required to enlighten people about CKD/chronic kidney disease. en-copyright= kn-copyright= en-aut-name=UchidaHaruhito A. en-aut-sei=Uchida en-aut-mei=Haruhito A. kn-aut-name=内田治仁 kn-aut-sei=内田 kn-aut-mei=治仁 aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name=杉山斉 kn-aut-sei=杉山 kn-aut-mei=斉 aut-affil-num=2 ORCID= en-aut-name=MiyazakiMasashi en-aut-sei=Miyazaki en-aut-mei=Masashi kn-aut-name=宮崎雅史 kn-aut-sei=宮崎 kn-aut-mei=雅史 aut-affil-num=3 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name=和田淳 kn-aut-sei=和田 kn-aut-mei=淳 aut-affil-num=4 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name=四方賢一 kn-aut-sei=四方 kn-aut-mei=賢一 aut-affil-num=5 ORCID= en-aut-name=KashiharaNaoki en-aut-sei=Kashihara en-aut-mei=Naoki kn-aut-name=柏原直樹 kn-aut-sei=柏原 kn-aut-mei=直樹 aut-affil-num=6 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name=槇野博史 kn-aut-sei=槇野 kn-aut-mei=博史 aut-affil-num=7 ORCID= affil-num=1 en-affil=Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　CKD・CVD地域連携包括医療学 affil-num=2 en-affil=Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　血液浄化療法人材育成システム開発学 affil-num=3 en-affil=Saiwaicho Memorial Hospital kn-affil=幸町記念病院 affil-num=4 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=5 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil=岡山大学病院　新医療研究開発センター affil-num=6 en-affil=Department of Nephrology/Hypertension, Kawasaki Medical School kn-affil=川崎医科大学　腎臓・高血圧内科学 affil-num=7 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 en-keyword=慢性腎臓病 (chronic kidney disease) kn-keyword=慢性腎臓病 (chronic kidney disease) en-keyword=CKD kn-keyword=CKD en-keyword=認知度 (perception) kn-keyword=認知度 (perception) en-keyword=岡山県 (Okayama) kn-keyword=岡山県 (Okayama) en-keyword=医療圏別 (medical distinct) kn-keyword=医療圏別 (medical distinct) END start-ver=1.4 cd-journal=joma no-vol=129 cd-vols= no-issue=1 article-no= start-page=9 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2017 dt-pub=20170403 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Does hydrogen-rich water really work? kn-title=水素水は怪しい水でしょうか？ en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=NakaoAtsunori en-aut-sei=Nakao en-aut-mei=Atsunori kn-aut-name=中尾篤典 kn-aut-sei=中尾 kn-aut-mei=篤典 aut-affil-num=1 ORCID= affil-num=1 en-affil=Department of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil=岡山大学大学院医歯薬学総合研究科　救急医学 en-keyword=水素水 kn-keyword=水素水 en-keyword=抗酸化作用 kn-keyword=抗酸化作用 en-keyword=抗炎症作用 kn-keyword=抗炎症作用 en-keyword=臨床応用 kn-keyword=臨床応用 en-keyword=疑似科学 kn-keyword=疑似科学 END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=4 article-no= start-page=295 end-page=297 dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=201608 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Efficacy of Rituximab in High-risk Renal Transplant Recipients en-subtitle= kn-subtitle= en-abstract= kn-abstract=Although graft survival following renal transplantation (RTx) has improved, outcomes following highrisk RTx are variable. Preexisting antibodies, including donor-specific antibodies (DSA), play an important role in graft dysfunction and survival. We have designed a study to investigate the safety and efficacy of anti-CD20 monoclonal antibodies (rituximab) in high-risk RTx recipients. Major eligibility criteria include: 1) major and minor ABO blood group mismatch, 2) positive DSA. Thirty-five patients will receive 200 mg/body of rituximab. The primary endpoint is the incidence of B cell depletion. This study will clarify whether rituximab is efficacious in improving graft survival in high-risk RTx recipients. en-copyright= kn-copyright= en-aut-name=ArakiMotoo en-aut-sei=Araki en-aut-mei=Motoo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WadaKoichiro en-aut-sei=Wada en-aut-mei=Koichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MitsuiYosuke en-aut-sei=Mitsui en-aut-mei=Yosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KubotaRisa en-aut-sei=Kubota en-aut-mei=Risa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YoshiokaTakashi en-aut-sei=Yoshioka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=AriyoshiYuichi en-aut-sei=Ariyoshi en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KitagawaMasashi en-aut-sei=Kitagawa en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SugiyamaHiroshi en-aut-sei=Sugiyama en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=WatanabeMasami en-aut-sei=Watanabe en-aut-mei=Masami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=WatanabeToyohiko en-aut-sei=Watanabe en-aut-mei=Toyohiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=HottaKatsuyuki en-aut-sei=Hotta en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= en-aut-name=NasuYasutomo en-aut-sei=Nasu en-aut-mei=Yasutomo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=15 ORCID= affil-num=1 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=4 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=5 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=6 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=7 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=8 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=11 en-affil=Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=12 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=13 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=14 en-affil=Center for Innovative Clinical Medicine, Okayama University Hospital kn-affil= affil-num=15 en-affil=Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= en-keyword=end-stage renal disease kn-keyword=end-stage renal disease en-keyword=immunosuppression kn-keyword=immunosuppression en-keyword=kidney transplantation kn-keyword=kidney transplantation END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2016 dt-pub=20160325 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=急性非代償性心不全に対するトルバプタン治療レスポンダーの特徴：腎臓サイズ維持の重要性 kn-title=Clinical characteristics of responders to treatment with tolvaptan in patients with acute decompensated heart failure: Importance of preserved kidney size en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=TodaHironobu en-aut-sei=Toda en-aut-mei=Hironobu kn-aut-name=戸田洋伸 kn-aut-sei=戸田 kn-aut-mei=洋伸 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END start-ver=1.4 cd-journal=joma no-vol=9 cd-vols= no-issue=1 article-no= start-page=e85594 end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140122 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Nuclear Hormone Receptor Expression in Mouse Kidney and Renal Cell Lines en-subtitle= kn-subtitle= en-abstract= kn-abstract=Nuclear hormone receptors (NHRs) are transcription factors that regulate carbohydrate and lipid metabolism, immune responses, and inflammation. Although several NHRs, including peroxisome proliferator-activated receptor-γ (PPARγ) and PPARα, demonstrate a renoprotective effect in the context of diabetic nephropathy (DN), the expression and role of other NHRs in the kidney are still unrecognized. To investigate potential roles of NHRs in the biology of the kidney, we used quantitative real-time polymerase chain reaction to profile the expression of all 49 members of the mouse NHR superfamily in mouse kidney tissue (C57BL/6 and db/m), and cell lines of mesangial (MES13), podocyte (MPC), proximal tubular epithelial (mProx24) and collecting duct (mIMCD3) origins in both normal and high-glucose conditions. In C57BL/6 mouse kidney cells, hepatocyte nuclear factor 4α, chicken ovalbumin upstream promoter transcription factor II (COUP-TFII) and COUP-TFIII were highly expressed. During hyperglycemia, the expression of the NHR 4A subgroup including neuron-derived clone 77 (Nur77), nuclear receptor-related factor 1, and neuron-derived orphan receptor 1 significantly increased in diabetic C57BL/6 and db/db mice. In renal cell lines, PPARδ was highly expressed in mesangial and proximal tubular epithelial cells, while COUP-TFs were highly expressed in podocytes, proximal tubular epithelial cells, and collecting duct cells. High-glucose conditions increased the expression of Nur77 in mesangial and collecting duct cells, and liver x receptor α in podocytes. These data demonstrate NHR expression in mouse kidney cells and cultured renal cell lines and suggest potential therapeutic targets in the kidney for the treatment of DN. en-copyright= kn-copyright= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TeramiNaoto en-aut-sei=Terami en-aut-mei=Naoto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HatanakaTakashi en-aut-sei=Hatanaka en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TachibanaHiromi en-aut-sei=Tachibana en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=Sato HoriguchiChikage en-aut-sei=Sato Horiguchi en-aut-mei=Chikage kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=NishiiNaoko en-aut-sei=Nishii en-aut-mei=Naoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Diabetic Nephropathy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Diabetic Nephropathy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences END start-ver=1.4 cd-journal=joma no-vol=33 cd-vols= no-issue=3 article-no= start-page=774 end-page=784 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201503 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Single adult kidney stem/progenitor cells reconstitute three-dimensional nephron structures in vitro. en-subtitle= kn-subtitle= en-abstract= kn-abstract=The kidneys are formed during development from two distinct primordial tissues, the metanephric mesenchyme and the ureteric bud. The metanephric mesenchyme develops into the kidney nephron, the minimal functional unit of the kidney. A nephron consists of several segments and regulates water, electrolyte, and acid-base homeostasis in addition to secreting certain hormones. It has been predicted that the kidney will be among the last organs successfully regenerated in vitro due to its complex structure and multiple functions. Here, we show that adult kidney stem/progenitor cells (KS cells), derived from the S3 segment of adult rat kidney nephrons, can reconstitute a three-dimensional kidney-like structure in vitro. Kidney-like structures were formed when a cluster of KS cells was suspended in an extracellular matrix gel and cultured in the presence of several growth factors. Morphological analyses revealed that these kidney-like structures contained every substructure of the kidney, including glomeruli, proximal tubules, the loop of Henle, distal tubules, and collecting ducts, but no vasculature. Our results demonstrate that a cluster of tissue stem/progenitor cells has the ability to reconstitute the minimum unit of its organ of origin by differentiating into specialized cells in the correct location. This process differs from embryonic kidney development, which requires the mutual induction of two different populations of progenitors, metanephric mesenchymal cells and ureteric bud cells. en-copyright= kn-copyright= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SakuraiHiroyuki en-aut-sei=Sakurai en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Pharmacology and Toxicology, Kyorin University School of Medicine affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=Adult kidney tissue stem cells kn-keyword=Adult kidney tissue stem cells en-keyword=Three-dimensional nephron structures in vitro kn-keyword=Three-dimensional nephron structures in vitro en-keyword=Organogenesis kn-keyword=Organogenesis END start-ver=1.4 cd-journal=joma no-vol=127 cd-vols= no-issue=3 article-no= start-page=203 end-page=207 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=20151201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Non-high-output cardiac failure in patients undergoing hemodialysis through an arteriovenous shunt kn-title=透析シャント心不全―非過大シャント心不全 “Non-High-Output Cardiac Failure”の病態― en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background: Hemodialysis-related heart failure has been considered to be associated with excessive blood flow through the arteriovenous (AV) shunt used for vascular access. However, some patients undergoing dialysis have heart failure in the absence of an increase in cardiac output (CO) related to shunt blood-flow loading because the loading cannot be compensated for by increasing CO. This condition may be challenging to manage ; thus, early diagnosis is important. Methods and Results: Twelve patients (mean age, 71 years ; 9 men) with end-stage renal disease, dialysis-related heart failure, a high brain natriuretic peptide (BNP) level, and a mean New York Heart Association (NYHA) class of II underwent AV shunt closure. Their cardiac index (CI), pre- and post-dialysis BNP levels, and several cardiac variables were assessed pre- and postoperatively. All patients achieved relief of heart failure symptoms and a reduction in NYHA class after AV closure, but six patients had a postoperative increase in CI (the "non-high-output" cardiac failure group), whereas the other six had a decrease in CI (the "high-output" cardiac failure group). The high-output patients had greater improvements in BNP levels and most cardiac variables compared to the non-high-output group ; therefore, the heart failure in the non-high-output patients was considered more serious than that in the high-output group. Conclusions: The selection of effective strategies for treating dialysis-related heart failure may depend partly on identifying which patients have non-high-output failure. Such identification requires serial measurements of BNP levels and evaluations of cardiac variables other than the ejection fraction. en-copyright= kn-copyright= en-aut-name=UgawaToyomu en-aut-sei=Ugawa en-aut-mei=Toyomu kn-aut-name=鵜川豊世武 kn-aut-sei=鵜川 kn-aut-mei=豊世武 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 en-keyword=心拍出量（cardiac output） kn-keyword=心拍出量（cardiac output） en-keyword=心不全（heart failure） kn-keyword=心不全（heart failure） en-keyword=脳性ナトリウム利尿ペプチド（brain natriuretic peptide） kn-keyword=脳性ナトリウム利尿ペプチド（brain natriuretic peptide） en-keyword=非過大シャント心不全（non-high-output cardiac failure） kn-keyword=非過大シャント心不全（non-high-output cardiac failure） en-keyword=腎臓（kidney） kn-keyword=腎臓（kidney） END start-ver=1.4 cd-journal=joma no-vol=127 cd-vols= no-issue=3 article-no= start-page=187 end-page=195 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=20151201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Basic and clinical research regarding vascular endothelial function kn-title=血管内皮機能を対象にした基礎および臨床医学研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=TsukaharaHirokazu en-aut-sei=Tsukahara en-aut-mei=Hirokazu kn-aut-name=塚原宏一 kn-aut-sei=塚原 kn-aut-mei=宏一 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 en-keyword=アルギニン代謝 kn-keyword=アルギニン代謝 en-keyword=一酸化窒素 kn-keyword=一酸化窒素 en-keyword=ガス生物学 kn-keyword=ガス生物学 en-keyword=血管内皮学 kn-keyword=血管内皮学 en-keyword=酸化ストレス kn-keyword=酸化ストレス END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=2 article-no= start-page=119 end-page=122 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201504 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=A Paraganglioma in a Hypertensive Patient with Unilateral Renal Hypoplasia en-subtitle= kn-subtitle= en-abstract= kn-abstract=We report the case of a 46-year-old hypertensive Japanese female with renal insufficiency related to unilateral renal hypoplasia. The patient was found to have developed paraganglioma in the retroperitoneal space over a 5-year period. Catecholamine-producing tumors are not usually recognized as conditions associated with renal hypoplasia. Our long-term observation of the patient eventually led us to the diagnosis of paraganglioma. In hypertensive patients with chronic kidney disease, not only the renin-angiotensin-aldosterone system but also catecholamine activity may be involved, particularly in the patients whose cases are complicated with unilateral renal hypoplasia. en-copyright= kn-copyright= en-aut-name=TerasakaTomohiro en-aut-sei=Terasaka en-aut-mei=Tomohiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HagiyaHideharu en-aut-sei=Hagiya en-aut-mei=Hideharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=KimuraKosuke en-aut-sei=Kimura en-aut-mei=Kosuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NadaTakahiro en-aut-sei=Nada en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakamuraEri en-aut-sei=Nakamura en-aut-mei=Eri kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=HanayamaYoshihisa en-aut-sei=Hanayama en-aut-mei=Yoshihisa kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KobayashiYasuyuki en-aut-sei=Kobayashi en-aut-mei=Yasuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=YanaiHiroyuki en-aut-sei=Yanai en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=OtsukaFumio en-aut-sei=Otsuka en-aut-mei=Fumio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Departments of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Departments of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Departments of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Departments of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=catecholamine kn-keyword=catecholamine en-keyword=paraganglioma kn-keyword=paraganglioma en-keyword=renal hypoplasia kn-keyword=renal hypoplasia en-keyword=renovascular hypertension kn-keyword=renovascular hypertension en-keyword=secondary hypertension kn-keyword=secondary hypertension END start-ver=1.4 cd-journal=joma no-vol=6 cd-vols= no-issue= article-no= start-page=233 end-page=240 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=20131022 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Urinary angiotensinogen is a marker for tubular injuries in patients with type 2 diabetes en-subtitle= kn-subtitle= en-abstract= kn-abstract=Purpose: Urinary angiotensinogen has been reported as a marker for the activation of intrarenal renin?angiotensin system (RAS) in various kidney diseases. To investigate the importance of urinary angiotensinogen in diabetic nephropathy, we compared the urinary levels of angiotensinogen, albumin, and α1-microglobulin. Materials and methods: Japanese patients with type 2 diabetes at various stages of nephropathy (n=85) were enrolled, and we measured albumin/creatinine ratio (ACR) and urinary excretion of angiotensinogen and α1-microglobulin. We also compared the clinical data of the patients treated with or without angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors (RAS inhibitors [+], n=51; RAS inhibitors [?], n=34). Results: Urinary angiotensinogen levels positively correlated with ACR (r =0.367, P=3.84×10-4) and urinary α1-microglobulin (r=0.734, P=1.32 × 10-15), while they negatively correlated with estimated glomerular filtration ratio (eGFR) (r=?0.350, P=1.02 × 10-3) and high-density lipoprotein cholesterol (r=?0.216, P=0.049). Multiple regression analysis was carried out to predict urinary angiotensinogen levels by employing eGFR, ACR, and urinary α1-microglobulin as independent variables; only urinary α1-microglobulin entered the regression equation at a significant level. Although ACR was higher in the RAS inhibitors (+) group, urinary α1-microglobulin and angiotensinogen did not show significant increase in the RAS inhibitors (+) group. Conclusion: Urinary angiotensinogen is well correlated with urinary α1-microglobulin and reflected the tubular injuries which may be associated with the intrarenal RAS activation in patients with type 2 diabetes. en-copyright= kn-copyright= en-aut-name=TeramiTakahiro en-aut-sei=Terami en-aut-mei=Takahiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=InoueKentaro en-aut-sei=Inoue en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TeshigawaraSanae en-aut-sei=Teshigawara en-aut-mei=Sanae kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=MurakamiKazutoshi en-aut-sei=Murakami en-aut-mei=Kazutoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=KatayamaAkihiro en-aut-sei=Katayama en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=EguchiJun en-aut-sei=Eguchi en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Medicine and Clinical Science,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=diabetic nephropathy kn-keyword=diabetic nephropathy en-keyword=urinary biomarkers kn-keyword=urinary biomarkers en-keyword=renin?angiotensin system kn-keyword=renin?angiotensin system en-keyword=angiotensinogen kn-keyword=angiotensinogen en-keyword=α1-microglobulin kn-keyword=α1-microglobulin en-keyword=albumin kn-keyword=albumin END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=4 article-no= start-page=219 end-page=233 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201408 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Renal Distribution of Vasohibin-1 in Patients with Chronic Kidney Disease en-subtitle= kn-subtitle= en-abstract= kn-abstract=Experimental studies have demonstrated the involvement of angiogenesis-related factors in the progression of chronic kidney disease (CKD). There have so far been no reports investigating the distribution and clinical roles of Vasohibin-1 (VASH-1), a negative feedback regulator of angiogenesis, in CKD. We recruited 54 Japanese CKD patients and 6 patients who had normal renal tissues excised due to localized renal cell carcinoma. We evaluated the correlations between the renal expression level of VASH-1 and the clinical/histological parameters. VASH-1 was observed in renal endothelial/mesangial cells, crescentic lesions and interstitial inflammatory cells. Significant positive correlations were observed between 1) crescent formation and the number of VASH-1+ cells in the glomerulus (r＝0.48, p＝0.001) or cortex (r＝0.64, p＜0.0001), 2) interstitial cell infiltration and the number of VASH-1+ cells in the cortex (r＝0.34, p＝0.02), 3) the glomerular VEGFR-2+ area and the number of VASH-1+ cells in the glomerulus (r＝0.44, p＝0.01) or medulla (r＝0.63, p＝0.01). These results suggest that the renal levels of VASH-1 may be affected by local inflammation, crescentic lesions and VEGFR-2. en-copyright= kn-copyright= en-aut-name=HinamotoNorikazu en-aut-sei=Hinamoto en-aut-mei=Norikazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=MaeshimaYohei en-aut-sei=Maeshima en-aut-mei=Yohei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=SaitoDaisuke en-aut-sei=Saito en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YamasakiHiroko en-aut-sei=Yamasaki en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TanabeKatsuyuki en-aut-sei=Tanabe en-aut-mei=Katsuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=NasuTatsuyo en-aut-sei=Nasu en-aut-mei=Tatsuyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=WatataniHiroyuki en-aut-sei=Watatani en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UjikeHaruyo en-aut-sei=Ujike en-aut-mei=Haruyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=KinomuraMasaru en-aut-sei=Kinomura en-aut-mei=Masaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SonodaHikaru en-aut-sei=Sonoda en-aut-mei=Hikaru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=KanomataNaoki en-aut-sei=Kanomata en-aut-mei=Naoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=SatoYasufumi en-aut-sei=Sato en-aut-mei=Yasufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=11 en-affil= kn-affil=Discovery Research Laboratories, Shionogi affil-num=12 en-affil= kn-affil=Department of Pathology 2, Kawasaki Medical School affil-num=13 en-affil= kn-affil=Department of Vascular Biology, Institute of Development, Aging, and Cancer, Tohoku University affil-num=14 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=chronic kidney disease kn-keyword=chronic kidney disease en-keyword=inflammation kn-keyword=inflammation en-keyword=Vasohibin-1 kn-keyword=Vasohibin-1 en-keyword=VEGF-A kn-keyword=VEGF-A en-keyword=VEGFR-2 kn-keyword=VEGFR-2 END start-ver=1.4 cd-journal=joma no-vol=126 cd-vols= no-issue=1 article-no= start-page=1 end-page=6 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=20140401 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Cholecystokinin plays a novel protective role in diabetic kidney through anti-inflammatory actions on macrophages kn-title=糖尿病の腎臓においてcholecystokininはマクロファージに対する抗炎症作用を介した新規の保護効果を発揮する en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name=宮本聡 kn-aut-sei=宮本 kn-aut-mei=聡 aut-affil-num=1 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name=四方賢一 kn-aut-sei=四方 kn-aut-mei=賢一 aut-affil-num=2 ORCID= en-aut-name=MiyasakaKyoko en-aut-sei=Miyasaka en-aut-mei=Kyoko kn-aut-name=宮坂京子 kn-aut-sei=宮坂 kn-aut-mei=京子 aut-affil-num=3 ORCID= en-aut-name=OkadaShinichi en-aut-sei=Okada en-aut-mei=Shinichi kn-aut-name=岡田震一 kn-aut-sei=岡田 kn-aut-mei=震一 aut-affil-num=4 ORCID= en-aut-name=SasakiMotofumi en-aut-sei=Sasaki en-aut-mei=Motofumi kn-aut-name=佐々木基史 kn-aut-sei=佐々木 kn-aut-mei=基史 aut-affil-num=5 ORCID= en-aut-name=KoderaRyo en-aut-sei=Kodera en-aut-mei=Ryo kn-aut-name=小寺亮 kn-aut-sei=小寺 kn-aut-mei=亮 aut-affil-num=6 ORCID= en-aut-name=HirotaDaisho en-aut-sei=Hirota en-aut-mei=Daisho kn-aut-name=廣田大昌 kn-aut-sei=廣田 kn-aut-mei=大昌 aut-affil-num=7 ORCID= en-aut-name=KajitaniNobuo en-aut-sei=Kajitani en-aut-mei=Nobuo kn-aut-name=梶谷展生 kn-aut-sei=梶谷 kn-aut-mei=展生 aut-affil-num=8 ORCID= en-aut-name=TakatsukaTetsuharu en-aut-sei=Takatsuka en-aut-mei=Tetsuharu kn-aut-name=高塚哲全 kn-aut-sei=高塚 kn-aut-mei=哲全 aut-affil-num=9 ORCID= en-aut-name=Kataoka UsuiHitomi en-aut-sei=Kataoka Usui en-aut-mei=Hitomi kn-aut-name=片岡仁美 kn-aut-sei=片岡 kn-aut-mei=仁美 aut-affil-num=10 ORCID= en-aut-name=NishishitaShingo en-aut-sei=Nishishita en-aut-mei=Shingo kn-aut-name=西下伸吾 kn-aut-sei=西下 kn-aut-mei=伸吾 aut-affil-num=11 ORCID= en-aut-name=Horiguchi SatoChikage en-aut-sei=Horiguchi Sato en-aut-mei=Chikage kn-aut-name=堀口千景 kn-aut-sei=堀口 kn-aut-mei=千景 aut-affil-num=12 ORCID= en-aut-name=FunakoshiAkihiro en-aut-sei=Funakoshi en-aut-mei=Akihiro kn-aut-name=船越顕博 kn-aut-sei=船越 kn-aut-mei=顕博 aut-affil-num=13 ORCID= en-aut-name=NishimoriHisakazu en-aut-sei=Nishimori en-aut-mei=Hisakazu kn-aut-name=西森久和 kn-aut-sei=西森 kn-aut-mei=久和 aut-affil-num=14 ORCID= en-aut-name=UchidaHaruhito Adam en-aut-sei=Uchida en-aut-mei=Haruhito Adam kn-aut-name=内田治仁 kn-aut-sei=内田 kn-aut-mei=治仁 aut-affil-num=15 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name=小川大輔 kn-aut-sei=小川 kn-aut-mei=大輔 aut-affil-num=16 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name=槇野博史 kn-aut-sei=槇野 kn-aut-mei=博史 aut-affil-num=17 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=3 en-affil= kn-affil=東京家政大学　栄養学科 affil-num=4 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=7 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=8 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=9 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=10 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=11 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=12 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=13 en-affil= kn-affil=国立病院機構九州がんセンター　消化器肝胆膵内科 affil-num=14 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　血液・腫瘍・呼吸器内科学 affil-num=15 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=16 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=17 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 en-keyword=cholecystokinin kn-keyword=cholecystokinin en-keyword=糖尿病性腎症 kn-keyword=糖尿病性腎症 en-keyword=抗炎症作用 kn-keyword=抗炎症作用 en-keyword=腎保護効果 kn-keyword=腎保護効果 END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=1 article-no= start-page=7 end-page=15 dt-received= dt-revised= dt-accepted= dt-pub-year=2014 dt-pub=201402 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mizoribine Inhibits the Proliferation of Renal Stem/Progenitor Cells by G1/S Arrest during Renal Regeneration en-subtitle= kn-subtitle= en-abstract= kn-abstract=Immunosuppressive agents are generally administered to treat kidney diseases. However, it is unclear whether renal stem/progenitor cells are directly affected by the immunosuppressive agents. We used normal rat kidney cells, ureteric bud cells and rat kidney stem/progenitor cells in this study. Mizoribine (MZR), cyclophosphamide (CPA) and cyclosporine (CyA) were added to the culture media of these cells. We evaluated the effects of these immunosuppressive agents on cell proliferation using an electrical cell-substrate impedance sensing system (ECIS) and their effects on the process of renal regeneration using the ischemia-reperfusion (I/R) injury rat model. The ECIS data showed that proliferation of each of the 3 types of cells was significantly suppressed by MZR. MZR treatment enhanced renal tubular injury in ischemia-reperfusion (I/R) injured rats, and significantly decreased levels of M-phase cells and Nestin-positive cells. These results suggested that MZR inhibits the cell cycle of renal stem/progenitor cells;thus, physicians should take note that MZR might affect not only inflammation but also renal regeneration. en-copyright= kn-copyright= en-aut-name=HorimotoNaoya en-aut-sei=Horimoto en-aut-mei=Naoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KitamuraShinji en-aut-sei=Kitamura en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TsujiKenji en-aut-sei=Tsuji en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=cell biology kn-keyword=cell biology en-keyword=immunosuppression kn-keyword=immunosuppression en-keyword=stem cells kn-keyword=stem cells END start-ver=1.4 cd-journal=joma no-vol=16 cd-vols= no-issue=5 article-no= start-page=739 end-page=748 dt-received= dt-revised= dt-accepted= dt-pub-year=2012 dt-pub=201210 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Phenotypic change of macrophages in the progression of diabetic nephropathy; sialoadhesin-positive activated macrophages are increased in diabetic kidney en-subtitle= kn-subtitle= en-abstract= kn-abstract=Inflammatory process is involved in pathogenesis of diabetic nephropathy, although the activation and phenotypic change of macrophages in diabetic kidney has remained unclear. Sialoadhesin is a macrophage adhesion molecule containing 17 extracellular immunoglobulin-like domains, and is an I-type lectin which binds to sialic acid ligands expressed on hematopoietic cells. The aim of this study is to clarify the activation and phenotypic change of macrophages in the progression of diabetic nephropathy. We examined the expression of surface markers for pan-macrophages, resident macrophages, sialoadhesin, major histocompatibility complex class II and alpha-smooth muscle actin in the glomeruli of diabetic rats using immunohistochemistry at 0, 1, 4, 12, and 24 weeks after induction of diabetes by streptozotocin. Expression of type IV collagen and the change of mesangial matrix area were also measured. The mechanism for up-regulated expression of sialoadhesin on macrophages was evaluated in vitro. The number of macrophages was increased in diabetic glomeruli at 1 month after induction of diabetes and the increased number was maintained until 6 months. On the other hand, sialoadhesin-positive macrophages were increased during the late stage of diabetes concomitantly with the increase of alpha-smooth muscle actin-positive mesangial cells, mesangial matrix area and type IV collagen. Gene expression of sialoadhesin was induced by stimulation with interleukin (IL)-1 beta and tumor necrosis factor-alpha but not with IL-4, transforming growth factor-beta and high glucose in cultured human macrophages. The present findings suggest that sialoadhesin-positive macrophages may contribute to the progression of diabetic nephropathy. en-copyright= kn-copyright= en-aut-name=NagaseRyo en-aut-sei=Nagase en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KajitaniNobuo en-aut-sei=Kajitani en-aut-mei=Nobuo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KoderaRyo en-aut-sei=Kodera en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OkadaShinichi en-aut-sei=Okada en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KidoYuichi en-aut-sei=Kido en-aut-mei=Yuichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=2 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=3 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=4 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=5 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=6 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=7 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci affil-num=8 en-affil= kn-affil=Okayama Univ, Dept Med & Clin Sci, Grad Sch Med Dent & Pharmaceut Sci END start-ver=1.4 cd-journal=joma no-vol=67 cd-vols= no-issue=3 article-no= start-page=129 end-page=134 dt-received= dt-revised= dt-accepted= dt-pub-year=2013 dt-pub=201306 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Cell Cycle Abnormality in Metabolic Syndrome and Nuclear Receptors as an Emerging Therapeutic Target en-subtitle= kn-subtitle= en-abstract= kn-abstract=In recent years, many researchers have emphasized the importance of metabolic syndrome based on its increasing prevalence and its adverse prognosis due to associated chronic vascular complications. Upstream of a cluster of metabolic and vascular disorders is the accumulation of visceral adipose tissue, which plays a central role in the pathophysiology. In the accumulation of adipose tissues, cell cycle regulation is tightly linked to cellular processes such as proliferation, hypertrophy and apoptosis. In addition, various cell cycle abnormalities have also been observed in other tissues, such as kidneys and the cardiovascular system, and they are critically involved in the progression of disease. Here, we discuss cell cycle abnormalities in metabolic syndrome in various tissues. Furthermore, we describe the role of nuclear receptors in cell growth and survival, and glucose and lipid metabolism in the whole body. Therapeutic strategies for modulating various cell cycles in metabolic disorders by targeting nuclear receptors may overcome obesity and its chronic vascular complications in the future. en-copyright= kn-copyright= en-aut-name=NakatsukaAtsuko en-aut-sei=Nakatsuka en-aut-mei=Atsuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=nuclear receptor kn-keyword=nuclear receptor en-keyword=cell cycle kn-keyword=cell cycle en-keyword=metabolic syndrome kn-keyword=metabolic syndrome en-keyword=diabetic nephropathy kn-keyword=diabetic nephropathy END start-ver=1.4 cd-journal=joma no-vol=65 cd-vols= no-issue=4 article-no= start-page=247 end-page=257 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=201108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Involvement of MAPKs in ICAM-1 Expression in Glomerular Endothelial Cells in Diabetic Nephropathy en-subtitle= kn-subtitle= en-abstract= kn-abstract=Inflammatory processes are involved in the pathogenesis of diabetic nephropathy. The aim of this study was to clarify the role of mitogen-activated protein kinase (MAPK) pathways for induction of intercellular adhesion molecule-1 (ICAM-1) expression in glomerular endothelial cells under diabetic conditions. We examined the expression of ICAM-1 in the kidneys of experimental diabetic rats. Human glomerular endothelial cells (GE cells) were exposed to normal glucose concentration, high glucose concentration (HG), or high mannitol concentration (HM), and then the expression of the ICAM-1 protein and the phosphorylation of the 3 subfamilies of mitogen-activated protein kinase (MAPK) were determined using Western blot analysis. Next, to evaluate the involvement of MAPKs in HG- or HM-induced ICAM-1 expression, we preincubated GE cells with the inhibitors for ERK, p38 or JNK 1h prior to the application of glucose or mannitol. Expression of ICAM-1 was increased in the glomeruli of diabetic rats. Both HG and HM induced ICAM-1 expression and phosphorylation of ERK1/2, p38 and JNK in GE cells. Expression of ICAM-1 was significantly attenuated by inhibitors of ERK, p38 and JNK. We conclude that activation of ERK1/2, p38 and JNK cascades may be involved in ICAM-1 expression in glomerular endothelial cells under diabetic conditions. en-copyright= kn-copyright= en-aut-name=WatanabeNaomi en-aut-sei=Watanabe en-aut-mei=Naomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShikataYasushi en-aut-sei=Shikata en-aut-mei=Yasushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=SaraiKei en-aut-sei=Sarai en-aut-mei=Kei kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OmoriKazuyoshi en-aut-sei=Omori en-aut-mei=Kazuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KoderaRyo en-aut-sei=Kodera en-aut-mei=Ryo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SatoChikage en-aut-sei=Sato en-aut-mei=Chikage kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Diabetic Nephropathy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=diabetic nephropathy kn-keyword=diabetic nephropathy en-keyword=ICAM-1 kn-keyword=ICAM-1 en-keyword=ERK kn-keyword=ERK en-keyword=p38 MAPK kn-keyword=p38 MAPK en-keyword=JNK kn-keyword=JNK END start-ver=1.4 cd-journal=joma no-vol=65 cd-vols= no-issue=2 article-no= start-page=81 end-page=89 dt-received= dt-revised= dt-accepted= dt-pub-year=2011 dt-pub=201104 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The Macrophage Is a Key Factor in Renal Injuries Caused by Glomerular Hyperfiltration en-subtitle= kn-subtitle= en-abstract= kn-abstract=Glomerular hyperfiltration is a common pathway leading to glomerulosclerosis in various kinds of kidney diseases. The 5/6 renal ablation is an established experimental animal model for glomerular hyperfiltration. On the other hand, low-grade inflammation is also a common mechanism for the progression of kidney diseases including diabetic nephropathy and atherosclerosis. Here we analyzed the gene expression profile in the remnant kidney tissues of 5/6 nephrectomized mice using a DNA microarray system and compared it with that of sham-operated control mice. The 5/6 nephrectomized mice showed glomerular hypertrophy and an increase in the extracellular matrix in the glomeruli. DNA microarray analysis indicated the up-regulated expression of various kinds of genes related to the inflammatory process in remnant kidneys. We confirmed the up-regulated expression of platelet factor-4, and monocyte chemoattractant protein-1, 2, and 5 in remnant kidneys by RT-PCR. The current results suggest that the inflammatory process is involved in the progression of glomerulosclerosis and is a common pathway of the pathogenesis of kidney disease. en-copyright= kn-copyright= en-aut-name=SasakiMotofumi en-aut-sei=Sasaki en-aut-mei=Motofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkadaShinichi en-aut-sei=Okada en-aut-mei=Shinichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MiyamotoSatoshi en-aut-sei=Miyamoto en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NishishitaShingo en-aut-sei=Nishishita en-aut-mei=Shingo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=Usui KataokaHitomi en-aut-sei=Usui Kataoka en-aut-mei=Hitomi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SatoChikage en-aut-sei=Sato en-aut-mei=Chikage kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=WadaJun en-aut-sei=Wada en-aut-mei=Jun kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=OgawaDaisuke en-aut-sei=Ogawa en-aut-mei=Daisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=kidney kn-keyword=kidney en-keyword=inflammation kn-keyword=inflammation en-keyword=chemokine kn-keyword=chemokine END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=12 article-no= start-page=2607 end-page=2615 dt-received= dt-revised= dt-accepted= dt-pub-year=1956 dt-pub=19561231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=EFFECT OF CHEMOTHERAPY ON TUBERCULOSIS OF KIDNEY kn-title=腎結核に対する化学療法の効果について en-subtitle= kn-subtitle= en-abstract= kn-abstract=81 cases of tuberculosis of kidney were treated with various chemotherapeutics, i.e. Streptomycin (Dihydrostreptomycin), PAS, Tibione, Isonicotinic acid hydrazide and combination of Streptomycin and Tibion, Streptomycin and Isonicotinic acid hydrazide respectively. The effects of these chemotherapies were satisfactory, especially Streptomycin alone or combination of Streptomycin and Isonicotinic acid hydrazide indicated the marked clinical improvements. en-copyright= kn-copyright= en-aut-name=KosokabeYoshio en-aut-sei=Kosokabe en-aut-mei=Yoshio kn-aut-name=香曾我部芳夫 kn-aut-sei=香曾我部 kn-aut-mei=芳夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部皮膚科泌尿器科教室 END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=935 end-page=943 dt-received= dt-revised= dt-accepted= dt-pub-year=1957 dt-pub=19570331 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Experimental and Clinical Studies on Parathionpoisoning Part 2. Mucoprotein in the Cases of Parathion Poisoning kn-title=パラチオン中毒に関する実験的並びに臨床的研究 第二編 パラチオン中毒のムコ蛋白に及ぼす影響 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Mucoprotein of sera and organs was examined in rabbits and patients with parathion poisoning to clarify the mechanism of poisoning and the advanced information was acquired as follows. 1. Serum mucoprotein was considerably inhibited in parathion poisoning and its inhibition correlated with the degrees of parathion poisoning as the cases of serum cholinesterase and protein active SH radical. Moreover, its recovery was quicker than that of serum cholinesterase and protein active SH radical. 2. Mucoprotein was, in the rabbits subcutaneously injected with 5 mg/kg of parathion, inhibited considerably in all organs, especially in the liver and then followed by the kidney, brain, spinal cord, spleen, intestine, stomach, muscle, lung, and heart, in the order mentioned. But in the case of kidney, both the inhibition and recovery of mucoprotein were delayed markedly. In the fatal cases with the subcutaneous injection of 100 mg/kg parathion, mucoprotein decreased considerably in all organs, especially in the case of the liver where it decreased to 13.8 per cent. From the above-mentioned, parathion absorbed into a living body, combine with SH radical, especially of lower molecule such as mucoprotein mainly fixed in liver, brain, spinal cord etc. These SH radical consumption was supposed to be a cause of the inhibition of cholinesterase activity. en-copyright= kn-copyright= en-aut-name=HukuharaArimitsu en-aut-sei=Hukuhara en-aut-mei=Arimitsu kn-aut-name=福原有光 kn-aut-sei=福原 kn-aut-mei=有光 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部平木内科教室 END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=925 end-page=933 dt-received= dt-revised= dt-accepted= dt-pub-year=1957 dt-pub=19570331 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Experimental and Clinical Studies on Parathionpoisoning Part 1. Protein Active SH Radical in the Case of Parathion Poisoning kn-title=パラチオン中毒に関する実験的並びに臨床的研究 第一編 パラチオン中毒の蛋白活性SH基に及ぼす影響 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Protein active SH radical of sera and orgaus was examined in rabbits and patients with parathion poisoning. Advanced informations in this experiment were as follows. 1. In parathion poisoning, serum protein active SH radical was markedly inhibited. 2. Inhibition and recovery of serum protein SH radical correlated with that of serum cholineterase activity. 3. The decrease of serum protein active SH radical was relative to the symptoms of poisoning in their degrees, and it took about two weeks to restore in serious cases. 4. In rabbits subcutaneously injected with 5 mg/kg of parathion, protein active SH radical of organs was slightly inhibited only in the initial stage, thereafter reactive increase was observed. In the case of kidney, however, it decreased considerably and its recovery took much longer time in comparison with the others. In the fatal cases with the subcutaneous injection of 100 mg/kg parathion, the protein active SH radical of rabbit organs tended to increase generally. From the above-mentioned, parathion inhibited not only cholinesterase but also protein active SH radical of SH ferment as the cases of arsenic or heavy metal poisoning. en-copyright= kn-copyright= en-aut-name=HukuharaArimitsu en-aut-sei=Hukuhara en-aut-mei=Arimitsu kn-aut-name=福原有光 kn-aut-sei=福原 kn-aut-mei=有光 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部平木内科教室 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=12-2 article-no= start-page=8593 end-page=8601 dt-received= dt-revised= dt-accepted= dt-pub-year=1959 dt-pub=19591130 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on the Organic Antibody by the Precipitation Test in the Agar Layer Part II Studies on the Clinical Significance of Auto-liver Antibody kn-title=寒天層内沈降反応による臓器抗体の研究 第2編 肝自己抗体の臨床的意義について en-subtitle= kn-subtitle= en-abstract= kn-abstract=Liver diseases, especially epidemic hepatitis were studied, employing the Oudin's precipitation test in the agar layer. And the results were as follows. 1. The auto-antibodies corresponding to the liver and kidney antigens were observed, by the Oudin's precipitation test in the agar layer, on 9 cases of acute hepatitis, 17 cases of chronic hepatitis, 6 cases of liver cirrhosis and other diseases. In liver diseases, it remarkably reacted to the liver antigen and showed many precipitation bands, and the precipitation band became numerous with the progress of disease in order of acute hepatitis, chronic hepatitis and liver cirrhosis. On the other hand, it remarkably reacted to the kidney antigen and showed many precipitation bands, in kidney diseases. 2. Comparing each form on the classification of epidemic hepatitis with the results of the Oudin's precipitation test in the agar layer, the liver antigen remarkably reacted to the typical form, jaundiced form and influenza form and the precipitation band appeared few in the gastroenteric form, mixed form and latent form, in comparison with the former. On the other hand, the kidney antigen showed no difference on the number of precipitation band in each form of kidney diseases. 3. Comparing the number of days after the attack of epidemic hepatitis with the results of the Oudin's precipitation test in the agar layer by the liver antigen, the appearance of precipitation band was remarkably seen at 6-9th month after the attack of disease and it became more remarkable at the chronic stadium and the shifting stadium to liver cirrhosis. 4. Comparing the liver function with the Oudin's precipitation test in the agar layer, the higher the positive serum colloidal reaction (the results judged on the serum Takata's test, Gross test, Weltman's test, thymol turbidity test, cobalt chloride test, colloidal red test, cephalin-cholesterol flocculation test and cadmium test etc.) became, the more was the number of precipitation band. No correlation between the above precipitation test and the hippuric acid test was observed, but there were some correlation between the above, precipitation test and the bromsulphalein test, and the appearance of precipitation band was remarkably observed on the cases with the liver function damage. 5. As for the relation of it with the blood picture, the more the precipitation band corresponding to the liver antigen appeared, the fewer were the hemoglobin value, erythrocyte, thrombocyte, leukocyte and monocyte count, and the more were the lymphocyte and eosinocyte count. 6. As for the relation of it with the serum protein value showed the declining tendency, the albumin value on the proportional picture of serum protein showed the decreasing tendency, the α-, β- globulin value slightly showed the decreasing tendency and the γ-globulin value showed the increasing tendency. en-copyright= kn-copyright= en-aut-name=NagoshiKazuma en-aut-sei=Nagoshi en-aut-mei=Kazuma kn-aut-name=名越一馬 kn-aut-sei=名越 kn-aut-mei=一馬 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一内科教室 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=11-1 article-no= start-page=7389 end-page=7407 dt-received= dt-revised= dt-accepted= dt-pub-year=1959 dt-pub=19591020 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical Studies on the Taste Part 1 Studies on the Change of the Throshold Value of Taste kn-title=味覚の臨床的研究 第1編 疾病に依る味覚閾値の変動 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The threshold value of taste was measured in 144 cases on the admission and the convalescent period with treatment. And the result were as follows. 1. On the attac of disease, the rate showing the threshold value over normal was high in ordor of the sweet, bitter, sour and salty taste. 2. As for the rising degree of threshold value over normal limit, many cases showed the slight rise of sweet, salty and sour taste and there were considerably many cases with the high rise of bitter taste. 3. As for the change of the threshold value of taste before and after the treatment, the salty and sour taste changesd within normal limit in many cases, the sweet and bitter teste showed abnormal threshold value before the treatment in pretty many cases. But the cases showing abnormal threshold value of the above 4 tastes before the treatment showed the returning tendency to normal threshold value after the treatment. 4. The resing degree of the threshold value of taste was different with eaoh disase, the sweet saste showed the high rise in dncdenal ulcer and hapatitis and it showed the slight rise in chronic gastritis and anemia. The cases with the rise of salt taste were few and the degree of rise was also slight, but there were many cases with the rise of salt taste in nephritis and heart failure. And there were few cases with the rise of salt taste in fever disease, out there were many cases with the high rise in the above cases. The rising degree of sour taste was slight in many cases, but there were many cases with the rise of the threshold value in livercirrhosis and high fever. The bitter teste showed considerably high rise, especially it was remarkable in stomach ulcer, liver disease, heart failure, and high fever. But it died not show in most of chronic gastritis and diabetes. 5. There were many cases showing the high threshold value in the cases with thick fur and it was thought that the multiplication of tongue papilla influenced upon the sweet taste. The remarkable change of threshold value was not observed on the cases with papillar atrophy and tongue fissure. 6. No fixed correlation between the colloidal reaction of liver function in liver disease and the threshold value of taste was observed. 7. The rise of the threshold value of bitter taste was observed on many cases with the decline of glomerular filtrating dosis in kidney disease, but the relation to the salt taste and other taste was not observed. en-copyright= kn-copyright= en-aut-name=HondaKimiaki en-aut-sei=Honda en-aut-mei=Kimiaki kn-aut-name=本田公昶 kn-aut-sei=本田 kn-aut-mei=公昶 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一内科教室 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=10-2 article-no= start-page=6857 end-page=6862 dt-received= dt-revised= dt-accepted= dt-pub-year=1959 dt-pub=19590930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on the Development of Hydronephrosis kn-title=水腎症発生に関する臨床的研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Clinical observation of hydronephrosis on 97 cases was carried out and 31 exstirpated cases were studied histopathologically and histochemically. On hydronephrosis, the author recognized the reactive inflammation in early and intermediate stages histopathologically. These observations indicate the considerable influences of the infection upon the ureter and kidney, when the passage of urine was obstructed. en-copyright= kn-copyright= en-aut-name=SeraMasaho en-aut-sei=Sera en-aut-mei=Masaho kn-aut-name=世良昌穂 kn-aut-sei=世良 kn-aut-mei=昌穂 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部皮膚科泌尿器科教室 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=10-1 article-no= start-page=6611 end-page=6619 dt-received= dt-revised= dt-accepted= dt-pub-year=1959 dt-pub=19590920 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on Incomplete Antibody and Organ Antibodies Part 2. Incomplete antibody and liver auto-antibody in liver diseases kn-title=不完全抗体並に臓器抗体に関する研究 第2編 肝疾患における不完全抗体と肝自己抗体について en-subtitle= kn-subtitle= en-abstract= kn-abstract=In the study on the correlation between the incomplete antibody (Coombs' antibody) and the liver auto-antibody in liver diseases the author obtained the following results. 1. On 37 cases of acute hepatitis, 11 serum hepatitis, 40 chronic hepatitis; and 29 liver cirrhosis to the total of 117 cases the incomplete antibodies were detected by direct Coombs' tests, and they were divided into Coombs' test positive and negative groups. These two groups were compared as regards hepatomegaly, splenomegaly, the liver function and serum protein picture. Hepatomegaly and splenomegaly can be frequently found in Coombs' test positive group, and especially splenomegaly shows a marked difference from Coombs' test negative group. Disturbances in various liver functions such as the serum bilirubin content, serum colloid reaction, bromsulphalein test, urobilinogen reaction in urine are found mostly in Coombs' test positive group. The serum total protein content is low in Coombs' test positive group, and the serum protein picture shows an increase in γ-globulin in most of the two groups, especially a higher values of β-and γ-globulins in Coombs' test positive group than those in the negative group. 2. In the comparative study on 107 cases of liver diseases with respect to the incomplete antibody and liver auto-antibodv a significant correlation can be recognized between the two antibodies. When these cases are divided into four groups of those negative to both antibodies, those positive only to the incomplete antibody, those positive only to the liver auto-antibody, and those positive to both antibodies, the grades of the disturbances in the liver function are in the descending order of the incomplete antibody positive group, the liver auto-antibody positive group, and the both-antibody positive group. 3. In infectious hepatitis the incomplete antibody and the liver auto-antibody make their appearance gradually around the second week after the onset of disease and reach the maximum around the first to the second month. However, most of them disappear along with the improvement in clinical symptoms, and in the chronic stage of the sixth month and thereon a high percentage of the antibodies reappear, showing approximately parallel fluctuations between them. 4. In pursuing the order how the two antibodies appeared in those cases whose incomplete antibody and liver auto-antibody had taken comparable course, those showing the incomplete antibody prior to the liver auto-antibody are somewhat greater but there can be observed no fixed tendency. 5. In the serum of liver diseases positive to the liver autoantibody a high proportion of the antibody that responds to the kidneys, the spleen and other viscera can be detected simultaneously. 6. Summing up the above findings, when the liver autoantibody is produced secondarily due to the destruction of the liver tissue, another antibody that responds to visceral tissue other than the liver tissue or to the components of blood seems to be produced simultaneously. Especially in hepatitis and stilly further in the virus infection abnormal changes in vivo antibody producing tissues of the patients induced by such infections seem to be involved in bringing about complicated immuno-serological changes in the body. en-copyright= kn-copyright= en-aut-name=UjikeMutsuo en-aut-sei=Ujike en-aut-mei=Mutsuo kn-aut-name=氏家睦夫 kn-aut-sei=氏家 kn-aut-mei=睦夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一内科教室 END start-ver=1.4 cd-journal=joma no-vol=71 cd-vols= no-issue=6-2 article-no= start-page=3393 end-page=3402 dt-received= dt-revised= dt-accepted= dt-pub-year=1959 dt-pub=19590515 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Serological Studies on Radiation Injuries Part III Influence of X-Irradiation upon Reverse-anaphylaxis with Forssman's Antibody kn-title=放射線障害の血清学的研究 第III編 Forssman氏抗体による逆過敏症に及ぼすX線の影響について en-subtitle= kn-subtitle= en-abstract= kn-abstract=Forssman's antibody was obtained from rabbits by injecting 10 percent saline emulsion of guinea pig kidney seven times every four day. The minimum lethal dose of Forssman's antibody was administered into guinea pigs after the whole body X-irradiation. The effect of the irradiation on the lethality, the time to the death, the reduction rate of the complement, weight of the lung and clinical signs were investigated. The results were as follows: 1) By 200r irradiation, the reverse-anaphylaxis of guinea pigs by Forssman's antibody was restrained, and the lethal minimum dose was highest around the 14th day, and gradually returned to normal around the 21st day. 2) By 200r iradiation, the period of incubation until the typical shock of reverseanaphylaxis and the duration until the death by shock were prolonged. 3) By 200r irradiation, the lung-weight showed a tendency to be lightened in comparison with the control group. 4) By X-irradiation below 100r, no typical view was found, but it seemed to have the same tendency with the 200r exposure as a whole. en-copyright= kn-copyright= en-aut-name=MurakamiSadao en-aut-sei=Murakami en-aut-mei=Sadao kn-aut-name=村上貞夫 kn-aut-sei=村上 kn-aut-mei=貞夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部衛生学教室 END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=1 article-no= start-page=19 end-page=26 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Irinotecan Hydrochloride (CPT-11) in Dialysis Patients with Gastrointestinal Cancer en-subtitle= kn-subtitle= en-abstract= kn-abstract=

We investigated changes in drug disposition and toxicities with CPT-11 in 15 dialysis patients with gastrointestinal cancers to clarify whether CPT-11 could be administered safely in such patients. For comparison, the same parameters were also investigated in 10 cancer patients not undergoing dialysis. Items investigated included (1) plasma concentrations of SN-38, SN-38G and CPT-11 at 0, 1, 12, 24, 36, 48 and 72h after administration, together with a comparison of mean AUC values for 3 dose levels of CPT-11 (50, 60 and 70mg/m2) in dialysis patients and controls;and (2) occurrence of adverse events. Several findings emerged from this study:(1) No significant difference was observed in the AUC for SN-38 or CPT-11 between the dialysis and control groups;(2) The AUC for SN-38G at each dose was significantly higher in dialysis patients;and (3) Grade 1-4 leucopenia was observed in 11 of the dialysis patients. One patient developed grade 4 leucopenia and died due to sepsis. Anorexia, diarrhea, nausea, alopecia and interstitial pneumonia occurred in 6 dialysis patients. We found changes in drug dispositions of CPT-11, SN-38 and SN-38G in dialysis patients, suggesting that hepatic excretion, especially that of SN-38G, was increased. No significant difference in occurrence of adverse events was observed between the 2 groups. This indicates that CPT-11 can be administered safely in patients on dialysis.

en-copyright= kn-copyright= en-aut-name=AshizawaTatsuto en-aut-sei=Ashizawa en-aut-mei=Tatsuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IwahoriTohru en-aut-sei=Iwahori en-aut-mei=Tohru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=YokoyamaTakayoshi en-aut-sei=Yokoyama en-aut-mei=Takayoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KiharaYuu en-aut-sei=Kihara en-aut-mei=Yuu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=KonnnoOsamu en-aut-sei=Konnno en-aut-mei=Osamu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=JyojimaYoshimaro en-aut-sei=Jyojima en-aut-mei=Yoshimaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=AkashiIsao en-aut-sei=Akashi en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NakamuraYuuki en-aut-sei=Nakamura en-aut-mei=Yuuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HamaKouichirou en-aut-sei=Hama en-aut-mei=Kouichirou kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=IwamotoHitoshi en-aut-sei=Iwamoto en-aut-mei=Hitoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=SegawaMai en-aut-sei=Segawa en-aut-mei=Mai kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=TakeuchiHironori en-aut-sei=Takeuchi en-aut-mei=Hironori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=HiranoToshihiko en-aut-sei=Hirano en-aut-mei=Toshihiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=NagaoTakeshi en-aut-sei=Nagao en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=2 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=3 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=4 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=5 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=6 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=7 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=8 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=9 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=10 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=11 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University affil-num=12 en-affil= kn-affil=Department of Practical Pharmacy, Tokyo University of Medical University Pharmacy and Life Science affil-num=13 en-affil= kn-affil=Department of Clinical Pharmacology, Tokyo University of Medical University Pharmacy and Life Science affil-num=14 en-affil= kn-affil=Department of Surgery, Hachioji Medical Center of Tokyo Medical University en-keyword=irinotecan hydrochloride (CPT-11) kn-keyword=irinotecan hydrochloride (CPT-11) en-keyword=chronic kidney disease (CKD) kn-keyword=chronic kidney disease (CKD) en-keyword=end-stage renal disease (ESRD) kn-keyword=end-stage renal disease (ESRD) en-keyword=dialysis kn-keyword=dialysis en-keyword=colorectal cancer kn-keyword=colorectal cancer END start-ver=1.4 cd-journal=joma no-vol=64 cd-vols= no-issue=1 article-no= start-page=39 end-page=47 dt-received= dt-revised= dt-accepted= dt-pub-year=2010 dt-pub=201002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Influencing Factors for Dietary Behaviors of Patients with Diabetic Nephropathy en-subtitle= kn-subtitle= en-abstract= kn-abstract=

The aim of this study was to clarify the factors influencing the dietary behavior of patients with diabetic nephropathy. One hundred twenty-two patients with type 2 diabetes were recruited from the outpatients of Okayama University Hospital in Okayama, Japan. We performed a cross-sectional study using a questionnaire including 206 items among 18 categories as follows:background factors, coping behavior (coping scale), degree of uncertainty in illness (uncertainty scale), and dietary behavior. The data were analyzed by correlation analysis, t-test, one-way analysis of variance, Pearson correlation analysis, and multiple regression analysis. We found that those patients with microalbuminuria alone tended to recognize more mild about their kidney status than those with macroalbuminuria and chronic renal failure. We also found that common factors influencing the dietary behavior of diabetic patients with and without nephropathy are as follows:1. coping with the problem (beta0.342, p0.01);2. anxiety about prognosis (beta0.344, p0.01);3. sex (beta0.234, p0.05);4. uncertainty regarding treatment (beta0.377, p0.01);5. negative coping (beta0.354, p0.01);and 6. employment status (beta0.367, p0.01). Coping and uncertainty in illness had a significant relation to positive support and lack of support. To maintain appropriate dietary behavior in diabetic patients, medical staff need to determine what the social supports are important for the patient, and also to ensure good communication among healthcare personnel as well as positive support for patients and families.

en-copyright= kn-copyright= en-aut-name=SumiyoshiKazuko en-aut-sei=Sumiyoshi en-aut-mei=Kazuko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KawataChieko en-aut-sei=Kawata en-aut-mei=Chieko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShikataKenichi en-aut-sei=Shikata en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences affil-num=2 en-affil= kn-affil=Mejiro Unibersity Graduate School of Nursing affil-num=3 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences affil-num=4 en-affil= kn-affil=Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmceutical Sciences en-keyword=diabetic nephropathy kn-keyword=diabetic nephropathy en-keyword=dietary behavior kn-keyword=dietary behavior en-keyword=coping kn-keyword=coping en-keyword=uncertainty in illness kn-keyword=uncertainty in illness en-keyword=social support kn-keyword=social support END start-ver=1.4 cd-journal=joma no-vol=28 cd-vols= no-issue=1 article-no= start-page=59 end-page=67 dt-received= dt-revised= dt-accepted= dt-pub-year=1974 dt-pub=197402 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Experimental studies of the endolymphatic radiotherapy en-subtitle= kn-subtitle= en-abstract= kn-abstract=

By injecting 131I-Lipiodol into lymphatics of the dorsum of dog feet, the distribution of 13JI in the lymph nodes and other principal organs as well as its histological effect were studied periodically after the injection for the period of two months. The characteristic feature of J3JI distribution was the fact that J31I was accumulated into lymph nodes markedly higher than in any other organs and it was retained there over a long period of time. Histological examinations of the lymph nodes revealed a marked lymphocytopenia, the loss of germinal center, practically complete loss of lymphoid elements already 5 days after injection, and marked fibrosis. In the lung a considerable J3JI?distribution could be seen in early stage:, but with lapse of time it decreased rapidly. The distribution in other organs such as liver, spleen, bone marrow, kidney, ureter, bladder, thyroid gland, pancreas, testicles and small and large intestines was negligible in amount, and any specific histologic effect of irradiation could not be recognized in these organs including the lung. From these results, the authors concluded that 131I-Lipiodol has a selective activity on lymph nodes by injecting it via lymphatics and it is a safe method in clinical application to treat the patients bearing malignant lymphoma or metastatic lymph nodes.

en-copyright= kn-copyright= en-aut-name=IrinoShozo en-aut-sei=Irino en-aut-mei=Shozo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TanjiTameyo en-aut-sei=Tanji en-aut-mei=Tameyo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=UnoJunichiro en-aut-sei=Uno en-aut-mei=Junichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OkaAkira en-aut-sei=Oka en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University END start-ver=1.4 cd-journal=joma no-vol=46 cd-vols= no-issue=1 article-no= start-page=53 end-page=56 dt-received= dt-revised= dt-accepted= dt-pub-year=1992 dt-pub=199202 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=The impact of triple drug immunosuppression on clinical results of cadaveric kidney transplantation: a comparison of conventional immunosuppression. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

A retrospective study was carried out in 110 cadaveric kidney transplant recipients to compare the effects of low doses of cyclosporine (CsA), azathioprine (AZP) and steroids (triple-drug therapy) with those of higher doses of steroids plus AZP (conventional immunosuppression). Graft survival rate in the triple-drug therapy was 77%, 69%, and 69% at 1, 3, and 5 years, respectively. This was significantly better than 48%, 34%, and 29% in conventional immunosuppression. The incidence of acute rejection episodes was significantly lower in the triple-drug therapy than in conventional immunosuppression (25% vs 58%). In conclusion, our study shows that triple-drug therapy using low-dose cyclosporine is the safest of the immunosuppressive regimens and provides a beneficial effect on the long-term survival of cadaveric kidney transplants.

en-copyright= kn-copyright= en-aut-name=SakagamiKenichi en-aut-sei=Sakagami en-aut-mei=Kenichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SaitoShinya en-aut-sei=Saito en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ShiozakiShigehiro en-aut-sei=Shiozaki en-aut-mei=Shigehiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TakasuShinji en-aut-sei=Takasu en-aut-mei=Shinji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MatsunoTsuyoshi en-aut-sei=Matsuno en-aut-mei=Tsuyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=FujiwaraTakuzo en-aut-sei=Fujiwara en-aut-mei=Takuzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KusakaSatoshi en-aut-sei=Kusaka en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=UdaMasashi en-aut-sei=Uda en-aut-mei=Masashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MatsuokaJunji en-aut-sei=Matsuoka en-aut-mei=Junji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NaomotoYoshio en-aut-sei=Naomoto en-aut-mei=Yoshio kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=GouchiAkira en-aut-sei=Gouchi en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=HamazakiKeisuke en-aut-sei=Hamazaki en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=TanakaShinichiro en-aut-sei=Tanaka en-aut-mei=Shinichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= en-aut-name=OritaKunzo en-aut-sei=Orita en-aut-mei=Kunzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=14 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University affil-num=7 en-affil= kn-affil=Okayama University affil-num=8 en-affil= kn-affil=Okayama University affil-num=9 en-affil= kn-affil=Okayama University affil-num=10 en-affil= kn-affil=Okayama University affil-num=11 en-affil= kn-affil=Okayama University affil-num=12 en-affil= kn-affil=Okayama University affil-num=13 en-affil= kn-affil=Okayama University affil-num=14 en-affil= kn-affil=Okayama University en-keyword=cadaveric kindney transplantation kn-keyword=cadaveric kindney transplantation en-keyword=cyclosporine kn-keyword=cyclosporine en-keyword=triple-drug therapy kn-keyword=triple-drug therapy END start-ver=1.4 cd-journal=joma no-vol=46 cd-vols= no-issue=4 article-no= start-page=233 end-page=239 dt-received= dt-revised= dt-accepted= dt-pub-year=1992 dt-pub=199208 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Histochemical detection of lipid peroxidation in human gastrointestinal, mammary and renal carcinomas. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Constitutional lipid peroxidation in randomly selected 32 cases of clinically advanced carcinoma from human gastrointestinal tract (20 cases), breast (8 cases) and kidney (4 cases) was examined histochemically in frozen sections using cold Schiff's reagent. Only two cases of gastrointestinal carcinoma were positive by the reagent. Non-cancerous parenchymal cells were negative. These findings suggest that detectable constitutional lipid peroxidation seldom occurs in either cancerous or normal tissues. The capacity for normal and neoplastic tissues to undergo lipid peroxidation was also studied by incubation with an iron-NADPH pro-oxidant system. Normal parenchymal cells showed, to various degrees, a positive reactivity. In gastrointestinal carcinoma, 6 out of 7 cases of well differentiated adenocarcinoma reacted positively, whereas 2 out of 8 cases of moderately to poorly differentiated adenocarcinoma disclosed weakly positive reactions. Mucinous adenocarcinomas (4 cases) were all negative. Signet-ring cell carcinoma (1 case) was positive. One out of 8 cases of breast cancer also showed positive reaction. Four renal cell carcinomas were all negative. Cancer cells have lower capacity to undergo lipid peroxidation than normal cells, when the iron-NADPH pro-oxidant system was employed. In gastrointestinal carcinoma, the ability to undergo lipid peroxidation by the iron-NADPH pro-oxidant seems to be correlated with their histological differentiation. This fact may suggest that differences in lipid composition or the NADPH enzyme system exist between well differentiated and poorly differentiated gastrointestinal malignancies.

en-copyright= kn-copyright= en-aut-name=YuYing-yan en-aut-sei=Yu en-aut-mei=Ying-yan kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OginoTeteuya en-aut-sei=Ogino en-aut-mei=Teteuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OkadaShigeru en-aut-sei=Okada en-aut-mei=Shigeru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Himeji Red-Cross Hospital affil-num=3 en-affil= kn-affil=Okayama University en-keyword=lipid peroxidation kn-keyword=lipid peroxidation en-keyword=histochemistry kn-keyword=histochemistry en-keyword=cancer kn-keyword=cancer en-keyword=iron kn-keyword=iron en-keyword=NADPH kn-keyword=NADPH END start-ver=1.4 cd-journal=joma no-vol=37 cd-vols= no-issue=3 article-no= start-page=259 end-page=263 dt-received= dt-revised= dt-accepted= dt-pub-year=1983 dt-pub=198306 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Possible induction by blood transfusion of immunological tolerance against growth of transplanted tumors in mice. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

That blood transfusions aid kidney graft survival is well known. Our data show that blood transfusions, except for the red blood cell component, promote growth of transplanted tumors in mice. These clinical and experimental observations suggest that blood transfusions may induce some immunological tolerance.

en-copyright= kn-copyright= en-aut-name=HorimiTadashi en-aut-sei=Horimi en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KagawaShigeo en-aut-sei=Kagawa en-aut-mei=Shigeo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NinomiyaMotoki en-aut-sei=Ninomiya en-aut-mei=Motoki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=YoshidaEiichi en-aut-sei=Yoshida en-aut-mei=Eiichi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HiramtsuSatoshi en-aut-sei=Hiramtsu en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=OritaKunzo en-aut-sei=Orita en-aut-mei=Kunzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University en-keyword=blood transfusion kn-keyword=blood transfusion en-keyword=immunological tolerance kn-keyword=immunological tolerance en-keyword= growth of transplanted tumors (in mice) kn-keyword= growth of transplanted tumors (in mice) en-keyword=blood component kn-keyword=blood component END start-ver=1.4 cd-journal=joma no-vol=45 cd-vols= no-issue=3 article-no= start-page=195 end-page=199 dt-received= dt-revised= dt-accepted= dt-pub-year=1991 dt-pub=199106 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Tissue concentration of doxorubicin (adriamycin) in mouse pretreated with alpha-tocopherol or coenzyme Q10. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

<P>The tissue concentration of doxorubicin (adriamycin; ADM) and its major metabolite (aglycone I) was examined in mice pretreated with alpha-tocopherol (VE) or coenzyme Q10 (CoQ). In VE-pretreated group, the concentrations of aglycone I of the liver (1, 3 and 5 h after the administration), kidney (1 and 3h) and heart (3h) were significantly higher than those in the saline group. The clinical application of VE or CoQ concomitant with anti-tumor drugs especially ADM, requires caution.

en-copyright= kn-copyright= en-aut-name=ShinozawaShinya en-aut-sei=Shinozawa en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=GomitaYutakata en-aut-sei=Gomita en-aut-mei=Yutakata kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=ArakiYasunori en-aut-sei=Araki en-aut-mei=Yasunori kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University affil-num=3 en-affil= kn-affil=Okayama University en-keyword=doxorubicin kn-keyword=doxorubicin en-keyword=tissue concentration kn-keyword=tissue concentration en-keyword= ?-tocopherol kn-keyword= ?-tocopherol en-keyword=coenzymeQ10 kn-keyword=coenzymeQ10 END start-ver=1.4 cd-journal=joma no-vol=62 cd-vols= no-issue=4 article-no= start-page=217 end-page=226 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=200808 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Current Status of Autoimmune Hepatitis in Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Autoimmune hepatitis (AIH) is a chronic and progressive disease characterized by histological interface hepatitis, hypergammaglobulinemia, and circulating autoantibodies. Multiple factors, including molecular mimicry, a genetic background including major histocompatibility complex class II, and defective function of regulatory T-cells, are involved in the pathogenesis. The diagnosis is made based on the scoring system of the International Autoimmune Hepatitis Group, the sensitivity and specificity of which are90%, respectively. AIH is classified into 3 sub-types based on the profiles of circulating autoantibodies: anti-nuclear antibody and/or smooth muscle antibody-positive (type 1), anti-liver-kidney microsomal antibody-positive (type 2), and anti-soluble liver antigen/liver-pancreas antigen antibody- positive (type 3). Recently, however, the number of atypical cases lacking the usual features has increased-for example, patients with acute-onset or fulminant-type AIH, autoantibody-negative patients, male patients, and patients with bile duct injury-and thus the clinical features of AIH have been diversified. AIH is responsive to immunosuppressive treatment in most cases; however, relapse occurs in more than 80% of patients within 1 year after immunosuppressive treatment withdrawal. The 10-year survival rate and the 10-year hepatocellular carcinoma-free rate are90%, respectively, indicating that some patients reach liver failure or develop hepatocellular carcinoma. To improve the prognosis of these patients, persistent normalization of transaminase is required.

en-copyright= kn-copyright= en-aut-name=MiyakeYasuhiro en-aut-sei=Miyake en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=autoimmune hepatitis kn-keyword=autoimmune hepatitis en-keyword=epidemiology kn-keyword=epidemiology en-keyword=pathogenesis kn-keyword=pathogenesis en-keyword=diagnosis kn-keyword=diagnosis en-keyword=prognosis kn-keyword=prognosis END start-ver=1.4 cd-journal=joma no-vol=29 cd-vols= no-issue=6 article-no= start-page=431 end-page=436 dt-received= dt-revised= dt-accepted= dt-pub-year=1975 dt-pub=197512 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Tissue distributions of 97Ru and 103Ru in subcutaneous tumor of rodents en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Mice bearing Ehrlich tumor were administered 97Ru-chloride or 103Ru-chloride intravenously. Examinations of various tissues indicated similar distributions by the two radionuclides. The levels were higher in the lung, liver and kidney than in the tumor tissue. Rats bearing AH-130 tumor were administered 103Ru-chloride intravenously. The 103Ru distribution in rats was highest in the spleen, followed by the liver and kidney; however, the radioactive distribution in the tumor tissue exceeded the muscle level by about 5-fold. Tumors were delineated in rats by scintigraphy. The findings indicate that ruthenium radionuclides may be a useful clinical agent in the delineation of some types of tumors. Ruthenium-97 would be favored in possible clinical usage due to its shorter physical half-life and lower levels of gamma energy.

en-copyright= kn-copyright= en-aut-name=TanabeMasatada en-aut-sei=Tanabe en-aut-mei=Masatada kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=YamamotoGoki en-aut-sei=Yamamoto en-aut-mei=Goki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University END start-ver=1.4 cd-journal=joma no-vol=10 cd-vols= no-issue=4 article-no= start-page=175 end-page=213 dt-received= dt-revised= dt-accepted= dt-pub-year=1956 dt-pub=195609 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Pathology of "landry-guillain-barr? syndrome" in children, prevailing in the regions surrounding the Inland Sea of Japan en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Histopathological investigations were carried out on five fatal cases of a type of polyneuritis of unknown etiology diagnosed as Landry-Guillain-Barre syndrome, which endemically occurred in children in the regions surrounding the Inland Sea of Japan. The most characteristic pathologic feature in the nervous system was pronounced patchy degenerative changes with slight or moderate degree of inflammatory cell response of focal type in the peripheral and cranial nerves, predominantly in the nerve fibers of the spinal and cranial roots. In the spinal cord, medulla, pons, and in some portions of the cerebrum and cerebellum, engorgement of the small blood vessels as well as edema and the less predominant scattered degenerative changes of ganglioncells and nerve fibers with extremely slight degree of glial response and sparse perivascular cell collections were encountered. The cerebrospinal meninges displayed edema and congestion of the pial blood vessels with focal collections of a small number of lymphocytes and/or monocytes. No advanced involvement of the anterior horn of the spinal cord in a strict sense of anterior poliomyelitis was, however, recognized. These changes may lead the histopathologic diagnosis of the present disease to infectious encephalomyelo-polyradiculoneuritis or a type of infectious polyneuritis. The main histopathologic changes in the visceral organs were a moderate degree of engorgement of the small blood vessels, degeneration of parencymatous organs such as the liver and kidney, hyperplasia or follicular atrophy of the lymphatic tissues, interalveolar pneumonia, focal myositis, and slight degree of round cell infiltrations in the interstitial tissues of the other viscera, such as the liver, heart, and gastrointestinal canal. Based upon the observations on the histopathological changes as well as clinical manifestations, discussions were made on the pathogenesis and etiologic factor of the present endemic disease with critique on the literatures.

en-copyright= kn-copyright= en-aut-name=OdaTakuzo en-aut-sei=Oda en-aut-mei=Takuzo kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=AkagiSeiji en-aut-sei=Akagi en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama University END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=10 article-no= start-page=1575 end-page=1584 dt-received= dt-revised= dt-accepted= dt-pub-year=1956 dt-pub=19561031 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical and Experimental Studies on Iron Metabolism in Hypoplastic Anemia (Panmyelopathia) Part U. About the quantity of serum iron and storage iron in hypoplastic anemia kn-title=再生不良性貧血（汎骨髓病症）の鉄代謝に関する臨床的並びに実験的研究 第二編 再生不良性貧血患者に於ける血清鉄量,並びに貯蔵鉄量に就て en-subtitle= kn-subtitle= en-abstract= kn-abstract=The author performed the iron tolerance test, iron absorption test and fractional measurement of depot iron(liver, spleen, kidney, duodenum and bune marrow) on patients of hypoplastic anemia, and obtained the result as follows. 1) Iron tolerance test; The amount of serum iron was generally high, that is, 240 γ % on the average. The increased amount of serum iron in 5 minutes after the intravenous administration of 10 mg. gluferricon was 25 γ % to 133 γ % showing the rather wide movement, and was 64 γ % on the average and this is only 33 % of the normal healthy men’s avererage increased amount. The decreasing amount of serum iron in the two hours was 13 γ % to 64 γ % averaging 34 γ % which was one third that of normal subjects (101 γ % ). Namely the decreasing amount in this case was very slight, and in some cases the decreasing amount in two hours was almost equal with that in 5 minutes. 2) Iron absorption test; The increasing quantities of serum iron in two hours after the administration of 1 g reduced iron was 45 γ % on the average. These were slightly lower than those in normal human beings which were 59 γ % on the average. The serum iron in hypoplastic anemia in 4 hours was 265 γ % and in two hours 256 γ % , namely the former only increased by 3.3 % . On the other hand, the decreasing amount of the serum iron of normal human beings was 32 γ % , which decreases by 16.7 % that in two hours. The decreasing amount of serum iron in 6 hours was 33 γ % in normal human being, 11 γ % in hypoplastic anemia. According to these findings, the author confirmed that the absoption of iron in hypoplastic anemia was not only poor, but also retarded. 3) Fractional measurement of depot iron ; Every fractionation of depot iron in liver, spleen, kidney, bone marrow and duodenum was higher than those in other diseases. P(1) fraction in hypoplastic anemia increased 1.2 ×, 1.4 ×, 2.6 ×, 2.8 × and 1.9 × in each organs respectively than those in other diseases. P(11) fraction exhibited an increase of 2.2 ×, 1.3 ×, 0.7 ×, 3.4 × and 2.0 ×. P(111) fraction increased markedly compared with P(1) and P(11), viz., 6.9 ×, 8.4 ×, 7.1 ×, 10.0 ×, 3.8 ×, S(111) fraction, 9.9 ×, 4.8 ×, 10.0 ×, 18.5 ×, 4.8 × in each organ respectively. Namely, P(111) and S(111) fraction increased remarkably in bone marrow. As mentioned above, the quantity of depot iron in hypoplastic anemia was of surplus, and by the investigation of the movement of each fractionation in the course of the metabolism of non-hemin iron, the author confirmed that P(111) and S(111) exhibited a remarkably risein hypoplastic anemia. en-copyright= kn-copyright= en-aut-name=MizutaMasaru en-aut-sei=Mizuta en-aut-mei=Masaru kn-aut-name=水田勝 kn-aut-sei=水田 kn-aut-mei=勝 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部平木内科 END start-ver=1.4 cd-journal=joma no-vol=68 cd-vols= no-issue=10 article-no= start-page=1561 end-page=1574 dt-received= dt-revised= dt-accepted= dt-pub-year=1956 dt-pub=19561031 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical and Experimental Studies on Iron Metabolism in Hypoplastic Anemia (Panmyelopathia) Part T. About the quantity of serum iron, function of R. E. S., and stored iron in case of many kinds experimental anemia kn-title=再生不良性貧血（汎骨髓病症）の鉄代謝に関する臨床的並びに実験的研究 第一編 各種実験的貧血に於ける血清鉄量，網内系機能並びに貯蔵鉄量に就て en-subtitle= kn-subtitle= en-abstract= kn-abstract=The author did the measurement of the quantity of serum iron and the fractionation of depot iron (liver, spleen, kidney, duodenum and bone marrow) together with the examination of reticuloendothelial system in various experimental anemic rabbits. Next he investigated the iron metabolism in case of venesection or the administration of phenilhydracine which brings out the accelerating function of the bone marrow, and in case of collargol, benzol, X-ray or saponin which bring out the disturbing function of the bone marrow. And he clarified movements of each fractionation that is P(1), P(11), P(111) or S(111) of non-hemin iron in the intermediate process of iron metabolism. At the time of being disturbed of the hematopoietic function. There is a delicate and important relation between the function of R. E. S. and the iron metabolism. At least, the author can say that P(111) and S(111) iron fraction was metabolized more rapidly and sharply than P(1) and P(11) done, and increased when the hematopoietic function was declined. en-copyright= kn-copyright= en-aut-name=MizutaMasaru en-aut-sei=Mizuta en-aut-mei=Masaru kn-aut-name=水田勝 kn-aut-sei=水田 kn-aut-mei=勝 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部平木内科 END start-ver=1.4 cd-journal=joma no-vol=70 cd-vols= no-issue=5 article-no= start-page=1609 end-page=1615 dt-received= dt-revised= dt-accepted= dt-pub-year=1958 dt-pub=19580531 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical and Experimental Studies on the Artificial Hypotensive Operation. Part X. Experimental Comparative Studies on Anesthesia under Normal Blood Pressure and Hypotention Nucleic Acid in Dogs kn-title=人為低血圧下手術に関する臨床的ならびに実験的研究 第5編 核酸の消長からみた正常血圧下麻酔と人為低血圧下麻酔との実験的比較検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Male dogs were anesthetized with endotracheal anesthesia under the normal and the artificial hypotensive blood pressure and the influences of the anesthesia on the nucleic acid metabolism in the liver and the kidney were studied. 1) No marked degenerative changes were generally observed in both normal and hypotensive groups by anesthesia. 2) The influences on the nucleic acid metabolism were very slight in both groups. 3) In the hypotensive group, dilatation of the capillary vessels in the kidney and liver was observed. 4) The changes of R.N.A. seemed a little greater than those of D.N.A. in both groups, but no definite tendency was hardly observed. 5) Histological changes including the change of nucleic acid seemed stronger as the duration of anesthesia became longer and the grade of hypotention became greater. However, no marked difference observed between 2 and 3.5 hours of anesthesia and between 20% and 40% of hypotensive rate. en-copyright= kn-copyright= en-aut-name=NakagawaToshimi en-aut-sei=Nakagawa en-aut-mei=Toshimi kn-aut-name=中川俊美 kn-aut-sei=中川 kn-aut-mei=俊美 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第1（陣内）外科教室 END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=8-9 article-no= start-page=1317 end-page=1336 dt-received= dt-revised= dt-accepted= dt-pub-year=1965 dt-pub=19650930 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Experimental stndies on Open Heart Surgery by Profound Hypothermia. With a Special Reference to Physiologic Observations and Histologic Changes of Internal Organs kn-title=超低体温法による開心術の研究 特に生理的観察ならびに主要臓器の病理組織学的変化について en-subtitle= kn-subtitle= en-abstract= kn-abstract=Experimental studies of profound hypothermia were performed on dogs. Rapid cooling and rewarming were obtained by means of extracorporeal circulation combined with heat exchanger. Some physiologic and pathohistologic changes of several organs were followed at the various stages through the experiment. Following results were obtained. 1) There were found no marked differences in results between Kay-Anderson machine and bubble type oxygenator. 2) Changes of temperature of internal organs on cooling and rewarming were observed proportionately to vascularity of the given organ, most rapid in liver and most lagging in muscles. Changes of rectal temperature were not constant. 3) Pupils of dogs became dilated on cooling, maximum during circulatory cessation, and retuned to previous size on rewarming. 4) On histologic study of liver, appearance of vecuoles was observed at both stages of cooling and rewarming, which were proved to be neither fat nor glycogen by histochemical examination. They were considered merely watery vacuoles and reversible changes. Marked decreaae of liver glycogen was observed on both cooling and rewarming and its disappearanse was first observed at the vicinity of central vein. 5) Renal congestion and claudy swelling of epithelial cell of renal tubules, especially in proximal part, were prominent, although these changes were considered reversible. 6) Stagnation of blood was a main change found in the histologic study of heart, lung and adrenal gland. It was most prominent in liver, kidney and spleen, however, degeneration or necrosis of the tissue were not found at all. 7) Based on these experimental data, profound hypothermia is considered applicable to the clinical case and better results will be expected with the use of low molecular weight dextran. en-copyright= kn-copyright= en-aut-name=KimuraHiroshi en-aut-sei=Kimura en-aut-mei=Hiroshi kn-aut-name=木村博 kn-aut-sei=木村 kn-aut-mei=博 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部砂田外科教室 END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1-3 article-no= start-page=361 end-page=374 dt-received= dt-revised= dt-accepted= dt-pub-year=1962 dt-pub=19620330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on the Kidney Auto-Antibody Part U Experimental Studies on Auto-Kidney or Homologeous-Kidney Antibody kn-title=腎自己抗体に関する研究 第2編 腎自己又は同種抗体に関する実験的研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The vicissitude of the anti-kidney antibody was mainly observed on the cases of experimental nephritis in tabbit by the methode of Masugi's nephritis and kidney homosensitization, and the significance of its antibody and the movement of its antibody into urine were also studied. And the following results were obtained. 1. The slight elevation of the kidney auto-antibody was observed in all cases of Masugi's nephritis and the elevation of its antibody was observed since the 5th or 7th day after the injection of nephrotoxin and the persistence of the elevated antibody titer (1:4~1:8) was observed until one month later. 2. The correlation between the appeance of the kidney auto-antibody in peripheral blood in Masugi's nephritis and the various clinical findings or histological changes in kidney was relatively observed. 3. The elevation of the kidney homo-antibody was observed in all cases with the homo-sensitization by the kidney emulsion adding adjuvant, after 17 or 24 days and the occurrence of nephritis was even slightly observed in half of them, comparing with Masugi's nephritis. 4. In the above cases of experimental nephritis, the decrease of complement value was observed in accordance with the appearance of the anti-kidney antibody (kidney auto-or homo-antibody). 5. The movement of the kidney auto-antibody into urine was observed, and the correlation between the above phenomenon and the fall of the Albumin-Globulin ratio in urinary protein or the increase of the γ-globulin fraction was also observed. 6. Since the above results, the participation of the anti-kidney antibody (kidney auto-or homo-antibody) was clear for the development of the above experimental nephritis. And it was thought that the participation of its antibody could not be disregarded for the appearance of the pathological change in the kidney since there was the close correlation between the appearance of the anti-kidney antibody and the fall of the complement titer or the appearance of renal symptom. en-copyright= kn-copyright= en-aut-name=MoritaniYui en-aut-sei=Moritani en-aut-mei=Yui kn-aut-name=森谷有為 kn-aut-sei=森谷 kn-aut-mei=有為 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一内科教室 END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1-3 article-no= start-page=349 end-page=360 dt-received= dt-revised= dt-accepted= dt-pub-year=1962 dt-pub=19620330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on the Kidney Auto-Antibody Part 1 Clinical Significance of Auto-Kidney Antibody kn-title=腎自己抗体に関する研究 第1編 腎自己抗体の臨床的意義について en-subtitle= kn-subtitle= en-abstract= kn-abstract=The Kidney auto-antibody was measured by the complement fixation test on the 92 cases in kidney diseases, mainly diffuse glomerulonephritis and 305 cases in other various diseases and the clinical significance was studied, And the following results were obtained. 1. The positive rate of the kidney auto-antibody in diffuse glomerulonephritis was 48.4% at the acute stage and 80.0% at the chronic stage, but it was 20.0% in nephrosis, 25.0% in kidney tuberculosis, 20.0% in kidney tumor and 33.3% of the kidney in pregnancy. 2. It was 18.3% in various diseases other than kidney diseases, and 16.6% in acute tonsillitis, 20.0% in chronic tonsilitis, 20.8% in essential hypertension with albuminuria, 8.7% in that without albuminuria, and it was shown a little high rate in liver diseases, such as 18.6% in acute hepatitis, 28.3% in chronic hepatitis and 59.0% in livercirrhosis, but the peculiarity to the each antigen was relatively strong by the crossing test with the liver and kidney antigen. The diseases, other than the above diseases, showing the rather high positive rate of kidney auto-antibody were 22.2% in diabetes mellitus and 66.6% in collagen disease. 3. In diffuse glomerulonephritis, it was low at the acute early stage and it gradually elevated since about one month later and it showed the tendency of decrease since two month later at which time it was the highest, but it was generally high at the chronic stage. 4. The serum complement titer showed relatively high decrease at the acute stage of diffuse glomerulonephritis and it showed a little decrease in most of the chronic cases, and the correlation between the kidney auto-antibody and the complement titer was observed. 5. The correlation between the kidney auto-antibody and the findings of various clinical tests, for example urinary change, glomerular filtrating value, nonprotein nitrogen and the increase of serum γ-globulin fraction was observed. 6. The vicissitude of the kidney auto-antibody became the characteristic of the clinical cause and prognosis in diffuse glomerulonephritis, and it also agreed with the histological change of kidney. 7. The kidney auto-antibody moved into urine in the form not loosing the activity and its antibody contained in the γ-globulin of urinary ablumin. en-copyright= kn-copyright= en-aut-name=MoritaniYui en-aut-sei=Moritani en-aut-mei=Yui kn-aut-name=森谷有為 kn-aut-sei=森谷 kn-aut-mei=有為 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一内科教室 END start-ver=1.4 cd-journal=joma no-vol=74 cd-vols= no-issue=1-3 article-no= start-page=43 end-page=62 dt-received= dt-revised= dt-accepted= dt-pub-year=1962 dt-pub=19620330 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Effect of Nucleic Acids on Bone-Marrow Tissue Culture Part 3. Effect of nucleic acids on the erythrocyte series of bone marrow in normal rabbits, normal persons, and patients with aplastic anemia kn-title=腎性貧血の成因に関する研究 第1編 腎疾患患者血液に関する臨床統計的研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The nature of renal anemia has been obscure despite numerous investigations initiated by Bright (1836). The author conducted a statistical analysis, with purpose of elucidating the cause of renal anemia, on peripheral blood pictures and myelograms of a total of 136 patients (80 cases of acute and chronic glomerulonephritis, 35 cases of uremia, 14 cases of nephrosis and 7 cases of polycystic kidneys) being admitted to our department in the past 10 years, and obtained the following results. 1) The hemoglobin and RBC showed a inverse correlation with the NPN and the color index tended to be normochromic or hyperchromic in the presence of elevated NPN. 2) The leukocyte count, as a rule, was within normal limits except for leukopenia observed in severe and prolonged azotemia. 3) The absolute lymphocyte count in the peripheral blood was decreased in azotemia. 4) The platelet count had a inverse correlation with the NPN. 5) Nucleated cells in the bone marrow were decreased in number in severe azotemic cases. 6) Myelograms in azotemia revealed marked maturation arrest and depression of the erythroid series. 7) There was normal to slightly deceased cellularity of the myeloid series in azotemia. 8) The serum iron tended to show a proportional correlation with the NPN and a inverse correlation with the RBC. 9) The serum copper became elevated prior to the increase of the serum iron. 10) In azotemia many sideroblasts appeared in the bone marrow, the sideroblast ratio being over 1.0. 11) Sideroblastograms assumed the normal pattern in nephrosis and the hypoplastic pattern in uremia. In chronic glomerulonephritis there was the intermediate pattern of the two. From the results obtained, it is most likely that renal anemia results from the deleterious effects upon bone marrow hematopoiesis, particularly upon erythropoiesis of the noxious substances present in azotemia. Such a bone marrow dysfunction of severe degree and of prolonged duration would ultimately lead to the development of a clinical picture compatible with hypoplastic anemia. en-copyright= kn-copyright= en-aut-name=ArimoriShigeru en-aut-sei=Arimori en-aut-mei=Shigeru kn-aut-name=有森茂 kn-aut-sei=有森 kn-aut-mei=茂 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部平木内科教室 END start-ver=1.4 cd-journal=joma no-vol=77 cd-vols= no-issue=2 article-no= start-page=379 end-page=388 dt-received= dt-revised= dt-accepted= dt-pub-year=1965 dt-pub=19650228 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Application of Ultrasonics to Medical Diagnostic Method Part 2. Application of Ultrasonic Probe to Diagnosis of Diestive Organs kn-title=医学的診断領域における超音波に関する研究 第2編 消化管内よりの超音波診断方法に関する基礎的研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=New application method of ultrasonic probe to diagnosis of digestive organs was deviced by the author. The special ultrasonic probes for this study have been designed and producel by the author. Transdnsducers with barium titanate ceramic vibrator (2.25MC) and 10mm or 7mm in diameter have been used at the tip of the flexible probes. Probes are 2〜3m in length and 5mm in diameter and can be rotate in all directions in the oesophagus, stomach, rectum and discending colon. Clinically, digestive organs would be examined by transoral or transanal application of these probes. In the experimental and clinical studies, the ethos from the vagus, heart and mediastinum were obtained from the probe which was located in the oesophagus: the echos from the liver, gall bladder, diaphragm, pancreas, spleen and retroperitoneum were obtained from the probe which was located in the stomach; the echo from the urinary bladder, small intestine and kidney were obtained from the probe which was located in the descending colon. In the clinical studies, the echos from the heart, aorta and inferier vena cava showed pulsating, fine and multiple wave form; the echos from the cancer tissues, scharp and multiple wave form; the echo from the diaphragm, sharp wave form and movable by respiration. en-copyright= kn-copyright= en-aut-name=SadamotoKazuhiko en-aut-sei=Sadamoto en-aut-mei=Kazuhiko kn-aut-name=貞本和彦 kn-aut-sei=貞本 kn-aut-mei=和彦 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第1外科教室 END start-ver=1.4 cd-journal=joma no-vol=80 cd-vols= no-issue=11-12 article-no= start-page=1105 end-page=1117 dt-received= dt-revised= dt-accepted= dt-pub-year=1968 dt-pub=19681230 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on (90)YCl(3) Colloid for Clinical Use Part 2. Experimental and Clinical Use by Intraperitoneal and Intralymphatic Administration of (90)YCl(3) Colloid kn-title=(90)YCl(3)コロイドに関する基礎的研究 第2編 腹腔内およびリンパ管内注入について―動物実験ならびに臨床成績― en-subtitle= kn-subtitle= en-abstract= kn-abstract=It is an expectation on radiocolloid therapy from the standpoint of prevention of side efects, that the administered radiocolloid is not removing in blood stream or in some organs. Old (90)YCl(3) colloid at pH 7.0 (20mμ diameter) and new type of a mixture of YCl(3) and (90)YCl(3) colloid at pH 7.0 (3-15μ diameter) were administered into peritoneal cavity of mice and rabbits. The distributions of administered (90)Y in serum and organs were compared. Also, these two colloids were examined by intralymphatic administration for clinical use, and the distributions were observed in serum and the excretion of urine. 1) (90)Y in peripheral blood by peritoneal administration of mice were higher in old(90)YCl(3) colloid than that of new type of YCl(3) and (90)YCl(3) mixture. The c. p. m. in peripheral blood were generally decreased by addition of YCl(3). Minimum distribution in peripheral blood was obtained by addition of 1mg/ml of YCl(3). 2) The same results were obtained from rabbit experiment. Old (90)YCl(3) colloid was 2 times of c. p. m. than that of new type mixture colloid at 7th day. (90)Y excretion in urine of old (90)Y colloid was 51 times than that of new type colloid after 3 hrs colloid administration. The distributions of old (90)YCl(3) colloid were spleen, kidney, liver, marrow, lung, heart muscle, and thigh, in the orders, 7 days after administration, and that of new type colloid were spleen, liver, marrow, lung, kidney, heart muscle, and thigh. (90)Yc. p. m. of old colloid was 4 times than that of new colloid in kidney, heart muscle and thigh. New colloid was 5 times than old colloid in spleen, liver, marrow and lung. 3) (90)Yc. p. m. in peripheral blood of intralymphatic administration was observed in both colloid, below 1% excretion in urine of administered dose after 3 days. In clinical use, one case was visible reduction of metastatic lymphnode, but clinical effects were not clear, for control patients were end stadium of malignant tumor. en-copyright= kn-copyright= en-aut-name=TachibanaAkihisa en-aut-sei=Tachibana en-aut-mei=Akihisa kn-aut-name=立花明久 kn-aut-sei=立花 kn-aut-mei=明久 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第1外科教室 END start-ver=1.4 cd-journal=joma no-vol=83 cd-vols= no-issue=11-12 article-no= start-page=579 end-page=590 dt-received= dt-revised= dt-accepted= dt-pub-year=1971 dt-pub=19711230 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=EXPRIMENTAL AND CLINICAL STUDY ON THE HEMODIALYSIS (WITH SPECIAL REFERENCE TO THE DIALYSIS COMPLICATION) kn-title=血液透析に関する実験的並びに臨床的研究（特に透析合併症に関して） en-subtitle= kn-subtitle= en-abstract= kn-abstract=This is an experimental and clinical study to investigate the mechanism of the Disequilibrium-Syndrome in hemodialysis from the point of biochemical changes of the body fluid and osmotic pressure. METHOD. Mongrel dogs were used for this study. Three hour hemodialysis using Kolff's single coil kidney was performed on uremic dogs, which had been nephrec tomized bilatelally and, clinically hemodialysis was performed on 40 patients with renal failure, since November 1967, to December 1970. Dialyzers used in the study were either Kolff-Twin-coil type or Kiil's type. Effort has been made in this study to investigate correlations of parameters followed to patient with or without Disequilibrium-Syndrome. 1. Dialyzer. 2. BUN-Dialisanse. 3. Time of dialysis. 4. Severity of patient. RESULT. 1. The level of Urea-N in lymph and serum, resumed to normal by the end of the first hour of dialysis, but those in cerebrospinal fluid decreased very slowly. There were notable changes of excretory gradient on Urea-N between blood and cerebrospinal fluid. 2. Biochemical changes of thoracic duct lymph during hemodialysis were very similar to those of serum. 3. There was slight change of osmotic pressure between serum and cerebrospinal fluid before and after dialysis. 4. None of patients developed Disequilibrium-Syndrome in case of BUN below 110mg/dl, within 3 hour of dialysis, and 30 % of BUN-dializanse. CONCLUSION. It was fond in this study that osmotic-gradient per se might be one, not all, of cause of Disequilibrium-Syndrome. However. in clinical practice, rapid alteratons of homeostasis seems to be related to this syndrome. en-copyright= kn-copyright= en-aut-name=KutomiKatsumi en-aut-sei=Kutomi en-aut-mei=Katsumi kn-aut-name=九富勝美 kn-aut-sei=九富 kn-aut-mei=勝美 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学第二外科教室 END start-ver=1.4 cd-journal=joma no-vol=88 cd-vols= no-issue=3-4 article-no= start-page=169 end-page=176 dt-received= dt-revised= dt-accepted= dt-pub-year=1976 dt-pub=19760430 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Diagnosis and treatment of acute rejection after kidney homotransplantation in dog Part 1. Clinical results and change of macrophage migration inhibition activity at the administration of methylprednisolone in a large dose kn-title=犬同種腎移植後の急性拒絶反応に対する診断と治療に関する研究 第1編 メチルプレドニン大量投与時の臨床検査成績とマクロファージ遊走阻止活性の推移について en-subtitle= kn-subtitle= en-abstract= kn-abstract=After kidney homotransplantation in dogs we pursued daily the macrophage migration inhibitory (MI) activity, which is one of the diagnostic parameters, and obtained the following results. At the time when it was diagnosed to have an acute rejection from routine clinical findings in the untreated control group, MI-activity was positive in 77% of the cases. The MI-activity was positive in 65% already 36 hours prior to the diagnosis was clinicaly made as of acute rejection case. With the test group treated with MPSS (methylprednisolone) MI-activity was positive in 75% of the cases at the time when diagnosed as of acute rejection. In 6 cases (43%) out of 14 the MI-activity was positive 48 hours prior to the diagnoses of acute rejection. When 20 mg/kg/day of MPSS was injected intravenously to 14 cases that had shown acute rejection despite Imuran administration for 3 consecutive days, serum creatinine decreased from 3.4 mg/dl to 2.4 mg/dl, urine excretion increased, and MI-activity also recovered to the normal range from 75% to 94% by a significant difference (P<0.001). These findings seem to indicate that the macrophage migration inhibitory activity test after kidney transplantation is not only an effective, immunological diagnosis to assess the acute rejection after kidney transplantation but also useful in determining the effect of immunosuppression. en-copyright= kn-copyright= en-aut-name=TanakaKohki en-aut-sei=Tanaka en-aut-mei=Kohki kn-aut-name=田中浩毅 kn-aut-sei=田中 kn-aut-mei=浩毅 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一外科教室 END start-ver=1.4 cd-journal=joma no-vol=87 cd-vols= no-issue=9-10 article-no= start-page=867 end-page=875 dt-received= dt-revised= dt-accepted= dt-pub-year=1975 dt-pub=19751030 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Two Cases of Atypical Lymphocytos is Resembling "Prolymphocytic Leukemia" (Galton et al.) kn-title="Prolymphocytic leukemia" （Galtonら）に近似せると考えられる異型リンパ球の著増を来した2例 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Case 1: A 38-year-old housewife was admitted to our clinic on January 1973 because of fever and lymphocytosis of 4-months' duration. Leukocytosis (25,500/m?) with a marked lymphocytosis (70%) was present in peripheral blood. Twenty-four out of this 70% of lymphocytes were markedly atypical, showing indented or lobated nuclei and rather abundant basophilic cytoplasm. These cells were also seen in bone marrow in 2.6%. Phase contrast and electron microscopic observation revealed these cells to be rather mature atypical lymphocytes. Negative Paul-Bunnell test, low antibody titer for EB virus, and poor blstogenesis to stimulation by phytohemaggulutinin and T-cell nature of these lymphocytes were demonstrated. Prominent hepatosplenomegaly was characteristic though lymphoadenopathy was absent. Peripheral leukocyte counts increased progressively up to 20.4×10(4)/m? while blasts were scarecely seen. In spite of administering Neocarzinostatin, vincristine and prednisolone. the patient died of pneumonia three months after admission. Necropsy using a Silverman needle revealed cytomegalic inclusion bodies in the lung and massive infiltration of, what appeared to be, atypical lymphocytes into the liver, spleen and kidney. Case 2: A 56-year-old male was admitted to the Okayama University Hospital at Misasa on March 1974, complaining of high temperature of 2-weeks' duration. Leukocyte counts in peripheral blood was 7,550/m? with atypical lymphocytes, which were quite similar in shapes as well as in maturities to those seen in the Case 1 and were seen in 23.5%, whereas they were 7.8% in the bone marrow. Fever continued without responding to various antibiotics and prednisolone. Leukocyte counts were increased up to 23,600/m? within two weeks and he died of massive interstitial pneumonia one month after the admission. Necropsy with a Silverman needle revealed cytomegalic inclusion bodies in the lung and infiltrations of atypical lymphocytes into the liver, spleen and kidney. Infectious mononucleosis can be ruled out on the basis of progressive and fatal clinical courses and other specific laboratory findings, although infection by Herpes type virus might play some role at the terminal stage of the disease. As the increase of atypical lymphocytes is so prominent in the peripheral blood and bone marrow, these 2 cases probably belong to lymphocytic leukemia; acute lymphocytic leukemia can easily be omitted because no blasts were seen. On the other hand, these cases cannot be categorized as conventional chronic lymphocytic leukemia in various points, showing atypical lymphocytes with variegated shapes and sizes, much shorter surviving time than that and poor response to therapy. Differentiation of these cases from "lymphosarcoma cell leukemia" is also made by their shorter clinical courses than that leukemia and absence of very characteristic nucleoli seen in that leukemia. Maturity of the cells from our cases also differ from those in lymphosarcoma cell leukemia; cells in our cases are maturer than those of that leukemia. "Prolymphocytic leukemia" reported by Galton et al. may be a disease entity to be most compatible with our cases. Marked lymphocytosis, short survival time, poor response to therapy, hepatosplenomegaly and absence of peripheral lymphoadenopathy accord well with the clinical features described by them. The characteristic cells, however, in the peripheral blood of prolymphocytic leukemia are somewhat different from those seen in our cases. The cells of that leukemia have a large vesicular nucleolus in almost every cases without appreciable clefts, indentations or lobations of nucleus, whereas less conspicuous nucleoli and more irregular nuclei in shape were frequently observed in our cases than in prolymphocytic leukemia. Incidentally, Akihama et al. reported a case quite resembling our cases, and proposed a new clinical entity which should be differentiated from chronic lymphocytic leukemia due to several reasons as stated before. Because of, however, the lack of proper autopsies and limited numbers of cases experienced so far, it will be too premature to state that these 3 cases, including that of Akihama et al., should be regarded as a new clinical entity. Further studies on the similar cases to ours will be needed to decide as to whether or not our 2 cases are indeed a variant of prolymphocytic leukemia. en-copyright= kn-copyright= en-aut-name=TaguchiHirokuni en-aut-sei=Taguchi en-aut-mei=Hirokuni kn-aut-name=田口博国 kn-aut-sei=田口 kn-aut-mei=博国 aut-affil-num=1 ORCID= en-aut-name=SanadaHiroshi en-aut-sei=Sanada en-aut-mei=Hiroshi kn-aut-name=真田浩 kn-aut-sei=真田 kn-aut-mei=浩 aut-affil-num=2 ORCID= en-aut-name=TanakaToshio en-aut-sei=Tanaka en-aut-mei=Toshio kn-aut-name=田仲俊雄 kn-aut-sei=田仲 kn-aut-mei=俊雄 aut-affil-num=3 ORCID= en-aut-name=HayashiTakehiko en-aut-sei=Hayashi en-aut-mei=Takehiko kn-aut-name=林健彦 kn-aut-sei=林 kn-aut-mei=健彦 aut-affil-num=4 ORCID= en-aut-name=MiyoshiIsao en-aut-sei=Miyoshi en-aut-mei=Isao kn-aut-name=三好勇夫 kn-aut-sei=三好 kn-aut-mei=勇夫 aut-affil-num=5 ORCID= en-aut-name=KitayamaMinoru en-aut-sei=Kitayama en-aut-mei=Minoru kn-aut-name=北山稔 kn-aut-sei=北山 kn-aut-mei=稔 aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部中央検査部 affil-num=2 en-affil= kn-affil=岡山大学医学部中央検査部 affil-num=3 en-affil= kn-affil=岡山大学医学部中央検査部 affil-num=4 en-affil= kn-affil=岡山大学医学部第二内科 affil-num=5 en-affil= kn-affil=岡山大学医学部第二内科 affil-num=6 en-affil= kn-affil=岡山大学医学部三朝分院内科 END start-ver=1.4 cd-journal=joma no-vol=87 cd-vols= no-issue=9-10 article-no= start-page=787 end-page=804 dt-received= dt-revised= dt-accepted= dt-pub-year=1975 dt-pub=19751030 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Experimental and clinical study of the histological changes after administration of hyperosmolar solution kn-title=高浸透圧輸液における組織変化の検討―特にブドウ糖を中心とした基礎的及び臨床的研究― en-subtitle= kn-subtitle= en-abstract= kn-abstract=Intravenous hyperalimentation requires hyperosmolar solution to supply sufficient calorie. The present study was designed to investigate the effect of hyperosmolar solution on various organs in dogs. Further investigation in man was carried out on the pathologic changes of the liver and kidney obtained from the autopsy who had been administered intravenous hyperalimentation. The conclusion as follows. 1. In the acute experiment, the group that received hypertonic glucose solution showed much more diuresis than that of more hypertonic ones. The grade of diuresis seemed to be ralated to the volume of water that was infused. 2. Cloudy swelling of the proximal kidney tubules was observed markedly in the higher glucose concentration group and there was high correlation between the change of tubules and glucose concentration. When dehydration was accompanied, these changes became more severe. 3. In the group infused fructose, the tissue damage was not observed. In the group infused xylitol, the liver and kidney damage was remarkable and all animals died during the experiment. 4. In the autopsy study, osmotic nephrosis was found 13 of 35 cases that had been administered intravenous hyperalimentation. All 7 cases that had been infused dextran showed osmotic nephrosis but there was no relation between the grade of osmotic nephrosis and infused volume or time of infused dextran. 5. Study of different combination of solutions revealed that lipofuscin of the liver which means consumption pigments was noticed in the group infused glucose exclusively. Therefore careful considerations should be taken on the possibility of over-load to the various organs during intravenous hyperalimentation. en-copyright= kn-copyright= en-aut-name=MaeshimaKoji en-aut-sei=Maeshima en-aut-mei=Koji kn-aut-name=前島皎仁 kn-aut-sei=前島 kn-aut-mei=皎仁 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第2外科教室 END start-ver=1.4 cd-journal=joma no-vol=92 cd-vols= no-issue=7-8 article-no= start-page=959 end-page=979 dt-received= dt-revised= dt-accepted= dt-pub-year=1980 dt-pub=19800831 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical significance of monitoring T-lymphocytes (total T, active T) in kidney-transplanted patients -with special reference to acute rejection and lung infection- kn-title=腎移植患者におけるTリンパ球（total T,active T）monitoringの臨床的意義―特に急性拒絶反応と肺感染症を中心として― en-subtitle= kn-subtitle= en-abstract= kn-abstract=T-lymphocytes, B-lymphocytes and macrophages in vivo maintain orderly constant immunological adjustment mechanisms by acting with each other in a complex manner. T-lymphocytes, that are main actors of cell-mediated immunity and form the rosette by binding with sheep red blood cells, are by no means a single cell group, and along with functional differentiation they show peculiar markers on the cell surface so that they can be divided into individual subsets. In view of the fact that an early foreknowledge or diagnosis of immunological behaviors, especially the acute rejection, in the patient transplanted with kidney, would not only lessen disturbances of the transplanted kidney but also it would diminish the danger of subsequent complication, time-lapse measurements were taken frequently of total T-lymphocytes and active T-lymphocytes known to have biological activity using peripheral blood before and after kidney transplantation, and their changes were studied. The subjects consisted of 22 living related and 9 cadaveric kidney transplantations that we handled in the First Department of Surgery, Okayama University during the period from March 1974 to August 1978. Peripheral blood lymphocytes were isolated by Ficoll-Conray method (a modification of Boyum's method) from 5ml of fresh heparinized blood obtained from kidney-transplanted patients. By the method of Tachibana-Yata the sheep red blood cell suspension was prepared for measuring total T, active T, and B-lymphocytes, and the measurements were taken by the test-tube method of Felsburg et al, -Kerman et al. To total T and active T lymphocytes the nonspecific rosette formation reaction with sheep red blood cells was applied, and to B-lymphocytes the complement binding reaction with complementsensitized sheep red blood cells was used. The reaction of lymphocytes to sheep red blood cells was conducted in the ratio of about 1:100, and those sheep red blood cells showing the adhesion of over 3 sheep red blood cells were taken as the rosette formation positive cells. The lymphocyte subpopulation was measured frequently for a long period of time before and after the operation of kidney transplanted patients, and the percentage of total T (Tt), active T (Ta) and B-lymphocytes was calculated, and such a percentage was observed along with changes of clinical symptoms after the kidney transplantation, and these findings were used to serve for the early fore-knowledge of acute rejection crisis or lung infection, and also to serve for the determination of the optimal dose of immuno-suppressive agents. The results are described as follows. 1) The test results by the test-tube method with 36 materials from 20 normal individuals are: Tt 60.3±6.1% , Ta 40.2±10.3% , B 21.0±8.0% . The results of 18 cases undergoing hemodialysis prove to be Tt 52.3±8.8% (p<0.01), Ta 32.5±10.6% (p<0.02), and B 25.0±9.7% . 2) In those cases showing favorable progress after kidney transplantation there can be observed a marked decrease in Tt and Ta ratios, which gradually show a recovery tendency after 3 months, but the decrease of T-lymphocyte level continues for a fairly long period of time. Especially the decrease of Ta level is markedly prolonged. 3) Four to 9 days before the onset of acute renal rejection Tt and Ta showed a significant rise, but by MPSS-high-dosage treatment there was a rapid decreasing tendency. 4) In those cases having lung infection the decrease of T-lymphocyte level has been continued for a fairly long time before the onset of disease, especially marked is the decrease of Ta level. Those having favorable results after treatment showed a significant rise of T-lymphocyte level, showing a recovery tendency. 5) Ta ratio can be obtained by a simple procedure and the result can be clarified in a short period of time, and it is a useful immunological parameter that reflects sharply and accurately the immunity of the host. 6) From these findings it is concluded that the ratio of Tt and Ta lymphocytes, by measuring frequently along with lapse of time would give the foreknowledge of postoperative immunosuppressive conditions and acute rejection crisis in kidney-transplanted patients and the prognosis determination of lung infection cases. In addition, such a ratio is useful in determination of the optimal dose of immuno-suppressive agents. en-copyright= kn-copyright= en-aut-name=NakaharaHarutsugu en-aut-sei=Nakahara en-aut-mei=Harutsugu kn-aut-name=中原東亜 kn-aut-sei=中原 kn-aut-mei=東亜 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一外科教室 en-keyword=腎移植患者の免疫能（免疫学的指標） kn-keyword=腎移植患者の免疫能（免疫学的指標） en-keyword=total Tリンパ球 kn-keyword=total Tリンパ球 en-keyword=active Tリンパ球 kn-keyword=active Tリンパ球 en-keyword=急性拒絶反応 kn-keyword=急性拒絶反応 en-keyword=肺感染症 kn-keyword=肺感染症 END start-ver=1.4 cd-journal=joma no-vol=92 cd-vols= no-issue=5-6 article-no= start-page=597 end-page=612 dt-received= dt-revised= dt-accepted= dt-pub-year=1980 dt-pub=19800630 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Study on early evaluation of mixed lymphocyte culture test kn-title=リンパ球混合培養試験の迅速化判定に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=In the clinic of renal transplantation the difference of histocompatibility matching is significant in judging the prognosis of renal transplantation. MLC test is one of the histocompatibility tests indispensable to select donor-recipient combination, but generally it takes as long as 4-6 days, and it is not easy to use as routine for the practice of urgent renal transplantation. In this study, for the purpose of clinical application of cadaver renal transplantation on the basis of protein synthesis rate with (3)H-leucine pulse label method, this method was used to conduct technical basic experiment for rapid MLC test. First in establishing the condition of culture, Eagle's MEM was used which contains no leucine in the culture, and human serum was not added. The maximum number of reacting lymphocytes in MLC test was 1×10(6)/0.2ml/well. At 24 hours after commencement of culture % SPS (stimulation of protein synthesis) became maximum, and it was decided as time of judgement. There was correlation between rapid and standard MLC tests. % SPS of 10 cases of living donor transplantation was 11.8±16.7, % SPS of 10 cases of cadaver donor transplantation 97.6±31.5, and there was a significant difference (p<0.001). About 9 cases of cadaver kidney transplantation, low HLA matching grade showed high % SPS and a tendency of bad renal function after transplantation. In the cases whose renal function was lost within 3 months after transplantation % SPS tended to be higher than in the cases whose transplanted kidney survived longer. Although there are many factors which influence the prognosis of renal transplantation, it has been suggested that at least such a combination should be selected as % SPS below 80 and HLA matching above 2 matched to maintain good renal function for a long time. From the above, this rapid MLC test has been recognized retrospectively useful to test histocompatibility matching of urgent cadaver renal transplantation. en-copyright= kn-copyright= en-aut-name=YamamotoTaizo en-aut-sei=Yamamoto en-aut-mei=Taizo kn-aut-name=山本泰三 kn-aut-sei=山本 kn-aut-mei=泰三 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学第一外科教室 en-keyword=リンパ球混合培養 kn-keyword=リンパ球混合培養 en-keyword=PHA kn-keyword=PHA en-keyword=主要組織適合性抗原 kn-keyword=主要組織適合性抗原 en-keyword=死体腎移植 kn-keyword=死体腎移植 END start-ver=1.4 cd-journal=joma no-vol=94 cd-vols= no-issue=3-4 article-no= start-page=201 end-page=210 dt-received= dt-revised= dt-accepted= dt-pub-year=1982 dt-pub=19820430 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=EAC Rosette Inhibition for Detecting Immune Complexes in Renal Transplant Patients kn-title=腎移植患者におけるEACロゼット阻止試験を用いたImmune Complex測定の試み en-subtitle= kn-subtitle= en-abstract= kn-abstract=In human renal allografts, recipients respond with various specific immune reactions, such as the production of immune complexes. The circulating immune complexes provoke damage of the grafted kidney under the appropriate condition. Therefore, the detection of circulating immune complexes is important in predicting the rejection of grafted kidneys. Several methods of measuring immune complexes have been reported. In this study, sera from 25 patients who had received renal allografts were studied for the presence of circulating immune complexes by using a EAC rosette inhibition test. Sera from 25 patients were divided into three groups (1. acute rejection, 2. chronic rejection, 3. no rejection episode) and EAC rosette inhibition tests performed. Serum samples from the chronic rejection group gave high inhibition of EAC rosette formation, showing good correlation with clinical chronic rejection episodes. It was concluded that circulating immune complexes play an important role in chronic rejection. Therefore, the EAC rosette inhibition test is useful for predicting chronic rejection, and measuring circulating immune complexes. en-copyright= kn-copyright= en-aut-name=FujiwaraTouru en-aut-sei=Fujiwara en-aut-mei=Touru kn-aut-name=藤原徹 kn-aut-sei=藤原 kn-aut-mei=徹 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一外科学教室 en-keyword=腎移植 kn-keyword=腎移植 en-keyword=拒絶反応 kn-keyword=拒絶反応 en-keyword=EACロゼット阻止試験 kn-keyword=EACロゼット阻止試験 en-keyword=Immune Complex kn-keyword=Immune Complex END start-ver=1.4 cd-journal=joma no-vol=95 cd-vols= no-issue=3-4 article-no= start-page=283 end-page=294 dt-received= dt-revised= dt-accepted= dt-pub-year=1983 dt-pub=19830430 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Immunopathological studies on lupus nephritis; Detection of antibodies to nuclear ribonucleoprotein(RNP) and Sm in kidney eluates. kn-title=ループス腎炎の免疫病理学的研究腎誘出液における抗RNP,抗Sm抗体の検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=For Immunological and immunopathological studies on lupus nephritis, kidneys from nine autopsied and one nephrectomized patients with systemic lupus erythematosus (SLE) were subjected to immunofluorescence(IF) and elution study. Six patients had diffuse proliferative lupus nephritis, showing granular or lumpy glomerular deposits by IF. Three had chronic renal failure with scanty glomerular deposits. One had no clinical renal disease but showed glomerular mesangial deposits. The serum level of antibodies to native(n)-DNA were slightly or moderately elevated in six patients. Hemolytic activity of serum complement(CH50) was markedly decreased in seven. Elution was performed as follows: the renal cortex was homogenized and washed repeatedly with cold saline, then the sediment containing glomeruli was disrupted by ultrasonication, and then suspended in 0.02 M glycine buffer, pH 2.8, in phosphate buffered saline for the control study. Antibodies to RNP were detected in six instances, and those to Sm in five. The hemagglutinating titers of antibodies to RNP and Sm in acid eluates were 8 to 128 times and 32 to 256 times higher than those in controls, respectively. However, when compared with the hemagglutinating titers in sera, specific enrichment of antibodies to RNP and Sm in acid eluates was less than 8 times. Three of ten acid eluates were demonstrated to contain antibodies to n-DNA which were determined by counterimmunoelectrophoresis(CIE). Two of these showed a positive precipitin reaction against denatured DNA. Minimum amounts of IgG producing positive reaction by CIE were measured in kidney eluates and sera obtained from the same patients. The ratio of the minimum concentrations of IgG in sera to those in eluates ranged between 33 and 125 with n-DNA system. Similarly, the ratio was between 33 and 62 with denatured DNA system. The results suggest that not just DNA immune complex but RNP and Sm immune complexes could be involved in the pathogenesis of lupus nephritis. en-copyright= kn-copyright= en-aut-name=HaraIkuo en-aut-sei=Hara en-aut-mei=Ikuo kn-aut-name=原郁夫 kn-aut-sei=原 kn-aut-mei=郁夫 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第三内科教室 en-keyword=ループス腎炎 kn-keyword=ループス腎炎 en-keyword=腎誘出液 kn-keyword=腎誘出液 en-keyword=抗Sm抗体 kn-keyword=抗Sm抗体 en-keyword=抗RNP抗体 kn-keyword=抗RNP抗体 en-keyword=抗DNA抗体 kn-keyword=抗DNA抗体 END start-ver=1.4 cd-journal=joma no-vol=102 cd-vols= no-issue=1-2 article-no= start-page=143 end-page=152 dt-received= dt-revised= dt-accepted= dt-pub-year=1990 dt-pub=199002 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Integration and expression of E1 region DNA in human adenovirus type 12-induced tumors kn-title=ヒトアデノウィルス12型誘発腫瘍におけるE1領域遺伝子の組み込みと発現 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Integration and expression of human adenovirus type 12 (Ad12) were studied on two Ad12-induced tumor lines of C3Hf/OK mouse origin (IC and D tumors). Southern hybridization using whole Ad12 genome as probe demonstrated that DNA of IC and D tumors contained about 9 and 23 copies, respectively, of the entire Ad12 genome eqivalent per diploid cell. Left ends of Ad12 DNA appeared as off-size bands, indicating their linkage to different cellular DNAs. Southern hybridization using and Ad12 EcoRI-C fragment containing the E1 region as a probe revealed that intergration sites were much fewer than presumen numbers of integrated Ad12 genones. These results suggested that the viral and cellular DNA complex was repeated at integration sites. Northen hybridization using an Ad12 EcoRI-C fragment as a probe showed that tha E1 region was transcribed in both IC and D tumors. Much more intensive expression in the D tumor suggested possible dependence of the expression of the E1 region on the copy numbers of Ad12 genomes. en-copyright= kn-copyright= en-aut-name=MorikawaTomoko en-aut-sei=Morikawa en-aut-mei=Tomoko kn-aut-name=森川智子 kn-aut-sei=森川 kn-aut-mei=智子 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=香川医科大学病理学講座第一病理学 en-keyword=ヒトアデノウィルス12型 kn-keyword=ヒトアデノウィルス12型 en-keyword=E1領域 kn-keyword=E1領域 en-keyword=C3Hf/OK マウス kn-keyword=C3Hf/OK マウス en-keyword=ウィルス発癌 kn-keyword=ウィルス発癌 END start-ver=1.4 cd-journal=joma no-vol=103 cd-vols= no-issue=11-12 article-no= start-page=1177 end-page=1181 dt-received= dt-revised= dt-accepted= dt-pub-year=1991 dt-pub=1991 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Evaluation of renal function by the ultrasonic Doppler technique kn-title=超音波パルスドップラ法による腎機能評価に関する検討―Dynamic CT 及び Ccr との比較を中心として― en-subtitle= kn-subtitle= en-abstract= kn-abstract=To evaluate the clinical application of the ultrasonic Doppler technique, renal arterial blood flow was measured in 7 normal subjects and 3 patients with renal dysfunction. For the purpose of correction of blood flow measured by the Doppler technique, some basic studies were performed. The ratio of peak diastolic to peak systolic velocity (D/S ratio) correlated well with both the creatinine clearance and the CA ratio calculated from the results of Dynamic CT. There was no correlation between the corrected velocity of the arterial blood flow and the creatinine clearance. The D/S ratio obtained by the ultrasonic Doppler technique is thought to be a useful parameter in the evaluation of the renal function. However, the Dynamic CT is thought to be superior in objectiveness to the ultrasonic Doppler technique. en-copyright= kn-copyright= en-aut-name=SatohShuhei en-aut-sei=Satoh en-aut-mei=Shuhei kn-aut-name=佐藤修平 kn-aut-sei=佐藤 kn-aut-mei=修平 aut-affil-num=1 ORCID= en-aut-name=KitagawaTakahiro en-aut-sei=Kitagawa en-aut-mei=Takahiro kn-aut-name=北川尚広 kn-aut-sei=北川 kn-aut-mei=尚広 aut-affil-num=2 ORCID= en-aut-name=SatohNobuo en-aut-sei=Satoh en-aut-mei=Nobuo kn-aut-name=佐藤伸夫 kn-aut-sei=佐藤 kn-aut-mei=伸夫 aut-affil-num=3 ORCID= en-aut-name=TogamiIzumi en-aut-sei=Togami en-aut-mei=Izumi kn-aut-name=戸上泉 kn-aut-sei=戸上 kn-aut-mei=泉 aut-affil-num=4 ORCID= en-aut-name=KimotoShin en-aut-sei=Kimoto en-aut-mei=Shin kn-aut-name=木本真 kn-aut-sei=木本 kn-aut-mei=真 aut-affil-num=5 ORCID= en-aut-name=HirakiYoshio en-aut-sei=Hiraki en-aut-mei=Yoshio kn-aut-name=平木祥夫 kn-aut-sei=平木 kn-aut-mei=祥夫 aut-affil-num=6 ORCID= en-aut-name=UnoSatoru en-aut-sei=Uno en-aut-mei=Satoru kn-aut-name=宇埜智 kn-aut-sei=宇埜 kn-aut-mei=智 aut-affil-num=7 ORCID= en-aut-name=KumonHiromi en-aut-sei=Kumon en-aut-mei=Hiromi kn-aut-name=公文裕巳 kn-aut-sei=公文 kn-aut-mei=裕巳 aut-affil-num=8 ORCID= en-aut-name=OhmoriHiroyuki en-aut-sei=Ohmori en-aut-mei=Hiroyuki kn-aut-name=大森弘之 kn-aut-sei=大森 kn-aut-mei=弘之 aut-affil-num=9 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=2 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=3 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=4 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=5 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=6 en-affil= kn-affil=岡山大学医学部放射線医学教室 affil-num=7 en-affil= kn-affil=岡山大学医学部泌尿器科学教室 affil-num=8 en-affil= kn-affil=岡山大学医学部泌尿器科学教室 affil-num=9 en-affil= kn-affil=岡山大学医学部泌尿器科学教室 en-keyword=超音波パルスドップラ法 kn-keyword=超音波パルスドップラ法 en-keyword=D/S 比 kn-keyword=D/S 比 en-keyword=DCT kn-keyword=DCT en-keyword=CA ratio kn-keyword=CA ratio END start-ver=1.4 cd-journal=joma no-vol=103 cd-vols= no-issue=9-10 article-no= start-page=1065 end-page=1073 dt-received= dt-revised= dt-accepted= dt-pub-year=1991 dt-pub=199110 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Comparison of Ciclosporin dosage in serum and lymphocytes and suppressive effect on NK activity kn-title=Ciclosporin 投与におけるリンパ球中濃度及びNK活性 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Ciclosporin is an effective immunosuppressant for kidney transplantation, although it has the side effect of nephrotoxicity. Ordinarily, the optimal dosage of Ciclosporin is determined by the serum trough level. However, it might be better to make the determination from the concentration in immunocompetent cells. In this report, the serum level of Ciclosporin was compared with the lymphocyte concentration along with the inhibiting activity to NK cells. In in vivo administration, Ciclosporin levels in serum and lymphocytes increased in proportion to the dosage. The suppression of NK activity correlated with the dosage. The suppression of NK activity ceased within 4 days after cessation of administration. In in vitro administration, the Ciclosporin level in lymphocytes increased in proportion to the dosage. The suppression of NK activity correlated with its level in the lymphocytes. Ciclosporin successfully suppressed NK activity against both K562 cells and skin cells. en-copyright= kn-copyright= en-aut-name=InoueFumiyuki en-aut-sei=Inoue en-aut-mei=Fumiyuki kn-aut-name=井上文之 kn-aut-sei=井上 kn-aut-mei=文之 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第一外科学教室 en-keyword=ciclosporin kn-keyword=ciclosporin en-keyword=NK活性 kn-keyword=NK活性 en-keyword=ラット皮膚細胞 kn-keyword=ラット皮膚細胞 END start-ver=1.4 cd-journal=joma no-vol=103 cd-vols= no-issue=7-8 article-no= start-page=963 end-page=972 dt-received= dt-revised= dt-accepted= dt-pub-year=1991 dt-pub=199108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Analysis of pathogenic factors of Proteus mirabilis isolated from urinary tract infection kn-title=尿路感染症患者分離 Proteus mirabilis の病原性発現因子の解析 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Proteus mirabilis has several pathogenic factors such as adherent ability to urinary tract epitherial cells, urease, motility and resistance to urine. The pathogenic activities of clinically isolated P. mirabilis were analyzed. Higher pathogenic strains (No. 25 and No. 30) which had morphologically different pili but had a higher density of pili showed strong adherent activity to bladder epithelial cells of mouse and rat. These strains also showed a clear chemotaxis to urinary tract tissue extracts. These findings indicate that the combination of adherent, chemotaxis and urease activities is essential for causing of tipical kidney infection by P. mirabilis. en-copyright= kn-copyright= en-aut-name=MurotaniKatsuhisa en-aut-sei=Murotani en-aut-mei=Katsuhisa kn-aut-name=室谷勝久 kn-aut-sei=室谷 kn-aut-mei=勝久 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部細菌学教室 en-keyword=P. mirabilis kn-keyword=P. mirabilis en-keyword=尿路感染 kn-keyword=尿路感染 en-keyword=病原因子 kn-keyword=病原因子 en-keyword=走化性 kn-keyword=走化性 en-keyword=ウレアーゼ kn-keyword=ウレアーゼ en-keyword=付着性 kn-keyword=付着性 END start-ver=1.4 cd-journal=joma no-vol=104 cd-vols= no-issue=11-12 article-no= start-page=1023 end-page=1032 dt-received= dt-revised= dt-accepted= dt-pub-year=1992 dt-pub=199212 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Effects of ferric citrate or hyperoxygenation on guanidino compounds in mouse organs kn-title=クエン酸鉄投与及び純酸素負荷マウスのグアニジノ化合物の変動に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The guanidino compounds in various mouse organs after i.p. administration of ferric citrate(Fe) and after inhalation of pure oxygen(O(2)) were studied. Guanidinoacetic acid and N-acetylarginine levels were markedly higher in the kidney, and they decreased after administration of Fe or inhalation of O(2). Creatinine decreased in the liver after administration of Fe, and it decreased in the liver and muscle after inhalation of O(2). γ-Guanidinobutyric acid level was significantly higher in the normal liver, but decreased after administration of Fe or inhalation of O(2). Arginine(Arg) increased in the kidney and muscle after administration of Fe, while it decreased in the liver. Arg decreased in the kidney and the muscle after inhalation of O(2). Methylguanidine(MG) increased in the brain after administration of Fe or inhalation of O(2). However, MG decreased in the liver after administration of Fe, and also decreased in the liver, kidney and muscle after inhalation of O(2). MG increased only in the brain. This finding suggested that the reactive oxygen species(O(2)(-), H(2)O(2), ・OH) were most effective there, because oxygen consumpution in the brain was much more than in the other organs. en-copyright= kn-copyright= en-aut-name=WatanabeSeigo en-aut-sei=Watanabe en-aut-mei=Seigo kn-aut-name=渡邊省吾 kn-aut-sei=渡邊 kn-aut-mei=省吾 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属分子細胞医学研究施設神経情報学部門 en-keyword=hyperoxygenation kn-keyword=hyperoxygenation en-keyword=iron ion kn-keyword=iron ion en-keyword=guanidino compounds kn-keyword=guanidino compounds en-keyword=methylganidine kn-keyword=methylganidine en-keyword=free radicals kn-keyword=free radicals END start-ver=1.4 cd-journal=joma no-vol=103 cd-vols= no-issue=7-8 article-no= start-page=803 end-page=811 dt-received= dt-revised= dt-accepted= dt-pub-year=1991 dt-pub=199108 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on the pathogenesis in iron deficiency anemia Part 1. Urinary iron excretion in iron deficiency anemia patients and rats in various iron states kn-title=鉄欠乏性貧血の発症要因に関する研究　第1編　尿中鉄排泄の臨床的並びに実験的検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=In the "iron excretion test" , urinary iron excretion after injection of saccharated iron oxide has been reported to be accelerated in relapsing idiopathic iron deficiency anemia. To determine the relevance of urinary iron excretion to clinical factors other than iron metabolism, 15 clinical parameters were evaluated. The serum creatinine level was positively and the serum albumin level was negatively correlated with urinary iron excretion, showing coefficients of r＝0.97,−0.86 respectively, and suggesting a relationship between urinary iron excretion and subclinical abnormalities of kidney function. In experimental studies, the relation of urinary iron excretion to the renal function was examined by administration of iron in various forms to rats. Only saccharated iron oxide was excreted; chondroitin sulfate Fe, Tf-Fe and ferric chloride were not excreted in the urine. Then, iron excretion was examined in iron deficient, iron overloaded and puromycin aminonucleoside (PA)-treated animals. Iron deficient rats did not show any change in urinary iron excretion compared to the controls. Urinary iron excretion was increased in iron overloaded rats, and was further increased in the PA-treated group. These findings suggest that the subclinical abnormality in kidney function leads to the increased urinary iron excretion as a possible factor in the pathogenesis of relapsisg iron deficiency. en-copyright= kn-copyright= en-aut-name=NakanishiNorihiko en-aut-sei=Nakanishi en-aut-mei=Norihiko kn-aut-name=中西徳彦 kn-aut-sei=中西 kn-aut-mei=徳彦 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=iron deficiency anemia kn-keyword=iron deficiency anemia en-keyword=urinary iron excretion kn-keyword=urinary iron excretion END start-ver=1.4 cd-journal=joma no-vol=106 cd-vols= no-issue=5-6 article-no= start-page=549 end-page=560 dt-received= dt-revised= dt-accepted= dt-pub-year=1994 dt-pub=1994 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical studies on plasma cyclic nucleotide levels in acute leukemia kn-title=急性白血病における血漿cyclic nucleotides動態に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Plasma levels of cyclic nucleotides were measured in 71 patients with acute leukemia [50 patients with acute nonlymphocytic leukemia (ANLL), five patients with hypoplastic leuke-mia, and 16 patients with acute lymphocytic leukemia (ALL)], five patients with myelodysplas-tic syndrome (MDS), and 47 healthy volunteers. The cyclic GMP (c-GMP) level, cyclic AMP (c-AMP) level, and c-AMP/c-GMP ratio in healthy volunteers were 15.74±5.10 pmol/ml, 3.20±1.15 pmol/ml and 5.39±2.18, respectively. In the patients with untreated acute leukemia other than hypoplastic leukemia, c-GMP levels were significantly elevated (ANLL : 11.31±13.61 pmol/ml ; ALL : 10.66±7.23 pmol/ml) and c-AMP/c-GMP ratios were significantly reduced (ANLL : 2.01±1.03 ; ALl : 1.66±1.03). These values normalized at remission, than increased or decreased again with recurrence of the disease. Although patients with MDS showed normal c-GMP levels or c-AMP/c-GMP rations, these values were increased or decreased when progression to acute leukemia occurred. There was correlation between c-GMP levels and peripheral leukocyte counts (r=0.429,p<0.05), plasma c-GMP levels and peripheral leukemic cell counts (r=0.412,p<0.05), c-AMP/c-GMP rations and peripheral leukocyte counts (r=-0.577,p<0.05), c-AMP/c-GMP rations and periph-eral leukemic cell counts (r=-0.512,p<0.05), and c-AMP/c-GMP rations and periph-eral leukemic cell counts (r=-0.512,p<0.05), and c-AMP/c-GMP rations and maximum counts of colonies derived from leukemic blast progenitors (r=-0.996,p<0.01). Since plasma levls of cyclic nucleotides reflect the leukemic cell proliferation, measurement of these nucleotides was considered useful for monitoring leukemic cell volume. en-copyright= kn-copyright= en-aut-name=NonakaKenichi en-aut-sei=Nonaka en-aut-mei=Kenichi kn-aut-name=野中研一 kn-aut-sei=野中 kn-aut-mei=研一 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=血漿 cyclic nucleotides kn-keyword=血漿 cyclic nucleotides en-keyword=急性白血病 kn-keyword=急性白血病 en-keyword=低形成型白血病 kn-keyword=低形成型白血病 END start-ver=1.4 cd-journal=joma no-vol=106 cd-vols= no-issue=5-6 article-no= start-page=505 end-page=516 dt-received= dt-revised= dt-accepted= dt-pub-year=1994 dt-pub=1994 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Studies on malignant lymphoma Part 2. Natural killer activity in patients with malignant lymphoma kn-title=悪性リンパ腫の病態と治療に関する研究　第2編　悪性リンパ腫における natural killer 活性の検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=The natural killer (NK) activity of peripheral blood mononuclear cells (PBMC) from patients with malignant lymphoma was examined. In 54 untreated patients, the mean NK activity did not differ significantly from that in healthy controls. However, 17 (31%) of 54 patients showed low NK activity. NK activity did not correlate with the stage, histologic type or patient age. Significant reduction of NK activity was observed during combination chemo-therapy. The mean NK activity in complete respondors (CRs) did not differ significantly from that in healthy controls. However, 5 (14%) of 37 patients who were disease-free for more than 3 years showed low NK activity. Low NK activity was frequently observed in long-term CRs with non-Hodgkin's lymphoma compared with negative PPD skin test, negative PHA skin test, low CD4/CD8 ratio and decreased response of PBMC to PHA and/or Con A. These results indicate that patients with malignant lymphoma have decreased immunity even while in long-term continuous remission and that measuring NK activity is useful for evaluating their immunologic status. en-copyright= kn-copyright= en-aut-name=TagawaShinya en-aut-sei=Tagawa en-aut-mei=Shinya kn-aut-name=田川真也 kn-aut-sei=田川 kn-aut-mei=真也 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=lymphoma kn-keyword=lymphoma en-keyword=natural killer activity kn-keyword=natural killer activity en-keyword=immunity kn-keyword=immunity en-keyword=complete respondor kn-keyword=complete respondor en-keyword=chemotherapy kn-keyword=chemotherapy END start-ver=1.4 cd-journal=joma no-vol=105 cd-vols= no-issue=3-4 article-no= start-page=291 end-page=302 dt-received= dt-revised= dt-accepted= dt-pub-year=1993 dt-pub=1993 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The effect of hyperbaric oxygen on lipid peroxidation, antioxidant activity and guanidines and amino acids metabolism in rat brain kn-title=高気圧酸素曝露のラット脳内の脂質過酸化，活性酸素消去能，グアニジノ化合物およびアミノ酸代謝におよぼす影響 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Lipid peroxidation, free radical contents, antioxidant activity, guanididno compound metabolism and changes in amino acid contents in rat brain were studied to clarify the effect of a clinically relevant dose of hyperbaric oxygen (HBO). Seven-week-old rats were exposed to HBO at 3 atmosphere absolute for 2 hours. An increase in thiobarbituric acid reactive substances and carbon centered radicals was observed after exposure. Supreoxide dismutase-like activity also increased. The measurement of guanidino compounds revealed a significant rise in arginine and guanidinoacetic acid (GAA) levels. Since arginase activity decreased while there was no significant alteration in arginine : glycine-amidinotransferase activity, these changes in enzyme activities seem to cause the increase of arginine and GAA levels. In relation to guanidino compound metabolism, the amino acid contents were determined. An increase in glutamine and taurine levels were observed and these seemed to favor the defense mechanism. These data suggested that ongoing lipid peroxidation in the brain was caused by HBO, and that the defense mechanism against the oxidative stress was activated in response. en-copyright= kn-copyright= en-aut-name=ItohTakehiko en-aut-sei=Itoh en-aut-mei=Takehiko kn-aut-name=伊藤武彦 kn-aut-sei=伊藤 kn-aut-mei=武彦 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部附属分子細胞医学研究施設神経情報学部門 en-keyword=hyperbaric oxygen kn-keyword=hyperbaric oxygen en-keyword=lipid peroxidation kn-keyword=lipid peroxidation en-keyword=antioxidants kn-keyword=antioxidants en-keyword=guanidino compounds kn-keyword=guanidino compounds en-keyword=amino acids kn-keyword=amino acids END start-ver=1.4 cd-journal=joma no-vol=106 cd-vols= no-issue=3-4 article-no= start-page=325 end-page=334 dt-received= dt-revised= dt-accepted= dt-pub-year=1994 dt-pub=1994 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Enhancement of anti-tumor activity of 1-β-D-arabinofuranosyl-cytosine kn-title=1-β-D-arabinofuranosyl-cytosineの抗腫瘍効果増強に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=1-β-D-arabinofuranosyl-cytosine (ara-C) is one of the most effective agents in the chemo-therapy of acute non-lymphocytic leukemia (ANLL). Herein, the effects of uracil(U), deoxyuridine (UdR) and uridine (UR) on the anti-tumor activity of ara-C and on ara-C accumulation in the cells were studied. Growth-inhibition activities of ara-C alone and in combination with U, UdR and UR were determined by the trypan blue method. Cell-killing activities against MOLT-4, HL60, human leukemic progenitors (L-CFU) and human colony forming units (G-CSF) were determined by a colonogenic assay. The growth-inhibition activity of ara-C against MOLT-4 and HL60 was not enhanced by U or UdR. On the other hand, 10(-3)mol UR enhanced the growth-inhibition activity of ara-C against both MOLT-4 and HL60. The 50% inhibition dose (ID50) of ara-C was 6.0×10(-7)mol for MOLT-4 and 4.0×10(-7)mol for MOLT-4 and HL60. On the other hand, in the culture medium containing 10(-3)mol UR ID50 was 3.0×10(-8)mol for MOLT-4 and HL60. Cell-killing acticvity of ara-C was enhanced by 10(-3)mol UR. The 50% lethal dose (LD50) of ara-C for MOLT-4 and HL60 was decreased from 9.0×10(-7)mol to 5.0×10(-8)mol and from 5.0×10(-7)mol to 5.0×10(-8)mol after a 72-hour exposure to 10(-3)mol of UR, respectively. Cell-killing activity of ara-C against L-CFU was enhanced by 10(-3)mol UR in 4 of the 9 ANLL patients. On the other hand, the cell-killing activity of ara-C against G-CSF was enhanced in 2 of the 9 healthy individuals. 10(-8)mol ara-C, UR enhanced the cell-killing activity against L-CFU in 2 of the 9 ANLL patients, but not for G-CSF. Accumlation of (3)H-sra-C in MOLT-4 cells at 12, 24 and 48 hours was significantly increased in culture medium containing 10(-8)mol of (3)H-ara-C and 10(-3)mol of UR. Accumulation of 3H-ara-C in HL60 cells at 24 and 48 hours was also significantly increased. It is noteworthy that the cell-killing activity of ara-C against not only human lymphoid and myeloid leukemic cell lines but also L-CFU was enhanced by the combination with a nucleoside (UR), but not with anti-lrukemic agents. These findings provide some information on the enhancement of the anti-tumor activity and mechanims of resistance of ara-C. en-copyright= kn-copyright= en-aut-name=HayashiNaoki en-aut-sei=Hayashi en-aut-mei=Naoki kn-aut-name=林直樹 kn-aut-sei=林 kn-aut-mei=直樹 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=1-β-D-arabinofuranosyl-cytosine kn-keyword=1-β-D-arabinofuranosyl-cytosine en-keyword=cytosine arabinoside kn-keyword=cytosine arabinoside en-keyword=uridine kn-keyword=uridine en-keyword=enhancement of antitumor effect kn-keyword=enhancement of antitumor effect en-keyword=in vitro chemotherapy kn-keyword=in vitro chemotherapy END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=3 article-no= start-page=337 end-page=341 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20081201 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical practice guidelines and recommendations for diabetic nephropathy, anemia and medication in chronic kidney disease kn-title=慢性腎臓病の治療 (糖尿病腎症，貧血管理，薬物治療の注意点など） en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=MorinagaHiroshi en-aut-sei=Morinaga en-aut-mei=Hiroshi kn-aut-name=森永裕士 kn-aut-sei=森永 kn-aut-mei=裕士 aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name=杉山斉 kn-aut-sei=杉山 kn-aut-mei=斉 aut-affil-num=2 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name=槇野博史 kn-aut-sei=槇野 kn-aut-mei=博史 aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　慢性腎臓病対策腎不全治療学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎・免疫・内分泌代謝内科学 END start-ver=1.4 cd-journal=joma no-vol=106 cd-vols= no-issue=1-2 article-no= start-page=131 end-page=143 dt-received= dt-revised= dt-accepted= dt-pub-year=1994 dt-pub=199402 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The pathogenesis of iron deficiency anemia : Experimental iron deficiency derived from renal injury induced by Puromycin aminonucleoside kn-title=鉄欠乏性貧血の成因に関する研究―Puromycin aminonucleoside 投与腎障害に由来する実験的鉄欠乏状態の検討― en-subtitle= kn-subtitle= en-abstract= kn-abstract=To clarify the pathogenesis of idiopathic iron deficiency anemia, small amounts of Puromycin aminonucleoside (PAN) which is known to be nephrotoxic, was administered repeatedly to induce continuous urinary iron excretion in rats. Urinary iron, serum iron, stored iron content and hemoglobin concentration were investigated. Urinary iron excretion was increased by PAN administration along with increased excretion of urinary transferrin. Consequently, a large amount of urinary iron seemed to be was observed with respect to continuous urinary iron excretion, manifesting normocytic hypochromic anemia at 13th week. These results suggest that prolonged loss of small amounts of iron through the urinary tract causes iron deficiency without alinical manifestation of ranal failure. en-copyright= kn-copyright= en-aut-name=FujiiSoichiro en-aut-sei=Fujii en-aut-mei=Soichiro kn-aut-name=藤井総一郎 kn-aut-sei=藤井 kn-aut-mei=総一郎 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科学教室 en-keyword=urinary iron kn-keyword=urinary iron en-keyword=renal injury kn-keyword=renal injury en-keyword=iron deficiency anemia kn-keyword=iron deficiency anemia en-keyword=Puromycin aminonucleoside kn-keyword=Puromycin aminonucleoside en-keyword=rat kn-keyword=rat END start-ver=1.4 cd-journal=joma no-vol=108 cd-vols= no-issue=11-12 article-no= start-page=333 end-page=342 dt-received= dt-revised= dt-accepted= dt-pub-year=1997 dt-pub=19970228 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Clinical, radiographic, and histological studies on rapidly destructive coxopathy kn-title=急速破壊型股関節症の病態に関する研究 en-subtitle= kn-subtitle= en-abstract= kn-abstract=Clinical and radiological studies were performed on 25 hips of 25 patients with rapidly destructive coxopathy within 3 years after the onset. The mean age at the time of onset was 68.3 years. Two patients were males, and the other 23 were females ; many patients were aged females. The mean Japanese Orthopaedic Association hip score for pain was 13/40 while that for the range of motion (flexion) was 9.4/12. Inspite of marked pain, the motion range was relatively good. The mean disease duration was 10.3 months in the group showing an increased blood sedimentation rate and 20.8 months in the group with a normal sedimentation rate, being shorter in the former showing positive inflammatory reactios. Hypertension was observed in 44%. Radiographic examination showed osteoporosis in all patients. According to Singh's classification, the disease duration was shorter in patients with advanced osteoporosis. The Center-Edge angle and Acetabular-Head Index as the acetabular covering rate were below the mean value in 65%, showing slight dysplasia of hip joint. Histopathological examination revealed exposure of eburnated bone on the surface of the capital lesion in many patients, but only slight proliferative changes. In the synovial membrane, villous hyperplasia and cell proliferation were observed in the surface layer in most of patients. Free fragments of the cartilage and bone were phagositized with nonspecific inflammatory findings in the deep layer. en-copyright= kn-copyright= en-aut-name=IwasakiHiromitsu en-aut-sei=Iwasaki en-aut-mei=Hiromitsu kn-aut-name=岩崎裕光 kn-aut-sei=岩崎 kn-aut-mei=裕光 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部整形外科学教室 en-keyword=rapidly destructive coxopathy kn-keyword=rapidly destructive coxopathy en-keyword=osteoarthrosis kn-keyword=osteoarthrosis en-keyword=bone necrosis kn-keyword=bone necrosis END start-ver=1.4 cd-journal=joma no-vol=111 cd-vols= no-issue=3-8 article-no= start-page=61 end-page=69 dt-received= dt-revised= dt-accepted= dt-pub-year=1999 dt-pub=19990831 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Aging and exocrine pancreatic function evaluated by endoscopic retrograde aspiration of pure pancreatic juice kn-title=膵外分泌機能の加齢による変化 ―内視鏡的純粋膵液採取法による検討― en-subtitle= kn-subtitle= en-abstract= kn-abstract=I syudied the relationship between aging and exocrine pancreatic function by endoscopic retrograde aspiration of pure pancreatic juice (PPJ). Control subjects consisted of 65 out-patients presenting mild vague abdominal aymptoms who fulfilled the following three criteria : 1) good general condition with no known organic diseaes ; 2) no abnormality in the live, bile duct, pancreas. kidney or metabolism ; 3) no alcohol consumption. Nineteen patients with definite pancreatitis were also studied. PPJ was collected form within the pancreatic duct by endoscopic retrograde catheterization of the papilla for 10 minutes after a bolus intravenous injection of secretion (Secrepan, Eisai co., Ltd., 100 U/bpdy). Exocrine pancreatic function was evaluated three parameters as fillows : secretory volume, maximal bicarbonate concentration or bicarbonate output, and enyme (amyase and lipase) output. The ordinary duodenal secretin test was also performed. Exocrine pancreatic function (both duct-cell and acinar-cell function) was significantly reduced in the elderly. The age-associated reduction showed a different pattern between duct-cell and acinar-cell function. The degree of duct-cell dysfunction was significantly higher than that of acinar-cell dysfuntion in the elderly. Influence of aging on maximal bicarbonate concentration was more clearly demonstrated by PPJ aspiration than by the ordinary secretin test. Elderly controls showed as much exocrine dysfuction as patients with chronic pancreatitis, making it difificult to diagnose chronic pancreatitis based on the exocrine function test alone. Therfore, clinical symptoms and findings as well as imaging tests should be considered for the correct diagnosis. en-copyright= kn-copyright= en-aut-name=IshibashiTadaaki en-aut-sei=Ishibashi en-aut-mei=Tadaaki kn-aut-name=石橋忠明 kn-aut-sei=石橋 kn-aut-mei=忠明 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学医学部第二内科教室 en-keyword=加齢 kn-keyword=加齢 en-keyword=膵外分泌機能 kn-keyword=膵外分泌機能 en-keyword=内視鏡的純粋膵液採取法 kn-keyword=内視鏡的純粋膵液採取法 en-keyword=セクレチン試験 kn-keyword=セクレチン試験 en-keyword=慢性膵炎 kn-keyword=慢性膵炎 END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=2 article-no= start-page=215 end-page=218 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Introduction to chronic kidney disease treatment : Anti-hypertensive and dietary treatment kn-title=慢性腎臓病の治療総論 (降圧療法，食事療法を含めて) en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=InoueTatsuyuki en-aut-sei=Inoue en-aut-mei=Tatsuyuki kn-aut-name=井上達之 kn-aut-sei=井上 kn-aut-mei=達之 aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name=杉山斉 kn-aut-sei=杉山 kn-aut-mei=斉 aut-affil-num=2 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name=槇野博史 kn-aut-sei=槇野 kn-aut-mei=博史 aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 腎･免疫･内分泌代謝内科学 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 慢性腎臓病対策腎不全治療学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科 腎･免疫･内分泌代謝内科学 END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=2 article-no= start-page=159 end-page=168 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Examination of dialysis patients by a systematic review focused on serum phosphorus value kn-title=透析患者における至適血清リン値に関する文献による検討 en-subtitle= kn-subtitle= en-abstract= kn-abstract=In November 2006, The Japanese Society for Dialysis Therapy (JSDT) announced its first guideline, "The guideline for the management of secondary hyperparathyroidism in chronic dialysis patients," which gives the recommended range of management target values, especially for serum phosphorus, corrected serum calcium and serum intact parathyroid hormone concentrations. Recent studies have suggested that these factors are independently associated with mortality, especially increased cardiovascular mortality. In this research we focused on the serum phosphorus concentration because it is the highest clinical factor among these three. We systematically reviewed almost all documents that discussed the relation between serum phosphorus concentration and mortality as well as the "range of the management target value" specified by foreign guidelines from the US, UK, Canada, Australia and other countries. We summarized the finding concerning the serum phosphorus value of dialysis patients (especially the upper bound value). As a result, it was found that the "range of the management target value" varied among these guidelines. The reasons for this variation likely included differences in the measurement day, in the categories of serum phosphorus concentration, and in the exposure conditions among the studies to which the guidelines referred. Moreover, it was concluded that the Japanese guideline announced by the JSDT should be updated based on the results of future studies. en-copyright= kn-copyright= en-aut-name=TsukijiMakoto en-aut-sei=Tsukiji en-aut-mei=Makoto kn-aut-name=築地淳 kn-aut-sei=築地 kn-aut-mei=淳 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院環境学研究科　生命環境学専攻　国際保健学分野 en-keyword=透析患者 (dialysis patients) kn-keyword=透析患者 (dialysis patients) en-keyword=血清リン値 (phosphatemia) kn-keyword=血清リン値 (phosphatemia) en-keyword=CKD-MBD kn-keyword=CKD-MBD en-keyword=ガイドライン (guideline) kn-keyword=ガイドライン (guideline) en-keyword=生命予後 (prognosis) kn-keyword=生命予後 (prognosis) en-keyword=JSDT kn-keyword=JSDT END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=1 article-no= start-page=83 end-page=86 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080501 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=The diagnosis and follow-up of chronic kidney disease kn-title=慢性腎臓病の診断とフォローアップ en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=KinomuraMasaru en-aut-sei=Kinomura en-aut-mei=Masaru kn-aut-name=木野村賢 kn-aut-sei=木野村 kn-aut-mei=賢 aut-affil-num=1 ORCID= en-aut-name=SugiyamaHitoshi en-aut-sei=Sugiyama en-aut-mei=Hitoshi kn-aut-name=杉山斉 kn-aut-sei=杉山 kn-aut-mei=斉 aut-affil-num=2 ORCID= en-aut-name=MakinoHirofumi en-aut-sei=Makino en-aut-mei=Hirofumi kn-aut-name=槇野博史 kn-aut-sei=槇野 kn-aut-mei=博史 aut-affil-num=3 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎･免疫･内分泌代謝内科学 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　慢性腎臓病対策腎不全治療学 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　腎･免疫･内分泌代謝内科学 END