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21.
Toshihiro Sawai Masaomi Nangaku Akira Ashida Rika Fujimaru Hiroshi Hataya Yoshihiko Hidaka Shinya Kaname Hirokazu Okada Waichi Sato Takashi Yasuda Yoko Yoshida Yoshihiro Fujimura Motoshi Hattori Shoji Kagami 《Clinical and experimental nephrology》2014,18(1):4-9
Atypical hemolytic uremic syndrome (aHUS) is rare and comprises the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Recently, abnormalities in the mechanisms underlying complement regulation have been focused upon as causes of aHUS. The prognosis for patients who present with aHUS is very poor, with the first aHUS attack being associated with a mortality rate of ~25 %, and with ~50 % of cases resulting in end-stage renal disease requiring dialysis. If treatment is delayed, there is a high risk of this syndrome progressing to renal failure. Therefore, we have developed diagnostic criteria for aHUS to enable its early diagnosis and to facilitate the timely initiation of appropriate treatment. We hope these diagnostic criteria will be disseminated to as many clinicians as possible and that they will be used widely. 相似文献
22.
Takao Saito Masayuki Iwano Koichi Matsumoto Tetsuya Mitarai Hitoshi Yokoyama Noriaki Yorioka Shinichi Nishi Ashio Yoshimura Hiroshi Sato Satoru Ogahara Hideki Shuto Yasufumi Kataoka Shiro Ueda Akio Koyama Shoichi Maruyama Masaomi Nangaku Enyu Imai Seiichi Matsuo Yasuhiko Tomino The Refractory Nephrotic Syndrome Study Group 《Clinical and experimental nephrology》2014,18(5):784-794
Background
Combined treatment with cyclosporine microemulsion preconcentrate (CyA MEPC) and steroids has been widely used for idiopathic membranous nephropathy (IMN) associated with steroid-resistant nephrotic syndrome (SRNS). Recent studies have shown that once-a-day and preprandial administration of CyA MEPC is more advantageous than the conventional twice-a-day administration in achieving the target blood CyA concentration at 2 h post dose (C2). We designed a randomized trial to compare these administrations.Methods
IMN patients with SRNS (age 16–75 years) were divided prospectively and randomly into 2 groups. In group 1 (n = 23), 2–3 mg/kg body weight (BW) CyA MEPC was given orally once a day before breakfast. In group 2 (n = 25), 1.5 mg/kg BW CyA MEPC was given twice a day before meals. CyA + prednisolone was continued for 48 weeks.Results
Group 1 showed a significantly higher cumulative complete remission (CR) rate (p = 0.0282), but not when incomplete remission 1 (ICR1; urine protein 0.3–1.0 g/day) was added (p = 0.314). Because a C2 of 600 ng/mL was determined as the best cut-off point, groups 1 and 2 were further divided into subgroups A (C2 ≥600 ng/mL) and B (C2 <600 ng/mL). Groups 1A and 2A revealed significantly higher cumulative remission (CR + ICR1) (p = 0.0069) and CR-alone (p = 0.0028) rates. On the other hand, 3 patients with high CyA levels (C2 >900 ng/mL) in Group 1A were withdrawn from the study because of complications.Conclusion
CyA + prednisolone treatment is effective for IMN with associated SRNS at a C2 of ≥600 ng/mL. To achieve remission, preprandial once-a-day administration of CyA at 2–3 mg/kg BW may be the most appropriate option. However, we should adjust the dosage of CyA by therapeutic drug monitoring to avoid complications. 相似文献23.
Hiromichi Ishiyama Takefumi Satoh Masashi Kitano Ken-ichi Tabata Shouko Komori Masaomi Ikeda Itaru Soda Shinji Kurosaka Akane Sekiguchi Masaki Kimura Shogo Kawakami Masatsugu Iwamura Kazushige Hayakawa 《Journal of radiation research》2014,55(3):509-517
The purpose of this study was to report the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiotherapy (EBRT) combined with long-term androgen deprivation therapy (ADT) for National Comprehensive Cancer Network (NCCN) criteria-defined high-risk (HR) and very high-risk (VHR) prostate cancer. Data from 178 HR (n = 96, 54%) and VHR (n = 82, 46%) prostate cancer patients who underwent 192Ir-HDR brachytherapy and hypofractionated EBRT with long-term ADT between 2003 and 2008 were retrospectively analyzed. The mean dose to 90% of the planning target volume was 6.3 Gy/fraction of HDR brachytherapy. After five fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administered. All patients initially underwent ≥6 months of neoadjuvant ADT, and adjuvant ADT was continued for 36 months after EBRT. The median follow-up was 61 months (range, 25–94 months) from the start of radiotherapy. The 5-year biochemical non-evidence of disease, freedom from clinical failure and overall survival rates were 90.6% (HR, 97.8%; VHR, 81.9%), 95.2% (HR, 97.7%; VHR, 92.1%), and 96.9% (HR, 100%; VHR, 93.3%), respectively. The highest Radiation Therapy Oncology Group-defined late genitourinary toxicities were Grade 2 in 7.3% of patients and Grade 3 in 9.6%. The highest late gastrointestinal toxicities were Grade 2 in 2.8% of patients and Grade 3 in 0%. Although the 5-year outcome of this tri-modality approach seems favorable, further follow-up is necessary to validate clinical and survival advantages of this intensive approach compared with the standard EBRT approach. 相似文献
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26.
Goro Fukami Tasuku Hashimoto Yukihiko Shirayama Tadashi Hasegawa Hiroyuki Watanabe Mihisa Fujisaki Kenji Hashimoto Masaomi Iyo 《Annals of general psychiatry》2010,9(1):1-7
Background
Benzodiazepines carry the risk of inducing cognitive impairments, which may go unnoticed while profoundly disturbing social activity. Furthermore, these impairments are partly associated with the elimination half-life (EH) of the substance from the body. The object of the present study was to examine the effects of etizolam and ethyl loflazepate, with EHs of 6 h and 122 h, respectively, on information processing in healthy subjects.Methods
Healthy people were administered etizolam and ethyl loflazepate acutely and subchronically (14 days). The auditory P300 event-related potential and the neuropsychological batteries described below were employed to assess the effects of drugs on cognition. The P300 event-related potential was recorded before and after drug treatments. The digit symbol test, trail making test, digit span test and verbal paired associates test were administered to examine mental slowing and memory functioning.Results
Acute administration of drugs caused prolongation in P300 latency and reduction in P300 amplitude. Etizolam caused a statistically significant prolongation in P300 latency compared to ethyl loflazepate. Furthermore, subchronic administration of etizolam, but not ethyl loflazepate, still caused a weak prolongation in P300 latency. In contrast, neuropsychological tests showed no difference.Conclusions
The results indicate that acute administration of ethyl loflazepate induces less effect on P300 latency than etizolam. 相似文献27.
The familial occurrence of epidermoid cysts of the spleen is rare, with only six cases having ever been reported, to our knowledge.
We recently diagnosed epidermoid cysts of the spleen in a mother and son. First, a 15-year-old boy was admitted to our hospital
for management of blunt abdominal trauma. Computed tomography (CT) showed a ruptured large splenic cyst with an intraabdominal
hematoma. We performed a splenectomy, and histopathological examination confirmed the existence of an epidermoid cyst of the
spleen. About 2 years and 6 months later, the family physician found that the patient's 41-year-old mother had a large splenic
cyst, and she was referred to our hospital for further investigation. CT showed a 10 × 8 cm cyst occupying most of the spleen.
The patient underwent splenectomy, and a pathological diagnosis of an epidermoid cyst of the spleen was confirmed. Although
the etiology of epidermoid cysts of the spleen is unclear, this familial occurrence may support the hypothesis of congenital
malformation as a result of genetic change. 相似文献
28.
Gen Taniguchi Masatoshi Nakajima Keiichi Hosaka Nanako Iwamoto Masaomi Ikeda Richard M. Foxton Junji Tagami 《Journal of dentistry》2009,37(10):769-775
Objective
To evaluate the effect of sodium hypochlorite pretreatment on adhesion to normal and caries-affected dentin using self-etch adhesives.Methods
Forty extracted human molars with coronal carious lesions were used in this experiment. The occlusal dentin surfaces including the caries-affected dentin in each group were treated as follows: group 1, rinsed with water; group 2, treated with 6% NaOCl for 15 s; group 3, treated with 6% NaOCl for 30 s; group 4, application with Accel for 30 s after NaOCl-30 s pretreatment. After rinsing with water and air-drying, the treated dentin surfaces were applied with self-etch systems (Bond Force and Clearfil Protect Bond) according to the manufacturers’ instructions, and built-up with resin composite. After 37 °C water storage for 24 h, the bonded normal or caries-affected dentin areas were isolated to create an hourglass configuration with a cross-sectional area of approximately 1 mm2. The specimens were subjected to tensile stress at a cross-head speed of 1.0 mm/min.Results
NaOCl-15 s pretreatment significantly improved the μTBS of both self-etch adhesives to caries-affected dentin, while the 30 s pretreatment did not affect them. For normal dentin, NaOCl-30 s pretreatment significantly reduced the μTBS of both self-etch adhesives although the 15 s pretreatment did not alter them. Furthermore, the application of Accel with a reducing effect increased the μTBS to normal and caries-affected dentin treated with NaOCl for 30 s.Conclusions
The effects of NaOCl pretreatment on bonding of both self-etch adhesives were dependent upon type of dentin (normal and caries-affected dentin) and the treatment time. 相似文献29.
Expression of MUC5AC and MUC6 in invasive ductal carcinoma of the pancreas and relationship with prognosis 总被引:2,自引:0,他引:2
Jinfeng M Kimura W Hirai I Sakurai F Moriya T Mizutani M 《Journal of gastrointestinal cancer》2003,34(1):9-18
AIM/BACKGROUND: MUC5AC and MUC6 are two major types of mucin that are abundantly present in the stomach; both of them form a gel of high viscosity that provides protection and lubrication. Expressions of MUC5AC and MUC6 are seen in pancreatic neoplasms, whereas the relationships between MUC5AC/MUC6 expression and clinicopathological factors and patient prognosis in invasive ductal carcinoma (IDC) of the pancreas have not been investigated. The aim of this study was to investigate MUC5AC and MUC6 expressions in IDC with special reference to clinicopathological factors and patient prognosis. METHODS: Tissue samples were taken from 33 patients with IDC of the pancreas after radical surgical treatment. MUC5AC and MUC6 expressions were examined immunohistochemically. RESULTS: The expressions of MUC5AC and MUC6 were observed in the cytoplasm of the tumor cells. MUC5AC and MUC6 immunoreactivities in the cancer tissues were found in 21 (63.6%) and 15 (45.5%) of 33 cases of IDC of the pancreas, respectively. MUC5AC-negative expression was associated significantly with lymphatic invasion, venous invasion, lymph node metastasis, and MUC5AC-positive patients showed significant better survival than those MUC5AC-negative patients. MUC6 expression was significantly related to tumor location, whereas MUC6 expression did not show significant relationship with patient survival. CONCLUSION: The results indicate that MUC5AC expression plays an important role in impacting tumor progression in IDC of the pancreas. MUC5AC expression is a benefit to better survival of patients with IDC of the pancreas. MUC6 expression is not involved in tumor progression in IDC of the pancreas. 相似文献
30.
Kenichi Shikata Sadayoshi Ito Naoki Kashihara Masaomi Nangaku Takashi Wada Yasuyuki Okuda Tomoko Sawanobori Kotaro Sugimoto 《Journal of diabetes investigation.》2022,13(7):1190
Aims/IntroductionWe 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 MethodsWe 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.ResultsIn 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.ConclusionsIn 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. 相似文献