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Koyama T, Kita Y, Makinouchi R, Machida S, Shirai S, Imai N. Frailty and dialysis initiation in the super-elderly. Clin Exp Nephrol 2024:10.1007/s10157-023-02453-8. [PMID: 38206541 DOI: 10.1007/s10157-023-02453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Teppei Koyama
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Yohei Kita
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Ryuichiro Makinouchi
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Shinji Machida
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan
| | - Naohiko Imai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama City Seibu Hospital, 1197-1 Yasashico, Asahi-ku, Yokohama, Kanagawa, Japan.
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Tomosugi N, Koshino Y, Ogawa C, Maeda K, Shimada N, Tomita K, Daimon S, Shikano T, Ryu K, Takatani T, Sakamoto K, Ueyama S, Nagasaku D, Nakamura M, Ra S, Nishimura M, Takagi C, Ishii Y, Kudo N, Takechi S, Ishizu T, Yanagawa T, Fukuda M, Nitta Y, Yamaoka T, Saito T, Imayoshi S, Omata M, Oshima J, Onozaki A, Ichihashi H, Matsushima Y, Takae H, Nakazawa R, Ikeda K, Tsuboi M, Konishi K, Kato S, Ooura M, Koyama M, Naganuma T, Ogi M, Katayama S, Okumura T, Kameda S, Shirai S. Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial. Int J Mol Sci 2023; 24:13779. [PMID: 37762085 PMCID: PMC10531220 DOI: 10.3390/ijms241813779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body's iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (-0.459, -0.643 to -0.276, p = 0.000; -0.648, -1.099 to -0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (-1.392, -1.749 to -1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.
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Affiliation(s)
- Naohisa Tomosugi
- Division of Systems Bioscience for Drug Discovery, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku 920-0293, Ishikawa, Japan
| | | | - Chie Ogawa
- Maeda Institute of Renal Research Musashikosugi, Kawasaki 211-0063, Kanagawa, Japan;
| | - Kunimi Maeda
- Maeda Institute of Renal Research Shakujii, Nerima 177-0041, Tokyo, Japan;
| | | | - Kimio Tomita
- The Chronic Kidney Disease Research Center, Tomei Atsugi General Hospital, Atsugi 243-8571, Kanagawa, Japan;
| | - Shoichiro Daimon
- Department of Nephrology, Daimon Clinic for Internal Medicine, Nonoichi 921-8802, Ishikawa, Japan;
| | - Tsutomu Shikano
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Kazuyuki Ryu
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Toru Takatani
- Nephrology Division, Tojinkai Hospital, Fushimi 612-8026, Kyoto, Japan;
| | - Kazuya Sakamoto
- Department of Urology, Tomakomai Nisshou Hospital, Tomakomai 053-0803, Hokkaido, Japan;
| | - Satonori Ueyama
- Jinaikai Ueyama Hospital, Kagoshima 890-0073, Kagoshima, Japan;
| | | | | | - Shibun Ra
- Noheji Clinic, Noheji 039-3152, Aomori, Japan;
| | | | | | - Yoji Ishii
- Nozatomon Clinic, Himeji 670-0011, Hyogo, Japan;
| | | | | | - Takashi Ishizu
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | - Takamoto Yanagawa
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | | | - Yutaka Nitta
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Takayuki Yamaoka
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Taku Saito
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Suzuko Imayoshi
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Momoyo Omata
- Department of Internal Medicine, Hachioji Azumacho Clinic, Hachioji-shi 192-0082, Tokyo, Japan;
| | - Joji Oshima
- Kubojima Clinic, Kumagaya 360-0831, Saitama, Japan;
| | - Akira Onozaki
- Tokatsu-Clinic Hospital, Matsudo 271-0067, Chiba, Japan;
| | | | | | | | | | - Koichi Ikeda
- Tokatsu Clinic Koiwa, Edogawa 133-0056, Tokyo, Japan;
| | - Masato Tsuboi
- Kaikoukai Anjo Kyoritsu Clinic, Anjo 446-0065, Aichi, Japan;
| | | | - Shouzaburo Kato
- Nishi Interchange Clinic for Internal Medicine and Dialysis, Kanazawa 921-8001, Ishikawa, Japan;
| | - Maki Ooura
- Maro Clinic, Tanabe 646-0004, Wakayama, Japan;
| | | | - Tsukasa Naganuma
- Department of Nephrology, Yamanashi Prefectural Central Hospital, Kofu 400-0027, Yamanashi, Japan;
| | - Makoto Ogi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, Gotemba 412-0043, Shizuoka, Japan;
| | | | | | - Shigemi Kameda
- Joetsu General Hospital, Joetsu 943-8507, Niigata, Japan;
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, Yokohama 241-0811, Kanagawa, Japan;
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Ogata M, Yazawa M, Terashita M, Osako K, Shirai S. Acute tubulointerstitial nephritis possibly caused by vedolizumab for ulcerative colitis in a kidney transplant recipient: A case report. Clin Nephrol 2023:CN111029. [PMID: 37288829 DOI: 10.5414/cn111029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 06/09/2023] Open
Abstract
Vedolizumab, which is used to effectively treat ulcerative colitis (UC), is a humanized monoclonal antibody that specifically inhibits α4β7 integrin on lymphocytes and prevents lymphocyte migration into the intestinal tissues. Herein, we report a case of acute tubulointerstitial nephritis (ATIN) probably caused by vedolizumab in a kidney transplant recipient (KR) with UC. Approximately 4 years after kidney transplantation, the patient developed UC and was treated initially with mesalazine. Treatment continued with the addition of infliximab later; however, he was hospitalized because of poor symptom control and treated with vedolizumab. His graft function declined rapidly after vedolizumab was administered. Allograft biopsy revealed ATIN. Since no evidence of graft rejection was found, vedolizumab-associated ATIN was diagnosed. The patient was treated with steroids, and his graft function improved. Unfortunately, he finally underwent total colectomy considering that UC was refractory to medical treatment. Previously, cases of vedolizumab-induced acute interstitial nephritis have been reported; however, none were associated with KRs. This is the first report of ATIN in KR which was possibly induced by vedolizumab.
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Shirai S, Yasuda T, Kumagai H, Matsunobu H, Ichikawa D, Shibagaki Y, Yasuda Y, Matsuzaki K, Hirano K, Kawamura T, Suzuki Y, Maruyama S. Prognostic factors of IgA nephropathy presenting with mild proteinuria at the time of diagnosis (a multicenter cohort study). Clin Exp Nephrol 2023; 27:340-348. [PMID: 36705811 PMCID: PMC10023643 DOI: 10.1007/s10157-023-02316-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Clinical factors affecting renal prognosis in patients with immunoglobulin A nephropathy (IgAN) and low urinary protein excretion (U-Prot) remain unclear. This study evaluated such factors in patients with clinical grade I (CG-I) IgAN with U-Prot < 0.5 g/day. METHODS This secondary analysis of a previous retrospective study included 394 patients with CG-I IgAN. The primary outcome was the first occurrence of a 1.5-fold increase in serum creatinine levels from baseline. Factors related to renal prognosis were examined using univariate and multivariate Cox regression analyses. CG-I was divided into C-Grade Ia (CG-Ia) (n = 330) with baseline eGFR ≥ 60 ml/min/1.73 m2, and C-Grade Ib (CG-Ib) (n = 64) with baseline eGFR < 60 ml/min/1.73 m2. Outcome incidence was compared between conservative and aggressive therapy (corticosteroids and/or tonsillectomy) groups. RESULTS Overall outcome incidence was significantly higher in CG-Ib than in CG-Ia; the cumulative incidence was significantly higher in CG-Ib (hazard ratio, 9.67; 95% confidence interval, 2.90-32.23). Older age, higher IgA levels, eGFR < 60 mL/min/1.73 m2, lower eGFR at baseline were independent prognostic factors for CG-I. Older age, lower eGFR, higher IgA levels at baseline, and U-Prot remission at 1-year post-diagnosis were independent prognostic factors for CG-Ib. Aggressive therapy tended to suppress the cumulative outcome incidence compared with conservative therapy in CG-Ib (p = 0.087). CONCLUSION An eGFR < 60 mL/min/1.73 m2 is a significant predictor of renal prognosis in patients with IgAN and U-Prot < 0.5 g/day.
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Affiliation(s)
- Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
| | - Takashi Yasuda
- Department of Internal Medicine, Kichijoji Asahi Hospital, Tokyo, Japan
| | - Hiroo Kumagai
- Department of Nephrology and Endocrinology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hanako Matsunobu
- Division of Nephrology, Self-Defense Forces Central Hospital, Tokyo, Japan
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshinari Yasuda
- Department of Nephrology/CKD Initiatives, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Keita Hirano
- Division of Nephrology, Department of Internal Medicine, Ashikaga Red Cross Hospital, Ashikaga, Japan
| | - Tetsuya Kawamura
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Shoichi Maruyama
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Nagoya, Japan
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Kohatsu K, Suzuki T, Takimoto M, Matsui K, Hashiguchi A, Koike J, Shirai S. Granulomatous interstitial nephritis with CTLA-4 haploinsufficiency: a case report. BMC Nephrol 2022; 23:367. [PMID: 36384506 PMCID: PMC9670605 DOI: 10.1186/s12882-022-02999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cytotoxic T lymphocyte antigen-4 (CTLA-4) is an essential inhibitory regulator of immune activation. CTLA-4 haploinsufficiency is known to be associated with dysregulation of FOXP3+ regulatory T cells, hyperactivation of effector T cells, and lymphocytic infiltration of multiple organs. However, there have only been a few reports of renal involvement with CTLA-4. Herein, we present a case of acute granulomatous tubulointerstitial nephritis (TIN) in a patient with CTLA-4 haploinsufficiency. CASE PRESENTATION A 44-year-old man presented with a 3-week history of fever and malaise, and subsequently developed acute kidney injury (AKI) a few days after treatment with levofloxacin (LVFX). A kidney biopsy and immunohistochemical staining revealed granulomatous TIN with dominantly infiltrating CD4+ T cells. General symptoms and renal impairment showed improvement after discontinuation of LVFX and initiation of oral steroids. However, they worsened following steroid tapering. Further, a colon biopsy analysis showed similar findings to the renal tissue analysis. We suspected that granulomatous TIN was possibly associated with CTLA-4 haploinsufficiency. Therefore, the patient was transferred to another hospital for further treatment of CTLA-4 haploinsufficiency using immunosuppressive agents. CONCLUSIONS There have been few reports regarding renal involvement of CTLA-4 haploinsufficiency. In the present case, granulomatous TIN could have arisen due to instability of immune regulatory functions, such as CTLA-4 haploinsufficiency, and treatment with LVFX could have triggered immunologic activation and severe inflammation as well as renal dysfunction.
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Affiliation(s)
- Kaori Kohatsu
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tomo Suzuki
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Madoka Takimoto
- Department of Hematology, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Katsuomi Matsui
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Akinori Hashiguchi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Junki Koike
- Department of Diagnostic Pathology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
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Shirai S, Wang W, Guo T, Buryanek J, Chen L. Plasma cell neoplasm with initial presentation as an ovarian mass: a rare case report. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Plasmacytoma is a discrete, solitary mass of neoplastic plasma cells. Extramedullary plasmacytoma (EMP) is a rare entity arising in tissues other than bone and it constitutes about 1% of all plasma cell neoplasms. Most cases of reported EMPs are in the upper aerodigestive tract (~80%). We present a very rare case with the initial presentation as an ovarian mass with metastasis into the peritoneal and pleural cavity.
Methods/Case Report
This is a 66-year-old female who presented with generalized abdominal pain, unexpected weight loss, and occasional fever and night sweats. Computed tomography (CT) scan of abdomen and pelvis showed an extensive metastatic disease including bilateral cardiophrenic angle lymphadenopathy, peritoneal spread encasing the bowel loops, bladder, and uterus as well as moderate right pleural effusion. The positron emission tomography (PET)-CT showed an ill-defined soft tissue density in the pelvis with hypermetabolism. The pelvic ultrasound showed a 2.6 x 2.2 x 1.1 cm hypoechoic mass in the left adnexa. The patient's serum cancer antigen (CA-125) was elevated at 123 U/mL and the post-thoracentesis chest x-ray was unremarkable with no acute osseous abnormalities. Other clinical data were not available.
Results (if a Case Study enter NA)
Cytopathologic evaluation of the pleural fluid showed abundant atypical cells with eccentrically located nuclei, scant to moderate cytoplasm with a paranuclear hof, frequent binucleation and mitoses. The cells ranged in size from small to large. Further immunohistochemical (IHC) analysis on the cell block showed that the tumor cells diffusely positive for CD138 and lambda light chain and negative for MOC31, BerEP4, calretinin, D2-40, WT1, HHV8, ALK1, and EBER in situ hybridization (ISH). The biopsy of the left adnexal mass showed a diffuse proliferation of tumor cells with frequent mitotic figures. The IHC analysis on the biopsy specimen showed tumor cells positive for CD79a and CD56 (weak) and negative for CD20 and PAX5. Kappa/lambda ISH analysis confirmed lambda light chain restriction of the tumor cells. These morphological and immunophenotypic features were consistent with plasma cell neoplasm.
Conclusion
The ovary is an unusual location to be involved by plasma cell neoplasm. We use this case to remind the pathologists and clinicians that ovarian plasmacytoma can be the initial presentation of the plasma cell neoplasm, although rare, and to aid the patients to receive an appropriate treatment. A thorough workup is needed to make an accurate diagnosis of this entity.
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Affiliation(s)
- S Shirai
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - W Wang
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - T Guo
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - J Buryanek
- Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston , Houston, Texas , United States
| | - L Chen
- Hematopathology, MD Anderson Cancer Center , Houston, Texas , United States
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Nagai A, Nagai T, Yaguchi H, Fujii S, Horiuchi K, Ura S, Shirai S, Iwata I, Matsushima M, Anzai T, Yabe I. VP.45 Clinical features of anti-mitochondrial M2 antibody-positive myositis: Case series of 17 patients. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Sato H, Ichikawa D, Okada E, Suzuki T, Watanabe S, Shirai S, Shibagaki Y. Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy. PLoS One 2021; 16:e0251294. [PMID: 34043669 PMCID: PMC8159003 DOI: 10.1371/journal.pone.0251294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background There are few studies describing the clinical course and spontaneous remission of IgA nephropathy (IgAN) in adult patients receiving conservative treatment. Method Data from 62 adult patients with biopsy-diagnosed IgAN, who received conservative treatment at least 5 years prior, were retrospectively investigated. No patients received corticosteroids, other immunosuppressants, or tonsillectomy. Remission of proteinuria and hematuria were defined as proteinuria <0.3 g/gCr and urine red blood cells (RBC) <5 / high power field (HPF) on three consecutive urinalyses obtained during an observation period of ≥6 months. Result Thirty-eight (61.3%) patients had remission of hematuria, 24 (38.7%) had remission of proteinuria, and 19 (30.6%) had remission of both. Remission rates increased in patients with proteinuria <0.5 g/g Cr at diagnosis. The median time to remission of hematuria was 2.8 years and that of proteinuria was 2.6 years. Patients who showed renal function decline (defined as 30% decline of estimated glomerular filtration rate [eGFR] from baseline) were older, had significantly lower eGFR, and higher proteinuria at diagnosis. Two patients with preserved renal function and normal proteinuria at diagnosis experienced renal function decline. Renal function did not decline within 3 years of diagnosis in patients with proteinuria <1 g/gCr at diagnosis. Conclusions Relatively high rates of spontaneous remission were observed. Remission of both hematuria and proteinuria were frequent within 3 years after diagnosis, and renal function was well preserved during this period. These data indicate that it is rational to use conservative treatment for 3 years after the diagnosis instead of aggressive treatments.
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Affiliation(s)
- Hirotaka Sato
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Eri Okada
- Kidney Center, National Hospital Organization Chiba-East Hospital, Chiba, Japan
| | - Tomo Suzuki
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Shiika Watanabe
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, Kanagawa, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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Yamauchi Y, Saito Y, Shirai S, Yokote F, Sakai T, Dejima H, Sakao Y, Kawamura M. P04.08 Dynamics of Coagulation Factor XIII Activity After Thoracoscopic Lobectomy for Early-Stage Lung Cancer Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Ishizu K, Takiguchi H, Ito S, Taniguchi T, Kawaguchi T, Hayashi M, Isotani A, Yamaji K, Shirai S, Ando K. Impact of tapered-shaped left ventricular outflow tract on permanent pacemaker implantation after the third-generation balloon-expandable valve implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the era of transcatheter aortic valve implantation (TAVI) for patients with lower surgical risk, conduction disturbances requiring permanent pacemaker implantation (PPI) after TAVI remain a serious concern. The association between tapered-shaped left ventricular outflow tract (LVOT) and PPI after TAVI has not been elucidated.
Purposes
This study sought to identify predictors for PPI after TAVI with the third-generation balloon-expandable valve, with focus on LVOT morphology.
Methods
Of 272 consecutive patients treated with the third-generation balloon-expandable valve, 256 patients without previous PPI or bicuspid valve were retrospectively analyzed.
Results
PPI was implanted after TAVI in 20 (7.8%) patients. Patients requiring PPI had smaller LVOT area (356.3 mm2 vs. 399.4 mm2, p=0.011). Moreover, receiver-operating characteristic (ROC) statistics showed that LVOT area /annulus area possessed significantly higher predictive ability than LVOT area (area under the curve: 0.91 [95% confidence interval [CI]: 0.84 to 0.95] vs. 0.67 [95% CI: 0.57 to 0.77], p<0.001). Multivariable analysis revealed LVOT area /annulus area (odds ratio [OR]: 1.93 [95% CI: 1.38–2.71]; p<0.001 per % of decreasing), the difference between membranous septum length and implantation depth (ΔMSID) (OR: 6.82 [95% CI 2.39–19.48]; p<0.001 per mm of decreasing) and pre-existing complete right bundle branch block (CRBBB) (OR: 32.38 [95% CI 2.30–455.63]; p=0.002) as independent predictors of PPI. Further analysis using ROC statistics revealed LVOT area / annulus area of 88.5% and ΔMSID of 1.8 mm as the optimal cutoff points for prediction of PPI after the third-generation balloon-expandable valve implantation, with high negative predictive values of 98.1% and 99.0%, respectively. Figure shows the PPI rates stratified by the number of following predictors: LVOT area /annulus area <88.5%, ΔMSID <1.8 mm and pre-existing CRBBB. Patients with 2 or more predictors had significantly higher PPI rates than those with 1 or less predictor (67% [18 of 27 patients] vs. 1% [2 of 229 patients], p<0.001).
Conclusions
LVOT area /annulus area, ΔMSID and pre-existing CRBBB were identified as powerful independent predictors for PPI after TAVI. Higher valve implantation is important to prevent excessive PPI especially for patients with pre-procedural tapered-shaped LVOT, short membranous septum or pre-existing CRBBB.
PPI rates stratified by predictors
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Ishizu
- Kokura Memorial Hospital, Fukuoka, Japan
| | | | - S Ito
- Kokura Memorial Hospital, Fukuoka, Japan
| | | | | | - M Hayashi
- Kokura Memorial Hospital, Fukuoka, Japan
| | - A Isotani
- Kokura Memorial Hospital, Fukuoka, Japan
| | - K Yamaji
- Kokura Memorial Hospital, Fukuoka, Japan
| | - S Shirai
- Kokura Memorial Hospital, Fukuoka, Japan
| | - K Ando
- Kokura Memorial Hospital, Fukuoka, Japan
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11
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Hiromasa T, Kuramitsu S, Yamaji K, Domei T, Hyodo M, Soga Y, Shirai S, Ando K. Impact of SYNTAX score 2 on 7-year clinical outcomes in patients treated with cobalt-chromium everolimus-eluting stent. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Impact of SYNTAX score II (SSII) on long-term clinical outcomes after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation remains unclear.
Methods
Between February 2010 and May 2011, 1064 consecutive patients with 1440 lesions were treated only with CoCr-EES implantation. Of these, the SSII was calculated in 1013 patients with 1345 lesions. Patients were divided into the tertile group: Tertiles for SSII (low SSII [12–28.9], n=334; intermediate SSII [29–39.1], n=339; and high SSII [39.2–80.8], n=340). We assessed the cumulative 7-year incidences of major adverse cardiac events (MACE), defined as a composite of cardiac death, myocardial infarction, definite stent thrombosis, and clinically driven target lesion revascularization (CDTLR) based on SSII groupings.
Results
Cumulative 7-year incidence of MACE was significantly higher in the high SSII group than in the other groups (34.1% vs. 18.6% vs. 17.2%, p<0.001). The cumulative incidence of cardiac death, myocardial infarction and stent thrombosis were significantly higher in the high SSII group than in the other groups (22.1% vs. 2.0% vs. 5.3%, p<0.001; 6.6% vs. 4.9% vs. 1.7%, p=0.01; 2.9% vs. 1.7% vs. 0.3%, p=0.03, respectively). The cumulative incidence of CDTLR was similar between the groups (15.2% vs. 12.8% vs. 15.7%, p=0.57). High SSII group (hazard ratio [HR] 2.18 [vs. low SS], 95% confidence intervals [CI]: 1.56–3.06, p<0.001) and diabetes mellitus (HR 1.37, 95% CI: 1.04–1.81, p=0.03) were predictors of 7-year MACE.
Conclusions
SSII has significantly impact on 7 years clinical outcomes after CoCr-EES implantation.
Cumulative incidence of MACE
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Hiromasa
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - K Yamaji
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - T Domei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodo
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Soga
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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12
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Mori S, Ito Y, Kishida T, Fukagawa T, Nakano T, Makino K, Mizusawa M, Shirai S, Honda Y, Tsutsumi M, Sakamoto Y, Kobayashi N, Araki M, Yamawaki M, Hirano K. Occurrence and clinical course of peri-stent contrast staining: comparison between second-generation drug-eluting stents and third generation drug-eluting stents. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Peri-stent contrast staining (PSS) has been reported to be associated with very late stent thrombosis.
The aims of this study was to compare the occurrence rate of PSS between second generation drug-eluting stents (2nd DES) and third generation drug-eluting stents (3rd DES), and to identify clinical characteristics associated with PSS.
Methods and results
This study comprised 1899 patients with 2493 de novo lesions treated with 2nd or 3rd DES from October 2015 to September 2018. Follow-up angiography was available for 1883 lesions (75.5%). There were 725 patients with 968 lesions treated with 2nd DES, and 716 patients with 915 lesions treated with 3rd DES. The occurrence of PSS, types of PSS, and VLST related to PSS were compared between 2nd and 3rd DES implantation. Mean follow-up period was 30±12 months. The occurrence rate of PSS and segmental type of PSS were similar between two groups (2nd DES vs. 3rd DES, 1.5% vs. 1.7%, p=0.73, 47% vs. 50%, p=0.85, and respectively). The VLST related to PSS occurred in only one case in 3rd DES group. (0% vs. 6.3%, p=0.33).
Conclusion
The occurrence rate of PSS and clinical course were similar between 2nd and 3rd DES.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Mori
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - Y Ito
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - T Kishida
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - T Fukagawa
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - T Nakano
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - K Makino
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - M Mizusawa
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - S Shirai
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - Y Honda
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - M Tsutsumi
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - Y Sakamoto
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - N Kobayashi
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - M Araki
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - M Yamawaki
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
| | - K Hirano
- Saiseikai Yokohama City Eastern Hospital, Cardiology, Yokohama, Japan
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13
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Suzuki T, Ichikawa D, Nakata M, Watanabe S, Han W, Kohatsu K, Shirai S, Imai N, Koike J, Shibagaki Y. Nephrotic syndrome due to preeclampsia before 20 weeks of gestation: a case report. BMC Nephrol 2020; 21:240. [PMID: 32600286 PMCID: PMC7322849 DOI: 10.1186/s12882-020-01876-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023] Open
Abstract
Background Preeclampsia (PE) refers to the development of hypertension and new-onset proteinuria or progressive organ damage (especially kidney) in a previously normotensive pregnant women after 20 weeks of gestation. Thus, new-onset nephrotic syndrome due to PE before 20 weeks of gestation seems to be rare, making its diagnosis difficult in this time period. Case presentation A 28-year-old woman presented with a new-onset nephrotic syndrome at 16 weeks of gestation. A high dose of oral glucocorticoids (prednisolone, 40 mg) was initiated for presumed glomerulonephritis since she presented with severe nephrotic syndrome before 20 weeks of gestation, however, the treatment was not effective. At 21 weeks of gestation, we confirmed that the soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio was very high (sFlt-1, 13,400 pg/mL; PlGF, 21.9 pg/mL; serum sFlt-1/PlGF ratio 611.9). Therefore, we diagnosed nephrotic syndrome due to PE, and oral glucocorticoids were discontinued. After she underwent a cesarean section at 24 weeks & 3 days, we performed a kidney biopsy. Focal segmental sclerotic lesions with epithelial cell hyperplasia and foam cells in the tubular poles were seen on light microscopy. On immunofluorescence tests, C4d staining showed linear peripheral patterns in the glomeruli. Electron microscopy revealed diffuse subendothelial edema with focal foot process effacement. The histological diagnosis was severe glomerular endotheliosis with focal segmental glomerulosclerosis. Furthermore, the histology of placenta was consistent with PE. Eight months after delivery, her proteinuria disappeared completely. Conclusions We not only confirmed an abnormal serum sFlt-1/PlGF ratio but also presented the histology compatible with pure PE in the kidney and placenta in a case of nephrotic syndrome before 20 weeks of gestation. The serum sFlt-1/PlGF ratio may be useful in determining the treatment strategy for atypical cases of pregnant women with nephrotic syndrome, particularly before 20 weeks of gestation.
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Affiliation(s)
- Tomo Suzuki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan. .,Department of Nephrology, Kameda Medical Center, Chiba, Japan.
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Mayumi Nakata
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Shiika Watanabe
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Wei Han
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Kaori Kohatsu
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Sayuri Shirai
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Naohiko Imai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
| | - Junki Koike
- Department of Diagnostic Pathology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 216-8511, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan
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14
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Suzuki T, Kohatsu K, Han W, Watanabe S, Yahagi K, Nakata M, Ueno T, Ichikawa D, Imai N, Shirai S, Koike J, Shibagaki Y. Morphological Features of Minimal Change Disease and Focal Segmental Glomerulosclerosis Using Repeat Biopsy and Parietal Epithelial Cell Marker. Kidney Dis (Basel) 2020; 6:119-124. [PMID: 32309294 DOI: 10.1159/000505125] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/28/2019] [Indexed: 12/18/2022]
Abstract
Introduction Minimal change disease (MCD) and primary focal segmental glomerulosclerosis (FSGS) are representative podocyte diseases. The clinical cause of MCD and FSGS has not been clearly elucidated yet. However, it is important to distinguish MCD and FSGS because their prognoses and responses to treatment are quite different. Objective This study aimed to examine whether parietal epithelial cell (PEC) marker and repeat biopsy are useful for diagnosing primary FSGS. Methods Clinicopathological features of 17 patients with the nephrotic syndrome, who underwent kidney biopsy ≥2 times from 1975 to 2017, and had MCD or FSGS were analyzed using PAX8. We defined patients with PAX8+ cells as PAX8+ and the remainder as PAX8- patients. Three cases of sample insufficiency and 1 non-steroid-resistant or frequently relapsing case indicated for repeat biopsy were excluded. Results Among the 13 patients studied, 4 were PAX8+ and 9 were PAX8- (median age: 41 and 46 years, -respectively, at first biopsy). PAX8+ and PAX8- patients showed no significant differences in clinical data and histological diagnosis except for a significant difference in histological diagnosis at the second biopsy. The number of PAX8+ patients increased to 6. Unlike the first biopsy results, FSGS was present in 5 of 6 (83.3%) PAX8+ patients; MCD occurred in all 7 (100%) PAX8- patients. Three of 6 (50.0%) PAX8+ patients undergoing repeat biopsy were steroid resistant; no (0%) PAX8- patient was steroid resistant. All cases of final FSGS diagnosis were PAX8+ at the first or second biopsy. Only 1 PAX8+ MCD patient was steroid resistant. All PAX8- MCD patients were frequently relapsing. Conclusions More PAX8+ patients were diagnosed with FSGS than PAX8- patients. Clinical presentation of MCD in PAX8- patients was frequently relapsing. PEC marker staining in patients with the nephrotic syndrome, e.g., MCD, may help to diagnose FSGS.
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Affiliation(s)
- Tomo Suzuki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.,Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Kaori Kohatsu
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Wei Han
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shiika Watanabe
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Koichi Yahagi
- Department of Nephrology and Hypertension, Yokohama City Seibu Hospital, St. Marianna University School of Medicine, Yokohama, Japan
| | - Mayumi Nakata
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Toshiharu Ueno
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.,Department of Dialysis, Nakayama Station Clinic, Kanagawa, Japan
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Naohiko Imai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Sayuri Shirai
- Department of Nephrology and Hypertension, Yokohama City Seibu Hospital, St. Marianna University School of Medicine, Yokohama, Japan
| | - Junki Koike
- Department of Diagnostic Pathology, Kawasaki Municipal Tama Hospital, Kawasaki, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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15
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Suzuki T, Han W, Watanabe S, Terashita M, Nakata M, Ichikawa D, Shirai S, Shibagaki Y. Clinical characteristics of thrombospondin type-1 domain-containing 7A-associated membranous nephropathy. Ren Fail 2020; 42:966-968. [PMID: 32935600 PMCID: PMC7534214 DOI: 10.1080/0886022x.2020.1819318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tomo Suzuki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
- Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Wei Han
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shiika Watanabe
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Maho Terashita
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Mayumi Nakata
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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16
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Mallinson JB, Shirai S, Acharya SK, Bose SK, Galli E, Brown SA. Avalanches and criticality in self-organized nanoscale networks. Sci Adv 2019; 5:eaaw8438. [PMID: 31700999 PMCID: PMC6824861 DOI: 10.1126/sciadv.aaw8438] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/16/2019] [Indexed: 05/30/2023]
Abstract
Current efforts to achieve neuromorphic computation are focused on highly organized architectures, such as integrated circuits and regular arrays of memristors, which lack the complex interconnectivity of the brain and so are unable to exhibit brain-like dynamics. New architectures are required, both to emulate the complexity of the brain and to achieve critical dynamics and consequent maximal computational performance. We show here that electrical signals from self-organized networks of nanoparticles exhibit brain-like spatiotemporal correlations and criticality when fabricated at a percolating phase transition. Specifically, the sizes and durations of avalanches of switching events are power law distributed, and the power law exponents satisfy rigorous criteria for criticality. These signals are therefore qualitatively and quantitatively similar to those measured in the cortex. Our self-organized networks provide a low-cost platform for computational approaches that rely on spatiotemporal correlations, such as reservoir computing, and are an important step toward creating neuromorphic device architectures.
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17
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Abstract
We report a detailed study of neuromorphic switching behaviour in inherently complex percolating networks of self-assembled metal nanoparticles. We show that variation of the strength and duration of the electric field applied to this network of synapse-like atomic switches allows us to control the switching dynamics. Switching is observed for voltages above a well-defined threshold, with higher voltages leading to increased switching rates. We demonstrate two behavioral archetypes and show how the switching dynamics change as a function of duration and amplitude of the voltage stimulus. We show that the state of each synapse can influence the activity of the other synapses, leading to complex switching dynamics. We further demonstrate the influence of the morphology of the network on the measured device properties, and the constraints imposed by the overall network conductance. The correlated switching dynamics, device stability over long periods, and the simplicity of the device fabrication provide an attractive pathway to practical implementation of on-chip neuromorphic computing.
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Affiliation(s)
- S K Bose
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
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18
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Okonogi H, Kawamura T, Joh K, Koike K, Miyazaki Y, Ogura M, Tsuboi N, Hirano K, Matsushima M, Yokoo T, Horikoshi S, Suzuki Y, Yasuda T, Shirai S, Shibata T, Hattori M, Akioka Y, Katafuchi R, Hashiguchi A, Hisano S, Shimizu A, Kimura K, Maruyama S, Matsuo S, Tomino Y. A grading system that predicts the risk of dialysis induction in IgA nephropathy patients based on the combination of the clinical and histological severity. Clin Exp Nephrol 2018; 23:16-25. [PMID: 30367317 PMCID: PMC6344391 DOI: 10.1007/s10157-018-1657-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 10/01/2018] [Indexed: 12/02/2022]
Abstract
Histological classification is essential in the clinical management of immunoglobulin A nephropathy (IgAN). However, there are limitations in predicting the prognosis of IgAN based on histological information alone, which suggests the need for better prognostic models. Therefore, we defined a prognostic model by combining the grade of clinical severity with the histological grading system by the following processes. We included 270 patients and explored the clinical variables associated with progression to end-stage renal disease (ESRD). Then, we created a predictive clinical grading system and defined the risk grades for dialysis induction by a combination of the clinical grade (CG) and the histological grade (HG). A logistic regression analysis revealed that the 24-h urinary protein excretion (UPE) and the estimated glomerular filtration rate (eGFR) were significant independent variables. We selected UPE of 0.5 g/day and eGFR of 60 ml/min/1.73 m2 as the threshold values for the classification of CG. The risk of progression to ESRD of patients with CG II and III was significantly higher than that of patients with CG I. The patients were then re-classified into nine compartments based on the combination of CG and HG. Furthermore, the nine compartments were grouped into four risk groups. The risk of ESRD in the moderate, high, and super-high-risk groups was significantly higher than that in the low-risk group. Herein, we are giving a detailed description of our grading system for IgA nephropathy that predicted the risk of dialysis based on the combination of CG and HG.
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Affiliation(s)
- Hideo Okonogi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tetsuya Kawamura
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Kensuke Joh
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Koike
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoichi Miyazaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Makoto Ogura
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Nobuo Tsuboi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Keita Hirano
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, General Research Center of Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoshi Horikoshi
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yusuke Suzuki
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Takashi Yasuda
- Department of Internal Medicine, Kichijoji Asahi Hospital, Tokyo, Japan
| | - Sayuri Shirai
- Division of Kidney and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takanori Shibata
- Division of Nephrology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Motoshi Hattori
- Department of Pediatric Nephrology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Yuko Akioka
- Department of Pediatric Nephrology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Ritsuko Katafuchi
- Kidney Unit, National Fukuoka-Higashi Medical Center, Fukuoka, Japan
| | - Akinori Hashiguchi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Hisano
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Kenjiro Kimura
- Division of Kidney and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shoichi Maruyama
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Nagoya, Japan
| | - Seiichi Matsuo
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Nagoya, Japan
| | - Yasuhiko Tomino
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan
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Kuramitsu S, Masuda H, Domei T, Hyodo M, Shirai S, Ando K. P6449Difference in clinical outcomes of drug-coated balloon between patients with early and late drug-eluting stent restenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - H Masuda
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - T Domei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodo
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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20
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Masuda H, Kuramitsu S, Domei T, Hyodo M, Shirai S, Ando K. P6448Clinical impact of neointimal tissue characteristics in patients treated with drug-coated balloon for newer-generation drug-eluting stent restenosis: an optical coherence tomography study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Masuda
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - T Domei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodo
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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21
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Hiromasa T, Kuramitsu S, Dohmei T, Yamaji K, Hyodoh M, Soga Y, Shirai S, Ando K. P2641Impact of SYNTAX score on 5 years clinical outcomes in patients treated with cobalt-chromium everolimus-eluting stent for unprotected left main disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Hiromasa
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - T Dohmei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Yamaji
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodoh
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Soga
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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22
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Kobayashi N, Ito Y, Hirano K, Yamawaki M, Araki M, Sakai T, Sakamoto Y, Mori S, Tsutsumi M, Nauchi M, Honda Y, Makino K, Shirai S. P2630Comparison of tissue characteristics in restenosis lesion between bioabsorbable polymer drug-eluting stent and durable polymer drug-eluting stent. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Kobayashi
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Y Ito
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - K Hirano
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - M Yamawaki
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - M Araki
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - T Sakai
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Y Sakamoto
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - S Mori
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - M Tsutsumi
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - M Nauchi
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Y Honda
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - K Makino
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - S Shirai
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
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23
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Hiramori S, Soga Y, Tomoi Y, Ito N, Hirose K, Shirai S, Ando K. P3566Impact of baseline characteristics on efficacy of cilostazol for patients performing endovascular therapy for femoropopliteal lesions. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Hiramori
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Soga
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Tomoi
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - N Ito
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Hirose
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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Hiromasa T, Kuramitsu S, Dohmei T, Yamaji K, Hyodoh M, Soga Y, Shirai S, Ando K. P6379Impact of Body Mass Index on 3 years clinical outcomes in patients treated with platinum chromium-everolimus eluting stent implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Hiromasa
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - T Dohmei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Yamaji
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodoh
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Soga
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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25
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Tsutsumi M, Ito Y, Hirano K, Yamawaki M, Araki M, Kobayashi N, Mori S, Sakamoto Y, Honda Y, Tokuda T, Makino K, Shirai S. P791Comparison between a novel bioabsorbable polymer everolimus-eluting stent and a durable polymer everolimus-eluting stent. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Tsutsumi
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Ito
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - K Hirano
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - M Yamawaki
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - M Araki
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - N Kobayashi
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - S Mori
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Sakamoto
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Honda
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - T Tokuda
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - K Makino
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
| | - S Shirai
- Saiseikai Yokohama City Eastern Hospital, Department of Cardiology, Yokohama, Japan
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Hiromasa T, Kuramitsu S, Dohmei T, Yamaji K, Hyodoh M, Soga Y, Shirai S, Ando K. P1666Impact of SYNTAX score and Clinical SYNTAX score on 5 years clinical outcomes in patients treated with cobalt-chromium everolimus-eluting stent. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Hiromasa
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - T Dohmei
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Yamaji
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - M Hyodoh
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - Y Soga
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - S Shirai
- Kokura Memorial Hospital, Kitakyushu, Japan
| | - K Ando
- Kokura Memorial Hospital, Kitakyushu, Japan
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Naganuma R, Sato S, Kudo A, Sato C, Uwatoko H, Shirai S, Nishimura H, Takahashi I, Matsushima M, Kano T, Yabe I, Houzen H, Sasaki H. Long term observation of Lambert-Eaton myasthenic syndrome patients treated with 3,4-diaminopyridine. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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28
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Sakai T, Uehara H, Shirai S, Kanaoka R, Nakayama T, Matsutani N, Kawamura M, Kondo H. P-242SUCCESSFUL SURGICAL REMOVAL OF A FOREIGN BODY IN THE PULMONARY ARTERY. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Shirai S, Matsushima M, Yabe I, Sasaki H. Quantitative evaluation of spinocerebellar degeneration by triaxial accelerometers and 9-Hole peg test. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tsutsumi M, Ito Y, Hirano K, Yamawaki M, Araki M, Kobayashi N, Sakamoto Y, Mori S, Takama T, Honda Y, Tokuda T, Makino K, Shirai S. P5188Long-term clinical outcomes after polymer-free paclitaxel-coated stent implantation for femoropopliteal disease in comparison with bare metal stent. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Hayashi M, Miura M, Kawaguchi T, Yano M, Itou S, Morinaga T, Isotani A, Tsubota H, Arai Y, Hanyu M, Shirai S. P3293One year result of the underfilling strategy in transcatheter aortic valve implantation with balloon expandable valve. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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32
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Hiromasa T, Kuramitsu S, Jinnouchi H, Domei T, Hyodo M, Soga Y, Shirai S, Ando K. P1385Impact of SYNTAX score on 5 years clinical outcomes in patients treated with cobalt-chromium everolimus-eluting stent. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Makino K, Hirano K, Yamawaki M, Araki M, Kobayashi N, Mori S, Sakamoto Y, Tsutsumi M, Takama T, Honda Y, Takahiro T, Shirai S, Ito Y. P5202The effectiveness of ultrasound-guided tibial artery endovascular interventions for chronic total occlusion lesions in critical limb ischemia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Kobayashi N, Hirano K, Yamawaki M, Araki M, Sakamoto Y, Mori S, Tsutsumi M, Honda Y, Tokuda T, Makino K, Shirai S, Ito Y. P5215Severity of angiographic dissection and future restenosis after balloon angioplasty for femoropopliteal disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Fujioka S, Kuramitsu S, Hiromasa T, Jinnouchi H, Morinaga T, Domei T, Hyodo M, Soga Y, Shirai S, Ando K. P3315Long-term efficacy and safety of biodegradable polymer biolimus-eluting vs. permanent polymer everolimus-eluting stents in diabetic Patients: 4-year clinical outcomes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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36
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Kuramitsu S, Sonoda S, Shinozaki T, Jinnouchi H, Muraoka Y, Domei T, Hyodo M, Shirai S, Ando K, Otsuji Y. P2361Impact of lesion complexity on long-term vascular response to cobalt-chromium everolimus-eluting stent: five-year follow-up optical coherence tomography study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Shirai S, Imai N, Sueki S, Matsui K, Tominaga N, Sakurada T, Yasuda T, Kimura K, Shibagaki Y. Combined cyclosporine and prednisolone therapy using cyclosporine blood concentration monitoring for adult patients with new-onset minimal change nephrotic syndrome: a single-center pilot randomized trial. Clin Exp Nephrol 2017; 22:283-290. [PMID: 28699032 DOI: 10.1007/s10157-017-1443-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/01/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Minimal change nephrotic syndrome (MCNS) responds well to steroids, but some patients show frequent relapses. Long-term steroid administration leads to various adverse effects. We previously reported the effectiveness in refractory nephrosis patients of administrating microemulsified CyA (ME-CyA) once before meals and setting the target value of the CyA blood concentration at 2 h after ME-CyA administration (C2) to 600-1200 ng/ml. On this trial we evaluate the effectiveness and safety of ME-CyA for suppressing relapse of adult new-onset MCNS patients using C2 monitoring. METHODS Adult new-onset MCNS patients were randomly allocated to a ME-CyA + prednisolone group ("CyA + PSL") (n = 11) and a PSL-alone group ("PSL-alone") (n = 10). The drug administration period was 18 months followed by an observation period of 12 months. RESULTS The duration of remission tended to be longer in CyA + PSL with C2 >600 ng/ml than in PSL-alone (P = 0.112). The relapse rate up to 18 months was significantly lower in CyA + PSL with C2 >600 ng/ml than in PSL-alone (P = 0.02). C2 was significantly higher in the patients with no relapse at 18 months than that in the patients with relapse (P = 0.048). In CyA + PSL, the total dose of PSL was significantly reduced compared with PSL-alone (P = 0.002). Cosmetic adverse effects tended to be fewer in CyA + PSL. CONCLUSIONS The combination treatment regimen of ME-CyA and PSL with C2 >600 ng/ml has potential to be an important treatment option for adult new-onset MCNS patients. However, after ME-CyA dosage reduction and discontinuation, the relapse rate increased. It is thus necessary to establish a better dose-reduction method.
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Affiliation(s)
- Sayuri Shirai
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan.
| | - Naohiko Imai
- Department of Nephrology and Hypertension, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan
| | - Shina Sueki
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Katsuomi Matsui
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Kanagawa, Japan
| | - Naoto Tominaga
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Tsutomu Sakurada
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Takashi Yasuda
- Department of Nephrology, Kichijoji Asahi Hospital, Musashino, Tokyo, Japan
| | - Kenjiro Kimura
- Department of Nephrology, JHCO Tokyo Takanawa Hospital, Takanawa, Tokyo, Japan
| | - Yugo Shibagaki
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Hanaoka H, Kiyokawa T, Iida H, Ishimori K, Takakuwa Y, Okazaki T, Yamada H, Ichikawa D, Shirai S, Koike J, Ozaki S. Comparison of renal response to four different induction therapies in Japanese patients with lupus nephritis class III or IV: A single-centre retrospective study. PLoS One 2017; 12:e0175152. [PMID: 28384208 PMCID: PMC5383240 DOI: 10.1371/journal.pone.0175152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/21/2017] [Indexed: 12/29/2022] Open
Abstract
The recent recommendations for the management of lupus nephritis suggest that racial background should be considered while choosing induction therapy. However, the responses to different induction regimens have been poorly studied in Japanese population. Here, we assessed the renal response to different induction therapies in Japanese patients with lupus nephritis class III or IV. The records of 64 patients with biopsy-proven lupus nephritis class III or IV were retrospectively evaluated according to therapy received: monthly intravenous cyclophosphamide (IVCY), the Euro-lupus nephritis trial (ELNT) protocol-IVCY, tacrolimus (TAC), or mycophenolate mofetil (MMF). We investigated cumulative complete renal response (CR) rates and relapse rates for each group for 3 years. Organ damage was assessed with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). There were 22 patients on monthly IVCY, 18 on ELNT-IVCY, 13 on TAC, and 11 on MMF. Lower systemic lupus erythematosus disease activity index (SLEDAI) and higher CH50 were found in the TAC group at baseline (p<0.01 and p<0.01, respectively). There were no significant differences of cumulative CR rates and relapse free survival for 3 years among the four different therapeutic regimens (p = 0.2 and p = 0.2, respectively). There was a tendency to have early response and early relapse in TAC group and late response in MMF group. The SDI increase over 3 years was found more frequently in the TAC group than in the monthly-IVCY group (p = 0.04). Multivariate analysis indicated that CR at 3 months was independent prognosticator for low damage accrual. Regarding lower damage accrual, early CR achievement might be essential in induction therapy regardless of immunosuppressant choice.
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Affiliation(s)
- Hironari Hanaoka
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Tomofumi Kiyokawa
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Harunobu Iida
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kana Ishimori
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yukiko Takakuwa
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Takahiro Okazaki
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hidehiro Yamada
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Daisuke Ichikawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Junki Koike
- Department of Pathology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Shoichi Ozaki
- Division of Rheumatology and Allergology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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Imai N, Machida S, Oishi D, Matsui K, Shirai S, Shibagaki Y. End-stage renal disease secondary to pelvic organ prolapse. Saudi J Kidney Dis Transpl 2017; 28:199-200. [DOI: 10.4103/1319-2442.198280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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40
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Muramatsu K, Ujiie H, Ito T, Fujita Y, Inokuma D, Tsukinaga I, Abe T, Shirai S, Fukuda N, Shimizu H. Image Gallery: Vasculo-Behçet disease. Br J Dermatol 2016; 175:e150. [PMID: 27996152 DOI: 10.1111/bjd.15044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K Muramatsu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan.,Department of Dermatology, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - H Ujiie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - T Ito
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Y Fujita
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
| | - D Inokuma
- Department of Dermatology, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - I Tsukinaga
- Department of Dermatology, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - T Abe
- Department of Cardiovascular Internal Medicine, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - S Shirai
- Department of Cardiovascular Internal Medicine, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - N Fukuda
- Department of Gastroenterological Medicine, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan
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Hisamichi M, Kawarazaki H, Oroku M, Tsuruoka K, Sakurada T, Shirai S, Kido R, Kimura K, Shibagaki Y. Risk factors for allergic reaction at initial therapeutic plasma exchange in a single-center study: beware of high rates of severe allergic reaction. Ren Replace Ther 2016. [DOI: 10.1186/s41100-016-0076-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Murasawa M, Sakurada T, Oishi D, Suzuki T, Tominaga N, Kawarazaki H, Shirai S, Shibagaki Y, Kimura K. Collagenous Colitis Associated with Rabeprazole in a Peritoneal Dialysis Patient. Perit Dial Int 2016; 35:588-90. [PMID: 26450480 DOI: 10.3747/pdi.2014.00184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Masaru Murasawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tsutomu Sakurada
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Daisuke Oishi
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Tomo Suzuki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Naoto Tominaga
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroo Kawarazaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenjiro Kimura
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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Imai N, Shirai S, Yasuda T, Shibagaki Y, Kimura K. Long-term prognosis of IgA nephropathy presenting with minimal or no proteinuria: A single center experience. Indian J Nephrol 2016; 26:107-12. [PMID: 27051134 PMCID: PMC4795425 DOI: 10.4103/0971-4065.157010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The long-term prognosis of patients with IgA nephropathy (IgAN) who present with preserved renal function and minimal proteinuria is not well described. We investigated the long-term outcomes of IgAN patients with an apparently benign presentation and evaluated prognostic factors for renal survival and clinical remission. We studied Japanese patients with biopsy-proven IgAN who had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and proteinuria <0.5 g/day at the time of renal biopsy. The renal biopsies were reviewed using the Oxford classification. Twenty patients met the inclusion criteria. At diagnosis, the median eGFR (interquartile range) was 76.8 (65.2–91.1) mL/min/1.73 m2, and the median proteinuria level was 0.31 (0.16–0.39) g/day. Only one patient had an increase in serum creatinine of over 50% and no patient progressed to end-stage renal disease. The 15-year renal survival rate was 93.8%. Clinical remission was observed in 9 (45%) patients. Baseline proteinuria was the only factor significantly associated with the absence of clinical remission. The long-term prognosis of Japanese patients with IgAN who presents with minor urinary abnormalities and preserved renal function is excellent.
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Affiliation(s)
- N Imai
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - S Shirai
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - T Yasuda
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Y Shibagaki
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - K Kimura
- Department of Internal Medicine, Tokyo Takanawa Hospital, Tokyo, Japan
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Affiliation(s)
- Naohiko Imai
- St. Marianna University School of Medicine , Kawasaki, Kanagawa , Japan
| | - Sayuri Shirai
- St. Marianna University School of Medicine , Kawasaki, Kanagawa , Japan
| | - Yugo Shibagaki
- St. Marianna University School of Medicine , Kawasaki, Kanagawa , Japan
| | - Kenjiro Kimura
- St. Marianna University School of Medicine , Kawasaki, Kanagawa , Japan
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Kitajima K, Sasaki H, Koike J, Nakazawa R, Sato Y, Yazawa M, Tsuruoka K, Kawarazaki H, Imai N, Shirai S, Shibagaki Y, Chikaraishi T. Asymptomatic post-transplant lymphoproliferative disorder diagnosed at one year protocol renal allograft biopsy. Nephrology (Carlton) 2015; 19 Suppl 3:42-4. [PMID: 24842822 DOI: 10.1111/nep.12246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a neoplastic complication with a potentially fatal outcome that develops as a consequence of immunosuppression, and is mainly associated with Epstein-Barr virus (EBV) infection. A 70-year-old woman underwent a live unrelated, ABO-incompatible renal transplant for end-stage renal disease. One year after transplantation, protocol biopsy revealed pathological changes indicative of the histological subtype of 'early lesions of PTLD' according to the World Health Organization classification, while the patient showed no clinical signs or symptoms. The patient was finally diagnosed with EBV-positive PTLD by in situ hybridization for EBER (EBV-encoded RNA), and was successfully treated based on the reduction of immunosuppression. Protocol biopsy within the first post-transplant year is the only diagnostic measure to detect asymptomatic early PTLD, which allows for early intervention and leads to better outcomes.
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Affiliation(s)
- Kazuki Kitajima
- Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
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Akimov AV, Jinnouchi R, Shirai S, Asahi R, Prezhdo OV. Theoretical Insights into the Impact of Ru Catalyst Anchors on the Efficiency of Photocatalytic CO2 Reduction on Ta2O5. J Phys Chem B 2014; 119:7186-97. [DOI: 10.1021/jp5080658] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alexey V. Akimov
- Department
of Chemistry, University of Southern California, Los Angeles, California 90089, United States
| | - R. Jinnouchi
- Toyota Central Research and Development Laboratories, Inc., 41-1 Yokomichi, Nagakute, Aichi 480-1192, Japan
| | - S. Shirai
- Toyota Central Research and Development Laboratories, Inc., 41-1 Yokomichi, Nagakute, Aichi 480-1192, Japan
| | - R. Asahi
- Toyota Central Research and Development Laboratories, Inc., 41-1 Yokomichi, Nagakute, Aichi 480-1192, Japan
| | - Oleg V. Prezhdo
- Department
of Chemistry, University of Southern California, Los Angeles, California 90089, United States
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Kawakami T, Yamaguchi N, Soma Y, Yokoyama K, Shirai S, Kimura K. Immunoglobulin G4-related disease associated with cutaneous vasculitis. Acta Derm Venereol 2014; 94:327-8. [PMID: 24096856 DOI: 10.2340/00015555-1707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tamihiro Kawakami
- Department of Dermatology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
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Kawamura T, Yoshimura M, Miyazaki Y, Okamoto H, Kimura K, Hirano K, Matsushima M, Utsunomiya Y, Ogura M, Yokoo T, Okonogi H, Ishii T, Hamaguchi A, Ueda H, Furusu A, Horikoshi S, Suzuki Y, Shibata T, Yasuda T, Shirai S, Imasawa T, Kanozawa K, Wada A, Yamaji I, Miura N, Imai H, Kasai K, Soma J, Fujimoto S, Matsuo S, Tomino Y. A multicenter randomized controlled trial of tonsillectomy combined with steroid pulse therapy in patients with immunoglobulin A nephropathy. Nephrol Dial Transplant 2014; 29:1546-53. [PMID: 24596084 PMCID: PMC4106640 DOI: 10.1093/ndt/gfu020] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background The study aim was, for the first time, to conduct a multicenter randomized controlled trial to evaluate the effect of tonsillectomy in patients with IgA nephropathy (IgAN). Methods Patients with biopsy-proven IgAN, proteinuria and low serum creatinine were randomly allocated to receive tonsillectomy combined with steroid pulses (Group A; n = 33) or steroid pulses alone (Group B; n = 39). The primary end points were urinary protein excretion and the disappearance of proteinuria and/or hematuria. Results During 12 months from baseline, the percentage decrease in urinary protein excretion was significantly larger in Group A than that in Group B (P < 0.05). However, the frequency of the disappearance of proteinuria, hematuria, or both (clinical remission) at 12 months was not statistically different between the groups. Logistic regression analyses revealed the assigned treatment was a significant, independent factor contributing to the disappearance of proteinuria (odds ratio 2.98, 95% CI 1.01–8.83, P = 0.049), but did not identify an independent factor in achieving the disappearance of hematuria or clinical remission. Conclusions The results indicate tonsillectomy combined with steroid pulse therapy has no beneficial effect over steroid pulses alone to attenuate hematuria and to increase the incidence of clinical remission. Although the antiproteinuric effect was significantly greater in combined therapy, the difference was marginal, and its impact on the renal functional outcome remains to be clarified.
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Affiliation(s)
- Tetsuya Kawamura
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | | | - Yoichi Miyazaki
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Hidekazu Okamoto
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Kenjiro Kimura
- Division of Kidney and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Keita Hirano
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Science, Jikei University School of Medicine, Tokyo, Japan
| | - Yasunori Utsunomiya
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Makoto Ogura
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Yokoo
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Hideo Okonogi
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Takeo Ishii
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Akihiko Hamaguchi
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Hiroyuki Ueda
- Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Akira Furusu
- Second Department of Internal Medicine, Nagasaki University Hospital of Medicine and Dentistry, Nagasaki, Japan
| | - Satoshi Horikoshi
- Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Takanori Shibata
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Takashi Yasuda
- Division of Kidney and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Sayuri Shirai
- Division of Kidney and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | | | - Koichi Kanozawa
- Division of Kidney and Hypertension, Department of Internal Medicine, Saitama University Medical Centre, Saitama, Japan
| | - Akira Wada
- Department of Internal Medicine, National Hospital Organization, Osaka National Hospital, Osaka, Japan
| | - Izumi Yamaji
- Department of Internal Medicine, Teine Keijinkai Hospital, Sapporo, Japan
| | - Naoto Miura
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Hirokazu Imai
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kenji Kasai
- Department of Internal Medicine, Fuji City Central Hospital, Fuji, Japan
| | - Jun Soma
- Department of Internal Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Shouichi Fujimoto
- Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Seiichi Matsuo
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Nagoya, Nagoya, Japan
| | - Yasuhiko Tomino
- Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Nasu K, Oikawa Y, Hozawa H, Kadotani M, Shirai S, Okamura A, Nakagawa Y, Takeda Y, Abe H, Ujiie Y. Impact of multiple overlapping everolimus-eluting stents for the patients with diffuse long coronary artery disease: results of XILLION registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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