Publications by authors named "Shin-Ichi Takeda"

100 Publications

Dataset for surface and internal damage after impact on CFRP laminates.

Data Brief 2022 Aug 10;43:108462. Epub 2022 Jul 10.

Aeronautical Technology Directorate, Japan Aerospace Exploration Agency (JAXA), 6-13-1 Osawa, Mitaka-shi, Tokyo 181-0015, Japan.

Various foreign objects can collide with CFRP structures, such as CFRP aircraft. Once something impacts with CFRP laminates, both surface damage and internal damage can occur. Even if the external damage is such invisible as called barely visible impact damage, there are matrix cracks or delamination that are the main cause of compressive strength reduction, so it is difficult to find the relationship between external and internal damage on CFRP laminates. This dataset is prepared for predicting impact information only from surface damage profiles using Machine Learning (Hasebe et al., 2022). It includes three data, surface damage image (png), surface depth contour image(png), and internal damage image after ultrasound C-scanning (jpg) after low-velocity impact testing under various impact conditions. The data are helpful for researchers and engineers who deal with the impact behavior of CFRP or data science.
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http://dx.doi.org/10.1016/j.dib.2022.108462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294053PMC
August 2022

Hansen Solubility Parameter Analysis on Dispersion of Oleylamine-Capped Silver Nanoinks and their Sintered Film Morphology.

Nanomaterials (Basel) 2022 Jun 10;12(12). Epub 2022 Jun 10.

Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, Osaka 564-8680, Japan.

Optimizing stabilizers and solvents is crucial for obtaining highly dispersed nanoparticle inks. Generally, nonpolar (hydrophobic) ligand-stabilized nanoparticles show superior dispersibility in nonpolar solvents, whereas polar ligand (hydrophilic)-stabilized nanoparticles exhibit high dispersibility in polar solvents. However, these properties are too qualitative to select optimum stabilizers and solvents for stable nanoparticle inks, and researchers often rely on their experiences. This study presents a Hansen solubility parameter (HSP)-based analysis of the dispersibility of oleylamine-capped silver nanoparticle (OAm-Ag NP) inks for optimizing ink preparation. We determined the HSP sphere of the OAm-Ag NPs, defined as the center coordinate, and the interaction radius in 3D HSP space. The solvent's HSP inside the HSP sphere causes high dispersibility of the OAm-Ag NPs in the solvent. In contrast, the HSPs outside the sphere resulted in low dispersibility in the solvent. Thus, we can quantitatively predict the dispersibility of the OAm-Ag NPs in a given solvent using the HSP approach. Moreover, the HSP sphere method can establish a correlation between the dispersibility of the particles in inks and the sintered film morphology, facilitating electronic application of the nanoparticle inks. The HSP method is also helpful for optimizing stabilizers and solvents for stable nanoparticle inks in printed electronics.
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http://dx.doi.org/10.3390/nano12122004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230637PMC
June 2022

Viral isolation analysis of SARS-CoV-2 from clinical specimens of COVID-19 patients.

J Infect Chemother 2022 Feb 10;28(2):347-351. Epub 2021 Nov 10.

Toyama Institute of Health, Toyama, Japan.

Genetic testing using reverse transcriptase real-time polymerase chain reaction (rRT-PCR) is the mainstay of diagnosis of COVID-19. However, it has not been fully investigated whether infectious viruses are contained in SARS-CoV-2 genome-positive specimens examined using the rRT-PCR test. In this study, we examined the correlation between the threshold Cycle (Ct) value obtained from the rRT-PCR test and virus isolation in cultured cells, using 533 consecutive clinical specimens of COVID-19 patients. The virus was isolated from specimens with a Ct value of less than 30 cycles, and the lower the Ct value, the more efficient the isolation rate. A cytopathic effect due to herpes simplex virus type 1 contamination was observed in one sample with a Ct value of 35 cycles. In a comparison of VeroE6/TMPRSS2 cells and VeroE6 cells used for virus isolation, VeroE6/TMPRSS2 cells isolated the virus 1.7 times more efficiently than VeroE6 cells. There was no significant difference between the two cells in the mean Ct value of the detectable sample. In conclusion, Lower Ct values in the PCR test were associated with higher virus isolation rates, and VeroE6/TMPRSS2 cells were able to isolate viruses more efficiently than VeroE6 cells.
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http://dx.doi.org/10.1016/j.jiac.2021.10.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578003PMC
February 2022

Calciprotein particles and fibroblast growth factor 23 contribute to the pathophysiology of hypercalcemia in a patient with renal sarcoidosis.

Clin Kidney J 2021 Jan 4;14(1):421-423. Epub 2019 Aug 4.

Department of Medicine, Division of Nephrology, Jichi Medical University, Shimotsuke, Tochigi, Japan.

In patients with sarcoidosis, dysregulated calcium metabolism is one of the frequently observed complications. However, little attention has been paid to abnormal phosphate metabolism. Herein we present the case of a 42-year-old Japanese man with renal sarcoidosis who developed acute kidney injury due to hypercalcemia and nephrolithiasis. Laboratory data showed hypercalcemia with a normal serum phosphate level and high serum 1,25-hydroxyvitamin D, fibroblast growth factor 23 (FGF23) and calciprotein particle (CPP) levels. After treatment with oral prednisone and bisphosphonate, the laboratory abnormalities and renal dysfunction were resolved. Thus increases in FGF23 and CPP may indicate disturbed phosphate metabolism in renal sarcoidosis.
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http://dx.doi.org/10.1093/ckj/sfz086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857787PMC
January 2021

Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin.

Clin Med Insights Case Rep 2018 20;11:1179547618763358. Epub 2018 Mar 20.

Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.

Blood glucose management in patients undergoing dialysis is clinically challenging. In this population, most conventional oral hypoglycemic agents are contraindicated, especially from the perspective of pharmacokinetics. Dipeptidyl peptidase-4 inhibitors exert unique pharmacologic actions via glucose-dependent mechanism and have an excellent tolerability profile with a very low risk of hypoglycemia. Furthermore, the literature reports that some dipeptidyl peptidase-4 inhibitors such as teneligliptin can be administered at the usual dose, regardless of a patient's level of renal impairment. In this article, we report a case of hypoglycemic coma with a blood glucose level of 23 mg/dL. The patient became fully conscious shortly after receiving a glucose injection; however, severe hypoglycemia recurred for approximately 1.5 days. It eventually disappeared on the discontinuation of teneligliptin, which was the only antidiabetic agent that he had received. The present case may provide deep insights into promoting the safe use of hypoglycemic agents in patients undergoing dialysis.
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http://dx.doi.org/10.1177/1179547618763358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863859PMC
March 2018

Peritoneal Dialysis and Retroperitoneal Laparoscopic Radical Nephrectomy: A Favorable Experience With a Patient Complicated by Renal Cell Carcinoma.

Clin Med Insights Case Rep 2017 10;10:1179547617746362. Epub 2017 Dec 10.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Japan.

Peritoneal dialysis (PD) is an accepted modality for managing end-stage kidney disease. We herein report a 75-year-old female patient on chronic PD who was complicated by renal cell carcinoma. She was successfully treated with retroperitoneal laparoscopic radical nephrectomy followed by a prompt resumption of the procedure. Various surgeries disturbing the abdominal wall integrity often disrupt the regular PD schedule, and using minimally invasive approaches is therefore an attractive therapeutic option. Our experience emphasizes the feasibility and safety of a retroperitoneal approach-based laparoscopic technique based on several empirical examples. However, systemic studies on this topic are obviously lacking, so we strongly recommend the accumulation of more cases similar to our own. Several surgical concerns that need to be dealt with among PD patients are also discussed.
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http://dx.doi.org/10.1177/1179547617746362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731611PMC
December 2017

Performing Anticoagulation: A Puzzling Case of Cholesterol Embolization Syndrome.

Clin Med Insights Case Rep 2017 17;10:1179547616684649. Epub 2017 Feb 17.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Japan.

The avoidance of any form of anticoagulation is advised in cases of cholesterol embolization syndrome (CES). We herein describe a case of CES in a man with a history of unprovoked pulmonary embolism for which warfarinization was performed. Despite anecdotal reports of successful anticoagulation in CES patients with certain indications, irreversible renal failure, which was sufficiently severe to require chronic hemodialysis, eventually developed in our patient. Our results emphasize the pitfalls of this procedure, which imply its limited feasibility and safety. Several therapeutic concerns associated with this case are also discussed.
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http://dx.doi.org/10.1177/1179547616684649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5398301PMC
February 2017

Characterization and Functional Analysis of Extracellular Vesicles and Muscle-Abundant miRNAs (miR-1, miR-133a, and miR-206) in C2C12 Myocytes and mdx Mice.

PLoS One 2016 15;11(12):e0167811. Epub 2016 Dec 15.

Administrative Section of Radiation Protection, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.

Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder. Here, we show that the CD63 antigen, which is located on the surface of extracellular vesicles (EVs), is associated with increased levels of muscle-abundant miRNAs, namely myomiRs miR-1, miR-133a, and miR-206, in the sera of DMD patients and mdx mice. Furthermore, the release of EVs from the murine myoblast C2C12 cell line was found to be modulated by intracellular ceramide levels in a Ca2+-dependent manner. Next, to investigate the effects of EVs on cell survival, C2C12 myoblasts and myotubes were cultured with EVs from the sera of mdx mice or C2C12 cells overexpressing myomiRs in presence of cellular stresses. Both the exposure of C2C12 myoblasts and myotubes to EVs from the serum of mdx mice, and the overexpression of miR-133a in C2C12 cells in presence of cellular stress resulted in a significant decrease in cell death. Finally, to assess whether miRNAs regulate skeletal muscle regeneration in vivo, we intraperitoneally injected GW4869 (an inhibitor of exosome secretion) into mdx mice for 5 and 10 days. Levels of miRNAs and creatine kinase in the serum of GW4869-treated mdx mice were significantly downregulated compared with those of controls. The tibialis anterior muscles of the GW4869-treated mdx mice showed a robust decrease in Evans blue dye uptake. Collectively, these results indicate that EVs and myomiRs might protect the skeletal muscle of mdx mice from degeneration.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167811PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158003PMC
July 2017

Dual Impact of Tolvaptan on Intracellular and Extracellular Water in Chronic Kidney Disease Patients with Fluid Retention.

Intern Med 2016;55(19):2759-2764. Epub 2016 Oct 1.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.

Objective Tolvaptan, an oral selective V2-receptor antagonist, is a water diuretic that ameliorates fluid retention with a lower risk of a worsening renal function than conventional loop diuretics. Although loop diuretics predominantly decrease extracellular water (ECW) compared with intracellular water (ICW), the effect of tolvaptan on fluid distribution remains unclear. We therefore examined how tolvaptan changes ICW and ECW in accordance with the renal function. Methods Six advanced chronic kidney disease patients (stage 4 or 5) with fluid retention were enrolled in this study. Tolvaptan (7.5 mg/day) added to conventional diuretic treatment was administered to remove fluid retention. The fluid volume was measured using a bioimpedance analysis device before (day 0) and after (day 5 or 6) tolvaptan treatment. Results Body weight decreased by 2.6%±1.3% (64.4±6.5 vs. 62.8±6.3 kg, p=0.06), and urine volume increased by 54.8%±23.9% (1,215±169 vs. 1,709±137 mL/day, p=0.03) between before and after tolvaptan treatment. Tolvaptan significantly decreased ICW (6.5%±1.5%, p=0.01) and ECW (7.5%±1.4%, p=0.02), which had similar reduction rates (p=0.32). The estimated glomerular filtration rate remained unchanged during the treatment (14.6±2.8 vs. 14.9±2.7 mL/min/1.73 m, p=0.35). Conclusion Tolvaptan ameliorates body fluid retention, and induces an equivalent reduction rate of ICW and ECW without a worsening renal function. Tolvaptan is a novel water diuretic that has a different effect on fluid distribution compared with conventional loop diuretics.
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http://dx.doi.org/10.2169/internalmedicine.55.7133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088534PMC
February 2017

Acute Kidney Injury Associated with Renal Cell Carcinoma Complicated by Renal Vein and Inferior Vena Cava Involvement.

Intern Med 2016 1;55(17):2447-52. Epub 2016 Sep 1.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.

Acute kidney injury (AKI) is caused by diverse pathologies, although it may occasionally result from concurrent renal efflux disturbances. We herein describe a case of AKI in a patient complicated by renal cell carcinoma (RCC) with renal vein and inferior vena cava (IVC) involvement. A neoplastic thrombus which disrupted the blood flow in the renal vein appeared to play a role in the rapid decline in the renal function. Such a scenario has rarely been mentioned in the previous literature describing the cases of RCC complicated by AKI. Concerns regarding the diagnostic and therapeutic strategies for RCC are also discussed.
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http://dx.doi.org/10.2169/internalmedicine.55.6724DOI Listing
February 2017

Renal Failure Found during the Follow-up of Sarcoidosis: The Relevance of a Delay in the Diagnosis of Concurrent Hypercalcemia.

Intern Med 2016 15;55(14):1893-8. Epub 2016 Jul 15.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.

We herein present a case of relapsed sarcoidosis with a deteriorated renal function accompanied by hypercalcemia, nephrolithiasis, and a ureteral stone in a woman with a history of ocular sarcoidosis. The ocular involvement appeared to be well controlled for a long period of time with a topical ophthalmic steroid; however, we believe that the absence of apparent recrudescence could have led to the delay in our diagnosis of relapse of the disease during the follow-up period. The conundrums regarding longitudinal surveillance for both evaluating the disease activity and determining the necessity of therapeutics are also discussed.
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http://dx.doi.org/10.2169/internalmedicine.55.6194DOI Listing
March 2017

Subclinical growth of an arteriovenous fistula associated with renal biopsy: a case report.

BMC Nephrol 2016 07 12;17(1):81. Epub 2016 Jul 12.

Division of Nephrology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan.

Background: Renal biopsy is not free from complications and patients who undergo this procedure are usually hospitalized to receive intensive care for several days after biopsy. In contrast, after this period, routine follow-up to detect biopsy-associated complications is rarely scheduled, unless the patient develops a clinical manifestation. We describe a case of marked enlargement of arteriovenous fistula in the kidney that occurred many years after renal biopsy. In contrast to the previous cases requiring interventional radiology, our patient showed subclinical growth of fistula over about nine years.

Case Presentation: A 24-year-old man with a history of percutaneous renal biopsy was hospitalized for interventional radiology. Gross hematuria emerged shortly after biopsy, but completely disappeared with administration of hemostatic agents and bed rest. Subsequently, the patient had few symptoms for many years. A giant fistula (a gourd-shaped mass, size 26 × 22 and 12 × 11 mm) was unexpectedly detected by ultrasonography performed for examination of an unrelated disorder (slight elevation of serum transaminase) at 9 years after the original biopsy. The fistula was successfully treated with radiological intervention. Thus, subclinical development of complications associated with renal biopsy should be considered, even in an uneventful course.

Conclusions: This case provides a platform to discuss the importance of long-term follow-up of patients after renal biopsy despite of its difficulty.
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http://dx.doi.org/10.1186/s12882-016-0289-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942951PMC
July 2016

Development of Acute Pericarditis Associated with New-onset Rheumatoid Arthritis in a Diabetic Patient with Renal Impairment: The Elusive Nature of Uremia.

Intern Med 2016 15;55(8):955-9. Epub 2016 Apr 15.

Division of Nephrology, Department of Medicine, Jichi Medical University, Japan.

Uremic patients may have a variety of organ involvement, however, the precise causality may be impossible to determine in some cases because the symptoms of uremia are also associated with other diseases. With an emphasis on the elusive nature of uremia, we herein describe a 53-year-old man with preexisting renal impairment who developed acute pericarditis with deterioration of his renal function. Hemodialysis was immediately initiated on the presumption of uremia, however, articular symptoms emerged approximately a month later and led to a final diagnosis of rheumatoid arthritis, followed by successful withdrawal of hemodialysis.
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http://dx.doi.org/10.2169/internalmedicine.55.5438DOI Listing
November 2016

Tubulointerstitial Nephritis and Uveitis Syndrome: Are Drugs Offenders or Bystanders?

Clin Med Insights Case Rep 2016 16;9:21-4. Epub 2016 Mar 16.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.

A 16-year-old female patient was admitted to our hospital due to progressive renal dysfunction with an increased serum creatinine (sCr) level of 1.7 mg/dL. Her clinical course without any ocular manifestations and results of drug-induced, lymphocyte-stimulating tests, in addition to a renal histological assessment, initially encouraged us to ascribe the patient's renal abnormalities to drug-induced acute interstitial nephritis (AIN). Four months later, she started to complain about reduced visual acuity when she was found to have anterior bilateral uveitis despite the recovered renal function with almost constant sCr levels around 0.7 mg/dL. Thus, a diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome was finally made. Our case illustrates the difficulties in distinguishing late-onset uveitis TINU syndrome from drug-induced AIN at the time of the renal biopsy, thereby suggesting the importance of a longitudinal follow-up to overcome the potential underdiagnosis of the disease. Several diagnostic conundrums that emerged in this case are also discussed.
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http://dx.doi.org/10.4137/CCRep.S36862DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795485PMC
March 2016

Therapeutic Challenges to End-Stage Kidney Disease in a Patient with Tetralogy of Fallot.

Clin Med Insights Case Rep 2015 15;8:97-100. Epub 2015 Nov 15.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke-Shi, Tochigi, Japan.

In this report, we describe the case of an end-stage kidney disease patient with tetralogy of Fallot (TOF). A 33-year-old female with TOF was admitted to our hospital with complaints of general fatigue and appetite loss probably due to uremic milieu. She was ultimately treated with peritoneal dialysis (PD) with a favorable clinical course. TOF patients with chronic kidney disease are not exceptional, although the currently available information regarding the association between TOF and renal failure severe enough to require dialysis treatment is limited. We also discuss the complex processes of how and why PD was selected as a mode of chronic renal replacement therapy in this case.
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http://dx.doi.org/10.4137/CCRep.S32121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648563PMC
November 2015

Antineutrophil Cytoplasmic Antibody-associated Glomerulonephritis Complicated by Pneumatosis Intestinalis.

Clin Med Insights Case Rep 2015 10;8:65-70. Epub 2015 Aug 10.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.

Pneumatosis intestinalis is a characteristic imaging phenomenon indicating the presence of gas in the bowel wall. The link between pneumatosis intestinalis and various kinds of autoimmune diseases has been reported anecdotally, while information regarding the cases with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis complicated by concurrent pneumatosis intestinalis is lacking. In this report, we describe our serendipitous experience with one such case of pneumatosis intestinalis in a patient with ANCA-associated glomerulonephritis. We also discuss several therapeutic concerns that arose in the current case, which had an impact on the pathogenesis of the disease.
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http://dx.doi.org/10.4137/CCRep.S26155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533850PMC
August 2015

Delayed Development of Primary Biliary Cirrhosis in a Patient with Acute Glomerulonephritis: A Possible Pitfall of a Self-limiting Disease.

Intern Med 2015 1;54(15):1885-9. Epub 2015 Aug 1.

Division of Nephrology, Department of Medicine, Jichi Medical University, Japan.

Acute poststreptococcal glomerulonephritis (APSGN) is a well-established disease. Although various immune responses are thought to be involved in the pathogenesis of APSGN, the disease has a self-limiting nature in clinical practice, despite the presence of severe acute symptoms. We herein report the case of a 78-year-old woman with APSGN who developed primary biliary cirrhosis (PBC) after achieving remission of renal manifestations, including anasarca and elevation of serum creatinine, indicating that persistent alterations in the immune system can cause extrarenal disorders. This case provides insights into the appropriate clinical management of ASPGN and pathogenesis of PBC.
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http://dx.doi.org/10.2169/internalmedicine.54.3634DOI Listing
March 2016

Nephrotic syndrome complicated with deep venous thrombosis in the upper extremities.

Case Rep Nephrol Dial 2015 Jan-Apr;5(1):1-5. Epub 2014 Jul 30.

Division of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke City, Japan.

Deep venous thrombosis (DVT) in the upper extremities is a rare but important clinical illness, which leads to severe complications such as pulmonary embolism. Unlike DVT in the lower extremities, which is mainly induced by a hypercoagulable state, DVT in the upper extremities is usually caused by mechanical obstruction or anatomical stenosis in the venous system. We herein report a case in which DVT developed in the left upper limb during treatment of nephrotic syndrome. This is the first case report of upper-extremity DVT in association with nephrotic syndrome in the literature. Our patient was a 56-year-old male with nephrotic syndrome due to idiopathic membranous nephropathy who was treated with 40 mg/day of prednisolone. During corticosteroid therapy, he developed a swelling of the left upper limb. Computed tomography revealed thrombi in the left internal jugular vein and the left subclavian vein without anatomical abnormalities in his venous system. Thus, he was diagnosed with DVT of the upper extremities. After the initiation of warfarin treatment and subsequent regression of nephrotic syndrome, the swelling disappeared and the thrombi significantly diminished. DVT should be considered when upper-extremity edema is observed in patients with nephrotic syndrome.
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http://dx.doi.org/10.1159/000365567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294448PMC
April 2015

Three novel serum biomarkers, miR-1, miR-133a, and miR-206 for Limb-girdle muscular dystrophy, Facioscapulohumeral muscular dystrophy, and Becker muscular dystrophy.

Environ Health Prev Med 2014 Nov 24;19(6):452-8. Epub 2014 Aug 24.

Administrative Section of Radiation Protection, National Institute of Neuroscience, Tokyo, Japan.

Objectives: Muscular dystrophies are a clinically and genetically heterogeneous group of inherited myogenic disorders. In clinical tests for these diseases, creatine kinase (CK) is generally used as diagnostic blood-based biomarker. However, because CK levels can be altered by various other factors, such as vigorous exercise, etc., false positive is observed. Therefore, three microRNAs (miRNAs), miR-1, miR-133a, and miR-206, were previously reported as alternative biomarkers for duchenne muscular dystrophy (DMD). However, no alternative biomarkers have been established for the other muscular dystrophies.

Methods: We, therefore, evaluated whether these miR-1, miR-133a, and miR-206 can be used as powerful biomarkers using the serum from muscular dystrophy patients including DMD, myotonic dystrophy 1 (DM1), limb-girdle muscular dystrophy (LGMD), facioscapulohumeral muscular dystrophy (FSHD), becker muscular dystrophy (BMD), and distal myopathy with rimmed vacuoles (DMRV) by qualitative polymerase chain reaction (PCR) amplification assay.

Results: Statistical analysis indicated that all these miRNA levels in serum represented no significant differences between all muscle disorders examined in this study and controls by Bonferroni correction. However, some of these indicated significant differences without correction for testing multiple diseases (P < 0.05). The median values of miR-1 levels in the serum of patients with LGMD, FSHD, and BMD were approximately 5.5, 3.3 and 1.7 compared to that in controls, 0.68, respectively. Similarly, those of miR-133a and miR-206 levels in the serum of BMD patients were about 2.5 and 2.1 compared to those in controls, 1.03 and 1.32, respectively.

Conclusions: Taken together, our data demonstrate that levels of miR-1, miR-133a, and miR-206 in serum of BMD and miR-1 in sera of LGMD and FSHD patients showed no significant differences compared with those of controls by Bonferroni correction. However, the results might need increase in sample sizes to evaluate these three miRNAs as variable biomarkers.
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http://dx.doi.org/10.1007/s12199-014-0405-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235845PMC
November 2014

Delayed development of pulmonary hemorrhage in a patient with positive circulating anti-neutrophil cytoplasmic antibody: a clinical dilemma.

Case Rep Nephrol Urol 2013 2;3(2):121-7. Epub 2013 Oct 2.

Department of Internal Medicine, Oyama Municipal Hospital, Oyama, Jichi Medical University, Shimotsuke, Japan ; Dialysis Center, Oyama Municipal Hospital, Oyama, Jichi Medical University, Shimotsuke, Japan ; Divison of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.

Detection of circulating anti-neutrophil cytoplasmic antibody (ANCA) provides a powerful clue in the diagnosis of vasculitis, but the clinical interpretation of the results is difficult in some cases. Here, we describe the case of a 65-year-old man who underwent hemodialysis due to focal segmental glomerulosclerosis and abruptly developed hemoptysis 14 years after a renal biopsy. At the time of the biopsy, computed tomography (CT) showed interstitial shadows in the lungs and pleural thickening, indicating pneumoconiosis that was accompanied by tuberculosis. Circulating myeloperoxidase-ANCA (10.5-32.5 U/ml) was subsequently noted, but the significance of this observation was unclear due to the preexisting disorders in the lungs and kidneys. Potent immunosuppressive therapies were avoided because of the pulmonary lesions and decreased renal function. There were few changes noted on follow-up CT, but infiltrative shadows emerged in the bilateral lungs, consistent with hemoptysis. The hemorrhagic shadows completely disappeared shortly after initiation of steroid therapy, with normalization of the serum ANCA level. Herein, we report this case, with an emphasis on the clinical dilemma faced in deciding the appropriate treatment. The findings in the case provide deep insights into clinical management of ANCA-positive patients.
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http://dx.doi.org/10.1159/000355509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806712PMC
October 2013

Is calcium replacement therapy unnecessary for severe hypocalcemia associated with rhabdomyolysis?

Clin Exp Nephrol 2014 Feb 19;18(1):172-3. Epub 2013 Jun 19.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.

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http://dx.doi.org/10.1007/s10157-013-0826-4DOI Listing
February 2014

Successful treatment of serial opportunistic infections including disseminated nocardiosis and cryptococcal meningitis in a patient with ANCA-associated vasculitis.

Intern Med 2012 1;51(21):3051-6. Epub 2012 Nov 1.

Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Japan.

We herein present a case of serial opportunistic infections that included disseminated nocardiosis and cryptococcal meningitis in a 67-year-old man who was diagnosed with ANCA-associated vasculitis and treated with corticosteroids. Upon admission, the initial manifestations of the disease included subcutaneous tumors and multiple lesions in the brain and lungs. Nocardia farcinica was identified in a culture of the aspirated pus. The patient was successfully treated for disseminated nocardiosis with antibiotics. However, three months after discharge, he was hospitalized with complaints of nuchal pain. Cryptococcus neoformans was identified on a culture of the cerebrospinal fluid. Anti-fungal treatment resulted in the remission of cryptococcal meningitis.
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http://dx.doi.org/10.2169/internalmedicine.51.7886DOI Listing
April 2013

Matrix metalloproteinase 2 induces epithelial-mesenchymal transition in proximal tubules from the luminal side and progresses fibrosis in mineralocorticoid/salt-induced hypertensive rats.

J Hypertens 2011 Dec;29(12):2440-53

Department of Nephrology, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Objectives: Excess mineralocorticoids such as deoxycorticosterone acetate (DOCA) together with salt are known to cause tubulointerstitial fibrosis, but the mechanisms underlying fibrosis progression are unclear. Therefore, we investigated the role of matrix metalloproteinase 2 (MMP2) in the epithelial-mesenchymal transition and fibrosis progression.

Methods: Uninephrectomized rats drank 0.9% NaCl and 0.3% KCl solution and were treated with DOCA alone, DOCA + spironolactone, or vehicle for 1, 4, or 8 weeks. SBP, kidney function and morphology, and kidney and urine MMP2 activity were compared among the groups.

Results: At week 4, the DOCA-treated group exhibited hypertension, tubulointerstitial fibrosis, increased MMP2 activity in the kidney and urine, and overexpression of MMP2 in proximal tubule cells and MMP14 in apical membranes; these results were more pronounced at week 8. At week 8, the proximal tubule cell apicolateral surface proteins villin, claudin 2, and E-cadherin were downregulated, and the mesenchymal marker α-smooth muscle actin was upregulated in the tubulointerstitium of DOCA-treated rats. These DOCA/salt-induced changes (except for hypertension) and fibrosis progression observed at week 8 were reversed by TISAM (a selective MMP2 inhibitor), which was administered from week 4 to week 8. All of the effects of DOCA/salt at week 8 were attenuated by spironolactone.

Conclusion: Eight weeks of treatment with DOCA/salt activated MMP2, primarily on the apical surface of proximal tubule cells, which induced epithelial-mesenchymal transition from the luminal side and promoted tubulointerstitial fibrosis progression. These MMP2-induced changes occurred via downstream processes regulated by mineralocorticoid receptors.
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http://dx.doi.org/10.1097/HJH.0b013e32834c31f5DOI Listing
December 2011

Development of features of glomerulopathy in tumor-bearing rats: a potential model for paraneoplastic glomerulopathy.

Nephrol Dial Transplant 2012 May 24;27(5):1786-92. Epub 2011 Oct 24.

Division of Nephrology, Department of Medicine, Jichi Medical University, Tochigi, Japan.

Background: It has been well-recognized that cancer patients occasionally develop renal disorders independently of direct tumor invasion. However, the clinical entity of paraneoplastic glomerulopathy remains poorly understood, in part due to the lack of an animal model for basic research. In the present study, we investigated whether cancer-bearing rats develop features of glomerulopathy.

Methods: RCN-9 rat colon cancer cells (1 × 10(7)) were injected into F344 rats (n = 13) and T cell-deficient F344 rats (nude rats; n = 7) via the portal system. Urinalysis and histological examinations were performed in comparison with control rats (n = 6) that received a vehicle injection.

Results: Metastatic growth of RCN-9 cells exclusively in the liver was observed in the cancer-injected F344 rats, whereas direct invasion into the kidney was not evident even microscopically. Two of the cancer-injected F344 rats died within 2 days, but 9 of the 11 that avoided early death showed elevation of urinary protein (up to 158.0 mg/day) compared to controls (mean values: 60.8 ± 12.9 versus 17.8 ± 2.1 mg/day, P = 0.0291). Although morphological changes were not evident in light microscopy, abundant IgG in the glomerular tufts of the proteinuric rats was shown immunohistochemically. Ultrastructure analysis revealed electron-dense deposits in the glomerular basement membrane zone and effacement of the podocytic foot process. Interestingly, none of the nude rats showed proteinuria despite of cancer growth, suggesting that a specific immune response was involved.

Conclusions: The tumor-bearing rats developed features of glomerulopathy, as expected from the clinical perspective, and this animal model may provide new insights into the development of paraneoplastic glomerulopathies.
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http://dx.doi.org/10.1093/ndt/gfr565DOI Listing
May 2012

Anatomical lung segmentectomy simulated by computed tomographic angiography.

Ann Thorac Surg 2010 Oct;90(4):1382-3

Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.

We describe the benefits of simulating lung segmentectomy by using multi-detector computed tomographic angiography. Preoperative determination of the anatomical, intersegmental plane is possible by visualizing the branches of the pulmonary veins. This new technique could be useful in thoracoscopic segmentectomy of the lung.
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http://dx.doi.org/10.1016/j.athoracsur.2009.11.062DOI Listing
October 2010

Tumor histology affects the accuracy of clinical evaluative staging in primary lung cancer.

Lung Cancer 2010 Nov;70(2):195-9

Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, 5-5-1 Toneyama, Toyonaka, Osaka 560-8552, Japan.

Objective: Pathological examination of lung cancer often reveals a more advanced stage than clinical stage. The objective of this study was to evaluate whether the association between clinical and pathologic stages depends on tumor histology.

Methods: This retrospective study enrolled patients who had undergone major lung resections and systemic lymph node dissections (1990-2004). In total, 483 patients had adenocarcinoma and 225 had squamous cell carcinoma.

Results: Clinical and pathologic N-status were significantly different in patients with adenocarcinoma (p<0.0001) but not in those with squamous cell carcinoma. Patients with adenocarcinoma were more likely to be upstaged from clinical N0 disease to pathologic N2 disease than those with squamous cell carcinoma (p = 0.04). Of those patients with adenocarcinoma, surgical procedure, clinical N-status, metastatic pathologic N2 stations and curability were significant prognostic factors. It is of interest, however, that a similar statistically significant difference could not be shown in patients with squamous cell carcinoma. Furthermore, multivariate analysis demonstrated that clinically detectable N2 disease and multiple pathologic N2 stations significantly affected the poorer prognosis in adenocarcinoma. Adenocarcinoma patients with clinically undetectable N2 disease had significantly better 5-year survival than those with clinically detectable N2 disease (p<0.0001), although this was not the case for patients with squamous cell carcinoma (p = 0.81).

Conclusion: In adenocarcinoma patients with pathologic N2 disease, clinical N-status and metastatic pathologic N2 stations were significant prognostic factors. A similar difference was not found in patients with squamous cell carcinoma. Adenocarcinoma and squamous cell carcinoma appear to have different tendencies for lymph node metastasis.
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http://dx.doi.org/10.1016/j.lungcan.2010.02.010DOI Listing
November 2010
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