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1.
Phys Rev Lett ; 120(18): 183601, 2018 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-29775324

RESUMO

We report on experimentally measured light shifts of superconducting flux qubits deep-strongly coupled to LC oscillators, where the coupling constants are comparable to the qubit and oscillator resonance frequencies. By using two-tone spectroscopy, the energies of the six lowest levels of each circuit are determined. We find huge Lamb shifts that exceed 90% of the bare qubit frequencies and inversions of the qubits' ground and excited states when there are a finite number of photons in the oscillator. Our experimental results agree with theoretical predictions based on the quantum Rabi model.

2.
Phys Rev Lett ; 119(2): 023602, 2017 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-28753365

RESUMO

A superconducting qubit in the strong dispersive regime of circuit quantum electrodynamics is a powerful probe for microwave photons in a cavity mode. In this regime, a qubit excitation spectrum is split into multiple peaks, with each peak corresponding to an individual photon number in the cavity (discrete ac Stark shift). Here, we measure the qubit spectrum in a cavity that is driven continuously with a squeezed vacuum generated by a Josephson parametric amplifier. By fitting the obtained spectrum with a model which takes into account the finite qubit excitation power, we determine the photon number distribution, which reveals an even-odd photon number oscillation and quantitatively fulfills Klyshko's criterion for nonclassicality.

3.
Phys Rev Lett ; 113(6): 063604, 2014 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-25148329

RESUMO

By driving a dispersively coupled qubit-resonator system, we realize an "impedance-matched" Λ system that has two identical radiative decay rates from the top level and interacts with a semi-infinite waveguide. It has been predicted that a photon input from the waveguide deterministically induces a Raman transition in the system and switches its electronic state. We confirm this through microwave response to a continuous probe field, observing near-perfect (99.7%) extinction of the reflection and highly efficient (74%) frequency down-conversion. These proof-of-principle results lead to deterministic quantum gates between material qubits and microwave photons and open the possibility for scalable quantum networks interconnected with waveguide photons.

4.
Phys Rev Lett ; 110(26): 263601, 2013 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-23848874

RESUMO

We have investigated the microwave response of a transmon qubit coupled directly to a transmission line. In a transmon qubit, owing to its weak anharmonicity, a single driving field may generate dressed states involving more than two bare states. We confirmed the formation of three-state dressed states by observing all of the six associated Rabi sidebands, which appear as either amplification or attenuation of the probe field. The experimental results are reproduced with good precision by a theoretical model incorporating the radiative coupling between the qubit and the microwave.

5.
J Int Med Res ; 38(4): 1473-83, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20926021

RESUMO

This two-way crossover study investigated possible differences between the proton pump inhibitors, omeprazole and rabeprazole, in their effect on gastric acid secretion in Japanese subjects with differing cytochrome P450, family 2, subfamily C, polypeptide 19 (CYP2C19) genotypes. A total of 23 Helicobacter pylori-negative healthy volunteers received omeprazole 20 mg/day and rabeprazole 10 mg/day. Each drug treatment was given for a continuous 7-day period allocated in random order, with an interval of at least 1 week between drug treatment periods to allow for wash-out. Intragastric pH was measured on days 1 and 7. Overall median intragastric pH levels at 7 and 8 h after the first administration were significantly higher with omeprazole. There was no significant difference in intragastric pH in homozygous extensive metabolizers, whereas intragastric pH was significantly higher with omeprazole in combined data from heterozygous extensive metabolizers and poor metabolizers at 6, 7 and 8 h after the first drug administration. There were no significant differences in intragastric pH between omeprazole and rabeprazole irrespective of genotype on day 7 of administration. In conclusion, on day 1 the time to onset of the antisecretory action of 20 mg/day omeprazole was more rapid than that of 10 mg/day rabeprazole in Japanese individuals who have a higher incidence of the CYP2C19 poor metabolizer genotype, however by day 7 no difference in antisecretory effect was found, regardless of genotype.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/farmacologia , Hidrocarboneto de Aril Hidroxilases/genética , Povo Asiático/genética , Omeprazol/farmacologia , Inibidores da Bomba de Prótons/farmacologia , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Adulto , Estudos Cross-Over , Citocromo P-450 CYP2C19 , Feminino , Genótipo , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/fisiologia , Humanos , Concentração de Íons de Hidrogênio/efeitos dos fármacos , Japão , Masculino , Omeprazol/administração & dosagem , Inibidores da Bomba de Prótons/administração & dosagem , Rabeprazol , Adulto Jovem
6.
Nat Commun ; 11(1): 3683, 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-32703942

RESUMO

The rapid development in designs and fabrication techniques of superconducting qubits has made coherence times of qubits longer. In the future, however, the radiative decay of a qubit into its control line will be a fundamental limitation, imposing a trade-off between fast control and long lifetime of the qubit. Here, we break this trade-off by strongly coupling another superconducting qubit along the control line. This second qubit, which we call "Josephson quantum filter" (JQF), prevents the first qubit from emitting microwave photons and thus suppresses its relaxation, while transmitting large-amplitude control microwave pulses due to the saturation of the quantum filter, enabling fast qubit control. This device functions as an automatic decoupler between a qubit and its control line and could help in the realization of a large-scale superconducting quantum processor by reducing the heating of the qubit environment and the crosstalk between qubits.

7.
Transplant Proc ; 49(5): 1053-1055, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28583525

RESUMO

BACKGROUND: Hepatitis C virus (HCV) infection is known to affect long-term patient and graft survivals after kidney transplantation (KT). Recently, combination therapy with the use of 2 oral direct-acting antivirals, daclatasvir (DCV) and asunaprevir (ASV) reportedly showed a high rate of HCV eradication. We report the safety and efficacy of DCV and ASV therapy in 2 KT patients. METHODS: The safety and viral responses were investigated in a prospective study of KT patients infected with HCV genotype 1. Two patients received 60 mg DCV once daily plus 100 mg ASV twice daily for 24 weeks. RESULTS: A 69-year-old woman and a 57-year-old man underwent DCV and ASV therapy for 24 weeks. In both cases, the HCV genotype was 1b. Case 1 had undergone KT twice and had received treatment with pegylated interferon and ribavirin. She received DCV and ASV therapy 12 years after the 2nd KT, and had undetectable virus after only 6 weeks of treatment and at 24 weeks after the end of treatment (SVR24). The post-transplantation immunosuppressive therapy at that time comprised tacrolimus, mycophenolate mofetil, and prednisolone. The other case, after failure of interferon treatment, received DCV and ASV therapy 27 years after his KT and achieved SVR24. His immunosuppressive regimen at that time was mizoribine and prednisolone. DCV and ASV therapy did not affect renal graft function or tacrolimus blood concentrations. CONCLUSIONS: DCV and ASV therapy had high antiviral effect and a low rate of adverse events in KT patients.


Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Imidazóis/uso terapêutico , Isoquinolinas/uso terapêutico , Transplante de Rim/efeitos adversos , Sulfonamidas/uso terapêutico , Idoso , Carbamatos , Quimioterapia Combinada , Feminino , Hepacivirus , Humanos , Imunossupressores/uso terapêutico , Interferons/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Estudos Prospectivos , Pirrolidinas , Ribavirina/uso terapêutico , Resultado do Tratamento , Valina/análogos & derivados
8.
Transplant Proc ; 49(5): 1187-1188, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28583553

RESUMO

INTRODUCTION: There is no obvious criterion about kidney transplantation for patients with pretransplant malignancy. Minimum tumor-free waiting periods differ according to type of cancer, staging, site of occurrence, response to therapy, and risk of cancer recurrence. We report a case of living donor kidney transplantation (LDKT) in a patient after brachytherapy for prostate cancer. CASE REPORT: The patient was a 65-year-old man with chronic kidney disease due to chronic glomerular nephritis. He received hemodialysis 3 times a week. His prostate-specific antigen level (PSA) was high (6.57 ng/mL), and he was diagnosed with prostate cancer (T1cN0M0, Gleason Score 3 + 4 = 7, 3/10) by needle biopsy in urology. He was treated with maximum androgen blockade (MAB) therapy and brachytherapy in May 2014. He underwent LDKT from a spousal donor at our department in December 2015, because urologists concluded that the prostate cancer was completely cured. Immunosuppression consisted of induction with basiliximab and maintenance with tacrolimus, mizoribine, and steroids. The postoperative course was uneventful. He discharged at postoperative day 29 with a serum creatinine level of 1.30 mg/dL. Three months after LDKT, his PSA level was 0.477 ng/mL, and there was no evidence of prostate cancer recurrence. CONCLUSION: This is the first case of LDKT for patients with prostate cancer after brachytherapy in combination with MAB. There is no recurrence of prostate cancer so far; however, careful follow-up including PSA is necessary and important.


Assuntos
Transplante de Rim/métodos , Doadores Vivos , Neoplasias da Próstata/complicações , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/cirurgia , Idoso , Braquiterapia , Humanos , Masculino , Neoplasias da Próstata/radioterapia
9.
Transplant Proc ; 49(5): 955-958, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28583566

RESUMO

BACKGROUND: Advances in immunosuppressants enable organ transplantation for sensitized patients. However, influences of pre-formed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA) have not been fully understood in renal transplantation (RT). On the other hand, immunocomplex capture fluorescence analysis (ICFA) is a reliable method to detect donor-specific anti-HLA antibodies and HLA antigen complexes. Graft ICFA can detect DSA in an allograft (g-DSA). METHODS: To elucidate the consequences of pre-formed DSA, 198 patients who underwent living-donor RT were enrolled for this study (observation period: 57.8 ± 34.9 months); 187 patients in the DSA- group (excluding ABO-incompatible cases) and 11 patients in the DSA+ group. Before RT, all DSA+ patients had undergone rituximab administration and plasmapheresis. For a graft ICFA, the biopsy specimen (1 × 105 cells) was dissolved, and HLA antigens were captured by anti-HLA beads. Finally, DSA-HLA complexes were detected by means of PE-conjugated anti-human IgG antibodies and analyzed by use of a Luminex system. A ratio (sample/blank beads, mean of fluorescence intensity) was calculated: ≥1.0 was determined as positive g-DSA. RESULTS: There were no significant differences in 5-year graft survival (87.9%/100% in the DSA-/DSA+ groups, respectively). In terms of antibody-mediated rejection (AMR), within 1 month after RT, pathologically determined AMR occurred 3.2% and 63.4% in the DSA- and DSA+ groups, respectively (P < .0001). However, interestingly, more than half of them (57.1%) indicated only subclinical AMR, that is, no fluctuation of S-Cr. As representative of 2 cases of subclinical AMR, g-DSA deposition could be confirmed (1.15 ± 0.04) at 1 hour after reperfusion by graft ICFA. Furthermore, g-DSA shifted to 2.20 ± 0.98 at 3 weeks after transplantation, along with a decline in s-DSA mean of fluorescence intensity (1718-506.5). CONCLUSIONS: Although pathologically determined AMR occurred more frequently in pre-formed DSA+ recipients, it can be argued that a successful de-sensitization protocol inhibits further production of DSA and graft destruction.


Assuntos
Anticorpos/imunologia , Rejeição de Enxerto/imunologia , Antígenos HLA/imunologia , Transplante de Rim/métodos , Doadores Vivos , Adulto , Feminino , Sobrevivência de Enxerto , Humanos , Imunossupressores , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Transplante Homólogo
10.
Aliment Pharmacol Ther ; 24(10): 1445-51, 2006 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-17032285

RESUMO

BACKGROUND: The absorption and bioavailability of proton pump inhibitors is influenced by food intake. Proton pump inhibitors bind to the parietal cell active proton pump, which is maximally stimulated after dinner: usually the largest meal of the day. However, it has not been fully clarified whether the efficacy of proton pump inhibitors differs between post-breakfast and pre-dinner dosing. AIM: To perform a pH-monitoring study to clarify this issue for two low-dose proton pump inhibitors. SUBJECTS AND METHODS: The subjects were 20 healthy male volunteers (seven Helicobacter pylori-positive and 13 H. pylori-negative), who were divided into two groups of 10 and administered 15 mg lansoprazole or 10 mg rabeprazole, respectively. All subjects underwent ambulatory intragastric 24-h pH- monitoring under three conditions allocated randomly: (i) without medication, (ii) seventh day of post-breakfast administration and (iii) eighth day of pre-dinner administration of each drug. RESULTS: There was no significant difference in the percentage time during which pH > or =4.0 in the 24-h period between post-breakfast and pre-dinner administration of both drugs (56.6% vs. 55.8%; P = 0.557), although intragastric acidity during administration of both drugs was significantly lower than that without medication. CONCLUSIONS: The timing of drug administration does not significantly influence the efficacy of low-dose proton pump inhibitors.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Suco Gástrico/metabolismo , Inibidores da Bomba de Prótons , Adulto , Antiulcerosos/administração & dosagem , Estudos Cross-Over , Esquema de Medicação , Determinação da Acidez Gástrica , Infecções por Helicobacter/metabolismo , Helicobacter pylori , Humanos , Concentração de Íons de Hidrogênio/efeitos dos fármacos , Lansoprazol , Masculino , Pessoa de Meia-Idade , Bombas de Próton/administração & dosagem , Rabeprazol , Fatores de Tempo
11.
Dig Liver Dis ; 38(5): 296-300, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16542886

RESUMO

BACKGROUND: Pit pattern diagnosis is important for endoscopic detection of dysplastic Barrett's lesions, though using magnification endoscopy can be difficult and laborious. We investigated the usefulness of a modified crystal violet chromoendoscopy procedure and utilised a new pit pattern classification for diagnosis of dysplastic Barrett's lesions. METHODS: A total of 1,030 patients suspected of having a columnar lined oesophagus were examined, of whom 816 demonstrated a crystal violet-stained columnar lined oesophagus. The early group of patients underwent 0.05% crystal violet chromoendoscopy, while the later group was examined using 0.03% crystal violet with 3.0% acetate. A targeted biopsy of the columnar lined oesophagus was performed using crystal violet staining after making a diagnosis of closed or open type pit pattern with a newly proposed system of classification. The relationship between type of pit pattern and histologically identified dysplastic Barrett's lesions was evaluated. RESULTS: Dysplastic Barrett's lesions were identified in biopsy samples with an open type pit pattern with a sensitivity of 96.0%. Further, Barrett's mucosa with the intestinal predominant mucin phenotype was closely associated with the open type pit pattern (sensitivity 81.9%, specificity 95.6%). CONCLUSIONS: The new pit pattern classification for diagnosis of Barrett's mucosa was found to be useful for identification of cases with dysplastic lesions and possible malignant potential using a crystal violet chromoendoscopic procedure.


Assuntos
Anti-Infecciosos Locais , Esôfago de Barrett/patologia , Endoscopia do Sistema Digestório/métodos , Violeta Genciana , Acetatos , Adulto , Idoso , Idoso de 80 Anos ou mais , Esôfago de Barrett/classificação , Biópsia , Esôfago/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa/patologia
12.
Transplant Proc ; 48(3): 786-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27234736

RESUMO

BACKGROUND: Everolimus (EVR) has been used widely for the purpose of reducing the dosage of calcineurin inhibitor (CNI), leading to decreasing CNI nephrotoxicity. In Japan, high-dose mizoribine (MZR) (6 mg/kg/day) has been increasingly used because of incidences of virus infection and gastrointestinal disorder in kidney transplant recipients. However, the efficacy and safety of EVR and MZR combination therapy is still uncertain. METHODS: A total of 29 living kidney transplant recipients from October 2012 to June 2014 were analyzed. Tacrolimus (TAC), MZR, basiliximab, and prednisolone were administered to all recipients. EVR was added to the regimen for 10 recipients from postoperative day 10 to 14; TAC trough levels were minimized simultaneously (EVR group). The remaining 19 recipients were defined as the control group. We evaluated the outcomes between the 2 groups. RESULTS: The mean TAC trough level was 5.17 ng/mL at 1 month after transplantation in the EVR group, and 7.89 ng/mL in the control group (P = .007), respectively. The mean TAC trough level was 4.0 ng/mL at 18 months after transplantation in the EVR group, and 6.97 ng/mL in the control group (P = .003) respectively. There were no differences in the rate of acute rejection and serum creatinine level. There was no significant difference in the incidence of histological nephrotoxicity between the 2 groups in the 1-year biopsy results. CONCLUSIONS: We succeeded in reducing TAC trough level immediately after transplantation by adding EVR. Our study results suggest that this combination therapy is effective for kidney transplantation recipients.


Assuntos
Everolimo/uso terapêutico , Imunossupressores/uso terapêutico , Transplante de Rim , Ribonucleosídeos/uso terapêutico , Tacrolimo/uso terapêutico , Transplantados , Adulto , Idoso , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Humanos , Imunossupressores/sangue , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Tacrolimo/sangue , Adulto Jovem
13.
Transplant Proc ; 48(4): 1115-8, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27320569

RESUMO

BACKGROUND: Among living donor liver transplant (LDLT) recipients, the number of elderly individuals has been increasing because of longer survival due to the improvement of treatment for hepatic diseases such as hepatitis C (HCV). Here we report the outcomes of living donor recipients over the age of 60 years. MATERIALS AND METHODS: In 76 adult LDLT patients at our institution before September 2015, there were 21 recipients over 60 years old. We divided all of the recipients into 2 groups ("elderly" recipient group >60 years of age [n = 21], and a "nonelderly" recipient group <60 years [n = 55]), and we investigated outcomes in each group. RESULTS: The graft survival rates in the elderly group were 89.9% at 1 year, 89.9% at 3 years, 83.0% at 5 years, and 83.0% at 10 years. The graft survival rates in the nonelderly group was 91.1% at 1 year, 85.2% at 3 years, 82.8% at 5 years, and 82.9% at 10 year. There was no significant difference between the 2 age groups. In the elderly group, 3 patients died (2 patients had HCV recurrence and 1 patient had fungal infection in the brain, leading to a fatal subarachnoid hemorrhage). In the nonelderly group, 4 of 10 patients died of graft failure due to the graft size being too small. CONCLUSION: Elderly patients, at the end stage of liver failure, are likely very frail and may have latent infections. Careful examination for latent infections before LDLT should be carefully performed in regard to indications for LDLT, which might reach satisfactory outcomes as in nonelderly LDLT recipients. Even if elderly patients are approved for transplantation, very careful management is needed.


Assuntos
Doença Hepática Terminal/cirurgia , Transplante de Fígado , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Doença Hepática Terminal/mortalidade , Feminino , Sobrevivência de Enxerto , Humanos , Japão , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Recidiva , Taxa de Sobrevida , Resultado do Tratamento
14.
J Comp Pathol ; 155(2-3): 263-266, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27421619

RESUMO

A 9-year-old male red panda (Ailurus fulgens) became emaciated and died. Necropsy examination revealed systemic lymphadenomegaly. The liver, lungs and left kidney contained multifocal yellow nodules. Microscopical examination revealed granulomatous inflammation in the liver, lungs, kidney, spleen and lymph nodes, with numerous acid-fast bacilli. Sequencing of genetic material isolated from the tissues classified the pathogen as Mycobacterium gastri. Lymphoma was found in the liver, lungs, kidney and lymph nodes. The neoplastic cells were strongly labelled for expression of CD3, Ki67 and proliferating cell nuclear antigen by immunohistochemistry. This is the first report of M. gastri infection with T-cell lymphoma in a red panda.


Assuntos
Ailuridae , Linfoma de Células T/veterinária , Infecções por Mycobacterium/veterinária , Ailuridae/microbiologia , Animais , Animais de Zoológico/microbiologia , Masculino , Mycobacterium
15.
Transplant Proc ; 47(3): 612-6, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891696

RESUMO

Improving the short-term outcome of kidney transplantation, the rejection induced by anti-donor specific antibody (DSA) has been the large complication. We analyzed 324 living-donor kidney transplant recipients (procedures performed between April 2003 and August 2014) to investigate the outcome of kidney transplant recipients with DSA. We divided them into four groups (anti-blood type antibody alone, group A [n = 73]; anti-human lymphocyte antigen [HLA] antibody alone, group B [n = 11]; both antibodies, group C [n = 8]; and no DSA, group D [n = 232]) and investigated the incidence of rejection and those histologic findings. Each case with DSA underwent some desensitization therapy before transplantation. There was no significant difference in graft survival (all cases: 100% at 1 year, group A: 97.6%, B: 95.9%, C: 100%, and at 5 years, group D: 96.1%). There were some significant differences in incidence of acute antibody-mediated rejection (AAMR) and chronic active antibody-mediated rejection (CAAMR) among four groups (group A: 4.1% and 2.7%, B: 18.2% and 9.1%, C: 12.5% and 12.5%, D: 0% and 0.9%, respectively). Each AAMR case was improved by ordinary desensitization therapy, but half of the CAAMR cases, diagnosed early after transplantation, had no effect of any therapy to result in graft failure. Our results suggested that even the case with DSA could be transplanted safely by some desensitization therapy. However, we should be cautious regarding recipients with DSA for the long term even if there is no histologic change early after transplantation because graft loss may occur due to CAAMR.


Assuntos
Anticorpos/imunologia , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Transplante de Rim/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Dessensibilização Imunológica/métodos , Feminino , Rejeição de Enxerto/epidemiologia , Humanos , Incidência , Japão , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
16.
Transplant Proc ; 47(3): 626-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891699

RESUMO

BACKGROUND: There is a growing tendency to perform pre-emptive kidney transplantation (PKT). However, less research has been performed on outcomes of PKT and kidney transplantation (KT) after long-term dialysis (LD). METHODS: To elucidate advantages of PKT to KTLD, 96 patients who underwent living-donor KT at our university from 2000 to 2011 were enrolled for this study: 64 patients in the PKT0 (0 months dialysis) group; 14 patients in the PKT-3 group (less than 3 months dialysis); 18 patients in the LD (dialysis > 120 months) group. All recipients were assessed for patients' survival, graft survival, urinary tract infection, laboratory data, episodes of acute rejection, cytomegalovirus-related diseases, and other significant infectious diseases which required hospitalization. RESULTS: Although there were no significant differences in 5-year graft survival (93.8% in PKT0, 85.7% in PKT-3, and 83.7% in control), 5-year patient survival is better in the PKT0 group (96.9%) and the PKT-3 group (92.9%) compared to 88.9% in the control group. Urinary tract infection is clearly correlated with the LD group (44.4% in the LD group vs 19.2% in the PKT group) primarily due to atrophic bladder and subsequent vesicoureteral reflux. Slightly higher rates of acute rejection were found in the PKT groups (30.8% vs 26.3%). CONCLUSION: This study revealed that there are both advantages and disadvantages of PKT. It is clear, therefore, that PKT can be recommended for end-stage renal disease patients provided enough attention is paid to the onset of acute rejection.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Adulto , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Diálise Renal , Estudos Retrospectivos , Resultado do Tratamento
17.
Transplant Proc ; 47(3): 630-4, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891700

RESUMO

BACKGROUND: Introduction of everolimus (RAD) has been established as a new immunosuppressive medication for kidney transplant (KT) recipients. Administration of RAD is capable of reducing the dosage of coadministrated calcineurin inhibitors (CNI). However, histological investigations have rarely been performed. METHODS: To clarify histopathologic effects of RAD, a total of 9 adult KT recipients were enrolled (RAD group, n = 5; Mycophenolate mofetil (MMF) group, n = 4). Renal graft biopsies had been performed at 3 weeks and 1 year following KT. RESULTS: There were no differences in 1-, 3-, and 5-year graft survival rates (RAD group: 100%, 100%, and 80%, respectively; MMF group: 100%, 100%, and 75%, respectively), and patient survival between the 2 groups (no deaths during the 5 years post-transplantation). Interestingly, although 2 patients in the RAD group had developed CNI nephrotoxicity clinically, renal biopsies had proven no CNI-related lesions 1 year later, which might be due to the reduction in CNI. On the other hand, 1 patient, in the MMF group, had been diagnosed histologically with new-onset CNI nephrotoxicity 1 year following KT. Importantly, the frequency and mean arteriolar hyalinosis (ah) scores, which reflect CNI nephrotoxicity, were significantly higher in the MMF group at 1-year biopsy (P < .05, P < .0001). Two patients in the RAD group improved their ah scores between 3 weeks and 1 year. CONCLUSIONS: Pathological findings revealed that reversible CNI nephrotoxicity can be improved by RAD with reduced CNI maintenance therapy. It is reasonable to believe, therefore, that introduction of RAD is useful for patients who have been diagnosed with CNI nephrotoxicity.


Assuntos
Rejeição de Enxerto/prevenção & controle , Imunossupressores/uso terapêutico , Transplante de Rim , Rim/efeitos dos fármacos , Sirolimo/análogos & derivados , Adulto , Biópsia , Inibidores de Calcineurina/efeitos adversos , Inibidores de Calcineurina/uso terapêutico , Quimioterapia Combinada , Everolimo , Feminino , Rejeição de Enxerto/patologia , Humanos , Imunossupressores/efeitos adversos , Rim/patologia , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Estudos Prospectivos , Sirolimo/efeitos adversos , Sirolimo/uso terapêutico , Resultado do Tratamento
18.
Transplant Proc ; 47(3): 640-3, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891702

RESUMO

BACKGROUND: Chronic allograft injury (CAI) is one of the most important factors for graft failure after renal transplantation. Protocol biopsy is the most valuable tool for revealing subclinical renal allograft failure. Transient elastography (TE) is a noninvasive technique that has shown utility for the assessment of hepatic and renal fibrosis. This study sought to evaluate whether TE was a viable and effective method for the assessment of renal allograft failure. PATIENTS AND METHODS: Thirty-five patients underwent TE by Fibro Scan (Echosense, Paris, France). Biopsies were performed in 27 patients, allowing classification according to Banff chronic changes in the interstitium grade 0, grade 1 or grade 2. RESULTS: Measurement of parenchymal stiffness was successful in 31 of 35 patients (91%). Stiffness was significantly correlated with interstitial fibrosis (P < .05) and inversely related with estimated glomerular filtration rate (eGFR; P < .05). Stiffness values of patients with eGFR > 50 mL/min were lower than those of patients with eGFR < 50 mL/min (P < .05). Patients classed as CAI Banff grade 0 had significantly less parenchymal stiffness than patients with Banff grade 1 or grade 2 CAI (P < .05). Parenchymal stiffness measured by TE reflected interstitial fibrosis in renal allograft. CONCLUSION: Assessment of parenchymal renal allograft stiffness by TE was effective for identifying patients with CAI who may subsequently benefit from biopsy and modification of the immunosuppressive regimen. Assessment of parenchymal renal allograft stiffness can be effective for identifying patients with CAI. TE has the potential to reduce the number of renal allograft biopsies required for accurate assessment of CAI.


Assuntos
Aloenxertos/patologia , Técnicas de Imagem por Elasticidade , Transplante de Rim , Rim/patologia , Adulto , Idoso , Aloenxertos/diagnóstico por imagem , Biópsia , Feminino , Fibrose/diagnóstico por imagem , Humanos , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Transplante Homólogo
19.
Transplant Proc ; 47(3): 644-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891703

RESUMO

BACKGROUND: The introduction of rituximab has led to a growing tendency to perform ABO-incompatible living-donor kidney transplantation (LDKT) without splenectomy. However, the optimal dosage of rituximab is undefined. METHOD: Fifty-five LDKT recipients who had neither a history of hepatitis B infection nor positive crossmatch were enrolled between October 2005 and June 2014. Recipients were divided into three groups by year of transplantation: 2005 to 2008; 2009 to 2011; and 2012 to 2014. Percentages of CD20-positive B lymphocytes and blood-group antibody titers were monitored before renal transplantation. An initial rituximab dosage of 100 mg/body (for titers below 64) or 200 mg/body (for titers above 128) was administered 2 weeks before transplantation. If the percentage of peripheral B lymphocytes remained greater than 0.5%, additional rituximab (100 mg or 200 mg) was administered. Patient demographics, patient survival, graft survival, and complication rates were compared. RESULTS: Nine patients received rituximab 100 mg/body (low-dose rituximab [LDR] group). Overall survival and graft survival rates did not differ significantly between the LDR group and other cases. The incidences of myelosuppression and viral infection were lower in the LDR group than the other cases. CONCLUSION: A low dose of rituximab (100 mg/body) is adequate in ABO-incompatible LDKT, especially in cases with low blood-type antibody titer against ABO-antigens. Rituximab dosage reduction has been successful in our hospital without serious complications. Moreover, as over-dosage of rituximab may cause myelosuppression, it is reasonable to believe that LDR is a suitable option to safely perform ABO-incompatible LDKT without splenectomy.


Assuntos
Sistema ABO de Grupos Sanguíneos/imunologia , Anticorpos Monoclonais Murinos/administração & dosagem , Incompatibilidade de Grupos Sanguíneos/imunologia , Rejeição de Enxerto/prevenção & controle , Imunossupressores/administração & dosagem , Transplante de Rim , Doadores Vivos , Adulto , Idoso , Anticorpos Monoclonais Murinos/uso terapêutico , Tipagem e Reações Cruzadas Sanguíneas , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Humanos , Imunossupressores/uso terapêutico , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Rituximab , Taxa de Sobrevida , Resultado do Tratamento
20.
Phys Rev Lett ; 84(14): 3181-4, 2000 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-11019042

RESUMO

We report a dynamical study on the photoinduced cooperative changes of the spin configurations in single crystals of the organometal spin-crossover complex. In the photoswitching process between low- and high-spin states, nonlinear characteristics such as thresholdlike behavior, incubation period, and phase separation have been observed. These results demonstrate that the cooperative intersystem crossing mediated by spin-lattice interaction plays a key role in the driving process of a new class of nonequilibrium phenomena so called photoinduced phase transition.

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