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1.
Phys Rev Lett ; 122(7): 076402, 2019 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-30848650

RESUMO

Topological semimetals materialize a new state of quantum matter where massless fermions protected by a specific crystal symmetry host exotic quantum phenomena. Distinct from well-known Dirac and Weyl fermions, structurally chiral topological semimetals are predicted to host new types of massless fermions characterized by a large topological charge, whereas such exotic fermions are yet to be experimentally established. Here, by using angle-resolved photoemission spectroscopy, we experimentally demonstrate that a transition-metal silicide CoSi hosts two types of chiral topological fermions, a spin-1 chiral fermion and a double Weyl fermion, in the center and corner of the bulk Brillouin zone, respectively. Intriguingly, we found that the bulk Fermi surfaces are purely composed of the energy bands related to these fermions. We also find the surface states connecting the Fermi surfaces associated with these fermions, suggesting the existence of the predicted Fermi-arc surface states. Our result provides the first experimental evidence for the chiral topological fermions beyond Dirac and Weyl fermions in condensed-matter systems, and paves the pathway toward realizing exotic electronic properties associated with unconventional chiral fermions.

2.
Nano Lett ; 15(6): 4013-8, 2015 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-25996311

RESUMO

Single-layer transition-metal dichalcogenides (TMDs) receive significant attention due to their intriguing physical properties for both fundamental research and potential applications in electronics, optoelectronics, spintronics, catalysis, and so on. Here, we demonstrate the epitaxial growth of high-quality single-crystal, monolayer platinum diselenide (PtSe2), a new member of the layered TMDs family, by a single step of direct selenization of a Pt(111) substrate. A combination of atomic-resolution experimental characterizations and first-principle theoretic calculations reveals the atomic structure of the monolayer PtSe2/Pt(111). Angle-resolved photoemission spectroscopy measurements confirm for the first time the semiconducting electronic structure of monolayer PtSe2 (in contrast to its semimetallic bulk counterpart). The photocatalytic activity of monolayer PtSe2 film is evaluated by a methylene-blue photodegradation experiment, demonstrating its practical application as a promising photocatalyst. Moreover, circular polarization calculations predict that monolayer PtSe2 has also potential applications in valleytronics.


Assuntos
Processos Fotoquímicos , Platina/química , Compostos de Selênio/química , Semicondutores
3.
Clin Exp Nephrol ; 19(4): 661-8, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25399058

RESUMO

BACKGROUND: Dietary protein intake (PI) induces glomerular hyperfiltration and reduced dietary PI can be effective in preserving kidney function. However, there is limited information regarding the relationship between dietary PI and glomerular histological changes in chronic kidney disease. We investigated the relationship between changes in dietary PI and both the changes in creatinine clearance and glomerular histomorphometry in adult patients with IgA nephropathy (IgAN). METHODS: A total of 24 consecutive adult patients with biopsy-confirmed IgAN were enrolled and glomerular histomorphometric variables and clinical variables were investigated. The main clinical variables were differences in creatinine clearance (Ccr) (dCcr) and in PI (dPI) which were calculated by subtracting PI and Ccr values in patients on a controlled diet during hospitalization for kidney biopsy from the respective values in patients on daily diets as outpatients. These values of PI were estimated from urinary urea excretion measured by 24-h urine collection. The main renal histomorphometric variable was glomerular tuft area (GTA) (µm(2)). RESULTS: dCcr positively correlated with dPI (r = 0.726, P < 0.001). GTA correlated positively with dPI (r = 0.556, P = 0.013). Multiple regression analysis showed that dPI was independently associated with both dCcr and GTA. Additionally, GTA positively correlated with dietary PI as outpatients (r = 0.457, P = 0.043). CONCLUSION: Changes in dietary PI were associated with the changes in glomerular filtration rate. Furthermore, histomorphometric findings suggested that a greater dietary PI can affect the glomerular size at the time of the initial diagnostic biopsy for IgAN.


Assuntos
Proteínas Alimentares/farmacologia , Glomerulonefrite por IGA/fisiopatologia , Glomérulos Renais/efeitos dos fármacos , Adulto , Creatinina/urina , Feminino , Taxa de Filtração Glomerular , Glomerulonefrite por IGA/patologia , Glomerulonefrite por IGA/urina , Humanos , Glomérulos Renais/patologia , Masculino , Adulto Jovem
4.
Blood Purif ; 38(2): 149-53, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25471451

RESUMO

BACKGROUND/AIMS: Combining peritoneal dialysis (PD) and hemodialysis (HD) has been common treatment option in Japan. METHODS: In this retrospective, multicenter, observational study, the clinical characteristics and outcomes of 104 patients (57 ± 11 years, males 72%) who had switched from PD alone to combined therapy with PD and HD were studied. Clinical parameters were measured at baseline and after 3 months of combined therapy. RESULTS: At baseline, urine volume, dialysate-to-plasma ratio of creatinine (D/P Cr), and total Kt/V were 150 ml/day (range: 0-2,000 ml/day), 0.67 ± 0.11, and 1.8 ± 0.4, respectively. During the first 3 months of combined therapy, body weight, urine volume, serum creatinine level, and D/P Cr decreased, whereas hemoglobin levels increased. CONCLUSIONS: In patients where PD does not result in acceptable outcomes, combined therapy with PD and HD may have potential benefits in terms of dialysis adequacy and hydration status. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=368389


Assuntos
Creatinina/sangue , Falência Renal Crônica/terapia , Diálise Peritoneal , Idoso , Feminino , Soluções para Hemodiálise/química , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/patologia , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Diálise Renal , Estudos Retrospectivos , Urinálise
5.
Sci Rep ; 14(1): 20970, 2024 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-39313521

RESUMO

The experimental efficiency has been a central concern for time-consuming experiments. Spin- and angle-resolved photoemission spectroscopy (spin-resolved ARPES) is renowned for its inefficiency in spin-detection, despite its outstanding capability to directly determine the spin-polarized electronic properties of materials. Here, we investigate the potential enhancement of the efficiency of spin-resolved ARPES experiments through the integration of measurement informatics. We focus on a representative topological insulator Bi 2 Te 3 , which has well-understood spin-polarized electronic states. We employ Gaussian process regression (GPR) to assess the accumulation of spin polarization information using an indicator known as the GPR score. Our analyses based on the GPR model suggest that the GPR score can serve as a stopping criterion for spin-resolved ARPES experiments. This criterion enables us to conduct efficient spin-resolved ARPES experiments, significantly reducing the time costs by 5-10 times, compared to empirical stopping criteria.

6.
Nature ; 446(7133): E5, 2007 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-17361133

RESUMO

The possibility that a pairing boson might act as the 'glue' to bind electrons into a Cooper pair in superconductors with a high critical temperature (T(c)) is being actively pursued in condensed-matter physics. Gweon et al. claim that there is a large and unusual oxygen-isotope effect on the electronic structure, indicating that phonons have a special importance in high-temperature superconductors. However, we are unable to detect this unusual oxygen-isotope effect in new data collected under almost identical material and experimental conditions. Our findings point towards a more conventional influence of phonons in these materials.

7.
Nephrology (Carlton) ; 18(4): 285-91, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23432763

RESUMO

AIM: We investigated the handling of phosphate by end-stage kidneys and the contribution of residual renal function (RRF) to phosphate homeostasis in haemodialysis patients. METHODS: Blood and 24 h urinary specimens were obtained from 79 consecutive chronic haemodialysis patients with a urinary output greater than 100 mL/day. Thirty-five patients with a glomerular filtration rate (GFR) ≥ 3.0 mL/min were included as group A, and 44 patients with GFR < 3.0 mL/min as group B. Additionally, the whole dialysed fluids during a session of haemodialysis were collected from another nine patients. Concentrations of phosphate, creatinine, urea nitrogen, intact parathyroid hormone (iPTH) and fibroblast growth factor 23 (FGF-23) were measured. RESULTS: Twenty-four hour urinary phosphate excretion (UPE) was 283 ± 115 and 139 ± 57 mg/day (9.1 ± 3.5 and 4.5 ± 1.8 mmol/day) in groups A and B, respectively. Tubular reabsorption of phosphate (TRP) was 39.2 ± 13.3 and 31.7 ± 13.6% in groups A and B, respectively (P = 0.02). UPE significantly correlated with GFR (r = 0.85, P < 0.001) and PTH (r = 0.44, P < 0.001), but not with FGF-23, in the entire patient population. The correlation between UPE and intact PTH levels was absent in group B. Weekly UPE in group A was significantly greater (P < 0.001), while that in group B was similar to the amount of phosphate removed by a haemodialysis session. CONCLUSIONS: Urinary phosphate excretion by end-stage kidneys depends more on GFR than diminishing TRP. The action of PTH on the kidneys remains until GFR decreases to as low as 3 mL/min. Residual renal function plays a significant role in phosphate elimination, and it is possible that FGF-23 no longer acts effectively to excrete phosphate in the urine in these patients.


Assuntos
Falência Renal Crônica/terapia , Rim/metabolismo , Fosfatos/metabolismo , Diálise Renal , Idoso , Biomarcadores/sangue , Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Estudos Transversais , Feminino , Fator de Crescimento de Fibroblastos 23 , Fatores de Crescimento de Fibroblastos/sangue , Taxa de Filtração Glomerular , Homeostase , Humanos , Rim/fisiopatologia , Falência Renal Crônica/sangue , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/urina , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Fosfatos/urina , Estudos Retrospectivos , Fatores de Tempo
8.
Sci Rep ; 13(1): 13451, 2023 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-37596292

RESUMO

The role of spin-orbit interaction has been recently reconsidered in high-[Formula: see text] cuprates, stimulated by the recent experimental observations of spin-polarized electronic states. However, due to the complexity of the spin texture reported, the origin of the spin polarization in high-[Formula: see text] cuprates remains unclear. Here, we present the spin- and angle-resolved photoemission spectroscopy (ARPES) data on the facing momentum points that are symmetric with respect to the [Formula: see text] point, to ensure the intrinsic spin nature related to the initial state. We consistently found the very weak spin polarization only along the nodal direction, with no indication of spin-splitting of the band. Our findings thus call for a revision of the simple application of the spin-orbit interaction, which has been treated within the standard framework of the Rashba interaction in high-[Formula: see text] cuprates.

9.
Nephrology (Carlton) ; 16(3): 319-25, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21077987

RESUMO

AIM: Chronic nephrotoxicity of long-term cyclosporine A (CsA) treatment is a matter of concern in patients with steroid-dependent nephrotic syndrome (SDNS). METHODS: Twenty-eight adult NS patients (25, minimal-change nephrotic syndrome (NS); three, focal-segmental glomerulosclerosis) were divided into three groups. Group A was continuously treated with CsA for more than 5 years (143 ± 40 months, 1.3 ± 0.4 mg/kg per day at final analysis, n = 12); group B had been previously treated with CsA (70 ± 27 months, n = 6); and group C had been treated with corticosteroids alone (n = 10). The clinical variables related to chronic CsA nephrotoxicity were examined. RESULTS: In groups A and B, estimated glomerular filtration rate decreased from 86 ± 22 and 107 ± 17 to 83 ± 23 and 88 ± 13 mL/min per 1.73 m(2) , respectively, at final analysis (both P < 0.05). Serum magnesium levels in group A were significantly lower than those in group B or C (A, 1.78 ± 0.16 mg/dL; B, 2.00 ± 0.14 mg/dL; C, 2.03 ± 0.10 mg/dL; A vs B, C, P < 0.01), and a significant correlation between these and the duration of CsA treatment was found (r = -0.68, P < 0.001). There was a trend towards a correlation between the duration of CsA administration and urinary α1-microglobulin (r = 0.38, P = 0.07). CONCLUSION: Mild decrease in renal function and hypomagnesemia were found in adult SDNS patients with long-term CsA treatment. Careful monitoring of renal function, blood pressure and serum magnesium levels is necessary.


Assuntos
Corticosteroides/administração & dosagem , Ciclosporina/efeitos adversos , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Rim/efeitos dos fármacos , Síndrome Nefrótica/tratamento farmacológico , Adolescente , Adulto , Idoso , Análise de Variância , Biomarcadores/sangue , Pressão Sanguínea/efeitos dos fármacos , Ciclosporina/administração & dosagem , Esquema de Medicação , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Glomerulosclerose Segmentar e Focal/sangue , Glomerulosclerose Segmentar e Focal/fisiopatologia , Humanos , Japão , Rim/metabolismo , Rim/fisiopatologia , Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/sangue , Síndrome Nefrótica/fisiopatologia , Recidiva , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Nephrology (Carlton) ; 16(5): 476-82, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21126287

RESUMO

AIM: Haemodiafiltration (HDF) is the most efficient blood purification method and can remove a wide spectrum of solutes of different molecular weights (MW). The purpose of this study was to investigate whether the removed amounts of solutes, especially the larger molecules, could be increased by changing the HDF filtration procedure. METHODS: A new first-half intensive HDF treatment (F-HDF) was designed, whereby convective clearance is intensively forced during the first half of a HDF session. We compared the removed amounts of solutes in the same group of nine patients treated by F-HDF, constant rate-replacing HDF (C-HDF) and a high-flux haemodialysis (HD). RESULTS: F-HDF can remove significantly larger amounts of α(1) -microglobulin (MG), molecular weight (MW) 33,000, compared with HD and C-HDF (30.1 ± 15.1 vs 12.4 ± 0.3, 15.0 ± 3.1 mg, P < 0.01). Regarding the removal amounts and clear space of ß(2) MG, MW 11,800, there were no significant differences between the three treatment modalities. Regarding amounts of creatinine, urea nitrogen and phosphorus, there were no significant differences between the three treatment modalities. CONCLUSION: In post-replacement HDF with a high-flux membrane dialyzer, the method used in the present study in which replacement is completed during the first half of the process, is associated with a greater rate of larger molecule removal than the conventional uniform replacement method.


Assuntos
Hemodiafiltração/métodos , Uremia/terapia , Adulto , Idoso , Nitrogênio da Ureia Sanguínea , Creatinina/isolamento & purificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fosfatos/isolamento & purificação , Uremia/sangue , Microglobulina beta-2/isolamento & purificação
11.
Nihon Jinzo Gakkai Shi ; 50(5): 588-96, 2008.
Artigo em Japonês | MEDLINE | ID: mdl-18767487

RESUMO

PURPOSE: We examined the characteristics of the day-by-day variability of home blood pressure (HBP) in patients with chronic kidney disease (CKD). METHODS: We obtained HBP recordings from 368 CKD patients (63+/-13 years, eGFR 34+/-23 mL/min/1.73 m2, males 253). The day-by-day variability of HBP was defined as the coefficient of variation (CV) values of BP measurements every morning after waking and every evening before sleeping on 7 consecutive days. In a portion of the patients, the CV values of HBP were collected every 6 months during a 2-year period and the association with a decline in GFR was examined. RESULTS: CV values of morning/evening systolic BP (SBP) were 5.4+/-2.4%, 6.1+/-2.9 % (p<0.01). The CV values of morning SBP in females or patients with diabetic nephropathy (DN) were significantly greater than those in males or patients without DN, respectively (females 5.9+/-2.3%, males 5.2+/-2.4%, p< 0.01, DN 6.1+/-2.8 %, non DN 5.2+/-2.2 %, p<0.05). Multivariate linear regression analysis showed that female gender, DN, the number of antihypertensive drugs, higher heart rate and higher CV values of heart rate were associated with higher CV values of the morning SBP. CV values of the morning SBP showed no significant change during the 2-year period (0; 5.4+/-2.6%, 1 year; 5.3+/-2.9%, 2 years 5.6+/-3.1%, n=200). There was no significant difference in the change in eGFR between a group with high CV values (greater than 5 %) and a group with low CV values (lower than 5 %) during the 2-year period. CONCLUSIONS: In CKD patients, the day-by-day variability of HBP tended to be greater in the evening, in female and DN patients. There was no significant association between the day-by-day variability of HBP and decline rate in eGFR. Further studies are needed to clarify the clinical significance of the day-by-day variability of HBP in CKD patients.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Ritmo Circadiano/fisiologia , Nefropatias/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada
12.
Sci Rep ; 8(1): 17431, 2018 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-30479359

RESUMO

Angle-resolved photoemission spectroscopy (ARPES) is a powerful experimental technique in materials science, as it can directly probe electronic states inside solids in energy (E) and momentum (k) space. As an advanced technique, spatially-resolved ARPES using a well-focused light source (high-resolution ARPES microscopy) has recently attracted growing interests because of its capability to obtain local electronic information at micro- or nano-metric length scales. However, there exist several technical challenges to guarantee high precision in determining translational and rotational positions in reasonable measurement time. Here we present two methods of obtaining k-space mapping and real-space imaging in high-resolution ARPES microscopy. One method is for k-space mapping measurements that enables us to keep a target position on a sample surface during sample rotation by compensating rotation-induced displacements (tracing acquisition method). Another method is for real-space imaging measurements that significantly reduces total acquisition time (scanning acquisition method). We provide several examples of these methods that clearly indicate higher accuracy in k-space mapping as well as higher efficiency in real-space imaging, and thus improved throughput of high-resolution APRES microscopy.

13.
Ultramicroscopy ; 182: 85-91, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28666139

RESUMO

We have developed a laser-based scanning angle-resolved photoemission spectroscopy system (µ-ARPES) equipped with a high precision 6-axis control system, realizing not only high-resolution photoemission spectroscopy in energy and momentum, but also spatial resolution of a µm scale. This enables our µ-ARPES system to probe fine details of intrinsic electronic states near the Fermi level such as the superconducting gaps and lifetime broadening.

14.
J Phys Condens Matter ; 29(47): 475502, 2017 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-28891807

RESUMO

Electronic structures of ferromagnetic heavy fermion Yb compounds of YbPdSi, YbPdGe, and YbPtGe are studied by photoelectron spectroscopy around the Yb 4d-4f resonance, resonant x-ray emission spectroscopy at the Yb L 3 absorption edge, and density functional theory combined with dynamical mean field theory calculations. These compounds all have a temperature-independent intermediate Yb valence with large [Formula: see text] and small [Formula: see text] components. The magnitude of the Yb valence is evaluated to be YbPtGe [Formula: see text] YbPdGe [Formula: see text] YbPdSi, suggesting that YbPtGe is the closest to the quantum critical point among the three Yb compounds. Our results support the scenario of the coexistence of heavy fermion behavior and ferromagnetic ordering which is described by a magnetically-ordered Kondo lattice where the magnitude of the Kondo effect and the RKKY interaction are comparable.

15.
J Phys Condens Matter ; 29(28): 285501, 2017 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-28530634

RESUMO

We have investigated the influence of metal adsorbates (sodium and cobalt) on the occupied and unoccupied electronic structure of MoS2(0 0 0 1) and WSe2(0 0 0 1), through a combination of both photoemission and inverse photoemission. The electronic structure is rigidly shifted in both the WSe2 and MoS2 systems, with either Na or Co adsorption, generally as predicted by accompanying density functional theory based calculations. Na adsorption is found to behave as an electron donor (n-type) in MoS2, while Co adsorption acts as an electron acceptor (p-type) in WSe2. The n-type transition metal dichalcogenide (MoS2) is easily doped more n-type with Na deposition while the p-type transition metal dichalcogenide (WSe2) is easily doped more p-type with Co deposition. The binding energy shifts have some correlation with the work function differences between the metallic adlayer and the transition metal dichalcogenide substrate.

16.
Nihon Jinzo Gakkai Shi ; 48(7): 680-4, 2006.
Artigo em Japonês | MEDLINE | ID: mdl-17128886

RESUMO

A 32-year-old woman was admitted at 36 weeks' gestation because of increasing proteinuria and generalized edema. At the time of admission, serum creatinine was 1.3 mg/dl, and urinalysis demonstrated 4+ protein and 2+ occult blood. During her pregnancy, her blood pressure had been in the normal range. A normal healthy female neonate was delivered by caesarean section at 38 weeks' gestation. After delivery, the woman's 24-hour urine protein excretion was 11 g/day and serum albumin was 1.4 g/dl , hence nephrotic syndrome was diagnosed. Eleven days after delivery, a renal biopsy showed focal segmental lesions with glomerular epithelial cell injury. She was given 50 mg/day prednisolone and after a month, her 24-hour urinary protein excretion decreased to 2 g/day. One year later, she achieved complete remission. Although she had a relapse of nephrotic syndrome after twenty-one months, steroid therapy again achieved a good response.


Assuntos
Glomerulosclerose Segmentar e Focal/patologia , Síndrome Nefrótica/patologia , Complicações na Gravidez , Adulto , Anti-Inflamatórios/administração & dosagem , Feminino , Glomerulosclerose Segmentar e Focal/complicações , Glomerulosclerose Segmentar e Focal/tratamento farmacológico , Humanos , Síndrome Nefrótica/complicações , Síndrome Nefrótica/tratamento farmacológico , Prednisolona/administração & dosagem , Gravidez
17.
J Phys Condens Matter ; 28(34): 345503, 2016 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27362263

RESUMO

The orbital symmetry of the band structure of 2H-WSe2(0 0 0 1) has been investigated by means of angle-resolved photoelectron spectroscopy (ARPES) and density functional theory (DFT). The WSe2(0 0 0 1) experimental band structure is found, by ARPES, to be significantly different for states of even and odd reflection parities along both the [Formula: see text]-[Formula: see text] and [Formula: see text]-[Formula: see text] lines, in good agreement with results obtained from DFT. The light polarization dependence of the photoemission intensities from the top of the valence band for bulk WSe2(0 0 0 1) is explained by the dominance of W 5[Formula: see text] states around the [Formula: see text]-point and W 5d xy states around the [Formula: see text]-point, thus dominated, respectively, by states of even and odd symmetry, with respect to the [Formula: see text]-[Formula: see text] line. The splitting of the topmost valence band at [Formula: see text], due to spin-orbit coupling, is measured to be 0.49 ± 0.01 eV, in agreement with the 0.48 eV value from DFT, and prior measurements for the bulk single crystal WSe2(0 0 0 1), albeit slightly smaller than the 0.513 ± 0.01 eV observed for monolayer WSe2.

18.
Intern Med ; 44(6): 548-53, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16020878

RESUMO

OBJECTIVE: Proteinuria is a recognized complication of obesity, but the pathogenesis remains unclear. We undertook the present study to clarify the factors contributing to proteinuria associated with obesity. METHODS: We studied 12 obese patients with proteinuria. Twenty-seven age-matched obese subjects without proteinuria served as controls. A glucose tolerance test and renal biopsy were performed in all patients. Fasting serum insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were regarded as reflecting insulin resistance. To delineate the relation between insulin resistance and proteinuria, troglitazone, which acts an insulin sensitizer was given to 6 of 12 patients with a regular diet for 8 weeks. The 6 others were observed without receiving troglitazone. RESULTS: The 12 patients showed the presence of a cluster of insulin resistance factors: higher blood pressure, higher body mass index, higher fasting plasma glucose, higher fasting serum insulin, and higher HOMA-IR than controls. The renal biopsy specimens exhibited no histological abnormalities in 7, focal segmental glomerulosclerosis in 3 and benign nephrosclerosis in 2. Troglitazone attenuated HOMA-IR and ameliorated proteinuria, but did not affect body weight, creatinine clearance, or blood pressure. In contrast, the parameters in the patients not given troglitazone did not change. CONCLUSION: Insulin resistance is a factor contributing to obesity-related proteinuria. The role of insulin resistance as a factor reducing proteinuria remains to be clarified.


Assuntos
Glicemia/metabolismo , Resistência à Insulina , Obesidade/complicações , Proteinúria/etiologia , Adulto , Biópsia , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Cromanos , Creatinina/sangue , Feminino , Seguimentos , Teste de Tolerância a Glucose/métodos , Humanos , Hipoglicemiantes , Rim/patologia , Masculino , Modelos Biológicos , Obesidade/metabolismo , Obesidade/fisiopatologia , Proteinúria/metabolismo , Proteinúria/patologia , Fatores de Risco , Tiazolidinedionas , Troglitazona
19.
Intern Med ; 43(8): 668-73, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15468963

RESUMO

OBJECTIVE: There have been few studies on cyclosporine (CsA) monotherapy in adult minimal change nephrotic syndrome (MCNS). To delineate CsA therapy as new treatment options for MCNS, we conducted a prospective single-center study. METHODS: We assessed the efficacy of 3 different regimens in 36 patients, consisting of 26 first attacks or 10 relapses, of adult-onset MCNS. In 12 patients, CsA alone was given orally at a dose of 2-3 mg/kg/d, and in 12 patients, CsA after intravenous pulse methylprednisolone therapy (CsA/PMT) was given at the same dose. CsA was given for 12 months, tapered slowly, then stopped. The other 12 patients were treated with oral prednisolone (PSL, 40-60 mg/d) alone for 4 to 6 weeks, followed by daily PSL, with slowly tapering doses. RESULTS: Complete remission (CR) was obtained in 75% with CsA alone, 100% with CsA/PMT and 92% with PSL alone (p = 0.0379). The days required for CR were shortest in the CsA/PMT group (40.9 +/- 35.5 days with CsA alone vs. 11.0 +/- 5.6 with CsA/PMT vs. 21.5 +/- 15.8 with PSL alone). The cumulative rates of CR were significantly different among the 3 groups (p < 0.0001). The real numbers of the relapse were smallest in the CsA/PMT group, however, the cumulative rates of sustained remission among the 3 treatment arms were not statistically different. Renal function was well preserved with each treatment period. CsA-associated adverse effects were minimal but one patient developed new-onset hypertension and gingival hyperplasia. However, the adverse effects of PSL alone were serious in 3 cases: bleeding from gastric ulcer, diabetes mellitus, and aseptic necrosis. Many patients with PSL but few with CsA experienced cosmetic problems. CONCLUSIONS: CsA/PMT may be the most advantageous when the clinical efficacy of each treatment for MCNS is integrated.


Assuntos
Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Nefrose Lipoide/tratamento farmacológico , Adulto , Relação Dose-Resposta a Droga , Humanos , Japão , Metilprednisolona/administração & dosagem , Estudos Prospectivos , Pulsoterapia , Recidiva , Indução de Remissão , Resultado do Tratamento
20.
Nihon Jinzo Gakkai Shi ; 44(1): 34-43, 2002 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-11925945

RESUMO

We investigated 1) the association between serum albumin levels(Alb) at the initiation of dialysis and survival after a mean follow-up period of 30.1 +/- 23.1 months following the commencement of chronic dialysis, and 2) the factors associated with hypoalbuminemia at the initiation of dialysis in diabetic patients with end-stage renal failure(ESRF). A hundred and thirty diabetic patients who were initiated on chronic dialysis in our department between January 1992 and November 2000 were studied. Alb and some variables were collected at 12, 6, 3, and 1 month before the initiation of dialysis(-12, -6, -3, -1 M), at the initiation of dialysis(0 M), and 1, 6, and 12 months after commencing chronic dialysis(1, 6, 12 M). Multivariate logistic regression analysis showed that hypoalbuminemia(less than 3 g/d/) at 0 M was significantly associated with an increase in urinary protein excretion per 1 g/day during -12 M and -1 M and total blindness due to diabetic retinopathy(Odds ratio 1.41, 8.83, p = 0.01, 0.03). Cox's proportional-hazard model demonstrated that a decrease in Alb per 1 g/dl at 0 M was significantly associated with survival(Hazard ratio 3.69, p = 0.03, adjusted age, sex, mode of dialysis, and urinary protein excretion during -12 M and -1 M). In addition, a decrease in Alb between -1 M and 0 M was significantly associated with elevated C-reactive protein at 0 M and a decrease in hematocrit between -1 M and 0 M. In conclusion, hypoalbuminemia at the initiation of dialysis, from any cause other than proteinuria, was associated with a poor prognosis after commencing chronic dialysis in diabetic ESRF patients.


Assuntos
Nefropatias Diabéticas/mortalidade , Falência Renal Crônica/mortalidade , Diálise Renal/efeitos adversos , Albumina Sérica/deficiência , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Nefropatias Diabéticas/sangue , Feminino , Humanos , Falência Renal Crônica/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Albumina Sérica/análise , Análise de Sobrevida
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