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1.
Phys Rev E ; 106(5-2): 055207, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36559487

RESUMEN

Magnetic reconnection in laser-produced magnetized plasma is investigated by using optical diagnostics. The magnetic field is generated via the Biermann battery effect, and the inversely directed magnetic field lines interact with each other. It is shown by self-emission measurement that two colliding plasmas stagnate on a midplane, forming two planar dense regions, and that they interact later in time. Laser Thomson scattering spectra are distorted in the direction of the self-generated magnetic field, indicating asymmetric ion velocity distribution and plasma acceleration. In addition, the spectra perpendicular to the magnetic field show different peak intensity, suggesting an electron current formation. These results are interpreted as magnetic field dissipation, reconnection, and outflow acceleration. Two-directional laser Thomson scattering is, as discussed here, a powerful tool for the investigation of microphysics in the reconnection region.

2.
Physiol Res ; 69(5): 861-870, 2020 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-32901491

RESUMEN

The effects of exercise on mechanical hyperalgesia, joint contracture, and muscle injury resulting from immobilization are not completely understood. This study aimed to investigate the effects of cyclic stretching on these parameters in a rat model of chronic post-cast pain (CPCP). Seventeen 8-week-old Wistar rats were randomly assigned to (1) control group, (2) immobilization (CPCP) group, or (3) immobilization and stretching exercise (CPCP+STR) group. In the CPCP and CPCP+STR groups, both hindlimbs of each rat were immobilized in full plantar flexion with a plaster cast for a 4-week period. In the CPCP+STR group, cyclic stretching exercise was performed 6 days/week for 2 weeks, beginning immediately after cast removal prior to reloading. Although mechanical hyperalgesia in the plantar skin and calf muscle, ankle joint contracture, and gastrocnemius muscle injury were observed in both immobilized groups, these changes were significantly less severe in the CPCP+STR group than in the CPCP group. These results clearly demonstrate the beneficial effect of cyclic stretching exercises on widespread mechanical hyperalgesia, joint contracture, and muscle injury in a rat model of CPCP.


Asunto(s)
Dolor Crónico/rehabilitación , Contractura/rehabilitación , Hiperalgesia/rehabilitación , Músculo Esquelético/fisiología , Condicionamiento Físico Animal/métodos , Animales , Moldes Quirúrgicos , Dolor Crónico/etiología , Dolor Crónico/patología , Contractura/etiología , Contractura/patología , Modelos Animales de Enfermedad , Humanos , Hiperalgesia/etiología , Hiperalgesia/patología , Inmovilización , Masculino , Ratas , Ratas Wistar
3.
Scand J Rheumatol ; 49(4): 301-311, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32286129

RESUMEN

OBJECTIVE: The complement cascade, especially the alternative pathway of complement, has been shown in basic research to be associated with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). We aimed to elucidate relationships between serum complement components and clinical characteristics in AAV. METHOD: In a nationwide prospective cohort study (RemIT-JAV-RPGN), we measured the serum levels of C1q, C2, C3, C3b/iC3b, C4, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, mannose-binding lectin, and properdin in 52 patients with microscopic polyangiitis (MPA) and 39 patients with granulomatosis with polyangiitis (GPA). RESULTS: The properdin level of MPA and GPA was significantly lower than that of healthy donors. The properdin level was negatively correlated with the Birmingham Vasculitis Activity Score (BVAS) (ρ = -0.2148, p = 0.0409). The factor D level at 6 months was significantly positively correlated with the Vasculitis Damage Index (VDI) at 6, 12, and 24 months (ρ = 0.4207, 0.4132, and 0.3115, respectively). Patients with a higher ratio of C5a to C5 had higher neutrophil percentage and serum immunoglobulin G levels, and significantly lower creatinine levels. Cluster analysis divided the MPA and GPA patients into three subgroups. A principal component (PC) analysis aggregated 15 types of complements into alternative pathway-related PC 1 and complement classical pathway and common pathway-related PC 2. CONCLUSIONS: The serum levels of properdin and factor D were correlated with the BVAS and the VDI in MPA and GPA, respectively. Our analyses suggested the pathological heterogeneity of MPA and GPA from the aspect of complement components.


Asunto(s)
Proteínas del Sistema Complemento/metabolismo , Granulomatosis con Poliangitis/sangre , Poliangitis Microscópica/sangre , Anciano , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Análisis por Conglomerados , Femenino , Granulomatosis con Poliangitis/tratamiento farmacológico , Granulomatosis con Poliangitis/etiología , Humanos , Inmunosupresores/uso terapéutico , Masculino , Poliangitis Microscópica/tratamiento farmacológico , Poliangitis Microscópica/etiología , Persona de Mediana Edad , Análisis de Componente Principal , Estudios Prospectivos , Recurrencia , Inducción de Remisión
4.
Gen Thorac Cardiovasc Surg ; 68(11): 1325-1328, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31784884

RESUMEN

Left ventriculocoronary artery fistulae can cause deterioration of postoperative outcomes in patients with hypoplastic left heart syndrome. We successfully performed the Norwood operation with right ventricle-pulmonary artery shunt without a cardiac arrest in an infant with hypoplastic left heart syndrome and large coronary artery fistulae. Temporary postoperative right ventricular dysfunction gradually improved, and left ventricular volume decreased by the time of bidirectional Glenn shunt procedure. Left ventriculocoronary artery fistulae regressed after the Norwood operation, illustrating that large coronary artery fistulae can regress over time following right ventricular decompression.


Asunto(s)
Vasos Coronarios , Síndrome del Corazón Izquierdo Hipoplásico/cirugía , Fístula Vascular/cirugía , Procedimiento de Fontan , Humanos , Síndrome del Corazón Izquierdo Hipoplásico/complicaciones , Recién Nacido , Masculino , Procedimientos de Norwood , Fístula Vascular/complicaciones
5.
Diabet Med ; 34(4): 586-589, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-27859559

RESUMEN

AIM: To examine the contribution of the FUT2 gene and ABO blood type to the development of Type 1 diabetes in Japanese children. METHODS: We analysed FUT2 variants and ABO genotypes in a total of 531 Japanese children diagnosed with Type 1 diabetes and 448 control subjects. The possible association of FUT2 variants and ABO genotypes with the onset of Type 1 diabetes was statistically examined. RESULTS: The se2 genotype (c.385A>T) of the FUT2 gene was found to confer susceptibility to Type 1A diabetes in a recessive effects model [odds ratio for se2/se2, 1.68 (95% CI 1.20-2.35); corrected P value = 0.0075]. CONCLUSIONS: The FUT2 gene contributed to the development of Type 1 diabetes in the present cohort of Japanese children.


Asunto(s)
Diabetes Mellitus Tipo 1/genética , Fucosiltransferasas/genética , Sistema del Grupo Sanguíneo ABO/genética , Pueblo Asiatico/genética , Estudios de Casos y Controles , Predisposición Genética a la Enfermedad , Humanos , Japón , Galactósido 2-alfa-L-Fucosiltransferasa
6.
Hum Reprod ; 31(10): 2352-9, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27591226

RESUMEN

STUDY QUESTION: What are the characteristics of spontaneous endometriosis in cynomolgus monkeys? SUMMARY ANSWER: Spontaneous endometriosis in cynomolgus monkeys exhibited similar characteristics to the human disease. WHAT IS KNOWN ALREADY: One previous report described the prevalence and the basic histopathology of spontaneous endometriosis in cynomolgus monkeys. STUDY DESIGN, SIZE, DURATION: Endometriotic lesions that had been histologically confirmed in 8 female cynomolgus monkeys between 5 and 21 years old were subjected to study. PARTICIPANTS/MATERIALS, SETTING, METHODS: The monkeys died of, or were sacrificed because of, sickness consequent on endometriosis. Specimens were evaluated histopathologically with haematoxylin and eosin staining, iron staining and immunohistochemistry (CD10, CD31, α-SMA and PGP9.5), and by observing them under a microscope. MAIN RESULTS AND THE ROLE OF CHANCE: Endometriotic and stromal cells (CD10-positive) with haemorrhage and inflammation were observed. Smooth muscle metaplasia and nerve fibres were also noted in the endometriotic lesions. Endometriotic lesions in lymph nodes were incidentally found. LIMITATIONS AND REASONS FOR CAUTION: Since laparoscopic analysis for monitoring the disease state was not set as a parameter of the current study, time course changes (progression) of the disease were not assessed. WIDER IMPLICATIONS OF THE FINDINGS: Further investigation of spontaneous endometriosis in cynomolgus monkeys may contribute to better understanding of the disease pathobiology. STUDY FUNDING/COMPETING INTERESTS: No external funds were used for this study. A.N.K., S.M., S.H., T.I., O.K., A.K. and M.S. are full-time employees of Chugai Pharmaceutical Co., Ltd. R.K. received lecture fees from Chugai Pharmaceutical Co., Ltd., unrelated to the submitted work. S.N., S. O., L.Y., K.Y. and T.S. have nothing to declare. TRIAL REGISTRATION NUMBER: N/A.


Asunto(s)
Endometriosis/patología , Endometrio/patología , Enfermedades del Ovario/patología , Células del Estroma/patología , Animales , Proliferación Celular , Femenino , Fibrosis/patología , Ganglios Linfáticos/patología , Macaca fascicularis
7.
Diabet Med ; 33(12): 1717-1722, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27352912

RESUMEN

AIMS: The aim of this study was to clarify the significance of previously reported susceptibility variants in the development of autoimmune Type 1 diabetes in non-white children. Tested variants included rs2290400, which has been linked to Type 1 diabetes only in one study on white people. Haplotypes at 17q12-q21 encompassing rs2290400 are known to determine the susceptibility of early-onset asthma by affecting the expression of flanking genes. METHODS: We genotyped 63 variants in 428 Japanese people with childhood-onset autoimmune Type 1 diabetes and 457 individuals without diabetes. Possible association between variants and age at diabetes onset was examined using age-specific quantitative trait locus analysis and ordered-subset regression analysis. RESULTS: Ten variants, including rs2290400 in GSDMB, were more frequent among the people with Type 1 diabetes than those without diabetes. Of these, rs689 in INS and rs231775 in CTLA4 yielded particularly high odds ratios of 5.58 (corrected P value 0.001; 95% CI 2.15-14.47) and 1.64 (corrected P value 5.3 × 10-5 ; 95% CI 1.34-2.01), respectively. Age-specific effects on diabetes susceptibility were suggested for rs2290400; heterozygosity of the risk alleles was associated with relatively early onset of diabetes, and the allele was linked to the phenotype exclusively in the subgroup of age at onset ≤ 5.0 years. CONCLUSIONS: The results indicate that rs2290400 in GSDMB and polymorphisms in INS and CTLA4 are associated with the risk of Type 1 diabetes in Japanese children. Importantly, cis-regulatory haplotypes at 17q12-q21 encompassing rs2290400 probably determine the risk of autoimmune Type 1 diabetes predominantly in early childhood.


Asunto(s)
Cromosomas Humanos Par 17/genética , Diabetes Mellitus Tipo 1/genética , Haplotipos/genética , Polimorfismo de Nucleótido Simple/genética , Adolescente , Adulto , Edad de Inicio , Anciano , Alelos , Niño , Preescolar , Femenino , Frecuencia de los Genes/genética , Predisposición Genética a la Enfermedad/genética , Humanos , Lactante , Japón/etnología , Masculino , Persona de Mediana Edad , Adulto Joven
8.
Nutr Metab Cardiovasc Dis ; 26(1): 67-76, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26631437

RESUMEN

BACKGROUND AND AIMS: To elucidate implication of upper-normal waist circumference (WC), we examined whether the normal range of WC still represents a risk of metabolic syndrome (MetS) or non-adipose MetS components among normal-weight subjects. METHODS AND RESULTS: A total of 173,510 persons (100,386 men and 73,124 women) with normal WC (<90/80 cm in men/women) and body mass index (BMI) of 18.5-24.9 were included. Subjects were categorized as having low, moderate, and upper-normal WC for those with WC < 80, 80-84, and 85-89 cm in men and <70, 70-74, and 75-79 cm in women, respectively. The prevalence of all the non-adipose MetS components (e.g. prediabetes and borderline dyslipidemia) was significantly higher in subjects with upper-normal WC on comparison with those with low WC. Overall, the prevalence of MetS (having three or more of four non-adipose MetS components) gradually increased with increasing WC (12%, 21%, and 27% in men and 11%, 14%, and 19% in women for low, moderate, and upper-normal WC, respectively). Moreover, the risk of having a greater number of MetS components increased in subjects with upper-normal WC compared with those with low WC (odds ratios for the number of one, two, three, and four MetS components: 1.29, 1.81, 2.53, and 2.47 in men and 1.16, 1.55, 1.49, and 2.20 in women, respectively). CONCLUSION: Upper-normal WC represents a risk for acquiring a greater number of MetS components and the early stage of MetS components (prediabetes and borderline dyslipidemia), after adjusting for BMI, in a large general population with normal WC and BMI.


Asunto(s)
Peso Corporal Ideal , Síndrome Metabólico/epidemiología , Circunferencia de la Cintura , Adulto , Anciano , Biomarcadores/sangre , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Dislipidemias/diagnóstico , Dislipidemias/epidemiología , Dislipidemias/fisiopatología , Femenino , Hemoglobina Glucada/análisis , Humanos , Japón/epidemiología , Lípidos/sangre , Modelos Logísticos , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Dinámicas no Lineales , Oportunidad Relativa , Estado Prediabético/diagnóstico , Estado Prediabético/epidemiología , Estado Prediabético/fisiopatología , Prevalencia , Medición de Riesgo , Factores de Riesgo
9.
Opt Express ; 23(18): 23660-6, 2015 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-26368463

RESUMEN

A novel mode-selective optical packet switching, based on mode-multiplexers/demultiplexers and multi-port optical micro-electro-mechanical systems (MEMS) switches, has been proposed and experimentally demonstrated. The experimental demonstration was performed using the LP(01), LP(11a) and LP(11b) modes of a 30-km long mode-division multiplexed few-mode fiber link, utilizing 40 Gb/s, 16-QAM signals.

10.
Transplant Proc ; 46(2): 314-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24655951

RESUMEN

BACKGROUND: It was reported that the glomerula filtration rate (GFR) equation based on serum creatinine underestimated the GFR in potential kidney donors. Recently, the Japanese GFR equation based on standardized serum cystatin C was reported. Therefore, we assessed the performance of the equation in potential kidney donors. METHODS: Forty-five potential kidney donors from 2 hospitals were included. GFR was measured (mGFR) using inulin renal clearance. Serum creatinine was measured using the enzymatic method. Serum cystatin C was measured using a nephelometric immunoassay (Siemens) and calibrated to the standardized value traceable to ERM-DA471/IFCC using an equation reported previously. The estimated GFR (eGFR) was calculated using the Japanese GFR equation based on serum creatinine (eGFRcreat) and the Japanese GFR equation based on serum cystatin C (eGFRcys). Bias (mGFR - eGFR) and accuracy (P30) of the equations were evaluated. RESULTS: Inulin clearance, eGFRcreat, and eGFRcys were 91.0 ± 18.2, 78.5 ± 18.8, and 93.3 ± 16.3 mL/min/1.73 m(2), respectively. Bias of eGFRcreat was 12.4 ± 15.8 mL/min/1.73 m(2) and significantly different from zero, indicating underestimation of GFR. Bias of eGFRcys was -2.3 ± 16.3 mL/min/1.73 m(2) and was not significantly different from zero, suggesting better performance. But, the precision (standard deviation [SD] of bias) and accuracy (P30: Percentage of participants with eGFR within 30% of mGFR) of eGFRcys were not better compared with eGFRcreat. Accuracies (P30) of eGFRcreat and eGFRcys were 87% (95% confidence interval [CI], 74-94) and 82% (95% CI, 69-91), respectively. CONCLUSION: Bias of eGFRcys was better compared with eGFRcreat. But, the precision (SD of bias) and accuracy of eGFRcys were not superior compared with eGFRcreat in potential kidney donors.


Asunto(s)
Cistatina C/sangre , Tasa de Filtración Glomerular , Trasplante de Riñón , Donantes de Tejidos , Anciano , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad
11.
Nutr Metab Cardiovasc Dis ; 24(3): 277-85, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24418372

RESUMEN

BACKGROUND AND AIMS: Renal hyperfiltration (early-stage kidney damage) and hypofiltration (late-stage kidney damage) are common in populations at high risk of chronic kidney disease. This study investigated the associations of renal hyperfiltration and hypofiltration with the number of metabolic syndrome (MetS) components. METHODS AND RESULTS: The study subjects included 205,382 people aged 40-74 years who underwent Specific Health Checkups in Aichi Prefecture, Japan. The prevalence of renal hyperfiltration [estimated glomerular filtration rate (eGFR) above the age-/sex-specific 95th percentile] and hypofiltration (eGFR below the 5th percentile) was compared according to the number of MetS components. We found that the prevalence of both hyperfiltration and hypofiltration increased with increasing number of MetS components (odds ratios for hyperfiltration: 1.20, 1.40, 1.42, 1.41, and 1.77; odds ratios for hypofiltration: 1.07, 1.25, 1.57, 1.89, and 2.21 for one, two, three, four, and five components, respectively, compared with no MetS components). These associations were observed in both normal weight [body mass index (BMI) < 25 kg/m(2)] and overweight (BMI ≥ 25 kg/m(2)) subjects. Renal hyperfiltration was associated with prehypertension and prediabetes, while hypofiltration was associated with dyslipidemia, abdominal obesity, overt hypertension, and overt diabetes. CONCLUSION: The number of MetS components is a good risk indicator of early- and late-stage kidney damage. Therefore, kidney function should be monitored in subjects with MetS components. MetS components should be treated as early as possible to prevent the development of kidney damage and cardiovascular diseases in people with hyperfiltration, regardless of their body weight.


Asunto(s)
Síndrome Metabólico/epidemiología , Sobrepeso/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Anciano , Glucemia/metabolismo , Presión Sanguínea , Índice de Masa Corporal , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Tasa de Filtración Glomerular , Humanos , Japón/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Circunferencia de la Cintura
12.
Lupus ; 23(4): 342-52, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24474704

RESUMEN

OBJECTIVE: A glycosylated transmembrane protein, CD147, has been implicated in regulating lymphocyte responsiveness and leukocyte recruitment. As lupus nephritis (LN) often follows a relapsing-remitting disease course, accurate understanding of the disease activity would be extremely helpful in improving prognosis. Unfortunately, neither clinical nor serological data can accurately reflect the histological features of LN. The present study investigated whether CD147 can accurately predict pathological features of LN. METHODS: Plasma and spot urine samples were collected from 64 patients who underwent renal biopsy between 2008 and 2011. Disease activity for LN tissues was evaluated using the biopsy activity index, and compared to levels of biomarkers including CD147. RESULTS: In LN tissues, CD147 induction was striking in injured glomeruli and infiltrating inflammatory cells, but not in damaged tubules representing atrophy. Plasma CD147 levels accurately reflected the histological disease activity. However, prediction using a single molecule would be quite difficult because of the complex pathogenesis of LN. The diagnostic accuracy of multiplex parameters indicated that the combination including plasma CD147 might yield excellent diagnostic abilities for guiding ideal LN therapy. CONCLUSION: Plasma CD147 levels might offer useful insights into disease activity as a crucial biomarker in patients with LN.


Asunto(s)
Basigina/sangre , Nefritis Lúpica/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Nefritis Lúpica/sangre , Nefritis Lúpica/diagnóstico , Masculino , Persona de Mediana Edad , Pronóstico , Adulto Joven
13.
Genes Immun ; 14(8): 527-9, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23985571

RESUMEN

Interferon regulatory factor 5 (IRF5) and signal transducer and activator of transcription 4 (STAT4) are shared susceptibility genes for various autoimmune diseases. In this study, we investigated whether these genes also contribute to susceptibility to anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in a Japanese population. A case-control study was carried out on IRF5 rs10954213 and STAT4 rs7574865 in 232 Japanese myeloperoxidase (MPO)-ANCA-positive AAV patients, including 177 microscopic polyangiitis and 710 healthy controls. IRF5 rs10954213G was significantly increased in MPO-ANCA-positive AAV (additive model, P=0.023, odds ratio=1.27, 95% confidence interval=1.03-1.57). The risk allele was previously shown to be associated with lower mRNA level of IRF5. On the other hand, significant association of STAT4 rs7574865T with AAV was not detected. These observations suggested that IRF5 may contribute to susceptibility to MPO-ANCA-positive AAV in a Japanese population.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/genética , Factores Reguladores del Interferón/genética , Peroxidasa/metabolismo , Polimorfismo de Nucleótido Simple , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Japón , Masculino , Poliangitis Microscópica/genética , Persona de Mediana Edad , Peroxidasa/genética , Factor de Transcripción STAT4/genética
14.
Physiol Res ; 62(6): 653-62, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23869890

RESUMEN

This study was undertaken to investigate the effects of lower body positive pressure (LBPP) on cardiovascular responses during a 15-min walking trial in young (22.1+/-0.4 years) and elderly women (67.8+/-1.1 years). The application of 20 mm Hg LBPP reduced ground reaction forces by 31.2+/-0.5 kgw in both groups. We hypothesized that cardiovascular responses to LBPP during walking were different between the young and elderly subjects. Applying 20 mm Hg of LBPP increased diastolic and mean blood pressure but not systolic blood pressure in both groups. LBPP-induced reduction in heart rate (HR) occurred more quickly in the young group compared to the elderly group (p<0.05). Applying LBPP also decreased double product (systolic blood pressure x HR) in both groups, suggesting that LBPP reduces myocardial oxygen consumption during exercise. These results suggest that heart rate responses to LBPP during exercise vary with increasing age.


Asunto(s)
Marcha/fisiología , Frecuencia Cardíaca/fisiología , Presión Negativa de la Región Corporal Inferior/métodos , Esfuerzo Físico/fisiología , Caminata/fisiología , Adulto , Anciano , Presión Sanguínea/fisiología , Prueba de Esfuerzo , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven
15.
Phys Rev Lett ; 110(17): 175301, 2013 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-23679740

RESUMEN

We investigate the magnetic response of a dirty-normal-Fermi-liquid-spin-triplet-superfluid proximity system consisting of liquid 3He and aerogel. In contrast to bulk superfluids, Pauli spin susceptibility in the proximity system exceeds its normal-state value locally around the interface. This enhanced Pauli paramagnetism originates from odd-frequency s-wave pairing arising due to spatial inhomogeneity. A characteristic observable signature of the paramagnetic effect can be found in the spin susceptibility temperature dependence.

16.
Pediatr Cardiol ; 34(5): 1094-9, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23229292

RESUMEN

We investigated the optimal treatment for refractory chylothorax after pediatric cardiovascular surgery. We retrospectively reviewed the cases of 15 consecutive patients who developed chylothorax after congenital heart surgery performed between December 2004 and November 2010. Among the 15 patients (12 male and 3 female; median age 13.9 months) who developed postoperative chylothorax, 10 recovered with conservative therapy, such as a low-fat diet, medium chain triglyceride-enriched diet, or total parenteral nutrition. Of the remaining 5 patients who underwent surgical treatment followed by conventional therapy, 4 showed improvement, and 1 died from cardiac failure. Surgical treatment was performed at a median of 19 days after diagnosis of chylothorax. Average drainage output of thoracocentesis for the first 5 days before thoracic duct ligation was 33.1 ml/kg/day. Duration of chylous fluid drainage was significantly longer in surgical patients than in patients who recovered with conservative therapy (p < 0.01). Surgical patients tended to be younger with lower body weight. Significant risk factors for surgical intervention were age <4 months, body weight <4 kg, and duration of drainage >10 days. In cases of refractory postoperative chylothorax, surgical therapy such as thoracic duct ligation should be considered when discharge from the drainage tube is >30 ml/kg/day or chylothorax is not improved within 10 days.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Quilotórax/terapia , Cardiopatías Congénitas/cirugía , Complicaciones Posoperatorias/terapia , Quilotórax/etiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento
18.
Diabetologia ; 55(5): 1304-9, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22297583

RESUMEN

AIMS/HYPOTHESIS: End-stage renal disease (ESRD) patients with diabetes have been regarded as being at the highest risk of cardiovascular disease. We therefore investigated the relationship between diabetes and the incidence of peripheral artery disease (PAD) in new haemodialysis patients. METHODS: We enrolled 1,513 ESRD patients who had just begun haemodialysis therapy. They were divided into two groups: those with (n = 739) and those without diabetes (n = 774). The endpoint was the development of PAD, defined as ankle brachial pressure index ≤ 0.9 or toe brachial pressure index <0.7 in patients with an ankle brachial pressure index >0.9. RESULTS: According to the Kaplan-Meier method, the 10 year event-free rate for development of PAD and lower limb amputation was significantly lower in the diabetes group than in the non-diabetes group (60.3% vs 82.8%, HR 2.99, 95% CI 2.27, 3.92, p<0.0001 and 93.9% vs 98.9%, HR 5.59, 95% CI 2.14, 14.7, p = .0005 for PAD and lower limb amputation, respectively). In patients with diabetes, quartile analysis of HbA1c levels showed that the highest quartile group (≥ 6.8% [51 mmol/mol]) had significant development of PAD and lower limb amputation compared with lower quartile groups (PAD HR 1.63, 95% CI 1.17, 2.28, p = .0038; lower limb amputation HR 2.99, 95% CI 1.17, 7.70, p = .023). CONCLUSIONS/INTERPRETATION: Diabetes was a strong predictor of PAD after initiation of haemodialysis therapy in patients with ESRD. In addition, higher HbA1c levels were associated with increased risk of developing PAD and requiring limb amputation in such diabetic populations.


Asunto(s)
Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/epidemiología , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Enfermedad Arterial Periférica/etiología , Diálisis Renal/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica/estadística & datos numéricos , Pueblo Asiatico/estadística & datos numéricos , Femenino , Estudios de Seguimiento , Hemoglobina Glucada/análisis , Humanos , Japón/epidemiología , Fallo Renal Crónico/epidemiología , Extremidad Inferior/cirugía , Masculino , Persona de Mediana Edad , Enfermedad Arterial Periférica/epidemiología , Resultado del Tratamiento
19.
Mod Rheumatol ; 22(3): 394-404, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21928092

RESUMEN

We (JMAAV [Japanese patients with MPO-ANCA-associated vasculitis] Study Group) performed a prospective, open-label, multi-center trial to evaluate the usefulness of severity-based treatment in Japanese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibodies (MPO-ANCA)-associated vasculitis. Patients with MPO-ANCA-associated vasculitis received a severity-based regimen according to the appropriate protocol: low-dose corticosteroid and, if necessary, cyclophosphamide or azathioprine in patients with mild form; high-dose corticosteroid and cyclophosphamide in those with severe form; and the severe-form regimen plus plasmapheresis in those with the most severe form. We followed up the patients for 18 months. The primary end points were the induction of remission, death, and end-stage renal disease (ESRD). Fifty-two patients were registered, and 48 patients were enrolled in this study (mild form, n = 23; severe form, n = 23; most severe form, n = 2). Among the 47 patients who received the predefined therapies, 42 achieved remission within 6 months, 5 died, and 1 developed ESRD. Disease flared up in 8 of the 42 patients with remission during the 18-month follow-up period. The JMAAV trial is the first prospective trial for MPO-ANCA-associated vasculitis to be performed in Japan. The remission and death rates were comparable to those in several previous clinical trials performed in western counties. The regimen employed in this trial was tailor-made based on patients' disease severity and disease type, and it seems that standardization can be consistent with treatment choices made according to severity.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Peroxidasa/inmunología , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/inmunología , Pueblo Asiatico , Ciclofosfamida/uso terapéutico , Femenino , Glucocorticoides/uso terapéutico , Humanos , Inmunosupresores/uso terapéutico , Japón , Masculino , Persona de Mediana Edad , Prednisolona/uso terapéutico , Inducción de Remisión , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
20.
Eur J Gynaecol Oncol ; 32(3): 325-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21797126

RESUMEN

Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is a rare variant of squamous cell carcinoma of the uterine cervix. This tumor is characterized by nests of poorly differentiated epithelial cells surrounded by a prominent lymphocytic infiltration. Despite the poorly differentiated pathological findings, it appears to have a better outcome than the usual squamous cell carcinoma of the uterine cervix. Therefore, it is quite important to differentiate this tumor from poorly differentiated squamous cell carcinoma and lympho-proliferative disorders of the cervix. LELC arising from the nasopharynx has been suggested to be associated with Epstein-Barr virus (EBV), whereas the involvement of EBV in LELC of the uterine cervix is still controversial. In addition, the role of high-risk human papilloma virus (HPV) in this type of tumor remains unknown. We report a case of LELC of the cervix with diagnosis on the basis of histopathology in a 52-year-old Japanese woman who presented with a history of continuous bleeding post menopause. We also examine the association of EBV and HPV in this case.


Asunto(s)
Carcinoma de Células Escamosas/patología , Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Carcinoma de Células Escamosas/virología , Cuello del Útero/virología , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae , Neoplasias del Cuello Uterino/virología
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