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1.
Int J Biol Macromol ; 265(Pt 1): 130962, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38503370

RESUMEN

Combining a Sodium-Glucose-Cotransporter-2-inhibitor (SGLT2i) with metformin is recommended for managing hyperglycemia in patients with type 2 diabetes (T2D) who have cardio-renal complications. Our study aimed to investigate the metabolic effects of SGLT2i and metformin, both individually and synergistically. We treated leptin receptor-deficient (db/db) mice with these drugs for two weeks and conducted metabolite profiling, identifying 861 metabolites across kidney, liver, muscle, fat, and plasma. Using linear regression and mixed-effects models, we identified two SGLT2i-specific metabolites, X-12465 and 3-hydroxybutyric acid (3HBA), a ketone body, across all examined tissues. The levels of 3HBA were significantly higher under SGLT2i monotherapy compared to controls and were attenuated when combined with metformin. We observed similar modulatory effects on metabolites involved in protein catabolism (e.g., branched-chain amino acids) and gluconeogenesis. Moreover, combination therapy significantly raised pipecolate levels, which may enhance mTOR1 activity, while modulating GSK3, a common target of SGLT2i and 3HBA inhibition. The combination therapy also led to significant reductions in body weight and lactate levels, contrasted with monotherapies. Our findings advocate for the combined approach to better manage muscle loss, and the risks of DKA and lactic acidosis, presenting a more effective strategy for T2D treatment.


Asunto(s)
Diabetes Mellitus Tipo 2 , Metformina , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Ratones , Animales , Humanos , Metformina/farmacología , Metformina/uso terapéutico , Ácido 3-Hidroxibutírico , Ácido Láctico/uso terapéutico , Glucógeno Sintasa Quinasa 3/uso terapéutico , Inhibidores del Cotransportador de Sodio-Glucosa 2/farmacología , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico
2.
J Clin Med ; 13(3)2024 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-38337335

RESUMEN

Vascular access (VA) flow suppression surgery augments VA flow resistance and can increase other circulation flows hindered by high-flow VA. However, whether VA flow suppression surgery affects cervical circulation has rarely been reported. We aimed to determine the effect of VA flow suppression surgery on the cervical circulation in patients with high-flow VA. This single-center, retrospective, observational study included 85 hemodialysis patients who underwent VA flow suppression surgery at the Kanno Dialysis and Access Clinic between 2009 and 2018. Blood flow in the VA, bilateral vertebral arteries, and common carotid artery was measured before and after VA flow suppression surgery. The VA flow decreased from 1548 mL/min to 693 mL/min postoperatively. The flow of the vertebral artery on the VA side increased from 55 mL/min to 81 mL/min. The flow in the bilateral common carotid arteries also increased. Patients whose symptoms improved postoperatively showed better improvement in the vertebral artery on the VA side. VA flow suppression surgery in patients with high-flow VA increases the flow of the vertebral artery on the VA side and of the bilateral common carotid arteries. High-flow VA can hinder the vertebral and common carotid circulation.

3.
Int J Mol Sci ; 25(2)2024 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-38255886

RESUMEN

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) can occasionally trigger thrombotic microangiopathy (TMA). Cytomegalovirus (CMV) may be reactivated during intensive immunosuppressive therapy for AAV and cause TMA. Therefore, we aimed to evaluate the clinical features of and the association between vascular endothelial injury markers and TMA due to CMV in patients with AAV. A 61-year-old female was diagnosed with AAV and severe kidney injury. Immunosuppressive therapy gradually improved her symptoms and laboratory findings. However, 2 weeks after induction therapy initiation, she exhibited altered consciousness, a significant decrease in platelet count, and hemolytic anemia, resulting in a TMA diagnosis. Plasma exchange did not improve TMA findings and routine screening test revealed CMV infection. Ganciclovir injection improved the infection and TMA findings. Consequently, we diagnosed her with CMV-induced TMA. Both AAV and CMV may induce severe vascular endothelial injury, potentially leading to TMA development. CMV-induced TMA should be considered when TMA develops during induction therapy against AAV. Moreover, of the three serum markers of vascular injury-serum sulfatides, soluble thrombomodulin, and pentraxin 3-serum sulfatides may be associated with the development of TMA, and a high level of soluble thrombomodulin may be associated with the development of CMV viremia during the clinical course of AAV.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Infecciones por Citomegalovirus , Microangiopatías Trombóticas , Lesiones del Sistema Vascular , Humanos , Femenino , Persona de Mediana Edad , Anticuerpos Anticitoplasma de Neutrófilos , Trombomodulina , Sulfoglicoesfingolípidos , Infecciones por Citomegalovirus/complicaciones , Citomegalovirus , Microangiopatías Trombóticas/diagnóstico , Microangiopatías Trombóticas/etiología , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones
4.
Front Immunol ; 14: 1271741, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38111574

RESUMEN

Sulfatides are a type of sulfated glycosphingolipid that are secreted with lipoproteins into the serum. These molecules are involved in the inflammatory pathway of vessels in addition to coagulation and platelet aggregation. Previous studies have proposed that sulfatides play a pivotal role in regulating inflammation-related disorders. Systemic vasculitis (SV) diseases are generally caused by autoimmune diseases and often involve kidney vasculitis, which may lead to rapidly progressive kidney dysfunction and end-stage kidney disease. Our earlier pilot study revealed that the level of serum sulfatides (SSs) was significantly decreased in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), a representative disease-causing SV with kidney involvement (SVKI), especially in patients exhibiting active crescentic findings on kidney biopsy. To further explore the clinical significance of an association between SS and SVKI, we analyzed and compared the SS level of patients with various SVKI diseases in this retrospective cohort study. Among patients admitted to our hospital between 2008 and 2021, we ultimately enrolled 26 patients with IgA vasculitis (IgAV), 62 patients with AAV, and 10 patients with anti-glomerular basement membrane disease (GBM) as examples of SVKI diseases, as well as 50 patients with IgA nephropathy (IgAN) and 23 donors for living kidney transplantation as controls. The mean ± standard deviation SS level in the donor, IgAN, IgAV, AAV, and GBM groups was 8.26 ± 1.72, 8.01 ± 2.21, 6.01 ± 1.73, 5.37 ± 1.97, and 2.73 ± 0.99 nmol/mL, respectively. Analysis of patients in the SVKI disease group showed that those with the crescentic class kidney biopsy finding exhibited a significantly lower SS level than did those with other class biopsy features. Additionally, the SS level had a higher detection ability for SVKI patients with crescentic class kidney biopsy findings (area under the receiver operating characteristic curve 0.90, 95% confidence interval 0.82-0.99) than did several other predictor candidates. Our results indicate that the SS level is decreased in more severe SVKI diseases and may be associated with active glomerular lesions in SVKI kidney biopsy samples.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Glomerulonefritis por IGA , Glomerulonefritis , Humanos , Sulfoglicoesfingolípidos , Estudios Retrospectivos , Proyectos Piloto , Riñón/patología , Glomerulonefritis por IGA/patología
5.
Case Rep Rheumatol ; 2023: 4246075, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37662600

RESUMEN

Antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is a systemic vasculitis characterized by ANCA positivity and categorized into three main types: microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatous with polyangiitis. Although AAV leads to systemic organ injury, such as of the lungs, kidneys, nerves, and skin, patients with AAV sometimes develop ocular lesions. Here, we report the case of an elderly woman who had been treated for AAV for seven years. She developed scleritis and relapsed twice, with elevation of serum disease markers such as ANCA titer and C-reactive protein. After the decline of these markers due to treatment with additional medication, her scleritis relapsed again and caused a corneal ulcer, which resulted in perforation without obvious marker elevation. She did not present with any symptoms of organ injury, except for ocular lesions. She was treated with surgery, followed by methylprednisolone and rituximab therapy. Subsequently, her ocular lesions and symptoms improved, and she did not relapse. AAV can cause various ocular manifestations. Although C-reactive protein and ANCA titers are useful markers of disease activity and the relapse of AAV complications, including ocular lesions, these markers do not always increase at the time of worsening ocular lesions. Therefore, it is important for clinicians treating patients with AAV to pay careful attention to serum data and physical findings, including the eyes.

6.
CEN Case Rep ; 2023 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-37737333

RESUMEN

Emphysematous pyelonephritis (EPN) is a necrotizing bacterial infection characterized by gas retention and a poor prognosis. We present the case of a 75-year-old man who was diagnosed early with EPN and received multidisciplinary treatment. He had poorly controlled type 2 diabetes mellitus (DM) and chronic kidney disease (CKD), and was treated with oral hypoglycemic drugs, including a sodium-glucose co-transporter-2 inhibitor. He experienced the onset of back pain in the midsection of his back, tenderness in the costovertebral angle, and a high fever (> 39 °C), accompanied by tachycardia, hypotension, and tachypnea. The patient was diagnosed with pyelonephritis and septic shock. Immediate measures encompassing empirical antibiotic therapy, administration of noradrenaline, blood glucose regulation, and urethral catheterization were implemented. However, due to the persistent fever (> 38 °C) and lack of improvement in his condition, abdominal computed tomography (CT) was repeated on the fourth day. This revealed the presence of gas around the right kidney parenchyma, leading to a diagnosis of EPN that had evolved from acute pyelonephritis. Subsequently, percutaneous drainage of the right kidney parenchyma was performed. Subsequently, multidisciplinary treatment was continued, and his condition gradually improved. Clinicians should evaluate abdominal CT when acute pyelonephritis does not improve within a few days of antibiotic therapy. Disease progression from acute pyelonephritis to EPN should be considered in patients with DM and CKD.

7.
Chem Commun (Camb) ; 59(63): 9595-9598, 2023 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-37476925

RESUMEN

In this study, we found that a pristine buckybowl, sumanene, can form solution-state supramolecular polymers. We also demonstrated that sumanene supramolecular polymers can be dynamically controlled by external stimuli, in which solvation plays a significant role. This study not only provides new guidelines for the rational design of supramolecular polymers, particularly for the use of buckybowls, but also presents interesting dynamic behaviors of supramolecular polymerization.

8.
Cardiovasc Diabetol ; 22(1): 141, 2023 06 16.
Artículo en Inglés | MEDLINE | ID: mdl-37328862

RESUMEN

BACKGROUND: Metabolic Syndrome (MetS) is characterized by risk factors such as abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), hypertension, and hyperglycemia, which contribute to the development of cardiovascular disease and type 2 diabetes. Here, we aim to identify candidate metabolite biomarkers of MetS and its associated risk factors to better understand the complex interplay of underlying signaling pathways. METHODS: We quantified serum samples of the KORA F4 study participants (N = 2815) and analyzed 121 metabolites. Multiple regression models adjusted for clinical and lifestyle covariates were used to identify metabolites that were Bonferroni significantly associated with MetS. These findings were replicated in the SHIP-TREND-0 study (N = 988) and further analyzed for the association of replicated metabolites with the five components of MetS. Database-driven networks of the identified metabolites and their interacting enzymes were also constructed. RESULTS: We identified and replicated 56 MetS-specific metabolites: 13 were positively associated (e.g., Val, Leu/Ile, Phe, and Tyr), and 43 were negatively associated (e.g., Gly, Ser, and 40 lipids). Moreover, the majority (89%) and minority (23%) of MetS-specific metabolites were associated with low HDL-C and hypertension, respectively. One lipid, lysoPC a C18:2, was negatively associated with MetS and all of its five components, indicating that individuals with MetS and each of the risk factors had lower concentrations of lysoPC a C18:2 compared to corresponding controls. Our metabolic networks elucidated these observations by revealing impaired catabolism of branched-chain and aromatic amino acids, as well as accelerated Gly catabolism. CONCLUSION: Our identified candidate metabolite biomarkers are associated with the pathophysiology of MetS and its risk factors. They could facilitate the development of therapeutic strategies to prevent type 2 diabetes and cardiovascular disease. For instance, elevated levels of lysoPC a C18:2 may protect MetS and its five risk components. More in-depth studies are necessary to determine the mechanism of key metabolites in the MetS pathophysiology.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipertensión , Síndrome Metabólico , Humanos , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Metabolómica , Factores de Riesgo , Biomarcadores , Hipertensión/diagnóstico , Hipertensión/epidemiología
9.
Clin Exp Nephrol ; 27(8): 660-671, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37095343

RESUMEN

BACKGROUND: Coronavirus disease (COVID-19) vaccination is recommended for patients undergoing renal replacement therapy (RRT), including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT). However, the difference in the immune response between RRT patients and healthy individuals after mRNA vaccines remains uncertain. METHODS: This retrospective observational study evaluated the anti-severe-acute-respiratory-syndrome-coronavirus-2 (anti-SARS-CoV-2) IgG antibody acquisition, titers and their changes, normal response rate (reaching titers of healthy individuals), factors associated with a normal response, and effectiveness of booster vaccination in Japanese RRT patients. RESULTS: Most HD and PD patients acquired anti-SARS-CoV-2 IgG antibodies after the second vaccination; however, their antibody titers and normal response rates (62-75%) were low compared with those of healthy subjects. Approximately 62% of KT recipients acquired antibodies, but the normal response rate was low (23%). Anti-SARS-CoV-2 IgG antibody waning occurred in the control, HD, and PD groups, while negative or very low titers remained in KT recipients. Third booster vaccination was effective in most HD and PD patients. However, the effect was mild in KT recipients - only 58% reached a normal response level. Multivariate logistic regression analyses demonstrated that younger age, higher serum albumin level, and RRT other than KT were significantly associated with a normal response after the second vaccination. CONCLUSIONS: RRT patients, particularly KT recipients, exhibited poor vaccine responses. Booster vaccination would be beneficial for HD and PD patients; however, its effect in KT recipients was mild. Further COVID-19 vaccinations using the latest vaccine or alternative procedures should be considered in RRT patients.


Asunto(s)
COVID-19 , Trasplante de Riñón , Diálisis Peritoneal , Humanos , Vacuna BNT162 , Vacunas contra la COVID-19 , Pueblos del Este de Asia , COVID-19/prevención & control , Terapia de Reemplazo Renal , Diálisis Renal , Anticuerpos Antivirales , Inmunoglobulina G , Vacunación
10.
Chem Sci ; 14(12): 3293-3301, 2023 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-36970074

RESUMEN

Singlet fission (SF), which produces two triplet excitons from a singlet exciton, has been identified as a novel nanointerface for efficient (photo)energy conversion. This study aims to control exciton formation in a pentacene dimer through intramolecular SF using hydrostatic pressure as an external stimulus. We reveal the hydrostatic-pressure-induced formation and dissociation processes of correlated triplet pairs (TT) in SF by means of pressure-dependent UV/vis and fluorescence spectrometry and fluorescence lifetime and nanosecond transient absorption measurements. The photophysical properties obtained under hydrostatic pressure suggested distinct acceleration of the SF dynamics by microenvironmental desolvation, the volumetric compaction of the TT intermediate based on solvent reorientation toward an individual triplet (T1), and pressure-induced shortening of T1 lifetimes. This study provides a new perspective on the control of SF by hydrostatic pressure as an attractive alternative to the conventional control strategy for SF-based materials.

11.
J Clin Med ; 12(1)2023 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-36615150

RESUMEN

We aim to elucidate factors to aid in the prediction of cytomegalovirus viremia during the treatment of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). We conducted a single-center, retrospective, observational study of 35 patients with newly diagnosed AAV. Factors associated with the development of CMV viremia were investigated via a logistic regression analysis. The CMV antigenemia test was performed in 25 patients (71%), of whom 15 (60%) were diagnosed with CMV viremia. Of these 15 patients, 5 developed a CMV infection. The total protein, hemoglobin, platelet count and lymphocyte counts at the time of the CMV antigenemia test were significantly lower in patients who developed CMV viremia. In addition, total protein, hemoglobin, platelet count and lymphocyte count also presented significantly decreasing trends in the following order: patients who did not develop CMV viremia, patients who developed CMV viremia without any symptoms, and patients who developed CMV infection. All patients with CMV recovered. In conclusion, the total protein, hemoglobin, platelet count and lymphocyte count may be useful markers for the prediction of CMV viremia and infection after the start of induction of immunosuppressive therapy for patients with AAV.

12.
CEN Case Rep ; 12(1): 110-115, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36018508

RESUMEN

An 88-year-old male patient on maintenance hemodialysis (HD) therapy experienced gradual losses in appetite and liveliness during the course of 1 month. Physical examinations revealed no abnormalities. However, blood testing indicated non-thyroidal illness syndrome (NTIS) typically observed in patients with severe illness, with serum levels of thyroid stimulating hormone, free triiodothyronine, and free thyroxine of 0.17 µIU/mL, < 1.0 pg/mL, and 0.23 ng/dL, respectively. Brain magnetic resonance imaging to exclude the possibility of central hypothyroidism unexpectedly displayed slight abnormalities inside of the thalami that were characteristic of Wernicke's encephalopathy. Additional examination disclosed low serum thiamine of 20 ng/mL. Thiamine injections of 100 mg at every HD treatment rapidly restored his appetite, liveliness, and NTIS findings. HD patients are at a particularly high risk of thiamine deficiency (TD) and associated severe symptoms due to losses of thiamine during HD sessions. However, its non-specific initial symptoms, including decreases in appetite and liveliness, as well as undetectability in routine blood tests complicate early detection, resulting in underdiagnosis and more severe outcomes. In the present case, TD manifested only as non-specific symptoms and was ultimately revealed by the presence of NTIS, which was resolved with thiamine supplementation. Thus, NTIS might assist in the early detection of TD as an initial sign in HD patients.


Asunto(s)
Síndromes del Eutiroideo Enfermo , Deficiencia de Tiamina , Encefalopatía de Wernicke , Masculino , Humanos , Anciano de 80 o más Años , Síndromes del Eutiroideo Enfermo/complicaciones , Deficiencia de Tiamina/diagnóstico , Deficiencia de Tiamina/tratamiento farmacológico , Deficiencia de Tiamina/etiología , Encefalopatía de Wernicke/etiología , Tiamina/uso terapéutico , Diálisis Renal/efectos adversos
13.
Clin Case Rep ; 10(3): e05539, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35280085

RESUMEN

A 93-year-old hemodialysis patient became hospitalized for thiamine deficiency-induced appetite loss and ultimately experienced consciousness disorder diagnosed as Wernicke's encephalopathy (WE). Since brain MRI on admission was retrospectively found to display faint WE findings, careful brain MRI assessment is recommended in hemodialysis patients with appetite loss alone.

14.
Tohoku J Exp Med ; 256(2): 161-168, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35228453

RESUMEN

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) affects small blood vessels and causes severe systemic organ injury commonly affecting the lungs and kidney. However, gastrointestinal, especially pancreatic, lesions are rare. We report the case of a 67-year-old Japanese man diagnosed with myeloperoxidase (MPO) AAV who developed pancreatic lesions and diabetes mellitus. The patient was admitted to our hospital due to fever, cough, and weight loss. He developed progressive glomerulonephritis, lung nodules, and pancreatic swelling and mass. Additionally, laboratory examination revealed positive MPO-ANCA and elevated glycated hemoglobin A1c, which were suggestive of diabetes mellitus. Renal biopsy revealed necrotizing crescentic glomerulonephritis and vasculitis in the small arteries. Endoscopic ultrasound-guided fine needle aspiration of the pancreas was performed, and histological findings suggested the possibility of pancreatic vasculitis and parenchymal injury. The patient was diagnosed with AAV, which was managed with glucocorticoids. This improved the renal function and pancreatic lesions. Furthermore, blood glucose levels improved despite treatment with glucocorticoids. These findings suggest that AAV-related pancreatic lesions worsened glycemic control. However, glucocorticoid therapy improved vasculitis and pancreatic lesions, which resulted in improved glycemic control.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Diabetes Mellitus , Glomerulonefritis , Neoplasias Pancreáticas , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Anticuerpos Anticitoplasma de Neutrófilos , Glomerulonefritis/complicaciones , Humanos , Masculino , Páncreas/patología , Peroxidasa
15.
J Clin Med ; 11(3)2022 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-35160215

RESUMEN

Sulfatides are glycosphingolipids that are associated with coagulation and platelet aggregation. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) activates platelet function and often leads to thrombotic complications. These facts suggest an association between serum sulfatides and AAV. We aimed to clarify the significance of serum sulfatide levels in patients with AAV. We conducted a retrospective, single-center, observational pilot study that included 35 patients who developed AAV and 10 control patients who were candidates for living-donor kidney transplantation. We compared serum sulfatide levels between the control and AAV patients. We analyzed the differences in serum sulfatide levels among four classes (focal, crescentic, mixed, and sclerotic class) of glomerular lesions that were categorized by histopathologic classification of ANCA-associated glomerulonephritis. Serum sulfatide levels in patients with AAV were significantly lower than those in the controls. Serum sulfatide levels were significantly different between the four classes. Additionally, serum sulfatide levels in the crescentic class were significantly lower than those in the other classes. Serum sulfatide levels were significantly correlated with albumin, cholesterol, C-reactive protein, and pentraxin 3. In conclusion, serum sulfatide levels are significantly correlated with inflammation, reflecting crescentic glomerulonephritis, which is an active glomerular lesion in AAV patients.

16.
Clin Exp Nephrol ; 26(5): 424-434, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35103876

RESUMEN

BACKGROUND: On-site evaluation of fresh kidney biopsy (FKB) samples at the time of biopsy is useful to verify that adequate specimens are acquired. However, some cases present poor correlation between glomerular number in FKB samples and light microscopy (LM) samples. We examined the usefulness of such on-site evaluation. METHODS: We conducted a retrospective cross-sectional observational study (n = 129) to assess the correlation between glomerular number in FKB samples and LM samples and the associated factors hindering the evaluation. RESULTS: There was a significant positive correlation between glomerular number in FKB samples and LM samples. The median ratio of glomerular number (LM samples/FKB samples) was 0.74. According to this ratio, cases were divided into three groups: reasonable estimation (65 cases), underestimation (32 cases), and overestimation (32 cases). Comparing the reasonable and underestimation groups, significant differences were detected in the extent of interstitial fibrosis and tubular atrophy (IFTA) and interstitial inflammation. Logistic regression analysis demonstrated that IFTA and interstitial inflammation were significantly associated with the underestimation. Moreover, the cortex length of FKB samples correlated with glomerular number in LM samples regardless of tubulointerstitial lesions. CONCLUSIONS: Glomerular number determined during on-site evaluation can be a reference for the actual number of glomeruli in LM samples. Since tubulointerstitial lesions make it difficult to recognize glomeruli in FKB samples, the possibility of underestimation for cases with possibly severe tubulointerstitial lesions should be considered. In such cases, evaluation of cortex length of FKB samples may substitute for evaluating glomeruli on-site.


Asunto(s)
Enfermedades Renales , Microscopía , Biopsia , Estudios Transversales , Femenino , Fibrosis , Humanos , Inflamación , Riñón/patología , Enfermedades Renales/diagnóstico , Enfermedades Renales/patología , Glomérulos Renales/patología , Masculino , Estudios Retrospectivos
17.
Clin Exp Rheumatol ; 40(4): 705-713, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34524078

RESUMEN

OBJECTIVES: The difference in factors associated with the prognosis between elderly and non-elderly patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is uncertain. We aimed to elucidate the clinical factors associated with the short-term prognosis (within 6 months from the start of the treatment) and investigate the differences in the associated factors between elderly and non-elderly individuals. METHODS: We performed a dual centre retrospective observational study of patients newly treated with AAV (eosinophilic granulomatous with polyangiitis was excluded). The primary outcome was all-cause death, and the secondary outcome was end-stage renal disease (ESRD) and infectious complications within 6 months after the start of treatment. We analysed factors associated with these outcomes using logistic regression analyses. RESULTS: Of the 79 patients, patients aged ≥75 years were defined as elderly (n=41), whereas those aged <75 years were de¬fined as non-elderly (n=38). In elderly patients, age was significantly associated with all-cause mortality. In the non-elderly patients, the geriatric nutritional risk index was significantly associated with all-cause death. The estimated glomerular filtration rate (eGFR) before the start of treatment was significantly associated with ESRD in elderly and non-elderly patients. In elderly patients, the Birmingham vasculitis score 3, eGFR, methylprednisolone pulse use, and cyclophosphamide use were significantly associated with infectious complications. Factors other than the serum albumin level were not significantly associated with infectious complications in the non-elderly population. CONCLUSIONS: The factors associated with all-cause death and infectious complications differed between elderly and non-elderly patients. Awareness of these differences may contribute to better management of AAV.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Fallo Renal Crónico , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Anticuerpos Anticitoplasma de Neutrófilos , Ciclofosfamida/uso terapéutico , Femenino , Humanos , Fallo Renal Crónico/etiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos
18.
Micromachines (Basel) ; 12(12)2021 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-34945430

RESUMEN

We conducted a theoretical investigation of the cross-sectional aspect ratio of a rectangular channel to have sufficiently low frictional resistance under less than 150 of the Reynolds number. From the theoretical consideration, it was clarified that 3.40 or more is recommended as a criterion for determining the aspect ratio. This addresses the problem of determining the interval of rectangle channels, installed in a plate reactor. There is a concern that the real system does not follow the analytical solution, assuming laminar flow, since the higher aspect ratio leads to disturbances of the flow such as the emergence of vortices. However, in the channel's volume range of (W × H × L) = (7.0 mm × 0.38 mm × 0.26 m), such a turbulence was not observed in the detailed numerical calculation by CFD, where both calculation results were in agreement to within 3% accuracy. Moreover, even in an experimental system with a surface roughness of ca. 7%, friction resistance took agreement within an accuracy of ±30%.

19.
Mikrochim Acta ; 188(11): 406, 2021 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-34734344

RESUMEN

Raman spectroscopy is a powerful method to characterize molecules in various media. Although surface-enhanced Raman scattering (SERS) is often employed to compensate for the intrinsically poor sensitivity of Raman spectroscopy, there remain serious tasks, such as simple preparations of SERS substrates, sensitivity control, and reproducible measurements. Here, we propose freezing as an efficient way to overcome these problems in SERS measurements using DNA bases as model targets. Solutes are expelled from ice crystals and concentrated in the liquid phase upon freezing. Silver nanoparticles (AgNPs) are also concentrated in the liquid phase to aggregate with Raman target analytes. The SERS signal intensity is maximized when the AgNP concentration exceeds the critical aggregation value. Freezing allows up to 5000 times enhancements of the SERS signal. Thus, an efficient SERS platform is prepared by simple freezing. The simultaneous detection of four DNA bases effectively eliminates variations of signal intensities and allows the reliable determination of concentration ratios.


Asunto(s)
Adenina/análisis , Citosina/análisis , Guanina/análisis , Nanopartículas del Metal/química , Timidina/análisis , Cerveza/análisis , Crioprotectores/química , Congelación , Glicerol/química , Límite de Detección , Plata/química , Espectrometría Raman/métodos , Sacarosa/química
20.
Phys Chem Chem Phys ; 23(34): 18595-18601, 2021 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-34612396

RESUMEN

When an aqueous solution freezes at temperatures above the eutectic point, a freeze concentrated solution (FCS) is separated from the ice phase. Reactions of environmental importance often occur in the FCS and, in some cases, are accelerated compared to those in solution conditions. The pH of the FCS is an essential factor governing the thermodynamics and kinetics of the reactions occurring therein. It is known that freezing of aqueous NaCl causes an increase in the FCS pH, which arises from the difference in the partition to the ice phase between Na+ and Cl-. It has also been shown that H+ and other ions show surface-specific behaviors on ice. Although the details are not known, the ice/FCS interface can also affect the behaviors of ions. In this study, the pH distribution in the FCS is evaluated using ratiometric fluorescence microscopy, and the pH inhomogeneity is confirmed for frozen aqueous NaCl. However, interestingly, buffered solutions and frozen aqueous glycerol result in a uniform pH value. The pH in frozen NaCl is always higher near the ice/FCS interface than in the middle of the FCS vein.

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