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1.
Epidemiol Infect ; 144(6): 1286-90, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26584624

RESUMO

We previously reported an association between human parechovirus type 3 (HPeV3) and epidemic myalgia with myositis in adults during summers in which an HPeV3 outbreak occurred in children. However, this disease association has not yet been reported elsewhere. We have since continued our surveillance to accumulate data on this disease association and to confirm whether myalgia occurs in children as well as adults. Between June and August 2014, we collected 380 specimens from children with infectious diseases. We also collected clinical specimens from two adult and three paediatric patients suspected of myalgia. We then performed virus isolation and reverse-transcription-PCR using the collected specimens. We detected HPeV3 in 26 children with infectious diseases, which we regarded as indicating an outbreak. We also confirmed HPeV3 infection in all patients suspected of myalgia. In particular the symptoms in two boys, complaining of myalgia and fever, closely matched the criteria for adult myalgia. Based on our findings from 2008, 2011 and 2014, we again urge that clinical consideration be given to the relationship between myalgia and HPeV3 infections during HPeV3 outbreaks in children. Furthermore, our observations from 2014 suggest that epidemic myalgia and myositis occur not only in adults but also in children.


Assuntos
Miosite/epidemiologia , Miosite/etiologia , Parechovirus/isolamento & purificação , Infecções por Picornaviridae/complicações , Infecções por Picornaviridae/epidemiologia , Pleurodinia Epidêmica/epidemiologia , Pleurodinia Epidêmica/etiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Miosite/virologia , Infecções por Picornaviridae/virologia , Pleurodinia Epidêmica/virologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
2.
Osteoporos Int ; 24(11): 2863-70, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24030285

RESUMO

UNLABELLED: We reported previously that serum parathyroid hormone [PTH(1-84)]/intact PTH[PTH(1-84) + PTH(7-84)] ratio provides the better marker for parathyroid function and bone turnover state than serum PTH level itself. The present study demonstrated that higher PTH(1-84)/intact PTH ratio, but not serum PTH(1-84) and intact PTH, predicted higher all-cause mortality in 177 male hemodialysis patients. INTRODUCTION: We reported that PTH(1-84)/intact PTH ratio provides a clinically relevant marker for parathyroid function and the resultant bone turnover state. The purpose of our study was to investigate the association of PTH(1-84)/intact PTH ratio with all-cause mortality (ACM) in male hemodialysis patients. METHODS: The study was performed for 70 months. Serum PTH in 177 male hemodialysis patients was measured with PTH(1-84)-specific whole PTH assay and intact PTH assay which cross-reacts with N-truncated PTH including PTH(7-84). RESULTS: The patients (n = 177) were divided into higher and lower halves based on serum levels of PTH(1-84)/intact PTH ratio (cutoff value, 0.484), intact PTH (143.8 pg/mL), and PTH(1-84) (64.1 pg/mL). In Kaplan-Meier analysis, the higher group in whole PTH/intact PTH ratio had significantly higher ACM than the lower group (P = 0.020 by log-rank test), in contrast with the insignificant difference between the higher and lower groups in intact PTH and PTH(1-84). Multivariate Cox regression hazard analysis identified higher log [PTH(1-84)/intact PTH ratio], but not log intact PTH or log PTH(1-84) as a significant independent predictor [hazard ratio 14.428 (95% CI 2.486-83.728)] for ACM after adjustment for various factors including age, hemodialysis duration, presence/absence of diabetes mellitus, BMI, log C-reactive protein, serum albumin, calcium, and phosphate. The association existed between log [PTH(1-84)/intact PTH ratio] and ACM in those without vitamin D administration (n = 95). CONCLUSION: Higher PTH(1-84)/intact PTH ratio, which provides a relevant marker for parathyroid function, may be a significant predictor of ACM in male hemodialysis patients.


Assuntos
Falência Renal Crônica/terapia , Hormônio Paratireóideo/sangue , Diálise Renal/mortalidade , Idoso , Biomarcadores/sangue , Colecalciferol/uso terapêutico , Humanos , Japão/epidemiologia , Estimativa de Kaplan-Meier , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos
3.
Osteoporos Int ; 24(2): 605-12, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22581293

RESUMO

SUMMARY: Increased levels of serum undercarboxylated osteocalcin, which were associated with bone metabolism markers, correlated inversely with indices of glucose metabolism (plasma glucose, hemoglobin A1C, and glycated albumin) in hemodialysis patients with abnormalities of bone metabolism. INTRODUCTION: Undercarboxylated osteocalcin (ucOC), a possible marker of bone metabolism and one of the osteoblast-specific secreted proteins, has recently been reported to be associated with glucose metabolism. We tested the hypothesis that ucOC levels are associated with indices of glucose metabolism in chronic hemodialysis patients with abnormalities of bone metabolism. METHODS: Serum ucOC, bone alkaline phosphatase (BAP, a bone formation marker), and tartrate-resistant acid phosphatase-5b (TRACP-5b, a bone resorption marker) were measured in 189 maintenance hemodialysis patients (96 diabetics and 93 non-diabetics), and their relationships with glucose metabolism were examined. RESULTS: ucOC correlated positively with BAP (ρ = 0.489, p < 0.0001), TRACP-5b (ρ = 0.585, p < 0.0001) and intact parathyroid hormone (iPTH; ρ = 0.621, p < 0.0001). Serum ucOC levels in the diabetic patients were lower than those of non-diabetic patients (p < 0.001), although there were no significant differences in serum BAP or TRACP-5b between diabetic and non-diabetic patients. Serum ucOC correlated negatively with plasma glucose (ρ = -0.303, p < 0.0001), hemoglobin A1C (ρ = -0.214, p < 0.01), and glycated albumin (ρ = -0.271, p < 0.001), although serum BAP or TRACP-5b did not. In multiple linear regression analysis, log [plasma glucose], log [hemoglobin A1C], and log [glycated albumin] were associated significantly with log [ucOC] after adjustment for age, gender, hemodialysis duration, and body mass index but were not associated with log [BAP], log [TRACP-5b], or log [intact PTH]. CONCLUSION: Increased levels of serum ucOC, which were associated with bone metabolism markers, were inversely associated with indices of glucose metabolism in hemodialysis patients.


Assuntos
Glicemia/metabolismo , Falência Renal Crônica/sangue , Osteocalcina/sangue , Diálise Renal , Fosfatase Ácida/sangue , Idoso , Idoso de 80 Anos ou mais , Fosfatase Alcalina/sangue , Biomarcadores/sangue , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/etiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/complicações , Feminino , Hemoglobinas Glicadas/metabolismo , Produtos Finais de Glicação Avançada , Humanos , Isoenzimas/sangue , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Albumina Sérica/metabolismo , Fosfatase Ácida Resistente a Tartarato , Albumina Sérica Glicada
4.
Osteoporos Int ; 23(7): 2027-35, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21927917

RESUMO

SUMMARY: Bone mineral density of the 1/3 distal radius, ultra-distal radius, and lumbar spine correlated significantly and negatively with serum adiponectin. There was a significant positive correlation between serum adiponectin and serum NTX. Thus, adiponectin may play a role in mineral and bone disorder in chronic kidney disease stage 5 dialysis (CKD 5D) patients. INTRODUCTION: Serum adiponectin, an adipocyte-produced hormone, has been reported to correlate negatively with bone mineral density (BMD) in the general population. However, little is known about the association between adiponectin and BMD in patients with CKD. METHODS: BMD of the 1/3 distal and ultra-distal radius, which are enriched with cortical and cancellous bone, respectively, and the lumbar spine was measured by dual X-ray absorptiometry in 114 Japanese male hemodialysis patients (age 61.0 ± 11.1 years; hemodialysis duration 6.6 ± 3.0 years; 43.9% diabetics). Serum total adiponectin, bone formation marker (bone alkaline phosphatase, BAP), and bone resorption marker (cross-linked N-telopeptide of type I collagen (NTX)) were measured. RESULTS: The BMD of the 1/3 distal radius, ultra-distal radius, and lumbar spine correlated significantly and negatively with serum adiponectin level (r = -0.229, p = 0.014; r = -0.286, p = 0.002; r = -0.227, p = 0.013, respectively). In multiple linear regression analyses, serum adiponectin was significantly and independently associated with the BMD of the 1/3 distal radius (R(2) = 0.173, p < 0.001) and ultra-distal radius (R(2) = 0.278, p < 0.001) after adjustment of age, hemodialysis duration, body weight, %fat mass, and log [intact PTH], although it was not with the BMD of the lumbar spine. There was a significant positive correlation between serum adiponectin and serum NTX (r = 0.321, p < 0.001), although there was no significant correlation between serum adiponectin and serum BAP. CONCLUSION: Increased levels of serum adiponectin were associated with decrease in BMD in male hemodialysis patients. Adiponectin may play a role in mineral and bone disorder, possibly in bone resorption, of patients with CKD 5D.


Assuntos
Adiponectina/sangue , Densidade Óssea/fisiologia , Falência Renal Crônica/sangue , Diálise Renal , Absorciometria de Fóton , Idoso , Biomarcadores/sangue , Composição Corporal/fisiologia , Peso Corporal/fisiologia , Remodelação Óssea/fisiologia , Reabsorção Óssea/sangue , Reabsorção Óssea/etiologia , Reabsorção Óssea/fisiopatologia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Rádio (Anatomia)/fisiopatologia
5.
Osteoporos Int ; 22(3): 923-30, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20449572

RESUMO

UNLABELLED: In cinacalcet treatment of hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT), not only intact parathyroid hormone (I-PTH), whole PTH (W-PTH), and bone markers, but also W-PTH/I-PTH ratio as proportion of active PTH(1-84) molecules were decreased. Changes in W-PTH/I-PTH ratio significantly correlated and predicted changes in bone marker. INTRODUCTION: Cinacalcet partly suppresses the secretion of PTH by enhancing PTH(1-84) degradation into N-truncated fragments. The objectives of this study is to investigate the significance of the N-truncated PTH/PTH(1-84) ratio for the prediction of the effect of cinacalcet in HD patients. METHODS: Serum parameters were measured during 12 weeks of oral cinacalcet administration at 25 mg daily in 39 HD patients with SHPT. RESULTS: Serum Ca, Pi, W-PTH, I-PTH, and W-PTH/I-PTH ratio all decreased significantly in a time-dependent manner during cinacalcet administration. Serum tartrate-resistant acid phosphatase (TRAP) 5b reflected these changes more precisely than serum N-telopeptide of type-I collagen. At 1 week, changes in I-PTH and W-PTH correlated significantly with those in serum Pi, but not Ca. Changes in serum Pi (but not Ca) and serum W-PTH also correlated significantly with changes in serum TRAP5b at both 4 and 12 weeks, while changes in serum I-PTH correlated significantly with those in serum TRAP5b only at 12 weeks. Changes in the serum W-PTH/I-PTH ratio correlated significantly with those in serum TRAP5b at both 4 and 12 weeks, and changes in serum W-PTH/I-PTH ratio at 4 weeks showed a tendency for a correlation with changes in serum TRAP5b at 12 weeks. HD patients with a reduced W-PTH/I-PTH ratio after 4 weeks had a significantly greater reduction of TRAP5b over 12 weeks. CONCLUSION: W-PTH and the W-PTH/I-PTH ratio allow estimation of the potency of cinacalcet in enhancement of PTH degradation, and thus no less reliable markers than I-PTH for reflecting cinacalcet-induced bone resorption.


Assuntos
Remodelação Óssea/efeitos dos fármacos , Hiperparatireoidismo Secundário/tratamento farmacológico , Naftalenos/farmacologia , Hormônio Paratireóideo/sangue , Fosfatase Ácida/sangue , Adulto , Idoso , Cálcio/sangue , Cinacalcete , Colágeno Tipo I/sangue , Feminino , Humanos , Hiperparatireoidismo Secundário/complicações , Isoenzimas/sangue , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/metabolismo , Peptídeos/sangue , Fósforo/sangue , Diálise Renal , Fosfatase Ácida Resistente a Tartarato , Uremia/complicações , Uremia/terapia
6.
Clin Nephrol ; 76(4): 259-65, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21955860

RESUMO

BACKGROUND/AIM: Cinacalcet, an allosteric modulator of the calcium sensing receptor, effectively reduces serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism. It is not well known whether bone mineral density (BMD) of hemodialysis patients with secondary hyperparathyroidism is altered after cinacalcet treatment. METHODS: The BMD in the distal 1/3 of the radius and in the ultradistal radius, which are enriched with cortical and cancellous bone, respectively, was examined by dual X-ray absorptiometry, 1 year prior to, at the start, and 1 year after cinacalcet treatment, in 61 patients. RESULTS: The BMD of both the distal 1/3 and ultradistal radius decreased significantly in the year prior to cinacalcet treatment (p < 0.01). However, the BMD at either site did not change significantly in the year after cinacalcet treatment. The annual changes in the BMD of the distal 1/3 radius increased significantly from -0.023 ± 0.029 g/cm2/year to -0.002 ± 0.033 g/cm2/year, prior to and after cinacalcet treatment, respectively; however, the annual changes in the BMD of the ultradistal radius did not change significantly prior to and after cinacalcet treatment. CONCLUSION: There was a significant association between cinacalcet treatment and reduction in BMD loss in patients with secondary hyperparathyroidism. Cortical bone, rather than cancellous bone, was particularly affected by cinacalcet treatment.


Assuntos
Densidade Óssea/efeitos dos fármacos , Hiperparatireoidismo Secundário/tratamento farmacológico , Falência Renal Crônica/terapia , Naftalenos/uso terapêutico , Diálise Renal , Absorciometria de Fóton , Análise de Variância , Cinacalcete , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rádio (Anatomia)/diagnóstico por imagem , Resultado do Tratamento
7.
Kyobu Geka ; 64(5): 419-21, 2011 May.
Artigo em Japonês | MEDLINE | ID: mdl-21591447

RESUMO

We reported a case of surgical treatment of iatrogenic cardiac injury. A 67-year-old man with cardiac tamponade was treated by pericardiocentesis. At night he was transferred to our hospital for emergent treatment of shock state. We found the pericardiocentesis drainage tube perforated left ventricle on computed tomography (CT). This perforation was repaired on the beating heart state using 5-0 monofilament mattress sutures reinforced by felt pledgets. Fatal complications might not occur when appropriate procedures are followed during the placement of a catheter for pericardiocentesis. Iatrogenic cardiac injury is rare but nevertheless requires caution.


Assuntos
Ventrículos do Coração/lesões , Doença Iatrogênica , Pericardiocentese/efeitos adversos , Idoso , Tamponamento Cardíaco/cirurgia , Cateteres de Demora/efeitos adversos , Humanos , Masculino , Pericardiocentese/instrumentação
8.
Clin Nephrol ; 74(4): 266-72, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20875378

RESUMO

BACKGROUND: The serum creatinine level is significantly lower in well-nourished hemodialysis patients with diabetes mellitus (DM) than in their non-DM counterparts, despite the presence of anuria in these patients. The factors associated with this finding have not been determined. PATIENTS AND METHODS: We evaluated the association of serum creatinine with handgrip strength (HGS) and lean body mass index (LMI) in a cross-sectional study of 102 DM and 208 non-DM hemodialysis patients to determine if poorer muscle quality in DM patients could explain the reduced level of serum creatinine. All the DM patients were well-nourished. Grip dynamometry and dual-energy X-ray absorptiometry (DXA) were used to measure HGS and LMI, respectively. RESULTS: The DM patients had a significantly lower serum creatinine level and HGS compared to the non-DM patients, but whole-body LMI and LMI of the upper limbs did not differ between the two groups of patients. The DM patients had significantly lower serum creatinine/whole-body LMI, serum creatinine/arm LMI, HGS/whole-body LMI, and HGS/arm LMI ratios. The serum creatinine level was significantly correlated with HGS and with whole-body and upper limb LMI in both groups of patients. However, regression analyses of LMI with serum creatinine and HGS gave significantly shallower slopes for the DM patients compared to the non-DM patients. CONCLUSION: This suggests that the muscle strength generated per unit of muscle mass, which is reflected well by the serum creatinine level, is significantly reduced in DM hemodialysis patients. Therefore, our results show that the significantly lower serum creatinine levels in DM hemodialysis patients compared to non-DM hemodialysis patients may be explained by poor muscle quality rather than by reduced muscle mass or malnutrition.


Assuntos
Índice de Massa Corporal , Creatinina/sangue , Diabetes Mellitus/fisiopatologia , Força Muscular , Diálise Renal , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redução de Peso
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2019: 4173-4176, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946789

RESUMO

A telemeter and garment-type electrode to measure heart rate variability (HRV) and perform analysis based on the R-R interval (RRI) of electrocardiograms (ECGs) were developed to improve the detection of cardiac disease. The optimum electrode arrangement depends on individual differences such as the patient's physique. To solve this problem, a garment-type textile electrode and telemeter were developed; these can select an optimal induction from four different choices to measure RRI. In this study, the R-wave detection rate and system reliability were evaluated by comparing the RRIs of the telemeter and signals from the reference ECG measurement system. Results show that the system provides sufficient RRI measurement accuracy for HRV analysis.


Assuntos
Vestuário , Eletrocardiografia , Frequência Cardíaca , Dispositivos Eletrônicos Vestíveis , Eletrodos , Humanos , Reprodutibilidade dos Testes
10.
Clin Nephrol ; 68(4): 222-7, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17969489

RESUMO

AIM: Vascular calcification, which significantly increases cardiovascular and other causes of mortality, is highly prevalent in hemodialysis patients. The aim of the present study was to examine the association between serum magnesium levels and vascular calcification in hemodialysis patients. METHODS: 390 nondiabetic patients on maintenance hemodialysis (226 males and 164 females, 59 +/- 13 years) were examined. Hand roentgenography was performed in each patient, and visible vascular calcification of the hand arteries was evaluated. Blood was drawn to measure serum calcium, phosphate, magnesium and intact parathyroid hormone levels. RESULTS: There were 52 patients (38 males and 14 females) with vascular calcification, and 338 (188 males and 150 females) without. Serum phosphate was significantly higher in the former compared with the latter group (p < 0.005); serum intact parathyroid hormone was significantly higher (p < 0.05), whereas serum calcium was not statistically different between the two groups. Serum magnesium was significantly lower in patients with vascular calcification than in those without (2.69 +/- 0.28 vs. 2.78 +/- 0.33 mg/dl, p < 0.05). Multivariate logistic regression analysis revealed that serum magnesium concentration was a significant independent factor associated with the presence of vascular calcification in hemodialysis patients (odds ratio 0.28, 95% CI 0.09 - 0.92/1 mg/dl increase in serum magnesium, p = 0.036) after adjustment for age, gender, duration of hemodialysis, calcium, phosphate and intact parathyroid hormone concentrations. CONCLUSION: Hypomagnesemia is significantly associated with the presence of vascular calcification of the hand arteries, independent of serum calcium and phosphate levels. These results suggest that higher serum magnesium concentrations may play an important protective role in the development of vascular calcification in hemodialysis patients, and that magnesium concentration of dialysis fluid may be reconsidered in view of preventing vascular calcification in hemodialysis patients.


Assuntos
Calcinose/fisiopatologia , Magnésio/sangue , Doenças Vasculares Periféricas/fisiopatologia , Diálise Renal , Idoso , Calcinose/diagnóstico por imagem , Feminino , Mãos/irrigação sanguínea , Mãos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/diagnóstico por imagem , Radiografia
11.
Clin Nephrol ; 68(2): 93-8, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17722708

RESUMO

AIMS: Histamine H2 receptor antagonists (HRA) or proton pump inhibitors (PPI) are frequently administered to patients on hemodialysis, because their intestinal mucosa is fragile. Although three studies have indicated that concomitant HRA administration causes a decrease in the binding of phosphate by calcium carbonate, the HRA doses tested in these studies were 2-4 times higher than the recommended dose for hemodialysis patients. In addition, it remains unclear whether PPI therapy affects serum phosphate levels in hemodialysis patients taking calcium carbonate. Accordingly, the aim of this study was to evaluate the influence of lansoprazole and the recommended dose of famotidine on serum phosphate and calcium levels in hemodialysis patients. METHODS: The study included 115 hemodialysis patients who were taking calcium carbonate and who were also treated with either famotidine (10 mg/day) or lansoprazole (30 mg/day). Changes of the mean serum phosphate and calcium levels over 2 months before and after the start of famotidine or lansoprazole therapy were compared. The same parameters were also compared when famotidine was switched to lansoprazole. RESULTS: The mean serum phosphate level increased significantly after administration of either famotidine or lansoprazole (by 6.6 +/- 21.9% or 13.0 +/- 26.3%, p = 0.032 and p = 0.029, respectively). The mean serum calcium level was unchanged after administration of famotidine, but showed a significant decrease after administration of lansoprazole (by 3.44 +/- 7.73%, p = 0.013). Therefore, the calcium x phosphorus product was significantly increased by administration of famotidine, but not by administration of lansoprazole (6.68 +/- 23.37% and 8.73 +/- 27.41%, p = 0.046 and p = 0.251, respectively). When famotidine was switched to lansoprazole, the serum phosophate level did not change, but serum calcium decreased significantly by 3.8 +/- 13.0% (p = 0.0006). CONCLUSION: Not only administration of 20 mg/ day of famotidine as previously reported, but also 10 mg/day of this drug (the recommended dose for hemodialysis patients) caused a significant increase of serum phosphate in patients taking calcium carbonate. PPIs have been reported to show no effect on the serum phosphate level, but 30 mg/day of lansoprazole also caused a significant increase of serum phosphate in patients taking calcium carbonate.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/farmacologia , Carbonato de Cálcio/uso terapêutico , Famotidina/farmacologia , Antagonistas dos Receptores H2 da Histamina/farmacologia , Fósforo/sangue , Inibidores da Bomba de Prótons , Diálise Renal , Feminino , Humanos , Lansoprazol , Masculino , Pessoa de Meia-Idade
12.
Transplant Proc ; 49(1): 78-83, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28104164

RESUMO

BACKGROUND: Previously, we explored the histopathologic characteristics of medullary ray injury (MRI) inducing interstitial fibrosis and tubular atrophy (IF/TA) to determine its etiologies, which include calcineurin inhibitor (CNI) toxicity and urologic complications. However, we did not examine the effects of these etiologies on long-term kidney allograft prognosis, because biopsy timing differed among cases. AIM: We examined the influence of early MRI on kidney allograft prognosis using protocol biopsies taken within a 3-month time frame. METHODS: We defined early MRI as tubular degeneration with interstitial edema or mild fibrosis localized to the medullary ray. We divided 53 protocol biopsies into 2 groups, with and without early MRI. Early MRI+ cases with isometric vacuolization were classified as CNI toxicity; those with Tamm-Horsfall protein in the interstitium and a thyroidlike appearance were classified as urinary tract system abnormalities; remaining cases were classified as "others." We compared changes in serum levels of creatinine (sCr) over 3 years and fibrosis extent at 1 year. RESULTS: The sCr levels were significantly higher in the MRI+ group than the MRI- group at 3 years (P = .024). Examining the 3 MRI+ subgroups, only the MRI+ urinary tract system abnormalities group had significantly high sCr levels compared to the MRI- group (P = .019). The MRI+ group showed significant signs of IF/TA at 1 year. CONCLUSIONS: Early MRI after kidney transplantation was significantly more likely to develop IF/TA at 1 year and had higher sCr levels at 3 years. In such cases, intervention might preserve graft function over the long term.


Assuntos
Rejeição de Enxerto/patologia , Transplante de Rim/efeitos adversos , Rim/patologia , Adulto , Biópsia , Creatinina/sangue , Feminino , Fibrose/patologia , Humanos , Masculino , Pessoa de Meia-Idade
13.
Circ Res ; 85(1): 5-11, 1999 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-10400905

RESUMO

The growth-promoting effect of mechanical stress on vascular smooth muscle cells (VSMCs) has been implicated in the progress of vascular disease in hypertension. Extracellular signal-regulated kinases (ERKs) have been implicated in cellular responses, such as vascular remodeling, induced by mechanical stretch. However, it remains to be determined how mechanical stretch activates ERKs. The cytoskeleton seems the most likely candidate for force transmission into the interior of the cell. Therefore, we examined (1) whether the cytoskeleton involves mechanical stretch-induced signaling, (2) whether Rho is activated by stretch, and (3) whether Rho mediates the stretch-induced signaling in rat cultured VSMCs. Mechanical stretch activated ERKs, with a peak response observed at 20 minutes, followed by a significant increase in DNA synthesis. Treatment with the ERK kinase-1 inhibitor, PD98059, inhibited the stretch-induced increase in DNA synthesis. Cytochalasin D, which selectively disrupts the network of actin filaments, markedly inhibited stretch-induced ERK activation. In the control state, RhoA was observed predominantly in the cytosolic fraction, but it was translocated in part to the particulate fraction in response to mechanical stretch. Botulinum C3 exoenzyme, which inactivates Rho p21 (known to participate in the reorganization of the actin cytoskeleton), attenuated stretch-induced ERK activation. Inhibition of Rho kinase (p160ROCK) also suppressed stretch-induced ERK activation dose dependently. Our results suggest that mechanotransduction in VSMCs is dependent on intact actin filaments, that Rho is activated by stretch, and that Rho/p160ROCK mediates stretch-induced ERK activation and vascular hyperplasia.


Assuntos
Actinas/fisiologia , Aorta/fisiologia , Toxinas Botulínicas , Proteínas de Ligação ao GTP/fisiologia , Músculo Liso Vascular/fisiologia , Transdução de Sinais/fisiologia , ADP Ribose Transferases/farmacologia , Angiotensina II/farmacologia , Animais , Aorta/citologia , Transporte Biológico/fisiologia , Proteínas Quinases Dependentes de Cálcio-Calmodulina/antagonistas & inibidores , Proteínas Quinases Dependentes de Cálcio-Calmodulina/metabolismo , DNA/biossíntese , Ativação Enzimática/efeitos dos fármacos , Ativação Enzimática/fisiologia , Proteínas de Ligação ao GTP/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular , Músculo Liso Vascular/citologia , Fator de Crescimento Derivado de Plaquetas/farmacologia , Proteínas Serina-Treonina Quinases/antagonistas & inibidores , Ratos , Estresse Mecânico , Quinases Associadas a rho , Proteína rhoA de Ligação ao GTP
14.
J Orthop Surg (Hong Kong) ; 14(1): 9-12, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16598079

RESUMO

PURPOSE: To study the prevalence of osteoarthritis, osteoporotic vertebral fractures, and spondylolisthesis among elderly residents of a Japanese village and to examine the correlation between radiographic evidence of abnormality and lower back pain. METHODS: 205 men (mean age, 70.7 years) and 323 women (mean age, 70.5 years) in a Japanese village participated in this cross-sectional study. Plain lateral radiographs were taken from the lower thoracic spine to the sacral spine. They were evaluated by 3 independent orthopaedic surgeons for degree of osteoarthritis (using Weiner grading system) and the presence of osteoporotic vertebral fractures and spondylolisthesis. RESULTS: The prevalence of osteoarthritis in elderly Japanese villagers was 38.3%, whereas that of osteoporotic vertebral fractures and spondylolisthesis was 17.8% and 8.9%, respectively. There was no significant difference in osteoarthritis between men and women, but osteoporotic vertebral fractures and spondylolisthesis were significantly more common in females (p<0.01). No significant correlation was observed between lower back pain and radiographic evidence of degenerative spinal disease. CONCLUSION: The prevalence of spondylolisthesis in elderly Japanese was much lower than that in whites or African Americans. The prevalence of osteoarthritis or osteoporotic vertebral fractures was comparable with other English or US studies. Radiographic evidence of osteoarthritis, osteoporotic vertebral fractures, and spondylolisthesis is not necessarily associated with lower back pain.


Assuntos
Fraturas Espontâneas/epidemiologia , Osteoartrite/epidemiologia , Osteoporose/epidemiologia , Fraturas da Coluna Vertebral/epidemiologia , Espondilartrite/epidemiologia , Espondilolistese/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Humanos , Japão/epidemiologia , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Masculino , Osteoartrite/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Osteoporose/etiologia , Prevalência , Radiografia , Saúde da População Rural , Fraturas da Coluna Vertebral/diagnóstico por imagem , Espondilartrite/diagnóstico por imagem , Espondilolistese/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem
15.
Biochim Biophys Acta ; 487(1): 61-73, 1977 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-870059

RESUMO

1. The sterochemical configuration of glycerol moiety of seminolipid (1-O-alkyl-2-O-beta-D-(3'-sulfo) galactopyranosylglycerol: Ishizuka, I., Suzuki, A. and Yamakawa, T. (1973). J. Biochem. 73, 77--87) from mammalian testis was determined by measurement of optical rotatory dispersion of alkylglyceryl ether moiety, establishing the final structure of the major glycolipid from mature testis of mammals as 1-O-alkyl-2-O-beta-D-(3'-sulfo)-galactopyranosyl-sn-glycerol. 2. The simple and sensitive modification of fluorometric determination of galactolipids and sphingolipids was described. This method does not require lipid extraction from silica gel of thin-layer chromatography, and allows a quantitative assessment of the sphingoglycolipids and galactosyl glycerides using a small amount of testicular tissue. 3. Various lipid classes from human testis of varying age groups were compared. The total lipid and seminolipid content was highest in adult (40-years-old) testis amounting to 39.0 mg and 158.7 nmol/g tissue, respectively. Seminolipid was not detected in infant (2 years old) or child (9 years old) and found only at the concentration of 25.3 nmol/g in the testis of aged (60--90 years of age) supporting the postulated relation of seminolipid with spermatogenesis and sexual activity. In contrast, ganglioside content was highest in the testis of aged probably reflecting fibrosis of the testis. The main ganglioside was found to be hematoside with N-acetylneuraminic acid. Gangliosides Gm1 and GD1a were also detected.


Assuntos
Glicolipídeos , Sêmen/metabolismo , Testículo/metabolismo , Adulto , Fatores Etários , Idoso , Criança , Cromatografia em Gel , Cromatografia em Camada Fina , Gangliosídeos/metabolismo , Glicolipídeos/metabolismo , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Conformação Molecular , Rotação Ocular , Fosfolipídeos/análise , Ácidos Siálicos/análise , Espectrometria de Fluorescência , Estereoisomerismo , Testículo/crescimento & desenvolvimento
16.
Biochim Biophys Acta ; 572(2): 325-32, 1979 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-427180

RESUMO

Bovine adrenocortical mitochondria were sonicated and subjected to extraction with sodium cholate. The extract contained not only cytochrome P-450 activities, but also an activity which catalyzed the conversion of deoxycorticosterone to an unknown steroid (designated X). The latter activity was concentrated by (NH4)2SO4 fractionation in the presence of sodium cholate, and separated from P-450 by taking advantage of their different solubilities in phosphate buffer without sodium cholate. The specific activity of the partially purified enzyme fraction was 70 times higher than that of sonicated mitochondria. The conversion of deoxycorticosterone to steroid X required NAD or NADP. The conversion rate was dependent on the concentration of deoxycorticosterone. The major product, steroid X, was isolated from the reaction mixture by means of silicic acid and Iatrobeads column chromatography. The steroid was characterized as 3-keto-4-etienic acid (3-oxoandrost-4-ene-17beta-carboxylic acid). This result suggests that an enzyme system for the conversion of deoxycorticosterone to 3-keto-4-etienic acid exists in adrenocortical mitochondria.


Assuntos
Córtex Suprarrenal/metabolismo , Androstenos/biossíntese , Desoxicorticosterona/metabolismo , Mitocôndrias/metabolismo , Animais , Bovinos , Sistema Enzimático do Citocromo P-450/metabolismo , Espectroscopia de Ressonância Magnética , Espectrometria de Massas
17.
Biochim Biophys Acta ; 1148(1): 133-8, 1993 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-8499461

RESUMO

(1) Glycophorins (GPs) AM, AN, B, C and D were each isolated into a high state of purity from human erythrocyte membranes by a combination of lithium diiodosalicylate (LIS)-phenol extraction, gel-filtration with Bio-Gel A1.5m and HPLC with LiChrospher 1000 TMAE. (2) GPs-B, -C and -D reacted with influenza A and B viruses as well as GPs-AM and -AN and the order of reactivities against two viruses of the glycophorins was as follows: GP-B > GP-C > GP-AM = GP-AN >> GP-D for the former virus and GP-C > GP-B > GP-AM = GP-AN >> GP-D for the latter virus.


Assuntos
Membrana Eritrocítica/metabolismo , Glicoforinas/isolamento & purificação , Orthomyxoviridae/metabolismo , Aminoácidos/análise , Carboidratos/análise , Glicoforinas/química , Glicoforinas/metabolismo , Hemaglutinação/efeitos dos fármacos , Humanos
18.
Biochim Biophys Acta ; 618(2): 202-13, 1980 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-6990992

RESUMO

The mechanism of hydrogen incorporation into fatty acids was investigated with intact Escherichia coli cells, a crude enzyme preparation and purified reductases of fatty acid synthetase system. The distributions of deuterium atoms incorporated into fatty acids from 2H2O and stereospecifically deuterium-labeled NADPH or NADH were determined by mass spectrometry. When E. coli was grown in 2H2O, almost every hydrogen atom of cellular fatty acids was incorporated from the medium. When fatty acids were synthesized from acetyl-CoA, malonyl-CoA and NADPH in the presence of a crude enzyme preparation of either E. coli or Bacillus subtilis, almost every hydrogen atom was also incorporated from the medium. In contrast to these results, purified beta-ketoacyl acyl carrier reductase directly transferred the HB hydrogen of NADPH to beta-ketoacyl acyl carrier protein, and purified enoyl acyl carrier protein reductase also transferred the HB hydrogen of NADPH and NADH directly to enoyl acyl carrier protein. In the crude enzyme preparation of E. coli, we found high activities which exchanged the HB hydrogen of NADPH with the deuterium of 2h2o. the conflicting results of the origin of hydrogen atoms of fatty acids mentioned above are explained by the presence of enzymes, which catalyzed the rapid exchange of NADPH with the deterium of 2H2O prior to the reaction of fatty acid synthetase.


Assuntos
Deutério/metabolismo , Ácido Graxo Sintases/metabolismo , NADP/metabolismo , NAD/metabolismo , Água/metabolismo , Escherichia coli/enzimologia , Cromatografia Gasosa-Espectrometria de Massas , Glutamatos/metabolismo
19.
Biochim Biophys Acta ; 620(3): 356-63, 1980 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-7016184

RESUMO

Acyl phosphatidylglycerol, isolated from Escherichia coli, has been identified as 3-sn-phosphatidyl-1'-(3'-acyl)-sn-glycerol. The fatty acids of the diacylglycerol moiety of acyl phosphatidylglycerol resemble those of phosphatidylglycerol in composition. However, the monoacylglycerol moiety of this lipid contains more unsaturated fatty acids than the diacylglycerol part of this lipid or other phospholipids in E. coli. Furthermore, the fatty acids present in the monoacylglycerol moiety, were found to contain major amounts of an unsaturated acid identified as 7-tetradecenoic acid by combined gas-liquid chromatography-mass spectrometry. This acid was present only in low concentrations in most phospholipids of E. coli.


Assuntos
Escherichia coli/metabolismo , Fosfatidilgliceróis/isolamento & purificação , Diglicerídeos/análise , Ácidos Graxos/análise , Ácidos Graxos Insaturados/análise , Cromatografia Gasosa-Espectrometria de Massas , Glicerídeos/análise , Fosfatidilgliceróis/análise , Fosfolipídeos/análise
20.
Biochim Biophys Acta ; 1090(2): 216-22, 1991 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-1932113

RESUMO

A high-level and stable expression system of human tissue-type plasminogen activator (t-PA) was accomplished in human cells by selecting a promoter and a host cell line. First, we have constructed two types of t-PA expression plasmids containing 3 kb of the human beta-actin promoter region or 0.3 kb of SV40 early promoter region and these plasmids were transfected into HeLa cells, respectively, and the resulting transfectants were found to secrete various amounts of t-PA derived from the plasmids to the culture media. Southern blot analysis revealed that the beta-actin promoter was more efficient than the SV40 early promoter with regard to the expression level per single copy of the t-PA gene in the transfected HeLa cells. Next, the t-PA expression plasmid containing the beta-actin promoter was also transfected into WI-38 VA13 cells, a human fibroblastic cell line, and KMS-5 cells, a human lymphoid cell line, in order to compare the expression ability of the promoter among these three cell lines. Some of the transfectants from both cell lines were also found to produce t-PA. It was also found that the expression levels in HeLa and WI-38 VA13 seemed to be more efficient than that in KMS-5.


Assuntos
Actinas/genética , Expressão Gênica , Regiões Promotoras Genéticas , Proteínas Recombinantes/biossíntese , Ativador de Plasminogênio Tecidual/biossíntese , Linhagem Celular , Fibroblastos , Células HeLa , Humanos , Plasmídeos , Ativador de Plasminogênio Tecidual/genética , Transfecção
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