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Kawasaki, Japan

Oshikawa J.,Yokohama City University | Toya Y.,Yokohama City University | Morita S.,Yokohama City University | Taguri M.,Yokohama City University | And 10 more authors.
Clinical and Experimental Hypertension | Year: 2014

Diuretics or calcium channel blockers (CCBs) are used concomitantly with an angiotensin II receptor blocker (ARB). However, it is not established which ARB-based combination therapy is the most effective and safe. This prospective randomized open-label study compared the efficacy and safety of a fixed-dose tablet of losartan (LST)-hydrochlorothiazide (HCTZ) (n===99) and LST-amlodipine (AML) (n===77) in Japanese patients whose hypertension was uncontrolled by ARB monotherapy. Blood pressure changed similarly over the 12-month study period. Only LST-HCTZ significantly increased serum uric acid (SUA) in patients with low baseline SUA (<5.6=mg/dL) but not in patients with high baseline SUA. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.

Toki D.,Tokyo Womens Medical University | Inui M.,Tokyo Womens Medical University | Ishida H.,Tokyo Womens Medical University | Okumi M.,Tokyo Womens Medical University | And 9 more authors.
Nephrology | Year: 2016

Aim: Transplant glomerulopathy (TG) is a feature of chronic antibody-mediated injury in the glomerular capillaries in renal transplant recipients. TG is generally associated with proteinuria; however, renal function at the diagnosis of TG varies. This study aimed to determine which morphological abnormalities are associated with renal function and proteinuria at the diagnosis of TG. Methods: A total of 871 renal transplantations were performed at Tokyo Women's Medical University between 2005 and 2013. TG was diagnosed in 127 biopsies from 58 (6.7%) recipients. Renal function was evaluated by the estimated glomerular filtration rate (eGFR). Proteinuria was assessed by a dipstick test: positive for +1 and over. Results: At diagnosis, of 127 biopsies, 72, 37, and 18 had mild, moderate, and severe TG (Banff cg). The severity of TG was not associated with decreased eGFR at the time of biopsy (cg1: 36.1 ± 14.8, cg2-3: 38.8 ± 14.5 mL/min per 1.73 m2, P = 0.25), whereas the severity of interstitial fibrosis (IF) (Banff ci) was significantly associated with decreased eGFR (ci0-1: 42.75 ± 13.32, ci2-3: 27.69 ± 11.94 mL/min per 1.73 m2, P < 0.0001). The multivariate analysis revealed that IF was the only independent risk factors for decreased eGFR (OR = 4.38, P = 0.0006). Meanwhile, TG was identified as the only independent risk factor for the incidence of proteinuria (OR = 2.67, P = 0.014). Conclusion: Interstitial fibrosis was a critical determinant of impaired renal function at the diagnosis of TG. The severity of TG was significantly associated with proteinuria, but did not contribute to renal dysfunction. © 2016 Asian Pacific Society of Nephrology

Ito H.,St. Marianna University School of Medicine | Morishima H.,Kawasaki City Tama Hospital | Onodera H.,St. Marianna University School of Medicine | Wakui D.,Yokohama city Seibu Hospital | And 4 more authors.
Journal of NeuroInterventional Surgery | Year: 2015

A 79-year-old woman presented with a subarachnoid hemorrhage. Angiography revealed pseudoaneurysm formation due to rupture of a true saccular anterior communicating artery aneurysm. Coil embolization, limited to the true aneurysm, was performed successfully with a favorable clinical outcome. This procedure can be considered as an alternative treatment option for similar aneurysms in cases where surgical clipping is contraindicated.

Miura K.,St. Marianna University School of Medicine | Nakano H.,St. Marianna University School of Medicine | Sakurai J.,St. Marianna University School of Medicine | Kobayashi S.,St. Marianna University School of Medicine | And 7 more authors.
International Journal of Clinical Oncology | Year: 2011

Background; Chemotherapy-associated hepatotoxicity is a common cause of postoperative complications after major hepatectomy. Splenomegaly may indicate portal hypertension due to chemotherapy. To identify chemotherapynai ̈ve patients with liver damage, the splenic volume (SV) and aspartate aminotransferase to platelet ratio (APR) were investigated. Methods; Seventy-one patients receiving FOLFIRI, FOLFOX, or FOLFOX plus bevacizumab as first-line chemotherapy were included in this study. The SV measurement was performed by helical computed tomography volumetry, and the SV index (SVI) was calculated during 6 cycles of chemotherapy. The APR was used as an indicator of liver injury and the APR index (APRI) was calculated. Results The SVI and APRI were significantly higher in the FOLFOX group than in the FOLFIRI group. In the FOLFOX group, the maximum APR during FOLFOX administration was significantly higher in the subjects with SVI ≥+30% than in those with SVI<+30% (p<0.01). The incidences of grade 3 or 4 adverse events and grade 2 or greater histopathological sinusoidal injury were significantly higher in the SVI ≥+30% than in the SVI<+30% group. Interestingly, the SVI was significantly higher in the group with APR <0.17 before FOLFOX than in the subjects with an APR<0.17 before FOLFOX (p<0.05). Conclusion Splenomegaly due to FOLFOX-associated hepatotoxicity can be predicted if the APR before FOLFOX is 0.17 or higher. © Japan Society of Clinical Oncology 2011.

Nakamura H.,St. Marianna University School of Medicine | Mochizuki A.,St. Marianna University School of Medicine | Shinmyo T.,St. Marianna University School of Medicine | Ando K.,St. Marianna University School of Medicine | And 3 more authors.
Anticancer Research | Year: 2010

Background: Epidermal growth factor receptor (EGFR) mutational analysis has become essential in determining a therapeutic strategy for lung cancer. This study validated the reliability of recently generated rabbit monoclonal antibodies that recognise specific mutations of the EGFR protein. Patients and Methods: Pulmonary adenocarcinoma tissue from 20 previously genotyped specimens was prepared for immunohistochemical staining by two antibodies that recognise products of in-frame deletions in exon 19 (E746-A750del) and a point mutation that replaces leucine with arginine at codon 858 in exon 21 (L858R) of the EGFR gene. Results: The findings of EGFR-mutation-specific immunohistochemistry were concordant with the results of DNA analysis in 18 of 20 tested samples leading to 90% sensitivity and 100% specificity of the method. Conclusion: This immunohistochemical assay for products of representative EGFR gene mutations may be performed reliably using tissue specimens from resected pulmonary adenocarcinomas.

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