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Nakamura K.,Nagasaki University | Kawasaki E.,Nagasaki University | Imagawa A.,Osaka University | Awata T.,Saitama University | And 8 more authors.
Diabetes Care | Year: 2011

OBJECTIVE - Interferon therapy can trigger induction of several autoimmune diseases, including type 1 diabetes. To assess the clinical, immunologic, and genetic characteristics of type 1 diabetes induced by interferon therapy, we conducted a nationwide cross-sectional survey. RESEARCH DESIGN AND METHODS - Clinical characteristics, anti-islet autoantibodies, and HLA-DR typing were examined in 91 patients for whom type 1 diabetes developed during or shortly after interferon therapy. RESULTS - Median age at the onset of type 1 diabetes was 56 (interquartile range 48-63) years and mean ± SD BMI was 20.8 ± 2.7 kg/m 2. The time period from the initiation of interferon therapy to type 1 diabetes onset in patients receiving pegylated interferon and ribavirin was significantly shorter than that in patients with nonpegylated interferon single therapy (P < 0.05). Anti-islet autoantibodies were detected in 94.5% of patients at diabetes onset. Type 1 diabetes susceptibility HLA-DRs in the Japanese population, DR4 and DR9, were also associated with interferon treatment-related type 1 diabetes. Furthermore, the prevalence of HLA-DR13 was significantly higher in interferon treatment-related type 1 diabetes than in healthy control subjects (odds ratio 3.80 [95% CI 2.20-7.55]; P < 0.0001) and classical type 1 diabetes (2.15 [1.17-3.93]; P < 0.05). CONCLUSIONS - Anti-islet autoantibodies should be investigated before and during interferon therapy to identify subjects at high risk of type 1 diabetes. Stronger antiviral treatment may induce earlier development of type 1 diabetes. Furthermore, patients who develop interferon-induced type 1 diabetes are genetically susceptible. © 2011 by the American Diabetes Association.

Seki M.,Saitama Social Insurance Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2012

This report presents the case of a 79-year old woman who developed radionecrosis after irradiation following a radical mastectomy at the age of 50 and complicated lung adenocarcinoma in the left upper lobe. Chest wall resection and reconstruction were performed simultaneously with left upper lobectomy, and a latissimus dorsi musculocutaneous flap was used for reconstruction via the left pleural cavity after lobectomy. The flap was well adapted to the defect of the chest wall. This clinical course indicates that a transpleural musculocutaneous flap can be a reconstructive procedure for such patients showing chest wall radionecrosis complicated with an intrathoracic disease. © 2011 The Author 2011. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Nishimura S.,35 Shinanomachi | Nishimura S.,Keio University | Yasuda A.,35 Shinanomachi | Iwai H.,35 Shinanomachi | And 12 more authors.
Molecular Brain | Year: 2013

Background: The transplantation of neural stem/progenitor cells (NS/PCs) at the sub-acute phase of spinal cord injury, but not at the chronic phase, can promote functional recovery. However, the reasons for this difference and whether it involves the survival and/or fate of grafted cells under these two conditions remain unclear. To address this question, NS/PC transplantation was performed after contusive spinal cord injury in adult mice at the sub-acute and chronic phases. Results: Quantitative analyses using bio-imaging, which can noninvasively detect surviving grafted cells in living animals, revealed no significant difference in the survival rate of grafted cells between the sub-acute and chronic transplantation groups. Additionally, immunohistology revealed no significant difference in the differentiation phenotypes of grafted cells between the two groups. Microarray analysis revealed no significant differences in the expression of genes encoding inflammatory cytokines or growth factors, which affect the survival and/or fate of grafted cells, in the injured spinal cord between the sub-acute and chronic phases. By contrast, the distribution of chronically grafted NS/PCs was restricted compared to NS/PCs grafted at the sub-acute phase because a more prominent glial scar located around the lesion epicenter enclosed the grafted cells. Furthermore, microarray and histological analysis revealed that the infiltration of macrophages, especially M2 macrophages, which have anti-inflammatory role, was significantly higher at the sub-acute phase than the chronic phase. Ultimately, NS/PCs that were transplanted in the sub-acute phase, but not the chronic phase, promoted functional recovery compared with the vehicle control group. Conclusions: The extent of glial scar formation and the characteristics of inflammation is the most remarkable difference in the injured spinal cord microenvironment between the sub-acute and chronic phases. To achieve functional recovery by NS/PC transplantation in cases at the chronic phase, modification of the microenvironment of the injured spinal cord focusing on glial scar formation and inflammatory phenotype should be considered. © 2013 Nishimura et al.; licensee BioMed Central Ltd.

Taniyama M.,Showa University | Maruyama T.,Saitama Social Insurance Hospital | Tozaki T.,Showa University | Nakano Y.,Showa University | Ban Y.,Showa University
Human Immunology | Year: 2010

The R620W polymorphism in the protein-tyrosine-phosphatase nonreceptor type 22 gene (PTPN22) confers susceptibility to type 1 diabetes (T1D) and other autoimmune diseases. This polymorphism is reportedly nonpolymorphic in the Asian population. Additional polymorphisms and specific haplotypes have also been associated with T1D, rheumatoid arthritis (RA) and Graves' disease in Caucasians. We examined whether PTPN22 single nucleotide polymorphisms (SNPs) other than R620W and haplotypes are associated with T1D in the Japanese population. We compared the allele frequencies of five haplotype-tagging SNPs in the PTPN22 gene, 2 of which are reportedly associated with RA in Caucasians (rs3789604 and rs1310182), and compared haplotype distributions between 184 Japanese T1D patients and 179 healthy controls. rs3789604 was not associated with T1D in our Japanese subjects. The frequency of the C allele of rs1310182 differed significantly between T1D patients and controls. Permutation analysis revealed the distribution of this haplotype to differ significantly between T1D patients and controls. One rare haplotype that included the susceptibility allele of rs1310182 was more frequent, while another rare haplotype that included the protective allele of rs1310182 was absent, in T1D patients. This significant haplotype distribution difference suggests that polymorphisms in the PTPN22 gene other than R620W are involved in either predisposition to or protection from T1D in the Japanese population. © 2010 American Society for Histocompatibility and Immunogenetics.

Hirata T.,Foundation for Biomedical Research and Innovation | Koga M.,Kawanishi City Hospital | Kasayama S.,Nissay Hospital | Morimoto J.,Saitama Social Insurance Hospital | Maruyama T.,Saitama Social Insurance Hospital
Clinica Chimica Acta | Year: 2015

Background: No previous reports have clarified the relationship between glycated albumin (GA) and BMI in patients with acute-onset type 1 diabetes. Methods: We conducted a cross-sectional study evaluating the correlation between GA and BMI in 209 patients with acute-onset type 1 diabetes and in 159 patients with type 2 diabetes who were designated as the control group. The correlation between fasting serum C-peptide immunoreactivity (CPR) and GA or BMI was also evaluated to clarify the impact of insulin secretion capacity on the relationship between GA and BMI. Results: GA was significantly inversely correlated with BMI in patients with type 2 diabetes (r = -. 0.317, p. <. 0.001) but not in patients with type 1 diabetes (r = 0.031, p = NS). In patients with type 2 diabetes, GA was significantly inversely correlated with fasting CPR, and BMI was significantly correlated with fasting CPR. In patients with type 1 diabetes, GA was significantly inversely correlated with fasting CPR (r = -. 0.291, p. <. 0.001), but BMI was not correlated with fasting CPR (r = -. 0.010, p = NS). Conclusions: Unlike in patients with type 2 diabetes, GA was not significantly correlated with BMI in patients with acute-onset type 1 diabetes. © 2014 Elsevier B.V.

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