Takikawa Municipal Hospital
Takikawa Municipal Hospital
Matsuki M.,Sapporo Medical University |
Tanaka T.,Sapporo Medical University |
Maehana T.,Sapporo Medical University |
Kyoda Y.,Sapporo Medical University |
And 10 more authors.
Clinical and Experimental Nephrology | Year: 2017
Background: Although serum cystatin C and creatinine are used as practical markers of renal function, the discrepancy between them in postrenal acute kidney injury (AKI) cases was reported. The aim of this study was to determine whether the preoperative serum cystatin C (pre-CysC) level could predict clinical outcomes after treatment in patients with postrenal AKI. Methods: Patients who underwent urological interventions with postrenal AKI were enrolled in this prospective observational study. Associations among preoperative serum creatinine (pre-sCr), pre-CysC, and nadir postoperative serum creatinine (post-sCr) were evaluated. In addition, based on our results in combination with detailed data from the literature, a predictive equation for postoperative serum creatinine (post-sCr) was developed by simple regression analysis and validated using Bland–Altman plots. Results: Finally, 19 patients were eligible for analysis in this study. The value calculated by subtracting pre-CysC (mg/L) from pre-sCr (mg/dl) had a strong correlation to the decrement of serum creatinine (r = 0.9508, p < 0.0001). We added the data of 16 patients obtained from the literature to our series, which were totally randomized into 2 groups, training set and validation set in a 2:1 ratio (n = 23 and 12, respectively) to develop and validate a predictive equation for post-sCr. The mean difference between the predictive and actual post-sCr, −0.68 mg/dl (95% CI −1.62 to 0.26) in the validation set was within the limits of agreement. Conclusion: We showed that the discrepancy between pre-sCr and pre-CysC could predict improvement of renal function after intervention in patients with postrenal AKI. © 2017 Japanese Society of Nephrology
Nishiyama N.,Sapporo Medical University |
Kitamura H.,Sapporo Medical University |
Hotta H.,Red Cross |
Takahashi A.,Hakodate Goryoukaku Hospital |
And 8 more authors.
Japanese Journal of Clinical Oncology | Year: 2014
Objective: The aims of this study were to clarify the prognostic factors and to validate the bacillus Calmette-Guérin failure classification advocated by Nieder et al. in patients with nonmuscle-invasive bladder cancer who had intravesical recurrence after bacillus Calmette-Guérin therapy. Methods: Data from 402 patients who received intravesical bacillus Calmette-Guérin therapy between January 1990 and November 2011 were collected from 10 institutes. Among these patients, 187 with bacillus Calmette-Guérin failure were analyzed for this study. Results: Twenty-nine patients (15.5%) were diagnosed with progression at the first recurrence after bacillus Calmette-Guérin therapy. Eighteen (62.1%) of them died of bladder cancer. A total of 158 patients were diagnosed with non-muscle-invasive bladder cancer at the first recurrence after bacillus Calmette-Guérin therapy. Of them, 23 (14.6%) underwent radical cystectomy. No patients who underwent radical cystectomy died of bladder cancer during the followup. On multivariate analysis of the 135 patients with bladder preservation, the independent prognostic factors for cancer-specific survival were age (>70 [P 1/4 0.002]), tumor size (>3 cm [P 1/4 0.015]) and the Nieder classification (bacillus Calmette-Guérin refractory [P, 0.001]). In a subgroup analysis, the estimated 5-year cancer-specific survival rates in the groups with no positive, one positive and two to three positive factors were 100, 93.4 and 56.8%, respectively (P, 0.001). Conclusions: Patients with stage progression at the first recurrence after bacillus Calmette-Gué rin therapy had poor prognoses. Three prognostic factors for predicting survival were identified and used to categorize patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Guérin into three risk groups based on the number of prognostic factors in each one. © The Author 2014. Published by Oxford University Press. All rights reserved.
PubMed | Red Cross, Takikawa Municipal Hospital, Nippon Telegraph and Telephone, University of Toyama and 8 more.
Type: Journal Article | Journal: Anticancer research | Year: 2016
To determine prognostic factors for overall survival (OS) in renal cell carcinoma (RCC) patients with bone metastasis in the targeted-therapy era.We conducted a retrospective multi-institutional review of the medical records of 149 RCC patients with bone metastasis. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were performed to identify independent factors associated with OS.The median OS was 13.4 months. In multivariate analysis, molecular-targeted therapy, nephrectomy and surgery for bone metastasis were independent prognostic factors. Bone-modifying agents (BMAs) were not associated with OS. The median OS of patients receiving molecular-targeted therapy after diagnosis of bone metastasis was significantly better than that of those who did not receive targeted therapy.Molecular-targeted therapy, nephrectomy and surgery for bone metastasis should be considered for RCC patients with metastasis in the bones.
PubMed | Red Cross, Hokkaido Social Work Association Obihiro Hospital, Takikawa Municipal Hospital, Nippon Telegraph and Telephone and 6 more.
Type: Journal Article | Journal: Japanese journal of clinical oncology | Year: 2014
The aims of this study were to clarify the prognostic factors and to validate the bacillus Calmette-Gurin failure classification advocated by Nieder et al. in patients with non-muscle-invasive bladder cancer who had intravesical recurrence after bacillus Calmette-Gurin therapy.Data from 402 patients who received intravesical bacillus Calmette-Gurin therapy between January 1990 and November 2011 were collected from 10 institutes. Among these patients, 187 with bacillus Calmette-Gurin failure were analyzed for this study.Twenty-nine patients (15.5%) were diagnosed with progression at the first recurrence after bacillus Calmette-Gurin therapy. Eighteen (62.1%) of them died of bladder cancer. A total of 158 patients were diagnosed with non-muscle-invasive bladder cancer at the first recurrence after bacillus Calmette-Gurin therapy. Of them, 23 (14.6%) underwent radical cystectomy. No patients who underwent radical cystectomy died of bladder cancer during the follow-up. On multivariate analysis of the 135 patients with bladder preservation, the independent prognostic factors for cancer-specific survival were age (70 [P = 0.002]), tumor size (3 cm [P = 0.015]) and the Nieder classification (bacillus Calmette-Gurin refractory [P < 0.001]). In a subgroup analysis, the estimated 5-year cancer-specific survival rates in the groups with no positive, one positive and two to three positive factors were 100, 93.4 and 56.8%, respectively (P < 0.001).Patients with stage progression at the first recurrence after bacillus Calmette-Gurin therapy had poor prognoses. Three prognostic factors for predicting survival were identified and used to categorize patients with non-muscle-invasive bladder cancer treated with bacillus Calmette-Gurin into three risk groups based on the number of prognostic factors in each one.
PubMed | JCHO Sapporo Hokushin Hospital, Takikawa Municipal Hospital and Sapporo Medical University
Type: | Journal: Modern rheumatology | Year: 2016
Cutaneous polyarteritis nodosa (CPAN) is characterized by a necrotizing vasculitis of small and medium-sized arteries in the skin, which can be associated with fever, arthralgia, myalgia, and neuropathy, but, unlike polyarteritis nodosa (PAN), there is no visceral involvement. CPAN is rare in childhood. We report two siblings who developed CPAN during childhood. Interestingly, both had Mediterranean fever gene (MEFV) mutation, i.e. heterozygous E148Q. They also shared HLA-A24, -DR15 alleles. Simultaneous occurrence of MEFV mutation and HLA alleles with CPAN has never been reported in Japan. These cases could provide some hereditary clue for the development of CPAN.
PubMed | Red Cross, Takikawa Municipal Hospital, Sapporo Medical University, Oji General Hospital and 7 more.
Type: Journal Article | Journal: Japanese journal of clinical oncology | Year: 2015
Although some new drugs for castration-resistant prostate cancer are available, docetaxel still plays an important role in castration-resistant prostate cancer treatment. In this study, we evaluated the efficacy and safety of docetaxel and prednisolone in patients with castration-resistant prostate cancer.We conducted a retrospective chart review of castration-resistant prostate cancer patients who received docetaxel and prednisolone at 14 hospitals in the Sapporo Medical University Urologic Oncology Consortium from August 2004 to December 2011.A total of 140 patients with castration-resistant prostate cancer received docetaxel and prednisolone (median age, 73.8 years; median prostate specific antigen, 54.7 ng/ml). A median of six cycles (range: 1-43) of docetaxel and prednisolone was administered per patient. Median follow-up was 13.7 months. Median overall survival was 22.0 months. The log-rank test revealed that prostate specific antigen before docetaxel and prednisolone (<50 ng/ml) and the prostate specific antigen reduction rate (30%) were associated with overall survival (P < 0.001 and P < 0.001, respectively). Eighty patients (57.1%) achieved a prostate specific antigen reduction rate of over 30%. All except two (97.5%) reached 30% prostate specific antigen reduction within five cycles of docetaxel and prednisolone. There were two (1.4%) treatment-related deaths due to adverse events, which were interstitial lung disease, and febrile neutropenia and bacterial pneumonia. Interstitial lung disease occurred in 14 (10.0%) patients within a median of 2.5 cycles of docetaxel and prednisolone. Grade 5 interstitial lung disease was seen after three cycles of docetaxel and prednisolone.If a prostate specific antigen reduction rate of over 30% is not obtained within five cycles of docetaxel and prednisolone, other treatment options should be considered. Although most patients safely received docetaxel and prednisolone, we must always keep interstitial lung disease in mind as a possible lethal adverse event.
Hikami K.,University of Tsukuba |
Kawasaki A.,University of Tsukuba |
Ito I.,University of Tsukuba |
Koga M.,University of Tsukuba |
And 12 more authors.
Arthritis and Rheumatism | Year: 2011
Objective. SPI1, also referred to as PU.1, is an Ets family transcription factor that interacts with IRF2, IRF4, and IRF8. In view of the significance of the type I interferon pathway in systemic lupus erythematosus (SLE), this study was undertaken to investigate a possible association between SPI1 polymorphisms and SLE. Methods. A case-control association study was performed using 6 tag single-nucleotide polymorphisms (SNPs), as well as a SNP located upstream of SPI1 previously found to be associated with acute myelogenous leukemia, in 400 Japanese patients with SLE and 450 healthy controls. Resequencing of all exons and known regulatory regions was performed to identify functional polymorphisms. Association of genotype and SPI1 expression was examined using the GENEVAR database and reporter assays. Results. A significant association was detected in 2 SNPs in intron 2 (rs10769258 and rs4752829) (P = 0.005 and P = 0.008, respectively, under the dominant model). The association was stronger in patients with nephropathy. Resequencing identified a potentially functional polymorphism in the 3'-untranslated region (3'-UTR), rs1057233, which was in strong linkage disequilibrium with the SNPs in intron 2. The number of risk alleles at rs1057233 was strongly correlated with SPI1 messenger RNA (mRNA) level in the database analysis (P = 0.0002), and was confirmed by a reporter assay. Interestingly, rs1057233 alters a target sequence for microRNA hsa-miR-569 (miR-569). Transfection experiments demonstrated that miR-569 inhibits expression of a reporter construct with the 3'-UTR sequence containing the nonrisk allele but not the risk allele. Conclusion. Our findings indicate that a SNP in the 3'-UTR of SPI1 is associated with elevated SPI1 mRNA level and with susceptibility to SLE. © 2011, American College of Rheumatology.
Kimura Y.,Asahikawa Redcross Hospital |
Kimura S.,Sapporo Medical University |
Inoue H.,Takikawa Municipal Hospital |
Yamauchi M.,Sapporo Medical University |
Sumita S.,Asahikawa Redcross Hospital
Japanese Journal of Anesthesiology | Year: 2012
Background : The radial artery cannulation is often associated with damped arterial waveforms with the hand moving. We used cannulation of the dorsal branch of the radial artery (DRA) and compared the stability of measurement, safety and complications with those of the radial artery (RA). Methods : The study was a prospective single-blinded comparative study. Seventy-six patients under-going general anesthesia requiring arterial cannulation were included. Patients were divided randomly into two separate groups of 35 patients each according to cannulation site : the radial artery (RA group) or the dorsal branch of the radial artery (DRA group). After induction of general anesthesia, cannulation was performed. Three hours after the successful cannulation, the changes of waveforms were noted with the hand moving. We examined whether there were any complications around the cannulation site after cannula removal. Results : With the wrist flexion at all angles (30, 60 and 90 degrees), the frequency of worsening of arterial waveforms was significantly higher in RA group compared with DRA group. Some difficulties in catheter placement were observed in DRA group. No concomitant complication was noticed. Conclusions : Arterial line monitoring from DRA had better waveforms compared with RA monitoring without any complications.