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Sato M.,Tokyo Womens Medical University | Iwasa Y.,Tokyo Womens Medical University | Otsubo S.,Sangenjaya Hospital | Otsubo S.,Tohto College of Health Sciences | And 5 more authors.
International Urology and Nephrology

Background: The insidious onset and occult characteristic of psoas abscess can cause diagnostic delays, resulting in high mortality and morbidity rates. Here, we investigated the characteristics of psoas abscess in hemodialysis patients. Methods: This study was carried out in eight patients with psoas abscess who were admitted in our hospital. The clinical data were retrospectively collected. Results: The frequency of polycystic kidney disease as the primary cause of end-stage kidney disease was significantly higher in the hemodialysis patients with psoas abscess (25.0%) than in prevalent Japanese hemodialysis patients (3.4%, P = 0.028). All patients had a preceding infection (discitis in two, blood access-related infections in two, colitis in two, infection of a hematoma in the kidney in one, and endocarditis in one). Seven patients survived, while the remaining one patient died. Conclusion: Psoas abscess could be a complication of discitis, blood access infection and colitis in hemodialysis patients. The frequency of polycystic kidney disease as the primary cause of ESKD was significantly higher in the hemodialysis patients with psoas abscess than in prevalent Japanese hemodialysis patients. We should consider psoas abscess as a possibility in hemodialysis patients with infection of unknown cause, especially in patients with polycystic kidney disease. © 2009 Springer Science+Business Media, B.V. Source

Otani Y.,Tokyo Womens Medical University | Otsubo S.,Sangenjaya Hospital | Otsubo S.,Tohto College of Health Sciences | Kimata N.,Tokyo Womens Medical University | And 7 more authors.
Internal Medicine

Objective Clinically, the ankle-brachial blood pressure index (ABI) and skin perfusion pressure (SPP) are used to screen for subclinical peripheral artery disease. However, the association between the SPP and mortality in hemodialysis patients has not been previously reported. We investigated these factors and compared the ABI and SPP in patients receiving hemodialysis. Methods A total of 102 patients receiving maintenance hemodialysis were enrolled in this study. The ABI was determined using an ABI-form (Colin, Japan). The SPP was measured using a SensiLase™ PAD3000 (Kaneka, Osaka, Japan). Results The mean follow-up period was 3.2±1.4 years. A multivariate Cox analysis identified a low ABI (p=0.019) and a low SPP (p=0.047) as being independent predictors of mortality. A receiver operating characteristic (ROC) analysis of the ABI revealed a cutoff point of 1.1 and an area under the curve (AUC) of 0.79, with a sensitivity of 90% and a specificity of 62%. A ROC analysis of the SPP revealed a cutoff point of 54.0 mmHg and an AUC of 0.71, with a sensitivity of 55% and a specificity of 84%. Conclusion Both low ABI and SPP values were found to be independent risk factors for mortality among hemodialysis patients. The cutoff point for ABI as a predictor of mortality was 1.1, while that for SPP was 54.0 mmHg. © 2013 by The Japanese Society of Internal Medicine. Source

Nakazawa A.,Tohto College of Health Sciences | Nakamura K.,Niigata University | Kitamura K.,Niigata University | Yoshizawa Y.,Niigata Council of Institutions for the Elderly
Journal of Epidemiology

Background: We assessed the association between activities of daily living (ADL) and mortality among nursing home residents in Japan. Methods: This 1-year prospective cohort study investigated 8902 elderly adults in 140 nursing homes. Baseline measurements included age, sex, height, weight, body mass index (BMI), ADL, and dementia level. ADL levels were obtained by caregivers, using the Barthel Index (BI), after which total BI scores were calculated (higher scores indicate less dependence). Information on dates of discharge and mortality was also obtained to calculate personyears. The Cox proportional hazards model was used to estimate hazard ratios(HRs). Results: Mean age was 84.3 years, and mean total BI score was 38.5. The HRs of mortality adjusted for sex, age,BMI, and type of nursing home were 7.6 (95% CI: 3.3-17.8) for those with a BI score of 0 (totally dependent), 3.9 (1.7-9.0) for those with a score of 1 to 10, 3.5 (1.4-8.7) for those with a score of 11 to 40, 2.7 (1.4-5.1) for those with a score of 41 to 70, and 1.3 (0.7-2.4) for those with a score of 71 to 99 (P for trend <0.001), as compared with those with a score of 100. Multivariate analysis revealed that BI, sex, age, and BMI were significantly associated with mortality rate. Conclusions: There was a clear inverse association between ADL level and mortality. In conjunction with other risk factors, ADL level might effectively predict short-term mortality in institutionalized elderly adults. © 2012 by the Japan Epidemiological Association. Source

Mikami S.,Keio University | Oya M.,Keio University | Mizuno R.,Keio University | Kosaka T.,Keio University | And 2 more authors.
Medical Molecular Morphology

Renal cell carcinoma (RCC) represents over 80 % of kidney cancer, and about 30 % of the patients with RCC develop metastasis after the surgery. Invasion of basement membrane (BM) and extracellular matrix (ECM) is an essential event in tumor invasion and metastasis. Matrix metalloproteinases (MMPs), which digest the main components of BM and ECM, are expressed in RCC. Heparanase, which degrades heparan sulfate proteoglycans, is predominantly expressed in high-grade RCCs with a positive correlation with pathological tumor stage and poor prognosis. Bone metastasis is common among the patients with RCC, and increased osteoclastic activity was observed at metastatic sites. Receptor activator of nuclear factor κB ligand (RANKL), which plays an important role in osteoclastogenesis, is predominantly expressed in high-grade RCC and its expression level is associated with bone metastasis and prognosis. Epithelial-mesenchymal transition (EMT), a switch of epithelial cells to sarcomatoid phenotype, is considered to be critical step during metastasis, and Snail, a major regulator of EMT, is predominantly expressed in high-grade RCC, and high Snail expression is a worse prognostic factor. Accordingly, heparanase, RANKL and Snail may be targets for the development of anti-tumor therapies for RCCs. © 2013 The Japanese Society for Clinical Molecular Morphology. Source

Mandasari M.,Tokyo Medical and Dental University | Sawangarun W.,Tokyo Medical and Dental University | Katsube K.-I.,Tokyo Medical and Dental University | Katsube K.-I.,Tohto College of Health Sciences | And 4 more authors.
Biochemical and Biophysical Research Communications

NOTCH1 plays an important role in epithelial differentiation and carcinogenesis. To investigate the impact of Notch1 inactivation in oroesophageal epithelium, we generated conditional knockout (cKO) mice, using a combined construct which induces the expression of single guide RNA targeting Notch1 and Cas9 by the KRT14 promoter. The cKO mice exhibited patchy hair loss and multiple NOTCH1-negative areas in the tongue epithelium, indicative of heterogeneous knockout. The cKO mice showed susceptibility to esophageal tumorigenesis, underscoring Notch1 as a tumor suppressor. Our one-step strategy for generation of cKO mice provides a versatile method to examine a gene function in vivo. © 2015 Elsevier Inc. All rights reserved. Source

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