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Nishi-Tokyo-shi, Japan

Iimori S.,Tokyo Medical and Dental University | Noda Y.,Tokyo Medical and Dental University | Okado T.,Tokyo Medical and Dental University | Naito S.,Tokyo Medical and Dental University | And 19 more authors.
BMC Nephrology | Year: 2013

Background: About 39,000 patients were newly prescribed renal replacement therapy in Japan in 2011, resulting in a total of more than 300,000 patients being treated with dialysis. This high prevalence of treated end stage kidney disease (ESKD) patients is an emergent problem that requires immediate attention. We launched a prospective cohort study to evaluate population specific characteristics of the progression of chronic kidney disease (CKD). In this report, we describe the baseline characteristics and risk factors for cardiovascular disease (CVD) prevalence among this cohort. Methods. New patients from 16 nephrology centers who were older than 20 years of age and who visited or were referred for the treatment of CKD stage 2-5, but were not on dialysis therapy, were recruited in this study. At enrollment, medical history, lifestyle behaviors, functional status and current medications were recorded, and blood and urine samples were collected. Estimated glomerular filtration rate (eGFR) was calculated by a modified three-variable equation. Results: We enrolled 1138 patients, 69.6% of whom were male, with a mean age of 68 years. Compared with Western cohorts, patients in this study had a lower body mass index (BMI) and higher proteinuria. The prevalence of CVD was 26.8%, which was lower than that in Western cohorts but higher than that in the general Japanese population. Multivariate analysis demonstrated the following association with CVD prevalence: hypertension (adjusted odds ratio (aOR) 3.57; 95% confidence interval (CI) 1.82-7.02); diabetes (aOR 2.45; 95% CI 1.86-3.23); hemoglobin level less than 11 g/dl (aOR 1.61; 95% CI 1.21-2.15); receiving anti-hypertensive agents (aOR 3.54; 95% CI 2.27-5.53); and statin therapy (aOR 2.73; 95% CI 2.04-3.66). The combination of decreased eGFR and increased proteinuria was also associated with a higher prevalence of CVD. Conclusions: The participants in this cohort had a lower BMI, higher proteinuria and lower prevalence of CVD compared with Western cohorts. Lower eGFR and high proteinuria were associated with CVD prevalence. Prospective follow up of these study patients will contribute to establishment of individual population-based treatment of CKD. © 2013 Iimori et al.; licensee BioMed Central Ltd.

Kakimoto M.,Tokyo Metropolitan Otsuka Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

This is a case of a 58-year-old woman who underwent mastectomy for advanced right breast cancer (T2N2M0, stage IIIA, ER+, PR+, and HER2 0) at another hospital 13 years ago. Tamoxifen was administered after the operation. Two years later, bone and lung metastases appeared and she was transferred to our hospital. Hormonal therapies, epirubicin- cyclophosphamide-5-FU, doxifluridine, paclitaxel, vinorelbine, and capecitabine were ineffective. We planned a sixth-line chemotherapy comprising gemcitabine combined with docetaxel, but not paclitaxel. Partial response was obtained by treatment with 3 courses of gemcitabine-docetaxel. The same treatment was continued and the patient is alive in a good condition without progression for 14 months.

Kikuchi A.,Tokyo Metropolitan Otsuka Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

Here, we present the case of a 73-year-old woman in whom abdominal computed tomography showed an abdominal tumor (13 cm in diameter) in the backspace of the posterior gastric wall. Its feeding artery was detected to be the left gastric artery by abdominal angiography. We diagnosed it as a gastrointestinal stromal tumor (GIST) of the stomach and performed an operation. Peritoneal dissemination was observed and the tumor was connected to the gastric wall by a stalk. Histologically, the tumor consisted of spindle-shaped cells. Immunohistochemical staining showed positive c-kit and CD34 expression and negative SMA and S100 protein expression. Therefore, we diagnosed this as a case of extragastric pedunculated GIST of the stomach with peritoneal dissemination. After surgery, internal use of imatinib was started. The patient is still followed up 15 months after the operation. Combination therapy of tumor resection and imatinib chemotherapy might improve the prognosis of patients with GIST of the stomach with pedunculated growth.

Koshiishi H.,Tokyo Metropolitan Otsuka Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

The case is a 60-year-old female who underwent an operation as a right lobectomy of the thyroid and the resection of neck enlarged cystic lymph nodes in 2006. Pathological results were adenomatous goiter and the metastatic lymph nodes of papillary thyroid carcinoma. The primary lesion of thyroid carcinoma was not found. In four years after the operation, the local recurrence with anaplastic formation of the tumor occurred and tracheobronchial expandable metallic stent( EMS) therapy was performed to the tracheal stenosis. But she died of rapidly enlargement of the anaplastic thyroid carcinoma in two months after stent therapy. It was necessary to observe this case severely after the first operation because the primary lesion of the thyroid carcinoma was not resected. The tracheobronchial EMS therapy was effective to the respiratory failure for a short-term caused by the tracheal stenosis of the thyroid anaplastic carcinoma.

Miyauchi J.,Tokyo Dental College | Ito Y.,National Center for Child Health and Development | Tsukamoto K.,National Center for Child Health and Development | Takahashi H.,Tokyo Metropolitan Otsuka Hospital | And 3 more authors.
British Journal of Haematology | Year: 2010

Mutations of GATA1, leading to aberrant expression of a truncated form of GATA1 (called GATA1s), are present in transient leukaemia (TL) in neonates with Down syndrome. Using these molecular markers of TL, we investigated the growth and differentiation potential of TL blasts in the presence of hematopoietic growth factors (HGFs). Interleukin-3, stem cell factor and granulocyte- macrophage colony-stimulating factor potently stimulated the growth of TL blast progenitors and induced differentiation towards basophil/mast cell lineages, whereas thrombopoietin induced differentiation towards megakaryocytes. GATA1s was expressed in TL blasts in all five patients examined but was down-regulated during differentiation induced by these HGFs, while full-length GATA1 was not expressed throughout the culture. GATA1 mutations were detected in TL blasts in four patients, including one patient with two distinct mutations. The cells of this patient exhibited identical and only mutated sequences both before and after culture with HGFs, confirming the leukemic cell origin of these differentiated cells. Erythroid differentiation of TL blasts was not evident with any HGFs. These data indicate that TL blasts have the potential to grow and differentiate towards particular hematopoietic lineages in the presence of specific HGFs and that the down-regulation of GATA1s might be involved in blast cell differentiation. © 2010 Blackwell Publishing Ltd.

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