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Ito H, Ashida K, Demiya M, Motomura S, Nagayama A, Kubo S, Ueda U, Fukami K, Nomura M, Akashi T. IgG4-Related Membranous Nephropathy with Acute Nephrotic Syndrome During Successful Steroid Maintenance Treatment for Type 1 Autoimmune Pancreatitis. Am J Case Rep 2023; 24:e940707. [PMID: 37592742 PMCID: PMC10441582 DOI: 10.12659/ajcr.940707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/15/2023] [Accepted: 06/26/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Immunoglobulin G4 (IgG4)-related diseases (IgG4-RD) are systemic fibroinflammatory diseases that can develop asynchronously in multiple organs. IgG4-related kidney disease (IgG4-RKD) is generally characterized by tubulointerstitial nephritis but can also manifest as membranous nephropathy without tubulointerstitial nephritis. IgG4-related membranous nephropathy can present as a phenotype of systemic disorders, including autoimmune pancreatitis-associated diabetes mellitus; however, its clinical features remain unclear. CASE REPORT A 56-year-old Japanese man presented to our university hospital with bilateral edema of his lower legs. He had received a diagnosis of type 1 autoimmune pancreatitis and associated diabetes mellitus 16 months prior. He was successfully treated with oral glucocorticoids 25 mg/day of prednisolone as an initial dose, followed by titration down to a maintenance dose (5 mg/day), without recurrence of autoimmune pancreatitis. The pancreas showed atrophy and required basal-bolus insulin therapy owing to insulin insufficiency. Massive proteinuria and hypoalbuminemia with nephrotic syndrome on examination led to a renal biopsy to investigate the etiology and diagnosis of IgG4-RKD. Methylprednisolone and cyclosporine A were successfully administered to ameliorate the proteinuria and control systemic IgG4-RD with IgG4-related membranous nephropathy. CONCLUSIONS Ig4-RKD occurred despite maintenance treatment with prednisolone monotherapy and was controlled with methylprednisolone and cyclosporine A. Measurement of clinical parameters, including proteinuria, was important, and a renal biopsy finally established the diagnosis of IgG4-RKD. IgG4-RKD can present with progressive glomerular lesions and can be latent in cases diagnosed with diabetic kidney disease, particularly in patients with insulin insufficiency.
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Affiliation(s)
- Hiroshi Ito
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Department of Diabetology, Shimada Hospital, Ogori, Fukuoka, Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Department of Diabetology, Shimada Hospital, Ogori, Fukuoka, Japan
| | - Mutsuyuki Demiya
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Seiichi Motomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Ayako Nagayama
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Saori Kubo
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Utako Ueda
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kei Fukami
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tomoyuki Akashi
- Department of Diabetology, Shimada Hospital, Ogori, Fukuoka, Japan
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Ito H, Fukuda K, Ashida K, Nagayama A, Sako T, Mizuochi K, Kabashima M, Yoshinobu S, Iwata S, Hasuzawa N, Hayashi S, Akashi T, Nomura M. Case Report: Myxedema Coma Caused by Immunoglobulin A Vasculitis in a Patient With Severe Hypothyroidism. Front Immunol 2022; 13:838739. [PMID: 35251034 PMCID: PMC8895252 DOI: 10.3389/fimmu.2022.838739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Myxedema coma is a critical disorder with high mortality rates. Disruption of the compensatory mechanism for severe and long-term hypothyroidism by various causes leads to critical conditions, including hypothermia, respiratory failure, circulatory failure, and central nervous system dysfunction. Infectious diseases, stroke, myocardial infarction, sedative drugs, and cold exposure are considered the main triggers for myxedema coma. A 59-year-old Japanese woman presented with bilateral painful purpura on her lower legs. She was diagnosed with coexisting immunoglobulin A (IgA) vasculitis and severe IgA vasculitis with nephritis and was consequently treated with intravenous methylprednisolone (125 mg/day). However, she rapidly developed multiple organ failure due to the exacerbation of severe hypothyroidism, i.e., myxedema. Her condition improved significantly following oral administration of prednisolone along with thyroxine. There was a delayed increase in the serum free triiodothyronine level, while the serum free thyroxine level was quickly restored to normal. Rapid deterioration of the patient’s condition after admission led us to diagnose her as having myxedema coma triggered by IgA vasculitis. Hence, clinicians should be aware of the risks of dynamic exacerbations in patients with hypothyroidism. Furthermore, our study suggested that combination therapy with thyroxine and liothyronine might prove effective for patients with myxedema coma, especially for those who require high-dose glucocorticoid administration.
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Affiliation(s)
- Hiroshi Ito
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
- Department of Diabetology, Shimada Hospital, Ogori, Japan
| | - Kenzo Fukuda
- Department of Diabetology, Shimada Hospital, Ogori, Japan
- Department of Intensive Care Medicine, Imamura Hospital, Tosu, Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
- Department of Diabetology, Shimada Hospital, Ogori, Japan
- *Correspondence: Kenji Ashida ,
| | - Ayako Nagayama
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tomoki Sako
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kouichiro Mizuochi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masaharu Kabashima
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoko Yoshinobu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shimpei Iwata
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Nao Hasuzawa
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sumika Hayashi
- Department of Diabetology, Shimada Hospital, Ogori, Japan
| | | | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Hagiwara A, Kamagata K, Shimoji K, Yokoyama K, Andica C, Hori M, Fujita S, Maekawa T, Irie R, Akashi T, Wada A, Suzuki M, Abe O, Hattori N, Aoki S. White Matter Abnormalities in Multiple Sclerosis Evaluated by Quantitative Synthetic MRI, Diffusion Tensor Imaging, and Neurite Orientation Dispersion and Density Imaging. AJNR Am J Neuroradiol 2019; 40:1642-1648. [PMID: 31515218 DOI: 10.3174/ajnr.a6209] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/28/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A number of MR-derived quantitative metrics have been suggested to assess the pathophysiology of MS, but the reports about combined analyses of these metrics are scarce. Our aim was to assess the spatial distribution of parameters for white matter myelin and axon integrity in patients with relapsing-remitting MS by multiparametric MR imaging. MATERIALS AND METHODS Twenty-four patients with relapsing-remitting MS and 24 age- and sex-matched controls were prospectively scanned by quantitative synthetic and 2-shell diffusion MR imaging. Synthetic MR imaging data were used to retrieve relaxometry parameters (R1 and R2 relaxation rates and proton density) and myelin volume fraction. Diffusion tensor metrics (fractional anisotropy and mean, axial, and radial diffusivity) and neurite orientation and dispersion index metrics (intracellular volume fraction, isotropic volume fraction, and orientation dispersion index) were retrieved from diffusion MR imaging data. These data were analyzed using Tract-Based Spatial Statistics. RESULTS Patients with MS showed significantly lower fractional anisotropy and myelin volume fraction and higher isotropic volume fraction in widespread white matter areas. Areas with different isotropic volume fractions were included within areas with lower fractional anisotropy. Myelin volume fraction showed no significant difference in some areas with significantly decreased fractional anisotropy in MS, including in the genu of the corpus callosum and bilateral anterior corona radiata, whereas myelin volume fraction was significantly decreased in some areas where fractional anisotropy showed no significant difference, including the bilateral posterior limb of the internal capsule, external capsule, sagittal striatum, fornix, and uncinate fasciculus. CONCLUSIONS We found differences in spatial distribution of abnormality in fractional anisotropy, isotropic volume fraction, and myelin volume fraction distribution in MS, which might be useful for characterizing white matter in patients with MS.
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Affiliation(s)
- A Hagiwara
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Radiology (A.H., S.F., T.M., R.I., O.A.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Kamagata
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
| | - K Shimoji
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Diagnostic Radiology (K.S.), Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - K Yokoyama
- Neurology (K.Y., N.H.), Juntendo University School of Medicine, Tokyo, Japan
| | - C Andica
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
| | - M Hori
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Radiology (M.H.), Toho University Omori Medical Center, Tokyo, Japan
| | - S Fujita
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Radiology (A.H., S.F., T.M., R.I., O.A.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Maekawa
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Radiology (A.H., S.F., T.M., R.I., O.A.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - R Irie
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
- Department of Radiology (A.H., S.F., T.M., R.I., O.A.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Akashi
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
| | - A Wada
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
| | - M Suzuki
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
| | - O Abe
- Department of Radiology (A.H., S.F., T.M., R.I., O.A.), Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - N Hattori
- Neurology (K.Y., N.H.), Juntendo University School of Medicine, Tokyo, Japan
| | - S Aoki
- From the Departments of Radiology (A.H., K.K., K.S., C.A., M.H., S.F., T.M., R.I., T.A., A.W., M.S., S.A.)
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Tanaka N, Yabe D, Murotani K, Ueno S, Kuwata H, Hamamoto Y, Kurose T, Takahashi N, Akashi T, Matsuoka T, Osonoi T, Minami M, Shimono D, Seino Y. Mental distress and health-related quality of life among type 1 and type 2 diabetes patients using self-monitoring of blood glucose: A cross-sectional questionnaire study in Japan. J Diabetes Investig 2018; 9:1203-1211. [PMID: 29493881 PMCID: PMC6123045 DOI: 10.1111/jdi.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/18/2018] [Accepted: 02/20/2018] [Indexed: 12/01/2022] Open
Abstract
AIMS/INTRODUCTION The present multicenter, cross-sectional survey was initiated to evaluate self-monitoring of blood glucose (SMBG)-associated mental distress among patients with diabetes. MATERIALS AND METHODS The survey was carried out in patients with type 1 diabetes and type 2 diabetes using SMBG recruited from 42 medical institutions. Profiles of Mood States 2 and diabetes therapy-related quality of life questionnaires were used to evaluate mood status and health-related quality of life. Two original questionnaires were also developed to evaluate SMBG 'importance,' 'painfulness' and 'confidence' among patients, and to evaluate physician attitudes to SMBG use. RESULTS Questionnaires from 517 type 1 diabetes and 1,648 type 2 diabetes patients showed that 46.0% of type 1 diabetes and 37.5% of type 2 diabetes patients reported 'painfulness,' and that these patients reporting 'painfulness' showed significantly higher Profiles of Mood States 2 scores, lower diabetes therapy-related quality of life scores and higher glycated hemoglobin compared with those not reporting 'painfulness,' whereas the number of their daily SMBG tests were comparable. Patients reporting 'painfulness' also reported that SMBG use was significantly less important. Whether or not patients recognized the importance of SMBG use was well correlated with the frequency of physicians checking patient diaries. CONCLUSIONS Type 1 diabetes and type 2 diabetes patients reporting 'painfulness' in SMBG use had more mental distress, lower health-related quality of life and higher glycated hemoglobin regardless of their number of daily SMBG tests. The importance of SMBG use was recognized less by patients experiencing pain, and the importance of SMBG use was recognized more in medical institutions in which physicians regularly checked SMBG diaries to provide meaningful feedback to patients in clinical settings.
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Affiliation(s)
- Nagaaki Tanaka
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Daisuke Yabe
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
| | - Kenta Murotani
- Division of BiostatisticsClinical Research CenterAichi Medical University HospitalNagakuteJapan
| | - Shinji Ueno
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Hitoshi Kuwata
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Yoshiyuki Hamamoto
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
- Center for Metabolism and Clinical NutritionKansai Electric Power HospitalOsakaJapan
| | - Takeshi Kurose
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | | | | | | | | | | | | | - Yutaka Seino
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
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Yoshida K, Saku K, Kamada K, Abe K, Akashi T, Kishi T, Tsutsui H, Sunagawa K. 1205Vagal nerve stimulation restores autonomic balance, super-normalizes right ventricular function and prevents the worsening of right heart failure in chronic pulmonary arterial banding model rats. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Yoshida
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Saku
- Kyushu University, Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, Fukuoka, Japan
| | - K Kamada
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Abe
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - T Akashi
- Kyushu University, Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, Fukuoka, Japan
| | - T Kishi
- Kyushu University, Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Sunagawa
- Kyushu University, Therapeutic Regulation of Cardiovascular Homeostasis, Center for Disruptive Cardiovascular Medicine, Fukuoka, Japan
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Yoshida K, Saku K, Kamada K, Abe K, Tanaka M, Akashi T, Kishi T, Sunagawa K, Tsutsui H. 5023Vagal nerve stimulation ameliorates severe pulmonary arterial hypertension via anti-inflammatory effects in rats. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sunagawa G, Saku K, Arimura T, Akashi T, Murayama Y, Sakamoto T, Kishi T, Sunagawa K, Tsutsui H. P1574Mechano-chronotropic unloading during the acute phase of myocardial infarction markedly reduces the infarct size and prevents the development of heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mu P, Akashi T, Lu F, Kishida S, Kadomatsu K. A novel nuclear complex of DRR1, F-actin and COMMD1 involved in NF-κB degradation and cell growth suppression in neuroblastoma. Oncogene 2017; 36:5745-5756. [DOI: 10.1038/onc.2017.181] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 04/25/2017] [Accepted: 05/08/2017] [Indexed: 12/11/2022]
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Nishimura S, Mizuno H, Akashi T, Takata T, Nakamura F, Goda F, Mihara C, Sato H, Kurihara M, Sasaki M. MON-P192: Clinical Usefulness of New Type Formulathat Features a State Change from Liquid to Semi-Solidified in the Stomach. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30826-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Satoh-Asahara N, Ito H, Akashi T, Yamakage H, Kotani K, Nagata D, Nakagome K, Noda M. A Patient-Held Medical Record Integrating Depression Care into Diabetes Care. Jpn Clin Med 2016; 7:19-22. [PMID: 27478395 PMCID: PMC4951113 DOI: 10.4137/jcm.s39766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 11/13/2022]
Abstract
PURPOSE Depression is frequently observed in people with diabetes. The purpose of this study is to develop a tool for individuals with diabetes and depression to communicate their comorbid conditions to health-care providers. METHOD We searched the Internet to review patient-held medical records (PHRs) of patients with diabetes and examine current levels of integration of diabetes and depression care in Japan. RESULTS Eight sets of PHRs were found for people with diabetes. All PHRs included clinical follow-up of diabetes and multidisciplinary clinical pathways for diabetes care. No PHRs included depression monitoring and/or treatment. In terms of an integrated PHR for a patient comorbid with diabetes and depression, necessary components include hopes/preferences, educational information on diabetes complications and treatment, medical history, stress and coping, resources, and monitoring diabetes and depression. CONCLUSION A new PHR may be suitable for comorbid patients with diabetes and depression.
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Affiliation(s)
- Noriko Satoh-Asahara
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Fushimi, Kyoto, Japan
| | - Hiroto Ito
- National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | | | - Hajime Yamakage
- Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Fushimi, Kyoto, Japan
| | | | | | | | - Mitsuhiko Noda
- Department of Endocrinology and Diabetes, Saitama Medical University, Irumagun, Saitama, Japan.; National Centre for Global Health and Medicine, Shinjuku, Tokyo, Japan
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Hashiguchi S, Yoshida H, Akashi T, Hirose A, Sugita C, Kurokawa M, Watanabe W. Effects of multi-walled carbon nanotubes on the pneumonia in respiratory syncytial virus-infected mice. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tajiri Y, Kawano S, Hirao S, Oshige T, Iwata S, Ono Y, Inada C, Akashi T, Hayashi H, Sato Y, Tojikubo M, Yamada K. Adding of Sitagliptin on Insulin Therapy Effectively and Safely Reduces a Hemoglobin A1c Level and Glucose Fluctuation in Japanese Patients with Type 2 Diabetes. Int Sch Res Notices 2014; 2014:639489. [PMID: 27419209 PMCID: PMC4897314 DOI: 10.1155/2014/639489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 06/05/2014] [Indexed: 11/18/2022]
Abstract
Aims. Efficacy and safety of DPP-4 inhibitor, sitagliptin, add-on therapy to insulin were investigated in Japanese patients with type 2 diabetes. Subjects and Methods. Two hundred and sixteen patients (126 men, 65 ± 12 years old, BMI 24.9 ± 4.5, means ± S.D.) who had been treated by insulin alone or insulin combined with other oral hypoglycemic agents (OHAs) were recruited, and sitagliptin was added for 3 months. Results. HbA1c was significantly decreased after 3 months of add-on therapy as a whole (8.56 ± 1.50% to 7.88 ± 1.25%, P < 0.0001). Body weight did not change and insulin dosage was significantly (P < 0.0001) decreased for 3 months. Furthermore, day-to-day glucose variability was significantly reduced (18.3 ± 9.1 to 16.1 ± 8.1%, P < 0.05). In stepwise multiple regression analysis on ΔHbA1c as an outcome variable, the higher baseline HbA1c value and a preserved CPR were selected as significant predictive variables. Fifteen patients complained of mild hypoglycemia without any assistance during 3 months of sitagliptin add-on, while no severe hypoglycemic episode was reported. Conclusions. Add-on of sitagliptin to ongoing insulin therapy effectively reduced either HbA1c level or glucose fluctuation and could be a practical and well-tolerated alternative to treat Japanese patients with type 2 diabetes who had been inadequately controlled by insulin with or without other OHAs.
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Affiliation(s)
- Yuji Tajiri
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan
| | - Seiko Kawano
- Municipal Yame General Hospital, Yame 834-0034, Japan
| | - Saori Hirao
- Municipal Yame General Hospital, Yame 834-0034, Japan
| | - Tamami Oshige
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan
| | - Shinpei Iwata
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan
| | - Yasuhiro Ono
- Kouhoukai Takagi Hospital, Okawa 831-0016, Japan
| | | | | | | | | | | | - Kentaro Yamada
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume 830-0011, Japan
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Taoka T, Fujioka M, Sakamoto M, Miyasaka T, Akashi T, Ochi T, Hori S, Uchikoshi M, Xu J, Kichikawa K. Time course of axial and radial diffusion kurtosis of white matter infarctions: period of pseudonormalization. AJNR Am J Neuroradiol 2014; 35:1509-14. [PMID: 24699091 DOI: 10.3174/ajnr.a3908] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Diffusion kurtosis is a statistical measure for quantifying the deviation of the water diffusion profile from a Gaussian distribution. The current study evaluated the time course of diffusion kurtosis in patients with cerebral infarctions, including perforator, white matter, cortical, and watershed infarctions. MATERIALS AND METHODS Subjects were 31 patients, representing 52 observations of lesions. The duration between the onset and imaging ranged from 3 hours to 122 days. Lesions were categorized into 4 groups listed above. Diffusion kurtosis images were acquired with b-values of 0, 1000, and 2000 s/mm(2) applied in 30 directions; variables including DWI signal, ADC, fractional anisotropy, radial diffusivity, axial diffusivity, radial kurtosis, and axial kurtosis, were obtained. The time courses of the relative values (lesion versus contralateral) for these variables were evaluated, and the pseudonormalization period was calculated. RESULTS Diffusion kurtosis was highest immediately after the onset of infarction. Trend curves showed that kurtosis decreased with time after onset. Pseudonormalization for radial/axial kurtosis occurred at 13.2/59.9 days for perforator infarctions, 33.1/40.6 days for white matter infarctions, 34.8/35.9 days for cortical infarctions, and 34.1/28.2 days after watershed infarctions. For perforator infarctions, pseudonormalization occurred in the following order: radial kurtosis, ADC, axial kurtosis, and DWI. CONCLUSIONS Diffusion kurtosis variables in lesions increased early after infarction and decreased with time. Information provided by diffusion kurtosis imaging, including axial and radial kurtosis, seems helpful in conducting a detailed evaluation of the age of infarction, in combination with T2WI, DWI, and ADC.
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Affiliation(s)
- T Taoka
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | - M Fujioka
- Critical Care Medicine (M.F.), Nara Medical University, Nara, Japan
| | - M Sakamoto
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | - T Miyasaka
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | - T Akashi
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | - T Ochi
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | - S Hori
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
| | | | - J Xu
- Siemens Medical Solutions USA (J.X.), New York, New York
| | - K Kichikawa
- From the Department of Radiology (T.T., M.S., T.M., T.A., T.O., S.H., K.K.)
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Saku K, Kakino T, Sakamoto K, Sakamoto T, Akashi T, Hata Y, Kishi T, Ide T, Sunagawa K. Total unloading of the Left Ventricle by circulatory Assist Device (LVAD) strikingly reduces the infract size in ischemia-reperfusion injury. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Kakino T, Sakamoto K, Saku K, Sakamoto T, Akashi T, Oga Y, Nishizaki A, Kishi T, Ide T, Sunagawa K. Prediction of hemodynamic impact of the venoarterial Extracorporeal Membrane Oxygenation (ECMO). Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Katsuta H, Aguayo-Mazzucato C, Katsuta R, Akashi T, Hollister-Lock J, Sharma AJ, Bonner-Weir S, Weir GC. Subpopulations of GFP-marked mouse pancreatic β-cells differ in size, granularity, and insulin secretion. Endocrinology 2012; 153:5180-7. [PMID: 22919061 PMCID: PMC3473214 DOI: 10.1210/en.2012-1257] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is growing information about the heterogeneity of pancreatic β-cells and how it relates to insulin secretion. This study used the approach of flow cytometry to sort and analyze β-cells from transgenic mice expressing green fluorescent protein (GFP) under the control of the mouse insulin I gene promoter. Three populations of β-cells with differing GFP brightness could be identified, which were classified as GFP-low, GFP-medium, and GFP-bright. The GFP-medium population comprised about 70% of the total. The GFP-low population had less insulin secretion as determined by the reverse hemolytic plaque assay and reduced insulin gene expression. Additionally, all three subpopulations of β-cells were found in mice of varying ages (embryonic d 15.5 and postnatal wk 1-9). The three populations from the youngest had larger cells (forward scatter) and less granularity (side scatter) than those from the adults. This approach opens up new ways to advance knowledge about β-cell heterogeneity.
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Affiliation(s)
- Hitoshi Katsuta
- Section on Islet Cell and Regenerative Biology, Research Division, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, Massachusetts 02215, USA
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Sugawara E, Yamamoto K, Umeda S, Suzuki S, Kurata M, Endo Y, Uchibori K, Akashi T, Inase N, Kitagawa M. Giant cell carcinoma causing rapidly progressive respiratory failure as the presenting feature of AIDS. Int J STD AIDS 2012; 23:e7-8. [PMID: 22844020 DOI: 10.1258/ijsa.2009.009519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The incidence of lung cancer has been increasing among HIV-positive patients. The majority of these cases were in patients previously diagnosed as HIV-positive and treated with highly active antiretroviral therapy (HAART). Here, we report a 56-year-old male patient with lung cancer, who was diagnosed as HIV-positive after the onset of neck pain and lumbago and thus, was not treated with anti-AIDS therapy. The patient developed rapidly progressive and fatal respiratory failure. Autopsy demonstrated giant cell carcinoma of the lung responsible for carcinomatous lymphangitis. This case highlighted the possibility that pulmonary carcinogenesis in HIV-positive patients is not necessarily associated with HAART therapy.
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Affiliation(s)
- E Sugawara
- Department of Comprehensive Pathology, Tokyo Medical and Dental University, Tokyo, Japan
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18
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Taoka T, Aida N, Ochi T, Takahashi Y, Akashi T, Miyasaka T, Iwamura A, Sakamoto M, Kichikawa K. Transient hyperintensity in the subthalamic nucleus and globus pallidus of newborns on T1-weighted images. AJNR Am J Neuroradiol 2011; 32:1130-7. [PMID: 21511869 DOI: 10.3174/ajnr.a2451] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In the brains of newborns, changes in signal intensity in most structures can be explained by the development of myelination. However, there are some structures for which signal intensity changes cannot be accounted for by myelination alone. We examined the STN and globus pallidus signal intensities and tried to determine whether a relationship exists between the signal intensity and the postnatal age or the gestational age at the examination. MATERIALS AND METHODS We examined T1WI and T2WI obtained from 79 neonates who showed normal development at their 2-year follow-up examinations. We performed both qualitative and quantitative (signal intensity ratio to the thalamus) evaluation of the STN and globus pallidus signals, and we examined the correlation between signal intensity changes and the age of neonates. RESULTS With increasing postnatal age at examination, the high signal intensity on the T1WI for both STN and globus pallidus diminished. Although the disappearance of this hyperintensity was well correlated with the postnatal age at examination for both the qualitative and quantitative studies, there was no correlation with gestational age at examination. For the T2WI, there was no correlation with either the postnatal age or the gestational age at examination. CONCLUSIONS Signal intensity on T1WI in the STN and globus pallidus is not related to the gestational age at examination; instead, signal intensities on T1WI seem to be more dependent upon the postnatal age at examination.
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Affiliation(s)
- T Taoka
- Department of Radiology, Nara Medical University, Japan.
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Hamamoto Y, Akashi T, Inada A, Bonner-Weir S, Weir GC. Lack of evidence for recipient precursor cells replenishing β-cells in transplanted islets. Cell Transplant 2010; 19:1563-72. [PMID: 20719077 DOI: 10.3727/096368910x515881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Bone marrow and tissue precursor cells have been postulated to replenish grafts of transplanted islets. Several investigators have reported that bone marrow cells can promote the regeneration of injured islets. In this study, we investigated the potential of recipient-derived precursor cells to form new pancreatic endocrine cells in islet grafts transplanted under the kidney capsule. Mouse insulin promoter (MIP)-green fluorescence protein (GFP) mice, which express GFP only in β-cells, or β-actin GFP mice, which express GFP ubiquitously, were used to determine if the recipient-derived cells differentiate into β-cells or other types of endocrine cells. We transplanted MIP-GFP islets into wild-type mice, wild-type islets into MIP-GFP mice, β-actin GFP islets into wild-type mice, and wild-type islets into β-actin GFP mice. β-Actin GFP bone marrow cells were then injected into wild-type mice to evaluate the potential role of bone marrow stem cells to provide new islet cells to the graft. No β-cells with green fluorescence were seen in the graft when wild-type islets were transplanted into MIP-GFP mice. When wild-type islets were transplanted into β-actin GFP mice, no β-cells with GFP staining could be identified in the grafts. Similarly, no endocrine cells with GFP staining could be identified in the grafts after injection of β-actin GFP bone marrow cells into wild-type islet-transplanted wild-type mice. This study provides further support for the concept that recipient precursor cells do not produce new β-cells in grafts of transplanted islets.
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Affiliation(s)
- Yoshiyuki Hamamoto
- Section on Islet Transplantation and Cell Biology, Research Division, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA
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Suzuki M, Niimi A, Limsirichaikul S, Tomida S, Huang QM, Izuta S, Usukura J, Itoh Y, Hishida T, Akashi T, Nakagawa Y, Kikuchi A, Pavlov Y, Murate T, Takahashi T. PCNA Mono-Ubiquitination and Activation of Translesion DNA Polymerases by DNA Polymerase. J Biochem 2010. [DOI: 10.1093/jb/mvq059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Takayama K, Nakagawa H, Taoka T, Miyouchin K, Wada T, Sakamoto M, Miyasaka T, Akashi T, Kichikawa K, Kurokawa S. O-003 Prediction of periprocedual ischemic complication in carotid artery stenting with filter embolic protection device: feasibility of MR plaque imaging. J Neurointerv Surg 2010. [DOI: 10.1136/jnis.2010.003244.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Toru S, Uchihara T, Akashi T, Kobayashi T. Minimal cytological changes of progressive supranuclear palsy type in clinically possible progressive supranuclear palsy. Eur Neurol 2010; 63:122-5. [PMID: 20110714 DOI: 10.1159/000277610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 11/17/2009] [Indexed: 11/19/2022]
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Katsuta H, Akashi T, Katsuta R, Nagaya M, Kim D, Arinobu Y, Hara M, Bonner-Weir S, Sharma AJ, Akashi K, Weir GC. Single pancreatic beta cells co-express multiple islet hormone genes in mice. Diabetologia 2010; 53:128-38. [PMID: 19851748 PMCID: PMC2789931 DOI: 10.1007/s00125-009-1570-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 09/08/2009] [Indexed: 11/24/2022]
Abstract
AIMS/HYPOTHESIS It is widely accepted that production of insulin, glucagon, somatostatin and pancreatic polypeptide in islet cells is specific to beta, alpha, delta and pancreatic polypeptide cells, respectively. We examined whether beta cells express other genes encoding islet hormones. METHODS Nested RT-PCR was performed on single beta cells of transgenic mice with green fluorescent protein (GFP) driven by mouse insulin I promoter (MIP-GFP). RESULTS Only 55% of adult beta cells expressed the insulin gene alone, while others expressed two or more islet hormone genes; 4% expressed all four hormone genes. In embryonic and neonatal cells, 60% to 80% of GFP(+) cells co-expressed pancreatic polypeptide and insulin genes in contrast to 29% in adult. To clarify cell fate, we conducted lineage tracing using rat insulin II promoter-cre mice crossed with reporter mice Gt(ROSA)26Sor-loxP-flanked STOP-cassette-GFP. All GFP(+) cells expressed insulin I and II genes, and showed similar heterogeneity of co-expression to that seen in MIP-GFP mice. Although we report expression of other hormone genes in a significant proportion of beta cells, our lineage tracing results demonstrate that after inducing InsII (also known as Ins2) expression, beta cell progenitors do not redifferentiate to non-beta cells. CONCLUSIONS/INTERPRETATION This study shows co-expression of multiple hormone genes in beta cells of adult mice as well as in embryos and neonates. This finding could: (1) represent residual expression from beta cell precursors; (2) result from alternative developmental pathways for beta cells; or (3) denote the differentiation potential of these cells. It may be linked to functional heterogeneity. This heterogeneity in gene expression may provide a means to characterise the functional, cellular and developmental heterogeneity seen in beta cells.
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Affiliation(s)
- H. Katsuta
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - T. Akashi
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - R. Katsuta
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - M. Nagaya
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - D. Kim
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - Y. Arinobu
- Department of Cancer Immunology and AIDS, Dana-Farber Cancer Institute, Boston, MA USA
| | - M. Hara
- Department of Medicine, University of Chicago, Chicago, IL USA
| | - S. Bonner-Weir
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - A. J. Sharma
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
| | - K. Akashi
- Department of Cancer Immunology and AIDS, Dana-Farber Cancer Institute, Boston, MA USA
| | - G. C. Weir
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215 USA
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Fuse H, Akashi T, Mizuno I, Nozaki T, Watanabe A. POSTOPERATIVE CHANGES OF SPERM CHROMATIN HETEROGENEITY, USING ACRIDINE ORANGE STAINING, IN VARICOCELE PATIENTS. ACTA ACUST UNITED AC 2009; 52:223-6. [PMID: 16574605 DOI: 10.1080/01485010500428397] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate postoperative changes in sperm chromatin heterogeneity in varicocele patients. In 15 infertile patients with varicocele, sperm parameters including concentration, motility, and morphology were evaluated before and after surgical correction of varicocele. Sperm motion analysis using computer-assisted semen analyzer (CASA) was also performed. To analyze the sperm nuclear proteins, the acridine orange staining method was used. On semen analysis, sperm concentration and motility significantly increased after surgery (p = 0.002, p = 0.003, respectively), although sperm morphology was unaltered postoperatively. CASA parameters, including velocity, linearity, amplitude of lateral head displacement and beat cross frequency were unaltered postoperatively. On the other hand, acridine orange staining significantly increased postoperatively (p = 0.002). Varicocele influences the sperm chromatin condition, as well as sperm concentration and motility.
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Affiliation(s)
- H Fuse
- Department of Urology, Faculty of Medicine, National University Corporation, University of Toyama, Toyama, Japan.
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Taoka T, Morikawa M, Akashi T, Miyasaka T, Nakagawa H, Kiuchi K, Kishimoto T, Kichikawa K. Fractional anisotropy--threshold dependence in tract-based diffusion tensor analysis: evaluation of the uncinate fasciculus in Alzheimer disease. AJNR Am J Neuroradiol 2009; 30:1700-3. [PMID: 19541775 DOI: 10.3174/ajnr.a1698] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Tract-based analysis can be used to investigate required tracts extracted from other fiber tracts. However, the fractional anisotropy (FA) threshold influences tractography analysis. The current study evaluated the influence of the FA threshold in measuring diffusion tensor parameters for tract-based analysis of the uncinate fasciculus in subjects with Alzheimer disease (AD). MATERIALS AND METHODS Subjects included 30 patients with AD and 10 healthy controls. We acquired tractographies of the uncinate fasciculus by using different FA thresholds. We measured mean FA and the apparent diffusion coefficient (ADC) along the uncinate fasciculus for different FA thresholds and evaluated the correlation between diffusion tensor parameters (FA, ADC) and the Mini-Mental State Examination (MMSE) scores. RESULTS The uncinate fasciculus showed lower mean FA and higher mean ADC values in cases with more severe AD. A higher FA threshold led to a lower mean ADC value and a higher mean FA value along the uncinate fasciculus, whereas the relative order of measured values according to the severity of AD was not influenced by the FA threshold. An FA threshold of 0.2 showed higher correlation between mean ADC values and MMSE scores. FA thresholds of 0.15 and 0.20 showed higher correlation between mean FA values and MMSE scores. CONCLUSIONS Appropriate selection of the FA threshold leads to higher correlation between diffusion tensor parameters and the severity of AD. For tract-based analysis of degenerative diseases such as AD, appropriate selection of the FA threshold for tractography is important.
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Affiliation(s)
- T Taoka
- Department of Radiology, Nara Medical University, Nara, Japan.
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Taoka T, Hirabayashi H, Nakagawa H, Sakamoto M, Akashi T, Miyasaka T, Kichikawa K. Displacement of the Facial Nerve Course by Vestibular Schwannoma: Preoperative Visualization Using Diffusion Tensor Tractography. Skull Base 2009. [DOI: 10.1055/s-2009-1222351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kikugawa R, Katsuta H, Akashi T, Yatoh S, Weir GC, Sharma A, Bonner-Weir S. Differentiation of COPAS-sorted non-endocrine pancreatic cells into insulin-positive cells in the mouse. Diabetologia 2009; 52:645-52. [PMID: 19183938 PMCID: PMC4336153 DOI: 10.1007/s00125-009-1260-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Accepted: 12/17/2008] [Indexed: 10/21/2022]
Abstract
AIMS/HYPOTHESIS The regenerative process in the pancreas is of particular interest, since insulin-producing beta cells are lost in diabetes. Differentiation of new beta cells from pancreatic non-endocrine cells has been reported in vivo and in vitro, a finding that implies the existence of pancreatic stem/progenitor cells. However, while tissue-specific stem cells are well documented in skin, intestine and testis, pancreatic stem cells have been elusive. We hypothesised that pancreatic stem/progenitor cells within the non-endocrine fraction could be a source of new islets in vitro. METHODS To test if there were such cells within the pancreas, we generated pancreatic cell aggregates from tissue remaining after islet isolation from mouse insulin promoter 1-green fluorescent protein (MIP-GFP) mice. To eliminate any contamination of insulin-positive cells, we deleted all GFP-positive aggregates using COPAS Select and cultured with Matrigel. Immunohistochemistry, quantitative real-time PCR and single-cell nested RT-PCR were performed to confirm formation of insulin-producing cells. RESULTS The GFP-negative cells were expanded as monolayers and then differentiated into three-dimensional cystic structures. After 1 week of culture, GFP-positive cells were found as clusters or single cells. By quantitative real-time PCR, no insulin mRNA was detected immediately after COPAS sorting, but after differentiation insulin mRNA of the whole preparation was 1.91 +/- 0.31% that of purified MIP-GFP beta cells. All GFP-positive cells expressed insulin 1; most expressed insulin 2, pancreas duodenum homeobox-1 and cytokeratin 19 by single cell nested RT-PCR. CONCLUSIONS/INTERPRETATION Our data support the concept that within the exocrine (acinar and ductal) pancreas of the adult mouse there are cells that can give rise to insulin-positive cells in vitro.
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Affiliation(s)
- R Kikugawa
- Section of Islet Transplantation and Cell Biology, Joslin Diabetes Center, 1 Joslin Place, Boston, MA, 02215, USA
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Akashi T, Shigematsu H, Hamamoto Y, Iwasaki H, Yatoh S, Bonner-Weir S, Akashi K, Weir GC. Bone marrow or foetal liver cells fail to induce islet regeneration in diabetic Akita mice. Diabetes Metab Res Rev 2008; 24:585-90. [PMID: 18727153 DOI: 10.1002/dmrr.884] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND In this study, we carried out bone marrow and foetal liver cell transplantation to determine if these cells could differentiate into pancreatic beta-cells or promote regeneration. METHODS To exclude an artificial or immunological influence for induction of diabetes to recipients, Akita mice, which develop diabetes spontaneously,were used. In addition, we used mice harbouring the transgenic green fluorescent protein (GFP) reporter for insulin 1 gene as donors to mark donor-derived beta-cells. RESULTS All transplanted Akita mice after intravenous injection showed full donor chimerism in peripheral blood analysis. Their diabetic state represented by blood glucose levels did not change after transplantation. In spite of examination of more than 200 islets in each group, we could not find GFP-positive cells in any of the recipients. CONCLUSIONS Bone marrow cells or foetal liver cells do not differentiate to new pancreatic beta-cells or promote regeneration in Akita mice, a non-chemical or non-immune model of diabetes.
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Affiliation(s)
- Tomoyuki Akashi
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
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Kounoue E, Izumi KI, Ogawa S, Kondo S, Katsuta H, Akashi T, Niho Y, Harada M, Tamiya S, Kurisaki H, Nagafuchi S. The significance of T cells, B cells, antibodies and macrophages against encephalomyocarditis (EMC)-D virus-induced diabetes in mice. Arch Virol 2008; 153:1223-31. [PMID: 18500429 DOI: 10.1007/s00705-008-0106-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Accepted: 04/11/2008] [Indexed: 11/26/2022]
Abstract
In order to clarify the significance of protective mechanisms against encephalomyocarditis (EMC) virus-induced diabetes in mice, we studied the relative importance of T cells, B cells, antibodies and macrophages in the prevention of virus-induced diabetes. Neither T cell-deficient athymic nude mice nor B cell-deficient microMT/microMT mice showed an enhanced clinical course of EMC-D virus-induced diabetes, indicating that neither T cells nor B cells played a major role in the protection against EMC-D-virus-induced diabetes. Transfer of a large amount of antiserum to EMC-D-virus-infected mice protected the development of diabetes only when transferred within 36 h of infection, the timing of which was earlier than that for the production of natural neutralizing antibodied. Since pretreatment of mice with the macrophage-activating immunopotentiator Corynebacterium parvum (CP) completely prevented the development of diabetes, we studied the clinical outcome of EMC-D-virus-infected mice pretreated with CP. Mice treated with CP showed reduced proliferation of EMC-D virus in the affected organs, including the pancreas, while the levels of development of neutralizing antibody and serum interferon were not enhanced compared with the controls. Finally, we studied the macrophages derived from mice pretreated with CP and found that they inhibited the growth of EMC-D virus in vitro more than those derived from non-treated and thioglycolate-treated mice. Taken together, it can be suggested that neither T cells nor B cells, which have to do with adaptive immunity, play a significant role in the pathogenesis of EMC-D-virus-induced diabetes, while innate immunity, which is dependent on activated macrophages, contributes to in vivo resistance against EMC-D-virus-induced diabetes.
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Affiliation(s)
- Etsushi Kounoue
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
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Nakamura H, Dan S, Akashi T, Okui M, Katayose Y, Ishikawa Y, Unno M, Yamori T. 387 POSTER Ectopic expression of PIK3CD in human cancer cell lines and human lung carcinoma. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
To test whether pancreatic duct cells are in vitro progenitors, they were purified from dispersed islet-depleted human pancreatic tissue using CA19-9 antibody. The purified fraction was almost entirely CK19+ with no insulin+ cells, whereas the unpurified cells (crude duct) were 56% CK19+ and 0.4% insulin+ of total cells (0.7% of CK19+ cells). These cells were expanded as monolayers, aggregated under serum-free conditions, and transplanted into normoglycemic NOD/SCID mice. In crude duct grafts, insulin+ cells increased to 6.1% of CK19+ cells. Purified duct cells had slow expansion and poor aggregation, as well as engraftment. The addition of 0.1% cultured stromal cells improved these parameters. These stromal cells contained no CK19+ cells and no insulin by either quantitative RT-PCR or immunohistochemistry; stromal cell aggregates and grafts contained no insulin+ cells. Aggregation of purified duct plus stromal preparations induced insulin+ cells (0.1% of CK19+ cells), with further increase to 1.1% in grafts. Insulin mRNA mirrored these changes. In these grafts, all insulin+ cells were in duct-like structures, while in crude duct grafts, 85% were. Some insulin+ cells coexpressed duct markers (CK19 and CA19-9) and heat shock protein (HSP)27, a marker of nonislet cells, suggesting the transition from duct. Thus, purified duct cells from adult human pancreas can differentiate to insulin-producing cells.
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Affiliation(s)
- Shigeru Yatoh
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA
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Yatoh S, Akashi T, Chan PP, Kaneto H, Sharma A, Bonner-Weir S, Weir GC. NeuroD and reaggregation induce beta-cell specific gene expression in cultured hepatocytes. Diabetes Metab Res Rev 2007; 23:239-49. [PMID: 16921545 DOI: 10.1002/dmrr.678] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Our goal was to convert adult mouse hepatocytes to pancreatic beta-cells. METHODS AND RESULTS To facilitate conversion, cultured primary hepatocytes were dedifferentiated by the removal of dexamethasone (Dex) from the culture media. Removal of Dex caused detachment of hepatocytes from the culture dish, but the addition of betacellulin prevented this from happening. With the combination of lack of Dex and addition of betacellulin, albumin mRNA levels decreased. Cultured hepatocytes had a faint expression of insulin 2 mRNA, Nkx 6.1 and Pax 6 mRNA. Dedifferentiated hepatocytes were transduced with adenoviruses expressing NeuroD1, Ngn 3, or Pax 4. NeuroD1 transduction increased the insulin 2 mRNA but caused detachment of cells. However, when hepatocytes were allowed to reaggregate for 4 and 6 days in hydrophobic plates after transduction with NeuroD1, further increases of insulin 2 mRNA were found along with induction of PDX-1, IAPP, NeuroD1, Ngn3, Pax 4, Isl-1, PC1, PC2 and islet glucokinase. Additionally, glucagon, pancreatic polypeptide and somatostatin expression were induced, but neither elastase 1 nor insulin 1 mRNA could be detected. Ngn 3 and Pax 4 had effects similar to NeuroD1, but did not increase insulin 2 mRNA as much as NeuroD1. CONCLUSION We conclude that the combination of NeuroD1 and reaggregation promotes cultured dedifferentiated hepatocytes to differentiate towards a pancreatic beta-cell phenotype.
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Affiliation(s)
- Shigeru Yatoh
- Section on Islet Transplantation and Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA
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Kinoshita T, Shien T, Terada K, Yoshida M, Nakano E, Akashi T, Hojo T, Seki K. P69 Sentinel lymph node biopsy is feasible for breast cancer patients with clinically negative axillary lymph nodes after neoadjuvant chemotherapy. Breast 2007. [DOI: 10.1016/s0960-9776(07)70134-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Sakai Y, Maruyama T, Katsuta H, Kogawa K, Akashi T, Izumi KI, Tominaga H, Kono S, Nagafuchi S, Harada M. Patients with dilated cardiomyopathy possess insulin resistance independently of cardiac dysfunction or serum tumor necrosis factor-alpha. Int Heart J 2007; 47:877-87. [PMID: 17268122 DOI: 10.1536/ihj.47.877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It has recently been reported that insulin resistance is prevalent in patients with dilated cardiomyopathy (DCM); however, it remains unclear whether insulin resistance is directly induced by DCM or if it is caused by congestive heart failure associated with DCM. We evaluated homeostasis model assessment insulin resistance (HOMA-R) in 14 patients with DCM in comparison with 9 patients with valvular heart diseases (VHD). We also measured the level of serum tumor necrosis factor (TNF)-alpha as a possible causative factor for inducing insulin resistance. Even after the adjustment for age, body mass index, and cardiac function, HOMA-R was significantly higher in patients with DCM than in those with VHD (P = 0.012) (mean +/- SEM: 3.51 +/- 0.59, and 0.80 +/- 0.64, respectively). The serum TNF-alpha level tended to be higher in patients with DCM than in those with VHD; however, the difference was not significant. In conclusion, patients with DCM possess insulin resistance independently of the severity of cardiac dysfunction or serum TNF-alpha, suggesting that insulin resistance in patients with DCM may be closely associated with the pathogenic condition of DCM itself.
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Affiliation(s)
- Yumiko Sakai
- Department of Medicine and Biosystemic Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ogawa J, Harigai M, Akashi T, Nagasaka K, Suzuki F, Tominaga S, Miyasaka N. Exacerbation of chronic active Epstein-Barr virus infection in a patient with rheumatoid arthritis receiving humanised anti-interleukin-6 receptor monoclonal antibody. Ann Rheum Dis 2006; 65:1667-9. [PMID: 17105857 PMCID: PMC1798471 DOI: 10.1136/ard.2006.054197] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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Akashi T, Watanabe A, Morii A, Mizuno I, Fuse H. UP-01.18. Urology 2006. [DOI: 10.1016/j.urology.2006.08.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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37
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Sasaki T, Yamamoto K, Akashi T. Granular cell tumour arising from the Kiesselbach's area of the nasal septum. J Laryngol Otol 2006; 121:170-3. [PMID: 17059623 DOI: 10.1017/s002221510600394x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2006] [Indexed: 11/07/2022]
Abstract
An extremely rare case of a granular cell tumour arising from the right Kiesselbach's area (Little's area) of the nasal septum is reported. A 69-year-old Japanese woman consulted our clinic and her chief complaints were of continuous serous discharge, stuffiness and occasional slight bleeding from the right nasal cavity. Fibrescopy showed a multilocular mass, which was provisionally considered a nasal polyp. Surgical excision was attempted. During surgery, the tumour shrank markedly following local application of adrenaline, suggestive of hypervascularity. The tumour was successfully excised by careful dissection after cauterisation of the mucosa surrounding the tumour. Histopathological examination revealed morphological features of granular cell tumour immunopositive for S-100 protein. This is the first report of granular cell tumour arising from the Kiesselbach's area in the English literature. The eccentric behaviour of the tumour and the management of a granular cell tumour arising from this area are discussed, together with a literature review.
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Affiliation(s)
- T Sasaki
- Department of Otolaryngology, Tokyo-Kita Social Insurance Hospital, Kita-ku, Tokyo, Japan.
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Akashi T, Mizuno I, Okumura A, Fuse H. Usefulness of sperm quality analyzer-V (SQA-V) for the assessment of sperm quality in infertile men. ACTA ACUST UNITED AC 2005; 51:437-42. [PMID: 16214729 DOI: 10.1080/014850190959081] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to evaluate the correlation of new of Sperm Quality Analyzer (SQA-V) with the computer-assisted sperm analysis (CASA) and manual semen analysis estimates. One hundred five fresh semen samples were analyzed using SQA-V and CASA and manual semen analysis. Significant correlations of sperm concentration (p < 0.0001), sperm motility (p < 0.0001), and normal morphology (p < 0.0001) were observed between SQA-V variables and manual semen analysis estimates. There also were significant correlations of sperm concentration (p < 0.0001), sperm motility (p < 0.0001), and sperm velocity (p = 0.0235) between SQA-V variables and CASA estimates. Meanwhile, it did not correlate with amplitude of lateral head displacement, beat cross frequency, lineality assessed by CASA. The value of the sperm concentration and the sperm motility measured by SQA-V showed high correlations with the value of those measured by CASA and manual semen analysis. In addition, velocity and sperm morphology may also be evaluated to some extent using SQA-V.
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Affiliation(s)
- T Akashi
- Department of Urology,Faculty of Medicine, National University Corporation, Toyama Medical andPharmaceutical University, Toyama, Japan.
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Michiue Y, Yamamoto A, Onoda M, Sato A, Akashi T, Yamane H, Goto T. Incommensurate crystallographic shear structure of Ba xBi 2-2xTi 4-xO 11-4x( x= 0.275). Acta Crystallogr A 2005. [DOI: 10.1107/s0108767305098727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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40
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Nakamura Y, Takeuchi H, Okuyama K, Akashi T, Jojima Y, Konno O, Akashi I, Hama K, Iwahori T, Ashizawa T, Hirano T, Oka K, Matsuno N, Nagao T. Evaluation of Appropriate Blood Level in Continuous Intravenous Infusion From Trough Concentrations After Oral Administration Based on Area Under Trough Level in Tacrolimus and Cyclosporine Therapy. Transplant Proc 2005; 37:1725-7. [PMID: 15919445 DOI: 10.1016/j.transproceed.2005.02.076] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The target blood concentrations of tacrolimus (TAC) and cyclosporine (CYA) during continuous intravenous infusion (C(ss)) have been determined based on clinical experience. However, it is desirable that C(ss) should be set so that the AUC after intravenous infusion is equal to the AUC after oral administration (AUC(po)). Accordingly, we performed 12-hour monitoring of blood concentrations to calculate C(ss) from the blood trough levels (C(TL)) on 15 kidney recipients administered TAC and 12 recipients administered CYA (Neoral). We used an area under the trough level (AUTL) as a new pharmacokinetic parameter. The C(ss) was evaluated from C(TL), AUC(po), and AUTL was calculated to be C(ss) = C(TL) x (AUC(po)/AUTL). In addition, AUTL/AUC(po) ratio and blood peak/trough level ratio (C(max)/C(min)) were examined to compare pharmacokinetics of TAC and CYA. The formula for TAC was C(ss) = C(TL) x 1.40 and that for CYA, C(ss) = C(TL) x 2.55. The calculated target C(ss) of TAC was 1.40 times that of C(TL), which was similar to the present clinical C(TL). In contrast, the calculated target C(ss) of CYA was 2.55 times the C(TL), and therefore an extremely high C(ss) was necessary to obtain a sufficient AUC that will be available after oral administration. Consequently, intravenous administration of CYA twice a day was considered to be more appropriate to obtain sufficient CYA pharmacokinetics, rather than a continuous intravenous administration. We conclude that the formula, C(ss) = C(TL) x (AUC(po)/AUTL) was useful to calculate the target blood concentration of calcineurin inhibitors when changing from continuous intravenous infusion to oral administration of these drugs.
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Affiliation(s)
- Y Nakamura
- The 5TH Department of Surgery, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
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Abstract
Two hundred and seven patients with male infertility were investigated. Total sperm concentration and percent progressive motility by SQA IIB showed high correlations with those of conventional manual method. Percent of normal morphology showed a significant correlation among these techniques. The sperm motility index (SMI) and total functional sperm concentration (TFSC) demonstrated high correlations with any variables of manual analysis. Only velocity and amplitude of lateral head displacement showed significant correlations with the variables obtained by SQA IIB, especially with SMI and TFSC. It was suggested that SQA IIB could be a useful instrument in the clinical practice of infertility as a screening test for semen quality.
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Affiliation(s)
- H Fuse
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan.
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Kondo S, Akashi T, Katsuta H, Iwakiri R, Anzai K, Nagafuchi S, Niho Y, Harada M. [B cells as key contributors in determining the level of immune responses -B-cell-targeted therapy in patients with autoimmune diseases]. Fukuoka Igaku Zasshi 2005; 96:86-92. [PMID: 15991605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The levels and types of immune responses are determined dependent on the extent of pathogen invasion, reactions to antigens mediated by macrophage-dendritic cells, T cells and antibodies. Recently, accumulating evidence suggests that B cells also play an important role in the regulation of immune responses. Here we have made a review to present a role of B cells in determining the level of immune responses and discussed about the clinical significance of B cell-targeted therapy in patients with autoimmune diseases. Type 1 diabetes is a T cell-mediated autoimmune disease characterized by the destruction of insulin-producing pancreatic beta cells. We and other groups have elucidated that B cells play a critical role in the development of insulitis and diabetes, as B-cell-deficient NOD mice are protected from developing type 1 diabetes. B cells are essential for the T cell receptor clonotype spreading of islet-infiltrating T cells, indicating that B cells may play a role in determining the level of immune responses by antigen presentation to antigen specific T cells. There are now numerous case reports and small series of clinical trials regarding rituximab therapy in autoimmune diseases, such as refractory autoimmune hemolytic anemia, IgM antibody-associated polyneuropathy, systemic lupus erythematosus and rheumatoid arthritis. Rituximab is a genetically engineered chimeric anti-CD 20 monoclonal antibody that is approved for the treatment of lymphoma. CD20 is a B-cell surface antigen that is expressed only on pre- B and mature B cells. Thus, rituximab causes a selective transient depletion of the CD20+ B -cell subpopulation. Rationale and strategy for targeting B cells in the treatment of autoimmune diseases consist of the inhibition of antigen-presentation and co-stimulation that induces T cell expansion and activation. Further careful mechanistic studies are required to develop therapies in patients with autoimmune diseases.
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Affiliation(s)
- Shiori Kondo
- Department of Internal Medicine, Matsuyama Red Cross Hospital
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Abstract
Twenty-two idiopathic infertile patients were treated with Oriental herbal medicine, Bu-zhong-yi-qi-tang (Hochu-ekki-to). Seminal plasma sFas level elevated significantly after herb administration. There was an inverse correlation between seminal plasma IL-6 level and sperm concentration before treatment. After the administration of herb seminal plasma, sFas levels significantly correlated with sperm concentration. Seminal plasma IL-8 level did not change. Certain kinds of cytokine in the seminal plasma might play some role in improving semen quality with treatment.
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Affiliation(s)
- Y Furuya
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani 2630, Toyama 930-0194, Japan.
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Abstract
The seminal plasma levels of soluble Fas (sFas) and interleukins IL-6 and IL-8 were measured and their relationship with semen qualities was examined. The seminal plasma sFas level in fertile males was significantly higher than that in the infertile group. On the other hand, seminal plasma level of IL-6 was significantly lower in fertile males than in the infertile group. In the infertile group, patients with oligozoospermia had a lower seminal plasma sFas and a higher IL-6 level than those with normal sperm concentration. There was an inverse correlation between IL-6 and sperm concentration in infertile patients. Seminal plasma IL-8 was not correlated with sperm parameters. It would appear that certain kinds of cytokine in the seminal plasma might play an important role in improving semen quality.
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Affiliation(s)
- Y Furuya
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani 2630, Toyama 930-0194, Japan
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Abstract
Laparoscopy revealed a left inguinal testis and a right abdominal testis. Surgery revealed uterus-like structures. The bilateral testes showed primitive testis without ovarian tissue. Physical examination showed a normal and an empty scrotum with a nonpalpable gonad. Chromosome analysis revealed 46,XY. Pathological findings demonstrated the immature testis and the immature uterus.
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Affiliation(s)
- R Nishio
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani 2630, Toyama 930-0194, Japan.
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Isomoto H, Maeda T, Akashi T, Tsuchiya T, Kawaguchi Y, Sawayama Y, Koida S, Ohnita K, Kohno S, Tomonaga M. Multiple lymphomatous polyposis of the colon originating from T-cells: a case report. Dig Liver Dis 2004; 36:218-21. [PMID: 15046193 DOI: 10.1016/j.dld.2003.09.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multiple lymphomatous polyposis is an unusual form of non-Hodgkin's lymphoma characterised by myriad polyps throughout the alimentary tract. Most multiple lymphomatous polyposis cases are derived from B-cell, and there has been little information on multiple lymphomatous polyposis of T-cell origin. A 67-year-old Japanese man presented with lower abdominal pain and diarrhoea of 4-week duration. Colonoscopy revealed numerous small umbilicated polyps and several raised erosions in the colorectum. Biopsy specimens showed diffuse proliferation of lymphoma cells negative for B-cell markers but positive for T-cell markers. Polymerase chain reaction using extracted chromosomal deoxyribonucleic acid from paraffin-embedded samples identified T-cell receptor gamma and delta gene recombination. The patient was treated with combined chemotherapy, leading to complete resolution of the lesions.
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Affiliation(s)
- H Isomoto
- Department of Endoscopy, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8102, Japan.
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Fuse H, Mizuno I, Iwasaki M, Akashi T. Transurethral treatment of ejaculatory duct obstruction in infertile men. Arch Androl 2003; 49:429-31. [PMID: 14619943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Ten cases of ejaculatory duct obstruction with midline cyst, complaining of male infertility, were treated with transurethral incision. They had azoospermia or oligozoospermia, and physical examination did not show any abnormal findings. Serum levels of testosterone, LH, and FSH were within normal limits. The diagnosis of ejaculatory duct obstruction with midline cyst was made by transurethral ultrasonography and vasography. Thereafter, patients underwent transurethral incision of the verumontanum with a cold knife. Semen volume increased in all patients, and sperm concentration and/or motility improved in 7 patients (70%). Pregnancy was achieved by 3 couples (30%). Incision of the ejaculatory duct via an endoscopic technique could improve seminal findings and subsequent fertility.
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Affiliation(s)
- H Fuse
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani 2630, Toyama 930-0194, Japan.
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Fuse H, Akashi T, Yasuda K, Mizuno I. Tubularized incised plate urethroplasty for distal hypospadia, using overlapping dorsal subcutaneous flaps. Int Urol Nephrol 2003; 34:535-7. [PMID: 14577500 DOI: 10.1023/a:1025610800998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This paper presents a newly developed simple procedure using overlapping vascularized dorsal dartos subcutaneous flaps to cover the neourethra after hypospadias correction. A 3-year old boy with distal hypospadias underwent the tubularized incised plate urethroplasty using this method. Postoperative complications, which include urethrocutaneous fistula, were not observed, but the glans did exhibit a vertical, slit-like meatus. Covering the neourethra with overlapping dorsal dartos flaps is expected to prevent the development of urethrocutaneous fistula in patients with distal hypospadias.
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Affiliation(s)
- H Fuse
- Department of Urology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Sugitani, Toyama, Japan.
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Kim KH, Kanbe T, Akashi T, Mizuguchi I, Kikuchi A. Identification of a single nuclear localization signal in the C-terminal domain of an Aspergillus DNA topoisomerase II. Mol Genet Genomics 2002; 268:287-97. [PMID: 12436251 DOI: 10.1007/s00438-002-0758-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2002] [Accepted: 09/12/2002] [Indexed: 10/27/2022]
Abstract
DNA topoisomerase II (topo II) is a major nuclear protein that plays an important role in DNA metabolism. We have isolated the gene for topo II ( TOP2) from the filamentous fungus Aspergillus terreus. The deduced amino acid sequence revealed that topo II consists of 1,587 amino acids and has a calculated molecular weight of 180 kDa; the protein expressed in Escherichia coli has an estimated molecular weight of 185 kDa. Expression of topo II polypeptides tagged with yellow fluorescent protein (YFP) in budding yeast suggests that the C-terminal region of the topo II is essential for transport of the fusion protein into the nucleus. The nuclear localization signal (NLS) sequence of topo II is a non-classical bipartite type containing two interdependent, positively charged clusters separated by 15 amino acids. Alanine scanning mutagenesis and deletion analyses showed further that a stretch of 23 amino acid residues (positions 1,234-1,256) is necessary for nuclear import. In addition, we confirmed, using co-immunoprecipitation and two-hybrid analysis, that this non-classical NLS interacts with importin alpha in budding yeast. These results suggest that the fungal topo II NLS is functional in yeast cells.
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Affiliation(s)
- K-H Kim
- Laboratory of Medical Mycology, Research Institute of Disease Mechanisms and Control, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550 Japan
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