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Motoshi Hattori,
Akira Matsunaga,
Yuko Akioka,
Shuichiro Fujinaga,
Takuhito Nagai,
Osamu Uemura,
Hyogo Nakakura,
Akira Ashida,
Koichi Kamei,
Shuichi Ito,
Takuji Yamada,
Yoshimitsu Goto,
Toshiyuki Ohta, Masataka Hisano,
Yasuhiro Komatsu,
Noritomo Itami
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ABSTRACT: BACKGROUND: Darbepoetin alfa (DA) is an attractive alternative to recombinant human erythropoietin (rHuEPO) in managing renal anemia. Since DA has not been approved by the appropriate Japanese drug regulatory agencies for the indication of renal anemia in children in Japan, we have conducted a multicenter prospective study to determine the efficacy and safety of DA in Japanese children undergoing peritoneal dialysis (PD). METHODS: Pediatric patients subcutaneously receiving rHuEPO were switched to DA treatment for a period of 28 weeks. The conversion to the initial dose of DA was calculated as 1 μg DA for 200 IU rHuEPO, and DA was administered intravenously once every 2 weeks. The target hemoglobin (Hb) concentration was defined as 11.0 to ≤13.0 g/dL. In some patients, the dose of DA was adjusted appropriately to achieve this target level, and/or the dosing frequency changed to once every 4 weeks. RESULTS: In the 25 patients switched from rHuEPO to DA the mean Hb concentration increased from 9.9 ± 1.0 to 11.1 ± 1.0 g/dL at 8 weeks following commencement of the DA treatment. The target Hb concentration was achieved in 88 % of these patients, and 60 % maintained this target value on completion of the study. The dosing frequency was extended to once every 4 weeks in 60 % of patients. Twenty-four adverse events were noted in 11 of 25 patients (44 %); however, there was no causality between DA and adverse events. CONCLUSIONS: The results of this study suggest that intravenous administration of DA once every 2 or 4 weeks is an effective and safe treatment for renal anemia in Japanese children undergoing PD.
Clinical and Experimental Nephrology 10/2012; · 1.37 Impact Factor
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Kazuhiro Takahashi,
Noriko Makita,
Katsunori Manaka, Masataka Hisano,
Yuko Akioka,
Kenichiro Miura,
Noriyuki Takubo,
Atsuko Iida,
Norishi Ueda,
Makiko Hashimoto,
Toshiro Fujita,
Takashi Igarashi,
Takashi Sekine,
Taroh Iiri
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ABSTRACT: Inactivating mutations of the V2 vasopressin receptor (V2R) cause cross-linked congenital nephrogenic diabetes insipidus (NDI), resulting in renal resistance to the antidiuretic hormone AVP. In two families showing partial NDI, characterized by an apparently normal response to diagnostic tests and an increase in the basal ADH levels suggesting AVP resistance, we have identified two V2R mutations, Ser-333del and Y128S. Both mutant V2Rs, when expressed in COS-7 cells, show partial defects in vasopressin-stimulated cAMP accumulation and intracellular localization. The inhibition of internalization does not rescue their localization. In contrast, the non-peptide V2R antagonists OPC41061 and OPC31260 partially rescue the membrane localization and basal function of these V2R mutants, whereas they inhibit the basal activity of the wild-type V2R. These results indicate that a partial loss of function of Ser-333del and Y128S mutant V2Rs results from defective membrane trafficking. These findings further indicate that V2R antagonists can act as protean agonists, serving as pharmacological chaperones for inactivating V2R mutants and also as inverse agonists of wild-type receptors. We speculate that this protean agonism could underlie the possible dual beneficial effects of the V2R antagonist: improvement of hyponatremia with heart failure or polycystic kidney disease and potential rescue of NDI.
Journal of Biological Chemistry 12/2011; 287(3):2099-106. · 4.77 Impact Factor
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Hiroko Chikamoto,
Motoshi Hattori,
Nao Kuroda,
Yuko Kajiho,
Hideki Matsumura,
Hiroshi Fujii,
Kiyonobu Ishizuka, Masataka Hisano,
Yuko Akioka,
Kandai Nozu,
Hiroshi Kaito,
Maki Shimizu
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ABSTRACT: Chikamoto H, Hattori M, Kuroda N, Kajiho Y, Matsumura H, Fujii H, Ishizuka K, Hisano M, Akioka Y, Nozu K, Kaito H, Shimizu M. Pretransplantation combined therapy with plasmapheresis and rituximab in a second living-related kidney transplant pediatric recipient with a very high risk for focal segmental glomerulosclerosis recurrence. Pediatr Transplantation 2011. © 2011 John Wiley & Sons A/S. Abstract: Prophylactic PP can provide some protection against post-transplantation recurrences of FSGS, but it cannot prevent recurrences in all cases. Therefore, new preventive therapies are needed. We report on a 7.9-yr-old girl treated with pretransplantation prophylactic combined therapy consisting of four sessions of PP and one dose of rituximab before a second living-related KTX. The patient had a very high risk of post-transplantation FSGS recurrence because this had occurred after the first KTX. During the 36 months since the second transplantation, she has had no evidence of proteinuria or significant infectious complications. Although our experience is too preliminary to draw any generalizable conclusions, pretransplantation combined therapy with PP and rituximab might be a possible option for the prevention of FSGS recurrence in very high-risk recipients undergoing living-donor KTXs.
Pediatric Transplantation 11/2011; 16(7):E286-90. · 1.48 Impact Factor
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Eriko Tanaka,
Tetsuya Sato,
Masayuki Ishihara,
Yasushi Tsutsumi, Masataka Hisano,
Hiroko Chikamoto,
Yuko Akioka,
Sumitaka Dohno,
Akihiko Maeda,
Motoshi Hattori,
Hiroshi Wakiguchi,
Mikiya Fujieda
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ABSTRACT: High viral load carriage of EBV is one of the risks for PTLD in transplant recipients. We reviewed retrospectively in pediatric renal transplant recipients with EBV seronegative. EBV loads in peripheral blood and EBV-CTLs were measured every 1-3 months in 13 patients after grafting. Immunosuppressants were reduced when the patients were considered to have persistent high EBV loads (>1000 copies/μgDNA for over six months). All showed primary EBV infection: six with asymptomatic persistent high EBV loads (group A) and seven with neither EBV-associated symptoms nor persistent high EBV loads (group B). No patient developed PTLD in either group. Chronic rejection occurred in one patient in group A after immunosuppressants' reduction. There was no difference in renal dysfunction rates between the two groups. The maximum and increase rates in EBV loads were significantly higher in group A. The CTLs' percentage was significantly lower in group A when EBV loads first rose above 100 copies/μg DNA. This study suggests the possibility that EBV loads and CTLs' monitoring may be useful for avoidance of PTLD, as patients with asymptomatic persistent high EBV loads had higher EBV loads and lower percentages of CTLs.
Pediatric Transplantation 05/2011; 15(3):306-13. · 1.48 Impact Factor
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ABSTRACT: Mizoribine (MZR) has been successfully used without serious adverse effects in patients with various types of glomerulonephritis, but there are only a few pharmacokinetic studies of MZR. The purpose of the present paper was to report the results of a pharmacokinetic study of MZR in child-onset glomerulonephritis.
Nine patients were enrolled. MZR was administered orally at 60-300 mg/day (3.0-8.4 mg/kg bodyweight/day) divided in one or two daily doses. Blood samples were collected 7-10 times before and after drug administration. Urine samples were also collected during the blood sampling periods. Twenty-three concentration curves of MZR were analyzed in the present study. Pharmacokinetic parameters for mizoribine were estimated using concentration-time profiles. The non-parametric Spearman correlation coefficient was calculated to determine significant associations between variables. P < 0.05 was considered significant.
The obtained pharmacokinetic values at a dose of 3.36 +/- 1.91 mg/kg bodyweight were as follows: time to peak serum MZR concentration, 2.94 +/- 0.82 h; peak serum MZR concentration, 1.59 +/- 1.16 microg/mL; half-life, 1.96 +/- 0.92 h; area under the serum MZR concentration-time curve from time zero to infinity, 9.36 +/- 6.58 microg h/mL; volume of the distribution of MZR at a steady state, 2.03 +/- 0.80 L/kg; and rate of urinary excretion of MZR, 49.1 +/- 18.7%.
The parameters estimated in the present study may be useful for the MZR treatment of patients with child-onset glomerulonephritis.
Pediatrics International 10/2008; 50(5):615-9. · 0.63 Impact Factor
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Tetsuya Sato,
Mikiya Fujieda,
Eriko Tanaka,
Masakazu Miyamura,
Hiroko Chikamoto, Masataka Hisano,
Yuko Akioka,
Yoshihito Ishiura,
Sumitaka Dohno,
Akihiko Maeda,
Motoshi Hattori,
Hiroshi Wakiguchi
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ABSTRACT: Epstein-Barr virus (EBV) infection can lead to life-threatening post-transplant lymphoproliferative disorder (PTLD). The aim of the present study was to establish EBV monitoring methods to prevent PTLD.
EBV-DNA load was investigated, using real-time polymerase chain reaction (PCR) and anti-EBV antibody titers, in peripheral blood mononuclear cells of 21 renal transplant patients (seven recipients who were EBV-seronegative, R[-]; 14 who were EBV-seropositive, R[+]) before grafting. The mean age at entry and the mean follow-up period was 7.8 years of age (range, 3.3-12.0 years) and 1.8 years (range, 0.4-4.0 years), respectively, in the R(-) group, and 12.5 years of age (range, 3.9-17.7 years) and 3.8 years (range, 0.8-8.2 years) in the R(+) group, respectively.
The mean maximum load of the EBV genome was 1071 copies/microg DNA (range, 106-20700 copies/microg DNA) in the R(-) group, and 61 copies/microg DNA (range, <50-552 copies/microg DNA) in the R(+) group. During follow up no patient in the R(+) group had any noticeable symptoms that could be related to EBV, but three recipients in the R(-) group developed EBV-related symptoms including adenoid hypertrophy, cervical lymphadenopathy, and PTLD (B cell lymphoma), in one patient each. In the R(-) group the first leukocyte-associated viremia was detected at 30-180 days, and seroconversion at 43-266 days after transplantation.
Viral DNA detection using PCR is a useful tool for EBV surveillance, but the maximum EBV load was not markedly elevated (2474 copies/microg DNA) in a patient with PTLD. Therefore, EBV surveillance using only monitoring of EBV load in peripheral leukocyte may be insufficient. Histology may therefore be necessary to accurately diagnose PTLD.
Pediatrics International 08/2008; 50(4):454-8. · 0.63 Impact Factor
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Takeki Furue,
Motoshi Hattori,
Hiroyasu Tsukaguchi,
Akiko Kitamura,
Tae Oomori,
Daisuke Ogino,
Hyogo Nakakura,
Akira Ashida,
Kenichiro Miura, Masataka Hisano,
Kazuhiro Takahashi,
Hiroko Chikamoto,
Yuko Akioka,
Takashi Sakano
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ABSTRACT: Recurrent FSGS is a major challenge in the field of nephrology. To clarify the role of NPHS2 defects in the pathogenesis of FSGS recurrence, we sequenced all eight exons of NPHS2 in 11 Japanese pediatric FSGS patients with or without post-transplant recurrence. All patients had biopsy-proven primary FSGS, had no family history of renal diseases or consanguinity, were steroid-resistant, and received living-related renal transplantation. The mean age at onset was 5.0 +/- 3.1 yr and mean age at renal transplantation was 10.4 +/- 4.1 yr. Mutational analysis of NPHS2 was performed using polymerase chain reaction and direct sequencing. We found a synonymous T/C polymorphism at alanine 318 (GCC to GCT) in seven of 11 patients but no other causative NPHS2 mutations. FSGS recurred immediately after transplant in seven patients, while the remaining four patients had no recurrence for 3.2-5.8 yr. There were no differences between recurrent and non-recurrent patients in the onset age and the interval from onset to ESRD. In conclusion, we detected no causative NPHS2 mutations in Japanese pediatric FSGS patients with or without post-transplant recurrence. Further studies on the involvement of other genes are required to better understand recurrent FSGS.
Pediatric Transplantation 06/2008; 12(3):341-6. · 1.48 Impact Factor
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ABSTRACT: In an adult patient with a severe skeletal Class III malocclusion with midline deviation, combined surgical-orthodontic therapy is often the treatment of choice because it has a satisfying outcome, and the results tend to be stable. Sometimes, however, patients will not accept surgery as a part of the treatment. We report a nonsurgical treatment approach and its outcomes for an adult patient with a skeletal Class III malocclusion with a lateral shift. Treatment included distal movement of the mandibular arch and extraction of the third molars.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 07/2007; 131(6):797-804. · 1.33 Impact Factor
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ABSTRACT: A boy aged six yr and six months with end-stage renal disease because of focal segmental glomerulosclerosis underwent cadaveric renal transplantation. Ischemic injury during the operation resulted in a severely dysfunctional graft. A renal graft biopsy was performed on post-operative day (POD) 21. The biopsy specimen showed the presence of many intratubular calcium crystals, patchy tubular injury, and focal aggressive tubulointerstitial rejection. Pelvic computed tomography performed on POD 23 also showed prominent calcification in and around up to two-thirds of the graft. After the biopsy, the graft function recovered, and hemodialysis was stopped on POD 22. A second graft biopsy was performed on POD 52. This biopsy specimen showed recovery from rejection, although the nephrocalcinosis remained. It was suggested that secondary hyperparathyroidism and hyperphosphatemia provoked nephrocalcinosis in this patient.
Clinical Transplantation 06/2007; 21(s18):40 - 45. · 1.67 Impact Factor
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ABSTRACT: To investigate the patterns of dental crowding in the lower arch and their contributing morphological and functional factors.
Pretreatment diagnostic materials from 168 patients exhibiting dental crowding were selected, and the patients, dental casts, lateral cephalograms, and occlusal forces were evaluated. The crowding in the lower dental arch was quantified and the patterns of crowding were identified. Crowding patterns in the anterior region were classified by cluster analysis. The relationship between the crowding patterns and morphological and functional factors was investigated by correspondence analysis.
The prevalence of dental crowding was highest in the anterior region and was related to the same tooth on each side (eg, right lateral incisor vs left lateral incisor). In the premolar and molar region, the prevalence of dental crowding was related to the adjacent tooth (eg, right first premolar vs second premolar). Three crowding patterns were found in the anterior region: (1) a "symmetry pattern," (2) a "rotation pattern," and (3) an "irregular pattern." The first pattern was related to the factors of discrepancy, whereas the latter two patterns were related to functional factors such as occlusal force and its center of gravity.
These results suggest that crowding patterns can be useful information for treatment planning and achieving dental stability.
The Angle Orthodontist 04/2007; 77(2):303-10. · 1.21 Impact Factor
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ABSTRACT: The purpose of this study was to investigate the functional relationship between masseter muscle (MM) and sternocleidomastoid muscle (SCM) activities and between mandibular and head movements during mastication, under experimental muscle fatigue. The sample consisted of 12 adults with individually normal occlusion. The subjects were asked to chew gum at three different times: before maximum clenching, immediately after maximum clenching, and 3 minutes after maximum clenching. At these times, we examined the activity of the MM and SCM as well as the movement of the mandible and head. The activity and movement were simultaneously measured using both electromyography and the motion capture system. The MM activity time after clenching was significantly shorter than that before clenching, whereas the SCM activity time was significantly longer after clenching. There was no significant difference in the changes of three-dimensional distance of the mandibular movement between the respective times. On the other hand, the changes in the three-dimensional distance of head movement after clenching increased when compared with before clenching. Furthermore, the difference in the time of MM and SCM activity onset and of mandibular and head movement onset after clenching was shorter than that before clenching. A functional relationship exists between the MM and SCM activities and between mandibular and head movements during mastication.
The Angle Orthodontist 06/2006; 76(3):452-8. · 1.21 Impact Factor
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ABSTRACT: Monoblock appliances were used in combination with intermaxillary elastics for treatment of adult skeletal Class III patients. The patients showed predisposing upper incisors problems, significant mobility in patient 1 and root resorption in patient 2, which contraindicated direct intrusion of the incisors. Using the monoblock with selective extrusion of the molars, a clockwise rotation was induced to reduce overbite and to achieve a better profile. It was also possible to reduce the excessive force to the upper incisors during and after treatment, which improved incisor mobility to a physiologic extent (patient 1) and prevented further progression of root resorption (patient 2). Stability was high after the 2-year follow-up, which suggests a stable vertical control approach by using the monoblock appliance in combination with a fixed appliance in adults.
The Angle Orthodontist 04/2006; 76(2):226-35. · 1.21 Impact Factor
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Pediatrics International 11/2004; 46(5):597-600. · 0.63 Impact Factor
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ABSTRACT: Mechanisms of disc displacement in temporomandibular joint (TMJ) internal derangement (ID) in mandibular asymmetry have not been clearly defined. This study examines the degree and direction of disc displacement and their relationship with vertical asymmetry in terms of both clinical and biomechanical aspects. A retrospective study of disc displacement was performed in 31 mandibular asymmetry patients using MR imaging. The degree and direction of disc displacements on the shifted side and contralateral side TMJ were investigated with the degree of vertical asymmetry. Furthermore, three-dimensional finite element models of entire mandible include TMJ and maxillary teeth in occlusion were created to simulate displacement of the articular disc during clenching condition. The direction of displacement on the shifted side and contralateral side were significantly different. Articular disc has tendencies to displace more on the shifted side even in mild degree of vertical asymmetry. The degree of displacement was correlated with the amount of asymmetry. The MR results were consistent with the tendencies of disc displacement predicted from the finite element models. We suggest that disturbance in the direction of stress distribution through asymmetry of the mandible is one of the mechanisms related to disc displacement.
Journal of medical and dental sciences 04/2004; 51(1):75-81.
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ABSTRACT: To explain the pain and dysfunction of neck during jaw movement associated with malocclusion, the physiologic relationships between jaw and cervical movement should be understood. However the complicated reflex effects made it difficult to investigate the biomechanical relationship between the head-neck components. For this reason we have created a model for mechanical system dynamic analysis of the normal stomatognathic system to assess the biomechanics of the cervical movement and muscle activity during jaw movement. We have also statistically validated the model and quantitatively verified the model to the human subject by the amounts and conditions of cervical muscle activity. During jaw opening-closing phases the movement of the model was highly correlated to the subject with an identical movement. However low consistency was achieved during intercuspid phase. These findings indicate the establishment of a valid system, which can be used to evaluate the biomechanical relationships between jaw and cervical movement. Moreover the model verification of cervical muscle activity indicate the mechanical action of jaw can be the primary factor to modify cervical muscles, and cervical muscles coordinate to resist changes in head balance during jaw movement to maintains head posture.
Journal of medical and dental sciences 01/2004; 50(4):285-90.
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Yoshifusa Abe,
Mayumi Takamura,
Madoka Sawada, Masataka Hisano,
Yuichiro Tsuji,
Noriko Saikawa,
Torayuki Okuyama,
Yasuhei Odajima,
Kazunobu Fujita,
Hiroshi Chikaoka,
Yoji Iikura
Pediatrics International 11/2002; 44(5):530-3. · 0.63 Impact Factor
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Yoshifusa Abe,
Mayumi Takamura,
Madoka Sawada, Masataka Hisano,
Yuichiro Tsuji,
Noriko Saikawa,
Torayuki Okuyama,
Yasuhei Odajima,
Kazunobu Fujita,
Hiroshi Chikaoka,
Yoji Iikura
Pediatrics International 10/2002; 44(5):530 - 533. · 0.63 Impact Factor
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ABSTRACT: This report presents the case of a 25-year-old male patient who sought orthodontic treatment. Oral examination revealed an Angle Class I relation, with a bimaxillary dento-alveolar protrusion, evidence of anterior crowding, and a large overbite and overjet. Radiographic examination revealed a skeletal Class I occlusion. During the distal movement of the canines, occlusal interferences between the canines occurred and the commencement of a tongue thrust was observed. After correction of the applied forces, the canine movement was completed and the habit was no longer detectable. The incident indicates that an unusual oral habit suspiciously occurring during treatment should lead to an immediate reconsideration of the orthodontic treatment strategy.
Australian orthodontic journal 04/2002; 18(1):39-46. · 0.25 Impact Factor
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ABSTRACT: It has been recognized that mandibular movements evoke head movements during jaw tapping. However there have been only a few studies that investigated the aspects of head movements during mastication. The objective of this study was to demonstrate the hypothesis that the head moves actively in mastication in order to achieve effective destruction of a food bolus. Head and mandibular movements during gum, gummi candies and kelp chewing among nine adult volunteers have been recorded as time series data with a three-dimensional motion capture system and the vertical components of the movements have been analyzed. To focus on occlusal phase of mastication, the following parameters have been examined: time lag of the head movements at the beginning of occlusal phase, perpendicular velocity of the head at the beginning of the phase of occlusion, and average velocity of the head during occlusal phase. The results showed that the head moved downward in mastication and the velocity of the head movements increased in the order of gum, gummi candies and kelp chewing. There is a possibility that the elasticity of a food bolus affects the activity of head movements, and the kinetic energy was increased to achieve effective destruction of a food bolus.
Journal of medical and dental sciences 04/2002; 49(1):37-42.