Serum Uromodulin Is a Possible Auxiliary Diagnostic Tool for Acute Tubular Injury and Acute Interstitial Nephritis: A Case Series.

Recently, the usefulness of serum uromodulin (sUmod) as a novel renal biomarker has been attracting attention. Clinical evidence regarding sUmod measurements has been accumulated by analyzing cross-sectional data. However, little is known about the longitudinal data on sUmod.

Serum uromodulin is a novel renal function marker in the Japanese population.

Background: Uromodulin, also known as Tamm-Horsfall protein, is the most abundant protein in urine. It has recently been reported that uromodulin exists in a small amount in blood and that its concentration correlates with the estimated glomerular filtration rate (eGFR).

Methods: First, we generated anti-human uromodulin mouse monoclonal antibodies (mAb(s)) and established a specific enzyme-linked immunosorbent assay (ELISA) for uromodulin.

Efficacy of Semiannual Single Fixed Low-Dose Rituximab Therapy in Steroid-Dependent Minimal Change Nephrotic Syndrome: A Case Series.

The frequency of using rituximab to treat refractory nephrotic syndrome has recently been increasing, and the conventional dose of rituximab used to treat it, 375 mg/m body surface area once weekly for 4 weeks, has been modelled on the chemotherapy regimen for B-cell non-Hodgkin's lymphoma. The dose and intervals of rituximab in refractory nephrotic syndrome remain controversial. Clear lymphoma cell hyperplasia is seen in lymphoma patients, but not in nephrotic syndrome patients.

A case of acetaminophen-induced acute tubulointerstitial nephritis in adult.

We report a case of allergic acute tubulointerstitial nephritis (TIN) induced by acetaminophen in a 48-year-old Japanese man with no past medical history. Two days after receiving the non-steroidal anti-inflammatory drug (NSAID) loxoprofen for left shoulder pain, he developed cold symptoms such as fever and sore throat. He then took a 300 mg dose of acetaminophen three times a day and a 100 mg dose of minocycline hydrochloride twice a day for 7 days.

Five-year follow-up of a case of lipoprotein glomerulopathy with APOE Kyoto mutation.

We report the case of a 34-year-old Japanese male with lipoprotein glomerulopathy (LPG). Renal biopsy showed LPG, and followed by a genetic analysis revealed a mutation in apolipoprotein E gene (APOE Kyoto; Arg25Cys). We started treatment with probucol, bezafibrate, losartan, and allopurinol.

The Improvement of the Outcome of Osmotic Demyelination Syndrome by Plasma Exchange.

A 71-year-old Japanese woman presented with progressive fatigue, lethargy, dysarthria and a gait disorder. Her laboratory data revealed hyponatremia (Na 101 mEq/L), and we started correcting her serum sodium level. Within a few days, she became comatose, bedridden, and was intubated.

[A case of posterior reversible leukoencephalopathy syndrome caused by fibromuscular dysplasia].

A 23-year-old woman presented with disturbance of consciousness and seizure. Her blood pressure was remarkably high, and brain magnetic resonance imaging (MRI) showed high-intensity T2 signals in the bilateral basal ganglia, corpus callosum, cerebral white matter, and cortex. With the administration of angiotensin II receptor blocker, the symptoms and MRI findings improved, along with normalization of blood pressure, and a diagnosis of posterior reversible leukoencephalopathy syndrome (PRES) was made.

[Treatment of hypertriglyceridemia: plasma exchange].

Severe hypertriglyceridemia ( >1,000 -2,000 mg/dL) is known to cause acute pancreatitis (AP). If standard treatment regimen including absolute diet restriction regarding fats, use of lipid -lowering agents and combination of low molecular weight heparin with insulin is not effective, plasma exchange (PE) has emerged as an effective modality in rapidly lowering serum triglyceride levels and helping to treat and prevent hypertriglyceridemia-induced AEP. It has been shown to reduce triglyceride levels by an average of 61% after 1 session and provide rapid resolution of AP symptoms.

A case of TSH-producing adenoma treated with octreotide in combination with thiamazole for the control of TSH and thyroid hormones after trans-sphenoidal neurosurgery.

While TSH-producing adenoma (TSHoma) is rare, the diagnosis is often delayed because the clinical features are heterogeneous. The patient was a 69-year-old woman who had been referred to the Yachiyo Medical Center in August 2008, because of dyspnea, loss of appetite, weight loss of 10 kg, and diarrhea that lasted 4 years. We diagnosed this patient with pituitary TSH-producing macroadenoma.

[Chronic kidney disease and atherosclerosis].

Atherosclerosis is common in patients with chronic kidney disease (CKD), and cardiovascular disease (CVD) represents a major cause of death in these patients, especially, in patients with end-stage renal disease(ESRD). The pathological features in ESRD patients are intimal atherosclerosis and medial calcific sclerosis. The important risk factors for CVD in ESRD patients are hypertension, dyslipidemia and CKD bone and mineral disorder (CKD-MBD).

Inhibitory effects of whisky congeners on IgE-mediated degranulation in rat basophilic leukemia RBL-2H3 cells and passive cutaneous anaphylaxis reaction in mice.

Whisky is matured in oak casks. Many nonvolatile substances (whisky congeners, WC) seep from the oak cask during the maturing process. In this study, three antiallergic agents (syringaldehyde, SA; lyoniresinol, Lyo; and ellagic acid, EA) were isolated from WC.

Frequency of renal disease in Japan: an analysis of 2,404 renal biopsies at a single center.

Background: Evaluating the frequency of renal disease according to sex, age, time period and ethnicity is of considerable importance.

Methods: Disease frequency was evaluated in a total of 2,404 cases that had undergone a renal biopsy at Tokyo Women's Medical University between 1979 and 2008.

Results: The overall frequencies of primary glomerulonephritis (GN) and secondary GN were 77.

Structure-activity relationship study on alpha1 adrenergic receptor antagonists from beer.

Hordatine A and aperidine have been previously isolated from beer as active ingredients, which bind to muscarinic M3 receptor. In addition, these compounds have exhibited antagonist activity against the alpha1A adrenoceptor. Although the relative structures of these two molecules have previously been determined, the absolute stereochemistry was unclear.

Clinical assessment of low-dose steroid therapy for patients with IgA nephropathy: a prospective study in a single center.

Background/aim: No accepted therapy has been established for progressive IgA nephropathy (IgAN). The purpose of the present study was to assess low-dose steroid therapy in the treatment of patients with IgAN.

Methods: A prospective trial of low-dose steroid therapy was performed in patients with IgAN with mild histological activities.

Fatal diffuse pulmonary arterial thrombosis as a complication of nephrotic syndrome.

A 21-year-old man was admitted to our hospital because of leg edema. Because laboratory findings revealed massive proteinuria and hypoproteinemia, he was diagnosed as having nephritic syndrome caused by minimal change disease. He was given a continuous heparin infusion and intravenous steroid therapy, at a prednisolone dose of 1 mg/kg per day, and his condition gradually improved.

The characteristics of relapse in adult-onset minimal-change nephrotic syndrome.

Background: Although minimal-change nephrotic syndrome (MCNS) is highly steroid-responsive, the frequency of relapses in some patients is high, necessitating the administration of repeated courses of prednisolone in high doses. It is, therefore, necessary to identify factors that can predict this increased risk of relapse in some patients in order to establish useful treatment methods to reduce the risk.

Methods: To clarify the factors that might increase the risk of relapses, the data of 82 Japanese adult patients with MCNS receiving treatment at our department were analyzed retrospectively.

Wegener's granulomatosis complicated by intestinal ulcer due to cytomegalovirus infection and by thrombotic thrombocytopenic purpura.

A 61-year-old woman was admitted to our hospital because of acute kidney injury. She complained of general fatigue, appetite loss, and a high fever. Nodular lesions were observed on chest X-rays and there were >100 erythrocytes per high power field in her urinary sediment.

Anti-glomerular basement membrane antibody disease with granulomatous lesions on renal biopsy.

We present the case of a 56-year-old woman with anti-glomerular basement membrane (anti-GBM) antibody disease accompanied by granulomatous reaction in the kidney. Three months prior to admission to our kidney center, she had suffered from interstitial pneumonia and had a slightly elevated level of MPO-ANCA (13 EU). Her serum level of creatinine was normal (0.

Structural determination of two active compounds that bind to the muscarinic M3 receptor in beer.

Background: It is known that beer accelerates gastrointestinal motility in humans. Our previous studies showed that beer congener stimulates gastrointestinal motility by directly stimulating the muscarinic M3 receptor. Further, we isolated 2 active compounds (compounds A and B) from beer by liquid chromatography.

[A case of immunotactoid glomerulopathy with IgA2, kappa deposition ameliorated by steroid therapy].

We report a case of idiopathic immunotactoid glomerulopathy with IgA2, kappa light chain deposition, ameliorated by steroid therapy. A 28-year-old male patient was admitted to our hospital due to exacerbation of nephrotic syndrome. The onset of his renal disease was at 24 years of age and the renal biopsy revealed membranoproliferative glomerulonephritis with moderate-degree deposition of IgA, IgG, IgM, C3 and C1q.

[Low-dose cyclosporin therapy combined with prednisolone for relapsing minimal change nephrotic syndrome in adults].

Low-dose cyclosporin(CsA) therapy combined with prednisolone was performed in 10 adult patients with frequently relapsing minimal change nephrotic syndrome(MCNS). Oral CsA was administered at the dose of 1-3 mg/kg/day(50-150 mg/day) in combination with preceding prednisolone(32.5 +/- 13.

Speech rehabilitation after total laryngectomy.

The outcome of speech therapy for 65 laryngectomees at Kitasato University Hospital is reported and what needs to be done in order to establish a better system for laryngectomee rehabilitation in Japan is discussed. Of the 65 patients, 53 were trained for both esophageal and electrolarynx speech, 8 for electrolarynx speech only and 4 for esophageal speech only. Of the 57 patients who were trained for esophageal speech, 38 continued the training for a period of > 6 months.