Publications by authors named "Takahisa Kobayashi"
Article Synopsis
- This study investigates the effects of prehabilitation in patients undergoing surgery for esophageal cancer at a hospital since October 2019.
- It analyzed data from 621 patients to determine how prehabilitation, alongside various patient factors, impacted postoperative outcomes, specifically hospital stay durations and complications.
- The results show that while prehabilitation did not affect overall complication rates, it significantly reduced the length of hospital stays for patients who experienced complications, suggesting its benefits in enhancing recovery.
Article Synopsis
- - Black hairy tongue (BHT) is a rare, harmless condition characterized by a black, hairy appearance on the tongue and occurs in 0.6% to 11.3% of the population; its exact cause is not well understood.
- - A case report details a 69-year-old woman whose BHT developed after taking moxifloxacin during treatment for an infection linked to Mycobacterium chelonae, following a series of other antibiotics.
- - Improvement in her condition was noted just two days after discontinuing moxifloxacin, highlighting the need for healthcare providers to be aware of medications that might trigger BHT and to inform patients about potential side effects.
Article Synopsis
- - An isolated case of tubulointerstitial nephritis (TIN) is presented, likely linked to antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in a patient also suffering from monoclonal gammopathy, a condition where abnormal proteins are present in the blood.
- - Laboratory tests showed acute kidney injury and elevated markers indicating kidney damage; a biopsy confirmed TIN without glomerular lesions, suggesting AAV involvement along with potential effects of monoclonal gammopathy.
- - The patient experienced improvement after treatment with oral prednisone, highlighting the complexities of diagnosing TIN when both AAV and monoclonal gammopathy are present, necessitating further research into their possible connection.
The methylenation reagent 1-methylbenzimidazol-2-yl methyl sulfone reacts with various aldehydes and ketones in the presence of -BuOK (room temperature, 1 h) in dimethylformamide to give the corresponding terminal alkenes generally in high yields. For sensitive substrates, the reaction is better carried out at low temperature using sodium hexamethyldisilazide in 1,2-dimethoxyethane. The byproduct is easily removed from the products, and the reaction conditions are mild and practical.
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- * Treatment with furosemide reduced extracellular fluid more than intracellular fluid, while adding tolvaptan led to a more balanced reduction and better overall diuretic response.
- * This case highlights for the first time how furosemide and tolvaptan affect fluid distribution differently in the same patient, with tolvaptan also increasing plasma colloid osmotic pressure.
Hemolytic Uremic Syndrome: An Increasingly Recognized Public Health Problem.
Clin Med Insights Case Rep
July 2018
Article Synopsis
- A 28-year-old man was hospitalized for severe complications from O157-mediated hemorrhagic colitis, leading to low platelet counts.
- The patient was also diagnosed with acute pancreatitis and hemolytic uremic syndrome.
- The case highlights the need for more research on this public health issue and discusses various diagnostic and management challenges encountered.
Article Synopsis
- * Her serum creatinine level was critically high at 7.44 mg/dL, indicating severe kidney dysfunction, but she fully recovered and was discharged with a normal level of 0.68 mg/dL.
- * The case highlights the need for better awareness and caution among physicians when prescribing valacyclovir to elderly patients, especially regarding their renal function and potential management strategies.
Article Synopsis
- - Peritoneal dialysis is commonly used to treat end-stage kidney disease, but can face interruptions due to surgeries for other health issues.
- - A case study describes a 40-year-old woman whose dialysis was temporarily halted due to pleuroperitoneal communication and ovarian cancer, both of which were addressed through surgery.
- - The article highlights ongoing concerns in nephrology about managing dialysis during the recovery period, specifically regarding care for the dialysis catheter and the duration of necessary interruptions.
Article Synopsis
- A 68-year-old man was admitted for nephrotic syndrome evaluation, complicated by recurring thymoma in his chest and abdomen.
- He had a history of invasive thymoma and had undergone surgery to remove it seven years earlier; renal biopsy showed his nephrotic syndrome was due to minimal change disease.
- He was treated with corticosteroids, achieving full remission of the nephrotic syndrome within six months, although the thymoma persisted, raising questions about its role in kidney issues and treatment challenges.
Performing Anticoagulation: A Puzzling Case of Cholesterol Embolization Syndrome.
Clin Med Insights Case Rep
February 2017
Article Synopsis
- Avoiding anticoagulation is essential in treating cholesterol embolization syndrome (CES), as highlighted by a case of a man with a history of pulmonary embolism who was on warfarin.
- Despite some reports suggesting anticoagulation might be safe for certain CES patients, this case ultimately led to irreversible renal failure requiring hemodialysis.
- The findings stress the risks and limited effectiveness of anticoagulation in CES, prompting further discussion on the associated treatment concerns.
Article Synopsis
- Tolvaptan is an oral medication that helps reduce fluid retention in patients with advanced chronic kidney disease, showing a lower risk of harming kidney function compared to typical diuretics.
- In a study involving six patients, tolvaptan significantly decreased both intracellular and extracellular water while increasing urine output and causing a slight reduction in body weight.
- The treatment did not negatively affect kidney function, indicating that tolvaptan provides a different and potentially safer approach to managing fluid retention in these patients.
Article Synopsis
- Renal biopsy can lead to complications that may not be immediately apparent, with patients often hospitalized for recovery but rarely monitored for long-term issues.
- A case is presented of a 24-year-old man who, nine years after a seemingly uneventful renal biopsy, developed a significant enlargement of an arteriovenous fistula, detected by chance during an unrelated health examination.
- The importance of long-term follow-up after renal biopsy is underscored, highlighting that complications can develop silently over the years, even if the initial recovery seems successful.
Tubulointerstitial Nephritis and Uveitis Syndrome: Are Drugs Offenders or Bystanders?
Clin Med Insights Case Rep
March 2016
Article Synopsis
- A 16-year-old girl was admitted for worsening kidney function, showing elevated serum creatinine levels, initially thought to be due to drug-induced acute interstitial nephritis (AIN).
- Four months later, despite improved kidney function, she developed vision issues and was diagnosed with tubulointerstitial nephritis and uveitis (TINU) syndrome, which was not apparent at first.
- The case highlights the challenges in differentiating TINU from AIN during early diagnosis and stresses the importance of ongoing monitoring to ensure accurate identification of such conditions.
Article Synopsis
- A novel methylenation reagent called 1-methyl-2-(methylsulfonyl)benzimidazole has been developed.
- It effectively reacts with different aldehydes and ketones using specific bases (NaHMDS or t-BuOK) under mild conditions to produce terminal alkenes in high yields.
- The reaction process is efficient, generating byproducts that can be easily eliminated.
We herein report the case of a 75-year-old man who developed an increased serum creatinine level (4.93 mg/dL) and oliguria with massive proteinuria (7.14 g/day) on the second day after a single oral administration of high-dose (56 mg) minodronate.
View Article and Find Full Text PDFThe reversibility of diabetic nephropathy remains controversial. Here, we tested whether replacing leptin could reverse the advanced diabetic nephropathy modeled by the leptin-deficient BTBR ob/ob mouse. Leptin replacement, but not inhibition of the renin-angiotensin-aldosterone system (RAAS), resulted in near-complete reversal of both structural (mesangial matrix expansion, mesangiolysis, basement membrane thickening, podocyte loss) and functional (proteinuria, accumulation of reactive oxygen species) measures of advanced diabetic nephropathy.
View Article and Find Full Text PDFTo examine whether and how heart ANG II influences the coordination between cardiomyocyte hypertrophy and coronary angiogenesis and contributes to the pathogenesis of diabetic cardiomyopathy, we used Spontaneously Diabetic Torii (SDT) rats treated without and with olmesartan medoxomil (an ANG II receptor blocker). In SDT rats, left ventricular (LV) ANG II, but not circulating ANG II, increased at 8 and 16 wk after diabetes onset. SDT rats developed LV hypertrophy and diastolic dysfunction at 8 wk, followed by LV systolic dysfunction at 16 wk, without hypertension.
View Article and Find Full Text PDFA 43-year-old man had severe circumocular exanthema associated with chronic rejection 10 years after receiving a kidney transplant to treat end-stage renal failure. After the renal allograft was extracted, the exanthema diminished rapidly without any treatment. Donor-reactive immune cells seem to have cross-reacted with unknown pathogens on the skin and contributed to inflammation.
View Article and Find Full Text PDFOrganogenesis accompanies the establishment of the vascular system which begins with sprouting angiogenesis. Vascular endothelial growth factor (VEGF) provides the primary stimulation in the vascular sprouting process but the negative regulation of this process remains unclear. This study examined the role of the transforming growth factor-beta (TGF-beta) superfamily in vascular sprouting using a three-dimensional dorsal aorta culture system, in which the dissected tissue was embedded in type I collagen gel.
View Article and Find Full Text PDFAlthough it is well known that platelet-derived growth factor (PDGF) causes mesangial cell proliferation (presumably contributing to progression of glomerular disease), targeted inhibition of the PDGF receptor system has shown only limited efficacy against glomerular diseases. To examine whether this discrepancy is due to the involvement of other pathways, we used phosphorylated receptor tyrosine kinase arrays and found that RON (recepteur d'origine nantais) was phosphorylated while the PDGF receptor was dephosphorylated (thus inactive) in human mesangial cells (HMCs) at the time of cell cycle entry. Further, RON remained active during steady-state growth.
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- * Increased levels of beta2-microglobulin (beta 2MG) and N-acetyl-beta-D-glucosaminidase (NAG) in urine suggest tubulointerstitial damage in lupus nephritis, though their clinical progression is not well understood.
- * The report discusses how beta 2MG and NAG levels changed during immunosuppressive therapy combined with double filtration plasmapheresis in a lupus nephritis case.
Marinobufagenin and telecinobufagin have been identified as digitalis-like factors in mammals. In toads, marinobufagenin-related compounds, such as marinobufotoxin (MBT), have been isolated in some tissues but not in mammals, and its biological action has not been elucidated. Herein, we aimed to explore the possible production and/or secretion of MBT and the biological action in rats.
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