Mineralocorticoid Receptor Blocker Prevents Mineralocorticoid Receptor-Mediated Inflammation by Modulating Transcriptional Activity of Mineralocorticoid Receptor-p65-Signal Transducer and Activator of Transcription 3 Complex.

Background: Mineralocorticoid receptor (MR) induces cardiac inflammation cooperatively with nuclear factor-κB and signal transducer and activator of transcription 3 (STAT3); MR blockers exert anti-inflammatory effects. However, the underlying mechanism remains unclear. We investigated the anti-inflammatory effect of esaxerenone, a novel MR blocker, in experimental myocardial infarction (MI) and its underlying mechanisms.

A case of secondary pseudohypoaldosteronism that presented as poor weight gain.

Key Clinical Message: Pseudohypoaldosteronism (PHA) carries a good prognosis if treated early and appropriately, but some cases can have life-threatening events. We underscored the need to consider secondary PHA as one of the differential diagnoses of hyponatremia and hyperkalemia in infancy.

Abstract: Pseudohypoaldosteronism (PHA) type 1 has two classifications; the primary type, caused by genetic abnormalities that develop during neonatal and infancy periods, and the secondary type, caused by urinary tract malformation and urinary tract infection.

Renal arteriovenous fistula discovered ~2 years after renal biopsy: A case report.

Key Clinical Message: Although percutaneous renal biopsy is considered safe, this invasive procedure has complications such as renal arteriovenous fistula (RAVF). Even if complications such as RAVFs are not observed early after renal biopsy, considering the possibility of delayed renal hemorrhage, follow-up with ultrasound after renal biopsy even in asymptomatic cases could be important.

Abstract: Although percutaneous renal biopsy is considered safe, this invasive procedure can lead to complications such as renal arteriovenous fistula (RAVF).

Successful treatment with dupilumab for mucus plugs in severe asthma.

A 29-year-old man presented to our hospital with severe eosinophilic asthma. He needed a short OCS burst for exacerbation of asthma once every 1 or 2 months, although he used a high dose of inhaled corticosteroids and a long-acting beta-2 agonists. Chest CT showed multiple mucous plugs with bronchiectasis, but further examination found that he did not meet the diagnostic criteria for allergic bronchopulmonary aspergillosis.

A diagnostically challenging case of pyelonephritis caused by .

Extracellular polysaccharides produced by have been shown to stimulate the immune system, suppress reactivity to allergens, and protect from infections; these properties underlie the use of in probiotic formulations and in the prevention and treatment of urinary tract infections. However, can be independently isolated at high numbers from sites of infection and has been rarely considered as the causative agent of infections in immunocompromised individuals. We herein report the case of a 46-year-old female patient who developed pyelonephritis due to following total thyroidectomy for papillary thyroid cancer.

A case of tubulointerstitial nephritis and uveitis syndrome following drug-induced acute interstitial nephritis.

Distinguishing between late-onset TINU syndrome and drug-induced AIN remains difficult given that patients with TINU syndrome may develop uveitis long after the onset of AIN. Therefore, ophthalmic examination is required not only upon diagnosis but also continuously or when eye symptoms and relapse of urinary findings are observed.

Absence of microsatellite instability in extramammary Paget's disease.

Background: Deficiency of DNA mismatch repair (MMR) induces microsatellite instability (MSI). Pembrolizumab, an antibody targeting PD-1 (an immune checkpoint inhibitor), is more effective against MMR-deficient tumours than against MMR-proficient tumours. The status of MMR is a useful biomarker for predicting the effectiveness of pembrolizumab administration.

Summary of the Clinical Practice Guidelines for Penile Cancer 2021 by the Japanese Urological Association.

Penile cancer is a rare cancer for which no medical guidelines have been established before in Japan. These guidelines aim to standardize, as much as possible, the therapeutic modality for penile cancer, for which empirical evidence is limited on a global scale, thereby bolstering therapeutic outcomes for patients with penile cancer. The new guidelines conform to the Minds Guide for Developing Clinical Practice Guidelines (2017) as much as possible.

Attempt for a Recombinant Thrombomodulin Alpha Treatment in a Rat Disseminated Intravascular Coagulation Model Using Yamakagashi () Venom.

Yamakagashi () inhabits Japan widely, and incidents involving its bites occur every year. Its bite causes disseminated intravascular coagulation when the amount of infused venom is high, and it can be fatal if treatment with Yamakagashi antivenom is delayed. Although Yamakagashi antivenom is used for treating Yamakagashi bites, it is an unapproved drug and its capacity for storage is limited.

F-FDG uptake in accessory respiratory muscles shows the respiratory effort of patients with pleuroparenchymal fibroelastosis.

Patients with pleuroparenchymal fibroelastosis (PPFE) have severe breathlessness even with mild hypoxaemia. In patients with PPFE, accessory respiratory muscles, such as the sternocleidomastoid muscles, are used to maintain ventilation. An intense F-fluorodeoxyglucose uptake in accessory respiratory muscles using positron emission tomography/computed tomography reflects the strong respiratory effort of patients with PPFE.

t(6; 11) renal cell carcinoma. A case report successfully diagnosed by using fluorescence in situ hybridization.

Introduction: Definitive diagnosis of translocation renal cell carcinoma is challenging. We herein experienced a case of translocation(6;11) renal cell carcinoma, successfully diagnosed by using fluorescence in situ hybridization.

Case Presentation: During the follow-up of a 21-year-old man with Crohn's disease, computed tomography revealed a 40-mm mass in the right kidney.

HE4 Predicts Progressive Fibrosis and Cardiovascular Events in Patients With Dilated Cardiomyopathy.

Background Cardiac fibrosis plays a crucial role in the pathogenesis of dilated cardiomyopathy (DCM). HE4 (human epididymis protein 4) is a secretory protein expressed in activated fibroblasts that exacerbates tissue fibrosis. In the present study, we investigated the clinical utility of HE4 measurement in patients with DCM and its pathophysiological role in preclinical experiments in vivo and in vitro.

Impact of the 2016 Kumamoto earthquake on patients with nephrogenic diabetes insipidus and preparations for the future.

Patients with nephrogenic diabetes insipidus should establish a support network system by contacting the government to ensure that water can be preferentially obtained in the event of a disaster and create and carry a medical alert card.

Ungual hyalohyphomycosis caused by .

onychomycosis is uncommon in the temperate climate zone of Japan. Based on the morphological characteristics and a gene analysis, we diagnosed a patient with ungual hyalohyphomycosis caused by belonging to the complex. This intractable disease was cured by 6-month treatment with efinaconazole 10% solution.

Tubulointerstitial nephritis and uveitis syndrome with concurrent macular edema caused by granulomatous uveitis.

It is difficult to differentiate between TINU syndrome and sarcoidosis in young people with renal abnormalities and ocular lesions. Since the spontaneous prognosis of interstitial nephritis is different between the two, it was considered necessary to actively conduct tests for differentiation.

Remarkable antitumor effect of nivolumab in a patient with metastatic renal cell carcinoma previously treated with a peptide-based vaccine.

Introduction: The safety and efficacy of combination therapy comprising immune checkpoint inhibitors and cancer-specific peptide vaccines have not yet been established.

Case Presentation: A 71-year-old female metastatic renal cell carcinoma patient with multiple lung and pleural metastases. She had been treated with interferon alpha, sunitinib, axitinib, and pazopanib sequentially, but no clinical efficacy was observed.

Erythroplasia of Queyrat treated with imiquimod 5% cream: The necessity of regimen guidelines.

Development of noninvasive treatments for erythroplasia of Queyrat, a carcinoma in situ, is expected. This case suggests topical imiquimod might be a candidate with regimens consisting of much longer duration of the treatment than for genital warts and the maintenance phase of the treatment course to prevent the relapse.

Immune checkpoint inhibitors in the onset of myasthenia gravis with hyperCKemia.

Immune checkpoint inhibitors sometimes cause neuromuscular adverse events. Although a few cases of myasthenia gravis with hyperCKemia triggered by immune checkpoint inhibitors have been described, conclusive evidence remains limited. We conducted a systematic review of published cases of myasthenia gravis with hyperCKemia related to immune checkpoint inhibitors.

Introduction of H2C2-type zinc-binding residues into HIV-2 Vpr increases its expression level.

Human immunodeficiency virus type 2 has two structurally similar proteins, Vpx and Vpr. Vpx degrades the host anti-viral protein SAMHD1 and is expressed at high levels, while Vpr is responsible for cell cycle arrest and is expressed at much lower levels. We constructed a Vpr mutant with a high level of expression by replacing the amino acids HHCR/HHCH with a putative H2C2-type zinc-binding site that is carried by Vpx.

Effectiveness of adjuvant systemic chemotherapy for intermediate-risk stage IB cervical cancer.

Objective: To examine the effectiveness of systemic chemotherapy following radical hysterectomy for women with intermediate-risk stage IB cervical cancer.

Materials And Methods: This is a retrospective analysis of a previously organized nation-wide cohort study examining 6,003 women with stage IB-IIB cervical cancer who underwent radical hysterectomy between 2004 and 2008 in Japan. Survival of 555 women with stage IB cervical cancer in the intermediate-risk group (deep stromal invasion > 50%, large tumor size > 4 cm, and lympho-vascular space invasion [LVSI]) were examined based on adjuvant therapy patterns: chemotherapy alone ( 223, 40.