237 results match your criteria: "Toranomon Hospital Kajigaya.[Affiliation]"

Individuals diagnosed with Castleman disease (CD) and TAFRO syndrome (characterized by thrombocytopenia, anasarca, fever, bone marrow fibrosis, and organomegaly) displays a wide range of clinical symptoms, including varying patterns of lymph node enlargement, systemic inflammation, and impaired organ function. Some patients may present with both CD and TAFRO syndrome concurrently. A retrospective study conducted across multiple centers in Japan examined 321 cases to determine if the quantity and position of swollen lymph nodes could forecast the clinical progression and intensity of these conditions.

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Objectives: To evaluate the efficacy and safety of first-line targeted synthetic disease-modifying anti-rheumatic drugs (tsDMARDs) in patients with rheumatoid arthritis (RA) and chronic kidney disease (CKD).

Methods: This retrospective cohort study included 216 patients with RA prescribed their first tsDMARDs at two hospitals between 2013 and 2022. Dose reduction and contraindication guidelines for tsDMARDs according to kidney function were followed.

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There are no clear strategies for non-insulin-dependent slowly progressive type 1 diabetes mellitus (SPIDDM). We herein report a 25-year-old man with SPIDDM in whom appropriate diet therapy and exercise improved the initial insulin secretion without medication. After 12 months, his body weight decreased by 5.

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Polyarteritis nodosa (PAN) is a rare systemic necrotizing vasculitis that can lead to the formation of refractory lower limb ulcers requiring amputation. The standard treatment for severe PAN involves combination therapy with steroids and cyclophosphamide; however, some cases prove to be challenging. Recently, case reports have described the use of biological agents for PAN treatment.

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Background: Kidney complications associated with anticancer drug therapy have greatly increased recently. We aimed to investigate the real-world clinical outcomes of anticancer drug therapy-associated renal complications in Japan using the national kidney biopsy database, Japan Renal Biopsy Registry (J-RBR).

Methods: From 2018 to 2021, 449 cases from 49 facilities identified as 'drug-induced' histopathology in the J-RBR were screened, of which a total of 135 were confirmed as anticancer drug-related cases and included in the analysis.

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Patient-reported outcomes (PROs) are becoming pivotal in managing gastroesophageal reflux disease (GERD). Current Japanese guidelines for GERD recommend vonoprazan (VPZ) as a treatment option for mild reflux esophagitis (RE). However, it has been hypothesized that 4 weeks of VPZ 20 mg is not always necessary for mild RE if the treatment outcome is based on patient symptoms.

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Comparison of Nonrelapse Mortality After Haploidentical Hematopoietic Stem Cell Transplantation With Post-transplant Cyclophosphamide Versus Single Umbilical Cord Blood Transplantation in Hematologic Disease.

Transplant Cell Ther

November 2024

Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Emerging Medicine for Integrated Therapeutics (EMIT), Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan.

Article Synopsis
  • The study compares outcomes of unrelated cord blood transplantation (UCBT) and haploidentical transplantation with posttransplant cyclophosphamide (PTCy-haplo) in patients without a matched donor, focusing on the impact of CD34 cell counts in cord blood.
  • Data from 2014 to 2020 was analyzed, categorizing UCBT cases into those with high (≥0.84 × 10/kg) and low (<0.84 × 10/kg) CD34 cell counts, revealing better neutrophil engraftment in PTCy-haplo compared to both UCB groups.
  • While UCB-H showed similar nonrelapse mortality (NRM) and overall survival
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BK virus-associated nephritis (BKVAN) is an important cause of graft loss in renal transplant recipients B K viremia occurs in up to 30% of renal transplant recipients. Since the discovery of BKV in 1971, effective prophylaxis and treatment have not been established, and it is not uncommon for a transplant kidney to be lost without cure of BKVAN. BK virus infection is reactivated when cellular immunity is suppressed, which is often during the first year after kidney transplantation when cellular immunity is most suppressed.

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Article Synopsis
  • The study aimed to compare two types of major depressive disorder: anxious distress (ANXD) and melancholic features (MEL), focusing on psychomotor disturbances like agitation and retardation.
  • A total of 106 patients were assessed using the CORE measure, and logistic analysis showed that lower retardation scores were linked to ANXD diagnoses, while higher agitation scores were associated with both ANXD and MEL.
  • The findings suggest that while ANXD and MEL can share agitation, they differ in terms of psychomotor retardation and noninteractiveness, indicating a potential overlap in how these disorders are defined.
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Aim: The aim of this study was to develop quantitative outcome indicators for psychiatric training programs integrated into the General Medicine In-Training Examination (GM-ITE) and to investigate which characteristics correlate with high scores in psychiatry.

Methods: A nationwide cross-sectional study was conducted over 3 fiscal years (2021-2023). An anonymous online questionnaire was distributed to postgraduate year 1 and 2 residents who completed the GM-ITE.

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Background: MRI is expected to be a valuable tool for evaluating disease activity in immunoglobulin G4 (IgG4)-related tubulointerstitial nephritis (IgG4-TIN). However, the correlation between MRI findings and renal histopathological findings remains to be elucidated.

Purpose: This study aimed to clarify the correlation between MRI findings and renal histopathological findings in IgG4-TIN.

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Article Synopsis
  • After a relapse two years later, he was switched to baricitinib, achieving remission again before RA recurred and he discovered a tumor in his kidney at age 72.
  • Following surgical removal of the tumor, which was identified as renal cell carcinoma (RCC), the patient reported joint pain relief but ultimately died from systemic metastases about 10 weeks later, with the RA and RCC linked as a paraneoplastic syndrome.
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Hepatoid adenocarcinoma of the lung is a rare variant of adenocarcinoma. We describe a case of hepatoid adenocarcinoma of the lung that harbored KRAS G12C and responded favorably to sotorasib. A man in his 70s was found to have an abnormality on his chest X-ray.

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Introduction: This study aimed to analyze the clinical course of TAFRO syndrome in patients through extended follow-up, focusing on recurrent cases and long-term remission.

Methods: This was a retrospective case series study. We assessed the clinical course of patients diagnosed with TAFRO syndrome between January 2012 and September 2022 at Toranomon Hospital or Toranomon Hospital Kajigaya, excluding those patients who died during the initial hospitalization.

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Objective: To evaluate the efficacy and safety of first-line biological disease-modifying antirheumatic drugs (bDMARDs) in patients with rheumatoid arthritis (RA) with chronic kidney disease (CKD), including those undergoing haemodialysis (HD).

Methods: This retrospective cohort study included 425 patients with RA prescribed their first bDMARDs at two hospitals from 2004 to 2021. Patients were categorised by kidney function and bDMARD modality (TNFα inhibitors (TNFαis), interleukin-6 inhibitors (IL-6is), cytotoxic T-lymphocyte antigen-4 immunoglobulin (CTLA4-Ig)).

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Aberrant proximal tubule DNA methylation underlies phenotypic changes related to kidney dysfunction in patients with diabetes.

Am J Physiol Renal Physiol

September 2024

Division of Clinical Epigenetics, Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.

Epigenetic mechanisms are considered to contribute to diabetic nephropathy by maintaining memory of poor glycemic control during the early stages of diabetes. However, DNA methylation changes in the human kidney are poorly characterized, because of the lack of cell type-specific analysis. We examined DNA methylation in proximal tubules (PTs) purified from patients with diabetic nephropathy and identified differentially methylated CpG sites, given the critical role of proximal tubules in the kidney injury.

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Clinical management of liver cyst infections: an international, modified Delphi-based clinical decision framework.

Lancet Gastroenterol Hepatol

September 2024

European Reference Network RARE-LIVER, Hamburg, Germany; Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, Netherlands. Electronic address:

Article Synopsis
  • - A study involving 24 medical specialists developed a clinical decision framework for managing liver cyst infections, which often require long-term hospitalization and can have serious consequences.
  • - The modified Delphi method involved three rounds of surveys and discussions to gather expert opinions on management strategies and define treatment outcomes, resulting in consensus on various aspects of the condition.
  • - The experts identified important indicators like fever and elevated C-reactive protein for treatment decisions, along with subclassifications of liver cyst infections, leading to 26 agreed-upon management statements and two treatment algorithms.
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Article Synopsis
  • 90% of the 49 enrolled patients carried pathogenic or suspected pathogenic variants in known polycystic disease genes.
  • The research highlighted differences in organ volumes between patients with autosomal dominant polycystic kidney disease (ADPKD) and those with isolated PLD, indicating that some patients can experience severe liver disease without significant kidney involvement.
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Early diagnosis of tuberculous peritonitis in peritoneal dialysis patients using the T-SPOT test.

CEN Case Rep

December 2024

Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, 1-3-1, Kajigaya, Takatsu, Kawasaki, Kanagawa, 213-8587, Japan.

Article Synopsis
  • Despite negative cultures, his condition improved, and he was discharged 20 days later without peritonitis symptoms.
  • After a 40-day follow-up culture revealed Mycobacterium tuberculosis and the recurrence of peritonitis, a positive T-SPOT test led to successful anti-tuberculosis treatment, highlighting its potential for early diagnosis.
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  • A 28-year-old woman with untreated high blood pressure for 5 years was hospitalized due to breathing issues, coughing up blood, and eye problems.
  • Imaging revealed lung plaques and she experienced kidney damage, low platelets, and anemia.
  • After 8 weeks of antihypertensive treatment, her kidney function improved, leading to a diagnosis of malignant nephrosclerosis linked to a hypertensive crisis.
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Aims/introduction: This study aimed to identify risk factors that contribute to the progression of slowly-progressive type 1 diabetes by evaluating the positive predictive value (PPV) of factors associated with the progression to an insulin-dependent state.

Materials And Methods: We selected 60 slowly-progressive type 1 diabetes patients who tested positive for glutamic acid decarboxylase autoantibodies (GADA) at diagnosis from the Japanese Type 1 Diabetes Database Study. GADA levels in these patients were concurrently measured using both radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) techniques.

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The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline.

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We experienced three cases of a fever and subsequent severe, prolonged gross hematuria after COVID-19 vaccination. A kidney biopsy revealed immunoglobulin A (IgA) nephropathy, and electron microscopy showed two types of podocytopathy (podocyte damage): loss of foot processes from the glomerular basement membrane and foot process effacement. Mesangial interposition was also present in cases 1 and 3 but not in case 2.

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Introduction: Data on longitudinal trajectory of kidney function decline and fluctuation in albuminuria leading to end-stage kidney disease (ESKD) is sparse in patients with type 2 diabetes.

Methods: Using data from an observational study of patients with type 2 diabetes and biopsy-confirmed diabetic kidney disease (DKD), generalized additive mixed models (GAMMs) were performed to quantify patterns of longitudinal trajectory of estimated glomerular filtration rate (eGFR) decline to ESKD associated with repeated measures of urine albumin-to-creatinine ratio (ACR).

Results: Over a median follow-up period of 3.

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