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論文
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Furuichi, Kengo ; Yuzawa, Yukio ; Shimizu, Miho ; Hara, Akinori ; Toyama, Tadashi ; Kitamura, Hiroshi ; Suzuki, Yoshiki ; Sato, Hiroshi ; Uesugi, Noriko ; Ubara, Yoshifumi ; Hisano, Satoshi ; Ueda, Yoshihiko ; Nishi, Shinichi ; Yokoyama, Hitoshi ; Nishino, Tomoya ; Kohagura, Kentaro ; Ogawa, Daisuke ; Mise, Koki ; Shibagaki, Yugo ; Kimura, Kenjiro ; Haneda, Masakazu ; Makino, Hirofumi ; Matsuo, Seiichi ; Wada, Takashi ; 古市, 賢吾 ; 清水, 美保 ; 原, 章規 ; 遠山, 直志 ; 和田, 隆志
概要:
金沢大学医薬保健研究域医学系<br />Background. The clinical and pathologic manifestations of nephropathy due to type 2 diabetes are div
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erse, but large-scale pathologic studies with long-termobservations are limited. Methods. Kidney biopsies and clinical data of 600 patients with type 2 diabetes were collected retrospectively from 13 centres across Japan. Thirteen pathologic findings (nine glomerular lesions, two interstitial lesions and two vascular lesions) were clearly defined and scored. Results. During the observation period, there were 304 composite kidney events [dialysis, doubling of creatinine or reduction of estimated glomerular filtration rate (eGFR) by half], 31 instances of chronic kidney disease (CKD) G5D, 76 cardiovascular events and 73 deaths. The mean observation period was 72.4 months. The distribution of CKD heat map categories for the 600 patients was 103 green or yellow, 149 orange and 348 red. Even in the cases in the green and yellow category, diffuse lesions (81.6%), polar vasculosis (42.6%) and subendothelial space widening (35.1%) were commonly detected. Cox proportional hazard analysis revealed that the presence of nodular lesions [hazard ratio (HR) 21.1, 95% confidence interval (CI) 5.3-84.6], exudative lesions (HR 5.1, 95% CI 1.3-20.3) and mesangiolysis (HR 7.6, 95% CI 2.0-28.8) in cases in the green and yellow category were associated with significantly great impact on composite kidney events after adjustment for clinical risk factors. Conclusions. This nationwide study on kidney biopsy of 600 cases with type 2 diabetes revealed that pathologic findings (presence of nodular lesions, exudative lesions and mesangiolysis) were strong predictors of kidney events in low-risk patients. © The Author 2017.<br />Embargo Period 12 months
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徳丸, 季聡 ; 遠山, 直志 ; 和田, 隆志 ; Tokumasu, Toshiaki ; Toyama, Takashi ; Wada, Takashi
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修士課程優秀論文
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遠山, 直志 ; Toyama, Tadashi
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博士論文要旨Abstract 以下に掲載：PLOS ONE 8(8) pp.e71810-e71810 2013. Library pf science. 共著者：Tadashi Toyama, Kengo Furuichi, Toshih
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aru Ninomiya, Miho Shimizu, Akinori Hara, Yasunori Iwata, Shuichi Kaneko, Takashi Wada
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学位論文 |
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遠山, 直志 ; Toyama, Tadashi
概要:
博士論文本文Full 以下に掲載：PLOS ONE 8(8) pp.e71810-e71810 2013. Library pf science. 共著者：Tadashi Toyama, Kengo Furuichi, Toshiharu Ninomiya, Miho Shimizu, Akinori Hara, Yasunori Iwata, Shuichi Kaneko, Takashi Wada
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北島, 信治 ; 遠山, 直志 ; 原, 章規 ; 岩田, 恭宜 ; 坂井, 宣彦 ; 清水, 美保 ; 古市, 賢吾 ; 和田, 隆志
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坂井, 宣彦 ; 遠山, 直志 ; 岩田, 恭宣 ; 清水, 美保 ; 古市, 賢吾 ; 今村, 龍 ; 須田, 貴司 ; 金子, 周一 ; 和田, 隆志
概要:
金沢大学医薬保健研究域医学系<br />Mortality from infections has been reported to be higher in hemodialysis (HD) patients. Although dys
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function of neutrophils against bacterial infection was reported in HD patients, the precise mechanism remains to be clarified. We therefore examined the impacts of neutrophil inflammatory signaling on bactericidal activity in HD patients. Comprehensive analyses of intracellular signalings were performed in whole blood of HD patients and control using a microarray system. To confirm the contribution of the signaling to bactericidal activity in neutrophils, we examined the phosphorylation, bacterial killing function, reactive oxygen species (ROS) production, and myeloperoxidase (MPO) release in neutrophils against Staphylococcus aureus. RNA microarray analysis showed the suppression of p38 mitogen activated protein kinase (MAPK) signaling in HD patients. Neutrophils in HD patients showed the impairment of bactericidal activity against S. aureus compared to healthy subjects. Phosphorylation rate of p38MAPK of neutrophils in response to S. aureus was lower in HD patients than healthy subjects. The levels of ROS produced by neutrophils after co-culture with S. aureus were lower in HD patients, on the other hand, there was no difference of MPO release between HD patients and healthy subjects. A selective pharmacological inhibitor of p38MAPK suppressed bacterial killing function as well as ROS production in neutrophils of healthy subjects. Impairment of p38MAPK signaling pathway might contribute to the suppression of neutrophil bactericidal activity in HD patients through less production of ROS. © 2018 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.<br />Embargo Period 12 months
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遠山, 直志 ; Toyama, Tadashi
概要:
金沢大学附属病院集中治療部<br />慢性腎臓病（CKD）の進展に関連した尿酸の影響について、1998年から2007年までに健康診断を受診した方を対象に縦断的な検討を行った。eGFR 60 mL/min/1.73 m2 未満をアウトカムとし
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た検討では、男性において尿酸値 4-4.9 mg/dL の群と比較して、尿酸値 6 mg/dL 以上の群においてリスクが高値であった。女性においても同様の検討を行ったが、明らかな傾向は認めなかった。一方で蛋白尿 1+ 以上をアウトカムとした検討では、女性において血清尿酸値 6 mg/dL 以上の群が 4 mg/dL 未満の群と比較してリスクが高値であり、男性では明らかな傾向を認めなかった。<br />A longitudinal study was conducted for those who received a medical examination from 1998 to 2007 on the relationships between serum uric acid (SUA) and the development of chronic kidney disease (CKD). In a study with eGFR less than 60 mL /min/1.73m2 as an outcome, the risk was high in the group with SUA 6 mg/dL or higher, compared to the group with SUA 4 to 4.9 mg/dL in men. The same study was done for women, but no obvious trend was observed. On the other hand, in a study with proteinuria 1+ or more as an outcome, the risk is higher in women with SUA 6 mg/dL or higher than the group with SUA less than 4 mg/dL, and an obvious trend was not observed in men.<br />研究課題/領域番号:26870218, 研究期間(年度):2014-04-01 - 2017-03-31
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