Purpose: This study aimed to evaluate masticatory performance in cases where one molar was missing.Methods: Participants were 156 adults with one molar missing from their natural teeth, who were ...divided into group A (without prosthetic treatment) and group B (with prosthetic treatment). The non-missing side was designated as A1 or B1, and the missing side was designated as A2 or B2. The amount of glucose eluted (AG) when the participants chewed a gummy jelly was measured and used as a parameter for masticatory performance. AG was compared between the non-missing side (A1, B1) and missing side (A2, B2), and between the first molar missing group and second molar missing group.Results: AG was significantly greater on the dentate side (P < 0.001) and was significantly less in the A2 group when the first molar was missing (P = 0.002). The rate of decrease of AG was 11.1%, 14.3%, and 8.4% in groups A+B, A, and B, respectively.Conclusion: Masticatory performance appears to decrease even with only one missing molar. Although improvement is achieved by prosthetic treatment, performance remains inferior to that on the dentate side.
A 71-year-old man with hypertension and diabetes mellitus presented with proteinuria. Laboratory data showed proteinuria of 3.1 g/g creatinine, serum albumin of 3.5 g/dL and serum creatinine of 1.03 ...mg/dL without autoantibodies. A renal biopsy revealed segmental granular IgG depositions on glomerular capillary walls. Electron microscopy showed segmentally subepithelial, intramembranous and mesangial deposits. Diffuse segmental membranous glomerulonephritis (MGN) was diagnosed with only IgG1 deposition and without M-type phospholipase A2 receptor or thrombospondin type-1 domain-containing 7A staining, suggesting secondary MGN with an unknown target antigen in immune deposits. Physicians should keep in mind the existence of segmental MGN to better understand the clinicopathological characteristics.
A 1-year multicenter prospective randomized controlled study was conducted on the effects of vitamin E-bonded polysulfone dialyzers on erythropoiesis-stimulating agent response in hemodialysis ...patients.
Major inclusion criteria were use of high-flux polysulfone dialyzers with 50-70 ml/min β2-microglobulin clearance over 3 months, transferrin saturation over 20%, same erythropoiesis-stimulating agent for over 3 months, and hemoglobin at 10-12 g/dl. Hemodialysis patients were placed in four interventional groups: two hemoglobin ranges (10.0-10.9 or 11.0-11.9 g/dl) and two dialyzers. Patients were randomly assigned by central registration to a vitamin E-bonded polysulfone dialyzers or polysulfone control group. Primary end point was relative erythropoiesis resistance index at baseline between groups at 12 months. Erythropoiesis resistance index was defined as total weekly erythropoiesis-stimulating agent dose divided by hemoglobin.
There were no statistically significant differences in age or sex. There was no significant difference in relative erythropoiesis resistance index between vitamin E-bonded polysulfone dialyzers and control groups at 12 months (vitamin E-bonded polysulfone dialyzers: 1.1, control: 1.3). The vitamin E-bonded polysulfone dialyzers group showed better relative erythropoiesis resistance index than the control group at 11.0-11.9 g/dl hemoglobin (vitamin E-bonded polysulfone dialyzers: 1.0, control: 1.4 at 12 months, significant difference) but no difference at 10.0-10.9 g/dl hemoglobin.
The overall relative erythropoiesis resistance index showed no difference between the vitamin E-bonded polysulfone dialyzers and control groups, although the change in relative erythropoiesis resistance index differed according to hemoglobin level.
We encountered a case of primary lung cancer complicated with membranous nephropathy as primary nephrotic syndrome. Because treatment approaches vary greatly for primary and secondary nephrotic ...syndrome, a renal biopsy was performed for diagnosis. Much time was required to make a definitive diagnosis of primary nephrotic syndrome, as opposed to paraneoplastic nephrotic syndrome. Consequently, the subsequent chemotherapy was ineffective and caused significant toxicity due to reduced performance status (PS) and progression of hypoalbuminemia. Therefore, it is imperative that a diagnosis be made and treatment be initiated without delay before PS declines and hypoalbuminemia progresses.
Background
Combination drugs containing an angiotensin receptor blocker and a calcium channel blocker have been widely commercialized in recent years, and their advantages, such as improvements in ...adherence, and reductions in medication costs, have been greatly emphasized. However, the actual situations and the impact of switching to combination drugs in clinical practice of nephrology are not fully understood.
Methods
This study was conducted in outpatients of nephrology who received antihypertensive medicines, and who switched to combination drugs. Changes in the potency of the antihypertensive drugs, and blood pressure were examined retrospectively before and after changing treatments. In addition, the study also involved patients’ questionnaire, which examined changes in blood pressure at home, the presence or absence of missed doses, the impact on medication-related expenses, and the level of patients’ satisfaction with regard to combination drugs.
Results
Survey results from 90 participants revealed that changing to combination drugs resulted in a reduction of missed doses, a decrease in blood pressure measured in an outpatient setting, and a reduction in medication-related expenses in total patients, non-chronic kidney disease (CKD) patients, and CKD patients.
Conclusion
Our study shows that switching to combination antihypertensive drugs resulted in an improvement in adherence and a reduction in medication-related expenses, and revealed that patient satisfaction was high. Combination drugs for hypertensive patients may be beneficial in both medical and economical viewpoints.
Because reactive oxygen species (ROS) are involved in the development of puromycin aminonucleoside nephrosis (PAN), we examined whether superoxide dismutase (SOD) could ameliorate this condition. ...Phosphatidyl choline–bound SOD (PC-SOD) has higher affinity for the cell membrane than recombinant human SOD (rhSOD). In this study, PC-SOD had a longer half-life in the circulation and also higher affinity to renal fractions (glomerulus, brush border, and tubulus) than rhSOD. PAN was induced in rats with single injections of puromycin aminonucleoside. Rats were divided into four groups: group P, PAN rats without treatment; group PC-T and group rh-T, PAN rats treated with 30,000 U/kg PC-SOD and rhSOD, respectively; and group C, normal controls. The effect of PC-SOD versus rhSOD on PAN was evaluated by morphological podocyte changes (podocyte density along the GBM) and α3 integrin expression at days 4 and 10. Proteinuria was measured over time until day 14. Distribution and quantitation of α3 integrin were studied by confocal laser scan microscopy. On day 4, glomerular ROS was measured by chemiluminescence without stimulation. PC-SOD decreased proteinuria to the control level, but rhSOD only decreased proteinuria by 31%. PC-SOD significantly improved podocyte density (P < 0.05 versus group P). Total α3 integrin expression decreased in the P and rh-T groups at day 4 and then had recovered by day 10, but the polarity of the site of expression did not recover. PC-T preserved both the amount and polarity of integrin expression on days 4 and 10. PC-SOD significantly suppressed ROS generation in PAN (P < 0.05). These findings suggest that α3 integrin regulates glomerular permeability by maintaining podocyte shape and adhesion, which is disrupted by ROS overproduction.
Background
To investigate the renoprotective effects and safety of angiotensin II receptor blocker (ARB) for patients with stage 4–5 chronic kidney disease.
Methods
An ARB, candesartan cilexetil, was ...administered to 13 patients (ARB group,
n
= 7; control group,
n
= 6) with a serum creatinine level of 2.52–5.95 mg/dl whose blood pressure had been maintained below 140/90 mmHg by the use of drugs other than ARBs. Routine measurements were conducted for 48 weeks, and renal survival analysis was observed for up to 3 years with the endpoints being doubling of the serum creatinine level, entry to hemodialysis, or death. The results were compared with those of the control group that was not treated with ARB.
Results
No significant changes were observed in the blood pressure in either group. Proteinuria significantly decreased from 0.95 ± 0.51 to 0.39 ± 0.12 g/day (paired
t
test,
P
= 0.033) in the ARB group, but did not change in the control group. Creatinine clearance in the control group decreased significantly from 16.2 ± 5.7 to 10.4 ± 4.8 ml/min per 1.73 m
2
(paired
t
test,
P
= 0.011), but did not change in the other group. Thus, the slopes of the reciprocal serum creatinine values became less steep in the ARB group as compared with the control (−0.002 ± 0.015 vs. −0.025 ± 0.015 dl/mg per month; unpaired
t
test,
P
= 0.019). Kaplan–Meier analysis revealed that ARB exhibited more favorable renal outcome at 3 years (log-rank,
P
= 0.025). No serious adverse events were noted in the study.
Conclusion
These results show that ARB reduces proteinuria and protects renal function even in the advanced renal failure.
Purpose: This study aimed to evaluate masticatory performance in cases where one molar was missing.Methods: Participants were 156 adults with one molar missing from their natural teeth, who were ...divided into group A (without prosthetic treatment) and group B (with prosthetic treatment). The non-missing side was designated as A1 or B1, and the missing side was designated as A2 or B2. The amount of glucose eluted (AG) when the participants chewed a gummy jelly was measured and used as a parameter for masticatory performance. AG was compared between the non-missing side (A1, B1) and missing side (A2, B2), and between the first molar missing group and second molar missing group.Results: AG was significantly greater on the dentate side (P < 0.001) and was significantly less in the A2 group when the first molar was missing (P = 0.002). The rate of decrease of AG was 11.1%, 14.3%, and 8.4% in groups A+B, A, and B, respectively.Conclusion: Masticatory performance appears to decrease even with only one missing molar. Although improvement is achieved by prosthetic treatment, performance remains inferior to that on the dentate side.
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