A 20-year-old woman was admitted to our hospital with an elevated serum creatinine level of 1.61 mg/dL and a normal C-reactive protein level of less than 0.1 mg/dL. Her myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA) titer was slightly increased at 9.2 U/mL; a kidney biopsy revealed that 23 of 32 glomeruli had crescents. The expression of pentraxin 3 was detected in her kidney and her plasma pentraxin 3 level was elevated at 63.53 ng/mL. Plasma pentraxin 3 levels may be an activity marker for ANCAassociated glomerulonephritis, particularly when serum C-reactive protein levels are within the normal limits.
Calibration of the molecular rate is one of the major challenges in marine population genetics. Although the use of an appropriate evolutionary rate is crucial in exploring population histories, calibration of the rate is always difficult because fossil records and geological events are rarely applicable for rate calibration. The acceleration of the evolutionary rate for recent coalescent events (or more simply, the time dependency of the molecular clock) is also a problem that can lead to overestimation of population parameters. Calibration of demographic transition (CDT) is a rate calibration technique that assumes a post-glacial demographic expansion, representing one of the most promising approaches for dealing with these potential problems in the rate calibration. Here, we demonstrate the importance of using an appropriate evolutionary rate, and the power of CDT, by using populations of the sandy beach amphipod Haustorioides japonicus along the Japanese coast of the northwestern Pacific Ocean. Analysis of mitochondrial sequences found that the most peripheral population in the Pacific coast of northeastern Honshu Island (Tohoku region) is genetically distinct from the other northwestern Pacific populations. By using the two-epoch demographic model and rate of temperature change, the evolutionary rate was modeled as a log-normal distribution with a median rate of 2.2%/My. The split-time of the Tohoku population was subsequently estimated to be during the previous interglacial period by using the rate distribution, which enables us to infer potential causes of the divergence between local populations along the continuous Pacific coast of Japan.
Under certain pathologic conditions AGEs formation can be increased beyond normal levels.The purpose of the study was to investigate essential RF and AGEs before, immediately after and 2 days after runs. Nine trained runners (43 7 9yr) during 9.5 km and 13 trained runners (48 7 11yr) during 16.3 km long-distance runs were investigated. Standard blood and urinary RF parameters were investi-gated in all runners using spectrophotometric methods by Roche analyzer Integra 800.Serum cystatin C was determined using immu-noturbidimetric method (PETIA Gentian). Plasma AGEs and malon-dialdehyde (MDA) were determined by spectrofluorimetric methods, N e -carboxylmethyllysine using ELISA method and advanced oxidation protein products(AOPPs) using spectrophotometric method.Total proteinuria was 0.467 0.4 g/L after 9.5 km run and 0.35 7 0.3 g/L after 16.3 km run. Serum urea and creatinine significantly increased after both runs (creatinine in 28% after 9.5 km and in 41% after 16.3 km run). Estimated glomerular filtration rate (eGFR) MDRD and eGFR-PETIA significantly decreased after both runs (9.5 km: in 27.6% resp. 21.3% and 16.3 km: in 34,6% resp. 30.3%, p o0.01). Direct relationship between serum cystatin C and plasma AGEs after 16.3 km run was found (r ¼ 0.66, p ¼ 0,014). No significant changes in plasma AGEs (from 277 7 86-286 7 72 resp. from 2837 64-292 790 AU), CML (from 6197 78-665 7 131 resp. from 7247 92-762 7135 ng/mL) and AOPPs (from 1517 58-106 7 21 resp. from 1597 100-133 7 67 mmol/L) were found after both runs.
Keywords:cryptococcosis, amphotericin B, flucytosine, fluconazole 〈Abstract〉Here, we report a case of occult cryptococcuria involving the delayed development of cryptococcal meningitis after the initiation of hemodialysis. The patient was a 72-year-old Japanese male. His medical history included diabetes and hypertension. At the age of 71, he developed tubulointerstitial nephritis, and steroid treatment was started. However, he needed to start hemodialysis therapy due to progressive kidney dysfunction 7 months later. On admission for the initiation of hemodialysis, his laboratory data showed elevated inflammatory marker levels, and Cryptococcus neoformans was isolated from his urine. However, we decided to follow him without providing any specific therapy because a re-examination of his inflammatory marker levels and a urinary culture produced negative findings. He was hospitalized for fever and personality changes 34 days after the initiation of hemodialysis therapy. Cryptococcus was isolated from his spinal fluid, and he was diagnosed with cryptococcal meningitis. He was treated with liposomal amphotericin B and flucytosine, which cured his meningitis. The combination therapy was switched to fluconazole, and he was discharged. Hemodialysis patients are immunocom-渡邉 健太郎 神戸大学大学院医学研究科腎臓内科/腎・血液浄化センター 〒 ₆₅₀⊖₀₀₁₇ 兵庫県神戸市中央区楠町 ₇ 丁目 ₅⊖₂ Kentaro Watanabe Tel:₀₇₈⊖₃₈₂⊖₆₅₀₀ Fax:₀₇₈⊖₃₈₂⊖₆₅₀₉ 〔受付日:₂₀₁₆ 年 ₉ 月 ₁₃ 日,受理日:₂₀₁₆ 年 ₁₁ 月 ₁ 日〕
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