Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
1.
Sci Rep ; 12(1): 6367, 2022 04 16.
Article in English | MEDLINE | ID: mdl-35430596

ABSTRACT

The identification of acquired resistance mutations has been essential in non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) active mutations. Rebiopsy plays a pivotal role in selecting the optimal treatment for patients who develop resistance to initial EGFR-tyrosine kinase inhibitors (EGFR-TKIs). This multicenter, observational study was conducted to investigate the details of rebiopsy in Japanese clinical practice. The primary endpoints were the implementation rate of rebiopsy and the concordance rate for T790M mutation detection between histological and cytological specimens using the cobas EGFR Mutation Test, version 2. One hundred ninety-four patients with EGFR-mutant NSCLC were enrolled, and 120 patients developed acquired resistance to EGFR-TKIs. The median age was 68 years (range 20-87), and 52.5% of the patients were women. Rebiopsy was performed in 109 patients, and the implementation rate of rebiopsy was 90.8%. The success rates of rebiopsy in the total, histology, cytology and liquid biopsy populations were 67.9%, 81.3%, 66.7% and 43.8%, respectively. The positive percent agreement and the negative percent agreement in the detection of the T790M mutation between the histological and cytological specimens were both 90.9%. Obtaining histological or cytological tissue samples at rebiopsy may contribute to improving the detection rate of the T790M mutation (trial registration number: UMIN000026019).


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Adult , Aged , Aged, 80 and over , Biopsy , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/enzymology , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Drug Resistance, Neoplasm , ErbB Receptors , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/enzymology , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Middle Aged , Mutation , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Young Adult
2.
Intern Med ; 55(18): 2649-58, 2016.
Article in English | MEDLINE | ID: mdl-27629962

ABSTRACT

A 73-year-old Japanese woman with untreated Graves' hyperthyroidism developed glucocorticoid-induced adrenal insufficiency (AI) after a supraphysiological dose of prednisolone therapy for bronchial asthma. Days later, she had high plasma adrenocorticotropic hormone (ACTH) levels and was expected to recover from glucocorticoid-induced AI. Her plasma ACTH levels remained high over 3 months during a physiological dose of hydrocortisone replacement. However, she suffered a further decrease in her serum cortisol level and was diagnosed with isolated adrenocorticotropin deficiency (IAD), in which bioinactive ACTH likely caused the high ACTH value. IAD should be considered as an unusual disorder associated with Graves' disease, especially in older patients.


Subject(s)
Adrenal Insufficiency/chemically induced , Adrenocorticotropic Hormone/blood , Adrenocorticotropic Hormone/deficiency , Asthma/drug therapy , Endocrine System Diseases/chemically induced , Genetic Diseases, Inborn/chemically induced , Glucocorticoids/adverse effects , Graves Disease/drug therapy , Hydrocortisone/therapeutic use , Hypoglycemia/chemically induced , Prednisolone/adverse effects , Adrenal Insufficiency/drug therapy , Adrenal Insufficiency/physiopathology , Adrenocorticotropic Hormone/drug effects , Aged , Anorexia/blood , Anorexia/drug therapy , Antithyroid Agents/therapeutic use , Fatigue/blood , Fatigue/drug therapy , Female , Glucocorticoids/therapeutic use , Graves Disease/complications , Graves Disease/physiopathology , Humans , Hydrocortisone/blood , Prednisolone/therapeutic use , Treatment Outcome
3.
Gan To Kagaku Ryoho ; 41(7): 869-73, 2014 Jul.
Article in Japanese | MEDLINE | ID: mdl-25131874

ABSTRACT

We report a case of a 38-year-old man who was diagnosed with a mediastinal germ cell tumor. After induction chemotherapy, the tumor marker levels normalized, but the tumor itself continued to grow. Surgical resection was performed successfully, but the patient developed acute megakaryoblastic leukemia 6 months later, and induction and consolidation therapies failed to achieve remission. Leukemia cells invaded the central nervous system following hematopoietic stem cell transplantation, and the patient died 5 months after being diagnosed with leukemia. This very rare case of a mediastinal germ cell tumor met the criteria for "growing teratoma syndrome", against a background of acute megakaryoblastic leukemia.


Subject(s)
Leukemia, Megakaryoblastic, Acute/therapy , Neoplasms, Germ Cell and Embryonal/therapy , Teratoma/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fatal Outcome , Humans , Male , Neoplasm Invasiveness
4.
Nihon Kokyuki Gakkai Zasshi ; 49(2): 97-102, 2011 Feb.
Article in Japanese | MEDLINE | ID: mdl-21400905

ABSTRACT

We describe 2 cases of IgG4-related disease with pleural effusion in elderly men. Both patients had elevated serum IgG4 levels, and the characteristics of their pleural effusion were similar. Patient 1 had pericardial effusion and retroperitoneal fibrosis, and a biopsy specimen from the pericardium showed infiltration of abundant IgG4-positive plasma cells with fibrosis. Because his pleurisy, pericarditis and retroperitoneal fibrosis responded to steroid therapy, we diagnosed pleurisy associated with IgG4-related disease. Patient 2 had been treated with steroids because of IgG4-related sialadenitis and interstitial pneumonitis, but pleural effusion developed. Although histopathological examination of the pleura showed infiltration of abundant IgG4-positive plasma cells with fibrosis, Mycobacterium tuberculosis was cultured from the pleural effusion, and histologic examination also showed epithelioid granuloma. Chemotherapy for tuberculosis was effective for the pleurisy, and we diagnosed tuberculous pleurisy as a complication of IgG4-related disease. In cases of IgG4-related disease associated with pleural effusion, the clinical course should be considered together with the serum IgG4 levels and pleural histology.


Subject(s)
Immunoglobulin G/blood , Pleural Effusion/complications , Aged , Humans , Lung Diseases, Interstitial/complications , Male , Pericardial Effusion/complications , Pleural Effusion/pathology , Pneumonia/complications , Retroperitoneal Fibrosis/complications , Sialadenitis/complications , Tuberculosis, Pleural/complications
5.
Nihon Kokyuki Gakkai Zasshi ; 47(7): 652-7, 2009 Jul.
Article in Japanese | MEDLINE | ID: mdl-19637811

ABSTRACT

A 63-year-old man was admitted to our hospital, because of exacerbation of backache and erythema. At the time of admission the chest X-ray film showed infiltrative shadows in the left middle and lower lung fields. Our investigation revealed primary mucinous type bronchioloalveolar carcinoma in the left lung (cT4N2M1 Stage IV). Radiotherapy (C7-Th2, L3-L5. Total 30 Gy/10 fr) was administered to relieve his pain. After radiotherapy, he developed respiratory failure, fever, and infiltrative shadow in his chest X-ray. Antibiotic therapy improved his symptoms, laboratory findings and radiological abnormal findings. We suspected complication with nosocomial infection. However the ground-glass appearance appeared in the right lung a few days later. Although antibiotics and steroids were administered, he died of respiratory failure in 6 days. Necropsy findings revealed bronchioloalveolar carcinoma in the right lung suggesting aerogenous metastasis. Considering these facts together, we diagnosed non-small cell lung carcinoma dying of acute respiratory failure due to aerogenous metastasis.


Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/secondary , Carcinoma, Non-Small-Cell Lung/pathology , Lung Neoplasms/pathology , Respiratory Insufficiency/etiology , Acute Disease , Carcinoma, Non-Small-Cell Lung/secondary , Humans , Lung Neoplasms/secondary , Male , Middle Aged
6.
Intern Med ; 48(4): 203-8, 2009.
Article in English | MEDLINE | ID: mdl-19218769

ABSTRACT

OBJECTIVE: To assess the relationship between in vitro chemosensitivity evaluated by the histoculture drug response assay (HDRA) and the expression of beta-tubulin isotypes in tumors of patients with completely resected NSCLC in order to determine the predictive value of beta-tubulin in chemotherapy for NSCLC. METHODS: Expression of beta-tubulin isotypes was immunohistochemically analyzed in a series of 58 tumor samples from patients with completely resected NSCLC. The sensitivity of individual tumors to anticancer agents was evaluated by HDRA. RESULTS: Class III beta-tubulin expression by tumor cells was significantly correlated with resistance to docetaxel (p=0.0250), but not related with resistance to gemcitabine. Patient characteristics (age, gender, histology, and stage) were not associated with class III beta-tubulin expression. CONCLUSION: An abundance of class III beta-tubulin in tumor cells could be a biomarker for resistance to docetaxel in patients with completely resected NSCLC.


Subject(s)
Antineoplastic Agents/pharmacology , Carcinoma, Non-Small-Cell Lung/metabolism , Drug Resistance, Neoplasm , Lung Neoplasms/metabolism , Taxoids/pharmacology , Tubulin/metabolism , Aged , Biomarkers, Tumor/metabolism , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/surgery , Cells, Cultured , Docetaxel , Drug Screening Assays, Antitumor , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Male
7.
Rheumatol Int ; 29(11): 1363-6, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19089428

ABSTRACT

A 64-year-old Japanese female, diagnosed as dermatomyositis with acute interstitial pneumonia, complained of acute abdominal pain. Computed tomography of the abdomen showed hematoma in the right retroperitoneum and left rectus-sheath. Angiogram showed multiple small aneurysms on left iliolumbar artery and a horizontal linear flush, suggesting active bleeding foci in the muscles. Although arterial embolization therapy was effective for hemostatic treatment, she died of thrombotic thrombocytopenic purpura and multiple organ failure without respiratory insufficiency. Other causes of microaneurysm, such as systemic vasculitides or infectious diseases, were excluded. We considered that this is the first case report of dermatomyositis with hemorrhagic myositis associated with small aneurysms.


Subject(s)
Dermatomyositis/complications , Hemorrhage/etiology , Myositis/etiology , Abdominal Pain/etiology , Aneurysm/complications , Female , Hematoma/complications , Hematoma/etiology , Hemorrhage/diagnosis , Humans , Middle Aged , Retroperitoneal Space
8.
Clin Cancer Res ; 14(21): 6770-9, 2008 Nov 01.
Article in English | MEDLINE | ID: mdl-18980970

ABSTRACT

PURPOSE: Small cell lung cancer (SCLC) possesses high tendency to disseminate. However, SCLC patients with paraneoplastic syndrome mediated by immunity against onconeural antigens remain in limited-stage disease (LD) without distant metastases. Cumulative evidence regulates that a balance between immune and regulatory T (Treg) cells determines the magnitude of immune responses to not only self-antigens but also tumor-associated antigens. The purpose of this study was to elucidate the immunologic balance induced in SCLC patients. EXPERIMENTAL DESIGN: We analyzed T cells in the peripheral blood of 35 consecutive SCLC patients, 8 long-term survivors, and 19 healthy volunteers. RESULTS: Purified CD4(+) T cells with down-regulated expression of CD62L (CD62L(low)) produced IFN-gamma, interleukin (IL)-4, and IL-17, thus considered to be immune effector T cells (Teff). Significantly more Teff cell numbers were detected in LD-SCLC patients than that of extended-stage SCLC (ED-SCLC). By contrast, induction of CD62L(high)CD25(+) CD4(+) Treg cells was significantly higher in ED-SCLC patients. Long-term survivors of SCLC maintained a high Teff to Treg cell ratio, whereas patients with recurrent disease exhibited a low Teff to Treg cell ratio. Teff cells in LD-SCLC patients included more IL-17-producing CD4(+) T cells (Th17). Moreover, dendritic cells derived from CD14(+) cells of LD-SCLC patients secreted more IL-23. CONCLUSION: These results show that CD4(+) T-cell balance may be a biomarker that distinguishes ED-SCLC from LD-SCLC and predicts recurrence. This study also suggests the importance of inducing Teff cells, particularly Th17 cells, while eliminating Treg cells to control systemic dissemination of SCLC.


Subject(s)
CD4 Antigens/analysis , L-Selectin/analysis , Lung Neoplasms/immunology , Small Cell Lung Carcinoma/immunology , T-Lymphocytes, Regulatory/immunology , Adult , Aged , Female , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Prognosis , Small Cell Lung Carcinoma/pathology , T-Lymphocyte Subsets/immunology
9.
Gan To Kagaku Ryoho ; 35(1): 109-11, 2008 Jan.
Article in Japanese | MEDLINE | ID: mdl-18195537

ABSTRACT

Post-operative adjuvant chemotherapy(POAC)combining cisplatin(CDDP)and vinorelbine(VNR)for non-small cell lung cancer(NSCLC)patients is considered as a standard regimen. However, some Japanese investigators point out the toxic profile of this regimen in the practice settings. Thus, five consecutive patients with mean age of 61.6 years old were treated to evaluate the feasibility of this regimen among Japanese patients. Three male and 2 female patients were enrolled, with post-operative stage of IIB/IIIA/IIIB in 1/2/2 patients, respectively. CDDP was administered on day 1 at 80 mg/m(2), and VNR on days 1 and 8 at 25 mg/m(2) intravenously, every 21 days. The regimen was aimed to complete 4 cycles, and 4 patients have completed the treatment without reducing the doses. Average treatment interval was 23 days. Four patients experienced grade(Gr)4 neutropenia, and 1 patient had Gr 3 liver damage. Other mild toxicities included Gr 1 nausea/vomiting in all patients, and Gr 1 GFR reduction in 3 patients. Combination of CDDP and VNR seems to be tolerable in terms of POAC, with relatively mild toxicity profile similar to the previous reports.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Non-Small-Cell Lung/drug therapy , Cisplatin/therapeutic use , Lung Neoplasms/drug therapy , Vinblastine/analogs & derivatives , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/surgery , Chemotherapy, Adjuvant , Cisplatin/administration & dosage , Cisplatin/adverse effects , Female , Humans , Lung Neoplasms/pathology , Lung Neoplasms/surgery , Male , Middle Aged , Vinblastine/administration & dosage , Vinblastine/adverse effects , Vinblastine/therapeutic use , Vinorelbine
10.
Cell Immunol ; 243(1): 30-40, 2006 Sep.
Article in English | MEDLINE | ID: mdl-17207783

ABSTRACT

Dendritic-tumor heterokaryons generated by electrofusion are highly immunogenic. In animal studies, a single vaccination was therapeutic for tumors established in the lung, skin, and brain. However, effective therapy required a third signal which could be provided by exogenous IL-12 or the agonistic anti-OX-40R monoclonal antibody (mAb). In this study, we investigated the mechanism and mode of actions of these two seemingly distinct adjuvants. In immunotherapy of the MCA205 sarcoma, administration of the neutralizing anti-IL-12 mAb nearly completely blocked the adjuvant effect of IL-12, but had minimal inhibitory effects on anti-OX-40R mAb. By contrast, in vivo administration of the antagonistic anti-OX-40L mAb inhibited the adjuvant effects of both IL-12 and anti-OX-40R mAb. Thus, a common pathway of endogenous OX-40 interaction is critical for the development of a therapeutic immune response. Analysis of the third signal mechanism revealed that in the absence of an adjuvant, vaccination with fusion hybrids led to IL-10 production without eliciting IFN-gamma secreting cells. The addition of IL-12 to vaccination suppressed IL-10 production and initiated sensitization of specific IFN-gamma secreting cells, resulting in a type 1-like antitumor immunity. These findings underscore the significance of the third signal in the design of dendritic cell-based cancer vaccines.


Subject(s)
Adjuvants, Immunologic/pharmacology , Cancer Vaccines/therapeutic use , Dendritic Cells/immunology , Immunity, Cellular , Interleukin-12/pharmacology , OX40 Ligand/pharmacology , Sarcoma, Experimental/therapy , Animals , Antibodies, Monoclonal/immunology , Cell Fusion , Dendritic Cells/metabolism , Female , Interferon-gamma/metabolism , Interleukin-10/metabolism , Interleukin-12/therapeutic use , Mice , Mice, Inbred C57BL , OX40 Ligand/therapeutic use , Vaccination/methods
11.
J Neurosurg ; 103(1): 156-64, 2005 Jul.
Article in English | MEDLINE | ID: mdl-16121986

ABSTRACT

OBJECT: Immunotherapy for malignant brain tumors by active immunization or adoptive transfer of tumor antigen-specific T lymphocytes has the potential to make up for some of the limitations of current clinical therapy. In this study, the authors tested whether active immunotherapy is curative in mice bearing advanced, rapidly progressive intracranial tumors. METHODS: Tumor vaccines were created through electrofusion of dendritic cells (DCs) and irradiated tumor cells to form multinucleated heterokaryons that retained the potent antigen processing and costimulatory function of DCs as well as the entire complement of tumor antigens. Murine hosts bearing intracranial GL261 glioma or MCA 205 fibrosarcoma were treated with a combination of local cranial radiotherapy, intrasplenic vaccination with DC/tumor fusion cells, and anti-OX40R (CD134) monoclonal antibody (mAb) 7 days after tumor inoculation. Whereas control mice had a median survival of approximately 20 days, the treated mice underwent complete tumor regression that was immunologically specific. Seven days after vaccination treated mice demonstrated robust infiltration of CD4+ and CD8+ T cells, which was exclusively confined to the tumor without apparent neurological toxicity. Cured mice survived longer than 120 days with no evidence of tumor recurrence and resisted intracranial tumor challenge. CONCLUSIONS: These data indicate a strategy to achieve an antitumor response against tumors in the central nervous system that is highly focused from both immunological and anatomical perspectives.


Subject(s)
Brain Neoplasms/drug therapy , Cancer Vaccines/therapeutic use , Dendritic Cells/physiology , Fibrosarcoma/drug therapy , Glioma/drug therapy , Immunotherapy, Active/methods , Animals , Brain Neoplasms/radiotherapy , Cell Fusion , Chemotherapy, Adjuvant , Disease Models, Animal , Female , Fibrosarcoma/radiotherapy , Glioma/radiotherapy , Mice , Mice, Inbred C57BL , Radiotherapy, Adjuvant , Receptors, OX40 , Receptors, Tumor Necrosis Factor/antagonists & inhibitors , Receptors, Tumor Necrosis Factor/therapeutic use
12.
Gan To Kagaku Ryoho ; 31(11): 1637-9, 2004 Oct.
Article in Japanese | MEDLINE | ID: mdl-15553668

ABSTRACT

The findings summarized here provide a direct comparison of the immunogenicity of various DC loading strategies included pulsing with protein, peptide, tumor cell lysate, irradiated tumor cells and electrofusion of DCs and tumor cells. For the treatment of 3-day established pulmonary metastases, electrofusion of DCs and tumor cells generated a therapeutic vaccine far superior to other methods of DC loading. Consistent with their therapeutic activity, fusion hybrids stimulated the release of the largest amount of interferon-gamma from immune T cells. However, IL-10 secretion did not correlate with in vivo therapeutic reactivity. In conclusion, DC-tumor fusion hybrids were the most effective vaccine to eradicate existing tumors. These data support the use of DC-tumor electrofusion cells for the treatment of human cancer.


Subject(s)
Antigens, Neoplasm/immunology , Cancer Vaccines/immunology , Dendritic Cells/immunology , Lung Neoplasms/therapy , Melanoma, Experimental/therapy , Animals , Cell Fusion/methods , Female , Hybrid Cells/immunology , Interferon-gamma/metabolism , Interleukin-10/metabolism , Lung Neoplasms/secondary , Mice , Mice, Inbred C57BL , Pulse , Vaccination
13.
J Immunother ; 27(4): 265-72, 2004.
Article in English | MEDLINE | ID: mdl-15235387

ABSTRACT

Dendritic cells (DCs) loaded with antigens can effectively stimulate host immune responses to syngeneic tumors, but there is considerable controversy as to which forms of antigen-loading are most immunogenic. Here, the authors compared immunotherapeutic reactivities of DCs loaded with a variety of antigen preparations. Because DC maturation stages affect their capacities of antigen processing and presentation, two DC populations were used for the current analysis: in vivo Flt-3 ligand-induced mature DCs and in vitro bone marrow-derived DCs, which were less mature. To facilitate a direct comparison, the LacZ gene-transduced B16 melanoma model system was used, where beta-galactosidase served as the surrogate tumor-rejection antigen. DC loading strategies included pulsing with the beta-galactosidase protein, H-2K restricted peptide, tumor cell lysate, and irradiated tumor cells and fusion of DCs with tumor cells. Our results demonstrated that electrofusion of DCs and tumor cells generated a therapeutic vaccine far superior to other methods of DC loading. For the treatment of 3-day established pulmonary tumor nodules, a single intranodal vaccination plus IL-12 resulted in a significant reduction of metastatic nodules, while other DC preparations were only marginally effective. Immunotherapy mediated by the fusion cells was tumor antigen-specific. Consistent with their therapeutic activity, fusion hybrids were the most potent stimulators to induce specific IFN-gamma secretion from immune T cells. Furthermore, fusion cells also stimulated a small amount of IL-10 production from immune T cells. However, this IL-10 secretion was also induced by other DC preparations and did not correlate with in vivo therapeutic reactivity.


Subject(s)
Antigens/immunology , Dendritic Cells/immunology , Immunotherapy/methods , Neoplasms/immunology , Neoplasms/therapy , Animals , Antigen Presentation/immunology , Cancer Vaccines/immunology , Cell Fusion , Cells, Cultured , Female , Interferon-gamma/metabolism , Interleukin-10/metabolism , Lymphocyte Activation/immunology , Mice , Mice, Inbred BALB C , Neoplasms/pathology , T-Lymphocytes/metabolism
14.
Clin Exp Nephrol ; 7(4): 290-5, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14712359

ABSTRACT

A 24-year-old woman was admitted to Toyosaka Hospital with proteinuria, hematuria, lymphopenia, hypocomplementemia, positive anti-nuclear antibody (ANA), and elevation of anti-streptolysin O (ASO). Renal biopsy specimen revealed diffuse mesangial and endocapillary glomerulonephritis with crescent formation and duplication of the capillary loop on light microscopic examination. Mild to moderate proliferation of mesangial matrix and cells were observed. On immunofluorescence (IF) examination, deposition of IgG, IgA, IgM, C1q, C3, and C4 to the mesangium and capillary wall were observed. By electron microscopy (EM), mesangial, subendothelial, and subepithelial deposits were recognized. However, microtubular structure in glomerular endothelial cells, fingerprint structures, and circumferential mesangial interposition were not observed by EM. The patient was referred to our hospital, but there was no change in her proteinuria 3 weeks after admission. The elevation of ASO, hypocomplementemia, and endocapillary proliferation suggested acute glomerulonephritis, while lymphocytopenia, positive ANA, the persistent hypocomplementemia, and various deposits detected by IF and EM suggested lupus nephritis; however, she did not fulfill the classification criteria of systemic lupus erythematosus. We started prednisolone (40 mg/day) with the diagnosis of chronic glomerulonephritis revealing diffuse mesangial and endocapillary proliferative glomerulonephritis, but it was not effective for the proteinuria. Quinapril (10 mg/day) and losartan (25 to 50 mg/day) were administered and the proteinuria decreased. It is possible that this use of an angiotensin converting-enzyme inhibitor and an angiotensin II receptor antagonist was effective in reducing the proteinuria in this patient.


Subject(s)
Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Complement System Proteins/deficiency , Glomerulonephritis, Membranoproliferative/pathology , Prednisolone/therapeutic use , Streptolysins/immunology , Adult , Angiotensin II/metabolism , Female , Humans , Kidney Glomerulus/pathology , Lupus Nephritis/complications , Lupus Nephritis/pathology
SELECTION OF CITATIONS
SEARCH DETAIL
...