Importance of AST-120 (Kremezin®) Adherence in a Chronic Kidney Disease Patient with Diabetes.

We report herein an adult case of chronic kidney disease (CKD) associated with diabetes. The patient had been treated with insulin injection for diabetes 10 years ago. At the time of his first visit to our division for further examinations, we diagnosed him as CKD: cause (C) diabetes; glomerular filtration rate (GFR) (G) G5 (estimated [e] GFR, 10.2 mL/min/1.73 m2; serum creatinine of 4.90 mg/dL); and albuminuria (A) A3 (2.62 g/gCr) by the Japanese Society of Nephrology (JSN) CGA classification. Because he had complained of severe constipation and kidney function, i.e., eGFR was not improved by previous medications, we added on a minimal dosage (2 g/day) of AST-120 (Kremezin®; ordinary dose 6 g/day). After 3 months of AST-120 therapy, eGFR was increased to 17.8 mL/min/1.73 m2 (serum creatinine of 2.90-2.72 mg/dL). Although the patient used some laxative products, he could not continue to take Kremezin and completely stopped 8 months after starting this drug. Kidney function then abruptly declined and progressed to end-stage kidney disease (ESKD). In June 2017, he was introduced to hemodialysis. It appears that the adherence of Kremezin is very important for inhibiting the progression to ESKD for patients with CKD with diabetes.

Impact of preoperative ultrasonography findings on the patency rate of vascular access in Japanese hemodialysis patients.

BACKGROUND: Although ultrasonography before a vascular access (VA) operation has become popular in recent years, benchmarks for the diameter or blood flow of arteries or veins are not defined in Japan. The objective of the present study is to analyze the relationship between preoperative US findings and the patency rate of VA in Japanese hemodialysis patients. METHODS: 139 patients with end stage kidney disease were enrolled in this study. They had been given primary radiocephalic arteriovenous fistula (AVF) from February 2009 to December 2010 at the Juntendo University Hospital and were followed up over 2 years. We defined the interval from the time of AVF creation until first access thrombosis or any intervention to maintain or restore blood flow as patency time (primary patency). We examined the correlation between the 2-year primary patency rate of VA and the diameter of the radial artery (RA), brachial artery (BA), or cephalic vein at an anastomosis presumptive region by US, the blood flow of RA or BA, as measured by US, age, gender, and primary kidney diseases. RESULTS: The average patency term was 448.6 ± 271.3 days, with the 1-year and 2-year patency rate as 64.0 and 51.2 %, respectively. The patency rate was significantly lower in elderly patients over the age of 75 and in patients with diabetes mellitus. US findings of 2.0 mm or less in the RA diameter also resulted in a noticeably low patency rate. A multivariate analysis indicated that those factors were risk factors for early VA failure. CONCLUSIONS: Preoperative US findings of the diameter of RA may involve the patency rate of VA, making it appears that an RA of 2.0 mm or more in diameter at an anastomosis region may be more effective for the improvement in the patency rate of VA.

Oxidation of primary amines to oximes with molecular oxygen using 1,1-diphenyl-2-picrylhydrazyl and WO3/Al2O3 as catalysts.

The oxidative transformation of primary amines to their corresponding oximes proceeds with high efficiency under molecular oxygen diluted with molecular nitrogen (O2/N2 = 7/93 v/v, 5 MPa) in the presence of the catalysts 1,1-diphenyl-2-picrylhydrazyl (DPPH) and tungusten oxide/alumina (WO3/Al2O3). The method is environmentally benign, because the reaction requires only molecular oxygen as the terminal oxidant and gives water as a side product. Various alicyclic amines and aliphatic amines can be converted to their corresponding oximes in excellent yields. It is noteworthy that the oxidative transformation of primary amines proceeds chemoselectively in the presence of other functional groups. The key step of the present oxidation is a fast electron transfer from the primary amine to DPPH followed by proton transfer to give the α-aminoalkyl radical intermediate, which undergoes reaction with molecular oxygen and hydrogen abstraction to give α-aminoalkyl hydroperoxide. Subsequent reaction of the peroxide with WO3/Al2O3 gives oximes. The aerobic oxidation of secondary amines gives the corresponding nitrones. Aerobic oxidative transformation of cyclohexylamines to cyclohexanone oximes is important as a method for industrial production of ε-caprolactam, a raw material for Nylon 6.

Pathological role of tonsillar B cells in IgA nephropathy.

Although impaired immune regulation along the mucosa-bone marrow axis has been postulated to play an important role, the pathogenesis of IgA nephropathy (IgAN) is unknown; thus, no disease-specific therapy for this disease exists. The therapeutic efficacy of tonsillectomy or tonsillectomy in combination with steroid pulse therapy for IgAN has been discussed. Although randomized control trials for these therapies are ongoing in Japan, the scientific rationale for these therapies remains obscure. It is now widely accepted that abnormally glycosylated IgA1 and its related immune complex (IC) are probably key molecules for the pathogenesis, and are thus considered possible noninvasive biomarkers for this disease. Emerging evidence indicates that B cells in mucosal infections, particularly in tonsillitis, may produce the nephritogenic IgA. In this paper, we briefly summarize characteristics of the nephritogenic IgA/IgA IC, responsible B cells, and underlying mechanisms. This clinical and experimental information may provide important clues for a therapeutic rationale.

Synthesis of oxazolidinones initiated by regio- and diastereo-controlled crotylation of alpha-dicarbonyl compounds.

A one-pot synthesis of oxazolidinones was initiated via the allylation of alpha-dicarbonyl compounds, accompanying regio- and diastereo-controlled carbon-carbon bond formation on the side chains of the oxazolidinones.

Species-specific insecticide resistance to imidacloprid and fipronil in the rice planthoppers Nilaparvata lugens and Sogatella furcifera in East and South-east Asia.

BACKGROUND: In 2003 the development of insecticide resistance against neonicotinoids in the brown planthopper (BPH), Nilaparvata lugens (Stål) (Homoptera: Delphacidae), was first observed in Thailand and has since been found in other Asian countries such as Vietnam, China and Japan. However, the LD(50) values of BPH and the whitebacked planthopper (WBPH), Sogatella furcifera (Horváth), against both neonicotinoid and phenylpyrazole insecticides have been poorly reported in many Asian countries. RESULTS: The topical LD(50) values for imidacloprid in the BPH populations collected from East Asia (Japan, China, Taiwan) and Vietnam in 2006 were 4.3-24.2 microg g(-1) and were significantly higher than those collected from the Philippines (0.18-0.35 microg g(-1)). The BPH populations indicated a positive cross-resistance between imidacloprid and thiamethoxam. Almost all the WBPH populations from Japan, Taiwan, China, Vietnam and the Philippines had extremely large LD(50) values (19.7-239 microg g(-1) or more) for fipronil, except for several populations from the Philippines and China. CONCLUSION: Species-specific changes in insecticide susceptibility were found in Asian rice planthoppers (i.e. BPH for imidacloprid and WBPH for fipronil). Insecticide resistance in BPH against imidacloprid occurred in East Asia and Indochina, but not in the Philippines. In contrast, insecticide resistance in WBPH against fipronil occurred widely in East and South-east Asia.

Regulation of gonad development and respiratory metabolism associated with food availability and reproductive diapause in the rice bug Leptocorisa chinensis.

Food has an influence on many life history traits related to dormancy in insects. In our previous study with the rice bug Leptocorisa chinensis (Dallas) (Hemiptera: Alydidae), diapausing females transferred to conditions physically favorable for promoting the gonad development required food intake to resume gonad development, whereas males did not. These differences in response to food between males and females lead to two questions: (1) Was diapause in the starved females completed? (2) Were the starved males that resumed gonad development at the same physiological status as fed males? We tested these questions with two physiological indicators: gonad status and respiratory rate. Results indicate that starved females are able to complete diapause, but show depressed respiration relative to well-fed insects in diapause. Similar to females, starved males that resumed postdiapause gonad development also had depressed respiratory rate, and hence physiological status is presumed to be different between starved and fed individuals. In this study, it was also found that the photoperiodic signal is storable, whereas the food signal acts directly. The adaptive significance of regulation of gonad development and respiratory metabolism in relation to phenology of suitable host plant and reproductive strategy is discussed in both sexes.

Mating attraction by Stenotus rubrovittatus (Heteroptera: Miridae) females and its relationship to ovarian development.

Stenotus rubrovittatus (Matsumura) (Heteroptera: Miridae) causes brown or black marks on rice, Oryza sativa L., grains (pecky rice), and it is becoming of increasing importance in Japan. Attractiveness of adult females or males of S. rubrovittatus to conspecific individuals was examined in the field in 2003 and 2004. Unmated female-baited traps captured significantly more males than did the unmated male-baited traps. However, the numbers of females captured by female- or male-baited traps were low, and they were not significantly different from the numbers caught by the control traps. No nymphs were captured by any traps. In 2004, we examined the effects of age and mating experience on female attraction ability with the goal of understanding the role of reproductive development in the observed behavior. The daily number of males captured by young unmated female (3-d-old)-baited traps increased from the first day until the fourth day of experiments, and then capture started to decrease. The peak in the number of captured males corresponded to the preoviposition period. When we observed ovarian development of S. rubrovittatus females under 25 degrees C and a photoperiod of 16:8 (L:D) h, we found that vitellogenesis had already started in approximately 30-50% of 1-d-old individuals. By the fifth day after emergence, 50-70% of individuals had mature eggs. These results indicated that the attractiveness of females is the strongest when egg laying becomes possible. Therefore, S. rubrovittatus females attract males selectively for mating, and it is probable that females use a sex pheromone for the attraction.

Sexual differences in the crucial environmental factors for the timing of postdiapause development in the rice bug Leptocorisa chinensis.

Although the regulation of reproductive diapause by environmental factors has been extensively studied in a variety of insect orders, sexual differences in the regulation of diapause are still poorly understood. We examined the effects of environmental factors including photoperiod, temperature and food on the regulation of reproductive diapause in both sexes of the rice bug Leptocorisa chinensis (Dallas) (Hemiptera: Alydidae) in the laboratory and under natural conditions. There was no significant difference in critical daylength (CDL) for diapause induction between the sexes. The CDL corresponded to the daylength in which development of the gonads was suppressed in half the insects caught in the field. Both sexes enter diapause at the same time in successive seasons. In diapause insects, on the other hand, there were sexual differences not only in retention of responsiveness to photoperiod and temperature but also in the food requirement, and these sexual differences lead to different timing of the resumption of reproductive development after overwintering.

Mortality factors of eggs of Leptocorisa chinensis (Hemiptera: Alydidae) in rice fields.

To clarify factors causing mortality of Leptocorisa chinensis Dallas (Hemiptera: Alydidae) eggs in rice fields, sentinel egg masses were exposed for seven days in two rice, Oryza sativa L. (Poaceae), fields. An insecticide was sprayed to remove natural enemies in one-half of each field before exposing egg masses to predation. An egg mass containing 14 eggs was glued to a plastic label, and 21 egg masses each were placed in the sprayed and unsprayed control plots. During exposure, the number of hatched and missing eggs was observed daily. Egg predators were sampled in the fields before and after insecticide application. After the egg masses were retrieved from the fields, mortality factors of the unhatched eggs were assessed in the laboratory. The mean number of hatched and missing eggs was not significantly different between the sprayed and control plots in field A. In field B, however, the numbers were significantly different. The percentage of missing eggs in damaged egg masses ranged from 80 to 100%. In the laboratory, we observed that feeding marks caused by the grasshopper Conocephalus chinensis (Redtenbacher) were similar to those on the eggs exposed in the rice fields. The density of C. chinensis was low in control plots of field A. In contrast, the density was high in those of field B. These observations suggest that the density of egg predators, e.g., C. chinensis, is a mortality factor of L. chinensis eggs in rice fields.

Rice morphogenesis and plant architecture: measurement, specification and the reconstruction of structural development by 3D architectural modelling.

BACKGROUND AND AIMS: The morphogenesis and architecture of a rice plant, Oryza sativa, are critical factors in the yield equation, but they are not well studied because of the lack of appropriate tools for 3D measurement. The architecture of rice plants is characterized by a large number of tillers and leaves. The aims of this study were to specify rice plant architecture and to find appropriate functions to represent the 3D growth across all growth stages. METHODS: A japonica type rice, 'Namaga', was grown in pots under outdoor conditions. A 3D digitizer was used to measure the rice plant structure at intervals from the young seedling stage to maturity. The L-system formalism was applied to create '3D virtual rice' plants, incorporating models of phenological development and leaf emergence period as a function of temperature and photoperiod, which were used to determine the timing of tiller emergence. KEY RESULTS: The relationships between the nodal positions and leaf lengths, leaf angles and tiller angles were analysed and used to determine growth functions for the models. The '3D virtual rice' reproduces the structural development of isolated plants and provides a good estimation of the tillering process, and of the accumulation of leaves. CONCLUSIONS: The results indicated that the '3D virtual rice' has a possibility to demonstrate the differences in the structure and development between cultivars and under different environmental conditions. Future work, necessary to reflect both cultivar and environmental effects on the model performance, and to link with physiological models, is proposed in the discussion.