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Shunta Hori, Tatsuki Miyamoto, Keiichi Sakamoto, Takuto Shimizu, Kazuki Ichikawa, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda, Nobumichi Tanaka, Katsunori Yoshida, Kiyohide Fujimoto Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan Background: Transplant renal vein thrombosis (TRVT) is a severe vascular complication and is caused by various factors, including recipient factors, donor factors, immunosuppression regimens, and surgical techniques. Despite adequate interventions, including thrombolytic therapy or surgical thrombectomy, successful salvage of the allograft is often difficult. We observed a case of TRVT induced by compression of the renal vein immediately after intraoperative abdominal closure.Case presentation: A 41-year-old male underwent ABO-compatible living kidney transplantation. The donor was his 45-year-old sister, and her right kidney was donated. The allograft had a single artery and vein. One of the preoperative recipient problems was obesity (body mass index, 33.4 kg/m2). Intraoperative Doppler ultrasonography (US) revealed sufficient blood flow throughout the allograft, and urine output was also observed. After surgery, hematuria was observed; the urine output decreased and serum creatinine levels increased to 7.0 mg/dL. Doppler US showed a decrease in diastolic flow and an elevated resistive index, which were similar findings to those noted in acute rejection. Although steroid pulse therapy was initiated, allograft dysfunction was worsening. On postoperative day 4, surgical exploration revealed TRVT; consequently, thrombectomy was performed. The urine output increased, and serum creatinine levels decreased to 1.8 mg/dL. The cause of TRVT development may be that the transplant renal vein was relatively short, due to the right kidney being compressed by surrounding tissues after abdominal closure, and that TRVT was gradually developing due to stagnant blood flow.Conclusion: Although TRVT is induced by multiple factors, an accurate diagnosis is often difficult. Understanding these factors, including obesity, and considering TRVT as a cause of allograft dysfunction are important during the pre-, peri-, and postoperative periods. Knowledge of TRVT can lead to early and accurate diagnosis and intervention, resulting in better outcomes for the patients with allograft dysfunction. Keywords: kidney transplantation, surgical exploration, transplant renal vein thrombosis, thrombectomy

Background Transplant kidney function is thought to be affected by sex differences, such as physical conditions including muscle volume, sex hormones, immune responses, and so forth. We examined the effect of sex differences on transplant kidney function. Methods The subjects were selected from kidney transplant recipients, who received kidney transplantation on our hospital between January 2000 and August 2015. Cadaveric donors and parent-child pairs with an age difference were excluded, then we included 47 recipients whose sex was different from the sex of the donor. We compared transplant kidney function between male donors and female recipients group (M→F, n = 20) and female donors and male recipients group (F→M, n = 27). Results Nadir creatinine value was higher in the F→M group than in the M→F group (1.09 mg/dL vs 0.76 mg/dL, P < .0001). The estimated glomerular filtration rate (eGFR) was significantly higher in the M→F group than in the F→M group (66.6 mL/min/1.73 m 2 vs 50.1 mL/min/1.73 m 2 , P = .002), and eGFR ratio (recipient to donor) was significantly higher in the M→F group than in the F→M group (1.13 vs 0.57, P < .0001). Multiple linear regression analysis showed that the only the sex of the recipient was significant prognostic factor of eGFR after renal transplantation ( P = .037). Conclusions The short-term kidney function of the graft from male to female was better than that of the graft from female to male. [ABSTRACT FROM AUTHOR]

Aims To test the hypothesis that 1-h plasma glucose in an oral glucose tolerance test is a better predictor of the development of diabetes than 2-h plasma glucose, independently of indices of insulin secretion or action in Japanese adults. Methods A historical cohort study was conducted in 1445 Japanese workers who did not have diabetes. The association between 1-h plasma glucose and the development of Type 2 diabetes was analysed. Results Overall, 95 of the study participants developed Type 2 diabetes during a mean follow-up of 4.5 years. The area under the receiver-operating characteristic curve for 1-h plasma glucose for future diabetes [0.88 (95% CI 0.84-0.91)] was greater than that for 2-h plasma glucose [0.79 (95% CI 0.74-0.84)], and for insulinogenic [0.73 (95% CI 0.68-0.78)] and disposition indices [0.79 (95% CI 0.74-0.84); P < 0.05]. Compared with the first quartile, the hazard ratio for future diabetes in the fourth quartile of 1-h plasma glucose was 42.5 [95% CI 5.7-315.2 ( P < 0.05)] and the hazard ratio in the fourth quartile of 2-h plasma glucose was 4.4 [95% CI 1.8-10.8 ( P < 0.05)], after adjustments for covariates including fasting plasma glucose. The significance of the elevated hazard ratio in the fourth quartile of 1-h plasma glucose was maintained after adjustments for 2-h plasma glucose, insulinogenic index or disposition index, whereas the elevation of the hazard ratio in the fourth quartile of 2-h plasma glucose was diminished and was no longer significant after adjustments for 1-h plasma glucose. Conclusions One-hour plasma glucose had a greater association with the future development of Type 2 diabetes than did 2-h plasma glucose, independently of oral glucose tolerance test-derived indices of insulin action in a Japanese population. [ABSTRACT FROM AUTHOR]

Dlx5 plays an important role in the embryonic development of mineralized tissues. We hypothesized that Dlx5 also functions in regulating post-natal bone formation in mice. To prove this hypothesis, we infected 5-day-old bone sialoprotein (BSP)/avian retroviral receptor gene (TVA) transgenic mice with replication-competent retroviral vectors expressing wild-type Dlx5 (RCAS-Dlx5WT) and mutated Dlx5 at arginine (R) 31 of its homeodomain (RCAS-Dlx5RH). Immunohistochemistry indicated that RCAS-Dlx5WT increased BSP and osteopontin (OPN) expression, whereas it decreased that of osteocalcin (OC). RCAS-Dlx5RH mediated opposite effects. Semi-quantitative RT-PCR confirmed these results. Ex vivo overexpression of RCAS-Dlx5WT in BSP/TVA calvarial cells promoted, whereas that of RCAS-Dlx5RH inhibited, mineralized nodule formation as compared with that in control cells. Our results suggest that Dlx5 promotes expression of early markers of osteogenic differentiation and increases mineralization post-natally. [ABSTRACT FROM AUTHOR]

Chlorite (C)-corrensite (Co)-smectite (S) seriesminerals occur as vein constituents in the two epithermal ore veins, the Chuetsu and Shuetsu veins of the Todoroki Au-Ag deposit. The characteristics of the C-Co-S seriesminerals indicate that the clays may be products of direct precipitation from hydrothermal fluids and subsequent mineralogical transformations during and/or after vein formation. The minerals from the Chuetsu vein are characterized by 'monomineralic' corrensite showing an extensive distribution throughout the vein, and trioctahedral smectite occurring locally. The Shuetsu vein minerals are characterized by C-Co series minerals which can be divided into three different types: a I type including discrete chlorite with minor amounts of S layers, a II type comprising interstratified C/Co and discrete chlorite, and a III type characterized by segregation structures of C and Co layers. The C-Co series minerals show slightly different spatial distributions in the Shuetsu vein. Different epithermal environments during the vein formations and possible kinetic effects may have played a role in the formation and conversion of Co-C series at the Shuetsu vein and S-Co series at the Chuetsu vein. [ABSTRACT FROM AUTHOR]

Tornadoes are one type of violent flow phenomenon and occur in many places in the world. There are many research methods that aim to reduce the loss of human lives and material damage caused by tornadoes. One effective method is numerical simulation such as that in Ishihara et al. (J. Wind Engng Ind. Aerodyn., vol. 99, 2011, pp. 239-248). The swirling structure of the Navier-Stokes flow is significant for both the mathematical analysis and numerical simulations of tornadoes. In this paper, we try to clarify the swirling structure. More precisely, we performed numerical computations on axisymmetric Navier-Stokes flows with a no-slip flat boundary. We compared a hyperbolic flow with swirl and one without swirl, and observed that the following phenomenon occurs only in the swirl case: the distance between the point with the maximum magnitude of velocity |v| and the z-axis changed drastically at a specific time (which we call the turning point). Besides, an 'increasing velocity phenomenon' occurred near the boundary, and the maximum value of |v| was obtained near the axis of symmetry and the boundary when the time was close to the turning point in the swirl case. [ABSTRACT FROM AUTHOR]