Kenichi Asakura
Akita University
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Featured researches published by Kenichi Asakura.
Clinical Nephrology | 2008
Hideki Wakui; Nobuki Maki; Kuroki J; Tamio Nishinari; Kenichi Asakura; Atsushi Komatsuda; Kenichi Sawada
A 48-year-old man without underlying disease developed mediastinitis and was treated by mediastinal drainage. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in a culture of the abscess material. He was treated with anti-MRSA antibiotics and the MRSA infection improved. Four weeks after the onset of MRSA infection, he developed rapidly progressive glomerulonephritis (RPGN) with nephrotic syndrome (NS). A renal biopsy showed endocapillary proliferative glomerulonephritis with IgA-predominant glomerular deposition. These clinicopathological findings were consistent with those in glomerulonephritis following MRSA infection (post-MRSA infection glomerulonephritis). The level of serum creatinine increased to 6.3 mg/dl, 7 weeks after the onset of RPGN. At that time, the eradication of MRSA infection was considered. He was given middle-dose steroid therapy. Thereafter, his RPGN with NS improved. MRSA infection did not recur. If the disease activity of post-MRSA infection glomerulonephritis persists after the disappearance of MRSA infection, the application of immunosuppressive therapy with steroids may be useful.
Human Pathology | 1989
Yasushi Nakamoto; Hirokazu Imai; Tadashi Yasuda; Kenichi Asakura; Akira B. Miura; Shigeki Nishimura
Renal biopsy specimens from five patients with Takatsukis syndrome were studied. Proteinuria and hematuria were modestly positive in four cases and three cases, respectively. One case demonstrated early azotemia, while four cases revealed normal serum creatinine levels. All cases displayed glomerular enlargement and lobulation, mesangial cell proliferation, and double contour structure, simulating membranoproliferative glomerulonephritis. It is noteworthy that mesangial loosening was also detected in the renal biopsy specimens of this study. This change was present diffuse-globally in the well-developed cases and focal-globally or segmentally in the developing cases. In addition, various morphologic expressions were observed, ie, microaneurysms congested with RBCs, tentatively termed mesangial hyaline thrombi, nodule-like lesions, and tiny to small-sized mesangiolytic lesions. Since all these features could be explained by low-grade mesangiolysis, the renal alteration associated with this syndrome was termed mesangiolytic glomerulonephritis. Humoral factor(s) also toxic to the mesangium were implicated.
The American Journal of the Medical Sciences | 1992
Atsushi Komatsuda; Yasushi Nakamoto; Kenichi Asakura; Tadashi Yasuda; Hirokazu Imai; Akira-B. Miura
The authors describe a 51-year-old Japanese woman who developed nephrotic syndrome in association with a total hydatidiform mole. The nephrotic syndrome remitted completely following hysterectomy. A renal biopsy performed before the operation showed diffuse mesangial cell proliferation of a moderate degree, and thickened capillary walls with focal and segmental subendothelial deposits, as well as circumferential mesangial interposition. Occasional foci of the mesangiolysis were also observed. Immunofluorescence microscopy revealed granular staining of IgM along the glomerular capillary walls in a fringe pattern. A review of the literature revealed that this patient appears to be the first case of nephrotic syndrome associated with a total mole, although there have been two cases of nephrotic syndrome due to preeclamptic nephropathy associated with a partial or transitional mole.
Modern Rheumatology | 2016
Yasuhiko Hirabayashi; Yasuhiko Munakata; Masayuki Miyata; Yukitomo Urata; Koichi Saito; Hiroshi Okuno; Masaaki Yoshida; Takao Kodera; Ryu Watanabe; Seiya Miyamoto; Tomonori Ishii; Shigeshi Nakazawa; Hiromitsu Takemori; Takanobu Ando; Takashi Kanno; Masataka Komagamine; Ichiro Kato; Yuichi Takahashi; Atsushi Komatsuda; Kojiro Endo; Chihiro Murai; Yuya Takakubo; Takao Miura; Yukio Sato; Kazunobu Ichikawa; Tsuneo Konta; Noriyuki Chiba; Tai Muryoi; Hiroko Kobayashi; Hiroshi Fujii
Abstract Objective: To evaluate the clinical and structural efficacy of tocilizumab (TCZ) during its long-term administration in patients with rheumatoid arthritis (RA). Methods: In total, 693 patients with RA who started TCZ therapy were followed for 3 years. Clinical efficacy was evaluated by DAS28-ESR and Boolean remission rates in 544 patients. Joint damage was assessed by calculating the modified total Sharp score (mTSS) in 50 patients. Results: When the reason for discontinuation was limited to inadequate response or adverse events, the 1-, 2-, and 3-year continuation rates were 84.0%, 76.8%, and 72.2%, respectively. The mean DAS28-ESR was initially 5.1 and decreased to 2.5 at 6 months and to 2.2 at 36 months. The Boolean remission rate was initially 0.9% and increased to 21.7% at 6 months and to 32.2% at 36 months. The structural remission rates (ΔmTSS/year ≤ 0.5) were 68.8%, 78.6%, and 88.9% within the first, second, and third years, respectively. The structural remission rate at 3 years (ΔmTSS ≤ 1.5) was 66.0%, and earlier achievement of swollen joint count (SJC) of 1 or less resulted in better outcomes. Conclusions: TCZ was highly efficacious, and bone destruction was strongly prevented. SJC was an easy-to-use indicator of joint destruction.
Internal Medicine | 2017
Masayuki Miyata; Yasuhiko Hirabayashi; Yasuhiko Munakata; Yukitomo Urata; Koichi Saito; Hiroshi Okuno; Masaki Yoshida; Takao Koderai; Ryu Watanabei; Seiya Miyamoto; Tomonori Ishii; Shigeshi Nakazawa; Hiromitsu Takemori; Takanobu Ando; Takashi Kanno; Masataka Komagamine; Ichiro Kato; Yuichi Takahashi; Atsushi Komatsuda; Kojiro Endo; Chihiro Murai; Yuya Takakubo; Takao Miura; Yukio Sato; Kazunobu Ichikawa; Tsuneo Konta; Noriyuki Chiba; Tai Muryoi; Hiroko Kobayashi; Hiroshi Fujii
Objectives: To determine the necessity of methotrexate (MTX) in patients with rheumatoid arthritis (RA) achieving clinical remission treated by tocilizumab (TCZ) and MTX (TCZ+MTX). Methods: A 3 year, multicenter, observational cohort study was performed. RA patients were treated by TCZ with or without MTX depending on the attending doctor’s decision. Of the patients treated with TCZ+MTX, the patients who discontinued MTX after achieving clinical remission (discontinued group: DISC) were compared with those who maintained the same dose of MTX after achieving clinical remission (maintained group: MAIN). Results: The DISC and MAIN consisted of 33 patients and 37 patients, respectively. The mean DAS28-ESR was significantly lower in the DISC than in the MAIN at 3 months, 6 months and 9 months (3 months: 1.8 ± 0.8 and 2.4 ± 1.0, p=0.018, 6 months: 1.5 ± 0.7 and 2.2 ± 1.0, p=0.009 and 9 months: 1.4 ± 0.6 and 2.0 ± 1.0, p=0.008, respectively). The DAS28-ESR remission rate and Boolean remission rate were significantly higher in the DISC than in the MAIN (93.8% and 64.5%, respectively in the DAS28-RSR, p=0.04; 51.6% and 17.2%, respectively in the Boolean, p=0.005) at 6 months. Conclusions: RA patients treated by the combination of TCZ and MTX who achieved deep remission (DAS28- ESR ≤ 1.98) at as early as 3 months could discontinue taking MTX.
Kidney International | 1985
Hirokazu Imai; Yasushi Nakamoto; Kenichi Asakura; Kazunobu Miki; Tadashi Yasuda; Akira B. Miura
Internal Medicine | 1992
Akihiko Chubachi; Hideki Wakui; Kenichi Asakura; Shigeki Nishimura; Yasushi Nakamoto; Akira B. Miura
Clinical Nephrology | 1995
Hirokazu Imai; Kodama T; Ishino T; Yasuda T; Miura Ab; Kenichi Asakura; Nishimura S; Yasushi Nakamoto
Internal Medicine | 1992
Hideki Wakui; Akihiko Chubachi; Kenichi Asakura; Shigeki Nishimura; Yasushi Nakamoto; Akira B. Miura
Internal Medicine | 2002
Kenichi Asakura