Long-term maintenance of hemoglobin levels in hemodialysis patients treated with bi-weekly epoetin beta pegol switched from darbepoetin alfa: a single-center, 12-month observational study in Japan

Recent evidence on maintenance administration of epoetin beta pegol, a continuous erythropoiesis receptor activator (CERA), in dialysis patients shows the clinical benefit of bi-weekly administration (Q2W) in improving hematopoiesis and iron use efficiency. We undertook a single-center observational study of 33 Japanese maintenance dialysis patients, whose anemia had been kept stable through weekly administration (Q1W) of darbepoetin (DA), to evaluate the effectiveness of CERA Q2W switched from DA in maintaining hemoglobin (Hb) levels over a 12-month period. The target Hb level was 10.0–12.0 g/dL. Throughout the 12-month period, the mean Hb was stably maintained at 10.5–10.8 g/dL, 69.7–87.9% of the patients achieving the target Hb level. The mean CERA dose was within the range of 62.9–78.8 µg/2 weeks. The average CERA dose adjustment frequency after switching was low at 0.42–0.67 times/3 months. In both subgroups stratified by the DA dose prior to the switch, Hb levels were kept stable during CERA administration; however, in the low-dose group (10–20 µg/week of DA), the CERA and iron doses decreased over time, whereas in the high-dose group (30–60 µg/week of DA) they remained unchanged. CERA Q2W achieved long-term successful anemia management in Japanese maintenance dialysis patients after switching from DA Q1W. CERA dose was adjusted based on an overall consideration of past changes in Hb levels, erythropoiesis-stimulating agent and iron doses. Subgroup analysis showed the CERA dose in the low-dose group decreased continuously, due possibly to a long-term improvement in iron use efficiency

Tolerance induction after organ transplantation, “delayed tolerance,” via the mixed chimerism approach: Planting flowers in a battle field

We have previously reported that peri-transplant conditioning leads to successful induction of renal allograft tolerance via the mixed chimerism approach in nonhuman primates (NHP) and humans. However, this strategy requires treatments beginning six days prior to transplantation, which limits its relevance only to living donor transplant recipients. To extend the clinical applicability of this approach, we developed a novel regimen “delayed tolerance,” with which the recipient initially undergoes organ transplantation with conventional immunosuppression, followed by conditioning and donor bone marrow transplantation (DBMT) at a later date. This approach might be likened to “planting flowers in a battle field.” That is, the recipient’s immunologic environment after organ transplantation is like a battlefield filled with hostile innate and adaptive immune-responses directed against donor antigeneic specificities. Implanting fragile donor hematopoietic progenitors into this environment and encouraging them to bloom in this vicious field requires special treatments

An examination for increasing the motor constant of a cylindrical moving magnet-type linear actuator

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One-loop analyses of lattice QCD with the overlap Dirac operator

We discuss the weak coupling expansion of lattice QCD with the overlap Dirac operator. The Feynman rules for lattice QCD with the overlap Dirac operator are derived and the quark self-energy and vacuum polarization are studied at the one-loop level. We confirm that their divergent parts agree with those in the continuum theory.Comment: 19pages, 7figures, latex; added references :final version for publicatio

Suzaku and Optical Spectroscopic Observations of SS 433 in the 2006 April Multiwavelength Campaign

We report results of the 2006 April multi-wavelengths campaign of SS 433, focusing on X-ray data observed with Suzaku at two orbital phases (in- and out-of- eclipse) and simultaneous optical spectroscopic observations. By analyzing the Fe25 K_alpha lines originating from the jets, we detect rapid variability of the Doppler shifts, dz/dt ~ 0.019/0.33 day^-1, which is larger than those expected from the precession and/or nodding motion. This phenomenon probably corresponding to "jitter" motions observed for the first time in X-rays, for which significant variability both in the jet angle and intrinsic speed is required. From the time lag of optical Doppler curves from those of X-rays, we estimate the distance of the optical jets from the base to be ~(3-4) \times 10^14 cm. Based on the radiatively cooling jet model, we determine the innermost temperature of the jets to be T_0 = 13 +/- 2 keV and 16 +/- 3 keV (the average of the blue and red jets) for the out-of-eclipse and in-eclipse phase, respectively, from the line intensity ratio of Fe25 K_alpha and Fe26 K_alpha. While the broad band continuum spectra over the 5--40 keV band in eclipse is consistent with a multi-temperature bremsstrahlung emission expected from the jets, and its reflection component from cold matter, the out-of-eclipse spectrum is harder than the jet emission with the base temperature determined above, implying the presence of an additional hard component.Comment: 12 pages, 15 figures, accepted for publication in PAS

Peripheral Chorioretinal Imaging Through a Front Prism on Optical Coherence Tomography Angiography

Purpose: To evaluate the clinical feasibility of peripheral chorioretinal imaging through a front prism on swept-source optical coherence tomography angiography (SS-OCTA). Methods: We prospectively obtained en face OCTA images using SS-OCTA in 10 eyes of 10 healthy volunteers. For the peripheral chorioretinal imaging, the scanning laser passed and refracted through a 45 −90 −45 right-angle prism. We evaluated the qualitative and quantitative characteristics of chorioretinal vessels in the periphery. Results: Using peripheral chorioretinal imaging through a prism, the retinal vasculature was delineated to the equator on the OCTA images, and varices of the vortex vein ampullae were observed on choroidal OCT images. The 3×3-mm images revealed three-dimensional morphologies unique to the peripheral vasculature, such as the gap between retinal arterioles and venules in the superficial capillary plexus (SCP) and elliptical and greater lobules in the choriocapillaris layer. Compared with OCTA images obtained without the prism, those obtained through the prism demonstrated an approximately 1.24-fold increase in the lengths in the base apex direction, whereas the lengths in the perpendicular direction showed concordance. The peripheral vessel density (VD) in the inferior quadrant was lower than those in the other quadrants on the SCP and deep capillary plexus, whereas on the SCP images of the macula the lowest VD was observed in the temporal subfield. Conclusions: Peripheral chorioretinal imaging allowed us to generate ultra-widefield panoramic OCTA images and demonstrated morphologic characteristics unique to peripheral chorioretinal vessels. Translational Relevance: OCTA imaging through a front prism can be a technique for acquiring chorioretinal vasculature images in the periphery