Details of a Researcher - Hashiguchi, Akinori

Papers - Hashiguchi, Akinori

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Undifferentiated carcinoma of the mandible detected simultaneously with the liver: A case report

Asoda S, Morita M, Soma T, Sato H, Hasegawa T, Nakagawa T, Hashiguchi A, Kawana H

Oral and Maxillofacial Surgery Cases (Oral and Maxillofacial Surgery Cases) 7 ( 3 ) 100228 - 100228 2021.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 2214-5419

We herein report a rare case of undifferentiated carcinoma that originated in the mandible with the same pathological findings as seen in the liver. A 64-year-old man underwent surgery for a hepatic tumor in October 2006, and the pathological diagnosis was undifferentiated carcinoma. The patient was referred to our department in January 2007, when whole-body positron emission tomography/computed tomography showed the uptake of fluorodeoxyglucose in the right mandibular ramus. The patient underwent right hemimandibulectomy in April 2007. The resected tumor was also undifferentiated carcinoma. In May 2014, seven years after the lower mandibular operation, the tumor recurred at the site corresponding to the right mandibular ramus after resection, and tumor resection and right neck dissection were performed. As a result of the histopathological examination, the undifferentiated carcinoma findings were the same as before. There have been no signs of local recurrence or metastases for over six years since the second mandibular surgery.

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MPGN様の病理像を呈したλ鎖単独陽性イムノタクトイド腎症の一例

杉田絵里那, 神田武志, 竜崎正毅, 橋口明典, 林香, 徳山博文, 脇野修, 伊藤裕

日本腎臓学会誌 ((一社)日本腎臓学会) 63 ( 6-E ) 739 - 739 2021.09

Joint Work, ISSN 0385-2385

たこつぼ心筋症の発症後に、内皮細胞障害との鑑別を要したフィブロネクチン腎症の1例

畔上達彦, 中山尭振, 林香, 橋口明典, 神田武志, 伊藤裕

日本腎臓学会誌 ((一社)日本腎臓学会) 63 ( 6-E ) 685 - 685 2021.09

Joint Work, ISSN 0385-2385

キャッスルマン病によるネフローゼ症候群にトシリズマブが有効であった一例

児島大輝, 山口慎太郎, 安達京華, 安田格, 西岡謙, 吉本憲史, 内山清貴, 田島敬也, 林香, 長谷川一宏, 吉野純, 目黒周, 橋口明典, 神田武志, 伊藤裕

日本腎臓学会誌 ((一社)日本腎臓学会) 63 ( 6-E ) 703 - 703 2021.09

Joint Work, ISSN 0385-2385

A girl with a mutation of the ciliary gene CC2D2A presenting with FSGS and nephronophthisis.

Midori Awazu, Mamiko Yamada, Nariaki Asada, Akinori Hashiguchi, Kenjiro Kosaki, Kazuya Matsumura

CEN case reports (CEN case reports) 11 ( 1 ) 116 - 119 2021.08

Research paper (scientific journal), Joint Work, Accepted

Mutations in the ciliary gene TTC21B, NPHP4, and CRB2 cause familial focal and segmental glomerulosclerosis (FSGS). We report a girl with a mutation of the ciliary gene CC2D2A presenting with FSGS and nephronophthisis. The patient had mental retardation, postaxial polydactyly, and ataxic breathing, and was diagnosed as having compound heterozygous CC2D2A missense mutations at age 5. Retrospectively, azotemia at 1 year and proteinuria at 5 years were recorded but not investigated. At age 6, she was referred to the pediatric nephrology service because of hypertension, pretibial pitting edema, heavy proteinuria, and hematuria. eGFR was 66 ml/min/1.73 m2, total protein 5.3 g/dl, albumin 2.4 g/dl, and cholesterol 317 mg/dl. Ultrasonography showed normal-sized kidneys with a cyst in the right. Losartan was started. On renal biopsy, 8 out of 24 glomeruli were globally sclerosed, and three showed segmental sclerosis and/or hyalinosis with no immune deposits. Mild tubular dilatation, tubular atrophy, and interstitial fibrosis were observed. On electron microscopy, glomeruli showed focal foot process effacement with no electron dense deposits. Since losartan did not exert an obvious effect, treatment with prednisolone was tried. Urine protein decreased from 6.6 to 3.7 g/gCr. Prednisolone was discontinued after 10 days, however, because she developed duodenal ulcer perforation that necessitated omentoplasty. Subsequently, she was treated with losartan only. Her renal function deteriorated and peritoneal dialysis was initiated 8 months later. FSGS in this patient could be primary glomerular associated with CC2D2A mutation, rather than the consequences of tubulointerstitial fibrosis.

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Grading of Multifocal Prostate Cancer Cases in which the Largest Volume and the Highest Grade do Not Coincide within One Lesion.

Kazuhiro Matsumoto, Minami Omura, Toshikazu Takeda, Takeo Kosaka, Akinori Hashiguchi, Kimiharu Takamatsu, Yota Yasumizu, Nobuyuki Tanaka, Shinya Morita, Ryuichi Mizuno, Hiroshi Asanuma, Mototsugu Oya

The Journal of urology (The Journal of urology) 206 ( 2 ) 338 - 345 2021.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 0022-5347

PURPOSE: In general, the index lesion of prostate cancer has the largest tumor volume, the highest Grade Group (GG), and the highest stage (concordant cases). However these factors sometimes do not coincide within one lesion (discordant cases). In such discordant cases, the largest tumor may not be of biological significance and the secondary tumor may more greatly impact the prognosis. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent radical prostatectomy, and we identified 580 (85.3%) concordant cases and 100 (14.7%) discordant cases. The endpoint of this study was biochemical recurrence (BCR) and median follow-up was 4.2 years. RESULTS: Among discordant cases in which GGs of the largest tumor and the highest GG tumor differed, the majority (67 patients) had the largest tumor of GG 2 and we set them as the study cohort. On the other hand, we regarded 212 concordant cases with an index tumor of GG 2 as the control cohort. The study cohort comprised 48 (71.6%) patients with a secondary tumor of GG 3 and 19 (28.4%) with a secondary tumor of GG 4/5. Kaplan-Meier curves revealed that the 5-year BCR-free survival rates were 76%, and 67%, respectively. The 5-year BCR-free survival rate of the control cohort was 91%, which was significantly better than that of the study cohort (p=0.013 and 0.014, respectively). CONCLUSIONS: Our study suggested that the prognosis of discordant cases is better determined by the secondary cancer lesion with the highest GG instead of the largest lesion.

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Development of nephropathy in an adult patient after Fontan palliation for cyanotic congenital heart disease.

Kaori Hayashi, Akinori Hashiguchi, Masako Ikemiyagi, Hirobumi Tokuyama, Shu Wakino, Hiroshi Itoh

CEN case reports (CEN case reports) 10 ( 3 ) 354 - 358 2021.08

Research paper (scientific journal), Joint Work, Accepted

Cyanotic congenital heart disease is occasionally associated with kidney dysfunction, which is known as cyanotic nephropathy or cyanotic glomerulopathy. The clinical presentation of cyanotic nephropathy includes proteinuria, decreased estimated glomerular filtration rate, hyperuricemia, thrombocytopenia, or polycythemia. Although advances in surgical procedures have improved the prognosis of cyanotic congenital heart diseases, adult cases of cyanotic nephropathy are still rare, and there are few reports of kidney biopsy in adults with cyanotic nephropathy. Here, we present the case of a 41-year-old patient with Fontan palliation who developed nephrotic range proteinuria and had a kidney biopsy, which showed glomerular hypertrophy with segmental glomerulosclerosis around vascular poles, suggesting adaptive focal segmental glomerulosclerosis. This case provides further understanding of kidney dysfunction due to cyanotic congenital heart disease and shows the need for attention in the management for prevention of progression to end-stage renal disease and in the selection of renal replacement therapy.

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C3腎症を基準とした一次性MPGNの再分類:電顕PAMを用いたType 3 Anders-Strife型の鑑別のもとに

本間志功, 佐藤直実, 橋口明典, 上杉憲子, 中村保宏, 城謙輔

日本腎臓学会誌 ((一社)日本腎臓学会) 63 ( 4 ) 436 - 436 2021.06

Joint Work, ISSN 0385-2385

DNA修復因子KAT5を介した尿細管糸球体フィードバック制御

菱川彰人, 林香, 久保亜紀子, 宮下和季, 橋口明典, 吉本憲史, 中道蘭, 杉田絵里那, 赤塩理起, 門川俊明, 末松誠, 伊藤裕

日本腎臓学会誌 ((一社)日本腎臓学会) 63 ( 4 ) 488 - 488 2021.06

Joint Work, ISSN 0385-2385

Malignancy-associated membranous nephropathy with PLA2R double-positive for glomeruli and carcinoma.

Itaru Yasuda, Hirobumi Tokuyama, Akinori Hashiguchi, Kazuhiro Hasegawa, Kiyotaka Uchiyama, Masaki Ryuzaki, Marie Yasuda, Ryuichi Mizuno, Shigeto Ishidoya, Shu Wakino, Hiroshi Itoh

CEN case reports (CEN case reports) 10 ( 2 ) 281 - 286 2021.05

Research paper (scientific journal), Joint Work, Accepted

Phospholipase A2 receptor (PLA2R) is the most common primary target antigen of idiopathic membranous nephropathy (MN) although PLA2R antibodies are also reported to be present in malignancy-associated MN. However, a case of PLA2R-positive MN secondary to PLA2R-positive carcinoma has not been reported. A 26-year-old Japanese woman presented with general fatigue, fever, and nonproductive cough. Computed tomography demonstrated a left kidney mass with pathologic diagnosis of Xp11.2 translocation renal cell carcinoma (RCC). After the second time of administration with Sunitinib, the patients exhibited significant proteinuria and hypoalbuminemia. Renal biopsy revealed a diagnosis of diffuse MN secondary to RCC. Immunofluorescence staining showed granular patterns positive for immunoglobulin (Ig) G, IgA, and C3c. PLA2R and IgG1-3 were positive, while IgG4 was negative. For the treatment of severe nephrotic syndrome, we attempted steroid therapy without any clinical improvement. Open nephrectomy was performed and surprisingly, RCC was stained for PLA2R with polarity for the basal side. At outpatient follow-up, 4 months after the operation, urinary protein had still persisted, although serum albumin was slightly increased. We report a case of PLA2R-positive MN secondary to PLA2R-positive RCC.

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デジタル画像解析を用いたIgA腎症糸球体病変定量化

橋口明典, 石川雅浩, 城謙輔, 坂本直樹, 山内暁, 大塚武, 福西宗憲, 清水章, 片渕律子, 川村哲也

日本病理学会会誌 ((一社)日本病理学会) 110 ( 1 ) 327 - 327 2021.03

Joint Work, ISSN 0300-9181

A cross-sectional study in patients with IgA nephropathy of correlations between clinical data and pathological findings at the time of renal biopsy: a Japanese prospective cohort study.

Chisako Kamano, Akira Shimizu, Kensuke Joh, Akinori Hashiguchi, Satoshi Hisano, Ritsuko Katafuchi, Tetsuya Kawamura

Clinical and experimental nephrology (Clinical and Experimental Nephrology) 25 ( 5 ) 509 - 521 2021

Research paper (scientific journal), Joint Work, Accepted, ISSN 13421751

BACKGROUND: The correlations between clinical data and pathological findings at the time of renal biopsy were investigated in IgA nephropathy patients. METHODS: 771 patients diagnosed with IgA nephropathy by renal biopsy were enrolled. The correlations between clinical variables including eGFR, daily proteinuria, mean arterial pressure (MAP), serum uric acid (UA) values, and pathological parameters were examined. These patients were further divided into three groups: children (< 19 years old), young adults (19-60 years), and elderly patients (> 60 years). RESULTS: Daily proteinuria was moderately correlated with all pathological parameters (Rs = 0.23-0.49). The mesangial score, the percentage of glomeruli that contained endocapillary hypercellularity, cellular/fibrocellular crescents or tuft necrosis, and segmental glomerulosclerosis (GS) affected daily proteinuria most on multiple linear regression analysis (MLRA). eGFR, MAP, and serum UA levels were mainly correlated with the degree of GS and interstitial lesions. In children, the degree of cellular/fibrocellular crescents or tuft necrosis was correlated with not only daily proteinuria, but also decreased eGFR (Rs = 0.51, - 0.24). Endocapillary hypercellularity was the only independent variable related to daily proteinuria on MLRA. CONCLUSION: In all age cohorts of IgA nephropathy patients, daily proteinuria was correlated with all histological parameters, including both acute and chronic glomerular lesions, and the mesangial score. Independent variables for daily proteinuria were the meangial score, acute histological lesions, and segmental GS on MLRA, whereas the remaining independent variable in the pediatric group was endocapillary hypercellurality. The clinical pathological correlation at the time of biopsy varied depending on the age group.

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A Case of Glomerulonephritis Caused by Bartonella spp. Infective Endocarditis: The Difficulty and Importance of Differentiation from Anti-neutrophil Cytoplasmic Antibody-related Rapidly Progressive Glomerulonephritis.

Ayumi Yoshifuji, Yuuka Hibino, Motoaki Komatsu, Seiichi Yasuda, Koji Hosoya, Emi Kobayashi, Yuko Baba, Shigemichi Hirose, Akinori Hashiguchi, Yoshihiko Kanno, Munekazu Ryuzaki

Internal medicine (Tokyo, Japan) (Internal Medicine) 60 ( 12 ) 1899 - 1906 2021

Research paper (scientific journal), Joint Work, Accepted, ISSN 09182918

A 65-year-old man with valvular disorder presented to his physician because of widespread purpura in both lower extremities. Blood tests showed elevated serum creatinine levels and proteinase 3-anti-neutrophil cytoplasmic antibody (ANCA) with hematuria, suggesting ANCA-related rapidly progressive glomerulonephritis (RPGN). Although multiple blood cultures were negative, transthoracic echocardiography revealed warts in the valves, and a renal biopsy also showed findings of glomerular infiltration by mononuclear leukocytes and C3 deposition in the glomeruli, suggesting infection-related glomerulonephritis. Later, Bartonella antibody turned positive. Antimicrobial treatment improved the purpura and renal function without any recurrence. ANCA-positive RPGN requires the exclusion of infective endocarditis, especially that induced by Bartonella spp.

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Association of glomerular DNA damage and DNA methylation with one-year eGFR decline in IgA nephropathy

Hayashi K, Hishikawa A, Hashiguchi A, Azegami T, Yoshimoto N, Nakamichi R, Tokuyama H, Itoh H

Scientific Reports (Scientific Reports) 10 ( 1 ) 237 - 237 2020.12

Research paper (scientific journal), Joint Work, Accepted

© 2020, The Author(s). Accumulation of DNA double-strand breaks (DSBs) is linked to aging and age-related diseases. We recently reported the possible association of DNA DSBs with altered DNA methylation in murine models of kidney disease. However, DSBs and DNA methylation in human kidneys was not adequately investigated. This study was a cross-sectional observational study to evaluate the glomerular DNA DSB marker γH2AX and phosphorylated Ataxia Telangiectasia Mutated (pATM), and the DNA methylation marker 5-methyl cytosine (5mC) by immunostaining, and investigated the association with pathological features and clinical parameters in 29 patients with IgA nephropathy. To evaluate podocyte DSBs, quantitative long-distance PCR of the nephrin gene using laser-microdissected glomerular samples and immunofluorescent double-staining with WT1 and γH2AX were performed. Glomerular γH2AX level was associated with glomerular DNA methylation level in IgA nephropathy. Podocytopathic features were associated with increased number of WT1(+)γH2AX(+) cells and reduced amount of PCR product of the nephrin gene, which indicate podocyte DNA DSBs. Glomerular γH2AX and 5mC levels were significantly associated with the slope of eGFR decline over one year in IgA nephropathy patients using multiple regression analysis adjusted for age, baseline eGFR, amount of proteinuria at biopsy and immunosuppressive therapy after biopsy. Glomerular γH2AX level was associated with DNA methylation level, both of which may be a good predictor of renal outcome in IgA nephropathy.

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最大病変が最高Gleason scoreでないmultifocal前立腺癌症例へのGleason scoreの付け方

松本一宏, 橋口明典, 武田利和, 小坂威雄, 高松公晴, 安水洋太, 田中伸之, 森田伸也, 水野隆一, 浅沼宏, 大家基嗣

日本癌治療学会学術集会抄録集 ((一社)日本癌治療学会) 58回 P - 353 2020.10

Research paper (scientific journal), Joint Work, Accepted

腎臓病理所見からT細胞型悪性リンパ腫と診断し得た一例

押田卓磨, 徳山博文, 安田格, 竜崎正毅, 大島洋一, 内山清貴, 橋口明典, 脇野修, 伊藤裕

日本腎臓学会誌 ((一社)日本腎臓学会) 62 ( 6 ) 567 - 567 2020.09

Joint Work, ISSN 0385-2385

多彩な臨床症状を示した顕微鏡的多発血管炎に続発した血栓性微小血管症の1例

坂巻裕介, 小西孝之助, 橋口明典, 松崎達, 香野日高, 中川健, 寺嶋毅, 林晃一

日本腎臓学会誌 ((一社)日本腎臓学会) 62 ( 5 ) 465 - 476 2020.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0385-2385

症例は70歳代、女性。微熱、頭重感、両大腿のだるさを契機に他院を受診、腎機能障害を指摘され、精査目的で当院を紹介された。血液検査でミエロペルオキシダーゼ抗好中球細胞質抗体(myeloperoxidase anti-neutrophil cytoplasmic antibody:MPO-ANCA)陽性が判明し、腎生検病理所見の結果、血栓性微小血管症(thrombotic microangiopathy:TMA)を合併した顕微鏡的多発血管炎(microscopic polyangiitis:MPA)と診断した。プレドニゾロン(40mg/日)の投与を開始し、ステロイドパルス療法を2クール、静注シクロホスファミドパルス療法(intravenous cyclophosphamide:IVCY)を1クール行った。また、中等度の高血圧を認めたため、ニフェジピンを投与し、血圧コントロールを行った。その後、両下腿浮腫と両側胸水貯留を認めたため、フロセミドを投与した。患者の病状は安定し、入院37日目に退院した。しかし、退院後に、痙攣と夜間に増悪する呼吸困難を認め、うっ血性心不全の診断で再度入院した。入院後、フロセミドを投与したが、尿量の増加は得られず、急速に呼吸状態の悪化を認めたため、気管内挿管後、人工呼吸器を装着した。14時間にわたる持続低効率血液透析(sustained low efficiency dialysis:SLED)を行い、患者の呼吸状態は著明に改善した。抜管後、意識レベルの低下を伴う痙攣を認め、頭部単純CTでは、両側後頭葉に低吸収域を認めたことから、可逆性後頭葉白質脳症(posterior reversible encephalopathy syndrome:PRES)の関与が示唆された。12誘導心電図検査では、経時的にT波の陰転化を認め、心臓超音波検査では、心尖部に限局した壁運動の低下を認めた。冠動脈造影CTでは、血管病変は認めず、たこつぼ心筋症と診断した。本症例は、重篤で多彩な臨床症状を示した、TMAを合併したMPAの1例である。ANCA関連血管炎に続発したTMA症例では免疫抑制療法開始後も注意深い経過観察が必要である。(著者抄録)

デジタル画像解析を用いたIgA腎症腎生検糸球体病変定量化

橋口明典, 石川雅浩, 城謙輔, 坂本直樹, 山内暁, 大塚武, 福西宗憲, 清水章, 久野敏, 片渕律子, 川村哲也

日本腎臓学会誌 ((一社)日本腎臓学会) 62 ( 4 ) 317 - 317 2020.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0385-2385

IgA腎症の組織分類の治療選択における有用性の検証

城謙輔, 中里毅, 橋口明典, 清水章, 片渕律子, 川村哲也

日本腎臓学会誌 ((一社)日本腎臓学会) 62 ( 4 ) 265 - 265 2020.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0385-2385

IgA腎症の組織学的重症度分類に関する亜型分類(A/C)のエヴィデンスに関する前向き多施設共同研究

城謙輔, 橋口明典, 久野敏, 清水章

日本病理学会会誌 ((一社)日本病理学会) 109 ( 1 ) 291 - 291 2020.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 0300-9181

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