Clinical guidelines of IgA nephropathy.
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Glomerulonephritis, IGA↗
Biomedical subjects
H Sakai
Publications and source records attributed to H Sakai.
The use of percutaneous ethanol injection therapy for recurrence of hepatocellular carcinoma.
Forty patients with hepatocellular carcinoma were treated with percutaneous ethanol injection therapy. All patients had fewer than three tumors of less than 30 mm in diameter. Additionally, all recurrences with fewer than 3 tumors of less than 30 mm in diameter was repeated for 33 recurrences and discontinued in 17 cases. Duration between treatments became significantly shorter with successive treatments. There was no significant difference in the duration between treatments in patients classified by tumor size (less than 20 mm vs. 20 mm or more), whereas there was a significantly lower recurrence rate in patients with solitary tumors as compared with those with multiple HCC. Laboratory data before successive PEI-treatments were also compared, and showed that hepatic functional reserve did not decrease with repeat percutaneous ethanol injection. The cumulative survival rate in all 40 patients after the first treatment was significantly higher than in the 17 patients for whom treatment was discontinued.
Carcinoma, Hepatocellular↗
Postmarketing surveillance on side-effects of cefminox sodium (Meicelin).
A postmarketing surveillance of cefminox sodium (Meicelin, CMNX) for intravenous injection was conducted for about 4 years from August 1987 through June 1991, and 13,431 patients were followed up to evaluate the safety of the drug. The incidence of side-effects was 1.76%. By organ, the most frequently observed were hepatic and of the bile duct system (0.87%) followed by those on leukocytes and reticuloendothelial system (0.24%), skin and adnexa (0.24%) and digestive tract (0.16%) indicating a tendency similar to that of other injectable cephalosporins. The incidence of the side-effects among elderly patients (65 years old or older) was 2.12%, whereas among patients 64 years old or younger it was 1.58% with no significant differences between the two groups. No side-effects specific to the elderly were observed. Among children 15 years old or younger the incidence was 0.59%, which was lower than that for patients 16 years old or older (1.90%). Potential side-effects on pregnant women (n = 101) and their babies were also checked. No side-effects occurred among the 52 pregnant women evaluated and no abnormalities were detected in their babies who were followed up for up to 4 years. Cefminox is thus considered to be a highly safe cephalosporin antibiotic.
Adolescent↗
Polymorphism of immunoglobulin heavy chain switch region gene in children with severe IgA nephropathy.
We examined restriction fragment length polymorphisms (RFLPs) of the switch region genes of the IgM (S mu) and IgA1 (S alpha 1) heavy chain in 78 Japanese children with IgA nephropathy and 88 normal Japanese controls. Genomic DNA obtained from patients and controls was digested with the restriction endonuclease SacI, transferred to nylon membrane using Southern blot procedure, and hybridized with a DNA probe homologous to S mu. This probe detects RFLPs at the S mu and S alpha 1 loci by enhanced chemiluminescence. The genotypic frequency of the S mu and S alpha 1 alleles in patients with IgA nephropathy was similar to normal controls. However, there was a significant association of genotypes with the pathological severity. There was a decreased frequency of the 2.6/2.1 kb S mu heterozygous genotype in patients showing diffuse mesangial proliferation compared to controls or patients showing minimal or focal mesangial proliferation. Our results suggest that immunoglobulin heavy chain switch region genes may not influence susceptibility to IgA nephropathy in children, but may influence the pathological expression of childhood IgA nephropathy.
Alleles↗
[Measurement of electrooculogram in the cat].
In humans, the light peak/dark trough ratio (L/D ratio or Arden ratio) of the electrooculogram (EOG) is conventionally used as an index to estimate the function of the retinal pigment epithelium, but it is rarely in animals. We obtained stable EOG recording in the cat under general anesthesia during light and dark adaptations by applying mechanical forced duction of approximately 3.0 mm in width to one eye of an animal. In five animals, voltages of the dark baseline, the light peak, and dark trough were 580-1,800 (mean, 1,312 microV), 825-2,660 microV (mean, 1,881 microV) and 415-1,480 microV (mean, 1,030 microV), respectively. The L/D ratio in the five animals was 1.70-1.99 (mean, 1.83), similar to that in humans. The present results suggest that the EOG recording by forced duction in experimental animals can be developed into another method to evaluate the retinal pigment epithelial function, particularly to evaluate its potential disorder induced by fluoroquinolones.
Animals↗
Patients with hepatitis A with negative IgM-HA antibody at early stages.
Two patients with acute liver dysfunction who were negative for serum IgM-HA antibody on presentation became positive a week later. At early stages of hepatitis A, serum IgM-HA antibody may be negative. Another assay approximately 2 wk apart is recommended.
Adult↗
[Unexpected intraoperative respiratory distress; an infant who developed tracheomalacia and fatal aortoesophageal fistula due to unrecognized vascular ring].
Vascular rings cause respiratory distress and dysphasia by tracheoesophageal compression. We present a case of tracheomalasia and fatal aortoesophageal fistula due to unrecognized vascular ring. A 3-month-old (7.3 kg) boy underwent V-P shunt operation under sevoflurane anesthesia. The trachea was intubated easily using vecuronium with a relatively large-size tube with a diameter of 4.5 mm, because of leakage. Gastric intubation was difficult. During scrubbing of the head, an asthma-like respiratory distress suddenly occurred. The condition responded poorly to ventilatory support and pharmacological interventions. Although intraoperative fiberscopy through the tracheal tube and chest X-ray showed no tracheobroncheal abnormality, postoperative fiberscopy revealed a tracheomalacia. Adequate ventilation was possible only when the tip of the tracheal tube was located between the stenotic part and the tracheal carina. On the 9th postoperative day, during respiratory management with a tracheal tube, fatal esophageal hemorrhage broke out. Postmortern examination revealed a double aortic arch with tracheal stenosis and aortoesophageal fistula. The nasogastric tube may have led to fistula formation by compression of the esophageal wall against an anomalous vessel. When anesthetists encounter an infantile respiratory distress, even in perioperative period, vascular rings should be taken into consideration.
Aorta, Thoracic↗
[Absorption, distribution, excretion and metabolism of [14C] T-3761 in rats and mice].
Absorption, distribution, excretion and metabolism were studied in rats and mice after oral and intravenous administration of 5 mg/kg of [14C] T-3761. 1. [14C] T-3761 was rapidly absorbed after oral administration and maximum serum concentration of radioactivity was observed at 15 min. and at 10 min. in rats and mice, respectively. After that, radioactivity of serum declined rapidly. 2. The administered radioactivity was excreted mainly in the urine in rats and mice and excretion rate was 84% and 74%, respectively. The residual radioactivity was excreted in the feces. In both species, the urinary excretion rate after oral administration was similar to that after intravenous administration, suggesting that [14C] T-3761 was absorbed almost completely. 3. In the rat urine, over 90% of excreted radioactivity was T-3761. On the other hand, about 57% of excreted radioactivity was presumed to be glucuronide conjugate of T-3761 in the mice urine. 4. The biliary excretion of radioactivity in rats after oral administration was approximately 22%, and about 83% of those was presumed to be glucuronide conjugate. About 40% of the excreted radioactivity was reabsorbed from the intestinal tract. 5. Except gastrointestinal tract, tissue concentration of radioactivity after oral administration was high in kidney and liver. Radioactivity was widely distributed in other tissues at lower concentration than in the plasma, whereas hardly distributed in brain and spinal cord. 6. Whole body autoradiograms in rats indicate that radioactivity were widely distributed except central nervous systems. 7. The extent of the binding of [14C] T-3761 to serum protein was 23-31% and 25-34% in rats and mice, respectively.
Administration, Oral↗
[Relationship between proliferative activity, and tissue differentiation and invasive mode in human oral squamous cell and colorectal carcinomas analysed by PCNA immunostaining].
The proliferative activity of carcinoma cells is generally considered to relate to the degree of the malignancy of carcinoma tissues. In this study, the proliferative activity at the tumor-stromal border was studied in 17 cases of oral squamous cell carcinoma (OSCC) and in 30 cases of colorectal adenocarcinoma (CAC) by means of proliferating cell nuclear antigen (PCNA) immunostaining, to evaluate the correlation between proliferative activity and tissue differentiation or invasive mode at the tumor-stromal border. No statistical difference was detected between the PCNA labelling index (PI) and the tissue differentiation of both OSCC and CAC. A significant difference was demonstrated between PI and invasive mode in OSCC, suggesting that the invasive mode at the tumor-stromal border relate to the degree of the malignancy of carcinoma tissues. However, no significance was found between PI and invasive mode of CAC. In addition, no difference of PI was demonstrated between tissue differentiation or invasive mode, and vascular invasion or lymph node metastasis. Therefore, it seems likely that the invasive mode at the tumor-stromal border in CAC also has no significance in deciding the degree of the malignancy of carcinoma tissues.
Adenocarcinoma↗
[Adeno-tonsillectomy after cardiac transplantation in a child].
A case report of a boy who had a heart transplant at age one, and an adeno-tonsillectomy at age 2 years and 2 months, is presented. The patient showed severe episodic hypoxemia and poor weight gain (below 3 SD) due to upper airway obstruction caused by enlarged adenoids and tonsils. He was very active and no signs of congestive heart failure were noted. General anesthesia was induced with thiopental and maintained with a balanced anesthesia of nitrous oxide, oxygen, fentanyl, and vecuronium bromide. The heart rate did not increase with endotracheal intubation nor adenoidectomy but heart rate and blood pressure did increase slowly by the time the tonsillectomy was performed. Arrhythmia did not appear throughout the procedure and anesthesia was uneventful. A nasal endotracheal tube was kept in place for 4 days until surgical edema subsided. Respiratory inductive plethysmography performed before surgery and 2 days after extubation showed improvement of upper airway obstruction. The patient's blood concentration of cyclosporine fell briefly below the optimal level perioperatively due to unavailability of intravenous preparation in Japan. Various aspects of non-cardiac anesthesia for children who have experienced cardiac transplants are discussed.
Anesthesia, General↗
[A case of Kasabach-Merrit syndrome complicated with DIC treated effectively by long term oral administration of warfarin].
A 20 year-old female patient with Kasabach-Merrit syndrome, suffered from chronic consumption coagulopathy due to localized intravascular coagulation in the tumors. She had been diagnosed as Kasabach-Merrit syndrome immediately after birth and below knee amputation of her right lower leg was performed at the age of 2 years because of her giant hemangioma on the right foot and lower leg. After the operation, she had often complained of severe pain and enlargement of the residual tumors due to continuous thrombus formation within the tumors. She was admitted to the third Department of Tohoku University Hospital in order to initiate oral anticoagulant therapy with Warfarin at the age of 12 years. After the administration of 2.5 mg/day Warfarin, she has maintained good clinical condition until now, despite the occasional occurrence of coagulation abnormalities. We believe that the results of this case indicate the efficacy of oral anticoagulant therapy in the treatment of chronic consumption coagulopathies complicated with other diseases.
Administration, Oral↗
[Atrophic gastritis in Sjögren's syndrome].
In patients with Sjögren's syndrome (SJS), it has been found that chronic atrophic gastritis is often associated with low HCl secretion or achlorhydria. However, the role of autoimmune injuring mechanism in the pathogenesis of the atrophic gastritis in SJS is unclear. In recent studies, Helicobacter pylori (HP) infection is accepted as the major cause of chronic gastritis. In our studies, HP infection was present in the half of SJS patients with atrophic gastritis. We also determined HP specific IgG antibody levels by enzyme-linked immunosorbent assay (ELISA). In SJS patients with gastric inflammatory cell infiltration, the IgG levels were high. We determined gastric parietal cell antibody (PCA) levels by ELISA, using a recombinant fusion protein of the alpha subunit of gastric H+, K(+)-ATPase. Our observation suggests that atrophic gastritis in SJS is caused by HP infection associated with gastric mucosal injury due to PCA.
Autoantibodies↗
Aeromonas sobria infection with severe muscle degeneration in a patient with alcoholic liver cirrhosis.
A 56-yr-old male who had been followed for alcoholic liver disease was admitted for abdominal pain and a high fever. Gastrointestinal endoscopy revealed bleeding esophageal varices that were treated by endoscopic sclerotherapy. Blood culture on admission was positive for Aeromonas sobria. Then skin bullas and ulcers and severe muscle degeneration developed. The patient died despite extensive treatment with antibiotics. A. sobria infection in patients with liver cirrhosis is rare.
Aeromonas↗
Etiology and prognosis of liver cirrhosis in elderly patients.
We compared the etiology and prognosis of liver cirrhosis in patients age 60 and older with that of patients under age 60 during the 1980s (1981-89, n = 207). Non-A, non-B hepatitis (NANB) was significantly more prevalent in the elderly (p < 0.05), and the mean age of NANB and alcoholic cirrhosis (Alc) were significantly older than those with hepatitis B virus (HBV) (p < 0.05). Evaluation using hepatitis C virus (HCV) antibody also revealed significantly higher mean age of HCV (p < 0.05). Male patient was predominant in the younger patients than in the elderly patients. (M/F = 2.94 and 1.33, respectively) The estimated 5-year survival rate was 73.1% in the younger patients and 60.2% in the elderly patients (p < 0.05). Multivariate analysis revealed that male sex, a lower serum albumin level, and the presence of the encephalopathy were significantly associated with poor prognosis in the elderly, while a lower serum cholinesterase level and a higher indocyanin green retention rate at 15 minutes (ICGR15) were significantly associated with poor prognosis in younger patients. However, causes of deaths were not significantly different between the younger patients and the elderly patients, the proportion of deaths unrelated to liver disease predominated in the elderly patients. Thus, the etiology and the prognostic factors of liver cirrhosis in elderly patients differ from those in younger patients.
Age Factors↗
[Fitz-Hugh-Curtis syndrome].
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Chlamydia Infections↗
Establishment of a melanoma cell line with metastatic characteristics.
We report here the establishment and characterization of a human melanoma cell line derived from the ascitic fluid of a patient with metastatic malignant melanoma with peritonitis carcinomatosa. This cell line was easily transplanted into nude mice. Flow cytometry and immunocytochemical analyses demonstrated that the cells expressed melanotransferrin and S-100 protein. Expression of cell adhesion and HLA molecules on the cells was also investigated. The results indicate that the cell line possesses some metastatic characteristics.
Aged↗
Wegener's granulomatosis with relapsed bleeding of gastric ulcers: a case report.
We treated a 55-year-old male patient with Wegener's granulomatosis (WG) associated with frequent gastric bleeding from multiple ulcerative lesions. Only a few cases of frequent hemorrhaging of peptic ulcers associated with WG have been reported. In our case, a gastric biopsy showed mononuclear cell infiltration in the submucosal area, without granulomas or vasculitis. An endoscopic maneuver, as well as administration of immunosuppressive agents, combined with an H2 receptor antagonist and proton pump inhibitor successfully eliminated the gastrointestinal bleeding. In this case, proof that the gastrointestinal involvement was pathologically related to WG could not be demonstrated because neither granulomas nor vasculitis were observed in the insufficient biopsy specimen of the stomach. It is also possible that the uremic state and cytotoxic agents worsened the gastrointestinal involvement. However, immunosuppressive therapy combined with routine antiulcer treatment was very effective in repairing the ulcerative lesions. The gastrointestinal involvement was considered a possible complication of the WG.
Gastroscopy↗
Intracellular Ca2+ concentration change of T24 cell under irradiation in the presence of TiO2 ultrafine particles.
We reported that malignant cells are inactivated by photo-excited TiO2 particles (Cai, R.-X., et al. (1992) Cancer Res. 52, 2346-2348). In the present study, the process of cell death of a human bladder cell line T24 with the irradiated TiO2 was investigated by monitoring the time course change in intracellular calcium concentration ([Ca2+]i) under UV irradiation using calcium fluorescence indicator, fura-2. In the presence of photo-excited TiO2 particles (100 micrograms/ml), [Ca2+]i showed a rapid two-step increase; while in the absence of TiO2, it exhibited only a slight and monotonous increase or maintained a constant level. The rapid elevation of [Ca2+]i in the presence of photo-excited TiO2 particles was caused by the influx of extracellular Ca2+ through the plasma membrane and cell death occurred only after the second rapid elevation of [Ca2+]i. These results suggested that the cell membrane permeability to Ca2+ was promoted prior to cell death.
Calcium↗