Seven hundred and twenty-seven renal transplant patients are reviewed with respect to the occurrence of urinary tract infection (UTI) after renal transplantation. UTI was defined as the detection of both bacteriuria (10(5) CFU/ml) and pyuria (10 leukocytes/hpf). UTI developed in 11 of the inpatients (20.8%) and in 30 (4.2%) of the outpatients during a one-year period. Among outpatients, 12 had symptomatic infections, comprising seven with acute pyelonephritis and five with acute cystitis. Asymptomatic UTI was detected in 18 patients. In addition, asymptomatic bacteriuria without pyuria was observed in ten (1.4%) patients. UTI was more common in patients with diabetes, and underlying urinary tract complications were present in some patients. Administration of trimethoprim-sulfamethoxazole for about 4 months is suggested to reduce the frequency of UTI in the early period after renal transplantation.

Anti-Bacterial Agents↗

PubMedDate not supplied

Combined intensive chemotherapy and radical surgery for incurable gastric cancer.

BACKGROUND: To improve the poor prognosis of patients with advanced incurable gastric cancer, intensive chemotherapy combined with radical surgery was used. PATIENTS AND METHODS: Thirty patients with incurable gastric cancer were treated with a combination of 5-fluorouracil (370 mg/m2) and leucovorin (30 mg/person), given intravenously for five consecutive days, followed by cisplatinum (70 mg/m2) and etoposide (70 mg/m2) on days 6 and 20, delivered through a catheter placed either in the aorta with its tip at the level of the ninth thoracic vertebra or in the celiac artery. This treatment (FLEP therapy) was repeated twice every 5 weeks. Radical or palliative surgery followed chemotherapy. RESULTS: The overall response rate to the chemotherapy was 50.0% (15 of 30 patients, 95% confidence limit 0.305-0.671). Nineteen patients (15 with a partial response, three showing no change, and one with progressive disease) underwent surgery. Of these, nine underwent curative surgery and 10 palliative surgery. The median survival time was 6.5 months overall, 12.7 months for responders, and 4.7 months for nonresponders. Long-term survivors were exclusively found among patients with distant lymph node metastasis treated by curative surgery (55.6% at 5 years). CONCLUSIONS: Favorable results of this small phase II study justify a phase III trial.

Adenocarcinoma↗

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A simple method for cryopreservation of purified adult pig pancreatic cells.

Cryopreservation of islet cells may benefit many aspects of islet transplantation including storage, transport of islets, immunomodulation, reduction of the exocrine contaminants. Isolation and purification of islets from large mammalian pancreases have been encountered by many problems. We reported an autodigestion method for preparation of adult pig pancreatic cells. In this paper, we describe a newly invented simple method for cryopreservation of purified adult pig pancreatic cells. The viability and function of islet cells before (precryo.) and after (postcryo.) the cryopreservation procedure were compared. Islet cell harvested by the autodigestion method were suspended in cryoprotectant "Cell banker." A biofreezing vessel "Bicell" containing a cryogenic vial with cell suspension was frozen at -80 degrees C. After 4 wk, the cryogenic vial was rapidly thawed at 37 degrees C water, the islet cells were washed and cultured for overnight. Number of dithizone-stained precryo. and postcryo. cells were 1.71 +/- 0.5 x 10(5) and 1.75 +/- 0.98 x 10(5) cells/pancreas respectively; therefore, the viability was 99%. Insulin release following high and low concentrations of glucose in precryo. (12.02 +/- 3.63 ng/ml: low-glucose, 9.81 +/- 3.59 ng/ml: high glucose) and precryo. (5.57 +/- 4.03 ng/ml: low-glucose, 10.24 +/- 8.88 ng/ml: high glucose) cells showed a marked improvement in response in postcryo. cells. The insulin content of precryo. and postcryo. cells were 914.4 +/- 277.4 and 93.6 +/- 15.4 ng/ml, respectively. This simple and efficient cryopreservation protocol may be applied for a large-scale storage of adult pig islet cells to establish an islet bank for transplantation.

Age Factors↗

PubMedDate not supplied

Upregulation of insulin-like growth factor receptor gene in experimental diabetic rat glomeruli.

Renal hypertrophy is a characteristic and early manifestation of diabetes in human and experimental animals. We examined the precise distribution of insulin-like growth factor-I (IGF-I) receptor mRNA in the experimental diabetic rat kidney using a nonradioactive in situ hybridization technique. Expression of IGF-I receptor mRNA was rarely seen in the glomeruli of control rats. IGF-I receptor mRNA was detected after induction of diabetes in glomerular mesangial, visceral epithelial, and parietal epithelial cells. The number of IGF-I receptor mRNA-positive cells in a glomerulus increased significantly at 4 weeks as compared with the control rats. Overexpression of IGF-I receptor in glomerular cells may contribute to the glomerular hypertrophy in diabetic nephropathy.

Animals↗

PubMedDate not supplied

Localization of advanced glycation endproducts in the kidney of experimental diabetic rats.

Advanced glycation endproducts (AGE) have been proposed as a major mediator in the development of various diabetic complications. In order to evaluate the involvement of AGE in the development of diabetic nephropathy, we examined the localization of AGE in the kidney of the streptozotocin-induced diabetic rats immunohistochemically using a monoclonal antibody directed to AGE. In the diabetic rats, glomerular hypertrophy, thickening of the glomerular basement membrane, and expansion of mesangial matrix were observed. AGE was detected in expanded mesangial area and glomerular basement membrane in the kidneys of diabetic rats. The present results suggest that AGE may participate in the development of diabetic nephropathy.

Animals↗

PubMedDate not supplied

The ultrastructural disruption of the glomerular basement membrane in diabetic nephropathy revealed by "tissue negative staining method".

To clarify the ultrastructural changes of the glomerular basement membrane (GBM) in diabetic nephropathy, the renal tissues of the patients with diabetic nephropathy were examined by electron microscopy using our newly devised "tissue negative staining method." A fine meshwork structure consisting of fibrils forming the small pores are observed in the normal human GBM. The diameter of these pores was slightly smaller than that of human albumin molecules. The GBM in patients with diabetic nephropathy showed irregular thickening. At higher magnification, cavities and tunnel structures, which were not seen in normal controls, were observed in the thickened GBM. As the diameters of the cavities and tunnels were far larger than the dimensions of albumin molecules, these enlarged structures are considered to allow serum protein molecules to pass through the GBM from the capillary lumen to the urinary space. The present results suggest that the cause of massive proteinuria in diabetic nephropathy is the disruption of the size barrier of the GBM.

Basement Membrane↗

PubMedDate not supplied

Two factors of experienced deficits in schizophrenia and their relationships with positive, negative, and depressive symptoms.

Eighty inpatients and 20 outpatients with ICD-10 schizophrenia were assessed with the Manchester Scale (MS) and the scale for the assessment of Subjective Experience of Deficits in Schizophrenia (SEDS). A factor analysis on MS scores yielded a three-factor solution: negative symptoms, positive symptoms, and anxious-depressive factor. On the other hand, a factor analysis on SEDS scores provided a seven-factor solution. The first factor, "awareness of social incompetence (ASI)," positively correlated with the anxious-depressive factor. ASI may reflect a negative cognitive attitude of persons who easily become depressive. The second factor, "subjective cognitive disturbance (SCD)," positively correlated with the positive-symptoms factor. SCD might represent a subtle disturbance, which can also produce positive symptoms. We found no factor on SEDS that correlated with the negative-symptoms factor. It was noted that a selection and comparison of items and the cultural background of subjects should be considered.

Adolescent↗

PubMedDate not supplied