[Blood purification after kidney transplantation].
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Adult↗
Biomedical subjects
M Arima
Publications and source records attributed to M Arima.
[Mediastinitis with bilateral empyemas following neck phlegmon].
A 46-year-old male complaining of fever and neck swelling was transferred to our department because of bilateral empyemas in the pleural spaces following neck phlegmon. A culture of the right pleural effusion obtained at his local hospital revealed Gram-positive anaerobic cocci. Chest roentgenogram showed bilateral effusions and widening of the upper mediastinum. Neck roentgenogram confirmed widening of the retropharyngeal space. CT clearly demonstrated a continuous lesion from the neck to the mediastinum and occupying the pleural spaces bilaterally. The patient responded to intravenous antibiotics and tube drainage of the pleural cavities, and was discharged after 10 weeks of hospitalization. Because no mediastinal abscess requiring drainage was recognized on CT, surgical drainage of the mediastinal space was not performed. Sequential CT was used to follow the lesion in the retropharyngeal space, mediastinum and pleural spaces, to check and reposition the tubes for drainage of pleural exudate.
Cellulitis↗
[Survey of Fukuyama type congenital muscular dystrophy in Tokyo].
On the 1st of April in 1988, we identified 26 children with Fukuyama type congenital muscular dystrophy (FCMD) among 1,227,000 children in Tokyo whose ages ranged from 6 to 14 years. The prevalence rate of FCMD was 2.1 per 100,000. All affected children attended special school for crippled children. Mean absence from school on account of illness was 33.9 days in a year. Fifteen among 26 affected children had ability of verbal communication. The loss of gross motor function started at ages 6-7 years but muscle weakness might have occurred earlier. Ten affected children were treated with antiepileptic drugs. Six affected children needed to be hospitalized for the treatment of vomiting with dehydration, acute bronchitis, or pertussis infection during one year until the 1st of April in 1989. Two cases among 26 with FCMD died of respiratory complications shortly after admission.
Adolescent↗
Giant somatosensory evoked potentials in the Rett syndrome.
Somatosensory evoked potentials (SEP) were recorded in ten patients with the Rett syndrome. Seven cases showed abnormal SEP, and five of these cases showed giant SEP. The five cases with giant SEP were relatively young girls with epilepsy and parieto-central spikes on the electro-encephalogram (EEG). Older patients did not show giant SEP. These giant SEP may be the reflection of cortical hyperexcitability and they may subside as the disease progresses.
Adolescent↗
A rare case with diurnal fluctuation of head instability, hypotonia and choreoathetotic movements improved by L-dopa treatment.
This report concerns a 6-year-old girl who showed peculiar symptoms but responded favourably to L-dopa. She developed normally until around 1 year of age, at which time head instability, hypotonia, increased deep tendon reflexes and choreoathetotic movements developed. These symptoms appeared to worsen in the afternoon and were alleviated after sleep. An extremely small dose of L-dopa (2 mg/kg) showed dramatic effects and her symptoms disappeared. This condition may be associated with the supersensitivity of the dopamine receptors, caused by hypofunction of the dopamine neurones.
Child↗
Evidence that a solubilizing agent has no effect on cyclosporine-associated hyperpotassemia.
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Castor Oil↗
Pion-nucleus scattering at 800 MeV/c.
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Journal Article↗
[Congenital lower urinary tract obstruction and enuresis in children].
We reviewed enuretic children among patients with congenital lower urinary tract obstructions experienced in the Department of Urology, Hyogo College of Medicine during 16 years from 1974 to 1989. Among 612 patients with congenital lower urinary tract obstructions, 139 (22.7%) had enuresis nocturna and/or diurna. The incidence of enuresis was 24.7% with posterior urethral valve (77 cases), 50.0% with anterior urethral valve (6 cases), 23.8% with congenital bulbar urethral stenosis in boys (303 cases) and 19.9% with congenital distal urethral stenosis in girls (226 cases). Diurnal enuresis was more common in enuresis associated with congenital lower urinary tract obstructions than in usual enuresis. In urodynamic examinations, more than half of enuretic children with congenital lower urinary obstructions showed hyperactive detrusor activity. Treatment of congenital lower urinary tract obstructions through operation resulted in cure or amelioration of enuresis in about 80% of the patients. Enuresis associated with lower urinary tract obstruction or neurogenic bladder is sometimes called complicated enuresis and it is an important role of a urologist to differentiate complicated enuresis from simple enuresis.
Adolescent↗
[A case of malakoplakia of the kidney and urinary bladder].
A case of malakoplakia which co-existed in the kidney and the urinary bladder is reported. The patient was a 51-year-old female who had been suffering from asymptomatic macroscopic hematuria. Cystoscopic examination revealed multiple yellow-red nodules in the posterior and lateral wall of the bladder. Transurethral punch biopsy of the mucosa was performed and histopathological examination of the specimens revealed the diagnosis of malakoplakia. The laboratory data at admission were within normal limits except for slightly accelerated erythrocyte sedimentation rate. The culture of urine was negative. The cytology of urine was interpreted as Papanicolaou class I. Intravenous pyelography demonstrated filling defect of the left upper renal calyx, which was confirmed by retrograde pyelography. Computerized tomography showed dilatation of the left upper calyx. An exploratory operation disclosed that the upper calyceal neck was obstructed by several small nodular lesion, which were very similar to the lesions in the bladder. Because intraoperative pathological diagnosis of the frozen section was malakoplakia, partial nephrectomy was performed. Histopathological examination of the kidney and the bladder showed typical Michaelis-Gutmann bodies in the granulomatous lesions. Follow-up examinations 4 months after operation revealed some residual lesions in the bladder which were treated with bethanechol, but no recurrence in the kidney.
Bethanechol↗
[Treatment of 300 patients with bladder cancer].
From September 1973 to September 1989, 300 patients with bladder cancer were treated at the Department of Urology, Hyogo College of Medicine. They were 231 males and 69 females with an average age of 65.3 years old. The overall 5-year survival rate (Kaplan-Meier's method) was 64.7%. The 5-year survival rates were not different between male patients and female patients, or between patients with single tumor and patients with multiple tumors. Patients with vesical irritation symptoms had more unfavorable prognosis than patients with painless hematuria. Size and configuration of the tumors also affected the prognosis. Histological diagnosis was transitional cell carcinoma in 291 patients, squamous cell carcinoma in 7 patients, adenocarcinoma in one patient and undifferentiated carcinoma in one patient. In patients with transitional cell carcinoma, the 5-year survival rates according to histological grades were 93.5% for G1, 77.8% for G2 and 31.6% for G3. The 5-year survival rate according to clinical stage was 94.4% for Ta, 79.7% for T1, 66.7% for Tis, 46.1% for T2, 38.5% for T3 and 26.6% for T4. Transurethral resection of bladder tumor (TUR-b.t.) was performed in 208 patients as an initial operation and the 5-year survival rate in these patients was 78.6%. The 5-year survival rates for total cystectomy (52 patients), partial cystectomy (6 patients) and simple tumor resection (4 patients) were 51.9%, 25.0% and 37.5%, respectively. These findings suggest that superficial tumors (Ta, T1) can be controlled with TUR-b.t. but infiltrating tumors (T2, T3, T4) should be treated more vigorously with multidisciplinary approaches.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Cyclosporine A inhibits allergen-induced late asthmatic response and increase of airway hyperresponsiveness in guinea pigs].
Considerable interest has recently focused on the role of T-cell function in the pathogenesis of asthma. We have previously demonstrated that repeated inhaled antigen (ovalbumin; OA) exposure resulted in an appearance of late phase airway obstruction (LAR) in more than 50% and significant increase of airway hyperresponsiveness (AH) in guinea pig experimental models. We have studied the effect of cyclosporine A (CsA), a potent helper T-cell suppressant, on these models in vivo. Respiratory resistance (Rrs) of sensitized guinea pigs by repeated OA inhalation was measured by the oscillation method and AH estimated as an inhaled concentration of histamine, causing a 200% increase in the baseline Rrs (PC200 Hist). The magnitude of immediate OA (10 mg/ml/min) inhalation-induced bronchoconstriction was not significantly different in CsA-treated (25 mg/kg/day, 7-day oral administration) and non-treated groups. However, the development of LAR was markedly inhibited in CsA treatment groups (n = 5). Antigen-induced increase of AH at 24 hr and 5 days was also significantly inhibited by CsA pretreatment. We conclude that CsA is capable of inhibiting the development of LAR and increase of AH, and thus the regulation of T-cell function may contribute to the treatment of asthma.
Airway Resistance↗
[Negative myoclonus; a simple partial seizure].
Negative myoclonus in a 4-year-old boy was analyzed by polygraphic study, which lead to the diagnosis of simple partial seizure. He had irregularly trembling movements of right upper limb when he held some objects with his right hand. There were also coarse trembling movements in his body and lower limbs while sitting or standing. Polygraphic recording showed that the involuntary movements were caused by intermittent inhibition of muscle contraction associated with electrical silence on EMG and spikes in the left central area on EEG.
Child, Preschool↗
[Cerebral white matter lesions in a case of incontinentia pigmenti with infantile spasms, mental retardation and left hemiparesis].
A Japanese girl with incontinentia pigmenti had characteristic skin lesions at birth. The diagnosis was confirmed by skin biopsy and positive family history. Her mother and sisters also suffered from IP. She had generalized tonic seizures at 1 month of age, and infantile spasms at 7 months. ACTH therapy was very effective to infantile spasms. At 9 years now, she is suffering from atypical absence, mild mental retardation and mild left hemiparesis. MRI revealed marked atrophy of the cerebral white matter predominantly around the posterior horn of right lateral ventricle, cystic lesions in the white matter around the anterior horns of both lateral ventricles, which were not clear by CT scan, and atrophy of the right cerebral peduncle and pontine basis. Although these findings are non-specific, they may be clues which explicate the mechanism of central nervous system involvement in incontinentia pigmenti.
Atrophy↗
[Involvement of platelet activating factor (PAF) in ovalbumin antigen-induced late asthmatic response and increase of airway hyperresponsiveness in a guinea pig experimental model of asthma].
Platelet activating factor, a potent chemical mediator, has been implicated in the pathogenesis of asthma in terms of inflammatory cell recruitment and activation. We have recently demonstrated that repeated antigen (ovalbumin; OA) exposure by inhalation to guinea pigs results in a development of late asthmatic response (LAR) in more than 50% of the animals and significant increase in airway hyperresponsiveness (AH). We have studied the effect of WEB 2086, a specific PAF receptor-antagonist, on this model. Respiratoly resistance (Res) of guinea pigs was measured by a oscillation technique and AH was evaluated by the provocative concentration of aerosols of histamine causing 200% increase of Rrs over the baseline Rrs (PC200 Hist). Four out of 5 actively sensitized and diphenhydramine-pretreated animals developed LAR 3 to 9 hr after allergen (20 mg/ml OA, 10 min inhalation)-induced immediate bronchoconstriction (LAR). Treatment with WEB 2086 (3 mg/kg intravenously) 30 min before and 3 hr after the exposure suppressed LAR clearly without affecting the IAR. Significant increase in AH from 2.80 +/- 0.03 to 2.51 +/- 0.01 and 2.60 +/- 0.08 (p less than 0.05, n = 8) of PC200 Hist (mg/ml, log) was observed 24 hr and 5 day after the OA exposure, respectively. The WEB 2086 treatment also prevented the increase of AH after the OA exposure (PC200 Hist; 2.82 +/- 0.09 before the challenge 2.80 +/- 0.07 and 2.75 +/- 0.09 24 hr and 5 days after, respectively. n = 8). Administration of WEB 2086 did not affect baseline Rrs and PC200 Hist in normal guinea pigs without any antigen challenge. We conclude that WEB 2086 is capable of preventing the development of LAR and increase in AH, and thus PAF may play an important causal role in LAR and increased AH observed in asthma.
Airway Resistance↗
Combined cisplatin and radiation therapy in patients with invasive bladder cancer.
Thirty-five patients with T2-T4 invasive bladder cancer were treated with combined cisplatin and radiation therapy. In 18 patients radical cystectomy was performed after the combined therapy. In the other 17 patients radical cystectomy could not be performed for various reasons. Pathological examination of the cystectomy specimens showed down-staging in 66.7% and no residual tumour in 33.3%. These results suggest a synergistic action of cisplatin and radiation. Side effects were not severe and were well tolerated. This combined therapy of cisplatin and radiation is very effective for invasive bladder cancer.
Adult↗
Ultrasonographically demonstrated nutcracker phenomenon: alternative to angiography.
We report on a child with nutcracker phenomenon, which is a possible cause of intermittent gross haematuria of unknown origin. Early serial ultrasound examinations can demonstrate the lesions. The merits and demerits of conventional angiographic imaging are also discussed.
Aorta, Abdominal↗
Clinical and immunohistochemical studies of subependymal giant cell astrocytomas associated with tuberous sclerosis.
Two cases of TS associated with brain tumors had severe psychomotor retardation and early onset of long-term intractable convulsions, compared with cases without tumors. In one case, the tumor was partially cystic and progressed rapidly. Immunohistochemical studies of neuron specific enolase, glial fibrillary acidic protein and myelin basic protein revealed differences in positivity between cell types and between cases. These results suggested that the origin of the tumor cells could be variably differentiated cells.
Adolescent↗
[Autotransfusion in urological surgery--experience with transurethral resection].
With the purpose to avoid the risk of homologous transfusion, autologous blood transfusion was performed in 26 patients who underwent transurethral resection of the prostate (TUR-P). Autologous blood (200-400 ml/time, 1-3 times, total 200-800 ml, mean 381 ml) was predeposited 4 days to 3 weeks prior to elected TUR-P and was transfused during or just after the operation. Since the start of this program in February 1988, homologous transfusion rate was decreased to 13.1%, whereas it has been 22.3% in 203 cases between January 1984 and January 1988. The mean hemoglobin level fell to 81.6% of the predeposition level. However, the hemoglobin level recovered to 90.1% one month after operation. The circulatory condition of the patients with autologous transfusions was stabler than that of the patients with homologous transfusion or no transfusion. No clinical hemostatic problems occurred. In cases with mild to moderate volume resection of the prostate, this autologous blood transfusion is recommended.
Aged↗