Biomedical subjects

M Miki

Publications and source records attributed to M Miki.

At least 55 records · Page 3Linked to original sources

PubMed1998

A combination of semiquantitative telomerase assay and in-cell telomerase activity measurement using exfoliated urothelial cells for the detection of urothelial neoplasia.

BACKGROUND: Telomerase is a ribonucleoprotein that synthesizes telomeres. It is detected in more than 85% of samples obtained from cancer tissues, including urologic neoplasia. The authors determined telomerase activity semiquantatively and in-cell telomerase activity in exfoliated urothelial cells obtained from urologic neoplasia specimens. The goal of this study was to provide additional information regarding a noninvasive approach to the detection of urologic neoplasia. METHODS: The authors used voided urine from 23 patients with urologic neoplasia, 2 patients with nonmalignant urologic disorders, and 10 normal individuals. Semiquantative determination of telomerase activity was performed using a fluorescence-based telomeric repeat amplification protocol (TRAP), and telomerase activity at the cellular level was determined by an in situ TRAP assay. RESULTS: The fluorescence-based TRAP assay detected urinary telomerase activity in samples from 10 of 13 patients with urologic neoplasia before treatment, whereas urinary cells obtained from 3 of 10 patients (including 1 patient with relapse) during or after treatment had detectable telomerase activity. In contrast, the in situ TRAP assay detected telomerase positive cells in samples from 11 of 13 patients before treatment and 6 of 10 patients during or after treatment. Of note was a dissociation of the results of the fluorescence-based TRAP assay and those of the in situ TRAP assay for some patients. Some patients for whom telomerase activity was not detected with the fluorescence-based TRAP assay had a low frequency of telomerase positive cells in their urine. CONCLUSIONS: A combination of semiquantative analysis and an in situ TRAP assay to detect telomerase positive cells might be a useful tool in the identification and monitoring of patients with urothelial neoplasia.

Adult↗

PubMed1998

Local expression of immunoregulatory IL-12p40 gene prolonged syngeneic islet graft survival in diabetic NOD mice.

Local production of immunosuppressive cytokines will be one of the most suitable therapeutic strategies against organ-specific autoimmune diabetes. To establish such a new therapy, we constructed recombinant adenoviral vectors with inserted mIL-12p40 (Ad.IL-12p40) and mIL-10 (Ad.IL-10). Sufficient amounts of IL-12p40 and IL-10 were secreted by relevant adenovirus-transfected nonobese diabetic (NOD) islets. Shortly after transfection, 400 NOD islets transfected with Ad.IL-12p40 or Ad.IL-10 were transplanted under the renal capsule of a newly diabetic NOD mouse. NOD mice with IL-12p40-producing islet grafts kept normoglycemia in all of 14 grafted mice for over 4 wk after transplantation. In contrast, NOD mice with IL-10-producing islet grafts became diabetic in all of six grafted mice within 2 wk af-ter transplantation. Reverse transcription-PCR analysis revealed that local production of IL-12p40 led to the decrease of interferon-gamma and the augmentation of transforming growth factor-beta at the graft site. These results suggest that IL-12 plays an important role in the destruction of islet cells at the inflamed site of autoimmunity. Such a local blockade of IL-12 would be a useful gene therapy for human autoimmune diabetes.

Adenoviridae↗

PubMed1998

Administration of IL-4 prevents autoimmune diabetes but enhances pancreatic insulitis in NOD mice.

The present study demonstrated that the administration of recombinant interleukin-4 (rIL-4) prevented overt diabetes in nonobese diabetic (NOD) mice whose T cells produced relatively low amounts of IL-4. However, massive insulitis was observed in rIL-4-treated NOD mice. The flow cytometric analysis of islet-infiltrating T cells revealed that the number of CD45RBlowCD4+ T cells was significantly increased by in vivo administration of rIL-4. By measuring the cytokine production of splenic T cells after stimulation, it was shown that CD45RBlowCD4+ T cells predominantly produced IL-4 and IL-10 but produced less IL-2 and interferon-gamma (IFN-gamma). A semiquantitative reverse-transcriptase polymerase chain reaction assay revealed a higher expression of IL-4 and IL-10 mRNA and an apparent decrease in IFN-gamma mRNA in the islets of NOD mice which were administered rIL-4. These results suggested that autoreactive CD45RBlowCD4+ T helper 2 (Th2)-like cells which developed following rIL-4 administration were predominant in the infiltrate of the islets, and overt diabetes was prevented. On the other hand, when splenocytes from rIL-4-treated NOD mice were transferred to irradiated NOD recipients, along with splenocytes from diabetic NOD mice, all of the recipient mice became diabetic within 8 weeks after transfer. Considered together, a supplement of rIL-4 administered to NOD mice may protect against autoimmune diabetes by facilitating the development of Th2-like autoreactive T cells in the islets.

Animals↗

PubMed1998

Actions of cyclic esters, S-esters, and amides of phenyl- and phenylthiophosphonic acids on mammalian and insect GABA-gated chloride channels.

Cyclic esters, S-esters, and amides of phenyl(thio)phosphonic acid were synthesized to probe the interaction between noncompetitive antagonists of ionotropic gamma-aminobutyric acid (GABA) receptors and their binding site. Some of these compounds competitively inhibited the specific binding of [3H]EBOB, a noncompetitive GABA antagonist, to rat-brain and housefly-head membranes. The trans isomer of the ester bearing a tert-butyl group at the 5-position and a bromine atom at the p-position (5t) was most potent in rat receptors with an IC50 value of 40 nM, while the trans isomer of the S-ester bearing the same substituents (10t) was most potent in housefly receptors with an IC50 value of 55 nM. In both cases, the corresponding amide analogue (12t) was less potent. The potencies of 5t and 12t tended to decrease in the presence of GABA, particularly in housefly receptors, while that of 10t remained unchanged. The rank order of activity in inhibiting [3H]EBOB binding to housefly-head membranes in the presence of GABA (10t > 5t > 12t) was in accord with that of insecticidal activity. S-Ester 10t depressed 10 microM and 300 microM GABA-induced 36Cl- influx into mouse cerebral synaptoneurosomes, whereas ester 5t depressed 10 microM GABA-induced 36Cl- influx but not 300 microM GABA-induced flux. Amide 12t was inactive at both GABA concentrations. These findings indicate that six-membered cyclic phenylthiophosphonic acid derivatives act as noncompetitive antagonists of GABA receptors and suggest that 10t is able to bind to the receptor in the open, desensitized, and closed states, whereas the affinity of 5t and 12t is lower in the open and desensitized states than in the closed state. The derivatives have similar structures except for the heteroatoms at the 1- and 3-positions, so that the heteroatoms may play a unique role when antagonists bring the open state of the GABA-gated channel to the desensitized or closed state.

Affinity Labels↗

PubMed1998

Ca2+-induced distance change between points on actin and troponin in skeletal muscle thin filaments estimated by fluorescence energy transfer spectroscopy.

Fluorescence resonance energy transfer spectroscopy has been used to study the spatial relationships between probes attached to actin and troponin in the reconstituted skeletal muscle thin filament in the presence and absence of Ca2+ ions. Gln-41 and the nucleotide-binding site of actin were selectively labeled with the acceptor probe: fluorescein cadaverine and 2'(or 3')-O-(2,4,6-trinitrophenyl)adenosine 5'-diphosphate (TNP-ADP), respectively. Troponin was selectively labeled at positions 9 or 133 of troponin-I and 98 of troponin-C with a donor probe; 5-(2-iodoacetylaminoethyl)aminonaphthalene 1-sulfonic acid (IAEDANS). The distances between probes attached to position 133 of TnI and Gln-41 or the nucleotide site of actin were determined to be 51.6+/-1.2 and 42.7+/-0.9 A respectively in the presence of Ca2+, and these distances decreased by 11.5 and 9.3 A respectively in the absence of Ca2+ ions. The distances between the probes attached to position 9 of TnI and Gln-41 or the nucleotide site of actin were determined to be 59.1+/-2.0 or 49.3+/-1.5 A respectively in the presence of Ca2+, and the distances decreased by 5.3 or 3.7 A in the absence of Ca2+. The distances between probes attached to position 98 of TnC and Gln-41 or the nucleotide site of actin were determined to be 55.1+/-1.7 and 57+/-5 A in the presence of Ca2+ and the distances increased slightly by approximately 1 A in the absence of Ca2+. The results suggest that the C-terminal domain of troponin I moves to the outer domain of actin during inhibition, while the C-terminal domain of TnC does not move much.

Actin Cytoskeleton↗

PubMed1998

Fluorescence resonance energy transfer between points on tropomyosin and actin in skeletal muscle thin filaments: does tropomyosin move?

Fluorescence resonance energy transfer (FRET) spectroscopy has been used to determine spatial relationships between residues on tropomyosin and actin in reconstituted muscle thin filament, and to detect a positional change of tropomyosin relative to actin on the thin filament in the presence and absence of Ca2+ ions. In addition to Cys-190 which is a single cysteine residue in rabbit skeletal muscle alpha-tropomyosin, a new site, Cys-87 which is a unique cysteine residue in a mutant alpha-tropomyosin, was labeled with a resonance energy donor molecule, 5-(2-iodoacetylaminoethyl)aminonaphthalene 1-sulfonic acid (IAEDANS). On the other hand, Gln-41, Lys-61, Cys-374, and the ATP-binding site of actin were selectively labeled with acceptor probes: fluorescein cadaverine, fluorescein 5-isothiocyanate, 4-dimethyl-aminophenylazophenyl 4'-maleimide, and TNP-ATP (or TNP-ADP), respectively. The distances between probes attached to position 87 of the mutant tropomyosin and Gln-41, Lys-61, Cys-374, or the nucleotide-binding site of actin on the reconstituted thin filament in the presence of Ca2+ ion were measured to be 43.2, 49.7, 45.4, and 35.2 A, respectively, and the distance between probes attached to position 190 of tropomyosin and Gln-41 or the nucleotide-binding site of actin were 51.6 and 43.1 A, respectively. The transfer efficiencies between these donor and acceptor molecules were large, so that the efficiency should be very sensitive to changes in distance between probes attached to tropomyosin and actin. However, the transfer efficiency did not change appreciably upon removal of Ca2+ ions, suggesting that tropomyosin does not change its position on the reconstituted thin filament in response to a change in Ca2+ ion concentration. The present results do not support the notion of tropomyosin movement on skeletal muscle thin filaments as proposed in the steric blocking theory.

Actins↗

PubMed1998

Follow-up of patients with superior vena cava syndrome by functional analysis of radionuclide venography.

In addition to imaging, radionuclide venography can be used for studying haemodynamic changes in superior vena cava syndrome (SVCS) by using the indices of transit time (TT), time of half peak count (TH) and peak count ratio (PC ratio). The objective of this study was to examine the utility of applying these indices, alongside images, in the post-therapy assessment of SVCS patients. Radionuclide venography was performed twice on 36 patients with SVCS due to thoracic malignancies, 29 of whom received specific anti-cancer therapy between the two studies (Group I); the other 7 did not receive such therapy (Group II). On the images, 12 patients in Group I showed improvement, one a deterioration and 16 no change; in Group II, 4 showed a deterioration and 3 no change. Using the indices, nearly all patients in Group I had decreased post-therapy values indicating haemodynamic improvement. A significant difference was seen between the mean (+/- S.E.) pre- and post-therapy values for TT (pre vs post: 6.2 +/- 0.7 vs 2.7 +/- 0.3 s) and TH (pre vs post: 16.9 +/- 2.3 vs 7.9 +/- 0.8 s) (P < 0.001). Although the PC ratio showed a non-significant decrement, it related to the status of collateral change. The above indices provide clinically valuable information about the haemodynamic status of patients with SVCS and can be used for their post-therapy evaluation.

Adult↗

PubMed1998

Gastrospirillum hominis and Helicobacter pylori infection in Thai individuals: comparison of histopathological changes of gastric mucosa.

The presence of Helicobacter pylori (H. pylori) in the stomach is closely associated with histological signs of chronic active gastritis and peptic ulcer. Another spiral organism named Gastrospirillum hominis (G. hominis) has led to further interest in the bacterial pathogenesis of gastritis. Due to the low prevalence of G. hominis, it is difficult to evaluate its biological behavior. Recently 16 cases of G. hominis-associated gastritis were found in 257 Thai individuals, which made it possible to study the biological characteristics of G. hominis and its relationship with gastric mucosal inflammation. The results showed that H. pylori and G. hominis could be easily observed in the lower third of the mucous layer and in the mucosa of the gastric pits by means of toluidine blue staining. Both bacteria immunostained positive. Helicobacter pylori were usually in the shape of curved bacillary while G. hominis often appeared in spiral configuration. In 257 cases of Thai subjects, 169 cases were found to be H. pylori positive, the detection rate was 65.7%, and 16 cases were G. hominis positive, with a 6.2% detection rate. In G. hominis infection, 43.6% of cases had normal gastric mucosa. Superficial, erosive and atrophic gastritis cases were 13.2, 10.9 and 12.5%, respectively. Mucosal inflammation was usually severe in H. pylori, but neutrophil polymorph infiltration was often mild and focal in G. hominis infection. Although no G. hominis infection with carcinoma was shown in our cases, the occurrence of mucosal atrophy, metaplasia and dysplasia was higher in both bacterial infections compared with H. pylori- and G. hominis-negative cases. It is suggested that G. hominis may be partly responsible for the mucosal inflammation and some malignant-associated lesions.

Adult↗

PubMed1998

Molecular screening of uncoupling protein 2 gene in patients with noninsulin-dependent diabetes mellitus or obesity.

Uncoupling protein 2 (UCP2), a member of the family of mitochondrial carrier proteins, has been implicated in the control of whole-body energy balance. The coding region of the human UCP2 gene has now been shown to comprise six exons, and the sequences of the exon-intron boundaries were determined. With the use of this sequence information, 25 Japanese patients with obesity and noninsulin-dependent diabetes mellitus (NIDDM) and 25 subjects with simple obesity were screened for mutations in the entire coding region of UCP2 by PCR and single-strand conformation polymorphism analysis. Two nucleotide polymorphisms resulting in Ala55 --> Val and Ala232 --> Thr substitutions were detected. With the use of PCR and restriction fragment length polymorphism analysis, the allele frequencies for each of these polymorphisms were determined in 210 Japanese patients with NIDDM, 42 obese individuals, and 218 normal control subjects. The frequency of the Val55 allele did not differ significantly among the NIDDM group (46.0%), the obesity group (48.8%), and the normal control group (48.4%). The Thr232 allele was detected in only three subjects, who were heterozygotes and in the NIDDM group (allele frequency, 0.7%). However, expression in yeast of the human wild-type UCP2 protein and UCP2 containing Thr232 revealed no difference in functional activity. These results indicate that the Ala55 --> Val and Ala232 --> Thr variants of UCP2 do not play an important role in the pathogenesis of NIDDM or obesity in the Japanese population.

Adult↗

PubMed1998

[Enterohemorrhagic Escherichia coli O157 infection in an elderly patient with secondary hemolytic uremic syndrome who developed recurrent acute exacerbation of chronic cholecystitis].

We encountered a patient with enterohemorrhagic Escherichia coli (EHEC) O157:H7 infection and secondary hemolytic uremic syndrome (HUS). The patient was a 79-year-old woman with hypertension, constipation, and asymptomatic cholelithiasis. She complained of nausea and abdominal pain, and had bloody stool EHEC O157 was detected by fecal culture. The bloody stool resolved after treatment with antibiotics, but the patient was hospitalized on July 23, 1996 because of abdominal distention. HUS was diagnosed because of proteinuria, hematuria, thrombocytopenia, hemolytic anemia, fragmentation of red blood cells, and increased serum LDH. Treatment was focused on plasma exchange, administration of antibiotics, large doses of gamma-globulin, haptoglobin replacement, and anticoagulation. Within about 2 weeks, the level of hemoglobin, the number of platelets, and the serum LDH had normalized, and the patient recovered from HUS. The decreased intestinal movement continued. On August 23, acute cholecystitis was diagnosed, and percutaneous transhepatic gall bladder drainage was done. Another exacerbation was noted on October 13, and cholecystectomy was done on November 12, when the patient's status had improved after instillation of antibiotics. Macroscopically, the gallbladder wall was thickened. Histopathological examination showed diffuse infiltration of lymphocytes into the mucosa, chronic cholecystitis was diagnosed. Because the postoperative course was satisfactory, the patient was discharged from the hospital on December 15. Acute exacerbation of chronic cholecystitis might have been caused by decreased cholic excretion after the marked decrease in intestinal movement due to O157 infection and secondary HUS. Because elderly people frequently have anamnesis of the digestive system, considerably attention should be paid to the management of anamnesis, as well as O157 infection and secondary HUS.

Aged↗

PubMed1998

[A case of metastasis to the seminal vesicle of renal cell carcinoma].

A case of metastasis to the seminal vesicle of renal cell carcinoma is reported. A 60-year-old man was referred to our department for evaluation of intermittent hematospermia and asymptomatic macrohematuria for about 2 years. He had a left radical nephrectomy for localized renal cell carcinoma 5 years ago. Panendscopy showed a little bleeding of posterior urethra, but there were no abnormal images of upper urinary tracts. Two years later he had asymptomatic macrohematuria again and panendscopy showed swelling and bleeding of verumontanum. Transurethral resection of verumontanum revealed clear cell carcinoma histopathologically and CT revealed seminal vesicle or prostate tumor, then total cystectomy was performed. Pathological examination indicated metastasis to siminal vesicle of renal cell ccarcinoma. There has been no report of metastasis to seminal vesicle of renal cell carcinoma in literature. This is the first case in the world.

Carcinoma, Renal Cell↗

PubMed1998

[Thermal effect on alpha 1-adrenoceptors in the guinea-pig vas deferens: histological and binding studies].

OBJECTIVE: To study the mechanism of thermotherapy on benign prostatic hyperplasia, we examined thermal effects on alpha 1-adrenoceptors in the guinea-pig vas deferens. The histological changes in the muscle cells after thermal exposure were also examined by electron microscopy. METHODS: The guinea-pig vasa deferentia were pretreated at 4 degrees C (control group), 43 degrees C, 50 degrees C, and 55 degrees C (heated group) for 1 hour and returned to 37 degrees C for 1 hour or 2 hours. Radioligand binding assay for alpha 1-adrenoceptors was performed by an incubation of [3H]prazosin with the crude membrane fraction from vasa deferentia. The dissociation constant (Kd) and the number of binding sites (NBS) of alpha 1-adrenoceptors were calculated from Scatchard analysis. The histological changes in the muscle cells were also examined at 4 degrees C, 40 degrees C, 50 degrees C, and 55 degrees C for 1 hour by electron microscopy. RESULTS: Kd and NBS did not change at 43 degrees C, but declined significantly above 50 degrees C for 1 hour. The changes in Kd and NBS above 50 degrees C for 1 hour did not recover after returning to 37 degrees C for 1 hour or 2 hours. Electron microscopic observations revealed a loss of myofilaments and dark staining of nuclear chromatin of the smooth muscle cells after thermal exposure above 50 degrees C. CONCLUSION: The binding ability of [3H]prazosin to alpha 1-adrenoceptors declined after thermal exposure above 50 degrees C. Also, the muscular damages were observed histologically after thermal exposure above 50 degrees C. These results indicated that the irreversible decrease in NBS and the disruption of smooth muscle fibers were associated with the thermotherapy.

Animals↗

PubMed1998

[A case of labial adhesions in an elderly woman].

A 90-year-old woman was admitted with a chief complaint of difficulty in urination. She had severe labial adhesions with a pin point opening. Urinary tract infection was detected by urine examination. The adhesions were surgically dissected under local anesthesia and recurrence was not seen at follow-up 6 months after the operation. Labial adhesions in adult women are rare and only 28 cases of labial adhesions in adults have been reported in the Japanese literature. Labial adhesions in adults may be more closely related with chronic inflammation such as recurrent urinary tract infections and vulvovaginitis than in pediatric cases.

Aged↗

PubMed1998

[Telomerase activity and determination of cancer in urological neoplasias using exfoliated urinary cells: in situ TRAP assay and its application].

We determined telomerase activity semiquantitatively and in-cell telomerase activity in exfoliated urinary cells obtained from urological neoplasias. Semiquantitative determination of telomerase activity was performed using a fluorescent-based telomeric repeat amplification protocol (TRAP) and telomerase activity at the cellular level was determined by an in situ TRAP assay. Fluorescent-based TRAP assay detected urinary telomerase activity in about 80% patients with urological neoplasia before treatment, whereas urinary cells obtained from 30% patients after/during treatment with either chemotherapy or operation (class II-V) had detectable telomerase activity. In contrast, the in situ TRAP assay detected telomerase-positive cells in 85% patients before treatment and 60% patients after/during treatment. Of note is a dissociation of the results between fluorescent-based TRAP assay and that of in situ TRAP assay in some patients. Some patients without detectable telomerase activity using the fluorescent-based TRAP assay showed a low frequency of telomerase-positive cells in the urine. A combination of semiquantitative analysis and an in situ TRAP assay to detect telomerase-positive cells might be a useful tool in the detection and monitoring of patients with urological neoplasias.

Humans↗

PubMed1998

[The effects of LH-RH agonist alone or with flutamide in the treatment of stage D2 prostate cancer].

We compared the clinical efficacy of treatment with a luteinizing hormone-releasing hormone (LH-RH) agonist alone to combined androgen blockade (CAB) with a LH-RH agonist and fiutamide. A total of 66 stage D2 prostate cancer patients were enrolled from Nov. 1992 to Mar. 1996 (n = 30: LH-RH agonist alone, n = 36 CAB). Serum PSA levels after 3 months of treatment and progression-free survival rates (Kaplan-Meier curves) were compared. Results were statistically evaluated by Wilcoxon's text. There were no differences in PSA levels between LH-RH agonist alone and CAB. Progression-free survival rates were longer in the patients treated CAB compared to LH-RH agonist alone (P = 0.041). Furthermore, in patients with poorly differentiated prostate cancers, longer survival rates were also observed with CAB (P = 0.030). However, there were no differences in high EOD (> or = 2) patients between the two treatments (P = 0.652).

Aged↗

PubMed1998

[A case of xanthogranulomatous pyelonephritis followed by computed tomographic scan].

Since it is difficult to differentiate xanthoglanulomatous pyelonephritis (XGP) from renal cancer, most cases of XGP are diagnosed after nephrectomy. We report a rare case of XGP followed by abdominal computed tomographic (CT) scan. A 65-year-old woman was admitted with high fever. Drip infusion pyelography showed a right renal stone but did not visualize the right kidney. A swollen right kidney was revealed on abdominal CT scan. Diabetes mellitus was detected by blood examinations and XGP was suspected. Conservative therapy with antibiotics was performed, the symptoms disappeared within 2 weeks and the right atrophic kidney was revealed on abdominal CT scan 12 months after onset. Histopathological findings on a renal biopsy specimen obtained 1.5 months after treatment were compatible with XGP. The diagnosis of XGP will become easier by using a combined approach including radiographic findings, physical finding and other data.

Aged↗

PubMed1998

[Clinical utility of the free prostate specific antigen (PSA), alpha 1-antichymotrypsin-complexed PSA, and free/total PSA ratio using the specific and sensitive enzyme-linked immunosorbent assay "E-plate EIKEN PSA"].

We studied the clinical significance of serum prostate specific antigen (PSA) ratio: free-PSA/total-PSA and free-PSA/complex-PSA to discriminate between prostate cancer (PC) and prostate benign disease (non-PCa) by using total-PSA, alpha 1-antichymotrypsin complexed (complex)-PSA and free-PSA enzyme-linked immunosorbent assay (ELISA) kits newly developed at EIKEN Chemical Co, Ltd. Fre-PSA and complex-PSA ELISA kits demonstrated high sensitivity and specificity. Total-PSA ELISA kit also demonstrated equimolarity for free-PSA and complex-PSA. On the total-PSA range of 4-10 ng/ml, free-PSA/total-PSA% (f/t%) and free-PSA/complex-PSA% (f/c%) were very useful to discriminate between PCa and non-PCa by receiver operating characteristic curve analysis as well as PSA density (PSA-D) but not free-PSA level. F/t% and f/c% were even useful to discriminate early stage PCa (i.e. A1 or B0) from non-PCa by the Mann-Whitney U-test.

Enzyme-Linked Immunosorbent Assay↗

PubMed1998

[Clinical study on 6 cases of urosepsis associated with septic shock].

At Asama General Hospital, we experienced six cases of urosepsis with septic shock during a period of five years between 1989 and 1993. All six patients, whose average age was 74 years old, recovered. In four patients, the condition was caused by obstructive uropathy. The remaining two cases were caused by renal inflammatory disease, which was complicated by diabetes mellitus. One of them was renal abscess with renal papillary necrosis, and the other was emphysematous pyelonephritis. The patients, who exhibited symptoms such as gram-negative bacteremia, severe hypotension, tachycardia, decrease of urine volume and mental disturbance, were diagnosed with urosepsis with septic shock. In all cases, symptoms such as a high fever of over 39 degrees C, hypoxemia and thrombocytopenia were observed. Renal dysfunction was found in 67%, and both liver dysfunction and disseminated intravascular coagulation (DIC) were found in 50% of the cases. Since no patients suffered from adult respiratory distress syndrome, a high survival rate was apparent. Anti-shock therapy and anti-coagulation therapy were ineffective for the patients who had septic shock due to urinary tract obstruction. Urinary tract drainage was required to treat the latter patients. Nephrectomy could not be avoided in renal parenchymatous inflammatory disease. In the future, what might be essential in therapeutics against urosepsis with septic shock, particularly to avoid nephrectomy, are the treatments such as immunotherapy against endotoxins and their mediators, and hemoperfusion for the removal of endotoxins.

Aged↗