Multivariate analysis of factors affecting cadaver kidney allograft survival in the chronic stage.
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Adult↗
Biomedical subjects
N Katoh
Publications and source records attributed to N Katoh.
Kidney transplantation from older ( > or = 55 years) donors: a risk factor for graft survival.
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Adolescent↗
Laparoscopic nephrectomy via the retroperitoneal approach.
PURPOSE: We evaluated efficacy of the retroperitoneal approach for laparoscopic nephrectomy of kidneys with benign disease. MATERIALS AND METHODS: Eight men and 12 women (mean age 55 years) with severely damaged kidneys underwent laparoscopic retroperitoneal nephrectomy. One patient had a history of multiple open abdominal and gynecological operations. Kidneys were removed laparoscopically from the working space, which was created by finger and balloon dissection, and maintained by carbon dioxide insufflation in the retroperitoneal cavity. RESULTS: All kidneys were removed successfully via this procedure. Mean operative time was 3.3 hours and mean estimated blood loss was 135 ml. One patient experienced bleeding from the injured capsular artery just after removal of the kidney. CONCLUSIONS: The retroperitoneal approach is recommended for laparoscopic nephrectomy.
Adolescent↗
[Hautmann's ileal neobladder: experience of 37 cases].
Between April 1993 and August 1995, a Hautmann's ileal neobladder was created in 37 men after total cystectomy for bladder cancer. Ureteroileostomy was performed using a submucosal tunnel instead of the Le-Duc Camey procedure. There was no operative mortality and only a few early complications. The mean postoperative follow-up time was 16 months, with a range of 3 to 31 months. Hydronephrosis occurred in 3 patients, being caused by stenosis at the uretero-ileo anastomosis in 2 and by proximal stenosis in 1. Neobladder-ureteral reflux did not occur in any of the patients. Postoperative ileus developed in 3 patients, and one required laparotomy. Stenosis of the urethro-ileal anastomosis developed in 3 patients, who were successfully treated by transurethral incision. Thirty five patients achieved daytime continence, while 2 patients had slight incontinence. Twenty nine patients achieved nighttime continence, and most of the patients awoke 1-4 times to prevent overflow incontinence. The mean maximum flow rate, average flow rate and post-voiding residual urine volume were respectively 15.3 ml/sec, 5.5 ml/sec and 81 ml at 6 months postoperatively, and 14.9 ml/sec, 5.4 ml/sec and 76 ml at 12 months. Four patients with more than 100 ml of residual urine required sterile intermittent catheterization 2-4 times a day. Urethral recurrence was detected in 2 patients. One was treated with transurethral resection and cisplatinum-based systemic chemotherapy, and the other required urethrectomy and urinary diversion using a new continent efferent limb.
Aged↗
Long-term stone recurrence rate after extracorporeal shock wave lithotripsy.
PURPOSE: We followed patients who were stone-free after extracorporeal shock wave lithotripsy (ESWL) to investigate the factors that contributed to recurrent calculi. MATERIALS AND METHODS: For longer than 5 years 903 patients without residual fragments 3 months after ESWL were enrolled in this study. Plain abdominal films and/or excretory urograms were evaluated every 6 months for recurrent stones on the side of ESWL. Patients who presented with colic pain or other complaints and who were suspected of having recurrent stones were also examined. Stone recurrence rates were calculated with the Kaplan-Meier method. We assessed the influence of patient age; size, location, composition and configuration of the original stones, and pyuria after ESWL on stone recurrence. RESULTS: Mean followup was 25 months and stones recurred in 183 of 903 renal units (20.3%). Kaplan-Meier recurrence rates were 6.7, 28.0 and 41.8% after 1, 3 and 5 years, respectively. There was a significant correlation between stone recurrence and multiple stones on one hand, and pyuria after ESWL on the other hand. Stones recurred most frequently in the lower calix. Recurrent stones were passed without intervention in 33 cases, while ESWL was repeated in 53. CONCLUSIONS: These data demonstrate the importance of long-term followup and the search for an effective prophylactic therapy to prevent recurrence.
Adolescent↗
[An operative case of bilateral partial anomalous pulmonary venous return using a direct anastomosis between the right atrial appendage and the superior vena cava].
We have experienced a case of bilateral partial anomalous pulmonary venous return without atrial septal defect. Right upper pulmonary vein returned to the superior vena cava and left upper pulmonary vein returned to the left brachiocephalic vein. This type of bilateral partial anomalous pulmonary venous return was extremely rare, and only 4 such cases have been reported in the Japanese literature. The patient, aged 3 years and 11 months, was successfully operated on, using a direct anastomosis between the right atrial appendage and the superior vena cava. This procedure is considered to be advantageous because both this right atriotomy line and suture line avoid injury of the sinus node and the sinuatrial node artery and no foreign material is used. A decrease in postoperative arrhythmia can also be expected from this procedure.
Anastomosis, Surgical↗
Inhibition by phospholipids, lysophospholipids and gangliosides of melittin-induced phosphorylation in bovine mammary gland.
Melittin, a toxic peptide from bee venom known to inhibit protein kinase C (PKC) activity, induces, like sphingosine, phosphorylation of proteins, such as the 19 kDa and 27 kDa, in bovine mammary gland. This phosphorylation is inhibited by the addition of phosphatidylserine (PS). The present study was conducted to examine whether phospholipids (other than PS), lysophospholipids and gangliosides can inhibit the phosphorylation of cytosolic proteins from bovine mammary gland. The lipid effects were also explored in the sphingosine-induced phosphorylation for comparison. Like PS, phosphatidic acid, phosphatidylglycerol and phosphatidylinositol inhibited the melittin-induced phosphorylation. Phosphatidylcholine was less potent and phosphatidylethanolamine was inactive in inhibiting the phosphorylation. Similar results were obtained when sphingosine was used instead of melittin. Of the lysophospholipids tested, lysophosphatidic acid was most effective in inhibiting the phosphorylation induced by melittin. Lysophosphatidylcholine was inactive in reversing the melittin-induced phosphorylation, but it selectively suppressed the 19 kDa phosphorylation induced by sphingosine. Gangliosides inhibited both melittin- and sphingosine-induced phosphorylation and their effectiveness was: GT1b > GD1a = GD3 > GM3. Of the phosphoproteins, the 19 kDa was most sensitive to ganglioside inhibition. These results suggest that melittin-induced phosphorylation is selectively inhibited by specific lipids and also that the enzyme(s) responsible for the phosphorylation is not identical to the sphingosine-activated protein kinases.
Animals↗
The activity of lecithin:cholesterol acyltransferase in the serum of cows at parturition or with fatty liver.
The activity of lecithin:cholesterol acyltransferase (LCAT), which is responsible for esterification of plasma cholesterol, was evaluated in bovine serum. It was associated with the high-density lipoprotein fraction that contains apolipoprotein A-I, an activator of LCAT. In lactating cows, the activity was around 1000 U (decrease in nmol of free cholesterol per h per ml of serum), slightly higher than in 1-month-old calves. LCAT activity decreased around parturition, at which the time the serum concentrations of cholesteryl esters and free cholesterol were concomitantly decreased. A reduced LCAT activity was also found in cows with fatty livers induced by the administration of ethionine. In the cows with fatty livers, the serum concentration of cholesteryl esters was markedly decreased, whereas that of free cholesterol was only slightly decreased, thereby increasing the free- to esterified-cholesterol ratio. These results suggest that the decrease in LCAT activity may be involved in the reduction in fertility associated with fatty liver because esterification of cholesterol by LCAT is essential for its transport from the liver to peripheral tissues, such as the corpus luteum, and because cholesterol serves as the source of progesterone synthesis in the latter organ.
Animals↗
Inhibition by gangliosides GM3, GD3 and GT1b of substrate phosphorylation by protein kinase C in bovine mammary gland and its reversal by phosphatidylserine.
Effects of gangliosides GM3, GD3 and GT1b on protein kinase C (PKC) activity and endogenous protein phosphorylation by PKC were examined in bovine mammary gland. The gangliosides inhibited PKC activity in both cytosolic and total particulate fractions with IC50 values (concentrations causing 50% inhibition) of 100-115 microM (GM3), 75-80 microM (GD3) and 20-28 microM (GT1b). Several proteins were shown to be substrates for PKC by phosphorylation in the absence or presence of the PKC cofactors 1-oleoyl-2-acetyl-sn-glycerol (OAG, 5 micrograms/ml), phosphatidylserine (PS, 25 micrograms/ml) and Ca2+ (1 microM). GM3 at 100 microM suppressed phosphorylation in cytosol of 91 kDa and 89 kDa proteins. Similar suppression of phosphorylation of these proteins was achieved by the addition of 50 microM GD3 and 10 microM GT1b; thus the order of suppressive capacity for substrate phosphorylation was parallel to their IC50 values. GT1b (100 microM) inhibited phosphorylation of 56 kDa, 43 kDa and 36 kDa proteins, in addition to that of the 91 kDa and 89 kDa ones. Phosphorylation of 72 kDa and 21 kDa proteins was resistant even at this concentration, suggesting the selective suppression by gangliosides of phosphorylation of individual substrates. In the particulate fraction, phosphorylation of a 91 kDa protein was suppressed by 100 microM GT1b, whereas phosphorylation of the other substrates was unaffected by any ganglioside used. Suppression of phosphorylation of cytosolic 91 kDa and 89 kDa and particulate 91 kDa proteins could be reversed by addition of PS (250 micrograms/ml), but not by OAG (50 micrograms/ml) or Ca2+ (250 microM). These results suggest that gangliosides are involved in the regulation of PKC-dependent phosphorylation by modulating the association of PKC or its substrates with membrane phospholipids.
Animals↗
Inhibition by dexamethasone of interleukin-1 beta and interleukin-6 expression in alveolar macrophages from cows.
The suppression by the synthetic glucocorticoid dexamethasone of the expression of interleukin-1 beta and interleukin-6 was examined in alveolar macrophages from cows. The expression of interleukin-1 beta mRNA was inhibited by treatment with dexamethasone for 16 hours in a dose-dependent fashion. The values of the concentration causing 50 per cent inhibition were in the range of 10(-9) to 10(-8) M. Dexamethasone similarly inhibited the expression of interleukin-6 mRNA by 50 per cent at a concentration of approximately 10(-8) M. In the concentration range from 10(-12) to 10(-4) M, dexamethasone had no effect on the expression of beta-actin. These results suggested that glucocorticoids may be involved in the regulation of the expression of interleukin-1 beta and interleukin-6 by the alveolar macrophages of cows.
Animals↗
Piroxicam induced Stevens-Johnson syndrome.
Stevens-Johnson syndrome in a 63-year-old Japanese woman is described. Oral provocation test revealed the causative agent to be piroxicam.
Anti-Inflammatory Agents, Non-Steroidal↗
Sequential changes in the prostatic fluid level of latamoxef in patients with acute bacterial prostatitis.
The sequential expressed prostatic secretion (EPS) levels of latamoxef (LMOX) were measured in 14 patients with acute bacterial prostatitis to evaluate the diffusion of this antibiotic from the plasma into the prostatic fluid. All patients received 2 g of LMOX on the 1st, 4th, and 7th days of hospitalization. The mean LMOX level in EPS and the EPS/serum ratio were 16.4 micrograms/ml and 0.24 on the 1st day, 5.5 micrograms/ml and 0.08 on the 4th day, and 3.5 micrograms/ml and 0.04 on the 7th day, respectively. The mean value of prostatic fluid was 7.7, 7.8, and 7.8, respectively. Thus, both the EPS level of LMOX and the EPS/serum ratio decreased along with the recovery from acute bacterial prostatitis and did not correlate with the pH gradient between prostatic fluid and plasma.
Acute Disease↗
Microcirculatory segments identified with monoclonal antibody against alpha-smooth muscle actin: comparison between Kimura's disease and angiolymphoid hyperplasia with eosinophilia.
Microcirculatory systems, which can be divided into several segments, have crucial physiological functions. We investigated whether monoclonal antibody against alpha-smooth muscle actin (alpha SMA) was useful for the identification of microcirculatory segments, according to the structure of their periendothelial cells, in two pathological cutaneous conditions. We examined skin specimens from patients with Kimura's disease and with angiolymphoid hyperplasia with eosinophilia, since little information is available on microvascular segments in these conditions. Immunostaining for alpha SMA revealed the morphological characteristics of the periendothelial cells clearly enough to identify five segments in the proliferative microvessels of Kimura's disease and angiolymphoid hyperplasia with eosinophilia. In Kimura's disease, postcapillary venules were predominant, while each vascular segment in angiolymphoid hyperplasia with eosinophilia was uniform. Vessels without periendothelial cells were detected to a greater extent in angiolymphoid hyperplasia with eosinophilia than in Kimura's disease. The antibody against alpha SMA appeared to be useful in the observation of periendothelial cells for the identification of vascular segments in pathological cutaneous conditions.
Actins↗
Distribution of annexins I, II, and IV in bovine mammary gland.
Annexins belong to a family of proteins that are characterized by their ability to bind phospholipids in a Ca(2+)-dependent manner that is thought to be involved in a variety of biological processes. The present study determined the localization of annexins in subcellular fractions, nuclei in particular, of cow mammary gland by immunoblot analysis using monoclonal antibodies to annexins I, II, IV, and VI. The analysis revealed that annexins I, II, and IV were present in cytosol, but VI was not. Annexins I and IV were found in the nuclear fraction, but annexin II was only faintly present. Annexin VI was also undetectable in this fraction. Cytosolic annexin I had a molecular mass of 36 kDa. The 36-kDa annexin I was also found in the nuclear fraction. A 38-kDa annexin I was additionally detected in nuclei. The cytosolic and nuclear 36-kDa annexin I and the nuclear 38-kDa annexin I showed different isoelectric points, as revealed by two-dimensional PAGE. Annexin IV from cytosolic and nuclear fractions had similar molecular masses and isoelectric points.
Animals↗
[Treatment of stone street after extracorporeal shock wave lithotripsy of staghorn calculi].
During ESWL monotherapy for staghorn calculi, the formation of a stone street in the ureter is often encountered, and can be a troublesome problem. At the Komaki Shimin Hospital, 75 patients with staghorn calculi were treated with ESWL monotherapy using a Dornier HM-3 lithotriptor between October 1987 and August 1992. Among them, three patients had involvement of both collecting systems. An indwelling double J catheter was always inserted during treatment. Our strategy for the treatment of stone street was as follows; observation was initially performed for one month after ESWL, as long as pyelonephritis and/or complete obstruction did not occur. In the patients without any improvement of the stone street, TUL or ESWL was then performed for removal. A stone street (stone fragments extending > or = 4 cm) was formed in 38 of 78 renal units (49%). In 14 cases (37%), it disappeared spontaneously. TUL was required in 14 unit (37%), ESWL in eight units (21%), and both procedures in two units (5%). In one unit (3%), renal function was severely damaged. In another unit, ureteric perforation occurred during the TUL procedure, and caused stone loss outside the ureter. To clarify the factors causing stone street, we compared the number of shock waves, the size of the stones, the severity of hydronephrosis and renal function in stone street formers and non-formers. However there were no significant differences among these factors. In conclusion, since it is impossible to predict stone street formation after ESWL monotherapy for staghorn calculi, patency of the indwelling double J catheter should be maintained and stone removal should be attempted after one month if necessary.
Calcium Oxalate↗
[The efficacy of endopyeloureterotomy via a transpelvic extraureteral approach].
To evaluate the efficacy of endopyeloureterotomy via a transpelvic extraureteral approach for the treatment of ureteropelvic junction obstruction or upper ureteric stenosis, we analysed the results of 85 patients treated with this procedure between Aug. 1988 and June 1993. Eighty-five patients underwent 87 procedures. Each patient has been followed-up more than 6 months postoperatively. Of 87 procedures, 71 were performed in patients with ureteropelvic junction obstruction and 16 were in patients with stenosis of the upper third ureter. Primary disease was 59 and secondary disease was 28. Twenty-one procedures were performed in patients with the stenotic segment over 2 cm. The operative procedure was performed by first incising with a 22 Fr. urethrotome (ACMI Co.); the dilated renal pelvic or ureteral wall posterolaterally as long as 1-1.5 cm junction from the stenotic segment toward ureteropelvic junction, then bringing the urethrotome out retroperitoneally through the incision and finally incising the stenotic segment with the cold knife under direct vision. A 12-16 Fr. PTCS tube (Sumitomo Behkuraito Co.) was left in place for 3 weeks as a stent. Mean operative time was 101 min and average length of incised segment was 3.7 cm. Complication included pneumothorax (1 case), pseudo ureter (1 case) and renal arterial anexryma (1 case). Followed-up period ranged from 6 to 64 months with the average being 26 months. Of 87 procedures, 80 (92%) achieved a disappearance or improvement of the obstructive change and 7 failed.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Pelvic lymph node involvement in primary bladder cancer. A clinicopathological study of radical cystectomies].
Between 1984 and 1992, 131 patients with bladder cancer underwent radical cystectomy and pelvic lymph node dissection with urinary diversion. There were 110 male and 21 female patients, aged between 35 and 86 with a mean of 64 years. The follow-up period ranged from 1 month to 113 months, with a median of 34 months. The five-year survival estimated by the Kaplan-Meier method was 66.9% over all 131 patients. The five-year survival rates were 83.3% for stage pTis patients, 66.7% for stage pTa, 97.0% for pT1, 70.7% for pT2, 47.9% for pT3a, 26.2% for pT3b, and four-year survival was 25% for pT4 disease. Under the grading system, the five-year survival was 80.0% for cases of grade 2 disease and 63.6% for grade 3. There were two grade 1 patients who died of other diseases 15 and 16 months after surgery. Of all 131 patients, 22 (16.8%) had lymph node involvement. The five-year survival was 34.5% for patients with positive lymph nodes in comparison with 73.8% for those without lymph node involvement. The frequency of lymph node involvement was 26.1% in the non TCC group and 14.8% in the TCC group including 23.7% of the grade 3 and 4.3% of the grade 2 cases. Pathologically, the patients with higher stages had a higher frequency of lymph node involvement, and there was a significant difference in the frequency between pT3a (14.3%) and pT3b (47.8%) disease. The five-year survival of patients with positive lymph nodes was 40.0% for pN1, 32.1% for pN2 disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Enzyme-linked immunosorbent assay for apolipoprotein A-I in the serum of cattle.
An ELISA was developed to evaluate the concentration of apolipoprotein A-I, a major apoprotein in high-density lipoprotein, in the serum of cattle. Serum apolipoprotein A-I was purified electrophoretically, and antibodies to this protein were raised in rabbits. The specificity of the antiserum was assessed by use of several immunologic techniques including western blotting. The ELISA was sensitive (detection limit was 70 ng of apolipoprotein A-I/ml) and reliable (coefficients of variance were in the range of 3.5 to 8.2%). By use of this method, the serum apolipoprotein A-I concentration was higher in 2- to 6-year-old Holstein cows (mean +/- SD, 0.580 +/- 0.304 mg/ml) than in 7- to 15-month-old heifers (0.339 +/- 0.237 mg/ml), 6-month-old heifers (0.238 +/- 0.188 mg/ml), and 6-month-old steers (0.173 +/- 0.146 mg/ml). The concentration, however, is not largely different in cows in early, middle, and late lactation and in non-lactating stages. Results also indicated that apolipoprotein A-I concentration was decreased in cows with hepatic lipidosis (fatty liver) induced by administration of ethionine, suggesting that this method is a useful tool for the pathophysiologic study of lipid metabolism and its impairment in cattle.
Aging↗