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Biomedical subjects

S Shishido

Publications and source records attributed to S Shishido.

At least 55 records · Page 3Linked to original sources
PubMed1997

A prospective trial of steroid cessation after renal transplantation in pediatric patients treated with cyclosporine and mizoribine.

We conducted a multi-center prospective study to evaluate the safety and efficacy of steroid withdrawal after renal transplantation in children. In 52 children (51 living-related donor transplants and 1 cadaver donor transplant), immunosuppressive therapy was started with cyclosporine (CyA), mizoribine (MZ), methylprednisolone (MPL) and anti-lymphocyte globulin. Administration of MPL was reduced to alternate days more than 6 months after transplantation, and attempts were made to withdraw it. Acute rejection was noted in 19 patients (36.5%) by 1 month after transplantation. The whole-blood CyA trough level using monoclonal antibody was 175.0+/-17.0 ng/ml in patients who developed acute rejection and 282.0+/-25.3 ng/ml in those who did not show acute rejection (p<0.01). During the 37 attempts at alternate-day MPL administration, clinical acute rejection was observed in only 1 patient and chronic rejection in 3. During 10 attempts to withdraw MPL, acute rejection was noted in 3 patients, but graft function recovered to the pre-rejection level after treatment of the acute rejection. At the last observation, graft function was lost in 3 patients, 22 were receiving MPL on alternate days, and MPL had been withdrawn from 7 for a mean period of 16.7 months. The survival rate of the patients and the grafts was 100% and 94% after an average follow-up period of 4 years. Evaluation of growth showed catch-up growth in all patients during the withdrawal period.

Anti-Inflammatory Agents↗
PubMed1997

[A clinicopathological study of 218 patients with bladder carcinoma treated by radical cystectomy].

Between 1986 and 1995, 218 patients with primary carcinoma of the bladder were treated with radical cystectomy at our hospitals. Clinicopathological specimens and the relative value of prognostic factors were analyzed with both the univariate and multivariate method. Univariate analysis indicated that age, sex, pathological tumor stage, grade, vessel involvement, tumor infiltrating type and positive nodes were predictive of poor cancer-specific survival. Multivariate analysis demonstrated that female patients were predictive of poor cancer-specific survival. As for the risk ratio, the prognostic factors in lymphatics involvement and tumor infiltrating type were 2.77 and 2.47, respectively.

Aged↗
PubMed1996

Biochemical and functional characterization of xenoreactive natural antibodies in hu-PBL-SCID mice.

An in vivo model system to understand the mechanism of xenograft rejection was established using human peripheral blood leukocyte-reconstituted SCID (hu-PBL-SCID) mice. Human xenoreactive natural antibodies (XNA), of IgM and IgG subtypes, capable of binding to pig aortic endothelial cells (PAEC) were detected in the sera of hu-PBL-SCID by ELISA and flowcytometric methods. Western blot analysis of PAEC lysates showed that IgM and IgG XNA from hu-PBL-SCID recognized xenoantigens with similar molecular mass as those recognized by XNA from normal human serum (NHS). This result demonstrated that hu-PBL-SCID contained XNA representing the same repertoire as that of the NHS. XNA from NHS and hu-PBL-SCID were also able to induce intracellular Ca2+ signals in cultured PAEC several fold above the basal level. This result revealed their functional similarity and demonstrated for the first time that XNA in the absence of C can activate PAEC, which may lead to the pathology of xenograft rejection. In vivo, PAEC transplanted under the kidney capsule of hu-PBL-SCID mice showed deposition of human IgM and mouse C. In summary, the present study demonstrates that hu-PBL-SCID can serve as a useful model to characterize innate immunity against xenograft.

Animals↗
PubMed1996

[Intermittent hydronephrosis. A clinical study in 23 pediatric patients].

BACKGROUND: It is difficult to diagnose intermittent hydronephrosis and to decide the indication of surgical intervention. We investigated 23 cases of intermittent hydronephrosis. METHODS: From 1978 to 1995, a total of 23 patients were diagnosed as intermittent hydronephrosis in our institution. We inspected their clinical features and treatment which had been performed to them. RESULTS: Our study comprised 21 boys and 2 girls, whose mean age was 6 year old. Their chief complaint was intermittent flank pain (left: 21, right: 1, bilateral: 1) accompanied with gross hematuria (30%) and vomiting (39%). When they were asymptomatic, an excretory urogram revealed only mild pelvic dilatation without calyceal distension and kinking of ureteropelvic junction. Split renal function study by RI showed no difference between the affected side and the normal side except one case. When pelvic or calyceal enlargement was confirmed on ultrasonography while they were symptomatic, surgery was indicated. Surgery was performed in 17 cases (74%) including dismembered pyeloplasty in 14 cases, resection of aberrant vessel in 1, relocation of lower pole renal vessel in 1 and nephrectomy in 1. In surgical and histological view points, intrinsic stenosis was seen in 10 cases, extrinsic obstruction caused by aberrant vessels was seen in 4 and ureteral polyp was seen in 3 (bilateral polyp in 1 case). CONCLUSION: They had no more symptoms after operation. Of 23 among followed up cases without surgery, we experienced 2 cases unexpectedly advancing irreversible hydronephrotic change after the last attack, 1 case of gradually progressing hydronephrotic change and 1 case of severe renal dysfunction after many attacks. Therefore intermittent hydronephrosis should be followed up carefully.

Child↗
PubMed1995

Growth, development and nutritional status in Japanese children under 2 years on continuous ambulatory peritoneal dialysis.

We examined the growth, development and nutritional status over a period of 10 years of 15 young children (< 2 years old) on continuous ambulatory peritoneal dialysis (CAPD). There were 6 males and 9 females with a mean age of 12.5 months, mean weight of 6.3 kg, mean height of 66.2 cm at the start of CAPD and a mean duration of therapy of 2.6 years. Height, weight, head circumference, development quotient (DQ), blood chemistry and dietary intake were assessed over a period of 10 years. The patients' mean height standard deviation score (SDS) did not change significantly (from -2.51 to -2.74) during CAPD therapy. The mean growth velocity index (GVI) during CAPD was 76.5% and correlated positively with energy intake but not with protein intake. The mean DQ was low (67.0%) at the start of CAPD and 69.3% at the end of CAPD. DQ did not correlate with energy intake, GVI, head circumference SDS or with the weight/height ratio; however, 2 patients with low DQ (< 60%) had a low energy intakes. Although most patients had a low DQ, the IQ at 5-6 years of age was normal in all patients except 1 without cerebral disease. Our study showed minimal growth (delta SDS) and mental developmental (IQ) delays during CAPD therapy, but an adequate nutritional intake must be assured to obtain the above results.

Blood Proteins↗
PubMed1995

[A case of miliary tuberculosis during pregnancy in a patient on hemodialysis].

A 33-year-old woman had been on hemodialysis since she was 25 years old. In September, 1993, she had cough, which gradually increased in severity, and was accompanied by slight fever. No abnormality was observed on the chest radiography taken on November 2. However, bilateral diffuse miliary shadows were observed on the radiograph taken on November 30. Tubercle bacilli were detected by the examination of sputum smear. As she was pregnant 20 weeks, therapeutic abortion was done on December 8. A case of miliary tuberculosis occurring during pregnancy in a patient on hemodialysis has not been documented in Japan to date, and the first case in Japan was reported with a review of the literature.

Abortion, Therapeutic↗
PubMed1995

[Double uterus and double vagina with unilateral imperforate vagina associated with ipsilateral renal agenesis: an infant case report].

Duplicated uterus associated with unilateral imperforate vagina and ipsilateral renal agenesis is a very rare anomaly. We report a case of a 10-month-old female infant presenting with pus discharge from vagina, and discussed the embryologic and clinical features relevant to this interesting disease complex with a review of the past literature. Echographic and CT examinations demonstrated a right-sided cystic pelvic mass. IVP revealed a left slight hydronephrosis and non-visualizing right kidney. No right ureteral orifice was found at cystoscopy. Under anesthesia the mass and pus was aspirated. Under the diagnosis of Gartner's cystic duct and a right renal agenesis or dysplasia with or without ectopic ureter, we subsequently performed laparotomy. Surgical exploration revealed a duplicated uterus with a normal ovary, and the mass was an imperforate right-sided vagina which communicated through the uterus. The diagnosis was changed to a double uterus with right-sided imperforate vagina, then the vaginal septum was excised. The post-operative course was uneventful, and pus discharge and the left hydronephrosis have disappeared.

Female↗
PubMed1994

Comparison of the effects of eleven histamine H1-receptor antagonists on monoamine turnover in the mouse brain.

To compare in vivo effects of eleven compounds of different classes of histamine H1-receptor antagonists (alcoholamines: diphenhydramine, carbinoxamine, and clemastine; ethylenediamines: mepyramine, tripelennamine, and clemizole; alkylamines: triprolidine and chlorpheniramine; piperazines: meclizine and homochlorcyclizine; phenothiazines: promethazine) on neuronal uptake of dopamine (DA), noradrenaline (NA), and 5-hydroxytryptamine (5-HT), the effects on the turnover of these monoamines were examined in the mouse brain, based on the alpha-methyl-p-tyrosine-induced depletion of DA and NA or probenecid-induced accumulation of 5-hydroxyindoleacetic acid. The DA turnover was reduced remarkably by diphenhydramine, tripelennamine, and promethazine, and also significantly by chlorpheniramine, mepyramine, clemizole, and homochlorcyclizine, at doses used in the ordinary animal experiments. The 5-HT turnover was reduced markedly by mepyramine, tripelennamine, and chlorpheniramine. In contrast, the NA turnover was increased by promethazine and homochlorcyclizine, possibly due to their antagonistic effects on alpha-adrenoceptors. These results suggest that (1) the degree of inhibition of the uptake of DA and 5-HT by histamine H1-receptor antagonists is considerably different, (2) most H1-antagonists have little influence on NA uptake and some compounds enhance NA release, and that (3) carbinoxamine, clemastine, triprolidine, and meclizine have comparatively weak influences on monoamine metabolism. These effects on brain monoamine systems may be related to some central actions of histamine H1-receptor antagonists, such as an addiction to these compounds combined with opioids.

Animals↗
PubMed1994

[Reflux nephropathy within first year of life. Studies of its clinical features and kidney scar-formation according to treatment modalities].

Clinical data of 106 patients (177 renal units) with vesicoureteral reflux diagnosed within first year of life were reviewed to clarify its clinical feature and reflux nephropathy. 1) 82.1% (87/106) of them were boy, 83.1% (147/177) of renal units had high grade reflux (VUR grade III or more). These findings suggested that some of them were Fetal Vesicoureteral Reflux. 2) At presentation, 57.1% (101/177) of renal units showed renal parenchymal scars and 18.9% (20/106) of cases had renal dysfunction (s-Cr > or = 0.6 mg/dl). Renal dysplasia or hypoplasia was found in rather high incidence of 8.5% (15/177) suggested that normal fetal nephrogenesis is also disturbed in early infants having VUR. 3) The patients having multiple renal scarring bilaterally had significant impaired both tubular and glomerular function, showing reflux nephropathy. 4) During more than 2 years follow-up on 102 renal units, totally 29 of them (28.4%) showed new scar-formation and/or scar-advancement. Among the kidneys more than grade III reflux and undergone antireflux surgery, those with delayed surgery had the incidence of new scar-formation and/or scar-progression as high as 48.6% (18/37). On the other hand, in those with immediate surgery, the incidence was much lower of 14.3% (5/35). In addition, the incidence in case of non-surgery was 38.5% (5/13). Indication or timing of antireflux surgery for infants is still controversial however, the above results suggest that early antireflux surgery which aimed to eliminate reflux and risk of upper urinary tract deterioration from infantile immatured kidney is more beneficial in order to prevent progression of renal scarring and attain normal renal development.(ABSTRACT TRUNCATED AT 250 WORDS)

Cicatrix↗
PubMed1994

[Scrotal calcification associated with hydrocele testis in a child: a case report].

Scrotal calcification is a rare complication of childhood hydrocele testis. Herein, a 12-year-old boy who suffered from left hydrocele testis with intrascrotal calcification is reported. The boy had experienced scrotal pain about 6 months prior to the first visit to our hospital, and gradually noted scrotal swelling. Physical examination revealed left scrotal enlargement with transillumination. Sonographic examination revealed a left hydrocele testis, and a 1.5 cm discrete focus of calcification was found immediate cranio-lateral to the left testis, contour, size and consistency of which were palpated normally. In left hydrocelectomy, no appendix epididymidis was found. A smooth, white, spherical, firm body connecting to the head of the epididymidis was removed. A microscopic examination revealed multiple layers of collagenous tissue with the necrotic tissue in the core. We concluded that this case presented with hydrocele testis secondary to a growing calcification reacting to the infarction due to the repeated torsion of the appendix epididymidis.

Calcinosis↗
PubMed1994

[Experimental tuberculosis infection of guinea pigs in the necropsy room and examination of infection risk using guinea pigs with tuberculosis].

The high incidence of tuberculosis among necropsy workers is well known and several problems related to their working conditions have been pointed out. We investigated the possibility of infection with tubercle bacilli under necropsy working conditions using guinea pigs housed in a necropsy room in which about 2,000 necropsies per year were carried out. Tuberculosis infection developed in one out of five guinea pigs. In addition, we exposed five guinea pigs to tubercle bacilli and sacrificed them in a safety cabinet. The lungs, livers, and spleens were resected, flattened, and sliced finely on a cutting board. Detection of tubercle bacilli from filtered air and the surfaces of the room was attempted, however, no bacilli were cultured. The resected tuberculous lungs were intra-tracheally treated with formalin or physiological saline and the viability of the bacilli in the lung was assessed. Bacilli survived up to two hours after physiological saline injection but no viable organisms were detected after 15 minutes of formalin treatment. These findings indicate that the necropsy room workers were exposed to tuberculosis infection. As a preventive control measure, we recommend to treat tuberculous organs in the safety cabinet and to slice lungs after formalin treatment.

Air Microbiology↗
PubMed1994

[Investigation of tuberculosis among the necropsy staff and environment in necropsy rooms].

We examined the incidence of tuberculosis among necropsy staff and the environment in the necropsy rooms at five medical institutions carrying out a large number of necropsy annually in the metropolis of Tokyo. The following results were obtained: 1) Incidence of tuberculosis was high among necropsy workers. 2) The method of wearing face masks was inadequate. 3) Tubercle bacilli were detected from the necropsy workers' aprons and the air-conditioning equipment of the necropsy room. 4) Formalin treatment of resected organs, especially the lungs, was inadequate. 5) The air conditioners in necropsy rooms were not effective. Considering these findings, improvement of the working conditions and environment of the necropsy rooms is needed.

Autopsy↗
PubMed1993

[A case of alveolar microlithiasis which developed spontaneous pneumothorax due to progression of emphysematous bullae during 34 years after established diagnosis].

The patient was a 46-year-old man who was taxi driver. He had received therapy for miliary tuberculosis from nine years old, and the diagnosis of alveolar microlithiasis was made by open lung biopsy at twelve years of age in 1956. At that time, there were no emphysematous bullae, and slight alveolar wall thickening was observed histopathologically. After a 34 year interval, he developed spontaneous pneumothorax with sudden dyspnea. Multiple emphysematous bullae were found at thoracoscopy performed to treat the pneumothorax. Arterial blood gas analysis after resolution of the pneumothorax showed hypoxia with a PO2 of 65.4 torr, and lung function tests revealed restrictive disorder. Thus, in this patient, emphysematous bullae progressed resulting in a pneumothorax, and lung fibrosis also developed 34 years after the diagnosis of alveolar microlithiasis. Alveolar microlithiasis is occasionally misdiagnosed as miliary tuberculosis. The authors stress that the chest roentgenographic finding of ari-bronchogram demonstrating intra-alveolar foci is an important sign in the differential diagnosis.

Calculi↗
PubMed1991

In vivo effects of some histamine H1-receptor antagonists on monoamine metabolism in the mouse brain.

The in vivo effects of four H1-antagonists, diphenhydramine, chlorpheniramine, mepyramine, and promethazine, on the metabolism of noradrenaline (NA), dopamine (DA), and 5-hydroxytryptamine (5-HT) were investigated in the whole mouse brain. Diphenhydramine and chlorpheniramine had no significant effect on levels of NA, 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), DA, and 5-HT, but they significantly decreased levels of 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5-HIAA). In particular chlorpheniramine markedly decreased 5-HIAA levels at doses as low as 1 mg/kg, i.p. Mepyramine significantly decreased 5-HIAA levels but not those of other substances. High doses of promethazine significantly decreased NA levels but markedly increased those of MHPG, DOPAC, HVA, 5-HT, and 5-HIAA. The DA reduction induced by alpha-methyl-p-tyrosine (alpha-MT) was significantly inhibited by diphenhydramine, chlorpheniramine, and promethazine, but the alpha-MT-induced NA decrease was significantly enhanced by promethazine. The 5-HIAA accumulations induced by probenecid were significantly inhibited by chlorpheniramine and mepyramine. These results suggest: (1) Diphenhydramine and chlorpheniramine inhibit the turnover of both DA and 5-HT by blocking their neuronal uptake. (2) Promethazine and mepyramine inhibit DA and 5-HT turnover, respectively, as a result of the inhibition of the uptake mechanism. (3) Promethazine increases NA turnover by enhancing NA release. The discriminative effects of these drugs on the monoamine systems may be related to some differences in their CNS actions.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1991

[An autopsied case of chronic active Epstein-Barr virus (EBV) infection with various symptom].

A 19-year-old boy, who complained of fever and fatigue was hospitalized in November 1986. On physical examination, he had a temperature of 37 degrees C, cervical lymphadenopathy and hepatosplenomegaly. Serum transaminase was elevated moderately, while serum alkaline-phosphatase was elevated severely. Extremely elevated antibody titers to the EBV capsid antigen (IgG: 2560x, IgA: 160x), early antigen (IgG: 1280x, IgA: 160x) and nuclear antigen (160x) were noted. PPD and DNCB skin test were negative. Severe mobilization of Kupfer cells and mild proliferation of pseudoductule were seen in liver biopsied specimen. Cervical lymphnode biopsy showed necrotizing lymphadenitis associated with proliferation of histiocyte. In February 1987 his temperature was elevated to 40 degrees C and he had arthralgia and exanthema. Intravenous Acyclovir (500 mg every 8 hours) and Interferon alpha (6 million u/day) were administered together for 1 month. After that he improved for about a week. In March 1987 he had dyspnea. Arterial blood gas analysis in room air showed a PO2 of 51.8 mmHg, a PCO2 of 28.9 mmHg. A chest radiograph showed thickening of bilateral bronchial walls and obscurity of pulmonary vascular shadows. The effects of transfer factor and Interleukin-2 were unremarkable. High antibody titers to EBV, liver dysfunction and hypo-oxygenemia continued. He died of respiratory and heart failure on 24 October 1987. The most interesting finding of autopsied specimens was stenosis of pulmonary artery associated with interstitial pneumonitis. Hemophagocytosis was seen in liver, spleen and bone marrow.

Adult↗
PubMed1991

[Clinicopathological studies and flow cytometric analysis on renal cell carcinoma after incidental finding].

Of 173 patients with renal cell carcinoma treated at the Keio University Hospital between 1979 and 1989, 48 cases were found to have their tumors incidentally (group 1), and the remaining patients presented with signs and/or symptoms related to their tumors (group 2). In this study we attempted to define the clinicopathological and ploidy characteristics of the tumors in the patients of the two groups. The number of patients having tumor stages not exceeding pT2NOMOV- was significantly higher in group 1 (81.3%) than in group 2 (36.0%) (p less than 0.001), and the median tumor size was significantly smaller in group 1 (4.32 +/- 2.38 cm) than in group 2 (7.86 +/- 4.07 cm) (p less than 0.001). The survival rate in group 1 was significantly favorable when compared with group 2 (p less than 0.005). And even in the same stage (pT1-2NOMOV-) there were statistical significance in the survival and relapse rate between the two groups (p less than 0.05), which indicate that renal cell carcinomas detected incidentally are associated with biologically low malignant potential. From 1985, flow cytometric DNA analysis was performed in 32 tumors from the group 1 and in 50 from the group 2. The frequency of occurrence of aneuploid pattern was significantly lower in tumors from the group 1 (25.0% in the overall patients and 16.0% in those with stage pT1-2NOMOV- tumors of group 1) than in those from the group 2 (52.0% in the overall patients and 42.9% in those with stage pT1-2NOMOV- tumors) (p less than 0.05). These results also suggest that renal cell carcinomas detected incidentally are associated with low malignant potential biologically.

Adult↗
PubMed1991

[Retrospective clinical evaluation of prognosis factors in stage D2 prostatic cancer treated with endocrine therapy].

Of 91 patients with prostatic cancer treated at our Department of Urology, from January 1976 through December 1987, 42 cases of stage D2 cancer treated with endocrine therapy were evaluated retrospectively with regard to clinical parameters and prognoses. The patients with marked increase in the level of the prostatic acid phosphatase (PACP), and the lactate dehydrogenase (LDH) in serum, and marked decrease in volume of hemoglobin (Hb) had a poor prognosis. The patients who took a long time to obtain a favorable response to the therapy had a poor prognosis. The response grade in NPCP criteria at 3 months after the initiation of therapy reflected the prognosis, and showed good correlation to the grade of favorable response.

Acid Phosphatase↗