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Biomedical subjects

T Agishi

Publications and source records attributed to T Agishi.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Prevalence of urinary tract infection during outpatient follow-up after renal transplantation.

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↗
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Improvement of peripheral circulation by low density lipoprotein adsorption.

Low density lipoprotein (LDL) was removed by repeated extracorporeal adsorption with a dextran sulphate cellulose column in 5 patients with clinical signs of poor peripheral circulation. The LDL apheresis was continued for 2 to 10 months, and symptoms such as cold or "heavy" legs, or intermittent claudication rapidly improved early in the treatment course in all 5 patients. Clearing of mentation occurred in 3, and recovery of kidney function was seen in 1 patient. These improvements occurred concomitant with a reduction in LDL level.

Aged↗
PubMedDate not supplied

Extracorporeal hybridization of proximal renal tubular cells and an artificial membrane for the purpose of beta 2 microglobulin removal.

The present study was designed to develop a bioartificial kidney hybridized with LLC-PK1 cells for the purpose of beta 2microglobulin (B2M) removal. Cells were prepared in polystyrene culture wells; the bottom of each was covered with collagen fiber and the cells grown as monolayer cultures. Each well was inoculated with 1 ml cell suspensions with 0.0, 1.0 X 10(6), 2.0 X 10(6), or 4.0 X 10(6) cells/well. B2M was added to the culture system at a concentration of 80 micrograms/dl. Results were as follows: 1) Concentration of B2M in the supernatant of 4 X 10(6) cultivated LLC-PK1 cells was decreased from 79.32 +/- 2.41 micrograms/dl to 67.02 +/- 3.00 micrograms/dl (n = 6, p less than 0.01) at 2 hr; 2) Concentration of B2M in the supernatant of 1 X 10(6), 2 X 10(6), and 4 X 10(6) cultivated LLC-PK1 cells was 75.06 +/- 2.31 micrograms/dl (n = 6, p less than 0.05); 67.27 +/- 11.41 micrograms/dl (n = 6, p less than 0.001); and 67.02 +/- 3.00 micrograms/dl (n = 6, p less than 0.001), respectively, vs. 79.32 +/- 2.41 micrograms/dl in controls at 2 hr; 3) There was a significant positive correlation between the efficacy of B2M removal and cell number; and 4) These results suggested that it is possible to develop an artificial kidney hybridized with proximal tubular cells that possesses a high affinity for B2M removal.

Animals↗
PubMedDate not supplied

Development of continuous recirculating peritoneal dialysis using a double lumen catheter.

Continuous recirculating peritoneal dialysis (CRPD) was newly introduced to improve solute removal efficiency in conventional dialysis therapies such as hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). In CRPD, a part of the dialysate in the peritoneal cavity was drained through a double-lumen catheter and purified by an extracorporeal dialyzer. Urea removal characteristics in CRPD were examined in a canine study. In this study, a recirculation-dialysis experiment using a dog weighing 9.0 kg was carried out under 100 and 200 ml/min of flow for recirculating and delivered dialysates, respectively. An FB-50H (Nipro Medical Industries, Ltd., Osaka, Japan) composed of cellulose diacetate membrane with 0.5 m2 of surface area and Dianeal-1.5 (Baxter Limited Laboratories, Tokyo, Japan) containing urea were used as the extracorporeal dialyzer and dialysate. Urea peritoneal and dialyzer dialysances (DBP and DBD) were 3.05 and 33.3 ml/min by computer simulation using a compartment model for CRPD. This DBP value can be estimated as 20.3 ml/min for a 60 kg human. From this result, time-averaged value for BUN over an 8 hr/day CRPD, combined with three exchanges/day as CAPD is estimated to be 34.3 mg/dl, which is much lower than 45.2 mg/dl for a 12 hr/week HD, or 53.0 mg/dl for conventional CAPD.

Animals↗
PubMedDate not supplied

LDL apheresis in atherosclerotic disease with hyperlipidemia.

Low density lipoprotein (LDL) apheresis was carried out in 28 atherosclerotic patients with clinical signs of poor peripheral circulation and abnormally high LDL levels. The LDL apheresis using extracorporeal adsorption with a dextran sulfate cellulose column (Liposorber, Kaneka, Japan) was done 10 times over 3 months. Hyperlipidemia was rapidly corrected after the initial two aphereses, whereas clinical signs of arteriosclerosis obliterans (ASO), such as coldness of the legs in 17 of 19 patients (89.5%), intermittent claudication in 14 of 17 patients (82.4%), foot pain at rest in 15 of 18 patients (83.3%), poor arterial pulsation in 12 of 16 patients (75.0%), and diminution of ulcer/necrosis in 3 of 5 patients (60.0%), improved in parallel. Improvement in plethysmographic and thermographic findings were observed in 10 of 10 patients (100.0%) and 13 of 14 patients (92.9%), respectively. Our tentative conclusion is that LDL apheresis using the Liposorber system was very effective in removing LDL from blood, and clinical symptoms rapidly improved in all patients concomitant with a reduction in plasma LDL levels. Hyperlipidemia may be a risk factor for symptomatic ASO in the lower extremities, and its active correction may be worth trying.

Aged↗
PubMedDate not supplied

Prolongation of cardiac xenograft survival by double filtration plasmapheresis and ex vivo immunoadsorption.

A double filtration plasmapheresis (DFPP) technique and ex vivo immunoadsorption were applied to remove natural antibodies and avoid hyperacute rejection in discordant xenotransplantation. A swine heart was heterotopically transplanted into a dog's neck after DFPP and ex vivo immunoadsorption using a swine spleen or liver. Mean graft survival time was prolonged to 240 +/- 141 min in the group treated by combined DFPP and splenic adsorption, and 225 +/- 62 min in the group treated by combined DFPP and hepatic adsorption, whereas it was 9 +/- 5 min in the group without any treatment (p < 0.01). Mean removal rates of IgG and IgM were 85.5% and 93.3%, respectively. Anti-swine lymphocytotoxic antibodies and hemagglutination antibodies were also effectively removed. Deposits of canine IgM and C3 on the vascular endothelium of the graft were observed on immunofluorescence, which suggested that natural antibodies in the IgM fraction played an important role in xenohyperacute rejection.

Animals↗
PubMedDate not supplied

Continuous monitoring of blood volume in double filtration plasmapheresis.

A continuous hematocrit (HCT) monitor, Crit-Line, was introduced to examine the change in patients' blood volume (BV) due to albumin loss during double filtration plasmapheresis (DFPP) treatments. Nine patients with autoimmune diseases or ABO incompatible renal transplantation received 15 DFPP treatments under Crit-Line monitoring. In these patients, plasma albumin concentration (C(P)) changed from 3.7 +/- 0.6 g/dl to 3.5 +/- 0.5 g/dl and HCT from 28.7% +/- 3.3% to 31.3% +/- 4.3% (change ratio [CR] of BV = -8.1%) during treatment with albumin concentrations (C(S)) of 9.5 +/- 1.0 g/dl and 500 ml volumes (V(S)) of supplementation fluid. Although the apparent CR value of C(P) was -5.3%, on average, the CR of albumin in the patients' plasma (M(P)) was -16.1%, which means a corrected CR value of C(P) by the HCT value to eliminate the influence of the patient's blood volume contraction during treatment. Albumin loss usually occurred in DFPP treatments. The decrease in BV was induced by an oncotic pressure drop due to albumin loss, and often resulted in a blood pressure drop. The amount of albumin loss during DFPP treatments strongly depends on sieving coefficients of the plasma separator (SC(PS)) and the plasma fractionator (SC(PF)), the filtration fraction of the plasma fractionator (FF(PF)), pretreatment C(P) value, and C(S) and V(S) values of the supplementation fluid. To determine the optimum C(S) and V(S) values for each patient, the authors introduced a variable blood volume model for albumin transport in DFPP. In this model, changes in C(P), HCT, and BV values could be estimated during treatment. For example, a patient with an HCT of 31.2%, body weight of 61.1 kg, and pretreatment C(P) of 4.4 g/dl received a DFPP treatment using a plasma separator, OP-05 (SC(PS) of 0.99), and a plasma fractionator, Evaflux 2A (SC(PF) of 0.40), under FF(PF) of 0.8 with a V(S) of 500 ml. A value for C(S) of about 10 g/dl is required for the patient to maintain a normal C(P) level during treatment by an estimation from the model. As a result of the treatment with a C(S) of 10 g/dl, the patient had no adverse reactions, such as a blood pressure decrease, during treatment under these conditions.

Blood Volume↗