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Biomedical subjects

T Kinukawa

Publications and source records attributed to T Kinukawa.

At least 109 records · Page 6Linked to original sources
PubMed1986

[A study of prostatic tissue levels of latamoxef, cefoperazone and cefotaxime].

Although Cephem antibiotics are transferred to the prostatic fluid in relatively low levels, they are clinically effective for bacterial prostatitis. In the present study, the prostatic tissue concentration of Latamoxef (LMOX), Cefoperazone (CPZ) and Cefotaxime (CTX) were determined, and their penetration rates into the prostatic tissue were analyzed. Before the transurethral resection of the prostate (TUR-P), 2 g of LMOX (21 patients), 1 g of CPZ (15 patients) and 2 g of CTX (14 patients) were intravenously administered in a total of 50 patients with benign prostatic hypertrophy at our two Hospitals. The prostatic tissue was taken by TUR-P at 30 minutes and 60 minutes after the injection. The serum concentration and the prostatic tissue concentration of the three antibiotics were determined by the bioassay method. Additionally their serum concentration and the prostatic tissue concentration in the six cases of CTX-injected patients were also determined by high performance liquid chromatography (HPLC). The penetration rate into the prostatic tissue was obtained by the formula; the penetration rate = the prostatic tissue concentration/the serum concentration. The prostatic tissue concentrations determined by the bioassay method were, 36.9 +/- 10.6 micrograms/g at 30 minutes after the injection of 2 g of LMOX and 28.0 +/- 9.0 micrograms/g at 60 minutes, 31.0 +/- 8.3 micrograms/g at 30 minutes after the injection of 1 g of CPZ and 21.1 +/- 10.0 micrograms/g at 60 minutes, and 8.8 +/- 4.1 micrograms/g at 30 minutes after the injection of 2 g of CTX and 4.5 +/- 2.0 micrograms/g at 60 minutes (mean +/- S.D.). The penetration rates determined by the bioassay method were 36.2 +/- 10.9% at 30 minutes after the injection of LMOX and 34.8 +/- 15.3% at 60 minutes, 43.6 +/- 14.4% at 30 minutes after the injection of CPZ and 39.7 +/- 24.1% at 60 minutes, and 11.1 +/- 4.1% at 30 minutes after the injection of CTX and 9.6 +/- 3.8% at 60 minutes (mean +/- S.D.). The penetration rate of CPZ and LMOX were significantly higher than that of CTX (P less than 0.05, P less than 0.01). In 6 of the 14 CTX-injected patients, the serum and prostatic tissue concentrations of CTX and its metabolite, desacetyl-CTX, were also determined by HPLC. The penetration rate of CTX into the prostatic tissue was obtained by the formula; the penetration rate of CTX = the prostatic tissue concentration (CTX + Desacetyl-CTX)/the serum concentration (CTX + Desacetyl-CTX).(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1985

Improved allograft survival in nonidentical living related donor transplants using donor-specific blood transfusions.

A total of 78 consecutive HLA nonidentical living related donor transplant recipients with moderate to high stimulating mixed lymphocyte culture indexes underwent a deliberate donor-specific blood transfusion protocol. Of the patients 67 were first and 11 were second allograft recipients. Patients were monitored for immunological responses by cytotoxic B-cold, B-warm and T-warm antibody responses to a random panel of 30 donors, and by serial crossmatches to their donor subset B and T lymphocytes at 5C and 37C before beginning the protocol and after each donor-specific blood transfusion. Patients were followed from 3 months to 2 1/2 years, with allograft survival rates reported by the actuarial method. Survival rates of first allograft recipients were 96.0 plus or minus 2.77, 93.97 plus or minus 3.37, 93.97 plus or minus 3.37 and 90.68 plus or minus 4.50 per cent at 3 and 6 months, and 1 and 2 years, respectively. Of the patients entering the protocol for a primary transplant 20.18 per cent had persistently positive crossmatches. With increasing numbers of previous random blood transfusions a statistically significant sensitization rate was noted. Patient sensitization showed a general pattern of initial development of B-warm lymphocytotoxins resulting in positive B-warm crossmatches, which progressed to T-warm lymphocytotoxins and positive T-warm crossmatches if donor-specific blood transfusions continued. However, on development of B-warm positive crossmatches reversion to a negative crossmatch with successful transplantation was possible upon cessation of transfusions. No patient in the study was rendered nontransplantable due to donor-specific blood transfusions. All 5 patients who were completely disparate suffered amnestic type rejection episodes but following control of the rejection the course mimicked that of mixed lymphocyte culture identical living related donor transplants. Donor-specific blood transfusion is highly successful among first allograft recipients and success in extending the procedure to more disparate relatives is noted.

Blood Transfusion↗
PubMed1985

[The residual calculi in conservative operation for renal calculi].

One hundred and three kidneys with calculi in 100 patients, were treated by conservative renal surgery from Jan., 1980 to Dec., 1982. The operative technique consisted of pyelolithotomy, extended pyelolithotomy, dismembered pyelolithotomy, nephrolithotomy (bivalve or anatrophic nephrolithotomy) partial nephrectomy and pyelo-nephrolithotomy. Intraoperative X-ray and coagulum lithotomy were employed when pyelolithotomy was performed. Thirty-five residual calculi in 20 kidneys were observed on postoperative X-ray film. The rate of residual calculi was 19.4%. Factors causing residual calculi, were analysed on these 103 kidneys. The factors were as follows; the shape of calculi: staghorn calculus with multiple small calculi, the shape of the renal collecting system: narrow pelvis with narrow caliceal neck and dilatated calices, and the operative technique: nephrolithotomy. These results suggested that it would be necessary to minimize residual calculi when performing nephrolithotomy.

Adolescent↗
PubMed1985

[Surgical removal of the staghorn calculi in the solitary kidney patients].

Seven patients undergoing surgical removal of extensive renal calculi involving a solitary kidney are reviewed. Problems arising from the surgery for the extensive renal calculi in a solitary kidney patient are demonstrated and indication of the surgery is also discussed. From January, 1978 to July, 1984, extensive renal calculi were removed in 7 solitary kidney patients. The operative technique for removing calculi consisted of anatrophic nephrolithotomy (in 2 patients) and ex vivo surgery (in 5 patients). There were 2 operative deaths and 2 major complications. Calculi were completely removed in 6 and 1 patient undergoing anatrophic nephrolithotomy, had a 3 X 4 mm residual calculus. The postoperative serum creatinine was improved in 5 patients. These major complications were observed in the patients who had severe renal dysfunction during the early postoperative period. It was indicated that good renal function should be maintained even during the early postoperative period in the surgery on a solitary kidney patient. Investigating injury to the operated kidney, the early postoperative serum creatinine level was analysed in these 7 patients and 3 patients undergoing ex vivo surgery for removal of aneurysm in a solitary kidney. The results indicated that nephrotomy was the most extensive damage to the kidney. However, pyelotomy and cold ischemia during ex vivo surgery, are not always harmful. In performing surgery for extensive renal calculous disease involving a solitary kidney, we should choose pyelotomy rather than nephrotomy in in situ operation. Ex vivo surgery can provide an effective treatment.

Adult↗
PubMed1984

[Renal autotransplantation and ex vivo surgery in renal calculus disease].

Renal autotransplantation and ex vivo surgery in renal calculus disease are reviewed and their indications were discussed. In recent years, renal autotransplantation and ex vivo surgery have been applied in the management of renal calculus diseases. This technique has been believed to be a complete method for removing extensive renal calculi. However, this technique has some disadvantages such as technical difficulties and serious complications. Therefore, this technique should be indicated for cases carefully selected. At present, indications of this technique in the management of renal calculus disease are as follows; multiple or complicated calculi contained in a solitary kidney with narrow infundibla and dilated calices or in the kidney with history of previous surgery for calculus disease. This technique might not be chosen in those cases with perihilar inflammation, uncontrollable infection in the kidney or extensively damaged kidney (S-Cr 2.5 mg/dl, especially in solitary kidney).

Adolescent↗
PubMed1983

Reversal of transplant rejection by monoclonal antiblast antibody.

The first clinical trial of an antiblast monoclonal antibody, CBL1, in the treatment of kidney allograft rejection is described. The theory that this antibody might destroy active clones of cells without major side effects was given validity by a previously described study showing prolongation of skin allograft survival in rhesus monkeys. CBL1 was used to treat kidney allograft rejections in 11 patients with a one-haplotype-identical related-donor graft who had been prestimulated with donor-specific transfusions and 8 patients with cadaver grafts who had been prestimulated with multiple transfusions. 15 of the rejections were steroid-resistant. Although CBL1 had no effect on the peripheral blood lymphocyte counts, rejections were reversed in 17 of 19 patients. There was 1 graft loss in the 11 recipients of related-donor grafts and 3 in patients with cadaver-donor grafts. Side effects associated with administration of antilymphocyte serum--ie, chills, fever, and thrombocytopenia--did not develop in any of the patients treated with CBL1. It is postulated that administration of an antiblast monoclonal antibody during rejection of a kidney kills only those cells that are reacting against the graft. This could result in the maintenance of normal lymphocyte numbers and immunological functions against other antigens.

Antibodies, Monoclonal↗
PubMed1983

Crossreactivity between human and canine Ia antigens using a mouse monoclonal antibody (CIA).

A mouse monoclonal antibody (CIA) produced against human Ia antigens that reacts with 20-30% of human peripheral blood lymphocytes was found to react with more than 90% of dog lymphocytes. Less than 41% of the Ia-positive dog lymphocytes expressed surface immunoglobulins. Immunoprecipitation studies with 125I-labeled cells precipitated heavily labeled Ia bands at 28K and 35K from human cells, but from dog cells the 29K beta chain of Ia was much more heavily labeled than the alpha chain.

Animals↗