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Biomedical subjects

Yuichiro Yamashiro

Publications and source records attributed to Yuichiro Yamashiro.

At least 37 records · Page 2Linked to original sources
PubMed2005

Gastrointestinal stromal tumor in a child and review of the literature.

Gastrointestinal stromal tumors (GIST) are c-KIT positive neoplasm that occur predominantly in adults. A 13-year-old boy who presented with massive gastrointestinal hemorrhage was subsequently diagnosed with GIST of the stomach. The tumor originated from the lesser curvature with a narrow base and no infiltration into surrounding organs. Two metastatic lesions in the liver were also found. Total excision of the gastric lesion was performed followed by adjuvant imatinib mesylate chemotherapy. He has had no signs of recurrence during 8 months of follow-up. GIST in children are rare and their behavior is notoriously difficult to predict. We report our experience and review the literature.

Adolescent↗
PubMed2005

Outcome and cost analysis of laparoscopic or open surgery versus conservative management for multicystic dysplastic kidney.

PURPOSE: To determine whether laparoscopic nephrectomy (LN), open nephrectomy (ON), or observation (OB) is most efficient for managing multicystic dysplastic kidney (MCDK). METHODS: We performed a retrospective review of the management of our 12-year clinical experience of 32 MCDK patients to analyze the estimated total cost (ETC) of various treatment options and compare them with respect to survival, development of hypertension, and postoperative cosmetic appearance, to determine the most efficient treatment option. RESULTS: There were 12 cases in the LN group, 6 in the ON group, and 14 in the OB group. ETC was lower for ON than for LN. But the length of preoperative observation and length of follow-up after spontaneous regression greatly affected ETC. If MCDK cases were observed > 5 years with standard investigations performed regularly, ETC was higher for the OB group than for the LN group. In 6/14 (42.9%) of OB cases, MCDK resolved within 5 years, and this subgroup had the lowest ETC up to the time of this review. Six cases initially in the OB group were managed surgically (4 by LN and 2 by ON) in accordance with parental requests, and ETC in these cases was highest. All cases are well after a mean follow-up of 5.7 years, without any impairment of renal function, or hypertension. CONCLUSION: The decision to operate after lengthy observation increases costs. Overall, the most efficient surgical technique for managing MCDK was LN because of greater patient satisfaction with postoperative cosmesis. We recommend MCDK be treated by LN after a short period of observation.

Costs and Cost Analysis↗
PubMed2005

Effects of human milk and spermine on hydrogen peroxide-induced oxidative damage in IEC-6 cells.

OBJECTIVE: Oxidative stress is intimately involved in the pathologic processes of serious diseases in the perinatal period. Human milk (HM) contains various bioactive substances, some of which are known as antioxidants, including polyamines such as spermine (SPM). We examined the antioxidative properties of HM and SPM in an intestinal epithelial cell line. METHOD: Confluent Intestinal Epithelial Cells-6 (IEC-6) cells were preincubated with 100-fold dilutions of defatted HM, bovine milk, or three artificial milks for 24 hours, followed by hydrogen peroxide (H2O2) challenge (0.5 mM, 30 min) for oxidative stress. Cells were preincubated with either HM or increasing concentrations (within the range of HM) of SPM for 24 hours followed by an H2O2 challenge (0.25 mM, 30 min). RESULTS: HM-treated cells showed the highest survival rate (50%) compared with no pretreatment (27%), bovine milk-treated (6%), or artificial formula-treated (13-16%) cells. Significantly higher survival rates were observed in the cells treated with HM (44.0%) and in those treated with 0.5, 1, or 5 microM of SPM (12.6, 13.1, or 22.2%, respectively) in comparison with the nontreated cells (7.0%). CONCLUSION: Our results demonstrated that HM and SPM alleviated H2O2-induced oxidative damage in IEC-6 cells, whereas bovine milk and artificial formula did not show any antioxidative capacity. These results suggest that HM acts as an antioxidant in the gastrointestinal tract of infants and that SPM plays an important role in the antioxidative properties of HM.

Animals↗
PubMed2005

Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated international expert group.

The Codex Alimentarius Commission of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) develops food standards, guidelines and related texts for protecting consumer health and ensuring fair trade practices globally. The major part of the world's population lives in more than 160 countries that are members of the Codex Alimentarius. The Codex Standard on Infant Formula was adopted in 1981 based on scientific knowledge available in the 1970s and is currently being revised. As part of this process, the Codex Committee on Nutrition and Foods for Special Dietary Uses asked the ESPGHAN Committee on Nutrition to initiate a consultation process with the international scientific community to provide a proposal on nutrient levels in infant formulae, based on scientific analysis and taking into account existing scientific reports on the subject. ESPGHAN accepted the request and, in collaboration with its sister societies in the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition, invited highly qualified experts in the area of infant nutrition to form an International Expert Group (IEG) to review the issues raised. The group arrived at recommendations on the compositional requirements for a global infant formula standard which are reported here.

Evidence-Based Medicine↗
PubMed2005

Primary malignant lymphoma of the central nervous system in an immunocompetent child: a case report.

Primary lymphoma of the central nervous system (PCNSL) is extremely rare, especially in childhood. A 9-year-old Japanese boy was diagnosed as having precursor-B cell-type lymphoblastic lymphoma, based on morphologic and immunocytochemical analysis of mononuclear cells in the cerebrospinal fluid and a positive reaction for terminal deoxynucleotidyl transferase (TdT), CD19, CD79a, and CD179b. After seven courses of chemotherapy and craniospinal radiotherapy, the patient is alive, well, and in continuous complete remission. Despite its rarity, PCNSL should be included in the differential diagnosis in the presence of symptoms of increased intracranial pressure and/or unusual imaging findings of the brain.

Antigens, CD↗
PubMed2005

Factors involved in the regulation of plasma leptin levels in children and adolescents with anorexia nervosa.

OBJECTIVE: The effects of changes in body mass index (BMI) and other factors on plasma leptin levels in children and adolescents with anorexia nervosa (AN) were examined. METHODS: Plasma leptin levels and BMI was measured before and after initiation of refeeding therapy every 2 weeks for 8 weeks in 12 children and adolescents with AN. The plasma levels of insulin, cortisol, insulin-like growth factor-I (IGF-I), and tumor necrosis factor-alpha (TNF-alpha) were also measured in these subjects before and after 8 weeks of the refeeding therapy, and the results were compared with those from 12 age-matched healthy girls. RESULTS: The plasma leptin and IGF-I levels, as well as the BMI, in the AN patients before refeeding therapy were significantly lower than both of these indices in the AN patients 8 weeks after initiation of the therapy and in the controls. The plasma leptin levels and BMI in the AN patients 8 weeks after initiation of the therapy were still significantly lower than those in the controls. Significant correlations between the plasma leptin levels and BMI were detected in the AN patients both before and 8 weeks after initiation of the refeeding therapy, as well as in the controls. The BMI showed a significant increase beginning at 2 weeks after initiation of the therapy compared with that before refeeding, but the plasma leptin levels did not significantly increase until 4 weeks after the initiation of therapy. CONCLUSION: The results suggest that plasma leptin levels reflect changes in body fat content in children and adolescents with AN, although there is a delay in the recovery of plasma leptin levels compared with those of BMI in the early period of refeeding therapy, which is probably regulated by other factors.

Adolescent↗
PubMed2005

Serum and urine Helicobacter pylori antibody titer after intravenous gamma-globulin treatment for Kawasaki disease and its clearance.

BACKGROUND: It is not clear the effect of gamma-globulin therapy on results of enzyme-linked immunosorbent assays (ELISA) based on serum and urine for detection of Helicobacter pylori (H. pylori) antibodies, although the therapy can cause false-positive results in those assays. METHODS: To examine the effect of intravenous gamma-globulin (IVIG) treatment on the results of ELISA based on serum and urine, levels of H. pylori IgG were measured in the serum and urine before and after IVIG therapy in 18 children with Kawasaki disease (KD) uninfected with H. pylori. RESULTS: The serum and urine H. pylori IgG levels decreased time-dependently after the IVIG therapy and there were significant differences (P < 0.01) in the levels prior to therapy and at 7 days and 1 month after the therapy. The significant difference in the H. pylori IgG levels prior to therapy and 3 months after the therapy was observed in the serum but not in the urine. CONCLUSION: The results suggest that gamma-globulin administration can cause false-positive results in ELISA based both on serum and urine for detection of H. pylori antibodies, and that the H. pylori antibodies cleared much more quickly from the urine than from the serum.

Antibodies, Bacterial↗
PubMed2005

Dissemination of methicillin-resistant staphylococci among healthy Japanese children.

Methicillin-resistant Staphylococcus aureus (MRSA), regarded as a tenacious pathogen in the hospital, has recently become increasingly prevalent as a community pathogen. We evaluated the prevalence and characteristics of methicillin-resistant staphylococci in the Japanese community by testing nasal samples of 818 children of five day care centers and two kindergartens in three districts. We found that methicillin-resistant staphylococci are already prevalent among healthy children. Among 818 children, 35 children (4.3%) carried MRSA and 231 children (28.2%) carried methicillin-resistant coagulase-negative staphylococci (MRC-NS). The types of staphylococcal cassette chromosome mec (SCCmec) found among 44 MRSA isolates were as follows: type IIa, 11 isolates; type IIb, 19 isolates; and type IV, 14 isolates. The type IIb SCCmec element was a new SCCmec element found in this study. Eleven (25%) strains which belonged to clonal complex 5 (CC5) carried type IIa SCCmec, and they produced type 2 coagulase and toxic shock syndrome toxin 1. They were indistinguishable from health care-associated MRSA (H-MRSA) strains in Japan, represented by strain N315. On the other hand, 33 (75%) strains, most of which belonged to CC78 or CC91, carried small SCCmec elements, such as type IIb or type IV, and they produced type 1 or type 3 coagulase and exfoliative toxin. The data indicated that MRSA clones distinct from H-MRSA have disseminated in healthy children. The fact that MRC-NS strains were prevalent in the community suggested that they might serve as a reservoir for the SCCmec element carried by MRSA strains disseminated in the community.

Bacterial Proteins↗
PubMed2004

Polarized production of T-helper cell type 1 cells in Peyer's patches in Crohn's disease.

BACKGROUND/AIMS: Although Peyer's patches (PPs) serve as important antigen-sampling sites for the immune system, surprisingly little attention has been paid to their associations with the onset of Crohn's disease (CD) as antigen entry sites. To examine the immunological events in PPs, we performed functional and phenotypical studies on PP cells, the lamina propria cells in the colonic mucosa and peripheral blood mononuclear cells (PBMC) in inflammatory bowel disease. PATIENTS: The subjects were 9 children and adolescents with active CD, 9 with inactive CD, 11 with active ulcerative colitis (UC), and 22 normal controls. METHODS: The cytokine profile in PPs and lamina propria was performed through Elispot assay and RT-PCR. PP mononuclear cells and PBMC from the subjects were analyzed by flow cytometry using monoclonal antibodies to interferon-gamma and interleukin-4, and CC chemokine receptors (CCR) 4 and 5. RESULTS: Th1 together with Tc1 cells were dominant in PPs in the active phase of CD, but not in inactive CD, UC, or normal controls. They did not actually produce interferon-gamma, however they have abundant mRNA of the cytokine. Substantial levels of CCR5 ligands, MIP-1alpha and RANTES mRNA were found in the inflamed intestinal mucosa in CD. CONCLUSIONS: It is conceivable that PPs in the terminal ileum in CD may initially sample luminal antigens where Th1-type memory cells are activated which migrate to the peripheral intestinal mucosa. Those immunological changes may not be related to the etiology of UC.

Adolescent↗
PubMed2004

Usefulness of an automated urinary flow cytometer in mass screening for nephritis.

We aimed to assess the utility of a newly developed automated urinary flow cytometer (UFCM) in differentiating the origin of hematuria in the mass screening system for renal diseases in school children. In total, 4,620 children aged 6-14 years with abnormal urinary findings by the screening program in Tokyo were enrolled. Tentative diagnoses were made based on the criteria for this screening program: nephritis in 11, suspected nephritis in 104, hematuria in 771, minimal hematuria in 1,506, proteinuria in 477, urinary tract infection in 83, and healthy in 1,668. Glomerular hematuria, assessed by UFCM, was found in 81.8% of nephritis, 58.7% of suspected nephritis, 59.7% of hematuria, 57.4% of minimal hematuria, 13.4% of proteinuria, and 21.5% of the healthy group. The presence of glomerular hematuria assessed by UFCM had a sensitivity of 61.0%, specificity of 78.5%, positive predictive value of 16.3%, and negative predictive value of 96.7% for the diagnosis of nephritis and suspected nephritis. Thus, our results imply that the absence of glomerular hematuria as assessed by UFCM is highly predictive of the absence of nephritis. If "healthy" children with non-glomerular hematuria by UFCM could be excluded, the total annual cost saving would be approximately 147.4 million JPY, which is equivalent to 5.2% of the current system. In conclusion, a simple, automated and rapid test for glomerular hematuria using UFCM is useful for mass screening. It can precisely predict children with only transient hematuria who do not have any serious illness, and therefore can exclude further unnecessary examinations, resulting in the improvement of cost-effectiveness of the current program.

Adolescent↗
PubMed2004

Congenital fibromuscular dysplasia involving multivessels in an infant with fatal outcome.

UNLABELLED: We report the unusual case of a 2-month-old boy with systemic fibromuscular dysplasia (FMD). He presented with congenital renovascular hypertension due to stenosis of the right renal artery, and later developed renal infarction on the contralateral side resulting in renal failure. The boy subsequently died of intracranial haemorrhage at the age of 14 months. During the course, hemiconvulsion caused by a Moyamoya disease-like vascular lesion was noted. Stenotic lesions of both the abdominal aorta and its branches were also revealed by angiography. Post-mortem examination confirmed that the coronary, splenic and mesenteric arteries were also affected and their histological findings were compatible with FMD. To our knowledge, this is the first congenital case of FMD demonstrating a rapidly progressive course resulting in a fatal outcome. In this case, multivessels in both intracranial and extracranial arteries were involved. CONCLUSION: Our case suggests that the nature of fibromuscular dysplasia is congenital in origin and its aetiology, at least in some cases, is a systemic abnormality of vascular development.

Angiography↗
PubMed2004

Sigmoidocolocystoplasty for augmentation of iatrogenic small capacity bladder caused by direct injury to the bladder during inguinal hernia repair: long-term follow-up.

Inguinal hernia repair is the most common operation performed in pediatric surgical practice. However, this procedure can be difficult, even in the most experienced hands, and result in complications, especially in small infants. Injury to the bladder is one of the known complications of inguinal herniotomy, especially in infants less than 6 months old. We report the long-term follow-up of a case having bladder injury during inguinal hernia repair at the age of 3 months and at the age of 10 underwent sigmoidocolocystoplasty for augmentation of a small, contracted bladder and high-grade vesicoureteric reflux caused by the bladder injury.

Colon, Sigmoid↗