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Biomedical subjects

H Yaguchi

Publications and source records attributed to H Yaguchi.

At least 19 recordsLinked to original sources
PubMed1995

Cytomegalovirus-associated hepatitis and duodenal ulcer in kidney allograft recipients.

We report here on two patients with kidney allografts who had hepatitis and duodenal ulcer caused by cytomegalovirus. In one case, hepatosplenomegaly and jaundice appeared after high fever lasting for ten days. Laboratory examinations showed liver dysfunction and lymphocytosis with atypical forms. Virological studies revealed cytomegalovirus infection and we successfully treated the patient with human interferon-beta. In the other case, duodenal bleeding followed by interstitial pneumonia occurred at the 54th day after transplantation. Bleeding from the small duodenal ulcer did not stop in spite of conservative and endoscopic therapies, and gastrectomy was performed. Histologically many epithelial cells with intranuclear inclusions were found around the ulcer. Virological studies showed elevation of antibody titres to cytomegalovirus which was isolated from the urine and oropharyngeal secrete. After gastrectomy and treatment with ganciclovir, the general condition improved and graft function was maintained. Our experience with these cases suggests that aggressive diagnostic investigations for cytomegalovirus infection are essential in patients with organ allografts who present liver and gastrointestinal lesions.

Adult↗
PubMed1995

Acute hemorrhagic cystitis caused by adenovirus after kidney transplantation.

We report on 10 kidney transplant patients with acute hemorrhagic cystitis caused by adenovirus, accompanied by the deterioration of kidney function. They developed macrohematuria with urgency, frequency and micturition pain for more than 7 days within 1 year after transplantation. Adenovirus type 11 was isolated from the urine of 6 patients, and complement-fixing antibody became positive in 9 patients. Hematuria and irritative voiding symptoms disappeared without any specific treatment; however, serum creatinine rapidly increased. The histological findings of the biopsy specimens indicated that renal impairment was attributed to acute rejection in some cases and virus-associated nephropathy in other cases. Acute hemorrhagic cystitis caused by adenovirus is an interesting complication after kidney transplantation, especially with regard to kidney impairment and treatment.

Adenoviridae Infections↗
PubMed1995

Successful renal autotransplantation with Y-prosthetic aortic replacement in a patient with complete occlusion of abdominal aorta and renal artery.

Occlusion of the abdominal aorta represents the end stage of an atherosclerotic process and often is associated with stenosis of renal artery inducing renal failure and hypertension. Surgical and medical treatments are indicated to preserve and restore renal function in patients with these conditions. We report herein the first successful renal autotransplantation combined with aortic replacement by Y prosthesis in a patient with complete occlusion of abdominal aorta and bilateral renal arteries, resulting in limb-threatening ischemia and progressive renal failure.

Aorta, Abdominal↗
PubMed1995

[Pharmacokinetic study of UFT in cancer patients receiving maintenance dialysis].

Six post-operative cancer patients receiving chronic dialysis (4 colorectal and 2 gastric cancer) were given daily UFT (300 mg/day tid). To determine the clearance of UFT with dialysis, the plasma concentration of tegafur, 5-FU and uracil were measured on the day with dialysis and without dialysis. The plasma concentrations of tegafur at 2 hours after oral administration of UFT showed no difference between the day with dialysis and without dialysis. The concentration of 5-FU on the next day with dialysis was almost same as that of the patients with normal renal function because of the clearance of 5-FU with dialysis, although that on the 2nd day after dialysis was higher than that with dialysis. It was difficult to compare the plasma concentrations of uracil, because they are different in each patient. Therefore, it was considered to be difficult to maintain the suitable plasma concentration of uracil. However, clearance of UFT with dialysis was good and no severe side effect was observed in administration of UFT. These data suggest that UFT can be useful drug for gastrointestinal cancer patients receiving dialysis in a post-operative adjuvant chemotherapy.

Adult↗
PubMed1994

Successful surgical management and long-term follow-up of epidermolysis bullosa.

BACKGROUND: Esophageal stenosis and hand deformity are serious complications of recessive dystrophic epidermolysis bullosa that influence the prognosis of patients. To control such complications we have used surgical treatments with favorable results. Additional objectives were to summarize the results of long-term follow-up. METHODS: Six patients with esophageal stenosis and nine patients (13 hands) with hand deformity (contracted fingers, mitten-like deformity) were treated surgically after anemia and malnutrition were corrected by intravenous iron infusion, high-energy diet, and blood transfusion. As intubation was contraindicated, topical anesthesia was used (eg., lidocaine spray to the nasopharyngeal mucosa for esophageal dilatation and brachial block, ketamine drip, and nitrous oxide inhalation for reconstruction of contracted fingers). We established a new method for esophageal dilatation using a microvasive rigiflex balloon catheter. This catheter was advanced to the stenotic area under radiography and then expanded by injecting contrast medium into the balloon. For reconstruction of hand deformities, the epidermal glove was initially peeled off, and then the combined digits separated carefully by hand. If the release of the contracture was not sufficient, a skin incision was made avoiding injury to nerves and blood vessels. Any skin defects that appeared after the release of the contracture were covered with skin grafts taken from the abdominal wall. K-wire fixation was used to maintain the extended position of the fingers. Three weeks after the operation, the K-wires were removed and rehabilitation was commenced. RESULTS: The esophageal stenosis was successfully dilated with the balloon catheter; in all six cases the dysphagia was relieved immediately. There was no recurrence in any of the patients on long-term follow-up. After reconstruction of the hand, daily activity improved in 12 of the 13 hands. The remaining hand was difficult to reconstruct due to severe mutilation and bone deformity. During follow-up, 6 of the 12 hands maintained successful reconstruction, whereas the remaining 6 hands showed slight to moderate recontraction of the fingers. CONCLUSION: Esophageal dilatation with a balloon catheter is safer and has fewer side effects compared to other surgical procedures. This method can provide favorable results and can be carried out repeatedly in a short time. Daily and social activities of patients can be improved upon reconstruction of hand deformities.

Adolescent↗
PubMed1994

Penile block via subpubic space for children who underwent superficial operation of the penis.

Penile nerve block via the subpubic space was performed to relief the postoperative pain of children who underwent superficial surgery of the penis. Thirty-one male children were subdivided into two groups. After dorsal split procedure had been carried out under general anesthesia, 16 patients underwent subpubic penile nerve block (group 1), while 15 patients had no additional anesthetic procedure (group 2). Time to the first postoperative pain in group 1 was statistically longer than that in group 2 (p < 0.05). Most patients in group 1 did not require postoperative analgesics during the first 24 h after surgery. This technique appeared to be effective in relieving the postoperative pain of children who underwent superficial operation of the penis.

Anesthesia, General↗
PubMed1994

Fission yeast protein kinase C gene homologues are required for protoplast regeneration: a functional link between cell wall formation and cell shape control.

Two novel protein kinase C (n PKC) gene homologues, pck1+ and pck2+ were isolated from the fission yeast Schizosaccharomyces pombe (Toda et al. (1993) EMBO J. 12, 1987). We examined the functional differences of pck1+ and pck2+ in cell wall formation and actin organization of S. pombe. Regenerating protoplasts of a wild-type strain, single gene disruptants of pck1+ (delta pck1) and pck2+ (delta pck2) were used as a simple model to examine the functional links between PKC, cell wall formation and actin organization. Protoplasts of the wild-type strain and those of delta pck1 reverted to intact cells in osmotically stabilized liquid medium. A close spatial association between new cell wall formation and actin was observed in these two strains. In delta pck2, protoplasts did not revert to intact cells: (1) scarcely any new cell wall material was formed; (2) actin was not reorganized; and (3) nuclear division and an increase in the amount of cytoplasm were observed in the regenerating protoplasts. These findings demonstrate that the pck2+ gene has a function essential for protoplast regeneration but the pck1+ gene does not. Involvement of n PKCs in cell wall formation and actin organization was also clarified. The effect of staurosporine (a potent inhibitor of protein kinases) on regenerating protoplasts of the three strains confirmed the assumption that the pck2 protein is an in vivo target of staurosporine in the fission yeast.

Actins↗
PubMed1993

Immunohistochemical localization of basic fibroblast growth factor in skin diseases.

The basic fibroblast growth factor (bFGF) is an angiogenic factor and also a mitogen for epidermal keratinocytes. In order to investigate the role of bFGF in human skin we examined the distribution of bFGF immunoreactivity in normal and diseased human skin. Antigen expression was demonstrated by direct immunofluorescence staining of cryostat sections with a polyclonal anti-bFGF antibody. In normal human skin, bFGF-like immunoreactivities were observed in the basal cells, while in the case of psoriasis, positive immunoreactivities were observed in the basal cells and several supra-basal layers at rete ridges. Seborrheic keratosis and basal cell epithelioma showed diffuse immunoreactivities in the basaloid cells of the tumor. Concurrently, benign nevus cell nevus, capillary hemangioma, squamous cell carcinoma and malignant melanoma displayed negative immunoreactivities. These results suggest that bFGF is important for basal or basaloid cell proliferation.

Biopsy↗
PubMed1992

Isolation and characterization of a lower molecular weight protein doublet of horny cell outer leaflet: a possible novel epidermal differentiation marker.

The water-soluble fraction of stratum corneum contains numerous unidentifiable proteins and polypeptides when examined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Intensely stained polypeptide bands of low molecular weights (LMW) [8 and 10 kDa] are also present, and the abundance and invariable presence of this LMW protein doublet in the soluble proteins of stratum corneum prompted us to isolate and characterize them. Extracts of stratum corneum, using 8 M urea, 0.05 M Tris, pH 9.0, 0.025 M 2-mercaptoethanol, were dialysed against water. Water-insoluble proteins were removed by repeated dialysis and centrifugation. From the remaining soluble proteins, a LMW protein doublet was isolated by Sephadex G50 column chromatography and reversed-phase high-performance liquid chromatography (HPLC). The amino acid compositions of the 8 and 10 kDa proteins were similar to, but different from, those of known structural proteins in the stratum corneum. Rabbit antibody was raised against the 10-kDa protein band and cross-reacted with the 8-kDa protein band by Western immunoblot technique. The antibody recognized only this protein doublet amongst the proteins extracted from cultured keratinocytes. The 8- and 10-kDa proteins therefore appear to be closely related to, but different from, known structural proteins or degradation products. Immunofluorescence and immunoelectron microscopy demonstrated that this protein doublet was located in the cytoplasm of the cells of the malpighian layer, and in the outer layer of the marginal band of the horny layer. Its distribution was shown to be limited to stratified squamous epithelia by organ specificity studies. These results suggest that this protein doublet appears to be a novel soluble protein and a new epidermal differentiation marker of stratified epithelium.

Amino Acids↗
PubMed1992

Primary cutaneous plasmacytoma: treatment with intralesional tumour necrosis factor-alpha.

We report a case of primary multiple cutaneous plasmacytomas, without underlying multiple myeloma, treated with intralesional tumour necrosis factor-alpha (TNF-alpha). A marked reduction in tumour size, with no significant adverse effects, suggests that intralesional TNF-alpha is an effective treatment for non-solid malignant tumours. Extramedullary plasmacytoma, especially involving the skin as a primary site, has rarely been reported in the English literature. We describe the ninth reported case of multiple cutaneous plasmacytomas without underlying multiple myeloma. Intralesional tumour necrosis factor-alpha (TNF-alpha) was used to treat this disease and its anti-tumour effect quantitatively evaluated by comparing the tumour size and histological change before and after treatment.

Aged↗
PubMed1991

[A case report of progressive symmetric erythrokeratodermia and a review of progressive erythrokeratodermia in Japan].

The patient is a 5-year-old boy. There was no family history of the similar skin eruptions. The erythema with scales appeared on his head, face and neck at 1 month of birth. The erythematous hyperkeratotic plaques spread symmetrically. There was no follicular components. The eruption was chronic and persistent. In histopathology, hyperkeratosis with focal parakeratosis, acanthosis and intact granular layer were observed. In electron microscopy, a large number of mitochondria that frequently appeared to be swollen and lipidlike vacuoles in corneocytes were observed. On account of the features, we diagnosed this case as progressive symmetric erythrokeratodermia (PSE). PSE is a rare disease, and besides, it is difficult to define PSE because of contradictions in existing literatures, the variability of clinical expression and the lack of histologic, hereditary, and biochemical criteria. Nearly 70 cases were diagnosed as PSE and its variants in Japan i.e. 4 cases with PSE, 8 cases with progressive erythrokeratodermia, and 58 cases with Asahi-Ijiri disease and its variants. However, only 2 cases diagnosed as PSE and 4 cases nominated as others satisfied the recently established criteria by Ruiz-Maldonado, et al. In this paper, reported cases of PSE and its variants were reviewed and reassessed.

Child, Preschool↗
PubMed1990

Expression of extracellular and intracellular bullous pemphigoid antigens at the dermal-epibolic junction in organ culture of human skin.

Recent papers have reported that there are at least two distinct binding sites of bullous pemphigoid (BP) antibodies; one is the extracellular (lamina lucida) BP antigen (E-BPA) and the other is the intracellular (basal cell cytomembrane-hemidesmosome-cytoskeleton) BP antigen (I-BPA). In attempting to characterize the properties of these two BP antigens (BPA), we have investigated the expression of E-BPA and I-BPA as well as other basement membrane zone (BMZ) components such as type IV collagen, laminin, and epidermolysis bullosa acquisita (EBA) antigen at the dermal-epibolic junction as a model system for BMZ neogenesis. I-BPA was found along the dermal-epidermal junction and throughout the whole length of the dermal-epibolic junction. However, E-BPA and other BMZ components were found along the dermal-epidermal junction and along only the most proximal portion of the dermal-epibolic junction. These results suggest 1) that emergence of E-BPA varies from that of I-BPA in such a model system of BMZ neogenesis, and 2) that the emerged E-BPA may attach to the newly formed basement membrane complex.

Antibodies↗
PubMed1989

[Lichen planus pemphigoides--report of a case and binding sites of circulating anti-basement membrane zone antibodies].

In this paper, we initially report a case which had clinical, histological and immuno-histochemical features consistent with the diagnosis of lichen planus pemphigoides (LPP). We then examined in vitro binding sites of circulating anti-basement membrane zone (BMZ) antibodies (Ab) from the patient using skin substrate separated through the lamina lucida by incubation in 1.0 M NaCl in order to study the localization of the LPP antigen. In indirect immunofluorescence examination, binding of anti-BMZ Ab from this patient was observed along the epidermal side of the separated skin in a linear pattern. When an indirect immunoelectron microscopy was performed on the separated skin, immune-reaction products were localized at basal cells from cytomembrane to hemidesmosomes in a massive and discontinuous fashion. These findings suggest that the binding sites of anti-BMZ Ab in LPP (localization of LPP antigen) are quite different from those of epidermolysis bullosa acquisita Ab, and show an intracellular association with hemidesmosomes in a fashion similar to those of bullous pemphigoid Ab.

Autoantibodies↗
PubMed1989

[Surgical treatment of esophageal stenosis with recessive dystrophic epidermolysis bullosa--esophageal dilatation using balloon catheter method].

We report the details of our treatment of 5 patients with recessive dystrophic epidermolysis bullosa (RDEB). Good results were obtained by esophageal dilatation using the balloon catheter method. Prior to the operation, we corrected the patients' nutritional status with oral supplementation of Hinex-R as well as intravenous drip infusion of Intra-lipid, based on the nutrition index obtained by body weight, serum albumin, rapid turnover proteins, and blood minimum essence. After sufficient anesthesia of the nasopharyngeal mucosa with xylocain spray, we inserted a Microvasive Rigiflex Balloon Dilator into the stenotic region while scanning the upper GI. Then we dilated gradually by barium injection. The patients' condition improved after this treatment and follow up X-ray examination revealed no recurrence of stenosis. There were several advantages to this method: 1) It was safer and could be done repeatedly. 2) It caused less stress for patients. 3) Its effectiveness appeared rapidly. We analyzed the frequency and severity of esophageal stenosis of 12 cases with EB in our department. Ten out of 12 cases complained of subjective esophageal symptoms. Esophageal stenosis was observed in all 8 cases examined by esophagogram. We concluded that this surgical procedure for esophageal stenosis was as important as digit reconstruction in the management of RDEB.

Adolescent↗
PubMed1988

Vulvitis circumscripta plasmacellularis treated successfully with interferon alpha.

A 74-year-old woman with vulvitis circumscripta plasmacellularis was successfully treated with intralesional injections of interferon alpha. Although the patient had been previously treated unsuccessfully for 5 years with topical administration of a potent corticosteroid, with cryotherapy, and with surgical procedures, the disease continually recurred. A course of interferon alpha resulted in a significant clinical improvement of the lesions, a histologically verified decrease of plasma cell infiltrate, and the disappearance of the antigen of herpes simplex virus that had been detected before treatment by direct immunofluorescence staining of the lesion. This clinical course demonstrates the effectiveness of local injections of interferon alpha into those lesions with vulvitis circumscripta plasmacellularis that did not previously respond to conventional therapy. Therefore an implication exists that herpes simplex virus infection may be one of the factors involved in the pathogenesis of this disease.

Aged↗