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Biomedical subjects

I Aikawa

Publications and source records attributed to I Aikawa.

At least 37 records · Page 2Linked to original sources
PubMed1988

The effect of cyclosporine on mortality and renal function in living related pediatric kidney transplant recipients.

The outcome, incidence of acute rejection episodes, complications and cyclosporine (CyA) induced nephrotoxicity were studied in 10 pediatric kidney transplant recipients who were grafted from one-haplotype indentical parent with immunosuppression of CyA and prednisolone (Pred). Excellent patient and graft survival could be achieved in this population with low incidences of acute rejection or serious complications as when compared with the results of azathioprine (AZ) treated pediatric patients. With a mean follow-up of 12.9 months (range 1 to 50 months), the patient survival rate was 100 per cent and the graft survival rate was 100, 84, 84 and 84 per cent at 1, 2, 3 and 4 years post transplantation, respectively. Serum creatinine levels in the group were 0.97, 1.17, 1.14 and 1.2 mg/dl at 3, 6, 12 and 24 months post transplantation, respectively. The incidence of treated acute rejection episodes was 20 per cent (2 out of 10) in the CyA-treated children, whereas it was 53 per cent (9 of 17) in the Az-treated children. Five children who had undergone transplant surgery before they were 11 years old displayed linear growth in height after their transplantation. There have been no opportunistic infections, aseptic necrosis or peptic ulcers in this group and cyclosporine nephrotoxicity has not been a serious problem in the pediatric recipients. Only 10 per cent (1 out of 10) of the recipients displayed acute nephrotoxicity and only one recipient has converted from CyA + Pred to CyA + AZ + Pred (Three drug therapy) due to persistent nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

A kidney transplant recipient with renal cell carcinoma derived from a native kidney.

A case of renal cell adenocarcinoma which originated from a left native kidney following kidney transplantation, with widespread metastases, including multiple bone and liver metastases, is presented herein. An extensive clinical investigation, including bone marrow biopsy, liver biopsy, abdominal computerized tomography, excretory urography and examination of the gastrointestinal tract failed to determine the site of the primary lesion in this patient. Examination at autopsy revealed a small adenocarcinoma of the left native kidney with lobulated nodular capsular invasion and metastases to the bone and liver.

Adult↗
PubMed1988

Experience with 247 living related donor nephrectomy cases at a single institution in Japan.

There is currently much concern over the morbidity and mortality of donors undergoing nephrectomy for living related renal transplants. Between April, 1970 and July, 1986, 247 cases of living related renal transplants were performed at the Second Department of Surgery, Kyoto Prefectural University of Medicine. The average age of the donors was 50.3 +/- 9.7 years, 81 per cent of the donors being parents of the recipients. Minor abnormalities which did not affect the donors suitability were found in 71 cases. Nephrectomies were performed extraperitoneally in all cases. Peri-operative complications, including wound complications in 13 cases, urinary infection in 12 cases and pulmonary complications and arrhythmia in 4 cases, were considered to be minor in nature. A variety of renal function tests, carried out two weeks after nephrectomy revealed normal levels, although they had become slightly worse than those estimated pre-operatively. Long-term sequelae in the follow-up period from 18 months to 16 years and 2 months, was studied on 124 donors who answered questionnaires. Currently, there are 5 late deaths, none of which are directly related to the nephrectomy. Of the 124 donors, 85.5 per cent stated that there had been no change in their physical states following surgery. Pain or a feeling of discomfort at the wound site was reported by 10 donors (8.1 per cent) and hypertension was observed only in 3 (2.4 per cent). No major complication directly related to the donor nephrectomy was found, except for one case of incisional hernia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Infiltrating ductal carcinoma developing within cystosarcoma phyllodes--a case report.

Malignancy in cystosarcoma phyllodes is uncommon and often confined to the stromal element. An extremely rare case of infiltrating ductal carcinoma developing within the stroma of cystosarcoma phyllodes is reported herein. A breast tumor with a diameter of 15 cm, which was diagnosed as cystosarcoma phyllodes, was excised from the right breast of a 47-year old woman. The histopathological examination revealed that hyperplastic ductal epithelial cells with dark cytoplasm and enlarged hyperchromatic nuclei were infiltrating the stroma. Thus, a diagnosis of ductal carcinoma within cystosarcoma was made. Subsequently, a standard radical mastectomy was performed. No recurrence or metastasis has been observed over the post-operative period of 5 years and 6 months.

Breast↗
PubMed1988

Effect of cyclosporine on the endocrine and exocrine pancreas in kidney transplant recipients.

In order to assess whether cyclosporine (CsA) affects the endocrine and exocrine pancreas, 105 patient courses comprised of 87 living related donor (LRD) and 18 cadaver donor (CAD) transplants treated with cyclosporine and prednisolone (Pred) were compared with the results of historical controls of 170 LRD and 10 CAD transplants treated with azathioprine (Az) and Pred. All of the recipients were followed for over 6 months after transplantation. There were no differences in age, sex, Broca index, family history, and preoperative evaluation on diabetic dispositions between the two treatment groups. The incidence of diabetes mellitus (DM) requiring insulin therapy was higher in CsA-treated recipients (18/105, 17.1%) than in Az-treated recipients (23/180, 12.8%; P less than 0.05), although both the daily Pred and cumulative doses of methylprednisolone (MP) at the onset of DM were significantly smaller in the CsA group than in the Az group (26.1 +/- 2.2 mg v 41.4 +/- 3.4 mg, P less than 0.01 and 3,086 +/- 626 mg v 7,133 +/- 1,129 mg, P less than 0.01, respectively). Diabetic patients with CsA showed higher levels of blood glucose (401 +/- 46 mg/dL), but lower amounts of urinary glucose (40 +/- 4.3 g/d) compared with patients treated with Az (239 +/- 31 mg/dL, and 61.4 +/- 4.6 g/d, respectively, P less than 0.05). In the CsA group, the onset of DM was related to high CsA plasma trough levels (greater than 350 ng/mL) in 23% of patients. Insulin could be withdrawn within 3 months in six of eight patients who had been converted from CsA to Az.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1987

Results of kidney transplantation in 25 pediatric patients.

Outcome, long-term prognosis, growth activity and rehabilitation after kidney transplantation were studied in 25 pediatric patients transplanted with a kidney graft from one-haplotype identical parent. Excellent patient and graft survival with low incidences of acute rejection or serious complications could be achieved in this population, as compared with the results of adult recipients. Growth retardations in height and weight were observed in these patients before transplantation, and were significantly correlated with the duration of low or no kidney function. In 12 recipients who were transplanted at ages of younger than 15 years and followed up over two years, a dramatic increase in weight appeared within one year after transplantation and a greater increase in height was exhibited in the second and third year than in the first. Increase in height was significantly greater in those children transplanted at ages of younger than 10 years than in those transplanted at ages of older than 11 years. Catch-up growth was observed in one-third of these children. Retrospectively, there was no difference in the doses of prednisolone given between the two groups of patients with, and without catch-up growth, but the incidence of acute rejection was higher in the group without catch-up growth. Currently, 18 recipients have functioning grafts and 16 (88.9 per cent) of them are in full-time school or working. From these results it is concluded that kidney transplantation is the first feasible manoeuvre for those children with chronic renal failure and it should be performed as soon an possible in order to preserve their growth activity.

Adolescent↗
PubMed1987

[Long-term follow-up study of renal autotransplantation in reno-vascular hypertension].

Therapeutic effects of heterotopic renal transplantation for renovascular hypertension were evaluated in ten patients with a follow-up period of more than three years. These ten patients consisted of 4 males and 6 females with the range of age from 21 to 55. The causes of renovascular hypertension were fibromuscular dysplasia in five patients, atherosclerosis in 3 and aortitis syndrome in 2. All the ten patients had a unilateral stenosis of the renal artery. At 3 years after operation, the blood pressure fell to normal range without any medication in 9 patients (90%) and it could be controlled with antihypertensive drugs in the remaining one patient. Operative mortality or deterioration of graft function was not experienced in any of them. One of the female patients had three deliveries after operation. The heterotopic renal autotransplantation is a therapeutic method to be selected for renovascular hypertension, since excellent and stable long-term results can be achieved.

Adult↗
PubMed1986

Improved outcome of renal transplantation with cyclosporine compared with azathioprine--experience in 33 recipients followed for over one year.

Long-term clinical aspects after kidney transplantation using cyclosporine (CsA) were studied in 33 patients who received kidney grafts from one haplotype identical living related donor and who were followed for at least one year. Both actual graft and patient survival rates were 97 per cent at one year. Incidence and severity of acute rejection were reduced to a greater extent in patients treated with CsA than in patients treated with azathioprine (AZ). The incidence of infections was low, and no serious bacterial infection occurred in these 33 patients. In 17 of 33 patients with a deteriorative graft function caused by intractable nephrotoxicity, CsA was converted to AZ. The mean serum creatinine level of converted patients was significantly higher than that of patients maintained with CsA at each time when a dose of CsA was stepwise reduced from 14 mg/kg/day to 6 mg/kg/day. Conversion to AZ improved graft function dramatically, although it resulted in reversible acute rejections in 4 patients. CsA induced hepatotoxicity occurred in 10 patients, but in all normal liver function was restored with decrease in the dose. The potent immunosuppressive effect of CsA compensates for its side effects. However, CsA should be converted to AZ when the chronic nephrotoxicity persists at a late stage of post-transplantation.

Adolescent↗
PubMed1983

Spontaneous blastogenesis assay for detection of renal allograft rejection in man.

In attempts to assess the possibility of allograft rejection, serial assays of spontaneous blastogenesis (SB) by uptake of tritium thymidine in 50 microliters whole blood were performed in 72 consecutive renal allograft recipients. Of 79 clinically diagnosed rejection episodes, 65 (82 per cent) had an associated elevation of SB values, and 14 (18 per cent) showed false negative results. In 38 (59 per cent) of 65 episodes in which the elevations of SB values were observed, the elevations preceded the clinical diagnosis by 1-7 days. Although large doses of steroids did not affect the values of SB, false positive elevations which were mainly caused by systemic infections occurred in 12 cases. There was no significant association between severity of rejection crisis and the maximum value of SB in the course. The SB assay requiring only a small amount of blood can be accomplished within 4-5 hours and provides a simple means of assessing and predicting host's immune responsiveness to the histocompatibility antigens.

Graft Rejection↗