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Biomedical subjects

K Kanagawa

Publications and source records attributed to K Kanagawa.

At least 19 recordsLinked to original sources
PubMed1995

Strain combination-dependent genesis of necrotizing arteritis in anti-ICAM-1 antibody-perfused renal allografts in the rat.

Rat kidneys were perfused with anti-intercellular adhesion molecule-1 (anti-ICAM-1) monoclonal antibody prior to allotransplantation. In the two strain combinations examined, LEF-to-WKAH transplants resulted in accelerated graft loss, and no prolongation of graft survival. The accelerated graft loss was the result of frequent occurrence of necrotizing arteritis within the grafts. In contrast, TO-to-WKAH transplants resulted in no change in graft survival and no arteritis. Necrotizing vasculitis in the LEJ-to-WKAH grafts was characterized by fibrinoid necrosis, collection of cellular infiltrates and serum macromolecular protein entrapment. The F(ab1)2 form of anti-ICAM-1 antibody partially preserved the antibody's capacity to accelerate graft loss. Therefore, although endothelial injury by Fc-mediated cytotoxicity may be involved in vascular damage, other mechanisms also come into play. The amount and distribution pattern of ICAM-1 antigen were identical in both TO and LEJ strains. Intravenous anti-ICAM-1 antibody administration combined with lipopolysaccharide, Poly(I)-Poly(C), warm ischemia to the kidney, or subcutaneous immunization with allogeneic spleen cells, but without renal transplantation, did not generate necrotizing vasculitis or proteinuria. These observations plus our previous data on the rat liver transplantation model clearly show that graft perfusion with anti-ICAM-1 monoclonal antibody invokes extensive vascular damage within allografts by Fc-mediated and Fc-independent mechanisms, depending on the donor-to-host combination.

Animals↗
PubMed1995

[Kidney transplantation].

From March 1986 to August 1994, 110 living-related renal transplants were performed under the cyclosporine combination immunosuppression. Age of the recipients ranged from 4 to 48 years old (mean 29.3), and 81 patients were male and 29 were female. The mean duration on dialysis before the transplants were 39.7 months (0 to 210), and the methods of dialysis were divided with hemodialysis in 94 patients, CAPD in 15 and no dialysis in 1. The donors consisted of 96 parents (87.3%), 66 mothers and 30 fathers, and 14 siblings (12.7%). Age of the donors ranged from 28 to 73 years old (mean 48.7). The number of patients with acute rejection episodes were 48 patients with once, 18 with twice, 10 with 3 times and 34 (30.9%) with no rejection. Patient survival rate was 99.0% after 1 year posttransplantation, 97.9% after 3 years and 95.7% after 5 years. Graft survival rate was 91.5%, 85.1% and 77.8%, respectively. Twenty grafts were lost with the most common causes of graft loss being chronic rejection (55%), acute rejection (20%) and accelerated acute rejection (15%). In cadaveric renal transplants, because of very small number of informations for cadaver donor, only 13 cadaveric renal transplants were performed in Hokkaido, from 1984 to August 1994. There was no case over 5 years follow up postoperatively, so patient survival rate was 100% and 90% after 1 year and 3 years posttransplantation, and graft survival rate was 84.6% and 74.0%, respectively. Two kidneys of 13 cadaveric renal transplants were never functioning grafts. We have to make more efforts for propagation of the donation system.

Adolescent↗
PubMed1994

One-stage repair of hypospadias: is there no simple method universally applicable to all types of hypospadias?

A simple method of hypospadias repair is described. The operative technique consists of 7 steps, including 1) outlining the skin incision and dartos mobilization; 2) artificial erection, harvesting parameatal foreskin flap and release of chordee as needed; 3) glans splitting and creation of glanular wings; 4) 1-stage urethroplasty with parameatal foreskin flap; 5) meatal glanuloplasty; 6) creation of Byars' flaps of the skin, and 7) skin closure. Central to the technique is the feasibility of the choice of 1-stage urethroplasty with meatal based manta-wing flap or with parameatal based and fully extended circumferential foreskin flap even after the skin incision is made, which enables its application to all types of hypospadias. Of 120 patients the 1-stage urethroplasty was performed with meatal based manta-wing flap in 50, and with parameatal based and fully extended circumferential foreskin flap in 70. Primary success was obtained in 82% of the cases with meatal based manta-wing flap, and in 53% with parameatal based and fully extended circumferential foreskin flap. Complications requiring secondary repair occurred in 42 cases (9 with meatal based manta-wing flap, and 33 with parameatal based and fully extended circumferential foreskin flap) but repair was successful in 32. Thus, the overall success rate was 91% (96% with meatal based manta-wing flap, and 87% with parameatal based and fully extended circumferential foreskin flap). Additional repair (10 secondary, 2 tertiary and 1 quaternary) is planned in 13 cases. The technique of 1-stage urethroplasty with parameatal foreskin flap is recommended as a simple and reliable treatment for hypospadias with a reasonable success rate.

Child↗
PubMed1994

Management and outcome of antenatally diagnosed hydronephrosis.

From March 1989 to December 1992, we encountered 25 kidneys in 21 patients with a suspicious ureteropelvic junction (UPJ) obstruction detected only on prenatal ultrasound. In all these patients other urological abnormalities were excluded by voiding cystourethrography and other radiological findings. Diuretic renography (DR) was initially performed at an age ranging from 15 days to 32 months in all patients and repeated a total of 39 times. Both the split renal function (SRF) and diuretic drainage half-time clearance (DT1/2) of radioagent were within their normal ranges in the case of 15 (60%) of the kidneys on initial DR. In these kidneys, there were no aggravated signs on repeated DR. Decreased SRF was found in 3 kidneys (12%) on initial DR. Of these, the renal function spontaneously reverted to normal in 2 cases with bilateral hydronephrosis. Another 1 kidney revealed significant UPJ obstruction assessed by pressure flow study and continuous nephrostomy drainage had brought relief from the obstruction 1 year later. Prolonged DT1/2 with normal SRF was found in 7 (28%) kidneys. The renal function did not deteriorate and the diuretic response improved on repeat DR except for 1 kidney, whose function deteriorated and on which ultimately, pyeloplasty was performed at 7 months of age. Prenatally diagnosed hydronephrosis is usually asymptomatic and clinically significant UPJ obstruction should be always verified. Although even today there is still no examination which can detect a definite obstruction, we can identify one as significant by careful repeat examinations and thus avoid unnecessary surgery without causing any renal deterioration.

Child, Preschool↗
PubMed1994

In vivo effect of a selective endothelin receptor antagonist, BQ-123, on renal function in cyclosporin A-treated rats.

To investigate the possible involvement of endogenous endothelin (ET) in cyclosporin A (CsA) nephrotoxicity, we examined the renal effects of the selective [125I]ET-1 binding to porcine aortic membrane (ETA) receptor antagonist, BQ-123 (BQ), on CsA-treated rats. An osmotic minipump filled with BQ or its vehicle (saline), was subcutaneously implanted and animals were treated with CsA (50 mg/kg/d, i.p.) for 4 d. In both BQ- and its vehicle-treated rats, the 24-hour urine volume, urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion, urinary Ca/creatinine (Cr) and urinary NAG/Cr ratios were significantly increased compared with those before administration of CsA. In contrast, after administration of CsA, urinary Cr excretion was significantly decreased in both rat groups. Although urinary NAG excretion and the NAG/Cr ratio in the rats treated with BQ were significantly increased compared with those treated with saline, the serum Cr levels in BQ-treated rats were significantly lower than those in saline-treated rats. Urinary immunoreactive ET-1 (irET-1) excretion in all animals was significantly increased after administration of CsA. There were no significant differences in urinary irET-1 excretion in both BQ-treated and saline-treated rats with and without CsA. Expression of irET-1 was seen in the cytoplasm of renal tubules, but the degree of expression was similar in the BQ-treated and saline-treated rats on CsA. In the BQ-treated rats, small round areas with high grain densities over the glomeruli in the cortex and vesa recta bundles in the outer medulla were masked by the antagonist action of BQ.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

[Bladder calculus after augmentation ileocystoplasty in children].

Of 12 children who had undergone augmentation ileocystoplasty for treatment of neurogenic bladder, 3 developed bladder calculi 9 to 19 months after the operation. All these 3 children had simultaneously undergone procedure to ensure urinary continence together with ileocystoplasty, and postoperative persistent bacteriuria was found in these 3 children. Component of bladder calculi was magnesium-ammonium phosphate in 2 and calcium phosphate in the other child, and all were successfully removed by endoscopic lithotripsy. These data suggest that postoperative persistent bacteriuria as well as procedures to ensure urinary continence might play a role in the formation of bladder calculus after augmentation cystoplasty.

Adolescent↗
PubMed1994

Intraperitoneal leakage of technetium-99m-DTPA following renal transplantation: a sign of chylous ascites.

UNLABELLED: A 7-yr-old girl developed persistent ascites following renal transplantation. METHODS: Renal scintigraphy periodically performed to monitor renal function of the transplanted kidney showed increased 99mTc-DTPA in the abdominal cavity on delayed imaging. RESULTS: Paracentesis demonstrated a cloudy yellow, odorless fluid which was identified as chylous ascites, an extremely rare complication of abdominal vascular surgery. CONCLUSION: Technetium-99m-DTPA in the peritoneal cavity following renal transplantation should be recognized as a sign suggestive of chylous ascites.

Child↗
PubMed1993

Susceptibility of renal tubular cells to lymphokine-activated killer (LAK) cells: application of culture system using a collagen gel matrix.

Monolayer cultures of renal tubular (hKEC) cells were established. These cells formed empty spheroids after 2-3 weeks of culture in a collagen gel matrix. A subcellular polarity from the apex to basement was induced in these "spheroidal" hKEC cells. The weak expression of laminin at the outer surface was evident on spheroidal but not on monolayered hKEC cells. The regulation of HLA-ABC, DR, and intercellular adhesion molecule-1 (ICAM-1) antigens on hKEC cells in the gel matrix was investigated utilizing digestion of gel matrix by collagenase. Enzymatic digestion of the collagen gel did not significantly affect the surface expression of HLA-ABC and ICAM-1, but reduced HLA-DR expression as shown by flow cytometry. The MHC and ICAM-1 molecules on both spheroid-forming and monolayered hKEC cells were upregulated by adding a supernatant of mixed lymphocyte reaction (MLR) and recombinant human interferon (IFN)-gamma. HLA-DR antigen expression was inconsistently induced on the hKEC cells cultured in collagen gel without MLR supernatant or IFN-gamma. In contrast, no HLA-DR expression was found on monolayered hKEC cells in the absence of MLR supernatant or IFN-gamma. Spheroid-forming hKEC cells, when dispersed by enzymatic digestion, were more susceptible to cytolysis by lymphokine-activated killer (LAK) cells than were the enzymatically dispersed, monolayered cells in the 51Cr-release assay. The LAK cells were seen to migrate into the collagen gel and kill the hKEC cells. Thus, LAK cells may function to favor the acceleration of graft rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Surface↗
PubMed1992

A case of neurofibromatosis associated with clitoral enlargement and hypertension.

We report a case of clitoral and renovascular involvement of neurofibromatosis resulting in an enlarged phallus with juvenile hypertension. The patient was successfully treated by removal of the clitoral tumor and nephrectomy. This is the first of 15 reported cases with clitoral involvement, that showed concurrent renovascular hypertension.

Child↗
PubMed1992

Effects of aging on plasma islet amyloid polypeptide basal level and response to oral glucose load.

To delineate the effects of aging on basal and glucose-stimulated secretion of islet amyloid polypeptide (IAPP), we compared the basal level of plasma IAPP and its response to an oral glucose load in elderly subjects with those of young subjects. Plasma IAPP level was determined by radioimmunoassay. Basal level of plasma IAPP in 20 elderly subjects (mean age 63 yr) was 5.3 +/- 0.4 pmol/l, which was not significantly different from 5.0 +/- 0.3 pmol/l in 22 young subjects (mean age 26 yr). Plasma glucose levels after an oral glucose load in elderly subjects (n = 8, mean age 67 yr) and young subjects (n = 8, mean age 29 yr) were within normal limits. However, the plasma glucose response in the aged group was significantly higher than that in the young group. The plasma insulin response to a glucose load in elderly subjects was not different from that in young subjects. The plasma IAPP level in the aged group significantly increased from 5.3 +/- 0.5 to 16.4 +/- 2.3 pmol/l 120 min after the oral glucose load. This result was quite similar to that in the young group whose plasma IAPP level increased from 4.9 +/- 0.5 to 14.1 +/- 1.5 pmol/l 120 min after the glucose load. We concluded that the basal level of plasma IAPP and its response to glucose were not affected by aging.

Adult↗
PubMed1992

[Study of 54 renal allograft recipients in the cyclosporin A era. What influences acute rejection episode and long-term graft survival?].

During the past 5-year period from 1986 to 1991, a total of 54 patients received living-related renal allograft and has been managed with vagaries of cyclosporin A (CYA) immunosuppressive regimen. In order to determine the ideal form of induction regimen, combination drugs with CYA, the initial dosage of CYA and its blood trough level were retrospectively analyzed with particular reference to the possible factors relevant to the occurrence of acute rejection episode in the first three post-transplant months and graft survival. The combination drugs with CYA were prednisolone (PRD) in 10 patients, PRD + azathioprine (AZA) in 19 and PRD+mizoribine (MIZ) in 25. The initial dosage of CYA was 6 mg/kg B.W. in 6 patients, 8 mg/kg in 17, 10 mg/kg in 15 and > or = 12 mg/kg in 16. Blood trough level of CYA measured principally by high performance liquid chromatography was arbitrarily divided into < 100, 100-150, 150-200, > or = 200 mg/kg ranges for the analysis. By arbitrarily dividing the post-transplant period into four (period I: 0-15th day, period II: 16-30th, period III: 31-60th and period IV: 61-90th), the correlation of the incidence of acute rejection episode and aforementioned factors was studied. Relevance of these factors to the graft survival was also studied. The administration of AZA to MIZ to CYA + PRD had no suppressive effect upon the occurrence of acute rejection during the first three months and similarly it had no effect upon graft survival. Rejection episodes, however, occurred more frequently in the recipients with less than 150 ng/ml of CYA trough level in the period I and less than 100 ng/ml in the period III (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Cytokine regulation of ICAM-1 expression on human renal tubular epithelial cells in vitro.

Regulation of the intercellular adhesion molecule-1 (ICAM-1) expression on human renal tubular epithelial cells in culture (hKEC-1) was investigated. A large proportion of hKEC-1 cells from the primary cultures expressed the ICAM-1 antigen. Supernatants from mixed lymphocyte reaction (MLR) of both specific and third-party combinations augmented the expression of the ICAM-1 antigen, in a dose-dependent manner. A kinetic study revealed maximal augmentation by MLR supernatant on the first day, with a gradual decrease thereafter. Among several recombinant human cytokines tested, i.e., interferon-gamma, tumor necrosis factor-alpha, interleukin 1 alpha and beta, and IL-4, IFN-gamma, TNF-alpha, and IL-1 alpha/beta were shown to augment the expression of ICAM-1. MLR supernatants and IFN-gamma were more effective in augmenting ICAM expression than TNF-alpha and IL-1 alpha/beta. IFN-gamma upregulated ICAM-1 expression in a dose-dependent manner, and maximal augmentation was achieved on the first day. The MLR supernatants were shown to contain IFN-gamma and TNF-alpha, and the activity of the MLR supernatant was partially inhibited by neutralizing antibody against IFN-gamma. These data suggest that cytokines, especially IFN-gamma, TNF-alpha, and IL-1 alpha/beta, released by T cells and antigen-presenting cells upon recognition of alloantigens upregulate ICAM-1 expression on renal tubular epithelial cells. This may result in an increase in the attachment of graft-infiltrating T cells to the renal tubular cells, by the ICAM-1-LFA-1 interaction.

Antigens, CD↗