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K Morozumi

Publications and source records attributed to K Morozumi.

At least 55 records · Page 3Linked to original sources
PubMed1999

Case study of paired cadaver renal allografts from the same donor: influence of local DIC kidney and concomitant acute rejection on early graft outcome.

We report the clinical course of 2 recipients whose renal allografts were obtained from the same cadaver donor after cardiac arrest. The recipients showed different outcomes after transplantation. Graft biopsy after reperfusion revealed disseminated intravascular coagulation (so-called DIC kidney) and severe acute tubular necrosis (ATN) in both recipients. While one graft showed primary nonfunction, the other graft became functional after a post-operative anuric period. Serial graft biopsies performed during the oligo-anuric period revealed recovery of ATN and no intra-glomerular fibrin thrombi, but development of acute rejection was detected in both recipients. The left kidney graft showed more severe local DIC kidney than the right kidney, as well as more severe acute rejection in the oligo-anuric period. Despite aggressive anti-rejection therapy, the left kidney graft showed primary nonfunction. Therefore, severe acute rejection leading to primary nonfunction might have been related to more severe ischemic injury and more extensive local DIC kidney in the left kidney.

Adult↗
PubMed1999

Significance of interstitial lesions as the early indicator for acute vascular rejection in human renal allografts.

To evaluate the relevance between interstitial lesions and acute vascular rejection of renal allograft, we examined 129 renal allograft biopsy samples obtained from 60 transplant patients within 90 d post-transplantation. Plasma cells, eosinophils and polymorphonuclear cells (PMNs) in the cortical interstitium were counted, respectively, and the number of each cells per 10 fields at a magnification of 200x was calculated. Then, the existence of interstitial edema was judged. We categorized 129 biopsy specimens into specimens before (Pre), on (R) and after acute rejection (Post). An increased number of eosinophils (mean +/- SE; 15.4 +/- 9.2 per 10 fields) was observed in R rather than in Pre (0.6 +/- 0.3, p < 0.05). The increasing number of plasma cells depends on a time course following the onset of acute rejection. The number is significantly larger in acute vascular rejection (4.3 +/- 1.1) than in non-vascular rejection (1.3 +/- 0.4, p < 0.01). In living donor transplants, the number of PMNs in patients before vascular rejection (median, 16.7 per 10 fields; range, 5.0-20.0 per 10 fields) was significantly larger than in normal or borderline patients (2.2; 0.0-36.7, p < 0.01). The incidence of interstitial edema in patients before vascular rejection (55.6%) was significantly higher than in normal or borderline patients (8.0%, p < 0.01). This study suggested that acute vascular rejection is relevant to interstitial lesions, such as for a plasma cell, eosinophil and PMN infiltrate, and edema. Also, these lesions seem to be the indicator of acute vascular rejection. These findings may contribute to the refinement of histological diagnosis of acute vascular rejection.

Acute Disease↗
PubMed1999

Electron microscopic peritubular capillary lesions: a new criterion for chronic rejection.

Typical chronic rejection showing prominent glomerular and/or arterial lesions is less common in renal allograft patients treated with cyclosporin A (CsA). We investigated the value of peritubular capillary lesions as a criterion for chronic rejection in the CsA era. A total of 129 renal graft biopsies, taken from recipients showing graft dysfunction after more than 2 months post-operatively, were examined by electron microscopy, and peritubular capillary lesions were studied, especially multi-layered basement membrane lesions (MLPTC). Eighty-two biopsy specimens taken from non-transplantation patients were also studied as a control. Five biopsies (6%) showed mild and atypical MLPTC in the control group. Of the 129 allograft biopsies, MLPTC was seen in 55 (42.6%). The prevalence showed no significant relationship to the interval from operation to biopsy. MLPTC was either typical (n = 10) or incomplete (n = 45). Concomitant membrane disruption, edema and lymphocyte infiltration of the subendothelial space, reflecting acute cellular rejection, were occasionally noted in both groups. Incomplete MLPTC often developed within 1 yr after surgery, in association with acute rejection. It was found in 26-50% of biopsies at any time up to 5 yr post-operatively. The incidence of typical MLPTC was 5.7-12.8% over 1 yr post-operatively. These findings suggest that the development of chronic rejection is closely related to relapsing acute tubulo-interstitial allograft rejection which is often clinically silent. We concluded that MLPTC is useful as a specific criterion for chronic rejection.

Basement Membrane↗
PubMed1999

A case of IgA nephropathy after ABO-incompatible living kidney transplantation.

A 39-yr-old Japanese man underwent living related kidney transplantation. Because the graft was ABO-incompatible, he was treated with double filtration plasmapheresis before transplantation and his immunosuppressive therapy was stronger than usual. However, immunoglobulin A nephropathy, accompanied by cellular crescents and necrotizing lesions, developed after 18 months. To our knowledge, the association of IgA nephropathy with ABO-incompatible kidney transplantation has not been reported previously.

ABO Blood-Group System↗
PubMed1999

[A case of multiple early gastric cancer showing complete response to UFT-E after endoscopic mucosal resection].

A 78-year-old male underwent endoscopic mucosal resection for early gastric cancer (type II a) in the anterior wall of antrum. Follow-up endoscopy showed another early gastric cancer (type II c) in the posterior wall of cardia. He refused an operation. UFT-E 300 mg/day has been administered daily since then. After 6 months, a complete tumor response was observed. The patient has been in good health without any sign of relapse for 14 months after achievement of the complete response.

Adenocarcinoma↗
PubMed1998

The aberrant expression of Lewis a antigen in intestinal metaplastic cells of gastric mucosa is caused by augmentation of Lewis enzyme expression.

Immunohistochemical staining showed an aberrant expression of Le(a) antigen in the intestinal metaplastic glands of the gastric mucosa of secretors, as reported by others. In this study, we have demonstrated for the first time that the Lewis enzyme is well colocalized with Le(a) antigen, indicating that the Lewis enzyme is responsible for Le(a) antigen synthesis in the gastric mucosa. The staining intensity of the Lewis enzyme was much stronger in the cells with intestinal metaplasia than the cells without metaplasia, regardless of the secretor status. The amount of transcript of the Lewis gene was related to the degree of metaplasia; i.e., the more severe the metaplastic change was, the more abundantly the transcripts of the Lewis gene were expressed. This augmentation of the Lewis enzyme in metaplastic tissues was also confirmed by Western blotting analysis using a specific antibody against the Lewis enzyme. We conclude that intestinal metaplastic change of gastric mucosa is usually accompanied by a marked augmentation of the Lewis enzyme expression, which results in the enhanced expression of Le(a) antigens, particularly in secretors.

Adult↗
PubMed1998

[Current topics of the rejection pathology in human renal allografts].

The topics of renal allograft pathology; validation of the Banff classification and a new criterion for chronic rejection are reviewed. Although the clinico-pathologic utility of the Banff classification is remarkably high in acute rejection, the Banff scheme is still incomplete. The severity of rejection based on the Banff schema well correlated with the deterioration of graft function and also with reversibility of the graft function. Grade III acute rejection in the Banff schema suggested poor graft function, while grade IIb acute rejection could be cured by rejection therapy in the CyA era. The morphological characteristics of chronic rejections in renal allografts become milder and less specific in the CyA era. The differentiation of chronic rejection of immunologic origin from other conditions leading to renal scarring remains one of the major problems in renal allograft biopsy interpretation. Chronic CyA nephrotoxicity and/or glomerulonephritis frequently accompany chronic rejection. Electron microscopic peritubular capillary basement membrane lesion (MSPTC) was a sensitive indicator for chronic rejection of immunologic origin as well as glomerular capillary lesions. The negative MSPTC in the patients with chronic rejection suggest that the deterioration of the graft function is probably non-immunologic in origin.

Biopsy↗
PubMed1998

Up-regulation of a set of glycosyltransferase genes in human colorectal cancer.

The carbohydrate structures of glycoconjugates of cancer cells change markedly in comparison with those of noncancerous cells. We aimed to determine which glycosyltransferases are up-regulated or down-regulated in human colon cancer tissues in order for the dramatic change in carbohydrate structures to occur. The transcript levels of 12 glycosyltransferase genes were measured by a competitive reverse-transcription-PCR method in noncancerous and cancerous colorectal tissues. Eight well- to moderately differentiated and three poorly differentiated carcinomas were examined in comparison with noncancerous colon epithelial tissues adjacent to the carcinoma tissues. Two of the twelve glycosyltransferase genes, Fuc-TIV and ST3Gal II, were significantly up-regulated in all cancerous tissues regardless of the histologic features. Four genes, ST3Gal I, ST6Gal I, beta1,4GalT, and Core2 GnT, showed a tendency toward up-regulation, and a ST3Gal III gene showed a tendency toward down-regulation. The other genes, Fuc-TIII, Fuc-TVI, and ST3Gal IV, which were most abundantly expressed in colorectal tissues, did not show significant up-regulation except in the poorly differentiated carcinomas. The Fuc-TVII gene was expressed at a very low level and was not up-regulated, and the Fuc-TV gene was not expressed at all in the colorectal tissues. Interestingly, all of the 12 glycosyltransferase genes examined, except the Fuc-TV, Fuc-TVI, Fuc-TVII, and ST3Gal III genes, were markedly up-regulated in all of the poorly differentiated carcinomas. We concluded that multiple glycosyltransferase genes are up-regulated, probably leading to extensive glycosylation of glycoconjugates in colorectal cancer cells. Lastly, sialyl Lewis antigens, ie, sialyl Lewis x and a antigens, which are terminal epitopes of sugar chains and well known as tumor-associated antigens, were quantified by Western blotting analysis. Based on the levels of transcripts of the 12 enzymes together with the amounts of sialyl Lewis antigens, we concluded that Fuc-TIII, Fuc-TVI, and ST3Gal IV are mainly responsible for synthesis of the sialyl Lewis antigens in colon tissues, but are not responsible for the augmented expression of the antigens in colorectal cancers. The amounts of sialyl Lewis x and a epitopes on mucins in colon cancer tissues can thus be determined through combinatorial up-regulation of the multiple glycosyltransferase genes.

Adult↗
PubMed1998

The side-effects of ciclosporine-A and tacrolimus.

Ciclosporine-A (CSA) has been in clinical use as an immunosuppressive drug in transplant recipients for over a decade. Unfortunately, CSA also has major side-effects (including nephrotoxic ones). In an attempt to find safer agents, tacrolimus (TAC) has been introduced recently. Despite major differences in the chemical structure, TAC and CSA seem to have many effects in common. This phenomenon can be explained by the inhibition of the calcineurin pathway characteristic for both drugs. The aim of our brief review was to compare personal observations regarding side-effects encountered under CSA or TAC therapy with data reported previously. We found that the profile of side-effects both under CSA and TAC was nearly identical. In particular, morphologic changes associated with toxic drug effects in the kidney were indistinguishable from one another, i.e. tubular lesions, arteriolopathy, HUS-like changes in glomeruli and vessels. The prevalence of defined nephrotoxic lesions was very similar. Some differences were found regarding the prevalence of clinical side effects. Hypertension, hypertrichosis and gingival hyperplasia were less pronounced in the TAC group and an elevated blood glucose level in the CSA group. We conclude that TAC and CSA are closely related immunosuppressive drugs with regard to adverse effects.

Cyclosporine↗
PubMed1997

Abnormal cyanide metabolism in uraemic patients.

BACKGROUND: We previously investigated the factors involved in uraemic neuropathy in patients undergoing regular haemodialysis and found a significant relationship between the severity of vibration sensation impairment and the patients' smoking habits. The administration of methylcobalamin markedly improved the severity of uraemic neuropathy in terms of vibration perception thresholds. We presumed that abnormal cyanide metabolism is involved in the development of uraemic neuropathy. METHODS: Serum levels of thiocyanate (SCN-), the detoxication product of cyanide, were determined in 12 patients with preterminal chronic renal failure (PCRF), 30 patients undergoing regular haemodialysis (HD patients), and 13 healthy volunteers as a control group. Nine of the 30 HD patients were smokers. In addition, in 10 HD patients without smoking habits and 10 non-smoking healthy volunteers, the proportion of each vitamin B12 analogue in total vitamin B12 was estimated. RESULTS: The mean serum SCN- level of the 12 PCRF patients (5.1 +/- 1.5 micrograms/ml) was significantly higher than that of the control (2.8 +/- 0.9 micrograms/ml) (P < 0.01). The mean SCN- level before haemodialysis in the 21 non-smoking HD patients was identical to that in the PCRF group, whereas the level in the nine smoking HD patients (7.2 +/- 1.8 micrograms/ml) significantly higher than that in the non-smoking subgroup (P < 0.01). In 16 HD patients with methylcobalamin treatment, serum SCN- levels were lower than in those without methylcobalamin treatment (4.5 +/- 0.5 micrograms/ml in non-smoking subgroup, P < 0.05). And in the methylcobalamin-treated subgroup (n = 5), the proportion of each vitamin B12 analogue in total vitamin B12 was normal. In the untreated subgroup (n = 5), the proportion of cyanocobalamin fraction (10.5 +/- 2.6%) was as high as the level in Leber's disease patients, while the proportion of methylcobalamin fraction was low. And the serum cyanocobalamin level was higher in the treated subgroup. CONCLUSION: In uraemic patients, cyanide detoxication capability is impaired because of a reduced SCN- clearance, and increased cyanocobalamin synthesis indicates elevation of cyanide pool, which would be related to the development of uraemic neuropathy. Methylcobalamin was considered to be utilized in cyanide detoxication process via cyanocobalamin synthesis.

Adult↗