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Biomedical subjects

M Hida

Publications and source records attributed to M Hida.

At least 19 recordsLinked to original sources

Clinical evidence of peroxynitrite formation in chronic renal failure patients with septic shock.

The production of both nitric oxide (NO) and superoxide increases in septic shock. The cogeneration of these molecules is known to yield peroxynitrite, which preferentially nitrates tyrosine residues of protein and non-protein origins. We present evidence of peroxynitrite production in septic shock by measuring plasma nitrotyrosine. The nitrotyrosine was measured by an HPLC C-18 reverse-phase column and ultraviolet detector in chronic renal failure patients with or without septic shock, and in healthy volunteers. Plasma nitrite + nitrate (NOx) was also measured to evaluate NO production. Nitrotyrosine was selected as an index for production of peroxynitrite because the direct measurement of peroxynitrite in vivo is difficult. Patients with renal failure were selected in order to minimize nitrotyrosine excretion through the kidney. Plasma nitrotyrosine levels were not detectable in volunteers, 28.0 +/- 12.3 microM (1.6 +/- 1.1% of total tyrosine) in renal failure patients without septic shock, and 118.2 +/- 22.0 microM (5.5 +/- 1.2% of total tyrosine) in patients with septic shock. NOx levels were also higher in patients with septic shock than in patients without septic shock (173.9 +/- 104.7 vs. 75.6 +/- 19.1 microM). Although renal failure itself increases plasma concentrations of both molecules, the higher levels in patients with septic shock suggest that peroxynitrite is generated and the nitration of tyrosine residues is increased in this disease.

Adult

Functional evaluation of the remaining kidney in kidney donors by radionuclide dynamic imaging using a graphic method with factor analysis.

An uptake coefficient proportional to the glomerular filtration rate (GFR) can be estimated from dynamic renal images with 99Tcm-DTPA using Rutland's graphic method. We have developed a new method of extracting the input and retention functions by applying factor analysis to the renal dynamic images obtained with 99Tcm-DTPA, which we have called the 'factor uptake coefficient' (Factor UC). In the present study, we followed 13 living kidney donors (7 males, 6 females) by measuring the Factor UC in each kidney before nephrectomy and in the remaining kidney 3 weeks and 1 year after nephrectomy. The median Factor UC in the remaining kidney increased from a pre-nephrectomy value of 0.31 to 0.52 three weeks post-nephrectomy, which then remained unchanged for up to 1 year. These results indicate that functional compensation occurs following unilateral nephrectomy, and that this process is complete within 3 weeks after nephrectomy.

Adult

Cellular proliferation and secretion in secondary hyperparathyroidism during renal failure.

Secondary hyperparathyroidism is one of the severe complications of chronic renal failure. In this study, we investigated the cellular components of parathyroid tissue, with measurements of various serum parathyroid hormone (PTH) types in the circulation, and evaluated their clinical significance in hemodialysis patients. Thirty-eight patients who underwent both subtotal parathyroidectomy and autotransplantation in Tokai University Hospital from 1979 to 1994 were divided into two groups. Group 1 (G-1) was not administered active-type vitamin D3 (VD; 19 patients; 15 males and 4 females), and group 2 (G-2) was administered VD (19 patients; 10 males and 9 females). The parathyroid tissues which were obtained from G-1 and G-2 patients were classified into three classes based on the size of the oxyphilic cell area (class I < 25%, class II 25-50% and class III > 50%). Our results showed that the proliferation index of parathyroid tissues in the oxyphilic cell area was higher in G-2 than that in G-1. Immunohistochemically, MIB-1 staining was more intense than that in the chief cell area in G-2 patients. Moreover, the proliferative index in the same specimen was also higher in the oxyphilic cell area than in the chief cell area. It was suggested that the oxyphilic cells proliferated independently. Furthermore, synthesis of PTH in the oxyphilic cell area was revealed immunohistochemically by the presence of PTH and was confirmed by positive staining of PTH mRNA in the oxyphilic cell area with in situ hybridization. HS(M-terminal)- and C-PTH levels in the serum were significantly higher in class III than in class I (p < 0.01). No significant difference of HS- and C-PTH levels between class II and class III was noted. Moreover, no significant difference of intact-PTH levels was found in all three classes. From the above findings, it was suggested that proliferation of the parathyroid tissues or secretory state of PTH in hemodialysis-maintained patients with secondary hyperparathyroidism, which was closely related to the proliferation of oxyphilic cells, can be more accurately reflected by HS- and C-PTH levels than by the intact-PTH level. Therefore, it was suggested that HS- and C-PTH levels in the serum are important indices for accurate evaluation of the pathology and suitable therapy of secondary hyperparathyroidism, as well as observation of the clinical course.

Adult

A polymorphism observed in the experimentally successful peptide vaccine sequence derived from Theileria sergenti piroplasm major surface antigen (p33).

A polymorphism in the experimentally successful peptide vaccine sequence (EVVWKEKKEVKDLDA, amino acids 134-148) derived from the 33 kDa piroplasm major surface antigen (p33) of Theileria sergenti was examined. The vaccine sequences obtained by PCR amplification and sequencing of the p33 gene from a total of 15 parasite-infected cattle blood samples collected from 4 prefectures through Hokkaido to Kumamoto revealed the two major sequences (Ikeda and Chitose stock types) either of which was identified in all samples. Since the peptide vaccine develops the parasite species- or stock-specific immunity in the animals, an application of the two major peptide sequences as cocktailed vaccine should be evaluated for a practical use of this strategy to controlling T. sergenti infection in Japan.

Amino Acid Sequence

[A severe form of urinary tuberculosis in children].

Urinary tuberculosis is a rare disease in children. It poses major diagnostic problems because of clinical symptoms, which are often atypical and misleading. It causes serious lesions which are often multifocal and extensive, requiring complex surgical excision and urinary tract reconstruction. Prevention of this disease is based on generalized vaccination with BCG and adequate treatment of pulmonary tuberculosis. The authors report a case of urinary tuberculosis in a fourteen-year-old child who presented episodes of cystitis and hematuria refractory to treatment. The diagnosis, confirmed by the positive test for AFB in the urine was established late, at the stage of silent kidney and scleroatrophic bladder. The patient was treated with antituberculous chemotherapy (Isoniazid; Rifampicin, PZA) and nephro-ureterectomy with augmentation enterocystoplasty.

Adolescent

Inhibition of the accumulation of uremic toxins in the blood and their precursors in the feces after oral administration of Lebenin, a lactic acid bacteria preparation, to uremic patients undergoing hemodialysis.

The plasma levels of phenol, p-cresol, and indican are markedly increased in uremic patients, and cannot be efficiently reduced by hemodialysis. Such uremic toxins, which are produced in the intestine as bacterial putrefactive metabolites, accumulate to a great degree in the feces of hemodialysis patients. Oral administration of Lebenin, a preparation consisting of antibiotic-resistant lactic acid bacteria, reduced the levels of fecal putrefactive metabolites to levels comparable with those of healthy subjects. Moreover, the plasma level of indican also significantly decreased in these Lebenin-treated patients. An analysis of the fecal microflora revealed that a disturbed composition of the microflora characterized by an overgrowth of aerobic bacteria is restored to normal by oral administration of Lebenin in hemodialysis patients. These results thus demonstrate that oral administration of lactic acid bacteria in uremic patients is effective in reducing the levels of uremic toxins, especially that of indican, in the blood by inhibiting bacterial production by means of correcting the intestinal microflora.

Administration, Oral

[A case of toxic shock syndrome (TSS) induced by methicillin-resistant staphylococcus aureus (MRSA) presenting as acute renal failure with disseminated intravascular coagulation].

A case of a 73-year-old woman with acute renal failure due to toxic shock syndrome (TSS) is reported. The patient was admitted to our hospital with the complaints of high fever, disturbance of consciousness and shock. Laboratory findings on admission were; CRP 25.11 mg/dl, WBC 35000/ microl, Plt 1.6 x 10(4)/ microl, GOT 155 U/l, GPT 65 U/l, CPK 4202 U/l (CPK-MM 96%), BUN 123 mg/dl and SCr 7.0 mg/dl. Because of anuria, hemodialysis was performed. This patient was treated with dopamine, methyl prednisolone (MP), frozen fresh plasma, AT III, antibiotics, and platelet transfusion. The bacterial cultures of blood and cerebrospinal fluid were negative, but MRSA was isolated subsequently from the pharynx and vagina. We investigated the production of toxic shock syndrome toxin 1 (TSST-1) and staphylococcal enterotoxins (SE). The isolated MRSA produced TSST-1, SEB and SEC. Accordingly, we made the diagnosis of TSS. After improvement of acute renal failure and the patient's general condition, MRSA persisted and TSST-1 was still found in the patient's blood. Finally we eradicated the MRSA and TSST-1 after administration of ciprofloxacin hydrochloride (CPFX) and Rifampicin (RFP).

Acute Kidney Injury

[Hemolytic anemias observed in SLE].

Hemolytic anemia observed in patients with SLE include autoimmune hemolytic anemia (AIHA) and thrombotic microangiopathic hemolytic anemia (TMHA). AIHA is caused by anti-erythrocyte antibody, which can be detected by direct Coombs' test. Recently, anti-phospholipid antibody draw attention as a cause of AIHA in SLE. TMHA include thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). Patients with TTP show CNS symptoms and renal damage, while those with HUS develop renal insufficiency, but show minimal CNS symptoms. Clinical findings of TMHA are fever, hemolytic anemia, thrombocytopenia, CNS symptoms, and renal insufficiency, which are quite same as the findings of SLE itself. TMHA should be considered for differential diagnosis in acute exacerbation of SLE.

Anemia, Hemolytic

Mitochondrial myopathy with progressive decrease in mitochondrial tRNA(Leu)(UUR) mutant genomes.

A female patient with mitochondrial myopathy had a mitochondrial DNA mutation at nucleotide pair 3243, commonly seen in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS), but unlike MELAS patients, she had no central nervous system symptoms. Muscle weakness, which was most severe when she was 7 years old, improved gradually with age. Comparison of two muscle biopsies obtained at an interval of 12.5 years (7 and 20 years of age, respectively), revealed that the number of ragged-red fibers was markedly decreased and histochemical cytochrome c oxidase activity increased in parallel with the decrease in population of mutant genomes.

Adult

[The usefulness of the bayesian method for the prediction of plasma theophylline levels in asthmatic children during RTC therapy by the sustained preparation of theophylline].

Pharmacokinetic prediction of plasma theophylline levels during RTC therapy by the sustained release preparation of theophylline was studied with a one compartment model in children aged 1-6 years old showing comparatively long sleeping time. Using the parameters measured from the population of 1-17 year olds, the accuracy of the prediction was studied by the Bayesian method. Absolute error (A.E.) and estimation error (E.E.) were about 2.0. The prediction values of E.E. seemed to be rather higher if the measured values of the absorption phase were used, and the values seemed to be rather lower if the values of the elimination phase were used. From these results it might be concluded that the Bayesian method seems to be useful for RTC therapy in children under 6 years old.

Adolescent

[Vitamin and mineral status in chronic renal failure--the effect of protein restriction].

Essential amino acid (EAA), vitamin and mineral abnormalities are found in patients with chronic renal failure (CRF). We considered altered dietary restriction to be one of many factors that can promote these abnormalities. We determined the EAA, vitamin and mineral content of low-protein diets and vitamins and minerals in the blood of outpatient populations with various degrees of CRF (serum creatinine 3.6-6.8mg/dl). The results obtained were as follows: 1. 20g-protein/day diet can provide an adequate amount of EAA. 2. Low protein diets (30g protein/day diets) were inadequate in vitamins A, B1, B2 and B6. Vitamins A, B1, B2 and B6 in these diets were 70-80%, 40-50%, 30-35% and 20-25% of the minimum daily requirements, respectively. 3. Low protein diets (30g protein/day diets) were inadequate in Ca, Fe and Zn. The Ca and Fe contents of these diets were 30% and 50% of the minimum daily requirements, respectively. The Zn content of a diet rich in vegetable protein, although low in protein, overall (vegetable: animal = 2:1), was about 55% of the minimum daily requirement. 4. About 21.4% of the CRF patients had low levels of plasma vitamins B1. About 28.6% and 33.3% of the CRF patients had low levels of plasma vitamins B2 and B6, respectively. Plasma folic acid levels were not inadequate in these patients. 5. About 28.6%, 50% and 35.7% of the CRF patients had low levels of plasma Ca, Fe and Zn, respectively. In conclusion, it seems that supplementation of vitamins B1, B2, B6, Ca, Fe and Zn should be considered for protein-restricted CRF patients.

Amino Acids, Essential

[Evaluation of renal graft function with radionuclide dynamic images--application of modified Rutland's analytical method].

An uptake coefficient (UC) is estimated with applying the method proposed by Rutland to the renal dynamic images with 99mTc-diethyltriamine pentaacetate (DTPA). UC estimated with this method is proportional to glomerular filtration rate in the original Rutland's method the cardiac and renal time-activity curves (TAC) were used for input and output functions, respectively. In this paper, our method of estimating an input and output function by applying factor analysis method to renal dynamic images and it's clinical application are presented. In 11 patients, U"s estimated by this modified method revealed good correlations between the UCs and CCr (r = 0.75), between UCs and effective renal plasma flow (r = 0.67), and inverse correlations between UCs and serum creatinine values (r = 0.65). The results showed that UC in this method can be a useful parameter for grafted renal function. This method is simple in technique and applicable for the evaluation of split renal function in renal transplant donors.

Creatinine

Plasma free catecholamine level during hemopurification in a case of pheochromocytoma.

To examine the alteration of the plasma free-catecholamine level during hemopurification in a patient with pheochromocytoma, the levels of plasma free-catecholamine and total catecholamine in the filtrate were monitored pre- and post-hemopurification. Approximately 100 micrograms of total catecholamine was removed by the hemopurification procedure though the high level of plasma-free catecholamine remained unaltered.

Adrenal Gland Neoplasms