Depressed expression of CD 28 antigen on lymphocytes in long-term kidney transplant patients.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
O Kamihira
Publications and source records attributed to O Kamihira.
[Bilateral synchronous testicular seminomas: a case report and review of the Japanese literature].
A 39-year-old man was referred to our hospital with right testicular swelling. Ultrasonography and magnetic resonance imaging revealed bilateral, synchronous testicular tumors. Bilateral high inguinal orchiectomy was performed. Histological examination revealed anaplastic seminomas. Prophylactic radiation therapy was performed in the para-aortic and pelvic regions postoperatively, and no signs of metastasis have been found during the follow-up period of more than 5 months. Including the present case, 186 cases of bilateral testicular tumors reported in Japan are reviewed.
Adult↗
Long-term stone recurrence rate after extracorporeal shock wave lithotripsy.
PURPOSE: We followed patients who were stone-free after extracorporeal shock wave lithotripsy (ESWL) to investigate the factors that contributed to recurrent calculi. MATERIALS AND METHODS: For longer than 5 years 903 patients without residual fragments 3 months after ESWL were enrolled in this study. Plain abdominal films and/or excretory urograms were evaluated every 6 months for recurrent stones on the side of ESWL. Patients who presented with colic pain or other complaints and who were suspected of having recurrent stones were also examined. Stone recurrence rates were calculated with the Kaplan-Meier method. We assessed the influence of patient age; size, location, composition and configuration of the original stones, and pyuria after ESWL on stone recurrence. RESULTS: Mean followup was 25 months and stones recurred in 183 of 903 renal units (20.3%). Kaplan-Meier recurrence rates were 6.7, 28.0 and 41.8% after 1, 3 and 5 years, respectively. There was a significant correlation between stone recurrence and multiple stones on one hand, and pyuria after ESWL on the other hand. Stones recurred most frequently in the lower calix. Recurrent stones were passed without intervention in 33 cases, while ESWL was repeated in 53. CONCLUSIONS: These data demonstrate the importance of long-term followup and the search for an effective prophylactic therapy to prevent recurrence.
Adolescent↗
[Treatment of stone street after extracorporeal shock wave lithotripsy of staghorn calculi].
During ESWL monotherapy for staghorn calculi, the formation of a stone street in the ureter is often encountered, and can be a troublesome problem. At the Komaki Shimin Hospital, 75 patients with staghorn calculi were treated with ESWL monotherapy using a Dornier HM-3 lithotriptor between October 1987 and August 1992. Among them, three patients had involvement of both collecting systems. An indwelling double J catheter was always inserted during treatment. Our strategy for the treatment of stone street was as follows; observation was initially performed for one month after ESWL, as long as pyelonephritis and/or complete obstruction did not occur. In the patients without any improvement of the stone street, TUL or ESWL was then performed for removal. A stone street (stone fragments extending > or = 4 cm) was formed in 38 of 78 renal units (49%). In 14 cases (37%), it disappeared spontaneously. TUL was required in 14 unit (37%), ESWL in eight units (21%), and both procedures in two units (5%). In one unit (3%), renal function was severely damaged. In another unit, ureteric perforation occurred during the TUL procedure, and caused stone loss outside the ureter. To clarify the factors causing stone street, we compared the number of shock waves, the size of the stones, the severity of hydronephrosis and renal function in stone street formers and non-formers. However there were no significant differences among these factors. In conclusion, since it is impossible to predict stone street formation after ESWL monotherapy for staghorn calculi, patency of the indwelling double J catheter should be maintained and stone removal should be attempted after one month if necessary.
Calcium Oxalate↗
Extracorporeal shock wave lithotripsy using the Dornier MPL 9000 lithotriptor.
336 patients with urinary calculi were treated between June 1988 and October 1991 with extracorporeal shock wave lithotripsy using the Dornier MPL 9000 lithotriptor. Of 352 renal units (a kidney and its ureter), 286 had renal stones, 62 had ureteral stones and 10 had both. There were radiolucent stones in 6 units. The complete disintegration rate was 94%. The mean number of shock waves was 2,973, the range being from 300 to 16,131. In 310 of 447 (64%) sessions, treatment was done without any anesthesia. The rate of complete removal was 67.3% 3 months after the last treatment. Only 11 patients required supplementary treatment consisting of percutaneous nephrolithotripsy and transurethral lithotripsy. There were no severe complications except subcapsular hematomas observed in 2 patients. The Dornier MPL 9000 is a useful lithotriptor for the treatment of urinary calculi, except staghorn calculi.
Female↗
[Transrectal hyperthermia for chronic prostatitis].
Transrectal hyperthermia was performed on 13 patients with chronic non-bacterial prostatitis which failed to respond to the conventional treatments. We used "Prostathermer" (Biodan-Medical system, Israel) for heating the prostate gland. The prostate was heated at 42 degrees C-43 degrees C, for 60 minutes in 1 session. Treatment consisted of 6 sessions, and was performed during a period of three weeks on an outpatient basis. Of 11 patients re-evaluated after 3 months, 6 (55%) achieved improvement of subjective symptoms. Of 9 patients, 4 (44%) showed reduction of the number of white blood cells (> or = 10 leukocytes count per high-power field) in their expressed prostatic secretion (EPS), which however was not always correlate with improvement of subjective symptoms. No complications were encountered in our series. Our result indicates that local hyperthermia is safe, and would become new modality in the treatment for chronic prostatitis.
Adult↗
[Transurethral ureterolithotripsy with rigid ureteroscope--efficacy of balloon dilation of ureteral orifice and intramural ureter].
In order to minimize the late complications of transurethral ureterolithotripsy with a rigid ureteroscope such as distal ureteral stricture or vesicoureteral reflux, we have performed a balloon dilation of the ureteral orifice and the intramural ureter prior to insertion of a rigid ureteroscope in 62 cases with ureteral calculi between October 1986 and December 1991. A 7F balloon dilator (Bard Co. USA) was cystoscopically inserted into the ureter over a 0.038 inches Radifocus guide wire (Terumo Co., Japan) and then, a balloon was inflated to 15F size with saline using a 10 ml disposal syringe. Thereafter, an 11.5F rigid ureteroscope (Wolf Co., Germany) was inserted instead of a balloon dilator. The stone was disintegrated and removed by ultrasonic lithotripter, electrohydraulic lithotripter and/or basket forceps. The stone was removed completely in 45 cases (72.6%) and incompletely in 10 (16.1%). In 7 cases (11.3%), the stone removal was failed. Long-term follow up with an excretory urography obtained at 6 months or later in 31 cases showed no distal ureteral stricture. Voiding cystography was performed in 33 cases at a mean 2.8 months postoperatively and no vesicoureteral reflux was observed. In control group, 309 cases were treated with transurethral ureterolithotripsy without dilation of the ureteral orifice and the intramural ureter between the same period. A complete removal was achieved in 262 cases (84.8%) and an incomplete removal in 16 (5.2%). 31 (10%) was failed. Distal ureteral stricture due to this procedure was found in 3 cases (2.1%) in 141 long term followed up cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[A case with arteriovenous fistula from renal injury].
We report on a 58-year-old male treated with transcatheter embolization for arteriovenous fistula due to renal injury. The patient was transferred to our hospital on December 10, 1989, with left renal injury and left temporal bone fractures. Enhanced CT revealed parenchymal fracture with peri-renal hematoma in the left kidney. Antibiotics were prescribed to prevent bacterial infection of the injured kidney. Urine cleared and pain in the left loin area disappeared 17 days later. However, on December 28, gross hematuria and pain in the left flank suddenly reappeared. He was given a blood transfusion and was diagnosed with re-bleeding from the injured kidney. Renal angiography performed on January 10, 1990, revealed arteriovenous fistula of the kidney. Transcatheter embolization was done using a metal coil to close the arteriovenous fistula. The patient has had no further problems or complaints. Excretory pyelogram showed no hydronephrosis in the left kidney. TcDMSA renoscintiscan showed a defect in the mid-portion of the kidney. These results suggest that transcatheter embolization can be useful to alleviate arteriovenous fistula in cases of renal injury.
Arteriovenous Fistula↗
[A case of testicular tumor arising in the undescended testis].
A 42-year-old man with testicular tumor arising in the left undescended testis is reported. The patient had bilateral cryptorchidism and was admitted to our clinic on March 20, 1989, complaining of a mass in the lower abdomen. Colography indicated complete obstruction at the sigmoid colon, and computed tomography showed a larger mass in the lower abdomen and paraaortic lymph node swelling, as well as left hydronephrosis. We suspected that a testicular tumor had arisen in the undescended testis, and ileus was caused by the tumor mass. Since the patient was in a poor condition from preexisting ileus, chemotherapy consisting of cisplatin, bleomycin and vinblastine (PVB regimen) was immediately started without confirming the histology. After two courses of PVB regimen, bilateral orchiectomy, retroperitoneal lymphadenectomy, and left nephrectomy were performed. Pathological examination of the testis and resected lymph nodes revealed no residual tumor cells, and we could not identify the original histology. Additionally, two courses of chemotherapy were performed after surgery. The patient is well without evidence of disease one year and ten months after surgery.
Adult↗
Five-year results of thoracic duct drainage in living related donor kidney transplantation.
Explore the source record for details and available documents.
Azathioprine↗
[Extracorporeal shock wave lithotripsy monotherapy in the treatment of staghorn calculi].
From October, 1987 to September, 1989, 53 staghorn calculi of 51 patients underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy by using Dornier HM3 lithotriptor. All patients were treated with double J stenting preoperatively. Mean number of shock waves was 6092 and mean number of sessions was 2.1. In 52 out of 53 kidneys (98%), the stones were disintegrated completely. Complete removal of the stone were observed in 29 kidneys (55%) 3 months after the last ESWL treatment. Complications consisted of fever attack (more than 38 degrees C) (26 patients), ileus (2), subcapsular hematoma (2) and gastrointestinal hemorrhage (1). They could be conservatively treated except one case with percutaneous nephrostomy. Supplementary procedures for the stone street were necessary in 23 patients. They consisted of ESWL (16 patients) and transuretheral lithotripsy (7). The indication of this procedure for the treatment of staghorn calculi was also discussed.
Adult↗
[Extracorporeal shock wave lithotripsy using Dornier modified HM3 lithotripter comparison with the results by Dornier HM3 lithotripter].
Ninety-four kidneys with renal stones less than or equal to 20 mm in diameter were treated by extracorporeal shock wave litotripsy (ESWL) using a Dornier modified HM3 lithotripter and the results were compared with those of 98 kidneys with similar size stones treated with a Dornier HM3 lithotripter. The Dornier modified HM3 lithotripter is equipped with a new type of shock wave generator with a reduced capacity for 30% less pressure peakes at the same voltage. It has an enlarged ellipsoid leading to a smaller focus and a reduced pressure per area at the shock wave entry into the skin. All treatments of modified HM3 litotripter series were performed under only intravenous analgosedation, without epidural anesthesia. The number of shock waves in the modified HM3 series ranged 900 to 6000, with the mean values of 2863 +/- 1234, which was 1.55 times as that in the Dornier HM3 series. Complete disintegration was achieved in 94 of 94 modified HM3 series kidneys and 98 of 98 kidneys of HM3 series. Complete removal of the stone was done at 72.6% in the modified HM3 series and at 70.4% in the HM3 series 3 months after ESWL. There were no severe complications in both modified HM3 series and HM3 series. Renal damage caused by ESWL was monitored by the level of urinary enzyme, N-acetyl-beta-glucosaminidase (NAG) and beta 2 microglobulin (beta 2MG) and the level of urinary protein. The levels of NAG, beta 2MG and urinary protein in the HM3 series were higher than those of the modified HM3 series.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Thoracic duct drainage pretreatment and low dose cyclosporine and low dose steroid immunosuppressive treatment in living related kidney transplantation].
The results of 20 HLA 1-haploidentical donor kidney transplant patients treated with preoperative lymphocyte deletion through thoracic duct drainage and low dose of cyclosporine and steroid immunosuppressive therapy, were presented. The number of removed lymphocytes was 114 +/- 36 X 10(9) (mean +/- SD) and the duration of thoracic duct drainage was 35 +/- 7 days. Graft survival was 100% at 3-9 months and 89% at 1-2 years after transplantation. Patient survival was 100% at 3-9 months and 89% at 1-2 years. A patient died from lung cancer (adenocarcinoma) in the 9th posttransplant month. Acute rejection was not seen in 20 patients during the first 3 months. Life-threatening infectious disease was never seen either. Diabetes mellitus was observed in 1 patient. No other complications were observed. These results indicated that thoracic duct drainage and low dose cyclosporine and steroid postoperative immunosuppressive treatment might yield complete success in HLA 1-haploidentical kidney transplant patients.
Cyclosporins↗
Direct activation of Sendai virus (HVJ)-specific cell-mediated immunity of mice for second set rejection of the virus-infected syngeneic tumor by noninfectious virus-sensitized spleen cells.
Syngeneic spleen cells (SPC) sensitized in vitro with noninfectious NVJ were shown to effectively stimulate mice to generate the HVJ-specific cell-mediated immunity for second set rejection (SSR) of virus-infected syngeneic leukemia cells. As few as 10(4) live but not disrupted SPC either infected with a temperature-sensitive mutant of HVJ (HVJts) or sensitized passively with ultraviolet (UV)-inactivated HVJts were active as immunogen. Syngeneic SPC as the carrier of virus could be replaced by allogeneic SPC or L cells, a fibroblast cell line, without reduction of the immunogenicity. Further study demonstrated that a special density of antigen on the surface of HVJts-sensitized SPC is required for high immunogenicity. It was suggested that live cells appropriately sensitized with noninfectious virus would serve as an excellent vaccine for virus-specific cell-mediated immunity.
Animals↗