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Biomedical subjects

T Shiramizu

Publications and source records attributed to T Shiramizu.

At least 19 recordsLinked to original sources
PubMed1992

Multicentre trial of ABO-incompatible kidney transplantation. Japanese Biosynsorb ABO-incompatible kidney transplant study group.

A multicentre study of ABO incompatible kidney transplantation using Biosynsorb was started in Japan in November 1989. A total of 51 cases were registered comprising 23 cases of A incompatibility, 26 cases of B incompatibility and two cases of AB incompatibility. The removal of antibodies (IgG and IgM) was carried out using Biosynsorb in 16 cases, plasmapheresis in four cases and use of both combined in 31 cases. The treatment using Biosynsorb was repeated 3.4 times on average. Serum titres of anti-A (IgG and IgM) antibodies decreased to 4.9 +/- 5.0 and 2.7 +/- 1.7 and for anti-B titres decreased to 2.8 +/- 3.5 and 2.4 +/- 3.2. Rejection was found in 33 cases: hyperacute one, accelerated acute five, and acute 27. In two cases rejection was developed concomitantly with a steep elevation in antibody titres. Three patients died, two with functioning grafts. Eight grafts were lost. Patient and graft survivals at 2 years were 94.1% and 84.3%, respectively. From these results it is concluded that: 1. Biosynsorb and plasmapheresis are effective in removing anti-A and anti-B antibodies; 2. graft and patient survivals are similar to those in ABO compatible cases; 3. anti-A and anti-B titres less than 16 are recommended at the time of transplantation; 4. anti-A and anti-B titres higher than 128 may be considered as a risk factor for rejection in the early stages after transplantation.

ABO Blood-Group System↗
PubMed1992

Dilated cardiomyopathy caused by cytomegalovirus infection in a renal transplant recipient.

In immunocompromised patients, cytomegalovirus myocarditis leading to dilated cardiomyopathy is rare, and the duration of myocardial damage in such patients has not yet been determined. We report here one renal transplant recipient with cytomegalovirus myocarditis. This case shows that the myocardial damage secondary to cytomegalovirus may be insidious and persist for a relatively long period in the immunocompromised patient.

Adult↗
PubMed1990

[The alternation of CD8+ cells and its subpopulations by serial monitoring of peripheral blood lymphocytes of renal allograft recipients].

To catch and treat the initial alternation of a rejection and infection, we have introduced the serial analysis of lymphocyte surface antigens of peripheral blood lymphocytes by flow cytometry for 9 cases of renal allo-graft recipients since September 30 in 1988. In three recipients without rejection and infection, we found that T8+(CD8+), T8+Mo1+(CD11b+), T8+Mo1-(CD11b-), and T8+IL-2R+(CD25+) subsets were variable for first 20 days and then they were stable. However, another activated CD8+ T-cell subset such as T8+I2+(HLA-DR+) subset gradually increased after first 20 days, so that we investigated the different processes between these two activated subsets. On primary rejection of 5 cases, T8+I2+ and T8+IL-2R+ subsets showed peak formations within 2 days before the rejection. Two of these 5 cases resisted to a primary rejection therapy and showed rebounding arise of these subsets. We could easily convert to OKT-3 rescue therapy and treat them successfully. In order to catch the initial alternation of the primary rejection and treat the rebounding reaction successfully, we should monitor the T8+I2+ and T8+IL-2R+ subsets daily for first 2 weeks and after then 3 times a week.

Adult↗
PubMed1990

[A clinical case of ABO-incompatible living renal transplantation].

We successfully made ABO-incompatible renal transplantation, of which report is methodologically the first in Japan and probably the second in the world to our knowledge. Sixty year-old-female (mother) with B-blood type donated her right kidney to 36 years-old male (son) with O-blood type. Pretransplant removal of plasma isoagglutinin of the recipient through plasma exchange with albumin solution followed by hemodialysis with administration of fresh frozen B-type plasma effectively reduced the anti-BIgM-antibody titre of x256 to x8 and the anti-IgG-antibody titre of x512 to x16. Splenectomy was performed at the time of transplantation. On the 10th POD, the anti-B antibody titres were more decreased to IgM antibody x2 and IgG antibody x8. Patient is doing well without any sign of rejection as of 4 months postoperatively.

ABO Blood-Group System↗
PubMed1990

[The alternation of CD4+ cells and its subpopulations by serial monitoring of peripheral blood lymphocytes of renal allograft recipients].

Immunologic monitoring for renal allograft recipients should be carried out serially and as conveniently as possible so that we can catch and treat the initial alternation of the rejection and infection. We have introduced the serial analysis of lymphocyte surface antigens of peripheral blood lymphocytes by flow cytometry for 9 cases of renal allograft recipients (3 cases of living related, 2 cases of living non-related, and 4 cases cadaver donors). In three recipients without rejection and infection, T4+(CD4+), T4+4B4+(CDw29+), T4+2H4+(CD45R+), T4+I2+(HLA-DR+), and T4+IL-2R+(CD25+) subsets showed variable processes for first 10 days and then stable processes. On primary rejection of 5 cases, activated T cell subsets such as T4+I2+ and T4+IL-2R+ subsets showed peak formations within 2 days before the rejection. Two of these 5 cases resisted a primary rejection therapy and showed a rebounding rise of these subsets. We could easily convert to OKT-3 rescue therapy and treat them successfully. We could not find out the specific alternation in the secondary rejection of 2 cases and all the infection cases. On the basis of these findings, we should serially monitor the T4+I2+ and T4+IL-2R+ subsets daily for first 2 weeks and after then 3 times a week, in order to catch the initial alternation of the primary rejection and treat its rebound successfully.

Adult↗
PubMed1986

Renal allograft dysfunction with acute hemorrhagic cystitis caused by adenovirus in a recipient of a transplanted kidney.

We experienced acute hemorrhagic cystitis with renal dysfunction in a recipient of a transplanted kidney. This acute hemorrhagic cystitis was caused by adenovirus type 11. Either elevation of antibody titers or isolation in urine of adenovirus type 11 was identified in six cases out of 11 in seven reports which we collected. Graft dysfunctions were complicated on seven cases out of 11 in these seven reports. These graft dysfunctions have been considered as an acute rejection, but we suggest that they may be graft nephropathy caused by adenovirus type 11 infection.

Acute Disease↗
PubMed1986

Continuous ambulatory peritoneal dialysis (CAPD) policy for renal transplantations in adults.

In Japan CAPD in cases of renal transplantation used to be feared because of CAPD peritonitis occurring under conditions of immunosuppression. We experienced two cases of CAPD with renal transplantation. Case 1 was a 27-year-old woman who underwent living related renal transplantation on March 7, 1986 after 4 months CAPD without CAPD peritonitis. In this patient the CAPD catheter was removed on the 17th POD with a good graft function. Case 2 was a 38-year-old woman who underwent living related renal transplantation on November 8, 1985. The graft deteriorated due to acute rejection and ALG allergy. On February 1, 1986 the graft was removed after insertion of a CAPD catheter. The patient began CAPD. Therefore, CAPD was found to be a safe procedure for renal transplantation. Our policy concerning CAPD for renal transplantation is as follows: A patient should not be transplanted for 1 month after successful treatment of an episode of peritonitis. After renal transplantation the catheter is removed on completion of the transplantation procedure in cases of two haploidentical living related transplants and electively 2-12 weeks after renal transplantation in cases of one haploidentical living related transplant or cadaveric transplants. The CAPD catheter is used again when there is temporary or permanent graft failure.

Adult↗
PubMed1985

Somatostatinoma of the pancreas.

A case of a pancreatic somatostatinoma in a 74-year-old male is presented. It was very difficult to establish the clinical diagnosis because of absence of typical symptoms. However, it was very easy to establish the histological diagnosis because typical cytoplasmic neurosecretory granules (D-cell granules) and immunoreactivity for somatostatin were demonstrated. Moreover, immunoassay of tumor tissues enables one to not only establish a definitive diagnosis but also to demonstrate multiple hormone production.

Adenoma, Islet Cell↗
PubMed1985

[Intraperitoneal cisplatin in peritoneal carcinomatosis patients].

Cisplatin (100 mg) was given by intraperitoneal infusion to 23 patients with peritoneal carcinomatosis. Eighteen patients had gastric cancer, and five had colorectal cancer. The effects of this therapy were as follows. 1) In gastric cancer patients, the mean survival period was 11.0 months. The cumulative survival rate was superior at the level of statistical significance in comparison with controls. 2) The side effects of this agent given intraperitoneally were mild. In particular, nausea was slightly less than with intravesicular or intraarterial infusion.

Adult↗
PubMed1984

Primary leiomyosarcoma of the lesser sac--report of a case.

A case of leiomyosarcoma arising in the lesser sac in a 64-year-old man is presented. A second operation was required because of local recurrence 6 years following the first operation. A review of the literature revealed that only eight cases of leiomyosarcoma arising in the lesser sac, including our case, were reported. Almost all of these patients had symptoms of abdominal pain or distension. The tumor tended to grow to a large size and about 90 percent were over 10 cm in the maximal diameter. The prognosis of these series was poor and our own patient seems to be the second 5 year survivor.

Humans↗
PubMed1984

[Clinical study of cis-platinum in the chemotherapy for malignant gastrointestinal disease: arterial infusion and intraperitoneal administration].

We studied the antitumor effects and the side effects of CDDP in the main cancer chemotherapy for gastrointestinal cancer. CDDP (100mg) was administered through the hepatic artery, systemic vein and peritoneal cavity. The administration period was four weeks. In the cases of the hepatic arterial infusion, the size of metastatic liver tumors and CEA level decreased markedly. In those of the intraperitoneal administration, ascites decreased and performance status was well maintained. There was no bone marrow depression or nephropathy. Nausea and vomiting were the main side effects, being associated with 29 administrations (52%). Acute intrahepatic biliary stasis was found in the case of hepatic arterial administration of 300mg of CDDP.

Adult↗
PubMed1982

Age changes in metastatic patterns in renal adenocarcinoma.

The metastatic pattern in primary renal adenocarcinoma with respect to age has been studied by analyzing the necropsy records of 1828 patients. Metastasis-free cases were noticeably frequent in the patients over 70 years of age. The metastatic pattern varied with age and was classified grossly into four types according to the age-associated change in frequency: (1) diminishing; (2) increasing; (3) peaked; and (4) invariable. The incidence of hematogenous metastases showed little or no relation to advancing age whereas dissemination, which was possibly lymphogenous, was found to diminish as the age advanced, the latter trend being especially conspicuous in patients with lymph nodes distant from the primary lesion. It has been inferred that organs displaying comparable tendencies of age-associated change in frequency of metastasis may share the same route of dissemination.

Adenocarcinoma↗
PubMed1982

Construction of internal arteriovenous fistulas for hemodialysis using Inokuchi's vascular stapler.

Using Inokuchi's vascular stapler, arteriovenous fistulas with an end-to-end fashion for hemodialysis were constructed in 80 patients (82 limbs) with chronic renal failure. In 76 patients and 76 limbs (95%) of a total of 80 patients, the fistulas were patent and hemodialysis could be effectively carried out. Use of Inokuchi's vascular stapler facilitated a rapid construction of subcutaneous end-to-end arteriovenous fistulas, and no particular training in vascular surgery was required for the operator. Since the anastomosis was constructed in an end-to-end fashion, complications such as swollen hand, peripheral steal syndrome and cardiac failure were nil.

Arteriovenous Shunt, Surgical↗
PubMed1982

Metastatic processes and a potential indication of treatment for metastatic lesions of renal adenocarcinoma.

Renal adenocarcinoma findings from 307 autopsied cases with metastasis to 1 and 2 organs were investigated concerning the mode of metastasis. The lung was the most frequent site of metastasis to 1 organ, although the frequency was rather low (30 per cent), followed by bones (over-all), lymph nodes (over-all) and brain, and involving frequently the thoracic spine and retroperitoneal lymph nodes. In patients with metastases to 2 organs a significant correlation was found between the pulmonary-tracheal lymph nodes and those to the lungs. Potential indications for treatment of metastatic lesions were 1) lymphadenectomy and/or radiation therapy for the retroperitoneal and para-aortic lymph nodes and 2) resection of metastatic lesions in the lungs combined with lymphadenectomy and/or radiation therapy for the pulmonary-tracheal lymph nodes. In patients without lung metastasis lymphadenectomy and/or radiation therapy for the pulmonary-tracheal lymph nodes is not always necessary.

Adenocarcinoma↗
PubMed1982

Influence of age and nephrectomy on metastatic patterns in Wilms' tumors.

Data from 194 autopsy cases of Wilms' tumor were analyzed statistically to investigate the mode of dissemination by classifying them according to the number of organs involved in metastasis, age and history of nephrectomy. Metastasis-free cases were more frequent in cases under two years of age, in bilateral cases, and in non-nephrectomized cases. The frequencies of metastasis to various organs were essentially similar among the various age groups, except those to the contralateral kidney and intestines in cases under two years of age, which were significantly more frequent. Nephrectomized cases showed a significantly higher incidence of metastasis to the peritoneum than non-nephrectomized cases. In cases with metastasis to one organ, metastasis to the lungs, lymph nodes and liver showed low frequencies (17%, 13% and 17%, respectively), but that to the peritoneum showed a rather high frequency (21%). Radiation therapy for the peritoneum after nephrectomy is recommended.

Adolescent↗
PubMed1982

Red blood cell types and living related renal transplantation.

We studied the effects of red blood cell types on 34 cases of living related renal transplantation. Red blood cell types were examined retrospectively concerning the ABO, Lewis, P, Rh-Hr, Kell, Duffy and MNSs systems in both donors and recipients. The correlation between red blood cell type and acute rejection in HLA identical pairs and the effects of the Lewis, P and other systems on graft outcome in HLA semi-identical pairs were considered. In the HLA identical group, the Rh-Hr and MNSs systems participated in acute rejection. In addition to the ABO and Rh-Hr systems, the Lewis and P systems influenced the graft rejection in the HLA semi-identical group.

ABO Blood-Group System↗