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Biomedical subjects

Y Hiki

Publications and source records attributed to Y Hiki.

At least 19 recordsLinked to original sources
PubMed1992

[Left upper abdominal quadrant evisceration].

To improve the surgical outcome of patients with advanced gastric cancer, we performed left upper abdominal quadrant evisceration (LUAE), which was introduced by Prof. T. Kajitani in 1980. From 1980 to 1989, 0.2% of 5123 gastric resections performed in the cancer institute Hospital and the National Cancer Center were total gastrectomies, in 4.5% (i.e., 232 patients) LUAE was the operative treatment. The 5-year survival rate of patients who underwent LUAE was 28%. Complications of the operation were 39.6%, other complications occurred in 15.1%. The mortality of patients who underwent LUAE was 2.2%.

Abdominal Neoplasms↗
PubMed1992

Analysis of glycoform of O-glycan from human myeloma immunoglobulin A1 by gas-phase hydrazinolysis following pyridylamination of oligosaccharides.

A comparative study was made on the glycoform of O-glycan from human myeloma immunoglobulin A1. By gas-phase hydrazinolysis, O-glycan was released from its hinge portion. The released oligosaccharide was pyridylaminated and separated by a two-dimensional analytical method of gel filtration and reverse-phase HPLC. Four major pyridylamino derivatives (P1-P4) were obtained. The neutral component (P4) among them was identified as Gal beta 1,3GalNAc-PA by cochromatography with an authentic standard pyridylamino sugar. The desialylation of the other components indicated the largest P1 and middle size P2 components possibly corresponded to a disialylated structure, NeuAc alpha 2,3Gal beta 1,3(NeuAc alpha 2,6)GalNAc-PA, and a monosialylated component, NeuAc alpha 2,3Gal beta 1,3GalNAc-PA, respectively. The structural assignment of P3 is still incomplete. Four similar components were also detected in bovine fetuin whose relative content (P1:P2: P3:P:4) was 16:43:19:22. The relative content (%) of P1-P4 (glycoform) in IgA1 from the healthy control was 10.1 +/- 3.3, 48.2 +/- 4.6, 7.0 +/- 2.6, and 34.7 +/- 4.5. The glycoform of O-glycan on IgA1 thus appears the same for any individual. Analysis of IgA1 myeloma protein indicated glycoforms distinct from those of the healthy controls. The relative content of these component could be classed as 2:8:0:90 (Type I, only one case designated as Kita), 5:24:3:68 (Type II, seven cases), and 9:41:5:45 (Type III, four cases). Thus, the results for IgA1 myeloma protein indicate that at least three glycoforms of O-glycan are possible for the IgA1 hinge structure. However, only one glycoform was found in the healthy controls.

Amination↗
PubMed1992

Laser therapy for early upper gastrointestinal carcinoma.

An invasive procedure generally is the first choice of therapy for the treatment of gastric cancer. The development of improved microimaging and innovative engineering, however, has established a new field of endoscopic laser therapy. This article discusses the use of high-power and low-power lasers in the treatment of early gastric cancer.

Carcinoma↗
PubMed1992

Immunogenic deposition and destruction of glomerulus in IgA nephritis.

The correlation between glomerular immune deposition and histological alteration was studied in serial paraffin sections of kidney biopsy specimens from patients with IgA nephritis using the peroxidase-antiperoxidase (PAP) method. IgA deposition was detected in preserved glomerular extracellular matrix or in newly formed interposed matrix along the capillary loops (mesangial interposition). On the other hand, deposition of IgA was scanty or absent in the distorted extracellular matrix where severe exudative inflammation or extracapillary escape of exudates was occurring segmentally. Ultrastructurally such extracellular matricial destruction was expressed as splitting or thinning of the lamina densa, as well as mesangial edema, reticulation or mesangiolysis of the axial matrix. Therefore it appears that at least two types of change in the extracellular matrix are induced by IgA immune complexes in IgA nephritis; immunogenic deposition and destruction.

Adolescent↗
PubMed1992

[Pathological studies on microvasculature of arteriovenous malformation in the intestinal tract].

Intestinal arterio-venous malformation (AVM) is one of the uncommon causes of gastrointestinal hemorrhage and is usually difficult to diagnose before pathological study. Five operated cases with the AVM were presented. The vascular lesions were studied by barium-gelatin injection and routine histological procedures. The AVM lesion was detected in the proximal jejunum and in the distal ileum in each one case, respectively. In two other cases the AVM lesion was observed as a protruded tortuous vascular plexus in colonic mucosa. By the microangiographical study, it was confirmed that the main lesion of AVM was located in submucosal layer with complicating minute AVM in lamina propria of intestinal mucosa. In the mucosal lesion of AVM it was disclosed that arterialization of precapillary arterioles was a remarkable finding. Thickened intimal layer and duplication of internal elastic lamina were recognized in these arteriolar lesions. Two kinds of intestinal AVM were classified, one is located in the submucosal layer and another one is located in mucosal layer. It was suggested that a marked ectasia of mucosal vessels seemed to be a secondary change of the submucosal AVM. The pathogenesis of the mucosal AVM was discussed.

Adult↗
PubMed1991

Effect of urine on clonal growth of human bladder cancer cell lines.

Human urine contains growth factors; their physiological roles have not been established. The effect of normal human urine was examined in vitro on clonal growth of human bladder cancer cell lines. Clonal growth of HT-1376, HT-1197, and T24 was enhanced by five different fresh human urine samples from young men. Colony stimulating activity was detected in fractions with a molecular weight greater than 5000 by ultrafiltration. Sephadex G-50 gel chromatography identified two peaks of colony stimulative activity in HT-1376 with molecular weights of approximately 6000 and greater than 12,400, respectively; these two peaks also possessed immunoreactive epidermal growth factor (EGF) and NRK-49F transforming activities. The three bladder cancer cell lines possessed large quantities of EGF specific binding sites and exogenous EGF stimulated colony formation; EGF concentrations in human urine were found to be remarkably higher than those of exogenously added EGF which stimulated clonal growth of bladder cancer cell lines. Moreover, it was demonstrated that fresh urine samples (5%) incubated with anti-human EGF monoclonal antibody (KEM-10) neutralized completely the colony stimulating effects in HT-1376. These results indicate that fresh human urine stimulates clonal growth in human bladder cancer cell lines and that a major part of the activity is represented by urinary EGF. The data promote urinary EGF as a progressive agent of human bladder cancer.

Cell Division↗
PubMed1991

Endoscopic treatment of gastric cancer.

We analyzed 445 cases of early gastric cancer to confirm which were associated with lymph-node metastases. Overall, gastric cancers less than 2 cm in size, without an ulcer or ulcer scar, or protuberant or mixed morphology could be expected to be free of lymph-node metastases. In these patients with early gastric cancer without lymph-node metastasis, local treatment using surgical endoscopy could effectively eradicate the disease. Laser irradiation was performed in 44 cases and mucosal resection in 18 cases. All early gastric cancers less than 2 cm in size, with the exception of those located in the prepylorus or high on the posterior wall of the body of the stomach were eradicated by laser irradiation. Mucosal resection was used to ablate cancers less than 1 cm in size and with the exception of 1 case, total clearance was obtained. We conclude that early gastric cancer without lymph-node metastases can be eradicated by surgical endoscopic treatment.

Gastroscopy↗
PubMed1991

Clinical treatment of gastroduodenal bleeding.

Our present study was conducted by cooperation between Departments of Internal Medicine and surgery of a hospital, which was highly significant because the results were comprehensive without a bias toward either department. The present report describes whether or not emergency operations have decreased because of progress in various conservative hemostatic methods for hemorrhagic ulcer and short-term and long-term prognoses after conservative therapy. Compared with the first 8-year period, the number of patients treated by conservative therapy increased with a definite decrease in that of emergency operations in the latter 8-year period. As for the results of conservative treatment, the rate of short-term prognostic hemostasis was 81.3%. Of the long-term prognostic cases, ulcers recurred in 50%, accompanied by recurrent bleeding in 34.8%. These patients were again treated by conservative therapy, and hemostasis was successful in 95.7%. The mortality rate following conservative therapy was 13.7% in the first period and 11.0% in the latter period. The surgical mortality rate was 6.0% in the first period and 5.4% in the latter period. There was no surgical death among the patients undergoing palliative operation. Our therapeutic policy for hemorrhagic ulcer will be described based on these findings.

Emergencies↗
PubMed1991

Study of lupus nephritis in males.

Clinical and pathological findings were studied in 23 male patients with lupus nephritis who were followed up for a period of 41 +/- 36 months after renal biopsy. Age at renal biopsy was 31 +/- 14 years and 19 patients (83 per cent) were between 15 and 50 years old. C3 and C4 levels were below normal in 23 (100 per cent) and 16 (70 per cent) respectively, CH50 was less than 25 u/ml in 67 per cent, and antinuclear and anti-DNA antibodies were found in 87 per cent and 82 per cent respectively. Serum albumin level increased from 2.9 +/- 0.8 g/dl to 3.7 +/- 0.8 g/dl during the follow up period (p less than 0.01), while urinary protein decreased from 2.0 +/- 2.3 g/day to 1.4 +/- 2.5 g/day. There was a significant improvement in the degree of haematuria (p less than 0.01), but serum creatinine levels showed no change (mean 1.5 mg/ml). Active proliferative lupus nephritis of moderate or severe degree was observed in 65 per cent of patients at the initial biopsy. A trend to regression in this activity was seen in most serial biopsies, but the chronicity index showed a slight increase. These data demonstrate that systemic lupus erythematosus in males, in comparison to our previous report of the disease in female patients, is accompanied by more active nephritis, but that it follows a benign course with therapy.

Adolescent↗
PubMed1991

Rapidly progressive renal failure associated with angiofollicular lymph node hyperplasia.

The authors report a case of rapidly progressive renal failure associated with Castleman's disease. Renal biopsy revealed crescentic glomerulonephritis associated with marked tubulointerstitial nephritis. This kind of renal lesion has never been reported in association with angiofollicular lymph node hyperplasia (Castleman's disease) or other immunoblastic disorders. The patient initially required hemodialysis therapy. However, steroid therapy was effective in treating the systemic manifestations of Castleman's disease and some renal function was recovered. The patient was finally withdrawn from hemodialysis therapy.

Acute Kidney Injury↗
PubMed1991

Superimposition of poststreptococcal acute glomerulonephritis on the course of IgA nephropathy.

A 17-year-old male with poststreptococcal acute glomerulonephritis (PSAGN) superimposed on the course of IgA nephropathy is presented. The histological findings of the first renal biopsy showed mild IgA nephropathy with a mesangial deposition of IgA and C3. Eighteen months later, acute nephritic syndrome with hypocomplementemia and rising antihyaluronidase titer occurred 10 days following the onset of an upper respiratory infection. The second renal biopsy revealed severe diffuse endocapillary proliferative and exudative glomerulonephritis with cellular crescents in 70% of the glomeruli. Immunofluorescence showed granular staining of C3 alone along the capillary walls. The pre-existing IgA deposits had disappeared. Typical 'humps' were observed by electron microscopy. The symptoms were gradually resolved by intensive steroid and anticoagulant therapy. Five months after the episode of acute nephritic syndrome, the patient was clear of symptoms except for mild proteinuria and hematuria. The third renal biopsy at that time showed morphologic changes similar to those of the first renal biopsy with mild mesangial IgA deposits.

Adolescent↗
PubMed1991

Association of HLA-DQw4 with IgA nephropathy in the Japanese population.

We have studied HLA-A, B, DR and DQ phenotypes in 50 Japanese patients with IgA nephropathy. The antigen frequency of HLA-DQw4, which is known to be associated with DR4/Dw15 specificity, was increased in the patient group as well as in those of B35 and DR4. The increase of DQw4 (36.0%) was significantly different from that of national controls (corrected p less than 0.004).

Adult↗
PubMed1991

Serum IgA class anti-IgA antibody in IgA nephropathy.

IgA class anti-IgA antibody was sought by an immunoabsorbent technique in sera from patients with IgA nephropathy (IgA-N, n = 62), other forms of primary glomerulonephritis (PGN, n = 41), seropositive rheumatoid arthritis (RF-positive, n = 18) and normal controls (c, n = 50). IgA-N (31%) and RF-positive (56%) patients showed a significant increase in IgA anti-IgA antibody levels. The subclass of IgA anti-IgA antibody was predominantly IgA1 in both IgA-N and RF-positive patients. Size analysis revealed the dimer/monomer ratio to be significantly increased in IgA-N patients compared with that of RF-positive patients (p = 0.03). These results indicate the possible existence of the dimeric form of IgA class anti-IgA antibody in the circulation of IgA-N patients.

Antibodies, Anti-Idiotypic↗
PubMed1990

The role of HLA-DR4 in the long-term prognosis of IgA nephropathy.

The study was performed to clarify the relationship between the long-term prognosis of IgA nephropathy and the HLA-DR4 antigen. From the 130 patients typed for HLA antigens, stable (n = 42) and progressive (n = 45) patient groups were selected. DR4 frequency was not different in the two groups (stable, 66.7 vs. progressive, 53.3%). However, the frequencies of HLA-DR4 and B35 in the 130 patients were significantly higher than those in the national control (DR4; 60.0 vs. 41.6%; B35:30.0 vs. 15.5%). We concluded that DR4 played no role in the long-term prognosis of IgA nephropathy, but that B35 and DR4 were associated with the disease in the Japanese population.

Adult↗