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Biomedical subjects

Y Ichigi

Publications and source records attributed to Y Ichigi.

14 recordsLinked to original sources
PubMed2000

Trans-mesosigmoid cutaneous ureterostomy.

BACKGROUND: A new method was developed in order to create a single stoma cutaneous ureterostomy in which both ureters traverse the abdominal cavity and yet are buttressed by the mesosigmoid and covered by its visceral peritoneum. METHODS: The long mesenterium which is attached to the most mobile part of the sigmoid colon was used for the bilateral ureteral pathway. Tunnels for the ureteral path were made just underneath the visceral peritoneum on the bilateral side of the mesosigmoid. Through the tunnels both ureteral ends were brought from the retroperitoneal space to the mesenterocolonic junction (MCJ) and the MCJ is then approximated and sutured to the inside of the ureteral tract through the abdominal wall. The ureters brought outside the skin, are conjoined and sutured to the V skin flap. Eight patients who carried a high risk for operation and/or had a bladder tumor judged to be incurable underwent this cutaneous ureterostomy. RESULTS: All cases except one with low urinary output could be managed without catheter indwelling during the follow-up period. Three patients suffered from paralytic ileus and one required laparotomy for mechanical ileus during the short postoperative period. Postoperative excretory urography evaluated 14 kidneys during the follow-up period from 2 to 61 months and showed normal upper urinary tract in 11 and a mildly hydronephrotic tract in three. CONCLUSIONS: Transmesosigmoid cutaneous ureterostomy provides a single catheterless stoma even when the available ureters are relatively short. It appears to be a good method for supravesical urinary diversion when indicated.

Aged↗
PubMed1999

Significance of hematoma size for evaluating the grade of blunt renal trauma.

BACKGROUND: The hematoma size relative to the body size was measured on computed tomography films using a personal computer system in order to define whether that parameter is useful for decision-making in the management of blunt renal trauma. METHODS: From 1982 to 1997, 33 patients with intermediate or severe grade blunt renal trauma were retrospectively divided into three groups: group 1, managed conservatively without transcatheter embolization; group 2, managed by bedrest after selective transcatheter embolization; and group 3, managed operatively. In these three groups, the hematoma area (H) and the ratio of hematoma area to body area on CT (H/B) were measured and the chronological changes of the H/B in groups 1 and 2 were studied. RESULTS: The H and H/B of group 3 were significantly larger than those of group 1. The H/B was more clearly distinguished for each group compared with the H alone. Well-preserved kidney integrity, despite the presence of a large hematoma in group 2, allowed the conservative treatment following transcatheter embolization of the bleeding site. The H/B of all group 1 patients gradually decreased and on the 40th or 50th day after injury they reached a level equivalent to the ratio of contra-lateral normal kidney area to body area. CONCLUSION: The ratio of hematoma area to body area on CT was very useful in evaluating the grade of blunt renal trauma. In conservative treatment for blunt renal trauma changes of the hematoma size is a useful indicator for management.

Adolescent↗
PubMed1998

A case of chronic graft-versus-host disease following living-related donor kidney transplantation.

A 25-year-old man with a 2.5-year history of maintenance hemodialysis underwent a living-related donor (father) kidney transplantation. He was free from acute rejection, but 8 months after the kidney transplantation, he complained of malaise and fever which were accompanied by eruptions on the face, fingers, and hips which resembled symptoms seen in patients suffering from systemic vasculitis. Skin biopsy findings were compatible with those of chronic graft-versus-host disease (GVHD). The human leukocyte antigen (HLA) family study disclosed that the donor's HLA haplotype was homozygous and identical to one of the recipient's HLA haplotypes which indicated that the host would not resist engraftment. On the basis of these findings, a diagnosis of chronic GVHD was made, and increasing doses of immunosuppressants resulted in a resolution of these symptoms. Our report is the first describing GVHD that developed in a patient undergoing related-donor kidney transplantation.

Adult↗
PubMed1996

[The management selection of renal angiomyolipoma].

BACKGROUND: Nephron-sparing surgery is ideal in the treatment of renal angiomyolipoma (AML). But, in fact, occasional cases are found in post-ruptured AML and/or in bilateral multiple AMLs, that is seen in tuberous sclerosis. And we cannot perform nephron sparing surgery so easily. We proposed the treatment selection in such complicated AML. METHODS: We experienced 10 cases (12 kidneys) for about ten years, and studied our treatment selection and prognosis on each cases retrospectively. RESULTS: Of the 5 kidneys with AML less than 4 cm in diameter, 4 have not encountered with rupture. Of the 7 kidneys with AML more than 4 cm in diameter, 4 kidneys had rupture. Of the 3 kidneys unruptured AML more than 4 cm in diameter, 2 kidneys were treated by enucleation and we performed preventive embolization for rupture in residual one kidney. The patients was suffered from tuberculosis sclerosis, and she had bilateral multiple AMLs. Of the 4 kidneys with ruptured AML, 2 kidneys were treated by enucleation, and the other 2 kidneys were entirely resected. We succeeded enucleation in 2 of 4 kidneys with ruptured complicated AML. In those cases, we did long term watching after rupture and in-situ perfusion technique at the operation. CONCLUSIONS: Active treatment of AML, that is more than 4 cm in diameter, might be recommended. Because most of those will be ruptured. The ideal treatment, nephron-sparing surgery is difficult in complicated situation, such as after rupture and bilateral multiple AMLs. In our opinion, the point of success of nephron-sparing surgery might be long term watching after rupture and in-situ perfusion technique at the operation.

Adult↗
PubMed1995

In situ perfusion by retrograde cannulation of a tumor artery for nephron-sparing surgery.

BACKGROUND: Although ice slush cooling or ex situ perfusion with bench surgery is most widely used for protecting ischemic renal damage which possibly accompanies complicated nephron-sparing surgery, each has its own disadvantages. The former does not allow excessively long ischemia and the latter requires complicated procedures as autotransplantation. In order to mitigate against these problems, we devised a novel method of in situ renal perfusion with intracellular hyperosmolar solution. METHODS: One renal segmental artery mainly supplying a tumor was isolated and cannulated with a small feeding tube. The tube was introduced through a small arteriotomy incision directed towards the proximal side, advanced until its tip remained in the main or first branch of the renal artery, and then it was anchored to that artery. After the main renal artery and vein were clamped, the kidney was perfused with cold Euro-Collins' solution through the tube, while the venous blood and perfusate were drained from the left gonadal vein or small venotomy incision of the right renal vein. RESULTS: In one case of renal cell carcinoma and three cases of angiomyolipoma, two of which ruptured, nephron-sparing surgery was carried out under in situ hyperosmolar perfusion. Ischemic time of these four cases was an average of 96 minutes, varying from 45 to 145 minutes. All the kidneys functioned well postoperatively. CONCLUSIONS: The method presented here is very simple, requires no unusual dexterity and safely allows for a long period of renal ischemia. This method is best indicated in cases where simple clamping of the renal pedicle with ice-slush cooling appears insufficient, yet ex situ surgery with autotransplantation seems excessive.

Angiography↗
PubMed1995

[Megaureter in adults].

In comparison with megaureters in children, their reports in adult are not common. We had an opportunity to treat seven adults with megaureters during the last six years. They were all female and ages ranged from 46 to 67 years. Five patients with grade II and one with grade III (Pfister-Hendren's classification) were treated by reconstructive surgery, excision of the narrow segment, tapering of the dilated lower ureter and reimplantation through a submucosal tunnel. The outcome of all the grade II patients was excellent and the case with grade III showed mild improvement. The results suggested that surgical reconstruction could be equally effective for megaureters in adults compared to those in children.

Aged↗
PubMed1994

Signal transmission through MHC class II molecules in a human B lymphoid progenitor cell line: different signaling pathways depending on the maturational stages of B cells.

The function of MHC class II HLA-DR molecules expressed on a human B lymphoid progenitor cell line FL8.2.4.4 (abbreviated as FL4.4) was examined. FL4.4 cells expressed HLA-DR molecules and stimulation of the DR molecules by anti-DR mAb or by superantigen TSST-1 induced strong augmentation of homocytic aggregation and protein tyrosine phosphorylation in FL4.4 cells. Induced homocytic aggregation in FL4.4 consists both of LFA-1/ICAM-1-dependent and -independent pathways as revealed by mAb blocking experiments. Metabolic inhibitors, NaN3 and cytochalasin B, blocked the induced homocytic aggregation of FL4.4. Early mature Daudi B cell lines also showed a similar type of homocytic aggregation by stimulation with anti-DR mAb. Daudi cells are more sensitive to protein kinase inhibitors herbimycin A and H7 than FL4.4 cells in their blocking of induced homocytic aggregation, while W7 showed stronger inhibitory effects on FL4.4 cells than on Daudi cells. Western blotting analysis revealed that the stimulation of DR molecules induced protein tyrosine phosphorylation of 100-kDa, 90-kDa, 60-kDa and 55-kDa proteins in FL4.4 cells, while, in Daudi cells 110-kDa, 100-kDa and 80-kDa proteins were phosphorylated. These results suggest that different signaling pathways through class II molecules are employed depending on the maturational stage of B-cell differentiation.

Antibodies, Monoclonal↗
PubMed1994

[The prognostic value of mean nuclear area and mean nuclear volume in bladder cancer].

To evaluate the prognostic value of mean nuclear area (MNA) and mean nuclear volume (MNV) in bladder cancer, a retrospective study was performed comprising 67 bladder cancer patients who could be followed up for more than 3 years. Cosmozone 1SA, a Nikon image analyzing system was used for the morphometric study. The specimen of initially biopsied tumor tissue was set in an Olympus microscope at 400-fold magnification, and the image was superimposed on the monitor picture through a video camera attached to the microscope. MNA and MNV were measured by tracing the contour of the nucleus which were selected by the point-sampled intercept methods. The time required for measurement of the area and volume was about 15 minutes per case. MNA in cases with histological grade 1, 2 and 3 were 35 +/- 3 microns2 (mean +/- SD), 42 +/- 10 microns2 and 62 +/- 12 microns2 respectively. MNV with grade 1, 2 and 3 were 282 +/- 46 microns3, 371 +/- 148 microns3 and 644 +/- 182 microns3 respectively. The morphometric results were significantly related to histological grade. In cases with a value of MNA of 40 microns2 or more and/or a value of MNV of 370 microns3 or more, the proportion of cases who underwent cystectomy or died of cancer was significantly high and demonstrated poor survival. In contrast, those who showed MNA and MNV less than the above value had better prognosis. These results suggest that the measurements of MNV seems to be useful for objectively evaluating the malignant potential of bladder cancer.

Adult↗
PubMed1993

Induction of tyrosine phosphorylation in human B lineage cells by crosslinking MB-1 molecule of B cell receptor-related heterodimer complex.

B cell antigen receptor is composed of immunoglobulin and associated MB-1 and B29. Here, we found that anti-human MB-1 stimulation induced tyrosine phosphorylation in immature B cells (FL4.4 and Nalm-6) but not in mature B cells (Daudi). Coprecipitated complex with the heterodimer component in Daudi and Nalm-6 contained the kinase molecule(s) which act on the heterodimer protein, while the complex in early lymphoid cell with germ line antigen receptor genes (FL4.4) did not. Candidate Fyn and Lyn are expressed in Nalm-6 and Daudi but are not expressed in FL4.4. These results suggested that src-type tyrosine kinases as Fyn and Lyn are responsible for the phosphorylation of MB-1 and B29 heterodimer, but anti-MB-1 stimulation can induce tyrosine phosphorylation reaction mediated by other kinase molecule(s) in the progenitor type cells.

Amino Acid Sequence↗
PubMed1993

Generation of cells with morphological and antigenic properties of microglia from cloned EBV-transformed lymphoid progenitor cells derived from human fetal liver.

Single-cell clones from the Epstein Barr virus transformed lymphoid progenitor-like cell line established from human fetal liver at 8-week gestation, have been derived and characterized. These clones retained immunoglobulin (Ig) and T cell receptor (TCR) genes in their germ line configuration. They expressed HLA-DR and some B lymphoid markers such as CD19, CD20, and in some, the T lymphoid marker, CD2. They did not express surface Igs, CD3, CD4, CD8 or TCRs (alpha/beta, gamma/delta). A sensitive RT-PCR assay revealed that they did not express mRNA for a recombination activating gene-1, which is expressed after commitment to lymphoid cells. These results suggest that the established cloned lines are very early lymphoid progenitors that have not yet been committed to lymphoid cell lineage. In one of the lines, FL8.2.1.4, a marked morphological change that resembled microglia was induced when the cells were cultured in the presence of phorbol myristate acetate (PMA). After 72 hr of culture, 5-10% of FL8.2.1.4 cells developed a microglial morphology when stimulated with 10 to 100 ng/ml PMA. The newly generated cells with microglial morphology expressed HLA-DR and stained with Recinus communis agglutinin-1, which has been reported to bind specifically to brain microglia. In contrast, expression of lymphoid markers on cells with microglia-shaped morphology was remarkably diminished by PMA stimulation. Thus, the early lymphoid progenitor cells have the capacity to differentiate into cells with the morphological and antigenic properties of microglia cells. This system might be useful for further understanding of the characteristics and functions of microglia cells distributed in the central nerve system.

Antigens, CD↗
PubMed1992

Expression of the CD2 molecule on human B lymphoid progenitors.

CD2 expression on human B lymphoid progenitor cells was examined. By immunofluorescence analysis, a small fraction of bone marrow B cells was found to express CD2 on their surface. CD2 expression was not demonstrated on peripheral B cells. Epstein-Barr virus-transformed B cell lines derived from fetal liver at 8 weeks of gestation were analyzed to delineate the expression and function of CD2 at the early stage of human B cell development. Characterization of surface and genomic phenotypes of cell lines revealed that the established cell lines represent at least three different phenotypic characteristics of early B lineage cell: B progenitor, pre B, or early B cell. None of the 18 cell lines and 13 subclones with the phenotype of the early B lymphoid cells initially expressed CD2 antigen. However, CD2 expression was induced by the successive cultivation of some cloned B progenitor cell lines. In spite of the expression of CD2, these clones cell lines were unable to form rosettes with sheep red blood cells. By immunoprecipitation analysis, an identical 50 kDa protein was precipitated with anti-CD2 antibody from the lysates of the radioiodinated CD2+B progenitor cell line and peripheral blood T cells. Anti-CD2 antibody induced significant enhancement of proliferation of the CD2+B progenitor subline. These data indicate that human CD2 is expressed on a fraction of B lineage cells at a very early differentiation stage and may play a role in B lymphopoiesis.

Antigens, CD↗
PubMed1992

["Dismembered spiral flap pyeloplasty" for uretero-pelvic junction obstruction].

We report a new operative technique for plastic correction of uretero-pelvic junction (UPJ) obstruction: dismembered spiral flap pyeloplasty. It is similar to the method described by Culp & DeWeerd in that a flap is made spirally but different in that UPJ is detached. Relatively a long and wide spiral (oblique) flap, the apex of which directs cranioventrally or craniodorsally, is made using the dilated pelvis. The apex of the flap is reflected downward and anastomosed to the split ureteral end. Because the flap is made obliquely, one side of the flap base is approximated to the opposite pelvic margin; this helps to make gradual funnelling of pelvio-ureteric transition. The method seems to be fit for cases with considerably long stenosis of UPJ and with the UPJ locating relatively close to the medial margin of the renal parenchyma. Seven of 26 pyeloplasties were done by this method in our institute, and all the 7 cases had satisfactory results.

Adolescent↗
PubMedDate not supplied

Testicular malignant lymphoma; imaging and diagnosis.

The sonographic and magnetic resonance imaging findings of three cases of surgically proven malignant lymphoma of the testis were reviewed and their diagnostic implications were evaluated. In all three cases ultrasonography showed striated hypoechoic bands with paralleling hyperechoic lines radiating peripherally from the mediastinum testis. We believe they represented blood vessels. On T1-weighted MR images, the tumor showed homogenous hyperintensity in one case and homogenous isointensity in the other two. On T2-weighted images the tumor showed homogenous hypointensity in two cases and homogenous isointensity in one. After Gd-DTPA administration, the tumor showed homogenous enhancement in two cases and inhomogenous enhancement in one. In two cases there were enhancing striated bands in the tumor. Despite the diffuse infiltration by the tumor, the basic architecture of the testis, epididymis, and spermatic cord was preserved. When MRI and ultrasonography show an infiltrative disease preserving the basic architecture of the testis and ultrasonography presents hypoechoic bands radiating peripherally from the mediastinum testis, a diagnosis of malignant lymphoma should be considered.

Contrast Media↗