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Yuki Uehara

Publications and source records attributed to Yuki Uehara.

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Surveillance of infection control procedures in dialysis units in Japan: a preliminary study.

As there is a high risk of indirect and direct transmission of infectious agents in chronic hemodialysis, infection control procedures should be established in dialysis units. This paper presents the findings of a questionnaire designed to survey the current status of infection control procedures in hemodialysis settings. Two hundred and forty-three hemodialysis units in Japan were surveyed. Nearly 90% of hemodialysis units reported compliance with each procedure recommended by the Center for Disease Control and Prevention in the United States, including use of disposable gloves, handling of non-disposable or non-single-use items, and routine serological testing of blood-borne viruses. However, more than 50% of units reported that they did not comply with recommendations concerning some procedures, such as places for preparing medications and their delivery, clean areas in the units, vaccination for hepatitis B, and additional measures for hepatitis B surface antigen (HBs-Ag) positive patients. Especially, the concept of universal precautions seemed to be misunderstood in units with a high prevalence of anti-hepatitis C antibody-positive (anti-HCV Ab-positive) patients. In conclusion, further intensive education and training will be necessary to establish infection control procedures.

Disposable Equipment↗

[Evaluation of renal damage using urinary ATP analysis].

It is reported that urinary ATP concentration analysis is useful for determining urinary tract infection and renal damage caused by drugs. By means of the firefly luciferin-luciferase method, we determined the reference value of urinary free ATP and evaluated the effects of urine sediments and conditions of storage. The reference value was established as 1.77 x 10(-10) to approximately 7.70 x 10(-9)M using urine samples obtained from 63 outpatients who seemed to have no renal disease. There was no significant difference in ATP concentration between 33 males and 30 females. No significant changes were observed in 11 healthy volunteers during a 1-year period. Within-run reproducibility of ATP was satisfying (8.28% and 11.4% of coefficient value in low and high concentration samples, respectively). ATP concentration was significantly decreased after centrifugation (p < 0.05) and after filtration (p < 0.01). The amounts of the red blood cells (RBC) and white blood cells (WBC) in samples whose ATP concentration was decreased after centrifugation or filtration were significantly higher than those in samples whose concentration did not decrease (p < 0.05). Urine containing many RBCs and/or WBCs might show an artificially higher ATP concentration if no preparations has been performed. There were significant positive correlations between the ATP concentrations before and after refrigeration, but no correlations before and after freezing. It is concluded that the reference value of urinary free ATP concentration was 1.77 x 10(-10) to approximately 7.70 x 10(-9) M and that care is required in the estimation of urinary ATP concentrations in samples containing many sediments, especially with WBC and RBC.

Adenosine Triphosphate↗

[Urinary ATP].

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Adenosine Triphosphate↗

Autoimmune hemolytic anemia occurred prior to evident nephropathy in a patient with chronic hepatitis C virus infection: case report.

BACKGROUND: Renal involvement in patients with chronic hepatitis C virus infection has been suggested to be due to a variety of immunological processes. However, the precise mechanism by which the kidneys are damaged in these patients is still unclear. CASE PRESENTATION: A 66 year old man presented with the sudden onset of autoimmune hemolytic anemia. Concomitant with a worsening of hemolysis, his initially mild proteinuria and hemoglobinuria progressed. On admission, laboratory tests revealed that he was positive for hepatitis C virus in his blood, though his liver function tests were all normal. The patient displayed cryoglobulinemia and hypocomplementemia with cold activation, and exhibited a biological false positive of syphilic test. Renal biopsy specimens showed signs of immune complex type nephropathy with hemosiderin deposition in the tubular epithelial cells. CONCLUSIONS: The renal histological findings in this case are consistent with the deposition of immune complexes and hemolytic products, which might have occurred as a result of the patient's underlying autoimmune imbalance, autoimmune hemolytic anemia, and chronic hepatitis C virus infection.

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