Akinobu Suga

Urinary tract infections following renal transplantation.

The incidence of urinary tract infections (UTIs) in 363 adult renal transplant recipients transplanted during the period 1990-96 has been analysed. UTI occurred in 96 patients (26%), most frequently during the first year after transplantation. Female recipients had significantly more UTI than male recipients (49% vs. 14%, p < 0.0001). There was no difference in the incidence of UTI between recipients receiving pig-tail catheters as ureteral stents or not, the figures being 21% vs. 28%, respectively. Age had no influence on the incidence of UTI. In 341 patients treated with cyclosporine the incidence of UTI was 28%, while in 15 patients treated with FK-506 only 1 patient (7%) had a UTI (ns). The majority of organisms cultured were gram-negative (76%), with approximately 1/3 being Escherichia coli and 1/5 being Enterococcus and Klebsiella/Enterobacter. The bacterial spectrum was not influenced by the recipients age. UTI had no effect on the number of rejections, or on graft and patient survival in living donor transplant recipients. No significant difference was found in graft and patient survival rates at 3 yr between patients who had UTI or no UTI.

Risk group stratification to predict recurrence after transurethral resection in Japanese patients with stage Ta and T1 bladder tumours: validation study on the European Association of Urology guidelines

Study Type – Therapy (case series) 
Level of Evidence 4

Expression of thymidine phosphorylase in human superficial bladder cancer

Abstract Background:  The purpose of the present paper was to investigate the expression level of thymidine phosphorylase (TPase) in superficial bladder cancer tissues obtained by transurethral resection, and determine whether its expression correlates with tumor recurrence.

22-Oxacalcitriol Upregulates p21WAF1/Cip1 in Human Parathyroid Glands

In the era of 22-oxacalcitriol (OCT), newly synthesized 1α,25-dihydroxyvitamin D3 analogue, against secondary hyperparathyroidism, the indications of parathyroidectomy (PTx) has been restricted. Recent investigations on animal models have revealed the inhibitory effects on PTH secretion after OCT treatment, whereas there has been no evidence about human parathyroid glands. A 38-year-old man with a 19-year history of hemodialysis was performed PTx after the failure of OCT treatment. Expressions of proliferative nuclear cell antigen (PCNA), calcium-sensing receptor (CaSR), vitamin D receptor (VDR), p53 and p21WAF1/Cip1 were analyzed by Western blotting and immunohistochemistry on resected parathroid glands. We confirmed up-regulations of CaSR and VDR, which contribute the reduction of serum PTH, by OCT treatment. Concomitant up-regulation of p21WAF1/Cip1 but not p53, especially in nodular hyperplasia, can be considered to induce cell cycle arrest of the parathyroid cells, but not cytocidal effect of OCT.

Transitional cell carcinoma of the renal pelvis with vena caval tumor thrombus.

We report a case of transitional cell carcinoma of the renal pelvis with vena caval tumor thrombus. To our knowledge only 14 cases of transitional cell carcinoma of the renal pelvis protruding into the vena cava have been reported. The literature regarding these cases is reviewed, and the differential diagnosis of this tumor from renal cell carcinoma is discussed.

A Case of Adenocarcinoma Arising within a Urethral Diverticulum Diagnosed Only by the Surgical Specimen

We report an extremely rare case of a 50-year-old woman with an adenocarcinoma arising within a urethral diverticulum. She could not be diagnosed correctly before operation and the microscopic pathological examination of the surgical specimen was the only indication showing the cancer origin.

Effect of Oral Adsorbent AST‐120 on Cyclosporin Absorption in Rats

The oral adsorbent AST‐120 is used to inhibit the progression of renal failure by adsorbing uraemic toxins in the gastrointestinal tract. When AST‐120 is administered to patients receiving immunosuppressive medicines, it is important to study the effect of AST‐120 on the amount of these and other drugs absorbed. We have, therefore, studied the in‐vitro adsorption of cyclosporin by AST‐120 and investigated the effect of oral administration of AST‐120 on the absorption of cyclosporin in rats.

Expression of mRNA for growth factors and extracellular matrix proteins after injury to cultured peritoneal cells: does the healing process contribute to peritoneal ultrastructural alteration?

The purpose of this study was to investigate the possibility that healing processes following repeated injury by nonphysiological dialysate play a significant role in the pathogenesis of peritoneal ultrastructural alteration, mediated by the production of growth factors and extracellular matrix proteins (ECM). To test a possible mechanism for peritoneal membrane alteration, we investigated whether chemically injured peritoneal mesothelial cells and fibroblasts upregulate their production of growth factors and ECM as a consequence of the healing process. Using 1 N NaOH, circular wounds of uniform surface area were made in monolayers of subconfluent rat peritoneal mesothelial cells (RPMC) and peritoneal fibroblasts (RPFB). At 0, 24, and 72 h after wounding, changes in mRNA expression of transforming growth factor-beta 1 (TGF-Β1), b-FGF, HGF, VEGF, and FN were semiquantified by reverse transcription-polymerase chain reaction. Nonwounded monolayers of RPMC and RPFB were used as controls with mRNA expression being determined at the same times. For RPMC, TGF-Β1, HGF, b-FGF, and FN mRNA gradually increased up to 72 h postwounding to 1.5-fold, 1.6-fold, 1.3-fold, and 2.1-fold of the control levels, respectively. A significant increase was only observed for TGF-Β1, while VEGF showed the least change with time. For RPFB, HGF, b-FGF, VEGF, and FN mRNA expression were slightly suppressed compared to control levels up to 72 h postwounding. TGF-Β1, however, increased markedly above control expression levels by the end of the wound healing process. The production of profibrotic growth factors by mesothelial cells in response to injury may represent a mechanism whereby fibroblast activation, resulting in fibroblast hyperplasia and excessive extracellular matrix accumulation, culminates in alteration of the peritoneal membrane ultrastructure.

Diabetes mellitus after renal transplantation under tacrolimus-based immunosuppression

TACROLIMUS, a potent immunosuppressive drug, has been associated with improved kidney graft survival, although there is an increased incidence of posttransplant diabetes mellitus (PTDM). PTDM is a serious complication of immunosuppressive drugs that increases the risk of both graft loss and patient death, and predisposes patients to diabetic complications, including retinopathy and neuropathy. We reported here two cases of PTDM under a tacrolimus-based immunosuppression.

Effects of tacrolimus on rat thymic epithelial cells.

FK506 is an immunosuppressive agent that was discovered in Japan. Many experiments on organ transplantation have shown the prolongation of allograft survival in animals by treatment with FK506. Previous studies have also shown that FK506 has a remarkable immunosuppressive effect and improves the outcome of liver transplantation. We recently analyzed the effect of FK506 on thymocyte differentiation by the immunoperoxidase technique and flow cytometry using monoclonal antibodies (MoAbs) for thymus and T-cell surface antigens, and we found a reduction of major histocompatibility complex (MHC) class II antigen expression on thymic epithelial cells. Our results have suggested that FK506 inhibited thymocyte differentiation in rats by not only directly but also by indirectly acting on thymic epithelial cells. In the present study, we investigated the effect of FK506 on rat thymic epithelial cells by immunohistochemistry using various MoAbs.