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Biomedical subjects

F Ishimoto

Publications and source records attributed to F Ishimoto.

At least 37 records · Page 2Linked to original sources
PubMed1992

Renal artery thrombosis in a patient with membranous glomerulonephritis.

A 64-year-old man with renal artery thrombosis (RAT) associated with nephrotic syndrome (NS) is reported. Although this patient was diagnosed as NS due to membranous glomerulonephritis (MGN) and treated with prednisolone, RAT occurred as a result of unknown mechanisms and caused mild renal dysfunction. Creatinine clearance has been about 70 ml/min for 9 years since the onset of RAT. The renal scintigraphic image has not changed since the onset. NS responded to prednisolone therapy initially and at the time of the relapse. Recent data have shown proteinuria levels of less than 0.2 g/day.

Glomerulonephritis, Membranous↗
PubMed1991

Clinical characterization of drug-induced allergic nephritis.

To elucidate the clinical characterization of drug-induced allergic nephritis (DIAN), we analyzed the cases attending our department. We now report on the 14 cases of DIAN due to administration of penicillin in 2 cases, cephem antibiotics in 6 cases, nonsteroidal anti-inflammatory drugs in 4 cases and new quinolone anticidal drugs in 2 cases. With 1 exception, all these cases reached the stage of acute renal failure after taking these drugs for 2-13 days, followed by characteristic allergic symptoms such as fever, skin eruptions and serum IgE elevation in 5 of the 14 cases. A lymphocyte stimulation test (LST) with the suspected drugs proved to be positive in 10 of the 12 cases examined, and the uptake of 67Ga in the kidneys was extremely positive in all 6 cases examined, reflecting the natural course of this disease. Furthermore, there were some cases where 67Ga accumulated in the kidneys in spite of the negative result of LST examination. In all of these cases, a needle or open renal biopsy was performed, and acute tubulointerstitial nephritis (AIN) was diagnosed. Almost all cases were treated with glucocorticoid for AIN or dialysis for acute uremic symptoms several times. However, 4 of the 14 cases could not return to normal condition in spite of these forms of treatment. We would therefore like to suggest that LST and 67Ga scintigram are useful diagnostic tools for DIAN as an alternative to renal biopsy.

4-Quinolones↗
PubMed1991

An experimental study on selective elimination of beta 2-microglobulin using immunoadsorption method in patients with chronic renal failure.

We studied selective elimination of beta 2-microglobulin (beta 2-m) from plasma of patients with chronic renal failure (CRF) by using immunoadsorption method. Anti-human beta 2-m antibody of rabbit IgG was coated with cellulose beads, which were filled into a small-column. One gm of cellulose beads contains 5.0 mg of the protein of antibody. Five to 7 ml of plasma samples with 40 to 70 mg/l of beta 2-m were passed through the column at 1.0 ml/10 min and each effluent was then collected by 1.0 ml consecutively. Before and after passing through the column, beta 2-m and other plasma proteins were measured. Plasma beta 2-m concentrations in all the effluent fractions after passing through the column were greatly reduced to 1/100. But no other plasma protein components than beta 2-m varied in concentration. Neither Immune complex (IC) nor rabbit IgG was detected in any effluent fraction. These results indicate that selective and effective elimination of beta 2-m from plasma in patients with CRF was possible by using our method. In addition, since neither IC nor rabbit IgG was detected in the effluent, this method was considered to be clinically applicable.

Antigen-Antibody Complex↗
PubMed1991

[Intravenous cyclophosphamide therapy in patients with steroid-resistant lupus nephritis].

We evaluated short term clinical effects of intravenous cyclophosphamide (iv CyP) therapy performed by every three month in 7 patients with steroid-resistant lupus nephritis. Significant improvements were observed in daily urinary protein excretion (3.1 to 0.83 g/day), creatinine clearance (65.4 to 95.3 ml/min), CH 50 levels (20.8 to 37.4 U/ml), and anti-DNA antibody titer (26.6 to 7.0 U/ml). In addition, the mean daily dose of prednisolone (PSL) could be markedly reduced from 38.6 mg to 13.9 mg at the final observation. Two patients suffered from Herpes Zoster infection at a few months after ivCyP therapy, however this incidence were not considered as critical side effect which reached to the discontinuation of this therapy. We concluded that ivCyP therapy by every three months were safety and achieved beneficial clinical effects on steroid-resistant lupus nephritis as far as short observation. On the contrary, the long term effect of this mode of therapy is to be defined.

Administration, Oral↗
PubMed1991

Soluble IL-2 receptor in patients with primary nephrotic syndrome.

The soluble interleukin-2 receptor (SIL-2R) levels in 46 patients with primary nephrotic syndrome were examined. The values in the nephrotic patients exceeded those in healthy controls (p less than 0.05), and were the same at the nephrotic and non-nephrotic stages. The serum interleukin-2 (IL-2) levels in the nephrotic patients were low and did not correlate with the serum SIL-2R levels. Only at the nephrotic stage were the latter closely correlated with the serum IgG (p less than 0.001) but not with the serum IgA or IgM. The SIL-2R production by phytohemagglutinin stimulated peripheral blood lymphocytes (PBL) in the nephrotic patients was less at the nephrotic and non-nephrotic stages than that in the healthy controls. The IgG production by pokeweed mitogen stimulated PBL was low at the nephrotic stage but not at the non-nephrotic stage. Based on these findings, it is suggested that SIL-2R determinations should prove useful in clarifying the relationship between cellular and humoral immunological disorders in nephrotic syndrome.

Adult↗
PubMed1991

Characterization of acute renal failure due to primary nephrotic syndrome.

Acute renal failure (ARF) associated with primary nephrotic syndrome (PNS) was analyzed clinically in order to evaluate the mechanism of onset. The incidence of induced ARF with PNS was found to be cases (2.1%) out of 420 cases attending our outpatient clinic. The renal histological changes included 2 cases of minimal change nephrotic syndrome (MCNS), 6 of focal glomerular sclerosis (FGS) and one of unknown origin. The 6 cases which recovered from ARF were designated as group A. The 3 cases of group B required maintenance dialysis; they included one case of MCNS, one of FGS and one of unknown origin, and showed resistance to aggressive treatments, such as steroid pulse therapy, anticoagulants and plasmapheresis. In the patients of group A, follow up studies for 10 years confirmed that their condition was not progressive. There were no significant differences between the reversed group A cases recovering from ARF and the non-reversed group B cases in terms of their clinical parameters, such as age, sex, urinary protein excretion, initial renal function, blood pressure, renal histological damage and complications. Specific factors associated with the induction of reversibility from ARF could not be identified. Further research is needed to elucidate the precise characteristics of the ARF occurring in PNS.

Acute Kidney Injury↗
PubMed1990

Effects of low protein diet in puromycin aminonucleoside-induced nephrotic rats.

Wistar rats were injected with puromycin aminonucleoside (PAN) to induce massive proteinuria and were raised on a low protein diet to determine whether the urinary protein excretion might be reduced. Although PAN nephrotic rats fed with a normal protein diet containing 20% protein (group A) did not show any reduction of their urinary protein excretion, PAN rats fed with a low protein diet containing 6% protein (group B) revealed a marked reduction at day 9 of the present study in comparison with group A. The total serum protein levels were low in groups A and B as compared to group C, the non-treated control. However, group A recovered to normal levels at day 13. In terms of the absolute amount of oral protein intake, marked differences were observed between groups B and C, but little difference was observed between groups A and C. The body weight in all three groups was decreased at 8 days after the start of this study. The serum levels of creatinine were elevated to 1.1 +/- 0.3 mg/dl and 1.0 +/- 0.2 mg/dl in groups A and B, respectively, on day 7, but abruptly recovered to normal levels by day 12. These data indicate that the decreased urinary protein excretion in group B might be dependent on the total protein volume intake, and not on the renal function nor serum levels of total protein.

Animals↗
PubMed1990

A case of nephrotic syndrome due to alpha-mercaptopropionyl glycine in a patient with familial cystinuria.

A 26-year-old male with nephrotic syndrome (NS) due to alpha-mercaptopropionyl glycine (MPG) is described. In March, 1988, he was diagnosed as having familial cystinuria after receiving urolithiasis treatment since December, 1985. Massive proteinuria and slight pedal edema were noted. Nephrotic syndrome was suggested and renal biopsy was performed. The renal pathological finding demonstrated membranous glomerulonephritis (MN) at stage I. This case was defined as NS clinically associated with MPG, and glucocorticoid intake was initiated. The response to the glucocorticoids was fairly good with no clinical problems after discontinuation of MPG, and the cystinuria was maintained with alkaline medication. The patient's parents and younger brother were suggested and confirmed to have cystinuria based on urinary aminogram analysis, but displayed no symptoms. We present a rare case of NS due to MPG therapy in a patient with familial cystinuria. However, the mechanism of onset remains unclear.

Adult↗
PubMed1990

Urinary N-acetyl-beta-D-glucosaminidase isoenzyme activity as measured by fast protein liquid chromatography in patients with nephrotic syndrome.

Exactly why N-acetyl-beta-D-glucosaminidase (NAG) excretion is increased in patients with nephrotic syndrome with glomerular lesions is poorly understood. Glomeruli contain less NAG than do proximal tubules. In this study, we have tried to measure the NAG isoenzymes automatically by use of the recently developed fast protein liquid chromatography (FPLC) system, followed by column chromatography on DEAE cellulose (Mono Q). Three isoenzyme peaks--B, I + II, and A--were observed for urine from both healthy subjects and nephrotic patients. The B isoenzyme usually constituted about 10% of the total NAG in healthy controls, 30% in nephrotic patients. In contrast, the proportion of the A isoenzyme was inversely related to that of the B isoenzyme when healthy controls and nephrotic patients were compared. Our system for measuring NAG isoenzymes is reproducible and fast, and it should be useful in further studies.

Acetylglucosaminidase↗