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Biomedical subjects

N Tomosugi

Publications and source records attributed to N Tomosugi.

At least 55 records · Page 3Linked to original sources
PubMed1986

Participation of extracapillary lesions (ECL) in progression of IgA nephropathy.

To clarify long-term prognosis and risk factors of IgA nephropathy, 205 patients with the disease were followed up for a period of 1 to 22 years with a mean of 7.9 years. According to the percentage of glomeruli involved with extracapillary lesions (ECL), which were defined by crescents and fibrous adhesion of glomerular tufts to Bowman's capsule, the patients were divided into four groups: group 1-absence of ECL; group 2-less than 25%; group 3-25-50%; group 4-more than 50%. During the follow-up period, 26 patients progressed to chronic renal failure requiring hemodialysis, and one patient died of acute peritonitis. The actuarial kidney survival rate was 90.4% for 5 years and 86.0% for 10 years. Ten-year survival rates were 100% in group 1, 94.3% in group 2, 81.8% in group 3 and 25.5% in group 4. Re-biopsy specimens, observed in 31 patients after intervals of 1.4 to 13.4 years, revealed an increase of ECL in 20 patients concomitant with an apparent reduction of renal function in 13, whereas in the other 11 patients with no increase, renal function remained unchanged. These results strongly suggest that ECL plays an important role in the progression of IgA nephropathy, and renal function could be impaired by repeated formation and accumulation of these lesions.

Adolescent↗
PubMed1985

Peculiar glomerular lesions in Takayasu's arteritis.

Seventeen kidney specimens (6 biopsies and 11 autopsies) of Takayasu's arteritis disclosed two types of glomerular lesions. One was a mild axial mesangial proliferation associated with intramembranous and mesangial electron dense deposits consisting of IgG, IgM and C3 (axial type). The other was a centrolobular mesangial thickening associated with a hyaline deposition showing a mosaic pattern ("centrolobular mesangiopathy": centrolobular type). Mesangiolytic lesions, nodulous lesions, microaneurysms in glomeruli and extensive deposition of hyaline materials both in afferent and efferent arterioles were also observed. The former lesion was found in 4 patients with an active arteritis; and the latter was mainly observed in autopsy cases having a long-term clinical course. In the genesis of the axial type, immune complex deposition caused by the active aortitis may be involved, while the glomerular ischemia caused by the vascular lesions may be implicated in the development of the centrolobular type.

Adolescent↗
PubMed1985

Immunodynamics of minimal change nephrotic syndrome in adults T and B lymphocyte subsets and serum immunoglobulin levels.

Thirty-two adult patients with minimal change nephrotic syndrome (MCNS) were studied in order to clarify the characteristics of the immune system in MCNS and their relation to clinical activity. In the active phase (n = 17), serum immunoglobulin (Ig) M and E levels, B lymphocytes (surface Ig-positive cells) and their subsets, surface IgG, IgM and IgE positive cells; B gamma, B mu and B epsilon, were increased, whereas the serum IgG level and OKT3-reactive cells, peripheral T lymphocytes; T3, were decreased. In the remitted phase maintained by steroid therapy (n = 17), serum Igs and B lymphocyte subsets tended to return to normal levels concomitant with decreases in T3 and T4, and an increase in T8 in consequence of a marked decrease in T4/T8 (helper/suppressor) ratio. In stable remission continuing with no steroid therapy (n = 14), the above abnormalities returned to normal ranges, except for serum IgM which remained at a high level and re-elevated serum IgE. These results suggest that immunological abnormalities in MCNS are characterized by acceleration of the IgE and IgM producing systems and impaired maturation of the IgG producing system despite normal differentiation from the IgM producing to IgG producing system, possibly caused by T lymphocyte dysfunction.

Adolescent↗
PubMed1985

Psoriasis vulgaris associated with mesangiocapillary glomerulonephritis.

A patient experienced the concomitant onset of psoriasis vulgaris and mesangiocapillary glomerulonephritis (MCGN) with massive proteinuria. Laboratory examination revealed reduced glomerular filtration rate (GFR), elevated serum IgG, IgA and circulating immune complex (CIC) levels. Both diseases responded promptly to combined therapy with prednisolone, urokinase and plasma exchange. CIC and GFR were normalized with histological improvement. To our knowledge, this is the first case of glomerulonephritis, which can be related to psoriasis vulgaris through an immune mechanism.

Antigen-Antibody Complex↗
PubMed1985

Focal glomerular sclerosis in pre-eclampsia.

Renal biopsy specimens of 16 patients with massive proteinuria, which developed during pregnancy and had lasted as late as one month after delivery, but disappeared within 15 months were studied. Four of them disclosed focal segmental hyalinosis, sclerosis, markedly swollen and foamy endocapillary cells, and ballooning of the involved tufts. Double contour of the capillary walls, predominance of epithelial cells as well as swelling of endocapillary cells known in pre-eclampsia were also observed. Electron and immunofluorescence microscopies revealed subendothelial deposition of IgM, C3 and rather weak fibrinogen-related antigens. These results indicate that focal glomerular sclerosis may develop during pre-eclamptic pregnancy, but may follow a non-progressive clinical course after delivery.

Adult↗
PubMed1984

Prediction of the long-term outcome in acute interstitial nephritis.

Fourteen patients with acute interstitial nephritis have been followed for an average of 64 months. Initial renal failure estimated by a reciprocal of serum creatinine improved rapidly and linearly within 6 to 8 weeks ("early improvement"). A slow improvement of GFR followed within one year, showing a new base line level of renal function, which was assessed as normal in five patients and was reduced in seven patients. Two patients died of non-renal disease. Final GFR was closely correlated with a degree of "early improvement", ages at onset and severity of interstitial lesions. The results suggest, 1) these indices are of much value in predicting long-term prognosis and 2) a certain degree of permanent impairment of renal function is rather common in the disease.

Acute Disease↗