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Biomedical subjects

N Yoshikawa

Publications and source records attributed to N Yoshikawa.

At least 217 records · Page 12Linked to original sources
PubMed1984

Twenty-seven children with focal segmental glomerulosclerosis: correlation between the segmental location of the glomerular lesions and prognosis.

Twenty-seven children with focal segmental glomerulosclerosis (FSGS) were studied for clinical and pathological manifestations in order to determine whether the location of the sclerotic lesions bears prognostic implications. There were 11 children with peripheral FSGS and 16 with hilar FSGS. During a mean follow-up period of 6 years, 10 of the 16 with hilar FSGS developed renal failure (GFR less than 20 ml/min/m2) but all of the 11 with peripheral FSGS maintained normal renal function. We suggest that FSGS may be divided into a hilar type with poor prognosis and a peripheral type with benign prognosis. It is conceivable that these two groups represent etiologically different entities.

Adolescent↗
PubMed1983

The prevalence of diabetic autonomic neuropathy indicated by abnormal R-R interval variation.

The variation in R-R interval in ECG has been reported to decrease in diabetics with autonomic neuropathy. To investigate the diagnostic value of heart rate monitoring and the prevalence of diabetic autonomic neuropathy, R-R interval variations (CVs) were measured, and the relationships between CV and MCV, FCV, SCV, retinopathy, nephropathy, peripheral neuropathy, and duration of diabetes were investigated. 70 diabetics aged 19 approximately 74 were studied. A total of 100 consecutive R-R intervals on ECG were analyzed by computer. 16 patients (22.8%) of 70 had one or more symptoms of autonomic neuropathy, while the prevalence of diabetic autonomic neuropathy indicated by abnormally low CV was 41.4%. Diabetics with retinopathy, nephropathy or peripheral neuropathy had significantly lower CVs than diabetics without these complications (p less than 0.01). The correlation coefficients for CV and duration of diabetes, and CV and SCV were -0.69 and 0.57 respectively (p less than 0.01). CV (%) of R-R interval was a useful parameter for the determination of diabetic autonomic neuropathy and our results showed that autonomic nerve damage was more prevalent than were symptoms of autonomic neuropathy.

Adult↗
PubMed1983

[Efficacy of chemo-endocrine therapy for recurrent breast cancer].

Recurrent breast cancer can now be treated more effectively with endocrine therapy, combined with chemotherapy. Between April 1977 and March 1982, 127 breast cancer operations were performed at Kumamoto Municipal Hospital; recurrence was found in 13 cases (approx. 10%). Treatment of 7 of these cases with endocrine therapy (mainly Nolvadex, anti-estrogen) combined with chemotherapy resulted in 6 cases showing either complete response (CR) or partial response (PR). The efficacy of chemo-endocrine therapy was obvious when compared with cases without therapy. Further studies on hormone receptors and the establishment of guidelines for chemo-endocrine therapy as post-operative adjuvant therapy are justified.

Adult↗
PubMed1982

Microfibrils in glomerulopathies of children: an ultrastructural study.

Extracellular microfibrils were found in 47 per cent. of 360 renal biopsies performed in children with a variety of nephropathies. They were observed in the mesangial matrix and basal lamina. They are 17 to 35 nm in diameter and a few show cross-striations with a periodicity of about 10 nm. They are different from fibrin or interstitial collagen. Their close association with thinner filaments in the mesangial matrix and basal lamina suggests that they are derived from such filaments.

Adolescent↗
PubMed1982

Ultrastructure of the non-sclerotic glomeruli in childhood nephrotic syndrome.

An electron-microscopic (EM) study of the non-sclerotic glomeruli was made in 96 children with the nephrotic syndrome in whom light microscopy had shown minimal change, focal global glomerulosclerosis or segmental glomerulosclerosis. EM showed a variety of alterations. Foot process fusion, duplication and crenation of the lamina densa, and granular and lucent expansion of lamina rara interna were noted in almost all patients in all three groups. Localised ulceration of the podocytes was noted in some patients in each group. There was no difference in the mean thickness of the glomerular basal lamina but there was an increase with age in minimal change. Curious extracellular curved striated bodies, clusters of electron-dense, round microparticles and microfilaments were found in all three, but most frequently in segmental glomerular sclerosis. Electron-dense deposits were seen in all but one of the patients with segmental glomerular sclerosis and usually involved the capillary wall. They were seen in one third of those with minimal change and focal glomerular sclerosis but rarely in the capillary wall. There were no specific features which distinguished segmental glomerular sclerosis although the various types of deposits were more extensive and more frequent than in minimal change and focal glomerular sclerosis. These observations are consistent with common pathogenetic factors operating at different intensities in segmental glomerular sclerosis, focal glomerular sclerosis and minimal change.

Basement Membrane↗
PubMed1982

Familial hematuria; clinico-pathological correlations.

The findings are reported in 38 patients with familial hematuria. In 10 of the 24 families investigated, a familial incidence of hematuria was revealed only by routine urinalysis in first-degree relatives. Where there was either neurosensory deafness of heavy proteinuria in the patient or family, or a history of chronic renal failure in the family, the patient generally ran a progressive clinical course. Light microscopy (LM) of renal biopsy specimens revealed little abnormality in young children, but segmental glomerular sclerosis was frequently observed in older patients. The most characteristic change, observed on electron microscopy (EM) in 27 out of 31 renal biopsies was complex replication of the lamina densa of the capillary basement membrane, to form a "basket weave" pattern. Families with and without deafness (groups 1 and 2) were both considered to fall within the spectrum of Alport's syndrome, although the presence of deafness adversely affected the prognosis. In contrast, patients from families showing neither deafness, heavy proteinuria nor chronic renal failure (group 3) ran a non-progressive course. Their biopsies showed little or no glomerular changes other than attenuation of the lamina densa on EM. In Alport's syndrome, deafness, heavy proteinuria, segmental sclerosis and foam cells were not often present before the age of 10 years, whereas the "basket weave" alteration of the lamina densa was found in all three children biopsied under 5 years of age. We therefore emphasize the importance of EM in the differential diagnosis from benign familial hematuria.

Adolescent↗
PubMed1981

The glomerular basal lamina in hereditary nephritis.

Characteristic ultrastructural alterations of the glomerular basal lamina have been reported in hereditary nephritis. The basal lamina is irregularly thickened and the lamina densa shows replication with a "basket weave" pattern, enclosing electron-lucent lacunae which frequently contain small dense particles. However there is controversy regarding the specificity of this lesion in hereditary nephritis. To determine the specificity, 366 renal biopsies from 310 children were studied retrospectively. Twenty-four out of 27 patients with hereditary nephritis showed the characteristic changes of the basal lamina and they were widespread in 17. Two patients with recurrent haematuria but no family history of deafness or haematuria showed similar extensive changes and are regarded as new mutant cases of hereditary nephritis. Similar changes were seen in 17 of the 281 patients with other conditions but were always localized to a few capillary loops. We conclude that a widespread "basket weave" pattern appears to be confined to hereditary nephritis and is seen in the great majority of such cases.

Adolescent↗
PubMed1981

Curved striated and round bodies in glomerulopathies of children; an ultrastructural study.

Extracellular curved striated bodies and round bodies were found in 62 and 41 per cent, respectively of 360 renal biopsies performed in children with a variety of nephropathies. They were observed in the basal lamina and mesangial matrix. The fact that they commonly occurred together appears to suggest a common aetiology and they are probably derived from altered protein of the basal lamina and mesangial matrix, or from proteins of immune deposits.

Adolescent↗
PubMed1981

Glomerular morphometry I: nephrotic syndrome in childhood.

Glomerular morphometry was performed on needle biopsy specimens from 53 children with the nephrotic syndrome with minimal change (MC), focal global glomerulosclerosis (FGS) and segmental glomerulosclerosis (SGS). There were significantly fewer epithelial cells and more mesangial cells in SGS compared with MC and FGS. The number of epithelial cells decreased with age in MC and FGS, but was constantly low at all ages in SGS. There were no significant differences in differential cellularity between MC, with or without focal glomerular obsolescence or focal tubular atrophy, and FGS. Glomerular diameter increased with age in MC and FGS, but not in SGS. These findings support the view that SGS is a distinct entity rather than a variant of MC.

Age Factors↗
PubMed1981

Glomerular morphometry II: familial and nonfamilial haematuria.

Differential glomerular cell counts and measurements of glomerular diameter were made in 13 children with Alport's syndrome (AS), four with benign familial haematuria (BFH) and 15 with nonfamilial haematuria (NFH). Mesangial cellularity was increased in the six cases of NFH with diffuse mesangial deposits of IgA (IgA +). In AS, IgA + and -NFH, epithelial cellularity decreased with age while glomerular diameter increased. In AS mesangial and endothelial cellularity also decreased with age. These findings support the view that AS, IgA + and -NFH are three distinct entities. BFH, although similar in several respects to IgA -NFH, should nevertheless be retained as a separate category by virtue of its familial incidence of haematuria.

Adolescent↗
PubMed1981

Prognostic significance of the glomerular changes in Henoch-Schoenlein nephritis.

Eighty-three children with Henoch-Schoenlein nephritis were studied to establish the prognostic significance of the glomerular changes. After a mean follow-up period of 6 years, 44 patients had no demonstrable abnormality, 21 had minor urinary abnormalities, 8 had heavy proteinuria and/or hypertension, and 10 had either died or developed chronic renal failure. Patients presenting with hypertension and/or acute renal insufficiency were more likely to develop chronic renal failure than those with milder presentations. A poor outcome was found to correlate with (1) crescents and segmental lesions affecting a high proportion of glomeruli, (2) the presence of subepithelial electron-dense deposits and (3) the finding of extracellular "lead shot" microparticles. While the clinical presentation is not a good means of predicting the outcome, an acute nephritic onset nevertheless appears to be the best available indication for renal biopsy, which should include both light and electron microscopy in order to increase the precision of prognostication.

Adolescent↗
PubMed1980

Sequential computed tomography scans in acute cerebral infarction.

Sequential computed tomography (CT) scans were obtained in 30 patients with acute cerebral infarction. In some cases, infarction was seen on the scans as early as three to six hours after onset of symptoms. Although small areas of petechial hemorrhagic infarction are not easily detected by currently available equipment, positive contrast enhancement helps locate petechial hemorrhagic infarction, which is usually in the cortical gray matter of the cerebral mantle and the central gray matter of the deep central gray matter. Contrast-enhanced CT scans are a useful method for detecting small infarctions. However, when a CT scan is performed within five days of ictus, contrast enhancement is usually not required.

Acute Disease↗
PubMed1980

Clinicopathological correlations of persistent asymptomatic proteinuria in children.

36 patients with persistent asymptomatic proteinuria were studied over an average period of 2.9 years. All fulfilled the following criteria:persistent proteinuria, normal blood pressure, renal function and pyelogram, no previous nor family history of renal disease. Renal biopsy showed minimal change or diffuse proliferation of glomeruli. The disappearance of proteinuria correlated inversely with the degree of glomerular sclerosis. 12 of 14 children with minimal or no sclerosis lost their proteinuria. In contrast, in 8 of 11 patients with moderate sclerosis and in all 7 patients with marked sclerosis proteinuria persisted. Age over 16 years or heavy proteinuria with or without haematuria were indicative of marked glomerular sclerosis. The thickness of the glomerular basement increased with age. Impairment of renal function occurred in only 1 patient.

Adolescent↗
PubMed1979

[Experimental study of the biliary excretion of antibiotic (cefotiam) in the presence of biliary tract obstruction (author's transl)].

Excretion of a new semisynthetic analogue of cephalosporin, cefotiam (CTM), and cefazolin (CEZ) in bile was investigated in dogs with experimental obstruction of biliary tract. In the control group, peak concentrations of antibiotics in bile after 50 mg/kg intravenous administration were as follows: In CTM administrated groups, 5,302 micrograms/ml at one hour after administration; and in CEZ administrated group, 1,249 micrograms/ml after one hour. The total biliary excretory rates summed to 6 hours after administration of antibiotics were 7.8% in the CTM group, and 2.1% in the CEZ group. On the other hand, in the biliary tract obstruction group, the peak concentration in bile in CTM group was 65.7 micrograms/ml after 1 hours, and in CEZ group, 62.4 micrograms/ml after 2 hours. The total biliary excretory rate in the CTM group was 0.202%, while in the CEZ group 0.12%. The peak concentration and the excretory rate of CTM in bile was four times higher than that of CEZ in the control group. No significant difference was revealed in the peak concentration and the excretory rate in bile between CTM and CEZ in the biliary tract obstruction group.

Animals↗