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Biomedical subjects

S Takebayashi

Publications and source records attributed to S Takebayashi.

At least 181 records · Page 10Linked to original sources
PubMed1987

Morphometrical and functional correlations in benign nephrosclerosis.

To ascertain whether or not vascular lesions lead to renoparenchymal damage through ischemia and to a deterioration of renal function in patients with essential hypertension, correlations among morphometrical findings and renal function were examined in 36 renal biopsies from Japanese patients with a benign nephrosclerosis. The following histological parameters were investigated; glomerular sclerotic index (GS), interstitial volume (IV), measured by the point-counting method, index of arteriolar hyaline change (HC) and intimal thickening (IT), determined by morphometry. Arteries were divided into two groups; those with less than 3 layers of medial smooth muscle cells (SMC less than 3) and those with more than 3 cell layers (SMC greater than or equal to 3). The mean of IT in each size was calculated. IT (SMC less than 3) showed a significant correlation with GS and IV. IT (SMC less than 3), GS and IV significantly correlated with Ccr. On the other hand, IT (SMC greater than or equal to 3) and HC showed no correlation with GS nor Ccr. IT (SMC less than 3) and HC correlated with both blood pressure and the duration of hypertension, and here, IT (SMC greater than or equal to 3) showed no correlation. These data suggest that hyaline change and intimal thickening of small arteries and arterioles (SMC less than 3) are closely related to high blood pressure and that intimal thickening of small arteries rather than hyaline change causes renoparenchymal damage through ischemia and leads to a deterioration of renal function, in those with a benign nephrosclerosis.

Adolescent↗
PubMed1987

Cadmium-induced osteopathy: clinical and autopsy findings of four patients.

Clinical and autopsy findings of 4 patients with chronic cadmium toxication by peroral uptake of cadmium are reported. Cadmium toxication was liable to occur in multiparous postmenopausal women, and it began with proteinuria, glycosuria, lumbago and bone pain. Then, renal function gradually decreased being accompanied with renal tubulopathy. Autopsy disclosed renal tubulopathy, which consisted of the flattening of the epithelium of proximal convoluted tubules at the peripheral portion and the mild thickening of the tubular basement membrane. There was no primary change in the glomerulus and renal interstitium. Osteomalacia was observed in the vertebrae and several other bones. The degree of osteomalacia was in good agreement with chronic renal tubular dysfunction. A decrease of the estrogen content, in addition to renal tubulopathy due to biological saturation of cadmium, seems to play an important role in the pathogenesis of cadmium-induced osteomalacia.

Acidosis, Renal Tubular↗
PubMed1987

Long-term prognosis and prognostic indices of IgA nephropathy in juvenile and in adult Japanese.

For a comparative study of IgA nephropathy occurring in Japanese adolescents and adults, the clinical and histological findings and prognosis (follow-up period; 12 +/- 6 years for children and 10 +/- 5 years for adults) were compared. The subjects studied included 98 children and 86 adults. Development into renal failure occurred in 9 children (9.2%) and in 20 adults (23.3%), (p less than 0.01). The actuarial renal survival rate at year 10 after the onset of glomerulonephritis in children and adults was 95% and 80%, respectively, and at year 20, 82% and 50%, respectively. The prognosis was definitely better in the children and this was attributable to the observation that (1) the glomerular injury at the initial biopsy in children was less extensive than in adults; (2) the frequency of complication with hypertension was lower in children (27.6%) than in adults (41.9%), (p less than 0.05); (3) hypertension was one prognostic indice, even in children, after age 30; (4) after age 40, aging and arteriosclerosis were more contributory than hypertension to the progress of IgA nephropathy; and (5) the quantity of intraglomerular immune deposits and the period of deposition were not related of prognostic indices. Thus, in the long-term prognosis of IgA nephropathy in both children and adults, immunological disorders seem to have little influence while factors such as hypertension, arteriosclerosis and aging play important roles.

Adolescent↗
PubMed1987

Structural-functional correlations in serial biopsies from patients with glomerulonephritis.

It has been proposed that interstitial fibrosis is causally related to a progressive decrease in glomerular filtration rate (GFR), in patients with various renal diseases. We examined the relationship between morphological and functional parameters in 200 samples from 74 patients with mesangial proliferative glomerulonephritis. The glomerular lesion was semiquantitatively analyzed using the Glomerular Index (GI). Interstitial volume (IV) was determined by the point-counting method. Both GI and IV showed a significant negative correlation with Ccr and a positive correlation with serum creatinine. The serial change in IV from the first to the last biopsy (delta IV) showed a weak but significant negative correlation with those in Ccr, over the same period (delta Ccr). The serial change in GI (delta GI) did not correlate with delta Ccr. There was a significant positive correlation between GI and IV and between delta GI and delta IV. These data confirmed a cause-and-effect relationship between interstitial damage and GFR and also showed that the glomerular lesion as well as the interstitial change play an important role in the deterioration of renal function. Thus, the interstitial lesion alone should not be emphasized as a determinant of renal function, as we noted a close correlation between the interstitial and glomerular lesion. Interstitial damage is apparently secondary to the glomerular lesion in patients with mesangial proliferative glomerulonephritis.

Adolescent↗
PubMed1987

Benign persistent asymptomatic proteinuria with incomplete foot process disease in adolescents: a new clinical entity?

A distinct glomerular damage characterized by the following clinical and pathological findings was verified in 20 children with a proteinuria. The clinical features were: 1) glomerular damage was frequent in adolescent males, the male to female ratio being 3:1; 2) the onset was initiated by asymptomatic proteinuria which remitted spontaneously after 3-5 years, with no resulting nephrotic syndrome; 3) there was no apparent cause for the proteinuria such as postural proteinuria, wandering kidney, hypertension or heart disease; 4) in no patient was there a past history of infection or occurrence of other diseases; 5) there were no morphological alterations except for fusion of the epithelial foot processes in about 40% of the glomerular capillary wall; and 6) immunofluorescence microscopy revealed the lack of deposition of immunoglobulins in 20 patients and deposits of complement (C3) or fibrinogen in 4 out of 20. The degree of fusion of epithelial foot processes in incomplete foot process disease was significantly different from that seen in orthostatic proteinuria, thin basement membrane syndrome and minimal change nephrotic syndrome. Compared to the latter, incomplete foot process disease is likely to occur at a higher age with a peak at adolescence, then remit spontaneously without therapy. These events may constitute a distinct entity.

Adolescent↗
PubMed1986

Glomerulonephritis in diabetic patients and its effect on the prognosis.

Renal biopsies were obtained from 164 patients with diabetes mellitus. Their histological changes were evaluated together with clinical findings and prognosis. In 36 patients, various types of glomerulonephritis were complicated: mesangial proliferative glomerulonephritis (17 patients), membranous glomerulonephritis (8), endocapillary proliferative glomerulonephritis (5), membranoproliferative glomerulonephritis (4) and minimal change nephrotic syndrome (2). Superimposed glomerulonephritis was suspected in diabetic patients with a short history of less than 5 years, persistent proteinuria, occasional hematuria and no retinopathy. They may, however, produce little effects on the long-term prognosis of diabetic patients except membranoproliferative glomerulonephritis.

Adolescent↗
PubMed1986

Evaluation and correlation of clinical and histological features of focal segmental glomerulosclerosis.

Clinico-histological features in 32 patients with nephrotic syndrome (NS) due to focal segmental glomerulosclerosis (FSGS) were examined. Thirteen (group A1) were diagnosed as cases of FSGS within 2 years of the onset of NS, and 8 (61%) showed progressive renal dysfunction. Ten (group A2) developed FSGS more than 2 years after the onset of NS and had a favorable prognosis. Nine (group B) differed from groups A1 and A2 in that the remaining nonsclerosed glomeruli showed slight mesangial proliferation. All but 1 patient of group B developed FSGS within 2 years of the onset of NS, and the prognosis was poor. No patient studied showed a transition between groups A and B. In some patients, lipoid nephrosis preceded FSGS, in group A2. Thus, for an accurate prediction of the prognosis, FSGS should be divided into three subclasses, based on clinico-histological features.

Adolescent↗
PubMed1986

[Evaluation of cis-diamminedichloroplatinum (II) in the multidisciplinary treatment of head and neck cancers].

Thirty-eight cases of head and neck cancer treated with cis-diamminedichloroplatinum (II) (CDDP) with/without the combination of Peplomycin (PEP) from 1982 to 1985 were evaluated. The overall response rate was 55%. Eleven of 16 patients who had received no prior therapy obtained CR and 4 patients obtained PR, the response rate being 94%. In contrast, only 6 of 22 patients who had been previously treated achieved CR and PR, the response rate being 27%. According to the pharmacokinetics of CDDP and clinical observation of measurable recurrent tumors after the administration of CDDP alone, it was revealed that the volume of CDDP-sensitive and-resistant cells were balanced at 3 weeks after the injection of CDDP. After this time, CDDP-resistant cells exceeded CDDP-sensitive cells in volume. From viewpoint, in the case of multidisciplinary treatment with CDDP, other therapies should be induced within 3 weeks after CDDP injection.

Adult↗
PubMed1985

Sonographic evaluation of kidneys undergoing dialysis.

Sonograms in 205 patients undergoing dialysis were obtained to evaluate renal features according to duration of treatment. Both length and parenchymal thickness had gradually decreased in kidneys treated for less than 3 years. After the 3rd year of treatment, an apparent increase in the incidence of cysts was seen. Forty-three cases of acquired cystic disease, including 1 case with renal cell carcinoma, were detected. All kidneys had increased cortical echogenicity, with prominence first occurring after 7 years of dialysis. In patients undergoing dialysis for less than 3 years, those with diabetic nephropathy showed fewer changes from normal appearances than patients undergoing dialysis for treatment of glomerulonephritis.

Adolescent↗
PubMed1985

Intravascular bronchioloalveolar tumor. Report of an autopsy case and review of literature.

An autopsy case with intravascular bronchioloalveolar tumor occurring in a 51-year-old Japanese woman is reported. The lungs contained multiple nodules which were characteristic features of this tumor. In addition, the tumor diffusely involved bilateral lower lobes associated with extensive pleural invasion. And the tumor tended to spread along vascular and bronchial trees. No extrathoracic metastasis was noted. Histologically, the nodules showed hypocellular hyaline or myxoid tissue surrounded by peripheral cellular layers. Diffuse consolidated areas were composed of collagenous connective tissue with scattered tumor cells. Factor VIII-related antigen could not be demonstrated in tumor cells, but the negative result was considered to be secondary to antigen deterioration by delayed fixation of the tissue. Electron microscopic examination did not support the alveolar epithelial cell origin, but revealed morphological characteristics of myofibroblasts and endothelial cells. The tumor is presumed to be derived from vascular stem cell with a tendency of endothelial differentiation.

Female↗
PubMed1985

Ultrastructure of microcirculation in renal grafts in patients with acute or chronic rejections.

Using electron microscopy, we studied the renal microcirculation in 31 biopsied specimens from 24 transplants in patients with acute or chronic rejection. Endothelial damage was followed by extensive denudation and platelet attachment, fibrin deposition, focal or whole cytoplasmolysis, rarefaction necrosis of the medial smooth muscle cells, with or without the attachment of inflammatory cells. Medial smooth muscle cells modified by hyperplasia of ergastoplasm, appeared to migrate into the intima and to proliferate there. The endothelium was regenerated with time. Chronic rejection was characterized by "moth-eaten-like" atrophic changes of the medial smooth muscle cells in interlobular arteries with an increase in intercellular spaces with necrotic debris and basement membrane densities. Larger interlobular arteries showed additional mucoid lamellar thickening of the intima, with stenosis. Acute changes in glomerular capillaries included endothelial injury and denudation, thrombotic occlusion and enlargement of subendothelial spaces, apparently due to an increase in permeability. Extensive circumferential mesangial interposition was present in one case of a repeated rejection. Thus, chronicity with various rejections leads to severe luminal narrowing and obstruction in both interlobular arteries and the glomerulus of the grafts.

Endothelium↗
PubMed1985

Significance of adventitial inflammation of the coronary artery in patients with unstable angina: results at autopsy.

A quantitative analysis of adventitial inflammation of the coronary artery with intimal lesions is described in 12 patients who suffered coronary death and had had unstable angina (crescendo angina) at rest (group 1). After autopsy in these patients we examined epon-embedded cross sections by light and electron microscopy, paying particular attention to the adventitia, and compared these results with those in six patients who had had angina but died of noncardiac causes (group 2) and those in 22 patients who did not have angina (group 3). Of the 132 segments from group 1 patients, 39 (30%) were narrowed 76% to 100% by atherosclerotic plaque (group 2, 27%; group 3, 1%), and 23 (17%) had occlusive thrombi. Of the 264 sections (two from each segment) from group 1 that were examined, 98 (37%) (group 2, 15%; group 3, 9%) revealed clustered infiltration of inflammatory cells in the adventitia, half of which were associated with vascular nerve involvement. These findings in the adventitia may be related to the vasospastic component of unstable angina.

Angina Pectoris↗