Localization of 25-hydroxyvitamin D3-1 alpha-hydroxylase activity in the mammalian kidney.
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Biomedical subjects
Publications and source records attributed to T Akiba.
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Ten patients with renal failure not on dialysis were subjected to our study to evaluate the effect of 1 alpha (OH)D3 on calcium metabolism and its influence on renal function. The results suggest the possibility that 1 alpha (OH)D3 might be effective in bone disease due to secondary hyperparathyroidism. On the other hand, 1 alpha (OH)D3 depressed creatinine clearance without any increase of Ca, Ca x P product or PRA. 1 alpha (OH)D3 is to be prescribed to patients not on dialysis only with careful attention to the dosage and the duration, and frequent observation of renal function is necessary.
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Tuberculosis associated with dialysis was studied at the Renal Unit of the Tokyo Medical and Dental University and Yokosuka Mutual Aid Hospital Kidney Center, in both of which the treatments of chronic renal failure are the same. There are 12 tuberculosis patients out of 367 patients on maintenance hemodialysis from January 1967 to December 1976, an incidence of 3.3%. This was 6-16 times greater than that in the general population of this country according to yearly statistics. The characteristics of dialysis-associated tuberculosis include a high incidence of miliary tuberculosis, especially in aged patients and difficulty in establishing the diagnosis before death. Clinical features which are helpful in the early diagnosis are intermittent high fever of unknown origin, weight loss, anorexia, abnormalities of the central nervous system, erythrocyte sedimentation rate over 100 mm/h, leukocytosis and high value of the C-reactive protein. With the increasing number of dialysis patients, an increase of dialysis-associated tuberculosis is expected and this will be one of the major problems of dialysis patients in future.
Severe combined immunodeficiency disease with adenosine deaminase deficiency was reported of a 1-year-2-month-old boy, who showed clinical picture of pulmonary candidiasis. The serum immunoglobulin level and absolute lymphocyte count were markedly diminished. But immunological study revealed both T- and B-cell surface markers on the peripheral lymphocytes, in spite of complete deficiency of both systems.
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The thermosensitive kanamycin (KM) resistance factor, R(KM)(t), and a nonthermosensitive multiple-drug resistance factor, R(100), were simultaneously introduced into Escherichia coli and Salmonella typhimurium. The temperature sensitivity of both R factors remained unchanged as long as they replicated independently. Under certain conditions, however, a new thermosensitive R factor harboring resistance markers for kanamycin, streptomycin (SM), and sulfanilamide (SA) was obtained by recombination between the R(KM)(t) and R(100) factors. R factors carrying resistance markers for KM and SA, or for SM and SA, were obtained from the recombinant R(KM SA SM)(t) by spontaneous segregation. Though the R(100) factor has been known as an fi(+) (positive for F-mediated fertility inhibition of its host) type and it does not restrict any coexisting phages, the thermosensitive recombinants of R(100) with R(KM)(t) and their segregants were found to be fi(-) and to restrict the replication of all T-even phages, as does the R(KM)(t) factor. Double infection immunity was not observed between the R(KM)(t) and R(100) factors.
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A strain of Proteus vulgaris isolated from the urinary tract of a patient with postoperative pyelonephritis and resistant to sulfonamide, streptomycin, tetracycline, and kanamycin (KM) was found to transfer only KM resistance by cell-to-cell conjugation. The genetic determinant controlling the transferable KM resistance was considered to be an R factor and was designated R (KM). Successive transfer of KM resistance was demonstrated also from Escherichia coli 20S0, which received the R (KM) factor, to other substrains of E. coli K-12 or Salmonella typhimurium LT-2. The transfer of the R (KM) factor was strongly affected by the temperature at which the mating culture was kept. The transfer frequency of R (KM) at 25 C was about 10(5) times higher than at 37 C. The R (KM) factor was spontaneously eliminated from the host bacterial cells when P. vulgaris was cultured at 42 C, but no elimination occurred at 25 C. This elimination of the R (KM) factor at elevated temperature was also observed when the R (KM) factor infected E. coli and S. typhimurium. On the other hand, a normal R factor could not be eliminated from the same E. coli host strain by cultivation at the higher temperature. We consider the thermosensitive transfer and the spontaneous elimination of the R (KM) factor at higher temperature to depend upon thermosensitive replication of the R (KM) factor.
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The body surface isopotential T map was analyzed to detect right ventricular volume and pressure overloads in 25 patients with secundum atrial septal defect. Three patterns were distinguished: a T map resembling normal (type A, n = 9); that with an isolated negative area in a positive area (type B, n = 11); and that with rightward movement of maximum (type C, n = 5). Right ventricular end-diastolic volumes in types B (161 +/- 19% of normal; %N) and C (175 +/- 40% N) were significantly (p < 0.01) greater than those in controls (100 +/- 9% N) and type A (113 +/- 18% N). Right ventricular systolic pressure in type C (48 +/- 11 mmHg) was significantly (p < 0.01) higher than those in the controls (30 +/- 5 mmHg), type A (31 +/- 4 mmHg), or type B (34 +/- 5 mmHg). These results suggest that the patients with type B have right ventricular volume overload and those with type C have both volume and pressure overloads.