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Biomedical subjects

Y Nakamoto

Publications and source records attributed to Y Nakamoto.

At least 109 records · Page 6Linked to original sources
PubMed1992

Goodpasture's syndrome: a report of an autopsy case and a review of Japanese cases.

A 75-yr-old man was admitted because of acute renal failure. On the 9th hospital day, pulmonary hemorrhage occurred. He was treated with a bolus dose of methylprednisolone and plasma exchange, but died from respiratory failure on the 16th hospital day. Autopsy findings demonstrated marked intraalveolar hemorrhage and crescentic glomerulonephritis. Linear depositions of IgG along both alveolar and glomerular basement membranes (GBM) were shown by direct immunofluorescent studies. Circulating anti-GBM antibodies were demonstrated by indirect immunofluorescent techniques. This is a confirmatory case of Goodpasture's syndrome, which is rare in Japan. A review of the Japanese literature revealed some characteristics of Japanese cases.

Aged↗
PubMed1992

48, XXYY syndrome associated with ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia.

A 56-yr-old man with hypogonadism, gynecomastia, and mental retardation was evaluated for chromosome constitution and thrombocytopenia. Chromosomal analysis demonstrated the mosaicism of 48, XXYY and 47, XXY in the peripheral lymphocytes. Twenty out of twenty-five cells were 48, XXYY karyotype and the remaining five were 47, XXY karyotype. Thrombocytopenia was the EDTA-dependent pseudothrombocytopenia type 1 (platelet agglutination). Serological examination suggests that the platelet agglutinin belongs to IgM-kappa type. The present case exhibited both EDTA-dependent pseudothrombocytopenia and the 48, XXYY syndrome. Although this combination may have occurred purely by change, the possibility of whether or not the mosaicism of lymphocytes produces platelet agglutinin remains to be clarified.

Edetic Acid↗
PubMed1992

Acute renal failure following hypokalemic rhabdomyolysis due to chronic glycyrrhizic acid administration.

A 72-year-old man developed acute renal failure (ARF) following severe hypokalemic rhabdomyolysis. The hypokalemia was due to chronic glycyrrhizin (glycyrrhizic acid) administration. Although glycyrrhizin-induced hypokalemic rhabdomyolysis has been occasionally reported, the association of this type of rhabdomyolysis with ARF has not been described. In the present case, there was a sensitivity to glycyrrhizin the preceding renal insufficiency, and dehydration which was thought to have contributed to ARF. It should be recognized that elderly patients with such predisposing factors may be susceptible to a rapid deterioration of renal function after glycyrrhizin-induced hypokalemic rhabdomyolysis.

Acute Kidney Injury↗
PubMed1992

[Cushing's syndrome found during long-term glucocorticoid treatment of rheumatoid arthritis in an elderly woman].

A 69-year-old female patient had been treated with glucocorticoid for eight years because of rheumatoid arthritis. She showed characteristic Cushingoid features such as central obesity, moon face, and fragility of skin and vessels. She was disabled because of spinal compression fracture and muscle weakness. The blood pressure was 186/100 mmHg and the laboratory tests revealed serum K: 2.8 mEq/l, WBC: 15, 510/mm3, total cholesterol: 310 mg/dl. These suggested that she had iatrogenic Cushing's syndrome. After discontinuation of glucocorticoid, however, the serum cortisol level remained high. This fact prompted us to conduct further examinations for Cushing's syndrome. Oral dexamethasone administration did not suppress the plasma cortisol level and a left adrenal adenoma was found on abdominal CT scan. Because of the presence of bleeding diathesis, operation for adenoma was contraindicated. Though we tried to treat her with metyrapone, trilostane or opeprim (OP'-DDD), we had to abandon specific treatment because of severe side effects such as acute adrenal dysfunction and gastrointestinal problems. Decrease in the endogenous cortisol level after metyrapone treatment caused exacerbation of symptoms of rheumatoid arthritis. This is a peculiar case in which the long-term administration of glucocorticoid for rheumatoid arthritis might have concealed Cushing's syndrome, and conversely the increased intrinsic adrenal steroid hormone might have suppressed the activity of the rheumatoid arthritis.

Aged↗
PubMed1992

Circumferential mesangial interposition: a form of mesangiolysis.

A wide variety of glomerular lesions express circumferential mesangial interposition (CMI). The pathomorphogenesis of CMI involves low-grade mesangiolysis and subsequent passive dislocation of mesangial cells towards the lateral wall of glomerular capillaries through a high hydraulic pressure of blood flow penetrating the lytic mesangium. This is in contrast to the previous theories which advocate an active movement of mesangial cells. Moreover, circumferential mesangial interposition can disappear spontaneously or after treatment, suggesting that mesangial cells may return to the original site with their inherent contractility after the insults are removed, in order to restore handicapped filtering surfaces. But the precise mechanisms of its regression will be a subject for future investigation.

Capillaries↗
PubMed1992

Glomerular deposition of complex-forming glycoprotein heterogenous in charge (protein HC) in IgA nephropathy.

IgA immune complexes and polymeric IgA are presumed to play important roles in the development and progression of IgA nephropathy. Complex-forming glycoprotein heterogenous in charge (protein HC), being inhibitors of neutrophilic chemotaxis, has been reported as binding to IgA. As a working hypothesis it was assumed that complexes of protein HC and IgA are present in glomeruli from IgA nephropathy patient in stable state. In this study, we examined the glomerular deposition of protein HC in 40 patients with IgA nephropathy and in 10 patients with non-IgA nephropathy. We used highly specific antibody against protein HC, that does not cross-react with alpha-1-microglobulin. An immunofluorescent study revealed that 10 out of the 40 patients (25%) showed an intensity of 1+, 16 (40%) showed weak positive (+/-), and the other 14 (35%) were negative. There was no deposition of protein HC in non-IgA nephropathy patients. Histopathological analysis demonstrated a significant correlation between the intensity of glomerular-deposited protein HC and pathological activity (p less than 0.005); the latter was defined as having either crescents in more than 15% of the remaining glomeruli (excluding global sclerotic glomeruli), or segmental necrosis or sclerosis in more than 30% of the remaining glomeruli. A significant correlation was observed between pathological activity and the intensity of deposited IgG, IgA and IgM (p = 0.01), and lambda chain (p less than 0.005). Considering anti-inflammatory activity of protein HC, these results suggest that protein HC cannot protect sufficiently acute inflammation or tissue damages due to co-deposited IgG and IgM and/or other factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Renal and electrolyte disturbances in chronic myelogenous leukemia].

Renal and electrolyte disturbances in 91 patients with chronic myelogenous leukemia (CML) were analyzed over a period of these twenty years. At diagnosis, renal and electrolytes were studied in 72 patients including 65 in chronic cases, 5 in accelerated phase and 2 in blastic crisis. There were 8 cases of hypocalcemia among 62 patients and 5 cases of hyperphosphatemia among 48 patients. The cases of hyperphosphatemia and renal dysfunction had short median survival. There were no significant differences of renal and electrolyte disturbances between before and after chemotherapy. Various electrolyte disturbances, that is, hyponatremia, hypo-, hyperkalemia, hypocalcemia, hypo-, hyperphosphatemia, were found in the blastic crisis of CML. In the last admission, renal dysfunction and various electrolyte disturbances were present in almost half of the cases. Pathological studies were performed in 18 autopsy cases. Acute tubular insufficiency or necrosis, hypercalcemic nephropathy, and renal infiltration of leukemic cells were recognized in patients who had renal dysfunction.

Adolescent↗
PubMed1992

[B-cell chronic lymphocytic leukemia complicated by autoimmune thrombocytopenic purpura].

A 74-year-old Japanese male was admitted because of anemia. Hepatosplenomegaly, lymphoadenopathy, and purpura were not found. The laboratory data on admission revealed that the white-cell count was 9,400/microliters, the hemoglobin 11.1 g/dl, and the platelet count 17,000/microliters. Platelet-associated IgG was 794.2 ng/10(7) cells. The patient was diagnosed as having autoimmune thrombocytopenic purpura (ATP) at this time. He was treated with prednisolone, but his thrombocytopenia not improve. In addition to prednisolone, azathioprine was given to him. During the course of treatment, leukocytosis gradually appeared and the white-cell count reached more than 30,000/microliters with over 70% lymphocytes. A bone marrow aspiration revealed 70% of small lymphocytes, and surface marker analysis showed that CD19 and HLA-DR were positive on these lymphocytes. Southern blotting analysis demonstrated rearrangements of JH and JK. He was finally diagnosed as B-CLL complicated by ATP. One month after the azathioprine administration, the platelet count increased more than 30,000/microliters and the white-cell count decreased less than 10,000/microliters. About 2% of patients with CLL are known to be complicated by ATP. To our knowledge, the present case is the first case of B-CLL complicated by ATP in Japan.

Aged↗
PubMed1991

Specific antibodies against the stress-inducible 72-kDa protein, a member of the heat-shock protein hsp70, in healthy human subjects.

1. On Western blot analysis, serum IgG from a healthy human subject reacted with a stress-induced protein, having an apparent molecular mass of 70 kDa, from PC12 cells. 2. This serum IgG also reacted with hsp70 (70-kDa heat-shock protein) purified from the bovine brain. 3. In 5 out of 34 healthy human subjects, IgG antibodies against hsp70 were detected. 4. These antibodies were directed against the stress-inducible 72-kDa protein, but did not cross-react with the constitutive 73-kDa protein.

Adult↗
PubMed1991

Biochemical characterization of contractile proteins of rat cultured mesangial cells.

We examined characteristics of contractile proteins of rat cultured mesangial cells. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that actomyosin was a major protein component in the extract of mesangial cells. By Western blot, tropomyosin, caldesmon, alpha-actinin, and vinculin were recognized in mesangial cells. The molecular masses of alpha-actinin and vinculin were the same as aortic smooth muscle. Mesangial cells contained five tropomyosin isoforms: TM-1, -2, -3, -4, and -5. TM-1 was present as a major isoform in mesangial cells, and it had an immunological cross reactivity with beta-tropomyosin of aortic smooth muscle. On the other hand, the molecular mass of caldesmon was similar to dermal fibroblasts, and differed from aortic smooth muscle. Immunofluorescent studies showed that the staining patterns of tropomyosin and caldesmon between cultured mesangial cells and cultured vascular smooth muscle cells were somewhat different. From these results, we conclude that mesangial cells abound in contractile proteins, and that the compositions of these proteins are similar to those of aortic smooth muscle with minor differences. Thus, this study appears to biochemically support a hypothesis that mesangial cells are derived from vascular smooth muscle cells, but with a minor modification in their evolution.

Actomyosin↗
PubMed1991

Inappropriate secretion of antidiuretic hormone in isolated adrenocorticotropin deficiency.

A 62-year-old man was admitted because of nausea and vomiting. Severe hyponatremia with renal sodium loss was found. Endocrinological studies revealed that the patient had isolated adrenocorticotropin (ACTH) deficiency and secondary adrenocortical insufficiency. Furthermore, an inappropriate secretion of antidiuretic hormone (ADH) in relation to the low plasma osmolality was observed at an early stage of hyponatremia. Hydrocortisone therapy effectively corrected his hyponatremia. Following the correction of hyponatremia, the value of free water clearance increased and the level of the plasma ADH decreased. Thus, the present case indicates that ACTH deficiency can cause the syndrome of inappropriate secretion of ADH.

Adrenocorticotropic Hormone↗
PubMed1991

Increases in circulating level of platelet-activating factor lag behind transient neutropenia during hemodialysis with cuprophane membranes.

The significance of the level of circulating 1-O-hexadecyl-2-acetyl-sn-glycero-3-phosphorylcholine (C16-PAF, platelet-activating factor) in relation to transient neutropenia during hemodialysis with cuprophane membranes was examined. The neutrophil count was transiently and significantly decreased at 30 min after the start of hemodialysis, and it then gradually recovered during the period from 60 to 240 min after the start. Mirror image changes were observed in the circulating levels of C3a and C5a, suggesting that the decrease in the neutrophil count was triggered by activation of the complement factors. The circulating level of C16-PAF, although being similar to the basal level after 30 min of hemodialysis, was significantly increased after 60 and 120 min of hemodialysis. These data indicate that the increase in the circulating PAF level is not a direct cause of the transient decrease in the neutrophil count, but may be the result of activated neutrophils during hemodialysis with cuprophane membranes.

Adult↗
PubMed1991

[Electrolyte abnormality and renal insufficiency in malignant lymphoma; clinical and pathological analysis in 123 cases].

The clinical studies about the electrolyte abnormality (EA) in patients with malignant lymphoma (ML) are rarely reported. We analyzed the EA and renal insufficiency in 123 patients with ML between June. 1976 and Jan. 1989; 8 patients with Hodgkin's disease, and 115 patients with non-Hodgkin's lymphoma (NHL). Before treatment, the incidence of the EA was 24.2% and hypercalcemia, hypocalcemia, and hyperkalemia were predominant. After treatment it became to 74.7% and the number of hyponatremia and hypokalemia increased. The incidence of proteinuria and renal insufficiency (serum creatinine above 1.5 mg/dl), were 7.3% and 2.4% before treatment, and became to 26.8% and 26.8% after treatment, respectively. There was a significant difference between two groups with and without the EA before treatment as for serum lactate dehydrogenase (LDH) levels (p less than 0.01), clinical stages (p less than 0.05) and the incidence of bone marrow involvement (p less than 0.01). In 34 autopsied cases, 3 cases showed massive renal involvement and about a half of cases showed various renal changes. The EA before treatment was caused by extrarenal factors, because the incidence of proteinuria and renal insufficiency were almost same to healthy controls. And renal factors play an important role on the E.A after treatment. Above results suggest that the EA before treatment indicates the progress of malignant lymphoma and the EA after treatment means not only the progress of the disease but also therapy-related renal damages.

Adult↗
PubMed1991

[Relation of mass screening blood pressure to usual 24-hour working day blood pressure variation and left ventricular hypertrophy].

Fifty-three regularly employed hypertensive men (HT group) aged 38 to 68 years, whose blood pressure measured at a health evaluation clinic was systolic blood pressure (SBP) greater than or equal to 160 mmHg and/or diastolic pressure (DBP) greater than or equal to 95, and 21 age-matched normal controls (NC group), whose SBP was less than 140 and DBP was less than 90 had their blood pressure monitored over 24 hours during a usual working day. Age and clinical pressure were 53.1 +/- 7.1 years (mean +/- SD) and 147 +/- 18/97 +/- 10 mmHg (SBP/DBP) in the HT group, and 52.7 +/- 8.9 and 117 +/- 8/78 +/- 7 in the NC group. In the HT group, blood pressure during work (146/96 mmHg) was similar to clinical blood pressure, while blood pressure at home (135/89 mmHg) was considerably lower than clinic measured values. In contrast, blood pressure variabilities in the NC group during non-sleep hours were less, and clinical measurement was lower than that at home (122/80 mmHg), and during work (126/82 mmHg). For those examined by echocardiogram (46 in HT and 21 in NC), end-diastolic left ventricular wall thickness (LVT), and left ventricular mass index (LVMI) correlated most strongly with pressure during work by partial correlation analysis with age as a covariant (LVT:: SBP: r = 0.47, DBP: r = 0.53 both p less than 0.001, and LVMI:: SBP: r = 0.29, DBP: r = 0.25 both p less than 0.25). Clinical blood pressure as well as blood pressure at home and during sleep correlated significantly with LVT. These findings suggest that the blood pressure measurements obtained at a mass screening clinic, although infrequent, have important implications in relation to cardiac organ damage and for providing an estimate of blood pressure during work for hypertensives.

Adult↗
PubMed1990

Enhanced blood pressure response to regular daily stress in urban hypertensive men.

Twenty-eight urban untreated hypertensive men (mean age: 54 years; systolic (SBP)/diastolic (DBP) blood pressure at clinic: 148/96 mmHg] and 26 age- and sex-matched normal controls (54 years, 118/78 mmHg) were examined during normal daily activities by ambulatory blood pressure monitoring. When compared with home blood pressures, clinic blood pressures were 8/10% (SBP/DBP) higher in the hypertensives, but 1/3% lower in the normotensives. The values were significantly different for both groups (P less than 0.01 for SBP; P less than 0.001 for DBP). In contrast, the blood pressures fell in a similar manner in both groups during sleep. On working days, the blood pressures during work were 10/9% higher than the corresponding home blood pressures in the hypertensives and only 3/3% higher in the normotensives. These differences were significant (P less than 0.01 for both SBP and DBP). The results show that the blood pressures of hypertensives were hyperreactive to casual daily stress. In the normotensives, left ventricular wall thickness determined by echocardiography was correlated significantly with the blood pressures during work (r = 0.5, P less than 0.05 for SBP and DBP) and at home (r = 0.4, P less than 0.05 for SBP).

Adult↗