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Y Nomoto

Publications and source records attributed to Y Nomoto.

At least 127 records · Page 7Linked to original sources
PubMed1990

[A method to predict pulmonary blood flow by nitrous oxide washout curve].

The study was performed to obtain a relationship between the pulmonary blood flow and the tau b (time constant) calculated from multiple-breath nitrous oxide (N2O) washout curve. Elimination of N2O depends on pulmonary blood flow and alveolar ventilation. From the theoretical consideration, tau b can be calculated by the following formula; tau b = Vd[1/Qt-Qs) + 0.47/VA) Vd = N2O volume of distribution in the body Qt = cardiac output, Qs = shunt blood flow VA = alveolar ventilation. Relationship between observed Qt-Qs and observed tau b was admitted to the predicted formula. The method was compared with the thermodilution method in almost simultaneous measurement of the cardiac output. A good correlation was obtained between them (r = 0.87). Washout curve of nitrous oxide can be used for a reliable measurement of pulmonary perfusion.

Adult↗
PubMed1989

Detection of anionic sites and immunoglobulin A deposits in the glomerular capillary walls from patients with IgA nephropathy.

A study of anionic sites in the glomerular basement membrane (GBM) from patients with immunoglobulin A (IgA) nephropathy is described. The relationship between the deposition of IgA and the detection of glomerular extracellular components, i.e., noncollagenous (NC-1) domain of Type IV collagen, in the glomerular capillary walls was examined by double immunofluorescence. Renal biopsy specimens from patients with IgA nephropathy were immersed in polyethyleneimine (PEI) as a cationic probe and then examined by electron microscopy. Renal specimens were also incubated with mouse monoclonal anti-NC-1 domain of Type IV collagen and then stained with fluorescein isothiocyanate (FITC)-labelled goat antimouse Ig antiserum. After these reactions, sections were stained with rhodamine-labelled rabbit antihuman IgA antiserum. GBM subepithelial anionic sites marked by PEI were altered by the deposition of electron-dense deposits (EDD) in patients with IgA nephropathy and there was a significant correlation between the levels of proteinuria and the incidence of EDD in the GBM in such patients. Marked proteinuria was observed in patients who showed loss of anionic sites in the GBM by electron microscopy. By double immunofluorescence, IgA was shown to be focally deposited outside the NC-1 domain of Type IV collagen-detected regions in the same patients. The authors concluded that high levels of proteinuria might be due to alterations of the size barrier and/or anionic sites of GBM in the moderate stage of IgA nephropathy.

Basement Membrane↗
PubMed1989

Pulmonary gas exchange effects by nitroglycerin, dopamine and dobutamine during one-lung ventilation in man.

The effects of nitroglycerin, dopamine and dobutamine on pulmonary gas exchange were determined in 21 adult patients during two-lung and one-lung ventilation. Nitroglycerin, in 1 microgram.kg-1.min-1, decreased cardiac index (CI) and PaO2 during both two- and one-lung ventilation, and increased in Qs/Qt during one-lung ventilation. There were no significant changes in the measured variables during infusion of dopamine, 5 microgram.kg-1.min-1. Dobutamine, 5 microgram.kg-1.min-1, increased CI and PaO2 did not change during two-lung ventilation. During one-lung ventilation, PaO2 increased from (mean value +/- SD) 168 +/- 46 to 201 +/- 52 mmHg (P less than 0.01) with dobutamine infusion. Qs/Qt decreased from 29.2 +/- 7.0 to 26.0 +/- 6.2 per cent (P less than 0.05) without any change in pulmonary vascular resistance index during one-lung ventilation. We conclude that dobutamine has advantages over dopamine and nitroglycerin during one-lung ventilation.

Blood Pressure↗
PubMed1989

Subpopulations of T alpha cells in patients with IgA nephropathy: correlation between T alpha 4 cells and in vitro IgA production.

T cells play important roles in the regulation of the immune system and are divided into subpopulations by various kinds of markers on the membrane surface. T cells with Fc-receptors for IgA are termed T alpha cells, and the properties of this cell population have been revealed in recent years. T alpha cells are increased in patients with IgA nephropathy and possess IgA specific helper activity. T alpha cells consist of two subpopulations, T alpha cells with OKT4 antigen (T alpha 4 cells) and with OKT8 antigen (T alpha 8 cells). To investigate the immunological aberrations in patients with IgA nephropathy, we detected immunoglobulin produced by peripheral blood lymphocytes and enumerated the numbers of T alpha cells (including both T alpha 4 and T alpha 8 cells). The numbers of T alpha 4 cells (but not T alpha 8 cells) and in vitro IgA production were increased in patients with IgA nephropathy (IgA nephropathy, mean 1.9%. Control, mean 0.8%. P = 0.0075). In addition, the numbers of T alpha 4 cells and the amount of IgA in the supernatant of lymphocyte cultures were positively correlated in these patients (P = 0.025. r = 0.3836). From the results in the present study, it was suggested that T alpha 4 cells might be related to immunological aberrations, such as an increase in IgA seen in patients with IgA nephropathy.

Adult↗
PubMed1989

Acute hydrothorax in continuous ambulatory peritoneal dialysis--a collaborative study of 161 centers.

Follow-up studies on 3,195 patients from 161 centers in Japan undergoing continuous ambulatory peritoneal dialysis (CAPD) were performed for 1-104 months to clarify the incidence as well as the clinical features of acute hydrothorax. In these studies, 50 patients (1.6%) developed this complication. Twenty-seven (54%) were men, and 23 (46%) were women, ranging in age from 6 to 79 (average 49) years. The interval between onset of CAPD and hydrothorax ranged from 1 day to 8 years. Four had left-sided, and 2 had bilateral hydrothorax, but the majority (88%) were right-sided. Dyspnea was experienced by 37 of these 50 patients, but the remaining 13 (26%) patients were asymptomatic. Hydrothorax was fully resolved in 27 of them following a brief interruption of CAPD or the combined use of small exchange volumes in a semi-sitting position and pleurodesis with tetracycline or other agents. The remaining 23 patients (46%) were switched to hemodialysis permanently. Despite recurrence, 1 patient continued successfully on CAPD. It was concluded that acute hydrothorax is one important possible complication, although the risk may be low. Constant surveillance is necessary to detect pleural effusions in patients during CAPD.

Acute Disease↗
PubMed1989

Association of IgA nephropathy and myasthenia gravis.

Three patients with IgA nephropathy associated with myasthenia gravis are described. In all 3 cases, myasthenia gravis emerged after the discovery of glomerulonephritis. Myasthenic symptoms were improved by thymectomy in 2 cases, but progression of the renal disease was not improved. Some systemic abnormalities, including immunological aberrations, were observed in these two disorders. It is postulated that T cell abnormalities in IgA nephropathy might be independent of the development of myasthenia gravis.

Adult↗
PubMed1989

Three cases of acute massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD).

Acute hydrothorax is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). We experienced three such cases among patients who started CAPD in our institute between April 1984 and April 1989. One was resolved with pleurodesis using autologous blood. The other two patients were switched to hemodialysis permanently because pleurodesis with autologous blood, tetracycline or OK432 failed. Acute hydrothorax is one important possible complication in CAPD.

Adult↗
PubMed1989

Long-term effect of urokinase therapy in IgA nephropathy.

Effects of urokinase (UK) therapy in patients with moderate to advanced degrees of IgA nephropathy (IgAN) were examined. Twenty-seven patients were treated by "two weeks" UK administration, 14 patients were treated by "consecutive" UK administration and 16 patients were treated by antiplatelet drugs. There were marked improvements in urinary protein concentration, serum creatinine and blood urea nitrogen after UK therapy, especially in patients treated by "consecutive" UK administration which was performed by "single shot" UK injection. Clinical prognosis was favorable in patients treated by UK administration compared with those given antiplatelet treatment. It was concluded that "consecutive" UK administration might be useful for treatment of IgAN with moderate to advanced renal injuries.

Adult↗
PubMed1989

Determination of tissue type plasminogen activator in the glomeruli of patients with IgA nephropathy.

The detection, by immunofluorescence, of tissue type plasminogen activator (t-PA) in the glomeruli of 50 patients with IgA nephropathy was described. Patients with t-PA deposits revealed a higher frequency in the glomerular deposition of fibrin and/or fibrinogen than did patients without t-PA deposits. There also was a distinct relationship between the level of serum t-PA and the degree of renal tissue injury in patients with glomerular t-PA deposits. It was concluded that the deposition of t-PA along with fibrin and/or fibrinogen might reduce the effectiveness of fibrinolysis in the glomeruli of patients with IgA nephropathy.

Adult↗
PubMed1989

Increase of IgA-specific switch T cells in patients with IgA nephropathy.

Enumeration and functional analysis of CD4+ T cells with receptors for the Fc portion of IgA (i.e. T alpha 4 cells) in the peripheral blood of patients with IgA nephropathy, their relatives and age-matched controls were performed to elucidate polyclonal activation of IgA production in this disease. Enumeration of T alpha 4 cells was performed by a fluorescence activated cell sorter, and functional analysis was carried out by separation of T alpha 4 cells, and IgM-, IgA- and IgG-bearing lymphocytes using panning methods followed by cultures of these cells for 7 days with pokeweed mitogen. There was a significant increase in the amount of peripheral blood T alpha 4 cells in patients with IgA nephropathy and their relatives. T alpha 4 cells specifically enhanced the switch of IgM-bearing cells to IgA-bearing cells, and this switch activity was inhibited by addition of human myeloma IgA. It is suggested that T alpha 4 cells may be responsible for polyclonal activation of IgA production in IgA nephropathy.

Adult↗
PubMed1989

[Precordial ST segment depression in acute inferior myocardial infarction: the importance of posterolateral wall infarction].

To determine whether precordial ST segment depression during acute inferior myocardial infarction indicates posterolateral wall ischemia, anatomical predominance of coronary circulation was examined by coronary angiography and evaluated in 43 patients who experienced first acute inferior myocardial infarction. Among patients who underwent intracoronary thrombolysis within six hours from the onset of symptoms, the infarct-related artery was the right coronary artery (RCA) in 35. In addition, their early 12-lead electrocardiographic features were compared with those in eight patients having the infarct-related left circumflex coronary artery (group Cx). Thirty-five patients with RCA obstruction were categorized in four groups: Four patients with left predominant type (group L), 10 with balanced type (group B), five with right super-predominant type (group SR), and 16 with right intermediate type (group RI). Seventeen of the 21 patients in groups SR and RI demonstrated precordial ST segment depression, whereas it was present in only six of the 14 patients in groups L and B (p less than 0.05). Of the 29 patients in groups SR, Cx and RI, total ST segment depression in leads V1 through V4 (sigma ST) was greater in the 14 patients in groups L and B (p less than 0.05) than in other groups. Furthermore, in these 29, all patients in groups SR and Cx had greater sigma ST than did the patients in group RI (p less than 0.05). There was no significant difference in sigma ST between groups SR and Cx. Precordial ST segment depression did not correlate with concomitant disease of the left anterior descending artery and was not a mirror image of ST segment elevation in inferior leads. On thallium-201 scintigraphy, additional perfusion defects of the posterolateral wall were present in all eight patients in group Cx and in ten of the 21 patients in groups SR and RI. Thus, precordial ST segment depression during acute inferior myocardial infarction seemed to be affected by the pattern of coronary circulation. It was concluded that this ST depression represents more extensive involvement of the posterolateral wall in patients with right predominant coronary circulation as well as in those with left circumflex artery obstruction.

Adult↗
PubMed1989

Rapidly progressive glomerulonephritis undetected by routine school urinalysis: a case report.

A twelve year old girl with rapidly progressive glomerulonephritis (RPGN) is reported. First symptoms of renal failure developed in August 1987 just five months after a routine school urinalysis which detected no abnormalities. The patient developed end stage renal failure within 2 months of onset. Continuous ambulatory peritoneal dialysis (CAPD) was introduced to manage the renal failure, and open renal biopsy was performed simultaneously in order to elucidate the underlying renal disease in this patient. Microscopic examination of the biopsy specimen demonstrated marked formation of crescents in about 90% of the glomeruli, and some of the glomeruli were already sclerotic. Granular depositions of IgG(trace), IgA(1+), IgM(3+), properdine(3+), Clq(3+) and C3(3+) were observed by immunofluorescence staining. A definite diagnosis of rapidly progressive glomerulonephritis was made as the cause of renal failure in this patient. It was suggested that open renal biopsy is useful in diagnosing the underlying kidney disease of end stage renal failure in cases where the clinical course is relatively short.

Child↗
PubMed1989

Continuous ambulatory peritoneal dialysis in a diabetic patient with renal insufficiency and ventricular aneurysm.

A diabetic patient with renal insufficiency and a giant ventricular aneurysm was treated by continuous ambulatory peritoneal dialysis (CAPD). No apparent exacerbation of the patient's cardiovascular function was observed after starting CAPD therapy, although his ejection fraction remained low and his angina attacks persisted. It is suggested that CAPD therapy has no deleterious effects on the cardiovascular system of patients with ventricular aneurysms, and that the benefits outweigh the risks.

Angina Pectoris↗
PubMed1989

Short term effect of lactulose therapy in patients with chronic renal failure.

Effect of lactulose therapy was examined in patients with chronic renal failure (CRF) prior to hemodialysis (HD). Twenty three patients were included in this study. Ten out of the 23 patients were continuously treated with lactulose at a dosage of 18 g/day for eight weeks. However, 12 out of the 23 patients dropped out because of nausea and/or watery diarrhea during the therapy. One patient was transfered to HD one month after the beginning of lactulose therapy. Ratios of guanidinosuccinic acid (GSA) in plasma after eight weeks were significantly lower than those before treatment. Cessation of treatment was significantly related to worsening of the GSA (p less than 0.01). It seems that lactulose therapy could be useful in the treatment of CRF if compliance of the therapy is maintained after reducing some adverse effects.

Clinical Trials as Topic↗
PubMed1989

Glomerular T cell and monocyte populations in patients with IgA nephropathy.

Renal tissues from 19 patients with the minimal or slight stage of IgA nephropathy were examined for evidence of glomerular T cell or monocyte infiltration using monoclonal antibodies to identify T cells (OKT3, OKT11), T cell subsets (OKT4, OKT8), and monocytes and null cells (OKM1) by indirect immunofluorescence. Renal tissues from 12 patients at the same stage of mesangial proliferative glomerulonephritis without IgA deposition were also investigated by these procedures. Light microscopic examination of the same renal tissues was also performed. Reactive glomerular mononuclear cells were found to be numerous in patients with IgA nephropathy. The most prominent type of glomerular cells was OKT8 positive. T cell subsets and OKM1 positive cells in glomeruli from patients with IgA nephropathy were significantly increased as compared to those from patients with mesangial proliferative glomerulonephritis. Focal segmental proliferation of mesangial cells was observed in glomeruli which showed an accumulation of OKT8 positive cells. It is concluded that the immuno-regulatory mechanism involving T cells and/or monocytes might be one of the exacerbating factors in patients with IgA nephropathy.

Glomerulonephritis, IGA↗
PubMed1988

Detection of glomerular sialic acids in patients with diabetic nephropathy.

A study on immunofluorescence of sialic acids in glomeruli from patients with diabetic nephropathy is described. Measurement of sialic acid in sera from 25 patients with diabetes mellitus was also performed. Renal biopsy specimens from 12 patients with diabetic nephropathy were stained with FITC-labeled antihuman IgG antiserum and rhodamine-labeled Triticum vulgaris (WGA) or Limulus polyphemus (LPA). These specimens were also stained with such reagents after treatment with neuraminidase, trypsin or citrate buffer. Both deposition of IgG and binding of WGA in the glomerular capillary walls were observed in all patients with diabetic nephropathy. The binding of WGA in the glomerular capillary walls in diabetic nephropathy was significantly increased compared with that in four normal renal tissues. However, the binding of LPA was hardly observed in the glomerular capillary walls of patients with diabetic nephropathy. The binding of WGA in the glomeruli was markedly decreased after treatment with neuraminidase although it was hardly decreased after treatment with trypsin or citrate buffer. The levels of sialic acid in sera from patients with diabetic nephropathy were markedly increased. It is suggested that accumulated substances in the glomerular capillary walls with an affinity for WGA are mainly composed of N-acetyl glucosamine and/or N-acetyl neuraminic acid in patients with diabetic nephropathy.

Adult↗
PubMed1988

Levels of circulating IgA immune complexes after gluten-rich diet in patients with IgA nephropathy.

Measurement of IgA circulating immune complexes (IgA-CIC) in sera from patients with IgA nephropathy after a gluten-poor diet, an unrestricted diet and a gluten-rich diet is described. High levels of IgA-CIC in sera were detected in patients after these diets. However, the levels of IgA-CIC in sera 2 weeks after the gluten-rich diet were not significantly increased compared with those after the other diets. It is suggested that, for a short duration, the gluten-rich diet might not increase the levels of IgA-CIC in sera from Japanese patients with IgA nephropathy.

Adolescent↗