Percutaneous transluminal laser-assisted angioplasty of a renal artery stenosis was performed in a 16-year-old woman with renovascular hypertension. The stenotic portion of the renal artery was predilated by delivering Nd-YAG laser energy to the terminal tip of a laser catheter. Although the luminal diameter did not increase sufficiently with laser angioplasty alone, it allowed passage of the balloon catheter and subsequent successful balloon angioplasty. Immediately after dilatation, the patient's blood pressure fell to normal, and plasma renin activity decreased. There were no serious complications. Thermal laser angioplasty seems to be an effective adjunct technique for the treatment of severe renal artery stenosis which does not allow initial passage of a balloon catheter.

Adolescent↗

PubMedDate not supplied

Elevated plasma catecholamines in hypertensives with primary glomerular diseases.

Supine plasma concentration of norepinephrine (PNE), epinephrine (PE), and aldosterone (PA), plasma renin activity (PRA), and blood volume (BV) were measured in 25 normotensive and 11 hypertensive patients with biopsy-proven glomerulonephritis who had serum creatinine concentrations of less than 1.6 mg/dl, and in 20 normotensive control subjects. PNE and PE were measured according to the trihydroxyindol method using high pressure liquid chromatography. Renal clearances of p-aminohippurate (CPAH) and endogenous creatinine (Ccr) were also determined. Age, BV, and 24-hour urinary excretion of sodium were not significantly different in the three groups. Although all the measured variables were comparable between the control subjects and the normotensive nephritic patients, blood pressure, PNE, PE, PRA, and PA were significantly higher and CPAH and Ccr were significantly lower in the hypertensive nephritic patients than in the normotensive nephritic patients or the control subjects. In the pooled nephritic patients, mean blood pressure was significantly correlated with PNE (r = 0.76, p less than 0.001), PE (r = 0.34, p less than 0.05), PRA (r = 0.33, p less than 0.05), PA (r = 0.40, p less than 0.05) and CPAH (r = -0.51, p less than 0.01). Highly significant positive correlation was also observed between PNE and systolic pressure (r = 0.63, p less than 0.001) or diastolic blood pressure (r = 0.78, p less than 0.001). The results suggest that deterioration of renal function is an important factor in the development of hypertension even in non-azotemic patients with glomerulonephritis, and that increased activities of the sympathetic nervous system and the renin-aldosterone system participate, in part, in elevating blood pressure in the hypertensive nephritic patients. Mechanisms involved in the elevation of plasma concentrations of catecholamines and renal effects on the plasma catecholamines remain to be elucidated.

Adult↗

PubMedDate not supplied

A case of pyrazinamide-associated myoglobinuric renal failure.

A 50-year-old man developed myoglobinuric renal failure after taking pyrazinamide. Both serum and urine myoglobin levels were elevated and tubulo-interstitial nephropathy was demonstrated on renal biopsy. After pyrazinamide was discontinued, the myoglobin concentrations were normalized and his renal function ameliorated. The rhabdomyolysis was considered to be caused by pyrazinamide. To our knowledge, this is the first reported case of rhabdomyolysis associated with pyrazinamide.

Acute Kidney Injury↗

PubMedDate not supplied

Enhanced expression of translation factor mRNAs in hepatocellular carcinoma.

Several studies have demonstrated elevated expression of translation factor mRNAs in malignant tissues. In this study, using primary human hepatocellular carcinoma (HCC) tissues, we examined gene expression of translation factors, including 2 eukaryotic initiation factors (eIFs-4A1, -4E), 4 elongation factors (eEFs-1 alpha, -1 gamma, -1 delta, and -2) and 10 ribosomal proteins (Rps P1, P2, S10, L35, L5, L39, L9, L6, S3a and S17), whose mRNA expression has never been examined in HCC. Our results demonstrated that all the mRNAs examined were up-regulated in HCC tissues. Among 7 HCC tissues of different histological grades, the expression of these mRNAs remained at basal levels in a well to moderately differentiated (W/M-) HCC, was coordinately up-regulated in moderately differentiated (M-) HCCs. In moderately to poorly differentiated (M/P-) HCCs, the expression of eEFs-1 gamma, -1 delta, -2, Rps P0 and L9 mRNAs was further up-regulated along with the histological grading. These results therefore suggest that coordination and specific activation of translation factor genes might be involved in the process of liver carcinogenesis.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

Serotonin metabolism and its enzymic activities in joint diseases.

In order to clearly understand the synovial metabolic pathway of 5-HT, which is interesting as an inflammatory mediator and a pain producing substance, in patients with RA and with OA, determinations were made of 5-HIAA levels and of the activities of MAO-A and MAO-B, in the synovial fluid and the blood. With respect to 5-HIAA levels, there was no significant difference in the synovial levels between patients with RA and those with OA, although higher values were obtained in the plasma of patients with RA. A correlation was found between synovial and plasma levels in both diseases. In patients with RA, 5-HIAA levels tended to increase in both levels of the synovial fluid and the plasma in higher stages. The activities of MAO-A and MAO-B in the synovial fluid were found to be lower in patients with RA than in those with OA. The MAO-B activity in the synovial fluid increased in higher stages and correlated with ESR in patients with RA. In patients with RA the efflux of 5-HIAA from the synovial fluid was reduced. No remarkable changes occurred in the permeability of 5-HIAA. The ability to inactivate 5-HT was lower than in OA. The determination of synovial MAO-B activity is useful in diagnosing the status of the patient with respect to rheumatoid arthritis.

Arthritis, Rheumatoid↗

PubMedDate not supplied

The double balloon cannula in the treatment of ruptured abdominal aneurysms.

Two cases of ruptured abdominal aneurysm were successfully treated, using the double balloon cannula, which was devised in our surgical department. After cross-clamping of the descending thoracic aorta and both common iliac arteries, a small incision was made in the aneurysm and the cannula was inserted through this incision into the lumen of the abdominal aorta and positioned at the proximal end of the aneurysm. Then the double balloon was inflated, blocking the blood flow just above the aneurysm. The aneurysm was incised, and grafting was performed, in the usual manner, in a bloodless surgical field. The double balloon cannula was beneficial not only in preventing massive blood loss during surgery, but also in maintaining the blood supply to various abdominal organs.

Aorta, Abdominal↗

PubMedDate not supplied

Long-term results of omental transplantation for chronic occlusive arterial diseases.

Twenty cases of thromboangitis obliterans (21 limbs) and five cases of atherosclerosis obliterans (five limbs) were treated with omental transplantation. Angiographic findings in these patients showed poor distal run-off, and direct reconstructive surgery was not indicated. Follow-up studies were conducted for an average of five years and one month (3 mos to 9 yrs. and 8 mos.). The long-term follow-up of 19 cases with thromboangitis obliterans (TAO) (20 limbs) revealed excellent results in 62%, good results in 19% and poor results in 19%. The results of the five cases with atherosclerosis obliterans (ASO) (5 limbs) were good in 20% and poor in 80%. Long-term results of omental transplantation show it to be remarkably effective in treating TAO but not ASO.

Adult↗

PubMedDate not supplied

Treatment for cerebral embolism following prosthetic valve replacement.

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Adolescent↗

PubMedDate not supplied

A remarkable increase of superoxide dismutase activity in synovial fluid of patients with rheumatoid arthritis.

Superoxide dismutase activities in the synovial fluid of patients with rheumatoid arthritis and osteoarthritis were determined by the technique of McCord and Fridovich. The superoxide dismutase activity from the rheumatoid arthritis group was found to be remarkably higher than that from the osteoarthritis group. The high superoxide dismutase activity of rheumatoid arthritis is correlated with the severity of the disease. A significant correlation was also found between C-reactive protein and superoxide dismutase activity. These observations suggest that superoxide dismutase activity is a manifestation of the acute inflammatory stage of rheumatoid arthritis.

Arthritis, Rheumatoid↗