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Biomedical subjects

T Shiigai

Publications and source records attributed to T Shiigai.

107 records · Page 6Linked to original sources
PubMed1982

Hypouricemia due to an increment in renal tubular urate secretion.

Two patients had hypouricemia due to increased uric acid clearance. Their daily urinary uric acid excretions were normal. In both patients, pyrazinamide decreased urinary uric acid clearance to almost while probenecid increased it markedly. No other renal tubular or metabolic abnormalities were found. The serum electrolytes and the urinary electrolytes excretions showed no abnormalities. It appears that increased secretion of uric acid in the renal tubule is most probably responsible for hypouricemia in these patients. This report adds to the list of hypouricemic conditions due to a new isolated renal tubular abnormality.

Adult↗
PubMed1980

Baroreflex sensitivity in renal failure.

1. Baroreflex sensitivity was evaluated in 22 non-dialysed patients with chronic renal failure secondary to chronic glomerulonephritis. Baroreflex sensitivity was judged by the slope of the linear regression of the pulse interval on the rise in systolic blood pressure with injection of phenylephrine or reduction by amyl nitrite inhalation. 2. Baroreflex sensitivity was reduced in these patients as compared with normal controls. Reduction of baroreflex sensitivity was significantly greater in nine hypertensive than 13 normotensive patients with chronic renal failure. 3. A significant positive correlation was found between baroreflex sensitivity and motor nerve conduction velocity measured on ulnar nerve in 13 patients examined. 4. Saline was given with high dietary salt intake to seven normotensive patients with chronic renal failure for 2 or 5 days in order to determine whether the severe depression of baroreflex sensitivity can be an initiating factor for hypertension. Blood pressure was raised to hypertensive levels within 5 days in two patients in whom baroreflex sensitivity was nearly as low as that of hypertensive patients, but not in five cases whose baroreflex sensitivity was normal or only mildly depressed. Plasma volume increased to the same degree in both groups. Baroreflex sensitivity did not change in the former two cases despite blood pressure elevation. 5. It is concluded that reduced baroreflex sensitivity in chronic renal failure correlated with the prescence ofhypertension, as well as uraemic neuropathy, and may be one of the pathogenetic mechanisms of hypertension in end-stage chronic glomerulonephritis.

Adult↗
PubMed1979

The early phase of experimental acute renal failure. V. The influence of suppressing the renin-angiotensin system.

Experiments were conducted to determine whether suppression of the renin-angiotensin-system and inhibition of the tubuloglomerular feedback response offer protection from acute renal failure, as found in chronically-salt loaded animals. The juxtaglomerular renin activity and tubuloglomerular feedback response were inhibited acutely, by saline expansion, or chronically, by DOCA-treatment with saline drinking fluid or salt diet, by high salt diet alone, or by inducing two-kidney Goldblatt hypertension. The chronic pretreatment procedures depressed juxtaglomerular renin to 16, 7, 13 and 4% of control, respectively, inhibited the feedback response to 53, 37, 56, and 38% of control, respectively, but conferred no benefit in the first hours following a nephrotoxin or ischaemia. In contrast, the acute treatment procedure reduced juxtaglomerular renin activity to only 56% and lowered the feedback response to only 71%, but improved renal function after the nephrotoxin, although not after ischaemia. It is concluded that since severe restrictions of renin activity and tubuloglomerular feedback are not protective, neither is primarily involved in generating the functional restrictions early in acute renal failure. The restoration of renal function by saline expansion accompanied only a modest depression of these two systems and suggests that the beneficial effect may result more from volume expansion or diuresis than from suppression of renal renin or inhibition of tubuloglomerular feedback.

Acute Kidney Injury↗
PubMedDate not supplied

Repeat MRI in acute rhabdomyolysis: correlation with clinicopathological findings.

OBJECTIVE: Four cases of acute rhabdomyolysis are presented and the correlation between clinicopathological and MR findings is discussed. MATERIALS AND METHODS: The cases include carnitine palmitoyltransferase I deficiency presenting as compartment syndrome, acute polymyositis, acute myositis associated with Epstein-Barr virus infection, and glycyrrhizin- and diuretic-induced hypokalemic myopathy. RESULTS: The T2-weighted MR images revealed high intensity lesions in the affected muscle groups. The lesions seen on MR correlated precisely with the symptoms and neurological deficits of the patients. Repeat MR studies showed that the high intensity lesions seen on T2-weighted MR images resolved in parallel with the clinical course. CONCLUSION: This reversibility of the MR findings suggests that the high intensity lesions do not reflect permanent myopathic changes, but probably represent transient edema in the acute phase of rhabdomyolysis.

Acute Disease↗
PubMedDate not supplied

Urinary indoxyl sulfate is a clinical factor that affects the progression of renal failure.

We recently demonstrated that indoxyl sulfate is a stimulating factor for the progression of chronic renal failure (CRF). In this study we determined whether the urine or serum levels of indoxyl sulfate are related to the progression rate of CRF in undialyzed uremic patients. Fifty-five CRF patients with a serum creatinine of >2 mg/dl who had not been treated with an oral sorbent (AST-120) were randomly enrolled in the study. We measured the serum and urine levels of indoxyl sulfate, and estimated the recent progression rate of CRF as the slope of the reciprocal serum creatinine versus time (1/S-Cr-time) plot. The mean urinary amount of indoxyl sulfate in the patients was 60 mg/day. Those with indoxyl sulfate urine levels of >60 mg/day had a significantly faster progression rate of CRF than those with <60 mg/day. Especially, those patients with indoxyl sulfate urine levels of >90 mg/day had the highest CRF progression rate and those with indoxyl sulfate urine levels of <30 mg/day had the slowest CRF progression rate. Urinary indoxyl sulfate had a significantly negative correlation with the slope of the 1/S-Cr-time plot. However, the serum level of indoxyl sulfate or the ratio of serum indoxyl sulfate to creatinine was not significantly correlated with the slope of the 1/S-Cr-time plot. In conclusion, high urine levels of indoxyl sulfate are related with a rapid progression of CRF in undialyzed uremic patients. Thus, urinary indoxyl sulfate is one of the clinical factors that affect CRF progression.

Adult↗
PubMedDate not supplied

Increased urinary kallikrein-like activity during ADH-induced hyponatremia in rats.

The urinary kallikrein system was studied during hyponatremia associated with water and vasopressin administration in rats. Two groups of animals were studied. In the experimental group (n = 5), vasopressin (0.4 U/day) was injected intramuscularly for 7 days, and water (15%-20% body weight per day) was given via a stomach tube. The control group (n = 6) received only vasopressin. In the experimental group, plasma sodium concentration (PNa) decreased from 143.2 +/- 0.5 to 130.8 +/- 1.8 (m +/- SEM) mmol/liter (5th day, p less than 0.01) along with plasma osmolality. Urinary kallikrein-like activities (UkaV) increased from 99.1 +/- 7.5 to 172.6 +/- 23.5 mumol X min/day (100 g body weight) (5th day, p less than 0.05; 6th day, p less than 0.05; and 7th day, p less than 0.05) after the administration of vasopressin. Uric acid clearance (Cua) increased from 0.153 +/- 0.014 to 0.275 +/- 0.041 ml/min (5th day, p less than 0.05; 7th day, p less than 0.05). No change was observed in urinary aldosterone excretion (UAldV), creatinine clearance, or blood pressure. UkaV correlated with Cua (r = 0.81, p less than 0.01) and with the degree of change of PNa (r = --0.79, p less than 0.01), respectively. In the control group, no change was observed in the above parameters. A significant relationship between UkaV and fractional Na clearance (r = 0.60, p less than 0.01) was observed. We conclude that the urinary kallikrein system in rats may be stimulated during hyponatremia when induced by water and vasopressin. This increased activity is probably the result of volume expansion associated with water and vasopressin and may have some relationship to fractional Na clearance in the kidney.

Aldosterone↗
PubMedDate not supplied

Systemic lupus erythematosus presenting with pericardial tamponade and lupus pneumonitis.

A previously-well 37-year-old woman presented with pericardial tamponade and pulmonary infiltrates. Systemic lupus erythematosus was diagnosed. Pericardiocentesis and systemic treatment with prednisolone produced dramatic improvement with no recurrence. The patient underwent bronchoalveolar lavage and transbronchial lung biopsy, which established the diagnosis of lupus pneumonitis.

Adult↗
PubMedDate not supplied

Effects of long-term therapy with arotinolol on blood pressure and renal function in hypertensive patients with chronic renal failure.

The effects on blood pressure and renal function of long-term treatment with the alpha- and beta-blocker arotinolol at a dose of 20 mg/day were studied in 10 hypertensive patients with chronic renal failure. Patients received low-protein therapy in which the protein and phosphorus intakes were controlled at a certain level. The average duration of arotinolol treatment was 18.4 months. A significant decrease in blood pressure was seen after the second month of treatment, and this effect continued up to the 20th month. The progression rates of renal failure (creatinine clearance/month) before and after treatment were -0.377 +/- 0.344 and -0.164 +/- 0.172 ml/min/month, respectively. No side effects attributable to the drug were observed. These findings indicate that arotinolol has a stable antihypertensive effect and no adverse effects on renal function. Arotinolol appears to be a useful drug in the long-term treatment of hypertension in patients with chronic renal failure.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Paradoxical hyperfixation of hexamethylpropyleneamine oxime in cerebral infarction.

We describe four patients with cerebral infarction and 99mTc-hexamethylpropyleneamine oxime (HMPAO) hyperfixation in distributions corresponding to the infarctions seen at CT and/or MR imaging. Increased HMPAO extraction due to hyperpermeability across the blood-brain barrier and increased retention due to reduced back diffusion of the tracer probably accounted for the increased fractional fixation in infarcts seen in our patients.

Aged↗