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Biomedical subjects

Y Ubara

Publications and source records attributed to Y Ubara.

18 recordsLinked to original sources
PubMed1999

Proliferation of parathyroid cells negatively correlates with expression of parathyroid hormone-related protein in secondary parathyroid hyperplasia.

BACKGROUND: Parathyroid hormone-related protein (PTHrP) is now suspected to act as an autocrine or paracrine regulator of cell growth or differentiation, although it was originally reported as a hypercalcemic substance in malignancies. This study was performed to assess the relationship between PTHrP expression and cell proliferation in human parathyroid glands. METHODS: The localization of PTH and PTHrP was studied in 42 samples of hyperplastic parathyroid from 14 long-term hemodialysis cases with immunohistochemistry and in situ hybridization. Results were compared with proliferative activity (proliferating cell nuclear antigen index: counts of proliferating cell nuclear antigen-positive cells/100 cells). The localization of the PTH/PTHrP receptor was also examined. Ten normal glands were studied as controls. RESULTS: In hyperplasia, cells positive for PTH, PTHrP, or both were observed immunohistochemically. The areas expressing PTHrP mRNA completely coincided with those positive for PTHrP immunohistochemically. Oxyphilic or transitional oxyphilic cells were consistently positive for PTHrP. PTH/PTHrP receptors were located in the cytoplasmic membrane in most parathyroid cells. Proliferating cell nuclear antigen-positive cells were rare in normal glands with an index of 0. 22 +/- 0.09 (mean +/- sem). They were significantly increased in hyperplastic cases but less for PTHrP-positive than for -negative cells (1.25 +/- 0.16 as compared with 7.80 +/- 0.52; P < 0.0001). CONCLUSION: The observed low level of proliferation of PTHrP-positive cells suggests a functional role for PTHrP as a possible growth suppressor in the human parathyroid.

Adult↗
PubMed1999

[A case of rheumatoid arthritis with bucillamine-induced myasthenia gravis treated by immunoadsorption therapy].

We report a case of 48-year old female with rheumatoid arthritis (RA) complicated with myasthenia gravis. In 1988, she was diagnosed of having RA, and several therapeutic drugs were administered, but her disease activity was in poor control. In July 1993, bucillamine (BU) was started at a dose of 100 mg/day, and her arthritis subsided. However, in October 1996, she was admitted with a rapidly progressive ptosis and double vision in the left eye, which became prominent in the evening. Because serum concentration of the antibody to acetylcholine receptors (AchR Ab) was elevated at 12.6 nmol/l, and the ptosis was reversed immediately after a tensilon test, ocular type myasthenia gravis (MG) was diagnosed and it was thought to have been induced by BU. Immunoadsorption therapy was started after discontinuation of this drug, and was continued for 6 months, resulting in improvement of neurological symptoms and decrease in AchR Ab level. MG has not recurred since. Although several cases of D-penicillamine (DP) induced MG are reported, only two cases are reported which were induced by BU, sulfhydryl compound which has a structure similar to DP. Since BU has been widely used as one of the disease modifying anti-rheumatic drugs in Japan, MG induced by this drug should be paid attention as one of the adverse effects.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1998

Bone histomorphometrical analysis in patients on long-term dialysis treatment for more than ten years.

In Japan there is a steady increase in patients who have been on dialysis therapy for more than 10 years. Bone lesions could emerge as a serious problem during this dialysis period. From 1986 to 1993, bone lesions were examined by histomorphometry of the bone tissues (40 biopsis, 17 autopsies) in fifty seven patients who have undergone a long-term hemodialysis treatment (37 males, 20 females) at Toranomon hospital. Mean age of the patients was 56 +/- 11 (SD) years (range; 22 to 74) and mean dialysis period, 14.5 +/- 11 (SD) years (range; 10 to 28). The results were compared with biochemical and endocrinological data. The subjects were classified into osteitis fibrosa group (33%), osteomalacia group (12%), mixed group (7%) and mild group (48%). Intact parathyroid hormone (PTH) and alkaline phosphatase (Al-P) value were significantly higher in osteitis fibrosa and mixed groups, all cases showing intact-PTH values greater than 500 pg/ml (normal value; 20-53), but not in osteomalcia and mild groups. The analysis of 32 cases with intact-PTH higher than 500 pg/ml showed osteitis fibrosa in 59.4% mixed in 12.5%, osteomalacia in 3.1% and mild in 25%. Aluminum was positive in 41% for osteitis fibrosa, 25% for mixed, 60% for osteomalacia and 52% for mild group. In summary, cases having undergone hemodialysis more than 10 years showed higher frequency of osteitis fibrosa when intact-PTH exceeded 500 pg/ml. Al-P values in such cases were high in association with the intact-PTH values. There was no significant correlation between aluminum deposition and respective bone tissue types.

Adult↗
PubMed1997

Association of Sjögren's syndrome with hereditary angioneurotic edema: report of a case.

A case of hereditary angioneurotic edema (HANE) associated with Sjögren's syndrome is presented. One of the members of a pedigree of HANE due to deficiency of C1 inhibitor (C1INH) had a positive titer for anti-SS-A and anti-SS-B antibodies in the serum, complaining of symptom of dry eyes and dry mouth. A lip biopsy revealed lymphocytic infiltration of minor salivary glands. The patient had renal tubular acidosis (RTA). Thus the patient was diagnosed as suffering from Sjögren's syndrome with RTA.

Angioedema↗
PubMed1997

Renovascular hypertension may cause nephrotic range proteinuria and focal glomerulosclerosis in contralateral kidney.

Little attention has been paid to nephropathies and proteinuria in renovascular hypertension (RVH). Recently there has been a growing interest in the conditions induced by RVH. 10 cases of RVH were diagnosed by angiography and renin sampling from renal veins in the last 6 years in our hospital. The patients were all male and mean age was 64 +/- 8 (SD) years. Data were as follow: protein excretion was 3.8 +/- 2.2 g/day (> or = 3.5 g/day in 8 patients), sBP 202 +/- 24 mmHg, dBP 113 +/- 17 mmHg, serum renin concentration 64 +/- 45 pg/ml, and ipsilateral/contralateral renal vein renin ratio 3.3 +/- 1.0. RVH was treated by nephrectomy in 3 patients, percutaneous transluminal renal angioplasty (PTA) in 2, and angiotensin converting enzyme inhibitors (ACE-I) administration in 8. Biopsies were performed on contralateral kidney in 4 patients. Focal segmental glomerulosclerosis (FGS) was found in 3 patients, and nephrosclerosis in 1, whereas only nephrosclerosis was found in nephrectomized kidneys in all 3 patients. After nephrectomy, PTA and the treatment by ACE-I, not only blood pressure but also proteinuria was markedly reduced. These findings suggest that severe stenosis of the renal artery led to renal ischemia, which activated renin excretion, to cause glomerular hyperfiltration through vasoconstriction of the efferent arterioles in the contralateral kidney. FGS-like lesion thus induced appeared to have caused massive proteinuria.

Aged↗
PubMed1996

[Computed tomographical evaluation of diabetic nephropathy].

Diabetic nephropathy can be regarded mainly as a type of microangiopathy, but is a disease that may also include aspects of macroangiopathy. This is especially true of renal disease in non-insulin dependent diabetes mellitus (NIDDM), which is characterized not only by diabetic glomerulosclerosis, but also by atherosclerosis. We performed morphological studies on the kidney, using computed tomography (CT), focusing on such points as: (1) abdominal aortic calcifications at the level of kidney, (2) calcifications in the renal artery, and (3) wedge-shaped defects on the renal surface. We noted that these findings became more prominent in NIDDM patients during end-stage renal failure than during normal renal function, and were significantly more common in those two NIDDM groups than in age-matched nondiabetic patients without hypertension, hyperlipidemia or gout. NIDDM patients exhibited these features more frequently than IDDM patients.

Aged↗
PubMed1995

Relation between parathyroid hormone and cardiac function in long-term hemodialysis patients.

Radionuclide ventriculographic and echocardiographic assessments of left ventricular cardiac function were studied in 46 long-term maintenance hemodialysis patients, and comparison of cardiac function pre- and post-parathyroidectomy in 10 hemodialysis patients with secondary hyperparathyroidism was investigated. In long-term hemodialysis patients, impairment of cardiac function was observed in 80.4%. In an overall study of 46 patients, no correlation between intact parathyroid hormone (iPTH) level and left ventricular ejection fraction (LVEF) was observed, but a significant (p < 0.05) negative correlation was observed in patients with an iPTh blood level over 200 pg/ml. A negative correlation between fractional fiber shortening and an iPTh level over 200 pg/ml was observed (p < 0.05). There was neither a correlation between the iPTH level and left ventricular (LV) mass, nor was there a correlation between the iPTH level and wall thickness. After parathyroidectomy, systolic and diastolic blood pressure, cardiothoracic ratio, LVEF, and LV mass decreased significantly (p < 0.05), but no significant difference was detected in cardiac thickness. In summary, the present data suggest that high levels over 200 pg/ml of the iPTH in long-term hemodialysis patients adversely affect the myocardial function, induce cardiac hypertrophy and cause high arterial blood pressure. After parathyroidectomy, the cardiac function improved with a reduction of cardiac mass and an improvement of cardiac contraction.

Adult↗
PubMedDate not supplied

Risk factors for retardation of renal function in IDDM and NIDDM with nephropathy.

Risk factors for retardation of renal function in 22 patients with non-insulin-dependent diabetes mellitus (NIDDM) were studied and compared with those in 16 patients with insulin-dependent diabetes mellitus (IDDM). The annual decline rate of reciprocal serum creatinine was calculated from the rise of creatinine to the commencement of dialysis. The annual decline rate was compared with levels of blood pressure, fasting blood glucose, HbA1, and lipids, and clinical findings in patients with or without nephrotic syndrome during the same period. There was no significant difference in the rate of decline in levels of fasting blood glucose and HbA1, in IDDM and NIDDM. In NIDDM, the major risk factor is hypertension, as in IDDM. Triglycerides and total cholesterol also play roles in the retardation of renal function. Nephrotic syndrome also influenced the retardation of renal function in both IDDM and NIDDM.

Blood Glucose↗