The Japanese Journal of Nephrology
Online ISSN : 1884-0728
Print ISSN : 0385-2385
ISSN-L : 0385-2385
Volume 14, Issue 6
Displaying 1-3 of 3 articles from this issue
  • Kaizo Kobayashi, Masao Shibata, Katsumi Kato, Shinya Nakamura, Shigeno ...
    1972 Volume 14 Issue 6 Pages 539-553
    Published: 1972
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    A new method of controlling body fluids in the patients receiving long term hemodialysis has been developed and has come to be applied clinically. This method we call Extra Corporeal Ultrafiltration Method (ECUM) was developed after extensive laboratory studies has produced excellent results. In this method using the standard Kiil dialyser, the dialysate outlet is closed and the inlet is connected to the suction pump. With negative pressure (200 mmHg), body fluids from the patients suffering from overhydration and congestive heart failure can be filtrated effectively. This method was used eighty one times in total on thirty one patients who were receiving long term hemodialysis and were unable to control their body fluids adequately. Before the treatment, the symptons of overhydration were observed in twenty patients. 500-1000 ml/hr, of ultrafiiltrate was removed from each patient by ECUM. The volume of filtrate varied according to the flow rate through the shunt, and the blood pressure of the patient, as well as to the rate of negative pressure in the pump during treatment. The volume varied also in proportion to the duration of the treatment. The concentrations of urea nitrogen, creatinine, uric acid, sodium, potassium and inorganic phos-phorus in the ultrafiltrate were the same as in the serum after the treatment and the concentrations of those in the serum before the treatmentwere also the same as after the treatment. The total protein filtered from the serum was very little, and the ultrafiltrate concentration ranges from 0 to 0.2 gm/dl. The concentration of calcium in thefiltrate was 70-80% of that in the serum. As side effects of ECUM, chills and fever were observed in six patients, abnormal thirst in two, and headache in one. There were no undesirable alternation in blood pressure and no abnormal findings in ECG during or after the treatment. The results of our studies suggest that ECUM might be a good method for controlling body fluids in the overhydrated patients. It could be also useful for the research on the many substances in the ultrafiltrate, and it may very well be applied to the research on the artificial kidney machines. Finally it could be helpful in the study of matters concerning uremia.
    Download PDF (2449K)
  • Soichiro Takahashi, Zyuzi Wada, Yasutami Kinoshita
    1972 Volume 14 Issue 6 Pages 555-567
    Published: 1972
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Forty rabbits were injected with 20 mg of prednisolone intramuscularly daily and sacrificed at 2, 5, 11, 24, 42 and 91 days by air-infusion. Kidneys were investigated by histochemical, immunofluo-rescent, light and electron-miroscopic methods. Urinary findings, blood coagulations, plasma lipids, plasma total protein and blood sugar levels were determined serially. The platelet aggregation as well as the plasma recalcification time reduced markedly from 2 to 42' days after starting-injections. Thrombotest activities already markedly increased on the 12th hour, and these conditions persisted during the treatment. Increases with transitory falls of platelet counts and plasma fibrinogen concentrations, accompanying suppressions or activations of fibrinolysis were observed. We thought that these findings of blood coagulations represented essentially a hypercoagulable state and both transitory falls of platelet counts as well as plasma fibrinogen concentrations and activations of fibrinolysis suggested slight intravascular coagulation with increased utilization of clotting factors such as platelets and fibrinogen, as well as secondary activation of fibrinolysis. In plasma lipids, only triglyceride levels increased significantly and directly proportional to the number of glomerulus affected with the lesions. Levels of fasting blood sugar almost unchanged except those of 42 nd day. In urinalysis, proteinuria, occasionally with hematuria began to appear early and increased gradually in quantity showing several peaks. Glycosuria appeared transitory early, became persistent in the latter part of the experimental period. Morphologically, the exudative lesions with various quantities of fibrin or fibrinoid, plasma protein, inucopolysaccharides, lipids, hyaline-material, blood corpuscles and degenerated constituents of capillary wall, intracapillary microthrombi and focal capillary dilatations were noticed in renal glomeruli. Lesions observed at 2nd and 5th days were composed of fresh, eosinophilic exudations but lesions after 11 st day chiefly of so-called exudative ones. Healing processes of those were observed at 42 nd and 91 st days. Incidences of the lesions gradually increased with times of injection repeated. Immunofluorescent studies for IgG, alc-globulin, fibrinogen and platelet deposits revealed localizations of those in exudative and other minimal glomerular lesions. The fluorescence of these two were more striking than others generally. When viewed in electronmicoscope, the exudative lesions were found to be composed principally of an intraluminal mass of fine-fibrillar substance. Besides, same substances appeared in mesangial matrixx and epithelial cytoplasm, and communicated with the intraluminal one. Conclusions are as follows : 1) Thrombocapillaropathy initiated by intracapillary microthrombi of glomeruli is an essential process in steroidnephropathy, 2) Formations and resolutions of the exudative lesion are repeated during the administration of glucocorticoids.
    Download PDF (2355K)
  • Ryuichi Kimura
    1972 Volume 14 Issue 6 Pages 569-579
    Published: 1972
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    Several investigators reported that the administrations of exogenous ACTH into various animals stimulated their renin-angiotensin systems. So I studied the effect of exogenous ACTH on renin-angiotensin system in man; especially human plasma renin activity and angiotensin II levels. Plasma renin activity was measured by the "improved" method of Skinner. For the measurement of plasma angiotensin II level, the preparation of antiangiotensin II serum was made out by combining of the rabbit serum albumin and the synthetic angiotensin II amide with the carbodiimide reaction (the method of Goodfriend et al) and injecting its combining material into several rabbits. And the extraction of angiotensin II from human plasma was carried out through the column of Dowex 50 W-X 2 (NH4) by the method of Haas et al. The plasma angiotensin II level was radioimmunoassayed with the procedures of the dextran-coated charcol method. The human plasma renin activity and angiotensin II levels were significantly rised at 30 minutes after the intramuscular injections of ACTH (ORGANON) 25 units into the normotensives and the hy-pertensives, and were concomitantly failed at 60 or 120 minutes compared with the control values. And the plasma renin activity and angiotensin II levels of the normotensives could not differ from that of the hypertensives. It was concluded that the administration of exogenous ACTH into man could abruptly raise his plasma renin activity and angiotensin II level.
    Download PDF (1165K)
feedback
Top