Renal funcsion in casec of cervical carcinoma of the uterus was analyzed with RI-renogram Before treatment, the ratios of obstructive change in the findings of C. R. C. were 19.2% of the cases and 14.2% of total number of the kidneys examined (Stage O to I., 7.4% of cases, 6.1% of kidneys ; Stage II., 25.4% of cases, 20.5% of kidneys; Stage III., 46.6% of cases, 26.6% of kidneys ; Stage IV., 75.0% of cases, 50.0% of kidneys respectively). In cases with no urological changes before treatment, increased ratios of the obstructive findings were noted after total hysterectomy. And, these obstructive changes progressed gradually after additional irradiation. (1 month after operation, 58.4% of cases, 47.2% of kidneys; 2 to 3 months, 73.3% of cases, 61.7% of kidneys ; 4 to 6 months, 86.7% of cases, 70.0% of kidneys; 12 months, 72.7% of cases, 52.3% of kidneys respectively). The observations clearly demonstrated that the case; of moderately advanced obstructive changes resulted in renal failure after short period. It may be concluded that renal function of the patient of cervical carcinoma of the uterus should be checked at regular intervals during the course of treatment, and renogram is one of the most useful tool for this purpose.

抄録全体を表示

A case of prolonged oliguria for 105 days due to potassium bromate poisoning in 22 years old woman who was salvaged by repeated hemodialyses was reported, 37 hemodialyses were necessary to control her uremia. Renal function tests including PSP test, Fishberg concentration test, CThio, CPAH, osmolar clearance, and others were examined on 6, 12, and 18 months after onset of her illness, which showed decreased renal blood flow and glomerular filtration rate, but increased osmolar clearance per nephron. These data suggest that the damage of her renal function was due to decreased nephron population of her kidney and recovery of renal function was by mean of compensatory hypertrophy of the residual nephrons. Also, analysis of clinical date on 63 survival cases of prolonged oliguria over 20 days which were collected in the literatures were made and pathogenesis and prognosis of renal function of these cases were discussed. 27 out of 63 cases were due to acute tubular necrosis, 19 due to bilateral cortical necrosis, 9 due to acute glomerunephritis and other 8 cases respectively. Analysis of these data suggests that the cases with prolonged oliguria over 60 days have markedly poor prognosis regarding renal function. Complete recovery of renal function can be expected in cases of oliguric period under 60 days.

抄録全体を表示

Effects of intrarenol isoproterenol (IP) infusion (0.1, 0.05 and 0.01μg/kg/min) on renal functions and renin secretion were studied in the anesthetized dog. Intrarenal infusion of IP at doses of 0.1 and 0.05 μg/kg/min caused a slight decrease in systemic blood pressure (BP) but an increase in renal blood flow (RBF) accompanying by increase in urine flow (UF) and sodium excretion. At dose of 0.01 μg/kg/min, change in BP was not recognized but RBF and glomerular filtration rate (GFR) significantly increased concomitant with increases of OF and sodium excretion. The all three doses of IP produced increases in both systemic arterial and renal venous plasma renin activity (PRA) resulting in a significant increase of the renal venous-arterial difference of PRA. Thus renin secretion rate (RSR), the product of renal plasma flow and renal venous-arterial difference of PRA, significantly increased. The intrarenal distribution of blood flow during IP infusion (0.01 μg/kg/min) was determined by means of radioactive microsphere method. IP caused significant increase in RBF and RSR but no change in the intrarenal distribution of blood flow. Following intrarenal arterial injection of propranolol (1 mg), IP (0.01 μg/kg/min) caused no change in RBF and GFR, but produced a slight and significant increase of sodium excretion. While, intrarenal infusion of propranolol (1 μg/kg/min) completely blocked increase in RBF, GER, OF and sodium excretion induced by IP. Those propranolol administrations supressed both systemic arterial and renal venous PRA, and the latter was significantly lowered resulting in significant decrease in RSR. Furthermore, both PRA and RSR were not altered by IP in the presence of propranolol. Diuretic and natriuretic effects of IP seems to be due to increase in GFR and direct tubular effect was also suggested. An increase of RSR responded to IP was likely independent from the change in renal hemodynamics and tubular function. Thus it is suggested that IP stimulates renin release via β-adrenergic receptor in the kidney.

抄録全体を表示

Attempts were made to demonstrate circulating autoantibodies against the kidney of 42 patients in terminal stage of glomerulonephritis controlled by maintenance dialysis. To detect antibodies, cryostat sections of normal kidney of blood group 0 individual were incubated with patient sera, and the bound immunoglobulins were stained with fluorescent antiglobulin reagents. As the results, 3 cases with autoantibodies against tubular cells and 1 case with antinuclear antibody were found. Anti-glomerular basement membrane antibodies (anti-GBM) were negative in all cases including 6 nephrectomied-anephric patients. However, some sera reacted with the glomerular and in-tertubular capillaries in the manner as though indicating the presence of anti-GBM. This false positive reaction occurred only in the combination of special blood groups : the serum (0 type) and the kidney (A type). These data warrant the greatest possible care to differentiate the true autoantibodies from allo- and heterophilic antibodies. The selection of detecting antigens as well as the use of a panel of antigens obtained from different sources are highly recommended. All the anti-tubular cytoplasmic antibodies in the 3 sera were complement fixing IgG, and directed to the same antigen. This antigen was distributed not only in tubuli, but in gastric and intestinal mucosa of all the mammalian species tested, including humans, rats, rabbits, mice and guinea pigs. Differential centrifugation study revealed the exclusive localization of the antigen in microsome fraction. This antibody (tubular microsomal antibody) cannot be discriminated from the mitochondrial antibody (Doniack 1966) in the routine screening by immunofluorescence utilizing kidney sections as detecting antigen because of the similarity of specific staining with both antisera in the cytoplasma of tubular epithelia. Although the tubular microsomal antibody reported here has not been described, it may well have been overlooked for this reason. It would be necessary to identify mitochondrial antibodies not only by the traditional immunofluorescent method using kidney sections, but also by the more detailed study of the corresponding antigen by means of the above mentioned methods. The possibility of the tubular microsomal antibody in producing antigen-antibody complex and thus mediating glomerulonephritis is currently under our investigations through the elution study of this anti-body from the diseased kidney.

抄録全体を表示