The Japanese Journal of Nephrology
Online ISSN : 1884-0728
Print ISSN : 0385-2385
ISSN-L : 0385-2385
Volume 36, Issue 4
Displaying 1-14 of 14 articles from this issue
  • KEIKO TAKAHASHI, MAKOTO SUZUKI
    1994 Volume 36 Issue 4 Pages 289-297
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Glucagon (Glu) influences renal tubular function and growth, although the sigal transduction of Glu in the kidney still remains obscure. Rabbit cortical tubules were transformed by the pSV-neo3 gene to make a homogeneous cell colony, which responded to vasopressin but not to parathyroid hormone. The [Ca2+]i of the cells at the 9-10th passages was measured by the fluorescence indicator, fura-2. The [Ca2+]i was increased by Glu (10-8 M) or bradykinin (10-8 M), between which heterologous desen sitization was observed. The Glu range of 10-14 to 10-6 M significantly increased [Ca2+]i, while CAMP was not produced at any dose of Glu. Since the ranges of doses were from physiological to pharmaco logical, two concentrations of 10-13 and 10-8 M were employed to investigate the mechanisms . Glu at 10-13 M led to a sustained rise in [Ca2+]i, which was completely blocked by external EGTA (5 mM, Ca-free solution). Glu at 10-8 M provided a similar level of peak and sustained rise in [Ca2+]i, the sustained phase of which was blunted in Ca-free solution. Inositol tri/tetra phosphates were significantly increased by 10-8 M, but not by 10-13M Glu. These data suggest that [Ca2+]i elevation is a major component of Glu-induced second messengers in the physiological and pharmacological range of doses of Glu, and that there might be two classes of pathways leading to increase in [Ca2+]i in transformed rabbit cortical collecting tubule cells.
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  • NOBUYASU NISHISAKA, TAKETOSHI KISHIMOTO
    1994 Volume 36 Issue 4 Pages 298-306
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    The purpose of the present study was to conduct a light and electron microscopic investigation of pathological alterations of the kidney during the recovery phase after injury caused by mercuric chloride toxicity, and the morphological changes in regenerating cells influenced by subsequent mercuric chloride toxicity. The first administration of mercuric chloride to female albino rabbits was performed by intravenous injection at the dose of 1.3 mg/kg, and a second similar injection was given 14 days later. Regenerating cells first appeared 3 days after the first administration and gradually increased thereafter. However, maturation of these cells was incomplete even on the 14th day. After re-administration, the degree of tubular necrosis was significantly reduced compared with that after the initial injection, and most parts of the basement membranes of the degenerated tubules were covered with epithelial cells. Electron microscopy showed that almost all of the cells underwent changes, including disrupted microvilli, irregularly dilated rough endoplasmic reticulum, and dense free polyribosomes arranged as rosettes. Moreover, S-phase cells were found adjacent to the cells. These findings suggested that the regenerating cells were influenced again by the toxic effect of mercuric chloride, but escaped cell necrosis and remained within the reversible stage because of their immaturity and reduced sensitivity to mercuric chloride.
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  • HIROAKI KANAYA, FUMIO ISHITOBI, YUKO ONO, TADASHI YAGUCHI, YOSHIHIKO V ...
    1994 Volume 36 Issue 4 Pages 307-316
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    The purpose of this study was to investigate the mechanism of glomerulosclerosis, which is an important histopathological feature of various renal diseases. Puromycin aminonucleoside (PAN) was administered to rats to produce glomerular lesions, and the kidneys were examined by repeated renal biopsy with light microscopy and immunohistochemical detection of glomerular extracellular matrix (ECM) components (laminin, fibronectin, type I, III, and IV collagen). Immunohistochemical studies utilizing the streptavidin-biotin method showed marked accumulation of laminin and type IV collagen in the adhesions between the glomerular epithelium and Bowman's capsule, as well as in the mesangial matrix. Fbbronectin was detected in the normal mesangium and the basement membrane of Bowman's capsule, while adhesions and the matrix accumulations were also positive. The sclerotic lesions of the glomeruli were also stained for type I and III collagen, which exist in normal interstitial tissue, but never in healthy glomeruli. Type I collagen appeared in the lesions after type III collagen. All of the ECM components examined in this study were present in advanced glomerulosclerosis and showed distinctive patterns of progression. These finding suggest that abnormal accumulation and production of ECM components in the glomeruli may have a role in the development of glomerulosclerosis.
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  • TAKAKO YOKOZAWA, TERUHITO YASUI, SANAE ISHII, HIKOKICHI OURA
    1994 Volume 36 Issue 4 Pages 317-321
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Variations in the level of albumin mRNA and the transcription rate of the albumin gene in rats with adenine-induced renal failure were compared with those in normal rats . A paired feeding schedule was employed to eliminate any nutritional differences between normal rats and rats with adenine induced renal failure. The albumin mRNA level isolated from the liver became lower as the period of adenine administration lengthened. However, there was no difference in the transcription rate of the albumin gene between the two rat groups. These results suggest that a post-transcriptional process is responsible for the renal failure-induced repression of albumin synthesis . Furthermore, plasma glucagon levels in adenine-induced renal failure specimens were markedly higher than those in the normal group, whereas we found no difference in the plasma insulin level between normal and adenine -fed rats . These investigations provide evidence that the decrease in the level of albumin mRNA in renal failure may be partly related to the elevated level of glucagon.
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  • NOBUYUKI YOSHIZAWA, TAKASHI ODA, YASUHIRO OSHIKAWA, YOSHIHIRO AKASHI, ...
    1994 Volume 36 Issue 4 Pages 322-330
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    To evaluate the role of cell-mediated immunity in acute poststreptococcal glomerulonephritis (APSGN), we identified the immune cell population infiltrating the glomeruli. Renal biopsies were obtained from 22 patients with APSGN, 16 with overt and 6 with asymptomatic disease, one to 30 days after onset. Samples of normal renal tissue were used as controls. Frozen sections were examined using monoclonal antibodies that recognize various leukocyte surface markers. Double staining for granulocytes and monocyte/macrophages (Mφ) was performed using chloroesterase staining and indirect immuno-alkalinephosphatase staining with Leu M-5 sequentially. In overt APSGN, there was a sub stantial increase in the total number of granulocytes and Mφ with a slight increase in T cells. Numbers correlated with time after onset, as more leukocytic infiltration was observed when the tissue was taken earlier. Furthermore, a significant positive linear correlation was seen between helper/inducer T cells and Mφ (r = 0.86, p < 0.01). Helper T cells tended to be increased to a higher proportion during the early stage, while suppressor T cells remained constant throughout the course. Analysis with anti proliferating cell nuclear antigen antibody revealed increased glomerular cell proliferation in the early phase of APSGN. In asymptomatic patients, the total number of leukocytes was less than in the overt patients, but the proportions of infiltrating cells were similar. These data suggest that Mφ are important effector cells causing endothelial and mesangial cell proliferation in APSGN. Mφ infiltration in the glomeruli appears to be mediated by complementinduced chemotaxis and probably be an antigen specific event related to the delayed type hypersensitivity mediated by helper/inducer T cells.
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  • HIDEKAZU SHIGEMATSU, AKIO KOYAMA
    1994 Volume 36 Issue 4 Pages 331-338
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Histological differences were analyzed in the first renal biopsy specimen of IgA nephropathy of patients treated with or without the use of steroids, using samples supplied from multi-institutional sources. The application of acuteness and chronicity index indicated that the occurrence of acute intra and/or extra-capillary lesions was significantly high in progressive cases. Though in present study the dosage or duration of steroids was different in each case, steroids appeared to have been selected preferencially for histologically active cases. Since steroids are used clinically in acute inflammatory disease like SLE, and have been experimentally demonstrated to be effective in suppressing the extent of acute inflammation, effective usage of steroids is recommended in attempts to treat IgA nephritis with high acuteness index scores. The high acuteness index seems appropriate for the selection of steroids for IgA nephropathy.
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  • HARUYOSHI YOSHIDA, KAZURO KANATSU, ERI MUSO, TAKASHI KUWAHARA, KEN-ICH ...
    1994 Volume 36 Issue 4 Pages 339-344
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    To investigate renal biopsy findings arizing in response to treatment with an anti-platelet drug in IgA nephropathy, 46 patients were treated with dilazep dihydrochloride (Dilazep), and a retrospective comparison was performed between the clinical effects and renal biopsy findings. After 6 months of treatment, 18 patients (39%) were judged to be improved if their proteinuria was ameliorated by a 25% or grater decrease with improved or persistent renal function. The group of improved patients exhibited mean decreased levels of urinary proteins in the range from 1.9 to 0.8 g/day after treatment (p <0.01). By contrast, the unimproved group showed increased urinary proteins in the range from 1.2 to 2.0 g/day (p <0.05). The improved group showed histological findings with fewer glomeruli exhibiting sclerosis and/or cellular crescents, with a lesser increase in mesangial matrix and with smaller tubulo-interstitial lesions than the unimproved group. By immunofluorescence, the improved group was found to have smaller amounts of glomerular IgA and IgG deposits. These findings suggest that an anti-proteinuric effect of Dilazep administration can be expected in patients with IgA nephropathy with relatively mild glomerulosclerotic lesions.
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  • ERI MUSO, MASATOMO YASHIRO, YOZO ITO, HARUYOSHI YOSHIDA, SHIGETAKE SAS ...
    1994 Volume 36 Issue 4 Pages 345-354
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    The serum levels of circulating immune complexes (CIC) measured by three different types of enzyme immunoassay (ETA) using monoclonal anti-C1q and anti-C3d antibodies and C1q as solid phase reagents were compared with clinical disease activity and immunohistological glomerular lesions in 29 SLE patients. Three types of CIC measured by these assays (anti -C1q CIC, anti-C3d CIC and C1q SP CIC) showed significantly higher levels in patients than in controls and were significantly associated with the clinical and serological disease activities . Anti-C1q CIC showed good correlation not only with mesangial IgG depositions (P <0.01), but also with that of C1q (P <0.05). Clq SP CIC also showed a weak correlation with mesangial C1q deposition (P < 0.05). Serum levels of anti-C3d CIC increased with the degree of mesangial IgG and complement depositions . Analysis of the clinical course of a patient with active SLE revealed a more rapid decrease of anti-C1q CIC and anti -C3d CIC along with the improvement of disease activity, including the mesangial lesion, than that of C1q SP CIC. According to these results, the CIC detected with assays using monoclonal antibodies against complement fragments, especially the anti-C1q assay, is likely to provide specific information regarding the clinical, serological and immunohistological disease activity in lupus nephritis.
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  • KOJI KANAHARA, NORIAKI YORIOKA, TAKAHIKO OGAWA, YOSHIHIKO TANIGUCHI, A ...
    1994 Volume 36 Issue 4 Pages 355-364
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    The localization of extracellular matrix components and their cell surface receptors (integrins) was studied in 130 subjects in order to clarify their participation in the progression and aggravation of various types of nephritis. Included in the study were 2 normal subjects, 14 patients with minimal change disease, 2 patients with minimal change nephrotic syndrome, 65 patients with IgA nephropathy, 18 patients with mesangial proliferative glomerulonephritis, 15 patients with membranous glomerulonephritis, 5 patients with membranoproliferative glomerulonephritis and 9 patients with systemic lupus erythematosus (SLE). The distribution of fibronectin (FN), vitronectin (VN), laminin (LN), heparan sulfate proteo glycan (HSPG), type III, IV, V, VI collagen, fibronectin receptor (FNR) and vitronectin receptor (VNR) in the glomerulus was studied employing the indirect immunoperoxidase method. FN, LN, type IV, V and VI collagen, FNR and VNR were found to be distributed in the expanded mesangial region in IgA nephropathy, mesangial proliferative glomerulonephritis and membranoproliferative glomerulo nephritis. Deposition of VN was observed in some of the patients. In membranous glomerulonephritis and membranoproliferative glomerulonephritis, the distribution of FN, LN, type IV collagen, FNR and VNR was increased in the thickened loop wall and VN deposition was also observed. Quantitative and functional changes in the extracellular matrix and integrins, therefore, appear to participate in the progression and aggravation of glomerulonephritis.
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  • KOJI KIRYU, HIROYUKI MORITA, YOSHIROU FUJITA, MASAAKI KAWASUMI, TAKAHI ...
    1994 Volume 36 Issue 4 Pages 365-373
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    Molecular organization of extracellular matrix (ECM) in the kidney may change as impairment of renal function progresses. The present Immunohistochemical study of the kidney was designed to compare localization of type I, III, IV, V, and VI collagens between "Group A" (13 patients on main tenance hemodialysis due to diabetic nephropathy) and "Group B" (13 patients with diabetic nephro pathy and massive proteinuria whose serum creatinine levels were 1.3 ± 0.5 mg/dl, mean ± SD). Nodular scleroses that were commonly observed both in Group A (87.8±10.1%) and B (80.5±17.0%) were stained in a very similar way with antibodies against collagen types IV, V, and VI. On the contrary, thickened Bowman's capsules that were observed exclusively in Group A (80.7±10.4% in Group A versus 5.7±6.2% in Group B) were stained intensely with antibodies against collagen types I and III. Normal and expanded peritubular interstitium from every group was stained with all of the above antibodies in an identical manner. Taken together, these results indicated a close relationship between severe impairment of residual renal function and a high incidence of thickened Bowman's capsule rich in type I and III collagens.
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  • MASAHIKO NAKAMOTO
    1994 Volume 36 Issue 4 Pages 374-381
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Hemodynamic changes in diabetic patients were studied in both acetate and bicarbonate modes of hemodialysis (HD) where both body weight and plasma volume did not change. Diabetic patients showed a significant decrease in mean arterial pressure and cardiac output in both HD modes when compared to the predialysis values. Despite a decreased cardiac output, total peripheral vascular resistance did not increase, probably because of the sympathetic nerve dysfunction in diabetic patients. In addition, diabetic patients with acetate HD demonstrated peripheral vasodilation at a later stage of acetate HD. Increase in plasma acetate may have caused peripheral vasodilation in these patients. It is concluded that intradialytic hypotension in diabetic patients is mainly associated with a decrease in cardiac output and loss of compensatory increase in peripheral vascular tone.
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  • HISASHI ODA, SUMI TANAKA, HIDEHISA SATTA, YASUO TOKITA, NOBUYOSHI TAKA ...
    1994 Volume 36 Issue 4 Pages 382-388
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    The development and progress of renal deterioration in patients with essential hypertension administered antihypcrtcnsive therapy remain unclear. In this retrospective analysis, we divided 25 essential hypertension patients who eventually required hemodialysis (HD) from 1981 to 1990, into those with malignant essential hypertension (MEH) (N = 9) and those with benign essential hypertension (BEH) (N =16), and analyzed the clinical features, the rate of renal deterioration, and outcome in each group. The patients with MEH were significantly younger, and had a shorter duration of hypertension than those with BEH. There were no significant differences between the two groups in urinary volume, cardiothoracic ratio, hcmatological findings or blood chemistry at the initiation of HD. However, blood pressure in the patients with MEH was significantly higher than that in the patients with BEH at that time despite antihypcrtcnsive treatment. There was also no significant difference between the groups in the slope of reciprocal creatinine. The latter was significantly correlated with the level of blood pressure and serum total cholesterol. Considering the outcome, all of the patients with MEH survived for 5 years. These results suggest that the more rapid progression of renal deterioration in the patients with essential hypertension might be related to the severity of hypertension and to lipid abnormalities during antihypcrtcnsive therapy.
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  • MINORU CHIMATA, HIROYUKI MASAOKA, MICHITAKA FUJIMAKI, NATSUKO HAMADA, ...
    1994 Volume 36 Issue 4 Pages 389-395
    Published: 1994
    Released on J-STAGE: July 05, 2010
    JOURNAL FREE ACCESS
    Of 150 patients undergoing regular hemodialysis (HD), 14 (9.3%) and 12 (8.0%), respectively, showed low serum activity of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). An investigation was conducted to elucidate the underlying mechanisms in 20 patients with low serum AST and/or ALT activity. Fifty-five percent of the patients with low aminotransferase activity manifested serum levels of pyridoxal phosphate (PLP) that were lower than normal. Serum PLP levels correlated neither with AST nor with ALT activity. Oral administration of vitamin B6 to the cases with low aminotransferase activity resulted in an increase in pre-hemodialysis aminotransferase activity. Addition of vitamin B6 in vitro to the sera from the patients with low aminotransferase activity did not increase the values when the added vitamin B6 was within the physiological range, but did increase when added in larger (pharmacological) amounts. However, aminotransferase activity increased, but PLP levels remained unchanged when these values were compared before and after HD. On the other hand, guanase being within the normal range in all cases studied, did not change after HD. Although our study does not correlate with vitamin B6 deficiency, but rather with some uremic substance(s) which interfere(s) with the enzyme reaction as a cause of low aminotransferase activity, the fact that less than 10% of our patients showed low AST and/or ALT points to the latter possibility, suggesting the need of further study.
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  • TADAHISA OGIHARA, TAKASHI MORITA, SHIGERU MIYAZAKI, YOSHIHEI HIRASAWA
    1994 Volume 36 Issue 4 Pages 396-402
    Published: 1994
    Released on J-STAGE: March 01, 2011
    JOURNAL FREE ACCESS
    Renal biopsy of a 70-year-old woman with clinical features of rapidly progressive glomerulonephritis revealed nodular glomerulosclerosis with conspicuous crescent formation. Other peculiar findings were the presence of many mesangiolytic cystic lesions and multinucleated giant cells in the cystic lesions. By immunofluorescent microscopic study, lambda light and gamma heavy chains were found in mesangial nodules, Bowman's capsule and the tubular basement membrane. Multiple myeloma was diagnosed by bone marrow examination. Autopsy performed two months later revealed systemic deposition of lambda light and gamma heavy chains, and fairly advanced nodular glomerulosclerosis. Most of the glomerular nodular lesions had a lamellar structure. Amyloid was not found. The high incidence of both mesangiolytic lesions in the biopsy specimen and laminated glomerular nodules in the autopsy material supports the previously proposed pathogenetic relationship of these two findings.
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