- 著者
- 辻 正人 斉藤 元章 吉田 雅治 中林 公正 北本 清 長沢 俊彦 干川 就可
- 出版者
- 一般社団法人 日本内科学会
- 雑誌
- 日本内科学会雑誌 (ISSN:00215384)
- 巻号頁・発行日
- vol.77, no.5, pp.700-704, 1988-05-10 (Released:2008-06-12)
- 参考文献数
- 19
症例は39才,男性. 28才時に全身性エリテマトーデスの診断にて,以後ステロイド療法が施行された. 34才時,胸痛が出現し急性心筋梗塞と診断された. 36才時に言語障害と右不全麻痺が出現し,脳梗塞を合併した. 39才時,二度目の心筋梗塞発作で死亡した.剖検上,全身の著しい動脈硬化性病変を認め,特に冠状動脈と中大脳動脈に器質化血栓を伴うアテローム性動脈硬化症が認められた.全身性エリテマトーデス症例における動脈硬化促進因子については,全身性エリテマトーデス固有の血管炎・血栓をきたしやすい病態,ステロイド長期投与の影響の他に,高血圧,高脂血症,大量喫煙などの多様な因子の存在も重要な役割を果たしていると考えられた.
2 0 0 0 OA 高ミオグロビン血症を呈した急性腎不全症例7例の臨床的検討とその病態に関する考察
- 著者
- 副島 昭典 北本 清 長沢 俊彦
- 出版者
- 社団法人 日本腎臓学会
- 雑誌
- 日本腎臓学会誌 (ISSN:03852385)
- 巻号頁・発行日
- vol.24, no.11, pp.1289-1298, 1982-11-25 (Released:2011-07-04)
- 参考文献数
- 18
During two year periods between 1979 and 1981, we have experienced 28 cases of acute renal failure (ARF) with various causes. Among them 7 cases were thought to be originated from myoglobinuric ARF due to rhabdomyolysis. The causes of rhabdomyolysis were burns in one case, crush injury in one case, marathon running in one case, hypoxygenation from acute adrenal insufficiency in 2 cases and drugs in 2 cases. The serum and/or urinary level of myoglobin (Mb) detected by radioimmunoassy were moderately or highly elevated at the initial phase of ARF in these 7 cases. Also, there were hematest positive dark urine and dehydration of various degrees. There were no constant tendency in the serum level of uric acid, calcium, potassium in our cases with myoglobinuric acute renal failure (Mb-ARF), althought these parameters were fairly abnormal in Mb-ARF in the previous reports. Five cases received hemodialysis and two cases were treated conservatively. Six cases recovered completely from ARF and one case due to haloperidol induced Mb-ARF died, although frequent hemodialysis were performed. It was concluded that (1) Mb-ARF might be a considerably common cause of ARF, (2) measure-ment of serum and/or urine Mb might be very sensitive diagnostic tool for the differentiation of etiology of ARF. (3) However, Mb-ARF must be carefully differentiated from the acute exacerbation of chronic renal failure (CRF), since in patients with CRF the serum level of Mb were considerably high due to the disturbance of urinary excretion of Mb, (4) The outcome of Mb-ARF was relatively good.
- 著者
- 副島 昭典 石塚 俊二 鈴木 道彦 蓑島 忍 中林 公正 北本 清 長沢 俊彦
- 出版者
- 社団法人 日本腎臓学会
- 雑誌
- 日本腎臓学会誌 (ISSN:03852385)
- 巻号頁・発行日
- vol.37, no.1, pp.81-85, 1995 (Released:2010-07-05)
- 参考文献数
- 23
In recent years, several laboratories have suggested that serum levels of antioxidant activity and redox balance are reduced in patients with chronic renal failure. Some clinical reports have also proposed that defective serum antioxidative enzymes may contribute to a certain uremic toxicity through peroxidative cell damage. A 48-year-old woman was referred to us from the surgical department of our hospital because of consciousness disturbance, panctytopenia and acute acceleration of chronic azotemia after postoperative radiation therapy. We diagnosed acute acceleration of chronic renal failure with severe acidemia and started hemodialysis therapy immediately. Two days after admission to our department, she developed upper abdominal sharp pain and bradyarrhythmia. Serum amylase activity was elevated markedly and the ECG finding showed myocardial ischemia. On the 24th hospital day these complications were treated successfully with conservative therapy and hemodialysis. We considered that radiation therapy in this patient with chronic renal failure evoked marked oxidative stress and that deficency of transferrin played an important role in peroxidative cell damage.