-
[show abstract]
[hide abstract]
ABSTRACT: We report a 57-year-old woman with concurrent tubulointerstitial nephritis and uveitis syndrome (TINU) and Fanconi's syndrome. She presented with sudden onset of bilateral ocular pain, blurred vision, acute renal failure, glucosuria and proteinuria. Slit lamp examination revealed acute bilateral anterior uveitis. Tubulointerstitial nephritis was confirmed by kidney biopsy. Laboratory examination revealed normoglycemic glucosuria, proteinuria, normal anion-gap metabolic acidosis, phosphaturia, urinary uric acid wasting and kaliuresis leading to hypokalemia. Her vision and renal function improved gradually after systemic steroid therapy. There have been rare reports of TINU syndrome which had features of Fanconi's syndrome. The prevalence of TINU syndrome may be underestimated, and its association with Fanconi's syndrome requires further investigation.
Clinical nephrology 02/2011; 75 Suppl 1:75-8. · 1.17 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Carotid-femoral pulse wave velocity (cf-PWV) is a validated marker of arterial stiffening over the central arteries. Brachial-ankle pulse wave velocity (ba-PWV) integrates the mechanical properties from both the central and peripheral arteries and may be more representative than cf-PWV as arterial load for left ventricle (LV). We compared ba-PWV with cf-PWV for the association of cardiovascular structure and function in 320 subjects with various degrees of abnormality in cardiac structure and function. ba-PWV (by oscillometric technique) and cf-PWV (by tonometric technique) were measured simultaneously, and were highly correlated (r=0.79, P<0.001). Both ba-PWV and cf-PWV were significantly correlated with LV mass, but the correlation was better with ba-PWV (r=0.29 vs r=0.22, P=0.0219). While ba-PWV and cf-PWV were similarly significantly correlated with LV end-systolic elastance and mitral E/A ratio, ba-PWV had better correlation with isovolumic relaxation constant (r=0.34 vs r=0.27, P=0.0202) than cf-PWV. In addition, the correlation was also significantly stronger with ba-PWV than with cf-PWV for other indices of arterial stiffness, including carotid incremental modulus (r=0.59 vs 0.50, P=0.0013), effective arterial elastance (r=0.41 vs r=0.33, P=0.0081) and carotid augmentation index (r=0.38 vs r=0.32, P=0.0368). In conclusion, ba-PWV correlates better with LV mass and diastolic function and other indices of arterial function than cf-PWV, probably because ba-PWV encompasses a greater territory of arterial tree than cf-PWV.
Journal of Human Hypertension 01/2008; 22(1):24-31. · 2.80 Impact Factor
-
Journal of Human Hypertension 07/2005; 19(6):425-7. · 2.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Pulse wave velocity (PWV) is a surrogate marker of arteriosclerosis. It can be measured by recording pressure or flow wave signals at two recording sites of an arterial segment simultaneously or sequentially. However, it is unknown how the values of pulse wave velocity derived from various techniques can be compared. Thus, the aims of the present study were to investigate whether different techniques result in different values of PWV.
We measured aortic PWV from 101 uremic and non-uremic patients using both applanation tonometry and Doppler velocimetry by sequential method. To evaluate whether there is a difference between the sequentially and simultaneously derived PWV, simultaneous method using 2 tonometer or 2 Doppler probes was also applied in 50 and 23 subjects, respectively.
There was no significant difference between PWV derived from sequential and simultaneous tonometry (933+/-310 cm/s and 919+/-301 cm/s,p = 0.09). Likewise, there was no significant difference between PWV derived from sequential and simultaneous velocimetry (778+/-241 cm/s and 761+/-205 cm/s,p = 0.35). However, PWV determined by sequential tonometry was significantly greater than (949+/-315 cm/s and 735+/-208 cm/s, respectively,p < 0.001), yet also significantly correlated with that determined by sequential velocimetry (r = 0.83, p < 0.001).
Sequential applanation tonometry is a practical approach to measure PWV in view of technical convenience and the cost of equipment and manpower. Furthermore, we should be cautious in interpreting PWV derived from different methodologies as greater PWV value might be obtained by applanation tonometry than by Doppler velocimetry.
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed 12/2001; 64(12):693-702.
-
[show abstract]
[hide abstract]
ABSTRACT: The incidence of syncope increases with age, while aging is also associated with increased arterial wave reflection.
The study was undertaken to determine whether increased arterial wave reflection is a predisposing factor of syncope.
We recruited 38 patients (28 men and 10 women, mean age 57.2 +/- 20.3 years, range 17-87 years) with a history of syncope within 6 months of entry. The etiology of syncope was documented for each patient by a complete assessment of vasomotor function and cerebral flow. All patients received a comprehensive echocardiographic evaluation of cardiac structure and function. Carotid augmentation index (AI) was estimated noninvasively with the tonometry technique. The results were compared with those from 54 age- and gender-matched controls.
The most frequent diagnoses of syncope were postural hypotension (13 patients) and cerebrovascular dysautoregulation (10 patients), and the cause could not be determined in 9 patients. Compared with the control group, the syncope group had a greater AI (20 +/- 21 vs. 10 +/- 15%, p = 0.013). Subgroup analysis of 20 patients aged > 50 years and with the aforementioned diagnoses showed even more striking results: AI, 29 +/- 10 vs. 11 +/- 15%, p < 0.001. The enhanced augmentation in the patients remained when age, systolic blood pressure, height, and heart rate were accounted for. Analysis of the carotid pulse wave suggested that both the timing and intensity of wave reflection were enhanced in patients with a history of syncope compared with controls.
Our results support the hypothesis that enhanced arterial wave reflection is associated with the occurrence of syncope, especially in the elderly.
Clinical Cardiology 12/2000; 23(11):825-30. · 2.15 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Spiral computed tomographic angiography (CTA), a new noninvasive imaging technique, was used to study 10 arteriovenous fistulas (AVF) in 9 hemodialysis patients. Digital subtraction angiography (DSA) was also performed as a gold standard for comparison. AVF stenosis was graded by a four-point scale: grade 0, well patency of supplying artery, anastomosis and drainage vein; grade 1, < 50% stenosis; grade 2, 50-70% stenosis; grade 3, 70-99% stenosis, and grade 4, total occlusion. We found CTA correlated closely to DSA in detecting both stenosis and dilatation of AVF and it spared all the shortcomings of DSA. CTA has the potential to be alternative for imaging of dialysis fistulas. Further studies will be performed to specify the role of CTA images in the assessment of the hemodialysis vascular access.
American Journal of Nephrology 01/1998; 18(2):117-22. · 2.54 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: For better simulation of the long-dwell exchanges in conventional CAPD, we have developed a modified mesothelial cell culture system consisting of a Transwell culture apparatus. The equilibration patterns of pH, dextrose and osmolality in the present culture system were observed to be very similar to those in human CAPD. The effects of six different peritoneal dialysis solutions on the apoptosis of mesothelial cells were evaluated using this modified culture system. The results imply that peritoneal dialysis solution per se may incite apoptosis of mesothelial cells, and also that low calcium peritoneal dialysis solution is a milder apoptosis stimulant as compared to the conventional peritoneal dialysis solution. Moreover, varying concentrations of dextrose in the peritoneal dialysis solution were not observed to significantly affect the apoptosis rate. The roles of ambient high concentrations of calcium and dextrose, low pH, as well as high osmolality in the apoptosis are also discussed.
Kidney International 05/1997; 51(4):1280-8. · 6.61 Impact Factor
-
Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 16(5):538-9. · 2.10 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the modulation of superoxide dismutase, glutathione peroxidase, and catalase by cytokines and endotoxin in human peritoneal mesothelial cells.
Cultured human peritoneal mesothelial cells were treated with various concentrations of interleukin-1 alpha, tumor necrosis factor-alpha (TNF-alpha), interleukin-6, interleukin-8, transforming growth factor-beta (TGF beta), and lipopolysaccharide. Cell morphology was observed and the activities of superoxide dismutase, catalase, and glutathione peroxidase were assayed. The antioxidant enzyme activities of human peritoneal mesothelial cells were also compared with those of human liver and kidney tissues.
Interleukin-1 alpha, TNF alpha, TGF beta, and lipopolysacharide caused dose-dependent cytotoxicities in mesothelial cells. The activities of these three antioxidant enzymes did not change after treatment with cytokines and endotoxin. The total superoxide dismutase activity of confluent human peritoneal mesothelial cells was found to be greater than that of human liver and kidney tissues and was composed mostly of manganese superoxide dismutase activity. Furthermore, glutathione peroxidase and catalase activities of human peritoneal mesothelial cells were lower than those of human liver and kidney tissues.
In human peritoneal mesothelial cells, lack of induction of antioxidant enzymes by inflammatory cytokines, as well as high superoxide dismutase activity accompanied by insufficient glutathione peroxidase and catalase activities may both contribute to the susceptibility of these cells to oxidative damage. Therefore, appropriate management to decrease oxidative injury to the peritoneum should be taken into consideration when treating long-term continuous ambulatory peritoneal dialysis patients.
Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 17(5):455-66. · 2.10 Impact Factor
