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  • 1
    ISSN: 1437-773X
    Keywords: Key words Nodular lesion ; Diffuse lesion ; Exudative lesion ; Microangiopathy ; Interstitial lesion ; Diabetic nephropathy ; Ultrastructural pathology ; AGEs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Diabetic nephropathy is a major cause of chronic renal failure in Japan, and the prevalence rate has markedly increased during the past decade. Diabetic nephropathy shows various specific histological changes not only in glomeruli but also in the interstitial region. Nodular, diffuse, and exudative lesions, so-called diabetic glomerulosclerosis, are well known as glomerular lesions. At first, they were historically evaluated only by light microscopy, and thus which components of the glomeruli were modified was not sufficiently clear. Subsequent electron microscopic studies clarified that the expansion of the mesangial matrix was the true form of nodular and diffuse lesions, and that insudated serum substance was the real appearance of an exudative lesion. Interstitial lesions also exhibit specific features in diabetic nephropathy. In electron microscopic studies, it was proved that the size of mitochondria and thickness of the tubular basement membrane were increased in diabetic nephropathy. In this review, we introduce typical electron microscopic findings in diabetic nephropathy and recent opinions on the progression of diabetic nephropathy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1437-7799
    Keywords: abdominal aortic aneurysm ; aortocaval fistula ; acute renal failure ; hepatic injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aortocaval fistula is an unusual complication of an abdominal aortic aneurysm. We describe 2 patients with abdominal aortic aneurysms who presented with acute renal failure and hepatic injury secondary to spontaneous aortocaval fistulas. The fistulas were shown by computed tomography, right heart catheterization, and abdominal aortography, and were confirmed at surgery. Increases in the fractional excretion of filtered sodium, the urine sodium concentration divided by the urine-to-plasma creatinine ratio (the renal failure index), and the urine sodium concentration were observed. The patients recovered renal and hepatic function after closure of the fistulas. Increased venous pressure resulting from aortocaval shunt might cause the alteration of renal and hepatic function. Therefore, it is important to accurately diagnose the aortocaval fistula and to close it urgently by surgical methods.
    Type of Medium: Electronic Resource
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