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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The actuarial survival rate for 58 unselected patients who entered a program of maintenance hemodialysis and transplantation was found to be 43.0 +/- 8.3 (SE)% for the six-year period of observation. The survival rate was considerably lower in hypertensive patients as well as in patients with familial Mediterranean fever with amyloidosis, all of whom were nonhypertensive. When the patients with familial Mediterranean fever were excluded from the non-hypertensive group, the expected survival rate of this group became greater than that of the hypertensive group, the difference being about 25% in five years and about 50% in six years. This difference in the survival rate approaches that between normotensive subjects and untreated severely hypertensive patients in the general population. It is concluded that hypertension is a serious limiting factor in the survival of patients on chronic hemodialysis, and that the difference in survival between the hypertensive and the non-hypertensive patients is attributable to hypertension.
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PMID:Probability of survival in hypertensive and nonhypertensive patients on maintenance hemodialysis. 32 Jan 59

The observation of a non-metastatic reactive hepatopathy associated with a hypernephroma in a 39-year-old man who had had fever for 4 months led to a review of the literature and an analysis of basically three aspects of the disorder: a) The various manifestations of carcinoma of the kidney, which include a large number of paraneoplastic clinical symptoms (polycythemia, anemia, prolonged fever, hypercalcemia, hypertension, nefropathy, loss of salt, peripheral neuropathy, and amyloidosis); b) an alteracion of hepatic function known since 1961 which is characterized by an abnormal retention of sulfobromophthalein, increase of alkaline phosphatase, prothrombin decrease, dysproteinemia with hypoalbuminemia, and alpha2-globulin increase. It may or may not be accompanied by enlargement of the liver. c) Criteria of operability of the primary tumor.
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PMID:[Liver disease associated with hypernephroma. A case report (author's transl)]. 45 99

Morphometrical investigations (point-counting method) showed that in different inflammatory (endocapillary -- acute -- GN, mesangioproliferative GN, membranoproliferative GN) glomerulonephritides and in non-inflammatory glomerular diseases (perireticular amyloidosis), there are statistically significant correlation between serum creatine concentrations at the time of biopsy and the enlargement of the cortical interstitium by fibrosis. Similar results were obtained in investigating different grades of benign nephrosclerosis with transition into secondary malignant nephrosclerosis conditioned by hypertension and in chronic diffuse sclerosing interstitial nephritides of different etiologies. As hypothesis, we assume that a narrowing of the postglomerular vessel network by interstitial fibrosis take place. This could lead to an increase resistance of the renal cortical blood flow. In spite of an elevated effective filtration pressure, the slowing of the glomerular blood flow may lead to the reduction of GRF and to an increase of the serum creatinine concentration. Additionally, in the case of interstitial fibrosis the tubules look atrophied. This could be the consequence of the reduced GFR as a sign of inactivity. On the other hand, tubular atrophy could result from malnutrition in the case of interstitial fibrosis. The resorptive capacity of these atrophied-looking tubules could be lowered and the GFR could be diminished by the so-called Thurau mechanism.
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PMID:The role of the interstitium of the renal cortex in renal disease. 46 60

All the cases of spontaneous intracerebral hemorrhage that were autopsied between 1965 and 1976 at at Kuakini Hospital, Hawaii, were analyzed to determine the frequency of coexistent cerebral congophilic angiopathy. Seven of 75 cases (9.3%) were confirmed to have deposition of amyloid in the intracerebral vessels by means of polarized light microscopy and electron microscopy. The cerebral congophilic angiopathy was found to have predilection for aged patients and women (ratio of 6:1). Diabetes mellitus, hypertension, atherosclerosis, systemic amyloidosis, and paraproteinemia did not appear to be associated with this change. There is, however, a strong correlation between classic as well as compact senile plaques and this vascular lesion.
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PMID:Congophilic angiopathy and cerebral hemorrhage. 58 Jul 26

Over the years, hemodynamic stresses and biologic changes bring about reduced cardiac function. The addition of one or more types of organic heart disease leds to further deterioration of fuction. This is why elderly patients require special consideration and management, why their clinical manifestations and therapeutic responses differ from those in young patients. Although no single abnormality characterizes the aging process, cellular, functional, and structural changes support the existence of a cardiopathy. However, there are insufficient data to link so-called senile cardiopathy directly to otherwise unexplained heart failure. Failure is usually due to the typical reasons, i.e., coronary artery or valvular disease, hypertension, amyloidosis, and chronic pulmonary lesions. Nevertheless, the possibility of senile heart failure should not be overlooked in case of impending or actual myocardial failure. In patients over 60, edema, dyspnea, or tachycardia cannot always be attributed to heart disease. It is hazardous to diagnose and prescribe treatment for cardiac failure if the heart shadow is not enlarged on the x-ray,the circulation time is not prolonged, and the heart sounds and rhythmare normal. Other reasons for the complaints should be looked for, even when the heart rate is fast.
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PMID:Cardiopathy of aging: are the changes related to congestive heart failure? 83 76

Following the induction of three different forms of experimental hypertension, deposits of amyloid were found in the spleens of 5-20 per cent of the mice late in the course of the hypertension, Amyloidosis was found in nude (with genetical aplasia of the thymus) as well as in haired (normal) mice. The highest frequency of amyloidosis was observed in mice with hypertension due to partial infarction of one kidney and contralateral nephrectomy. The hypertensive vascular disease, involving lesion of the vessels and of the organs supplied by the affected vessels, is believed, to represent a stimulus for the reticulo endothelial system (RES) with development of amyloidosis as a secondary event.
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PMID:Occurrence of amyloidosis secondary to the induction of experimental hypertension in mice. 84 92

Indentations of the glomerular basement membrane were observed by light microscopy in ultrathin Epon-embedded serial sections from the renal biopsies of patients who had membranous glomerulonephritis, minimal change glomerulonephrits, acute or resolving exudative glomerulonephritis and focal glomerulonephrits, interstitial nephritis, amyloidosis, rheumatoid arthritis, or ankylosing spondylitis. In patients with membranous glomerulonephritis, acute or resolving exudative glomerulonephritis, amyloidosis, or rheumatoid arthritis, the occurrence of indentations in the glomerular basement membrane differed significantly from that in controls. The presence of indentations did not correlate with proteinuria, hematuria, leukocyturia, arterial hypertension, or with the nephrotic syndrome or its treatment with steroids. Examination of alternate serial sections by light and be electron microscopy showed that the indentations that were light microscopically visible corresponded to craters on the epithelial surface of the glomerular basement membrane seen in the electron microscope. These craters contained protruding portions of the epithelial cells, extracellular electron-lucent material or electron-dense amorphous or striated membranous material. They were often surrounded by spikelike protrusions of the lamina densa. These indentations might represent solitary remnants of former subepithelial deposits.
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PMID:Indentations of the glomerular basement membrane in renal diseases. A light and electron microscopic study on ultrathin serial sections. 97 63

Three siblings (two brothers and a sister) of Polish origin, presented in late middle age with the features of the nephrotic syndrome and hypertension. Glomerular deposition of amyloid was found in all on renal biopsy. No amyloid was seen on rectal or gingival biopsy. Their mother and a maternal aunt died in middle age with a clincally similar disease. These cases are compared with other forms of hereditary amyloidosis which are briefly reviewed. The hereditary amyloidoses are classified with particular emphasis on neural and renal involvement.
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PMID:Familial renal amyloidosis. Case reports, literature review and classification. 113 43

Six patients with cardiac amyloidosis (four males, two females; age 27-60 years) were evaluated by us. Four patients presented with congestive heart failure, while one patient each presented with effort angina and giddiness. Extracardiac clues to the diagnosis in the form of involvement of other systems were present in only two patients. The electrocardiogram was abnormal in four patients while three exhibited roentgenographic evidence of cardiomegaly or pulmonary venous hypertension. Echocardiography suggested the diagnosis of amyloidosis in only two patients, restrictive cardiomyopathy in two other patients and dilated and hypertrophic cardiomyopathy in one patient each. Cardiac catheterisation and angiography suggested restrictive heart disease in four patients and hypertrophic cardiomyopathy in one. One patient, whose initial haemodynamic study was normal, had features of dilated cardiomyopathy at repeat study after 11 months. Endomyocardial biopsies showed amyloid deposits in all patients. We emphasise the varied clinical manifestation of cardiac amyloidosis and the need for a high index of suspicion. The diagnosis can be safely and reliably confirmed by endomyocardial biopsy.
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PMID:Cardiac amyloidosis: hemodynamic, echocardiographic and endomyocardial biopsy studies. 130 87

The cerebellum, frontal cortex, hippocampal and parahippocampal regions of 100 patients older than 80 years, most of whom had died of stroke, were examined. Eighteen percent were diagnosed as clinically demented. On the specimens labeled previously with Thioflavin S and Bielschowsky method, immunohistochemical studies were performed with Fab (antigen-binding fragment) of the anti beta-amyloid antibody 4G8. Positive amyloid immunoreactivity was observed in the cerebrum in 71 of 100 cases, Cerebella of 31 subjects of 71 with cerebral amyloidosis also revealed amyloid deposits. They appeared in various morphological forms, such as diffuse plaques and focal subpial deposits, as well as classical and primitive neuritic plaques. Cases with amyloid in the cerebellum alone were not observed. Beta-amyloid deposits in the cerebellum were associated with a significant number of beta-amyloid plaques in the cerebrum, which showed other Alzheimer-type pathology, also in individuals without clinical symptoms of dementia. There was no correlation either between cerebellar amyloid deposits and clinical cerebellar symptoms or between the presence of diabetes mellitus, arterial hypertension, and neuropathological changes. A clear association of microglial cells with amyloid deposits in the cerebellum was demonstrated. In our experience, LN-1 and RCA-1 were not as suitable for formalin-fixed paraffin-embedded tissue, as was anti-ferritin. Negative staining for tau-1 and positive staining for anti-ubiquitin characterized neurites within primitive and classical plaques. No neurofibrillary pathology was detected in the cytoplasm of cerebellar neurons when we used anti tau-1 labeling.
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PMID:beta-Amyloid deposits within the cerebellum of persons older than 80 years of age. 134 Sep 21


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