Abstract. Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a pri... more Abstract. Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idiopathic) entity and in a secondary form, typically in association with reduced functional renal mass. Familial forms have been observed and two loci for autosomal dominant FSGS have been mapped. This study shows that an adolescent/adult form of recessive FSGS maps to a locus on chromosome 1q25–31, which overlaps with a region previously identified as harboring a locus for an early childhood onset recessive form of nephrotic syndrome (SRN1). Evaluation of a large family demonstrated linkage with a maximum two-point lod score of 3.98 at D1S254 and D1S222. Lod score calculations support the conclusion of linkage in four of five additional families. Haplotype analysis suggests that this FSGS gene is located in a 19-cM region flanked by D1S416 and D1S413, of which 6 cM overlaps with
Journal of the American Society of Nephrology, 2000
Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idio... more Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idiopathic) entity and in a secondary form, typically in association with reduced functional renal mass. Familial forms have been observed and two loci for autosomal dominant FSGS have been mapped. This study shows that an adolescent/adult form of recessive FSGS maps to a locus on chromosome 1q25-31, which overlaps with a region previously identified as harboring a locus for an early childhood onset recessive form of nephrotic syndrome (SRN1). Evaluation of a large family demonstrated linkage with a maximum two-point lod score of 3.98 at D1S254 and D1S222. Lod score calculations support the conclusion of
JAMA: The Journal of the American Medical Association, 1976
A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple sy... more A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple system involvement including arthralgias, glomerulonephritis, myositis, pseudotumor cerebri, and adenopathy. Persistent hypocomplementemia is noted with classic pathway activation. The syndrome recognized in this patient and those few individuals reported previously seems to constitute a distinct category of collagen-vascular disease.
The vasodilator drugs act directly on vascular smooth muscle to produce vasodilatation and reduct... more The vasodilator drugs act directly on vascular smooth muscle to produce vasodilatation and reduction in peripheral resistance. They include hydralazine, diazoxide, minoxidil, guancydine, and sodium nitroprusside. With the exception of sodium nitroprusside, these drugs have a selective effect on arterioles with little if any effect on venous capacitance vessels. This selective dilatation of arterioles results in an increase in venous return, which triggers a reflex increase in heart rate and stroke volume mediated through the sympathetic nervous system. As a result they share several common side effects due to increased cardiac action. These include palpitation, headache, and the capacity to precipitate angina pectoris in patients with coronary disease. In addition, drugs in this group share an ability to stimulate renin release and promote sodium retention. Increased cardiac output and sodium retention both act to reduce the hypotensive effects of vasodilatation. In most circumstances, drugs in this group should be use d together with propranolol and diuretics which counteract these effects, enhance the effectiveness of vasodilatation, and minimize side effects. Of the vasodilators, only hydralazine is available for oral use in the United States at present. Minoxidil and guancydine have given promising results in clinical trials. Diazoxide and sodium nitroprusside are available only for intravenous use, although diazoxide has been shown to be effective given orally, s:~
Rauwolfia alkaloids Actions. The rauwolfia compounds exert their antihypertensive action primaril... more Rauwolfia alkaloids Actions. The rauwolfia compounds exert their antihypertensive action primarily by interfering with chemical neurotransmission at the postganglionic adrenergic nerve endings, resulting in a decrease in peripheral vascular resistance? 6' 47 In experimental animals, depletion of norepinephrine from the adrenergic nerve endings occurs approximately 24 hours after the administration of the drug. The rauwolfia alkaloids appear to deplete the adrenergic nerve ending of the bound stores of norepinephrine. The released norepinephrine is metabolized by monoamine oxidase resulting in a decrease in norepinephrine content in the storage sites. In addition, sympathetic discharge is inhibited by direct action of these drugs on the hypothalmus and the vasomotor centers in the brain stem27. ~8 The antihypertensive effect of the rauwolfia alkaloids is due much more to their peripheral than to their central actions2 ~ In animals, the reduced concentration of catecholamines in the brain and in postganglionic adrenergic nerve fibers can be measured within an hour after administration2 ~ The rauwolfia compounds also reduce the catecholamine content of the myocardium. Although this action has not been implicated in the develop: ment of congestive heart failure, these drugs should be used cautiously in the presence of congestive failure. Depletion of catecholamines and serotonin in brain tissue produced by the rauwolfia alkaloids results in noticeable tranquilizing and sedating effects. ~1 However, this sedating action has little if any role in the antihypertensive action of these drugs. ~(~ Uses. The rauwolfia alkaloids include reserpine
JAMA: The Journal of the American Medical Association, 1972
In a recently developed hemodialyzer, closely set rows of tiny, flat-topped pyramids have been su... more In a recently developed hemodialyzer, closely set rows of tiny, flat-topped pyramids have been substituted for the usual parallel grooves on the membrane-supporting surfaces of standard Kiil artificial kidneys. We compared dialysance rates for urea, creatinine, and phosphate in the old and new kinds of kidney. For all three substances, rate of dialysance was approximately 50% greater in the pyramid-surface machines than in the Kiil kidneys. These data suggest that the substitution of the pyramids for the usual parallel grooves on kidney boards will permit reduction of dialysis time by one third.
Three postoperative patients with oliguirc renal failure and hypochloremic metabolic alkalosis we... more Three postoperative patients with oliguirc renal failure and hypochloremic metabolic alkalosis were treated with hemodialysis using a specailly prepared high-chloride, low-acetate dialysate. This mode of therapy corrected the metabolic abnormalities and was significantly more effective than treatment with commercially available high-acetate dialysate at increasing the serum chloride and hydrogen ion concentration. Furthermore, hemodialysis with high-chloride, low-acetate dialysate corrected the clinical sequelae of hypoventilation, cardiac arrhythmia, and neuromuscular irritability associated with metabolic alkalosis while treating uremia simultaneously.
Abstract. Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a pri... more Abstract. Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idiopathic) entity and in a secondary form, typically in association with reduced functional renal mass. Familial forms have been observed and two loci for autosomal dominant FSGS have been mapped. This study shows that an adolescent/adult form of recessive FSGS maps to a locus on chromosome 1q25–31, which overlaps with a region previously identified as harboring a locus for an early childhood onset recessive form of nephrotic syndrome (SRN1). Evaluation of a large family demonstrated linkage with a maximum two-point lod score of 3.98 at D1S254 and D1S222. Lod score calculations support the conclusion of linkage in four of five additional families. Haplotype analysis suggests that this FSGS gene is located in a 19-cM region flanked by D1S416 and D1S413, of which 6 cM overlaps with
Journal of the American Society of Nephrology, 2000
Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idio... more Focal segmental glomerulosclerosis is a nonspecific renal lesion observed both as a primary (idiopathic) entity and in a secondary form, typically in association with reduced functional renal mass. Familial forms have been observed and two loci for autosomal dominant FSGS have been mapped. This study shows that an adolescent/adult form of recessive FSGS maps to a locus on chromosome 1q25-31, which overlaps with a region previously identified as harboring a locus for an early childhood onset recessive form of nephrotic syndrome (SRN1). Evaluation of a large family demonstrated linkage with a maximum two-point lod score of 3.98 at D1S254 and D1S222. Lod score calculations support the conclusion of
JAMA: The Journal of the American Medical Association, 1976
A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple sy... more A patient with cutaneous necrotizing vasculitis had chronic urticaria associated with multiple system involvement including arthralgias, glomerulonephritis, myositis, pseudotumor cerebri, and adenopathy. Persistent hypocomplementemia is noted with classic pathway activation. The syndrome recognized in this patient and those few individuals reported previously seems to constitute a distinct category of collagen-vascular disease.
The vasodilator drugs act directly on vascular smooth muscle to produce vasodilatation and reduct... more The vasodilator drugs act directly on vascular smooth muscle to produce vasodilatation and reduction in peripheral resistance. They include hydralazine, diazoxide, minoxidil, guancydine, and sodium nitroprusside. With the exception of sodium nitroprusside, these drugs have a selective effect on arterioles with little if any effect on venous capacitance vessels. This selective dilatation of arterioles results in an increase in venous return, which triggers a reflex increase in heart rate and stroke volume mediated through the sympathetic nervous system. As a result they share several common side effects due to increased cardiac action. These include palpitation, headache, and the capacity to precipitate angina pectoris in patients with coronary disease. In addition, drugs in this group share an ability to stimulate renin release and promote sodium retention. Increased cardiac output and sodium retention both act to reduce the hypotensive effects of vasodilatation. In most circumstances, drugs in this group should be use d together with propranolol and diuretics which counteract these effects, enhance the effectiveness of vasodilatation, and minimize side effects. Of the vasodilators, only hydralazine is available for oral use in the United States at present. Minoxidil and guancydine have given promising results in clinical trials. Diazoxide and sodium nitroprusside are available only for intravenous use, although diazoxide has been shown to be effective given orally, s:~
Rauwolfia alkaloids Actions. The rauwolfia compounds exert their antihypertensive action primaril... more Rauwolfia alkaloids Actions. The rauwolfia compounds exert their antihypertensive action primarily by interfering with chemical neurotransmission at the postganglionic adrenergic nerve endings, resulting in a decrease in peripheral vascular resistance? 6' 47 In experimental animals, depletion of norepinephrine from the adrenergic nerve endings occurs approximately 24 hours after the administration of the drug. The rauwolfia alkaloids appear to deplete the adrenergic nerve ending of the bound stores of norepinephrine. The released norepinephrine is metabolized by monoamine oxidase resulting in a decrease in norepinephrine content in the storage sites. In addition, sympathetic discharge is inhibited by direct action of these drugs on the hypothalmus and the vasomotor centers in the brain stem27. ~8 The antihypertensive effect of the rauwolfia alkaloids is due much more to their peripheral than to their central actions2 ~ In animals, the reduced concentration of catecholamines in the brain and in postganglionic adrenergic nerve fibers can be measured within an hour after administration2 ~ The rauwolfia compounds also reduce the catecholamine content of the myocardium. Although this action has not been implicated in the develop: ment of congestive heart failure, these drugs should be used cautiously in the presence of congestive failure. Depletion of catecholamines and serotonin in brain tissue produced by the rauwolfia alkaloids results in noticeable tranquilizing and sedating effects. ~1 However, this sedating action has little if any role in the antihypertensive action of these drugs. ~(~ Uses. The rauwolfia alkaloids include reserpine
JAMA: The Journal of the American Medical Association, 1972
In a recently developed hemodialyzer, closely set rows of tiny, flat-topped pyramids have been su... more In a recently developed hemodialyzer, closely set rows of tiny, flat-topped pyramids have been substituted for the usual parallel grooves on the membrane-supporting surfaces of standard Kiil artificial kidneys. We compared dialysance rates for urea, creatinine, and phosphate in the old and new kinds of kidney. For all three substances, rate of dialysance was approximately 50% greater in the pyramid-surface machines than in the Kiil kidneys. These data suggest that the substitution of the pyramids for the usual parallel grooves on kidney boards will permit reduction of dialysis time by one third.
Three postoperative patients with oliguirc renal failure and hypochloremic metabolic alkalosis we... more Three postoperative patients with oliguirc renal failure and hypochloremic metabolic alkalosis were treated with hemodialysis using a specailly prepared high-chloride, low-acetate dialysate. This mode of therapy corrected the metabolic abnormalities and was significantly more effective than treatment with commercially available high-acetate dialysate at increasing the serum chloride and hydrogen ion concentration. Furthermore, hemodialysis with high-chloride, low-acetate dialysate corrected the clinical sequelae of hypoventilation, cardiac arrhythmia, and neuromuscular irritability associated with metabolic alkalosis while treating uremia simultaneously.
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Papers by Henry Yager