ISSN:1660-8151    

DOI:10.1159/000182985

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Out of 105 renal transplant recipients 100 had skin lesions: 55% iatrogenic, 74% infectious, 12% precancerous or cancerous and 4% miscellaneous. Many of these lesions were at least in part transient, and steroid-related skin lesions became less frequent as years progressed. The more frequent infections were the fungal ones, followed by viral and bacterial infections with different patterns of onset. All the precancerous lesions appeared late and were almost exclusively represented by actinic keratoses; 2 evolved into squamous cell epitheliomata. 2 patients died due to Kaposi’s sarcoma and melanoma. The high incidence of skin cancers in transplanted patients and the rapid evolution of dyskeratoses into spinaliomas warrants close dermatological surveillanc

ISSN:1660-8151    

DOI:10.1159/000182986

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Renal handling of sodium, potassium, calcium and phosphorus was investigated in 9 patients with cystic fibrosis (CF). Both under baseline conditions and during saline-induced diuresis, urinary excretion rate of sodium (UNaV), potassium, phosphorus and calcium did not differ significantly from control values although the fractional excretion of sodium was significantly higher in patients with CF during saline diuresis. When distally acting diuretics were administered, this difference between CF patients and controls was magnified and in addition, UNaV in CF patients was also significantly higher than in controls. Following saline loading the increment in glomerular filtration rate (GFR) in patients with CF was significantly lower than that of controls. We conclude that patients with CF when subjected to volume expansion demonstrate a lower tubular reabsorptive capacity of sodium as well as a reduced ability to increase their GFR. The defect in sodium reabsorption is probably located in the proximal tubule.

ISSN:1660-8151    

DOI:10.1159/000182987

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In the present experiment, we investigated the mechanism of the suppressed mitogen responses of peripheral blood mononuclear cells (PBMC) from uremic patients. We used phytohemagglutinin (PHA) and concanavalin A (Con A) as T cell mitogens, pokeweed mitogen (PWM) as a T cell-dependent B cell mitogen, and Staphylococcus aureus Cowan I (STA) as a T cell-independent B cell mitogen. PBMC from uremic patients showed significantly suppressed responses to PHA (p < 0.05), Con A (p < 0.05) and STA (p < 0.01) compared with those from healthy controls, but there was no significant difference in PWM response. However, these suppressed responses to PHA and Con A were markedly restored by depletion of phagocytic cells from PBMC. Although STA responses were also restored markedly in uremic patients, some patients still showed lower responsiveness to STA indicating the possibility of functional B cell defects. To further clarify the mechanism of the suppressed responses to mitogens, PBMC or nonphagocytic cells from uremic patients were cocultured with control T cells in the presence of PHA, or the effects of adherent cells from uremic patients on PHA responses of autologous or allogeneic control T cells were studied. From these experiments, it was suggested that the suppressed responses of PBMC to mitogens in uremia were mediated by monocytes.

ISSN:1660-8151    

DOI:10.1159/000182988

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

In a postmortem study of 8 uremic patients (mean age 63.0), the concentration of 23 trace elements was determined in heart tissue with neutron activation analysis. The concentration was significantly increased in 10 elements – e.g. Co (p < 0.001), As, Br, Ce, La, Sb, Sc (p < 0.01), Fe, K and P (p < 0.05) – compared to a control group of non-uremic individuals. As some of these elements are cardiotoxic, the results support our opinion that an excess of certain trace elements, cobalt in particular, may be etiological agents of importance in uremic heart fail

ISSN:1660-8151    

DOI:10.1159/000182989

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Previously, we have shown that insulin binding (IB) to erythrocytes was decreased in uremic patients and that hemodialysis corrected the receptor defect. In the present study cross-incubation experiments were performed using uremic and control erythrocytes and plasma. Incubation of control erythrocytes with uremic plasma resulted in a 60% decrease in specific insulin binding, and progressive dilutions of uremic plasma revealed a parallel decrease in degree of inhibition suggesting the presence of an inhibitor of insulin binding in uremic plasma. Plasma obtained from uremic patients exhibiting lower IB to their erythrocytes was more potent in inhibition of IB to control erythrocytes, i.e. predialysis in comparison with postdialysis plasma. The alteration of IB was reversible since incubation of uremic erythrocytes with normal plasma restored IB towards normal values. Subjects having higher IB to their erythrocytes had more efficient plasma in restoring IB to uremic erythrocytes. The data indicate that alteration of insulin binding in uremia is mediated by dialysable plasma inhibitors. The possibility that humoral factors affecting binding of insulin to its receptors can in this way influence the sensitivity of peripheral tissues to insulin is considered.

ISSN:1660-8151    

DOI:10.1159/000182990

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Small intestinal dipeptidases (substrate: glycyl-L-leucine, L-methionyl-L-methionine, and L-alanyl-L-proline) were determined in uraemic and sham-operated rats given normal protein diet (24%), low protein diet (6%), and total parenteral nutrition for 10–14 days. Disaccharidases (substrate: maltose, sucrose, trehalose, and lactose) were measured after normal and low protein diet orally. Glycyl-L-leucine and L-methionyl-L-methionine splitting activities were increased on normal protein diet but decreased after low protein feeding in uraemic rats. Parenteral nutrition further lowered the enzyme activity. L-Alanyl-L-proline dipeptidase activity showed an inverse relation to protein intake with the highest values after parenteral nutrition. Lactase increased in uraemic rats after low protein feeding and was the only disaccharidase to be affected by the nutritional change. It is suggested that the changes of the intestinal dipeptidase activities in uraemia are adaptive to variation in the luminal content of di- and ohgopeptides because of the type of nutrition give

ISSN:1660-8151    

DOI:10.1159/000182991

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Chronic psychosocial stress in male mice produces chronic interstitial nephropathy not explained by renal vascular disease or urinary infection. Four groups of male CBA mice were studied. Group 1 and group 2 were placed in Henry-Stephens complex population cages for 5 months. Group 2 had caffeine, 800 µg/ml, added to their drinking water. Control groups 3 and 4 were unstressed, but group 4 had 800 µg/ml of caffeine added to their water. Stressed animals developed chronic interstitial nephropathy which was more severe in animals drinking caffeinated water. In addition, the percent of cortex involved in interstitial fibrosis was higher in group 2,18.0 ± 1.4, than in group 1 15.2 ± 2.3 (p < 0.05). Both groups had more fibrosis than unstressed animals (p < 0.01). Blood urea nitrogen was more elevated in group 2, 47 ± 13 mg/dl, than in group 1 29 ± 17 mg/dl (p < 0.05). Again both values exceeded those in unstressed animals (p < 0.01). It is concluded that prolonged environmental stress can lead to the renal morphologic changes of chronic interstitial nephritis. Both renal pathology and function are worse when there is concurrent high caffeine intake. The relevance of this model to human disease related to analgesic use or with affective illness requires further

ISSN:1660-8151    

DOI:10.1159/000182992

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

Light and electron microscopy were used to study the effects of a lithium-supplemented diet on renal structure in the rat. At the end of a 7-week experimental period serum lithium levels were 1.14 ± 0.20mM. Lesions consisting of groups of dilated tubules were found in the immediate vicinity of the interlobular arteries in all experimental animals. These tubules were identified as the connecting tubule or the initial portion of the collecting tubule. The epithelium of these tubules was generally flattened but was punctuated by markedly swollen epithelial cells. PAS-positive deposits found in both types of cells were identified as glycogen. Electron microscopy revealed considerable lithium-induced damage in the swollen cells including increased numbers of mitochondria, many of which were swollen or otherwise damaged, dilated cisternae of endoplasmic reticulum and vacuolization of the apical cytoplasm. The flattened cells of these tubules were similar to the dark or intercalated cells of normal collecting tubules. Some detachment of epithelial cells from their basement membrane was evident in these tubules. Damage was less severe in distal convoluted tubules. Lithium-induced changes were not observed in glomeruli, proximal tubules or ascending thick limbs of Henle. In medullary collecting tubules damage was less severe than in cortical collecting tubules, but detachment of epithelial cells was a common finding. The interstitial tissue of the papilla exhibited histochemical and ultrastructural changes consistant with lithium blockade of the action of antidiuretic hormone. The ultrastructural damage to cortical tubules is similar to that found in patients receiving therapeutic lithium for long periods of time. The anatomic sites of lithium-induced pathology correspond to the location of lithium-induced pathophysiology

ISSN:1660-8151    

DOI:10.1159/000182993

出版商:S. Karger AG    

年代:1983

数据来源: Karger

摘要:

A patient with acute myelomonocytic leukemia (AML) developed nephrotic syndrome. The renal biopsy showed focal glomerulosclerosis by light microscopy. Electron microscopy and immunofluorescence revealed electron-dense deposits, IgG and C′3 in the glomerular mesangium. A 21S circulating immune complex (CIC) present in the patient’s serum and the renal biopsy eluate contained immunochemically identical materials. The isolated antibodies from the 21S CIC and the eluate showed restricted reactivity against autologous AML cells. Immunodiífusion studies demonstrated common antigenicity between the 21S CIC antigen, the eluted antigen and between autologous AML cell membrane anti

ISSN:1660-8151    

DOI:10.1159/000182994

出版商:S. Karger AG    

年代:1983

数据来源: Karger