ISSN:0886-022X    

DOI:10.3109/08860229309054958

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

In the interstitial cell infiltrates associated with primary glomerulonephritis, approximately the same cellular composition has been found, T cells being predominant, monocytes fewer, and B cells least. Cell composition did not seem to be related to the cell density; the lowest percentages of monocytes have been observed with either very high (FSGS) or very low (MGN) cell densities; and the highest percentages of T cells, with either the highest (FSGS) or the lowest (MGN) cell densities. On the other hand, some relationship seemed to exist with the cell distribution in the interstitium. The cell composition was nearly the same in diffuse and disseminated patterns, but was markedly different in nodular (focal) cell infiltrates; T cells were always in first place, but B cells instead of monocytes were in second place. Furthermore, IL2-receptor-presenting cells have been more often observed in nodular (focal) than in both diffuse and disseminated patterns, and more markedly in noniuxtaglomerular than in iuxtaglomerular noduli (foci). In conclusion, cell composition of intersitial infiltrates seems to reflect a cell-mediated immune reaction, leading to all interstitial cell infiltrates associated with primary glomerulonephritis. It is conceivable that the nodular (focal) pattern of distribution might correspond to a discrete mechanism and have a different meaning.

ISSN:0886-022X    

DOI:10.3109/08860229309054959

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Renal functions during the early stage of hepatic damage before ascites formation were studied in adult female rats. Tubular and hemodynamic parameters were analyzed for 12 days after common bile duct ligation. The fractional excretion of water, sodium, and potassium increased from control values at every day studied. Glomerular filtration rate and renal plasma flow were found to be diminished on the fourth day. Renal plasma flow remained decreased while glomerular filtration rate was recovered on the sixth day after common bile duct ligation. Filtration fraction in both experimental groups (4 and 6 days) was higher than in control animals. These observations suggested a preferential efferent arteriole vasoconstriction that could be responsible for a blood flow redistribution to the medulla. This fact might cause the sodium diuresis with diminished urine-to-plasma osmolalities ratio. The onset of cortical vasoconstriction was confirmed by dopamine infusion to bile duct-ligated rats 4 days postsurgery. Hemodynamic and tubular parameters recovered to control values during dopamine administration. All the data point out diuresis and natriuresis as the earliest renal abnormalities in bile duct-ligated rats. This phenomenon could be associated not only to the cortical vasoconstriciton proposed but also to another systemic modification associated to liver damage.

ISSN:0886-022X    

DOI:10.3109/08860229309054960

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

The aim of this study was to compare nephrotoxicity of the combinations ami-kacinlvancomycin and amikacinlteicoplanin. Eighteen male Wistar rats were divided into 3 groups of 6 animals each. The first group received 50 mg-kg-1of amikacin (i.m. route) and 100 mg-kg-1of vancomycin (i.p. route). The second group received 50 mg-kg-1of amikacin (i.m. route) and 40 mg-kg-1of teicoplanin (i.p. route). The third group received an isotonic solution of sodium chloride. The antibiotics were injected for a period of 6 days. Urine samples of animals were taken 24 h before the beginning of the experiment, then every day, throughout the duration of the treatment (6 days), continuing for an additional 3 days following completion of the administration of the drugs. There were no significant modifications in the urinary excretions of alanine aminopeptidase and the creatinine between the 3 groups; but in the group receiving amikacinlteicoplanin, we observed between days 3 and 8 an increase in the excretion of N-acetyl-β-D-glucosaminidase when compared to the group receiving amikacin/vancomycin (p≤0.05) and to the control group (p≤0.07).

ISSN:0886-022X    

DOI:10.3109/08860229309054961

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Compared to prior studies which frequently pinpoint the impairment of one parameter or function, this paper reports for the first time an extensive characterization of the toxic effects of gentamicin in a single model of primary cultured rabbit proximal tubule cells developed without insulin and glucose. Biochemical, functional and morphological approaches were used. Cellular response pattern was examined after a 72-h exposure during either the exponential growth phase or the stationary confluency phase of the culture to 0.2, 1, and 2.5 mM gentamicin. The biochemical study after gentamicin exposure showed increased activities for N-acetyl-β-D-glucosaminidase and alkaline phosphatase, decreased activities for sphingomyelinase, cathepsin B, Na+/K+-ATPase, lactate dehydrogenase and NADPH cytochrome C reductase. Functional evaluation revealed decreased protein synthesis andα-methylglucose transport after gentamicin exposure. Morphometric study made it possible to show that the density of lysosomes, the cell fractional volume of the lysosomal compartment, and the mean size of the lysosomal profiles are increased in the cells. Intracellular accumulation of gentamicin in proximal tubular cells was dose dependent and reached high levels in cultured cells. In conclusion, this model compared to others in the literature allowed us to demonstrate in vitro a close response pattern to the in vivo situation after gentamicin exposure.

ISSN:0886-022X    

DOI:10.3109/08860229309054962

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

In the present study of 246 patients with primary forms of glomerulonephritis (GN) we investigated their tubular and interstitial changes, especially mononuclear cell infiltration and optical microscopy, and compared this finding with the outcome of the disease (5-year survival rate). Only first biopsies were analyzed in order to detect early tubulointerstitial changes which occur together with the glomerular changes. Different degrees of the lesions of tubules and interstitium were present in different forms of GN. Mononuclear cell infiltration was present in 100% of the patients with crescentic, in 90.9% in focal sclerosing, in 89% in mem-branoproliferative, and in 76.4% of patients with chronic diffuse GN. Less than 50% of the other patients showed infiltration. Using monoclonal antibodies it was demonstrated that mononuclear cell infiltrates mainly consisted of T and T4 cells. Interstitial edema was expressed in the same forms of GN and in similar proportions. Interstitial fibrosis was found only in patients with: focal sclerosing GN (13.7%), IgA GN (4.1%), membranoproliferative GN (31.4%), chronic diffuse GN (23%), and crescentic GN (27.7%). Tubular atrophic changes were again domi-nantly present in: crescentic GN (94.2%), focal sclerosing GN (77.8%), chronic diffuse GN (76.4%), and membranoproliferative GN (68.4%). Patients with severe tubulointerstitial changes together with the glomerular changes had a low 5-year survival rate of renal function.

ISSN:0886-022X    

DOI:10.3109/08860229309054963

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

In a previous study, we found that aggressive immunosuppressive therapy with continuous high-dose oral steroid and cyclophosphamide combined with plasma exchanges for extracapillary crescentic glomerulonephritis gave controversial results since, although disease activity was controlled, iatrogenic complications had led to death in some aged patients. We then modified our therapeutic regimen, and we analyze here the evolution of 30 consecutive patients who were admitted for biopsy-proven crescentic glomerulonephritis between 1989 and 1991. The mean plasma creatinine level at admission was 393±59μmol/L (range 70 to 1100), and 15 patients had crescent formation in more than 50% of glomeruli on initial renal biopsy. Ten patients did not receive any immunosuppressive treatment since they either had a normal renal function or they had terminal renal failure and no severe extrarenal manifestation. The 20 other patients received initial steroid pulses 500 mg x3 (n = 17), low oral steroid treatment (n = 20), cyclophosphamide pulses (n = 13), or oral cyclophosphamide (n = 3). In 4 cases plasma exchanges were also used. As a whole, 10 patients (33%) were discharged with a normal renal function, and 18 patients (60%) had chronic renal failure, 7 of them requiring dialysis or transplantation; only 2 patients died of pulmonary hemorrhage. No severe iatrogenic complication was observed. These results indicate that reduction in oral steroid dosage, cyclophosphamide pulse therapy rather than continuous oral treatment, and plasma exchanges do not induce overimmunosuppression and iatro-genic complication. It can be safe, well tolerated, and as effective as a more intensive immunosuppressive regimen for the treatment of crescentic extracapillary glomerulonephritis.

ISSN:0886-022X    

DOI:10.3109/08860229309054964

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

Indirect immunofluorescence study with laminin and fibronectin monoclonal antibodies on paraffin sections, as well as with serum from a patient with Goodpasture's syndrome with high liter of autoantibodies that recognize the antigenic determinants in human glomerular and tubular basement membrane, was performed on 14 patients with Alport's syndrome and 5 specimens of normal renal tissue obtained from donors in cases of renal transplantation (control group). We found no binding of Goodpasture antigen to glomerular and distal tubular basement membranes internal biopsy tissue from all 14 patients with Alport's syndrome. In contrast, there was bright linear fluorescence of Goodpasture antigen on glomerular and tubular basement membranes of normal renal material. There was no difference in laminin and fibronectin binding in patients with Alport's syndrome and controls. In all the cases binding was strongly positive. These results suggest an abnormality or absence of immunoreactive autoantigen in the glomerular and distal tubular basement membrane in patients with Alport's syndrome. Therefore, Goodpasture antigen detection could be an important diagnostic method in early stages of Alport's syndrome when characteristic morphological changes are not yet developed.

ISSN:0886-022X    

DOI:10.3109/08860229309054965

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

The aim of our study was to investigate the effects of exercise on albuminuria and blood pressure in patients with essential hypertension, and the short-term effect of the calcium channel blocker isradipine on exercise-induced albuminuria (UAE) and blood pressure in the same patients. Ten patients (7 males, 3 females) with essential hypertension were admitted to the study. The mean age was 54±2.7 years and the mean body mass index was 27±1 kglm2. Patients performed two physical exercise tests on a cycloergometer. Workload was increased by 30 watts every 2 min until 90% of the theoretical maximal heart rate was achieved. This workload was maintained for 5 min. Samples for albuminuria assay were collected at the end of exercise and 1 h after exercise. The first physical exercise test was performed after 15 days of placebo washout; the second exercise was performed after 10 days of therapy with isradipine 5 mg once daily p.o. After 10 days of therapy with isradipine, UAE immediately after (31±8.3μg/min) and 1 h after exercise (31.5±7.3μg/ min) were significantly (p<0.05) lower as compared to the values found after placebo (37.1±9.3μg/min; 43.5±9.9μg/min). Our data show that short-term administration of the calcium channel blocker isradipine is able to cause a concomitant significant decrease in exercise-induced pressor and albuminuric response in patients with essential hypertension. The finding that short-term calcium channel blockade can reduce exercise-induced albuminuria in essential hypertensive patients suggests that progression of nephropathy in this early phase could be slowed by isradipine in these patients.

ISSN:0886-022X    

DOI:10.3109/08860229309054966

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor

摘要:

We monitored the effect of 7 intermittent machine hemofiltration treatments in 4 patients with fulminant hepatic failure who had progressed to grade IV coma and developed acute oliguric renal failure. Prior to treatment the processed EEG showed excess slow wave activity, and the latency of the later visual evoked potentials (N2 and P2) was delayed. Following treatment there was a further increase in both EEG slow wave activity and latency of the N1,N2, and P2 potentials. Intrac-ranial pressure increased from a median of 8 mm Hg (2–12, range) to 14 (8–28) following treatment, p<0.05. There was a correlation between intracranialpressure and all of the later visual evoked potentials, for N3r = 0.71, for Pl r = 0.39, and P2 r = 0.74, all p<0.05. Although there appeared to be a good correlation between intracranial pressure and the noninvasive electrophysiological recordings, there were major changes in intracranial pressure, cerebral perfusion pressure, and cerebrospinal fluid pH during the first hour of treatment, during which time there were no discernable changes in EEG or evoked potentials. In this study, non-invasive neurophysiological methods were not found to be reliable as invasive methods in assessing acute, minute-by-minute changes in cerebral metabolism but these methods may have a role in the longer term in assessing patient prognosis.

ISSN:0886-022X    

DOI:10.3109/08860229309054967

出版商:Taylor&Francis    

年代:1993

数据来源: Taylor