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Biomedical subjects

A Bohle

Publications and source records attributed to A Bohle.

At least 91 records · Page 5Linked to original sources
PubMed1982

[Importance of the renal interstitium for kidney function].

After presentation of the structure of the cortical interstitium, numerous examples are cited illustrating the significance of the cortical interstitium for the function of the glomeruli and the tubular epithelium. Details are presented showing that every form of interstitial fibrosis increases the resistance of the postglomerular capillary network through the obliteration of the postglomerular capillaries and therefore negatively influences the function of the filter organ by hindering the outflow of blood from the glomeruli. It is also shown that, when glomerular involvement is isolated (e.g., glomerulonephritis, amyloidosis), even the most severe forms of glomerular nephropathy do not compromise the excretory function of the kidneys if the tubular epithelium and the intertubular capillaries are intact. On the basis of these findings, it is concluded that uremia does not develop in isolated glomerular nephropathy, but that the tubulo-interstitial system is also involved when the serum creatinine concentration is slightly increased in the various forms of "glomerular disease".

Acute Kidney Injury↗
PubMed1982

The compensated and the decompensated form of benign nephrosclerosis.

Decompensated benign nephrosclerosis, a disease which was briefly described by Theodor Fahr in 1925, defended by him in 1934, and then forgotten, is reported and differentiated from compensated benign nephrosclerosis. Decompensated benign nephrosclerosis can be differentiated from compensated benign nephrosclerosis by the frequent appearance of interstitial cortical fibrosis and glomerular alterations in the sense of hypertensive glomerulopathy. Hypertensive glomerulopathy results in ascending obliteration of the glomeruli, i.e., their transformation into PAS-positive hyaline globules. In compensated benign nephrosclerosis, interstitial fibrosis, if present at all, can usually be identified only in the subcapsular areas. In decompensated benign nephrosclerosis, however, a pyramid-like structure with its base at the corticomedullary border is formed. The severity of preglomerular vascular alterations does not differ in compensated and decompensated benign nephrosclerosis. Clinically, there is no significant difference between the degree of hypertension and the development of the disease. The nephritic symptoms are more pronounced in decompensated benign nephrosclerosis, which predominantly affects middle-aged men (male:female, 5.7:1), than in compensated benign nephrosclerosis. As a result, decompensated benign nephrosclerosis is frequently diagnosed and treated as chronic glomerulonephritis.

Chronic Disease↗
PubMed1982

Granular epithelioid cells in the kidney of the Atlantic salmon (Salmo salar).

Two-year-old salmon at the migrating stage were kept in two different aquaria, the one containing seawater, the other freshwater. The fish kept in seawater showed retarded growth at the beginning of the year, but their growth had caught up with and passed the freshwater fish by the end of the year. At this time, 69 out of 79 of the freshwater fish died without any evident reason. When the fish were in seawater or freshwater at the biologically appropriate time, the number of granular epithelioid cells was equal in both groups. But the fish forced to remain in freshwater subsequently developed a considerably higher number of epithelioid cells. This may reflect an effort to maintain normal blood pressure.

Animals↗
PubMed1982

Juxtaglomerular apparatus of the human kidney: correlation between structure and function.

Electron microscopic and morphometric evaluation of the juxtaglomerular apparatus (JGA) of the human kidney showed the following: (1) The JGA of the human kidney consists of the epithelioid cells of afferent and efferent arterioles, the Goormaghtigh cells, and the macula densa, and it is abundantly supplied with sympathetic nerves. (2) The macula densa is in contact with the juxtaglomerular cell complex (JGC), the endocrine part of the JGA, via the Goormaghtigh cell field. The surface area of the macula densa is much larger than is the contact area with the JGA, totalling, in the healthy human kidney, some 66 cm2. (3) The total volume of all JGC's is 26 to 40 mm3. (4) Morphometric investigations of the JGC showed that appropriate stimulation by a decrease in the intrarenal or systemic blood pressure led to hypertrophy and hyperplasia of the JGC, which, in extreme cases, may also lead to a transformation of both the Goormaghtigh cells and mesangium cells into epithelioid cells.

Humans↗
PubMed1982

Juxtaglomerular apparatus in the domestic fowl (Gallus domesticus).

The juxtaglomerular apparatus in the kidney of the domestic fowl was studied with the light and electron microscope after fixation by vascular perfusion. The height of the macula densa cells was greater and the internuclear distance less than were those of other distal tubule cells. Goormaghtigh (lacis) cells were found in the angle between the hilar arterioles and the glomerulus. The branching pattern of the basement membrane of the macula densa was extensive, surrounding both the Goormaghtigh cells and the mesangial cells. The basement membrane ended in the walls of both hilar arterioles and in the glomerular capillaries. Thus, all juxtaglomerular and glomerular structures were linked together by the branches of basement membrane. The afferent and efferent arterioles were often found ramifying in the mesangial cell mass. Granular epithelioid cells and adrenergic nerves were found within the glomerulus.

Animals↗
PubMed1981

Nephrotic syndrome and renal insufficiency in association with amyloidosis: a correlation between structure and function.

The following results were obtained by correlating light and electron microscopic findings from 85 cases of glomerular renal amyloidosis with clinical parameters: 1. Amyloid masses deposited in the glomeruli do not represent an effective filtration barrier, i.e., the formation of primary urine is not significantly influenced even by extensive amyloid masses in the glomeruli; protein retention is first observed when the glomerular capillaries are almost totally obliterated. 2. Once the nephrotic syndrome has developed in association with glomerular renal amyloidosis, it shows no tendency for remittance, despite progressing renal insufficiency. 3. The reason for this persistance of the nephrotic syndrome, despite increasing renal insufficiency, is a progressive reduction in the capacity of the tubules for protein reabsorption in the presence of increasing interstitial fibrosis of the kidney. 4. Interstitial fibrosis of the kidney cortex leads to increasing impairment in the oxygen and energy supply to the tubule cells together with considerable functional deterioration which, in addition to other metabolic disturbances, also results in a reduced capacity for protein reabsorption.

Amyloidosis↗
PubMed1981

Early glomerular lesions in amyloidosis. Electronmicroscopic findings.

Our investigations on early glomerular changes in renal amyloidosis showed the following: 1. In some renal biopsies, amyloid was demonstrated in the mesangial matrix predominantly and could be seen penetrating through the basement membrane of the mesangial region into the subepithelial space of adjacent glomerular capillaries. 2. In other biopsies, showing the same severity of amyloidosis, deposits were demonstrated in the mesangium and in the capillary walls distant from the mesangium on both sides of the basement membrane. There was no apparent connection between the deposits in these two areas. 3. On the basis of the morphological changes found in the cytoplasm of the mesangial cells, the glomerular epithelial cells and partly also in the endothelial cells, supported by our electron microscopic findings in the immediate vicinity of these cells, we come to the conclusion that amyloid in the glomerulus is formed from amyloid precursors brought via the blood stream. 4. Amyloid fibrils may be formed in the extracellular space of the glomerulus under the influence of lysosomal enzymes released from epithelial, mesangial and perhaps endothelial cells, by action of these enzymes on extracellularly deposited amyloid precursors.

Amyloidosis↗
PubMed1981

The lymphocyte-epithelial cell ratio in tubal mucosa of patients with cervical carcinoma.

The lymphocytes in the luminal subepithelial basement membrane of the uterine tube from patients with cervical carcinoma were counted, and the results compared with those obtained from women of the same age but without cervical carcinoma (cf. Geppert et al. 1977) to determine whether a relationship exists between emigration of lymphocytes into the tubal epithelium and the clinical diagnosis of cervical carcinoma. The comparison indicated that the number of lymphocytes emigrating into the tubal epithelium during the secretory and the proliferative phase in women with cervical carcinoma is significantly lower than that in healthy women from the control group. The differences during the secretory phase were particularly pronounced. The lymphocyte count in patients with cervical carcinoma was only one third that of the healthy women in the control group. Assuming that an immunologic defect is determinative for the development of carcinoma, a decline in the number of lymphocytes emigrating into the tubal epithelium can be interpreted as the reflexion of an immunologic deficiency. It is possible that a disturbance in the lymphocytes epithelial cell ratio in this stage of life could indicate a disposition for those tumors the incidence of which is high in this age group (e.g., squamous cell carcinoma of the cervix). Further study is necessary to establish whether these cells be classified as B or T lymphocytes.

Adult↗
PubMed1981

Correlations between renal cortical interstitial fibrosis, atrophy of the proximal tubules and impairment of the glomerular filtration rate.

This study has confirmed impairment of the glomerular filtration rate (GFR) (increase of the serum creatinine concentration) by fibrosing processes in the renal cortical interstitium. In addition statistically significant correlations were found between the decrease of the total area of the proximal tubules and of the area of the epithelial cells and both the extent of the renal cortical interstitial fibrosis and the serum creatinine concentration. Further statistically significant positive correlations were observed between the age of the patients and both the grade of interstitial fibrosis and the serum creatinine concentration. No correlation could be established between the age of the patients and the total area of the epithelial cells of the proximal tubules. Pathogenetically it is conceivable that with progressive interstitial fibrosis the tubules become atrophic as a result of malnutrition. The function of these atrophied tubules may be disturbed, the reabsorptive capacity for NaCl impaired and consequently the GFR reduced not only by slowing of the glomerular blood flow secondary to interstitial fibrosis, but also by the tubular-glomerular feedback-mechanism.

Acute Kidney Injury↗
PubMed1980

Structure and function of the kidney in diabetic glomerulosclerosis. Correlations between morphological and functional parameters.

Histological and clinical findings in 103 middle-aged patients suffering from diabetic glomerulosclerosis (gs) (biopsy material) are reported. In diabetic gs (as in other inflammatory and non-inflammatory glomerular disease) a statistically highly significant positive correlation exists between the grade of fibrosis of the renal cortical interstitium and the serum creatinine concentration at the time of biopsy. Rank correlations exist between vessel index and relative cortical interstitial volume on the one hand as well as serum creatinine concentration on the other. Significant differences are also shown to exist between the mean values of the cortical interstitium as well as the serum creatinine concentration and the vessel index in the four grades of diabetic gs. Severe glomerular lesions may be accompanied by a normal serum creatinine concentration, only if the interstitium shows no fibrotic changes. Mild glomerular lesions, when accompanied by an interstitial fibrosis, always have elevated serum creatinine concentrations. The incidence of hypertension, proteinuria, the nephrotic syndrome and hematuria in diabetic gs appears to vary greatly. From the highly significant correlation between the cortical interstitium and the serum creatinine concentration we presume the following: Alterations of the postglomerular vessels by interstitial fibrotic changes result in an increased resistance to renal cortical blood flow with a subsequent reduction of glomerular perfusion. This reduction of the glomerular perfusion may result in a rise of the serum creatinine concentration, independently of the severity of the glomerulosclerosis. It is also conceivable that glomerular function is affected by the malfunctioning atrophic tubules in areas of interstitial fibrosis.

Biopsy↗
PubMed1980

Acute interstitial nephritis: correlations between clinical and morphological findings.

The clinical and morphological findings in 30 cases of acute interstitial nephritis were compared in an attempt to find possible correlations. Patchy and/or incompletely diffuse interstitial infiltration was considered a milder form of the disease, the prognosis of which was significantly better than that of diffuse disease (P less than 0.01, Wilcoxon test). The prognosis was significantly poorer when acute renal failure persisted for three weeks or more (P less than 0.01), Wilcoxon test). Serum creatinine values served as a criterion for evaluating the course and prognosis of the disease. The patients were assigned to one of four prognosis groups.

Acute Disease↗