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Biomedical subjects

A Modesto

Publications and source records attributed to A Modesto.

54 records · Page 3Linked to original sources

Fanconi's syndrome, kappa light-chain myeloma, non-amyloid fibrils and cytoplasmic crystals in renal tubular epithelium.

A 59-year-old woman with kappa light-chain myeloma had Fanconi's syndrome characterized by renal glycosuria, generalized aminoaciduria, bicarbonaturia and decrease of phosphorus and uric acid reabsorption. A bone marrow biopsy showed the presence of 27% of dystrophic plasma cells; the cytoplasm of these cells was intensely stained with anti-kappa light-chain monoclonal antibodies. By light microscopy, the renal biopsy revealed a tubulointerstitial nephritis without glomerular lesions and with intratubular casts. By immunofluorescence, no deposits were observed along the glomerular and tubular basement membranes, but a positivity with anti-kappa light chain was noticed in some tubular epithelia and casts. By electron microscopy, fibrils (35-nm diameter) were observed in the cytoplasm of proximal tubular cells. These fibrils were situated in vesicles (100- to 600-nm diameter) in the luminal side of tubular cells. In the basal pole of the cell, fibrils seemed to group in crystals (120- to 200-nm diameter). Only kappa light-chain protein was demonstrated in these fibrils and crystals by an immunoelectron microscopic technique. These data suggested the pathogenic role of the fibrils and crystals present in tubular epithelium in the tubular proximal syndrome.

Bone Marrow↗

Renal complications of intravesical bacillus Calmette-Guérin therapy.

We report 3 patients who developed signs of systemic infection and renal insufficiency after intravesical bacillus Calmette-Guérin (BCG) instillations for a bladder cancer. Renal biopsy showed tubulo-interstitial nephritis with or without epithelioid granulomas in 2 cases, and mesangial glomerulonephritis in the last case. All patients had granulomatous hepatitis in association. It seems that hematogenous dissemination via a traumatic instillation of BCG and/or an immune-complex mechanism may have contributed to the renal damage, which was only partially reversible in 2 patients.

Administration, Intravesical↗

[Segmental renal hypoplasia of an adult originating from pseudo-tumor hyperreninism].

A 38 year-old man was admitted for severe hypertension with hypokalemia. Blood pressure was 180-120 mmHg, funduscopic examination revealed grade II retinopathy and left ventricular hypertrophy was present. Laboratory data disclosed: natremia = 140 mmol/ml, kalemia = 2.8 mmol/l, chloride = 105 mmol/l, bicarbonate = 30 mmol/l, creatinine clearance = 100 ml/mn, natriuresis = 140 mmol/day, kaliuresis = 80 mmol/day. Intravenous pyelography was normal. Angiography revealed a defect in the mid third of the right kidney without arterial abnormalities. Study of renin angiotensin aldosterone system showed: plasma renin activity: peripheric blood = 36 ng/ml/h (normal range I to 2), right renal vein = 30 ng/ml/h. Left renal vein = 18 ng/ml/h, inferior cava vein = 19 ng/ml/h. Plasma aldosterone level = 86 ng/100 ml (normal range 10 to 15). Captopril acute administration was followed by a fall of BP to 70-50 mmHg at 2 hours. Right nephrectomy was performed and revealed an ischemic retracted cortical area without necrosis nor tumoral aspect. The day after BP was 140/80 mmHg. Eight days after, kaliemia was 4.2 mmol/l, PRA was 0.5 ng/ml/h. Light microscopy showed that affected area was sharply delimited from surrounding normal tissue. In this area, glomeruli were present and seemed more numerous as usual; interstitial fibrosis and infiltrates of inflammatory cells were also noted. The main fact was tortuosities of intralobular arteries, thickened, with intimal proliferation. There was a pelvic recess near this cortical tissue. Immunofluorescence findings: antirenin serum fixed on JGA but also on interlobular arterial walls and on peritubular interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Renal cholesterol embolisms: apropos of 6 case reports].

Often unrecognized, renal cholesterol embolization generally results in renal failure and a high rate of death. In the recent years, it was discovered only during autopsy, but now antemortem observations are not exceptional. In the most cases, the existence of a triggering factor may suggest a iatrogenic cause. We report six patients who developed cholesterol atheroembolic renal disease after aortic surgery and/or retrograde catheterization. Cholesterol embolism was demonstrated by the finding of cholesterol crystals in the arteriolar lumens: either on renal biopsies, or on skin biopsy. The five surviving patients required dialysis with recovery of renal function in only one case. Three of four patients on regular dialysis treatment died of unrelated complications. The responsibility of angiography in the origin of acute renal failure appeared major in this report. It is the rupture of an eroded atherosclerotic plaque caused by the catheter which causes the release of large quantity of cholesterol crystals in the circulation. Therefore, in the atheromatous patients, it appears safer to realize a computerized i.v. angiography.

Acute Kidney Injury↗

Abdominal fat tissue aspirate in human amyloidosis: light, electron, and immunofluorescence microscopic studies.

Abdominal fat tissue aspirates from 12 patients with biopsy-proved amyloidosis were investigated by different morphologic techniques. By light microscopy, after staining of the fat tissue aspirates with Congo red and examination with a polarizing microscope, positive results were obtained in nine patients with amyloidosis, two of the three with primary (AL) amyloidosis and seven of the nine with secondary (AA) amyloidosis. By indirect immunofluorescence, using AA antiserum, positive results were obtained in five of the nine cases of AA amyloidosis (aspirates from these five patients were positive on Congo red staining). By electron microscopy, amyloid fibrils were observed in five cases of amyloidosis (two of the AL and three of the AA type, all positive on Congo red staining). Although amyloid was demonstrated less frequently by immunofluorescence and electron microscopy, perhaps because of the small numbers of fat particles examined, it seems that, with Congo red staining, abdominal fat tissue aspiration is a simple and sensitive method for the diagnosis of amyloidosis. Immunofluorescence studies allow discrimination between the different types of amyloidosis. The method could be used in patients in whom other types of tissue biopsy are not recommended because of risks of bleeding or other problems.

Adipose Tissue↗

[Endosteal hyperostosis with dominant transmission. Description of 8 cases in 3 generations of the same nuclear family].

The authors report on 8 patients with the dominant type of endosteal hyperostosis (Worth's disease), found in the same kindred over 3 generations. Three were males, five females, from 5 to 49 years of age. Major radiographic features were an increased density of bones of the skull and spine, with thickening of the diaphyseal cortex of tubular bones, without any change in remodeling. Seven patients were almost asymptomatic. A decompressive craniotomy had been performed in one, who showed a compression of the 2nd, 5th and 8th cranial nerves. Blood alkaline phosphatase was normal. The bone density increases with age, but in spite of this the clinical course if milder than in recessive type of generalized cortical hyperostosis (Van Buchem's disease, as reported in the 35 cases of endosteal hyperostosis (dominant type) previously described.

Adolescent↗

[Routine double-contrast radiographic examination of the esophagus].

The authors evaluate the opportunity of extending the double-contrast technique to the X-rays examination of the esophagus, with particular regard to physical and chemical features of barium compounds used at present for the X-rays study of digestive tract. The authors expose the results of this kind of X-rays examination in the most important fields of esophageal pathology. Personal experience actually demonstrate the opportuny of extending the double-contrast technique to routine practice, as a first approach to the double-contrast study of the upper digestive tract.

Air↗

Regional odontodysplasia: report of a case involving two separate affected areas.

The purpose of this study was to report in a 12-year old white child a rare clinical condition called regional odontodysplasia. The diagnosis was based on clinical and radiographic findings. Due to the patient's concern over appearance, the treatment involved extracting the affected teeth and subsequently placing partial removable prostheses, thus providing the patient better function and appearance. The teeth that were removed were examined histologically, both in routine preparation stained by hematoxyline and eosin, and in ground sections.

Child↗

Effects of solutions used in infants' oral hygiene on biofilms and oral microorganisms.

The purpose of this work was to evaluate the effects of oral hygiene solutions used for infants on biofilms formed in vitro from infants' saliva and dental plaque: ATCC reference strains A. viscosus; C. albicans; L. casei; S. mitis; S. mutans; S. oralis; S. sanguis; S. sobrinus and clinically isolated microorganisms (saliva) C. albicans, S. mitis, S. mutans, S. oralis, S. sanguis and S. sobrinus. After exposure of the oral biofilms to H2O2 diluted 1/4 to 1/16; and NaF 0.02 percent, concentrated and diluted 1/2, for 1 and 3 minutes, the viable count of microorganisms, compared to the controls was significantly reduced (p < 0.05). They also showed a significant antimicrobial effect for all the microorganisms evaluated, when compared to the control (p < 0.05). Exposure to sodium bicarbonate solution and a camomile solution, for 1 and 3 minutes, was not significantly lethal to oral biofilms nor to any microorganism evaluated, regardless of whether they were concentrated or diluted. We do not recommend the use of H2O2 but suggest using the camomile solution and NaF 0.02 percent in a rational manner for cleaning the infant's mouth.

Biofilms↗

[Computerized tomography in cochlear otosclerosis].

After a review on osseous labyrinthine modifications in cochlear otosclerosis, the authors report their experience, based on four patients, in CT evaluation of the disease. CT high resolution programs detect demineralization centres, which are distinctive of cochlear otosclerosis, at an early stage. CT must be considered a more informative investigation than multidirectional tomography.

Adult↗

Gingival status of HIV+ children and the correlation with caries incidence and immunologic profile.

PURPOSE: The aim of this study was to determine gingival health and caries levels in HIV-infected children. METHODS: The modified gingival index (GI) of 43 HIV+ children of both sexes, aged between 2 and 12 years, was measured and correlated with the DMFT/dmf. The children's immunodeficiency level was also established by means of the CD4:CD8 ratio. Pearson's product-moment correlation co-efficient and the Mann-Whitney U test were used. RESULTS: The GI was significantly related to the DMFT/dmf. The children with a GI = 0 presented significantly more DMFT/dmf than the children with a GI > or = 0.1, but there were no significant differences between the GIs of caries-free children and those with DMFT/dmf > or = 1. The children who presented a CD4:CD8 > or = 0.5 ratio presented less DMFT/dmf compared with children who presented a CD4:CD8 < 0.5 ratio. The children who presented a CD4:CD8 < 0.5 ratio presented a statistically significant correlation between their GI and their DMFT/dmf, unlike children who presented a CD4:CD8 > or = 0.5 ratio. Children with a CD4:CD8 < 0.5 who showed a greater DMFT/dmf index also showed greater gingival inflammation. CONCLUSIONS: In this study, children with greater caries experience showed more gingival inflammation. In addition, a greater immunological deficiency might indicate a greater caries experience in children.

CD4 Lymphocyte Count↗