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Biomedical subjects

A Pasternack

Publications and source records attributed to A Pasternack.

At least 163 records · Page 9Linked to original sources
PubMed1986

Urinary tract and renal findings in acute Yersinia infections.

We studied 71 patients with acute Yersinia infection for the occurrence of pathologic urinary and renal findings. Transient proteinuria and/or microhematuria was found in 17 patients (24%) and slightly elevated serum creatinine in seven patients (10%). Renal biopsy was done in two patients and revealed mild mesangial glomerulonephritis in both cases. One of these patients had IgA glomerulonephritis and Reiter's syndrome. Pyuria occurred in 16 patients (23%) and was frequently associated with Reiter's syndrome. Seventy-three patients with acute intrinsic renal failure were studied for the occurrence of acute Yersinia infection by determining Yersinia antibodies by ELISA. One out of 13 patients with acute glomerulonephritis but none of 60 patients with acute tubulointerstitial renal disease had acute Yersinia infection. Acute Yersinia infection seems to be rarely an etiologic factor in acute intrinsic renal failure. Our results indicate that transient proteinuria, microhematuria, pyuria or impaired renal function are frequent findings in patients with acute Yersinia infections. However, glomerulonephritis seems to be a rather infrequent and mild complication of acute Yersinia infection.

Acute Disease↗
PubMed1986

Rheumatoid factor in rheumatoid arthritis associated renal disease and in lupus nephritis.

To test the hypothesis that rheumatoid factor (RF) protects against (immune complex mediated) renal disease, patients with rheumatoid arthritis (RA; 48 with nephropathy of various types, 35 without renal disease) and systemic lupus erythematosus (SLE; 35 with and 17 without nephritis) were evaluated for the presence and titre of RF. There was no correlation between RF and nephropathy in RA, whereas in SLE RFs were almost exclusively seen in patients without nephropathy. This result supports the above hypothesis for lupus nephropathy but not for RA associated renal disease, and it may be explained by a more pronounced role for immune complexes in SLE and interference of RFs with the complexes.

Arthritis, Rheumatoid↗
PubMed1986

Mild mesangial glomerulopathy--a frequent finding in rheumatoid arthritis patients with hematuria or proteinuria.

Renal biopsy specimens from 39 patients with rheumatoid arthritis and clinical signs of renal disease disclosed a mild mesangial glomerulopathy in more than 1 in 4 cases. Almost all patients had deposits of immunoglobulin and complement in the mesangial lesions. This type of glomerulopathy was the most common cause of hematuria and was also frequently encountered in proteinuric patients. Clinically it was not possible to distinguish between mesangial and membranous nephropathy.

Adult↗
PubMed1986

Subnormal concentrations of urinary epidermal growth factor in patients with kidney disease.

We determined the concentrations of immunoreactive epidermal growth factor (irEGF) and creatinine in urine samples from 47 adult patients with various kidney diseases and wide ranges of azotemia and proteinuria. In most of the patients, urinary irEGF concentrations (nanograms per mg creatinine) were markedly subnormal. In the entire group, urinary irEGF correlated with creatinine clearance (r = 0.79; P less than 0.001) and serum creatinine concentration (r = -0.85; P less than 0.001). In the subgroups of patients with primarily glomerular or tubulointerstitial diseases, similar correlations were found. By contrast, there was no correlation with proteinuria. We also determined the concentrations of plasma irEGF in five patients with azotemia. In four patients, the irEGF to creatinine concentration ratio was 1.9- to 8.9-fold higher in urine than in plasma, indicating that plasma irEGF was not the main source of urinary irEGF in these patients. Our data are compatible with the theory that urinary irEGF originates from nephrons per se.

Adolescent↗
PubMed1986

Humoral immune response in patients with IgA and IgM glomerulonephritis.

A single dose of inactivated mumps virus vaccine was administered to male patients with IgA glomerulonephritis (IgA-GN), IgM glomerulonephritis (IgM-GN) and to healthy males. Antibodies to mumps virus were determined using an enzyme-linked immunosorbent assay. Patients with IgA-GN showed a higher and more sustained IgG and IgA antibody response compared to patients with IgM-GN or healthy controls. Before vaccination, patients with IgM-GN had higher levels of IgG antibodies than the controls or those with IgA-GN. However, the IgA antibody and IgG responses after vaccination were low. IgM antibody responses did not vary among the groups studied. It is concluded that patients with IgA-GN are high responders for IgA and IgG antibody production. Patients with IgM-GN are low responders, especially for IgA antibody.

Adolescent↗
PubMed1985

Bumetanide kinetics in renal failure.

To study the effects of renal failure on bumetanide kinetics, we administered single intravenous doses of 1.0 mg/3.08 microCi 14C-bumetanide to six healthy subjects and 22 patients with variable degrees of renal failure. The kinetics of 14C-bumetanide and total 14C were adequately described by a two-compartment open model in the control subjects and in the patients. The volume of the central compartment and the distribution t1/2 were of the same order in both groups, whereas the mean (+/- SE) volume at steady state was larger (22.1 +/- 1.6 and 16.9 +/- 1.0 L) and the elimination t1/2 was longer (1.9 +/- 0.2 and 1.4 +/- 0.1 hours) in patients with renal failure than in healthy controls. Bumetanide renal clearance was lower (10 +/- 3 and 90 +/- 13 ml/min) in patients than in subjects and correlated with creatinine clearance (r = 0.784) and log serum creatinine level (r = -0.843), whereas nonrenal clearance was significantly higher in the patients (153 +/- 14 and 99 +/- 6 ml/min). Bumetanide total plasma clearance did not significantly change. The non-protein-bound, free fraction of bumetanide was higher in patients and correlated with plasma albumin levels (r = -0.777). The kinetics of total 14C showed similar but greater changes than those of 14C-bumetanide. Thus the most important changes in bumetanide kinetics in patients with renal failure are low renal clearance and a high free fraction, with a consequent increase in nonrenal clearance, volume of distribution, and elimination t1/2.

Acute Kidney Injury↗
PubMed1985

Prevalence and incidence of moderate and severe chronic renal failure in south-western Finland, 1973-76.

In an area of south-western Finland with 195 000 inhibitants and a highly centralized health care system, all subjects with elevated serum creatinine (greater than or equal to 230 mumol/l) were registered on the basis of data collected from all hospitals and clinical laboratories of the region. The prevalence of chronic renal failure (S-creatinine greater than or equal to 230 mumol/l) was 67 per 100 000 inhabitants and that of severe chronic renal failure (S-creatinine greater than or equal to 500 mumol/l) 12.3/10(5). The annual incidence of chronic renal failure (S-creatinine greater than or equal to 230 mumol/l) was 31.7 per 100 000 inhabitants and that of severe chronic renal failure (S-creatinine greater than or equal to 500 mumol/l) 11.9/10(5). Age-specific prevalences and incidences rose progressively with age and were very high in the aged population. Chronic interstitial nephritis, in a broad sense, was the most common cause of chronic renal failure, and it was related to analgesic abuse in about half of the cases. Eleven of 68 subjects entering the study with a serum creatinine greater than or equal to 500 mumol/l had no previous knowledge of their chronic renal disease.

Adolescent↗
PubMed1985

Clinicopathologic correlations in a series of 143 patients with IgA glomerulonephritis.

In an unselected series of patients with IgA glomerulonephritis, old age, high blood pressure, and high urinary protein excretion at the time of renal biopsy were found to correlate with impaired renal function, whereas sex, estimated duration of the disease, or high serum IgA levels did not. The following clinical features were favorable prognostic signs: asymptomatic proteinuria, macroscopic hematuria, and isolated microscopic hematuria. The degree of diffuse mesangial alteration and the presence of segmental glomerular lesions correlated clearly with the subsequent clinical outcome. Vascular lesions, i.e. arteriosclerosis and renal vascular deposition of C3, were most often present in patients with severe glomerulopathy. The presence of electron-dense deposits in glomerular capillary walls was also an unfavorable prognostic finding. Renal biopsy findings of interstitial infiltrates of inflammatory cells and IgA distributed along glomerular capillary walls were usually associated with extrarenal manifestations of the disease.

Adolescent↗
PubMed1984

Thyroid autoimmunity and cardiovascular diseases.

The relationship of thyroid autoantibodies and elevated TSH level to indices of cardiovascular diseases was studied in two population series monitored for 5 years and in a cross-sectional hospital series. In a cohort of 1105 males, initially 55-74 years of age, deaths due to cardiovascular causes occurred in 19% of subjects with thyroid autoantibodies and in 11% of controls matched for age (P less than 0.05). In another cohort of 1045 males and 1223 females, initially 40-64 years of age, no difference emerged in males, while 6 out of 20 females who died of cardiovascular causes had thyroid autoantibodies, compared with 18% in the whole series. In a series of 97 hospital patients with myocardial infarction, 7 patients had thyroid autoantibodies as opposed to 12 antibody-positive subjects among controls matched for age and sex. Elevated TSH level appeared to be no better an indicator of cardiovascular morbidity or mortality than thyroid autoantibodies. It is concluded that thyroid autoimmunity may act as a cardiovascular risk factor under certain circumstances, but it does not have any general significance and the mechanism of action remains unclear.

Adult↗
PubMed1984

Immunoelectron microscopic localization of immune deposits in IgA glomerulonephritis.

Renal biopsy specimens obtained from twelve patients with IgA glomerulonephritis (IgA GN) were studied by immunoelectron microscopy (IEM) concomitantly with light microscopy (LM), immunofluorescence microscopy (IF), and electron microscopy (EM). For IEM, we used horseradish peroxidase (HRP)-conjugated antisera to human immunoglobulins (Ig) and to the complement component C3, and a diffusion technique with periodate-lysine-paraformaldehyde (PLP)-fixed tissue-chopper or cryostat sections. Due to well-preserved ultrastructure and good penetration of the antisera in the tissue-chopper sections, a detailed analysis of the distribution of immune material in the glomeruli was possible. In cryostat sections, ice crystal artifacts could not be avoided. The typical features of IgA GN could be reliably confirmed by IEM. Furthermore, IEM revealed the presence of Ig's and C3 in mesangial channels, in the intracellular vacuoles of glomerular cells, and in the electron-lucent areas along the glomerular basement membranes (GBMs). Staining of the mesangial channels indicates that they represent a route for the immune material gaining access into the mesangium. Intracellular vacuoles suggest that the deposited immune material can be partly eliminated through endocytosis by glomerular cells. The presence of Ig's and C3 in the electron-lucent areas supplies an explanation to the discrepancy sometimes observed between a positive finding in IF and a lack of deposits in EM.

Basement Membrane↗
PubMed1984

Renal biopsy in acute renal failure.

Renal biopsies were performed on 91 out of 99 patients with acute intrinsic renal failure. In all these 91 cases a clinical diagnosis was suggested by an experienced nephrologist unaware of the renal biopsy findings. Most diagnoses agreed with the histopathological findings, but there were important exceptions. On clinical grounds, acute tubulointerstitial renal disease was diagnosed correctly in 77% and acute glomerulonephritis in 56%. In 15% of the patients the clinical data did not permit any certain diagnostic suggestion. In about 20% the biopsy finding definitely influenced the choice of medical treatment. In those 15 patients who needed dialysis treatment, the biopsy findings helped in determining whether this need was temporary or permanent. Our results show that renal biopsy is valuable in settling the diagnosis, in determining the prognosis, and in planning the treatment of acute intrinsic renal failure.

Acute Kidney Injury↗
PubMed1984

Quality control of insulin radioreceptor assay for human erythrocytes. Effect of ageing of mono-125I-Tyr-A14-insulin preparation.

The quality control of insulin radioreceptor assay for human erythrocytes is based on the storage of erythrocyte preparations in Hepes buffer of pH 8.0, containing 10 g/l of albumin and 20 mmol/l of glucose. The change of erythrocytes into spherocytes and crenated cells reduces the apparent number of insulin receptors in a relatively constant way by less than 8% a week after 10 days of storage. At the same time the dissociation constants of the insulin-receptor complex increase rapidly. Thus the use of a preparation must be limited to controlling the determination of the insulin binding sites of erythrocytes, and not to the measurement of the affinities of the receptors. When mono-125I-Tyr-A14-insulin gets old, a slow decrease in the insulin binding sites can be measured, but the dissociation constants of the insulin receptor complex are not affected.

Erythrocytes↗