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Biomedical subjects

A V Richman

Publications and source records attributed to A V Richman.

At least 19 recordsLinked to original sources
PubMed1986

Endotoxemic acute renal failure in awake rats.

The sequence of changes in renal function in endotoxemic acute renal failure (ARF) and the role of hypotension and systemic hemodynamics were evaluated in awake female Sprague-Dawley rats given an intravenous bolus of Escherichia coli endotoxin (20-40 mg/kg). After endotoxin ARF was abrupt in onset as glomerular filtration rate (GFR) fell promptly and progressively by 53% within 3.5 h, whereas renal blood flow decreased by 42% and renal vascular resistance nearly doubled. Systemic hemodynamics remained stable, including mean arterial blood pressure, cardiac output, and total peripheral resistance. Early endotoxemic ARF was associated with oliguria and sodium retention, a finding consistent with intact tubular function. Three and one-half hours after endotoxin, however, fractional water and sodium excretion were significantly increased. Ultrastructural studies then demonstrated sequestration of phagocytic leukocytes and intracellular edema in the peritubular capillaries with normal glomeruli. The decrease in GFR was spontaneously reversible within 7-9 days. Extracellular fluid volume expansion with saline either before or 24 h after administration of endotoxin failed to prevent the decrease in GFR or to normalize renal function. The data suggest that endotoxin has direct renal effects. The endothelial cells may be the primary target of endotoxin in the kidney.

Acute Kidney Injury↗
PubMed1983

An evaluation of the tendency of Avitene to produce periureteral fibrosis in the dog.

This study was designed to evaluate whether a microfibrillary collagen hemostatic agent (Avitene) would cause retroperitoneal fibrosis and ureteric obstruction when applied along the side of the ureter and left in situ for a period of 6 months. The contralateral side served as a control. Serial intravenous urograms were obtained and histopathologic studies were conducted to evaluate these effects. No evidence of significant retroperitoneal fibrosis or ureteric obstruction was found either on serial intravenous urograms or on histopathologic examination of the ureter after 6 months.

Animals↗
PubMed1983

Carcinomas of the lung: an ultrastructural and immunocytochemical study.

Fifty-two primary carcinomas of the lung were studied by electron microscopy and by an immunoperoxidase method, using an anti-human keratin antiserum. The results were compared with light microscopic observations. One-third of the carcinomas of the lung showed ultrastructural evidence of both glandular and squamous differentiation. The group of small cell carcinomas was found to be particularly heterogenous ultrastructurally with only three out of eight tumors showing neurosecretory-type granules. Indirect immunoperoxidase staining revealed presence of a keratin-type protein in the vast majority of carcinomas, including foci of small cell carcinomas. Our studies emphasize the heterogeneity and frequent intermixing of the four major categories of lung carcinomas: squamous cell carcinomas, adenocarcinomas, small cell carcinomas, and large cell carcinomas. It is suggested that all these tumors might be derived from pluripotential "reserve" bronchial or bronchioalveolar cells. The segregation of small cell carcinomas from other groups continues to be justified on pragmatic grounds because these carcinomas constitute a group of predominantly small fast-replicating cells amenable to chemotherapy.

Adenocarcinoma↗
PubMed1983

Rheumatoid meningitis. A case report and review of the literature.

Focal rheumatoid inflammation of the dura and leptomeninges was found in an 89-year-old man who was neurologically asymptomatic and had clinically inactive rheumatoid disease. Previous reports of this entity have not stressed that rheumatoid meningitis can be virtually asymptomatic and can develop in persons with apparently quiescent joint disease. The presence of vasculitis of the meningeal or cerebral vessels is associated with symptoms. Intracranial rheumatoid lesions were associated with rheumatoid lesions in other organs, especially the heart and lungs.

Aged↗
PubMed1982

"Undifferentiated" large cell malignancies: an ultrastructural and immunocytochemical study.

One of the most difficult areas of surgical pathology is the classification of "undifferentiated" or "anaplastic" large cell malignant tumors. The differential diagnosis of these tumors includes poorly differentiated carcinomas, large cell malignant lymphomas, and amelanotic malignant melanomas. In this study of 56 such cases, the application of electron microscopy and, in selected instances, of indirect immunofluorescence and immunoperoxidase staining methods have helped us reach a precise histopathologic diagnosis in the majority of neoplasms that were considered to be "undifferentiated" by light microscopy.

Adolescent↗
PubMed1982

Endothelial and platelet reactions in the idiopathic nephrotic syndrome: an ultrastructural study.

In this ultrastructural study we have critically examined blood vascular reactions in the glomerular microcirculation of 14 patients with idiopathic membranous nephropathy and 11 patients with minimal change disease. In all patients, bullous intracellular edema was observed in the glomerular endothelium, a change interpreted as reflecting endothelial injury. Platelets in various stages of degranulation were seen in relation to the endothelium. In ten biopsy specimens platelet aggregates were observed. Platelets with exhausted secretory products ("ghosts") were frequently identified in areas contiguous with other obvious degranulating platelets. In some cases, pseudopodia of degranulating platelets were observed in direct contact with the glomerular basement membrane in areas denuded of endothelium. Tactoids of fibrin were seen in nine cases in relation to degranulating platelets or edematous endothelium, or both. Our data suggest that these endothelial and platelet reactions play a role in the pathophysiology oi the nephrotic syndrome in patients with minimal change disease or idiopathic membranous nephropathy.

Adult↗
PubMed1981

Acute interstitial nephritis and acute renal failure associated with cimetidine therapy.

We are reporting the clinical and pathologic features of severe acute renal failure which developed in a patient after the institution of cimetidine (Targamet) therapy. A renal biopsy specimen revealed an acute interstitial nephritis with numerous plasma cells and eosinophils suggestive of an immunologic reaction. Marked improvement of renal function occurred within three weeks after cessation of the drug therapy. Our clinical and pathologic data strongly suggest an association between acute interstitial nephritis and cimetidine, a suggestion which should be confirmed by additional case studies.

Acute Kidney Injury↗
PubMed1981

Testicular seminoma metastatic to the orbit.

Painful exophthalmos, ophthalmoplegia, and visual loss in the right eye developed in a 28-year-old man four months after he underwent a radical orchiectomy and irradiation for a seminoma of the right testicle. Prednisone therapy failed to relieve the symptoms, and an orbital biopsy found a metastatic testicular seminoma. Orbital irradiation with radioactive cobalt reduced the exophthalmos, reversed the ophthalmoplegia, and improved his visual acuity. Previous cases of nonmetastatic exophthalmos in patients who had testicular seminoma have been reported, but, to the best of our knowledge, this is the first report of a patient who had orbital seminoma metastatic from the testis. Successful irradiation of the orbital focus can minimize ocular morbidity and may improve the prognosis.

Adult↗
PubMed1981

Rapidly progressive glomerulonephritis. Combined antiglomerular basement membrane antibody and immune complex pathogenesis.

We present the clinical and pathologic data from two patients with rapidly progressive glomerulonephritis in whom the unusual combination of antiglomerular basement membrane antibody and immune complex disease was observed. In both patients the diagnosis of antiglomerular basement membrane disease was confirmed by renal tissue immunofluorescence and by positive assays for circulating antiglomerular basement membrane antibody. Ultrastructural studies revealed membranous nephropathy in one patient. Our data from this patient suggested evolution of pre-existing membranous nephropathy into antiglomerular basement membrane disease. In the second patient electron microscopy of renal tissue demonstrated numerous subendothelial, mesangial, and subepithelial deposits. It was impossible to ascertain in this patient whether antiglomerular basement membrane antibody or immune complex mediated injury was the primary pathogenetic event. Our data provide additional evidence for the rare clinical appearance of concurrent antiglomerular basement membrane and immune complex disease. Although the coexistence in both patients of antiglomerular basement membrane disease with immune complexes may have been coincidental, we think that this is unlikely. Rather our data suggest that the two mechanisms are causally related and that either one could have been the primary disease process.

Aged↗
PubMed1980

Primary intracerebral tumor with mixed chondrosarcoma and glioblastoma--gliosarcoma or sarcoglioma?

An unusual primary intracerebral tumor with combined features of chondrosarcoma and glioblastoma multiforme is presented. Glial elements showing a spectrum of hyperplastic and neoplastic changes were intermingled with sarcomatous areas, similar to that recently described by Lalitha and Rubinstein as "sarcoglioma." Many vessels in the gliomatous regions contained proliferating endothelial cells with marked cytologic abnormalities. Although no direct extension out of the vessel wall was conclusively identified, the possibility of sarcomatous change could not be completely excluded. We conclude that, in this case, we could not establish whether the sarcoma was primary and the glioma secondary ("sarcoglioma") or vice versa ("gliosarcoma"), nor could we rule out that the two components originated from the same ancestral pluripotential cells.

Brain↗
PubMed1980

Peritubular capillaries. A major target site of endotoxin-induced vascular injury in the primate kidney.

We have examined by light and electron microscopy the kidneys of rhesus monkeys infused either with a single bolus of endotoxin (10 mg. per kg.) or continuously at the rate of 10 mg. per kg. per hour for periods of up to 22 hours. Controls included monkeys infused with Ringer's lactate solution. Only minor morphologic changes were seen in animals receiving a bolus of endotoxin. In the animals continuously infused, sequestration of neutrophils and monocytes was observed in the peritubular capillaries and to a lesser extent in the glomeruli. These changes were associated with phagocytosis of endotoxin, occasional fibrin deposits, and extensive endothelial cell damage with focal capillary disruption. Changes found in the advanced stages included prominent interestitial edema with focal necrosis of tubular epithelium. Endothelial cell changes seen in the glomeruli were far less sever than those observed in the peritubular capillaries. Our data indicate that endothelial damage and associated events relating to the sequestration of phagocytic leukocytes primarily involve the peritubular capillaries and that this "inflammatory" process plays a basic role in the development of acute tubular necrosis during shock associated with endotoxemia.

Acute Kidney Injury↗
PubMed1979

Does malignant hibernoma exist?

The authors present a case of a highly atypical, possibly malignant, hibernoma. It presented as a deep-seated tumor in the retropharynx of a 57-year-old male. A review of possible similar cases is presented. The patient is without recurrence 4 years after complete excision and radiation therapy. The tumor must be differentiated from liposarcoma. The clinical potential must await the accumulation and observation of additional cases.

Diagnosis, Differential↗
PubMed1979

Immunity to cell surface antigens and immune complex glomerulonephritis in hamsters bearing human epithelial tumors.

A glomerulopathy in hamsters bearing human epithelial tumors is described. The tumors resulted from the s.c. implantation of human heteroploid cells (MA160) derived originally from a benign prostatic adenoma. The renal immunomorphological and ultrastructural changes include expansion of mesangial matrix and cellularity, electron-dense mesangial deposits, and mesangial deposits of immunoglobulin G and C'3. Renal eluates obtained from the tumor-bearing animals contained substantial amounts of immunoglobulins. Our immunopathological studies demonstrated that virtually all of the eluate immunoglobulin G was tumor-specific antibody directed exclusively against surface determinants of the MA160 cells. There was no demonstrable activity against cytoplasmic or nuclear constituents of the MA160 cells or against certain hamster antigenic determinants. The antibody in the eluate could be removed by repetitive absorptions with viable MA160 cells but not with similar absorptions with either normal human diploid fibroblasts, human heteroploid HeLa cells, or BHK21 hamster cells. Our data support the concept of a specific nephritogenic immunopathological process occurring as a result of immunity to tumor-specific surface determinants.

Adenoma↗