Search PubMed⌕ Search

Biomedical subjects

B J Junor

Publications and source records attributed to B J Junor.

At least 91 records · Page 5Linked to original sources
PubMed1983

Effect of acute aluminium overload on calcium and parathyroid-hormone metabolism.

Accidental exposure of 25 patients on continuous ambulatory peritoneal dialysis to a high aluminium level in the dialysate for a month provided an opportunity to investigate the interrelation between the metabolism of parathyroid hormone (PTH), calcium, and aluminium. After exposure to the high-aluminium dialysate, the mean serum aluminium had risen from 1.85 to 7.11 mumol/l and serum calcium from 2.27 to 2.44 mmol/l, and serum PTH had fallen from 744 to 580 ng/l. After a further 2 months, during which time the dialysate was aluminium-free, the mean serum aluminium and calcium fell to previous levels. There were no changes in calcium or vitamin-D therapy which could have influenced these results. The rise in serum calcium and fall in PTH during a period of aluminium toxicity strongly support the hypothesis that aluminium suppresses PTH through an elevation of serum calcium.

Accidents, Home↗
PubMed1983

Continuous ambulatory peritoneal dialysis and pulmonary function.

Pulmonary function tests were performed in ten patients established on continuous ambulatory peritoneal dialysis. A decrease in all lung volumes was observed after instillation of dialysate and a further decrease on change from the erect to the supine posture. This change was small and unlikely to have a functionally significant effect in patients with a healthy respiratory system. However, in patients with pre-existing lung disease, respiratory function might be further compromised.

Adult↗
PubMed1983

Early detection of obstructed ureter by ultrasound following renal transplantation.

Serial ultrasound examinations were carried out following 144 renal transplants. Eleven patients (8%) required surgery for ureteric obstruction and in all cases the ultrasound correctly identified the obstruction at an early stage. One false positive result was obtained with the ultrasound and this compared favourably with both the intravenous urogram (IVU) and isotope renogram. There were false positive and false negative results with both the IVU and renogram in addition to which neither of these techniques, particularly the IVU, is as simple or atraumatic for the patient as the ultrasound. Serial ultrasound examinations have a useful role in the detection of ureteric obstruction as well as being of value in the detection of perinephric fluid collections and acute rejection.

Diagnostic Errors↗
PubMed1983

The influence of aluminium on parathyroid hormone levels in haemodialysis patients.

In order to investigate the relationship between parathyroid hormone (PTH) and aluminium we studied 86 haemodialysis patients whom we separated into three groups according to their serum PTH values. Group I: PTH less than 600ng/L; Group II: PTH 600-900ng/L; Group III: PTH greater than 900ng/L. A significant difference was found between Groups I and III in the serum aluminium (Group I: 4.85 mumol/L; Group III: 2.84 mumol/L, p less than 0.003) and serum calcium (Group I: 2.43mmol/L; Group III: 2.32mmol/L, p less than 0.0125). The association of higher serum aluminium and calcium with lower PTH concentrations suggests that aluminium can suppress PTH release through an elevation of the serum calcium.

Adolescent↗
PubMed1982

Hypercalcaemic osteomalacia due to aluminium toxicity.

In 16 patients with chronic renal failure and osteomalacia resistant to vitamin-D therapy, aluminium was demonstrated in bone biopsy specimens at the interface between thickened osteoid and calcified bone by means of both X-ray microanalysis and a specific histochemical stain. 14 patients also had hypercalcemia. It is suggested that this is due to the blocking by aluminium of additional calcium uptake into bone coupled with the availability of additional calcium from dialysis fluid and vitamin-D therapy. This study provides more aetiological evidence linking aluminium and the development of osteomalacia in chronic renal failure. Further, if hypercalcaemia develops in such patients it is important that aluminium toxicity be excluded as the cause to prevent unnecessary parathyroidectomy.

Adolescent↗
PubMed1981

Hypohyperparathyroidism: a model for renal osteodystrophy?

A child who presented with features of renal osteodystrophy but with normal renal function is described. Improvement occurred both on large doses of vitamin D and small doses of 1, alpha-hydroxy-vitamin D3 (1, alpha-OHD3). Investigations suggested that the primary defect was an impaired renal response to parathyroid hormone. The relationship between renal osteodystrophy, abnormalities of vitamin D metabolism and hypohyperparathyroidism is discussed and an alternative hypothesis for the development of renal bone disease suggested.

Child, Preschool↗
PubMed1980

Circulation immune complexes after renal transplantation.

The liquid phase C1q-binding assay was used as a measure of circulating immune complexes in 147 renal transplant recipients. Thirty-six patients were studied serially from the time of transplantation. Abnormal levels of C1q-binding activity (C1qBA) were most frequently detected in the first 6 months post-transplant. Although there was a statistically significant association of elevated C1qBA with rejection, the incidence of "false positives" and "false negatives" was high and particularly evident in serial studies. There was no evidence of association between C1qBA and the recipients' original renal diseases. Post-transplant monitoring of renal transplant recipients for circulating immune complexes by the C1q-binding assay is an unreliable guide to rejection.

Antigen-Antibody Complex↗
PubMed1980

Beta-thromboglobulin and platelet aggregates in glomerulonephritis.

Circulating platelet aggregate ratios (CPAR) and plasma beta-thromboglobulin (B-TG) concentrations were determined in 53 patients with chronic progressive glomerulonephritis [mesangiocapillary glomerulonephritis (15) and focal and segmental hyalinosis and sclerosis (38)] and compared with those from both normal subjects and patients with no evidence of renal disease. The mean B-TG concentration was higher in patient controls [32.6 +/- 6.2 ng/ml (SEM)] than in normal subjects [19.0 +/- 2.0 ng/ml (SEM)] but this did not reach significance (P < 0.10 > 0.05). Nephritic patients had markedly elevated levels [49.8 +/- 4.0 ng/ml (SEM)], but B-TG was significantly correlated with renal impairment. Elevated B-TG levels in patients with nephritis may thus reflect renal impairment or ill-health. The mean CPAR of the nephritic patients [0.75 +/- 0.02 (SEM)] was lower than that of both normal [0.86 +/- 0.03 (SEM), P < 0.001] and patient controls [0.87 +/- 0.02 (SEM), P < 0.001]. CPAR was not correlated with renal function or platelet concentration. Low CPAR in nephritic subjects provides further evidence for in-vivo activation of platelets in patients with glomerulonephritis.

Adult↗
PubMed1979

Renal osteopenia - an assessment of long-term therapy with vitamin D analogues.

Renal bone disease was assessed for an average of 5.5 years in 9 patients on maintenance haemodialysis. The investigative methods included serial biochemical estimations, radiographic skeletal surveys and quantitative bone histology. Repeated bone mineral analyses and neutron activation analyses of a hand were also performed in order to monitor changes in skeletal calcium content. Before treatment, progressive osteodystrophy was demonstrated by all techniques. Following therapy with the vitamin D analogues, all patients noted symptomatic improvement; serum alkaline phosphatase reverted to normal and serum parathyroid hormone concentrations decreased. Radiographically, subperiosteal erosions healed while the histological features of osteomalacia and osteitis fibrosa were abolished. Both bone mineral and neutron activation analyses indicated that progressive skeletal demineralisation had been halted. However, a sustained increase in the overall mineral content of bone was not demonstrated. Thus, vitamin D therapy although improving the biochemical, radiological, and histological features of renal osteodystrophy may not restore bone mass to osteopenic bone.

Adult↗
PubMed1978

The radiological assessment of gastric acid output in chronic renal failure.

The presence of hypertrophied gastric and duodenal mucosa as seen in the barium meal examination has been widely accepted as indicating an increase in gastric acid content. The present study of 31 uraemic patients undergoing maintenance haemodialysis suggests that in the uraemic patient this is not the case. Nineteen showed hypertrophy of the gastric mucosa radiologically but only eight had an abnormal pattern of gastric secretion. Of the 12 patients with a normal gastric and duodenal mucosal pattern, four showed an increase in the acid output of the stomach. It is concluded that the radiologist should beware of equating hypertrophy of the gastric and duodenal mucosa with a high gastric acid output in the chronically uraemic patient.

Adult↗