Biomedical subjects
Publications and source records attributed to D J Harrison.
The presence of apoptotic bodies in proliferative glomerulonephritis was investigated by light and electron microscopy. They were identified in small numbers in 35 of 68 biopsies studied, especially biopsies containing numerous neutrophils. Apoptosis may be a mechanism reducing acute glomerular damage and allowing a hypercellular glomerulus to return to normal.
In a case of focal and segmental glomerulonephritis unusual cell junctions were discovered between podocytes. These most closely resembled lesions described in aminonucleoside induced nephrosis in rats and were unlike anything previously seen in our experience. Shortly after renal transplantation nephrotic syndrome recurred and biopsy specimens showed recurrent focal and segmental glomerulonephritis, with the appearance of these unusual interpodocyte junctions in the graft kidney. This may be related to circulating factors in the blood of the patient.
A series of renal biopsy specimens taken at the time of percutaneous nephrolithotomy were investigated for the presence and location of foci of microcalcification. Calcium was found in 18 of 25 (72%) of biopsy specimens from stone formers and in only seven of 30 (23%) of control biopsy specimens. This may indicate defective intrarenal handling of calcium as plasma calcium concentration was normal and 40% had a raised 24 hour urinary calcium excretion.
We report a case of the deliberate inhalation of a toluene-containing adhesive which caused acute renal failure and hepatic damage. Renal biopsy disclosed a severe tubulo-interstitial nephritis, renal function recovered after 14 days' haemodialysis. The literature on renal complications of toluene exposure is reviewed, this is the only case of acute renal failure due to interstitial nephritis after toluene exposure with subsequent recovery. Recovery in this case may have been related to the avoidance of further toluene exposure.
A comparison was made between the renal biopsy appearances of Wegener's granuloma, microscopic polyarteritis and diffuse endocapillary proliferative glomerulonephritis, including the distribution of surface IgE-bearing mast cells. In microscopic polyarteritis and in other inflammatory conditions mast cells were usually associated with areas of interstitial inflammatory infiltrate, whereas in Wegener's granuloma mast cells were usually separate from areas of inflammation, suggesting a role for mast cells in the development of the renal lesion of Wegener's granulomatosis.
Six cases of acute renal failure associated with mefenamic acid therapy are described. Five patients were non-oliguric and five patients had clinical features of salt and water depletion. In these patients the presenting symptoms were abdominal pain, diarrhoea and vomiting. Renal biopsy in five patients showed interstitial nephritis and mesangial proliferation. All patients recovered without specific therapy after withdrawal of the drug, but in four patients mild renal impairment persisted. These findings indicate that both interstitial and mesangial changes are common features of acute renal failure due to mefenamic acid therapy.
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A single blind randomised trial of two different anti-emetic regimens (A and B) was performed in 26 patients with breast carcinoma undergoing emetic i.v. cytotoxic chemotherapy. They all received oral Motival (nortriptylene/fluphenazine) for 48 h after therapy and for regimen A received N-saline i.v. with their cytotoxics whilst for regimen B patients were given 16 mg dexamethasone i.v. Patients were given the alternative regimen at the subsequent course of treatment. They were asked to assess overall nausea and number of vomiting episodes in the 24 h following therapy. There was a statistically significant reduction in both for the regimen containing dexamethasone. This agent causes few side effects and is particularly suited for out-patient use.
A study was made of the cells forming the crescents in human crescentic glomerulonephritis. The investigation was performed using a panel of antibodies with immunoperoxidase techniques in formalin fixed, paraffin embedded renal biopsy material. Some of the cells of glomerular crescents were found to contain cytokeratin intermediate filaments, as did some of the cells of the normal parietal epithelium of Bowman's capsule. Leucocytes were also found in crescents, often in the outer part, and their presence was associated with a mantle of inflammatory cells around the glomerulus. The use of paraffin embedded rather than frozen tissue allowed better histological assessment than has been possible in previous studies. The glomerular crescents appeared to be primarily epithelial in origin, with leucocytes contributing to the overall inflammatory response.
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In a clinicopathological survey of idiopathic membranous glomerulonephritis (MGN) in 85 patients the predominance of the condition among men could be at least partly explained by an increased risk of exposure to organic solvents and heavy metals in the course of work. This may have implications for the advice given to these patients after MGN has been diagnosed. The selectivity of proteinuria could predict the likely outcome of the disease.
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Two experiments were performed to study the effects of bromocriptine and alpha-ergocryptine on oxytocin secretion in lactating rats. In both experiments, after overnight separation from their litters, rats were injected with either vehicle alone or ergot alkaloid plus vehicle; 4 h later the litters were returned. In the first experiment the mothers were conscious. Treatment did not affect suckling behaviour, number of stretch reactions or little weight gain in the first 30 min. Oxytocin injection before the second 30 min period of suckling caused no extra milk to be obtained. In the second experiment the mothers were anaesthetized with ethyl carbamate (1.1 g/kg body weight) at the time of the ergot alkaloid or vehicle injection. Changes in intramammary pressure were recorded during suckling. Ergot alkaloids altered neither the number of milk ejections caused by suckling, nor the proportion of milk ejections equivalent to 0.2 millimicron or more oxytocin. In both experiments treatment with ergot alkaloids suppressed secretion of prolactin. It is concluded that (a) in suppressing lactation, bromocriptine and alpha-ergocryptine do not inhibit oxytocin secretion as well as prolactin secretion, and that (b) prolactin secretion is not a necessary concomitant of oxytocin secretion.