Platelet aggregation and dipyridamole therapy in nephrotics.
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Biomedical subjects
Publications and source records attributed to H C Hsu.
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The glomeruli of newborn mice from mothers given a single intraperitoneal injection of cyclophosphamide (50 or 110 mg. per kg.) showed varying degrees of mesangiolysis and subsequent diffuse mesangial and segmental sclerosis. The sclerosis was preceded by the formation of a considerable amount of mesangial microfibrils. This change was accompanied by a marked subendothelial widening of the glomerular capillary and an increase in the number of microfibrils in this space. These results support our previous notion that glomerular microfibrils play an important role in the process of glomerular repair. The results also show that cyclophosphamide can induce injury in the developing glomeruli of newborn mice.
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Thirty-one specimens of tissue were obtained from 15 renal allografts 3-96 months after transplantation and studied by light, electron and in some cases also by immunofluorescence microscopy. All patients had a degree of renal insufficiency and almost all had proteinuria and moderate hypertension; nephrotic syndrome was present in one and hematuria in two. On histological examination one patient showed cellular proliferation suggestive of glomerulonephritis (recurrent or de novo) and another patient had numerous crescents. The most frequent glomerular lesion was widening of the lamina rara interna with subendothelial accumulation of finely granular material, formation of new subendothelial basement membrane and deposition of microfibrils and fine filaments. The mesangial changes were mainly those of mesangiolysis and mesangial sclerosis with deposition of mesangial matrix and microfibrils, but little cellular proliferation. Fragmented red blood cells were seen in nearly half of the patients. In another seven patients the lesion resembled focal segmental glomerulosclerosis. This combination of changes termed transplant glomerulopathy leads to diffuse glomerular sclerosis. Arterial intimal thickening and occasionally also thrombosis produced ischaemic changes in the kidney and in the glomeruli and contributed significantly to the process of transplant rejection.
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A 17-year-old school boy with recurrent sinopulmonary infection and diarrhea was found to have marked hypogammaglobulinemia. He had no family history of similar disorder. Serum IgG was measured 240 mg/dl, whereas all the other classes of immunoglobulins were undetectable with Mancini's technique. The polymorphonuclear leukocyte function and complement system were normal. Although the numbers of T and B lymphocytes were normal, we demonstrated that the patient's B cells were able to produce only IgG in subnormal amount and unable to secrete other classes of immunoglobulins. No hyperactive suppressor T cell function or inadequate helper T cell function was found. Therefore, the basic immmunopathogeneic mechanism was ascribed to intrinsic B cell defect.
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Microfibrils are a common component of connective tissue that have been described only rarely in the renal glomerulus. Structurally, microfibrils are fibrotubules with an average diameter of 12 nm, a lucid core, and a dark periphery. High resolution electron microscopy, including stereo microscopy performed on renal biopsy tissues, demonstrated the presence of microfibrils under the endothelium of the capillary walls and in the mesangium in several glomerular diseases. These diseases were characterized by widening of lamina rara interna or separation of the endothelium from the basement membrane, among them transplant glomerulopathy, focal segmental glomerulosclerosis (including a case associated with Marfan syndrome), preeclamptic toxemia, and less frequently hemolytic-uremic syndrome and malignant hypertension. The number of microfibrils generally correlated with the degree of subendothelial widening.
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The properties of the sustained cells in the lateral geniculate nucleus of cat have been studied quantitatively. These cells may be subdivided into two groups, the brightness and the darkness detectors. The former is photoexcitatory neurone and the latter, photoinhibitory. In both types, the rates of sustained discharges are closely related to the levels of retinal illumination over a range about 4 log units. The receptive fields of sustained cells again can be roughly divided into two subtypes according to their size. The large receptive field cells all belong to darkness detectors and are distributed mostly at retinal periphery, which may play some role in signalling the background luminance. The small receptive field cells comprise all brightness detectors and a part of darkness detectors, which are located predominantly around area centralis and may transmit the message of brightness or darkness about picture details and enhance the boundaries of a two-dimensional figure.
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