Biomedical subjects

H L Corwin

Publications and source records attributed to H L Corwin.

43 records · Page 3Linked to original sources

PubMed1985

Clinical correlates of eosinophiluria.

We assessed the clinical correlates of eosinophils in the urine in 65 patients. In 16% of 470 patients whose urine was specifically examined, eosinophils were noted in the urine sediment. Review of the 65 patients with eosinophiluria demonstrated that when eosinophils were expressed as a percentage of total urine white blood cells, 85% (55/65 patients) had less than 5% urine eosinophils and 45% (29/65 patients) had less than 1%. Infection of the upper and lower urinary tract accounted for 45% of the clinical conditions associated with eosinophiluria. In nine (14%) of the 65 patients a diagnosis of acute interstitial nephritis could be made by clinical criteria or from renal biopsy specimens. We conclude that the finding of urine eosinophils is associated with a variety of clinical conditions and may be most useful when expressed as a percentage of total white blood cells in the urine. At a low-percentage positive (less than 5%), it may not be a good predictor of acute interstitial nephritis, but at a higher level (greater than 5%) it may be a more valuable predictor.

Eosinophilia↗

PubMed1984

Low fractional excretion of sodium. Occurrence with hemoglobinuric- and myoglobinuric-induced acute renal failure.

Ten patients with myoglobinuric and hemoglobinuric acute renal failure demonstrated low fractional excretion of sodium (FENa) values (less than 1%) during the oliguric phase of their course. Acute renal failure secondary to hemoglobinuria developed in five patients, and five demonstrated acute deterioration with myoglobinuria. The mean serum creatinine level increased from 1.1 mg/dL (range, 0.6 to 1.7 mg/dL) to a maximum of 6.9 mg/dL (range, 2 to 13.1 mg/dL). Although three patients required dialysis, all individuals eventually returned or were returning toward their baseline renal function at discharge. The importance of a low FENa in the setting of myoglobinuric and hemoglobinuric renal failure is reviewed. The findings in this report raise the possibility that a common mechanism may underlie the renal injury in both types of pigment toxicity.

Acute Kidney Injury↗

PubMed1984

Renal failure from metastatic breast carcinoma reversed by radiotherapy and chemotherapy.

We treated a patient who had acute renal failure secondary to obstructive uropathy from metastatic breast carcinoma. Attempts at ureteral catheterization and nephrostomy failed. Bilateral ureteral irradiation was given, followed immediately by chemotherapy, with relief of obstruction and normalization of renal function. Nineteen months later, the patient died; at that time, her serum urea nitrogen and serum creatinine levels were normal.

Acute Kidney Injury↗

PubMed1984

Renal insufficiency associated with nonsteroidal anti-inflammatory agents.

In an attempt to characterize the clinical spectrum of renal insufficiency associated with nonsteroidal anti-inflammatory agents, 26 patients with 27 episodes of renal insufficiency secondary to these agents are described. These patients were seen over a 27-month period during which the inpatient distribution of these drugs by our hospital pharmacy was sufficient for approximately 92,000 patient-days of therapy. During these 27 episodes, serum creatinine increased from a mean value of 1.6 +/- .1 mg/dL to a mean maximum value of 3.3 +/- .3 mg/dL with a return to 1.7 +/- .1 mg/dL after discontinuation of the drug. Serum urea nitrogen increased from a mean of 27.8 +/- 2.5 mg/dL to 54.5 +/- 4.0 mg/dL and returned to 31.0 +/- 2.5 mg/dL. The mean duration of therapy in 25 patients was 4.2 +/- .7 days, and time to return to baseline renal function was 5.3 +/- .7 days. Five patients were briefly oliguric. No patient required dialysis. Only one patient had findings suggestive of interstitial nephritis. Patients were generally characterized by hemodynamic stress. In spite of only modest increases in serum creatinine, six patients had hyperkalemia with one sustaining a cardiac arrest secondary to a serum potassium of 7.9. We conclude that (1) the incidence of significant insufficiency in the general patient population is low but may be significant in a group characterized by hemodynamic stress; (2) the most common form of renal insult associated with nonsteroidal anti-inflammatory agents is mild renal insufficiency, which rapidly reverses when the agent is discontinued; and (3) hyperkalemia is relatively frequent, can be out of proportion to the degree of renal insufficiency, and can be life threatening.

Acute Kidney Injury↗

PubMed1984

Identification of actin-binding protein and villin in toad bladder epithelia.

Two actin-modulating proteins, actin-binding protein and villin, have been identified and functionally characterized in toad bladder epithelial cells. A 270-kdalton protein from bladder epithelial extracts 1) cross-reacts with antibodies to purified toad oocyte or rabbit macrophage actin-binding protein and comigrates with these proteins on gel electrophoresis, 2) contains all of the actin filament cross-linking activity found in epithelial cell extracts, and 3) its activity is calcium insensitive. A 95-kdalton protein from the same extracts 1) cross-reacts with antibodies to purified toad oocyte villin and comigrates with purified villin from the oocyte and chicken intestine on polyacrylamide gels, and 2) is capable of decreasing the viscosity of actin solutions only in the presence of calcium. These proteins offer potential sites for calcium-dependent and -independent regulation of toad bladder epithelial cell structure.

Animals↗

PubMed1983

Isolation of actin-binding protein and villin from toad oocytes.

Two actin-modulating proteins have been purified from toad oocytes. A high-molecular weight protein, similar in structure and function to macrophage actin-binding protein, accounts for the isotropic actin-crosslinking activity in oocyte homogenates. A calcium-dependent activity in toad oocyte homogenates which shortens actin filaments is accounted for by a 95,000-dalton protein which resembles villin, an actin-severing and -bundling protein of avian epithelial brush borders. In the presence of high (greater than or equal to microM) calcium, this protein shortens actin filaments in a concentration-dependent fashion and stimulates filament assembly when added to monomeric actin. In the absence of calcium the protein promotes the formation of actin filament bundles. Therefore, in the toad oocyte actin can be crosslinked into a network by actin-binding protein. Calcium regulation of the actin network may be mediated by villin. These results are different from those reported in echinoderm eggs.

Actins↗

PubMed1982

Failure of trimethoprim-sulfamethoxazole in the therapy of recurrent Pneumocystis carinii pneumonia.

The use of trimethoprim-sulfamethoxazole in the treatment and prophylaxis of Pneumocystis cariniii is well established. Treatment failure with this regimen has been ascribed to inadequate antibiotic serum concentrations. We describe an immunosuppressed patient with recurrent Pneumocystis carinii pneumonia who failed to respond to trimethoprim-sulfamethoxazole therapy despite high antibiotic serum concentrations. Subsequently, a response to pentamidine isethionate was obtained. The reason for failure and therapeutic implications in patients with Pneumocystis carini pneumonia who have received trimethoprim-sulfamethoxazole are discussed.

Child↗