[Renal insufficiency disclosing granulomatous interstitial nephropathy of sarcoidosis].
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Acute Kidney Injury↗
Biomedical subjects
J Bernheim
Publications and source records attributed to J Bernheim.
Advanced primary ovarian carcinoma in pregnancy.
A case of advanced ovarian carcinoma in pregnancy is described. The entity is usually difficult to diagnose; when it does occur, the objective should be to optimize both fetal and maternal outcome.
Adult↗
Endogenous digoxin-like factor raises blood pressure and protects against digitalis toxicity.
Digoxin-like immunoreactive factor (DLIF) is an endogenous natriuretic material which causes diuresis and natriuresis after salt or fluid loading and which may play a pathogenetic role in various hypertensive states. In order to study the cardiovascular effects of DLIF, we administered partially purified material (500 ng/kg) iv to normal rats. DLIF administration caused a significant rise in blood pressure, induced a brisk diuresis, and slowed the heart rate. In addition, DLIF protected against digitalis toxicity. While iv digoxin, 1 mg/kg, uniformly produced lethal arrhythmias, administration of DLIF 15 min prior to digoxin infusion consistently protected against arrhythmias. These findings support the theory that DLIF may play a role in hypertension. In addition, DLIF may compete with digoxin for cardiac receptors.
Animals↗
Histopathology of the soft parts in 50 patients with malignant external otitis.
Reports concerning the lesions of the skin coverage of the external ear canal in malignant external otitis (M.E.O.) are very few. To evaluate this problem, we studied the skin lesions of 45 skin biopsies from 40 M.E.O. patients, 23 from regions covering the osseous part of the ear structure, seven from the cartilaginous part of the external canal and 15 from both parts. The epidermis was normal in nine, thickened in 16, with acanthotic thickening and pseudoepitheliomatous hyperplasia in 20. In the dermis the amount of collagen was normal, but it was infiltrated by the inflammatory process. Acute inflammation was observed in 16 biopsies, subacute in 23, chronic in six. A mixture of acute and chronic changes was present in 18 biopsies. No major abnormalities of the vasculature could be detected. The distinguishing pathological feature of M.E.O. concerns the typical topographic distribution of the inflammation in the osseous part of the external ear canal.
Ear Canal↗
Presence of an anti-viral factor in peritoneal dialysis effluent.
Viral peritonitis is an exceptionally rare occurrence in peritoneal dialysis. In fact, up to now, only one case report has been documented in the literature. In a prospective study, peritoneal dialysis effluent (PDE) was specifically cultured for the following viruses: the herpes group of viruses, including herpes simplex types I (HSV) and II, cytomegalovirus (CMV) and varicella-zoster (V-Z), and the enteroviruses group including coxsackie B-5 (Cox B), echo, enterovirus and polio. Cultures were performed under both basal conditions and in the presence of peritonitis. No viral growth was demonstrated. The possible existence of an anti-viral factor in the PDE was therefore raised. In order to investigate this hypothesis, the PDE of 16 patients undergoing intermittent peritoneal dialysis and of 24 patients on continuous ambulatory peritoneal dialysis were examined for anti-viral activity. The method used was analogous to that employed for testing the anti-viral effect of interferon (IFN). The inhibition of the cytopathic effect (CPE) of various viruses was examined in the following tissue cultures: Vero cells (a line of monkey kidney cells) incubated with HSV, vesicular stomatitis virus (VSV) and Cox B; human kidney cells incubated with parainfluenza 3 (Para-3); human foreskin fibroblasts incubated with CMV, HSV and VSV and L-929 (a line of mouse cells) incubated with VSV. As control, unused Dianeal (Travenol, Ashdod, Israel) 1.5 and 4.25 g/dl, normal saline and 5 g/dl dextrose solutions were tested under the same conditions using VSV on Vero. The PDE was also examined for the presence of specific anti-viral antibodies by microneutralization and ELISA tests.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Effects of sodium depletion on renal prostanoid synthesis in rats: influence of the converting enzyme inhibitor captopril.
1. The synthesis of prostaglandin (PG) E2, PGF2 alpha, 6-keto-PGF1 alpha and thromboxane (TX) B2 by isolated glomeruli, cortical tubules, inner medullary slices and outer medullary slices was measured in salt-depleted (LNa) rats and in salt-depleted rats receiving captopril (LNa-CEI). Animals were studied before and after 4, 9 and 15 days of Na+ depletion. 2. Na+ balance was reached in LNa rats after 4 days. Blood pressure and creatinine clearance remained stable. Serum Na+ decreased from 140 +/- 1 to 126 +/- 1 mmol/l (mean +/- SEM, P less than 0.01). In contrast, LNa-CEI rats were unable to conserve Na+ adequately: fractional excretion of Na+ and natriuresis were constantly greater than in LNa animals. As a consequence, LNa-CEI rats developed severe hyponatraemia, lost weight and their creatinine clearance decreased. 3. The glomerular synthesis of PGE2, PGF2 alpha and 6-keto-PGF1 alpha, but not of TXB2, was significantly increased in LNa rats. In LNa-CEI rats, the synthesis of PGE2 and 6-keto-PGF1 alpha was similar to control values, but PGF2 alpha and TXB2 synthesis was elevated at day 9. In cortical tubules, PGE2 and PGF2 alpha were unaffected by Na+ depletion, but 6-keto-PGF1 alpha and TXB2 were increased and a similar trend was observed in LNa-CEI rats. In outer medulla of LNa rats, a decrease in all the eicosanoids measured was observed at day 4. In LNa-CEI animals, the synthesis of PGE2 and PGF2 alpha, but not of 6-keto-PGF1 alpha and TXB2, was significantly depressed. In inner medulla, Na+ depletion only tended to decrease PGF2 alpha and 6-keto-PGF1 alpha, but in the presence of captopril, the synthesis of all prostanoids was significantly decreased.
6-Ketoprostaglandin F1 alpha↗
Changes in renal prostanoid synthesis induced by potassium loading in rats.
Previous works have demonstrated changes in the urinary excretion of prostaglandins (PG) in response to changes in potassium (K) or sodium (Na) intake. In the present study, the production of PGE2, PGF2 alpha, 6-keto-PGF1 alpha and thromboxane B2 (TXB2) by isolated glomeruli, cortical homogenates, medullary and papillary slices was measured in K-loaded rats on either a normal or a low Na intake. In glomeruli, K loading increased selectively PGE2 synthesis. In Na-depleted animals, all prostanoids were elevated and K loading did not induce a further increase. In cortical and medullary preparations, PGE2 was decreased by K loading irrespective of the state of Na balance. In papilla, PGE2 decreased (in all K-loaded rats) and PGF2 alpha increased (only in rats with normal Na intake). 6-Keto-PGF1 alpha and TXB2 did not change significantly. No correlation was present between changes of PG synthesis and urinary kallikrein excretion. The results demonstrate a specific effect of K on PGE2 and PGF2 alpha, and suggest a role for these substances in K homeOstasis.
6-Ketoprostaglandin F1 alpha↗
Thrombin inhibits the synthesis of prostanoids by isolated glomeruli and peritoneal macrophages in rats.
Activation of macrophages and release of mediators that activate the coagulation system characterize proliferative glomerulonephritis. To evaluate the possible role of prostanoids in this process, isolated rat glomeruli (G) and peritoneal macrophages (M) or a combination of the two (G + M) were incubated in the presence of thrombin (2 U/ml). In G, thrombin inhibited only the synthesis of thromboxane B2. In M and G + M incubations, the synthesis of prostaglandin I2 and thromboxane A2 was inhibited by thrombin. This effect was abolished by the addition of arachidonic acid. As prostanoids may play a modulatory role in the interaction between macrophages and glomerular cells, inhibition of their synthesis by thrombin might enhance macrophage activity.
6-Ketoprostaglandin F1 alpha↗
Quantitative method of measuring anti-viral activity of peritoneal dialysis effluent.
We have previously documented the presence of anti-viral activity in the peritoneal effluent of uremic patients treated by peritoneal dialysis. Anti-viral activity was determined by recording the inhibition of the cytopathic effect (CPE) of various viruses on Vero cells in a semi-quantitative manner based on observer's subjective judgment of the degree of inhibition of CPE. This degree of inhibition is a measure of the anti-viral activity. Although peritoneal dialysis effluent (PDE) was consistently seen to inhibit CPE we sought a quantitative method to accurately assess such anti-viral activity. To this end, the CPE of Parainfluenza virus (Para-3) on human kidney (Hu-K) cells was evaluated. The CPE of this virus is manifested by distinct plaques which can be easily counted after staining the tissue culture plate. Eighty-three (83) samples of PDE (0.5 ml) were added to Hu-K cells after which Para-3 was added. As control para-3 on Hu-K was used. The number of plaques obtained by virus control was taken as 100% CPE. The anti-viral activity of PDE was then recorded as the percentage of the CPE shown by virus control and averaged 20.9 +/- 28.6% (p less than 0.001 vs virus control). In addition PDE was diluted down to 1/64 concentration and the inhibitory effect again determined. Percent CPE of undiluted, 1/2, 1/64 PDE samples were 18.11 +/- 24.2, 33.57 +/- 18.16 and 77.93 +/- 17.4% respectively (p less than 0.01 between undiluted and 1/64 PDE). These data reaffirm that PDE possesses an inherent anti-viral activity which can now be quantitatively assessed using Para-3 on Hu-K cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
Clinical and laboratory findings of spotted fever in Israeli children.
In a prospective study of 70 Israeli children with spotted fever the major clinical features were fever (100%), skin rash (98.5%), myalgia (54%) and vomiting (40%). Thrombocytopenia (75%) and hyponatremia (62.5%) were common, but were not associated with increased mortality. Antibodies to Rickettsia conorii were detected by the indirect immunofluorescent antibody assay. In one patient Rickettsia was grown from blood. Contacts with dogs were reported in 17 of 40 patients questioned, and in only 2 was a canine tick bite obvious. Hospitalization was required in 11 (16%) patients. There was 1 fatality. The rickettsia responsible for spotted fever in Israel appears to be an antigenic variant of R. conorii. Early recognition and treatment of this disease permits rapid eradication of the rickettsiae and facilitates complete recovery.
Antibodies, Bacterial↗
Heterotopic and metaplastic gastric mucosa in the duodenum.
The presence of gastric epithelium or mucosa at any level of the gastrointestinal tract is a well-known phenomenon. In duodenal mucosa, congenital heterotopic gastric mucosa or acquired metaplastic gastric surface epithelium (MGE) may be found. In the present study 325 duodenal biopsies (260 upper gastrointestinal endoscopy and 65 abdominal surgery biopsies) from 297 patients were retrospectively reviewed. Normal duodenal mucosa was present in 119 specimens, duodenitis in 155 and duodenal ulcer in 51. Heterotopic gastric mucosa was present in only one patient with duodenal ulcer, and MGE in 31% of the biopsies with a normal mucosa, in 21.7% with duodenitis and in 82% with duodenal ulcer (P less than 0.01). MGE was present in 120 biopsies of 109 patients--68 men and 41 women, 91% Jews, and 9% Arabs. The hospitalized population of our region comprised 82% Jews and 18% Arabs. Duodenal ulcer was more frequently found in Arab (69%) than in Jewish patients (41%). We conclude that MGE is a common finding, even in the presence of normal duodenal mucosa (30%) and occurs in most (80%) duodenal ulcer cases. The fact that MGE is more frequent in the Jewish population suggests that a genetic factor may be involved.
Adult↗
Role of glomerular prostanoid in control of glomerular filtration rate in rats.
It is generally accepted that the main action of glomerular prostanoids (GPs) on glomerular filtration rate (GFR) is to modulate the activity of different vasoconstrictors, specially in states of renal hypoperfusion. However it was also suggested that GPs may directly affect GFR. The present study was focused on this last hypothesis, in different experimental models, in rats. In adriamycin induced acute renal failure, the transient decrease of GFR is associated with higher levels of thromboxane B2. Later on, when GFR returns to normal, vasodilator prostaglandins synthesis was also increased. In captopril induced renal failure in Na depleted rats (where GPs synthesis remained normal), stimulation of PGE2 and PGI2 production by K and NaCl was associated with a significant improvement of GFR. Furthermore, the increase in GFR induced by NaCl was prevented by inhibition of prostaglandin synthesis. Infusion of atrial natriuretic peptide in euvolemic rats induce a marked elevation both of GFR and PGE2 synthesis. It was abolished by previous administration of prostaglandin synthesis inhibitor. In conclusion, glomerular prostanoids may influence GFR, either directly, or as mediator or modulator of other vasoactive hormones.
Acute Kidney Injury↗
Nephrotic syndrome after treatment with 5-aminosalicylic acid.
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Aminosalicylic Acids↗
Malignant thymoma with peripheral blood lymphocytosis.
A 37-year-old woman with a giant, lymphocytic predominant thymoma involving the pleura and accompanied by a sharp peripheral blood lymphocytosis is described. Only electromicroscopic and immunohistologic studies could exclude the alternative diagnosis of mediastinal lymphoma. The tumor and peripheral blood lymphocytes were characterized as T4 lymphocytes. The thymoma responded very well to a combination of radiation and cytotoxic therapy. Forty-two months after diagnosis, the patient is still is complete remission.
Adult↗
Atrial natriuretic peptide administration to normal and salt depleted rats--effects on digoxin-like immunoreactive factor, aldosterone, ACTH, and renal function.
In view of the known interrelationships between renin, aldosterone, and atrial natriuretic peptide (ANP), we sought to examine whether there also exists an interaction between ANP and digoxin-like immunoreactive factor (DLIF). We therefore studied the effects of ANP administration on normal and salt-depleted rats, and measured the effects on blood pressure, urine output, glomerular filtration rate, sodium excretion, aldosterone, ACTH, and DLIF levels. ANP administration resulted in a significant elevation of sodium excretion and glomerular filtration rate and a fall in blood pressure. DLIF concentrations in plasma rose significantly, as did urinary DLIF excretion. ANP administration resulted in a fall in aldosterone as well as ACTH. These observations suggest that ANP has a direct inhibitory effect on ACTH secretion. Our findings support the concept of an interrelationship between ANP and DLIF.
Adrenocorticotropic Hormone↗
Possible long-term complications of autotransplanted parathyroid glands in haemodialysed patients.
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Humans↗
Transcutaneous monitoring of blood gas tensions in patients on intermittent peritoneal dialysis.
A relative contraindication to intermittent peritoneal dialysis (IPD) is chronic lung disease. To evaluate whether the instillation of 2 L of fluid into the peritoneal cavity affects respiratory function, five IPD patients were studied in the supine position during the first 4 h of a routine IPD session. Blood gas tensions were monitored transcutaneously throughout the study period. At the onset of dialysis, mean transcutaneous blood oxygen tension (PtcO2) was 70.6 +/- 9.1 mm Hg. It decreased to 55 +/- 9.9 mm Hg (22% change from basal values) during the instillation of dialysate. Upon drainage, PtcO2 returned to baseline. This sequence of events repeated itself on subsequent exchanges, although with decreasing decrements of PtcO2 with each consecutive exchange (decrease to 58.6 +/- 7.05, 61 +/- 6.5, 63.8 +/- 5.2 mm Hg corresponding to 16%, 12.7%, and 9.6%, respectively, during the second to fourth exchanges). Transcutaneous blood carbon dioxide tension, PtcCO2, showed a very mild increase during the study (33 +/- 7.1 to 38 +/- 6.0 mm Hg). In two patients, the same study protocol was performed during the last 4 h of an IPD session. In these two patients, there was only a 5% variation of PtcO2 from baseline values. These results suggest that an adaptive response to the hypoxemia induced by dialysate instillation rapidly occurs in IPD patients.
Adult↗
Prostanoids in renal failure induced by converting enzyme inhibition in sodium-depleted rats.
Clearances of inulin (CIn) and p-aminohippurate (CPAH) were measured in four groups of rats before and after intravenous administration of acetylsalicylic acid (ASA): 1) controls, on normal Na intake, 2) captopril-treated (30 mg.kg-1.day-1) on normal Na intake, 3) Na depleted, and 4) Na depleted, captopril-treated. In Na-depleted animals, CIn and CPAH were similar to controls but decreased significantly with ASA. In Na-depleted, captopril-treated rats, CPAH was slightly decreased, but CIn was significantly reduced (P less than 0.01). Both were not affected by ASA. Urine output was unchanged and the kidneys appeared normal on histological examination. The production of prostaglandins E2 (PGE2), F2 alpha (PGF2 alpha), and thromboxane B2 (TxB2) was measured in isolated glomeruli, cortical tubule suspensions, and medullary and papillary slices. Captopril increased PGE2 production by glomeruli and PGF2 alpha and TxB2 synthesis in papillary slices. Na depletion selectively enhanced the production of PGE2 by glomeruli and papillae. In contrast, the synthesis of prostanoids was significantly decreased in captopril-treated, Na-depleted rats. These findings suggest that in this model, functional nonoliguric renal failure may be related to abnormalities of prostanoid synthesis.
Angiotensin-Converting Enzyme Inhibitors↗