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Biomedical subjects

J Hopper

Publications and source records attributed to J Hopper.

At least 55 records · Page 3Linked to original sources
PubMed1984

Late development of systemic lupus erythematosus in patients with glomerular "fingerprint" deposits.

Two patients presenting with nephrotic syndrome but without evidence of collagen vascular disease had organized glomerular immune deposits with a "fingerprint" pattern. This finding has been previously associated with lupus nephritis and, in our institution, has been seen in 6% of the biopsy specimens from patients with lupus nephritis. Clinical signs and symptoms of systemic lupus erythematosus in these two patients did not develop until 2 and 5 years later, respectively. The cases of these patients suggest that glomerular deposits with a fingerprint pattern may be a specific marker for lupus erythematosus even when overt clinical features of this disease are lacking. Patients with this finding on renal biopsy should have an extended follow-up for possible development of lupus erythematosus.

Adult↗
PubMed1983

Failure of sodium aurothiomalate and triethyl phosphine gold to cause renal tubular injury in rheumatoid arthritis: implications for the aetiology of gold-related nephropathy.

The urinary excretion of two proteins, B-2-microglobulin (beta 2M) and N-acetyl-B-D-glucosaminidase (NAG) was measured in 25 patients with rheumatoid arthritis (RA) on nonsteroidal anti-inflammatory drugs (NSAID). Although beta 2M excretion was normal NAG excretion was raised. As NAG excretion by a group of osteoarthritis patients receiving similar doses of NSAIDs was normal, it is concluded that rheumatoid disease per se may be associated with mild renal tubular dysfunction. Twelve of the above 25 patients were then given oral triethylphosphine-gold (auranofin) 6 mg daily and urinary beta 2M and NAG were measured after 6 months' treatment. Urinary excretion of beta 2M and NAG was also measured in 13 patients with RA established on intramuscular sodium aurothiomalate (MGST) and NSAIDs. Neither auranofin nor myocrisin were found to further significantly increase beta 2M and NAG excretion. These results suggest that gold compounds are not toxic to renal tubular epithelium.

Acetylglucosaminidase↗
PubMed1983

Successful management of acute traumatic duodenocaval fistula.

Acute traumatic duodenocaval fistula is a devastating injury, usually resulting in early exsanguination and death due to lack of retroperitoneal tamponade of vena caval bleeding. Early recognition of possible entericvascular communication and rapid transport to the operating room are prerequisites for successful management of this rare injury.

Adult↗
PubMed1982

The information content from renal biopsy in systemic lupus erythematosus.

We analyzed data for the 12-month period after renal biopsy was done in 130 patients with systemic lupus erythematosus to examine whether renal biopsy provides useful information on the nephritis of systemic lupus erythematosus beyond that clinically available. A stepwise linear regression analysis was used to construct a linear before biopsy model that predicted the change in renal function 12 months after biopsy. The model included serum creatinine, patient age, 24-hour urine protein, a laboratory index of renal activity, antibodies to DNA, urinalysis protein, change in inverse creatinine from 6 weeks before biopsy, and urine light chain protein, and had a squared multiple correlation coefficient (R2) of 0.246. Four prospectively chosen renal biopsy variables (glomerular cell counts, percent of sclerotic glomeruli, percent of glomeruli with crescents, and interstitial fibrosis) resulted in a 0.079 improvement in R2 (p less than or equal to 0.012). Both the percent glomerular sclerosis (p less than or equal to 0.0032) and subendothelial deposits shown by electron microscopy (p less than or equal to 0.0026) added significantly to the predictive power of the before biopsy model. Histologic classification did not add significantly to the before biopsy model. The renal biopsy information increased the power of a linear regression model to predict the effect of 12 months of treatment of active lupus nephritis.

Adult↗
PubMed1982

Recognition of information in renal biopsies of patients with lupus nephritis.

To evaluate the informational value of renal biopsy in nephritis of systemic lupus erythematosus, we selected the records of 30 patients who had a renal biopsy done and also had a known clinical outcome. Detailed case histories were prepared, and three distinct randomly chosen cases were given to 197 academic rheumatologists. The rheumatologists estimated the probability of future clinical events (worsened serum creatinine, worsened urine protein, renal death, and aggressive therapy) at 3 and 12 months after the biopsy. Biopsy results were given in detail, and probability estimates were made of the same clinical events using the additional information. The accuracy of each probability estimate was measured using a scoring function that depends on the estimates and the actual outcomes. Knowledge of the renal biopsy failed to improve predictive accuracy scores of estimates of future serum creatinine levels, urine protein levels, and renal death at 3 and 12 months (p less than 0.0001), and for estimates of the probability of the use of aggressive therapy at 12 months (p less than 0.007). The renal biopsy information improved only the accuracy of predictions concerning the use of aggressive therapy at 3 months (p less than or equal to 0.0003). Knowledge of the renal biopsy results failed to add important prognostic information about the future course of treated lupus nephritis to information already obtained from history, physical examination, and laboratory tests.

Adult↗
PubMed1981

Characterization of glycosaminoglycans in urine from patients with nephrotic syndrome and control subjects, and their effects on lipoprotein lipase.

Previously we found that alpha 2-acid glycoprotein fraction from urine of patients with the nephrotic syndrome stimulated the lipoprotein lipase reaction in vivo and in vitro. The activator was separated from the alpha 1-acid glycoprotein and identified as a glycosaminoglycan. The studies reported here were undertaken to characterize and quantify the glycosaminoglycans contained in urine of patients with the nephrotic syndrome and to compare these to the glycosaminoglycans in urine of the control subjects. We found that free low molecular weight glycosaminoglycans, heparan sulfate and chondroitin 4-sulfate, are excreted in both patients with the nephrotic syndrome and controls however, patients with the nephrotic syndrome excreted much less of both glycosaminoglycans. The free form of heparan sulfate was found to be the activator which stimulated the lipoprotein lipase reaction in vitro in the presence of apolipoprotein CII. In addition, the urine from patients with the nephrotic syndrome contained a protein-glycosaminoglycan complex which was absent in control urine. Glycosaminoglycans in the complex could be released by papain digestion or by trichloroacetic acid. Our evidence indicates that this glycosaminoglycans fraction is a law charge form of chondroitin sulfate.

Chondroitin Sulfates↗
PubMed1981

Renal vein thrombosis: occurrence in membranous glomerulonephropathy and lupus nephritis.

Renal vein thrombosis developed in 11 of 280 patients having either biopsy-proved membranous glomerulonephropathy or systemic lupus erythematosus with nephritis. All 11 also were found to have nephrotic syndrome. In nine, nephrotic syndrome developed before renal vein thrombosis; the diagnoses of nephrotic syndrome and renal vein thrombosis were made simultaneously in the other two. Ten of the 11 patients also had pulmonary emboli at or near the time of renal vein thrombosis.

Adolescent↗
PubMed1981

Membranous nephropathy: its relative benignity in women.

By means of renal biopsy and light, immunofluorescence, and electron microscopy, a diagnosis of membranous nephropathy (MN) was made in 100 patients. The nephrotic syndrome was present in 83 of these patients. 65 of the patients were men and 35 were women. The average period of follow-up was 99.8 months. As judged by the incidence of death and of improvement or complete healing, the women fared better than the men, whether given high-dose alternate-day prednisone therapy or not. The incidence of improvement or complete healing in the patients given prednisone was higher than the reported for patients who were not given corticosteroids. We have shown that occurrence of MN is more frequent in women than men and the course of MN is more benign in women than in men; alternate-day prednisone therapy appears to be beneficial in patients with MN.

Adolescent↗
PubMed1981

Membranous nephropathy: high-dose alternate-day therapy with prednisone.

Fifteen cases were selected for study from 100 consecutive cases of membranous nephropathy diagnosed by renal biopsy and light, immunofluorescence, and electron microscopy. The cases were chosen because during a pretreatment observation period ranging from 8 to 66 months (median, 18 months), the patients' disease state had progressed. Data gathered during this period served as a baseline against which to evaluate the effects of treatment with prednisone; thus, the patients served sequentially as their own controls. All but one of the patients had nephrotic syndrome, and 11 had renal insufficiency. Treatment with prednisone administered on alternate days was accompanied by decreasing proteinuria and increasing serum levels of albumin in all the patients. Healing, defined as proteinuria of no greater than 0.2 grams per 24 hours for at least a year with maintenance of normal creatinine clearance, occurred in eight patients. Renal function, judged by rate of creatinine clearance or level of creatinine in serum, improved in all 11 patients with renal insufficiency; in eight of these, normal function was attained. Poor renal function could not be attributed to diminished blood volume measured by chromium 51 red-blood-cell tag.

Adolescent↗
PubMed1980

Membranous lupus nephropathy initially seen as idiopathic membranous nephropathy. Possible diagnostic value of tubular reticular structures.

When a renal lesion is the sole manifestation of systemic lupus erythematosus (SLE), differentiation from other nephropathies is difficult. The membranous form of lupus nephritis is especially difficult to distinguish from idiopathic membranous nephropathy, particularly when multisystem and serologic features of SLE are absent. We report two cases in which the initial renal biopsy findings suggested idiopathic membranous nephropathy and in which the subsequent emergence of SLE might have been predicted by the presence of tubular reticular structures. We identified these structures in 177 of 183 (96.7%) renal biopsy specimens from patients with SLE, but in only three of 128 (2.3%) renal specimens from patients with membranous nephropathy. Tubular reticular structures are markers of the renal lesion of SLE and may be helpful in differentiation from membranous nephropathy.

Adult↗
PubMed1979

Comparative surfact structure of 16S ribosomal ribonucleic acid of 30S ribosomes of procaryotic cells.

Ribonuclease T(1) treatment of 30S ribosomes of Escherichia coli converts a large region at the 3' OH end of 16S ribosomal ribonucleic acid (rRNA) to low-molecular-weight RNA. The final 25 nucleotides at the 3' terminus of the molecule emerge relatively intact, whereas most of the region "upstream," for about 150 nucleotides, is converted to oligonucleotides. Identical enzyme treatment generates a fragment of about 60 nucleotides from the middle of 16S rRNA (section D'). To determine whether there are similar sequences in other bacteria, which occupy similar accessible surface locations, we treated 30S ribosomes from Azotobacter vinelandii and Bacillus stearothermophilus with RNase T(1). In each case, a fragment of RNA about 25 nucleotides in length containing the 3' OH end of 16S rRNA and a fragment of about 60 nucleotides in length similar, but not identical, in oligonucleotide composition to section D' of E. coli 16S rRNA were obtained from nuclease-treated 30S ribosomes. These data indicate that, although the primary structure at the 3' end and the middle (section D') of the various 16S rRNA's is not completely conserved, their respective conformations are conserved. A number of identical oligonucleotides were found in the low-molecular-weight fraction obtained from RNase T(1)-treated E. coli, A. vinelandii, and B. stearothermophilus 30S ribosomes. These results show that identical RNase T(1)-sensitive sequences are present in all three bacteria. Hydrolysis of these regions leads to the production of the fragments 25 and 60 nucleotides in length.

Azotobacter↗
PubMed1978

Membranous nephropathy in patients with rheumatoid arthritis: relationship to gold therapy.

Of 90 patients with membranous nephropathy proved by biopsy, 8 (8.9%) had pre-existing rheumatoid arthirtis. Four of these eight patients received systemic treatment with gold. Two others received only token amounts of gold. In two patients who received gold, the renal lesions did not occur until months after discontinuance of gold therapy. We found that clinically significant renal lesions (lesions associated with proteinuria) in patients with rheumatoid arthritis were more likely to be membranous nephropathy than occult amyloidosis or adult lipoid nephrosis. The membranous lesion in patients with rheumatoid arthritis may be difficult to identify by light microscopy, and, although special strains can be helpful, the pathology is frequently sufficiently subtle to require immunofluorescence and electron microscopy for definitive diagnosis. We postulate that chrysotherapy may not be the cause of membranous nephropathy in patients with classic rheumatoid arthritis in whom gold has been used. Whether it merely exacerbates a lesion already present in these patients, or whether it plays little or no role in the development of membranous nephropathy is an unsettled question. Our data lead to think that RA can induce MN and that gold is not the primary inciting agent.

Adult↗
PubMed1976

Erythrocytosis associated with diffuse parenchymal lesions of the kidney.

Thirteen patients with diffuse parenchymal disease of the kidney and erythrocytosis are reported. In five the haematocrit was only minimally elevated because of an associated increase in plasma volume. The erythrocytosis in three patients was of particular interest: (1) transient appearance in a 23-year-old man with glomerulonephritis; (2) persistence despite the partial remission of nephrotic state in a 19-year-old man; (3) appearance following removal of a nephrosclerotic kidney from a 54-year-old woman. Because an associated expansion of plasma volume is not uncommon with parenchymal renal disease, it is suggested that the only reliable screening method for renal erythrocytosis is direct measurement of red cell volume.

Adult↗