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Biomedical subjects

J M Suc

Publications and source records attributed to J M Suc.

At least 109 records · Page 6Linked to original sources
PubMed1986

Abdominal fat tissue aspirate in human amyloidosis: light, electron, and immunofluorescence microscopic studies.

Abdominal fat tissue aspirates from 12 patients with biopsy-proved amyloidosis were investigated by different morphologic techniques. By light microscopy, after staining of the fat tissue aspirates with Congo red and examination with a polarizing microscope, positive results were obtained in nine patients with amyloidosis, two of the three with primary (AL) amyloidosis and seven of the nine with secondary (AA) amyloidosis. By indirect immunofluorescence, using AA antiserum, positive results were obtained in five of the nine cases of AA amyloidosis (aspirates from these five patients were positive on Congo red staining). By electron microscopy, amyloid fibrils were observed in five cases of amyloidosis (two of the AL and three of the AA type, all positive on Congo red staining). Although amyloid was demonstrated less frequently by immunofluorescence and electron microscopy, perhaps because of the small numbers of fat particles examined, it seems that, with Congo red staining, abdominal fat tissue aspiration is a simple and sensitive method for the diagnosis of amyloidosis. Immunofluorescence studies allow discrimination between the different types of amyloidosis. The method could be used in patients in whom other types of tissue biopsy are not recommended because of risks of bleeding or other problems.

Adipose Tissue↗
PubMed1986

[Predictability of post-captopril acute renal failure in hypertension with renal artery stenosis of a single kidney or bilateral stenosis].

Use of converting-enzyme inhibitors in patients with hypertension and bilateral renal artery stenosis or renal artery stenosis in a single kidney may be complicated by acute renal failure (ARF). The aim of this work was to find a simple test to predict this accident. PAH clearance (CPAH), Inuline clearance (CIn) and Glomerular Filtration Fraction (GFF) were measured before and three hours after a single oral dose of Captopril (50 mg) in 7 hypertensive patients (sodium intake = 6 g/24 h). All these patients presented significant stenosis (greater than 60%) of the artery of a transplanted kidney (5), of a single kidney (1) or a bilateral renal artery stenosis (1). During the following three days, 50 mg captopril was given twice a day. ARF with creatinine serum level higher than 300 mumoles/l was seen in 4 patients (Group II); in 3 patients (Group I) creatinine serum level didn't change. Values measured before the single dose of captopril and variations after three hours are reported in the table: (Table: see text). Before captopril, in Group II CPAH and CIn are lower and GFF is higher, but these is not significant difference between the two groups. After Captopril CIn and GFF are significantly decreased in Group II (29.1 and 36.6% vs 7.8 and 10%). These results allow two conclusions: 1) Basal values of Glomerular Filtration Rate plasma flow and filtration fraction are not predictive parameters for acute renal failure after captopril therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1985

Low haematocrit and prolonged bleeding time in uraemic patients: effect of red cell transfusions.

This study demonstrates that a low haematocrit is the main determining factor of the prolonged bleeding time often encountered in uraemic haemodialysed patients. Thirty-three patients submitted to regular haemodialysis and having a platelet count greater than 100 X 10(9)/l were investigated with the following tests: simplate bleeding time, blood cell count, platelet aggregation induced by ADP, collagen and sodium arachidonate, arachidonate induced MDA synthesis, tests for detection of an acquired storage pool disease, and factor VIII complex level. The results were compared to two other groups; one of uraemic patients not yet subjected to haemodialysis and another of healthy volunteers. The results were basically identical in the two groups of uraemic patients. The only consistent abnormality was a 30-35% reduction in the platelet MDA synthesis in comparison with control subjects. There was a negative correlation between the log bleeding time and the haematocrit (r = 0.78, P less than 0.01). Fourteen uraemic patients having a prolonged bleeding time were submitted to a red cell transfusion programme and were investigated a second time under identical conditions. There was no change in any of the platelet function tests or in the factor VIII complex level, but the bleeding time was normalized when the post-transfusion haematocrit was over 26% (nine patients). This study emphasizes the role of anaemia in the pathogenesis of the prolonged bleeding time in uraemia and suggests that red cell transfusion can be a long-term efficient therapeutic measure to stop bleeding in these patients.

Adolescent↗
PubMed1985

[Reversible renal insufficiency and arterial hypertension after renal transplantation: role of transplant artery stenosis and a captopril-furosemide combination].

Acute renal failure after captopril therapy in patients with transplant artery stenosis is well known. The study of a new observation may stress three particular points: 1) Diagnosis may be difficult just after transplantation in case of initial acute renal failure. 2) Renal function rapidly improved after withdrawing captopril and furosemide; after surgical treatment of the stenosis, a new course of captopril therapy was possible without any decrease of glomerular filtration rate. 3) A critical fall in filtration fraction seems to be the essential mechanism of renal failure, but specific interstitial lesions of the transplant showed on kidney biopsies, might be discussed.

Acute Kidney Injury↗
PubMed1985

[Renal biopsy and diagnosis of angiitis. 13 cases].

The renal biopsies of 13 patients presenting with a predominantly renal form of angiitis were reviewed. The principal lesions were glomerular with a segmental and focal extracapillary glomerular nephritis in all cases. Arteriolar lesions with necrosis or granuloma were inconstant (6/13) but necrosis of the tuft reflecting capillary involvement were common (11/13). Interstitial tubular disease and immunofluorescence were not specific. Renal biopsy is a good indication of diagnostic when performed early before the development of sclerosis: arteriolar necrosis and suggestive changes: extracapillary segmental and focal glomerulonephritis. In the latter case, a careful search for extrarenal involvement with guided biopsy studies usually allow a diagnosis to be confirmed. The renal and extrarenal clinical signs, the biochemical changes, treatment and outcome were analysed. Two of the 13 patients had Wegener's disease, one patient had angiitis and linear fixation of IgG along the glomerular and tubular basal membranes.

Adult↗
PubMed1984

Immunofluorescence and ultrastructural localization of beta 2-microglobulin in human renal allografts.

The localization of beta 2-microglobulin (beta 2m) was studied in renal biopsies from 18 patients with pathological transplanted kidney using immunofluorescence and electron-immunohistochemical techniques; the renal biopsies of 4 cases with normal kidneys were used as controls. Using immunofluorescence, beta 2m was not observed in the normal kidneys, beta 2m was found in the glomeruli (7 cases) and the tubular epithelium (16 cases) of the transplanted kidneys. Using immunoelectron microscopy, some labelling of the normal kidneys was observed mainly along the cell coat of foot processes and in tubular-epithelial lysosomes. In the glomeruli of transplanted kidneys, particularly in cases of acute or chronic rejection, beta 2m was most frequently localized on the outer layer of the basement membrane and along the cell coat of foot processes. The brush border of the proximal tubules and the lysosomal structures were intensely labelled. Although immunoelectron-microscopy studies are unable to discriminate between the localization of beta 2m in normal and transplanted kidneys, these findings nevertheless suggest the glomerular filtration of beta 2m and its metabolism in the tubular epithelium.

Adolescent↗
PubMed1984

[Pelvic lipomatosis: value of x-ray computed tomography. Apropos of a case].

Pelvic lipomatosis is characterised by an excessive amount of adipose tissue in the pelvis. Although there are usually few clinical symptoms, the radiological changes are characteristic: pear-shaped bladder, straightened and displaced rectosigmoid junction. However, these changes are not specific and some workers advise histological confirmation with or without surgical exploration. The authors describe a case illustrating the diagnostic value of computerised axial tomography, as has previously been reported. This investigation seems to give reliable results in the diagnosis of pelvic tumours, especially those of adipose tissue.

Aged↗
PubMed1984

[Changes in the activity of renal intracortical kallikrein during induction of Goldblatt arterial hypertension of the 2 kidney--1 clip type in the rat].

Renal tissue kallikrein and proteins were measured in two kidney-one clip Goldblatt hypertensive rats both in the stenotic and the controlateral kidney and in sham operated rats at either 1 or 2 weeks after clipping. Activity was assessed by the amidolytic activity and by the kininogenase activity. Kallikrein in normotensive controls was 97.4 +/- 13 ng of bradykinin min-1 mg-1 of protein at week 1 and increased up to 116 +/- 18. Kallikrein in the GH rats was 83 +/- 12 in the stenotic kidney and 85,6 +/- 14 in the controlateral one at week 1, these values remained unchanged at week 2. As a consequence renal tissue kallikrein became significantly lower in the GH rats only at week 2 when compared to controls both the clipped and unclipped kidney showed the same magnitude decrease. Protein concentration remained at a steady level through out the 2 weeks of study. The results suggest that the lower renal kallikrein activity secondary to hypertension found in GH rats result from a decreased activation of prekallikrein in both kidney.

Animals↗
PubMed1984

[Renal insufficiency after administration of captopril in renal artery stenosis with a single kidney or bilateral stenosis is not compulsory].

Acute renal failure has been reported during captopril therapy of hypertension due to renal artery stenosis with a single kidney or bilateral renal artery stenosis. Under low perfusion pressures inhibition of the renin-angiotensin system could disturb the autoregulation, decrease efferent arteriolar resistance and lead to a critical decrease in glomerular filtration. Renal function tests were repeated in a patient with hypertension due to 90 p. 100 renal artery stenosis with a single kidney, before and after captopril administration (sodium intake 100 mmol/24 h). (table; see text) Identical results have also been observed in a patient with bilateral renal artery stenosis. Both patients presented high risk renal haemodynamic states. The control of systemic blood pressure and the fall in filtration fraction were not associated with a critical, immediate or short term fall in glomerular filtration. The isolated administration of captopril is therefore not systematically contra-indicated in these two clinical situations.

Acute Kidney Injury↗
PubMed1983

Immunofluorescence study of "non-idiopathic" renal amyloidosis.

The authors report the results of immunofluorescence (IF) studies of 17 cases of "non-idiopathic" renal biopsy-proven amyloidosis and 18 cases of various nephropathies and normal kidneys (as controls), investigated by IF by simultaneous use of antisera against routine IgG, IgM, IgA, C3, C4, Clq, beta-lipoprotein, albumin, and fibrinogen. Antisera against kappa and lambda light chains and amyloid A and amyloid P components were also used. Six of the 17 cases of amyloidosis were associated with immunocyte dyscrasia, and 11 were cases of reactive systemic amyloidosis associated with chronic infections or inflammatory and neoplastic disorders. In amyloidosis, IF deposits appeared for all antisera as homogeneous staining of mesangial nodules, and, more rarely, there was staining along the glomerular basement membranes. Overall immunoglobulins and C3 were present in 11 cases (64 per cent). Kappa and lambda light chains were demonstrated in 14 (82 per cent) and 12 (70 per cent) cases, respectively. In immunocyte dyscrasia associated with amyloidosis, immunoglobulin and light-chain deposits corresponding to a paraprotein abnormality were demonstrated in glomeruli and in tubular casts. Amyloid P component was always present in glomeruli with a bright and characteristic fluorescence, and it was frequently observed in arterioles. Amyloid A component was observed in six cases of reactive systemic amyloidosis but also in one case of immunocyte dyscrasia with amyloidosis. In view of the diversity of amyloid fibril types and their chemical nature, IF studies confirm the presence of different constituents but do not warrant any conclusion concerning the pathogenesis of this disease.

Adult↗
PubMed1983

Bilateral urinary kallikrein excretion in the Goldblatt hypertensive rat.

Separate kallikrein excretions [RIA of generated Bradykinins (BK)] and renal functions were measured in 32 two-kidney, one-clip Goldblatt hypertensive (GH) and in 16 sham-operated (SO) rats either one, two, three or four weeks after operation. Mean blood pressure and plasma renin activity were higher in GH rats than in the respective controls. In GH rats, kallikrein excretion was lower from the clipped kidney than from the controlateral one (114 +/- 63 vs 220 +/- 87 ng BK min-1 per 30 min urine collection at week 1, P less than 0.05; 151 +/- 94 vs 425 +/- 125 ng BK min-1 per 30 min urine volume at week 4, P less than 0.01). While the excretion was normal from the controlateral kidney, GH rats had lower total kallikrein excretions than SO rats (335 +/- 138 vs 476 +/- 81 ng BK min-1 per 30 min urine volume at week 1, P less than 0.05; 556 +/- 179 vs 1078 +/- 191 ng BK min-1 per 30 min urine volume at week 4, P less than 0.01). Urinary kallikrein excretion is decreased in 2K-1C Goldblatt hypertension from one week to four weeks after clipping on account of an exclusive reduction in that from the stenotic kidney.

Animals↗
PubMed1983

[Side effects induced by captopril. Comparison of a series of hypertensive patients with renal failure and a series with cardiac failure].

The first oral converting enzyme inhibitor, Captopril, has been used to treat hypertension and cardiac failure since 1978. Based on this two year experience, we studied the side-effects of this drug in 64 patients, a privileged series as it included 32 hypertensive patients with chronic renal failure and 32 patients with cardiac failure and normal renal function. After 16 months of treatment, we observed 19 p. 100 of skin complaints, 17 p. 100 disturbance of taste, 6 p. 100 oral problems, and one case of orthostatic hypotension. From the biological point of view: 20 p. 100 eosinophilia, 10 p. 100 hyperkalemia, 5 p. 100 antinuclear antibodies, 2 p. 100 renal failure, and one case of agranulocytosis. The group with renal failure had many more side effects due to a relative dosage (corrected for weight and renal function) which was three times as great. It would therefore appear to be essential to adapt the dosage in each individual case, a task which we have attempted using a formula which considerably reduced the incidence of side effects in our series: (formula; see text)

Captopril↗
PubMed1982

Immunofluorescence study of amyloid P-component patterns in human nephropathies.

The localization of amyloid P-component (AP) staining was studied by immunofluorescence in renal biopsies from 106 patients with various nephropathies and from 3 patients with normal kidneys. Linear staining was observed along the glomerular basement membranes (GBM) of normal kidneys. In amyloidosis, AP was always present in the glomeruli. In arteriolar walls, AP was present in numerous cases with varied intensity. No fixation was observed along tubular basement membranes. The possible modification of the permeability of GBM, related to a possible modification of the electrical charge of the filtration barrier, can be supposed.

Amyloid↗
PubMed1982

[Long-term treatment with captopril in arterial hypertension complicated by renal failure].

Twenty patients with severe hypertension and chronic renal failure were given Captopril during a one year period. Hypertension was always severe: BP: 193 +/- 11.8 mmHg/120.2 +/- 6.7 mm Hg. Mean glomerular filtration rate (GRF) was 42 +/- 10 ml/mn and renal plasma flow (RPF) was 160 +/- 35 ml/min. Mean plasma renin activity was 1.5 +/- 1.1 ng/ml/h and plasma aldosterone 15.9 +/- 1.9 ng/100 ml. Captopril was given in daily doses from 75 to 300 mg. Furosemide was added in 13 cases, and bêta inhibitions in 10 cases. Blood pressure and renal function were measured eight days, every month end after one year of treatment: the fall in diastolic blood pressure was 13 p. 100 after eight days, 23 p. 100 after one year; a period of at least 6 months was necessary to obtain normal blood pressure values; and after one year blood pressure was normalized (diastolic BP less than 90 mmHg) in 19 patients. Renal function was compared with pretreatment values, after 8 days and one year: --RPF was increased (+18 p. 100 and +10.3 p. 100); --GFR was unchanged (+3,8 p. 100 and -8.8 p. 100); --filtration fraction was significantly decreased: (-12.3 p. 100 and -18.3 p. 100); --sodium excretion rate (+16 p. 100 and +9.9 p. 100) and kaliemia increased (+10 p. 100 and +8 p. 100) but severe hyperkalemia never occurred; --PRA increased (+270 p. 100 and +400 p. 100); --Plasma aldosterone was decreased after eight days --28.9 p. 100 but identical to control after one year -4.4 p. 100. Diuretics were efficient to enhance the antipressor of Captopril, whereas bêta inhibitions appeared less useful, and may be indicated only when tachycardia occurs. These results show that long term use of Captopril alone or associated with Furosemide, can normalise blood pressure in patients with renal insufficiency, without any impairment in GFR, and with an increase in RBF.

Adrenergic beta-Antagonists↗