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J Nagy

Publications and source records attributed to J Nagy.

At least 19 recordsLinked to original sources

[The thinning of the glomerular basal membrane in IgA glomerulonephritis].

Ultrastructural changes of the glomerular basement membrane (GBM) in 34 patients with IgA nephritis and their possible correlation with the main clinical symptoms were examined. In 23 patients thinner than normal GBM segments were found with a mean thickness of 116-120 nm (measured by the method of Osawa). Often foot process fusion but neither disruption nor deposition of immune complexes was seen in the affected capillaries. All patients had hematuria, while those with thin GBM segments had more severe hematuria and more episodes of macrohematuria. Other clinical features were unrelated to ultrastructural changes. It is suggested that the thin GBM may be a predisposing factor to hematuria.

Adult

[Surgical cerclage in the treatment of cervical incompetence during pregnancy (determining the legitimacy of the procedure)].

The authors studied the effectiveness of the cervical cerclage operation in the therapy of cervical insufficiency during the pregnancy. Two Hundred sixteen pregnant women took part in this trial in whose pregnancy the necessity of cerclage operation was not unequivocal. It means, that the therapeutical cerclage operation was not necessary, but the necessity of prophylactic cerclage operation was doubtful as well. From the randomized 216 cases they performed cerclage operation in 108 pregnancies and in 108 cases they did not perform it. In the respect of pregnancy care they did not make any difference between the two groups. The authors from their trial draw the conclusion, that in doubtful cases where the necessity of cervical cerclage operation is not unequivocal--e.g. at serious gestational case history--it is advisable to perform the operation. The danger of premature birth can be diminished in this way.

Female

[Long-term phenytoin (Diphedan) therapy leading to IgA nephropathy].

A single case of IgA nephropathy with a concomitant tubulointerstitial nephritis, developing during a long-term phenytoin therapy is reported. The prolonged phenytoin therapy did neither prevent the transitional increases of serum IgA level nor ward off deterioration of the histological alterations. This case suggests that acute tubulointerstitial nephritis may have played a role in the mesangial trapping of IgA immunocomplexes.

Adult

[Questions concerning transhepatic gallbladder puncture].

Development and spread of several diagnostic and therapeutic procedures focuses the radiologists' attention on the percutaneous gall-bladder puncture. Percutaneous rapid gall-stone dissolution is one of these important questions. Authors studied the anatomical situation of the liver and gall-bladder regarding the possibilities of the percutaneous gall-bladder puncture. Authors have concluded that the transhepatic approach is possible in every case. The extra-peritoneal approach cannot be avoided. On the basis of the results lateral direction of puncture on the so-called one-stick-introduces system is recommended by the authors.

Cholangiography

Light chain deposition nephropathy in necropsy material.

The clinical and necropsy findings on 7 patients with monoclonal immunoglobulin light chain deposition nephropathy are described (4 cases with a myelomatous and 3 with a non-myelomatous background). All patients had moderate proteinuria and progressive azotemia. Three myelomatous and all three non-myelomatous patients died from uremia after a mean time of 12 and 23 months, respectively, from the first presentation. Immunohistochemically, 6 patients had kappa, and one had lambda light chain deposition. Light microscopically, interstitial fibrosis, tubular atrophy and arteriolar hyalinosis were present in all cases. The glomeruli showed no changes (1 case), or displayed patterns of mesangial widening: mild (1 case), nodular (mesangial nodules, 4 cases) or global lobular expansion (1 case). Mesangial nodules were observed either with or without lamellation. Around the nodules, microaneurysms were seen in 2 cases. Mesangial nodular expansion was accompanied by crescents in 56% of the glomeruli in a male patient suffering from kappa light chain deposition nephropathy without myeloma. The present findings and a review of the literature indicate the following mesangial changes in light chain deposition nephropathy: 1. no changes, 2. mild expansion, 3. nodular expansion with and without lamellation, and 4. lobular expansion. Subtypes 2, 3 and 4 may be present in parallel, may occur with or without cellular proliferation, and may be accompanied by crescents. The term nodular glomerulosclerosis to describe mesangial nodular expansion is not completely correct, and hence its use is not recommended.

Aged

IgA glomerulonephritis. Mesangial IgA deposition without systemic signs (Berger's disease).

Renal biopsy specimens from 204 patients with glomerulonephritis or nephrotic syndrome have been studied. In ten of the patients not suffering from acute poststreptococcal glomerulonephritis, systemic lupus erythematosus or Schönlein-Henoch syndrome, diffuse, selective mesangial IgA deposition was observed. Clinically, persistent microscopic haematuria, mild proteinuria and, except in one patient, normal renal function were found. Light microscopically the histological picture was dominated by a diffuse or focal increase in volume of the mesangial matrix, and mild mesangial cell proliferation. Exceptionally, there was also crescent formation. Immunofluorescence revealed large IgA, IgG and C3 deposits, as well as small IgM and fibrinogen deposits in the mesangial glomeruli. The authors' assumption that immunocomplexes containing a secretory component might be implicated in the pathomechanism of Berger's disease, could not be proved.

Adolescent

The role of hepatitis B surface antigen in the pathogenesis of glomerulopathies.

The frequency of hepatitis B surface antigen (HBsAg) has been studied in the sera and renal biopsies of 276 patients with various forms of glomerulonephritis (GN), the nephrotic syndrome and other nephropathies. Using a modified Hepanosticon method, HBs antigenemia was detected in 32 of 196 patients (16.3%) with immune complex (IC) GN and the nephrotic syndrome. Indirect immunofluorescence revealed HBsAg in 33 renal biopsy tissue specimens (16.8%). HBsAg was found in the sera of four of the 80 remaining patients with other renal diseases (5%), and in the renal biopsy tissues of another four (5%). Antibody against HBsAg could only be demonstrated in the serum of one glomerulonephritic patient. The sera of 18,799 normal blood donors were used as controls; of these 186 (0.99%) had positive tests for HBsAg. It is concluded that, in some patients with GN and the nephrotic syndrome, HBsAg-containing IC may be implicated in the development and/or progression of the disease.

Adolescent

Blood coagulation abnormalities in the Schönlein-Henoch syndrome in adults.

23 adult patients with Schönlein-Henoch's syndrome were observed between 1965 and 1976. Nephropathy was noted in 18, gastrointestinal bleedings in 13, thrombosis of legs in 4, cases. Haemostasis was studied in the successive phases of the process on 185 occasions altogether. The studies included four different capillary tests, thromboelastography, the Gerendás coagulogram, determination of partial thromboplastin time and two platelet-function tests. Additional renal biopsy was performed in 10 cases, mesocolon and skin biopsy in one case each. The results of at least one of the capillary tests were found positive in each of the patients in some stage of the process. The coagulation status was marked by hyperocagulability either in itself or combined with laboratory signs of hypocoagulability. Immunohistological study of the biopsy specimens revealed glomerular fibrin deposits in 7 cases. On the evidence of the follow-up studies the laboratory tests may be used for the assessment of the activity of the process. The alternatives of local intravascular coagulation (LIC) or of compensated diffuse intravascular coagulation (DIC) are offered for the interpretation of hypercoagulability.

Adolescent