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Biomedical subjects

J Nemeth

Publications and source records attributed to J Nemeth.

At least 73 records · Page 4Linked to original sources
PubMed1988

Massive plasma cell infiltration of the digestive tract. Secretory component as the rate-limiting factor of immunoglobulin secretion in external fluids.

A 29-yr-old Tunisian man had a clinical immunoproliferative small intestinal disease, different from alpha-chain disease. Serum contained 52.5 mg/ml of polymeric immunoglobulin A (IgA). Immunohistochemistry revealed a massive diffuse polyclonal IgA (99%)-plasma cell infiltration in the small bowel mucosa, with a smaller increase of IgA-producing cells in gastric and colonic mucosae. Secretory IgA levels were normal in jejunal and bronchoalveolar secretions. However, both fluids contained polymeric IgA devoid of secretory component, and free secretory component was absent. This suggests that secretory component was the limiting factor in transport of IgA in the secretions. A relative deficiency in secretory component, as compared with the huge supply of polymeric IgA, may have limited the secretory component-mediated active transport of IgA into secretions. This resulted in the appearance of high levels of polymeric IgA, unlinked to secretory component, both in serum and in the jejunal and bronchoalveolar fluids.

Adult↗
PubMed1987

Neuron-specific enolase and malignant lymphomas (23 cases).

The immunoreactivity of polyclonal antiserum to neuron-specific enolase (NSE) has been investigated. Twenty-three cases of malignant lymphoma (ML) were studied and compared with previously published reports. In our study 11 out of 23 cases showed strong or weak NSE positivity; any type of ML could be positive or negative even among B or T cell ML. This study indicated that polyclonal NSE is not a specific marker; it might be an inconstant marker of ML with no apparent correlation between reactivity and morphology or phenotype.

Antibodies, Monoclonal↗
PubMed1985

[Acute interstitial nephritis and uveitis: a recently recognized syndrome].

The case is described of a 14-year-old boy who presented with a 6-week history of fatigue, severe weight loss (15 kg) and glycosuria. On admission he was in non-oliguric renal failure (serum creatinine 1360 mumol/l) with moderate proteinuria (1.3 g per 24 h), glycosuria (9.5 g per 24 h) and generalized aminoaciduria. Renal biopsy showed acute interstitial nephritis (AIN) with severe mononuclear cell infiltration. No etiology was found. The patient required hemodialysis (5 times) and responded dramatically to therapy with prednisone (initially 75 mg per day), which was discontinued after 2 months. He presented again 11 weeks after admission with iridocyclitis of the right eye, and 2 months later with the same condition in the left eye. Response to local application of steroids was slow. The association of AIN with uveitis has so far been reported in 12 other pediatric patients aged 10 to 16 years, and in one adult patient; 64% were female. Uveitis often recurred, in contrast to nephritis. The etiology of the syndrome is unknown, a transient defect in cell-mediated immunity being postulated.

Acute Disease↗
PubMed1984

Serotonin-secreting and insulin-secreting ileal carcinoid tumor and the use of in vitro culture of tumoral cells.

The authors report the case of a patient with a typical carcinoid syndrome and a severe hypoglycemia due to hyperinsulinism. He was found to have an ileal carcinoid tumor with hepatic metastasis and no evidence of pancreatic insulinoma at surgery and autopsy. By assaying serotonin and insulin in the tumor and in the supernatants of the culture derived from hepatic metastasis, the authors have been able to show that both hormones were produced by the carcinoid tissue. Cultured cells also synthesized minute amounts of gastrin and thyrocalcitonin.

Blood Glucose↗
PubMed1984

[Hyperparathyroidism secondary to renal insufficiency: anatomo-clinical relations and the potential role of an aluminum overload].

Severe secondary hyperparathyroidism is still observed at present in 5-10% of haemodialysis patients. It requires surgical correction. Fifty-eight haemodialysis patients had neck surgery and their 222 parathyroid glands analysed. The individual gland weight was comprised between 22 and 3880 mg (mean +/- SEM, 689 +/- 62 mg). Mean total parathyroid gland weight per patient was comprised between 2 and 3 g. Schematically, 4 types of gland architecture could be distinguished: diffuse hyperplasia alone; diffuse hyperplasia associated with incipient nodule formation; hyperplasia with pronounced nodule formation; and nodule formations alone. Total gland weight was significantly higher for the latter two histological forms than for the former suggesting transformation with time of pure hyperplasia to nodular hyperplasia. Patients with chronic pyelonephritis had a mean gland weight higher than that of patients with chronic glomerulonephritis (3308 +/- 498 mg versus 1824 +/- 358 mg, p less than 0.01). No relation was found between total gland weight and plasma calcium, phosphate or alkaline phosphatases. However, a weak relation existed between total gland weight and plasma immunoreactive parathyroid hormone. In addition, a negative relation was observed between highest prior plasma aluminium and gland weight when considering only patients with a gland weight less than 2000 mg. Parathyroid gland aluminium content was significantly higher in haemodialysis patients than in nonuraemic patients with primary hyperparathyroidism. A direct relation was found between parathyroid gland and bone aluminium. In conclusion, in haemodialysis patients with evolving hyperparathyroidism initially diffuse gland hyperplasia appears to be associated progressively with nodule formation. Circulating immunoreactive parathyroid hormone is positively related to total gland weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Secondary hyperparathyroidism in chronic haemodialysis patients: a clinico-pathological study.

Fifty-eight patients on intermittent haemodialysis underwent parathyroidectomy because of severe secondary hyperparathyroidism. Mean individual parathyroid gland weight was 689 +/- 62 (SEM) mg. Mean total gland weight per patient was between two and three grams. Increasing nodule formation within hyperplastic glands appeared to develop with increasing time of duration of hyperparathyroidism. Patients with chronic pyelonephritis had a higher gland weight than those with chronic glomerulonephritis. A direct relationship was found between gland weight and circulating immunoreactive parathyroid hormone, but an inverse relationship between gland weight and plasma aluminium concentration. The higher the parathyroid gland aluminium, the higher was the bone aluminium concentration.

Adolescent↗
PubMedDate not supplied

Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases.

We described the sonographic, computed tomographic (CT), and magnetic resonance (MR) imaging features of one atypical case of nodular regenerative hyperplasia of the liver. The presence of multiple hepatic nodules suggested the diagnosis of metastatic disease to the liver because of a peripheral rim of enhancement on CT obtained after intravenous administration of contrast material and a halo sign on T2-weighted spin-echo MR imaging. Examination of the pathologic specimen obtained after surgical biopsy showed that the nodules were made of hepatocytes, with a nodular arrangement surrounded by peliosis, without fibrosis or cirrhosis. These findings suggested that peliosis may cause peripheral rim of enhancement on CT and halo sign on MR imaging. In light of this case, nodular regenerative hyperplasia of the liver should be considered in the differential diagnosis of hepatic metastases.

Adult↗
PubMedDate not supplied

[5 years of continuous ambulatory peritoneal dialysis in the child].

Ten patients aged 5-14 years and 1 adolescent were treated by CAPD during 12 patient years. Overall survival and rehabilitation were good despite relatively high serum concentrations of urea (19 mmol/l) and creatinine (735 mumol/l). Dietary restrictions were only occasionally necessary, 6 patients required phosphate binders. No radiological bone changes developed in 4 patients with initially normal x-rays, but lesions progressed in 3 with pre-existing osteodystrophy despite administration of 1.25 (OH) 2D3 and Al-hydroxide. Statural growth was unsatisfactory: Height decreased in the 7 patients observed over 1 year from -2.4 to -2.7 SDS. Peritoneal diffusion curves varied considerably between patients, yet remained unchanged at repeat examination. Parents fatigue developed in 6 families and was partly responsible for peritonitis. The incidence of peritonitis fell from 1 episode in 3.3 months to 1 in 8 months. Intensive family support by regular telephone contact and home visits appeared as the most important measure in prevention of parents fatigue and hence of peritonitis. We consider CAPD as a valuable alternative method to haemodialysis.

Adolescent↗
PubMedDate not supplied

A new etiology of acute abdominal emergencies in cirrhotic patient: secondary pneumococcal peritonitis with jejunitis.

We report the first case of secondary pneumococcal peritonitis associated with acute jejunitis in a 52-year-old homeless Child-Pugh C cirrhotic man without ascitis. The patient was admitted with clinical signs of peritonitis, and jaundice. Morphologic examination was unremarkable. A laparotomy revealed a diffuse peritonitis, and an acute jejunitis with prenecrotic lesion. The lesion was located within the first centimeters of the jejunum, immediately after the duodeno-jejunal angle, extented on 15 cm. A resection of the first 15 cm of the jejunum was performed with duodeno-jejunal side-to-side manual anastomosis. Gram-stain and cultures of blood, peritoneal pus, and jejunal mucosa revealed a penicillin-sensitive Streptococcus pneumoniae. Appropriate parenteral antibiotic treatment was initiated (aminopenicillin). The postoperative course was marked by a transient hepatic failure associated with an ascitis controlled by diuretics. The patient was discharged on the 26th day after surgery. This case reports a new etiology of acute abdominal emergencies in cirrhotic patients.

Abdomen, Acute↗