Acute renal failure due to bacterial pyelonephritis.
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Biomedical subjects
Publications and source records attributed to J R Shortland.
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A patient with essential mixed cryoglobulinemia was treated for deteriorating renal function with plasma exchange alone. This therapy was immediately followed by acute oliguric renal failure due to precipitation of the cryoglobulin within glomerular capillary loops, probably as a result of infusion of cold plasma. The composition of the intracapillary deposits reflected not only the variety of cryoglobulin but the rapidity of deposition. Renal function returned when plasma exchange was re-introduced, this time coupled with immunosuppressive chemotherapy. After resolution of the intraluminal caogula a membranoproliferative picture remained. Replacement fluids for plasma exchange in cryoglobulinemia should be warmed before infusion.
We describe a case of immune complex crescentic glomerulonephritis associated with invasive pulmonary Aspergillus fumigatus infection. Immunofluorescent and immunoperoxidase investigations showed the presence of Aspergillus fumigatus antigen in the glomerular immune complexes.
A case of antibiotic associated pseudomembranous colitis following total cystectomy is reported, in which there was involvement of the ileal conduit. The small bowel remaining in situ was uninvolved. Bacteriological studies revealed Clostridium difficile and the toxin in both colon and ileal conduit. Relevant publications concerning pathogenesis are discussed, in relation to the unusual site described in this case. Epidemiological evidence is reviewed which suggests that isolation of patients with pseudomembranous colitis is a logical course of action.
A 71-year-old woman with the blue rubber bleb naevus syndrome experienced 4 episodes of self-limiting unilateral exophthalmos. Is is suggested that a vascular malformation in the orbit is responsible for this phenomenon. A biopsy sample was taken of one of the cutaneous lesions and studied by light and transmission electron microscopy. The histological appearances are discussed in relation to possible mechanisms causing this periodic exophthalmos.
Hamster embryo cells transformed by Herpesvirus Type 2 (HSV-2) virus (two separate cell lines) and by HSV-1 virus (one cell line) were inoculated into hamsters. The morphological appearance of tumours was studied by both light and electron microscopy, and the results compared to similar studies of tumours induced by SV40 virus. The tumours were also tested for immunogenicity, and for susceptibility to contact suppression with BCG. The results indicated that the tumours induced by inoculation of HSV-transformed cells were distinct from those of other DNA viruses; that the two cell lines transformed by HSV-2 were very similar but distinct from the cell line transformed by HSV-1; that all 3 HSV tumour cell lines were weakly immunogenic, and 2 were susceptible to contact inhibition with BCG. The relevance of the morphological and immunogenic properties of the animal tumour is discussed with relation to the possible importance of the findings to human malignant disease.
In an attempt to investigate the origin of crystalloid inclusions present in bone-marrow macrophages of normal adult mice and in man, murine peritoneal macrophages (which normally do not contain inclusions of this nature) were studied by light and electron microscopy 24 h after 3 daily injections of various preparations of erythrocytes. The preparations included mouse erythrocytes with and without pretreatment with collagenase, human erythrocytes and human-erythrocyte ghosts. Crystalloid inclusions were only rarely seen in the peritoneal macrophages in these circumstances. The results offered little support for the idea that crystalloid inclusions are derived from the breakdown of erythrocytes.
Peritoneal macrophages were studied by light and electron microscopy in normal adult mice 24 h after 3 daily injections of preparations of leucocytes and platelets. Crystalloid inclusions, similar to those seen in bone marrow macrophages of normal adult mice and in man, were occasionally observed in peritoneal macrophages after administration buffy-coat white cells but not after platelets. They were much more frequently seen following the ingestion of eosinophil-rich granulocytes and were almost always associated with secondary lysosomes. Energy-dispersive analysis of X-ray provided further evidence that both crystalloid inclusions and lysosomes originated from the injected granulocytes. These observations suggest that crystalloid inclusions in marrow macrophages are derived from granulocyte breakdown and that in this respect eosinophil granulocytes are of prime importance.
The recognition of the non-respiratory functions of the lung has led to an increased interest in pulmonary metabolism. The practical methods used to study metabolism in other tissues have all been applied to the investigation of lung metabolism. Methods fall into two groups: those used in vivo and those used in vitro after disrupting the organ or isolating it from other tissues and perfusing its circulation. Some of the methods used in vitro disturb the tissue environment in such a way as to introduce experimental artifacts which make the interpretation of results difficult. There are advantages to the use of the isolated perfused organ technique which, although it has been established for many years, has recently been improved. This method lends itself particularly well to studies of the intermediary metabolism and uptake of drugs by lung tissue. These improvements are described and the application to pulmonary drug uptake is illustrated by reference to the drug mexiletine. The relative advantages of the various methods and their applications are discussed.
Inoculation of adult hamsters with greater than 1.5 X 10(2) Herpesvirus type 2 (HSV-2) transformed hamster embryo fibroblasts induced rapidly growing tumours at the site of inoculation, in more than 50 per cent of animals. The tumours were examined by light and electron microscopy, and were histologically anaplastic fibrosarcomas. Lung metastases were frequently found in tumour-bearing animals; these were usually only seen microscopically, and were cytologically similar to the primary tumours. The nature of tumour development showed similarities with naturally occurring tumours of man, and HSV-2 tumour is probably a better model of human cancer than other virus-induced tumours studied in the past.
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