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Biomedical subjects

J Traeger

Publications and source records attributed to J Traeger.

At least 181 records · Page 10Linked to original sources

[Association of nephrotic syndrome and Hodgkin's disease. Role of the Epstein-Barr virus].

The clinical association between glomerulonephrtis (GN) and malignant hematological disease is very rare. We report, in a 24 years old male, the occurrence of an apparently idiopathic nephrotic syndrome with minimal change glomerular lesions. This GN was in fact closely related to the progression of a stage 2A of Hodgkin's disease, following an infectious mononucleosis contracted one year ago. The nephrotic syndrome responded well to the therapy by Prednisone and Chlorambucil, and the complete remission persisted after eradication of Hodgkin's disease and despite early treatment discontinuation. Renal vein thrombosis, renal amyloidosis and renal interstitial infiltration with malignant cells were ruled out. Immunofluorescent and electron microscopy examination of the renal biopsies were consistent with, but not demonstrative of, an immune complex nephritis. Because of the chronological succession of infectious mononucleosis, Hodgkin's disease, and GN, we are stressing the possible oncogenic and immunogenic role of the Epstein-Barr virus.

Adult↗

Thrombocytopenia, macrothrombocytopathia, nephritis and deafness.

The association of thrombocytopenia, macrothrombocytopathia, nephritis and deafness is rare. Reported here is a new case of this triple association. The clinical course, the nephropathologic findings and the bilateral neurologic hearing loss were similar to those already reported, with a slowly progressive impairment of renal function accompanied by a persistent proteinuria. The platelet diameters were increased. These macroplatelets contained granules of normal structure but with an irregular distribution in the cytoplasm. In other areas the cytoplasm was rich in surface connected system. The survival of these platelets and their contraction were normal. Their aggregation and excretion in response to collagen, adenosine diphosphate and thrombin, and the values of platelet factor 3 activity were all decreased. The degranulation defect, also present, was observed in the absence of a decrease in intracellular cyclic adenosine 5'-monophosphate (AMP) suggesting a relationship between these two findings.

Adenosine Diphosphate↗

Evolution of secondary hyperparathyroidism after renal transplantation.

Parathormone levels were determined in 17 patients with functioning renal transplants. In 8 patients recently transplanted, very high serum levels of parathormone were found without obvious relation to the glomerular filtration rate. Hypophosphatemia was also present in these cases. In 9 other patients studied 2-7 years after transplantation the mean level of parathormone was lower than in the previous group but levels above normal were noted in half of the patients, some of which had perfect renal function and normal serum phosphorus. The response to induced hypercalcemia was used as a sensitive test to reveal abnormal responses even in cases which initially had normal peripheral levels of parathormone. From these results, tertiary hyperparathyroidism would appear to be rare although hyperfunctioning parathyroid glands can be demonstrated long after kidney transplantation, even when renal function is close to normal.

Creatinine↗

Antilymphocyte antibodies:an approach to dissecting the heterogeneity of the immune system.

Antilymphocyte antibodies can be used to dissect the lymphocyte populations and subpopulations. In the mouse, at least seven gene loci govern the expression of allo-, hetero-and autoantigens at the surface of T-lymphocytes. The antisera, especially the alloantisera, permit definition of the differentiative state of cells and discriminate between subsets of T-cells with different functions. Less is known about human T-lymphocyte differentiation antigens and their genetic determinism. However, heterologous antisera specific for human T-cells have been prepared and their use has been of help in studying this cell population. The antigens recognized by such antisera are present at a higher concentration on thymocytes than on peripheral blood T-lymphocytes. They appear at the surface of bone marrow T-cell precursors after a short incubation with thymic factors. Such markers of T-lymphocytes in various stages of differentiation and the study of in vitro differentiation from precursor cells have already proven to be valuable tools for clinical investigation, especially in the realm of immunodeficiency diseases.

Animals↗

[Usefulness of renal scinitigraphic scanning in the prognosis of acute renal failure (author's transl)].

The authors present their first results concerning the use of renal scintigraphic scanning using hippuran in acute renal failure (A.R.F.). The tubular stages of hippuran, extraction and secretion then excretion correspond to phenomena which are normally apparent within the first 10 minutes following the injection of hippuran, also it seemed interesting to study the changes which occur in A.R.F. 18 hospital in-patients with A.R.F. were studied, 10 of them suffering from tubulointerstitial nephropathy (T.I.N.) 4 with acute glomerulonephritis (A.G.N.), 2 with obstruction of the urinary pathways and 2 with tubular necrosis on underlying chronic renal failure. In the 10 cases of T.I.N. the phenomenon of extraction was evident without any sign of secretion appearing during the 24 minutes of the investigation. No relationship could be found between the scintigram and the rapidity of recovery from A.R.F., but 8/10 recovered satisfactory renal function, the two others died from their disease, the A.R.F. being only secondary. Two of the 4 cases of A.G.N. had normal or slightly lowered extraction and minimal or absent secretion, and they recovered, in the 2 others no image of extraction appeared within 24 mn. and in these 2 cases the course was unfavorable. Finally, the last four had evident extraction and for 3 of them the course was favorable, the death of the fourth being consecutive to the primary disease. It therefore seems that the presence of an extraction phenomenon, whatever the aetiology of the A.R.F., is a parameter which authorizes the prognosis of a favorable course whereas its absence during the 24 mn. of the investigation permits one to envisage an unfavorable course.

Acute Kidney Injury↗

Acute renal effects of new beta-adrenergic receptor site blocking agents on renal function.

The effects of two new beta blockers on renal function have been studied. There were significant decreases in urine flow, urea clearance, sodium and chloride excretion rates after acute administration. Fractional excretion of sodium (FeNa) fell significantly but did not continue to fall during chronic administration. Blood pressure and plasma renin activity decreased significantly after two months' therapy. These findings suggest that beta blockers in patients with unstable cardiovascular function increase the need for concomitant diuretic therapy.

Acebutolol↗

Apparent total alpha1-antitrypsin deficiency: report of a case.

A 29-year-old female, with chronic renal failure and chronic bilateral emphysema, was admitted with severe uremia and septicemia secondary to multiple abscesses in the right kidney. Her condition improved after right nephrectomy. Pulmonary function studies showed marked obstructive and restrictive lung disease consistent witht the diagnosis of primary emphysema. On biochemical and histological examination, the liver was found to be normal. Alpha1-antitrypsin could not be demonstrated in the patient's serum at normal pH by any of the known techniques, but protein molecules with alpha1-antitrypsin antigencity were found at pH 4.8; this suggests a pH-dependent structural difference in alpha1-antitrypsin protein. Starch gel electrophoresis gave a multibanding pattern not previously described. A new form of apparent total alpha-1-antitrypsin deficiency is postulated.

Abscess↗

[Changes in renal function in the hours following an intravenous injection of acebutolol].

A study was carried out, of the changes of renal functional value and of urinary electrolytes excretion after rapid intravenous injection of acebutolol in twelve subjects with various glomerular filtration. Renal functional value was estimated by measuring inuline. P.A.H., urea and creatinin clearances during a control period of thirty minutes and during the four hours following administration of acebutolol. The variations in the excretion of electrolytes: chloride, sodium, potassium, calcium and phosphorus were measured during the same periods. The following results were obtained: in subjects with normal renal functional value, administration of acetubolol brings about: a variation which is under 20 p.cent of glomerular filtration and P.A.H. clearance; a 50 p.cent average decrease of natriuresis. in cases of renal insufficiency: clearances of inuline and P.A.H. are unchanged. There is a 20 p.cent average decrease of natriuresis. There is a decrease of urinary output (35-45 p.cent) and of urea clearance (20-50 p.cent).

Acebutolol↗

Renal hemodynamic response to l-dopa during acute renal failure in man.

Twelve patients with acute renal failure underwent L.dopa infusion into a renal artery and 133Xenon wash-out recordings before and during the infusion. Urine volume and sodium output were also compared during two 24 hours periods, before and after the procedure. Hemodynamic data were compared with data obtained from a matched group of patients receiving Furosemide (8 patients) in place of L.dopa. Only L.dopa infusion significantly increased outer cortical distribution (p less than 0.005 using paired t-test). No blood flow change could be demonstrated in any component nor did the drug improve urinary excretion or the general course of the disease. Control data shows that reduced cortical distribution is the most consistent feature of acute renal failure, so that L.dopa does partially improve intrarenal hemodynamics in this condition. The failure of the drug to restore kidney function may be explained by the following reasons: a) Inability of the agent to restore a normal wash-out pattern; b) Involvement of non-hemodynamic factors, as suggested by comparing similar wash-out improvements after L.dopa in acute glomerulonephritis and in reversible acute renal failure.

Acute Kidney Injury↗

Inhibitory effect of medium sized molecules from patients with renal failure on lymphocyte stimulation by phytohemagglutinin.

Middle molecular weight molecules were separated from uremic sera by chromatography on Sephadex G25 fine and assayed on lymphocyte cultures stimulated by phytohemagglutinin. They were found to inhibit markedly the cell proliferation by this mitogen, and this inhibition was still noticeable when cells were incubated for only one hour with eluate, before the culture. These molecules, as well as methylguanidine, might play a part in the cell-mediated immunodeficiency secondary to renal failure.

Cells, Cultured↗

[Renal venous thrombosis in the adult].

Eleven cases of renal vein thrombosis (RVT) are reported, 9 of which presented with nephrotic syndrome (NS) and 2 with acute renal failure (ARF). Hematuria, enlarged kidneys, assymetric peripheral edema and collateral vein dilatations were the classic symptoms. Phlebography was employed in 101 suspected cases and permitted definitive diagnosis in 11 percent. Phlebography was performed in 13 percent of the NS cases and 11 percent of the ARF cases, but in none of the other cases. Fifteen kidney biopsies (KB) were performed in 8 patients, 6 with NS and 2 with ARF. In the 6 cases of NS, 4 presented a pattern of membranous glomerulonephritis and 2 had mild thickening of the basement membrane. This was confirmed by electromicroscopy in 5. In the 2 with ARF capillary dilatations, polynuclear infiltrates and interstitial edema was found. Repetitive KB, performed in 3 cases, revealed the same histological pattern in 2, while in the other case granular membranous deposits were found on the second biopsy that were not apparent in the first. This last patient was free from clinical manifestations at the time of this last biopsy. Immunofluorescent studies (iF) were performed on 7 KB of 5 patients, 4 with NS and 1 with ARF. Three of the 4 with NS presented a pattern of membranous deposits. On i.F one patient was found to have IgG and C3 deposits, one IgG and fibrinogen and one no detectable IgG, IgA, IgM, IgE, C3 or fibrinogen. The fourth with minimal histological changes was also negative for i.F, as was the case of ARF. Sequential treatment by heparin and antivitamin K was administered in 8 patients. Recovery occurred in 3 and stabilization in 4, while in 1 case this treatment was without effect.

Acute Kidney Injury↗