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Biomedical subjects

J Winberg

Publications and source records attributed to J Winberg.

At least 91 records · Page 5Linked to original sources

Structure of carbohydrate part of receptor on human uroepithelial cells for pyelonephritogenic Escherichia coli.

The binding of pyelonephritogenic Escherichia coli strains to human uroepithelial cells from patients with and without P blood group antigens was investigated. Uroepithelial cells from p phenotypes bound pyelonephritogenic e. coli to a significantly lesser extent than did cells from P1 and P2 phenotypes. The binding of pyelonephritogenic E. coli to urinary epithelial cells of P1 phenotypes was blocked by the synthetic disaccharide alpha-D-Galp-(1 leads to 4)-beta-D-Galp whose structures is related to that of the P blood group antigens. Coating of P1 cells with a synthetic disaccharide derivative increased the binding of bacteria. None of 30 individuals of p phenotype had had urinary tract infection. The findings show that the disaccharide alpha-D-Galp-(1 leads to 4)-beta-D-Galp, previously shown to be the erythrocyte receptor for the fimbriae of pyelonephritongenic E. coli, is also the receptor structure on uroepithelial cells.

Adhesiveness↗

Compensatory kidney growth in children with urinary tract infection and unilateral renal scarring: an epidemiologic study.

Compensatory renal growth was estimated from repeated urograms over 8 to 15 years in 26 children with urinary tract infection and unilateral renal scarring. These children were derived from an unselected series of 596 patients followed from their first symptomatic urinary tract infection. Renal size was assessed from the renal area, length, and parenchymal thickness. The renal area proved to be a good measure of the compensatory growth of the unscarred kidney as well as of the loss of substance of the scarred kidney. In this series of children, who had been closely supervised from the time of their first infection, unilateral renal scarring was well compensated for by hypertrophy of the contralateral kidney. Thus, the total renal parenchymal area 8 to 15 years after the first investigation was 98 to 99% of the expected normal area. Interestingly, a conspicuous growth spurt was observed at puberty in some of the scarred kidneys, sometimes a decade after the original damage. Prognosis was not influenced by sex, age at onset, or complications such as vesicoureteric reflux and frequent febrile recurrences. Reflux with dilatation was compatible with compensatory renal growth. We conclude that acute febrile pyelonephritis in childhood carries a good prognosis with regard to preservation of renal parenchyma and level of GFR, if diagnosis and treatment are prompt and long-term supervision is provided.

Adolescent↗

Catecholamine and cortisol excretion patterns in three-year-old children and their parents.

Urinary catecholamine and cortisol excretion was studied in a group of three-year-olds, their mothers and fathers during night rest, one day at home and one day at hospital. The stay in the hospital, which was part of a longitudinal study of the families, induced a pronounced rise in adrenaline excretion and a moderate increase in noradrenaline excretion in relation to the at-home level. Although the catecholamine excretion in relation to body weight was much higher in the children, the magnitude of the increase at the hospital was about the same in all the family members. The adrenaline excretion was also affected by the diverse conditions at the hospital and showed, for example, a marked decrease during lunch hour. The cortisol excretion at the hospital tended to be elevated only in fathers. On the average, mothers excreted about the same amount of adrenaline as the fathers at the hospital, but significantly more noradrenaline. In earlier studies males have shown a greater adrenaline output than females during achievement-demanding situations. The findings of this study were interpreted within the context of the specific challenge that the situation represented to the mothers. The mothers also excreted more noradrenaline in the at-home condition. Catecholamine and cortisol excretion levels within family members tended to be positively correlated, but the correlations were generally low.

Adult↗

Early detection of nephropathy in childhood urinary tract infection.

Early detection and treatment of nephropathy in childhood urinary tract infection is important for the planning of treatment and supervision. In patients without abnormalities of calyces or defects of kidney outline standardized measurements of the thickness of the parenchyma at three sites on each kidney are more informative in establishing early affection of the kidney than other measurable parameters available. The majority of patients who will develop focal renal scarring can be identified early after their first symptomatic infection from measurement of the appropriate dimensions of the parenchyma.

Child↗

Identification of a carbohydrate receptor recognized by uropathogenic Escherichia coli.

Earlier investigations have shown that pyelonephritic Escherichia coli specifically recognize and bind to carbohydrate structures correlated to the P blood group antigens. These findings are confirmed and extended in this study. Twenty-two of 23 nonselected E. coli strains from children with acute febrile pyelonephritis failed to agglutinate human erythrocytes lacking the antigens within the P blood group system. Only one of 32 faecal isolates exhibited this specific agglutinating property. The new informatin in this paper is that P2k erythrocytes, containing only the Pk antigen, were agglutinated to the same extent by pyelonephritic E. coli strains, giving further support to the proposal that the Pk glycosphingolipid is related to the receptor for pyelonephritic E. coli. In addition, the importance of the oligosaccharide moiety of the Pk glycosphingolipid for the binding of E. coli was further investigated. The synthesized disaccharide alpha-D-Galp-(1-4)-beta-D-Galp-1-O-0-NO2 inhibited the agglutination of human erythrocytes caused by two pyelonephritic E. coli strains at concentrations of less than 1 mM. Hence, the minimal receptor structure recognized by these E. coli strains appears to be the alpha-D-Galp-(1-4)-beta-D-Galp structure. How generally valid this observation may be needs further investigation. The findings may open new possibilities for diagnosis and treatment of urinary tract infection.

Animals↗

Chronic renal failure in Swedish children.

In a retrospective study covering the years 1974 to 1977 the prevalence of non-terminal renal failure in Swedish children on to 15 years of age was registered as 4.50 per million total population. The mean yearly incidence of terminal renal failure during the same period was registered as 0.94 per million total population. Nephronophthisis was the most common single cause of renal failure. No case of coarse renal scarring due to recurrent urinary tract infections was reported. The Swedish study shows a good agreement with an earlier Swiss one concerning the diseases causing chronic renal failure in children. The frequency of chronic renal failure is expected to be essentially unchanged until breakthroughs occur in research on glomerulonephritis.

Adolescent↗

In vitro adhesion of uropathogenic Escherichia coli to human periurethral cells.

The in vitro adhesion of three uropathogenic strains of Escherichia coli to epithelial cells from the periurethral area (area surrounding the urethral orifice) of women with and without a history of recurrent urinary tract infections was investigated. All strains showed a specific mannose-resistant hemagglutination restricted to human erythrocytes. Since only a few hundred periurethral cells were used in each test, gentle methods were required. Optimal results were obtained with bacteria grown for 16 h at 37 degrees C in nutrient broth without shaking. The binding of bacteria seemed to be irreversible under the conditions studied, since repeated washings of the epithelial cells after incubation did not decrease the number of adhering bacteria. Chloramphenicol was used to control the number of added bacteria in the incubation system. A difference in the adhesive capacity of periurethral cells of infection-prone and healthy individuals was most evident at concentrations of 2.5 x 10(9) bacteria/ml. Electron microscope studies indicated that pili mediated the adhesion. Adhesion was correlated with the mannose-resistant hemagglutination of human erythrocytes, indicating that the pili were not type 1 pili. Day-to-day variations in the adhesiveness of the bacteria were reduced by selecting well-adhering bacteria with the aid of in vitro passage on periurethral cells or human erythrocytes, and by exclusion of bacteria with low hemagglutination ability.

Cell Survival↗

Urinary tract infections treated with single dose of short-acting sulphonamide.

In a prospective study 29 patients with urinary tract infections caused by sulphonamide-sensitive organisms were treated with a single oral dose of the short-acting sulphonamide sulphafurazole. Twenty-seven (93%) of the 29 patients--and possibly all 29--were cured of their infections. There was no difference in the recurrence rates after single-dose treatment and treatment for 10 days or more. Six out of eight strains of Escherichia coli causing early recurrences were sensitive to sulphonamides. These results suggest that uncomplicated infections may safely and successfully be treated by a single oral dose of a short-acting sulphonamide.

Administration, Oral↗

Dealing with suspicions of malformation frequency increase. Experience with the Swedish register of congenital malformations.

Strategies in dealing with data obtained from malformation monitoring based on experiences with the Swedish monitoring systems, operating since 1965 (Register of Congenital Malformations) and 1973 (Medical Birth Register) are discussed. The importance of checking data that have sounded an alarm is stressed. Experience has shown that false alarms due to artefacts, such as changed diagnostic routines, changed reporting or registration of malformations, or random fluctuations, comprise most suspected changes in incidence. If a true increase in malformation frequency or a local cluster is observed, a hint of possible aetiological factors can be obtained from studies of maternal age distribution, seasonal viriation, geographical distribution, etc. The last step of the analysis consists of a case-control or a cohort study, aimed at revealing a specific teratogen. The importance of locating limited research resources to well-defined problems using high quality data is stressed.

Abnormalities, Drug-Induced↗

Periurethral anaerobic microflora of healthy girls.

The periurethral anaerobic and aerobic microfloras were investigated in 18 healthy premenarcheal girls, 5 to 14 years of age, by using a quantitative sampling method. Colonization of the female periurethral area with enterobacteria seems to be an important step in the development of urinary tract infections, and the present study was undertaken as a stage in elucidating factors that might control the establishment of urinary tract pathogens periurethrally. The study showed that obligate anaerobic bacteria constituted 95.0% (standard error, +/- 5.8%) of the total colony-forming units per square centimeter of periurethral area. An average of 7.0 different anaerobic and 2.7 different aerobic strains per specimen was obtained. The flora was dominated by anaerobic gram-positive cocci and gram-positive rods, whereas anaerobic gram-negative rods comprised a minor part. The most commonly encountered anaerobic isolates were peptococci and peptostreptococci, propionibacteria, bifidobacteria, eubacteria, and bacteroides in decreasing order of frequency. The aerobic flora consisted most commonly of nonhemolytic streptococci and diphtheroids. The findings suggest that the periurethral microenvironment is a distinctive ecological niche, separate from the fecal and skin biotas, although it has some characteristics in common with the vaginal flora.

Aerobiosis↗