Biomedical subjects
Publications and source records attributed to K T Woo.
A patient with lymphatic filariasis, developing the nephrotic syndrome is reported. Renal biopsy showed a diffuse mesangial proliferative glomerulonephritis with C3 deposition in the glomeruli. Glomerulonephritis associated with filariasis has been reported previously, however definite identification of filarial antigen in glomerular deposits or of specific antibodies in kidney eluates is still awaiting.
The glomerular lesions of 90 patients with asymptomatic glomerulonephritis and proteinuria of more than 1.0 gm per day were compared with 8.3 similar patients with less than 1.0 gm proteinuria. 68% of those patients with more than Igm proteinuria had glomerular sclerosis compared to 19% of those with less than Igm proteinuria (p less than 0.001). Immunofluorescence studies revealed that 77% of patients studied had IgA deposits in the mesangial region. There was no correlation between the degree of microscopic haematuria and the severity of glomerular lesions. Patients with more than 1 gm proteinuria also had significantly higher incidence of granular casts (p less than 0.001) and the presence of casts was also significantly associated with the finding of glomerular sclerosis (p 0.005). The data suggest that 1 gm proteinuria is a useful predictive index of glomerular sclerosis in patients with asymptomatic urinary abnormalities.
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Paraquat poisoning has become a significant clinical problem since the early 1960s. Its high mortality has posed a major challenge to clinicians treating these patients. Two patients who survived and one who did not are reported. The management of these patients and the possible factors affecting their outcome are discussed.
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An open study was undertaken in 31 patients with moderate to severe hypertension to compare labetalol (a competitive antagonist of both alpha-adrenoreceptors and beta-adrenoreceptors) alone and in combination with a thiazide diuretic, with a combination of thiazide, beta-adrenergic blocking agent and the alpha-adrenoreceptor blocker prazosin. After introduction of labetalol, six patients withdrew because of intolerable side effects. All 25 remaining patients were controlled on diuretic and labetalol. On labetalol alone, 14 patients were controlled, two withdrew because of side effects and nine had inadequate blood pressure control. Labetalol is an effective antihypertensive agent, but side effects are common and it has few advantages over drugs presently available.
Circulating platelet aggregate ratios (CPAR) and plasma beta-thromboglobulin (B-TG) concentrations were determined in 53 patients with chronic progressive glomerulonephritis [mesangiocapillary glomerulonephritis (15) and focal and segmental hyalinosis and sclerosis (38)] and compared with those from both normal subjects and patients with no evidence of renal disease. The mean B-TG concentration was higher in patient controls [32.6 +/- 6.2 ng/ml (SEM)] than in normal subjects [19.0 +/- 2.0 ng/ml (SEM)] but this did not reach significance (P < 0.10 > 0.05). Nephritic patients had markedly elevated levels [49.8 +/- 4.0 ng/ml (SEM)], but B-TG was significantly correlated with renal impairment. Elevated B-TG levels in patients with nephritis may thus reflect renal impairment or ill-health. The mean CPAR of the nephritic patients [0.75 +/- 0.02 (SEM)] was lower than that of both normal [0.86 +/- 0.03 (SEM), P < 0.001] and patient controls [0.87 +/- 0.02 (SEM), P < 0.001]. CPAR was not correlated with renal function or platelet concentration. Low CPAR in nephritic subjects provides further evidence for in-vivo activation of platelets in patients with glomerulonephritis.
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Renal artery stenosis occurred in 13.5% of 229 consecutive cadaver renal transplants performed at the Royal Melbourne Hospital over an eight and a half year period. Clinical and laboratory indices which suggested the diagnosis were examined. The presence and severity of hypertension were of little predictive value, while deterioration of renal function for which other causes had been excluded and the histological appearance of renal biopsy speciments were valuable in suggesting the diagnosis. A selective approach in both investigation and attempted surgical repair is recommended.
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HLA locus A and B typing was performed on 86 Chinese thyrotoxicosis (Graves' Disease) patients and 238 normal Chinese subjects. The frequency of HLA-Bw46 (Sin 2) was found to be significantly higher among the patients than controls (x2 = 26.15, corrected P less than .003, relative risk = 3.74). The risk associated with Bw46 was reflected in the Bw46 heterozygotes. The relative risks of the joint occurrence of Bw46/B40 and Bw46/B13 were 8.74 and 5.88 respectively.
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