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Biomedical subjects

N Edward

Publications and source records attributed to N Edward.

At least 55 records · Page 3Linked to original sources
PubMed1983

Diagnostic value of urinary N-acetyl-beta-D-glucosaminidase, its isoenzymes and the fractional excretion of sodium following renal transplantation.

Daily total urine N-acetyl-beta-D-glucosaminidase activity, isoenzyme profile and fractional excretion of sodium were measured in 13 consecutive renal transplant patients. Rejection episodes were clinically diagnosed in 12 patients, 11 of whom (92%) showed an increased enzymuria either before or during the onset of clinical signs. The ratio of the two major isoenzymes (A/B) fell during 10 episodes (83%) and in six of these (50%) increased levels of the minor isoenzyme forms were observed. Increased fractional excretion of sodium was associated with nine (75%) of the episodes. Increased fractional excretion of sodium with a raised total enzymuria accompanied by a reduced A/B ratio and an increased proportion of the minor isoenzyme forms occurred in eight (67%) of the rejection episodes. The use of these measurements in the diagnosis of episodes of acute rejection in renal transplantation is discussed.

Acetylglucosaminidase↗
PubMed1983

Hyperimmune immunoglobulin therapy for cytomegalovirus infections in renal transplant patients.

Eleven renal transplant patients with CMV infection have been treated by passive immunisation, one with high-titre anti-CMV plasma and 10 with fractionated hyperimmune anti-CMV immunoglobulin. All were pyrexial for at least seven days before treatment with typical clinical and laboratory features of CMV infection. Seven of the 11 patients treated showed a striking and sustained response within 24-48 hours of therapy, with lysis of fever, resolution of pneumonitis, a rise in white cell count and improvement in renal function and liver function tests.

Adolescent↗
PubMed1983

Pretransplant antibodies and renal allograft survival.

Fc receptor blocking antibodies directed against autologous lymphocytes were present in pretransplant sera from only one of a group of 24 cadaver donor renal transplant recipients. Such antibodies were present in recipient sera against B lymphocytes from the donor in 11/24, against normal B lymphocytes in 12/24 and against leukaemic B lymphocytes in 15/24 cases. There was a significant correlation between EA inhibiting antibodies directed against donor (p less than 0.01), normal (p less than 0.05) and leukaemic B lymphocytes (p less than 0.001) and improved one year allograft survival. No autolymphocytotoxic antibodies were detected. Fc receptor blocking antibodies detected by the Erythrocyte Antibody Inhibition assay may thus have a beneficial effect on graft outcome but do not appear to be autoantibodies.

Antilymphocyte Serum↗
PubMed1983

B lymphocyte antibodies associated with successful renal transplantation and successful pregnancy.

This study shows that non-cytotoxic Fc receptor blocking antibodies occurred more frequently in pre-transplant sera when the recipient had been transfused over five units of blood. Moreover 7/12 previously untransfused patients developed Fc receptor blocking antibodies during an elective blood transfusion regime. Erythrocyte antibody-rosette-inhibiting antibodies were also found at significantly higher values in the sera of women during the first trimester of a normal first pregnancy than in women studied at the time of spontaneous abortion. Family studies showed that this activity was linked to the HLA gene complex. These results indicate that EA inhibiting antibodies directed against MHC linked antigens are associated with specific abrogation of the immune response.

Abortion, Habitual↗
PubMed1982

Possible mechanism of action of transfusion effect in renal transplantation.

The mechanism by which blood transfusions given before renal transplantation improves allograft survival was studied in 31 transplant recipients. The presence of non-cytotoxic, Fc receptor blocking antibodies to donor and leukaemic B lymphocytes in pre-transplant sera correlated with both improved graft survival (p less than 0.03 and less than 0.1, respectively) and the number of blood transfusions given (p less than 0.05 and less than 0.03, respectively). Moreover, 6 out of 10 previously untransfused prospective transplant recipients developed these potentially protective antibodies during a course of elective blood transfusions. These results indicate that such non-cytotoxic, Fc receptor blocking antibodies in pretransplant recipient sera (a) are associated with improved allograft survival, (b) correlate with the number of blood transfusions given, and (c) can develop in response to blood transfusion.

B-Lymphocytes↗
PubMed1982

Loin pain and haematuria in young women: diagnostic pitfalls.

Cystoscopy, intravenous urography and urine culture frequently fail to reveal the cause of loin pain and haematuria in young women. Two such women are presented in whom renal biopsy was not only unhelpful but also misleading. Subsequent renal arteriography showed arteriovenous fistulae which were considered erroneously to be the cause of the symptoms in both patients; in fact the fistulae were traumatic post-biopsy fistulae rather than congenital malformations. These patients were probably examples of the "loin/pain/haematuria syndrome" which is thought to have a vascular basis and may have predisposed to the formation of fistulae.

Adolescent↗
PubMed1982

Long-term effects of 1,25-dihydroxy vitamin D3 and 24,25-dihydroxy vitamin D3 in renal osteodystrophy.

Twenty-three patients with end-stage renal failure on maintenance haemodialysis were treated with 1,25-dihydroxy vitamin D3 or 24-25-dihydroxy vitamin D3 for 3-32 months (total 232 patient months). Treatment with 1,25-dihydroxy vitamin D3 was marked by symptomatic, biochemical and histological improvements in the majority of patients. In contrast, treatment with 24,25-dihydroxy vitamin D3 produced no biochemical or histological improvements and such patients developed severe symptomatic bone disease. Successful renal transplantation resulted in rapid improvement in symptoms, biochemistry and bone histology in nine of 10 patients irrespective of whether prior treatment was with 1,25-dihydroxy vitamin D3, 24,25-dihydroxy vitamin D3 or both. During treatment with 1,25-dihydroxy vitamin D3 progressive reduction in dosage was required in the majority of patients because of hypercalcaemia, which was rapidly corrected by stopping treatment for a few days. Hypercalcaemia did not occur until serum alkaline phosphatase (AP) and amino terminal parathyroid hormone (N-PTH) had fallen towards normal. Treatment failure was uncommon in 1,25-dihydroxy vitamin D3-treated patients and was characterized by the early development of hypercalcaemia. Addition of 24,25-dihydroxy vitamin D3 in such patients rendered the hypercalcaemia more manageable but did not lead to any further improvement in biochemistry or bone histology. Treatment with 24,25-dihydroxy vitamin D3 was accompanied by the development of severe symptomatic bone disease in the majority of patients and a characteristic pattern of biochemical abnormalities with hypocalcaemia and rises in AP and N-PTH. Substitution of 1,25-dihydroxy vitamin D3 treatment for 24,25-dihydroxy vitamin D3 in these patients resulted in prompt improvement in clinical, biochemical and histological abnormalities. Successful renal transplantation was accompanied by rapid resolution of clinical, biochemical and histological features of renal osteodystrophy irrespective of whether previous treatment was with 1,25-dihydroxy vitamin D3 or 24,25-dihydroxy vitamin D3. Hypophosphataemia was common in the early months after renal transplantation without evidence of continuing hyperparathyroidism. The studies have confirmed that 1,25-dihydroxy vitamin D3 is effective in controlling clinical, biochemical and histological features of renal osteodystrophy while 24,25-dihydroxy vitamin D3 did not have a useful therapeutic effect in the dose used.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Effect of dihydroxylated metabolites of vitamin D3 on calcium absorption in uraemic man.

1. Peak 47Ca absorption and 7 day 47Ca retention were measured by a whole-body radioactivity counting technique in 10 haemodialysis patients before and after treatment with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3] and 24,25-dihydroxycholecalciferol [24,25-(OH)2D3]. 2. Before treatment all patients had low peak 47Ca absorption and 7 day 47Ca retention. 3. After treatment with 1,25-(OH)2D3 (0 . 25-l microgram/day for 4-12 months) peak 47Ca absorption and 7 day 47Ca retention returned to normal. 4. After treatment with 24,25-(OH)2D3 (2 microgram/day for 4-12 months) peak 47Ca absorption and 7 day 47Ca retention remained at pretreatment levels. 5. It is concluded that physiological doses of 24,25-(OH)2D3 have no effect on calcium absorption or retention in uraemic man.

24,25-Dihydroxyvitamin D 3↗
PubMed1981

Hypohyperparathyroidism: a model for renal osteodystrophy?

A child who presented with features of renal osteodystrophy but with normal renal function is described. Improvement occurred both on large doses of vitamin D and small doses of 1, alpha-hydroxy-vitamin D3 (1, alpha-OHD3). Investigations suggested that the primary defect was an impaired renal response to parathyroid hormone. The relationship between renal osteodystrophy, abnormalities of vitamin D metabolism and hypohyperparathyroidism is discussed and an alternative hypothesis for the development of renal bone disease suggested.

Child, Preschool↗
PubMed1981

Lipid relation ships in dialysis and renal transplant patients.

The relationship of high density lipoprotein cholesterol (HDL-CHOL) to other lipid fractions and the factos influencing post-transplant hyperlipidaemia have been explored in 28 chronic haemodialysis patients and 20 stable renal allograft recipients. In both groups of patients mean triglyceride (TG) and very low density lipoprotein cholesterol VLDL-CHOL) were elevated, but total CHOL and low density lipoprotein cholesterol (LDL-CHOL) were elevated only in transplanted patients. HDL-CHOL was uniformly low in dialysis patients irrespective of TG, whereas after transplantation mean HDL-CHOL was normal and varied inversely with TG and VLDL-CHOL. Serum creatinine correlated with TG and VLDL-CHOL in transplant patients, and was inversely related to HDL-CHOL. No factors correlated with CHOL or LDL-CHOL in transplant patients, but these lipids were only moderately elevated. Hyperlipidaemia in dialysis and transplant patients is not invariable; its importance for atherogenesis remains to be determined.

Adolescent↗
PubMed1980

Patterns of N-acetyl-beta-D-glucosaminidase excretion after renal transplantation.

N-Acetyl-beta-D-glucosaminidase activity (NAG) was assayed in 750 early morning urine samples from 25 renal transplant patients during the post operative period. Eighty four per cent of all acute rejection episodes were preceded or accompanied by a greater than two-fold rise in NAG activity; similar increases were caused by dialysis, gentamicin therapy and ureteric dehiscence. Only 9% of all significant increases in NAG excretion could not be accounted for by any of these four processes. Analysis of the day-to-day pattern of NAG activity as opposed to individual NAG values provided a clue to the occurrence of rejection during immediate post-transplantation oliguria.

Acetylglucosaminidase↗