Biomedical subjects
Publications and source records attributed to R L Wathen.
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A 26-year-old woman, who had undergone jejunoileal bypass surgery six years previously for obesity, had symptoms of intermittent fever, myalgia, polyarthralgia, and aseptic joint swelling. These symptoms commenced one year after her surgery and gradually grew in intensity and frequency of occurrence. The patient, observed to have moderately decreased renal function, hyperoxaluria, and circulating cryoglobulins, underwent liver and renal biopsies. Both organ specimens demonstrated granulomatous involvement, but the kidneys exhibited no evidence of oxalate deposition. The findings of circulating cryoglobulins and suppression of symptoms with doxycycline, taken collectively with the circumstances surrounding this case, suggest that the observed granulomatous disease may be due to systematically adsorbed bacterial antigen(s).
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71 chronic renal failure patients undergoing long-term hemodialysis were evaluated for the effects of a dialysis event on hearing function. Osmotically active serum constituents were examined for relationship to fluctuating hearing threshold levels. Reliabiliity of hearing levels was found to be better in those patients tested without an intervening dialysis event. Those patients tested before and after hemodialysis demonstrated greater hearing fluctuation than those patients evaluated between dialysis events. This threshold fluctuation was unrelated to serum urea nitrogen, creatinine, K+, Na+, Ca++, or glucose. It was concluded that hearing test reliability in dialyzing renal patients is resonably good, but test results are likely to be more consistent if testing is accomplished a number of hour after a given dialysis event. Contrary to a number of reports in the recent literature, no direct relationship between hearing level fluctuation and fluctuation in individual osmotically active serum constituents appeared to be present.
A middle-aged man with idiopathic membranous nephropathy, who developed chronic renal failure, received a cadaver renal allograft. Two months later, massive, persistent proteinuria developed. A biopsy specimen of the allograft showed changes characteristic of membranous nephropathy and identical to those present in the patient's own kidney. The criteria for recurrence of glomerulonephritis in renal allografts are met in this case.
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