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Biomedical subjects

R Lannigan

Publications and source records attributed to R Lannigan.

At least 55 records · Page 3Linked to original sources

Possible savings with appropriate antibiotic prophylaxis.

Antibiotic utilization was studied for one month in 52 patients from two surgical wards and one urology ward in an 835 bed teaching hospital. The use of antibiotics was classified as prophylaxis or treatment and the cost of each regimen was determined. The appropriate antibiotic for prophylaxis was chosen according to the surgical procedure and as a result of a literature review. Using cefazolin as the drug of choice in suitable general surgery cases resulted in a justifiable cost for prophylaxis of $17.64 per patient and a possible saving of up to $67.01 per patient (possible total saving of up to $670.05 for the study population). It was concluded that appropriate antibiotic prophylaxis in surgical patients could lead to significant cost savings. Some techniques for improving antibiotic prescribing are reviewed.

Anti-Bacterial Agents↗

The effect of pre-injection of rat kidney F3 antigen on the development of passive Heymann nephritis.

The effect of repeated i.p. injections of a small dose of rat kidney F3 antigen, in an aqueous solution, on the development of passive Heymann nephritis in the rat has been investigated. The test animals receiving the antigen before the i.v. injection of the heterologous antibody developed more numerous and larger immune complexes on the epithelial side of the glomerular basement membrane than the control rats. It is suggested that the injected antigen is trapped in the glomerular basement membrane at sites where the pre-existing nephritogenic antigen is present making it possible for the more numerous and larger deposits to form.

Animals↗

Progressive passive Heymann nephritis in the rat.

Progressive passive Heymann nephritis was produced in rats by simultaneous intravenous injections of heterologous antirat glomerular basement membrane antiserum and heterologous antirat kidney tubular fraction 3 antibody. The animals were killed at 16 weeks by which time approximately one-half of them were severely proteinuric. The glomeruli showed beaded immune deposits around the capillaries by immunofluorescence, and on electron microscopy osmiophilic deposits were noted in the subepithelial zones and within the glomerular basement membrane. The lesion resembled that of severe Heymann nephritis. gamma-Globulin eluted from the kidneys contained an autologous IgG that reacted with the brush border region of the renal proximal tubules of normal rats. This component was present in proteinuric and nonproteinuric animals. It is concluded that the progression results from the development of autoantibodies to the tubular nephritogenic antigen and the proteinuria is related to increasing deposition of immune complexes in the glomeruli.

Animals↗

Immune-complex nephritis in the rabbit produced by injections of rat renal tubular fraction 3 antigen.

Rabbits used for the production of anti-rat kidney tubular fraction 3 antibody developed a form of immune-complex glomerulonephritis which was characterized by the deposition of immune complexes in the glomerular basement membrane and in the mesangium. The deposits were composed of the injected rat kidney antigen and rabbit antibody to the injected antigen. Eluted gamma-globulin obtained from the diseased rabbit kidneys reacted only with the brush-border region of the proximal convoluted tubules of normal rat kidney sections but not with normal rabbit kidney sections, in an indirect fluorescent antibody test. The developing kidney disease does not appear to have an autoimmune component.

Animals↗

Unilateral Masugi nephritis in the rat.

In unilateral nephritis produced in rats by clamping one kidney, injecting heterologous Masugi antiserum prepared from homogenates of cortex, and releasing the clamp after 30 to 60 minutes, nephritis develops in the unclamped kidney. In the clamped kidney, although nephritis does not occur, the injected heterologous antibody can be demonstrated in the glomeruli with immunofluorescence techniques, and the intensity increases with time. Antirat glomerular basement membrane antisera and antirat tubular fraction 3 antisera were raised separately in rabbits. Rats with one kidney pedicle clamped were injected with antirat raised separately in rabbits. Rats with one kidney pedicle clamped were injected with antirat glomerular basement membrane antiserum alone, antirat tubular fraction 3 alone, or a mixture of both. The clamp was released after 1 hour. Frozen sections of the kidney were stained at intervals for the presence of rabbit IgG and rat IgG. When antirat glomerular basement membrane was injected alone, faint linear fluorescence was noted at 24 hours in the clamped kidney, and this did not increase over 4 weeks. Antirat tubular fraction 3 antiserum injected alone showed fine granular deposits around the capillary walls at 24 hours, and the intensity of fluorescence increased with time. When a mixture of antirat glomerular basement membrane and antirat tubular fraction 3 was injected, in the clamped kidney, there was initially faint linear fluorescence. By the 8th day, a granular pattern was noted superimposed on a linear background. By 32 days, the granular pattern was evident. The presence of subepithelial deposits was confirmed by electron microscopy. It is deduced that the slow reacting factor in Masugi antiserum prepared from homogenates of cortex is partly a "contaminating" antitubular antibody and that injections of Masugi antiserum may produce two superimposed types of immunologic glomerular lesions.

Animals↗

Evaluation of cerebrospinal fluid lactic acid levels as an aid in differential diagnosis of bacterial and viral meningitis in adults.

The level of lactic acid in cerebrospinal fluid has been suggested as a useful diagnostic parameter to differentiate between bacterial and viral meningitis, especially in patients partially treated before admission to hospital. A concentration of greater than or equal to 35 mg/dl, determined by either gas-liquid chromatography or an enzymatic method, has been considered in several studies to provide definite evidence of meningitis of bacterial origin, whereas a lower level indicates no bacterial involvement. Over the past 18 months, we have analyzed by the enzymatic method the lactate level in 493 spinal fluids submitted from 434 adult patients with various conditions involving the central nervous system. Fifty fluids had a lactate level of greater than 35 mg/dl, of which 19 were cases of infective meningitis of varying etiology. The 435 specimens with lactate levels within the range considered normal included three cases of infective meningitis, of which two were cryptococcal and one was bacterial. In this adult study, the lactate level in the cerebrospinal fluid did not provide unequivocal evidence of bacterial infection and did not provide assistance to any greater degree than the standard parameters of leukocyte count, protein, and glucose contents in the differential diagnosis of bacterial meningitis from that of any other etiology.

Adolescent↗

An experimental kidney disease in dogs produced by injection of heterologous antisera to dog tubular fraction 3 antigen.

Glomerular disease characterised by morphological alterations of the glomerular basement membrane and the mesangium was produced in dogs by injections of heterologous anti-dog renal tubular fraction 3 antibody. The renal lesion was characterised by irregular thickening of the glomerular basement membrane, with electron-dense deposits and loose granular material within it.

Animals↗

Induction of an autologous immune-complex glomerulonephritis in the rat by intravenous injection of heterologous anti-rat kidney tubular antibody IV: Effect of injection of HgCl2 prior to the antibody.

Autologous immune-complex glomerulonephritis developed in rats injected s.c. with HgCl2 2 days before the injection of anti-tubular fraction 3 antibody. The glomerulonephritis was progressive and characterized by granular deposition of IgG and C-3, with proteinuria from the eighth week onwards. Granular densities and severe glomerular basement membrane changes were observed when the experiment was terminated after 9 months. A possible mechanism of the glomerular lesion is discussed.

Animals↗

Induction of an autologous immune complex glomerulonephritis in the rat by intravenous injection of heterologous anti-rat kidney tubular antibody. III. Long-term effects.

The long-term effects of a single intravenous injection of anti-rat kidney fraction 3 antibody were studied in rats. At the end of the experiment at one year the kidneys had deposition of immune complexes in the glomeruli staining for autologous IgG and C-3. The number and size of the deposits did not appear to increase during the experiment although proteinuria eventually developed in most test animals. Control rats injected with normal rabbit serum had no immune complexes in their kidneys.

Animals↗

Clinical, light, and electron microscopy findings in idiopathic haematuria.

The electron microscopic findings are reported in detail in 20 patients submitted to renal biopsy with the major complaint or clinical finding of gross or microscopic haematuria. The lesions were classified histologically into four groups: group 1, minor glomerular alterations; group 2, focal mesangial thickening and/or cellular proliferation; group 3, diffuse mesangial proliferation; and group 4, other lesions. The major ultrastructural alterations included irregularity in thickness and density of the capillary basement membrane, with apparent discontinuity and bi- or multilaminar splitting of the lamina densa. There were varying degrees of foot process fusion, visceral epithelial polykaryocytosis, and granular deposits related to the capillary basement membrane. Densities were found in the mesangial basement membrane-like material, which was often markedly increased in quantity. A few microtubular aggregates were observed in endothelial cell cytoplasm. Changes consistent with acute diffuse proliferative and membrano-proliferative glomerulonephritis were also seen. The significant clinical findings, histological groups, and ultrastructural changes are correlated.

Adolescent↗

Primary glomerular disease with extraglomerular vascular osmiophilic deposits.

The ultrastructural changes in renal arterioles and capillaries from three cases of epimembranous nephropathy, one case of minimal change, and one case of minimal change with mild focal proliferation are presented. In addition to the usual subepithelial deposits on the glomerular capillary basement membranes in the cases of epimembranous nephropathy, osmiophilic granular deposits were observed on the outer aspect of extraglomerular vascular basement membranes. No clinical history of hypertension was obtained and there was no histological evidence of renal hypertensive vascular disease.

Adult↗