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Biomedical subjects

W Lawler

Publications and source records attributed to W Lawler.

At least 37 records · Page 2Linked to original sources
PubMed1986

Diagnosis of disease in renal allografts: correlation between ultrasound and histology.

Ultrasound was compared with histology in 66 cases to assess the accuracy of sonography in demonstrating abnormality in renal allografts. Patients with suspected acute, chronic or acute and chronic rejection, acute tubular necrosis and glomerulonephritis in the transplant kidney were included in the study. It was noted in this trial that ultrasound is less accurate at demonstrating abnormality in the grafted kidney than has been suggested previously in the literature. It was concluded that, where doubt exists, even when ultrasound examination is normal, biopsy should be considered.

Biopsy↗
PubMed1984

A scoring system for Wilms' tumour: pathological study of the second Medical Research Council (MRC) trial.

The second MRC nephroblastoma trial was devised to determine whether more intensive chemotherapy in the early stages and multiple chemotherapy in the poorer prognosis groups would give improved results. As a separate study the pathological and clinical aspects were assessed to see whether information may be obtained concerning the behaviour of individual tumours of the 159 cases included, 142 were regarded as nephroblastoma. Significant features were the age of the patient, clinical stage at diagnosis, tubular status of the neoplasm and the presence or absence of anaplasia. A scoring system has been devised to take account of these factors.

Adolescent↗
PubMed1983

Primary renal tumours in the first year of life. A population based review.

Of 30 patients presenting with primary renal tumours in the first year of life, there were 23 Wilms' tumours (15 classical, six epithelial and two rhabdomyomatous), three rhabdoid neoplasms and four mesoblastic nephromas. Criteria for the diagnosis of rhabdoid tumours and mesoblastic nephromas are discussed with reference to histological difficulties. Although Wilms' tumour was the commonest neoplasm, mesoblastic nephroma predominated in the first three months of life. The clinical behaviour of the cases is reviewed, and rhabdoid tumours, although relatively few in number, accounted for a significant part of the overall mortality.

Female↗
PubMed1982

Wilm's tumour and renal dysplasia: an hypothesis.

The incidence of renal dysplasia in a series of Wilms' tumours is presented. The distribution of such lesions is discussed, together with their course of development and regression. The kidney is regarded as a particularly suitable organ for studying the relation between dysplasia and neoplasia. A schema is suggested for this association with regard to Wilms' tumour.

Child↗
PubMed1982

Relapsing idiopathic membranous nephropathy.

In a series of 60 patients with idiopathic membranous nephropathy (IMN), 8 subjects, aged 16-65 years at presentation, suffered spontaneous relapse of proteinuria after remissions of 25 months to 30 years. Renal biopsy was performed at the time of relapse in 5 cases and revealed histopathology identical to that of the original lesion. Eight courses of immunosuppressive therapy given to 6 patients did not affect either the appearance or duration of remission or relapse. No patient had a familial tendency to renal disease. Immunogenetic markers, HLA A, B and DR, did not distinguish those who relapsed from other patients with IMN. At the end of the study, 3 patients were in a second remission, one had died of myocardial infarction during relapse, 3 remained nephrotic and one had mild renal insufficiency but no proteinuria. As compared with the rest of the series the overall prognosis was not influenced by the relapses.

Adolescent↗
PubMed1981

Experimental mesangial proliferative glomerulopathy.

A mesangial proliferative glomerulopathy was induced in rabbits by repeated, intravenous fixed doses of heterologous (porcine) thyroglobulin. Twenty-five (75.8 per cent) of 33 rabbits showed mesangial proliferation with normal peripheral capillary basement membranes. Immunofluorescence revealed mesangial deposits of host immunoglobulins in 16 (59 per cent.) of 27 rabbits, and 6 (32 per cent.) of 19 showed similar thyroglobulin deposition. Ultrastructurally, irregular, ill defined areas of increased electron density were seen in the mesangial matrix in 14 (86 per cent.) of the 16 examined, and in eight (50 per cent.), discrete, granular intramesangial electron dense deposits were also identified. Results indicate that chronic immunisation with fixed doses of heterologous thyroglobulin is a reliable and reproducible method for inducing an experimental mesangial proliferative glomerulopathy in rabbits. This glomerulopathy is very similar morphologically to humans primary mesangial proliferative glomerulonephritis, particularly when the latter is associated with IgM deposition.

Animals↗
PubMed1981

Complement and glomerular disease - a natural history study.

Over a 5-year period we have performed sequential measurements of a range of complement components in 127 patients. Each had a well-characterised glomerular lesion and there was no evidence of an underlying connective tissue disorder. In 17 patients with varied histopathology, who did not have C3 nephritic factor, there was a persisting complement defect which was present during remission in the patients we were able to study. The finding of such defects is consistent with the thesis that primary complement system abnormalities predispose to the development of glomerular lesions. Interestingly, these abnormalities did not influence the prognosis of our patients. In 12 other cases without C3 nephritic factor, complement levels were below the normal range when the glomerular lesion was active but returned to it in remission; these were secondary changes. We showed by discriminant analysis that some circulating complement component levels, assessed in relation to each other and without reference to a statistically derived 'normal' range, discriminated between histological subgroups and had prognostic significance as well. These patterns could not be distinguished until the data were stored and analysed by computer.

Analysis of Variance↗
PubMed1981

Reduction of post-transplant proteinuria due to recurrent mesangial proliferative (IgM) glomerulonephritis following plasma exchange.

A patient developed recurrent IgM proliferative glomerulonephritis and a nephrotic syndrome following HLA-identical living donor renal transplantation. Two intensive five-day courses of plasma exchange were followed by sustained reduction of proteinuria. Renal function has remained normal at all times. Immune complex sizing revealed a high titer of middle range complexes (mol. wt. 1 x 10(6) daltons app.); immune complex clearance following an antigen load was not improved by plasma exchange suggesting no alteration of reticulo-endothelial function. Possible mechanisms of benefit are discussed.

Adolescent↗
PubMed1980

Bone metastasizing renal tumour of childhood. Histopathological and clinical review of 38 cases.

The histopathological spectrum of a large series of a recently described tumour entity is presented. Seven diagnostic features which may be encountered are described and their frequency discussed. The most striking clinical feature was the marked male preponderance (M:F = 7.6:1). It is suggested that an appreciation of the full histopathological spectrum is necessary to ensure adequate diagnosis.

Adolescent↗
PubMed1980

Bone metastases in childhood renal tumours.

Analysis of data from 1434 children with primary renal tumours revealed 57 who developed bone metastases. Of these, 54 were initially recorded as nephroblastoma. Fifty-two of the 57 cases were reviewed histologically, and only 18 were found to be Wilms' tumours. Twenty-three were classified as "Bone-Metastasizing Renal Tumour of Childhood" (BMRTC), and a high male incidence was found for these tumours (M:F=6.7:1). Differences in the pattern of metastasis and the one-year survival between BMRTC and nephroblastoma are discussed. The rarity of bone metastases from true Wilms' tumours is emphasized.

Adolescent↗
PubMed1980

IgM associated primary diffuse mesangial proliferative glomerulonephritis.

Twenty-three cases of IgM associated primary diffuse mesangial proliferative glomerulonephritis are presented. In 18, IgM was the sole localising host immunoglobulin, and it was the predominant globulin in five; C3 was also present in 18. Light microscopy revealed variable diffuse and global mesangial proliferation in all cases, with additional focal global sclerosis in 16, focal segmental sclerosis in 15, and small capsular crescents in seven. Material for electron microscopy was available from 19 patients; in 13, occasional intramesangial electron dense deposits were identified, and in 18 there were irregular, rather ill defined areas of increased electron density in mesangial regions. Clinically, 14 patients presented with the nephrotic syndrome, and nine had asymptomatic proteinuria. During follow-up, only 10 patients showed no change in renal function or improved; the remainder showed increasing hypertension and/or renal function deterioration and four developed end stage renal failure. It is suggested that IgM associated mesangial proliferative glomerulonephritis should be considered as a distinct clinicoimmunopathological entity.

Adolescent↗
PubMed1979

Strong association between idiopathic membranous nephropathy and HLA-DRW3.

HLA A, B, and DR antigens were determined in a homogeneous group of patients with idiopathic membranous nephropathy. The frequency of HLA-DRW3 was significantly higher in the patients than in a control population. The frequencies of HLA B8 and B18, which are in linkage disequilibrium with DRW3, were also increased.

Adolescent↗