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Nephrocalcinosis in children.

Nephrocalcinosis is an uncommon condition is childhood. The commonest cause is renal tubular acidosis, although this may not manifest itself radiographically until adolescence. Recognizing the calcification as either cortical, medullary or mixed is not always possible, but may sometimes be an aid to differentiate metabolic from vascular causes.

Acidosis, Renal Tubular↗

Incidence of renal infarctions after transrenal stent placement in an animal model.

PURPOSE: To evaluate the incidence and appearance of renal infarctions after transrenal stent placement in an animal model. METHODS: An aortic stent was placed via a femoral approach in 20 female Merino sheep. Ten animals had intentional coverage of one renal ostium with the bare struts, 1 sheep had both renal artery ostia covered, and the other 9 sheep had no stent impingement on the renal orifices. Animals were sacrificed after 3 to 12 months (mean 6) for gross pathological and histological evaluation. Infarction locations and patterns were evaluated and correlated to stent placement. RESULTS: Of the 40 renal arteries, coverage was proven at autopsy in 12 cases; the remaining 28 arteries were free of any stent overlay. Overall, 14 (35%) renal infarctions were detected; 7 were found in the 12 arteries with a transrenal stent (58.3% incidence in covered renal arteries). By comparison, the other 7 infarctions were found in the 28 unaffected arteries (25% incidence in noncovered renal arteries; p = 0.04). All infarctions appeared to be well-defined punctate lesions. CONCLUSIONS: A transrenal stent position in the abdominal aorta is related to increased renal infarctions in an animal model.

Animals↗

Segmental cortical renal infarction with spontaneous regression. A clinical and roentgenological study.

A patient with a suspected segmental aseptic renal infarction is described. Initially, the clinical picture was characterized by pain and macroscopic haematuria. An acute intravenous pyelography showed a normal roentgen anatomy. At a second intravenous pyelography one week later, an incomplete filling of the two cranial calyces was found. A subsequent renal angiography showed an avascular area within the corresponding parenchyma. The distinct demarcation of the avascular zone caused us to suspect that the disease might be ischemic. A second and a third renal angiography 6 weeks and 4 months later, respectively, both showed complete restoration with a normal vascular pattern. The necessity of performing an acute renal angiography in every case of a suspected renal infarction is stressed. The possibility of preventing hypertension by kidney resection in patients with incomplete restoration of the renal parenchyma is evaluated.

Adult↗

[Toxicity of silica-gel polymers].

Mice of the ICR strain were tested for the effect of intraperitoneally applied polymers of silicagel. Silicagel applied in the form of spherical-shaped particles caused local irritation and resorptive reaction with granulocytes. There was also renal damage of the type of necronephrosis and signs of necronephrosis.

Animals↗

Antiserum treatment of gram-negative bacteremia.

In order to lower the mortality rate from gram-negative bacteremia, 136 patients were treated with human antiserum against core glycolipid, or with control nonimmune human serum, in a double-blind clinical trial. The antiserum was prepared by immunizing healthy young men with a vaccine composed of heat killed cells of the J5 mutant of E. coli 0111 B4. Since the core glycolipid in this mutant is not encumbered with "O" side chains, it can stimulate antibody against the core glycolipid possessed in common by the different species of gram-negative bacteria responsible for lethal bacteremia in patients. No serious reactions occurred in over 300 men receiving this vaccine, and the J5 antiserum gave striking broad-spectrum protection against experimental gram-negative bacteremia and endotoxemia. When human J5 antiserum was administered to seriously ill bacteremic patients, the mortality rate was virtually cut in half, as compared to controls. The death rate from gram-negative bacteremia was 14% in patients treated with J5 antiserum, and 26% in those given nonimmune control human serum. Among patients in profound gram-negative bacteremic shock, the recovery rate rose from 29% in controls to 82% in those treated with J5 antiserum (p = 0.02). On the basis of these encouraging results we propose to treat more bacteremic patients with J5 antiserum, because larger groups are needed to establish the full significance of the initial findings.

Animals↗

[Decrease of sisomicin nephrotoxicity as affected by cephalothin: pharmacokinetic evaluation].

The effect of cephalothin on the nephrotoxicity and pharmacokinetics of sisomicin was studied on Wistar rats. Sisomicin was injected intramuscularly in doses of 12.5 and 25 mg/kg alone or in combination with cephalothin in a dose of 360 mg/kg once a day for 16 days. It was shown that the combined use of sisomicin and cephalothin resulted in less pronounced functional and morphological changes in the kidneys as compared to the use of sisomicin alone. The decrease in the nephrotoxic effect was accompanied by a decrease in the sisomicin concentration in the blood serum and the site of the nephrotoxic effect (the kidney cortical layer) and the period of the aminoglycoside half-life in the kidney cortical layer under the action of cephalothin. The analysis of the relation between the nephrotoxic effect and the concentration of sisomicin in the kidney cortical layer and blood serum demonstrates that the nephrotoxicity of the sisomicin combination with cephalothin is mainly due to a decrease in the aminoglycoside concentration in the zone of the nephrotoxic effect.

Animals↗