[Incidence of kidney and urinary tract diseases in preschool children].
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Biomedical subjects
Publications and source records attributed to A E Lison.
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Unilateral hydronephrosis was induced by temporary ligature of the left ureter in 29 rabbits. In 21 animals so treated, chronic pyelonephritis was simultaneously induced by intravenous application of a suspension of E. coli. Histologic examination of renal pelvic epithelia in animals killed four weeks after the surgical intervention, revealed the following features: 1. Simple hyperplasia of urothelium in 12 cases, 2. atypical hyperplasia - (dysplasia) of urothelium in 10 cases, 3. v. Brunn's nests in 20 renal pelvises; 11 cases of cystic pyelitis, all combined with Brunn's nests, 4. metaplastic transformation of visceral mono- or bilayered epithelium into multi-layered urothelium-like structures in 19 renal pelvises. These changes are observed almost exclusively in the left renal pelvis of animals subjected to temporary ureteral ligature. Atypical urothelial hyperplasia is found only together with chronic pyelonephritis. Hyperplastic and dysplastic epithelial changes in the renal pelvis, the formation of Brunn's nests, and cystic pyelitis are interpreted as sequelae of postrenal obstruction or concomitant chronic inflammation.
Mononuclear cells from peripheral blood of six patients with polycythemia after kidney transplantation were studied in methyl cellulose cultures using fetal calf serum with and without adding erythropoietin. Parallel tests were run with "synthetic medium". The data obtained were compared to those of patients with polycythemia vera and normal subjects. The erythropoietin independent proliferation in synthetic medium typical for polycythemia vera could not be found in patients with renal grafts. However, in the preparations with fetal calf serum without erythropoietin, a formation of erythroid colonies could be detected suggesting an increased sensitivity or proliferation of erythropoietically determined stem cells in patients with transplanted kidneys.
Within the period of 1972 to 1982, 35 patients suffering from lymphogranulomatosis had to be treated by para-aortal pendulum therapy and irradiation of the spleen or spleen pedicle. Some of these patients received an additional polychemotherapy. All of these 35 patients were regularly checked-up by clinical and laboratory examinations in oncologic departments. There were no signs of radiogenic lesions of the kidney. In spite of this, the urines of these patients were examined by discelectrophoresis. Eight patients had a pathologic protein spectrum which was a symptom of other diseases in two cases and did not appear again in four cases, when control examinations were performed. One patient refused the control examination, but this one had no pathologic modifications in abdominal CT. Just one female patient showed in three control examinations protein spectra resembling to those of a proliferating glomerular lesion and a tubular lesion. All the other parameters, including a functional scintigraphy of the kidney, were normal. The patient felt well and had no clinical signs of disease. A functional damage of the kidney after irradiation of the spleen cannot be identified by current clinical and laboratory methods.
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With islet cell transplantation it would be possible to achieve a generally improved treatment of diabetes mellitus and avoid late complications. Since the problems of preparation, conservation and implantation of the islet cells have been satisfactorily solved, it ought to be possible to master the immune reaction in the future. The successful progressive development of islet cell transplantation in recent years justifies this optimism.
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The term "urinary tract infection" covers a variety of different diseases including acute and chronic pyelonephritis, cystitis, urethral syndrome and asymptomatic bacteriuria. Each of these terms is defined and etiology, diagnostic procedures as well as modern therapy are discussed in detail.
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