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Biomedical subjects

A Pomeranz

Publications and source records attributed to A Pomeranz.

35 records · Page 2Linked to original sources
PubMed1988

Prostanoids in renal failure induced by converting enzyme inhibition in sodium-depleted rats.

Clearances of inulin (CIn) and p-aminohippurate (CPAH) were measured in four groups of rats before and after intravenous administration of acetylsalicylic acid (ASA): 1) controls, on normal Na intake, 2) captopril-treated (30 mg.kg-1.day-1) on normal Na intake, 3) Na depleted, and 4) Na depleted, captopril-treated. In Na-depleted animals, CIn and CPAH were similar to controls but decreased significantly with ASA. In Na-depleted, captopril-treated rats, CPAH was slightly decreased, but CIn was significantly reduced (P less than 0.01). Both were not affected by ASA. Urine output was unchanged and the kidneys appeared normal on histological examination. The production of prostaglandins E2 (PGE2), F2 alpha (PGF2 alpha), and thromboxane B2 (TxB2) was measured in isolated glomeruli, cortical tubule suspensions, and medullary and papillary slices. Captopril increased PGE2 production by glomeruli and PGF2 alpha and TxB2 synthesis in papillary slices. Na depletion selectively enhanced the production of PGE2 by glomeruli and papillae. In contrast, the synthesis of prostanoids was significantly decreased in captopril-treated, Na-depleted rats. These findings suggest that in this model, functional nonoliguric renal failure may be related to abnormalities of prostanoid synthesis.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

Increased drainage volume in intermittent peritoneal dialysis using a two-bag, low hydrostatic pressure drainage system.

Adequate drainage volume (DV) is a prerequisite for long-term success of intermittent peritoneal dialysis (IPD). Ultrafiltration (UF) is basically determined by the interplay of two major forces: a driving osmotic force created by a hyperosmolar dialysate solution versus an opposing force--the intraperitoneal hydrostatic pressure. Conventional drainage procedures (CS) are capable of achieving a fluid volume of 3 L per bag. We found that this intrabag volume corresponds to an intrabag hydrostatic pressure of 60 cm water. Because this drainage system is closed, the intrabag hydrostatic pressure reflects intraperitoneal hydrostatic pressure. A low-pressure system (LPS) was devised to evaluate the possible influence on DV of reducing HP. Our results show that such LPS does indeed significantly improve DV, using a decreased number of exchanges. The residual volume and its glucose concentration (in a 1.5-g/dl exchange) were measured with CS. When followed by an 4.25-g/dl exchange, an 11% reduction in glucose concentration was evident. Thus, the osmotic driving force may also be impaired by incomplete drainage. To obtain maximal DV during IPD, a LPS should be used. This could be achieved by using 2 L dialysate in 3-L bags.

Aged↗
PubMed1987

IgM nephropathy: morphological study related to clinical findings.

This study describes 10 cases of IgM nephropathy in whom the main morphological findings consisted of diffuse mesangial deposition of IgM and varying degrees of mesangial cell proliferation. In addition, focal segmental sclerosis was present in 1 patient and global sclerosis in another. An ill-defined electron-dense deposit was seen within the mesangial area in 1 case. Except for 1 patient, who had hematuria only, all suffered from nephrotic syndrome without deterioration of renal function. In view of the constant and characteristic finding of a diffuse mesangial IgM deposition, it is suggested that this form of nephropathy constitutes an entity separate from focal glomerulosclerosis or minimal change disease.

Adolescent↗
PubMed1986

Natriuretic response to i.v. saline loading after acute poststreptococcal glomerulonephritis.

The outcome of acute poststreptococcal glomerulonephritis (APSGN) is still controversial. Whereas many studies show a good prognosis, particularly in children, late morphologic and functional renal abnormalities have been described. To verify this latter finding, we evaluated the sodium handling of the kidney several years after APSGN. Eleven subjects (9 children and adolescents and 2 adults) were studied 2 to 3 years after APSGN. At the time of the study all patients were well, without pathologic urinary findings and with normal blood pressures. Five healthy subjects (3 adults and 2 children) served as controls. Following two control periods of 30 min, an i.v. saline load (2.5% NaCl, 1 l/1.73 m2 body surface area) was administered over 45 min. Sodium excretion was measured during the control and salt-loading periods, and during four additional 30-min collection periods. No exaggerated natriuresis was found. We therefore conclude that epidemic APSGN in Israel carries not only an excellent clinical but also a good renal functional prognosis.

Adolescent↗
PubMed1985

Acute renal failure in a burn patient: the advantages of continuous peritoneal dialysis.

An 8-year-old girl sustained 65-70 per cent body surface area burns when her clothes caught fire. Two weeks later, she developed acute renal failure (ARF) and needed dialysis therapy. The extensive, infected burn area prevented the establishment of a safe vascular access for haemodialysis. Continuous peritoneal dialysis proved to be a valid alternative form of treatment and even had advantages over haemodialysis. Large amounts of fluids, calories and electrolytes could be administered via the peritoneal route. This facilitated the treatment of the catabolic state of the uraemic burn patient and served to correct the electrolyte losses via the skin. Peritoneal dialysis is a valuable adjunct to the treatment of acute renal failure in burn patients who need renal replacement therapy.

Acute Kidney Injury↗
PubMed1984

Dialysis-induced hypoxemia. Continuous monitoring of blood oxygen and carbon dioxide tension in children.

We report our experience with continuous, transcutaneous monitoring of capillary oxygen and carbon dioxide tension (PtcO2, PTlcCO2 ) during the entire length of hemodialysis treatment in 8 pediatric patients. The relative changes in PtcO2 and PtcCO2 observed with this method were in accordance with those reported in the literature, obtained with frequent arterial blood sampling. There was a temporary fall of PtcO2, averaging 26.2% after 2h of dialysis, with a concomitant rise of PtcCO2 of 9.9%. The noninvasive, transcutaneous measurement of PtcO2 and PtcCO2 is a reliable and valuable adjunct for the monitoring of the dialysis patient who is prone to develop hypoxemia. It is particularly useful in the very young.

Adolescent↗
PubMed1984

Renal candidiasis in infancy--a case with fungus ball obstruction.

A sixteen day old infant developed candiduria after surgery on a single functioning, hydronephrotic kidney with ureteropelvic junction stenosis. Masses of candida albicans caused obstruction of the ureter with acute anuria. Endoscopic relief of the obstruction together with aggressive antifungal therapy led to irradication of the fungal infection. This case history emphasizes the fact that candida infection in early childhood should be evaluated carefully. Unfortunately no guidelines are yet available for the indications and the preferred mode of treatment, and length of therapy of infantile renal candidiasis.

Amphotericin B↗
PubMed1983

Candida peritonitis-inefficacy of amphotericin-B and 5-fluorocytosine treatment.

A 3 1/2 year old child with chronic renal failure twice developed severe candida peritonitis in the course of treatment with continuous ambulatory peritoneal dialysis. Medical treatment was unsuccessful but removal of the catheter led to immediate cure. This case documents a long held clinical impression that the best, if not the only way of treatment of candida peritonitis is removal of the indwelling catheter. Thus, potentially hazardous, painful and costly medical treatment can and should be avoided.

Amphotericin B↗
PubMed1975

Altered distribution and excretion of N-1-methylnicotinamide in rats with Walker 256 carcinosarcoma.

Levels of nicotinamide and N-1-methylnicotinamide in serum, liver, and kidney as well as renal clearances and 24-hr urine levels of N-1-methylnicotinamide were compared in normal rats and rats bearing Walker 256 tumors. There was no significant difference between normal and tumor-bearing rats with regard to nicotinamide levels. With regard to N-1-methylnicotinamide, tumor-bearing rats had significantly lower serum and liver levels and significantly higher 24-hr urine levels and renal clearances. Walker 256 tumor tissue and liver and kidney from a normal and a tumor-bearing rat were separately examined for S-adenosylmethionine:nicotinamide methyltransferase activity. The specific activity in tumor tissue extract was greater than that in each liver extract, which, in turn, was much greater than the specific activity in each tissue (liver and kidney) from the tumor-bearing rat was equal to the specific activity in the corresponding tissue of the normal rat. S-adenosylmethionine:nicotinamide methyltransferase was obtained with 18-fold purification from a tissue extract of Walker 256 tumor. The enzyme activity required activation by thiols, and maximal activity was observed at pH 8.6. The Km's for the substrates, S-adenosylmethionine and nicotinamide, were 7.0 x 10--3 mM and 0.50 mM respectively. The Ki's for the products, S-adenosylhomocysteine and N-1-methylnicotinamide, were respectively, 25 x 10--3 mM and greater than 5 mM.

Animals↗
PubMedDate not supplied

Acute carbamazepine poisoning and hyponatremia.

A case of acute carbamazepine poisoning is described, which demonstrates all the immediate side effects of poisoning. Emphasis is placed on water intoxication and hyponatremia as the main cause of irreversible cerebral damage.

Carbamazepine↗
PubMedDate not supplied

Intestinal fat malabsorption in the uremic rat.

In the past we have shown that patients with chronic renal failure (CRF) on hemodialysis show evidence of intestinal malabsorption of fat. The present study was designed to verify this finding in an animal model. Male rats weighing +/- 200 g were studied. Uremia (U) was induced by 2-stage subtotal (5/6) nephrectomy. Control (C) animals were sham-operated. Fat absorption was studied after 6 weeks of uremia with the oral fat loading test. Twenty percent intralipid (0.25 g/100 gBW) was given by gastric tube feeding to fasting animals and the appearance of chylomicrons (CHYL) and the rise of triglycerides (TG) in the serum was followed for 5 hrs. In order to isolate the effect of fat absorption, an additional group of U and C animals was pretreated with orotic acid and triton, thus blocking hepatic TG synthesis and neutralizing peripheral lipoprotein lipase activity. The absorption of CHYL was significantly (p less than 0.01) impaired in all U animals and averaged 43 and 70 percent of that of the C animals, 1 and 2 hrs after the load respectively. The rise in serum TG did not differ from C in mildly U animals (Scr 1.0 +/- 0.04). In the more severely uremic animals (Scr 2.6 +/- 0.2), however, pretreated with orotic acid and triton, the rise in serum TG was far less (p less than 0.01) than in C animals (111 +/- 26-903 +/- 111 delta % V.780 +/- 170-5032 +/- 746 delta %) 1 and 5 hrs after the load.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Acute glomerulonephritis secondary to lobar pneumonia.

We report 4 cases of children who developed lobar pneumonia and subsequently acute glomerulonephritis, all within a period of six weeks. In one case streptococcus pneumonia type 5 was isolated, a strain not previously described in the literature as being nephritogenic.

Acute Disease↗
PubMedDate not supplied

Hypercalcemia in acute lymphatic leukemia.

We report the case histories of 2 patients with a rapidly fatal form of acute lymphatic leukemia, who showed severe hypercalcemia during the acute phase of the disease. The pathogenetic mechanism of the hypercalcemia in these two cases was different. A short review of present day theories regarding the pathogenesis of tumor hypercalcemia is presented.

Child↗
PubMedDate not supplied

Computerized tomography of the brain in children with chronic renal failure.

We performed computerized tomography (CT) of the brain in 22 patients, 2 to 18 years of age, with stable chronic renal failure (n = 6), on dialysis (n = 14) and after renal transplantation (n = 2). None suffered from a systemic disease known to affect the central nervous system (CNS) and none had overt CNS dysfunction at the time of the CT examination. The most striking pathological finding was brain atrophy, which was present in 13 patients (59%). In two patients cortical infarcts were present and one patient was found to have a hypodense area in the basal ganglia. The brain atrophy could not be related to the type of basic renal disease, the age of the patient, corticosteroid dosage, the duration of the renal failure or the presence of hypertension However, the mode of treatment, i.c. hemodialysis, seemed to be a risk factor. We assume that metabolic derangements and/or the accumulation of toxic substances due to the uremic state may be responsible for the brain atrophy in young patients with CRF. Recurrent osmotic changes of the brain during hemodialysis may aggravate the process of brain atrophy.

Adolescent↗