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Biomedical subjects

A Pruna

Publications and source records attributed to A Pruna.

At least 19 recordsLinked to original sources
PubMed1997

Thrombomodulin is synthesized by human mesangial cells.

Thrombomodulin (TM), an endothelial receptor for thrombin, endowed with a powerful anticoagulant activity, plays an important role in the antithrombogenicity of the vascular endothelium. Its presence within the human renal glomerulus is already known but was thought to be only endothelial. We looked for TM expression in human mesangial cells (MC), both in situ, in freshly prepared glomeruli, and in primary culture. Both fresh and cultured MC were strongly reactive for TM by immunocytochemical methods. Total TM antigen measured on MC lysates and surface TM activity on MC were 0.292 +/- 0.075 ng/mg of cellular proteins and 1.20 +/- 0.02 pmole of activated protein C/min/mg of cellular proteins, respectively. As shown by the presence of numerous transcripts detected by in situ hybridization, TM was shown to be synthesized by MC in vivo and in culture. The synthesis of active TM by both endothelial and mesangial cells within the renal glomerulus stresses the importance of its role in maintaining renal hemostatic equilibrium, and sheds some light on the conflicting reports of TM over- and underexpression in glomerulopathies to open a new field for investigation.

Antigens↗
PubMed1996

[Occurrence of extracapillary glomerulonephritis during Mediterranean boutonneuse fever].

Boutonneuse spotted fever is a summer and late spring infection caused by Rickettsia Conorii mainly in Middle East countries adjacent to the mediterranean coast (1). Malignant forms have been described in debilitated patients associated with prerenal azotemia, acute tubular necrosis or renal vasculitis (2, 3). We report for the first time to our knowledge, the association of an extracapillary glomerulonephritis with a Boutonneuse spotted fever. This observation suggest that Rickettsia Conorii, as other bacteria, could participate to the development of glomerulonephritis.

Aged↗
PubMed1995

Hypertensive encephalopathy after bilateral carotid endarterectomy.

BACKGROUND: Hypertension occurs frequently after carotid endarterectomy and may lead to cerebral vascular complications and myocardial infarction. Its pathophysiology has recently been related to surgically induced damage of carotid baroreceptors. CASE DESCRIPTION: A 45-year-old normotensive man with no history of epilepsy was admitted 3 weeks after bilateral carotid endarterectomy for severe repetitive paroxysmal headaches, vomiting, and agitation that were closely associated with attacks of marked hypertension. During one of these attacks, he had a grand mal seizure. Plasma catecholamine levels during hypertensive attacks were highly elevated despite the absence of pheochromocytoma, reflecting abnormalities in baroreceptor sensitivity that lead to unrestrained activation of the central sympathetic nervous system. Heart rate response to Valsalva maneuver showed suppression of the usual tachycardia, indicating baroreceptor reflex insensitivity. CONCLUSIONS: We report the first case of hypertensive encephalopathy associated with baroreflex failure syndrome after bilateral carotid endarterectomy. The role of blood pressure monitoring may be critical in revealing carotid baroreceptor insensitivity in such clinical settings.

Baroreflex↗
PubMed1993

Renal disease associated with HIV infection: a multicentric study of 60 patients from Paris hospitals.

Sixty HIV-infected patients presenting renal symptoms who underwent percutaneous renal biopsies were analysed. According to the CDC classification, 44 patients were staged in group IV, five in group III, and 11 in group II. Patients were divided in two groups according to their ethnic origin (29 black patients and 31 white patients). Risk factors such as homosexuality, multiple transfusions or intravenous drug abuse (IVDA) were identified in all white patients except two, but in only nine (31%) of the black patients. Three main patterns of renal disease were observed: focal and segmental glomerulosclerosis (FSGS) was found predominantly in black patients (23 black patients versus 3 Caucasians, P < 0.001) and was associated with the nephrotic syndrome; immune-complex-type glomerulonephritis (ICGN) was frequent in black and white patients (21% and 52% respectively) including four cases of IgA nephritis all seen in white patients; and 10 cases of lupus-like nephritis (4 black and 6 white patients). The frequent hypergammaglobulinaemia in those patients suggests a pathogenic role of polyclonal B cell activation in ICGN. Interstitial nephritis was present in 48 and 52% of the black and white patients respectively and did not seem related to drug toxicity or superimposed infectious disease. In addition to interstitial nephritis, the coexistence of multivisceral lymphocytic infiltration involving accessory salivary glands, liver and/or lung, found in six patients possibly suggests a virus-induced immune disorder.

AIDS-Associated Nephropathy↗
PubMed1993

Proton nuclear magnetic resonance spectroscopy of urine and plasma in renal transplantation follow-up.

Urine and plasma samples from 39 patients who underwent renal transplantation were analyzed by proton nuclear magnetic resonance (NMR) spectroscopy. The most relevant resonances for evaluating renal function after transplantation were those arising from citrate, trimethylamine-N-oxide (TMAO), alanine, and lactate when compared to creatinine. A resonance at 3.7 ppm was related to cyclosporine toxicity when associated with elevated levels of TMAO. The respective variations in these metabolites in urine could contribute to prognosis and diagnosis of renal function impairment related to cyclosporine toxicity or overdosage, or to rejection. Thus, NMR spectroscopy should improve the follow-up and management of renal transplantation patients.

Alanine↗
PubMed1991

[Emphysematous pyelonephritis associated to urogenital tuberculosis].

Emphysematous pyelonephritis is a rare condition which in most cases occurs as a result of Escherichia coli infection of the urinary tract in patients known as being diabetic. The gas-filled abscesses carry a high mortality rate, especially when the antibiotic treatment is not combined with early surgery. We report a case where the failure of medical treatment led to curative nephrectomy. Unusually, diabetes was revealed by the pyelonephritis. Another particularity of this case was that the emphysematous pyelonephritis was associated with genitourinary tuberculosis. This association, of which no other example could be found in the literature, is discussed.

Adult↗
PubMed1991

Recurrence of Fabry's disease in a renal allograft eleven years after successful renal transplantation.

A case of Fabry's disease in a renal transplant recipient with a follow-up period of 11 years is reported. The patient suffered from renal, skin, peripheral nerve lesions, and asymptomatic cardiomegaly. Fabry's disease symptoms disappeared after transplantation. Improvement of renal function was rapidly observed, and it remained satisfactory during the whole posttransplantation period. The patient died of a severe, uncontrolled infection and of biliary peritonitis. Autopsy showed a polyvisceral accumulation of sphingolipids deposits. The engrafted kidney was histologically free of disease. Ultrastructurally, it revealed numerous sphingolipid inclusions in the endothelial cells of capillaries. The explanation of this complication could be attributed to: (1) high circulating levels of plasma substrates locally overwhelming the enzymatic capability of the graft endothelial cells; and (2) the endothelial cells originated from the recipient but not from the donor, an occurrence that has been described after transplantation. Rejection and the newly formed deposits in the endothelial cells may lead to the loss of the engrafted organ. As a consequence of the increasing possibility of organ transplantation, this complication should be detected by studying the blood vessels ultrastructurally in order to evaluate the condition of the transplant.

Adolescent↗
PubMed1990

Granzyme B-gene expression: a marker of human lymphocytes "activated" in vitro or in renal allografts.

Human killer cells contain cytoplasmic granules in which serine esterases, or granzymes, and perforin have been identified. We have studied the induction of granzyme B-gene expression in peripheral blood lymphocytes and large granular lymphocytes activated by various stimuli in vitro as well as in cellular infiltrates at the site of renal allografts in patients with and without rejection. Using in situ hybridization, kinetic experiments have shown that granzyme B mRNA is an early marker of in vitro cell activation. Data obtained in vivo also indicate the presence of granzyme B mRNA-bearing cells, which argues in favor of the induction of granzyme B gene in cells activated in vivo.

Gene Expression Regulation, Enzymologic↗
PubMed1990

[Emphysematous pyelonephritis. Apropos of a case].

Emphysematous pyelonephritis is a rare form of pyelonephritis that carries a very poor prognosis. This article reports a review of the literature on this condition and describes the clinical and roentgenographic criteria for diagnosis. Diagnosis rests on the presence of clinical manifestations of pyelonephritis with intrarenal air-filled images on the roentgenograms. Both the author's personal experience and the data from the literature confirm the need for urgent treatment combining antimicrobial agents effective against Escherichia coli, the most common causative agent, and surgery, which usually consists in a nephrectomy.

Emphysema↗