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Biomedical subjects

D Modai

Publications and source records attributed to D Modai.

At least 91 records · Page 5Linked to original sources

The effect of several uremic parameters on uremic serum inhibition of lymphocyte blastogenesis.

Uremic sera are known to inhibit thymidine incorporation of normal lymphocytes. The nature of the factor(s) responsible for this inhibitory effect has not been completely elucidated. In this study a possible correlation was investigated between a number of uremic blood constituents altered with the progression of the disease and the immunoinhibitory effect of the respective sera. No such correlation was found with the values of hematocrit, urea, creatinine, calcium and phosphorus. On the other hand a significant negative correlation emerged between H+ and Mg2+ ion levels and the inhibition imposed on normal lymphocyte thymidine incorporation. This apparently paradoxical result would indicate that with regard to these two parameters the greater the severity of renal failure the smaller would be the immunoinhibitory effect of the respective serum. The inhibition imposed by uremic serum on immune functions is probably a multifactorial phenomenon, in which H+ and Mg2+ might play a role antagonistic to inhibitory factors.

Adult↗

Hypercalciuric rickets: metabolic studies and pathophysiological considerations.

Extensive metabolic studies were performed in a 14-year-old boy suffering from the rare clinical entity known as childhood idiopathic hypercalciuria associated with dwarfism, renal tubular abnormalities and bone lesions. The salient features were: hyperphosphaturia with hypophosphatemia, hypercalciuria with normocalcemia, elevated serum 1,25-dihydroxycholecalciferol[1,25(OH)2D3] levels, marked intestinal hyperabsorption of calcium and phosphorus, with low serum parathyroid hormone (PTH) and urinary adenosine 3':5'-cyclic monophosphate (c-AMP). Bone biopsy confirmed the clinical and radiological diagnosis of rickets. It appears that the following pathophysiological sequence is operating: primary renal phosphate leak with hypophosphatemia, increased 1,25(OH)2D3 synthesis, enhanced intestinal calcium absorption which in turn inhibits release of PTH and c-AMP. Hypercalciuria is seen to be secondary to both avid intestinal calcium absorption and depressed PTH activity, and rickets the result of phosphate depletion. Treatment with oral phosphorus only resulted in an acceleration of growth rate, cure of rickets, and return of urinary calcium excretion to normal values.

Adolescent↗

Induction of chronic renal failure in the mouse: a new model.

An animal model with experimental uremia is an important research tool for the study of the sequence of pathophysiological events taking place in the uremic syndrome. An appreciable number of animal models and methods for the induction of chronic uremia have been published. It is surprising that no such method has been reported in the mouse, which is an important laboratory animal. A new method for the induction of chronic uremia in the mouse is described. It consists of unilateral destruction of most of the renal cortex by burns combined with contralateral nephrectomy. This method can be carried out in one or two stages. Follow-up of the experimental animals reveals that significant uremia developed within 4 weeks and remained constant for the rest of the study period, i.e. 10 weeks.

Animals↗

Levamisole circumvents inhibition of lymphocyte activation imposed by uremic serum.

Uremic serum inhibits thymidine incorporation of phytohemagglutinin-stimulated lymphocytes originating in normal individuals. In this study the effect of levamisole on such inhibition was investigated. Preincubation with a wide range of levamisole concentrations resulted in complete prevention of the inhibitory effect imposed by uremic serum on thymidine incorporation. We would like to suggest that uremic serum possibly inhibits thymidine incorporation of normal lymphocytes by imposing an abnormal cyclic GMP/cyclic AMP intracellular ratio, and that levamisole may restore this ratio to normal.

Adolescent↗

Symptomatic renal artery stenosis superimposed on chronic glomerulonephritis.

We present two patients with proved chronic glomerulonephritis who had severe refractory hypertension and chronic renal failure. In both patients normal-sized kidneys were demonstrated in addition to vascular bruits and Grade III hypertensive retinopathy. These findings raised the suspicion of an etiological condition other than chronic glomerulonephritis underlying the hypertension and renal failure. Renal angiography revealed bilateral severe renal artery stenosis. In both cases renal revascularization was followed by a drop in blood pressure to normal or near normal levels. In selected cases with severe hypertension and chronic renal failure, renal artery stenosis should be considered, despite the coexistence of chronic glomerulonephritis.

Antihypertensive Agents↗

Congenital afibrinogenemia: an unusual case.

We describe a congenitally afibrinogenemic young man who experienced massive spontaneous bleeding episodes at unusual sites, including the thigh muscles, lung and brain. Each of these life-threatening episodes raised theoretical and critical practical problems. A large local hematoma was responsible for an accelerated consumption of fibrinogen, which was relieved following evacuation. It is unusual for an afibrinogenemic patient to survive a number of potentially lethal bleeding episodes.

Adult↗

Biopsy proven evolution of post streptococcal glomerulonephritis to rapidly progressive glomerulonephritis of a post infectious type.

A 15 year old boy with chronic impetigo was admitted with severe acute oliguric renal failure requiring temporary dialytic treatment. Renal biopsy revealed typical diffuse and proliferative glomerulonephritis of the poststreptococcal type. Subsequently high temperature developed with flank pains at the biopsy site, concomitantly with deterioration of renal function. On exploration, a sterile perirenal hematoma was found and a wedge renal biopsy revealed crescentic rapidly progressive glomerulonephritis of the post infectious type. Deterioration to end stage renal failure occurred within a few months. Although universally accepted, biopsy proven evolution from diffuse proliferative and exudative glomerulonephritis to crescentic form of post streptococcal glomerulonephritis has been rarely reported.

Adolescent↗

Should acute gold overdose be invariably treated?

Acute gold overload is rare and its clinical and pathophysiological consequences are not well delineated. Consequently the therapeutic approach has not been formulated. We describe 2 patients with rheumatoid arthritis in whom an acute gold overload was inadvertently administered. Their subsequent course, without specific treatment, was benign and uneventful. We suggest that with similar cases a conservative approach of watchful expectancy be adopted.

Acute Disease↗

Infantile achalasia.

Achalasia in infancy is rare. A male infant who started to have symptoms at the age of 4 months, and who was operated at the age of 17 months is described. Post operatively the symptoms subsided and normal growth and development were regained. Achalasia should be included in the differential diagnosis of children with regurgitation, vomiting and failure to thrive.

Diagnosis, Differential↗

Breast mycobacterial infection in a haemodialysis patient.

Mycobacterial infection is relatively common among patients maintained on haemodialysis and may present in uncommon locations and acquire an unusual course. We present a patient in whom a breast mass was found to be caused by primary mycobacterial infection. This is to our knowledge the first report on breast mycobacterial infection in a haemodialysis patient.

Breast Diseases↗

Blunt abdominal trauma with unrecognized urinary tract injury.

We report three cases of serious renal injuries due to blunt abdominal trauma within the context of multiple organ trauma. The renal involvement was not initially suspected, with resulting serious consequences. We suggest that infusion pyelography be performed prior to or shortly after surgery in all cases with extensive abdominal trauma. A retroperitoneal hematoma on explorative laparotomy in cases of multiple trauma should raise the suspicion of a concomitant serious renal injury, and an immediate diagnostic investigation should be conducted.

Abdominal Injuries↗

Zinc and copper levels in plasma, erythrocytes, and whole blood in cancer patients.

Zinc and copper levels in erythrocytes, plasma, and whole blood were determined in 35 cancer patients and compared with 24 normal individuals. A decrease in zinc was found in all three blood constituents of the cancer patients. The decrease was significant in plasma and whole blood and nonsignificant in erythrocytes. Copper levels in the cancer group showed a slight and nonsignificant increase in erythrocytes, plasma, and whole blood. The copper to zinc ratio revealed a significant increase only for plasma levels. Further investigations are indicated to determine whether these two elements could serve as indicators for diagnosis or prognosis in cancer patients.

Aged↗