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Biomedical subjects

G Elinder

Publications and source records attributed to G Elinder.

At least 73 records · Page 4Linked to original sources
PubMed1986

Immunological effects of intravenous gammaglobulin treatment in childhood idiopathic thrombocytopenic purpura.

The effects of high-dose intravenous IgG treatment on circulating and bound platelet antibodies, immunoglobulin synthesis and lymphocyte subpopulations were studied in children with idiopathic thrombocytopenic purpura (ITP). The levels of circulating IgM platelet antibodies increased in 3 patients and remained unaffected in 9 others after treatment. Platelet-associated IgM levels decreased in all patients, while platelet-associated IgG decreased in 10 out of 12 patients. The spontaneous non-specific immunoglobulin synthesis by peripheral lymphocytes determined with a protein-A plaque assay was rather increased than suppressed. There was no consistent effect on the frequency of surface immunoglobulin-positive lymphocytes (B cells), although an increase was seen after treatment in 5 out of 8 patients, due to an increased number of surface IgM-positive cells. The frequencies of T cells and T cell subpopulations determined with the help of monoclonal antisera (OKT 3, 4, 8) were not affected. No major side effects were observed and serum transaminase levels were normal during and after the treatment. It is suggested that the short-term effect of IgG treatment in ITP is not due to an immunomodulating or suppressive action. It might, in some patients, be due to interaction of the IgG with antibody or immune complex binding to platelets.

Adolescent↗
PubMed1986

A comparative study of size and function of the remnant kidney in patients nephrectomized in childhood for Wilms' tumor and hydronephrosis.

To obtain more information about the natural history of compensatory renal hypertrophy beginning in childhood we traced those who were nephrectomized in childhood for Wilm's tumor (W) and hydronephrosis (Hn) between 1950 and 1978 at one department of surgery in Stockholm. All W patients had received treatment that suppresses cellular division. None of the patients were in renal failure or treated with antihypertensive drugs. All the patients in the follow-up study (22 W, 15 Hn) had a normal contralateral kidney at nephrectomy. Five healthy adults served as controls. The kidney was enlarged in both Hn (142%) and W (125%), but significantly larger in Hn than in W. Renal compensatory growth in W was retarded during the first two years after nephrectomy. The glomerular filtration rate (GFR) was 92% of control in Hn and 82% of control in W. The GFR did not seem to decline with a longer follow-up time in any of the groups. PAH clearance was the same in Hn and W. Albumin excretion was significantly higher in Hn than in W, but not significantly higher in W than in controls. The highest albumin excretion rates were found among the Hn patients with long follow-up time. The results suggest that the large increases in size and function that follow childhood nephrectomy can be blunted by antimitotic agents.

Adolescent↗
PubMed1985

Effect of Uristop on primary nocturnal enuresis. A prospective randomized double-blind study.

Primary nocturnal enuresis (PNE) is a very common problem in pediatric and child psychiatric practice. Many treatments have been tried, but none has proved entirely successful. Uristop, a commercially available alarm device based on a theory somewhat different from those used in the common alarm devices, was tried in a prospective randomized double-blind study. Of 134 enuretic children who were examined on an out-patient ward, 53 were selected for inclusion in this study on the basis of certain criteria. The children were randomized either in a treatment group with a functioning device, or in a control group with a non-functioning device. They used their devices for 6 weeks and were followed for an additional 12 weeks. The sex, age, history of previous urinary tract infection (UTI) or treatment of PNE and a family history of PNE were compared between the groups and no statistical differences were found. In the control group, however, there was significantly more often a history of upsetting life events and previous child psychiatric contact. This difference was not considered as having any effect on the results. The results showed that the device had no effect on the study group as compared with the control group. However, both groups improved significantly as compared with the expected sponaneous cessation of bedwetting.

Child↗
PubMed1984

Pathophysiological changes in rat kidneys with partial ureteral obstruction since infancy.

A partial ureteral obstruction (PUO) was created in 5-day-old rats by implanting the left ureter in the psoas muscle. The surgical technique was modified to produce mild or severe hydronephrosis [Hn (m) and Hn (s)]. The rats were studied at ages between 45 and 65 days with regard to kidney weight, number of functioning glomeruli, mean arterial blood pressure (MAP), total glomerular filtration rate (GFR), nephron filtration rate (SNGFR), tubular free-flow pressure (PT, and stop-flow pressure (SFP). Total GFR was determined after the release of obstruction. The other studies were performed in the obstructed state. Reference values were obtained from sham-operated and untouched control rats. The number of functioning nephrons was depressed 38% in Hn (m) and 73% in Hn (s). Total GFR was preserved in Hn (m) and depressed 54% in Hn (s). SNGFR in the remaining nephrons was significantly elevated in Hn (m) and normal in Hn (s). SFP was significantly elevated in Hn (s). The Hn (s) rats were hypertensive. The glomerular density was lower in the hydronephrotic than in the contralateral kidneys. This suggests a compensatory growth of the remaining nephrons in the Hn kidneys. We conclude that PUO present since infancy will either destroy the nephrons or elicit an adaptive response that will tend to preserve GFR.

Aging↗
PubMed1984

Idiopathic pulmonary haemosiderosis in Swedish children.

During the 3 decades 1950-1979 onset of idiopathic pulmonary haemosiderosis occurred in 10 Swedish children. Complete records were available from the eight children with onset during 1960-1979, which indicates that the yearly risk of onset is 0.24 case per million children. The first symptoms started at the mean age of 5.8 years (range: 10 months-11 years). From the beginning all children had a severe microcytic, hypochromic, sideropenic anaemia. Pulmonary symptoms were present from the beginning in four children (but haemoptysis in only one) and developed in the remaining children after 1 1/2-2 1/2 years. Various therapeutical regimens were tried. Iron therapy seemed of temporary beneficial effect and most children seemed to benefit from prednisone therapy during disease bouts, although the effect of the therapy in the long run could not be determined. The four children with onsets during the 1960s died of their disease after 2-13 years. The four children with onset during the 1970s are still alive. One of them--a 20-year-old female, has for two years complete clinical remission and has normalized haematological, X-ray and pulmonary function data.

Child↗
PubMed1983

Development of glomerular filtration rate and excretion of beta 2-microglobulin in neonates during gentamicin treatment.

Ten infants of different gestational ages (GA) and postnatal ages (PNA), treated with gentamicin, were compared with 10 control patients of similar GA and PNA to evaluate the possible nephrotoxic effects of this drug. Changes in the glomerular filtration rate (GFR) and the fractional excretion of beta 2-microglobulin in urine (FE beta) were used as indicators of renal dysfunction. In the control infants there was a postnatal increase in the GFR that was higher in full-term than in preterm infants. The FE beta decreased logarithmically as a function of both the GA and the PNA. The GFR was statistically lower in 5/10 and 6/10 of the patients on the first and the last days of gentamicin treatment (GT) respectively. Three weeks after GT, 8/10 had a normal GFR. The FE beta was statistically higher in 4/10 of the patients on their first day of GT and 7/10 on their last day of GT. Three weeks after GT, 9/10 of the patients had a normal FE beta for their postnatal and gestational ages. It is concluded that GT influences filtration and proximal reabsorption in GT infants by decreasing the GFR and increasing the FE beta. However, the observed renal dysfunction seemed to be reversible.

Beta-Globulins↗
PubMed1983

Structural and functional development of the nephron.

The present review deals with structural and functional relationships during the development of the nephron. Ultrastructural morphometric technique has been used to obtain quantitative data on structural observations in order to make correlations between structure and function possible. The area of the glomerular basement membrane was found to increase by a factor 1.7 when relating the change in glomerular basement surface area to kidney weight. Furthermore it is suggested that a permeability change of the glomerular basement membrane occurs during development and that this change probably is the result of an increased area of endothelial pores and epithelial slits. The increased capacity of different nephron segments to transport Na and fluid is directly correlated to the increase in the area of the basal and lateral cell membranes as well as the amount of Na-K-ATPase. This suggests a significant contribution of these factors to the maturation of solute and fluid transport through the tubular wall.

Absorption↗
PubMed1983

Dynamics of glomerular ultrafiltration in the neonate kidney.

In the neonate kidney the glomerular filtration rate is generally depressed both in absolute terms and when calculated per gram kidney weight. Micropuncture studies have revealed that this phenomenon is due, not to changes in the driving pressures or the hydraulic conductivity of the glomerular capillary membrane, but to a retarded glomerular blood flow. A retarded flow will thus mean a steep rise in the protein concentration in parallel to the filtration of the protein-free filtrate. The corresponding steep rise of the colloid osmotic pressure will then induce cessation of the filtration in the distal parts of the glomerular capillary. In dehydrated states this phenomenon will be even more aggravated. An extracellular volume expansion with saline induces relaxation of the two arterioles with subsequent rise in the glomerular blood flow. The rise in the colloid osmotic pressure along the capillary is then less and the filtration can proceed along the whole of the glomerulus. Accordingly the glomerular filtration rate will be increased, reaching figures typical of the mature kidney.

Animals↗
PubMed1981

Postnatal development of renal function in pre-term and full-term infants.

This study has been designed to examine the effect of gestational age (GA) on the postnatal development of renal function and has been performed in pre-term (PT) infants (GA=30-34 weeks) and in full-term (FT) infants (GA=39-41 weeks). Postnatal age has ranged from 1-35 days. From 8 hour urine samples collected after spontaneous voiding and a capillary blood sample, determinations have been made of the clearance of creatinine (CCr), the fractional excretion of beta 2-microglobulin (FE beta 2) and the fractional excretion of sodium (FENa). In some infants receiving fluid parenterally, simultaneous determinations were made of the clearance of creatinine and inulin. As judged from this study, CCr is a reliable indicator of the glomerular filtration rate (GFR). GFR was almost the same in newborn PT and FT, but from 0.3--1 week of age GFR increased significantly more rapidly in FT than in PT. From 1--5 weeks of age GFR increased at approximately the same rate in PT and FT infants. The absolute value for GFR in 3--5 weeks old infants was lower in PT than in FT. FE beta 2 was higher in PT than in FT infants during the entire first month of life and FENa was higher in PT than in FT infants during the first week of life, suggesting a glomerular tubular imbalance at least at the level of the proximal tubule in PT infants. It is concluded that different stages of maturation will alter the preconditions for the renal adaptation to extrauterine life during at least the first month of life. Therefore special attention must be paid to the limited renal function in PT during their entire first month of life.

Age Factors↗
PubMed1981

Effect of isotonic volume expansion on proximal tubular reabsorption of Na and fluid in the developing rat kidney.

Young rats (aged 22-24 days) and adult rats (aged 40-42 days) were studied during hydropenia (HP) and during volume expansion (VE) in order to clarify the role of the proximal tubule of the immature kidney in the blunted natriuretic response seen in young mammals during VE. The position of the last accessible site for micropuncture of the proximal tubular segment was determined. The disadvantages of using lissamine green as a marker of different tubular segments were investigated. Tubular function was ascertained by micropuncture of superficial proximal nephrons. Measurements of tubular length were made from latex casts of the proximal tubule. No side-effects of lissamine green were detected, when small quantities were used (20-30 microliter) and at least 20 min elapsed between the infusions of the dye and tubular samplings. The last accessible proximal tubule available for micropuncture was found to be similarly located in young and adult rats. Fractional reabsorption during HP remained constant during development. An equivalent degree of VE induced an increase in tubular load in both age groups, but it was more marked among younger rats. Absolute proximal reabsorption in both young and old rats in HP paralleled that of the tubular load. Fractional reabsorption, however, decreased slightly during VE but to the same extent in both age groups. This indicates a great flexibility in the immature proximal tubular under various tubular loads although it had been thought that this part of the nephron was in the later stages of development. The results simply that the proximal tubule does not create the blunted sodium response in the immature kidney during VE.

Absorption↗
PubMed1981

Distal tubular sodium reabsorption in the developing rat kidney.

The immature kidney has a blunted natriuretic response to saline loading. to localize the high fractional Na reabsorption in the developing nephron, we determined Na delivery to the early distal tubule (EDT) and the fraction of filtered Na remaining in the tubular fluid [(TF/P)Na/In] in the EDT and late distal tubule (LDT) in 24- and 40-day-old hydropenic (HP) and volume-expanded (VE) rats. During HP the (TF/P)Na/In ratio in EDT was significantly higher in the younger rats (12.6 +/- 2.0%) than in the older rats (4.2 +/- 0.6%), but because of a lower SNGFR in the younger rats th Na delivery to EDT was the same in both age groups. The (TF/P)Na/In ratio in LDT was not different in 24- and 40-day-old HP rats (1.1 +/- 0.4 and 1.7 +/- 0.3%, respectively). During VE th (TF/P)Na/In ratio in LDT was significantly lower in 24- (3.0 +/- 0.7%) than in 40-day-old rats (8.3 +/- 1.1%). The (TF/P)Na/In ratio in LDT correlated well with the urinary fractional Na excretion. It is concluded that the Na reabsorption capacity of the developing nephron is more efficient in the distal tubule than in the more proximal tubular segments.

Aging↗
PubMed1981

Treatment of neonatal osteomyelitis with cloxacillin in combination with fusidic acid.

Four immature infants developed staphylococcal neonatal osteomyelitis. In spite of standard treatment with cloxacillin, gentamicin and surgical drainage new lesions developed in all 4 patients. Following the addition of fusidic acid no further progress was seen in any of the infants. Fusidic acid was administered intravenously for 10-14 days in a dose of 40 mg/kg/day in 2 divided doses. The therapy was well tolerated. Thoracic kyphosis in one patient was the only sequelae seen.

Cloxacillin↗
PubMed1980

Effect of isotonic volume expansion on glomerular filtration rate and renal hemodynamics in the developing rat kidney.

Young rats (20-24 days) and adult rats (40-45 days) were studied during hydropenia and volume expansion with regard to glomerular filtration rate (GFR) and the determinants of GFR. During hydropenia, GFR and renal blood flow (RBF) were significantly lower in younger than in adult rats both in absolute terms and when related to bodyweight. Equivalent degrees of volume expansion (6% of b.wt.) resulted in a much more pronounced increase in GFR and RBF in younger than in older rats. This suggests that the high renal vascular resistance in hydropenic young rats is primarily due to vasoconstriction. The relationship between the filtration rate of superficial nephrons and the total GFR was the same in hydropenic and volume expanded rats in both age groups. The tubular stop flow pressure, the calculated hydrostatic glomerular capillary pressure and ultrafiltration pressure in the afferent part of the glomerular capillaries was slightly lower in hydropenic young rats than in hydropenic adult rats. The pressures did not rise after volume expansion. It is concluded that the marked increase in GFR in volume expanded young rats is mainly due to increased renal plasma flow.

Animals↗
PubMedDate not supplied

Lipoprotein alterations and plasma lipoprotein lipase reduction in familial hemophagocytic lymphohistiocytosis.

Serum lipid abnormalities are common in familial hemophagocytic lymphohistocytosis (FHL), a disorder also characterized by fever, hepatosplenomegaly, pancytopenia and a prominent lymphohistiocytic accumulation in the mononuclear phagocyte system. The lipoprotein pattern in nine children with FHL was studied with a quantitative method measuring cholesterol and triglycerides in each major class of lipoproteins. Triglycerides were markedly elevated during active FHL in serum, very low density lipoproteins, and low density lipoproteins. Cholesterol was increased in very low density lipoproteins whereas both triglycerides and cholesterol were extremely low in high density lipoproteins. These lipoprotein abnormalities, reversible on successful therapy, are compatible with a depressed lipolytic activity. Post-heparin levels of lipoprotein lipase and hepatic lipase in plasma were studied in four children and found to be markedly low during active FHL. We suggest that inflammatory cytokines, which may strongly suppress lipoprotein lipase activity, can be important mediators in the pathophysiology of FHL and that they may participate in the development of the lipid abnormalities.

Child, Preschool↗