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Biomedical subjects

J E Lewy

Publications and source records attributed to J E Lewy.

At least 55 records · Page 3Linked to original sources
PubMed1976

Micropuncture study of fluid transfer in aminonucleoside nephrosis in the rat.

The relationship between glomerular filtration rate and proximal tubular fluid reabsorption was evaluated in control rats and in rats 96 and 144 hr after the injection of an aminonucleoside of puromycin. Urine volume and sodium excretion were decreased in the rats injected with aminonucleoside. Proteinuria increased progressively. Total kidney glomerular filtration rate (GFR) was diminished less than surface nephron GFR at 96 hr and greater than single nephron GFR at 144 hr after injection when a large proportion of nephrons are nonfunctional. Clearance of p-aminohippurate was unchanged initially and depressed subsequently after aminonucleoside injection. Absolute reabsorption to the end of the proximal convolution was unaltered despite a decrease in total kidney filtration fraction. This decrease in GFR coupled with unchanged absolute reabsorption and hence increased fractional proximal reabsorption leads to decreased delivery of sodium and fluid to the more distal portions of the nephron.

Absorption↗
PubMed1975

Growth in children with renal failure.

Chronic renal insufficiency in childhood is often associated with growth delay. Undernutrition, osteodystrophy and diminished somatomedin levels appear to be importantly related to this growth delay. In many but not all children with renal failure and growth retardation, somatomedin levels are diminished, growth hormone levels are normal or elevated, and glucose tolerance is often abnormal. Following renal transplantation, growth restoration appears to be related to bone age, renal function, somatomedin and steroid therapy.

Bone Development↗
PubMed1975

Nephrosonography in the evaluation of renal failure and masses in infants.

The diagnostic accuracy of nephrosonography is compared with conventional radiologic techniques and surgical findings in 13 infants aged 1 day to 14 months, who were in renal failure or had abdominal masses. Ten of the 13 infants presented with marked renal failure and in half of them neither kidneys nor collecting systems were visualized on the first intravenous pyelogram. Normal renal architecture was demonstrated by nephrosonography in three, hypoplastic kidneys in three, hydronephrosis in three, and a combination of hydronephrosis and contralateral multicystic kidney in one. In the three infants without renal failure, only one kidney was demonstrated by IVP; The cystic contralateral kidney in each of them was demonstrated by nephrosonography. In all cases the diagnosis was confirmed by conventional radiologic techniques when renal function had improved or by surgical exploration. This technique appears to be a useful adjunct to conventional radiography in the differential diagnosis of the infant with abnormalities of the urinary tract. Nephrosonography is of especial value when a kidney is not visualized by IVP, and it may appropriately aid in therapeutic decisions regarding the use of invasive procedures in small critically ill infants.

Diagnosis, Differential↗
PubMed1974

Kidney transplantation: Improvement in patient and graft survival.

Patient and graft survival were reviewed in a series of 249 kidney transplants done from 1963 to March 1973. Patient survival was calculated by the life table method for the periods 1963-1970, and 1970-1973, since in 1970 a formal Kidney Center was established and mortality rates changed. Graft survival was analyzed in terms of donor source, HL-A matching and immune responsiveness to HL-A antigens. Three-year predicted mortality for cadaver kidney recipients was 62% between 1963 and 1969 (42 patients) and 8% between 1970 anid 1973 (67 patients). Similar predicted mortality for related living donors was 30% between 1963 and 1969 (52 patients) and 14% between 1970 and 1973 (85 patients). Mortality has continued to decrease and there has been only one death in the last 87 consecutive transplants, including 57 consecutive cadaver transplants. Oneyear predicted kidney survival for the 10-year period is 44% for cadaveric, 60% for non HL-A identical related living and 90% for HL-A identical sibling donors. In the cadaver group, those sharing 2 or more HL-A antigens had the same kidney survival as the non HL-A identical related living donor grafts. Since cadaver graft recipients are on dialysis for a longer period of time, immune responsiveness can be detected by their response to blood transfusions, whereas this determination could not be made in our related living donor group. Non-responsive cadaver kidney recipients had 80% one year kidney survival. We conclude that transplant mortality can be reduced to less than 10% by the Center approach to treatment of renal disease, dialysis does not adversely affect future transplantation, and excellent (80%) kidney survival can be expected in properly selected cadaver graft recipients.

Blood Transfusion↗