[Association of renal microaneurysms and nephroangiosclerosis].
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Acute Kidney Injury↗
Biomedical subjects
J Levi
Publications and source records attributed to J Levi.
Effect of bicarbonate feeding on intestinal absorption of calcium and vitamin D metabolism in rats.
The effect of bicarbonate (NaHCO3) feeding on intestinal absorption of calcium and phosphorus and vitamin D metabolism was investigated. Gut sac uptake of 45Ca and [32P]phosphate in vitro, as well as the plasma level of vitamin D metabolites, was determined in rats fed with NaHCO3 for 9 days and their pair-fed controls. Duodenal uptake of 45Ca and [32P]phosphate by alkalotic rats was less than duodenal uptake by controls. 1,25(OH)2D plasma level was much higher in alkalotic rats than in their controls, and 25(OH)D slightly higher than in controls. These data suggest that NaHCO3 feeding causes a substantial increase in 1,25(OH)2D plasma level, but interferes with calcium and phosphorus absorption in the duodenum.
24,25-Dihydroxyvitamin D 3↗
Campylobacter pyloridis in peptic ulcer disease: microbiology, pathology, and scanning electron microscopy.
After the recent successful isolation of spiral organisms from the stomach this paper presents the bacteriological and pathological correlation of gastric antral biopsies from 51 patients endoscopied for upper gastrointestinal symptoms. Campylobacter pyloridis was cultured from 29 patients and seen by either silver staining of the biopsy or scanning electron microscopy in an additional three. The organism was cultured from 23 of the 33 (69%) patients with peptic ulcer disease and from within this group 17 (80%) of the 21 patients with duodenal ulceration. It was cultured only once from the 12 normal biopsies in the series but from 27 of the 38 (71%) biopsies showing gastritis. C pyloridis was also cultured from five out of seven of the 14 endoscopically normal patients, who despite this had biopsy evidence of gastritis. It was the sole organism cultured from 65% of the positive biopsies and scanning electron microscopy invariably revealed it deep to the surface mucus layer. C pyloridis persisted in the three patients with duodenal ulcers after treatment and healing. The findings support the hypothesis that C pyloridis is aetiologically related to gastritis and peptic ulceration though its precise role still remains to be defined.
Campylobacter↗
Intraocular pressure in uremic patients on chronic hemodialysis.
Intraocular pressure (IOP) was measured before and after hemodialysis in 30 uremic patients receiving regular treatment. Osmolality, blood pressure and weight before and after dialysis were also determined. Low IOP of 11.4 +/- 2.7 and 11.5 +/- 3.1 mm Hg was found in the left and right eye, respectively. Following hemodialysis osmolality, blood pressure and body weight decreased significantly but IOP did not rise significantly. This study suggests that there is only a remote possibility for severe IOP increase following hemodialysis in uremic patients on chronic treatment.
Adolescent↗
Sialic acid content of erythrocytes in uremic patients. Correlation with the age distribution of erythrocytes as assessed by glutamic oxaloacetic transaminase determination.
In a previous study we suggested that an enrichment in young red blood cells (RBC) should occur in the erythrocyte population of uremic-anemic patients. This change in RBC age distribution together with the fact that young cells were reported to be richer in sialic acid would provide an explanation for the observed lack of difference in sialic acid content between patients' and controls' whole erythrocyte populations in spite of an increased neuraminidase activity found to be present in patients' serum. To verify this assumption glutamic oxaloacetic transaminase (GOT) activity, which is an erythrocyte age index, and sialic acid were determined in low and high density fractions separated by centrifugation of packed cells representing young and old RBC, respectively, from two groups of 8 individuals with chronic renal failure and two groups of controls. GOT was determined also in whole erythrocyte populations. Mean GOT activity was significantly higher in the young fractions compared to the old of both patients' and control RBC (14.9 vs. 7.8 and 12.4 vs. 7.5 IU/g Hb). Activity of the whole RBC population was significantly higher in uremics as compared to controls (11.7 vs. 5.6 IU/g Hb) which is compatible with a lower median erythrocyte age. Mean sialic acid was higher in the young fractions as compared to the old (42.7 vs. 35.3 nmol/10(9) cells in controls and 48.9 vs. 43.0 nmol/10(9) cells in patients). These differences together with an enrichment in young cells would compensate for the eventual loss of sialic acid in the whole population resulting from an increased neuraminidase-like activity in patients' serum.
Aspartate Aminotransferases↗
Effect of hyperparathyroidism on cardiac function in patients with end-stage renal disease.
Heart studies were carried out in 7 patients with end-stage renal disease (ESRD) who underwent parathyroidectomy for secondary hyperparathyroidism. The studies, which included echocardiography and equilibrium radionuclide angiography (ERNA), were performed prior to parathyroidectomy and 2 weeks, 3 months, and 6 months following it, on a nondialytic day. Heart rate decreased from 89.3 +/- 1.3 to 81.4 +/- 1.5 min-1 (p less than 0.001) following parathyroidectomy and returned to the initial level at 3- and 6-month examination. Cardiac output decreased from 3170 +/- 68 to 2943 +/- 57 ml/min (p less than 0.01) following parathyroidectomy and returned to basal level on 3 and 6-month determinations. End-diastolic dimension (EDD), end-systolic dimension (ESD), septal and posterior wall thickness and shortening fraction (SF) as measured by echocardiography were normal prior to parathyroidectomy and remained unchanged following it. Left ventricular ejection fraction (LVEF), end-diastolic and end-systolic volumes measured by ERNA did not change following parathyroidectomy. This study suggests that hyperparathyroidism has little effect on cardiac performance and, except for a short-lived decrease in heart rate and cardiac output, parathyroidectomy does not affect cardiac performance when performed in patients with preoperatively normal cardiac output.
Adult↗
Platelet X-ray microanalysis in patients with chronic renal failure.
The platelet element content was determined by semiquantitative X-ray microanalysis in 6 patients with chronic renal failure. The patients showed a different degree of thrombocytopathy expressed by impaired adhesiveness, epinephrine-induced aggregation and platelet factor 3 availability. The microanalysis indicated significantly increased quantities of phosphorus and copper in patients' platelets. Sodium and zinc showed a decrease in about half of the patients, whereas iron was significantly increased in at least 50% of the patients. Magnesium and potassium did not show any difference from the control. The results of sulfur, chlorine and calcium did not reveal a consistent pattern.
Arachidonic Acid↗
Subcellular fractionation of rectal biopsy homogenates from patients with inflammatory bowel disease.
Rectal biopsy specimens from control subjects and from patients with Crohn's colitis, non-rectal Crohn's disease, and acute ulcerative colitis were homogenized in isotonic sucrose and subjected to analytical subcellular fractionation by sucrose density gradient centrifugation. The gradient fractions and tissue homogenates were assayed for marker enzymes for the principal organelles: 5'nucleotidase (plasma membrane), malate dehydrogenase (mitochondria), catalase (peroxisomes), lactate dehydrogenase (cytosol), N-acetyl-beta-glucosaminidase (lysosomes), and neutral-alpha-glucosidase (endoplasmic reticulum). In normal tissue there was a distinct plasma membrane peak at density 1.12 g/ml. In tissue from patients with Crohn's disease the activity was increased approximately twofold even when the rectum showed no evidence of histological involvement. A second plasma membrane component was noted in Crohn's disease at density 1.19 g/ml. The total activity of the mitochondrial enzyme was similar in the various patient groups, but there was evidence of mitochondrial damage. There were no significant alterations in activity and density gradient distributions of catalase or of neutral alpha-glucosidase in the various patient groups, although less membrane-bound lactate dehydrogenase was noted in the patients with inflammatory bowel disease. There was a reduction of both cytosolic and particulate N-acetyl-beta-glucosaminidase in ulcerative colitis and a selective reduction in particulate activity in non-rectal Crohn's disease, demonstrating lysosomal alterations in these disorders. These results indicate selective and specific alterations in the principal subcellular organelles, especially the plasma membrane, lysosomes, and mitochondria, in the inflammatory bowel disease.
Cell Membrane↗
Alcoholic skeletal myopathy, a clinical and pathological study.
One hundred and fifty-one inpatients with a history of chronic heavy alcohol intake were examined for evidence of muscle disease. Ninety-two patients (60 per cent) had histologically abnormal biopsies of the quadriceps muscle. The most common abnormality, which was often severe, was type II muscle fibre atrophy. Seven patients (5 per cent) had histological evidence of acute myopathy, one of whom presented with the full clinical picture of acute rhabdomyolysis. Twenty-three patients had cirrhosis, 36 were significantly malnourished and 98 had evidence of a peripheral neuropathy. None of these features, however, were sufficient to account for the muscle abnormalities. There was no clear relationship between musculo-skeletal symptoms and muscle biopsy histology. Serum creatine kinase activity was elevated in only 23 subjects and was an insensitive indicator of subclinical acute myopathy and of chronic alcoholic myopathy. Follow-up studies after abstinence from alcohol invariably showed both objective and subjective improvement of muscle function - often in the absence of any clinical recovery from the peripheral neuropathy. Continued alcohol consumption was accompanied by persistence and often deterioration of muscle fibre atrophy. It is concluded that chronic skeletal myopathy is a frequent consequence of alcohol abuse and may result from a direct toxic effect of ethanol on muscle fibres.
Acute Disease↗
Rejection-related nephrotic syndrome associated with massive antiglomerular and antitubular basement membrane deposits.
A patient with end-stage renal disease due to nephronophthisis developed nephrotic syndrome following renal transplantation. Renal biopsy revealed rejection glomerulopathy with massive linear deposition of immunoglobulin (Ig) G and complement C3 along the glomerular and tubular basement membranes. The association of nephrotic syndrome with linear deposition of Ig is rare in chronic rejection of kidney allografts. The nephrotic syndrome in this case responded to treatment with plasmapheresis.
Adolescent↗
Ben-Ari v. Shapira: contempt proceedings against mentally ill persons in the Supreme Court of Israel Civil Appeal.
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Female↗
The use of an unauthorized drug by a terminally ill person.
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Antineoplastic Agents↗
Liver granulomas: a possible paraneoplastic manifestation of hypernephroma.
A patient with hypernephroma presented with signs of liver dysfunction. Liver biopsy disclosed the presence of granulomas. Extensive search for a known cause of hepatic granulomas was negative. The presence of granulomas in lymph nodes draining the neoplasm, the improvement of liver dysfunction after nephrectomy, and its aggravation preceding overt metastatic manifestation support the existence of a cause and effect relationship between the renal cell carcinoma and the liver granulomatous disease.
Aged↗
Proteinuria and chronic renal failure associated with unilateral renal agenesis.
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Adult↗
Effect of verapamil on uremic myocardial disease in the rat.
It has been shown that calcium content of myocardium is increased in uremia and calcium overload has been implicated in the genesis of uremic myocardial disease. To determine whether verapamil (V) may prevent the development of myocardial lesions in uremic rats, the left ventricular myocardium has been examined with an electron microscope (EM) in 4 groups of Wistar male rats: 1) subtotally nephrectomized (SNX, n = 10); 2) SNX treated by V, 1.5 mg/kgx2/day (SNX-V, n = 8); 3) sham-operated (Sh, n = 5); 4) Sh treated by V (Sh-V, n = 5). EM examinations were performed after 13 weeks of uremia and V treatment. Serum urea and creatinine were similar in SNX and SNX-V rats and were higher in SNX and SNX-V than in Sh and Sh-V rats. The mitochondria of the myocardium in SNX rats showed damage of varying degree, starting from disrupted cristae to very dense mitochondrial structure with barely visible cristae. Myofibrils appeared disorganised with marked clear intermyofibrillar spaces. The myocardial ultrastructure of Sh, Sh-V and SNX-V rats was normal. It may be concluded that V seems to prevent the development of myocardial damage in the uremic rats.
Animals↗
Should cholecystography or ultrasound be the primary investigation for gallbladder disease?
The conclusions drawn from a prospective survey of 500 patients examined by cholecystography (OCG) and ultrasound (UCG) are presented. First, both procedures were found to be highly accurate in detecting calculi, with false-negative rates of 1%. Secondly, if OCG is abandoned in favour of UCG, most acalculous adenomyomatosis (and many polyps) will not be diagnosed. If acalculous as well as calculous disease is regarded as clinically important, fluoroscopic OCG is the examination of choice. However, if a clinician wishes solely to find or exclude stones the investigations are equally accurate. Thirdly, since some calculi and some acalculous disease will be missed by either technique, serious consideration should be given to the further investigation of all gallbladders considered normal by either examination. A protocol is described which, though unorthodox, enables a decision on the status of the gallbladder to be made on a single visit to the radiology department.
Administration, Oral↗
Effect of cimetidine on granulocyte-macrophage colony formation by normal and chronic renal failure bone marrow cells.
The effect of cimetidine, an antihistaminic blocker of the H2 receptors, on the development of granulocyte-macrophage colonies (GMC) was examined in vitro on bone marrow cells from healthy individuals and chronic renal failure (CRF) patients. The drug caused a dose-dependent decrease in the number of GMC from bone marrow samples in both healthy subjects and patients, being much more expressed in the latter group. The addition of urea to bone marrow cultures of healthy subjects increased the inhibition of colony formation caused by cimetidine alone. CRF or control serum added to normal bone marrow cells enhanced the colony growth which was significantly more expressed when using a CRF serum sample.
Adult↗
Neuraminidase-like activity in sera of uremic anemic patients.
A shortened life of erythrocytes in uremia has been suggested as one of the causes of anemia in this condition. Since partially desialylated erythrocytes are promptly removed from the circulation, we examined whether sera from renal failure patients would exhibit increased neuraminidase activity which could be held responsible for this phenomenon. Sera of 22 patients with end stage renal failure were examined for neuraminidase activity by assessing their effect on desialylation upon incubation at 37 degrees C for 2 and 1 h, respectively, of erythrocytes of healthy donors matched for blood group and of fetuin as substrate. As deduced from the residual content of sialic acid of erythrocytes and of the amount of sialic acid released from fetuin, the results showed a statistically higher neuraminidase-like activity of patients' sera as compared to sera of healthy individuals. It is suggested that increase in neuraminidase activity could be one of the factors involved in the mechanism of generation of anemia in uremia by acting on erythrocytes, rendering them more prone to sequestration by the liver and spleen.
Adult↗