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Biomedical subjects

J S Fennell

Publications and source records attributed to J S Fennell.

9 recordsLinked to original sources
PubMed1991

Effect of cyclosporin on immune complex deposition in murine glomerulonephritis.

Chronic glomerulonephritis (GN) was induced in N/M mice by daily injections of human serum albumin (HSA). The glomerular lesion was similar to that observed in human membranous GN and was characterized by intense mesangial and capillary loop immunofluorescent staining for HSA, IgG and C3. Electron microscopic examination revealed numerous electron-dense deposits in the mesangium and along the subepithelial side of the glomerular basement membrane, the latter deposits being associated with membranous spikes. Chronically injected mice that had been treated with cyclosporin (CsA) from Day 1 had different patterns of immune complex deposition. Mesangial deposition was apparently unaltered but no subepithelial deposits or spikes were evident. In addition, only two out of 21 HSA-injected mice which began CsA treatment on Day 21 had subepithelial deposits. There was no significant difference in serum levels of HSA-specific IgG between the three groups of mice. CsA treatment would therefore appear to ameliorate the immunopathology of antigen-induced glomerulonephritis in this model without affecting serum antibody levels, and may be of therapeutic value in the treatment of human membranous GN.

Animals↗
PubMed1982

Pathologic changes in the renal tubule in systemic lupus erythematosus.

Interstitial nephritis may be prominent morphologic feature in systemic lupus erythematosus (SLE), but there are limited data relating the pathologic findings to renal function impairment. We studied 69 biopsy specimens from 55 patients by light, fluorescence, and electron microscopy and compared the results with the serum creatinine levels. The relative interstitial volume, a measure of tubular damage and interstitial expansion, was the only morphologic feature that correlated well with renal function (serum creatinine level). Fifty-nine per cent of the biopsy specimens studied by fluorescence microscopy and 31 per cent of the biopsy specimens studied by electron microscopy had extraglomerular deposits. Ultrastructural studies determined that the sites of the deposits were the tubular basal lamina in five cases, the peritubular capillaries in four, and both in 12. In addition, the deposits were irregularly deposited along the nephron, with examples of isolated proximal and distal tubular involvement. Ultrastructural changes in the tubular basal lamina were interpreted as reparative responses to injury. Tubular pathologic features included reduplicated basal lamina and the apparent incorporation of electron-dense deposits and cellular debris. These data support the concept of a role for immune deposits in the pathogenesis of the tubulointerstitial lesion in SLE.

Creatinine↗
PubMed1981

Streptozotocin nephrotoxicity: studies on the defect in renal tubular acidification.

A 64-year-old man developed hyperchloremic acidosis while being treated with streptozotocin for an unresectable hepatoma. Studies done during acid and alkali loading suggested that the defect in urinary acidification resided in the proximal tubule and thus represented a Type II or proximal renal tubular acidosis (RTA).

Acidosis, Renal Tubular↗
PubMed1978

Sub-acute thyroiditis and hepatitis in a case of infectious mononucleosis.

A viral aetiology for sub-acute (de Quervain's) thyroiditis has long been postulated although proof has been elusive. Infectious mononucleosis has been associated with sub-acute thyroiditis in only two papers, and histological evidence of sub-acute thyroiditis was lacking in both. A case of sub-acute thyroiditis, confirmed by histology, occurring in a patient with infectious mononucleosis is now reported.

Adult↗
PubMedDate not supplied

Dissatisfaction with Do Not Attempt Resuscitation Orders: A nationwide study of Irish consultant physician practices.

The legal/ethical status of Do Not Attempt Resuscitation (DNAR) orders in Ireland has not been clarified, nor have national policies been formulated. We questioned 298 consultant physicians in the Republic of Ireland about DNAR orders. 173 replies were received (58%). 85 expressed unsatisfactory understanding of issues relating to Irish DNAR orders (49%). 116 physicians felt that alert patients preferred not to discuss their own resuscitation (67%). 55 physicians felt that if a competent adult patient is the subject of a DNAR order without the patient's knowledge, the reasons for this decision are "almost never" documented in the patient's medical record (32%). 75 consultants "almost never" had advance discussion of resuscitation preferences with the patient (43%). 47 physicians had experienced advance directives for Irish patients (27%). 102 physicians felt that both they and the patient's next of kin had joint responsibility for deciding resuscitation status for an incapacitated patient with no advance directive (59%). 37 respondents described a formal resuscitation policy in their place of work (21%). We feel that physicians require greater national guidance regarding DNAR order-making, and we advocate more widespread use of resuscitation policies.

Advance Directives↗