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Biomedical subjects

J V Nally

Publications and source records attributed to J V Nally.

8 recordsLinked to original sources
PubMed1992

Hypoechoic renal pyramids: sonographic visualization in older children and young adults.

The frequency and degree of visualization of medullary pyramids in a normal population, aged 10-29 years, was analyzed. Hypoechoic pyramids were visualized in 42% of right kidneys in subjects aged 10-18 years and in 27% of subjects aged 19-29 years. Prominently hypoechoic pyramids, mimicking the appearance of neonatal kidneys, were seen in an additional 34% of subjects aged 10-18 years and in 16% aged 19-29 years. Prominent pyramids were present in 50% of subjects with renal cortical echogenicity (RCE) equal to liver, but also in 21% of subjects with RCE less than liver. Our study expands the age at which prominently hypoechoic medullary pyramids can be considered a normal finding. This may relate to recent improvements in ultrasound technology.

Adolescent↗
PubMed1992

State-of-the-art review: captopril renography--pathophysiological considerations and clinical observations.

Advances in renal angiography and revascularization techniques have renewed interest in developing a better noninvasive screening test for identifying patients with potentially correctable renovascular hypertension. Captopril renography is a promising diagnostic tool in the evaluation of the hypertensive patient. This review highlights the important pathophysiological changes in renal hemodynamics and humoral response attributable to significant renal artery stenosis, and underscores the dramatic effects of angiotensin-converting enzyme inhibition on the renovascular bed. The review also summarizes the available clinical information in captopril renography, and presents consensus recommendations on appropriate patient selection, radionuclide(s) of choice, and suggested diagnostic criteria.

Captopril↗
PubMed1992

Studies on the afferent and efferent renal nerves following autotransplantation of the canine kidney.

The presence of both afferent and efferent renal nerves following renal transplantation was investigated in a canine autotransplant model. The efferent postganglionic sympathetic renal nerves were studied using the glyoxylic acid histofluorescence technique to identify renal tissue adrenergic amines (Grade 0-4). The afferent sensory renal nerves were studied by the systemic blood pressure response to renal arterial injection of capsaicin. In 8 control dogs with native innervated kidneys (Group I), intrarenal injection of capsaicin significantly increased the systemic blood pressure from baseline by 32.4 +/- 6.3 mm. Hg (p less than 0.01). This response was equivalent to the blood pressure increase following injection of capsaicin into the mesenteric artery which was 37.3 +/- 9.8 mm. Hg. The renal tissue histofluorescence grade in this group was 4. Six dogs were studied two to three weeks after autotransplantation of a solitary kidney (Group II). Intrarenal injection of capsaicin did not increase the systemic blood pressure in these animals. Three dogs in this group had no evidence of renal tissue adrenergic amines by histofluorescence (Grade 0); the remaining two animals had renal tissue histofluorescence grades of 1 and 2. Eight dogs were studied 12 to 35 months after autotransplantation of a solitary kidney (Group III). Intrarenal injection of capsaicin in these animals significantly increased the systemic blood pressure from baseline by 10 +/- 1.4 mm. Hg (p less than 0.001). The renal tissue histofluorescence grade in this group ranged from 1 to 3. These data support the presence of both afferent and efferent renal nerves in the kidney at greater than or equal to one year post-transplant.

Animals↗
PubMed1992

Transplant renal artery stenosis in a canine model: evaluation of hemodynamic changes, renal function, and captopril renography.

The utility of captopril renography in the diagnosis of renal artery stenosis was examined in a canine model of renal autotransplantation with and without renal artery clipping. Autotransplantation of the left kidney to the right iliac fossa with contralateral nephrectomy was done in female mongrel dogs. One group served as controls (n = 6). A second group underwent constriction of the external diameter of the renal artery at the time of the operation to produce renal artery stenosis (n = 7). At two weeks postoperatively, glomerular filtration rate was significantly lower in the renal artery stenosis group (26.2 +/- 3.4 ml./min. vs. 38.2 +/- 3.2 ml./min., p less than 0.05), and deteriorated further after captopril administration (17.9 +/- 2.7 ml./min. vs. 26.2 +/- 3.4 ml./min., p less than 0.05). Despite the presence of hemodynamically significant renal artery stenosis, mean arterial pressure was not different between the two groups (134 +/- 4 mm. Hg vs. 132 +/- 6 mm. Hg, control vs. renal artery stenosis, p = NS). Captopril renography did not enable detection of renal artery stenosis in this autotransplant model.

Animals↗
PubMed1992

Pseudo-gamma heavy chain (IgG4 lambda) deposition disease.

Two patients with Ig deposition disease presented with acute renal failure, moderate proteinuria, and hematuria. A plasmacytoid lymphocytic infiltrate was identified in bone marrow that produced IgG4 lambda and free lambda light chains. One patient developed an anaplastic plasmacytoma (secreting only lambda light chains) 1 yr after renal biopsy. Renal biopsy in both patients demonstrated a nodular intercapillary glomerulopathy and electron dense granular deposits, associated with a linear pattern of IgG4 heavy chain deposition in vascular, tubular, and glomerular basement membranes (VBM, TBM, and GBM). In one patient this entrapped IgG4 was unassociated with detectable kappa or lambda light chains. In the second patient, lambda light chains (1+) were detected only in the GBM, but IgG4 (4+) was identified in GBM/TBM. Neither circulating (peripheral blood and bone marrow serum) nor cellular free gamma chains were present. We propose the term "pseudo-gamma heavy chain deposition disease" for the process.

Aged↗
PubMed1991

Renal physiology of renal artery stenosis. Implications for captopril-stimulated renography.

Captopril-stimulated renography is emerging as a useful diagnostic tool for the evaluation of the hypertensive patient suspected of having renovascular hypertension (RVHT). This overview focuses upon the alterations in renal hemodynamics and function induced by renal artery stenosis (RAS) and reviews the effects of angiotensin-converting enzyme (ACE) inhibition upon blood pressure and kidney function in the various experimental models of RVHT. Understanding the effects of ACE inhibition upon the kidney distal to a stenosis and appreciating the potential effect of sodium balance or antihypertensive medications are crucial in anticipating the putative changes in the radionuclide studies of the renovascular bed following ACE inhibition.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1979

Acute thrombotic thrombocytopenic purpura. Another cause for hemolytic anemia and thrombocytopenia in cirrhosis.

Severe hemolytic anemia and thrombocytopenia developed in a 56-year-old man with Laennec's cirrhosis. Rather than having one or more of the expected causes for these problems associated with cirrhosis, he proved to have acute thrombotic thrombocytopenic purpura. Treatment with platelet antiaggregant drugs and exchange plasmapheresis was ineffective in controlling the disease. The presence of advanced liver disease may precipitate or complicate this unusual syndrome.

Acute Disease↗