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Biomedical subjects

L Reisman

Publications and source records attributed to L Reisman.

32 records · Page 2Linked to original sources
PubMed1989

Characteristics of social networks in adolescents with end-stage renal disease treated with renal transplantation.

In adolescents, the establishment of same- and opposite-sex nonfamily peer relations facilitates the normal development of independence and separation from family. Adolescents with end-stage renal disease (ESRD) may be particularly vulnerable to delayed social development and isolation from their peers because of the unique physical and psychosocial aspects of their illness. The characteristics of the social networks of 16 adolescents with ESRD treated with renal transplantation were studied using the Social Networks of Youth Questionnaire. Compared with a matched group of healthy adolescents, these teenagers named fewer significant others in their total social networks, as well as fewer unrelated and opposite-sex peers. Family members comprised a greater proportion of the transplant patients' networks compared to controls. Self-esteem, measured by the Coopersmith Self-Esteem Scale, was similar for transplant and control groups, with the exception of home self-esteem, which was higher in the chronically ill adolescents. Body image was somewhat lower, but not significantly, in adolescents with ESRD. The characteristics of the chronically ill adolescents' social networks suggest that these patients may experience a degree of social isolation. Interventions that promote increased peer contacts and enhance interpersonal skills should be included in the psychosocial management of adolescents with ESRD after renal transplantation.

Acute Disease↗
PubMed1988

Immunopharmacodynamic profiles in children with renal allografts receiving cyclosporine therapy.

Eleven renal transplant patients between the ages of 4 and 19 years, on a single daily oral dose of cyclosporine (CsA) and either a low oral dose or no dose of prednisone, had venous blood drawn at periodic intervals throughout a 24-hour period. CsA levels were measured by whole blood radioimmunoassay. All the patients had similar patterns of CsA pharmacokinetics with a single peak blood level at two to eight hours after the drug was given. Plasmas separated from the bloods at 37 degrees C were added to third party mixed lymphocyte reactions (MLR). The kinetics of suppression of the MLR by serial plasmas did not follow the CsA levels. Instead, we observed patterns of suppression similar to those that have been described in adults. Five patients had pattern I with two peaks of plasma-mediated MLR suppression, and had no rejection episodes. Two of the patients had pattern II with only one peak of MLR suppression, and both had episodes of acute rejection. One patient showed pattern III with a pleateau of MLR suppression, and has had no rejection episodes and no obvious CsA toxicity. Three patients showed pattern IV with a continuously low level of plasma-mediated MLR suppression throughout the day, and two of them have had severe rejection episodes. Immunopharmacodynamic profiling (IP) may prove to be useful in individualizing therapeutic regimens for patients with renal allografts treated with CsA.

Adolescent↗
PubMed1986

Immune complex glomerulopathy in a child with food hypersensitivity.

This report describes the occurrence of immune complex glomerulonephritis in a patient with eosinophilic gastroenteritis and food hypersensitivity. A coincident allergen injection may have been a contributing factor in the sudden development of the nephrotic syndrome. Markedly elevated levels of circulating immune complexes (greater than 6400 mg/dl) were found containing kappa-casein and bovine serum albumin (BSA), the latter predominating. Markedly elevated serum BSA hemagglutinating titers were also present (1:40,960). Cross-reacting precipitating antibodies to BSA, beef, and pork were demonstrated, but not to flounder or ovalbumin. Renal biopsy revealed immune complex glomerulonephritis with BSA, immunoglobulins M and G and complement deposited focally in the glomerular basement membrane. With strict dietary limitation of identified causative antigens and prednisone therapy, CIC levels decreased to 16,000 micrograms/dl and serum BSA antibody hemagglutinating titer fell 32-fold over a period of 15 months. There was prompt symptomatic relief and amelioration of signs of nephritis. The patient was able to consume a diet normal in protein and caloric content, and statural catch-up growth occurred. Recognition of food antigens to which the patient was hypersensitive provided a rationale for the relief of the gastrointestinal disturbance, growth stunting, and renal disease.

Adolescent↗
PubMed1978

Structure, function, and long-term maintenance of the isolated turtle colon.

We describe the 5-day maintenance of sacs of turtle colonic mucosa in enriched bathing solutions. The mean maximum transepithelial potential difference (PD) developed by the sacs in Ringer solution enriched with tissue-culture medium and gassed with 95% air-5% CO2 was 126 mV at 24 hours. Lower values were observed in other solutions. The PD of 24-hour sacs was partially or totally inhibited by ouabain, replacement of Na by choline in mucosal bathing fluids, or removal of Ca from serosal bathing fluids. The sacs transported Na in excess of H2O forming a dilute mucosal solution. The response of four different sac preparations (normally oriented or everted, and stripped normally oriented or everted) to long incubation were compared. Stripped normally oriented tissue developed the highest PD and maintained the lowest water content. The morphology of fresh and long-incubated tissue was examined. This investigation demonstrates that the turtle colon can be maintained in vitro for long periods, and it provides information on the morphology and physiology of this tissue.

Animals↗
PubMedDate not supplied

Cellular and humoral mechanisms in the pathogenesis of tubulointerstitial nephritis.

Brown-Norway (BN) rats immunized with renal medulla from Sprague-Dawley (SD) rats developed a renal lesion characterized by focal interstitial and perivascular mononuclear cell infiltrates without glomerular involvement. The cellular infiltrates were extracted from the affected kidneys and determined to consist of monocytes 64 +/- 4% (mean +/- S.D.) and T cells 2 +/- 9%. IgG antibodies directed at tubular basement membrane and tubular cell antigens were found in the affected kidneys and in circulation. Sera of immunized rats were used in in vitro studies to determine the presence of antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). In the CDC there was cytolysis of SD kidney and spleen cells but not BN kidney cells. In the ADCC there was significant lysis of BN kidney cells as well as SD kidney cells. Antibodies have been raised in the immunized rats against major histocompatibility (MHC) antigens as well as against autologous tubular cells. The finding of monocytes bearing Fc receptors among the infiltrating cells, as well as antibodies that can function in an ADCC indicates the presence of a combined immune effector mechanism that might be operative in tubulointerstitial nephritis.

Animals↗
PubMedDate not supplied

Renal biopsy: why and when.

The purpose of this paper is to emphasize the importance of information obtained by renal biopsy in the diagnosis, prognosis, and therapy of patients with renal disease. Because controversy persists regarding the value of renal biopsy as an aid in determining prognosis and in choosing appropriate therapy, there has been some reluctance to use it early after the onset of obvious signs, symptoms, and laboratory findings indicative of renal disease with or without involvement of other organs. Although all such patients may not benefit from the information provided by a proper biopsy, we will illustrate some of the characteristic histologic details found in specific circumstances in our experience where the biopsy has been particularly helpful in reaching a diagnosis, in assessing prognosis, and in choosing therapy.

Adult↗