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Biomedical subjects

M Forland

Publications and source records attributed to M Forland.

At least 19 recordsLinked to original sources

Relationships between human blood groups, bacterial pathogens, and urinary tract infections.

Blood groups of 137 patients with acute pyelonephritis and chronic upper tract infection, cystitis, and asymptomatic bacteriuria were compared with those of a normal uninfected control population. In addition, the identified uropathogens were categorized according to the patient's blood group. There was a significant association between the diagnosis of chronic upper tract infection and blood group B as compared with controls (p = less than 0.05, chi 2). Analysis of the bacterial isolates showed that more patients with blood group B had infections with Pseudomonas sp., Klebsiella pneumoniae, and Proteus sp. than was expected; and fewer patients with blood group A had infections with Pseudomonas than predicted (p = less than 0.05, chi 2). There was an increased number of patients in blood group AB with infections caused by Escherichia coli and Klebsiella pneumoniae. These results suggest that an individual's blood group may be a significant factor in the host-response to bacterial invasion and influence the development of infection with certain gram-negative bacilli.

ABO Blood-Group System

Mannose-resistant hemagglutination and P receptor recognition of uropathogenic Escherichia coli isolated from adult patients.

Adhesions of 211 strains of uropathogenic Escherichia coli and 19 strains of normal fecal E. coli were characterized by patterns of agglutination with human erythrocytes, Saccharomyces cerevisiae, and horse erythrocytes coated with the P blood-group receptor (P). Mannose-resistant (MR) hemagglutination was significantly associated with P agglutination (P less than .001). E. coli expressing MR and/or P (MR/P) agglutinins concurrently with mannose-sensitive (MS) agglutinins predominated in all clinical categories. The highest percentage of E. coli demonstrating MR/P agglutinins, in the absence of MS agglutinins, was recovered from patients with acute pyelonephritis (35%) compared with percentages of patients with chronic pyelonephritis (13%), asymptomatic bacteriuria (16%), cystitis (11%), and normal fecal control E. coli (11%). Sixty-nine percent of E. coli isolates causing acute pyelonephritis agglutinated P-coated horse erythrocytes compared with only 11% of the fecal isolates. Strains expressing MR/P agglutinins (in the absence of MS agglutinins) isolated from patients with acute pyelonephritis, chronic pyelonephritis, and asymptomatic bacteriuria were significantly associated with the presence of antibody-coated bacteria in patients' urine sediments (P less than .010), an observation indicative of an immune response associated with bacterial invasion of host tissues.

Adhesins, Escherichia coli

Minimal-change lesion nephrotic syndrome with renal oncocytoma.

A renal mass was found in a 49-year-old man presenting with idiopathic nephrotic syndrome. The excised tumor was a well-encapsulated renal oncocytoma. Examination of the kidney revealed a minimal-change glomerular lesion and moderate arterionephrosclerosis. Nephrotic range proteinuria persisted through a postoperative course of prednisone therapy, but diminished and cleared within the subsequent two-year period. Renal function has remained stable and proteinuria has not recurred over a four-year follow-up. The clinical course suggests a previously unreported relationship between renal oncocytoma and minimal-change lesion nephrotic syndrome.

Adenoma

Antibody to kidney antigen in the urine of patients with urinary tract infections.

One hundred six urine specimens from 26 patients with acute and chronic pyelonephritis and cystitis were tested by radioimmunoassay to determine (1) whether antibody to normal human kidney antigen was present and (2) whether the presence or absence of this antibody correlated quantitatively with antibody to the patient's own infecting organism. Of the 106 urine specimens tested, 55 (52%) contained elevated antibody to human kidney antigen. For 80 (75%) of 106 urine specimens there was a correlation between the results of quantitative assays for antibody levels to kidney antigen and to the bacterial antigen. Indirect fluorescent antibody studies of thin sections of normal human kidneys and a patient's urine containing elevated levels of antibody to kidney antigen and to bacterial antigen demonstrated diffuse renal localization. Results indicate the occurrence of antibody to kidney antigen, particularly in urine specimens from patients with chronic pyelonephritis and from urine specimens containing elevated levels of antibody to bacterial antigen.

Antibodies

Immune response in urinary tract infection determined by radioimmunoassay and immunofluorescence: serum antibody levels against infecting bacterium and Enterobacteriaceae common antigen.

A solid-phase radioimmunoassay (RIA) procedure was compared with the indirect fluorescent antibody (IFA) test in a serological study of 76 female adults with urinary tract infections. Relative serum antibody activity was determined against patients' homologous infecting enterobacteria by RIA and IFA and against heterologous enterobacterial common antigen (Escherichia coli O14) by RIA. There was marked correlation between results of the IFA and RIA methods using the homologous system; 22 of 51 patients (43%) with pyelonephritis had significantly elevated serum antibody activity by both IFA (titers greater than or equal to 512) and RIA (binding ratio greater than or equal to 2.0) when compared with normal serum controls; three had significant antibody activity detectable by RIA only. Eighteen (72%) of 25 patients with pyelonephritis had RIA binding ratios of greater than or equal to 2.0 against their homologous bacterial isolates and the enterobacterial common antigen; an additional 6 patients had binding ratios of greater than or equal to 2.0 against the antigen only. All 25 patients with cystitis had low serum antibody levels by IFA and RIA when tested against their own isolate as well as enterobacterial common antigen. The RIA procedure was objective, quantitative, and less tedious to perform than IFA.

Adult

Urinary tract infections in patients with diabetes mellitus. Studies on antibody coating of bacteria.

The prevalence of urinary tract infection was determined in 333 patients attending a diabetes mellitus outpatient clinic during a one-year period. A total of 19% of the women and 2% of the men were found to have urinary tract infections. Antibody-coated bacteria, indicating parenchymal infection, were initially present in 43% of patients and rose to 79% within a mean pretreatment period of seven weeks. In those with recurrent infection following treatment, there were more reinfections than relapses, both in those with kidney infections (67%) and those with bladder infections (57%). The high prevalence of urinary tract infection among diabetic women and the evidence of rapid parenchymal involvement emphasizes the need for clinical awareness of the problem and clarification of its consequences.

Antibodies, Bacterial

Immunoglobulin levels and antibody-coated bacteria in urines from patients with urinary tract infections.

The presence of antibody-coated bacteria in urines from patients with urinary tract infections has previously been reported to correlate with renal infection as opposed to bladder infection. Urine specimens from 12 patients with pyelonephritis and 12 patients with cystitis were studied to determine whether the antibody coating the bacteria is associated with elevated urine levels of total protein or of particular classes of immunoglobulins. The classes of antibody bound to the infecting bacteria in urines from the patients with pyelonephritis were compared to the levels of unbound antibody in the urine. Each specimen was found to contain antibody-coated bacteria, but not all of the specimens had elevated levels of total protein or immunoglobulins. Thus, the occurrence of antibody-coated bacteria in pyelonephritis did not depend on marked elevations of total urinary protein or immunoglobulins. Studies of patients with cystitis showed that immunoglobulins and protein present in the urines, even in elevated quantities, did not react with the infecting bacteria in patients with bladder infections, as each of these patients had negative FA tests for antibody-coated bacteria.

Antibodies, Bacterial