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Biomedical subjects

M Hall-Craggs

Publications and source records attributed to M Hall-Craggs.

36 records · Page 2Linked to original sources
PubMed1984

Interstitial nephritis, proteinuria, and renal failure caused by nonsteroidal anti-inflammatory drugs. Immunologic characterization of the inflammatory infiltrate.

Nine patients with the unusual combination of renal failure, nephrotic-range proteinuria, and biopsy-proved interstitial nephritis are described. Six of these patients had received nonsteroidal anti-inflammatory agents (three fenoprofen, one ibuprofen, one zomepirac, and one tolmetin). The remaining three patients had no history of exposure to drugs known to cause interstitial nephritis. Immunologic characterization of the infiltrating cells with monoclonal antibodies showed that the majority of cells in most cases were cytotoxic T cells, although some B cells were present in all cases. Giant collecting duct cells were seen in half the patients with drug exposure but in none of the others. Otherwise, there were no conspicuous morphologic differences between patients with and without drug exposure. Many of the patients had associated glomerular abnormalities. Only the zomepirac and tolmetin recipients showed pure interstitial disease. The three fenoprofen recipients and the zomepirac and tolmetin recipients regained normal renal function after the drug was discontinued. The combination of renal failure, nephrotic range proteinuria, and interstitial nephritis is one form of nephrotoxicity observed in patients treated with nonsteroidal anti-inflammatory agents. However, this lesion, which may be mediated by cytotoxic T cells, may also be seen rarely in patients with no apparent drug exposure.

Adult↗
PubMed1983

Biochemical and morphological studies on human kidneys preserved for transplantation.

Seven human kidneys that had been preserved for transplantation by pulsatile perfusion were studied to correlate the biochemical data with morphologic changes. Metabolite concentrations in mumol/g wet tissue were ATP = 0.26; ADP = 0.34; AMP = 0.45; lactate = 15.21; pyruvate = 0.23; 3-phosphoglycerate = 0.05; fructose-1,6-bisphosphate = 0.06; and hexose-6-phosphate = 0.03. Enzyme activities in mumol/min . mg protein found in the microsomal fraction were alkaline phosphatase = 0.049 and gamma-glutamyl transpeptidase = 0.844. Morphologically, none of the kidneys showed irreversible cell injury in the renal tubules, but some glomeruli showed areas where the endothelial cells appeared stripped off of the capillary basement membranes, indicating possible perfusion injury. The data suggest that it is the resynthesizing ability, as opposed to the absolute concentration of ATP, which determines the recovery and the subsequent viability of the tissue.

Adenine Nucleotides↗
PubMed1982

Basaloid tumor of the sigmoid colon.

A second case of basaloid carcinoma arising in the midsigmoid colon is reported. By light microscopy the tumor was seen to be composed of islands of small, poorly differentiated cells separated by cellular connective tissue. Also seen were small foci of keratinized cells, Ultrastructure study confirms the largely basal character of the tumor and also shows some cells containing tonofilament bundles, representing a more squamoid differentiation. The similarity of this tumor to basaloid tumors arising in the transitional epithelium of the anal canal is discussed, and the suggestion that the tumor arises from a pluripotential basal cell is made.

Aged↗
PubMed1982

Acute renal failure and renal tubular squamous metaplasia following treatment with streptozotocin.

Nephrotoxicity, in the form of transient proteinuria, azotemia, abnormalities of tubular function, and acute renal failure, is the major toxic condition following administration of streptozotocin. The renal morphologic and ultrastructural abnormalities associated with streptozotocin remain poorly defined. We describe a patient with metastatic islet cell tumor of the pancreas who was treated with 16 weekly courses of 1 g/m2 of streptozotocin without marked change in renal function. Following a six-week hiatus without change in renal function, a single course of 1 g/m2 of streptozotocin was administered and resulted in acute renal failure. Light microscopic examination of the kidneys showed irregularly dilated renal tubules lined by low cuboid epithelium. The cells were pleomorphic and showed some mitoses. Nuclei were irregular and variably hyperchromatic. Electron microscopic examination disclosed large aggregates of fine microfilaments in the proximal convoluted tubules and collecting ducts. Microfilament aggregates were both free in the cytoplasm and membrane bound. Microfilaments were proved to be tonofilaments by the demonstration of keratin within the epithelium, using the immunoperoxidase method. These data suggest that squamous metaplasia may be an important part of streptozotocin renal toxicity, and the suggestion is made that they may be an antecedent of neoplastic change.

Acute Kidney Injury↗
PubMed1981

Carcinosarcoma of the uterine cervix: a light and electron microscopic study.

A case of carcinosarcoma of the uterine cervix is presented. Light microscopic and ultrastructural features of the tumor are described. While the epithelial component had the appearance of a carcinoma arising from endocervical epithelium, the stromal component was composed of malignant smooth muscle cells together with some cells having the charactristics of malignant fibroblasts. The tumor is considered to arise from the müllerian tract mesoderm and to be part of the spectrum of tumors which range from the totally benign adenofibroma to the malignant heterologous mixed mesodermal tumor.

Carcinosarcoma↗
PubMed1981

Oat cell carcinoma of larynx.

Mucus secretion, cytoplasmic argyrophilia, intracellular lumen, neurosecretory granules, and tonofilaments were observed in a histologic and ultrastructural study of laryngeal oat cell carcinoma. In theories of tumor genesis, more than one line of cellular differentiation is a significant finding.

Carcinoma, Small Cell↗
PubMed1981

Transformation of diffuse proliferative glomerulonephritis to membranous nephritis in a patient with systemic lupus erythematosus.

Transformation of diffuse proliferative glomerulonephritis to membranous nephropathy 10 years later, in a patient with systemic lupus erythematosus, is reported. The original biopsy showed diffuse proliferative glomerulonephritis with epithelial crescent formation, 'wire loop' thickening of the capillary walls and moderately severe interstitial inflammation. Electron microscopy showed large subendothelial electron-dense deposits. Following treatment with a combination of prednisone and azathioprine for 2 years the 24-hour urine protein decreased from 8.8 g to 300 mg. In September, 1979, she again developed facial and pedal edema. With the exception of proteinuria of 6.0 g/24 h, the renal function remained normal. Repeat renal biopsy showed membranous glomerulopathy. On electron microscopy, electron-dense deposits were predominantly in a subepithelial position. The significance of the original biopsy as a predictor of eventual outcome and of sequential biopsies to the clinical management of patients with systemic lupus erythematosus is discussed.

Adult↗
PubMed1980

Surreptitious habitual vomiting simulating Bartter's syndrome.

A patient with hypokalemic alkalosis, normotensive hyperreninism, hyperaldosteronism, increased levels of urinary and plasma prostaglandin E, and vascular hyporesponsivity to angiotensin II was thought to have Bartter's syndrome. Results of a kidney biopsy showed hyperplasia of the juxtaglomerular apparatus but no renomedullary cell hyperplasia. A 24-hour urine collection showed a low chloride level and no increase in the fractional chloride clearance, thus excluding Bartter's syndrome. Subsequent disclosure of surreptitious, habitual vomiting explained the hypokalemia.

Adult↗
PubMed1980

Structural changes following hypothermic preservation of human cadaveric kidneys.

Three kidneys preserved as though for transplantation became available for study. The clinical details relating to the donors and methods of preservation by simple hypothermia and pulsatile perfusion are presented. Light microscopic and ultrastructural features observed following perfusion fixation of the kidneys are described. All three kidneys showed some reversible ischemic cell damage, but only one showed evidence of ischemic cell damage that was considered to be irreversible. The latter was seen focally in the pars recta of the proximal convoluted tubules and in the ascending thick limb of the loop of Henle. The irreversible changes were present in the kidney that had undergone the longest period of simple hypothermic storage prior to transfer to pulsatile perfusion preservation. The similarity of the findings to those seen in vivo in the rat after one hour of total renal ischemia, followed by 24 hours' reflow, is discussed; a hypothesis is suggested to explain the site of the irreversible injury seen in the kidneys under study.

Adolescent↗
PubMed1979

Amyloid deposition in a renal allograft in a case of amyloidosis secondary to rheumatoid arthritis.

A case of amyloidosis secondary to rheumatoid arthritis is presented in which renal transplantation was performed. Five years after transplantation the patient died following an episode of acute pancreatitis. During the intervening period the rheumatoid arthritis was considered quiescent, but his course was marked by several infectious processes caused by unusual organisms. The allograft function remained normal. Apart from renal amyloid the autopsy showed extensive generalized amyloidosis, most marked in vessel walls and endocrine organs. Amyloid deposits were located exclusively in the vessel walls of the transplanted kidney.

Amyloid↗
PubMed1979

Unusual ultrastructural features in a case of acute diffuse proliferative glomerulonephritis.

A case consistent with recurrent acute poststreptococcal glomerulonephritis but with atypical features is described. Light microscopy revealed a diffuse proliferative glomerulonephritis. A spectrum of ultrastructural features, from the typical "humpy bumpy" subepithelial deposits to the apparent disappearance of the deposits within the epithelial cells, is presented. An unusual piling up of basement membrane material around the deposits is described, together with some areas showing an appearance reminiscent of membranous glomerulopathy. Resorption of the dense deposits within epithelial cells is suggested and a hypothesis advanced that the basement membrane reaction may indicate an incipient chronic immune complex lesion.

Acute Disease↗