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Biomedical subjects

O F Thomsen

Publications and source records attributed to O F Thomsen.

At least 19 recordsLinked to original sources
PubMed2002

Pyelonephritis and interstitial nephritis--clinical-pathological correlations.

AIMS: The relation between histological and clinical parameters were studied in 54 consecutive patients with acute interstitial nephritis or pyelonephritis without primary glomerular disorders, in all of whom percutaneous renal core biopsy had been performed. PATIENTS AND METHODS: Based on clinical criteria and without detailed knowledge of the appearance of the biopsy, the material was divided into 4 main groups: patients with septic and/or tubulotoxic conditions, hypersensitivity reactions (eosinophilic nephritis), ascending infections and other specified conditions. RESULTS: The overall correlation between the histological and the clinical diagnoses was good, but there were large overlaps between the histological findings in 3 of the groups, making classification of individual cases difficult. The histological and paraclinical findings were poorly correlated. Histologically, ascending infections were characterized by the presence of leukocyte casts and an increased number of neutrophilic granulocytes. CONCLUSION: The material justifies the present rough classification of the conditions mentioned above. By kidney biopsy, the interstitial conditions can be separated from glomerular and other conditions, but the biopsy offers little information about the clinical severity or the prognosis.

Adolescent↗
PubMed1995

[Glomerular tip lesions--a newly described glomerular change].

Glomerular tip lesion is a newly described histopathological lesion characterized by a focal and segmental widening of the mesangial matrix without hypercellularity together with capillary dilatation, hyaline exudation on the inside of capillary walls and occurrence of vacuolized cells, localized to the peripheral segments of the glomerular tuft. Clinically, these patients have a pronounced nephrotic syndrome with slightly reduced renal function, but terminal renal failure is seldom seen, even after many years of disorder. Two characteristic case histories are presented. The classification of this lesion among the glomerular disorders is at present uncertain. It may represent a transitional form between minor lesion nephritis and focal segmental sclerosis, a separate disorder, or a functional lesion associated with high proteinuria.

Aged↗
PubMed1995

Reproducibility of the WHO classification of glomerulonephritis.

The inter-observer variation of the WHO classification of glomerulonephritis (GN) was studied using Kappa statistics. One hundred renal biopsies were selected with almost equal representation of the following types of GN: minimal change nephropathy, membranous GN, focal proliferative GN, diffuse mesangial proliferative GN, endocapillary GN, membranoproliferative GN, and crescentic GN. Slides stained with silver-methenamine and PAS-hematoxylin were circulated among the members of the panel, who made their diagnoses without knowing those of the other participants and without knowledge of the clinical conditions. There was a very good overall diagnostic agreement of 0.67 with a Kappa value of 0.61, figures which compete very well with other diagnostic systems analysed with Kappa statistics. Analysing the single types of GN, we found that the highest Kappa values were obtained for crescentic GN (0.81), endocapillary GN (0.79) and membranous GN (0.74) and the lowest Kappa values for membranoproliferative GN (0.40) and diffuse mesangial proliferative GN (0.44). Basically, the international classification of GN is founded upon light microscopy. Our results demonstrate that this system works generally well. The diagnostic reproducibility of the types with less satisfactory Kappa values can be expected to be improved by including immunopathology and electron microscopy.

Biopsy↗
PubMed1994

Chronic interstitial nephropathy after plasma cutting in stainless steel.

Chromium is nephrotoxic in experimental animals. In subjects with acute chromium intoxication acute nephritis has been reported and renal function has been affected in chromium exposed workers with a high urinary chromium concentration. Chronic kidney disease after long term occupational exposure to chromium has, however, not been reported previously. A case report is presented concerning a 48 year old man who was diagnosed with chronic interstitial nephropathy. He had worked for nine years as a plasma cutter of stainless steel and had thereby been exposed to smoke containing chromium. At the time of diagnosis his blood chromium concentration was seven times higher and his urinary chromium concentration six times higher than reference values. Taking into account the nephrotoxicity of chromium and the high chromium burden of this patient it is considered likely that his exposure to smoke from plasma cutting of stainless steel was the cause of his chronic interstitial nephropathy.

Chromium↗
PubMed1991

Glomerular tip lesions in renal biopsies with focal segmental IgM.

Renal biopsies in which immunohistologic examination had shown the presence of glomerular focal segmental IgM were reviewed in order to investigate the histology and clinical course in these patients. Among 19 such biopsies, 12 had focal segmental glomerulosclerosis (FSGS), whereas seven had only so-called glomerular tip lesions (GTL). GTL also occurred moreover in four of the patients with FSGS. Clinical data suggest a somewhat milder course of disease in the seven patients with GTL as the sole lesion than in the patients of the FSGS group. The nature of GTL is at present unclear. We suggest that GTL may be an initial stage of FSGS, being a lesion that may or may not develop towards FSGS in its typical form. Regardless of its origin, attention is directed to the GTL as a characteristic histologic glomerular lesion, which may be the only significant histologic change in the renal biopsy from a patient with nephrotic syndrome or severe proteinuria.

Adult↗
PubMed1988

Eosinophilic cellulitis: five cases.

Five cases of eosinophilic cellulitis or Wells' syndrome are described. While only few children have been included in earlier reports, 4 of the 5 patients in the present paper were below 10 years of age, with the youngest being only 20 months when the disease started. One of the children developed hard and tender subcutaneous swellings on the scalp, the histology of which showed extensive subcutaneous necrotizing granulomas. Similar lesions have not been described previously in connection with eosinophilic cellulitis. Eosinophilic cellulitis may be called a rare disease. However, it is important that clinician and histopathologist are both acquainted with the pathological features of this condition, as the disease often responds readily to steroid therapy.

Cellulitis↗
PubMed1988

Focal segmental glomerular tip lesions with IgM. A case report.

In a 59-year-old man with nephrotic syndrome, immunohistochemical examination of a renal biopsy revealed exudations of IgM localized to peripheral segments of the tufts in some glomeruli. This pattern is known so far to occur only in some cases of focal segmental glomerulosclerosis (FSGS). In this patient, however, no histological criteria of FSGS were present, nor was the clinical course typical of this disease, being characterized by changing reactions to steroid therapy. The patient was therefore considered to suffer from a disease different from FSGS. The histological lesion may possibly be identical with what has recently been described as the glomerular "tip lesion".

Biopsy↗
PubMed1984

Renal changes in long-term type 1 (insulin-dependent) diabetic patients with and without clinical nephropathy: a light microscopic, morphometric study of autopsy material.

The relationship between clinical diabetic nephropathy and morphological renal changes was studied in autopsy material from 34 long-term Type 1 (insulin-dependent) diabetic patients of juvenile onset. Seventeen had no clinical signs of nephropathy (defined by persistent proteinuria, hypertension, and elevated serum creatinine) while a further 17 age-matched diabetic patients with a similar duration of diabetes had severe clinical nephropathy. The renal tissue was examined by morphometric light microscopy, using a point counting technique and the results compared with renal tissue from subjects who died without diabetes. In the diabetic patients without clinical nephropathy, arteriolohyalinosis was much more pronounced compared with non-diabetic subjects (2p less than 0.001) and within the glomeruli the amount of subcapsular fibrosis and glomerular mesangium was increased (2p less than 0.05 and less than 0.001, respectively). The area of open capillaries was decreased compared with non-diabetic subjects (2p less than 0.025), and the percentage of occluded glomeruli was significantly increased (2p less than 0.05). The diabetic patients with clinical nephropathy had significantly more interstitial tissue and glomerular mesangium (2p less than 0.001) and less open glomerular capillaries (2p less than 0.001) than diabetic subjects without clinical nephropathy, but severe glomerulosclerosis could be seen in the diabetic patients without any sign of clinical nephropathy. Serum creatinine correlated with the mesangial area (r = 0.792, 2 a less than 0.001). No difference was observed between the two diabetic groups regarding the degree of arteriolohyalinosis, the number of Kimmelstiel-Wilson lesions or exudative lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Inverted papilloma of the upper urinary tract.

Four cases of inverted papilloma in the upper urinary tract are reported-three were located in the ureter and one in the renal pelvis. Clinical and pathological findings are described. In two cases the patients had a history of transitional cell carcinoma; while in one case, inverted papilloma was found in the same lesion as transitional cell carcinoma. The question of malignant transformation of inverted papilloma is discussed. It is concluded that inverted papilloma is a benign tumor with a very low frequency of recurrence, but regular follow-up is advised.

Aged↗
PubMed1980

Light and electron microscopic investigation of parathyroid carcinoma during dedifferentiation. Survey and study of a case.

A case of parathyroid carcinoma in a 74-year-old female patient was studied by light and electron microscopy. The malignancy of the parathyroid tumour was confirmed by local recurrence and infiltration of adjacent structures. The tumour was composed of uniform chief cells without mitoses. Ultrastructurally, the cells were characterized by tortuous plasma membranes, numerous secretion granules, an extensive rough endoplasmic reticulum and lack of lipid vacuoles, all indicating hyperactivity, but not malignancy. At death, the autopsy revealed local recurrence of tumour tissue, but no distant metastases. Both light and electron microscopy showed that considerable dedifferentiation of the tumour tissue had occurred. The tumour cells were now characterized by a marked nuclear pleomorphism and a coarse clumping of the chromatin. The presence of secretion granules alone suggested a parathyroid origin. Thus, at death there was unequivocal histological evidence of a carcinoma, whereas no such diagnosis could be made from the early biopsy. The clinical course alone indicated the malignant nature of the lesion.

Aged↗
PubMed1980

Nonsecretory myeloma associated with nodular glomerulosclerosis.

A patient with nonsecretory multiple myeloma in associated with nodular glomerulosclerosis is reported. The clinical course was characterized by rapidly progressing renal insufficiency terminating in uremia within three months. Histological investigation of the kidney revealed extensive nodular formations in the mesangial areas consisting of basement membrane-like material, in places with content of fibrils. Immunofluorescence demonstrated deposition of kappa chains. Amyloid was not present. Routine methods for investigation of serum and urine showed severe hypogammaglobulinemia without M-components. Using a sensitive radioimmunoassay for free light chains, an abnormal non-dissociable kappa chain polymer with a molecular weight of 55 000 was found in serum and urine. The findings support the hypothesis that mesangial accumulation of paraproteins induce an increased synthesis of basement membrane material leading to formation of the nodules. Abnormal polymerization of kappa chains might provoke the formation of the glomerular nodules.

Fluorescent Antibody Technique↗
PubMed1977

Bacteria and bacterial antigen in the kidney in human chronic renal disease. Bacteriological and immunofluorescence Studies.

Kidneys obtained by nephrectomy from 85 patients with chronic nephropathy were examined by bacterial culture and by immunofluorescence for a content of E. coli antigen. A panel of 10 E. coli 0-antisera, representing the strains most commonly causing urinary tract infection, and antiserum against common enterobacterial antigen (CA), were used. Bacteria could be cultured from the nephrectomy specimens in 24 cases, mainly in cases of obstructive chronic pyelonephritis, analgesic nephropathy and congenital renal disease. By immunofluorescence, type-specific 0-antigen was found in whole bacteria and amorphously in macrophages, CA only in whole bacteria. Whole bacteria could be visualized in 12 cases, macrophages only in two cases. Amorphous bacterial antigen was no observed outside phagocytizing cells. On the basis of these results, it seems unlikely that progression of the renal lesions in chronic renal disease is due to persistant bacterial antigen in the absence of viable bacteria. Chronic pyelonephritis, defined as an interstitial nephritis due to the effects of bacterial infection in the renal parenchyma and pelvic mucosa, appears always to be a secondary manifestation following obstruction or primary renal disease, such as analgesic nephropathy or congenital renal disease.

Adolescent↗
PubMed1977

Bacteriuria and renal infection in kidney-transplant recipients.

In 64 patients who had undergone renal transplantation, later on followed by bilateral nephrectomy, bacterial growth culture was performed from the original kidneys. The presence of bacteria in the nephrectomy specimens was compared with the occurrence of significant bacteriuria before transplantation and in the period between transplantation and nephrectomy. Bacteria could be cultured from the nephrectomy specimens of 18 (28.1 per cent) of the patients, almost exclusively confined to cases of obstructive chronic pyelonephritis, analgesic nephropathy and congenital renal disease. Before transplantation, bacteriuria had been recorded in 34.4 per cent of the patients, most frequently in the three groups of diseases just mentioned. Between the transplantation and nephrectomy, bacteriuria occurred in 75.0 per cent of the patients. Patients with E. coliuria before transplantation were particularly liable to have E. coliuria also after the transplantation and to E. coli in the nephrectomy specimens, whereas patients in whon E. coliuria did not occur until in the post-transplantation period were less susceptible to E. coli infection involving the kidneys. Probably the presence of bacteria in the nephrectomy specimens is related to the primary disease rather than to immunosuppressive and antiobiotic agents administered in the post-transplantation period.

Adolescent↗
PubMed1977

Antibodies against E. coli O-antigens and common enterobacterial antigen in kidney-transplant recipients. Comparison of antibody findings with evidence of urinary tract infection.

Using indirect haemagglutination, sera from 45 patients who had undergone renal transplantation were examined for 0-antibodies against 10 selected uropathogenic E. coli strains, and against common enterobacterial antigen (anti-CA). Bilateral nephrectomy was carried out, usually less than three months after transplantation, and serum from the time of nephrectomy was examined. The aim was to correlate antibody findings with evidence of urinary tract infection (UTI), as assessed by significant bacteriuria or growth of bacteria from the nephrectomy specimens. All the sera contained antibodies against several of the E. coli strains, mostly in titres less than or equal to 160, but titres up to 5120 occurred. No statistically significant correlation was found between the occurrence of high titres of type-specific 0-antibodies to E. coli and evidence of E. coli UTI. In contrast, anti-CA-present in the sera of 19 patients, mostly in titres of 10-40-occured with significantly increased frequency in patients with E. coliuria before transplantation and in patients with growth of E. coli from the nephrectomy specimens. It is concluded that anti-CA-even in low titres-appeared to give a better serological parameter of E. coli UTI than screening for antibodies against the selected uropathogenic E. coli strains.

Adolescent↗
PubMed1975

Bacterial antigen and acid phosphatase in macrophages in experimental pyelonephritis.

Experimental retrograde E. coli pyelonephritis was produced in rats. The study covered the period from 6-24 hours up to 6 months. Macrophages in the renal tissue were studied using immunofluorescence staining for bacterial E. coli antigen and histochemical staining for aicd phosphatase. A comparison of sections stained according to the two methods showed that antigen-containing macrophages in nearly all cases yielded a positive reaction for acid phosphatase. On the other hand, in several kidneys acid phosphatase-positive macrophages occurred which in consecutive sections studied by immunofluorescence did not contain antigen. The possibility of using staining for acid phosphatase as a screening method for the detection of active, antigen-containing macrophages in human chronic pyelonephritis is discussed.

Acid Phosphatase↗