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Biomedical subjects

U Bengtsson

Publications and source records attributed to U Bengtsson.

17 recordsLinked to original sources

Malignancies of the urinary tract and their relation to analgesic abuse.

A relationship between analgesic abuse and urothelial renal pelvic tumors was first observed in 1965. Since then more than 100 cases of such tumors have been reported in abusers of phenacetin-containing drugs; most of these cases have been from Sweden. Many patients had a preexisting nephropathy with renal papillary necrosis. The total consumption of the drugs could be estimated to several kilograms, and the average period of consumption was 17 yr in the Göteborg study. The manifest development of the tumor often came a few years after the cessation of the drug abuse. The clinical picture and the pathologic findings are described and the five-year survival rate is given. Multiple tumors in the urinary tract were common. Carcinogenic factors are discussed. Phenacetin is an aromatic amide with N-hydroxylated metabolites, closely related to known carcinogenic amines like the naphthylamines which earlier caused occupational bladder cancer. Furthermore, the data on exposition (consumption) time and tumor induction time were very similar in occupational bladder cancer and in renal pelvic cancer related to analgesic abuse. Animal experiments of long-term phenacetin feeding have produced a high degree of papillary epithelial hyperplasia. Further investigations are under way.

Analgesics

Factors influencing the prognosis in diabetic patients accepted for renal transplantation.

Out of 27 patients with advanced diabetic nephropathy accepted for renal transplantation. 11 had cardiac symptoms and 10 others had advanced neuropathy. The former group had a poor outcome with 100% mortality within one year, seven patients dying before transplantation. Neuropathy also indicated a poor prognosis. Early transplantation, before the stage of terminal uraemia, was at no advantage in this material.

Adult

A clinicopathologic and prognostic study of epithelial tumors of the renal pelvis.

The aim of the present investigation was to assess the prognosis of epithelial pelvic tumors and evaluate from multivariate analysis the influence of different morphologic and clinical factors on the prognosis. The basic data are derived from the Swedish national series of patients with epithelial renal pelvic tumors diagnosed by histologic examination during 1962-63. Ninety-four of the 102 patients studied had a urothelial pelvic tumor and eight had an epidermoid carcinoma. The corrected 5-year survival rate was 51% in the curatively operated series, 60% among the males and 33% among the females. Infiltration depth was found to be of significant importance for the 5-year survival and thus a strong predictor for prognosis. Furthermore, each tumor grade and tumor structure exerts some influence on the prognosis independent of the infiltration depth. Nine patients had verified, and 16 patients had suspected phenacetin abuse and/or renal papillary necrosis. The survival rate was low and the relative frequency of females was high in this group of patients. These data may indicate a poorer prognosis in patients with phenacetin abuse, and may explain the sex difference in 5-year survival. Thirty-eight per cent of the patients with urothelial tumors of the renal pelvis had a synchronous or asynchronous tumor elsewhere in the urinary tract. The high frequency of local recurrence as well as the high frequency of infiltrating tumors and multiple tumors indicate the necessity for a more extensive operation such as perifascial nephrectomy with total ureterectomy including a cuff of the bladder.

Adult

Urine concentrating capacity in women: the results of a screening method in a population study.

Urine concentration tests were performed as part of a population study in 1405 women in age strata between 38 and 60 years. The measurement of urine osmolality from the 13th hour of fluid deprivation overnight was adopted as a screening test. If an osmolality of 600 mOsm/kg H2O was not attained, a second test was performed and if this was abnormal a pitressin tannate test was carried out (54 women). Among women with a low urine concentration after pitressin tannate (less than 700 mOsm/kg H20) all but one suffered from chronic renal disease. The urine concentration capacity decreased with age illustrating the inadequacy of using the same "normal" limits at different ages. The outcome of the study raises the question of whether one simple fluid deprivation test discriminates tubular damage sufficiently satisfactorily to justify its application to the screening of large groups of people.

Adult

Adult type of polycystic kidney disease in a new-born child.

A case of polycystic kidney disease in a newborn child is reported. Renal cortical necrosis due to asphyxia was the cause of death. The histopathological picture and a heavy family history support the rare diagnosis of polycystic kidney disease of adult type in a new-born child.

Adult

Antazoline-induced immune hemolytic anemia, hemoglobinuria, and acute renal failure.

A case of repeated antazoline-induced immune hemolytic anemia, thrombocytopenia, hemoglobinuria, and acute renal failure is reported. The first episode of renal failure occurred after an i.v. pyelography causing an anaphylactic shock, and the two later episodes were preceded by allergic reaction to drugs. Antazoline was given among other remedies, but this drug was the only one used for treatment on every occasion. The clinical picture and the immunological tests, including an antazoline-dependent Coombs' test, indicate that the blood disorders might have been caused by a type 2 allergic reaction and renal lesion by a type 3 reaction, at least on the second and third occasions.

Acute Kidney Injury

Phenacetin abuse and renal pelvic carcinoma.

This work is a review of 62 patients with abuse of phenacetin containing drugs and uroepithelial tumours of the renal pelvis, all of them carcinomas. Most of the patients had a pre-existing nephropathy with papillary necrosis as a prominent feature. Renal impairment contributed to the poor prognosis. On the basis of present knowledge of urinary tract carcinogens and phenacetin metabolites, it is assumed that phenacetin is the crucial factor for development of the tumours.

Adult

Monoclonal IgG cryoglobulinemia with secondary development of glomerulonephritis and nephrotic syndrome.

A 45-year-old man developed in 1965 skin lesions on cold exposure and was found to have cryoglobulinemia due to an M-component of IgG class. Glomerular damage was first noted in 1970, and progressed to renal impairment and nephrotic syndrome during the next two years. Reduced serum levels of complement components C3 and C4 were found, indicating in vivo complement activation. Renal biopsy revealed proliferative glomerulonephritis and deposition of IgG and C3 along the glomerular basement membrane. Electron microscopical examination revealed a striking deposition of a 'fibrillar' or microcrystalline material in the glomerular basement membrane. This material had an ultrastructure similar to that found in the cryoprecipitate from serum. There were no tubular changes of myeloma type, neither were there any monoclonal light chains detected in the urine. So far, there are no other signs of myeloma or lymphoma. Immunosuppressive treatment with prednisone and cyclophosphamide resulted in a decrease in the serum M-component as well as a decrease in protein leakage through the glomeruli and a return to normal of glomerular filtration rate. The finding of monoclonal cryoglobulinemia, demonstrable at room temperature, in a patient developing proliferative glomerulonephritis with complement activation is unusual. It is probably that the M-component is causally related to the glomerular lesions.

Basement Membrane