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Biomedical subjects

U Berg

Publications and source records attributed to U Berg.

At least 19 recordsLinked to original sources
PubMed1992

99mTechnetium-dimercaptosuccinic acid scan in the diagnosis of acute pyelonephritis in children: relation to clinical and radiological findings.

Seventy-two children, 59 girls and 13 boys, 0.1-15.9 (median 1.1) years of age, with acute pyelonephritis (APN) were investigated with the aid of a dimercaptosuccinic acid (DMSA) scan, renal ultrasonography (US) and a desmopressin test within 5 days of admission. Sixty-two children were reinvestigated approximately 2 months later when intravenous urography (IVU) and micturition cysto-urethrography were also performed. During infection, 92% of the children showed changes in the DMSA scan with 69% by US, and the two investigations agreed in 58% of the kidneys. At follow-up, 68% showed changes in the DMSA scan, 47% by US and 48% by IVU. The DMSA scan and IVU agreed in 60% of the kidneys. Twenty-nine percent of the children had vesico-ureteric reflux (VUR). The presence of grade greater than or equal to 3 VUR was associated with greater defects on the DMSA scan during infection, and at follow-up with a higher frequency of persistent changes compared with no VUR (P less than 0.02 and 0.01, respectively). During infection the size of the defect on the DMSA scan correlated with renal volume and C-reactive protein and inversely with the glomerular filtration rate, and at follow-up it correlated inversely with the renal concentration capacity. The DMSA scan is a sensitive method for diagnosing and localizing APN in children, and findings on DMSA scan show a weak but significant correlation with routine clinical and radiological parameters. It is suggested that persistent renal damage after APN in children without VUR may be more common than previously assumed.

Acute Disease↗
PubMed1992

Diagnostic significance of 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy in urinary tract infection.

A total of 106 children with symptomatic urinary tract infection (73 girls and 33 boys, 0-15.9 years of age) were studied by means of a dimercaptosuccinic acid (DMSA) scan, renal ultrasound, and a desmopressin test during infection and at follow up approximately two months later. At follow up they were also investigated by means of intravenous urography (IVU) and micturition cystourethrography (MCU). During infection 23 children had a normal DMSA scan while 83 children had an abnormal one. The median C reactive protein and SD score for renal concentration capacity in the former group were 15 (range < 10-178) mg/l and -1.0 SD score (range -2.4 to 1.8), respectively, and in the latter group 98 (range < 10-320) mg/l and -3.1 SD score (range -5.7 to 1.1), respectively. In the former group there was no significant finding in any child on ultrasound or IVU and only one had significant vesicoureteric reflux (VUR) (grade 3). At follow up 51 children had a normal DMSA scan while 55 children showed persistent changes. The median SD score for renal concentration capacity in the former group was -0.9 SD score (range -3.2 to 1.4) and in the latter group -1.6 SD score (range -4.6 to 2.5). No significant changes were found in the former group on ultrasound or IVU and only two children had significant VUR (grade 3). In the latter group 20 children showed changes on ultrasound, 15 showed changes on IVU, and 23 had VUR. These results suggest that a normal DMSA scan during or approximately two months after urinary tract infection in children indicates a low risk of finding significant pathology of the urinary tract.

Adolescent↗
PubMed1992

Pregnancy rates and births after unilateral or bilateral transfer of bovine embryos produced in vitro.

Late morulae and blastocysts produced in vitro were nonsurgically transferred to heifers by unilateral (n = 184) or bilateral (n = 94) transfer. Of the recipients, 58% had serum progesterone values greater than 1.4 ng ml-1 on day 21 and rectal palpation on day 35 showed that 50% (138 of 278) were pregnant. The embryonic mortality rate between days 21 and 35 was estimated to be about 14% and between days 36 and 90 to be about 12%. Of the animals, 8% aborted between days 91 and 250 of pregnancy. No difference was observed in pregnancy rates between unilateral transfer of one (47%) or two embryos (49%) and bilateral transfer (53%), or in the twinning rate between bilateral transfer (42%) and unilateral transfer of two embryos (33%). The pregnancy rate was 54% with embryos evaluated as morphologically excellent or good, 51% with fair embryos and 26% with poor ones. A higher pregnancy rate (60%) was obtained after embryo transfer when the synchrony between recipient and embryo was -1 day.

Abortion, Veterinary↗
PubMed1992

Urinary protein excretion and renal function in young people with diabetes mellitus.

To detect early renal involvement in young diabetic patients (IDDM), urinary protein excretion and renal function were examined in 110 patients aged 5.9-25.0 years. Clearances of inulin and PAH were determined as well as albumin (Alb), IgG, N-acetyl-beta-D-glucosaminidase (NAG) and creatinine (Cr) excretion rates (UV). The patients were grouped according to IDDM duration (2- less than 5, 5-10 and greater than 10 years) and albumin excretion rate (non-albuminuria less than 20, microalbuminuria 20-200, and albuminuria greater than 200 micrograms/min per 1.73 m2). Four patients had overt albuminuria, 17 microalbuminuria (equally distributed among the duration groups). Grouped according to albumin excretion rate, the mean GFR was increased in those without albuminuria but 'normalized' in patients with microalbuminuria/albuminuria. Grouped according to albumin excretion rate and the duration of the disease, the non-albuminuric patients with IDDM for greater than 10 years had a lower GFR than those with a shorter duration of IDDM. The patients with microalbuminuria/albuminuria and IDDM for less than 5 years had a reduced GFR. Patients with increased NAG excretion rate had lower Na excretion rate, lower fractional Na excretion and greater creatinine excretion than those with normal NAG excretion. Albumin excretion correlated with IgG excretion, but also with NAG excretion. Our results suggest that early albuminuria in IDDM is of both glomerular and tubular origin. The hyperfiltration declines with increasing albumin excretion but also with the duration of the disease.

Acetylglucosaminidase↗
PubMed1992

Proteinuria and renal function in relation to renal morphology. A clinicopathological study of IgA nephropathy at the time of kidney biopsy.

At the time of kidney biopsy the pattern of urinary protein excretion (UPE) and renal function were studied in 54 patients (age 16-62 years) with IgA nephropathy (IgAN). Serum and urinary albumin (alb), IgG, beta-2-microglobulin and creatinine were analysed, and excretion rates (UV) and clearances were calculated. The glomerular filtration rate (GFR) was determined by plasma 51Cr-EDTA clearance (51Cr-EDTA) and by 24-hour creatinine clearance (C-Cr 24 h). Glomerular mesangial (volume expansion and cell proliferation), tubulo-interstitial (fibrosis and inflammation) and vascular lesions were classified semiquantitatively on a five-degree scale, and the percentage of glomeruli showing global sclerosis, segmental sclerosis and cellular crescents was calculated. One third of our patients had reduced renal function, three patients uremia and 70 per cent of the patients overt albuminuria. The mean GFR was reduced in microalbuminurics and further decreased in albuminurics and nephrotics. A lower GFR and more proteinuria were found in the patients with more advanced morphological lesions also when the uremic patients were excluded. Segmental glomerular sclerosis correlated with GFR as well as with UalbV and UIgGV, while global sclerosis correlated only with GFR. UalbV and UIgGV also correlated with the extent of interstitial damage but not with mesangial lesions. In summary an accurate determination of GFR and UPE at the time of the kidney biopsy may give an indication of the extent of renal damage. A lowered GFR was also found in mild proteinuria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Evaluation of the formula clearance as a measure of the glomerular filtration rate in cyclosporin-treated children following renal transplantation.

Since the introduction of the nephrotoxic drug, cyclosporin, as the main immunosuppressive agent following organ transplantation, the need for an accurate method to determine the glomerular filtration rate (GFR) has arisen. In the present study the clearance of inulin has been compared to the clearance of creatinine estimated by short-term urine sampling or by the formula clearance in 29 children following renal transplantation. The children, 0.4-15.4 years of age at transplantation, were examined within 5 months following transplantation, and thereafter yearly. During the first 2 years after transplantation there was poor agreement between inulin clearance and formula clearance, while 3-4 years after transplantation there was good correlation between the two methods. However, the formula clearance generally overestimated GFR and the overestimation increased with decreasing renal function. In spite of the good correlations between the two methods after the first years following transplantation, the formula clearance in individual patients does not follow the inulin clearance changes very closely. In conclusion, formula clearance was found to be an inaccurate method of following GFR, especially during the first 2 years after transplantation. This might be caused by changes in habitus as well as an increased creatinine secretion caused by cyclosporin.

Adolescent↗
PubMed1991

Course and long-term outcome of idiopathic IgA nephropathy in children.

The long-term outcome of idiopathic IgA nephropathy (IgAN) in children was investigated with regard to clinical course and biopsy changes. All patients with biopsy-verified IgAN (diagnosed by kidney biopsy 1970-1985) at three children's clinics in Sweden were included in the study. Thirty-four (10 females, 24 males), out of a total of 72 patients, had a follow-up period of 8 years or more (10.7 +/- 1.9 years, range 8-14). After this duration of follow-up, urine abnormalities were found in 47% (group A), proteinuria in 35%, hypertension in 9%, and decreased glomerular filtration rate (GFR) in 3% of patients. However, 53% had no clinical signs of disease (group B). GFR depression at the time of clinical presentation of IgAN was more common in group A than in group B (P = 0.017). At the first renal biopsy, which was performed after the same duration of IgAN in both groups, focal segmental glomerular changes were more often found in group A (P = 0.017), while diffuse proliferative changes were more common in group B (P = 0.031). The course of the IgAN was thus often very protracted, with some children developing hypertension as well as decreased renal function. However, after a period of 8 years or more of follow-up half of the patients did not show any clinical signs of the disease, which may indicate low disease activity or, possibly, recovery.

Adolescent↗
PubMed1991

Renal functional adaptation of the adult kidney following transplantation to the child.

Nineteen child renal transplant recipients, aged 1.3 to 19.2 years at transplantation, and their adult living-related kidney donors, 27 to 60 years of age at nephrectomy, were investigated simultaneously with regard to renal function. At a median time of three months after transplantation clearances of inulin (GFR) and paraaminohippuric acid (ERPF) were measured, and serum urea and creatinine concentrations were determined. The absolute values for GFR (72 +/- 13 ml/min) and ERPF (369 +/- 76 ml/min) in the donors were significantly higher than those of the recipients (37 +/- 22 and 196 +/- 72 ml/min, respectively). The absolute values of GFR and ERPF were significantly correlated with the body surface areas of the recipients. Thus, in relation to body surface area, the GFR, 68 +/- 11 ml/min/1.73 m2, and ERPF, 348 +/- 65 ml/min/1.73 m2, of the donors did not differ from those of the recipients, 68 +/- 20 and 375 +/- 90 ml/min/1.73 m2, respectively. Because of the greater body mass, the serum creatinine concentrations of the donors were significantly higher than those of the recipients, whereas the serum urea concentrations were significantly higher in the recipients. The results suggest that transplantation of an adult kidney to a child results in a functional adaptation to the smaller body size of the recipient, and that this adaptation occurs within three months after transplantation.

Adaptation, Physiological↗
PubMed1991

[In vitro embryo production from oocytes from ovaries of a single slaughtered cow].

This communication describes the in vitro maturation and in vitro fertilization of bovine follicular oocytes. Further development of the embryos was achieved by using a granulosa cell culture system. The in vitro development of oocytes to morula/blastocyst stages obtained from individual cows was compared to the results of pooled simultaneous cultured oocytes and to our over-all results of this method. While there were no statistical differences in the developmental rates between these three groups (individual cows: 28.1%, simultaneous pool: 34.0%, over-all results: 32.7%) marked differences were found between the 22 animals investigated separately. These results indicate that there were great individual variabilities due to the oocyte population comparable to the variations in ovarian response to superovulation.

Animals↗
PubMed1990

Children with chronic renal failure in Sweden 1978-1985.

A survey of chronic renal failure (CRF) in Swedish children was carried out for the period 1978-1985, using age-related cut-off levels for creatinine concentrations corresponding approximately to a glomerular filtration rate of 30 ml/min per 1.73 m2. The mean annual incidence of CRF was 6.9 and of terminal renal failure (TRF) 4.4/million children. The prevalence increased during the study period, for preterminal renal failure from 14.1 (1978) to 26.1 (1985) and for TRF from 12.4 to 16/million children. The main groups of primary renal disease were malformations (42%), hereditary disorders (27%), and glomerular diseases (14%), while pyelonephritis with vesico-ureteral reflux only made up 5%.

Adolescent↗
PubMed1990

Factors related to renal haemodynamics in young type-1 diabetes mellitus patients.

The influence of metabolic control (HbA1c), noradrenaline (NA) and insulin-like growth factors (IGF-I and IGF-II) on renal function and size was investigated in 11 insulin-dependent diabetes mellitus patients aged 11-17 years. Renal function was evaluated in terms of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal size was determined as renal parenchymal volume (RPV) by ultrasonography. The patients' HbA1c values ranged from 8.2% to 12.9% (normal range 5.5-8.5%) and their GFR and ERPF were higher than normal. Their IGF-II values were higher, and NA and IGF-I levels were lower than those of healthy controls. Inverse correlations between NA and GFR (r = -0.66) and NA and ERPF (r = -0.63) were found. No correlation was found between serum IGF-I and renal functional parameters. The IGF-II values correlated with GFR and HbA1c (r = 0.63, r = 0.70 respectively). There were linear correlations between RPV and GFR, RPV and ERPF, HbA1c and GFR, and ERPF and RPV. Decreased NA concentrations and increased IGF-II values appear to be factors contributing to renal hyperfunction in these patients.

Adolescent↗
PubMed1990

Central nervous system complications in children treated with ciclosporin after renal transplantation.

Severe complications involving the central nervous system occurred in 7 of 36 children (19%) after renal transplantation. The children, aged 1.6-13.1 years at transplantation were treated with ciclosporin and prednisolone. Six of them had azathioprine as well. The neurological symptoms consisted of seizures, drowsiness, confusion, hallucinations, visual disturbances, and mental changes. In all cases electroencephalograms were severely pathological, showing diffuse abnormalities with or without focal abnormalities and epileptic activity. In all but one case the ciclosporin trough blood levels were within the therapeutic range. Blood glucose and electrolytes were normal. Several factors might contribute to the central nervous system complications: ciclosporin, corticosteroids, hypertension, rejection, and as yet unknown ones.

Adolescent↗
PubMed1989

Effect on renal function of essential fatty acid supplementation in cystic fibrosis.

Changes in renal hemodynamics, sodium homeostasis, renal acidifying capacity, and aldosterone excretion were studied before and after long-term intravenous essential fatty acid supplementation for a period of 3 years in 11 patients with cystic fibrosis. The mean (+/- SD) glomerular filtration rate was high at the start of the study (133 +/- 18 ml/min/1.73 m2 body surface area) and decreased significantly (p less than 0.05) to within normal values after 1 year of essential fatty acid supplementation. The urinary elimination of an oral sodium load initially was very low (3.6 +/- 2.5 mmol/hr/1.73 m2 body surface area vs control subjects' values of 7.9 +/- 2.0; p less than 0.001) and increased during treatment but was not normalized (p less than 0.05 vs control subjects' values). Free water clearance and distal tubular sodium delivery, which were significantly decreased before treatment (p less than 0.01 and p less than 0.001 vs control subjects' values, respectively) did not increase significantly. The mean urinary aldosterone excretion did not significantly differ from that in control subjects before and after treatment. The acidifying capacity was disturbed, indicating a low renal bicarbonate threshold, and was changed during treatment in only 2 of 10 patients. These data indicate that essential fatty acid deficiency may contribute to the renal disturbances in cystic fibrosis.

Acid-Base Equilibrium↗
PubMed1989

Long lasting respiratory depression induced by morphine-6-glucuronide?

We report a case of long lasting respiratory depression after intravenous administration of morphine to a 7 year old girl with haemolytic uraemic syndrome. The plasma concentrations of the active metabolite M6G were more than 10 times those normally seen and the half-lives of M6G and morphine were prolonged.

Child↗