Biomedical subjects

V P Petersen

Publications and source records attributed to V P Petersen.

At least 19 recordsLinked to original sources

PubMed1983

The impact of HLA-DR antigen matching on the survival of cadaveric renal allografts. A prospective one-center analysis.

The impact of HLA-DR antigen matching on the survival of cadaveric renal allografts was assessed in 158 consecutive transplants performed in our unit since early 1978. In 41 donor-recipient pairs with two shared HLA-DR antigens, the actuarial graft survival rate at 6 months was 73% as compared with 51% in 76 transplants with one HLA-DR antigen shared and 32% in 41 transplants with zero shared HLA-DR antigens. This finding is highly significant (P for heterogeneity [PH] = 0.0005 and P for trend, [PT] = 0.0001). Our data clearly indicate that HLA-DR antigen sharing is more beneficial than merely avoiding HLA-DR incompatibility. But, the frequent antigen HLA-DRw6 was not taken into account in this study due to difficulties in its identification. We found no evidence that the observed beneficial effect of HLA-DR matching could be explained by interaction of other prognostic factors, such as sex, age, previous transplantation, diabetes mellitus or pretransplant blood transfusion. Patients who did not receive blood transfusion prior to transplantation had a significantly lower graft survival rate than those who did (13% vs. 56% at 6 months). HLA-DR matching was found to have a powerful effect on graft survival even among pretransplant blood transfused recipients (PH = 0.002, PT = 0.0006). We conclude that selection of recipients for transplantation should attempt to achieve HLA-DR identical combinations.

Adolescent↗

PubMed1983

Ultrastructural lesions in lightmicroscopically defined types of glomerulonephritis. A blind and semiquantitative study.

Current classification of glomerulonephritis (GN) is based primarily on light microscopical (LM) histopathological criteria. The aim of the present study was to investigate the occurrence and severity of a number of electron microscopical (EM) lesions in different LM defined classes of GN in order to determine the degree of homogeneity of these classes and the degree of specificity of various EM lesions seen in GN. The analysis was performed using a blind, systematic and semiquantitative method and applied on 91 consecutive biopsies from patients with GN as well as on 11 reference biopsies. Most of the EM lesions were not restricted to a single or a few light microscopically defined classes of GN. EM lesions having direct LM counterparts used as classification criteria were generally present with high scores in the corresponding LM classes but were also present in other types of GN. When the EM-findings were compared with our original classification of the 91 biopsies it was found that about 13% of all biopsies were classified erroneously using only LM. Thus, the groups obtained with the presently used LM classification system are quite heterogenous with respect to ultrastructure and probably with respect to pathogenesis. On the other hand, it appears that many ultrastructural lesions display a more or less continuous spectrum of changes which therefore are difficult to use for classification purposes.

Biopsy↗

PubMed1981

Quantitative relationship between glomerular foot process width and proteinuria in glomerulonephritis.

The relationship between foot process fusion (retraction) and proteinuria in glomerular diseases has been known for many years, but only a few quantitative studies have been performed. The quantitative morphometrical method used here makes it possible to estimate the distribution of true foot process width from the observed apparent width on electron micrographs. The true foot process width was analyzed in a consecutive material of patients with glomerulonephritis and related to the diurnal urinary protein excretion. Only a weak correlation was found between these two parameters. Albeit an abnormal foot process width was invariably associated with proteinuria, a rather large fraction of patients with gross proteinuria had normal foot process width compared to control subjects. Thus, if foot process fusion causes proteinuria, this can not be the only mechanism leading to this permeability alteration. On the other hand, our results show that foot process fusion is not a necessary consequence of proteinuria. In addition, a methodologic study was performed, analyzing the relationship between the quantitative and a semiquantitative method for estimating foot process fusion. It is concluded that the latter method is fast and sufficiently precise for most evaluations of foot process width in human kidney biopsies.

Biopsy↗

PubMed1978

Bartter's syndrome without hyperplasia of the juxtaglomerular apparatus, treated with indomethacin.

The present report describes a case of potassium-wasting nephropathy with the physiological and endocrinological findings that are typical for Bartter's syndrome (BS). However, the renal juxtaglomerular apparatus showed no hyperplasia at two renal biopsies two years apart. The short-term (9 days) effect of indomethacin in combination with spironolactone was a suppression of hyperreninemia and hyperaldosteronism and an increase in vascular sensitivity to angiotensin II associated with potassium and sodium retention. Subsequently, on indomethacin alone, potassium balance was obtained on a lower level with persistent hypokalemia and persistent renal potassium leakage. Hypokalemia persisted during long-term (9 months) treatment with indomethacin despite normalization of the activity of the renin-aldosterone system. The results indicate that indomethacin as long-term treatment may be ineffective in maintaining a normal potassium balance in BS.

Adult↗

PubMed1977

[Nephrology].

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Animals↗

PubMed1975

Late failure or human renal transplants. An analysis of transplant disease and graft failure among 125 recipients surviving for one to eight years.

The purpose of the present paper was to study clinical, morphological and immunological aspects of late rejection of renal allotransplants. We have, therefore, analyzed the occurrence and nature of renal transplant disease and graft failure among 125 recipients surviving for 1 to more than 8 years after transplantation. In this population transplant disease as defined by the appearance of heavy proteinuria and/or steadily declining graft function occurred in 22 patients. At the closure date of the study on December 31, 1972 complete graft failure had occurred in 12 of these 22 patients and 4 of these have died. In addition two patients died in the presence of normal graft function, due to chronic hepatitis and metastatic cancer respectively. As based on clinical findings, pathophysiological features and renal lesions the patients with late transplant disease were classified into two groups and described accordingly. Group A, termed glomerular transplant disease, included a majority of 16 patients, constituting a rather homogenous idsease entity in relation to course of disease, clinical findings and renal lesions as studied by light-, immunofluorescence- and electron microscopy. All these patients presented with heavy proteinuria, which was non-selective in all but two, resulting eventually in complete loss of graft function in eight cases. All these patients developed hypoalbuminemia and hypercholesterolemia, and one half manifested a classical nephrotic syndrome. Arterial hypertension occurred in all patients except two. Glomerular structure as studied by light microscopy revealed a number of lesions of a rather polymorphous pattern in all patients in group A. Endomesangial proliferation, hyperplasia and segmental proliferation of epithelial cells and thickening of capillary walls were prominent features, although the degree of severity, extension and type of lesion occurred in such varying proportions that classification into any well characterized category of glomerulonephritis was not possible. All cases in group A revealed immune deposits, most frequently containing IgG, IgM, complement and fibrinogen. IgA, IgD and IgE were also demonstrated in a lesser proportion of cases in this group. The immunofluorescent pattern was a mixed granular and linear, and in no case strictly linear or granular alone. The ultrastructural investigation contains a detailed analysis of the

Adult↗

PubMed1974