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At least 1,189 records · Page 66Linked to original sources
PubMed2002

Reliability of contrast enhanced sonography with harmonic imaging for detecting early renal scarring in experimental pyelonephritis in a porcine model: preliminary results.

PURPOSE: Contrast medium enhanced harmonic ultrasound is a recently developed ultrasound technique that improves the assessment of renal parenchymal vascularity. We performed a preliminary study to define the ability of contrast enhanced ultrasound with harmonic imaging to detect and localize renal scars in a porcine model of experimentally induced pyelonephritis. MATERIALS AND METHODS: Vesicoureteral reflux was surgically induced in 10 pigs weighing 10 kg. with the contralateral kidney serving as a control. Approximately 4 weeks after the creation of vesicoureteral reflux cystography confirmed reflux. Infection was induced by placing a suspension of paraffin broth impregnated with Escherichia coli in the bladder of each pig. At 4 to 8 weeks (mean 6.5) after the induction of infection a radiologist blinded to the side of the previous procedure performed conventional gray scale ultrasound, color Doppler ultrasound and contrast enhanced ultrasound with harmonic power imaging. The animals were sacrificed; the kidneys were inspected and tissues from the upper, mid and lower poles were sent for culture and histological examination. Histology results were compared with the findings of the 3 ultrasound modalities. RESULTS: All 10 pigs survived the surgical procedures with no complications. Post-contrast harmonic ultrasound images were available in 9 pigs (18 renal units). Harmonic ultrasound revealed decreased blood flow in 11 renal units, including the upper pole in 7, lower pole in 3, and upper and lower poles in 2. Renal tissue cultures were positive in 11 renal units (6 refluxing units). Histological findings revealed fibrosis in 10 renal units (8 refluxing units). Harmonic ultrasound findings in these 10 renal units showed 9 with changes consistent with inflammation or scars. Using histological results as the gold standard for renal injury harmonic ultrasound was more sensitive than gray scale ultrasound for detecting renal injury with 90% sensitivity, 75% specificity, 81% positive predictive value and 85% negative predictive value. CONCLUSIONS: Preliminary results indicate that contrast enhanced ultrasound with harmonic imaging is a sensitive method for determining renal scarring without the need for radiation exposure. It may be prove to be a useful adjunct for evaluating children who present with urinary tract infection.

Animals↗
PubMed1993

Events leading to septic death from experimental acute pyelonephritis in the monkey.

Experimental acute pyelonephritis in monkeys led to death in some of the animals following renal E. coli inoculation. It was found that both the inflammatory response and cytokine activation were much more severe in these monkeys as compared with others that survived. IL-1 was decreased just before death, and there were early increases in IL-2 and IL-6 serum concentrations, but no significant increase in TNF values. The data suggest that death in sepsis is due in part to excessive cytokine release because of a decrease in the protective activity of IL-1.

Acute Disease↗
PubMed1989

Xanthogranulomatous pyelonephritis in a renal allograft: a case report.

We report a case of xanthogranulomatous pyelonephritis in a renal allograft. The kidney was not removed and there was an initial response to antibiotic therapy, with amelioration of toxicity and improvement in renal function. However, the kidney failed 10 months later in association with histological changes of chronic rejection.

Anti-Infective Agents, Urinary↗
PubMed1986

Emphysematous pyelonephritis caused by Candida albicans.

We report a case of emphysematous pyelonephritis that was proved by histological examination and culture to be caused by Candida albicans. The fungal infection caused ureteral obstruction. Nephrectomy alone resulted in complete recovery.

Candidiasis↗
PubMed1985

Emphysematous pyelonephritis: a 5-year experience with 13 patients.

Emphysematous pyelonephritis is a life-threatening necrotizing renal infection characterized by the production of gas. Of 8,105 admissions to our diabetes service during the last 5 years we identified 13 cases. The patients were managed aggressively with fluids and antibiotics, followed by immediate nephrectomy. The mortality rate is 40 to 50 per cent, primarily owing to sudden septic complications.

Adult↗
PubMed1984

The ultrastructure of acute pyelonephritis in the monkey.

P-fimbriated E. coli, which have specific receptors on urothelial cells for their fimbriae, were used to produce pyelonephritis. Using both scanning and electron microscopy, it was shown that the bacteria attached to ureteral epithelium by 12 hours after inoculation. They developed into a biolayer of bacteria covering the epithelium by 48 hours, but did not invade within that time. In the kidney, adherence was seen by 6 hours in collecting proximal and distal tubules. While many bacteria were seen, tubular epithelium remained normal through 24 hours. The inflammatory response was first seen at 48 hours. Phagocytosis was accompanied by mortal damage to both phagocytes and surrounding tubules. This was followed by bacterial invasion of the interstitium.

Animals↗
PubMed1984

Prevention of pyelonephritis by immunization with P-fimbriae.

P-fimbriae have been found to be a virulence factor in both human and nonhuman primate urinary tract infections caused by Escherichia coli. This is because of bacterial adherence to urothelial cells which is mediated by adherence of fimbriae to a specific glycolipid receptor on the cell membrane of these cells. We purified P-fimbriae for immunization of monkeys. High titers of antifimbrial antibody protected against both acute and chronic pyelonephritis after renal inoculations of P-fimbriate Escherichia coli.

Animals↗
PubMed1983

Computerized tomography in xanthogranulomatous pyelonephritis.

Computerized tomography offers the means to recognize changes in the kidney associated with xanthogranulomatous pyelonephritis. The preoperative extent of the inflammatory process, reaction of adjacent parenchymal structures, and extension to the muscles and abdominal wall are identifiable on computerized tomography. The presence of obstructing renal stones, thickening of the perirenal fascia and inability of the kidney to handle intravenously injected contrast medium can be assessed with computerized tomography. Low density renal areas measured on computerized tomography may indicate lipid infiltration of the kidney or incorporation of the fat of the renal bed into the tumefactive mass.

Female↗
PubMed1980

Emphysematous pyelonephritis in a solitary kidney.

Emphysematous pyelonephritis in a solitary kidney was present in a diabetic patient with servere electrolyte imbalance, hyperglycemia, oliguria and electrocardiographic changes suggestive of myocardial infarction. Percutaneous nephrostomy was performed as a life-saving procedure and a week later a large matrix stone obstructing the renal pelvis was removed. The optimal therapy with a surgical or conservative approach is discussed. The use of percutaneous nephrostomy as an initial lifesaving procedure is suggested.

Diabetes Complications↗
PubMed1980

Torulopsis pyelonephritis associated with papillary necrosis: a case report.

A case of Torulopsis glabrata pyelonephritis associated with papillary necrosis is presented. Torulopsis glabrata is a potential pathogen in the urinary tract capable of producing renal damage, sepsis and death. In this case the involved kidney sustained progressive damage, necessitating nephrectomy for cure. Examination of the kidney showed fungal involvement of the parenchyma and collecting system.

Candida↗
PubMed1977

Pediatric hypertension as a delayed sequela of reflux-induced chronic pyelonephritis.

Chronic pyelonephritis secondary to vesicoureteral reflux has been shown to cause occasionally systemic hypertension. The hypertension may occur in the presence or absence of bacterial urinary infection, is renin-mediated and may develop years after ureteral reimplantation. Surgical excision of a scarred atrophic renin-producing segment may result in amelioration of the hypertension or at least provide better medical control with less toxic antihypertensive agents. Surgical removal of renal tissue is not recommended in patients with depressed renal function unless the hypertension is malignant and uncontrolled.

Adolescent↗
PubMed1977

Emphysematous pyelonephritis.

We herein describe 2 cases of emphysematous pyelonephritis, which can be added to the 42 cases previously reported. Both female patients were diabetic and had Escherichia coli infections. Both had ureteral obstruction and underwent nephrectomy to survive septic and/or azotemic crises. Timely surgical intervention after unsuccessful antibiotics and conventional medical measurements is life-saving.

Adult↗
PubMed1977

Xanthogranulomatous pyelonephritis in children.

Xanthogranulomatous pyelonephritis in children, contrary to adult onset, rarely is associated with non-function or calcification. The lesion is predominantly on the left side in children. There appears to be a normal humoral but temporarily impaired cellular immune response in addition to sustained depression of polymorphonuclear chemotaxis. The etiology of this is uncertain but may be attributed partially to hyperosmolarity of serum and urine, and to leukocyte specific antinuclear antibodies. The presence of leukocyte specific antinuclear antibody or cold agglutining may interfere with normal phagocyte chemotaxis requiring tissue macrophages to produce a xanthogranulomatous reaction to bacterial invasion.

Cell Movement↗
PubMed1976

Xanthogranulomatous pyelonephritis in childhood.

We report the tenth case of xanthogranulomatous pyelonephritis, which is a rare cause of supperative proliferative pseudo tumor in children. The disease is more segmental in the child than in the adult and should be considered in the differential diagnosis of renal masses. Early recognition and conservative operation can result in a permanent cure.

Child↗
PubMed1976

The urographic findings in acute pyelonephritis: non-obstructive hydronephrosis.

Excretory urography was performed on 4 patients early in the course of acute pyelonephritis. These studies showed dilatation of the involved collecting system without obstruction. The dilatation resolved after therapy in 3 patients and was not present on a previous excretory urogram in the fourth. Although previous studies have shown that the excretory urogram is usually normal in cases of acute pyleonephritis these cases demonstrate that this disease can produce dilatation of the collecting system and mimic obstruction.

Acute Disease↗