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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The ultrastructure of the ureter in the nonhuman primate is described. In experimentally produced chronic pyelonephritis, the ureter shows extensive ultrastructural changes throughout the wall. The epithelium has cellular damage progressing from the basal cells to the superficial cells. There is an invasion of leukocytes into the intercellular spaces at all levels. The connective tissue layer seems thickened with an increase in active fibroblasts, leukocytes, collagen, and elastic fibers. There are various stages of damage in the smooth muscle layer and an abnormal increase of connective tissues between bundles and smooth muscle cells. The interdigitating nexuses seem stretched and altered. The changes are similar to those seen in ureteral obstruction and are assumed to be reparative.
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PMID:Chronic pyelonephritis. Electron microscopic study. III. The ureter. 11 82

Pyelonephritis was produced in 75 white rats by applying a 24-hour ligature on the ureter and by intravenous injection of a suspension of 5X10(9) cells of a stable Proteus mirabilis L-form. Pyelonephritis was proved microscopically in 44% of the animals. The revertants of the introduced L-form play an etiological role in the development of the infection. The stability of the pathohistological findings makes this model suitable for the purpose of experimental chemotherapy.
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PMID:Experimental pyelonephritis induced by L-forms of Proteus mirabilis in rats. 34 63

Rats with obstructive pyelonephritis due to Escherichia coli were treated for different intervals with ampicillin and gentamicin either alone or in combination. The combination of ampicillin and gentamicin was synergistic in vitro and significantly more effective in vivo than was either drug alone. After treatment for 10 days, the combination of ampicillin and gentamicin was the only regimen that sterilized all of the pyelonephritic kidneys. The importance of achieving sterility was illustrated by the observation that severe infection and acute pyelonephritis recurred after religation of the ureter in 12 (71%) of 17 ampicillin-treated animals that had harbored as few as 46 organisms per kidney before ligation. A synergistic combination of antibiotics rapidly sterilizes obstructed pyelonephritic kidneys. In view of the particular risk of renal infection in the presence of urinary obstruction in humans, synergistic antibiotic combinations may be useful in the treatment of obstructive pyelonephritis in humans.
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PMID:Synergism of ampicillin and gentamicin against obstructive pyelonephritis due to Escherichia coli in rats. 37 40

A case of unilateral emphysematous pyelonephritis is presented in a patient with uncontrolled diabetes mellitus. The diagnosis was established from the presence of gas in the renal parenchyma, the pelvicalyceal system and the ureter. The patient was treated with a prolonged course of antibiotics and the function of the left kidney returned to normal.
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PMID:Unilateral emphysematous pyelonephritis. 44 99

We like to discuss the comment of our clinic: In case of an acute stone-conditioned renal blockage complicated by fever we immediately perform a decompression by means of elevation of the ureter catheter and the antibiotic therapy. A shivering attack accompanied by fever we regard as a threatening sign of pyelonephritis apostematosa and possibly after the first or second shivering attack we perform an opening. Apart from emphasizing the importance of the shivering attack we still might refer to the fact that for the establishment of the therapy of choice the complex evaluation of the clinical picture is necessary.
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PMID:[Indication for operation in acute kidney obstruction caused by urinary calculi]. 48 57

Two cases are presented of reflux into a residual ureter causing recurrent urinary tract infection. A voiding cysto-urethrogram should be included in the investigative routines when nephrectomy for unilateral chronic pyelonephritis is planned. If severe reflux is seen, the entire ureter should be removed along with the kidney.
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PMID:Refluxing ureteral stump. 69 44

There is one renal disease in which unilateral estimation of GFR is desirable for clinical purposes: chronic pyelonephritis. Considering the possibilities for complications to determine unilateral renal function by ureter catheter just in this group of patients, we tried to estimate unilateral GFR with 66mTc-DTPA after a single injection of 5 mCi i.v. on the basis of blood samples at 90, 110 and 130 min after injection and evaluation of gamma-camera data from 25 to 35 min after administration of the dose. 31 patients were studied. In arenal patients clearance values were 7.5 ml/min (+/- 10.47 ml/min), unilaterally nephrectomized patients showed zero values for the removed kidney. Normal patients had a mean GFR of 107 +/- 17.7 ml/min with a partition between right and left kidney of 54.2 +/- 10 to 52.75 +/- 8.5 ml/min. Patients without urinary tract obstruction and unilateral renal disease had values of 27.1 +/- 11 ml/min for the diseased kidney while the normal kidneys gave a mean value of 59.6 ml/min (+/- 13 ml/min). In the presence of urinary tract obstruction, data could not be correlated to the state of renal function. This shows that unilateral estimation of GFR using 99mTc-DTPA is basically possible, but that it is useless in obstructive kidney disease.
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PMID:Unilateral estimation of glomerular filtration rate with 99mTc-DTPA. 69 96

Vesicoureteral reflux ceased after eradication of a reservoir of infection in 6 patients. In each case the reflux was mild, the ureter with reflux was not markedly dilated and no ureter had a golfhole orifice. A reservoir of infection should be sought for in adults with chronic or recurrent urinary tract infection and reflux. If it is found and eliminated ureteral reimplantation can be withheld while the patient is followed closely. However, if infection, reflux and associated pyelonephritis persist reimplantation may be necessary.
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PMID:Eradication of reflux in adults by excision of chronic infection reservoirs without antireflux operation. 80 72

The ultrastructure of xanthogranulomas developing during obstructive suppurative pyelonephritis was studied in rats with a permanent ligature of one ureter and an intravenous injection of E. coli suspension. The xanthogranulomas consisted of macrophages with numberous phagolysosomes containing rests of phagocytosed polymorphonuclear leucocytes and bacteria. Lipids identifiable as triglycerides were found in such cells particularly as isolated intracytoplasmic droplets and, less frequently, within the phagolysosomes. The source of isolated intracytoplasmic lipid droplets within the macrophages has remained obscure. Their origin in the macrophages by synthesis could not be excluded, similarly as in the polymorphonuclear leucocytes. PAS positive cells occurring as late as 2 months after the beginning of the experiment at the periphery of xanthogranulomas contained multiple intracytoplasmic vacuoles, most probably phagolysosomes. These cells, with high probability the oldes ones of the macrophagic population in the xanthogranulomas were virtually devoid of lipid droplets.
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PMID:Ultrastructure of experimental xanthogranulomatous pyelonephritis. 81 76

This review was done because most texts and some recent reviews do not recognize the obstructive cause. It is important only because of the high incidence of acute pyelonephritis during pregnancy. This is so common that it has been given a special name, "pyelitis of pregnancy". We have shown in the monkey that bacteria when introduced into the ureter under low pressure does not often cause pyelonephritis unless associated with ureteral obstruction. The presence of bacteria even with partial ureteral obstruction increases the chances of acute pyelonephritis. Care must thus be taken to eradicate bacteriuria during pregnancy to prevent acute pyelonephritis as has been shown by Kass, especially since vesicoureteral reflux occurs more frequently in the pregnant than nonpregnant primate. When we understand the obstructive cause of hydronephrosis of pregnancy and the effect of positional change, therapy will be more effective. The left lateral position then will not only relieve the pain of acute hydronephrosis of pregnancy but will also greatly assist in the therapy of acute pyelonephritis of pregnancy since it will relieve the associated ureteral obstruction.
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PMID:Hydronephrosis of pregnancy. 82 Dec 1


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