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

Escherichia coli-induced pyelonephritis was studied in untreated alloxan-diabetic rats, insulin-treated diabetic rats, glucose water-drinking (diuresing) nondiabetic rats, and tap water-drinking (nondiuresing) nondiabetic rats following injection of E. coli either into the emptied urinary bladder, into the left kidney, or intravenously. For prevention of an ascending infection in the right kidney, the right ureter was ligated and transected immediately prior to bladder or intrarenal inoculation. These experiments established that in normal rats ascending renal infection alone occurred following introduction of small inocula into the bladder--and then only when facilitated by diuresis. In diabetic rats both ascending and hematogenous renal infection occurred following introduction of small inocula into the bladder. Insulin treatment that reduced hyperglycemia also reduced glycosuria and restored urinary antibacterial activity against small inocula of E. coli but only partially reduced polyuria and prevented hematogenous but not ascending infection. Thus, hyperglycemia was probably the major factor promoting hematogenous renal infection, whereas polyuria--and therefore vesicoureteral reflux--was the major factor promoting ascending infection.
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PMID:Effect of insulin treatment on the susceptibility of the diabetic rat to Escherichia coli-induced pyelonephritis. 638 97

The purpose of this experimental study was to try to develop a continent appliance-free urinary diversion with a non-refluxing urinary reservoir to be emptied by intermittent catheterization. A reliable antireflux plasty can be performed only on the large bowel wall. Continence can only be achieved using small bowel. For these reasons an ileo-colic urinary reservoir was conceived and experienced in 20 beagle dogs of both sexes. The posterior wall of the reservoir is formed by an intestinal plate constructed with two ileal loops. Continence is achieved by intussuscepting the terminal ileum in a retrograde fashion into the reservoir for a distance of 5 cm, thus creating a competent nipple valve between the pouch and the ileostoma. The anterior wall of the reservoir is formed using a colonic plate obtained by dividing the excluded sigmoid colon at the antimesenteric border. A long submucuous tunnel is created in the colon in which to lay the ureter. Thus renal infection and chronic pyelonephritis are avoided. Continence of the stoma is both socially and economically acceptable and improves the quality of life.
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PMID:[Bladder replacement by a continent ileocolonic intestinal reservoir wih antireflux-plasty--experimental study in the dog]. 639 97

Renal autotransplantation has been a treatment of choice for renovascular hypertension, renal artery aneurysm, complicated staghorn calculi, ureteral disorders and others. The paper reports 5 cases of extensively damaged ureter and discusses the indication and the results of operation. There were three cases of postoperative extensive ureteral stricture. One patient had postoperative ureteral injury with retroperitoneal abscess. The last one showed renal foreign body calculi with recurrent pyelonephritis after ureterocutaneostomy. The postoperative course of four patients had been uneventful revealing well functioning autotransplanted kidneys without hydronephrosis and infection during the follow-up period of 22 to 42 months. However, the patient with the ureteral injury and retroperitoneal abscess died of bleeding from renal vein anastomosis on the 15th postoperative day, since the renal pedicle showed marked inflammatory change including renal vein wall. Subsequently, autotransplantation is contraindicated in the cases with marked inflammation in the renal pedicle. In cases of various other ureteral lesions including long distance ureteral stricture, this procedure is recommended when neither the end to side ureteral anastomosis, Boari's bladder flap operation nor bladder hitch operation is feasible.
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PMID:[Renal autotransplantation for ureteral lesions--the indication and the results of operation]. 639 56

The use of stemmed patches and tubes from the seromuscular layer of the colon wall to replace part of the ureter has proven unreliable because of complications such as urinary leakage and invagination, fibrosis, bone formation, shrinkage and disappearance of the intestinal wall due to ischemia and necrosis, causing hydronephrosis and pyelonephritis. The use of tubes and patches of tanned and untanned collagen, implanted in order to study the ingrowth of urothelium and possibly muscle cells, resulted in fibrosis, bone formation, rejection of the material and, in the case of the tubes, complete obstruction with hydronephrosis and destruction of the kidney.
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PMID:Ureter replacement by collagen and seromuscular parts of the large bowel in dogs. 647 2

Ureterosigmoidostomy (US) is an acceptable procedure for urinary diversion. Despite problems with ascending pyelonephritis, anal incontinence, and recently a reported 100- to 500-fold increase in the incidence of colonic carcinoma, the popularity of US is predicted to increase. The records of 110 patients who have undergone US at our institution have been reviewed. Invasive colon cancer developed at the site of ureter implantation in three of these patients. All patients had rectal bleeding and obstipation as initial symptoms. We have located 17 of our US patients and all consented to colonoscopy and urologic follow-up. At colonoscopy 41% of these patients had one to three polyps (0.5 to 6 cm) involving or near the site of the US. No polyps were seen proximal to the US sites. Polyps were histologically defined as tubovillous adenomas or mixed tubovillous-transitional cell adenomas. A single patient with three 4 to 6 cm polyps had superficial adenocarcinoma found in two of the polyps. Recurrent polyps or dysplasia has not been found on follow-up examination. Despite the disadvantages of US, the likely increased popularity of this procedure mandates that all patients be followed regularly for polyps and cancer. Our data support the following recommendations: (1) surveillance colonoscopy should be started soon after US, and (2) conversion to an alternative diversion should be made if recurrent polyps, cancer, or dysplasia is found. Yearly colonoscopy and screening for occult blood must be part of the comprehensive follow-up on all patients after US.
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PMID:Value of colonoscopy after ureterosigmoidostomy. 648 15

In the course of treatment of 224 patients with bladder neoplasms over an 18-year period, 44 patients were noted to have associated vesicoureteric reflux, bilateral in 12 and unilateral in 32. Reflux was suspected in 8 patients because of associated ureterotrigonal abnormalities such as paraureteric diverticulum, complete duplication of the ureter and gaping ureteric orifice, and it was diagnosed by micturating cystography obtained before the bladder tumour was treated. In the remaining 36 patients reflux developed after treatment of the bladder tumours. In most patients with reflux the clinical course was benign, but it caused recurrent pyelonephritis in 9 cases and secondary struvite calculi in 2. Five patients had antirefluxing ureteric reimplantation to control episodes of recurrent pyelonephritis. The pathogenesis and implications of vesicoureteric reflux in association with bladder tumours are discussed.
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PMID:Vesicoureteric reflux in patients with bladder tumours. 662 93

Acute experimental pyelonephritis was produced in rabbits by injecting E. coli (tobramycin MIC 1 mg/l) into the left kidney and temporarily obstructing the ureter. Animals were given 10 mg/kg tobramycin intramuscularly 48 h after surgery and subsequently every day for 7, 10 or 15 days, either in a single daily dose or in three divided doses at 8 h intervals. Animals were killed 24 h after the last injection. Comparison of results shows that kidneys were sterilized by a single daily dose but not by three divided daily doses. In rabbits given the single daily dose regimen, kidneys recovered a normal macroscopical and histological aspect, serum anti-E. coli antibodies rose more slowly and less significantly, serum creatinine increased less, and renal enzymatic activities were restored (alanine aminopeptidase and N-acetyl-beta-D-glucosaminidase). These findings suggest better efficacy and renal tolerance of the single daily dose regimen as compared to the three daily divided dose regimen in the treatment of acute experimental pyelonephritis.
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PMID:[Acute experimental pyelonephritis. Treatment with tobramycin. Influence of the rhythm of administration on efficacy and renal tolerability]. 673 54

Rejection processes concerning transplanted kidneys are traditionally classified as hyperacute, acute and chronic. It is, however, generally felt, that this time related classification is not satisfactorily in every respect. In order to come to a more differentiated histological diagnosis in the individual case, we resolved the time related classification categories and tried to specify rejection processes exclusively according to pathomorphological aspects. Thus 3 morphological rejection patterns or types can be differentiated: (1) a necrotizing-thrombotic rejection type (nth-rej), (2) a cellular rej (cell-rej) and (3) a sclerosing rej (scl-rej). These morphological rejection types match only partially with the time related categories. Especially it becomes apparent, that many cases have mixed rejection patterns. The pure as well as the mixed rejection patterns can exactly be defined in the histological diagnosis when the morphological categories are applied (e.g. severe cell-rej with moderate nth- and slight scl-component). This procedure is favourable in our opinion because a) the histological diagnosis now precisely informs the clinician about the whole spectrum of lesions present and b) individual cases can be compared with one another more effectively. In biopsy interpretation especially the following causes of functional deterioration have to be considered besides rejection processes: shock kidney, ureter stenosis, pyelonephritis, renal artery thrombosis and various types of glomerulonephritis (GN) in the transplant (de novo-GN, recurrent GN and others).
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PMID:[Pathomorphology of transplant rejection and kidney biopsy diagnosis of the transplant]. 675 47

Experimental models of urinary tract infection caused by a group D Streptococcus sp. in rabbits are described: retrograde pyelonephritis was induced by injecting 10(9) group D streptococci into the renal pelvis and obstructing the ureter by ligature for 24 h; cystitis was induced by injecting 5.10(9) group D streptococci through a transurethral catheter. The animals were observed for 3 months. Microbiological data from the urine and from the renal parenchyma were well correlated in 12 of 14 animals. A hemagglutination test for titration of serum antibodies in these infected rabbits is described. Before the beginning of experimentation, hemagglutination titers for all animals were below 160. During experimentation, titers for rabbits with cystitis were always below 640; in those with pyelonephritis, the highest titer was much greater than 640. These results show a positive correlation between serum antibody levels and the localization of urinary tract infection.
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PMID:Experimental retrograde pyelonephritis and cystitis induced in rabbits by a group D Streptococcus sp.: serum antibody assay by a hemagglutination test. 679 14

A partial obstruction of 1 ureter was created in newborn rats and its effects were studied in the adult rat. The obstructed pelvis was found to be considerably enlarged. Nevertheless, the GFR (glomerular filtration rate) was only slightly decreased (10 per cent), completely compensated by increase on the contralateral, non-obstructed side. The reduction in GFR was less than the reduction in number of glomeruli (19 per cent), indicating a raised filtration rate per glomerulus. Water excretion was slightly increased and potassium excretion moderately decreased; sodium and osmolar excretion were not significantly affected. There was no correlation between these changes and the degree of pelvic enlargement. Thus, in this model, in which there is no urinary tract infection or pyelonephritis, partial obstructive uropathy caused less damage to the kidney function than might have been expected.
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PMID:Experimental obstructive hydronephrosis in newborn rats. III. Long-term effects on renal function. 683 22


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