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

The clinical presentations and renal biopsy specimens of 18 patients with primary aldosteronism were reviewed to determine the characteristic pathologic features of the kidney in this syndrome. All patients were hypertensive with a mean blood pressure of 192 nm. Hg systolic and 122 mm. Hg diastolic. The average duration of hypertension was 6.88 years. The mean serum potassium was 2.88 mEq. per l. and the mean plasma carbon dioxide was 31.4 mEq. per l. A significant history of urinary tract disease was noted in 8 patients. Laboratory and diagnostic studies evaluating renal structure and function were abnormal in 11 patients. Renal biopsies from all 18 individuals showed evidence of parenchymal damage. Hypertensive and hypokalemic changes were the most significant abnormalities and were considered moderate to severe in 78 and 89 per cent of the patients, respectively. Histologic evidence of pyelonephritis was noted in 2 patients only and no renal specimens contained characteristic changes of metabolic alkalosis. The preoperatively hypertensive and renal evaluations did not reflect the severity of the renal changes noted histologically. The extent of renal injury caused by hypertension and hypokalemia in these patients emphasizes the consequences of primary aldosteronism. Early diagnosis and treatment of this disorder are essential if these consequences are to be avoided.
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PMID:Renal changes in primary aldosteronism. 83 53

Laparoscopic surgery has been widely performed for removing the gallbladder and the pelvic lymph-nodes in recent years. We have applied laparoscopy technique to nephrectomy and here we describe our procedures and the clinical results. The patient is placed in the supine position under general anesthesia. After a 4 liter CO2 pneumoperitoneum is induced, five trocars are inserted into the abdominal cavity through the ipsilateral abdominal wall. The patient is then turned to the lateral position to displace the bowel medially. The ipsilateral colon is reflected medially after incision of the parietal peritoneum was made along the line of Todt to expose the retroperitoneum. The ureter was identified and dissected. It was secured with 4 clips (2 clips on the renal side and 2 on the distal side) and then cut with scissors. The renal vein and artery were then dissected and separately ligated with clips as described above. These vessels were also cut. The upper pole of the kidney was dissected out and the adrenal gland was left in place. The kidney thus became completely free within the abdomen. It was then grasped by the forceps through a 10 mm sheath positioned below the umbilicus. After incising the abdominal wall, the kidney was removed from the abdominal cavity with the grasping forceps and the sheath. By this procedure right nephrectomy was completely performed in a 56-year-old female patient and left nephrectomy in a 56-year-old male patient. The underlying disease was recurrent pyelonephritis secondary to renal calculi in both cases. The operative times were 221 min and 346 min, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Laparoscopic nephrectomy. Preliminary report]. 153 98

The authors report a case of non-reversing acute renal failure following a carbon monoxide poisoning in a 28-year-old woman with a previous history of pyelonephritis. The renal biopsy reveals an IgA nephropathy with interstitial and tubular changes. The mechanism of this exceptional complication is discussed.
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PMID:[Acute renal insufficiency revealing an IgA nephropathy]. 203 17

Emphysematous pyelonephritis is a severe necrotizing infection that usually occurs in patients with diabetes mellitus or obstructive uropathy. Although glucose fermentation has been considered as the main cause of gas production the actual mechanism remains controversial. Compositions of gas samples from 2 patients with emphysematous pyelonephritis recently encountered were analyzed, and showed 15% hydrogen, 4.8% carbon dioxide, 60% nitrogen, 6.7% oxygen and some unknown gases in case 1, and 3.4% hydrogen, 22% carbon dioxide, 66% nitrogen and 9.8% oxygen in case 2. These results tend to implicate mixed acid fermentation of glucose as the pathway by which emphysematous urinary tract infections develop.
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PMID:Mixed acid fermentation of glucose as a mechanism of emphysematous urinary tract infection. 205 76

Microbial ureases hydrolyze urea to ammonia and carbon dioxide. Urease activity of an infectious microorganism can contribute to the development of urinary stones, pyelonephritis, gastric ulceration, and other diseases. In contrast to these harmful effects, urease activity of ruminal and gastrointestinal microorganisms can benefit both the microbe and host by recycling (thereby conserving) urea nitrogen. Microbial ureases also play an important role in utilization of environmental nitrogenous compounds and urea-based fertilizers. Urease is a high-molecular-weight, multimeric, nickel-containing enzyme. Its cytoplasmic location requires that urea enter the cell for utilization, and in some species energy-dependent urea uptake systems have been detected. Eucaryotic microorganisms possess a homopolymeric urease, analogous to the well-studied plant enzyme composed of six identical subunits. Gram-positive bacteria may also possess homopolymeric ureases, but the evidence for this is not conclusive. In contrast, ureases from gram-negative bacteria studied thus far clearly possess three distinct subunits with Mrs of 65,000 to 73,000 (alpha), 10,000 to 12,000 (beta), and 8,000 to 10,000 (gamma). Tightly bound nickel is present in all ureases and appears to participate in catalysis. Urease genes have been cloned from several species, and nickel-containing recombinant ureases have been characterized. Three structural genes are transcribed on a single messenger ribonucleic acid and translated in the order gamma, beta, and then alpha. In addition to these genes, several other peptides are encoded in the urease operon of some species. The roles for these other genes are not firmly established, but may involve regulation, urea transport, nickel transport, or nickel processing.
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PMID:Microbial ureases: significance, regulation, and molecular characterization. 265 66

Renal tubular function tests were performed in 45 children suffering from upper and lower urinary tract infections. Determinations were made of the urinary carbon dioxide tension in maximally alkaline urine as an index of distal tubular H+-ion secretion, of urinary protein excretion, and of urinary sodium and phosphate handling. Urinary PCO2 was low (2.7 +/- 13.9 mmHg) in acute pyelonephritis compared to values in healthy children (52 +/- 32 mmHg) or those with cystitis (48 +/- 34 mmHg). At the onset of pyelonephritis an elevated fractional excretion of sodium (1.38 +/- 0.38 vs. 0.50 +/- 0.20%) and decreased phosphate reabsorption (69.2 +/- 7.1 vs. 90.4 +/- 4.9%) were also observed. Significantly elevated urinary low molecular weight protein excretion was also found in pyelonephritis. These data indicate the existence of proximal and distal tubular dysfunction at the onset of acute bacterial pyelonephritis.
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PMID:Alterations of urinary carbon dioxide tension, electrolyte handling and low molecular weight protein excretion in acute pyelonephritis. 308 6

Genital condylomas in pregnancy pose several management problems for the obstetrician, including the mechanical problems of large condylomas and the issues relating to transmission of the human papillomavirus to the fetus during delivery. Transmission of papillomavirus occurs infrequently, but respiratory papillomatosis can result in mortality or lifelong morbidity. We evaluate our experience in treating condylomas in 32 pregnant women, using carbon dioxide laser therapy and 85% trichloroacetic acid. Condylomas in 31 (97%) of 32 women were controlled with this combination therapy. The only maternal complication was an episode of acute pyelonephritis secondary to urethral catheterization. One patient had premature rupture of the membranes 4 days after laser therapy and subsequently was delivered of a healthy neonate at 36 4/7 weeks. Prenatal photovaporization of condylomas appears to offer a method of treatment with a low complication and recurrence rate and helps avert the dilemma of whether patients with extensive genital condylomas should be delivered by cesarean section.
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PMID:Genital condylomas in pregnancy: use of trichloroacetic acid and laser therapy. 338 65

Some guidelines for the use of lasers in renal surgery are presented. The carbon dioxide laser was successfully used in 9 patients with diverse renal pathology (staghorn calculus, 4 patients; renal tumor, 3 patients; congenital arteriovenous (A-V) fistula, 1 patient; segmental chronic atrophic pyelonephritis, 1 patient) as an excisional tool, allowing us to reduce intraoperative blood loss, decrease operating time, and preserve the functional integrity on the remaining renal segment. This modality appears to be a safe addition to the urologic armamentarium, when used as an excisional tool in renal surgery.
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PMID:Some guidelines in use of lasers in renal surgery. 381 Oct 90

We studied the nutritional and metabolic features of Eubacterium suis, an anaerobic animal pathogen that causes cystitis and pyelonephritis in pigs. Peptone-yeast extract-starch (PYS) medium, which contained Trypticase (BBL Microbiology Systems), yeast extract, starch, minerals, cysteine, and sodium carbonate, was shown to support excellent growth of this organism (absorbance at 600 nm = 1.8). Growth was considerably less (absorbance at 600 nm = 0.6) when the starch in the medium was replaced by maltose. Formate, acetate, and ethanol were the major products of fermentation of starch or maltose. The organism appears to require a fermentable carbohydrate for growth since the deletion of starch from PYS resulted in a negligible amount of growth. Growth decreased by approximately 20% when CO2 was rigorously excluded from PYS minus Na2CO3. The deletion of only yeast extract from PYS resulted in a decrease in growth of about 75%, and the simultaneous deletion of both yeast extract and Trypticase resulted in negligible growth. When the yeast extract in PYS was replaced by a defined mixture of purine and pyrimidine bases, vitamins, and amino acids, growth was greater than or equal to 80% that observed in PYS. The deletion of Trypticase from this medium resulted in no detectable growth, suggesting a possible peptide requirement for E. suis growth. Good growth (absorbance at 600 nm = 1.4) was obtained when adenine and uracil were substituted for the mixture of purine and pyrimidine bases in modified PYS; the substitution of pyridoxal, riboflavin, and nicotinic acid for the vitamin mixture gave comparable growth. The nutritional requirement of E. suis apparently reflect the fact that the organism adapts to its natural niche by doing away with certain biosynthetic capabilities which it does not seem to require.
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PMID:Nutritional and metabolic features of Eubacterium suis. 680 18

Encouraged by the experimental work done on 40 kidneys in 20 dogs using the CO2 laser beam for partial nephrectomies, we decided to use the laser in four patients. Three of them underwent lower partial nephrectomy, and the fourth underwent bivalving of kidney through the anatrophic line. The use of this new instrument was very helpful in reducing blood loss, shortening the time of hemostasis, and minimizing parenchymal damage. Case No. 1 is the first published case of xanthogranulomatous pyelonephritis that underwent partial nephrectomy with success.
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PMID:The clinical use of CO2 laser beam in the surgery of kidney parenchyma. 681 46


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