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

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

Bacterial pyelonephritis is a common precipitating factor in the development of diabetic ketoacidosis. Prompt diagnosis and appropriate antimicrobial therapy usually result in resolution of constitutional symptoms and adequate control of serum glucose. However, occasional cases of presumed bacterial pyelonephritis may not respond to appropriate empiric antibiotic therapy, then causes should be sought such as obstruction or untreated fungal infections of the urinary tract. In this case a diabetic patient with classical pyelonephritis was found to have bilateral ureteral fungus balls as the underlying cause of refractory infection.
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PMID:Coexisting bacterial pyelonephritis and bilateral ureteral fungus balls in a diabetic patient. Case report. 219 32

The regulation of pyelonephritis-associated pili (pap) pilin gene transcription has been examined using two operons (pap-17 and pap-21) isolated from the pyelonephritogenic Escherichia coli strain C1212. DNA sequence analysis and E. coli minicell analysis were used to map two genes (papB and papI) within the pilin regulatory regions of both pap-17 and pap-21, and the protein products of these genes were identified. Pilin transcription, initiated at the papBA promoter, was monitored by constructing single copy operon fusions with lacZYA in E. coli K-12. Inoculation of E. coli (pap'-lac) strains onto solid M9 minimal medium containing glycerol and the Lac indicator X-gal (M9-Glycerol) yielded both Lac+ and Lac- colony phenotypes. The Lac+ ("phase on') and Lac- ("phase off') phenotypes were heritable since reinoculation of M9-Glycerol with bacteria picked from Lac+ colonies gave rise to a much higher fraction of Lac+ colonies than reinoculation of M9-Glycerol with bacteria picked from Lac- colonies. Measurement of phase transition rates for E. coli (pap17'-lac) inoculated onto M9-Glycerol showed that the Lac(-)----Lac+ transition frequency (1.57 X 10(-4)/cell/generation) was reduced 35-fold when cells were inoculated onto minimal medium containing glucose (M9-Glucose). However, the Lac+----Lac-transition frequency obtained using M9-Glycerol (2.60 X 10(-2)/cell/generation) was 1.4-fold lower compared to results obtained with M9-Glucose. In contrast, lowering the incubation temperature of E. coli (pap17'-lac) cultures from 37 degrees C to 23 degrees C caused all cells to shift to the Lac- state.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Phase-variation of pyelonephritis-associated pili in Escherichia coli: evidence for transcriptional regulation. 265 60

A strain of Escherichia coli originally isolated from urine of a patient with acute pyelonephritis was studied in detail for binding to glycosphingolipids. Bacteria labeled metabolically with [14C]glucose were layered over a glycolipid chromatogram and bound bacteria were detected by autoradiography. The detection was down to a few ng of glycolipid (pmol level) under these assay conditions. At a test level of 500 ng all glycolipids (more than a dozen molecular species analyzed) with Gal alpha 1----4Gal as an internal or terminal part bound the bacteria strongly while glycolipids known to lack this sequence were negative. Conformational analysis using hard sphere calculations including the exo-anomeric effect showed a bend in the saccharide chain at this disaccharide with a largely hydrophobic surface of the convex side, probably being part of the binding epitope. Mixtures of glycolipids isolated from a human ureter scraping and from urinary sediments bound bacteria in the 2- to 7-sugar interval. Thus, this infectious strain of E. coli recognizes glycolipids being present in epithelial cells lining the urinary tract.
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PMID:Specificity of binding of a strain of uropathogenic Escherichia coli to Gal alpha 1----4Gal-containing glycosphingolipids. 389 56

Most physicians believe that the diabetic patient is predisposed to infections and that infections complicate the control of the diabetes. Despite the lack of scientific proof, certain infections (such as tuberculosis, bacteriuria in females, malignant external otitis, rhinocerebral mucormycosis, emphysematous cholecystitis, emphysematous pyelonephritis, acute papillary necrosis etc) are widely regarded to be associated with the diabetic. Foot infections, infections of the respiratory tract and the urinary tract are very important in the diabetic. The reasons why diabetics are susceptible to infections are unclear: although the production of humoral antibody appear intact, defective function of the polymorphonuclear leucocytes has been demonstrated. Successful treatment of infections in the diabetic requires early and exact diagnosis, the exhibition of the correct antimicrobials, the treatment of the diabetic state and associated disorders and prompt surgical intervention where required. Good control of blood glucose in diabetic patients is a desirable goal in the prevention of certain infections and to ensure maintenance of normal host defense mechanisms that determine resistance and response to infection.
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PMID:Infections in diabetes with special reference to diabetics in Singapore. 389 79

The uptake of nutrients and activities of membrane enzymes in the kidney were investigated using renal brush border membrane (BBM) vesicles in acute pyelonephritis in rats. A significant decrease (P less than 0.001) in the uptake of D-glucose and L-phenylalanine was observed in both the unobstructed right and obstructed left kidney, while there was a significant increase (P less than 0.001) in the uptake of L-alanine in the left kidney of pyelonephritic rats, demonstrating disturbances in the reabsorption of the glucose and aminoacids in the kidneys. Vmax of alkaline phosphatase, leucine-amino-peptidase and maltase was found to be decreased in the left kidney, suggesting that there was a reduction in the active enzyme molecule number. Km of alkaline phosphatase and leucine-aminopeptidase remained unchanged, while km of maltase decreased in both the right and left kidneys. An increase in the Vmax of alkaline phosphatase and leucine-aminopeptidase and substrate affinity of the maltase in the right kidney demonstrated a compensatory phenomenon for the malfunctioning of the left kidney. This is the first report demonstrating alterations in reabsorption of nutrients and BBM enzymes in experimental pyelonephritis.
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PMID:Pyelonephritis alters the reabsorption of nutrients and brush border membrane enzymes of rat kidney. 390 22

Technical and maternal factors known to affect urinary estriol level or its measurement are discussed in view of the current use of serial estriol as an indicator of fetoplacental function. Technical artifacts can result from presence of methenamine mandelate, phenolphthalein, glucose, or high urine specific gravity. Aside from normal maternal factors such as inaccurate urine collection or variable fluid intake, estriol levels are depressed by corticosteroids and ampicillin. Pyelone phritis, anemia, hemoglobinopathy, abnormal renal status, malnutrition, and high altitude all depress estriol level or excretion. In some conditions such as pyelonephritis, amniotic estriol level may be a better indicator of fetal status.
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PMID:Factors affecting the yeild of urinary estriol. 433 82

In the Cornett strain of mice, water diuresis did not prevent hematogenous production of pyelonephritis by Staphylococcus aureus. Increased fluid intake did not affect the numbers of organisms deposited in the kidneys or the rate of growth during the first 4 hr after inoculation. Drinking the glucose solution did not enhance bacterial proliferation within the renal parenchyma. Subcutaneous injection of saline to supplement for interruption of drinking after inoculation reduced the numbers of organisms recovered in the kidneys but not sufficiently to prevent production of pyelonephritis. Incorporating penicillin as a marker indicated that fluids administered by subcutaneous injections were rapidly delivered to the kidneys. Combining diuresis with treatment did not influence the rapidity of delivery of antimicrobial to the kidneys or the length of time that it was present in the renal homogenate.
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PMID:Effect of diuresis on Staphylococcus aureus kidney infections in mice. 515 5

Glucose titration studies were performed on 17 patients with either chronic pyelonephritis or chronic glomerulonephritis. Glomerular filtration rates for the group ranged from 4.3 to 58.1 ml per minute. In none of the patients in whom the glomerular filtration rate was over 15 ml per minute was there appreciable splay, and the mean titration curve for these patients resembled that obtained by Smith and associates in normal man (1). In half of this group of eight patients, GFR ranged from 16.6 to 22.7 ml per minute; in the other half values ranged from 42.3 to 58.1 ml per minute. Yet, the mean titration curves were identical for the two groups. In addition, no difference was observed in the titration curves for patients with pyelonephritis and those with glomerulonephritis. In patients with GFR values below 15 ml per minute, increased splay was observed, and below a GFR of 10 ml per minute, the splay was very marked. Both the absence of exaggerated splay in patients with reduction of glomerular filtration rate by as much as 85%, and the emergence of exaggerated splay in patients with more marked reduction of GFR, require explanation. Theoretical considerations are presented in the text.
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PMID:Glucose titration studies in patients with chronic progressive renal disease. 601 55

Glucose titration studies were performed in rats with unilateral chronic pyelonephritis before and after removal of the contralateral control kidneys. Identical studies were performed in animals with unilateral partial renal infarction in which the experimental kidneys had a marked reduction in nephron population but no anatomic deformation in the surviving nephrons. In the initial studies, both groups of animals were free of clinical and chemical abnormalities of uremia. In the follow-up studies uremic abnormalities were present. Minimal splay was observed in the titration curves in the initial studies; marked splay was present in the group data from the same kidneys in the subsequent studies. Thus a marked reduction in the nephron population was associated with the evolution of splay in both groups of animals. In association with the increase in splay, the mean values for maximal glucose transport increased; thus a defect in glucose transport can be excluded as the basis of the splay. Glomerular filtration rate increased proportionately more than the maximal transport of glucose; hence the ratios of glomerular filtration rate to maximal glucose transport increased consistently. The possibility of asymmetric hypertrophy of glomerular and tubular functions among the nephron population imposed by scar tissue or other anatomic deformities was considered, but the results in the animals with partially infarcted kidneys militate against this explanation. The splay also could reflect an asymmetric alteration in the distribution of glomerulotubular balance among the residual units initiated by functional adaptations. Finally, the splay could relate to an alteration in the kinetics of glucose transport without any change in the level of functional homogeneity. The possible nature of these has been considered in the text.
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PMID:On the mechanism of the splay in the glucose titration curve in advanced experimental renal disease in the rat. 601 56


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