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51.
S.L. Atkin A.M. Coady D. Horton N. Sutaria L. Sellars C. Walton 《Diabetic medicine》1995,12(3):267-270
A 15-year-old girl presented de novo in diabetic ketoacidosis having been comatose for 24 h (day 1). A CT scan and lumbar puncture performed on admission were normal and her conscious level slowly improved over several days. On day 7 she had central neurological signs of bilateral knee clonus and an extensor plantar response. In addition, she had developed lower motor neurological signs of an ulnar nerve palsy of the left forearm, and ulnar, median, and radial nerve palsies of the right forearm. Magnetic resonance imaging (MRI), performed on day 12, showed multiple small cerebral haematomata with appearances at least several days of age. The scattered lesions were localized particularly to the parieto-occipital region, with sparing of the basal ganglia and without cerebral oedema, a novel feature not previously described in juvenile ketoacidosis. Four months later there was minimal residual disability of her right arm. The clinical findings together with the MRI images suggested that the peripheral nerve and central lesions were temporally related, suggesting a common aetiology. However, it is likely that MRI showed cerebral lesions which may have been missed by the conventional CT scanning performed initially. 相似文献
52.
Cytomegalovirus (CMV) is regarded as a predominant infectious agent in solid organ transplants. CMV disease has highly protean
clinical manifestations. Nevertheless, urinary tract involvement seems to be very rare during CMV infection. We report two
cases of renal transplant recipients in whom ureteral stricture developed in the course of CMV disease. Histologic data were
available for them and were consistent with CMV infection. We discuss previous case reports and propose physiopathologic mechanisms.
Received: 3 October 1996 Received after revision: 13 February 1997 Accepted: 17 February 1997 相似文献
53.
Abstract One hundred eighty-one consecutive patients with fulminant hepatic failure (FHF) presenting in a 2-year period were reviewed. In this cohort we examined the impact of pretransplant renal failure on mortality and morbidity following orthotopic liver transplantation (OLTx). Twenty-seven patients (18 female, 9 male) with a median age of 43.5 years (range 19–65 years) underwent OLTx. FHF was due to idiosyncratic drug reaction ( n = 4), paracetamol overdose ( n = 3), seronegative hepatitis ( n = 17), hepatitis B ( n = 1), veno-occlusive disease ( n = 1), and Wilson's disease ( n = 1). Renal failure was present in 14 patients, 7 of whom died (whereas there was 100 % survival in patients without renal failure). Pretransplant renal failure was associated with prolonged mechanical ventilation (13 days vs 6 days, P = 0.05), prolonged intensive care stay (17 days vs 8 days, P - 0.01) and prolonged hospital stay (27 vs 21 days, P = NS). Pretransplant renal failure did not predict renal dysfunction at 1 year after OLTx. We conclude that the survival of patients transplanted for FHF is inferior to that of patients transplanted for chronic liver disease (67 % vs 88 % 1-year survival in Birmingham). For patients with FHF undergoing transplantation, pretransplant renal failure strongly predicts poor outcome with significantly greater consumption of resources. 相似文献
54.
小儿肾脏疾病血,尿内皮素的变化 总被引:9,自引:0,他引:9
目的研究小儿肾脏疾病血、尿内皮素(PET、UET)的水平及其相互关系。方法采用同位素放免方法检测了肾病综合征(NS),肾小球肾炎(GN),肾功能衰竭(RF)共72例患儿血及尿中ET,血心钠素(ANP)水平。结果NS,GN,RF三组的PET及UET值明显高于对照组,尤其RF组(P<005,P<0.01)。ANP值在GN组和RF组明显高于对照组(P<001)。8例ARF患儿恢复期血ET水平下降,6例CRF患儿虽经治疗,但血ET水平不降或上升。结论ET在小儿肾脏疾病发病机理及病情进展中可能起重要作用,其值高低与病情严重程度及预后有关。 相似文献
55.
白细胞介素6在狼疮性肾炎患者小管间质的表达及其意义 总被引:12,自引:0,他引:12
探讨白细胞介素6(IL-6)在狼疮性小管间质病变中的作用。方法 采用ELISA方法与原位分子杂交技术(后者结合IBAS计算机图像分析系统),分别检测42例活动期狼疮性肾炎(LN)患者尿IL-6浓度与其中的15例肾小管间质IL-6mRNA水平。结果 42例活动期LN患者有36例尿IL-6>5pg/mg·cr,其增高程度与尿β_2-m及NAG活性水平呈显著正相关;其中15例肾组织切片中,肾小管间质均有IL-6mRNA表达,并且小管间质病变愈严重,其表达量愈高,而健康肾组织小管间质几无IL-6mRNA表达。结论 LN患者活动期尿IL-6浓度异常增高与肾小管间质IL-6mRNA异常表达有关,提示IL-6在狼疮性小管间质损害过程中可能具有重要作用。 相似文献
56.
Bo-Lennart Johansson Ulla Berg Ulla Freyschuss Kerstin Hall Staffan Troell 《Pediatric nephrology (Berlin, Germany)》1990,4(6):589-592
The influence of metabolic control (HbA1c), noradrenaline (NA) and insulin-like growth factors (IGF-I and IGF-II) on renal function and size was investigated in 11 insulin-dependent diabetes mellitus patients aged 11–17 years. Renal function was evaluated in terms of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal size was determined as renal parenchymal volume (RPV) by ultrasonography. The patients' HbA1c values ranged from 8.2% to 12.9% (normal range 5.5–8.5%) and their GFR and ERPF were higher than normal. Their IGF-II values were higher, and NA and IGF-I levels were lower than those of healthy controls. Inverse correlations between NA and GFR (r=–0.66) and NA and ERPF (r=–0.63) were found. No correlation was found between serum IGF-I and renal functional parameters. The IGF-II values correlated with GFR and HbA1c (r=0.63,r=0.70 respectively). There were linear correlations between RPV and GFR, RPV and ERPF, HbA1c and GFR, and ERPF and RPV. Decreased NA concentrations and increased IGF-II values appear to be factors contributing to renal hyperfunction in these patients. 相似文献
57.
Lorenzo E. Derchi Carlo Martinoli Roberto Pontremoli Stefano Saffioti Caterina Pastorino 《European radiology》1993,3(2):186-189
Two patients with arteriovenous fistulas of the native kidney occurring after needle biopsy were evaluated using duplex and color Doppler ultrasonography. The first patient had a fistula with associated pseudoaneurysm: color Doppler showed the lesion as a small rounded area with whirling flow; spectral analysis allowed recognition of both the afferent artery with low impedance flow and the draining vein with pulsatile, arterialized flow. The second patient had a normal color Doppler study; however, spectral analysis demonstrated signals with low vascular impedance from an intra-parenchymal artery at the lower pole, and a jet of turbulent flow. Following disappearance of clinical findings, such Doppler abnormalities were no longer detectable. When a iatrogenic arteriovenous fistula is considered on clinical grounds, both color and Doppler spectral analysis of waveforms from intra-parenchymal vessels should be performed. Possibly, further advances in color Doppler technology will permit the use of this examination as the first imaging procedure in these clinical situations.Correspondence to: L. E. Derchi 相似文献
58.
流行性出血热若干体液因子和肾脏血液动力学的变化 总被引:2,自引:0,他引:2
对28例流行性出血热(EHF)患者作了体液因子和肾脏血液动力学的观察研究。发现患者从发热期至多尿初期血浆内皮素(ET)、血栓素B2(TXB2)、血管紧张素-Ⅱ(AT-Ⅱ)均高于正常,P物质(SP)则低于正常,6-酮前列腺素F1α(6-k-PGF1α)除极期外其它各期亦见减低,肾小球滤过率(GFR)与肾有效血浆流量(ERPF)从发热后期至多尿期均显著下降,至恢复初期多数重型患者仍未达到正常。上述结果提示体液因子的失衡是造成内脏缺血和急性肾衰的重要因素。 相似文献
59.
60.
To investigate the relationship between age and renal vascular resistance and to establish nomative data of the systolic/diastolic
ratio (S/D ratio), pulsatility index (PI), and resistant index (RI) of the renal artery in the normal pediatric population,
we studied 252 normal children aged newborn to 13 years (a total of 449 kidneys) with a color Doppler unit. After the normality
of the kidney was established, color flow mapping was performed to localize the segmental portion of the renal artery. Flow
velocity waveforms were then obtained by pulsed Doppler, and S/D ratio, PI, and RI were calculated. Multiple regression analysis
confirmed the age dependence of the S/D ratio, PI, and RI of the renal artery in normal children. Renal vascular resistance
continuously declines after birth and stabilizes at the age of 102 – 130 months. Normative data for S/D ratio, PI, and RI
of the renal artery in normal children were established for each age group. Since renal vascular resistance decreases with
age and stabilizes at 8 – 10 years, we suggest using different normal ranges for each age group when studying renal vascular
resistance in pediatric patients.
Received October 5, 1995; received in revised form and accepted April 24, 1996 相似文献