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  • 1
    Keywords: ASSOCIATION ; autoimmune pancreatitis ; INTERSTITIAL NEPHRITIS ; Mycophenolate mofetil ; SYSTEMIC-DISEASE
    Abstract: Autoimmune pancreatitis is a rare form of pancreatitis characterized by responsiveness to steroid therapy and an often relapsing disease course. The mainstay of therapy is oral corticotherapy. Associations of interstitial nephritis with various autoimmune disorders have been described. We hereby report the case of a 69-year-old Caucasian man with a 2-year history of autoimmune pancreatitis, who presented with impairment of kidney function, proteinuria, and hypertension. Renal histopathology showed severe diffuse interstitial nephritis. With oral prednisone and ACE inhibitor therapy, complete recovery of kidney function was not achieved and proteinuria persisted. Therefore, mycophenolate mofetil was initiated. After 8 weeks, serum creatinine decreased, and a nearly complete and sustained resolution of proteinuria was seen, while tapering oral steroid doses. With autoreactive T cells playing a major role in the pathogenesis of both diseases, a common etiology of pancreatitis and interstitial nephritis can be assumed, and the beneficial effects of an inhibitor of lymphocyte proliferation, such as mycophenolate mofetil, can be explained. We infer from our case that mycophenolate mofetil can be effective in the control of simultaneous autoimmune pancreatitis and interstitial nephritis.
    Type of Publication: Journal article published
    PubMed ID: 21069569
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  • 2
    Keywords: DISEASE ; EPIDEMIOLOGY ; POPULATION ; kidney ; HEALTH ; glomerulonephritis ; HYPERTENSION ; REGISTRY ; GLOMERULAR-DISEASES ; renal biopsy ; BIOPSY-PROVEN GLOMERULONEPHRITIS ; Primary glomerulonephritis ; Secondary glomerulonephritis
    Abstract: BACKGROUND: Knowledge of the exact numbers of patients suffering from chronic diseases, possibly requiring costly continuous treatment, is mandatory for future health care plans. Despite some regional biopsy registries, no valid data about the epidemiology of glomerulonephritis in Germany exist, because all publications are hampered by their retrospective character and lack of completeness. METHODS: In a unique cooperation of out-patient nephrologists with a single major teaching hospital serving a population of approx. 600,000 in the capital of Schwerin and surrounding counties, all patients with abnormal urine findings and/or decreasing renal function of unknown cause were referred for renal biopsy between October 2002 and December 2008. The drop-out rate is assumed to be less than 5%. All biopsies were analysed according to international standards and traditional epidemiological and clinical parameters were collected for comparison with the micro-census of Mecklenburg-Lower Pomerania region of the year 2008. We present the first valid estimations of incidence and 7 year prevalence of glomerulonephritis in Germany. RESULTS: In 222 patients, 251 renal biopsies were performed. The annual biopsy rate was 64 per million population (pmp; range 46.2-87.2). The incidence and prevalence of glomerulonephritis over 7 years was 52 and 285 pmp, respectively. The most frequent glomerulonephritis subtype was mesangioproliferative glomerulonephritis (20.9 pmp) followed by focal and segmental glomerulosclerosis (FSGS, 11.2 pmp) of which 43% had an etiologic underlying condition. The incidences of minimal change nephropathy (MCN), membranous nephropathy and necrotising glomerulonephritis (NGN) were 3.2, 5.2 and 4.9 pmp. In one third of all cases, the glomerulonephritis was secondary (incidence of secondary glomerulonephritis 17.5 pmp). Lupus nephritis and ANCA-associated glomerulonephritis were found in 2.9 and 5.4 cases pmp.
    Type of Publication: Journal article published
    PubMed ID: 21505754
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  • 3
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Investigating their tuberculotic patients the authors have found that the number of nephrectomies performed due to tuberculosis has shown a marked decrease since the introduction of the combined antituberculotic treatment. A comparison between the histological picture of kidneys nephrectomized without preliminary suppressive drug treatment or only given insufficient streptomycin, and that gained from nephrectomies following combined suppressive drug treatment, shows that in the latter the perifocal diffuse lymphocyte infiltration gets reduced, while in the untreated cases it is high, and the number of histiocytes increases. Of this the conclusion is drawn that the non-specific component of the inflammation also decreases as a result of streptomycin. In the cases treated there were reticular fibres in the tubercles, epitheloid cells were characteristic of the picture, and there was a decrease in the number and size of the Langhans cells. It is also considered as the result of the treatment that reticular fibrosis was replaced by collagen fibrosis. Summing up, the authors state that the combined treatment not only accelerates recovery but considerably changes the histological picture too.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Author's clinical experiences with partial urinary bladder grafting, when the suturing was impossible, are described. The author recommends homografts. The employment of pedunculated peritoneal flaps, of the greater omentum and of uneliminated portions of the intestine is discussed. Other materials, recently suggested for grafting such as adequately prepared homologous and animal tissues or synthetic prostheses, are stated to be dispensable.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Referring to the experimental work of Lapides the author describes three successful cases of substituting the urethra with a tube made from the anterior wall of the bladder. The lack of urethra and the incontinence in the three female children were due to malformation. The paper also deals with the conditions of the operation. According to the author there is no lower age limit to using this operative method.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 135 ureteral reimplantations into the bladder have been reported. Indications, the employed operative methods and the results obtained in each group of patients are discussed. Detailed descriptions of the following operative techniques are given: ureter-flap technique of implantation, vesical (modified Boari) plasty, one-stage reimplantation of both ureters in bilateral ureterovaginal fistulas and ureteral intussusception for vesicoureteral reflux.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The value of a modified blood sedimentation reaction in distinguishing between inflammatory and malignant diseases has been examined in 109 urological patients. Inflammatory processes could be differentiated from untreated malignant tumours of the urinary tract with more than 90% accuracy. The method is particularly suited for the early diagnosis of tumours accompanied by an elevation of Westergreen's conventional ESR.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    International urology and nephrology 1 (1969), S. 187-192 
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The short-term dialysis occupies a medium position between the obligatory dialysis in patients with acute renal failure and the intermittent chronic dialysis in patients with irreversible renal diseases. By short-term dialysis many, eventually fatal, therapeutic errors may be avoided. In many cases, it is possible to gain time necessary for further diagnostic considerations in azotaemia of obscure origin, for overcoming the critical moments of exacerbation in chronic nephropathies and for obtaining a remission of variable duration. Thanks to the short-term dialysis, the condition of the patients in the preoperative period could be controlled, the surgical hazards reduced and the operative results improved. The performance of several dialyses permits a better selection of patients for chronic dialysis and renal transplantation and the avoidance of useless efforts to submit inappropriate patients to such a mode of treatment.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    International urology and nephrology 1 (1969), S. 179-185 
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty-four vesico-vaginal fistulas have been operated on in 62 patients during a period of 24 years at the Department of Urological Surgery of János Hospital, Budapest. During the first 14 years, Füth's method as modified by Noszkay was used completed by Martius' bulbocavernous operation. In the course of the last 10 years, the operations carried out in 24 patients have been modified in that the region of the fistula closed according to Füth's technique was supported by a bulbocavernous flap only in case of descension of the anterior vaginal wall, or if protection of sutures closing extensive fistulas made it necessary. On basis of the favourable results indicated by the improvement in almost all patients in a relatively large material (63 fistulas healed, and failure in only one case after two operations), the author recommends Füth's method with a suggested modification for the surgical treatment of vesico-vaginal fistulas.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    International urology and nephrology 1 (1969), S. 193-199 
    ISSN: 1573-2584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The kidneys were studied by the fluorescent antibody technique in four autopsy cases of human amyloidosis and casein-induced amyloidosis in rabbits. In the cases of human amyloid nephrosis massive deposits of human gamma-globulin were identified in the glomerules, in the vascular walls, in the tubular basement membrane and in the interstitial tissue, and lipoprotein was demonstrable in the cytoplasms of the tubular epithelial cells. In experimental amyloidosis the studies revealed the presence of rabbit gamma-globulin in the glomerules and in the vascular walls.
    Type of Medium: Electronic Resource
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