Pathogenic factors in recurrent urinary tract infections and renal scar formation in children

Congenital renal arteriovenous malformation (aneurysmal type) in childhood.

We report on a 9-year-old boy with a congenital renal arteriovenous fistula of the aneurysmal type, a form previously not observed in childhood. The clinical picture was unusual with severe arterial hypertension, excessive polyuria and decreased levels of serum sodium and chloride as main signs. Clinical and biochemical findings normalised after nephrectomy of the kidney involved.

Uretero-Sigmoideostomie im Kindesalter — klinische, psychische und soziale Aspekte

Zwischen 1967 und 1983 wurde an der Urologischen Klinik Mainz bei 40 Patienten mit Blasenekstrophie bzw. Epispadie die Uretero-Sigmoidostomie durchgefuhrt. Das Verhaltnis mannlicher zu weiblichen Patienten war 3:1.

Diagnostik und operative Therapie beim vesiko-renalen Reflux

Fur die Abklarung und Klassifizierung des vesiko-renalen Refluxes stehen eine Reihe diagnostischer Masnahmen zur Verfugung, deren Aussagekraft nicht unumstritten ist. Aus diesen Grunden mussen therapeutische Entscheidungen bei der Refluxerkrankung haufig vom klinischen Verlauf abhangig gemacht werden. Durch die operative Refluxkorrektur kann mit hoher Zuverlassigkeit und geringer Komplikationsrate der vesiko-renale Reflux unabhangig vom praoperativ nachgewiesenen Refluxgrad beseitigt werden.

IgE in patients with glomerulonephritis and minimal-change nephrotic syndrome

Serum levels of IgE were studied in 30 children with minimal-change nephrotic syndrome and 32 children with mesangioproliferative glomerulonephritis during different stages of the disease and treatment. In addition, tissue obtained by renal biopsy was investigated by immunofluorescence histology; no deposits of IgE could be found. The serum IgE levels, however, were increased, particularly in patients with minimal-change nephrotic syndrome. It is concluded that IgE does not play a pathogenic role in the development of the renal disease, but that increased IgE levels are an indication of a disturbance of the immune system.

Comparison of the antibacterial effect of uroepithelial cells from healthy donors and children with asymptomatic bacteriuria

Bacterial attachment to uroepithelial cells (UEC) and the effect of UEC on bacterial growth was investigated in 15 healthy persons and 12 patients suffering from asymptomatic bacteriuria (ABU) with recurrent urinary tract infections (UTI). Desquamated UEC and mannose-resistant Escherichia coli were co-cultivated for up to 90 min. While no difference in bacterial adherence was observed between healthy controls and patients, 33.4% of the bacteria attached to normal UEC were found to be dead under microscopic evaluation (acridine orange staining), whereas no killing effect could be observed in patients' UEC 5 min after the onset of incubation. This phenomenon was confirmed by investigating the…

Long-term follow-up of children with surgically treated vesicorenal reflux: postoperative incidence of urinary tract infections, renal scars and arterial hypertension.

With a mean follow-up of 10.8 years, 160 female and 29 male patients were investigated after successful correction of vesicoureterorenal reflux. All patients suffered from urinary tract infection (UTI) preoperatively, while postoperatively 42% of the patients developed further UTIs but with a significantly diminished rate of febrile infections. In comparison to a group of patients without postoperative UTI (n = 16), the uroepithelial cells of those patients with a high infection rate after reflux correction showed a significantly lower bacterial growth suppression (n = 37). Renal scars were found in 22% of the investigated renal units with operated ureters (n = 211). Of the preoperatively u…

Immunological investigations in two brothers with ataxia telangiectasia Louis-Bar

Two of three brothers with the classical signs of ataxia telangiectasia were investigated for their immunological disorders at the ages of 13 and 16 years, respectively. The elder brother also suffers from autoimmune hemolytic anemia, a complication which has not yet been described in the course of ataxia telangiectasia. Immunological investigations made in both brothers showed a reduction in the number and function of T lymphocytes. The number of B lymphocytes was normal, among which there were cells staining for IgA, although serum IgA was absent. It seems possible that this phenomenon is caused by a disturbance in the process of maturation of lymphoid cells with a lack of differentiation…

Immunpathogenese der Pyelonephritis

Fast regelmasig last sich bei der Pyelonephritis eine spezifische Immunantwort gegen den verursachenden Erreger finden. Inwieweit jedoch die Immunantwort Entstehung und Verlauf der Pyelonephritis beeinflust, ist bisher ungeklart. In Analogie zu anderen Infektionen konnte angenommen werden, das eine Verschiebung der Erreger-Wirt-Beziehung zu Gunsten eines virulenten Erregers die Niereninfektion begunstigt. Bei Etablierung der Infektion reagiert der Wirt zunachst mit einem Einstrom von Granulozyten; anschliesend herrschen lymphatische Zellen vor, wobei sowohl T-Lymphozyten, die fur verzogerte Immunreaktionen verantwortlich sind, als auch B-Lymphozyten und ihre Produkte (Antikorper) lokal nach…

Effect of L-thyroxine on renal excretion of water and electrolytes in both normal and mercury-intoxicated rats.

The urine output and the change in excretion of electrolytes (sodium, potassium, calcium, chloride, inorganic phosphate) in rats following mercury-induced acute tubular lesions showed marked recovery during L-thyroxine therapy. The kidney mechanisms responsible for this effect are discussed, considering especially the observation that rats treated with L-thyroxine have a reduced urinary output, unlike other species, including man, which react with polyuria. The oliguric effect of thyroid hormone in rats is attributed to the greater length of the vasa recta and loops of Henle.