The role of renal prostaglandin E as a possible modulator of cyclic AMP production in nephrotic syndrome.

Urinary prostaglandin E (PGE) and cyclic AMP (cAMP) excretions were studied by radioimmunoassay in children with nephrotic syndrome and in a control population. In cases with nephrotic syndrome there was a significant elevation in urinary PGE excretion and cAMP excretion was decreased. A positive correlation was found between urinary cAMP excretion and urinary osmolality (Uosm) and the ratio urine to plasma osmolality (Uosm/Posm); and a negative correlation between urinary cAMP excretion and urine volume. A negative correlation was observed between the values of PGE excretion and urinary cAMP. These data confirmed the role of PGE as a modulator of cAMP production, which was inhibited in the nephrotic syndrome.

Synergistic effect of promethazine with gentamycin in frequently recurring pyelonephritis.

The effects of promethazine were studied in children with frequently recurring pyelonephritis which was not associated with urological abnormalities. The results of three methods of treatment were compared: 10 children were given a combination of gentamycin and promethazine for 7 days (Group 1), 11 received gentamycin treatment alone for 10 days (Group 2), and 19 (Group 3) were on long-term oral antibiotic prophylaxis (5.6 +/- 2.1 years) with episodes of intensive treatment of recurrences. In a 3-year follow-up period, the number of pyelonephritis recurrences was significantly lower in Group 1 than in Groups 2 and 3. Six out of 19 children in Group 3 had renal scarring. The authors suggest a synergistic effect between gentamycin and promethazine therapy. Promethazine increases antibiotic sensitivity, which could contribute to the elimination of recurring urinary tract infections.

[Multiple primary cancer of the colon and rectum]. / A primaer multiplex vastag- és végbélrák.

Data of 33 patients operated on during 13 years because of primary multiple cancer of the colon are presented. The frequency of multiple occurrence was 4.1%. Synchronous tumors were observed in 1.8% (15 patients) and metachronous was (following 410 operations) 4.4% (18 patients). The attention is drawn to the relationship between polyps occurring simultaneously with colonic cancers and the following--metachronous tumors. Careful examinations must cover the period following the acute colon operation, as eliminating the cause of the emergency operation other--synchronous tumors or polyps may remain hidden. The significance of prevention and follow-up examinations in the treatment of metachronous tumors in stressed. It was stated that the malignancy and operability indices of the second tumor detected in this way did not differ significantly from the primary tumors. Preference was given to subtotal colectomy as operative principle in the treatment of metachronous cancers of the colon.

[Successful treatment of acute tubulointerstitial nephritis associated with infectious mononucleosis and causing severe uremia]. / Súlyos uraemiát okozó, mononucleosis infectiosához társult acut tubulointerstitialis nephritis sikeres kezelése.

A ten years old boy with severe acute renal failure was presented. The development of acute uremia was proceeded by infectious mononucleosis. Renal biopsy revealed acute tubulointerstitial nephritis. Peritoneal- and haemodialysis was completed by steroid therapy and cytostatic treatment when glomerular proteinuria was observed. Following a 2 months uremic period the patient cured completely.

[Macrothrombopenia, nephritis and hearing loss--a new case of Epstein syndrome]. / Macrothrombopenia, nephritis és halláscsökkenés--egy új Epstein-syndromás eset.

A 14 years old boy with persistent proteinuria (1.6-4.0 g/day), microscopic haematuria, macrothrombocytopenia (giant platelets, platelet number 30 G/l), and a familial sensorineural hearing loss (the father and the brother were also affected) was studied. Kidney biopsy presented a diffuse mesangial proliferation, and a focal thickening of the glomerular basement membrane was seen on electron microscopy. With bone marrow aspiration normal number of megacaryocytes was observed. The aggregation response of the platelets was decreased on collagen, epinephrine and ADP but it was normal on aggristin. The presented case with nephritis, platelet disorders and hearing loss corresponds to Epstein syndrome, a variant of Alport's syndrome.

[Recurrence of focal sclerosing glomerulonephritis in the kidney graft]. / Focalisan sclerotisáló glomerulonephritis recidívája vesetranszplantátumban.

This is the first report on the recurrence of a glomerular disease in renal transplant in Hungary. The primary disease of the girl died at the age of 13 was focal sclerosing glomerulonephritis with slight mesangial cell proliferation. The first symptoms appeared at the age of 6.5 and they progressed rapidly. Four years later, because of the severe nephrotic syndrome and chronic renal failure, renal transplantation was performed with the synchronous removal of the patient's own kidneys. In the latter an interesting immunohistological finding has been observed: beside the usual positivities, the basement membrane of the distal tubule at the opposite side of the macula densa showed a strong reaction with anti IgM and a somewhat weaker positivity with anti C3 sera. The primary disease recurred very soon. A mesangial cell proliferation, however did not develop, in contrary to the primary disease, which contradicts the theory that the mesangioproliferative form would be a distinct clinicopathological entity.

[Follow-up results of neonatal renal vein thrombosis after heparin treatment (author's transl)]. / Erfahrungen bei der Behandlung der Nierenvenenthrombose Neugeborener aufgrund von Spätkontrolluntersuchungen.

The authors report on their experiences gained during follow-up studies in 3 children, who as neonates had had renal venous thrombosis, and had been treated with heparin. On the basis of the relevant literature and their own observations, the authors suggest heparinisation during the acute stage.