Blood pressure and growth at 6 years of age among offsprings of mothers with hypertension of pregnancy.

The association between hypertension of pregnancy and blood pressure (BP) and physical growth of the offspring at 6 years of age has been studied in a historical prospective study. Ninety-four consecutive women who developed hypertension during pregnancy and were hospitalized with a diagnosis of pre-eclampsia and their children were included. The comparison group consisted of individually-matched normal pregnant women. Each mother-child pair was examined when the child was 6 years of age. The mean systolic BP (SBP) of the offspring was 101.3 +/- 10.2 (S.D.) mmHg and that of the controls 99.8 +/- 9.5 mmHg. The mean diastolic BP (DBP) was significantly higher among the cases than among the controls (66.2 +/- 8.3 mmHg and 63.9 +/- 8.0 mmHg, P = 0.03). Among the cases, 11 children had a DBP above the 90th centile, whereas only four among the controls. A low, but significant, correlation was found between maternal and child BP for the cases. The DBP of the children with a positive family history of high BP was significantly higher than those with a negative history. There were no differences in height, weight or obesity index between cases and controls.

Primary vertebral tumor in an adolescent girl.

A 13-year-old girl presented with a 6-month history of back pain, a palpable paravertebral mass, and a left third lumbar radiculopathy. Radiologic studies were consistent with a primary vertebral neoplasm. Posterior biopsy yielded material consistent with osteoblastoma. Anterior tumor excision and vertebral reconstruction followed. Elements consistent with aneurysural bone cyst were present in the resected tumor.

Unhealthy money: the growth in health PACs' congressional campaign contributions.

The health and insurance industries have launched a massive lobbying and public relations effort to undermine popular support in the United States for a national health care system. As part of their campaign, these industries have increased dramatically their PAC contributions to members of Congress. This article provides a detailed account of these PAC contributions to congressional incumbents and candidates, and discusses additional information on the health insurance industry's advertising campaigns.

[Present and future value of monoclonal antibodies in nephrology]. / Intérêt présent et futur des anticorps monoclonaux en néphrologie.

Many monoclonal antibodies directed against human T-lymphocytes have been produced in mice. Some of these, such as OKT 3, recognize all T-cells which can thus be counted in the blood; they have been used for the prevention of renal transplant rejection. Despite unexpected problems, such as antigenic modulation and anti-mouse sensitization, the first results obtained are promising. Other antibodies produced are directed against T-lymphocyte subsets, notably T-helpers (OKT4+) and T-suppressors or cytotoxic T-cells (OKT8+). Studies of the OKT4+/OKT8+ ratio have shown an imbalance in T-cell subsets in 2 types of glomerulonephritis: Berger's disease and membranous glomerulonephritis; they have also contributed to a better understanding of renal allograft rejection, where this ratio is often elevated.

T cell subset modulation of immunoglobulin production in IgA nephropathy and membranous glomerulonephritis.

Monoclonal antibodies directed against T cell subset antigens have been used to deplete peripheral blood human mononuclear cells from helper (OKT4+) and suppressor/cytotoxic (OKT8+) cells. Unfractionated cells and depleted cells were assayed for their capacity to modulate pokeweed mitogen (PWM)-driven IgG, IgA, and IgM production by autologous B lymphocytes. Immunoglobulin production in the presence of these various cell preparations paralleled the OKT4+/OKT8+ ratio defining the population. Importantly, there was no clear relationship between the level of PWM-driven Ig production by unfractionated cells and their initial relative content in OKT4+ and OKT8+ cells. Patients with IgA nephropathy and membranous glomerulonephritis showed a statistically significant increase of OKT4+/OKT8+ ratio, suggestive of suppressor T cell deficiency. There was no increase in IgA production in patients with IgA nephropathy, even in those showing high serum IgA level. A special feature found in patients with IgA nephropathy, irrespective of OKT4+/OKT8+ ratio in unfractionated cells, was a particularly intense enhancement of IgA production after OKT8+ cell depletion in some of the patients, contrasting with a particularly low effect of such depletion on the synthesis of all Ig classes in other patients. In patients with membranous glomerulonephritis there was no obvious abnormality in the modulation of Ig production by T cell subsets, with the exception of a weak suppressor activity with respect only to IgM production in a significant number of patients.

Evaluation of ureterocele with Doppler sonography.

Ureterocele is a common disorder characterized by cystic dilatation of the terminal submucosal portion of 1 or both ureters. Conventional imaging modalities for the diagnosis of ureterocele include intravenous urography and voiding cystourethrography; gray-scale sonography, augmented by color Doppler and spectral analysis studies, can be useful in diagnosing and managing this condition as well. We describe the diagnosis of ureterocele using transvaginal gray-scale and color Doppler sonography with spectral analysis in 2 women. Color Doppler sonography demonstrated urine flow into the bladder, and spectral analysis was used to measure the flow velocity. Together, these modalities can provide additional information about urinary flow dynamics, aid in implementing treatment for patients with ureterocele, and eliminate the need for invasive diagnostic procedures.

Tidal irrigation versus conservative medical management in patients with osteoarthritis of the knee: a prospective randomized study. Tidal Irrigation Cooperating Group.

To determine the efficacy of tidal knee irrigation for knee pain due to osteoarthritis (OA), we conducted a randomized, single blind, 14-week prospective trial comparing medical management with tidal knee irrigation in 77 patients with non-end stage OA of the knee and unilateral pain refractory to standard medical treatment. Fifty-seven patients completed the study. Statistically significant differences (p less than 0.05) favoring tidal knee irrigation over medical management were pain after 50' walk, pain after 4-stair climb, most intense pain in previous day, frequency of knee stiffness with inactivity, days of morning knee stiffness in previous week, physician assessment of knee tenderness and overall assessments of therapy effectiveness by both patient and physician. Tidal knee irrigation results in more favorable improvement of pain due to OA than can be accomplished with traditional medical management.

The value of sperm pooling and cryopreservation in patients with transient azoospermia or severe oligoasthenoteratozoospermia.

BACKGROUND: A transient state of azoospermia may occur due to toxic, environmental, infectious or iatrogenic conditions. Finding sperm in the ejaculate of such patients is often unpredictable and may be critical in IVF treatment. In the present study, the approach of pooling and cryopreservation of sperm is evaluated. Cryopreservation was performed in a unique group of patients in whom no sperm had been found in at least one previous sperm examination and in patients diagnosed as suffering from non-obstructive azoospermia in whom, occasionally, sperm were found. METHODS: A total of 157 semen pooling and cryopreservation procedures in 53 patients was performed between January 1998 and December 2000 in our centre. Forty five of these patients underwent an IVF-ICSI treatment during the study period. In 32 patients, fresh sperm were used to perform ICSI. In 13 patients no sperm were available, and the previously frozen sperm were used. RESULTS: Using our pooling system, 13 IVF-ICSI cycles were rescued. In seven patients with a previous testicular biopsy due to azoospermia, sperm cryopreservation was possible. Overall, 13 pregnancies (10 deliveries, two ongoing pregnancies and one missed abortion) were achieved. CONCLUSION: The introduction of semen banking for patients with transient azoospermia may increase the chance of pregnancy using their own sperm.

[Drug-induced renal insufficiency. Results of consensus meetings]. / Les insuffisances rénales d'origine médicamenteuse. Résultats de réunions de consensus.

We report the conclusions of consensus meetings organized by the "Direction de la Pharmacovigilance" of Roussel Uclaf, and attended by University Hospital Nephrologists, members of the National Network of Pharmacovigilance and representatives of Roussel Uclaf Drug Monitoring Department, in order to define more accurately, as regards drug-induced renal failure, the criteria and the terminology proposed by the French method of causality assessment of adverse drug reactions.

Retinal and choroidal ischemic syndrome, digestive tract and renal small vessel hyalinosis, intracerebral calcifications and phenotypic abnormalities: a new family syndrome.

A new family syndrome is described that affected three of seven siblings and another patient who had been abandoned at birth but came from the same area of France. All four patients were young women with a very peculiar phenotype, poikiloderma and greying of the hair, and idiopathic non-arteriosclerotic cerebral calcifications. Pathological studies demonstrated small-vessel hyalinosis due to basal membrane thickening, mainly in the digestive tract, kidneys and calcified areas of the brain. The clinical and biological expressions of these vascular changes varied. Peripheral retinal ischemic syndrome and chorioretinal scars were found in the ocular fundi of three patients. Malabsorption and protein-losing enteropathy was the main problem in all four, and was the cause of one patient's death. A subarachnoid hemorrhage due to a right sylvian aneurysm also occurred in two of the three sisters and was lethal for one. Nephropathy with renal failure and systemic hypertension is the major problem of the two surviving patients.