Reasons for adherence and nonadherence: a pilot study comparing first- and multi-episode schizophrenia patients.

Rationale: Most first-episode schizophrenia patients will stop their medication after their acute symptoms improve. Understanding the salient motivations and attitudes that drive adherence--as well as nonadherence--is an important part of developing strategies to prevent or delay nonadherence during the early phases of the illness.

Methods: Self-reported reasons for adherence and nonadherence among first-episode and multi-episode patients with schizophrenia were obtained from cross-sectional adherence interviews from two prospective adherence studies: one composed of a first-episode sample (n=33) and the other with recently relapsing multi-episode patients (n=16).

Immunological activity of larch arabinogalactan and Echinacea: a preliminary, randomized, double-blind, placebo-controlled trial.

Unlabelled: The immunomodulating effects of two Echinacea species, E. purpurea and E. angustifolia and larch arabinogalactan extracted from Larix occidentalis were examined in a randomized, double-blind, placebo-controlled, prospective four-week clinical trial at a naturopathic medical school research center.

Immunopathology of renal disease.

The reviewed information implicates immune mechanisms in a variety of renal glomerular and tubulointerstitial diseases. Antibodies reactive with intrinsic structural or planted endogenous or exogenous antigens, and with circulating endogenous or exogenous antigens can initiate inflammatory capillary injury by localization in glomerular capillary tufts or along tubular basement membranes. This results in activation of mediator systems, including complement, neutrophils and other leukocytes, amines, peptides, and proteases, which result in vascular and tissue alterations.

Glomerular disease in captive galagos.

A captive colony of galagos that for several years lived under poor housing conditions and suffered a variety of chronic illnesses showed a high incidence of renal glomerular disease. Several patterns of glomerular disease were seen: four types of proliferative lesions included a mild stalk glomerulitis, more severe stalk-lobular proliferative glomerulonephritis, diffuse proliferative glomerulonephritis, diffuse proliferative glomerulonephritis, and diffuse proliferative and sclerotic glomerulonephritis; and a form of glomerular capillary basement membrane thickening. Glomerular localization of immunoglobulin and the third component of complement as well as some unusual ultrastructural observations in diffuse proliferative and sclerotic glomerulonephritis suggest an immunopathogenesis for this disease.

Vasculitis in Goodpasture's syndrome.

Because of differing diagnostic criteria, a controversy exists as to whether vasculitis may occur in patients with Goodpasture's syndrome. Using strict criteria (pulmonary hemorrhage, glomerulonephritis, and antiglomerular basement membrane antibody), we found histological evidence of vasculitis in two of 18 patients with Goodpasture's syndrome. The vasculitis was found in kidney biopsy specimens.

Clinicopathologic, enzymatic, and genetic features in a case of Fabry's disease.

We report renal lesions and functional alterations in a 32-year-old man with Fabry's disease (ceramidetrihexosidase deficiency). By light microscopy of a renal biopsy specimen, distinctive "foamy" cytoplasmic alterations were observed in renal glomerular, tubular, vascular, and interstitial cells. Histochemical analysis of vacuolated epithelial cells showed glycolipid- and phospholipid-like material.

Culture of human glomerular cells.

Human glomeruli were routinely cultured in Waymouth's medium supplemented with insulin and conditioned medium. Three cell types were seen in the culture of both adult and infant kidneys, but the morphology of the glomerular cellular outgrowths depended on the age of the patient from which the kidney was obtained. Cultures of glomeruli from older individuals resulted in more "differentiated" cells, but both adult and infant glomerular cells rapidly became "dedifferentiated" as the length of time in culture increased.

Cytochemical characterization of cultured adult, guinea pig glomerular cells.

Methods are described for culture of intact or trypsin-digested adult guinea pig glomeruli. Cell types grown from intact glomeruli were distinctly different from those which dominated cultures of trypsin dissociated glomerular cells as determined by transmission and scanning electron microscopy as well as by fluorescence or enzyme cytochemical reaction with lectins and immunofluorescence cytochemical staining for actin or fibronectin. Cells with long cytoplasmic extensions (glomerular epithelial cells), cultured from intact glomeruli, have strong affinity for concanavalin-A and soybean agglutinin which react with glucose and galactose residues respectively.

Cadmium, a metallic inhibitor of antibody-mediated immunity in mice.

Chronic administration of cadmium chloride to B10-A-2R mice was discovered to severely depress the numbers and to delay the onset of appearance of splenic IgG and IgM plaque-forming cells (PFC) following injection of sheep erythrocytes. A recovery period of at least 1 month following cessation of administration of CdCl2 resulted in no increase in IgM PFC and only a minimal increase in IgG PFC. An apparent cadmium-induced splenomegaly was also noted in the intoxicated mice.

Pressure-flow relationships and pathological changes during renal preservation.

The renal pedicle of one kidney from each of four dogs was ligated for one hour. The contralateral kidney served as a control. Both kidneys were removed and perfused using the "Belzer" technique.

Myocardial infarct in a child with systemic lupus erythematosus.

An unusual case of systemic lupus erythematosus (SLE) in a young child is reported with sudden death from myocardial infarction. The diagnosis of lupus erythematosus in this patient was made by renal biopsy at the age of 3 years. Atherosclerosis of the coronary arteries and aorta was found at autopsy with occlusion of the anterior descending branch of the left coronary artery.

Enumeration and ultrastructure of C4-producing free alveolar cells from guinea pig lung.

Free alveolar cells from guinea pig lung producing the fourth emoponent of C (C4) were identified, enumerated, and characterized by using anti-C4 Fab-peroxidase conjugates in conjunction with transmission electron microscopy. The C4-producing cell population consisted of: 1) alveolar macrophages (AM); 2) less well differentiated phagocytes similar in morphology to exudate macrophages; and 3) weakly phagocytic secretory cells with numerous profiles of rough-surfaced endoplasmic reticulum (ER). Internal immunolabeling allowed the visualization of C4 in the ER, perinuclear space, and Golgi complex of producer cells and its release at cell surfaces; synthesis of C4 in vitro was sensitive to inhibitors both of protein synthesis and messenger RNA function.

Immunohistologic features of minimal-change nephrotic syndrome.

To assess the role of immune mechanisms in the pathogenesis of minimal-change nephrotic syndrome (MCNS), immunohistologic studies were performed on renal biopsy specimens from 31 patients. Glomerular immunoglobulin and/or complement (C3) deposition was present in 20 specimens. Deposits were usually minimal to moderate, granular, and focal in nature.

Immune adherence in renal glomeruli. Complement receptor sites on glomerular capillary epithelial cells.

Several very recent reports have indicated the presence of receptor sites for the third component of complement in human but not other vertebrate renal glomeruli. The present study constitutes a demonstration that the glomerular capillary epithelial cell bears this receptor, detectable with either EAC complexes (EAC1423b) or fluores ceinated zymosan-C3 (ZC3b) complexes, Fresh, unfixed frozen sections of normal or diseased human kidneys, mechanically isolated human glomeruli, dissociated glomerular cells, and glomeruli and golmerular cells maintained in tissue culture were examined with various EAC complexes or ZC3b and examined by phase light microscopy, fluorescence microscopy, or transmission and scanning electron microscopy. Clearly, by scanning electron microscopy it was determined that glomerular capillary epithelial cells bind the immune-adherence EAC indicator cells.

Prolonged survival of xenografts after organ culture.

Recent reports demonstrate that culture of thyroid allografts before transplantation results in prolonged and sometimes indefinite survival. The loss of passenger leukocytes during organ culture was discussed as a possible reason for these findings. Recent data from a genetically defined system in the mouse demonstrated that passenger leukocytes play an important role in providing a helper stimulus which potentiates the generation of cytotoxic T cells to serologically defined determinants.

Nephrotic syndrome in Hodgkin's disease. Evidence for pathogenesis alternative to immune complex deposition.

The nephrotic syndrome has been reported to occur in patients with Hodgkin's disease even in the absence of amyloidosis, tumor infiltration of renal vein thrombosis. Three patients are presented with Hodgkin's disease and the nephrotic syndrome whose renal biopsy specimens studied with light, immunofluorescence and electron microscopy were compatible with "lipoid nephrosis" (minimal change disease). A review of the literature reveals 35 patients with Hodgkin's disease and the nephrotic syndrome.