Diagnostic and therapeutic considerations for "mycotic" cerebral aneurysms: 2 case reports and review of the literature.

Objective: Cerebral aneurysms of an infectious etiology, so-called "mycotic" aneurysms, are rare neurovascular pathologies. Primary treatment may be targeted on the aneurysm, but care has to be driven by the underlying pathology to prevent an often fatal clinical course with a mortality rate reaching 90%. 2 case reports are presented, and the diagnostic and therapeutic issues outlined by reviewing the literature.

Renal renin-angiotensin system activity in naturally reared and cross-fostered spontaneously hypertensive rats.

Background: Young (4 week) spontaneously hypertensive rats (SHR) exhibit greater renal responses to angiotensin II (Ang II) than normotensive Wistar Kyoto (WKY) rats. SHR pups cross-fostering to a WKY dam at birth (SHRX) are less sensitive to Ang II and have lower adult blood pressure. The aim of this study was to compare renal renin-angiotensin system activity in young naturally reared and cross-fostered SHR pups.

The glomerulo-tubular junction: a target in renal diseases.

Both global and segmental glomerulopathies may damage specific areas of the renal glomerulus. Diseases associated with glomerular hyperperfusion cause lesions at the vascular pole, while diseases associated with proteinuria often damage the tubular pole. Atubular glomeruli are now known to be plentiful in a variety of common renal diseases.

Ectopic thyroid tissue on the ascending aorta: an operative finding.

We describe a case of benign ectopic thyroid tissue found attached to the ascending aorta at operation.

A proinflammatory role of IL-18 in the development of spontaneous autoimmune disease.

Serum from patients with systemic lupus erythematosus (SLE) contained significantly higher concentrations of IL-18 than normal individuals. MRL/lpr mice, which develop spontaneous lupus-like autoimmune disease, also had higher serum levels of IL-18 than wild-type MRL/++ mice. Daily injections of IL-18 or IL-18 plus IL-12 resulted in accelerated proteinuria, glomerulonephritis, vasculitis, and raised levels of proinflammatory cytokines in MRL/lpr mice.

Renin gene expression in fetal kidneys of pregnancies complicated by twin-twin transfusion syndrome.

Twin-twin transfusion syndrome (TTTS) complicates one in five monochorionic pregnancies and is generally associated with high mortality and morbidity. One twin (the recipient) grows appropriately and has polyhydramnios while the other (the donor) may have a reduced growth velocity and severe oligohydramnios. The disparities in amniotic fluid volumes represent differences in fetal urine output.

Effects of angiotensin II on remodelling of the airway and the vasculature in the rat.

Airway remodelling occurs in chronic asthma. Angiotensin II promotes growth in cardiovascular remodelling. Since the renin-angiotensin system is activated in acute severe asthma, we hypothesized that angiotensin II has a role in airway remodelling.

Modulation of autoimmune disease in the MRL-lpr/lpr mouse by IL-2 and TGF-beta1 gene therapy using attenuated Salmonella typhimurium as gene carrier.

We have investigated the effects of interleukin-2 (IL-2) and transforming growth factor-beta (TGF-beta) gene therapy on the progress of autoimmune disease in MRL-lpr/lpr mice, a murine model of systemic lupus erythematosus (SLE). These mice have uncontrolled proliferation of T cells, an impaired response to T cell mitogen and produce autoantibodies against nuclear antigens, including DNA. Immune complexes formed by these autoantibodies are believed to cause glomerulonephritis and vasculitis in lupus mice and human SLE.

Intrauterine growth restriction is associated with persistent juxtamedullary expression of renin in the fetal kidney.

Background: Intrauterine growth restriction (IUGR) has been linked to impaired renal function and hypertension, suggesting that an adverse prenatal environment could alter kidney development and renin production.

Methods: Immunohistochemistry and in situ hybridization were employed to localize renin-containing cells (RCCs) in the deep, middle, and superficial zones of autopsy kidney sections, in parallel with histologic maturation, from unexplained stillborn fetuses of normal weight (N = 26) and stillborn fetuses with IUGR (N = 17).

Results: In the control group, the number of RCC per 100 glomeruli in the deep zone decreased with advancing gestation from 40 at 20 weeks gestation to five at term (P < 0.

Tuft-to-capsule adhesions and their precursors: differences between the vascular and tubular poles of the human glomerulus.

Human glomerular capillary tufts were removed by microdissection and scanning electron microscopy was used to examine the surface of the capillary tuft and the interior of its Bowman's capsule in order to identify connections between the tuft and capsule. Glomeruli were examined in histologically normal renal cortex from 12 kidneys removed for tumour and 12 renal allografts removed for end-stage rejection. In normal kidney, the glomerular tuft was connected to Bowman's capsule by single podocytes and their processes.

Neuroendocrine cell hyperplasia in colonic tissue used for long term augmentation cystoplasty.

A case is described of neuroendocrine cell hyperplasia in intravesical colonic mucosa, implanted previously during augmentation cystoplasty. The patient was a 28 year old man born with posterior urethral valves, a non-functioning right kidney, and a poorly functioning dilated left kidney. The hyperplasia consisted of pure neuroendocrine acini and tubules within the lamina propria, separate from the normal intestinal glands.

A renin secreting ovarian steroid cell tumour associated with secondary polycythaemia.

A 67-year-old woman presented with dry skin, facial hair, hoarse voice, and weight gain. She was hypertensive (168/ 96 mm Hg), her haemoglobin concentration was 19 g/l, and haematocrit was 55.7%.

Nonsteroidal anti-inflammatory drug associated diaphragm disease.

We present a case of anaemia and intestinal obstruction in a 78-year-old woman taking nonsteroidal anti-inflammatory drugs who was found to have diaphragm disease at laparotomy.

Vascular remodelling in intramyocardial resistance vessels in hypertensive human cardiac transplant recipients.

Objective: Cardiac transplant recipients often develop hypertension as a side effect of immunosuppressive treatment. The aim of this study was to use the serial endomyocardial biopsies taken to monitor rejection to study the early and sequential arterial changes in human myocardial resistance arteries as hypertension develops.

Methods: At least 14 biopsies were studied from each of 23 patients, divided into a normotensive group (12 patients with a diastolic pressure never greater than 90 mm Hg) and a hypertensive group (11 patients with more than 10% of diastolic pressure measurements above 100 mm Hg).

Three-dimensional reconstruction of abnormal intramural coronary arteries in human cardiac allograft biopsies.

A novel abnormality of intramural coronary arteries has been recently described in allograft cardiac biopsies. Three-dimensional (3-D) models of these abnormal arteries have now been constructed from serial histological sections of diagnostic post-transplant endomyocardial biopsies. These revealed that there was an interlacing meshwork of longitudinal smooth muscle bundles in abnormal arteries.

An assessment of the distortion of arteries due to sectioning in endomyocardial biopsies.

Arteries are usually studied morphometrically after pressurized fixation and resin embedding. These procedures are impracticable when dealing with diagnostic biopsies. The accuracy of arterial morphometry is determined partly by the degree of tissue distortion during section preparation.

Demonstration of renin gene expression in nephroblastoma by in situ hybridization.

Most patients with nephroblastoma have high levels of plasma renin and some are hypertensive. Blood pressure falls after removal of the affected kidney, suggesting that nephroblastoma is associated with renin production either by the tumour or by the kidney. In this study, direct evidence was sought of renin gene expression in nephroblastoma using in situ hybridization.

Atubular glomeruli and glomerular cysts--a possible pathway for nephron loss in the human kidney?

Glomerular tufts were removed and scanning electron microscopy was used to study the interior of Bowman's capsule, in order to identify atubular glomeruli. Normal renal cortex was studied from six kidneys removed for tumour and six renal transplants removed for end-stage rejection. Atubular glomeruli occurred in normal renal cortex in less than 1 percent of glomeruli, but were more common in transplant nephropathy, representing up to 61 percent of glomeruli.

A case of neonatal Bartter's syndrome.

We describe a child with a neonatal presentation of Bartter's syndrome. Unlike infants previously described with a similar clinical presentation, the urinary excretion rate of prostaglandin E2 in this child was similar to normal children and Tamm-Horsfall protein was distributed normally in the thick ascending limb of the loop of Henle. The child failed to respond to indomethacin alone, but thrived after the addition of the angiotensin converting enzyme inhibitor, captopril.

Control of cell proliferation in the rat adrenal gland in vivo by the renin-angiotensin system.

Adrenal cytogenesis was investigated in response to 1) subcutaneous infusions of angiotensin (ANG) II (200 ng.kg-1.min-1); 2) high and low sodium intake; and 3) captopril treatment (10 mg.

The role of interleukin 12 and nitric oxide in the development of spontaneous autoimmune disease in MRL/MP-lpr/lpr mice.

MRL/MP-lpr/lpr (MRL/lpr) mice develop a spontaneous autoimmune disease. Serum from these mice contained significantly higher concentrations of nitrite/nitrate than serum from age-matched control MRL/MP-+/+ (MRL/+), BALB/c or CBA/6J mice. Spleen and peritoneal cells from MRL/lpr mice also produced significantly more nitric oxide (NO) than those from the control mice when cultured with interferon (IFN) gamma and lipopolysaccharide (LPS) in vitro.