ABSTRACT
AIM: To examine blood flow in renal and intrarenal arteries and its changes in the acute pharmacological test with captopril in patients with chronic glomerulonephritis (CGN). MATERIAL AND METHODS: Renal circulation was studied in 50 patients with CGN using ultrasound dopplerography (USDG) of renal vessels on the unit GE Logiq 400 CL PRO Series. The velocity and indices of peripheral blood resistance in the major renal artery (RA) and in intrarenal arteries were estimated. In 26 patients the blood flow was studied again after intake of 50 mg captopril. RESULTS: Poor renal blood flow was registered in cortical parenchyma in 36% CGN patients (with chronic renal failure in 75%). Multifactorial regression analysis has demonstrated that only blood creatinine was independently related with slowing down of the blood flow at the level of RA and intrarenal arteries. Morphological index of activity correlated with resistance indices while a high sclerosis index correlated with blood flow slowing. Older patients had higher resistance indices. Captopril significantly accelerated blood flow and insignificantly changed indices of peripheral resistance including those in CRF patients. CONCLUSION: Poor blood flow in the cortical layer of renal parenchyma in CGN, according to USDG, occurs rather frequently and was associated with CRF and older age of the patients. Blocking of renin-angiotensin system at the level of angiotensin II formation improves renal blood flow in most of the patients.
Subject(s)
Captopril , Glomerulonephritis/diagnostic imaging , Kidney , Renal Artery/diagnostic imaging , Renal Circulation/drug effects , Adolescent , Adult , Blood Flow Velocity/drug effects , Blood Flow Velocity/physiology , Chronic Disease , Female , Glomerular Filtration Rate/drug effects , Glomerular Filtration Rate/physiology , Glomerulonephritis/physiopathology , Humans , Kidney/blood supply , Kidney/diagnostic imaging , Kidney/physiopathology , Male , Middle Aged , Renal Artery/physiopathology , Renal Circulation/physiology , Ultrasonography, Doppler , Vascular Resistance/drug effects , Vascular Resistance/physiologyABSTRACT
4400 biopsies studied in the pathology department of I.M. Sechenov Moscow Medical Academy in 1970-1999 were analysed. Primary glomerulopathy (PGP) was found in 62.4% of nephrobiopsies. PGP was represented by mesangioproliferative glomerulonephritis (MPGN, 48.9%), mesangiocapillary glomerulonephritis (MCGN, 18.4%), membranous nephropathy (MN, 13.4%), focal segmentary glomerulosclerosis/hyalinosis (FSGH, 7.8%), minimal changes (MC, 5.6%). Mainly of nephrotic origin were MC, MN, FSGH. The hematuric form was primarily represented by MPGN. In 1970-1999, the share of non-inflammatory variants (MC, MN, FSGN) was increasing while hematuric variants (MPGN, MCGN) had the tendency to a decrease in their relative frequency.
Subject(s)
Kidney Diseases , Humans , Kidney Diseases/epidemiology , Kidney Diseases/pathology , Kidney Diseases/physiopathology , Moscow/epidemiologyABSTRACT
Liver cirrhosis (LC) comprises 2.1% of 17,458 autopsies in the pathology department for the period from 1962 to 1987, the incidence has increased during the last decade. LC is more frequent in males than in females (ratio 1.36:1.0), the highest incidence in males being at the age of 40-49 years, in females 50-59 years. The main etiological factors of LC, growing in importance, are hepatitis B virus (28.6%) and ethanol (26.1%). The incidence of primary liver carcinoma is 0.9% of all the autopsies, hepatocellular carcinoma (HCC) being predominant (86.3%); it develops more frequently in LC of viral and ethanol etiology. This liver carcinoma has become more frequent in the last decade. Primary liver carcinoma, particularly HCC, is more frequent in males than in females (ratio 3.1:1.0), age peak between 50 and 59 years in males and 60-62 years in females.
Subject(s)
Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Age Factors , Hepatitis B/complications , Hepatitis B/mortality , Hepatitis B/pathology , Humans , Liver Cirrhosis/etiology , Liver Cirrhosis/mortality , Liver Cirrhosis, Alcoholic/etiology , Liver Cirrhosis, Alcoholic/mortality , Liver Cirrhosis, Alcoholic/pathology , Liver Neoplasms/etiology , Liver Neoplasms/mortality , Moscow , Sex FactorsABSTRACT
Two variants of dysplastic hepatocytes are revealed: small and large which are characterized by cell atypia and probably result from the disturbance of regenerative processes. The disturbance of the liver lobule architectonics is also a feature of dysplasia. The degree of hepatocyte dysplasia assessed by morphometric indices (nuclei surface, ratio of ellipticity) and its frequency increase with progression of the pathological process: chronic persistent hepatitis----chronic active hepatitis----liver cirrhosis----hepatocellular carcinoma. More frequent observation of the hepatocyte dysplasia in viral liver conditions (HBsAg in dysplastic hepatocytes) indicates the role of hepatitis B virus in the development of hepatocyte dysplasia. Increase of DNA content and nuclei polymorphism are observed in small and large dysplastic hepatocytes when the degree of dysplasia is increasing, this making these cells closer to cells of hepatocellular carcinoma and favouring the concept of hepatocellular carcinoma development in the foci of dysplastic hepatocytes, particularly in liver cirrhosis.
