Chyluria and delayed graft function in early posttransplant period in a renal transplant patient.

Chyluria mostly occurs because of the leakage of lymphatic fluid into the urinary system from the lymphatic system. The patient reported here with end-stage renal disease caused by the nephrotic syndrome underwent renal transplantation from a living donor. During the early posttransplant period, her daily urine output was 300 to 400 mL, and it was chylous. The only abnormality on physical examination was pretibial edema. On renal biopsy, there was no sign of glomerular disease, acute tubular necrosis, or rejection that could have caused delayed graft function. All factors except surgery were excluded, and a lymphourinary fistula was demonstrated with lymphoscintigraphy. After 15 days, chyluria resolved and she recovered spontaneously. Normal diuresis began, and her creatinine level decreased to less than 1 mg/dL in 3 days. According to our knowledge, this is the first chyluria case secondary to surgery in the posttransplant setting.

Maternal origin and clinical findings in a case with trisomy 22.

We report a newborn girl with multiple congenital anomalies whose chromosomal analysis showed complete trisomy 22. Her phenotype included microcephaly, epicanthus, hypertelorism, micrognathia, cleft palate, microtia, and preauricular tag. She died in the 24th post-natal hour. Trisomy 22 was shown by fluorescence in situ hybridization technique and the parental origin of the extra chromosome was found to be maternal by DNA microsatellite marker analysis of chromosome 22. Postmortem examination revealed the presence of atrioseptal defect and stasis in the biliary canals. We believe that this patient will contribute to the literature both by clinical findings and short life span associated with maternal origin of extra chromosome 22.

The effects of recurrent Pseudomonas aeruginosa infection on pulmonary parenchyma and vasculature in rats fed on a cholesterol-rich diet.

It has been demonstrated that both hypercholesterolemia and infectious agents are contributing factors in atherosclerosis but their combined effect on the pulmonary vascular bed is not known. To answer this question, the authors tried to demonstrate the effects of recurrent infection on pulmonary parenchyma and vascular system in cholesterol-fed rats. Sixty-six rats were randomly divided into 4 groups: Groups I (control), II (cholesterol-rich diet), III (recurrent pulmonary Pseudomonas aeruginosa infection), IV (cholesterol-rich diet + recurrent infection). After 6 months serum cholesterol levels didn't increase in any of the groups. Central pulmonary artery wall thickness was increased in group IV (P < .0001). Although not significant, peripheral pulmonary artery wall thickness was increased in group IV. In rats fed on a cholesterol-rich diet, recurrent infection caused a significant increase in atherosclerosis, although serum cholesterol levels didn't increase. Infection and cholesterol-rich diet have a synergistic effect on atherosclerosis in the pulmonary vascular system in rats even in the absence of hypercholesterolemia.

Placental biopsy by frozen section: does it have a role in evaluation of fetal well-being?

AIM: To assess the effectiveness of post-partum placental biopsy and frozen section evaluation in diagnosing pregnancy disorders. STUDY DESIGN: Between January and July 1998, biopsies were carried out on 100 newly delivered placentas. Biopsies were carried out using a 14-gauge needle, and frozen section evaluations were reviewed. These were compared to the standard evaluation of histological evaluation of the whole placenta sections. Specimens were evaluated by standard placental pathologic criteria. RESULTS: Villous oedema which is associated with antenatal hypoxia was observed with a sensitivity of 78%, and specificity of 97%, yielding a positive predictive value of 84% in frozen section compared to standard placental evaluation. No statistical difference was observed in the evaluation of dysmaturity, intravillous fibrin agglutination and chronic villitis between frozen sectioning and whole placenta sections. Increased syncytial knots were detected with a sensitivity of 45% and specificity of 98%. CONCLUSION: Placental biopsy by frozen sectioning might be a useful and quick method of evaluation for placental pathology. Theoretically, fetal status could be more precisely evaluated by combining prenatal placental biopsy by permanent section with conservative ante-partum well-being tests.