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Pregnancy in Women With Renal Disease and Moderate Renal Insufficiency
213
MISCELLA.1\iEOtJS
which time the rats were sacrificed. Both agents were dissol.ved in corn oil and us,,w,v,,m The control group consisted of sham-operated, castrated and on,cton11zea rats who received injections of corn oil After the rats were sacrificed the livers were removed and homogenized in L15 per cent potassium chloride solution. The homogenate was centrifuged to obtain a microsomal pellet that was suspended in 1.15 per cent potassium chloride solution and kept at -80C until used. Determinations of hydrolysis of p-nitrophenylacetate, malathion, a-naphthy!acetate, acetanilide and isocarboxazid were made. The hepatic microsomal carboxylesterase activities towards p-nitrophenylacetate and malathion in normal male rats were significantly higher than in female rats, whereas the reverse was true with regard to acetanilide and isocarboxazid hydrolase activities. When a-naphthylacetate was used as a substrate, no difference in the activities of the enzyme was observed between the 2 sexes. When testosterone propionate was administered to the control male and female rats who had undergone a sham operation, no significant change in the hepatic microsomal carboxylesterase activities towards any substrate was observed. However, when estradiol benzoate was given to this control group ofrats the activity of only p-nitrophenylacetate hydrolase was decreased significantly. Castration resulted in a decrease in the activities of p-nitrophenylacetate and malathion hydrolases. However, when these rats were administered testosterone propionate, the levels of enzyme activities increased to that of the control group. h~·..-~~~M-" resulted in an increase in the activities of p-nitrophenylacetate and malathion, whereas the enzyme activity toward acetanilide and isocarboxazid hydrolase decreased. On the other hand, administration of estradiol ben zoate in the oophorectomized rats had the reverse effect. The authors conclude that hepatic microsomal carboxylesterases appear to be regulated at least partly by gonadal hormones. N. S. D. 2 figures, 3 tables, 17 references
Multicentric Al!!.giofollicular Lymph. Node Hyperplasia (Castleman'§ Di,iease) Followed by Kapo§i's S:u·coma in Two Homosexual Males With the Acquired Immu~ nodelficiency Syndrnme (AIDS)
;-r;,r/.1/UII! V and AND H. E. PRt:NCE, Torrance and DePediatrics, Harbor-UCLA Medical The Center partments of and of Medicine, Los Health
Amer. J. Clin.
83: 27-33
1985
The authors describe 2 homosexual men with the immune deficiency syndrome (AIDS) who suffered a variant of angiofollicular lymph node hyperplasia (Castleman's disease) followed by Kaposi's sarcoma. Both men had diffuse adenopathy, splenomegaly and a systemic inflammatory state. Angiofollicular lymph node hyperplasia represents another lymphoreticular complication of the (AIDS). Both patients had an unusually aggressive fatal clinical course, leading the authors to recommend aggressive use of lymph node biopsy as a prognosticator in victims of the AIDS. The immunological diagnostic studies of these patients are described in detail. J. H. N. 3 figures, 2 tables, 4 7 references
MISCELLANEOUS cg'""'"~'s in W:r;men With Renal Di§ea§e a:nrl Moderate Renal Inmd'fi.cl.ency
S. H. ester, Massachusetts, Department of Tufts UniuerSchool of Medicine, Massachusetts, Department of Medicine, New Jersey Medical College and Division of Nephrology, College Hospital, Newark, New Amer. J. Med., 78: 185-194
1985
The authors reviewed 25 pregnancies in 23 women with moderate renal insufficiency (serum creatinine 1.46 mg./dl. or greater before or at the onset of pregnancy). Of the women 12 had primary glomerular disease, 5 had interstitial disease and 6 had other renal diseases. A pregnancy-related decrease in renal function occurred in 7 women (30 per cent), 6 of whom had primary glomerular diseases. The degree of renal dysfunction was marked, with 1 of the 7 patients having progression to end stage renal failure. The data indicate that the normally expected increase in glomerular filtration rates seen during a normal pregnancy did not occur in the 23 patients. In 14 of the 25 pregnancies hypertension either (50 per cent of the women who were normotensive at conception) or worsened substantially (60 per cent of those who were h,n.,c,rt.<>n at There ,Nere no maternal deaths in this series and 23 of the pregnancies resulted in live births, while 1 was an ectopic pregnancy and there was 1 intrauterine death. Of the live births 61 per cent were premature, including 2 who died. Two congenital anomalies were noted: microcephaly in 1 infant and pyloric stenosis in 1. G. W. K. 5 12 references.
The Effect of Pregnancy 1:n1. Kkh1ey F,mcti.on in Rellml Ailog:raft Recipients J. JVL
tiue
Medical Research Council Human Reproducand
1985
In women with renal -···-.,,·-····- the filtration rate increases pregnancy but how soon the increment occurs, its ~"'-'""'"''..," to the pre-pregnancy filtration rate and the over-al.l pattern of change are unknown. The 24-hour creatinine clearances were measured prospectively in 8 allograft recipients pregnancies) before conception, throughout pregnancy, 8 to 12 weeks post partum and 4 to 6 months thereafter. Inulin and creatinine clearances during infusion also were determined, and protein excretion was evaluated. The results were compared to those of similar studies in 10 healthy women. By 10 weeks of gestation 24-hour creatinine clearance was 124 ± 15.9 ml. per minute (standard deviation) in healthy women (an increase of 38 per cent, range 18 to 69 per cent) and in transplant patients it was 105 ± 28.l ml. per minute (an increase of 34 per cent, range 10 to 60 per cent), with the
MISCELLA.1\iEOtJS
which time the rats were sacrificed. Both agents were dissol.ved in corn oil and us,,w,v,,m The control group consisted of sham-operated, castrated and on,cton11zea rats who received injections of corn oil After the rats were sacrificed the livers were removed and homogenized in L15 per cent potassium chloride solution. The homogenate was centrifuged to obtain a microsomal pellet that was suspended in 1.15 per cent potassium chloride solution and kept at -80C until used. Determinations of hydrolysis of p-nitrophenylacetate, malathion, a-naphthy!acetate, acetanilide and isocarboxazid were made. The hepatic microsomal carboxylesterase activities towards p-nitrophenylacetate and malathion in normal male rats were significantly higher than in female rats, whereas the reverse was true with regard to acetanilide and isocarboxazid hydrolase activities. When a-naphthylacetate was used as a substrate, no difference in the activities of the enzyme was observed between the 2 sexes. When testosterone propionate was administered to the control male and female rats who had undergone a sham operation, no significant change in the hepatic microsomal carboxylesterase activities towards any substrate was observed. However, when estradiol benzoate was given to this control group ofrats the activity of only p-nitrophenylacetate hydrolase was decreased significantly. Castration resulted in a decrease in the activities of p-nitrophenylacetate and malathion hydrolases. However, when these rats were administered testosterone propionate, the levels of enzyme activities increased to that of the control group. h~·..-~~~M-" resulted in an increase in the activities of p-nitrophenylacetate and malathion, whereas the enzyme activity toward acetanilide and isocarboxazid hydrolase decreased. On the other hand, administration of estradiol ben zoate in the oophorectomized rats had the reverse effect. The authors conclude that hepatic microsomal carboxylesterases appear to be regulated at least partly by gonadal hormones. N. S. D. 2 figures, 3 tables, 17 references
Multicentric Al!!.giofollicular Lymph. Node Hyperplasia (Castleman'§ Di,iease) Followed by Kapo§i's S:u·coma in Two Homosexual Males With the Acquired Immu~ nodelficiency Syndrnme (AIDS)
;-r;,r/.1/UII! V and AND H. E. PRt:NCE, Torrance and DePediatrics, Harbor-UCLA Medical The Center partments of and of Medicine, Los Health
Amer. J. Clin.
83: 27-33
1985
The authors describe 2 homosexual men with the immune deficiency syndrome (AIDS) who suffered a variant of angiofollicular lymph node hyperplasia (Castleman's disease) followed by Kaposi's sarcoma. Both men had diffuse adenopathy, splenomegaly and a systemic inflammatory state. Angiofollicular lymph node hyperplasia represents another lymphoreticular complication of the (AIDS). Both patients had an unusually aggressive fatal clinical course, leading the authors to recommend aggressive use of lymph node biopsy as a prognosticator in victims of the AIDS. The immunological diagnostic studies of these patients are described in detail. J. H. N. 3 figures, 2 tables, 4 7 references
MISCELLANEOUS cg'""'"~'s in W:r;men With Renal Di§ea§e a:nrl Moderate Renal Inmd'fi.cl.ency
S. H. ester, Massachusetts, Department of Tufts UniuerSchool of Medicine, Massachusetts, Department of Medicine, New Jersey Medical College and Division of Nephrology, College Hospital, Newark, New Amer. J. Med., 78: 185-194
1985
The authors reviewed 25 pregnancies in 23 women with moderate renal insufficiency (serum creatinine 1.46 mg./dl. or greater before or at the onset of pregnancy). Of the women 12 had primary glomerular disease, 5 had interstitial disease and 6 had other renal diseases. A pregnancy-related decrease in renal function occurred in 7 women (30 per cent), 6 of whom had primary glomerular diseases. The degree of renal dysfunction was marked, with 1 of the 7 patients having progression to end stage renal failure. The data indicate that the normally expected increase in glomerular filtration rates seen during a normal pregnancy did not occur in the 23 patients. In 14 of the 25 pregnancies hypertension either (50 per cent of the women who were normotensive at conception) or worsened substantially (60 per cent of those who were h,n.,c,rt.<>n at There ,Nere no maternal deaths in this series and 23 of the pregnancies resulted in live births, while 1 was an ectopic pregnancy and there was 1 intrauterine death. Of the live births 61 per cent were premature, including 2 who died. Two congenital anomalies were noted: microcephaly in 1 infant and pyloric stenosis in 1. G. W. K. 5 12 references.
The Effect of Pregnancy 1:n1. Kkh1ey F,mcti.on in Rellml Ailog:raft Recipients J. JVL
tiue
Medical Research Council Human Reproducand
1985
In women with renal -···-.,,·-····- the filtration rate increases pregnancy but how soon the increment occurs, its ~"'-'""'"''..," to the pre-pregnancy filtration rate and the over-al.l pattern of change are unknown. The 24-hour creatinine clearances were measured prospectively in 8 allograft recipients pregnancies) before conception, throughout pregnancy, 8 to 12 weeks post partum and 4 to 6 months thereafter. Inulin and creatinine clearances during infusion also were determined, and protein excretion was evaluated. The results were compared to those of similar studies in 10 healthy women. By 10 weeks of gestation 24-hour creatinine clearance was 124 ± 15.9 ml. per minute (standard deviation) in healthy women (an increase of 38 per cent, range 18 to 69 per cent) and in transplant patients it was 105 ± 28.l ml. per minute (an increase of 34 per cent, range 10 to 60 per cent), with the