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"Block, Seymour S"
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Transient urethral obstruction predisposes to ascending pyelonephritis and tubulo-interstitial disease: studies in rats
Chronic tubulo-interstitial disease, an important cause of end-stage renal disease, often results from the combined effects of a disturbed urinary outflow tract and urinary tract infection. Acute unilateral ureteral obstruction in rats rapidly induces foci of medullary necrosis, confined to the region of the papilla and fornices. This injury may provide a nidus for bacterial invasion and may invoke reactive and regenerative changes, ultimately leading to chronic pyelonephritis and tubulo-interstitial nephropathy. To explore this possibility, adult rats underwent renal morphological evaluation 2-7 days following transient 24-h unilateral ureteral obstruction. In some experiments the bladder was inoculated with bacteria (10(8)-10(9) cfu/ml Escherichia coli in 0.5 ml) after release of ureteral obstruction, with subsequent cultures obtained from the pelvis of both kidneys and from the urinary bladder. Morphologic evaluation of perfusion-fixed kidneys, 2-7 days after the release of 24-h ureteral obstruction disclosed papillary necrosis, urothelial proliferation, marked inner-stripe interstitial expansion, and fibrosis and proximal tubular (S3) dilatation. The lateral (perihilar region) was predominantly affected, with lesions spreading from the fornices. There was some progression of interstitial fibrosis during the postobstructive time course or following more prolonged ureteral obstruction. By contrast, infection hardly contributed to the tubulointerstitial changes. In rats subjected to infection, cultures were positive in all 15 postobstructive kidneys, as opposed to five contralateral kidneys (P < 0.0001). Viable counts from the postobstructive kidney were also higher than those from the contralateral side (79,000 +/- 12,000 vs 2900 +/- 1600 cfu/ml, mean +/- SEM, P < 0.0001), and were comparable to those obtained from the bladder (77,000 +/- 13,000 cfu/ml). We conclude that transient ureteral obstruction predisposes to ascending pyelonephritis and to tubulointerstitial disease. This vulnerability may relate to altered urodynamics and medullary tissue destruction.
Journal Article
A Bad Bill on Therapists
The lead editorial of June 1 regarding the regulation of psychoanalysts, marriage counselors, mental health practitioners and family therapists [\"Regulating Shrinks By Any Other Name\"] is severely lacking in communicating a true awareness of the bill sponsored by Assemb. Mark Alan Seigel (D-Manhattan).
Newspaper Article
Studies of the Aging of Flue-cured Cigarette-Leaf Tobacco
Before flue-cured tobacco is ready to be manufactured into cigarettes there elapses a period from two to three years of \"aging.\" During this process of aging there develops in the tobacco the aroma and mildness necessary for good smoking. As well as causing the tobacco producer to risk buying for a market three years hence, there is the expense and care connected with the storage of the tobacco. To add to the uncertainty is the natural quality of different tobaccos with respect to the aging process. Some tobaccos age much more readily than others, and some will not age properly.
Dissertation
Letter to the Editor 4 -- No Title
As members of the \"golden\" generation of psychiatrists, we applaud Daniel Carlat for his candor in exposing the severe limitations imposed by the \"split treatment\" model of psychiatry. Unfortunately, this is the only known form of...
Newspaper Article
BENJAMIN FRANKLIN: AMERICA'S INVENTOR
Born 300 years ago, Benjamin Franklin remains perhaps the most inquisitive, creative and prodigious inventor, innovator and thinker ever born on American soil. Franklin was a genius, recognized as such at home and abroad in his own time and still today. His reputation was a result of his phenomenal demonstration of capturing lightning from the sky and bringing it safely to the ground without harming people or property. Block discusses his life and works.
Magazine Article
