bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristic Cytokine Products of Th1 and Th2 Cells in Hemodialysis Patients
Authors: Daichou Yoshihiro , Kurashige Satonori , Hashimoto Saori , Suzuki Shousuke
Published: April 2003

Dysfunction of the host defense against infection in hemodialysis (HD) patients has major clinical and socioeconomic implications. T helper type 1 (Th1) and type 2 (Th2) cytokines are implicated in regulating the immune responses and, therefore, may be involved in impaired status. The present study was designed to examine Th1 and Th2 cytokine profiles in 22 stable HD patients (aged 63 ± 11 years) and 22 healthy controls (aged 60 ± 6 years). The T cell activity was significantly retarded in HD patients as compared with normal persons. The proportions of T cytotoxic/suppressor cells and natural killer cells were significantly higher in HD patients than in controls. In contrast, the proportions of T helper/inducer and B cells were significantly lower in HD patients than in controls. The production of interleukin (IL) 2, which is involved in cell-mediated immune responses, and the production of IL-4 and IL-10, which affect humoral immunity, were significantly lower in patients than in controls. The production of IL-12 by macrophages and of interferon gamma by Th1 cells was significantly higher in HD patients than in controls. The concentration of plasma sIL-2R was significantly higher in patients than in controls. These results suggest that both cellular immunity induced by Th1 and humoral immunity induced by Th2 decrease in HD patients, but that improved IL-12 secretion by macrophages activated natural killer cells to produce interferon gamma, which in turn induced macrophage activity.
Renal Complications of High-Dose Chemotherapy and Peripheral Blood Stem Cell Transplantation
Authors: Herget-Rosenthal Stefan , Uppenkamp Michael , Beelen Dietrich , Kohl Detlev , Kribben Andreas
Published: April 2003

Following bone marrow transplantation, acute renal failure and proteinuria are common complications with a high mortality, particularly in patients requiring hemodialysis. Incidence, potential predisposing factors, and outcome of acute renal complications in patients with hematological malignancies receiving autologous peripheral blood stem cell transplantation were prospectively studied in 53 patients. Eight patients developed acute renal failure. Three of them required hemodialysis. Of all patients with acute renal failure, only those requiring hemodialysis died, due to nonrenal causes. Only 1 of the 45 patients without renal failure died. Mild proteinuria of predominantly tubular origin occurred in 16 patients, in 3 with and in 13 without acute renal failure. As predisposing factors for acute renal failure were identified: renal hypoperfusion due to systemic inflammatory response syndrome, sepsis or septic shock, and combined administration of nephrotoxic drugs. Especially those patients receiving high numbers of nephrotoxic drugs in combination with renal hypoperfusion were likely to develop acute renal failure. These results suggest that patients receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation have a low risk of developing acute renal failure and proteinuria.
Clinicopathologic Study on Prognostic Markers in IgA Nephropathy
Authors: Mera Junichiro , Uchida Shunya , Nagase Mitsumasa
Published: April 2003

Background/Aim: Few prognostic markers have found general acceptance in IgA nephropathy (IgAN). The aim of the present study was to search for significant predictor(s) at the time of biopsy. Methods: Fifty-five patients with IgAN undergoing evaluation and treatment at our institution were examined regarding clinicopathologic features at the time of renal biopsy and, if possible, at follow-up. Factors predictive of outcome were evaluated. Renal histopathology was quantified using a glomerulosclerosis index (GSI), a tubulointerstitial index (TII), and a crescent index (CI). Results: The serum creatinine concentration (S-Cr) showed positive correlations with proteinuria and serum total cholesterol concentration, as well as with histopathologic findings. Heavy proteinuria (≧3.0 g/24 h) was associated with higher S-Cr and greater severity of pathologic abnormalities than with milder proteinuria. At follow-up, 6 patients progressed to chronic renal insufficiency, in whom the S-Cr increased by at least 50% to reach or exceed 1.5 mg/dl (132.6 µmol/l). By univariate analysis, elevated GSI, TII, and S-Cr, presence of nephrotic syndrome, elevated CI, and elevated total cholesterol were found to be negative predictors, in descending order of odds ratio. In multivariate analysis, however, only TII independently predicted unfavorable outcome. Conclusion: Renal biopsy in IgAN may be the most powerful predictor for renal outcome; an advanced tubulointerstitial lesion is unfavorable.
Hemolytic Uremic Syndrome Associated with Influenza A Virus Infection in an Adult Renal Allograft Recipient: Case Report and Review of the Literature
Authors: Asaka Mitsuhiro , Ishikawa Isao , Nakazawa Tetsuya , Tomosugi Naohisa , Yuri Takehisa , Suzuki Kouji
Published: April 2003

Hemolytic uremic syndrome (HUS) is a rare but serious complication following renal transplantation. It usually develops early after transplantation, and ciclosporin treatment is the most common triggering factor. We report the case of a 35-year-old male with posttransplant HUS which developed 1 year after renal transplantation. He became febrile 4 days before the onset of HUS, and the significant rise in viral titer confirmed the diagnosis of influenza A virus infection. The association of ciclosporin treatment with HUS was unlikely, because of the late onset of HUS and the low ciclosporin trough levels. The patient was treated successfully without a dose reduction of ciclosporin. An etiologic relationship between influenza A virus and HUS was highly probable in our patient. We also review a total of 156 adult cases with HUS after renal transplantation described in the literature. The prognosis of posttransplant HUS differs according to the cause. The advent of ciclosporin has improved the graft survival rate and mortality of patients with rejection-induced HUS.
Calcium Channel Blockers Inhibit Proliferation and Matrix Production in Rat Mesangial Cells: Possible Mechanism of Suppression of AP-1 and CREB Activities
Authors: Sugiura Toshihiro , Imai Enyu , Moriyama Toshiki , Horio Masaru , Hori Masatsugu
Published: April 2003

Background: Calcium channel blockers (CCBs) are reported to attenuate the loss of renal function in various glomerulonephritides. Methods: To determine the mechanism of action of these drugs, we investigated the effects of CCBs on cell proliferation and extracellular matrix (ECM) production in cultured rat mesangial cells. Results: While stimulation with 5% fetal calf serum (FCS) increased [3H]thymidine and [3H]proline incorporation into quiescent mesangial cells, incubation with nifedipine and cilnidipine inhibited the increase in a dose-dependent manner. Northern blot analysis demonstrated that 5% FCS increased the expression of transforming growth factor beta (TGF-β) and fibronectin (FN) mRNA and that CCBs significantly reduced this induction, indicating that CCBs may reduce ECM production through inhibiting TGF-β and FN. Since activator protein 1 (AP-1) regulates cell proliferation and TGF-β expression, we evaluated the AP-1 activity by gel mobility shift analysis. Nuclear extracts of FCS-treated cells showed a strong binding to AP-1-specific oligonucleotides which was suppressed by CCBs, suggesting that these agents may inhibit cell proliferation by suppressing AP-1. CCBs also inhibited the binding activity of cyclic adenosine monophosphate responsive element binding protein which regulates FN gene expression. However, neither CCBs nor FCS affected the NFĸB activity. Conclusion: These results suggest that CCBs may, in part, inhibit the progression of glomerulonephritis through non-hemodynamic actions that include the suppression of mesangial cell proliferation and the production of ECM.
Urinary Excretion of Glutathione S Transferases Alpha and Pi in Patients with Proteinuria: Reflection of the Site of Tubular Injury
Authors: Branten Amanda J.W. , Mulder Theo P.J. , Peters WilbertH.M. , Assmann Karel J.M. , Wetzels Jack F.M.
Published: April 2003

In patients with renal diseases, proteinuria is a major determinant of progressive renal failure, probably by causing tubular cell injury. Little is known on extent and site of tubular cell injury in patients with proteinuria. Glutathione S transferases (GST) are cytosolic enzymes. The alpha isoform is present only in proximal tubular cells, whereas the pi isoform is confined to distal tubular cells. We have studied the urinary excretion of both isoenzymes in 56 (38 male and 18 female) patients with glomerular diseases and proteinuria. The mean age was 45 ± (SD) 16 years, the median creatinine clearance was 80 (range 27–159) ml/min, and the median albuminuria was 4.2 (range 0.7–16.9) g/10 mmol creatinine. The excretions of both GST alpha (median 35.9 ng/10 mmol creatinine) and GST pi (median 24.8 ng/10 mmol creatinine) were elevated as compared with control values (upper limits 10 and 12 ng/10 mmol creatinine, respectively). The urinary excretion of GST pi, but not that of GST alpha, was inversely correlated with the creatinine clearance. The highest levels of GST alpha were found in patients with a well-preserved renal function, whereas highest levels of GST pi were found in patients with renal failure. In a small number of patients we performed immunofluorescent studies of renal tissue. An increased urinary excretion of GST alpha correlated with brush border damage and decreased staining of proximal tubules for that isoenzyme. Our data suggest that in patients with proteinuria initial injury is apparent at the proximal tubules. Measurements of GST alpha and GST pi appear useful to study longitudinal timing and site of proteinuria-induced tubular cell injury.
Sensitivity and Specificity of the Thermodilution Technique in Detection of Access Recirculation
Authors: Wang Erjun , Schneditz Daniel , Kaufman Allen M. , Levin Nathan W.
Published: April 2003

Background/Aim: Recirculation measured by thermodilution includes effects caused by access and cardiopulmonary recirculation. The aims of this study were to illustrate the accuracy of thermodilution in measurement of hemodialysis recirculation and also to identify a sensitive and specific threshold to detect access recirculation. Methods: 110 studies were performed in 19 patients. Recirculation obtained directly by the blood temperature monitor (BTM) was compared to that calculated from access blood flow, pump blood flow, and cardiac output determined by ultrasound dilution using the hemodialysis monitor (HDM). Results: A highly significant linear correlation was obtained between repeated BTM recirculation measurements (RBTM, 2 = 0.99·RBTM, 1 – 0.22%, r2 = 0.99). There were no significant differences between repeated BTM recirculation measurements with correct placement (11.4 ± 7.1 vs. 10.9 ± 7.4%, p = NS) or reversed placement (30.0 ± 15.6 vs. 30.2 ± 15.9%, p = NS) of blood lines. A strong linear relationship was obtained between the recirculation determined by thermodilution and the recirculation calculated from HDM measurements (Rcalc = 0.98·RBTM – 1.49%, r2 = 0.95). The mean recirculation obtained by BTM was not significantly different from the recirculation calculated by HDM with correct placement (9.5 ± 2.2 vs. 8.6 ± 2.5%, p = NS) or with reversed placement (25.4 ± 7.8 vs. 23.8 ± 7.7%, p = NS) of blood lines. When a recirculation greater than 15% measured by the BTM was considered as the threshold at which true access recirculation occurred, sensitivity and specificity of the thermodilution method to detect access recirculation were 93 and 98%, respectively. Conclusions: Recirculation measurements made by the BTM are accurate and precise. Even though BTM thermodilution includes effects of cardiopulmonary recirculation, so that low levels of access recirculation might not be detected, a BTM recirculation >15% represents a highly significant access recirculation.
Smoking – A Renal Risk Factor
Authors: Orth Stephan R.
Published: April 2003

One of the most important tasks of clinical and experimental nephrology is to identify the risk factors of progression of renal failure. A major renal risk factor which has not been sufficiently acknowledged despite increasing evidence is cigarette smoking. Diabetologists were the first to recognize the adverse effects of smoking on the kidney: both in type 1 and in type 2 diabetes smoking (i) increases the risk of development of nephropathy and (ii) nearly doubles the rate of progression to end-stage renal failure. Until recently it was not known whether smoking also increases the risk to progress to end-stage renal failure in patients with primary renal disease. A retrospective multicenter European case-control study showed that smoking is an independent risk factor for end-stage renal failure in patients with inflammatory and noninflammatory renal disease, i.e. IgA glomerulonephritis and polycystic kidney disease. The pathogenesis of the smoking-related renal damage is largely unknown. The intermittent increase in blood pressure during smoking seems to play a major role in causing renal damage, but further potential pathomechanisms are presumably also operative. Smoking as a renal risk factor is of great interest to diabetologists as well as nephrologists, but unfortunately so far this information has had little impact on patient management. The present article reviews the current knowledge about the renal risks of smoking and discusses the potential mechanisms of smoking-mediated renal injury.
A New Lactate-Based, Plasticizer-Free, Neutral Peritoneal Dialysis Fluid Provided in a Two-Compartment System: Effect on Peripheral Leukocyte Function
Authors: Alscher Dominik M. , Pauli-Magnus Christiane , Kirchgessner Judith , Kuhlmann Ulrich , Mettang Thomas
Published: April 2003

Background: A new neutral peritoneal dialysis fluid (PDF; Balance®) provided in a two-compartment bag (pH 7.4, no plasticizers, minimal glucose degradation products – GDP) was investigated in comparison with a neutral control (Hanks’ balanced salt solution with gelatin 0.1%) and other PDFs with standard properties and plasticizers (Andy plus®, pH 5.2, GDP), plasticizer free (stay safe®, pH 5.2, GDP), and in addition plasticizer free after sterile filtration instead of heat sterilization (pH 5.2) regarding the function of peripheral blood leukocytes. Methods: Blood was drawn from 12 volunteers, and blood monocytes (MN) and polymorphonuclear leukocytes (PMNL) were collected. The cells were incubated for 30 min in control medium and the PDFs: glucose 1.5% (83 mmol/l) and 4.25% (238 mmol/l). Respiratory burst of cells was evaluated by chemiluminescence and superoxide (SO) generation after stimulation with phorbol myristate acetate. Results: In comparison with the control medium, incubation of MN in the two-compartment PDF showed preservation of respiratory burst. In contrast, the incubation of MN in standard PDF and plasticizer-free PDF showed impaired functions. The same was found for PMNL. SO anion measurement in MN and PMNL after incubation in the new two-compartment PDF also showed preservation of cell function in comparison with the control medium. The incubation of PMNL in standard PDF and plasticizer-free PDF with a high glucose content showed depressed SO anion generation. Conclusions: These in vitro data demonstrate a better preservation of in vitro phagocyte function with adaptation of pH and reduction of glucose, GDP, and plasticizers in PDFs. The best results are achieved with the two-compartment, lactate-based neutral PDF.
Reversible Nephrotic Syndrome in a Patient with Amyloid A Amyloidosis of the Kidney following Methicillin-Resistant Staphylococcus aureus Infection
Authors: Yokota Naoko , Morita Hiroyuki , Iwasaki Shigeki , Ooba Hiroshi , Ideura Terukuni , Yoshimura Ashio
Published: April 2003

A common form of methicillin-resistant Staphylococcus aureus (MRSA) associated glomerulonephritis is either an endocapillary proliferative glomerulonephritis or a crescentic glomerulonephritis. This report describes the development of reversible nephrotic syndrome following MRSA infection in a patient with amyloid A amyloidosis. The patient had been diagnosed as having rheumatoid arthritis for 50 years. Suppurative arthritis due to MRSA became complicated 2 years prior to admission to our hospital. In the meantime, a nonnephrotic-range proteinuria developed. Two weeks before admission, nephrotic syndrome developed. The serum creatinine level remained unchanged throughout the course, but common features characteristic of MRSA-associated glomerulonephritis were observed in this patient, such as elevated serum IgG and IgA levels. A renal biopsy specimen showed glomerular amyloid A amyloidosis of a nodular type, infiltrated mononuclear cells in the mesangium, deposition of IgG, IgA, and C3, and swelling of glomerular endothelial cells. There were no crescentic glomeruli. Following surgical eradication of the MRSA focus in the right knee joint, nephrotic syndrome disappeared. Hence, it was highly possible that MRSA infection induced a reversible nephrotic syndrome by causing reversible injuries to glomerular endothelial cells. The description of this case serves to illustrate the range of MRSA infections that may cause various forms of glomerulonephritides.
Effect of High Glucose Concentration on the Synthesis of Monocyte Chemoattractant Protein-1 in Human Peritoneal Mesothelial Cells: Involvement of Protein Kinase C
Authors: Haslinger Bettina , Mandl-Weber Sonja , Sellmayer Alois , Lederer Stephan R. , Sitter Thomas
Published: April 2003

Human peritoneal mesothelial cells (HMC) contribute to the activation and control of inflammatory processes in the peritoneum by their potential to produce various inflammatory mediators. The present study was designed to assess the effect of glucose, the osmotic active compound in most commercially available peritoneal dialysis fluids, on the synthesis of the C-C chemokine monocyte chemoattractant protein-1 (MCP-1) in cultured HMC. The MCP-1 concentration in the cell supernatants was determined by enzyme-linked immunosorbent assay and the MCP-1 mRNA expression was examined using Northern blot analysis. Incubation of HMC with glucose (30–120 mM) resulted in a time- and concentration-dependent increase in MCP-1 protein secretion and mRNA expression. After 24 h the MCP-1 synthesis was increased from 2.8 ± 0.46 to 4.2 ± 0.32 ng/105 cells (n = 5, p < 0.05) in HMC treated with 60 mM glucose. In contrast, osmotic control media containing either the metabolically inert monosaccharide mannitol or NaCl did not influence MCP-1 production. The stimulating effect of high glucose on MCP-1 expression in HMC was mimicked by activation of protein kinase C (PKC) with the phorbol ester PMA (20 nM). Coincubation of the cells with glucose and the specific PKC inhibitor Ro 31–8220 completely blunted glucose-mediated MCP-1 expression. In summary, our results indicate that glucose induces MCP-1 synthesis by a PKC-dependent pathway. Since osmotic control media did not increase MCP-1 release, it is suggested that the effect of glucose is mainly related to metabolism and not to hyperosmolarity. These data may in part explain elevated steady-state levels of MCP-1 found in the dialysis effluent of continuous ambulatory peritoneal dialysis patients.
Relationship between Fluctuation Pattern of Blood Pressure during Hemodialysis Treatment and Cardiovascular Morphology: An Autopsy Study of 53 Cases
Authors: Matsumae Tomoji , Matsumae Masako , Hasegawa Yoshiyuki , Tanaka Tomoichiro , Yoshitake Keisuke , Noda Ritsuya , Ogahara Satoru , Murata Toshiaki , Kaneoka Hidetoshi
Published: April 2003

Background: Cardiovascular morphological changes are often conspicuous in autopsy examination of chronic hemodialysis (HD) patients. On the other hand, the fluctuation pattern in blood pressure (BP) during HD treatment varies from one patient to another. Cardiovascular changes may correlate with clinical findings including BP fluctuation patterns during HD, although no autopsy studies have previously examined this issue. Methods: In this study, 53 autopsies of patients who had been on chronic HD were reviewed. We determined the relationship between BP fluctuation during HD treatment along with stable and cardiovascular morphology, including heart weight, ventricular wall thickness, circumferences of the valves and the severity of aortic arteriosclerosis and coronary stenosis. Patients were divided into 4 groups according to the pattern of BP fluctuation during HD treatment at about 6 months before death: group 1 (n = 13), symptomatic hypotension and/or decline pattern during HD; group 2 (n = 11), continuously high BP during HD treatment; group 3 (n = 17), continuous normal BP during HD treatment, and group 4 (n = 12), continuously low BP without symptomatic hypotension during HD treatment. Results: Heart weight and ventricular wall thickness were greatest in group 2. The scores for aortic arteriosclerosis in groups 1 and 2 were higher than in groups 3 and 4. The coronary stenosis index was significantly higher in group 1 than in the other groups, and that in group 2 was higher than in group 4. Multiple regression analysis showed that age, HD duration and pulse pressure were independent variables for the score of arteriosclerosis, and the decline pattern of BP fluctuation during HD and pulse pressure were independent variables for coronary stenosis index. Conclusions: Our results suggest that certain clinical parameters including BP during HD may reflect cardiovascular morphological changes in stable HD patients, although further examination, such as 24-hour blood pressure measurement is recommended to elucidate the pathophysiology of cardiovascular diseases in HD patients.
Salviae Radix Extract Prevents Cisplatin-Induced Acute Renal Failure in Rabbits
Authors: Jeong Ji Cheon , Hwang Won Man , Yoon Cheol Ho , Kim Yong Keun
Published: April 2003

The present study was carried out to determine if salviae radix extract (SRE) exerts a beneficial effect against cisplatin-induced renal failure in rabbits. Rabbits were pretreated with SRE orally for 7 days, followed by cisplatin injection (5 mg/kg i.p.). Cisplatin injection caused a reduction in GFR, which was accompanied by an increase in serum creatinine levels. The fractional Na+ excretion was increased by cisplatin injection. PAH uptake by renal cortical slices was inhibited by the administration of cisplatin. Such changes were prevented by SRE pretreatment. Cisplatin injection increased lipid peroxidation, which was prevented by SRE pretreatment. The protective effect of SRE was supported by morphological studies. Cisplatin injection reduced renal blood flow that was not affected by SRE pretreatment. Cisplatin treatment in vitro in renal cortical slices increased LDH release and lipid peroxidation, which were prevented by 0.05% SRE. These results indicate that lipid peroxidation plays a critical role in cisplatin-induced acute renal failure. SRE exerts a protective effect against renal cell injury induced by cisplatin, and its effect may be attributed to its antioxidant action. However, the underlying mechanism by which SRE has antioxidant action remains to be defined.
Relationships of Serum Levels of Insulinlike Growth Factors with Indices of Bone Metabolism and Nutritional Conditions in Hemodialysis Patients
Authors: Nanba Kiyohito , Nagake Yoshio , Miyatake Nobuyuki , Nakao Kazushi , Akagi Shigeru , Sugimoto Taro , Yamasaki Hiroko , Oishi Kazuhiro , Ichikawa Haruo , Makino Hirofumi
Published: April 2003

Insulinlike growth factor (IGF) I and IGF-II are synthesized in osteoblasts and stimulate proliferation, differentiation, and matrix synthesis in these cells. There is some evidence that IGFs act on bone cells not only by paracrine but also by endocrine pathways, suggesting that circulating IGFs may be of importance for the regulation of bone metabolism. On the other hand, the serum IGF-I level is also thought to be a good indicator of the nutritional conditions in hemodialysis patients. The present study was performed to analyze the correlations of circulating levels of IGF-I, IGF-II, IGF-binding protein (IGFBP) 1 and IGFBP-3 with biochemical markers of bone metabolism and parameters of the urea kinetic model which reflect nutritional conditions in hemodialysis patients. We also examined the differences between these relationships in male and female patients on hemodialysis. Sixty-two hemodialysis patients, 36 men (male group) and 26 women (female group), were included in this study. We measured the serum levels of IGF-I, IGF-II, IGFBP-1, and IGFBP-3. The bone mineral content (BMC) of the radius was measured by dual-energy X-ray absorptiometry. We calculated Kt/V, protein catabolic rate, and percent creatinine generation rate (%CGR). We also examined the relationships between serum levels of IGFs and BMC and the parameters of the urea kinetic model. It was found that the serum levels of IGF-I in the hemodialysis patients were almost the same as those in the control group. However, the serum levels of IGF-II, IGFBP-1, and IGFBP-3 in the hemodialysis patients were significantly higher than those in the control group. In the male group, the serum IGF-I levels showed a significant correlation with both serum intact parathyroid hormone levels and BMC, but no significant correlations between these indices were found in the female group. The serum levels of both IGF-I and IGF-II showed significant correlations with %CGR in the male group, but not in the female group. Stepwise multiple regression analysis was performed to clarify the relationship between serum levels of IGFs and BMC or %CGR. It was found that age, hemodialysis duration, serum intact parathyroid hormone levels, and sex were independent factors associated with BMC. The %CGR was associated independently with serum levels of IGF-I, and IGF-II and with the presence of diabetes mellitus. In conclusion, it is thought that serum levels of IGF-I and IGF-II can be used as indices of nutritional conditions in hemodialysis patients. However, the serum IGF-I level cannot be used as a marker of bone metabolism in hemodialysis patients.
Effect of Steroid-Liposome on Immunohistopathology of IgA Nephropathy in ddY Mice
Authors: Liao Jie , Hayashi Kayo , Horikoshi Satoshi , Ushijima Hideto , Kimura Junji , Tomino Yasuhiko
Published: April 2003

Immunopathological studies were performed to determine whether glomerular injuries in ddY mice, a spontaneous animal model for IgA nephropathy, are influenced by treatment with a newly developed liposome loaded with prednisolone phosphate (PSL-liposome). The newly synthesized novel cationic lipid 3,6-dipentadeciroxy-1-amizino-benzene (TRX-20) was employed to obtain selective affinity to the anionic cell surface and extracellular matrices in glomerular mesangial lesions. ddY mice were treated intravenously with 1.0 mg/kg of PSL-liposome once a week for 16 weeks (from 45 weeks to 61 weeks of age). ddY mice were also intravenously treated with 1.0 mg/kg of ordinary PSL once a week for the same duration. On immunofluorescence, depositions of IgA and C3 in the glomerular mesangial areas and capillary walls of PSL-liposome-treated ddY mice were markedly decreased as compared with those of ordinary PSL-treated and untreated control ddY mice. The mean intensity of IgA and C3 in glomeruli of PSL-liposome-treated ddY mice was decreased as compared with that in ordinary PSL-treated and untreated control ddY mice. Glomerular mesangial expansion in PSL-liposome-treated ddY mice was milder than that found in ordinary PSL-treated ddY mice or untreated control ddY mice. It appears that treatment with PSL-liposome is effective in improving glomerular IgA and C3 depositions and glomerular expansion in IgA nephropathy of ddY mice.
TINU Syndrome Associated with Reduced Complement Levels
Authors: Conz P.A. , Milan M. , Bragantini L. , La Greca G. , Bevilacqua P.A.
Published: April 2003

The TINU syndrome (tubulointerstitial nephritis and uveitis) was first described by Dobrin et al. in 1975. Since then, more than 50 cases have been documented each with diverse immunopathogenetic and genetic characteristics. The aim of this report is to describe a case of TINU associated with reduced complement levels. We profile a 48-year-old white female with persistently reduced C4 complement levels during the acute phase of the pathology and with an unaltered immunologic profile. Renal biopsy evidenced a significant lymphocytic interstitial infiltration. Immunohistochemical studies of the interstitium infiltrates was positive for the presence of the T (CD3) markers (CD4 > CD8). Steroid therapy yielded a complete regression of the symptomatology with normalization of the complement levels. We suggest that it is possible to hypothesize that the various immunologic alterations associated with TINU, including the transient reduction complement levels, may be secondary to multiple inflammatory mechanisms which express themselves throughout the pathology.
Urinary Podocytes in Primary Focal Segmental Glomerulosclerosis
Authors: Hara Masanori , Yanagihara Toshio , Kihara Itaru
Published: April 2003

Background/Aim: Focal segmental glomerulosclerosis (FSGS) is a common cause of nephrotic syndrome. Although the pathogenesis is not known, recent studies suggest that FSGS may be a podocyte disease. The aim of this study was to look for podocyte injury in this disease, using measurements of urinary podocytes. Methods: We examined the first morning urine of the day collected from 71 patients (45 men and 26 women, median age and range 11.2 and 3–29 years) diagnosed as having nephrotic syndrome. Freshly voided urine samples were examined by immunofluorescence labeling using monoclonal antibodies against human podocalyxin. Renal histological examinations were performed in 58 of the 71 patients: 28 had minimal-change disease, 20 had FSGS, and 10 had membranous nephropathy. Results: Median and range of urinary podocytes measured were 0.2 and 0–40.8 cells/ml for 71 patients with nephrotic syndrome and 0 and 0–0.8 cells/ml for normal healthy control subjects (n = 200). Patients with FSGS had significantly higher levels of urinary podocytes (median and range 1.3 and 0–40.8 cells/ml) than those with minimal-change disease (median and range 0 and 0–6.9 cells/m; p = 0.003) or membranous nephropathy (median and range 0 and 0–1.4 cells/ml; p = 0.02). Conclusions: The urinary excretion of podocytes is significantly higher in patients with FSGS as compared with those having membranous nephropathy or minimal-change disease. These findings suggest that podocyte injury and loss in the urine may have an important role in the pathogenesis of FSGS.
A Novel Microperfusion System for the Long-Term Local Supply of Drugs to the Inner Ear: Implantation and Function in the Rat Model
Authors: Praetorius Mark , Limberger Annette , Müller Marcus , Lehner Rolf , Schick Bernhard , Zenner Hans-Peter , Plinkert Peter , Knipper Marlies
Published: April 2003

Local therapy is practiced for middle and inner ear diseases but is usually restricted to cases of ear drum perforation or repeated invasive intratympanic drug application. Perfusion of drugs on the round window or through the scalae of animals using a pump system suggests that the chronic local drug treatment might also be feasible in humans. However, drug delivery systems that are currently on the market involve repeated reimplantation if they are to be used for long-term drug supply. A bone-anchored, totally implantable micro-drug delivery system (MDS) for patient-controlled drug supply has been developed [Lehner et al., 1997]. In this study, we show the first successful long-term in vivo test of the MDS micro-pump in rats. The process of implantation and first functional tests will be described. The biomaterial used to manufacture the delivery system did not cause any inflammation reaction in any of the 9 animals successfully implanted. After activation of the micro-pump, the drug reservoir and port was found to be fluid-tight. Bolus applications of tetrodotoxin (TTX) to the round window induced a transient decrease of evoked brainstem responses. In 2 animals which carried the MDS for more than 8 months the proper functioning of the pumping device was examined in a 2–3 week interval over a 3 month period. The MDS can be autoclaved even after long-term implantation and can then be reused for subsequent implantations. Designed for life-long implantation in humans, the demonstration of an effective long-term drug supply to the inner ear using the MDS provides an encouraging first step towards future long-term drug treatment of the inner ear in humans.
HSV-1 Not Only in Human Vestibular Ganglia but Also in the Vestibular Labyrinth
Authors: Arbusow Viktor , Theil Diethilde , Strupp Michael , Mascolo Andrea , Brandt Thomas
Published: April 2003

Reactivation of herpes simplex virus type 1 (HSV-1) in the vestibular ganglion (VG) is the suspected cause of vestibular neuritis (VN). Recent studies reported the presence of HSV-1 DNA not only in human VGs but also in vestibular nuclei, a finding that indicates the possibility of viral migration to the human vestibular labyrinth. Distribution of HSV-1 DNA was determined in geniculate ganglia, VGs, semicircular canals, and macula organs of 21 randomly obtained human temporal bones by nested PCR. Viral DNA was detected in 48% of the labyrinths, 62% of the VGs, and 57% of the geniculate ganglia. The potential significance of this finding is twofold: (1) Inflammation in VN could also involve the labyrinth and thereby cause acute unilateral vestibular deafferentation. (2) As benign paroxysmal positional vertigo often occurs in patients who have had VN, it could also be a sequel of viral labyrinthitis.
Latency of Auditory Evoked Field Deflection N100m Ruled by Pitch or Spectrum?
Authors: Lütkenhöner Bernd , Lammertmann Christian , Knecht Stefan
Published: April 2003

The auditory evoked field (AEF) in response to pure tones of 250 and 1000 Hz and a complex tone with a periodicity of 4 ms (composed of the frequencies 1000, 1250, 1500, 1750, and 2000 Hz), corresponding to a pitch of 250 Hz, was recorded with a 37-channel neuromagnetometer system. The intensity was 60 dB sensation level (SL). Two different stimulus durations were examined in 12 subjects: 500 ms (long tones) and 100 ms (short tones). The stimulus onset asynchrony (SOA) was uniformly distributed between 3 and 4 s for the long tones and between 0.8 and 1.2 s for the short tones. Each subject was investigated four times, to assess the intraindividual variability. The mean latency of the AEF deflection N100m turned out to be similar for the long and the short tones: about 98 and 87 ms for the pure tones of 250 Hz and 1000 Hz, respectively, and 95 ms for the complex tone with a pitch of 250 Hz. However, a great interindividual variability was observed, exhibiting no consistent relationship between the N100m latencies for the three different tones, except that the response to the pure tone of 1000 Hz generally occurred earlier. In conclusion, this study does not support the proposal that the N100m latency represents a code for pitch, although a low pitch appears to be a factor favoring a longer N100m latency.
White Matter Injury in the Preterm Neonate: The Role of Perfusion
Authors: Greisen Gorm , Børch Klaus
Published: April 2003

The preterm infant is at special risk of white matter injury. It was hypothesized long ago that ischemia is the principal etiology. The commonly used experimental animals for perinatal brain injury research may differ importantly from humans as regards the white matter. Therefore, evidence from human neonates that the white matter is selectively exposed to ischemia is relevant. Blood flow to the white matter appears to be particularly low in the premature human infant, with only 17% of flow to the gray matter. Furthermore, the blood flow to the white matter appears to be selectively reduced when blood pressure is low. There are important methodological limitations to all the studies reviewed; whereas the hypothesis has not had strong support, it has not been refuted. It appears wise to consider ischemia to the white matter a real threat in sick preterm infants.
Mutual Apprentices: The Making of Parenthood and Childhood in Family Dinner Conversations
Authors: Pontecorvo Clotilde , Fasulo Alessandra , Sterponi Laura
Published: April 2003

Starting from a view of socialization as a bidirectional process, the paper contributes to the field of language socialization in detailing how conversational interaction provides tools for parents and children to collaboratively construe a sense of moral meaning and social order. The paper illustrates both the agentive participation of Italian children in dialogue on normative behavior and ways that their discursive contributions shape the structure and thematic content of parental talk that ensues. Parental responses to children’s normative transgressions socialize them also into the language of transgression. The children we studied supply and elicit accounts from others that attempt to justify or explain transgression.
Chronic Phosphorus Supplementation Decreases the Expression of Renal PTH/PTHrP Receptor mRNA in Rats
Authors: Masuyama Ritsuko , Kajita Yasutaka , Odachi Junko , Uehara Mariko , Shigematsu Takashi , Suzuki Kazuharu , Goto Shiro
Published: April 2003

Dietary intake of high levels of phosphorus is known to increase serum levels of parathyroid hormone (PTH); however, how this increased serum PTH affects the action of PTH in major target tissues, particularly by kidney, remains unknown. In the present study, we therefore undertook to clarify this point in intact animals fed a high-P diet by examining various parameters of PTH action. Twelve weanling Wistar male rats were assigned randomly to two groups: a control group with dietary Ca:P = 1:1 and a high-P group (Ca:P = 1:3) fed the standard AIN-76 diet supplemented with P (0.5 and 1.5 g/100 g of diet). After 3 weeks of feeding, in the high-P diet group, we observed that serum Ca was lowered, without a difference in serum P, when compared to the control group. Excretion of urinary cAMP, an index of renal PTH action, was also decreased, with higher excretion of urinary P in those rats fed the high-P diet. In agreement with the decreased cAMP excretion, a clear reduction in PTH/PTH-related protein (PTHrP) receptor gene expression as estimated by Northern blotting was observed in the kidney, despite increased levels of serum PTH. Thus, the present study indicated that a high-P diet reduces PTH action in the kidney, though the serum PTH is increased.
Membranoproliferative Glomerulonephritis Associated with a Mixed-Cell Germinal Ovary Tumor
Authors: Salazar-Exaire D. , Rodríguez A. , Galindo-Rujana M.E. , Briones J.C. , Arenas-Osuna J. , Rocha L.M. , Paniagua R.
Published: April 2003

We describe a patient with membranoproliferative glomerulopathy associated with a mixed-cell germinal ovary tumor (embryonal and dysgerminoma components). Advanced renal failure ensued without remission of nephrotic syndrome after surgery. Five other cases of ovary tumor associated with glomerulopathy and reported in the literature are reviewed. The association between membranoproliferative glomerulonephritis and mixed-cell germinal ovary tumor has not been previously reported.
Acute Renal Failure in a Renal Transplant Donor due to Primary Antiphospholipid Syndrome
Authors: Chitalia Vipul Chimanlal , Kolhe Nitin , Kothari Jatin , Almeida Alan Fernandes
Published: April 2003

Primary antiphospholipid antibody (APA) syndrome, a common prothrombotic disorder, has been known in dialysis patients and renal transplant recipients. We report a case of primary APA syndrome presenting as a posttransplant complication in a renal transplant donor. A renal donor presented with acute, painless anuria due to renal artery thrombosis 6 years following renal transplant surgery, subsequent thrombosis of jugular catheter and arteriovenous fistula occurred, despite anticoagulation treatment, due to primary APA syndrome. This incident represents the most catastrophic complication reported in a renal donor due to primary APA syndrome. The validity of a prothrombotic assay in an organ donor workup to detect predilection to hypercoagulable disorders and to prevent such complications is open to question. The actual significance of APA in the blood is unclear; hence, the presence of APA in a potential renal donor would pose an ethical and practical dilemma.
Acute Thrombosis of the Renal Transplant Artery after a Single Dose of OKT3
Authors: Shankar Ravi , Bastani Bahar , Salinas-Madrigal Luis , Sudarshan Ballal
Published: April 2003

We present the case of an 18-year-old male who 8 months after a living-related donor, one-haplotype-matched renal transplantation developed acute thrombosis of the renal allograft artery, within 10 h of the first dose of OKT3. The antibody therapy had followed five daily doses of intravenous pulse methylprednisolone for a Banff class 1B acute tubulointerstitial rejection, on a ciclosporin-based immunosuppression protocol. We briefly review the literature on the incidence of vascular thrombosis after transplantation and the procoagulant effects of OKT3, pulse methylprednisolone, and ciclosporin therapy.
Observations on Edema Formation and Resolution in Gleich Syndrome: Essential Role of the Kidneys in Effective Arterial Blood Volume Regulation
Authors: Oktenli Cagatay , Bulucu Fatih , Gurbuz Murat , Bozoglu Ergün , Oguz Yusuf , Koc Bayram
Published: April 2003

Gleich syndrome is clinically present with episodes of angioedema, hypereosinophilia, oliguria, and weight gain due to fluid retention which may be sudden and remarkable, sometimes increasing to 10–20% of the baseline weight. The purpose of this study was to evaluate body fluid regulation and hormonal responses during the episode of angioedema and during the recovery phase in a patient with Gleich syndrome. A 24-year-old male was referred to our hospital for further evaluation of recurrent attacks of swellings of face, upper arms, and legs, marked weight gain, and oliguria. On first admission, the patient was in a remission phase, and the initial physical examination showed no abnormalities. Underlying disorders causing edema, such as heart, kidney, and liver diseases, and the recognized causes for hypereosinophilia, such as allergy, parasites, and collagen diseases, were ruled out. After 2 months, since his course was monitored, the patient was hospitalized. During days 10–19, he developed pronounced nonpitting edema of face, upper arms, and legs. Constant leukocytosis and hypereosinophilia, oliguria, and marked weight gain were also noted. A clinical remission was observed without any medication: intensive diuresis, loss of weight, regression of edema, and decreased eosinophil and leukocyte counts within 2 weeks. Physiological mechanisms during edema and resolution are discussed. In conclusion, our patient represents a suitable model for the protection of effective arterial blood volume because of the absence of underlying disorders causing edema. The kidneys play an essential role in the effective arterial blood volume regulation.
Long-Term Impact of Hepatitis B, C Virus Infection on Renal Transplantation
Authors: Lee Wen-Chin , Shu Kuo-Hsiung , Cheng Chi-Hung , Wu Ming-Ju , Chen Cheng-Hsu , Lian Jong-Da
Published: April 2003

Chronic liver disease and its complications are major problems in renal transplant recipients. Our aim was to elucidate the influence of hepatitis B, C virus infection on the long-term outcome of renal transplantation. Four hundred and seventy-seven patients who received renal transplantation between January 1984 and December 1999, and who were followed up at our hospital were enrolled. HBsAg was detected by the RIA method and anti-HCV Ab was assayed by the second-generation RIA kit. SGOT/ SGPT were checked every 3 months. Hepatoma was diagnosed by dynamic CT scan, elevated α-fetoprotein, hypervascularity by angiography and confirmed by pathological examination. The prevalence of HBV, HCV, coinfected HBV/HCV was 9.9% (n = 47), 28.5% ( n = 136), 3.1% (n = 15), respectively. The incidences of hepatoma in the HBV–/HCV–, HBV–/HCV+, HBV+/HCV–, HBV+/HCV+ groups were 1.4% (n = 4), 4.4% (n = 6), 6.4% (n = 3), 6.7% (n = 1), respectively (p = 0.114). The incidences of liver cirrhosis/hepatic failure were 3.2% (n = 9) , 6.6% (n = 9) , 21.3% (n = 10) , 20% (n = 3), respectively (p < 0.001). The frequencies of chronic liver disease were 10.4% (n = 29) , 45.6% (n = 62) , 66% (n = 31) , 80% (n = 12), respectively (p < 0.001). Patient and graft survival rates were lower in the HBV-infected group than in the other groups. Cox regression analysis revealed that HBV infection is likely an independent risk factor for patient mortality although the statistical significance was only borderline. Patients with HBV as well as HCV infection were not at risk of graft loss according to this model of analysis. Patients with HBV infection showed higher incidences of hepatoma, hepatic failure, graft failure and death. Therefore, HBV-infected patients who are candidates for renal transplantation should be carefully evaluated. It seems that HCV infection has little influence on the outcome of renal transplant recipients. A longer period of follow-up is needed to clarify the impact of HCV on renal transplant recipients.
A Scanning Electron Microscopic Study of the Rete testis of the Guinea Pig
Authors: Beu C.C.L. , Orsi A.M. , Gregório E.A. , Matheus S.M.M. , Basso N.A.
Published: April 2003

Scanning electron microscopic (SEM) observations of the structure of the rete testis (RT) of guinea pigs preceded by and complemented with stereomicroscopy and light-microscopic studies showed that the RT of this species is predominantly cavitary. An axial and labyrinth-like morphological pattern was also observed in the RT complex, with partially interconnected chambers and epithelium-lined channels accompanying a connective axis observed in the middle portion of the cranial end of the testis. Characteristics of the chordaeretis and bullaeretis were also visualized in the guinea pig RT and the results are discussed in terms of the morphological patterns observed in the RT of other mammals and of man.
Variation in the Branching of the Axillary Artery
Authors: Kogan I. , Lewinson D.
Published: April 2003

A case is described in which a rare variation of a branch arising from the axillary artery is defined as a thoracoepigastric artery. This variation was observed in the cadaver of a 72-year-old man. This artery branched from the axillary artery, passing as a common trunk between the roots of the median nerve, and divided into two branches. The lateral one gave rise to muscular branches supplying the shoulder and fasciae, while the medial one descended on the anterior aspect of the axillary fossa, reaching the hypogastric region, and anastomosed with the superficial epigastric artery, which is a branch of the femoral artery. To our best knowledge, no variation similar to this one has been described. We suggest naming this artery the thoracoepigastric artery.
Strategies for Glycoconjugate Analysis
Authors: Geyer H. , Geyer R.
Published: April 2003

Glycoconjugates such as glycoproteins and glycosphingolipids exhibit multiple functions in biological systems. A correlation of functional features with defined structural parameters, however, presupposes detailed information on the glycoconjugates’ carbohydrate moieties including the type of linkage of the oligosaccharide chain(s), monosaccharide composition as well as sequence, linkage positions and anomeric configurations of individual sugar monomers. Chemical and biochemical analyses are often impeded by the limited amounts of sample available and the vast structural heterogeneity of glycoconjugate glycans, thus requiring highly sensitive and efficient methods for detection, separation and structural elucidation of these carbohydrates. The aim of the article is to present suitable strategies for structural characterization of glycoconjugate glycans and to briefly review some of the techniques commonly used in this field.