bluuebunny/crossref_metadata_2025 huggingface dataset:
Transrectal Ultrasound Appearance of Squamous Cell Carcinoma Involving the Prostate
Authors: Terris Martha K.
Published: April 2003

Purpose: This report describes the transrectal ultrasound appearance of squamous cell carcinoma of the prostate. Case Reports: One case of squamous cell carcinoma involving the prostate by extension from a primary urethral carcinoma and a second case of radiation-induced primary prostatic squamous cell carcinoma are presented and the ultrasound findings discussed. Conclusions: In these 2 cases, squamous cell carcinomas involving the prostate exhibited similar transrectal ultrasound appearances. Both lesions demonstrated an irregular, anterior, relatively hyperechoic appearance.
A Study of Struvite Precipitation and Urease Activity in Bacteria Isolated from Patients with Urinary Infections and Their Possible Involvement in the Formation of Renal Calculi
Authors: Rivadeneyra M.A. , Gutierrez-Calderón A. , Rivadeneyra A.M. , Ramos-Cormenzana A.
Published: April 2003

Struvite precipitation and urease activity were studied in 72 bacterial strains isolated from patients with an urinary infection. The results revealed struvite precipitation by urease-positive, urease-negative and weakly urealitic bacteria. However, in some strains of each of these groups, no precipitation was observed. Variations in pH within the cultures were also investigated as were the mineralogy and morphology of the crystals precipitated using X-ray diffraction and scanning electron microscopy, respectively. The role of urease activity and alkalinization of the medium in struvite precipitation is discussed, as is the possible involvement of bacteria in nucleation processes. We concluded that urease-negative bacteria or those with weak urease activity may also be involved in the formation of struvite renal calculi although urease-positive bacteria seem to make a greater contribution.
Accessory Scrotum
Authors: Budhiraja Sushil , Pandit S.K.
Published: April 2003

A 2-year-old male with a perineal swelling, covered with normal skin without any rugosities, was diagnosed as having an accessory scrotum on histopathology. There was no other congenital anomaly. The case is reported due to its rarity and unique clinical picture.
Urologic Complications of Extravesical Ureteroneocystostomy in Renal Transplantation from Living Related Donors
Authors: Nane İsmet , Kadioglu Teoman C. , Tefekli Ahmet , Koçak Taner , Ander Haluk , Köksal Türker
Published: April 2003

Introduction: Reconstruction of the urinary system during renal transplantation is usually performed with antirefluxive ureteroneocystostomy techniques and extravesical methods are usually preferred. Material and Methods: Between 1983 and 1997, 241 renal transplantations from living donors were performed at our institution. A variation of the Lich-Gregoir technique was used as the ureteroneocystostomy method in all cases. Results: A total of 12 (4.9%) urologic complications were observed. Urinary fistula developed in 5 (2%) cases and were explored surgically during the early postoperative period. Postoperative vesicoureteral reflux (VUR) to the transplanted kidney was identified in 7 (2.9%) cases. Either endoscopic or surgical interventions resolved VUR in 4 cases while the other 3 did not need further treatment. No ureteral stenosis was observed. There was no loss of graft due to urologic complications. Conclusions: Urologic complications after renal transplantation are reported to be about 7% and ischemia is blamed as the major contributing factor. Preparation of the native ureter during donor nephrectomy and preservation of distal periureteral fatty tissue, anastomosis technique variations in vascular anatomy, rejections and medications are the major factors determining the ischemia.
An Unusual Retroperitoneal Cystic Tumor
Authors: Salinas Sánchez A.S. , Lorenzo Romero J.G. , Segura Martín M. , Hernández Millán I.R. , Pastor Guzmán J.M. , Virseda Rodríguez J.A.
Published: April 2003

This report describes a case of textiloma (term given to an inflammatory swelling caused by a retained textile foreign body) in a 60-year-old patient who had undergone surgery for a perforated gastroduodenal ulcer 17 years earlier. On examination the presence of a large mass was detected on the left hypochondria. A CT scan confirmed a cystic tumor with images suggesting detritus or necrosis in its lower part, as well as calcifications. Transperitoneal midline laparotomy was performed with extension by thoracophrenolaparotomy. Splenectomy was necessary. Macroscopic examination showed a spherical mass. After opening the tumor, retained surgical gauze was found. The histopathological diagnosis was granulomatosis reaction to a foreign body.
Cytological Changes Induced by Intravesical Bacillus Calmette-Guérin Therapy for Superficial Bladder Cancer
Authors: Takashi Munehisa , Schenck Ulrich , Koshikawa Takashi , Nakashima Nobuo , Ohshima Shinichi
Published: April 2003

To evaluate cytological changes of urothelial cells with intravesical instillation therapy of the bacillus Calmette-Guérin (BCG), cytological specimens of voided urine from patients with superficial bladder cancer (pTa and pT1) treated with intravesical BCG therapy were examined. The following three groups of patients who had no evidence of recurrence more than 2 years after the treatment were studied: groups 1 and 2, patients who were treated with BCG (n = 22) and epirubicin, a derivative of doxorubicin (n = 22), respectively, for prophylaxis of intravesical recurrence after transurethral resection (TUR); and group 3, patients receiving no intravesical therapy after TUR (n = 12). Sixteen cytological characteristics were studied before and after the treatment in each group. In group 1 patients translucent nuclei and prominent nucleoli, vacuolization of cytoplasm, and eosinophilic cytoplasmic inclusions were frequently observed in urothelial cells as well as an increase in granulocytes, especially within 3 months after BCG instillation therapy. In group 2 patients an increased nuclear/cytoplasmic ratio, hyperchromatic nuclei and prominent nucleoli of urothelial cells were transiently found within 1–2 months after intravesical epirubicin therapy. In group 3, translucent nuclei and prominent nucleoli of urothelial cells were found within 1–2 months after TUR. In conclusion, cytological changes induced by BCG therapy are nonspecific and reactive in nature, different from those due to chemotherapeutic agents and distinguishable from malignant changes of urothelial cells.
Mondor’s Disease of the Penis
Authors: Kraus S. , Lüdecke G. , Weidner W.
Published: April 2003

Mondor’s disease of the penis has been reported after genital trauma such as stretching and torsion of the veins and can cause endothelial necrosis and thrombosis. We report a 35-year-old male with thrombosis of the penile superficial dorsal vein who did not respond to topical drug therapy. Surgical management, e.g. superficial vein resection, is the most effective therapy in refractory cases for relieving pain, diminishing skin induration and producing esthetically pleasing results.
Assessment of a Three-Dimensional Operating System with Skill Tests in a Pelvic Trainer
Authors: Sun Chi-Cheng , Chiu Allen W. , Chen Kuang-Kuo , Chang Luke S.
Published: April 2003

Objectives: To compare the performance of laparoscopic skill assisted by a traditional two-dimensional (2D) and a three-dimensional (3D) endoscopic video system in a pelvic trainer. Materials and Methods: The 3D imaging system (DeepVision®, Automated Medical Products Corp.) consists of a traditional single lens optic laparoscope, a light source, an endoscopic camera (Stryker), a DeepVision processor and a DeepVision monitor. The 2D images could be obtained with the same system without turning on the DeepVision processor. Thirty-four medical personnel with no laparoscopic surgical experience were enrolled to perform two skill tests, the object-pick-up and spatial orientation test in a trainer box. They were randomly divided into two groups, one group performed the test under 2D conditions first and 3D later, and another group performed the test under 3D conditions first and 2D later. The duration needed to complete the skill tests was recorded and the differences on performance time under 2D and 3D conditions were calculated for each participant. Two-way ANOVA was used to analyze the statistic difference on the performance time in two conditions. Results: The duration needed to complete the initial skill tests was similar among 2D and 3D conditions. For both tests, the average performance time decreased significantly for the second attempt regardless of 2D or 3D conditions. Statistic analysis disclosed significant difference for learning factor (p < 0.001 for object-pick-up test and p < 0.01 for spatial orientation test), but no significant difference betwen 2D and 3D conditions (p = 0.276 for object-pick-up test and p = 0.327 for spatial orientation test). Conclusion: A significant decrease of the performance time at the second attempt reflected the importance of a learning process in laparoscopic surgery. It appears that no significant benefits were obtained by this 3D operating system for surgeons without laparoscopic surgical experience.
Serum-Free Coculture of Stromal and Epithelial Cells from Benign Prostatic Hyperplasia with Keratinocyte Growth Factor
Authors: Hashiba Takahumi , Noguchi Sumio , Tsuchiya Futoshi , Takeda Mitsumasa , Masuda Mitsunobu , Kubota Yoshinobu , Hosaka Masahiko
Published: April 2003

We developed a serum-free coculture model of benign prostatic hyperplasia (BPH) to clarify whether stromal cells stimulate growth of epithelial cells from BPH tissues. Epithelial and stromal cells from freshly isolated BPH tissue were cultured separately in defined serum-free WAJC 404/RPMI 1640 medium supplemented with insulin, transferrin, selenium, hydrocortisone, bovine serum albumin, epidermal growth factor, basic fibroblast growth factor and keratinocyte growth factor. 3H-Tdr incorporation into epithelial cells and stromal cells was used as a measure of proliferation. When epithelial cells were cocultured with stromal cells, 3H-Tdr incorporation into epithelial cells was increased in comparison to that in epithelial cells cultured alone. Dihydrotestosterone significantly increased this effect. It is likely that the in vitro coculture model reported here will be useful for isolating and understanding stromal cell-derived paracrine growth factor(s).
Spontaneous Perirenal Hematoma
Authors: Gupta Narmada P. , Karan S.C. , Aron Monish , Pawar Ratnesh , Ansari M.S.
Published: April 2003

Spontaneous perirenal hematoma (SPH) is a clinical entity that poses a diagnostic and therapeutic challenge. We report a case of SPH in an adult where the cause could not be determined at first presentation, even with computed tomography (CT) of the abdomen and angiography. He was under close follow-up, and it was only with a repeat CT scan after 3 months that a mass lesion in the kidney was identified as the underlying cause. We also present a review of the literature so that a logical approach can be adopted for this problem.
A Case of Atypical Chronic Myeloid Leukemia Regarded as MDS with Myeloproliferative Features
Authors: Tohda Shuji , Koyama Nobuyuki , Tanaka Michiko , Kida Yujiro , Murakami Naomi , Nara Nobuo
Published: April 2003

We report a case of atypical chronic myeloid leukemia (aCML) who showed marked neutrophilia without dysplastic features, basophilia or monocytosis. These findings diverged somewhat from the FAB criteria for aCML. The patient’s erythroid cells and megakaryocytes were dysplastic. His marrow cells formed no spontaneous colonies, as shown by cell culture. The cells formed many small-sized neutrophil colonies with G-CSF stimulation. Interestingly, they formed mainly neutrophil colonies with GM-CSF stimulation. These findings were different from those of chronic myelomonocytic leukemia cells and chronic granulocytic leukemia cells. This aCML case showed the cytological features of myelodysplastic syndrome.
Selectins and IL-6 during the Clinical Course of Idiopathic Thrombocytopenic Purpura
Authors: Haznedaroglu İbrahim C. , Büyükaşık Yahya , Koşar Ali , Özcebe Osman İ. , Kirazlı Şerafettin , Dündar Semra
Published: April 2003

‘Stress thrombocytes’, i.e. large and presumably hyperfunctioning platelets, is a well-known characteristic of patients with idiopathic thrombocytopenic purpura (ITP). Therefore, despite what may be severe thrombocytopenia these patients generally do not suffer from severe life-threatening hemorrhage. The plasma level of soluble P-selectin (sP-selectin) is a valuable marker reflecting platelet activation. Available data suggest that interleukin-6 (IL-6) may contribute to the regulation of megakaryocytopoiesis and platelet activity. The purpose of this study is to investigate the status and kinetics of IL-6 and selectins, which are involved in the platelet function, production, and immunologic functions, during the clinical course of ITP, that may be helpful for understanding the biology of the disease. Twenty-two ITP patients were studied prospectively in the course of their disease. Sixteen, 8 and 6 patients were available after platelet recovery, relapse and splenectomy, respectively. Fifteen healthy persons served as a control group. Higher levels of both sP-selectin and IL-6 were observed in all clinical stages of disease compared to the control group. However, more prominent elevations were present during active stages of ITP, i.e. pretreatment (p < 0.001 vs. control group for both sP-selectin and IL-6) and relapse periods (p < 0.001 vs. control group for both sP-selectin and IL-6). Pretreatment soluble L-selectin and soluble E-selectin levels were not different from the controls. Both sP-selectin (r = –0.32, p = 0.019) and IL-6 (r = –0.41, p = 0.002) levels inversely correlated with platelet count during disease course. There was a positive correlation between the sL-selectin level and leukocyte count (r = 0.60, p < 0.001). These results suggest that residual platelets are activated in ITP, which offers a relatively benign clinical course compared to other thrombocytopenias. High IL-6 concentration during thrombocytopenia may be involved in compensatory megakaryocytopoiesis and augmented ‘residual platelet’ functions in ITP.
Spontaneous Remission of Anemia Associated with a Myelodysplastic Syndrome with Disease Evolution into a Myeloproliferative State
Authors: Tefferi Ayalew , Inwards David J. , Hoyer James D.
Published: April 2003

A red cell transfusion-dependent patient with a myelodysplastic syndrome had progression into a myeloproliferative state with thrombocytosis. At the same time, the patient became transfusion independent, and a subsequent bone marrow examination revealed a previously undetected loss of chromosome 7. The patient remains well with control of thrombocytosis by anagrelide therapy.
Gene Therapy for Severe Combined Immunodeficiency Caused by Adenosine Deaminase Deficiency: Improved Retroviral Vectors for Clinical Trials
Authors: Onodera Masafumi , Nelson DavidM. , Sakiyama Yukio , Candotti Fabio , Blaese R.Michael
Published: April 2003

Severe combined immunodeficiency (SCID) caused by adenosine deaminase deficiency (ADA–) is the first genetic disorder to be treated with gene therapy. Since 1990 when the first trial started for 2 patients with ADA– SCID, five clinical trials enrolling 11 patients have been conducted with different clinical approaches and the results obtained from these trials have recently been reported. According to these reports, T cell-directed gene transfer was useful in the treatment of ADA– SCID whereas the retroviral-mediated gene transfer to hematopoietic stem cells was insufficient for achievement of clinical benefits. This chapter reviews several crucial problems inherent in the current retroviral technology based on the clinical data observed in these pioneering ADA gene therapy trials and presents our new retroviral vector system for the next stem cell gene therapy.
Retroviral-Mediated Transfer andExpression of the Common Gamma Chain intoHuman Hematopoietic Progenitors
Authors: Candotti Fabio , Onodera Masafumi , Knazek RichardA. , Blaese R.Michael
Published: April 2003

The common gamma chain (γc) of cytokine receptors is mutated in X-linked severe combined immunodeficiency, a lethal disorder characterized by the absence of both humoral and cellular immune defenses. Allogeneic bone marrow transplantation from HLA-identical siblings usually results in complete reconstitution of the immune system and is the current treatment of choice. Genetic correction and reinfusion of autologous hematopoietic stem cells represents an alternative therapeutic approach for those patients who lack suitable marrow donors. In this study, we show that retroviral-mediated transfer of the γc gene results in efficient expression in CD34+ cells and high transduction rate of colony-forming progenitors.
Isolation of Large and Pure Samples of Human Erythroid Precursors at Different Stages of Maturation Using Immunomagnetic Separation of Cells from Liquid Cultures
Authors: Vaisman Boris , Konijn Abraham M. , Fibach Eitan
Published: April 2003

The two-phase liquid culture, which supports the development of human erythroid progenitors into hemoglobin-containing orthochromatic normoblasts, provides high yield of erythroblasts with synchronized development. However, other cell types are also present in the culture. In the present report, we used immunomagnetic separation for the purification of the developing erythroid precursors. At different stages of the culture, aliquots of the cells were incubated with anti-glycophorin A, B monoclonal antibodies, followed by anti-mouse IgG-coated magnetic beads, and separated by a magnet. In mature cultures, all isolated glycophorin-positive cells contained hemoglobin, as indicated by their staining with benzidine. All glycophorin-negative cells were benzidine negative. In earlier cultures, morphological examination and measurements of hemoglobin content showed that the erythroid precursors could be isolated at different stages of maturation. Thus, the combination of the liquid culture procedure with the immunomagnetic separation thechnique permitted to obtain large samples of pure erythroid cells, which were synchronized at subsequent stages of maturation. The method enables comprehensive studies of developing erythroid cells from normal donors as well as from patients with various disorders of erythropoiesis.
Sickle-Cell Disease in Brazzaville, Congo: Genetical, Hematological, Biochemical and Clinical Aspects
Authors: Mouélé R. , Boukila V. , Fourcade V. , Feingold J. , Galactéros F.
Published: April 2003

Clinical, hematological and molecular features of 116 unrelated sickle-cell anemia patients from Brazzaville were investigated. The mean age of the patients was 9.4 ± 5.3 years. 232 βs-chromosomes were haplotyped and almost all sickle cell anemia patients (91%) were homozygous for the Bantu haplotype. All hematological indices were similar for males and females. Mean hemoglobin (Hb) concentration was 6.6 ± 1.4 g/dl. Fetal Hb (HbF) levels were from 1 to 28%, with a mean of 8.8 ± 5.8%. There was a curvilinear relationship between %HbF and age suggesting that HbF level had a selective effect on the survival of patients. This effect was sex dependent. The (–α3.7) gene frequency was 0.45 and was not affected by stratification for age. Hematological characteristics of patients with (–α/αα, –α/–α) and without (αα/αα) the –α3.7 α-thal-2 deletion showed trends similar to those reported in Jamaican and US sickle cell anemia patients. Hyperbilirubinemia (>38 μmol/l) was common and high lactic dehydrogenase (LDH) concentrations were recorded. Bilirubin concentrations for males and females were similar whereas those for LDH concentration were not. Hepatomegaly and splenomegaly were common. Splenomegaly was strongly associated with the –α3.7 α-thal-2 deletion. These clinical and hematological observations indicate a more severe form of hemolytic disease in Congolese SS patients.
Factor VIII Inhibitors in Patients with Hemophilia A
Authors: Ören Hale , Yaprak Işın , İrken Gülersu
Published: April 2003

In 58 hemophilia A patients aged 1–18 years (mean 9.5 ± 4.7 years), the prevalence of inhibitors was found to be 27% by the Bethesda method in November 1995. Inhibitor activity was not detected in any of 14 patients with mild hemophilia while it was present in 9 of 27 (33%) patients with moderate, and 7 of 17 (41%) with severe disease. During follow-up, the inhibitors were transient in 10 of 16 patients (17%) and the prevalence of inhibitors was 10% at the end of the study. Our study has demonstrated that the patients’ age, factor VIII (F VIII) coagulant activity levels, type of F VIII replacement therapy, and frequency of F VIII administration affect inhibitor development, and these factors should be considered in the follow-up of hemophiliacs.
Premarital Screening of Beta-Thalassemia Trait in the Province of Denizli, Turkey
Authors: Keskin Ali , Türk Tufan , Polat Aziz , Koyuncu Hasan , Saracoglu Berna
Published: April 2003

A premarital screening program aiming at reducing the incidence of thalassemia major was started under the auspices of the Regional Health Administration in 1995 in the city of Denizli in the Aegean region of Turkey. In this report we assessed the 4-year results of the screening program. All couples who applied for marriage procedures were screened for β-thalassemia trait by automatic red cell indices and Hb A2 determination. The couples at risk were counseled and offered prenatal diagnosis and termination of pregnancy in case of an affected fetus. From October 1995 to August 1999, a total of 19,804 subjects (9,902 couples) were recruited for this study. The prevalence of β-thalassemia trait with increased Hb A2 was found to be 2.6% (514/19,804). In addition to the thalassemia trait, 22 patients (0.11%) had sickle trait. In 15 of the 9,902 couples, both partners were found to be carriers of the β-thalassemia trait. After genetic counseling, 2 of the 15 planned carrier marriages were canceled. Seven couples declared that they do not want to have a child at present. Prenatal diagnosis was sought by 6 couples. One fetus was found to be normal, 4 had thalassemia minor and 1 had thalassemia major; this pregnancy was terminated by elective abortion. This study indicated that premarital screening is a very useful tool for detecting carrier couples and an effective way of controlling thalassemia major.
Urinary Abnormalities in Chronic Hepatitis C – A Follow-Up Study
Authors: Lopes Lucila V. , Lopes Edmundo P.A. , Ferraz M. Lucia , Silva A. Eduardo , Kirsztajn Gianna , Sesso Ricardo , Pereira Aparecido B.
Published: April 2003

Extrahepatic manifestations of hepatitis C virus (HCV) infection have been reported, in particular essential mixed cryoglobulinemia, lichen planus and thyroid disorders [1]. In addition, evidence of HCV infection has been found in patients with glomerulonephritis, but the exact incidence of urinary abnormalities in patients with this infection is unknown [2]. The present study was undertaken to investigate urinary abnormalities in patients with chronic hepatitis C.
The Relationship between Pentosidine and Hemodialysis- Related Connective Tissue Disorders
Authors: Sakata Satoru , Takahashi Masaaki , Kushida Kazuhiro , Oikawa Michio , Hoshino Hironobu , Denda Masashi , Inoue Tetsuo
Published: April 2003

Dialysis-related amyloidosis (DRA), such as destructive spondyloarthropathy (DSA) and carpal tunnel syndrome (CTS), occurs in the connective tissues of patients on long-term hemodialysis (HD). Recently, it was suggested that advanced glycation end products (AGEs) and β2-microglobulin (β2m) modified with AGEs are related to DRA. The aim of this study is to elucidate whether serum levels of pentosidine, which is an AGE, relate to the occurrence of DRA in patients with long-term HD. 127 end-stage renal failure patients, with DSA or CTS and undergoing HD, were examined. Serum pentosidine was measured by the HPLC method with column switching. β2m and intact parathyroid hormone (i-PTH) were measured. Pentosidine levels were significantly elevated in the DSA, CTS, and DRA groups (patients in the DRA group had either DSA and/or CTS). There were no significant differences in the β2m and i-PTH levels between any group. The duration of HD did not correlate with either pentosidine or β2m levels, but did with i-PTH. Receiver-operating characteristic (ROC) analysis was performed to examine the discriminatory ability of pentosidine, β2m, and i-PTH for DRA. The area under the ROC curve was the greatest for pentosidine. Serum β2m levels were not related with the occurrence of DRA. The fact that serum pentosidine was higher in DRA than in non-DRA indicates that it has potential as an indicator of the occurrence of DRA in long-term HD patients.
Anticardiolipin Antibodies in Classic Pediatric Hemolytic-Uremic Syndrome: A Possible Pathogenic Role
Authors: Ardiles Leopoldo G. , Olavarría Fernando , Elgueta Mauricio , Moya Patricia , Mezzano Sergio
Published: April 2003

Anticardiolipin (aCL) antibodies have been associated with thrombocytopenia, hemolytic anemia and an increased risk of thrombosis in different vascular locations, even in the absence of lupus. The classic hemolytic-uremic syndrome is a postinfectious acute renal failure characterized by hemolytic anemia, thrombocytopenia and the presence of widespread glomerular thrombosis in the kidney, with pathogenic mechanisms that remain to be identified. In order to establish the frequency of aCL antibodies in this syndrome and to identify a possible role in the pathogenesis and clinical manifestations, 17 patients were studied during the reactant phase of the disease looking for an association between the presence of aCL antibodies (isotypes IgG, IgA and IgM) and the main clinical variables of the syndrome. In 8 patients IgG aCL was present, 2 patients had IgM aCL, and 1 had IgA antibodies on the solid-phase ELISA aCL assays, but no association could be demonstrated with the clinical variables studied. Although it might correspond to an epiphenomenon related to the triggering intestinal infection, a pathogenic role cannot be discarded and additional studies should be performed.
Experimental Focal Segmental Glomerulosclerosis in Mice
Authors: Chen Ann , Sheu Lai-Fa , Ho Yat-Sen , Lin Yu-Fen , Chou Wei-Yuan , Chou Tz-Chong , Lee Wei-Hwa
Published: April 2003

Although a lot of animal models of proteinuria have been established, proposals for the mechanisms of proteinuria are still controversial. In this work, during an 18-day trial, mice injected with a single dose of adriamycin (AD) rapidly showed combined glomerular albuminuria and immunoglobulinuria, progressively elevated levels of nitrite/nitrate in urine, hypercholesterolemia, abnormal renal function, segmentally or globally glomerular hyalinosis/sclerosis associated with tubular atrophy, enhanced glomerular deposition of immunoglobulins and fibrinogen, augmented expression of matrix components in the whole glomerular tuft, and loss of glomerular negative charge property. These laboratory and pathological features are comparatively similar to those of human focal segmental glomerulosclerosis in the advanced state. Juxtamedullary glomeruli appear to be more susceptible to the AD-related nephrotoxicity than those in the superficial renal cortex. A change in size-dependent glomerular permselectivity may precede a charge-dependent defect in glomeruli in this mouse model of proteinuria. Data in this study confirm the hypothesis of glomerular hyperfiltration involved in the pathogenesis of this chronic glomerulopathy associated with proteinuria in mice. In addition, nitric oxide may play a crucial role in the progression of the chronic glomerulopathy model.
Comparative Nephritogenicity of Two Monoclonal Antibodies That Recognize Different Epitopes ofRat Thy-1.1 Molecule
Authors: Nakayama H. , Oite T. , Kawachi H. , Morioka T. , Kobayashi H. , Orikasa M. , Arakawa M. , Shimizu F.
Published: April 2003

The pathophysiological role of the Thy-1.1 molecule expressed on rat mesangial cells with regard to mesangial cell dysfunction and injury remains unknown. The mechanism of Thy-1.1-associated injury has now been investigated with two monoclonal antibodies, 1-22-3 and OX7, that recognize different epitopes of Thy-1.1. Mesangiolysis and mesangial cell proliferation were more marked in rats injected with 1-22-3 than in those treated with OX7. Immunostaining for rat complement component C3 and also C9 was similar in the kidneys of rats 1 h after injection of either antibody. Alpha smooth muscle actin was first detected 3 days after injection of 1-22-3 and peaked on day 5; type I collagen staining showed a mesangial pattern on days 5 and 10. The staining for alpha smooth muscle actin and type I collagen was less intense in OX7-treated rats than in the 1-22-3-injected rats. The amounts of mRNAs encoding collagen types I and III peaked 5 days after injection of 1-22-3 and 10 days after injection of OX7. Rats injected with 1-22-3 developed proteinuria that was already marked on day 1 and peaked at 150 mg/day on day 3, whereas OX7 induced a low grade of proteinuria with large interindividual variability on day 3. Immunostaining for rat C3 in the normal rat kidneys, incubated in vitro with 1-22-3 or OX7 followed by incubation with normal rat fresh serum as a complement source, as well as the levels of serum complement activity, CH50, 30 min after injection of 1-22-3 or OX7 were similar, suggesting that the difference in the nephritogenicity of these two antibodies is not attributable to a difference in their complement-fixing activities, but rather may result from the difference in epitope specificities. The epitope recognized by 1-22-3 thus appears to be important in the initiation and progression of antibody-induced nephritis.
A High Glucose Concentration Stimulates the Expression of Monocyte Chemotactic Peptide 1 in Human Mesangial Cells
Authors: Ihm Chun-Gyoo , Park Jae-Kyung , Hong Seong-Pyo , Lee Tae-Won , Cho Byoung-Soo , Kim Myung-Jae , Cha Dae-Ryong , Ha Hunjoo
Published: April 2003

The mechanism of glomerular infiltration of monocytes remains unknown in diabetic nephropathy. We examined the effect of a high glucose concentration on monocyte chemotactic peptide 1 (MCP-1) expression in human mesangial cells (MCs) by using enzyme-linked immunosorbent assay and reverse transcription coupled with polymerase chain reaction (PCR). More than a 50% increase in the MCP-1 protein production was observed in MCs cultured in high-glucose medium (450 mg/dl) as compared to normal glucose (100 mg/dl; 1,496 ± 75 vs. 966 ± 15 pg/ml after 24 h, 1,910 ± 93 vs. 1,250 ± 55 pg/ml after 48 h). Semiquantitative PCR showed that phorbol myristate acetate (100 nM) increased the ratio of PCR products for MCP-1 to housekeeping gene glyceraldehyde-3-phosphate dehydrogenase on densitometric results at 24 h by 2.7-fold, which was prevented by calphostin C (200 nM) pretreatment. High glucose increased the ratio by 3-fold as compared to normal glucose at 24 h (0.72 ± 0.11 vs. 0.24 ± 0.01). This was also suppressed by calphostin C pretreatment. These findings demonstrate that high glucose can directly increase MCP-1 expression in MCs, which may contribute to monocyte infiltration in diabetic nephropathy, and this is regulated by protein kinase C.
Urinary Excretion of Tamm-Horsfall Protein and Epidermal Growth Factor in Chronic Nephropathy
Authors: Torffvit O. , Jørgensen P.E. , Kamper A.-L. , Holstein-Rathlou N.-H. , Leyssac P.P. , Poulsen S.S. , Strandgaard S.
Published: April 2003

Tamm-Horsfall protein (THP) and epidermal growth factor (EGF) are both synthesized by tubular cells in the distal part of the nephron and excreted with the urine. The present study examines the urinary excretion rates of the two peptides in relation to functional tubular markers in patients with chronic nephropathy. Four groups of patients with moderate to severely reduced renal function were studied: glomerulonephritis (n = 10), diabetic nephropathy (n = 11), tubulointerstitial nephropathy (n = 13), and polycystic kidney disease (n = 8). The renal function was evaluated by glomerular filtration rate (GFR) as an indicator for the general renal function, lithium clearance (CLi) as an indicator for proximal tubular function, and absolute distal reabsorption of sodium (ADRNa) as an indicator for distal tubular function. The excretion rate of EGF was rather closely correlated with GFR, CLi and ADRNa (Spearman coefficients of variation 0.88, 0.69, and 0.74, respectively). The correlations between the excretion rate of THP and GFR, CLi and ADRNa were weaker (Spearman coefficients of variation 0.68, 0.42, and 0.44). When the effect of GFR had been accounted for by multiple variance analyses, the excretion rates of the two peptides were still associated with ADRNa but not with CLi. In conclusion, the urinary excretion rates of especially EGF but also those of THP were correlated with renal function and distal tubular reabsorption of sodium in patients with chronic nephropathy.
Multiple Electrolyte Abnormalities after Pamidronate Administration
Authors: Elisaf M. , Kalaitzidis R. , Siamopoulos K.C.
Published: April 2003

Pamidronate constitutes a major advance in the treatment of tumor-associated hypercalcemia. However, transient electrolyte abnormalities have been reported after pamidronate administration. We describe here a patient with multiple myeloma and severe hypercalcemia who developed transient but significant electrolyte disturbances (mainly hypophosphatemia and hypomagnesemia) after a single dose of 90 mg of pamidronate, focusing on the underlying pathophysiological mechanisms.
Administration of Ascorbic Acid and an Aldose Reductase Inhibitor (Tolrestat) in Diabetes: Effect on Urinary Albumin Excretion
Authors: McAuliffe Aileen V. , Brooks Belinda A. , Fisher Elizabeth J. , Molyneaux Lynda M. , Yue Dennis K.
Published: April 2003

The important role of ascorbic acid (AA) as an anti-oxidant is particularly relevant in diabetes mellitus where plasma concentrations of AA are reduced. This study was conducted to evaluate the effects of treatment with AA or an aldose reductase inhibitor, tolrestat, on AA metabolism and urinary albumin excretion in diabetes. Blood and urine samples were collected at 0, 3, 6, 9, and 12 months from 20 diabetic subjects who were randomized into two groups to receive either oral AA 500 mg twice daily or placebo. Systolic and diastolic blood pressures, HbA1c, plasma lipids, urinary albumin, and total glycosaminoglycan excretion were measured at all time points, and heparan sulphate (glycosaminoglycan) was measured at 0 and 12 months. The same parameters, as well as urinary AA excretion, were determined at 0 and 3 months for 16 diabetes subjects receiving 200 mg tolrestat/day. AA treatment increased plasma AA (ANOVA, F ratio = 12.1, p = 0.004) and reduced albumin excretion rate (AER) after 9 months (ANOVA, F ratio = 3.2, p = 0.03), but did not change the other parameters measured. Tolrestat lowered plasma AA (Wilcoxon’s signed-rank test, p < 0.05), but did not change AER or the other parameters measured. The ability of AA treatment to decrease AER may be related to changes in extracellular matrix or improvement in oxidative defence mechanism. Unlike the rat model of diabetes, inhibition of aldose reductase did not normalize plasma AA or AER in humans. In fact, tolrestat reduced the plasma AA concentration, a phenomenon which may be due to increased utilization of AA. Dietary supplementation of AA in diabetic subjects may have long-term benefits in attenuating the progression of diabetic complications.
Soluble Interleukin-6 Receptor, Interleukin-10 and Granulocyte Colony-Stimulating Factor in Acute Pyelonephritis: Relationship to Markers of Bacterial Virulence and Renal Function
Authors: Jacobson Stefan H. , Lu Ying , Brauner Annelie
Published: April 2003

Background: Cytokines and cytokine receptors are involved in the systemic and local inflammatory response in patients with urinary tract infections. Methods: We examined urine and serum concentrations of soluble IL-6 receptor (sIL-6R), IL-10 and granulocyte colony-stimulating factor (G-CSF) in 29 women with acute pyelonephritis caused by Escherichia coli 2 weeks after the infection, during the subsequent episode of cystitis or asymptomatic bacteriuria and also later when the same patients were free from bacteriuria. Concentrations of sIL-6R, IL-10 and G-CSF were related to the expression of five virulence markers of E. coli and to glomerular filtration rate (GFR) after pyelonephritis. Results: On admission because of acute pyelonephritis the serum concentration of sIL-6R was similar to that of 12 healthy controls. Two weeks after the infection when all patients had received antibiotic treatment, the serum concentration of sIL-6R was significantly higher compared to that on admission (p < 0.001) and also higher compared to healthy controls (p = 0.001). Patients with increased concentrations of sIL-6R in serum 2 weeks after infection had significantly lower GFR at follow-up (p < 0.05). Patients with acute pyelonephritis had higher concentrations of G-CSF and IL-10 in serum compared to healthy subjects (p < 0.001 and p = 0.06, respectively). G-CSF in serum was higher in patients infected by E. coli producing cytotoxic necrotizing factor (p < 0.05). Patients infected by strains producing hemolysin had lower concentrations of sIL-6R (p < 0.001). Patients with detectable levels of the anti-inflammatory cytokine IL-10 in serum had significantly higher concentrations of IL-6 and the soluble tumor necrosis factor receptors I and II in serum as compared to patients in whom IL-10 was not detectable (p < 0.001, p = 0.001 and p < 0.05, respectively. Conclusion: These investigations, together with our previous findings summarized in this paper, contribute to an increased understanding of the local and systemic inflammatory response arising in response to acute pyelonephritis.
Deposition of Mannan Binding Protein and Mannan Binding Protein-Mediated Complement Activation in the Glomeruli of Patients with IgA Nephropathy
Authors: Matsuda Mitsuhiro , Shikata Kenichi , Wada Jun , Sugimoto Hikaru , Shikata Yasushi , Kawasaki Toshisuke , Makino Hirofumi
Published: April 2003

Mannan binding protein (MBP) is a C-type lectin and has a high affinity to mannose and N-acetyl glucosamine. It is also known to activate C4 and C2 without C1 component, which is called ‘lectin pathway’. We now report the presence of MBP and MBP-mediated complement activation in renal glomeruli of IgA nephropathy patients using an immunohistochemical method. In 7 of 42 cases with IgA nephropathy, MBP was detected in the glomerular mesangial area and colocalized with IgA1. In 19 cases with other types of IC-mediated glomerulonephritis including lupus nephritis and membranous nephropathy or without nephritis, MBP was not detected in the glomerulus. The C2- and/or C4-positive rate was 87.5% in the MBP-positive group and 20% in the MBP-negative group of IgA nephropathy. In addition, MBP-positive cases showed marked mesangial cell proliferation, lower creatinine clearance (53.4 ± 10.0 vs. 77.8 ± 4.7 ml/min) and higher urinary protein excretion (2.5 ± 0.9 vs. 0.9 ± 0.2 g/day) compared with MBP-negative cases. These findings suggested that MBP was involved in glomerular complement activation through the lectin pathway and thus induced glomerular injury of IgA nephropathy. Since oligosaccharide chain alterations such as reduced sialic acid and galactose of IgA1 molecule have been reported in IgA nephropathy patients, MBP might bind to the IgA1 molecule via interaction between MBP and sugar chain.
Effect of a Hemodialysis Session on Plasma Levels of Endothelin-1 in Hypertensive and Normotensive Subjects with End-Stage Renal Failure
Authors: Surdacki Andrzej , Sułowicz Władysław , Wieczorek-Surdacka Ewa , Herman ZbigniewS.
Published: April 2003

Background: Elevated plasma endothelin-1 (ET-1) was found in end-stage renal failure (ESRF). However, there are discordant reports on the influence of hypertension on plasma ET-1 in ESRF and on the effect of hemodialysis on ET-1 concentrations. Aim: To compare the time course of plasma ET-1 during hemodialysis in hypertensive (HT) and normotensive (NT) ESRF patients. Methods: Plasma ET-1 and mean blood pressure (MP) were measured in 12 HT patients and 11 matched NT patients on maintenance hemodialysis at baseline (B), after a 2.5–3.5 h hemodialysis with ultrafiltration (P1) and after a subsequent 1 h isovolumic dialysis (P2). Results: In HT patients, plasma ET-1 increased at P1 with no further change after P2 (B vs. P1 and P2, p < 0.05). In NT patients, ET-1 levels were similar at B, P1 and P2. In HT, but not in NT subjects, volume loss correlated with change of ET-1 at P1. In HT patients, MP fell during P1 and tended to return towards baseline at P2. In NT patients, MP dropped after P1 and remained lower also at P2. Conclusion: Hypertensive ESRF subjects exhibit potentiated ET-1 release on hemodialysis, possibly stimulated by volume depletion with sympathetic activation, which may attenuate hypotensive hemodialysis effects thus contributing to hypertension in ESRF.
Effect of a Novel Immunosuppressant, FK 506, on Autoimmune Glomerulonephritis in Brown Norway Rats
Authors: Nakahama H. , Obata K. , Matsuyama T. , Sugita M. , Horio M. , Oka K. , Moriyama T.
Published: April 2003

Mercuric-chloride (HgCl2) induces a lymphoproliferative disorder and autoimmune glomerulonephritis in Brown Norway rats. The effects of a new immunosuppressant FK 506 on this model of glomerulonephritis were studied. Brown Norway rats were treated with HgCl2 according to a standard protocol (HgCl2 1 mg/kg s.c. 3 times/ week). Rats developed proteinuria at day 7, which reached a plateau level at day 14. On day 14, renal histology showed prominent mesangial cellular proliferation and the expansion of mesangial matrix. Electron microscopic study showed the effacement of visceral epithelial foot processes and the microvillous transformation of the visceral epithelium. Immunofluorescence study showed a strong linear staining for IgG and the adhesion molecule ICAM-1 in all glomeruli. Coadministration of FK 506 (1 mg/kg s.c. daily) prevented the appearance of proteinuria at day 14 (621.4 ± 30.5 vs. 2.2 ± 2.7 mg/day) and the morphological lesions. These findings suggest that FK 506 could be useful for the therapy of certain types of human glomerulonephritis.
Laminin and β1 Integrin Distribution in the Early Stages of Human Kidney Development
Authors: Bernardini N. , Bianchi F. , Dolfi A.
Published: April 2003

Laminin, an extracellular matrix molecule (EMM) widely expressed in the basal laminae, interacts with specific membrane receptors among which the integrin molecules are the best known. During embryo development laminin is the first synthesized EMM and plays a significant role in the morphogenesis of organs in which epithelial-mesenchymal interactions and branching take place. The present study describes the distribution of laminin and of β1 integrin receptors during the very early stages of human kidney development. The observations were carried out on paraffin sections of human embryos ranging between the 4th and the 7th gestational week. Laminin was detected within the basement membranes of mesonephric duct, vesicles, glomerular vessels and celomic epithelium. The metanephric anlage reacted with anti-laminin immunoglobulins in the basement membrane underlying the ampullae and in few blastemic cap cells. Low levels of β1 integrin reactivity were found in both the mesonephric and metanephric structures. This study provides for the first time data about the distribution of laminin and β1 integrin in the early stages of human renal organogenesis suggesting a key role for these molecules in the epithelial-mesenchymal interactions necessary for kidney development.
Serum Levels of Soluble Fas and Disease Activity in Patients with IgA Nephropathy
Authors: Shou Ichiyu , Tashiro Kyouichi , Kurusu Atushi , Kaneko Shougo , Hayashi Takeshi , Fukui Mitumine , Shirato Isao , Kubota Kiichi , Tomino Yasuhiko
Published: April 2003

Using a sandwich ELISA, we studied 48 patients with IgA nephropathy and 10 patients with diffuse mesangial proliferative glomerulonephritis without IgA deposition (non-IgA PGN) to determine if levels of serum soluble Fas (s-Fas) might reflect the disease activity. The levels of serum s-Fas in patients with the advanced stage of IgA nephropathy were significantly higher than those in patients with the mild stage of the disease, in non-IgA PGN or in healthy controls. The results showed that advanced stage IgA nephropathy patients who showed heavy proteinuria and the presence of urinary casts revealed high levels of serum s-Fas. It was thus suggested that the measurement of serum s-Fas is useful in evaluating the degree of renal injury in patients with IgA nephropathy.
Hepatitis G Virus Infection in Haemodialysis and in Peritoneal Dialysis Patients
Authors: Campo Nadia , Sinelli Nicoletta , Brizzolara Renata , Torre Francesco , Gurreri Giovanna , Russo Rodolfo , Saffioti Stefano , Celle Guido , Picciotto Antonino
Published: April 2003

The aim of this study was to detect hepatitis G virus RNA (HGV RNA) and antibodies against the virus envelope protein E2 (anti-E2) in 107 patients either on maintenance haemodialysis (n = 78) or peritoneal dialysis (n = 29) to evaluate the prevalence of HGV infection and to establish its role in liver disease. The total prevalence of HGV infection was of 15.4% among haemodialysis patients, whereas it was 10.3% among peritoneal dialysis patients. HGV RNA was detected in 2 haemodialysis patients (2.6%) and in 3 peritoneal dialysis patients (10.3%). Anti-E2 was found in 10 haemodialysis patients (7.8%), whilst all peritoneal dialysis patients resulted negative. In only 1 patient the alanine aminotransferase level was elevated. This patient underwent liver biopsy that did not reveal evidence of chronic hepatitis. The lower HGV prevalence in haemodialysis patients, when compared with data reported by other European authors, should be related to the lower rate of polytransfused patients in our series (29.5%). Multiple blood transfusions should be considered as the main factor to explain the different prevalence of HGV infection among various European dialysis centres. Detection of both antibody and viraemia is important to establish the real rate of the infection.
Perinatal and Infant Outcome of Pregnant Patients Undergoing Chronic Hemodialysis
Authors: Nakabayashi Masao , Adachi Tomoko , Itoh Shoko , Kobayashi Makoto , Mishina Jun , Nishida Hiroshi
Published: April 2003

Recently, perinatal outcome in patients undergoing chronic hemodialysis has been improved. But the conditions that will most likely result in successful pregnancy are still obscure. We retrospectively analyzed 15 pregnant patients who were undergoing chronic hemodialysis before pregnancy treated in our perinatal center. We divided these 15 cases into 2 groups: one group of 11 patients whose infants survived and the other group of 4 patients whose infants died 6 h to 8 months after birth due to prematurity. The rate of successful pregnancies having a surviving infant was 73.3% (11/15). We compared the maternal conditions and the progress of pregnancy in the 2 groups. Significant differences (p < 0.01) were seen as follows. The patients in the group whose infants survived underwent hemodialysis for a shorter term before pregnancy (1–6 years), most of them (9/11) could produce urine (≧50 ml/day), and the period of gestation was extended (33.3 ± 4.7 weeks), so the infants were heavier (1,782.9 ± 678.3 g). All the patients who underwent more than 9 years of hemodialysis could not have a surviving infant. From this we can assume that the shorter the period of dialysis before pregnancy, the better the condition is that is likely to result in women giving birth and the better is their infant’s chance of survival.