bluuebunny/crossref_metadata_2025_split huggingface dataset:
Podocyte Phenotypes as Defined by Expression and Distribution of GLEPP1 in the Developing Glomerulus and in Nephrotic Glomeruli from MCD, CNF, and FSGS
Authors: Sharif Kaveh , Goyal Meera , Kershaw David , Kunkel Robin , Wiggins Roger 
Published: April 2003

Glomerular epithelial protein 1 (GLEPP1) is a podocyte receptor membrane protein tyrosine phosphatase located on the apical cell membrane of visceral glomerular epithelial cell (VGEC) foot processes. Double label immunofluorescence, immunoelectron microscopy, and peroxidase immunohistochemistry were used to map the GLEPP1 distribution in the developing glomerulus and in minimal-change nephropathy (MCN), congenital nephrotic syndrome of the Finnish type, and focal-segmental glomerulosclerosis (FSGS). In MCN GLEPP1 was shifted away from the glomerular basement membrane on the apical cell membrane of effaced foot processes. These data are compatible with the previously suggested concept that MCN can be considered a form of dedifferentiation of the podocyte phenotype. Similarly, changes seen in congenital nephrotic syndrome of the Finnish type can be considered a consequence of failure to complete normal podocyte development. In FSGS glomeruli GLEPP1 was frequently absent from VGECs, even when no sclerosis was detectable in that glomerulus. Therefore, in FSGS, VGECs may lose GLEPP1, and this loss appears to occur in the absence of scarring and may, therefore, precede the scarring process. We speculate that a changed VGEC phenotype that does not express GLEPP1 might have properties similar to the early undifferentiated VGEC developmental phenotype. GLEPP1 distribution pattern and absence from glomeruli of individuals with nephrotic syndrome may, therefore, represent a useful phenotypic marker.
Furosemide Compounds Enhance Urinary Excretion of Active Kallikrein Independently of Their Effects on Urinary Electrolyte Excretion
Authors: Bulmer Bronwyn , Penschow Jennifer D. 
Published: April 2003

The chemical and diuretic effects of furosemide on the excretion and activation of urinary prokallikrein were investigated in rats by treatment with furosemide compounds with a range of diuretic activity or amiloride hydrochloride or the vehicle. Diuresis occurred with furosemide and benzyl furosemide, but not with isofurosemide, amiloride hydrochloride, or the vehicle. The urinary excretion rate of active kallikrein was significantly elevated above controls throughout the 72 h of treatment with all of the drugs tested, regardless of the level of diuresis or the rate of urinary electrolyte excretion. In contrast, the urinary excretion rate of total kallikrein (prokallikrein + active kallikrein) was unchanged in all groups. These data indicate that furosemide derivatives increase the activation, but not the excretion, of urinary prokallikrein and that these effects are unrelated to the chemical structure or diuretic activity of the compounds or to overall changes in urinary electrolyte excretion rates.
Effect of Radiocontrast Agents on Intrarenal Nitric Oxide (NO) and NO Synthase Activity
Authors: Heyman Samuel N. , Goldfarb Marina , Carmeli Fanni , Shina Ahuva , Rahmilewitz Daniel , Brezis Mayer 
Published: April 2003

<b>Background/Aims:</b> Contrast media (CM) induce a biphasic renal hemodynamic response, with late prominent cortical vasoconstriction and marked outer medullary vasodilation. The objective of the study was to explore a possible role for altered nitric oxide (NO) production or bioavailability in these hemodynamic responses. <b>Methods:</b> We explored the impact of CM (sodium iothalamate) upon rat renal NO synthase (NOS) activity (citrulline recovery) and NO (using a NO electrode). <b>Results:</b> The cortical NOS activity following CM was 11.5 ± 1.0 versus 13.8 ± 1.1 nmol/gww/min (gww = gram wet weight) in controls (p = 0.16, NS). In rats pretreated with the nonselective endothelin antagonist bosentan, CM reduced the cortical NOS activity to 8.5 ± 1.2 nmol/gww/min (p < 0.005 vs. controls). Cortial NO readings declined over 30 min following CM by 13 ± 8% (p < 0.05, Anova), in parallel with the decline in cortical blood flow. The outer medullary NOS activity was not affected by CM (5.2 ± 1.5 vs. 5.5 ± 1.3) nmol/gww/min in controls) or bosentan. Nevertheless, the outer medullary NO reading increased by 36 ± 23% (p < 0.05), with a concomitant increase in regional blood flow. <b>Conclusion:</b> In the cortex, CM might reduce the NOS activity (an effect blunted by endothelin release). This may potentiate the effect of endothelin to induce regional vasoconstriction. In the outer medulla, the vasodilatory response to CM does not seem to be mediated by enhanced NOS activity and might reflect increased local NO bioavailability as the result of regional hypoxia.
Cloning of Rabbit Cct6 and the Distribution of the Cct Complex in Mammalian Tissues
Authors: Schwartz George J. , Kittelberger Ann M. , Segel George B. 
Published: April 2003

Cct6 protein is one of the subunits of the Cct complex involved in ATP-dependent folding of cellular proteins. We used the cDNA of the human <i>CCT6</i> subunit to obtain a full-length cDNA from a rabbit kidney cortex library. Two transcripts of 2 and 2.5 kb were detected in rabbit kidney and liver by Northern analysis. The rabbit <i>CCT6</i> was 93% identical to the human gene; the deduced amino acid sequence was 97% identical. A phylogenetic analysis of Cct6 proteins from mouse, rabbit, human, and yeast showed greater similarities of Cct6 protein among the species than among other Cct subunits. The ATP-binding sites were perfectly conserved among mammals and yeast, supporting the role of Cct complex in ATP-dependent protein folding. Using a polyclonal antibody to human Cct6 protein and Western analysis, we found expression of this subunit in a variety of rabbit organs and tissues, as well as in bovine testes, human lymphocytes, human and rabbit reticulocytes, and in two cultured kidney cell lines. We also found Cct1 protein by Western analysis in several rabbit organs as well as in bovine testes. These data characterize the rabbit Cct6 subunit and compare it to its homologues. The Western analyses support the concept that Cct complex is widely distributed among tissues and highly conserved among eukaryotes.
Reciprocal Regulation of LTA<sub>4</sub> Hydrolase Expression in Human Monocytes by γ-Interferon and Interleukins 4 and 13: Potential Relevance to Leukotriene Regulation in Glomerular Disease
Authors: Montero Angel , Nassar George M. , Uda Susumu , Munger Karen A. , Badr Kamal F. 
Published: April 2003

<i>Background/Aims:</i> Leukotriene A<sub>4</sub> (LTA<sub>4</sub>) hydrolase catalyzes the final step in the synthesis of leukotriene B<sub>4</sub> (LTB<sub>4</sub>). TH-1- and TH-2-derived cytokines may regulate LTB<sub>4</sub> synthesis by monocytes through their actions on the expression of LTA<sub>4</sub> hydrolase. <i>Methods:</i> Freshly isolated monocytes were incubated with pro- and anti-inflammatory cytokines for 36 h. mRNA expression was determined by Northern blot, protein expression was determined by Western blot and LTB<sub>4</sub> synthesis was determined by ELISA. <i>Results:</i> Interferon-γ (a TH-2-derived cytokine) increased significantly LTA<sub>4</sub> hydrolase mRNA expression, whereas interleukin (IL)-4 and IL-13 (both TH-2-derived cytokines) decreased LTA<sub>4</sub> hydrolase mRNA expression in these cells. The same effects were seen on the expression of immunoreactive LTA<sub>4</sub> hydrolase after incubating the monocytes with either TH-1- or TH-2-derived cytokines. The monocyte-derived cytokine IL-1β did not show any significant effect on LTA<sub>4</sub> hydrolase mRNA expression. When LTB<sub>4</sub> release was measured, both IL-1β and interferon-γ significantly increased LTB<sub>4</sub> production by monocytes, while TH-2 cytokines (IL-4 and IL-13) decreased it. <i>Conclusion:</i> The opposing effects of TH-1- and TH-2-derived cytokines on the expression of LTA<sub>4</sub> hydrolase mRNA may regulate LTB<sub>4</sub> synthesis by monocytes during inflammation.
Reduction in Mean Glomerular Pore Size Coincides with the Development of Large Shunt Pores in Patients with Diabetic Nephropathy
Authors: Oberbauer Rainer , Nenov Vesselin , Weidekamm Claudia , Haas Martin , Szekeres Thomas , Mayer Gert 
Published: April 2003

The glomerular size selectivity was determined by neutral dextran clearance sieving technique and plasma cystatin C levels in two groups of patients with long-standing type I diabetes mellitus and different stages of albuminuria but normal glomerular filtration rate and in a group of healthy controls. The sieving characteristics of the glomerular filter were determined using a mathematical model of log normal pore size distribution. Patients with albuminuria above 200 μg/min exhibited a significant increase of cystatin c plasma concentrations and a significant reduction in mean glomerular filtration slit size. Only these patients exhibited large, unrestrictive pores in the glomerular filter (shunt). The plasma cystatin c levels correlated significantly with 26-angstrom neutral dextran plasma levels in microalbuminuric patients and in patients with albuminuria above 200 μg/ min. We conclude that a reduction in average pore size of the glomerular filter does not occur earlier than the development of large shunt pores. The renal clearance of cystatin c in patients with proteinuric diabetic nephropathy but a normal glomerular filtration rate is reduced due to its molecular size.
Postnatal Follow-Up of Hydronephrosis Detected by Prenatal Ultrasound: The Natural History
Authors: Kitagawa H. , Pringle K.C. , Stone P. , Flower J. , Murakami N. , Robinson R. 
Published: April 2003

Babies with hydronephrosis detected antenatally who were born at or referred to our hospital from 1990 to 1995 were followed up with ultrasound (U/S), micturating cystourethrogram (MCU) or nuclear medicine studies after birth. One hundred and three patients were diagnosed antenatally at 17–42 weeks gestation. Twelve cases were excluded from the analysis of the results because of incomplete data. Fifty-one (56%) patients had hydronephrosis without organic obstruction, and 80% of these became normal in 3 years. Fifteen patients (17%) had a normal scan 4 days after birth. This suggests the possibility of antenatal spontaneous regression. Seven (8%) had a ureterocele and 4 (5%) had pelviureteric junction (PUJ) obstruction. Four (5%) had vesicoureteric reflux, and 4 (5%) had primary megaureter. Two (2%) had posterior urethral valves (PUV), 3 (3%) had refluxing primary megaureter, and 1 (1%) had urethral atresia. Fifteen patients (17%) underwent surgical intervention. Six had a nephrectomy, 1 a vesicostomy, 3 an Anderson-Hynes pyeloplasty, 3 had the ureterocele unroofed, 1 had a ureteric reimplant, and 1 ablation of valves. In 42 infants with 60 abnormal kidneys, the renal anteroposterior diameter of the pelvis was measured. Retrospectively, 48 kidneys diagnosed as having hydronephrosis, antenatally had a renal pelvis diameter ≥4 mm before 33 weeks gestation or ≥7 mm after 33 weeks gestation. One patient with PUJ obstruction lost kidney function, but there is no good marker to detect these patients. Early unroofing of ureteroceles may rescue kidney function. Our follow-up protocol for antenatal hydronephrosis is U/S at 4 days, 1 month and 1 year of age. An MCU is not required unless the ureter is seen on antenatal U/S. If dilatation persists past 1 month, a radionucleotide (MAG3) scan and repeat U/S are performed at 3 months. The methods for assessing obstruction and the indications for surgical intervention in these patients require reexamination.
Fatal Sepsis due to Escherichia coli after Second-TrimesterAmniocentesis
Authors: Ayadi Seamy , Carbillon Lionel , Varlet Catherine , Uzan Michelle , Pourriat Jean-Louis 
Published: April 2003

The case of a pregnant woman (16th week) needing an amniocentesis is reported. She rapidly developed a septic shock. Despite vaginal delivery, curettage and antibiotherapy, the patient deteriorated with the onset of an acute respiratory distress syndrome and a typical disseminated intravascular coagulation. Bacteriological data showed positive blood cultures to <i>Escherichis coli</i>. Amniotic liquid was positive to the same <i>E. coli</i>. Cultures obtained from instruments, disinfectant solutions and gel used during the procedure were negative. On the contrary, amniotic and fetal cultures were positive to <i>E. coli</i> and <i>Clostridium perfringens</i>. She died 2 days later.The incidence of septic shock following amniocentesis is very low but we report the first case of fatal sepsis and multiorgan failure, due to <i>E. coli</i> and <i>C. perfringens</i>. The mechanisms of infection are discussed: contamination from the instruments, systemic dissemination of bacteria coming from an asymptomatic intra-amniotic infection, and inoculation of the placenta with a needle passing through the bowel.
Perinatal Findings in a Male Fetus with Congenital Megacystis and Anorectal Malformations
Authors: Chen Chih-Ping , Wang Wayseen , Lin Shuan-Pei , Sheu Jin-Cherng , Tsai Jeng-Daw 
Published: April 2003

We report the perinatal findings in a male fetus with congenital megacystis and anorectal malformations. A 17-year-old primipara was referred to our department at 13 weeks of gestation for management of a 4.6 × 3.8 cm massive intra-abdominal fetal mass consistent with megacystis. The fetal thorax was severely compressed. We used a 22-gauge needle to perform intrauterine fetal vesicocentesis, removing 30 ml of fetal urine, decreasing the fetal bladder diameter/crown-rump length ratio from 65.7 to 17%. Cytogenetic analysis revealed a 46, XY karyotype. Intermittent bladder aspiration was performed weekly from 13 to 20 weeks of gestation and every 2–3 weeks from 21 to 35 weeks of gestation for the purpose of decompression. Mild dilation of both renal pelves was noted beginning at 20 weeks of gestation, however, neither progression of hydronephrosis nor development of oligohydramnios was noted. At 36 weeks of gestation, a live male neonate was delivered with a normal phallus, duodenal atresia, mild congenital heart defects, a distended bladder, bilateral hydronephrosis, megaureters, imperforate anus with rectovesical fistula, cryptorchidism and bilateral vesicoureteric reflux. The postnatal renal function was normal. He underwent serial operations including colostomy, anoplasty with repair of rectovesical fistula, duodeno-duodenostomy, bilateral re-implantation of ureters, orchiopexy and reduction cystoplasty. At 20 months of age, the child had normal renal function. The intravenous pyelogram showed normal functional kidneys, moderate megaureters and moderate megacystis. He underwent clean intermittent catheterization for residual urine. The recurrent urinary tract infections were under control.
Amnioreduction: How Much to Drain?
Authors: Abdel-Fattah Sherif A. , Carroll Stephen G. , Kyle Phillipa M. , Soothill Peter W. 
Published: April 2003

<i>Objectives:</i> To assess the relationship between the volume of amniotic fluid removed and the change in amniotic fluid index (AFI) and calculate an equation describing this association. <i>Materials and Methods:</i> A retrospective analysis of 19 amnioreduction procedures performed in our unit. Multiple regression analysis was used to assess the effect of gestational age and pre-procedure AFI on the change in AFI (ΔAFI) after adjusting for the volume removed. <i>Results:</i> As expected, a significant linear relationship was found between the change in AFI and the volume removed (r = 0.82, n = 19, p < 0.0001). ΔAFI was not dependent on the gestational age or the pre-procedure AFI. The equation describing the association between the volume removed and ΔAFI was: volume = (ΔAFI – 2.26)/0.008, which is close to 1 cm ΔAFI for every 100 ml removed. <i>Discussion:</i> Using the described equation, it is possible to predict the required volume to be removed in order to achieve a particular ΔAFI, which may reduce the need to interrupt the procedure to measure the AFI. However, the limitation of AFI as a semiquantitative assessment of the liquor volume, together with its inter- and intra-observer variations mean this equation should be used only as a guide.
Initiating Extradural Analgesia during Labour: Comparison of Three Different Bupivacaine Concentrations Used as the Loading Dose
Authors: Harms C. , Siegemund M. , Marsch S.C.U. , Surbek D.V. , Hösli I. , Schneider M.C. 
Published: April 2003

<i>Objective:</i> Potential effects of extradural analgesia on the progress of labour and obstetric outcome are still a matter of concern and the focus of ongoing debates. Despite this, little attention is paid to the initiation of extradural labour analgesia. The objective of this prospective, randomized, double-blind trial was to identify the optimal of three concentrations of bupivacaine used as a loading bolus for initiating extradural analgesia during labour. <i>Methods:</i> Sixty-seven full-term parturients requesting extradural analgesia received either bupivacaine 0.25% (group A), 0.125% (group B) or 0.0625% (group C). Bupivacaine administration was titrated to achieve a pain score ≤1.5 on a 10-cm visual analogue scale (VAS) and was limited to a maximum of 20 ml of the study drug. We recorded the time to achieve a VAS ≤1.5, the total amount of local anaesthetic used, sensory level, maternal and foetal as well as neonatal side effects. <i>Results:</i> The probability of obtaining a VAS pain score ≤1.5 was significantly lower in group C. Although mean times to reach a VAS pain score ≤1.5 were not statistically different, survival curves show a significantly lower probability for reaching this score. Significantly more parturients in group A developed a motor block ≥1 based on using a modified Bromage scoring scale. There were no differences in incidence of maternal hypotension, ephedrine requirements, foetal heart rate abnormalities, mode of delivery and neonatal outcome. <i>Conclusions:</i> Of the three concentrations used in this clinical setting, 0.125% was the most suitable concentration of plain bupivacaine to initiate extradural analgesia in labour. Using 0.25% bupivacaine increased the incidence of motor block, whereas for 0.0625% plain bupivacaine the probability to achieve adequate analgesia was unacceptably low.
Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome
Authors: Joern Hendrik , Rath Werner 
Published: April 2003

<i>Objective:</i> Subject of the study was the significance of umbilical artery Doppler velocimetry findings for the further course of pregnancy and fetal outcome in cases of twin pregnancies. <i>Methods:</i> In 206 cases of twin pregnancy, the umbilical artery was examined using Doppler velocimetry in the median 9 days prior to delivery, and the result was correlated with the further course of pregnancy and fetal outcome. 174 pregnancies showed normal Doppler findings of the umbilical artery (group A), 32 twin pregnancies showed pathological Doppler findings of at least one twin (group B). The median of the maternal age and the parity between the groups were not different. <i>Results:</i> In group B (pathological Doppler findings), intrauterine growth retardation and pre-eclampsia occurred 5 times more often than in group A (normal Doppler findings). The total rate of cesarean sections was not different between the study populations; the rate of deliveries by cesarean section in group B was significantly increased by a factor of 2.4 due to a pathological CTG. The median birth weight and the gestational age at birth were significantly lower in group B (1,660 g; 35 weeks) as compared to group A (2,460 g; 37 weeks; p < 0.001). In group B, the rate of premature deliveries up to reaching the 34th week of gestation was 3.4 times higher; the rate of SGA newborns was 6.3 times higher. Perinatal mortality was increased by a factor of 1.5 in group B compared to group A. <i>Conclusion:</i> The Doppler velocimetry findings have considerable effects on the further course of a multiple pregnancy. In case of pathological Doppler findings, early hospitalization and close monitoring of the pregnancy should be performed. In cases of additional pathological findings (maternal illness, pathological Doppler findings of fetal blood vessels), termination of the pregnancy has to be considered.
Frequency of Prenatal Diagnosis of Birth Defects in Houston, Galveston and the Lower Rio Grande Valley, Texas 1995
Authors: Waller D.K. , Pujazon M.A. , Canfield M.A. , Scheuerle A.E. , Byrne J.L.B. 
Published: April 2003

<i>Background:</i> Estimates of the proportion of birth defects diagnosed before birth exist for only a few types of birth defects and for a few geographic regions in the United States. This population-based study examines rates of prenatal diagnosis for previously unstudied birth defects in a new geographic region. <i>Methods:</i> Active surveillance of 23 categories of birth defects among 111,902 infants born in 77 birthing hospitals in Texas in 1995 identified 852 infants or fetuses with major birth defects. Surveillance was conducted by the Texas Birth Defects Monitoring Program of the Texas Department of Health. Two regions were covered, the Houston/Galveston metropolitan area as well as the Lower Rio Grande Valley of Texas. Rates of prenatal diagnosis were evaluated for 23 different types of birth defects, using proportions and 95% confidence intervals. <i>Results:</i> One third of the 852 infants or fetuses with birth defects were prenatally diagnosed. Diagnosis rates varied greatly depending on the type of birth defects and were lower among infants born to Black and Hispanic women. More than 60% of anencephaly, encephalocele, gastroschisis and trisomies 13 and 18 were diagnosed antenatally. Many of the fetuses that were electively terminated had birth defects or combinations of birth defects that were potentially lethal. Prevalence rates for birth defects generally do not include fetuses that die or are electively terminated before 20 weeks of gestation. Thus, 36% of anencephaly, 21% of omphalocele, 15% of encephalocele and between 7 and 10% of spina bifida, hydrocephaly, renal agenesis, and trisomies 13, 18, and 21 were not included in our published rates. <i>Conclusions:</i> Published rates for specific types of birth defects are spuriously low. This should be considered when investigating alleged clusters and comparing rates of birth defects across geographic areas. Since many elective abortions are for lethal or potentially lethal birth defects, a major effect of prenatal diagnosis is the resultant decrease in infant mortality attributable to birth defects.