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Sample records for acute tubular necrosis

  1. Acute tubular necrosis in a patient with paroxysmal nocturnal hemoglobinuria

    Eranga S Wijewickrama

    2013-01-01

    Full Text Available Acute renal failure (ARF is a well-recognized complication of paroxysmal nocturnal hemoglobinuria (PNH. The predominant mechanism is intravascular hemolysis resulting in massive hemoglobinuria ARF. We report a case of acute tubular necrosis (ATN developed in the absence of overwhelming evidence of intravascular hemolysis in a 21-year-old man with anemia, who was eventually diagnosed to have PNH. The patient presented with rapidly deteriorating renal functions in the background of iron deficiency anemia, which was attributed to reflux esophagitis. There was no clinical or laboratory evidence of intravascular hemolysis. Renal biopsy revealed ATN with deposition of hemosiderin in the proximal tubular epithelial cells. Diagnosis of PNH was confirmed with a positive Ham′s test and flow cytometry. Our case emphasizes the need to consider ATN as a possible cause for ARF in patients suspected to have PNH even in the absence of overwhelming evidence of intravascular hemolysis.

  2. Renal hyperconcentration of /sup 99m/Tc-HEDP in experimental acute tubular necrosis

    The effect of transient renal ischemia on renal concentration and distribution of /sup 99m/Tc-HEDP, /sup 99m/Tc-DMSA, and /sup 99m/Tc-DTPA was compared in rabbits with acute tubular necrosis. Scintigrams were obtained after injection in normal rabbits or ones with unilateral or bilateral ischemia. /sup 99m/Tc-HEDP concentration in ischemic tissue was 8 to 18 times normal 1 to 4 hrs after injection, and the resulting images delineated the morphological changes in the ischemic kidneys more accurately than those obtained with DMSA or DTPA. Calcium concentration in the ischemic kidneys increased sixfold. /sup 99m/Tc-HEDP may be useful in evaluation of renal failure secondary to tubular injury

  3. Renal blood flow after transplantation: Effects of acute tubular necrosis, rejection, and cyclosporine toxicity

    The authors incorporated their recently developed radionuclide first pass-technique for the quantitative measurement of renal transplant perfusion into routine DTPA imaging. Using this technique they investigated the effects of acute tubular necrosis (ATN), rejection, and cyclosporing toxicity on renal blood flow in a series of 80 studies in 35 patients, with independent evaluation of renal function. Transplant flow values were as follows: normal functioning, 439 mL/min +-83; ATN 248 mL/min +-63; rejection, 128 mL/min +-58; cyclosporing toxicity, 284 mL/min +-97; (normal flow in nontransplanted kidneys, approximately 550 mL/min). Differences between normal functioning, ATN, and rejection were significant (P < .05). Interestingly, immediate postsurgical hyperemia frequently occurred, with flow values sometimes exceeding 700 mL/min

  4. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Damianovich, Maya; Ziv, Ilan; Aloya, Tali; Grimberg, Hagit; Levin, Galit; Reshef, Ayelet; Bentolila, Alfonso; Cohen, Avi; Shirvan, Anat [NeuroSurvival Technologies (NST) Ltd., Petah Tikva (Israel); Heyman, Samuel N.; Shina, Ahuva [Mt.Scopus and the Hebrew University Medical School, Department of Medicine, Hadassah Hospital, Jerusalem (Israel); Rosen, Seymour [Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Pathology, Boston, MA (United States); Kidron, Dvora [Meir Hospital, Department of Pathology, Kfar-Saba (Israel)

    2006-03-15

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  5. ApoSense: a novel technology for functional molecular imaging of cell death in models of acute renal tubular necrosis

    Acute renal tubular necrosis (ATN), a common cause of acute renal failure, is a dynamic, rapidly evolving clinical condition associated with apoptotic and necrotic tubular cell death. Its early identification is critical, but current detection methods relying upon clinical assessment, such as kidney biopsy and functional assays, are insufficient. We have developed a family of small molecule compounds, ApoSense, that is capable, upon systemic administration, of selectively targeting and accumulating within apoptotic/necrotic cells and is suitable for attachment of different markers for clinical imaging. The purpose of this study was to test the applicability of these molecules as a diagnostic imaging agent for the detection of renal tubular cell injury following renal ischemia. Using both fluorescent and radiolabeled derivatives of one of the ApoSense compounds, didansyl cystine, we evaluated cell death in three experimental, clinically relevant animal models of ATN: renal ischemia/reperfusion, radiocontrast-induced distal tubular necrosis, and cecal ligature and perforation-induced sepsis. ApoSense showed high sensitivity and specificity in targeting injured renal tubular epithelial cells in vivo in all three models used. Uptake of ApoSense in the ischemic kidney was higher than in the non-ischemic one, and the specificity of ApoSense targeting was demonstrated by its localization to regions of apoptotic/necrotic cell death, detected morphologically and by TUNEL staining. (orig.)

  6. Differentiation of acute untreated rejection from cyclosporine nephrotoxicity and acute tubular necrosis by indium-111 labeled platelet scintigraphy

    The authors have previously reported that unlike normal and nephrotic native kidneys, acutely rejecting kidney transplants show significant platelet uptake by Indium-111 labeled platelet scintigraphy (lPLS). To determine if lLPS can differentiate acute rejection (AR) from cyclosporine (CY) nephrotoxicity and acute tubular necrosis (ATN). The authors studied 5 groups of kidney transplant recipients. Group 1, n=6 (3 on Imuran, 3 on CY, CR=1.4 +- 0.6, mean +- SD) had no evidence for rejection (kidney biopsy in 2). Group 11, n=4(1 on Imuran, 3 on CY, Cr=2.8 +- 1.1) had ATN (biopsy in 2). Group 111, n=3(all on CY, Cr=2.3 +- 1.9) had suspected CY nephrotoxicity:all patients (pts) improved upon withdrawal of CY and biopsies were negative for rejection in 2. Group IV, n=11 (10 on Imuran 1 on CY, CR=5.6 +- 4.1) had acute rejection on biopsy. In group V, n=7 (3 on imuran 4 on CY, Cr=6.1 +- 3.4) pts were treated for rejection for 12 +- 4 days. All pts received Prednisone. The first image was obtained 6 +- 4 hrs after injection of 215 +- 30μ Ci of lN-111 and thereafter 1 to 3 times a day for a maximum of 6 days. Platelet Uptake Index (PUl) was calculated as the ratio of uptake over the transplant against a contralateral reference area. One way analysis of variance was carried out. PUIs from groups I, II, III and V were significantly different from groups IV: 1.1 +- .07 (p<0.004), 1.22 +- .09 (p<0.05), 1.14 +- .05 (p<0.04) and 1.21 +- .07 (p<0.004) versus 1.52 +- .17. The authors conclude that 1) ILP can be used for the diagnosis of untreated AR. 2) Untreated AR can be differentiated from CY nephrotoxicity and ATN

  7. Early segmental changes in ischemic acute tubular necrosis of the rat kidney

    Faarup, Poul; Nørgaard, Tove; Hegedüs, Viktor; Holstein-Rathlou, N.-H.

    2004-01-01

    subsequent freeze-substitution in alcohol. The microscopic slides from the kidneys were silver methenamine-PAS stained. In the segments of the proximal convoluted tubules of the nephrons, presence of nuclear pyknosis, places of denuded basement membranes and presence of exfoliated tubular cells were counted...... tubule versus the subsequent loops. The distribution of the structural lesions is in accordance with the previously reported presence of a tubulo-capillary counter-current flow in the proximal convoluted tubule and, when related to the highly variable oxygen tension in the normal renal cortex of the rat...

  8. A comparative study of MRI findings of experimentally induced rapid progressive glomerulonephritis (RPGN) and acute tubular necrosis (ATN) in rabbits

    To evaluate the usefulness of MR imaging in the differential diagnosis of the underlying causes of early-stage acute renal failure (ARF) by comparing the MRI findings of experimentally-induced crescentic glomerulonephritis (CGN) and acute tubular necrosis (ATN) in rabbits. Experimental CGN was induced by injecting anti-glomerular basement membrane antibody into six rabbits, and ATN by injecting glycerol solution into six rabbits. A normal control group of three rabbits was also used. Renal MR imaging (T1-and T2-weighted coronal images and dynamic MRI : DMRI) was performed the day before, and one,four, and seven days after the induction of CGN; and immediately before, and four, and eight hours, and one, four, and seven days after the induction of ATN. Sequential renal gunbiopsies and blood sampling (serum creatinine, sCr) were performed. Renal area, corticomedullary differentiation (CMD), and the passage of Gd-DTPA (patter of dark band), as seen on MRI, were analyzed and correlated with serial change of sCr. In normal kidneys, CMD was clearly apparent on both T1-and T2-weighted images. DMRI demonstrated a progressively inwardly migrating dark band in the kidneys. CMD was relatively clearly demonstrated in the ATN group but less clearly identified in the CGN group. Renal size (area) and sCr gradually increased in both the CGN and ATN groups, and dark bands were moderately to poorly defined in both. We conclude that DMRI could be used to differentiate and evaluate disease processing and compromised renal function in cases of CGN and ATN. On T1-and T2-weighted images, CMD was relatively well preserved in the ATN group, but was less clear in the CGN group. These MRI findings may be helpful for differentiation of the underlying causes of early-stage ARF, particularly between CGN and ATN

  9. {sup 99m}Tc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    Bahk, Yong Whee; Kim, Jang Min [Sung Ae Hospital, Seoul (Korea, Republic of)

    2008-06-15

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, {sup 99}mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively.

  10. 99mTc-HDP Bone Scan Findings of Acute Rhabdomyolysis of Lumbar Multifidus and Thigh Muscles and Bone Scan and US Signs of Acute Tubular Necrosis in Excessive Rabbit's Leaping: A Case Report

    Marked rhabdomyolysis (RML) complicated by acute tubular necrosis is not a rare disease. It is characterized by disintegration of skeletal muscle fibers due to a variety of causes including excessive physical exercise, trauma, operation, infection, bed-ridden life, alcohol, drugs, toxins, exhaustion and others. We report a case of RML with acute renal failure studied using magnification bone scan which specifically identified the muscles injured by excessive rabbit's leap. The injured muscles recognized were the multifidus of the lumbar spine and the anterior and posterior muscle groups of the thigh. In addition, 99mTc-HDP bone scan findings of acute tubular necrosis correlated with that of the sonographic signs are described. Patient was treated simply with normal saline hydration and bed rest and uneventfully recovered to be discharged on the fourth hospital day. Lab data on the final hospital day: LDH=20 IU/L (normalized) and CPK=600 IU/L (still higher than normal), BUN=14.2 mg/dl (normalized) and creatinin=1.5 mg/dl (normalized) GOT=20 mg/dl (normalized) and GPT=72 mg/dl (higher than normal), respectively

  11. [Acute retinal necrosis].

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  12. Acute oesophageal necrosis syndrome

    Garas, George; Wou, Constance; Sawyer, Joseph; Amygdalos, Iakovos; Gould, Stuart

    2011-01-01

    An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced...

  13. Acute Retinal Necrosis in Childhood

    Yoav Y. Pikkel

    2014-05-01

    Full Text Available Background: Acute retinal necrosis (ARN is a viral syndrome consisting of uveitis/vitritis, occlusive vasculitis and peripheral necrosis. Few incidents are reported in children. The etiology is reactivated herpes simplex virus (HSV or varicella-zoster virus (VZV. Treatment with acyclovir is often used. The administration of oral glucocorticosteroids is of unproven benefit. Prognosis is variable but poor. Methods: Three weeks after contracting mild chickenpox, a healthy 4-year-old girl developed blurred vision in her right eye. Severely reduced visual acuity was noted, together with anterior uveitis, ‘mutton-fat' precipitates and vitral flare. Retinal vasculitis with necrosis was present. Serology for toxoplasma, cytomegalovirus and HIV was negative, while HSV and VZV IgG antibodies were positive. She was treated with 30 mg/kg of intravenous methylprednisolone (3 days, 30 mg of oral prednisone (3 days, and tapering for 8 weeks. Intravenous acyclovir was given for 10 days, followed by oral acyclovir for 4 months. Aspirin (100 mg/day was given for 4 months. Results: At 12 months, the girl felt good. Her right eye acuity was 6/9, with an intraocular pressure of 17 mm Hg. The peripheral retina showed scarring but no detachment. Conclusions: This is the first report of a once-daily high-dose methylprednisolone pulse therapy in one of the youngest known ARN cases. Pulsed steroid therapy was based on its known effectiveness in vasculitis, which is the main pathophysiology in ARN. There was no evidence of steroid-related viral over-replication. Our case achieved an excellent clinical and ophthalmic recovery in spite of the poor prognosis. The positive result of this case report provides a basis for further evaluation of high-dose steroid pulse therapy in ARN.

  14. Bilateral acute retinal necrosis after herpetic meningitis

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  15. Gastrointestinal stromal tumor: acute liquefaction necrosis

    Stromal tumors, together with leiomyomas and schwannomas, constitute the sol-called mesenchymal tumors of the intestinal wall. Stromal tumors are histologically differentiated from other mesenchymal tumors in that they are derived from the interstitial cell of Cajal. These tumors can be encountered at any point throughout the entire digestive tract, by usually develop in stomach or small bowel. the clinical presentation in anemia secondary to gastrointestinal bleeding. Acute abdomen due to perforation or necrosis is rare. We present a case of jejunal stromal tumors with massive liquefaction necrosis, a circumstance that resulted in the peculiar radiological features observed. (Author) 9 refs,

  16. Cisplatin induces primary necrosis through poly(ADP-ribose) polymerase 1 activation in kidney proximal tubular cells

    Park, Seulgee; Yoon, Sang Pil; Kim, Jinu

    2015-01-01

    Treatment with cisplatin for cancer therapy has a major side effect such as nephrotoxicity; however, the role of poly (ADP-ribose) polymerase 1 (PARP1) in necrosis in response to cisplatin nephrotoxicity remains to be defined. Here we report that cisplatin induces primary necrosis through PARP1 activation in kidney proximal tubular cells derived from human, pig and mouse. Treatment with high dose of cisplatin for 4 and 8 hours induced primary necrosis, as represented by the percentage of prop...

  17. Gastric Necrosis due to Acute Massive Gastric Dilatation

    Ibrahim Aydin

    2013-01-01

    Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

  18. Can deconvolution of renal transplant curves discriminate acute necrosis for acute rejection?

    Full text: The management of allogeneic renal transplants in the acute post-operative period is diagnostically challenging when there is poor or no function of the graft, which occurs in about 10-15% of cases. Although acute tubular necrosis (ATN) is most common, acute transplant rejection remains a possibility in 25% of cases. Radionuclide renography (RRG) allows a non invasive assessment of graft perfusion and function. However, the ability to differentiate ATN from acute rejection, in particular mild cellular type, is quite limited. Thus we sought to improve the diagnostic value of RRG. From a pool of 137 renal transplant recipients from 1997 to 1998, we studied 21 subjects who had had a renal transplant biopsy with a tissue diagnosis of ATN (13) or rejection (8). They were chosen because they had also had serial RRG done at day + 1 and another close to the day of biopsy (day X). For each study, using deconvolution analysis of the input iliac artery bolus as reference, and comparing it with the dispersion of radioactivity over time in the whole graft, which corresponds to the initial iliac artery bolus, we derived a graft delay index (GDI). We then compared the GDIs of day + 1 vs day X, as a simple subtraction and as a linear ratio. In 1 of 13 subjects with ATN, we found that the GDI decreased at day X compared with day + 1. In 7 of 8 with rejection, the GDI increased at day X. Thus by comparing the graft delay index of a study done at some point in the acute post-operative period with day + 1, we can discriminate between ATN and rejection. It is our intention to apply our method in a prospective study

  19. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD; Elif Hocaoglu, MD; Aylin Karahasanoglu, MD; Behlul Igus, MD; Mehtap Beker Acay, MD; Ercan Inci, MD

    2015-01-01

    Renal cortical necrosis (RCN), a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  20. Acute Tubuler Necrosis Related to Rhabdomyolysis

    Fatma Sarı DOĞAN

    2014-05-01

    Full Text Available Rhabdomyolysis is a clinical and laboratory syndrome due to traumatic or non-traumatic injury that leads muscle cell contents participation into circulation. Dehydration and acidosis may cause myoglobinuric acute renal failure in patient with rhabdomyolysis. This case presents a 27-year-old male referred to emergency unit with weakness and abdominal ache who has a story of urine decrease and trauma exposure. Diagnosis of rhabdomyolysis in this case highlights the importance of anamnesis in early diagnosis and treatment.

  1. Bisphosphonate-induced bilateral acute renal cortical necrosis

    Sema Aksoy, MD

    2015-01-01

    Full Text Available Renal cortical necrosis (RCN, a rare cause of renal failure in which there is death of the renal cortex but sparing of the medulla, is a catastrophic entity with high mortality. Its incidence and severity are higher in developing countries, mostly due to pregnancy-related complications. This paper presents the case of a 65-year-old woman who had bilateral renal cortical necrosis caused by bisphosphonate medication that was diagnosed by CT scan during the acute initial phase of the disease.

  2. A Rare Cause of Acute Abdomen: Idiopathic Isolated Cecal Necrosis

    Ender Özer

    2015-03-01

    Full Text Available Idiopathic isolated cecal necrosis is a clinical problem characterized by right-sided inferior abdominal pain. It is rarely seen, develops due to decreased blood flow to the colon and, imitates acute appendicitis. Its clinical signs are similar to many illnesses causing sensitivity in the right inferior quadrant and, the diagnosis is generally determined during surgery. An 86-year-old male patient presented with the complaints of abdominal pain, trichiniasis, nausea and vomiting. Surgical intervention was decided when physical examination and laboratory results were taken into consideration. After diagnostic laparoscopy, right hemicolectomy was performed because of cecal necrosis. While the mortality and morbidity rates for ischemic bowel disease are high, prognosis for early diagnosed patients with isolated cecal necrosis is better, provided that timely surgical treatment is decided.

  3. Contemporary management of infected necrosis complicating severe acute pancreatitis

    Jamdar, Saurabh; Siriwardena, Ajith K

    2006-01-01

    Pancreatic necrosis complicating severe acute pancreatitis is a challenging scenario in contemporary critical care practice; it requires multidisciplinary care in a setting where there is a relatively limited evidence base to support decision making. This commentary provides a concise overview of current management of patients with infected necrosis, focusing on detection, the role of pharmacologic intervention, and the timing and nature of surgical interventions. Fine-needle aspiration of necrosis remains the mainstay for establishment of infection. Pharmacological intervention includes antibiotic therapy as an adjunct to surgical debridement/drainage and, more recently, drotrecogin alfa. Specific concerns remain regarding the suitability of drotrecogin alfa in this setting. Early surgical intervention is unhelpful; surgery is indicated when there is strong evidence for infection of necrotic tissue, with the current trend being toward 'less drastic' surgical interventions. PMID:16356213

  4. Peripancreatic fat necrosis worsens acute pancreatitis independent of pancreatic necrosis via unsaturated fatty acids increased in human pancreatic necrosis collections

    Noel, Pawan; Patel, Krutika; Durgampudi, Chandra; Trivedi, Ram N; de Oliveira, Cristiane; Crowell, Michael D; Pannala, Rahul; Lee, Kenneth; Brand, Randall; Chennat, Jennifer; Slivka, Adam; Papachristou, Georgios I; Khalid, Asif; Whitcomb, David C; DeLany, James P; Cline, Rachel A; Acharya, Chathur; Jaligama, Deepthi; Murad, Faris M; Yadav, Dhiraj; Navina, Sarah; Singh, Vijay P

    2016-01-01

    Background and aims Peripancreatic fat necrosis occurs frequently in necrotising pancreatitis. Distinguishing markers from mediators of severe acute pancreatitis (SAP) is important since targeting mediators may improve outcomes. We evaluated potential agents in human pancreatic necrotic collections (NCs), pseudocysts (PCs) and pancreatic cystic neoplasms and used pancreatic acini, peripheral blood mononuclear cells (PBMC) and an acute pancreatitis (AP) model to determine SAP mediators. Methods We measured acinar and PBMC injury induced by agents increased in NCs and PCs. Outcomes of caerulein pancreatitis were studied in lean rats coadministered interleukin (IL)-1β and keratinocyte chemoattractant/growth-regulated oncogene, triolein alone or with the lipase inhibitor orlistat. Results NCs had higher fatty acids, IL-8 and IL-1β versus other fluids. Lipolysis of unsaturated triglyceride and resulting unsaturated fatty acids (UFA) oleic and linoleic acids induced necro-apoptosis at less than half the concentration in NCs but other agents did not do so at more than two times these concentrations. Cytokine coadministration resulted in higher pancreatic and lung inflammation than caerulein alone, but only triolein coadministration caused peripancreatic fat stranding, higher cytokines, UFAs, multisystem organ failure (MSOF) and mortality in 97% animals, which were prevented by orlistat. Conclusions UFAs, IL-1β and IL-8 are elevated in NCs. However, UFAs generated via peripancreatic fat lipolysis causes worse inflammation and MSOF, converting mild AP to SAP. PMID:25500204

  5. Valacyclovir in the treatment of acute retinal necrosis

    Taylor Simon RJ

    2012-09-01

    Full Text Available Abstract Background To report the outcome of oral valacyclovir as the sole antiviral therapy for patients with acute retinal necrosis (ARN. Methods This study reports a retrospective, interventional case series of nine consecutive patients with ten eyes with newly diagnosed ARN treated with oral valacyclovir as the sole antiviral agent. Eight patients received oral valacyclovir 2 g tid (Valtrex, GlaxoSmithKline and one patient with impaired renal function received oral 1 g tid. The main outcome measures were response to treatment, time to initial response to treatment, time to complete resolution of retinitis, best corrected visual acuity (BCVA at final follow-up, retinal detachment and development of recurrent or second eye disease. Results Retinitis resolved in ten of ten (100% affected eyes. The median time to initial detectable response was seven days and the median time to complete resolution was 21 days. A final BCVA of 20/40 or better was achieved in 6/10 (60% of eyes. 3/10 eyes (30% developed a retinal detachment. No patients developed either disease reactivation or second eye involvement over the course of the study (mean follow up 31 weeks, range 7 to 104 weeks. Conclusions Treatment with oral valacyclovir as the sole antiviral therapy resulted in complete resolution of retinitis. Final BCVA and retinal detachment rate were comparable with previously reported outcomes for intravenous acyclovir.

  6. Detection of acute hepatopancreatic necrosis disease (AHPND) in Mexico.

    Nunan, Linda; Lightner, Donald; Pantoja, Carlos; Gomez-Jimenez, Silvia

    2014-08-21

    Acute hepatopancreatic necrosis disease (AHPND), which has also been referred to as early mortality syndrome (EMS), initially emerged as a destructive disease of cultured shrimp species in Asia in 2009. The pathogen associated with the disease, Vibrio parahaemolyticus, subsequently spread to the Western Hemisphere and emerged in Mexico in early 2013. The spread to the Western Hemisphere is a major concern to shrimp producers in the region. To date, the only peer-reviewed published method for determining whether mortalities are due to AHPND is through histological examination. A novel PCR detection method was employed to assess samples from Mexico in order to confirm the presence of the pathogen in this country. This manuscript details the detection methods used to confirm the presence of AHPND in Mexico. Both immersion and per os challenge studies were used to expose the Penaeus vannamei to the bacteria in order to induce the disease. Histological analysis confirmed AHPND status following the challenge studies. Also provided are the details of the molecular test by PCR that was used for screening candidate V. parahaemolyticus isolates. A rapid PCR assay for detection of AHPND may help with early detection and help prevent the spread of AHPND to other countries. PMID:25144120

  7. Use of drug therapy to manage acute cutaneous necrosis of the skin.

    Wallace, Jill S; Hall, John C

    2010-04-01

    Acute cutaneous necrosis is defined as a sudden onset of gangrenous skin changes in the skin, associated with significant morbidity and mortality. The following diseases are included in this discussion: coumadin necrosis, heparin necrosis, brown recluse spider bite, necrotizing fasciitis, vasculitis, pyoderma gangrenosum, calciphylaxis, clotting abnormalities and embolic phenomena. The importance of early diagnosis, early distinction and early drug therapy or drug withdrawal must match the diagnosis for maximal preservation of the skin and underlying tissue. PMID:20514791

  8. Mesenchymal Stem Cell-Derived Microvesicles Protect Against Acute Tubular Injury

    Bruno, Stefania; Grange, Cristina; Deregibus, Maria Chiara; Calogero, Raffaele A.; Saviozzi, Silvia; Collino, Federica; Morando, Laura; Busca, Alessandro; Falda, Michele; Bussolati, Benedetta; Tetta, Ciro; Camussi, Giovanni

    2009-01-01

    Administration of mesenchymal stem cells (MSCs) improves the recovery from acute kidney injury (AKI). The mechanism may involve paracrine factors promoting proliferation of surviving intrinsic epithelial cells, but these factors remain unknown. In the current study, we found that microvesicles derived from human bone marrow MSCs stimulated proliferation in vitro and conferred resistance of tubular epithelial cells to apoptosis. The biologic action of microvesicles required their CD44- and β1-...

  9. Pathogenesis of acute hepatopancreatic necrosis disease (AHPND) in shrimp.

    Lai, Hung-Chiao; Ng, Tze Hann; Ando, Masahiro; Lee, Chung-Te; Chen, I-Tung; Chuang, Jie-Cheng; Mavichak, Rapeepat; Chang, Sheng-Hsiung; Yeh, Mi-De; Chiang, Yi-An; Takeyama, Haruko; Hamaguchi, Hiro-o; Lo, Chu-Fang; Aoki, Takashi; Wang, Han-Ching

    2015-12-01

    Acute hepatopancreatic necrosis disease (AHPND), also called early mortality syndrome (EMS), is a recently emergent shrimp bacterial disease that has resulted in substantial economic losses since 2009. AHPND is known to be caused by strains of Vibrio parahaemolyticus that contain a unique virulence plasmid, but the pathology of the disease is still unclear. In this study, we show that AHPND-causing strains of V. parahaemolyticus secrete the plasmid-encoded binary toxin PirAB(vp) into the culture medium. We further determined that, after shrimp were challenged with AHPND-causing bacteria, the bacteria initially colonized the stomach, where they started to produce PirAB(vp) toxin. At the same early time point (6 hpi), PirB(vp) toxin, but not PirA(vp) toxin, was detected in the hepatopancreas, and the characteristic histopathological signs of AHPND, including sloughing of the epithelial cells of the hepatopancreatic tubules, were also seen. Although some previous studies have found that both components of the binary PirAB(vp) toxin are necessary to induce a toxic effect, our present results are consistent with other studies which have suggested that PirB(vp) alone may be sufficient to cause cellular damage. At later time points, the bacteria and PirA(vp) and PirB(vp) toxins were all detected in the hepatopancreas. We also show that Raman spectroscopy "Whole organism fingerprints" were unable to distinguish between AHPND-causing and non-AHPND causing strains. Lastly, by using minimum inhibitory concentrations, we found that both virulent and non-virulent V. parahaemolyticus strains were resistant to several antibiotics, suggesting that the use of antibiotics in shrimp culture should be more strictly regulated. PMID:26549178

  10. Coagulopathy and encephalopathy in a dog with acute hepatic necrosis.

    Strombeck, D R; Krum, S; Rogers, Q

    1976-10-15

    Disseminated intravascular coagulation developed secondary to hepatic necrosis in a 5-year-old Saint Bernard. Although the coagulopathy responded to treatment with heparin, the dog died from the combined effects of gastric hemorrhage and encephalopathy, both of which are complications of hepatic necrosis. PMID:977448

  11. Case of severe acute pancreatitis with near total pancreatic necrosis diagnosed by dynamic CT scanning

    Takeda, Kazunori; Kakugawa, Yoichiro; Amikura, Katsumi; Miyagawa, Kikuo; Matsuno, Seiki; Sato, Toshio

    1987-09-01

    A 42 year-old woman with severe acute pancreatitis had drainage of the pancreatic bed, cholecystostomy and jejunostomy on admission, but symptoms were not improved. Fourteen days after admission, clinical sepsis and septisemia were recognized. Dynamic CT scanning of the pancreas showed near total pancreatic necrosis. Symptoms were improved after necrosectomy of the pancreas and debridement of the peripancreatic necrotic tissue were performed. Our experience suggests the usefulness of dynamic CT scanning for detection of pancreatic necrosis in severe acute pancreatitis.

  12. Tumor Necrosis Factor Receptor 2: Its Contribution to Acute Cellular Rejection and Clear Cell Renal Carcinoma

    Jun Wang; Al-Lamki, Rafia S.

    2013-01-01

    Tumor necrosis factor receptor 2 (TNFR2) is a type I transmembrane glycoprotein and one of the two receptors that orchestrate the complex biological functions of tumor necrosis factor (TNF, also designed TNF- α ). Accumulating experimental evidence suggests that TNFR2 plays an important role in renal disorders associated with acute cellular rejection and clear cell renal carcinoma but its exact role in these settings is still not completely understood. This papers reviews the factors that may...

  13. [Acute hemorrhagic necrosis of the breast following treatment with Cumarin].

    Lüchtrath, H; Walkowsky, A

    1983-08-01

    A case of hemorrhagic necrosis of the breast is reported in a thirty-four year old woman who received Cumarin treatment for deep leg vein thrombosis and pulmonary embolism. It was necessary to remove the breast. The microscopic examination showed complete blockage of the vessels by fibrin thrombi in almost all veins. The cause of this venous thrombosis was explained as a Shwartzman-Sanarelli-Phenomenon. PMID:6555120

  14. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis

    Tiffany J. Patton

    2016-01-01

    Full Text Available Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis.

  15. Ten years of experience with transgastric necrosectomy for walled-off necrosis in acute pancreatitis

    Busse, Malene Just; Ainsworth, Alan Patrick

    2015-01-01

    INTRODUCTION: The aim of this study was to report our results with open transgastric necrosectomy for walled-off necrosis in acute pancreatitis over a period of ten years. METHODS: Patients operated at the department from 2003 until 2012 were studied retrospectively. RESULTS: A total of 50 patients......: Acute pancreatitis with walled-off necrosis has a high mortality rate. Need for additional therapy following necrosectomy was associated with fatal outcome. Endocrine and exocrine insufficiency was often seen at follow-up. FUNDING: none. TRIAL REGISTRATION: The study was approved by the Danish Data...

  16. Colonic Necrosis in a 4-Year-Old with Hyperlipidemic Acute Pancreatitis.

    Patton, Tiffany J; Sentongo, Timothy A; Mak, Grace Z; Kahn, Stacy A

    2016-01-01

    Here we report the case of a 4-year-old male with severe acute pancreatitis due to hyperlipidemia, who presented with abdominal pain, metabolic abnormalities, and colonic necrosis. This colonic complication was secondary to the extension of a large peripancreatic fluid collection causing direct serosal autodigestion by pancreatic enzymes. Two weeks following the initial presentation, the peripancreatic fluid collection developed into a mature pancreatic pseudocyst, which was percutaneously drained. To our knowledge, this is the youngest documented pediatric case of colonic necrosis due to severe pancreatitis and the first descriptive pediatric case of a colonic complication due to hyperlipidemia-induced acute pancreatitis. PMID:26925282

  17. Acute hepatic encephalopathy presenting as cortical laminar necrosis: Case report

    Choi, Jong Mun; Kim, Yoon Hee; Roh, Sook Young [Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam (Korea, Republic of)

    2013-04-15

    We report on a 55-year-old man with alcoholic liver cirrhosis who presented with status epilepticus. Laboratory analysis showed markedly elevated blood ammonia. Brain magnetic resonance imaging (MRI) showed widespread cortical signal changes with restricted diffusion, involving both temporo-fronto-parietal cortex, while the perirolandic regions and occipital cortex were uniquely spared. A follow-up brain MRI demonstrated diffuse cortical atrophy with increased signals on T1-weighted images in both the basal ganglia and temporal lobe cortex, representing cortical laminar necrosis. We suggest that the brain lesions, in our case, represent a consequence of toxic effect of ammonia.

  18. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  19. Binge Eating Leading to Acute Gastric Dilatation, Ischemic Necrosis and Rupture –A Case Report

    Khare, Manish Kumar; Mishra, Sumanta; Marhual, Jogesh Chandra

    2016-01-01

    Acute gastric dilatation is a rarely encountered clinical scenario in our day to day practice. This is very rapidly progressing condition and can lead to ischemic necrosis and perforation/rupture of the stomach. It could be fatal if not timely intervened. We report such a case of a 17-year-old, otherwise healthy boy, who presented with pain and distension of abdomen following binge eating episode after 24 hours of prolonged fasting. On exploration, stomach was dilated with necrosis and perforation at fundus near greater curvature. He was managed with excision of all the devitalized area and primary repair with feeding jejunostomy. The case is presented due to its rarity. Acute gastric dilatation (AGD) leading to ischemic necrosis and perforation because of binge eating episode in an otherwise healthy person is an exceptional occurrence with only few cases reported in literature. The clinician should be aware of this condition for prompt and appropriate management. PMID:27134932

  20. INTRAOCULAR AND SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN ACUTE RETINAL NECROSIS AND OCULAR TOXOPLASMOSIS

    Wiertz, Karin; De Visser, Lenneke; Rijkers, Ger; De Groot-Mijnes, Jolanda; Los, Leonie; Rothova, Aniki

    2010-01-01

    Purpose: To determine the intraocular and serum vascular endothelial growth factor (VEGF) levels in patients with acute retinal necrosis (ARN) and compare those with VEGF levels found in patients with ocular toxoplasmosis (OT). Methods: Paired intraocular fluid and serum samples of 17 patients with

  1. Precursor T-cell acute lymphoblastic leukemia presenting with bone marrow necrosis: a case report

    Khoshnaw Najmaddin SH

    2012-10-01

    Full Text Available Abstract Introduction Bone marrow necrosis is a clinicopathological condition diagnosed most often at postmortem examination, but it is also seen during the course of malignancy and is not always associated with a poor prognosis. The morphological features of bone marrow necrosis are disruption of the normal marrow architecture and necrosis of myeloid tissue and medullary stroma. Non-malignant conditions associated with bone marrow necrosis are sickle cell anemia, infections, drugs (sulfasalazine, interferon α, all-trans retinoic acid, granulocyte colony-stimulating factor and fludarabine, disseminated intravascular coagulation, antiphospholipid antibody syndrome and acute graft versus host diseases. The malignant causes are leukemia, lymphoma and metastatic carcinomas. Herein we report the case of a patient with precursor T-cell acute lymphoblastic leukemia and bone marrow necrosis at initial presentation. Case presentation A 10-year-old Kurdish boy was presented with generalized bone pain and fever of 1 month’s duration which was associated with sweating, easy fatigability, nose bleeding, breathlessness and severe weight loss. On examination, we observed pallor, tachypnea, tachycardia, low blood pressure, fever, petechial hemorrhage, ecchymoses, tortuous dilated veins over the chest and upper part of abdomen, multiple small cervical lymph node enlargements, mildly enlarged spleen, palpable liver and gross abdominal distention. Blood analysis revealed pancytopenia and elevated lactate dehydrogenase and erythrocyte sedimentation rate. Imaging results showed mediastinal widening on a planar chest X-ray and diffuse focal infiltration of the axial bone marrow on magnetic resonance imaging of the lumbosacral vertebrae. Bone marrow aspiration and biopsy examination showed extensive bone marrow necrosis. Immunophenotyping analysis of the bone marrow biopsy confirmed T-cell acute lymphoblastic leukemia, as CD3 and terminal deoxynucleotidyl

  2. Perfusion CT is superior to angiography in predicting pancreatic necrosis in patients with severe acute pancreatitis

    We performed perfusion computed tomography (P-CT) and angiography of the pancreas in patients with severe acute pancreatitis (SAP) and compared the usefulness of these two methods in predicting the development of pancreatic necrosis. We compared P-CT and angiography results taken within 3 days after symptom onset in 21 SAP patients. We divided the pancreas into three areas, the head, body, and tail, and examined each area for perfusion defects (via P-CT) and arterial vasospasms (by angiography). Three weeks later, all patients underwent contrast-enhanced CT to determine whether pancreatic necrosis had developed. Of the 21 SAP patients, 16 exhibited perfusion defects, while 17 proved positive for vasospasms in at least one area. Fourteen patients developed pancreatic necrosis. Of the 63 pancreatic areas from the 21 SAP patients, perfusion defects appeared in 25 areas (39.7%), 24 of which showed vasospasms (96.0%). Angiography showed 33 areas with vasospasms (52.4%), of which 24 showed perfusion defects (72.7%). Of the 25 areas with perfusion defects, 21 developed pancreatic necrosis (84.0%). Of the 33 areas with vasospasms, 21 developed necrosis (63.6%). Pancreatic necrosis developed only in the areas positive both for perfusion defects and for vasospasms. No areas without perfusion defect or vasospasms developed pancreatic necrosis. P-CT predicted the development of pancreatic necrosis with significantly higher accuracy than angiography. While both P-CT and angiography are useful in predicting the development of pancreatic necrosis in patients with SAP, P-CT appears to be more accurate for this purpose. (author)

  3. IMPORTANCE OF MUSCLE MASS IN ACUTE TUBULAR NECROSIS DUE TO RHABDOMYOLISIS: CASE REPORT

    Özge Onur; Özlem Güneysel; Serkan Eroğlu; Arzu Denizbaşı; Erol Ünlüer

    2006-01-01

    30 years old male patient presented to our emergency clinic with complaint of left upper quadrant pain. We learned there has been a fight, he was assaulted with fists and iron bricks to his abdomen and right arm. Clinical examination revealed echymotic areas in his thorax, back and right arm; tenderness at left upper quadrant of abdomen. In laboratuary tests creatinin phosphokinase (CPK), creatinin(Cr) and potassium(K) levels were high. The patient admitted to emergency service with diagnosis...

  4. Role of procalcitonin and granulocyte colony stimulating factor in the early prediction of infected necrosis in severe acute pancreatitis

    Muller, C.; Uhl, W.; Printzen, G; Gloor, B; Bischofberger, H; Tcholakov, O; Buchler, M.

    2000-01-01

    BACKGROUND—Infected pancreatic necrosis (IPN) is the main cause of death in patients with severe acute pancreatitis. Therefore an early prediction of IPN is of utmost importance.
AIM—Analysis of new blood variables as potential early predictors to differentiate between IPN and sterile pancreatic necrosis (SPN).
PATIENTS—64 consecutive patients with acute pancreatitis were enrolled in this prospective study; 29 were suffering from acute oedematous pancreatitis (AIP), and 35 from necrotising di...

  5. Acute necrosis after Gamma Knife surgery in vestibular schwannoma leading to multiple cranial nerve palsies.

    Kapitza, Sandra; Pangalu, Athina; Horstmann, Gerhard A; van Eck, Albert T; Regli, Luca; Tarnutzer, Alexander A

    2016-08-01

    We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss. A diagnosis of acute vestibulocochlear and facial neuropathy was made. Brain MRI demonstrated focal contrast sparing within the schwannoma, likely related to acute radiation necrosis. Acute multiple cranial neuropathies of the cerebellopontine angle after Gamma Knife treatment should raise suspicion of acute tissue damage within the schwannoma and should result in urgent MRI. Treatment with steroids may be considered based on accompanying swelling and edema. PMID:26947104

  6. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation - and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly by computed tomography, plays a fundamental role in the definition of the management of severe cases, especially regarding the characterization of local complications with implications in the prognosis and in the definition of the therapeutic approach. New concepts include the subdivision of necrotizing pancreatitis into the following presentations: pancreatic parenchymal necrosis with concomitant peripancreatic tissue necrosis, and necrosis restricted to peripancreatic tissues. Moreover, there was a systematization of the terms acute peripancreatic fluid collection, pseudocyst, post-necrotic pancreatic/peripancreatic fluid collections and walled-off pancreatic necrosis. The knowledge about such terms is extremely relevant to standardize the terminology utilized by specialists involved in the diagnosis and treatment of these patients. (author)

  7. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis

    Cunha, Elen Freitas de Cerqueira [Image Memorial/DASA and Diagnoson Medicina Diagnostica, Salvador, BA (Brazil); Rocha, Manoel de Souza; Pereira, Fabio Payao; Blasbalg, Roberto; Baroni, Ronaldo Hueb [Universidade de Sao Paulo (FM/USPU), Sao Paulo, SP (Brazil). Faculdade de Medicina

    2014-05-15

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation - and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly by computed tomography, plays a fundamental role in the definition of the management of severe cases, especially regarding the characterization of local complications with implications in the prognosis and in the definition of the therapeutic approach. New concepts include the subdivision of necrotizing pancreatitis into the following presentations: pancreatic parenchymal necrosis with concomitant peripancreatic tissue necrosis, and necrosis restricted to peripancreatic tissues. Moreover, there was a systematization of the terms acute peripancreatic fluid collection, pseudocyst, post-necrotic pancreatic/peripancreatic fluid collections and walled-off pancreatic necrosis. The knowledge about such terms is extremely relevant to standardize the terminology utilized by specialists involved in the diagnosis and treatment of these patients. (author)

  8. Poloxamer 188 and antioxidants prevent acute radiation necrosis of adult skeletal muscle cells

    Full text: To date there are no effective therapeutic agents widely available for acute radiation sickness. Acute cellular necrosis occurring minutes to hours after exposure to high doses of ionizing radiation (IR) results from rapid membrane lipid peroxidation, blebbing and membrane breakdown. Not only can repairing the membrane prevent acute necrosis, but it can also provide a critical time period to address other mechanisms of cell death, such as apoptosis or mitotic arrest, which manifest over a longer time frame. We have previously shown that certain polymer surfactants can restore structural integrity and transport barrier function of cell membranes following high-dose IR. We now present data showing that the amphiphillic surfactant Poloxamer 188 (P188), a tri-block copolymer composed of two hydrocephalic blocks separated by a hydrophobic central block, has efficacy in preventing acute necrosis of adult rat skeletal muscle cells after high-dose IR and that at doses in which P188 is effective, adding the antioxidant ascorbate or n-acetyl cysteine further increases cell survival. Explanted rat flexor digitoum brevis muscle cells received 10, 40 or 40 Gy IR from Co 60 in a 21% oxygen atmosphere and their viability was determined using fluorometric probes (Calcein-AM and Ethidium homodimer) at 4 and 18 hours after IR. Compared to unirradiated cells, 10 Gy did not cause acute necrosis. Significant acute necrosis was observed after 40 and 80 Gy in a dose-dependent manner. Post-IR treatment with P188 significantly enhanced the cells' viability. By comparison, treating with 10 kDa neutral Dextran, a purely hydrophilic polymer, was not found to be effective. Despite progressive cell death over 18 h after high-dose IR, cells treated with P188 showed greater survival than cells grown only in media or Dextran-treated cells. Cells treated with 40 Gy survived better than those treated with 80 Gy, indicating some limits to the efficacy of treatment with P188. Cells

  9. Two sides of one coin: massive hepatic necrosis and progenitor cell-mediated regeneration in acute liver failure.

    Weng, Hong-Lei; Cai, Xiaobo; Yuan, Xiaodong; Liebe, Roman; Dooley, Steven; Li, Hai; Wang, Tai-Ling

    2015-01-01

    Massive hepatic necrosis is a key event underlying acute liver failure, a serious clinical syndrome with high mortality. Massive hepatic necrosis in acute liver failure has unique pathophysiological characteristics including extremely rapid parenchymal cell death and removal. On the other hand, massive necrosis rapidly induces the activation of liver progenitor cells, the so-called "second pathway of liver regeneration." The final clinical outcome of acute liver failure depends on whether liver progenitor cell-mediated regeneration can efficiently restore parenchymal mass and function within a short time. This review summarizes the current knowledge regarding massive hepatic necrosis and liver progenitor cell-mediated regeneration in patients with acute liver failure, the two sides of one coin. PMID:26136687

  10. Prognostic criteria in acute pancreatitis: importance of assessment of pancreatic necrosis by contrast-enhanced CT

    To compare the value of the clinical criteria of Ranson, the classical tomographic criteria of Balthzar and the severity of illness index according to CT in predicting the development of complications of acute pancreatitis. A retrospective study was performed in 100 patients with clinical and analytical evidence of acute pancreatitis. All patients were assessed according to Ranson score at admission and 48 hours later, and contrast-enhanced abdominal CT was carried out. The tomographic images were analyzed on the basis of the classical criteria of Balthazar and the new CT severity of illness index, which includes the assessment of pancreatic necrosis, identified as the areas of the pancreas that are not enhanced by the administration of the contrast material. These three criteria were then correlated with onset of medical and surgical implications. Our findings show that, of the three criteria analyzed, the CT severity of illness index presents the greatest specificity, sensitivity and positive and negative predictive values in the prediction of complications of acute pancreatitis. We conclude that the inclusion of pancreatic necrosis in the tomographic study improves the early assessment of the prognosis of acute pancreatitis. (Author) 20 refs

  11. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    Justin L, Regner, E-mail: Justin.Regner@BSWHealth.org; Angela, Lomas [Department of Surgery, Baylor Scott and White Health and Texas A& M Health Science Center College of Medicine, Temple, TX (United States)

    2016-03-25

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet.

  12. Gallbladder Volvulus: A Rare Emergent Cause of Acute Cholecystitis, if Untreated, Progresses to Necrosis and Perforation

    An 86 year-old woman with a past medical history significant for abdominal hernia and Alzheimer dementia presented to the Emergency Department with a 24 hour history of acute right upper quadrant pain associated with nausea and non-bilious emesis. Physical exam revealed right sided abdominal tenderness with associated mass. All laboratory values were within normal ranges. Both abdominal ultrasound and computed tomography of the abdomen/pelvis revealed a large distended gallbladder with wall thickening and gallstones. Based on presentation and radiologic findings, the emergency general surgery service was consulted for suspected acute cholecystitis. The patient was then admitted for intravenous antibiotics and scheduled for laparoscopic cholecystectomy the following day. Intra-operative findings revealed volvulus with acute necrosis of the entire gallbladder. The gallbladder had a long pedunculated cystic duct and artery that was detorsed before proceeding with resection. Postoperatively, the patient did well and was discharged a few days later tolerating a regular diet

  13. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  14. A vascular necrosis of bone. A complication of agressive therapy for acute lymphoblastic leukemia

    Vaidya, S.; Saika, S.; Sirohi, B.; Pai, S.; Advani, S. [Tata Memorial Hospital, Bombay (India). Dept. of Medical Oncology

    1998-09-01

    The purpose of the present paper was to report cases of avascular necrosis of bone (AVNB) arising as a complication of chemotherapy for acute lymphoblastic leukemia (ALL). X-rays and {sup 99m}technicium-MDP bone scans were performed on patients with symptoms of bone pain, whereby five patients out of 850 patients were detected to have avascular necrosis of the femoral head. All had received aggressive chemotherapy with steroids. Two patients were still on therapy for the primary disease. In these patients further chemotherapy was continued without steroids. The medium period from diagnosis of ALL to development of AVNB was 29 months. Three patients underwent corrective surgical procedures. To conclude, the data suggest that patients receiving combination chemotherapy, especially those with high cumulative doses, run a risk of developing AVNB. Awarness of this complication is important in order to have an early diagnosis so as to limit disability. (orig.)

  15. Necrosis and myelomalaic lesions in acute experimental allergic encephalomyelitis in guinea pigs

    Mohamed Noorulla

    2014-06-01

    Results: The histological observation revealed two stages of EAE; an initial inflammatory stage followed by demyelination. The inflammatory lesions were focal and invariably related to blood vessels. The inflammatory lesions consisted of perivascular cuffings with lymphocytes and mononuclear cells in the perivascular space and surrounding parenchyma. Perivascular demyelination was restricted to that part of the white matter which was infiltrated by mononuclear cells. The fibres in demyelinating lesions were demyelinated. Perivascular demyelination is followed by patchy demyelination and large plaques of demyelination. Neuronal and axonal damage, necrosis, tissue degeneration and cavity formation were seen in those animals which died during the acute phase of the disease. These changes were found in the spinal cord, brainstem and cerebellum. Conclusion: The changes observed in results lead to the conclusion that the acute EAE with severity of disease is no more a primary demyelinating disease. [Int J Res Med Sci 2014; 2(3.000: 945-955

  16. Lithium clearance and renal tubular sodium handling during acute and long-term nifedipine treatment in essential hypertension

    Bruun, N E; Ibsen, H; Skøtt, P; Toftdahl, D; Giese, J; Holstein-Rathlou, N H

    1988-01-01

    1. In two separate studies the lithium clearance method was used to evaluate the influence of acute and long-term nifedipine treatment on renal tubular sodium reabsorption. 2. In the acute study, after a 4 week placebo period two doses of 20 mg of nifedipine decreased supine blood pressure from 155....../101 (20.6/13.5) +/- 11/4 (1.5/0.5) to 139/88 (18.5/11.7) +/- 16/9 (2.1/1.2) mmHg (kPa) (means +/- SD; P less than 0.01). Lithium clearance, glomerular filtration rate and sodium clearance did not change. Therefore the calculated values of absolute proximal and absolute distal sodium reabsorption rates...... reabsorption did not change. Sodium clearance, fractional sodium excretion, potassium clearance, plasma volume and extracellular fluid volume were also unchanged. 4. In conclusion, we found no changes of renal tubular sodium reabsorption during acute nifedipine treatment, whereas long-term nifedipine treatment...

  17. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction

    Okabe, Tetsuhiko; Aida, Noriko; Nozawa, Kumiko [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Niwa, Tetsu [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Tokai University School of Medicine, Department of Radiology, Isehara (Japan); Shibasaki, Jun [Kanagawa Children' s Medical Center, Department of Neonatology, Yokohama (Japan); Osaka, Hitoshi [Kanagawa Children' s Medical Center, Department of Neurology, Yokohama (Japan)

    2014-05-15

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [<1 month], n=5; infants [1 month-12 months], n=3; others [≥1 year], n=4) with acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one. (orig.)

  18. Neonatal herpes simplex virus type-1 central nervous system disease with acute retinal necrosis.

    Fong, Choong Yi; Aye, Aye Mya Min; Peyman, Mohammadreza; Nor, Norazlin Kamal; Visvaraja, Subrayan; Tajunisah, Iqbal; Ong, Lai Choo

    2014-04-01

    We report a case of neonatal herpes simplex virus (HSV)-1 central nervous system disease with bilateral acute retinal necrosis (ARN). An infant was presented at 17 days of age with focal seizures. Cerebrospinal fluid polymerase chain reaction was positive for HSV-1 and brain magnetic resonance imaging showed cerebritis. While receiving intravenous acyclovir therapy, the infant developed ARN with vitreous fluid polymerase chain reaction positive for HSV-1 necessitating intravitreal foscarnet therapy. This is the first reported neonatal ARN secondary to HSV-1 and the first ARN case presenting without external ocular or cutaneous signs. Our report highlights that infants with neonatal HSV central nervous system disease should undergo a thorough ophthalmological evaluation to facilitate prompt diagnosis and immediate treatment of this rapidly progressive sight-threatening disease. PMID:24378951

  19. Tumor Necrosis Factor, but Not Neutrophils, Alters the Metabolic Profile in Acute Experimental Arthritis

    Oliveira, Marina C.; Tavares, Luciana P.; Vago, Juliana P.; Batista, Nathália V.; Queiroz-Junior, Celso M.; Vieira, Angelica T.; Menezes, Gustavo B.; Sousa, Lirlândia P.; van de Loo, Fons A. J.; Teixeira, Mauro M.; Amaral, Flávio A.; Ferreira, Adaliene V. M.

    2016-01-01

    Metabolic alterations are associated with arthritis apart from obesity. However, it is still unclear which is the underlying process behind these metabolic changes. Here, we investigate the role of tumor necrosis factor (TNF) in this process in an acute model of antigen-induced arthritis (AIA). Immunized male BALB/c mice received an intra-articular injection of PBS (control) or methylated bovine serum albumin (mBSA) into their knees, and were also pre-treated with different drugs: Etanercept, an anti-TNF drug, DF2156A, a CXCR1/2 receptor antagonist, or a monoclonal antibody RB6-8C5 to deplete neutrophils. Local challenge with mBSA evoked an acute neutrophil influx into the knee joint, and enhanced the joint nociception, along with a transient systemic metabolic alteration (higher levels of glucose and lipids, and altered adipocytokines). Pre-treatment with the conventional biological Etanercept, an inhibitor of TNF action, ameliorated the nociception and the acute joint inflammation dominated by neutrophils, and markedly improved many of the altered systemic metabolites (glucose and lipids), adipocytokines and PTX3. However, the lessening of metabolic changes was not due to diminished accumulation of neutrophils in the joint by Etanercept. Reduction of neutrophil recruitment by pre-treating AIA mice with DF2156A, or even the depletion of these cells by using RB6-8C5 reduced all of the inflammatory parameters and hypernociception developed after AIA challenge, but could not prevent the metabolic changes. Therefore, the induction of joint inflammation provoked acute metabolic alterations which were involved with TNF. We suggest that the role of TNF in arthritis-associated metabolic changes is not due to local neutrophils, which are the major cells present in this model, but rather due to cytokines. PMID:26742100

  20. Functional role of MicroRNA-19b in acinar cell necrosis in acute necrotizing pancreatitis.

    Hu, Ming-Xing; Zhang, Hong-Wei; Fu, Qiang; Qin, Tao; Liu, Chuan-Jiang; Wang, Yu-Zhu; Tang, Qiang; Chen, Yu-Xin

    2016-04-01

    The expression of microRNA-19b (miR-19b) in acute necrotizing pancreatitis (ANP) and its functional role in acinar cell necrosis of SD rats were investigated. Twelve SD rats were divided into two groups randomly, including control group and ANP group. The rat ANP models were established by intraperitoneal injection of L-arginine (2400 mg/kg body weight), and equal volume of 0.9% NaCl was injected in the control group. MiRNA chip assay was performed to examine the expression of miRNAs in the pancreas in two different groups. Besides, to further explore the role of miR-19b in ANP in vitro, taurolithocholic acid 3-sulfate disodium salt (TLC-S) (200 μmol/L) was administrated to treat the rat pancreatic acinar cell line, AR42J, for establishing the ANP cells model. The quantitative real-time PCR (qRT-PCR) was adopted to measure the miR-19b expression. Moreover, the mimic miRNA, miRNA antisense oligonucleotide (AMO) and control vector were used to transfect AR42J cells, the expression of miR-19b was confirmed by qRT-PCR and the necrotizing rate of AR42J cells was detected with AO/EB method. The expression of miR-19b was significantly higher in ANP group than in control group as displayed by the miRNA chip assay. Furthermore, after inducing necrosis of AR42J cells in vitro, the expression of miR-19b was significantly increased by 2.51±0.14 times in comparison with the control group. As revealed by qRT-PCR assay, the expression of miR-19b was 5.94±0.95 times higher in the mimic miRNA group than in the control vector group, companied with an obviously increased acinar cell necrotizing rate (50.3%±1.5% vs. 39.6%±2.3%, P0.05). The expression of miR-19b was significantly induced in ANP. In addition, up-regulation of miR-19b could promote the necrosis of pancreatic acinar cells and miR-19b deficiency could decrease the rate of pancreatic acinar cell necrosis. PMID:27072966

  1. Sup(99m)Tc-MDP bone scan in the cases of muscle necrosis associated with acute renal failure

    We studied four patients with muscle necrosis associated with acute renal failure to evaluate the diagnostic value of the bone scan in this disease. The illness followed carbon monoxide poisoning in two patients, acute physical exertion in one and contaminated intramuscular injection in the other. Whole-body rectilinear bone scans using technetium 99m-methyldiphosphonate were done. In all patients, increased muscle labelling at the regions of suspected muscle injury was shown, and in one, it was after normalization of serum muscle enzym levels. In one patient, the bone scan was rechecked 8 months later and showed no residual abnormality. Above all, the site and precise extent of muscle injury could be detected and the degree of muscle labelling seemed to correlate with the severity of muscle injury. These findings suggest that isotope scanning may be useful in the diagnosis of patients with acute muscle necrosis. (author)

  2. Esofagitis necrotizante aguda: Una entidad inusual Acute esophageal necrosis: An unusual entity

    Silvana E. Pramparo

    2010-12-01

    Full Text Available La esofagitis necrotizante aguda (ENA, también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El diagnóstico se realiza con endoscopia y confirmación histológica. La mortalidad es alta (más del 50% aunque relacionada a las enfermedades de base del paciente. Por último, podemos decir que la sospecha es muy importante en el diagnóstico de ENA, particularmente en pacientes ancianos con enfermedades asociadas y evidencia de hemorragia digestiva alta. En este trabajo describimos las características clínicas, endoscópicas e histopatológicas de un paciente con ENA.Acute esophageal necrosis (AEN, also designated black esophagus, is a rare disorder that is poorly described in the medical literature. We present the case of an 80 years old man, with upper gastrointestinal bleeding who developed a black esophagus after hypotensive episodes. Necrosis was confirmed histologically. Hematemesis and melena are present in more than 70% of the cases. Endoscopic findings show black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction. Diagnosis is reached endoscopically with histological support. Mortality is high (up to 50% even though related to the patient's underlying condition. Finally, we may say that to keep in mind the posibility of AEN is a key factor in its diagnosis, particularly in older patients with associated morbidity and evidence of upper gastrointestinal bleeding. In the present report we describe the clinical, endoscopic and histophatological characteristics of a patient with a

  3. Renal hemodynamics, tubular function, and response to low-dose dopamine during acute hypoxia in humans

    Olsen, Niels Vidiendal; Hansen, J M; Kanstrup, I L; Richalet, J P; Leyssac, P P

    1993-01-01

    Renal function was investigated in eight normal subjects before and during infusion of dopamine (3 micrograms.kg-1 x min-1) at sea level (SL) and at high altitude (HA, 4,350 m). Lithium clearance (CLi) was used as an index of proximal tubular outflow. HA significantly increased arterial pressure......, heart rate, and plasma norepinephrine. Effective renal plasma flow (ERPF) decreased at HA by 10% (P <0.05), but glomerular filtration rate (GFR), CLi, sodium clearance (CNa), and urine flow remained unchanged compared with SL. Dopamine at SL and HA increased ERPF by 47% (P <0.001) and 30% (P <0...

  4. Esofagitis necrotizante aguda: Una patología poco conocida Acute esophageal necrosis: An underdiagnosed disease

    L. Julián Gómez

    2008-11-01

    Full Text Available La esofagitis necrotizante aguda (ENA es una rara entidad cuya etiología es desconocida, siendo el mecanismo patogénico multifactorial, participando fundamentalmente el compromiso isquémico, la malnutrición y la obstrucción del tracto digestivo alto. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica con transición brusca a nivel de la unión esofagogástrica. El pronóstico depende de las enfermedades de base. Se revisan los casos de ENA, excluyendo los secundarios a caústicos, recogidos de forma retrospectiva durante los últimos 2 años. Se analizan los factores de riesgo, la presentación clínica, los hallazgos endoscópicos, la histología, el tratamiento y la evolución. En nuestro departamento, se han diagnosticado 7 casos de ENA en 6.003 gastroscopias realizadas en el periodo de estudio, representando así la ENA el 0,11% de la exploraciones.Acute esophageal necrosis is a rare disorder, and its etiology is unknown, the mechanism of damage being usually multifactorial and secondary to ischemic compromise, acute gastric outlet obstruction, and malnutrition. Endoscopic findings show circumferential black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction, which is the most common presentation. Prognosis depends on comorbid illnesses. In this study we analyze all cases reported in a retrospective analysis over a 2-year period to define risk factors, clinical presentation, endoscopic features, histological appearance, treatment and outcome. Our department has recorded 7 cases from 6,003 endoscopies performed in the last 2 years. The finding of a "black esophagus" represented 0.11% of cases.

  5. Plasmid mediated tetracycline resistance of Vibrio parahaemolyticus associated with acute hepatopancreatic necrosis disease (AHPND in shrimps

    Jee Eun Han

    2015-11-01

    Full Text Available Antimicrobial resistance is one of the most important problems in public health, veterinary medicine and aquaculture. Importantly, plasmid mediated antibiotic resistance of pathogenic Vibrio parahaemolyticus from shrimp can potentially be transferred through transposition, conjugation and plasmid uptake to different bacterial species in aquaculture systems. In this study, we evaluated the antibiotic resistance pattern in V. parahaemolyticus strains associated with acute hepatopancreatic necrosis disease (AHPND from penaeid shrimp and identified AHPND strains from Mexico showed a high level of resistance to tetracycline (≥5 μg/mL and have the tetB gene coding tetracycline resistance. In particular, the tetB gene was carried in a single copy plasmid (named as pTetB-VA1 comprising 5162-bp with 40% G + C content from the strain (13-511/A1. The plasmid pTetB-VA1 consists of 9 ORFs encoding tetracycline resistant and repressor proteins, transcriptional regulatory proteins and transposases and showed a 99% sequence identity to other tet gene plasmids (pIS04_68 and pAQU2.

  6. Acute hepatopancreatic necrosis disease (AHPND) outbreaks in Penaeus vannamei and P. monodon cultured in the Philippines.

    de la Peña, Leobert D; Cabillon, Nikko Alvin R; Catedral, Demy D; Amar, Edgar C; Usero, Roselyn C; Monotilla, Wilberto D; Calpe, Adelaida T; Fernandez, Dalisay Dg; Saloma, Cynthia P

    2015-10-27

    Acute hepatopancreatic necrosis disease (AHPND) has recently emerged as a serious disease of cultured shrimp. It has also been described as early mortality syndrome (EMS) due to mass mortalities occurring within 20 to 30 d after stocking of ponds with postlarvae. Here, Penaeus vannamei and Penaeus monodon from shrimp farms in the Philippines were examined for the toxin-producing strain of Vibrio parahaemolyticus due to AHPND-like symptoms occurring in marketable size shrimp. In the P. vannamei, histology revealed typical AHPND pathology, such as sloughing of undifferentiated cells in the hepatopancreatic tubule epithelium. Analysis using the IQ2000 AHPND/EMS Toxin 1 PCR test generated 218 bp and 432 bp amplicons confirmative of the toxin-producing strain of V. parahaemolyticus among shrimp sampled from 8 of 9 ponds. In the P. monodon, histology revealed massive sloughing of undifferentiated cells of the hepatopancreatic tubule epithelium in the absence of basophilic bacterial cells. PCR testing generated the 2 amplicons confirmatory for AHPND among shrimp sampled from 5 of 7 ponds. This study confirms the presence of AHPND in P. vannamei and P. monodon farmed in the Philippines and suggests that the disease can also impact late-stage juvenile shrimp. PMID:26503780

  7. Late Metabolic Acidosis Caused by Renal Tubular Acidosis in Acute Salicylate Poisoning.

    Sakai, Norihiro; Hirose, Yasuo; Sato, Nobuhiro; Kondo, Daisuke; Shimada, Yuko; Hori, Yasushi

    2016-01-01

    A 16-year-old man was transferred to our emergency department seven hours after ingesting 486 aspirin tablets. His blood salicylate level was 83.7 mg/dL. He was treated with fluid resuscitation and sodium bicarbonate infusion, and his condition gradually improved, with a decline in the blood salicylate level. However, eight days after admission, he again reported nausea, a venous blood gas revealed metabolic acidosis with a normal anion gap. The blood salicylate level was undetectable, and a urinalysis showed glycosuria, proteinuria and elevated beta-2 microglobulin and n-acetyl glucosamine levels, with a normal urinary pH despite the acidosis. We diagnosed him with relapse of metabolic acidosis caused by renal tubular acidosis. PMID:27181539

  8. Intratracheal administration of endotoxin and cytokines. IV. The soluble tumor necrosis factor receptor type I inhibits acute inflammation.

    Ulich, T R; Yin, S.; Remick, D G; Russell, D; Eisenberg, S P; Kohno, T

    1993-01-01

    Endotoxin lipopolysaccharide (LPS) administered intratracheally to rats causes pulmonary tumor necrosis factor alpha (TNF) and interleukin-1 (IL-1) production and results in acute broncho-alveolar neutrophilic inflammation. In the present study, the recombinant human TNF soluble receptor type I (sTNFrI) co-injected intratracheally with LPS is shown to inhibit significantly (P < 0.0001) the number of neutrophils in bronchoalveolar lavage specimens at 6 hours as compared to intratracheal inject...

  9. Field and Experimental Evidence of Vibrio parahaemolyticus as the Causative Agent of Acute Hepatopancreatic Necrosis Disease of Cultured Shrimp (Litopenaeus vannamei) in Northwestern Mexico

    Gomez-Gil, Bruno; Lozano-Olvera, Rodolfo; Betancourt-Lozano, Miguel; Morales-Covarrubias, Maria Soledad

    2014-01-01

    Moribund shrimp affected by acute hepatopancreatic necrosis disease (AHPND) from farms in northwestern Mexico were sampled for bacteriological and histological analysis. Bacterial isolates were molecularly identified as Vibrio parahaemolyticus by the presence of the tlh gene. The tdh-negative, trh-negative, and tlh-positive V. parahaemolyticus strains were further characterized by repetitive extragenic palindromic element-PCR (rep-PCR), and primers AP1, AP2, AP3, and AP and an ems2 IQ2000 detection kit (GeneReach, Taiwan) were used in the diagnostic tests for AHPND. The V. parahaemolyticus strains were used in immersion challenges with shrimp, and farmed and challenged shrimp presented the same clinical and pathological symptoms: lethargy, empty gut, pale and aqueous hepatopancreas, and expanded chromatophores. Using histological analysis and bacterial density count, three stages of AHNPD (initial, acute, and terminal) were identified in the affected shrimp. The pathognomonic lesions indicating severe desquamation of tubular epithelial cells of the hepatopancreas were observed in both challenged and pond-infected shrimp. The results showed that different V. parahaemolyticus strains have different virulences; some of the less virulent strains do not induce 100% mortality, and mortality rates also rise more slowly than they do for the more virulent strains. The virulence of V. parahaemolyticus strains was dose dependent, where the threshold infective density was 104 CFU ml−1; below that density, no mortality was observed. The AP3 primer set had the best sensitivity and specificity. Field and experimental results showed that the V. parahaemolyticus strain that causes AHPND acts as a primary pathogen for shrimp in Mexico compared with the V. parahaemolyticus strains reported to date. PMID:25548045

  10. Endoscopic ultrasound-guided transmural drainage of infected pancreatic necrosis developing 2 years after acute pancreatitis

    Eliason, Kyle; Douglas G. Adler

    2015-01-01

    This is a case report of endoscopic ultrasound guided transmural drainage of a large infected pancreatic necrosis. The infected necrosis was treated by placement of a fully covered metal stent with subsequent endoscopic necrosectomy to remove solid debris. The case is notable for the fact that the patient developed infection of a long-standing and previously stable area of walled-off pancreatic necrosis 2 years after it formed. We believe this is the longest time ever reported between necroti...

  11. The protective or damaging effect of Tumor necrosis factor-α in acute liver injury is concentration-dependent

    Dong, Yulong; Liu, Yuzhou; Kou, Xingrui; Jing, Yingying; Sun, Kai; Sheng, Dandan; Yu, Guofeng; Yu, Dandan; Zhao, Qiudong; Zhao, Xue; Li, Rong; Wu, Mengchao; Wei, Lixin

    2016-01-01

    Background Inflammatory cytokine is important in modulating injured diseases. Tumor necrosis factor-α (TNF-α), one of potent inflammatory cytokines, plays a dominant role in host defense reaction. However, the concrete effect of TNF-α on acute liver injury is totally unclear. Here we reported the concrete effect and possible mechanisms of TNF-α on acute liver injury induced by carbon tetrachloride (CCl4). Methods SD male rats were equally divided into nine groups. CCl4 (1 ml/kg) was subcutane...

  12. The relationship between tumor necrosis factor-α gene polymorphisms and acute severe pancreatitis

    张佃良; 黎介寿; 江志伟; 于宝军; 唐星明; 李维勤

    2003-01-01

    Objective To investigate the relationship between the presence of the TNF2 allele and plasma concentrations of tumor necrosis factor-α (TNFα) and soluble TNF receptor (Stnf-R) with the development of acute severe pancreatitis (ASP) and severe sepsis.Methods Genomic DNA was prepared from peripheral blood leukocytes. The TNF1 and TNF2 biallelic polymorphisms were identified by analyzing Ncol-digested DNA fragments obtained from PCR products. Plasma levels of TNFα and sTNF-R were measured by EASIA.Results The overall TNF2 allele frequency in ASP patients was comparable to that found in healthy volunteers (29. 2% vs. 29. 3%, P>0. 05). Severe sepsis occurred in 26 of 72 patients. Patients with severe sepsis showed a significantly higher prevalence of TNF2 than those without (46. 2% vs.19.6%, P<0.05). Plasma TNFα, sTNF-RI, and sTNF-RII levels were (36 ±31 ) pg/ml, (5.4 ±3.5) ng/ml, and (11.2 ±7. 8) ng/ml, respectively, in patients with severe sepsis, and (31 ±25)pg/ml, (4. 6 ± 3. 8) ng/ml, and (8. 8 ± 6.6) ng/ml in non-severe sepsis subjects. Differences in TNF levels were not statistically significant between patients with ASP and control group (P >0. 05).Moreover, there was no correlation between TNF2 allele frequency and TNFα levels [(37 ±31) pg/mlvs. (31 ±25) pg/ml in TNF2 group and TNF1 group, respectively, P>0. 05].Conclusions Our results suggest that there is no relationship between ASP and the TNF2 allele, but that the TNF2 allele is associated with a susceptibility to severe sepsis as a result of ASP.

  13. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-01-01

    Abstract Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN). Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes. Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula. GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  14. Acute kidney injury and rhabdomyolysis due to multiple wasp stings

    Hemachandar Radhakrishnan

    2014-01-01

    In most patients, wasp stings cause local reactions and rarely anaphylaxis. Acute kidney injury and rhabdomyolysis are unusual complications of wasp stings. We report a case of acute kidney injury and rhabdomyolysis secondary to multiple wasp stings. A 55-year-old farmer developed multi organ dysfunction with acute kidney injury and rhabdomyolysis 3 days after he had sustained multiple wasp stings. The etiology of acute kidney injury is probably both rhabdomyolysis and acute tubular necrosis....

  15. Insulin's acute effects on glomerular filtration rate correlate with insulin sensitivity whereas insulin's acute effects on proximal tubular sodium reabsorption correlate with salt sensitivity in normal subjects

    ter Maaten, JC; Bakker, SJL; Serne, EH; ter Wee, PM; Gans, ROB

    1999-01-01

    Background. Insulin induces increasing distal tubular sodium reabsorption. Opposite effects of insulin to offset insulin-induced sodium retention are supposedly increases in glomerular filtration rate (GFR) and decreases in proximal tubular sodium reabsorption. Defects in these opposing effects coul

  16. Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial infarction: Clinical, histochemical, and autoradiographic correlation of myocardial necrosis

    Indium-111-labeled antimyosin has been utilized in the diagnosis and localization of acute transmural myocardial infarction. The present report describes a patient who presented with a massive subendocardial infarction. Two days after the injection of antimyosin, the patient's clinical status markedly deteriorated and he expired. Postmortem examination demonstrated severe three-vessel coronary artery disease with extensive myocyte death in the endocardium. Autoradiography and histochemical staining of the prosected heart demonstrated high correlation for myocardial necrosis and corresponded to clinical evidence for diffuse subendocardial infarction

  17. Myocardial uptake of indium-111-labeled antimyosin in acute subendocardial infarction: Clinical, histochemical, and autoradiographic correlation of myocardial necrosis

    Hendel, R.C.; McSherry, B.A.; Leppo, J.A. (Univ. of Massachusetts Medical Center, Worcester (USA))

    1990-11-01

    Indium-111-labeled antimyosin has been utilized in the diagnosis and localization of acute transmural myocardial infarction. The present report describes a patient who presented with a massive subendocardial infarction. Two days after the injection of antimyosin, the patient's clinical status markedly deteriorated and he expired. Postmortem examination demonstrated severe three-vessel coronary artery disease with extensive myocyte death in the endocardium. Autoradiography and histochemical staining of the prosected heart demonstrated high correlation for myocardial necrosis and corresponded to clinical evidence for diffuse subendocardial infarction.

  18. Radiation-induced acute necrosis of the pancreatic islet and the diabetic syndrome in the golden hamster (Mesocricetus auratus)

    Tsubouchi, S.; Suzuki, H.; Ariyoshi, H. (Aichi Cancer Center, Nagoya (Japan)); Matsuzawa, T. (Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis and Cancer)

    1981-07-01

    Exposure of golden hamsters to 35 000 rad of X-rays induced acute and specific necrosis of the cells of the islets of Langerhans of the pancreas within 4 hours, whereas no other tissue revealed any drastic changes which would lead to a critical illness until 36 hours. Animals began to show the characteristic signs of diabetes, that is, hyperglycaemia, hyperkalaemia, ketonemia, and acidosis at 12 hours and these continued until death, 56+-8 hours later. These were accompanied by the disappearance of ..beta..-cell granules and a decrease of plasma insulin. Treatment of irradiated animals with injections of insulin resulted in a reduction in high blood glucose and the prolongation of survival time up to 5 days, which is comparable to the survival time when the cause of death is gastrointestinal. It is concluded that this radiation-induced diabetic syndrome resulted from acute necrosis of the cells of the islets of Langerhans, a previously unreported lethal effect of radiation in golden hamsters.

  19. Radiation-induced acute necrosis of the pancreatic islet and the diabetic syndrome in the golden hamster (Mesocricetus auratus)

    Exposure of golden hamsters to 35 000 rad of X-rays induced acute and specific necrosis of the cells of the islets of Langerhans of the pancreas within 4 hours, whereas no other tissue revealed any drastic changes which would lead to a critical illness until 36 hours. Animals began to show the characteristic signs of diabetes, that is, hyperglycaemia, hyperkalaemia, ketonemia, and acidosis at 12 hours and these continued until death, 56+-8 hours later. These were accompanied by the disappearance of β-cell granules and a decrease of plasma insulin. Treatment of irradiated animals with injections of insulin resulted in a reduction in high blood glucose and the prolongation of survival time up to 5 days, which is comparable to the survival time when the cause of death is gastrointestinal. It is concluded that this radiation-induced diabetic syndrome resulted from acute necrosis of the cells of the islets of Langerhans, a previously unreported lethal effect of radiation in golden hamsters. (author)

  20. Pancreatic necrosis

    Pancreatic necrosis is a possible complication of acute pancreatitis. It is characterized by diffuse inflammation associated with exudation or leakage of pancreatic juice with its proteolytic enzymes into the peripancreatic tissues. Colonic complications of acute pancreatitis are uncommon events. Tha main purpose of our study was to correlate radiological findings of pancreatic necrosis as observed during barium enema to CT patterns. A retrospective study was therefore carried out on 40 patients affected with acute pancreatitis with local and systemic complication. The analysis of the results allowed different patterns to be observed, with the two techniques, in the acute and in the chronich phases. In the acute phase, barium enema of the colon showed inflammatory extrinsic processes involving the wall, with a typical localization related to the spread of pancreatic enzymes along mesenteric pathways, as described by Meyers. CT allowed a thorough evaluation of both the pathologic process and its spatial balance. In the chronic phase, barium enema showed fibrotic trictures and fistulas. CT demonstrated pseudoeystic masses and irregular focal areas of decreased attenuation or irregular pancreatic margins. This correlation shows how an extrinsic inflammatory involvement of the colon with a characteristic tomography may help make a diagnosis and plan therapy

  1. Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging.

    Block, S; Maier, W.; Bittner, R.; Büchler, M; Malfertheiner, P; Beger, H G

    1986-01-01

    One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor ...

  2. Esofagitis necrotizante aguda: Una entidad inusual Acute esophageal necrosis: An unusual entity

    Silvana E. Pramparo; Pablo M. Ruiz; Rogelio Flores Valencia; José Rodeyro (h)

    2010-01-01

    La esofagitis necrotizante aguda (ENA), también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El d...

  3. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis*

    Cunha, Elen Freitas de Cerqueira; Rocha, Manoel de Souza; Pereira, Fábio Payão; Blasbalg, Roberto; Baroni, Ronaldo Hueb

    2014-01-01

    Acute pancreatitis is an inflammatory condition caused by intracellular activation and extravasation of inappropriate proteolytic enzymes determining destruction of pancreatic parenchyma and peripancreatic tissues. This is a fairly common clinical condition with two main presentations, namely, endematous pancreatitis - a less severe presentation -, and necrotizing pancreatitis - the most severe presentation that affects a significant part of patients. The radiological evaluation, particularly...

  4. Draft Genome Sequence of Non-Vibrio parahaemolyticus Acute Hepatopancreatic Necrosis Disease Strain KC13.17.5, Isolated from Diseased Shrimp in Vietnam

    Kondo, Hidehiro; Van, Phan Thi; Dang, Lua T.; Hirono, Ikuo

    2015-01-01

    A strain of Vibrio (KC13.17.5) causing acute hepatopancreatic necrosis disease (AHPND) in shrimp in northern Vietnam was isolated. Normally, AHPND is caused by Vibrio parahaemolyticus, but the genomic sequence of the strain indicated that it belonged to Vibrio harveyi. The sequence data included plasmid-like sequences and putative virulence genes.

  5. Draft Genome Sequence of Non-Vibrio parahaemolyticus Acute Hepatopancreatic Necrosis Disease Strain KC13.17.5, Isolated from Diseased Shrimp in Vietnam

    Kondo, Hidehiro; Van, Phan Thi; Dang, Lua T.

    2015-01-01

    A strain of Vibrio (KC13.17.5) causing acute hepatopancreatic necrosis disease (AHPND) in shrimp in northern Vietnam was isolated. Normally, AHPND is caused by Vibrio parahaemolyticus, but the genomic sequence of the strain indicated that it belonged to Vibrio harveyi. The sequence data included plasmid-like sequences and putative virulence genes. PMID:26383659

  6. Serum-mucoid fraction content in development of skin acute radiation necrosis in rats

    Serum-mucoid fraction composition (in polyacrilamide gel) in rats during the different stages of local acute radiation injury of skin (6000 rad irradiation) has been studied. For this injury type during all the periods no appearance of new, unusual for the norm, fractions of serum-mucoids is noted. 2 stages of changes in serum-mucoid fractions have been revealed: the simultaneous increase in the content of all the serum-mucoid components is observed during acute period (bullous dermatitis); during a necrotic period of development of acute skin radiation injury the level of the third fraction increases, the number of the first fraction decreases, the content of the second and forth fractions changes slightly. The level of total serum-mucoids is predominantly determined by the changes of the third fraction, growth of which during the ulcer-necrotic period depends clearly on an injury degree. The determination of the third fraction containing, likely, low molecular haptoglobin in these cases can be of prognostic and diagnostic values

  7. Eugenol reduces acute pain in mice by modulating the glutamatergic and tumor necrosis factor alpha (TNF-α) pathways.

    Dal Bó, Wladmir; Luiz, Ana Paula; Martins, Daniel F; Mazzardo-Martins, Leidiane; Santos, Adair R S

    2013-10-01

    Eugenol is utilized together with zinc oxide in odontological clinical for the cementation of temporary prostheses and the temporary restoration of teeth and cavities. This work explored the antinociceptive effects of the eugenol in different models of acute pain in mice and investigated its possible modulation of the inhibitory (opioid) and excitatory (glutamatergic and pro-inflammatory cytokines) pathways of nociceptive signaling. The administration of eugenol (3-300 mg/kg, p.o., 60 min or i.p., 30 min) inhibited 82 ± 10% and 90 ± 6% of the acetic acid-induced nociception, with ID₅₀ values of 51.3 and 50.2 mg/kg, respectively. In the glutamate test, eugenol (0.3-100 mg/kg, i.p.) reduced the response behavior by 62 ± 5% with an ID₅₀ of 5.6 mg/kg. In addition, the antinociceptive effect of eugenol (10 mg/kg, i.p.) in the glutamate test was prevented by the i.p. treatment for mice with naloxone. The pretreatment of mice with eugenol (10 mg/kg, i.p.) was able to inhibit the nociception induced by the intrathecal (i.t.) injection of glutamate (37 ± 9%), kainic (acid kainite) (41 ± 12%), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) (55 ± 5%), and substance P (SP) (39 ± 8%). Furthermore, eugenol (10 mg/kg, i.p.) also inhibited biting induced by tumor necrosis factor alpha (TNF-α, 65 ± 8%). These results extend our current knowledge of eugenol and confirm that it promotes significant antinociception against different mouse models of acute pain. The mechanism of action appears to involve the modulation of the opioid system and glutamatergic receptors (i.e., kainate and AMPA), and the inhibition of TNF-α. Thus, eugenol could represent an important compound in the treatment for acute pain. PMID:22775297

  8. Fever and acute phase response induced in dwarf goats by endotoxin and bovine and human recombinant tumour necrosis factor alpha.

    van Miert, A S; van Duin, C T; Wensing, T

    1992-12-01

    Tumour necrosis factor (TNF), a polypeptide produced by mononuclear phagocytes, has been implicated as an important mediator of inflammatory processes and of clinical manifestations in acute infectious diseases. To study further the potential role of TNF in infectious diseases, recombinant Escherichia coli (E. coli) derived human (r.HuTNF-alpha) and bovine TNF (r.BoTNF-alpha) were intravenously (i.v.) administered in dwarf goats. Rectal temperature, heart rate, rumen motility, plasma zinc and iron concentrations, and certain other blood biochemical and haematological values were studied and compared with the changes seen after E. coli endotoxin (LPS) was administered (dose: 0.1 microgram/kg i.v.). Following a single injection of 4 micrograms/kg of r.BoTNF-alpha, shivering and biphasic febrile response were observed, accompanied by tachycardia, inhibition of rumen contractions, drop in plasma zinc and iron concentrations, lymphopenia, and neutropenia followed by neutrophilia. The i.v. administration of a single injection of 4 micrograms/kg r.HuTNF-alpha induced shivering and biphasic febrile responses, accompanied by anorexia and a similar drop in plasma trace metal concentrations when compared with r.BoTNF-alpha-treated goats. The TNF-alpha-induced symptoms were essentially the same as those that occurred after LPS administration. However, the time of onset of these changes after the injection of TNF-alpha was significantly shorter than after LPS. Moreover, the r.BoTNF-alpha induced a longer lasting neutrophilic leucopenia, less neutrophilia, and a more persistent lymphopenia than after LPS injection. Neither r.BoTNF-alpha nor LPS caused severe haemo-concentration. Furthermore, no cross-tolerance between r.BoTNF-alpha and LPS could be demonstrated. We conclude that both r.BoTNF-alpha and r.HuTNF-alpha induce many of the physiologic, haematologic and metabolic changes that characterize the acute phase response to LPS. The overlapping biological activities of r

  9. Review Study of Renal Tubular Injury Markers in the Acute Kidney Injury%急性肾损伤中肾小管损伤标志物的研究进展

    李一飞; 姚广涛

    2011-01-01

    The reports concerned with renal injury markers in recent 10 years were consulted through Science Direct database, and literature related to specific markers of renal tubular injury were compiled and analyzed. Some biomarkers have been partially verified the good sensitivity and high specificity in experimental studies and clinical observations. For example, Kidney injury molecule-1 .which would over express in the kidney injury in renal tubular epithelial cells,is sensitive to the early diagnosis of kidney cancer, ischemic and renal toxic renal injury,and detected with high stability. Liver-type fatty acid binding protein involved in local lipid metabolism of renal,with high specificity to renal proximal tubule. Its content in urine were of great value for early evaluation of various types of acute kidney injury. As a diagnostic indicator,sensitivity and specificity of Interleukin-18 were more than 90%. It could distinguish acute tubular necrosis from other types of kidney diseases, also predict the renal injury occurrence and renal function recovery. Neutrophil gelatinase-associated lipocalin was often detected as the first expressed product in the injury kidney,which changed earlier than creatinine and other markers, with obvious time advantage. All biomarkers have different characteristics and respective shortage. So joint detection were better to wider and sensitive evaluation of renal injury.%通过Science Direct数据库查阅了近10年有关肾损伤标志物的报道,对肾小管损伤特异性标志物方面的文献进行了整理和分析.一些敏感性好、特异性高的肾小管损伤标志物已在实验研究和临床观察得到了部分验证,如肾损伤分子-1,肾损伤时在肾小管上皮细胞过度表达,对肾肿瘤、缺血性和肾毒性肾损伤的早期诊断敏感性好,且检测稳定性高;肝型脂肪酸结合蛋白,参与肾局部的脂质代谢,对肾近端小管的特异性很高,其尿液含量变化在多种类型的急

  10. Extensive Bone Marrow Necrosis and Osteolytic Lesions in a Case of Acute Myeloid Leukemia Transformed from Polycythemia Vera.

    Chambers, Isaac; Truong, Phu; Kallail, K James; Palko, William

    2016-01-01

    Acute myeloid leukemia (AML) is the most common leukemia in adults. In rare cases, bone marrow necrosis (BMN) and osteolytic lesions are presenting features of AML. The following case describes a patient with known polycythemia vera (PV) that presented with signs of multiple myeloma, including hypercalcemia, anemia, and lytic lesions of the thoracic spine and skull. Laboratory workup was not indicative of myeloma. A bone marrow biopsy was performed, which revealed extensive BMN and initial pathology was consistent with metastatic carcinoma. However, no immunohistochemical stains could be performed due to the extent of BMN; a repeat biopsy was therefore performed. Flow cytometry and CD45 staining were consistent with PV that had transformed to AML. Due to the patient's comorbidities, she was a poor candidate for stem cell transplant and did not wish to pursue chemotherapy. Ultimately, she pursued hospice care. Based on our literature review, both BMN and osteolytic lesions are rare manifestations of AML and have not been reported to occur simultaneously. These findings can lead to a diagnostic dilemma and suspicion of other malignancies. This case demonstrates that AML should remain in the differential diagnosis in those patients who present with BMN and osteolytic lesions. PMID:27433418

  11. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Anna Janowska-Wieczorek

    2012-07-01

    Full Text Available Membrane type-1 matrix metalloproteinase (MT1-MMP has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML cells. Because tumor necrosis factor (TNF-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML.

  12. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Marquez-Curtis, Leah A.; Shirvaikar, Neeta [Canadian Blood Services R& D, Edmonton, Alberta T6G 2R8 (Canada); Turner, A. Robert [Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada); Mirza, Imran [Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta T6G 2B7 (Canada); Surmawala, Amir; Larratt, Loree M. [Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada); Janowska-Wieczorek, Anna, E-mail: anna.janowska@blood.ca [Canadian Blood Services R& D, Edmonton, Alberta T6G 2R8 (Canada); Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada)

    2012-07-25

    Membrane type-1 matrix metalloproteinase (MT1-MMP) has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML) cells. Because tumor necrosis factor (TNF)-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i) MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii) activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii) inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML.

  13. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Membrane type-1 matrix metalloproteinase (MT1-MMP) has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML) cells. Because tumor necrosis factor (TNF)-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i) MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii) activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii) inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML

  14. Field and Experimental Evidence of Vibrio parahaemolyticus as the Causative Agent of Acute Hepatopancreatic Necrosis Disease of Cultured Shrimp (Litopenaeus vannamei) in Northwestern Mexico

    Soto-Rodriguez, Sonia A.; Gomez-Gil, Bruno; Lozano-Olvera, Rodolfo; Betancourt-Lozano, Miguel; Morales-Covarrubias, Maria Soledad

    2014-01-01

    Moribund shrimp affected by acute hepatopancreatic necrosis disease (AHPND) from farms in northwestern Mexico were sampled for bacteriological and histological analysis. Bacterial isolates were molecularly identified as Vibrio parahaemolyticus by the presence of the tlh gene. The tdh-negative, trh-negative, and tlh-positive V. parahaemolyticus strains were further characterized by repetitive extragenic palindromic element-PCR (rep-PCR), and primers AP1, AP2, AP3, and AP and an ems2 IQ2000 det...

  15. Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study

    Liu, Kai; Meng, Jiaxiang; Yang, Shuofei; Liu, Baochen; Ding, Weiwei; Wu, Xingjiang; Li, Jieshou

    2015-01-01

    Objective This study aims to evaluate the clinical outcomes of transcatheter thrombolysis in acute superior mesenteric venous thrombosis (ASMVT) associated with bowel necrosis. Methods A retrospective study of six patients with ASMVT treated with catheter-directed thrombectomy/thrombolysis and damage control surgery at Jinling Hospital (Nanjing, China) between 2010 and 2013 was conducted. Demographics, past medical history, risk factors, therapeutic methods and effects, mortality, and follow-...

  16. Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

    Siddhesh Prabhavalkar

    2013-01-01

    Full Text Available Acute kidney injury (AKI is a recognised complication of intravenous pentamidine therapy. A direct nephrotoxic effect leading to acute tubular necrosis has been postulated. We report a case of severe renal allograft dysfunction due to nebulised pentamidine. The patient presented with repeated episodes of AKI without obvious cause and acute tubular necrosis only on renal histology. Nebulised pentamidine was used monthly as prophylaxis for Pneumocystis jirovecii pneumonia, and administration preceded the creatinine rise on each occasion. Graft function stabilised following discontinuation of the drug. This is the first report of nebulized pentamidine-induced reversible nephrotoxicity in a kidney allograft. This diagnosis should be considered in a case of unexplained acute renal allograft dysfunction.

  17. Acute interstitial nephritis induced by intermittent use of Rifampicin in patient with Brucellosis

    Acute oliguric renal failure (ARF) developed in a patient 2 days after she was started on intermittent anti-Brucella therapy including rifampicin. The clinical picture was compatible with acute allergic interstitial nephritis. Renal histology revealed mainly acute tubular necrosis with mild tubulo-intertitial mononuclear cellular infiltrate. Intermittent therapy, as in our patient, has been the major factor in the development of rifampicin induced ARF in cases reviewed in literature. (author)

  18. Glycyrrhizin Protects against Acetaminophen-Induced Acute Liver Injury via Alleviating Tumor Necrosis Factor α-Mediated Apoptosis.

    Yan, Tingting; Wang, Hong; Zhao, Min; Yagai, Tomoki; Chai, Yingying; Krausz, Kristopher W; Xie, Cen; Cheng, Xuefang; Zhang, Jun; Che, Yuan; Li, Feiyan; Wu, Yuzheng; Brocker, Chad N; Gonzalez, Frank J; Wang, Guangji; Hao, Haiping

    2016-05-01

    Acetaminophen (APAP) overdose is the leading cause of drug-induced acute liver failure in Western countries. Glycyrrhizin (GL), a potent hepatoprotective constituent extracted from the traditional Chinese medicine liquorice, has potential clinical use in treating APAP-induced liver failure. The present study determined the hepatoprotective effects and underlying mechanisms of action of GL and its active metabolite glycyrrhetinic acid (GA). Various administration routes and pharmacokinetics-pharmacodynamics analyses were used to differentiate the effects of GL and GA on APAP toxicity in mice. Mice deficient in cytochrome P450 2E1 enzyme (CYP2E1) or receptor interacting protein 3 (RIPK3) and their relative wild-type littermates were subjected to histologic and biochemical analyses to determine the potential mechanisms. Hepatocyte death mediated by tumor necrosis factorα(TNFα)/caspase was analyzed by use of human liver-derived LO2 cells. The pharmacokinetics-pharmacodynamics analysis using various administration routes revealed that GL but not GA potently attenuated APAP-induced liver injury. The protective effect of GL was found only with intraperitoneal and intravenous administration and not with gastric administration. CYP2E1-mediated metabolic activation and RIPK3-mediated necroptosis were unrelated to GL's protective effect. However, GL inhibited hepatocyte apoptosis via interference with TNFα-induced apoptotic hepatocyte death. These results demonstrate that GL rapidly attenuates APAP-induced liver injury by directly inhibiting TNFα-induced hepatocyte apoptosis. The protective effect against APAP-induced liver toxicity by GL in mice suggests the therapeutic potential of GL for the treatment of APAP overdose. PMID:26965985

  19. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis: A 4-Year Single-Center Experience.

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-04-01

    Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN).Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes.Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula.GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  20. A CMR study of the effects of tissue edema and necrosis on left ventricular dyssynchrony in acute myocardial infarction: implications for cardiac resynchronization therapy

    Manka Robert

    2012-07-01

    Full Text Available Abstract Background In acute myocardial infarction (AMI, both tissue necrosis and edema are present and both might be implicated in the development of intraventricular dyssynchrony. However, their relative contribution to transient dyssynchrony is not known. Cardiovascular magnetic resonance (CMR can detect necrosis and edema with high spatial resolution and it can quantify dyssynchrony by tagging techniques. Methods Patients with a first AMI underwent percutaneous coronary interventions (PCI of the infarct-related artery within 24 h of onset of chest pain. Within 5–7 days after the event and at 4 months, CMR was performed. The CMR protocol included the evaluation of intraventricular dyssynchrony by applying a novel 3D-tagging sequence to the left ventricle (LV yielding the CURE index (circumferential uniformity ratio estimate; 1 = complete synchrony. On T2-weighted images, edema was measured as high-signal (>2 SD above remote tissue along the LV mid-myocardial circumference on 3 short-axis images (% of circumference corresponding to the area-at-risk. In analogy, on late-gadolinium enhancement (LGE images, necrosis was quantified manually as percentage of LV mid-myocardial circumference on 3 short-axis images. Necrosis was also quantified on LGE images covering the entire LV (expressed as %LV mass. Finally, salvaged myocardium was calculated as the area-at-risk minus necrosis (expressed as % of LV circumference. Results After successful PCI (n = 22, 2 female, mean age: 57 ± 12y, peak troponin T was 20 ± 36ug/l and the LV ejection fraction on CMR was 41 ± 8%. Necrosis mass was 30 ± 10% and CURE was 0.91 ± 0.05. Edema was measured as 58 ± 14% of the LV circumference. In the acute phase, the extent of edema correlated with dyssynchrony (r2 = −0.63, p 2 = −0.19, p = 0.05. PCI resulted in salvaged myocardium of 27 ± 14%. LV dyssynchrony (=CURE decreased at 4 months from 0.91

  1. Sodium hypochlorite-induced acute kidney injury

    Brandon W Peck

    2014-01-01

    Full Text Available Sodium hypochlorite (bleach is commonly used as an irrigant during dental proce-dures as well as a topical antiseptic agent. Although it is generally safe when applied topically, reports of accidental injection of sodium hypochlorite into tissue have been reported. Local necrosis, pain and nerve damage have been described as a result of exposure, but sodium hypo-chlorite has never been implicated as a cause of an acute kidney injury (AKI. In this report, we describe the first case of accidental sodium hypochlorite injection into the infraorbital tissue during a dental procedure that precipitated the AKI. We speculate that oxidative species induced by sodium hypochlorite caused AKI secondary to the renal tubular injury, causing mild acute tubular necrosis.

  2. Gene Expression in Biopsies of Acute Rejection and Interstitial Fibrosis/Tubular Atrophy Reveals Highly Shared Mechanisms That Correlate With Worse Long-Term Outcomes.

    Modena, B D; Kurian, S M; Gaber, L W; Waalen, J; Su, A I; Gelbart, T; Mondala, T S; Head, S R; Papp, S; Heilman, R; Friedewald, J J; Flechner, S M; Marsh, C L; Sung, R S; Shidban, H; Chan, L; Abecassis, M M; Salomon, D R

    2016-07-01

    Interstitial fibrosis and tubular atrophy (IFTA) is found in approximately 25% of 1-year biopsies posttransplant. It is known that IFTA correlates with decreased graft survival when histological evidence of inflammation is present. Identifying the mechanistic etiology of IFTA is important to understanding why long-term graft survival has not changed as expected despite improved immunosuppression and dramatically reduced rates of clinical acute rejection (AR) (Services UDoHaH. http://www.ustransplant.org/annual_reports/current/509a_ki.htm). Gene expression profiles of 234 graft biopsy samples were obtained with matching clinical and outcome data. Eighty-one IFTA biopsies were divided into subphenotypes by degree of histological inflammation: IFTA with AR, IFTA with inflammation, and IFTA without inflammation. Samples with AR (n = 54) and normally functioning transplants (TX; n = 99) were used in comparisons. A novel analysis using gene coexpression networks revealed that all IFTA phenotypes were strongly enriched for dysregulated gene pathways and these were shared with the biopsy profiles of AR, including IFTA samples without histological evidence of inflammation. Thus, by molecular profiling we demonstrate that most IFTA samples have ongoing immune-mediated injury or chronic rejection that is more sensitively detected by gene expression profiling. These molecular biopsy profiles correlated with future graft loss in IFTA samples without inflammation. PMID:26990570

  3. Acute Retinal Necrosis: A Report of 18 Cases%急性视网膜坏死18例临床分析

    李军; 曲新英

    2009-01-01

    Objective To investigate the early diagnosis and treatment of acute retinal necrosis (ARN).Methods The clinical manifestations and therapeutic measures in 18 patients (21eyes) with ARN were studied retrospectively.Results Seventeen eyes of ARN patients were subjected to vitreetomy combined tamponade with silicone oil.Retinal reattachment achieved in 14 eyes (82.35%) after operation.The opposite eyes in single-eye involved patients were not suffered from the attack of acute retinal necrosis following early sufficient dose of antiviral therapy.Conelusions Earlier adminiswation of antiviral drugs in large dose coordinated with prophylactic vitrectomy can improve the therapeutic efficacy of ARN and simultaneously reduce the morbidity of opposite eyes.%目的 探讨急性视网膜坏死(acute retinal necrosis,ARN)的早期诊断和治疗方法.方法 回顾性研究18例21只眼急性视网膜坏死患者的临床表现和治疗方法.结果 17只眼玻璃体切除联合眼内硅油填充术,术后视网膜复位14只眼(82.35%),早期大剂量抗病毒药物治疗后单眼发病者未发现对侧眼发病.结论 尽早诊断和应用足量的抗病毒药物,结合预防性视网膜激光光凝和玻璃体切除术可提高急性视网膜坏死的治疗效果,同时减少对侧眼的发病率.

  4. Photorhabdus insect-related (Pir) toxin-like genes in a plasmid of Vibrio parahaemolyticus, the causative agent of acute hepatopancreatic necrosis disease (AHPND) of shrimp

    Han, Jee Eun; Kathy F.J. Tang; Tran, Loc H.; Lightner, Donald V.

    2015-01-01

    The 69 kb plasmid pVPA3-1 was identified in Vibrio parahaemolyticus strain 13-028/A3 that can cause acute hepatopancreatic necrosis disease (AHPND). This disease is responsible for mass mortalities in farmed penaeid shrimp and is referred to as early mortality syndrome (EMS). The plasmid has a GC content of 45.9% with a copy number of 37 per bacterial cell as determined by comparative quantitative PCR analyses. It consists of 92 open reading frames that encode mobilization proteins, replicati...

  5. Tratamento da necrose aguda de retina: revisão sistemática Treatment of acute retinal necrosis: systematic review

    Moysés Eduardo Zajdenweber

    2005-08-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi pela realização de revisão sistemática, determinar o melhor tratamento para a necrose aguda de retina. MÉTODOS: Seguindo a orientação metodológica da Colaboração Cochrane e de seu subgrupo editorial "Eye and Vision Group", o autor, por meio de mecanismos de busca, selecionou trabalhos sobre o tratamento da necrose aguda de retina. RESULTADO: Foram selecionadas 146 referências bibliográficas, sendo considerados como relevantes 13 estudos. Destes estudos 2 foram considerados como preenchendo os critérios de inclusão. O primeiro estudo aponta a possibilidade de o tratamento para necrose aguda de retina, com aciclovir endovenoso associado a corticóide sistêmico, proteger o olho contralateral de acometimento. Foram estudados 54 pacientes, 31 tratados e 23 não tratados, sendo observada incidência de doença no olho contralateral de 12,9% no grupo tratado e de 69,5% no grupo não tratado. O segundo estudo incluído mostra 19 olhos acometidos com necrose aguda de retina, sendo que 12 destes olhos foram submetidos à fotocoagulação com laser de argônio, com o objetivo de prevenir o descolamento de retina. Dos 12 olhos, 2 desenvolveram descolamento de retina (16,6% ao passo que, no grupo não tratado, composto por 7 olhos, 4 desenvolveram descolamento de retina (57,1%. CONCLUSÃO: O autor conclui que os dois tipos de intervenção propostos se mostraram eficazes, porém, como os estudos são metodologicamente fracos, torna-se necessária a realização de estudos clínicos randomizados para que se possa estabelecer o melhor tratamento para a necrose aguda de retina.PURPOSE: The purpose of this study was to identify, according to an sistematic review, the best treatment for acute retinal necrosis. METHODS: Following the methodologic guidance of the Cochrane Collaboration and its editorial subgroup "Eye and Vision Group", using search strategy for study identification, articles about the treatment

  6. Partial liquid ventilation decreases tissue and serum tumor necrosis factor-α concentrations in acute lung injury model of immature piglet induced by oleic acid

    ZHU Yao-bin; FAN Xiang-ming; LI Xiao-feng; LI Zhi-qiang; WANG Qiang; SUN Li-zhong; LIU Ying-long

    2012-01-01

    Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation (PLV) has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study was designed to examine the hypothesis that PLV would attenuate the production of local and systemic tumor necrosis factor (TNF)-α in an immature piglet model of acute lung injury induced by oleic acid (OA).Methods Twelve Chinese immature piglets were induced acute lung injury by OA.The animals were randomly assigned to two groups of six animals,(1) conventional mechanical ventilation (MV) group and (2) PLV with 10 ml/kg FC-77 group.Results Compared with MV group,the PLV group had better cardiopulmonary variables (P <0.05).These variables included heart rate,mean blood pressure,blood pH,partial pressure of arterial oxygen (PaO2),PaO2/inspired O2 fraction (FiO2) and partial pressure of arterial carbon dioxide (PaCO2).PLV reduced TNF-α levels both in plasma and tissue compared with MV group (P <0.05).Conclusion PLV provides protective effects against TNF-a response in OA-induced acute lung injury in immature piglets.

  7. Clinical Spectrum of Acute Renal Failure in Dammam Central Hospital, Dammam, Saudi Arabia

    Ghacha Reda

    2000-01-01

    Full Text Available Fifty consecutive patients of acute renal failure (ARF seen over a period of two years at the Dammam Central Hospital, Dammam were studied. The mean age of the patients was 39.3 years ranging from 14 to 90 years. The main etiological factors for ARF were acute tubular necrosis (67.5% and obstructive uropathy (30%. The mortality rate was 26% and the poor prognostic factors included sepsis, acidosis, shock and the need for emergency hemodialysis.

  8. Failure to visualize acutely injured kidneys with technetium-99m DMSA does not preclude recoverable function

    A 35-yr-old patient developed severe acute tubular necrosis requiring hemodialysis. A [99mTc]dimercaptosuccinic acid scan of the kidneys showed no renal uptake at 4 or 24 hr, but the patient subsequently recovered normal renal function as judged by a normal serum creatinine. Based on this case report and a review of the literature, one cannot assume irreversible loss of function in patients with acute renal failure, based on the absence of radiopharmaceutical uptake by the kidneys

  9. Tubular Coupling

    Rosenbaum, Bernard J. (Inventor)

    2000-01-01

    A system for coupling a vascular overflow graft or cannula to a heart pump. A pump pipe outlet is provided with an external tapered surface which receives the end of a compressible connula. An annular compression ring with a tapered internal bore surface is arranged about the cannula with the tapered internal surface in a facing relationship to the external tapered surface. The angle of inclination of the tapered surfaces is converging such that the spacing between the tapered surfaces decreases from one end of the external tapered surface to the other end thereby providing a clamping action of the tapered surface on a cannula which increases as a function of the length of cannula segment between the tapered surfaces. The annular compression ring is disposed within a tubular locking nut which threadedly couples to the pump and provides a compression force for urging the annular ring onto the cannula between the tapered surfaces. The nut has a threaded connection to the pump body. The threaded coupling to the pump body provides a compression force for the annular ring. The annular ring has an annular enclosure space in which excess cannula material from the compression between the tapered surfaces to "bunch up" in the space and serve as an enlarged annular ring segment to assist holding the cannula in place. The clamped cannula provides a seamless joint connection to the pump pipe outlet where the clamping force is uniformly applied to the cannula because of self alignment of the tapered surfaces. The nut can be easily disconnected to replace the pump if necessary.

  10. Etiological study of acute retinal necrosis%急性视网膜坏死的病原学研究

    徐海燕; 叶俊杰; 耿爽

    2015-01-01

    目的 探讨急性视网膜坏死(ARN)病原学研究在临床治疗中的价值.方法 回顾性系列病例研究.总结分析1996年1月至2012年12月在北京协和医院眼科诊断为ARN的39例(45眼)患者(ARN组)的临床资料.所有患者均行常规眼部检查.39例患者均抽取静脉血行血清TORCH检测,其中22例患者行血清总IgG检测.15眼于玻璃体切除术中抽取玻璃体液,行玻璃体液总TORCH及IgG检测.对照组为2006年6月至2008年11月因非感染性视网膜疾病而行玻璃体切除手术的患者15例(15眼).15例患者术前均行血清总IgG检测,术中抽取玻璃体液,行玻璃体液总TORCH及IgG检测.数据采用独立样本t检验进行分析.结果 对照组患者血清总IgG含量为(10.02±2.69) g/L,ARN组为(10.10±2.38)g/L,2组差异无统计学意义.对照组玻璃体液总IgG为(135.3±178.0)mg/L;ARN患眼玻璃体液中检测出HSV-IgG、CMV-IgG,玻璃体液总IgG含量为(2 949.2±1 845.1)mg/L,2组患者的玻璃体液总IgG的差异有统计学意义(t=6.024,P<0.01).对照组血清HSV-IgG的几何平均滴度为86.10-62.02,ARN组为86.30-±-65.31,2组差异无统计学意义.ARN组患者7眼HSV的Goldmann-Witmer系数C值(CWC)>6,提示为HSV感染;1眼CMV的CWC值>6,提示CMV感染.结论 ARN患者玻璃体液的特异性病毒抗体检测可提示感染病原体,对因治疗可提高ARN的治疗效果.%Objective To investigate the importance of etiological research in clinical therapy of acute retinal necrosis (ARN).Methods Retrospective cases-series study.Analyzed the clinical data of 45 eyes (39 cases) of ARN patients who were diagnosised in the Department of Ophthalmology of PUMCH during January 1996 to December 2012.All patients underwent routine eye examination.Blood samples were taken from 39 patients for serum TORCH test,22 patients underwent total serum IgG detection.15 eyes underwent the TORCH and total IgG detection of vitreous humor.The control group:15 patients (15 eyes

  11. Nuclear medicine in acute and chronic renal failure

    The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

  12. Anti-tumor necrosis factor-a for the treatment of steroid-refractory acute graft-versus-host disease

    M.C. Nogueira

    2007-12-01

    Full Text Available Allogeneic stem cell transplantation has been increasingly performed for a variety of hematologic diseases. Clinically significant acute graft-versus-host disease (GVHD occurs in 9 to 50% of patients who receive allogeneic grafts, resulting in high morbidity and mortality. There is no standard therapy for patients with acute GVHD who do not respond to steroids. Studies have shown a possible benefit of anti-TNF-a (infliximabfor the treatment of acute GVHD. We report here on the outcomes of 10 recipients of related or unrelated stem cell transplants who received 10 mg/kg infliximab, iv, once weekly for a median of 3.5 doses (range: 1-6 for the treatment of severe acute GVHD and who were not responsive to standard therapy. All patients had acute GVHD grades II to IV (II = 2, III = 3, IV = 5. Overall, 9 patients responded and 1 patient had progressive disease. Among the responders, 3 had complete responses and 6 partial responses. All patients with cutaneous or gastrointestinal involvement responded, while only 2 of 6 patients with liver disease showed any response. None of the 10 patients had any kind of immediate toxicity. Four patients died, all of them with sepsis. Six patients are still alive after a median follow-up time of 544 days (92-600 after transplantation. Considering the severity of the cases and the bad prognosis associated with advanced acute GVHD, we find our results encouraging. Anti-TNF-a seems to be a useful agent for the treatment of acute GVHD.

  13. 急性胰周积液和胰腺坏死对急性胰腺炎预后的影响%Effect of acute peripancreatitc fluid collection and pancreatic necrosis to the prognosis of acute pancreatitis

    李能平; 杨欣; 顾永峰; 王华; 丛建农; 施玲华

    2009-01-01

    目的 探讨急性胰周积液和胰腺坏死对急性胰腺炎(AP)预后的影响.方法 回顾分析2003年1月至2007年12月收治的323例AP患者早期CT影像学表现,探讨急性胰周积液、胰腺坏死程度与全身炎症反应综合征(SIRS)、胰腺感染及病死率的关系.结果 发病5 d内出现SIRS并持续2 d或以上者97例(30%),12例(3.7%)在病程中、后期出现胰腺感染;病死14例(4.3%).有急性胰周积液者142例(44.0%).单个部位发生急性胰周积液者76例,其中31例发生SIRS,病死2例;多个部位急性胰周积液者66例,发生SIRS 62例,病死11例.急性胰周积液部位数量与早期SIRS发生及病死率显著相关(P<0.01).277例(85.8%)无胰腺坏死,均未继发胰腺感染,病死4例;46例(14.2%)有不同程度胰腺坏死.胰腺坏死面积≤30%32例,胰腺感染发生率12.5%,病死率15.6%;>30%~≤50%7例,感染发生率42.9%,病死率28.6%;>50%7例,感染发生率为71.4%,病死率42.9%,胰腺坏死的程度与胰腺感染的发生及病死率显著相关(P<0.05).结论 急性胰周积液和胰腺坏死对AP预后的影响不同.急性胰周积液与病程早期SIRS的发生及病死率相关;胰腺坏死与胰腺继发感染的发生及病死率有关,坏死面积越大,越容易发生胰腺感染,病死率越高.%Objective To study the Effect of acute peripancreatitc fluid collection and pancreatic necrosis to the prognosis of acute pancreatitis.Methods Retrospectively analyzing the prognostic effect of acute peripancreatitc fluid collection and pancreatic necrosis according to the early Computed-Tomograghy of 323 consecutive acute pancreatitis patients from Jan 2003 to Dec 2007,the end points are systemic inflammation response syndrome ( SIRS),pancreatic infection,and mortality.Results Within 5d after onset,97 of 323 cases (30%) presented with SIRS and lasted more than 2d,12 cases (3.7%) occurred pancreatic infection during middle or late phase,14 cases died,the mortality is 4

  14. Analysis of 9 Cases Misdiagnosed as Acute Retinal Necrosis Syndrome%急性视网膜坏死综合征九例误诊分析

    金绘祥; 黄宝玲; 吴昌凡; 郎平; 梅立新

    2012-01-01

    目的 提高对急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNs)的认识,以避免或减少误诊.方法 对2007年6月-2011年10月在我院误诊的9例(9眼)ARNs的诊疗过程进行回顾性分析,内容包括主诉、眼部体征、检查项目和初始诊断.结果 本组分别误诊为虹膜睫状体炎4例,全葡萄膜炎2例,急性结膜炎、青光眼睫状体炎综合征及视网膜血管炎各1例.误诊时间为3 ~28 d,平均(15.0±9.5)d;就诊次数为2~6次,平均(3.7±1.2)次.本组9例中有7例眼压升高,范围在22~ 38 mmHg,6例系统应用了糖皮质激素,平均(8.2±2.4)d.确诊后所有病例均予抗病毒治疗,同时3例实施外路视网膜光凝术,5例行玻璃体切割术.随访3个月~2年,2例发生视网膜脱离,4例视力恢复,3例视力下降.结论 ARNs易误诊为葡萄膜炎等,临床接诊眼压增高、系统应用糖皮质激素治疗后眼部病情仍加重者,应警惕ARNs的可能.%Objective To improve cognitive level of acute retinal necrosis syndrome (ARNs) in order to avoid misdiagnosis. Methods A retrospective analysis was performed on clinical data of 9 patients (9 eyes) with acute retinal necrosis syndrome admitted in our department during June 2007 and October 2011 , including analysis of complain, signs of ocular region , examination items and incipient diagnosis. Results There were misdiagnosed as iridocyclitis (4 cases) , panuveitis (2 cases), acute conjunctivitis (1 case) , glaucomato cyclitic syndrome (1 case) and retinal vasculitis (1 case). Misdiagnosed times were 3-28 days and the average times were (15 ±9.5)days. The patients paid 2 ~6 visits with an average of (3.7 ±1.2)visits. Elevated intraocular pressure (ranging from 22 to 38 mmHg) developed in 7 eyes out of 9 cases before final diagnosis, and 6 patients had been treated with glucocorti-coid (an average of 8.2 ±2.4 days). All the patients received systemic antiviral agents after final diagnosis, 3 eyes were treated

  15. Inflammatory cascades driven by tumor necrosis factor-alpha play a major role in the progression of acute liver failure and its neurological complications.

    Anne Chastre

    Full Text Available BACKGROUND/AIMS: Acute liver failure (ALF due to ischemic or toxic liver injury is a clinical condition that results from massive loss of hepatocytes and may lead to hepatic encephalopathy (HE, a serious neuropsychiatric complication. Although increased expression of tumor necrosis factor-alpha (TNF-α in liver, plasma and brain has been observed, conflicting results exist concerning its roles in drug-induced liver injury and on the progression of HE. The present study aimed to investigate the therapeutic value of etanercept, a TNF-α neutralizing molecule, on the progression of liver injury and HE in mice with ALF resulting from azoxymethane (AOM hepatotoxicity. METHODS/PRINCIPAL FINDINGS: Mice were administered saline or etanercept (10 mg/kg; i.p. 30 minutes prior to, or up to 6 h after AOM. Etanercept-treated ALF mice were sacrificed in parallel with vehicle-treated comatose ALF mice and controls. AOM induced severe hepatic necrosis, leading to HE, and etanercept administered prior or up to 3 h after AOM significantly delayed the onset of coma stages of HE. Etanercept pretreatment attenuated AOM-induced liver injury, as assessed by histological examination, plasma ammonia and transaminase levels, and by hepatic glutathione content. Peripheral inflammation was significantly reduced by etanercept as shown by decreased plasma IL-6 (4.1-fold; p<0.001 and CD40L levels (3.7-fold; p<0.001 compared to saline-treated ALF mice. Etanercept also decreased IL-6 levels in brain (1.2-fold; p<0.05, attenuated microglial activation (assessed by OX-42 immunoreactivity, and increased brain glutathione concentrations. CONCLUSIONS: These results indicate that systemic sequestration of TNF-α attenuates both peripheral and cerebral inflammation leading to delayed progression of liver disease and HE in mice with ALF due to toxic liver injury. These results suggest that etanercept may provide a novel therapeutic approach for the management of ALF patients awaiting

  16. The roles of tumor necrosis factor-alpha in colon tight junction protein expression and intestinal mucosa structure in a mouse model of acute liver failure

    Lv Sa

    2009-09-01

    Full Text Available Abstract Background Spontaneous bacterial peritonitis (SBP is a common clinical disease and one of the most severe complications of acute liver failure (ALF. Although the mechanism responsible for SBP is unclear, cytokines play an important role. The aim of this study was to investigate the effects of tumor necrosis factor-alpha (TNF-α on the structure of the intestinal mucosa and the expression of tight junction (Zona Occludens 1; ZO-1 protein in a mouse model of ALF. Methods We induced ALF using D-galactosamine/lipopolysaccharide (GalN/LPS or GalN/TNF-α and assessed the results using transmission electron microscopy, immunohistochemistry, Western blotting, ELISA and real-time quantitative PCR. The effects of administration of anti-TNF-α IgG antibody or anti-TNF-α R1 antibody before administration of GalN/LPS or GalN/TNF-α, respectively, on TNF-α were also assessed. Results Morphological abnormalities in the intestinal mucosa of ALF mice were positively correlated with serum TNF-α level. Electron microscopic analysis revealed tight junction (TJ disruptions, epithelial cell swelling, and atrophy of intestinal villi. Gut bacteria invaded the body at sites where TJ disruptions occurred. Expression of ZO-1 mRNA was significantly decreased in both ALF models, as was the level of ZO-1 protein. Prophylactic treatment with either anti-TNF-α IgG antibody or anti-tumor necrosis factor-a receptor1 (anti-TNF-α R1 antibody prevented changes in intestinal tissue ultrastructure and ZO-1 expression. Conclusion TNF-α affects the structure of the intestinal mucosa, decreases expression of ZO-1, and affects the morphology of the colon in a mouse model of ALF. It also may participate in the pathophysiological mechanism of SBP complicated to ALF.

  17. Clinical analysis of 27 cases of acute retinal necrosis syndrome%27例急性视网膜坏死综合征的临床分析

    汪静; 柯根杰

    2012-01-01

    To analyze the treatment effect of 27 cases ( 29 eyes ) of acute retinal necrosis syndrome ( ARNS ) with antivirus drugs, laser treatment, vitreous and retinal surgery retrospectively. Inflammations were all controlled, their visual acuity improved in 16 eyes ( 55. 2% ). The retinas of 28 eyes were successfully recovery except one refused the surgery. Although the prognosis of ARNS is poor, it is very important to get correct diagnosis and antivirus drugs, laser treatment, laser photocoagulation and vitrectomy in time can improve the prognosis obviously.%回顾性分析采用抗病毒药物、眼内激光光凝及玻璃体视网膜联合手术综合治疗27例急性视网膜坏死综合征(ARNS)的效果.29眼炎症均得到有效控制,视力提高16眼(55.2%),除1例拒绝手术外,视网膜均恢复良好.ARNS的预后较差,明确诊断后使用抗病毒药物,及时施行预防性眼内激光光凝和玻璃体视网膜手术可明显改善预后.

  18. Silencer of death domains controls cell death through tumour necrosis factor-receptor 1 and caspase-10 in acute lymphoblastic leukemia.

    Adam Cisterne

    Full Text Available Resistance to apoptosis remains a significant problem in drug resistance and treatment failure in malignant disease. NO-aspirin is a novel drug that has efficacy against a number of solid tumours, and can inhibit Wnt signaling, and although we have shown Wnt signaling to be important for acute lymphoblastic leukemia (ALL cell proliferation and survival inhibition of Wnt signaling does not appear to be involved in the induction of ALL cell death. Treatment of B lineage ALL cell lines and patient ALL cells with NO-aspirin induced rapid apoptotic cell death mediated via the extrinsic death pathway. Apoptosis was dependent on caspase-10 in association with the formation of the death-inducing signaling complex (DISC incorporating pro-caspase-10 and tumor necrosis factor receptor 1 (TNF-R1. There was no measurable increase in TNF-R1 or TNF-α in response to NO-aspirin, suggesting that the process was ligand-independent. Consistent with this, expression of silencer of death domain (SODD was reduced following NO-aspirin exposure and lentiviral mediated shRNA knockdown of SODD suppressed expansion of transduced cells confirming the importance of SODD for ALL cell survival. Considering that SODD and caspase-10 are frequently over-expressed in ALL, interfering with these proteins may provide a new strategy for the treatment of this and potentially other cancers.

  19. Silencer of Death Domains Controls Cell Death through Tumour Necrosis Factor-Receptor 1 and Caspase-10 in Acute Lymphoblastic Leukemia

    Khan, Naveed I.; Welschinger, Robert; Basnett, Jordan; Fung, Carina; Rizos, Helen; Bradstock, Kenneth F.; Bendall, Linda J.

    2014-01-01

    Resistance to apoptosis remains a significant problem in drug resistance and treatment failure in malignant disease. NO-aspirin is a novel drug that has efficacy against a number of solid tumours, and can inhibit Wnt signaling, and although we have shown Wnt signaling to be important for acute lymphoblastic leukemia (ALL) cell proliferation and survival inhibition of Wnt signaling does not appear to be involved in the induction of ALL cell death. Treatment of B lineage ALL cell lines and patient ALL cells with NO-aspirin induced rapid apoptotic cell death mediated via the extrinsic death pathway. Apoptosis was dependent on caspase-10 in association with the formation of the death-inducing signaling complex (DISC) incorporating pro-caspase-10 and tumor necrosis factor receptor 1 (TNF-R1). There was no measurable increase in TNF-R1 or TNF-α in response to NO-aspirin, suggesting that the process was ligand-independent. Consistent with this, expression of silencer of death domain (SODD) was reduced following NO-aspirin exposure and lentiviral mediated shRNA knockdown of SODD suppressed expansion of transduced cells confirming the importance of SODD for ALL cell survival. Considering that SODD and caspase-10 are frequently over-expressed in ALL, interfering with these proteins may provide a new strategy for the treatment of this and potentially other cancers. PMID:25061812

  20. MRI Findings of Pericardial Fat Necrosis: Case Report

    Lee, Hyo Hyeok; Ryu, Dae Shick; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee [Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung (Korea, Republic of)

    2011-06-15

    Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.

  1. Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and Procalcitonin in Predicting Severity, Organ Failure, Pancreatic Necrosis, and Mortality in Acute Pancreatitis

    Ajay K. Khanna

    2013-01-01

    Full Text Available Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP. Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%. Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study.

  2. 急性视网膜坏死综合征15例临床研究%The Clinical Analysis of Acute Retinal Necrosis in 15 Cases

    任丹; 陈莲

    2012-01-01

    Objective To observe the treatment of acute retinal necrosis syndrome (ARNS). Methods The treatment experiences of 16 eyes with ARNS in 15 patients during January 2008 to December 2010 were reviewed. The preoperative vision was 0.01 ~0. 1 in 10 eyes(62. 50% ) , 0. 2 in 2 eyes( 12. 50% ) , 0. 3 in 1 eye (6.25%) , 0.4 in 2 eyes(12.50% ) , 0.5 in 1 eye(6.25%). Results Postoperative vision was improved by different degree in 15 cases of 16 eyes diagnosed ARNS- The vision was 0. 01 ~0. 1 in 5 eyes(31. 25% ) , 0. 2 in 1 eye(6.25%), 0.3 in 4 eyes(25.00%), 0.4 in 3 eyes(18.75%) , 0. 5 in 1 eyes(6. 25%), 0. 6 in 2 eyes( 12. 50% ). The condition of all patients was effectively controlled when discharged from hospital. The vision was corrected more than 0. 2 in 5 eyes (31. 25% ) , more than 0.1 in 6 eyes{37. 50% ), and was not obviously improved in 5 eyes(31. 25% ). The best vision was 0.6. Conclusion If necessary, vitrectomy is a useful treatment for ARNS in most cases and anti-virus medicine may be used at least 2 weeks before operation.%目的 探讨急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)的有效治疗方法. 方法 研究15例(16眼)ARNS患者的临床表现和治疗方法.术前视力光感0.1以下者10眼(62.50%),0.2者2眼(12.50%),0.3者l眼(6.25%),0.4者2眼(12.50%),0.5者1眼(6.25%).结果 15例(16眼)ARNS术后视力均有不同程度提高,治疗3个月后视力0.01~0.1者5眼(31.25%);0.2者1眼(6.25%);0.3者4眼(25.00%);0.4者3跟(18.75%);0.5者1眼(6.25%);0.6者2眼(12.50%).其中矫正视力0.2以上者5眼(31.25%);矫正视力0.1以上者6眼(37.5%);5眼(31.25%)视力无明显改变;最好视力达0.6. 结论 所有病人出院时病情都得到有效控制,对大部分病例而言,术前至少需2周抗病毒治疗;必要时行玻璃体切除手术,效果较好.

  3. 十九例急性视网膜坏死临床分析%Acute Retinal Necrosis:A Report of 19 Cases

    郭梦翔; 易长贤

    2004-01-01

    目的:探讨提高对急性视网膜坏死(acute retinal necrosis,ARN)的临床诊治水平的有效方法.方法:回顾性分析本院1996年1月至2003年11月以来19例ARN患者的临床表现、检查、诊治及预后.结果:19例患者中除1例元眼前段表现外,其余18例(23只眼)都表现为不同程度的眼前段炎症、玻璃体炎、坏死性视网膜炎和闭塞性视网膜血管炎.19例患者中5例(5只眼)HSV-1阳性.治疗后视力提高共11只眼(45.8%).最终视力≤0.05者11只眼(45.8%).随访期内21只眼(87.5%)病变控制.结论:ARN的诊断以临床表现为主.早期、足量的抗病毒、皮质类固醇激素的应用以及预防性视网膜光凝、必要时玻璃体手术是控制病变的关键.

  4. Photorhabdus insect-related (Pir) toxin-like genes in a plasmid of Vibrio parahaemolyticus, the causative agent of acute hepatopancreatic necrosis disease (AHPND) of shrimp.

    Han, Jee Eun; Tang, Kathy F J; Tran, Loc H; Lightner, Donald V

    2015-02-10

    The 69 kb plasmid pVPA3-1 was identified in Vibrio parahaemolyticus strain 13‑028/A3 that can cause acute hepatopancreatic necrosis disease (AHPND). This disease is responsible for mass mortalities in farmed penaeid shrimp and is referred to as early mortality syndrome (EMS). The plasmid has a GC content of 45.9% with a copy number of 37 per bacterial cell as determined by comparative quantitative PCR analyses. It consists of 92 open reading frames that encode mobilization proteins, replication enzymes, transposases, virulence-associated proteins, and proteins similar to Photorhabdus insect-related (Pir) toxins. In V. parahaemolyticus, these Pir toxin-like proteins are encoded by 2 genes (pirA- and pirB-like) located within a 3.5 kb fragment flanked with inverted repeats of a transposase-coding sequence (1 kb). The GC content of these 2 genes is only 38.2%, substantially lower than that of the rest of the plasmid, which suggests that these genes were recently acquired. Based on a proteomic analysis, the pirA-like (336 bp) and pirB-like (1317 bp) genes encode for 13 and 50 kDa proteins, respectively. In laboratory cultures of V. parahaemolyticus 13-028/A3, both proteins were secreted into the culture medium. We developed a duplex PCR diagnostic method, with a detection limit of 10(5) CFU ml(-1) and targeting pirA- and pirB-like genes in this strain of V. parahaemolyticus. This PCR protocol can reliably detect AHPND-causing strains of V. parahaemolyticus and does not cross react with non-pathogenic strains or with other species of Vibrio isolated from shrimp ponds. PMID:25667334

  5. Time profile of viral DNA in aqueous humor samples of patients treated for varicella-zoster virus acute retinal necrosis by use of quantitative real-time PCR.

    Bernheim, D; Germi, R; Labetoulle, M; Romanet, J P; Morand, P; Chiquet, C

    2013-07-01

    The objective of this study was to evaluate the kinetics of varicella-zoster virus (VZV) loads using quantitative PCR (qPCR) in patients treated for acute retinal necrosis (ARN). Six patients (52 ± 13 years old) with ARN syndrome were consecutively studied. Aqueous humor (AH) was sampled from both eyes of all patients for qPCR evaluation. The patients were treated with intravenous acyclovir and intravitreal injections of antiviral drugs. The mean follow-up time was 17.6 ± 16.4 months. Main outcome measures were the numbers of viral genome copies in the AH, assessed using real-time qPCR with hydrolysis probe technology with a threshold of detection of 200 copies/ml. Two main portions of the viral load curves were observed for each patient: a plateau phase (27.8 ± 24.9 days) and a decrease in the number of viral genome copies. The mean baseline viral load was 3.4 × 10(7) ± 4.45 × 10(7) copies/ml (6 × 10(6) to 1.2 × 10(8) copies/ml). The viral load decreased according to a logarithmic model, with a 50% reduction obtained in 3 ± 0.7 days. There was a significant viral load (>102 copies/ml) at 50 days after the onset of treatment, despite antiviral drugs. qPCR use demonstrated reproducible VZV DNA kinetics with a two-phase evolution: a plateau followed by a logarithmic decrease. These data suggest that high-dosage antiviral therapy administered for the conventional 10-day duration is insufficient for most patients. This series of patients responded with a similar decrease in viral load once treatment was initiated, and the data from these patients may be used to predict the responses of future patients. PMID:23637296

  6. C1q/Tumor Necrosis Factor-Related Protein 9 Protects against Acute Myocardial Injury through an Adiponectin Receptor I-AMPK-Dependent Mechanism.

    Kambara, Takahiro; Shibata, Rei; Ohashi, Koji; Matsuo, Kazuhiro; Hiramatsu-Ito, Mizuho; Enomoto, Takashi; Yuasa, Daisuke; Ito, Masanori; Hayakawa, Satoko; Ogawa, Hayato; Aprahamian, Tamar; Walsh, Kenneth; Murohara, Toyoaki; Ouchi, Noriyuki

    2015-06-01

    Obesity is a risk factor for cardiovascular disease. C1q/tumor necrosis factor-related protein 9 (CTRP9) is an adipokine that is downregulated by obesity. We investigated the role of CTRP9 in cardiac injury with loss-of-function genetic manipulations and defined the receptor-mediated signaling pathway downstream of this adipokine. CTRP9-knockout (CTRP9-KO) mice at the age of 12 weeks were indistinguishable from wild-type (WT) mice under basal conditions. CTRP9-KO mice had exacerbated contractile left ventricle dysfunction following intraperitoneal injection of lipopolysaccharide (LPS) compared to WT mice. Administration of LPS to CTRP9-KO mice also resulted in increased expression of proinflammatory cytokines and oxidative stress markers in the heart compared to WT mice. Likewise, CTRP9-KO mice showed increased myocardial infarct size and elevated expression of inflammatory mediators in ischemic heart following ischemia and reperfusion compared to WT mice. Treatment of cardiac myocytes with CTRP9 protein led to suppression of LPS-induced expression of proinflammatory genes, which was reversed by blockade of AMPK or ablation of adiponectin receptor I (AdipoR1). Systemic delivery of CTRP9 attenuated LPS-induced cardiac dysfunction in WT mice but not in muscle-specific transgenic mice expressing dominant-negative mutant form of AMPK or in AdipoR1-knockout mice. CTRP9 protects against acute cardiac damage in response to pathological stimuli by suppressing inflammatory reactions through AdipoR1/AMPK-dependent mechanisms. PMID:25870106

  7. Minimally invasive treatment of infected pancreatic necrosis

    Wroński, Marek; Cebulski, Włodzimierz; Słodkowski, Maciej; Krasnodębski, Ireneusz W.

    2014-01-01

    Infected pancreatic necrosis is a challenging complication that worsens prognosis in acute pancreatitis. For years, open necrosectomy has been the mainstay treatment option in infected pancreatic necrosis, although surgical debridement still results in high morbidity and mortality rates. Recently, many reports on minimally invasive treatment in infected pancreatic necrosis have been published. This paper presents a review of minimally invasive techniques and attempts to define their role in t...

  8. A supramolecular tubular nanoreactor.

    Li, Zhi-Qiang; Zhang, Ying-Ming; Chen, Yong; Liu, Yu

    2014-07-01

    The extremely strong noncovalent complexation between the rigid host of phthalocyanine-bridged β-cyclodextrins and the amphiphilic guest carboxylated porphyrin is employed to construct a hollow tubular structure as a supramolecular nanoreactor. A representative coupling reaction occurs in the hydrophobic interlayers of the tubular walls in pure water at room temperature, leading to an enhancement of ten times higher reaction rate without any adverse effect on catalytic activity and conversion. PMID:24890802

  9. Renal Contrast-Enhanced Sonography Findings in a Model of Acute Cellular Allograft Rejection.

    Grabner, A; Kentrup, D; Pawelski, H; Mühlmeister, M; Biermann, C; Edemir, B; Heitplatz, B; Van Marck, V; Bettinger, T; Pavenstädt, H; Schlatter, E; Stypmann, J; Tiemann, K; Reuter, S

    2016-05-01

    Noninvasive methods to diagnose and differentiate acute cellular rejection from acute tubular necrosis or acute calcineurin inhibitor toxicity are still missing. Because T lymphocytes play a decisive role in early states of rejection, we investigated the suitability and feasibility of antibody-mediated contrast-enhanced ultrasound by using microbubbles targeted to CD3(+) , CD4(+) , or CD8(+) T cells in different models of renal disease. In an established rat renal transplantation model, CD3-mediated ultrasound allows the detection of acute rejection as early as on postoperative day 2. Ultrasound signal intensities increased with the severity of inflammation. Further, an early response to therapy could be monitored by using contrast-enhanced sonography. Notably, acute tubular necrosis occurring after ischemia-reperfusion injury as well as acute calcineurin inhibitor toxicity could easily be differentiated. Finally, the quantified ultrasound signal correlated significantly with the number of infiltrating T cells obtained by histology and with CD3 mRNA levels, as well as with chemokine CXCL9, CXCL11, and CCL19 mRNA but not with KIM-1 mRNA expression, thereby representing the severity of graft inflammation but not the degree of kidney injury. In summary, we demonstrate that antibody-mediated contrast-enhanced ultrasound targeting T lymphocytes could be a promising tool for an easy and reproducible assessment of acute rejection after renal transplantation. PMID:26613381

  10. GATA1 mutation negative acute megakaryoblastic leukemia with acquired trisomy 21 presenting with extensive bone marrow necrosis in an adult: A case report and review of the literature

    Todd P. Williams

    2016-03-01

    Conclusions: To our knowledge, this is the first reported case of an adult with AMKL with acquired trisomy 21 in which the GATA1 mutation was investigated and the second reported case of AMKL presenting with extensive bone marrow necrosis. We will present a diagnostic approach to AMKL in which extensive bone marrow necrosis renders examination of the bone marrow difficult. Furthermore, we will examine the absence of the GATA1 mutation in a case of AMKL with trisomy 21 in an adult.

  11. Research advance in mechanism of acute retinal necrosis%急性视网膜坏死发病机制的研究进展

    刘鑫

    2014-01-01

    Acute retinal necrosis (ARN) syndrome is a kind of rare eye infectious disease caused by herpetic virus primarily.Visual prognosis of ARN patient is poor because of a high rate of complications including retinal detachment.The infection and antiinfection runs through the pathological process in ARN,such as invasion and dissemination of virus as well as the immunologic response of body.The multiple mechanisms are associated with the entry and spread of virus,including binding of viral surface protein and host receptor.Establishment of latency of the virus relies on access to related neuron,ganglion,ocular tissue which may occur after initial entry and replication.Activation of the immunologic system makes it possible to eliminate the virus and control infection.The relationship of viral invasion,dissemination and immune response with ARN pathogenesis and progression were reviewed.%急性视网膜坏死(ARN)是一种少见的病毒感染性疾病,其致病病毒主要是疱疹病毒,易引起视网膜脱离等并发症,故视力预后较差.ARN的发生和发展主要为感染与抗感染的过程,包括病毒入侵、播散、潜伏活化及机体免疫应答等方面.病毒进入宿主细胞是病毒表面蛋白与宿主细胞表面受体结合的过程,病毒感染后可潜伏于眼部相关的神经组织及眼内组织中.研究表明,病毒感染后可活化机体的免疫系统,诱发免疫细胞吞噬病毒、活化其他免疫细胞、产生细胞因子并介导炎症反应等,从而起到清除病毒、控制感染的目的,这些免疫细胞及细胞因子相互作用,共同参与ARN的发病过程.就病毒入侵、播散及机体免疫等与ARN发生和发展的关系进行综述.

  12. Clinical observation the effects of combination application of salvia miltiorrhiza and acyclovir (ACV) on acute retinal necrosis (ARN)%丹参、无环鸟苷联合治疗急性视网膜坏死

    蒋美峰; 方春庭

    2000-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对6例(8只眼)ARN患者采用丹参、无环鸟苷(acyclovir,ACV)联合治疗.结果:随访6~18个月,7只眼视力有不同程度提高,视力提高达88.8%.结论:丹参、ACV联合应用是治疗ARN的一种有效方法.

  13. 8102 and 7601 as antidotes for acute uranyl nitrate intoxication in rats

    The effect of phenolic chelating agents, 8102 and 7601, as antidotes for acute uranyl nitrate (100-500 mg/kg) intoxication was examined. The results show that after intraperitoneal injection of 50 mg of uranyl nitrate per kg, all the control rats died at 3rd and 4th days and exhibited acute renal tubular necrosis and protein casts. 8102 and 7601 could promote the animals survival and reduce the histologic lesion of kidneys in rats intoxicated with uranyl nitrate (100-350 mg/kg). 8102 is more effective than 7601

  14. Acute renal failure and severe thrombocytopenia associated with metamizole

    Maria Dolores Redondo-Pachon

    2014-01-01

    Full Text Available Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diag-nosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously.

  15. Acute renal failure and severe thrombocytopenia associated with metamizole.

    Redondo-Pachon, Maria Dolores; Enriquez, Ricardo; Sirvent, Ana Esther; Millan, Isabel; Romero, Alberto; Amorós, Francisco

    2014-01-01

    Metamizole or dipyrone is a pyrazolone derivative that belongs to the non-steroidal anti-inflammatory drugs. Its main side-effect is hematological toxicity. Thrombocytopenia due to metamizole is rare and is usually associated with the involvement of the two other blood series. Drug-induced thrombocytopenia is more frequently related to immune mechanisms, and the diagnosis is still largely made by exclusion of other causes and by correlation of timing of thrombocytopenia with the administration of drug. Metamizole may cause acute renal failure due to hemodynamic renal failure/acute tubular necrosis and/or acute tubulointerstitial nephritis. We report a case of acute renal failure and severe thrombocytopenia after metamizole. As far as we know, this combination of adverse effects from this drug has not been reported previously. PMID:24434395

  16. Fas Ligand Has a Greater Impact than TNF-α on Apoptosis and Inflammation in Ischemic Acute Kidney Injury

    Kengo Furuichi

    2012-02-01

    Full Text Available Background/Aim: Fas ligand (FasL and tumor necrosis factor (TNF-α are major pro-apoptotic molecules and also induce inflammation through cytokine and chemokine production. Although precise intracellular mechanisms of action have been reported for each molecule, the differential impact of these molecules on kidney injury in vivo still requires clarification. Methods: We explored the differential impact of FasL and TNF-α upon apoptosis and inflammation in ischemic acute kidney injury using neutralizing anti-FasL antibodies and TNF-α receptor 1 (TNFR1-deficient mice. Results: TNFR1 deficiency was associated with a lesser anti-inflammatory effect upon leukocyte infiltration and tubular necrosis than treatment with anti-FasL antibody. Furthermore, the number of TUNEL-positive cells was significantly reduced in anti-FasL antibody-treated mice, whereas it was only partially diminished in TNFR1-deficient mice. In vitro studies confirmed these findings. FasL administration induced both apoptosis and cytokine/chemokine production from cultured tubular epithelial cells. However, TNF-α had a limited effect upon tubular epithelial cells. Conclusion: In ischemic acute kidney injury, FasL has a greater impact than TNF-α on the apoptosis and inflammatory reaction through cytokine/chemokine production from tubular epithelial cells.

  17. Clinical and CT imaging features of abdominal fat necrosis

    Fat necrosis is a common pathological change at abdominal cross-sectional imaging, and it may cause abdominal pain, mimic pathological change of acute abdomen, or be asymptomatic and accompany other pathophysiologic processes. Fat necrosis is actually the result of steatosis by metabolism or mechanical injury. Common processes that are present in fat necrosis include epiploic appendagitis, infarction of the greater omentum, pancreatitis, and fat necrosis related to trauma or ischemia. As a common fat disease, fat necrosis should be known by clinicians and radiologists. Main content of this text is the clinical symptoms and CT findings of belly fat necrosis and related diseases. (authors)

  18. Reliability of Tubular Joints

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose of th...

  19. Clinical analysis on acute retinal necrosis syndrome%急性视网膜坏死综合征的临床分析

    周旻; 高巧云; 徐格致; 王文吉

    2009-01-01

    Objective To observe the clinical features of acute retinal necrosis syndrome (ARN).Methods The clinical data of 84 patients (98 eyes) with ARN were retrospective analyzed.The patietns had undergone the examinations of best visual acuity,intraocular pressure,B-scanning,slit-lamp biomicroscope,preset lens,direct and (or) indirect ophthalmolscope,and trihedral reflector;fundus fluorecein angiography had been performed on the patients with clear refracting media.Some of the patients had undergone polymerase chain reaction (PCR) to dectet the types of the causative virus.Medication,laser photocoagulation,and vitreous surgery had been performed on the patients after the diagnosis was confirmed.The visual acuity and the change of ocular fundus had been followed up;the average follow-up was 24.1 months.Results The average age of the patients at the onset was 42.8 years with the bilateraleye rate of 16.6% and retinal-detachment rate of 57.1%.There were 53.5% and 35.5% patients had the final visual acuity of>0.02 after 6 and 12 months,respectively.Better prognosis was found in patients diagnosed within 2 weeks and second involved eye.Varicella zoster virus DNA was identified in 15 patients and herpes simplex virus 1 was found in 3.Conclusions ARN is an acute disease with high incidence of retinal detachment.Serious retinal vasculopathy always happens at the late stage,and the prognosis is poor.Diagnosis in early stage is important and application of PCR will do contribution to the right diagnosis.%目的 观察急性视网膜坏死综合征(ARN)的临床特征.方法 回顾性分析84例98只眼ARN患者的临床资料.患者进行了最佳矫正视力、眼压、B型超声检查、裂隙灯生物显微镜、前置镜、直接和(或)间接检眼镜结合三面镜检查,屈光间质清楚者行荧光素眼底血管造影.部分患者行聚合酶链反应(PCR)检查鉴定致病病毒种类,明确诊断ARN后抗病毒、选择性激光和玻璃体手术治疗.并对视力

  20. Tubular Secretion in CKD.

    Suchy-Dicey, Astrid M; Laha, Thomas; Hoofnagle, Andrew; Newitt, Rick; Sirich, Tammy L; Meyer, Timothy W; Thummel, Ken E; Yanez, N David; Himmelfarb, Jonathan; Weiss, Noel S; Kestenbaum, Bryan R

    2016-07-01

    Renal function generally is assessed by measurement of GFR and urinary albumin excretion. Other intrinsic kidney functions, such as proximal tubular secretion, typically are not quantified. Tubular secretion of solutes is more efficient than glomerular filtration and a major mechanism for renal drug elimination, suggesting important clinical consequences of secretion dysfunction. Measuring tubular secretion as an independent marker of kidney function may provide insight into kidney disease etiology and improve prediction of adverse outcomes. We estimated secretion function by measuring secreted solute (hippurate, cinnamoylglycine, p-cresol sulfate, and indoxyl sulfate) clearance using liquid chromatography-tandem mass spectrometric assays of serum and timed urine samples in a prospective cohort study of 298 patients with kidney disease. We estimated GFR by mean clearance of creatinine and urea from the same samples and evaluated associations of renal secretion with participant characteristics, mortality, and CKD progression to dialysis. Tubular secretion rate modestly correlated with eGFR and associated with some participant characteristics, notably fractional excretion of electrolytes. Low clearance of hippurate or p-cresol sulfate associated with greater risk of death independent of eGFR (hazard ratio, 2.3; 95% confidence interval, 1.1 to 4.7; hazard ratio, 2.5; 95% confidence interval, 1.0 to 6.1, respectively). Hazards models also suggested an association between low cinnamoylglycine clearance and risk of dialysis, but statistical analyses did not exclude the null hypothesis. Therefore, estimates of proximal tubular secretion function correlate with glomerular filtration, but substantial variability in net secretion remains. The observed associations of net secretion with mortality and progression of CKD require confirmation. PMID:26614381

  1. Acute kidney injury associated with androgenic steroids and nutritional supplements in bodybuilders†

    Almukhtar, Safa E.; Abbas, Alaa A.; Muhealdeen, Dana N.; Hughson, Michael D.

    2015-01-01

    Four bodybuilders who injected anabolic steroids and ingested commercial protein (78–104 g/day) and creatine (15 g/day) products presented with serum creatinine levels between 229.84 and 335.92 µmol/L (2.6–3.8 mg/dL). Renal biopsies revealed acute tubular necrosis. Four weeks after discontinuing injections and supplements, serum creatinine was in the normal range and estimated glomerular filtration rate > 1.00 mL/s (60 mL/min), including two patients with biopsies showing >30% interstitial fibrosis and tubular atrophy. The findings highlight a risk for acute and potentially chronic kidney injury among young men abusing anabolic steroids and using excessive amounts of nutritional supplements. PMID:26251708

  2. 99mTc-tin colloid scintigraphy in the diagnosis of acute rejection. Reactions of renal transplants

    Quantitative measurements of 99mTc-tin colloid uptake in renal transplants permits differentiation of acute rejection from other causes of deteriorating renal function, such as acute tubular necrosis, cyclosporin A nephrotoxicity or chronic rejection. 144 99mTc-tin colloid scintigrams were performed on 71 renal transplants; the results were compared with clinical, biochemical and histological findings. Sensitivity of colloid scintigraphy is 97.4% and specificity is 80%. Compared with other isotope methods, this has the advantage that it does not depend on comparison with repeated examinations. (orig.)

  3. Tubular toxicity of proteinuria.

    Baines, Richard J; Brunskill, Nigel J

    2011-03-01

    Proteinuria is a prognostic indicator of progressive kidney disease and poor cardiovascular outcomes. Abnormally filtered bioactive macromolecules interact with proximal tubular epithelial cells (PTECs), which results in the development of proteinuric nephropathy. This condition is characterized by alterations in PTEC growth, apoptosis, gene transcription and inflammatory cytokine production as a consequence of dysregulated signaling pathways that are stimulated by proteinuric tubular fluid. The megalin-cubilin complex mediates the uptake of several proteins, including albumin, into PTECs. Megalin might also possess intrinsic signaling properties and the ability to regulate cell signaling pathways and gene transcription after processing regulated intramembrane proteolysis. Megalin could, therefore, link abnormal PTEC albumin exposure with altered growth factor receptor activation, proinflammatory and profibrotic signaling, and gene transcription. Evidence now suggests that other PTEC pathways for protein reabsorption of (patho)physiological importance might be mediated by the neonatal Fc receptor and CD36. PMID:21151210

  4. Regulation of necrotic cell death: p53, PARP1 and cyclophilin D-overlapping pathways of regulated necrosis?

    Ying, Yuan; Padanilam, Babu J

    2016-06-01

    In contrast to apoptosis and autophagy, necrotic cell death was considered to be a random, passive cell death without definable mediators. However, this dogma has been challenged by recent developments suggesting that necrotic cell death can also be a regulated process. Regulated necrosis includes multiple cell death modalities such as necroptosis, parthanatos, ferroptosis, pyroptosis, and mitochondrial permeability transition pore (MPTP)-mediated necrosis. Several distinctive executive molecules, particularly residing on the mitochondrial inner and outer membrane, amalgamating to form the MPTP have been defined. The c-subunit of the F1F0ATP synthase on the inner membrane and Bax/Bak on the outer membrane are considered to be the long sought components that form the MPTP. Opening of the MPTP results in loss of mitochondrial inner membrane potential, disruption of ATP production, increased ROS production, organelle swelling, mitochondrial dysfunction and consequent necrosis. Cyclophilin D, along with adenine nucleotide translocator and the phosphate carrier are considered to be important regulators involved in the opening of MPTP. Increased production of ROS can further trigger other necrotic pathways mediated through molecules such as PARP1, leading to irreversible cell damage. This review examines the roles of PARP1 and cyclophilin D in necrotic cell death. The hierarchical role of p53 in regulation and integration of key components of signaling pathway to elicit MPTP-mediated necrosis and ferroptosis is explored. In the context of recent insights, the indistinct role of necroptosis signaling in tubular necrosis after ischemic kidney injury is scrutinized. We conclude by discussing the participation of p53, PARP1 and cyclophilin D and their overlapping pathways to elicit MPTP-mediated necrosis and ferroptosis in acute kidney injury. PMID:27048819

  5. Acute kidney injury: A rare cause.

    Mendonca, Satish; Barki, Satish; Mishra, Mayank; Kumar, R S V; Gupta, Devika; Gupta, Pooja

    2015-09-01

    We present a young lady who consumed hair dye, which contained paraphenylene diamine (PPD), as a means of deliberate self-harm. This resulted in severe angio-neurotic edema for which she had to be ventilated, and thereafter developed rhabdomyolysis leading to acute kidney injury (AKI). The unusual aspect was that the patient continued to have flaccid quadriparesis and inability to regain kidney function. Renal biopsy performed 10 weeks after the dye consumption revealed severe acute tubular necrosis with myoglobin pigment casts. This suggests that PPD has a long-term effect leading to ongoing myoglobinuria, causing flaccid paralysis to persist and preventing the recovery of AKI. In such instances, timely treatment to prevent AKI in the form alkalinization of urine should be initiated promptly. Secondly, because PPD is a nondialyzable toxin, and its long-term effect necessitates its speedy removal, hemoperfusion might be helpful and is worth considering. PMID:26354573

  6. Acute renal failure due to rhabdomyolyisis

    Nieto-Ríos, John Fredy

    2016-04-01

    Full Text Available Acute renal failure is a frequent cause of morbidity and mortality in emergency, hospitalization and critical care services. In 15 % of cases it is due to rhabdomyolysis, in which there is breakdown of skeletal muscle with massive necrosis and leakage of muscle cell contents into the circulation. It has many different etiologies. The rhabdomyolysis-induced acute kidney injury results from the combination of several mechanisms, including tubular obstruction, vasoconstriction and oxidative stress. The most important therapeutic measures are: Aggressive repletion of fluids, forced diuresis and avoidance of exposure to nephrotoxic substances. In cases of severe uremia, metabolic acidosis, hiperkalemia or fluid overload it is necessary to start renal replacement therapy. As a rule, kidney function is completely recovered, but these patients have higher risk of future chronic kidney disease.

  7. Acute kidney injury: A rare cause

    Satish Mendonca

    2015-01-01

    Full Text Available We present a young lady who consumed hair dye, which contained paraphenylene diamine (PPD, as a means of deliberate self-harm. This resulted in severe angio-neurotic edema for which she had to be ventilated, and thereafter developed rhabdomyolysis leading to acute kidney injury (AKI. The unusual aspect was that the patient continued to have flaccid quadriparesis and inability to regain kidney function. Renal biopsy performed 10 weeks after the dye consumption revealed severe acute tubular necrosis with myoglobin pigment casts. This suggests that PPD has a long-term effect leading to ongoing myoglobinuria, causing flaccid paralysis to persist and preventing the recovery of AKI. In such instances, timely treatment to prevent AKI in the form alkalinization of urine should be initiated promptly. Secondly, because PPD is a nondialyzable toxin, and its long-term effect necessitates its speedy removal, hemoperfusion might be helpful and is worth considering

  8. Pregnancy related acute kidney injury: nondialytic management

    Kaliki Hymavathi Reddy

    2015-04-01

    Full Text Available Acute Kidney Injury (AKI is associated with increased mortality and morbidity unless timely diagnosed and promptly managed. An understanding of the renal physiologic changes that occur during pregnancy is essential for Proper evaluation, diagnosis, and management of Pregnancy Related AKI (PRAKI. In the general population, AKI can occur from prerenal, intrinsic/renal, and post-renal causes. Major causes of pre-renal azotemia include hyperemesis gravidarum and uterine hemorrhage in the setting of placental abruption. Intrinsic etiologies include infections from acute pyelonephritis and septic abortion, bilateral cortical necrosis, and acute tubular necrosis. Particular attention should be paid to specific conditions that lead to AKI during the second and third trimesters, such as preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, and TTP-HUS. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management and prevention of adverse maternal/fetal outcomes. Sometimes PRAKI may require intensive management and even dialysis adding additional economical burden to the patient. We here, with report an interesting case of PRAKI diagnosed and managed in time by simple medical measures thus delivering an effective treatment at a much lesser cost. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 486-489

  9. Metabolic effects of cachectin/tumor necrosis factor are modified by site of production. Cachectin/tumor necrosis factor-secreting tumor in skeletal muscle induces chronic cachexia, while implantation in brain induces predominantly acute anorexia.

    Tracey, K J; Morgello, S; Koplin, B; Fahey, T J; Fox, J; Aledo, A; Manogue, K R; Cerami, A

    1990-12-01

    We have developed a murine model of wasting by injecting intracerebrally cells which continuously secrete h-cachectin/TNF (CHO-TNF) to: (a) determine the effects of cachectin/TNF produced continuously in the central nervous system (CNS), and (b) compare the metabolic effects of cachectin/TNF-secreting tumor in the brain to the cachexia caused by CHO-TNF tumor in peripheral tissue (IM). Intracerebral CHO-TNF tumors produced increased serum h-cachectin/TNF levels with lethal hypophagia and weight loss (mean survival time of 11 d); these changes were not observed in association with nonsecretory control brain tumors. The metabolic consequences of intracerebral cachectin/TNF production were indistinguishable from acute, lethal starvation: whole-body lipid content was decreased significantly but protein was conserved. Although intramuscular cachectin/TNF-secreting tumors caused similar increases of serum h-cachectin/TNF levels, profound anorexia did not develop; wasting developed after a longer period of tumor burden (50 d) with classical signs of cachexia (i.e., anemia and depletion of both protein and lipid). These studies provide a reproducible animal model of site-specific cytokine production and suggest that, regardless of serum levels, cachectin/TNF produced locally in brain influences both the rate of development of wasting and its net metabolic effects. PMID:2254457

  10. C1q/Tumor Necrosis Factor-Related Protein 9 Protects against Acute Myocardial Injury through an Adiponectin Receptor I-AMPK-Dependent Mechanism

    Kambara, Takahiro; Shibata, Rei; Ohashi, Koji; Matsuo, Kazuhiro; Hiramatsu-Ito, Mizuho; Enomoto, Takashi; Yuasa, Daisuke; Ito, Masanori; Hayakawa, Satoko; Ogawa, Hayato; Aprahamian, Tamar; Walsh, Kenneth; Murohara, Toyoaki; Ouchi, Noriyuki

    2015-01-01

    Obesity is a risk factor for cardiovascular disease. C1q/tumor necrosis factor-related protein 9 (CTRP9) is an adipokine that is downregulated by obesity. We investigated the role of CTRP9 in cardiac injury with loss-of-function genetic manipulations and defined the receptor-mediated signaling pathway downstream of this adipokine. CTRP9-knockout (CTRP9-KO) mice at the age of 12 weeks were indistinguishable from wild-type (WT) mice under basal conditions. CTRP9-KO mice had exacerbated contract...

  11. Phenazopyridine associated acute interstitial nephritis and review of literature.

    Singh, Manisha; Shailesh, Fnu; Tiwari, Upasana; Sharma, Shree G; Malik, Bilal

    2014-06-01

    Phenazopyridine is a urinary analgesic; commonly seen side-effects of this drug include, orange discoloration of urine, methemoglobinemia, yellowish skin discoloration, hepatitis and acute renal failure. Various case reports with phenazopyridine associated acute renal failure secondary to acute tubular necrosis have been reported in the literature. Acute kidney injury in these patients is caused by either direct injury to renal tubular epithelial cells or secondary to pigment induced nephropathy from hemolytic anemia. Hypoxic injury from phenazopyridine-induced methemoglobinemia has been well documented. We report a case of biopsy proven acute interstitial nephritis, associated with therapeutic doses of phenazopyridine without any evidence of methemoglobinemia or other mechanism of renal injury. Clinicians should be aware of the toxicity of this commonly used drug and should look closely for signs of renal insufficiency. Identifying and stopping the offending medication stays as the first step, but recent studies indicate that early steroid administration improves renal recovery, as well as decreasing the risk of progression to chronic kidney disease with fibrosis and consequent permanent renal damage. PMID:24575779

  12. Renal papillary necrosis

    ... your provider. Alternative Names Necrosis - renal papillae; Renal medullary necrosis Images Kidney anatomy Kidney - blood and urine flow References Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, ...

  13. Classifying Virtually Special Tubular Groups

    Woodhouse, Daniel J.

    2016-01-01

    A group is tubular if it acts on a tree with $\\mathbb{Z}^2$ vertex stabilizers and $\\mathbb{Z}$ edge stabilizers. We prove that a tubular group is virtually special if and only if it acts freely on a locally finite CAT(0) cube complex. Furthermore, we prove that if a tubular group acts freely on a finite dimensional CAT(0) cube complex, then it virtually acts freely on a three dimensional CAT(0) cube complex.

  14. [Digital necrosis in hand by uncommon mechanism].

    Leroux, Maria Bibiana; Lashak, Celina; Mazzurco, Martin

    2013-07-01

    A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler, and nailfold videocapillaroscopy were performed. Digital necrosis owing to an unusual combination of ischemic mechanisms is assumed. PMID:24010508

  15. Tubular closure mechanism

    This invention relates to a closure mechanism for tubular irradiation surveillance specimen assembly holder used in nuclear reactors. The closure mechanism is composed of a latching member which includes a generally circular chamber with a plurality of elongated latches depending therefrom. The latching member circumscribes part of an actuator member which is disposed within the latching member so as to be axially movable. The axial movement of the actuator actuates positioning of the latches between positions in which the latches are locked and secured within the actuator member. Means, capable of being remotely manipulated, are provided to move the actuator in order to position the latches and load the articles within the tube

  16. Ketoconazole attenuates radiation-induction of tumor necrosis factor

    Previous work has demonstrated that inhibitors of phospholipase A2 attenuate ionizing radiation-induced arachidonic acid production, protein kinase C activation, and prevent subsequent induction of the tumor necrosis factor gene. Because arachidonic acid contributes to radiation-induced tumor necrosis factor expression, the authors analyzed the effects of agents which alter arachidonate metabolism on the regulation of this gene. Phospholipase A2 inhibitors quinicrine, bromphenyl bromide, and pentoxyfylline or the inhibitor of lipoxygenase (ketoconazole) or the inhibitor of cycloxygenase (indomethacine) were added to cell culture 1 h prior to irradiation. Radiation-induced tumor necrosis factor gene expression was attenuated by each of the phospholipase A2 inhibitors (quinicrine, bromphenylbromide, and pentoxyfylline). Furthermore, ketoconazole attenuated X ray induced tumor necrosis factor gene expression. Conversely, indomethacin enhanced tumor necrosis factor expression following irradiation. The finding that radiation-induced tumor necrosis factor gene expression was attenuated by ketoconazole suggests that the lipoxygenase pathway participates in signal transduction preceding tumor necrosis factor induction. Enhancement of tumor necrosis factor expression by indomethacin following irradiation suggests that prostaglandins produced by cyclooxygenase act as negative regulators of tumor necrosis factor expression. Inhibitors of tumor necrosis factor induction ameliorate acute and subacute sequelae of radiotherapy. The authors propose therefore, that ketoconazole may reduce acute radiation sequelae such as mucositis and esophagitis through a reduction in tumor necrosis factor induction or inhibition of phospholipase A2 in addition to its antifungal activity. 25 refs., 2 figs

  17. A bedside technique for the diagnosis of acute rejection in renal transplants using 111-In platelets

    A total of 33 patients was studied with the aim of developing a bedside method for providing early diagnosis of acute rejection using 111-In labelled platelets. Platelet deposition was detected in all patients suffering acute rejection. A significant increase in kidney/aortic arch ratio, as measured by the portable bedside system, preceded the clinical diagnosis in 70% of patients. Using this system, it appeared possible not only to diagnose acute rejection at an earlier stage but also to predict irrecoverable transplant loss even in the presence of tubular necrosis. By labelling the platelets repeatedly for at least two weeks after transplantation, the period of highest risk for acute rejection and other complications. The gamma camera should still be employed in the event of markedly increased platelet deposition to differentiate between rejection and vascular complications

  18. Acute renal failure due to phenazopyridine (Pyridium) overdose: case report and review of the literature.

    Onder, Ali Mirza; Espinoza, Veronica; Berho, Mariana E; Chandar, Jayanthi; Zilleruelo, Gaston; Abitbol, Carolyn

    2006-11-01

    Phenazopyridine (Pyridium) is a commonly used urinary tract analgesic. It has been associated with yellow skin discoloration, hemolytic anemia, methemoglobinemia, and acute renal failure, especially in patients with preexisting kidney disease. We report a 17-year-old female with vertically transmitted human immunodeficiency virus (HIV) infection, presenting with acute renal failure and methemoglobinemia following a suicidal attempt with a single 1,200 mg ingestion of Pyridium. She had no prior evidence of HIV nephropathy. The patient had a progressive nonoliguric renal failure on the 3rd day following the ingestion. She was treated with N-acetylcysteine, intravenous carnitine, and alkalinization of the urine. Her kidney biopsy revealed acute tubular necrosis with no glomerular changes. After 7 days of conservative management, she was discharged home with normal kidney function. To our knowledge, this is the second smallest amount of Pyridium overdose resulting in acute renal failure with no previous history of kidney disease. PMID:16897003

  19. Pancreatic Necrosis Associated with Preeclampsia-Eclampsia

    Parmar MS

    2004-03-01

    Full Text Available CONTEXT: Acute pancreatitis during pregnancy is rare and commonly occurs in association with biliary disease. Preeclampsia is associated with microvascular abnormalities that may involve cerebral, placental, hepatic, renal and splanchnic circulation and rarely can cause acute pancreatitis. CASE REPORT: A case of acute pancreatitis in a patient with preeclampsia-eclampsia where the diagnosis was missed initially that resulted in a protracted course and development of organized pancreatic necrosis. The pancreatic necrosis resolved with conservative management over 8 weeks. CONCLUSIONS: The development of severe hypoalbuminemia, out of proportion to proteinuria, hypocalcemia and findings of capillary leak should alert the physician to search for other inflammatory causes, including acute pancreatitis so that early and effective management be given to avoid complications.

  20. Autophagy, Innate Immunity and Tissue Repair in Acute Kidney Injury

    Duann, Pu; Lianos, Elias A.; Ma, Jianjie; Lin, Pei-Hui

    2016-01-01

    Kidney is a vital organ with high energy demands to actively maintain plasma hemodynamics, electrolytes and water homeostasis. Among the nephron segments, the renal tubular epithelium is endowed with high mitochondria density for their function in active transport. Acute kidney injury (AKI) is an important clinical syndrome and a global public health issue with high mortality rate and socioeconomic burden due to lack of effective therapy. AKI results in acute cell death and necrosis of renal tubule epithelial cells accompanied with leakage of tubular fluid and inflammation. The inflammatory immune response triggered by the tubular cell death, mitochondrial damage, associative oxidative stress, and the release of many tissue damage factors have been identified as key elements driving the pathophysiology of AKI. Autophagy, the cellular mechanism that removes damaged organelles via lysosome-mediated degradation, had been proposed to be renoprotective. An in-depth understanding of the intricate interplay between autophagy and innate immune response, and their roles in AKI pathology could lead to novel therapies in AKI. This review addresses the current pathophysiology of AKI in aspects of mitochondrial dysfunction, innate immunity, and molecular mechanisms of autophagy. Recent advances in renal tissue regeneration and potential therapeutic interventions are also discussed. PMID:27153058

  1. Autophagy, Innate Immunity and Tissue Repair in Acute Kidney Injury

    Pu Duann

    2016-05-01

    Full Text Available Kidney is a vital organ with high energy demands to actively maintain plasma hemodynamics, electrolytes and water homeostasis. Among the nephron segments, the renal tubular epithelium is endowed with high mitochondria density for their function in active transport. Acute kidney injury (AKI is an important clinical syndrome and a global public health issue with high mortality rate and socioeconomic burden due to lack of effective therapy. AKI results in acute cell death and necrosis of renal tubule epithelial cells accompanied with leakage of tubular fluid and inflammation. The inflammatory immune response triggered by the tubular cell death, mitochondrial damage, associative oxidative stress, and the release of many tissue damage factors have been identified as key elements driving the pathophysiology of AKI. Autophagy, the cellular mechanism that removes damaged organelles via lysosome-mediated degradation, had been proposed to be renoprotective. An in-depth understanding of the intricate interplay between autophagy and innate immune response, and their roles in AKI pathology could lead to novel therapies in AKI. This review addresses the current pathophysiology of AKI in aspects of mitochondrial dysfunction, innate immunity, and molecular mechanisms of autophagy. Recent advances in renal tissue regeneration and potential therapeutic interventions are also discussed.

  2. Hypoplasia of exocrine pancreas with myocardial necrosis

    Xiang Sheng Zhang; Xin Xiu Xu; Yan Zhang; Sbu Hua Wu

    2000-01-01

    AIM To study the clinical and pathological features of hypoplasia of exocrine pancreas with myocardialnecrosis.METHODS One ease of hypoplasia of exocrine pancreas with myocardial necrosis was autopsied. Theclinical signs and pathological changes were analyzed.RESULTS A 15-month-old boy with hypoplasia of exocrine pancreas was reported. The main clinicalfeatures were steatorrhea and marked underdevelopment. He died of acute heart failure afterhospitalization. Autopsy showed that there were aplasia of exocrine portion and fatty metaplasia ofpancreas, the myocardium revealed focal necrosis and sear formation.CONCLUSION Atrophy of exocrine pancreas and myocardial necrosis exist at the same time, suggestingthat there may be some relationship between them. It was likely that the damaged pancreatic tissue releasedsome active materials that may harm the myocardium or decrease pancreatic juice that results in lack ofnutrient and myocardial necrosis.

  3. Draft genome sequence of pathogenic bacteria Vibrio parahaemolyticus strain Ba94C2, associated with acute hepatopancreatic necrosis disease isolate from South America.

    Restrepo, Leda; Bayot, Bonny; Betancourt, Irma; Pinzón, Andres

    2016-09-01

    Vibrio parahaemolyticus is a pathogenic bacteria which has been associated to the early mortality syndrome (EMS) also known as hepatopancreatic necrosis disease (AHPND) causing high mortality in shrimp farms. Pathogenic strains contain two homologous genes related to insecticidal toxin genes, PirA and PirB, these toxin genes are located on a plasmid contained within the bacteria. Genomic sequences have allowed the finding of two strains with a divergent structure related to the geographic region from where they were found. The isolates from the geographic collection of Southeast Asia and Mexico show variable regions on the plasmid genome, indicating that even though they are not alike they still conserve the toxin genes. In this paper, we report for the first time, a pathogenic V. parahaemolyticus strain in shrimp from South America that showed symptoms of AHPND. The genomic analysis revealed that this strain of V. parahaemolyticus found in South America appears to be more related to the Southeast Asia as compared to the Mexican strains. This finding is of major importance for the shrimp industry, especially in regards to the urgent need for disease control strategies to avoid large EMS outbreaks and economic loss, and to determine its dispersion in South America. The whole-genome shotgun project of V. parahaemolyticus strain Ba94C2 have been deposited at DDBJ/EMBL/GenBank under the accession PRJNA335761. PMID:27570736

  4. Peripancreatic fat necrosis mimicking pancreatic cancer

    Thurnher, M.M.; Schima, W.; Turetschek, K.; Thurnher, S.A. [Vienna Univ. (Austria). Inst. fuer Radiologie; Fuegger, R. [Dept. of Surgery, University of Vienna (Austria); Oberhuber, G. [Dept. of Pathology, University of Vienna (Austria)

    2001-06-01

    A case of peripancreatic fat necrosis, after an episode of acute pancreatitis, which mimicked pancreatic cancer with lymph node metastases, is presented. We describe the imaging findings with helical CT scanning and with unenhanced and mangafodipir-enhanced MR imaging, with special emphasis on the differential diagnoses. (orig.)

  5. Peripancreatic fat necrosis mimicking pancreatic cancer

    A case of peripancreatic fat necrosis, after an episode of acute pancreatitis, which mimicked pancreatic cancer with lymph node metastases, is presented. We describe the imaging findings with helical CT scanning and with unenhanced and mangafodipir-enhanced MR imaging, with special emphasis on the differential diagnoses. (orig.)

  6. The clinical effects and the selectiori of juncture for the integrated treatment of acute retinal necrosis%急性视网膜坏死综合治疗的时机选择及疗效分析

    许立帅; 李文生; 吴荣瀚; 郑钦象; 赵立娟

    2008-01-01

    目的 探讨急性视网膜坏死(acute retinal necrosis,ARN)综合治疗时机选择及疗效.方法 ARN患者15例(18只眼),病程1周至6月,初诊视力:光感、手动和数指各2只眼,0.02~0.1者4只眼,0.12~0.4者6只眼,0.5、0.6各1只眼.所有患者确诊后均全身使用抗病毒药物阿昔洛韦或更昔洛韦,并根据病情不同采用玻璃体腔注药、激光光凝及玻璃体切割术等治疗方法 ,随访3~26月,平均(14.3±6.5)月.结果 14只眼在单纯全身抗病毒治疗后5只眼视力提高,8只眼经玻璃体腔注药后视力提高4只眼,行玻璃体切割术9只眼,术后均视网膜在位,7只眼视力提高,2只眼无提高.结论 ARN患者早期诊断是治疗的关键,早期全身抗病毒治疗是基础,玻璃体腔注药联合预防性眼内激光光凝及适时的玻璃体切割术是治疗ARN的有效手段.%Objective To discuss the clinical effects and the selection of methods and juncture for thetreatment of acute retinal necrosis (ARN).Methods Fifteen cases (18eyes)of ARN.Course of disease was 1week to 6 months.Preoperative visual acuity were light perception (LP) ,hand movement (HM)and countingfingers(CF) ,each in 2 eyes,0.02~0.1 in 4 eyes,0.12~0.4 in 6 eyes,0.5 and 0.6 in each 1 eye.All of the patientstreated with antivirus drug by intervenous drop infusion,then they were treated with Ganciclovir which wasinjected into vitreous cavity, Endophotocoagulation or vitrectomy based on those eunditions.Followed up from3 to 26 months.Results After the treatment of antivirus drug intervenous drop infusion, 5 of the 14 eyes hadelevated visual acuity.4 eyes visual acuity increased after treated with Ganciclovir which was injected intovitreous cavity in 8 eyes.All of 9 eyes obtained anatomic success after vitreetomy,and 7 eyes of 9 eyes aftersurgery had up visual acuity.Conclusions Early diagnosis is the key of the treatment of ARN, antivirus drugby intervenous drop infusion in earlier period is basal therapy

  7. The acute and sensitization effects of tumor necrosis factor-α: implications for immunotherapy as well as psychiatric and neurological conditions.

    Hayley, Shawn; Merali, Zul; Anisman, Hymie

    2002-12-01

    In addition to their role as signaling molecules of the immune system, cytokines may participate in central neurotransmission. Variations of the central and/or peripheral levels of the proinflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-β (IL-1β), impact on neuroendocrine processes as well as central neurotransmitter activity. To a considerable extent, these effects are reminiscent of those elicited by psychogenic stressors. The current review describes recent findings consistent with a role for these cytokines in the neurochemical and behavioral manifestations of clinical depression, as well as the cellular death associated with cerebral ischemia. Moreover, the increasing use of cytokines in the immunotherapeutic treatment of various autoimmune diseases (e.g. rheumatoid arthritis) and cancers prompted us to consider the potential role of central processes in subserving the mood-related side-effects elicited by these treatments. Finally, a single administration of TNF-α has been shown to elicit a time-dependent sensitization effect, wherein the behavioral and neurochemical responses elicited by later cytokine treatment are greatly enhanced. Thus, particular attention was devoted to the possibility that elevated levels of TNF-α, through either exogenous (e.g. immunotherapy) or endogenous (e.g. brain damage or stressors) means may sensitize neurotransmitter or second messenger pathways important for the pathology. Given the time-dependent nature of cytokine sensitization effects, the schedule of cytokine administration during immunotherapy, or the timing of cytokine up-regulation in response to traumatic or stressful events may favor the development of sensitized central processes, which may influence clinical outcome. PMID:26984578

  8. The tubular extraction rate (TER) of 99mTc-MAG3: A new quantitative parameter of renal function

    First clinical results have shown that among the 99mTc-complexes which were synthesized for renal function studies 99mTc-MAG3 revealed the most similar biokinetical characteristics compared with o-I-hippurate (OIH). Totally 90 simultaneous investigations of 12 kidney transplant patients were performed with 99mTc-MAG3 and 131I-OIH during the early post-transplantation period. It could be demonstrated that in case of an acute graft rejection or an acute tubular necrosis the respective renograms were qualitatively identical. Therefore, loss of information caused by using 99mTc-MAG3 instead of 131I-OIH could be excluded (BUBECK et al. 1987 b). During slope-clearance calculations after simultaneous application of both radiopharmaceuticals (n=16), volumes of distribution were revealed to be 11% for Tc-MAG3 and 16% for OIH related to the body weight. By determination of the plasma-protein binding, the glomerular filtered fraction of both substances were estimated to be 5 and 2% of the plasma activity for OIH and Tc-MAG3, respectively. Due to the negligible amount, which is eliminated by glomerular filtration, the clearance of Tc-MAG3 is a measure of its tubular extraction. It therefore may be termed as the 'Tubular Extraction Rate' (TER) of Tc-MAG3. From totally 103 simultaneous clearance-measurements with both 131I-OIH and 99mTc-MAG3 (88 were estimated on steady state conditions) the clearance-ration of Tc-MAG3/OIH was determined to be 0.67 (r=0.94). All these data yielded a 'Tubular Extraction Coefficient' (TEC) of 0.83 for OIH and 0.56 for Tc-MAG3. Derived from the known OIH-clearances in normal subjects an age-dependent formula for Tc-MAG3 was established: TER(MAG3) = 435.8-(3.03xage). Due to the hitherto known characteristics 99mTc-MAG3 can clinically be used as a substitute for radioiodinated OIH in both application areas, renal imaging and quantitative function studies of the kidneys. (orig.)

  9. Analysis of the misdiagnosis and missed diagnosis of Acute Retinal Necrosis syndrome in China%急性视网膜坏死综合征的误诊分析

    王绍伟; 张少冲; 李梅; 曾骏文

    2008-01-01

    Objective To investigate the present status in the diagnosis of Acute Retinal Necrosis syndrome in China.Methods Clinic data of 114 in-patients with ARN syndrome from January 1998 to October 2006 in Zhongshan Ophthalmic Center were retrospectively analyzed,especially with respects to the former misdiagnosis and missed diagnosis.Results Blindness occurred in 29.79% of these investigated patients.Misdiagnosis or missed diagnosis occurred in 87.14%,93.0% and 73.68% of these patients respectively in Ⅰ,Ⅱ and Ⅲ-Ⅳ stage.The average duration between ARN onset and the time to make correct diagnosis was 46.16 days.Conclusions The misdiagnosis or missed diagnosis of ARN syndrome is very common in China.It is absolutely necessary to improve earlier diagnosis rate and recover some useful vision.%目的 分析急性视网膜坏死综合征(Acute retinal necrosis syndrome,ARN)临床诊断中存在的问题.方法 收集1998年1月至2006年10月中山眼科中心确诊住院治疗、以往资料完整的114例ARN病人的临床资料,重点分析初诊时误诊、漏诊原因,发病至确诊时间、确诊前诊断、治疗等情况.结果 114例(141眼)ARN病人的盲目率(42/141)为29.79%;初诊时,Ⅰ、Ⅱ、Ⅲ-Ⅳ期误诊率分别为61/70(87.14%)、23/25(93.0%)、13/19(73.68%),发病至确诊时间最短为3 d,最长为420 d,平均为46.16 d.结论 ARN综合征漏诊、误诊率较高,急需提高ARN的早期确诊率使病人保存部分有用视力.

  10. Effects of Schizolobium parahyba extract on experimental Bothrops venom-induced acute kidney injury.

    Monique Silva Martines

    Full Text Available BACKGROUND: Venom-induced acute kidney injury (AKI is a frequent complication of Bothrops snakebite with relevant morbidity and mortality. The aim of this study was to assess the effects of Schizolobium parahyba (SP extract, a natural medicine with presumed anti-Bothrops venom effects, in an experimental model of Bothrops jararaca venom (BV-induced AKI. METHODOLOGY: Groups of 8 to 10 rats received infusions of 0.9% saline (control, C, SP 2 mg/kg, BV 0.25 mg/kg and BV immediately followed by SP (treatment, T in the doses already described. After the respective infusions, animals were assessed for their glomerular filtration rate (GFR, inulin clearance, renal blood flow (RBF, Doppler, blood pressure (BP, intra-arterial transducer, renal vascular resistance (RVR, urinary osmolality (UO, freezing point, urinary neutrophil gelatinase-associated lipocalin (NGAL, enzyme-linked immunosorbent assay [ELISA], lactate dehydrogenase (LDH, kinetic method, hematocrit (Hct, microhematocrit, fibrinogen (Fi, Klauss modified and blinded renal histology (acute tubular necrosis score. PRINCIPAL FINDINGS: BV caused significant decreases in GFR, RBF, UO, HcT and Fi; significant increases in RVR, NGAL and LDH; and acute tubular necrosis. SP did not prevent these changes; instead, it caused a significant decrease in GFR when used alone. CONCLUSION: SP administered simultaneously with BV, in an approximate 10∶1 concentration, did not prevent BV-induced AKI, hemolysis and fibrinogen consumption. SP used alone caused a decrease in GFR.

  11. Effects of increased human tumor necrosis factor-like molecule 1A expression in peripheral blood of children with acute Guillain-Barre syndrome on interferon-gamma secretion

    Libin Yang; Shulei Li; Yan Tana; Shufen Xu; Xiumei Duan; Yanqiu Fang; Lihua Liu; Yuanyuan Che; Lei Liu

    2009-01-01

    BACKGROUND:Human tumor necrosis factor-like molecule 1A (hTL1A) is a strong T helper cell type 1 (Th1) co-stimulator.Guillain-Barre syndrome (GBS) is an autoimmune disorder of the nervous system,which is mediated by Th1 cells.OBJECTIVE:To determine hTL1A expression in peripheral blood T lymphocytes of acute GBS children and the effects of hTL1A on secretion of interferon-γ.DESIGN,TIME AND SETTING:A randomized,controlled,neuroimmunological in vitro study was performed at the Central Laboratory of First Hospital of Jilin University,China from November 2005 to November 2007.MATERIALS:Venous blood samples were obtained from 6 healthy donors,aged 6-12 years (all routine blood examination items were normal),and 6 additional children with acute GBS,aged 6-12years.The GBS children fell itl within 1 week and were not treated with hormones or immunoglobulin.Purified recombinant human soluble tumor necrosis factor-like molecule 1A (rhsTL1A,1 mg/mL,relative molecular mass 22 000,6×His tag,soluble form) was supplied by the Central Laboratory of First Hospital of Jilin University,China.METHODS:Peripheral blood mononuclear cells were isolated from healthy donors using the standard Ficoll gradient centrifugation and were incubated in 96-well culture plates.The cells were assigned to the following groups:control (2 μg/mL phytohemagglutinin),2 μg/mL phytohemagglutinin+25,100 and 400 ng/mL rhsTL1A.T cell proliferation was quantified using the tritiated thymidine (~3H-TdR) method.Serum interferon-γ levels in acute GBS children were detected by enzyme-linked immunosorbent assay (ELISA).The ratio of hTL1A-positive T cells to CD3-positive T cells in peripheral blood of acute GBS children was determined using flow cytometry.Following in vitro pre-activation of peripheral blood mononuclear cells by 2 μg/mL phytohemagglutinin,the peripheral blood mononuclear cells were treated with 400 ng/mL exogenous rhsTL1A.Finally,peripheral blood mononuclear cell-secreted interferon-γ levels were

  12. Protective effect of nitric oxide in aristolochic acid-induced toxic acute kidney injury: an old friend with new assets.

    Declèves, Anne-Émilie; Jadot, Inès; Colombaro, Vanessa; Martin, Blanche; Voisin, Virginie; Nortier, Joëlle; Caron, Nathalie

    2016-01-01

    Aristolochic acid (AA) nephropathy (AAN), a progressive tubulointerstitial injury of toxic origin, is characterized by early and transient acute tubular necrosis. This process has been demonstrated to be associated with reduced nitric oxide (NO) production, which can disrupt the regulation of renal function. In this study, we tested the hypothesis that L-arginine (L-Arg) supplementation could restore renal function and reduce renal injury after AA intoxication. C57BL/6 J male mice were randomly subjected to daily i.p. injection of either sterile saline solution or AA (2.5 mg kg(-1)) for 4 days. To determine whether AA-induced renal injuries were linked to reduced NO production, L-Arg, a substrate for NO synthase, was supplemented (5%) in drinking water. Mice intoxicated with AA exhibited features of rapid-onset acute kidney injury, including polyuria, significantly increased plasma creatinine concentrations, proteinuria and fractional excretion of sodium (P < 0.05), along with severe proximal tubular cell injury and increased NADPH oxidase 2 (Nox2)-derived oxidative stress (P < 0.05). This was associated with a significant reduction in NO bioavailability. L-Arg supplementation in AA-treated mice significantly increased NO bioavailability, which in turn improved renal function (creatininaemia, polyuria, proteinuria, fractional excreted sodium and N-acetyl-β-D-glucosaminidase enzymuria) and renal structure (tubular necrosis and tubular cell apoptosis). These changes were associated with significant reductions in Nox2 expression and in production of reactive oxygen species and with an increase in antioxidant concentrations. Our results demonstrate that preservation of NO bioavailability leads to renal protection in AA-induced acute kidney injury by reducing oxidative stress and maintaining renal function. PMID:26442795

  13. An Unusual Complication of Foam Sclerotherapy: Acute Kidney Injury

    Müge EREK

    2014-09-01

    Full Text Available Sclerotherapy, in which an irritant solution is administered, is a method used to treat venous failure that results in complete venous destruction due to endothelial reaction and fibrosis. In recent years, foam sclerotherapy, in which a sclerosing agent (aethyl sclerole and air are mixed until they turn into foam and the resultant mixture is injected into noticeable veins directly and into other veins under ultrasonography in doses depending on the diameters of the varices, has been introduced. The drugs or gases used in foam sclerotherapy can cause local or systemic complications. Foam affects vessel endothelial cells and causes severe spasm in the vessel. It has been reported that endothelin-1 levels are high after foam sclerotherapy compared to the initial levels and that neurological complications vary with the endothelin levels. In this report, we present a case of acute kidney injury due to acute tubular necrosis probably caused by endothelin release following foam sclerotherapy.

  14. The pathology of acute Nolletia gariepina poisoning of cattle

    E. C. Du Plessis

    2011-04-01

    Full Text Available Toxicity in cattle by the shrub Nolletia gariepina was induced experimentally by intraruminal administration of 3 g/kg dried, milled plant material as a single dose. The animals had to be starved for 24 hours before dosing, as dosing on a full rumen did not induce any signs of toxicity during 5 days of observation and clinical pathology monitoring. Clinical signs were not specific and varied according to the duration (acute versus subacute of the toxicological process. Clinical pathological parameters indicated renal and to a lesser extent hepatic damage, with raised serum concentrations of urea, creatinine, aspartate aminotransferase (AST and gamma glutamyl transferase (GGT. Increased urinary sodium and potassium concentration and GGT activity, as well as proteinuria, were evident. Histological and electron microscopic examinations revealed acute renal tubular epithelial cell degeneration and necrosis, especially of the proximal convoluted tubules. Mild hepatocellular degeneration was also noticeable.

  15. General Construction of Tubular Geometry

    Mukhopadhyay, Partha

    2016-01-01

    We consider the problem of locally describing tubular geometry around a submanifold embedded in a (pseudo)Riemannian manifold in its general form. Given the geometry of ambient space in an arbitrary coordinate system and equations determining the submanifold in the same system, we compute the tubular expansion coefficients in terms of this {\\it a priori data}. This is done by using an indirect method that crucially applies the tubular expansion theorem for vielbein previously derived. With an explicit construction involving the relevant coordinate and non-coordinate frames we verify consistency of the whole method up to quadratic order in vielbein expansion. Furthermore, we perform certain (long and tedious) higher order computation which verifies the first non-trivial spin connection term in the expansion for the first time. Earlier a similar method was used to compute tubular geometry in loop space. We explain this work in the light of our general construction.

  16. Abrasion resistant tubular member

    A surface of a tubular member made of an austenite stainless steel having a molybdenum content of from 2 to 3% is subjected to a low temperature ionization nitriding treatment in a gas atmosphere of N2: from 5 to 15% by volume, H2: from 95 to 85% by volume, at a temperature of from 400 to 470degC to form a nitride layer. Since the low temperature ion nitriding treatment is thus applied, generation of ε phase which lowers corrosion resistance can be suppressed. That is, the hardened layer (nitride layer) is provided with abrasion resistance, while the inside can keep the inherent characteristic of the austenite stainless steel having high toughness. In addition, this can avoid the tendency of lowering corrosion resistance due to the formation of a ε phase caused by exposure to high temperature for a long time in order to increase the thickness of the nitrided layer. When the thickness of the tube is 1.3mm, the less than 130μm is enough for the nitride layer. Abrasion resistance can be improved by thus applying ion nitriding treatment to the austenite stainless steel containing molybdenum under controlled temperature and atmosphere. (N.H.)

  17. A 5-Case report of treating acute retinal necrosis syndrome with operation%手术治疗急性视网膜坏死5例报告

    李达璟; 张皙; 李佩娟; 蔡文泉

    2004-01-01

    目的通过5例病例总结,探讨手术治疗急性视网膜坏死综合征(acute retinal necrosis,ARN)的临床效果.方法应用巩膜环扎联合玻璃体切除加气/硅油交换手术治疗ARN. 结果 5例患者(5只眼)均视网膜复位,裂孔封闭,视力提高至0.1~0.15.结论对急性视网膜坏死综合征(ARN)后期致视网膜裂孔、脱离者,应用巩膜环扎联合玻璃体切除加气/硅油交换手术治疗,可以解除玻璃体对视网膜的牵引,封闭视网膜裂孔,使脱离的视网膜复位,最大限度地挽救患眼视功能.

  18. Fat Necrosis and Oil Cysts

    ... Granular cell tumors Fat necrosis and oil cysts Mastitis Duct ectasia Other non-cancerous breast conditions Summary ... References Previous Topic Granular cell tumors Next Topic Mastitis Fat necrosis and oil cysts Fat necrosis happens ...

  19. Glutaric Aciduria type I and acute renal failure — Coincidence or causality?

    Ben Pode-Shakked

    2014-01-01

    Full Text Available Glutaric Aciduria type I (GA-I is a rare organic acidemia, caused by mutations in the GCDH gene, and characterized by encephalopathic crises with neurological sequelae. We report herein a patient with GA-I who presented with severe acute renal failure requiring dialysis, following an acute diarrheal illness. Histopathological evaluation demonstrated acute tubular necrosis, and molecular diagnosis revealed the patient to be homozygous for a previously unreported mutation, p.E64D. As renal impairment is not part of the clinical spectrum typical to GA-I, possible associations of renal failure and the underlying inborn error of metabolism are discussed, including recent advancements made in the understanding of the renal transport of glutaric acid and its derivatives during metabolic disturbance in GA-I.

  20. Acute bile nephropathy secondary to anabolic steroids.

    Alkhunaizi, Ahmed M; ElTigani, Mohamed A; Rabah, Rola S; Nasr, Samih H

    2016-02-01

    Renal dysfunction in cholestatic liver disease is multifactorial. Acute kidney injury may develop secondary to renal vasoconstriction in the setting of peripheral vasodilation and relative hypovolemia, tubular obstruction by bile casts, and direct tubular toxicity from bile. Anabolic steroids are frequently used by athletes to boost endurance and increase muscle mass. These agents are a recently recognized cause of hepatotoxicity and jaundice and may lead to acute kidney injury. To increase awareness about this growing problem and to characterize the pathology of acute kidney injury in this setting, we report on a young male who developed acute kidney injury in the setting of severe cholestatic jaundice related to ingestion of anabolic steroids used for bodybuilding. Kidney biopsy showed bile casts within distal tubular lumina, filamentous bile inclusions within tubular cells, and signs of acute tubular injury. This report supports the recently re-emerged concept of bile nephropathy cholemic nephrosis. PMID:26587777

  1. Hypokalemic quadriparesis and rhabdomyolysis as a rare presentation of distal renal tubular acidosis.

    Ahmad Bhat, Manzoor; Ahmad Laway, Bashir; Mustafa, Farhat; Shafi Kuchay, Mohammad; Mubarik, Idrees; Ahmad Palla, Nazir

    2014-01-01

    Distal renal tubular acidosis is a syndrome of abnormal urine acidification and is characterized by hyperchloremic metabolic acidosis, hypokalemia, hypercalciurea, nephrocalcinosis and nephrolithiasis. Despite the presence of persistent hypokalemia, acute muscular paralysis is rarely encountered in males. Here, we will report an eighteen year old male patient who presented with flaccid quadriparesis and was subsequently found to have rhabdomyolysis, severe short stature, skeletal deformities and primary distal renal tubular acidosis. PMID:25250276

  2. Comparison of two different drug therapies for acute retinal necrosis syndrome%对比两种给药方案治疗急性视网膜坏死综合征患者的效果

    袁菁; 胡维琨

    2016-01-01

    AIM: To investigate clinical efficacy of two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) for acute retinal necrosis syndrome. METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared. RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0. 05). There was no significant difference on the pre - treatment visual acuity between the two groups (P>0. 05). After different treatments, the visual acuity in group B was ≥0. 5 in 12 eyes, 0. 1≤and CONCLUSION: Two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin ) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.%目的:探讨阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案治疗急性视网膜坏死综合征的临床疗效。  方法:采用随机数字表法将我院急性视网膜坏死综合征患者30例40眼分为 A、B 两组,其中 A 组采用阿昔洛韦+醋酸泼尼松片的给药方案,B 组采用丙氧鸟苷+醋酸泼尼松片+阿司匹林的给药方案,观察并比较两组患者治疗后的临床效果。  结果:经过治疗后,B 组总有效率(90%)明显高于 A 组(70%),两种给药方案均有效,差异无统计学意义( P>0.05);两组患者在治疗前视力情况差异无统计学意义(P>0.05);经不同给药方案治疗后,A 组视力≥0.5者9眼,视力0.1~  结论:阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+

  3. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris.

    Ryan, Margaret; Lazar, Ira; Nadasdy, Gyongyi M; Nadasdy, Tibor; Satoskar, Anjali A

    2015-03-01

    Acute tubular necrosis (ATN), especially from toxic injury is frequently accompanied by tubular casts and crystals. Myeloma casts, myoglobin, red blood cell and granular casts are well described. However, bile casts in tubules are rarely seen. We describe a case of Tribulus terrestris toxicity in a young healthy male, presenting with severe hyperbilirubinemia followed by acute renal failure and bile containing casts in the tubules. Tribulus terrestris is an herb often used by athletes as a nutritional supplement for performance enhancement. Although it is thought to be relatively safe, serious side effects have been reported before. Our aim is to increase awareness of the potential toxicities of performance enhancing herbal medications. These are often sold over-the-counter and therefore casually used, especially by young healthy individuals. Beneficial effects are controversial. Under-reporting by patients and infrequent documentation by health-care providers can delay diagnosis. We elaborately describe the kidney biopsy findings in Tribulus terrestris toxicity, and also provide a concise overview of the spectrum of tubular casts and their staining patterns, found in various kidney diseases. PMID:25295577

  4. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of urinary protein in acute kidney injury.

    Suhail, Sufi M; Woo, K T; Tan, H K; Wong, K S

    2011-07-01

    Recent experimental and clinical studies have shown the importance of urinary proteomics in acute kidney injury (AKI). We analyzed the protein in urine of patients with clinical AKI using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) for its diagnostic value, and followed them up for 40 months to evaluate prognosis. Urine from 31 consecutive cases of AKI was analyzed with SDS-PAGE to determine the low, middle and high molecular weight proteins. Fractional excretion of sodium (FENa) was estimated from serum and urine creatinine and sodium (Na). The cases were followed-up for 40 months from the end of the recruitment of study cases. Glomerular protein was higher in the hematuria group when compared with the non-hematuria group (P <0.04) and in the AKI group than in the acute on chronic renal failure (AKI-on-CRF) group (P <0.002). Tubular protein was higher in the AKI-on-CRF group (P <0.003) than in the AKI group. Tubular protein correlated with FENa in groups with diabetes mellitus (DM), AKI-on-CRF, and without hematuria (P <0.03, P <0.02 and P <0.004, respectively). Pattern of protein did not differ between groups with and without DM and clinical acute tubular necrosis (ATN). At the end of 40 months follow-up, category with predominantly glomerular protein progressed to chronic renal failure (CRF) or end-stage renal failure in higher proportion (P <0.05). In clinical AKI, we observed that glomerular protein dominated in cases with glomerular insult, as indicated by hematuria. Tubular protein was common in the study cases with CRF, DM and cases without hematuria. This indicates tubulo-interstitial injury for AKI in these cases. Patients with predominantly glomerular protein had an adverse outcome. PMID:21743220

  5. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE of urinary protein in acute kidney injury

    Sufi M Suhail

    2011-01-01

    Full Text Available Recent experimental and clinical studies have shown the importance of urinary proteomics in acute kidney injury (AKI. We analyzed the protein in urine of patients with clinical AKI using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE for its diagnostic value, and followed them up for 40 months to evaluate prognosis. Urine from 31 consecutive cases of AKI was analyzed with SDS-PAGE to determine the low, middle and high molecular weight proteins. Fractional excretion of sodium (FENa was estimated from serum and urine creatinine and sodium (Na. The cases were followed-up for 40 months from the end of the recruitment of study cases. Glomerular protein was higher in the hematuria group when compared with the non-hematuria group (P <0.04 and in the AKI group than in the acute on chronic renal failure (AKI-on-CRF group (P <0.002. Tubular protein was higher in the AKI-on-CRF group (P <0.003 than in the AKI group. Tubular protein correlated with FENa in groups with diabetes mellitus (DM, AKI-on-CRF, and without hematuria (P <0.03, P <0.02 and P <0.004, respectively. Pattern of protein did not differ between groups with and without DM and clinical acute tubular necrosis (ATN. At the end of 40 months follow-up, category with predominantly glomerular protein progressed to chronic renal failure (CRF or end-stage renal failure in higher proportion (P <0.05. In clinical AKI, we observed that glomerular protein dominated in cases with glomerular insult, as indicated by hematuria. Tubular protein was common in the study cases with CRF, DM and cases without hematuria. This indicates tubulo-interstitial injury for AKI in these cases. Patients with predominantly glomerular protein had an adverse outcome.

  6. Renal tubular acidosis and nerve deafness.

    Dunger, D B; Brenton, D. P.; Cain, A R

    1980-01-01

    Two brothers are described with renal tubular acidosis and nerve deafness: the elder also had rickets and hypokalaemia. The parents were unaffected. Studies of urinary acidification and bicarbonate excretion were consistent with a distal tubular abnormality. This report strengthens the view previously proposed in similar cases that nerve deafness and renal tubular acidosis constitute a genetic entity. Examination for nerve deafness is indicated in any child with renal tubular acidosis.

  7. Hemodynamic and tubular changes induced by contrast media.

    Caiazza, Antonella; Russo, Luigi; Sabbatini, Massimo; Russo, Domenico

    2014-01-01

    The incidence of acute kidney injury induced by contrast media (CI-AKI) is the third cause of AKI in hospitalized patients. Contrast media cause relevant alterations both in renal hemodynamics and in renal tubular cell function that lead to CI-AKI. The vasoconstriction of intrarenal vasculature is the main hemodynamic change induced by contrast media; the vasoconstriction is accompanied by a cascade of events leading to ischemia and reduction of glomerular filtration rate. Cytotoxicity of contrast media causes apoptosis of tubular cells with consequent formation of casts and worsening of ischemia. There is an interplay between the negative effects of contrast media on renal hemodynamics and on tubular cell function that leads to activation of renin-angiotensin system and increased production of reactive oxygen species (ROS) within the kidney. Production of ROS intensifies cellular hypoxia through endothelial dysfunction and alteration of mechanisms regulating tubular cells transport. The physiochemical characteristics of contrast media play a critical role in the incidence of CI-AKI. Guidelines suggest the use of either isoosmolar or low-osmolar contrast media rather than high-osmolar contrast media particularly in patients at increased risk of CI-AKI. Older age, presence of atherosclerosis, congestive heart failure, chronic renal disease, nephrotoxic drugs, and diuretics may multiply the risk of CI-AKI. PMID:24678510

  8. 病毒性脑炎合并急性视网膜坏死10例的临床特征%The clinical features of 10 cases of acute retinal necrosis complicated by viral encephalitis

    孙冉; 彭晓燕; 侯明勃

    2015-01-01

    Objective To investigate the clinical features of acute retinal necrosis (ARN) complicated by viral encephalitis.Methods Ten cases of ARN complicated by viral encephalitis were treated in the Department of Ophthalmology,Beijing Tongren Hospital from November 2013 to August 2014.Clinical manifestation,especially the fundus characteristics,was summarized.Results In thel0 patients (19 eyes ;6 men and 4 women)with an age of (40.1 ± 13.44)years,1 patients had unilateral ARN,and 9 patients had bilateral ARN.The visual acuity was no light perception in 9 eyes,light perception to hand motion in 7 eyes,0.05 in 1 eye,0.2 in 1 eye,and 0.3 in 1 eye.Seven cases suffered ARN during the onset of viral encephalitis,and other cases suffered ARN at 2 to 3 months after the recovery of viral encephalitis.Seventeen eyes had mild to moderate vitreous opacity,and 2 eye shad severe vitreous opacity.Sixteen eyes had focal (1 or 2quadrants)retinal necrosis,and 2 eyes had massive(> 2 quadrants) retinal necrosis.Occlusive vasculitis obviously occurred in 18 eyes.Sixteen eyeshad retinal detachment.All affected eves had early optic nerve atrophy.Conclusion ARN can occur during the onset of viral encephalitis or after the recovery of viral encephalitis.The clinical features of ARN complicated by viral encephalitis may be generally mild to moderate vitreous opacity,small range retinal necrosis foci,early and severe optic atrophy,and occlusive retinal vasculitis.%目的 探讨病毒性脑炎合并急性视网膜坏死(ARN)的临床特征.方法 回顾2013年11月至2014年8月北京同仁眼科中心收治的10例病毒性脑炎合并ARN的患者,其中男性6例,女性4例,年龄(40±13)岁.总结其临床发病、眼底表现特点.结果 10例患者中单眼发病1例,双眼发病9例,共19只眼患病.视力检查:9只眼无光感,7只眼光感至手动,1只眼0.05,1只眼0.2,1只眼0.3;7例病毒性脑炎发病期间并发ARN,3例病毒性脑炎后2~3个月ARN发病;眼底表现:玻璃

  9. Acute renal failure in pregnancy, its causes and outcome, 1 year study at sheikh zayed hospital lahore

    Objective: The objective of this study was to deter-mine the frequency, etiology, clinical course and out-come of pregnancy related acute renal failure. Type of Study: Observational and prospective hospital based study. Place of Study: Department of Nephrology, Shaikh Zayed Hospital Lahore. Duration of Study: One year from November 2010 - October 2011. Patients and Methods: Total 210 patients of Acute renal failure (ARF) were admitted with 92 (44%) males and 118 (56%) females during this period of which 40 (19%) females were pregnancy related ARF that were included in this study. A Predesigned proforma was used. The clinical history and physical examination was carried out. Relevant laboratory tests were performed. Renal biopsy was done in few cases. The final outcome was recorded. Twenty four (24) patients were from rural community of Punjab province and remaining (16) were from urban areas. Results: Pregnancy related ARF occurred in forty (40) patients. Twenty two (55%) were multipara and 18 (45%) were primigravida. Their age was between 29 +- 4.5 years. Majority 32 (80%) patients had not received any antenatal care as compared to 8 (20%) patients who had adequate antenatal care. Twelve cases (15%) presented in their first and second trimester of pregnancy while 28 (70%) patients developed ARF in their third trimester or the puerperium. Twenty four (60%) patients were anuric. Antepartum haemorrhage (APH) in 2 (5%) cases, postpartum haemorrhage (PPH) in 6 (15%) cases, Septic abortion in 6 (15%), puerperal sepsis in 8 (20%) and DIC in 4 (10%) cases, Intra-uterine fetal death (IUD) in 12 (30%) and HELLPS in 2 (5%) cases. Sepsis was the commonest cause of ARF. Thirty four (85%) patients received hemodialysis and 6 (15%) did not require any dialysis. Commonest clinical diagnosis was acute tubular necrosis (ATN). Complete recovery was seen in 8 (20%) cases .Acute renal cortical necrosis was seen in 14 (35%) cases and 18 (45%) patients had patchy cortical necrosis

  10. Bidirectional signalling between EphA2 and ephrinA1 increases tubular cell attachment, laminin secretion and modulates erythropoietin expression after renal hypoxic injury.

    Rodriguez, Stéphane; Rudloff, Stefan; Koenig, Katrin Franziska; Karthik, Swapna; Hoogewijs, David; Huynh-Do, Uyen

    2016-08-01

    Acute kidney injury (AKI) is common in hospitalized patients and has a poor prognosis, the severity of AKI being linked to progression to chronic kidney disease. This stresses the need to search for protective mechanisms during the acute phase. We investigated kidney repair after hypoxic injury using a rat model of renal artery branch ligation, which led to an oxygen gradient vertical to the corticomedullary axis. Three distinct zones were observed: tubular necrosis, infarction border zone and preserved normal tissue. EphA2 is a receptor tyrosine kinase with pivotal roles in cell architecture, migration and survival, upon juxtacrine contact with its membrane-bound ligand EphrinA1. Following hypoxia, EphA2 was up-regulated in cortical and medullary tubular cells, while EphrinA1 was up-regulated in interstitial cells adjacent to peritubular capillaries. Moreover, erythropoietin (EPO) messenger RNA (mRNA) was strongly expressed in the border zone of infarcted kidney within the first 6 h. To gain more insight into the biological impact of EphA2 and EphrinA1 up-regulation, we activated the signalling pathways in vitro using recombinant EphrinA1/Fc or EphA2/Fc proteins. Stimulation of EphA2 forward signalling in the proximal tubular cell line HK2 increased cell attachment and laminin secretion at the baso-lateral side. Conversely, activation of reverse signalling through EphrinA1 expressed by Hep3B cells promoted EPO production at both the transcriptional and protein level. Strikingly, in co-culture experiments, juxtacrine contact between EphA2 expressing MDCK and EphrinA1 expressing Hep3B was sufficient to induce a significant up-regulation of EPO mRNA production in the latter cells, even in the absence of hypoxic conditions. The synergistic effects of EphA2 and hypoxia led to a 15-20-fold increase of EPO expression. Collectively, our results suggest an important role of EphA2/EphrinA1 signalling in kidney repair after hypoxic injury through stimulation of (i) tubular

  11. Robotic cystogastrostomy and debridement of walled-off pancreatic necrosis.

    Nassour, Ibrahim; Ramzan, Zeeshan; Kukreja, Sachin

    2016-09-01

    Walled-off pancreatic necrosis is a known complication of acute pancreatitis and requires intervention if symptomatic or complicated. Laparoscopic cystogastrostomy as a minimally invasive surgical intervention has been well-described in surgical literature but data on a robotic approach is limited. Here we report a case of robotic cystogastrostomy and debridement of walled-off pancreatic necrosis in a patient with a history of severe biliary pancreatitis. PMID:27039191

  12. Gastric volvulus with partial and complete gastric necrosis

    Ram Mohan Shukla

    2014-01-01

    Full Text Available Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  13. Gastric volvulus with partial and complete gastric necrosis.

    Shukla, Ram Mohan; Mandal, Kartik Chandra; Maitra, Sujay; Ray, Amit; Sarkar, Ruchirendu; Mukhopadhyay, Biswanath; Bhattacharya, Malay

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature. PMID:24604987

  14. Gastric volvulus with partial and complete gastric necrosis

    Ram Mohan Shukla; Kartik Chandra Mandal; Sujay Maitra; Amit Ray; Ruchirendu Sarkar; Biswanath Mukhopadhyay; Malay Bhattacharya

    2014-01-01

    Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

  15. Infectious Haematopoietic Necrosis

    Institute, Marine

    2011-01-01

    This leaflet gives information on infectious haematopoietic necrosis. This disease is caused by a single stranded RNA virus of the family Rhabdoviridae, genus Novirhabdoviridae. IHN is listed as a non-exotic disease under EU Directive 2006/88/EC, and is notifiable in Ireland, according to S.I. No. 261 of 2008.

  16. Analysis of causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome%急性视网膜坏死综合征的误诊原因分析及治疗效果

    闫焱; 沈玺; 张琼; 李娜

    2011-01-01

    目的 探讨急性视网膜坏死综合征(ARN)的误诊原因及治疗效果.方法 回顾性分析7例(7眼)ARN患者的误诊原因及治疗效果.结果 7例患者中3例误诊为虹膜睫状体炎,2例误诊为全葡萄膜炎,1例误诊为青光眼-睫状体炎综合征,1例误诊为视网膜出血.确诊后,7眼中4眼给予抗病毒药物及玻璃体手术治疗,3眼予抗病毒药物及眼底激光治疗.随访3~39个月,6例治疗后视力比治疗前有明显改善,治疗后最佳矫正视力从眼前指数至0.6不等.2例玻璃体手术患者取硅油后,均出现低眼压,视力下降.结论 ARN的早期诊断至关重要,如误诊会失去最佳治疗机会.早期、足量药物治疗联合眼内激光,必要时行玻璃体手术,可挽救ARN患者的残存视力.%Objective To investigate the causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome (ARN). Methods The causes of misdiagnosis and treatment effects of 7 patients (7 eyes) with ARN were retrospectively analysed. Results Three patients were misdiagnosed as iridocyclitis, 2 as panuveitis, 1 as Posner-Schlossman Syndrome and 1 as retinal hemorrhage. After the diagnosis was confirmed, antiviral medications and vitrectomy were administered to 4 patients, and antiviral medications and prophylactic laser were performed in the other 3 cases. During the follow up, visual acuity significantly improved in 6 patients. Ocular hypotony and decreased visual acuity took place in 2 patients after oil removal in vitrectomy. Conclusion The early diagnosis of ARN is of great significance, and best treatment opportunity may be missed due to misdiagnosis. As soon as the diagnosis is confirmed, the early management with sufficient medications and prophylactic laser, with vitrectomy if necessary, may preserve the residual visual acuity of patients with ARN.

  17. Miopatias associadas a agregados tubulares

    Mary Souza Carvalho

    1993-09-01

    Full Text Available Os autores relatam a caso de paciente de 58 anos de idade do sexo masculino, com quadro de características miastênicas tanto clínica como eletromiograficamente, no qual a biópsia muscular com histoquímica e microscopia eletrônica permitiu fazer o diagnostico de miopatia associada a agregados tubulares. É chamada a atenção para o fato de que as alterações anátomo-patológicas encontradas podem estar presentes em um grupo heterogêneo de pacientes com grande variedade de sintomas, não havendo portanto motivo para considerar-se a existência de uma miopatia com agregados tubulares, já que os achados anátomo-patológicos são inespecíficos e não configuram moléstia específica.

  18. Tubular crystals of acetylcholine receptor

    1984-01-01

    Well-ordered tubular crystals of acetylcholine receptor were obtained from suspensions of Torpedo marmorata receptor-rich vesicles. They are composed of pairs of oppositely oriented molecules arranged on the surface lattice with the symmetry of the plane group p2 (average unit cell dimensions: a = 90 A, b = 162 A, gamma = 117 degrees). The receptor in this lattice has an asymmetric distribution of mass around its perimeter, yet a regular pentagonal shape; thus its five transmembrane subunits ...

  19. Modified tubularized incised plate urethroplasty

    Shivaji Mane; Jamir Arlikar; Nitin Dhende

    2013-01-01

    Aim: To share our experience of doing tubularized incised plate urethroplasty with modifications. Materials and Methods: This is a single surgeon personal series from 2004 to 2009. One hundred patients of distal hypospadias were subjected for Snodgrass urethroplasty with preputioplasty. The age range was 1 to 5 year with mean age of 2.7 years. Selection criteria were good urethral plate, without chordee and torsion needing complete degloving. Main technical modification from original Snodgras...

  20. Paraphenylene diamine ingestion: An uncommon cause of acute renal failure

    Ram R

    2007-01-01

    Full Text Available Paraphenylene diamine (PPD is a major component of hair dyes. The aim is to study the renal manifestations and outcome of PPD consumption. During a four-year period from 2002 to February 2006, 10 persons were admitted to our Institute after consuming a hair dye in a suicidal bid. The percentage of ARF due to PPD at our Institute was 0.95%. Seven patients out of 10 (70% who consumed PPD developed ARF. All 10 patients, including the patients who had normal renal function had features of rhabdomyolysis. Two patients required ventilator support for respiratory distress and two more required tracheostomy due to upper airway tract edema. One patient has expired after two sessions of dialysis. Renal biopsy in two patients (one, postmortem showed acute tubular necrosis along with presence of casts in tubules due to myoglobin.

  1. Analysis of the causes of misdiagnosis of acute retinal necrosis syndrome and our measure in preventing it%急性视网膜坏死综合征误诊原因分析

    吴红云; 易长贤; 杨莎莎; 练苹

    2013-01-01

    Objective To analyze the causes of misdiagnosis of acute retinal necrosis syndrome (ARN),and possible critical points in preventing misdiagnosis.Methods Clinical data of 81 cases (93 eyes) in-patients with ARN from May 2006 to May 2012 in Zhongshan Ophthalmic Center,Sun Yat-sen University were retrospectively analyzed.Results The average time of first visit after appearance of ocular symptoms was 7.03 days (1 to 21 days),86 eyes (91.36%) was misdiagnosed in total.There were only 7 eyes that were correctly diagnosed at initial ophthalmic consultation.It took 31.11 days (ranging from 5 to 280 days) to reach the correct diagnose.Among the misdiagnosed eyes,22 eyes (29.73%) experienced one time misdiagnosis,35 eyes (47.3%) twice and 17 eyes (22.97%) had correctly diagnosis after three or even more time of ophthalmic examinations.Of the 86 misdiagnosed eye,55 eyes (63.95%) was labeled as uveitis,27 eyes (31.40.%) as kidocyclitis,28 eyes (32.55%) as other without explicit type of uveitis.Fifteen eyes (17.44%) were as conjunctivitis and 3 eyes (3.49%) as glaucoma and 13 eyes (15.12%) as others such as retinitis,Eales disease,retinal artery occlusion and retinal hemorrhage.Conclusions ARN is a easily misdiagnosed severe eye diseases.Ophthalmic professional have be alert when come across various uveitis and retinal diseases.%目的 分析急性视网膜坏死综合征(Acute retinal necrosis syndrom,ARN)误诊的原因,探讨防止误诊的对策.方法 收集2006年5月至2012年5月在中山大学中山眼科中心确诊并住院治疗81例(93只眼)ARN患者的临床病史资料,并对临床资料进行回顾性分析.结果 81例患者发病至初诊时间1~21天不等,平均7.03天,发病至正确诊断为ARN的时间为5~280天不等,平均31.11天;初次就诊确诊病例7例7只眼,多次就诊后确诊病例74例86只眼,误诊率91.36%; 74例误诊病例中1次误诊后确诊病例22例,占29.73%,2次误诊后确诊病例35例,占47.30

  2. Possible role of mtDNA depletion and respiratory chain defects in aristolochic acid I-induced acute nephrotoxicity

    Jiang, Zhenzhou, E-mail: jiangcpu@yahoo.com.cn; Bao, Qingli, E-mail: bao_ql@126.com; Sun, Lixin, E-mail: slxcpu@126.com; Huang, Xin, E-mail: huangxinhx66@sohu.com; Wang, Tao, E-mail: wangtao1331@126.com; Zhang, Shuang, E-mail: cat921@sina.com; Li, Han, E-mail: hapo1101@163.com; Zhang, Luyong, E-mail: lyzhang@cpu.edu.cn

    2013-01-15

    This report describes an investigation of the pathological mechanism of acute renal failure caused by toxic tubular necrosis after treatment with aristolochic acid I (AAI) in Sprague–Dawley (SD) rats. The rats were gavaged with AAI at 0, 5, 20, or 80 mg/kg/day for 7 days. The pathologic examination of the kidneys showed severe acute tubular degenerative changes primarily affecting the proximal tubules. Supporting these results, we detected significantly increased concentrations of blood urea nitrogen (BUN) and creatinine (Cr) in the rats treated with AAI, indicating damage to the kidneys. Ultrastructural examination showed that proximal tubular mitochondria were extremely enlarged and dysmorphic with loss and disorientation of their cristae. Mitochondrial function analysis revealed that the two indicators for mitochondrial energy metabolism, the respiratory control ratio (RCR) and ATP content, were reduced in a dose-dependent manner after AAI treatment. The RCR in the presence of substrates for complex I was reduced more significantly than in the presence of substrates for complex II. In additional experiments, the activity of respiratory complex I, which is partly encoded by mitochondrial DNA (mtDNA), was more significantly impaired than that of respiratory complex II, which is completely encoded by nuclear DNA (nDNA). A real-time PCR assay revealed a marked reduction of mtDNA in the kidneys treated with AAI. Taken together, these results suggested that mtDNA depletion and respiratory chain defects play critical roles in the pathogenesis of kidney injury induced by AAI, and that the same processes might contribute to aristolochic acid-induced nephrotoxicity in humans. -- Highlights: ► AAI-induced acute renal failure in rats and the proximal tubule was the target. ► Tubular mitochondria were morphologically aberrant in ultrastructural examination. ► AAI impair mitochondrial bioenergetic function and mtDNA replication.

  3. Possible role of mtDNA depletion and respiratory chain defects in aristolochic acid I-induced acute nephrotoxicity

    This report describes an investigation of the pathological mechanism of acute renal failure caused by toxic tubular necrosis after treatment with aristolochic acid I (AAI) in Sprague–Dawley (SD) rats. The rats were gavaged with AAI at 0, 5, 20, or 80 mg/kg/day for 7 days. The pathologic examination of the kidneys showed severe acute tubular degenerative changes primarily affecting the proximal tubules. Supporting these results, we detected significantly increased concentrations of blood urea nitrogen (BUN) and creatinine (Cr) in the rats treated with AAI, indicating damage to the kidneys. Ultrastructural examination showed that proximal tubular mitochondria were extremely enlarged and dysmorphic with loss and disorientation of their cristae. Mitochondrial function analysis revealed that the two indicators for mitochondrial energy metabolism, the respiratory control ratio (RCR) and ATP content, were reduced in a dose-dependent manner after AAI treatment. The RCR in the presence of substrates for complex I was reduced more significantly than in the presence of substrates for complex II. In additional experiments, the activity of respiratory complex I, which is partly encoded by mitochondrial DNA (mtDNA), was more significantly impaired than that of respiratory complex II, which is completely encoded by nuclear DNA (nDNA). A real-time PCR assay revealed a marked reduction of mtDNA in the kidneys treated with AAI. Taken together, these results suggested that mtDNA depletion and respiratory chain defects play critical roles in the pathogenesis of kidney injury induced by AAI, and that the same processes might contribute to aristolochic acid-induced nephrotoxicity in humans. -- Highlights: ► AAI-induced acute renal failure in rats and the proximal tubule was the target. ► Tubular mitochondria were morphologically aberrant in ultrastructural examination. ► AAI impair mitochondrial bioenergetic function and mtDNA replication.

  4. The Effects of Combination of Traditional Chinese Medicine, Acyclovir (ACV) and Corticosteroid on Acute Retinal Necrosis (ARN)%中药、无环鸟苷、皮质激素联合治疗急性视网膜坏死

    陈卫玲; 杨志坤; 滕颖; 马晓萍

    2001-01-01

    目的:为了探讨急性视网膜坏死(acute retinal necrosis,ARN)的有效疗法.方法:对8例(11只眼)ARN患者用中药、无环鸟苷(acyclovir,ACV)、激素联合治疗.结果:随访3~36个月,10只眼视力有不同程度提高,视力提高达90.9%结论:中药、ACV、激素联合应用是治疗ARN的一种有效方法.

  5. Nutritional parameters are associated with mortality in acute kidney injury

    Marina Nogueira Berbel

    2014-07-01

    Full Text Available OBJECTIVE:The objective of this study was to perform a nutritional assessment of acute kidney injury patients and to identify the relationship between nutritional markers and outcomes.METHOD:This was a prospective and observational study. Patients who were hospitalized at the Hospital of Botucatu School of Medicine were evaluated between January 2009 and December 2011. We evaluated a total of 133 patients with a clinical diagnosis of acute kidney injury and a clinical presentation suggestive of acute tubular necrosis. We explored the associations between clinical, laboratory and nutritional markers and in-hospital mortality. Multivariable logistic regression was used to adjust for confounding and selection bias.RESULTS:Non-survivor patients were older (67±14 vs. 59±16 years and exhibited a higher prevalence of sepsis (57.1 vs. 21.4% and higher Acute Tubular Necrosis-Individual Severity Scores (0.60±0.22 vs. 0.41±0.21 than did survivor patients. Based on the multivariable analysis, laboratorial parameters such as blood urea nitrogen and C-reactive protein were associated with a higher risk of death (OR: 1.013, p= 0.0052; OR: 1.050, p= 0.01, respectively, and nutritional parameters such as low calorie intake, higher levels of edema, lower resistance based on bioelectrical impedance analysis and a more negative nitrogen balance were significantly associated with a higher risk of death (OR: 0.950, p= 0.01; OR: 1.138, p= 0.03; OR: 0.995, p= 0.03; OR: 0.934, p= 0.04, respectively.CONCLUSIONS:In acute kidney injury patients, a nutritional assessment seems to identify nutritional markers that are associated with outcome. In this study, a low caloric intake, higher C-reactive protein levels, the presence of edema, a lower resistance measured during a bioelectrical impedance analysis and a lower nitrogen balance were significantly associated with risk of death in acute kidney injury patients.

  6. Acute kidney injury in children

    Peco-Antić Amira

    2014-01-01

    Full Text Available Acute kidney injury (AKI is a clinical condition considered to be the consequence of a sudden decrease (>25% or discontinuation of renal function. The term AKI is used instead of the previous term acute renal failure, because it has been demonstrated that even minor renal lesions may cause far-reaching consequences on human health. Contemporary classifications of AKI (RIFLE and AKIN are based on the change of serum creatinine and urinary output. In the developed countries, AKI is most often caused by renal ischemia, nephrotoxins and sepsis, rather than a (primary diffuse renal disease, such as glomerulonephritis, interstitial nephritis, renovascular disorder and thrombotic microangiopathy. The main risk factors for hospital AKI are mechanical ventilation, use of vasoactive drugs, stem cell transplantation and diuretic-resistant hypervolemia. Prerenal and parenchymal AKI (previously known as acute tubular necrosis jointly account for 2/3 of all AKI causes. Diuresis and serum creatinine concentration are not early diagnostic markers of AKI. Potential early biomarkers of AKI are neutrophil gelatinase-associated lipocalin (NGAL, cystatin C, kidney injury molecule-1 (KIM-1, interleukins 6, 8 and 18, and liver-type fatty acid-binding protein (L-FABP. Early detection of kidney impairment, before the increase of serum creatinine, is important for timely initiated therapy and recovery. The goal of AKI treatment is to normalize the fluid and electrolyte status, as well as the correction of acidosis and blood pressure. Since a severe fluid overload resistant to diuretics and inotropic agents is associated with a poor outcome, the initiation of dialysis should not be delayed. The mortality rate of AKI is highest in critically ill children with multiple organ failure and hemodynamically unstable patients.

  7. [Acute kidney injury in children].

    Amira-Peco-Antić; Paripović, Dusan

    2014-01-01

    Acute kidney injury (AKI) is a clinical condition considered to be the consequence of a sudden decrease (> 25%) or discontinuation of renal function. The term AKI is used instead of the previous term acute renal failure, because it has been demonstrated that even minor renal lesions may cause far-reaching consequences on human health. Contemporary classifications of AKI (RIFLE and AKIN) are based on the change of serum creatinine and urinary output. In the developed countries, AKI is most often caused by renal ischemia, nephrotoxins and sepsis, rather than a (primary) diffuse renal disease, such as glomerulonephritis, interstitial nephritis, renovascular disorder and thrombotic microangiopathy. The main risk factors for hospital AKI are mechanical ventilation, use of vasoactive drugs, stem cell transplantation and diuretic-resistant hypervolemia. Prerenal and parenchymal AKI (previously known as acute tubular necrosis) jointly account for 2/3 of all AKI causes. Diuresis and serum creatinine concentration are not early diagnostic markers of AKI. Potential early biomarkers of AKI are neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM-1), interleukins 6, 8 and 18, and liver-type fatty acid-binding protein (L-FABP). Early detection of kidney impairment, before the increase of serum creatinine, is important for timely initiated therapy and recovery. The goal of AKI treatment is to normalize the fluid and electrolyte status, as well as the correction of acidosis and blood pressure. Since a severe fluid overload resistant to diuretics and inotropic agents is associated with a poor outcome, the initiation of dialysis should not be delayed. The mortality rate of AKI is highest in critically ill children with multiple organ failure and hemodynamically unstable patients. PMID:25033598

  8. Hypokalemic quadriparesis and rhabdomyolysis as a rare presentation of distal renal tubular acidosis

    Ahmad Bhat, Manzoor; Ahmad Laway, Bashir; Mustafa, Farhat; Shafi Kuchay, Mohammad; Mubarik, Idrees; Ahmad Palla, Nazir

    2014-01-01

    Distal renal tubular acidosis is a syndrome of abnormal urine acidification and is characterized by hyperchloremic metabolic acidosis, hypokalemia, hypercalciurea, nephrocalcinosis and nephrolithiasis. Despite the presence of persistent hypokalemia, acute muscular paralysis is rarely encountered in males. Here, we will report an eighteen year old male patient who presented with flaccid quadriparesis and was subsequently found to have rhabdomyolysis, severe short stature, skeletal deformities ...

  9. Necrosis digital en la mano por mecanismo infrecuente

    Leroux, Maria Bibiana; Lashak, Celina; Mazzurco, Martin

    2013-01-01

    A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler...

  10. Doppler sonography in renal transplants; differential diagnosis of normal from acute rejection

    We undertook a combined retrospective and prospective analysis of duplex Doppler examinations performed over a perion of 10 months in order to assess the value of Doppler study(DS)in evaluating renal allograft dysfunction. A total of 110 DS on 82 transplant patients were performed including 79 normal transplants, 29 acute rejections and 2 acute tubular necrosis(ATN). Resistive Index(RI) in 79 normal transplants ranged from 0.44 to 0.7 (Mean;0.59+0.07) in the arcuate artery, and from 0.45 to 0.75(mean;0.61+0.08) in the interlobar artery. RI in 29 cases of acute rejection ranged from 0.61 to 1.0(mean ;0.77+0.10)in the interlobar artery. In ATNRI ranged from 0.59 to 0.63(mean 0.62) in the arcuate artery, and from 0.59 to 0.62(mean 0.61) in the interlobar artery. The RI in acute rejection is significantly higher than that of the normal transplants (p<0.001). With a resistive index greater than 0.8, 100% positive predictive value was obtained for the diagnosis of acute rejection. The value less than 0.7 was unlikely to suggest acute rejection(negative predictive value 92%)

  11. Modified tubularized incised plate urethroplasty

    Shivaji Mane

    2013-01-01

    Full Text Available Aim: To share our experience of doing tubularized incised plate urethroplasty with modifications. Materials and Methods: This is a single surgeon personal series from 2004 to 2009. One hundred patients of distal hypospadias were subjected for Snodgrass urethroplasty with preputioplasty. The age range was 1 to 5 year with mean age of 2.7 years. Selection criteria were good urethral plate, without chordee and torsion needing complete degloving. Main technical modification from original Snodgrass procedure was spongioplasty, preputioplasty, and dorsal slit when inability to retract prepuce during surgery. Results: Average follow-up period is 23 months. Seven (7% patients developed fistula and one patient had complete preputial dehiscence. Phimosis developed in three (3% patients and required circumcision. Dorsal slit was required in seven patients. One patient developed meatal stenosis in postoperative period. All other patients are passing single urinary stream and have cosmesis that is acceptable. Conclusions: Modified tubularized incised plate urethroplasty with preputioplasty effectively gives cosmetically normal looking penis with low complications.

  12. Warfarin-Induced Skin Necrosis

    Kakagia, Despoina D.; Papanas, Nikolaos; Karadimas, Efthimios; Polychronidis, Alexandros

    2014-01-01

    Warfarin-induced skin necrosis is an infrequent complication occurring in individuals under warfarin treatment who have a thrombophilic history or after administration of large loading doses of warfarin particularly without simultaneous initial use of heparin. A 62-year-old lady developed skin necrosis 4 days after initiating warfarin therapy of 5 mg daily without initial co-administration of heparin. The patient had a normal clotting profile. Skin necrosis progressed to eschar formation afte...

  13. Tubular lining material for pipelines having bends

    Moringa, A.; Sakaguchi, Y.; Hyodo, M.; Yagi, I.

    1987-03-24

    A tubular lining material for pipelines having bends or curved portions comprises a tubular textile jacket made of warps and wefts woven in a tubular form overlaid with a coating of a flexible synthetic resin. It is applicable onto the inner surface of a pipeline having bends or curved portions in such manner that the tubular lining material with a binder onto the inner surface thereof is inserted into the pipeline and allowed to advance within the pipeline, with or without the aid of a leading rope-like elongated element, while turning the tubular lining material inside out under fluid pressure. In this manner the tubular lining material is applied onto the inner surface of the pipeline with the binder being interposed between the pipeline and the tubular lining material. The lining material is characterized in that a part of all of the warps are comprised of an elastic yarn around which, over the full length thereof, a synthetic fiber yarn or yarns have been left-and/or right-handedly coiled. This tubular lining material is particularly suitable for lining a pipeline having an inner diameter of 25-200 mm and a plurality of bends, such as gas service pipelines or house pipelines, without occurrence of wrinkles in the lining material in a bend.

  14. Acute pancreatitis

    Al Mofleh Ibrahim

    1997-01-01

    Full Text Available The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy.

  15. Acute Pancreatitis: Surgery, Pathophysiology and Probiotic Prophylaxis

    Minnen, L.P. van

    2006-01-01

    Acute pancreatitis is a challenging disease with a clinical course that is often difficult to predict. In severe acute pancreatitis, mortality increases significantly if intestinal bacteria translocate from the intestine and infect pancreatic necrosis. Surgical and prophylactic treatment strategies

  16. Individual electrostatic astigmatic tubular lenses

    Electron-optical properties of three-electrode individual astigmatic tubular lenses with similar electrode diameters are investigated. It has been assumed while calculations that gaps between the el ctrodes are infinitely small and lines separating them are presented as part of line of intersection of two cylinders with equal radius. Parameters characterizing paraxial properties of lenses and coefficients of their spherical aberration for subject position on the infinity at different ratios of electrode potential and distances between gaps are determined. The three-electrode individual lens focuses charged particle beams in one plain and it scatters them in another one in the whole chosen range of potential ratios. It is revealed that coefficients of spherical aberration in individual lenses have different signs and one of the coefficients passes through zero

  17. Interferon-γ Reduces the Proliferation of Primed Human Renal Tubular Cells

    Omar García-Sánchez

    2014-01-01

    Full Text Available Background/Aims: Chronic kidney disease (CKD is a progressive deterioration of the kidney function, which may eventually lead to renal failure and the need for dialysis or kidney transplant. Whether initiated in the glomeruli or the tubuli, CKD is characterized by progressive nephron loss, for which the process of tubular deletion is of key importance. Tubular deletion results from tubular epithelial cell death and defective repair, leading to scarring of the renal parenchyma. Several cytokines and signaling pathways, including transforming growth factor-β (TGF-β and the Fas pathway, have been shown to participate in vivo in tubular cell death. However, there is some controversy about their mode of action, since a direct effect on normal tubular cells has not been demonstrated. We hypothesized that epithelial cells would require specific priming to become sensitive to TGF-β or Fas stimulation and that this priming would be brought about by specific mediators found in the pathological scenario. Methods: Herein we studied whether the combined effect of several stimuli known to take part in CKD progression, namely TGF-β, tumor necrosis factor-α, interferon-γ (IFN-γ, and Fas stimulation, on primed resistant human tubular cells caused cell death or reduced proliferation. Results: We demonstrate that these cytokines have no synergistic effect on the proliferation or viability of human kidney (HK2 cells. We also demonstrate that IFN-γ, but not the other stimuli, reduces the proliferation of cycloheximide-primed HK2 cells without affecting their viability. Conclusion: Our results point at a potentially important role of IFN-γ in defective repair, leading to nephron loss during CKD.

  18. Analysis of 10 cases died from the acute infections disease with the severe adrenalitis, necrosis and hemorrhage%急性重症感染合并出血坏死性肾上腺炎死亡十例分析

    李品玉; 于晓军; 徐小虎; 刘卯阳

    2009-01-01

    Objective To discuss the potential mechanisms and the role of adrenaliris with extensive hemorrhage and necrosis in acute critical infectious diseases.Methods Forensic autopsy cases from 1998 to 2007 were retrospectively analyzed.And 10 cases of them were involved in the primary and critical infecfion with acute infiammation,hemorrhage and necrosis of adrenal glands.Results Clinical diagnoses of 10 Cases were respiratory tract infection(n=6),septic shock(n=2),acute esophagitis(n=1),and undefined causes(n=1),and the quickly aggravatinng conditions resulted in death ultimately.However,systematic autopsy confirmed that 7 cages died of acute lymphocytic pancarditis,2 cases acute and lymphocytic interstitial pneumonia and 1 cKse epidemic cerebrospinal meningitis with septicemia.And severe complications of all cases included hemorrhagic necmtizing adrenalitis,systemic inflammatory response syndrome and multiple organ failure(MOF).Conclusions Hemorrhagic necrotizing adrenalitis should be considered as one of the important pathological changes in fatal MOF resulting from severe infection and trauma etc.More attention should be paid in clinical treatment.%目的 探讨出血坏死性肾上腺炎在急性生症感染性疾病死亡中的作用.方法 回顾性分析1998至2007年系统法医病理学解剖案例中10例原发性重症感染性疾病合并严重出血坏死性肾上腺炎案例的临床病理资料.结果 10例中临床诊断上呼吸道感染6例,感染性休克2例,急性食管炎1例,诊断不明1例.均病情迅速恶化而死亡.尸检7例为急性淋巴细胞性全心炎,2例为急性淋巴细胞性间质性肺炎,1例为暴发性脑膜炎球菌败血症,均合并严重的出血坏死性肾上腺炎、全身炎症反应综合征和多器官衰竭.结论 肾上腺炎性出血坏死应属于常见的致死性多器官功能衰竭的重要器官病变之一,临床应予重视.

  19. Ileal bladder substitute: antireflux nipple or afferent tubular segment?

    Studer, U E; Spiegel, T; Casanova, G A; Springer, J; Gerber, E; Ackermann, D K; Gurtner, F; Zingg, E J

    1991-01-01

    Spheroidal bladder substitutes made from double-folded ileal segments, similar to Goodwin's cup-patch technique, are devoid of major coordinated wall contractions. This, together with the reservoir's direct anastomosis to the membranous urethra, prevents major intraluminal pressure peaks and assures a residue-free voiding of sterile urine. In order to determine whether, under these conditions, an afferent tubular isoperistaltic ileal segment of 20-cm length protects the upper urinary tract as efficiently as an antireflux nipple, 60 male patients who were subjected to radical cystectomy were prospectively randomised to groups in which a bladder substitute was formed together with either of these 2 antireflux devices. An analysis of the results obtained in 20 patients from each group who could be followed for more than 1 year (median observation time 30 and 36 months) showed no differences between the groups in metabolic disturbances, kidney size, reservoir capacity, diurnal and nocturnal urinary continence, the incidence of urinary tract infection or episodes of acute pyelonephritis. Later than 1 year postoperatively, intravenous urograms of the renoureteral units of 25% of the patients with antireflux nipples showed persistent but generally slight dilatation of the upper urinary tracts. This observation was significantly more frequent than it was in patients with afferent tubular segments. Urodynamic and radiographic studies showed that the competence of the antireflux nipples was secured by the raised surrounding intravesical pressure. This, however, also resulted in a transient functional obstruction, and a gradual rise of the basal pressure in the upper urinary tracts was recorded. In patients with afferent ileal tubular segments, contrast medium could be forced upwards into the renal pelvis when the bladder substitutes were overfilled. However, despite raised intravesical pressures, peristalsis in the isoperistaltic afferent tubular segment gradually returned

  20. Complete Penile Necrosis in a Patient With Heparin-induced Thrombocytopenia: A Case Report*

    Blais, Anne-Sophie; Deschênes Rompré, Marie-Pier; Lacombe, Louis

    2014-01-01

    Penile necrosis is a rare condition that has been mostly described in association with diabetes mellitus and end-stage renal disease. We report an unusual case of acute penile necrosis because of heparin-induced thrombocytopenia. A 75-year-old man presented with acute renal failure and experienced cardiac complications during the hospitalization. The patient was treated twice with intravenous heparin. He developed symptoms of penile necrosis 4 days after the reintroduction of heparin. At that moment, the platelet count dropped by 61%, and the analysis of heparin-pf4 antibodies was positive for heparin-induced thrombocytopenia. The patient underwent a total penectomy and a perineal urethrostomy. PMID:26954936

  1. Bullous lesions, sweat gland necrosis and rhabdomyolysis in alcoholic coma

    Neelakandhan Asokan

    2014-01-01

    Full Text Available A 42-year-old male developed hemorrhagic bullae and erosions while in alcohol induced coma. The lesions were limited to areas of the body in prolonged contact with the ground in the comatose state. He developed rhabdomyolysis, progressing to acute renal failure (ARF. Histopathological examination of the skin showed spongiosis, intraepidermal vesicles, and necrosis of eccrine sweat glands with denudation of secretory epithelial lining cells. With supportive treatment and hemodialysis, the patient recovered in 3 weeks time. This is the first reported case of bullous lesions and sweat gland necrosis occurring in alcohol-induced coma complicated by rhabdomyolysis and ARF.

  2. Involvement of the transcription factor NF-kappaB in tubular morphogenesis of human microvascular endothelial cells by oxidative stress.

    Shono, T; Ono, M; H. Izumi; Jimi, S I; Matsushima, K; Okamoto, T.; Kohno, K.; Kuwano, M.

    1996-01-01

    Oxygen radicals are induced under various pathologic conditions associated with neovascularization. Oxygen radicals modulate angiogenesis in cultured human microvascular endothelial cells by an unknown mechanism. Treatment of human microvascular endothelial cells for 15 min with 0.1 to 0.5 mM hydrogen peroxide (H2O2) or 100 U of tumor necrosis factor alpha per ml induced tubular morphogenesis in type I collagen gels. Gel shift assays with nuclear extracts demonstrated that H2O2 increases the ...

  3. Nonsurgical Treatment of Infected Pancreatic Necrosis: A Falling Myth or a Still Impassable Frontier?

    Generoso Uomo

    2007-07-01

    Full Text Available Acute pancreatitis is a disease of increasing annual incidence associated with significant morbidity and mortality and with an increasing consumption of health care resources [1]. In particular, patients suffering from acute necrotizing pancreatitis who develop infected necrosis present a severe prognosis with mortality ranging from 20% to 70% [2, 3]. The diagnosis of infected pancreatic necrosis is usually based on Gram stain and cultures of material obtained from the necrotic area by fine-needle aspiration. On a clinical basis, infected pancreatic necrosis should be suspected in the presence of worsening abdominal pain, fever, and leukocytosis, usually 1-2 weeks after disease onset. In accordance with the current recommendations [4], sterile necrosis should be managed conservatively, whereas the occurrence of infected pancreatic necrosis requires immediate surgery. The standard approach to infected pancreatic necrosis has been open surgical debridement with a variety of drainage and closure techniques (multiple drainages, marsupialization of the lesser sac, continuous or intermittent lavage, unique o repeated necrosectomy, etc. [5]. So, the paradigm “infected pancreatic necrosis = surgery” seems to be an accepted principle in clinical pancreatology. However, over the last ten years some controversies have arisen regarding this topic. In fact, some reports have shown that early surgical intervention for pancreatic necrosis could result in a worse prognosis in comparison with patients who underwent surgery in a later phase of the disease [6, 7]. In addition, some reports have shown surprisingly enough, the efficacy of nonsurgical management for infected pancreatic necrosis [8, 9, 10, 11].

  4. PHYSIOPATHOLOGY OF ACUTE RENAL FAILURE.NEW CLUES FOR AN OLD DILEMMA

    Carlos G. Musso

    2008-01-01

    Full Text Available Acute renal failure (ARF is the term used to describe the sustained and abrupt reduction of the glomerular filtration, which causes the retention of waste products that come from the metabolism. Normally, the mechanisms potentially involved in ARF are divided into: pre-renal, parenchymatous, and post-renal. Regarding the etiology of the parenchymatous ARF, it would seem to be the sum of multiple pathogenic variables such as: tubular necrosis and apoptosis, alteration of the filtration barrier, retrodifusion of glomerular filtration, intrarenal vasoconstriction, contraction of the mesangium, intratubular obstruction, intersticial swelling, activation of proteolytic enzymes, and so on. Because of the above exposed data, only a multicausal perspective would seem to be adequate to understand and solve this syndrome.

  5. Genetics Home Reference: tubular aggregate myopathy

    ... M, Laporte J. Constitutive activation of the calcium sensor STIM1 causes tubular-aggregate myopathy. Am J Hum ... personal health condition should consult with a qualified healthcare professional . About Genetics Home Reference Site Map Contact ...

  6. Iatrogenic Digital Compromise with Tubular Dressings

    Corre, Kenneth A

    2009-08-01

    Full Text Available Objective: This case report describes a digit amputation resulting from an improperly applied tubular dressing. The safe application of digital tubular dressings, and the rationale behind it, is detailed to raise emergency physician (EP awareness.Methods: We present a case report of a recent iatrogenic-induced digit ischemia caused by improperly applied tube gauze. We review the literature on the subject and the likely sources of poor outcomes presented. The proper application of tubular gauze dressings is then outlined.Conclusion: EPs and emergency department personnel must be educated on the safe application of tubular gauze dressings to avoid dire outcomes associated with improper applications.[WestJEM. 2009;10:190-192.

  7. Thermal CFD Analysis of Tubular Light Guides

    Ondřej Šikula; Jitka Mohelníková; Josef Plášek

    2013-01-01

    Tubular light guides are applicable for daylighting of windowless areas in buildings. Despite their many positive indoor climate aspects they can also present some problems with heat losses and condensation. A computer CFD model focused on the evaluation of temperature distribution and air flow inside tubular light guides of different dimensions was studied. The physical model of the tested light guides of lengths more than 0.60 m proves shows that Rayleigh numbers are adequate for a turbulen...

  8. Sustained oxidative stress causes late acute renal failure via duplex regulation on p38 MAPK and Akt phosphorylation in severely burned rats.

    Yafei Feng

    Full Text Available BACKGROUND: Clinical evidence indicates that late acute renal failure (ARF predicts high mortality in severely burned patients but the pathophysiology of late ARF remains undefined. This study was designed to test the hypothesis that sustained reactive oxygen species (ROS induced late ARF in a severely burned rat model and to investigate the signaling mechanisms involved. MATERIALS AND METHODS: Rats were exposed to 100°C bath for 15 s to induce severe burn injury (40% of total body surface area. Renal function, ROS generation, tubular necrosis and apoptosis, and phosphorylation of MAPK and Akt were measured during 72 hours after burn. RESULTS: Renal function as assessed by serum creatinine and blood urea nitrogen deteriorated significantly at 3 h after burn, alleviated at 6 h but worsened at 48 h and 72 h, indicating a late ARF was induced. Apoptotic cells and cleavage caspase-3 in the kidney went up slowly and turned into significant at 48 h and 72 h. Tubular cell ROS production shot up at 6 h and continuously rose during the 72-h experiment. Scavenging ROS with tempol markedly attenuated tubular apoptosis and renal dysfunction at 72 h after burn. Interestingly, renal p38 MAPK phosphorylation elevated in a time dependent manner whereas Akt phosphorylation increased during the first 24 h but decreased at 48 h after burn. The p38 MAPK specific inhibitor SB203580 alleviated whereas Akt inhibitor exacerbated burn-induced tubular apoptosis and renal dysfunction. Furthermore, tempol treatment exerted a duplex regulation through inhibiting p38 MAPK phosphorylation but further increasing Akt phosphorylation at 72 h postburn. CONCLUSIONS: These results demonstrate that sustained renal ROS overproduction induces continuous tubular cell apoptosis and thus a late ARF at 72 h after burn in severely burned rats, which may result from ROS-mediated activation of p38 MAPK but a late inhibition of Akt phosphorylation.

  9. 78 FR 37584 - U.S. Steel Tubular Products, Inc., Mckeesport Tubular Operations Division, Subsidiary of United...

    2013-06-21

    ... Employment and Training Administration U.S. Steel Tubular Products, Inc., Mckeesport Tubular Operations Division, Subsidiary of United States Steel Corporation, Mckeesport, Pennsylvania; Notice of Amended... workers of U.S. Steel Tubular Products, McKeesport Tubular Operations Division, a subsidiary of...

  10. Transient osteoporosis or femoral head necrosis? Early diagnosis via MRI

    Transient osteoporosis of the hip is a syndrome that does not seem to be widely known; this is also true for its radiological appearance. It is often mistaken for avascular necrosis of the femoral head, metastatic or inflammatory disease. These differential diagnoses lead to more or less invasive procedures, although transient osteoporosis does not require more than immobilisation for complete remission. MRI was done in 38 patients with acute hip pain, 13 had femoral head necrosis and 8 transient osteoporosis. Follow-up studies via MRI in patients with transient osteoporosis revealed 3 stages (diffuse, focal, residual) during the clinical course of which stage II is similar to femoral head necrosis but always without the typical sclerotic rim. (orig.)

  11. Discussion Tumor necrosis factor-Alpha and Interleukin-6 in acute pancreatitis diagnosis and early severity appraisal%探讨肿瘤坏死因子-a和白细胞介素-6在急性胰腺炎诊断及早期严重度评估的价值

    何晃养

    2012-01-01

    Objective:To explore the value dynamic changes of serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6)and to determine their predictive value for severity and prognosis of acute pancreatitis(AP).Methods 81 patients with acute pancreatitis were divided into mild acute pancreatitis group(MAP,n=57) and severe acute pancreatitis group(SAP,n=24),SAP and MAP Group at post admission 1h,24h,3d,dedicated TNF-a and IL-6,then analysed and contrasted the results.Results The chang of TNF-a and IL-6 levels at post-admission 1h、24h、2d、3d、5d between SAP and MAP duringhospitalization in patients were statistically significant difference(P<0.05).Conclusion Dynamic changes of the serum levels of TNF-α and IL-6 are related to the occurance and development of acute pancreatitis,and the serum levels of TNF-α and IL-6 on 3rd day may be a predictive index for severity and prognosis of acute pancreatitis.%目的探讨肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)在急性胰腺炎(AP)患者中诊断及早期病情严重度评估中的价值.方法选取81例AP患者,分为轻症急性胰腺炎(MAP)组57例和重症急性胰腺炎(SAP)组24例,对SAP组和MAP组在入院后1h、24h、2d、3d、5d抽血测定TNF-α和IL-6,并对结果进行分析.结果 SAP组和MAP组在入院后1h、24h、3d检测TNF-α和IL-6的水平比较差异有统计学意义(P<0.05).结论血清TNF-α和IL-6水平变化与AP的发生发展密切相关,可作为AP病情变化和程度判断的参考指标,对AP早期严重度具有良好的预测作用.

  12. Contribution of Proteus mirabilis urease to persistence, urolithiasis, and acute pyelonephritis in a mouse model of ascending urinary tract infection.

    Johnson, D E; Russell, R G; Lockatell, C V; Zulty, J C; Warren, J W; Mobley, H L

    1993-07-01

    Proteus mirabilis, a significant cause of bacteriuria and acute pyelonephritis in humans, produces urease. This high-molecular-weight, multimeric, cytoplasmic enzyme hydrolyzes urea to ammonia and carbon dioxide. To assess the role of urease in colonization, urolithiasis, and acute pyelonephritis in an animal model of ascending urinary tract infection, we compared a uropathogenic strain of P. mirabilis with its isogenic urease-negative mutant, containing an insertion mutation within ureC, the gene encoding the large subunit of the enzyme. Mice challenged transurethrally with the parent strain developed significant bacteriuria and urinary stones. The urease-negative mutant had a 50% infective dose of 2.7 x 10(9) CFU, a value more than 1,000-fold greater than that of the parent strain (2.2 x 10(6) CFU). The urease-positive parent strain reached significantly higher concentrations and persisted significantly longer in the bladder and kidney than did the mutant. Indeed, in the kidney, the parent strain increased in concentration while the mutant concentration fell so that, by 1 week, the parent strain concentration was 10(6) times that of the mutant. Similarly, the urease-positive parent produced significantly more severe renal pathology than the mutant. The initial abnormalities were in and around the pelvis and consisted of acute inflammation and epithelial necrosis. By 1 week, pyelitis was more severe, crystals were seen in the pelvis, and acute pyelonephritis, with acute interstitial inflammation, tubular epithelial cell necrosis, and in some cases abscesses, had developed. By 2 weeks, more animals had renal abscesses and radial bands of fibrosis. We conclude that the urease of P. mirabilis is a critical virulence determinant for colonization, urolithiasis, and severe acute pyelonephritis. PMID:8514376

  13. Plasma cytokines in acute stroke

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik;

    2011-01-01

    months later plasma levels of interleukin 1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1RA), interleukin 6 (IL-6), interleukin 10 (IL-10), soluble tumor necrosis factor receptor 1 (sTNF-R1), and soluble tumor necrosis factor receptor 2 (sTNF-R2) were......GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...

  14. Thermal CFD Analysis of Tubular Light Guides

    Ondřej Šikula

    2013-12-01

    Full Text Available Tubular light guides are applicable for daylighting of windowless areas in buildings. Despite their many positive indoor climate aspects they can also present some problems with heat losses and condensation. A computer CFD model focused on the evaluation of temperature distribution and air flow inside tubular light guides of different dimensions was studied. The physical model of the tested light guides of lengths more than 0.60 m proves shows that Rayleigh numbers are adequate for a turbulent air flow. The turbulent model was applied despite the small heat flux differences between the turbulent and laminar model. The CFD simulations resulted into conclusions that the growing ratio of length/diameter increases the heat transmission loss/linear transmittance as much as by 50 percent. Tubular light guides of smaller diameters have lower heat transmission losses compared to the wider ones of the same lengths with the same outdoor temperature being taken into account. The simulation results confirmed the thermal bridge effect of the tubular light guide tube inside the insulated flat roof details. The thermal transmittance of the studied light guides in the whole roof area was substituted with the point thermal bridges. This substitution gives possibility for simple thermal evaluation of the tubular light pipes in roof constructions.

  15. Neurogenic pulmonary edema due to delayed radiation necrosis

    Mani R

    2005-01-01

    Full Text Available Neurogenic pulmonary edema is oftten missed in the ICU setting as it is mistaken for pneumonia or ARDS. The case presented here illustrates how a high index of suspicion in the appropriate setting can lead to the diagnosis. The patient in this report developed acute-on-chronic cerebral edema due to radiation necrosis following gamma-knife radiation therapy for cerebral arteriovenous malformation.

  16. Involvement of caspase-12-dependent apoptotic pathway in ionic radiocontrast urografin-induced renal tubular cell injury

    Wu, Cheng Tien [Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan (China); Weng, Te I. [Department of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan (China); Chen, Li Ping [Department of Dentistry, Chang Gang Memorial Hospital, Chang Gang University, Taoyuan, Taiwan (China); Chiang, Chih Kang [Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (China); Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (China); Liu, Shing Hwa, E-mail: shinghwaliu@ntu.edu.tw [Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan (China); Department of Urology, National Taiwan University Hospital, Taipei, Taiwan (China)

    2013-01-01

    Contrast medium (CM) induces a direct toxic effect on renal tubular cells. This toxic effect subjects in the disorder of CM-induced nephropathy. Our previous work has demonstrated that CM shows to activate the endoplasmic reticulum (ER)-related adaptive unfolding protein response (UPR) activators. Glucose-regulated protein 78 (GRP78)/eukaryotic initiation factor 2α (eIF2α)-related pathways play a protective role during the urografin (an ionic CM)-induced renal tubular injury. However, the involvement of ER stress-related apoptotic signals in the urografin-induced renal tubular cell injury remains unclear. Here, we examined by the in vivo and in vitro experiments to explore whether ER stress-regulated pro-apoptotic activators participate in urografin-induced renal injury. Urografin induced renal tubular dilation, tubular cells detachment, and necrosis in the kidneys of rats. The tubular apoptosis, ER stress-related pro-apoptotic transcriptional factors, and kidney injury marker-1 (kim-1) were also conspicuously up-regulated in urografin-treated rats. Furthermore, treatment of normal rat kidney (NRK)-52E tubular cells with urografin augmented the expressions of activating transcription factor-6 (ATF-6), C/EBP homologous protein (CHOP), Bax, caspase-12, JNK, and inositol-requiring enzyme (IRE) 1 signals. Urografin-induced renal tubular cell apoptosis was not reversed by the inhibitors of ATF-6, JNK signals or CHOP siRNA transfection, but it could be partially reversed by the inhibitor of caspase-12. Taken together, the present results and our previous findings suggest that exposure of CM/urografin activates the ER stress-regulated survival- and apoptosis-related signaling pathways in renal tubular cells. Caspase-12-dependent apoptotic pathway may be partially involved in the urografin-induced nephropathy. -- Highlights: ► Ionic contrast medium-urografin induces renal tubular cell apoptosis. ► Urografin induces the ER stress-regulated survival and apoptosis

  17. Involvement of caspase-12-dependent apoptotic pathway in ionic radiocontrast urografin-induced renal tubular cell injury

    Contrast medium (CM) induces a direct toxic effect on renal tubular cells. This toxic effect subjects in the disorder of CM-induced nephropathy. Our previous work has demonstrated that CM shows to activate the endoplasmic reticulum (ER)-related adaptive unfolding protein response (UPR) activators. Glucose-regulated protein 78 (GRP78)/eukaryotic initiation factor 2α (eIF2α)-related pathways play a protective role during the urografin (an ionic CM)-induced renal tubular injury. However, the involvement of ER stress-related apoptotic signals in the urografin-induced renal tubular cell injury remains unclear. Here, we examined by the in vivo and in vitro experiments to explore whether ER stress-regulated pro-apoptotic activators participate in urografin-induced renal injury. Urografin induced renal tubular dilation, tubular cells detachment, and necrosis in the kidneys of rats. The tubular apoptosis, ER stress-related pro-apoptotic transcriptional factors, and kidney injury marker-1 (kim-1) were also conspicuously up-regulated in urografin-treated rats. Furthermore, treatment of normal rat kidney (NRK)-52E tubular cells with urografin augmented the expressions of activating transcription factor-6 (ATF-6), C/EBP homologous protein (CHOP), Bax, caspase-12, JNK, and inositol-requiring enzyme (IRE) 1 signals. Urografin-induced renal tubular cell apoptosis was not reversed by the inhibitors of ATF-6, JNK signals or CHOP siRNA transfection, but it could be partially reversed by the inhibitor of caspase-12. Taken together, the present results and our previous findings suggest that exposure of CM/urografin activates the ER stress-regulated survival- and apoptosis-related signaling pathways in renal tubular cells. Caspase-12-dependent apoptotic pathway may be partially involved in the urografin-induced nephropathy. -- Highlights: ► Ionic contrast medium-urografin induces renal tubular cell apoptosis. ► Urografin induces the ER stress-regulated survival and apoptosis

  18. Luminal nucleotides are tonic inhibitors of renal tubular transport

    Leipziger, Jens Georg

    2011-01-01

    in all renal tubular segments and their stimulation generally leads to transport inhibition. Recent evidence has identified the tubular lumen as a restricted space for purinergic signaling. The concentrations of ATP in the luminal fluids are sufficiently high to inflict a tonic inhibition of renal...... necessary for flow-stimulated luminal ATP release. Tubular ATP secretion may occur via nonjunctional connexin-hemichannels (connexin 30), which are strategically placed in the apical membrane of distal tubular intercalated cells and can be activated by tubular flow. SUMMARY: The tubular lumen has been...

  19. [Renal ultrasound in fat necrosis].

    Tizki, S; Lasry, F; Elftoiki, F Z; Hadj Khalifa, H; Itri, M; Khadir, K; Benchikhi, H

    2013-07-01

    Subcutaneous fat necrosis is an uncommon disease that may be complicated with potentially fatal hypercalcemia or with nephrocalcinosis. We report on the case of a patient with a history of significant perinatal asphyxia, hospitalized for a urinary tract infection. Lesions of subcutaneous fat necrosis were noted, with asymptomatic hypercalcemia at 3.9mmol/L. A renal ultrasound was performed and showed echogenic medullary pyramids bilaterally, consistent with nephrocalcinosis and left nephrolithiasis. The treatment of hypercalcemia included hyperhydration, a diuretic and corticosteroids. Progression was characterized by the total regression of skin lesions and normalization of serum calcium. Hypercalcemia is a rare complication of subcutaneous fat necrosis. It develops within days to weeks after the appearance of skin lesions. Nephrocalcinosis appears after several weeks or months. Hypercalcemia must be treated in due time to avoid the impact on the kidney. PMID:23726682

  20. Significance of downregulation of renal organic cation transporter (SLC47A1 in cisplatin-induced proximal tubular injury

    Mizuno T

    2015-07-01

    Full Text Available Tomohiro Mizuno,1–3 Waichi Sato,2,3 Kazuhiro Ishikawa,4 Yuki Terao,1 Kazuo Takahashi,2 Yukihiro Noda,5 Yukio Yuzawa,2 Tadashi Nagamatsu1 1Department of Analytical Pharmacology, Meijo University Faculty of Pharmacy, Nagoya, 2Department of Nephrology, School of Medicine, Fujita Health University, Toyoake, 3Department of Nephrology, Nagoya University School of Medicine, Nagoya, 4Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya, 5Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, Nagoya, Japan Background/aim: To elucidate the mechanism responsible for developing acute kidney injury in patients with diabetes mellitus, we also evaluated the issue of whether advanced glycation endproducts (AGEs influence the expressions of multi antimicrobial extrusion protein (MATE1/SLC47A1 in tubular cells. Materials and methods: To detect changing expression of MATE1/SLC47A1 in dose- and time-dependent manners, human proximal tubular epithelial cells were incubated with AGE-aggregated-human serum albumin. As a function assay for MATE1/SLC47A1, human proximal tubular epithelial cells were incubated with cisplatin or carboplatin. Results: On incubation with AGEs, the expressions of MATE1/SLC47A1 were decreased in tubular cells. In addition, the toxicities of cisplatin were increased in tubular cells that had been pretreated with AGEs. However, the toxicities of carboplatin were smaller than that of cisplatin in proximal tubular epithelial cells. Conclusion: The expression of the MATE1/SLC47A1 is decreased by AGEs, which increases the risk for proximal tubular injury. Keywords: advanced glycation endproducts, cisplatin, SLC47A1, diabetes mellitus, acute kidney injury

  1. Lithium-induced minimal change disease and acute kidney injury

    Parul Tandon

    2015-01-01

    Full Text Available Context: Lithium carbonate is a psychiatric medication commonly used in the treatment of bipolar disorder. It has been implicated in inducing nephrogenic diabetes inspidus, chronic tubulointerstitial nephropathy, and acute tubular necrosis. We describe a case of lithium-induced minimal change disease (MCD and acute kidney injury (AKI. Case Report: A 32-year-old female with a medical history of bipolar disorder treated with chronic lithium therapy presented with anasarca, fatigue, and tremors. Work-up revealed supra-therapeutic lithium levels, hypoalbuminemia, and significant proteinuria. The patient was treated conservatively with fluids and discontinuation of lithium therapy. Subsequently, she developed significant AKI and persistent proteinuria. She underwent a renal biopsy that demonstrated effacement of podocyte foot processes consistent with lithium-induced MCD. This was treated with corticosteroids, which decreased the proteinuria and resolved all the patient′s symptoms. Conclusion: Lithium-induced MCD is a rare disease that affects patients of all ages. It is often associated with therapeutic lithium and is typically resolved with discontinuation of lithium. In some cases, concurrent AKI may result due to vascular obstruction from hyperalbuminuria and associated renal interstitial edema. Corticosteroids may be needed to reduce the proteinuria and prevent progression to chronic kidney disease. As such, patients on lithium therapy may benefit from monitoring of glomerular function via urinalysis to prevent the onset of nephrotic syndrome.

  2. Tubular solid oxide fuel cell current collector

    Bischoff, Brian L.; Sutton, Theodore G.; Armstrong, Timothy R.

    2010-07-20

    An internal current collector for use inside a tubular solid oxide fuel cell (TSOFC) electrode comprises a tubular coil spring disposed concentrically within a TSOFC electrode and in firm uniform tangential electrical contact with the electrode inner surface. The current collector maximizes the contact area between the current collector and the electrode. The current collector is made of a metal that is electrically conductive and able to survive under the operational conditions of the fuel cell, i.e., the cathode in air, and the anode in fuel such as hydrogen, CO, CO.sub.2, H.sub.2O or H.sub.2S.

  3. The role of medications and their management in acute kidney injury

    McDaniel BL

    2015-05-01

    Full Text Available Bradford L McDaniel,1 Michael L Bentley1,2 1Department of Pharmacy, Carilion Clinic, Roanoke, VA, USA; 2Department of Biomedical Science, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA Abstract: Prior to 2002, the incidence of acute renal failure (ARF varied as there was no standard definition. To better understand its incidence and etiology and to develop treatment and prevention strategies, while moving research forward, the Acute Dialysis Quality Initiative workgroup developed the RIFLE (risk, injury, failure, loss, end-stage kidney disease classification. After continued data suggesting that even small increases in serum creatinine lead to worse outcomes, the Acute Kidney Injury Network (AKIN modified the RIFLE criteria and used the term acute kidney injury (AKI instead of ARF. These classification and staging systems provide the clinician and researcher a starting point for refining the understanding and treatment of AKI. An important initial step in evaluating AKI is determining the likely location of injury, generally classified as prerenal, renal, or postrenal. There is no single biomarker or test that definitively defines the mechanism of the injury. Identifying the insult(s requires a thorough assessment of the patient and their medical and medication histories. Prerenal injuries arise primarily due to renal hypoperfusion. This may be the result of systemic or focal conditions or secondary to the effects of drugs such as nonsteroidal anti-inflammatory drugs, calcineurin inhibitors (CIs, and modulators of the renin–angiotensin–aldosterone system. Renal, or intrinsic, injury is an overarching term that represents complex conditions leading to considerable damage to a component of the intrinsic renal system (renal tubules, glomerulus, vascular structures, interstitium, or renal tubule obstruction. Acute tubular necrosis and acute interstitial nephritis are the more common types of intrinsic renal injury. Each type of

  4. Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity.

    Sens, Florence; Bacchetta, Justine; Rabeyrin, Maud; Juillard, Laurent

    2016-01-01

    We report a case of a 37-year-old man with Maturity Onset Diabetes of the Youth (MODY) type 5, admitted for an episode of cholestasis and a simultaneous acute kidney injury (AKI). Chronic liver disease was due to a mutation in the transcription factor 2 (TCF2) gene, thus highlighting the need for a close liver follow-up in these patients. AKI was attributed to a cholemic nephropathy based on the following rationale: (1) alternative diagnoses were actively ruled out; (2) the onset of AKI coincided with the onset of severe hyperbilirubinaemia; (3) renal pathology showed large bile tubular casts and a marked tubular necrosis and (4) creatinine serum dramatically decreased when bilirubin levels improved after the first sessions of extracorporeal albumin dialysis (ECAD), thus suggesting its role in renal recovery. Even though cholestasis can precipitate renal injury, the diagnosis of cholemic nephropathy could require a renal biopsy at times. Future studies should confirm the benefits of ECAD in cholemic nephropathy. PMID:27389722

  5. 急性视网膜坏死患者玻璃体MMP-2和MMP-9活性研究%Investigation of the activity of matrix metalloproteinases 2 and 9 in vitreous of patients with acute retinal necrosis

    顾永昊; 石磊; 柯根杰

    2009-01-01

    目的 检测急性视网膜坏死(acute retinal necrosis,ARN)患者玻璃体内基质金属蛋白酶(matrix metallopreteinases,MMPs)2和9的活性.方法 6例ARN患者行玻璃体切割术抽取玻璃体液,6例单纯孔源性视网膜脱离(rhegmatogenous detachment,RD)患者作为对照.采用明胶酶谱法进行MMP-2和MMP-9活性检测.结果 RD患者玻璃体标本显示72kDaMMP-2酶原和62kDa MMP-2活性酶条带,无明显MMP-9条带成分,ARN患者标本可见到92kDaMMP-9酶原、82kDaMMP-9活性酶、72kDaMMP-2酶原和62kDa MMP-2活性酶条带,ARN组所有条带的表达都要显著高于RD组(P<0.01).结论 MMP-2和MMP-9可能在ARN的玻璃体视网膜炎症反应中起到非常重要的作用.%Objective To detect the activity of matrix metalloproteinases (MMP) 2 and 9 in vitreous of patients with acute retinal necrosis (ARN). Methods Vitreous samples from 6 cases with ARN were obtained in process of vitrectomy. Samples from 6 cases of rheg-matogenous detachment of retina (RD) without PVR were set as control. Activities of MMP-2 and-9 were detected by gelatin zymography. Re-stilts Only 72kDa zemogen and 62 active enzyme of MM-2 could be detected in control, while 92kDa zemogen and 82 active enzyme of MM-9 and 72kDa zemogen and 62 active enzyme of MM-2 could be detected in vitreous of ALAN. Concentrations of all four bands were significantly higher in ARN patients than that in control (P<0.01). Conclusion Gelatinase A (MMP-2) and B (MMP-9) might play important roles in in-flammatory responses of ALAN patients.

  6. Tubular Membrane Plant-Growth Unit

    Dreschel, Thomas W.

    1992-01-01

    Hydroponic system controls nutrient solution for growing crops in space. Pump draws nutrient solution along inside of tubular membrane in pipe from reservoir, maintaining negative pressure in pipe. Roots of plants in slot extract nutrient through membrane within pipe. Crop plants such as wheat, rice, lettuce, tomatoes, soybeans, and beans grown successfully with system.

  7. Work tool in a tubular element

    The stand, which is positioned in relation with the tubular element, has clutch disengagement means for a working rod in rotation, with at least two positioning regions on the rod. Application for laser welding a sleeve into PWR steam generator tubes

  8. [Hypokalemic pareses secondary to renal tubular acidosis].

    Gøransson, L G; Apeland, T; Omdal, R

    2000-01-30

    A 24 year old woman presented with flaccid paralysis, severe hypokalaemia and hyperchloremia, metabolic acidosis. Immunological tests and labial glandular biopsy indicated primary Sjögren's syndrome as the underlying cause of her distal renal tubular acidosis. The patient recovered after alkali and potassium substitution and was put on oral treatment with potassium citrate. PMID:10827521

  9. Tubular spring slip joint and jar

    The present invention comprises a pressure balanced tubular spring slip-joint and jar including a generally tubular outer housing having longitudinal slot means in the wall thereof, and a hammer area of increased wall thickness at one end thereof, within which housing slidably extends a jar mandrel means having first and second longitudinally spaced enlarged diameter anvil areas, at least one fastener tapped into one of those anvil areas, the heads of said fastener protruding into said slot means. Both said housing and said mandrel means possesses axial bores therethrough, which are placed in communication via the bore of a tubular spring within the housing, whereby during extension and contraction of the slip-joint and jar means of the present invention the area within said axial bores and said spring bore is of a constant volume. The invention may be employed to provide force impulses in either longitudinal direction, said tubular spring aiding the application of those impulses when said housing and said mandrel means move relatively toward each other. By proper selection of spring length and use of a coiled spring having spaced coils, the present invention may also be employed as a bi-directional shock absorber

  10. Tubular spring slip joint and jar

    Heemstra, T. R.

    1985-04-23

    The present invention comprises a pressure balanced tubular spring slip-joint and jar including a generally tubular outer housing having longitudinal slot means in the wall thereof, and a hammer area of increased wall thickness at one end thereof, within which housing slidably extends a jar mandrel means having first and second longitudinally spaced enlarged diameter anvil areas, at least one fastener tapped into one of those anvil areas, the heads of said fastener protruding into said slot means. Both said housing and said mandrel means possesses axial bores therethrough, which are placed in communication via the bore of a tubular spring within the housing, whereby during extension and contraction of the slip-joint and jar means of the present invention the area within said axial bores and said spring bore is of a constant volume. The invention may be employed to provide force impulses in either longitudinal direction, said tubular spring aiding the application of those impulses when said housing and said mandrel means move relatively toward each other. By proper selection of spring length and use of a coiled spring having spaced coils, the present invention may also be employed as a bi-directional shock absorber.

  11. Mesangial cell-derived tumor necrosis factor α up-regulates the expression of tubular liver type fatty acid binding-protein and its renoprotective role in IgA nephropathy%系膜细胞源性肿瘤坏死因子α上调IgA肾病肾小管肝型脂肪酸结合蛋白的表达及其肾脏保护作用

    佐楠; 栗霄立; 王力宁; 李子龙; 王均; 冯江敏; 马健飞; 范秋灵; 姚丽

    2011-01-01

    Objective To explore the mechanism of up-regulation of tubular liver-type fatty acid binding-protein (L-FABP) in IgA nephropathy (IgAN) and its renoprotective role.Methods Murine mesangial cells (MCs) from primary cell culture were cultured with aggregated IgA (AIgA) (10 to 250 mg/L) for 48 hours. The supernatant after culture was collected as AIgA-MC medium. Murine proximal tubular cell line (mProx) stably expressing human L-FABP (hL-FABP) by transfection (mProx-L) were cultured with AIgA, AIgA-MC medium and /or neutralizing anti-TNF-α antibody and recombinant murine TNF-α, respectively. AIgA-MC medium (AIgA final concentration was 25 mg/L) was cultured with mProx and mProx-L cells. The mRNA expressions of hL-FABP and MCP-1 of the cells were detected by real-time PCR. The protein expressions of hL-FABP and 4-HNE of the cells were detected by Western blotting. Results (1) The hL-FABP mRNA and protein expression stimulated by AIgA-MC medium was significantly higher as compared to AIgA (P<0.01). (2) Pre-incubation of neutralizing anti-TNF-α antibody (final concentration was 1 and 5 mg/L) with mProx-L cells could significantly suppress the up-regulation of hL-FABP protein expression induced by AlgA-MC medium (P<0.05 and P<0.01).(3) Recombinant murine TNF-α (final concentration was 50 and 250 ng/L) also induced a significant up-regulation of hL-FABP expression (P<0.01). (4) After the stimulation of AIgA-MC medium, both 4-HNE protein expression and MCP-1 mRNA expression were significantly suppressed in mProx-L cells compared to those of mProx cells (P <0.05 and P<0.01). Conclusion Mesangial cell-derived TNF-α can induce up-regulation of tubular L-FABP expression. Overexpression of tubular L-FABP may lessen the progression of IgAN by reducing oxidative stress and inflammatory mediators.%目的 探讨体外近曲小管肝型脂肪酸结合蛋白(L-FABP)在IgA肾病(IgAN)中的上调机制及其对肾脏的保护作用.方法 原代培养的小鼠系膜

  12. Vibration analysis of ultrasonic tubular resonators

    LIANG Zhaofeng; MO Xiping; ZHOU Guangping

    2012-01-01

    The frequency equation of the axisymmetric coupled vibration of a ultrasonic tubular resonator with both ends free is derived by an exact solution method, based on classical Fliigge thin shell theory. The dependence of the dimensionless frequency Ω on the ratio of length to radius 1/a, the ratio of radius to thickness a/h and Poisson's ratio v is investigated, and the axisymmetric coupled vibration of the ultrasonic tubular resonator with both ends shear diaphragm is compared with that with both ends free. The accuracy of two-dimensional and three-dimensional apparent elasticity method is also assessed by the comparison with the exact solution method. Finally, the mode shapes of the ultrasonic tubular resonator are calculated by the exact solution method, and its transform efficient is analyzed. The results show that as for two boundary conditions of both ends free and both ends shear diaphragm, the difference of the effect of the boundary conditions on the dimensionless frequency of the axisymmetric coupled vibration of the ultrasonic tubular resonator becomes smaller as l/a increases, and the larger a/h, the smaller the difference. Moreover, for free-free boundary conditions, the change of a/h has nearly no effect on the dimensionless frequency of the thin tubular resonator usually considered to mean a/h 〉 10. Purthermore, the dimensionless frequency Ω decreases as v in- creases for a given l/a, and the impact of v on Ω is different for different l/a, and the maximum impact will appear when l/a = π. Finally, the study also shows the three-dimensional apparent elasticity method has very high accuracy.

  13. Prognostic value of CT in acute pancreatitis

    The presence and degree of pancreatic necrosis and peripancreatic phlegmon were evaluated by dynamic, bolus-contrast-enhanced CT in 88 patients with acute pancreatitis and were correlated with clinical evaluation; morbidity (infection, pseudocyst); and mortality. Patients with necrosis had a 23% mortality and 82% morbidity, compared with 0% mortality and 6% morbidity in patients without necrosis. Patients with peripancreatic phlegmons and necrosis had a 26% mortality and 84% morbidity compared with 0% mortality and 22% morbidity in individuals with phlegmons but without necrosis. In this study, the CT severity index, which combines necrosis and peripancreatic phlegmon into a grading system at the initial CT examination, was a good prognostic indicator of severity of acute pancreatitis

  14. 78 FR 14361 - U.S. Steel Tubular Products, Inc., Mckeesport Tubular Operations Division, Subsidiary of United...

    2013-03-05

    ... Employment and Training Administration U.S. Steel Tubular Products, Inc., Mckeesport Tubular Operations Division, Subsidiary of United States Steel Corporation, Mckeesport, PA; Notice of Initiation of...) filed on December 20, 2012 on behalf of workers of U.S. Steel Tubular Products, McKeesport...

  15. STUDY OF ACUTE KIDNEY INJURY IN CHILDREN: ITS AETIOLOGY, CLINICAL PROFILE AND OUTCOME

    Garuda

    2015-03-01

    Full Text Available OBJECTIVES : To determine the incidence , age & sex ratio , analyse the spectrum of Acute Kidney Injury (AKI in its aetiopathology , complications including mortality , prognostic factors and the role of dialysis in the management. METHODS : This prospective observational study was conducted on serial cases of 30 patients a dmitted in Paediatrics department from Feb 2012 - Aug 2014 (30 months. RESULTS : The incidence of AKI was 0.44%. Children in age group of 0 - 4 yrs were affected most , predominantly males. Distribution of AKI according to aetiopathogenesis was Acute Tubular Necrosis (ATN 50% , Haemolytic Uraemic Syndrome (HUS 19.8% , Glomerulonephritis (GN 13.2% , Obstructive uropathy 9.9% and Acute on Chronic renal failure (CRF 6.6%. Dialysis was required in 53.3% of patients. Mortality was 57%. Patients with complications of sepsis , neurological & respiratory problems , hyperkalemia , metabolic acidosis and gastrointestinal bleeding were associated with high mortality. CONCLUSIONS : AKI is a common life threatening condition seen in childhood. Early referral , proper assessment , adequate & timely treatment and prompt institution of dialysis helps in decreasing mortality.

  16. Laboratory prediction of the requirement for renal replacement in acute falciparum malaria

    Yunus Emran

    2011-08-01

    Full Text Available Abstract Background Acute renal failure is a common complication of severe malaria in adults, and without renal replacement therapy (RRT, it carries a poor prognosis. Even when RRT is available, delaying its initiation may increase mortality. Earlier identification of patients who will need RRT may improve outcomes. Method Prospectively collected data from two intervention studies in adults with severe malaria were analysed focusing on laboratory features on presentation and their association with a later requirement for RRT. In particular, laboratory indices of acute tubular necrosis (ATN and acute kidney injury (AKI that are used in other settings were examined. Results Data from 163 patients were available for analysis. Whether or not the patients should have received RRT (a retrospective assessment determined by three independent reviewers was used as the reference. Forty-three (26.4% patients met criteria for dialysis, but only 19 (44.2% were able to receive this intervention due to the limited availability of RRT. Patients with impaired renal function on admission (creatinine clearance Conclusions In adult patients with severe malaria and impaired renal function on admission, none of the evaluated laboratory indices was superior to the plasma creatinine level when used to predict a later requirement for renal replacement therapy.

  17. Distal renal tubular acidosis in recurrent renal stone formers

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    metabolic disturbances in renal stone formers. Distal renal tubular acidosis (dRTA) was relatively more common in female stone formers and most often found in patients with bilateral stone disease (36%). Since prophylactic treatment in renal stone formers with renal acidification defects is available, this...... (1.1%) had complete distal renal tubular acidosis and 14 (15.5%) incomplete distal renal tubular acidosis. Our results confirm that distal renal tubular acidification defects are associated with a more severe form of stone disease and make distal renal tubular acidosis one of the most frequent...

  18. Renal tubular acidosis complicated with hypokalemic periodic paralysis.

    Chang, Y C; Huang, C C; Chiou, Y Y; Yu, C Y

    1995-07-01

    Three Chinese girls with hypokalemic periodic paralysis secondary to different types of renal tubular acidosis are presented. One girl has primary distal renal tubular acidosis complicated with nephrocalcinosis. Another has primary Sjögren syndrome with distal renal tubular acidosis, which occurs rarely with hypokalemic periodic paralysis in children. The third has an isolated proximal renal tubular acidosis complicated with multiple organ abnormalities, unilateral carotid artery stenosis, respiratory failure, and consciousness disturbance. The diagnostic evaluation and emergent and prophylactic treatment for these three types of renal tubular acidosis are discussed. PMID:7575850

  19. [Latest advances in acute pancreatitis].

    de-Madaria, Enrique

    2015-09-01

    The present article analyses the main presentations on acute pancreatitis at Digestive Disease Week 2015. Arterial pseudoaneurysm is an uncommon complication of acute pancreatitis (incidence 0.7%) and mortality from this cause is currently anecdotal. Diabetes mellitus has little impact on the clinical course of acute pancreatitis, unlike cirrhosis, which doubles the risk of mortality. Intake of unsaturated fat could be associated with an increased severity of acute pancreatitis and is a confounding factor in studies evaluating the relationship between obesity and morbidity and mortality. PET-CT (positron emission tomography-computed tomography) could be a non-invasive tool to detect infection of collections in acute pancreatitis. Peripancreatic fat necrosis is less frequent than pancreatic fat necrosis and is associated with a better clinical course. If the clinical course is poor, increasing the calibre of the percutaneous drains used in the treatment of infected necrosis can avoid surgery in 20% of patients. The use of low molecular-weight heparin in moderate or severe pancreatitis could be associated with a better clinical course, specifically with a lower incidence of necrosis. In acute recurrent pancreatitis, simvastatin is a promising drug for prophylaxis of new episodes of acute pancreatitis. Nutritional support through a nasogastric tube does not improve clinical course compared with oral nutrition. PMID:26520203

  20. Acute pancreatitis : new frontiers in diagnosis and treatment

    van Santvoort, H.C.

    2010-01-01

    Acute pancreatitis is an acute inflammation of the pancreas mostly caused by gallstones and alcohol abuse. Around 15 to 20% of patients show a severe clinical course, which is characterised by multiple organ failure and necrosis of the pancreatic parenchyma and/ or peripancreatic fat tissue. In around 30% of patients with necrotising pancreatitis, secondary infection of necrosis occurs, probably due to bacterial translocation from the patient’s own gut. Infected necrosis is an indication for ...

  1. RIP Kinases Initiate Programmed Necrosis

    Lorenzo Galluzzi; Oliver Kepp; Guido Kroemer

    2009-01-01

    Some lethal stimuli can induce either apoptosis or necrosis, depending on the cell type and/or experimental setting. Until recently,the molecular bases of this phenomenon were largely unknown. Now, two members of the receptor-interacting serine-threonine kinase (RIP) family, RIP1 and RIP3, have been demonstrated to control the switch between apoptotic and necrotic cell death.Some mechanistic details, however, remain controversial.

  2. [Talus necrosis and its treatment].

    Trauth, J; Bläsius, K

    1988-08-01

    Aetiopathogenesis of the necrosis of the talus has not yet been definitely clarified, and neither has that of the other aseptic necroses. We were able to study the aetiopathogenesis, course of the disease and therapy in 20 of our own patients by follow-up; two of these developed necrosis of the talus in both feet. We definitely excluded patients suffering from osteochondrosis dissecans. Even though fracture of the talus is on the whole relatively rare, it remains the most frequent cause of necrosis of the talus. We also found talonecrosis after surgical correction of clubfoot, after Sudeck's disease (Sudeck-Leriche syndrome, Sudeck's atrophy or dystrophy), suppurative arthritis of the ankle joint, subtalar luxation and haematogenic osteomyelitis. Only few patients required surgery. In most cases a special boot constructed for arthrodesis patients proved sufficient. Each patient developed arthrodesis to a different degree. Depending upon the complaints and stiffening of the ankle joint or of the talo-calcanonavicular joint, the capacity of the patients to be gainfully employed was reduced by an amount between 20 and 30 per cent. PMID:2905578

  3. Hypokalemic periodic paralysis in Sjogren's syndrome secondary to distal renal tubular acidosis.

    Yılmaz, Hakkı; Kaya, Mustafa; Özbek, Mustafa; ÜUreten, Kemal; Safa Yıldırım, İ

    2013-07-01

    We report a 53-year-old Turkish female presented with progressive weakness and mild dyspnea. Laboratory results demonstrated severe hypokalemia with hyperchloremic metabolic acidosis. The urinary anion gap was positive in the presence of acidemia, thus she was diagnosed with hypokalemic paralysis from a severe distal renal tubular acidosis (RTA). Immunologic work-up showed a strongly positive ANA of 1:3,200 and positive antibodies to SSA and SSB. Schirmer's test was abnormal. Autoimmune and other tests revealed Sjögren syndrome as the underlying cause of the distal renal tubular acidosis. Renal involvement in Sjogren's syndrome (SS) is not uncommon and may precede sicca complaints. The pathology in most cases is a tubulointerstitial nephritis causing among other things, distal RTA, and, rarely, hypokalemic paralysis. Treatment consists of potassium repletion, alkali therapy, and corticosteroids. Primary SS could be a differential in women with acute weakness and hypokalemia. PMID:22212410

  4. Tubular Heart Pumping Mechanisms in Ciona Intestinalis

    Battista, Nicholas; Miller, Laura

    2015-11-01

    In vertebrate embryogenesis, the first organ to form is the heart, beginning as a primitive heart tube. However, many invertebrates have tubular hearts from infancy through adulthood. Heart tubes have been described as peristaltic and impedance pumps. Impedance pumping assumes a single actuation point of contraction, while traditional peristalsis assumes a traveling wave of actuation. In addition to differences in flow, this inherently implies differences in the conduction system. It is possible to transition from pumping mechanism to the other with a change in the diffusivity of the action potential. In this work we consider the coupling between the fluid dynamics and electrophysiology of both mechanisms, within a basal chordate, the tunicate. Using CFD with a neuro-mechanical model of tubular pumping, we discuss implications of the both mechanisms. Furthermore, we discuss the implications of the pumping mechanism on evolution and development.

  5. Glomerular tubular balance: mediation by luminal hypotonicity.

    Häberle, D A; Müller, U; Nagel, W

    1989-01-01

    Late proximal rat tubular segments were microperfused with slightly hypo- or hypertonic artificial late proximal tubular fluid (ATF) at low (11-13 nl/min) or high (30-38 nl/min) perfusion rates. Volume reabsorption, net chloride and solute reabsorption were measured as a function of length. In addition, the transepithelial resistance and voltage (Vte) were measured as a function of the applied osmotic gradient. Hypertonic solutions equilibrated to isotonicity by solute outflow rather than water influx. With hypertonic ATF the lumen positive Vte was decreased compared with free flow or with hypotonic ATF. The resistance was not significantly different between the different groups. In contrast to hypotonic ATF, hypertonic or isotonic ATF was not significantly reabsorbed. In addition, hypotonic ATF maintained its hypotonicity along the perfused segments. Its reabsorption was flow-dependent. Hypotonicity appeared to enhance solute reabsorption. PMID:2725432

  6. Acute pancreatitis; Pancreatite aigue

    Mehdi, M.; Deutsch, J.P.; Arrive, L.; Ayadi, K.; Ladeb, M.F.; Tubiana, J.M. [Centre Hospitalier Universitaire Saint-Antoine, 75 - Paris (France)

    1996-12-31

    The diagnosis of acute pancreatitis is based on clinical examination and basic laboratory tests. The main role of sonography in acute pancreatitis is to evaluate gallstones and small fluid collections. However, sonography is frequently difficult due to intestinal ileus related to pancreatitis. CT is indicated early in the clinical course of acute severe pancreatitis when the diagnosis is uncertain or when complications such as abscess, hemorrhage, or necrosis, are suspected. In addition, CT may be used to assess the prognosis and follow-up of patients. (authors). 20 refs., 12 figs., 4 tabs.

  7. Treatment of acute pancreatitis

    Al-Mofleh Ibrahim

    1998-01-01

    Full Text Available There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future.

  8. Tubular electric heater with a thermocouple assembly

    This patent relates to a thermocouple or other instrumentation which is installed within the walls of a tubular sheath surrounding a process device such as an electric heater. The sheath comprises two concentric tubes, one or both of which have a longitudinal, concave crease facing the other tube. The thermocouple is fixedly positioned within the crease and the outer tube is mechanically reduced to form an interference fit onto the inner tube

  9. Clinical profile of distal renal tubular acidosis

    Ratan Jha; Muthukrishnan, J.; Shekhar Shiradhonkar; Kiran Patro; Harikumar KVS; Modi, K.D.

    2011-01-01

    To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA), we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive ...

  10. Inherited renal tubular defects with hypokalemia

    Muthukrishnan J; Modi K; Kumar P; Jha Ratan

    2009-01-01

    Bartter′s and Gitelman′s syndrome are two ends of a spectrum of inherited renal tubular disorders that present with hypokalemic metabolic alkalosis of varying severity. Clinical features and associated calcium and magnesium ion abnormalities are used to diagnose these cases after excluding other commoner causes. We report on two cases, the first being a young boy, born of pregnancy complicated by polyhydramnios, who had classical dysmorphic features, polyuria, hypokalemia and hy...

  11. Energy production with a tubular propeller turbine

    Almeida Samora, Irene; Hasmatuchi, Vlad; Münch-Alligné, C.; Franca, Mário J.; Schleiss, Anton; Helena M. Ramos

    2016-01-01

    Micro-hydropower is a way of improving the energetic efficiency of existent water systems. In the particular case of drinking water systems, several studies have showed that pressure reducing valves can be by-passed with turbines in order to recover the dissipated hydraulic energy to produce electricity. As conventional turbines are not always cost-effective for power under 20 kW, a new energy converter is studied. A five blade tubular propeller (5BTP), assessed through laboratorial tests on ...

  12. 更昔洛韦及水痘致血栓性微血管病并发急性肾小管坏死一例%One case of thrombotic microangiopathy (TMA) complicated with acute tubular necrosis induced by ganciclovir and chickenpox

    连希艳; 黄胜华; 赵劲涛; 曾怡

    2010-01-01

    @@ 患者,女,20岁,学生,因反复皮肤紫癜、关节痛1个月,腹痛半个月,加重5 d入院.患者1个月前无明显诱因出现双下肢紫癜,四肢关节疼痛.半个月前以上症状再次出现,双下肢紫癜明显增多,呈片状、双侧对称,伴腹痛.5 d前腹痛加重,遂收住我院血液科.查体:BP 120/75mm Hg,躯干、双下肢、臀部皮肤新旧不一,点片状紫癜,浅表淋巴结未触及肿大,咽充血,心、肺、腹未见明显异常.

  13. Evaluation of autologous bone marrow-derived mesenchymal stem cells on renal regeneration after experimentally induced acute kidney injury in dogs.

    Lim, Chae-Young; Han, Jae-Ik; Kim, Seung-Gon; Lee, Chang-Min; Park, Hee-Myung

    2016-02-01

    OBJECTIVE To evaluate the usefulness of autologous bone marrow-derived mesenchymal stem cell (BM-MSC) therapy for the treatment of dogs with experimentally induced acute kidney injury. ANIMALS 6 healthy dogs. PROCEDURES After induction of kidney injury (day 0) with cisplatin (5 mg/kg, IV), dogs immediately received saline (0.9% NaCl) solution (10 mL; n = 3) or BM-MSCs (1 × 10(6) cells/kg in 10 mL of saline solution; 3) IV. A CBC, serum biochemical analysis, and urinalysis were performed for each dog before administration of cisplatin and on days 1 through 4. Glomerular filtration rate was determined for all dogs on days -7 and 2; BM-MSC tracking by MRI was performed on BM-MSC-treated dogs on days -14 and 4. After sample collection and BM-MSC tracking on day 4, all dogs were euthanized; kidney tissue samples underwent histologic evaluation, immunohistochemical analysis, and cytokine profiling via reverse transcriptase PCR assays. RESULTS Kidney tissue from both groups had mononuclear inflammatory cell infiltration, tubular necrosis, dilated tubules, and glomerular damage. However, there was less fibrotic change and increased proliferation of renal tubular epithelial cells in the BM-MSC-treated dogs, compared with findings for the control dogs. Expressions of tumor necrosis factor-α and transforming growth factor-β were lower in the BM-MSC-treated group, compared with findings for the control group. Laboratory data revealed no improvement in the renal function in BM-MSC-treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study suggested that autologous BM-MSCs may accelerate renal regeneration after experimentally induced acute kidney injury in dogs. (Am J Vet Res 2016;77:208-217). PMID:27027716

  14. Blocking TGF-β Signaling Pathway Preserves Mitochondrial Proteostasis and Reduces Early Activation of PDGFRβ+ Pericytes in Aristolochic Acid Induced Acute Kidney Injury in Wistar Male Rats

    Pozdzik, Agnieszka A.; Giordano, Laetitia; Li, Gang; Antoine, Marie-Hélène; Quellard, Nathalie; Godet, Julie; De Prez, Eric; Husson, Cécile; Declèves, Anne-Emilie; Arlt, Volker M.; Goujon, Jean-Michel; Brochériou-Spelle, Isabelle; Ledbetter, Steven R.; Caron, Nathalie; Nortier, Joëlle L.

    2016-01-01

    Background The platelet-derived growth factor receptor β (PDGFRβ)+ perivascular cell activation becomes increasingly recognized as a main source of scar-associated kidney myofibroblasts and recently emerged as a new cellular therapeutic target. Aims In this regard, we first confirmed the presence of PDGFRβ+ perivascular cells in a human case of end-stage aristolochic acid nephropathy (AAN) and thereafter we focused on the early fibrosis events of transforming growth factor β (TGFβ) inhibition in a rat model of AAN. Materials and Methods Neutralizing anti-TGFβ antibody (1D11) and its control isotype (13C4) were administered (5 mg/kg, i.p.) at Days -1, 0, 2 and 4; AA (15 mg/kg, sc) was injected daily. Results At Day 5, 1D11 significantly suppressed p-Smad2/3 signaling pathway improving renal function impairment, reduced the score of acute tubular necrosis, peritubular capillaritis, interstitial inflammation and neoangiogenesis. 1D11 markedly decreased interstitial edema, disruption of tubular basement membrane loss of brush border, cytoplasmic edema and organelle ultrastructure alterations (mitochondrial disruption and endoplasmic reticulum edema) in proximal tubular epithelial cells. Moreover, 1D11 significantly inhibited p-PERK activation and attenuated dysregulation of unfolded protein response (UPR) pathways, endoplasmic reticulum and mitochondrial proteostasis in vivo and in vitro. Conclusions The early inhibition of p-Smad2/3 signaling pathway improved acute renal function impairment, partially prevented epithelial-endothelial axis activation by maintaining PTEC proteostasis and reduced early PDGFRβ+ pericytes-derived myofibroblasts accumulation. PMID:27379382

  15. Non-invasive in vivo imaging of myocardial apoptosis and necrosis

    Myocardial necrosis plays an important role in the pathogenesis of various cardiovascular disorders and can result from different myocardial insults. Its non-invasive identification and localisation therefore may help in the diagnosis of these disorders, as well as in prognosis and assessment of treatment response. Apoptosis, or programmed cell death, is important in the spectrum of myocardial damage since it is gradually becoming more apparent that cell death may begin as apoptosis and not as necrosis. First attempts to directly visualise the area of myocardial necrosis were based on recognition of myocardial infarction with ''hot spot imaging agents'' in patients with chest pain. Since then, the study of myocardial necrosis with gamma imaging agents has gone beyond the detection of myocardial infarction, and attempts have been made to diagnose other cardiovascular disorders associated with cardiac cell death such as heart transplant rejection, myocarditis, cardiotoxicity and cardiomyopathies. Traditionally, two hot spot imaging agents have been used for the detection of myocardial necrosis, 99mTc-pyrophosphate and 111In-antimyosin. In addition, preliminary studies have demonstrated promising results with 99mTc-glucarate. Recently, 99mTc-annexin V has been successfully used for non-invasive gamma imaging of apoptosis after acute myocardial infarction, acute myocardial ischaemia, acute cardiac allograft rejection and malignant intracardiac tumours. This review article focusses on the characteristics of these different myocardial necrotic and apoptotic markers and compares their role in the assessment of myocardial damage. (orig.)

  16. Non-invasive in vivo imaging of myocardial apoptosis and necrosis

    Flotats, Albert; Carrio, Ignasi [Hospital de la Santa Creu i Sant Pau, Barcelona (Spain)

    2003-04-01

    Myocardial necrosis plays an important role in the pathogenesis of various cardiovascular disorders and can result from different myocardial insults. Its non-invasive identification and localisation therefore may help in the diagnosis of these disorders, as well as in prognosis and assessment of treatment response. Apoptosis, or programmed cell death, is important in the spectrum of myocardial damage since it is gradually becoming more apparent that cell death may begin as apoptosis and not as necrosis. First attempts to directly visualise the area of myocardial necrosis were based on recognition of myocardial infarction with ''hot spot imaging agents'' in patients with chest pain. Since then, the study of myocardial necrosis with gamma imaging agents has gone beyond the detection of myocardial infarction, and attempts have been made to diagnose other cardiovascular disorders associated with cardiac cell death such as heart transplant rejection, myocarditis, cardiotoxicity and cardiomyopathies. Traditionally, two hot spot imaging agents have been used for the detection of myocardial necrosis, {sup 99m}Tc-pyrophosphate and {sup 111}In-antimyosin. In addition, preliminary studies have demonstrated promising results with {sup 99m}Tc-glucarate. Recently, {sup 99m}Tc-annexin V has been successfully used for non-invasive gamma imaging of apoptosis after acute myocardial infarction, acute myocardial ischaemia, acute cardiac allograft rejection and malignant intracardiac tumours. This review article focusses on the characteristics of these different myocardial necrotic and apoptotic markers and compares their role in the assessment of myocardial damage. (orig.)

  17. Skin necrosis caused by prallethrin-A worldwide used insecticide.

    Botnariu, Gina; Birsan, Cristina; Podoleanu, Cristian; Moldovan, Cosmin; Stolnicu, Simona; Chiriac, Anca

    2016-04-01

    We report a case of necrosis caused by the use of prallethrin (mosquito repellent) on the skin in a 67-year-old diabetic female patient suffering from delusions of parasitosis. Cutaneous toxicity due to pyrethroids is less known or reported, despite well-documented pyrethroid poisoning involving the gastrointestinal, respiratory, cardiac, and nervous systems. Skin irritation has been described after acute accidental exposure but, as far as we know, no data have been published on the effects of pyrethroids when applied directly to the skin. PMID:26987111

  18. Prevention and Intervention Strategies in Acute Pancreatitis

    Besselink, M.G.H.

    2008-01-01

    Acute pancreatitis is a common, costly, potentially lethal, and poorly understood disease, mostly caused by gallstones. In the past decade the incidence of acute pancreatitis in the Netherlands increased by 50% to over 3400 admissions in 2006, most likely due to an increase of gallstone disease. About 20% of patients will develop severe acute pancreatitis, a disease characterized by organ failure and/or pancreatic necrosis, resulting in a high mortality rate. Because the incidence of acute pa...

  19. Magnetic resonance imaging for acute pancreatitis

    Xiao, Bo; Zhang, Xiao-Ming

    2010-01-01

    Acute pancreatitis is characterized by acute chemical injury of the pancreatic parenchyma and peripancreatic tissue. The increased frequency of death in acute pancreatitis is directly correlated with the degree and progress of pancreatic necrosis. Moreover, the occurrence of some local complications in acute pancreatitis, such as pancreatic hemorrhage, peripancreatic abscess or large pseudocyst, and pseudoaneurysm, could influence the choice of treatment for these patients. Magnetic resonance...

  20. A simple auxetic tubular structure with tuneable mechanical properties

    Ren, Xin; Shen, Jianhu; Ghaedizadeh, Arash; Tian, Hongqi; Xie, Yi Min

    2016-06-01

    Auxetic materials and structures are increasingly used in various fields because of their unusual properties. Auxetic tubular structures have been fabricated and studied due to their potential to be adopted as oesophageal stents where only tensile auxetic performance is required. However, studies on compressive mechanical properties of auxetic tubular structures are limited in the current literature. In this paper, we developed a simple tubular structure which exhibits auxetic behaviour in both compression and tension. This was achieved by extending a design concept recently proposed by the authors for generating 3D metallic auxetic metamaterials. Both compressive and tensile mechanical properties of the auxetic tubular structure were investigated. It was found that the methodology for generating 3D auxetic metamaterials could be effectively used to create auxetic tubular structures as well. By properly adjusting certain parameters, the mechanical properties of the designed auxetic tubular structure could be easily tuned.

  1. Complete Penile Necrosis in a Patient With Heparin-induced Thrombocytopenia: A Case Report

    Anne-Sophie Blais

    2014-01-01

    Full Text Available Penile necrosis is a rare condition that has been mostly described in association with diabetes mellitus and end-stage renal disease. We report an unusual case of acute penile necrosis because of heparin-induced thrombocytopenia. A 75-year-old man presented with acute renal failure and experienced cardiac complications during the hospitalization. The patient was treated twice with intravenous heparin. He developed symptoms of penile necrosis 4 days after the reintroduction of heparin. At that moment, the platelet count dropped by 61%, and the analysis of heparin-pf4 antibodies was positive for heparin-induced thrombocytopenia. The patient underwent a total penectomy and a perineal urethrostomy.

  2. Expression of matrix metalloproteinases and tissue inhibitors of metalloproteinases in epiretinal membranes of proliferative diabetic retinopathy,proliferative vitreoretinopathy and acute retinal necrosis patients%三种视网膜病视网膜前膜中基质金属蛋白酶及其天然抑制分子的表达

    顾永昊; 石磊; 柯根杰; 孙思勤

    2008-01-01

    Objective To examine the expression of matrix metalloproteinases (MMPs)and tissueinhibitors of metalloproteinases (TIMPs)in epiretinal membranes of proliferative diabetic retinopathy(PDR),proliferative vitreoretinopathy (PVR)and acute retinal necrosis (ARN)patients.Methods Epiretinalmembranes were obtained from PVR, PDR and ARN patients undergoing pars plana vitrectomy.Normal retinaobtained from donor eyes were used as control.Results MMP-1, MMP-3,TIMP-1 and TIMP-2 were stainedin normal retina.For PVR, PDR and ARN specimens, the increase portion of all iMPs and TIMPs stainingwere observed,especially MMP-2,MMP-7 and MMP-9.Conelusions There are MMPs and TIMPs existed innormal retina to balance the integrity of extracellular matrix.lncreased expression of MMPs, such as MMP-2,iMP-7 and iMP-9, might play the important roles in pathologic processes of PVR, PDR and AKN.%目的 研究增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)、增殖性玻璃体视网膜疾病(proliferative vitreoretinopathy,PVR)和急性视网膜坏死(acute retinalnecrosis,ARN)患者视网膜前膜中基质金属蛋白酶(matrixmetalloproteinases:MMPs)及其天然抑制物(tissueinhibitorsofmetalloproteinages,TIMPs)的表达情况.方法 玻璃体手术中剥取PVR、PDR和ARN患者的视网膜前膜,同供体眼视网膜作为正常对照,冰冻切片后进行免疫组织化学染色,包括:MMP-1,MMP-2,MMP-3,MMP-7,MMP-9,TIMP-1和TIMP-2.结果 正常视网膜中能够观察到MMP-1,MMP-3,TIMP-1和TIMP-2的表达,在PVR、PDR和ARN患者标本中各种分子的表达都增强,尤以MMP-2,MMP-3和MMP-7明显.结论 正常视网膜中存在MMPs和TIMPs分子维持着细胞外基质动态的平衡,在PVR,PDR和ARN患者中MMP-2,MMP-3和MMP-7等MMPs分子表达增强,在其病变过程中可能起重要作用.

  3. Necrosis and haemorrhage of the putamen in methanol poisoning shown on MRI

    Kuteifan, K.; Gutbub, A.M.; Laplatte, G. [Service de Reanimation Medicale, Centre Hospitalier Louis Pasteur, Colmar (France); Oesterle, H.; Tajahmady, T. [Service de Neuroradiologie, Centre Hospitalier Louis Pasteur, Colmar (France)

    1998-03-01

    Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter. (orig.) With 1 fig., 8 refs.

  4. Necrosis and haemorrhage of the putamen in methanol poisoning shown on MRI

    Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter. (orig.)

  5. Optimizing Mouse Surgery with Online Rectal Temperature Monitoring and Preoperative Heat Supply. Effects on Post-Ischemic Acute Kidney Injury.

    Marschner, Julian A; Schäfer, Hannah; Holderied, Alexander; Anders, Hans-Joachim

    2016-01-01

    Body temperature affects outcomes of tissue injury. We hypothesized that online body core temperature recording and selective interventions help to standardize peri-interventional temperature control and the reliability of outcomes in experimental renal ischemia reperfusion injury (IRI). We recorded core temperature in up to seven mice in parallel using a Thermes USB recorder and ret-3-iso rectal probes with three different protocols. Setup A: Heating pad during ischemia time; Setup B: Heating pad from incision to wound closure; Setup C: A ventilated heating chamber before surgery and during ischemia time with surgeries performed on a heating pad. Temperature profile recording displayed significant declines upon installing anesthesia. The profile of the baseline experimental setup A revealed that <1% of the temperature readings were within the target range of 36.5 to 38.5°C. Setup B and C increased the target range readings to 34.6 ± 28.0% and 99.3 ± 1.5%, respectively. Setup C significantly increased S3 tubular necrosis, neutrophil influx, and mRNA expression of kidney injury markers. In addition, using setup C different ischemia times generated a linear correlation with acute tubular necrosis parameters at a low variability, which further correlated with the degree of kidney atrophy 5 weeks after surgery. Changing temperature control setup A to C was equivalent to 10 minutes more ischemia time. We conclude that body temperature drops quickly in mice upon initiating anesthesia. Immediate heat supply, e.g. in a ventilated heating chamber, and online core temperature monitoring can help to standardize and optimize experimental outcomes. PMID:26890071

  6. Hyaluronan in Tubular and Interstitial Nephrocalcinosis

    Verkoelen, Carl F.

    2007-04-01

    Hyaluronan (HA) is the major glycosaminoglycan (GAG) component of the renal medullary interstitium. HA is extremely large (up to 104 kDa) and composed of thousands repeating disaccharides of glucuronic acid (GlcUA) and N-acetylglucosamine (GlcNAc). HA is synthesized by hyaluronan synthases (HASs) and degraded by hyaluronidases (Hyals). The production of HA by renomedullary interstitial cells is mediated by local osmolality. When excess water needs to be excreted, increased interstitial HA seems to antagonize water reabsorption, while the opposite occurs during water conservation. Hence, papillary interstitial HA is low and Hyal high during anti-diuresis, whereas during diuresis HA is high and Hyal low. The polyanion HA plays a role in the reabsorption of hypotonic fluid by immobilizing cations (Na+) via the carboxylate (COO-) groups of GlcUA. The binding of Ca2+ to anionic HA is probably also responsible for the fact that the papilla does not become a stone despite the extremely high interstitial phosphate and oxalate. HA is also an excellent crystal binding molecule. The expression of HA at the luminal surface of renal tubular cells leads to tubular nephrocalcinosis (tubular NC). Calcium staining methods (Von Kossa, Yasue) demonstrated that crystallization inhibitors cannot avoid the occasional precipitation of calcium phosphate in the papillary interstitium (interstitial NC). These crystals are probably immediately immobilized by the gel-like HA matrix. After ulcerating through the pelvic wall the calcified matrix becomes a Randall's plaque. The attachment of calcium oxalate crystals from the primary urine to plaque may ultimately lead to the development of clinical stones in the renal calyces (nephrolithiasis).

  7. Carbon Tubular Morphologies in Blast Furnace Coke

    Stanislav S. Gornostayev; Jouko J. Härkki

    2008-01-01

    The paper reports on the first occurrence of microscale carbon tubular morphologies (CMTs) in a blast furnace (BF) coke. The CMTs were probably formed as a result of the conversion of solid disordered carbon via liquid phase metal particles involving a gas phase containing a substantial amount of N 2 and O 2 . The presence of CMTs may lie behind the generation of the smallest fraction of fines in BF exhaust dust. If the amount of CMTs present in the BF exhausts gases at any particular metallu...

  8. Carbon Tubular Morphologies in Blast Furnace Coke

    Stanislav S. Gornostayev

    2008-01-01

    Full Text Available The paper reports on the first occurrence of microscale carbon tubular morphologies (CMTs in a blast furnace (BF coke. The CMTs were probably formed as a result of the conversion of solid disordered carbon via liquid phase metal particles involving a gas phase containing a substantial amount of N2 and O2. The presence of CMTs may lie behind the generation of the smallest fraction of fines in BF exhaust dust. If the amount of CMTs present in the BF exhausts gases at any particular metallurgical site proves to be substantial, it could become a subject of environmental concern.

  9. TUBULAR PHOTOBIOREACTOR FOR MICROALGAE BIODIESEL PRODUCTION

    Nkongolo Mulumba; Ihab H. Farag

    2012-01-01

    Biodiesel production from algae is a promising technique. Microalgae have the potential to produce 5,000-15,000 gallons of biodiesel/(acre-year). However, there are challenges; these include high yieldof algae biomass with high lipid content and the effective technique to harvest the grown algae, extract the algal oil and transesterify the oil to biodiesel. In this project Tubular PhotoBioReactor (TPBR) was designed and achieved a ten times increase in algae concentration. It produced 1g of d...

  10. Tubular solid oxide fuel cell development program

    NONE

    1995-08-01

    This paper presents an overview of the Westinghouse Solid Oxide Fuel Cell (SOFC) development activities and current program status. The Westinghouse goal is to develop a cost effective cell that can operate for 50,000 to 100,000 hours. Progress toward this goal will be discussed and test results presented for multiple single cell tests which have now successfully exceeded 56,000 hours of continuous power operation at temperature. Results of development efforts to reduce cost and increase power output of tubular SOFCs are described.

  11. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

    Moe, Orson W.; Fuster, Daniel G.; Xie, Xiao-Song

    2008-09-01

    Calcium stones are commonly encountered in patients with congenital distal renal tubular acidosis, a disease of renal acidification caused by mutations in either the vacuolar H+-ATPase (B1 or a4 subunit), anion exchanger-1, or carbonic anhydrase II. Based on the existing database, we present two hypotheses. First, heterozygotes with mutations in B1 subunit of H+-ATPase are not normal but may harbor biochemical abnormalities such as renal acidification defects, hypercalciuria, and hypocitraturia which can predispose them to kidney stone formation. Second, we propose at least two mechanisms by which mutant B1 subunit can impair H+-ATPase: defective pump assembly and defective pump activity.

  12. Renal Papillary Necrosis: Role of Radiology

    Sutariya, Harsh C.; Pandya, Vaidehi K.

    2016-01-01

    Renal Papillary Necrosis (RPN) is idefined as Ischemic necrobiosis of the papilla in the medulla of the kidneys. Variety of etiological factors are recognized which cause papillary necrosis, such as analgesic nephropathy, diabetes mellitus, urinary obstruction and sickle cell haemoglobinopathy. The early diagnosis of RPN is important to improve prognosis and reduce morbidity. Radiological Imaging offers early diagnosis and can guide prompt treatment of papillary necrosis and can minimize a de...

  13. Cortical necrosis of the renal transplant

    Cortical necrosis is a rare complication of renal transplants, which requires urgent diagnosis and management to avoid unnecessary immunosuppression. Seven renal transplants with suspected cortical necrosis were evaluated by Doppler-US, 99mTc-DTPA-perfusion study and Gd-DTPA-enhanced dynamic MRI. In four transplants, cortical necrosis was confirmed by angiography and histology. In diagnosing cortical necrosis with preserved medullary perfusion (n=2) dynamic MRI was superior to the other modalities. Totally necrotic renal transplants (n=2) were reliably diagnosed by all imaging methods. (orig.)

  14. Effect of taurine on advanced glycation end products-induced hypertrophy in renal tubular epithelial cells

    Mounting evidence indicates that advanced glycation end products (AGE) play a major role in the development of diabetic nephropathy (DN). Taurine is a well documented antioxidant agent. To explore whether taurine was linked to altered AGE-mediated renal tubulointerstitial fibrosis in DN, we examined the molecular mechanisms of taurine responsible for inhibition of AGE-induced hypertrophy in renal tubular epithelial cells. We found that AGE (but not non-glycated BSA) caused inhibition of cellular mitogenesis rather than cell death by either necrosis or apoptosis. There were no changes in caspase 3 activity, bcl-2 protein expression, and mitochondrial cytochrome c release in BSA, AGE, or the antioxidant taurine treatments in these cells. AGE-induced the Raf-1/extracellular signal-regulated kinase (ERK) activation was markedly blocked by taurine. Furthermore, taurine, the Raf-1 kinase inhibitor GW5074, and the ERK kinase inhibitor PD98059 may have the ability to induce cellular proliferation and cell cycle progression from AGE-treated cells. The ability of taurine, GW5074, or PD98059 to inhibit AGE-induced hypertrophy was verified by the observation that it significantly decreased cell size, cellular hypertrophy index, and protein levels of RAGE, p27Kip1, collagen IV, and fibronectin. The results obtained in this study suggest that taurine may serve as the potential anti-fibrotic activity in DN through mechanism dependent of its Raf-1/ERK inactivation in AGE-induced hypertrophy in renal tubular epithelial cells

  15. Renal proximal tubular dysgenesis associated with severe neonatal hemosiderotic liver disease.

    Bale, P M; Kan, A E; Dorney, S F

    1994-01-01

    We report the necropsy findings for three infants with the unusual combination of proximal renal tubular dysgenesis and severe congenital liver disease with excessive iron in several organs resembling neonatal hemochromatosis. Two of the infants were caucasian siblings and one was an Australian aborigine. One died in utero at 35 weeks of gestation and two died at 7 days. The liveborn infants presented with anuria and liver failure. The livers all showed marked loss of hepatocytes and replacement by pseudotubules in the collapsed lobules. The liveborn infants also showed giant cell transformation of hepatocytes, small regenerative nodules, cholestasis, and normal bile ducts. Absence of proximal renal convolutions was confirmed by epithelial membrane antigen positivity in nearly all tubules. In each family there was another sibling with congenital liver disease, fatal in one case, but no renal tubular dysgenesis. No infection or metabolic disease was uncovered in any of our patients, and the cause of the hepatocyte destruction was not determined. The combination in three infants of two rare congenital diseases could be genetic or acquired in utero from the same etiological agent. Alternatively, the absence of proximal convolutions could be secondary to hypoperfusion, perhaps because of shock due to extensive necrosis of hepatocytes. PMID:8066004

  16. Strength of Concrete Filled Steel Tubular Columns

    Muhammad Naseem Baig; FAN Jiansheng; NIE Jianguo

    2006-01-01

    Composite columns of steel and concrete have been used and studied world wide, but filled tubular columns need more attention. This paper presents an experimental study on the behavior of short concrete filled steel tubular columns (CFT) axially loaded in compression to failure. A total of 28 specimens (16 were filled with concrete and 12 were kept hollow) with different cross-sections were tested to investigate the load capacity. The length-to-diameter ratios of these columns were between 4 and 9. Parameters for the tests were tube shape and diameter-to-thickness ratio. Some of the concrete filled columns had internal bracing of #3 deformed bars. The test results are compared with the theoretical results and previous studies. The results show that the confinement effect on concrete does play a role in increasing the compressive strengths to almost 60% in some cases. Based on the test results, an equation to estimate the ultimate axial compressive loading capacities is also proposed for square CFT columns.

  17. Does hypokalemia contribute to acute kidney injury in chronic laxative abuse?

    Lee, Eun-Young; Yoon, Hyaejin; Yi, Joo-Hark; Jung, Woon-Yong; Han, Sang-Woong; Kim, Ho-Jung

    2015-06-01

    Prolonged hypokalemia from chronic laxative abuse is recognized as the cause of chronic tubulointerstitial disease, known as "hypokalemic nephropathy," but it is not clear whether it contributes to acute kidney injury (AKI). A 42-year-old woman with a history of chronic kidney disease as a result of chronic laxative abuse from a purging type of anorexia nervosa (AN-P), developed an anuric AKI requiring hemodialysis and a mild AKI 2 months later. Both episodes of AKI involved severe to moderate hypokalemia (1.2 and 2.7 mmol/L, respectively), volume depletion, and mild rhabdomyolysis. The histologic findings of the first AKI revealed the remnants of acute tubular necrosis with advanced chronic tubulointerstitial nephritis and ischemic glomerular injury. Along with these observations, the intertwined relationship among precipitants of recurrent AKI in AN-P is discussed, and then we postulate a contributory role of hypokalemia involved in the pathophysiology of the renal ischemia-induced AKI. PMID:26484031

  18. Overview of management of acute renal failure and its evaluation; a case analysis

    Nazar Chaudhary Muhammad Junaid

    2015-01-01

    Full Text Available The annual incidence is about 150 per million in the UK, but this figure is six times greater in the >80 years old group. Prerenal azotemia is considered as the most serious reason in community or hospital acquired acute renal failure (ARF. A 67-year-old middle age male was admitted to the hospital with a chief complaint of generalized weakness, volume depletion and dysuria. He has treated with metronidazole for diarrhoea caused by Clostridium difficile considered as the precipitating factor for the ARF. The patient has severe osteoarthritis and takes high dose non-steroidal anti-inflammatory drugs from the last two years. He also complains for obstructive sleep apnea (OSA and obesity. He has controlled hypertension was on lisinopril to control blood pressure. ARF is quite common, occurring in 80 million populations. Urinary obstruction should be excluded (a cause in around 5-10 of cases because this is readily reversible if it is diagnosed early. A renal US will be sufficient to identify obstruction in 95 of cases. Most cases of ARF are expected to pre renal failure/acute tubular necrosis (ATN 70-80%. Risk factor for development for at ATN are old age, drugs (non-steroidal anti-inflammatory drugs, gentamicin, sepsis, and chronic kidney disease and must be considered.

  19. Acute and subchronic toxicity assessment model of Ferula assa-foetida gum in rodents

    Ayman Goudah

    2015-05-01

    Full Text Available Aim: The present study was performed to investigate acute and subchronic oral toxicity of Ferula assa-foetida gum (28 days in Sprague Dawley rats. Materials and Methods: Acute oral administration of F. assa-foetida was done as a single bolus dose up to 5 g/kg in mice and subchronic toxicity study for 28 days was done by oral administration at doses of 0 (control and 250 mg/kg in Sprague Dawley rats. Results: The obtained data revealed that oral administration of F. assa-foetida extract in rats for 28 successive days had no significant changes on body weight, body weight gain, the hematological parameters in rats all over the period of the experiment, and there are no significant increases in the activity of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, creatinine and urea. Liver of treated rats showed mild changes as thrombosis and sinusoidal leukocytosis. It also showed portal infiltration with inflammatory cells, while kidney of treated rat showed an atrophy of glomerular tuft, thickening of parietal layer of Bowman capsule, and focal tubular necrosis. It also showed dilatation and congestion of renal blood vessels. Conclusion: We concluded that F. assa-foetida gum had broad safety and little toxicity for short term use in dose of 250 mg/kg.

  20. [Acute pancreas necrosis with biliary peritonitis in cesarean section].

    Zoldos, L; Hincová, M

    1986-01-01

    The authors describe the case of a hemorrhagic pancreatitis with non-perforating biliary peritonitis. The abdomen symptomatology was hidden by the beginning contractions and due to the dystocia the delivery was finished by caesarean section. The presence of choleperitoneum required a surgical revision of the abdominal cavity which enabled to make the right diagnosis. This thesis deals with aetiology and mechanism of choleperitoneum inception during hemorrhagic pancreatitis. PMID:3788337

  1. Ritonavir-induced acute kidney injury: kidney biopsy findings and review of literature

    Shafi, T.; Choi, M.J.; Racusen, L. C.; Spacek, L. A.; Berry, C; Atta, M.; Fine, D.M.

    2011-01-01

    Ritonavir therapy is not generally considered nephrotoxic. We report a case of acute kidney injury secondary to ritonavir, with kidney biopsy demonstrating extensive acute tubular injury. This is the first report of a kidney biopsy and pathology in acute kidney injury associated with ritonavir. A review of published medical literature on the topic is also presented.

  2. Cortical necrosis secondary to trauma in a child: contrast-enhanced ultrasound comparable to magnetic resonance imaging

    Yusuf, Gibran T.; Sellars, Maria E.; Huang, Dean Y.; Deganello, Annamaria; Sidhu, Paul S. [King' s College Hospital, King' s College London, Department of Radiology, London (United Kingdom)

    2014-04-15

    Cortical necrosis is an uncommon cause of renal impairment and is rarely a consequence of blunt abdominal trauma. We present a case of unilateral traumatic acute cortical necrosis in a child demonstrated on contrast-enhanced US with confirmation on MRI. Contrast-enhanced US provides a rapid, accurate evaluation of renal parenchyma abnormalities in blunt abdominal trauma in children without exposure to ionising radiation or the risk of sedation. (orig.)

  3. Cortical necrosis secondary to trauma in a child: contrast-enhanced ultrasound comparable to magnetic resonance imaging

    Cortical necrosis is an uncommon cause of renal impairment and is rarely a consequence of blunt abdominal trauma. We present a case of unilateral traumatic acute cortical necrosis in a child demonstrated on contrast-enhanced US with confirmation on MRI. Contrast-enhanced US provides a rapid, accurate evaluation of renal parenchyma abnormalities in blunt abdominal trauma in children without exposure to ionising radiation or the risk of sedation. (orig.)

  4. Type IV renal tubular acidosis associated with Alport's syndrome.

    Tkácová, R.; Roland, R.; Böör, A.; Kovácová, A.; Lazúrová, I.; Tkác, I.; Hildebrand, T.; Sefara, P.

    1993-01-01

    A case of hereditary nephritis with mild reduction of renal function associated with renal tubular acidosis type IV is described. The patient was admitted with life-threatening hyperkalaemia. To our knowledge, type IV renal tubular acidosis has not been reported previously in association with Alport's syndrome in an adult patient.

  5. Theoretical and experimental investigations of Chinese evacuated tubular solar collectors

    Qin, Lin; Furbo, Simon

    1999-01-01

    Four different marketed Chinese evacuated tubular solar collectors have been investigated both theoretically and experimentally. The advantages of the investigated solar collectors compared to normal flat plate collectors were elucidated.......Four different marketed Chinese evacuated tubular solar collectors have been investigated both theoretically and experimentally. The advantages of the investigated solar collectors compared to normal flat plate collectors were elucidated....

  6. Acute pancreatitis in pregnancy

    Pitchumoni, Capecomorin S; Yegneswaran, Balaji

    2009-01-01

    Acute pancreatitis (AP) is a rare event in pregnancy, occurring in approximately 3 in 10 000 pregnancies. The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated wit...

  7. Acute ischemic cerebral attack

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  8. 奥曲肽联合乌司他丁对老年急性胰腺炎患者血清肿瘤坏死因子α及白细胞介素-2水平的影响分析%The impact analysis of Octreotide Combined Ulinastatin on Elderly Patients with Acute Pancreatitis, Serum Tumor Necrosis Factor-αand Interleukin-2 levels

    吴军

    2014-01-01

    Objective:To analyse the octreotide combined ulinastatin on elderly patients with acute pancreatitis serum tumor necrosis factor alpha and interleukin 2 levels, for clinical reference. Methods:From August 2010 to July 2013 elderly patients with acute pancreatitis,65 cases included in this study,both on the basis of conventional treatment accepted Mr Octreotide combined ulinastatin treatment.Compared before and after treatment in patients with serum tumor necrosis factor alpha and interleukin-2levels of change. Results:Compared with before treatment,we found that after treatment in patients with serum tumor necrosis factor alpha and interleukin-2 levels have declined,after statistical analysis that the significant dif erence (p<0.05). Conclusion:In the treatment of senile acute pancreatitis by Mr Octreotide combined ulinastatin treatment,can ef ectively reduce the level of serum tumor necrosis factor alpha and interleukin 2,by blocking the release of inflammatory mediators in serum and play the role of pancreas injury,control the condition.%目的:分析奥曲肽联合乌司他丁对老年急性胰腺炎患者血清肿瘤坏死因子α及白细胞介素-2水平的影响,以供临床参考。方法将我院2010年8月~2013年7月收治的老年急性胰腺炎患者65例纳入本研究,均在常规治疗基础上接受奥曲肽联合乌司他丁治疗。对比治疗前后患者血清肿瘤坏死因子α及白细胞介素-2水平的变化。结果与治疗前对比,我们发现患者治疗后血清肿瘤坏死因子α及白细胞介素-2水平均有所下降,差异经统计学分析后认为有意义(P<0.05)。结论在老年急性胰腺炎的治疗中采用奥曲肽联合乌司他丁治疗,可有效降低血清肿瘤坏死因子α及白细胞介素-2水平,通过阻断血清中炎症介质的释放而发挥减轻胰腺损伤、控制病情的作用。

  9. Renal tubular acidosis due to the milk-alkali syndrome.

    Rochman, J; Better, O S; Winaver, J; Chaimowitz, C; Barzilai, A; Jacobs, R

    1977-06-01

    A 60-year-old man with a history of excessive ingestion of calcium carbonate presented with azotemia, hypercalcemia and hyperphosphatemia. His acid-base status was initially normal. Following the cessation of calcium carbonate treatment, the hypercalcemia and azotemia disappeared, and the patient was found to be in metabolic acidosis with blunted acid excretion and a urine pH of 6.1. Kidney biopsy showed focal tubular calcification; the tubular damage was apparently caused by hypercalcemia and had resulted in renal tubular acidosis. During the three months of observation since that time there has been a tendecy for spontaneous remission of the renal tubular acidosis. Impaired renal hydrogen ion excretion prevented the development of metabolic alkalosis despite ingestion of alkali initially, and was later responsible for the metabolic acidosis. Renal tubular acidosis occurring as a sequel to the milk-alkali syndrome may aggravate the danger of nephrocalcinosis in this syndrome. PMID:885714

  10. [Acute myocarditis].

    Combes, Alain

    2013-05-01

    Myocarditis is defined as inflammation of the myocardium accompanied by myocellular necrosis. Acute myocarditis must be considered in patients who present with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackievirus and adenovirus being the most frequently viruses responsible for the disease. Treatment of myocarditis remains largely supportive, since immunosuppression has not been proven to be beneficial for acute lymphocytic myocarditis. Trials of antiviral therapies, or immunostimulants such as interferons, suggest a potential therapeutic role but require further investigation. Lastly, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted. In this setting, ECMO should be the first-line mechanical assistance. For highly unstable patients, a Mobile Cardiac Assistance Unit, that rapidly travels to primary care hospitals with a portable ECMO system and hooks it up before refractory multiorgan failure takes hold, is the preferred option. PMID:23789482

  11. TUBULAR PHOTOBIOREACTOR FOR MICROALGAE BIODIESEL PRODUCTION

    Nkongolo Mulumba

    2012-02-01

    Full Text Available Biodiesel production from algae is a promising technique. Microalgae have the potential to produce 5,000-15,000 gallons of biodiesel/(acre-year. However, there are challenges; these include high yieldof algae biomass with high lipid content and the effective technique to harvest the grown algae, extract the algal oil and transesterify the oil to biodiesel. In this project Tubular PhotoBioReactor (TPBR was designed and achieved a ten times increase in algae concentration. It produced 1g of dry algal biomass per liter of medium within 12 days, with a lipid content of 12% approximately. Healthy algal culture grew well in the TPBR reaching 56x106 cells/mL of culture medium. The 10 fold increase is higher than those reported for open ponds and helical photobioreactor.

  12. Inherited renal tubular defects with hypokalemia

    Muthukrishnan J

    2009-01-01

    Full Text Available Bartter′s and Gitelman′s syndrome are two ends of a spectrum of inherited renal tubular disorders that present with hypokalemic metabolic alkalosis of varying severity. Clinical features and associated calcium and magnesium ion abnormalities are used to diagnose these cases after excluding other commoner causes. We report on two cases, the first being a young boy, born of pregnancy complicated by polyhydramnios, who had classical dysmorphic features, polyuria, hypokalemia and hypercalciuria and was diagnosed as having Bartter′s syndrome. The second patient is a lady who had recurrent tetany as the only manifestation of Gitelman′s syndrome, which is an unusual presentation. Potassium replacement with supplementation of other deficient ions led to satisfactory clinical and biochemical response.

  13. Cytocompatibility of a silk fibroin tubular scaffold

    Wang, Jiannan, E-mail: wangjn@suda.edu.cn; Wei, Yali; Yi, Honggen; Liu, Zhiwu; Sun, Dan; Zhao, Huanrong

    2014-01-01

    Regenerated silk fibroin (SF) materials are increasingly used for tissue engineering applications. In order to explore the feasibility of a novel biomimetic silk fibroin tubular scaffold (SFTS) crosslinked by poly(ethylene glycol) diglycidyl ether (PEG-DE), biocompatibility with cells was evaluated. The novel biomimetic design of the SFTS consisted of three distinct layers: a regenerated SF intima, a silk braided media and a regenerated SF adventitia. The SFTS exhibited even silk fibroin penetration throughout the braid, forming a porous layered tube with superior mechanical, permeable and cell adhesion properties that are beneficial to vascular regeneration. Cytotoxicity and cell compatibility were tested on L929 cells and human umbilical vein endothelial cells (EA.hy926). DNA content analysis, scanning electron and confocal microscopies and MTT assay showed no inhibitory effects on DNA replication. Cell morphology, viability and proliferation were good for L929 cells, and satisfactory for EA.hy926 cells. Furthermore, the suture retention strength of the SFTS was about 23 N and the Young's modulus was 0.2–0.3 MPa. Collectively, these data demonstrate that PEG-DE crosslinked SFTS possesses the appropriate cytocompatibility and mechanical properties for use as vascular scaffolds as an alternative to vascular autografts. - Highlights: • A PEG-DE cross-linked small caliber porous silk fibroin tubular scaffold (SFTS) • PEG-DE cross-linked SF film had no inhibitory effect on DNA replication of cells. • Cells cultured on the SFTS showed good morphology, cell viability and proliferative activity. • SFTS would be beneficial to endothelialization. • SFTS had good suture retention strength and flexibility.

  14. Hepatic necrosis associated with drug-induced hypersensitivity syndrome

    Fernando Peixoto Ferraz de Campos

    2012-12-01

    Full Text Available Drug-induced hypersensitivity syndrome (DIHS; also known as drug reaction with eosinophilia and systemic symptoms [DRESS] is a life-threatening condition first described by Chaikenetal. in 1950. It is characterized by extensive mucocutaneous rash; fever; lymphadenopathy; hepatitis; hematological abnormalities; damage to several organs such as kidney, heart, lungs, and pancreas; and possible reactivation of human herpesvirus-6 (HHV-6 or other herpes virus. Rare and severe cases may present hepatic necrosis, and about 15% of them result in death or liver transplantation. A hallmark of this syndrome is the late onset of symptoms after the drug exposure. The most common culprit drugs are the aromatic anticonvulsants (in almost 30% of the cases and the antibiotics (which in some series represent 20% of the cases. The authors report a case of a 41-year-old female who presented to the emergency department with erythroderma, acute hepatitis, acute pancreatitis and acute renal failure, and was then treated with corticosteroid after the diagnosis of DIHS/DRESS. A specific culprit drug could not confidently be determined due to the presence of multiple drugs used by the patient. The clinical and laboratory outcome was apparently satisfactory, but unexpectedly, on the sixth day of hospitalization, the patient complained of nonspecific malaise, drowsiness, which progressed in a few hours with signs and symptoms of hepatic failure, refractory shock, and death. The autopsy findings showed submassive hepatic necrosis, and the immediate cause of death was attributed to hepatic failure.

  15. Extent and distribution of skeletal muscle necrosis after graded periods of complete ischemia

    Labbe, R.; Lindsay, T.; Walker, P.M.

    1987-08-01

    The management of an acutely ischemic extremity requires knowledge of the response of skeletal muscle (the largest component of the lower limb) to prolonged periods of complete normothermic ischemia. We have used the canine gracilis muscle model to evaluate the extent and distribution of ischemic necrosis after 3 and 5 hours of ischemia and 48 hours of reperfusion. Each muscle was cut into six slices, and the extent and distribution of postischemic necrosis identified by means of nitroblue tetrazolium staining and 99mTc pyrophosphate uptake. After 3, 4, and 5 hours of ischemia the extent of necrosis was 2.0% +/- 0.9%, 30.3% +/- 6.0%, and 90.1% +/- 3.5% (mean +/- SEM), respectively. A statistically significant correlation exists between the extent of necrosis and the uptake of 99mTc pyrophosphate uptake per gram of tissue (y = 1574.9x - 8.4, r = 0.84, p less than 0.001). Most necrosis was centrally located and found in the thickest portion of the muscle. We conclude that there is a graded response in the extent of skeletal muscle necrosis related to the length of ischemic stress rather than an ''all-or-none'' phenomenon. This central distribution of necrosis makes the usual external evaluation of ischemic damage clinically unreliable. In addition, since there was no enveloping fascia in this model, a compartment release alone may not prevent the development of skeletal muscle necrosis. This knowledge of the response of skeletal muscle to ischemia may lead to an improved clinical approach to an extremity suffering a prolonged ischemic insult.

  16. INFECTION AND OSSICULAR NECROSIS IN ATTICOANTRAL DISEASE

    Ramagiri Vijay kumar

    2015-01-01

    Full Text Available In view of probable role of infection in middle ear to ossicular necrosis a prospective study was done on 50 patients at tertiary care centre, where the intraoperative specimen collected during Mastoidectomy was sent for culture sensitivity for any microorganisms . Ossiclar status was also noted during surgery and we tried to correlate if there is any relation ship between infection in middle ear and ossicular necrosis. In our study we found that there was a significant relationship between presence of microorganism and ossicular necrosis.

  17. ROLE OF THE MITOCHONDRION IN PROGRAMMED NECROSIS

    Christopher eBaines

    2010-11-01

    Full Text Available In contrast to the programmed nature of apoptosis and autophagy, necrotic cell death has always been believed to be a random, uncontrolled process that leads to the accidental death of the cell. This dogma, however, is being challenged and the concept of necrosis also being programmed is gaining ground. In particular, mitochondria appear to play a pivotal role in the mediation of programmed necrosis. The purpose of this review, therefore, is to appraise the current concepts regarding the signaling mechanisms of programmed necrosis, with specific attention to the contribution of mitochondria to this process.

  18. Acute Pancreatitis: Surgery, Pathophysiology and Probiotic Prophylaxis

    van Minnen, L. P.

    2006-01-01

    Acute pancreatitis is a challenging disease with a clinical course that is often difficult to predict. In severe acute pancreatitis, mortality increases significantly if intestinal bacteria translocate from the intestine and infect pancreatic necrosis. Surgical and prophylactic treatment strategies are challenged by complex pathophysiology of the disease. This thesis addresses some key aspects of acute pancreatitis: surgical management, pathophysiology and probiotic prophylaxis. Outcome in pa...

  19. Size effect of welded thin-walled tubular joints

    Mashiri, Fidelis Rutendo; Zhao, Xiao-Ling; Hirt, Manfred A.; NUSSBAUMER, Alain

    2007-01-01

    This paper clarifies the terminologies used to describe the size effect on fatigue behaviour of welded joints. It summarizes the existing research on size effect in the perspective of newly defined terminologies. It identifies knowledge gaps in designing tubular joints using the hot spot stress method, i.e. thin-walled tubular joints with wall thickness less than 4 mm and thick-walled tubular joints with wall thickness larger than 50 mm or diameter to thickness ratio less than 24. It is the t...

  20. Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection?

    Yan Luo; Chao Xin Yuan; Yu Lan Peng; Pei Lin Wei; Zhao Da Zhang; Jun Ming Jiang; Lin Dai; Yun Kai Hu

    2001-01-01

    @@INTRODUCTION The spectrum of acute pancreatitis (AP) ranges from a mild spontaneously resolved disorder to severe disease with mortality up to 20%-48.4%[1-3]. sAP is defined as the AP with organ failure and /or local complications which developed form acute fluid collection (AFC) including necrosis ,abscess , pseudocyst formation into or around the pancreas [4].

  1. Administration of bone marrow-derived stem cells suppresses cellular necrosis and apoptosis induced by reperfusion of ischaemic kidneys in rats

    2008-01-01

    @@ Ischaemic reperfusion injury (IRI) is a crucial element in the pathogenesis of acute ischaemic renal failure and influences the early functional recovery and even long term survival of a transplanted kidneyIt is generally thought that renal repair following IRI requires the replacement or regeneration of renal tubular epithelial cells that are detached or damaged.

  2. [Palatal necrosis in children. Case report].

    Sancho, M A; Parri, F J; Raigosa, J M; Lerena, J; Cacéres, F; Muñoz, M E

    2006-04-01

    Palate necrosis as a consequence of palate infection it's an exceptional condition about there's not too much references at literature. We present a case of a 6 months old child who present a palatal necrosis after a supurative medial otitis that involved hard and soft palate, with positive culture for Pseudomona aeruginosa causing a almost complete absence of the palate that simulate a bilateral palatal cleft. PMID:16846136

  3. Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review

    A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease

  4. Imaging Tumor Necrosis with Ferumoxytol.

    Maryam Aghighi

    high T1 signal in areas of tumor necrosis and low signal in areas of intracellularly compartmentalized iron.Differential T1- and T2-enhancement patterns of USPIO in tumors enable conclusions about their intracellular and extracellular location. This information can be used to characterize the composition of the tumor microenvironment.

  5. Rhabdomyolysis and Acute Kidney Injury Requiring Dialysis as a Result of Concomitant Use of Atypical Neuroleptics and Synthetic Cannabinoids

    Aiyu Zhao

    2015-01-01

    Full Text Available The use of synthetic cannabinoids (SCBs is associated with many severe adverse effects that are not observed with marijuana use. We report a unique case of a patient who developed rhabdomyolysis and acute kidney injury (AKI requiring dialysis after use of SCBs combined with quetiapine. Causes for the different adverse effects profile between SCBs and marijuana are not defined yet. Cases reported in literature with SCBs use have been associated with reversible AKI characterized by acute tubular necrosis and interstitial nephritis. Recent studies have showed the involvement of cytochromes P450s (CYPs in biotransformation of SCBs. The use of quetiapine which is a substrate of the CYP3A4 and is excreted (73% as urine metabolites may worsen the side effect profiles of both quetiapine and K2. SCBs use should be included in the differential diagnosis of AKI and serum Creatinine Phosphokinase (CPK level should be monitored. Further research is needed to identify the mechanism of SCBs nephrotoxicity.

  6. Erythropoietin-enhanced endothelial progenitor cell recruitment in peripheral blood and renal vessels during experimental acute kidney injury in rats.

    Cakiroglu, Figen; Enders-Comberg, Sora Maria; Pagel, Horst; Rohwedel, Jürgen; Lehnert, Hendrik; Kramer, Jan

    2016-03-01

    Beneficial effects of erythropoietin (EPO) have been reported in acute kidney injury (AKI) when administered prior to induction of AKI. We studied the effects of EPO administration on renal function shortly after ischemic AKI. For this purpose, rats were subjected to renal ischemia for 30 min and EPO was administered at a concentration of 500 U/kg either i.v. as a single shot directly after ischemia or with an additional i.p. dose until 3 days after surgery. The results were compared with AKI rats without EPO application and a sham-operated group. Renal function was assessed by measurement of serum biochemical markers, histological grading, and using an isolated perfused kidney (IPK) model. Furthermore, we performed flow cytometry to analyze the concentration of endothelial progenitor cells (EPCs) in the peripheral blood and renal vessels. Following EPO application, there was only a statistically non-significant tendency of serum creatinine and urea to improve, particularly after daily EPO application. Renal vascular resistance and the renal perfusion rate were not significantly altered. In the histological analysis, acute tubular necrosis was only marginally ameliorated following EPO administration. In summary, we could not demonstrate a significant improvement in renal function when EPO was applied after AKI. Interestingly, however, EPO treatment resulted in a highly significant increase in CD133- and CD34-positive EPC both in the peripheral blood and renal vessels. PMID:26616141

  7. Oliguric and non-oliguric acute renal failure in malaria in west zone of rajasthan, India-A comparative study

    Bal Kishan Gupta; Kailash Chandra Nayak; Sunil Kumar; Surendra Kumar; Anjli Gupta; Parul Prakash

    2012-01-01

    Objective: To report a comparative clinical and histopathological study on oliguric and non-oliguric acute renal failure (ARF) in malaria. Method: 311 consecutive cases of malaria out of which 74 (23.79%) had ARF as per WHO criteria were conducted. Mean age was 32.58 (range 15-60 years) and male: female was 2:1. Result: Most of the cases developed ARF within 10 d of onset. 18 cases (11 falciparum, 2 mixed, 5 vivax) presented with oliguric and 56 (41 falciparum, 6 mixed, 9 vivax) with non-oliguric renal failure. Associated major manifestations were jaundice (75.68%), cerebral malaria (41.89%), bleeding manifestations (32.43%), severe anemia (27.03%), hypotension (25.68%), multi-organ failure (18.92%), severe thrombocytopenia (12.16%), and ARDS (8.11%). Kidney biopsy (n=20) showed acute tubular necrosis (n=7), Mesangioproliferative glomerulonephritis (n=4) or both (n=9). Hemodialysis was done in 8 cases of oliguric renal failure out of which 4 survived (average no. of session 2.9). Conclusion: Most of the cases recovered within 3 weeks. Total mortality was 28.38% (n=21) and mortality was more in oliguric renal failure (72.22%) as compare to non-oliguric renal failure (14.29%).

  8. ERCP in acute pancreatitis

    Jijo V Cherian; Joye Varghese Selvaraj; Rajesh Natrayan; Jayanthi Venkataraman

    2007-01-01

    BACKGROUND:The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute pancreatitis has evolved over years since its introduction in 1968. Its importance in diagnosing the etiology of pancreatitis has steadily declined with the advent of less invasive diagnostic tools. The therapeutic implications of ERCP in acute pancreatitis are many fold and are directed towards management of known etiological factors or its related complications. This article highlights the current status of ERCP in acute pancreatitis. DATA SOURCES:An English literature search using PubMed database was conducted on ERCP in acute pancreatitis, the etiologies and complications of pancreatitis amenable to endotherapy and other related subjects, which were reviewed. RESULTS: ERCP serves as a primary therapeutic modality for management of biliary pancreatitis in speciifc situations, pancreatitis due to microlithiasis, speciifc types of sphincter of Oddi dysfunction, pancreas divisum, ascariasis and malignancy. In recurrent acute pancreatitis and smoldering pancreatitis it has a deifnite therapeutic utility. Complications of acute pancreatitis including pancreatic-duct disruptions or leaks, benign pancreatic-lfuid collections and pancreatic necrosis can be beneifcially dealt with. Intraductal ultrasound and pancreatoscopy during ERCP are useful in detecting pancreatic malignancy. CONCLUSIONS:The role of ERCP in acute pancreatitis is predominantly therapeutic and occasionally diagnostic. Its role in the management continues to evolve and advanced invasive procedures should be undertaken only in centers dedicated to pancreatic care.

  9. Effect of tamoxifen on spermatogenesis and tubular morphology in rats

    UrbanJ.A.D'Souza

    2004-01-01

    Aim: To observe the effect of tamoxifen citrate on spermatogenesis and tubular morphology in rats.Methods: The effect of tamoxifen citrate i.g. at doses of 400 and 800 mg·kg-1·day-1 in 0.1 mL olive oil for 30 days on seminiferous tubular morphology, seminiferous epithelial diameter (STD), epithelial height (SEH), epididymal sperm count and percent abnormal sperm were evaluated at day 1, 12 and 36 after treatment. Controls were given the vehicle. Results: The higher dose resulted in tubular atrophy on day 31. The STD, SEH and sperm count were decreased and the abnormal spermatozoa increased in a dose-dependent manner with the maximal effect on day 36.Conclusion: Tamoxifen citrate induces tubular shrinkage and atrophy and sperm abnormality at a dose-dependent manner. (Asian J Androl 2004 Sep; 6: 223-226)

  10. Device for internal laser welding of tubular elements

    During the welding, the position of the returning mirror of the laser beam is on the order of a transducer in support on the tubular element to be welded. Application for sleeving PWR steam generator tubes

  11. Atypical presentation of distal renal tubular acidosis in two siblings.

    Tasic, Velibor; Korneti, Petar; Gucev, Zoran; Hoppe, Bernd; Blau, Nenad; Cheong, Hae Il

    2008-07-01

    Primary distal renal tubular acidosis (dRTA) is an inherited disease characterized by the inability of the distal tubule to lower urine pH hypokalemic paralysis. Laboratory investigations revealed proximal tubular dysfunction (low molecular weight proteinuria, generalized hyperaminoaciduria, hypophosphatemia with hyperphosphaturia, and hypouricemia with hyperuricosuria). There was significant hyperoxaluria and laboratory evidence for mild rhabdomyolysis. Under potassium and alkali therapy, proximal tubular abnormalities, muscular enzymes, and oxaluria normalized. A homozygous mutation in the ATP6V1B1 gene, which is responsible for dRTA with early hearing loss, was detected in both siblings. In conclusion, proximal tubular dysfunction and hyperoxaluria may be found in children with dRTA and are reversible under appropriate therapy. PMID:18386070

  12. Solar Heating Systems with Evacuated Tubular Solar Collector

    Qin, Lin; Furbo, Simon

    1998-01-01

    Recently different designed evacuated tubular solar collectors were introduced on the market by different Chinese companies. In the present study, investigations on the performance of four different Chinese evacuated tubular collectors and of solar heating systems using these collectors were...... carried out, employing both laboratory test and theoretical calculations. The collectors were tested in a small solar domestic hot water (SDHW) system in a laboratory test facility under realistic conditions. The yearly thermal performance of solar heating systems with these evacuated tubular collectors......, as well as with normal flat-plate collectors was calculated under Danish weather conditions. It is found that, for small SDHW systems with a combi tank design, an increase of 25% -55% net utilized solar energy can be achieved by using these evacuated tubular collectors instead of normal flat...

  13. Elastic Deployable Composite Tubular Roll-Out Boom Project

    National Aeronautics and Space Administration — DSS's innovative Elastic Deployable Composite Tubular Roll-Out Boom will provide revolutionary performance when compared to conventional state-of-the-art...

  14. Genetics Home Reference: renal tubular acidosis with deafness

    ... Prevention: Hearing Loss in Children Centre for Genetics Education (Australia): Deafness and Hearing Loss Gallaudet University: Laurent Clerc National Deaf Education Center KidsHealth: What's Hearing Loss? MalaCards: renal tubular ...

  15. TWEAK activates the non-canonical NFkappaB pathway in murine renal tubular cells: modulation of CCL21.

    Ana B Sanz

    Full Text Available TWEAK is a member of the TNF superfamily of cytokines that contribute to kidney tubulointerstitial injury. It has previously been reported that TWEAK induces transient nuclear translocation of RelA and expression of RelA-dependent cytokines in renal tubular cells. Additionally, TWEAK induced long-lasting NFkappaB activation suggestive of engagement of the non-canonical NFkappaB pathway. We now explore TWEAK-induced activation of NFkappaB2 and RelB, as well as expression of CCL21, a T-cell chemotactic factor, in cultured murine tubular epithelial cells and in healthy kidneys in vivo. In cultured tubular cells, TWEAK and TNFalpha activated different DNA-binding NFkappaB complexes. TWEAK-induced sustained NFkappaB activation was associated with NFkappaB2 p100 processing to p52 via proteasome and nuclear translocation and DNA-binding of p52 and RelB. TWEAK, but not TNFalpha used as control, induced a delayed increase in CCL21a mRNA (3.5+/-1.22-fold over control and CCL21 protein (2.5+/-0.8-fold over control, which was prevented by inhibition of the proteasome, or siRNA targeting of NIK or RelB, but not by RelA inhibition with parthenolide. A second NFkappaB2-dependent chemokine, CCL19, was upregulates by TWEAK, but not by TNFalpha. However, both cytokines promoted chemokine RANTES expression (3-fold mRNA at 24 h. In vivo, TWEAK induced nuclear NFkappaB2 and RelB translocation and CCL21a mRNA (1.5+/-0.3-fold over control and CCL21 protein (1.6+/-0.5-fold over control expression in normal kidney. Increased tubular nuclear RelB and tubular CCL21 expression in acute kidney injury were decreased by neutralization (2+/-0.9 vs 1.3+/-0.6-fold over healthy control or deficiency of TWEAK (2+/-0.9 vs 0.8+/-0.6-fold over healthy control. Moreover, anti-TWEAK treatment prevented the recruitment of T cells to the kidney in this model (4.1+/-1.4 vs 1.8+/-1-fold over healthy control. Our results thus identify TWEAK as a regulator of non-canonical NFkappa

  16. A tubular electrode for radiofrequency ablation therapy

    Antunes, Carlos Lemos Lemos Lemos

    2012-07-06

    Purpose – Due to its good mechanical and biocompatibility characteristics, nitinol SEMS is a popular endoprothesis used for relieving stricture problems in hollow organs due to carcinomas. Besides its mechanical application, SEMS can be regarded as well as potential electrode for performing RF ablation therapy on the tumor. The purpose of this work is to perform numerical and experimental analyses in order to characterize the lesion volume induced in biological tissue using this kind of tubular electrode. Design/methodology/approach – Data concerning electrical conductivity and dimension of the damaged tissue after RF ablation procedure were obtained from ex vivo samples. Next, numerical models using 3D finite element method were obtained reassembling the conditions considered at experimentation setup and results were compared. Findings – Numerical and experimental results show that a regular volume of damaged tissue can be obtained considering this type of electrode. Also, results obtained from numerical simulation are close to those obtained by experimentation. Originality/value – SEMSs, commonly used as devices to minimize obstruction problems due to the growth of tumors, may still be considered as an active electrode for RF ablation procedures. A method considering this observation is presented in this paper. Also, numerical simulation can be regarded in this case as a tool for determining the lesion volume.

  17. Clinical profile of distal renal tubular acidosis

    Ratan Jha

    2011-01-01

    Full Text Available To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA, we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive urine anion gap. In those patients who had fasting urine pH >5.5 with normal baseline systemic pH and bicarbonate levels (incomplete RTA, acid load test with ammonium chloride was done. A cause of dRTA could be established in 53 (54% patients. Urological defect in children (22/44 and autoimmune disease in adults (11/52 were the commonest causes. Hypokalemic paralysis, proximal muscle weakness and voiding difficulty were the common modes of presentation. Doubling of serum creatinine during the study period was noted in 13 out of 27 patients who had GFR 60 mL/min (P <0.005. In conclusion, urological disorders were the commonest cause of dRTA in children while autoimmune disorders were the commonest asso-ciation in adults. Worse baseline renal function, longer duration of disease and greater frequency of nephrolithiasis/nephrocalcinosis and urological disorders were noted in those who had wor-sening of renal dysfunction during the study period.

  18. Clinical profile of distal renal tubular acidosis.

    Jha, Ratan; Muthukrishnan, J; Shiradhonkar, Shekhar; Patro, Kiran; Harikumar, Kvs; Modi, K D

    2011-03-01

    To determine the clinical profile and progression of renal dysfunction in distal renal tubular acidosis (dRTA), we retrospectively studied 96 consecutive cases of dRTA diagnosed at our center. Patients with unexplained metabolic bone disease, short stature, hypokalemia, re-current renal stones, chronic obstructive uropathy or any primary autoimmune condition known to cause dRTA were screened. Distal RTA was diagnosed on the basis of systemic metabolic acidosis with urine pH >5.5 and positive urine anion gap. In those patients who had fasting urine pH >5.5 with normal baseline systemic pH and bicarbonate levels (incomplete RTA), acid load test with ammonium chloride was done. A cause of dRTA could be established in 53 (54%) patients. Urological defect in children (22/44) and autoimmune disease in adults (11/52) were the commonest causes. Hypokalemic paralysis, proximal muscle weakness and voiding difficulty were the common modes of presentation. Doubling of serum creatinine during the study period was noted in 13 out of 27 patients who had GFR 60 mL/min (P <0.005). In conclusion, urological disorders were the commonest cause of dRTA in children while autoimmune disorders were the commonest asso-ciation in adults. Worse baseline renal function, longer duration of disease and greater frequency of nephrolithiasis/nephrocalcinosis and urological disorders were noted in those who had wor-sening of renal dysfunction during the study period. PMID:21422623

  19. Hereditary Hypokalemic salt-losing tubular disorders

    The inherited hypokalemic tubular disorders are frequently summarized under the heading Bartter Syndrome since they share several clinical and biochemical findings such as renal salt wasting, hypokalemic metabolic alkalosis, normal blood pressure despite hypereninemic hyperaldosteronism and hyperplasia of the juxtaglomerular apparatus. However, careful characterization of the clinical phenotype and correlation with the clinical phenotype and the correlation with the underlying molecular basis justifies the differentiation into at least four distinct disease entities: (i) the hyperprostaglandin E syndrome or antenatal variant of Bartter syndrome (HPS/aBS), which is caused by mutations in either the Na-K-2Cl cotransporter or the potassium channel of the medullary thick ascending limb of Henle's loop; (ii) the HPS/aBS with sensorineural deafness which results from inactivating mutation in the Barttin beta-subunit of the renal chloride channels; (iii) the classic Bartter syndrome caused by mutations in the chloride channel of the distal nephron; and (iv)Gitelman's variant of Bartter syndrome which is caused by mutations of the Na-Cl cotransporter of the distal convoluted tubule. This review will summarize the clinical characteristics of these diseases and progress recently made in the identification of the underlying molecular defects that will hopefully add to the current knowledge of the pathogenesis of these diseases. (author)

  20. The Fourier transform of tubular densities

    Prior, C B

    2012-05-18

    We consider the Fourier transform of tubular volume densities, with arbitrary axial geometry and (possibly) twisted internal structure. This density can be used to represent, among others, magnetic flux or the electron density of biopolymer molecules. We consider tubes of both finite radii and unrestricted radius. When there is overlap of the tube structure the net density is calculated using the super-position principle. The Fourier transform of this density is composed of two expressions, one for which the radius of the tube is less than the curvature of the axis and one for which the radius is greater (which must have density overlap). This expression can accommodate an asymmetric density distribution and a tube structure which has non-uniform twisting. In addition we give several simpler expressions for isotropic densities, densities of finite radius, densities which decay at a rate sufficient to minimize local overlap and finally individual surfaces of the tube manifold. These simplified cases can often be expressed as arclength integrals and can be evaluated using a system of first-order ODEs. © 2012 IOP Publishing Ltd.

  1. Behaviour of concrete filled steel tubular columns under fire

    查晓雄; 钟善桐

    2002-01-01

    A three dimensional nonlinear FE program is used to calculate the fire resistances of concrete filledsteel tubular columns under fire. The temperature distributions in the circular section fire are decided by solvingthe Fourier Transfer Equation , and the mechanical behaviour and failure of concrete filled steel tubular columnsunder fire are thus investigated, and the effects of several parameters on the fire resistance are analysed. Theresults obtained are in good agreement with the Eurocode.

  2. The origin of tubular lava stalactites and other related forms

    Kevin Allred; Carlene Allred

    1998-01-01

    Tubular lava stalactites are often found in lava tubes. Field observations, sample analysis, and comparative studies indicate that these are segregations extruded during cooling from partially crystallized lava al about 1,070 - 1,000 °C. Retrograde boiling (gas pressure) within the lava provides a mechanism to expel the interstitial liquid. In addition to tubular lava stalactites, a variety of other lava features can also result, such as lava helictites, lava coralloids, barnacle-like stretch...

  3. Stresses at weld toes in tubular joints in offshore structures

    Elliott, Kim S.

    1987-01-01

    The accurate prediction of stress concentration factors (SCF) at weld toes is recognised as one of the most important factors in the design, against fatigue failure, of welded tubular joints in offshore structures. The objectives of this work are i) to study the influence of some important tubular joint and weld profile geometric parameters on the elastic SCFs at weld toes, ii) compare these values with strains which could be measured by strain gauges, and iii) to determine plastic-elastic st...

  4. A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia

    C. Ripoli; Pinna, A.; Marras, S.; M.L. Fenu; Nurchi, A M

    2012-01-01

    Introduction: distal renal tubular acidosis (dRTA) presents itself with variable clinical manifestations and often with late expressions that impact on prognosis. Case report: A 45-day-old male infant was admitted with stopping growth, difficult feeding and vomiting after meals. Clinical tests and labs revealed a type 1 renal tubular acidosis, even if the first blood tests showed ammonium and lactate increase. We had to exclude metabolic diseases before having a certain diagnosis. Conclusions...

  5. Modeling constrained sintering of bi-layered tubular structures

    Tadesse Molla, Tesfaye; Kothanda Ramachandran, Dhavanesan; Ni, De Wei; Esposito, Vincenzo; Teocoli, Francesca; Olevsky, Eugene A.; Bjørk, Rasmus; Pryds, Nini; Kaiser, Andreas; Frandsen, Henrik Lund

    2015-01-01

    densification and stress developments during sintering of tubular bi-layered samples. The correspondence between linear elastic and linear viscous theories is used as a basis for derivation of the model. The developed model is first verified by finite element simulation for sintering of tubular bi-layer system...... thermo-mechanical analysis. Results from the analytical model are found to agree well with finite element simulations as well as measurements from sintering experiment....

  6. Straightening tubular flow for side-by-side visualization.

    Angelelli, Paolo; Hauser, Helwig

    2011-12-01

    Flows through tubular structures are common in many fields, including blood flow in medicine and tubular fluid flows in engineering. The analysis of such flows is often done with a strong reference to the main flow direction along the tubular boundary. In this paper we present an approach for straightening the visualization of tubular flow. By aligning the main reference direction of the flow, i.e., the center line of the bounding tubular structure, with one axis of the screen, we are able to natively juxtapose (1.) different visualizations of the same flow, either utilizing different flow visualization techniques, or by varying parameters of a chosen approach such as the choice of seeding locations for integration-based flow visualization, (2.) the different time steps of a time-dependent flow, (3.) different projections around the center line , and (4.) quantitative flow visualizations in immediate spatial relation to the more qualitative classical flow visualization. We describe how to utilize this approach for an informative interactive visual analysis. We demonstrate the potential of our approach by visualizing two datasets from two different fields: an arterial blood flow measurement and a tubular gas flow simulation from the automotive industry. PMID:22034324

  7. A cut-off tubular geometry of loop space

    Mukhopadhyay, Partha

    2014-01-01

    Motivated by the computation of loop space quantum mechanics as indicated in [7], here we seek a better understanding of the tubular geometry of loop space ${\\cal L}{\\cal M}$ corresponding to a Riemannian manifold ${\\cal M}$ around the submanifold of vanishing loops. Our approach is to first compute the tubular metric of $({\\cal M}^{2N+1})_{C}$ around the diagonal submanifold, where $({\\cal M}^N)_{C}$ is the Cartesian product of $N$ copies of ${\\cal M}$ with a cyclic ordering. This gives an infinite sequence of tubular metrics such that the one relevant to ${\\cal L}{\\cal M}$ can be obtained by taking the limit $N\\to \\infty$. Such metrics are computed by adopting an indirect method where the general tubular expansion theorem of [12] is crucially used. We discuss how the complete reparametrization isometry of loop space arises in the large-$N$ limit and verify that the corresponding Killing equation is satisfied to all orders in tubular expansion. These tubular metrics can alternatively be interpreted as some n...

  8. Toxicological significance of renal Bcrp: Another potential transporter in the elimination of mercuric ions from proximal tubular cells

    Secretion of inorganic mercury (Hg2+) from proximal tubular cells into the tubular lumen has been shown to involve the multidrug resistance-associated protein 2 (Mrp2). Considering similarities in localization and substrate specificity between Mrp2 and the breast cancer resistance protein (Bcrp), we hypothesize that Bcrp may also play a role in the proximal tubular secretion of mercuric species. In order to test this hypothesis, the uptake of Hg2+ was examined initially using inside-out membrane vesicles containing Bcrp. The results of these studies suggest that Bcrp may be capable of transporting certain conjugates of Hg2+. To further characterize the role of Bcrp in the handling of mercuric ions and in the induction of Hg2+-induced nephropathy, Sprague–Dawley and Bcrp knockout (bcrp−/−) rats were exposed intravenously to a non-nephrotoxic (0.5 μmol·kg−1), a moderately nephrotoxic (1.5 μmol·kg−1) or a significantly nephrotoxic (2.0 μmol·kg−1) dose of HgCl2. In general, the accumulation of Hg2+ was greater in organs of bcrp−/− rats than in Sprague–Dawley rats, suggesting that Bcrp may play a role in the export of Hg2+ from target cells. Within the kidney, cellular injury and necrosis was more severe in bcrp−/− rats than in controls. The pattern of necrosis, which was localized in the inner cortex and the outer stripe of the outer medulla, was significantly different from that observed in Mrp2-deficient animals. These findings suggest that Bcrp may be involved in the cellular export of select mercuric species and that its role in this export may differ from that of Mrp2. - Highlights: • Bcrp may mediate transport of mercury out of proximal tubular cells. • Hg-induced nephropathy was more severe in Bcrp knockout rats. • Bcrp and Mrp2 may differ in their ability to transport Hg

  9. Toxicological significance of renal Bcrp: Another potential transporter in the elimination of mercuric ions from proximal tubular cells

    Bridges, Christy C., E-mail: bridges_cc@mercer.edu; Zalups, Rudolfs K.; Joshee, Lucy

    2015-06-01

    Secretion of inorganic mercury (Hg{sup 2+}) from proximal tubular cells into the tubular lumen has been shown to involve the multidrug resistance-associated protein 2 (Mrp2). Considering similarities in localization and substrate specificity between Mrp2 and the breast cancer resistance protein (Bcrp), we hypothesize that Bcrp may also play a role in the proximal tubular secretion of mercuric species. In order to test this hypothesis, the uptake of Hg{sup 2+} was examined initially using inside-out membrane vesicles containing Bcrp. The results of these studies suggest that Bcrp may be capable of transporting certain conjugates of Hg{sup 2+}. To further characterize the role of Bcrp in the handling of mercuric ions and in the induction of Hg{sup 2+}-induced nephropathy, Sprague–Dawley and Bcrp knockout (bcrp{sup −/−}) rats were exposed intravenously to a non-nephrotoxic (0.5 μmol·kg{sup −1}), a moderately nephrotoxic (1.5 μmol·kg{sup −1}) or a significantly nephrotoxic (2.0 μmol·kg{sup −1}) dose of HgCl{sub 2}. In general, the accumulation of Hg{sup 2+} was greater in organs of bcrp{sup −/−} rats than in Sprague–Dawley rats, suggesting that Bcrp may play a role in the export of Hg{sup 2+} from target cells. Within the kidney, cellular injury and necrosis was more severe in bcrp{sup −/−} rats than in controls. The pattern of necrosis, which was localized in the inner cortex and the outer stripe of the outer medulla, was significantly different from that observed in Mrp2-deficient animals. These findings suggest that Bcrp may be involved in the cellular export of select mercuric species and that its role in this export may differ from that of Mrp2. - Highlights: • Bcrp may mediate transport of mercury out of proximal tubular cells. • Hg-induced nephropathy was more severe in Bcrp knockout rats. • Bcrp and Mrp2 may differ in their ability to transport Hg.

  10. Correlation of MRI Biomarkers with Tumor Necrosis in Hras5 Tumor Xenograft in Athymic Rats

    Daniel P. Bradley

    2007-05-01

    Full Text Available Magnetic resonance imaging (MRI can measure the effects of therapies targeting the tumor vasculature and has demonstrated that vascular-damaging agents (VDA induce acute vascular shutdown in tumors in human and animal models. However, at subtherapeutic doses, blood flow may recover before the induction of significant levels of necrosis. We present the relationship between changes in MRI biomarkers and tumor necrosis. Multiple MRI measurements were taken at 4.7 T in athymic rats (n = 24 bearing 1.94 ± 0.2-cm3 subcutaneous Hras5 tumors (ATCC 41000 before and 24 hours after clinically relevant doses of the VDA, ZD6126 (0-10 mg/kg, i.v.. We measured effective transverse relaxation rate (R2*, initial area under the gadolinium concentration-time curve (IAUGC60/150, equivalent enhancing fractions (EHF60/150, time constant (Ktrans, proportion of hypoperfused voxels as estimated from fit failures in Ktrans analysis, and signal intensity (SI in T2-weighted MRI (T2W. ZD6126 treatment induced < 90% dose-dependent tumor necrosis at 10 mg/kg; correspondingly, SI changes were evident from T2W MRI. Although R2* did not correlate, other MRI biomarkers significantly correlated with necrosis at doses of ≥ 5 mg/kg ZD6126. These data on Hras5 tumors suggest that the quantification of hypoperfused voxels might provide a useful biomarker of tumor necrosis.

  11. Hyperglycemia Increases Susceptibility to Ischemic Necrosis

    D. Lévigne

    2013-01-01

    Full Text Available Diabetic patients are at risk for spontaneous foot ulcers, chronic wounds, infections, and tissue necrosis. Current theories suggest that the development and progression of diabetic foot ulcers are mainly caused by arteriosclerosis and peripheral neuropathy. Tissue necrosis plays a primordial role in the progression of diabetic foot ulcers but the underlying mechanisms are poorly understood. The aim of the present study was to investigate the effects of hyperglycemia per se on the susceptibility of ischemic tissue to necrosis, using a critical ischemic hind limb animal model. We inflicted the same degree of ischemia in both euglycemic and streptozotocin-induced hyperglycemic rats by resecting the external iliac, the femoral, and the saphenous arteries. Postoperative laser Doppler flowmetry of the ischemic feet showed the same degree of reduction in skin perfusion in both hyperglycemic and euglycemic animals. Nevertheless, we found a significantly higher rate of limb necrosis in hyperglycemic rats compared to euglycemic rats (71% versus 29%, resp.. In this study, we revealed that hyperglycemia per se increases the susceptibility to limb necrosis in ischemic conditions. Our results may help to better understand the physiopathology of progressive diabetic wounds and underline the importance of strict glycemic control in patients with critical limb ischemia.

  12. IGF-1 protects tubular epithelial cells during injury via activation of ERK/MAPK signaling pathway

    Wu, Zengbin; Yu, Yang; Niu, Lei; Fei, Aihua; Pan, Shuming

    2016-01-01

    Injury of renal tubular epithelial cells can induce acute renal failure and obstructive nephropathy. Previous studies have shown that administration of insulin-like growth factor-1 (IGF-1) ameliorates the renal injury in a mouse unilateral ureteral obstruction (UUO) model, whereas the underlying mechanisms are not completely understood. Here, we addressed this question. We found that the administration of IGF-1 significantly reduced the severity of the renal fibrosis in UUO. By analyzing purified renal epithelial cells, we found that IGF-1 significantly reduced the apoptotic cell death of renal epithelial cells, seemingly through upregulation of anti-apoptotic protein Bcl-2, at protein but not mRNA level. Bioinformatics analyses and luciferase-reporter assay showed that miR-429 targeted the 3′-UTR of Bcl-2 mRNA to inhibit its protein translation in renal epithelial cells. Moreover, IGF-1 suppressed miR-429 to increase Bcl-2 in renal epithelial cells to improve survival after UUO. Furthermore, inhibition of ERK/MAPK signaling pathway in renal epithelial cells abolished the suppressive effects of IGF-1 on miR-429 activation, and then the enhanced effects on Bcl-2 in UUO. Thus, our data suggest that IGF-1 may protect renal tubular epithelial cells via activation of ERK/MAPK signaling pathway during renal injury. PMID:27301852

  13. Sub-nephrotoxic cisplatin sensitizes rats to acute renal failure and increases urinary excretion of fumarylacetoacetase.

    Vicente-Vicente, Laura; Sánchez-Juanes, Fernando; García-Sánchez, Omar; Blanco-Gozalo, Víctor; Pescador, Moisés; Sevilla, María A; González-Buitrago, José Manuel; López-Hernández, Francisco J; López-Novoa, José Miguel; Morales, Ana Isabel

    2015-04-16

    Nephrotoxicity limits the therapeutic efficacy of the antineoplastic drug cisplatin. Due to dosage adjustment and appropriate monitoring, most therapeutic courses with cisplatin produce no or minimal kidney damage. However, we studied whether even sub-nephrotoxic dosage of cisplatin poses a potential risk for the kidneys by predisposing to acute kidney injury (AKI), specifically by lowering the toxicity threshold for a second nephrotoxin. With this purpose rats were treated with a single sub-nephrotoxic dosage of cisplatin (3mg/kg, i.p.) and after two days, with a sub-nephrotoxic regime of gentamicin (50mg/kg/day, during 6 days, i.p.). Control groups received only one of the drugs or the vehicle. Renal function and renal histology were monitored throughout the experiment. Cisplatin treatment did not cause any relevant functional or histological alterations in the kidneys. Rats treated with cisplatin and gentamicin, but not those under single treatments, developed an overt renal failure characterized by both renal dysfunction and massive tubular necrosis. In addition, the urinary excretion of fumarylacetoacetase was increased in cisplatin-treated animals at subtoxic doses, which might be exploited as a cisplatin-induced predisposition marker. In fact, the urinary level of fumarylacetoacetase prior to the second nephrotoxin correlated with the level of AKI triggered by gentamicin in predisposed animals. PMID:25677510

  14. Lipopolysaccharide-induced acute renal failure in conscious rats

    Jonassen, Thomas E N; Graebe, Martin; Promeneur, Dominique;

    2002-01-01

    In conscious, chronically instrumented rats we examined 1) renal tubular functional changes involved in lipopolysaccharide (LPS)-induced acute renal failure; 2) the effects of LPS on the expression of selected renal tubular water and sodium transporters; and 3) effects of milrinone, a......-alpha and lactate, inhibited the LPS-induced tachycardia, and exacerbated the acute LPS-induced fall in GFR. Furthermore, Ro-20-1724-treated rats were unable to maintain MAP. We conclude 1) PDE3 or PDE4 inhibition exacerbates LPS-induced renal failure in conscious rats; and 2) LPS treated rats develop an...... phosphodiesterase type 3 (PDE3) inhibitor, and Ro-20-1724, a PDE4 inhibitor, on LPS-induced changes in renal function. Intravenous infusion of LPS (4 mg/kg b.wt. over 1 h) caused an immediate decrease in glomerular filtration rate (GFR) and proximal tubular outflow without changes in mean arterial pressure (MAP...

  15. Fatigue Life of High-Strength Steel Offshore Tubular Joints

    Petersen, Rasmus Ingomar; Agerskov, Henning; Lopez Martinez, Luis

    1996-01-01

    In the present investigation, the fatigue life of tubular joints in offshore steel structures is studied. Two test series on full-scale tubular joints have been carried through. One series was on joints in conventional offshore structural steel, and the other series was on joints in high-strength......In the present investigation, the fatigue life of tubular joints in offshore steel structures is studied. Two test series on full-scale tubular joints have been carried through. One series was on joints in conventional offshore structural steel, and the other series was on joints in high...... from Ø 324-610 mm tubes, and the joints were loaded in in-plane bending. Both fatigue tests under constant amplitude loading and tests with a stochastic loading that is realistic in relation to offshore structures, are included in the investigation.A comparison between constant amplitude and variable...... amplitude fatigue test results showed shorter fatigue lives in variable amplitude loading than should be expected from the linear fatigue damage accumulation formula. Furthermore, the fatigue tests on high-strength steel tubular joints showed slightly longer fatigue lives than those obtained in...

  16. [Laparascopic cholecystectomy in patients with acute cholecystitis].

    Tokin, A N; Chistiakov, A A; Mamalygina, L A; Zheliabin, D G; Osokin, G Iu

    2008-01-01

    Experience of diagnostics and treatment of 758 patients with acute cholecystitis was summarized. Authors attach the main importance to evaluation of ultrasound data and functional condition of respiratory and cardio-vascular sistem choosing the method of surgical treatment. Sparse use of laparoscopic cholecystectomy in treatment of acute cholecystitis compared with chronic may be explouned by presence of complications in patients which make problems in differentiation of tubular structures during the operation. Authors offered to use ultrasound dissection for clear identification of tubular structures and argon coagulation for hemostasis and safe mobilization of gall bladder. Stick to suggested tactics authors practically doubled the amount of performed laparoscopic cholecystectomies reducing at the same time the frequency of complications. PMID:19301492

  17. The prognostic value of tumor necrosis in patients undergoing stereotactic radiosurgery of brain metastases

    significant if only smaller tumors with a volume below 3.5 cm3 (p = 0.03). Side effects were rare, only one patient suffered from serious acute side effects. Results of this retrospective study support that stereotactic radiotherapy is an effective treatment option for patients with metastatic brain lesions. The prognostic impact of visible tumor necrosis (ring-enhancement) on pretreatment MRI scans should be further investigated

  18. Power generation characteristics of tubular type SOFC by wet process

    Tajiri, H.; Nakayama, T. [Kyushu Electric Power Company, Inc., Fukuoka (Japan); Kuroishi, M. [TOTO Ltd., Kanagawa (Japan)] [and others

    1996-12-31

    The development of a practical solid oxide fuel cell requires improvement of a cell performance and a cell manufacturing technology suitable for the mass production. In particular tubular type SOFC is thought to be superior in its reliability because its configuration can avoid the high temperature sealing and reduce the thermal stress resulting from the contact between cells. The authors have fabricated a tubular cell with an air electrode support by a wet processing technique, which is suitable for mass production in improving a power density. To enhance the power output of the module, the Integrated Tubular-Type (ITT) cell has been developed. This paper reports the performance of the single cells with various active anode areas and the bundle with series-connected 9-ITT cells with an active anode area of 840 cm{sup 2}.

  19. Numerical study of cavitation flows inside a tubular pumping station

    Based on RNG k−ε turbulence model and the full cavitation model, the cavitation flows inside a low-head tubular-pump model were predicted by using the FLUENT software. For a operating case of given flow rate, cavitation happens near the inlet on the suction surfaces of the impeller blades at the initial cavitating stage, and the cavitating area spreads to the impeller passage and hub as NPSH (net positive suction head) decreases, which will affect energy transformation. For various operating cases of cavitation flows at the given flow rates, the predicted velocity and pressure distributions as well as the vapor volumetric fraction are systematically analyzed. Finally, the cavitation performance curve of the tubular-pump model is obtained by means of the further post-processing. All the comparisons and analysis can be further employed to optimize the hydraulic and structural design of the tubular pump and to guide its safe operation.

  20. Mediators of Inflammation in Acute Kidney Injury

    Ali Akcay; Quocan Nguyen; Edelstein, Charles L.

    2010-01-01

    Acute kidney injury (AKI) remains to be an independent risk factor for mortality and morbidity. Inflammation is now believed to play a major role in the pathopathophysiology of AKI. It is hypothesized that in ischemia, sepsis and nephrotoxic models that the initial insult results in morphological and/or functional changes in vascular endothelial cells and/or in tubular epithelium. Then, leukocytes including neutrophils, macrophages, natural killer cells, and lymphocytes infiltrate into the in...

  1. Segmental tubular sodium reabsorption in type 1 diabetes

    Dieperink, H; Eshøj, O; Leyssac, P P;

    1993-01-01

    Segmental tubular sodium reabsorption in Type 1 (insulin-dependent) diabetes was measured in 36 patients in a cross-sectional study including one group (n = 13) without significant albuminuria (UalbV < 30 mg 24 h-1), one group (n = 16) with albuminuria in the range from 30 to 300 mg 24 h-1, and a...... group (n = 7) with nephropathy (UalbV > 300 mg 24 h-1). Lithium clearance was used to measure end proximal delivery. From end proximal delivery, 51Cr-EDTA clearance (GFR) and sodium clearance, segmental tubular reabsorption was calculated. For all patients, GFR was directly correlated with end proximal...

  2. Study of Internal Ballistics of Hepta-Tubular Powders

    M. C. Gupta

    1959-04-01

    Full Text Available In thin paper a solution of the system of equations in Internal Ballistics of a, conventional gun has been discussed for the hepta-tubular powder. The shot-start pressure is taken diffe- rent from zero and the covolume correction also is taken I. into amount and thus some of the results of Tavernierl who has taken zero shot-start preasure and has neglected the . covolume~omtion, have been generalised. It has been. found out that the maximum pressure in the case of hepta-tubular powders always occurs before the all-burnt position.

  3. Acute Pancreatitis Classifications: Basis and Key Goals.

    Xu, Xiao Dong; Wang, Zhe Yuan; Zhang, Ling Yi; Ni, Rui; Wei, Feng Xian; Han, Wei; Zhang, Hui Han; Zhang, Ya Wu; Wei, Zhen Gang; Guo, Xiao Hu; Guo, Liu Qiang; Ma, Jian Zhong; Zhang, You Cheng

    2015-12-01

    To explore the efficacy of the revised Atlanta classification (RACAP) and the determinant-based classification of acute pancreatitis severity (DBCAPS) on the basis of clinical data and feedback from patients with acute pancreatitis (AP). The authors retrospectively investigated a total of 573 patients with AP admitted to our hospital between December 2011 and December 2014. The definitions of severity and local complications in AP using RACAP and DBCAPS are presented and common points and mutual differences between the 2 groups are analyzed and discussed. Classification according to RACAP and DBCAPS found 86 (15%) and 178 (31.1%) mild cases (P peripancreatic fluid collection (236 patients, 75.40%), pancreatic pseudocysts (20 patients, 6.4%), acute necrotic collection (42 patients, 13.4%), and walled-off necrosis (15 patients, 4.8%) were observed. Among the 153 DBCAPS-defined cases, sterile peripancreatic necrosis (105 patients, 68.6%), sterile pancreatic necrosis (44 patients, 28.8%), infected peripancreatic necrosis (2 patients, 1.3%), and infected pancreatic necrosis (2/153 patients, 1.3%) were observed. Both classifications adopted organ failure and complications as determinants of severity. Revised Atlanta classification refined local complications and DBCAPS modified severity to include critical AP. In accordance with the demands of precision medicine, a combination of the 2 could be important for further clinical practice and scientific research. PMID:26632905

  4. INFLAMMATION AND ACUTE PHASE RESPONSE

    Farah Aziz Khan; Mohd Fareed Khan

    2010-01-01

    Inflammation caused by infection takes place by the cooperative cascade of cytokines and leukocytes. Tumor necrosis factor, interlukin-1, and interlukin-6 play important roles as proinflammatory cytokines to mediate local inflammation and activate other inflammatory cells e.g. neutrophils, monocytes, and macrophages. At least 15 different low molecular weight cytokine are secreted by activated leukocytes and are responsible for triggering acute phase response in the form of fever, leukocytosi...

  5. Acute pancreatitis : new frontiers in diagnosis and treatment

    van Santvoort, H.C.

    2010-01-01

    Acute pancreatitis is an acute inflammation of the pancreas mostly caused by gallstones and alcohol abuse. Around 15 to 20% of patients show a severe clinical course, which is characterised by multiple organ failure and necrosis of the pancreatic parenchyma and/ or peripancreatic fat tissue. In arou

  6. An unreported complication of acute pancreatitis

    Muthukumarasamy, G; V. Shanmugam; Yule, SR; Ravindran, R

    2007-01-01

    Acute pancreatitis constitutes 3% of all admissions with abdominal pain. There are reports of osteal fat necrosis leading to periosteal reactions and osteolytic lesions following severe pancreatitis, particularly in long bones. A 54-year-old man was admitted to our hospital with acute pancretitis, who later developed spinal discitis secondary to necrotizing pancreatitis. He was treated conservatively with antibiotics and after a month he recovered completely without any neurological deficit. ...

  7. Peroxisome proliferator-activated receptor δ agonist, HPP593, prevents renal necrosis under chronic ischemia.

    Larisa V Fedorova

    Full Text Available The Goldblatt's 2 kidney 1 clip (2K1C rat animal model of renovascular hypertension is characterized by ischemic nephropathy of the clipped kidney. 2K1C rats were treated with a specific peroxisome proliferator-activated receptor δ (PPARδ agonist, HPP593. Clipped kidneys from untreated rats developed tubular and glomerular necrosis and massive interstitial, periglomerular and perivascular fibrosis. HPP593 kidneys did not exhibit any histochemical features of necrosis; fibrotic lesions were present only in perivascular areas. Necrosis in the untreated clipped kidneys was associated with an increased oxidative stress, up regulation and mitochondrial translocation of the pro-death protein BNIP3 specifically in tubules. In the kidneys of HPP593-treated rats oxidative stress was attenuated and BNIP3 protein decreased notably in the mitochondrial fraction when compared to untreated animals. In untreated clipped kidneys, mitochondria were dysfunctional as revealed by perturbations in the levels of MCAD, COXIV, TFAM, and Parkin proteins and AMPK activation, while in HPP593-treated rats these proteins remained at the physiological levels. Nuclear amounts of oxidative stress-responsive proteins, NRF1 and NRF2 were below physiological levels in treated kidneys. Mitochondrial biogenesis and autophagy were inhibited similarly in both treated and untreated 2K1C kidneys as indicated by a decrease in PGC1-α and deficiency of the autophagy-essential proteins LC3-II and ATG5. However, HPP593 treatment resulted in increased accumulation of p62 protein, an autophagic substrate and an enhancer of NRF2 activity. Therefore, inhibition of BNIP3 activation by the preservation of mitochondrial function and control of oxidative stress by PPARδ is the most likely mechanism to account for the prevention of necrotic death in the kidney under conditions of persistent ischemia.

  8. Muscle imaging in patients with tubular aggregate myopathy caused by mutations in STIM1

    Tasca, Giorgio; D'Amico, Adele; Monforte, Mauro; Nadaj-Pakleza, Aleksandra; Vialle, Marc; Fattori, Fabiana; Vissing, John; Ricci, Enzo; Bertini, Enrico

    2015-01-01

    Tubular aggregate myopathy is a genetically heterogeneous disease characterized by tubular aggregates as the hallmark on muscle biopsy. Mutations in STIM1 have recently been identified as one genetic cause in a number of tubular aggregate myopathy cases. To characterize the pattern of muscle involvement in this disease, upper and lower girdles and lower limbs were imaged in five patients with mutations in STIM1, and the scans were compared with two patients with tubular aggregate myopathy not...

  9. The role of AT1 and AT2 angiotensin receptors in the mechanism of apoptosis in renal tubular cells after physical exercise.

    Podhorska-Okołów, M; Dziegiel, P; Gomułkiewicz, A; Dolińska-Krajewska, B; Murawska-Ciałowicz, E; Jethon, Z; Zabel, M

    2004-01-01

    Intensive physical exercise disturbs the entire homeostasis in the body and leads to changes in haemodynamic and metabolic alterations not only in skeletal muscles but also in many distant organs. In response to acute physical exercise, a decrease of the glomerular filtration may occur, followed by stimulation of the renin-angiotensin system (RAS). Recent studies have shown that both AT1 and AT2 angiotensin receptors may play a role in mediating the apoptotic process in the kidney. Our previous studies have demonstrated an occurrence of apoptosis in rat renal tubular cells after an excessive exercise. The aim of the present study was to determine the possible mechanism of exercise-induced apoptosis in rat kidney. The analysis was performed on kidneys of rats, subjected to treadmill running until exhaustion. Apoptosis was detected in paraffin sections by the TUNEL technique. The expression of AT1 and AT2 receptors in renal tubular cells was examined by immunohistochemistry and Western blot. Our results confirmed that apoptosis after physical exercise is present in renal distal tubular cells. Moreover, there was an increased expression of AT1 and AT2 receptors in distal tubular cells. These studies suggest that physical exercise may induce apoptosis by a mechanism, involving the activation of angiotensin AT1 and AT2 receptors. PMID:15638358

  10. Subanalytic Bundles and Tubular Neighbourhoods of Zero-Loci

    Vishwambhar Pati

    2003-08-01

    We introduce the natural and fairly general notion of a subanalytic bundle (with a finite dimensional vector space of sections) on a subanalytic subset of a real analytic manifold , and prove that when is compact, there is a Baire subset of sections in whose zero-loci in have tubular neighbourhoods, homeomorphic to the restriction of the given bundle to these zero-loci.

  11. Urinary Markers of Tubular Injury in Early Diabetic Nephropathy

    Temesgen Fiseha

    2016-01-01

    Full Text Available Diabetic nephropathy (DN is a common and serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease, and premature mortality. Early and accurate identification of DN is therefore of critical importance to improve patient outcomes. Albuminuria, a marker of glomerular involvement in early renal damage, cannot always detect early DN. Thus, more sensitive and specific markers in addition to albuminuria are needed to predict the early onset and progression of DN. Tubular injury, as shown by the detection of tubular injury markers in the urine, is a critical component of the early course of DN. These urinary tubular markers may increase in diabetic patients, even before diagnosis of microalbuminuria representing early markers of normoalbuminuric DN. In this review we summarized some new and important urinary markers of tubular injury, such as neutrophil gelatinase associated lipocalin (NGAL, kidney injury molecule-1 (KIM-1, liver-type fatty acid binding protein (L-FABP, N-acetyl-beta-glucosaminidase (NAG, alpha-1 microglobulin (A1M, beta 2-microglobulin (B2-M, and retinol binding protein (RBP associated with early DN.

  12. Urinary Markers of Tubular Injury in Early Diabetic Nephropathy.

    Fiseha, Temesgen; Tamir, Zemenu

    2016-01-01

    Diabetic nephropathy (DN) is a common and serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease, and premature mortality. Early and accurate identification of DN is therefore of critical importance to improve patient outcomes. Albuminuria, a marker of glomerular involvement in early renal damage, cannot always detect early DN. Thus, more sensitive and specific markers in addition to albuminuria are needed to predict the early onset and progression of DN. Tubular injury, as shown by the detection of tubular injury markers in the urine, is a critical component of the early course of DN. These urinary tubular markers may increase in diabetic patients, even before diagnosis of microalbuminuria representing early markers of normoalbuminuric DN. In this review we summarized some new and important urinary markers of tubular injury, such as neutrophil gelatinase associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (L-FABP), N-acetyl-beta-glucosaminidase (NAG), alpha-1 microglobulin (A1M), beta 2-microglobulin (B2-M), and retinol binding protein (RBP) associated with early DN. PMID:27293888

  13. Modelling the cardiac transverse-axial tubular system

    Pásek, Michal; Šimurda, J.; Christé, G.; Orchard, C.

    2008-01-01

    Roč. 96, - (2008), s. 226-246. ISSN 0079-6107 Institutional research plan: CEZ:AV0Z20760514 Keywords : cardiac cell * transverse-axial tubular system * quantitative modelling Subject RIV: BO - Biophysics Impact factor: 6.388, year: 2008

  14. Glutamatergic signaling maintains the epithelial phenotype of proximal tubular cells

    Bozic, M.; de Rooij, J.; Parisi, E.; Ortega, M.R.; Fernandez, E.; Valdivielso, J.M.

    2011-01-01

    Epithelial-mesenchymal transition (EMT) contributes to the progression of renal tubulointerstitial fibrosis. The N-methyl-d-aspartate receptor (NMDAR), which is present in proximal tubular epithelium, is a glutamate receptor that acts as a calcium channel. Activation of NMDAR induces actin rearrange

  15. Acute cardiac failure in neuroleptic malignant syndrome.

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  16. The pathogenesis of late cerebral radiation necrosis

    For more detailed study of the problem of pathogenesis of late cerebral radiation necrosis a patient after a course of remote radiotherapy for endocellar hypophysis tumor has been observed. Appearance of ''secondary'' necrosis foci is described. Necrotic changes which emerge in various terms after immediate radiation effect are shown. An assumption is made that the developing pathological process occurs by the type of autoallergic reaction. Where the role of the allergen is played by the products of intensive decomposition of myelin which is observed in injury foci. Attention of clinical physicians Ond radiation therapeutists is drawn to the fact that when prescribing radio therapy and particularly repetition courses one should consider a possibility of autoimmune after-effects

  17. Giant cell arteritis presenting as scalp necrosis.

    Maidana, Daniel E; Muñoz, Silvia; Acebes, Xènia; Llatjós, Roger; Jucglà, Anna; Alvarez, Alba

    2011-01-01

    The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness. PMID:21789466

  18. Sunflower necrosis disease management with thiomethoxam

    Shirshikar S.P.

    2010-01-01

    Sunflower necrosis disease (SND), observed during 1997 in India has now become established in all major sunflower-growing states and has assumed the status of disease of national importance, thereby threathening sunflower cultivation in general. As it is a new disease, reliable resistance sources are still under investigation. A new insecticide thiomethoxam (Cruiser 70 W.S.) was tested for three years at Oilseeds Research Station, Latur (M.S.), India, to ma...

  19. Integrated management of sunflower necrosis disease

    Shirshikar S.P.

    2008-01-01

    Sunflower necrosis disease (SND) is a new threat for sunflower cultivation in India. The disease was observed during 1997 in Karnataka, a major sunflower growing state of India. Later, its occurrence was reported from almost all sunflower growing states of India, posing threat to sunflower cultivation. Presently no reliable resistant sources are available. The disease being viral in nature is very much difficult to combat by single approach. At Oilseeds Research Station, Latur (M.S.), India, ...

  20. Tracheal necrosis with surgical emphysema following thyroidectomy

    Chauhan A; Ganguly M; Saidha N; Gulia P

    2009-01-01

    Tracheal necrosis after thyroidectomy is an extremely rare event with only a few published reports. We present a case of a 65-year-old male who developed rapidly progressive surgical emphysema of face and upper thorax on the seventh day following total thyroidectomy. Prompt surgical exploration of neck revealed a tracheal rent at the level of the second tracheal ring. This hole was then refashioned into a formal tracheostomy. Patient had an eventful recovery. Tracheostomy was closed by the 14...

  1. Tissue necrosis following intramuscular diclofenac injection

    Baykan, Halit; Kuvat, Samet Vasfi; Bozkurt, Mehmet; Kapı, Emin; Çelik, Feyzi

    2010-01-01

    Following intramuscular drug injections, livedoid dermatitis (also known as embolia cutis medicamentosa or Nicolau Syndrome), characterized by pain, skin discoloration, and cutaneous necrosis, may rarely be observed. In the present study, we present a 32-year-old male patient who developed Nicolau Syndrome after intramuscular injection of single-dose diclofenac sodium 75 mg due to renal colic pain. The physical examination revealed skin discoloration in his left gluteal region, and a skin nec...

  2. Tissue necrosis following intramuscular diclofenac injection

    Feyzi Çelik; Emin Kapı; Mehmet Bozkurt; Samet Vasfi Kuvat; Halit Baykan

    2010-01-01

    Following intramuscular drug injections, livedoid dermati-tis (also known as embolia cutis medicamentosa or NicolauSyndrome), characterized by pain, skin discoloration,and cutaneous necrosis, may rarely be observed. In thepresent study, we present a 32-year-old male patient whodeveloped Nicolau Syndrome after intramuscular injec-tion of single-dose diclofenac sodium 75 mg due to renalcolic pain. The physical examination revealed skin discol-oration in his left gluteal region, and a skin necro...

  3. Liquefaction necrosis of mitral annulus calcification.

    Mallisho, Maram; Hwang, Inyong; Alsafwah, Shadwan F

    2014-01-01

    Liquefaction necrosis of the mitral annulus is a rare form of peri-annular calcification that the cardiologist must be able to differentiate from other cardiac masses. It classically looks like a round or semilunar hyperdense mass with a denser peripheral rim, located mainly in the posterior mitral annulus. The case we report here was diagnosed in a 78-year-old female patient who presented with an embolic cerebral vascular accident, which raises the question of its etiopathogenic responsibility. PMID:24420234

  4. An investigation of ear necrosis in pigs

    Park, Jeonghwa; Friendship, Robert M.; Poljak, Zvonimir; DeLay, Josepha; Slavic, Durda; Dewey, Catherine E.

    2013-01-01

    Porcine ear necrosis was investigated in 23 conveniently chosen farms, consisting of 14 case farms and 9 control farms. Biopsies of lesions and oral swabs from pigs on 11 case farms were examined by histology and bacterial culture. All farms were visited for observations and a survey on management, housing, and the presence of other clinical signs or behavioral vices. Histological examination revealed that the lesions began on the surface and progressed to deeper layers, and that vascular dam...

  5. Eosinophilic Gastritis Presenting as Tissue Necrosis

    Jo, Yong Min; Jang, Jin Seok; Han, Seung Hee; Kang, Sang Hyun; Kim, Woo Jae; Jeong, Jin Sook

    2015-01-01

    Eosinophilic gastroenteritis is very rare disorder that is characterized by eosinophilic infiltration of the gastrointestinal tract in the absence of any definite causes of eosinophilia. It is associated with various clinical gastrointestinal manifestations, and depends on the involved layer and site. We report a case of eosinophilic gastritis presenting with severe necrosis. The symptoms disappeared immediately after beginning steroid treatment, and the eosinophil count decreased to the refe...

  6. Tumor necrosis factor-a in atherosclerosis

    Jovinge, Stefan

    1997-01-01

    Tumor necrosis factor-a in atherogenesis Stefan Jovinge, Department of Medicine, King Gustaf Vth Research, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden The presence of inflammatory cells is prominent at all phases of the atherosclerotic process leaving no doubt that the inflammation is of central importance in atherosclerosis. The recruitment of inflammatory cells into the vessel wall is therefore a key event in early lesion formation. Hypercholesterol...

  7. INFLAMMATION AND ACUTE PHASE RESPONSE

    Farah Aziz Khan

    2010-10-01

    Full Text Available Inflammation caused by infection takes place by the cooperative cascade of cytokines and leukocytes. Tumor necrosis factor, interlukin-1, and interlukin-6 play important roles as proinflammatory cytokines to mediate local inflammation and activate other inflammatory cells e.g. neutrophils, monocytes, and macrophages. At least 15 different low molecular weight cytokine are secreted by activated leukocytes and are responsible for triggering acute phase response in the form of fever, leukocytosis, increased secretion of adreno corticotropic hormones, and production of acute phase proteins. Acute phase proteins are produced in liver under the influence of cytokines, which through blood stream passes to the site of inflammation and kill the pathogens by opsonization and activating complement pathways. The changes in the concentrations of positive acute-phase proteins and negative acute-phase proteins are due to the changes in their production by liver. Three of the best known acute phase proteins are C-reactive protein, serum anyloid A, and haptoglobin. Some disease states are casually related to acute phase proteins. C-reactive protein mediated compliment activation has a key role in some forms of tissue alteration such as cardiac infarction. Elevated S amyloid A levels are seen in chronic arthritis and tuberculosis. Other acute phase proteins show more moderate rise, usually less than fivefold.

  8. Cutaneous necrosis from calcific uremic arteriolopathy.

    Coates, T; Kirkland, G S; Dymock, R B; Murphy, B F; Brealey, J K; Mathew, T H; Disney, A P

    1998-09-01

    Calcific uremic arteriolopathy (calciphylaxis) is an uncommon complication of chronic renal failure that is associated with high morbidity and mortality. We report 16 patients (13 female) who presented between 1985 and 1996. All patients developed painful livido reticularis that progressed to cutaneous necrosis and ulceration (11 cases on the proximal extremities and five cases on the distal extremities). Two patients with predominately distal leg disease survived; the cause of death in the other 14 patients was sepsis (six patients), withdrawal from dialysis (three), cardiac arrest (three), and gastrointestinal hemorrhage (two). Mesenteric ischemia from intestinal vascular calcification occurred in two cases. Clinical factors identified included the use of warfarin therapy in seven cases and significant weight loss (>10% body weight) in seven cases in the 6 months preceding the development of calcific uremic arteriolopathy. Skin pathology was studied in 12 cases, with all showing calcific panniculitis and small vessel calcification. Electron microscopic spectral analysis of the mineral content of the calcific lesions in the subcutaneous tissue showed only calcium and phosphorous. In two cases, substitution of low molecular weight heparin for warfarin therapy resulted in clinical improvement. Current theories of pathogenesis and treatment are reviewed. This study confirms the high morbidity and mortality of calcific uremic arteriolopathy producing ischemic tissue necrosis while drawing attention to significant weight loss and warfarin therapy as risk factors for the development of ischemic tissue necrosis. Hyperbaric oxygen therapy warrants further study. PMID:9740153

  9. Idiopathic incus necrosis: Analysis of 4 cases.

    Kansu, Leyla; Yilmaz, Ismail; Akdogan, Volkan; Avci, Suat; Ozluoglu, Levent

    2013-02-01

    We evaluated ossicular chain reconstruction in patients with idiopathic incus necrosis who have conductive hearing loss and an intact ear drum. The study included four patients (3 women and 1 man; the ages of the patients were 22, 31, 35, and 56 years, respectively) with unilateral conductive hearing loss, no history of chronic serous otitis media, an intact ear drum, normal middle ear mucosa, and necrosis of the long processes of the incus. On preoperative pure tone audiometry, air-bone gaps were 24, 25, 38, and 33 dB. Bilateral tympanometry and temporal bone computed tomography results were normal. All 4 patients underwent an exploratory tympanotomy. During the operation, the mucosa of the middle ear was normal, with a mobile stapes foot plate and malleus. No evidence of any granulation tissue was found; however, necrosis of the incus long processes was seen. For ossicular reconstruction, we used tragal cartilage between the incus and the stapes in 1 patient; in the other 3 patients, glass ionomer bone cement was used (an interposition cartilage graft also was used in the patients who received the glass ionomer bone cement). In all patients, air-bone gaps under 20 dB were established in the first year after surgery. In the ossicular disorders within the middle ear, the incus is the most commonly affected ossicle. While, the most common cause of these disorders is chronic otitis media, it may be idiopathic rarely. Several ossicular reconstruction techniques have been used to repair incudostapedial discontinuity. PMID:23460219

  10. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  11. Successful treatment of multidrug-resistant tuberculosis following drug-induced hepatic necrosis requiring liver transplant.

    Marra, F; Cox, V C; FitzGerald, J M; Moadebi, S; Elwood, R K

    2004-07-01

    A 28-year-old female developed multidrug-resistant (MDR) tuberculous lymphadenitis following a trip to India. She was initially treated with a four-drug regimen of first-line anti-tuberculosis medications, but when sensitivities indicated resistance to isoniazid and rifampin, her regimen was altered to ciprofloxacin (CFX), pyrazinamide (PZA) and ethambutol. She subsequently developed a rash, flu-like symptoms and fever, which progressed to acute hepatic necrosis despite discontinuation of medication. The clinical presentation and subsequent investigations suggested a hypersensitivity reaction, possibly related to the quinolone. The patient subsequently had an orthoptic liver transplant; second-line anti-tuberculosis medications were restarted to which she responded clinically and radiologically. Our findings raise the possibility that the CFX and PZA combination was responsible for the hepatic necrosis. The patient also illustrates that active, even MDR tuberculosis is not a contraindication to hepatic transplant. PMID:15260286

  12. Genetic and immunologic aspects of acute pancreatitis : An odyssey

    Nijmeijer, R.M.

    2014-01-01

    Acute pancreatitis is the leading cause of acute hospitalization for gastrointestinal diseases. The course of acute pancreatitis is often mild and self-limiting, but in 15-25% of patients, pancreatitis is severe with an increased mortality risk. Infectious complications, and especially bacterial infection of pancreatic necrosis, are commonly accepted as the major cause of death for patients with this disease. The aim of the research described in this thesis was to gain more insight in some of...

  13. Some biomarkers of acute kidney injury are increased in pre-renal acute injury

    Nejat, Maryam; Pickering, John W; Devarajan, Prasad; Edelstein, Charles L.; Walker, Robert J.; Endre, Zoltán H; Bonventre, Joseph Vincent

    2012-01-01

    Pre-renal acute kidney injury (AKI) is assumed to represent a physiological response to underperfusion. Its diagnosis is retrospective after a transient rise in plasma creatinine, usually associated with evidence of altered tubular transport, particularly that of sodium. In order to test whether pre-renal AKI is reversible because injury is less severe than that of sustained AKI, we measured urinary biomarkers of injury (cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), \\(\\gamma\\...

  14. Ultrasonographic diagnosis of acute appendicitis

    Acute appendicitis is the most common surgical disease of acute abdomen, But the diagnosis of acute appendicitis is often difficult, and not in frequently, operation for appendicitis is performed only to find a normal appendix. Various radiological examinations have been proposed to improve diagnostic accuracy of appendicitis. The purpose of this study was to improve the diagnostic accuracy of appendicitis, and to decline negative exploration. High resolution real time ultrasonographical examination using graded compression was performed in 57 consecutive patients who were clinically suspected of appendicitis. Autors analysed ultrasonographical, surgical, and clinical follow up findings. The results were are follows: 1. Ultrasonographical finding of acute appendicitis was visualization of appendix as a tubular structure with one bline end, or target phenomenon. 2. Hypoechoic area over the appendix was thought to be a sign of periappendiceal abscess. 3. The sensitivity of US diagnosis of acute appendicitis in this study was 92.8% with a specificity of 93.1%. The overall accuracy was 93.0%. 4. In control group of 50 individuals, the abnormal appendix was not visualized. 5. In cases of clinically suspected appendicitis, the US evaluation with graded compression technique is very accurate and effective examination.

  15. Tumor necrosis factor (TNF) inhibits interleukin (IL)-1 and/or IL-6 stimulated synthesis of C-reactive protein (CRP) and serum amyloid A (SAA) in primary cultures of human hepatocytes

    Yap, S.H.; Moshage, H.J.; Hazenberg, B.P.C.; Roelofs, H.M.J.; Bijzet, J.; Limburg, P.C.; Aarden, L.A.; Van Rijswijk, M.H.

    1991-01-01

    Interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF) are considered as important mediators for the modulation of liver synthesis of acute phase proteins. However, studies of the direct effect of individual or a combination of these cytokines on the synthesis of acute phase proteins in human hepa

  16. Ulinastatin Protects against Acute Kidney Injury in Infant Piglets Model Undergoing Surgery on Hypothermic Low-Flow Cardiopulmonary Bypass.

    Xiaocou Wang

    Full Text Available Infants are more vulnerable to kidney injuries induced by inflammatory response syndrome and ischemia-reperfusion injury following cardiopulmonary bypass especially with prolonged hypothermic low-flow (HLF. This study aims to evaluate the protective role of ulinastatin, an anti-inflammatory agent, against acute kidney injuries in infant piglets model undergoing surgery on HLF cardiopulmonary bypass.Eighteen general-type infant piglets were randomly separated into the ulinastatin group (Group U, n = 6, the control group (Group C, n = 6, and the sham operation group (Group S, n = 6, and anaesthetized. The groups U and C received following experimental procedure: median thoracotomy, routine CPB and HLF, and finally weaned from CPB. The group S only underwent sham median thoracotomy. Ulinastatin at a dose of 5,000 units/kg body weight and a certain volume of saline were administrated to animals of the groups U and C at the beginning of CPB and at aortic declamping, respectively. Venous blood samples were collected at 3 different time points: after anesthesia induction in all experimental groups, 5 minutes, and 120 minutes after CPB in the Groups U and C. Markers for inflammation and acute kidney injury were tested in the collected plasma. N-acetyl-β-D-glucosaminidase (NAG from urine, markers of oxidative stress injury and TUNEL-positive cells in kidney tissues were also detected.The expressions of plasma inflammatory markers and acute kidney injury markers increased both in Group U and Group C at 5 min and 120 min after CPB. Also, numbers of TUNEL-positive cells and oxidative stress markers in kidney rose in both groups. At the time point of 120-min after CPB, compared with the Group C, some plasma inflammatory and acute kidney injury markers as well as TUNEL-positive cells and oxidative stress markers in kidney were significantly reduced in the Group U. Histologic analyses showed that HLF promoted acute tubular necrosis and dilatation

  17. Delayed radiation necrosis in the optochiasmatic region

    Two cases with delayed radiation necrosis of the chiasmatic region following irradiation of the hypophysis for treatment of Cushing's disease were presented. Case 1 was a 36-year-old female who had reduction of visual acuity and bitemporal hemianopsia 2 years after 60Co-irradiation therapy (total 8000 rads) for Cushing's disease. CT scans showed low density in the pituitary fossa and irregular contrast-enhanced suprasellar mass, and metrizamide CT cisternography revealed the pituitary fossa filled with contrast medium. From those findings, secondary empty sella syndrome was suspicious. Case 2 was a 35-year-old male who had progressive visual disturbance 3 years after 60Co-irradiation therapy (total 9050 rads) for Cushing's disease. The right visual acuity was 0.05 and the left one was 0.1. Examination of visual field showed left homonymous hemianopsia. CT scans showed the contrast enhanced suprasellar mass extending to the right anterior thalamic region, and metrizamide CT cisternography detected secondary empty sella as same as that of Case 1. Authors reviewed and analyzed literatures of delayed radiation necrosis. The incidence of this condition was 4% to 9% and onset of the symptoms occured approximately 2 years after irradiation to hypophysis. Administration of steroid hormone and surgical treatment for the radiation necrosis involving the chiasmatic region were almost ineffective and also the prognosis of radionecrotic lesions involving the hypothalamus was very poor. Therefore, radiotherapy for hypophyseal region must be carried out by means of a rotation or arching technique in order to avoid this condition and further total dosage and its fractionation in radiation therapy should not exceed 6000 rads and 200 rads a day. (J.P.N.)

  18. Effect of renal nerve activity on tubular sodium and water reabsorption in dog kidneys as determined by the lithium clearance method

    Abildgaard, U; Holstein-Rathlou, N H; Leyssac, P P

    1986-01-01

    reabsorption of sodium and water increased significantly by 9 +/- 2% and 8 +/- 2%. Low-frequency electrical stimulation of the distal nerve bundle of the denervated kidney caused a significant decrease in urine flow rate (37 +/- 6%), sodium clearance (31 +/- 4%), lithium clearance (17 +/- 5%) and in fractional......The reliability of the lithium clearance method in studies of the effect of renal nerve activity upon tubular sodium and water handling in the dog kidney was investigated. Following unilateral acute surgical denervation of the kidney a significant increase in urinary flow rate (40 +/- 7%), sodium...... lithium clearance (18 +/- 5%). Calculated absolute proximal reabsorption rate increased significantly by 17 +/- 3%, while calculated absolute rates of distal sodium and water reabsorption decreased significantly by 16 +/- 5% and 16 +/- 5%. These changes in tubular sodium and water reabsorption during...

  19. Pancreatic panniculitis: a cutaneous manifestation of acute pancreatitis

    Laureano, A; Mestre, T; Ricardo, L; Rodrigues, AM; Cardoso, J.

    2014-01-01

    Pancreatic panniculitis is a rare disease in which necrosis of fat in the panniculus and other distant foci occurs in the setting of pancreatic diseases; these diseases include acute and chronic pancreatitis, pancreatic carcinoma, pseudocyst, and other pancreatic diseases. This malady is manifested as tender erythematous nodules on the legs, buttock, or trunk. Histopathologically, it shows the pathognomonic findings of focal subcutaneous fat necrosis and ghost-like anucleated cells with a thi...

  20. Fatal Pancreatic Panniculitis Associated with Acute Pancreatitis: A Case Report

    Lee, Woo Sun; Kim, Mi Yeon; Kim, Sang Woo; Paik, Chang Nyol; Kim, Hyung Ok; Park, Young Min

    2007-01-01

    Pancreatic panniculitis is a rare disease in which necrosis of fat in the panniculus and other distant foci occurs in the setting of pancreatic diseases; these diseases include acute and chronic pancreatitis, pancreatic carcinoma, pseudocyst, and other pancreatic diseases. This malady is manifested as tender erythematous nodules on the legs, buttock, or trunk. Histopathologically, it shows the pathognomonic findings of focal subcutaneous fat necrosis and ghost-like anucleated cells with a thi...

  1. Luminous effectiveness of tubular light-guides in tropics

    Darula, Stanislav; Kittler, Richard; Kocifaj, Miroslav [ICA, Slovak Academy of Sciences, 9, Dubravska Road, 845 03 Bratislava (Slovakia)

    2010-11-15

    Novel tubular light-guides with a transparent hemispherical cupola placed on an unobstructed flat roof collect all sunlight and skylight available at ground level year round. This advantage is heightened in the dry and sunny tropical regions where the sun rises to very high altitudes and often the hours of sunshine last throughout the whole day. Hollow light-guides with very high inner specular reflectances can transport sunbeams downward into the windowless building core very effectively. Due to the tube's diameter and length and multiple reflections, complex illuminance patterns are produced on the underside of the tube, i.e. on top of the glazed ceiling aperture that illuminates the interior space or its working plane. This paper discusses several daylight conditions in tropical interiors illuminated by tubular light-guides. The recently published HOLIGILM calculation program and the user-friendly tool HOLIGILM 4.2 have facilitated the production of this paper. (author)

  2. [Primary distal renal tubular acidosis: a case report].

    Abdallah, Jihene Ben; Charfeddine, Bassem; Braham, Imen; Neffati, Souhir; Othmen, Leila Ben; Letaief, Affef; Smach, Mohamed Ali; Bourfifa, Zoheier; Dridi, Hedi; Limem, Khalifa

    2011-01-01

    The primary distal renal tubular acidosis is characterized biochemically by the inability of the kidney to produce appropriately acid urine in the presence of systemic metabolic acidosis or after acid loading (e.g. ammonium chloride). It is secondary to defective excretion of H(+) by the cells of the collecting duct. We report the observation of the child MC, 4-year-old, for whom the association of polyuria-polydipsia syndrome, a failure to thrive, nephrolithiasis, hypercalciuria, and especially a high urine pH in the presence of metabolic acidosis did evoke diagnosis of distal renal tubular acidosis. An urine acidification test with ammonium chloride was performed, the urinary pH was always higher than 5.5, thus confirming the diagnosis. PMID:21464016

  3. Dynamic model of microalgal production in tubular photobioreactors.

    Fernández, I; Acién, F G; Fernández, J M; Guzmán, J L; Magán, J J; Berenguel, M

    2012-12-01

    A dynamic model for microalgal culture is presented. The model takes into account the fluid-dynamic and mass transfer, in addition to biological phenomena, it being based on fundamental principles. The model has been calibrated and validated using data from a pilot-scale tubular photobioreactor but it can be extended to other designs. It can be used to determine, from experimental measurements, the values of characteristic parameters. The model also allows a simulation of the system's dynamic behaviour in response to solar radiation, making it a useful tool for design and operation optimization of photobioreactors. Moreover, the model permits the identification of local pH gradients, dissolved oxygen and dissolved carbon dioxide; that can damage microalgae growth. In addition, the developed model can map the different characteristic time scales of phenomena inside microalgae cultures within tubular photobioreactors, meaning it is a valuable tool in the development of advanced control strategies for microalgae cultures. PMID:23073105

  4. Inner-tubular physicochemical processes of carbon nanotubes

    YANG Quanhong; LI Lixiang; CHENG Huiming; WANG Maozhang; BAI Jinbo

    2003-01-01

    Nanosized inner cavities of carbon nanotubes (CNTs) afford quasi-one-dimensional (1D) confined space, in which materials adsorbed or filled are of reactivity greatly different from the materials adsorbed on a planar surface and quite a number of curious physicochemical processes will possibly occur. In other words, 1D CNT nanochannels may serve as "nanosized test tubes". In this article, on the basis of the unique chemical and physical properties of CNTs, the latest progresses of the research on peculiar inner-tubular physicochemical processes of CNTs are briefly reviewed from several aspects. The extraordinary 1D adsorption, capillary filling and nanoscale-confined reaction are discussed in detail. Moreover, the characteristics of "nanosized test tubes" are summarized and many unfamiliar inner cavity chemical processes are expected. Finally, the future direction and challenges on basic researches and potential applications of inner-tubular chemistry of CNTs are discussed.

  5. Screening renal stone formers for distal renal tubular acidosis

    Osther, P J; Hansen, A B; Røhl, H F

    1989-01-01

    A group of 110 consecutive renal stone formers were screened for distal renal tubular acidosis (RTA) using morning fasting urinary pH (mfUpH) levels followed by a short ammonium chloride loading test in patients with levels above 6.0. In 14 patients (12.7%) a renal acidification defect was noted......; 13 had incomplete and 1 had complete distal RTA. Distal RTA was found particularly in recurrent stone formers (17%), and especially in those with bilateral stone disease, where a distal renal tubular acidification defect was found in 50%. We have been unable to differentiate primary from secondary...... RTA in renal stone formers. Regardless of whether the acidification defect is primary or secondary to stone formation, however, all renal stone formers with distal RTA can expect to benefit from prophylactic alkaline therapy and it is recommended that the screening procedure, which is easy to use in...

  6. A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia

    C. Ripoli

    2012-08-01

    Full Text Available Introduction: distal renal tubular acidosis (dRTA presents itself with variable clinical manifestations and often with late expressions that impact on prognosis. Case report: A 45-day-old male infant was admitted with stopping growth, difficult feeding and vomiting after meals. Clinical tests and labs revealed a type 1 renal tubular acidosis, even if the first blood tests showed ammonium and lactate increase. We had to exclude metabolic diseases before having a certain diagnosis. Conclusions: blood and urine investigations and genetic tests are fundamental to formulate dRTA diagnosis and to plan follow-up, according to possible phenotypic expressions of recessive and dominant autosomal forms in patients with dRTA.

  7. Tubular separate first wall for ITER-EDA

    The tubular solution first wall is the most suitable one to cope with the thermal stresses, the use of double wall reduces the risk of leaks inside the vacuum vessel by avoiding the growth of a crack through both walls: the soft brazing in between wall stops the growth of a crack from one tube to the other. The eddy currents induced in the tubes are low and the Halo current flowing poloidally in the tubes exert a radial pressure which is supported by the blanket box via ad hoc supporting points provided in between first wall and blanket. The tubes can be made of steel to resist a heat flux of up to 1 MW/m2. For higher heat loads copper or vanadium can be used. The tubular first wall can be replaced independently from the blanket. The thermo-hydraulic electro-magnetic and dynamic analysis confirm the viability of the solution proposed

  8. Tubular separate first wall for ITER-EDA

    Pizzuto, A.; Riccardi, B. [Associazione EURATOM-ENEA sulla Fusione, Frascati (Italy); Salpietro, E.; Malavasi, G. [Max-Planck-Institut fuer Plasmaphysik, Garching (Germany). NET Design Team

    1994-11-01

    The tubular solution first wall is the most suitable one to cope with the thermal stresses, the use of double wall reduces the risk of leaks inside the vacuum vessel by avoiding the growth of a crack through both walls: the soft brazing in between wall stops the growth of a crack from one tube to the other. The eddy currents induced in the tubes are low and the Halo current flowing poloidally in the tubes exert a radial pressure which is supported by the blanket box via ad hoc supporting points provided in between first wall and blanket. The tubes can be made of steel to resist a heat flux of up to 1 MW/m{sup 2}. For higher heat loads copper or vanadium can be used. The tubular first wall can be replaced independently from the blanket. The thermo-hydraulic electro-magnetic and dynamic analysis confirm the viability of the solution proposed.

  9. Intrarenal purinergic signaling in the control of renal tubular transport

    Prætorius, Helle; Leipziger, Jens Georg

    2010-01-01

    Renal tubular epithelial cells receive hormonal input that regulates volume and electrolyte homeostasis. In addition, numerous intrarenal, local signaling agonists have appeared on the stage of renal physiology. One such system is that of intrarenal purinergic signaling. This system involves all ...... of NaCl at the macula densa. This review describes the relevant aspects of local, intrarenal purinergic signaling and outlines its integrative concepts....

  10. Renal tubular acidosis secondary to jejunoileal bypass for morbid obesity

    Schaffalitzky de Muckadell, O B; Ladefoged, Jens; Thorup, Jørgen Mogens

    1985-01-01

    Renal handling of acid and base was studied in patients with persistent metabolic acidosis 3-9 years after jejunoileal bypass for morbid obesity. Excretion of acid was studied before and after intravenous infusion of NH4Cl and excretion of bicarbonate after infusion of NaHCO3. Bypass patients...... groups. Fractional loss of bicarbonate in urine was higher in controls than in bypass patients. The renal impairment is classified as distal renal tubular acidosis....

  11. Electrolytic-Plasma Treatment of Inner Surface of Tubular Products

    Yu. G. Alekseev; A. Yu. Korolyov; V. S. Niss; A. E. Parshuta

    2016-01-01

    While manufacturing a number of important tubular products stringent requirements have been imposed on quality of their inner surfaces. The well-known methods for inner surface treatment of pipes include sandblasting, chemical cleaning with acid reagents (oxalic, formic, sulfamic, orthophosphoric acids) and electrochemical polishing. Disadvantages of the chemical method are cleaning-up irregularities, high metal removal, limited number of reagent application, complicated selection of reagent ...

  12. Stator iron loss of tubular permanent-magnet machines

    Amara, Y; Wang, J B; Howe, D

    2005-01-01

    While methods of determining the iron loss in rotating permanent-magnet (PM) machines have been investigated extensively, the study of iron loss in linear machines is relatively poorly documented. This paper describes a simple analytical method to predict flux density waveforms in discrete regions of the laminated stator of a tubular PM machine, and employs an established iron loss model to determine the iron loss components, on both no load and on load. Analytical predictions are compared wi...

  13. Optimal startup control of a jacketed tubular reactor.

    Hahn, D. R.; Fan, L. T.; Hwang, C. L.

    1971-01-01

    The optimal startup policy of a jacketed tubular reactor, in which a first-order, reversible, exothermic reaction takes place, is presented. A distributed maximum principle is presented for determining weak necessary conditions for optimality of a diffusional distributed parameter system. A numerical technique is developed for practical implementation of the distributed maximum principle. This involves the sequential solution of the state and adjoint equations, in conjunction with a functional gradient technique for iteratively improving the control function.

  14. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association

    Ravi, P.; Ekambaranath, T. S.; Arasi, S. Ellil; Fernando, E.

    2013-01-01

    Renal tubular acidosis (RTA) is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I) is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI) represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previ...

  15. Study of maximum pressure for composite hepta-tubular powders

    M. C. Gupta

    1959-10-01

    Full Text Available In this paper the expressions for maximum pressure occurring positions in the case of composite hepta-tubular powers used in conventional guns and the corresponding conditions have been derived under certain conditions, viz., the value of n, the ratio of specific heats, has been assumed to be the same for both the charges and the covolume corrections have not been neglected.

  16. CHARACTERISTICS OF CORN STALK HEMICELLULOSE PYROLYSIS IN A TUBULAR REACTOR

    Gao-Jin Lv; Shu-Bin Wu; Rui Lou

    2010-01-01

    Pyrolysis characteristics of corn stalk hemicellulose were investigated in a tubular reactor at different temperatures, with focus mainly on the releasing profiles and forming behaviors of pyrolysis products (gas, char, and tar). The products obtained were further identified using various approaches (including GC, SEM, and GC-MS) to understand the influence of temperature on product properties and compositions. It was found that the devolatilization of hemicellulose mainly occurred at low tem...

  17. CT diagnosis of intramedulear lesions of the tubular bone

    Three cases are used to demonstrate that intramedullary masses of the tubular bones can be discovered using computered tomography even when changes in the plain film are lacking or discrete. However, it was not possible to differentiate between osteomyelitis, chondrosarcoma and enchondroma owing to the identical morphology of these three diseases. Consequently, CT does not allow any statement on type and dignity and histological clarification is indispensable. (orig./WU)

  18. Tubular biomarkers to assess progression of diabetic nephropathy.

    Tramonti, Gianfranco; Kanwar, Yashpal S

    2011-05-01

    Despite aggressive management, many patients with diabetic nephropathy still develop end-stage renal disease. Accompanying tubulointerstitial damage is important in the progression of diabetic nephropathy. Markers of tubular damage, such as NGAL, KIM-1, and LFABP, have been proposed for monitoring the effectiveness of therapy. However, Nielsen et al. report a lack of an independent correlation between these biomarkers and glomerular filtration rate. Therefore, these markers seem to offer no improvement in the management of diabetic nephropathy. PMID:21527942

  19. ELECTROLYTIC-PLASMA TREATMENT OF INNER SURFACE OF TUBULAR PRODUCTS

    Yu. G. Alekseev

    2016-01-01

    Full Text Available While manufacturing a number of important tubular products stringent requirements have been imposed on quality of their inner surfaces. The well-known methods for inner surface treatment of pipes include sandblasting, chemical cleaning with acid reagents (oxalic, formic, sulfamic, orthophosphoric acids and electrochemical polishing. Disadvantages of the chemical method are cleaning-up irregularities, high metal removal, limited number of reagent application, complicated selection of reagent chemical composition and concentration, complicated and environmentally harmful recycling of waste chemicals, high cost of reagents. Low productivity at a high cost, as well as hazardous impact on personnel due to high dispersion of abrasive dust are considered as disadvantages of sandblasting. Electrochemical polishing is characterized by the following disadvantages: low processing productivity because supply of high currents is rather difficult due to electrolyte scattering capacity away from the main electrode action zone, limited length of the cavity to be treated due to heating of flexible current leads at operating current densities, application of expensive aggressive electrolytes and high costs of their recycling. A new method for polishing and cleaning of inner surfaces of tubular products based on electrolyte-plasma treatment has been developed. In comparison with the existing methods the proposed methods ensures quality processing with high intensity while applying non-toxic, environmentally friendly and cheap electrolytes. The paper presents results of investigations on technological specific features of electrolyte-plasma treatment for inner surfaces of tubular products: influence of slotted nozzle width, electrolyte flow and rate on stability of gas-vapor blanket, current density and productivity. Results of the research have made it possible to determine modes that provide stability and high productivity in the process of electrolyte

  20. Fatigue behaviour and detailing of slotted tubular connection

    Pereira Baptista, Claudio Alexandre; Borges, Luis; Yadav, Santosh; NUSSBAUMER, Alain

    2015-01-01

    Tubular elements are used in steel structures not only for bracing of other members but also as cross girders diaphragms. They are a competitive solution both due to the lightweight and structural efficiency. Slotted tube-to-plate connections are the natural and most common choice. However, fatigue design of the abrupt transition and differences in the stiffness corresponding to the welded connection, is a critical part of the design. Although such a fatigue connection is classified in differ...

  1. Manufacture and optimization of tubular ceramic membrane supports / Hertzog Bissett

    Bissett, Hertzog

    2005-01-01

    Inorganic membranes can be considered an alternative to organic membranes, due to their thermal, chemical and mechanical stability under harsh conditions. Ceramic membranes are used as support structures to increase permeability through composite inorganic membranes in separation processes. Tubular α-alumina membrane supports with smooth inner surfaces can be manufactured by means of the centrifugal casting technique. In this study, the effect of three different AKP powder size...

  2. Characterisitics of Streptomyces griseus biofilms in continuous flow tubular reactors

    Winn, Michael; Habimana, Olivier; Casey, Eoin; Murphy, Cormac D.

    2014-01-01

    The purpose of this study was to investigate the feasibility of cultivating the biotechnologically important bacterium Streptomyces griseus in single-species and mixed- species biofilms using a Tubular Biofilm Reactor (TBR). Streptomyces griseus biofilm development was found to be cyclical, starting with the initial adhesion and subsequent development of a visible biofilm after 24 hours growth, followed by the complete detachment of the biofilm as a single mass, and ending with the re-coloni...

  3. Elastomer liners for geothermal tubulars Y267 EPDM Liner Program:

    Hirasuna, A.R.; Davis, D.L.; Flickinger, J.E.; Stephens, C.A.

    1987-12-01

    The elastomer, Y267 EPDM, has been identified as a hydrothermally stable material which can operate at temperatures in excess of 320/sup 0/C. The goal of the Y267 Liner Program was to demonstrate the feasibility of using this material as a liner for mild steel tubulars to prevent or mitigate corrosion. If successful, the usage of EPDM lined pipe by the geothermal community may have a significant impact on operating costs and serve as a viable alternative to the use of alloyed tubulars. Tooling procedures were developed under this program to mold a 0.64 cm (0.25'') thick Y267 EPDM liner into a tubular test section 61 cm (2') in length and 19.1 cm (7.5'') in diameter (ID). A successful effort was made to identify a potential coupling agent to be used to bond the elastomer to the steel tubular wall. This agent was found to withstand the processing conditions associated with curing the elastomer at 288/sup 0/C and to retain a significant level of adhesive strength following hydrothermal testing in a synthetic brine at 260/sup 0/C for a period of 166 hours. Bonding tests were conducted on specimens of mild carbon steel and several alloys including Hastelloy C-276. An objective of the program was to field test the lined section of pipe mentioned above at a geothermal facility in the Imperial Valley. Though a test was conducted, problems encountered during the lining operation precluded an encouraging outcome. The results of the field demonstration were inconclusive. 6 refs., 13 figs., 13 tabs

  4. Load introduction into concrete-filled steel tubular columns

    Mollazadeh, Mohammad Hassan

    2015-01-01

    Concrete-Filled Steel Tubular (CFST) columns are increasingly being used because of their many advantages, including high strength, high ductility, and higher fire resistance than conventional steel or concrete columns of the same size. In order to maximise the advantages of CFST column, composite action of the column should be ensured. In realistic structures, the load is not directly applied to the entire CFST column section and is introduced from the beam-column connection. Simple shear c...

  5. Renal Papillary Necrosis Caused by Protein C Deficiency Leading to Recurrent Hydronephrosis.

    Chugh, Rohit Kumar; Olorunnisomo, Vincent; Fowle, Evan James; Modica, Ippolito; Meisels, Ira; Gupta, Mantu

    2016-01-01

    A patient with history of a solitary functioning kidney and protein C deficiency (PCD) presented with recurrent severe hydronephrosis causing acute kidney injury upon chronic kidney disease. Work-up with endoscopic evaluation revealed renal papillary necrosis (RPN) and sloughed renal papillae to be the true cause of the recurrent obstruction. Pathologic evaluation of the sloughed tissue confirmed the diagnosis of RPN. This is the first case reported in the literature illustrating the unique presentation of RPN in the setting of PCD. PMID:27579411

  6. Ileo-anal pouch necrosis secondary to small bowel volvulus: A case report

    Hewes Jim

    2008-05-01

    Full Text Available Abstract Introduction Small bowel volvulus is a rare occurrence in the Western world and its occurrence after ileo-anal ouch formation is even rarer. Case Presentation We report a case of a 26 year old lady who presented with small bowel volvulus and subsequent ischaemia and necrosis of her ileo-anal pouch created 5 years previously. Conclusion This case illustrates a rare but potentially devastating complication of ileo-anal pouch formation and as such the diagnosis should be borne in mind when a patient with a pouch presents with an acute abdomen.

  7. A Tubular Biomaterial Construct Exhibiting a Negative Poisson's Ratio.

    Jin Woo Lee

    Full Text Available Developing functional small-diameter vascular grafts is an important objective in tissue engineering research. In this study, we address the problem of compliance mismatch by designing and developing a 3D tubular construct that has a negative Poisson's ratio νxy (NPR. NPR constructs have the unique ability to expand transversely when pulled axially, thereby resulting in a highly-compliant tubular construct. In this work, we used projection stereolithography to 3D-print a planar NPR sheet composed of photosensitive poly(ethylene glycol diacrylate biomaterial. We used a step-lithography exposure and a stitch process to scale up the projection printing process, and used the cut-missing rib unit design to develop a centimeter-scale NPR sheet, which was rolled up to form a tubular construct. The constructs had Poisson's ratios of -0.6 ≤ νxy ≤ -0.1. The NPR construct also supports higher cellular adhesion than does the construct that has positive νxy. Our NPR design offers a significant advance in the development of highly-compliant vascular grafts.

  8. A Tubular Biomaterial Construct Exhibiting a Negative Poisson's Ratio.

    Lee, Jin Woo; Soman, Pranav; Park, Jeong Hun; Chen, Shaochen; Cho, Dong-Woo

    2016-01-01

    Developing functional small-diameter vascular grafts is an important objective in tissue engineering research. In this study, we address the problem of compliance mismatch by designing and developing a 3D tubular construct that has a negative Poisson's ratio νxy (NPR). NPR constructs have the unique ability to expand transversely when pulled axially, thereby resulting in a highly-compliant tubular construct. In this work, we used projection stereolithography to 3D-print a planar NPR sheet composed of photosensitive poly(ethylene) glycol diacrylate biomaterial. We used a step-lithography exposure and a stitch process to scale up the projection printing process, and used the cut-missing rib unit design to develop a centimeter-scale NPR sheet, which was rolled up to form a tubular construct. The constructs had Poisson's ratios of -0.6 ≤ νxy ≤ -0.1. The NPR construct also supports higher cellular adhesion than does the construct that has positive νxy. Our NPR design offers a significant advance in the development of highly-compliant vascular grafts. PMID:27232181

  9. The rebirth of interest in renal tubular function.

    Lowenstein, Jerome; Grantham, Jared J

    2016-06-01

    The measurement of glomerular filtration rate by the clearance of inulin or creatinine has evolved over the past 50 years into an estimated value based solely on plasma creatinine concentration. We have examined some of the misconceptions and misunderstandings of the classification of renal disease and its course, which have followed this evolution. Furthermore, renal plasma flow and tubular function, which in the past were estimated by the clearance of the exogenous aryl amine, para-aminohippurate, are no longer measured. Over the past decade, studies in experimental animals with reduced nephron mass and in patients with reduced renal function have identified small gut-derived, protein-bound uremic retention solutes ("uremic toxins") that are poorly filtered but are secreted into the lumen by organic anion transporters (OATs) in the proximal renal tubule. These are not effectively removed by conventional hemodialysis or peritoneal dialysis. Residual renal function, urine produced in patients with advanced renal failure or undergoing dialysis treatment, may represent, at least in part, secretion of fluid and uremic toxins, such as indoxyl sulfate, mediated by proximal tubule OATs and might serve as a useful survival function. In light of this new evidence of the physiological role of proximal tubule OATs, we suggest that measurement of renal tubular function and renal plasma flow may be of considerable value in understanding and managing chronic kidney disease. Data obtained in normal subjects indicate that renal plasma flow and renal tubular function might be measured by the clearance of the endogenous aryl amine, hippurate. PMID:26936872

  10. Tubular transport and metabolism of cimetidine in chicken kidneys

    Renal tubular transport and renal metabolism of [14C]cimetidine (CIM) were investigated by unilateral infusion into the renal portal circulation in chickens (Sperber technique). [14C]CIM was actively transported at a rate 88% that of simultaneously infused p-aminohippuric acid, and its transport was saturable. The following organic cations competitively inhibited the tubular transport of [14C]CIM with decreasing potency: CIM, ranitidine, thiamine, procainamide, guanidine and choline. CIM inhibited the transport of [14C]thiamine, [14C]amiloride and [14C]tetraethylammonium. During CIM infusion, two renal metabolites, CIM sulfoxide and hydroxymethylcimetidine, were found in urine. When CIM sulfoxide was infused, its transport efficiency was 32% and not saturable. CIM sulfoxide did ot inhibit the simultaneous renal tubular transport of p-aminohippuric acid or tetraethylammonium. CIM is transported by the organic cation transport system and the kidney metabolizes CIM. Transport of CIM and other cationic drugs could produce a drug interaction to alter drug excretion

  11. Fat necrosis of the breast: Sonographic features

    To describe the ultrasonographic (US) features of us necrosis of breast. The authors retrospectively reviewed US findings of 12 patients (all females, mean age: 54 years) with histopathologically (n=9) or clinically (n=3) proven fat necorsis of the breast. On US, size, depth/width (D/W) ratio, shape, margin, location, echogenicity and retrotumoral echo (enhancement/attenuation), pattern of the superficial fascia, and skin change were analyzed by two radiologists in agreement. On US, size of the lesion ranged between 0.9 and 4.0 cm in the greatest diameter (mean: 2.2 cm). The D/W ratio ranged between 0.4 and 0.7 (mean: 0.55). The shapes of the lesions were oval in all cases. The margins of the lesions were ill-defined in 9 cases. All lesions were located in the subcutaneous fat layer and the echogenicity was hyperechoic in all cases. Nine patients showed inhomogeneous internal echogenicity. Five cases demonstrated posterior acoustic shadowing. In all cases, the lesions displaced the superficial fascia without disruption. Mild-skin thickening was associated in 6 cases. Fat necrosis of the breast had characteristic US features of heterogeneously high echogenic mass in subcutaneous fat layer.

  12. Delayed radiation necrosis of the brain

    The cases of six patients are presented to delineate the clinical profile of delayed radiation necrosis of the brain. In five the diagnosis was verified histologically. Symptoms most often begin 9 months to 2 years after radiotherapy. Progressive visual impairment and dementia are common following perisellar irradiation, while hemispheric signs predominate following irradiation of the cerebrum. Cerebrospinal fluid protein may be elevated. Focal delta slowing is usually present on electroencephalography. The necrotic brain may appear on radionuclide brain scan as an area of abnormal uptake and also act as an avascular space-occupying lesion. With computerized tomography, radiation necrosis appears as an intracerebral area with diminished absorption coefficient that is often enhanced with intravenous contrast medium. The syndrome may be sufficiently characteristic to eliminate the need for surgical exploration and biopsy in some cases. Cumulative experience suggests that the risk-to-benefit ratio of radiotherapy becomes increasingly unfavorable for most patients with benign intracranial neoplasms when the standard brain tumor dose of 5000 to 7000 rads is fractionated at greater than 200 rads per day

  13. Minimally invasive treatment of pancreatic necrosis

    Brian Bello; Jeffrey B Matthews

    2012-01-01

    AIM:To systematically review these minimally invasive approaches to infected pancreatic necrosis.METHODS:We used the MEDLINE database to investigate studies between 1996 and 2010 with greater than 10 patients that examined these techniques.Using a combination of Boolean operators,reports were retrieved addressing percutaneous therapy (341 studies),endoscopic necrosectomy (574 studies),laparoscopic necrosectomy via a transperitoneal approach (148 studies),and retroperitoneal necrosectomy (194 studies).Only cohorts with at least 10 or more patients were included.Non-English papers,letters,animal studies,duplicate series and reviews without original data were excluded,leaving a total of 27 studies for analysis.RESULTS:Twenty-seven studies with 947 patients total were examined (eight studies on percutaneous approach; ten studies on endoscopic necrosectomy;two studies on laparoscopic necrosectomy via a transperitoneal approach; five studies on retroperitoneal necrosectomy; and two studies on a combined percutaneous-retroperitoneal approach).Success rate,complications,mortality,and number of procedures were outcomes that were included in the review.We found that most published reports were retrospective in nature,and thus,susceptible to selection and publication bias.Few reports examined these techniques in a comparative,prospective manner.CONCLUSION:Each minimally invasive approach though was found to be safe and feasible in multiple reports.With these new techniques,treatment of infected pancreatic necrosis remains a challenge.We advocate a multidisciplinary approach to this complex problem with treatment individualized to each patient.

  14. Fat necrosis of the breast: Sonographic features

    Rhim, Soo A; Kim, Hak Hee; Cha, Eun Suk; Kim, Bum Soo; Choi, Kyu Ho [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1999-12-15

    To describe the ultrasonographic (US) features of us necrosis of breast. The authors retrospectively reviewed US findings of 12 patients (all females, mean age: 54 years) with histopathologically (n=9) or clinically (n=3) proven fat necorsis of the breast. On US, size, depth/width (D/W) ratio, shape, margin, location, echogenicity and retrotumoral echo (enhancement/attenuation), pattern of the superficial fascia, and skin change were analyzed by two radiologists in agreement. On US, size of the lesion ranged between 0.9 and 4.0 cm in the greatest diameter (mean: 2.2 cm). The D/W ratio ranged between 0.4 and 0.7 (mean: 0.55). The shapes of the lesions were oval in all cases. The margins of the lesions were ill-defined in 9 cases. All lesions were located in the subcutaneous fat layer and the echogenicity was hyperechoic in all cases. Nine patients showed inhomogeneous internal echogenicity. Five cases demonstrated posterior acoustic shadowing. In all cases, the lesions displaced the superficial fascia without disruption. Mild-skin thickening was associated in 6 cases. Fat necrosis of the breast had characteristic US features of heterogeneously high echogenic mass in subcutaneous fat layer.

  15. Single-dose tumor necrosis factor protection against endotoxin-induced shock and tissue injury in rats.

    Alexander, H R; Doherty, G M; Block, M. I.; Kragel, P J; Jensen, J C; Langstein, H N; Walker, E; Norton, J A

    1991-01-01

    Tumor necrosis factor (TNF), a macrophage product released in response to endotoxin and other stimuli, has been shown to be a central mediator of endotoxin or septic shock. However, its highly conserved and wide-ranging physiological effects suggest that it may also be an essential cytokine in the host defense against acute bacterial infection or sepsis. A single nontoxic dose of human recombinant TNF administered intravenously 24 h prior to a lethal infusion of Escherichia coli lipopolysacch...

  16. Surgical treatment of acute pancreatitis

    Klose, K.J.; Neher, M.; Kuhn, F.P.; Kuemmerle, F.; Thelen, M.

    1983-03-31

    The diagnosis of acute pancreatitis is based on anamnestic, clinical and chemical data. Ultrasound and computed tomography permit direct visualisation of the pancreas and establish the diagnosis. In cases of haemorrhagic-necrotising pancreatitis they demonstrate the extent of morphological changes and permit exclusion of other causes of an acute abdomen. The imaging methods support indications for operation in cases of subtotal or total parenchymatous necrosis and in pancreatic abscesses. Conservative expectant approaches in patients with severe clinical course and slight morphological changes as well as in agreement of clinical and morphological findings are facilitated. Complete demonstration of parenchymatous and peripancreatic necroses furnishes useful additional information for total extirpation. Gallstone disease can be demonstrated or excluded preoperatively. Since introduction of ultrasound and computed tomography for the diagnosis of acute pancreatitis a marked diminution of early surgical intervention and delayed operation has been achieved.

  17. The Pathology of Acute Liver Failure.

    Lefkowitch, Jay H

    2016-05-01

    Acute liver failure (ALF) is a rare and severe liver disease that usually develops in 8 weeks or less in individuals without preexisting liver disease. Its chief causes worldwide are hepatitis virus infections (hepatitis A, B, and E) and drug hepatotoxicity (particularly intentional or unintentional acetaminophen toxicity). Massive hepatic necrosis is often seen in liver specimens in ALF and features marked loss of hepatocytes, variable degrees of inflammation, and a stereotypic proliferation of bile ductular structures (neocholangioles) derived from activated periportal hepatic progenitor cells. This paper reviews the liver pathology in ALF, including forms of zonal necrosis and their etiologies. PMID:27058243

  18. Histologic variant form of autoimmune hepatitis with prominent zonal necrosis

    Stanković Ivica; Zlatković Marija; Prokić Dragan; Plamenac Pavle

    2002-01-01

    Autoimmune hepatitis type 1 in a 8-year old girl is described. The diagnosis was established using International Autoimmune hepatitis group scoring system. In addition to characteristic histologic features of autoimmune hepatitis (periportal hepatitis, piecemeal necrosis and rozettes) prominent centrilobular necrosis was discovered. As an isolate finding in autoimmune hepatitis, this type was described only in five cases. In our unique case centrilobular necrosis is a very important parallel ...

  19. Avascular necrosis of the femoral head presenting as trochanteric bursitis.

    Mandell, B F

    1990-01-01

    Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluate...

  20. Pretreatment by low-dose fibrates protects against acute free fatty acid-induced renal tubule toxicity by counteracting PPARα deterioration

    Development of a preventive strategy against tubular damage associated with proteinuria is of great importance. Recently, free fatty acid (FFA) toxicities accompanying proteinuria were found to be a main cause of tubular damage, which was aggravated by insufficiency of peroxisome proliferator-activated receptor alpha (PPARα), suggesting the benefit of PPARα activation. However, an earlier study using a murine acute tubular injury model, FFA-overload nephropathy, demonstrated that high-dose treatment of PPARα agonist (0.5% clofibrate diet) aggravated the tubular damage as a consequence of excess serum accumulation of clofibrate metabolites due to decreased kidney elimination. To induce the renoprotective effects of PPARα agonists without drug accumulation, we tried a pretreatment study using low-dose clofibrate (0.1% clofibrate diet) using the same murine model. Low-dose clofibrate pretreatment prevented acute tubular injuries without accumulation of its metabolites. The tubular protective effects appeared to be associated with the counteraction of PPARα deterioration, resulting in the decrease of FFAs influx to the kidney, maintenance of fatty acid oxidation, diminution of intracellular accumulation of undigested FFAs, and attenuation of disease developmental factors including oxidative stress, apoptosis, and NFκB activation. These effects are common to other fibrates and dependent on PPARα function. Interestingly, however, clofibrate pretreatment also exerted PPARα-independent tubular toxicities in PPARα-null mice with FFA-overload nephropathy. The favorable properties of fibrates are evident when PPARα-dependent tubular protective effects outweigh their PPARα-independent tubular toxicities. This delicate balance seems to be easily affected by the drug dose. It will be important to establish the appropriate dosage of fibrates for treatment against kidney disease and to develop a novel PPARα activator that has a steady serum concentration regardless of

  1. Necrosis-Driven Systemic Immune Response Alters SAM Metabolism through the FOXO-GNMT Axis

    Fumiaki Obata

    2014-05-01

    Full Text Available Sterile inflammation triggered by endogenous factors is thought to contribute to the pathogenesis of acute and chronic inflammatory diseases. Here, we demonstrate that apoptosis-deficient mutants spontaneously develop a necrosis-driven systemic immune response in Drosophila and provide an in vivo model for studying the organismal response to sterile inflammation. Metabolomic analysis of hemolymph from apoptosis-deficient mutants revealed increased sarcosine and reduced S-adenosyl-methionine (SAM levels due to glycine N-methyltransferase (Gnmt upregulation. We showed that Gnmt was elevated in response to Toll activation induced by the local necrosis of wing epidermal cells. Necrosis-driven inflammatory conditions induced dFoxO hyperactivation, leading to an energy-wasting phenotype. Gnmt was cell-autonomously upregulated by dFoxO in the fat body as a possible rheostat for controlling energy loss, which functioned during fasting as well as inflammatory conditions. We propose that the dFoxO-Gnmt axis is essential for the maintenance of organismal SAM metabolism and energy homeostasis.

  2. Modulation of Endogenous Hormone Action by Recombinant Human Tumor Necrosis Factor

    Warren, Robert S.; Donner, David B.; Fletcher Starnes, H.; Brennan, Murray F.

    1987-12-01

    Tumor necrosis factor (TNF) has been implicated in the toxic manifestations of overwhelming bacterial infection and in the tissue wasting that often accompanies prolonged infections and malignancy. We have examined a possible role of TNF in the early metabolic alterations following acute tissue injury or sepsis. Recombinant human TNF stimulated rat liver amino acid uptake up to 5-fold in vivo and there was a concomitant increase in plasma glucagon. In vitro TNF had no direct effect on hepatocyte amino acid uptake, but it markedly enhanced the stimulation of amino acid transport by glucagon, without an alteration in binding of glucagon to hepatocytes. This permissive effect of TNF on glucagon action represents an interrelationship between the immune and endocrine systems, and it may help to explain the mechanism of hormonal regulation of both the anabolic and catabolic responses to acute injury.

  3. A Case of Hemorrhagic Necrosis of Ectopic Liver Tissue within the Gallbladder Wall.

    Nagar, Sapna

    2012-02-01

    Ectopic liver tissue is a rare clinical entity that is mostly asymptomatic and found incidentally. In certain situations, however, patients may present with symptoms of abdominal pain secondary to torsion, compression, obstruction of adjacent organs, or rupture secondary to malignant transformation. Herein, we report a case of a 25-year-old female that presented with acute onset of epigastric pain found to have ectopic liver tissue near the gallbladder complicated by acute hemorrhage necessitating operative intervention in the way of laparoscopic excision and cholecystectomy. The patient\\'s postoperative course was uneventful. Gross pathology demonstrated a 1.2 x 2.8 x 4.5 cm firm purple ovoid structure that histologically revealed extensive hemorrhagic necrosis of benign ectopic liver tissue.

  4. Effect of granulocyte colony-stimulating factor administration on renal regeneration after experimentally induced acute kidney injury in dogs.

    Lim, Chae-Young; Han, Jae-Ik; Kim, Seung-Gon; Lee, Chang-Min; Park, Hee-Myung

    2016-02-01

    OBJECTIVE To evaluate the effects of granulocyte colony-stimulating factor (GCSF) administration in dogs with experimentally induced acute kidney injury. ANIMALS 6 healthy dogs. PROCEDURES After induction of kidney injury (day 0) with cisplatin (5 mg/kg, IV), the dogs were randomly assigned into 2 groups (n = 3 dogs/group). Then dogs immediately received GCSF (10 μg/kg) or 1 mL of saline (0.9% NaCl) solution (control group) SC; this treatment was repeated once daily for 4 additional days (days 1 through 4). A once-daily CBC (day 0 to 4), serum biochemical analysis (day 0 to 3), and urinalysis (day 0 to 3) were performed for each dog; samples were collected before administration of cisplatin (day 0) and before treatment with GCSF or saline solution (days 1 through 4). After sample collection and treatment on day 4, all dogs were euthanized; kidney tissue samples underwent histologic evaluation, immunohistochemical analyses, and cytokine profiling via reverse transcriptase PCR assay. RESULTS In the GCSF-treated group, the histologic evaluation and immunohistochemical analyses of kidney tissue revealed less fibrotic change and greater proliferation of renal tubular epithelial cells, compared with findings in the control group. The mRNA profiles of kidney tissue from the GCSF-treated group indicated lower expression of tumor necrosis factor-α and tumor growth factor-β, compared with findings in the control group; however, concentrations of factors related to renal regeneration were not greater in the GCSF-treated group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that GCSF treatment can impede renal fibrosis and increase proliferation of renal tubules after experimentally induced acute kidney injury in dogs. (Am J Vet Res 2016;77:199-207). PMID:27027715

  5. Patterns of severe acute renal failure in a referral center in Sudan: Excluding intensive care and major surgery patients

    Acute renal failure (ARF) is a common health problem worldwide. There is limited data on the pattern of ARF in Sudan. Moreover, glomerular diseases, which are a well known cause of ARF, have not been accurately and adequately diagnosed previously. A retrospective study on the patterns of ARF was carried out in a general nephrology referral center in Sudan during the period from February 2003 to February 2004.Patients from intensive care units with ARF and those who developed ARF after massive surgery were excluded from the study. Renal biopsy was performed when indicated and studied with light and immunofluorescent microscopy. Eighty-nine patients (57 (64%) cases were males and mean age was 39+-19.4 years) fulfilled the criteria for the diagnosis of advanced renal failure requiring renal function replacement therapy. Acute tubular necrosis (ATN) was diagnosed in 50 (56%) patients; 33 (66%) ATN patients had renal failure as a complication of volume depletion, fulminant infections (particularly malaria and typhoid fever) or snakebites, and 12 (13.4%) patients ingested paraphenylene-diamine (PPD) (hair/Henna dye) in suicidal attempts. Eight (9%) patients of the total study group had glomerural diseases and 11 (12.3%) had obstructive uropathy associated with ARF; cause of ARF could not be determined in 17 (19%) patients. Fifty-three (60%) patients recovered their renal function, six (6.7%) patients progressed to chronic kidney disease (CKD), 16(18%) died and 14(16%) were lost to follow-up. In conclusion, patients with ARF associated with ATN had a favorable prognosis except when ATN was associated PPD poisoning. (author)

  6. Effects of specific interleukin-1β-converting enzyme inhibitor on ischemic acute renal failure in murine models

    Hua-feng LIU; Dong LIANG; Li-ming WANG; Nan ZHOU; Cui-wei YAO; Tao HONG; De-shen TANG; Xiao-wen CHEN

    2005-01-01

    Aim: To study the effect of selective interleukin-1 β-converting enzyme (ICE,caspase-1) inhibitor on ischemic acute renal failure (ARF). Methods: Mouse models of ischemic ARF were treated with the specific ICE inhibitor AC-YVAD-CMK.A renal function assay and renal morphological studies were employed to estimate the renal protective effect of AC-YVAD-CMK. The survival rate of mouse models was also analyzed by a time series test. Furthermore, renal ICE activity,mature interleukin-18 (IL-18) protein expression and interferon-γ (IFN-γ) mRNA expression were also detected by fluorescent enzyme-linked immunosorbent assay (ELISA), ELISA, and semi-quantitative reverse transcription-polymerase chain reaction, respectively. Results: The levels of blood urea nitrogen (BUN) and serum creatinine (Scr) increased remarkably in the model controls compared with the sham-operated groups (P<0.01). Typical renal tubular necrosis was found in the model controls. Renal ICE activity, mature IL-18 protein expression, and IFN-γmRNA expression were also increased significantly in the model controls compared with the sham-operated groups. The levels of BUN and Scr in the AC-YVAD-CMK therapy group were decreased significantly compared with the untreated model controls (P<0.01). Renal tubulointerstitial lesion was also attenuated significantly (P<0.05). AC-YVAD-CMK therapy alleviated the clinical features of ARF, and increased the survival rate (P<0.01). Furthermore, AC-YVADCMK therapy also decreased ICE activity, mature IL-18 protein expression, and IFN-γ mRNA expression in renal tissue (P<0.05). Conclusion: The selective ICEinhibitor AC-YVAD-CMK can effectively protect the kidney from acute ischemic lesions. This protective effect is associated with decreased renal ICE activity and suppressed IL- 18 maturation and IFN-γ mRNA transcription.

  7. The restrained expression of NF-kB in renal tissue ameliorates folic acid induced acute kidney injury in mice.

    Kumar, Dev; Singla, Surinder K; Puri, Veena; Puri, Sanjeev

    2015-01-01

    The Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) represent family of structurally-related eukaryotic transcription factors which regulate diverse array of cellular processes including immunological responses, inflammation, apoptosis, growth & development. Increased expression of NF-kB has often been seen in many diverse diseases, suggesting the importance of genomic deregulation to disease pathophysiology. In the present study we focused on acute kidney injury (AKI), which remains one of the major risk factor showing a high rate of mortality and morbidity. The pathology associated with it, however, remains incompletely known though inflammation has been reported to be one of the major risk factor in the disease pathophysiology. The role of NF-kB thus seemed pertinent. In the present study we show that high dose of folic acid (FA) induced acute kidney injury (AKI) characterized by elevation in levels of blood urea nitrogen & serum creatinine together with extensive tubular necrosis, loss of brush border and marked reduction in mitochondria. One of the salient observations of this study was a coupled increase in the expression of renal, relA, NF-kB2, and p53 genes and proteins during folic acid induced AKI (FA AKI). Treatment of mice with NF-kB inhibitor, pyrrolidine dithio-carbamate ammonium (PDTC) lowered the expression of these transcription factors and ameliorated the aberrant renal function by decreasing serum creatinine levels. In conclusion, our results suggested that NF-kB plays a pivotal role in maintaining renal function that also involved regulating p53 levels during FA AKI. PMID:25559736

  8. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  9. Stimulation of Na+/H+ antiport is an early event in hypertrophy of renal proximal tubular cells

    Renal hypertrophy in vivo is achieved by an increase in protein content per cell and an increase in cell size with minimal hyperplasia. Hypertrophied renal tubular cells remain quiescent and demonstrate an increase in transcellular transport rates. This situation was simulated in vitro by exposing a confluent, quiescent primary culture of rabbit renal proximal tubular cells to either insulin, prostaglandin E1, or hypertonic NaCl for 24 or 48 hr. Protein per cell increased by 20-30% with little or no increase in [3H]thymidine incorporation into DNA. Mean cell volume was also increased in insulin- and hypertonic NaCl-treated but not in prostaglandin E1-treated cells. Two hours of exposure to the growth stimuli increased amiloride-sensitive Na+ uptake, Na-dependent H+ efflux, and ouabain-sensitive Rb+ uptake, indicating that stimulation of Na+/H+ antiport (exchange) occurs as an early event in their action. Hypertrophied cells continued to demonstrate enhanced Na+/H+ antiport after the growth stimuli were removed for 3 hr, by which time their acute effects are reversed

  10. The molecular interactions between filtered proteins and proximal tubular cells in proteinuria.

    Baines, Richard J; Brunskill, Nigel J

    2008-01-01

    Proteinuria is associated with progressive chronic kidney disease and poor cardiovascular outcomes. Exposure of proximal tubular epithelial cells to excess proteins leads to the development of proteinuric nephropathy with tubular atrophy, interstitial inflammation and scarring. Numerous signalling pathways are activated in proximal tubular epithelial cells under proteinuric conditions resulting in gene transcription, altered growth and the secretion of inflammatory and profibrotic mediators. Megalin, the proximal tubular scavenger receptor for filtered macromolecules, has intrinsic signalling functions and may also link albumin to growth factor receptor signalling via regulated intramembrane proteolysis. It now seems that endocytosis is not always a prerequisite for albumin-evoked alterations in proximal tubular cell phenotype. Recent evidence shows the presence of other potential receptors for proteins, such as the neonatal Fc receptor and CD36, in the proximal tubular epithelium. PMID:18849618

  11. Method and tool for contracting tubular members by electro-hydraulic forming before hydroforming

    Golovashchenko, Sergey Fedorovich

    2011-03-15

    A tubular preform is contracted in an electro-hydraulic forming operation. The tubular preform is wrapped with one or more coils of wire and placed in a chamber of an electro-hydraulic forming tool. The electro-hydraulic forming tool is discharged to form a compressed area on a portion of the tube. The tube is then placed in a hydroforming tool that expands the tubular preform to form a part.

  12. Inverse Approach to Evaluate the Tubular Material Parameters Using the Bulging Test

    Yulong Ge; Xiaoxing Li; Lihui Lang

    2015-01-01

    Tubular material parameters are required for both part manufactory process planning and finite element simulations. The bulging test is one of the most credible ways to detect the property parameters for tubular material. The inverse approach provides more effective access to the accurate material evaluation than with direct identifications. In this paper, a newly designed set of bulging test tools is introduced. An inverse procedure is adopted to determine the tubular material properties in ...

  13. Generation of Urinary Albumin Fragments Does Not Require Proximal Tubular Uptake

    Weyer, K.; Nielsen, R; Christensen, E.I.; Birn, H

    2012-01-01

    Urinary albumin excretion is an important diagnostic and prognostic marker of renal function. Both animal and human urine contain large amounts of albumin fragments, but whether these fragments originate from renal tubular degradation of filtered albumin is unknown. Here, we used mice with kidneys lacking megalin and cubilin, the coreceptors that mediate proximal tubular endocytosis of albumin, to determine whether proximal tubular degradation of albumin forms the detectable urinary albumin f...

  14. A tubular segmented-flow bioreactor for the infection of insect cells with recombinant baculovirus

    Hu, Yu-Chen; Wang, Ming-Ying; Bentley, William E.

    1997-01-01

    A continuous process of insect cell (S f9) growth and baculovirus infection is tested with the sequential combination of a CSTR and a tubular reactor. A tubular infection reactor enables continuous introduction of baculovirus and therefore avoids the ‘passage effect’ observed in two-stage CSTR systems. Moreover, a tubular reactor can be used to test cell infection kinetics and the subsequent metabolism of infected insect cells. Unlike batch and CSTR culture, cells in a horizontally positioned...

  15. Acute pancreatitis in pregnancy

    Capecomorin S Pitchumoni; Balaji Yegneswaran

    2009-01-01

    Acute pancreatitis (AP) is a rare event in pregnancy,occurring in approximately 3 in 10 000 pregnancies.The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic tests and assessment of severity of AP. As in any other disease associated with pregnancy, AP is associated with greater concerns as it deals with two lives rather than just one as in the nonpregnant population. The recent advances in clinical gastroenterology have improved the early diagnosis and effective management of biliary pancreatitis. Diagnostic studies such as endoscopic ultrasound,magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography and therapeutic modalities that include endoscopic sphincterotomy, biliary stenting, common bile duct stone extraction and laparoscopic cholecystectomy are major milestones in gastroenterology. When properly managed AP in pregnancy does not carry a dismal prognosis as in the past.

  16. Bronchitis - acute

    ... sharing features on this page, please enable JavaScript. Acute bronchitis is swelling and inflammation in the main passages ... present only for a short time. Causes When acute bronchitis occurs, it almost always comes after having a ...

  17. Bronchitis - acute

    Acute bronchitis is swelling and inflammation in the main passages that carry air to the lungs. The swelling narrows ... makes it harder to breathe. Another symptom of bronchitis is a cough. Acute means the symptoms have ...

  18. Acute Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  19. Stem cell factor expression after renal ischemia promotes tubular epithelial survival.

    Geurt Stokman

    Full Text Available BACKGROUND: Renal ischemia leads to apoptosis of tubular epithelial cells and results in decreased renal function. Tissue repair involves re-epithelialization of the tubular basement membrane. Survival of the tubular epithelium following ischemia is therefore important in the successful regeneration of renal tissue. The cytokine stem cell factor (SCF has been shown to protect the tubular epithelium against apoptosis. METHODOLOGY/PRINCIPAL FINDINGS: In a mouse model for renal ischemia/reperfusion injury, we studied how expression of c-KIT on tubular epithelium and its ligand SCF protect cells against apoptosis. Administration of SCF specific antisense oligonucleotides significantly decreased specific staining of SCF following ischemia. Reduced SCF expression resulted in impaired renal function, increased tubular damage and increased tubular epithelial apoptosis, independent of inflammation. In an in vitro hypoxia model, stimulation of tubular epithelial cells with SCF activated survival signaling and decreased apoptosis. CONCLUSIONS/SIGNIFICANCE: Our data indicate an important role for c-KIT and SCF in mediating tubular epithelial cell survival via an autocrine pathway.

  20. Granuloma necrosis during Mycobacterium avium infection does not require tumor necrosis factor

    Florido, M; Appelberg, R.

    2004-01-01

    The infection of tumor necrosis factor (TNF)-deficient mice with low doses of the virulent Mycobacterium avium strain 25291 led to the appearance of necrotic granulomas at 93 days of infection, i.e., sooner than necrotic granulomas appeared in C57BL/6 animals. Additionally, TNF-deficient mice exhibited higher mycobacterial loads in the infected organs, had extremely exacerbated gamma interferon responses as evaluated in the sera of infected animals, and showed reduced survival. Thus, TNF is n...

  1. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline) addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingest...

  2. Acute pancreatitis

    Bo-Guang Fan; Åke Andrén-Sandberg

    2010-01-01

    Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline) addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion....

  3. Change of Interleukin-6 and Tumor Necrosis Factor alpha in Acute Pancreatitis and Their Relationship with Disease Condition%急性胰腺炎患者血清白细胞介素6及肿瘤坏死因子α的改变及与病情的关系

    王先坤; 王秉钧; 李培武; 晏波

    2014-01-01

    目的:探讨急性胰腺炎患者血清白细胞介素6( IL-6)及肿瘤坏死因子α( TNF-α)的改变及与病情的关系。方法选择2010年2月至2012年2月兰州大学第二医院住院治疗的116例急性胰腺炎患者为研究对象,其中重症急性胰腺炎患者66例,轻型急性胰腺炎患者50例。采用酶联免疫吸附测定法检测患者血清IL-6及TNF-α水平,探讨两者与病情的关系。结果重症急性胰腺炎患者血清IL-6和TNF-α水平分别为(97.62±13.42)μg/L和(5.49±2.40)μg/L,显著高于轻型急性胰腺炎患者(42.17±8.72)μg/L和(2.46±1.37)μg/L(P<0.05);两组患者治疗后1周血清IL-6和TNF-α水平均显著下降,分别为(22.76±4.38)μg/L和(2.41±1.24)μg/L及(13.23±3.95)μg/L和(1.69±0.82)μg/L(P<0.05);重症急性胰腺炎存活患者的血清IL-6及TNF-α水平显著低于死亡患者(P<0.05)。结论血清IL-6及TNF-α水平与急性胰腺炎患者疾病严重程度密切相关,可作为临床评估病情、疗效及预后的指标。%Objective To explore the change of IL-6 and TNF-αin acute pancreatitis and their relationship with disease condition. Methods 116 patients with acute pancreatitis who treated in Second Hospital Affiliated to Lanzhou University from 2010 February to 2012 February were selected as research subjects, including 66 cases of severe acute pancreatitis and 50 cases of mild acute pancreatitis. Serum IL-6 and TNF-αlevel were detected by En-zyme linked immunosorbent assay, and their relationships with disease were studied. Results The serum IL-6 and TNF-α levels in patients with severe acute pancreatitis were (97. 62 ± 13. 42) μg/L and (5. 49 ± 2. 40) μg/L, sig-nificantly higher than those in patients with mild acute pancreatitis(42. 17 ± 8. 72) μg/L and (2. 46 ± 1. 37) μg/L (P<0. 05);After 1 weeks,the serum IL-6 and and TNF-levels were significantly decreased,respectively (22. 76 ± 4.38) μg/L and(2.41 ±1.24) μg/L,(13.23 ±3.95) μg/L and (1.69 ±0.82)

  4. High temperature fatigue experiments on welded stainless steel tubular elements

    A test rig has been designed to perform high temperature fatigue experiments on AISI 304 stainless steel tubular elements of 500 mm length, 60.3 mm outer diameter and 2 mm thickness; they are composed by two butt welded tubular elements with welded end flanges. During the experiments it is possible to control the axial strain range, the strain rate and the hold time; the specimen temperature is obtained by an inner heating device, controlled by a series of measuring thermocouples; until now the imposed temperature is 6500C. A preliminary series of experiments has been carried out, with the aim at getting informations for a proper development of the main experimental program, while in the meantime the adjustment of the specimen manufacturing process and its characterization have been performed. Each specimen is welded on the same TIG welding rig, which accounts both for a uniformly reliable welding process and for a proper alignment of the tubular elements. The specimens are then marked by a high precision grid which allows a measurement of the residual localized plastic strain along some generatrix of the specimen and on its thickness. The basic fatigue data have to be measured through a series of standard tests carried out on small size specimens obtained either from the base material and around the welded, heat affected zone. It is also planned to carry out a detailed study on the crack surfaces and to use acoustical emission techniques to properly assess the initial crack propagation. The first results show a marked reduction of the number of cycles at failure, if compared with existing data about small size specimens; the measurement of residual plastic strains shows clearly non-uniform distribution of the plastic zones

  5. High temperature helical tubular receiver for concentrating solar power system

    Hossain, Nazmul

    In the field of conventional cleaner power generation technology, concentrating solar power systems have introduced remarkable opportunity. In a solar power tower, solar energy concentrated by the heliostats at a single point produces very high temperature. Falling solid particles or heat transfer fluid passing through that high temperature region absorbs heat to generate electricity. Increasing the residence time will result in more heat gain and increase efficiency. A novel design of solar receiver for both fluid and solid particle is approached in this paper which can increase residence time resulting in higher temperature gain in one cycle compared to conventional receivers. The helical tubular solar receiver placed at the focused sunlight region meets the higher outlet temperature and efficiency. A vertical tubular receiver is modeled and analyzed for single phase flow with molten salt as heat transfer fluid and alloy625 as heat transfer material. The result is compared to a journal paper of similar numerical and experimental setup for validating our modeling. New types of helical tubular solar receivers are modeled and analyzed with heat transfer fluid turbulent flow in single phase, and granular particle and air plug flow in multiphase to observe the temperature rise in one cyclic operation. The Discrete Ordinate radiation model is used for numerical analysis with simulation software Ansys Fluent 15.0. The Eulerian granular multiphase model is used for multiphase flow. Applying the same modeling parameters and boundary conditions, the results of vertical and helical receivers are compared. With a helical receiver, higher temperature gain of heat transfer fluid is achieved in one cycle for both single phase and multiphase flow compared to the vertical receiver. Performance is also observed by varying dimension of helical receiver.

  6. The role of duplex stainless steels for downhole tubulars

    In sour conditions there is an increasing trend to turn to corrosion resistant alloys for downhole tubulars. The most commonly used CRA tubular is 13Cr, and there are thousands of feet in service. However, there are limits to the use of 13Cr, ie., the risk of sulphide stress corrosion cracking at high H2S levels, and the possibility of pitting or high corrosion rates in waters with high chloride contents. Where the service conditions are felt to be too severe for 13Cr alloys it has been traditional to switch to nickel base alloys such as alloys 825 and C-276 (UNS N08825 and N10276). The alloys are much more expensive than 13Cr, and in recent years the duplex stainless steels have been selected as alloys with superior corrosion and SSCC resistance compared with 13Cr, and having lower cost than nickel alloys. Originally the 22Cr duplex alloy (UNS 31803) was used, but more recently the 25Cr super duplex alloys (UNS S32760 and S32750) have become more available. The present paper reviews the data available for 13Cr and the limits of applicability. Data is also presented for laboratory tests for both the 22Cr and 25Cr super duplex alloys. There is extensive service experience with both 22Cr and 25Cr super duplex in the North Sea, covering both downhole tubulars, manifold and post wellhead equipment. Data is presented showing some of the sour condition being experienced in the North Sea by super duplex alloys. These results show that there is a substantial gap between the limits of use for 13Cr and the 25Cr super duplex stainless steel alloys. This means that in many sour environments super duplex stainless steel provides a cost effective alternative to nickel-base alloys

  7. Superradiance at the localization-delocalization crossover in tubular chlorosomes

    Molina, Rafael A; Somoza, Alejandro; Chen, Lipeng; Zhao, Yang

    2016-01-01

    We study the effect of disorder on spectral properties of tubular chlorosomes in green sulfur bacteria Cf. aurantiacus. Employing a Frenkel-exciton Hamiltonian with diagonal and off-diagonal disorder consistent with spectral and structural studies, we analyze excitonic localization and spectral statistics of the chlorosomes. A size-dependent localization-delocalization crossover is found to occur as a function of the excitonic energy. The crossover energy region coincides with the more optically active states with maximized superradiance, and is, consequently, more conducive for energy transfer.

  8. Partial oxidation of methane to syngas in tubular oxygenpermeable reactor

    2002-01-01

    A dense Ba0.5Sr0.5Co0.8Fe0.2O3-δ membrane tube was prepared by the extruding method. Furthermore, a membrane reactor with this tubular membrane was successfully applied to partial oxidation of methane (POM) reaction,in which the separation of oxygen from air and the partial oxidation of methane are integrated in one process. At 875℃,94% of methane conversion, 98% of CO selectivity, 95% of H2 selectivity, and as high as 8.8 mL/(min @cm2) of oxygen flux were obtained. In POM reaction condition, the membrane tube shows a very good stability.

  9. On the volume of tubular neighbourhoods of real algebraic varieties

    Martin Lotz

    2012-01-01

    The problem of determining the volume of a tubular neighbourhood has a long and rich history. Bounds on the volume of neighbourhoods of algebraic sets have turned out to play an important role in the probabilistic analysis of condition numbers in numerical analysis. We present a self-contained derivation of bounds on the probability that a random point, chosen uniformly from a ball, lies within a given distance of a real algebraic variety of any codimension. The bounds are given in terms of t...

  10. Distal renal tubular acidosis and amelogenesis imperfecta: A rare association.

    Ravi, P; Ekambaranath, T S; Arasi, S Ellil; Fernando, E

    2013-11-01

    Renal tubular acidosis (RTA) is characterized by a normal anion gap with hyperchloremic metabolic acidosis. Primary distal RTA (type I) is the most common RTA in children. Childhood presentation of distal RTA includes vomiting, failure to thrive, metabolic acidosis, and hypokalemia. Amelogenesis imperfecta (AI) represents a condition where the dental enamel and oral tissues are affected in an equal manner resulting in the hypoplastic or hypopigmented teeth. We report a 10-year-old girl, previously asymptomatic presented with the hypokalemic paralysis and on work-up found out to have type I RTA. The discoloration of teeth and enamel was diagnosed as AI. PMID:24339526

  11. A Tubular Ionizer as an Efficient Negative Fluorine Ion Source

    In order to establish the optimal conditions of F- ion production by the tubular ionizer extensive studies of SF6 ionization using the mass separator were performed. The SF6, SF5, SF4, SF3 and F negative ions were observed, and the F- yields as a function of the source temperature, gas pressure and an amount of alkaline metal vapors (K, Na, Ca, Sr, Ba) were measured. The efficiency of F- production of about 40 obtained for the optimal conditions. The delay time and adsorption enthalpy of fluorine on the tantalum surface has been measured for the first time. (author)

  12. Use of graphite layer open tubular (GLOT) in environmental analysis

    Recently it has been developed a series of new capillary columns characterised by the use of graphitized carbon black modified from different amount of liquid phase. The characteristics of these columns, called graphite layer open tubular (GLOT), are described together with their application to the environmental analysis. A specific application of GLOT columns is for the direct analysis of aqueous solutions avoiding solvent extraction procedure. A comparison between a GLOT column and a traditional capillary column, estimating their behaviour after repeated direct injections of aqueous solution sample is written. Some applications regarding the analysis of the atmosphere pollutants, as aliphatic and aromatic hydrocarbons, and their compounds are written too

  13. Type 4 renal tubular acidosis in a kidney transplant recipient.

    Kulkarni, Manjunath

    2016-02-01

    We report a case of a 66-year-old diabetic patient who presented with muscle weakness 2 weeks after kidney transplantation. Her immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and steroids. She was found to have hyperkalemia and normal anion gap metabolic acidosis. Tacrolimus levels were in therapeutic range. All other drugs such as beta blockers and trimethoprim - sulfamethoxazole were stopped. She did not respond to routine antikalemic measures. Further evaluation revealed type 4 renal tubular acidosis. Serum potassium levels returned to normal after starting sodium bicarbonate and fludrocortisone therapy. Though hyperkalemia is common in kidney transplant recipients, determining exact cause can guide specific treatment. PMID:27105603

  14. Tubular algebras and affine Kac-Moody algebras

    Zheng-xin CHEN; Ya-nan LIN

    2007-01-01

    The purpose of this paper is to construct quotient algebras L(A)C1/I(A) of complex degenerate composition Lie algebras L(A)C1 by some ideals, where L(A)C1 is defined via Hall algebras of tubular algebras A, and to prove that the quotient algebras L(A)C1/I(A) are isomorphic to the corresponding affine Kac-Moody algebras. Moreover, it is shown that the Lie algebra Lre(A)C1 generated by A-modules with a real root coincides with the degenerate composition Lie algebra L(A)C1 generated by simple A-modules.

  15. Tubular algebras and affine Kac-Moody algebras

    2007-01-01

    The purpose of this paper is to construct quotient algebras L(A)1C/I(A) of complex degenerate composition Lie algebras L(A)1C by some ideals, where L(A)1C is defined via Hall algebras of tubular algebras A, and to prove that the quotient algebras L(A)1C/I(A) are isomorphic to the corresponding affine Kac-Moody algebras. Moreover, it is shown that the Lie algebra Lre(A)1C generated by A-modules with a real root coincides with the degenerate composition Lie algebra L(A)1C generated by simple A-modules.

  16. A case of radiation necrosis seemingly appearing as brain tumor

    A 56 years old female with late irradiation necrosis of the frontal cerebrum was presented. It appeared 3.5 years later of Betatron electron irradiation for the treatment of skin cancer along the forehead and simulated clinically to tumor of the frontal cerebrum. The patient underwent removal of that late irradiation necrosis and took satisfactory postoperative course. (auth.)

  17. [Acute pancreatitis with hypertriglyceridemia--an underestimated disease?].

    Wild, Wolfgang; Tajjiou, Morad; Ferschke, Melanie; Bormann, Fabian; Dörr, Pius; Schwarzbach, Matthias

    2016-01-01

    Hypertriglyceridemia is a rare, but since a long time well known etiology for acute pancreatitis. It could occure alone or coactive with other triggers like alcohlic excess. Nevertheless it found no approach to the current classifications and parameters of prognosis of the acute pancreatitis. We refer about two patients with hypertriglyceridemia and acute pancreatitis, whose initial disease was limited on the tail of the pancreas with just a circumscripted or--in the other case--no necrosis. However, in both cases and although a consequent treatment started immediately, a serious process developed including a life-threatening acute respiratory distress syndrome in one case, which necessitated an extracorporal membrane oxygenation. PMID:26710203

  18. Prevalence of leptospira in acute hepatitis syndrome and assessment of IL-8 and TNF-alpha level in leptospiral hepatitis

    Rizvi, M; Azam, M; Ajmal, M. R.; Shukla, I; Malik, A.

    2011-01-01

    To study the prevalence of leptospira in acute hepatitis syndrome and to assess interleukin (IL)-8 and tumour necrosis factor (TNF)-alpha levels in the pathogenesis of hepatitis due to leptospiral infection.

  19. [Programmed necrosis: a new target for
ischemia reperfusion injury].

    Li, Xiaojing; Ming, Yingzi; Niu, Ying; Liu, Qianwen; Ye, Qifa

    2016-07-01

    Recent years, the researchers have found a new type of cell death, referred to programmed necrosis or necroptosis, which involves the death receptor and the ligand binds and is initiated under the inhibition of apoptosis pathway. Programmed necrosis possesses the morphological features of typical necrosis accompanied by inflammation. The receptor interacting protein kinase 1/3(RIPK1/3) can be inhibited by the specific inhibitors, such as necrostatin-1. RIPK1/3 could regulate programmed necrosis and play a key role in the process. The significance of programmed necrosis in ischemia-reperfusion injury (IRI) has been attracted great attention at present. Simultaneously, a series of studies have found it also involves in the IRI of heart, kidney, brain and retina. PMID:27592584

  20. Percutaneous Access: Acute Effects on Renal Function and Structure in a Porcine Model

    Handa, Rajash K.; Willis, Lynn R.; Evan, Andrew P.; Connors, Bret A.; Ying, Jun; Fat-Anthony, William; Wind, Kelli R.; Johnson, Cynthia D.; Blomgren, Philip M.; Estrada, Mark C.; Paterson, Ryan F.; Kuo, Ramsay L.; Kim, Samuel C.; Matlaga, Brian R.; Miller, Nicole L.; Watkins, Stephanie L.; Handa, Shelly E.; Lingeman, James E.

    2007-04-01

    Percutaneous nephrolithotomy (PCNL) involves gaining access into the urinary collecting system to remove kidney stones. Animal studies demonstrated that a reduction in renal filtration and perfusion in both kidneys, and a decline in tubular organic anion transport in the treated kidney characterizes the acute (hours) functional response to unilateral percutaneous access. The acute morphologic and histological changes in the treated kidney were consistent with blunt trauma and ischemia. Only tubular organic anion transport remained depressed during the late (3-day) response to the access procedure. Human studies revealed an acute decline in glomerular function and bilateral renal vasoconstriction following unilateral PCNL. Therefore, percutaneous access is not a benign procedure, but is associated with acute functional and structural derangements.

  1. Tumor Necrosis Factor Induces Developmental Stage-Dependent Structural Changes in the Immature Small Intestine

    Kathryn S. Brown

    2014-01-01

    Full Text Available Background. Premature infants are commonly subject to intestinal inflammation. Since the human small intestine does not reach maturity until term gestation, premature infants have a unique challenge, as either acute or chronic inflammation may alter the normal development of the intestinal tract. Tumor necrosis factor (TNF has been shown to acutely alter goblet cell numbers and villus length in adult mice. In this study we tested the effects of TNF on villus architecture and epithelial cells at different stages of development of the immature small intestine. Methods. To examine the effects of TNF-induced inflammation, we injected acute, brief, or chronic exposures of TNF in neonatal and juvenile mice. Results. TNF induced significant villus blunting through a TNF receptor-1 (TNFR1 mediated mechanism, leading to loss of villus area. This response to TNFR1 signaling was altered during intestinal development, despite constant TNFR1 protein expression. Acute TNF-mediated signaling also significantly decreased Paneth cells. Conclusions. Taken together, the morphologic changes caused by TNF provide insight as to the effects of inflammation on the developing intestinal tract. Additionally, they suggest a mechanism which, coupled with an immature immune system, may help to explain the unique susceptibility of the immature intestine to inflammatory diseases such as NEC.

  2. Gentamicin-induced preconditioning of proximal tubular LLC-PK1 cells stimulates nitric oxide production but not the synthesis of heat shock protein

    E.A. Pessoa

    2009-07-01

    Full Text Available Nephrotoxicity is the main side effect of antibiotics such as gentamicin. Preconditioning has been reported to protect against injuries as ischemia/reperfusion. The objective of the present study was to determine the effect of preconditioning with gentamicin on LLC-PK1 cells. Preconditioning was induced in LLC-PK1 cells by 24-h exposure to 2.0 mM gentamicin (G/IU. After 4 or 15 days of preconditioning, cells were again exposed to gentamicin (2.0 mM and compared to untreated control or G/IU cells. Necrosis and apoptosis were assessed by acridine orange and HOESCHT 33346. Nitric oxide (NO and endothelin-1 were assessed by the Griess method and available kit. Heat shock proteins were analyzed by Western blotting. After 15 days of preconditioning, LLC-PK1 cells exhibited a significant decrease in necrosis (23.5 ± 4.3 to 6.5 ± 0.3% and apoptosis (23.5 ± 4.3 to 6.5 ± 2.1% and an increase in cell proliferation compared to G/IU. NO (0.177 ± 0.05 to 0.368 ± 0.073 µg/mg protein and endothelin-1 (1.88 ± 0.47 to 2.75 ± 0.53 pg/mL production significantly increased after 15 days of preconditioning compared to G/IU. No difference in inducible HSP 70, constitutive HSC 70 or HSP 90 synthesis in tubular cells was observed after preconditioning with gentamicin. The present data suggest that preconditioning with gentamicin has protective effects on proximal tubular cells, that involved NO synthesis but not reduction of endothelin-1 or production of HSP 70, HSC 70, or HSP 90. We conclude that preconditioning could be a useful tool to prevent the nephrotoxicity induced by gentamicin.

  3. Acute interstitial nephritis - a reappraisal and update.

    Raghavan, Rajeev; Eknoyan, Garabed

    2014-09-01

    Acute interstitial nephritis (AIN) is an under recognized and under diagnosed cause of acute kidney injury (AKI). It is estimated to account for 15 - 20% of cases of AKI; it is the reported diagnosis in 2.8% of all kidney biopsies, and 13.5% of biopsies done specifically for acute renal failure. Considerable evidence implicates antigen initiated cell-mediated injury in the pathogenesis of AIN. Drugs account for 70% of all cases, with over 150 different agents incriminated. The remaining cases are due to infections, autoimmune diseases, and rarely idiopathic. The central component of renal injury in AIN is altered tubular function, which usually precedes decrements in filtration rate. The key to early diagnosis is vigilance for the presence of tubular dysfunction in non-oliguric individuals, especially in patients with modest but gradual increments in creatinine level. The utility of urinary biomarkers to diagnose AIN in its early nascent and potentially reversible stage remains to be determined. Prompt recognition, elimination of the offending source of antigen, and use of a limited course of steroid therapy where indicated, will result in complete resolution in ~ 65% of cases, partial resolution in up to 20%, and irreversible damage in the rest. PMID:25079860

  4. Therapeutic approaches for tumor necrosis factor inhibition

    Maria Letícia de Castro Barbosa

    2011-09-01

    Full Text Available Tumor necrosis factor (TNF consists of an inflammatory cytokine essential for homeostasis and organism defense. Despite its physiological relevance, both increased biosynthesis and release of TNF lead to the exacerbation of inflammatory and oxidative responses, which are related to the pathogenesis of a host of diseases of an inflammatory, autoimmune and/or infectious nature. In this context, effective therapeutic approaches for the modulation of TNF have been the focus of research efforts. Approximately one million individuals worldwide have been treated with biotechnological inhibitors of this cytokine, the so-called anti-TNF biopharmaceuticals. However, given the high risk of infection and the limitations related to cost and administration routes, new therapeutic approaches aimed at biological targets that directly or indirectly modulate the production and/or activation of TNF appear promising alternatives for the discovery of new anti-inflammatory and immunomodulatory orally active drugs and are therefore discussed in this paper.O fator de necrose tumoral (do inglês, tumor necrosis factor - TNF consiste em uma citocina inflamatória essencial para a homeostase e defesa do organismo. A despeito de sua relevância fisiológica, o aumento da biossíntese e liberação do TNF conduzem à exacerbação das respostas inflamatória e oxidativa, as quais estão relacionadas à patogênese de várias doenças de natureza inflamatória, auto-imune e/ou infecciosa. A busca por abordagens terapêuticas eficientes na modulação do TNF tem sido alvo de diversos esforços de pesquisa. Aproximadamente um milhão de pessoas ao redor do mundo já foi tratado com inibidores biotecnológicos desta citocina, os chamados biofármacos anti-TNF. Entretanto, em face ao elevado risco de infecções e as limitações relacionadas ao custo e a via de administração, novas abordagens terapêuticas com foco em alvos que modulem, de forma direta ou indireta, a produ

  5. Contribution of bone marrow-derived cells in renal repair after acute kidney injury.

    Masereeuw, R.

    2009-01-01

    Acute kidney injury (AKI) is a frequent clinical problem with a high mortality rate, generally caused by ischemic insults. Nevertheless, the kidney has a remarkably high capacity to regenerate after ischemic injury. Tubular cells can restore renal function by proliferation and dedifferentiation into

  6. Acute pancreatitis

    Bo-Guang Fan

    2010-05-01

    Full Text Available Background: Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims: The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods: We reviewed the English-language literature (Medline addressing pancreatitis. Results: Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions: Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  7. Acute pancreatitis

    Bo-Guang Fan

    2010-01-01

    Full Text Available Background : Acute pancreatitis continues to be a serious illness, and the patients with acute pancreatitis are at risk to develop different complications from ongoing pancreatic inflammation. Aims : The present review is to highlight the classification, treatment and prognosis of acute pancreatitis. Material & Methods : We reviewed the English-language literature (Medline addressing pancreatitis. Results : Acute pancreatitis is frequently caused by gallstone disease or excess alcohol ingestion. There are a number of important issues regarding clinical highlights in the classification, treatment and prognosis of acute pancreatitis, and treatment options for complications of acute pancreatitis including pancreatic pseudocysts. Conclusions : Multidisciplinary approach should be used for the management of the patient with acute pancreatitis.

  8. The effects of the recommended dose of creatine monohydrate on kidney function

    Taner, Basturk; Aysim, Ozagari; Abdulkadir, Unsal

    2010-01-01

    We report a case of a heretofore healthy 18-year-old man who presented with a 2-day history of nausea, vomiting and stomach ache while taking creatine monohydrate for bodybuilding purposes. The patient had acute renal failure, and a renal biopsy was performed to determine the cause of increased creatinine and proteinuria. The biopsy showed acute tubular necrosis. In the literature, creatine monohydrate supplementation and acute tubular necrosis coexistence had not been reported previously. Tw...

  9. Numerical investigation of cavitation performance on bulb tubular turbine

    Sun, L. G.; Guo, P. C.; Zheng, X. B.; Luo, X. Q.

    2016-05-01

    The cavitation flow phenomena may occur in the bulb tubular turbine at some certain operation conditions, which even decrease the performance of units and causes insatiably noise and vibration when it goes worse. A steady cavitating flow numerical simulations study is carried out on the bulb tubular unit with the same blade pitch angle and different guide vane openings by using the commercial code ANSYS CFX in this paper. The phenomena of cavitation induction areas and development process are obtained and draws cavitation performance curves. The numerical results show that the travelling bubble cavity is the main types of cavitation development over a wide operating range of discharge and this type of cavitation begins to sensitive to the value of cavitation number when the discharge exceeding a certain valve, in this condition, it can lead to a severe free bubble formation with the gradually decrement of cavitation number. The reported cavitation performance curves results indicate that the flow blockage incident would happen because of a mount of free bubble formation in the flow passage when the cavity developed to certain extend, which caused head drop behavior and power broken dramatically and influenced the output power.

  10. High temperature fatigue experiments on welded stainless steel tubular elements

    One of the most important problems concerning the design of advanced type reactors regards the high temperature low-cycle fatigue behaviour of structural elements. Design Guides and Codes report reference data, mainly based on strain range versus failure cycles results, which have been determined by various researchers. The data have been obtained through different test techniques applied to different types of specimens. As a consequence such data are not easily correlated; moreover at present an exhaustive series of results about high temperature low-cycle fatigue behaviour of structures is not available. A test rig has been designed to perform high temperature fatigue experiments on AISI 304 stainless steel tubular elements of 500 mm length, 60.3 mm outer diameter and 2 mm thickness, they are composed of two butt welded tubular elements with welded end flanges. During the experiments it is possible to control the axial strain range, the strain rate and the hold time; the specimen temperature is obtained by an inner heating device, controlled by a series of measuring thermocouples; until now the imposed temperature is 6500C. The first results show a marked reduction of the number of cycles at failure, if compared with existing data about small size specimens; the measurement of residual plastic strains shows clearly non-uniform distribution of the plastic zones. (Auth.)

  11. Surface and interfacial creases in a bilayer tubular soft tissue

    Razavi, Mir Jalil; Pidaparti, Ramana; Wang, Xianqiao

    2016-08-01

    Surface and interfacial creases induced by biological growth are common types of instability in soft biological tissues. This study focuses on the criteria for the onset of surface and interfacial creases as well as their morphological evolution in a growing bilayer soft tube within a confined environment. Critical growth ratios for triggering surface and interfacial creases are investigated both analytically and numerically. Analytical interpretations provide preliminary insights into critical stretches and growth ratios for the onset of instability and formation of both surface and interfacial creases. However, the analytical approach cannot predict the evolution pattern of the model after instability; therefore nonlinear finite element simulations are carried out to replicate the poststability morphological patterns of the structure. Analytical and computational simulation results demonstrate that the initial geometry, growth ratio, and shear modulus ratio of the layers are the most influential factors to control surface and interfacial crease formation in this soft tubular bilayer. The competition between the stretch ratios in the free and interfacial surfaces is one of the key driving factors to determine the location of the first crease initiation. These findings may provide some fundamental understanding in the growth modeling of tubular biological tissues such as esophagi and airways as well as offering useful clues into normal and pathological functions of these tissues.

  12. Renal Tubular Functions in Children with Primary Nocturnal Enuresis

    Süleyman Kalman

    2012-03-01

    Full Text Available Introduction: The etiology of primary nocturnal enuresis (PNE is multifactorial. The effects of genetic and hormonal factors, sleep disorders, and bladder dysfunction have been claimed. The other factors include increased urine production at night and impairment of the circadian rhythm of antidiuretic hormone. Aim: To investigate renal tubular functions in children with PNE. Methods: Forty patients with PNE were included in the study. Urine density, FENa, FEK and TRP were analyzed in daytime and nighttime urine. Results: The mean nighttime urine density was 1020.12±7.38 and the mean daytime urine density was 1013.20±7.11 (p0.05. Conclusion: Urine density in children with PNE was lower at night. However, there was no difference in of FENa, FEK and TRP. Further studies are needed in order to investigate renal tubular functions in children with PNE (The Me di cal Bul le tin of Ha se ki 2012; 50: 10-3

  13. Understanding shape and morphology of unusual tubular starch nanocrystals.

    Gong, Bei; Liu, Wenxia; Tan, Hua; Yu, Dehai; Song, Zhaoping; Lucia, Lucian A

    2016-10-20

    Starch nanocrystals (SNC) are aptly described as the insoluble degradation byproducts of starch granules that purportedly display morphologies that are platelet-like, round, square, and oval-like. In this work, we reported the preparation of SNC with unprecedented tubular structures through sulfuric acid hydrolysis of normal maize starch, subsequent exposure to ammonia and relaxation at 4°C. High-resolution transmission electron microscopy observation clearly proved that the SNCs possess tubular nanostructures with polygonal cross-section. After further reviewing the transformations of SNC by acid hydrolysis, ammonia treatment, and curing time at 4°C, a mechanism for T-SNC formation is suggested. It is conjectured that T-SNC gradually self-assembles by combination of smaller platelet-like/square nanocrystals likely loosely aggregated by starch molecular chains from residual amorphous regions. This work paves the way for the pursuit of new approaches for the preparation of starch-based nanomaterials possessing unique morphologies. PMID:27474612

  14. Nano-tubular cellulose for bioprocess technology development.

    Athanasios A Koutinas

    Full Text Available Delignified cellulosic material has shown a significant promotional effect on the alcoholic fermentation as yeast immobilization support. However, its potential for further biotechnological development is unexploited. This study reports the characterization of this tubular/porous cellulosic material, which was done by SEM, porosimetry and X-ray powder diffractometry. The results showed that the structure of nano-tubular cellulose (NC justifies its suitability for use in "cold pasteurization" processes and its promoting activity in bioprocessing (fermentation. The last was explained by a glucose pump theory. Also, it was demonstrated that crystallization of viscous invert sugar solutions during freeze drying could not be otherwise achieved unless NC was present. This effect as well as the feasibility of extremely low temperature fermentation are due to reduction of the activation energy, and have facilitated the development of technologies such as wine fermentations at home scale (in a domestic refrigerator. Moreover, NC may lead to new perspectives in research such as the development of new composites, templates for cylindrical nano-particles, etc.

  15. Advances in tubular solid oxide fuel cell technology

    Singhal, S.C. [Westinghouse Electric Corp., Pittsburgh, PA (United States)

    1996-12-31

    The design, materials and fabrication processes for the earlier technology Westinghouse tubular geometry cell have been described in detail previously. In that design, the active cell components were deposited in the form of thin layers on a ceramic porous support tube (PST). The tubular design of these cells and the materials used therein have been validated by successful electrical testing for over 65,000 h (>7 years). In these early technology PST cells, the support tube, although sufficiently porous, presented an inherent impedance to air flow toward air electrode. In order to reduce such impedance to air flow, the wall thickness of the PST was first decreased from the original 2 mm (the thick-wall PST) to 1.2 mm (the thin-wall PST). The calcia-stabilized zirconia support tube has now been completely eliminated and replaced by a doped lanthanum manganite tube in state-of-the-art SOFCs. This doped lanthanum manganite tube is extruded and sintered to about 30 to 35 percent porosity, and serves as the air electrode onto which the other cell components are fabricated in thin layer form. These latest technology cells are designated as air electrode supported (AES) cells.

  16. Distribution of common acute lymphoblastic leukemia antigen in nonhematopoietic tissues

    1981-01-01

    The common acute lymphoblastic leukemia antigen (CALLA), as defined by J-5 murine monoclonal antibodies, was detected on renal tubular and glomerular cells from fetal and adult donors by an indirect immunoperoxidase technique. CALLA could also be detected on epithelial cells of the fetal small intestine and on myoepithelial cells of adult breast but not on myoepithelial cells of the salivary gland. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of immunoprecipitated 125I-l...

  17. Genetic deficiency of adiponectin protects against acute kidney injury

    Jin, Xiaogao; Chen, Jiyuan; Hu, Zhaoyong; Chan, Lawrence; Wang, Yanlin

    2013-01-01

    Adiponectin is a multifunctional cytokine that has a role in regulating inflammation. Here we determined if adiponectin modulates ischemic acute kidney injury. Compared with wild-type mice, adiponectin knockout mice were found to have lower serum creatinine and less tubular damage or apoptosis following ischemia/reperfusion injury. This latter process was associated with decreased Bax and reduced activation of p53 and caspase-3. Targeted disruption of adiponectin was also found to inhibit the...

  18. Acute effect of cisplatin on renal hemodynamics and tubular function in dog kidneys

    Daugaard, G; Abildgaard, U; Holstein-Rathlou, N H; Leyssac, P P; Amtorp, O; Dikhoff, T G

    1986-01-01

    /min) and fractional lithium clearance (from 0.31 +/- 0.03 to 0.44 +/- 0.04) was seen. This occurred without measurable changes in glomerular filtration rate and renal blood flow. The calculated fractional as well as absolute rates of proximal reabsorption of sodium decreased significantly from 0.68 +/- 0...... significant increase in urinary flow rate (from 0.39 +/- 0.07 ml/min to 0.73 +/- 0.12 ml/min), sodium clearance (from 0.33 +/- 0.11 ml/min to 0.65 +/- 0.14 ml/min), potassium clearance (from 9.23 +/- 0.48 ml/min to 10.77 +/- 0.95 ml/min), lithium clearance (from 15.55 +/- 2.21 ml/min to 23.76 +/- 4.00 ml...

  19. Hepatocyte growth factor prevents acute renal failure and accelerates renal regeneration in mice.

    Kawaida, K; Matsumoto, K.; Shimazu, H.; Nakamura, T.(International Center for Elementary Particle Physics and Department of Physics, The University of Tokyo, Tokyo, Japan)

    1994-01-01

    Although acute renal failure is encountered with administration of nephrotoxic drugs, ischemia, or unilateral nephrectomy, there has been no effective drug which can be used in case of acute renal failure. Hepatocyte growth factor (HGF) is a potent hepatotropic factor for liver regeneration and is known to have mitogenic, motogenic, and morphogenic activities for various epithelial cells, including renal tubular cells. Intravenous injection of recombinant human HGF into mice remarkably suppre...

  20. MR mammography of fatty tissue necrosis

    Purpose: To evaluate MR-imaging for the differentiation of fatty necrosis (FN) of the breast. Material and methods: In 1016 MR mammographies FN was found in 13 patients aged 44 to 69 years. In all studies we used a proton-weighted fat suppressed sequence (STIR) and serial T1-weighted gradient echo sequences before and after bolus injection of Gd-DTPA, MRI was correlated to ultrasound and in 8 cases to mammographic findings. Results: All 15 FN displayed fat-isointense signal on T1-weighted and on proton-weighted, fat-suppressed sequences. They were delineated by a more or less wide rim of low signal intensity with sharp border to the center. After intravenous injection of gadopentetate dimeglumine they showed no increase of signal intensity in the centre and no increase, or only a minor increase, of the rim. Ultrasound could not distinguish FN from recurrent tumour in 6 cases. 7 FN looked like atypical cysts. Conclusion: MR-mammography is very promising in the diagnosis of FN. (orig.)