Sample records for acute tubular necrosis

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

    Eranga S Wijewickrama


    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. Tubular Peroxiredoxin 3 as a Predictor of Renal Recovery from Acute Tubular Necrosis in Patients with Chronic Kidney Disease.

    Wu, Chia-Lin; Su, Tzu-Cheng; Chang, Chia-Chu; Kor, Chew-Teng; Chang, Chung-Ho; Yang, Tao-Hsiang; Chiu, Ping-Fang; Tarng, Der-Cherng


    Peroxiredoxin 3 (PRX3) is a mitochondrial antioxidant that regulates apoptosis in various cancers. However, whether tubular PRX3 predicts recovery of renal function following acute kidney injury (AKI) remains unknown. This retrospective cohort study included 54 hospitalized patients who had AKI with biopsy-proven acute tubular necrosis (ATN). The study endpoint was renal function recovery within 6 months. Of the 54 enrolled patients, 25 (46.3%) had pre-existing chronic kidney disease (CKD) and 33 (61%) recovered renal function. Tubular PRX3 expression was higher in patients with ATN than in those without renal function recovery. The level of tubular but not glomerular PRX3 expression predicted renal function recovery from AKI (AUROC = 0.76). In multivariate Cox regression analysis, high PRX3 expression was independently associated with a higher probability of renal function recovery (adjusted hazard ratio = 8.99; 95% CI 1.13-71.52, P = 0.04). Furthermore, the discriminative ability of the clinical model for AKI recovery was improved by adding tubular PRX3. High tubular PRX3 expression was associated with a higher probability of renal function recovery from ATN. Therefore, tubular PRX3 in combination with conventional predictors can further improve recovery prediction and may help with risk stratification in AKI patients with pre-existing CKD.

  3. Differentiation between renal allograft rejection and acute tubular necrosis by renal scan

    Delmonico, F.L.; McKusick, K.A.; Cosimi, A.B.; Russell, P.S.


    The usefulness of the renal scan in diagnosing technical complications in the transplant patient is well established. However, the ability of the renal scan to differentiate between acute rejection and acute tubular necrosis has remained uncertain. We have evaluated the effectiveness of the /sup 99m/Tc DTPA computer-derived time-activity curve of renal cortical perfusion, as well as data obtained from scintillation camera images, in making such diagnoses. Fifteen patients with a clinical diagnosis of either acute rejection or acute tubular necrosis, or both, were studied retrospectively. Technetium scan diagnoses did not agree with the clinical assessment in nine of the patients. Thus selection of a course of treatment should not be based on data obtained from the scan alone.

  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)


    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. Power doppler sonography in early renal transplantation: Does it differentiate acute graft rejection from acute tubular necrosis?

    Haytham M Shebel


    Full Text Available To evaluate the role of power Doppler in the identification and differentiation bet-ween acute renal transplant rejection and acute tubular necrosis (ATN, we studied 67 live donor renal transplant recipients. All patients were examined by spectral and power Doppler sono-graphy. Assessment of cortical perfusion (CP by power Doppler was subjective, using our grading score system: P0 (normal CP; homogenous cortical blush extending to the capsule, P1 (reduced CP; cortical vascular cut-off at interlobular level, P2 (markedly reduced CP; scattered cortical color flow at the interlobar level. Renal biopsies were performed during acute graft dysfunction. Pathological diagnoses were based on Banff classification 1997. The Mann- Whitney test was used to test the difference between CP grades with respect to serum creatinine (SCr, and resistive index (RI. For 38 episodes of acute graft rejection grade I, power Doppler showed that CP was P1 and RI ranging from 0.78 to 0.89. For 21 episodes of acute graft rejection grade II, power Doppler showed that CP was P1, with RI ranging from 0.88 to >1. Only one case of grade III rejection had a CP of P2. Twelve biopsies of ATN had CP of P0 and RI ranging from 0.80 to 0.89 There was a statistically significant correlation between CP grading and SCr (P <0.01 as well as between CP grading and RI (P <0.05. CP grading had a higher sensitivity in the detection of early acute rejection compared with RI and cross-sectional area measurements. We conclude that power Doppler is a non-invasive sensitive technique that may help in the detection and differentiation between acute renal transplant rejection and ATN, particularly in the early post-transplantation period.

  6. Protective effect of human amniotic fluid stem cells in an immunodeficient mouse model of acute tubular necrosis.

    Laura Perin

    Full Text Available Acute Tubular Necrosis (ATN causes severe damage to the kidney epithelial tubular cells and is often associated with severe renal dysfunction. Stem-cell based therapies may provide alternative approaches to treating of ATN. We have previously shown that clonal c-kit(pos stem cells, derived from human amniotic fluid (hAFSC can be induced to a renal fate in an ex-vivo system. Herein, we show for the first time the successful therapeutic application of hAFSC in a mouse model with glycerol-induced rhabdomyolysis and ATN. When injected into the damaged kidney, luciferase-labeled hAFSC can be tracked using bioluminescence. Moreover, we show that hAFSC provide a protective effect, ameliorating ATN in the acute injury phase as reflected by decreased creatinine and BUN blood levels and by a decrease in the number of damaged tubules and apoptosis therein, as well as by promoting proliferation of tubular epithelial cells. We show significant immunomodulatory effects of hAFSC, over the course of ATN. We therefore speculate that AFSC could represent a novel source of stem cells that may function to modulate the kidney immune milieu in renal failure caused by ATN.


    Liliany P. Repizo


    Full Text Available Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI. We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.

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

    Faarup, Poul; Nørgaard, Tove; Hegedüs, Viktor;


    and 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...... 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...

  9. Acute tubular necrosis

    ... Liver disease and kidney damage caused by diabetes ( diabetic nephropathy ) may make a person more susceptible to the ... Urine sodium Urine specific gravity and osmolarity urine Treatment In most people, ATN is reversible. The goal ...

  10. Poly[ADP-ribose] polymerase-1 expression is related to cold ischemia, acute tubular necrosis, and delayed renal function in kidney transplantation.

    Francisco O'Valle

    Full Text Available UNLABELLED: Cold ischemia time especially impacts on outcomes of expanded-criteria donor (ECD transplantation. Ischemia-reperfusion (IR injury produces excessive poly[ADP-Ribose] Polymerase-1 (PARP-1 activation. The present study explored the hypothesis that increased tubular expression of PARP-1 contributes to delayed renal function in suboptimal ECD kidney allografts and in non-ECD allografts that develop posttransplant acute tubular necrosis (ATN. MATERIALS AND METHODS: Nuclear PARP-1 immunohistochemical expression was studied in 326 paraffin-embedded renal allograft biopsies (193 with different degrees of ATN and 133 controls and in murine Parp-1 knockout model of IR injury. RESULTS: PARP-1 expression showed a significant relationship with cold ischemia time (r coefficient = 0.603, time to effective diuresis (r = 0.770, serum creatinine levels at biopsy (r = 0.649, and degree of ATN (r = 0.810 (p = 0.001, Pearson test. In the murine IR model, western blot showed an increase in PARP-1 that was blocked by Parp-1 inhibitor. Immunohistochemical study of PARP-1 in kidney allograft biopsies would allow early detection of possible delayed renal function, and the administration of PARP-1 inhibitors may offer a therapeutic option to reduce damage from IR in donor kidneys by preventing or minimizing ATN. In summary, these results suggest a pivotal role for PARP-1 in the ATN of renal transplantation. We propose the immunohistochemical assessment of PARP-1 in kidney allograft biopsies for early detection of a possible delayed renal function.

  11. Acute retinal necrosis

    Hugo Hernán Ocampo


    Full Text Available Purpose: Clinical features in a case of acute retinal necrosis are described as well as its diagnostic approach and response to early treatment. Methods: This is a descriptive and retrospective study case report of a 26 year old male patient who arrived to the emergency room with a three day history of sudden visual loss in the right eye (RE. At initial evaluation a visual acuity of hand movements in the RE, 20/15 in the left eye (LE and a right relative afferent pupillary defect were found. Fundoscopy revealed profuse soft exudates and hemorrhages involving posterior pole, inferior hemiretina and superotemporal periphery. Infectious workup and fluoresceinic angiography were made and positive serologies for herpes virus types 1 and 2, without HIV, were found. A diagnosis of acute retinal necrosis was made and treatment with intravenous valgancyclovir for two weeks and intra-vitreous triamcinolone for severe vasculitis, was given. Then a 3 months treatment with oral antiviral agents was prescribed. Results: Patient’s evolution showed improvement with treatment and at two and a half months of follow up, visual acuity was 20/50 in the right eye, normal slit lamp examination, tonometry of 12 mm Hg and fundoscopy improved when compared to initial pictures.Conclusions: A high index of suspicion is needed for diagnosing ARN taking into account clinical findings. Prompt intravenous and intra-vitreous treatments are needed to achieve good clinical and functional outcomes and to avoid central nervous system complications.

  12. 促红细胞生成素防治大鼠急性肾小管坏死的实验研究%Experimental study of the prevention and treatment of acute renal tubular necrosis with erythropoietin in rats

    余堂宏; 胡宏; 梁伟; 刘金洪


    目的 探讨促红细胞生成素对大鼠急性肾小管坏死的防治作用.方法 按10 mL·kg-1肌肉注射甘油建立大鼠急性肾小管坏死模型.30只Wistar大鼠随机(随机数字法)分为正常组、模型组、治疗组.治疗组予促红细胞生成素(1000 IU·kg-1)尾静脉注射,实验结束时检测各组大鼠血尿素氮(Bun)、血肌酐(Scr)、尿渗量、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿β2微球蛋白(β2-MG),肾组织匀浆丙二醇(MDA)和超氧化物歧化酶(SOD),并进行肾脏组织学观察.结果 与模型组比较,治疗组大鼠Bun、Scr、尿NAG、尿β2-MG、肾组织匀浆MDA明显下降,而尿渗量、肾组织匀浆SOD升高,肾脏病理改变好转.结论 促红细胞生成素可能通过抗氧自由基损伤,提高内源性抗氧化能力达到对急性肾小管坏死大鼠肾脏的部分保护作用.%Objective To study the preventive effects of erythropoietin (EPO) on acute tubular necrosis of kidney in rats. Method The rat models of acute renal tubular necrosis were established with injecting glycerol in dose of 10 mL/kg. Thirty Wistar rats were randomly (random number) divided into control group, model group and EPO treatment group. EPO was administered intravenously into rats of treatment group in a dose of 1000IU/kg. Levels of blood urea nitrogen (BUN) and serum creatinine (Scr), urine osmolality, urine N-acetyl-D-glucosaminidase (NAG), urine β2-microglobulin (β2-MG), tissue MDA and SOD of rats in the three groups were assayed after the experiment. Renal histological examination was also performed. Results Compared with model group, the levels of BUN and Scr, urine osmolality, NAG,β2-MG and tissue MDA in EPO treament group were significantly lower, but urine osmolality and tissue SOD of rats remarkably increased in comparison with model group. EPO also lessened the histological changes in treatment group. Conclusions EPO has some protective effects on acute renal tubular necrosis in rats, which

  13. Acute Necrotizing Esophagitis Followed by Duodenal Necrosis.

    Del Hierro, Piedad Magdalena


    Acute Necrotizing Esophagitis is an uncommon pathology, characterized by endoscopic finding of diffuse black coloration in esophageal mucosa and histological presence of necrosis in patients with upper gastrointestinal bleeding. The first case of acute necrotizing esophagitis followed by duodenal necrosis, in 81 years old woman with a positive history of Type 2 Diabetes Mellitus, Hypertension, and usual intake of Nonsteroidal Anti-inflammatory drugs, is reported. Although its etiology remains unknown, the duodenal necrosis suggests that ischemia could be the main cause given that the branches off the celiac axis provide common blood supply to the distal esophageal and duodenal tissue. The massive gastroesophagic reflux and NSAID intake could be involved.

  14. Pharm GKB: Acute necrosis of liver NOS [PharmGKB

    Full Text Available MeSH: Massive Hepatic Necrosis (D047508) SnoMedCT: Acute necrosis of liver NOS (197273006) UMLS: C0001364 (C...000011090) Common Searches Search Medline Plus Search CTD Pharm GKB: Acute necrosis of liver NOS ...

  15. Bilateral acute retinal necrosis after herpetic meningitis

    Katsura T


    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

  16. Inhibition of gentamicin–induced renal tubular cell necrosis

    Tavafi, Majid


    Gentamicin nephrotoxicity limit its usage against gram negative bacteria. Most researches showed that antioxidant agents improved gentamicin nephrotoxicity. According to these investigations oxidative stress play a central role in the mechanism of gentamicin induced nephrotoxicity. Recently Rafieian-Kopaei and colleagues showed that erythropoietin significantly ameliorated serum creatinine, blood urea nitrogen and tubal necrosis in gentamicin induced nephrotoxicity in rat. One of the advantag...

  17. Acute esophageal necrosis caused by alcohol abuse

    Tetsu Endo; Juichi Sakamoto; Ken Sato; Miyako Takimoto; Koji Shimaya; Tatsuya Mikami; Akihiro Munakata; Tadashi Shimoyama; Shinsaku Fukuda


    Acute esophageal necrosis (AEN) is extremely rare and the pathogenesis of this is still unknown. We report a case of AEN caused by alcohol abuse. In our case, the main pathogenesis could be accounted for low systemic perfusion caused by severe alcoholic lactic acidosis. After the healing of AEN, balloon dilatation was effective to manage the stricture.

  18. Black esophagus: Acute esophageal necrosis syndrome

    Grigoriy; E; Gurvits


    Acute esophageal necrosis (AEN), commonly referred to as "black esophagus", is a rare clinical entity arising from a combination of ischemic insult seen in hemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophago-gastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. AEN may arise in the setting of multiorgan dysfunction, hypoperfusi...

  19. Black esophagus (acute esophageal necrosis) after spinal anesthesia.

    Román Fernández, A; López Álvarez, A; Fossati Puertas, S; Areán González, I; Varela García, O; Viaño López, P M


    Acute esophagic necrosis or black esophagus is an uncommon clinical entity that owes its name to the endoscopic view of the necrotic esophageal mucosa. It is always related with a critical medical condition and usually has an ischemic etiology. We report the first case of acute esophageal necrosis after a spinal anesthetic for partial hip joint arthroplasty. We discuss the underlying pathophysiological mechanisms.

  20. Lipasuria in acute pancreatitis: result of tubular dysfunction?

    Muench, R; Buehler, H; Kehl, O; Ammann, R


    Lipase, in contrast to amylase, is completely reabsorbed by the proximal tubules after glomerular filtration. Therefore, no lipase is detectable in the unconcentrated urine according to the current opinion. The handling of lipase (detected with an enzyme-immunoassay) by the kidney was investigated in comparison with creatinine, amylase, and beta-2-microglobulin by clearance studies in acute pancreatitis (n = 10), burn injury (n = 4), glomerular proteinuria (n = 8), and controls without evidence of pancreatic or renal diseases (n = 5). In initial stages of acute pancreatitis a measurable clearance of lipase (mean: 49.6 microliters/min, range: 0.5-234) was found in association with corresponding increased clearances of beta-2-microglobulin (mean: 10.5 ml/min, range: 0.02-58.9) and of amylase (mean: 8.9 ml/min, range: 2.4-22.6) in nine of ten patients. This finding is consistent with a defect of tubular function. However, regression analysis failed to show a significant correlation between lipase and beta-2-microglobulin clearance. Repeated measurements during the course of pancreatitis in seven patients showed reversibility of tubular dysfunction. In patients with burn injury a similar elevation of clearances of beta-2-microglobulin and of amylase was found, but tubular dysfunction in this condition was not associated with lipasuria. In glomerular proteinuria a lipase clearance was found in two of five cases with moderate, and in the other three cases with severe impairment of creatinine clearance. beta-2-microglobulin clearance was normal in the former and only slightly elevated in the latter group. In conclusion lipase is measurable in the urine of most patients with acute pancreatitis as a result of a reversible tubular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Acute esophageal necrosis and liver pathology, a rare combination

    Amir Maqbul Khan; Rangit Hundal; Vijaya Ramaswamy; Mark Korsten; Sunil Dhuper


    Acute esophageal necrosis (AEN) or "black esophagus" is a clinical condition found at endoscopy. It is a rare entity the exact etiology of which remains unknown. We describe of liver cirrhosis and hepatic encephalopathy.

  2. Amylase/creatinine clearance ratio and tubular proteinuria in acute pancreatitis.

    Lankisch, P G; Wolfrum, D I; Koop, H; Winckler, K


    Amylase/creatinine clearance ratio (CAm/CCr), urinary protein concentration and urinary protein pattern were studied in 102 samples from 27 patients with acute pancreatitis and in 46 controls. Raised CAm/CCr, proteinuria and a tubular protein pattern were present in 74, 56 and 96% of the patients, respectively. However, CAm/CCr and proteinuria and CAm/CCr and tubular protein pattern were not correlated. These results do not support the suggestion that an elevated CAm/CCr in acute pancreatitis is due to generalized tubular protein reabsorption failure presenting with tubular proteinuria.

  3. Acute tubular nephropathy in a patient with acute HIV infection: review of the literature.

    Ananworanich, Jintanat; Datta, Anandita A; Fletcher, James Lk; Townamchai, Natavudh; Chomchey, Nitiya; Kroon, Eugene; Sereti, Irini; Valcour, Victor; Kim, Jerome H


    We report a 57-year old man with diabetes mellitus and hypertension who presented with acute HIV infection. Routine blood tests showed an elevated blood urea nitrogen and creatinine. Renal biopsy showed acute tubular nephropathy, which has not been reported to occur during acute HIV infection, in the absence of rhabdomyolysis or multiple organ system failure. Antiretroviral therapy was initiated. His renal failure gradually resolved without further intervention. At one year of follow-up his HIV RNA was undetectable, and his renal function was normal. The case illustrates a rare manifestation of acute HIV infection - acute renal failure - in an older man with diabetes and hypertension. In this setting acute kidney injury might mistakenly have been attributed to his chronic comorbidities, and this case supports early HIV-1 testing in the setting of a high index of suspicion.

  4. A rare entity of acute bilateral cortical renal necrosis following acute pancreatitis

    Kruti D Dave


    Full Text Available Acute bilateral renal cortical necrosis following acute pancreatitis is extremely rare condition. Among all cases of acute renal failure, the incidence of renal cortical necrosis was 3.8% in one of the study in North India. Till date, only eight cases of bilateral cortical necrosis following acute pancreatitis were reported in the literature. We report a case of a 27-year-old male patient with abdominal pain, nausea and vomiting since 2 days duration and anuria since 24 h. Serum amylase and lipase were raised, and elevated serum creatinine was noted on admission. Contrast-enhanced computed tomography scan of the abdomen revealed changes of acute pancreatitis with hypoenhancement of renal cortex compared to medulla on both sides (reverse rim sign-stronger enhancement of the renal medulla compared to cortex, suggest an acute renal cortical necrosis.

  5. Acute Tubuler Necrosis Related to Rhabdomyolysis

    Fatma Sarı DOĞAN


    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.

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

    Ender Özer


    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.

  7. Acute retinal necrosis following intravitreal dexamethasone (Ozurdex® implant

    Murat Kucukevcilioglu


    Full Text Available A 52-year-old woman undergoing azathioprine treatment for rheumatoid arthritis developed acute retinal necrosis a month after intravitreal dexamethasone (Ozurdex ® implantation for posterior uveitis in the left eye. Varicella zoster virus (VZV DNA was detected in the anterior chamber and vitreous samples on polymerase chain reaction (PCR analysis. Retinal detachment occurred despite systemic and intravitreal antiviral therapy. Favorable structural and functional outcomes were achieved after retinal surgery with silicone oil. To the authors’ knowledge, this is the first reported case of acute retinal necrosis following placement of an Ozurdex® implant. Physicians practicing Ozurdex® implantations should be aware of this unusual but devastating complication. Extra caution and frequent follow-up are required in all immunocompromised patients receiving Ozurdex® implantation.

  8. Renal Cortical Lactate Dehydrogenase: A Useful, Accurate, Quantitative Marker of In Vivo Tubular Injury and Acute Renal Failure.

    Richard A Zager

    Full Text Available Studies of experimental acute kidney injury (AKI are critically dependent on having precise methods for assessing the extent of tubular cell death. However, the most widely used techniques either provide indirect assessments (e.g., BUN, creatinine, suffer from the need for semi-quantitative grading (renal histology, or reflect the status of residual viable, not the number of lost, renal tubular cells (e.g., NGAL content. Lactate dehydrogenase (LDH release is a highly reliable test for assessing degrees of in vitro cell death. However, its utility as an in vivo AKI marker has not been defined. Towards this end, CD-1 mice were subjected to graded renal ischemia (0, 15, 22, 30, 40, or 60 min or to nephrotoxic (glycerol; maleate AKI. Sham operated mice, or mice with AKI in the absence of acute tubular necrosis (ureteral obstruction; endotoxemia, served as negative controls. Renal cortical LDH or NGAL levels were assayed 2 or 24 hrs later. Ischemic, glycerol, and maleate-induced AKI were each associated with striking, steep, inverse correlations (r, -0.89 between renal injury severity and renal LDH content. With severe AKI, >65% LDH declines were observed. Corresponding prompt plasma and urinary LDH increases were observed. These observations, coupled with the maintenance of normal cortical LDH mRNA levels, indicated the renal LDH efflux, not decreased LDH synthesis, caused the falling cortical LDH levels. Renal LDH content was well maintained with sham surgery, ureteral obstruction or endotoxemic AKI. In contrast to LDH, renal cortical NGAL levels did not correlate with AKI severity. In sum, the above results indicate that renal cortical LDH assay is a highly accurate quantitative technique for gauging the extent of experimental acute ischemic and toxic renal injury. That it avoids the limitations of more traditional AKI markers implies great potential utility in experimental studies that require precise quantitation of tubule cell death.

  9. Direct acute tubular damage contributes to Shigatoxin-mediated kidney failure.

    Porubsky, Stefan; Federico, Giuseppina; Müthing, Johannes; Jennemann, Richard; Gretz, Norbert; Büttner, Stefan; Obermüller, Nicholas; Jung, Oliver; Hauser, Ingeborg A; Gröne, Elisabeth; Geiger, Helmut; Gröne, Hermann-Josef; Betz, Christoph


    The pathogenesis and therapy of Shigatoxin 2 (Stx2)-mediated kidney failure remain controversial. Our aim was to test whether, during an infection with Stx2-producing E. coli (STEC), Stx2 exerts direct effects on renal tubular epithelium and thereby possibly contributes to acute renal failure. Mice represent a suitable model because they, like humans, express the Stx2-receptor Gb3 in the tubular epithelium but, in contrast to humans, not in glomerular endothelia, and are thus free of glomerular thrombotic microangiopathy (TMA). In wild-type mice, Stx2 caused acute tubular dysfunction with consequent electrolyte disturbance, which was most likely the cause of death. Tubule-specific depletion of Gb3 protected the mice from acute renal failure. In vitro, Stx2 induced secretion of proinflammatory cytokines and apoptosis in human tubular epithelial cells, thus implicating a direct effect of Stx2 on the tubular epithelium. To correlate these results to human disease, kidney biopsies and outcome were analysed in patients with Stx2-associated kidney failure (n = 11, aged 22-44 years). The majority of kidney biopsies showed different stages of an ongoing TMA; however, no glomerular complement activation could be demonstrated. All biopsies, including those without TMA, showed severe acute tubular damage. Due to these findings, patients were treated with supportive therapy without complement-inhibiting antibodies (eculizumab) or immunoadsorption. Despite the severity of the initial disease [creatinine 6.34 (1.31-17.60) mg/dl, lactate dehydrogenase 1944 (753-2792) U/l, platelets 33 (19-124)/nl and haemoglobin 6.2 (5.2-7.8) g/dl; median (range)], all patients were discharged after 33 (range 19-43) days with no neurological symptoms and no dialysis requirement [creatinine 1.39 (range 0.84-2.86) mg/dl]. The creatinine decreased further to 0.90 (range 0.66-1.27) mg/dl after 24 months. Based on these data, one may surmise that acute tubular damage represents a separate

  10. The diagnostic value of contrast-enhanced CT in Acute bilateral renal cortical necrosis: a case report

    Choi, Pil Youb; Lee, Su Han; Lee, Woo Dong [Masan Samsung General Hospital, Seoul (Korea, Republic of)


    Acute renal cortical necrosis in which there is destruction of the renal cortex and sparing of the renal medulla, is a relatively rare cause of acute renal failure. A definitive diagnosis of acute renal cortical necrosis is based on renal biopsy, but on CT(computed tomography) the rather specific contrast-enhanced appearance of acute renal cortical necrosis has been described. As renal biopsy is not available, contrast-enhanced CT is a useful, noninvasive investigate modality for the early diagnosis of acute renal cortical necrosis. We report the characteristic CT findings of acute renal cortical necrosis in a patient with acute renal failure following an operation for abdominal trauma.

  11. Valacyclovir in the treatment of acute retinal necrosis

    Taylor Simon RJ


    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.

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

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


    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.

  13. Acute effect of cisplatin on renal hemodynamics and tubular function in dog kidneys

    Daugaard, G; Abildgaard, U; Holstein-Rathlou, N H


    The present study was designed to investigate the early hemodynamic and tubular effects of cisplatin administration on dogs. To localize the nephrotoxic actions of cisplatin, we have taken advantage of the lithium clearance method. After infusion of 5 mg of cisplatin per kg, an immediate and sign.......56 +/- 0.04 and from 4.76 +/- 0.32 mmol/min to 3.92 +/- 0.23 mmol/min, respectively. The results show that administration of cisplatin causes an acute, mainly proximal tubular impairment in dogs without alterations in renal hemodynamics......./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 +/- 0.03 to 0...

  14. An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis

    Nikhil R. Kalva


    Full Text Available Acute esophageal necrosis (AEN, also called “black esophagus,” is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition. Alcoholism and substance abuse could be seen in younger patients. Patients usually have systemic hypotension along with upper abdominal pain in the background of clinical presentation of hematemesis and melena. The endoscopic findings confirm the diagnosis and biopsy is not always necessary unless clinically indicated in atypical presentations. Herein we present two cases with distinct clinical presentation and discuss the endoscopic findings along with a review of the published literature on the management of AEN.

  15. Quantification and localization of M2 macrophages in human kidneys with acute tubular injury

    Palmer MB


    Full Text Available Matthew B Palmer,1 Alfred A Vichot,2 Lloyd G Cantley,2 Gilbert W Moeckel1 1Department of Pathology, Yale University School of Medicine, New Haven, CT, USA; 2Department of Medicine, Yale University School of Medicine, New Haven, CT, USA Abstract: This study addresses for the first time the question whether there is significant macrophage population in human kidney sections from patients with acute tubular injury (ATI. We examined therefore the interstitial macrophage population in human kidney tissue with biopsy-proven diagnosis of ATI, minimal change disease (MCD, and MCD with ATI. Kidney biopsies from patients with the above diagnoses were stained with antibodies directed against CD68 (general macrophage marker, CD163 (M2 marker, and HLA-DR (M1 marker and their respective electron microscopy samples were evaluated for the presence of interstitial macrophages. Our study shows that patients with ATI have significantly increased numbers of interstitial CD68+ macrophages, with an increase in both HLA-DR+ M1 macrophages and CD163+ M2 macrophages as compared to patients with MCD alone. Approximately 75% of macrophages were M2 (CD163+ whereas only 25% were M1 (HLA-DR+. M2 macrophages, which are believed to be critical for wound healing, were found to localize close to the tubular basement membrane of injured proximal tubule cells. Ultra structural examination showed close adherence of macrophages to the basement membrane of injured tubular epithelial cells. We conclude that macrophages accumulate around injured tubules following ATI and exhibit predominantly an M2 phenotype. We further speculate that macrophage-mediated repair may involve physical contact between the M2 macrophage and the injured tubular epithelial cell. Keywords: macrophages, acute kidney injury, CD163, HLA-DR, CD68, electron microscopy

  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


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

    Tiffany J. Patton


    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.

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

    Busse, Malene Just; Ainsworth, Alan Patrick


    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...

  19. Acute hepatic encephalopathy presenting as cortical laminar necrosis: case report.

    Choi, Jong Mun; Kim, Yoon Hee; Roh, Sook Young


    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.

  20. 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)


    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.

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

    R. Ramos


    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


    Jin Zhou; Ran Meng; Xin-hua Sui; Bao-feng Yang


    @@ Arsenic trioxide (As2O3) is an effective agent used in treatment of acute promyelocytic leukemia (APL). However,appearances of side effects using clinical therapeutic dosages of As2O3 occur during the initial or consolidated stage in APL therapy. We report two APL patients suffering focal bone marrow necrosis after discontinuous As2O3 treatment during consolidated stage.

  3. Quantitative Evaluation of Acute Renal Transplant Dysfunction with Low-Dose Three-dimensional MR Renography

    Yamamoto, Akira; Zhang, Jeff L.; Rusinek, Henry; Chandarana, Hersh; Vivier, Pierre-Hugues; Babb, James S.; Diflo, Thomas; John, Devon G.; Benstein, Judith A.; Barisoni, Laura; Stoffel, David R.; Lee, Vivian S.


    Our new quantitative analysis method of MR renography, which includes our multicompartmental tracer kinetic renal model, may help to diagnose noninvasively acute rejection or acute tubular necrosis after kidney transplantation.

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

    Khoshnaw Najmaddin SH


    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

  5. Metformin Protects Against Cisplatin-Induced Tubular Cell Apoptosis and Acute Kidney Injury via AMPKα-regulated Autophagy Induction.

    Li, Jianzhong; Gui, Yuan; Ren, Jiafa; Liu, Xin; Feng, Ye; Zeng, Zhifeng; He, Weichun; Yang, Junwei; Dai, Chunsun


    Metformin, one of the most common prescriptions for patients with type 2 diabetes, is reported to protect the kidney from gentamicin-induced nephrotoxicity. However, the role and mechanisms for metformin in preventing cisplatin-induced nephrotoxicity remains largely unknown. In this study, a single intraperitoneal injection of cisplatin was employed to induce acute kidney injury (AKI) in CD1 mice. The mice exhibited severe kidney dysfunction and histological damage at day 2 after cisplatin injection. Pretreatment of metformin could markedly attenuate cisplatin-induced acute kidney injury, tubular cell apoptosis and inflammatory cell accumulation in the kidneys. Additionally, pretreatment of metformin could enhance both AMPKα phosphorylation and autophagy induction in the kidneys after cisplatin injection. In cultured NRK-52E cells, a rat kidney tubular cell line, metformin could stimulate AMPKα phosphorylation, induce autophagy and inhibit cisplatin-induced cell apoptosis. Blockade of either AMPKα activation or autophagy induction could largely abolish the protective effect of metformin in cisplatin-induced cell death. Together, this study demonstrated that metformin may protect against cisplatin-induced tubular cell apoptosis and AKI through stimulating AMPKα activation and autophagy induction in the tubular cells.

  6. Avascular necrosis of bone in severe acute respiratory syndrome

    Hong, N. E-mail:; Du, X.K


    AIM: To report the incidence of avascular osteonecrosis (AVN) in severe acute respiratory syndrome (SARS) patients. MATERIALS AND METHODS: Sixty-seven SARS patients who had large joint pain between March 2003 and May 2003 underwent both plain radiographs and magnetic resonance imaging (MRI) examination on the same day. All patients received steroids and ribavirin treatment. All plain radiographs and MR images were analysed by two experienced musculoskeletal radiologists. Any abnormalities, location, extent, morphology, the number, size and signal intensity of lesions were evaluated. RESULTS: Twenty-eight patients were identified with AVN, The mean time to diagnosis of AVN was 119 days after the onset of SARS, or 116 days after steroid use. Three patients had early bilateral AVN of the femoral head, four patients of one femoral head, five patients of the bilateral hips and knees, four patients of the ipsilateral hip and knees, 10 patients of the knee(s), one patient of the right proximal fibula, and one patient of the knees and talus. Results of hip, knee and ankle plain radiographs were negative. CONCLUSION: AVN can occur in the patients with SARS. AVN had a strong association with steroid use. More studies are required to confirm whether the virus itself can also lead to AVN.

  7. Autophagy Limits Endotoxemic Acute Kidney Injury and Alters Renal Tubular Epithelial Cell Cytokine Expression.

    Leventhal, Jeremy S; Ni, Jie; Osmond, Morgan; Lee, Kyung; Gusella, G Luca; Salem, Fadi; Ross, Michael J


    Sepsis related acute kidney injury (AKI) is a common in-hospital complication with a dismal prognosis. Our incomplete understanding of disease pathogenesis has prevented the identification of hypothesis-driven preventive or therapeutic interventions. Increasing evidence in ischemia-reperfusion and nephrotoxic mouse models of AKI support the theory that autophagy protects renal tubular epithelial cells (RTEC) from injury. However, the role of RTEC autophagy in septic AKI remains unclear. We observed that lipopolysaccharide (LPS), a mediator of gram-negative bacterial sepsis, induces RTEC autophagy in vivo and in vitro through TLR4-initiated signaling. We modeled septic AKI through intraperitoneal LPS injection in mice in which autophagy-related protein 7 was specifically knocked out in the renal proximal tubules (ATG7KO). Compared to control littermates, ATG7KO mice developed more severe renal dysfunction (24hr BUN 100.1mg/dl +/- 14.8 vs 54.6mg/dl +/- 11.3) and parenchymal injury. After injection with LPS, analysis of kidney lysates identified higher IL-6 expression and increased STAT3 activation in kidney lysates from ATG7KO mice compared to controls. In vitro experiments confirmed an altered response to LPS in RTEC with genetic or pharmacological impairment of autophagy. In conclusion, RTEC autophagy protects against endotoxin induced injury and regulates downstream effects of RTEC TLR4 signaling.

  8. Autophagy Limits Endotoxemic Acute Kidney Injury and Alters Renal Tubular Epithelial Cell Cytokine Expression.

    Jeremy S Leventhal

    Full Text Available Sepsis related acute kidney injury (AKI is a common in-hospital complication with a dismal prognosis. Our incomplete understanding of disease pathogenesis has prevented the identification of hypothesis-driven preventive or therapeutic interventions. Increasing evidence in ischemia-reperfusion and nephrotoxic mouse models of AKI support the theory that autophagy protects renal tubular epithelial cells (RTEC from injury. However, the role of RTEC autophagy in septic AKI remains unclear. We observed that lipopolysaccharide (LPS, a mediator of gram-negative bacterial sepsis, induces RTEC autophagy in vivo and in vitro through TLR4-initiated signaling. We modeled septic AKI through intraperitoneal LPS injection in mice in which autophagy-related protein 7 was specifically knocked out in the renal proximal tubules (ATG7KO. Compared to control littermates, ATG7KO mice developed more severe renal dysfunction (24hr BUN 100.1mg/dl +/- 14.8 vs 54.6mg/dl +/- 11.3 and parenchymal injury. After injection with LPS, analysis of kidney lysates identified higher IL-6 expression and increased STAT3 activation in kidney lysates from ATG7KO mice compared to controls. In vitro experiments confirmed an altered response to LPS in RTEC with genetic or pharmacological impairment of autophagy. In conclusion, RTEC autophagy protects against endotoxin induced injury and regulates downstream effects of RTEC TLR4 signaling.

  9. Acute Retinal Necrosis Presenting in Developmentally-delayed Patients with Neonatal Encephalitis: A Case Series and Literature Review.

    Okafor, Kingsley; Lu, Jonathan; Thinda, Sumeer; Schwab, Ivan; Morse, Lawrence S; Park, Susanna S; Moshiri, Ala


    We report three cases of patients with developmental-delay from neonatal herpetic encephalitis and/or meningitis who presented years later with acute retinal necrosis due to herpes simplex virus. The diagnosis was delayed in all cases due to the patients' inability to verbalize their ocular complaints and cooperate with eye examinations. This case series documents the clinical course, pathophysiologic mechanism, and treatment of acute retinal necrosis in this patient population. Clinicians should understand the importance of prudent consideration of acute retinal necrosis in patients with a history of neonatal herpetic encephalitis and/or meningitis presenting with a red eye.

  10. 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


    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)

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

    Wei JIANG; Tong, Zhihui; YANG, DONGLIANG; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou


    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 ...

  12. [Acute kidney failure due to kidney cortex necrosis. 2 clinical cases of surviving patients].

    Fuenzalida, E


    A 22 year old female developed preeclampsia with fetal death in utero. After cesarean section she developed uterine inertia and acute hemorrhagic anemia complicated by sepsis, disseminated intravascular coagulation and total anuria for 4 weeks. She was treated with hemodialysis. The second patient, a 49 year old man developed sepsis and intravascular coagulation after a dog bite. Acute renal failure with a 3 week total anuria followed. He was initially treated with peritoneo dialysis. Renal biopsy showed evidence of renal cortical necrosis in both patients.

  13. Tumor necrosis factor α antibody prevents brain damage of rats with acute necrotizing pancreatitis

    Yan-Ling Yang; Ji-Peng Li; Kai-Zong Li; Ke-Feng Dou


    AIM: To study the protective effects of tumor necrosis factor á (TNFα) antibody on pancreatic encephalopathy in rats.METHODS:One hundred and twenty SD rats were randomly divided into normal control group,acute necrotizing pancreatitis group and TNFα antibody treated group.Acute hemorrhage necrotizing pancreatitis model in rats was induced by retrograde injection of 50 g/L sodium taurocholate into the pancreatobiliary duct.Serum TNFα was detected and animals were killed 12 h after drug administration.Changes in content of brain water,MDA and SOD as well as leucocyte adhesion of brain microvessels were measured.RESULTS:In TNFα antibody treated group,serum TNFálevel was decreased.Content of brain water,MDA and SOD as well as leucocyte adhesion were decreased significantly in comparison with those of acute necrotizing pancreatitis group (P<0.05).CONCLUSION:TNFα antibody can alleviate the brain damage of rats with acute hemorrhage necrotizing pancreatitis.

  14. Obese rats exhibit high levels of fat necrosis and isoprostanes in taurocholate-induced acute pancreatitis.

    Javier Pereda

    Full Text Available BACKGROUND: Obesity is a prognostic factor for severity in acute pancreatitis in humans. Our aim was to assess the role of oxidative stress and abdominal fat in the increased severity of acute pancreatitis in obese rats. METHODOLOGY: Taurocholate-induced acute pancreatitis was performed in lean and obese Zucker rats. Levels of reduced glutathione, oxidized glutathione, L-cysteine, cystine, and S-adenosylmethionine were measured in pancreas as well as the activities of serine/threonine protein phosphatases PP1 and PP2A and tyrosin phosphatases. Isoprostane, malondialdehyde, triglyceride, and free fatty acid levels and lipase activity were measured in plasma and ascites. Lipase activity was measured in white adipose tissue with and without necrosis and confirmed by western blotting. FINDINGS: Under basal conditions obese rats exhibited lower reduced glutathione levels in pancreas and higher triglyceride and free fatty acid levels in plasma than lean rats. S-adenosyl methionine levels were markedly increased in pancreas of obese rats. Acute pancreatitis in obese rats led to glutathione oxidation and lower reduced glutathione levels in pancreas together with decreased activities of redox-sensitive phosphatases PP1, and PP2A. S-adenosyl methionine levels decreased but cystine levels increased markedly in pancreas upon pancreatitis. Acute pancreatitis triggered an increase in isoprostane levels in plasma and ascites in obese rats. Free fatty acid levels were extremely high in pancreatitis-associated ascitic fluid from obese rats and lipase was bound with great affinity to white adipose tissue, especially to areas of necrosis. CONCLUSIONS: Our results show that oxidative stress occurs locally and systemically in obese rats with pancreatitis favouring inactivation of protein phosphatases in pancreas, which would promote up-regulation of pro-inflammatory cytokines, and the increase of isoprostanes which might cause powerful pulmonary and renal

  15. 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


    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.

  16. Prognosis of Acute Kidney Injury and Hepatorenal Syndrome in Patients with Cirrhosis: A Prospective Cohort Study

    Andrew S. Allegretti


    Full Text Available Background/Aims. Acute kidney injury is a common problem for patients with cirrhosis and is associated with poor survival. We aimed to examine the association between type of acute kidney injury and 90-day mortality. Methods. Prospective cohort study at a major US liver transplant center. A nephrologist’s review of the urinary sediment was used in conjunction with the 2007 Ascites Club Criteria to stratify acute kidney injury into four groups: prerenal azotemia, hepatorenal syndrome, acute tubular necrosis, or other. Results. 120 participants with cirrhosis and acute kidney injury were analyzed. Ninety-day mortality was 14/40 (35% with prerenal azotemia, 20/35 (57% with hepatorenal syndrome, 21/36 (58% with acute tubular necrosis, and 1/9 (11% with other (p=0.04 overall. Mortality was the same in hepatorenal syndrome compared to acute tubular necrosis (p=0.99. Mortality was lower in prerenal azotemia compared to hepatorenal syndrome (p=0.05 and acute tubular necrosis (p=0.04. Ten participants (22% were reclassified from hepatorenal syndrome to acute tubular necrosis because of granular casts on urinary sediment. Conclusions. Hepatorenal syndrome and acute tubular necrosis result in similar 90-day mortality. Review of urinary sediment may add important diagnostic information to this population. Multicenter studies are needed to validate these findings and better guide management.

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

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


    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.

  18. Acute kidney injury, hyperbilirubinemia, and ischemic skin necrosis due to massive sulindac overdose.

    Vaughn, John L; Shah, Kejal V; Ghossein, Maroun M; Meyer, William L; Kirkpatrick, Robert B


    Sulindac is a long-acting nonsteroidal anti-inflammatory drug (NSAID) widely used for the management of osteoarthritis, rheumatoid arthritis, ankylosing sponydlitis, and acute gouty arthritis. Reports of sulindac toxicity in the literature are rare. We report the case of a 22-year old male with a history of bipolar disorder who was brought to the emergency department after ingesting approximately 15 g of sulindac in a suicide attempt. He was found to have acute kidney injury and hyperbilirubinemia. Despite aggressive fluid resuscitation, his renal function progressively worsened requiring the initiation of hemodialysis. Ten days following ingestion of sulindac, he began to develop ischemic skin changes with a gangrenous appearance in his hands and feet. He continued to receive supportive treatment, and his acute kidney injury, hyperbillirubinemia, and ischemic skin necrosis eventually resolved. Clinicians should be aware of this long-acting NSAID and its ability to cause prolonged multisystem organ dysfunction.

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

    Neha Goel


    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.

  20. Fulminant bilateral acute retinal necrosis syndrome associated with viral encephalitis: A case report

    Zhou, Chunkui; Zhu, Lijun; Fang, Shaokuan


    Herpes simplex virus (HSV) is the most common cause of acute viral encephalitis. Acute retinal necrosis (ARN) is a rapidly progressing and potentially blinding eye disease that may be induced by HSV. The present case study reports the very rare case of a patient with herpes simplex encephalitis (HSE) combined with acute retinal necrosis (ARN). A 47-year-old woman was admitted to hospital with persistent high fever and somnolence for 5 days. Magnetic resonance imaging showed abnormal signals in the right medial temporal lobes, and HSV-1 was identified in the serum and cerebrospinal fluid. Five days later, despite treatment with intravenous acyclovir and partial improvement in consciousness, the patient suddenly developed blurred vision and bilateral visual pain. Fundus fluorescence angiography revealed bilateral vessel obstruction and flaky reduced fluorescence. ARN was diagnosed clinically. Dexamethasone was administered as an anti-inflammatory adjunct to intravenous acyclovir therapy. The visual acuity of the patient was reduced to mere light perception a further 4 days later. The present case indicates that HSE may be complicated with ARN, causing a reduction in visual acuity to mere light perception within a very short time. PMID:27698716

  1. Toll-like receptor and tumour necrosis factor dependent endotoxin-induced acute lung injury

    Togbe, Dieudonnée; Schnyder-Candrian, Silvia; Schnyder, Bruno; Doz, Emilie; Noulin, Nicolas; Janot, Laure; Secher, Thomas; Gasse, Pamela; Lima, Carla; Coelho, Fernando Rodrigues; Vasseur, Virginie; Erard, François; Ryffel, Bernhard; Couillin, Isabelle; Moser, Rene


    Recent studies on endotoxin/lipopolysaccharide (LPS)-induced acute inflammatory response in the lung are reviewed. The acute airway inflammatory response to inhaled endotoxin is mediated through Toll-like receptor 4 (TLR4) and CD14 signalling as mice deficient for TLR4 or CD14 are unresponsive to endotoxin. Acute bronchoconstriction, tumour necrosis factor (TNF), interleukin (IL)-12 and keratinocyte-derived chemokine (KC) production, protein leak and neutrophil recruitment in the lung are abrogated in mice deficient for the adaptor molecules myeloid differentiation factor 88 (MyD88) and Toll/Interleukin-1 receptor (TIR)-domain-containing adaptor protein (TIRAP), but independent of TIR-domain-containing adaptor-inducing interferon-beta (TRIF). In particular, LPS-induced TNF is required for bronchoconstriction, but dispensable for inflammatory cell recruitment. Lipopolysaccharide induces activation of the p38 mitogen-activated protein kinase (MAPK). Inhibition of pulmonary MAPK activity abrogates LPS-induced TNF production, bronchoconstriction, neutrophil recruitment into the lungs and broncho-alveolar space. In conclusion, TLR4-mediated, bronchoconstriction and acute inflammatory lung pathology to inhaled endotoxin are dependent on TLR4/CD14/MD2 expression using the adapter proteins TIRAP and MyD88, while TRIF, IL-1R1 or IL-18R signalling pathways are dispensable. Further downstream in this axis of signalling, TNF blockade reduces only acute bronchoconstriction, while MAPK inhibition abrogates completely endotoxin-induced inflammation. PMID:18039275

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

    Mohamed Noorulla


    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

  3. Inhibition of tubular cell proliferation by neutralizing endogenous HGF leads to renal hypoxia and bone marrow-derived cell engraftment in acute renal failure.

    Ohnishi, Hiroyuki; Mizuno, Shinya; Nakamura, Toshikazu


    During the progression of acute renal failure (ARF), the renal tubular S3 segment is sensitive to ischemic stresses. For reversing tubular damage, resident tubular cells proliferate, and bone marrow-derived cells (BMDC) can be engrafted into injured tubules. However, how resident epithelium or BMDC are involved in tubular repair remains unknown. Using a mouse model of ARF, we examined whether hepatocyte growth factor (HGF) regulates a balance of resident cell proliferation and BMDC recruitment. Within 48 h post-renal ischemia, tubular destruction became evident, followed by two-waved regenerative events: 1) tubular cell proliferation between 2 and 4 days, along with an increase in blood HGF; and 2) appearance of BMDC in the tubules from 6 days postischemia. When anti-HGF IgG was injected in the earlier stage, tubular cell proliferation was inhibited, leading to an increase in BMDC in renal tubules. Under the HGF-neutralized state, stromal cell-derived factor-1 (SDF1) levels increased in renal tubules, associated with the enhanced hypoxia. Administrations of anti-SDF1 receptor IgG into ARF mice reduced the number of BMDC in interstitium and tubules. Thus possible cascades include 1) inhibition of tubular cell proliferation by neutralizing HGF leads to renal hypoxia and SDF1 upregulation; and 2) BMDC are eventually engrafted in tubules through SDF1-mediated chemotaxis. Inversely, administration of recombinant HGF suppressed the renal hypoxia, SDF1 upregulation, and BMDC engraftment in ARF mice by enhancing resident tubular cell proliferation. Thus we conclude that HGF is a positive regulator for eliciting resident tubular cell proliferation, and SDF1 for BMDC engraftment during the repair process of ARF.

  4. 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)


    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.)

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

    Marina C Oliveira

    Full Text Available 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.

  6. Determination of the infectious nature of the agent of acute hepatopancreatic necrosis syndrome affecting penaeid shrimp.

    Tran, Loc; Nunan, Linda; Redman, Rita M; Mohney, Leone L; Pantoja, Carlos R; Fitzsimmons, Kevin; Lightner, Donald V


    A new emerging disease in shrimp, first reported in 2009, was initially named early mortality syndrome (EMS). In 2011, a more descriptive name for the acute phase of the disease was proposed as acute hepatopancreatic necrosis syndrome (AHPNS). Affecting both Pacific white shrimp Penaeus vannamei and black tiger shrimp P. monodon, the disease has caused significant losses in Southeast Asian shrimp farms. AHPNS was first classified as idiopathic because no specific causative agent had been identified. However, in early 2013, the Aquaculture Pathology Laboratory at the University of Arizona was able to isolate the causative agent of AHPNS in pure culture. Immersion challenge tests were employed for infectivity studies, which induced 100% mortality with typical AHPNS pathology to experimental shrimp exposed to the pathogenic agent. Subsequent histological analyses showed that AHPNS lesions were experimentally induced in the laboratory and were identical to those found in AHPNS-infected shrimp samples collected from the endemic areas. Bacterial isolation from the experimentally infected shrimp enabled recovery of the same bacterial colony type found in field samples. In 3 separate immersion tests, using the recovered isolate from the AHPNS-positive shrimp, the same AHPNS pathology was reproduced in experimental shrimp with consistent results. Hence, AHPNS has a bacterial etiology and Koch's Postulates have been satisfied in laboratory challenge studies with the isolate, which has been identified as a member of the Vibrio harveyi clade, most closely related to V. parahemolyticus.

  7. Liver necrosis induced by acute intraperitoneal ethanol administration in aged rats.

    Giavarotti, Leandro; D'Almeida, Vania; Giavarotti, Karin A S; Azzalis, Ligia A; Rodrigues, Luciano; Cravero, Amerys A M; Videla, Luis A; Koch, Osvaldo R; Junqueira, Virginia B C


    It is generally agreed that the deleterious pathophysiological effects of ethanol are caused, at least partially by an increase in free radical production. However, little attention has been directed to the effects of ethanol upon elderly organisms. Male Wistar rats at ages 3, 6, 12, 18 and 24 months were treated either with a single i.p. dose of 35% ethanol (v/v) at 3 g ethanol/kg body weight or an isovolumetric amount of 0.9% saline solution. We then assessed the plasma levels of transaminases and hepatic levels of oxidative stress-related parameters, followed by liver histological evaluation. The younger rats (3 months old) were not affected by the treatment with ethanol with respect to any of the studied parameters except for a lowering of total hepatic GSH and an increase in hepatic thiobarbituric acid reactants (TBARS) formation, while animals older than 3 months were increasingly more affected by the treatment. Acute ethanol treatment elicited the similar responses to those in the 3 months-old group, plus a decrease in the hepatic and plasma levels of beta-carotene and the plasma level of alpha-tocopherol, as well as an increase in the activity of plasma transaminases. In the 12,18 and 24 months old groups, there was increasing liver necrosis. These findings suggest that liver damage induced by acute ethanol administration in elderly rats may involve a lack of antioxidants.

  8. Changing picture of renal cortical necrosis in acute kidney injury in developing country.

    Prakash, Jai; Singh, Vijay Pratap


    Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis. It is a rare cause of acute kidney injury (AKI) in developed countries with frequency of 1.9%-2% of all patients with AKI. In contrast, RCN incidence is higher in developing countries ranging between 6%-7% of all causes of AKI. Obstetric complications (septic abortion, puerperal sepsis, abruptio placentae, postpartum haemorrhage and eclampsia) are the main (60%-70%) causes of RCN in developing countries. The remaining 30%-40% cases of RCN are caused by non-obstetrical causes, mostly due to sepsis and HUS. The incidence of RCN ranges from 10% to 30% of all cases of obstetric AKI compared with only 5% in non-gravid patients. In the developed countries, RCN accounts for 2% of all cases of AKI in adults and more than 20% of AKI during the third trimester of pregnancy. The reported incidence of RCN in obstetrical AKI varies between 18%-42.8% in different Indian studies. However, the overall incidence of RCN in pregnancy related AKI has decreased from 20%-30% to 5% in the past two decades in India. Currently RCN accounts for 3% of all causes of AKI. The incidence of RCN in obstetrical AKI was 1.44% in our recent study. HUS is most common cause of RCN in non-obstetrical group, while puerperal sepsis is leading cause of RCN in obstetric group. Because of the catastrophic sequelae of RCN, its prevention and aggressive management should always be important for the better renal outcome and prognosis of the patients.

  9. Serum and urinary insulin-like growth factor-1 and tumor necrosis factor in neonates with and without acute renal failure.

    Kornhauser, Carlos; Dubey, Luis-Antonio; Garay, M-Eugenia; Pérez-Luque, Elva-Leticia; Malacara, Juan-Manuel; Vargas-Origel, Arturo


    Acute renal failure (ARF) in neonates may occur after renal ischemia. Growth factors participate in the tubular regeneration process. Insulin-like growth factor-1 (IGF-1) is produced in the kidney during the recovery phase of ARF. Tumor necrosis factor-alpha (TNFalpha) may play a role in renal apoptosis. We examined serum and urinary IGF-1 and TNFalpha in neonates with or without ARF after asphyxia, in order to assess their possible use as markers of renal damage and recovery. We studied 20 full-term asphyxiated neonates, 10 with ARF and 10 without ARF, and compared them with 13 normal newborns for 7 days after birth. Blood urea, creatinine, pH, base deficit, and serum and urine IGF-1 and TNFalpha were assessed. Neonates with ARF had more-severe acidosis than patients without ARF. All patients had lower serum IGF-1 values immediately after birth than control children. Serum IGF-1 remained low in the ARF patients. The initial urinary IGF-1 was higher in all patients compared with control newborns, and remained elevated for the rest of the study only in the ARF neonates. Serum and urinary TNFalpha concentrations were similar for all healthy and diseased neonates. Measurement of serum and urinary IGF-1 levels in ARF neonates might be of additional value for clinical assessment of ARF.

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

    L. Julián Gómez


    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.

  11. 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


    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.

  12. 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


    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 10(4) 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.

  13. 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


    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

  14. Acute Kidney Injury: Tubular Markers and Risk for Chronic Kidney Disease and End-Stage Kidney Failure.

    Tan, Hon Liang; Yap, John Q; Qian, Qi


    Acute kidney injury (AKI) is a common clinical syndrome directly related to patient short-term and long-term morbidity and mortality. Over the last decade, the occurrence rate of AKI has been increasing, and there has also been a growing epidemic of chronic kidney diseases (CKD) and end-stage kidney disease (ESRD) linked to severe and repeated episodes of AKIs. The detection and management of AKI are currently far from satisfactory. A large proportion of AKI patients, especially those with preexisting CKD, are at an increased risk of non-resolving AKI and progressing to CKD and ESRD. Proposed pathological processes that contribute to the transition of AKI to CKD and ESRD include severity and frequency of kidney injury, alterations of tubular cell phenotype with cells predominantly in the G2/M phase, interstitial fibrosis and microvascular rarification related to loss of endothelial-pericyte interactions and pericyte dedifferentiation. Innate immune responses, especially dendritic cell responses related to inadequate adenosine receptor (2a)-mediated signals, autophagic insufficiency and renin-angiotensin system activation have also been implicated in the progression of AKI and transitions from AKI to CKD and ESRD. Although promising advances have been made in understanding the pathophysiology of AKI and AKI consequences, much more work needs to be done in developing biomarkers for detecting early kidney injury, prognosticating kidney disease progression and developing strategies to effectively treat AKI and to minimize AKI progression to CKD and ESRD.

  15. Tumor necrosis factor downregulates granulocyte-colony-stimulating factor receptor expression on human acute myeloid leukemia cells and granulocytes.

    Elbaz, O; Budel, L M; Hoogerbrugge, H; Touw, I P; Delwel, R.; Mahmoud, L A; Löwenberg, B. (Bernward)


    Tumor necrosis factor (TNF) inhibits granulocyte-colony-stimulating factor (G-CSF)-induced human acute myeloid leukemia (AML) growth in vitro. Incubation of blasts from three patients with AML in serum-free medium with TNF (10(3) U/ml), and subsequent binding studies using 125I-G-CSF reveal that TNF downregulates the numbers of G-CSF receptors by approximately 70%. G-CSF receptor numbers on purified blood granulocytes are also downmodulated by TNF. Downregulation of G-CSF receptor expression ...

  16. Detecting Acute Myocardial Infarction by Diffusion-Weighted versus T2-Weighted Imaging and Myocardial Necrosis Markers

    Chen, Min; Li, Yongjun; Wang, YaLing; Zhang, Shijun; Wang, Zhen; Wang, Lin; Ju, Shenghong


    We used a porcine model of acute myocardial infarction to study the signal evolution of ischemic myocardium on diffusion-weighted magnetic resonance images (DWI). Eight Chinese miniature pigs underwent percutaneous left anterior descending or left circumflex coronary artery occlusion for 90 minutes followed by reperfusion, which induced acute myocardial infarction. We used DWI preprocedurally and hourly for 4 hours postprocedurally. We acquired turbo inversion recovery magnitude T2-weighted images (TIRM T2WI) and late gadolinium enhancement images from the DWI slices. We measured the serum myocardial necrosis markers myoglobin, creatine kinase-MB isoenzyme, and cardiac troponin I at the same time points as the magnetic resonance scanning. We used histochemical staining to confirm injury. All images were analyzed qualitatively. Contrast-to-noise ratio (the contrast between infarcted and healthy myocardium) and relative signal index were used in quantitative image analysis. We found that DWI identified myocardial signal abnormity early (clinical serologic biomarkers.

  17. Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis.

    Shahi, Sanjeet K


    Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis.

  18. Effect of Tumor Necrosis Factor-α on Neutralization of Ventricular Fibrillation in Rats with Acute Myocardial Infarction

    Yu Chen


    Full Text Available The purpose of this study was to explore the effects of tumor necrosis factor-α (TNF-α on ventricular fibrillation (VF in rats with acute myocardial infarction (AMI. Rats were randomly classified into AMI group, sham operation group and recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNFR:Fc group. Spontaneous and induced VFs were recorded. Monophasic action potentials (MAPs among different zones of myocardium were recorded at eight time points before and after ligation and MAP duration dispersions (MAPDds were calculated. Then expression of TNF-α among different myocardial zones was detected. After ligation of the left anterior descending coronary artery, total TNF-α expression in AMI group began to markedly increase at 10 min, reached a climax at 20–30min, and then gradually decreased. The time-windows of VFs and MAPDds in the border zone performed in a similar way. At the same time-point, the expression of TNF-α in the ischemia zone was greater than that in the border zone, and little in the non-ischemia zone. Although the time windows of TNF-α expression, the MAPDds in the border zone and the occurrence of VFs in the rhTNFR:Fc group were similar to those in the AMI group, they all decreased in the rhTNFR:Fc group. Our findings demonstrate that TNF-α could enlarge the MAPDds in the border zone, and promote the onset of VFs.

  19. Acute pancreatitis-induced enzyme release and necrosis are attenuated by IL-1 antagonism through an indirect mechanism.

    Fink, G; Yang, J; Carter, G; Norman, J


    Interleukin-1 beta (IL-1) is a proinflammatory cytokine which is produced within the pancreas during acute pancreatitis reaching levels which are toxic to many cell types. Since antagonism of this cytokine provides dramatic survival benefits during lethal pancreatitis, we hypothesized that IL-1 had direct secretagogue and cytolytic effects within the pancreas. The effect of IL-1 on pancreatic exocrine function and tissue viability was assessed in vivo by blockade of IL-1 with varying doses of IL-1 receptor antagonist (IL-1ra) prior to the induction of either moderate (caerulein-induced) or severe (choline deficient diet-induced) necrotizing pancreatitis. Subsequent in vitro studies were conducted to determine the direct effect of IL-1 on dispersed rat acini prepared through collagenase digestion. Amylase release was measured after a 30-min incubation with varying doses of recombinant IL-1 beta. Viability was determined in the presence of IL-1 via trypan blue exclusion at multiple time points. Blockade of the IL-1 receptor decreased pancreatic amylase release and tissue necrosis in both models of pancreatitis in a dose-dependent fashion (1.0 mg/kg, P = NS; 10 mg/kg, P amylase release and tissue necrosis are significantly attenuated during experimental pancreatitis by IL-1 antagonism. These changes do not appear to be due to the direct action of IL-1 on pancreatic acini and are likely due to more complex interactions between acini and cytokine-producing leukocytes.

  20. Detecting Acute Myocardial Infarction by Diffusion-Weighted versus T2-Weighted Imaging and Myocardial Necrosis Markers.

    Jin, Jiyang; Chen, Min; Li, Yongjun; Wang, YaLing; Zhang, Shijun; Wang, Zhen; Wang, Lin; Ju, Shenghong


    We used a porcine model of acute myocardial infarction to study the signal evolution of ischemic myocardium on diffusion-weighted magnetic resonance images (DWI). Eight Chinese miniature pigs underwent percutaneous left anterior descending or left circumflex coronary artery occlusion for 90 minutes followed by reperfusion, which induced acute myocardial infarction. We used DWI preprocedurally and hourly for 4 hours postprocedurally. We acquired turbo inversion recovery magnitude T2-weighted images (TIRM T2WI) and late gadolinium enhancement images from the DWI slices. We measured the serum myocardial necrosis markers myoglobin, creatine kinase-MB isoenzyme, and cardiac troponin I at the same time points as the magnetic resonance scanning. We used histochemical staining to confirm injury. All images were analyzed qualitatively. Contrast-to-noise ratio (the contrast between infarcted and healthy myocardium) and relative signal index were used in quantitative image analysis. We found that DWI identified myocardial signal abnormity early (acute myocardial infarction and identified the infarct-related high signal more often than did TIRM T2WI: 7 of 8 pigs (87.5%) versus 3 of 8 (37.5%) (P=0.046). Quantitative image analysis yielded a significant difference in contrast-to-noise ratio and relative signal index between infarcted and normal myocardium on DWI. However, within 4 hours after infarction, the serologic myocardial injury markers were not significantly positive. We conclude that DWI can be used to detect myocardial signal abnormalities early after acute myocardial infarction-identifying the infarction earlier than TIRM T2WI and widely used clinical serologic biomarkers.

  1. One compound of saponins from Disocorea zingiberensis protected against experimental acute pancreatitis by preventing mitochondria-mediated necrosis

    Zhang, Rui; Wen, Li; Shen, Yan; Shi, Na; Xing, Zhihua; Xia, Qing; Niu, Hai; Huang, Wen


    Acute pancreatitis (AP) is a painful inflammatory disorder of the exocrine pancreas, ranking as the most common gastrointestinal reasons for hospitalization with no specific therapy currently. Diosgenyl saponins extracted from natural products and diosgenin or its derivatives have been shown to exert anti-inflammatory effects in various diseases. However, the therapeutic effects of diosgenyl saponins from Dioscorea zingiberensis C. H. Wright in AP have not yet been determined. Five compounds were extracted and screened for taurocholate-induced necrosis in mouse pancreatic acinar cells. Particularly, 26-O-β-d-glucopyranosyl-3β, 22α, 26-trihydroxy-25(R)-furosta-5-en-3-O-[α-L-rhamnopyranosyl-(1 → 4)]-β-d-glucopyranoside (compound 1) exhibited the best protective effects with no toxicity observed. Next, we showed compound 1 concentration-dependently inhibited necrotic cell death pathway activation and 2.5 mM compound 1 also prevented the loss of mitochondrial membrane potential, adenosine triphosphate production, and reactive oxygen species generation in mouse pancreatic acinar cells. Finally, we showed compound 1 protected against three clinically representative murine models of AP and significantly improved pancreatitis-associated acute lung injury. These data provide in vitro and in vivo evidence that one compound of diosgenyl saponins can be potential treatment for AP. This study suggests natural saponins may serve as fruitful sources for exploring/identifying potential therapies for inflammatory diseases. PMID:27779235

  2. 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


    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

  3. 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


    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.

  4. Association of two polymorphisms of tumor necrosis factor gene with acute biliary pancreatitis

    Dian-Liang Zhang; Jie-Shou Li; Zhi-Wei Jiang; Bao-Jun Yu; Xing-Ming Tang; Hong-Mei Zheng


    AIM: To investigate TNF-α-308 and TNFB polymorphisms in acute biliary pancreatitis (ABP) and to related them to the plasma TNF-α levels.METHODS: Genomic DNA was prepared from peripheral blood leukocytes. Genotypes and allele frequencies were determined in patients (n=127) and healthy controls (n=-102)using restriction fragment length polymorphism analysis of polymerase chain reaction (PCR) products. Reading the size of digested bands from polyacrylamide gel demonstrated the two alleles TNF1 and TNF2, or the two alleles TNFB1and TNFB2.RESULTS: The frequencies of TNF2 polymorphism and TNFB2 polymorphism were both similar in patients with mild or severe pancreatitis, so were in pancreatitis patients and in controls. Patients with septic shock showed a significantly higher prevalence of the TNF2 than those without. No significant differences were found in the genotype distribution of TNF-α-308 and TNFB among different groups. Plasma TNF-α levels did not differ significantly in ASBP patients displaying different alleles of the TNF gene studied.CONCLUSION: Results indicate that TNF gene polymorphisms studied play no part in determination of disease severity or susceptibility to acute biliary pancreatitis; however, TNF2polymorphism is associated with septic shock from ASBP.Genetic factors are not important in determining plasma TNF-α levels in ASBP.

  5. Role of interleukin-1 and tumour necrosis factor in leukocyte recruitment to acute dermal inflammation

    Andrew C. Issekutz


    Full Text Available The cytokines IL-1 and TNF-α are involved in inflammation and their production is stimulated by various agents, especially endotoxin (LPS. Here, using the human IL-1 receptor antagonist (IL-1RA and a new monoclonal antibody (mAb 7F11 to rabbit TNF, the role of endogenous IL-l and TNF production in acute (3h leukocyte (PMNL recruitment to dermal inflammation in rabbits has been studied. IL-1RA inhibited by 27% the PMNL accumulation in reactions induced by killed Escherichia coli (p < 0.05 but not by LPS. The monoclonal antibody to TNF inhibited by 27% and 38% (p < 0.002 the PMNL accumulation in LPS and E. coli reactions respectively, but a combination of the mAb with IL-1RA was not more effective. Treatment of human umbilical vein endothelium with LPS for 3 h activated endothelium to induce PMNL transendothelial migration in vitro, which was not inhibited by IL-1RA, antibody to TNF-α, IL-1 or to IL-8. In conclusion, TNF and IL-1 may partially mediate acute PMNL infiltration in vivo to LPS and Gram negative bacteria, but there is a major IL-1/TNF independent mechanism, at least in dermal inflammation, which may be due to direct LPS activation of the microvasculature or perhaps the generation of cytokines other than IL-1 and TNF.

  6. Markers of tubular dysfunction.

    Piscator, M


    Since the first description of tubular proteinuria in 1958, much progress has been made with regard to diagnostic means for detecting small changes in the function of the proximal tubule. Small increases in the excretion of low-molecular-weight proteins can now be determined with great accuracy. Determination of total protein is an economic way of screening large populations but does not give specific information on the type of damage. Determinations of glucose, phosphate and amino acids are relatively insensitive methods, since their excretion is also dependent on diet and nutritional status. Determination of high-molecular-weight enzymes released from damaged tubular cells may be of use for studies of acute as well as chronic effects of nephrotoxic agents, but more data are needed.

  7. 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: [Canadian Blood Services R& D, Edmonton, Alberta T6G 2R8 (Canada); Departments of Medicine and Oncology, University of Alberta, Edmonton, Alberta T6G 2G3 (Canada)


    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.

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

    Anna Janowska-Wieczorek


    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.

  9. High-Quality Draft Genomes of Two Vibrio parahaemolyticus Strains Aid in Understanding Acute Hepatopancreatic Necrosis Disease of Cultured Shrimps in Mexico

    Noriega-Orozco, Lorena; Sotelo-Mundo, Rogerio R.; Cantu-Robles, Vito A.; Cobian-Guemes, Ana G.; Cota-Verdugo, Rosario G.; Gamez-Alejo, Luis A.; del Pozo-Yauner, Luis; Guevara-Hernandez, Eduardo; Garcia-Orozco, Karina D.; Lopez-Zavala, Alonso A.


    The high-quality draft genomes of two Vibrio parahaemolyticus strains, one that causes the acute hepatopancreatic necrosis disease (AHPND) in cultured shrimps (FIM-S1708+), and another that does not (FIM-S1392−) are reported. A chromosome-scale assembly for the FIM-S1392− genome is reported here. The analysis of the two genomes gives some clues regarding the genomic differences between the strains. PMID:25125645

  10. Nebulized Pentamidine-Induced Acute Renal Allograft Dysfunction

    Siddhesh Prabhavalkar


    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.

  11. Acute Interstitial Nephritis induced by Intermittent use of Rifampicin in Patient with Brucellosis

    Salih S


    Full Text Available 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.

  12. Proximal renal tubular acidosis

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... are neutralized by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate ...

  13. The expression of tumor necrosis factor-alpha, its receptors and steroidogenic acute regulatory protein during corpus luteum regression

    Arfuso Frank


    Full Text Available Abstract Background Corpus luteum (CL regression is known to occur as two parts; functional regression when steroidogenesis declines and structural regression when apoptosis is induced. Previous studies suggest this process occurs by the production of luteolytic factors, such as tumour necrosis factor-alpha (TNF-alpha. Methods We examined TNF-alpha, TNF-alpha receptors (TNFR1 and 2 and steroidogenic acute regulatory (StAR protein expression during CL regression in albino Wistar rats. CL from Days 16 and 22 of pregnancy and Day 3 post-partum were examined, in addition CL from Day 16 of pregnancy were cultured in vitro to induce apoptosis. mRNA was quantitated by kinetic RT-PCR and protein expression examined by immunohistochemistry and Western blot analyses. Results TNF-alpha mRNA increased on Day 3 post-partum. TNFR were immunolocalized to luteal cells, and an increase in TNFR2 mRNA observed on Day 3 post-partum whilst no change was detected in TNFR1 mRNA relative to Day 16. StAR protein decreased on Day 3 post-partum and following trophic withdrawal but no change was observed following exogenous TNF-alpha treatment. StAR mRNA decreased on Day 3 post-partum; however, it increased following trophic withdrawal and TNF-alpha treatment in vitro. Conclusion These results demonstrate the existence of TNFR1 and TNFR2 in rat CL and suggest the involvement of TNF-alpha in rat CL regression following parturition. Furthermore, decreased StAR expression over the same time points was consistent with the functional regression of the CL.

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

    Parul Tandon; Natalie Wong; Zaltzman, Jeffrey S.


    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 tremor...

  15. Isoniazid-induced seizures with secondary rhabdomyolysis and associated acute renal failure in a dog.

    Haburjak, J J; Spangler, W L


    Isoniazid-induced seizures resulted in rhabdomyolysis and associated acute renal tubular necrosis in a dog. Rhabdomyolysis and myoglobinuric renal failure, although recognised in the dog, are reported infrequently as a consequence of seizures. The clinical presentation of isoniazid toxicity in a dog is described.

  16. A unified theory of sepsis-induced acute kidney injury: inflammation, microcirculatory dysfunction, bioenergetics, and the tubular cell adaptation to injury.

    Gomez, Hernando; Ince, Can; De Backer, Daniel; Pickkers, Peter; Payen, Didier; Hotchkiss, John; Kellum, John A


    Given that the leading clinical conditions associated with acute kidney injury (AKI), namely, sepsis, major surgery, heart failure, and hypovolemia, are all associated with shock, it is tempting to attribute all AKI to ischemia on the basis of macrohemodynamic changes. However, an increasing body of evidence has suggested that in many patients, AKI can occur in the absence of overt signs of global renal hypoperfusion. Indeed, sepsis-induced AKI can occur in the setting of normal or even increased renal blood flow. Accordingly, renal injury may not be entirely explained solely on the basis of the classic paradigm of hypoperfusion, and thus other mechanisms must come into play. Herein, we put forward a "unifying theory" to explain the interplay between inflammation and oxidative stress, microvascular dysfunction, and the adaptive response of the tubular epithelial cell to the septic insult. We propose that this response is mostly adaptive in origin, that it is driven by mitochondria, and that it ultimately results in and explains the clinical phenotype of sepsis-induced AKI.

  17. 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


    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

  18. 30-MM Tubular Projectile


    Suiza tubular projectile 20 9. Inspection of Hispano Suiza sabot 21 10. Inspection of GAU-8 sabot 22 11. Firing data - 30-rn tubular projectile (Hispano... Suiza 23 copper banded) 12. Firing data - 30-m tubular projectile (GAU-8 plastic 24 banded) 13. Firing data - 30-m tubular projectile (GAU-8 copper 25...42 13. In-flight Hispano Suiza tubular projectiles 43 14. In-flight C4U-8 (plastic) tubular projectile 44 15. In-flight GCU-8 (copper) tubular

  19. Effects of tumor necrosis factor, endothelin and nitric oxide on hyperdynamic circulation of rats with acute and chronic portal hypertension

    Ji-Jian Wang; Gen-Wu Gao; Ren-Zhong Gao; Chang-An Liu; Xiong Ding; Zhen-Xiang Yao


    AIM: To evaluate the effect of tumor necrosis factor (TNF),endothelin (ET) and nitric oxide (NO) on hyperdynamic circulation (HC) of rats with acute and chronic portal hypertension(PHT).METHODS: Chronic portal hypertension was induced in Wistar rats by injection of carbon tetrachloride. After two weeks of cirrhosis formation, L-NMMA (25 mg/kg) was injected into one group of cirrhotic rats via femoral vein and the experiment was begun immediately. Another group of cirrhotic rats was injected with anti-rat TNFa(300 mg/kg)via abdominal cavity twice within 48 h and the experiment was performed 24 h after the second injection. The blood concentrations of TNFc, ET-1 and NO in portal vein and the nitric oxide synthase (NOS) activity in hepatic tissue were determined pre-and post-injection of anti-rat TNFa or LNMMA. Stroke volume (SV), cardiac output (CO), portal pressure (PP), superior mesenteric artery blood flow (SMA flow) and lilac artery blood flow (IAflow) were measured simultaneously. Acute portal hypertension was established in Wistar rats by partial portal-vein ligation (PVL). The parameters mentioned above were determined at 0.5 h,24 h, 48 h, 72 h and 120 h after PVL. After the formation of stable PHT, the PVL rats were injected with anti-rat TNFa or L-NMMA according to different groups, the parameters mentioned above were also determined.RESULTS: In cirrhotic rats, the blood levels of TNFa, NO in portal vein and the liver NOS activity were significantly increased (P<0.05) while the blood level of ET-1 was not statistically different (P>0.05) from the control animals (477.67±83.81 pg/mL vS48.87±32.79 pg/mL, 278.41±20.11 μmol/L vs 113.28±14.51 μmol/L, 1.81±0.06 u/mg.prot vs 0.87±0.03 u/mg.prot and 14.33±4.42 pg/mL vs 8.72±0.79 pg/mL, respectively). After injection of anti-rat TNFa,the blood level of TNFa was lower than that in controls (15.17±18.79 pg/mL vs48.87±32.79 pg/mL). The blood level of NO and the liver NOS activity were significantly

  20. 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


    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.

  1. Flavonoid-induced acute nephropathy by Cupressus funebris Endl (Mourning Cypress).

    Lee, Jia-Jung; Chen, Hung-Chun


    Worldwide use of herbal therapy has increased dramatically in recent years. Most herbal therapies were not regulated as medicines, and their adverse effects often were underreported. We report a patient who developed acute renal failure, acute hepatic failure, autoimmune hemolytic anemia, and thrombocytopenia after oral intake of hot-water extract of Cupressus funebris Endl (Mourning Cypress), which is rich in flavonoids. Her renal biopsy showed acute tubular necrosis, interstitial nephritis, and hemoglobin casts. The clinical course and pathological findings were consistent with flavonoid-induced acute nephropathy. We emphasize that flavonoids are not harmless and may induce acute life-threatening renal damage.

  2. Paradoxical Effect of Hyperoncotic Albumin in Acutely Burned Children


    lob (gnil respiratory acidosis : but within a few hours, she suffered a I 12 2.880 1,8) 1(0.0 cardiac arrest and (tied. Acute tubular necrosis and...only minimally, and the acidosis er- stitial pulmonary edema were found at autopsy. sisted. Thirty-six hours postburn, the patient suffered the first...urea fluids and protein as fluid infusion proceeds (1). .4 nitrogen 48 mg/di. The hyperkalemia was treated with glucose, Certainly, the most

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

    M.C. Nogueira


    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.

  4. Avascular Necrosis

    ... Medical conditions, such as sickle cell anemia and Gaucher's disease, also can cause diminished blood flow to bone. ... conditions associated with avascular necrosis include: Pancreatitis Diabetes Gaucher's disease HIV/AIDS Systemic lupus erythematosus Sickle cell anemia ...

  5. 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 the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  6. Acute tubulo-interstitial nephritis leading to acute renal failure following multiple hornet stings

    Bambery Pradeep


    Full Text Available Abstract Background Hornet stings are generally associated with local and occasionally anaphylactic reactions. Rarely systemic complications like acute renal failure can occur following multiple stings. Renal failure is usually due to development of acute tubular necrosis as a result of intravascular haemolysis, rhabdomyolysis or shock. Rarely it can be following development of acute tubulo-interstitial nephritis. Case presentation We describe a young male, who was stung on face, head, shoulders and upper limbs by multiple hornets (Vespa orientalis. He developed acute renal failure as a result of acute tubulo-interstitial nephritis and responded to steroids. Conclusion Rare causes of acute renal failure like tubulo-interstitial nephritis should be considered in a patient with persistent oliguria and azotemia following multiple hornet stings. Renal biopsy should be undertaken early, as institution of steroid therapy may help in recovery of renal function

  7. Acute Portal Vein Thrombosis and Massive Necrosis of the Liver. An Unusual Complication After Stenting for Chronic Pancreatitis

    Velayutham Vimalraj


    Full Text Available Context ERCP can provide information which is invaluable in managing chronic pancreatitis but it is associated withinfrequent, although significant, complications and rare mortality. The complications uniquely associated withdiagnostic ERCP include pancreatitis and sepsis (primary cholangitis. Case report A 32-year-old man presented with severe upper abdominal pain radiating to the back, associated with vomiting and abdominal distension. The patient was diagnosed as having had chronic calcific pancreatitis recently and had undergone ERCP with pancreatic duct stenting elsewhere. Two days after the procedure, the patient developed severe abdominal pain, vomiting and abdominal distention, and patient was referred to our hospital 7 days after the procedure. Investigation revealed massive liver necrosis and portal vein thrombosis. This patient had a life-threatening complication following pancreatic duct stenting for chronic pancreatitis and was managed medically.Conclusion Therapeutic pancreatic endoscopy procedures are technically demanding and should be restricted to highvolume centers. There is a continuing need for evaluation and comparison with alternative strategies. In a good surgical candidate, it is better to avoid stenting.

  8. 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

  9. Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis.

    Smith, Joshua P; Arnoletti, J Pablo; Varadarajulu, Shyam; Morgan, Desiree E


    Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections typically become lower in attenuation over time, and often appear as homogeneous fluid collections. Saponification as a complication of fat necrosis in patients with acute pancreatitis is a well recognized clinical entity. While retroperitonal fat necrosis is commonly seen on CECT, saponification is not a prominent imaging feature. We present a case of acute pancreatitis complicated by extensive saponification of fat throughout the retroperitoneum and peritoneal lining, mimicking carcinomatosis.

  10. Acute p38-mediated modulation of tetrodotoxin-resistant sodium channels in mouse sensory neurons by tumor necrosis factor-alpha.

    Jin, Xiaochun; Gereau, Robert W


    Tumor necrosis factor-alpha (TNFalpha) is a proinflammatory cytokine involved in the development and maintenance of inflammatory and neuropathic pain conditions. TNFalpha can have long-lasting effects by regulating the expression of a variety of inflammatory mediators, including other cytokines and TNFalpha itself. However, the speed with which TNFalpha induces tactile and thermal hypersensitivity suggests that transcriptional regulation cannot fully account for its sensitizing effects, and some recent findings suggest that TNFalpha may act directly on primary afferent neurons to induce pain hypersensitivity. In the present study, we show that peripheral administration of TNFalpha induces thermal hypersensitivity in wild-type mice but not in transient receptor potential vanilloid receptor TRPV1(-/-) mice. In contrast, TNFalpha produced equivalent mechanical hypersensitivity in TRPV1(-/-) mice and wild-type littermates, suggesting a role for TRPV1 in TNFalpha-induced thermal, but not mechanical, hypersensitivity. Because tetrodotoxin (TTX)-resistant Na+ channels are a critical site of modulation underlying mechanical hypersensitivity in inflammatory and neuropathic pain conditions, we tested the effects of TNFalpha on these channels in isolated mouse dorsal root ganglion (DRG) neurons. We report that acute application of TNFalpha rapidly enhances TTX-resistant Na+ currents in isolated DRG neurons. This potentiation of TTX-resistant currents by TNFalpha is dramatically reduced in DRG neurons from TNF receptor 1 (TNFR1) knock-out mice and is blocked by the p38 mitogen-activated protein kinase inhibitor SB202190 [4-(4-fluorophenyl)-2-(4-hydroxyphenyl)-5-(4-pyridyl)1H-imidazole]. Mechanical hypersensitivity induced by peripherally applied TNFalpha is also significantly reduced by SB202190. These results suggest that TNFalpha may induce acute peripheral mechanical sensitization by acting directly on TNFR1 in primary afferent neurons, resulting in p38-dependent modulation

  11. 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.

  12. Impact of farm management on expression of early mortality syndrome/acute hepatopancreatic necrosis disease (EMS/AHPND) on penaeid shrimp farms in Thailand.

    Boonyawiwat, V; Patanasatienkul, T; Kasornchandra, J; Poolkhet, C; Yaemkasem, S; Hammell, L; Davidson, J


    Asian shrimp farming industry has experienced massive production losses due to a disease caused by toxins of Vibrio bacteria, known as early mortality syndrome/acute hepatopancreatic necrosis disease (EMS/AHPND) for the last 5 years. The disease can cause up to 100% cumulative pond mortality within a week. The objective of this study was to identify factors associated with AHPND occurrence on shrimp farms. A case-control study was carried out on shrimp farms in four provinces of Thailand. Factors related to farm characteristics, farm management, pond and water preparation, feed management, post-larvae (PL) shrimp and stock management were evaluated. Multivariable logistic regression analysis identified factors affecting AHPND occurrence at the pond level. Chlorine treatment, reservoir availability, use of predator fish in the water preparation, culture of multiple shrimp species in one farm and increased PL stocking density contributed to an increased risk of AHPND infection, while delayed first day of feeding, polyculture and water ageing were likely to promote outbreak protection. Additionally, the source of PL was found to be associated with AHPND occurrence in shrimp ponds, which requires further study at the hatchery level. Identification of these factors will facilitate the development of effective control strategies for AHPND on shrimp farms.

  13. Genetic diversity of Vibrio parahaemolyticus strains isolated from farmed Pacific white shrimp and ambient pond water affected by acute hepatopancreatic necrosis disease outbreak in Thailand.

    Chonsin, Kaknokrat; Matsuda, Shigeaki; Theethakaew, Chonchanok; Kodama, Toshio; Junjhon, Jiraphan; Suzuki, Yasuhiko; Suthienkul, Orasa; Iida, Tetsuya


    Acute hepatopancreatic necrosis disease (AHPND) is an emerging shrimp disease that causes massive die-offs in farmed shrimps. Recent outbreaks of AHPND in Asia have been causing great losses for shrimp culture and have become a serious socioeconomic problem. The causative agent of AHPND is Vibrio parahaemolyticus, which is typically known to cause food-borne gastroenteritis in humans. However, there have been few reports of the epidemiology of V. parahaemolyticus AHPND strains, and the genetic relationship among AHPND strains is unclear. Here, we report the genetic characterization of V. parahaemolyticus strains isolated from AHPND outbreaks in Thailand. We found eight isolates from AHPND-suspected shrimps and pond water that were positive for AHPND markers AP1 and AP2. PCR analysis confirmed that none of these eight AP-positive AHPND strains possesses the genes for the conventional virulence factors affecting to humans, such as thermostable direct hemolysin (TDH), TDH-related hemolysin (TRH) and type III secretion system 2. Phylogenetic analysis by multilocus sequence typing showed that the AHPND strains are genetically diverse, suggesting that AHPND strains were not derived from a single genetic lineage. Our study represents the first report of molecular epidemiology of AHPND-causing V. parahaemolyticus strains using multilocus sequence typing, and provides an insight into their evolutionary mechanisms.

  14. Effects of transforming growth factor beta, tumor necrosis factor alpha, interferon gamma and LIF-HILDA on the proliferation of acute myeloid leukemia cells.

    Kerangueven, F; Sempere, C; Tabilio, A; Mannoni, P


    A group of polypeptide factors that regulate cell growth and differentiation has been tested for their biological activities on the growth and differentiation of leukemic cells isolated from patients with Acute Myeloid Leukemias (AML). The effects of Transforming Growth Factor beta 1 (TGF beta), Tumor Necrosis Factor alpha (TNF alpha), Interferon gamma (IFN gamma) and LIF-HILDA were compared on leukemic cells cultured in vitro for seven days. Spontaneously growing leukemic cells were selected in order to study either inhibition or enhancement of proliferation induced by these factors. Only TGF beta 1 was found to induce a clear inhibition of leukemic proliferation in all cases tested. Recombinant TNF alpha and IFN gamma were found to induce either inhibition or enhancement of the proliferation on separate specimens. Under the conditions of culture, it was not possible to document any effect of LIF-HILDA. Cell differentiation and cell maturation were documented studying the modulation of cell surface antigens. TGF beta did not modify antigen expression on the cells surviving after 3 days in culture. Both TNF alpha and IFN gamma were found to enhance the expression of adhesion molecules and to a lesser extent, the expression of some lineage associated antigens. No effect of LIF-HILDA on antigen modulation was documented in the cases tested. These data confirm that TGF beta is by itself a potent inhibitor of the myeloid leukemia cells proliferation.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Acute renal failure after treatment with sunitinib in a patient with multiple myeloma.

    Leung, Nelson; Saucier, Nathan A; Zeldenrust, Steven R; Gunderson, Heidi D; Cornell, Lynn D


    Sunitinib is a multiple tyrosine kinase receptors inhibitor that is approved for the treatment of advanced renal cell carcinoma. Amongst its targets are fetal liver tyrosine kinase receptor 3 (FLT 3) and vascular endothelial growth factor receptor (VEGFR). Renal toxicity has not been reported from the trials, but several patients have been reported to develop a pre-eclampsia-like syndrome. We report the first case of acute tubular necrosis in a patient with multiple myeloma following treatment with sunitinib.

  16. Lipopolysaccharide-induced acute renal failure in conscious rats

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


    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 phosphodies......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......). LPS-induced fall in GFR and proximal tubular outflow were sustained on day 2. Furthermore, LPS-treated rats showed a marked increase in fractional distal water excretion, despite significantly elevated levels of plasma vasopressin (AVP). Semiquantitative immunoblotting showed that LPS increased...... the expression of the Na(+),K(+),2Cl(-)-cotransporter (BSC1) in the thick ascending limb, whereas the expression of the AVP-regulated water channel aquaporin-2 in the collecting duct (CD) was unchanged. Pretreatment with milrinone or Ro-20-1724 enhanced LPS-induced increases in plasma tumor necrosis factor...

  17. Distal renal tubular acidosis

    ... get better with treatment. When to Contact a Medical Professional Call your health care provider if you have symptoms of distal renal tubular acidosis. Get medical help right away if you develop emergency symptoms ...

  18. Tubular apocrine adenoma.

    Toribio, J; Zulaica, A; Peteiro, C


    We report a case of tubular apocrine adenoma located on the scalp, with characteristics of syringocystadenoma papilliferum in the superior part of the lesion. An interesting feature of the growth is its connective tissue involvement.

  19. Beneficial effects of post-transfusional hepatitis in acute myelogenous leukemia may be mediated by lipopolysaccharides, tumor necrosis factor alpha and interferon gamma.

    Treon, S P; Broitman, S A


    Post-transfusional hepatitis is often a complication in patients with acute myelogenous leukemia (AML) in whom survival is paradoxically prolonged. The etiology is unknown. In previous studies, we showed that impaired hepatic endotoxin (lipopolysaccharide, LPS) clearance in patients with acute viral hepatitis A, B, or C versus controls results in endotoxemia and tumor necrosis factor alpha (TNF-alpha) release. TNF-alpha mediates anti-proliferative and differentiating effects in AML cell lines. Interferon-gamma (IFN-gamma) released in acute viral hepatitis, acts in synergy with TNF-alpha. HL60, KG1, and U937 AML cells treated 3, 6, and 9 days with physiologically attainable TNF-alpha (10 U/ml), IFN-gamma (100 U/ml) and LPS (10 ng/ml) levels, have significantly diminished viability and cell growth versus controls. Treatment of HL60 AML cells with LPS/TNF-alpha/IFN-gamma also resulted in significantly increased monocytic pathway differentiation not seen with KG1 or U937 AML cells. HL60 AML cells treated with TNF-alpha/IFN-gamma for 6 days released endogenous TNF-alpha (1.57 U/10(6) cells) upon LPS stimulation compared to less than 0.01 U/10(6) cells in non-LPS-stimulated TNF-alpha/IFN-gamma-treated cells or untreated cells (p less than 0.0001). Untreated HL60 AML cells co-cultured with HL60 cells pretreated for 6 days with TNF-alpha/IFN-gamma and then subjected to LPS stimulation had significantly diminished cell growth compared to controls (p less than 0.0001). This effect could be reversed with anti-TNF-alpha antibody, supporting the concept that endogenous TNF-alpha release by LPS/TNF-alpha/IFN-gamma treated HL60 AML cells may act by paracrine means to suppress growth of other AML cells. The beneficial effects of post-transfusional hepatitis in AML patients may be mediated via LPS/TNF-alpha/IFN-gamma-induced AML cell growth suppression and/or terminal differentiation in which AML cells participate by releasing TNF-alpha after being acted upon by LPS

  20. [Complex etiology of acute renal failure in a newborn].

    Krzemień, Grazyna; Szmigielska, Agnieszka; Bieroza, Iwona; Roszkowska-Blaim, Maria


    Acute renal failure (ARF), which is diagnosed in 3.4-20% of newborns, is polyetiological in most cases. We present a newborn with non-oliguric ARF diagnosed in the first day of life, and caused by asphixia, intrauterine infection (IUI) and nephrotoxic effects of metotrexate treatment during pregnancy. Antibiotics, including netilmicin and vankomycin, were given because of IUI and infected central venous catheter. Dosage of drugs was adjusted to renal failure parameters, but monitoring of their serum levels was not available. It could cause augmented acute tubular necrosis and interstitial nephritis. Analysis of ARF risk factors in newborns helps in early diagnosis of renal damage and in prompt implementation of therapy.

  1. The role of necrosis, acute hypoxia and chronic hypoxia in 18F-FMISO PET image contrast: a computational modelling study

    Warren, Daniel R.; Partridge, Mike


    Positron emission tomography (PET) using 18F-fluoromisonidazole (FMISO) is a promising technique for imaging tumour hypoxia, and a potential target for radiotherapy dose-painting. However, the relationship between FMISO uptake and oxygen partial pressure ({{P}{{\\text{O}2}}} ) is yet to be quantified fully. Tissue oxygenation varies over distances much smaller than clinical PET resolution (<100 μm versus  ˜4 mm), and cyclic variations in tumour perfusion have been observed on timescales shorter than typical FMISO PET studies (˜20 min versus a few hours). Furthermore, tracer uptake may be decreased in voxels containing some degree of necrosis. This work develops a computational model of FMISO uptake in millimetre-scale tumour regions. Coupled partial differential equations govern the evolution of oxygen and FMISO distributions, and a dynamic vascular source map represents temporal variations in perfusion. Local FMISO binding capacity is modulated by the necrotic fraction. Outputs include spatiotemporal maps of {{P}{{\\text{O}2}}} and tracer accumulation, enabling calculation of tissue-to-blood ratios (TBRs) and time-activity curves (TACs) as a function of mean tissue oxygenation. The model is characterised using experimental data, finding half-maximal FMISO binding at local {{P}{{\\text{O}2}}} of 1.4 mmHg (95% CI: 0.3-2.6 mmHg) and half-maximal necrosis at 1.2 mmHg (0.1-4.9 mmHg). Simulations predict a non-linear non-monotonic relationship between FMISO activity (4 hr post-injection) and mean tissue {{P}{{\\text{O}2}}} : tracer uptake rises sharply from negligible levels in avascular tissue, peaking at  ˜5 mmHg and declining towards blood activity in well-oxygenated conditions. Greater temporal variation in perfusion increases peak TBRs (range 2.20-5.27) as a result of smaller predicted necrotic fraction, rather than fundamental differences in FMISO accumulation under acute hypoxia. Identical late FMISO uptake can occur in regions with differing

  2. Characterization and PCR Detection Of Binary, Pir-Like Toxins from Vibrio parahaemolyticus Isolates that Cause Acute Hepatopancreatic Necrosis Disease (AHPND in Shrimp.

    Ratchanok Sirikharin

    Full Text Available Unique isolates of Vibrio parahaemolyticus (VPAHPND have previously been identified as the causative agent of acute hepatopancreatic necrosis disease (AHPND in shrimp. AHPND is characterized by massive sloughing of tubule epithelial cells of the hepatopancreas (HP, proposed to be induced by soluble toxins released from VPAHPND that colonize the shrimp stomach. Since these toxins (produced in broth culture have been reported to cause AHPND pathology in reverse gavage bioassays with shrimp, we used ammonium sulfate precipitation to prepare protein fractions from broth cultures of VPAHPND isolates for screening by reverse gavage assays. The dialyzed 60% ammonium sulfate fraction caused high mortality within 24-48 hours post-administration, and histological analysis of the moribund shrimp showed typical massive sloughing of hepatopancreatic tubule epithelial cells characteristic of AHPND. Analysis of the active fraction by SDS-PAGE revealed two major bands at marker levels of approximately 16 kDa (ToxA and 50 kDa (ToxB. Mass spectrometry analysis followed by MASCOT analysis revealed that both proteins had similarity to hypothetical proteins of V. parahaemolyticus M0605 (contig034 GenBank accession no. JALL01000066.1 and similarity to known binary insecticidal toxins called 'Photorhabdus insect related' proteins A and B (Pir-A and Pir-B, respectively, produced by the symbiotic, nematode bacterium Photorhabdus luminescens. In in vivo tests, it was shown that recombinant ToxA and ToxB were both required in a dose dependent manner to cause AHPND pathology, indicating further similarity to Pir-A and -B. A single-step PCR method was designed for detection of the ToxA gene and was validated using 104 bacterial isolates consisting of 51 VPAHPND isolates, 34 non-AHPND VP isolates and 19 other isolates of bacteria commonly found in shrimp ponds (including other species of Vibrio and Photobacterium. The results showed 100% specificity and sensitivity for

  3. Walled-off pancreatic necrosis

    Michael; Stamatakos; Charikleia; Stefanaki; Konstantinos; Kontzoglou; Spyros; Stergiopoulos; Georgios; Giannopoulos; Michael; Safioleas


    Walled-off pancreatic necrosis (WOPN), formerly known as pancreatic abscess is a late complication of acute pancreatitis. It can be lethal, even though it is rare. This critical review provides an overview of the continually expanding knowledge about WOPN, by review of current data from references identified in Medline and PubMed, to September 2009, using key words, such as WOPN, infected pseudocyst, severe pancreatitis, pancreatic abscess, acute necrotizing pancreatitis (ANP), pancreas, inflammation and al...

  4. A unified theory of sepsis-induced acute kidney injury: inflammation, microcirculatory dysfunction, bioenergetics, and the tubular cell adaptation to injury

    Gomez, H.; Ince, C.; Backer, D. de; Pickkers, P.; Payen, D.; Hotchkiss, J.; Kellum, J.A.


    Given that the leading clinical conditions associated with acute kidney injury (AKI), namely, sepsis, major surgery, heart failure, and hypovolemia, are all associated with shock, it is tempting to attribute all AKI to ischemia on the basis of macrohemodynamic changes. However, an increasing body of

  5. Espirales tubulares para turbinas

    Editorial, Equipo


    Full Text Available Para el suministro y fabricación de las espirales tubulares que debían alimentar las turbinas del aprovechamiento hidroeléctrico de Brownlee, que constituye el primero de los cuatro saltos del grupo Hells Canyon, del río Snake, la conocida factoría S. Morgan Smith, especializada en la construcción de turbinas y material a ellas accesorio, se encargó del estudio, fabricación y montaje de cuatro de estas espirales tubulares de 5,50 m de diámetro máximo.

  6. [Rhabdomyolysis with acute renal failure and malignant neuroleptic syndrome].

    Kleinknecht, D; Parent, A; Blot, P; Bochereau, G; Lallement, P Y; Pourriat, J L


    Seven episodes of rhabdomyolysis with acute renal failure (ARF) have been observed in 6 patients treated with various short-acting tranquilizers and antidepressants. Clinical features usually included severe hyperthermia, diffuse hypertonicity with or without coma, circulatory failure or unstable blood pressure, and often acute respiratory failure. Serum CPK were always elevated. The type of ARF was prerenal failure without oliguria in 5/7 episodes, and acute tubular necrosis in 2/7 episodes, requiring hemodialyses in one patient. Three patients died. In any case, the tranquilizers and antidepressants responsible for this syndrome were stopped, and electrolyte disorders and acidosis were corrected. Associated acute circulatory failure, septicemia and/or acute hepatic failure required prompt therapy, and artificial ventilation was required in 4 instances. The further use of phenothiazines, butyrophenones, sulpiride and their derivatives should be avoided in any patient having developed such an accident, whose pathophysiology is similar to that described in malignant hyperthermia of various origin.

  7. Acute renal failure following Bull ant mass envenomation in two dogs.

    Abraham, L A; Hinkley, C J; Tatarczuch, L; Holloway, S A


    Acute renal failure was diagnosed in a German Short Haired Pointer bitch and a Kelpie cross-bred dog following envenomation by Bull ants. Both dogs had been tethered over a Bull ant nest and had experienced mass envenomation. There was local reaction at the envenomation sites and each dog had experienced vomiting that was poorly controlled by symptomatic therapy. Intensive treatment of renal failure was successful in the German Short Haired Pointer and the bitch remains well 19 months after envenomation. The Kelpie cross-bred deteriorated despite intensive treatment and was euthanased 36 hours after presentation. Necropsy examination revealed haemorrhage and necrosis of the small intestine and myocardium, bilateral nephrosis with tubular necrosis, and patchy haemorrhage of the lung alveoli, pancreas and adrenal cortices. Electron microscopy revealed necrosis of the small intestine and hydropic swelling of proximal renal tubules with necrosis of medullary tubules.

  8. 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


    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.

  9. Measurement of tumor necrosis factor-α, leukotriene B4, and interleukin 8 in the exhaled breath condensate in patients with acute exacerbations of chronic obstructive pulmonary disease

    Fanny WS Ko


    Full Text Available Fanny WS Ko1, Ting-Fan Leung2, Gary WK Wong2, Jenny Ngai1, Kin W To1, Susanna Ng1, David SC Hui11Department of Medicine and Therapeutics; 2Department of Pediatrics, The Chinese University of Hong Kong, Hong KongBackground: Assessment of airway inflammation in the clinical course of acute exacerbations of chronic obstructive pulmonary disease (AECOPD may advance our understanding of the pathogenesis and treatment.Objectives: To assess airway inflammation in patients during the course of AECOPD by serial analyses of their exhaled breath condensates (EBC.Methods: Twenty-six patients with AECOPD (22 males, mean[SD] percentage predicted forced expiratory volume in one second (FEV1 44.8 [14.3], 11 with stable COPD, and 14 age and sex-matched healthy controls were studied. Patients with AECOPD were treated with systemic steroid and antibiotic for 7 days. EBC was collected from each patient with AECOPD on Day 5, 14, 30, and 60 post-hospitalization using EcoScreen (VIASYS Healthcare, USA during tidal breathing over 10 minutes. Concentrations of tumor necrosis factor-α (TNF-α, leukotriene B4 (LTB4, and interleukin-8 (IL-8 were measured by enzyme-linked immunosorbent assay.Results: The median (IQR of TNF-α level on Day 5 was 5.08 (3.80–6 .32 pg/ml, which was lower than on Day 14 (5.84 [4.91–9.14] pg/ml, p = 0.017, Day 30 (6.14 [3.82–7.67] pg/ml, p = 0.045, and Day 60 (5.60 [4.53–8.80] pg/ml, p = 0.009. On Day 60, subjects receiving inhaled corticosteroid (ICS had a lower level of TNF-α than those who were not (4.82 [4.06–5.65] vs 7.66 [5.48–10.9] pg/ml, p = 0.02. EBC LTB4 level did not change significantly during recovery from AECOPD whereas IL-8 was mostly undetectable.Conclusions: EBC TNF-α level was low in patients receiving systemic steroid and antibiotic therapy for AECOPD. These findings suggest a potential role for serial EBC TNF-α for noninvasive monitoring of disease activity.Keywords: COPD, exacerbation, exhaled breath

  10. Acute kidney injury and disseminated intravascular coagulation due to mercuric chloride poisoning

    Dhanapriya, J.; Gopalakrishnan, N.; Arun, V.; Dineshkumar, T.; Sakthirajan, R.; Balasubramaniyan, T.; Haris, M.


    Mercury is a toxic heavy metal and occurs in organic and inorganic forms. Inorganic mercury includes elemental mercury and mercury salts. Mercury salts are usually white powder or crystals, and widely used in indigenous medicines and folk remedies in Asia. Inorganic mercury poisoning causes acute kidney injury (AKI) and gastrointestinal manifestations and can be life-threatening. We describe a case with unknown substance poisoning who developed AKI and disseminated intravascular coagulation (DIC). Renal biopsy showed acute tubular necrosis. Later, the consumed substance was proven to be mercuric chloride. His renal failure improved over time, and his creatinine normalized after 2 months. PMID:27194836

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

    Kengo Furuichi


    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.

  12. Acute renal failure and severe thrombocytopenia associated with metamizole

    Maria Dolores Redondo-Pachon


    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.

  13. Extrapancreatic necrosis without pancreatic parenchymal necrosis : a separate entity in necrotising pancreatitis?

    Bakker, Olaf J.; van Santvoort, Hjalmar; Besselink, Marc G. H.; Boermeester, Marja A.; van Eijck, Casper; Dejong, Kees; van Goor, Harry; Hofker, Hendrik; Ali, Usama Ahmed; Gooszen, Hein G.; Bollen, Thomas L.


    Objective In the revised Atlanta classification of acute pancreatitis, the term necrotising pancreatitis also refers to patients with only extrapancreatic fat necrosis without pancreatic parenchymal necrosis (EXPN), as determined on contrast-enhanced CT (CECT). Patients with EXPN are thought to have

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

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


    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

  15. Nephrotic Syndrome and Acute Renal Failure Apparently Induced by Sunitinib

    Ying-Shou Chen


    Full Text Available We report a case of nephrotic syndrome and acute renal failure apparently induced by sunitinib. A 67-year-old man with a history of metastatic renal cell carcinoma presented with progressive kidney dysfunction with proteinuria, general edema, and body weight gain of 21 kg after undergoing 3 weeks of sunitinib therapy. The patient had taken no other over-the-counter medications, and all other possible causes of nephrotic syndrome were excluded. The Naranjo Adverse Drug Reaction Probability Scale score for this event was 6, indicating a high probability that the observed presentations were associated with use of the drug. However, despite the discontinuation of sunitinib, his condition deteriorated, and hemodialysis was initiated for respiratory distress. A renal biopsy was performed, which revealed ischemic acute tubular necrosis with minimal change nephropathy. In conclusion, nephrologists and oncologists should be aware that nephrotic syndrome with ischemic acute tubular necrosis is a possible adverse effect of sunitinib. For early diagnosis of this condition and to avoid renal damage, we recommend differential diagnosis of serum creatinine and proteinuria in patients undergoing sunitinib therapy.

  16. Histopathological Sequential Changes in Sodium Taurocholate-Induced Acute Pancreatitis

    Ashwinikumar Kudari


    Full Text Available Context Experimental models of acute pancreatitis have been developed in order to understand its pathophysiology and extrapancreatic manifestations. Objective The objective of our study was to study sequential changes in the pancreas and distant organs in sodium taurocholate-induced acute pancreatitis in a rat model. Animals Sixteen male Wistar rats weighing 250-300 g. Design The rats were distributed into two groups: induced acute pancreatitis (study group: 8 rats and a control group (8 rats. Within each group, the animals were divided into subgroups: those who were sacrificed early (24 h and 72 h; two each and those who were sacrificed late (120 h and 240 h; two each. Intervention Acute pancreatitis was induced in the rats by multiple intraparenchymal injections of 10% sodium taurocholate solution. In the controls, the same amount of normal saline was injected into the pancreatic parenchyma. Main outcome measures Pathological examination of the pancreas, lungs, kidneys, intestine and liver was done. Results In this model of taurocholate-induced acute pancreatitis, the early changes observed in the pancreas were focal hemorrhages, parenchymal necrosis and neutrophil infiltration. At 72 hours, the changes observed were acinar necrosis, edema, fibrin deposition and inflammatory cell infiltration. Late changes were fibrinoid necrosis and fibroblast proliferation. In the acute phase, the histological changes in the lungs were congestion, focal pulmonary edema and intraalveolar hemorrhages while, in the late stage, there was persistence of vascular congestion. The changes observed in the kidneys were vacuolization of tubular epithelium in the subcapsular region and areas of hemorrhage in the interstitium. Intestinal changes included degenerative changes in the villous epithelium in the acute phase with normalization of the histology in the late phase. Conclusion Our findings correlate with the clinical observation of multisystem organ failure in

  17. Acute kidney injury: A rare cause

    Satish Mendonca


    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

  18. Acute renal failure due to rhabdomyolyisis

    Nieto-Ríos, John Fredy


    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.

  19. Acute kidney injury in the pregnant patient.

    Nwoko, Rosemary; Plecas, Darko; Garovic, Vesna D


    Acute kidney injury (AKI) is costly and is associated with increased mortality and morbidity. An understanding of the renal physiologic changes that occur during pregnancy is essential for proper evaluation, diagnosis, and management of AKI. As in the general population, AKI can occur from prerenal, intrinsic, 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. For each of these disorders, delivery of the fetus is the recommended therapeutic option, with additional therapies indicated for each specific disease entity. An understanding of the various etiologies of AKI in the pregnant patient is key to the appropriate clinical management, prevention of adverse maternal outcomes, and safe delivery of the fetus. In pregnant women with pre-existing kidney disease, the degree of renal dysfunction is the major determining factor of pregnancy outcomes, which may further be complicated by a prior history of hypertension.

  20. Pregnancy related acute kidney injury: nondialytic management

    Kaliki Hymavathi Reddy


    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

  1. The thalidomide analogue CC-3052 inhibits HIV-1 and tumour necrosis factor-alpha (TNF-α) expression in acutely and chronically infected cells in vitro

    La Maestra, L; Zaninoni, A; Marriott, J B; Lazzarin, A; Dalgleish, A G; Barcellini, W


    We investigated the in vitro effect of the water-soluble, highly stable thalidomide analogue CC-3052 on HIV-1 expression and TNF-α production in latently infected promonocytic U1 cells, acutely infected T cells and monocyte-derived human macrophages (MDM), and in mitogen-stimulated ex vivo cultures from patients with primary acute HIV-1 infection. HIV-1 expression was assessed by Northern blot analysis of RNAs, and ELISA for p24 antigen release and reverse transcriptase (RT) activity. TNF-α expression was evaluated by RT-polymerase chain reaction (PCR)-ELISA for mRNA and ELISA for protein secretion. We demonstrated that CC-3052 is able to inhibit HIV-1 expression, as evaluated by mRNA, p24 release and RT activity, in phorbol myristate acetate (PMA)- and cytokine-stimulated U1 cells. Furthermore, CC-3052 inhibited HIV-1 expression, as evaluated by p24 and RT activity, in acutely infected MDM and T cells. As far as TNF-α is concerned, CC-3052 significantly reduced TNF-α mRNA and protein secretion in PMA-stimulated U937 and U1 cells, and in PMA-stimulated uninfected and acutely infected MDM. Consistently, the addition of CC-3052 reduced TNF-α production in phytohaemagglutinin (PHA) and lipopolysaccharide (LPS)-stimulated whole blood cultures from patients during the primary acute phase of HIV-1 infection. Since TNF-α is among the most potent enhancers of HIV-1 expression, the effect of CC-3052 on TNF-α may account for its inhibitory activity on HIV-1 expression. Given the well documented immunopathological role of TNF-α and its correlation with viral load, advanced disease and poor prognosis, CC-3052 could be an interesting drug for the design of therapeutic strategies in association with anti-retroviral agents. PMID:10606973

  2. Renal pathophysiologic role of cortical tubular inclusion bodies.

    Radi, Zaher A; Stewart, Zachary S; Grzemski, Felicity A; Bobrowski, Walter F


    Renal tubular inclusion bodies are rarely associated with drug administration. The authors describe the finding of renal cortical tubular intranuclear and intracytoplasmic inclusion bodies associated with the oral administration of a norepinephrine/serotonin reuptake inhibitor (NSRI) test article in Sprague-Dawley (SD) rats. Rats were given an NSRI daily for 4 weeks, and kidney histopathologic, ultrastructural pathology, and immunohistochemical examinations were performed. Round eosinophilic intranuclear inclusion bodies were observed histologically in the tubular epithelial cells of the renal cortex in male and female SD rats given the NSRI compound. No evidence of degeneration or necrosis was noted in the inclusion-containing renal cells. By ultrastructural pathology, inclusion bodies consisted of finely granular, amorphous, and uniformly stained nonmembrane-bound material. By immunohistochemistry, inclusion bodies stained positive for d-amino acid oxidase (DAO) protein. In addition, similar inclusion bodies were noted in the cytoplasmic tubular epithelial compartment by ultrastructural and immunohistochemical examination.  This is the first description of these renal inclusion bodies after an NSRI test article administration in SD rats. Such drug-induced renal inclusion bodies are rat-specific, do not represent an expression of nephrotoxicity, represent altered metabolism of d-amino acids, and are not relevant to human safety risk assessment.

  3. General Construction of Tubular Geometry

    Mukhopadhyay, Partha


    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.

  4. Tubular organ epithelialisation

    Rhea Saksena


    Full Text Available Hollow, tubular organs including oesophagus, trachea, stomach, intestine, bladder and urethra may require repair or replacement due to disease. Current treatment is considered an unmet clinical need, and tissue engineering strategies aim to overcome these by fabricating synthetic constructs as tissue replacements. Smart, functionalised synthetic materials can act as a scaffold base of an organ and multiple cell types, including stem cells can be used to repopulate these scaffolds to replace or repair the damaged or diseased organs. Epithelial cells have not yet completely shown to have efficacious cell–scaffold interactions or good functionality in artificial organs, thus limiting the success of tissue-engineered grafts. Epithelial cells play an essential part of respective organs to maintain their function. Without successful epithelialisation, hollow organs are liable to stenosis, collapse, extensive fibrosis and infection that limit patency. It is clear that the source of cells and physicochemical properties of scaffolds determine the successful epithelialisation. This article presents a review of tissue engineering studies on oesophagus, trachea, stomach, small intestine, bladder and urethral constructs conducted to actualise epithelialised grafts.

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

    Pu Duann


    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.

  6. Pancreatic Necrosis Associated with Preeclampsia-Eclampsia

    Parmar MS


    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.

  7. The -308G/A of Tumor Necrosis Factor (TNF-α and 825C/T of Guanidine Nucleotide Binding Protein 3 (GNB3 are Associated with the Onset of Acute Myocardial Infarction and Obesity in Taiwan

    Fu-Hsin Chang


    Full Text Available Acute myocardial infarction is a highly prevalent cardiovascular disease in Taiwan. Among several etiological risk factors, obesity and inflammation are strongly associated with the frequency of hypertension, cardiovascular disease, diabetes, and myocardial infarction. To discriminate obesity- and inflammation-related genes and the onset of acute myocardial infarction (AMI, a case-control study was conducted to investigate the association of the -308G/A polymorphisms of tumor necrosis factor (TNF-α and the C825T polymorphism of guanidine nucleotide binding protein 3 (GNB3 with the onset of AMI among Taiwanese cohorts. A total of 103 AMI patients and 163 matched normal control samples were enrolled in the present study. The genomic DNA was extracted and subjected into polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP analysis. An association between the A homozygosity of the TNF-α-308G/A polymorphism and the onset of AMI was observed among the male subjects (p = 0.026; Spearman index = 0.200, p = 0.008. An association between the T homozygosity of GNB3 C825T polymorphism and obesity was also observed (Fisher’s exact, p = 0.009. The TT genotype has a protective effect against acquiring AMI among the obese female population in Taiwan (Fisher’s exact, p = 0.032. In conclusion, TNF-α-308G/A and the GNB3 C825T polymorphisms are associated with obesity and AMI in the Taiwanese population.

  8. Hypoplasia of exocrine pancreas with myocardial necrosis

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


    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.

  9. The significance of urine microscopy and urinary kidney injury molecular 1 and neutrophil gelatinase associated lipocalin in patients with primary kidney disease complicated with acute tubular interstitial lesion%尿沉渣联合尿KIM-1、NGAL在诊断原发性肾脏病合并急性肾小管间质病变中的意义

    刘亚红; 苑丽华


    目的 观察原发性慢性肾脏病(CKD)合并急性肾小管间质病变(ATIL)时尿沉渣积分情况和尿肾损伤因子1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平的变化,以期早期、准确发现ATIL.方法 经临床和病理确诊为CKD并发ATIL病例52例,对照组为无急性肾损伤(AKI)的原发性CKD患者33例,15例健康人为正常对照组.比较三组尿KIM-1、NGAL水平与尿沉渣积分的不同.结果 ①三组的尿KIM-1、NGAL水平和尿沉渣积分相比较,原发性CKD并发ATIL患者均高于其他两组(P<0.05),无AKI的CKD患者高于健康对照组(P<0.05);②尿KIM-1、NGAL水平与尿沉渣评分呈正相关(r=0.711,0.683,P<0.05),三者又均与CKD患者的ATIL严重程度呈正相关(r=0.892,0.735,0.745,P<0.05);③N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、视黄醇结合蛋白(RBP)和α1-微球蛋白(α1-MG)尚在正常范围的患者尿KIM-1、NGAL水平已有升高,肾脏组织病理证实存在不同程度的ATIL;④尿KIM-1、NGAL、光抑素C(CysC)、NAG诊断ATIL的ROC曲线下面积大于尿RBP、α1-MG.尿沉渣诊断ATIL的受试者工作(ROC)曲线下面积为84%.尿KIM-1、NGAL联合尿沉渣积分诊断ATIL的准确性达100%.结论 尿沉渣联合尿KIM-1、NGAL可作为诊断原发性CKD并发ATIL的早期、无创、敏感的指标.%Objectives We explored urinary sediment scoring on the basis of the number of renal tubular epithelial cells and granular casts and the urinary level of KIM-1 and NGAL in patients with primary and chronic kidney disease (CKD) complicated with acute tubular interstitial lesion(ATIL),in order to find tubular interstitial injury early and accurately.Methods Data of 52 cases of primary CKD with ATIL and of 33 cases of CKD without acute kidney injury (AKI)admitted to Second Affiliated Hospital of Xingtai Medical College from February 2012 to February 2013 were analyzed.Urinary sediment scoring on the basis of the number of renal tubular epithelial

  10. 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


    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.

  11. Establishment of a nested PCR for rapid detection of Chlamys farreri acute viral necrosis virus%栉孔扇贝急性病毒性坏死病毒巢式PCR检测方法的建立

    李晨; 王崇明; 曲朋; 黄倢


    为更好地实现对养殖海区栉孔扇贝急性病毒性坏死病毒(acute viral necrosis virus,AVNV)的快速诊断和分子流行病学的调查,以及AVNV的疫情监测,选择AVNV全基因组序列中的保守区段,应用Accelrys gene 2.5软件设计一对巢式引物,用于AVNV的检测.结果显示,引物的扩增片段分别为979和548 bp.实验优化了PCR体系中Mg2+和dNTPs浓度及扩增程序中的退火温度,并建立了完善的AVNV巢式PCR检测技术.研究表明,该PCR检测技术具有较高的敏感性,可稳定检测出5 pg扇贝样品组织总核酸中5×10 copies的病毒粒子.%The scallop Chlamys farreri is one of the major species cultured in North China, and its culture in commercial scale has been performed for more than 20 years. However, the great expansion and intensification have induced the occurrence of disease called " acute viral necrosis disease" ( AVND) since 1990's,and the cumulative mortality could be higher than 90%. This disease is caused by a virus called "acute viral necrosis virus"(AVNV),which is a spherical enveloped virus(130 to 170 nm in diameter) with spike-like surface protrusions and has been becoming the major limiting factor in the development of the scallop industry. In order to establish a rapid diagnosis method of AVNV parasitizing on scallop( C. farreri) , a pair of primers of nested-PCR were developed by Accelrys gene 2. 5 based on the conserved region of the AVNV genome ( GenBank accession number; GQ153938 ) in this study. The reactive conditions such as concentration of Mg2 + , dNTPs and annealing temperature were optimized for the PCR system, and the expected products of the external and internal primers were 979 and 548 bp respectively. The results showed that the primers were specific for AVNV and did not amplify marine aquaculture animals' s and bacteria' s genome DNA,and the method can be stably amplified 5 x 10 copies virus particles in 5 pg total nucleic acid of scallop tissue. Also this

  12. 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.

  13. Tumor necrosis factor-α regulates glucocorticoid synthesis in the adrenal glands of Trypanosoma cruzi acutely-infected mice. the role of TNF-R1.

    Silvina R Villar

    Full Text Available Adrenal steroidogenesis is under a complex regulation involving extrinsic and intrinsic adrenal factors. TNF-α is an inflammatory cytokine produced in response to tissue injury and several other stimuli. We have previously demonstrated that TNF-R1 knockout (TNF-R1(-/- mice have a dysregulated synthesis of glucocorticoids (GCs during Trypanosoma cruzi acute infection. Since TNF-α may influence GCs production, not only through the hypothalamus-pituitary axis, but also at the adrenal level, we now investigated the role of this cytokine on the adrenal GCs production. Wild type (WT and TNF-R1(-/- mice undergoing acute infection (Tc-WT and Tc-TNF-R1(-/- groups, displayed adrenal hyperplasia together with increased GCs levels. Notably, systemic ACTH remained unchanged in Tc-WT and Tc-TNF-R1(-/- compared with uninfected mice, suggesting some degree of ACTH-independence of GCs synthesis. TNF-α expression was increased within the adrenal gland from both infected mouse groups, with Tc-WT mice showing an augmented TNF-R1 expression. Tc-WT mice showed increased levels of P-p38 and P-ERK compared to uninfected WT animals, whereas Tc-TNF-R1(-/- mice had increased p38 and JNK phosphorylation respect to Tc-WT mice. Strikingly, adrenal NF-κB and AP-1 activation during infection was blunted in Tc-TNF-R1(-/- mice. The accumulation of mRNAs for steroidogenic acute regulatory protein and cytochrome P450 were significantly increased in both Tc-WT and Tc-TNF-R1(-/- mice; being much more augmented in the latter group, which also had remarkably increased GCs levels. TNF-α emerges as a potent modulator of steroidogenesis in adrenocortical cells during T. cruzi infection in which MAPK pathways, NF-κB and AP-1 seem to play a role in the adrenal synthesis of pro-inflammatory cytokines and enzymes regulating GCs synthesis. These results suggest the existence of an intrinsic immune-adrenal interaction involved in the dysregulated synthesis of GCs during murine Chagas

  14. Acute renal injury and tubular acidosis caused by intravenous voriconazole%静脉应用伏立康唑致急性肾损伤及肾小管性酸中毒

    周晓明; 陈愉; 冯学威; 赵立


    1例80岁男性患者因术后感染给予亚胺培南西司他汀钠、万古霉素、卡泊芬净、米卡芬净及美罗培南,效果不佳,后治疗改为联用美罗培南1.0 g,1次/8 h静脉滴注及伏立康唑200 mg(首日剂量400 mg,1次/12 h),1次/12 h静脉滴注.第5~9天,实验室检查示血清肌酐(SCr)154~208 μmol/L,尿素氮(BUN)24.3~35.9 mmol/L,血清胱抑素C 4.54~5.44 mg/L;血pH值7.18~7.34,氯离子122~130 mmol/L,钾离子3.4~4.1 mmol/L,标准碳酸氢盐波动于12~15 mmol/L,实际碳酸氢盐 13~14 mmol/L,阴离子间隙13~14 mmol/L.尿分析示红细胞3.8~4.8个/HP,蛋白±,pH值保持在5.5.诊断为肾小管性酸中毒、急性肾损伤.第9天,伏立康唑用法改为每晨静脉滴注200 mg,每晚鼻饲给药200 mg.调整用法后第3天患者出现高氯性酸中毒、低钾血症,第11天停用伏立康唑,美罗培南继续应用.停药2 d后,患者血清SCr及BUN水平升至最高,分别达282 μmol/L及49.4 mmol/L,随后逐渐降低,分别于停药后第25天和停药后34天降至正常,血气分析各项指标于停药后第25天基本恢复正常.%An 80-year-old male; patient was given imipenem/cilastatin, vancomycin, caspofungin, micafungin, and meropenem for post-operative infections, but these had no effect. The treatment was then switched to an IV infusion of meropenem 1. 0 g every 8 hours combined with an IV infusion of voriconazole 400 mg every 12 hours on the first day followed by 200 mg every 12 hours. On days 5-9 of treatment, the laboratory tests showed the following levels; serum creatine ( SCr ) 154-208 (xmol/L, blood urea nitrogen ( BUN ) 24.3-35.9 mmol/L, serum cystatin C 4. 54-5.44 mg/L, blood pH 7. 18-7. 34, Cl" 122-130 mmol/L, K*3.4-4. 1 mmol/L, standard bicarbonate 12-15 mmol/L, actual bicarbonate 13-14 mmol/L,anion gap 13-14 mmol/L. Urinalysis revealed the following levels; RBC connt 3. 8-4. 8 cells/HP, protein ?, and pH 5. 5. Acute renal tubular acidosis and acute renal injury were

  15. 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


    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

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

    Müge EREK


    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.

  17. A Simple Tubular Reactor Experiment.

    Hudgins, Robert R.; Cayrol, Bertrand


    Using the hydrolysis of crystal violet dye by sodium hydroxide as an example, the theory, apparatus, and procedure for a laboratory demonstration of tubular reactor behavior are described. The reaction presented can occur at room temperature and features a color change to reinforce measured results. (WB)

  18. Tubular cystourethroneostomy after total prostatectomy.

    Melchior, H


    After radical prostatectomy cystourethroneostomy is done as a tubular cystourethroplasty. In the last 13 months 14 patients have been operated on in this manner. In 12 patients continence was achieved; 2 patients had a temporary stress incontinence. The stress incontinence could be treated successfully by temporary electrostimulation of the pelvic floor by an anal plug stimulator.

  19. The value of urine cytologic examination findings in the diagnosis of the acute renal allograft rejection

    Tatomirović Željka


    Full Text Available Background. Acute rejection of allograft is one of the most serious complications of renal transplantation that requires fast and precise diagnostic approach. In this paper our experience in cytologic urinalysis as a diagnostic method of the acute renal allograft rejection was reviewed. Methods. The study group included 20 of 56 patients with transplanted kidneys who were assumed for the acute allograft rejection according to allograft dysfunction and/or urine cytology findings. Histological findings confirmed allograft rejection in 4 patients. Urine sediment obtained in cytocentrifuge was air-dried and stained with May-Grunwald-Giemsa. Acute allograft rejection was suspected if in 10 fields under high magnification 15 or more lymphocytes with renal tubular cells were found. Results. Acute transplant rejection occured in 32.1% patients. In 15 patients clinical findings of the acute renal allograft rejection corresponded with cytological and histological findings (in the cases in which it was performed. Three patients with clinical signs of the acute allograft rejection were without cytological confirmation, and in 2 patients cytological findings pointed to the acute rejection, but allograft dysfunction was of different etiology (acute tubular necrosis, cyclosporine nephrotoxicity. In patients with clinical, cytological and histological findings of the acute allograft rejection urine finding consisted of 58% lymphocytes, 34% neutrophilic leucocytes and 8% monocytes/macrophages on the average. The accuracy of cytologic urinalysis related to clinical and histological finding was 75%. Conclusion. Urine cytology as the reliable noninvasive, fast and simple method is appropriate as the a first diagnostic line of renal allograft dysfunction, as well as for monitoring of the graft function.

  20. Changes at the glomerulo-tubular junction in renal transplants.

    Lee, S J; Howie, A J


    We studied by microscopy 377 biopsies, nephrectomies, and necropsy kidneys from 123 human renal transplants. We discovered two common abnormalities of the renal corpuscle, both affecting the glomerulo-tubular junction. Adhesion of the tip of the glomerular tuft to the origin of the tubule, as reported in various non-transplant glomerulopathies, was seen in 197 specimens (52 per cent). This change was common in material showing acute or chronic vascular rejection and glomerulopathy, and was almost universal in transplants that had been in place for over 1 year. Another change at the glomerulo-tubular junction, not previously highlighted, consisted of an infiltrate of lymphocytes or neutrophil polymorphs into the epithelium at the tubular origin. This change was seen in 145 specimens (38 per cent) and was associated with cellular rejection and ascending infection. These changes are of importance because they show two responses of the kidney to injury that involve the glomerulo-tubular junction and thus suggest that this part of the kidney has some specific properties that have been largely neglected up to now.

  1. 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


    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.

  2. Early detection of tubular dysfunction.

    Piscator, M


    The determination of low-molecular-weight proteins in urine as a tool for early detection of damage to the proximal tubules is briefly discussed. Beta 2-microglobulin, retinol-binding protein and alpha 1-microglobulin are at present the most widely used markers for tubular dysfunction. The determination of beta 2-microglobulin has earlier been the method of choice, but due to its instability at low pH there are certain disadvantages. Available data indicate that alpha 1-microglobulin may replace beta 2-microglobulin for screening purposes. The low-molecular-weight proteins are at present the best markers for early detection of tubular dysfunction; other constituents are not as well suited for this, even if the determination of urine enzymes has its supporters.

  3. Miopatias associadas a agregados tubulares

    Mary Souza Carvalho


    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.

  4. Acute interstitial nephritis in patients with viperine snake bite: Single center experience of a rare presentation

    Vishal Golay


    Full Text Available Acute renal failure following vasculotoxic viperine snake bites is very common in South Asia. Acute tubular necrosis and acute cortical necrosis are the common findings, with acute interstitial nephritis (AIN being a rare presentation. We conducted renal biopsies in all patients who were admitted in our institute with viperine snake bite-related acute kidney injury (AKI and who did not improve after three weeks of supportive care. Patients who had findings of AIN on renal histology were included for this study. Of a total of 42 patients, there were five patients (11.9% with AIN. Our series of five patients is the largest series of this rare presentation in the literature. All of these five patients had features of severe envenomation, severe AKI network stage of AKI and very high antivenom requirements. They had a very prolonged stay in the hospital, and four of the five patients developed chronic kidney disease on follow-up. The overall outcome in this group was worse as compared with those who did not have AIN. AIN following viperine snake bites is not a very rare presentation. The reason for the development of this pathology is unclear, but direct venom-related effects are possible. This presentation portends a poor overall long-term prognosis as demonstrated in our case series.

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

    Sufi M Suhail


    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. Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats.

    Schmiedt, C W; Brainard, B M; Hinson, W; Brown, S A; Brown, C A


    The objectives of this study were to define the acute and chronic effects of 1-hour unilateral in vivo renal ischemia on renal function and histology in cats. Twenty-one adult purpose-bred research cats were anesthetized, and 1 kidney underwent renal artery and vein occlusion for 1 hour. Serum creatinine and urea concentrations, urine protein:creatinine ratio, urine-specific gravity, glomerular filtration rate, hematocrit, platelet concentration and function, and white blood cell count were measured at baseline and variable time points after ischemia. Renal histopathology was evaluated on days 3, 6, 12, 21, 42, and 70 postischemia; changes in smooth muscle actin and interstitial collagen were examined. Following ischemia, whole animal glomerular filtration rate was significantly reduced (57% of baseline on day 6; P acute epithelial necrosis accompanied by evidence of regeneration of tubules predominantly within the corticomedullary junction. At later periods, postischemic kidneys had evidence of tubular atrophy and interstitial inflammation with significantly more smooth muscle actin and interstitial collagen staining and interstitial fibrosis when compared with the contralateral control kidneys. This study characterizes the course of ischemic acute kidney injury in cats and demonstrates that ischemic acute kidney injury triggers chronic fibrosis, interstitial inflammation, and tubular atrophy in feline kidneys. These late changes are typical of those observed in cats with naturally occurring chronic kidney disease.

  7. (Toxic hepatitis and acute renal failure after inhalation of chloride solvents: report of one case (author's transl))

    Teixido Planas, J.; Martinez-Castelao, A.; Romero Gonzalez, R.; Grino Boira, J.; Gonzalez Segura, C.; Caralps Riera, A.


    Due to a combination of ingested ethanol and inhaled trichloroethylene (Tri) a 28 year old man developed toxic hepatitis and acute oliguric renal failure, both of which had a favorable evolution. Tri has been described as a cause of hepatic disfunction and acute renal failure due to acute tubular necrosis, although some of the cases described are controversial, because Tri was either contaminated by other dissolvents or could not be proven pure, with the exception of one case. In many there was ethanol ingestion. The Tri inhaled by our patient was found to contain less than 1% of carbon tetrachloride (C-Tchl). This would suggest the C-Tchl to be responsible for the clinical picture although the combination Tri/ethanol cannot be discarded as the causal agent, due to the small amount of contaminant present.

  8. Subcutaneous encapsulated fat necrosis

    Aydin, Dogu; Berg, Jais O


    We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help f...... future surgeons to establish the diagnosis peroperatively....

  9. Pathophysiology of Cisplatin-Induced Acute Kidney Injury

    Abdullah Ozkok


    Full Text Available Cisplatin and other platinum derivatives are the most widely used chemotherapeutic agents to treat solid tumors including ovarian, head and neck, and testicular germ cell tumors. A known complication of cisplatin administration is acute kidney injury (AKI. The nephrotoxic effect of cisplatin is cumulative and dose-dependent and often necessitates dose reduction or withdrawal. Recurrent episodes of AKI may result in chronic kidney disease. The pathophysiology of cisplatin-induced AKI involves proximal tubular injury, oxidative stress, inflammation, and vascular injury in the kidney. There is predominantly acute tubular necrosis and also apoptosis in the proximal tubules. There is activation of multiple proinflammatory cytokines and infiltration of inflammatory cells in the kidney. Inhibition of the proinflammatory cytokines TNF-α or IL-33 or depletion of CD4+ T cells or mast cells protects against cisplatin-induced AKI. Cisplatin also causes endothelial cell injury. An understanding of the pathogenesis of cisplatin-induced AKI is important for the development of adjunctive therapies to prevent AKI, to lessen the need for dose decrease or drug withdrawal, and to lessen patient morbidity and mortality.

  10. Renal tubular acidosis type 4 in pregnancy.

    Jakes, Adam Daniel; Baynes, Kevin; Nelson-Piercy, Catherine


    We describe the clinical course of renal tubular acidosis (RTA) type 4 in pregnancy, which has not been previously published. Renal tubular acidosis type 4 is a condition associated with increased urinary ammonia secondary to hypoaldosteronism or pseudohypoaldosteronism. Pregnancy may worsen the hyperkalaemia and acidosis of renal tubular acidosis type 4, possibly through an antialdosterone effect. We advise regular monitoring of potassium and pH throughout pregnancy to ensure safe levels are maintained.

  11. Miopatias associadas a agregados tubulares

    Mary Souza Carvalho; Lusvarghi,Edgard S.; Ângela Lobo F. Levy; Paulo N. Borsoi Salum; Consuelo J. Rodrigues; José Antonio Levy


    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 por...

  12. Modified tubularized incised plate urethroplasty

    Shivaji Mane


    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.

  13. FTY720 impairs necrosis development after ischemia-reperfusion injury.

    Oliveira, C M S; Borra, R C; Franco, M; Schor, N; Silva, H T; Pestana, J O M; Bueno, V


    Ischemia-reperfusion (IR) injury is a common early feature that contributes to graft damage by impairing resident cell function. Our previous results showed that IR injury impaired renal function, by causing extensive tubular necrosis and increasing MHC class II and ICAM-1 molecule expression by mesangial cells (MC). MCs are likely candidates to come into close contact with immune cells such as monocytes or lymphocytes. It has been suggested that under inflammatory circumstances, there is increased MC expression of MHC class II, of adhesion molecules (such as ICAM-1), of cytokines receptors, and of molecules associated with cellular death (apoptosis). The immunosuppressive properties of FTY720 have been shown in clinical and experimental situations. It has also been shown to be protective against IR injury in rats. We sought to evaluate the role of FTY720 in a murine IR model by measuring renal function, tubular necrosis, and surface molecule expression by cultured mesangial cells. Intravenous administration of FTY720 (1 mg/kg) immediately before IR induction did not improve the short-term (24 hours) outcome of renal function or reduced MHC class II and ICAM-1 surface molecule expression. However, there was a decreased percentage of tubular necrosis in mice treated with FTY720 (51.3% +/- 1.6%) compared with vehicle-treated mice (66% +/- 5.5%). These results suggest a protective role of FTY720 in an IR injury model. More studies are required to identify the mechanisms involved in the protective activity of FTY720 in the IR injury model.

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

    Jiang, Zhenzhou, E-mail:; Bao, Qingli, E-mail:; Sun, Lixin, E-mail:; Huang, Xin, E-mail:; Wang, Tao, E-mail:; Zhang, Shuang, E-mail:; Li, Han, E-mail:; Zhang, Luyong, E-mail:


    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.

  15. Tubular lining material for pipelines having bends

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


    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.

  16. Tubular stabilizer bars – calculations and construction

    Adam-Markus WITTEK


    Full Text Available The article outlines the calculation methods for tubular stabilizer bars. Modern technological and structural solutions in contemporary cars are reflected also in the construction, selection and manufacturing of tubular stabilizer bars. A proper construction and the selection of parameters influence the strength properties, the weight, durability and reliability as well as the selection of an appropriate production method.

  17. Tubular inverse opal scaffolds for biomimetic vessels

    Zhao, Ze; Wang, Jie; Lu, Jie; Yu, Yunru; Fu, Fanfan; Wang, Huan; Liu, Yuxiao; Zhao, Yuanjin; Gu, Zhongze


    There is a clinical need for tissue-engineered blood vessels that can be used to replace or bypass damaged arteries. The success of such grafts depends strongly on their ability to mimic native arteries; however, currently available artificial vessels are restricted by their complex processing, controversial integrity, or uncontrollable cell location and orientation. Here, we present new tubular scaffolds with specific surface microstructures for structural vessel mimicry. The tubular scaffolds are fabricated by rotationally expanding three-dimensional tubular inverse opals that are replicated from colloidal crystal templates in capillaries. Because of the ordered porous structure of the inverse opals, the expanded tubular scaffolds are imparted with circumferentially oriented elliptical pattern microstructures on their surfaces. It is demonstrated that these tailored tubular scaffolds can effectively make endothelial cells to form an integrated hollow tubular structure on their inner surface and induce smooth muscle cells to form a circumferential orientation on their outer surface. These features of our tubular scaffolds make them highly promising for the construction of biomimetic blood vessels.There is a clinical need for tissue-engineered blood vessels that can be used to replace or bypass damaged arteries. The success of such grafts depends strongly on their ability to mimic native arteries; however, currently available artificial vessels are restricted by their complex processing, controversial integrity, or uncontrollable cell location and orientation. Here, we present new tubular scaffolds with specific surface microstructures for structural vessel mimicry. The tubular scaffolds are fabricated by rotationally expanding three-dimensional tubular inverse opals that are replicated from colloidal crystal templates in capillaries. Because of the ordered porous structure of the inverse opals, the expanded tubular scaffolds are imparted with circumferentially

  18. Diagnostic features in 10 naturally occurring cases of acute fatal canine leptospirosis.

    Rissi, Daniel R; Brown, Cathy A


    The current report describes the diagnostic features in 10 cases of acute fatal canine leptospirosis with minimal renal and hepatic changes that may present a diagnostic challenge for the pathologist. Most affected dogs were less than 6 months of age and had a biochemical profile consistent with hepatorenal dysfunction. Clinical signs consisted of vomiting, depression, icterus, dehydration, diarrhea, and anorexia. All dogs died or were humanely euthanized within 3-7 days after the onset of clinical disease. Necropsy findings included pulmonary edema with hemorrhages, icterus, renal and hepatic pallor and swelling, and gastric edema with hemorrhage. Despite severe azotemia, histological changes in the kidneys were subtle in all dogs, and included mild renal tubular simplification, with single-cell necrosis and attenuation, along with minimal interstitial lymphoplasmacytic inflammation, edema, and hemorrhage. Hepatic lesions included scattered hepatocellular single-cell necrosis and hepatocellular dissociation. Prominent extrarenal lesions typically associated with uremia including vascular fibrinoid necrosis in multiple organs, pulmonary mineralization with occasional fibrinosuppurative exudation, and gastric mineralization were also present. Postmortem diagnostic confirmation was based on the detection of leptospiral antigen on fresh renal samples by fluorescent antibody test and on the demonstration of intact spirochetes in sections of kidneys using immunohistochemical staining. Acute fatal canine leptospirosis occurred as a fulminant hepatorenal disease affecting mainly young dogs, and the diagnosis was dependent on the recognition of the subtle renal changes with confirmation via fluorescent antibody testing or immunohistochemical staining.

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

    Marina Nogueira Berbel


    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.

  20. Acute kidney injury in children

    Peco-Antić Amira


    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.

  1. 急性缺糖缺氧通过增强胆碱酯酶表达促进肾小管细胞的炎性损伤%Acute oxygen and glucose deprivation promotes inflammatory injury of renal tubular cells by enhancing the expression of cholinesterase

    吴明; 吴乐锋; 李明利; 陆俊福; 赖凯; 徐迹; 刘芬; 冯永文


    Objective To investigate the injury mechanism of renal tubular cells induced by acute oxygen and glucose depri-vation. Methods Isolation and culture of rat kidney macrophages and renal epithelial cells,constructing co-cultivating model of lacking Oxygen and sugar(Oxygen and glucose deprivation,OGD),Cells were devided into control group and OGD group,and were given OGD treatment for 1 hour,and then carried out normal culture for up to 24 hours in each group. the expression of TNF al-pha,IL-1 beta,IL-10 in supernatant fluid was detected by ELISA,the viability of renal tubular cells was determined by MTT,the expression of mRNA and protein of acetylcholine esterase (AChE) were determined by RT-qPCR and Western Blot respectively. Results The levels of TNF alpha (pg/ml) in the supernatant fluid in cultivation system were (231.67±36.28) in control group VS (428.67±43.16)(P<0.05) in OGD group,the levels of IL-1β (pg/ml) were (116.67±21.64) in control group VS (219.63±43.86) in OGD group(P<0.05),the levels of IL-10 (pg/ml) were (235.67±39.35) in control group VS (432.67±49.72) in OGD group (P<0. 01). The viability of renal tubular cells was (88.41±18.25) VS (46.98±13.87)(P<0.01);The levels of mRNA and protein of AChE in OGD group were higher than those in control group,they were raised (3.82±0.73) and (2.17±0.46) times respectively (P<0.01). Conclusion Acute oxygen and glucose deprivation enhances the expression of cholinesterase in renal macrophages ,the acute in-jury of renal tubular cells induced by OGD was mediated through inflammatory mediators.%目的:探讨急性缺糖缺氧导致肾小管细胞损伤的机制。方法分离培养大鼠肾内巨噬细胞、肾小管上皮细胞,构建两者共培养(transwell)模型,细胞分成对照组及缺糖缺氧(Oxygen and glucose deprivation,OGD)组,给予缺糖缺氧处理细胞1h后再正常培养24h,ELISA法检测两组上清液TNF-α,IL-1β和IL-10的浓度,噻唑蓝(MTT)检测肾小

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

    Omar García-Sánchez


    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.

  3. Tubular bioreactor and its application; Tubular bioreactor to sono tekiyo

    Endo, I.; Nagamune, T. [The University of Tokyo, Tokyo (Japan). Faculty of Engineering; Yuki, K. [Nikka Whisky Distilling Co. Ltd. Tokyo (Japan); Inaba, H. [Sumitomo Heavy Industries, Ltd., Tokyo (Japan)


    The loop type tubular bioreactor (TBR) was developed where biocatalysts are trapped in the reactor by membrane module. A UF membrane or MF membrane and crossflow filtration were adopted for the membrane module, and the reactor loop was composed of four membrane modules. The reactor was operated at 2-4 m/s in membrane surface velocity and 300-400 kPa in filtration pressure. As the result of the high-density culture of lactic acid bacteria and yeast, a biomass concentration was more than 10 times that in batch culture, suggesting the remarkable enhancement of a production efficiency. As the result of the continuous fermentation of cider, the fast fermentation more than 60 times that in conventional ones was obtained together with the same quality as conventional ones. Such a fast fermentation was probably achieved by yeast suspended in the fermenter of TBR, by yeast hardly affected physico-chemically as compared with immobilized reactors, and by small effect of mass transfer on reaction systems. 4 refs., 6 figs.

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

    Lim, Gyeh Yon; Lee, M. H.; Son, K. M.; Shin, K. S.; Park, Y. H. [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    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%)

  5. Proximal tubular hypertrophy and enlarged glomerular and proximal tubular urinary space in obese subjects with proteinuria.

    Ana Tobar

    Full Text Available BACKGROUND: Obesity is associated with glomerular hyperfiltration, increased proximal tubular sodium reabsorption, glomerular enlargement and renal hypertrophy. A single experimental study reported an increased glomerular urinary space in obese dogs. Whether proximal tubular volume is increased in obese subjects and whether their glomerular and tubular urinary spaces are enlarged is unknown. OBJECTIVE: To determine whether proximal tubules and glomerular and tubular urinary space are enlarged in obese subjects with proteinuria and glomerular hyperfiltration. METHODS: Kidney biopsies from 11 non-diabetic obese with proteinuria and 14 non-diabetic lean patients with a creatinine clearance above 50 ml/min and with mild or no interstitial fibrosis were retrospectively analyzed using morphometric methods. The cross-sectional area of the proximal tubular epithelium and lumen, the volume of the glomerular tuft and of Bowman's space and the nuclei number per tubular profile were estimated. RESULTS: Creatinine clearance was higher in the obese than in the lean group (P=0.03. Proteinuria was similarly increased in both groups. Compared to the lean group, the obese group displayed a 104% higher glomerular tuft volume (P=0.001, a 94% higher Bowman's space volume (P=0.003, a 33% higher cross-sectional area of the proximal tubular epithelium (P=0.02 and a 54% higher cross-sectional area of the proximal tubular lumen (P=0.01. The nuclei number per proximal tubular profile was similar in both groups, suggesting that the increase in tubular volume is due to hypertrophy and not to hyperplasia. CONCLUSIONS: Obesity-related glomerular hyperfiltration is associated with proximal tubular epithelial hypertrophy and increased glomerular and tubular urinary space volume in subjects with proteinuria. The expanded glomerular and urinary space is probably a direct consequence of glomerular hyperfiltration. These effects may be involved in the pathogenesis of obesity

  6. Iatrogenic Digital Compromise with Tubular Dressings

    Corre, Kenneth A


    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. Nasal Skin Necrosis: An Unexpected New Finding in Severe Chikungunya Fever.

    Torres, Jaime R; Córdova, Leopoldo G; Saravia, Víctor; Arvelaez, Joanne; Castro, Julio S


    Three adult Venezuelan patients with virologically confirmed Chikungunya fever, who developed extensive acute nasal skin necrosis early in the course of a life-threatening illness characterized by shock and multiple organ dysfunction syndrome, are discussed. One patient survived and fully recovered. Nasal necrosis has not previously been associated with the disease.

  8. Acute and Subacute Oral Toxicity of Periodate in Rats


    Inflammation - Minimal, Subacute Necrosis, glandular stomach - Minimal Testes (Required) Degeneration - Mild, Germinal Epithelium Thymus (Required...diagnosed separately). Necrosis, glandular stomach- Minimal, Acute Testes (Required) Degeneration - Mild, Germinal Epithelium Thymus (Required...Stomach (Required) Necrosis, glandular stomach - :tvfinimal, Acute Testes (Required) Degeneration - Mild, Germinal Epithelium Thymus (Required) Atrophy

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


    ... 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. Acute Pancreatitis: Surgery, Pathophysiology and Probiotic Prophylaxis

    Minnen, L.P. van


    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

  11. Avascular Necrosis of the Capitate

    Bekele, Wosen; Escobedo, Eva; Allen, Robert


    Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma.

  12. Histopathological alterations of white seabass, Lates calcarifer, in acute and subchronic cadmium exposure

    Thophon, S.; Kruatrachue, M.; Upatham, E.S.; Pokethitiyook, P.; Sahaphong, S.; Jaritkhuan, S


    White seabass responded differently to cadmium at chronic and subchronic levels. - Histopathological alterations to white seabass, Lates calcarifer aged 3 months in acute and subchronic cadmium exposure were studied by light and scanning electron microscopy. The 96-h LC{sub 50} values of cadmium to L. calcarifer was found to be 20.12{+-}0.61 mg/l and the maximum acceptable toxicant concentration (MATC) was 7.79 mg/l. Fish were exposed to 10 and 0.8 mg/l of Cd (as CdCl{sub 2}H{sub 2}O) for 96 h and 90 days, respectively. The study showed that gill lamellae and kidney tubules were the primary target organs for the acute toxic effect of cadmium while in the subchronic exposure, the toxic effect to gills was less than that of kidney and liver. Gill alterations included edema of the epithelial cells with the breakdown of pillar cell system, aneurisms with some ruptures, hypertrophy and hyperplasia of epithelial and chloride cells. The liver showed blood congestion in sinusoids and hydropic swelling of hepatocytes, vacuolation and dark granule accumulation. Lipid droplets and glycogen content were observed in hepatocytes at the second and third month of subchronic exposure. The kidney showed hydropic swelling of tubular cell vacuolation and numerous dark granule accumulation in many tubules. Tubular degeneration and necrosis were seen in some areas.

  13. Interstitial nephritis, acute renal failure in a patient with non-fulminant hepatitis A infection.

    Vaboe, A L; Leh, S; Forslund, T


    This is the first report from Norway of a patient with interstitial nephritis and renal failure due to non-fulminant hepatitis A virus (HAV) infection. HAV infection was confirmed by positive anti-HAV IgM serology. All tests for other virus infections were negative. At admittance serum creatinine (s-Creat) and blood urea nitrogen (BUN) concentration were 539 microlmol/l and 32.6 mmol/l increasing the following days to 890 micromol/l and 39.9 mmol/l, respectively. Nine courses of hemodialysis had to be given. Kidney biopsy specimen showed interstitial edema, lymphocytic cell infiltration and acute tubular injury with normal glomeruli. Examination with immunohistochemistry was negative. In contrast to the findings associated with HBV and HCV infection in which glomerular disease is predominantly found, the HAV infection in our patient was associated with interstitial nephritis and acute tubular necrosis. The prognosis of the renal failure due to HAV infection was good although the recovery was substantially delayed.

  14. 阿司匹林对急性肺栓塞大鼠肿瘤坏死因子-α的干预%Intervention of aspirin on tumor necrosis factor alpha of rats with acute pulmonary embolism

    王灵燕; 周仁芳; 王灵聪


    Objective To explore the intervention of aspirin on tumor necrosis factor alpha (TNF-α) of rats with acute pulmonary (APE). Methods A total of 64 rats were randomly divided into 4 groups which were normal group(control), sham operation group(sham), model group(model) and aspirin group(aspirin) with 16 rats in each. The autologous blood clot were token to copy the APE animal mode. The serum TNF-αand the mRNA expression level of lung tissue were com-pared at 4-hour versus 72-hour after modeling. Results At 4-hour and 72-hour post-embolization, the control group and sham group showed normal lung tissue, the lung tissue of model group was significantly associated with alveolar wall con-gestion, emphysema, mild edema and inflammatory cells infiltration. At 4-hour after modeling, the degree of lung tissue lesion in the aspirin group was lighter than in the model group, the main lesions was alveolar wall edema while at 72-hour after modeling, the main pathological changes in lung tissue was mild or moderate hyperemia of alveolar walls, edema and inflammatory cell infiltration. The serum TNF-αamong four groups were significantly different at 4-hour and 72-hour after modeling (F=6.59, 23.09, P<0.05). The further multiple comparison showed that the level of serum TNF-α in aspirin group was significantly higher than those in the control group, sham group and model group at 4-hour after modeling (t=4.38,2.67,2.90,P<0.05). The levels of serum TNF-α in model was significantly higher than the control group, sham group and aspirin group at 72-hour af-ter modeling(t=5.43,7.37,6.64,P<0.05). The TNF-αmRNA among four groups were significantly differ-ent at 4-hour and 72-hour after modeling (F=39.35, 72.05,P<0.05). The TNF-α mRNA expression in lung tissue of the model group were significantly higher than those in control group, sham group and aspirin group at 4- hour and 72-hour after modeling(t=9.72, 8.36, 8.24; 12.12, 12.04, 11.85, P<0.05). Conclusion Aspirin can play an

  15. 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


    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.

  16. Protection of Renal Tubular Cells by Antioxidants: Current Knowledge and New Trends

    Azar Baradaran


    Full Text Available Acute renal damage mainly develops following toxic or ischemic insults and is defined as acute. These damages have largely been attributed to oxidative stress. Recently much attention has been directed toward decreased renal tubular cell regeneration during tubular cell injury. Antioxidants have recently been the focus of researchers and scientists for prevention and treatment of various oxidative stress-related conditions, including renal toxicities. Although free radicals are known to contribute in kidney injury and abundant researches, particularly laboratory trials, have shown the beneficial effects of antioxidants against these complications, long term clinical trials do not uniformly confirm this matter,especially for single antioxidant consumption such as vitamin C. The aim of this paper is to discuss the possible explanation of this matter.

  17. Pentavalent antimonial nephrotoxicity in the rat Disfunção tubular renal em ratos tratados com antimoniais pentavalentes

    Joel Paulo R. Veiga


    Full Text Available Aspects of the renal function were assessed in rats treated with the pentavalent antimonials Glucantime (Meglumine Antimoniate, Rhodia or Pentostam (Sodium Stibogluconate, Wellcome. In dose of 30 mg of Sb v (Glucantime or Pentostam by 100 mg of weight by day for 30 days, renal functional changes were observed consisting of disturbances in urine concentrating capacity. Such disturbances were expressed by significantly low values of urine osmolality as compared to the basal values previous to the drugs. The decrease in urine osmolality was associated to a significant increase in urinary flow and in negative free-water clearance. There was no alteration in osmolar clearance and in fractional excretion of sodium. These observations suggest an interference of the drugs in the action of the antidiuretic hormone. The disturbance in urine concentration was reversible after a seven days period without the drugs administration. No significant histopathological alterations were observed in the kidneys of the rats treated with the drugs. On the other hand, the rats treated with a high dose of Pentostam (200 mg/100 grams of weight/day showed the functional and the histopathological alterations of the acute tubular necrosis.Estudou-se a função renal de ratos tratados com Glucantime (Antimoniato de Meglumine, Rhodia e Pentostam (Estibogluconato de Sódio, Wellcome na dose de 30 mg de Sb v por 100 g de peso por dia, durante 30 dias. Observou-se um distúrio na concentração urinária, que foi reversível 7 dias após cessada a administração das drogas. O estudo histopatológico do rim, por meio da microscopia óptica, não evidenciou alterações significativas. Por outro lado, ratos tratados com altas doses dos antimoniais (200 mg de Sb v por 100 g de peso por dia mostraram alterações funcionais e histopatológicas renais compatíveis com necrose tubular aguda.

  18. The US color Doppler in acute renal failure.

    Nori, G; Granata, A; Leonardi, G; Sicurezza, E; Spata, C


    Imaging techniques, especially ultrasonography and Doppler, can give an effective assistance in the differential diagnosis of acute renal failure (ARF). An resistance Index (RI) value >0.75 is reported as optimal in attempting differential diagnosis between acute tubular necrosis (ANT) and prerenal ARF. In hepatorenal syndrome (HRS) RIs is very increased. In some renal vasculitis, as nodose panarteritis (PN), hemolytic-uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), parenchymal perfusion is reduced and RI increased. In lupus nephritis the RI values are correlated with creatinine level and normal RI are considered as a good prognostic tool. In acute primitive or secondary glomerulonephritis (GN), RI value is normal, with diffuse parenchymal hypervascularization. In acute crescentic and proliferative GN and tubulo-interstitial disease, color Doppler (CD) and power Doppler (PD) reveal a decreased renal parenchymal perfusion, which correlates with increased RI values. In acute thrombosis of renal artery, US color Doppler (DUS) reveals either an absence of Doppler signal or a tardus-parvus pulse distal to the vascular obstruction. In this situation it is possible to visualize hyperthropic perforating vessels that redirect their flow from the capsular plexus to the renal parenchyma. In acute thrombosis of the renal vein Doppler analysis of parenchymal vessels reveals remarkable RI values, sometimes with reversed diastolic flow. In postrenal ARF an adjunct to the differentiation between obstruction and non obstructive dilatation can be found through RIs. Diagnostic criteria of obstruction as reported by literature are: RI>0.70 in the obstructed kidney and, mostly, a difference in RI between the 2 kidneys >0.06-0.1.


    Carlos G. Musso


    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.

  20. Professor Eric G.L. Bywaters, Acute Kidney Injury and the "forgotten" letter.

    Almond, Michael


    The Bywaters seminal 1941 British Medical Journal paper on the crush syndrome was important both for its written content and for using a photomicrograph demonstrating pigmented casts in the renal tubules. He appeared to be reporting the first cases of renal failure secondary to crushing injuries. Most at this point would have been content yet Bywaters demonstrated both determination and humility by publishing a letter in the BMJ 4 months later. This letter, now almost forgotten and rarely referenced, significantly corrected his original paper. He identified that descriptions of the syndrome had been made before, not least by German pathologists in World War 1. The letter recognised various pathologists and surgeons, Colmers (1909) reporting on casualties from the Messina earthquake suffering from acute pressure necrosis and Frankenthal (1916) describing soldiers who had been buried in the trenches showing oedema, bloody urine and post mortem ischaemic muscle necrosis. Others were credited as describing similar cases in inaccessible journals or in "inaugural dissertations". Hackradt (1917) described injuries from burial with oedema of the leg and bloody urine containing albumin and casts, necropsy showed muscle necrosis and tubular degeneration in the kidneys with blood casts and Lewin (1919) described 3 similar cases. Bywaters subsequently credits Minami (1923) a Japanese dermatologist working in Germany for summarizing the literature and providing a description that tallied exactly with his own. Finally Bywaters puzzles why the standard textbooks on war surgery available in Great Britain and the U.S.A. in 1941 make no mention of this entity.

  1. Tubular Colonic Duplication Presenting as Rectovestibular Fistula.

    Karkera, Parag J; Bendre, Pradnya; D'souza, Flavia; Ramchandra, Mukunda; Nage, Amol; Palse, Nitin


    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

  2. 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: [Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan (China); Department of Urology, National Taiwan University Hospital, Taipei, Taiwan (China)


    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

  3. Deployable and retractable telescoping tubular structure development

    Thomson, M. W.


    A new deployable and retractable telescoping boom capable of high deployed stiffness and strength is described. Deployment and retraction functions are controlled by simple, reliable, and fail-safe latches between the tubular segments. The latch and a BI-STEM (Storable Tubular Extendible Member) actuator work together to eliminate the need for the segments to overlap when deployed. This yields an unusually lightweight boom and compact launch configuration. An aluminum space-flight prototype with three joints displays zero structural deadband, low hysteresis, and high damping. The development approach and difficulties are discussed. Test results provide a joint model for sizing flight booms of any diameter and length.

  4. Mechanisms of tumor cell necrosis.

    Proskuryakov, Sergey Y; Gabai, Vladimir L


    Until recently, necrosis, unlike apoptosis, was considered as passive and unregulated form of cell death. However, during the last decade a number of experimental data demonstrated that, except under extreme conditions, necrosis may be a well-regulated process activated by rather specific physiological and pathological stimuli. In this review, we consider mechanisms and the role of necrosis in tumor cells. It became recently clear that the major player in necrotic cascade is a protein kinase RIP1, which can be activated by number of stumuli including TNF, TRAIL, and LPS, oxidative stress, or DNA damage (via poly-ADP-ribose polymerase). RIP1 kinase directly (or indirectly via another kinase JNK) transduces signal to mitochondria and causes specific damage (mitochondrial permeability transition). Mitochondrial collapse activates various proteases (e.g., calpains, cathepsin) and phospholipases, and eventually leads to plasma membrane destruction, a hallmark of necrotic cell death. Necrosis, in contrast to apoptosis, usually evokes powerful inflammatory response, which may participate in tumor regression during anticancer therapy. On the other hand, excessive spontaneous necrosis during tumor development may lead to more aggressive tumors due to stimulatory role of necrosis-induced inflammation on their growth.

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

    Mizuno T


    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

  6. Development of Partial Tubular Flat Knitting Fabric Composite Preform

    Jiang Wei Qing


    Full Text Available After building some structures of partial tubular flat knitting fabric composite preform, the influencing factor on tubular section was analyzed and the fabric was knitted selectively. The partial tubular flat knitting fabric composite preform were Knitted by changing different yarn, row number and two-sided partial tubular flat knitting fabric. Multilayer sheet would be got after hot pressing and it has big market prospects and good application value.

  7. Drill pipes and casings utilizing multi-conduit tubulars

    Curlett, H.B.


    A seal adapted for use with a multi-conduit well tubular, or the like, is described which consists of: a plate with fluid passages, each passage corresponding to an opening of a conduit of the multiconduit tubular, and a groove on the plate around each passage; and elastomer means partially embeddable into each groove for sealing each conduit of a tubular to a corresponding conduit of another similar tubular.

  8. Tubular Membrane Plant-Growth Unit

    Dreschel, Thomas W.


    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.

  9. Startup of an industrial adiabatic tubular reactor

    Verwijs, J.W.; Berg, van den H.; Westerterp, K.R.


    The dynamic behaviour of an adiabatic tubular plant reactor during the startup is demonstrated, together with the impact of a feed-pump failure of one of the reactants. A dynamic model of the reactor system is presented, and the system response is calculated as a function of experimentally-determine

  10. Centrifugal Casting of Tubular Perovskite Membranes

    Mertins, Frederic H.B.; Kruidhof, Henk; Bouwmeester, Henny J.M.


    Dense tubular membranes were produced by centrifugal casting of an aqueous suspension, containing powder particles of the mixed-conducting perovskite La0.5Sr0.5CoO3−δ and a dispersant. The resulting green bodies were dried and sintered to produce tubes with a maximum length of 12 cm, having a relat

  11. Parametric sensitivity and runaway in tubular reactors

    Morbidelli, M.; Varma, A.


    Parametric sensitivity of tubular reactors is analyzed to provide critical values of the heat of reaction and heat transfer parameters defining runaway and stable operations for all positive-order exothermic reactions with finite activation energies, and for all reactor inlet temperatures. Evaluation of the critical values does not involve any trial and error.

  12. Fetal Kidney Cells Can Ameliorate Ischemic Acute Renal Failure in Rats through Their Anti-Inflammatory, Anti-Apoptotic and Anti-Oxidative Effects.

    Gupta, Ashwani Kumar; Jadhav, Sachin H; Tripathy, Naresh Kumar; Nityanand, Soniya


    Fetal kidney cells may contain multiple populations of kidney stem cells and thus appear to be a suitable cellular therapy for the treatment of acute renal failure (ARF) but their biological characteristics and therapeutic potential have not been adequately explored. We have culture expanded fetal kidney cells derived from rat fetal kidneys, characterized them and evaluated their therapeutic effect in an ischemia reperfusion (IR) induced rat model of ARF. The fetal kidney cells grew in culture as adherent spindle shaped/polygonal cells and expressed CD29, CD44, CD73, CD90, CD105, CD24 and CD133 markers. Administration of PKH26 labeled fetal kidney cells in ARF rats resulted in a significant decrease in the levels of blood urea nitrogen, creatinine, and neutrophil gelatinase-associated lipocalin and decreased tubular necrosis in the kidney tissues (pkidney cells were observed to engraft around injured tubular cells, and there was increased proliferation and decreased apoptosis of tubular cells in the kidneys (pkidney tissues of ARF rats treated with fetal kidney cells had a higher gene expression of renotropic growth factors (VEGF-A, IGF-1, BMP-7 and bFGF) and anti-inflammatory cytokine (IL10); up regulation of anti-oxidative markers (HO-1 and NQO-1); and a lower Bax/Bcl2 ratio as compared to saline treated rats (pkidney cells express mesenchymal and renal progenitor markers, and ameliorate ischemic ARF predominantly by their anti-apoptotic, anti-inflammatory and anti-oxidative effects.

  13. Reliability Analysis of Tubular Joints in Offshore Structures

    Thoft-Christensen, Palle; Sørensen, John Dalsgaard


    Reliability analysis of single tubular joints and offshore platforms with tubular joints is" presented. The failure modes considered are yielding, punching, buckling and fatigue failure. Element reliability as well as systems reliability approaches are used and illustrated by several examples....... Finally, optimal design of tubular.joints with reliability constraints is discussed and illustrated by an example....

  14. The first description of severe anemia associated with acute kidney injury and adult minimal change disease: a case report

    Qian Yimei


    Full Text Available Abstract Introduction Acute kidney injury in the setting of adult minimal change disease is associated with proteinuria, hypertension and hyperlipidemia but anemia is usually absent. Renal biopsies exhibit foot process effacement as well as tubular interstitial inflammation, acute tubular necrosis or intratubular obstruction. We recently managed a patient with unique clinical and pathological features of minimal change disease, who presented with severe anemia and acute kidney injury, an association not previously reported in the literature. Case presentation A 60-year-old Indian-American woman with a history of hypertension and diabetes mellitus for 10 years presented with progressive oliguria over 2 days. Laboratory data revealed severe hyperkalemia, azotemia, heavy proteinuria and progressively worsening anemia. Urine eosinophils were not seen. Emergent hemodialysis, erythropoietin and blood transfusion were initiated. Serologic tests for hepatitis B, hepatitis C, anti-nuclear antibodies, anti-glomerular basement membrane antibodies and anti-neutrophil cytoplasmic antibodies were negative. Complement levels (C3, C4 and CH50 were normal. Renal biopsy unexpectedly displayed 100% foot process effacement. A 24-hour urine collection detected 6.38 g of protein. Proteinuria and anemia resolved during six weeks of steroid therapy. Renal function recovered completely. No signs of relapse were observed at 8-month follow-up. Conclusion Adult minimal change disease should be considered when a patient presents with proteinuria and severe acute kidney injury even when accompanied by severe anemia. This report adds to a growing body of literature suggesting that in addition to steroid therapy, prompt initiation of erythropoietin therapy may facilitate full recovery of renal function in acute kidney injury.

  15. Spleen tyrosine kinase contributes to acute renal allograft rejection in the rat.

    Ramessur Chandran, Sharmila; Tesch, Greg H; Han, Yingjie; Woodman, Naomi; Mulley, William R; Kanellis, John; Blease, Kate; Ma, Frank Y; Nikolic-Paterson, David J


    Kidney allografts induce strong T-cell and antibody responses which mediate acute rejection. Spleen tyrosine kinase (Syk) is expressed by most leucocytes, except mature T cells, and is involved in intracellular signalling following activation of the Fcγ-receptor, B-cell receptor and some integrins. A role for Syk signalling has been established in antibody-dependent native kidney disease, but little is known of Syk in acute renal allograft rejection. Sprague-Dawley rats underwent bilateral nephrectomy and received an orthotopic Wistar renal allograft. Recipient rats were treated with a Syk inhibitor (CC0482417, 30 mg/kg/bid), or vehicle, from 1 h before surgery until being killed 5 days later. Vehicle-treated recipients developed severe allograft failure with marked histologic damage in association with dense leucocyte infiltration (T cells, macrophages, neutrophils and NK cells) and deposition of IgM, IgG and C3. Immunostaining identified Syk expression by many infiltrating leucocytes. CC0482417 treatment significantly improved allograft function and reduced histologic damage, although allograft injury was still clearly evident. CC0482417 failed to prevent T-cell infiltration and activation within the allograft. However, CC0482417 significantly attenuated acute tubular necrosis, infiltration of macrophages and neutrophils and thrombosis of peritubular capillaries. In conclusion, this study identifies a role for Syk in acute renal allograft rejection. Syk inhibition may be a useful addition to T-cell-based immunotherapy in renal transplantation.

  16. [A case report of progressive penile necrosis].

    Haba, Tomomi; Koike, Hiroshi


    The penis is provided with blood by multiple arteries. Penile necrosis is uncommon. Penile necrosis sporadically occurs in patients with progressive diabetes mellitus and/or end stage renal failure. Penile necrosis is often considered a poor prognostic feature. We present a case of penile necrosis in a patient with mild diabetes mellitus.

  17. Neurogenic pulmonary edema due to delayed radiation necrosis

    Mani R


    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.

  18. 78 FR 14361 - U.S. Steel Tubular Products, Inc., Mckeesport Tubular Operations Division, Subsidiary of United...


    ... 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...

  19. Cholestatic jaundice, acute kidney injury and acute pancreatitis secondary to the recreational use of methandrostenolone: a case report

    Kwan Peter


    Full Text Available Abstract Introduction Over the last few years the use of anabolic steroids has become increasingly common amongst amateur athletes and for aesthetic purposes. As a result, the adverse events related to their use are being seen more frequently. Methandrostenolone is an anabolic steroid which is widely available and has been used for both performance enhancement and aesthetic purposes. This drug has also been reported to cause cholestasis of the intra-hepatic bile ducts resulting in elevated aminotransferases, hyperbilirubinemia and clinical jaundice. However, to the best of our knowledge this agent has not been previously reported to cause pancreatitis or acute kidney injury. Case presentation In this paper, we report the case of a 50-year-old man of Indian descent who presented with a six week history of diffuse abdominal pain, anorexia and weight loss following an eight week cycle of methandrostenolone use. At initial presentation, his lipase level was 785 U/L, bilirubin was 922 μmol/L and creatinine was 200 U/L while his aspartate aminotransferase and alanine aminotransferase levels were only mildly elevated at 61 U/L and 56 U/L respectively. His lipase peaked on day nine at >3000 U/L whilst his creatinine level was 299 U/L. Imaging was consistent with acute pancreatitis while a liver biopsy was consistent with intra-hepatic cholestasis and a kidney biopsy revealed evidence of acute tubular necrosis. Conclusion Both acute pancreatitis and acute kidney injury have rarely been reported with anabolic steroid use and they have not been previously reported to occur in the same patient. This case demonstrates some potentially new and serious adverse consequences occurring with the use of anabolic steroids, of which physicians need to be aware.

  20. 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


    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

  1. Histopathological Alterations of Hybrid Walking Catfish (Clarias macrocephalus x Clarias gariepinus in Acute and Subacute Cadmium Exposure

    Nuntiya Pantung


    Full Text Available Histopathological alterations occur in the gills, livers and kidneys of 3-month old hybrid walking catsfich (Clarias macrocephalus x Clarias gariepinos after acute and subacute cadmium exposure in water, and after intraperitoneal injection.The 96-h LC50 for cadmium in recirculation open systems was 13.6 mg/l, and the 96-h LD50 1.6 mg/kg of fish. Light microscopic studies were carried out in gills, livers and kidneys. Gill alterations included an increased number of chloride cells, breakdown of the pillar cells and edema of the epithelial cells. In the liver there was blood conjestion in sinusoids and swelling of hepatocytes. The kidneys showed vacuolation and necrosis of proximal tubular cells.

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

    Parul Tandon


    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.

  3. A Tubular Aortopulmonary Window: An Embryological Curiosity.

    Chidambarathanu, Shanthi; Agarwal, Ravi; Hussain, Zahra M; Brown, Nigel A; Anderson, Robert H


    We describe, in this report, an unusually shaped aortopulmonary communication observed in a six-month-old infant who presented with an associated ventricular septal defect. The defect was tubular, measuring 7 mm in length, and located intrapericardially between the proximal ascending aorta and the pulmonary trunk. It was well defined by transthoracic echocardiogram and was suitable for surgical ligation. We share our dilemma in naming this defect appropriately. We base our explanation on our understanding of normal development of the intrapericardial arterial trunks. There is initially an extensive aortopulmonary foramen. This is closed by apposition of a protrusion from the dorsal wall of the aortic sac, the aortopulmonary septum, with the distal margins of the outflow cushions. The spiral nature of formation of the aortopulmonary septum provides an understanding of the configuration of our tubular aortopulmonary window.

  4. Study of hydrodynamic characteristics in tubular photobioreactors.

    Zhang, Qinghua; Wu, Xia; Xue, Shengzhang; Liang, Kehong; Cong, Wei


    In this work, the hydrodynamic characteristics in tubular photobioreactors with a series of helical static mixers built-in were numerically investigated using computational fluid dynamics (CFD). The influences of height and screw pitch of the helical static mixer and fluid inlet velocity on the cell trajectories, swirl numbers and energy consumption were examined. In order to verify the actual results for cultivation of microalgae, cultivation experiments of freshwater Chlorella sp. were carried out in photobioreactor with and without helical static mixer built-in at the same time. It was shown that with built-in helical static mixer, the mixing of fluid could be intensified, and the light/dark cycle could also be achieved which is of benefit for the growth of microalgae. The biomass productivity of Chlorella sp. in tubular photobioreactor with helical static mixer built-in was 37.26 % higher than that in the photobioreactor without helical static mixer.

  5. Pointlike Inclusion Interactions in Tubular Membranes

    Vahid, Afshin; Idema, Timon


    Membrane tubes and tubular networks are ubiquitous in living cells. Inclusions like proteins are vital for both the stability and the dynamics of such networks. These inclusions interact via the curvature deformations they impose on the membrane. We analytically study the resulting membrane mediated interactions in strongly curved tubular membranes. We model inclusions as constraints coupled to the curvature tensor of the membrane tube. First, as special test cases, we analyze the interaction between ring- and rod-shaped inclusions. Using Monte Carlo simulations, we further show how pointlike inclusions interact to form linear aggregates. To minimize the curvature energy of the membrane, inclusions self-assemble into either line- or ringlike patterns. Our results show that the global curvature of the membrane strongly affects the interactions between proteins embedded in it, and can lead to the spontaneous formation of biologically relevant structures.

  6. Distal renal tubular acidosis with hereditary spherocytosis.

    Sinha, Rajiv; Agarwal, Indira; Bawazir, Waleed M; Bruce, Lesley J


    Hereditary spherocytosis (HS) and distal renal tubular acidosis (dRTA), although distinct entities, share the same protein i.e. the anion exchanger1 (AE1) protein. Despite this, their coexistence has been rarely reported. We hereby describe the largest family to date with co-existence of dRTA and HS and discuss the molecular basis for the co-inheritance of these conditions.

  7. Mechanisms in hyperkalemic renal tubular acidosis.

    Karet, Fiona E


    The form of renal tubular acidosis associated with hyperkalemia is usually attributable to real or apparent hypoaldosteronism. It is therefore a common feature in diabetes and a number of other conditions associated with underproduction of renin or aldosterone. In addition, the close relationship between potassium levels and ammonia production dictates that hyperkalemia per se can lead to acidosis. Here I describe the modern relationship between molecular function of the distal portion of the nephron, pathways of ammoniagenesis, and hyperkalemia.

  8. Protective effect of Clostridium tyrobutyricum in acute dextran sodium sulphate-induced colitis: differential regulation of tumour necrosis factor-α and interleukin-18 in BALB/c and severe combined immunodeficiency mice

    Hudcovic, T; Kolinska, J; Klepetar, J; Stepankova, R; Rezanka, T; Srutkova, D; Schwarzer, M; Erban, V; Du, Z; Wells, J M; Hrncir, T; Tlaskalova-Hogenova, H; Kozakova, H


    One of the promising approaches in the therapy of ulcerative colitis is administration of butyrate, an energy source for colonocytes, into the lumen of the colon. This study investigates the effect of butyrate producing bacterium Clostridium tyrobutyricum on dextran sodium sulphate (DSS)-induced colitis in mice. Immunocompetent BALB/c and immunodeficient severe combined immunodeficiency (SCID) mice reared in specific-pathogen-free (SPF) conditions were treated intrarectally with C. tyrobutyricum 1 week prior to the induction of DSS colitis and during oral DSS treatment. Administration of DSS without C. tyrobutyricum treatment led to an appearance of clinical symptoms – bleeding, rectal prolapses and colitis-induced increase in the antigen CD11b, a marker of infiltrating inflammatory cells in the lamina propria. The severity of colitis was similar in BALB/c and SCID mice as judged by the histological damage score and colon shortening after 7 days of DSS treatment. Both strains of mice also showed a similar reduction in tight junction (TJ) protein zonula occludens (ZO)-1 expression and of MUC-2 mucin depression. Highly elevated levels of cytokine tumour necrosis factor (TNF)-α in the colon of SCID mice and of interleukin (IL)-18 in BALB/c mice were observed. Intrarectal administration of C. tyrobutyricum prevented appearance of clinical symptoms of DSS-colitis, restored normal MUC-2 production, unaltered expression of TJ protein ZO-1 and decreased levels of TNF-α and IL-18 in the descending colon of SCID and BALB/c mice, respectively. Some of these features can be ascribed to the increased production of butyrate in the lumen of the colon and its role in protection of barrier functions and regulation of IL-18 expression. PMID:22236013

  9. Protective effect of Clostridium tyrobutyricum in acute dextran sodium sulphate-induced colitis: differential regulation of tumour necrosis factor-α and interleukin-18 in BALB/c and severe combined immunodeficiency mice.

    Hudcovic, T; Kolinska, J; Klepetar, J; Stepankova, R; Rezanka, T; Srutkova, D; Schwarzer, M; Erban, V; Du, Z; Wells, J M; Hrncir, T; Tlaskalova-Hogenova, H; Kozakova, H


    One of the promising approaches in the therapy of ulcerative colitis is administration of butyrate, an energy source for colonocytes, into the lumen of the colon. This study investigates the effect of butyrate producing bacterium Clostridium tyrobutyricum on dextran sodium sulphate (DSS)-induced colitis in mice. Immunocompetent BALB/c and immunodeficient severe combined immunodeficiency (SCID) mice reared in specific-pathogen-free (SPF) conditions were treated intrarectally with C. tyrobutyricum 1 week prior to the induction of DSS colitis and during oral DSS treatment. Administration of DSS without C. tyrobutyricum treatment led to an appearance of clinical symptoms - bleeding, rectal prolapses and colitis-induced increase in the antigen CD11b, a marker of infiltrating inflammatory cells in the lamina propria. The severity of colitis was similar in BALB/c and SCID mice as judged by the histological damage score and colon shortening after 7 days of DSS treatment. Both strains of mice also showed a similar reduction in tight junction (TJ) protein zonula occludens (ZO)-1 expression and of MUC-2 mucin depression. Highly elevated levels of cytokine tumour necrosis factor (TNF)-α in the colon of SCID mice and of interleukin (IL)-18 in BALB/c mice were observed. Intrarectal administration of C. tyrobutyricum prevented appearance of clinical symptoms of DSS-colitis, restored normal MUC-2 production, unaltered expression of TJ protein ZO-1 and decreased levels of TNF-α and IL-18 in the descending colon of SCID and BALB/c mice, respectively. Some of these features can be ascribed to the increased production of butyrate in the lumen of the colon and its role in protection of barrier functions and regulation of IL-18 expression.

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

    McDaniel BL


    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

  11. Investigation of a Microcystis aeruginosa cyanobacterial freshwater harmful algal bloom associated with acute microcystin toxicosis in a dog.

    van der Merwe, Deon; Sebbag, Lionel; Nietfeld, Jerome C; Aubel, Mark T; Foss, Amanda; Carney, Edward


    Microcystin poisoning was diagnosed in a dog exposed to a Microcystis aeruginosa-dominated, freshwater, harmful algal bloom at Milford Lake, Kansas, which occurred during the summer of 2011. Lake water microcystin concentrations were determined at intervals during the summer, using competitive enzyme-linked immunosorbent assays, and indicated extremely high, localized microcystin concentrations of up to 126,000 ng/ml. Multiple extraction and analysis techniques were used in the determination of free and total microcystins in vomitus and liver samples from the poisoned dog. Vomitus and liver contained microcystins, as determined by enzyme-linked immunosorbent assays, and the presence of microcystin-LR was confirmed in vomitus and liver samples using liquid chromatography coupled with tandem mass spectrometry. Major toxic effects in a dog presented for treatment on the day following exposure included fulminant liver failure and coagulopathy. The patient deteriorated rapidly despite aggressive treatment and was euthanized. Postmortem lesions included diffuse, acute, massive hepatic necrosis and hemorrhage, as well as acute necrosis of the renal tubular epithelium. A diagnosis of microcystin poisoning was based on the demonstration of M. aeruginosa and microcystin-LR in the lake water, as well as in vomitus produced early in the course of the poisoning; the presence of microcystin-LR in liver tissue; and a typical clinical course including gastroenteritis and fulminant liver failure.

  12. Atorvastatin ameliorates contrast medium-induced renal tubular cell apoptosis in diabetic rats via suppression of Rho-kinase pathway.

    Su, Jinzi; Zou, Wenbo; Cai, Wenqin; Chen, Xiuping; Wang, Fangbing; Li, Shuizhu; Ma, Wenwen; Cao, Yangming


    Contrast medium-induced acute kidney injury (CI-AKI) remains a leading cause of iatrogenic, drug-induced acute renal failure. This study aimed to investigate the protective effects of atorvastatin against renal tubular cell apoptosis in diabetic rats and the related mechanisms. CI-AKI was induced by intravenous administration of iopromide (12ml/kg) in streptozotocin-induced diabetic rats. Atorvastatin (ATO) was administered intragastrically at the dose of 5, 10 and 30mg/kg/d in different groups, respectively, for 5 days before iopromide injection. Renal function parameters, kidney histology, renal tubular cell apoptosis, the expression of apoptosis regulatory proteins, caspase-3 and Rho-associated protein kinase 1 (ROCK-1), and the phosphorylation of myosin phosphatase target subunit -1 (MYPT-1), were determined. Atorvastatin was shown to notably ameliorate contrast medium induced medullary damage, restore renal function, and suppress renal tubular apoptosis. Meanwhile, atorvastatin up-regulated the expression of Bcl-2, down-regulated the expression of Bax, caspase-3 and ROCK-1, restored the ratio of Bcl-2/Bax, and suppressed the phosphorylation of MYPT-1 in a dose-dependent manner. Thus, atorvastatin pretreatment could dose-dependently ameliorate the development of CI-AKI, which was partly attributed to its suppression of renal tubular cell apoptosis by inhibiting the Rho/ROCK pathway.

  13. Behavior of horizontally curved steel tubular-flange bridge girders

    Fan, Zhuo

    A new type of curved steel bridge girder, called a curved tubular-flange girder, with rectangular tubes as flanges, is proposed and studied in this dissertation. A curved steel tubular-flange girder has much larger torsional stiffness than a curved I-girder and less potential for cross section distortion than a curved box-girder. Therefore, it has potential advantages compared to curved I-girders and box-girders. A theoretical analysis method for systems of curved tubular-flange girders braced by cross frames is presented. A stress analysis method for tubular-flange girders is also provided. The behavior of curved tubular-flange girder systems is studied using the theoretical analysis method and compared to the behavior of the corresponding curved I-girder systems. A parametric study is performed using the theoretical analysis method to investigate the effects of geometric parameters on the behavior of curved tubular-flange girder systems. The studied parameters include tubular-flange width, tubular-flange depth, cross section depth, girder curvature, and the number of cross frames. Finite element analyses are conducted to verify the theoretical analysis method, to study the behavior of a curved tubular-flange girder system under dead load, and to study the behavior of a curved tubular-flange girder system with a composite concrete deck under dead and live load. The study shows that a curved tubular-flange girder system develops much less warping normal stress and cross section rotation than a corresponding curved I-girder system. The difference is especially significant for a single curved girder under its own weight, suggesting that curved tubular-flange girders would be much easier to transport and erect than curved I-girders. As girder curvature increases, the rate of increase in the stresses and displacements for a single I-girder is much greater than for a single curved tubular-flange girder. Smaller cross frame forces develop in a tubular-flange girder

  14. Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.

    Emmanuel Canet

    Full Text Available BACKGROUND: Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy. DESIGN AND METHODS: To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI, we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma, 53.5%; acute myeloid leukemia, 29%; acute lymphoblastic leukemia, 11.5%; and Hodgkin disease, 6%. RESULTS: According to RIFLE criteria, 137 (68.5% patients had AKI. Five causes of AKI accounted for 91.4% of cases: hypoperfusion, tumor lysis syndrome, tubular necrosis, nephrotoxic agents, and hemophagocytic lymphohistiocytosis. Half of the AKI patients received renal replacement therapy and 14.6% received suboptimal chemotherapy. AKI was associated with a lower 6-month complete remission rate (39.4% vs. 68.3%, P<0.01 and a higher mortality rate (47.4% vs. 30.2%, P<0.01 than patients without AKI. By multivariate analysis, independent determinants of 6-month complete remission were older age, poor performance status, number of organ dysfunctions, and AKI. CONCLUSION: AKI is common in patients with newly diagnosed high-grade malignancies and is associated with lower complete remission rates and higher mortality.

  15. Selenium intoxication with selenite broth resulting in acute renal failure and severe gastritis

    Kamble P


    Full Text Available Selenium (Se is an essential trace element in human and animal nutrition. It is also widely utilized in industrial processes. Reports of acute selenium toxicity in humans are rare. We report a case of a 23-year-old female who consumed about 100 mL of liquid selenite broth and presented with severe nausea, vomiting, abdominal pain, hematemesis and acute renal failure (ARF. The serum selenium level was significantly increased. Gastro-duodenoscopy revealed severe corrosive gastritis. Renal biopsy showed features of acute tubular necrosis (ATN, affecting primarily the proximal tubules. The patient was managed with gastric lavage, blood transfusions, infusion of fresh frozen plasma (FFP and platelet concentrates and hemo-dialysis. The patient was discharged five weeks after admission and her renal functions reco-vered completely by eight weeks after admission. She continues to be on regular follow-up for any possible sequelae of mucosal corrosive damage. This case highlights a case of selenium intoxication from selenite broth resulting in ARF and corrosive gastritis. The recovery was complete.




    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.

  17. Distribution and chemotaxis of infused human umbilical cord-derived mesenchymal stem cells in the dogs of acute tubular necrosis by different transplantation methods%不同方法移植的人脐带间充质干细胞在ATN模型犬的体内分布及趋化性

    李芳; 胡祥; 贾丹兵; 赵红梅; 周燕妮; 党智杰


    目的:观察不同方法移植的人脐带间充质干细胞(HUC-MSCs)在家犬急性肾小管坏死的体内分布.方法: 健康家犬18只随机分为3组.模型1组:肌注0.2%二氯化汞溶液(7 mg/kg)建立急性肾小管坏死模型,采用经外周静脉注射法输注用DAPI标记的HUC-MSCs.模型2组:造模方法同1组,采用股动脉介入经左肾动脉直接注射体外分离培养并用DAPI标记的HUC-MSCs.对照组:健康家犬,细胞移植方法同2组.移植后48 h处死动物取肾脏、心脏、肝脏、胰腺,光镜及荧光显微镜观察.结果:①HUC-MSCs在1组及2组病变肾脏中均存在,且荧光强度无明显差异(P>0.05);②对照组肾脏中未发现HUC-MSCs存在;③1组及2组心脏、胰腺不存在或少量存在HUC-MSCs.结论:①HUC-MSCs可在病变肾脏内存活,两种移植方法无明显差异.②HUC-MSCs对正常肾脏无影响;③对于急性肾小管坏死家犬,HUC-MSCs在心脏、肝脏及胰腺内不存活.

  18. RIP Kinases Initiate Programmed Necrosis

    Lorenzo Galluzzi; Oliver Kepp; Guido Kroemer


    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.

  19. Discovery during Hydrogen Annealing: Formation of Nanoscale Fluorocarbon Tubular Structures

    Hao, Xiuchun; Tanaka, Sinya; Masuda, Atsuhiko; Maenaka, Kazusuke; Higuchi, Kohei


    A novel fabrication method for nanoscale tubular structures is presented in this paper. The tubular structures can be obtained by heating single-crystal silicon trenches or pillars formed by the inductively coupled plasma reactive-ion etching (ICP-RIE) Bosch process in hydrogen ambient. The importance of initial vacuum in the reaction chamber for tube formation and the tube formation mechanism were discussed. The components and sidewall size of the tubular structure were also studied to verify that the tube is made of the fluorocarbon (CF) passivation layer deposited by the Bosch process. The CF tubular structure would be a promising structure for BioMEMS.

  20. Flangeless Connections in Steel Tubular Wind Towers

    Heistermann, Christine; Tran, Anh Tuan; Veljkovic, Milan, ed. lit.; Rebelo, Carlos


    Extensive research is conducted on the improvement of renewable energies. One field is the use of wind energy, where the tower construction is one of the main issues. This paper deals with new ideas and ongoing research in this area. To raise the height of steel tubular towers, fatigue as the design limit and constraints due to transportation issues have to be overcome. Changes in the cross-section are considered as one of possible solutions. This work presents an extensive finite element stu...

  1. Distal Renal Tubular Acidosis and Calcium Nephrolithiasis

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


    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.

  2. Clinical features of acute renal failure associated with hepatitis A virus infection.

    Jung, Y J; Kim, W; Jeong, J B; Kim, B G; Lee, K L; Oh, K-H; Yoon, J-H; Lee, H-S; Kim, Y J


    Acute hepatitis A (AHA) is one of the most common infectious diseases; it is usually a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, some cases have been reported associated with acute renal failure. We reviewed the clinical features of patients with AHA complicated by acute renal failure (ARF group) and compared them with patients with noncomplicated AHA (non-ARF group). The medical records of 208 consecutive patients with AHA who were diagnosed between January 2003 and October 2008 were reviewed. We identified 15 patients (7.2%) with ARF associated with AHA. There were no differences between the ARF and non-ARF group with regard to gender and age. The peak value of alanine aminotransferase (ALT) (median: 6060 IU/L vs 1792 IU/L, P hepatic failure, and two patients died because of fulminant hepatic failure. There were no deaths among patients with noncomplicated AHA in the non-ARF group. Five patients underwent kidney biopsy; two patients were diagnosed with acute tubular necrosis, two patients with acute interstitial nephritis with IgA nephropathy and one patient with acute tubulointerstitial nephritis. All patients in the ARF group had microscopic haematuria and proteinuria (100%vs 31.1%, P < 0.001). Urine sodium levels were more than 10 mEq/L in 10 patients. The findings of high urinary sodium concentrations, microscopic haematuria and proteinuria did not support the diagnosis of hepatorenal syndrome (HRS). Patients with AHA with ARF had higher ALT levels, more prolonged PTs, and higher total bilirubin levels. The prognosis for these patients was poorer than for those without ARF. However, the patients with ARF and nonfulminant AHA had recovered with proper treatment and should not be confused with patients that have HRS.

  3. Energy and Oxygen Metabolism Disorder During Septic Acute Kidney Injury

    Rong-li Yang


    Full Text Available Background/Aims: Acute kidney injury (AKI during septic shock, which is one of the most common clinical syndromes in the intensive care unit (ICU, has a high mortality rate and poor prognosis, partly because of a poor understanding of the pathogenesis of renal dysfunction during septic shock. Although ischemic injury of the kidney has been reported to result from adenosine triphosphate (ATP depletion, increasing evidence has demonstrated that AKI occurs in the absence of renal hypoperfusion and even occurs during normal or increased renal blood flow (RBF; nevertheless, whether energy metabolism disorder is involved in septic AKI and whether it changes according to renal hemodynamics have not been established. Moreover, tubular cell apoptosis, which is closely related to ATP depletion, rather than necrosis, has been shown to be the major form of cell injury during AKI. Methods: We used canine endotoxin shock models to investigate the hemodynamics, renal energy metabolism, renal oxygen metabolism, and pathological changes during septic AKI and to explore the underlying mechanisms of septic AKI. Results: The present results revealed that the nicotinamide adenine dinucleotide (NAD+ pool and the ATP/adenosine diphosphate (ADP ratio were significantly decreased during the early phase of septic AKI, which is accompanied by a decreased renal oxygen extraction ratio (O2ER% and decreased renal oxygen consumption (VO2. Furthermore, significant apoptosis was observed following renal dysfunction. RBF and renal oxygen delivery were not significantly altered. Conclusion: These results suggest that imbalanced energy metabolism, rather than tubular cell apoptosis, may be the initiator of renal dysfunction during septic shock.

  4. Bilateral putaminal necrosis in a comatose patient with metabolic acidosis

    Sudhir Kumar


    Full Text Available We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming at admission, was confirmed later after the patient regained consciousness. A final diagnosis of methyl alcohol toxicity resulting in severe metabolic acidosis, coma, and bilateral blindness was made. This case is reported to emphasize the point that the finding of bilateral putaminal necrosis in a patient with coma and metabolic acidosis is virtually diagnostic of methyl alcohol toxicity even in the absence of any positive history.

  5. 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.

    Agnieszka A Pozdzik

    Full Text Available 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.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.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.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.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.

  6. Treatment of acute pancreatitis

    Al-Mofleh Ibrahim


    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.

  7. The syndrome of renal tubular acidosis with nerve deafness.

    Donckerwolcke, R A; Van Biervliet, J P; Koorevaar, G; Kuijten, R H; Van Stekelenburg, G J


    Two brothers with renal tubular acidosis and nerve deafness are described. Studies of the physiopathological characteristics of the renal acidification defect show that the defect is limited to the distal tubule. Renal tubular acidosis with nerve deafness is a distinct nosologic entity that is determined by an autosomal recessive trait.

  8. Complement activation by tubular cells is mediated by properdin binding

    Gaarkeuken, E.M.; Siezenga, M.A.; Zuidwijk, K.; Kooten, C. van; Rabelink, T.J.; Daha, M.R.; Berger, S.P.


    Activation of filtered complement products on the brush border of the tubular epithelium is thought to be a key factor underlying proteinuria-induced tubulointerstitial injury. However, the mechanism of tubular complement activation is still unclear. Recent studies on mechanisms of complement activa

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

    Qin, Lin; Furbo, Simon


    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....

  10. Metal Stents in Management of Pancreatic Pseudocyst and Walled Off Necrosis

    Rajesh Paramasivam


    Full Text Available The science behind pancreatitis and its complications is an ever evolving and challenging field. More than two centuries after the first description of pancreatic pseudocyst by Eugene Opie, some clear consensus and guidelines have evolved. Atlanta Symposium in 1992 attempted to offer a global ‘consensus’ and a universally applicable classification system for acute pancreatitis, tough comprehensive; some of the definitions were confusing [1]. Recent data and deeper understanding of pathophysiology of organ failure and necrotising pancreatitis, and the advent of superior diagnostic imaging have propelled towards the formation of revised Atlanta classification in 2012. Local complications of acute pancreatitis among others are acute pancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection and walled-off necrosis. Rarer complications are gastric outlet dysfunction, splenic and portal vein thrombosis, and colonic necrosis

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

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


    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.)

  12. 一期行肠切除术及无张力疝修补术治疗急性绞窄性腹股沟疝合并肠坏死58例%Emergency one-stage intestinal resection and tension-free hernioplasty for acutely strangulated inguinal hernia complicating intestinal necrosis in 58 cases

    陈庆永; 陈立波


    Objective To evaluate the validity and surgical outcome of emergency one-stage intestinal resection and tension-free hernioplasty for acutely strangulated inguinal hernia complicated with intestinal necrosis.Methods Clinical data of 58 patients diagnosed strangulated inguinal hernia and intestinal necrosis in our hospital from July 2011 to April 2014 were retrospectively analyzed.Of the 58 patients,33 were males and 25 were females,mean age of (64 ± 18) years (range 52-86).There were 28 strangulated inguinal and 30 femoral hernias undergoing emergency small bowel resection and tension-free mesh hernioplasty.Patients with intestinal perforations,preoperative peritonitis,inflammatory hernia and those who required colon resections were excluded from the study.Results The mean operative time was (92 ± 22) min (range,80-120 min).Average length of hospital stay was (8.6 ± 2.5) d (range,6-21 d).There were three postoperative c omplications (5.2%):one of subcutaneous hematoma,one of superficial surgical site infection and one of scrotal fluid collection,which were all cured by wound dressing,removal of infected prosthetic mesh,vacuum sealing drainage (VSD) and continuous irrigation,intravenous antibiotics and scrotal puncture.During a follow-up period of 6 to 32 months (mean 12 ± 6 months),there was no hernia recurrence.Conclusions Emergency one-stage intestinal resection and tension-free mesh hernioplasty for strangulated inguinal hernia complicated by intestinal necrosis is safe,feasible with a favourable outcome and low rate of postoperative complications.%目的 探讨急诊一期行肠切除术及无张力疝修补术治疗急性绞窄性腹股沟疝合并肠坏死的疗效.方法 回顾性分析华中科技大学同济医学院附属协和医院2011年7月至2014年4月58例成人急性绞窄性腹股沟疝合并肠坏死患者的临床资料,但除外合并肠穿孔、腹膜炎、炎性疝、嵌顿的内容物为结肠并需要做结肠

  13. Acute renal failure after rifampicin Insuficiência renal aguda por rifampicina

    Adriana Weinberg


    Full Text Available A patient with miliary tuberculosis and a chronic urogenital focus is described, who had a borderline renal function at diagnosis and developed overt renal failure upon daily treatment with rifampin (RMP, isoniazid (INH and ethambutol (EMB. This is the first Brazilian report of BMP induced renal damage. A renal biopsy taken on the third day of oliguria showed recent tubular necrosis with acute interstitial inflammation and granuloma formation. The aspect of the granulomatous lesion hightly suggested drug etiology because of the lack of palisading, high incidence of neutrophils and absence of facid-fast bacilli. This is the first presentation of an acute granulomatous interstitial nephritis probably due to RMP. Furthermore the pathogenesis of the renal damage caused by tuberculosis and RMP are discussed.Apresentamos um paciente com tuberculose miliar a partir de um foco crônico urogenital. Em sua entrada no hospital tinha uma função renal limítrofe e desenvolveu franca insuficiência renal na vigência da terapêutica específica constituída por RMP, INH e EMB. Bióp-sia renal realizada no 3° dia de uremia revelou necrose tubular recente, com inflamação intersticial aguda, permeada por granulomas. As formações granulomatosas foram altamente sugestivas de reação alérgica à droga devido à ausência de paliçadas, alta incidência de neutrófilos e o não encontro de bacilos-álcool-ácido-resistentes. Esta é a primeira descrição de nefrite intersticial granulomatosa provavelmente causada pela RMP. São discutidos os principais aspectos fisiopatogênicos da insuficiência renal causada pela tuberculose acrescida dos efeitos nefrotóxicos da RMP.

  14. Inherited renal tubular defects with hypokalemia

    Muthukrishnan J


    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.

  15. Multiplicity features of nonadiabatic, autothermal tubular reactors

    Lovo, M.; Balakotaiah, V. (Houston Univ., TX (United States). Dept. of Chemical Engineering)


    Singularity theory is combined with asymptotic analysis to determine the exact uniqueness-multiplicity boundary and ignition and extinction locus for the non-adiabatic, autothermal tubular reactor model. It is found that the steady-state behavior of the nonadiabatic reactor is described by the two limiting cases of adiabatic and strongly cooled models. The adiabatic case has been examined in a previous study. In this paper, the authors develop limiting models to describe the strongly cooled asymptotes. The authors also classify the different types of bifurcation diagrams of conversion vs. residence time using the results of singularity theory with a distinguished parameter. Analytical criteria are developed for predicting the conditions under which autothermal operation is feasible when heat losses are significant.

  16. Tubular initial conditions and ridge formation

    Borysova, M S; Karpenko, Iu A; Shapoval, V M; Sinyukov, Yu M


    The 2D azimuth & rapidity structure of the two-particle correlations in relativistic A+A collisions is altered significantly by the presence of sharp inhomogeneities in superdense matter formed in such processes. The causality constraints enforce one to associate the long-range longitudinal correlations observed in a narrow angular interval, the so-called (soft) ridge, with peculiarities of the initial conditions of collision process. This study's objective is to analyze whether multiform initial tubular structures, undergoing the subsequent hydrodynamic evolution and gradual decoupling, can form the soft ridges. Motivated by the flux-tube scenarios, the initial energy density distribution contains the different numbers of high density tube-like boost-invariant inclusions that form a bumpy structure in the transverse plane. The influence of various structures of such initial conditions in the most central A+A events on the collective evolution of matter, resulting spectra, angular particle correlations an...

  17. A case of spontaneous myocardial necrosis and cerebral ischemic lesions in a laboratory beagle dog.

    Matsushita, Kohei; Kohara, Yukari; Ito, Yuko; Yoshikawa, Tsuyoshi; Sato, Makoto; Kitaura, Keisuke; Matsumoto, Satoshi


    A beagle dog treated with saline as a control animal in a preclinical study was euthanized due to sudden systemic deterioration. On histopathological examination, contraction band necrosis of myocardial cells was observed widely in the left ventricular wall, including the papillary muscle and apex, and observed slightly in the ventricular septum and left atrium. In the brain, necrosis was observed in neurons and glia of the cerebral cortex, hippocampal pyramidal cells, glial cells of the rostral commissure and Purkinje cells of the cerebellar vermis. It is highly probable that the marked systemic deterioration was caused by cardiac dysfunction due to the spontaneous contraction band necrosis of the myocardial cells, although the pathogenesis of the myocardial lesions remains unclear. Given the distribution of neuronal necrosis in the brain, it is likely that these lesions resulted from the ischemia responsible for acute cardiac failure.

  18. 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


    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 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.

  19. 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)


    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.

  20. Extracellular calpains increase tubular epithelial cell mobility. Implications for kidney repair after ischemia.

    Frangié, Carlos; Zhang, Wenhui; Perez, Joëlle; Dubois, Yi-Chun Xu; Haymann, Jean-Philippe; Baud, Laurent


    Calpains are intracellular Ca2+-dependent cysteine proteases that are released in the extracellular milieu by tubular epithelial cells following renal ischemia. Here we show that externalized calpains increase epithelial cell mobility and thus are critical for tubule repair. In vitro, exposure of human tubular epithelial cells (HK-2 cells) to mu-calpain limited their adhesion to extracellular matrix and increased their mobility. Calpains acted primarily by promoting the cleavage of fibronectin, thus preventing fibronectin binding to the integrin alphavbeta3. Analyzing downstream integrin effects, we found that the cyclic AMP-dependent protein kinase A pathway was activated in response to alphavbeta3 disengagement and was essential for calpain-mediated increase in HK-2 cell mobility. In a murine model of ischemic acute renal failure, injection of a fragment of calpastatin, which specifically blocked calpain activity in extracellular milieu, markedly delayed tubule repair, increasing functional and histological lesions after 24 and 48 h of reperfusion. These findings suggest that externalized calpains are critical for tubule repair process in acute renal failure.

  1. Ultrasonographic findings of epipericardial fat necrosis: A case report

    Park, Chan Yeong; Hwang, Hye Jeon; Lee, Kwan Seop; Lee, In Jae; Park, Kyoung Ha [Dept. of Internal Medicine, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)


    Epipericardial fat necrosis (EFN) is an infrequent cause of acute chest pain. In rare cases like these, conservative treatment is necessary. Clinically, EFN may mimic emergent cardiopulmonary conditions, such as acute myocardial infarction. Computed tomography (CT) and magnetic resonance imaging characteristics of EFN is well described as encapsulated fatty lesion with perilesional soft tissue strands and thickening of adjacent pericardium in the epipericardial area. For confirmation of the diagnosis, involution of this lesion on follow-up is important. We present a case of EFN observed with ultrasonography (USG). This lesion was shown as a well-defined ovoid shaped mass with heterogeneous echogenicity in the left side of cardiophrenic space on USG. There was no color flow on Doppler USG. Follow-up USG and CT revealed decrease in the size of the lesion.

  2. Toxicological Significance of Renal Bcrp: Another Potential Transporter in the Elimination of Mercuric Ions from Proximal Tubular Cells

    Bridges, Christy C.; Zalups, Rudolfs K.; Joshee, Lucy


    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. PMID:25868844

  3. Cation dyshomeostasis and cardiomyocyte necrosis: the Fleckenstein hypothesis revisited

    Borkowski, Brian J.; Cheema, Yaser; Shahbaz, Atta U.; Bhattacharya, Syamal K.; Weber, Karl T.


    An ongoing loss of cardiomyocytes to apoptotic and necrotic cell death pathways contributes to the progressive nature of heart failure. The pathophysiological origins of necrotic cell loss relate to the neurohormonal activation that accompanies acute and chronic stressor states and which includes effector hormones of the adrenergic nervous system. Fifty years ago, Albrecht Fleckenstein and coworkers hypothesized the hyperadrenergic state, which accompanies such stressors, causes cardiomyocyte necrosis based on catecholamine-initiated excessive intracellular Ca2+ accumulation (EICA), and mitochondrial Ca2+ overloading in particular, in which the ensuing dysfunction and structural degeneration of these organelles leads to necrosis. In recent years, two downstream factors have been identified which, together with EICA, constitute a signal–transducer–effector pathway: (i) mitochondria-based induction of oxidative stress, in which the rate of reactive oxygen metabolite generation exceeds their rate of detoxification by endogenous antioxidant defences; and (ii) the opening of the mitochondrial inner membrane permeability transition pore (mPTP) followed by organellar swelling and degeneration. The pathogenesis of stress-related cardiomyopathy syndromes is likely related to this pathway. Other factors which can account for cytotoxicity in stressor states include: hypokalaemia; ionized hypocalcaemia and hypomagnesaemia with resultant elevations in parathyroid hormone serving as a potent mediator of EICA; and hypozincaemia with hyposelenaemia, which compromise antioxidant defences. Herein, we revisit the Fleckenstein hypothesis of EICA in leading to cardiomyocyte necrosis and the central role played by mitochondria. PMID:21398641

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

    Nazar Chaudhary Muhammad Junaid


    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.

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

    Eun-Young Lee


    Full Text Available 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.

  6. The acute, the chronic and the news of HIV-related renal disease in Africa.

    Arendse, Craig G; Wearne, Nicola; Okpechi, Ikechi G; Swanepoel, Charles R


    The burden of renal disease in human immunodeficiency virus (HIV) and AIDS patients living in Africa is adversely influenced by inadequate socio-economic and health care infrastructures. Acute kidney injury in HIV-positive patients, mainly as a result of acute tubular necrosis, may arise from a combination of hemodynamic, immunological, and toxic insult. A variety of histopathological forms of chronic kidney disease is also seen in HIV patients; HIV-associated nephropathy (HIVAN) and immune complex disease may require different treatment strategies, which at present are unknown. The role of host and viral genetics is still to be defined, especially in relation to the different viral clades found in various parts of the world and within Africa. The arrival and availability of highly active antiretroviral therapy in Africa has given impetus to research into the outcome of the renal diseases that are found in those with HIV. It has also generated a new look into policies governing dialysis and transplantation in this group where previously there were none.

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

    Ayman Goudah


    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.

  8. Jejunal Feeding in Chronic Pancreatitis with Severe Necrosis

    Hamvas J


    Full Text Available CONTEXT: Necrotizing pancreatitis is the most serious form of pancreatic inflammatory disease leading to multiorgan failure and a high (15-20% mortality rate. The poor nutritional and metabolic conditions and secondary bacterial translocation raise the mortality rate even more. OBJECTIVE: The aim of the study was to evaluate the effect of jejunal feeding in cases of chronic pancreatitis with extended necrosis. PATIENTS: In our institution, over a five-year period, 86 patients with severe necrotizing pancreatitis were treated for extended necrosis. In 19 patients, chronic calcifying pancreatitis was demonstrated by computed tomography showing more than 20% necrosis in the residual pancreas as well. SETTING: In 12 cases, nutrition was provided by jejunal feeding using an endoscopically placed nasojejunal feeding tube, whereas in 7 cases, hypocaloric parenteral nutrition was used. DESIGN: Retrospective unicenter study. MAIN OUTCOME MEASURES: The rate of healing with conservative treatment. RESULTS: Two of the 12 jejunally fed patients were operated on because of complications of pancreatitis. Five patients required intervention in the hypocaloric parenteral nutrition group: 4 were operated on and one more needed endoscopic intervention. The healing rate was significantly higher (P=0.045 in the jejunal feeding group (83.3% than in the parenteral nutrition (28.6% patients. CONCLUSIONS: In cases of chronic calcifying pancreatitis serious necrosis can develop in the residual pancreas resulting in a severe acute pancreatitis-like disease. A better healing rate was achieved and less interventions became necessary using nasojejunal tube feeding than in the parenteral nutrition group and this was analogous to what was observed in severe necrotizing pancreatitis This form of pancreatitis has not yet been described in the literature in detail. The authors suggest that it be regarded as a separate entity.

  9. Tacrolimus alleviates acute liver graft rejection by inhibiting glucocorticoid-induced tumor necrosis factor-related protein ligand in rats%他克莫司通过抑制GITRL减轻大鼠肝移植排斥反应的研究

    魏思东; 龚建平; 李金政; 黄中荣


    目的 探讨他克莫司(FK506)抑制大鼠肝移植排除反应中的作用机制。方法建立大鼠原位肝移植模型,分为3组。耐受组为Brown Norway (BN)到Lewis肝移植;排斥组为Lewis到BN肝移植;他克莫司(FK506)组在建立排斥模型基础上于术后注射FK506。术后7d检测肝组织病理改变及糖皮质激素诱导的肿瘤坏死因子相关蛋白配体(GITRL)的表达、Kupffer细胞GITRL的表达及细胞因子的改变。结果与耐受组比较,排斥组肝脏及kupffer细胞中GITRL表达升高,采用FK506后,降低了GITRL表达(P<0.05)。与耐受组比较,排斥组血清及kupffer细胞中IFN-γ表达升高,IL-10降低(P<0.05),而在FK506组,与排斥组比较,血清及kupffer细胞中IFN-γ表达降低,IL-10表达升高(P<0.05)。结论FK506能减轻大鼠肝移植后的急性排斥反应,其机制与降低GITRL的表达有关。%Objective To investigate the mechanism underlying the inhibitory effect of tacrolimus (FK506) against acute liver graft rejection. Methods Rat models of orthotopic liver transplantation were divided into 3 groups, namely the tolerance group with Brown Norway (BN) rats as the donors and Lewis rats as the recipients, rejection group with Lewis rats as donors and BN rats as recipients, and FK506 group with the same donor-recipient pair as in the rejection group and FK506 treatment. The recipients were sacrificed 7 days after the transplantation, and the hepatic histology, cytokine levels, and glucocorticoid-induced tumor necrosis factor-related protein ligand (GITRL) expression in the liver and Kupffer cells were observed and detected. Results Compared with the tolerance group, the rejection group showed increased GITRL expressions in the liver and Kupffer cells (PO.05), which was significantly lowered by FK506 treatment (PO.05). Acute liver graft rejection caused significantly elevated interferon-y (IFN-y) levels and decreased interieukin-10 (IL-10) levels in the plasma

  10. 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)


    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.)

  11. Solar Heating Systems with Evacuated Tubular Solar Collector

    Qin, Lin; Furbo, Simon


    , 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......-plate collectors. For solar heating plants, the yearly energy output from these evacuated tubular collectors is about 40%-90% higher than the output from typical flat-plate collectors at an operation temperature of about 50°C.......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...

  12. 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...

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



    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)

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

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


    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...... steel with a yield stress of 820-830 MPa and with high weldability and toughness properties. The test specimens of both series had the same geometry. The present report concentrates on the results obtained in the investigation on the high-strength steel tubular joints.The test specimens were fabricated...... 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...

  15. Scenario analysis of large scale algae production in tubular photobioreactors

    Slegers, P.M.; Beveren, van P.J.M.; Wijffels, R.H.; Straten, van G.; Boxtel, van A.J.B.


    Microalgae productivity in tubular photobioreactors depends on algae species, location, tube diameter, biomass concentration, distance between tubes and for vertically stacked systems, the number of horizontal tubes per stack. A simulation model for horizontal and vertically stacked horizontal tubul

  16. Tubular heart valves from decellularized engineered tissue.

    Syedain, Zeeshan H; Meier, Lee A; Reimer, Jay M; Tranquillo, Robert T


    A novel tissue-engineered heart valve (TEHV) was fabricated from a decellularized tissue tube mounted on a frame with three struts, which upon back-pressure cause the tube to collapse into three coapting "leaflets." The tissue was completely biological, fabricated from ovine fibroblasts dispersed within a fibrin gel, compacted into a circumferentially aligned tube on a mandrel, and matured using a bioreactor system that applied cyclic distension. Following decellularization, the resulting tissue possessed tensile mechanical properties, mechanical anisotropy, and collagen content that were comparable to native pulmonary valve leaflets. When mounted on a custom frame and tested within a pulse duplicator system, the tubular TEHV displayed excellent function under both aortic and pulmonary conditions, with minimal regurgitant fractions and transvalvular pressure gradients at peak systole, as well as well as effective orifice areas exceeding those of current commercially available valve replacements. Short-term fatigue testing of one million cycles with pulmonary pressure gradients was conducted without significant change in mechanical properties and no observable macroscopic tissue deterioration. This study presents an attractive potential alternative to current tissue valve replacements due to its avoidance of chemical fixation and utilization of a tissue conducive to recellularization by host cell infiltration.

  17. A tubular electrode for radiofrequency ablation therapy

    Antunes, Carlos Lemos Lemos Lemos


    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.

  18. Energy production with a tubular propeller turbine

    Samora, I.; Hasmatuchi, V.; Münch-Alligné, C.; Franca, M. J.; Schleiss, A. J.; Ramos, H. M.


    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 a reduced model with a diameter of 85 mm diameter and a maximal output power of 300 W, is addressed in this work. Having showed promising potential for further development, since global efficiencies of around 60% were observed, the turbine has been further used to estimate the potential for energy production in a real case study. A sub-grid of the drinking water system of the city of Lausanne, Switzerland, has been used to obtain an annual energy production through hourly simulations with several turbines.

  19. Tubular Steel Arch Stabilized by Textile Membranes

    Ondrej Svoboda


    Full Text Available Tubular steel arch supporting textile membrane roofing is investigated experimentally and numerically. The stabilization effects of the textile membrane on in-plane and out-of-plane behavior of the arch is of primary interest. First a model of a large membrane structure tested in laboratory is described. Prestressed membranes of PVC coated polyester fabric Ferrari® Précontraint 702S were used as a currently standard and excellent material. The test arrangement, loading and resulting load/deflection values are presented. The supporting structure consisted of two steel arch tubes, outer at edge of the membrane and inner supporting interior of the membrane roofing. The stability and strength behavior of the inner tube under both symmetrical and asymmetrical loading was monitored and is shown in some details. Second the SOFiSTiK software was employed to analyze the structural behavior in 3D, using geometrically nonlinear analysis with imperfections (GNIA. The numerical analysis, FE mesh sensitivity, the membrane prestressing and common boundary conditions are validated by test results. Finally a parametrical study concerning stability of mid arch with various geometries in a membrane structure with several supporting arches is presented, with recommendations for a practical design.

  20. The Fourier transform of tubular densities

    Prior, C B


    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. Pressure driven flow in porous tubular membranes

    Tilton, Nils; Martinand, Denis; Serre, Eric; Lueptow, Richard


    We consider the steady laminar flow of a Newtonian incompressible fluid in a porous tubular membrane with pressure-driven transmembrane flow. Due to its fundamental importance to membrane filtration systems, this flow has been studied extensively both analytically and numerically, yet a robust analytic solution has not been found. The problem is challenging due to the coupling between the transmembrane pressure and velocity with the simultaneous coupling between the axial pressure gradient and the axial velocity. We present a robust analytical solution which incorporates Darcy's law on the membrane surface. The solution is in the form of an asymptotic expansion about a small parameter related to the membrane permeability. We verify the analytical solution with comparison to 2-D spectral direct numerical simulations of ultrafiltration and microfiltration systems with typical operating conditions, as well as extreme cases of cross-flow reversal and axial flow exhaustion. In all cases, the agreement between the analytical and numerical results is excellent. Finally, we use the analytical and numerical results to provide guidelines about when common simplifying assumptions about the permeate flow may be made. Specifically, the assumptions of a parabolic axial velocity profile and uniform transmembrane velocity are valid only for small permeabilities.

  2. Changes of Serum Tumor Necrosis Factor-α Level and Blood-brain Barrier Permeability in Mice with Acute Liver Failure%急性肝衰竭小鼠血清TNF α与血脑屏障通透性的改变

    王文; 吕飒; 周莹; 刘沛


    Objective To investigate the changes of serum tumor necrosis factor (TNF)α level and the blood-brain barrier (BBB) permeability in acetaminophen (APAP)-induced ALF. Methods Acetaminophen was used to induce acute liver failure of male Balb/c mice. Serum levels of alanine transaminase (ALT) and TNFα were determined. The liver tissues were fixed for histopathologic analysis. The permeability of BBB was detected by Evans blue staining (EB). Results The mice began to die 4 h after injection of APAP and the mortality rate reached 25% at 6 h. The serum levels of ALT began to increase at 2 h,and reached the peak at 9 h,which was consistent with the changes of liver histopathology, showing massive or submassive necrosis. The level of serum TNFa was significantly increased at 6 h. The concentration of EB in brain tissue also reached the peak at 6 h. Conclusion In APAP-induced ALF,serum TNFα level was obviously increased , which was consistent with the increased concentration of EB in brain tissue. TNFα might be an important cytokine that increased the permeability of BBB in APAP-induced ALF.%目的 探讨对乙酰氨基酚/扑热息痛(APAP)导致的急性肝衰竭(ALF)小鼠模型中血清肿瘤坏死因子α(TNFα)及血脑屏障(BBB)通透性的改变.方法 应用APAP建立ALF小鼠模型,观察死亡率、血清丙氨酸氨基转移酶(ALT)及TNFo含量及肝组织病理学变化.利用伊文思蓝(EB)在脑中含量检测BBB通透性.结果 小鼠注射APAP后4h开始死亡,6h死亡率达到高峰.血清ALT水平2h开始升高,9h达到高峰.肝脏病理学9h病变最重,表现为大块或亚大块出血性坏死.6h组血清TNFα较0小时组显著升高.脑组织EB含量于2h开始升高,6h达到高峰.结论 在APAP所致的ALF动物模型中,血清TNFα水平明显增高,且与脑组织EB含量的显著升高相一致.TNFα可能是导致ALF时BBB通透性增加的重要细胞因子.

  3. [Neonatal hypoxic-ischemic nephropathy and urinary diagnostic indices: the utility of measuring tubular enzymes (NAG and AAP)].

    Bertotti, A; De Marchi, S; Brovedani, P; Gaeta, G; Peratoner, L; Mangiarotti, M A


    Feto-neonatal hypoxia can cause a functional kidney impairment, which is often temporary and not clinically overt, but sometimes leading to acute renal failure. Hypoxic stress may result in a tubulo-interstitial damage, and kidney tubular enzymes determination has proved to be an easy, early, and non invasive method to define a tubular interstitial lesion. A major target of nephrotoxicity is the proximal tubular cell: alterations in brush-border membrane and cytoplasm result in increased turnover processes in the kidney cortex, following by a corresponding increased excretion of alanine-aminopeptidase (AAP) and N-acetyl-glucosaminidase (NAG) from the proximal tubular cells, long before glomerular or tubular functions are impaired. AAP and NAG excretion is directly correlated with the strength and the duration of toxic alteration of the proximal tubule. NAG and AAP have been already studied in the adults and the children; they have been chosen for this investigation with a double aim: 1) to define the amount of their urinary excretion in relation with gestational age at birth; 2) to evaluate if in the newborn, independently of the gestational age, their urinary concentration may be increased by ischaemic conditions caused by hypoxia. We studied 52 healthy newborns (7 preterm of 33-36 weeks and 45 full-term) and 16 newborns with feto-neonatal hypoxia (8 preterm of 26-36 weeks and full-term) at the forth day of life. Urinary NAG and AAP were assayed by colorimetric methods and the results expressed as mU/mg. creatininuria.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Oxidative damage: the biochemical mechanism of cellular injury and necrosis in choline deficiency.

    Repetto, Marisa G; Ossani, Georgina; Monserrat, Alberto J; Boveris, Alberto


    Oxidative stress and damage are characterized by decreased tissue antioxidant levels, consumption of tissue alpha-tocopherol, and increased lipid peroxidation. These processes occur earlier than necrosis in the liver, heart, kidney, and brain of weanling rats fed a choline deficient (CD) diet. In tissues, water-soluble antioxidants were analyzed as total reactive antioxidant potential (TRAP), alpha-tocopherol content was estimated from homogenate chemiluminescence (homogenate-CL), and lipid peroxidation was evaluated by thiobarbituric acid reactive substances (TBARS). Histopathology showed hepatic steatosis at days 1-7, tubular and glomerular necrosis in kidney at days 6 and 7, and inflammation and necrosis in heart at days 6 and 7. TRAP levels decreased by 18%, 48%, 56%, and 66% at day 7, with t(1/2) (times for half maximal change) of 2.0, 1.8, 2.5, and 3.0 days in liver, kidney, heart, and brain, respectively. Homogenate-CL increased by 97%, 113%, 18%, and 297% at day 7, with t(1/2) of 2.5, 2.6, 2.8, and 3.2 days in the four organs, respectively. TBARS contents increased by 98%, 157%, 104%, and 347% at day 7, with t(1/2) of 2.6, 2.8, 3.0, and 5.0 days in the four organs, respectively. Plasma showed a 33% decrease in TRAP and a 5-fold increase in TBARS at day 5. Oxidative stress and damage are processes occurring earlier than necrosis in the kidney and heart. In case of steatosis prior to antioxidant consumption and increased lipid peroxidation, no necrosis is observed in the liver.

  5. B-tubular surfaces in Lorentzian Heisenberg Group H3

    Talat Körpınar


    Full Text Available In this paper, B-tubular surfaces in terms of biharmonic spacelike new type B-slant helices according to Bishop frame in the Lorentzian Heisenberg group H3 are studied. The Necessary and sufficient conditions for new type B-slant helices to be biharmonic are obtained. B-tubular surfaces in the cLorentzian Heisenberg group H3 are characterized. Additionally, main results in Figures 1, 2, 3 and 4 are illustrated.

  6. Behaviour of concrete filled steel tubular columns under fire

    查晓雄; 钟善桐


    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.

  7. Worse Prognosis in Papillary, Compared to Tubular, Early Gastric Carcinoma

    Yu, Huiping; Fang, Cheng; Chen, Lin; Shi, Jiong; Fan, Xianshan; Zou, Xiaoping; Huang, Qin


    Purpose: Papillary early gastric carcinoma (EGC) is uncommon but shows worse prognosis in our most recent study in a Chinese population with unknown reasons. The aim of the present study was to further investigate risk factors for worse prognosis in patients with papillary adenocarcinoma, compared to those with tubular adenocarcinoma. Methods: We searched the electronic pathology databank for radical gastrectomy cases over an 8-year period at a single medical center in Nanjing, China, and identified consecutive 240 EGC cases that were classified as either papillary (n=59) or tubular (n=181) EGC tumors in accordance with the World Health Organization (WHO) gastric cancer diagnosis criteria. We investigated and compared clinicopathologic risk factors for prognosis between papillary and tubular EGC groups. All patients were followed up and their 5-year survival rate was compared statistically with the Kaplan-Meier method with a log rank test. Results: Compared to tubular EGCs, papillary EGCs were significantly more common in elderly patients, more frequently occurred in the proximal stomach with protruding/elevated growth patterns, submucosal invasion, and a micropapillary component. Although lymphovascular invasion (16.9%), nodal (13.6%) and distant (11.8%) metastases in papillary EGCs were more frequent than those (8.3%, 7.2%, and 3.7%, respectively) in tubular EGCs, the differences approached but did not reach statistically significant levels. Significant risk factors for nodal metastasis included lymphovascular invasion in both EGC groups, but the ulcerative pattern and submucosal invasion only in tubular EGCs. The 5-year survival rate was significantly worse in papillary (80.5%) than in tubular (96.8%) EGCs. Conclusions: Compared to tubular EGCs, papillary EGCs diagnosed with the WHO criteria in Chinese patients were more frequent in elderly patients, proximal stomach and showed the significantly worse 5-year survival rate with more protruding/elevated growth

  8. Mitochondrial dysfunction contributes to the cytotoxicity induced by tentacle extract from the jellyfish Cyanea capillata in rat renal tubular epithelial NRK-52E cells.

    Wang, Tao; He, Qian; Xiao, Liang; Wang, Qianqian; Zhang, Bo; Wang, Beilei; Liu, Guoyan; Zheng, Jiemin; Yu, Bentong; Zhang, Liming


    Our previous studies have shown that tentacle extract (TE) from the jellyfish Cyanea capillata could induce a delayed jellyfish envenomation syndrome with severe multiple organ dysfunctions, among which renal injury with tubular necrosis seemed to be most serious. So, in this study, we aimed to explore the toxic effect of TE on rat renal tubular epithelial NRK-52E cells. Based on the previous findings that TE could cause oxidative damage in erythrocytes, the effects of TE on cell oxidative stress conditions, including ROS production and lipid peroxidation, and mitochondrial dysfunction associated with cell death were investigated in NRK-52E cells. The results showed that TE caused cell morphological change and decreased cell viability through induction of apoptosis and necrosis in NRK-52E cells. Meanwhile, ROS overproduction and mitochondrial membrane potential decrease were found before the cell death occurred. It was concluded that TE could induce cytotoxicity, especially apoptosis and necrosis, in NRK-52E cells, and mitochondrial dysfunction and ROS overproduction might play important roles in the process of cell injury and death.

  9. Tubular atrophy in the pathogenesis of chronic kidney disease progression.

    Schelling, Jeffrey R


    The longstanding focus in chronic kidney disease (CKD) research has been on the glomerulus, which is sensible because this is where glomerular filtration occurs, and a large proportion of progressive CKD is associated with significant glomerular pathology. However, it has been known for decades that tubular atrophy is also a hallmark of CKD and that it is superior to glomerular pathology as a predictor of glomerular filtration rate decline in CKD. Nevertheless, there are vastly fewer studies that investigate the causes of tubular atrophy, and fewer still that identify potential therapeutic targets. The purpose of this review is to discuss plausible mechanisms of tubular atrophy, including tubular epithelial cell apoptosis, cell senescence, peritubular capillary rarefaction and downstream tubule ischemia, oxidative stress, atubular glomeruli, epithelial-to-mesenchymal transition, interstitial inflammation, lipotoxicity and Na(+)/H(+) exchanger-1 inactivation. Once a a better understanding of tubular atrophy (and interstitial fibrosis) pathophysiology has been obtained, it might then be possible to consider tandem glomerular and tubular therapeutic strategies, in a manner similar to cancer chemotherapy regimens, which employ multiple drugs to simultaneously target different mechanistic pathways.

  10. 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

  11. Acute ischemic cerebral attack

    Franco-Garcia Samir; Barreiro-Pinto Belis


    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...

  12. Reduction in toxicity of coking wastewater to aquatic organisms by vertical tubular biological reactor.

    Zhou, Siyun; Watanabe, Haruna; Wei, Chang; Wang, Dongzhou; Zhou, Jiti; Tatarazako, Norihisa; Masunaga, Shigeki; Zhang, Ying


    We conducted a battery of toxicity tests using photo bacterium, algae, crustacean and fish to evaluate acute toxicity profile of coking wastewater, and to evaluate the performance of a novel wastewater treatment process, vertical tubular biological reactor (VTBR), in the removal of toxicity and certain chemical pollutants. A laboratory scale VTBR system was set up to treat industrial coking wastewater, and investigated both chemicals removal efficiency and acute bio-toxicity to aquatic organisms. The results showed that chemical oxygen demand (COD) and phenol reductions by VTBR were approximately 93% and 100%, respectively. VTBR also reduced the acute toxicity of coking wastewater significantly: Toxicity Unit (TU) decreased from 21.2 to 0.4 for Photobacterium phosphoreum, from 9.5 to 0.6 for Isochrysis galbana, from 31.9 to 1.3 for Daphnia magna, and from 30.0 to nearly 0 for Danio rerio. VTBR is an efficient treatment method for the removal of chemical pollutants and acute bio-toxicity from coking wastewater.

  13. Striatal necrosis in type 1 glutaric aciduria: Different stages in two siblings

    Anitha Sen


    Full Text Available Two siblings born of a consanguineous marriage with history of neurologic deterioration were imaged. Imaging features are classical of glutaric aciduria type 1 (GA-1, acute (striatal necrosis stage in younger sibling, and chronic stage in older sibling. GA-1 is an autosomal recessive disease with typical imaging features. Greater awareness about this condition among clinicians and radiologists is essential for early diagnosis and prevention of its catastrophic consequences. Striatal necrosis with stroke-like signal intensity on imaging correlates with clinical stage of patients.

  14. 微小RNA在肿瘤坏死因子α介导的急性肝功能衰竭小鼠体内的表达谱及其作用%The expression profile and roles of microRNA in tumor necrosis factor α-mediated acute liver failure in mouse model

    安方梅; 余东山; 龚邦东; 赵钢德; 王晖; 郭清; 俞红; 谢青


    Objective To study the expression profile of microRNA (miRNA) and the roles in pathogenesis of acute liver failure in mouse model. Methods Eighty-five BALB/c mice were divided into four groups: 40 in model group of acute liver failure were intraperitoneally injected with Dgalactosamine (D-GalN) and lipopolysaccharides (LPS); 20 in D-GalN group were injected with DGalN only; 20 in LPS group were injected with LPS only; 5 in control group were injected with saline.Liver histology of mouse was observed at hour 0, 5, 7 of injection, and sera and liver tissues were collected at hour 0, 1, 3, 5, 7, 9 of injection. Meanwhile, levels of inflammatory factors [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)] in serum and liver tissue were detected by realtime polymerase chain reaction (PCR). Lock nucleic acid (LNA)-based miRNA microarray technology was used to detect the expression profile of hepatic miRNA, and the expression of miRNA was verified by real time quantification-polymerase chain reaction (RT-PCR). Mouse macrophage Raw264.7 cells were induced by LPS in vitro and the expressions of miRNA at different time points were detected.The comparison of means among groups was analyzed using one way ANOVA and the correlation were analyzed by Pearson and Spearman correlation. Results Microarray analysis found that the expression profile of miRNA during the acute liver failure changed dramatically. There were 97 miRNA in model group changed significantly compared with control group (P<0.01), including 21 up-regulated and 27down-regulated at hour 5 and 7 of injection. Furthermore, the expressions of miR 146a and miR-155were verified by RT-PCR and found they both increased progressively over time after injection.Correlation analysis showed that miR-155 was well correlated with both TNF-α and IL-6 expressions.It was further found that miR-146a and miR-155 were both up-regulated in activated Raw264.7 cells in vitro. Conclusions The expression profile of miRNA changes

  15. Toward high-torque electrostatic tubular motors

    Helin, Philippe; Bourbon, Gilles; Minotti, Patrice; Fujita, Hiroyuki


    A new generation of electrostatic micro-motors is investigated using cooperation of arrayed direct-drive actuators. Electrostatic scratch-drive actuators (SDA), which combine active frictional contact mechanisms with electrostatic actuation, are particularly analyzed. Active polysilicon sheets of 2*3 mm2 that integrate up to several thousands of electrostatic scratch drive actuators are fabricated by silicon surface micro-machining process. Each elementary actuator provides its contribution according to the driving force superposition principle, with internal forces as high as 105uN are available from this sheet. According to their natural flexibility, active polysilicon sheets can be coated onto large surfaces. A new generation of self-assembled tubular electrostatic micromotors is developed using this concept. A prototype of a cylindrical micromotor, whose external diameter and length are 1 mm and 2 mm, respectively, has been realized through the insertion of a flexible active polysilicon sheet at the rotor/motor- frame interface. After final assembling, the sheet has to be jammed onto the chassis, in order to allow the rotor to be moved with respect to the motor frame. Thus, the sheet must be in close contact with both the rotor and the motor frame, whatever the gap, which separates the two macroscopic parts. The problem related to the micro/macro world interfacing is solved during the design of sheet in allowing an out-of- plane motion of SDA in order to provide a self gap compensation, whatever both the thermal expansion effects and the macroscopic machining tolerances. The expected driving characteristics show the interest of both cooperative arrayed microactuators and direct drive frictional mechanisms.

  16. Heme protein-induced tubular cytoresistance: expression at the plasma membrane level.

    Zager, R A


    Following experimental rhabdomyolysis, animals become resistant to heme protein-induced acute renal failure (ARF). The goals of this study were to: (a) ascertain whether this resistance, previously documented only in vivo, is expressed directly at the proximal tubular cell level; (b) determine whether heme proteinuria (vs. other consequences of rhabdomyolysis) is its trigger; and (c) ascertain some of its subcellular determinants. Rats were injected with a borderline toxic dose of glycerol and 24 hours later proximal tubular segments (PTS) were isolated for study. Their vulnerability to diverse forms of injury (FeSO4-induced oxidant stress, hypoxia, Ca2+ ionophore, cytochalasin D, PLA2) was compared to that found in normal PTS. Post-glycerol PTS manifested significant resistance to each insult (decreased lactate dehydrogenase +/- N-acetyl-beta-D-glucosaminidase release). Protection against FeSO4 was virtually complete and it was associated with a 50% decrease in membrane lipid peroxidation. No decrease in hydroxyl radical generation was noted during the FeSO4 challenge (salicylate trap assessment), suggesting a primary increase in membrane resistance to attack. That PLA2 addition caused less deacylation, plasma membrane enzyme (alanine aminopeptidase) release, and LDH leakage from post-glycerol versus normal tubules supported this hypothesis. To test whether cytoresistance was specifically triggered by heme proteins (vs. being a non-specific filtered protein effect, or a result of endotoxin cascade activation), rats were injected with purified myoglobin, non-heme containing filterable proteins, or endotoxin. Only myoglobin induced cytoresistance. In vivo heme oxygenase inhibition (tin-protoporphyrin) did not block the emergence of cytoresistance and it was expressed despite Na,K-ATPase inhibition (ouabain) or cytoskeletal disruption (cytochalasin D). In vivo heat shock failed to protect. In conclusion, (1) rhabdomyolysis induces broad based proximal tubular

  17. Impact of weaning from acute dialytic therapy on outcomes of chronic kidney disease following urgent-start dialysis.

    Chen, Yung-Ming; Li, Wen-Yi; Wu, Vin-Cent; Wang, Yi-Cheng; Hwang, Shang-Jyh; Lin, Shih-Hwa; Wu, Kwan-Dun


    Discontinuation of acute, unplanned dialysis is always an important therapeutic goal in dialysis-requiring patients with existing chronic kidney disease. Only a limited proportion of patients could be weaned off dialysis and remained dialysis-free. Here we performed a multicenter, observational study to investigate factors associated with successful weaning from acute dialysis, and to explore the potential impact of weaning itself on outcomes of patients with chronic kidney disease following urgent-start dialysis. We recruited 440 chronic kidney disease patients with a baseline estimated glomerular filtration rate 1 month died, and 36 (8.6%) were removed from dialysis, with 26 (6.2%) remaining alive and dialysis-free. Logistic regression analysis found that age ≧ 65 years, ischemic acute tubular necrosis, nephrotoxic exposure, urinary obstruction, and higher predialysis estimated glomerular filtration rate and serum hemoglobin were predictors of weaning off dialysis. After adjustment for propensity scores for dialysis weaning, Cox proportional hazards models showed successful weaning from dialysis (adjusted hazard ratio 0.06; 95% confidence interval 0.01 to 0.35), along with a history of hypertension and serum albumin, were independent protectors for early death. Conversely, a history of stroke, peripheral arterial disease and cancer predicted the occurrence of early mortality. In conclusion, this prospective cohort study shows that compared to patients with chronic kidney disease who became end-stage renal disease after acute dialysis, patients who could be weaned off acute dialytic therapy were associated with reduced risk of premature death over a 2-year observation period.


    Christopher eBaines


    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.

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

    Bridges, Christy C., E-mail:; Zalups, Rudolfs K.; Joshee, Lucy


    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.

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


    @@ 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.

  1. The dynamic changes of the serum levels of interleukin-1β, tumor necrosis factor-α, cyclooxygenase-2 in acute gouty arthritis patients%痛风性关节炎患者血清白细胞介素-1β肿瘤坏死因子-α环氧化酶-2水平的动态变化研究

    袁艳平; 李长贵


    目的 观察严重程度不同的急性痛风患者血清白细胞介素(IL)-1β、肿瘤坏死因子(TNF)-α、环氧化酶-2的动态变化,为确定痛风急性期镇痛药物的使用疗程提供依据.方法 选择痛风性关节炎患者90例,其中急性发作期60例,缓解期30例(观察组3),健康体检者(对照组)30名.参照主诉疼痛程度评分法(VRS-4法),将急性痛风性关节炎分为重度(观察组1)和轻度(观察组2)2个亚组.痛风急性发作期的患者均给予相同剂量和疗程的依托考昔和秋水仙碱治疗14 d,应用酶联免疫吸附法(ELISA)分别检测发病后第1、3、7、10、14天血清IL-1β、TNF-α、环氧化酶-2水平.组间比较采用t检验,多组间均数比较采用单因素方差分析.结果 ①与对照组相比,观察组1、2在急性痛风性关节炎发病的第1~7天IL-1β、TNF-α水平明显升高(P<0.01),第10~14天恢复正常水平;环氧化酶-2水平在第1~3天明显升高(P<0.01),第7~10天恢复正常水平;而上述指标观察组3与对照组比较差异无统计学意义(t=-0.880,-1.201,-0.548; P=0.383,0.235,0.586).②与观察组2相比,在急性痛风发病的第10天观察组1 IL-1β、TNF-α水平明显升高[(24±5) pg/ml和(19±3) pg/ml,(323±84)ng/ml和(234±29) ng/ml;P=0.001,0.002],而观察组2与对照组之间比较差异无统计学意义(P=0.357);环氧化酶-2水平在急性痛风发病的第7天观察组1明显升高[(12.9±2.0) pg/ml和(9.1±1.6) pg/ml],而观察组2与对照组之间比较差异无统计学意义(P=0.941).结论 急性痛风性关节炎镇痛治疗10~14 d炎性因子才能完全恢复正常.本研究为急性痛风性关节炎镇痛药物使用疗程提供了依据.%Objective To investigate the dynamic changes of serum interleukin (IL)-1β,tumor necrosis factor (TNF)-α,cyclooxygenase (COX)-2 levels in patients with acute gouty arthritis with various severityes and to provide evidence for the course of anti-inflammatory drug used

  2. Genetics of Infantile Bilateral Striatal Necrosis

    J Gordon Millichap


    Full Text Available The gene mutation causing autosomal recessive infantile bilateral striatal necrosis (IBSN was identified in eight consanguineous Israeli Bedouin families, in a study at Schneider Children’s Medical Center, Petah Tikva, Israel, and other centers.

  3. 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.

  4. 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


    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.

  5. 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


    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%).

  6. Acute ischemia/reperfusion injury after isogeneic kidney transplantation is mitigated in a rat model of chronic renal failure.

    Vercauteren, Sven R; Ysebaert, Dirk K; Van Rompay, An R; De Greef, Kathleen E; De Broe, Marc E


    The influence of chronic renal failure on renal susceptibility to an acute ischemic insult was evaluated. Recipient Lewis rats were randomly assigned to undergo 5/6 nephrectomy (chronic renal failure, CRF) or sham operation (normal renal function, NRF). After 11 weeks, normal kidneys of Lewis donor rats were transplanted in the recipients. The outcome of the isografts was assessed. Filtration capacity of the isografts in the CRF rats was preserved to approximately one-quarter of its normal capacity on the 1st day post-transplantation, whereas it fell to 0 in the NRF rats. This was reflected by a significantly higher increase in serum creatinine in the latter group. The isografts in the CRF rats had a significantly lower degree of acute tubular necrosis and no increase in the number of macrophages and T lymphocytes in the first 24 h in contrast to the NRF rats. Epithelial regeneration and repair started earlier in the CRF group. In conclusion, the present study indicated that CRF blunted ischemia/reperfusion injury of a transplanted kidney, and that its regeneration capacity was certainly not hampered by the presence of chronic uremia. These results will be the basis for studies on modulation of early leukocyte-endothelial interactions resulting from immunological disturbances inherent to the uremic environment.

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

    Aiyu Zhao


    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.

  8. Acute hepatic encephalopathy with diffuse cortical lesions

    Arnold, S.M.; Spreer, J.; Schumacher, M. [Section of Neuroradiology, Univ. of Freiburg (Germany); Els, T. [Dept. of Neurology, University of Freiburg (Germany)


    Acute hepatic encephalopathy is a poorly defined syndrome of heterogeneous aetiology. We report a 49-year-old woman with alcoholic cirrhosis and hereditary haemorrhagic telangiectasia who developed acute hepatic coma induced by severe gastrointestinal bleeding. Laboratory analysis revealed excessively elevated blood ammonia. MRI showed lesions compatible with chronic hepatic encephalopathy and widespread cortical signal change sparing the perirolandic and occipital cortex. The cortical lesions resembled those of hypoxic brain damage and were interpreted as acute toxic cortical laminar necrosis. (orig.)

  9. Proximal tubular dysfunction as an indicator of chronic graft dysfunction

    N.O.S. Câmara


    Full Text Available New strategies are being devised to limit the impact of renal sclerosis on graft function. Individualization of immunosuppression, specifically the interruption of calcineurin-inhibitors has been tried in order to promote better graft survival once chronic graft dysfunction has been established. However, the long-term impact of these approaches is still not totally clear. Nevertheless, patients at higher risk for tubular atrophy and interstitial fibrosis (TA/IF development should be carefully monitored for tubular function as well as glomerular performance. Since tubular-interstitial impairment is an early event in TA/IF pathogenesis and associated with graft function, it seems reasonable that strategies directed at assessing tubular structural integrity and function would yield important functional and prognostic data. The measurement of small proteins in urine such as α-1-microglobulin, N-acetyl-beta-D-glucosaminidase, alpha/pi S-glutathione transferases, β-2 microglobulin, and retinol binding protein is associated with proximal tubular cell dysfunction. Therefore, its straightforward assessment could provide a powerful tool in patient monitoring and ongoing clinical assessment of graft function, ultimately helping to facilitate longer patient and graft survival associated with good graft function.

  10. Urinary proteins of tubular origin: basic immunochemical and clinical aspects.

    Scherberich, J E


    A variety of tubular marker proteins, as compared to healthy controls, are excreted at an increased rate in the urine of patients with renal damage. Beside cytoplasmic glutathione-S-transferase and lysosomal beta-N-acetyl-glucosaminidase (beta-NAG) the majority of kidney-related urine proteins derives from membrane surface components of the most vulnerable proximal tubule epithelia, among them ala-(leu-gly)-aminopeptidase, gamma-glutamyl transpeptidase (GGT), the tubular portion of angiotensinase A, the major brush border glycoprotein 'SGP-240' and adenosine-deaminase-binding protein. Urinary tissue proteins, e.g. brush border (BB) microvilli, are immunologically identical with those antigens prepared from cell membranes of the human kidney itself. BB antigens are shed into the urine of patients with glomerulonephritis, interstitial nephritis, systemic diseases, e.g. systemic lupus erythematosus (SLE), diabetes mellitus and multiple myeloma, arterial hypertension, infectious diseases (malaria, AIDS) and after operations, renal grafting and administration of X-ray contrast media, aminoglycosides or certain cytostatics (cis-platinum). Tissue proteinuria of tubular proteins is determined by enzyme-kinetic or quantitative immunological assays applying either poly- or monoclonal antikidney antibodies. Clinical, ultrastructural and histochemical studies support the idea that both 'soluble' and high-molecular-weight membrane particles (vacuolar blebs, greater than 10(6) dalton) as well as microfilamental components of the epithelial cytoskeleton contribute to tubular 'histuria' which appears as a sensitive parameter in monitoring tubular damage under clinical conditions at a very early phase.

  11. Transient distal renal tubular acidosis following hump nosed viper bite: Two cases from Sri Lanka

    Ranga M Weerakkody


    Full Text Available Hump-nosed viper (Hypnale hypnale; HNV is one of the six major snake species in Sri Lanka that cause envenomation. Nephrotoxicity, coagulopathy, and neurotoxicity are wellrecognized features of its envenomation. Type 4 renal tubular acidosis (RTA4 has only once been described previously in this condition, and we report two further cases. Two patients aged 53 and 51 presented following HNV bites with acute kidney injury and microangiopathic hemolytic anemia. Both underwent multiple cycles of hemodialysis until the polyuric phase was reached. Despite polyuria, both patients developed resistant hyperkalemia that needed further hemodialysis. The urinary pH, arterial pH, delta ratio, and transtubular potassium gradient confirmed RTA4. HNV venom has been shown to damage the proximal convoluted tubules in animal studies, but not the distal convoluted tubule, and hence the mechanism of our observation in these two patients is unclear. Unexplained hyperkalemia in recovery phase of HNV bite should raise suspicions of RTA4.

  12. 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


    @@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].

  13. The glomerulo-tubular junction: a target in renal diseases.

    Lindop, G B M; Gibson, I W; Downie, T T; Vass, D; Cohen, E P


    Both global and segmental glomerulopathies may damage specific areas of the renal glomerulus. Diseases associated with glomerular hyperperfusion cause lesions at the vascular pole, while diseases associated with proteinuria often damage the tubular pole. Atubular glomeruli are now known to be plentiful in a variety of common renal diseases. These glomeruli are disconnected from their tubule at the tubular pole and therefore cannot participate in the production of urine. It is widely believed that the disconnection is a result of external compression by periglomerular fibrosis. However, the variable anatomy and cell populations within both the glomerulus and the beginning of the proximal tubule at the glomerulo-tubular junction may also have important roles to play in the response to damage at this sensitive site of the nephron.

  14. 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


    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}.

  15. Klinefelter's syndrome with renal tubular acidosis: impact on height.

    Jebasingh, F; Paul, T V; Spurgeon, R; Abraham, S; Jacob, J J


    A 19-year-old Indian man presented with a history of proximal muscle weakness, knock knees and gynaecomastia. On examination he had features of rickets and bilateral small testes. Karyotyping revealed a chromosomal pattern of 47,XXX, confirming the diagnosis of Klinefelter's syndrome. He was also found to have hyperchloraemic metabolic acidosis with hypokalaemia, hypophosphataemia, phosphaturia and glycosuria, which favoured a diagnosis of proximal renal tubular acidosis. Patients with Klinefelter's syndrome typically have a tall stature due to androgen deficiency, resulting in unfused epiphyses and an additional X chromosome. However, this patient had a short stature due to associated proximal renal tubular acidosis. To the best of our knowledge, this is the second case of Klinefelter's syndrome with short stature due to associated renal tubular acidosis reported in the literature. This report highlights the need to consider other causes when patients with Klinefelter's syndrome present with a short stature.

  16. ERCP in acute pancreatitis

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


    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.

  17. Spontaneous necrosis of solid gallbladder adenocarcinoma accompanied with pancreaticobiliary maljunction

    Tomohide Hori; Takashi Wagata; Kenji Takemoto; Takanobu Shigeta; Haruko Takuwa; Koichiro Hata; Shinji Uemoto; Naoki Yokoo


    A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder (GB) stone was admitted. Plain ultrasonography (US) incidentally detected a mass-like lesion in the fundus. Doppler US revealed that this elevated lesion had no blood flow. Computed tomography showed a relatively low-density mass, measuring 5 cm×4 cm in diameter, with no positive enhancement. Magnetic resonance imaging showed a mass in the fundus with a slightly low intensity on T1-weighted images and a slightly high intensity on T2-weighted images. We were agonized in making the qualitative diagnosis of mass-like lesions of the fundus, such as a benign tumor, cancer, or debris. We performed laparoscopic cholecystectomy, because the incarcerated GB stone clearly caused acute cholecystitis. Intra-operative cholangiography clearly revealed pancreaticobiliary maljunction. Amylase levels in the common bile duct and gallbladder were quite high. The elevated lesion in the fundus clearly showed severe necrosis. Although this necrotic nodule included non-viable adenocarcinoma cells, viable cancer cell nests were located in the muscularis propria and subcutaneous layer. Histopathological examination confirmed a solid adenocarcinoma. Thus, we diagnosed it as a gallbladder cancer, based on histopathological analysis of the resected specimen. We therefore undertook radical surgery, including wedge resection of the liver, radical dissection of regional lymph nodes, and resection of the extrahepatic bile duct. Histopathological findings revealed no cancer, hyperplasia or dysplasia in the additionally resected specimens. The patient was finally staged as T2, NO, H0, P0, M(-), stage 11. We present the first case of spontaneous necrosis of solid gallbladder adenocarcinoma, with a review of previous studies.

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

    Kevin Allred


    Full Text Available 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 stretched lava, runners, runner channels, and some lava blisters and squeeze-ups.


    X.S. Wang; S.J. Yuan; X.R. Huang; Y.X. Yao; Z.R. Wang


    The tube hydroforming process for manufacturing the tubular part with large perimeter difference was studied by means of experiments and FE simulation. It is an asymmetrical one and the expansion ratio is 70 percent. The part is successfully hydroformed by applying the useful wrinkles to accumulate suffcient metal in the area with large expansion ratio. The thickness distribution is analyzed, and the maximum thinning ratio of the part is 21.6 percent. It is shown from the experiment and simulation results that the tubular part with large perimeter difference, long expansion area and asymmetrical shape can be obtained in one step, applying the useful wrinkles. Typical failure modes were analyzed.

  20. Renal histology and immunopathology in distal renal tubular acidosis.

    Feest, T G; Lockwood, C M; Morley, A R; Uff, J S


    Renal biospy studies are reported from 10 patients with distal renal tubular acidosis (DRTA). On the biopsies from 6 patients who had associated immunological abnormalities immunofluorescent studies for immunoglobulins, complement, and fibrin were performed. Interstitial cellular infiltration and fibrosis were common findings in patients with and without immunological abnormalities, and were usually associated with nephrocalcinosis and/or recurrent urinary infection. No immune deposits were demonstrated in association with the renal tubules. This study shows that DRTA in immunologically abnormal patients is not caused by tubular deposition of antibody or immune complexes. The possibility of cell mediated immune damage is discussed.

  1. Effect of Shen Nong 33 on Gene Expression of Tumor Necrosis Factor inLipopolysacchride-Induced Acute Lung Injury Rat%神农33对急性肺损伤大鼠肿瘤坏死因子基因表达的影响

    刘继英; 李瑾; 王学谦


    Objective: To investigate the effect of Shen Nong 33(SN 33)(a traditional Chinese medicine)on gene expression of tu- mor necrosis factor( TNF-α) in lipopolysacchride(LPS)-induced acute lung injury( ALI)rat. Methods: The levels of TNF-α in rat serum were measured with ELISA and TNF-α gene expression in rat lung tissue was observed with Northern Blotting at different time courses. The effects of SN 33 and DXM on release and gene expression of TNF-α and the changes of lung his- topathology were observed at the same time. Results:The serum levels of TNF-α rapidly increased after LPS injection. TNF- α gene expression in rat lung tissue was dramatically upregulated during ALI. Both SN 33 and DXM could decreased the se- rum levels and lung gene expression of TNF-α. Conclusion: TNF-α plays an essential role in an inflammatory response. LPS- induced ALI may be prevented by SN 33 and DXM.%目的:探讨肿瘤坏死因子(TNF-α)在内毒素(LPS)所致急性肺损伤(ALI)发病过程中的作用,及神农33(SN 33)注射液对TNF-α基因表达的影响。方法:给大鼠静脉注射LPS,建立ALI模型。分别采用ELISA和Northern blotting方法检测LPS攻击后不同时间血清中TNF-α含量,及肺组织TNF-α mRNA水平的变化。同时以地塞米松(DXM)为对照,观察神农33注射液对TNF-α释放和表达的影响,及肺病理形态学的变化。结果:LPS诱发大鼠ALI过程中血清TNF-α水平均高于正常对照组(P<0.01)。肺组织TNF-α mRNA表达明显增高,以神农33保护的大鼠其TNF-α含量和mRNA表达均低于相应时相LPS攻击组,且肺损伤程度减轻。结论:TNF-α在LPS诱导的ALI过程中起着重要作用,神农33注射液可以抑制TNF-α的释放和表达,对肺脏有一定保护作用。

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

    Daniel P. Bradley


    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.

  3. Renal Papillary Necrosis: Role of Radiology

    Pandya, Vaidehi K.


    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 decline in renal function. Here we report three cases of RPN with typical imaging findings. One of them was diabetic and hypertensive female with recurrent Urinary tract Infections and other was a male with no known co-morbidity. Both of them were diagnosed to have renal papillary necrosis on CT scan and were managed operatively and conservatively, respectively. Third case was a healthy female being investigated to be renal donor for her son. Here RPN was an incidental finding and was treated conservatively. Thus CT scan could detect it pre-operatively and complications due to transplantation of a kidney with papillary necrosis were avoided. So, we want to emphasize the importance of Radiology, particularly CT scanning in detection of RPN and to guide early and prompt treatment. PMID:26894147

  4. Hyperglycemia Increases Susceptibility to Ischemic Necrosis

    D. Lévigne


    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.

  5. DNA damage response in renal ischemia-reperfusion and ATP-depletion injury of renal tubular cells.

    Ma, Zhengwei; Wei, Qingqing; Dong, Guie; Huo, Yuqing; Dong, Zheng


    Renal ischemia-reperfusion leads to acute kidney injury (AKI) that is characterized pathologically by tubular damage and cell death, followed by tubular repair, atrophy and interstitial fibrosis. Recent work suggested the possible presence of DNA damage response (DDR) in AKI. However, the evidence is sketchy and the role and regulation of DDR in ischemic AKI remain elusive. In this study, we demonstrated the induction of phosphorylation of ATM, H2AX, Chk2 and p53 during renal ischemia-reperfusion in mice, suggesting DDR in kidney tissues. DDR was also induced in vitro during the recovery or "reperfusion" of renal proximal tubular cells (RPTCs) after ATP depletion. DDR in RPTCs was abrogated by supplying glucose to maintain ATP via glycolysis, indicating that the DDR depends on ATP depletion. The DDR was also suppressed by the general caspase inhibitor z-VAD and the overexpression of Bcl-2, supporting a role of apoptosis-associated DNA damage in the DDR. N-acetylcysteine (NAC), an antioxidant, suppressed the phosphorylation of ATM and p53 and, to a less extent, Chk2, but NAC increased the phosphorylation and nuclear foci formation of H2AX. Interestingly, NAC increased apoptosis, which may account for the observed H2AX activation. Ku55933, an ATM inhibitor, blocked ATM phosphorylation and ameliorated the phosphorylation of Chk2 and p53, but it increased H2AX phosphorylation and nuclear foci formation. Ku55933 also increased apoptosis in RPTCs following ATP depletion. The results suggest that DDR occurs during renal ischemia-reperfusion in vivo and ATP-depletion injury in vitro. The DDR is partially induced by apoptosis and oxidative stress-related DNA damage. ATM, as a sensor in the DDR, may play a cytoprotective role against tubular cell injury and death.

  6. Immobilization increases interleukin-6, but not tumour necrosis factor-a, release from the leg during exercise in humans

    Reihmane, Dace; Hansen, Andreas Vigelsø; Jensen, Martin Gram;


    Data on interleukin-6 (IL-6) and tumour necrosis factor-a (TNF-a) release during acute exercise are not conclusive, and information is lacking about the impact of physical inactivity. Some studies have shown an increase, but others report no changes in IL-6 and TNF-a release during exercise. We...

  7. 78 FR 41421 - Certain Oil Country Tubular Goods From India, Korea, Philippines, Saudi Arabia, Taiwan, Thailand...


    ..., Philippines, Saudi Arabia, Taiwan, Thailand, Turkey, Ukraine, and Vietnam of certain oil country tubular goods... COMMISSION Certain Oil Country Tubular Goods From India, Korea, Philippines, Saudi Arabia, Taiwan, Thailand, Turkey, Ukraine, and Vietnam; Institution of Antidumping and Countervailing Duty Investigations...

  8. Tissue necrosis following intramuscular diclofenac injection

    Feyzi Çelik


    Full Text Available 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 necrosis. Caseis very interesting because of rarely.

  9. Intrarenal purinergic signaling in the control of renal tubular transport

    Prætorius, Helle; Leipziger, Jens Georg


    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 ...

  10. Luminal nucleotides are tonic inhibitors of renal tubular transport

    Leipziger, Jens Georg


    PURPOSE OF REVIEW: Extracellular ATP is an essential local signaling molecule in all organ systems. In the kidney, purinergic signaling is involved in an array of functions and this review highlights those of relevance for renal tubular transport. RECENT FINDINGS: Purinergic receptors are express...

  11. Distal renal tubular acidosis in recurrent renal stone formers

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


    Renal acidification ability was examined in 90 recurrent renal stone formers, using fasting morning urinary pH levels followed by a short ammonium chloride loading test in subjects with pH levels above 6.0. Fifteen patients (16.6%) revealed a distal renal tubular acidification defect: one patient...

  12. Screening renal stone formers for distal renal tubular acidosis

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


    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. 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.


    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

  14. Tubular aggregate myopathy: A phenotypic spectrum and morphological study

    Ghosh Amrita


    Full Text Available Tubular aggregates (TAs are inclusions described in skeletal muscle in a variety of disorders. In a retrospective analysis, TAs were found in 18 (0.24% cases and involved a spectrum of clinical phenotypes. Ultrastructurally, four distinct types of aggregates were noted. There was no correlation between the clinical phenotypes, duration of illness and types of TAs.

  15. Urinary Markers of Tubular Injury in Early Diabetic Nephropathy

    Temesgen Fiseha


    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.

  16. Cystinosis (ctns) zebrafish mutant shows pronephric glomerular and tubular dysfunction

    Elmonem, Mohamed A.; Khalil, Ramzi; Khodaparast, Ladan; Khodaparast, Laleh; Arcolino, Fanny O.; Morgan, Joseph; Pastore, Anna; Tylzanowski, Przemko; Ny, Annelii; Lowe, Martin; de Witte, Peter A.; Baelde, Hans J.; van den Heuvel, Lambertus P.; Levtchenko, Elena


    The human ubiquitous protein cystinosin is responsible for transporting the disulphide amino acid cystine from the lysosomal compartment into the cytosol. In humans, Pathogenic mutations of CTNS lead to defective cystinosin function, intralysosomal cystine accumulation and the development of cystinosis. Kidneys are initially affected with generalized proximal tubular dysfunction (renal Fanconi syndrome), then the disease rapidly affects glomeruli and progresses towards end stage renal failure and multiple organ dysfunction. Animal models of cystinosis are limited, with only a Ctns knockout mouse reported, showing cystine accumulation and late signs of tubular dysfunction but lacking the glomerular phenotype. We established and characterized a mutant zebrafish model with a homozygous nonsense mutation (c.706 C > T; p.Q236X) in exon 8 of ctns. Cystinotic mutant larvae showed cystine accumulation, delayed development, and signs of pronephric glomerular and tubular dysfunction mimicking the early phenotype of human cystinotic patients. Furthermore, cystinotic larvae showed a significantly increased rate of apoptosis that could be ameliorated with cysteamine, the human cystine depleting therapy. Our data demonstrate that, ctns gene is essential for zebrafish pronephric podocyte and proximal tubular function and that the ctns-mutant can be used for studying the disease pathogenic mechanisms and for testing novel therapies for cystinosis. PMID:28198397

  17. Distal renal tubular acidosis with multiorgan autoimmunity: A case report

    M.J. Van Den Wildenberg (Maria J.); E.J. Hoorn (Ewout); N. Mohebbi (Nilufar); C.A. Wagner (Carsten); A.J.J. Woittiez; P.A.M. de Vries; P. Laverman (Peter)


    textabstractA 61-year-old woman with a history of pernicious anemia presented with progressive muscle weakness and dysarthria. Hypokalemic paralysis (serum potassium, 1.4 mEq/L) due to distal renal tubular acidosis (dRTA) was diagnosed. After excluding several possible causes, dRTA was considered au

  18. Urinary Markers of Tubular Injury in Early Diabetic Nephropathy

    Fiseha, Temesgen; Tamir, Zemenu


    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

  19. Subanalytic Bundles and Tubular Neighbourhoods of Zero-Loci

    Vishwambhar Pati


    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.

  20. Modeling constrained sintering of bi-layered tubular structures

    Tadesse Molla, Tesfaye; Kothanda Ramachandran, Dhavanesan; Ni, De Wei;


    . Furthermore, the model is validated using densification results from sintering of bi-layered tubular ceramic oxygen membrane based on porous MgO and Ce0.9Gd0.1O1.95-d layers. Model input parameters, such as the shrinkage kinetics and viscous parameters are obtained experimentally using optical dilatometry...

  1. Geochemical characterization of tubular alteration features in subseafloor basalt glass

    Knowles, Emily; Staudigel, Hubert; Templeton, Alexis


    There are numerous indications that subseafloor basalts may currently host a huge quantity of active microbial cells and contain biosignatures of ancient life in the form of physical and chemical basalt glass alteration. Unfortunately, technological challenges prevent us from observing the formation and mineralization of these alteration features in situ, or reproducing tubular basalt alteration processes in the laboratory. Therefore, comprehensive analysis of the physical and chemical traces retained in mineralized tubules is currently the best approach for deciphering a record of glass alteration. We have used a number of high-resolution spectroscopic and microscopic methods to probe the geochemical and mineralogical characteristics of tubular alteration features in basalt glasses obtained from a suite of subseafloor drill cores that covers a range of different collection locations and ages. By combining three different synchrotron-based X-ray measurements - X-ray fluorescence microprobe mapping, XANES spectroscopy, and μ-XRD - with focused ion beam milling and transmission electron microscopy, we have spatially resolved the major and trace element distributions, as well as the oxidation state of Fe, determined the coordination chemistry of Fe, Mn and Ti at the micron-scale, and constrained the secondary minerals within these features. The tubular alteration features are characterized by strong losses of Fe2+, Mn2+, and Ca2+ compared to fresh glass, oxidation of the residual Fe, and the accumulation of Ti and Cu. The predominant phases infilling the alteration regions are Fe3+-bearing silicates dominated by 2:1 clays, with secondary Fe- and Ti-oxides, and a partially oxidized Mn-silicate phase. These geochemical patterns observed within the tubular alteration features are comparable across a diverse suite of samples formed over the past 5-100 Ma, which shows that the microscale mineralization processes are common and consistent throughout the ocean basins and

  2. Urinary granzyme A mRNA is a biomarker to diagnose subclinical and acute cellular rejection in kidney transplant recipients

    S.M. Ham; K.M. Heutinck; T. Jorritsma; F.J. Bemelman; M.C.M. Strik; W. Vos; J.J.F. Muris; S. Florquin; R.J.M. ten Berge; A.T. Rowshani


    The distinction between T-cell-mediated rejection (TCMR) and other causes of kidney transplant dysfunction such as tubular necrosis requires biopsy. Subclinical rejection (SCR), an established risk factor for chronic allograft dysfunction, can only be diagnosed by protocol biopsy. A specific non-inv

  3. Renal tubular function in patients treated with high-dose cisplatin

    Daugaard, G; Abildgaard, U; Holstein-Rathlou, N H;


    The effect of three cycles of high-dose cisplatin (40 mg/m2 day for 5 days) on renal tubular function was evaluated in 30 patients. A significant impairment of proximal tubular salt and water reabsorption rates was observed, but also distal tubular function seemed to be affected. These changes were...... and water reabsorption during cisplatin administration....

  4. 78 FR 52213 - Certain Oil Country Tubular Goods From India, Korea, the Philippines, Saudi Arabia, Taiwan...


    ... tubular goods from India and Turkey and LTFV imports of certain oil country tubular goods from India... COMMISSION Certain Oil Country Tubular Goods From India, Korea, the Philippines, Saudi Arabia, Taiwan, Thailand, Turkey, Ukraine, and Vietnam: Determinations On the basis of the record \\1\\ developed in...

  5. 78 FR 45502 - Certain Oil Country Tubular Goods From India and Turkey: Initiation of Countervailing Duty...


    ... International Trade Administration Certain Oil Country Tubular Goods From India and Turkey: Initiation of... country tubular goods (``OCTG'') from India and the Republic of Turkey (``Turkey''), filed in proper form... Countervailing Duties on Imports of Certain Oil Country Tubular Goods from India and the Republic of...

  6. Factor H and Properdin Recognize Different Epitopes on Renal Tubular Epithelial Heparan Sulfate

    Zaferani, Azadeh; Vives, Romain R.; van der Pol, Pieter; Navis, Gerjan J.; Daha, Mohamed R.; van Kooten, Cees; Lortat-Jacob, Hugues; Seelen, Marc A.; van den Born, Jacob


    During proteinuria, renal tubular epithelial cells become exposed to ultrafiltrate-derived serum proteins, including complement factors. Recently, we showed that properdin binds to tubular heparan sulfates (HS). We now document that factor H also binds to tubular HS, although to a different epitope

  7. Lateral diffusion on tubular membranes: quantification of measurements bias.

    Marianne Renner

    Full Text Available Single Particle Tracking (SPT is a powerful technique for the analysis of the lateral diffusion of the lipid and protein components of biological membranes. In neurons, SPT allows the study of the real-time dynamics of receptors for neurotransmitters that diffuse continuously in and out synapses. In the simplest case where the membrane is flat and is parallel to the focal plane of the microscope the analysis of diffusion from SPT data is relatively straightforward. However, in most biological samples the membranes are curved, which complicates analysis and may lead to erroneous conclusions as for the mode of lateral diffusion. Here we considered the case of lateral diffusion in tubular membranes, such as axons, dendrites or the neck of dendritic spines. Monte Carlo simulations allowed us to evaluate the error in diffusion coefficient (D calculation if the curvature is not taken into account. The underestimation is determined by the diameter of the tubular surface, the frequency of image acquisition and the degree of mobility itself. We found that projected trajectories give estimates that are 25 to 50% lower than the real D in case of 2D-SPT over the tubular surface. The use of 3D-SPT improved the measurements if the frequency of image acquisition was fast enough in relation to the mobility of the molecules and the diameter of the tube. Nevertheless, the calculation of D from the components of displacements in the axis of the tubular structure gave accurate estimate of D, free of geometrical artefacts. We show the application of this approach to analyze the diffusion of a lipid on model tubular membranes and of a membrane-bound GFP on neurites from cultured rat hippocampal neurons.

  8. Lateral diffusion on tubular membranes: quantification of measurements bias.

    Renner, Marianne; Domanov, Yegor; Sandrin, Fanny; Izeddin, Ignacio; Bassereau, Patricia; Triller, Antoine


    Single Particle Tracking (SPT) is a powerful technique for the analysis of the lateral diffusion of the lipid and protein components of biological membranes. In neurons, SPT allows the study of the real-time dynamics of receptors for neurotransmitters that diffuse continuously in and out synapses. In the simplest case where the membrane is flat and is parallel to the focal plane of the microscope the analysis of diffusion from SPT data is relatively straightforward. However, in most biological samples the membranes are curved, which complicates analysis and may lead to erroneous conclusions as for the mode of lateral diffusion. Here we considered the case of lateral diffusion in tubular membranes, such as axons, dendrites or the neck of dendritic spines. Monte Carlo simulations allowed us to evaluate the error in diffusion coefficient (D) calculation if the curvature is not taken into account. The underestimation is determined by the diameter of the tubular surface, the frequency of image acquisition and the degree of mobility itself. We found that projected trajectories give estimates that are 25 to 50% lower than the real D in case of 2D-SPT over the tubular surface. The use of 3D-SPT improved the measurements if the frequency of image acquisition was fast enough in relation to the mobility of the molecules and the diameter of the tube. Nevertheless, the calculation of D from the components of displacements in the axis of the tubular structure gave accurate estimate of D, free of geometrical artefacts. We show the application of this approach to analyze the diffusion of a lipid on model tubular membranes and of a membrane-bound GFP on neurites from cultured rat hippocampal neurons.

  9. sup 99m Tc renal tubular function agents: Current status

    Eshima, D.; Fritzberg, A.R.; Taylor, A. Jr. (Emory Univ. School of Medicine, Atlanta, GA (USA))


    Orthoiodohippuric (OIH) acid labeled with 131I is a widely used renal radiopharmaceutical agent and has been the standard radiopharmaceutical agent for the measurement of effective renal plasma flow (EPRF). Limitations to the routine clinical use of 131I OIH are related to the suboptimal imaging properties of the 131I radionuclide and its relatively high radiation dose. 123I has been substituted for 131I; however, its high cost and short shelf-life have limited its widespread use. Recent work has centered on the development of a new 99mTc renal tubular function agent, which would use the optimal radionuclidic properties and availability of 99mTc and combine the clinical information provided by OIH. The search for a suitable 99mTc renal tubular function agent has focused on the diamide dithiolate (N2S2), the paraaminohippuric iminodiacetic acid (PAHIDA), and the triamide mercaptide (N3S) donor ligand systems. To date, the most promising 99mTc tubular function agent is the N3S complex: 99mTc mercaptoacetyltriglycine (99mTc MAG3). Studies in animal models in diuresis, dehydration, acid or base imbalance, ischemia, and renal artery stenosis demonstrate that 99mTc MAG3 behaves similarly to 131I OIH. A simple kit formulation is available that yields the 99mTc MAG3 complex in high radiochemical purity. Studies in normal subjects and patients indicate that 99mTc MAG3 is an excellent 99mTc renal tubular agent, but its plasma clearance is only 50% to 60% that of OIH. In an effort to develop an improved 99mTc renal tubular function agent, changes have been made in the core N3S donor ligand system, but to date no agent has been synthesized that is clinically superior to 99mTc MAG3. 61 references.

  10. Amylase: creatinine clearance ratio and urinary excretion of lysozyme in acute pancreatitis and acute duodenal perforation.

    Berger, G M; Cowlin, J; Turner, T J


    The amylase:creatinine clearance ratio in patients suffering from acute pancreatitis or acute duodenal perforation was higher than normal in both groups of patients. These findings cast doubt on the value of this parameter as a specific index of acute pancreatitis. The mechanism or mechanisms underlying the increased amylase excretion have not been determined. However, the markedly elevated urinary excretion of lysozyme observed in some patients suggests, by analogy, that diminished tubular reabsorption of amylase may contribute towards the elevated amylase:creatinine ratio.

  11. Intoxicação aguda por fluorsilicato de sódio em bovinos no Estado de Santa Catarina Acute sodium fluorsilicate poisoning in cattle in the state of Santa Catarina

    Joelma Lucioli


    Full Text Available Descreve-se um surto de intoxicação aguda por fluorsilicato de sódio em seis bovinos e a reprodução experimental da intoxicação, através da administração de fluorsilicato de sódio a dois animais. O quadro clínico era caracterizado por tremores musculares em todo o corpo, salivação intensa, gemidos e inquietação, com morte rápida. Na intoxicação experimental foi observado também decúbito lateral, com respiração dificultosa, contração tônica e episódios de pedalagem. As lesões macroscópicas principais foram observadas no rúmen e abomaso, consistindo em mucosa difusamente vermelha, com edema de parede e ulceração. Na histologia havia necrose acentuada de segmentos da mucosa ruminal e abomasal, associada a infiltrado de polimorfonucleares na submucosa e muscular. Além de lesões gástricas os bovinos apresentavam necrose portal hepática, degeneração e necrose tubular renal e necrose de folículos linfóides. O fluorsilicato de sódio produziu sinais clínicos com 300mg/kg e morte com 400mg/kg.An acute poisoning with sodium fluorsilicate in six cattle is reported, as well as the experimental reproduction by oral administration of the compound to two bovines. Clinical manifestations of the natural poisoning include muscle tremors, hypersalivation, groaning and rapid death. In the experimental poisoning lateral recumbency, dyspnea, tetanic spasms and paddling was also observed. The main necropsy findings were reddening, edema and ulceration of the ruminal and abomasal mucosa. Histopathological findings were necrosis of the epithelium of the forestomachs with polymorphonuclear infiltration of the submucosal and muscular layers. Tubular renal necrosis, liver portal necrosis and necrosis of the lymphoid tissues was also noted. The sodium fluorsilicate caused clinical signs at a dose of 300mg/kg, and death from 400mg/kg on.

  12. [Acral necrosis as a complication of urosepsis].

    Blarer, J; Pfister, D; Jandali, A R; Gutzeit, A; John, H; Horstmann, M


    Sepsis is the third most common cause of death in Germany. Every fourth patient with sepsis has urosepsis. Even if substantial therapeutic progress has been made, sepsis remains a severe condition with high morbidity and mortality that requires rapid interdisciplinary measures. Besides life-threatening complications, acral necrosis as presented here can occur as a result of disseminated intravascular coagulation and severe microcirculatory disorders.

  13. Vitamin C Attenuates Hemorrhagic Shock-induced Dendritic Cell-specific Intercellular Adhesion Molecule 3-grabbing Nonintegrin Expression in Tubular Epithelial Cells and Renal Injury in Rats

    Li Ma; Jian Fei; Ying Chen; Bing Zhao; Zhi-Tao Yang; Lu Wang; Hui-Qiu Sheng


    Background:The expression of dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) in renal tubular epithelial cells has been thought to be highly correlated with the occurrence of several kidney diseases,but whether it takes place in renal tissues during hemorrhagic shock (HS) is unknown.The present study aimed to investigate this phenomenon and the inhibitory effect of Vitamin C (VitC).Methods:A Sprague-Dawley rat HS model was established in vivo in this study.The expression level and location of DC-SIGN were observed in kidneys.Also,the degree of histological damage,the concentrations of tumor necrosis factor-α and interleukin-6 in the renal tissues,and the serum concentration of blood urea nitrogen and creatinine at different times (2-24 h) after HS (six rats in each group),with or without VitC treatment before resuscitation,were evaluated.Results:HS induced DC-SIGN expression in rat tubular epithelial cells.The proinflammatory cytokine concentration,histological damage scores,and functional injury of kidneys had increased.All these phenomena induced by HS were relieved when the rats were treated with VitC before resuscitation.Conclusions:The results of the present study illustrated that HS could induce tubular epithelial cells expressing DC-SIGN,and the levels of proinflammatory cytokines in the kidney tissues improved correspondingly.The results also indicated that VitC could suppress the DC-SIGN expression in the tubular epithelial cells induced by HS and alleviate the inflammation and functional injury in the kidney.

  14. 重组人促红细胞生成素对脑缺血大鼠脑组织肿瘤坏死因子及白细胞介素6表达的影响%Effects of recombinant human erythropoietin on expressions of tumor necrosis factor-alpha and inter ieukin-6 in rats with acute cerebral ischemia

    张金; 郭军红; 严澎; 王慧芳


    Objective To investigate the effects of recombinant human erythropoietin(rhEPO)on expressions of tumon necrosis factor-alpha(TNF-α) and inter leukin-6(IL-6) in rats after focal cerebral ischemia and to explore its neuroprotective mechanism.Methods A total of 36 healthy male SD rats were randomly divided into sham-operated group (n=12),model group (n=12) and rhEPO treatment group (n=12).The suture method to make permanent middle cerebral artery occlusion model was adopted.rhEPO treatment group was injected with rhEPO 5000 U/kg intraperitoneally after 2 h of ischemia,whereas model group and sham-operated group were given identical saline at the same time.All rats were decapitated after 24 h of ischemia.6 rats were randomly selected in each group and the infarct volume of groups were measured by Triphenyl tetrazolium chloride (TTC)staining method.The expressions of TNF-α,IL-6 in other rats were detected by immunohistochemistry.Results No infarction was found in sham-operated group.Percentage of infarct volume in model group and rhEPO group were (36.672.40)% and (27.49± 1.47)%,respectively.Compared with the model group,the volume of infarction in rhEPO group was significantly reduced.Cells stained by immunohistochemistry showed that The numbers of TNF-α-positive cells in the 3 groups were 9.001.41,27.83±2.48,17.50±1.87 and IL 6 positive cells were 8.94±2.31,20.33±3.53,14.83±1.70,respectively.Compared with sham operated group,the expressions of TNF-α and IL 6 in model group were significantly increased (q=16.1,19.6,P<0.01).Compared with the model group,the expressions of TNF α and IL-6 in rhEPO group were significantly decreased (q=8.19,3.44,all P<0.01).Conclusions rhEPO can decrease the infarct volume in SD rats after acute focal cerebral ischemic injure.rhEPO might exert its neuroprotective effect by reducing the expressions of TNF α and IL-6.%目的 观察重组人促红细胞生成素(rhEPO)对大鼠永久性脑缺血脑组织中肿瘤坏死因

  15. 骨髓间充质干细胞移植对急性肝功能衰竭大鼠肝组织miRNA-155和TNF-α表达的影响%Effects of bone marrow mesechymal stem cells on microRNA-155 and tumor necrosis factor alpha expression in liver tissue of rats with acute liver failure

    郑盛; 肖琼怡; 殷芳; 郭致平; 刘汉屈; 王建刚; 朱为梅; 王玉波


    Objective To explore the effects of bone mesenchymal stem cells (BMSCs) on the microRNA-155 (miRNA-155) and tumor necrosis factor alpha (TNF-α) expression in liver tissue of rats with acute liver failure (ALF), and to explore the relationship between miRNA-155/TNF-α and the efficacy of BMSCs. Methods SD rats were randomly divided into four groups, including control group, ALF group, BMSC treatment group and BMSC pretreatment group. Rats in each group were sacrificed 7 h after intraperitoneal D-GalN/LPS administration. Liver function, serum TNF-α level, miRNA-155 and TNF-α mRNA of liver tissue were detected subsequently. Survival rate at 24 h was observed in each group. Results Seven hours after D-GalN/LPS induction, alanine aminotransferase and aspartate aminotransferase levels of BMSC treatment and BMSC pretreatment groups were significantly lower when compared with those of ALF group(all P < 0.01). Compared with ALF group, serum levels of TNF-α decreased in BMSC treatment and BMSC pretreatment groups and the difference was statistically significant (all P<0.01). The difference of the TNF-αmRNA expression in liver tissue between groups was statistically significant (F = 72.24, P< 0.01). The TNF-αmRNA and miRNA-155 expression of BMSC treatment and BMSC pretreatment groups were down-regulated in comparison with ALF group, which showed statistical difference (all P<0.01). The positive correlation between miRNA-155 and TNF-αmRNA in liver tissue was confirmed in ALF group (r=0.734, P=0.001), BMSC treatment (r=0.590, P=0.006) and BMSCs pretreatment (r = 0.687, P= 0.004). 24 h after D-GalN/LPS administration, the difference of mortalities between groups was statistically significant (χ2=19.078, P< 0.01). Conclusion With BMSC intervention in ALF, up-regulated miRNA-155 and TNF-αexpressions in liver tissue could be partially reversed by BMSCs, suggesting that BMSC alleciate ALF via regulating miRNA-155 and TNF-α.%目的:探讨骨髓间充质干细胞(BMSCs

  16. Mechanical reliability of geometrically imperfect tubular oxygen transport membranes

    Kwok, Kawai; Frandsen, Henrik Lund; Søgaard, Martin;


    Mixed ionic and electronic conductors have potential applications as oxygen transport membranes. Realization of the technology is challenged by mechanical reliability of the components which are subjected to stresses arising from oxygen stoichiometry gradients and external overpressure during...... operation. This paper investigates numerically the failure risk of tubular oxygen transport membranes under industrial operating conditions using finite element modeling and Weibull strength analysis. The effects of component manufacturing defects on fracture probability are elucidated by explicit modeling...... of imperfections in the tubular membrane geometry. A supported membrane made of dense and porous Zr-doped-BSCF is studied as an illustrative example. It is shown that stresses induced by oxygen stoichiometry gradients relax over time due to creep and external pressure is the dominating source of stress in the long...

  17. A distal renal tubular acidosis showing hyperammonemia and hyperlactacidemia

    C. Ripoli


    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.

  18. An early Cambrian agglutinated tubular lophophorate with brachiopod characters

    Zhang, Z.-F.; Li, G.-X.; Holmer, L. E.; Brock, G. A.; Balthasar, U.; Skovsted, C. B.; Fu, D.-J.; Zhang, X.-L.; Wang, H.-Z.; Butler, A.; Zhang, Z.-L.; Cao, C.-Q.; Han, J.; Liu, J.-N.; Shu, D.-G.


    The morphological disparity of lophotrochozoan phyla makes it difficult to predict the morphology of the last common ancestor. Only fossils of stem groups can help discover the morphological transitions that occurred along the roots of these phyla. Here, we describe a tubular fossil Yuganotheca elegans gen. et sp. nov. from the Cambrian (Stage 3) Chengjiang Lagerstätte (Yunnan, China) that exhibits an unusual combination of phoronid, brachiopod and tommotiid (Cambrian problematica) characters, notably a pair of agglutinated valves, enclosing a horseshoe-shaped lophophore, supported by a lower bipartite tubular attachment structure with a long pedicle with coelomic space. The terminal bulb of the pedicle provided anchorage in soft sediment. The discovery has important implications for the early evolution of lophotrochozoans, suggesting rooting of brachiopods into the sessile lophotrochozoans and the origination of their bivalved bauplan preceding the biomineralization of shell valves in crown brachiopods.

  19. Inner-tubular physicochemical processes of carbon nanotubes

    YANG Quanhong; LI Lixiang; CHENG Huiming; WANG Maozhang; BAI Jinbo


    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.

  20. Dynamic model of microalgal production in tubular photobioreactors.

    Fernández, I; Acién, F G; Fernández, J M; Guzmán, J L; Magán, J J; Berenguel, M


    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.

  1. A Long Term Test of Differently Designed Evacuated Tubular Collectors

    Fan, Jianhua; Dragsted, Janne; Furbo, Simon


    carried out with different mean solar collector fluid temperatures and in different seasons of the year. The results of the measurements are presented in this paper. The influence of the mean solar collector fluid temperature on the thermal performance of the different collector designs will be discussed......During three years seven differently designed evacuated tubular collectors (ETCs) utilizing solar radiation from all directions have been investigated experimentally. The evacuated tubular solar collectors investigated include one SLL all-glass ETC from Tshinghua Solar Co. Ltd, four heat pipe ETCs...... of the inlet fluid to the collectors have been the same for all collectors. The volume flow rate through each of the collectors is adjusted so that the mean solar collector fluid temperature has been the same for all collectors. Thus a direct performance comparison is possible. The side-by-side tests were...

  2. Understanding shape and morphology of unusual tubular starch nanocrystals.

    Gong, Bei; Liu, Wenxia; Tan, Hua; Yu, Dehai; Song, Zhaoping; Lucia, Lucian A


    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.

  3. Segmental tubular sodium reabsorption in type 1 diabetes

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


    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 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...... delivery (r = 0.62, p 1, the direct correlation between GFR and end proximal delivery was also significant (r = 0.77, p

  4. Catalytic Tubular Microjet Propulsion Model for Endovascular Navigation

    Sarkis, Bruno; Folio, David; Ferreira, Antoine


    International audience; This paper describes the propulsion of the catalytic tubular microjet using Navier-Stokes equations. Especially , the thrust capability of the microjet is outstanding compared with the other microsystems, but remains only partially understood. Studies have identified the internal precursory mechanisms of the propulsion of the microjet: its inner wall catalyzes the dismutation of aqueous hydrogen peroxide, and an oxygen bubble is then formed and migrates towards its wid...

  5. Study of maximum pressure for composite hepta-tubular powders

    M. C. Gupta


    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.

  6. Tissue cell assisted fabrication of tubular catalytic platinum microengines

    Wang, Hong; Moo, James Guo Sheng; Pumera, Martin


    We report a facile platform for mass production of robust self-propelled tubular microengines. Tissue cells extracted from fruits of banana and apple, Musa acuminata and Malus domestica, are used as the support on which a thin platinum film is deposited by means of physical vapor deposition. Upon sonication of the cells/Pt-coated substrate in water, microscrolls of highly uniform sizes are spontaneously formed. Tubular microengines fabricated with the fruit cell assisted method exhibit a fast motion of ~100 bodylengths per s (~1 mm s-1). An extremely simple and affordable platform for mass production of the micromotors is crucial for the envisioned swarms of thousands and millions of autonomous micromotors performing biomedical and environmental remediation tasks.We report a facile platform for mass production of robust self-propelled tubular microengines. Tissue cells extracted from fruits of banana and apple, Musa acuminata and Malus domestica, are used as the support on which a thin platinum film is deposited by means of physical vapor deposition. Upon sonication of the cells/Pt-coated substrate in water, microscrolls of highly uniform sizes are spontaneously formed. Tubular microengines fabricated with the fruit cell assisted method exhibit a fast motion of ~100 bodylengths per s (~1 mm s-1). An extremely simple and affordable platform for mass production of the micromotors is crucial for the envisioned swarms of thousands and millions of autonomous micromotors performing biomedical and environmental remediation tasks. Electronic supplementary information (ESI) available: Related video. See DOI: 10.1039/c4nr03720k

  7. Aerodynamic loads on a ball-obturated tubular projectile

    Bry, William Arthur


    Approved for public release, distribution unlimited A tubular projectile is one with a hole bored along its longitudinal axis. The hole presents a problem in getting the round expelled from a gun. Some means of sealing the hole until the round clears the muzzle is required. A ball -obturator offers one practical means of accomplishing this without any accompanying FOD hazard. The ball-obturator, analogous to a common ballvalve, remains closed under the force of the expand...

  8. Effect of Loading Paths on HydroformingTubular Square Components


    The influence of loading path on tube hydroforming process is discussed in this paper with finiteelement simulation. Four different loading paths are utilized in simulating the forming process of square tubular component with hydroforming and the result of different loading path is presented. Among the result, the thickness distribution of bilinear loading path is the most uniform one. It shows that the increase of punch displacement in the stage of high pressure is beneficial to the forming of component for optimized stress condition.

  9. Regulated necrosis and its implications in toxicology.

    Aki, Toshihiko; Funakoshi, Takeshi; Uemura, Koichi


    Recent research developments have revealed that caspase-dependent apoptosis is not the sole form of regulated cell death. Caspase-independent, but genetically regulated, forms of cell death include pyroptosis, necroptosis, parthanatos, and the recently discovered ferroptosis and autosis. Importantly, regulated necrosis can be modulated by small molecule inhibitors/activators, confirming the cell autonomous mechanism of these forms of cell death. The success of small molecule-mediated manipulation of regulated necrosis has produced great changes in the field of cell death research, and has also brought about significant changes in the fields of pharmacology as well as toxicology. In this review, we intend to summarize the modes of regulated cell death other than apoptosis, and discuss their implications in toxicology.

  10. The rebirth of interest in renal tubular function.

    Lowenstein, Jerome; Grantham, Jared J


    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.

  11. Plastic deformation of tubular crystals by dislocation glide

    Beller, Daniel A.; Nelson, David R.


    Tubular crystals, two-dimensional lattices wrapped into cylindrical topologies, arise in many contexts, including botany and biofilaments, and in physical systems such as carbon nanotubes. The geometrical principles of botanical phyllotaxis, describing the spiral packings on cylinders commonly found in nature, have found application in all these systems. Several recent studies have examined defects in tubular crystals associated with crystalline packings that must accommodate a fixed tube radius. Here we study the mechanics of tubular crystals with variable tube radius, with dislocations interposed between regions of different phyllotactic packings. Unbinding and separation of dislocation pairs with equal and opposite Burgers vectors allow the growth of one phyllotactic domain at the expense of another. In particular, glide separation of dislocations offers a low-energy mode for plastic deformations of solid tubes in response to external stresses, reconfiguring the lattice step by step. Through theory and simulation, we examine how the tube's radius and helicity affects, and is in turn altered by, the mechanics of dislocation glide. We also discuss how a sufficiently strong bending rigidity can alter or arrest the deformations of tubes with small radii.

  12. Evaluation of stress concentration for planar tubular joints



    In offshore tubular structures,a typical tubular joint may be subjected to three different types of basic loadings: axial,in-plane bending and out-of-plane bending,through its brace members. Each type will cause a different stress distribution at the joint intersection of structures. Moreover,the actual load condition of a tubular joint can be any combination of the above three basic load cases,for this reason,a combined loading was investigated in addition to these three basic loadings. This load is composed of an axial loading combined with a continuation of rotational bending loading obtained while rotate center of the brace around a circle. Different types of planar joints such as T,Y,X,K,DT,DY,DX,TY,TK,DTX,DTDY,and DTDK,with braces subjected to combined loading,were numerically analyzed to study the effect of those different cases of loading and different types of joints,on the stress concentration zone and values.

  13. 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.

  14. 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


    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...... 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...... 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...

  15. Acute pancreatitis : new frontiers in diagnosis and treatment

    van Santvoort, H.C.


    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

  16. Acute necrotising ulcerative gingivitis in an immunocompromised young adult.

    Hu, Jessie; Kent, Paul; Lennon, Joshua M; Logan, Latania K


    Acute necrotising ulcerative gingivitis is an acute onset disease characterised by ulceration, necrosis, pain and bleeding in gingival surfaces. It is predominantly seen in severely malnourished children and young adults with advanced HIV infection. We present a unique presentation in a young adult with high-grade osteogenic sarcoma.

  17. Timing and impact of infections in acute pancreatitis

    Besselink, M. G.; van Santvoort, H. C.; Boermeester, M. A.; Nieuwenhuijs, V. B.; van Goor, Harry; Dejong, C. H. C.; Schaapherder, A. F.; Gooszen, H. G.


    Background: Although infected necrosis is an established cause of death in acute pancreatitis, the impact of bacteraemia and pneumonia is less certain. Methods: This was a cohort study of 731 patients with a primary episode of acute pancreatitis in 2004-2007, including 296 patients involved in a ran

  18. Avascular necrosis of a vertebral body

    HUANG Sheng-li; SHI Wei; HE Xi-jing


    @@ Avascular necrosis of a vertebral body,a relatively uncommon entity,is caused by malicgnancy,infection,radiation,systemic stemid treatment,trauma,and the ike.1 Vertebral osteonecrosis induced by trauma is called Kümmell's disease,because it was initially described by Hermann KLimmell of Germany in 1891.2 This paper reported a young female with posttraumatic vertebral osteonecrosis and analyzed the causes.She was treated by thoracoscopic Surgery successfully.

  19. Intragraft Tubular Vimentin and CD44 Expression Correlate With Long-Term Renal Allograft Function and Interstitial Fibrosis and Tubular Atrophy

    J. Kers; Y.C. Xu-Dubois; E. Rondeau; N. Claessen; M.M. Idu; J.J.T.H. Roelofs; F.J. Bemelman; R.J.M. ten Berge; S. Florquin


    Background. Development of interstitial fibrosis and tubular atrophy (IF/TA) is the main histologic feature involved in renal allograft deterioration. The aim of this study was to validate whether de novo tubular expression of CD44 (transmembrane glycoprotein) and vimentin (mesenchymal cell marker),

  20. Laser capture microdissection and multiplex-tandem PCR analysis of proximal tubular epithelial cell signaling in human kidney disease.

    Ray Wilkinson

    Full Text Available Interstitial fibrosis, a histological process common to many kidney diseases, is the precursor state to end stage kidney disease, a devastating and costly outcome for the patient and the health system. Fibrosis is historically associated with chronic kidney disease (CKD but emerging evidence is now linking many forms of acute kidney disease (AKD with the development of CKD. Indeed, we and others have observed at least some degree of fibrosis in up to 50% of clinically defined cases of AKD. Epithelial cells of the proximal tubule (PTEC are central in the development of kidney interstitial fibrosis. We combine the novel techniques of laser capture microdissection and multiplex-tandem PCR to identify and quantitate "real time" gene transcription profiles of purified PTEC isolated from human kidney biopsies that describe signaling pathways associated with this pathological fibrotic process. Our results: (i confirm previous in-vitro and animal model studies; kidney injury molecule-1 is up-regulated in patients with acute tubular injury, inflammation, neutrophil infiltration and a range of chronic disease diagnoses, (ii provide data to inform treatment; complement component 3 expression correlates with inflammation and acute tubular injury, (iii identify potential new biomarkers; proline 4-hydroxylase transcription is down-regulated and vimentin is up-regulated across kidney diseases, (iv describe previously unrecognized feedback mechanisms within PTEC; Smad-3 is down-regulated in many kidney diseases suggesting a possible negative feedback loop for TGF-β in the disease state, whilst tight junction protein-1 is up-regulated in many kidney diseases, suggesting feedback interactions with vimentin expression. These data demonstrate that the combined techniques of laser capture microdissection and multiplex-tandem PCR have the power to study molecular signaling within single cell populations derived from clinically sourced tissue.

  1. Laser capture microdissection and multiplex-tandem PCR analysis of proximal tubular epithelial cell signaling in human kidney disease.

    Wilkinson, Ray; Wang, Xiangju; Kassianos, Andrew J; Zuryn, Steven; Roper, Kathrein E; Osborne, Andrew; Sampangi, Sandeep; Francis, Leo; Raghunath, Vishwas; Healy, Helen


    Interstitial fibrosis, a histological process common to many kidney diseases, is the precursor state to end stage kidney disease, a devastating and costly outcome for the patient and the health system. Fibrosis is historically associated with chronic kidney disease (CKD) but emerging evidence is now linking many forms of acute kidney disease (AKD) with the development of CKD. Indeed, we and others have observed at least some degree of fibrosis in up to 50% of clinically defined cases of AKD. Epithelial cells of the proximal tubule (PTEC) are central in the development of kidney interstitial fibrosis. We combine the novel techniques of laser capture microdissection and multiplex-tandem PCR to identify and quantitate "real time" gene transcription profiles of purified PTEC isolated from human kidney biopsies that describe signaling pathways associated with this pathological fibrotic process. Our results: (i) confirm previous in-vitro and animal model studies; kidney injury molecule-1 is up-regulated in patients with acute tubular injury, inflammation, neutrophil infiltration and a range of chronic disease diagnoses, (ii) provide data to inform treatment; complement component 3 expression correlates with inflammation and acute tubular injury, (iii) identify potential new biomarkers; proline 4-hydroxylase transcription is down-regulated and vimentin is up-regulated across kidney diseases, (iv) describe previously unrecognized feedback mechanisms within PTEC; Smad-3 is down-regulated in many kidney diseases suggesting a possible negative feedback loop for TGF-β in the disease state, whilst tight junction protein-1 is up-regulated in many kidney diseases, suggesting feedback interactions with vimentin expression. These data demonstrate that the combined techniques of laser capture microdissection and multiplex-tandem PCR have the power to study molecular signaling within single cell populations derived from clinically sourced tissue.

  2. The complex treatment of acute pancreatitis using miniinvasive surgical treatment

    G. I. Ohrimenko


    Full Text Available Nowadays methods used in acute pancreatitis diagnostic do not allow to find the most optimal indications, terms of surgical drainage approaches in surgical treatment of acute pancreatitis. Aim. In order to develop optimal diagnostic and treatment algorithm 316 patients took part in the study. Methods and results. Surgery outcomes were assessed by the next methods: ultrasound, computed tomography. We determined that destructive changes in pancreas in group of sterile pancreatic necrosis were limited. In cases of infected pancreatic necrosis the damage was spread and the disease course was septic. That’s why the operative treatment in cases of sterile pancreatitis has to be used with strict indications such as fermentative peritonitis, acute liquid formations, acute pseudocysts. Conclusion. In such cases miniinvasive surgery is mainly used while in the cases of infected pancreatic necrosis we ought to choose open surgery treatment.

  3. Analysis of constant tissue remodeling in Syrian hamster Harderian gland: intra-tubular and inter-tubular syncytial masses.

    Coto-Montes, Ana; García-Macía, Marina; Caballero, Beatriz; Sierra, Verónica; Rodríguez-Colunga, María J; Reiter, Russel J; Vega-Naredo, Ignacio


    The Syrian hamster Harderian gland (HG) has a marked sexual dimorphism and exhibits an extraordinary rate of porphyrinogenesis. The physiological oxidative stress, derived from constant porphyrin production, is so high that the HG needs additional survival autophagic mechanisms to fight against this chronic exposure, provoking the triggering of a holocrine secretion in female glands that forms two types of secretory masses: intra-tubular-syncytial and inter-tubular-syncytial masses. The aim of this work was to study the development of this inter-tubular holocrine secretion. To approach this task, we have considered that the steps developed during the formation of the so-called invasive masses consist of the growth of epithelial cells, cell detachment from the basal lamina and invasion of surrounding tissues. The presence of these masses, particularly in the female HG, are closely linked to sexual dimorphism in redox balance and to alterations in the expression of certain factors such as cytokeratins, P-cadherin, matrix metalloproteinases, cathepsin H, proliferating cell nuclear antigen, p53, CD-31 and vascular endothelial growth factor, which seem to be involved in tissue remodeling. The results document unusual mechanisms of secretion in Syrian hamster HG: an extraordinary system of massive secretion through the conjunctive tissue, disrupting the branched structure of the gland.

  4. Acute cardiac failure in neuroleptic malignant syndrome.

    Sparrow, Patrick


    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.

  5. Cytokines and Organ Failure in Acute Pancreatitis

    Malmstrøm, Marie Louise; Hansen, Mark Berner; Andersen, Anders Møller


    Objectives: We aimed at synchronously examining the early time course of 4 proinflammatory cytokines as predictive factors for development of organ failure in patients with acute pancreatitis (AP). Methods: Interleukin (IL) 6, IL-8, IL-18, and tumor necrosis factor > were measured on admission...

  6. 阿昔洛韦过量致急性肾衰竭诊治分析%Acyclovir-induced acute renal failure and a review of the literature

    侯欣; 王磊; 范晋海; 吕晶; 冯婕; 谭峰


    目的 探讨阿昔洛韦过量导致急性肾功能衰竭的组织学特点、临床表现、治疗以及预后.方法 报告1例阿昔洛韦过量导致的急性肾功能衰竭患者的临床、病理及预后资料,系统复习相关文献进行讨论.结果 患者中年男性,因右侧颈背部"带状疱疹"给予阿昔洛韦静滴联合口服治疗,于每次静滴半小时内出现突发腰痛、下腹坠胀,治疗2d后发生尿量减少、全身不适等症状.查肾功示:血尿素氮(BUN)20.7mmol/L,血清肌酐(CRE)560.3μmol/L;肾脏病理检查示:急性肾小管坏死伴轻度系膜增生及个别肾小球硬化.给予停药、紧急血液透析2次及对症支持治疗7d后痊愈.结论 阿昔洛韦导致肾功能衰竭最常见症状是突发腰痛、恶心,病理学多为肾小管病变,患者经过停药、透析及对症支持治疗后均能痊愈.%Objective To investigate the histological features, clinical manifestations, treatment options and prognosis of Acyclovir-induced acute renal failure. Methods The clinical, pathological and prognosis of 1 case of Acyclovir-induced acute renal failure were reviewed respectively, and the related literature was reviewed. ResultS A middle-aged man suffering from cutaneous herpes zoster was given Acyclovir by intravenous drip and per os, when he developed acute abdominal pain and general malaise. Renal examin on showed, his serum creatinine (CRE) and blood urea nitrogen (BUN) concentrations rose to 560.3 μmol/L and 20. 7 mmol/L, respectively. The pathology of kidney exhibited acute renal tubular necrosis acompanied with slight glomerular sclerosis. Renal impairment was restored after discontinuation of Acyclovir, hemodialysis and symptomatic treatment. Conclusion Acute abdominal pain and nausea are the most common symptoms of Acyclovir-induced acute renal failure. The pathology revealed acute renal tubular necrosis. Hemodialysis, symptomatic treatment and discontinuation of Acyclovir are the effective

  7. Mucinous tubular and spindle cell carcinoma of kidney: A clinicopathologic study of six cases

    Mudassar Hussain


    Full Text Available Background: Mucinous tubular and spindle carcinoma (MTSCC of kidney is a rare, low-grade polymorphic tumor. Recent studies have described a wide morphology spectrum of this tumor. Aim: To report the clinico-pathologic features of six cases of MTSCC of kidney. Materials and Methods: Six cases of MTSCC of kidney were studied and literature was reviewed. Immunohistochemistry was done by Envision method. Results: The age of the patients ranged from 44 to 84 years (mean 58.5 years. Four patients were males and two were females. The tumor was located in the left kidney in four cases and in the right kidney in two cases. The tumor size ranged from 4.5 to 15 cm (mean 6.4 cm. All tumors exhibited an admixture of tubules, spindle cells, and mucinous stroma in variable proportions. Tubules were predominant in five cases and spindle cells in one case. Psammomatous calcifications, papillations, and necrosis were seen in two cases. Collections of foamy histiocytes were noted in four cases. Cytoplasmic vacuoles and osseous metaplasia were seen in one case each. All cases were Fuhrman′s nuclear grade II. Five cases were of stage pT1, and one was pT3. All cases stained positive for alcian blue at pH 2.5. Immunohistochemical stain CK7 was positive in all cases and CD10 was positive in 1/1 case. All patients were alive and well at follow-up of 12-59 months (mean 33.5 months. No metastases were detected. Conclusions: We report six cases of MTSCC of kidney, a rare distinct variant of RCC, with a favorable prognosis. A male predominance was seen in our cases. MTSCC shares histologic and immunohistochemical overlap with papillary renal cell carcinoma (PRCC and cytogenetic analysis should be performed in difficult cases to avoid a misdiagnosis.

  8. Acute pancreatitis

    ... its blood vessels. This problem is called acute pancreatitis. Acute pancreatitis affects men more often than women. Certain ... pancreatitis; Pancreas - inflammation Images Digestive system Endocrine glands Pancreatitis, acute - CT scan Pancreatitis - series References Forsmark CE. Pancreatitis. ...

  9. Cystitis - acute

    Uncomplicated urinary tract infection; UTI - acute cystitis; Acute bladder infection; Acute bacterial cystitis ... cause. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  10. Drill pipes and casings utilizing multi-conduit tubular; Flerkanals roerstreng

    Curlett, H.B.


    The invention relates to a multi-conduit tubular having fluid conduits and electrical conduits, with associated surface fluid and electrical commutators, and downhole sensors for providing surface monitors with instantaneous formation data. Each tubular includes a plurality of uniform linear conduits there through, with a gasket seal plate interposed between joined tubular for assuring a high pressure seal between joined conduits. the seal plate includes an intermediate electrical connector for connecting electrical conduit connectors of one tubular to another. A coupling collar with uniform diameter internal coarse and fine threads joins the tubular ends having similar threads by differential thread action without respective tubular rotation. Each tubular end includes an inter-engaging index recess and index lug, and drive recesses and lugs for maintaining angular registry of the tubular string and for driving one drill tubular with another. A fluid commutator includes a rotating shaft with passages connected to the tubular conduits, and rotating in a manifold having annular grooves in communication with the shaft passages and external fluid sources. An adaptor couples each commutator shaft passage to one or more tubular conduits. Slip rings on a quill shaft and stationary brush means provide electrical continuity from the electrical conduit wires to surface equipment. A cross-over sub includes formation parameter sensors and telemetry equipment in a blocked off portion of a fluid conduit. An annular accumulator connected with the well bore annulus applies a pressure thereto in response to downhole sensors to change the effective density of the drill mud. The multi-conduit tubular is further adapted for use as a well casing to provide downhole access of a plurality of fluids and electrical parameter sensors. 28 figs.

  11. A tubular segmented-flow bioreactor for the infection of insect cells with recombinant baculovirus

    Hu, Yu-Chen; Wang, Ming-Ying; Bentley, William E.


    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...

  12. Distal extremity necrosis in captive birds.

    Calle, P P; Montali, R J; Janssen, D L; Stoskopf, M K; Strandberg, J D


    The necropsy files of the National Zoological Park and Baltimore Zoological Society were reviewed for cases of distal extremity necrosis (DEN) in birds. Nineteen cases of DEN occurred following either trauma or frostbite. Six birds developed an apparently primary type of DEN in which no predisposing factors were obvious clinically. The toes and feet were most commonly involved, and in several cases the beak was also affected. Some pathologic evidence is provided that certain cardiovascular lesions may predispose birds to DEN by compromising circulation of the extremities.

  13. 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.


    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

  14. 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.

  15. Tubular algebras and affine Kac-Moody algebras


    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. Tubular algebras and affine Kac-Moody algebras

    Zheng-xin CHEN; Ya-nan LIN


    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.

  17. Point-like inclusion interactions in tubular membranes

    Vahid, Afshin


    We analytically study membrane mediated interactions between inclusions embedded in a tubular membrane. We model inclusions as constraints coupled to the curvature tensor of the membrane tube. First, as special test cases, we analyze the interaction between ring and rod shaped inclusions. Using Monte Carlo simulations, we further show how point-like inclusions interact to form linear aggregates. Our results reveal that depending on the hard-core radius of the inclusions, they arrange into either lines or rings to globally minimize the curvature energy of the membrane.

  18. Partial oxidation of methane to syngas in tubular oxygenpermeable reactor


    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.

  19. Superradiance at the localization-delocalization crossover in tubular chlorosomes

    Molina, Rafael A; Somoza, Alejandro; Chen, Lipeng; Zhao, Yang


    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.

  20. Type 4 renal tubular acidosis in a kidney transplant recipient

    Manjunath Kulkarni


    Full Text Available 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.

  1. Type 4 renal tubular acidosis in a kidney transplant recipient.

    Kulkarni, Manjunath


    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.

  2. Effects of subtotal colectomy on bacterial translocation during experimental acute pancreatitis

    van Minnen, LP; Nieuwenhuijs, VB; de Bruijn, MT; Verheem, A; Visser, MR; van Dijk, JE; Akkermans, LMA; Gooszen, HG


    Objectives: The colon is considered a major source of bacteria causing infection of pancreatic necrosis in acute pancreatitis (AP). Subtotal colectomy before AP in rats reduces mortality, but its role in affecting small bowel flora, bacterial translocation, and infection of pancreatic necrosis is un

  3. Mastectomy skin flap necrosis: challenges and solutions

    Robertson, Stuart A; Jeevaratnam, Johann A; Agrawal, Avi; Cutress, Ramsey I


    Introduction Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%–30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. Methods A MEDLINE search was performed using the search term “mastectomy skin flap necrosis”. Titles and abstracts from peer-reviewed publications were screened for relevance. Results MSFN is a common complication and may present as partial- or full-thickness necrosis. Predictive patient risk factors include smoking, diabetes, obesity, radiotherapy, previous scars and severe medical comorbidity. MSFN leads to a number of challenges, including wound management problems, delays to adjuvant therapy, esthetic compromise, implant extrusion, patient distress and financial loss. Careful preoperative planning and meticulous surgical technique may reduce the incidence of MSFN. A number of intraoperative techniques are available to try and predict skin flaps at risk of MSFN. MSFN may be managed operatively or nonoperatively. Early intervention may reduce the morbidity of MSFN in selected cases. Topical nitroglycerin ointment may be beneficial in reducing MSFN following immediate reconstruction, but the evidence base is still limited. Conclusion MSFN can result in considerable challenges for the patient and the health care service. This review discusses the management options for this problem. PMID:28331365

  4. An unreported complication of acute pancreatitis

    G Muthukumarasamy; V Shanmugam; SR Yule; R Ravindran


    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.This case is reported for its unusual and unreported spinal complications after acute pancreatitis.

  5. 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.

  6. Toward automated cochlear implant insertion using tubular manipulators

    Granna, Josephine; Rau, Thomas S.; Nguyen, Thien-Dang; Lenarz, Thomas; Majdani, Omid; Burgner-Kahrs, Jessica


    During manual cochlear implant electrode insertion the surgeon is at risk to damage the intracochlear fine-structure, as the electrode array is inserted through a small opening in the cochlea blindly with little force-feedback. This paper addresses a novel concept for cochlear electrode insertion using tubular manipulators to reduce risks of causing trauma during insertion and to automate the insertion process. We propose a tubular manipulator incorporated into the electrode array composed of an inner wire within a tube, both elastic and helically shaped. It is our vision to use this manipulator to actuate the initially straight electrode array during insertion into the cochlea by actuation of the wire and tube, i.e. translation and slight axial rotation. In this paper, we evaluate the geometry of the human cochlea in 22 patient datasets in order to derive design requirements for the manipulator. We propose an optimization algorithm to automatically determine the tube set parameters (curvature, torsion, diameter, length) for an ideal final position within the cochlea. To prove our concept, we demonstrate that insertion can be realized in a follow-the-leader fashion for 19 out of 22 cochleas. This is possible with only 4 different tube/wire sets.

  7. Additive manufacturing of patient-specific tubular continuum manipulators

    Amanov, Ernar; Nguyen, Thien-Dang; Burgner-Kahrs, Jessica


    Tubular continuum robots, which are composed of multiple concentric, precurved, elastic tubes, provide more dexterity than traditional surgical instruments at the same diameter. The tubes can be precurved such that the resulting manipulator fulfills surgical task requirements. Up to now the only material used for the component tubes of those manipulators is NiTi, a super-elastic shape-memory alloy of nickel and titan. NiTi is a cost-intensive material and fabrication processes are complex, requiring (proprietary) technology, e.g. for shape setting. In this paper, we evaluate component tubes made of 3 different thermoplastic materials (PLA, PCL and nylon) using fused filament fabrication technology (3D printing). This enables quick and cost-effective production of custom, patient-specific continuum manipulators, produced on site on demand. Stress-strain and deformation characteristics are evaluated experimentally for 16 fabricated tubes of each thermoplastic with diameters and shapes equivalent to those of NiTi tubes. Tubes made of PCL and nylon exhibit properties comparable to those made of NiTi. We further demonstrate a tubular continuum manipulator composed of 3 nylon tubes in a transnasal, transsphenoidal skull base surgery scenario in vitro.

  8. Surface and interfacial creases in a bilayer tubular soft tissue

    Razavi, Mir Jalil; Pidaparti, Ramana; Wang, Xianqiao


    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.

  9. Radiologic findings of tubular adenoma of the breast

    Jeong, Mi Gyoung; Oh, Ki Keun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)


    Tubular adenoma (TA) is known as a rare lesion of the breast which is difficult to diagnosis preoperatively because of its rarity and similarity to fibroadenoma. Hence, our purpose is to suggest the characteristic sonographic features for its correct diagnosis. We retrospectively analyzed the clinical data and mammographic and sonographic findings. of seven patients(mean age, 23) who during the previous five years had presented at our hospital with pathologically-proven tubular adenoma. TA was misdiagnosed as fibroadenoma, since on physical examination of these young females, the lesions presented a palpable, non-tender mass. Mammographically, they showed a well defined mass similar to fibroadenoma. However, sonographic findings were characteristic of TA and compared to fibroadenoma, showed a well demarcated and smooth bordered mass with transverse long axis, posterior enhancement and homogeneous lower internal echogenecity. No case showed lateral wall refractive shadowing. In young females, the clinical and mammographic findings of TA are similar to those of fibroadenoma. However, sonographic findings of TA can, be helpful in the differential diagnosis of this entity and fibroadenoma.

  10. Advances in tubular solid oxide fuel cell technology

    Singhal, S.C. [Westinghouse Electric Corp., Pittsburgh, PA (United States)


    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.

  11. Acute Bronchitis

    ... Smoking also slows down the healing process. Acute bronchitis treatment Most cases of acute bronchitis can be treated at home.Drink fluids, but ... bronchial tree. Your doctor will decide if this treatment is right for you. Living with acute bronchitis Most cases of acute bronchitis go away on ...

  12. Acute kidney injury in acute liver failure: a review.

    Moore, Joanna K; Love, Eleanor; Craig, Darren G; Hayes, Peter C; Simpson, Kenneth J


    Acute liver failure is a rare and often devastating condition consequent on massive liver cell necrosis that frequently affects young, previously healthy individuals resulting in altered cognitive function, coagulopathy and peripheral vasodilation. These patients frequently develop concurrent acute kidney injury (AKI). This abrupt and sustained decline in renal function, through a number of pathogenic mechanisms such as renal hypoperfusion, direct drug-induced nephrotoxicity or sepsis/systemic inflammatory response contributes to increased morbidity and is strongly associated with a worse prognosis. Improved understanding of the pathophysiology AKI in the context of acute liver failure may be beneficial in a number of areas; the development of new and sensitive biomarkers of renal dysfunction, refining prognosis and organ allocation, and ultimately leading to the development of novel treatment strategies, these issues are discussed in more detail in this expert review.

  13. Endotoxin and tumor necrosis factor-receptor levels in portal and hepatic vein of patients with alcoholic liver cirrhosis receiving elective transjugular intrahepatic portosystemic shunt

    Trebicka, Jonel; Krag, Aleksander; Gansweid, Stefan


    In cirrhosis portal hypertension can promote bacterial translocation and increase serum endotoxin levels. Vice versa, endotoxin aggravates portal hypertension by induction of systemic and splanchnic vasodilation, and by triggering hepatic inflammatory response via tumor necrosis factor α (TNFα......). However, the hepatic elimination of endotoxin in cirrhotic patients with severe portal hypertension, in the absence of acute complications, has not been investigated so far....

  14. Gentamicin-induced preconditioning of proximal tubular LLC-PK1 cells stimulates nitric oxide production but not the synthesis of heat shock protein

    E.A. Pessoa


    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.

  15. [Endoscopic treatment of chemical burns to the stomach with mucosa ulceration and necrosis].

    Nalbandova, D A; Sogreshilin, S S; Pinchuk, T P; Klokova, T V; Il'iashenko, K K


    The prevalence of acute poisoning with caustic substances in Russia is higher than in other countries and is reported by different authors as accounting for 10-32% cases among the patients admitted to acute poisoning treatment centres. Especially unfavorable prognosis is considered for necrotizing burns to the stomach that increase the risk of severe complications leading to disability of patients. The study aimed at improving the treatment of necrotizing chemical burn to the stomach by the infusion of a 5% Mexidole solution into the edges of a burn lesion at different stages of the treatment course. The paper presents the outcomes of patients who sustained chemical burns to the stomach with mucosa ulceration and necrosis, and provides an assessment of early endoscopic treatment effect.

  16. A Case of Hemorrhagic Necrosis of Ectopic Liver Tissue within the Gallbladder Wall.

    Nagar, Sapna


    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.

  17. Activation of SUR2B/Kir6.1-type KATP channels protects glomerular endothelial, mesangial and tubular epithelial cells against oleic acid renal damage

    Ying ZHAO; Hai WANG


    Cumulative evidence suggests that renal vascular endothelial injury play an important role in initiating and extending tubular epithelial injury and contribute to the development of ischemic acute renal failure.Our previous studies have demonstrated that iptakalim's endothelium protection is related to activation of SUR2B/Kir6.1 subtype of ATP sensitive potassium channel (KATP) in the endothelium.It has been reported that SUR2B/Kir6.1 channels are widely distributed in the tubular epithelium,glomerular mesangium,and the endothelium and the smooth muscle of blood vessels.Herein,we hypothesized that activating renal KATP channels with iptakalim might have directly neroprotective effects.In this study,glomerular endothelial,mesangial and tubular epithelial cells which are the main cell types to form nephron were exposed to oleic acid (OA) at various concentrations for 24 h.0.25 μl/ml OA could cause cellular damage of glomerular endothelium and mesangium,while 1.25μl/ml OA could lead to the injury of three types of renal cells.It was observed that pretreatment with iptakalim at concentrations of 0.1,1,10 or 100 μmol/L prevented cellular damage of glomerular endothelium and tubular epithelium,whereas iptakalim from 1 to 100 μmol/L prevented the injury of mesangial cells.Our data showed iptakalim significantly increased survived cell rates in a concentration-dependent manner,significantly antagonized by glibenclamide,a KATP blocker.Iptakalim played a protective role in the main cell types of kidney,which was consistent with natakalim,a highly selective SUR2B/Kir6.1 channel opener.Iptakalim exerted protective effects through activating SUR2B/Kir6.1 channels,suggesting a new strategy for renal injury by its endothelial and renal cell protection.

  18. 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


    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.

  19. The restrained expression of NF-kB in renal tissue ameliorates folic acid induced acute kidney injury in mice.

    Dev Kumar

    Full Text Available 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.

  20. Sildenafil citrate for prophylaxis of nephropathy in an animal model of contrast-induced acute kidney injury.

    Lauver, D Adam; Carey, E Grant; Bergin, Ingrid L; Lucchesi, Benedict R; Gurm, Hitinder S


    Contrast-induced acute kidney injury (CIAKI) is one of the commonest complications associated with contrast media (CM). Although the exact etiology of CIAKI remains unclear, one hypothesis involves vasoconstriction of afferent arterioles resulting in renal ischemia. Increased renal blood flow, therefore, might represent an attractive target for the treatment of CIAKI. In this study we evaluated the protective effects of the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil citrate, in a rabbit model of CIAKI. New Zealand white rabbits were used due to their susceptibility to CIAKI. To evaluate the effects of sildenafil, the drug was administered before CM infusion and repeatedly throughout the remainder of the experiment (6 mg/kg, p.o.). Animals were sacrificed after 48 hours and kidneys were prepared for histological evaluation. Intravenous administration of CM produced marked kidney injury. Serum creatinine concentrations were elevated within two hours of the infusion and remained elevated for the duration of the experiment. Histological evaluation of the kidneys revealed significant tubular necrosis. The effects of the CM were dose dependent. Treatment with sildenafil was associated with lesser degree of histological injury, attenuation in markers of acute kidney injury (48 hour creatinine 1.54±0.21 versus 4.42±1.31 mg/dl, p<0.05) and reduction in electrolyte derangement (percent change in serum K+ at 48 hours 2.55±3.80% versus 15.53±4.47%, p<0.05; serum Na+ at 48 hours -0.14±0.26% versus -1.97±1.29%, p = 0.20). The results suggest a possible role for PDE5 inhibitors in the treatment of CIAKI and warrant further evaluation to determine the exact mechanism of protection.

  1. Cell Therapy Using Human Induced Pluripotent Stem Cell-Derived Renal Progenitors Ameliorates Acute Kidney Injury in Mice

    Toyohara, Takafumi; Mae, Shin-Ichi; Sueta, Shin-Ichi; Inoue, Tatsuyuki; Yamagishi, Yukiko; Kawamoto, Tatsuya; Kasahara, Tomoko; Hoshina, Azusa; Toyoda, Taro; Tanaka, Hiromi; Araoka, Toshikazu; Sato-Otsubo, Aiko; Takahashi, Kazutoshi; Sato, Yasunori; Yamaji, Noboru; Ogawa, Seishi; Yamanaka, Shinya


    Acute kidney injury (AKI) is defined as a rapid loss of renal function resulting from various etiologies, with a mortality rate exceeding 60% among intensive care patients. Because conventional treatments have failed to alleviate this condition, the development of regenerative therapies using human induced pluripotent stem cells (hiPSCs) presents a promising new therapeutic option for AKI. We describe our methodology for generating renal progenitors from hiPSCs that show potential in ameliorating AKI. We established a multistep differentiation protocol for inducing hiPSCs into OSR1+SIX2+ renal progenitors capable of reconstituting three-dimensional proximal renal tubule-like structures in vitro and in vivo. Moreover, we found that renal subcapsular transplantation of hiPSC-derived renal progenitors ameliorated the AKI in mice induced by ischemia/reperfusion injury, significantly suppressing the elevation of blood urea nitrogen and serum creatinine levels and attenuating histopathological changes, such as tubular necrosis, tubule dilatation with casts, and interstitial fibrosis. To our knowledge, few reports demonstrating the therapeutic efficacy of cell therapy with renal lineage cells generated from hiPSCs have been published. Our results suggest that regenerative medicine strategies for kidney diseases could be developed using hiPSC-derived renal cells. Significance This report is the first to demonstrate that the transplantation of renal progenitor cells differentiated from human induced pluripotent stem (iPS) cells has therapeutic effectiveness in mouse models of acute kidney injury induced by ischemia/reperfusion injury. In addition, this report clearly demonstrates that the therapeutic benefits come from trophic effects by the renal progenitor cells, and it identifies the renoprotective factors secreted by the progenitors. The results of this study indicate the feasibility of developing regenerative medicine strategy using iPS cells against renal diseases

  2. 78 FR 77420 - Certain Oil Country Tubular Goods From the Republic of Turkey: Preliminary Negative...


    ... International Trade Administration Certain Oil Country Tubular Goods From the Republic of Turkey: Preliminary... Turkey and several other countries.\\1\\ The CVD investigation and the AD investigations cover the same... Duty Investigation of Certain Oil Country Tubular Goods from the Republic of Turkey,''...

  3. 78 FR 56865 - Certain Oil Country Tubular Goods From India and Turkey: Postponement of Preliminary...


    ... International Trade Administration Certain Oil Country Tubular Goods From India and Turkey: Postponement of...\\ See Certain Oil Country Tubular Goods from India and Turkey: Initiation of Countervailing Duty...) 482-3964 (India); Shane Subler at (202) 482-0189 (Turkey), AD/CVD Operations, Import...

  4. Everything you need to know about distal renal tubular acidosis in autoimmune disease

    T. Both (Tim); R. Zietse (Bob); E.J. Hoorn (Ewout); P.M. van Hagen (Martin); V.A.S.H. Dalm (Virgil); J.A.M. van Laar (Jan); P.L.A. van Daele (Paul)


    textabstractRenal acid-base homeostasis is a complex process, effectuated by bicarbonate reabsorption and acid secretion. Impairment of urinary acidification is called renal tubular acidosis (RTA). Distal renal tubular acidosis (dRTA) is the most common form of the RTA syndromes. Multiple pathophysi

  5. Changes of Apoptosis in Rats of Acute Ischemic Renal Injury under Treatment of Tetrandrine

    钱玲梅; 王笑云; 冷静


    ObjectiveTo elucidate the effect of tetrandrine on acute ischemic renal injury and its relation with apoptosis.MethodsA model for bilateral post-ischemic renal injury in rats was developed by clamping renal pedicles for 45 min.Renal tissular DNA fragmentation analysis and renal tissular HE staining were used.Also quantitative analysis of apoptosis in injured renal tubular epithelium was carried out by using TdT-mediated dUTP nick and labeling (TUNEL).ResultsApoptosis of renal tubular epithelium increased in acute ischemic renal injury.Tetrandrine could remarkably decrease the level of apoptosis in injured renal tubule while protecting renal tissue against the ischemic injuries.ConclusionTetrandrine could adjust the level of apoptosis in renal tubular epithelium and alleviate renal tissular injury.``

  6. Changes of Apoptosis in Rats of Acute Ischemic Renal Injury under Treatment of Tetrandrine

    钱玲梅; 王笑云; 等


    Objective To elucidate the effect of tetrandrine on acute ischemic renal injury and its relation with apoptosis.Methods A model for bilateral post-ischemic renal injury in rats was developed by clamping renal pedicles for 45 min.Renal tissular DNA fragmentation analysis and renal tissular HE staining were used.Also quantitative analysis of apoptosis in injured renal tubular epithelium was carried out by using TdT-mediated dUTP nick and labeling(TUNEL).Results Apoptosis of renal tubular epithelium increased in acute ischemic renal injury.Tetrandrine could remarkably decrease the level of apoptosis in injured renal tubule while protecting renal tissue against the ischemic injuries.Conclusion Tetrandrine could adjust the level of apoptosis in renal tubular epithelium and alleviate renal tissular injury.

  7. Isolation of Leptospira from a phocid: acute renal failure and mortality from Leptospirosis in rehabilitated northern elephant seals (Mirounga angustirostris), California, USA.

    Delaney, Martha A; Colegrove, Kathleen M; Spraker, Terry R; Zuerner, Richard L; Galloway, Renee L; Gulland, Frances M D


    During rehabilitation, acute renal failure due to leptospirosis occurred in eight male northern elephant seals (Mirounga angustirostris) that stranded along the central California coast in 2011. Characteristic histologic lesions including renal tubular degeneration, necrosis, and mineralization, and mild lymphoplasmacytic interstitial nephritis were noted in the six animals examined. Immunohistochemistry, bacterial culture, and PCR were positive in 2/3, 2/3, and 3/4 seals, respectively, and 6/8 had high serum antibody titers to Leptospira interrogans serovar pomona. Pulsed-field gel electrophoresis confirmed one isolate as serovar pomona. Variable number tandem repeat (VNTR) analysis showed both elephant seal isolates were identical to each other but distinct from those isolated from California sea lions (Zalophus californianus). The time from stranding to onset of azotemia was 1 to 38 (median=24) days, suggesting some seals were infected at the rehabilitation facility. Based on temporal and spatial incidence of infection, transmission among elephant seals likely occurred during rehabilitation. Molecular (VNTR) analysis of the two isolates indicates there is a unique L. interrogans serovar pomona genotype in elephant seals, and sea lions were not the source of infection prior to or during rehabilitation. This study confirms the susceptibility of northern elephant seals to leptospirosis, indicates intraspecies transmission during rehabilitation, and reports the first isolation and preliminary characterization of leptospires from elephant seals.

  8. Acute renal failure in dogs after the ingestion of grapes or raisins: a retrospective evaluation of 43 dogs (1992-2002).

    Eubig, Paul A; Brady, Melinda S; Gwaltney-Brant, Sharon M; Khan, Safdar A; Mazzaferro, Elisa M; Morrow, Carla M K


    A review of records from the AnTox database of the American Society for the Prevention of Cruelty to Animals Animal Poison Control Center identified 43 dogs that developed increased blood urea nitrogen concentration, serum creatinine concentration, or both as well as clinical signs after ingesting grapes, raisins, or both. Clinical findings, laboratory findings, histopathological findings, treatments performed, and outcome were evaluated. All dogs vomited, and lethargy, anorexia, and diarrhea were other common clinical signs. Decreased urine output, ataxia, or weakness were associated with a negative outcome. High calcium x phosphorus product (Ca x P), hyperphosphatemia, and hypercalcemia were present in 95%, 90%, and 62% of the dogs in which these variables were evaluated. Extremely high initial total calcium concentration, peak total calcium concentration, initial Ca x P, and peak Ca x P were negative prognostic indicators. Proximal renal tubular necrosis was the most consistent finding in dogs for which histopathology was evaluated. Fifty-three percent of the 43 dogs survived, with 15 of these 23 having a complete resolution of clinical signs and azotemia. Although the mechanism of renal injury from grapes and raisins remains unclear, the findings of this study contribute to an understanding of the clinical course of acute renal failure that can occur after ingestion of grapes or raisins in dogs.

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

    Olsen, Niels Vidiendal; Hansen, J M; Kanstrup, I L


    , heart rate, and plasma norepinephrine. Effective renal plasma flow (ERPF) decreased at HA by 10% (P sodium clearance (CNa), and urine flow remained unchanged compared with SL. Dopamine at SL and HA increased ERPF by 47% (P


    Fan, Jianhua; Dragsted, Janne; Furbo, Simon


    cases, a good degree of similarity between measured and calculated results is found. With these validated models detailed parameter analyses and collector design optimization are now possible. Key words: Evacuated tubular collector, Heat pipe, Thermal performance, TRNSYS simulation.......Differently designed heat-pipe evacuated tubular collectors have been investigated theoretically and experimentally. The theoretical work has included development of two TRNSYS [1] simulation models for heat-pipe evacuated tubular collectors utilizing solar radiation from all directions. One model...... is developed for heat-pipe evacuated tubular collectors with flat fins and one model is developed for heat-pipe evacuated tubular collectors with curved fins. The models are characterized by detailed calculations of the heat transfer processes in the fins, by detailed shadow modeling and by fins with selective...

  11. Dysfunctional tubular endoplasmic reticulum constitutes a pathological feature of Alzheimer's disease.

    Sharoar, M G; Shi, Q; Ge, Y; He, W; Hu, X; Perry, G; Zhu, X; Yan, R


    Pathological features in Alzheimer's brains include mitochondrial dysfunction and dystrophic neurites (DNs) in areas surrounding amyloid plaques. Using a mouse model that overexpresses reticulon 3 (RTN3) and spontaneously develops age-dependent hippocampal DNs, here we report that DNs contain both RTN3 and REEPs, topologically similar proteins that can shape tubular endoplasmic reticulum (ER). Importantly, ultrastructural examinations of such DNs revealed gradual accumulation of tubular ER in axonal termini, and such abnormal tubular ER inclusion is found in areas surrounding amyloid plaques in biopsy samples from Alzheimer's disease (AD) brains. Functionally, abnormally clustered tubular ER induces enhanced mitochondrial fission in the early stages of DN formation and eventual mitochondrial degeneration at later stages. Furthermore, such DNs are abrogated when RTN3 is ablated in aging and AD mouse models. Hence, abnormally clustered tubular ER can be pathogenic in brain regions: disrupting mitochondrial integrity, inducing DNs formation and impairing cognitive function in AD and aging brains.

  12. MICAL-L1-related and unrelated mechanisms underlying elongated tubular endosomal network (ETEN) in human dendritic cells

    Compeer, E.B.; Boes, Marianne


    The endosomal pathway constitutes a highly dynamic intracellular transport system, which is composed of vesicular and tubular compartments. Endosomal tubules enable geometry-based discrimination between membrane and luminal content. Extended tubular endosomes were suggested to deliver a steady strea

  13. Necrosis: a specific form of programmed cell death?

    Proskuryakov, Sergey Ya; Konoplyannikov, Anatoli G; Gabai, Vladimir L


    For a long time necrosis was considered as an alternative to programmed cell death, apoptosis. Indeed, necrosis has distinct morphological features and it is accompanied by rapid permeabilization of plasma membrane. However, recent data indicate that, in contrast to necrosis caused by very extreme conditions, there are many examples when this form of cell death may be a normal physiological and regulated (programmed) event. Various stimuli (e.g., cytokines, ischemia, heat, irradiation, pathogens) can cause both apoptosis and necrosis in the same cell population. Furthermore, signaling pathways, such as death receptors, kinase cascades, and mitochondria, participate in both processes, and by modulating these pathways, it is possible to switch between apoptosis and necrosis. Moreover, antiapoptotic mechanisms (e.g., Bcl-2/Bcl-x proteins, heat shock proteins) are equally effective in protection against apoptosis and necrosis. Therefore, necrosis, along with apoptosis, appears to be a specific form of execution phase of programmed cell death, and there are several examples of necrosis during embryogenesis, a normal tissue renewal, and immune response. However, the consequences of necrotic and apoptotic cell death for a whole organism are quite different. In the case of necrosis, cytosolic constituents that spill into extracellular space through damaged plasma membrane may provoke inflammatory response; during apoptosis these products are safely isolated by membranes and then are consumed by macrophages. The inflammatory response caused by necrosis, however, may have obvious adaptive significance (i.e., emergence of a strong immune response) under some pathological conditions (such as cancer and infection). On the other hand, disturbance of a fine balance between necrosis and apoptosis may be a key element in development of some diseases.

  14. Theoretical flow investigations of an all glass evacuated tubular collector

    Shah, Louise Jivan; Furbo, Simon


    the highest efficiency, the optimal inlet flow rate was around 0.4-1 kg/min, the flow structures in the glass tubes were relatively uninfluenced by the inlet flow rate, Generally, the results showed only small variations in the efficiencies. This indicates that the collector design is well working for most......Heat transfer and flow structures inside all glass evacuated tubular collectors for different operating conditions are investigated by means of computational fluid dynamics. The investigations are based on a collector design with horizontal tubes connected to a vertical 14 manifold channel. Three...... different tube lengths varying from 0.59 in to 1.47 in have been modelled with five different inlet mass flow rates varying from 0.05 kg/min to 10 kg/min with a constant inlet temperature of 333 K. Under these operating conditions the results showed that: the collector with the shortest tube length achieved...

  15. [Diagnostic difficulties in a case of constricted tubular visual field].

    Dogaru, Oana-Mihaela; Rusu, Monica; Hâncu, Dacia; Horvath, Kárin


    In the paper below we present the clinical case of a 48 year old female with various symptoms associated with functional visual disturbance -constricted tubular visual fields, wich lasts from 6 years; the extensive clinical and paraclinical ophthalmological investigations ruled out the presence of an organic disorder. In the present, we suspect a diagnosis of hysteria, still uncertain, wich represented over time a big challenge in psychology and ophthalmology. The mechanisms and reasons for hysteria are still not clear and it could represent a fascinating research theme. The tunnel, spiral or star-shaped visual fields are specific findings in hysteria for patients who present visual disturbance. The question of whether or not a patient with hysterical visual impairment can or cannot "see" is still unresolved.

  16. Scalable Approach for Extrusion and Perfusion of Tubular, Heterotypic Biomaterials

    Jeronimo, Mark David

    Soft material tubes are critical in the vasculature of mammalian tissues, forming networks of blood vessels and airways. Homogeneous and heterogeneous hydrogel tubes were extruded in a one-step process using a three layer microfluidic device. Co-axial cylindrical flow of crosslinking solutions and an alginate matrix is generated by a radial arrangement of microfluidic channels at the device's vertical extrusion outlet. The flow is confined and begins a sol-gel transition immediately as it extrudes at velocities upwards of 4 mm/s. This approach allows for predictive control over the dimensions of the rapidly formed tubular structures for outer diameters from 600 microm to 3 mm. A second microfluidic device hosts tube segments for controlled perfusion and pressurization using a reversible vacuum seal. On-chip tube deflection is observed and modeled as a measure of material compliance and circumferential elasticity. I anticipate applications of these devices for perfusion cell culture of cell-laden hydrogel tubes.

  17. Design of a Compact and Versatile Bench Scale Tubular Reactor

    R. Prasad


    Full Text Available A compact and versatile laboratory tubular reactor has been designed and fabricated keeping in view of reducing capital cost and minimising energy consumption for gas/vapor-phase heterogeneous catalytic reactions. The reactor is consisted of two coaxial corning glass tubes with a helical coil of glass tube in between the coaxial tubes serving as vaporiser and pre-heater, the catalyst bed is in the inner tube. A schematic diagram of the reactor with detailed dimensions and working principles are described. The attractive feature of the reactor is that the vaporiser, pre-heater and fixed bed reactor are merged in a single compact unit. Thus, the unit minimises separate vaporiser and pre-heater, also avoids separate furnaces used for them and eliminate auxiliary instrumentation such as temperature controller etc. To demonstrate the system operation and illustrate the key features, catalyst screening data and the efficient collection of complete, and accurate intrinsic kinetic data are provided for oxidation of CO over copper chromite catalyst. CO oxidation is an important reaction for auto-exhaust pollution control. The suitability of the versatile nature of the reactor has been ascertained for catalytic reactions where either volatile or vaporizable feeds can be introduced to the reaction zone, e.g. oxidation of iso-octane, reduction of nitric oxide, dehydrogenation of methanol, ethanol and iso-propanol, hydrogenation of nitrobenzene to aniline, etc. Copyright (c 2009 by BCREC. All Rights reserved.[Received: 10 February 2009, Accepted: 9 May 2009][How to Cite: R. Prasad, G. Rattan. (2009. Design of a Compact and Versatile Bench Scale Tubular Reactor. Bulletin of Chemical Reaction Engineering and Catalysis, 4(1: 5-9.  doi:10.9767/bcrec.4.1.1250.5-9][How to Link/ DOI:

  18. On milling of thin-wall conical and tubular workpieces

    Tsai, Mu-Ping; Tsai, Nan-Chyuan; Yeh, Cheng-Wei


    Thin-wall tubular-geometry workpieces have been widely applied in aircraft and medical industries. However, due to the special geometry of this kind of workpieces and induced poor machinability, the desired accuracy of machining tends to be greatly degraded, no matter what type of metal-cutting task such as milling, drilling or turning is undertaken. Though numerous research reports are available that the tool path can be planned on the basis of preset surface profile before actual milling operation is performed, it is still difficult to predict the real-time surface profile errors for peripheral milling of thin-wall tubular workpieces. Instead of relying on tool path planning, this research is focused on how to real-time formulate the appropriate applied cutting torque via feedback of spindle motor current. On the other hand, a few suitable cutting conditions which are able to prevent potential break/crack of thin-wall workpieces and enhance productivity but almost retain the same cutting quality is proposed in this research. To achieve this goal, estimated surface profile error on machined parts due to deflections caused by both tool and workpiece is studied at first. Traditionally, by adjusting cutting parameters such as feed rate or cut depth, the deflection of tool or workpiece can be expected not to exceed the specified limit. Instead, an effective feedback control loop is proposed by this work for applying real-time appropriate applied cutting torque to prevent potential break/crack of the thin-wall conical workpieces. The torque estimation approach by spindle motor current feedback and the corresponding fuzzy logic controller are employed. Compared with constant cutting torque during milling operation in tradition manner, it is observed that the time consumption of milling cycle by aid of the aforesaid fuzzy logic controller is greatly shortened while the resulted cutting accuracy upon finish of workpiece can be almost retained.

  19. Experimental studies of a matrix-tubular solar air collector

    Plesca, M.; Varlan, P. [Moldova Technical Univ., Chisinau (Moldova, Republic of). Dept. of Heat and Gas Supply and Ventilation


    The most common types of solar air collectors (SAC) are contact-type and matrix-type collectors, with the latter being more efficient. This paper described the design and testing of a matrix-tubular flat solar air collector in the city of Chisinau, Moldova, where the outdoor climatic radiation, heat, and humidity characteristics are favorable for the efficient use of solar energy for building heating and drying applications. The amount of solar energy absorbed by a solar energy air collector depends on the level of insulation and orientation of the solar collector; the absorbance of the absorber surface; and the transmittance of the cover material. This study examined the heat transfer, efficiency, and pressure drop using copper tubes inserted perpendicular to the plane of the absorber plate. The SAC consists of a glazed insulated case, an absorber, and ducting for cold air delivery and hot air discharge. Copper tubes are inserted perpendicular to the plane of the absorber. The absorber is installed in the body of the SAC in such a way that it divides it into an upper channel and lower channel. The channel bottom is lined with aluminium foil that reflects solar radiation coming through the tubes and decreases heat loss in the solar collector. Copper tubes increase the heat exchange surface, create air turbulence and intensify heat transfer. This increases the efficiency of the solar collector. The pressure drop of the matrix-tubular solar air collector is 40 per cent lower than that of the matrix-plate collectors. 11 refs., 2 tabs., 6 figs.

  20. Tubular dysfunction after peritonectomy and chemohyperthermic treatment with cisplatin.

    La Manna, Gaetano; Virzì, Salvatore; Deraco, Marcello; Capelli, Irene; Accorsi, Alma; Dalmastri, Vittorio; Comai, Giorgia; Bonomi, Serena; Grassi, Antonio; Selva, Saverio; Feliciangeli, Giorgio; Scolari, Maria; Stefoni, Sergio


    Peritoneal carcinomatosis has always been regarded as a contraindication in traditional cancer surgery treatment; however, good results have been reported by using new combined medical-surgical loco-regional techniques. Peritonectomy and chemohyperthermic perfusion with cisplatinum (CIIP) seem to play a central role in obtaining a better survival rate than with the traditional procedures, even though there is a cisplatinum nephrotoxic effect. The aim of this study was to investigate entity and type of renal injury after CIIP. Forty-two patients (12 males and 30 females) with recurrent or primary peritoneal carcinomatosis who underwent peritonectomy and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy with cisplatin were enrolled. A significant worsening in renal function was observed on the third post-operative day and this condition then persisted for three months. A reduction in estimated-Glomerular Filtration Rate (e-GFR) and an alteration in the albumin:creatinine ratio proved tubular injury. On the third post-operative day after cisplatinum administration, a high toxicity peak was found following platinum free fraction excretion. Proximal tubular injury was confirmed even at the three month analysis. A significant correlation between the total protein reduction rate and the decrease in renal function was established. In relation to that, the platinum free fraction could increase because of a binding protein shortage and the nephrotoxic effect could be enhanced due to platinum accumulation within the post-operative period. This finding suggests that the higher the protein reduction is, the lower the e-GFR determination is at three months.

  1. Tubular Scaffold with Shape Recovery Effect for Cell Guide Applications

    Kazi M. Zakir Hossain


    Full Text Available Tubular scaffolds with aligned polylactic acid (PLA fibres were fabricated for cell guide applications by immersing rolled PLA fibre mats into a polyvinyl acetate (PVAc solution to bind the mats. The PVAc solution was also mixed with up to 30 wt % β-tricalcium phosphate (β-TCP content. Cross-sectional images of the scaffold materials obtained via scanning electron microscopy (SEM revealed the aligned fibre morphology along with a significant number of voids in between the bundles of fibres. The addition of β-TCP into the scaffolds played an important role in increasing the void content from 17.1% to 25.3% for the 30 wt % β-TCP loading, which was measured via micro-CT (µCT analysis. Furthermore, µCT analyses revealed the distribution of aggregated β-TCP particles in between the various PLA fibre layers of the scaffold. The compressive modulus properties of the scaffolds increased from 66 MPa to 83 MPa and the compressive strength properties decreased from 67 MPa to 41 MPa for the 30 wt % β-TCP content scaffold. The scaffolds produced were observed to change into a soft and flexible form which demonstrated shape recovery properties after immersion in phosphate buffered saline (PBS media at 37 °C for 24 h. The cytocompatibility studies (using MG-63 human osteosarcoma cell line revealed preferential cell proliferation along the longitudinal direction of the fibres as compared to the control tissue culture plastic. The manufacturing process highlighted above reveals a simple process for inducing controlled cell alignment and varying porosity features within tubular scaffolds for potential tissue engineering applications.


    朱世纯; 杜建华; 李倩


    目的 检测急腹症伴发全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)患者血浆细胞因子肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素6(interleukin-6,IL-6)及核因子κB(nuclear factor-κB ,NF-κB)水平的动态变化,并探讨与SIRS的关系.方法 81例急腹症伴SIRS患者于入院当日(0d)及入院后1、3、7d分别采集空腹外周静脉血,用酶联免疫吸附法测定TNF-α、IL-6及NF-κB的血浆浓度,另选30例健康成年人做为对照组.分别对NF-κB活性与TNF-α及IL-6水平进行相关统计学分析.结果 81例急腹症患者血浆各时间点TNF-α、IL-6及NF-κB水平均较对照组显著增高,差异有统计学意义(P<0.05).NF-κB活性增高与TNF-α及IL-6血浆浓度增高呈明显正相关(P<0.05).结论 急腹症伴SIRS时,TNF-α、IL-6及NF-κB表达增多.TNF-α及IL-6血浆浓度与NF-κB活性呈正相关.

  3. 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.


    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.

  4. 急性胰腺炎肺损伤大鼠肺组织肿瘤坏死因子受体-1与窖蛋白-1的表达及清胰汤的治疗作用%The expression of tumor necrosis factor receptor-1 and caveolin-1 in the lung of acute pancreatitisassociated lung injury rats and the therapeutic role of Qingyitang

    王钢; 陈海龙; 唐颖; 任凤; 李洁; 姜妙娜


    Objective To investigate the expression and function of tumor necrosis factor receptor-1 (TNFR-1) and caveolin-1 (Cav-1) in the lung of acute pancreatitis-associated lung injury rats, and to determine the potential role of Qingyitang. Methods Wistar rats were randomly divided into sham operation (SHAM) group, acute lung injury (ALI) group, dexamethasone (DEX) group and Qingyitang (QYT)group. ALI was induced by retrograde injection of deoxycholate into biliopancreatic duct of rats. Blood and lung tissues were drawn after 24 h. Serum amylase, lung wet/dry (W/D) ratio and pathological section were examined to evaluate the degree of lung injury. Immunoradioassay was used to detect serum tumor necrosis factor-α (TNF-α). Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were applied to detect the expression levels of TNFR-1 and Cav-1 mRNA and protein respectively. Results The concentration of serum amylase, the W/D ratio, TNF-α (4.82 ± 0.14 vs 2.96 ± 0. 30, P <0. 01 ) and the degree of pathological lung injury were obviously increased in ALI rats. The expression of TNFR-1 mRNA was increased in ALI rats (1.29 ±0. 15 vs 0.43 ±0.05,P<0.01), but Cav-1 mRNA expression was decreased ( 1.14 ±0. 10 vs 2.00 ±0. 10,P <0.01 ). The expression of TNFR-1 protein in both lipid rafts and non-lipid rafts was increased, but that of Cav-1 in both of the two fractions was decreased. As compared with ALI rats, the concentration of serum amylase, W/D ratio, TNF-αt ( DEX: 3.79 ± 0. 11,QYT: 3.66 ±0. 10, ALI: 4.82 ±0. 14,P <0.01 ) and the degree of pathological lung injury were obviously decreased in DEX and QYT rats. The expression of TNFR-1 mRNA was decreased in both DEX and QYT groups (DEX: 0.48±0.01, QYT: 0.49 ±0.02, ALI: 1.29 ±0. 15,P<0.01), but that of Cav-1 mRNA was up-regulated (DEX: 1.66 ±0.06, QYT: 1.52 ±0.04, ALI: 1.14 ±0. 10,P<0.01). The expression of TNFR-1 protein in both lipid rafts and non-lipid rafts was decreased, but

  5. Delayed Pneumoperitoneum and Acute Pulmonary Edema Secondary to Acute Gastric Dilatation

    Ahn, Jae Yun; Kim, Jong Kun


    Pneumoperitoneum caused by acute gastric dilatation (AGD) is a very rare complication. We report a case of pneumoperitoneum and acute pulmonary edema caused by AGD in a patient with Parkinson’s disease. A 78-year-old woman presented with pneumonia and AGD. We inserted a nasogastric tube and administered empirical antibiotics. We performed an endoscopy, and perforation or necrosis of the stomach and pyloric stenosis were not observed. Thirty-six hours after admission, the patient suddenly developed dyspnea and shock, and eventually died. We suspected the cause of death was pneumoperitoneum and acute pulmonary edema caused by AGD during the conservative treatment period. Immunocompromised patients with chronic illness require close observation even if they do not show any symptoms suggestive of complications. Even if the initial endoscopic or abdominal radiologic findings do not show gastric necrosis or perforation, follow-up with endoscopy is essential to recognize complications of AGD early. PMID:26668807

  6. Therapeutic approaches for tumor necrosis factor inhibition

    Maria Letícia de Castro Barbosa


    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

  7. Tumor Necrosis Factor Induces Developmental Stage-Dependent Structural Changes in the Immature Small Intestine

    Kathryn S. Brown


    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.

  8. Effect of saline loading on uranium-induced acute renal failure in rats

    Hishida, A.; Yonemura, K.; Ohishi, K.; Yamada, M.; Honda, N.


    Studies were performed to examine the effect of saline loading on uranium-induced acute renal failure (ARF) in rats. Forty-eight hours after the i.v. injection of uranyl acetate (UA, 5 mg/kg), inulin clearance rate (Cin) decreased to approximately 43% of the control value in water drinking rats (P less than 0.005). Animals receiving continuous isotonic saline infusion following UA showed higher urine flow and Cin (60% of control, P less than 0.01), and lessened intratubular cast formation when compared with water-drinking ARF rats. A short-term saline infusion following UA did not attenuate the decline in Cin (43% of control). An inverse relationship was found between Cin and the number of casts (r = -0.75, P less than 0.01). Multiple regression analysis showed that standardized partial regression coefficient is statistically significant between Cin and cast formation (-0.69, P less than 0.05), but not between Cin and tubular necrosis (-0.07, P greater than 0.05). Renin depletion caused by DOCA plus saline drinking did not attenuate the decline in Cin in ARF (47% of control). No significant difference was found in urinary uranium excretion between water-drinking and saline-infused ARF rats. The findings suggest that continuous saline infusion following UA attenuates the decline in Cin in ARF rats; and that this beneficial effect of saline loading is associated with lessened cast formation rather than with suppressed renin-angiotensin activity or enhanced urinary-uranium excretion.

  9. Assessment of the place of tubular reabsorption of phosphorus in the diagnosis of osteopenia of prematurity

    Acar, Duygu Besnili; Kavuncuoğlu, Sultan; Çetinkaya, Merih; Petmezci, Ercüment; Dursun, Mesut; Korkmaz, Orhan; Altuncu, Emel Kayrak


    Aim: In this study, we aimed to investigate the utility of tubular reabsorption of phosphorus in the diagnosis of osteopenia of prematurity in addition to biochemical markers. Materials and Method: Premature babies with a gestational age of ≤32 weeks and/or a birth weight of ≤1 500 g who were hospitalized in the neonatal intensive care unit between June 2009 and March 2011 were included in the study. These babies were evaluated at the 40th gestational week and serum calcium, phosphorus, alkaline phosphatase, urea, creatinine, urinary calcium and phosphorus levels were measured and tubular reabsorption of phosphorus was determined. The subjects who had bone graphy findings and/or an alkaline phosphatase level of >400IU/L and a phosphorus value of 499 IU were compared with the newborns who were found to have a tubular reabsorption of phosphorus of ≥%95 for the objective of evaluating the specificity and sensitivity of tubular reabsorption of phosphorus, the sensitivity, specificity, positive predictive value and negative predictive value of tubular reabsorption of phosphorus in the diagnosis of osteopenia were found to be 27%, 82%, 17% and 89%, respectively. When the osteopenic and non-osteopenic patients were compared in terms of the levels of tubular reabsorption of phosphorus, no statistically significant difference was found. Conclusions: It was thought that it was not appropriate to use tubular reabsorption of phosphorus alone in the diagnosis of osteopenia of prematurity. PMID:26078696

  10. Nephrotic syndrome and multiple tubular defects in children: an early sign of focal segmental glomerulosclerosis.

    McVicar, M; Exeni, R; Susin, M


    The nephrotic syndrome is rarely associated with renal tubular defects, and the combination has been reported only in association with advanced renal insufficiency. We report here five children with nephrotic syndrome and multiple tubular defects which evolved when glomular filtration rate ranged between 56 and 90 ml/minute/1.73 m2. The tubular defects were first noted at 3, 4, 4, 7, and 22 months after the onset of the nephrotic syndrome, and renal glycosuria was the first sign in all five children. Glycosuria was intermittent in three patients, constant in two, and ceased with loss of kidney function. Four patients had hyperaminoaciduria and renal tubular acidosis (two of four tested had distal renal tubular acidosis). Three patients had decreased tubular reabsorption of phosphorus and defective maximum concentrating capacity. All five had focal segmental glomerulosclerosis proven by renal biopsy. Over a follow-up period of seven years, all of the children have developed advanced renal insufficiency, four of the five have required dialysis or transplantation within 21 to 72 months after onset, and one has stabilized renal function at 35 ml/minute/1.73 m2. The one patient receiving a kidney transplant has had recurrence of focal segmental glomerulosclerosis in the transplanted kidney and became nephrotic with three subsequent transplants. Our experience suggests that the nephrotic syndrome associated with tubular defects in children forms a subgroup of focal segmental glomerulosclerosis, with rapid progression to renal insufficiency and the potential for recurrence of the lesion in the transplanted kidney.

  11. Necrosis, a regulated mechanism of cell death La necrosis, un mecanismo regulado de muerte celular

    Mauricio Rojas López


    Full Text Available

    Three types of cellular death have been defined by morphological and biochemical criteria: apoptosis, necrosis and autophagy. Apoptosis is a regulated cell death, mainly mediated by caspases; autophagy induces degradation of intracellular damaged organelles through the formation of vesicles that fuse with hydrolytic vacuoles.


    Necrosis has been traditionally defined by the rupture the cytoplasmic membrane with subsequent release of intracellular material, triggering localized inflammatory Intrinsic cellular activities and the events preceding cellular collapse are critical to determine the type of tissue damage.


    The fact that all three types of cellular death can coexist in any organ and tissue with different availabilities of ATP, suggests that necrosis can be conceived as an active event and that to some extent it may be regulated. Alterations in the structure of proteins and in the

  12. Role of TNF-associated cytokines in renal tubular cell apoptosis induced by hyperoxaluria.

    Horuz, Rahim; Göktaş, Cemal; Çetinel, Cihangir A; Akça, Oktay; Aydın, Hasan; Ekici, Işın D; Albayrak, Selami; Sarıca, Kemal


    Crystal-cell interaction has been reported as one of the most crucial steps in urinary stone formation. Hyperoxaluria-induced apoptotic changes in renal tubular epithelial cells is the end-stage of this interaction. We aimed to evaluate the possible pathways responsible in the induction of apoptosis within the involved cells by assessing the receptoral expression of three different pathways. 16 male Spraque-Dowley rats were divided into two groups: Group 1 (n:8) received only distilled water; Group 2 (n:8) received 0.75 % ethylene glycol (EG) in their daily water to induce hyperoxaluria for 2 weeks. After 24 h urine collection, all animals were euthenized and right kidneys were removed and fixed for immunohistochemical evaluation. Oxalate and creatinine levels (in 24 h-urine) and FAS, tumor necrosis factor (TNF), TNF-related apoptosis-inducing ligand (TRAIL) and TRAIL receptor-2 expressions (in tissue) have been assessed. In addition to TNF (p = 0.0007) expression; both FAS (p = 0.0129 ) and FASL (p = 0.032) expressions significantly increased in animals treated with EG. The expressions of TRAIL (p = 0.49) and TRAIL-R2 (p = 0.34) receptors did not change statistically after hyperoxaluria induction. Although a positive correlation with cytokine expression density and 24 h-urinary oxalate expression (mg oxalate/mg creatinine) has been assessed with TNF (p = 0.04, r = 0.82), FAS (p = 0.05, r = 0.80), FAS-L (p = 0.04, r = 0.82); no correlation could be demonstrated between TRAIL and TRAIL R2 expressions. Our results indicate that apoptosis induced by oxalate is possibly mediated via TNF and FAS pathways. However, TRAIL and TRAIL-R2 seemed to have no function in the cascade. Correlation with urinary oxalate levels did further strengthen the findings.

  13. Acute periodontal lesions.

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano


    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  14. Genetic ablation of soluble tumor necrosis factor with preservation of membrane tumor necrosis factor is associated with neuroprotection after focal cerebral ischemia

    Madsen, Pernille M; Clausen, Bettina H; Degn, Matilda;


    Microglia respond to focal cerebral ischemia by increasing their production of the neuromodulatory cytokine tumor necrosis factor, which exists both as membrane-anchored tumor necrosis factor and as cleaved soluble tumor necrosis factor forms. We previously demonstrated that tumor necrosis factor...

  15. Kidney specific protein-positive cells derived from embryonic stem cells reproduce tubular structures in vitro and differentiate into renal tubular cells.

    Morizane, Ryuji; Monkawa, Toshiaki; Fujii, Shizuka; Yamaguchi, Shintaro; Homma, Koichiro; Matsuzaki, Yumi; Okano, Hideyuki; Itoh, Hiroshi


    Embryonic stem cells and induced pluripotent stem cells have the ability to differentiate into various organs and tissues, and are regarded as new tools for the elucidation of disease mechanisms as well as sources for regenerative therapies. However, a method of inducing organ-specific cells from pluripotent stem cells is urgently needed. Although many scientists have been developing methods to induce various organ-specific cells from pluripotent stem cells, renal lineage cells have yet to be induced in vitro because of the complexity of kidney structures and the diversity of kidney-component cells. Here, we describe a method of inducing renal tubular cells from mouse embryonic stem cells via the cell purification of kidney specific protein (KSP)-positive cells using an anti-KSP antibody. The global gene expression profiles of KSP-positive cells derived from ES cells exhibited characteristics similar to those of cells in the developing kidney, and KSP-positive cells had the capacity to form tubular structures resembling renal tubular cells when grown in a 3D culture in Matrigel. Moreover, our results indicated that KSP-positive cells acquired the characteristics of each segment of renal tubular cells through tubular formation when stimulated with Wnt4. This method is an important step toward kidney disease research using pluripotent stem cells, and the development of kidney regeneration therapies.

  16. Undulating tubular liposomes through incorporation of a synthetic skin ceramide into phospholipid bilayers.

    Xu, Peng; Tan, Grace; Zhou, Jia; He, Jibao; Lawson, Louise B; McPherson, Gary L; John, Vijay T


    Nonspherical liposomes were prepared by doping L-alpha-phosphatidylcholine (PC) with ceramide VI (a skin lipid). Cryo-transmission electron microscopy shows the liposome shape changing from spherical to an undulating tubular morphology, when the amount of ceramide VI is increased. The formation of tubular liposomes is energetically favorable and is attributed to the association of ceramide VI with PC creating regions of lower curvature. Since ceramides are the major component of skin lipids in the stratum corneum, tubular liposomes containing ceramide may potentially serve as self-enhanced nanocarriers for transdermal delivery.

  17. Deficiency for the chemokine monocyte chemoattractant protein-1 aggravates tubular damage after renal ischemia/reperfusion injury.

    Ingrid Stroo

    Full Text Available Temporal expression of chemokines is a crucial factor in the regulation of renal ischemia/reperfusion (I/R injury and repair. Beside their role in the migration and activation of inflammatory cells to sites of injury, chemokines are also involved in other processes such as angiogenesis, development and migration of stem cells. In the present study we investigated the role of the chemokine MCP-1 (monocyte chemoattractant protein-1 or CCL2, the main chemoattractant for monocytes, during renal I/R injury. MCP-1 expression peaks several days after inducing renal I/R injury coinciding with macrophage accumulation. However, MCP-1 deficient mice had a significant decreased survival and increased renal damage within the first two days, i.e. the acute inflammatory response, after renal I/R injury with no evidence of altered macrophage accumulation. Kidneys and primary tubular epithelial cells from MCP-1 deficient mice showed increased apoptosis after ischemia. Taken together, MCP-1 protects the kidney during the acute inflammatory response following renal I/R injury.

  18. Deficiency for the chemokine monocyte chemoattractant protein-1 aggravates tubular damage after renal ischemia/reperfusion injury.

    Stroo, Ingrid; Claessen, Nike; Teske, Gwendoline J D; Butter, Loes M; Florquin, Sandrine; Leemans, Jaklien C


    Temporal expression of chemokines is a crucial factor in the regulation of renal ischemia/reperfusion (I/R) injury and repair. Beside their role in the migration and activation of inflammatory cells to sites of injury, chemokines are also involved in other processes such as angiogenesis, development and migration of stem cells. In the present study we investigated the role of the chemokine MCP-1 (monocyte chemoattractant protein-1 or CCL2), the main chemoattractant for monocytes, during renal I/R injury. MCP-1 expression peaks several days after inducing renal I/R injury coinciding with macrophage accumulation. However, MCP-1 deficient mice had a significant decreased survival and increased renal damage within the first two days, i.e. the acute inflammatory response, after renal I/R injury with no evidence of altered macrophage accumulation. Kidneys and primary tubular epithelial cells from MCP-1 deficient mice showed increased apoptosis after ischemia. Taken together, MCP-1 protects the kidney during the acute inflammatory response following renal I/R injury.

  19. [Torsion and necrosis of epiploic appendices of the large bowel].

    Timofeev, M E; Fedorov, E D; Krechetova, A P; Shapoval'iants, S G


    The features of the clinical symptoms was studied, the possibility of laparoscopy in modern diagnosis and treatment of epiploic appendices torsion and necrosis of the large bowel was assessed in the article. It was done the retrospective analysis of the medical records of 87 patients with a diagnosis of epiploic appendices torsion and necrosis of the large bowel. The patients had laparoscopic operations in our hospital in the period from January 1995 to December 2012. The clinical picture, laboratory and instrumental datas in cases of epiploic appendices torsion and necrosis were scarce and nonspecific. An abdominal pain preferentially localized in the lower divisions was the main symptom (97.7%). The instrumental methods did not allow to diagnose the torsion and necrosis of epiploic appendices in the majority of cases and all these techniques were used for the differential diagnosis with other diseases. The assumption of the presence of appendices torsion and necrosis occured just in 34.5% of cases before the operation. Diagnosis of epiploic appendices torsion and necrosis present significant difficulties on prehospital and preoperative stages. The diagnostic laparoscopy is the method of choice in unclear situations and it allows to diagnose the torsion and necrosis of epiploic appendices in 96.6% of cases. Successful surgical treatment by using laparoscopic approach is possible in 90.8% of cases.

  20. Acute pancreatitis

    Bo-Guang Fan


    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.

  1. Acute pancreatitis

    Bo-Guang Fan


    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.

  2. Tumor necrosis factor interaction with gold nanoparticles

    Tsai, De-Hao; Elzey, Sherrie; Delrio, Frank W.; Keene, Athena M.; Tyner, Katherine M.; Clogston, Jeffrey D.; Maccuspie, Robert I.; Guha, Suvajyoti; Zachariah, Michael R.; Hackley, Vincent A.


    We report on a systematic investigation of molecular conjugation of tumor necrosis factor-α (TNF) protein onto gold nanoparticles (AuNPs) and the subsequent binding behavior to its antibody (anti-TNF). We employ a combination of physical and spectroscopic characterization methods, including electrospray-differential mobility analysis, dynamic light scattering, polyacrylamide gel electrophoresis, attenuated total reflectance-Fourier transform infrared spectroscopy, fluorescence assay, and enzyme-linked immunosorbent assay. The native TNF used in this study exists in the active homotrimer configuration prior to conjugation. After binding to AuNPs, the maximum surface density of TNF is (0.09 +/- 0.02) nm-2 with a binding constant of 3 × 106 (mol L-1)-1. Dodecyl sulfate ions induce desorption of monomeric TNF from the AuNP surface, indicating a relatively weak intermolecular binding within the AuNP-bound TNF trimers. Anti-TNF binds to both TNF-conjugated and citrate-stabilized AuNPs, showing that non-specific binding is significant. Based on the number of anti-TNF molecules adsorbed, a substantially higher binding affinity was observed for the TNF-conjugated surface. The inclusion of thiolated polyethylene glycol (SH-PEG) on the AuNPs inhibits the binding of anti-TNF, and the amount of inhibition is related to the number ratio of surface bound SH-PEG to TNF and the way in which the ligands are introduced. This study highlights the challenges in quantitatively characterizing complex hybrid nanoscale conjugates, and provides insight on TNF-AuNP formation and activity.We report on a systematic investigation of molecular conjugation of tumor necrosis factor-α (TNF) protein onto gold nanoparticles (AuNPs) and the subsequent binding behavior to its antibody (anti-TNF). We employ a combination of physical and spectroscopic characterization methods, including electrospray-differential mobility analysis, dynamic light scattering, polyacrylamide gel electrophoresis

  3. Role of microRNA-181a in the apoptosis of tubular epithelial cell induced by cisplatin

    ZHU Han-yu; Liu Mo-yan; HONG Quan; ZHANG Dong; GENG Wen-jia; XIE Yuan-sheng; CHEN Xiang-mei


    Background Cisplatin (DDP) is one of most effective and most commonly used therapeutic agent in treating tumors,it can accumulate in the kidney and lead to acute renal failure.MicroRNA-181a can induce cell apoptosis by suppressing the expression of Bcl-2 family.In the present study,we investigated the role of microRNA-181a in the apoptosis of tubular epithelial cell induced by DDP.Methods HK-2 cells were cultured,transfected with microRNA-181a inhibitor for 48 hours,and stimulated with 50 μmol/L cisplatin for 24 hours.MicroRNA-181a expression was analyzed by real time PCR,and cell apoptosis was detected by flow cytometry.Moreover,Bcl-2 and Bcl-2-associated X protein (Bax) expression were measured by Western blotting.Results MicroRNA-181a expression significantly down-regulated in cells transfected with microRNA-181a inhibitor,compared with that in untransfectd cells (21.19±2.01 vs.38.87±1.97,P <0.05).Cell apoptosis induced by DDP significantly decreased in cells transfected with MicroRNA-181a inhibitor.Compared with DDP treated cells alone,Bcl-2 expression strikingly was up-regulated and Bax expression was down-regulated in cells transfected with microRNA-181a inhibitor.Conclusion One pathway of DDP induces apoptosis of tubular epithelial cell by suppressing Bcl-2 expression is achieved by regulating the target gene of MicroRNA-181a.

  4. Effect of mycophenolate mofetil on progression of interstitial fibrosis and tubular atrophy after kidney transplantation: a retrospective study

    Mihovilović, Karlo; Maksimović, Bojana; Kocman, Branislav; Guštin, Denis; Vidas, Željko; Bulimbašić, Stela; Ljubanović, Danica Galešić; Matovinović, Mirjana Sabljar; Knotek, Mladen


    Objectives Chronic transplant dysfunction after kidney transplantation is a major reason of kidney graft loss and is caused by immunological and non-immunological factors. There is evidence that mycophenolate mofetil (MMF) may exert a positive effect on renal damage in addition to immunosuppression, by its direct antifibrotic properties. The aim of our study was to retrospectively investigate the role of MMF doses on progression of chronic allograft dysfunction and fibrosis and tubular atrophy (IF/TA). Setting Retrospective, cohort study. Participants Patients with kidney transplant in a tertiary care institution. This is a retrospective cohort study that included 79 patients with kidney and kidney–pancreas transplantation. Immunosuppression consisted of anti-interleukin 2 antibody induction, MMF, a calcineurin inhibitor±steroids. Primary outcome measures An association of average MMF doses over 1 year post-transplant with progression of interstitial fibrosis (Δci), tubular atrophy (Δct) and estimated-creatinine clearance (eCrcl) at 1 year post-transplant was evaluated using univariate and multivariate analyses. Results A higher average MMF dose was significantly independently associated with better eCrcl at 1 year post-transplant (b=0.21±0.1, p=0.04). In multiple regression analysis lower Δci (b=−0.2±0.09, p=0.05) and Δct (b=−0.29±0.1, p=0.02) were independently associated with a greater average MMF dose. There was no correlation between average MMF doses and incidence of acute rejection (p=0.68). Conclusions A higher average MMF dose over 1 year is associated with better renal function and slower progression of IF/TA, at least partly independent of its immunosuppressive effects. PMID:24993756

  5. Metabolic epidermal necrosis-hepatocutaneous syndrome.

    Byrne, K P


    It is clear that cutaneous lesions of metabolic epidermal necrosis in the dog can occur either with a demonstrable glucagon-secreting tumor or with hepatic disease without any detectable glucagonoma. Additional clinical case reports of the disease in cats are needed to better characterize the disease in this species. The lesions of NME-MEN may not represent a specific physiological mechanism of cutaneous disease but instead a pathophysiological process that can be triggered by several systemic metabolic abnormalities. The fact that NME is observed in association with a variety of conditions supports the theory that an overall metabolic derangement results in the rash. The prognosis for canine MEN is poor; however, some affected dogs have been maintained for many months with dietary management. High-quality protein diets such as Hill's Prescription Diet a/d (Hill's Pet Products) or other "recovery" diets may be helpful. Zinc and essential fatty acid supplementation may help some patients. Dietary supplementation with cooked egg yolks may be helpful. It is prudent to avoid corticosteroids in these cases, as development of diabetes mellitus worsens the prognosis. Histopathological examination of the pancreas coupled with determination of plasma glucagon may help define the characteristics of GS versus HS in dogs. It is possible that some dogs diagnosed with MEN-HS may have an undetected pancreatic tumor. Although the hepatic ultrasound findings in dogs with MEN-HS are becoming well characterized, it is possible for dogs with pancreatic neuroendocrine tumors to also have abnormal hepatic ultrasonography. As the presence of MEN and hepatic disease does not necessarily rule out the presence of a pancreatic tumor, prospective studies correlating plasma glucagon levels with pancreatic histopathology in cases of MEN-GS versus MEN-HS seem warranted.

  6. Non-invasive imaging of acute renal allograft rejection in rats using small animal F-FDG-PET.

    Stefan Reuter

    Full Text Available BACKGROUND: At present, renal grafts are the most common solid organ transplants world-wide. Given the importance of renal transplantation and the limitation of available donor kidneys, detailed analysis of factors that affect transplant survival are important. Despite the introduction of new and effective immunosuppressive drugs, acute cellular graft rejection (AR is still a major risk for graft survival. Nowadays, AR can only be definitively by renal biopsy. However, biopsies carry a risk of renal transplant injury and loss. Most important, they can not be performed in patients taking anticoagulant drugs. METHODOLOGY/PRINCIPAL FINDINGS: We present a non-invasive, entirely image-based method to assess AR in an allogeneic rat renal transplantation model using small animal positron emission tomography (PET and (18F-fluorodeoxyglucose (FDG. 3 h after i.v. injection of 30 MBq FDG into adult uni-nephrectomized, allogeneically transplanted rats, tissue radioactivity of renal parenchyma was assessed in vivo by a small animal PET-scanner (post operative day (POD 1,2,4, and 7 and post mortem dissection. The mean radioactivity (cps/mm(3 tissue as well as the percent injected dose (%ID was compared between graft and native reference kidney. Results were confirmed by histological and autoradiographic analysis. Healthy rats, rats with acute CSA nephrotoxicity, with acute tubular necrosis, and syngeneically transplanted rats served as controls. FDG-uptake was significantly elevated only in allogeneic grafts from POD 1 on when compared to the native kidney (%ID graft POD 1: 0.54+/-0.06; POD 2: 0.58+/-0.12; POD 4: 0.81+/-0.06; POD 7: 0.77+/-0.1; CTR: 0.22+/-0.01, n = 3-28. Renal FDG-uptake in vivo correlated with the results obtained by micro-autoradiography and the degree of inflammatory infiltrates observed in histology. CONCLUSIONS/SIGNIFICANCE: We propose that graft FDG-PET imaging is a new option to non-invasively, specifically, early detect, and follow

  7. Differentiation of radiation necrosis from glioblastoma recurrence after radiotherapy

    Chrissa Sioka; Anastasia Zikou; Anna Goussia; Spyridon Tsiouris; Loucas G Astrakas; Athanassios P Kyritsis


    The standard treatment of glioblastoma, the most common type of primary-brain-tumor, involves radiotherapy with concomitant temozolomide chemotherapy. A patient with glioblastoma, post radiotherapy developed magnatic resonance imaging (MRI) changes consistent with either radiation-induced tumor necrosis or tumor recurrence. Perfusion MRI was suggestive of radiation necrosis, but magnetic resonance spectroscopy and99mTc-Tetrofosmin single photon emission computed tomography was indicative of tumor recurrence. Positron emission tomography scan was not available. Tumor recurrence was documented by biopsy. Several advanced imaging methods are available to differentiate tumor recurrence from radiation necrosis in glioblastoma patients. However, in inconclusive cases, brain biopsy should be performed for deifnite diagnosis.

  8. Mandibular bone necrosis after use of paraformaldehyde-containing paste

    Lee, Chi-hwan; Choi, Yoorina


    Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis. PMID:27847756

  9. Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis

    Chao, Samuel T., E-mail: [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Ahluwalia, Manmeet S. [Department of Medical Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Barnett, Gene H. [Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stevens, Glen H.J. [Department of Neurology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Murphy, Erin S. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Stockham, Abigail L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Shiue, Kevin [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)


    The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis.

  10. Practical quantification of necrosis in histological whole-slide images.

    Homeyer, André; Schenk, Andrea; Arlt, Janine; Dahmen, Uta; Dirsch, Olaf; Hahn, Horst K


    Since the histological quantification of necrosis is a common task in medical research and practice, we evaluate different image analysis methods for quantifying necrosis in whole-slide images. In a practical usage scenario, we assess the impact of different classification algorithms and feature sets on both accuracy and computation time. We show how a well-chosen combination of multiresolution features and an efficient postprocessing step enables the accurate quantification necrosis in gigapixel images in less than a minute. The results are general enough to be applied to other areas of histological image analysis as well.

  11. FADD: an endogenous inhibitor of RIP3-driven regulated necrosis

    Lorenzo Galluzzi; Oliver Kepp; Guido Kroemer


    Thanks to the work of multiple laboratories worldwide,the classical dichotomy postulating that apoptosis and necrosis would constitute diametrically opposed cell death subroutines has recently been dismissed [1].Thus,approximately in the same year when immunogenic instances of apoptosis were first characterized [2],the traditional belief that necrosis would represent a merely accidental,unregulated cell death modality has been definitely abandoned [3].This has fueled an intense wave of research,advancing our understanding of the molecular mechanisms and pathophysiological implications of regulated necrosis [4,5].

  12. Organ failure associated with severe acute pancreatitis

    Ai-Jun Zhu; Jing-Sen Shi; Xue-Jun Sun


    AIM: To investigate the relationship between severe acute pancreatitis (SAP) and organ failure.METHODS: Clinical data of 74 cases of SAP from Jan. 1993 to Dec. 2002 were retrospectively reviewed, and the relationship between organ failure and age, gender, etiology,extent of necrosis, infection of necrosis and mortality was analyzed.RESULTS: A total of 47 patients (63.5 %) showed organ failure, 20 patients (27.0 %) multiple organ failure, whereas 27 patients (36.5 %) with dysfunction of a single organ system. Pulmonary failure was the most common organ dysfunction (23.0 %) among single organ failures. There were no significant differences in age, gender and gallstone pancreatitis among patients with or without organ failure (P>0.05). The incidence of organ failure in infected necrosis was not higher compared with sterile necrosis, and patients with increased amount of necrosis did not have an increased prevalence of organ failure (P>0.05). Patients with organ failure had a higher mortality rate compared with those without organ failure (P<0.05). The death of SAP was associated with multiple organ failure (P<0.005), pulmonary failure (P<0.005), cardiovascular dysfunction (P<0.05) and gastrointestinal dysfunction (P<0.05).CONCLUSION: Organ failure is common in patients with SAP, and patients with multiple organ failure and pulmonary failure have a higher mortality rate. Prevention and active treatment of organ failure can improve the outcome of patients with SAP.

  13. Diaphragmatic suture with tubular stomach to prevent early delayed gastric emptying after esophagectomy

    Chao Sun; Weiping Shi; Yusheng Shu; Hongcan Shi; Shichun Lu; Kang Wang


    Objective The objective of this study was to evaluate the clinical ef icacy of a diaphragmatic suture with tubular stomach to prevent delayed gastric emptying (DGE) after esophagectomy through the cervico-tho-racoabdominal approach. Methods A total of 980 patients with esophageal cancer undergoing esophagectomy through the cer-vico-thoracoabdominal approach were retrospectively included in this study and divided into two groups. Al patients underwent tubular stomach creation (group A; n = 530) or a diaphragmatic suture and tubular stomach creation (group B; n = 450). The incidence of early DGE was observed. Results The incidence of early DGE in group A was significantly higher than that in group B (P Conclusion This observation study suggests that the use of a diaphragmatic suture with tubular stomach through the cervico-thoracoabdominal approach can decrease the incidence of early DGE after esopha-gectomy.

  14. An asymmetric tubular ceramic-carbonate dual phase membrane for high temperature CO2 separation.

    Dong, Xueliang; Ortiz Landeros, José; Lin, Y S


    For the first time, a tubular asymmetric ceramic-carbonate dual phase membrane was prepared by a centrifugal casting technique and used for high temperature CO2 separation. This membrane shows high CO2 permeation flux and permeance.

  15. A tubular dielectric elastomer actuator: Fabrication, characterization and active vibration isolation

    Sarban, R.; Jones, R. W.; Mace, B. R.;


    This contribution reviews the fabrication, characterization and active vibration isolation performance of a core-free rolled tubular dielectric elastomer (DE) actuator, which has been designed and developed by Danfoss PolyPower A/S. PolyPower DE material, PolyPower (TM), is produced in thin sheets...... of 80 mu m thickness with corrugated metallic electrodes on both sides. Tubular actuators are manufactured by rolling the DE sheets in a cylindrical shape. The electromechanical characteristics of such actuators are modeled based on equilibrium pressure equation. The model is validated with experimental...... the dominant dynamic characteristics of the core-free tubular actuator. It has been observed that all actuators have similar dynamic characteristics in a frequency range up to 1 kHz. A tubular actuator is then used to provide active vibration isolation (AVI) of a 250 g mass subject to shaker generated 'ground...

  16. Novel tubular and crystalline structures in purified preparations of Newcastle disease virus. Brief report.

    Gowans, E J; McNulty, M S


    Hitherto undescribed tubular and crystalline structures were detected by negative contrast electron microscopy in purified preparations of Newcastle disease virus. It is suggested that these are viral in origin and are composed of aggregates of viral glycoprotein.


    Qin, Lin; Furbo, Simon


    . Based on thesemodels, the thermal performance of large solar domestic hot water (DHW) systems and combined domestichot water and space heating systems with the four evacuated tubular collectors was determined. To make acomparison with traditional flat-plate collectors, similar simulations were also...... carried out for systems with atypical flat-plate collector. The results show that the thermal advantage of evacuated tubular collectors variesgreatly from system to system, and increases with the solar fraction. Furthermore, the higher the operationtemperature of the collector in the system is......In the present study, detailed investigations on evacuated tubular solar collectors for large solarheating systems have been carried out. Four types of evacuated tubular solar collectors were used in theinvestigation. Based on laboratory tests, simulation models for the collectors were determined...

  18. Microbial acetate oxidation in horizontal rotating tubular bioreactor

    A Slavica; B Šantek; S Novak; V Marić


    The aim of this work was to investigate the possibility of conducting a continuous aerobic bioprocess in a horizontal rotating tubular bioreactor (HRTB). Aerobic oxidation of acetate by the action of a mixed microbial culture was chosen as a model process. The microbial culture was not only grown in a suspension but also in the form of a biofilm on the interior surface of HRTB. Efficiency of the bioprocess was monitored by determination of the acetate concentration and chemical oxygen demand (COD). While acetate inlet concentration and feeding rate influenced efficiency of acetate oxidation, the bioreactor rotation speed did not influence the bioprocess dynamics significantly. Gradients of acetate concentration and pH along HRTB were more pronounced at lower feeding rates. Volumetric load of acetate was proved to be the most significant parameter. High volumetric loads (above 2 g acetate l–1 h–1) gave poor acetate oxidation efficiency (only 17 to 50%). When the volumetric load was in the range of 0.60–1.75 g acetate l–1 h–1, acetate oxidation efficiency was 50–75%. At lower volumetric loads (0.14–0.58 g acetate l–1 h–1), complete acetate consumption was achieved. On the basis of the obtained results, it can be concluded that HRTB is suitable for conducting aerobic continuous bioprocesses.

  19. Standing wave brass-PZT square tubular ultrasonic motor.

    Park, Soonho; He, Siyuan


    This paper reports a standing wave brass-PZT tubular ultrasonic motor. The motor is composed of a brass square tube with two teeth on each tube end. Four PZT plates are attached to the outside walls of the brass tube. The motor requires only one driving signal to excite vibration in a single bending mode to generate reciprocating diagonal trajectories of teeth on the brass tube ends, which drive the motor to rotate. Bi-directional rotation is achieved by exciting different pairs of PZT plates to switch the bending vibration direction. Through using the brass-PZT tube structure, the motor can take high magnitude vibration to achieve a high output power in comparison to PZT tube based ultrasonic motors. Prototypes are fabricated and tested. The dimension of the brass-PZT tube is 3.975mm×3.975mm×16mm. Measured performance is a no-load speed of >1000RPM, a stall torque of 370μNm and a maximum output power of 16 mW when a sinusoidal driving voltage of 50V is applied. The working frequencies of the motor are 46,050Hz (clockwise) and 46,200Hz (counter-clockwise).

  20. Bioprocess kinetics in a horizontal rotating tubular bioreactor.

    Ivancić, M; Santek, B; Novak, S; Horvat, P; Marić, V


    A horizontal rotating tubular bioreactor (HRTB) is a plug flow bioreactor whose interior is provided with O-ring-shaped partition walls that serve as carriers for microbial biomass. During this investigation, microbial biomass was grown in suspension and on the bioreactor inner surface as a microbial biofilm with average mass that was considerably higher than suspended biomass. The dynamics of bioprocess in HRTB was studied by different combinations of process parameters (bioreactor rotation speed and mean residence time) and it was monitored by withdrawing the samples from five positions along the bioreactor. During this investigation it was also observed that mean residence time had a more pronounced effect on the bioprocess dynamics than bioreactor rotation speed. For the description of bioprocess kinetics in HRTB an unstructured kinetic model was established that defines biomass growth, product formations and substrate consumption rate by using a modified Monod (Levenspiel) model. This kinetic model defines changes in suspension and in microbial biofilm, and it shows relatively good agreement with experimental data.

  1. Tubular occlusion optimizes bonding of hydrophobic resins to dentin.

    Sadek, F T; Pashley, D H; Ferrari, M; Tay, F R


    Although hydrophobic resins may be bonded to acid-etched dentin with an ethanol wet-bonding technique, the protocol is sensitive to moisture contamination when bonding is performed in deep dentin. This study tested the hypothesis that the use of oxalate or poly(glutamic) acid-modified, diluted ceramicrete (PADC) for dentinal tubule occlusion prevents fluid contamination and improves the bonding of an experimental hydrophobic adhesive to acid-etched, ethanol-dehydrated dentin. Mid-coronal and deep acid-etched moist dentin pre-treated with oxalate or PADC was dehydrated by ethanol wet-bonding and infiltrated with the experimental three-step etch-and-rinse hydrophobic adhesive under simulated pulpal pressure. Tensile bond strengths to deep dentin without pre-treatment were severely compromised. Conversely, oxalate and PADC pre-treatments reduced dentin permeability, prevented water contamination, and improved bond strengths. Minimal nanoleakage was identified within hybrid layers created in the oxalate- and PADC-pre-treated deep dentin. The use of tubular occluding agents optimized bonding of hydrophobic resins to dentin.

  2. Mechanism of hydrogen-induced intergranular cracking of tubular steels

    乔利杰; 褚武扬; 于广华; 程以环


    Hydrogen could be enriched on grain boundaries by stress induction and other traps.The enriched hydrogen facilitated emission and movement of dislocations and lowered plastic work.Consequently,fracture occurred easily along grain boundary.A normalized threshold value of hydrogen-induced cracking (HIC) along grain boundary is given as (KIH/KIC)2=1-0.162×10-3 βHCc(H)GH/(2γs-γb-0.16×103∑β CiGi),where βH and βi are the enrichment factors of hydrogen and other elements on grain boundaries,respectively;Cc(H) is hydrogen concentration induced by stress;C,is the average concentration of an element in the steel;GH and Gi are factors of fracture work along grain boundary with hydrogen and other elements,and γs and γb are surface free energy and grain boundary energy of Fe.For tubular steel,the calculated KH/KIC is 0.23 while the determined value is 0.26.The theoretical threshold value is well consistent with the experimental one.


    Najat J. Saleh


    Full Text Available Inpresent work tubular –shaped fiber reinforced composites were manufactured byusing two types of resins ( Epoxy and unsaturated polyester and separatelyreinforced with glass, carbon and kevlar-49 fibers (filament and woven roving,hybrid reinforcement composites of these fibers were also prepared. The fiberswere wet wound on a mandrel using a purposely designed winding machine,developed by modifying an ordinary lathe, in winding angle of 55° for filament. A creep test was made of either the fulltube or specimens taken from it. Creep was found to increase upon reinforcementin accordance to the rule of mixture and mainly decided by the type of singleor hybridized fibers. The creep behavior, showed that the observed strain tendsto appear much faster at higher temperature as compared with that exhibited atroom temperate. The creep rate also found to be depending on fiber type, matrixtype, and the fiber /matrix bonding. The creep energy calculated fromexperimental observations was found to exhibit highest value for hybridizedreinforcement.

  4. Design and Analysis of Tubular Permanent Magnet Linear Wave Generator

    Jikai Si


    Full Text Available Due to the lack of mature design program for the tubular permanent magnet linear wave generator (TPMLWG and poor sinusoidal characteristics of the air gap flux density for the traditional surface-mounted TPMLWG, a design method and a new secondary structure of TPMLWG are proposed. An equivalent mathematical model of TPMLWG is established to adopt the transformation relationship between the linear velocity of permanent magnet rotary generator and the operating speed of TPMLWG, to determine the structure parameters of the TPMLWG. The new secondary structure of the TPMLWG contains surface-mounted permanent magnets and the interior permanent magnets, which form a series-parallel hybrid magnetic circuit, and their reasonable structure parameters are designed to get the optimum pole-arc coefficient. The electromagnetic field and temperature field of TPMLWG are analyzed using finite element method. It can be included that the sinusoidal characteristics of air gap flux density of the new secondary structure TPMLWG are improved, the cogging force as well as mechanical vibration is reduced in the process of operation, and the stable temperature rise of generator meets the design requirements when adopting the new secondary structure of the TPMLWG.

  5. Steady State Response Analysis of a Tubular Piezoelectric Print Head.

    Chang, Jiaqing; Liu, Yaxin; Huang, Bo


    In recent years, inkjet technology has played an important role in industrial materials printing and various sensors fabrication, but the mechanisms of the inkjet print head should be researched more elaborately. The steady state deformation analysis of a tubular piezoelectric print head, which can be classified as a plane strain problem because the radii of the tubes are considerably smaller than the lengths, is discussed in this paper. The geometric structure and the boundary conditions are all axisymmetric, so a one-dimensional mathematical model is constructed. By solving the model, the deformation field and stress field, as well as the electric potential distribution of the piezoelectric tube and glass tube, are obtained. The results show that the deformations are on the nanometer scale, the hoop stress is larger than the radial stress on the whole, and the potential is not linearly distributed along the radial direction. An experiment is designed to validate these computations. A discussion of the effect of the tubes' thicknesses on the system deformation status is provided.

  6. A review of the ultimate strength of tubular framed structures

    Bolt, H.M.; Billington, C.J.; Ward, J.K.


    This review of the ultimate strength of tubular framed structures has been prepared for the Health and Safety Executive (HSE) by Billington Osborne-Moss Engineering Limited (BOMEL). A numerical capability to predict the nonlinear response of jacket structures has been developed over the last decade in parallel with experimental investigations. It is now being applied to assure the continued integrity of installations beyond the design event in circumstances of extreme environmental loading or damage. A recent investigation has confirmed that an extreme event static pushover analysis generally suffices to demonstrate a structure`s resistance to the cyclic loading of the full storm. This report draws together the results from published investigations and identifies key factors contributing to system reserve. It is shown that bracing configurations and relative member properties are important influences. From the work presented, it is demonstrated that many jacket analyses embody simplifying assumptions, and features such as loading asymmetry, joint nonlinearity, foundation interactions, global deflection criteria etc, are neglected. Specific examples highlighted in the review illustrate their potential importance and systematic sensitivity evaluations are therefore recommended. (UK)

  7. The thermal decomposition of methane in a tubular reactor

    Kobayashi, Atsushi; Steinberg, M.


    The reaction rate of methane decomposition using a tubular reactor having a 1 inch inside diameter with an 8 foot long heated zone was investigated in the temperature range of 700 to 900 C with pressures ranging from 28.2 to 56.1 atm. Representing the rate by a conventional model, {minus}dC{sub CH4}/dt= k1 C{sub CH4} {minus}k2 C{sub H2}{sup 2}, the rate constant k1 for methane decomposition was determined. The activation energy, 31.3 kcal/mol, calculated by an Arrhenius Plot was lower than for previously published results for methane decomposition. This result indicates that submicron particles found in the reactor adhere to the inside of the reactor and these submicron high surface area carbon particles tend to catalyze the methane decomposition. The rate constant has been found to be approximately constant at 900 C with pressure range cited above. The rate of methane decomposition increases with methane partial pressure in first-order. The rate of the methane decomposition is favored by higher temperatures and pressures while the thermochemical equilibrium of methane decomposition is favored by lower pressures. 8 refs., 7 figs., 2 tabs.

  8. Etiopathology of chronic tubular, glomerular and renovascular nephropathies: Clinical implications

    Ortiz Alberto


    Full Text Available Abstract Chronic kidney disease (CKD comprises a group of pathologies in which the renal excretory function is chronically compromised. Most, but not all, forms of CKD are progressive and irreversible, pathological syndromes that start silently (i.e. no functional alterations are evident, continue through renal dysfunction and ends up in renal failure. At this point, kidney transplant or dialysis (renal replacement therapy, RRT becomes necessary to prevent death derived from the inability of the kidneys to cleanse the blood and achieve hydroelectrolytic balance. Worldwide, nearly 1.5 million people need RRT, and the incidence of CKD has increased significantly over the last decades. Diabetes and hypertension are among the leading causes of end stage renal disease, although autoimmunity, renal atherosclerosis, certain infections, drugs and toxins, obstruction of the urinary tract, genetic alterations, and other insults may initiate the disease by damaging the glomerular, tubular, vascular or interstitial compartments of the kidneys. In all cases, CKD eventually compromises all these structures and gives rise to a similar phenotype regardless of etiology. This review describes with an integrative approach the pathophysiological process of tubulointerstitial, glomerular and renovascular diseases, and makes emphasis on the key cellular and molecular events involved. It further analyses the key mechanisms leading to a merging phenotype and pathophysiological scenario as etiologically distinct diseases progress. Finally clinical implications and future experimental and therapeutic perspectives are discussed.

  9. Ammonia-water absorption in vertical tubular absorbers

    Fernandez-Seara, Jose; Sieres, Jaime; Rodriguez, Cristobal; Vazquez, Manuel [Area de Maquinas y Motores Termicos, Escuela Tecnica Superior de Ingenieros Industriales, Campus Lagoas-Marcosende, No 9, 36200 Vigo (Spain)


    This paper presents a detailed analysis of the heat and mass transfer processes during the absorption of ammonia into water in a co-current vertical tubular absorber. The absorber configuration is of the shell and tubes type. The absorption process progresses as the vapour and liquid contact inside the tubes. Water is used as the absorber cooling medium. A differential mathematical model has been developed on the basis of mass and energy balances and heat and mass transfer equations, in order to provide further understanding of the absorber behaviour. The model takes into account separately for the churn, slug and bubbly flow patterns experimentally forecasted in this type of absorption processes inside vertical tubes and considers the simultaneous heat and mass transfer processes in both liquid and vapour phases, as well as heat transfer to the cooling medium. The model equations have been solved using the finite-difference method. Results obtained for specific data are depicted to show local values of the most important variables all along the absorber length. Parametric analyses have been performed to show the influence of design parameters and operating conditions on the absorber performance. The effect of the heat and mass transfer coefficients has also been evaluated. (authors)

  10. Study of tumor necrosis factor-αinduced protein 8 like-2 expression in peripheral blood mononuclear cells ;of patients with acute respiratory distress syndrome correlate with disease severity%急性呼吸窘迫综合征患者外周血单核细胞中 肿瘤坏死因子-α诱导蛋白8样分子2的 表达与病情程度相关

    黄鹤; 冯聪; 田昭涛; 姚咏明; 黎檀实


    目的:探讨肿瘤坏死因子-α诱导蛋白8样分子2(TIPE2)是否参与了急性呼吸窘迫综合征(ARDS)的发病过程及其机制。方法采用前瞻性观察性研究方法,选择2013年7月至2015年7月解放军总医院急诊科收治的39例ARDS患者为研究对象,以同期35例健康体检者作为健康对照组。记录患者入院24h内急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、血气分析、降钙素原(PCT)和C-反应蛋白(CRP)。采用实时定量反转录-聚合酶链反应(RT-PCR)检测外周血单核细胞(PBMC)中TIPE2和血浆黏病毒抗性蛋白1(MX1)的mRNA表达,采用Spearman等级分析各指标之间的相关性。结果39例ARDS患者入院24h内APACHEⅡ评分平均为(25±3)分,PCT平均为(1.85±0.41)μg/L,CRP平均为(18.0±3.0)mg/L。ARDS组PBMC中TIPE2mRNA表达水平显著低于健康对照组(2-ΔΔCt:3.28±0.15比8.87±0.20,P<0.001),而血浆MX-1mRNA表达水平显著高于健康对照组(2-ΔΔCt:39.44±0.46比20.10±0.32,P<0.001)。相关分析结果显示:TIPE2mRNA与MX1mRNA表达水平呈显著负相关(r=-0.630,P<0.001),与APACHEⅡ评分也呈显著负相关(r=-0.781,P<0.001),而与PCT、CRP均无显著相关性(r值分别为0.143、0.330,均P>0.05);MX1mRNA表达水平与APACHEⅡ评分呈显著正相关(r=0.893,P<0.001),而与PCT、CRP无显著相关性(r值分别为0.230、0.210,均P>0.05)。结论 ARDS患者存在TIPE2表达下调,并与病情严重程度呈负相关;提示TIPE2可能参与了ARDS的发病过程。%Objective To demonstrate the effect of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) expression in patients with acute respiratory distress syndrome (ARDS) and its mechanism. Methods A prospective observation was conducted. Thirty-nine patients with ARDS admitted to department of emergency of PLA General Hospital from July

  11. Carbofuran-Induced Acute Pancreatitis

    Rizos E


    Full Text Available CONTEXT: Carbamate insecticides are widely used in commercial agriculture and home gardening. A serious side effect of organophosphate and carbamate intoxication is the development of acute pancreatitis. CASE REPORT: A 36-year-old Caucasian woman was admitted to our hospital with cholinergic crisis and pancreatitis soon after the ingestion of a carbamate insecticide (carbofuran. An abdominal CT scan disclosed pancreatic necrosis with intrapancreatic fluid collection, consistent with the development of a pancreatic pseudocyst in a subsequent CT scan. No predisposing factor for pancreatitis was evident. Pseudocholinesterase levels returned to normal 7 days later and the patient was discharged in good physical condition one month after admission. DISCUSSION: Although acute pancreatitis is not infrequent after organophosphate intoxication, it is quite rare after carbamate ingestion and has not been previously reported after carbofuran intoxication.

  12. Pharmacological approach to acute pancreatitis

    Ulrich Christian Bang; Synne Semb; Camilla Nφjgaard; Flemming Bendtsen


    The aim of the present review is to summarize the current knowledge regarding pharmacological prevention and treatment of acute pancreatitis (AP)based on experimental animal models and clinical trials.Somatostatin (SS) and octreotide inhibit the exocrine production of pancreatic enzymes and may be useful as prophylaxis against Post Endoscopic retrograde cholangiopancreatography Pancreatitis (PEP). The protease inhibitor Gabexate mesilate (GM) is used routinely as treatment to AP in some countries, but randomized clinical trials and a meta-analysis do not support this practice. Nitroglycerin (NGL) is a nitrogen oxide (NO) donor, which relaxes the sphincter of Oddi.Studies show conflicting results when applied prior to ERCP and a large multicenter randomized study is warranted. Steroids administered as prophylaxis against PEP has been validated without effect in several randomized trials. The non-steroidal anti-inflammatory drugs (NSAID) indomethacin and diclofenac have in randomized studies showed potential as prophylaxis against PEP. Interleukin 10 (IL-10) is a cytokine with anti-inflammatory properties but two trials testing IL-10 as prophylaxis to PEP have returned conflicting results.Antibodies against tumor necrosis factor-alpha (TNF-α)have a potential as rescue therapy but no clinical trials are currently being conducted. The antibiotics betalactams and quinolones reduce mortality when necrosis is present in pancreas and may also reduce incidence of infected necrosis. Evidence based pharmacological treatment of AP is limited and studies on the effect of potent anti-inflammatory drugs are warranted.

  13. Influence of Geometrical Imperfections on Analyses of Door Openings in Tubular Steel Towers for Wind Turbines.

    Tran, Anh Tuan; Veljkovic, Milan, ed. lit.; Rebelo, Carlos; Da Silva, Luís Simões


    Towers for wind turbines are very sensitive to geometrical imperfections. Pattern and amplitude of imperfections significantly influence the strength of the towers. Rather limited number of experiments exists on a tubular tower like structure and no experiments are available considering door opening in towers with cylindrical or polygonal cross-section. One of the objectives of the RFCS research project “HIGH STEEL TUBULAR TOWERS FOR WIND TURBINES, HISTIWIN2” was to investigate current practi...

  14. Effect of cisplatin on renal haemodynamics and tubular function in the dog kidney

    Daugaard, G; Abildgaard, U; Holstein-Rathlou, N H


    Administration of cisplatin (5 mg/kg) to dogs results in polyuric renal failure due initially to a proximal tubular functional impairment. 48-72 h after the cisplatin administration the depressed renal function can be attributed to impairment of proximal as well as distal tubular reabsorptive...... capacities associated with increased renal vascular resistance. The polyuria seems to be due to the impaired reabsorption rate in the distal nephron segments....

  15. Distal renal tubular acidosis without renal impairment after use of tenofovir: a case report


    Background Tenofovir, one of antiretroviral medication to treat human immunodeficiency virus (HIV) infection, is known to cause proximal renal tubular acidosis such as Fanconi syndrome, but cases of distal renal tubular acidosis had never been reported. Case presentation A 20-year-old man with HIV infection developed nausea and vomiting without diarrhea after starting antiretroviral therapy. Arterial blood gas revealed non-anion-gap metabolic acidosis and urine test showed positive urine anio...

  16. Strength of Tubular Joints Made by Electromagnetic Compression at Quasistatic and Cyclic Loading

    Barreiro, P.; Beerwald, C.; Homberg, W.; Kleiner, M.; Löhe, D.; Marré, M.; Schulze, V.


    Electromagnetic compression of tubular profiles with high electrical conductivity is an innovative joining process for lightweight structures. The components are joined using pulsed magnetic fields which apply radial pressures of up to 200 MPa to tubular workpieces, causing a symmetric reduction of the diameter with typical strain rates of up to 10^4 sec^(-1). This process avoids any surface damage of the workpiece because there is no contact between component and forming tool. The strength o...

  17. Design and performance of tubular flat-plate solid oxide fuel cell

    Matsushima, T.; Ikeda, D.; Kanagawa, H. [NTT Integrated Information & Energy Systems Labs., Tokyo (Japan)] [and others


    With the growing interest in conserving the environmental conditions, much attention is being paid to Solid Oxide Fuel Cell (SOFC), which has high energy-conversion efficiency. Many organizations have conducted studies on tubular and flat type SOFCs. Nippon Telegraph and Telephone Corporation (NTT) has studied a combined tubular flat-plate SOFC, and already presented the I-V characteristics of a single cell. Here, we report the construction of a stack of this SOFC cell and successful generation tests results.

  18. Undulating tubular liposomes through incorporation of a synthetic skin ceramide into phospholipid bilayers

    Xu, Peng; Tan, Grace; Zhou, Jia; He, Jibao; Lawson, Louise B.; McPherson, Gary L.; John, Vijay T.


    Non-spherical liposomes were prepared by doping L-α-phosphatidylcholine (PC) with ceramide VI (a skin lipid). Cryo-transmission electron microscopy shows the liposome shape changing from spherical to an undulating tubular morphology, when the amount ofceramide VI is increased. The formation of tubular liposomes is energetically favorableand is attributed to the association of ceramide VI with PC creating regions of lower curvature. Since ceramides are the major component of skin lipids inthe ...

  19. Fabrication of Coiled Tubular Heat Exchanger%绕管式换热器的制造



    本文介绍了绕管换热器的技术特点及应用。从结构设计、技术等方面阐明了绕管换热器的设计制造的问题。%In is paper,the technical characteristics and application of coiled tubular heat exchanger were introduced. And the problem in design and manufacture of coiled tubular heat exchanger were clarified .

  20. Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

    Kang, Dong Joo; Lee, Sun Joo; Choo, Hye Jung [Busan Paik Hospital, Department of Radiology, Inje University College of Medicine, Busan (Korea, Republic of); Her, Minyoung [Busan Paik Hospital, Division of Rheumatology, Department of Internal Medicine, Inje University College of Medicine, Busan (Korea, Republic of); Yoon, Hye Kyoung [Busan Paik Hospital, Department of Pathology, Inje University College of Medicine, Busan (Korea, Republic of)


    Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees. (orig.)