Sample records for spleen kidney heart

  1. Sonographic Determination of Spleen to Left Kidney Ratio among ...

    African Journals Online (AJOL)

    The weight and height of the subjects were obtained with the participants wearing light weight street clothes without shoes. Results: Measurement of spleen and left kidney lengths were reliable within and between sonographers. The spleen and left kidney lengths were not statistically different in boys and girls (p > 0.05).

  2. Spleen

    International Nuclear Information System (INIS)

    Freedman, G.S.


    Careful examination of the left upper quadrant of the pediatric patient will usually disclose the presence or absence of an enlarged spleen. Although the spleen has a wide variation in weight and mobility, the normal spleen rarely extends below the left costal margin. While the presence of a palpable spleen is usually of pathological significance, the wide variation in splenic weight and position may make the detection of splenomegaly difficult on routine physical examination. When present, it may be difficult to differentiate the enlarged spleen from other palpable masses in the left upper quadrant. For these reasons, radionuclide imaging of the spleen has become a simple and valuable method for precisely locating and establishing the accurate size of functioning splenic tissue. The size and weight of the spleen can be approximated by direct measurement from the scan; normal values have been established based on the splenic length and the age and weight of the child. The diagnostic usefulness of radionuclide s []anning of the spleen in lymphoma, leukemia, other malignancies, anemia and other blood dyscrasias, infectious diseases, granuloma, and cysts is discussed. (CH)

  3. Observation on Therapeutic Effect of the Depression of Heart-spleen Deficiency with Wuling Capsule

    International Nuclear Information System (INIS)

    Li Jinbin; Liu Ping


    To evaluate the effect on the treatment of depression belong to the type of heart-spleen deficiency with Wuling capsule, 37 patients were assigned into two groups: the deficiency of both the heart and spleen group (I) and the non deficiency of both the heart and spleen group (II). The efficacy of two groups was surveyed and compared after taken Wuling capsule 2 and 4 weeks,respectively. After treatment, there was a difference (P 0.05). The satisfactory effects were showed on various kinds of depressions using wuling capsules,while deficiency of both the heart and spleen group effects were better than that of the non deficiency of both the heart and spleen group. (authors)

  4. Protease activity of legumain is inhibited by an increase of cystatin E/M in the DJ-1-knockout mouse spleen, cerebrum and heart

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    Takuya Yamane


    Full Text Available Legumain (EC is an asparaginyl endopeptidase. Legumain activity has been detected in various mouse tissues including the kidney, spleen and epididymis. Legumain is overexpressed in the majority of human solid tumors and transcription of the legumain gene is regulated by the p53 tumor suppressor in HCT116 cells. The legumain activity is also increased under acid conditions in Alzheimer's disease brains. DJ-1/PARK7, a cancer- and Parkinson's disease-associated protein, works as a coactivator to various transcription factors, including the androgen receptor, p53, PSF, Nrf2, SREBP and RREB1. Recently, we found that legumain expression, activation and cleavage of annexin A2 are regulated by DJ-1 through p53. In this study, we found that the expression levels of legumain mRNA were increased in the cerebrum, kidney, spleen, heart, lung, epididymis, stomach, small intestine and pancreas from DJ-1-knockout mice, although legumain activity levels were decreased in the cerebrum, spleen and heart from DJ-1-knockout mice. Furthermore, we found that cystatin E/M expression was increased in the spleen, cerebrum and heart from DJ-1-knockout mice. These results suggest that reduction of legumain activity is caused by an increase of cystatin E/M expression in the spleen, cerebrum and heart from DJ-1-knockout mice.

  5. Combined heart-kidney transplantation after total artificial heart insertion. (United States)

    Ruzza, A; Czer, L S C; Ihnken, K A; Sasevich, M; Trento, A; Ramzy, D; Esmailian, F; Moriguchi, J; Kobashigawa, J; Arabia, F


    We present the first single-center report of 2 consecutive cases of combined heart and kidney transplantation after insertion of a total artificial heart (TAH). Both patients had advanced heart failure and developed dialysis-dependent renal failure after implantation of the TAH. The 2 patients underwent successful heart and kidney transplantation, with restoration of normal heart and kidney function. On the basis of this limited experience, we consider TAH a safe and feasible option for bridging carefully selected patients with heart and kidney failure to combined heart and kidney transplantation. Recent FDA approval of the Freedom driver may allow outpatient management at substantial cost savings. The TAH, by virtue of its capability of providing pulsatile flow at 6 to 10 L/min, may be the mechanical circulatory support device most likely to recover patients with marginal renal function and advanced heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Study of the infestation rate of the kidney and spleen of domestic ruminants by Linguatula serrata nymphs in Urmia slaughterhouse

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    S Rasouli


    Full Text Available In this study, the prevalence of Linguatula serrata nymphs in kidneys and spleens of 800 domestic ruminants (cattle, buffalo, sheep and goat in different sexes, ages and seasons was investigated. First, the kidneys and spleens were examined macroscopically. Then, a digestion method was also applied. Infestation rate in the spleen of cattle, buffalo, sheep and goat were %0/5, %0, %0/5 and %1/5 respectively. No infestation was found in the kidneys. The results of this study shows that the infestation of domestic ruminants to Linguatula serrat nymphs in different sexes and ages were not significant. Also the infestation rate in different seasons was not significant.

  7. Creating computer aided 3D model of spleen and kidney based based on Visible Human Project

    International Nuclear Information System (INIS)

    Aldur, Muhammad M.


    To investigate the efficacy of computer aided 3-dimensional (3D) reconstruction technique on visualization and modeling of gross anatomical structures with an affordable methodology applied on the spleen and kidney. From The Visible Human Project Dataset cryosection images, developed by the National Library of Medicine, the spleen and kidney sections were preferred to be used due to their highly distinct contours. The software used for the reconstruction were Surf Driver 3.5.3 for Mac and Cinema 4D X L version 7.1 for Mac OS X. This study was carried out in May 2004 at the Department of Anatomy, Hacettepe University, Ankara, Turkey. As a result of this study, it is determined that these 2 programs could be effectively used both for 3D modeling of the mentioned organs and volumetric analyses on these models. It is also seen that it is possible to hold the physical models of these gross anatomical digital ones with stereolithography technique by means of the data exchange file format provided by the program and present such images as anaglyph. Surf Driver 3.5.3 for Mac OS and Cinema 4 DXL version 7.1 for Mac OS X can be used effectively for reconstruction of gross anatomical structures from serial parallel sections with distinct contours such as spleen and kidney and the animation of models. These software constitute a highly effective way of getting volumetric calculations, spatial relations and morphometrical measurements of reconstructed structures. (author)

  8. Morphological changes in the kidney, liver and spleen during prolonged administration of iron nanoparticles (United States)

    Navolokin, N. A.; Maslyakova, G. N.; Bucharskya, A. B.; Kong, X. M.; Zuev, V. V.; Medvedev, B. A.; Ignatiev, A. A.; Bochkaryeva, T. V.


    We determined the cytotoxic effect of iron nanoparticles of 70 nm, with a single per oral administration in an experiment on white outbred mice. Morphological changes were evaluated in the internal organs. Thus, changes depend on the concentration of nanoparticles at long-term per oral exposure: identified violations of the structure of the liver, kidneys and spleen as venous plethora and degeneration of cells at 250 and 500 mkg / kg dose of nanoparticles are reversible, changes in the organs were pronounced with a dosage of 1000 mkg / kg.

  9. 3D segmentation of liver, kidneys and spleen from CT images

    International Nuclear Information System (INIS)

    Bekes, G.; Fidrich, M.; Nyul, L.G.; Mate, E.; Kuba, A.


    The clinicians often need to segment the abdominal organs for radiotherapy planning. Manual segmentation of these organs is very time-consuming, therefore automated methods are desired. We developed a semi-automatic segmentation method to outline liver, spleen and kidneys. It works on CT images without contrast intake that are acquired with a routine clinical protocol. From an initial surface around a user defined seed point, the segmentation of the organ is obtained by an active surface algorithm. Pre- and post-processing steps are used to adapt the general method for specific organs. The evaluation results show that the accuracy of our method is about 90%, which can be further improved with little manual editing, and that the precision is slightly higher than that of manual contouring. Our method is accurate, precise and fast enough to use in the clinical practice. (orig.)

  10. Normal organ weights in men: part II-the brain, lungs, liver, spleen, and kidneys. (United States)

    Molina, D Kimberley; DiMaio, Vincent J M


    Organomegaly can be a sign of disease and pathologic abnormality, although standard tables defining organomegaly have yet to be established and universally accepted. This study was designed to address the issue and to determine a normal weight for the major organs in adult human males. A prospective study of healthy men aged 18 to 35 years who died of sudden, traumatic deaths was undertaken. Cases were excluded if there was a history of medical illness including illicit drug use, if prolonged medical treatment was performed, if there was a prolonged period between the time of injury and death, if body length and weight could not be accurately assessed, or if any illness or intoxication was identified after gross and microscopic analysis including evidence of systemic disease. Individual organs were excluded if there was significant injury to the organ, which could have affected the weight. A total of 232 cases met criteria for inclusion in the study during the approximately 6-year period of data collection from 2005 to 2011. The decedents had a mean age of 23.9 years and ranged in length from 146 to 193 cm, with a mean length of 173 cm. The weight ranged from 48.5 to 153 kg, with a mean weight of 76.4 kg. Most decedents (87%) died of either ballistic or blunt force (including craniocerebral) injuries. The mean weight of the brain was 1407 g (range, 1070-1767 g), that of the liver was 1561 g (range, 838-2584 g), that of the spleen was 139 g (range, 43-344 g), that of the right lung was 445 g (range, 185-967 g), that of the left lung was 395 g (range, 186-885 g), that of the right kidney was 129 g (range, 79-223 g), and that of the left kidney was 137 g (range, 74-235 g). Regression analysis was performed and showed that there were insufficient associations between organ weight and body length, body weight, and body mass index to allow for predictability. The authors, therefore, propose establishing a reference range for organ weights in men, much like those in use

  11. Differential transcriptomic response in the spleen and head kidney following vaccination and infection of Asian seabass with Streptococcus iniae.

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    Junhui Jiang

    Full Text Available Vaccination is an important strategy in the protection of aquaculture species from major diseases. However, we still do not have a good understanding of the mechanisms underlying vaccine-induced disease resistance. This is further complicated by the presence of several lymphoid organs that play different roles when mounting an immune response. In this study, we attempt to elucidate some of these mechanisms using a microarray-based approach. Asian seabass (Lates calcarifer were vaccinated against Streptococcus iniae and the transcriptomic changes within the spleen and head kidney at one and seven days post-vaccination were profiled. We subsequently challenged the seabass at three weeks post-vaccination with live S. iniae and similarly profiled the transcriptomes of the two organs after the challenge. We found that vaccination induced an early, but transient transcriptomic change in the spleens and a delayed response in the head kidneys, which became more similar to one another compared to un-vaccinated ones. When challenged with the pathogen, the spleen, but not the head kidneys, responded transcriptomically at 25-29 hours post-challenge. A unique set of genes, in particular those involved in the activation of NF-κB signaling, was up-regulated in the vaccinated spleens upon pathogen challenge but not in the un-vaccinated spleens. A semi-quantitative PCR detection of S. iniae using metagenomic DNA extracted from the water containing the seabass also revealed that vaccination resulted in reduction of pathogen shedding. This result indicated that vaccination not only led to a successful immune defense against the infection, but also reduced the chances for horizontal transmission of the pathogen. In conclusion, we have provided a transcriptomic analysis of how the teleost spleen and head kidneys responded to vaccination and subsequent infection. The different responses from the two organs are suggestive of their unique roles in establishing a

  12. Homing of antigen-presenting cells (APCs in head kidney and spleen – salmon head kidney hosts diverse APC types

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    Dimitar Borisov Iliev


    Full Text Available Lymph nodes and spleen are major organs where mammalian APCs initiate and orchestrate Ag-specific immune responses. Unlike mammals, teleosts lack lymph nodes and an interesting question is whether alternative organs may serve as sites for antigen presentation in teleosts. In the current study, fluorescent ovalbumin (Ova and CpG oligonucleotides (ODNs injected intra-abdominally were detected in significant numbers of salmon head kidney (HK MHCII+ cells over a period of 2 weeks while in spleen the percentage of these was transient and declined from day 1 post injection. In vitro studies further shed light on the properties of the diverse MHCII+ cell types found in HK. The ultrastructure of a subpopulation of MHCII+ cells with a high capacity to endocytose and process Ova indicated that these were able to perform constitutive macropinocytosis. Upon stimulation with CpG ODNs these cells upregulated CD86 and gave very high levels of TNF mRNA indicating that these are professional APCs, related to macrophages and dendritic cells (DCs. A subpopulation of HK granulocytes expressed high levels of surface MHCII and upon CpG stimulation upregulated most of the tested APC marker genes. Although these granulocytes expressed TNF weakly, they had relatively high basal levels of IL-1β mRNA and the CpG stimulation upregulated IL-1β, along with its signaling and decoy receptors, to the highest levels as compared to other HK cell types. Interestingly, the high expression of IL-1β mRNA in the granulocytes correlated with a high autophagy flux as demonstrated by LC3-II conversion. Autophagy has recently been found to be implicated in IL-1β processing and secretion and the presented data suggests that granulocytes of salmon, and perhaps other teleost species, may serve as a valuable model to study the involvement of autophagy in regulation of the vertebrate immune response.

  13. Sex, age, spleen size, and kidney fat of red deer relative to infection intensities of the lungworm Elaphostrongylus cervi (United States)

    Vicente, J.; Pérez-Rodríguez, L.; Gortazar, C.


    We analyzed the relationships among spleen size, body condition (measured as kidney fat), and larval counts of the nematode Elaphostrongylus cervi in red deer ( Cervus elaphus). The aim was to investigate the interaction between host body condition and intensity of infection with parasites. As red deer are highly polygynous, we also tested whether these relationships varied with sex and age of the hosts. Kidney fat and spleen size were positively correlated in subadults (2-3 years old) and adults (>3 years old), but not in calves (stressed, as subadult hinds are still growing and often engaging in rearing their first calf, and adult stags were sampled just after the rut, which is recognized as a substantial energy drain in this age-sex class, as they compete to hold females during the mating season. Body condition related negatively to parasite count only in adult males. In the context of red deer life history, these findings suggest that spleen size is dependent on body condition and that it could be affected by variation in resource partitioning among immune defense, growth, and reproductive effort in red deer. For the first time in a wild mammal, the spleen mass is shown to be positively related to body condition and negatively related to parasite infection. We conclude that elucidating whether spleen mass reflects immune defense investment or a measure of general body condition should contribute to understanding topical issues in mammal ecology.

  14. Heart failure in patients with kidney disease. (United States)

    Tuegel, Courtney; Bansal, Nisha


    Heart failure (HF) is a leading cause of morbidity and mortality in patients with chronic kidney disease (CKD), and the population of CKD patients with concurrent HF continues to grow. The accurate diagnosis of HF is challenging in patients with CKD in part due to a lack of validated imaging and biomarkers specifically in this population. The pathophysiology between the heart and the kidneys is complex and bidirectional. Patients with CKD have greater prevalence of traditional HF risk factors as well as unique kidney-specific risk factors including malnutrition, acid-base alterations, uraemic toxins, bone mineral changes, anemia and myocardial stunning. These risk factors also contribute to the decline of kidney function seen in patients with subclinical and clinical HF. More targeted HF therapies may improve outcomes in patients with kidney disease as current HF therapies are underutilised in this population. Further work is also needed to develop novel HF therapies for the CKD population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Age-related changes in liver, kidney, and spleen stiffness in healthy children measured with acoustic radiation force impulse imaging

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    Lee, Mi-Jung, E-mail: [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Kim, Myung-Joon, E-mail: [Department of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Han, Kyung Hwa, E-mail: [Biostatistics Collaboration Unit, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 (Korea, Republic of); Yoon, Choon Sik, E-mail: [Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, 211 Unjoo-ro, Gangnam-gu, Seoul (Korea, Republic of)


    Objectives: To evaluate the feasibility and age-related changes of shear wave velocity (SWV) in normal livers, kidneys, and spleens of children using acoustic radiation force impulse (ARFI) imaging. Materials and methods: Healthy pediatric volunteers prospectively underwent abdominal ultrasonography and ARFI. The subjects were divided into three groups according to age: group 1: <5 years old; group 2: 5–10 years old; and group 3: >10 years old. The SWV was measured using a 4–9 MHz linear probe for group 1 and a 1–4 MHz convex probe for groups 2 and 3. Three valid SWV measurements were acquired for each organ. Results: Two hundred and two children (92 male, 110 female) with an average age of 8.1 years (±4.7) were included in this study and had a successful measurement rate of 97% (196/202). The mean SWVs were 1.12 m/s for the liver, 2.19 m/s for the right kidney, 2.33 m/s for the left kidney, and 2.25 m/s for the spleen. The SWVs for the right and left kidneys, and the spleen showed age-related changes in all children (p < 0.001). And the SWVs for the kidneys increased with age in group 1, and those for the liver changed with age in group 3. Conclusions: ARFI measurements are feasible for solid abdominal organs in children using high or low frequency probes. The mean ARFI SWV for the kidneys increased according to age in children less than 5 years of age and in the liver, it changed with age in children over 10.

  16. Ultrasonographic parameters of the liver, spleen and kidneys among a cohort of school children in Sri Lanka. (United States)

    Warnakulasuriya, Dianne Tania Dayanthi; Peries, Pattiya Pathirennahalage Uddika Chamila; Rathnasekara, Yaddehi Arachchillage Chaminda; Jayawardena, KaluArachchige Thushari Madurika; Upasena, Angappulige; Wickremasinghe, Anada Rajitha


    Liver, spleen and kidney dimensions on ultrasonography vary with the age, weight and ethnicity. Reference standards of these parameters for normal Sri Lankan children are not available. Our aim was to establish normative data for longitudinal length of liver, spleen and kidneys in healthy children. Three hundred fifty-seven children, 5-13 years of age were selected from two randomly selected schools in the Gampaha district in the western province of Sri Lanka. A questionnaire was administered to the parents after obtaining informed written consent. Participants were screened for risk factors for organomegaly and were examined by a trained officer. Children with a past history of infective, inflammatory, haematological, malignant, congestive, collagenous or congenital conditions that can affect the size of the organs were excluded as well as those with clinically evident malnutrition, anemia, lymphadenopathy or organomegaly. Ultrasonographic assessment was done using a high resolution real-time scanner with a 3.5 MHz convex transducer by a trained officer. Children with ultrasonographic abnormalities of organs were also excluded from the study and referred for further evaluation. The study comprised 332 children comprising 176 girls (53%). There was a significant difference in the longitudinal dimension of the liver between the two sexes with a higher value recorded among females (Mann Whitney U = 11,830.5, p = 0.037). Body weight was correlated with the dimensions of the liver, the spleen and the kidneys. On multiple regression analysis body weight significantly associated with all the organs. (p < 0.01) Percentile graphs for longitudinal length of liver, spleen, right and left kidneys were formed according to the body weight. The organ dimensions showed the highest correlation with body weight. We hope the normal ultrasonographic values of healthy Sri Lankan children will assist in interpretation of sonographic examinations in daily clinical practice.

  17. Kidney injury and renal replacement therapy in heart transplant recipient

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    Ya. L. Poz


    Full Text Available The development of kidney injury and the characteristics of renal replacement therapy were considered in patient with dilated cardiomyopathy, who consequently underwent two heart transplantations and two kidney transplantations. Since the number of the patients needed both kidney and heart transplantation increases constantly, the multifaceted thorough research in this specific patient population is extremely important.

  18. Nonspecific targeting of iron oxide nanoparticles to the liver, kidney and spleen: A novel approach to achieving specificity (United States)

    Palihawadana Arachchige, Maheshika; Flack, Amanda; Chen, Xuequn; Li, Jing; Oupicky, David; Cheng, Y.-C. Norman; Shen, Yimin; Jena, Bhanu; Lawes, Gavin


    Recently, there has been significant interest in developing Fe3O4 nanoparticles for biomedical applications including targeted drug delivery and magnetic resonance imaging. One of the major problems in these applications is the undesirable filtration of these materials by the mononuclear phagocyte system. Preliminary magnetic resonance imaging and magnetization studies on hyaluronic acid coated nanoparticles injected intravenously into mice confirm that the nanoparticles accumulate in the liver, spleen, and kidneys. To identify whether certain specific proteins are responsible for nanoparticle accumulation in these organs, we exposed hyaluronic acid coated nanoparticles to proteins extracted from the liver, spleen, and kidneys, together with blood plasma proteins, then subsequently used gel electrophoresis and mass spectroscopy to identify the proteins binding to the nanoparticles. We find that the unwanted accumulation of nanoparticles in these organs can potentially be attributed to specific binding by a small number of proteins. By appropriately functionalizing the iron oxide nanoparticles, we expect that the nanoparticles uptake in the liver, spleen, and kidneys will be reduced.

  19. Expression of cytokine genes in head kidney and spleen cells of Japanese flounder (Paralichthys olivaceus) infected with Nocardia seriolae. (United States)

    Tanekhy, M; Matsuda, S; Itano, T; Kawakami, H; Kono, T; Sakai, M


    Nocardiosis caused by Nocardia seriolae is an important disease affecting marine fish for which neither control nor preventive measures are available. In this study, we investigated cytokine gene expression in Japanese flounder (Paralichthys olivaceus) infected with N. seriolae to understand the innate immune response. Japanese flounder were challenged with different concentrations of N. seriolae suspensions (0, 1, and 10 mg/L) by immersion for 10min. Mortality was 75% and 95% in fish infected by 1 and 10 mg/L, respectively. The expression of cytokine genes (TNF-alpha, IL-1beta, CC-chemokine) in head kidney and spleen cells to N. seriolae challenge was investigated 2, 24 h, 3 days, and 10 days post-challenge. TNF-alpha expression was significantly increased in spleen after 24 h in 1 mg/L group and in HK after 2 h in 10 mg/L group, but after 24 h and 3 days in 10 mg/L group and after 3 days in 1 mg/L group, it was significantly decreased. IL-1beta expression was significantly up-regulated in spleen after 24 h in 1 mg/l group while in HK only after 2 h in 10 mg/L group before suddenly down-regulated significantly 24 h in 10 mg/L group. The expression of CC-chemokine gene in both spleen and HK was significantly up-regulated in 10 mg/L group 2 h post-challenge and down-regulated in HK after 24 h and after 10 days in 1 mg/L group in spleen, compared to the control group. Copyright 2009 Elsevier B.V. All rights reserved.

  20. Human heart, spleen, and perirenal fat-derived mesenchymal stem cells have immunomodulatory capacities. (United States)

    Hoogduijn, M J; Crop, M J; Peeters, A M A; Van Osch, G J V M; Balk, A H M M; Ijzermans, J N M; Weimar, W; Baan, C C


    Mesenchymal stem cells (MSCs) have important tissue repair functions and show potent immunosuppressive capacities in vitro. Although usually isolated from the bone marrow, MSCs have been identified in other tissues, including the skin and liver. In the present study, we isolated and characterized MSCs from human heart, spleen, and perirenal adipose tissue. MSCs from these different tissue sites were similar to those derived from bone marrow in that they expressed comparable levels of the cell-surface markers CD90, CD105, CD166, and HLA class I, were negative for CD34, CD45, HLA class II, CD80, and CD86 expression, and were capable of osteogenic and adipogenic differentiation. Like bone marrow-derived MSCs, MSCs from these different tissue sources inhibited the proliferation of alloactivated peripheral blood mononuclear cells (PBMCs), giving 85%, 79%, 79%, and 81% inhibition, respectively. Also in line with bone marrow-derived MSCs they inhibited proliferative responses of PBMCs to phytohemagglutinin, a nonspecific stimulator of lymphocyte proliferation, and reduced-memory T lymphocyte responses to tetanus toxoid. The results of this study demonstrate that MSCs from various tissues have similar immunophenotypes, in vitro immunosuppressive properties, and differentiation potential.

  1. Simultaneous heart and kidney transplantation after bridging with the CardioWest total artificial heart. (United States)

    Jaroszewski, Dawn E; Pierce, Christopher C; Staley, Linda L; Wong, Raymond; Scott, Robert R; Steidley, Eric E; Gopalan, Radha S; DeValeria, Patrick; Lanza, Louis; Mulligan, David; Arabia, Francisco A


    End-stage renal failure is often considered a relative contraindication for total artificial heart implantation due to the increased risk of mortality after transplantation. We report the successful treatment of a patient having heart and renal failure with the CardioWest (SynCardia Inc, Tucson, AZ) total artificial heart for bridge-to-cardiac transplantation of a heart and kidney.

  2. Heavy metals burden in Kidney and heart tissues of Scarus ...

    African Journals Online (AJOL)

    Levels of selected heavy metals (Pb, Co, Cu, Ni, Zn, Mn and Cd) in the heart and kidney tissues of parrot fish, collected from the Arabian Gulf, Eastern Province of Saudi Arabia, were determined by wet-digestion based atomic absorption method. The results showed that accumulation pattern of analyzed metals in the kidney ...

  3. Histoautoradiographic and liquid scintillometric studies on DNA synthesis in the liver, kidneys, spleen and tongue after bilateral adrenalectomy in rats

    International Nuclear Information System (INIS)

    Schneider, A.


    Historadiographies and liquid scintillometries were carried out in 163 male Wistar rats in order to determine the effects of bilateral adrenalectomy on DNA synthesis in the liver, kidneys, spleen, and tongue. Both DNA synthesis and mitotic index are significantly increased from the 1st day p.o. onwards, with broad synthesis peaks between the 2nd and the 4th day. The intensity of DNA synthesis shows a gradual decrease with increasing duration of the experiment. In contrast to the adrenalectonized animals, the synthesis rate and mitotic index in the organs of sham-operated animals were significantly lower, although enhanced proliferation was observed after surgery. The enhanced DNA synthesis after bilateral adrenalectomy is interpreted in terms of a disinhibition; corticosteroids are assumed to play a key role. The effects of bilateral adrenalectromy on untreated organs are not organ-specific. The highest synthesis rate was observed in the tubular epithelia of the convoluted main parts, while the DNA synthesis in the tongue. The findings of autoradiography and liquid scintillometry are well correlated. (orig./MG) [de

  4. Collection of Macaca fascicularis cDNAs derived from bone marrow, kidney, liver, pancreas, spleen, and thymus

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    Kameoka Yosuke


    Full Text Available Abstract Background Consolidating transcriptome data of non-human primates is essential to annotate primate genome sequences, and will facilitate research using non-human primates in the genomic era. Macaca fascicularis is a macaque monkey that is commonly used for biomedical and ecological research. Findings We constructed cDNA libraries of Macaca fascicularis, derived from tissues obtained from bone marrow, liver, pancreas, spleen, and thymus of a young male, and kidney of a young female. In total, 5'-end sequences of 56,856 clones were determined. Including the previously established cDNA libraries from brain and testis, we have isolated 112,587 cDNAs of Macaca fascicularis, which correspond to 56% of the curated human reference genes. Conclusion These sequences were deposited in the public sequence database as well as in-house macaque genome database These data will become valuable resources for identifying functional parts of the genome of macaque monkeys in future studies.

  5. Evaluation of a manual biopsy device, the 'Spirotome', on fresh canine organs: liver, spleen, and kidneys, and first clinical experiences in animals. (United States)

    Vignoli, Massimo; Barberet, Virginie; Chiers, Koen; Duchateau, Luc; Bacci, Barbara; Terragni, Rossella; Rossi, Federica; Saunders, Jimmy H


    Several methods for obtaining specimens from abdominal organs have been described. Imaging-guided biopsy, particularly ultrasound-guided biopsy, is the most frequently used in clinical trials. The aim of this study was to evaluate the diagnostic quality of histological samples obtained with a manual biopsy device (Spirotome) on biopsies of the liver, spleen, and kidney, in fresh canine organs and in live animals in a clinical trial. The study was divided into two different parts, one using normal fresh canine organs with a total of 60 biopsies, 20 of liver, spleen, and kidney, respectively; and one on clinical patients, including 35 biopsied lesions in 28 animals (25 dogs and three cats) for a total of 95 biopsies. All the biopsy samples were considered satisfactory from canine cadavers, and all specimens were diagnostic in clinical cases. The technique was accurate and safe and no major complications were noted.

  6. Heart failure and kidney dysfunction: epidemiology, mechanisms and management. (United States)

    Schefold, Joerg C; Filippatos, Gerasimos; Hasenfuss, Gerd; Anker, Stefan D; von Haehling, Stephan


    Heart failure (HF) is a major health-care problem and the prognosis of affected patients is poor. HF often coexists with a number of comorbidities of which declining renal function is of particular importance. A loss of glomerular filtration rate, as in acute kidney injury (AKI) or chronic kidney disease (CKD), independently predicts mortality and accelerates the overall progression of cardiovascular disease and HF. Importantly, cardiac and renal diseases interact in a complex bidirectional and interdependent manner in both acute and chronic settings. From a pathophysiological perspective, cardiac and renal diseases share a number of common pathways, including inflammatory and direct, cellular immune-mediated mechanisms; stress-mediated and (neuro)hormonal responses; metabolic and nutritional changes including bone and mineral disorder, altered haemodynamic and acid-base or fluid status; and the development of anaemia. In an effort to better understand the important crosstalk between the two organs, classifications such as the cardio-renal syndromes were developed. This classification might lead to a more precise understanding of the complex interdependent pathophysiology of cardiac and renal diseases. In light of exceptionally high mortality associated with coexisting HF and kidney disease, this Review describes important crosstalk between the heart and kidney, with a focus on HF and kidney disease in the acute and chronic settings. Underlying molecular and cellular pathomechanisms in HF, AKI and CKD are discussed in addition to current and future therapeutic approaches.

  7. CHRONIC KIDNEY DISEASE RAAS blockade and diastolic heart failure in chronic kidney disease

    NARCIS (Netherlands)

    Franssen, Casper F. M.; Navis, Gerjan

    New data from Ahmed et al. show that discharge prescriptions for renin-angiotensin-aldosterone inhibitor therapy are associated with a significant reduction in all-cause mortality in elderly patients with diastolic heart failure and chronic kidney disease (CKD). These observational data support the

  8. A New UK 2006 National Kidney Allocation Scheme for deceased heart-beating donor kidneys. (United States)

    Johnson, Rachel J; Fuggle, Susan V; Mumford, Lisa; Bradley, J Andrew; Forsythe, John L R; Rudge, Chris J


    In 2004, it was agreed that a new allocation scheme for kidneys from deceased heart-beating donors was required in the United Kingdom to address observed inequities in access to transplant. The 2006 National Kidney Allocation Scheme (2006 NKAS) was developed to meet agreed objectives and preparatory work included a review of the criteria for human leukocyte antigen (HLA) matching and simulation evidence about the effectiveness of alternative schemes. ALGORITHM FOR 2006 NKAS: The 2006 NKAS gives absolute priority to all 000 HLA-A, -B, -DR-mismatched patients and well-matched pediatric patients (inequity of access will take a number of years to address fully.

  9. Effect of dietary phosphorus deficiency on the growth, immune function and structural integrity of head kidney, spleen and skin in young grass carp (Ctenopharyngodon idella). (United States)

    Chen, Kang; Jiang, Wei-Dan; Wu, Pei; Liu, Yang; Kuang, Sheng-Yao; Tang, Ling; Tang, Wu-Neng; Zhang, Yong-An; Zhou, Xiao-Qiu; Feng, Lin


    This study evaluates the effects of dietary phosphorus on the growth, immune function and structural integrity (head kidney, spleen and skin) of young grass carp (Ctenopharyngodon idella) that were fed graded levels of available phosphorus (0.95-8.75 g/kg diet). Results indicated that phosphorus deficiency decreased the growth performance of young grass carp. In addition, the results first demonstrated that compared with the optimal phosphorus level, phosphorus deficiency depressed the lysozyme (LZ) and acid phosphatase (ACP) activities and the complement 3 (C3), C4 and immunoglobulin M (IgM) contents, and down-regulated the mRNA levels of antimicrobial peptides, anti-inflammatory cytokines, inhibitor of κBα (IκBα) and target of rapamycin (TOR), whereas it up-regulated pro-inflammatory cytokines, nuclear factor kappa B (NF-κB) p65 and NF-κB p52 mRNA levels to decrease fish head kidney and spleen immune functions. Moreover, phosphorus deficiency up-regulated the mRNA levels of Kelch-like-ECH-associated protein 1a (Keap1a), Fas ligand (FasL), apoptotic protease activating factor-1 (Apaf-1), Bcl-2 associated X protein (Bax), caspase -2, -3, -7, -8 and -9, p38 mitogen-activated protein kinase (MAPK) and myosin light chain kinase (MLCK), whereas it depressed the glutathione (GSH) contents and antioxidant enzymes activities, and down-regulated the mRNA levels of antioxidant enzymes, NF-E2-related factor 2 (Nrf2), B-cell lymphoma protein-2 (Bcl-2), myeloid cell leukemia-1 (Mcl-1) and tight junction complexes to attenuate fish head kidney and spleen structural integrity. In addition, phosphorus deficiency increased skin hemorrhage and lesions morbidity. Finally, based on the percent weight gain (PWG) and the ability to combat skin hemorrhage and lesions, the dietary available phosphorus requirements for young grass carp (254.56-898.23 g) were estimated to be 4.10 and 4.13 g/kg diet, respectively. In summary, phosphorus deficiency decreases the growth

  10. Heart failure : Macrophages take centre stage in the heart-brain-kidney axis

    NARCIS (Netherlands)

    Sillje, Herman H. W.; de Boer, Rudolf A.

    A new study reports that a heart-brain-kidney network involving renal and cardiac macrophages is required for the adaptive response to cardiac stress. As well as highlighting the importance of inter-organ communication in complex pathological syndromes, the findings raise important questions with

  11. Accumulation of Copper in Gill, Liver, Spleen, Kidney and Muscle Tissues of Clarias gariepinus Exposed to the Metal Singly and in Mixture with Chitosan. (United States)

    Tunçsoy, Mustafa; Duran, Servet; Ay, Özcan; Cicik, Bedii; Erdem, Cahit


    Accumulation of copper (Cu), applied singly and in mixture with chitosan (CT), in gill, liver, spleen, kidney and muscle tissues of Clarias gariepinus was studied after exposing the fish to no Cu (control), 5 ppm Cu, 5 ppm Cu + 75 ppm CT mixture over 1, 7 and 15 days. Metal levels in tissues were determined using an ICP-AES spectrophotometer. No mortality was observed during the experiments. Highest accumulation of Cu was observed in liver while lowest accumulation was observed in muscle tissue. Exposure to Cu-CT mixture decreased Cu accumulation in liver at all exposure periods and in kidney on the 15th day compared to Cu alone. Exposure to Cu alone and Cu-CT mixture had no effect on Cu accumulation in spleen or muscle tissue. Copper accumulation increased in gill tissue compared to control when exposed to Cu alone at all exposure periods, and exposure to the Cu-CT mixture significantly increased Cu accumulation in this tissue at all exposure periods compared to Cu alone.

  12. Unusual Pathology in a Kidney from a Heart-Transplant Patient

    Directory of Open Access Journals (Sweden)

    Marie Larcher


    Full Text Available Acute kidney injury (AKI is often observed after heart transplantation. In this setting, acute tubular necrosis is the main histological finding on kidneys. We report the unusual pathology found in a kidney from a heart-transplant patient. The patient experienced several hemodynamic insults, massive transfusion, and implantation of a mechanical circulatory-support device before heart transplantation: there was prolonged AKI after transplantation. A kidney biopsy revealed acute tubular necrosis and renal hemosiderosis, which was probably related to the transfusion and to mechanical circulatory-support device-induced intravascular hemolysis. Assessment of iron during resuscitation could have prevented, at least partly, AKI.

  13. Congestive heart failure in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Poskurica Mileta


    Full Text Available Cardiovascular disorders are the most frequent cause of death (46-60% among patients with advanced chronic renal failure (CRF, and on dialysis treatment. Uremic cardiomyopathy is the basic pathophysiologic substrate, whereas ischemic heart disease (IHD and anemia are the most important contributing factors. Associated with well-know risk factors and specific disorders for terminal kidney failure and dialysis, the aforementioned factors instigate congestive heart failure (CHF. Suspected CHF is based on the anamnesis, clinical examination and ECG, while it is confirmed and defined more precisely on the basis of echocardiography and radiology examination. Biohumoral data (BNP, NT-proBNP are not sufficiently reliable because of specific volemic fluctuation and reduced natural clearance. Therapy approach is similar to the one for the general population: ACEI, ARBs, β-blockers, inotropic drugs and diuretics. Hypervolemia and most of the related symptoms can be kept under control effectively by the isolated or ultrafiltation, in conjunction with dialysis, during the standard bicarbonate hemodialysis or hemodiafiltration. In the same respect peritoneal dialysis is efficient for the control of hypervolemia symptoms, mainly during the first years of its application and in case of the lower NYHA class (II°/III°. In general, heart support therapy, surgical interventions of the myocardium and valve replacement are rarely used in patients on dialysis, whereas revascularization procedures are beneficial for associated IHD. In selected cases the application of cardiac resynchronization and/or implantation of a cardioverter defibrillator are advisable.

  14. De Novo Heart Failure After Kidney Transplantation: Trends in Incidence and Outcomes. (United States)

    Lenihan, Colin R; Liu, Sai; Deswal, Anita; Montez-Rath, Maria E; Winkelmayer, Wolfgang C


    Heart failure is an important cause of morbidity and mortality following kidney transplantation. Some studies in the general population have shown that the incidence of heart failure has decreased during the past 20 years. However, it is not currently known whether such a trend exists in the kidney transplantation population. Retrospective observational cohort study. Adult patients included in the US Renal Data System who underwent their first kidney transplantation in the United States between 1998 and 2010 with at least 6 months of continuous Medicare parts A and B coverage before transplantation and no prior evidence for a diagnosis of heart failure before kidney transplantation. Calendar year of transplantation and calendar year of posttransplantation heart failure diagnosis. De novo posttransplantation heart failure defined using International Classification of Diseases, Ninth Revision diagnosis codes and mortality following de novo posttransplantation heart failure diagnosis. Secular trends in de novo post-kidney transplantation heart failure were examined using Cox proportional hazards analysis. Within a study cohort of 48,771 patients, 7,269 developed de novo heart failure within 3 years of kidney transplantation, with a median time to heart failure of 0.76 years. The adjusted HR for heart failure with death as competing risk comparing patients who underwent transplantation in 2010 with those who underwent transplantation in 1998 was 0.69 (95% CI, 0.60-0.79). No temporal trend in mortality following a diagnosis of post-kidney transplantation heart failure was observed. Potential residual confounding from either incorrectly ascertained or unavailable confounders. The cohort was limited to Medicare beneficiaries. Adjusted for demographic and clinical characteristics, the risk for developing de novo post-kidney transplantation heart failure has declined significantly between 1998 and 2010, with no apparent change in subsequent mortality. Copyright © 2018

  15. roposal on the Method of Regulating Ascending Kidney Water and Descending Heart Fire -through pharmacopuncture technique-

    Directory of Open Access Journals (Sweden)

    Ki Rok, Kwon


    Full Text Available Objectives : The purpose of this study is aimed at diagnosing and suggesting treatment plans for commonly seen clinical manifestation of heat symptom in the upper body and coldness in the lower body, also known as hot above, cold below syndrome. Methods : Various reasons attribute to the presence of hot above, cold below syndrome, but mainly contributed by blockage of normal Qi flow by abnormality of heart-kidney root, spleen-stomach axis, and liver-lung axis. Diagnosing these abnormalities and timely alleviation to the healthy state is presented in the study. Results : 1For heat in the upper body, Huang Lian Jie Du Tang(黃連解毒湯, CF, or JsD pharmacopuctures are injected on GB21, GB20. Qi stagnation in the thoracic area is treated with BUM injection on CV17. For impairment of transportation and transformation in the middle energizer, BUM pharmacopuncture is injected on CV12. Coldness in the lower energizer was relieved by bee venom or Sweet BV(Bee Venom free from enzymes on CV6. Conclusion : Above proposed methods of regulating water-fire were effective in treating hot above, cold below syndrome in clinical manifestations. But once the symptom subsides, treatment focused on eliminating innate cause should be rendered to achieve more successful results.

  16. Spleen removal (United States)

    ... Philadelphia, PA: Elsevier; 2017:1505-1509. Poulose BK, Holzman MD. The spleen. In: Townsend CM Jr, Beauchamp ... provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial ...

  17. Renal Allograft Outcome After Simultaneous Heart and Kidney Transplantation. (United States)

    Grupper, Avishay; Grupper, Ayelet; Daly, Richard C; Pereira, Naveen L; Hathcock, Matthew A; Kremers, Walter K; Cosio, Fernando G; Edwards, Brooks S; Kushwaha, Sudhir S


    Chronic kidney disease frequently accompanies end-stage heart failure and may result in consideration of simultaneous heart and kidney transplantation (SHKT). In recent years, there has been a significant increase in SHKT. This single-center cohort consisted of 35 patients who underwent SHKT during 1996 to 2015. The aim of this study was to review factors that may predict better long-term outcome after SKHT. Thirteen patients (37%) had delayed graft function (DGF) after transplant (defined as the need for dialysis during the first 7 days after transplant), which was significantly associated with mechanical circulatory support device therapy and high right ventricular systolic pressure before transplant. Most of the recipients had glomerular filtration rate (GFR) ≥50 ml/min/1.73 m 2 at 1 and 3 years after transplant (21 of 26 [81%] and 20 of 21 [95%], respectively). Higher donor age was associated with reduced 1-year GFR (p = 0.017), and higher recipient pretransplant body mass index was associated with reduced 3-year GFR (p = 0.008). There was a significant association between DGF and reduced median GFR at 1 and 3 years after transplant (p transplant were 97%, 91%, and 86% respectively. In conclusions, our data support good outcomes after SHKT. Mechanical circulatory support device therapy and pulmonary hypertension before transplant are associated with DGF, which is a risk factor for poor long-term renal allograft function. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Heart-Kidney Biomarkers in Patients Undergoing Cardiac Stress Testing

    Directory of Open Access Journals (Sweden)

    Mikko Haapio


    Full Text Available We examined association of inducible myocardial perfusion defects with cardiorenal biomarkers, and of diminished left ventricular ejection fraction (LVEF with kidney injury marker plasma neutrophil gelatinase-associated lipocalin (NGAL. Patients undergoing nuclear myocardial perfusion stress imaging were divided into 2 groups. Biomarkers were analyzed pre- and poststress testing. Compared to the patients in the low ischemia group (n=16, the patients in the high ischemia group (n=18 demonstrated a significantly greater rise in cardiac biomarkers plasma BNP, NT-proBNP and cTnI. Subjects were also categorized based on pre- or poststress test detectable plasma NGAL. With stress, the group with no detectable NGAL had a segmental defect score 4.2 compared to 8.2 (P=.06 in the detectable NGAL group, and 0.9 vs. 3.8 (P=.03 at rest. BNP rose with stress to a greater degree in patients with detectable NGAL (10.2 vs. 3.5 pg/mL, P=.03. LVEF at rest and with stress was significantly lower in the detectable NGAL group; 55.8 versus 65.0 (P=.03 and 55.1 vs. 63.8 (P=.04, respectively. Myocardial perfusion defects associate with biomarkers of cardiac stress, and detectable plasma NGAL with significantly lower LVEF, suggesting a specific heart-kidney link.

  19. Combined heart-kidney transplant after CardioWest total artificial heart bridge. (United States)

    Hansen, Adam J; Copeland, Jack G


    Combined, single-donor, heart and kidney transplant (HKTx) recipients have survival rates comparable with those after heart transplantation alone. Although HKTx provides superior outcomes in patients with dual-organ failure, appropriate single-donor organ pairs are very scarce. Mechanical circulatory support thus seems an attractive option as a bridge to HKTx. We report the case of an adult with end-stage cardiomyopathy and renal failure who was successfully bridged to combined, single-donor HKTx with a total artificial heart. Infectious complications associated with the CardioWest cavity were encountered prior to transplantation. The patient recovered and was discharged 14 days after transplantation. At 4 months post-transplantation, the patient required single-vessel coronary stenting for a high-grade stenosis. At 1 year, he has had no further complications and has excellent function of both transplanted organs. Despite limited availability of same donor organ pairs, patients with combined cardiac and renal failure can be bridged effectively to transplant with the CardioWest total artificial heart. Copyright © 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  20. Acute kidney injury in children with heart failure: any relationship to ...

    African Journals Online (AJOL)

    Materials and Method : Prospective study of cohort of children with heart failure were studied. Heart failure was defined using heart rate for age, respiratory rate for age and tender hepatomegaly. Acute kidney injury was based on absolute serum creatinine level > 0.5 mg/dl on admission. Age, gender, and out come we r e ...

  1. Application and development of a TaqMan real-time PCR for detecting infectious spleen and kidney necrosis virus in Siniperca chuatsi. (United States)

    Lin, Qiang; Fu, Xiaozhe; Liu, Lihui; Liang, Hongru; Guo, Huizhi; Yin, Shuwen; Kumaresan, Venkatesh; Huang, Zhibin; Li, Ningqiu


    Infectious spleen and kidney necrosis virus (ISKNV) is one of the major epidemiological agents that had caused great economic loss in Chinese perch (Siniperca chuatsi). In this study, a specific TaqMan real-time PCR was developed using a pair of primers and a TaqMan probe specific to the ORF007 gene of ISKNV to rapidly detect ISKNV copies in Chinese perch samples. This assay was optimized to produce linearity from 8.75 × 10 8 to 8.75 × 10 1 copies in standard curve with an efficiency of 98% and a R 2 value of 0.9999. Moreover, the minimum detection limit of this assay was 10,000 times more sensitive than that of conventional PCR method. The coefficients of variation of intra- and inter-assay repeatability were less than 2.4% and 3.3%, respectively. The viral distribution in different tissues of diseased Chinese perch was evaluated by TaqMan real-time PCR method and the highest level of viral copies was detected in spleen. Among the 76 diseased Chinese perch clinical samples, 35 and 29 were positive samples based on the TaqMan real-time PCR and conventional PCR methods, respectively, indicating that the TaqMan real-time PCR was more sensitive than conventional PCR. Therefore, the TaqMan real-time PCR should be a useful tool for the early surveillance and quantitation of ISKNV. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Monocyte subset accumulation in the human heart following acute myocardial infarction and the role of the spleen as monocyte reservoir. (United States)

    van der Laan, Anja M; Ter Horst, Ellis N; Delewi, Ronak; Begieneman, Mark P V; Krijnen, Paul A J; Hirsch, Alexander; Lavaei, Mehrdad; Nahrendorf, Matthias; Horrevoets, Anton J; Niessen, Hans W M; Piek, Jan J


    Monocytes are critical mediators of healing following acute myocardial infarction (AMI), making them an interesting target to improve myocardial repair. The purpose of this study was a gain of insight into the source and recruitment of monocytes following AMI in humans. Post-mortem tissue specimens of myocardium, spleen and bone marrow were collected from 28 patients who died at different time points after AMI. Twelve patients who died from other causes served as controls. The presence and localization of monocytes (CD14(+) cells), and their CD14(+)CD16(-) and CD14(+)CD16(+) subsets, were evaluated by immunohistochemical and immunofluorescence analyses. CD14(+) cells localized at distinct regions of the infarcted myocardium in different phases of healing following AMI. In the inflammatory phase after AMI, CD14(+) cells were predominantly located in the infarct border zone, adjacent to cardiomyocytes, and consisted for 85% (78-92%) of CD14(+)CD16(-) cells. In contrast, in the subsequent post-AMI proliferative phase, massive accumulation of CD14(+) cells was observed in the infarct core, containing comparable proportions of both the CD14(+)CD16(-) [60% (31-67%)] and CD14(+)CD16(+) subsets [40% (33-69%)]. Importantly, in AMI patients, of the number of CD14(+) cells was decreased by 39% in the bone marrow and by 58% in the spleen, in comparison with control patients (P = 0.02 and <0.001, respectively). Overall, this study showed a unique spatiotemporal pattern of monocyte accumulation in the human myocardium following AMI that coincides with a marked depletion of monocytes from the spleen, suggesting that the human spleen contains an important reservoir function for monocytes.

  3. First successful combined heart and kidney transplant in Iran: a case report. (United States)

    Ahmadi, Zargham-Hossein; Mirhosseini, Seyed Mohsen; Fakhri, Mohammad; Mozaffary, Amirhossein; Lotfaliany, Mojtaba; Nejatollahi, Seyed Mohammad Reza; Marashi, Seyed-Ali; Behzadnia, Neda; Sharif-Kashani, Babak


    Combined heart and kidney transplant has become an accepted therapy for patients with coexisting heart and kidney failure. This method, compared with single-organ transplant, has a better outcome. Here, we report the first successful combined heart and kidney transplant in Iran. The patient was a 36-year-old man with end-stage renal disease owing to IgA nephropathy, admitted to Masih Daneshvari Hospital in Tehran, Iran for progressive dyspnea and chest pain. In-patient evaluations revealed cardiomyopathy leading to end-stage heart failure. Owing to concurrent heart and kidney end-stage diseases, combined cardiorenal transplant was done. Eight months after his transplant, routine follow-ups have not shown any signs of acute rejection. He is now New York Heart Association functional class I. Both cardiac and renal functions are within normal ranges. Good outcome during follow-up for this case justifies simultaneous heart plus kidney transplants as an alternate treatment for patients with advanced disease of both organs.

  4. Recompensation of Heart and Kidney Function after Treatment with Peritoneal Dialysis in a Case of Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Lars P. Kihm


    Full Text Available We report the case of a 57-year-old woman suffering from congestive heart failure. Due to refractory congestions despite optimised medical treatment, the patient was listed for heart transplantation and peritoneal dialysis was initiated. Peritoneal dialysis led to a significant weight loss, reduction of hyperhydration and extracellular water obtained by bioimpedance measurement, and a significant improvement in clinical and echocardiographic examination. Furthermore, residual kidney function increased during the long-term followup, and subsequently peritoneal dialysis was ceased. Pulmonary artery pressure and left ventricular ejection fraction remained stable and the patient did well. This case demonstrates the possibility of treating hyperhydration due to congestive heart failure with peritoneal dialysis resulting in recompensation of both heart and kidney functions.

  5. Cancer Incidence among Heart, Kidney, and Liver Transplant Recipients in Taiwan. (United States)

    Lee, Kwai-Fong; Tsai, Yi-Ting; Lin, Chih-Yuan; Hsieh, Chung-Bao; Wu, Sheng-Tang; Ke, Hung-Yen; Lin, Yi-Chang; Lin, Feng-Yen; Lee, Wei-Hwa; Tsai, Chien-Sung


    Population-based evidence of the relative risk of cancer among heart, kidney, and liver transplant recipients from Asia is lacking. The Taiwan National Health Insurance Research Database was used to conduct a population-based cohort study of transplant recipients (n = 5396), comprising 801 heart, 2847 kidney, and 1748 liver transplant recipients between 2001 and 2012. Standardized incidence ratios and Cox regression models were used. Compared with the general population, the risk of cancer increased 3.8-fold after heart transplantation, 4.1-fold after kidney transplantation and 4.6-fold after liver transplantation. Cancer occurrence showed considerable variation according to transplanted organs. The most common cancers in all transplant patients were cancers of the head and neck, liver, bladder, and kidney and non-Hodgkin lymphoma. Male recipients had an increased risk of cancers of the head and neck and liver, and female kidney recipients had a significant risk of bladder and kidney cancer. The adjusted hazard ratio for any cancer in all recipients was higher in liver transplant recipients compared with that in heart transplant recipients (hazard ratio = 1.5, P = .04). Cancer occurrence varied considerably and posttransplant cancer screening should be performed routinely according to transplanted organ and sex.

  6. Economic impact of heart failure according to the effects of kidney failure. (United States)

    Sicras Mainar, Antoni; Navarro Artieda, Ruth; Ibáñez Nolla, Jordi


    To evaluate the use of health care resources and their cost according to the effects of kidney failure in heart failure patients during 2-year follow-up in a population setting. Observational retrospective study based on a review of medical records. The study included patients ≥ 45 years treated for heart failure from 2008 to 2010. The patients were divided into 2 groups according to the presence/absence of KF. Main outcome variables were comorbidity, clinical status (functional class, etiology), metabolic syndrome, costs, and new cases of cardiovascular events and kidney failure. The cost model included direct and indirect health care costs. Statistical analysis included multiple regression models. The study recruited 1600 patients (prevalence, 4.0%; mean age 72.4 years; women, 59.7%). Of these patients, 70.1% had hypertension, 47.1% had dyslipidemia, and 36.2% had diabetes mellitus. We analyzed 433 patients (27.1%) with kidney failure and 1167 (72.9%) without kidney failure. Patients with kidney failure were associated with functional class III-IV (54.1% vs 40.8%) and metabolic syndrome (65.3% vs 51.9%, P<.01). The average unit cost was €10,711.40. The corrected cost in the presence of kidney failure was €14,868.20 vs €9,364.50 (P=.001). During follow-up, 11.7% patients developed ischemic heart disease, 18.8% developed kidney failure, and 36.1% developed heart failure exacerbation. Comorbidity associated with heart failure is high. The presence of kidney failure increases the use of health resources and leads to higher costs within the National Health System. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  7. Antihyperglycemic Medication Use Among Medicare Beneficiaries With Heart Failure, Diabetes Mellitus, and Chronic Kidney Disease. (United States)

    Patel, Priyesh A; Liang, Li; Khazanie, Prateeti; Hammill, Bradley G; Fonarow, Gregg C; Yancy, Clyde W; Bhatt, Deepak L; Curtis, Lesley H; Hernandez, Adrian F


    Diabetes mellitus, heart failure (HF), and chronic kidney disease are common comorbidities, but overall use and safety of antihyperglycemic medications (AHMs) among patients with these comorbidities are poorly understood. Using Get With the Guidelines-Heart Failure and linked Medicare Part D data, we assessed AHM use within 90 days of hospital discharge among HF patients with diabetes mellitus discharged from Get With the Guidelines-Heart Failure hospitals between January 1, 2006, and October 1, 2011. We further summarized use by renal function and assessed renal contraindicated AHM use for patients with estimated glomerular filtration rate chronic kidney disease is complex, and these patients are commonly treated with renal contraindicated AHMs, including over 6% receiving a thiazolidinedione, despite known concerns regarding HF. More research regarding safety and efficacy of various AHMs among HF patients is needed. © 2016 American Heart Association, Inc.

  8. A new procedure for imaging liver and spleen with water soluble contrast media in liposomes

    International Nuclear Information System (INIS)

    Zherbin, E.A.; Davidenkova, E.F.; Khanson, K.P.; Gubareva, A.V.; Zhdanova, N.V.; Aliyakparov, M.T.; Loshakova, L.V.; Fomina, Eh.V.; Rozenberg, O.A.


    The problems of long-term, reversible, and safe contrast investigation of liver and spleen and reduction of the irritating action of water-soluble contrast media on the wall of blood vessels are unresolved. The production and experimental application of contrast media encapsulated in liposomes are described. It is possible to produce a liposome preparation with 10-20 % Verografin content. After intravenous injection it leads to a quick (after 16-30 min), persisting (10-12 h) and reversible (24-30 h) contrast imaging of liver and spleen in rodents. The contrast medium has no pathological effects on heart, blood and circulatory system and on the morphology of liver, spleen, heart, lungs, kidneys and urinary bladder. The perspectives of clinical application of such contrast media are discussed. (author)

  9. Acute Kidney Injury and Risk of Incident Heart Failure Among US Veterans. (United States)

    Bansal, Nisha; Matheny, Michael E; Greevy, Robert A; Eden, Svetlana K; Perkins, Amy M; Parr, Sharidan K; Fly, James; Abdel-Kader, Khaled; Himmelfarb, Jonathan; Hung, Adriana M; Speroff, Theodore; Ikizler, T Alp; Siew, Edward D


    Acute kidney injury (AKI) is common and associated with poor outcomes. Heart failure is a leading cause of cardiovascular disease among patients with chronic kidney disease. The relationship between AKI and heart failure remains unknown and may identify a novel mechanistic link between kidney and cardiovascular disease. Observational study. We studied a national cohort of 300,868 hospitalized US veterans (2004-2011) without a history of heart failure. AKI was the predictor and was defined as a 0.3-mg/dL or 50% increase in serum creatinine concentration from baseline to the peak hospital value. Patients with and without AKI were matched (1:1) on 28 in- and outpatient covariates using optimal Mahalanobis distance matching. Incident heart failure was defined as 1 or more hospitalization or 2 or more outpatient visits with a diagnosis of heart failure within 2 years through 2013. There were 150,434 matched pairs in the study. Patients with and without AKI during the index hospitalization were well matched, with a median preadmission estimated glomerular filtration rate of 69mL/min/1.73m 2 . The overall incidence rate of heart failure was 27.8 (95% CI, 19.3-39.9) per 1,000 person-years. The incidence rate was higher in those with compared with those without AKI: 30.8 (95% CI, 21.8-43.5) and 24.9 (95% CI, 16.9-36.5) per 1,000 person-years, respectively. In multivariable models, AKI was associated with 23% increased risk for incident heart failure (HR, 1.23; 95% CI, 1.19-1.27). Study population was primarily men, reflecting patients seen at Veterans Affairs hospitals. AKI is an independent risk factor for incident heart failure. Future studies to identify underlying mechanisms and modifiable risk factors are needed. Copyright © 2017 National Kidney Foundation, Inc. All rights reserved.

  10. A heart-brain-kidney network controls adaptation to cardiac stress through tissue macrophage activation. (United States)

    Fujiu, Katsuhito; Shibata, Munehiko; Nakayama, Yukiteru; Ogata, Fusa; Matsumoto, Sahohime; Noshita, Koji; Iwami, Shingo; Nakae, Susumu; Komuro, Issei; Nagai, Ryozo; Manabe, Ichiro


    Heart failure is a complex clinical syndrome characterized by insufficient cardiac function. In addition to abnormalities intrinsic to the heart, dysfunction of other organs and dysregulation of systemic factors greatly affect the development and consequences of heart failure. Here we show that the heart and kidneys function cooperatively in generating an adaptive response to cardiac pressure overload. In mice subjected to pressure overload in the heart, sympathetic nerve activation led to activation of renal collecting-duct (CD) epithelial cells. Cell-cell interactions among activated CD cells, tissue macrophages and endothelial cells within the kidney led to secretion of the cytokine CSF2, which in turn stimulated cardiac-resident Ly6C lo macrophages, which are essential for the myocardial adaptive response to pressure overload. The renal response to cardiac pressure overload was disrupted by renal sympathetic denervation, adrenergic β2-receptor blockade or CD-cell-specific deficiency of the transcription factor KLF5. Moreover, we identified amphiregulin as an essential cardioprotective mediator produced by cardiac Ly6C lo macrophages. Our results demonstrate a dynamic interplay between the heart, brain and kidneys that is necessary for adaptation to cardiac stress, and they highlight the homeostatic functions of tissue macrophages and the sympathetic nervous system.

  11. Risk of stroke and bleeding in patients with heart failure and chronic kidney disease

    DEFF Research Database (Denmark)

    Melgaard, Line; Overvad, Thure Filskov; Skjøth, Flemming


    AIMS: The aim of this study was to assess the prognostic value of chronic kidney disease (CKD) in relation to ischaemic stroke, intracranial haemorrhage, major bleeding, and all-cause death in heart failure patients without atrial fibrillation. METHODS AND RESULTS: In this observational cohort...

  12. Peri-operative kidney injury and long-term chronic kidney disease following orthotopic heart transplantation in children. (United States)

    Hoskote, Aparna; Burch, Michael


    Significant advances in cardiac intensive care including extracorporeal life support have enabled children with complex congenital heart disease and end-stage heart failure to be supported while awaiting transplantation. With an increasing number of survivors after heart transplantation in children, the complications from long-term immunosuppression, including renal insufficiency, are becoming more apparent. Severe renal dysfunction after heart transplant is defined by a serum creatinine level >2.5 mg/dL (221 μmol/L), and/or need for dialysis or renal transplant. The degree of renal dysfunction is variable and is progressive over time. About 3-10 % of heart transplant recipients will go on to develop severe renal dysfunction within the first 10 years post-transplantation. Multiple risk factors for chronic kidney disease post-transplant have been identified, which include pre-transplant worsening renal function, recipient demographics and morbidity, peri-transplant haemodynamics and long-term exposure to calcineurin inhibitors. Renal insufficiency increases the risk of post-transplant morbidity and mortality. Hence, screening for renal dysfunction pre-, peri- and post-transplantation is important. Early and timely detection of renal insufficiency may help minimize renal insults, and allow prompt implementation of renoprotective strategies. Close monitoring and pre-emptive management of renal dysfunction is an integral aspect of peri-transplant and subsequent post-transplant long-term care.

  13. [Prevalence of congenitial kidney and urinary tract anomalies in neonates and infants with congenital heart disease]. (United States)

    Czarniak, Piotr; Kosiak, Wojciech; Chojnicki, Maciej; Król, Ewa; Zurowska, Aleksandra


    Congenital heart diseases are the most frequent anomalies and one of the most important reasons of mortality and morbidity in neonates and infants. Coincidence of additional malformation aggravates prognosis. The frequency of incidence of other anomalies accompanying congenital hart diseases is defined as 11 to 45%. Estimation of the frequency of a coincidence of congenital kidney anomalies on the basis of the ultrasound examination (US) in children with congenital heart disease in first year of life. Abdominal US were done in 350 neonates and infants hospitalized in Department of Pediatric Cardiology Medical University of Gdansk in the first twenty-four hours after diagnosis of congenital heart disease. Examinations were performed in 187 male (53%) and 163 female (47%) in average age 54.9 days (range from 1 to 349 days). In examined population congenital kidney anomalies were found in 4.9% of children from which 18% represent hipoplasia, and another 18% dysplasia. 15.3% of examined patients were diagnosed by dilatation of collecting system, whereof 3% mild, 7% moderate, and 5% severe degree. 1. The frequency of incidence of kidney anomalies and collecting system dilatation in the examined population of neonates and infants with congenital heart disease accounts for 20.2%. 2. Abdominal ultrasound screening with carefully examination of urinary tract should be performed in neonates and infants with congenital heart disease.

  14. Case Report: First Reported Combined Heart-Liver Transplant in a Patient With a Congenital Solitary Kidney. (United States)

    Hanna, R M; Kamgar, M; Hasnain, H; Khorsan, R; Nsair, A; Kaldas, F; Baas, A; Bunnapradist, S; Wilson, J M


    We report a case of successful combined heart liver transplant in a patient with a congenital solitary kidney. The patient had normal renal function before combined heart-liver transplantation and developed acute kidney injury requiring slow continuous dialysis and subsequent intermittent dialysis for almost 8 weeks post transplantation. Her renal function recovered and she remains off dialysis now 7 months post transplantation. She only currently has mild chronic renal insufficiency. We believe this is the first reported case of successful heart liver transplant in a patient with a congenital solitary kidney. Published by Elsevier Inc.

  15. Iron in kidney and heart failure: from theory to practice. (United States)

    Yerlikaya, Aslihan; Bulbul, Mustafa C; Afsar, Baris; Dagel, Tuncay; Aslan, Gamze; Voroneanu, Luminita; Siriopol, Dimitire; Covic, Adrian; Kanbay, Mehmet


    There is evidence that serum iron levels, regardless of the presence of anemia, directly impact outcomes in congestive heart failure (CHF) including quality of life, hospitalization rate and overall survival. Despite modern medical treatments, the prognosis of CHF remains grim. Ironically, simple iron replenishment may serve as a powerful tool in the armamentarium. This review will start from fundamental concepts of iron in oxygen delivery and analyze evidence-based outcomes in CHF iron-directed therapeutic trials. Imaging rationale that dovetails with this pathophysiology will also be detailed in a clinician-directed fashion.

  16. Urinary apolipoprotein M as a biomarker of acute kidney injury in children undergoing heart surgery

    DEFF Research Database (Denmark)

    Svarrer, Eva Martha Madsen; Andersen, Henrik Ørbæk; Helvind, Morten


    AIM: To investigate whether apoM is excreted in urine of children undergoing heart surgery and the potential of apoM as early biomarker of acute kidney injury (AKI). MATERIALS & METHODS: Urine was collected in children undergoing heart surgery. ApoM was measured with ELISA. U-apoM was characterized.......018). Sensitivity was 0.71 and specificity was 0.68 at a cutoff level at 1.45 nmol/l. CONCLUSION: ApoM is excreted in the urine of children after cardiac surgery. Its potential as biomarker of AKI deserves exploration....

  17. Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Svensson, My; Strandhave, Charlotte; Krarup, H.B.

    to a phenotype-dependent antioxidant capacity where Hp 2-2 exhibits a low antioxidant ability, increasing the risk of cardiovascular disease. An attenuated heart rate variability (HRV) may be an important predictor of mortality in patients with chronic kidney disease (CKD). In the present study, we examined......F-PO1096 Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease My Svensson,1 Charlotte Strandhave,1 Henrik My Svensson,1 Charlotte Strandhave,1 HenrikKrarup,2 Jeppe H. Christensen.1 1Department of Nephrology, Aalborg Hospital, Aalborg, Denmark; 2......Department of Clinical Biochemistry, Aalborg Hospital, Aalborg, Denmark. Introduction Three major phenotypes for the haptoglobin (Hp) gene has been identified: Hp 1-1, Hp 2-2, and the heterozygous Hp 2-1. Hp 2-2 is associated with a poor outcome in patients with cardiovascular disease. This may be due...

  18. Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease

    DEFF Research Database (Denmark)

    Svensson, My; Strandhave, Charlotte; Krarup, H.B.


    F-PO1096 Haptoglobin Phenotype Predicts a Low Heart Rate Variability in Patients with Chronic Kidney Disease My Svensson,1 Charlotte Strandhave,1 Henrik My Svensson,1 Charlotte Strandhave,1 HenrikKrarup,2 Jeppe H. Christensen.1 1Department of Nephrology, Aalborg Hospital, Aalborg, Denmark; 2...... to a phenotype-dependent antioxidant capacity where Hp 2-2 exhibits a low antioxidant ability, increasing the risk of cardiovascular disease. An attenuated heart rate variability (HRV) may be an important predictor of mortality in patients with chronic kidney disease (CKD). In the present study, we examined......Department of Clinical Biochemistry, Aalborg Hospital, Aalborg, Denmark. Introduction Three major phenotypes for the haptoglobin (Hp) gene has been identified: Hp 1-1, Hp 2-2, and the heterozygous Hp 2-1. Hp 2-2 is associated with a poor outcome in patients with cardiovascular disease. This may be due...

  19. Finerenone : third-generation mineralocorticoid receptor antagonist for the treatment of heart failure and diabetic kidney disease

    NARCIS (Netherlands)

    Liu, Licette C. Y.; Schutte, Elise; Gansevoort, Ron T.; van der Meer, Peter; Voors, Adriaan A.

    Introduction: The mineralocorticoid receptor antagonists (MRAs) spironolactone and eplerenone reduce the risk of hospitalizations and mortality in patients with heart failure (HF) with reduced ejection fraction (HFrEF), and attenuate progression of diabetic kidney disease. However, their use is

  20. Systemic arterial hypertension: etiologic diagnosis and evaluation of the effects on the kidneys and heart through nuclear medicine

    International Nuclear Information System (INIS)

    Martins, L.R.F.; Marioni Filho, H.


    Etiological diagnosis and evaluation of the effects on the kidneys and heart in systemic arterial hypertension through the nuclear medicine are presented. Different kinds of radioisotopes are used. (L.M.J.) [pt

  1. Kidney stones may increase the risk of coronary heart disease and stroke (United States)

    Peng, Jian-Ping; Zheng, Hang


    Abstract Background: We aimed to quantitatively assess the potential relationship between kidney stones and coronary heart disease or stroke. Methods: A meta-analysis was conducted on eligibly studies published before 31 May 2016 in PubMed or Embase. The data were pooled, and the relationship was assessed by the random-effect model with inverse variance-weighted procedure. The results were expressed as relative risk (RR) with 95% confidence intervals (95%CI). Results: Eight studies of 11 cohorts (n = 11) were included in our analysis with 3,658,360 participants and 157,037 cases. We found that a history of kidney stones was associated with increased risk of coronary heart disease (CHD) (RR = 1.24; 95%CI: 1.14–1.36; I2 = 79.0%, n = 11); similar effect on myocardial infarction, a serious condition of CHD, was observed (RR = 1.24; 95%CI: 1.10–1.40; I2 = 80.4%, n = 8). We also found that a history of kidney stones may increase the risk of stroke (RR = 1.21, 95%CI: 1.06–1.38; I2 = 54.7%, n = 4). In subgroup analysis, the risk of coronary heart disease was higher in men (RR = 1.23, 95%CI: 1.02–1.49) while the risk for stroke was higher in women (RR = 1.12; 95%CI: 1.03–1.21). No obvious publications bias was detected (Egger test: P = .47). Conclusion: Kidney stones are associated with increased risk of coronary heart disease and stroke, and the effect may differ by sex. PMID:28834909

  2. Chronic kidney disease in congenital heart disease patients: a narrative review of evidence. (United States)

    Morgan, Catherine; Al-Aklabi, Mohammed; Garcia Guerra, Gonzalo


    Patients with congenital heart disease have a number of risk factors for the development of chronic kidney disease (CKD). It is well known that CKD has a large negative impact on health outcomes. It is important therefore to consider that patients with congenital heart disease represent a population in whom long-term primary and secondary prevention strategies to reduce CKD occurrence and progression could be instituted and significantly change outcomes. There are currently no clear guidelines for clinicians in terms of renal assessment in the long-term follow up of patients with congenital heart disease. Consolidation of knowledge is critical for generating such guidelines, and hence is the purpose of this view. This review will summarize current knowledge related to CKD in patients with congenital heart disease, to highlight important work that has been done to date and set the stage for further investigation, development of prevention strategies, and re-evaluation of appropriate renal follow-up in patients with congenital heart disease. The literature search was conducted using PubMed and Google Scholar. Current epidemiological evidence suggests that CKD occurs in patients with congenital heart disease at a higher frequency than the general population and is detectable early in follow-up (i.e. during childhood). Best evidence suggests that approximately 30 to 50 % of adult patients with congenital heart disease have significantly impaired renal function. The risk of CKD is higher with cyanotic congenital heart disease but it is also present with non-cyanotic congenital heart disease. Although significant knowledge gaps exist, the sum of the data suggests that patients with congenital heart disease should be followed from an early age for the development of CKD. There is an opportunity to mitigate CKD progression and negative renal outcomes by instituting interventions such as stringent blood pressure control and reduction of proteinuria. There is a need to

  3. Cystatin C in the diagnostics of acute kidney injury after heart transplantation

    Directory of Open Access Journals (Sweden)

    A. G. Strokov


    Full Text Available Aim. To examine the assumption that significant concentrations of cystatin C in urine are the manifestation of the tubular necrosis and, respectively, the severity of kidney damage after heart transplantation (HTx.Materials and methods. In this study we evaluated 33 heart recipients (6 women and 27 men, aged from 24 to 68 years old who had risk factors of acute kidney injury: serum creatinine level >113 μmol/l and/or mechanical circulatory support requirement (20 patients, in 14 cases before HTx. Cystatin C concentration in serum and in urine was measured by DyaSis particle-enhanced immunoturbidimetric assay test «Cystatin C FS».Results. Recipients were divided into two groups according to the levels of cystatinuria. In the group with the significant (more than 0.18 mg/l urinary cystatin C concentrations the requirement of renal replacement therapy (RRT was 2.5-fold higher, and the mean duration of RRT was more than 10-fold longer. In 2 patients with the significant cystatinuria acute kidney injury (AKI has transformed into end-stage renal disease (ESRD.Conclusion. Due to data obtained we may suppose that significant concentrations of cystatin C in urine are the marker of the tubular necrosis with the prolonged RRT requirement. Further studies are needed to justify this relationship.

  4. A novel protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery under cardiopulmonary bypass. (United States)

    Odaka, Mizuho; Minakata, Kenji; Toyokuni, Hideaki; Yamazaki, Kazuhiro; Yonezawa, Atsushi; Sakata, Ryuzo; Matsubara, Kazuo


    This study aimed to develop and assess the effectiveness of a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. We established a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. This novel protocol was assessed by comparing patients undergoing open heart surgery before (control group; n = 30) and after its implementation (protocol group; n = 31) at Kyoto University Hospital between July 2012 and January 2013. Surgical site infections (SSIs) were observed in 4 control group patients (13.3 %), whereas no SSIs were observed in the protocol group patients (P protocol group (P protocol significantly decreased the total antibiotic dose used in the perioperative period (P protocol group patients required this additional change in the antibiotic regimen (P protocol based on preoperative kidney function effectively prevents SSIs in patients undergoing open heart surgery.

  5. Iron therapy in heart failure patients without anaemia: possible implications for chronic kidney disease patients. (United States)

    Malyszko, Jolanta; Anker, Stefan D


    Iron deficiency anaemia is a global health problem that manifests as fatigue and poor physical endurance. Anaemia can be caused by dietary iron deficiency, blood loss or a combination of poor iron absorption and ineffective iron mobilization in patients with chronic disease. Nephrologists caring for patients with impaired renal function understand that iron treatment is necessary to provide adequate iron for erythropoiesis during the treatment of overt anaemia. However, a less well-understood health problem is iron deficiency, which creates symptoms that overlap with those of anaemia and often occurs in concert with chronic disease. Recently, several randomized controlled clinical trials have been conducted to investigate the effects of treatment with intravenous iron in heart failure patients with iron deficiency who may or may not also have anaemia. Given that heart and kidney disease are often comorbid, these clinical trials may have implications for the way nephrologists view their patients with iron deficiency. In this article, we review several clinical studies of intravenous iron therapy for patients with iron deficiency and heart failure and discuss possible implications for the treatment of patients with kidney disease.

  6. Markers of kidney disease and risk of subclinical and clinical heart failure in African Americans: the Jackson Heart Study. (United States)

    Bansal, Nisha; Katz, Ronit; Himmelfarb, Jonathan; Afkarian, Maryam; Kestenbaum, Bryan; de Boer, Ian H; Young, Bessie


    African Americans and patients with chronic kidney disease (CKD) are at high risk for clinical heart failure (HF). In this study, we aimed to determine the association of markers of kidney disease with subclinical HF (by echocardiogram) and risk of clinical HF among a large, well-characterized community-based cohort of African American patients. We also examined whether the association of markers of kidney disease with HF was attenuated with adjustment for echocardiographic measures. We studied participants in the Jackson Heart Study, a large community-based cohort of African Americans. Estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (ACR) were measured at baseline. We tested the association of eGFR and urine ACR with left ventricular mass (LVM), left ventricular ejection fraction (LVEF) and physician-adjudicated incident HF. Among the 3332 participants in the study, 166 (5%) had eGFR <60 mL/min/1.73 m 2 and 405 (12%) had urine ACR ≥30 mg/g. In models adjusted for demographics, comorbidity and the alternative measure of kidney disease, lower eGFR and higher urine ACR were associated with higher LVM {β-coefficient 1.54 [95% confidence interval (CI) 0.78-2.31] per 10 mL/min/1.73 m 2 decrease in eGFR and 2.87 (95% CI 1.85-3.88) per doubling of urine ACR}. There was no association of eGFR and urine ACR with LVEF [β-coefficient -0.12 (95% CI -0.28-0.04) and -0.11 (95% CI -0.35-0.12), respectively]. There was no association of eGFR with the risk of incident HF [HR 1.02 (95% CI 0.91-1.14) per 10 mL/min/1.73 m 2 decrease], while there was a significant association of urine ACR [HR 2.22 (95% CI 1.29-3.84) per doubling of urine ACR]. This association was only modestly attenuated with adjustment for LVM [HR 1.95 (95% CI 1.09-3.49)]. Among a community-based cohort of African Americans, lower eGFR and higher ACR were associated with higher LVM. Furthermore, higher urine ACR was associated with incident HF, which was not entirely explained by

  7. Echocardiographic parameters of the heart with chronic kidney disease in children and adolescents

    Directory of Open Access Journals (Sweden)

    T. P. Makarova


    Full Text Available Chronic kidney disease (CKD in children is 1/3 of the nephrologic pathology, with the level of its morbidity increasing. CKD is an important factor affecting the development of cardiovascular events. Research objective was to study the structural and morphological parameters of the cardiac muscle in chronic kidney disease in children and adolescents, depending on the stage of CKD, according to the echocardiographic study. 83 patients with different stages of CKD were examined. There were statistically significant differences in the majority of echocardiography indicators depending on the stage of CKD. The study of structural and morphological parameters of the heart with the help of echocardiography makes it possible to detect changes in the cardiac muscle in patients already at the first stage of CKD. A significant increase in the volume of the heart cavities, the thickness of the walls and left ventricular myocardial mass in patients was detected in the terminal stage of CKD.

  8. Adenovirus disease in six small bowel, kidney and heart transplant recipients; pathology and clinical outcome. (United States)

    Mehta, Vikas; Chou, Pauline C; Picken, Maria M


    Adenoviruses are emerging as important viral pathogens in hematopoietic stem cell and solid organ transplant recipients, impacting morbidity, graft survival, and even mortality. The risk seems to be highest in allogeneic hematopoietic stem cell transplant recipients as well as heart, lung, and small bowel transplant recipients. Most of the adenovirus diseases develop in the first 6 months after transplantation, particularly in pediatric patients. Among abdominal organ recipients, small bowel grafts are most frequently affected, presumably due to the presence of a virus reservoir in the mucosa-associated lymphoid tissue. Management of these infections may be difficult and includes the reduction of immunosuppression, whenever possible, combined with antiviral therapy, if necessary. Therefore, an awareness of the pathology associated with such infections is important in order to allow early detection and specific treatment. We reviewed six transplant recipients (small bowel, kidney, and heart) with adenovirus graft involvement from two institutions. We sought to compare the diagnostic morphology and the clinical and laboratory findings. The histopathologic features of an adenovirus infection of the renal graft and one native kidney in a heart transplant recipient included a vaguely granulomatous mixed inflammatory infiltrate associated with rare cells showing a cytopathic effect (smudgy nuclei). A lymphocytic infiltrate, simulating T cell rejection, with admixture of eosinophils was also seen. In the small bowel grafts, there was a focal mixed inflammatory infiltrate with associated necrosis in addition to cytopathic effects. In the heart, allograft adenovirus infection was silent with no evidence of inflammatory changes. Immunohistochemical stain for adenovirus was positive in all grafts and in one native kidney. All patients were subsequently cleared of adenovirus infection, as evidenced by follow-up biopsies, with no loss of the grafts. Adenovirus infection can

  9. The anabolic androgenic steroid nandrolone decanoate disrupts redox homeostasis in liver, heart and kidney of male Wistar rats.

    Directory of Open Access Journals (Sweden)

    Stephan P Frankenfeld

    Full Text Available The abuse of anabolic androgenic steroids (AAS may cause side effects in several tissues. Oxidative stress is linked to the pathophysiology of most of these alterations, being involved in fibrosis, cellular proliferation, tumorigenesis, amongst others. Thus, the aim of this study was to determine the impact of supraphysiological doses of nandrolone decanoate (DECA on the redox balance of liver, heart and kidney. Wistar male rats were treated with intramuscular injections of vehicle or DECA (1 mg.100 g(-1 body weight once a week for 8 weeks. The activity and mRNA levels of NADPH Oxidase (NOX, and the activity of catalase, glutathione peroxidase (GPx and total superoxide dismutase (SOD, as well as the reduced thiol and carbonyl residue proteins, were measured in liver, heart and kidney. DECA treatment increased NOX activity in heart and liver, but NOX2 mRNA levels were only increased in heart. Liver catalase and SOD activities were decreased in the DECA-treated group, but only catalase activity was decreased in the kidney. No differences were detected in GPx activity. Thiol residues were decreased in the liver and kidney of treated animals in comparison to the control group, while carbonyl residues were increased in the kidney after the treatment. Taken together, our results show that chronically administered DECA is able to disrupt the cellular redox balance, leading to an oxidative stress state.

  10. Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study. (United States)

    Grubbs, Vanessa; Vittinghoff, Eric; Beck, James D; Kshirsagar, Abhijit V; Wang, Wei; Griswold, Michael E; Powe, Neil R; Correa, Adolfo; Young, Bessie


    Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. The authors seek to examine to what extent periodontal disease is associated with kidney function decline. This retrospective cohort study examines 699 African American participants with preserved kidney function (defined by estimated glomerular filtration rate (eGFR) >60 mL/minute/1.73 m(2) at baseline) who underwent complete dental examinations as part of the Dental-Atherosclerosis Risk in Communities study (1996 to 1998) and subsequently enrolled in the Jackson Heart Study (2000 to 2004). Using multivariable Poisson regression, the authors examined the association of periodontal disease (severe versus non-severe) with incident CKD, defined as incident eGFR periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow-up of 4.8 (± 0.6) years. Compared with participants with non-severe periodontal disease, those with severe periodontal disease had a four-fold greater rate of incident CKD (adjusted incidence rate ratio 4.18 [95% confidence interval 1.68 to 10.39], P = 0.002). Severe periodontal disease is prevalent among a population at high risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION Spleen is organ of lymphatic system located on left side of abdominal cavity under diaphragm. It is a secondary lymphatic organ that plays an important role in cell mediated immunity. Foetal spleen is erythropoietic in nature. MATERIAL & METHODS Present study was done in 50 adult spleens and 50 foetal spleens. RESULTS Morphometric features like length, breadth, thickness & weight are measured. Length varied from 6.3 to 12.5 cm, breadth varied from 2.6 to 8.6 cm, thickness ranged from 2 cm to 4.6 cm, weight ranged from 65 g to 225 g. Average total length of spleen is 2.52 cm x 1.76 x 2 cm, weight 6.5 g. Shapes of spleens observed wedge shape spleen–48%, tetrahedral spleen–24%, triangular spleen-28%. Splenic notches on superior border & inferior border are observed. Incident of accessory spleen in 1% of cases. CONCLUSIONS Present knowledge of study may be helpful for surgeons in surgical procedures like splenectomy, resection of tumours and extirpation of cysts

  12. Outcome in acute heart failure: prognostic value of acute kidney injury and worsening renal function. (United States)

    Berra, Gregory; Garin, Nicolas; Stirnemann, Jérôme; Jannot, Anne-Sophie; Martin, Pierre-Yves; Perrier, Arnaud; Carballo, Sebastian


    The prognostic value of worsening renal function (WRF) in acute heart failure is debated. Moreover, it is not clear if the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in this context is detrimental. In a retrospective cohort study of 646 patients hospitalized for acute heart failure, the risk of death or readmission associated with acute kidney injury (AKI) present at admission, WRF during the 1st 7 days, and up-titration of ACEI/ARB were analyzed in a Cox proportional hazards model. AKI, WRF, hemoglobin concentration, ACEI/ARB up-titration, and use of loop diuretics before admission were significantly associated with the primary outcome in univariate analysis. In a multivariate model, the association remained significant for AKI (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.13-1.47; P = .0002), WRF (HR 1.24, 95% CI 1.06-1.45; P = .0059), and ACEI/ARB up-titration (HR 0.79, 95% CI 0.64-0.97; P = .026). There was no excess mortality in patients with ACEI/ARB up-titration despite WRF. Both AKI and WRF are strongly associated with poor outcome in patients hospitalized for acute heart failure. ACEI/ARB up-titration seems to be protective. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Acute kidney injury after heart transplant in young children: risk factors and outcomes. (United States)

    MacDonald, Christine; Norris, Colleen; Alton, Gwen Y; Urschel, Simon; Joffe, Ari R; Morgan, Catherine J


    Critical illness following heart transplantation can include acute kidney injury (AKI). Study objectives were to define the epidemiology of, risk factors for, or impact on outcomes of AKI after pediatric heart transplant. Using data from a prospective study of 66 young children, we evaluated: (1) post-operative AKI rate (by pediatric modified RIFLE criteria); (2) pre, intra, and early post-operative AKI risk factors using stepwise logistic regression (3) effect of AKI on short-term outcomes (ventilation and length of pediatric intensive care unit (PICU) stay) using stepwise multiple regression. AKI occurred in 73 % of children. Pre-transplant ventilation and higher baseline estimated creatinine clearance (eCCl) were independent risk factors for AKI. Pre-operative inotrope use was associated with reduced risk of AKI. Tacrolimus level emerged as important in multivariable risk prediction. Children with AKI had a longer duration of ventilation and length of pediatric intensive care unit (PICU) stay, with AKI being an independent predictor. AKI was common after heart transplant and associated with more complicated early post-transplant course. Lower baseline eCCl was associated with lower incidence of AKI; this merits further investigation. The association of pre-operative inotropes with less AKI may reflect a pathophysiological mechanism or be a surrogate for clinical factors and management prior to transplant. Avoiding high tacrolimus levels may be a modifiable risk factor for AKI.

  14. Heart block and acute kidney injury due to hyperparathyroidism-induced hypercalcemic crisis. (United States)

    Brown, Taylor C; Healy, James M; McDonald, Mary J; Hansson, Joni H; Quinn, Courtney E


    We describe a patient who presented with multi-system organ failure due to extreme hypercalcemia (serum calcium 19.8 mg/dL), resulting from primary hyperparathyroidism. He was found to have a 4.8 cm solitary atypical parathyroid adenoma. His course was complicated by complete heart block, acute kidney injury, and significant neurocognitive disturbances. Relevant literature was reviewed and discussed. Hyperparathyroidism-induced hypercalcemic crisis (HIHC) is a rare presentation of primary hyperparathyroidism and only a small minority of these patients develop significant cardiac and renal complications. In cases of HIHC, a multidisciplinary effort can facilitate rapid treatment of life-threatening hypercalcemia and definitive treatment by surgical resection. As such, temporary transvenous cardiac pacing and renal replacement therapy can provide a life-saving bridge to definitive parathyroidectomy in cases of HIHC.

  15. Heart failure in a cohort of patients with chronic kidney disease: the GCKD study.

    Directory of Open Access Journals (Sweden)

    Hanna Beck

    Full Text Available Chronic kidney disease (CKD is a risk factor for development and progression of heart failure (HF. CKD and HF share common risk factors, but few data exist on the prevalence, signs and symptoms as well as correlates of HF in populations with CKD of moderate severity. We therefore aimed to examine the prevalence and correlates of HF in the German Chronic Kidney Disease (GCKD study, a large observational prospective study.We analyzed data from 5,015 GCKD patients aged 18-74 years with an estimated glomerular filtration rate (eGFR of 500 mg/d. We evaluated a definition of HF based on the Gothenburg score, a clinical HF score used in epidemiological studies (Gothenburg HF, and self-reported HF. Factors associated with HF were identified using multivariable adjusted logistic regression. The prevalence of Gothenburg HF was 43% (ranging from 24% in those with eGFR >90 to 59% in those with eGFR<30 ml/min/1.73m2. The corresponding estimate for self-reported HF was 18% (range 5%-24%. Lower eGFR was significantly and independently associated with the Gothenburg definition of HF (p-trend <0.001. Additional significantly associated correlates included older age, female gender, higher BMI, hypertension, diabetes mellitus, valvular heart disease, anemia, sleep apnea, and lower educational status.The burden of self-reported and Gothenburg HF among patients with CKD is high. The proportion of patients who meet the criteria for Gothenburg HF in a European cohort of patients with moderate CKD is more than twice as high as the prevalence of self-reported HF. However, because of the shared signs, symptoms and medications of HF and CKD, the Gothenburg score cannot be used to reliably define HF in CKD patients. Our results emphasize the need for early screening for HF in patients with CKD.

  16. Angiotensin II induced inflammation in the kidney and in the heart of double transgenic rats

    Directory of Open Access Journals (Sweden)

    Haller Hermann


    Full Text Available Abstract Background We are investigating a double transgenic rat (dTGR model, in which rats transgenic for the human angiotensinogen and renin genes are crossed. These rats develop moderately severe hypertension but die of end-organ cardiac and renal damage by week 7. The heart shows necrosis and fibrosis, whereas the kidneys resemble the hemolytic-uremic syndrome vasculopathy. Surface adhesion molecules (ICAM-1 and VCAM-1 are expressed early on the endothelium, while the corresponding ligands are found on circulating leukocytes. Leukocyte infiltration in the vascular wall accompanies PAI-1, MCP-1, iNOS and Tissue Factor expression. Furthermore we show evidence that Ang II causes the upregulation of NF-kB in our model. Methods We started PDTC-treatment on four weeks old dTGR (200 mg/kg sc and age-matched SD rats.. Blood-pressure- and albuminuria- measurements were monitored during the treatement period (four weeks. The seven weeks old animals were killed, hearts and kidneys were isolated and used for immunohistochemical-and electromobility shift assay analsis. Results Chronic treatment with the antioxidant PDTC decreased blood pressure (162 ± 8 vs. 190 ± 7 mm Hg, p = 0.02. Cardiac hypertrophy index was significantly reduced (4.90 ± 0.1 vs. 5.77 ± 0.1 mg/g, p Conclusion Our data show that inhibition of NF-κB by PDTC markedly reduces inflammation, iNOS expression in the dTGR most likely leading to decreased cytotoxicity, and cell proliferation. Thus, NF-κB activation plays an important role in ANG II-induced end-organ damage.

  17. Arteriosclerotic changes in the myocardium, lung, and kidney in dogs with chronic congestive heart failure and myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier


    Background: The occurrence of small vessel arteriosclerosis in the myocardium, kidney, and lung in dogs with naturally occurring myxomatous mitral valve disease has not been previously investigated systematically. Methods: Twenty-one dogs with naturally occurring congestive heart failure and 21 age...... and pulmonary artery. Results: Dogs with congestive heart failure had significantly more arterial narrowing in the left ventricle (Pdogs. However......, they did not have more plaque formation or intimal-medial thickening in the aorta than controls. There was significantly more arterial narrowing in papillary muscles than in all other locations in dogs with congestive heart failure (Pdogs, arterial changes were less pronounced and did...

  18. Laparoscopic Spleen Removal (Splenectomy) (United States)

    ... Affairs and Humanitarian Efforts Login Laparoscopic Spleen Removal (Splenectomy) Patient Information from SAGES Download PDF Find a ... are suspected. What are the Advantages of Laparoscopic Splenectomy? Individual results may vary depending on your overall ...

  19. Heart Failure in Patients with Chronic Kidney Disease: A Systematic Integrative Review

    Directory of Open Access Journals (Sweden)

    Liviu Segall


    Full Text Available Introduction. Heart failure (HF is highly prevalent in patients with chronic kidney disease (CKD and end-stage renal disease (ESRD and is strongly associated with mortality in these patients. However, the treatment of HF in this population is largely unclear. Study Design. We conducted a systematic integrative review of the literature to assess the current evidence of HF treatment in CKD patients, searching electronic databases in April 2014. Synthesis used narrative methods. Setting and Population. We focused on adults with a primary diagnosis of CKD and HF. Selection Criteria for Studies. We included studies of any design, quantitative or qualitative. Interventions. HF treatment was defined as any formal means taken to improve the symptoms of HF and/or the heart structure and function abnormalities. Outcomes. Measures of all kinds were considered of interest. Results. Of 1,439 results returned by database searches, 79 articles met inclusion criteria. A further 23 relevant articles were identified by hand searching. Conclusions. Control of fluid overload, the use of beta-blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and optimization of dialysis appear to be the most important methods to treat HF in CKD and ESRD patients. Aldosterone antagonists and digitalis glycosides may additionally be considered; however, their use is associated with significant risks. The role of anemia correction, control of CKD-mineral and bone disorder, and cardiac resynchronization therapy are also discussed.

  20. Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study. (United States)

    He, Jiang; Shlipak, Michael; Anderson, Amanda; Roy, Jason A; Feldman, Harold I; Kallem, Radhakrishna Reddy; Kanthety, Radhika; Kusek, John W; Ojo, Akinlolu; Rahman, Mahboob; Ricardo, Ana C; Soliman, Elsayed Z; Wolf, Myles; Zhang, Xiaoming; Raj, Dominic; Hamm, Lee


    Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study. Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24-hour urine albumin excretion. During an average of 6.3 years of follow-up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine-based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin C-based-eGFR was 2.43 (2.10, 2.80), and 1 SD higher log-albuminuria was 1.65 (1.53, 1.78), all P kidney function measures were simultaneously included in the model, lower cystatin C-based eGFR and higher log-albuminuria remained significantly and directly associated with incidence of heart failure. After adjusting for eGFR, albuminuria, and other traditional cardiovascular risk factors, anemia (1.37, 95% CI 1.09, 1.72, P =0.006), insulin resistance (1.16, 95% CI 1.04, 1.28, P =0.006), hemoglobin A1c (1.27, 95% CI 1.14, 1.41, P chronic kidney disease. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  1. Kidney Function, Proteinuria, and Cancer Incidence: The Korean Heart Study. (United States)

    Mok, Yejin; Matsushita, Kunihiro; Ballew, Shoshana H; Sang, Yingying; Jung, Keum Ji; Lee, Sunmi; Jee, Sun Ha; Coresh, Josef


    Reported associations of estimated glomerular filtration rate (eGFR) with cancer risk are inconsistent, and data for the proteinuria-cancer relationship are sparse. We sought to quantify the associations of cancer incidence with eGFR and with proteinuria in a large population-based cohort. A prospective cohort study. 242,583 adults (30-74 years old) without a diagnosis of cancer at baseline in the Korean Heart Study, based on health checkups in 1996 to 2004 with follow-up until 2012. Creatinine-based eGFR (≥90, 60-89, 45-59, and cancer incidence based on ICD-10 codes. 15,165 cases of cancer were detected. The relationship between eGFR and incidence of any cancer was J shaped, with the lowest risk at 45 to 59mL/min/1.73m 2 . There was 44% higher risk for any cancer among those with eGFRscancer risk, showing a dose-response relationship (HRs of 1.24 [95% CI, 1.13-1.35], 1.38 [95% CI, 1.17-1.63], and 1.66 [95% CI, 1.30-2.12] for 1+, 2+, and ≥3+ vs undetectable/trace). Examining site-specific cancer, eGFRkidney and ureteral cancer, multiple myeloma, and leukemia, whereas proteinuria ≥ 1+ (vs undetectable/trace) was related to a broader set of cancers (ie, stomach, rectal, liver, lung, ovarian, kidney, bladder, and multiple myeloma). After excluding study participants with follow-up less than 3 years, the associations remained consistent for kidney cancer and myeloma with eGFR and for rectal, liver, lung, and ovarian cancer with proteinuria. Relatively small number of participants with severely reduced eGFR or 70 years or older. Kidney measures, particularly proteinuria, were associated with increased incidence of cancer. Future studies are needed to better understand the pathophysiologic mechanisms underlying these associations. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. Detection of dwarf gourami iridovirus (Infectious spleen and kidney necrosis virus) in populations of ornamental fish prior to and after importation into Australia, with the first evidence of infection in domestically farmed Platy (Xiphophorus maculatus). (United States)

    Rimmer, Anneke E; Becker, Joy A; Tweedie, Alison; Lintermans, Mark; Landos, Matthew; Stephens, Fran; Whittington, Richard J


    The movement of ornamental fish through international trade is a major factor for the transboundary spread of pathogens. In Australia, ornamental fish which may carry dwarf gourami iridovirus (DGIV), a strain of Infectious spleen and kidney necrosis virus (ISKNV), have been identified as a biosecurity risk despite relatively stringent import quarantine measures being applied. In order to gain knowledge of the potential for DGIV to enter Australia, imported ornamental fish were sampled prior to entering quarantine, during quarantine, and post quarantine from wholesalers and aquatic retail outlets in Australia. Samples were tested by quantitative polymerase chain reaction (qPCR) for the presence of megalocytivirus. Farmed and wild ornamental fish were also tested. Megalocytivirus was detected in ten of fourteen species or varieties of ornamental fish. Out of the 2086 imported gourami tested prior to entering quarantine, megalocytivirus was detected in 18.7% of fish and out of the 51 moribund/dead ornamental fish tested during the quarantine period, 68.6% were positive for megalocytivirus. Of fish from Australian wholesalers and aquatic retail outlets 14.5% and 21.9%, respectively, were positive. Out of 365 farmed ornamental fish, ISKNV-like megalocytivirus was detected in 1.1%; these were Platy (Xiphophorus maculatus). Megalocytivirus was not detected in free-living breeding populations of Blue gourami (Trichopodus trichopterus) caught in Queensland. This study showed that imported ornamental fish are vectors for DGIV and it was used to support an import risk analysis completed by the Australian Department of Agriculture. Subsequently, the national biosecurity policy was revised and from 1 March 2016, a health certification is required for susceptible families of fish to be free of this virus prior to importation. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  3. Associations of N-terminal pro-B-type natriuretic peptide with kidney function decline in persons without clinical heart failure in the Heart and Soul Study. (United States)

    Park, Meyeon; Vittinghoff, Eric; Shlipak, Michael G; Mishra, Rakesh; Whooley, Mary; Bansal, Nisha


    Subclinical volume overload in the absence of diagnosed heart failure (HF) may be an underrecognized contributor to kidney function decline in coronary artery disease (CAD) patients. We evaluated associations of circulating N-terminal pro-B-type natriuretic peptide (NT-proBNP), a marker of ventricular stretch, with change in estimated glomerular filtration rate (eGFR). We evaluated 535 patients with stable CAD and no history of HF, who were enrolled in the Heart and Soul Study and followed for 5 years. N-terminal pro-B-type natriuretic peptide was measured at baseline. We evaluated the associations of NT-proBNP with change in kidney function over 5 years: (a) annual percent change in eGFR, (b) rapid kidney function loss (> 3% per year for 5 years), and (c) incident eGFR 280.9 pg/mL) had a greater odds of rapid kidney function loss after full adjustment (odds ratio 2.95; 95% CI 1-8.65; P = .0492). Associations with incident eGFR < 60 mL/min per 1.73 m2 were also significant (adjusted odds ratio 4.23; 95% CI 1.05-16.98; P = .0422). Results were similar when analyzed using BNP as the predictor. N-terminal pro-B-type natriuretic peptide and BNP are strongly and independently associated with accelerated kidney function loss, even in the absence of clinical HF. These findings suggest that subclinical cardiovascular dysfunction may contribute to elevated kidney disease risk in persons with CAD. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Examining the Protective Role of Caraway Hydroalcoholic Extract in Heart and Kidney Tissue Injury in CLP Rat Model

    Directory of Open Access Journals (Sweden)

    A Dadkhah


    Full Text Available

    Background and Objectives: Sepsis is a systemic response to infection leading to organdeath.With regard to the side effects of synthetic drugs, nowadays using medicinal plants in treatment of sepsis must not be ignored. In this study, the protective role of caraway hydroalcoholic extractin heart and kidney injuries in experimental inflammation model induced by cecal ligation and puncture (CLP was examined.


    Methods: For the purpose of this study, the rats were divided into five groups i.e: Sham-operated (SOP; CLP; CLP+hydroalcoholic extract (50&100 mg/kg and CLP+Indomethacin (10mg/kg as positive control. The extract and indomethacin were injected i.p immediately after sepsis induction. 24 hours after CLP, the rats were sacrificed and their hearts, kidneys and plasma were removed and analyzed. The differences between the results were assessed by one-way ANOVA test followed byTukey’s HSD.


    Results: The results of this study showed that lipid peroxidation (LP in kidney and alsoplasmaurea/creatinine ratio were increased in CLP rats. In contrast, the glutathione (GSH level of kidney was not changed indicating the partial damage of kidney tissue due to sepsis. Unlike indomethacine, treatment of rats with both doses of caraway hydroalcoholic extract did not modulate these parameters.


    Conclusion: It can be concluded that treatment of septic rats by caraway hydroalcoholic extract immediately after sepsis induction via i.p route cannot modulate parameters related to kidney damages.So, this extract is not able to protect the kidney tissue against oxidative injuries induced by sepsis.


  5. Prevalence and Outcomes of Left-Sided Valvular Heart Disease Associated With Chronic Kidney Disease. (United States)

    Samad, Zainab; Sivak, Joseph A; Phelan, Matthew; Schulte, Phillip J; Patel, Uptal; Velazquez, Eric J


    Chronic kidney disease (CKD) is an adverse prognostic marker for valve intervention patients; however, the prevalence and related outcomes of valvular heart disease in CKD patients is unknown. Included patients underwent echocardiography (1999-2013), had serum creatinine values within 6 months before index echocardiogram, and had no history of valve surgery. CKD was defined as diagnosis based on the International Classification of Diseases, Ninth Revision or an estimated glomerular filtration rate <60 mL/min per 1.73 m 2 . Qualitative assessment determined left heart stenotic and regurgitant valve lesions. Cox models assessed CKD and aortic stenosis (AS) interaction for subsequent mortality; analyses were repeated for mitral regurgitation (MR). Among 78 059 patients, 23 727 (30%) had CKD; of these, 1326 were on hemodialysis. CKD patients were older; female; had a higher prevalence of hypertension, hyperlipidemia, diabetes, history of coronary artery bypass grafting/percutaneous coronary intervention, atrial fibrillation, and heart failure ≥mild AS; and ≥mild MR (all P <0.001). Five-year survival estimates of mild, moderate, and severe AS for CKD patients were 40%, 34%, and 42%, respectively, and 69%, 54%, and 67% for non-CKD patients. Five-year survival estimates of mild, moderate, and severe MR for CKD patients were 51%, 38%, and 37%, respectively, and 75%, 66%, and 65% for non-CKD patients. Significant interaction occurred among CKD, AS/MR severity, and mortality in adjusted analyses; the CKD hazard ratio increased from 1.8 (non-AS patients) to 2.0 (severe AS) and from 1.7 (non-MR patients) to 2.6 (severe MR). Prevalence of at least mild AS and MR is substantially higher and is associated with significantly lower survival among patients with versus without CKD. There is significant interaction among CKD, AS/MR severity, and mortality, with increasingly worse outcomes for CKD patients with increasing AS/MR severity. © 2017 The Authors. Published on

  6. Glibenclamide improves kidney and heart structure and function in the adenine-diet model of chronic kidney disease. (United States)

    Diwan, Vishal; Gobe, Glenda; Brown, Lindsay


    The development of chronic kidney disease (CKD) and associated cardiovascular disease involves free radical damage and inflammation. Addition of adenine to the diet induces inflammation followed by CKD and cardiovascular disease. NOD-like receptor protein-3 (NLRP-3) is pro-inflammatory in the kidney; glibenclamide inhibits production of NLRP-3. Male Wistar rats were fed either control rat food or adenine (0.25%) in this food for 16 weeks. Glibenclamide (10 mg/kg/day) was administered to two groups with and without adenine for the final 8 weeks. Kidney function (blood urea nitrogen/BUN, plasma creatinine/PCr, plasma uric acid, proteinuria), kidney structure (fibrosis, inflammation), cardiovascular parameters (blood pressure, left ventricular stiffness, vascular responses and echocardiography) and protein expression of markers for oxidative stress (HO-1), and inflammation (TNF-α, NLRP-3) were assessed. In adenine-fed rats, glibenclamide decreased BUN (controls: 6±0.6; adenine: 56.6±5.4; adenine+glibenclamide: 19.4±2.7 mmol/L), PCr (controls: 42±2.8; adenine: 268±23; adenine+glibenclamide: 81±10 μmol/L), proteinuria (controls: 150±7.4; adenine: 303±19; adenine+glibenclamide: 220±13 μmol/L) (all pchronic inflammatory cells, fibrosis, tubular damage and expression of HO-1, TNF-α and NLRP-3 in the kidney. Glibenclamide did not alter plasma uric acid concentrations (controls: 38±1; adenine: 63±4; adenine+glibenclamide: 69±14 μmol/L). Cardiovascular changes included decreased systolic blood pressure and improved vascular responses although cardiac fibrosis, left ventricular stiffness and hypertrophy were not reduced. Glibenclamide improved kidney structure and function in CKD and decreased some cardiovascular parameters. Inflammatory markers and cell populations were attenuated by glibenclamide in kidneys. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Heart Failure Increases the Risk of Adverse Renal Outcomes in Patients With Normal Kidney Function. (United States)

    George, Lekha K; Koshy, Santhosh K G; Molnar, Miklos Z; Thomas, Fridtjof; Lu, Jun L; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P


    Heart failure (HF) is associated with poor cardiac outcomes and mortality. It is not known whether HF leads to poor renal outcomes in patients with normal kidney function. We hypothesized that HF is associated with worse long-term renal outcomes. Among 3 570 865 US veterans with estimated glomerular filtration rate (eGFR) ≥60 mL min -1 1.73 m -2 during October 1, 2004 to September 30, 2006, we identified 156 743 with an International Classification of Diseases , Ninth Revision , diagnosis of HF. We examined the association of HF with incident chronic kidney disease (CKD), the composite of incident CKD or mortality, and rapid rate of eGFR decline (slopes steeper than -5 mL min -1 1.73 m -2 y -1 ) using Cox proportional hazard analyses and logistic regression. Adjustments were made for various confounders. The mean±standard deviation baseline age and eGFR of HF patients were 68±11 years and 78±14 mL min -1 1.73 m -2 and in patients without HF were 59±14 years and 84±16 mL min -1 1.73 m -2 , respectively. HF patients had higher prevalence of hypertension, diabetes mellitus, cardiac, peripheral vascular and chronic lung diseases, stroke, and dementia. Incidence of CKD was 69.0/1000 patient-years in HF patients versus 14.5/1000 patient-years in patients without HF, and 22% of patients with HF had rapid decline in eGFR compared with 8.5% in patients without HF. HF patients had a 2.12-, 2.06-, and 2.13-fold higher multivariable-adjusted risk of incident CKD, composite of CKD or mortality, and rapid eGFR decline, respectively. HF is associated with significantly higher risk of incident CKD, incident CKD or mortality, and rapid eGFR decline. Early diagnosis and management of HF could help reduce the risk of long-term renal complications. © 2017 American Heart Association, Inc.

  8. Liver and spleen scintigraphy

    International Nuclear Information System (INIS)

    Devries, D.F.


    Since the introduction of liver and spleen scintigraphy in the early 1950s, it has undergone considerable changes, the most notable being technetium 99m sulfur colloid, the gamma camera, and single photon emission computed tomography (SPECT). What is the role f liver-spleen scintigraphy in this high-technology society? This chapter attempts to address this question by looking at the radiopharmaceuticals, the technique, and most importantly, the application of scintigraphy to the diagnosis of focal and diffuse hepatic and splenic disease

  9. Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database. (United States)

    Karamlou, Tara; Welke, Karl F; McMullan, D Michael; Cohen, Gordon A; Gelow, Jill; Tibayan, Frederick A; Mudd, James M; Slater, Matthew S; Song, Howard K


    Criteria for simultaneous heart-kidney transplant (HKTx) recipients are unclear. We characterized the evolution of combined HKTx in the United States over time compared with isolated heart transplantation (HTx) and determined factors maximizing post-transplant survival. We focused on whether a threshold estimated glomerular filtration rate (eGFR) could be identified that justified combined transplantation. A supplemented United Network Organ Sharing Dataset identified HTx and HKTx recipients from 2000 to 2010. eGFR was calculated for HTx and recipients were grouped into eGFR quintiles. Time-related mortality was compared among recipients, with multivariable factors sought using Cox proportional hazard regression models. We identified 26,183 HTx recipients, of whom 593 were HKTx recipients. HTx increased modestly over time (3.6%), whereas prevalence of HKTx increased dramatically (147%). Risk-unadjusted survival was similar among HTx recipients (8.4 ± 0.04 years) and HKTx recipients (7.7 ± 0.2 years) (P = .76). Isolated HTx recipients in the lowest eGFR quintile had decreased survival (P transplant survival in patients with eGFR <37 mL/minute and can be recommended in this subgroup. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. Effects of Hyperglycemia and Iron Deficiency on Kidney and Heart Function in Type 2 Diabetes Disease

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    Belma Aščić-Buturović


    Full Text Available Untreated anemia can caused significant cardiac and kidney damage. The aim of this study was to investigate the efficiency of anemia and hyperglycemia treatment in type 2 diabetes and their impact on kidney and heart impairment. The study is clinical retrospective and prospective and it was conducted in Clinic of Endocrinology, Diabetes Mellitus and Metabolic Diseases, University Clinical Center of Sarajevo. Prior to the study all patients were taking oral hypoglycemic drugs included sulfonylureas and biguanides. These subjects were put on 2 times daily fix mix insulin and biguanides after lunch. Each day, subjects received Iron tab 1 x 100 mg/ day, and C vitamin 1 x 100 mg/day. The results of our study are showing that effective treatment of glycaemia and anemia in patients with diabetes, reduces blood pressure, urine albumin secretion and pulse rate, diminishing cardiovascular damage and improving kidney function.

  11. Oxidative stress is associated with decreased heart rate variability in patients with chronic kidney disease. (United States)

    Fadaee, Shannon B; Beetham, Kassia S; Howden, Erin J; Stanton, Tony; Isbel, Nicole M; Coombes, Jeff S


    Elevated oxidative stress and reduced heart rate variability (HRV) is prevalent in patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. Previous studies have identified a positive association between elevated oxidative stress and autonomic dysfunction, however this relationship has not yet been investigated in the CKD population. Plasma was collected from 78 patients with stage 3-4 CKD (estimated glomerular filtration rate 25-60 ml/min/1.73 m 2 ) for the assessment of oxidative stress, including plasma total F2-isoprostanes, glutathione peroxidase activity and total antioxidant capacity. Time and frequency HRV parameters were measured from a three lead electrocardiogram. Participants with elevated F2-isoprostanes had reduced HRV compared to patients with normal levels of F2-isoprostanes. A number of HRV parameters were found to be inversely correlated with F2-isoprostanes in all CKD patients, including SDNN (r = -0.337; P stress is significantly and independently associated with HRV in patients with CKD. Identifying oxidative stress in the pathogenesis of autonomic dysfunction may help target therapeutic strategies.

  12. Heart ventricular activation in VAT difference maps from children with chronic kidney disease. (United States)

    Laszki-Szcząchor, Krystyna; Polak-Jonkisz, Dorota; Zwolińska, Danuta; Rusiecki, Lesław; Janocha, Anna; Sobieszczańska, Małgorzata


    Children with chronic kidney disease (CKD) are affected by cardiovascular complications, including disturbances in the intraventricular conduction system. Body surface potential mapping (BSPM) is a non-invasive method of assessing the cardioelectrical field. Our aim was to investigate conduction disturbances in young CKD patients using ventricular activation time (VAT) maps. Our study comprised 22 CKD children (mean age: 13.1 ± 2.5 years) treated conservatively and 29 control patients. For each child 12-lead electrocardiogram (ECG) readings were taken, and blood pressure and serum concentrations of iPTH, Pi, t-Ca, creatinine, Fe(+3), ferritin, and Hb, as well as eGFR were measured. All children underwent registration in the 87-lead BSPM system, and group-mean VAT maps and a difference map, which presents statistically significant differences between the groups, were created. The VAT map distribution in CKD patients revealed abnormalities specific to left anterior fascicle block. The difference map displays the areas of intergroup VAT changes, which are of discriminative value in detecting intraventricular conduction disturbances. Intraventricular conduction impairments in the left bundle branch may occur in children with CKD. BSPM enables conduction disturbances in CKD children to be detected earlier than using 12-lead ECG. The difference map derived from the group-mean isochrone maps precisely localizes the sites of disturbed conduction in the heart intraventricular conduction system.

  13. Plasma Zonulin and its Association with Kidney Function, Severity of Heart Failure, and Metabolic Inflammation. (United States)

    Dschietzig, Thomas B; Boschann, Felix; Ruppert, Jana; Armbruster, Franz P; Meinitzer, Andreas; Bankovic, Dragic; Mitrovic, Veselin; Melzer, Christoph


    The tight junction regulator zonulin has attracted clinical attention as a biomarker of increased gastrointestinal permeability. Recent work also suggests zonulin to represent a general regulator of tissue barriers and a player in metabolic inflammation. Here, we investigated the associations of zonulin with chronic heart failure (CHF), kidney function, and metabolic inflammation. Using multiple linear regression (Generalized Linear Model), this study determined the association of plasma zonulin with different laboratory and clinical parameters in 225 patients carrying automatic implantable cardioverters/defibrillators (AICD) for primary or secondary prevention. In another 115 patients with diastolic or systolic CHF, we investigated a possible relationship between zonulin and CHF severity. In the AICD cohort, zonulin associated inversely with serum creatinine (p = 0.013), carboxymethyl-lysine calprotectin (p zonulin increased significantly with high-sensitivity CRP (p = 0.014). In the CHF cohort, we found a highly significant rise of NT-proBNP, but not of zonulin with NYHA functional classes I-IV or other parameters of CHF severity. The inverse associations of zonulin with creatinine and markers of cardio-vascular risk (high CMLcalprotectin and kynurenine, low homoarginine) are novel findings that need further experimental and clinical clarification. Our study indicates zonulin involvement in metabolic inflammation in T2D, but no association with disease status in CHF.

  14. Heart failure in patients with kidney disease and iron deficiency: The role of iron therapy

    Directory of Open Access Journals (Sweden)

    Aleix Cases Amenós


    Full Text Available Chronic kidney disease and anaemia are common in heart failure (HF and are associated with a worse prognosis in these patients. Iron deficiency is also common in patients with HF and increases the risk of morbidity and mortality, regardless of the presence or absence of anaemia. While the treatment of anaemia with erythropoiesis-stimulating agents in patients with HF have failed to show a benefit in terms of morbidity and mortality, treatment with IV iron in patients with HF and reduced ejection fraction and iron deficiency is associated with clinical improvement. In a post hoc analysis of a clinical trial, iron therapy improved kidney function in patients with HF and iron deficiency. In fact, the European Society of Cardiology's recent clinical guidelines on HF suggest that in symptomatic patients with reduced ejection fraction and iron deficiency, treatment with IV ferric carboxymaltose should be considered to improve symptoms, the ability to exercise and quality of life. Iron plays a key role in oxygen storage (myoglobin and in energy metabolism, and there are pathophysiological bases that explain the beneficial effect of IV iron therapy in patients with HF. All these aspects are reviewed in this article. Resumen: La enfermedad renal crónica y la anemia son frecuentes en la insuficiencia cardíaca (IC y su presencia se asocia con un peor pronóstico en estos pacientes. La ferropenia es frecuente en pacientes con IC y aumenta el riesgo de morbimortalidad, independientemente de la presencia o no de anemia. Mientras el tratamiento de la anemia con agentes estimuladores de la eritropoyesis en pacientes con IC no ha demostrado un beneficio sobre la morbimortalidad, el tratamiento con hierro intravenoso (iv en pacientes con IC y fracción de eyección disminuida y déficit de hierro se asocia con una mejoría clínica. Además, en un análisis post hoc de un ensayo clínico, la ferroterapia mejoró la función renal en pacientes con IC y

  15. Heavy metals burden in kidney and heart tissues of Scarus ghobban fish from the eastern province of Saudi Arabia

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    Waqar Ashraf


    Full Text Available Levels of selected heavy metals (Pb, Co, Cu, Ni, Zn, Mn and Cd in the heart and kidney tissues of parrot fish, collected from the Arabian Gulf, Eastern Province of Saudi Arabia, were determined by wet-digestion based atomic absorption method. The results showed that accumulation pattern of analyzed metals in the kidney tissues followed the order; Zn > Cu > Co > Pb > Ni > Mn > Cd. In the heart tissue the analyzed metals followed similar pattern of metal accumulation. The average Pb (0.85 ± 0.50 ppm, Cd (0.12 ± 0.07 ppm, Ni (0.92 ± 0.35 ppm and Mn (0.86 ± 0.43 ppm were significantly lower in the heart tissue whereas Zn (26.4 ± 12.9 ppm and Cu (3.29 ± 2.18 ppm were higher in the kidney tissues. In general, the data indicated that marine fish from the sampling site of the Arabian Gulf contain relatively less burden of heavy metals in their tissues.

  16. Finerenone : third-generation mineralocorticoid receptor antagonist for the treatment of heart failure and diabetic kidney disease. (United States)

    Liu, Licette C Y; Schutte, Elise; Gansevoort, Ron T; van der Meer, Peter; Voors, Adriaan A


    The mineralocorticoid receptor antagonists (MRAs) spironolactone and eplerenone reduce the risk of hospitalizations and mortality in patients with heart failure (HF) with reduced ejection fraction (HFrEF), and attenuate progression of diabetic kidney disease. However, their use is limited by the fear of inducing hyperkalemia, especially in patients with renal dysfunction. Finerenone is a novel nonsteroidal MRA, with higher selectivity toward the mineralocorticoid receptor (MR) compared to spironolactone and stronger MR-binding affinity than eplerenone. This paper discusses the chemistry, pharmacokinetics, clinical efficacy and safety of finerenone. The selectivity and greater binding affinity of finerenone to the MR may reduce the risk of hyperkalemia and renal dysfunction and thereby overcome the reluctance to start and uptitrate MRAs in patients with HF and diabetic kidney disease. Studies conducted in patients with HFrEF and moderate chronic kidney disease and diabetic kidney disease, showed promising results. Phase III trials will have to show whether finerenone might become the third-generation MRA for the treatment of HF and diabetic kidney disease.

  17. Interaction of infectious spleen and kidney necrosis virus ORF119L with PINCH leads to dominant-negative inhibition of integrin-linked kinase and cardiovascular defects in zebrafish. (United States)

    Yuan, Ji-Min; He, Bai-Liang; Yang, Lu-Yun; Guo, Chang-Jun; Weng, Shao-Ping; Li, Shengwen Calvin; He, Jian-Guo


    Infectious spleen and kidney necrosis virus (ISKNV) is the type species of the Megalocytivirus genus, Iridoviridae family, causing a severe systemic disease with high mortality in mandarin fish (Siniperca chuatsi) in China and Southeast Asia. At present, the pathogenesis of ISKNV infection is still not fully understood. Based on a genome-wide bioinformatics analysis of ISKNV-encoded proteins, we found that ISKNV open reading frame 119L (ORF119L) is predicted to encode a three-ankyrin-repeat (3ANK)-domain-containing protein, which shows high similarity to the dominant negative form of integrin-linked kinase (ILK); i.e., viral ORF119L lacks the ILK kinase domain. Thus, we speculated that viral ORF119L might affect the host ILK complex. Here, we demonstrated that viral ORF119L directly interacts with particularly interesting Cys-His-rich protein (PINCH) and affects the host ILK-PINCH interaction in vitro in fathead minnow (FHM) cells. In vivo ORF119L overexpression in zebrafish (Danio rerio) embryos resulted in myocardial dysfunctions with disintegration of the sarcomeric Z disk. Importantly, ORF119L overexpression in zebrafish highly resembles the phenotype of endogenous ILK inhibition, either by overexpressing a dominant negative form of ILK or by injecting an ILK antisense morpholino oligonucleotide. Intriguingly, ISKNV-infected mandarin fish develop disorganized sarcomeric Z disks in cardiomyocytes. Furthermore, phosphorylation of AKT, a downstream effector of ILK, was remarkably decreased in ORF119L-overexpressing zebrafish embryos. With these results, we show that ISKNV ORF119L acts as a domain-negative inhibitor of the host ILK, providing a novel mechanism for the megalocytivirus pathogenesis. Our work is the first to show the role of a dominant negative inhibitor of the host ILK from ISKNV (an iridovirus). Mechanistically, the viral ORF119L directly binds to the host PINCH, attenuates the host PINCH-ILK interaction, and thus impairs ILK signaling. Intriguingly

  18. Shear mechanical properties of the spleen: experiment and analytical modelling. (United States)

    Nicolle, S; Noguer, L; Palierne, J-F


    This paper aims at providing the first shear mechanical properties of spleen tissue. Rheometric tests on porcine splenic tissues were performed in the linear and nonlinear regime, revealing a weak frequency dependence of the dynamic moduli in linear regime and a distinct strain-hardening effect in nonlinear regime. These behaviours are typical of soft tissues such as kidney and liver, with however a less pronounced strain-hardening for the spleen. An analytical model based on power laws is then proposed to describe the general shear viscoelastic behaviour of the spleen. Copyright © 2012 Elsevier Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Pablo C. B. Lollo


    Full Text Available Running on a horizontal plane is known to increase the concentration of the stress biomarker heat-shock protein (HSP, but no comparison of the expression of HSP70 has yet been established between the uphill (predominantly concentric and downhill (predominantly eccentric muscle contractions exercise. The objective of the study was to investigate the relationships between eccentric and concentric contractions on the HSP70 response of the lung, kidney, gastrocnemius, soleus and heart. Twenty-four male Wistar weanling rats were divided into four groups: non-exercised and three different grades of treadmill exercise groups: horizontal, uphill (+7% and downhill (-7% of inclination. At the optimal time-point of six hours after the exercise, serum uric acid, creatine kinase (CK and lactate dehydrogenase (LDH were determined by standard methods and HSP70 by the Western blot analysis. HSP70 responds differently to different types of running. For kidney, heart, soleus and gastrocnemius, the HSP70 expression increased, 230, 180, 150 and 120% respectively of the reference (horizontal. When the contraction was concentric (uphill and compared to downhill the increase in response of HSP70 was greater in 80% for kidney, 75% for gastrocnemius, 60% for soleus and 280% for the heart. Uric acid was about 50% higher (0.64 ± 0.03 mg·dL-1 in the uphill group as compared to the horizontal or downhill groups. Similarly, the activities of serum CK and LDH were both 100% greater for both the uphill and downhill groups as compared to the horizontal group (2383 ± 253 and 647.00 ± 73 U/L, respectively. The responsiveness of HSP70 appeared to be quite different depending on the type of tissue, suggesting that the impact of exercise was not restricted to the muscles, but extended to the kidney tissue. The uphill exercise increases HSP70 beyond the eccentric type and the horizontal running was a lower HSP70 responsive stimulus

  20. Postoperative weight gain during the first year after kidney, liver, heart, and lung transplant: a prospective study. (United States)

    Kugler, Christiane; Einhorn, Ina; Gottlieb, Jens; Warnecke, Gregor; Schwarz, Anke; Barg-Hock, Hannelore; Bara, Christoph; Haller, Hermann; Haverich, Axel


    Studies of all types of organ transplant recipients have suggested that weight gain, expressed as an increase in body mass index (BMI), after transplant is common. To describe weight gain during the first year after transplant and to determine risk factors associated with weight gain with particular attention to type of transplant. A prospective study of 502 consecutive organ transplant recipients (261 kidney, 73 liver, 29 heart, 139 lung) to identify patterns of BMI change. Measurements were made during regular outpatient clinical visits at 2, 6, and 12 months after transplant. Data were retrieved from patients' charts and correlated with maintenance corticosteroid doses. Overall, mean BMI (SD; range) was 23.9 (4.5; 13.6-44.1) at 2 months and increased to 25.4 (4.0; 13.0-42.2) by the end of the first postoperative year. BMI levels organized by World Health Organization categories showed a trend toward overweight/obesity in kidney (53.4%), liver (51.5%), heart (51.7%), and lung (33.1%) patients by 12 months after transplant. BMI changed significantly (P= .05) for all organ types and between all assessment points, except in kidney recipients. Maintenance corticosteroid doses were not a predictor of BMI at 12 months after transplant for most patients. Weight gain was common among patients undergoing kidney, liver, heart, and lung transplant; however, many showed BMI values close to normality at the end of the first year after transplant. In most cases, increased BMI levels were related to obesity before transplant and not to maintenance corticosteroid therapy.

  1. Spleen removal - open - adults - discharge (United States)

    ... discharge; Spleen removal - adult - discharge References Poulose BK, Holzman MD. The spleen. In: Townsend CM, Beauchamp RD, ... provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial ...

  2. Paediatric Wandering Spleens in Malawi

    African Journals Online (AJOL)

    by a double layer of peritoneum. The wandering spleen is the rare description of an abnormally positioned spleen, which is thought to occur due to laxity, abnormality or absence of the aforementioned ligaments. The wandering spleen is noted to have a longer than normal pedicle, and because of its intraperitoneal location, ...

  3. Joint eigenvector estimation from mutually anisotropic tensors improves susceptibility tensor imaging of the brain, kidney, and heart. (United States)

    Dibb, Russell; Liu, Chunlei


    To develop a susceptibility-based MRI technique for probing microstructure and fiber architecture of magnetically anisotropic tissues-such as central nervous system white matter, renal tubules, and myocardial fibers-in three dimensions using susceptibility tensor imaging (STI) tools. STI can probe tissue microstructure, but is limited by reconstruction artifacts because of absent phase information outside the tissue and noise. STI accuracy may be improved by estimating a joint eigenvector from mutually anisotropic susceptibility and relaxation tensors. Gradient-recalled echo image data were simulated using a numerical phantom and acquired from the ex vivo mouse brain, kidney, and heart. Susceptibility tensor data were reconstructed using STI, regularized STI, and the proposed algorithm of mutually anisotropic and joint eigenvector STI (MAJESTI). Fiber map and tractography results from each technique were compared with diffusion tensor data. MAJESTI reduced the estimated susceptibility tensor orientation error by 30% in the phantom, 36% in brain white matter, 40% in the inner medulla of the kidney, and 45% in myocardium. This improved the continuity and consistency of susceptibility-based fiber tractography in each tissue. MAJESTI estimation of the susceptibility tensors yields lower orientation errors for susceptibility-based fiber mapping and tractography in the intact brain, kidney, and heart. Magn Reson Med 77:2331-2346, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  4. Phosphorus-31 NMR magnetization transfer measurements of metabolic reaction rates in the rat heart and kidney in vivo

    International Nuclear Information System (INIS)

    Koretsky, A.P.


    31 P NMR is a unique tool to study bioenergetics in living cells. The application of magnetization transfer techniques to the measurement of steady-state enzyme reaction rates provides a new approach to understanding the regulation of high energy phosphate metabolism. This dissertation is concerned with the measurement of the rates of ATP synthesis in the rat kidney and of the creatine kinase catalyzed reaction in the rat heart in situ. The theoretical considerations of applying magnetization transfer techniques to intact organs are discussed with emphasis on the problems associated with multiple exchange reactions and compartmentation of reactants. Experimental measurements of the ATP synthesis rate were compared to whole kidney oxygen consumption and Na + reabsorption rates to derive ATP/O values. The problems associated with ATP synthesis rate measurements in kidney, e.g. the heterogeneity of the inorganic phosphate resonance, are discussed and experiments to overcome these problems proposed. In heart, the forward rate through creatine kinase was measured to be larger than the reverse rate. To account for the difference in forward and reverse rates a model is proposed based on the compartmentation of a small pool of ATP

  5. The decreased growth performance and impaired immune function and structural integrity by dietary iron deficiency or excess are associated with TOR, NF-κB, p38MAPK, Nrf2 and MLCK signaling in head kidney, spleen and skin of grass carp (Ctenopharyngodon idella). (United States)

    Guo, Yan-Lin; Jiang, Wei-Dan; Wu, Pei; Liu, Yang; Zhou, Xiao-Qiu; Kuang, Sheng-Yao; Tang, Ling; Tang, Wu-Neng; Zhang, Yong-An; Feng, Lin


    This study was conducted to investigate the effects of dietary iron on the growth, and immune function and structural integrity in head kidney, spleen and skin as well as the underlying signaling of young grass carp (Ctenopharyngodon idella). Total 630 grass carp (242.32 ± 0.58 g) were fed diets containing graded levels of iron at 12.15 (basal diet), 35.38, 63.47, 86.43, 111.09, 136.37 mg/kg (diets 2-6 were added with ferrous fumarate) and 73.50 mg/kg (diet 7 was added with ferrous sulfate) diet for 60 days. Then, a challenge test was conducted by infection of Aeromonas hydrophila for 14 days. The results firstly showed that compared with optimal iron level, iron deficiency decreased lysozyme (LZ) and acid phosphatase (ACP) activities, complement 3 (C3), C4 and immunoglobulin M (IgM) contents and down-regulated the mRNA levels of antibacterial peptides, anti-inflammatory cytokines, inhibitor of κBα (IκBα), target of rapamycin (TOR) and ribosomal protein S6 kinase 1 (S6K1), whereas up-regulated the mRNA levels of pro-inflammatory cytokines, nuclear factor kappa B (NF-κB) p65, IκB kinases β (IKKβ) and eIF4E-binding protein (4E-BP) in head kidney and spleen of young grass carp (P skin hemorrhage and lesion morbidity, and impaired immune function and structural integrity in skin of fish. Fourthly, iron excess decreased growth and impaired the immune function and structural integrity in head kidney, spleen and skin of fish. Besides, in young grass carp, based on PWG and ability against skin hemorrhage and lesion, the efficacy of ferrous fumarate relative to ferrous sulfate was 140.32% and 126.48%, respectively, and the iron requirements based on PWG, ability against skin hemorrhage and lesion, ACP activities and MDA contents in head kidney and spleen were estimated to be 75.65, 87.03, 79.74, 78.93, 83.17 and 82.14 mg/kg diet (based on ferrous fumarate), respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Histopatologia de fígado, rim e baço de piaractus mesopotamicus, prochilodus lineatus e pseudoplatystoma fasciatum parasitados por myxosporídios, capturados no Rio Aquidauana, Mato Grosso do Sul, Brasil Histopathology of liver, kidney and spleen of Piaractus mesopotamicus, Prochilodus lineatus and Pseudoplatystoma fasciatum infected by myxosporean parasite, caugth in Aquidauana River, Mato Grosso do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Cristiane M. de Campos


    Full Text Available Este estudo descreveu a histopatologia de rim, baço e fígado de Piaractus mesopotamicus, Prochilodus lineatus e Pseudoplatystoma fasciatum, parasitados por mixosporídios, capturados no Rio Aquidauana, MS. Após necropsia, amostras do fígado, rim cefálico e baço foram colhidas, fixadas em formalina a 10 % tamponada e processadas de acordo com a rotina histológica. Os cortes foram feitos à espessura de 5 μm e corados com hematoxilina-eosina. Foram encontrados Myxobolus porofilus em P. lineatus, M. colossomatis em P. mesopotamicus e Myxobolus spp. nas três espécies de hospedeiros. Cistos de mixosporídios no exame histopatológico foram vistos no fígado e baço de P. mesopotamicus. Mais de 50% das amostras de fígado de P mesopotamicus e P lineatus apresentou hepatodistrofia difusa. Mais de 80 % das amostras de fígado de P. fasciatum apresentou formações hialinas concêntricas e esteatose em 50% das amostras. Em 95,23 % das amostras de rins de P. mesopotamicus, foram observadas alterações teciduais, e em mais de 60 % dos casos nefrodistrofia difusa moderada e congestão de sinusóides glomerulares. Alterações teciduais nas amostras de rins de P. lineatus foram observadas em menos de 20 % da amostra. No baço dos peixes ora examinados não foram encontradas lesões dignas de relato.Histological analysis of kidney, spleen and liver of Piaractus mesopotamicus, Prochilodus lineatus and Pseudoplatystoma fasciatum, infected by myxosporean, caugth in Aquidauana river, MS, was studied. After necropsy, samples of liver, previous kidney and spleen were fixed in 10 % buffered formalin and processed followed histological routine methods. Sections of 5 μm were stained with hematoxylin and eosin. Myxobolusporofilus, M. colossomatis and were found in P. lineatus, in P. mesopotamicus respectively and Myxobolus spp. Were also found in all three species of fish. Myxosporideans cysts in the liver and spleen of P mesopotamicus were also related. Up

  7. Testing for Kidney Disease (United States)

    ... hypertension artérielle Heart Disease Mineral & Bone Disorder Chronic Kidney Disease Tests & Diagnosis How can I tell if I have kidney disease? Early kidney disease usually doesn’t have any ...

  8. At Risk for Kidney Disease? (United States)

    ... Heart Disease Mineral & Bone Disorder Causes of Chronic Kidney Disease Diabetes and high blood pressure are the most ... blood vessels in your kidneys. Other causes of kidney disease Other causes of kidney disease include a genetic ...

  9. The Management of Heart Failure in Kidney and Urinary Tract Syndromes

    Directory of Open Access Journals (Sweden)

    Yuri Lopatin


    Full Text Available Kidney dysfunction and other related abnormalities are extremely common in all HF syndromes, both because of the similarity of risk factors and the similarity of demography of the two types of patients but also because of the common renal effects of agents used for the treatment of HF. Important renal syndromes for the HF patient include including chronic kidney disease, acute kidney injury, cardio-renal syndrome, and prostatic obstruction. In HF (all types including HFrEF, HFmrEF and especially HFpEF chronic kidney disease (CKD frequently co-exists and almost as frequently complicates the HF management. The two groups of syndromes share many risk factors (diabetes, hypertension, hyperlipidaemia and often interact to worsen the prognosis of each other in a way that makes the patient with combined HF and renal disease at extremely high risk. This article reviews this common co-morbidity and how to manage it.

  10. Enlarged Spleen (Splenomegaly) (United States)

    ... Contributing factors include: Viral infections, such as mononucleosis Bacterial infections, such as syphilis or an infection of your heart's inner lining (endocarditis) Parasitic infections, such as malaria Cirrhosis and other ...

  11. Cordyceps sinensis protects against liver and heart injuries in a rat model of chronic kidney disease: a metabolomic analysis. (United States)

    Liu, Xia; Zhong, Fang; Tang, Xu-long; Lian, Fu-lin; Zhou, Qiao; Guo, Shan-mai; Liu, Jia-fu; Sun, Peng; Hao, Xu; Lu, Ying; Wang, Wei-ming; Chen, Nan; Zhang, Nai-xia


    To test the hypothesis that the traditional Chinese medicine Cordyceps sinensis could improve the metabolic function of extrarenal organs to achieve its anti-chronic kidney disease (CKD) effects. Male SD rats were divided into CKD rats (with 5/6-nephrectomy), CKD rats treated with Cordyceps sinensis (4 mg•kg-1•d-1, po), and sham-operated rats. After an 8-week treatment, metabolites were extracted from the hearts and livers of the rats, and then subjected to (1)H-NMR-based metabolomic analysis. Oxidative stress, energy metabolism, amino acid and protein metabolism and choline metabolism were considered as links between CKD and extrarenal organ dysfunction. Within the experimental period of 8 weeks, the metabolic disorders in the liver were more pronounced than in the heart, suggesting that CKD-related extrarenal organ dysfunctions occurred sequentially rather than simultaneously. Oral administration of Cordyceps sinensis exerted statistically significant rescue effects on the liver and heart by reversely regulating levels of those metabolites that are typically perturbed in CKD. Oral administration of Cordyceps sinensis significantly attenuates the liver and heart injuries in CKD rats. The (1)H NMR-based metabolomic approach has provided a systematic view for understanding of CKD and the drug treatment, which can also be used to elucidate the mechanisms of action of other traditional Chinese medicines.

  12. The effect of heart-and kidney-benefiting Chinese herbal medicines on the function of adrenergic receptors in brain tissues of analogue dementia rats

    International Nuclear Information System (INIS)

    Gong Bin; Mo Qizhong; Fang Jun


    Analogue dementia model of rats was produced by electrolytic lesion of brain. α-adrenergic receptors were assayed by radioligand binding assay (RRBA). It was found that B max of α1 receptors was decreased obviously in cerebral cortex, hippocampus and cerebellum of analogue dementia rats and was raised obviously by Heart-and Kidney-Benefiting Chinese Herbs as well as by Hydergin. The electrolytic lesion did not change the activity of MAO-B in model rat brains. Neither Heart-and Kidney-Benefiting Chinese Herb Medicines nor Hydergin showed marked effect on brain MAO-B activity of the model rats

  13. Isolated Amoebic Abscess of Spleen

    Directory of Open Access Journals (Sweden)

    Kaushik M


    Full Text Available Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis. Extrahepatic amoebic abscesses have occasionally been described in the lung, brain, and skin and presumably result from hematogenous spread. Isolated amoebic abscess of spleen has been reported scarcely in literature. We report here a case of isolated amoebic abscess of spleen.

  14. [Cardiac markers in different degrees of chronic kidney disease: influence of inflammation and previous heart disease]. (United States)

    Quiroga, Borja; Goicoechea, Marian; García de Vinuesa, Soledad; Verde, Eduardo; Verdalles, Ursula; Yuste, Claudia; Reque, Javier; Luño, José


    Troponin T (TnT), brain natriuretic peptide (BNP) and its precursor (NT-proBNP) are useful markers of acute coronary events and heart failure. The aim of this study was to analyze the influence of chronic renal failure, inflammation and heart disease in these biomarkers. In 266 patients with different stages of chronic renal diseases, the following parameters were measured: cardiac markers (TnT, BNP and NT-proBNP), renal function, inflammatory markers (hsCRP, fibrinogen, albumin, uric acid and white blood cells). We recorded the cardiovascular history. Ventricular dysfunction and left ventricular hypertrophy were assessed by echocardiography. A significant correlation between cardiac markers and inflammatory parameters such as fibrinogen, hsCRP and albumin was found. Age (OR 1.05, P = .021), serum albumin (OR: 0.06, P=.006), ischemic heart disease (OR: 8.17, P=.0092) and renal failure (OR: 1.67, P=.05) were predictors of higher BNP levels. Age (OR 1.05, P=.0097), serum albumin (OR: 0.12, P=.001), ischemic heart disease (OR: 3.43, P=.034), renal failure (OR: 1, 65, P=.036) and heart failure (OR: 4.33, P=.0312) were predictors of elevated NT-proBNP. Previous ischemic heart disease alone increased TnT levels (OR: 6.51, P=.0012). Age, previous cardiac disease and inflammation increase cardiac marker levels in patients with different stages of renal disease, but the degree of renal failure is an important factor influencing NT-proBNP levels. However, ischemic heart disease alone increases the levels of TnT. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  15. Bovine cytochrome c oxidases, purified from heart, skeletal muscle, liver and kidney, differ in the small subunits but show the same reaction kinetics with cytochrome c

    NARCIS (Netherlands)

    Sinjorgo, K. M.; Durak, I.; Dekker, H. L.; Edel, C. M.; Hakvoort, T. B.; van Gelder, B. F.; Muijsers, A. O.


    (1) Polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate of purified cytochrome c oxidase preparations revealed that bovine kidney, skeletal muscle and heart contain different cytochrome c oxidase isoenzymes, which show differences in mobility of the subunits encoded by the

  16. Carotid Catheterization and Automated Blood Sampling Induce Systemic IL-6 Secretion and Local Tissue Damage and Inflammation in the Heart, Kidneys, Liver and Salivary Glands in NMRI Mice

    DEFF Research Database (Denmark)

    Teilmann, Anne Charlotte; Rozell, Björn; Kalliokoski, Otto


    ) changes at surgical sites of all catheterized mice, with mild inflammatory changes extending into the salivary glands. Several catheterized mice had multifocal degenerative to necrotic changes with inflammation in the heart, kidneys and livers, suggesting that thrombi had detached from the catheter tip...

  17. Effects of short-term rosuvastatin therapy on heart and kidney function in patients with acute coronary syndrome combining diabetes mellitus and concomitant chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Heng WU


    Full Text Available Objective To observe the effects and safety of rosuvastatin therapy on protecting the renal and heart function in patients with acute coronary syndrome (ACS combining diabetes mellitus (DM and concomitant chronic kidney disease (CKD undergoing contrast media injection. Methods Concurrent parallel control and before-after self-control method were employed in present study. From Dec. 2008 to Oct. 2011, 2998 patients from 53 central hospitals in China were enrolled in a TRACK-D project. Out of 2998, 2309 patients with ACS combining DM and concomitant CKD were randomly assigned to rosuvastatin group (n=1183 or control group (n=1126. Patients in rosuvastatin group were given rosuvastatin 10mg/d for five days (two days before and three days post-procedure, while those in control group received no treatment. Isotonic non-ionic contrast medium (iodixanol was used in both groups when angiography, left ventriculography and percutaneous vascular intervention were started. Serum creatinine (Scr, estimated glomerular filtration rate (eGFR and urinary albumin/creatinine ratio (ACR were measured before and 48h, 72h after exposure to contrast medium. A 30-day clinical follow-up was conducted including the evaluation of aggravated heart failure, acute renal failure, dialysis/hemofiltration and all-cause mortality. Results No significant difference existed between the two groups at the preoperative levels of Scr (95.11±23.79μmol/L vs 94.88±20.31μmol/L, P=0.80 and eGFR [73.98±14.52ml/(min.1.73m2 vs 74.10±13.80ml/(min.1.73m2, P=0.85]. The postoperative Scr level showed no significant difference between the two groups (94.87±25.15μmol/L vs 95.74±30.50μmol/L, P=0.45, however, the postoperative Scr value presented a decline tendency in rosuvastatin group, while an upward trend in control group. The 30-day clinical follow-up found that the incidence of aggravated heart failure was significantly lower in rosuvastatin group than in control group (2.4% vs

  18. An integrative analysis of DNA methylation and RNA-Seq data for human heart, kidney and liver

    Directory of Open Access Journals (Sweden)

    Xie Linglin


    Full Text Available Abstract Background Many groups, including our own, have proposed the use of DNA methylation profiles as biomarkers for various disease states. While much research has been done identifying DNA methylation signatures in cancer vs. normal etc., we still lack sufficient knowledge of the role that differential methylation plays during normal cellular differentiation and tissue specification. We also need thorough, genome level studies to determine the meaning of methylation of individual CpG dinucleotides in terms of gene expression. Results In this study, we have used (insert statistical method here to compile unique DNA methylation signatures from normal human heart, lung, and kidney using the Illumina Infinium 27 K methylation arraysand compared those to gene expression by RNA sequencing. We have identified unique signatures of global DNA methylation for human heart, kidney and liver, and showed that DNA methylation data can be used to correctly classify various tissues. It indicates that DNA methylation reflects tissue specificity and may play an important role in tissue differentiation. The integrative analysis of methylation and RNA-Seq data showed that gene methylation and its transcriptional levels were comprehensively correlated. The location of methylation markers in terms of distance to transcription start site and CpG island showed no effects on the regulation of gene expression by DNA methylation in normal tissues. Conclusions This study showed that an integrative analysis of methylation array and RNA-Seq data can be utilized to discover the global regulation of gene expression by DNA methylation and suggests that DNA methylation plays an important role in normal tissue differentiation via modulation of gene expression.

  19. Cardiovascular prognosis in patients with type 2 diabetes: contribution of heart and kidney subclinical damage. (United States)

    Sosner, Philippe; Hulin-Delmotte, Charlotte; Saulnier, Pierre-Jean; Cabasson, Séverin; Gand, Elise; Torremocha, Florence; Piguel, Xavier; Miot, Aurélie; Maréchaud, Richard; Herpin, Daniel; Ragot, Stéphanie; Hadjadj, Samy


    Left ventricular hypertrophy (LVH) and kidney damage (abnormal urinary albumin-to-creatinine ratio [uACR] or estimated glomerular filtration rate [eGFR]) are predictive of major cardiovascular events (MACE) in patients with type 2 diabetes (T2D) but are rarely used in cardiovascular score calculators. Our study aimed to assess their respective prognostic values for MACE and the additive information they provide to score calculators. A total of 1298 T2D (43% women) aged 65 (SD 11) years were followed up for a median of 65 months, with MACE as a primary composite end point: cardiovascular death, nonfatal myocardial infarction, or stroke. Electrocardiogram (ECG)-derived LVH was defined using Sokolow, Gubner, and Cornell product indexes; uACR was considered as abnormal if >2.5 mg/mmol in men or >3.5 mg/mmol in women and eGFR if history of myocardial infarction, and peripheral artery disease, ECG-LVH and kidney damage were strong predictors for MACE (adjusted hazard ratio [1.64; 95% CI 1.23-2.20], [1.90; 95% CI 1.43-2.53], and [1.85; 95% CI 1.42-2.41] for ECG-LVH, uACR, and eGFR, respectively). Net reclassification improvement was higher with the model including both ECG-LVH and uACR than models with ECG-LVH alone (P calculators (Framingham score and others), we observed an additional prognostic value of ECG-LVH for each one of them. Electrocardiographic LVH is complementary to kidney damage for MACE prediction in T2D. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Evaluating the quality of the edible offal (heart, liver, kidney of rabbits (Flemish Giant breed during storage by refrigeration following the evolution of the pH

    Directory of Open Access Journals (Sweden)

    Gabriela FRUNZĂ


    Full Text Available The purpose of this paper was to determine the quality of the edible offal (heart, liver and kidney of rabbits (Flemish Giant breed during storage by refrigeration following the evolution of the pH, after slaughter, during maturation, to autolysis and alteration, from 27 individuals (15 males and 12 females. The rabbits had an average body weight of 11.5 kg being at the age of reproductive maturity (11-12 months. The pH evolution of the edible offal (heart, liver, kidney of rabbits (refrigerated at 20C was monitored during of 18 days after slaughter. The pH evolution had a fluctuant ascendant trend, quite similar for females and males, presenting insignificant differences by gender. At 24 h after slaughter, the mean values of pH of the main edible offal (from males and females had the highest average values to the kidneys 6.48, followed by the heart 6.32 and by the liver 6.23. The alteration occurred much faster in kidneys and was starting with the 13th day of storage, the pH being close to 6.8-7.

  1. Associations of TNFR1 with kidney function outcomes by age, gender, and baseline kidney function status: Data from the Heart and Soul Study. (United States)

    Park, Meyeon; Maristany, Daniela; Huang, Debbie; Shlipak, Michael G; Whooley, Mary


    Tumor necrosis factor receptor type 1 (TNFR1) is associated with kidney disease and mortality risk in various populations [1], [2]. We evaluated associations of TNFR1 with mortality and mediators of this relationship in doi: 10.1016/j.atherosclerosis.2017.05.021. Whether or not these associations are influenced by age, gender, or baseline kidney function are not known. We evaluated associations of TNFR1 levels with measures of kidney function stratifying by these variables. Our outcomes included estimated glomerular filtration rate (eGFR) 30 mg/g, and rapid kidney function loss, defined as a change in eGFR of greater than 3% per year.

  2. Kidneys and Urinary Tract (United States)

    ... kidneys , contains the by-products of our body's metabolism — salts, toxins, and water — that end up in ... blood. Acute kidney failure may be due to bacterial infection, injury, shock, heart failure, poisoning, or drug ...

  3. Abnormal central control underlies impaired baroreflex control of heart rate and sympathetic nerve activity in female Lewis polycystic kidney rats. (United States)

    Salman, Ibrahim M; Phillips, Jacqueline K; Ameer, Omar Z; Hildreth, Cara M


    Why baroreflex dysfunction occurs in females with chronic kidney disease is unknown. We therefore aimed to examine whether temporal changes in baroreflex control of heart rate (HR) and renal sympathetic nerve activity (RSNA) occur in female Lewis polycystic kidney (LPK) rats and whether this is associated with any changes in afferent, central or efferent processing of the reflex pathway. Using urethane-anaesthetized juvenile and adult LPK and Lewis control rats (n = 40), baroreflex-mediated changes in HR, RSNA and aortic depressor nerve activity (ADNA) were examined. Reflex changes to aortic depressor and vagal efferent nerve stimulation were also determined. In the juvenile LPK rats, except for a slight reduction in the gain of the normalized HR and RSNA baroreflex function curves, no difference in baroreflex control of HR, RSNA or ADNA was observed. Responses to aortic depressor and vagal efferent nerve stimulation were also comparable. In the adult hypertensive LPK rats, the range of both HR (35 ± 8 vs. 78 ± 9  bpm, P ≤ 0.05 LPK vs. Lewis) and RSNA (60 ± 7 vs. 80 ± 3%, P ≤ 0.05 LPK vs. Lewis) was also reduced. This was not associated with any change in the ADNA baroreflex function curves or reflex HR responses to vagal efferent nerve stimulation, but was associated with a reduction in the reflex bradycardic (-21 ± 4 vs. -34 ± 8 bpm, P baroreflex dysfunction results from impaired central processing of the reflex.

  4. Age dependence of spleen- and muscle-corrected hepatic signal enhancement on hepatobiliary phase gadoxetate MRI

    Energy Technology Data Exchange (ETDEWEB)

    Matoori, Simon [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Froehlich, Johannes M. [Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); ETH Zurich, Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences, Zurich (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Breitenstein, Stefan [Cantonal Hospital Winterthur, Department of Surgery, Clinic for Visceral and Thoracic Surgery, Winterthur (Switzerland); Doert, Aleksis [Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland); Pozdniakova, Viktoria [Stavanger University Hospital, Department of Radiology, Stavanger (Norway); Koh, Dow-Mu [Royal Marsden Hospital, Department of Radiology, Surrey, England (United Kingdom); Gutzeit, Andreas [Paracelsus Medical University Salzburg, Department of Radiology, Salzburg (Austria); Hirslanden Clinic St. Anna, Clinical Research Group, Lucerne (Switzerland); Cantonal Hospital Winterthur, Department of Radiology, Winterthur (Switzerland)


    To identify correlations of signal enhancements (SE) and SE normalized to reference tissues of the spleen, kidney, liver, musculus erector spinae (MES) and ductus hepatocholedochus (DHC) on hepatobiliary phase gadoxetate-enhanced MRI with patient age in non-cirrhotic patients. A heterogeneous cohort of 131 patients with different clinical backgrounds underwent a standardized 3.0-T gadoxetate-enhanced liver MRI between November 2008 and June 2013. After exclusion of cirrhotic patients, a cohort of 75 patients with no diagnosed diffuse liver disease was selected. The ratio of signal intensity 20 min post- to pre-contrast administration (SE) in the spleen, kidney, liver, MES and DHC, and the SE of the kidney, liver and DHC normalized to the reference tissues spleen or MES were compared to patient age. Patient age was inversely correlated with the liver SE normalized to the spleen and MES SE (both p < 0.001) and proportionally with the SE of the spleen (p = 0.043), the MES (p = 0.030) and the kidney (p = 0.022). No significant correlations were observed for the DHC (p = 0.347) and liver SE (p = 0.606). The age dependence of hepatic SE normalized to the enhancement in the spleen and MES calls for a cautious interpretation of these quantification methods. (orig.)

  5. Relationships between serum MCP-1 and subclinical kidney disease: African American-Diabetes Heart Study

    Directory of Open Access Journals (Sweden)

    Murea Mariana


    Full Text Available Abstract Background Monocyte chemoattractant protein-1 (MCP-1 plays important roles in kidney disease susceptibility and atherogenesis in experimental models. Relationships between serum MCP-1 concentration and early nephropathy and subclinical cardiovascular disease (CVD were assessed in African Americans (AAs with type 2 diabetes (T2D. Methods Serum MCP-1 concentration, urine albumin:creatinine ratio (ACR, estimated glomerular filtration rate (eGFR, and atherosclerotic calcified plaque (CP in the coronary and carotid arteries and infrarenal aorta were measured in 479 unrelated AAs with T2D. Generalized linear models were fitted to test for associations between MCP-1 and urine ACR, eGFR, and CP. Results Participants were 57% female, with mean ± SD (median age 55.6±9.5 (55.0 years, diabetes duration 10.3±8.2 (8.0 years, urine ACR 149.7±566.7 (14.0 mg/g, CKD-EPI eGFR 92.4±23.3 (92.0 ml/min/1.73m2, MCP-1 262.9±239.1 (224.4 pg/ml, coronary artery CP 280.1±633.8 (13.5, carotid artery CP 47.1±132.9 (0, and aorta CP 1616.0±2864.0 (319.0. Adjusting for age, sex, smoking, HbA1c, BMI, and LDL, serum MCP-1 was positively associated with albuminuria (parameter estimate 0.0021, P=0.04 and negatively associated with eGFR (parameter estimate −0.0003, P=0.001. MCP-1 remained associated with eGFR after adjustment for urine ACR. MCP-1 levels did not correlate with the extent of CP in any vascular bed, HbA1c or diabetes duration, but were positively associated with BMI. No interaction between BMI and MCP-1 was detected on nephropathy outcomes. Conclusions Serum MCP-1 levels are associated with eGFR and albuminuria in AAs with T2D. MCP-1 was not associated with subclinical CVD in this population. Inflammation appears to play important roles in development and/or progression of kidney disease in AAs.

  6. Microinflammation Factors in the Common Diseases of the Heart and Kidneys

    Directory of Open Access Journals (Sweden)

    Danijela Tasic


    Full Text Available Aim. To determine levels of interleukin-8 (IL-8 and plasminogen activator inhibitor-1 (PAI-1 in different cardiorenal syndrome (CRS modalities and to compare findings to some already investigated direct and indirect parameters of inflammation and atherosclerosis. Materials and Methods. Testing involved 114 examinees, divided into control and clinical groups suffering from different modalities and were formed according to the basis of a valid classification for CRS. Results. C-reactive protein (CRP was significantly higher in all CRSs in comparison to the control group P<0.05. PAI-1 in CRSs was statistically higher than in the control group. IL-8 was increased in all CRSs, and especially in CRS-5, where no significance was found. PAI-1 correlated with IL-8 in all CRSs, with significant value in CRS-2 and CRS-5. Correlation for PAI-1 and high-density lipoproteins (HDL was found in CRS-4, while IL-8 was found to be related to CRP level in all CRSs, with significance only in CRS-1 P<0.001. Conclusions. C-reactive protein, IL-8, and PAI-1 could be useful for clinical differentiation of chronic modalities of CRSs. Inflammation was the most pronounced in CRS-4. Lipid status parameters could be useful for differentiation of CRSs. Furthermore, HDL in chronic primary kidney diseases and triglycerides and total cholesterol in CRS-5 could be valuable.

  7. Lutein attenuates oxidative stress markers and ameliorates glucose homeostasis through polyol pathway in heart and kidney of STZ-induced hyperglycemic rat model. (United States)

    Sharavana, Gurunathan; Joseph, G S; Baskaran, Vallikannan


    Lutein's role on chronic hyperglycemia-induced oxidative stress and associated glucose homeostasis in heart and kidney is limited. Purpose of the study is to investigate the effect of lutein on cardiac and renal polyol pathway enzymes and oxidative stress markers under hyperglycemia-induced oxidative stress condition using streptozotocin (STZ)-injected rat model. STZ-induced hyperglycemic (fasting blood glucose ≥11 mM) male Wistar rats were divided into two groups (n = 11/group). Group 1 received micellar lutein (39 nmol/day/rat) and group 2 (negative control) received micelle without lutein for 8 weeks. A separate group (no STZ injected) served as a positive control (n = 11/group). Oral glucose tolerance test (OGTT), biweekly urine glucose and activities of aldose reductase (AR) and sorbitol dehydrogenase (SDH) enzymes were assessed. Activities of antioxidant enzymes and antioxidant level were also evaluated. Lutein-administered hyperglycemic rats showed better glucose tolerance as evidenced with OGTT and biweekly urine glucose when compared to negative control. Activities of AR and SDH were decreased in heart and kidney of lutein-fed hyperglycemic rats. Also, they had significantly (p heart and kidney, respectively. Altered antioxidant enzyme activities such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione transferase were also affected in serum, heart and kidney of lutein-fed diabetic group. Lutein prevented cardiac and renal injury in STZ-induced hyperglycemic rats due to potential amelioration of altered activities in polyol pathway and oxidative stress markers.

  8. Protective effects of azelaic acid against high-fat diet-induced oxidative stress in liver, kidney and heart of C57BL/6J mice. (United States)

    Muthulakshmi, Shanmugam; Saravanan, Ramalingam


    Excess fat intake induces hyperinsulinaemia, increases nutrient uptake and lipid accumulation, amplifies ROS generation, establishes oxidative stress and morphological changes leading to tissue injury in the liver, kidney and heart of high-fat diet (HFD)-fed mice. The effect of azelaic acid (AzA), a C9 α,ω-dicarboxylic acid, against HFD-induced oxidative stress was investigated by assaying the activities and levels of antioxidants and oxidative stress markers in the liver, kidney and heart of C57BL/6J mice. Mice were segregated into two groups, one fed standard diet (NC) and the other fed high-fat diet (HFD) for 15 weeks. HFD-fed mice were subjected to intragastric administration of AzA (80 mg/kg BW)/RSG (10 mg/kg BW) during 11-15 weeks. Glucose, insulin, triglycerides, hepatic and nephritic markers were analysed in the plasma and the activity of enzymatic, non-enzymatic antioxidants and lipid peroxidation markers were examined in the plasma/erythrocytes, liver, kidney and heart of normal and experimental mice. We inferred significant decrease in enzymatic and non-enzymatic antioxidants along with significant increase in glucose, insulin, hepatic and nephritic markers, triglycerides and lipid peroxidation markers in HFD-fed mice. Administration of AzA could positively restore the levels of plasma glucose, insulin, triglycerides, hepatic and nephritic markers to near normal. AzA increased the levels of enzymatic and nonenzymatic antioxidants with significant reduction in the levels of lipid peroxidation markers. Histopathological examination of liver, kidney and heart substantiated these results. Hence, we put forward that AzA could counteract the potential injurious effects of HFD-induced oxidative stress in C57BL/6J mice.

  9. Value of selective spleen scintigraphy when liver/spleen image shows equivocal spleen defects: concise communication

    International Nuclear Information System (INIS)

    Van Nostrand, D.; Corley, J.H.; Kyle, R.W.; Stotler, R.E.


    A retrospective review was performed to determine the utility of selective spleen scintigraphy (SSS) in the evaluation of equivocal defects on liver/splen (LS) image. Six of seven questionable features on LS image were classified on SSS to be definite defects in three, and normal in three. Three of seven patients had defects on SSS that were not seen on LS image. The inability of the LS image to exclude or delineate an abnormality in the spleen was attributed to an overlying left lobe of the liver in five, and to technique in one. The SSS is a valuable diagnostic tool in the further evaluation of equivocal spleen defects on LS image, and SSS may demonstrate abnormalities not demonstrated on LS image

  10. Axillofemoral Bypass Markedly Improved Acute Decompensated Heart Failure and Kidney Injury in a Patient with Severely Calcified Stenosis of Thoracoabdominal Aorta (Atypical Aortic Coarctation). (United States)

    Ishizuka, Masato; Yamada, Shintaro; Maemura, Sonoko; Yamamoto, Keisuke; Takizawa, Masataka; Uozumi, Hiroki; Minegishi, Sachito; Kobayashi, Jotaro; Ikenouchi, Hiroshi


    Atypical aortic coarctation (AAC) has been reported to occur anywhere along the aorta, except for the ascending aorta. The associated symptoms include hypotension in the lower half of the body, secondary hypertension in the upper half of the body, and heart failure. Here we present an 80-year-old Asian woman complaining of progressive exertional dyspnea. She was diagnosed with acute decompensated heart failure and kidney injury due to severely calcified stenosis of the thoracoabdominal aorta, the so called AAC. She received hemodiafiltration, and pulmonary congestion improved in part. Generally, surgical treatments are quite invasive in elderly patients. Endovascular stent graft placement is less invasive, however, fracture and rupture should be considered at severely calcified lesions like this case. Therefore, we selected extra-anatomical axillofemoral bypass. Her recovery after the surgery was remarkable. In a few days, she became free from hemodiafiltration, intravenous diuretics, and oxygen administration. We thought the contributive factors are the increase in kidney blood flow and the correction of afterload mismatch. The decrease in pulse pressure may reflect the reduction in systemic arterial compliance by axillofemoral bypass. The operative mortality of axillofemoral bypass was reported to be acceptable, although the patency of the axillofemoral bypass graft was not high enough. In conclusion, axillofemoral bypass is effective and feasible for elderly patients with acute decompensated heart failure and kidney injury due to AAC.

  11. Torsion of a wandering spleen

    African Journals Online (AJOL)

    No improvement was noted on detorsion of the vascular pedicle, and a splenectomy was performed. The spleen measured 120×90×55 mm and weighed 250 g. Histological examination of the organ identified significant haemorrhagic congestion associated with diffuse haemorrhagic necrosis, with no neoplasm or infiltrate.

  12. Effects of fluid overload on heart rate variability in chronic kidney disease patients on hemodialysis. (United States)

    Ferrario, Manuela; Moissl, Ulrich; Garzotto, Francesco; Cruz, Dinna N; Clementi, Anna; Brendolan, Alessandra; Tetta, Ciro; Gatti, Emanuele; Signorini, Maria G; Cerutti, Sergio; Ronco, Claudio


    While fluid overload (FO) and alterations in the autonomic nervous system (ANS) such as hypersympathetic activity, are known risk factors for cardiovascular morbidity and mortality in patients on chronic hemodialysis (HD), their relationship has not been thoroughly studied. In this observational study involving 69 patients on chronic HD, FO was assessed by whole body bioimpedance measurements before the midweek HD session and ANS activity reflected by Heart Rate Variability (HRV) was measured using 24-hour Holter electrocardiogram recordings starting before the same HD treatment. In total, 13 different HRV indices were analyzed, comprising a mixture of time domain, frequency domain and complexity parameters. A correlation analysis was performed between the HRV indices and hydration status indices. Successively, patients were retrospectively assigned to a high FO (H, FO > 2.5 L) or low FO (L, FO ≤ 2.5 L) group and these were further compared also after stratification by diabetes mellitus. Finally, a small number of patients without diabetes with significant and persistent FO were followed up for 3 months post-study to investigate how normalization of fluid status affects HRV. SDANN, VLF, LZC and HF% parameters significantly correlate with FO (correlation coefficients were respectively r = -0.40, r = -0.37, r = -0.28 and r = 0.26, p-value hydration status (correlation coefficients were respectively r = -0.31 and r = -0.33, p-value hydration status is accompanied by improved HRV.

  13. Structural characterization of alpha1,3-galactosyltransferase knockout pig heart and kidney glycolipids and their reactivity with human and baboon antibodies. (United States)

    Diswall, Mette; Angström, Jonas; Karlsson, Hasse; Phelps, Carol J; Ayares, David; Teneberg, Susann; Breimer, Michael E


    alpha1,3-galactosyltranferase knockout (GalT-KO) pigs have been established to avoid hyperacute rejection in GalT-KO pig-to-human xenotransplantation. GalT-KO pig heart and kidney glycolipids were studied focusing on elimination of Gal-antigens and whether novel antigens would appear. Non-human primates are used as pre-clinical transplantation experimental models. Therefore, sera from baboons transplanted with GalT-KO hearts were compared with human serum regarding reactivity with pig glycolipids. Neutral and acidic glycolipids were isolated from GalT-KO and WT pig hearts and kidneys. Glycolipid immune reactivity was tested on TLC plates using human affinity-purified anti-Gal Ig, anti-blood group monoclonal antibodies, lectins, and human serum as well as baboon serum collected before and after GalT-KO pig heart transplantations. Selected glycolipid fractions, isolated by HPLC, were structurally characterized by mass spectrometry and proton NMR spectroscopy. GalT-KO heart and kidney lacked alpha3Gal-terminated glycolipids completely. Levels of uncapped N-acetyllactosamine precursor compounds, blood group H type 2 core chain compounds, the P1 antigen and the x(2) antigen were increased. Human serum antibodies reacted with Gal-antigens and N-glycolylneuraminic acid (NeuGc) in WT organs of which only the NeuGc reactivity remained in the GalT-KO tissues. A clear difference in reactivity between baboon and human antibodies with pig glycolipids was found. This was most pronounced for acidic, not yet identified, compounds in GalT-KO organs which were less abundant or lacking in the corresponding WT tissues. GalT-KO pig heart and kidney completely lacked Gal glycolipid antigens whilst glycolipids synthesized by competing pathways were increased. Baboon and human serum antibodies showed a different reactivity pattern to pig glycolipid antigens indicating that non-human primates have limitations as a human pre-clinical model for immune rejection studies.

  14. The relation of C - reactive protein to chronic kidney disease in African Americans: the Jackson Heart Study

    Directory of Open Access Journals (Sweden)

    Akylbekova Ermeg L


    Full Text Available Abstract Background African Americans have an increased incidence and worse prognosis with chronic kidney disease (CKD - estimated glomerular filtration rate [eGFR] 2 than their counterparts of European-descent. Inflammation has been related to renal disease in non-Hispanic whites, but there are limited data on the role of inflammation in renal dysfunction in African Americans in the community. Methods We examined the cross-sectional relation of log transformed C-reactive protein (CRP to renal function (eGFR by Modification of Diet and Renal Disease equation in African American participants of the community-based Jackson Heart Study's first examination (2000 to 2004. We conducted multivariable linear regression relating CRP to eGFR adjusting for age, sex, body mass index, systolic and diastolic blood pressure, diabetes, total/HDL cholesterol, triglycerides, smoking, antihypertensive therapy, lipid lowering therapy, hormone replacement therapy, and prevalent cardiovascular disease events. In a secondary analysis we assessed the association of CRP with albuminuria (defined as albumin-to-creatinine ratio > 30 mg/g. Results Participants (n = 4320, 63.2% women had a mean age ± SD of 54.0 ± 12.8 years. The prevalence of CKD was 5.2% (n = 228 cases. In multivariable regression, CRP concentrations were higher in those with CKD compared to those without CKD (mean CRP 3.2 ± 1.1 mg/L vs. 2.4 ± 1.0 mg/L, respectively p 0.05. Conclusion CRP was associated with CKD however not albuminuria in multivariable-adjusted analyses. The study of inflammation in the progression of renal disease in African Americans merits further investigation.

  15. Effects of Melatonin and Epiphyseal Proteins on Fluoride-Induced Adverse Changes in Antioxidant Status of Heart, Liver, and Kidney of Rats

    Directory of Open Access Journals (Sweden)

    Vijay K. Bharti


    Full Text Available Several experimental and clinical reports indicated the oxidative stress-mediated adverse changes in vital organs of human and animal in fluoride (F toxicity. Therefore, the present study was undertaken to evaluate the therapeutic effect of buffalo (Bubalus bubalis epiphyseal (pineal proteins (BEP and melatonin (MEL against F-induced oxidative stress in heart, liver, and kidney of experimental adult female rats. To accomplish this experimental objective, twenty-four adult female Wistar rats (123–143 g body weights were divided into four groups, namely, control, F, F + BEP, and F + MEL and were administered sodium fluoride (NaF, 150 ppm elemental F in drinking water, MEL (10 mg/kg BW, i.p., and BEP (100 µg/kg BW, i.p. for 28 days. There were significantly P<0.05 high levels of lipid peroxidation and catalase and low levels of reduced glutathione, superoxide dismutase, glutathione reductase, and glutathione peroxidase in cardiac, hepatic, and renal tissues of F-treated rats. Administration of BEP and MEL in F-treated rats, however, significantly P<0.05 attenuated these adverse changes in all the target components of antioxidant defense system of cardiac, hepatic, and renal tissues. The present data suggest that F can induce oxidative stress in liver, heart, and kidney of female rats which may be a mechanism in F toxicity and these adverse effects can be ameliorated by buffalo (Bubalus bubalis epiphyseal proteins and melatonin by upregulation of antioxidant defense system of heart, liver, and kidney of rats.

  16. [Ultrasound of spleen and retroperitoneum]. (United States)

    Salcedo Joven, I; Segura-Grau, A; Díaz Rodríguez, N; Segura-Cabral, J M


    Ultrasound provides data of extremely great value when studying spleen pathology, being diagnostic in splenomegaly and splenic trauma, as well as offering a good approach to the diagnosis of both benign and malignant focal pathology, particularly lymphoma. However, for the evaluation of adrenal and retroperitoneal diseases, other techniques such as CT or MRI are more suitable, even though ultrasound is still an excellent screening and monitoring method, as well as being useful in non-invasive therapeutic approaches. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Congestive heart failure in patients with advanced chronic kidney disease: association with pre-emptive vascular access placement. (United States)

    Martínez-Gallardo, Rocío; Ferreira-Morong, Flavio; García-Pino, Guadalupe; Cerezo-Arias, Isis; Hernández-Gallego, Román; Caravaca, Francisco


    Congestive heart failure (CHF) is a common complication in patients with chronic kidney disease (CKD). In addition to classical risk factors (e.g. age and pre-existing cardiac diseases), other potential reversible abnormalities linked to CKD such as anaemia, volume overload, or vascular access placement may also influence the incidence and severity of acute exacerbations of CHF. This study aims to determine the incidence and main determinants of CHF in a cohort of patients with stage 4-5 pre-dialysis CKD. The study group consisted of 562 patients (mean age: 65 +/- 15 years, 260 females, 31% diabetics). Native arteriovenous fistulas (AVF) were created in 160 patients who chose haemodialysis as the initial technique for renal replacement therapy. The main outcome variables were: acute decompensated CHF (defined by standard criteria), dialysis initiation (planned and unplanned), and death before dialysis initiation. In addition to demographics, comorbidities, and clinical and biochemical data, AVF creation was also included as a potential determinant of CHF in multiple logistic regression models. Ninety-five patients (17%) developed at least one episode of acute decompensated CHF, and the incidence rate was 19 episodes per 1000 patient-years. In addition to classical risk factors (age, female sex, obesity, diabetes, and previous history of CHF or coronary artery disease), creation of a successful AVF significantly increased the risk of CHF (OR=9.54, 95% CI: 4.84-18.81, P<.0001). In 47 out of 95 patients who developed CHF, a functioning AVF had previously been created, 92% of which were upper arm native AVF, with a median of 51 days between the surgical procedure and CHF episode. The mortality of patients with CHF was similar to that of the rest of the study patients, although unplanned dialysis initiation was significantly more frequent in those who developed CHF. Acute decompensated CHF episodes are common in pre-dialysis CKD patients. In addition to classical risk

  18. Localizations of Na(+)-D-glucose cotransporters SGLT1 and SGLT2 in human kidney and of SGLT1 in human small intestine, liver, lung, and heart. (United States)

    Vrhovac, Ivana; Balen Eror, Daniela; Klessen, Dirk; Burger, Christa; Breljak, Davorka; Kraus, Ognjen; Radović, Nikola; Jadrijević, Stipe; Aleksic, Ivan; Walles, Thorsten; Sauvant, Christoph; Sabolić, Ivan; Koepsell, Hermann


    Novel affinity-purified antibodies against human SGLT1 (hSGLT1) and SGLT2 (hSGLT2) were used to localize hSGLT2 in human kidney and hSGLT1 in human kidney, small intestine, liver, lung, and heart. The renal locations of both transporters largely resembled those in rats and mice; hSGLT2 and SGLT1 were localized to the brush border membrane (BBM) of proximal tubule S1/S2 and S3 segments, respectively. Different to rodents, the renal expression of hSGLT1 was absent in thick ascending limb of Henle (TALH) and macula densa, and the expression of both hSGLTs was sex-independent. In small intestinal enterocytes, hSGLT1 was localized to the BBM and subapical vesicles. Performing double labeling with glucagon-like peptide 1 (GLP-1) or glucose-dependent insulinotropic peptide (GIP), hSGLT1 was localized to GLP-1-secreting L cells and GIP-secreting K cells as has been shown in mice. In liver, hSGLT1 was localized to biliary duct cells as has been shown in rats. In lung, hSGLT1 was localized to alveolar epithelial type 2 cells and to bronchiolar Clara cells. Expression of hSGLT1 in Clara cells was verified by double labeling with the Clara cell secretory protein CC10. Double labeling of human heart with aquaporin 1 immunolocalized the hSGLT1 protein in heart capillaries rather than in previously assumed myocyte sarcolemma. The newly identified locations of hSGLT1 implicate several extra renal functions of this transporter, such as fluid absorption in the lung, energy supply to Clara cells, regulation of enteroendocrine cells secretion, and release of glucose from heart capillaries. These functions may be blocked by reversible SGLT1 inhibitors which are under development.

  19. Heart MRI (United States)

    ... Heart defibrillator or pacemaker Inner ear (cochlear) implants Kidney disease or dialysis (you may not be able to receive contrast) Recently placed artificial joints Certain types of vascular stents Worked with ...

  20. Prophylactic perioperative sodium bicarbonate to prevent acute kidney injury following open heart surgery: a multicenter double-blinded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Michael Haase

    Full Text Available Preliminary evidence suggests a nephroprotective effect of urinary alkalinization in patients at risk of acute kidney injury. In this study, we tested whether prophylactic bicarbonate-based infusion reduces the incidence of acute kidney injury and tubular damage in patients undergoing open heart surgery.In a multicenter, double-blinded (patients, clinical and research personnel, randomized controlled trial we enrolled 350 adult patients undergoing open heart surgery with the use of cardiopulmonary bypass. At induction of anesthesia, patients received either 24 hours of intravenous infusion of sodium bicarbonate (5.1 mmol/kg or sodium chloride (5.1 mmol/kg. The primary endpoint was the proportion of patients developing acute kidney injury. Secondary endpoints included the magnitude of acute tubular damage as measured by urinary neutrophil gelatinase-associated lipocalin (NGAL, initiation of acute renal replacement therapy, and mortality. The study was stopped early under recommendation of the Data Safety and Monitoring Committee because interim analysis suggested likely lack of efficacy and possible harm. Groups were non-significantly different at baseline except that a greater proportion of patients in the sodium bicarbonate group (66/174 [38%] presented with preoperative chronic kidney disease compared to control (44/176 [25%]; p = 0.009. Sodium bicarbonate increased urinary pH (from 6.0 to 7.5, p<0.001. More patients receiving bicarbonate (83/174 [47.7%] developed acute kidney injury compared with control patients (64/176 [36.4%], odds ratio [OR] 1.60 [95% CI 1.04-2.45]; unadjusted p = 0.032. After multivariable adjustment, a non-significant unfavorable group difference affecting patients receiving sodium bicarbonate was found for the primary endpoint (OR 1.45 [0.90-2.33], p = 0.120]. A greater postoperative increase in urinary NGAL in patients receiving bicarbonate infusion was observed compared to control patients (p = 0

  1. Radiologic findings of intrapancreatic accessory spleen

    Directory of Open Access Journals (Sweden)

    Berat Acu


    Accessory spleen is a congenital abnormality consisting of normal splenic tissue in ectopic sites. They are found most commonly near the splenic hilum. One in every six accessory spleens is located in the tail of the pancreas. The diagnosis of an IPAS should be considered when a pancreatic mass has the CT densities and/or MRI signal intensities similar to those of the spleen, with and without contrast medium. [J Contemp Med 2015; 5(2.000: 140-143

  2. Sonographic determination of spleen to left kidney ratio among Igbo ...

    African Journals Online (AJOL)

    formed with high resolution real time scanner (DP-. 1100, Shenzhen Mindray Biomedical Electronics Co. ... Scanning Technique: A coupling medium was first applied to the area being scanned to ensure good .... other biometric parameters such as height, weight, BMI and BSA studied. Using 2 standard deviations above.

  3. Persistent high serum bicarbonate and the risk of heart failure in patients with chronic kidney disease (CKD): A report from the Chronic Renal Insufficiency Cohort (CRIC) study. (United States)

    Dobre, Mirela; Yang, Wei; Pan, Qiang; Appel, Lawrence; Bellovich, Keith; Chen, Jing; Feldman, Harold; Fischer, Michael J; Ham, L L; Hostetter, Thomas; Jaar, Bernard G; Kallem, Radhakrishna R; Rosas, Sylvia E; Scialla, Julia J; Wolf, Myles; Rahman, Mahboob


    Serum bicarbonate varies over time in chronic kidney disease (CKD) patients, and this variability may portend poor cardiovascular outcomes. The aim of this study was to conduct a time-updated longitudinal analysis to evaluate the association of serum bicarbonate with long-term clinical outcomes: heart failure, atherosclerotic events, renal events (halving of estimated glomerular filtration rate [eGFR] or end-stage renal disease), and mortality. Serum bicarbonate was measured annually, in 3586 participants with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. Marginal structural models were created to allow for integration of all available bicarbonate measurements and proper adjustment for time-dependent confounding. During the 6 years follow-up, 512 participants developed congestive heart failure (26/1000 person-years) and 749 developed renal events (37/1000 person-years). The risk of heart failure and death was significantly higher for participants who maintained serum bicarbonate >26 mmol/L for the entire duration of follow-up (hazard ratio [HR] 1.66; 95% confidence interval [CI], 1.23 to 2.23, and HR 1.36, 95% CI 1.02 to 1.82, respectively) compared with participants who kept their bicarbonate 22 to 26 mmol/L, after adjusting for demographics, co-morbidities, medications including diuretics, eGFR, and proteinuria. Participants who maintained serum bicarbonate renal disease progression (HR 1.97; 95% CI, 1.50 to 2.57) compared with participants with bicarbonate 22 to 26 mmol/L. In this large CKD cohort, persistent serum bicarbonate >26 mmol/L was associated with increased risk of heart failure events and mortality. Further studies are needed to determine the optimal range of serum bicarbonate in CKD to prevent adverse clinical outcomes. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. Impact of Variations in Kidney Function on Nonvitamin K Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Recent Acute Heart Failure. (United States)

    Andreu-Cayuelas, José M; Pastor-Pérez, Francisco J; Puche, Carmen M; Mateo-Martínez, Alicia; García-Alberola, Arcadio; Flores-Blanco, Pedro J; Valdés, Mariano; Lip, Gregory Y H; Roldán, Vanessa; Manzano-Fernández, Sergio


    Renal impairment and fluctuations in renal function are common in patients recently hospitalized for acute heart failure and in those with atrial fibrillation. The aim of the present study was to evaluate the hypothetical need for dosage adjustment (based on fluctuations in kidney function) of dabigatran, rivaroxaban and apixaban during the first 6 months after hospital discharge in patients with concomitant atrial fibrillation and heart failure. An observational study was conducted in 162 patients with nonvalvular atrial fibrillation after hospitalization for acute decompensated heart failure who underwent creatinine determinations during follow-up. The hypothetical recommended dosage of dabigatran, rivaroxaban and apixaban according to renal function was determined at discharge. Variations in serum creatinine and creatinine clearance and consequent changes in the recommended dosage of these drugs were identified during 6 months of follow-up. Among the overall study population, 44% of patients would have needed dabigatran dosage adjustment during follow-up, 35% would have needed rivaroxaban adjustment, and 29% would have needed apixaban dosage adjustment. A higher proportion of patients with creatinine clearance < 60 mL/min or with advanced age (≥ 75 years) would have needed dosage adjustment during follow-up. The need for dosage adjustment of nonvitamin K oral anticoagulants during follow-up is frequent in patients with atrial fibrillation after acute decompensated heart failure, especially among older patients and those with renal impairment. Further studies are needed to clarify the clinical importance of these needs for drug dosing adjustment and the ideal renal function monitoring regime in heart failure and other subgroups of patients with atrial fibrillation. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  5. The effect of Mastin® on expression of Nrf2 in the rat heart with subtotally nephrectomy chronic Kidney disease model (United States)

    Nathania, J.; Soetikno, V.


    Chronic kidney disease (CKD) is increasingly prevalent in Indonesia and worldwide. One of the major causes of morbidity and mortality in CKD is the complication of cardiovascular disease. Mastin® is a supplement that is locally produced in Indonesia and is made from extract of mangosteen pericarp, which is reported to have antioxidative, anti-inflammatory, and antitumor properties. The present study aimed to investigate whether Mastin® could improve antioxidant responses in the rat heart during CKD by measuring the expression of nuclear factor erythroid-2-related factor (Nrf)2, a master regulator of antioxidant response elements. RNA was extracted from the heart tissue of three groups of rats: a normal group, a nephrectomy group, and a nephrectomy with Mastin® group. Two-step real-time RT-PCR was then conducted to calculate the relative expression of the Nrf2 gene. Nrf2 expression was markedly decreased in the nephrectomy group vs the normal group, but slightly increas ed in the nephrectomy with Mastin® group vs the nephrectomy group. CKD resulted in impaired activation of the Nrf2 pathway in the rat heart. Although the administration of Mastin® slightly increased Nrf2 expression, it was not enough to confer cardioprotective effects through the Nrf2 pathway.

  6. Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease

    NARCIS (Netherlands)

    Bello, Natalie A.; Lewis, Eldrin F.; Desai, Akshay S.; Anand, Inder S.; Krum, Henry; McMurray, John J. V.; Olson, Kurt; Solomon, Scott D.; Swedberg, Karl; van Veldhuisen, Dirk J.; Young, James B.; Pfeffer, Marc A.


    Aims The use of an erythropoesis-stimulating agent, darbepoetin alfa (DA), to treat anaemia in patients with diabetes mellitus and chronic kidney disease was associated with a heightened risk of stroke and neutral efficacy in the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT),

  7. Ectopic Kidney (United States)

    ... for a Child with Kidney Disease Nutrition for Chronic Kidney Disease in Children Growth Failure in Children with Chronic Kidney Disease Ectopic Kidney Medullary Sponge Kidney Kidney Dysplasia Ectopic ...

  8. The Effects of Montelukast on Antioxidant Enzymes and Proinflammatory Cytokines on the Heart, Liver, Lungs, and Kidneys in a Rat Model of Cecal Ligation and Puncture–Induced Sepsis

    Directory of Open Access Journals (Sweden)

    Ali Kagan Coskun


    Full Text Available We investigated the potential protective effects of montelukast (MLK on cecal ligation and puncture (CLP–induced tissue injury in vital organs — liver, heart, kidneys, and especially lungs — through inhibition of the proinflammatory cytokine response and the generation of reactive oxygen species (ROS in rats. The rat groups were (1 a 10-mg/kg MLK-treated CLP group; (2 a 20-mg/kg MLK-treated CLP group; (3 a 20-mg/kg MLK-treated, sham-operated group; (4 a CLP control group; and (5 a sham-operated control group. MLK treatment significantly decreased proinflammatory (tumor necrosis factor-alpha, interleukin-6 cytokine levels following CLP. The lipid peroxide level increased in the lung, heart, liver, and kidney tissues after CLP-induced sepsis, and myeloperoxidase activity increased in the lung, heart, and liver tissues. MLK attenuated this elevation in all tissues except the kidney, dose dependently. The glutathione levels and superoxide dismutase activity were significantly increased in the lung, liver, and kidney tissues after MLK treatment. MLK treatment after CLP also potentially reduced mortality. The lung and kidney tissues were the most protected by MLK under sepsis conditions. We can suggest that MLK reverses the systemic inflammatory reaction to polymicrobial sepsis and thereby reduces multiple organ failure.

  9. Bridge with a left ventricular assist device to a simultaneous heart and kidney transplant: Review of the United Network for Organ Sharing database. (United States)

    Gaffey, Ann C; Chen, Carol W; Chung, Jennifer; Grandin, Edward Wilson; Porrett, Paige M; Acker, Michael A; Atluri, Pavan


    Left ventricular assist device (LVAD) implantation as a bridge to cardiac transplantation (BTT) is an effective treatment for end-stage heart failure patients. Currently, there is an increasing number of patients with a LVAD who need a heart and kidney transplant (HKT). Little is known of the prognostic outcomes in these patients. This study was undertaken to determine whether an equivalent outcome would be present in HKTs as compared to a non-LVAD primary HKT cohort. We reviewed the United Network for Organ Sharing database from 2004 to 2013. Orthotropic heart transplant recipients (n = 49 799) were subcategorized as dual organ HKT (n = 1 921) and then divided into cohorts of HKT following continuous flow left ventricular assist device placement (CF-VAD-HKT, n = 113) or no LVAD placement (HKT, n = 1 808). Survival after transplantation was analyzed. For CF-LVAD-HKT and HKT cohorts, preoperative characteristics were similar regarding age (50.8 ± 13.7, 50.1 ± 13.7, p = 0.75) and panel reactive antibody (12.3 ± 18.4 vs 7.1 ± 18.4, p = 0.06). Donors were similar in age, gender, creatinine, and ejection fraction. Post-transplant, there was no difference in complications. Survival for CF-LVAD-HKT and HKT were similar at 1 year (77% vs 82%) and 3 years (75% vs 77%, log rank p = 0.2814). For patients with advanced heart failure and persistent renal dysfunction, simultaneous HKT is a safe option. Survival after CF-LVAD-HKT is equivalent to conventional HKT. © 2017 Wiley Periodicals, Inc.

  10. Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease

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    Zi-lan JING


    Full Text Available Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP as an auxiliary treatment of percutaneous coronary intervention (PCI in patients with coronary heart disease (CHD associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP which was not allayed by medical treatment, or acute myocardial infarction (AMI, were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR showed also no statistically significant difference before surgery between two groups of patients (P>0.05. The difference in proportion of AMI, the left main trunk and (or three-branches involvement was of no statistical significance (P>0.05, but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05 between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality. DOI: 10.11855/j.issn.0577-7402.2015.04.03

  11. Protective Effects of Selenium, Vitamin E, and Purple Carrot Anthocyanins on D-Galactose-Induced Oxidative Damage in Blood, Liver, Heart and Kidney Rats. (United States)

    Li, Xia; Zhang, Yunlong; Yuan, Yuan; Sun, Yong; Qin, Yan; Deng, Zeyuan; Li, Hongyan


    The present study was performed to investigate the protective effects of selenium (Se), vitamin E (Vit E) and anthocyanins from purple carrots and their combination against the oxidative stress induced by D-galactose in rats. A total of 80 male rats were equally divided into 11 groups, one of which acted as control (I) just receiving intraperitoneal injections of physiological saline. The remaining ten groups (II-XI) were intraperitoneally injected with D-galactose at a dose of 400 mg kg(-1) body weight (BW) per day for 42 consecutive days. Rats in groups III-XI were treated with antioxidants via gavage per day as follows: group III: Se-methylselenocysteine (SeMSC), IV: Se as sodium selenite (Na2SeO3), V: Se-enriched yeast (SeY), VI: Vit E as α-tocopherol acetate, VII: anthocyanin from purple carrots (APC), VIII: APC + Vit E, IX: SeMSC + APC+ Vit E, X: Na2SeO3 + APC + Vit E, XI: SeY + Ant + Vit E. The results showed that the rats treated with antioxidants (III-XI) showed significant decreases in the levels of malondialdehyde (MDA) and carbonyl protein (PCO) compared with the D-galactose-treated group (II) in the heart, liver, kidneys, and blood. Moreover, there were significant increases in the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), glutathione (GSH) concentration, and total antioxidant capacity (T-AOC) in the heart, liver, kidneys, and blood of antioxidant-treated animals (III-XI) than those in control group (I). In addition, the combined treatments of two or three antioxidants showed greater antioxidant activities than those of individual treatments, suggesting the synergistic antioxidant effects of Se, Vit E, and APC. In conclusion, all the antioxidants exhibited protective effects against D-galactose-induced oxidative damage in rats, and these antioxidants showed a synergistic effect.

  12. Expert Panel Recommendations for the Identification and Management of Hyperkalemia and Role of Patiromer in Patients with Chronic Kidney Disease and Heart Failure. (United States)

    Rafique, Zubaid; Weir, Matthew R; Onuigbo, Macaulay; Pitt, Bertram; Lafayette, Richard; Butler, Javed; Lopes, Maria; Farnum, Carolyn; Peacock, W Frank


    Virtual panel meetings were conducted among 7 physicians, all of whom are independent experts, including 3 nephrologists, 2 cardiologists, and 2 emergency medicine physicians (the panel). The panel met with the purpose of discussing the current treatment landscape, treatment challenges, economic impact, and gaps in care for patients with hyperkalemia that is associated with heart failure and chronic kidney disease. The stated goal of the panel discussion was to develop practical solutions in the identification and management of hyperkalemia in this patient population. The panel noted that hyperkalemia is a serious condition that can lead to life-threatening complications, yet the treatment paradigm for hyperkalemia has remained without major advances for approximately 50 years, until the approval of patiromer. A number of issues still exist in the management of this patient population, including the lack of uniform treatment guidelines and consensus regarding the approach to treatment. As part of its effort, the panel developed an algorithm, the Proposed Diagnostic Algorithm for Hyperkalemia Treatment in the Acute Care Setting/Chronic Care. The panel agreed that patiromer appears to be a viable option for the management of hyperkalemia in patients with chronic kidney disease and/or heart failure and in patients who experience chronic hyperkalemia. This panel discussion was funded by Relypsa and facilitated by Magellan Rx Management. Rafique is a principal investigator for Relypsa and serves as a consultant for Instrumentation Laboratory, Magellan Health, Relypsa, and ZS-Pharma. Butler serves as consultant for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, CardioCell, Janssen, Merck, Novartis, Relypsa, and ZS-Pharma. Lopes and Farnum are employed by Magellan Rx Management. Rafique designed the management protocol for this panel discussion and contributed to the writing and editing of this report document. The other authors report no conflicting interests. Relypsa

  13. Predictors of Long-Term Mortality and Frequent Re-Hospitalization in Patients with Acute Decompensated Heart Failure and Kidney Dysfunction Treated with Renin-Angiotensin System Blockers. (United States)

    Baydemir, Canan; Ural, Dilek; Karaüzüm, Kurtuluş; Balci, Sibel; Argan, Onur; Karaüzüm, Irem; Kozdağ, Güliz; Ağır, Ayşen A


    BACKGROUND Assessment of risk for all-cause mortality and re-hospitalization is an important task during discharge of acute heart failure (AHF) patients, as they warrant different management strategies. Treatment with optimal medical therapy may change predictors for these 2 end-points in AHF patients with renal dysfunction. The aim of this study was to evaluate the predictors for long-term outcome in AHF patients with kidney dysfunction who were discharged on optimal medical therapy. MATERIAL AND METHODS The study was conducted retrospectively. The study group consisted of 225 AHF patients with moderate-to-severe kidney dysfunction, who were hospitalized at Kocaeli University Hospital Cardiology Clinic and who were prescribed beta-blockers and ACE-inhibitors or angiotensin II receptor blockers at discharge. Clinical, echocardiographic, and biochemical predictors of the composite of total mortality and frequent re-hospitalization (≥3 hospitalizations during the follow-up) were assessed using Cox regression and the predictors for each end-point were assessed by competing risk regression analysis. RESULTS Incidence of all-cause mortality was 45.3% and frequent readmissions were 49.8% in a median follow-up of 54 months. The associates of the composite end-point were age, NYHA class, respiration rate on admission, eGFR, hypoalbuminemia, mitral valve E/E' ratio, and ejection fraction. In competing risk regression analysis, right-sided HF, hypoalbuminemia, age, and uric acid appeared as independent associates of all-cause mortality, whereas NYHA class, NT-proBNP, mitral valve E/E' ratio, and uric acid were predictors for re-hospitalization. CONCLUSIONS Predictors for all-cause mortality in AHF with kidney dysfunction treated with optimal therapy are mainly related to advanced HF with right-sided dysfunction, whereas frequent re-hospitalization is associated with volume overload manifested by increased mitral E/E' ratio and NT-proBNP levels.

  14. Cadmium affects the mitochondrial viability and the acid soluble thiols concentration in liver, kidney, heart and gills of Ancistrus brevifilis (Eigenmann, 1920) (United States)

    Velasquez-Vottelerd, P.; Anton, Y.; Salazar-Lugo, R.


    The freshwater fish Ancistrus brevifilis, which is found in Venezuelan rivers, is considered a potential sentinel fish in ecotoxicological studies. The cadmium (Cd) effect on the mitochondrial viability (MV) and acid soluble thiols levels (AST) in A. brevifilis tissues (liver, kidney, heart, and gill) was evaluated. Forty-two fish with similar sizes and weights were randomly selected, of which 7 fish (with their respective replicate) were exposed for 7 and 30 days to a Cd sublethal concentration (0.1 mg.l-1). We determined the MV through a Janus Green B colorimetric assay and we obtained the concentration of AST by Ellman’s method. Mitochondrial viability decreased in fish exposed to Cd for 30 days with the liver being the most affected tissue. We also detected a significant decrease in AST levels was in fishes exposed to Cd for 7 days in liver and kidney tissues; these results suggests that AST levels are elevated in some tissues may act as cytoprotective and adaptive alternative mechanism related to the ROS detoxification, maintenance redox status and mitochondrial viability. Organ-specifics variations were observed in both assays. We conclude that the Cd exposure effect on AST levels and MV, vary across fish tissues and is related to the exposure duration, the molecule dynamics in different tissues, the organism and environmental conditions. PMID:26623384

  15. Cadmium affects the mitochondrial viability and the acid soluble thiols concentration in liver, kidney, heart and gills of Ancistrus brevifilis (Eigenmann, 1920

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    P. Velasquez-Vottelerd


    Full Text Available The freshwater fish Ancistrus brevifilis, which is found in Venezuelan rivers, is considered a potential sentinel fish in ecotoxicological studies. The cadmium (Cd effect on the mitochondrial viability (MV and acid soluble thiols levels (AST in A. brevifilis tissues (liver, kidney, heart, and gill was evaluated. Forty-two fish with similar sizes and weights were randomly selected, of which 7 fish (with their respective replicate were exposed for 7 and 30 days to a Cd sublethal concentration (0.1 mg.l-1. We determined the MV through a Janus Green B colorimetric assay and we obtained the concentration of AST by Ellman’s method. Mitochondrial viability decreased in fish exposed to Cd for 30 days with the liver being the most affected tissue. We also detected a significant decrease in AST levels was in fishes exposed to Cd for 7 days in liver and kidney tissues; these results suggests that AST levels are elevated in some tissues may act as cytoprotective and adaptive alternative mechanism related to the ROS detoxification, maintenance redox status and mitochondrial viability. Organ-specifics variations were observed in both assays. We conclude that the Cd exposure effect on AST levels and MV, vary across fish tissues and is related to the exposure duration, the molecule dynamics in different tissues, the organism and environmental conditions.

  16. Crosstalk between the heart and peripheral organs in heart failure. (United States)

    Jahng, James Won Suk; Song, Erfei; Sweeney, Gary


    Mediators from peripheral tissues can influence the development and progression of heart failure (HF). For example, in obesity, an altered profile of adipokines secreted from adipose tissue increases the incidence of myocardial infarction (MI). Less appreciated is that heart remodeling releases cardiokines, which can strongly impact various peripheral tissues. Inflammation, and, in particular, activation of the nucleotide-binding oligomerization domain-like receptors with pyrin domain (NLRP3) inflammasome are likely to have a central role in cardiac remodeling and mediating crosstalk with other organs. Activation of the NLRP3 inflammasome in response to cardiac injury induces the production and secretion of the inflammatory cytokines interleukin (IL)-1β and IL-18. In addition to having local effects in the myocardium, these pro-inflammatory cytokines are released into circulation and cause remodeling in the spleen, kidney, skeletal muscle and adipose tissue. The collective effects of various cardiokines on peripheral organs depend on the degree and duration of myocardial injury, with systematic inflammation and peripheral tissue damage observed as HF progresses. In this article, we review mechanisms regulating myocardial inflammation in HF and the role of factors secreted by the heart in communication with peripheral tissues.

  17. The impact of estimated glomerular filtration rate equations on chronic kidney disease staging in pediatric renal or heart transplant recipients

    NARCIS (Netherlands)

    A.B. Vroling (Aram Ben); E.M. Dorresteijn (Eiske); K. Cransberg (Karlien); Y.B. de Rijke (Yolanda)


    textabstractBackground: The aim of this study was to evaluate the performance of selected pediatric estimated glomerular filtration rate (eGFR) equations in relation to the clinical management of children after renal or heart transplantation or post-chemotherapy treatment. Methods: This study was a

  18. Anemia in Chronic Kidney Disease (United States)

    ... artérielle Heart Disease Mineral & Bone Disorder Anemia in Chronic Kidney Disease What is anemia? Anemia is a condition in ... as they should. How is anemia related to chronic kidney disease? Anemia commonly occurs in people with chronic kidney ...

  19. A genome-wide association for kidney function and endocrine-related traits in the NHLBI's Framingham Heart Study

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    Pearce Elizabeth N


    Full Text Available Abstract Background Glomerular filtration rate (GFR and urinary albumin excretion (UAE are markers of kidney function that are known to be heritable. Many endocrine conditions have strong familial components. We tested for association between the Affymetrix GeneChip Human Mapping 100K single nucleotide polymorphism (SNP set and measures of kidney function and endocrine traits. Methods Genotype information on the Affymetrix GeneChip Human Mapping 100K SNP set was available on 1345 participants. Serum creatinine and cystatin-C (cysC; n = 981 were measured at the seventh examination cycle (1998–2001; GFR (n = 1010 was estimated via the Modification of Diet in Renal Disease (MDRD equation; UAE was measured on spot urine samples during the sixth examination cycle (1995–1998 and was indexed to urinary creatinine (n = 822. Thyroid stimulating hormone (TSH was measured at the third and fourth examination cycles (1981–1984; 1984–1987 and mean value of the measurements were used (n = 810. Age-sex-adjusted and multivariable-adjusted residuals for these measurements were used in association with genotype data using generalized estimating equations (GEE and family-based association tests (FBAT models. We presented the results for association tests using additive allele model. We evaluated associations with 70,987 SNPs on autosomes with minor allele frequencies of at least 0.10, Hardy-Weinberg Equilibrium p-value ≥ 0.001, and call rates of at least 80%. Results The top SNPs associated with these traits using the GEE method were rs2839235 with GFR (p-value 1.6*10-05, rs1158167 with cysC (p-value 8.5*10-09, rs1712790 with UAE (p-value 1.9*10-06, and rs6977660 with TSH (p-value 3.7*10-06, respectively. The top SNPs associated with these traits using the FBAT method were rs6434804 with GFR(p-value 2.4*10-5, rs563754 with cysC (p-value 4.7*10-5, rs1243400 with UAE (p-value 4.8*10-6, and rs4128956 with TSH (p-value 3.6*10-5, respectively. Detailed

  20. Preservative spleen surgery and hyperbaric oxygen therapy. (United States)

    Paulo, Isabel Cristina Andreatta Lemos; Paulo, Danilo Nagib Salomão; Cintra, Luiz Cálice; Santos, Maria Carmem Silva; Rodrigues, Hildegardo; Ferrari, Thiago Antunes; Azevedo, Tiago Caetano V de; Silva, Alcino Lázaro da


    To assess functional and morphological aspects of spleen auto-implants and of the splenic inferior pole of rats, post-operatively treated or not with hyperbaric oxygen, as well as the survival of these animals, were studied. Seventy-eight male Wistar rats, weighing between 192 and 283 g ( 238,3 +/- 9,6g), were randomly distributed into three groups: Group 1--(n=20), spleen manipulation; group 2--(n=36), spleen auto-implantation; group 3--(n= 22), subtotal splenectomy preserving the inferior pole. Each group was subdivided as follows: subgroup a, not submitted to hyperbaric oxygen therapy: 1a(n=10), 2a(n=21), 3a(n= 13); subgroup b, submitted to the therapy: 1b(n=10), 2b(n=15), 3b(n=9). Blood was collected pre-operatively and 11 days after surgery, for the estimation of lipids and immunoglobulins and the counting of platelets and Howell-Jolly corpuscles. The spleen and remains were taken for histological study. The number of surviving animals was significantly higher in groups 1(p 2. The macro and microscopic appearance in subgroup 2b were more viable than in subgroup 2a, and that of group 3 more viable than in group 2. The survival of the animals carrying their whole spleen or its inferior pole was more frequent than that of the auto-implanted animals. Functionality and viability of the whole spleen or of its inferior pole, were better than in the auto-implanted animals. Hyperbaric oxygen-therapy contributed to increased survival frequency of auto-implanted animals, and to improve the functionality and viability of the auto-implants and the function of the inferior splenic pole, and did not interfere in animals carrying their whole spleen.

  1. [Fibroblast growth factor 23 and a novel high-sensitivity troponin I: Early markers and alternative ways of damaging the heart in chronic kidney disease]. (United States)

    Dzgoeva, F U; Sopoev, M Yu; Gatagonova, T M; Bestaeva, T L; Khamitsaeva, O V


    To establish possible pathogenetic relationships between the marker of bone mineral metabolism fibroblast growth factor 23 (FGF-23) and the markers of cardiovascular diseases characterizing the state of cardiomyocytes and that of the vascular wall of the aorta and large vessels in chronic kidney disease (CKD). A total of 110 patients (57 men and 53 women) aged 25 to 65 years (mean age 56 ± 2.2 years) with different stages of CKD were examined. FGF-23 and troponin I in the sera from all the patients were investigated using enzyme immunoassay kits. Doppler echocardiography was carried out to evaluate the morphofunctional state of the left ventricle (LV). Peak systolic blood flow velocity in the aortic arch and common carotid intima-media thickness were estimated to assess the wall of the aorta and large arteries. As renal failure progressed, just at the early CKD stages the patients were found to have elevating FGF-23 and troponin I levels forestalling an increase in parathyroid hormone concentrations and changes in other calcium-phosphorus metabolism indicators. The levels of FGF-23 and the morphofunctional indicators of LV lesion showed a strong direct correlation that preserved its significance in analyzing the factors under study in relation to the function of the kidneys. The morphogenetic protein FGF-23 seems to play a significant role not only in bone remodeling processes, but also in the development of cardiovascular events in CKD. However, the mechanisms of its implication in the development of heart disease, like the possibilities of using its level changes as early diagnostic criteria for cardiovascular involvement, call for further investigation.

  2. Spleen-preserving distal pancreatectomy in trauma. (United States)

    Schellenberg, Morgan; Inaba, Kenji; Cheng, Vincent; Bardes, James M; Lam, Lydia; Benjamin, Elizabeth; Matsushima, Kazuhide; Demetriades, Demetrios


    Traumatic injuries to the distal pancreas are infrequent. Universally accepted recommendations about the need for routine splenectomy with distal pancreatectomy do not exist. The aims of this study were to compare outcomes after distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy, and to define the appropriate patient population for splenic preservation. All patients who underwent distal pancreatectomy (January 1, 2007, to December 31, 2014) were identified from the National Trauma Data Bank. Patients with concomitant splenic injury and those who underwent partial splenectomy were excluded. Demographics, clinical data, procedures, and outcomes were collected. Study groups were defined by surgical procedure: distal pancreatectomy and splenectomy versus spleen-preserving distal pancreatectomy. Baseline characteristics between groups were compared with univariate analysis. Multivariate analysis was performed with logistic and linear regression to examine differences in outcomes. Over the 8-year study period, 2,223 patients underwent distal pancreatectomy. After excluding 1,381 patients with concomitant splenic injury (62%) and 8 (pancreatectomy and splenectomy, those who underwent spleen-preserving distal pancreatectomy were younger (p pancreatectomy (p = 0.017). Complications, mortality, and intensive care unit LOS were not significantly different. In young patients after blunt trauma who are not severely injured, a spleen-preserving distal pancreatectomy should be considered to allow for conservation of splenic function and a shorter hospital LOS. In all other patients, the surgeon should not hesitate to remove the spleen with the distal pancreas. Therapy, level IV.

  3. Solid solitary hamartoma of the spleen

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    Grubor Nikica


    Full Text Available Introduction. Hamartoma of the spleen is a rare, sometimes asymptomatic similar to hemangioma benign tumor of the spleen, which, owing to the new diagnostic imaging methods, is discovered with increasing frequency. It appears as solitary or multiple tumorous lesions. Case Outline. We present a 48-year-old woman in whom, during the investigation for Helicobacter pylori gastric infection and rectal bleeding, with ultrasonography, a mass 6.5×6.5 cm in diameter was discovered by chance within the spleen. Splenectomy was performed due to suspected lymphoma of the spleen. On histology, tumor showed to be of mixed cellular structure, with areas without white pulp, at places with marked dilatation of sinusoids and capillaries to the formation of „blood lakes“ between which broad hypercellular Billroth’s zones were present. Extramedullary hematopoiesis was found focally. The cells that covered vascular spaces were CD34+ and CD31+ and CD8- and CD21-. Conclusion. Hamartoma has to be taken into consideration always when well circumscribed hypervascular tumor within the spleen is found, particularly in children. Although the diagnosis of hamartoma may be suspected preoperatively, the exact diagnosis is established based on histological and immunohystochemistry examinations. Treatment is most often splenectomy and rarely a partial splenectomy is possible, which is recommended particularly in children.

  4. Recruitment of macrophages from the spleen contributes to myocardial fibrosis and hypertension induced by angiotensin II

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    Ning-Ping Wang


    Full Text Available Introduction: The purpose of this study was to determine whether macrophages migrated from the spleen are associated with angiotensin II-induced cardiac fibrosis and hypertension. Methods: Sprague-Dawley rats were subjected to angiotensin II infusion in vehicle (500 ng/kg/min for up to four weeks. In splenectomy, the spleen was removed before angiotensin II infusion. In the angiotensin II AT1 receptor blockade, telmisartan was administered by gastric gavage (10 mg/kg/day during angiotensin II infusion. The heart and aorta were isolated for Western blot analysis and immunohistochemistry. Results: Angiotensin II infusion caused a significant reduction in the number of monocytes in the spleen through the AT1 receptor-activated monocyte chemoattractant protein-1. Comparison of angiotensin II infusion, splenectomy and telmisartan comparatively reduced the recruitment of macrophages into the heart. Associated with this change, transforming growth factor β1 expression and myofibroblast proliferation were inhibited, and Smad2/3 and collagen I/III were downregulated. Furthermore, interstitial/perivascular fibrosis was attenuated. These modifications occurred in coincidence with reduced blood pressure. At week 4, invasion of macrophages and myofibroblasts in the thoracic aorta was attenuated and expression of endothelial nitric oxide synthase was upregulated, along with a reduction in aortic fibrosis. Conclusions: These results suggest that macrophages when recruited into the heart and aorta from the spleen potentially contribute to angiotensin II-induced cardiac fibrosis and hypertension.

  5. [Pyoderma gangrenosum with aseptic spleen abscess]. (United States)

    Brahimi, N; Maubec, E; Boccara, O; Marinho, E; Valeyrie-Allanore, L; Lecaille, C; Sebban, V; Hersent, B; Picard-Dahan, C; Descamps, V; Crickx, B


    Pyoderma gangrenosum is a neutrophilic dermatosis in which systemic involvement is rare. It may be associated with systemic disease. We report a case of pyoderma gangrenosum in the spleen. A 68-year-old man presenting pyoderma gangrenosum with pustules and stage I multiple myeloma was admitted for asthenia and abdominal pain. There were no skin lesions. Laboratory tests showed inflammatory syndrome with polynuclear leucocytes of 25,000/mm(3). CAT scans and abdominal ultrasound revealed a splenic abscess. A spleen biopsy was performed and histological examination showed polynuclear leukocyte infiltration, while cultures were negatives. Diagnosis of pyoderma gangrenosum with splenic involvement was made. Increased systemic corticosteroid therapy produced a successful outcome. Haematological findings remained unchanged. Spleen involvement in pyoderma gangrenosum is very rare and can mimic an infectious process. In such cases, routine screening is essential for associated diseases, particularly haematological malignancies.

  6. Function of the replanted spleen in dogs

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    Velcek, F.T.; Kugaczewski, J.T.; Jongco, B.; Shaftan, G.W.; Rao, P.S.; Schiffman, G.; Kottmeier, P.K.


    The function of replanted splenic fragments was studied by comparing three groups of five dogs each, one group with intact spleens; one, post-splenectomy; and one with splenic replantation. Fifteen fragments were implanted into the omentum. Howell-Jolly bodies appeared after splenectomy but cleared in the replanted group after several months. /sup 125/I-tagged attenuated pneumococcal clearance studies showed a significant difference between control and replanted group compared with the splenectomized group. The increase of pneumococcal antibody titers after vaccination differed significantly between the splenectomized and the replanted group. All replanted fragments were viable and showed growth over a 2-year period. These studies demonstrate that omental replantation of the canine spleen leads to the maintenance of certain functional splenic parameters comparable to the normal spleen which are significantly different from the splenectomized animal.

  7. High Blood Pressure and Kidney Disease (United States)

    ... Heart Disease Mineral & Bone Disorder High Blood Pressure & Kidney Disease What is high blood pressure? Blood pressure is ... are the symptoms of high blood pressure and kidney disease? Most people with high blood pressure do not ...

  8. Laparoscopic Splenectomy in Patients With Spleen Injuries. (United States)

    Ermolov, Aleksander S; Tlibekova, Margarita A; Yartsev, Peter A; Guliaev, Andrey A; Rogal, Mikhail M; Samsonov, Vladimir T; Levitsky, Vladislav D; Chernysh, Oleg A


    Spleen injury appears in 10% to 30% of abdominal trauma patients. Mortality among the patients in the last 20 years remains high (6% to 7%) and shows no tendency to decline. Nowadays nonoperative management is widely accepted management of patients with low-grade spleen injury, whereas management of patients with high-grade spleen injury (III and higher) is not so obvious. There are 3 methods exist in treatment of such patients: conservative (with or without angioembolization), spleen-preserving operations, and splenectomy. Today laparoscopic splenectomy is not a widely used operation and only few studies reported about successful use of laparoscopic splenectomy in patients with spleen injury.The aim of the study was to determine indications and contraindications for laparoscopic splenectomy in abdominal trauma patients and to analyze results of the operations. The study involved 42 patients with spleen injury grade III who were admitted in our institute in the years of 2010 to 2014. The patients were divided in 2 groups. Laparoscopic splenectomy was performed in 23 patients (group I) and "traditional" splenectomy was carried out in 19 patients (group II). There was no difference in the demographic data and trauma severity between the 2 groups. Noninvasive investigations, such as laboratory investigations, serial abdominal ultrasound examinations, x-ray in multiple views, and computed tomography had been performed before the decision about necessity of an operation was made. Patients after laparoscopic operations had better recovering conditions compared with patients with the same injury after "traditional" splenectomy. Neither surgery-related complications nor mortalities were registered in both groups. Laparoscopic splenectomy was more time-consuming operation than "traditional" splenectomy. We suggest that as experience of laparoscopic splenectomy is gained the operation time will be reduced. Laparoscopic splenectomy is a safe feasible operation in patients

  9. Comparison of Rates of Death Having any Death-Certificate Mention of Heart, Kidney, or Liver Disease Among Persons Diagnosed with HIV Infection with those in the General US Population, 2009-2011


    Whiteside, Y. Omar; Selik, Richard; An, Qian; Huang, Taoying; Karch, Debra; Hernandez, Angela L; Hall, H. Irene


    Objective : Compare age-adjusted rates of death due to liver, kidney, and heart diseases during 2009-2011 among US residents diagnosed with HIV infection with those in the general population. Methods : Numerators were numbers of records of multiple-cause mortality data from the national vital statistics system with an ICD-10 code for the disease of interest (any mention, not necessarily the underlying cause), divided into those 1) with and 2) without an additional code for HIV infection. Deno...

  10. Effect of rapamycin on spleen size in longstanding renal transplant recipients. (United States)

    Araújo, N C; Sampaio Gonçalves de Lucena, S B; da Silveira Rioja, S


    Based on evidence available in the literature, rapamycin, a mammalian target of rapamycin (mTOR) inhibitor, but not calcineurin inhibitors (CNIs), has been shown to decrease spleen size. Small spleen, in some instances, is associated with hyposplenism, a condition recently reported in patients with longstanding renal transplant. Accordingly, the effect of immunosuppressive drugs on spleen size was evaluated. Renal transplant recipients (35 taking mTOR and 68 CNI) were included, in whom a standardized investigation of the kidney allograft and spleen with the use of color Doppler ultrasound was performed and a peripheral smear were reviewed for the presence of Howell-Jolly bodies (HJBs). We enrolled 103 patients (64 men; 66 from a deceased donor). The mean age was 47.7 years (range, 23.0-74.0 y). Mean transplant duration was 1,899 days (range, 181-6,883 d). According to the presence of HJBs, the prevalence of hyposplenism was 47.6% for the entire cohort. The differences between the mTOR and CNI groups regarding sex and the presence of HJBs were not statistically significant (P > .05). Age, creatinine, hemoglobin, leukocytes, platelets, and Doppler parameters in spleen and kidney were similar in both groups (P > .05). mTOR patients had a decreased spleen length size (90.09 ± 13.02 mm vs 111.95 ± 18.66 mm; P < .001), a longer transplant duration (3,576 ± 1,594 d vs 1,036 ± 1,369 d; P < .001) and higher serum cholesterol (227.50 ± 38.75 mg/dL vs 182.67 ± 37.74 mg/dL; P < .001) and triglycerides (194.23 ± 79.88 mg/dL vs 148.70 ± 55.54 mg/dL; P = .003) levels compared with the CNI group. A multivariate analysis showed mTOR inhibitor to be the most important predictor of spleen size. In both the mTOR and CNI groups, the comparison between the subgroups of present and absent HJBs did not show any difference. The findings of this study suggest that small spleens in transplant recipients may be linked to treatment with an mTOR inhibitor, although this apparently does

  11. Kidney Dysplasia (United States)

    ... as the fetus grows in the womb. In kidney dysplasia, the tubules fail to branch out completely. Urine that would ... to form a network of tiny structures called tubules. Kidney dysplasia in one kidney What are the kidneys ...

  12. Kidney transplant (United States)

    ... place a healthy kidney into a person with kidney failure . ... Renal transplant; Transplant - kidney ... Becker Y, Witkowski P. Kidney and pancreas transplantation. In: Townsend CM ... Urology . 11th ed. Philadelphia, PA: Elsevier; 2016: ...

  13. Distal splenorenal shunt with partial spleen resection

    Directory of Open Access Journals (Sweden)

    Gajin Predrag


    Full Text Available Introduction: Hypersplenism is a common complication of portal hypertension. Cytopenia in hypersplenism is predominantly caused by splenomegaly. Distal splenorenal shunt (Warren with partial spleen resection is an original surgical technique that regulates cytopenia by reduction of the enlarged spleen. Objective. The aim of our study was to present the advantages of distal splenorenal shunt (Warren with partial spleen resection comparing morbidity and mortality in a group of patients treated by distal splenorenal shunt with partial spleen resection with a group of patients treated only by a distal splenorenal shunt. Method. From 1995 to 2003, 41 patients with portal hypertension were surgically treated due to hypersplenism and oesophageal varices. The first group consisted of 20 patients (11 male, mean age 42.3 years who were treated by distal splenorenal shunt with partial spleen resection. The second group consisted of 21 patients (13 male, mean age 49.4 years that were treated by distal splenorenal shunt only. All patients underwent endoscopy and assessment of oesophageal varices. The size of the spleen was evaluated by ultrasound, CT or by scintigraphy. Angiography was performed in all patients. The platelet and white blood cell count and haemoglobin level were registered. Postoperatively, we noted blood transfusion, complications and total hospital stay. Follow-up period was 12 months, with first checkup after one month. Results In the first group, only one patient had splenomegaly postoperatively (5%, while in the second group there were 13 patients with splenomegaly (68%. Before surgery, the mean platelet count in the first group was 51.6±18.3x109/l, to 118.6±25.4x109/l postoperatively. The mean platelet count in the second group was 67.6±22.8x109/l, to 87.8±32.1x109/l postoperatively. Concerning postoperative splenomegaly, statistically significant difference was noted between the first and the second group (p<0.05. Comparing the

  14. Effect of pomegranate (Punica granatum L.) juice on kidney, liver, heart and testis histopathological changes, and the tissues lipid peroxidation and antioxidant status in lead acetate-treated rats. (United States)

    Aksu, D S; Sağlam, Y S; Yildirim, S; Aksu, T


    Pomegranate juice (PJ) contains relevant amounts of active biological compounds which alleviate the detrimental effects of chronic heavy metal exposure. This study investigated the protective potential of PJ against lead-induced oxidative stress. A total of forty adult male Sprague Dawley rats were divided into four experimental groups. The animals were fed a standard pellet diet and tap water ad libitum. The rats were divided into four groups (n=10 for each group): control, lead asetat (2000 ppm), low-treated PJ- a daily dose of 2.000 ppm lead plus 30µl pomegranate juice (included 1.050 µmol total polyphenols, gallic acid equivalent), and high-treated PJ- a daily dose of 2.000 ppm lead plus 60µl pomegranate juice (included 2.100 µmol total polyphenols, gallic acid equivalent). The treatments were delivered for 5 weeks. After the treatment period, the tissues samples (kidney, liver, heart and testis) were collected. Tissue lead (Pb) and mineral amounts (copper, zinc, and iron), tissues lipid peroxidation level and antioxidant status, and tissues histopathological changes were determined. The results showed that the highest rate lead loading was in the kidney and the testis. Pomegranate juice was decreased the lead levels of soft tissues examined; increased Zn amounts in tissues of which the lead accumulation was higher (kidney and the testis); decreased the copper, zinc and the iron levels of the liver and heart tissues, without creating a weakness in antioxidant capacity of these tissues, restricted the oxidative stress by decreasing lipid peroxidation, improved both of the activities of antioxidant enzymes such as superoxide dismutase (SOD) and catalaz (CAT), and the level of glutathione (GSH) in all the tissues examined in lead-treated groups. As histopathological findings, the cellular damage induced by lead in the tissues of the kidney, liver and the heart were observed to have been partially prevented by PJ treatment. The protective effect of PJ was more

  15. Effects of pomegranate seed oil on oxidative stress markers, serum biochemical parameters and pathological findings in kidney and heart of streptozotocin-induced diabetic rats. (United States)

    Mollazadeh, Hamid; Sadeghnia, Hamid R; Hoseini, Azar; Farzadnia, Mehdi; Boroushaki, Mohammad Taher


    Oxidative stress due to hyperglycemia is a major cause of diabetes complications. The aim of this study was to evaluate the effects of pomegranate seed oil (PSO) on serum biochemical parameters, cardiomyopathy and nephropathy induced by diabetes mellitus. W/A adult rats were divided into four groups (12 each): group 1, received saline (1 mL/kg), group 2, received streptozotocin (STZ, 65 mg/kg, a single dose as i.p.), groups 3 and 4, received STZ + PSO (0.4 and 0.8 mL/kg, daily by gavage, respectively). After three weeks, six rats of each group and one week later the remaining animals were anesthetized, blood samples were taken for measuring serum biochemical parameters. Sections of heart and kidneys were used for histopathological studies and the remaining tissues were homogenized for measuring malondialdehyde (MDA) and total sulfhydryl groups. Significant elevation of serum creatinine and urea, LDL, triglyceride, glucose levels as well as urine markers, MDA levels in tissue homogenates and a significant decrease in total thiol content and serum HDL were observed in STZ-treated group as compared with control group. PSO treatment resulted in a significant decrease in tissue MDA content, serum creatinine and urea levels as well as urine markers as compared with STZ-treated group. Lipid profile was ameliorated with PSO treatment. PSO also significantly reversed STZ-induced depletion in thiol content and histological abnormality. Effect of PSO was more specific at 28th than 21th days of study. The results showed that PSO has a protective effect against diabetes complications in rats.

  16. Dobutamine stress echocardiography in the diagnosis of asymptomatic ischemic heart disease in patients with chronic kidney disease--review of literature and single-center experience. (United States)

    Januszko-Giergielewicz, B; Dębska-Ślizień, A; Górny, J; Kozak, J; Oniszczuk, K; Gromadziński, L; Dorniak, K; Dudziak, M; Malinowski, P; Rutkowski, B


    Coronary artery disease (CAD) may be present in kidney transplant (KT) candidates without the presence of CAD clinical symptoms. This study joins an ongoing discussion about appropriate noninvasive diagnostic approaches for ischemic heart disease (IHD) assessment and patient selection for revascularization procedures. The aim of this study was to evaluate the role of dobutamine stress echocardiography (DSE) in IHD diagnosis in initially asymptomatic maintenance hemodialysis (HD) patients. Forty HD patients aged 52.4 ± 2.0 years, were studied for 2.5 years. At inclusion, they were free of both symptoms and history of IHD. Standard electrocardiography (ECG), chest X-ray, standard echocardiography, DSE, 24-hour Holter ECG, and Doppler ultrasonography (carotids and lower extremities) were performed. Results were analyzed according to a predefined diagnostic algorithm. DSE yielded negative results in all patients. Left ventricular (LV) ejection fraction ≤ 60%, LV hypertrophy, and Holter ECG silent ischemia features were noticed in 15%, 70%, and 10% of patients, respectively. Atherosclerotic lesions in lower extremities and carotid arteries were present in 50% and 37.5% of patients, respectively. During the follow-up, 9/40 patients died, including 6 cardiovascular (CV) deaths: 2 with intermediate and 4 with high CV risk according to the proposed algorithm. In asymptomatic KT candidates, not only DSE, but also other noninvasive tests (eg, echocardiography and Doppler ultrasonography of the carotid and peripheral arteries) along with a detailed profile of the remaining CV risk factors should be performed and analyzed. Defined composition of risk factors and particular changes in noninvasive tests may be an indication for coronary angiography. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. B-type natriuretic peptide predicts an ischemic etiology of acute heart failure in patients with stage 4-5 chronic kidney disease. (United States)

    Kim, Sung Eun; Park, Sunghoon; Kim, Jwa-Kyung; Kim, Sung Gyun; Kim, Hyung Jik; Song, Young Rim


    The non-invasive differentiation of ischemic and non-ischemic acute heart failure (AHF) not resulting from acute myocardial infarction is difficult and has therapeutic and prognostic implications. The aim of this study was to assess whether plasma B-type natriuretic peptide (BNP) can identify ischemic etiology in patients with stage 4-5 chronic kidney disease (CKD) presenting with AHF. We prospectively analyzed 61 patients. The diagnosis of ischemic AHF was confirmed by coronary angiography or stress myocardial perfusion imaging. Plasma levels of BNP were measured at admission (BNP1) and 48 h after admission (BNP2). The mean age of the study patients was 67 years. In these patients, 70.5% had diabetes and 47.5% had dialysis-dependent CKD; 28 of these patients (45.9%) had an ischemic etiology with significantly higher concentrations of BNP1 and BNP2 than did patients without ischemia. The area under the receiver operating characteristic curve was 0.755 (P=0.001) for BNP1 and 0.868 (Pischemic etiology of AHF. Plasma BNP1 >2907 ng/L (odds ratio [OR], 10.9; 95% confidence interval [CI] 2.5-48.4; P=0.002) and BNP2 >2322 ng/L (OR 93.1, 95% CI 7.0-1238.7; P=0.001) were independently associated with an ischemic etiology of AHF. Plasma BNP may represent a clinically useful non-invasive tool for identification of ischemic etiology of AHF in patients with stage 4-5 CKD. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Attenuation of inflammatory response by a novel chalcone protects kidney and heart from hyperglycemia-induced injuries in type 1 diabetic mice

    International Nuclear Information System (INIS)

    Fang, Qilu; Wang, Jingying; Wang, Lintao; Zhang, Yali; Yin, Haimin; Li, Yunzhou; Tong, Chao; Liang, Guang; Zheng, Chao


    High glucose-induced inflammatory response in diabetic complications plays an important role in disease occurrence and development. With inflammatory cytokines and signaling pathways as important mediators, targeting inflammation may be a new avenue for treating diabetic complications. Chalcones are a class of natural products with various pharmacological activities. Previously, we identified L2H17 as a chalcone with good anti-inflammatory activity, inhibiting LPS-induced inflammatory response in macrophages. In this study, we examined L2H17's effect on hyperglycemia-induced inflammation both in mouse peritoneal macrophages and a streptozotocin-induced T1D mouse model. Our results indicate that L2H17 exhibits a strong inhibitory effect on the expression of pro-inflammatory cytokines, cell adhesion molecules, chemokines and macrophage adhesion via modulation of the MAPK/NF-κB pathway. Furthermore, in vivo oral administration of L2H17 resulted in a significant decrease in the expression of pro-inflammatory cytokines and cell adhesion molecules, contributing to a reduction of key markers for renal and cardiac dysfunction and improvements in fibrosis and pathological changes in both renal and cardiac tissues of diabetic mice. These findings provide the evidence supporting targeting MAPK/NF-κB pathway may be effective therapeutic strategy for diabetic complications, and suggest that L2H17 may be a promising anti-inflammatory agent with potential as a therapeutic agent in the treatment of renal and cardiac diabetic complications. - Highlights: • Chalcones are a class of natural products with various pharmacological activities. • We identified L2H17 a chalcone with good anti-inflammatory activity. • L2H17 improved histological abnormalities both in diabetic heart and kidney. • L2H17 reduced inflammatory responses in HG-stimulated mouse peritoneal macrophages. • MAPKs/NF-κB pathway may be a promising therapeutic target for diabetic complications.

  19. Major Cardiovascular Events in Patients with Gout and Associated Cardiovascular Disease or Heart Failure and Chronic Kidney Disease Initiating a Xanthine Oxidase Inhibitor. (United States)

    Foody, JoAnne; Turpin, Robin S; Tidwell, Beni A; Lawrence, Debra; Schulman, Kathy L


    Several observational studies and meta-analyses have suggested that treating hyperuricemia in patients with gout and moderate or severe chronic kidney disease (CKD) may improve renal and cardiovascular (CV) outcomes. To evaluate the impact of initiating allopurinol or febuxostat treatment on major CV events in patients with gout, preexisting CV disease (CVD) or heart failure (HF), and stage 3 or 4 CKD in a real-world setting. Patients with gout (aged >18 years) who initiated allopurinol or febuxostat treatment between 2009 and 2013 after a diagnosis of stage 3 or 4 CKD and CVD-including coronary artery disease (CAD), cerebrovascular disease, and peripheral vascular disease (PVD)-or HF were selected from the MarketScan databases. The major CV events included CAD-specific, cerebrovascular disease-specific, and PVD-specific events. Cox proportional hazards modeling identified the predictors of major CV events in aggregate, and of CAD, cerebrovascular disease, and PVD events, individually. During follow-up, 2426 patients (370 receiving febuxostat and 2056 receiving allopurinol; 63% male; mean age, 73 years) had 162 major CV events (3.8% in those receiving febuxostat vs 7.2% in those receiving allopurinol; P = .015). The rates of major CV events per 1000 person-years were 51.8 (95% confidence interval [CI], 28-87) in patients initiating febuxostat and 99.3 (95% CI, 84-117) among those initiating allopurinol. Overall, 49.4% of patients had a CAD event, 32.5% had a PVD event, and 23.5% had a cerebrovascular disease-specific event. Febuxostat initiation was associated with a significantly lower risk for a major CV event versus patients who initiated allopurinol (hazard ratio, 0.52; P = .02), driven in large part by lower PVD-specific events ( P = .026). Patients with moderate-to-severe CKD and CVD or HF who initiated febuxostat treatment had a significantly lower rate of major CV events than patients who initiated allopurinol.

  20. Chronic kidney disease and cardiac remodelling in patients with mild heart failure: results from the REsynchronization reVErses Remodeling in Systolic Left vEntricular Dysfunction (REVERSE) study. (United States)

    Mathew, Jehu; Katz, Ronit; St John Sutton, Martin; Dixit, Sanjay; Gerstenfeld, Edward P; Ghio, Stefano; Gold, Michael R; Linde, Cecilia; Shlipak, Michael G; Deo, Rajat


    Chronic kidney disease (CKD) is a risk factor for left ventricular hypertrophy (LVH) and heart failure. We evaluated the effect of CKD on left ventricular (LV) remodelling among patients with mild heart failure. REVERSE was a randomized, controlled trial evaluating cardiac resynchronization therapy (CRT) in patients with New York Heart Association (NYHA) class I/II heart failure. CKD was defined as an estimated glomerular filtration rate (eGFR) cardiac remodelling among patients randomized to CRT on or off. CKD was associated with worsening LV function and dilation compared with the non-CKD group {adjusted, 12-month β coefficients for the CKD group compared with the non-CKD referent group: LV ejection fraction (%) [-1.80, 95% confidence interval (CI) -3.36 to -0.24], LV end-systolic volume (mL) (14.16, 95% CI 3.96-24.36), LV end-diastolic volume (mL) (14.88, 95% CI 2.88-26.76), LV end-systolic diameter (cm) (0.36, 95% CI 0.12-0.48), LV end-diastolic diameter (cm) (0.24, 95% CI 0.012-0.36), mitral regurgitation (%) (3.12, 95% CI 0.48-5.76), and LV shape (0.036, 95% CI 0.012-0.060)}. In participants assigned to CRT, those without CKD had significantly greater improvements in LV structural parameters compared with the CKD group. In comparison with participants with normal kidney function, CKD is an independent risk factor for ventricular dysfunction and dilation. CRT improves LV function and structure to a lesser extent in patients with CKD than in those with normal kidney function.

  1. Associations of tumor necrosis factor alpha receptor type 1 with kidney function decline, cardiovascular events, and mortality risk in persons with coronary artery disease: Data from the Heart and Soul Study. (United States)

    Park, Meyeon; Maristany, Daniela; Huang, Debbie; Shlipak, Michael G; Whooley, Mary


    Tumor necrosis factor receptor type 1 (TNFR1) is associated with kidney disease and mortality risk in various populations. Whether or not kidney function mediates mortality risk is unknown. We evaluated associations of TNFR1 levels with measures of kidney function, cardiovascular events, and mortality in a population of veterans with stable ischemic heart disease. TNFR1 was measured from baseline serum samples in the Heart and Soul Study; elevated levels were defined by the highest quartile (Q4, >3.4 ng/ml). We evaluated associations of high TNFR1 with baseline estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR) and with longitudinal changes in eGFR (rapid loss), as well as with incident myocardial infarction (MI), heart failure hospitalizations (HF), and mortality over a median follow-up time of 8.9 years. Covariates included demographics and comorbid conditions. Among 985 participants who had TNFR1 measurements, median TNFR1 was 2.33 ng/ml (IQR 1.8-3.1). Relative to Q1, Q4 had higher risk of eGFR <60 ml/min/1.73 m 2 (RR 11.71 [95% CI 5.46, 25.11]); ACR ≥ 30 mg/g (2.44 [1.15, 5.19]); and rapid loss in kidney function (2.10 [1.12, 3.92]). Although TNFR1 Q4 was associated with MI, HF, and mortality after demographic adjustment, there were no associations in fully-adjusted models (1.04 [0.44, 2.49]; 1.02 [0.48, 2.15]; 1.42 [0.88, 2.28], respectively). Levels of TNFR1 are associated longitudinally with kidney function decline but not with MI, HF or mortality risk after adjustment. Kidney disease may mediate the risk of MI, HF, and mortality associated with TNFR1. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Sonographic assessment and grading of spleen index in various diseases

    Directory of Open Access Journals (Sweden)

    Rohani N


    Full Text Available Ultrasonography is a useful procedure in evaluation of spleen size in different clinical conditions. In this study, we used it to evaluate spleen size in patients with various heptologic, hematologic and autoimmune diseases. To express spleen size, a spleen index (SI, the product of the transverse diameter and its perpendiculr diameter measured on the maximum-sectional image of the spleen, was used. Splenomegaly was present in high percentages of patients with liver, blood, collagen or autoimmune diseases, even though a majority of these spleens were not large enough to palpate. By grading the SI, characteristic distributions of SI were obtained for patients with different types of diseases. Obtaining and grading the SI by the use of ultrasound appears to be a significant supplemental aid for evaluating spleen size, especially in patients whose spleen are not palpable.

  3. Wandering spleen with a ten-time twisted vascular pedicle

    Directory of Open Access Journals (Sweden)

    Marta Peretti


    Full Text Available Torsion of a wandering spleen is a rare cause of acute abdomen in children, usually diagnosed with color-Doppler ultrasonography and enhanced computed tomography. We report a pediatric case of torsion of wandering spleen.

  4. Value of transoperative scintigraphy in the detection of accessory spleens

    International Nuclear Information System (INIS)

    Sezeur, A.; Goujard, F.; Labriolle-Vaylet, C.L. de; Wioland, M.; Douay, L.; Desmarquet, J.


    A case of accessory spleen, 1 cm in diameter, responsible for recurrence of an idiopathic thrombocytopenic purpura after splenectomy is reported. This case is original in that the accessory spleen could only be detected by transoperative scintigraphy. Transoperative scintigraphy is a simple method to be used when one or several unrecognized accessory spleens are responsible for recurrence of a blood disease after excision of the principal spleen [fr

  5. Hemolysis and Acute Kidney Failure


    Qian, Qi; Nath, Karl A.; Wu, Yiming; Daoud, Tarek M.; Sethi, Sanjeev


    Deposits of iron and hemosiderosis in the kidney have been observed in diseases with intravascular hemolysis, including paroxysmal nocturnal hemoglobinuria, and valvular heart diseases and prosthetic heart valve implants. However, the decrease in kidney function associated with hemolysis caused by cardiac valvular disease or prostheses is less well recognized. We present a case of intravascular hemolysis after repair and banding of the mitral valve that resulted in massive renal tubular depos...

  6. Wandering Spleen with Splenic Vein Thrombosis: A Case Report ...

    African Journals Online (AJOL)

    A wandering spleen is a rare clinical occurrence with fewer than 500 cases reported and an incidence of less than 0.2%1, 2. The spleen is an important component of the reticuloendothelial system, which is involved in immunological defence and can serve as a storage site for red blood cells3. The spleen is normally ...

  7. A wandering spleen presenting as a hypogastric mass: Case report ...

    African Journals Online (AJOL)

    ... the spleen. A 26-year-old woman was admitted to our hospital with vomiting and abdominal pain. Abdominal examination revealed a large ovoid hypogastric mass. A CT scan showed a wandering spleen in the hypogastric region. Exploratory laparotomy revealed an ischemic spleen. A total splenectomy was performed.

  8. Polycystic kidney disease (United States)

    Cysts - kidneys; Kidney - polycystic; Autosomal dominant polycystic kidney disease; ADPKD ... kidneys may be needed. Treatments for end-stage kidney disease may include dialysis or a kidney transplant .

  9. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Baigent, Colin; Landray, Martin J; Reith, Christina


    Lowering LDL cholesterol with statin regimens reduces the risk of myocardial infarction, ischaemic stroke, and the need for coronary revascularisation in people without kidney disease, but its effects in people with moderate-to-severe kidney disease are uncertain. The SHARP trial aimed to assess ...

  10. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial

    DEFF Research Database (Denmark)

    Baigent, Colin; Landray, Martin J; Reith, Christina


    Lowering LDL cholesterol with statin regimens reduces the risk of myocardial infarction, ischaemic stroke, and the need for coronary revascularisation in people without kidney disease, but its effects in people with moderate-to-severe kidney disease are uncertain. The SHARP trial aimed to assess...

  11. Kidney Failure (United States)

    ... enough red blood cells. This is called kidney failure. If your kidneys fail, you need treatment to ... providers, family, and friends, most people with kidney failure can lead full and active lives. NIH: National ...

  12. Kidney Problems (United States)

    ... High Blood Pressure Nutrition Join our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & ... specialize in the care of people with kidney (renal) diseases are called nephrologists . What are Kidney Diseases? ...

  13. Kidney Transplant (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z Health ... Tests for Transplant Care After Kidney Transplant Common Organ Donation and Transplantation Terms The National Kidney Foundation (NKF) is the ...

  14. Kidney Diseases (United States)

    ... until you go to the bathroom. Most kidney diseases attack the nephrons. This damage may leave kidneys ... medicines. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or ...

  15. Kidney Cancer (United States)

    ... urine until it is peed out. What Causes Kidney and Renal Pelvis Cancers? Smoking is the most important risk ... grease from metal. What Are the Symptoms of Kidney and Renal Pelvis Cancers? A person with kidney or renal ...

  16. Blood leukocyte and spleen lymphocyte immune response of spleen lymphocytes and whole blood leukocytes of hamsters

    Energy Technology Data Exchange (ETDEWEB)

    Peters, B.A.; Sothmann, M.; Wehrenberg, W.B. (Univ. of Wisconsin, Milwaukee (USA))


    This study was designed to evaluate the effects of chronic physical activity on the immune response of spleen lymphocytes and whole blood leukocytes of hamsters. Animals were kept sedentary or allowed to exercise spontaneously on running wheels for eight weeks. Physically active animals averaged 12 kilometers per day. The immune response of spleen lymphocytes whole blood leukocytes was evaluated by {sup 3}H-thymidine incorporation in response to Concanavalin A or lipopolysaccharide. There was no treatment effect between physically active and sedentary hamster in response of spleen lymphocytes. The immune response of whole blood leukocytes to these mitogens was significantly greater in physically active vs. sedentary hamsters. These results demonstrate that chronic physical activity has the capacity to modulate immunoresponses.

  17. Renal resistive index by transesophageal and transparietal echo-doppler imaging for the prediction of acute kidney injury in patients undergoing major heart surgery. (United States)

    Regolisti, Giuseppe; Maggiore, Umberto; Cademartiri, Carola; Belli, Loredana; Gherli, Tiziano; Cabassi, Aderville; Morabito, Santo; Castellano, Giuseppe; Gesualdo, Loreto; Fiaccadori, Enrico


    Acute kidney injury (AKI) following major heart surgery (MHS) is associated with early decrease in renal blood flow and worsened prognosis. Doppler-derived renal resistive index (RRI), which reflects renal vascular resistance, may predict the development of AKI in patients undergoing MHS. We studied 60 consecutive patients (mean age 69.5 years, range 30-88, 41 males) undergoing MHS. We measured RRI, both at the renal sinus and intraparenchymally, by transesophageal echo-Doppler ultrasound (TE-ED us ) at anesthesia induction and at the end of surgery in all patients. Additionally, we measured RRI by external transparietal echo-Doppler ultrasound (TP-ED us ) at the following time points: anesthesia induction, end of surgery, 4 and 24 h from cardiopulmonary bypass (CPB) start. We also measured serum neutrophil gelatinase associated lipocalin (NGAL) at the same time points. AKI [serum creatinine (sCr) increase ≥0.3 mg/dl vs. baseline within 72 h] developed in 23/60 (38.3 %) patients, with two requiring dialysis. Systemic hemodynamic parameters were similar in the patients who developed AKI (AKI+) and in those who did not (AKI-). Intraparenchymal RRI at end-surgery was significantly higher in AKI+ compared to AKI- patients, both at TE-ED us and TP-ED us (TE-ED us mean difference, p = 0.004; TP-ED us mean difference, p = 0.013; difference between TE-ED us and TP-ED us results, p = 0.066), although the predictive performance was limited with both methods (area under the curve [AUC] of the receiver-operator characteristics: 0.71 and 0.70 for TE-ED us and TP-ED us , respectively). Serum NGAL values were higher in AKI + than in AKI- patients (anesthesia induction, p = 0.037; end-surgery, p = 0.007; 4 h from CPB start, p = 0.093; 24 h from CPB start, p = 0.024. However, combining RRI with serum NGAL at end-surgery did not provide a clear-cut advantage in predicting AKI. In patients undergoing MHS, increased echo-Doppler ultrasound-derived RRI at end

  18. Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease

    DEFF Research Database (Denmark)

    Pitt, Bertram; Kober, Lars; Ponikowski, Piotr


    Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), but their use is limited by hyperkalaemia and/or worsening renal function (WRF). BAY 94-8862 is a highly selective and strongly potent non-steroida......-steroidal MRA. We investigated its safety and tolerability in patients with HFrEF associated with mild or moderate chronic kidney disease (CKD).......Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), but their use is limited by hyperkalaemia and/or worsening renal function (WRF). BAY 94-8862 is a highly selective and strongly potent non...

  19. Relationship between number of spleen colonies and 125IdUrd incorporation into spleen and femur

    International Nuclear Information System (INIS)

    Inoue, T.; Bullis, J.E.; Cronkite, E.P.; Hubner, G.E.


    Graded numbers of bone marrow (BM) cells were injected into fatally irradiated mice. Eight days later the mice were given 3.0 μCi (1 Ci = 3.7 x 10 10 Bq) of 125 IdUrd to label proliferating cells in the spleen and BM. On day 9 the mice were killed and the spleens and femurs were removed for splenic colony assay and measurement of radioactivity in the spleen and femurs. The number of splenic colonies shows a linear relationship with dose of marrow cells injected from 10 4 to 10 5 cells. The slope of the curve of spleen colonies versus number of cells injected is 5 and below 10 4 there is a striking departure from the simple linearity. Below 2 x 10 3 cells injected, the logarithm of the observed colony yield is linear with logarithm of the number of cells injected. Poisson calculation of the average number of pluripotent stem cells that should be present with numbers of marrow cells injected below 2 x 10 3 followed closely the actual observations. The data show that there is no detectible proliferation in the BM until the dose of marrow cells exceeds 3.5 x 10 4 cells. Induction of cells into cycle increases the seeding into the BM, and thymidine cytocide drastically reduces seeding in the BM, leading us to conclude that the BM is repopulated almost exclusively by stem cells in DNA synthesis

  20. The effect of climbing Mount Everest on spleen contraction and increase in hemoglobin concentration during breath holding and exercise. (United States)

    Engan, Harald K; Lodin-Sundström, Angelica; Schagatay, Fanny; Schagatay, Erika


    Release of stored red blood cells resulting from spleen contraction improves human performance in various hypoxic situations. This study determined spleen volume resulting from two contraction-evoking stimuli: breath holding and exercise before and after altitude acclimatization during a Mount Everest ascent (8848 m). Eight climbers performed the following protocol before and after the climb: 5 min ambient air respiration at 1370 m during rest, 20 min oxygen respiration, 20 min ambient air respiration at 1370 m, three maximal-effort breath holds spaced by 2 min, 10 min ambient air respiration, 5 min of cycling at 100 W, and finally 10 min ambient air respiration. We measured spleen volume by ultrasound and capillary hemoglobin (HB) concentration after each exposure, and heart rate (HR) and arterial oxygen saturation (Sao2) continuously. Mean (SD) baseline spleen volume was unchanged at 213 (101) mL before and 206 (52) mL after the climb. Before the climb, spleen volume was reduced to 184 (83) mL after three breath holds, and after the climb three breath holds resulted in a spleen volume of 132 (26) mL (p=0.032). After exercise, the preclimb spleen volume was 186 (89) mL vs. 112 (389) mL) after the climb (p=0.003). Breath hold duration and cardiovascular responses were unchanged after the climb. We concluded that spleen contraction may be enhanced by altitude acclimatization, probably reflecting both the acclimatization to chronic hypoxic exposure and acute hypoxia during physical work.

  1. The influence of U-2 fraction of a tortoise spleen extract on the formation of ectopic locus of haemopoiesis

    International Nuclear Information System (INIS)

    Turdyev, A.A.; Prus, E.K.; Basova, A.R.


    The implantation of a bone marrow fragment of intact mouse donors below the kidney capsule of irradiated (7 Gy) recipients leads to the formation of the haemopoiesis locus that somewhat exceeds, by mass and cellularity, the new-formed locus of control animals. The U-2 fraction of a tortoise spleen extract administered to recipients irradiated with the same dose increases the mass and cellularity of the haemopoiesis locus by 2.2 and 4.9 times respectively

  2. [Delayed rupture of the spleen in a multiply injured patient]. (United States)

    Lică, I; Venter, M D; Mehic, R; Marian, R; Ionescu, G


    The authors present a case of delayed rupture of the spleen in a polytraumatised patient. This entity was defined as a late occurrence of signs and symptoms attributed to splenic injury not detected by diagnostic computed tomographic scanning during the initial examination. The mechanisms in which the delayed rupture of the spleen occurs are discussed and the conclusion is that the delayed rupture of the spleen represent a real clinical entity.

  3. Wandering spleen: a medical enigma, its natural history and rationalization. (United States)

    Magowska, Anita


    Wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant but is found lower in the abdomen or in the pelvic region because of the laxity of the peritoneal attachments. Many patients with wandering spleen are asymptomatic, hence the condition can be discovered only by abdominal examination or at a hospital emergency department if a patient is admitted to hospital because of severe abdominal pain, vomiting or obstipation. This article aims to provide a historical overview of wandering spleen diagnostics and surgical treatment supplemented with an analyses of articles on wandering spleen included in the PubMed database. One of the first clinical descriptions of a wandering spleen was written by Józef Dietl in 1854. The next years of vital importance are 1877 when A. Martin conducted the first splenectomy and in 1895 when Ludwik Rydygier carried out the first splenopexy to immobilize a wandering spleen. Since that time various techniques of splenectomy and splenopexy have been developed. Introducing medical technologies was a watershed in the development and treatment of wandering spleen, which is confirmed by the PubMed database. Despite the increased number of publications medical literature shows that a wandering spleen still remains a misdiagnosed condition, especially among children.

  4. Relation of Coronary Flow Reserve to Other Findings on Positron Emission Tomography Myocardial Perfusion Imaging and Left Heart Catheterization in Patients With End-stage Renal Disease Being Evaluated for Kidney Transplant. (United States)

    Paz, Yehuda; Morgenstern, Rachelle; Weinberg, Richard; Chiles, Mariana; Bhatti, Navdeep; Ali, Ziad; Mohan, Sumit; Bokhari, Sabahat


    Cardiovascular disease is the leading cause of death in patients with end-stage renal disease (ESRD) and often goes undetected. Abnormal coronary flow reserve (CFR), which predicts increased risk of cardiac death, may be present in patients with ESRD without other evidence of coronary artery disease (CAD). We prospectively studied 131 patients who had rest and dipyridamole pharmacologic stress N 13 -ammonia positron emission tomography myocardial perfusion imaging (PET MPI) for kidney transplant evaluation. Thirty-four patients also had left heart catheterization. Abnormal PET MPI was defined as qualitative ischemia or infarct, stress electrocardiogram ischemia, or transient ischemic dilation. CFR was calculated as the ratio of stress to rest coronary blood flow. Global CFR < 2 was defined as abnormal. Of 131 patients who had PET MPI (66% male, 55.6 ± 12.1 years), 30% (39 of 131) had abnormal PET MPI and 59% (77 of 131) had abnormal CFR. In a subset of 34 patients who had left heart catheterization (66% male, 61.0 ± 12.1 years), 68% (23 of 34) had abnormal CFR on PET MPI, and 68% (23 of 34) had ≥70% obstruction on left heart catheterization. Abnormal CFR was not significantly associated with abnormal PET MPI (p = 0.13) or obstructive CAD on left heart catheterization (p = 0.26). In conclusion, in the first prospective study of PET MPI in patients with ESRD, abnormal CFR is highly prevalent and is independent of abnormal findings on PET MPI or obstructive CAD on left heart catheterization. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Detrimental effects of rat mesenchymal stromal cell pre-treatment in a model of acute kidney rejection

    Directory of Open Access Journals (Sweden)

    Martina eSeifert


    Full Text Available Mesenchymal stromal cells (MSC have shown immunomodulatory and tissue repair potential including partial tolerance induction by pre-treatment of donor-specific cells in a rat heart transplantation model. Very recently, we could show that autologous MSC attenuated ischemia reperfusion injury in a highly mismatched donor-recipient rat kidney transplant model. Therefore, we investigated donor-specific MSC pre-treatment in this rat kidney transplantation model to study whether graft function could be improved, or if tolerance could be induced.Donor- and recipient-type MSC or PBS as a control were injected i.v. four days before kidney transplantation. Mycophenolate mofetil (MMF immunosuppression (20 mg/kg body weight was applied for 7 days. Kidney grafts and spleens were harvested between days 8-10 and analyzed by quantitative RT-PCR and immunohistology. In addition, creatinine levels in the blood were measured and serum was screened for the presence of donor-specific antibodies.Surprisingly, application of both donor- and recipient-specific MSC resulted in enhanced humoral immune responses verified by intragraft B cell infiltration and complement factor C4d deposits. Moreover, signs of inflammation and rejection were generally enhanced in both MSC-treated groups relative to PBS control group. Additionally, pre-treatment with donor-specific MSC significantly enhanced the level of donor-specific antibody formation when compared with PBS- or recipient-MSC-treated groups. Pre-treatment with both MSC types resulted in a higher degree of kidney cortex tissue damage and elevated creatinine levels at the time point of rejection. Thus, MSC pre-sensitization in this model impairs the allograft outcome.Our data from this pre-clinical kidney transplantation model indicate that pre-operative MSC administration may not be optimal in kidney transplantation and caution must be exerted before moving forward with clinical studies in order to avoid adverse effects.

  6. The long-term safety of chronic azithromycin use in patients with cystic fibrosis regarding the condition of the kidney, liver and heart

    NARCIS (Netherlands)

    Möhlmann, J.E.; Majoor, C.J.; Van Der Vaart, H.; Touw, D.


    Background: Azithromycin is a widely used macrolide antibiotic in cystic fibrosis (CF), but little is known about the safety of long-term use. Reported side effects only apply to short-term use. The aim of this study is to investigate possible azithromycin-induced toxicity of the kidney, liver and

  7. Kidney Failure (United States)

    ... The Hope Affair A Pairing for Prevention - Boston Classical Music For a Cause A Pairing for Prevention - ... kidney Financial Assistance Kidney patient assistance HelpLine Grants Management System (GMS) login Education & Research Patient Webinars Become ...

  8. Kidney stones (United States)

    ... be done include: Blood tests to check calcium, phosphorus, uric acid, and electrolyte levels Kidney function tests ... half an inch (1.25 centimeters) that are located in the kidney or ureter. It uses sound ...

  9. Kidney School (United States)

    ... Listen Printing multiple copies? Read our licensing agreement Sexuality and Fertility Maintaining a healthy sex life and ... run. Take Our Survey! Sponsors Help Keep Kidney School Free Visit Our Sponsors Page Kidney School is ...

  10. Kidney biopsy (United States)

    ... Results A normal result is when the kidney tissue shows normal structure. What Abnormal Results Mean An abnormal result means there are changes in the kidney tissue. This may be due to: Infection Poor blood ...

  11. Wandering spleen: Case report | Mwango | East African Medical ...

    African Journals Online (AJOL)

    Wandering spleens are rare clinical entities found more commonly in women aged 20-40 years. We report one such case found in a 24-year-old nulliparous woman who presented with low abdominal pains of sudden onset and splenomegaly. An emergency abdominal CT scan showed an enlarged spleen located in the ...

  12. Evolution of the CT imaging findings of accessory spleen infarction

    International Nuclear Information System (INIS)

    Mendi, Resham; Abramson, Lisa P.; Pillai, Srikumar B.; Rigsby, Cynthia K.


    We report the case of a 12-year-old girl presenting with multiple episodes of left upper-quadrant pain caused by torsion of an accessory spleen. We present the CT findings of progression of accessory spleen infarction over the course of 7 days. (orig.)

  13. A wandering spleen presenting as a hypogastric mass: case report

    African Journals Online (AJOL)



    Feb 21, 2012 ... Misawa T, Yoshida K, Shiba H, Kobayashi S, Yanaga K. Wandering spleen with chronic torsion. Am J Surg. 2008 Apr;195(4):504-5. This article on PubMed. 7. Fiquet-Francois C, Belouadah M, Ludot H, Defauw B. Wandering spleen in children: multicenter retrospective study. J Pediatr Surg. 2010.

  14. The wandering spleen: CT findings and possible pitfalls in diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Ben Ely, A.; Zissin, R.; Copel, L.; Vasserman, M.; Hertz, M.; Gottlieb, P.; Gayer, G


    Aim: To report the CT features of wandering spleen, a rare condition which can be incidentally detected as an abdominal or pelvic mass or can present with torsion, causing an acute abdomen. Materials and methods: The CT studies of seven patients, two children and five adults, with wandering spleen were reviewed. CT was performed urgently in three patients for acute abdomen, and electively in four. Results: CT findings of wandering spleen included absence of the spleen in its normal position and a mass located elsewhere in the abdomen or pelvis, i.e. an ectopic spleen, enhancing homogeneously in four cases and failing partially or completely to enhance in the other three, indicating infarction. A 'whirl' appearance representing the twisted splenic pedicle was seen in the three cases with torsion. Urgent splenectomy confirmed infarction secondary to torsion. Conclusion: The possible diagnosis of wandering spleen should be kept in mind when CT shows the spleen to be absent from its usual position and a mass is found elsewhere in the abdomen or pelvis. When, in addition, a 'whirl' or partial or no enhancement of this mass are seen in a case presenting with acute abdomen, torsion of a wandering spleen is a likely diagnosis.

  15. A true ectopic, locally vascularized spleen: a very rare anomaly. (United States)

    Darius, T; Tollens, T; Aelvoet, Chr; Vanrykel, J P


    In contrast to a wandering or ectopic spleen which is vascularized by the original splenic vessels this case describes a true ectopic, locally vascularized spleen in the pelvis. To our knowledge this anomaly has never been described in the literature before.

  16. Hemolysis and Acute Kidney Failure (United States)

    Qian, Qi; Nath, Karl A.; Wu, Yiming; Daoud, Tarek M.; Sethi, Sanjeev


    Deposits of iron and hemosiderosis in the kidney have been observed in diseases with intravascular hemolysis, including paroxysmal nocturnal hemoglobinuria, and valvular heart diseases and prosthetic heart valve implants. However, the decrease in kidney function associated with hemolysis caused by cardiac valvular disease or prostheses is less well recognized. We present a case of intravascular hemolysis after repair and banding of the mitral valve that resulted in massive renal tubular deposition of hemosiderin with decreased kidney function. We discuss the pathophysiologic process of both acute and chronic tubular injury from heme and heme proteins, including injury to organelles resulting in autophagic vacuoles containing damaged organelles, such as mitochondria. We conclude that tubular injury resulting from heme proteins should be considered as a cause of decreased kidney function in all patients with a cardiac valvular disease or prosthesis. PMID:20605299

  17. Randomized multicentre pilot study of sacubitril/valsartan versus irbesartan in patients with chronic kidney disease: United Kingdom Heart and Renal Protection (HARP)- III-rationale, trial design and baseline data. (United States)


    Patients with chronic kidney disease (CKD) are at risk of progression to end-stage renal disease and cardiovascular disease. Data from other populations and animal experiments suggest that neprilysin inhibition (which augments the natriuretic peptide system) may reduce these risks, but clinical trials among patients with CKD are required to test this hypothesis. UK Heart and Renal Protection III (HARP-III) is a multicentre, double-blind, randomized controlled trial comparing sacubitril/valsartan 97/103 mg two times daily (an angiotensin receptor-neprilysin inhibitor) with irbesartan 300 mg one time daily among 414 patients with CKD. Patients ≥18 years of age with an estimated glomerular filtration rate (eGFR) of ≥45 but 20 mg/mmol or eGFR ≥20 but III will provide important information on the short-term effects of sacubitril/valsartan on renal function, tolerability and safety among patients with CKD.

  18. The effect of heart-and kidney-Benefiting Chinese Herbal Medicine on the function of cholinergic M-and Gamma amino-butyric acid (GABA) receptor in brain tissues of analogue dementia rats

    International Nuclear Information System (INIS)

    Mo Qizhong; Gong Bin; Fang Jun


    3 H-QNB and 3 H-GABA were used as radioactive ligand for M-and GABA receptors respectively. M-and GABA receptors were assayed by radioligand binding assay (RBA) in cerebral cortex, hippocampus and cerebellum of analogue dementia rats. It was found that R t of M receptor was decreased in cerebral cortex and hippocampus and R t of GABA receptor was decreased in cerebellum of analogue dementia rats. The dissociation constant (K D ) of M-receptor was decreased significantly in cerebral cortex and K D value of (GABA) receptor was decreased in cerebellum of analogue dementia rats. The decreased R t of M-and GABA receptor in brain tissue of analogue dementia rats was raised by Heart- and Kidney-Benefiting Chinese Herbs as well as hydergin

  19. Uninephrectomy in rats on a fixed food intake results in adipose tissue lipolysis implicating spleen cytokines.

    Directory of Open Access Journals (Sweden)

    Denis eArsenijevic


    Full Text Available The role of mild kidney dysfunction in altering lipid metabolism and promoting inflammation was investigated in uninephrectomized rats (UniNX compared to Sham-operated controls rats. The impact of UniNX was studied 1, 2 and 4 weeks after UniNX under mild food restriction at 90% of ad libitum intake to ensure the same caloric intake in both groups.UniNX resulted in the reduction of fat pad weight. UniNX was associated with increased circulating levels of beta-hydroxybutyrate and glycerol, as well as increased fat pad mRNA of hormone sensitive lipase and adipose triglyceride lipase, suggesting enhanced lipolysis. No decrease in fat pad lipogenesis as assessed by fatty acid synthase activity was observed.Circulating hormones known to regulate lipolysis such as leptin, T3, ghrelin, insulin, corticosterone, angiotensin 1 and angiotensin 2 were not different between the two groups. In contrast, a select group of circulating lipolytic cytokines, including interferon-gamma and granulocyte macrophage–colony stimulating factor, were increased after UniNX. These cytokines levels were elevated in the spleen, but decreased in the kidney, liver and fat pads. This could be explained by anti-inflammatory factors SIRT1, a member of the sirtuins, and the farnesoid x receptor, which were decreased in the spleen but elevated in the kidney, liver and fat pads (inguinal and epididymal. Our study suggests that UniNX induces adipose tissue lipolysis in response to increased levels of a subset of lipolytic cytokines of splenic origin.

  20. Polycystic Kidney Disease (United States)

    ... Eating, Diet, & Nutrition for PKD Race, Ethnicity, & Kidney Disease Renal Artery Stenosis Renal Tubular Acidosis Simple Kidney Cysts ... sodium. Related Conditions & Diseases Chronic Kidney Disease Kidney Disease in Children Simple Kidney Cysts Kidney Stones Urinary Tract Infections ...

  1. The small spleen: sonographic patterns of functional hyposplenia or asplenia. (United States)

    Görg, Christian; Eichkorn, Miriam; Zugmaier, Gerhard


    Functional hyposplenia or asplenia (FAS) can be associated with potential fatal infections. The diagnosis of FAS is traditionally made on liver-spleen scintigraphy and finding Howell-Jolly bodies within erythrocytes. In this retrospective study, our goal was to identify any characteristic sonographic findings of the spleen in patients with FAS in an attempt to determine whether the diagnosis of FAS can be made sonographically. In a review of all medical and sonographic records from the period of January 1, 1985, through December 31, 2001, we identified 24 patients (11 men, 13 women) in whom FAS had been diagnosed by liver-spleen scintigraphy (n = 13) or the finding of Howell-Jolly bodies (n = 11). The following sonographic parameters were determined: size of spleen (small, normal, or large), echotexture of the spleen (homogeneous versus inhomogeneous), echogenicity (isoechoic versus hyperechoic), presence of focal splenic lesions, and patterns of splenic vascularization as determined by color Doppler sonography (absent flow, hilar flow, or parenchymal flow). The spleen was small in 20 patients (83%) and normal in the other 4 (17%). Echotexture was homogeneous in 13 patients (54%) and inhomogeneous in 11 (46%). The spleen was isoechoic in 18 cases (75%) and hyperechoic in 6 (25%). Six patients (25%) had focal lesions. Color Doppler sonography showed absent flow in 4 patients (17%), hilar flow in 17 (71%), and hilar and parenchymal vascularization in 3 (12%). Sonographic findings in the spleen of patients with FAS are characterized predominantly by a small spleen with absence of parenchymal vascularization on color Doppler sonography in most cases. Future prospective studies will be necessary to confirm these findings and to determine whether FAS can be diagnosed reliably with sonography. Copyright 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:152-155, 2003

  2. [Objective assessment of trauma severity in patients with spleen injuries]. (United States)

    Alekseev, V S; Ivanov, V A; Alekseev, S V; Vaniukov, V P


    The work presents an analysis of condition severity of 139 casualties with isolated and combined spleen injuries on admission to a surgical hospital. The assessment of condition severity was made using the traditional gradation and score scale VPH-SP. The degree of the severity of combined trauma of the spleen was determined by the scales ISS. The investigation showed that the scale ISS and VPH-SP allowed objective measurement of the condition severity of patients with spleen trauma. The score assessment facilitated early detection of the severe category of the patients, determined the diagnostic algorithm and the well-timed medical aid.

  3. Accessory spleen compromising response to splenectomy for idiopathic thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Ambriz, P.; Munoz, R.; Quintanar, E.; Sigler, L.; Aviles, A.; Pizzuto, J.


    Accessory spleens were sought in 28 patients who had undergone splenectomy for chronic idiopathic thrombocytopenic purpura (ITP), using a variety of techniques. Abdominal scintigraphy with autologous erythrocytes labeled with Tc-99m and opsonized with anit-D IgG (radioimmune method) proved to be most useful, clearly demonstrating one or more accessory spleens in 12 cases (43%). Computed tomography (CT) was also helpful. Four out of five patients demonstrated an increased platelet count following surgery, the effectiveness of which was illustrated by the radioimmune scan. Patients who have had splenectomy for chronic ITP should be scanned using radioimmune techniques and CT to determine whether an accessory spleen is present

  4. Kidneys and Urinary Tract (For Parents) (United States)

    ... produced by the kidneys, contains the byproducts of metabolism — salts, toxins, and water — that end up in ... failure may be due to many things, including bacterial infection, injury, shock, heart failure, poisoning, or drug ...

  5. Influence of vitamin D on the percentage time of cardiac resynchronization in patients with heart failure, premature ventricular complexes, and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Márcio Galindo Kiuchi


    Conclusions: We suggest that the effectiveness of cholecalciferol reposition for subjects with high incidence of PVCs, heart failure under optimal treatment, ICD + CRT, deficiency of vitamin D and CKD, restoring the function of the CRT, bringing the biventricular pacing to nearby 97%.

  6. Gastric volvulus associated with wandering spleen in adult: Case report

    Directory of Open Access Journals (Sweden)

    Oktay Büyükaşık


    Full Text Available Gastric volvulus associated with wandering spleen is a rare diagnosis in adult ages. So far, only two cases have been reported in the literature. 82 year old male patients admitted to emergency department with complaint of nausea, vomiting and constipation. Physical examination and computerize tomography detected a big solid mass with regular contour which is full filling abdominal left lower quadrant. Exploratory laparotomy revealed a wandering spleen in sizes of 13x13x15 cm in the mentioned region. The spleen which had two masses on was partially ischemic. The stomach had rotated through cardiopyloric axis due to long pedicle of the spleen and adhesions neighborhood to corpoantral junction. Thus gastric passage was partialy obstructed. Splenectomy and anterior gastropexy were applied. The patient was discharged in health at 6th day postoperatively.

  7. Torsion of a Wandering Spleen Presenting as Acute Abdomen

    International Nuclear Information System (INIS)

    Chauhan, Narvir Singh; Kumar, Satish


    Wandering spleen is a rare condition which if uncorrected, can result in torsion and infarction. Clinical presentation of a wandering spleen can vary from asymptomatic abdominal mass to acute abdominal pain. Radiological investigations play a pivotal role in diagnosis as the clinical diagnosis is usually impossible. We present a case of wandering spleen with torsion and complete infarction that occurred in a 32-year-old multiparous female. The diagnosis was established preoperatively on colour Doppler and CT of the abdomen with subsequent confirmation on surgery. Wandering spleen is a rare clinical condition which can present as acute abdomen. An increased awareness of this entity together with the timely use of ultrasound and CT of the abdomen can play an important role in preoperative diagnosis and surgical management

  8. RNA Sequence of Spleen of Newcastle Disease Infected Chickens (United States)

    US Agency for International Development — At 21 days of age, chickens were infected with Newcastle Disease virus (or a mock injection as controls), and spleens were harvested at 2 and 6 days post infection....

  9. Torsion of a wandering spleen | Carapinha | South African Journal of ...

    African Journals Online (AJOL)

    Abstract. Torsion of a wandering spleen is a rare and difficult diagnosis in the paediatric population, with death a possible outcome. In this paper we present our experience of a single case and discuss the embryology and management thereof.

  10. Investigation of the human spleen by X-ray microanalysis

    International Nuclear Information System (INIS)

    Kopani, M.; Jakubovsky, J.; Polak, S.


    Qualitative and quantitative topographic analysis using X-ray fluorescence (XRF), X-ray powder diffraction (XRD) and scanning electron microscopy was performed in tissue samples of rat and human spleens. The presence of silico-aluminium and silico-calcareous particles of various sizes could be seen. The presence of the inorganic substances mentioned in the human red pulp cords is assumed to be a consequence of the purifying function of the spleen. (Authors)

  11. [Torsion of wandering spleen in a teenager: about a case]. (United States)

    Dème, Hamidou; Akpo, Léra Géraud; Fall, Seynabou; Badji, Nfally; Ka, Ibrahima; Guèye, Mohamadou Lamine; Touré, Mouhamed Hamine; Niang, El Hadj


    Wandering or migrating spleen is a rare anomaly which is usually described in children. Complications, which include pedicle torsion, are common and can be life-threatening. We report the case of a 17 year-old patient with a long past medical history of epigastric pain suffering from wandering spleen with chronic torsion of the pedicle. The clinical picture was marked by spontaneously painful epigastric mass, evolved over the past 48 hours. Abdominal ultrasound objectified heterogeneous hypertrophied ectopic spleen in epigastric position and a subcapsular hematoma. Doppler showed a torsion of splenic pedicle which was untwisted 2 turns and a small blood stream on the splenic artery. Abdominal CT scan with contrast injection showed a lack of parenchymal enhancement of large epigastric ectopic spleen and a subcapsular hematoma. The diagnosis of wandering spleen with chronic torsion of the pedicle complicated by necrosis and subcapsular hematoma was confirmed. The patient underwent splenectomy. The postoperative course was uneventful. We here discuss the contribution of ultrasound and CT scan in the diagnosis of wandering spleen with chronic torsion of the pedicle.

  12. An easy way to put the spleen into the bag. (United States)

    Cakir, Murat; Tekin, Ahmet; Kartal, Adil; Tuncer, Fatma Betul


    Splenectomy is a therapeutic and diagnostic procedure used in a wide range of situations. Laparoscopic splenectomy has become the gold standard in some hematological diseases. The laparoscopically removed spleen is placed into a surgical bag, a step which is sometimes the most time-consuming part of the operation. To present the method that we employed in laparoscopic splenectomy to place the specimen into the bag and extract it in an easier and simpler way. The proximal part of the splenorenal ligament is left undivided in the size of one LigaSure cut length to use as a stalk while placing the spleen into the surgical bag. The bag is advanced from the inferior pole of the spleen toward the superior pole. Only keeping the bag open is sufficient to place the spleen into the bag. Recently, me started to put the spleen into the bag easily before cutting upper attachment of the spleen laparoscopically. So far we applied this procedure in more than eleven cases without complication. Splenectomy is now the gold standard in the treatment of hematologic diseases that are resistant to medical treatment or that are not amenable to medical treatment because of its complications. Through our experience, the method that we describe here easily overcomes one of the most unpleasant parts of laparoscopic splenectomy.

  13. Chronic kidney disease and cardiovascular risk : epidemiology, mechanisms, and prevention

    NARCIS (Netherlands)

    Gansevoort, Ron T.; Correa-Rotter, Ricardo; Hemmelgarn, Brenda R.; Jafar, Tazeen H.; Heerspink, Hiddo J. Lambers; Mann, Johannes F.; Matsushita, Kunihiro; Wen, Chi Pang


    Since the first description of the association between chronic kidney disease and heart disease, many epidemiological studies have confirmed and extended this finding. As chronic kidney disease progresses, kidney-specific risk factors for cardiovascular events and disease come into play. As a

  14. Kidney Infection (United States)

    ... symptoms. If you're being treated for a urinary tract infection but your signs and symptoms aren't improving, make an appointment. Severe kidney ... Seek immediate medical attention if you have kidney infection symptoms combined with ... that enter your urinary tract through the tube that carries urine from ...

  15. Kidney Stones (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  16. Chronic Kidney Disease and Kidney Failure (United States)

    ... Education Visitor Information RePORT NIH Fact Sheets Home > Chronic Kidney Disease and Kidney Failure Small Text Medium Text Large Text Chronic Kidney Disease and Kidney Failure YESTERDAY One third of diabetic ...

  17. Sonographic determination of normal spleen size in an adult African population

    Energy Technology Data Exchange (ETDEWEB)

    Mustapha, Zainab; Tahir, Abdulrahman [Department of Radiology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State (Nigeria); Tukur, Maisaratu [Department of Human Physiology, University of Maiduguri, Maiduguri, Borno State (Nigeria); Bukar, Mohammed [Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State (Nigeria); Lee, Wai-Kit, E-mail: [Department of Medical Imaging, St. Vincent' s Hospital, University of Melbourne, 41 Victoria Parade, Fitzroy, Victoria 3065 (Australia)


    Objective: The purpose of this study was to determine the normal range of spleen size in an adult African population, and compare the findings to published data to determine any correlation with ethnicity. Materials and methods: Three hundred and seventy-four African adults without conditions that can affect the spleen or splenic abnormalities were evaluated with ultrasonography. Spleen length, width and thickness were measured and spleen volume calculated. Spleen size was correlated with age, gender, height, weight, and body mass index. Results: The mean spleen volume was 120 cm{sup 3}. Spleen volume correlated with spleen width (r = 0.85), thickness (r = 0.83) and length (r = 0.80). Men had a larger mean spleen volume than women. No correlation was found between spleen volume and age, weight, height, or body mass index. Conclusion: Mean spleen volume in African adults is smaller than data from Western sources, and cannot be explained by difference in body habitus.

  18. Heart Health - Brave Heart (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  19. Kidney (Renal) Failure (United States)

    ... Physician Resources Professions Site Index A-Z Kidney Failure Kidney failure, also known as renal failure, is ... is kidney failure treated? What is kidney (renal) failure? The kidneys are designed to maintain proper fluid ...

  20. Acquired Cystic Kidney Disease (United States)

    ... Eating, Diet, & Nutrition for PKD Race, Ethnicity, & Kidney Disease Renal Artery Stenosis Renal Tubular Acidosis Simple Kidney Cysts ... kidneys to develop multiple cysts. Acquired cystic kidney disease occurs in children and adults who have chronic kidney disease (CKD) — ...

  1. Chapter 12. Kidneys

    International Nuclear Information System (INIS)

    Floyrac, R.; Sulman, C.


    The isotopic kidney check-up consists of the isotopic nephrogram with simultaneous clearance measurement. For clinicians it supplies a set of data which no other method can provide so quickly. This check-up offers many advantages. The examination is simple: after intraveinous injection of hippuran 131 I the radioactivity is followed for 20 minutes in the kidney, heart and bladder by external counting. A blood sample is taken between the 10th and 20th minutes and the urine collected at the 20th minute. The glomerular clearance may be calculated by injecting 125 I hypaque at the same time. The examination is fast: the process lasts half an hour altogether. The only preparation is an adequate hydration of the patient before the test. The examination is absolutely harmless: internal irradiation of the patient is negligible. Numerous data are obtained: pathological changes in the nephrogram: reduced affinity of a kidney for hippuran, heterogeneity of the nephrons, slowing down of transit times, intraparenchyme stases; blood concentration of hippuran and hypaque at the 10th or 20th minute, elimination in the urine at the 20th minute; total blood purification and glomerular and tubular excretion clearances, clearance of each kidney separately. No other method as simple, fast and harmless can yield such a complete set of data. Very often the nephrograms are obtained from gamma-camera recording on the dynamic mode, which allows a morphological study to be carried out at the same time [fr

  2. Mitochondria Damage and Kidney Disease. (United States)

    Duann, Pu; Lin, Pei-Hui


    The kidney is a vital organ that demands an extraordinary amount of energy to actively maintain the body's metabolism, plasma hemodynamics, electrolytes and water homeostasis, nutrients reabsorption, and hormone secretion. Kidney is only second to the heart in mitochondrial count and oxygen consumption. As such, the health and status of the energy power house, the mitochondria, is pivotal to the health and proper function of the kidney. Mitochondria are heterogeneous and highly dynamic organelles and their functions are subject to complex regulations through modulation of its biogenesis, bioenergetics, dynamics and clearance within cell. Kidney diseases, either acute kidney injury (AKI) or chronic kidney disease (CKD), are important clinical issues and global public health concerns with high mortality rate and socioeconomic burden due to lack of effective therapeutic strategies to cure or retard the progression of the diseases. Mitochondria-targeted therapeutics has become a major focus for modern research with the belief that maintaining mitochondria homeostasis can prevent kidney pathogenesis and disease progression. A better understanding of the cellular and molecular events that govern mitochondria functions in health and disease will potentially lead to improved therapeutics development.

  3. Perfusion of isolated organs and the first heart-lung machine. (United States)

    Zimmer, H G


    In 1885, Max von Frey (1852-1932), while working in Carl Ludwig's Physiological Institute in Leipzig, Germany, designed an apparatus that had criteria characteristic of a heart-lung machine. With this device, he perfused the entire lower extremity of dogs, and took measurements of oxygen consumption, and carbon dioxide and lactate production. In 1935, another type of perfusion apparatus was constructed by Charles A Lindbergh (1902-1973). This device was the result of cooperation with Alexis Carrel (1873-1944) who was a pioneer of experimental organ transplantation. Using Lindbergh's pulsating device, organs such as thyroid, ovary, suprarenal gland, spleen, heart and kidney from fowls and cats were perfused with an oxygenated medium, and were maintained under sterile conditions. Beginning in 1934, John H Gibbon (1903-1973) developed and tested a heart-lung machine to institute cardiopulmonary bypass in cats during experimental occlusion of the pulmonary artery. In 1953, he performed the first successful open-heart operation in a patient using a heart-lung machine. This included elements that were similar to those used by von Frey - ie, the oxygenator and the pumps for continuous circulation of blood. A comparison of the three experimental devices revealed the following: the application for experimental purposes preceded clinical use; the development shifted from Europe to the United States, and was achieved by people who were not specialists; and the intention to build such a device was first purely scientific interest, but later shifted to the care for and treatment of patients with heart and circulatory defects by open-heart surgery.

  4. Candidiasis of the liver and spleen in childhood

    International Nuclear Information System (INIS)

    Miller, J.H.; Greenfield, L.D.; Wald, B.R.


    Four children with acute leukemia and surgically documented candidiasis of the liver and/or spleen were examined with a combination of diagnostic imaging modalities including /sup 99m/Tc-sulfur colloid and /sup 67/Ga- citrate scintigraphy, gray-scale ultrasound, and body computed tomography (CT). Abnormalities were detected in every individual examined. /sup 99m/Tc-sulfur colloid scintigraphy revealed ''cold'' areas in the liver or spleen. With /sup 67/Ga scintigraphy, these areas were ''cold'' in some individuals and ''hot'' in others. Gray-scale ultrasound demonstrated hypoechoic lesions with central areas of increased echogenicity in hepatic involvement, and hypoechoic replacement of the spleen in splenic involvement. CT in one patient revealed low-density areas without contrast enhancement within the hepatic parenchyma and unsuspected renal involvement

  5. Candidiasis of the liver and spleen in childhood

    International Nuclear Information System (INIS)

    Miller, J.H.; Greenfield, L.D.; Wald, B.R.


    Four children with acute leukemia and surgically documented candidiasis of the liver and/or spleen were examined with a combination of diagnostic imaging modalities including 99 mTc-sulfur colloid and 67 Ga-citrate scintigraphy, gray-scale ultrasound, and body computed tomography (CT). Abnormalities were detected in every individual examined. 99 mTc-sulfur colloid scintigraphy revealed cold areas in the liver or spleen. With 67 Ga scintigraphy, these areas were cold in some individuals and hot in others. Gray-scale ultrasound demonstrated hypoechoic lesions with central areas of increased echogenicity in hepatic involvement, and hypoechoic replacement of the spleen in splenic involvement. CT in one patient revealed low-density areas without contrast enhancement within the hepatic parenchyma and unsuspected renal involvement

  6. Candidiasis of the liver and spleen in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.H. (Childrens Hospital of Los Angeles, CA); Greenfield, L.D.; Wald, B.R.


    Four children with acute leukemia and surgically documented candidiasis of the liver and/or spleen were examined with a combination of diagnostic imaging modalities including /sup 99m/Tc-sulfur colloid and /sup 67/Ga- citrate scintigraphy, gray-scale ultrasound, and body computed tomography (CT). Abnormalities were detected in every individual examined. /sup 99m/Tc-sulfur colloid scintigraphy revealed ''cold'' areas in the liver or spleen. With /sup 67/Ga scintigraphy, these areas were ''cold'' in some individuals and ''hot'' in others. Gray-scale ultrasound demonstrated hypoechoic lesions with central areas of increased echogenicity in hepatic involvement, and hypoechoic replacement of the spleen in splenic involvement. CT in one patient revealed low-density areas without contrast enhancement within the hepatic parenchyma and unsuspected renal involvement.

  7. Candidiasis of the liver and spleen in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.H.; Greenfield, L.D.; Wald, B.R.


    Four children with acute leukemia and surgically documented candidiasis of the liver and/or spleen were examined with a combination of diagnostic imaging modalities including /sup 99/mTc-sulfur colloid and /sup 67/Ga-citrate scintigraphy, gray-scale ultrasound, and body computed tomography (CT). Abnormalities were detected in every individual examined. /sup 99/mTc-sulfur colloid scintigraphy revealed cold areas in the liver or spleen. With /sup 67/Ga scintigraphy, these areas were cold in some individuals and hot in others. Gray-scale ultrasound demonstrated hypoechoic lesions with central areas of increased echogenicity in hepatic involvement, and hypoechoic replacement of the spleen in splenic involvement. CT in one patient revealed low-density areas without contrast enhancement within the hepatic parenchyma and unsuspected renal involvement.

  8. CT findings in children with blunt trauma in the spleen

    Energy Technology Data Exchange (ETDEWEB)

    Nishiguchi, Hiroyasu; Shimizu, Toshihisa; Ohmura, Makoto; Kawai, Naoki; Tauchi, Hayato; Hayakawa, Masao; Nishio, Yoshinori (Kyoto Second Red Cross Hospital (Japan)); Watanabe, Shinsuke


    We evaluated CT findings in 19 children with blunt injuries in the spleen. CT demonstrated laceration of the spleen in 7 children, rupture of the spleen in 7, and splenic hematoma in 5. Leakage of the contrast medium was observed in 3 children, of whom 1 was treated by arterial embolization. Laparotomy was performed in 3 children (15.8%) other than the 3 showing contrast medium leakage; hemostasis by compression was performed in 1 with laceration, and splenectomy in 2 with rupture. Late splenic rupture or abscess did not occur in any child. One child (5.3%) died of complicating injuries. Many of children with blunt splenic injuries can be successfully treated with conservative treatment, and CT scanning is useful for evaluating the degree of splenic injuries and complicating injuries. (author).

  9. Cancer of the colon spleen angle. Presentation of a case

    International Nuclear Information System (INIS)

    Martinez Sanchez, Yariana; De la Rosa Perez, Nereida; Barcelo Casanova, Renato E


    The colon cancer is currently an important public health problem in developed countries. It is the fourth most common cancer in the world. We report the case of a 65-years-old, black, female patient, assisting our consultation with dyspeptic disturbances as the unique symptom, without known risk factors. We indicated a colon by enema and a distal narrowing was observed at the colon spleen angle, at the same zone of the physiologic narrowing at that level. A colonoscopy was carried out diagnosing a left colon tumor near the spleen angle. It was operated with segmental resection of the spleen angle and a biopsy was made. Pathologic anatomy informed a well-differentiated colon adenocarcinoma

  10. Kidney Transplant (United States)

    ... type matches or is compatible to your own. Blood-type incompatible transplants are also possible but require additional medical treatment before and after transplant to reduce the risk of organ rejection. These are known as ABO incompatible kidney transplants. ...

  11. Kidney Facts (United States)

    ... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... treatment option for kidney failure or disease through organ donation from a healthy, living person who is a ...

  12. The forgotten organ: Contrast enhanced sonography of the spleen

    Energy Technology Data Exchange (ETDEWEB)

    Goerg, Christian [Medizinische Universitaetsklinik, Baldingerstrasse, 35043 Marburg/Lahn (Germany)], E-mail:


    Objective: Ultrasound contrast agents in conjunction with contrast specific imaging techniques, are increasingly accepted in clinical use for diagnostic imaging in several organs. Contrast enhanced sonography (CES) of second-generation contrast media have shown a spleen-specific uptake of the microbubble contrast agent. The aim of this review is to illustrate indications for the use of CES in patients with suspected (peri-)splenic pathology. Methods: This review based on the experience of transcutaneous CES in 200 patients with (peri-)splenic pathology diagnosed by B-mode sonography at an internal medicine center. CES studies were performed with a contrast-devoted unit (Acuson, Sequoia, Siemens medical solution) that had contrast-specific, continuous-mode software. A low mechanical index was used. A sulfur hexafluoride-based microbubble contrast medium (Sonovue, Bracco SpA, Milan, Italy) was injected. Results: On our experience, there are several clinical conditions which may show an diagnostic advantage of CES in comparison to B-mode US. CES should be performed to investigate: (1) the perisplenic tumor to diagnose or exclude accessory spleen, (2) the small-sized spleen to diagnose functional asplenia/hyposplenia, (3) the inhomogenous spleen of unknown cause to diagnose focal lesions within the spleen, (4) the incidentally found hypoechoic splenic tumor to diagnose high vascular splenic hemangioma, (5) focal lesions suspect for splenic abscess, hematoma, infarction to confirme diagnosis, and (6) patients with abdominal trauma to diagnose or exclude splenic injuriy. Conclusion: CES is of diagnostic value in several clinical circumstances to diagnose accessory spleen, functional asplenia, small-sized splenic involvement, high vascular splenic hemangioma, and vascular splenic pathology like splenic infarction, splenic abscess, and splenic laceration.

  13. Optical Coherence Tomography in Kidney Transplantation (United States)

    Andrews, Peter M.; Wierwille, Jeremiah; Chen, Yu

    End-stage renal disease (ESRD) is associated with both high mortality rates and an enormous economic burden [1]. The preferred treatment option for ESRD that can extend patients' lives and improve their quality of life is kidney transplantation. However, organ shortages continue to pose a major problem in kidney transplantation. Most kidneys for transplantation come from heart-beating cadavers. Although non-heart-beating cadavers represent a potentially large pool of donor kidneys, these kidneys are not often used due to the unknown extent of damage to the renal tubules (i.e., acute tubular necrosis or "ATN") induced by ischemia (i.e., lack of blood flow). Also, ischemic insult suffered by kidneys awaiting transplantation frequently causes ATN that leads to varying degrees of delayed graft function (DGF) after transplantation. Finally, ATN represents a significant risk for eventual graft and patient survival [2, 3] and can be difficult to discern from rejection. In present clinical practice, there is no reliable real-time test to determine the viability of donor kidneys and whether or not donor kidneys might exhibit ATN. Therefore, there is a critical need for an objective and reliable real-time test to predict ATN to use these organs safely and utilize the donor pool optimally. In this review, we provided preliminary data indicating that OCT can be used to predict the post-transplant function of kidneys used in transplantation.

  14. Effect of ionizing radiation on cell death in frog spleen

    International Nuclear Information System (INIS)

    Afonin, V.Yu.; Vojtovich, A.M.


    It was studied the number of dead cells in frog spleen by means of coloration with trypan blue which allowed to estimate last stage of apoptosis dead of cells.The investigated frogs (Rana arvalis) were caught in september 1997 at radionuclide contamination territory (the Gomel Region, the Khojniki District). Control animals were caught in village Ratamka of the Minsk District. The percent of dead cells was less in control group in 1,5 times. Under additional irradiation (2 Gy) the number of dead cells in spleen also differs significantly in the investigated and control groups

  15. Spleen and liver enlargement in a patient with rheumatoid arthritis. (United States)

    Bedoya, María Eugenia; Ceccato, Federico; Paira, Sergio


    We describe the case of a 51-year-old woman with a seropositive, erosive, and non-nodular rheumatoid arthritis of 15 year of evolution. The patient had poor compliance with medical visits and treatment. She came to the clinic with persistent pancytopenia and spleen and liver enlargement. Liver and bone marrow biopsies were carried out and amyloidosis, neoplasias and infections were ruled out. We discuss the differential diagnosis of pancytopenia and spleen and liver enlargement in a long-standing rheumatoid arthritis patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  16. Cystic lymphangioma of the spleen: US-CT-MRI correlation

    Energy Technology Data Exchange (ETDEWEB)

    Bezzi, M.; Spinelli, A.; Pierleoni, M.; Andreoli, G.M. [Dept. of Radiology, University of Rome ' La Sapienza' (Italy)


    A case of a surgically confirmed cystic lymphangioma of the spleen is presented. Preoperative imaging consisted of US, contrast-enhanced CT and MRI, all showing a multiloculated lesion with small cystic cavities divided by thin septa, corresponding to dilated lymphatic spaces. Preoperative studies correlated well with the pathologic findings. Cystic lymphangioma of the spleen is a very rare condition and is usually solitary and asymptomatic. Large lymphangiomas may be an indication for splenectomy, since the risk of rupture is high even from minor abdominal trauma. Preoperative diagnosis may be achieved with correlated noninvasive imaging. (orig.)

  17. 76 FR 72425 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings (United States)


    ... Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Hemodialysis and Markers of Heart...; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology...

  18. Ultrasonography of the liver, spleen, and urinary tract of the cheetah (Acinonyx jubatus). (United States)

    Carstens, Ann; Kirberger, Robert M; Spotswood, Tim; Wagner, Wencke M; Grimbeek, Richard J


    Diseases of the abdomen of the cheetah (Acinonyx jubatus) include those affecting the liver, spleen, and urinary tract. The most common diseases of captive-bred cheetah are gastritis, gastric ulceration, glomerulosclerosis, and hepatic veno-occlusive disease, and are the most frequent causes of mortality in these animals. The purpose of this study was to describe the ultrasonographic anatomy of the normal liver, spleen, kidney, and urinary bladder of the anesthetized captive-bred cheetah. Twenty-one cheetahs were examined. Eight of the 21 animals had subclinical evidence of either gastritis or chronic renal disease. The ultrasonographic appearances of the liver, gall bladder, common bile duct, and spleen were evaluated and various measurements made. Statistical analyses of the measurements were performed on all the healthy and subclinically ill animals taking sex, age, mass, and anesthetic protocol into account. There were no significant differences in any parameters between the healthy and subclinically ill animals (P > 0.25) and data were combined for statistical analyses. The mean mass was 41.1kg ( +/- 8.8) and the mean age was 5.0 years (+/- 2.2). The mean thickness of the liver medial to the gall bladder was 67.0 mm (+/- 14.8) and the liver was within the left costal arch in 75% of animals, extended caudal to the right costal arch in 50% of animals for an average of 30 mm, and extended caudal to the sternum in 63% of animals for an average of 32.5 mm. The maximum mean hepatic vein diameter at the entrance to the caudal vena cava was 8.6 +/- 2.8 mm; the mean diameters of the portal vein at the hilus and that of the caudal vena cava as it entered the liver were 7.5 +/- 1.6 and 9.9 +/- 4.1 mm, respectively. The mean diameter of the caudal vena cava was significantly affected by the type of anesthetic used (P < 0.10). The mass of the animals was significant in explaining the variance in maximum portal vein diameters (P < 0.10). The mean maximum velocity of the

  19. Sonographic biometry of spleen among school age children in ...

    African Journals Online (AJOL)


    among children population they studied. Thus the normal limits and percentile curves of the spleen among school age children were defined according to body weight in a Turkish population10. These differences with present study may be due to variations in race or different ethnic origins. There is no consensus on which.

  20. Detection of accessory spleens with indium 111-labeled autologous platelets

    International Nuclear Information System (INIS)

    Davis, H.H. II; Varki, A.; Heaton, W.A.; Siegel, B.A.


    In two patients with recurrent immune thrombocytopenia, accessory splenic tissue was demonstrated by radionuclide imaging following administration of indium 111-labeled autologous platelets. In one of these patients, no accessory splenic tissue was seen on images obtained with technetium 99m sulfur colloid. This new technique provides a simple means for demonstrating accessory spleens and simultaneously evaluating the life-span of autologous platelets

  1. Histopathological study and audit of the spleen in Nigerians ...

    African Journals Online (AJOL)


    underreporting both the gross and microscopic changes in the organ by pathologists. This paper therefore is a study on spleen specimens with a view to auditing the gross and microscopic description and analysing the pathological findings in splenectomy specimens with respect to gender and age. Materials and Methods.

  2. Sonographic assessment of the normal limits of the spleen in ...

    African Journals Online (AJOL)


    Dec 14, 2013 ... Tables 2 and 3 show a direct relationship of the spleen length with both age and body size indices. Table 3 shows a. Pearson correlation matrix of the splenic length with other variables. The splenic length correlated best with BSA, followed by WT. The splenic length was established to be longer in males.

  3. Differential expression of heparan sulfate domains in rat spleen.

    NARCIS (Netherlands)

    Dam, G.B. ten; Hafmans, T.G.M.; Veerkamp, J.H.; Kuppevelt, A.H.M.S.M. van


    The microarchitecture of the spleen is composed of a meshwork of reticulum cells and their matrix. Heparan sulfates (HS) are important components of this meshwork and are involved in processes such as cell adhesion, cell migration, and cytokine/growth factor binding. The expression of HS epitopes

  4. Morphology and some biomechanical properties of human liver and spleen

    Czech Academy of Sciences Publication Activity Database

    Stingl, J.; Bača, V.; Čech, V.; Kovanda, J.; Kovandová, H.; Mandys, Václav; Rejmontová, J.; Sosna, B.


    Roč. 24, - (2002), s. 285-289 ISSN 0930-1038 Institutional research plan: CEZ:AV0Z5039906 Keywords : Human liver and spleen Subject RIV: FE - Other Internal Medicine Disciplines Impact factor: 0.252, year: 2002

  5. Spleen Weight, Liver Weight And Levels Of Circulating Immune ...

    African Journals Online (AJOL)

    Three groups of mice viz: well fed mice, vitamin deficient mice and vitamin deficient Plasmodium berghei infected mice were studied. In these groups of mice, the weights of the liver and spleen were determined using a weighing balance and the levels of circulating immune complexes (CICS) measured ...

  6. Spontaneous rupture of the spleen after infectious mononucleosis

    DEFF Research Database (Denmark)

    Gulstad, Mikkel Bak; Thomsen, Henrik


    Non-traumatic rupture of the spleen (NRS) is a rare but serious complication to infectious mononucleosis (IM) and it is important to have in mind, when patients have IM. Although splenectomy has been advocated as the appropriate treatment for this problem, the trend goes towards conservative...

  7. Primary hemangiosarcoma of the spleen with angioscintigraphic demonstration of metastases

    DEFF Research Database (Denmark)

    Hermann, G G; Fogh, J; Graem, N


    A case of primary hemangiosarcoma of the spleen in a 48-year-old woman is presented. Twenty-eight months after splenectomy the patient developed a severe anemia of the microangiopathic type, thrombocytopenia, and a leukoerythroblastic peripheral blood picture. In contrast to x-ray and conventional...

  8. Sonographic Dimensions of the Spleen in Healthy School Age ...

    African Journals Online (AJOL)

    The spleen is the largest recticuloendothelial organ in the body which increases in size with several pathologies. Its average length and other dimensions have been documented in adults but none in children in our environment. This study is aimed at investigating with Ultrasonography the normal splenic dimensions in ...

  9. Proteomics analysis of IBS-D with spleen and kidney yang deficiency

    Directory of Open Access Journals (Sweden)

    Yijie Li


    Conclusion: These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation, cell growth, apoptosis, stress granule formation, immune activation, loss of epithelial cell integrity, and visceral hypersensitivity.

  10. [Panarteritis nodosa with kidney and spleen rupture: diagnostic and therapeutic possibilities]. (United States)

    Siebels, M; Nöldge, G; Sanwald, R; Andrassy, K


    Classic polyarteritis nodosa is a necrotizing vasculitis affecting medium- and small-sized arteries. Renal involvement from aneurysm formation is common and can result in perirenal or intrarenal bleeding. The gold standard of diagnostic procedures is the arteriography. Treatment of choice is a combination of steroids and cyclophosphamide, but in the case of severe hemorrhage surgery is mandatory. Patients with PAN need at least 2 years of long-term therapy; repeated arteriography will establish the efficacy of therapy.

  11. Take Steps to Keep Your Heart Healthy on Dialysis (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z ... calcium and phosphorus leading to disease and heart problems Each one of these conditions forces your heart ...

  12. Pathologic rupture of the spleen in a patient with acute myelogenous leukemia and leukostasis

    Directory of Open Access Journals (Sweden)

    Gil Cunha De Santis


    Full Text Available Rupture of the spleen can be classified as spontaneous, traumatic, or pathologic. Pathologic rupture has been reported in infectious diseases such as infectious mononucleosis, and hematologic malignancies such as acute and chronic leukemias. Splenomegaly is considered the most relevant factor that predisposes to splenic rupture. A 66-year-old man with acute myeloid leukemia evolved from an unclassified myeloproliferative neoplasm, complaining of fatigue and mild upper left abdominal pain. He was pale and presented fever and tachypnea. Laboratory analyses showed hemoglobin 8.3 g/dL, white blood cell count 278 × 109/L, platelet count 367 × 109/L, activated partial thromboplastin time (aPTT ratio 2.10, and international normalized ratio (INR 1.60. A blood smear showed 62% of myeloblasts. The immunophenotype of the blasts was positive for CD117, HLA-DR, CD13, CD56, CD64, CD11c and CD14. Lactate dehydrogenase was 2384 U/L and creatinine 2.4 mg/dL (normal range: 0.7-1.6 mg/dL. Two sessions of leukapheresis were performed. At the end of the second session, the patient presented hemodynamic instability that culminated in circulatory shock and death. The post-mortem examination revealed infiltration of the vessels of the lungs, heart, and liver, and massive infiltration of the spleen by leukemic blasts. Blood volume in the peritoneal cavity was 500 mL. Acute leukemia is a rare cause of splenic rupture. Male gender, old age and splenomegaly are factors associated with this condition. As the patient had leukostasis, we hypothesize that this, associated with other factors such as lung and heart leukemic infiltration, had a role in inducing splenic rupture. Finally, we do not believe that leukapheresis in itself contributed to splenic rupture, as it is essentially atraumatic.

  13. The ability of NT-proBNP to detect chronic heart failure and predict all-cause mortality is higher in elderly Chinese coronary artery disease patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Fu S


    Full Text Available Shihui Fu, Leiming Luo, Ping Ye, Shuangyan Yi, Yuan Liu, Bing Zhu, Liang Wang, Tiehui Xiao, Yongyi Bai Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China Objective: To analyze the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP and renal function, and compare the ability and cut-off thresholds of NT-proBNP to detect chronic heart failure (CHF and predict mortality in elderly Chinese coronary artery disease (CAD patients with and without chronic kidney disease (CKD. Methods: The study included 999 CAD patients older than 60 years. The endpoint was all-cause mortality over a mean follow-up period of 417 days. Results: The median age was 86 years (range: 60–104 years, and the median NT-proBNP level was 409.8 pg/mL. CKD was present in 358 patients. Three hundred and six patients were positive for CHF. One hundred and ten CKD patients and 105 non-CKD patients died. Not only CKD, but also estimated glomerular filtration rate independently affected NT-proBNP. NT-proBNP detected CHF with a cut-off value of 298.4 pg/mL in non-CKD patients and a cut-off value of 435.7 pg/mL in CKD patients. NT-proBNP predicted death with a cut-off value of 369.5 pg/mL in non-CKD patients and a cut-off value of 2584.1 pg/mL in CKD patients. The NT-proBNP level was significantly related to the prevalence of CHF and all-cause mortality in CAD patients with and without CKD; this effect persisted after adjustment. The crude and multiple adjusted hazard ratios of NT-proBNP to detect CHF and predict mortality were significantly higher in patients with CKD compared with the remainder of the population. The addition of NT-proBNP to the three-variable and six-variable models generated a significant increase in the C-statistic. Conclusion: Amongst elderly Chinese CAD patients, there was an independently inverse association between NT-proBNP and renal function. With the higher cutoff points, NT

  14. Heart murmurs (United States)

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  15. Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy

    NARCIS (Netherlands)

    van Dijck, Willemijn P M; Groot, Vincent P; Brosens, Lodewijk A A; Hagendoorn, Jeroen; Rinkes, Inne H M Borel; van Leeuwen, Maarten S; Molenaar, I Quintus


    Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted

  16. The function of the spleen in adults after ligation of the splenic artery of the traumatized spleen in childhood. (United States)

    Keramidas, Dimitrios C; Soutis, Michael


    Ligation of the splenic artery (LSA) has been successfully used as a spleen-saving procedure in rare cases of splenic trauma in children in which management with splenorrhaphy or partial splenectomy alone was not possible. There are no data regarding the long-term effects of the procedure on the functional status of the spleen. The purpose of this study is to present and discuss our clinical and laboratory findings in adults who underwent LSA in childhood. Our first 2 patients in whom LSA was done at ages 4 and 2 years in 1977 underwent the following examinations in the year 2000: 1, imaging of the spleen; 2, immunologic studies; and 3, peripheral blood tests. Their ages at reexamination were 27 and 25 years, respectively. Results were as follows: triplex ultrasound revealed normal size and echomorphology; Doppler techniques revealed normal vasculature; 99mTc-Tin colloid scanning revealed normal uptake. Immunoglobulins (IgG1 to IgG4, IgA, IgM, IgE), complement fraction (C3, C4), antibodies response to vaccinations, and peripheral blood tests all had normal results. No Howell-Jolly bodies were found. Laboratory investigations in adults with LSA during childhood disclosed undisturbed function of the spleen. LSA can be used as an adjunct to splenorrhaphy in children with rare splenic injuries involving major hilar vessels.

  17. Amyloidosis and Kidney Disease (United States)

    ... Solitary Kidney Your Kidneys & How They Work Amyloidosis & Kidney Disease What is amyloidosis? Amyloidosis is a rare disease ... Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive Diseases Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine ...

  18. About Chronic Kidney Disease (United States)

    ... Advocacy Donate A to Z Health Guide About Chronic Kidney Disease Tweet Share Print Email Chronic kidney disease (CKD) ... Learn about Glomerular Filtration Rate (GFR) What is chronic kidney disease (CKD)? Chronic kidney disease includes conditions that damage ...

  19. Chronic kidney disease (United States)

    Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... that you do not have symptoms until your kidneys have almost ... end-stage renal disease (ESRD). At this stage, the kidneys are ...

  20. Metabolism of 15(p123I iodophenyl-)pentadecanoic acid in heart muscle and noncardiac tissues

    International Nuclear Information System (INIS)

    Reske, S.N.; Sauer, W.; Winkler, C.; Machulla, H.J.; Knust, J.


    The uptake and turnover of W(p 123 I iodophenyl-)pentadecanoic acid (I-PPA), a radioiodinated free-fatty-acid analog, was examined in the heart, lung, liver, kidneys, spleen, and skeletal muscle of rats. At 2 min post injection, a high cardiac uptake of 4.4% dose per gram had already been achieved; this was followed by a rapid, two-component, tracer clearance. The kinetics of tissue concentrations of labeled hydrophilic catabolites indicated a rapid oxidation of I-PPA and the subsequent washout of I-PPA catabolites from heart-muscle tissue. The fractional distribution of the labeled cardiac lipids compared favorably with previously reported values for 3 H-oleic- or 14 C-palmitic-acid-labeled myocardial lipids. Typical patterns of I-PPA metabolism were observed in tissues; dedpending on primary fatty-acid oxidation, lipid metabolism regulation, or I-PPA-catabolite excretion. The tissue concentrations and kinetics of I-PPA and its metabolites in the heart muscle indicated that general pathways of cardiac-lipid metabolism are traced by this new γ-emitting isotope-labeled radiopharmaceutical. (orig.)

  1. Rapamycin protects kidney against ischemia reperfusion injury through recruitment of NKT cells. (United States)

    Zhang, Chao; Zheng, Long; Li, Long; Wang, Lingyan; Li, Liping; Huang, Shang; Gu, Chenli; Zhang, Lexi; Yang, Cheng; Zhu, Tongyu; Rong, Ruiming


    NKT cells play a protective role in ischemia reperfusion (IR) injury, of which the trafficking in the body and recruitment in injured organs can be influenced by immunosuppressive therapy. Therefore, we investigated the effects of rapamycin on kidneys exposed to IR injury in early stage and on trafficking of NKT cells in a murine model. Balb/c mice were subjected to kidney 30 min ischemia followed by 24 h reperfusion. Rapamycin (2.5 ml/kg) was administered by gavage daily, starting 1 day before the operation. Renal function and histological changes were assessed. The proportion of NKT cells in peripheral blood, spleen and kidney was detected by flow cytometry. The chemokines and corresponding receptor involved in NKT cell trafficking were determined by RT-PCR and flow cytometry respectively. Rapamycin significantly improved renal function and ameliorated histological injury. In rapamycin-treated group, the proportion of NKT cells in spleen was significantly decreased but increased in peripheral blood and kidney. In addition, the CXCR3+ NKT cell in the kidney increased remarkably in the rapamycin-treated group. The chemokines, CXCL9 and CXCL10, as the ligands of CXCR3, were also increased in the rapamycin-treated kidney. Rapamycin may recruit NKT cells from spleen to the IR-induced kidney to ameliorate renal IR injury in the early stage.

  2. Primary Angiosarcoma of the Spleen: An Oncological Enigma

    Directory of Open Access Journals (Sweden)

    Myoteri Despoina


    Full Text Available Introduction. Primary splenic angiosarcoma is an extremely unusual neoplasm originating from sinusoidal vascular endothelium. Surgical extirpation is the mainstay of treatment of this highly malignant disease. Case Presentation. An 82-year-old woman was admitted with left pleural effusion and a palpable left upper quadrant abdominal mass, secondary to splenomegaly by two large splenic tumors. Classic open splenectomy was performed and angiosarcoma of the spleen was the final histopathological diagnosis, which was primary since no other disease site was revealed. Discussion. The incidence of the disease is 0.14–0.23 cases per million, with slight male predominance. Etiology is not established and clinical presentation may confuse even experienced physicians. Imaging modalities cannot differentiate the lesion from other vascular splenic neoplasms and the correct diagnosis is mainly set after histopathological examination of the resected spleen. As with other sarcomas, surgery is the only curative approach, while chemo- and radiotherapy have poor results. Prognosis remains dismal.

  3. Primary hemangiosarcoma of the spleen with angioscintigraphic demonstration of metastases

    DEFF Research Database (Denmark)

    Hermann, G G; Fogh, J; Graem, N


    A case of primary hemangiosarcoma of the spleen in a 48-year-old woman is presented. Twenty-eight months after splenectomy the patient developed a severe anemia of the microangiopathic type, thrombocytopenia, and a leukoerythroblastic peripheral blood picture. In contrast to x-ray and conventional...... of extremely vascular metastases. Autopsy 15 months later confirmed the scintigraphic findings. Angiography with 99mTc-labeled erythrocytes seems to be useful for monitoring metastases from hemangiosarcomas....

  4. Spleen necrosis virus, an avian retrovirus, can infect primate cells.


    Koo, H M; Brown, A M; Ron, Y; Dougherty, J P


    Spleen necrosis virus (SNV) is an avian retrovirus that can infect some mammalian cells such as dog cells as well as all avian cells tested to date. We were interested in testing whether SNV could also infect primate cells. For these experiments, we used HeLa and COS-7 cells. Initially, we determined whether the SNV long terminal repeat promoter was functional in HeLa and COS-7 cells. In transient transfection assays, the SNV promoter efficiently directed chloramphenicol acetyltransferase gen...

  5. An easy way to put the spleen into the bag


    Cakir, Murat; Tekin, Ahmet; Kartal, Adil; Tuncer, Fatma Betul


    Introduction Splenectomy is a therapeutic and diagnostic procedure used in a wide range of situations. Laparoscopic splenectomy has become the gold standard in some hematological diseases. The laparoscopically removed spleen is placed into a surgical bag, a step which is sometimes the most time-consuming part of the operation. Aim To present the method that we employed in laparoscopic splenectomy to place the specimen into the bag and extract it in an easier and simpler way. Material and meth...

  6. Pancreatitis-associated fluid collections involving the spleen

    International Nuclear Information System (INIS)

    Vick, C.W.; Simeone, J.F.; Ferrucci, J.T. Jr.; Wittenberg, J.; Mueller, P.R.; Harvard Medical School, Boston, MA


    The clinical and radiographic features of 2 patients with dissecting pancreatitis-associated fluid collections involving the spleen are described. A typical appearance of left upper quadrant fluid collection lateral to the splenic pulp was observed by ultrasonography (US) or computed body tomography (CBT). Although these findings are nonspecific, a left upper quadrant fluid collection may be characterized definitively by US/CBT-guided needle aspiration. (orig.)


    Morphological difference in spleen and thymus are closely related to functional immune differences. Hormonal regulation of the immune system has been demonstrated in reptilian splenic and thymic tissue. Spleens and thymus were obtained from juvenile alligators at two reference si...

  8. Comparative study on glucocerebrosidase in spleens from patients with Gaucher disease

    NARCIS (Netherlands)

    Aerts, J. M.; Donker-Koopman, W. E.; Brul, S.; van Weely, S.; Sa Miranda, M. C.; Barranger, J. A.; Tager, J. M.; Schram, A. W.


    In Gaucher disease (glucosylceramide lipidosis), deficiency of glucocerebrosidase causes pathological storage of glucosylceramide, particularly in the spleen. A comparative biochemical and immunological analysis has therefore been made of glucocerebrosidase in spleens from normal subjects (n = 4)

  9. Heart transplantation in adults with congenital heart disease. (United States)

    Houyel, Lucile; To-Dumortier, Ngoc-Tram; Lepers, Yannick; Petit, Jérôme; Roussin, Régine; Ly, Mohamed; Lebret, Emmanuel; Fadel, Elie; Hörer, Jürgen; Hascoët, Sébastien


    With the advances in congenital cardiac surgery and postoperative care, an increasing number of children with complex congenital heart disease now reach adulthood. There are already more adults than children living with a congenital heart defect, including patients with complex congenital heart defects. Among these adults with congenital heart disease, a significant number will develop ventricular dysfunction over time. Heart failure accounts for 26-42% of deaths in adults with congenital heart defects. Heart transplantation, or heart-lung transplantation in Eisenmenger syndrome, then becomes the ultimate therapeutic possibility for these patients. This population is deemed to be at high risk of mortality after heart transplantation, although their long-term survival is similar to that of patients transplanted for other reasons. Indeed, heart transplantation in adults with congenital heart disease is often challenging, because of several potential problems: complex cardiac and vascular anatomy, multiple previous palliative and corrective surgeries, and effects on other organs (kidney, liver, lungs) of long-standing cardiac dysfunction or cyanosis, with frequent elevation of pulmonary vascular resistance. In this review, we focus on the specific problems relating to heart and heart-lung transplantation in this population, revisit the indications/contraindications, and update the long-term outcomes. Copyright © 2017. Published by Elsevier Masson SAS.

  10. Postnatal development of the spleen in Didelphis virginiana. (United States)

    Cutts, J H; Krause, W J


    The postnatal development of the spleen has been examined in 85 opossums ranging in age from newborn to adult. At birth the spleen consists of a well vascularized mass of mesenchymal tissue and lacks lymphatic tissue or any evidence of haemopoietic activity. Haemopoiesis is evident at seven days, increases to a maximum at about two to three weeks and thereafter gradually declines. Although production of granulocytes has disappeared by 60 days postnatum, a small degree of erythropoiesis and megakaryocyte formation continues throughout life. Lymphatic tissue appears by the third week, but germinal centres do not appear until after weaning. A feature of the spleen during the first three to four days is the presence of a population of primitive 'blast' cells. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 23 Fig. 24 PMID:7153176

  11. High dispersity of carbon nanotubes diminishes immunotoxicity in spleen. (United States)

    Lee, Soyoung; Khang, Dongwoo; Kim, Sang-Hyun


    From the various physiochemical material properties, the chemical functionalization order of single-walled carbon nanotubes (swCNTs) has not been considered as a critical factor for modulating immunological responses and toxicological aspects in drug delivery applications. Although most nanomaterials, including carbon nanotubes, are specifically accumulated in spleen, few studies have focused on spleen immunotoxicity. For this reason, this study demonstrated that the dispersity of swCNTs significantly influenced immunotoxicity in vitro and in vivo. For cytotoxicity of swCNTs, MTT assay, reactive oxygen species production, superoxide dismutase activity, cellular uptake, and confocal microscopy were used in macrophages. In the in vivo study, female BALB/c mice were intravenously administered with 1 mg/kg/day of swCNTs for 2 weeks. The body weight, organ weight, hematological change, reverse-transcription polymerase chain reaction, and lymphocyte population were evaluated. Different orders of chemical functionalization of swCNTs controlled immunotoxicity. In short, less-dispersed swCNTs caused cytotoxicity in macrophages and abnormalities in immune organs such as spleen, whereas highly dispersed swCNTs did not result in immunotoxicity. This study clarified that increasing carboxyl groups on swCNTs significantly mitigated immunotoxicity in vitro and in vivo. Our findings clarified the effective immunotoxicological factors of swCNTs by increasing dispersity of swCNTs and provided useful guidelines for the effective use of nanomaterials.

  12. Effects of saffron (Crocus sativus petal ethanolic extract on hematology, antibody response, and spleen histology in rats

    Directory of Open Access Journals (Sweden)

    Atefeh Babaei


    Full Text Available Objective: Saffron petal is a by-product that contains flavonoids and anthocyanins. In order to study the effects of saffron petal extract (SPE on blood parameters, immune system, and spleen histology, five treatments (n=6 were used in a completely randomized design. Materials and Methods: The treatments were 0, 75, 150, 225, and 450 mg/kg body weight of SPE. The SPE was injected intraperitoneally to 30 rats (10-week old, weighing 225±15 g for 14 days. Immunization was performed using 1×108 sheep red blood cells (SRBC on days 0 and 7 subcutaneously in all treatment groups. On day 15, blood was collected from the heart of rats after anesthesia. One part of samples were poured in heparinized tubes for counting whole blood cells (CBC and different white blood cells (WBC and the other part was used to measure IgG using ELISA technique. The spleen was stained by hematoxylin- eosin for histological study. The data were statistically analyzed using ANOVA program and the means evaluation was done using Tukey’s test. Results are presented as mean±SD. Results: Results showed no significant difference between treatments and control group regarding the amount of RBC, HGB, HCT, and PLT. The level of IgG at 75 mg/kg was significantly increased in comparison with other groups. No changes were observed in spleen histology. Conclusion: The results indicate that use of SPE at dose of 75 mg/kg causes an increase in antibody response without any change in hematological parameters and spleen histology.

  13. Management of Heart Failure in Advancing CKD: Core Curriculum 2018. (United States)

    House, Andrew A


    Heart failure and chronic kidney disease have increasing incidence and prevalence owing in part to the aging population and increasing rates of hypertension, diabetes, and other cardiovascular and kidney disease risk factors. The presence of one condition also has a strong influence on the other, leading to greater risks for hospitalization, morbidity, and death, as well as very high health care costs. Despite the frequent coexistence of heart failure and chronic kidney disease, many of the pivotal randomized trials that guide the management of heart failure have excluded patients with more advanced stages of chronic kidney disease. In this Core Curriculum article, management of a challenging, yet not unusual, case of heart failure with reduced ejection fraction in a patient with stage 4 chronic kidney disease provides an opportunity to review the relevant literature and highlight gaps in our knowledge. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Gray scale ultrasonography in the diagnosis of polycystic liver and kidney disease

    International Nuclear Information System (INIS)

    Oh, K. C.; Kim, J. W.; Park, B. H.; Lee, S.


    Although the term polycystic disease is usually associated with the kidneys, involvement of other organs such as the liver, pancreas, spleen and lung is not uncommon. However, in many such cases the polycystic disease is found only at autopsy or is an incidental finding during laparotomy. Eight patients with polycystic liver and kidney disease were examined with gray-scale ultrasonography. The value of gray-scale ultrasound as a noninvasive means of differing cystic disease from suspected neoplastic disease is emphasized.

  15. Medullary Sponge Kidney (United States)

    ... tubes, inside a fetus’ kidneys. In a normal kidney , urine flows through these tubules as the kidney is being formed during a ... not fully understand the cause of medullary sponge kidney or why cysts form in the tubules during fetal development. Even though medullary sponge kidney ...

  16. Contents of corticotropin-releasing hormone and arginine vasopressin immunoreativity in the spleen and thymus during a chronic inflammatory stress

    DEFF Research Database (Denmark)

    Chowdrey, H.S.; Lightman, S.L.; Harbuz, M.S.


    Corticotropin-releasing hormone, spleen, thymus, immune system, stress, arthritis, arginine vasopressin......Corticotropin-releasing hormone, spleen, thymus, immune system, stress, arthritis, arginine vasopressin...

  17. Cystatin C, N-terminal probrain natriuretic peptides and outcomes in acute heart failure with acute kidney injury in a 12-month follow-up: Insights into the cardiorenal syndrome

    Directory of Open Access Journals (Sweden)

    Zhong-bao Ruan


    Full Text Available Background: Cystatin C (Cys C has been implicated as a prognostic marker in cardiovascular disease. The aim of this study was to evaluate the value of Cys C as a marker of acute kidney injury (AKI in acute heart failure (AHF, the impact of Cys C and N-terminal probrain natriuretic peptides (NT-proBNP on in-hospital and 12 months mortality were also investigated. Materials and Methods: A total of 162 patients with AHF were enrolled. NT-proBNP, Cys C, serum creatinine (Scr, blood urea nitrogen (BUN and parameters of echocardiography were measured for analyze. The in-hospital and 12 months mortality was analyzed. Results: There was 28 (17% of all AHF patients with AKI. Compared with no-AKI patients, the levels of Cys C (1.51 ± 0.34 vs. 1.32 ± 0.29, P = 0.003 and NT-proBNP (8163.87 ± 898.06 vs. 5922.45 ± 576.73, P = 0.001 were higher in AKI patients. Higher levels of NT-proBNP (odds ratio (OR = 1.92, 95% confidence interval (CI: 2.19-10.98, P = 0.018, OR = 4.31, 95% CI: 2.35-9.82, P = 0.002, respectively and Cys C (OR = 1.48, 95% CI: 1.75-4.16, P = 0.027, OR = 2.72, 95% CI: 1.92-4.28, P = 0.017, respectively were independent association with the in-hospital and 12 months mortality. Cys C was positively correlated with NT-proBNP (r = 0.87, P < 0.001. Combining tertiles of Cys C and NT-proBNP improved risk stratification further. Compared with patients without AKI cysC , patients with AKI cysC was associated with higher in-hospital (7/28 vs. 10/134, P = 0.002 and 12-month mortality (13/28 vs. 32/134, P = 0.001. Conclusion: Cys C was not only a promising risk marker in patients hospitalized for AHF, but also an independent predictor of 12-month mortality. Combining tertiles of Cys C and NT-proBNP could be used to distinguish the mortality risk identification of patients with AHF. AKI was an independent predictor of in-hospital and 12-month mortality.

  18. Marginal kidney donor

    Directory of Open Access Journals (Sweden)

    Ganesh Gopalakrishnan


    Full Text Available Renal transplantation is the treatment of choice for a medically eligible patient with end stage renal disease. The number of renal transplants has increased rapidly over the last two decades. However, the demand for organs has increased even more. This disparity between the availability of organs and waitlisted patients for transplants has forced many transplant centers across the world to use marginal kidneys and donors. We performed a Medline search to establish the current status of marginal kidney donors in the world. Transplant programs using marginal deceased renal grafts is well established. The focus is now on efforts to improve their results. Utilization of non-heart-beating donors is still in a plateau phase and comprises a minor percentage of deceased donations. The main concern is primary non-function of the renal graft apart from legal and ethical issues. Transplants with living donors outnumbered cadaveric transplants at many centers in the last decade. There has been an increased use of marginal living kidney donors with some acceptable medical risks. Our primary concern is the safety of the living donor. There is not enough scientific data available to quantify the risks involved for such donation. The definition of marginal living donor is still not clear and there are no uniform recommendations. The decision must be tailored to each donor who in turn should be actively involved at all levels of the decision-making process. In the current circumstances, our responsibility is very crucial in making decisions for either accepting or rejecting a marginal living donor.

  19. Segmentation of liver and spleen based on computational anatomy models. (United States)

    Dong, Chunhua; Chen, Yen-Wei; Foruzan, Amir Hossein; Lin, Lanfen; Han, Xian-Hua; Tateyama, Tomoko; Wu, Xing; Xu, Gang; Jiang, Huiyan


    Accurate segmentation of abdominal organs is a key step in developing a computer-aided diagnosis (CAD) system. Probabilistic atlas based on human anatomical structure, used as a priori information in a Bayes framework, has been widely used for organ segmentation. How to register the probabilistic atlas to the patient volume is the main challenge. Additionally, there is the disadvantage that the conventional probabilistic atlas may cause a bias toward the specific patient study because of the single reference. Taking these into consideration, a template matching framework based on an iterative probabilistic atlas for liver and spleen segmentation is presented in this paper. First, a bounding box based on human anatomical localization, which refers to the statistical geometric location of the organ, is detected for the candidate organ. Then, the probabilistic atlas is used as a template to find the organ in this bounding box by using template matching technology. We applied our method to 60 datasets including normal and pathological cases. For the liver, the Dice/Tanimoto volume overlaps were 0.930/0.870, the root-mean-squared error (RMSE) was 2.906mm. For the spleen, quantification led to 0.922 Dice/0.857 Tanimoto overlaps, 1.992mm RMSE. The algorithm is robust in segmenting normal and abnormal spleens and livers, such as the presence of tumors and large morphological changes. Comparing our method with conventional and recently developed atlas-based methods, our results show an improvement in the segmentation accuracy for multi-organs (p<0.00001). Copyright © 2015 Elsevier Ltd. All rights reserved.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION : Horse Shoe Kidney was first recognized during an autopsy by De Carpi in 1521. This anomaly consists of two distinct renal masses lying vertically on either side of the midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus that crosses the mid pl ane of the body. This isthmus lies at the level of 4th lumbar vertebra just beneath the origin of inferior mesenteric artery in about 40% of cases. Fusion of upper poles instead of the lower poles results in a n inverted horse Shoe Kidney which constitute 5 - 10% of ail Horse - Shoe kidneys , (i.e. in 95% of HSK , fusion is at lower poles. HSK is found more commonly in males by a 2 : 1 margin. AIM OF STUDY : An attempt has been made to know the various anomalies . The study has been taken up with the fond hope of helping the clinician , sonologist , and surgeons during their routine work. To apply this knowledge to the incoming post graduates in their research works. EMBRIOLOGICAL BASIS & KDNEY : The abnormality originates between 4th and 6th weeks of gestation , after the ureteral bud has entered the renal blastema. Boyden (1931 postulated that at the 14mm stage (4.5 weeks the developing metanephric masses lie close to one another , any disturbance in their relationship may result in joining at their inferior poles. A slight alteration in the position of the umbilical or common iliac artery could change the orientation of migrating kidneys thus leading to contact and fusion. In 1941 Dees (Nation 1945 , Bell 1946 , Gleen 1959 , Campbell 1970 described horse - shoe kidney di sease occurrence in 0.25% of the population or about 1 in 400. OBSERVATION : In the present study 176 specimens of kidneys were studied out of which 40 were fetal specimens and the rest were adult specimens consisting of both cadaveric and sonograms. The ad ult specimens from cadavers were 76 and 60 from sonograms. MATERIAL & METHODS : Abdomen is opened ; superficial viscera and

  1. Laparoscopic splenectomy for spontaneous rupture of the spleen

    Directory of Open Access Journals (Sweden)

    Pinky M Thapar


    Full Text Available Laparoscopic splenectomy is a gold standard for management of planned benign splenic pathologies. Spontaneous rupture of the spleen (SRS leading to acute abdomen occurs in only 1% of all splenic ruptures. Laparoscopic splenectomy in traumatic and atraumatic rupture due to intra-splenic pathology is reported. We present the first reported case of laparoscopic splenectomy in a 23-year-old male who presented with hemoperitoneum due to idiopathic or SRS. The procedure was safely accomplished with slight modified technique and minimum usage of advanced gadgets.

  2. Anatomical description of arterial segments of the spleen of deer. (United States)

    Peres Ferraz de Melo, A; de Souza, W Machado; Rodrigues, R Felipe; Alves, F Ribeiro; Rici, R Eli Graci; Guerra, R Romão; Favaron, P Oliveira; Miglino, M Angélica; Di Dio, L John Aphonso


    With 2 figures The anatomosurgical segmentation of the arteries of the spleen was studied in 31 deer of the species Mazama gouazoubira and Blastocerus dichotomus by means of vascular injection with latex and vinyl acetate and radiographic examination. The arteria lienalis penetrated through the hilus lienis in 87% of the cases, whereas an extrahilar artery was present in the other cases. An extraparenchymal division of the lineal artery into two, three or four segmental arteries was observed in 74% of the cases. Anastomoses between intraparenchymal arterial branches were rare and of a reduced calibre. © 2011 Blackwell Verlag GmbH.

  3. Mucormycosis resulting in a pseudoaneurysm in the spleen

    Energy Technology Data Exchange (ETDEWEB)

    Nevitt, P.C.; Das Narla, L. [Medical College of Virginia, Virginia Commonwealth Univ., Richmond (United States); Hingsbergen, E.A. [Children' s Radiologic Institute, Children' s Hospital, Columbus, OH (United States)


    Mucormycosis is an uncommon and frequently fatal fungal infection. It characteristically affects patients with diabetes mellitus or patients with severe immunosuppression. The hallmark of mucormycosis infection is tissue infarction and vascular invasion. We present clinical data and imaging studies of a 16 year-old child with acute lymphoblastic leukemia complicated by disseminated mucormycosis resulting in a pseudoaneurysm of the spleen. This was successfully managed by a combination of systemic antifungal therapy (Amphotericin B) and surgery (splenectomy). This entity has not been described in the literature. (orig.)

  4. Psychosocial Predictors of Adverse Events in Heart Failure: The Utility of Multiple Measurements (United States)


    Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort...psychiatry 33:636-41 82. Tennant CC, Langeluddecke PM, Fulcher G, Wilby J. 1988. Acute and chronic life event stress in coronary atherosclerosis...underlying causes of heart failure include coronary heart disease, hypertension, valvular 15 heart disease, chronic pulmonary disease

  5. Acute kidney failure (United States)

    Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... Symptoms of acute kidney failure may include any of the following: Bloody stools Breath odor and metallic taste in the mouth Bruising easily Changes in ...

  6. Kidney Replacement Therapy (United States)

    ... Size: A A A Listen En Español Kidney Replacement Therapy Diabetes sometimes damages kidneys so badly that ... Dialysis Dialysis, the more common form of kidney-replacement therapy, is a way of cleaning the blood ...

  7. Chronic Kidney Disease (CKD) (United States)

    ... Immunosuppressant medicines Anxiety, depression and mental health Kidney rejection Lifestyle changes Donate a kidney Being a living ... Healthy kidneys take the waste out of your blood. One type of waste is called creatinine. If you have ...

  8. Chronic Kidney Disease (United States)

    ... control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged and ... don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are ...

  9. Kidney-Pancreas Transplant (United States)

    ... Menu Menu Search Home Prevention Kidney Disease Patients Organ Donation & Transplantation Professionals Events Advocacy Donate A to Z Health ... Tests for Transplant Care After Kidney Transplant Common Organ Donation and Transplantation Terms The National Kidney Foundation (NKF) is the ...

  10. Cadmium and the kidney.


    Friberg, L


    The paper is a review of certain aspects of importance of cadmium and the kidney regarding the assessment of risks and understanding of mechanisms of action. The review discusses the following topics: history and etiology of cadmium-induced kidney dysfunction and related disorders; cadmium metabolism, metallothionein and kidney dysfunction; cadmium in urine as indicator of body burden, exposure and kidney dysfunction; cadmium levels in kidney and liver as indicators of kidney dysfunction; cha...

  11. Dynamics of Red Cells in Spleen: How Does Vesiculation Happen? (United States)

    Zhu, Qiang; Salehyar, Sara; Cabrales, Pedro; Asaro, Robert


    Vesiculation of red blood cells as a result of local separation between lipid bilayer and cytoskeleton is known to happen in vivo, most likely inside spleen where they sustain large mechanical loads during the passage through venus slits. There is, however, little knowledge about the detailed scenario and condition. We address this question via a fluid-cell interaction model by coupling a multiscale model of the cell membrane (including molecular details) with a fluid dynamics model based on boundary-integral equations. A numerical flow channel is created where the cell is driven through a narrow slit by pressure (imitating the transit through venus slits in spleen). The concentration is the occurrence of large dissociation (negative) pressure between the skeleton/membrane connection that promotes separation, a precursor of vesicle formation. Critical levels for the negative pressure are estimated using published data. By following the maximum range of pressure, we conclude that for vesiculation to happen there must be biochemical influences (e.g. binding of degraded haemoglobin) that significantly reduce effective attachment density. This is consistent with reported trends in vesiculation that are believed to occur in cases of various hereditary anemias and during blood storage. Our findings also suggest the criticality of understanding the biochemical phenomena involved with cytoskeleton/membrane attachment.

  12. The spleen in the sickling disorders: an update

    Energy Technology Data Exchange (ETDEWEB)

    Khatib, Rana; Sarnaik, Sharada A. [Wayne State University School of Medicine, Children' s Hospital of Michigan, Carmen and Ann Adams Department of Pediatrics, Detroit, MI (United States); Rabah, Raja [Wayne State University School of Medicine, Department of Pathology, Detroit, MI (United States)


    In early life, patients with sickle cell disease (SCD) can have acute, life-threatening emergencies related to splenic hypofunction (overwhelming bacterial sepsis), as well as anemic crises from acute splenic sequestration because of sudden pooling of blood in the spleen. The landmark penicillin prophylaxis study in 1985 showed a remarkable decrease in mortality from sepsis in young children with SCD who were treated with oral penicillin prophylaxis compared to placebo. Since that study, newborns are screened for SCD and placed on oral penicillin prophylaxis in nearly all of the United States, as well as in other countries where the disease is highly prevalent. The previously described permanent, complete and nearly universal ''autosplenectomy'' emerging by late childhood or early adulthood is now challenged by recent findings of reversibility of splenic dysfunction by the antisickling drug hydroxyurea or by successful allogeneic stem cell transplantation, even in older patients. Imaging techniques for hypofunction of the spleen are the most commonly used modalities to guide the clinician in decisions regarding medical or surgical management. (orig.)

  13. Scintigraphy of liver and spleen in vinyl chloride workers

    International Nuclear Information System (INIS)

    Biersack, H.J.; San Luis, T. Jr.; Lange, C.E.; Thelen, M.; Veltman, G.; Winkler, C.; Bonn Univ.; Bonn Univ.


    In 152 VC-exposed workers of whom 124 were employed in the PVC-production and 28 in VC-processing plants liver and spleen imaging was performed using sup(99m)Tc-sulphur colloid and 197 Hg-BMHP. In 101 (= 81%) of the 124 workers of the PVC-production plant and in 18 (= 64%) workers of PVC-processing factories pathological liver and spleen scintigrams were found. The most frequent pathological change in the scintigraphic image was an increase in splenic colloid accumulation, when compared with the liver uptake. Three angiosarcomas of the liver were detected through circumscribed defects of colloid accumulation. Sequential liver scintigraphy was done in 15 cases. In 7 patients with esophageal varices considerable decrease in portal venous blood flow was demonstrated. - As a result of our investigations it can be stated that scintigraphically detectable changes are sensitive indicators of VC-induced lesions of the liver including liver fibrosis, portal hypertension and angiosarcoma. (orig.) [de

  14. The spleen in the sickling disorders: an update

    International Nuclear Information System (INIS)

    Khatib, Rana; Sarnaik, Sharada A.; Rabah, Raja


    In early life, patients with sickle cell disease (SCD) can have acute, life-threatening emergencies related to splenic hypofunction (overwhelming bacterial sepsis), as well as anemic crises from acute splenic sequestration because of sudden pooling of blood in the spleen. The landmark penicillin prophylaxis study in 1985 showed a remarkable decrease in mortality from sepsis in young children with SCD who were treated with oral penicillin prophylaxis compared to placebo. Since that study, newborns are screened for SCD and placed on oral penicillin prophylaxis in nearly all of the United States, as well as in other countries where the disease is highly prevalent. The previously described permanent, complete and nearly universal ''autosplenectomy'' emerging by late childhood or early adulthood is now challenged by recent findings of reversibility of splenic dysfunction by the antisickling drug hydroxyurea or by successful allogeneic stem cell transplantation, even in older patients. Imaging techniques for hypofunction of the spleen are the most commonly used modalities to guide the clinician in decisions regarding medical or surgical management. (orig.)

  15. [Discussion on treatment of hypertension by tonifying kidney]. (United States)

    Wang, Jie; Xiong, Xing-Jiang; Liu, Wei


    Hypertension is one of the important risk factors of chronic non-communicable diseases such as stroke, myocardial infarction, heart failure and so on. It seriously affects heart, brain, kidney and other vital organs of the structure and function. In recent years, prevalence of hypertension in China is growing rapidly. The natural process of hypertension is changed directly because of constantly optimizing and widely using antihypertensive drugs, which results in the change of evolution law in traditional Chinese medicine pathology correspondingly. Kidney deficiency is the key pathology of hypertension nowadays. It is demonstrated that hypertension could be treated by the therapeutic principle of tonifying kidney.

  16. Judge of surgical indication for blunt injuries of liver and spleen by CT imaging

    International Nuclear Information System (INIS)

    Nakagawa, Takao; Yokoyama, Toshimitsu; Suga, Hiroyasu; Deguchi, Yoshizumi; Hasegawa, Yasuhiro; Muraoka, Ryusuke; Ishikawa, Masatake; Suzuki, Tadashi.


    Recent studies have elucidated that the findings of injuries of parenchimatous organs such as liver and spleen by computed tomography (CT) are consistent with those by surgical operation. But it is still unclear whether CT findings can determine operative indication for blunt injuries of liver and spleen. We performed a retrospective study on 35 lesions of blunt injuries of liver and spleen in 33 cases for blunt injuries of liver and spleen at our hospitals to examine whether CT findings can determine the severity of damage and surgical indication for the injuries, and the following results were obtained. Based on CT findings, the presence of injury was confirmed in all cases except for one lesion. Comparison of CT findings and operative or laparoscopic findings in 12 cases undergoing operation or laparoscopy for liver/spleen injury revealed that the findings of each method were almost the same with few exceptions. When liver/spleen injuries were classified according to the Japanese Association for the Surgery of Trauma (JAST) Classification of injury of liver and spleen, cases with emergency operation had severe injury of Type IIIb for the liver and Type IIIb or higher for the spleen, while conservative treatment was possible for injury cases of Type IIIa or lower of the liver and spleen. From these results, the JAST Classification of these injuries based upon CT imaging was found to be a suitable method for selecting an appropriate treatment for blund injury of liver and spleen. (author)

  17. Judge of surgical indication for blunt injuries of liver and spleen by CT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Takao; Yokoyama, Toshimitsu; Suga, Hiroyasu; Deguchi, Yoshizumi; Hasegawa, Yasuhiro; Muraoka, Ryusuke [Fukui Medical School (Japan); Ishikawa, Masatake; Suzuki, Tadashi


    Recent studies have elucidated that the findings of injuries of parenchimatous organs such as liver and spleen by computed tomography (CT) are consistent with those by surgical operation. But it is still unclear whether CT findings can determine operative indication for blunt injuries of liver and spleen. We performed a retrospective study on 35 lesions of blunt injuries of liver and spleen in 33 cases for blunt injuries of liver and spleen at our hospitals to examine whether CT findings can determine the severity of damage and surgical indication for the injuries, and the following results were obtained. Based on CT findings, the presence of injury was confirmed in all cases except for one lesion. Comparison of CT findings and operative or laparoscopic findings in 12 cases undergoing operation or laparoscopy for liver/spleen injury revealed that the findings of each method were almost the same with few exceptions. When liver/spleen injuries were classified according to the Japanese Association for the Surgery of Trauma (JAST) Classification of injury of liver and spleen, cases with emergency operation had severe injury of Type IIIb for the liver and Type IIIb or higher for the spleen, while conservative treatment was possible for injury cases of Type IIIa or lower of the liver and spleen. From these results, the JAST Classification of these injuries based upon CT imaging was found to be a suitable method for selecting an appropriate treatment for blund injury of liver and spleen. (author)

  18. Heart Failure (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  19. Towards Mesenchymal Stem Cell Therapy in Kidney Transplant Recipients

    NARCIS (Netherlands)

    M. Roemeling-Van Rhijn (Marieke)


    markdownabstract__Abstract__ Body homeostasis is maintained by vital organs such as the heart, lungs, kidney and liver. Organ failure due to injury or disease will ultimately result in a life threatening situation. Heart and lung function can be supported and even temporarily replaced by

  20. Inflammatory Complications after Cardiac Surgery : Atrial Fibrillation and Kidney Injury

    NARCIS (Netherlands)

    Jacob, K.A.


    Heart surgery is a frequently performed type of surgery and is associated with an inflammatory response throughout the body. This inflammation can injure several organs, including the heart itself and the kidneys. This thesis has investigated the role of the systemic inflammatory response after

  1. Hemoperitoneum secondary to an spontaneous rupture of the spleen mimmicking a duodenal perforated ulcera: A case report. (United States)

    Ruiz-Tovar, Jaime; Díaz, Gustavo; Alias, David; Jiménez-Fuertes, Montiel; Durán, Manuel


    Spontaneous rupture of the spleen without traumatic cause is an unfrequent entity, usually related with pathologic spleens. We present a case of spontaneous rupture of an histologically normal spleen with splenomegalia secondary to smoking habit. The hemoperitoneum caused by the spontaneous rupture of the spleen mimmicked a hollow viscera perforation.

  2. [The use of diuretics in kidney disease]. (United States)

    Heramb, Lene; Hallan, Stein; Aasarød, Knut


    Diuretics are an important part of the therapy for a number of medical conditions such as heart, liver and kidney failure and hypertension. This article presents updated knowledge on the use of diuretics in kidney disease. The article is based on a literature search in PubMed, information obtained from textbooks on neurophysiology and kidney disease and on the authors' clinical experience. Kidney disease affects the pharmacokinetics and pharmacodynamics of diuretics, and this must be taken into account when selecting a drug and determining the dosage. This applies particularly to nephrotic syndrome and severe chronic renal disease (GFR diuretics is crucial to the rational use of diuretics in renal disease. Dose titration under close clinical monitoring and an optimal dosage interval make it possible to find the lowest possible effective dose and reduce the occurrence of side effects.

  3. Heart Anatomy (United States)

    ... kilometers), which is far enough to circle the earth more than twice! See also on other sites: ... For the Public Heart Information Center Project Heart Women’s Heart Health Clinical Trials 6770 Bertner Avenue Houston, ...

  4. [ACE inhibitors and the kidney]. (United States)

    Hörl, W H


    Treatment with ACE inhibitors results in kidney protection due to reduction of systemic blood pressure, intraglomerular pressure, an antiproliferative effect, reduction of proteinuria and a lipid-lowering effect in proteinuric patients (secondary due to reduction of protein excretion). Elderly patients with diabetes melitus, coronary heart disease or peripheral vascular occlusion are at risk for deterioration of kidney function due to a high frequency of renal artery stenosis in these patients. In patients with renal insufficiency dose reduction of ACE inhibitors is necessary (exception: fosinopril) but more important is the risk for development of hyperkalemia. Patients at risk for renal artery stenosis and patients pretreated with diuretics should receive a low ACE inhibitor dosage initially ("start low - go slow"). For compliance reasons once daily ACE inhibitor dosage is recommended.

  5. Pathomorphology of spleen lymphocyte apoptosis in large dose 60Co γ-irradiated mice

    International Nuclear Information System (INIS)

    Gao Linlu; Cui Yufang; Yang Hong; Xia Guowei; Peng Ruiyun; Gao Yabing; Wang Dewen


    Objective: The aim of the authors was to investigate the pathomorphology changes of spleen lymphocyte apoptosis after 60 Co γ-irradiation. Methods: The mice were irradiated with 6, 9, 12, 15 and 20 Gy of 60 Co γ-rays. At different times after irradiation, the mice were sacrificed and the pathological changes of spleen lymphocyte were observed by light and transmission electron microscopies. Results: Spleen lymphocyte decreased evidently and the peak of apoptosis in spleen lymphocyte was dependent on radiation dose and the time after irradiation. Conclusion: After γ-irradiation with large doses, pathological changes of spleen lymphocyte apoptosis in mice can be divided into obviously different stages. The main causes of death of spleen lymphocytes are different in different dose groups

  6. Role of nuclear medicine imaging in differential diagnosis of accessory spleens in patients after splenectomy

    International Nuclear Information System (INIS)

    D’Amico, Andrea; Cofalik, Anna; Przeorek, Cesary; Gawlik, Tomasz; Olczyk, Tomasz; Kalemba, Michał; Modorowska, Alicja; Turska-d’Amico, Maria; Bobek-Billewicz, Barbara; Jarzab, Barbara


    More than 10% of healthy population has one or more accessory spleens. The most common location is the hilum of the spleen or area near the tail of the pancreas. The radiological appearance of accessory spleens in oncologic patients who underwent splenectomy can be misinterpreted as a recurrence, especially in the case of compensatory growth of an accessory spleen in successive radiological examinations. We present the cases of three patients who underwent splenectomy for gastric carcinoid, gastric adenocarcinoma and cancer of the left adrenal gland, respectively. CT examination and/or PET-CT scan revealed suspicious findings in the left upper abdomen. In one patient, the dimensional increase of this finding in successive examinations was initially considered suggestive for cancer recurrence. Scintigraphy with 99m Tc-nanocolloid was able to confirm the presence of an accessory spleen in all these patients. Splenic scintigraphy is an economical, accessible and accurate tool in differential diagnosis of accessory spleens in patients after splenectomy

  7. Ultrasonography of the Kidney

    DEFF Research Database (Denmark)

    Lindskov Hansen, Kristoffer; Nielsen, Michael Bachmann; Ewertsen, Caroline


    Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound...

  8. Relative radiosensitivities of the thymus, spleen, and lymphohemopoietic systems

    International Nuclear Information System (INIS)

    Maruyama, Y.; Feola, J.M.


    Recently, dramatic advances have taken place in our knowledge of the organization and functions of the thymus and lymphoid system. Some of our understanding has come form the application of radiation therapy to diseases derived from lymphoid organs. Human investigations using radiotherapy have shed light on the radiosensitivities of the system as well as on its important functional activities. Likewise, studies of cellular traffic in the lymphoid organs, i.e., the thymus, spleen, and lymph nodes, showed that extensive cellular exchange occurs between the bone marrow compartment with its hemopoietic and progenitor cells and the various central and peripheral lymphoid organs. Because this is so, the term lymphohemopoietic (LH) system is appropriate. This very selective review will recapitulate some of the ongoing research in radiotherapy and radiobiology in these closely related fields. The clinical therapeutic advances have taken place in four important settings closely related to clinical therapy of tumor derived from the LH system

  9. Cat scratch disease with lymphadenitis, vertebral osteomyelitis, and spleen abscesses. (United States)

    Rolain, J M; Chanet, V; Laurichesse, H; Lepidi, H; Beytout, J; Raoult, D


    In this report we describe a 30-year old male patient with vertebral osteomyelitis and spleen abscesses with cat scratch disease. The diagnosis was made on the basis of molecular detection of Bartonella henselae either on lymph node biopsies or on bone biopsy, histology of the lymph node, serology using either our in-house microimmunofluorescence assay or a commercial kit (Focus Technologies). Immunofluorescent detection was also performed directly on slide appositions using a monoclonal antibody. Treatment consisted of administration of antibiotics with rapid clinical improvement and a stabilization of skeletal lesions on the magnetic resonance imaging performed three months later. Twenty two other cases of this unusual manifestation associated with cat scratch disease have been reported in the literature and are reviewed here. Our case represents the second case of osteomyelitis associated with cat scratch disease in which B. henselae has been specifically identified as the etiological agent using several direct and indirect methods.

  10. Primary hemangiosarcoma of the spleen with angioscintigraphic demonstration of metastases

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G.G.; Fogh, J.; Graem, N.; Hansen, O.P.; Hippe, E.


    A case of primary hemangiosarcoma of the spleen in a 48-year-old woman is presented. Twenty-eight months after splenectomy the patient developed a severe anemia of the microangiopathic type, thrombocytopenia, and a leukoerythroblastic peripheral blood picture. In contrast to x-ray and conventional /sup 99m/Tc-methylene-diphosphonate (MDP) bone scintigraphy, which showed only a few minor focal changes in the spine and ribs, angioscintigraphy with in vitro labeled /sup 99m/Tc-erythrocytes revealed extensive pathologic accumulations throughout the spine, femurs, and the liver, indicating the presence of extremely vascular metastases. Autopsy 15 months later confirmed the scintigraphic findings. Angiography with /sup 99m/Tc-labeled erythrocytes seems to be useful for monitoring metastases from hemangiosarcomas.

  11. GM-CSF augments the immunosuppressive capacity of neonatal spleen cells in vitro

    International Nuclear Information System (INIS)

    Morrissey, P.J.; Ireland, R.


    Addition of exogenous granulocyte-macrophage colony stimulating factor (GM-CSF) to cultures of adult murine spleen cells with sheep red blood cells (SRBC) results in an augmented plaque forming cell (PFC) response. The influence of GM-CSF on the ability of neonatal spleen cells to suppress the anti-SRBC plaque forming response of adult spleen cells was tested by adding GM-CSF to cultures of neonatal and adult spleen cells. The suppressive capacity of the neonatal spleen cells was augmented by exogenous GM-CSF. The augmented suppression of the neonatal spleen cells was dependent on a G-10 adherent population since the addition of GM-CSF to cultures containing G-10 passed neonatal spleen cells resulted in an augmented PFC response and not suppression. Neonatal splenic glass adherent cells were also capable of suppressing the response. Neonatal spleen cells or purified neonatal glass adherent spleen cells cultured in the presence of GM-CSF had markedly increased levels of PGE2 in the culture supernatant. Neonatal spleen cells cultured with GM-CSF had increased numbers of morphologically identifiable macrophages after 48 hr of culture. Both irradiation and G-10 passage of the neonatal spleen diminished the numbers of macrophages formed in response to GM-CSF, and both of these manipulations resulted in reversal of suppression in response to GM-CSF. Thus, the augmented suppressive capacity of neonatal spleen cells in response to GM-CSF is probably mediated by its ability to drive monocyte to macrophage differentiation as well as increase the suppressive capacity of the existing neonatal splenic macrophages by increasing their production of PGE2

  12. Single-Incision Laparoscopic Splenectomy and Splenic Autotransplantation for an Enlarged Wandering Spleen with Torsion


    Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu


    A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The t...

  13. Torsion of the accessory spleen with infarction : CT features in a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Jung Kyung; Lee, Jun Sik; Kim, Mee Eun; Pyun, Hae Wook; Lee, Il Gi; Lee, Jong Gil; Kim, Hee Jin; Kim, Ik Su [Fatima Hospital, Taegu (Korea, Republic of)


    Torsion of the accessory spleen is a rare entity that can have variable clinical presentations. We report case involving an 11-year-old boy with severe abdominal pain and a mass that was found to be due to infarction of the accessory spleen, which was twisted on its pedicle. CT revealed a low-attenuating mass with peripheral inflammatory changes in the left upper abdomen. The mass was pathologically confirmed as torsion of the accessory spleen with infarction. (author)

  14. Laparoscopic versus open splenectomy: the impact of spleen size on outcomes. (United States)

    Ardestani, Ali; Tavakkoli, Ali


    Although laparoscopic splenectomy (Lap-Spleen) has become the standard surgical approach for normal-sized spleens, open splenectomy (Open-Spleen) is still recommended by many in the setting of splenomegaly. We set out to compare the impact of spleen size on Lap-Spleen and Open-Spleen outcomes using a national database. We reviewed the American College of Surgeons' National Surgical Quality Improvement Program database to identify patients who had undergone non-emergency splenectomy during 2005-2010. To evaluate the impact of spleen size on outcomes, we considered patients with diagnoses of splenomegaly and hypersplenism as those having large spleens (Large-Sp group) and those with diagnoses of primary thrombocytopenia and immune thrombocytopenic purpura as having normal spleens (Normal-Sp group). Patients were also categorized based on surgical approach into Lap-Spleen and Open-Spleen groups. We identified 639 patients in the Large-Sp group and 879 patients in the Normal-Sp group. During 2005-2010 laparoscopy was used in 84.2% of cases in the Normal-Sp group (annual range, 77.8%-90.8%). However, the rate of laparoscopy in the Large-Sp group remained consistently below 50% with an average of 41.8% (annual range, 20%-47%). In the Lap-Spleen group, those with Large-Sp had longer operative time and length of stay and higher blood transfusion and morbidity compared with the Normal-Sp group. However, when looking specifically at the Large-Sp group, patients with Open-Spleen had more transfusion requirements, longer length of stay, and higher morbidity, compared with those with Lap-Spleen. Lap-Spleen leads to significant improvement in outcomes. These advantages were believed to be limited to normal-sized spleens, but this study demonstrates that laparoscopy can still be advantageous in patients with splenomegaly. We hope such data encourages wider utilization of laparoscopy in the setting of splenomegaly, especially among surgeons who are experienced with the technique.

  15. Effects of aluminum trichloride on the trace elements and cytokines in the spleen of rats. (United States)

    Zhu, Yanzhu; Li, Xinwei; Chen, Chongxiao; Wang, Fan; Li, Jing; Hu, Chongwei; Li, Yanfei; Miao, Liguang


    The bioaccumulation and immunotoxicity of aluminum (Al) have been previously documented. Al accumulates in the organs of the organism, including spleen. Spleen is a peripheral organ of the immune system. The accumulated Al may alter the immune function. Here, we investigated the bioaccumulation of Al in spleen and its alterations in the immune system. Forty male Wistar rats (5 weeks old) weighed 110-120 g were orally exposed to aluminum trichloride (AlCl(3)) (0, 64.18, 128.36 and 256.72 mg/kg body weight) in drinking water for 120 days. The concentrations of spleen's Al, iron (Fe), copper (Cu), zinc (Zn), interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α) and growth index were examined at the end of the experiment. The results showed that the concentrations of Al and Cu in the spleen were increased in an AlCl(3)-dose dependent manner, and the concentrations of spleen's growth index, Fe, Zn, IL-2 and TNF-α were reduced in AlCl(3)-treated rats. The results suggest that AlCl(3) can suppress the growth of spleen, disorder the balance of trace elements and inhibit the immune regulation of cytokines in the spleen. It indicates that AlCl(3) suppresses the immune function of spleen. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Role of the spleen in cyclophosphamide-induced hematosuppression and extramedullary hematopoiesis in mice. (United States)

    Wang, Yuli; Meng, Qinggang; Qiao, Haiquan; Jiang, Hongchi; Sun, Xueying


    Extramedullary hematopoiesis (EMH) is induced in spleens due to various diseases. The aim of this study is to investigate the role of spleen in cyclophosphamide (CTX)-induced hematosuppression and EMH in mice. Balb/c mice were IP injected with 300 mg/kg CTX 2 weeks after splenectomy or sham operation and randomly sacrificed 1, 3, 7, 14, and 21 days after injection. Blood samples were collected, and spleens were weighed, histologically analyzed, and then used for flow cytometry. There were significant differences in white blood count, red blood count, platelet numbers and hemoglobin concentration between the splenectomized and sham-operated mice after CTX injection. The cellularity of the spleen was reduced 3 days following CTX treatment but then rose 7 days after CTX treatment. The numbers of colony-forming units in the spleen reached a peak 7 days after CTX injection, then declined. Flow cytometry demonstrated the percentage of CD34(+) and CD117(+) cells in the spleen increased 7 days after CTX injection, indicating the hematopoietic stem and progenitor cells in the spleen. The study indicates that EMH occurs as a compensatory reaction to CTX-induced hematosuppression in the murine spleen, implying that conservation of the spleen may promote the recovery of cancer patients from chemotherapy-induced hematosuppression.

  17. Interactions between Biliverdin, Oxidative Damage, and Spleen Morphology after Simulated Aggressive Encounters in Veiled Chameleons.

    Directory of Open Access Journals (Sweden)

    Michael W Butler

    Full Text Available Stressors frequently increase oxidative damage--unless organisms simultaneously mount effective antioxidant responses. One putative mitigative mechanism is the use of biliverdin, an antioxidant produced in the spleen during erythrocyte degradation. We hypothesized that both wild and captive-bred male veiled chameleons (Chamaeleo calyptratus, which are highly aggressive to conspecifics, would respond to agonistic displays with increased levels of oxidative damage, but that increased levels of biliverdin would limit this increase. We found that even just visual exposure to a potential combatant resulted in decreased body mass during the subsequent 48-hour period, but that hematocrit, biliverdin concentration in the bile, relative spleen size, and oxidative damage in plasma, liver, and spleen were unaffected. Contrary to our predictions, we found that individuals with smaller spleens exhibited greater decreases in hematocrit and higher bile biliverdin concentrations, suggesting a revision to the idea of spleen-dependent erythrocyte processing. Interestingly, individuals with larger spleens had reduced oxidative damage in both the liver and spleen, demonstrating the spleen's importance in modulating oxidative damage. We also uncovered differences in spleen size and oxidative damage between wild and captive-bred chameleons, highlighting environmentally dependent differences in oxidative physiology. Lastly, we found no relationship between oxidative damage and biliverdin concentration, calling into question biliverdin's antioxidant role in this species.

  18. HE4 Serum Levels Are Associated with Heart Failure Severity in Patients With Chronic Heart Failure

    NARCIS (Netherlands)

    Piek, Arnold; Meijers, Wouter C.; Schroten, Nicolas F.; Gansevoort, Ron T.; de Boer, Rudolf A.; Sillje, Herman H. W.

    Background: The novel biomarker human epididymis protein 4 (HE4) shows prognostic value in acute heart failure (HF) patients. We measured HE4 levels in patients with chronic heart failure (CHF) and correlated them to HF severity, kidney function, and HF biomarkers, and determined its predictive

  19. Heart Attack (United States)

    Each year almost 800,000 Americans have a heart attack. A heart attack happens when blood flow to the heart suddenly ... it's important to know the symptoms of a heart attack and call 9-1-1 if you or ...

  20. Heart Transplantation (United States)

    A heart transplant removes a damaged or diseased heart and replaces it with a healthy one. The healthy heart comes from a donor who has died. It is the last resort for people with heart failure when all other treatments have failed. The ...

  1. Heart Diseases (United States)

    ... re like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  2. Laparoscopy-Assisted Spleen-Preserving Distal Pancreatectomy for Living-Donor Pancreas Transplantation. (United States)

    Date, S; Noguchi, H; Kaku, K; Kurihara, K; Miyasaka, Y; Okabe, Y; Nakamura, U; Ohtsuka, T; Nakamura, M


    Living pancreas transplantation plays an important role in the treatment of patients with severe type 1 diabetes. However, pancreatectomy is very invasive for the donor, and less-invasive surgical procedures are needed. Although some reports have described hand-assisted laparoscopic surgery for distal pancreatectomy in living-donor operations, less-invasive laparoscopy-assisted (LA) procedures are expected to increase the donor pool. We herein report the outcomes of four cases of LA spleen-preserving distal pancreatectomy (Warshaw technique [WT]) in living pancreas donors. Four living pancreas donors underwent LA-WT at our institution from September 2010 to January 2013. All donors fulfilled the donor criteria established by the Japan Society for Pancreas and Islet Transplantation. The median donor age was 54 years. Two donors underwent left nephrectomy in addition to LA-WT for simultaneous pancreas-kidney transplantation. The median donor operation time for pancreatectomy was 340.5 minutes. The median pancreas warm ischemic time was 3 minutes. The median donor blood loss was 246 g. All recipients immediately achieved insulin independence. One donor required reoperation because of obstructive ileus resulting from a port-site hernia. Another donor developed a pancreatic fistula (International Study Group of Pancreatic Fistula grade B), which was controlled with conservative management. After a maximum follow-up of 73 months, no clinically relevant adverse events had occurred. These results were comparable with those of previous studies concerning living-donor pancreas transplantation. The LA-WT is a safe and acceptable operation for living-donor pancreas transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Population pharmacokinetics of cyclosporine in kidney and heart transplant recipients and the influence of ethnicity and genetic polymorphisms in the MDR-1, CYP3A4, and CYP3A5 genes

    NARCIS (Netherlands)

    Hesselink, Dennis A.; van Gelder, Teun; van Schaik, Ron H. N.; Balk, Aggie H. M. M.; van der Heiden, Ilse P.; van Dam, Thea; van der Werf, Marloes; Weimar, Willem; Mathot, Ron A. A.


    Our objective was to determine the relationship between single nucleotide polymorphisms (SNPs) in the multidrug resistance 1 (MDR-1) gene and the cytochrome P450 (CYP) genes CYP3A4 and CYP3A5 and the pharmacokinetics of cyclosporine (INN, ciclosporin). Cyclosporine pharmacokinetics of 151 kidney and

  4. Is Increased Echogenicity Related to a Decrease in Glomerular Filtration Rate? Objective Measurements in Pediatric Solitary Kidney Patients--A Retrospective Analysis.

    Directory of Open Access Journals (Sweden)

    Yong Seung Lee

    Full Text Available Quantitative measurements of renal echogenicity using a graphic program show close correlation with renal histology in adult patients, but this has neither been applied in pediatric patients nor correlated with glomerular filtration rate (GFR. To determine the direct relationship between echogenicity and GFR, we retrospectively analyzed 91 patients with a solitary functioning kidney under the age of 10, who underwent ultrasonography and serum cystatin C evaluation on a single day between January 2013 and December 2014. Echogenicity was quantified as previously reported. Echogenicity and kidney length were correlated with age-matched values of serum cystatin C-based GFR. Evaluation was performed at a median age of 17.1 months. GFR was low for age in eight of 54 right solitary kidney patients and four of 37 left solitary kidney patients. The right kidney-liver ratio was significantly elevated in the right decreased GFR group, while the left kidney-spleen ratio was not different in the left decreased GFR group. Age-matched longitudinal kidney length ratios were similar between the decreased and normal GFR groups for both sides. This is the first report to objectively prove the relationship between echogenicity and renal function in patients with a right solitary kidney. The right kidney-liver echogenicity ratio, measured objectively, showed feasibility in clinical practice as it showed a close relationship with decreased renal function when increased. However, absolute kidney echogenicity values, or the left kidney-spleen echogenicity ratio, were not independent markers for decreased renal function.

  5. Focus on renal congestion in heart failure. (United States)

    Afsar, Baris; Ortiz, Alberto; Covic, Adrian; Solak, Yalcin; Goldsmith, David; Kanbay, Mehmet


    Hospitalizations due to heart failure are increasing steadily despite advances in medicine. Patients hospitalized for worsening heart failure have high mortality in hospital and within the months following discharge. Kidney dysfunction is associated with adverse outcomes in heart failure patients. Recent evidence suggests that both deterioration in kidney function and renal congestion are important prognostic factors in heart failure. Kidney congestion in heart failure results from low cardiac output (forward failure), tubuloglomerular feedback, increased intra-abdominal pressure or increased venous pressure. Regardless of the cause, renal congestion is associated with increased morbidity and mortality in heart failure. The impact on outcomes of renal decongestion strategies that do not compromise renal function should be explored in heart failure. These studies require novel diagnostic markers that identify early renal damage and renal congestion and allow monitoring of treatment responses in order to avoid severe worsening of renal function. In addition, there is an unmet need regarding evidence-based therapeutic management of renal congestion and worsening renal function. In the present review, we summarize the mechanisms, diagnosis, outcomes, prognostic markers and treatment options of renal congestion in heart failure.

  6. Spontaneous rupture of the spleen: A rare complication in a patient with lupus nephritis on hemodialysis

    Directory of Open Access Journals (Sweden)

    Nadri Quaid


    Full Text Available Rupture of the spleen is a life threatening condition. We report a 40-year-old fe-male patient, a known case of lupus nephritis receiving hemodialysis, who developed spontaneous rupture of the spleen during the course of her illness. The patient was managed conservatively with gradual regression of hematoma without further complications.

  7. Epithelial cyst of the spleen with squamous metaplasia: a rare entity. (United States)

    Shanthi, Vissa; Reddy, Vengala Chidananda; Rao, Nandam Mohan; Grandhi, Bhavana; Kona, Suneetha


    Epithelial splenic cysts are uncommon lesions which occur the spleen. The aetiopathogenesis of these cysts is not clear. We are reporting a case of an epithelial cyst which occurred in the spleen in a 40-year-old female, which was multi loculated and which had flattened lining epithelium. Some foci showed squamous metaplasia.

  8. An epidermoid cyst of accessory spleen simulating tumors of the tail of pancreas

    Directory of Open Access Journals (Sweden)

    Amit Kumar Sinha


    Full Text Available An epidermoid cyst of accessory spleen, a rare condition may present as pseudocyst of pancreas and other cystic tumors of the pancreas. This case report along with the review of literature attributes some clinical features and investigative pattern to differentiate between epidermoid cyst of accessory spleen and other cystic tumor of pancreas.

  9. Two different mechanisms of immune-complex trapping in the mouse spleen during immune responses

    NARCIS (Netherlands)

    Yoshida, K.; van den Berg, T. K.; Dijkstra, C. D.


    The capacity of immune-complex (IC) trapping was examined using purified horse radish peroxidase (HRP)-anti-HRP (PAP) on frozen sections of mouse spleen in vitro. We investigated the trapping mechanisms by applying the IC with or without fresh mouse serum added on the spleen sections of naive as

  10. Late return of function after intrathoracic torsion of the spleen in congenital diaphragmatic hernia

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Pedersen, P V


    , and the spleen were intrathoracic. There was a 720 degree torsion of the splenic pedicle. After reduction, the spleen was placed in the abdomen. At scintiscans 12 days and 14 weeks after operation, no certain splenic function was demonstrated, but at follow-up up 21/2 years later the splenic scan was normal....

  11. Accessory spleen presenting as acute abdomen: A case report and operative management

    Directory of Open Access Journals (Sweden)

    A. Landmann


    Full Text Available Accessory spleens are found in 10–30% of patients and are asymptomatic. Rarely, torsion of an accessory spleen can cause abdominal pain and acute abdomen. We present the case of an 8-year-old girl who arrives to the emergency room with left upper quadrant abdominal pain. CT scan revealed a non-enhancing soft tissue mass and multiple small splenules. Laparoscopy revealed a torsed accessory spleen and malrotation. Accessory spleen is a common congenital anomaly that is frequently asymptomatic. Rarely, an accessory spleen may become torsed around its vascular pedicle resulting in severe abdominal pain. Treatment is surgical resection. Torsion of accessory splenic tissue is a rare cause of acute abdomen in pediatric patients.

  12. Increased numbers of spleen colony forming units in B cell deficient CBA/N mice

    International Nuclear Information System (INIS)

    Wiktor-Jedrzejczak, W.; Krupienicz, A.; Scher, I.


    The formation of exogenous and endogenous spleen colonies was studied in immune-defective mice expressing the CBA/N X-linked xid gene. Bone marrow and spleen cells of immune deficient mice formed increased numbers of eight-day exogenous spleen colonies when transferred to either normal or B cell deficient lethally irradiated recipients. Moreover, defective mice showed increased formation of five-day endogenous spleen colonies (derived from transient endogenous colony forming units; T-CFU) and of ten-day endogenous spleen colonies (derived from CFU-S). Among the possible mechanisms responsible for the observed effects, the most probable appears the one in which decreased numbers of B cell precursors stimulate stem cell pools through a feedback mechanism. (orig.) [de

  13. A case of torsion of the wandering spleen presenting as hypersplenism and gastric fundal varices. (United States)

    Irak, Kader; Esen, Irfan; Keskın, Murat; Emınler, Ahmet Tarık; Ayyildiz, Talat; Kaya, Ekrem; Kiyici, Murat; Gürel, Selim; Nak, Selim Giray; Gülten, Macit; Dolar, Enver


    Wandering spleen is the displacement of the spleen from its normal location due to the loss or weakening of ligaments that hold the spleen in the left upper quadrant. The possibility of torsion of the spleen is high due to the long and mobile nature of the vascular pedicle. Generally, cases are asymptomatic. Under conditions of delayed diagnosis, symptoms of splenomegaly, left portal hypertension, gastric fundal varices, and hypersplenism may present as a result of development of vascular congestion associated with chronic torsion. There are only a few cases in the literature reporting the association of wandering spleen and fundal varices. We report herein the case of a 55-year-old female who admitted to our clinic with complaints of fatigue and epigastric pain. She was determined to have gastric fundal varices and hypersplenism secondary to the development of left portal hypertension due to chronic splenic torsion.

  14. The 2010 patent landscape for spleen tyrosine kinase inhibitors. (United States)

    Moretto, Alessandro F; Dehnhardt, Christoph; Kaila, Neelu; Papaioannou, Nikolaos; Thorarensen, Atli


    Discovery of small molecular inhibitors for treatment of rheumatoid arthritis is a major ongoing effort within the pharmaceutical industry. Spleen tyrosine kinase (SYK) is one of leading small molecular targets with regard to clinical development primarlly due to efforts by Rigel and Portola. In this review, we provide a comprehensive overview of the SYK patent landscape. The patent literature we evaluated relates to any organization that has filed applications that imply that SYK is the intended target. The interest in SYK was initiated in the early 2000's with many organizations, including several large pharmaceutical companies, and has been active for years. In general, the structural theme of most of the compounds in these applications is a traditional ATP competitive inhibitor with each organization having a different hinge binding element. In general, the attachment to the hinge is an aryl amine that is decorated with a solubilizing group. The other substituents are broadly variable across the numerous companies indicating that SYK has significant flexibility in its interactions in that portion of the kinase. This overview of the SYK patent literature and the learnings of the inhibitors' substitution patterns would be an important reference for anyone working in this area.

  15. Effect of Breath Holding on Spleen Volume Measured by Magnetic Resonance Imaging. (United States)

    Inoue, Yusuke; Nakajima, Ai; Mizukami, Shinya; Hata, Hirofumi


    Ultrasonographic studies have demonstrated transient reduction in spleen volume in relation to apnea diving. We measured spleen volume under various respiratory conditions by MR imaging to accurately determine the influence of ordinary breath holding on spleen volumetry. Twelve healthy adult volunteers were examined. Contiguous MR images of the spleen were acquired during free breathing and during respiratory manipulations, including breath holding at the end of normal expiration, breath holding at deep inspiration, and the valsalva maneuver, and spleen volume was measured from each image set based on the sum-of-areas method. Acquisition during free breathing was performed with respiratory triggering. The duration of each respiratory manipulation was 30 s, and five sets of MR images were acquired serially during each manipulation. Baseline spleen volume before respiratory manipulation was 173.0 ± 79.7 mL, and the coefficient of variance for two baseline measures was 1.4% ± 1.6%, suggesting excellent repeatability. Spleen volume decreased significantly just after the commencement of respiratory manipulation, remained constant during the manipulation, and returned to the control value 2 min after the cessation of the manipulation, irrespective of manipulation type. The percentages of volume reduction were 10.2% ± 2.9%, 10.2% ± 3.5%, and 13.3% ± 5.7% during expiration breath holding, deep-inspiration breath holding, and the valsalva maneuver, respectively, and these values did not differ significantly. Spleen volume is reduced during short breath-hold apnea in healthy adults. Physiological responses of the spleen to respiratory manipulations should be considered in the measurement and interpretation of spleen volume.

  16. Spleen histology in children with sickle cell disease and hereditary spherocytosis: hints on the disease pathophysiology. (United States)

    Pizzi, Marco; Fuligni, Fabio; Santoro, Luisa; Sabattini, Elena; Ichino, Martina; De Vito, Rita; Zucchetta, Pietro; Colombatti, Raffaella; Sainati, Laura; Gamba, Piergiorgio; Alaggio, Rita


    Hereditary spherocytosis (HS) and sickle cell disease (SCD) are associated with splenomegaly and spleen dysfunction in pediatric patients. Scant data exist on possible correlations between spleen morphology and function in HS and SCD. This study aimed to assess the histologic and morphometric features of HS and SCD spleens, to get possible correlations with disease pathophysiology. In a large series of spleens from SCD, HS, and control patients, the following parameters were considered: (i) macroscopic features, (ii) lymphoid follicle (LF) density, (iii) presence of perifollicular marginal zones, (iv) presence of Gamna-Gandy bodies, (v) density of CD8-positive sinusoids, (vi) density of CD34-positive microvessels, (vii) presence/distribution of fibrosis and smooth muscle actin (SMA)-positive myoid cells, and (viii) density of CD68-positive macrophages. SCD and HS spleens had similar macroscopic features. SCD spleens had lower LF density and fewer marginal zones than did HS spleens and controls. SCD also showed lower CD8-positive sinusoid density, increased CD34-positive microvessel density and SMA-positive myoid cells, and higher prevalence of fibrosis and Gamna-Gandy bodies. HS had lower LF and CD8-positive sinusoid density than did controls. No significant differences were noted in red pulp macrophages. By multivariate analysis, most HS spleens clustered with controls, whereas SCD grouped separately. A multiparametric score could predict the degree of spleen changes irrespective of the underlying disease. In conclusion, SCD spleens display greater histologic effacement than HS, and SCD-related changes suggest impaired function due to vascular damage. These observations may contribute to guide the clinical management of patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Pregnancy and Kidney Disease (United States)

    ... Donate A to Z Health Guide Pregnancy and Kidney Disease Tweet Share Print Email A new baby is ... disease and pregnancy. Can a woman with "mild" kidney disease have a baby? That depends. There is good ...

  18. Tests for Kidney Health (United States)

    ... The Hope Affair A Pairing for Prevention - Boston Classical Music For a Cause A Pairing for Prevention - ... kidney Financial Assistance Kidney patient assistance HelpLine Grants Management System (GMS) login Education & Research Patient Webinars Become ...

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  20. Acute Kidney Failure (United States)

    ... when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may ...

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    ... page: // Diet - chronic kidney disease To use the sharing features on this page, ... make changes to your diet when you have chronic kidney disease (CKD). These changes may include limiting fluids, eating ...

  2. Kidney stones - lithotripsy - discharge (United States)

    ... this page: // Kidney stones and lithotripsy - discharge To use the sharing features on this page, please enable JavaScript. A kidney stone is a solid mass made up of tiny ...

  3. Kidney Disease Basics (United States)

    ... Is Chronic Kidney Disease? Related Topics English English French Español Section Navigation Chronic Kidney Disease (CKD) What ... tips from the family health reunion guide and speak with your family during special gatherings. Your chances ...

  4. Acquired Cystic Kidney Disease (United States)

    ... ACKD)? M any people with chronic kid ney disease develop ACKD, a condition in which the kidneys develop fluid-filled sacs called renal (kidney) cysts. ACKD occurs in children and adults. The cysts are more likely to ...

  5. The senile kidney

    Directory of Open Access Journals (Sweden)

    Denisova Т.Р.


    Full Text Available The given work summarizes external data and self-obtained results on development and diagnostic of kidney involution modifications. Article discusses definition of "senile kidney" as a clinical and pathomorphological term. Major statements on pathophysiological causes of age-associated renal disorders and their prognosis, specifics of chronic kidney disease in elderly and senile patients have been reviewed. Phenomenon of renal "multimorbidity" in eldely maximizes worsening risk of unmodifiable kidney function.

  6. Study on the pathological basis of classification of spleen deficiency in chronic gastritis. (United States)

    Yin, Guang-yao; Zhang, Wu-ning; Shen, Xiao-jing; He, Xue-fen; Chen, Yi


    Spleen in Traditional Chinese Medicine (TCM) is not actually the spleen in the anatomic sense designated in western medicine because its functions basically belong to the physiological category of digestive system in modern medicine, and it represents a macroscopic concept of digestion, absorption and nutrition metabolism. Spleen deficiency syndrome refers to the clinical phenomena such as hypofunction of digestion, absorption and nutrition metabolism. By integrating TCM with modern medicine, this paper is intended to explore the pathological basis of classification of spleen deficiency in chronic gastritis. By means of optical microscope, scanning electron microscope (SEM), transmission electron microscope (TEM) and histochemical staining, we conducted histopathological and subcellular ultrastructural (nuclei and mitochondrial) analysis of gastric mucosa of 188 patients of spleen deficiency, and that of 42 voluntary blood donors without clinical symptoms. The gastric mucosa of patients with spleen Qi deficiency (SQD) and spleen yang deficiency (SyangD) could either be affected by organic lesion (type G-occurring on the basis of chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG)) or unaffected (type F-chiefly belonging to functional indigestion); spleen yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS) both occurred on the basis of CSG and CAG; and the degree of mucosa inflammatory cells infiltration, the degree of decrease in glands propria, and the incidence of IMIIb in CSG and CAG were more serious than those of G-SQD and G-SyangD, P < 0.05 - 0.01. Spleen deficiency syndrome is likely to occur on the basis of organic lesion of gastric mucosa (disease with symptoms of both CSG or CAG and spleen deficiency symptoms), as well as on the basis of inorganic lesion of gastric mucosa (nondisease with symptoms, which is, despite spleen deficiency symptoms, there is no CSG or CAG). Besides, the clinical phenomenon of disease without

  7. Kidney Cancer in Children (United States)

    What is Kidney Cancer in Children? Kidney (renal) tumors are very rare in children. Still, the three most common renal tumors found ... treatable and curable. What are the Types of Kidney Cancer in Children? Male urinary tract Medical Illustration Copyright © ...

  8. Phosphoprotein phosphatase of bovine spleen cell nuclei: physicochemical properties

    International Nuclear Information System (INIS)

    Rezyapkin, V.I.; Leonova, L.E.; Komkova, A.I.


    The physicochemical properties of phosphoprotein phosphatase (EC from bovine spleen cell nuclei were studied. The enzyme possesses broad substrate specificity and catalyzes the dephosphorylation of phosphocasein, ATP, ADP, and p-nitrophenyl phosphate (pNPP). K/sub m/ for ATP, ADP, and pNPP are equal to 0.44, 0.43, and 1.25 mM, respectively. M/sub r/ of the enzyme, according to the data of gel filtraction of Sephadex G-75 and electrophoresis in polyacrylamide gel of various concentrations is ∼ 33,000. In electrophoresis in the presence of SDS, two protein bands with M/sub r/ 12,000 and 18,000 are detected. In the enzyme molecule, acid amino acid residues predominate; two free SH groups and two disulfide bridges are detected. Phosphoprotein phosphatase is a glycoprotein, containing ∼ 22% carbonhydrates. The protein possesses a supplementary absorption maximum at 560 nm. Ammonium molybdate is a competitive inhibitor with K/sub i/ 0.37 μM, while sodium fluoride is a noncompetitive inhibitor with K/sub i/ 1.3 mM. Incubation in the presence of 2 mM phenylmethylsulfonyl fluoride for 25 h leads to a loss of ∼ 46% of the enzymatic activity. Ammonium molybdate, sodium fluoride, and PMSF are reversible inhibitors. Modifications of the SH groups, NH 2 groups, and histidine leads to a decrease in the enzymatic activity. Incubation of phosphoprotein phosphatase with [γ- 32 P]ATP leads to the incorporation of 0.33 mole 33 P per mole of the enzyme. The mechanism of hydrolysis of the phosphodiester bond, catalyzed by the enzyme, is discussed

  9. Heart Failure

    DEFF Research Database (Denmark)

    Jorsal, Anders; Wiggers, Henrik; McMurray, John J V


    This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint.......This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint....

  10. Spleen size changes in children with homozygous β-thalassaemia in relation to blood transfusion

    International Nuclear Information System (INIS)

    Karpathios, Th.; Antypas, A.; Dimitriou, P.; Nicolaidou, P.; Fretzayas, A.; Thomaidis, Th.; Matsaniotis, N.


    18 thalassaemic children, aged 3.5 to 13 years comprise our clinical material. In 14 of them, clinically elicited spleen markings, haematocrit, blood platelet count and red cell morphology were studied daily for a whole period between 2 transfusions. In 10 patients considerable changes in spleen size were noticed. According to our clinical observations the spleen size starts decreasing 1 to 3 d after blood transfusion up to the 10th posttransfusion day fluctuating thereafter to reach its maximum size again prior to the next blood transfusion. The decrease of spleen size was followed by an increase of haematocrit and blood platelet count and vice versa. 4 additional children were studied clinically only twice: prior to and 7 to 10 d after blood transfusion. A definite decrease of the spleen size following blood transfusion was observed. Spleen and liver sup(99m)Tc-sulfur colloid uptake was studied in 10 of the above children prior to and 7 to 10 d after blood transfusion. Statistically significant post-transfusion increase of the spleen uptake was demonstrated. Our findings suggest that (a) splenic size is relevant to blood volume sequestrated int this organ, (b) splenic radioactive uptake increases with its post-transfusion reductin in size. (author)

  11. Which common test should be used to assess spleen autotransplant effect? (United States)

    Soltani, Ehsan; Aliakbarian, Mohsen; Ghaffarzadegan, Kamran


    Historically, total splenectomy was the only choice of treatment for traumatic splenic injuries. However, nonoperative management and spleen-preserving surgical techniques are preferred in modern medicine. In some situations in which the surgeon has to perform splenectomy, spleen autotransplant may preserve the splenic function. Selecting the best method for evaluating the splenic autotransplant effect has been debated for several years. In this study, we compared three common tests in evaluating the implanted spleen function. Participants included 10 patients who were candidates for laparotomy and splenectomy. After performing splenectomy, we implanted five pieces of the spleen in the greater omentum of each patient. After 3 months, the implanted spleen function was evaluated by nuclear red blood cell (RBC) scan, serum immunoglobulin (Ig) M level, and presence of Howell-Jolly (HJ) bodies in the peripheral blood smear. All patients had normal peripheral blood smear. The IgM level was lower than normal in one patient, and scintigraphy did not demonstrate the transplanted spleen in another patient. All these tests may have comparable results, but because of availability and low cost of peripheral blood smear, which is also easily performed, it can be considered as the first option to evaluate the implanted spleen function.

  12. Microscopy of vascular architecture and arteriovenous communications in the spleen of two odontocetes. (United States)

    Tanaka, Y


    The red pulp of the spleens of the short-finned pilot whale (Globicephala macrorhynchus) and the Pacific bottle-nosed dolphin (Tursiops truncatus gilli) (Odontoceti) were examined by light and electron microscopy and found to comprise two venous layers, an inner and an outer. The inner layer is homologous to the intermediate zone (IZ) of primitive-type mammalian spleens and contains sinusoids consisting of endothelial cells and a thin layer of extracellular deposits. Its vascular structure is unclear. The venous vessels of this layer eventually communicate with veins of the perivenous outer layer. The perivenous layer contains veins of various sizes, interstitial elements, and trabeculae. It is filled with blood cells, particularly plasma cells, but no myeloid cells. The perivenous layer (PVL) is homologous to the red pulp of common mammalian spleens but shows signs of involution. The white pulp gives origin to arterial terminals that end in the red pulp, where they communicate directly with the sinusoidal veins producing a closed circulation. The arterial terminals do not show ellipsoids. The presence of an IZ with a closed circulation and the involution of the red pulp makes the spleen of Odeontoceti another example of a mammalian spleen of the primitive type that has been altered by the evolutionary process. Vascular remodelling of the spleen of Odontoceti seems to follow the pattern noted in the spleens of nonmammalian vertebrates.

  13. The spleen is the site where mast cells are induced in the development of food allergy. (United States)

    Toyoshima, Shota; Wakamatsu, Ei; Ishida, Yasuo; Obata, Yuuki; Kurashima, Yosuke; Kiyono, Hiroshi; Abe, Ryo


    It has been reported that splenic immune responses play pivotal roles in the development of allergic diseases; however, the precise role of the spleen remains unclear. Herein, we demonstrated a novel role of the spleen in the pathogenesis of food allergy (FA). We found that mast cells (MCs) developed from progenitor cells present in spleen during an antigen-specific T-cell response in vitro. In a Th2 response-mediated FA model, significant expansion of MCs was also observed in spleen. The incidence of allergic diarrhea was profoundly reduced in splenectomized mice, whereas adoptive transfer of in vitro-induced splenic MCs into these mice restored allergic symptoms, suggesting that the splenic MCs functioned as the pathogenic cells in the development of FA. The in vitro-generated MCs required not only IL-3 but also IFN-γ, and treatment of FA-induced mice with anti-IFN-γ antibody suppressed expansion of MCs in spleen as well as diarrhea development, highlighting that IFN-γ in the spleen orchestrated the development of FA, which was followed by a Th2 response in the local lesion. Overall, we propose that the role of the spleen in the development of FA is to provide a unique site where antigen-specific T cells induce development of pathogenic MCs. © The Japanese Society for Immunology. 2017. All rights reserved. For permissions, please e-mail:

  14. Heart attack (United States)

    ... part in support groups for people with heart disease . Outlook (Prognosis) After a heart attack, you have a higher ... P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  15. Release and retention of labelled DNA in the thymus and spleen of irradiated mice

    International Nuclear Information System (INIS)

    Suciu, D.; Uray, Z.; Abraham, A.D.


    The process of release and retention of labelled DNA in thymus and spleen of normal and irradiated ( 06 Co) mice has been studied after administration of 3 H-thymidine. The results indicate that the dividing fraction of lymphoid cells is more resistant to radiation than the fraction of nondividing lymphoytes. The time courses of the specific activities of DNA in thymus and spleen were different especially after irradiation with lethal doses. It is suggested that the process of depletion in the lymphoid series is probably similar for both thymus and spleen but, the different cellular composition of these organs led to apparently unrelated results. (orig.) [de

  16. Torsion of a wandering spleen. A rare cause of acute abdomen

    Directory of Open Access Journals (Sweden)

    Nwashilli N. Jude


    Full Text Available Wandering spleen is a rare condition that accounts for less than 0.25% of all indications for splenectomy. It is characterized by ectopic localization of the spleen owing to the lack or weakening of its ligaments. Torsion is the most common complication due to its long pedicle and high mobility, which may result in acute abdomen. We report a case of torsion in a wandering spleen in a 28-year-old male presenting with an acute abdomen that was treated by splenectomy.

  17. Active suppression of in vitro reactivity of spleen cells after BCG treatment

    International Nuclear Information System (INIS)

    Orbach-Arbouys, S.; Poupon, M.F.


    It was found that spleen cells from mice injected i.v. with large doses of BCG responded to PHA stimulation less intensely than did normal spleen cells. It was shown that nylon wool column purified BCG treated T cells also had a low PHA reactivity. Unfractionated spleen cells, adherent cells or T-enriched populations from BCG treated mice, when added to normal T cells lowered their PHA reactivity. When the same BCG treated cell populations were added to tumor cells in vitro, they inhibited their growth. (author)

  18. Knowledge of the anatomy and physiology of the spleen throughout Antiquity and the Early Middle Ages. (United States)

    Paraskevas, George K; Koutsouflianiotis, Konstantinos N; Nitsa, Zoi; Demesticha, Theano; Skandalakis, Panagiotis


    The evolution of knowledge regarding the anatomy and physiology of the spleen throughout Antiquity and the Early Middle Ages is described, and general perceptions about this organ during different eras along this time line are presented. The original words of great physicians from the period of time stretching from Ancient Egypt to the Avicennan era are quoted and discussed to demonstrate how knowledge of the spleen has evolved and to present the theories that dominated each era. Furthermore, theories about illnesses relating to the spleen are reported, which show how this organ was perceived-in terms of its function and anatomy-during each era.

  19. Size matters: Spleen and lung volumes predict performance in human apneic diving

    Directory of Open Access Journals (Sweden)

    Erika eSchagatay


    Full Text Available Humans share with e.g. seals the ability to contract the spleen and increase circulating hematocrit, which may improve apneic performance by enhancing gas storage. Seals have large spleens and while human spleen size is small in comparison, it shows great individual variation. Unlike many marine mammals, human divers rely to a great extent on lung oxygen stores, but the impact of lung volume on competitive apnea performance has never been determined. We studied if spleen- and lung size correlated with performance in elite apnea divers. Volunteers were 14 male apnea world championship participants, with a mean(SE of 5.8(1.2 years of previous apnea training. Spleen volume was calculated from spleen length, width and thickness measured via ultrasound during rest, and vital capacity via spirometry. Accumulated competition scores from dives of maximal depth, time and distance were compared to anthropometric measurements and training data. Mean dive performance was 75(4 m for constant weight depth, 5 min 53(39 s for static apnea and 139(13 m for dynamic apnea distance. Subjects’ mean height was 184(2 cm, weight 82(3 kg, vital capacity (VC 7.3(0.3 L and spleen volume 336(32 ml. Spleen volume did not correlate with subject height or weight, but was positively correlated with competition score (r=0.57; P<0.05. Total competition score was also positively correlated with VC (r=0.54; P<0.05. The three highest scoring divers had the greatest spleen volumes, averaging 538(53 ml, while the three lowest scoring divers had a volume of 270(71 ml (P<0.01. VC was also greater in the high-scorers, at 7.9(0.36 L as compared to 6.7(0.19 L in the low-scorers (P<0.01. Spleen volume was reduced to half after 2 min of apnea in the highest scoring divers, and the estimated resting apnea time gain from the difference between high and low scorers was 15 s for spleen volume and 60 s for VC. We conclude that both spleen- and lung volume predict apnea performance in elite

  20. Computed tomography of the spleen and liver in sickle cell disease

    International Nuclear Information System (INIS)

    Magid, D.; Fishman, E.K.; Siegelman, S.S.


    The spleen was assessed in 10 patients with sickle cell disease studied with computed tomography (CT) for abdominal pain and/or unexplained fever. Patients with homozygous sickle cell anemia were found to have small, densely calcified spleens with occasional low-density infarcts. Five of six had hepatomegaly, and there was one case each of hepatic abscess, infarcts, and hemochromatosis. All patients with heterozygous sickle cell disease were found to have splenomegaly, with a variety of findings including acute hemorrhage, acute and chronic infarcts, rupture, and possible sequestration. It was concluded that CT is useful for evaluating the status of the spleen and liver in symptomatic patients with sickle cell disease

  1. Nonsteroidal Mineralocorticoid Receptor Antagonist Finerenone Protects Against Acute Kidney Injury-Mediated Chronic Kidney Disease: Role of Oxidative Stress. (United States)

    Lattenist, Lionel; Lechner, Sebastian M; Messaoudi, Smail; Le Mercier, Alan; El Moghrabi, Soumaya; Prince, Sonia; Bobadilla, Norma A; Kolkhof, Peter; Jaisser, Frédéric; Barrera-Chimal, Jonatan


    Acute kidney injury induced by ischemia/reperfusion (IR) is a frequent complication in hospitalized patients. Mineralocorticoid receptor antagonism has shown to be helpful against renal IR consequences; however, the potential benefit of novel nonsteroidal mineralocorticoid receptor antagonists such as finerenone has to be further explored. In this study, we evaluated the efficacy of finerenone to prevent the acute and chronic consequences of ischemic acute kidney injury. For the acute study (24 hours), 18 rats were divided into sham, bilateral renal ischemia of 25 minutes, and rats that received 3 doses of finerenone at 48, 24, and 1 hour before the ischemia. For the chronic study (4 months), 23 rats were divided into sham, rats that underwent 45 minutes of bilateral ischemia, and rats treated with finerenone at days 2 and 1 and 1 hour before IR. We found that after 24 hours of reperfusion, the untreated IR rats presented kidney dysfunction and tubular injury. Kidney injury molecule-1 and neutrophil gelatinase associated to lipolacin mRNA levels were increased. In contrast, the rats treated with finerenone displayed normal kidney function and significantly lesser tubular injury and kidney injury molecule-1 and neutrophil gelatinase associated to lipolacin levels. After 4 months, the IR rats developed chronic kidney disease, evidenced by kidney dysfunction, increased proteinuria and renal vascular resistance, tubular dilation, extensive tubule-interstitial fibrosis, and an increase in kidney transforming growth factor-β and collagen-I mRNA. The transition from acute kidney injury to chronic kidney disease was fully prevented by finerenone. Altogether, our data show that in the rat, finerenone is able to prevent acute kidney injury induced by IR and the chronic and progressive deterioration of kidney function and structure. © 2017 American Heart Association, Inc.

  2. The kidneys in the Bible: what happened? (United States)

    Eknoyan, Garabed


    The kidneys, always used in the plural (kelayot), are mentioned more than 30 times in the Bible. In the Pentateuch, the kidneys are cited 11 times in the detailed instructions given for the sacrificial offering of animals at the altar. Whereas those instructions were for purification ceremonies at the Temple, sacrificial offerings were made subsequently in seeking divine intervention for the relief of medical problems. In the books of the Bible that follow the Pentateuch, mostly in Jeremiah and Psalms, the human kidneys are cited figuratively as the site of temperament, emotions, prudence, vigor, and wisdom. In five instances, they are mentioned as the organs examined by God to judge an individual. They are cited either before or after but always in conjunction with the heart as mirrors of the psyche of the person examined. There is also reference to the kidneys as the site of divine punishment for misdemeanors, committed or perceived, particularly in the book of Job, whose suffering and ailments are legendary. In the first vernacular versions of the Bible in English, the translators elected to use the term "reins" instead of kidneys in differentiating the metaphoric uses of human kidneys from that of their mention as anatomic organs of sacrificial animals burned at the altar. This initial effort at linguistic purity or gentility has progressed further in recent versions of the Bible, in which the reins are now replaced by the soul or the mind. The erosion may have begun in the centuries that followed the writing of the Bible, when recognition of the kidneys as excretory organs deprived them of the ancient aura of mysterious organs hidden deep in the body but accessible to the look of God. At approximately the same time, Greek analytical philosophy argued that the brain, which is never mentioned in the Bible, was the most divine and sacred part of the body. This argument gained ground in the past century, when the functions of the brain were elucidated, and

  3. Brain-kidney cross-talk: Definition and emerging evidence. (United States)

    Afsar, Baris; Sag, Alan A; Yalcin, Can Ege; Kaya, Eren; Siriopol, Dimitrie; Goldsmith, David; Covic, Adrian; Kanbay, Mehmet


    Cross-talk is broadly defined as endogenous homeostatic signaling between vital organs such as the heart, kidneys and brain. Kidney-brain cross-talk remains an area with excitingly few publications despite its purported clinical relevance in the management of currently undertreated conditions such as resistant hypertension. Therefore, this review aims to establish an organ-specific definition for kidney-brain cross-talk and review the available and forthcoming literature on this topic. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Imaging of liver and spleen candidiasis in patients with acute leukemia

    International Nuclear Information System (INIS)

    Seino, Yasuo; Tamakawa, Y.; Kato, T.; Kimura, Y.; Miyazaki, S.; Miura, R.; Ishida, H.


    Four patients with acute leukemia were found to have candidal abscess of liver and spleen. CT and US showed hepatosplenomegaly and microabscess. These findings might be useful in diagnosis of visceral candidiasis. (author)

  5. Imaging of liver and spleen candidiasis in patients with acute leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Seino, Yasuo; Tamakawa, Y.; Kato, T.; Kimura, Y.; Miyazaki, S.; Miura, R.; Ishida, H.


    Four patients with acute leukemia were found to have candidal abscess of liver and spleen. CT and US showed hepatosplenomegaly and microabscess. These findings might be useful in diagnosis of visceral candidiasis.

  6. Single-incision laparoscopic splenectomy and splenic autotransplantation for an enlarged wandering spleen with torsion. (United States)

    Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu


    A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The transplanted splenic tissues could be identified on a spleen scintigram obtained 3 months after the surgery. Howell-Jolly bodies were not observed in blood specimens. This procedure is able to prevent an overwhelming postsplenectomy infection, and leads to satisfactory cosmetic results.

  7. Enhancement of erythroid colony formation in vitro by spleen extract from irradiated rats

    International Nuclear Information System (INIS)

    Kasai, Shiro; Terasawa, Waka; Kodama, Hiroaki; Terasawa, Takashi


    The effect of spleen extract from irradiated rats on CFU-e and BFU-e colony formation of rat bone marrow cells was investigated by using modified plasma clot culture media. In the presence of erythropoietin (Ep), CFU-e colony formation peaked at 48 hr of culture, and the Ep-induced increase of CFU-e colonies was dose-dependent. The addition of spleen extract enhanced the colony formation more than two-fold in the Ep-containing culture. BFU-e colony formation was also enhanced by the addition of spleen extract. These results indicate that spleen extract from irradiated rats contains factor(s) which stimulates the proliferation of erythroid progenitors. (author)

  8. Scintigraphic diagnosis and computed tomographic localization of an accessory spleen following relapse of chronic immune thrombocytopaenia

    International Nuclear Information System (INIS)

    Cardaci, G.T.; Blake, M.P.


    Chronic immune thrombocytopaenia is an immunologically mediated disorder resulting in disordered platelet kinetics and potentially life-threatening disease. Failure of medical therapy is an indication for splenectomy, and responses are seen in 80% of patients following this procedure. An important cause of relapse following splenectomy is the presence of an accessory spleen. A patient with Hodgkin's Disease developed chronic immune thrombocytopaenia despite previous splenectomy. A remission was induced with immunosuppressive therapy, but he later relapsed. An accessory spleen was detected using 99 m Tc denatured red blood cells and localized using computed tomography. Resection of the accessory spleen resulted in clinical remission. As accessory spleens are often small in size, combined modality imaging is recommended in the evaluation of this disorder. 15 refs., 2 figs

  9. Effect of polysaccharides extract of rhizoma atractylodis macrocephalae on thymus, spleen and cardiac indexes, caspase-3 activity ratio, Smac/DIABLO and HtrA2/Omi protein and mRNA expression levels in aged rats. (United States)

    Guo, Ling; Sun, Yong Le; Wang, Ai Hong; Xu, Chong En; Zhang, Meng Yuan


    This study was designed to determine the possible protective effect of polysaccharides extract of rhizoma atractylodis macrocephalae on heart function in aged rats. Polysaccharides extract of rhizoma atractylodis macrocephalae was administered to aged rats. Results showed that thymus, spleen and cardiac indexs were significantly increased, whereas caspase-3 activity ratio, Smac/DIABLO and HtrA2/Omi protein expression, Smac/DIABLO and HtrA2/Omi mRNA expression levels were markedly reduced. It can be concluded that polysaccharides extract of rhizoma atractylodis macrocephalae may enhance immunity and improve heart function in aged rats.

  10. Loss of Sympathetic Nerves in Spleens from Patients with End Stage Sepsis

    Directory of Open Access Journals (Sweden)

    Donald B. Hoover


    Full Text Available The spleen is an important site for central regulation of immune function by noradrenergic sympathetic nerves, but little is known about this major region of neuroimmune communication in humans. Experimental studies using animal models have established that sympathetic innervation of the spleen is essential for cholinergic anti-inflammatory responses evoked by vagal nerve stimulation, and clinical studies are evaluating this approach for treating inflammatory diseases. Most data on sympathetic nerves in spleen derive from rodent studies, and this work has established that remodeling of sympathetic innervation can occur during inflammation. However, little is known about the effects of sepsis on spleen innervation. Our primary goals were to (i localize noradrenergic nerves in human spleen by immunohistochemistry for tyrosine hydroxylase (TH, a specific noradrenergic marker, (ii determine if nerves occur in close apposition to leukocytes, and (iii determine if splenic sympathetic innervation is altered in patients who died from end stage sepsis. Staining for vesicular acetylcholine transporter (VAChT was done to screen for cholinergic nerves. Archived paraffin tissue blocks were used. Control samples were obtained from trauma patients or patients who died after hemorrhagic stroke. TH + nerves were associated with arteries and arterioles in all control spleens, occurring in bundles or as nerve fibers. Individual TH + nerve fibers entered the perivascular region where some appeared in close apposition to leukocytes. In marked contrast, spleens from half of the septic patients lacked TH + nerves fibers and the average abundance of TH + nerves for the septic group was only 16% of that for the control group (control: 0.272 ± 0.060% area, n = 6; sepsis: 0.043 ± 0.026% area, n = 8; P < 0.005. All spleens lacked cholinergic innervation. Our results provide definitive evidence for the distribution of noradrenergic

  11. High Blood Pressure and Chronic Kidney Disease in Children: A Guide for Parents (United States)

    ... Events Advocacy Donate A to Z Health Guide High Blood Pressure and Kidney Disease in Children Print Email High ... such as the heart and brain. What is high blood pressure? Blood pressure is the force of your blood ...

  12. Aniline-induced nitrosative stress in rat spleen: Proteomic identification of nitrated proteins

    International Nuclear Information System (INIS)

    Fan Xiuzhen; Wang Jianling; Soman, Kizhake V.; Ansari, G.A.S.; Khan, M. Firoze


    Aniline exposure is associated with toxicity to the spleen which is characterized by splenomegaly, hyperplasia, fibrosis, and a variety of sarcomas on chronic exposure in rats. However, mechanisms by which aniline elicits splenotoxic responses are not well understood. Earlier we have shown that aniline exposure leads to increased nitration of proteins in the spleen. However, nitrated proteins remain to be characterized. Therefore, in the current study using proteomic approaches, we focused on characterizing the nitrated proteins in the spleen of aniline-exposed rats. Aniline exposure led to increased tyrosine nitration of proteins, as determined by 2D Western blotting with anti-3-nitrotyrosine specific antibody, compared to the controls. The analyzed nitrated proteins were found in the molecular weight range of 27.7 to 123.6 kDa. A total of 37 nitrated proteins were identified in aniline-treated and control spleens. Among them, 25 were found only in aniline-treated rats, 11 were present in both aniline-treated and control rats, while one was found in controls only. The nitrated proteins identified mainly represent skeletal proteins, chaperones, ferric iron transporter, enzymes, nucleic acids binding protein, and signaling and protein synthesis pathways. Furthermore, aniline exposure led to significantly increased iNOS mRNA and protein expression in the spleen, suggesting its role in increased reactive nitrogen species formation and contribution to increased nitrated proteins. The identified nitrated proteins provide a global map to further investigate alterations in their structural and functional properties, which will lead to a better understanding of the role of protein nitration in aniline-mediated splenic toxicity. - Highlights: → Proteomic approaches are used to identify nitrated proteins in the spleen. → Twenty five nitrated proteins were found only in the spleen of aniline-treated rats. → Aniline exposure led to increased iNOS mRNA and protein

  13. Outcome of children with blunt liver or spleen injuries: Experience from a single institution in Korea. (United States)

    Kim, Ki Hoon; Kim, Jin Soo; Kim, Woon-Won


    The aim of this study is to evaluate the demographics, injury pattern, and treatment outcomes among children hospitalized for the management of blunt liver and spleen injury at a single institution in Korea, and to document trends in treatment strategies of children with blunt torso trauma. Children (injuries, hospitalized at our center between May 2010 and February 2016, were included in the present study. Data were retrospectively analyzed for demographic and injury-related information were obtained. During the study period, 34 patients with blunt liver injury and 21 patients with blunt spleen injury presented at the center. The most common cause of liver and spleen injury was motor vehicle collision, followed by fall. Thirty patients (88.2%) with liver injuries and 18 patients (85.7%) with spleen injuries were managed conservatively. No cases of mortality occurred in patients with spleen injury group; one patient (2.9%) died in patients with liver injury due to uncontrolled bleeding. Our data demonstrated that 85.7% of patients with spleen injuries and 88.2% of patients with liver injuries were managed nonoperatively. Operative management was chosen more selectively, being applied in patients with high grade organ injury scores or abrupt changes in vital status. Our findings will contribute to the available data concerning children with traumatic injuries in Korea. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Role of the spleen in the maturation of B-lymphocytes

    International Nuclear Information System (INIS)

    Strober, S.


    Spleen cells from unimmunized Lewis rats were fractionated by 1 x g velocity sedimentation and assayed for their ability to restore the adoptive primary antibody response to horse spleen ferritin in irradiated syngeneic recipients given T cell supplementation. Large, medium and small cell fractions all showed virgin B cell activity. Similar studies with thoractic duct cells show that virgin B cell activity is restricted to the small and medium cells. Large spleen cells produced a 2-ME sensitive adoptive antibody response which persisted for 21 days. All antibody produced by small cells at 21 days was 2-ME resistant. Examination of spleen cells during recovery from sublethal irradiation showed that virgin B cell activity was first detected at 14 days, and is confined to the large cell fraction. Experiments with congenic rats which differ at the immunoglobulin (Ig) light chain allotype showed that small cells from the bone marrow injected intravenously can transform into large Ig-bearing cells in the spleen. The relationship of the subclasses of virgin B cells in the spleen to B cell maturation is discussed

  15. [Clinical and experimental study on treatment of anorexy in children with the activating spleen prescription]. (United States)

    Wang, S C; You, R D


    The treatment of 488 cases with anorexy in children showed that the curative effect of the group using Chinese medicines based on the differentiation of symptoms and signs by (1) activating the Spleen, (2) invigorating and activating the spleen was significantly higher than the control using concentrated vitamin B complex (P less than 0.001). The results of the experimental study were as follows: Erbao instant granules (the medicine for activating the Spleen) had the effect of raising the D-xylose excretion rate of urine; increasing the ratio of T-lymph cells in blood; raising the quality of 8 mineral elements in hair and the quality of SIgA in saliva; adjusting the abnormal peristalsis of the experimental rabbits and promoting the ability that duodenums which had been separated from rabbits had to absorb different amino acids and glucose. Jian'er syrup (the medicine for invigorating and activating the Spleen) had the effect of raising the quality of 14 mineral elements in hair; increasing the ratio of T-lymph cells in blood; increasing the index of thymus and spleen in the experimental rats and stimulating them to produce hemolysin. The authors tend to think that the therapeutic principle of activating the Spleen can improve appetite, help the body to absorb and utilize various nutrients which contain many kinds of essential trace elements.

  16. Incorporating parasite systematics in comparative analyses of variation in spleen mass and testes sizes of rodents. (United States)

    Ponlet, Nicolas; Chaisiri, Kitipong; Claude, Julien; Morand, Serge


    Parasite diversity is hypothesized to act on host life-history traits through investment in immunity. In order to incorporate the diversity of the parasite community that an individual host or a host species may face, two indices can be used: Taxonomic Species Richness and Taxonomic Entropy, where the taxonomic information is incorporated with the taxonomic weight. We tested whether these indices correlate with several morphological traits potentially implicated in immune defence and in reproduction, using data on gastrointestinal helminths and their rodent hosts sampled in Southeast Asia. We found no relationship between parasite diversity indices and either spleen mass or testes size at the intraspecific level, i.e. at the level of individuals. At the interspecific level, we found no relationship between the parasite diversity indices and testes size. However, we found that female spleen mass is significantly influenced by the specific species richness of parasites, whereas male spleen mass is influenced by individual mean parasite diversity indices. We concluded that female spleen mass may have evolved in response to gastrointestinal helminth pressure acting at species levels, while in males, the individual spleen mass could be constrained by other factors, such as the blood storage function of the spleen.

  17. Ultrasonography of polycystic kidney

    International Nuclear Information System (INIS)

    Oh, Seung Chul; Cho, Seung Gi; Lee, Kwan Seh; Kim, Kun Sang


    Polycystic disease is defined as a heritable disorder with diffuse involvement of both kidneys. The term 'Polycystic disease' comprises at least two separate, genetically different disease-one with an onset typically in childhood (infantile polycystic disease) and the other with an onset typically in adulthood (adult polycystic disease). Adult polycystic kidney disease is the most common form of cystic kidney disease in humans. Ultrasonography is a very useful noninvasive diagnostic modality in the patient with clinically suspected renal diseases as well as screening test. 14 cases of ultrasonography in patient with polycystic kidney were reviewed. All cases show unilateral or bilateral enlarged kidneys. 7 cases reveal kidneys and liver replaced by multiple cysts of varing size. Screening ultrasonography for a familial tree is reported

  18. Ingested Shiga Toxin 2 (Stx2) Causes Histopathological Changes in Kidney, Spleen and Thymus Tissues and Mortality in Mice (United States)

    The Shiga toxin (Stxs) producing bacterial strain, Escherichia coli O157:H7, colonizes the distal small intestine and the colon, initiating a very broad spectrum of illnesses such as hemolytic-uremic syndrome (HUS) characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal ...

  19. Spleen Stiffness Correlates with the Presence of Ascites but Not Esophageal Varices in Chronic Hepatitis C Patients

    Directory of Open Access Journals (Sweden)

    Kazuyo Mori


    Full Text Available Although spleen stiffness has recently been identified as potential surrogate marker for portal hypertension, the relationship between spleen stiffness and portal hypertension has not been fully elucidated. We attempted to determine the relationship between the liver or spleen stiffness and the presence of ascites or esophageal varices by acoustic radiation force impulse (ARFI imaging. A total of 33 chronic hepatitis C (CHC patients (median age 68; range 51–84 were enrolled. We evaluated the relationship between the liver or spleen stiffness and indicators of portal hypertension as well as clinical and biochemical parameters. Fourteen healthy volunteers were used for validating the accuracy of AFRI imaging. The liver and spleen stiffness increased significantly with progression of liver disease. A significant positive correlation was observed between the liver and spleen stiffness. However, spleen stiffness, but not liver stiffness, was significantly associated with the presence of ascites (, while there was no significant association between the spleen stiffness and spleen index/presence of esophageal varices in CHC patients. The area under the receiver operating characteristic curve based on the spleen stiffness was 0.80. In conclusion, spleen stiffness significantly correlates with the presence of ascites but not esophageal varices in CHC patients.

  20. Spherical harmonics based intrasubject 3-D kidney modeling/registration technique applied on partial information (United States)

    Dillenseger, Jean-Louis; Guillaume, Hélène; Patard, Jean-Jacques


    This paper presents a 3D shape reconstruction/intra-patient rigid registration technique used to establish a Nephron-Sparing Surgery preoperative planning. The usual preoperative imaging system is the Spiral CT Urography, which provides successive 3D acquisitions of complementary information on kidney anatomy. Because the kidney is difficult to demarcate from the liver or from the spleen only limited information on its volume or surface is available. In our paper we propose a methodology allowing a global kidney spatial representation on a spherical harmonics basis. The spherical harmonics are exploited to recover the kidney 3D shape and also to perform intra-patient 3D rigid registration. An evaluation performed on synthetic data showed that this technique presented lower performance then expected for the 3D shape recovering but exhibited registration results slightly more accurate as the ICP technique with faster computation time. PMID:17073323

  1. Epigenetics of kidney disease. (United States)

    Wanner, Nicola; Bechtel-Walz, Wibke


    DNA methylation and histone modifications determine renal programming and the development and progression of renal disease. The identification of the way in which the renal cell epigenome is altered by environmental modifiers driving the onset and progression of renal diseases has extended our understanding of the pathophysiology of kidney disease progression. In this review, we focus on current knowledge concerning the implications of epigenetic modifications during renal disease from early development to chronic kidney disease progression including renal fibrosis, diabetic nephropathy and the translational potential of identifying new biomarkers and treatments for the prevention and therapy of chronic kidney disease and end-stage kidney disease.

  2. Clinical characteristics of potential kidney donors with asymptomatic kidney stones


    Lorenz, Elizabeth C.; Lieske, John C.; Vrtiska, Terri J.; Krambeck, Amy E.; Li, Xujian; Bergstralh, Eric J.; Melton, L. Joseph; Rule, Andrew D.


    Background. Patients with symptomatic kidney stones are characterized by older age, male gender, white race, hypertension, obesity, metabolic syndrome and chronic kidney disease. Whether these characteristics differ in patients with asymptomatic kidney stones is unknown.

  3. Heart Rate and Increased Intravascular Volume

    Czech Academy of Sciences Publication Activity Database

    Souček, M.; Kára, T.; Jurák, Pavel; Halámek, Josef; Špinarová, L.; Meluzín, J.; Toman, J.; Řiháček, I.; Šumbera, J.; Fráňa, P.


    Roč. 52, - (2003), s. 137 - 140 ISSN 0862-8408 R&D Projects: GA ČR GA102/02/1339 Institutional research plan: CEZ:AV0Z2065902 Keywords : kidneys * heart rate * atrial mechanisms Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 0.939, year: 2003

  4. Autotransplantation of Spleen Mitigates Drug-Induced Liver Damage in Splenectomized Mice. (United States)

    Grunewald, Sabrine Teixeira Ferraz; Rezende, Alice Belleigoli; Figueiredo, Bárbara Bruna Muniz; Mendonça, Ana Carolina de Paula; Almeida, Caroline de Souza; de Oliveira, Erick Esteves; de Paoli, Flávia; Teixeira, Henrique Couto


    The spleen presents numerous functions, including the production of immunoglobulins and blood filtration, removing microorganisms and cellular debris. The spleen also has anatomical and functional relationship with the liver, but there are few studies on this topic. The aim of this study was to assess the effect of splenectomy and autologous spleen transplantation on both filtering functions of spleen and acetaminophen-induced hepatotoxicity. Fifty-two BALB/c mice were randomized into four groups: splenectomized; splenectomy and splenic autotransplantation in the greater omentum; sham operated control; and non-operated control. At day 7th, 14th, and 28th after surgery, splenic filtration was assessed by counting Howell-Jolly bodies (HJB) and pitted red cells (PIT). The animals received 400 mg/kg acetaminophen by gavage at day 28 th and after 12 or 24 hours were euthanized for evaluation of splenic and hepatic morphology. The splenectomized group demonstrated reduced filtration of HJB and PIT in all analyzes, while the autotransplanted group developed progressive recovery of function after the 14th day. At day 28 after surgery the implants showed similar histology in comparison to normal spleen. Liver histology showed more intense centrilobular necrosis in splenectomized group in comparison to the others, suggesting a protective role of spleen in acetaminophen-induced liver injury. Splenic implants showed structural and functional recovery, demonstrating the ability of autologous implant to rescue filtering function of intact spleen. Furthermore, the integrity of splenic function appears to influence liver morphology, since the presence of the splenic implants mitigated the effects of chemically-induced liver damage.

  5. Ginsenoside Rg1 improves bone marrow haematopoietic activity via extramedullary haematopoiesis of the spleen. (United States)

    Liu, Hua-Hsing; Chen, Fei-Peng; Liu, Rong-Kai; Lin, Chun-Lin; Chang, Ko-Tung


    Cyclophosphamide (CY) is a chemotherapeutic agent used for cancer and immunological diseases. It induces cytotoxicity of bone marrow and causes myelosuppression and extramedullary haematopoiesis (EMH) in treated patients. EMH is characterized with the emergence of multipotent haematopoietic progenitors most likely in the spleen and liver. Previous studies indicated that a Chinese medicine, ginsenoside Rg1, confers a significant effect to elevate the number of lineage (Lin(-) ) Sca-1(+) c-Kit(+) haematopoietic stem and progenitor cells (HSPCs) and restore the function of bone marrow in CY-treated myelosuppressed mice. However, whether the amelioration of bone marrow by Rg1 accompanies an alleviation of EMH in the spleen was still unknown. In our study, the cellularity and weight of the spleen were significantly reduced after Rg1 treatment in CY-treated mice. Moreover, the number of c-Kit(+) HSPCs was significantly decreased but not as a result of apoptosis, indicating that Rg1 alleviated EMH of the spleen induced by CY. Unexpectedly, the proliferation activity of c-Kit(+) HSPCs was only up-regulated in the spleen, but not in the bone marrow, after Rg1 treatment in CY-treated mice. We also found that a fraction of c-Kit(+) /CD45(+) HSPCs was simultaneously increased in the circulation after Rg1 treatment. Interestingly, the effects of Rg1 on the elevation of HSPCs in bone marrow and in the peripheral blood were suppressed in CY-treated splenectomized mice. These results demonstrated that Rg1 improves myelosuppression induced by CY through its action on the proliferation of HSPCs in EMH of the spleen and migration of HSPCs from the spleen to the bone marrow. © 2015 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  6. Autosomal Dominant Polycystic Kidney Disease (United States)

    ... RePORT NIH Fact Sheets Home > Autosomal Dominant Polycystic Kidney Disease Small Text Medium Text Large Text Autosomal Dominant Polycystic Kidney Disease YESTERDAY Autosomal Dominant Polycystic Kidney Disease (ADPKD) resulted ...

  7. Heart transplant (United States)

    ... hospital for 7 to 21 days after a heart transplant. The first 24 to 48 hours will likely be in ... follow your self-care instructions. Biopsies of the heart muscle are ... after transplant, and then less often after that. This helps ...

  8. Paediatric chronic kidney disease

    African Journals Online (AJOL)

    presence of markers of kidney damage. • Markers of kidney disease include any of the following: • proteinuria (urine dipstick ≥2+ or urine protein:creatinine ratio 5 × the upper limit of normal). • urine sediment abnormalities. • electrolyte and other abnormalities caused by tubular disorders. • histological abnormalities.

  9. Kidney Stones (For Parents) (United States)

    ... may cause long-term damage to the kidney. Diagnosis If your child has pain in the side, blood in the urine, or ... as soon as possible. If your child has pain along with nausea, vomiting, ... away. To make a diagnosis of kidney stones, the doctor will ask about ...

  10. Paediatric chronic kidney disease

    African Journals Online (AJOL)

    (oliguria) (<1.0 mL/kg/hour). • Serum calcium, phosphate, alkaline phosphatase and plasma parathyroid hormone should be determined to assess bone mineral disease and secondary hyperparathyroidism. • Renal ultrasound is necessary to demonstrate kidney size (small shrunken kidneys are characteristic of CKD) and.

  11. Kidney Stones in Children (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  12. Kidney Infection (Pyelonephritis) (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  13. [Promoting Living Kidney Transplantation]. (United States)

    Lin, Chiu-Chu


    Kidney transplantation is the best approach for treating patients with end stage renal disease, offering patients the best chance of returning to normal health. While the techniques used in kidney transplantation surgery are mature and highly successful, there is a severe shortage of donor organs. Statistics show a serious imbalance between organ donations and patients on the waiting list for organ transplantation. Moreover, evidence from empirical studies has shown a better transplantation outcome for patients who receive living donor transplantation than for those who receive organs from cadavers. Although using relatives as donors offers an effective way to reduce the problem of organ shortage, this strategy faces many challenges and many other factors affect the promotion of living donor transplantation. This article elaborates how cultural and psychological factors, kidney transplantation awareness, and ethics and laws impact upon living kidney donations and then proposes coping strategies for promoting living kidney transplantation.

  14. Obesity and kidney disease

    Directory of Open Access Journals (Sweden)

    Geraldo Bezerra da Silva Junior

    Full Text Available Abstract Obesity has been pointed out as an important cause of kidney diseases. Due to its close association with diabetes and hypertension, excess weight and obesity are important risk factors for chronic kidney disease (CKD. Obesity influences CKD development, among other factors, because it predisposes to diabetic nephropathy, hypertensive nephrosclerosis and focal and segmental glomerulosclerosis. Excess weight and obesity are associated with hemodynamic, structural and histological renal changes, in addition to metabolic and biochemical alterations that lead to kidney disease. Adipose tissue is dynamic and it is involved in the production of "adipokines", such as leptin, adiponectin, tumor necrosis factor-α, monocyte chemoattractant protein-1, transforming growth factor-β and angiotensin-II. A series of events is triggered by obesity, including insulin resistance, glucose intolerance, dyslipidemia, atherosclerosis and hypertension. There is evidence that obesity itself can lead to kidney disease development. Further studies are required to better understand the association between obesity and kidney disease.

  15. The world's first human-to-human heart transplant at Groote Schuur ...

    African Journals Online (AJOL)

    Even today many countries do not accept brain death, preventing organ transplantation as a therapeutic option for end-stage heart failure. This tremendous publicity generated by the first heart transplant occurred despite kidney and liver transplantation having preceded heart transplantation by many years. These prior.

  16. [Ginkgo biloba extract enhances the immune function of spleen and thymus in SD rats]. (United States)

    Wang, Yong; Si, Lifang; Li, Xiangneng; Li, Zhansheng


    To study the effect of Ginkgo biloba extract (GBE) on the immune function of spleen and thymus in SD rats. Forty SD rats were randomly divided into four groups (10 rats each group). Three experimental groups were given GBE daily by gavage in doses of 40, 120, 360 mg/(kg.d), respectively. Animals in the control group were fed the same amount of PBS. After 28 days, the rats were sacrificed by chloral hydrate anesthesia. The spleen and thymus were harvested to determine the organ index first. MTT assay was used to detect the concanavalin A (ConA)-induced splenic lymphocyte proliferation and transformation. Neutral red assay was performed to measure the rat peritoneal macrophage phagocytosis. The ultrastructural changes of spleen and thymus were observed under scanning electron microscope. Administration of GBE in the rats increased the mass indexes of rat thymus and spleen, dose-dependently elevated the lymphocyte proliferative responses and enhanced the peritoneal macrophage phagocytosis. In experimental groups, the numbers of mature spleen and thymus lymphocytes were significantly raised in comparison with the control rats. GBE plays a regulatory role in immune function of the rat by increasing the mass of immune organs, increasing the number of mature T lymphocytes as well as their proliferative responses, and enhancing the phagocytic capacity of peritoneal macrophages.

  17. Autophagy induces apoptosis and death of T lymphocytes in the spleen of pigs infected with CSFV. (United States)

    Gou, Hongchao; Zhao, Mingqiu; Fan, Shuangqi; Yuan, Jin; Liao, Jiedan; He, Wencheng; Xu, Hailuan; Chen, Jinding


    Lymphocyte depletion and immunosuppression are typical clinical characteristics of pigs infected with classical swine fever virus (CSFV). The apoptosis of virus-infected and bystander cells plays a role in the immunopathology of classical swine fever (CSF). Here, we offer the first evidence that autophagy is involved in apoptosis and death of T lymphocytes in the spleen of pigs infected with CSFV. Using immunohistochemical assays, we observed that more LC3II-positive cells appear in the T-cell zone of spleens. Spleen cell apoptosis was demonstrated using flow cytometry and TUNEL staining. Confocal immunofluorescence revealed that partial LC3II-positive cells were simultaneously TUNEL-positive. By cultivating spleen cells ex vivo, we demonstrated that the inhibition of autophagy by 3-MA treatment inhibited apoptosis and death of T lymphocytes caused by CSFV infection but did not have this effect  on B lymphocytes. Further observations demonstrated that uninfected cells in the spleen were also undergoing autophagy in vivo. In summary, these results linked autophagy with the apoptosis and cell death of splenic T cells, providing a new outlook to understand the mechanism of T lymphocyte depletion and immunosuppression during CSF.

  18. [Acute torsion of wandering spleen: a rare cause of acute abdomen]. (United States)

    de Andrés-Asenjo, Beatriz; Fernández-González, Nuria


    Wandering spleen is a rare clinical entity characterized by an anomalous position of the spleen in the abdomen due to impaired splenic ligamentous attachments that produce an elongation of the vascular pedicle. This makes a partial or complete volvulus of the vascular axis more likely. Wandering spleen's clinical presentation is variable--from an asymptomatic patient to one with chronic abdominal pain or an acute abdomen. The most common complication is the acute torsion of the splenic pedicle causing acute abdominal pain. A 30-year-old woman who turned up at the Emergency Department with acute abdominal pain. Diagnostic imaging (ultrasonography and computerized axial tomography) revealed a huge spleen in an abnormal location and without vascularization. An urgent splenectomy was performed. Acute torsion of wandering spleen is a rare cause of acute abdomen, which makes early diagnosis difficult and can result in delayed treatment. This would lead to having to perform a splenectomy. Due to splenic necrosis or infarction, which increases the risk of postsplenectomy sepsis.

  19. Ames hypopituitary dwarf mice demonstrate imbalanced myelopoiesis between bone marrow and spleen. (United States)

    Capitano, Maegan L; Chitteti, Brahmananda R; Cooper, Scott; Srour, Edward F; Bartke, Andrzej; Broxmeyer, Hal E


    Ames hypopituitary dwarf mice are deficient in growth hormone, thyroid-stimulating hormone, and prolactin. The phenotype of these mice demonstrates irregularities in the immune system with skewing of the normal cytokine milieu towards a more anti-inflammatory environment. However, the hematopoietic stem and progenitor cell composition of the bone marrow (BM) and spleen in Ames dwarf mice has not been well characterized. We found that there was a significant decrease in overall cell count when comparing the BM and spleen of 4-5 month old dwarf mice to their littermate controls. Upon adjusting counts to differences in body weight between the dwarf and control mice, the number of granulocyte-macrophage progenitors, confirmed by immunophenotyping and colony-formation assay was increased in the BM. In contrast, the numbers of all myeloid progenitor populations in the spleen were greatly reduced, as confirmed by colony-formation assays. This suggests that there is a shift of myelopoiesis from the spleen to the BM of Ames dwarf mice; however, this shift does not appear to involve erythropoiesis. The reasons for this unusual shift in spleen to marrow hematopoiesis in Ames dwarf mice are yet to be determined but may relate to the decreased hormone levels in these mice. Copyright © 2015. Published by Elsevier Inc.

  20. Spleen and thymic sonography as estimator of the immune response in children with repeated infections

    International Nuclear Information System (INIS)

    Rabaza, Jesus; Fundora, Hermes; Rodriguez, Alexis; Hernandez, Maria de los Angeles


    The spleen is a secondary lymphoid organ. The spleen has many functions: IgM class antibody production and phagocytosis of encapsulated bacteria. We propose to measure the dimensions of the spleen in children with repeated infections, in order to describe them as a diagnosis marker and to explore the probable correlation between the thymic characteristics and the dimensions of the spleen. We study 81 patients that attended the consultation of Immunology from Aballi hospital with repeated infections and they were from 8 months to 9 years old. Children with nutritional value up to the third percentile and those taking steroids 45 days before the study were excluded. We measured the thymic and splenic areas by mediastinal and abdominal echography. The length, the splenic index and the weight are less in patients with repeated infections. These data were significant in 12 to 23 month of age group. The length and the splenic index were less in patients with depletion of thymic area. The sonographic evaluation of the spleen is very important in patients from 1 to 2 years old and in patients with thymic depletion, because they are on the age of vaccine administration according to the Cuban schedule and having affected a main organ for immune response might be a reason for them to show a deficient response and need special schedules

  1. Trivial trauma and delayed rupture of a normal spleen: a case report

    Directory of Open Access Journals (Sweden)

    Sowers Nicholas


    Full Text Available Abstract Introduction Although a majority of splenic ruptures present acutely with a known mechanism of injury, a minority of patients present days to weeks following trauma with a delayed rupture. Also uncommon is the atraumatic rupture, the vast majority of which occur in patients with underlying splenic pathology. A handful of cases of apparently spontaneous rupture of a normal spleen are reported; however, there is debate about whether these actually represent delayed ruptures following a history of trauma that is not elicited. Although a few cases of delayed rupture of the spleen following trivial trauma have been reported, the majority of these present evidence of an underlying disease process. We found only two such cases that documented a normal spleen and three cases where underlying splenic pathology was not reported. We review the literature and discuss the phenomenon of delayed rupture of the normal spleen following trivial trauma. Case presentation A 27-year-old Caucasian man with no underlying splenic pathology presented with splenic rupture one week after playfully wrestling with his partner. The patient did not present at the time of the injury and only recalled it upon repeated questioning after computed tomography diagnosis. Conclusions This case lends support to the theory that the normal spleen can rupture some time after trivial trauma, which seems like a more plausible explanation than rupture without cause. However, given the dearth of similar reports in the literature, the possibility remains that the association we have observed is not causational.

  2. Atheroprotector role of the spleen based on the teaching of Avicenna (Ibn Sina). (United States)

    Emtiazy, Majid; Choopani, Rasool; Khodadoost, Mahmood; Tansaz, Mojgan; Nazem, Esmaiel


    Many studies have proven atherosclerosis is an inflammatory immune disease. The spleen plays an important immune role in the human body. Splenectomy is often used in several clinical disorders; but recent studies have shown that splenectomy may be effective in the development of atheroma lesions. Ibn Sina or Avicenna was known as one of the greatest philosopher and physician in Islam and in Medicine. He is remembered for his masterpiece, The "Al-Qanun fi al-Tibb" or "Qanun of medicine". According to the "Al-Qanun fi al-Tibb", spleen as storage organ plays an important role in absorption and secretion of the black bile in the human body. Therefore any disruption in the function of the spleen can lead to various diseases such as atherosclerosis. Based on his description, it is clear that Ibn Sina first described the role of spleen in prevention of atherosclerosis. In this review, we discuss the Avicenna (Ibn Sina) aspect of atheroprotector role of the spleen. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Survival of motor neurone protein is required for normal postnatal development of the spleen. (United States)

    Thomson, Alison K; Somers, Eilidh; Powis, Rachael A; Shorrock, Hannah K; Murphy, Kelley; Swoboda, Kathryn J; Gillingwater, Thomas H; Parson, Simon H


    Spinal muscular atrophy (SMA), traditionally described as a predominantly childhood form of motor neurone disease, is the leading genetic cause of infant mortality. Although motor neurones are undoubtedly the primary affected cell type, the severe infantile form of SMA (Type I SMA) is now widely recognised to represent a multisystem disorder where a variety of organs and systems in the body are also affected. Here, we report that the spleen is disproportionately small in the 'Taiwanese' murine model of severe SMA (Smn -/- ;SMN2 tg/0 ), correlated to low levels of cell proliferation and increased cell death. Spleen lacks its distinctive red appearance and presents with a degenerated capsule and a disorganised fibrotic architecture. Histologically distinct white pulp failed to form and this was reflected in an almost complete absence of B lymphocytes necessary for normal immune function. In addition, megakaryoctyes persisted in the red pulp. However, the vascular density remained unchanged in SMA spleen. Assessment of the spleen in SMA patients with the infantile form of the disease indicated a range of pathologies. We conclude that development of the spleen fails to occur normally in SMA mouse models and human patients. Thus, further analysis of immune function is likely to be required to fully understand the full extent of systemic disease pathology in SMA. © 2016 Anatomical Society.

  4. Factors influencing liver and spleen volume changes after donor hepatectomy for living donor liver transplantation

    International Nuclear Information System (INIS)

    Bae, Ji Hee; Ryeom, Hunku; Song, Jung Hup


    To define the changes in liver and spleen volumes in the early postoperative period after partial liver donation for living-donor liver transplantation (LDLT) and to determine factors that influence liver and spleen volume changes. 27 donors who underwent partial hepatectomy for LDLT were included in this study. The rates of liver and spleen volume change, measured with CT volumetry, were correlated with several factors. The analyzed factors included the indocyanine green (ICG) retention rate at 15 minutes after ICG administration, preoperative platelet count, preoperative liver and splenic volumes, resected liver volume, resected-to-whole liver volume ratio (LV R /LV W ), resected liver volume to the sum of whole liver and spleen volume ratio [LV R /(LV W + SV 0 )], and pre and post hepatectomy portal venous pressures. In all hepatectomy donors, the volumes of the remnant liver and spleen were increased (increased rates, 59.5 ± 50.5%, 47.9 ± 22.6%). The increment rate of the remnant liver volume revealed a positive correlation with LV R /LV W (r = 0.759, p R /LV W influences the increment rate of the remnant liver volume.

  5. When Your Child Needs a Kidney Transplant (United States)

    ... new (donor) kidney in the body dialysis , a therapeutic process that does the work of the kidneys ... Test: Comprehensive Metabolic Panel (CMP) Urine Test: Calcium Ultrasound: Renal (Kidneys, Ureters, Bladder) Word! Kidney Chronic Kidney ...

  6. Changes of red blood cell aggregation parameters in a long-term follow-up of splenectomy, spleen-autotransplantation and partial or subtotal spleen resections in a canine model. (United States)

    Miko, Iren; Nemeth, Norbert; Peto, Katalin; Furka, Andrea; Toth, Laszlo; Furka, Istvan


    Decrease or loss in splenic filtration function may influence the hemorheological state. To follow-up the long-term effects of splenectomy, spleen autotransplantation and spleen resections on red blood cell aggregation in a canine model. Beagle dogs were subjected to control (n = 6), splenectomy (SE, n = 4), spleen autotransplantation (AU, Furka's spleen-chip method, n = 8) or partial and subtotal spleen resection (n = 4/each) groups, and followed-up for 18 postoperative (p.o.) months. Erythrocyte aggregation was determined in parallel by light-transmittance aggregometry (Myrenne MA-1 aggregometer) and syllectometry (LoRRca). Erythrocyte aggregation decreased three months after splenectomy, with lower aggregation index and elongated aggregation time. It was more or less associated with relatively lower hematocrit and fibrinogen concentration. However, in autotransplantated animals a relatively higher fibrinogen did not increase the aggregation markedly. Spleen resection resulted in the most controversial red blood cell aggregation findings, and it seems, that the degree of the resection is an influencing factor. Splenectomy alters erythrocyte aggregation, spleen autotransplantation can be useful to preserve filtration function. However, the degree of restoration shows individual differences with a kind of 'functional periodicity'. Spleen resection controversially influences erythrocyte aggregation parameters. The subtotal resection is supposed to be worse than spleen autotransplantation.

  7. Multidetector computed tomography findings of mesenteroaxial gastric volvulus combined with torsion of wandering spleen: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Youn, In Kyung; Ku, Young Mi; Lee, Su Lim [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of)


    Gastric volvulus, defined as an abnormal rotation of stomach, may be idiopathic or secondary to abnormal fixation of intraperitoneal visceral ligaments. Wandering spleen is a movable spleen resulting from absence or underdevelopment of the splenic supporting ligaments that suspend the spleen to its normal position in the left part of the supramesocolic compartment of the abdomen. Wandering spleen increases the risk of splenic torsion. Both gastric volvulus and splenic torsion are potentially life-threatening if not urgently managed with surgery. Prompt and accurate diagnosis based on multidetector computed tomography (MDCT) is crucial to prevent unforeseen complications. Gastric volvulus and coexistent torsion of wandering spleen is a very rare condition. Herein, we described a case of gastric volvulus associated with wandering spleen and intestinal non-rotation in a 15-year-old girl focusing on MDCT findings.

  8. Shear-wave elastography of the liver and spleen identifies clinically significant portal hypertension

    DEFF Research Database (Denmark)

    Jansen, Christian; Bogs, Christopher; Verlinden, Wim


    BACKGROUND & AIMS: Clinically significant portal hypertension (CSPH) is associated with severe complications and decompensation of cirrhosis. Liver stiffness measured either by transient elastography (TE) or Shear-wave elastography (SWE) and spleen stiffness by TE might be helpful in the diagnosis...... of CSPH. We recently showed the algorithm to rule-out CSPH using sequential liver- (L-SWE) and spleen-Shear-wave elastography (S-SWE). This study investigated the diagnostic value of S-SWE for diagnosis of CSPH. METHODS: One hundred and fifty-eight cirrhotic patients with pressure gradient measurements...... were included into this prospective multicentre study. L-SWE was measured in 155 patients, S-SWE in 112 patients, and both in 109 patients. RESULTS: Liver-shear-wave elastography and S-SWE correlated with clinical events and decompensation. SWE of liver and spleen revealed strong correlations...

  9. Use of liver-spleen scintigraphy to detect immune status and Kaposi sarcoma in AIDS patients

    International Nuclear Information System (INIS)

    Ganz, W.I.; Heiba, S.; Ganz, S.S.; Serafini, A.N.


    Fifty-one patients seropositive for human immunodeficiency virus (HIV) underwent liver-spleen scintigraphy. In 43 clinically immunocompromised patients splenic activity was decreased or absent. Eight of these patients had enlarged spleens with decreased uptake. Autopsy results are available on three, all of whom had Kaposi sarcoma of the spleen. Splenic uptake was initially demonstrated in six HTV-positive patients. In three of these subsequently symptomatic patients, follow-up scans showed decreased splenic uptake. Two non-AIDS, HIV-positive patients had normal splenic uptake. These preliminary data suggest that AIDS patients initially have increased uptake, which progresses to decreased splenic uptake as the patients become immunocompromised. Azidothymidine reversed this pattern in one patient. In addition, splenic enlargement with decreased uptake suggests the presence of Kaposi sarcoma

  10. Nonvisualization of an enlarged spleen on Ga-67 scintigraphy but demonstrated by CT after splenic irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shih, W.J.; Domstad, P.A.; DeLand, F.H.; Maruyama, Y.


    The presence of an enlarged spleen using CT with the absence of splenic visualization in Ga-67 citrate images in a patient with chronic myelogenous leukemia and splenomegaly after splenic irradiation was observed. Since Howell-Jolly bodies had not been identified in the peripheral circulation, the finding of splenic nonvisualization was explained by disassociated splenic functions, which are not tightly coupled, and some activities that can be suppressed by irradiation without impairing others. The Ga-67 splenic localization mechanism is probably more sensitive and liable to disruption by irradiation, and was independent of spleen size. Ga-67 scintigraphy and Tc-99m sulfur colloid liver-spleen scintigraphy are two organ function-dependent imaging procedures, while CT provides anatomic information.

  11. Yersinia enterocolitica-associated generalized microinfarctions of bone and spleen in a child

    International Nuclear Information System (INIS)

    Reiss-Zimmermann, Martin; Sorge, Ina; Hirsch, Wolfgang; Schille, Regine; Beer, Joerg


    We report a case of unusual extraintestinal yersiniosis in a 16-year-old girl with generalized microinfarctions of the bone and spleen. For the past 2 years she had been repeatedly admitted to our hospital with reactive arthritis, erythema nodosum and iridocyclitis of unknown aetiology. Ultrasound showed multiple round hypoechoic lesions in the spleen that were shown to have low T2 signal on MRI. MRI also showed disseminated nodular lesions of the skeleton that were low T1 and high T2 signal and demonstrated inhomogeneous contrast enhancement. The patient is currently in good health on low-dose nonsteroidal immunosuppressive therapy. This is a unique case of microinfarctions of the skeleton and spleen caused by a severe postinfectious autoimmune reaction following extraintestinal Yersinia enterocolitica infection. (orig.)

  12. Yersinia enterocolitica-associated generalized microinfarctions of bone and spleen in a child

    Energy Technology Data Exchange (ETDEWEB)

    Reiss-Zimmermann, Martin; Sorge, Ina; Hirsch, Wolfgang [University Hospital Leipzig, Paediatric Radiology, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Schille, Regine [University Hospital Leipzig, Paediatric Department, Leipzig (Germany); Beer, Joerg [University of Leipzig, Institute for Medical Microbiology and Epidemiology of Infectious Diseases, Leipzig (Germany)


    We report a case of unusual extraintestinal yersiniosis in a 16-year-old girl with generalized microinfarctions of the bone and spleen. For the past 2 years she had been repeatedly admitted to our hospital with reactive arthritis, erythema nodosum and iridocyclitis of unknown aetiology. Ultrasound showed multiple round hypoechoic lesions in the spleen that were shown to have low T2 signal on MRI. MRI also showed disseminated nodular lesions of the skeleton that were low T1 and high T2 signal and demonstrated inhomogeneous contrast enhancement. The patient is currently in good health on low-dose nonsteroidal immunosuppressive therapy. This is a unique case of microinfarctions of the skeleton and spleen caused by a severe postinfectious autoimmune reaction following extraintestinal Yersinia enterocolitica infection. (orig.)

  13. Heart Attack (United States)

    ... pain Fatigue Heart attack Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  14. Heart Block (United States)

    ... graph show each step of an electrical signal's journey through the heart. EKG The image shows the ... and Usage No FEAR Act Grants and Funding Customer Service/Center for Health Information Email Alerts Jobs ...

  15. Heart Truth (United States)

    ... the stories that unite us in a shared journey toward better heart health. Hear from our new ... and Usage No FEAR Act Grants and Funding Customer Service/Center for Health Information Email Alerts Jobs ...

  16. Renal Resistive Index: not only kidney. (United States)

    Di Nicolò, Pierpaolo; Granata, Antonio


    From growing data from the literature emerges that so-called ecoDoppler "Renal" Resistive Indexes (RRI) are not only specific markers of kidney damage and indicators of renal functional prognosis but they always express more clearly a strong link with the systemic circulation. In fact, some cardiovascular parameters such as aortic pulse pressure, aortic stiffness, abdominal aortic calcifications and clinical settings for instance heart failure progression have shown a great association with RRI. Relationships between renal and inflammatory indexes in hypertensive patients have been found and data from the literature on kidney transplants underline the capability of the graft RRI to change according to host hemodynamic features. The purpose of this article is to explain the emerging pathophysiological aspects of this relationship between renal microcirculation and cardiovascular system by emphasizing the importance for the ultrasonographer and for the nephrologist of not overlooking a global vision of the patient before interpreting the RRI.

  17. About Heart Attacks (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More About Heart Attacks Updated:Jan 11,2018 A heart attack is ... coronary artery damage leads to a heart attack . Heart Attack Questions and Answers What is a heart attack? ...

  18. Types of Heart Failure (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Types of Heart Failure Updated:May 8,2017 Left-sided heart failure ... This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure Introduction Types of Heart ...

  19. Copper induced immunotoxicity promote differential apoptotic pathways in spleen and thymus

    International Nuclear Information System (INIS)

    Mitra, Soham; Keswani, Tarun; Ghosh, Nabanita; Goswami, Suranjana; Datta, Anuradha; Das, Salomie; Maity, Subhajit; Bhattacharyya, Arindam


    Highlights: ► Copper-induced ROS generation and mitochondrial trans-membrane potential changes result in different consequences in spleen and thymus. ► Inflammation appeared in both the spleen and thymus after to copper treatment. ► Apoptosis in the spleen appears to follow a p53-independent pathway. ► Apoptosis in the thymus appears to follow a p53-dependent intrinsic and extrinsic pathway. ► In both the spleen and thymus, the CD4+ T cell population decreased and CD8+ T cell population increased after copper treatment. - Abstract: Inorganic copper, such as that in drinking water and copper supplements, largely bypasses the liver and enters the free copper pool of the blood directly and that promote immunosuppression. Nevertheless, the signaling pathways underlying copper-induced immune cell death remains largely unclear. According to our previous in vivo report, to evaluate the further details of the apoptotic mechanism, we have investigated how copper regulates apoptotic pathways in spleen and thymus. We have analyzed different protein expression by western blotting and immunohistochemistry and mRNA expression by RT-PCR and gel electrophoresis. We also have measured mitochondrial trans-membrane potential, ROS and CD4 + and CD8 + population by flow cytometry. Sub lethal doses of copper in spleen and thymus of in vivo Swiss albino mice promote different apoptotic pathways. In case of spleen, ROS generation and mitochondrial trans-membrane potential changes promotes intrinsic pathway of apoptosis that was p53 independent, ultimately leads to decrease in CD4 + T cell population and increase in CD8 + T cell population. However in case of thymus, ROS generation and mitochondrial trans-membrane potential changes lead to death receptor that regulate extrinsic and intrinsic pathways of apoptosis and the apoptotic mechanism which was p53 dependent. Due to copper treatment, thymic CD4 + T cell population decreased and CD8 + T cell population was increased or

  20. Reactive Hypertrophy of an Accessory Spleen Mimicking Tumour Recurrence of Metastatic Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Christin Tjaden


    Full Text Available De novo occurrence of an accessory spleen after splenectomy is worth noting for two reasons. First, it is known that splenectomy can cause reactive hypertrophy of initially inactive and macroscopically invisible splenic tissue. Second, it can mimic tumour recurrence in situations in which splenectomy has been performed for oncological reasons. This might cause difficulties in differential diagnosis and the clinical decision for reoperation. We report the case of a patient with suspected recurrence of renal cell carcinoma after total pancreatectomy and splenectomy for metastatic renal cell carcinoma, which finally revealed an accessory spleen as the morphological correlate of the newly diagnosed mass in the left retroperitoneum.

  1. Determination of T1- and T2-relaxation times in the spleen of patients with splenomegaly

    DEFF Research Database (Denmark)

    Thomsen, C; Josephsen, P; Karle, H


    Twenty-nine patients with known splenomegaly and seven healthy volunteers were examined. The T1 and T2 relaxation times were read out from a region of interest centrally in the spleen. Even though different mean T1 and T2 relaxation times were found between the groups, the great scatter and the c......Twenty-nine patients with known splenomegaly and seven healthy volunteers were examined. The T1 and T2 relaxation times were read out from a region of interest centrally in the spleen. Even though different mean T1 and T2 relaxation times were found between the groups, the great scatter...

  2. Biomarkers of cardio-renal damage in chronic kidney disease: one size cannot fit all. (United States)

    Bolignano, Davide; Coppolino, Giuseppe


    Biomarkers are useful tools for diagnosis and risk assessment of acute kidney injury and acute heart failure, particularly in ICU patients. Most biomarkers are produced or cleared by the kidney, so the presence of chronic kidney disease may affect their clinical reliability, particularly if the putative diagnosis of acute kidney injury or acute heart failure is based on a single measurement/single threshold approach. Better alternatives, such as establishing different diagnostic cutoff values per different chronic kidney disease strata or evaluating the diagnostic performance of a delta value (change from baseline levels) instead of a single threshold, should be carefully considered in critically ill patients with renal impairment and other co-morbidities.

  3. Experimental study on irradiation injury of the kidneys, 2

    International Nuclear Information System (INIS)

    Tomita, Shinichi; Fuzikawa, Kiyozumi; Nishimori, Issei; Tsuda, Nobuo; Miyagawa, Naotaka


    In order to investigate irradiation injury of the kidney and effect of injured kidney on the whole body, especially cardiovascular changes, a single kidney was extracted from Wistar female rats and only the remained kidney was irradiated with a great amount of radiation in 4000 R dose experimentally. After seven weeks of irradiation, atrophy and involution of the highest region of the kidney were found. Histologically, fibrous proliferation of interstice accompanied with atrophy of the renal tubule, and slightly increased nuclei and lobulation of the glomerulus were recognized. After 15 weeks of irradiation, atrophy and involution of the whole kidney were found. Histologically, fibrous proliferation of interstice in the kidney accompanied with high degree atrophy of the renal tubule, marked increase and lobulation of mesangium ground substance of the glomerulus and mild hypertrophy of arteriole were recognized. Mild degeneration of myocardium was recognized. In the long-term cases passing 29 and 34 weeks after irradiation, blood pressure just before slaughter rose to 250 mmHg. The kidney showed malignant nephrosclerosis-like lesion, and panarteritis was found in the mesentery and peri-pancreatic artery. In the heart, hypertonic myocardosis was recognized. A rise of blood pressure which was observed in this experiment occurred in circulation degenerations resulted from the secondary hypertrophy of the blood vessels accompanied with fibrous proliferation of the interstice which appeared after degeneration of renal tubule. It was thought that panarteritis of cardiovascular system of the whole body, especially mesentery and peri-pancreatic artery, and fibrinoid degeneration of arteriole of the kidney were due to hypertension and angiopathic factors (non-vasopressor extracts from the injured kidney). (Tsunoda, M.)

  4. Reduced Noradrenergic Signaling in the Spleen Capsule in the Absence of CB1and CB2Cannabinoid Receptors. (United States)

    Simkins, Tyrell J; Fried, David; Parikh, Kevin; Galligan, James J; Goudreau, John L; Lookingland, Keith J; Kaplan, Barbara L F


    The spleen is a visceral organ that contracts during hypoxia to expel erythrocytes and immune cells into the circulation. Spleen contraction is under the control of noradrenergic sympathetic innervation. The activity of noradrenergic neurons terminating in the spleen capsule is regulated by α2-adrenergic receptors (AR). Interactions between endogenous cannabinoid signaling and noradrenergic signaling in other organ systems suggest endocannabinoids might also regulate spleen contraction. Spleens from mice congenitally lacking both CB 1 and CB 2 cannabinoid receptors (Cnr1 -/- /Cnr2 -/- mice) were used to explore the role of endocannabinoids in spleen contraction. Spleen contraction in response to exogenous norepinephrine (NE) was found to be significantly lower in Cnr1 -/- /Cnr2 -/- mouse spleens, likely due to decreased expression of capsular α1AR. The majority of splenic Cnr1 mRNA expression is by cells of the spleen capsule, suggestive of post-synaptic CB 1 receptor signaling. Thus, these studies demonstrate a role for CB 1 and/or CB 2 in noradrenergic splenic contraction.

  5. Automatized spleen segmentation in non-contrast-enhanced MR volume data using subject-specific shape priors (United States)

    Gloger, Oliver; Tönnies, Klaus; Bülow, Robin; Völzke, Henry


    To develop the first fully automated 3D spleen segmentation framework derived from T1-weighted magnetic resonance (MR) imaging data and to verify its performance for spleen delineation and volumetry. This approach considers the issue of low contrast between spleen and adjacent tissue in non-contrast-enhanced MR images. Native T1-weighted MR volume data was performed on a 1.5 T MR system in an epidemiological study. We analyzed random subsamples of MR examinations without pathologies to develop and verify the spleen segmentation framework. The framework is modularized to include different kinds of prior knowledge into the segmentation pipeline. Classification by support vector machines differentiates between five different shape types in computed foreground probability maps and recognizes characteristic spleen regions in axial slices of MR volume data. A spleen-shape space generated by training produces subject-specific prior shape knowledge that is then incorporated into a final 3D level set segmentation method. Individually adapted shape-driven forces as well as image-driven forces resulting from refined foreground probability maps steer the level set successfully to the segment the spleen. The framework achieves promising segmentation results with mean Dice coefficients of nearly 0.91 and low volumetric mean errors of 6.3%. The presented spleen segmentation approach can delineate spleen tissue in native MR volume data. Several kinds of prior shape knowledge including subject-specific 3D prior shape knowledge can be used to guide segmentation processes achieving promising results.

  6. Acute Kidney Injury in Heart Failure Revisited-The Ameliorating Impact of "Decongestive Diuresis" on Renal Dysfunction in Type 1 Acute Cardiorenal Syndrome: Accelerated Rising Pro B Naturetic Peptide Is a Predictor of Good Renal Prognosis. (United States)

    Onuigbo, Macaulay Amechi Chukwukadibia; Agbasi, Nneoma; Sengodan, Mohan; Rosario, Karen Flores


    There is mounting evidence that forward heart failure as manifested by low cardiac output alone does not define the degree of renal dysfunction in cardiorenal syndrome. As a result, the term "congestive renal failure" was coined in 2012 by Ross to depict the role of renal venous hypertension in type 1 acute cardiorenal syndrome. If so, aggressive decongestive therapies, either through mechanical ultrafiltration with dialysis machines or pharmacologic ultrafiltration with potent diuretics, would lead to improved cardio and renal outcomes. Nevertheless, as recently as 2012, a review of this literature had concluded that a renal venous hypertension-directed approach using diuretics to manage cardio-renal syndrome was yet to be fully investigated. We, in this review, with three consecutive case series, describe our experience with pharmacologic decongestive diuresis in this paradigm of care and argue for studies of such therapeutic interventions in the management of cardiorenal syndrome. Finally, based on our observations in the Renal Unit, Mayo Clinic Health System, in Northwestern Wisconsin, we have hypothesized that patients with cardiorenal syndrome presenting with accelerated rising Pro B Naturetic Peptide levels appear to represent a group that would have good cardio- and renal-outcomes with such decongestive pharmacologic therapies.

  7. Acute Kidney Failure (United States)

    ... breath Acute kidney failure Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  8. Kidney Cancer Risk Questionnaire (United States)

    ... NCI Cancer Information A to Z Treatment Roles Cancer Types Bladder Brain/Spine Breast Cervical Colorectal Esophageal Gallbladder Head/Neck Kidney Leukemia Liver Lung Lymphoma Multiple Myeloma Ovarian Pancreatic ...

  9. Images in kidney trauma

    International Nuclear Information System (INIS)

    Rodriguez, Jose Luis; Rodriguez, Sonia Pilar; Manzano, Ana Cristina


    A case of a 3 years old female patient, who suffered blunt lumbar trauma (horse kick) with secondary kidney trauma, is reported. Imaging findings are described. Renal trauma classification and imaging findings are reviewed

  10. World Kidney Day 2012

    African Journals Online (AJOL)


    stage renal disease (ESRD)) worldwide. What was an experimental, risky and .... of deceased and living donor kidney transplants in World Health Organization member states in 2010, correlated with Human Development Index.

  11. Living kidney donation

    DEFF Research Database (Denmark)

    Agerskov, Hanne; Bistrup, Claus; Ludvigsen, Mette Spliid


    BACKGROUND: When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows...... for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre. OBJECTIVE: The aim was to investigate early experiences in the process of becoming...... a living kidney donor (LKD). MATERIALS AND METHODS: The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation...

  12. Chronic Kidney Diseases (United States)

    ... changes, vitamins, minerals, and medications to help with growth and to prevent bone disease. Sometimes unhealthy kidneys have problems producing a hormone that helps make red blood cells, the cells ...

  13. Lymphoid leukosis in commercial layers in Morogoro | Mathew ...

    African Journals Online (AJOL)

    The surfaces of the liver, spleen, kidneys, lungs and the heart had yellowish white to grey multifocal and focally extensive patches of variable sizes. The lungs were consolidated. Histologically, the liver, spleen, kidneys, lungs, and the heart had heavy infiltration of large lymphocytes with abundant cytoplasm and poorly ...

  14. Obesity and kidney disease


    Silva Junior, Geraldo Bezerra da; Bentes, Ana Carla Sobral Novaes; Daher, Elizabeth De Francesco; Matos, Sheila Maria Alvim de


    Abstract Obesity has been pointed out as an important cause of kidney diseases. Due to its close association with diabetes and hypertension, excess weight and obesity are important risk factors for chronic kidney disease (CKD). Obesity influences CKD development, among other factors, because it predisposes to diabetic nephropathy, hypertensive nephrosclerosis and focal and segmental glomerulosclerosis. Excess weight and obesity are associated with hemodynamic, structural and histological rena...

  15. Osteoprotegerin and kidney disease. (United States)

    Montañez-Barragán, Alejandra; Gómez-Barrera, Isaias; Sanchez-Niño, Maria D; Ucero, Alvaro C; González-Espinoza, Liliana; Ortiz, Alberto


    Vascular calcification in chronic kidney disease (CKD) patients is associated to increased mortality. Osteoprotegerin (OPG) is a soluble tumor necrosis factor (TNF) superfamily receptor that inhibits the actions of the cytokines receptor activator of nuclear factor kappa-B ligand (RANKL) and TNF-related apoptosis-inducing ligand (TRAIL) by preventing their binding to signaling receptors in the cell membrane. OPG-deficient mice display vascular calcification while OPG prevented calcification of cultured vascular smooth muscle cells and protected kidney cells from TRAIL-induced death. OPG may be a biomarker in patients with kidney disease. Circulating OPG is increased in predialysis, dialysis and transplant CKD patients and may predict vascular calcification progression and patient survival. By contrast, circulating OPG is decreased in nephrotic syndrome. In addition, free and exosome-bound urinary OPG is increased in human kidney disease. Increased urinary OPG has been associated with lupus nephritis activity. Despite the association of high OPG levels with disease, experimental functional information available suggests that OPG might be protective in kidney disease and in vascular injury in the context of uremia. Thus, tissue injury results in increased OPG, while OPG may protect from tissue injury. Recombinant OPG was safe in phase I randomized controlled trials. Further research is needed to fully define the therapeutic and biomarker potential of OPG in patients with kidney disease.

  16. Determination of normal dimension of the spleen by ultrasound in an ...

    African Journals Online (AJOL)

    Materials and Methods: A prospective study of normal spleen ultrasound-based measurements in 200 Nigerian adults at the University of Benin Teaching Hospital Benin, Nigeria. Results: There were 91 males and 109 females; their age ranged between 20 and 60 years. For the males the mean age was 32.4 years (± 9.2 ...

  17. The involvement of the spleen during chronic phase of Schistosoma mansoni infection in galectin-3-/- mice. (United States)

    Brand, Camila; Oliveira, Felipe L; Takiya, Christina M; Palumbo, Antônio; Hsu, Daniel K; Liu, Fu-Tong; Borojevic, Radovan; Chammas, Roger; El-Cheikh, Márcia C


    Schistosoma mansoni synthesizes glycoconjugates which interact with galectin-3, eliciting an intense humoral immune response. Moreover, it was demonstrated that galectin-3 regulates B cell differentiation into plasma cells. Splenomegaly is a hallmark event characterized by polyclonal B cell activation and enhancement of antibody production. Here, we investigated whether galectin-3 interferes with spleen organization and B cell compartment during chronic schistosomiasis, using wild type (WT) and galectin-3-/- mice. In chronically-infected galectin-3-/- mice the histological architecture of the spleen, including white and red pulps, was disturbed with heterogeneous lymphoid follicles, an increased number of plasma cells (CD19-B220-/lowCD138+) and a reduced number of macrophages (CD19-B220-Mac-1+CD138-) and B lymphocytes (CD19+B220+/highCD138-), compared with the WT infected mice. In the absence of galectin-3 there was an increase of annexin-V+PI- cells and a major presence of apoptotic cells in spleen compared with WT infected mice. In spleen of WT infected mice galectin-3 was largely expressed in lymphoid follicles and extrafollicular sites. Thus, we propose that galectin-3 plays a role in splenic architecture, controlling distinct events such as apoptosis, macrophage activity, B cell differentiation and plasmacytogenesis in the course of S. mansoni infection.

  18. Amelioratory Effect of Nanoconjugated Vancomycin on Spleen during VRSA-Induced Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Subhankari Prasad Chakraborty


    Full Text Available Objective. The aim of the present study was to evaluate the possible antioxidant effects of nanoconjugated vancomycin against VRSA infection on select makers of oxidative damage and antioxidant status in spleen. Methods. A coagulase-positive VRSA strain was used for this study. VRSA infection was developed in Swiss mice by intraperitoneal injection of 5 × 106 CFU/mL bacterial solutions. VRSA-infected mice were treated with nanoconjugated vancomycin at its effective dose for 10 days. After decapitation, blood was used for determination of viable bacteria count and spleen was excised from control and experimental groups, homogenized and used for different biochemical estimations. Results. Nitrate level, myeloperoxidase activity, lipid peroxidation, protein oxidation, oxidized glutathione, and DNA fragmentation level were increased significantly (P<0.05 in spleen of VRSA-infected group as compared to control group, and reduced glutathione level, activity of SOD, CAT, GPx, GR, and GST were decreased significantly (P<0.05; which were increased or decreased significantly (P<0.05 near to normal in nanoconjugated vancomycin-treated group. Conclusion. These findings suggest the potential use and beneficial role of nanoconjugated vancomycin against VRSA-infection-induced oxidative stress and DNA damage in spleen.

  19. Spontaneous rupture of the spleen – a rare and potentially fatal ...

    African Journals Online (AJOL)

    Following prompt and aggressive surgical intervention, both mother and baby survived. S Afr J Obstet Gynaecol 2015;21(2):50-51. DOI:10.7196.SAJOG.858. Spontaneous rupture of the spleen – a rare and potentially fatal surgical emergency in the second trimester: Report of a case. M Heetun, MRCS; R Parameswaran, ...

  20. The onset of hemoglobin synthesis in spleens of irradiated mice after bone marrow transplantation

    International Nuclear Information System (INIS)

    Ponka, P.; Fuchs, O.; Borova, J.; Necas, E.


    Messenger RNA (mRNA) for globin was isolated from spleens of irradiated mice in which erythroid differentiation was induced by a bone marrow graft. The globin mRNA was isolated either by means of sucrose gradients of reticulocyte polysomal RNA or by affinity chromatography of total spleen RNA on poly (U)-sepharose. The globin mRNA was tested in a wheat embryo cell-free system. The appearance of mRNA in the spleen erythroid colonies was correlated with other parameters of erythroid differentiation such as globin synthesis, activity of delta-aminolevulinic acid synthetase and iron uptake. Poly(A) containing mRNA did appear already on the 3rd day after grafting. However, significant translational activity of globin mRNA could be demonstrated only one day later together with increase in globin synthesis and delta-aminolevulinic acid synthetase and enhanced iron uptake. In the second part of this study mouse spleen cells rich in erythroid elements were incubated with a specific heme synthesis inhibitor (isonicotinic acid hydrazide, INH) and the synthesis of 9 S RNA was estimated. It was found that a 40-minute incubation with INH reduced uridine incorporation into 9 S RNA fraction by about 40%. (author)

  1. Body mass, spleen mass and level of thyroid hormones in juvenile hypothyroid rats

    Directory of Open Access Journals (Sweden)

    Roksandić Dragutin


    Full Text Available In this paper, the effect of hypothyroidism on body mass and spleen mass of rats was examined during the prenatal and early juvenile periods. Hypothyroidism was induced by the application of propylthiouracil (PTU in drinking water to the mothers from the first day of gravidity and during lactation, and the offspring were sacrificed on the 14th and 21st days after birth. The body mass of the juvenile rats was measured just before they were sacrificed. The concentrations of triiodothyronine (T3 and thyroxine (T4 in blood serum were determined in control and treated juvenile rats. The results indicate that PTU leads to a reduction in T3 and T4 serum concentrations in treated juvenile rats. Treated juvenile rats had a bigger body mass and spleen mass in comparison with control animals. These data indicate that hypothyroidism induced in the prenatal and early juvenile period leads to an increase in the body mass and spleen mass and disrupts the normal development of the spleen in the course of the examined period. .

  2. Lysosomal acid lipase deficiency in rats: Lipid analyses and lipase activities in liver and spleen

    International Nuclear Information System (INIS)

    Kuriyama, M.; Yoshida, H.; Suzuki, M.; Fujiyama, J.; Igata, A.


    We report the biological characterization of an animal model of a genetic lipid storage disease analogous to human Wolman's disease. Affected rats accumulated cholesteryl esters (13.3-fold), free cholesterol (2.8-fold), and triglycerides (5.4-fold) in the liver, as well as cholesteryl esters (2.5-fold) and free cholesterol (1.33-fold) in the spleen. Triglycerides did not accumulate, and the levels actually decreased in the spleen. Analysis of the fatty acid composition of the cholesteryl esters and triglycerides showed high percentages of linoleic acid (18:2) and arachidonic acid (20:4) in both organs, especially in the liver. No accumulation of phospholipids, neutral glycosphingolipids, or gangliosides was found in the affected rats. Acid lipase activity for [14C]triolein, [14C]cholesteryl oleate, and 4-methyl-umbelliferyl oleate was deficient in both the liver and spleen of affected rats. Lipase activity at neutral pH was normal in both liver and spleen. Heterozygous rats showed intermediate utilization of these substrates in both organs at levels between those for affected rats and those for normal controls, although they did not accumulate any lipids. These data suggest that these rats represent an animal counterpart of Wolman's disease in humans

  3. Spontaneous rupture of the spleen – a rare and potentially fatal ...

    African Journals Online (AJOL)

    Spontaneous (non-traumatic) rupture of the normal spleen in pregnancy is a rare clinical event that can endanger the lives of both mother and baby. The aetiology of the condition is unknown, but it occurs most commonly in multiple pregnancies and in the third trimester. We present a case of a spontaneous splenic rupture ...

  4. Coconut water solutions for the preservation of spleen, ovary, and skin autotransplants in rats. (United States)

    Schettino César, J M; Petroianu, A; de Souza Vasconcelos, L; Cardoso, V N; das Graças Mota, L; Barbosa, A J A; Vianna Soares, C D; Lima de Oliveira, A


    The purpose of this study was to evaluate the efficacy of coconut water in the preservation of spleen, ovary, and skin autotransplantations in rats. Fifty female Wistar rats were divided randomly into 5 groups on the basis of the following tissue graft preservation solutions: group 1, lactated Ringer's; group 2, Belzer's solution; group 3, mature coconut water; group 4, green coconut water; and group 5, modified green coconut water. In group 5, the green coconut water solution was modified to obtain the same electrolyte composition as Belzer's solution. The spleen, ovaries, and a skin fragment were removed from each animal, stored for 6 hours in one of the solutions, and then re-implanted. The recoveries of tissue functions were assessed 90 days after surgery by means of spleen scintigraphy and blood tests. The implanted tissues were collected for histological analyses. Higher immunoglobulin G levels were observed in the animals of group 5 than in the animals of group 1. Differences in follicle-stimulating hormone levels were observed between groups 1 and 2 (P coconut water group (P coconut water allowed for the preservation of the spleen, ovaries, and skin for 6 hours, and the normal functions of these tissues were maintained in rats. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Autotransplant of spleen tissue in children with schistosomiasis: evaluation of splenic function after splenosis. (United States)

    Brandt, C T; Maciel, D T; Caneca, O A; Castro, C M; Araújo, L B


    Autotransplantation of spleen tissue has been done, in the past ten years, in children with schistosomiasis mansoni with bleeding varices. The purposes of this investigation were: (1) to study the morphology and function of the remnant spleen tissue; (2) to quantify the production of tuftsin; and (3) to assess the immune response to pneumococcal vaccine of these patients. Twenty three children, who underwent splenectomy and autologous implantation of spleen tissue into the greater omentum were included in this investigation. The average postoperative follow-up is five years. Splenosis was proved by colloid liver-spleen scans. Search for Howell-Jolly bodies assessed the filtration function. Tuftsin and the titer of pneumococcal antibodies were quantified by ELISA. Splenosis was evident in all children; however, it was insufficient in two. Howell-Jolly bodies were found only in these two patients. The mean tuftsin serum concentration (335.0 +/- 29.8 ng/ml) was inside the normal range. The immune response to pneumococcal vaccination was adequate in 15 patients; intermediate in four; and inadequate in four. From the results the following conclusions can be drawn: splenosis was efficient in maintaining the filtration splenic function in more than 90% and produced tuftsin inside the range of normality. It also provided the immunologic splenic response to pneumococcal vaccination in 65% of the patients of this series.

  6. Autotransplant of spleen tissue in children with schistosomiasis: evaluation of splenic function after splenosis

    Directory of Open Access Journals (Sweden)

    Carlos Teixeira Brandt


    Full Text Available Autotransplantation of spleen tissue has been done, in the past ten years, in children with schistosomiasis mansoni with bleeding varices. The purposes of this investigation were: (1 to study the morphology and function of the remnant spleen tissue; (2 to quantify the production of tuftsin; and (3 to assess the immune response to pneomococcal vaccine of these patients. Twenty three children, who underwent splenectomy and autologous implantation of spleen tissue into the greater omentum were included in this investigation. The average postoperative follow-up is five years. Splenosis was proved by colloid liver-spleen scans. Search for Howell-Jolly bodies assessed the filtration function. Tuftsin and the titer of pneumococcal antibodies were quantified by ELISA. Splenosis was evident in all children; however, it was insufficient in two. Howell-Jolly bodies were found only in these two patients. The mean tuftsin serum concentration (335.0 ± 29.8 ng/ml was inside the normal range. The immune response to pneumococcal vaccination was adequate in 15 patients; intermediate in four; and inadequate in four. From the results the following conclusions can be drawn: splenosis was efficient in maintaining the filtration splenic function in more than 90% and produced tuftsin inside the range of normality. It also provided the immunologic splenic response to pneumococcal vaccination in 65% of the patients of this series.

  7. Robot-assisted spleen preserving pancreatic surgery in MEN1 patients

    NARCIS (Netherlands)

    Nell, Sjoerd; Brunaud, Laurent; Ayav, Ahmet; Bonsing, Bert A.; Groot Koerkamp, Bas; Nieveen van Dijkum, Els J.; Kazemier, Geert; de Kleine, Ruben H. J.; Hagendoorn, Jeroen; Molenaar, I. Quintus; Valk, Gerlof D.; Borel Rinkes, Inne H. M.; Vriens, Menno R.


    Multiple Endocrine Neoplasia type 1 (MEN1) patients often undergo multiple pancreatic operations at a young age. To describe robot-assisted and laparoscopic spleen-preserving pancreatic surgery in MEN1 patients, and to compare both techniques. Robot-assisted pancreatectomies of the DutchMEN1 study

  8. Robot-assisted spleen preserving pancreatic surgery in MEN1 patients

    NARCIS (Netherlands)

    Nell, Sjoerd; Brunaud, Laurent; Ayav, Ahmet; Bonsing, Bert A.; Groot Koerkamp, Bas; Nieveen van Dijkum, Els J.; Kazemier, Geert; de Kleine, Ruben H J; Hagendoorn, Jeroen; Molenaar, I. Quintus; Valk, Gerlof D.; Borel Rinkes, Inne H M; Vriens, Menno R.


    Background: Multiple Endocrine Neoplasia type 1 (MEN1) patients often undergo multiple pancreatic operations at a young age. Objective: To describe robot-assisted and laparoscopic spleen-preserving pancreatic surgery in MEN1 patients, and to compare both techniques. Methods: Robot-assisted

  9. Robot-assisted spleen preserving pancreatic surgery in MEN1 patients

    NARCIS (Netherlands)

    Nell, Sjoerd; Brunaud, Laurent; Ayav, Ahmet; Bonsing, Bert A.; Koerkamp, Bas Groot; van Dijkum, Els J. Nieveen; Kazemier, Geert; de Kleine, Ruben H. J.; Hagendoorn, Jeroen; Molenaar, I. Quintus; Valk, Gerlof D.; Rinkes, Inne H. M. Borel; Vriens, Menno R.


    BackgroundMultiple Endocrine Neoplasia type 1 (MEN1) patients often undergo multiple pancreatic operations at a young age. ObjectiveTo describe robot-assisted and laparoscopic spleen-preserving pancreatic surgery in MEN1 patients, and to compare both techniques. MethodsRobot-assisted

  10. Solitary metastasis of ampullary carcinoma to the spleen: a case report. (United States)

    Phan, Tri M


    Here, we report a first case of ampullary cancer with solitary metastasis of the spleen, which was successfully treated with pancreatoduodenectomy and splenectomy and was discharged 7 days after the operation with outpatient chemotherapy. In such cases, physicians should consider splenectomy as an effective treatment option.

  11. Coexisting Sclerosing Angiomatoid Nodular Transformation of the Spleen with Multiple Calcifying Fibrous Pseudotumors in a Patient

    Directory of Open Access Journals (Sweden)

    Jen-Chieh Lee


    Full Text Available Primary tumor or tumor-like lesions of the spleen are rare. Among them, vascular lesions are the most common. Vascular tumor of the spleen is different from the usual hemangioma of soft tissue because the vascular structure of the spleen is unique. Sclerosing angiomatoid nodular transformation (SANT is a recently described vascular lesion of the spleen. Grossly, it is a multinodular, well-circumscribed tumor containing a hypervascular core. Microscopically, it comprises three types of vessels, and each type recapitulates the immunohistochemical characteristics of the normal vascular elements of the splenic red pulp, i.e. capillaries, sinusoids, and small veins, respectively. Because of the rarity of this entity, its actual pathogenesis is still unknown. In this study, we report a case of SANT occurring in a 43-year-old woman, in whom there were also multiple calcifying fibrous pseudotumors (CFPTs in the abdominal cavity. Both SANT and CFPT are thought to be variants of inflammatory pseudotumor. Coexistence of these two rare entities in a patient has never been reported, and this fact suggests that there might be a common mechanism contributing to the formation of these two types of lesions. [J Formos Med Assoc 2007;106(3:234-239

  12. Hypertension in Chronic Kidney Disease. (United States)

    Hamrahian, Seyed Mehrdad; Falkner, Bonita


    Hypertension, a global public health problem, is currently the leading factor in the global burden of disease. It is the major modifiable risk factor for heart disease, stroke and kidney failure. Chronic kidney disease (CKD) is both a common cause of hypertension and CKD is also a complication of uncontrolled hypertension. The interaction between hypertension and CKD is complex and increases the risk of adverse cardiovascular and cerebrovascular outcomes. This is particularly significant in the setting of resistant hypertension commonly seen in patient with CKD. The pathophysiology of CKD associated hypertension is multi-factorial with different mechanisms contributing to hypertension. These pathogenic mechanisms include sodium dysregulation, increased sympathetic nervous system and alterations in renin angiotensin aldosterone system activity. Standardized blood pressure (BP) measurement is essential in establishing the diagnosis and management of hypertension in CKD. Use of ambulatory blood pressure monitoring provides an additional assessment of diurnal variation in BP commonly seen in CKD patients. The optimal BP target in the treatment of hypertension in general and CKD population remains a matter of debate and controversial despite recent guidelines and clinical trial data. Medical therapy of patients with CKD associated hypertension can be difficult and challenging. Additional evaluation by a hypertension specialist may be required in the setting of treatment resistant hypertension by excluding pseudo-resistance and treatable secondary causes. Treatment with a combination of antihypertensive drugs, including appropriate diuretic choice, based on estimated glomerular filtration rate, is a key component of hypertension management in CKD patients. In addition to drug treatment non-pharmacological approaches including life style modification, most important of which is dietary salt restriction, should be included in the management of hypertension in CKD patients.


    Directory of Open Access Journals (Sweden)

    Sanjay Kumar Sinha


    Full Text Available Hilum of an organ is a depression, pit or slit like opening through which vital structures enter or leave the organ. In addition to the kidney, hilum is also observed in the cerebellum, lung, ovary, spleen and suprarenal gland. Laparoscopic nephron-sparing surgery for solid renal masses can be achieved successfully both transperitoneally and retroperitoneally if a comprehensive knowledge of both normal and variant hilar anatomy of the kidneys is in the mind of the operating surgeon. Documented text is available on various aspects of the kidneys but an observation on variations in hilar arrangement is infrequently cited. In standard text from anterior to posterior the structures at the renal hilum are renal vein, renal artery and the renal pelvis.

  14. Effect of orally administered zinc oxide nanoparticles on albino rat thymus and spleen. (United States)

    Abass, Marwa A; Selim, Sally A; Selim, Assmaa O; El-Shal, Amal S; Gouda, Zienab A


    This study aimed to evaluate the toxicological effects of oral intake of Zinc oxide nanoparticles (ZnO NPs) on the structure of thymus and spleen. Twenty-four young male Wistar albino rats were assigned into two groups: group I (control) and group II (ZnO NPs treated group).The thymus and spleen were analyzed biochemically, histopathologically and immunohistochemically. After ZnO NPs intake, hematologically, the total leucocytic count was significantly increased while the RBCs and platelets counts and Hb % were significantly decreased. Biochemically, a significant decrease in serum total antioxidant capacity and anti-inflammatory cytokines including interleukin 4 and 10 (IL-4 and IL-10) levels was noted. While a significant increase in splenic and thymic malondialdehyde (MDA) and DNA shearing, as well as the studied proinflammatory cytokines; IL-1β, tumor necrotic factor (TNF-α) and interferon (INF-γ) levels was detected. Notably, we noted upregulation of the immunomodulatory [CD3, CD11b, heme oxygenase (HO-1)] and the inflammatory [toll-like receptor 4 and 6 (TLR4 and TLR6)] genes. Histopathologically, degenerative changes were detected in thymus and spleen of ZnO NPs treated group. While the immunohistochemical analysis of the ZnO NPs treated group revealed a decrease in the number of cells expressed positive reactions of anti-PCNA and an increase in the number of cells expressed positive reaction of anti-p53 in the thymus and spleen. In conclusion, ZnO NPs induced obvious immunotoxicity in the thymus and spleen, where oxidative/inflammatory pathway may be the potential mechanism underlying this immunotoxicity. © 2017 IUBMB Life, 69(7):528-539, 2017. © 2017 International Union of Biochemistry and Molecular Biology.

  15. Leishmania donovani infection induces anemia in hamsters by differentially altering erythropoiesis in bone marrow and spleen.

    Directory of Open Access Journals (Sweden)

    William P Lafuse

    Full Text Available Leishmania donovani is a parasite that causes visceral leishmaniasis by infecting and replicating in macrophages of the bone marrow, spleen, and liver. Severe anemia and leucopenia is associated with the disease. Although immune defense mechanisms against the parasite have been studied, we have a limited understanding of how L. donovani alters hematopoiesis. In this study, we used Syrian golden hamsters to investigate effects of L. donovani infection on erythropoiesis. Infection resulted in severe anemia and leucopenia by 8 weeks post-infection. Anemia was associated with increased levels of serum erythropoietin, which indicates the hamsters respond to the anemia by producing erythropoietin. We found that infection also increased numbers of BFU-E and CFU-E progenitor populations in the spleen and bone marrow and differentially altered erythroid gene expression in these organs. In the bone marrow, the mRNA expression of erythroid differentiation genes (α-globin, β-globin, ALAS2 were inhibited by 50%, but mRNA levels of erythroid receptor (c-kit, EpoR and transcription factors (GATA1, GATA2, FOG1 were not affected by the infection. This suggests that infection has a negative effect on differentiation of erythroblasts. In the spleen, erythroid gene expression was enhanced by infection, indicating that the anemia activates a stress erythropoiesis response in the spleen. Analysis of cytokine mRNA levels in spleen and bone marrow found that IFN-γ mRNA is highly increased by L. donovani infection. Expression of the IFN-γ inducible cytokine, TNF-related apoptosis-inducing ligand (TRAIL, was also up-regulated. Since TRAIL induces erythroblasts apoptosis, apoptosis of bone marrow erythroblasts from infected hamsters was examined by flow cytometry. Percentage of erythroblasts that were apoptotic was significantly increased by L. donovani infection. Together, our results suggest that L. donovani infection inhibits erythropoiesis in the bone marrow by

  16. Heterogeneity within the spleen colony-forming cell population in rat bone marrow

    International Nuclear Information System (INIS)

    Martens, A.C.; van Bekkum, D.W.; Hagenbeek, A.


    The pluripotent hemopoietic stem cell (HSC) of the rat can be enumerated in a spleen colony assay (SCA) in rats as well as mice. After injection of rat bone marrow into lethally irradiated mice, macroscopically visible spleen colonies (CFU-S) are found from day 6 through 14, but the number varies on consecutive days. In normal bone marrow a constant ratio of day-8 to day-12 colony numbers is observed. However, this ratio is changed after in vivo treatment of rats with cyclophosphamide, as well as after in vitro treatment of rat bone marrow with cyclophosphamide derivatives. This indicates that the CFU-S that form colonies on day 8 react differently to this treatment than the CFU-S that form colonies on day 12, and suggests heterogeneity among the CFU-S population. Posttreatment regrowth of day-8 and day-12 CFU-S is characterized by differences in population-doubling times (Td = 0.85 days vs 1.65 days). Another argument in support of the postulate of heterogeneity within the rat CFU-S population is derived from the fact that (in contrast to normal rat spleen) the spleen of leukemic rats contains high numbers of CFU-S that show a ratio of day-8 to day-12 CFU-S of 4.5, which is different than that observed for a CFU-S population in normal bone marrow (a ratio of 2.4). It is concluded that, in rat hemopoiesis, two populations of spleen colony-forming cells can be distinguished using the rat-to-mouse SCA. This indicates that mouse and rat hemopoiesis are comparable in this respect and that heterogeneity in the stem cell compartment is a general phenomenon

  17. Bulk enrichment of transplantable hemopoietic stem cell subsets from lipopolysaccharide-stimulated murine spleen

    International Nuclear Information System (INIS)

    Ploemacher, R.E.; Brons, R.H.; Leenen, P.J.


    Counterflow centrifugal elutriation (CCE) in combination with density flotation centrifugation and fluorescence-activated cell sorting on wheat-germ agglutinin-FITC(WGA)-binding cells within the light-scatter ''blast window'' were used consecutively to enrich pluripotent hemopoietic stem cells (HSC) in bulk from lipopolysaccharide-stimulated mouse spleen. The medium-to-strong WGA + ve fraction contained 3.10(6) cells isolated from 3-4 X 10(9) spleen cells, with an average of 126% day-12 CFU-S and 65% day-8 CFU-S as calculated on the basis of their seeding fraction, suggesting that virtually all cells represented in vivo macroscopic colony formers. In view of the large differences reported elsewhere between stem cell subsets differing in reconstitutive capacity and secondary stem cell generation ability, we also studied various isolated cell fractions with respect to spleen colony formation, radioprotective ability, and spleen- and marrow- repopulating ability. Day-8 and day-12 CFU-S copurified when isolated by CCE. Cells from a fraction with high affinity for WGA were most highly enriched for their radioprotective ability (RPA) and their ability to repopulate the cellularity of the spleen and femur of irradiated recipients. This fraction contained virtually pure day-12 CFU-S. However, the ability to generate secondary day-12 CFU-S and CFU-GM in irradiated organs was enriched most in the medium WGA + ve cell fraction. MRA and SRA, according to the latter criteria, could therefore be partly separated from day-12 CFU-S and RPA on the basis of affinity for WGA. The data strongly suggest that at least part of all day-12 CFU-S have a high potential to proliferate and differentiate into mature progeny, but a relatively low self-renewal ability, and may therefore not be representative of the genuine stem cell

  18. Determinants of postoperative acute kidney injury. (United States)

    Abelha, Fernando José; Botelho, Miguela; Fernandes, Vera; Barros, Henrique


    Development of acute kidney injury (AKI) during the perioperative period is associated with increases in morbidity and mortality. Our aim was to evaluate the incidence and determinants of postoperative AKI after major noncardiac surgery in patients with previously normal renal function. This retrospective cohort study was carried out in the multidisciplinary Post-Anaesthesia Care Unit (PACU) with five intensive care beds. The study population consisted of 1166 patients with no previous renal insufficiency who were admitted to these intensive care unit (ICU) beds over 2 years. After admission patients were followed for the development of AKI, defined as proposed by The Acute Kidney Injury Network (increment of serum creatinine [greater than or equal to] 0.3 mg/dL or 50% from baseline within 48 hours or urine output 6 hours despite fluid resuscitation when applicable). Patient preoperative characteristics, intraoperative management and outcome were evaluated for associations with acute kidney injury using an univariate and multiple logistic regression model. A total of 1597 patients were admitted to the PACU and of these, 1166 met the inclusion criteria. Eighty-seven patients (7.5%) met AKI criteria. Univariate analysis identified age, American Society of Anesthesiologists (ASA) physical status, emergency surgery, high risk surgery, ischemic heart disease, congestive heart disease and Revised Cardiac Risk Index (RCRI) score as independent preoperative determinants for AKI in the postoperative period. Multivariate analysis identified ASA physical status, RCRI score, high risk surgery and congestive heart disease as preoperative determinants for AKI in the postoperative period. Patients that developed AKI had higher Simplified Acute Physiology Score (SAPS) II and Acute Physiology and Chronic Health Evaluation (APACHE) II, higher PACU length of stay (LOS), higher PACU mortality, higher hospital mortality and higher mortality at 6 months follow-up. AKI was an independent

  19. Obesity and Heart Failure as a Mediator of the Cerebrorenal Interaction


    Jindal, Ankur; Whaley-Connell, Adam; Sowers, James R.


    The obesity epidemic is contributing substantially to the burden of cardiovascular disease including heart disease and congestive heart failure, in the United States and the rest of the world. Overnutrition as a driver of obesity, promotes alterations in fatty acid, lipid, and glucose metabolism that influence myocardial function and progression of heart failure from diastolic to systolic failure. The association of progressive heart failure and progressive chronic kidney disease is well docu...

  20. Angiotensin AT1 Receptor-associated protein Arap1 in the Kidney Vasculature is Suppressed by Angiotensin II

    DEFF Research Database (Denmark)

    Doblinger, Elisabeth; Hoecherl, Klaus; Mederle, Katharina


    in the heart, kidney, aorta, and adrenal gland. Renal Arap1 protein was restricted to the vasculature and to glomerular mesangial cells and was absent from tubular epithelia. A similar localization was found in human kidneys. To test the hypothesis that angiotensin II may control renal Arap1 expression, mice......% and -62% in the clipped and contralateral kidney, respectively; and - 50% after water restriction; p...

  1. Evaluating the Contribution of the Cause of Kidney Disease to Prognosis in CKD

    DEFF Research Database (Denmark)

    Haynes, Richard; Staplin, Natalie; Emberson, Jonathan


    BACKGROUND: The relevance of the cause of kidney disease to prognosis among patients with chronic kidney disease is uncertain. STUDY DESIGN: Observational study. SETTINGS & PARTICIPANTS: 6,245 nondialysis participants in the Study of Heart and Renal Protection (SHARP). PREDICTOR: Baseline cause...... of kidney disease was categorized into 4 groups: cystic kidney disease, diabetic nephropathy, glomerulonephritis, and other recorded diagnoses. OUTCOMES: End-stage renal disease (ESRD; dialysis or transplantation) and death. RESULTS: During an average 4.7 years' follow-up, 2,080 participants progressed...... to ESRD, including 454 with cystic kidney disease (23% per year), 378 with glomerulonephritis (10% per year), 309 with diabetic nephropathy (12% per year), and 939 with other recorded diagnoses (8% per year). By comparison with patients with cystic kidney disease, other disease groups had substantially...

  2. Reduction of rainbow trout spleen size by splenectomy does not alter resistance against bacterial cold water disease (United States)

    In lower vertebrates, the contribution of the spleen to anti-bacterial immunity is poorly understood. Researchers have previously reported a phenotypic and genetic correlation between resistance to Flavobacterium psychrophilum, the causative agent of bacterial cold water disease (BCWD) and spleen so...

  3. Heart failure - tests (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  4. Monocyte subset accumulation in the human heart following acute myocardial infarction and the role of the spleen as monocyte reservoir

    NARCIS (Netherlands)

    van der Laan, Anja M.; ter Horst, Ellis N.; Delewi, Ronak; Begieneman, Mark P. V.; Krijnen, Paul A. J.; Hirsch, Alexander; Lavaei, Mehrdad; Nahrendorf, Matthias; Horrevoets, Anton J.; Niessen, Hans W. M.; Piek, Jan J.


    Monocytes are critical mediators of healing following acute myocardial infarction (AMI), making them an interesting target to improve myocardial repair. The purpose of this study was a gain of insight into the source and recruitment of monocytes following AMI in humans. Post-mortem tissue specimens

  5. Heart failure in children - overview (United States)

    Congestive heart failure - children; Cor pulmonale - children; Cardiomyopathy - children; CHF - children; Congenital heart defect - heart failure in children; Cyanotic heart disease - heart failure in children; Birth ...

  6. Role of spleen-derived IL-10 in prevention of systemic low-grade inflammation by obesity [Review]. (United States)

    Gotoh, Koro; Fujiwara, Kansuke; Anai, Manabu; Okamoto, Mitsuhiro; Masaki, Takayuki; Kakuma, Tetsuya; Shibata, Hirotaka


    Obesity can be associated with systemic low-grade inflammation that leads to obesity-related metabolic disorders. Recent studies raise the possibility that the inflammation in hypothalamus, liver and white adipose tissue (WAT) contributes to the pathogenesis of diet-induced obesity. We focus on the role of interleukin (IL)-10, an anti-inflammatory cytokine produced from spleen in obesity because it is indicated that obesity decreases the expression of pro-inflammatory cytokines in spleen. Obesity results in decrease of IL-10 synthesis from spleen, probably due to reduction of B-cells expression by promoting oxidative stress and apoptosis in spleen. Splenectomy (SPX) aggravates the inflammatory response in hypothalamus, liver and WAT. These SPX-induced alterations are inhibited by systemic administration of IL-10. Moreover, in IL-10 deficiency, SPX had little effect on the inflammatory responses in these multiple organs. We show the role of spleen-derived IL-10 on inflammatory responses in obesity.

  7. The time-course relationship between endogenous spleen colony formation and marrow cellularity after midlethal irradiation of mice

    International Nuclear Information System (INIS)

    Koch, I.; Wiktor-Jedrzejczak, W.; Wojskowa Akademia Medyczna, Warsaw


    The kinetics of appearance and disappearance of endogenous spleen colonies following 4 and 6 Gy of X-irradiation was compared with the kinetics of changes of cellular contents of femur cavities. Additionally, the effect of postirradiation bleeding and this way of the subsequent increase in the level of endogenous erythropoietin was studied. It was found that the kinetics of endogenous haemopoietic recovery in the marrow follows the same characteristic biphasic pattern as in the spleen although it is slightly delayed in time. First wave of regeneration corresponded in time with the formation of transient endogenous spleen colonies 4-7 days postirradiation, and the 2nd wave corresponded in time witn the formation of classical haemopoietic stem-cell derived endogenous spleen colonies 9-12 days following irradiation. Postirradiation bleeding markedly stimulated particularly the first wave of regeneration both in the marrow and in the spleen. (orig.) [de

  8. [Autophagy in the kidney]. (United States)

    Pallet, Nicolas


    Autophagy is a highly conserved, physiological, catabolic process, involving the lysosomal degradation of cytosolic components, including macromolecules (such as proteins and lipids) and cytosolic organelles. Autophagy is believed to be essential for the maintenance of cellular homeostasis, for a number of fundamental biological activities, and an important component of the complex response of cells to multiple forms of stress. Autophagy is involved in the pathogenesis of a number of clinically important disorders but, until recently, little was known about its connection to kidney diseases. However, there is now growing evidence that autophagy is specifically linked to the pathogenesis of important renal diseases such as acute kidney injury, diabetic nephropathy and polycystic kidney disease. However, an understanding of the precise role of autophagy in the course of kidney diseases is still in its infancy. The review points out areas of particular interest for future research, and also discusses the importance of such information on whether the pharmacologic agents that modulate autophagy are potentially usable as novel forms of treatment for various kidney diseases. © 2017 médecine/sciences – Inserm.

  9. Kidney and innate immunity. (United States)

    Wang, Ying-Hui; Zhang, Yu-Gen


    Innate immune system is an important modulator of the inflammatory response during infection and tissue injury/repair. The kidney as a vital organ with high energy demand plays a key role in regulating the disease related metabolic process. Increasing research interest has focused on the immune pathogenesis of many kidney diseases. However, innate immune cells such as dendritic cells, macrophages, NK cells and a few innate lymphocytes, as well as the complement system are essential for renal immune homeostasis and ensure a coordinated balance between tissue injury and regeneration. The innate immune response provides the first line of host defense initiated by several classes of pattern recognition receptors (PRRs), such as membrane-bound Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs), together with inflammasomes responsible for early innate immune response. Although the innate immune system is well studied, the research on the detailed relationship between innate immunity and kidney is still very limited. In this review, we will focus on the innate immune sensing system in renal immune homeostasis, as well as the corresponding pathogenesis of many kidney diseases. The pivotal roles of innate immunity in renal injury and regeneration with special emphasis on kidney disease related immunoregulatory mechanism are also discussed. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  10. [Living kidney donation]. (United States)

    Timsit, M-O; Kleinclauss, F; Mamzer Bruneel, M F; Thuret, R


    To review ethical, legal and technical aspects of living kidney donor surgery. An exhaustive systematic review of the scientific literature was performed in the Medline database ( and Embase ( using different associations of the following keywords: Donor nephrectomy; Kidney paired donation; Kidney transplantation; Laparoscopic nephrectomy; Living donor; Organs trafficking; Robotic assisted nephrectomy; Vaginal extraction. French legal documents have been reviewed using the government portal ( Articles were selected according to methods, language of publication and relevance. A total of 6421 articles were identified; after careful selection, 161 publications were considered of interest and were eligible for our review. The ethical debate focuses on organ shortage, financial incentive, organ trafficking and the recent data suggesting a small but significant increase risk for late renal disease in donor population. Legal decisions aim to increase the number of kidneys available for donation, such as kidney-paired donation that faces several obstacles in France. Laparoscopic approach became widely used, while robotic-assisted donor nephrectomy failed to demonstrate improved outcome as compared with other minimal invasive techniques. Minimally invasive living donor nephrectomy aims to limit side effects in the donor without increasing the morbidity in this specific population of healthy persons; long term surveillance to prevent the onset of renal disease in mandatory. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Heart Attack (United States)

    ... Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back Nausea, indigestion, heartburn or abdominal pain Shortness of breath Cold sweat Fatigue Lightheadedness or sudden dizziness Heart attack ...

  12. Heart Transplant (United States)

    ... may need to have a pacemaker. Rarely, the tricuspid valve can become damaged by the endomyocardial biopsy procedure; if that happens it will need to be repaired or replaced. Patients with congenital heart disease who have had a coarctation repair or problems ...

  13. Correlation study of spleen stiffness measured by FibroTouch with esophageal and gastric varices in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    WEI Yutong


    Full Text Available ObjectiveTo explore the correlation of spleen stiffness measured by FibroScan with esophageal and gastric varices in patients with liver cirrhosis. MethodsSpleen and liver stiffness was measured by FibroScan in 72 patients with liver cirrhosis who received gastroscopy in our hospital from December 2012 to December 2013. Categorical data were analyzed by χ2 test, and continuous data were analyzed by t test. Pearson's correlation analysis was used to investigate the correlation between the degree of esophageal varices and spleen stiffness. ResultsWith the increase in the Child-Pugh score in patients, the measurements of liver and spleen stiffness showed a rising trend. Correlation was found between the measurements of spleen and liver stiffness (r=0.367, P<0.05. The differences in measurements of spleen stiffness between patients with Child-Pugh classes A, B, and C were all significant (t=5.149, 7.231, and 6.119, respectively; P=0031, 0.025, and 0.037, respectively. The measurements of spleen and liver stiffness showed marked increases in patients with moderate and severe esophageal and gastric varices. The receiver operating characteristic (ROC curve analysis showed that the area under the ROC curve, sensitivity, and specificity for spleen stiffness were significantly higher than those for liver stiffness and platelet count/spleen thickness. ConclusionThe spleen stiffness measurement by FibroScan shows a good correlation with the esophageal and gastric varices in patients with liver cirrhosis. FibroScan is safe and noninvasive, and especially useful for those who are not suitable for gastroscopy.

  14. Heart Health: The Heart Truth Campaign 2009 (United States)

    ... Issues Cover Story Heart Health The Heart Truth Campaign 2009 Past Issues / Winter 2009 Table of Contents ... the celebrities supporting this year's The Heart Truth campaign. Both R&B singer Ashanti (center) and Allison ...

  15. Shaping Public Health Initiatives in Kidney Diseases: The Peer Kidney Care Initiative. (United States)

    Wetmore, James B; Gilbertson, David T; Collins, Allan J


    While broad-based societal efforts to improve public health have targeted disorders such as cardiovascular disease and cancer for several decades, efforts devoted to kidney disease have developed only more recently. The Peer Kidney Care Initiative, a novel effort designed to address knowledge gaps in the care of patients with kidney disease, examines key disease processes, the roles of geography and seasonality on outcomes, and longitudinal trends in outcomes over time. Admissions for gastrointestinal bleeds increased approximately 28% between 2004 and 2011 in prevalent patients. Infection with Clostridium difficile increased nearly 70% between 2003 and 2010 in patients within a year of initiation. Admissions for heart failure in prevalent patients decreased approximately 25% between 2004 and 2012, but admissions for volume overload increased a nearly equal amount. Incidence rates varied substantially by geographic region, such that unadjusted rates in the highest region were nearly double than those in the lowest. There was seasonal variation in all-cause mortality of approximately 15-20% in both incident and prevalent patients, suggesting a link between cardiovascular events and seasonally related environmental conditions. New cases of end-stage renal disease fell from 385 per million population in 2003 to 344 in 2012, a decline of approximately 10%. Peer complements existing kidney disease epidemiologic efforts by examining specific actionable disease entities, exploring geographic variation in care, highlighting the role of seasonality on outcomes, and emphasizing the importance of trending outcomes over time as overall societal progress is being made. © 2016 S. Karger AG, Basel.

  16. Oxidative DNA damage and its repair in rat spleen following subchronic exposure to aniline

    International Nuclear Information System (INIS)

    Ma Huaxian; Wang Jianling; Abdel-Rahman, Sherif Z.; Boor, Paul J.; Khan, M. Firoze


    The mechanisms by which aniline exposure elicits splenotoxic response, especially the tumorigenic response, are not well-understood. Splenotoxicity of aniline is associated with iron overload and generation of reactive oxygen species (ROS) which can cause oxidative damage to DNA, proteins and lipids (oxidative stress). 8-Hydroxy-2'-deoxyguanosine (8-OHdG) is one of the most abundant oxidative DNA lesions resulting from ROS, and 8-oxoguanine glycosylase 1 (OGG1), a specific DNA glycosylase/lyase enzyme, plays a key role in the removal of 8-OHdG adducts. This study focused on examining DNA damage (8-OHdG) and repair (OGG1) in the spleen in an experimental condition preceding a tumorigenic response. To achieve that, male Sprague-Dawley rats were subchronically exposed to aniline (0.5 mmol/kg/day via drinking water for 30 days), while controls received drinking water only. Aniline treatment led to a significant increase in splenic oxidative DNA damage, manifested as a 2.8-fold increase in 8-OHdG levels. DNA repair activity, measured as OGG1 base excision repair (BER) activity, increased by ∼ 1.3 fold in the nuclear protein extracts (NE) and ∼ 1.2 fold in the mitochondrial protein extracts (ME) of spleens from aniline-treated rats as compared to the controls. Real-time PCR analysis for OGG1 mRNA expression in the spleen revealed a 2-fold increase in expression in aniline-treated rats than the controls. Likewise, OGG1 protein expression in the NEs of spleens from aniline-treated rats was ∼ 1.5 fold higher, whereas in the MEs it was ∼ 1.3 fold higher than the controls. Aniline treatment also led to stronger immunostaining for both 8-OHdG and OGG1 in the spleens, confined to the red pulp areas. It is thus evident from our studies that aniline-induced oxidative stress is associated with increased oxidative DNA damage. The BER pathway was also activated, but not enough to prevent the accumulation of oxidative DNA damage (8-OHdG). Accumulation of mutagenic oxidative

  17. Imaging of kidney cancer

    International Nuclear Information System (INIS)

    Guermazi, A.


    This is one of the first books to deal specifically with diagnostic imaging of the entire spectrum of kidney cancers. Both new and conventional imaging modalities are fully considered. After an introductory chapter on the histopathological classification of kidney cancers, the advantages and disadvantages of the various imaging modalities used in the diagnosis and assessment of disease extension are documented. Subsequent chapters offer an exhaustive description of the radiological features of the different histological subtypes of kidney cancer, with radiological and histological illustrations and tables. The latest innovations in interventional and minimally invasive procedures are also well covered. The book benefits from carefully chosen and technically excellent images. Each of the 24 chapters is written by an internationally acclaimed expert, making this book the most current and complete treatment of the subject available. It should be of great interest to radiologists, oncologists, and urologists. (orig.)

  18. Connexins and the kidney

    DEFF Research Database (Denmark)

    Hanner, Fiona; Sørensen, Charlotte Mehlin; Holstein-Rathlou, Niels-Henrik


    Connexins (Cxs) are widely-expressed proteins that form gap junctions in most organs, including the kidney. In the renal vasculature, Cx37, Cx40, Cx43, and Cx45 are expressed, with predominant expression of Cx40 in the endothelial cells and Cx45 in the vascular smooth muscle cells. In the tubules......, the major function of Cxs in the kidney appears to be intercellular communication, although they may also form hemichannels that allow cellular secretion of large signaling molecules. Renal Cxs facilitate vascular conduction, juxtaglomerular apparatus calcium signaling, and tubular purinergic signaling....... Accordingly, current evidence points to roles for these Cxs in several important regulatory mechanisms in the kidney, including the renin angiotensin system, tubuloglomerular feedback, and salt and water reabsorption. At the systemic level, renal Cxs may help regulate blood pressure and may be involved...

  19. Heart attack first aid (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle becomes ...

  20. What Is Heart Surgery? (United States)

    ... which could relieve angina. Heart Valve Repair or Replacement For the heart to work well, blood must ... have blood flowing through it. Heart-Lung Bypass Machine The image shows how a heart-lung bypass ...