Thin foil preparation of metal particles in brittle ceramic matrices

Thin foil preparation for metal particles in brittle ceramic matrices is particularly difficult, due to differential thinning of the component materials. This paper considers the preparation of thin foils of stony meteorites. Stony meteorites have a composite nature consisting of small metal particles (< 200 microns) embedded in an inherently brittle silicate matrix. Specimens of this type are difficult to prepare as thin foils because the area of interest is limited to specific regions within the metal particles. The problems of thin foil preparation of metal particles in the stony meteorites were overcome by developing a technique involving electrochemical polishing prior to ion beam thinning. The metal particles were first separated from the silicate matrix and then embedded in Epo-Tek H20E silver epoxy. This specific epoxy was selected for its good electron conductivity which allowed the specimen to be thinned by the electrochemical polishing technique. Specimens prepared by this technique have permitted the direct observation and characterization of the metallic phases in stony meteorites.

[Air analysis of the doctor and nurse offices in tall hospital buildings]

O2, PO2, CO2, total number of bacteria were detected in doctor-nurse offices which are at the same side on the 6 and 7th floor in the first affiliated hospital of China Medical University. The results showed that the detected O2 and PO2 in doctor-nurse office were conformed to the normal range of country's indoor standard. The average value of bacteria detection was above the standard Which is less than 500/m3 in ordinary ward given by the Ministry of Health of China. The average CO2 detection was below 0.07%, but sometimes above 0.07% during the 8:30 detection in the morning, total number of bacteria was a little higher too, which suggested that more attention are needed.

Localization of glutamic acid decarboxylase in the kidneys of nonobese diabetic mice

Antibodies to glutamic acid decarboxylase (GAD), a pancreatic islet beta-cell antigen, are present in > 80% of newly diagnosed insulin-dependent diabetes mellitus (IDDM), and are found in nonobese diabetic (NOD) mice, a murine model of spontaneous IDDM. To determine whether GAD is a target antigen in the kidney damage of NOD mice, we studied GAD mRNAs (GAD65 and GAD67) by RT-PCR in mesangial cells, isolated glomeruli, and kidney cortex and medulla in NOD and SJL/C57BL mice. GAD mRNAs were detected in the cortex of both diabetic and nondiabetic NOD and SJL/C57BL mice and GAD antigen was present in proximal and distal tubules by immunofluorescence microscopy. Neither GAD antigen nor mRNA were present in mesangial cells or glomeruli of diabetic or nondiabetic mice. Thus, the expression of GAD in renal tubules raises the possibility that GAD antigens may play a role in diabetic tubulointerstitial disease, whereas the absence of these antigens in glomeruli suggests that GAD-triggered autoimmunity is not directly involved in the glomerular lesions.

Chronic granulomatous interstitial nephritis: unusual complication of acute pyelonephritis

We describe an unusual complication of acute pyelonephritis in a 45-year-old diabetic female. She was admitted to our hospital due to fever and flank pain which had developed 10 days earlier. Urinalysis showed many WBC and urine culture revealed Escherichia coli. After adequate antibiotic treatment, clinical symptoms abated but renal failure and leukocyturia persisted. Abdominal CT showed bilateral focal bacterial nephritis and renal biopsy disclosed chronic granulomatous interstitial nephritis. On the 80th hospital day she was discharged with a serum creatinine of 299 mumol/l. In the outpatient clinic, renal dysfunction and leukocyturia persisted up to 1 year. In conclusion, this case raises the possibility of a chronic interstitial process of acute pyelonephritis.

Early graft dysfunction due to renal vein compression

We here report on an unusual case of early renal transplant dysfunction due to renal vein compression. Graft function was initially good but oliguria and massive hematuria developed on the 3rd day after transplantation. Duplex sonography showed turbulent blood flow of the renal vein, and renal venography confirmed renal vein compression. Exploratory laparotomy was performed and diuresis was initiated just after nephropexy. In conclusion, renal vein compression is a rare complication but should be included in the possible causes of early renal transplant dysfunction since this can be simply diagnosed by duplex sonography and is easily remedied by nephropexy.

Cyanide-stimulated inositol 1,4,5-trisphosphate formation: an intracellular neurotoxic signaling cascade

Cyanide-induced neurotoxicity is associated with altered cellular Ca2+ homeostasis resulting in sustained elevation of cytosolic Ca2+. In order to characterize the effect of cyanide on intracellular signaling mechanisms, the interaction of KCN with the inositol 1,4,5-trisphosphate Ca2+ signaling system was determined in the PC12 cell line. KCN in the concentration range of 1.0-100 microM produced a rapid rise in intracellular IP3 levels (peak level occurred within 60 sec); 10 microM KCN elevated intracellular levels of IP3 to 148% of control levels. This response was mediated by phospholipase C (PLC) since U73122, a specific PLC inhibitor, blocked the response. Removal of Ca2+ from the incubation medium and chelation of intracellular Ca2+ with BAPTA partially attenuate the cyanide-stimulated IP3 generation, showing that the response is partially Ca2+ dependent. Also, treatment of cells with nifedipine or LaCl3, Ca2+ channel blockers, partially blocked the generation of IP3. This study shows that cyanide in concentrations as low as 1 microM stimulates IP3 generation that may be mediated by receptor and nonreceptor IP3 production since they have differential dependence on Ca2+. It is proposed that this response is an early intracellular signaling action that can contribute to altered Ca2+ homeostasis characteristic of cyanide neurotoxicity.

Prevention of posttransplant peptic ulcer by misoprostol

Misoprostol is effective in protecting the gastric mucosa against various injuries (cytoprotection), but its role in preventing peptic ulcer disease (PUD) is controversial. Therefore, this study was designed to evaluate the effect of misoprostol on preventing posttransplant PUD. 87 patients undergoing kidney transplantation (KT) were randomly separated into three groups according to the antiulcer regimen. Group 1 (n = 28) received antacid and ranitidine; group 2 (n = 34) received antacid, ranitidine, and bismuth (De Nol), and group 3 (n = 25) received antacid, ranitidine, and misprostol (prostaglandin E1). Antiulcer drugs started 1 week before KT and were continued after surgery. A pretransplant gastrofibroscopy was performed 1 month before KT, and a follow-up gastroscopy was performed 2-3 weeks after KT. The incidence of peptic ulcer in groups 1 and 2 was 50.0% (14/28) and 35.3% (12/34), respectively (p > 0.05 groups 1 vs. 2). In group 3, 12.0% (3/25) of the patients showed PUD (p < 0.05 when compared with group 1 or 2). The known risk factors of posttransplant PUD were not significantly different in three groups, but the KT recipients of groups 1 and 2 had 7.8 times the risk of PUD when compared with group 3. In conclusion, the antiulcer regimen including misoprostol is more effective than ranitidine or bismuth in preventing posttransplant PUD, and the antiulcer effect of misoprostol seems to be related to the cytoprotective effect of the drug.

Tuberculosis-associated hemophagocytic syndrome in a hemodialysis patient: case report and review of the literature

We present an unusual hematologic manifestation of tuberculosis in a hemodialysis patient. A 37-year-old man was admitted because of fever, anorexia, and weight loss which developed 3 months earlier. He previously received a renal transplant and commenced hemodialysis 1 year ago. Physical examination revealed hepatomegaly, and peripheral blood counts revealed pancytopenia. The delayed bone marrow biopsy demonstrated marked hemophagocytosis, granuloma and tubercle bacilli by the acid-fast stain. The clinical course was fatal and he died without definite treatment. Through this case, we would like to recommend early bone marrow biopsy and antituberculosis therapy if fever of unknown origin, anorexia, weight loss, hepatomegaly and pancytopenia develop in patients undergoing dialysis.

Relationships between mesangial cell proliferation and types I and IV collagen mRNA levels in vitro

Changes in the composition of the mesangial extracellular matrix (ECM) and cell turnover are present in glomerular disease. To determine if ECM changes play a role in perpetuating mesangial cell dysfunction, we examined a line of mouse mesangial cells cultured on films or gels of several ECM components and also on methyl cellulose, an inert substrate that prevents attachment. Cells on films of fibronectin or type IV or I collagen had persistently high growth rates and high levels of alpha 1-I and alpha 1-IV collagen mRNAs. In contrast, on gels of type IV or I collagen or matrigel, the growth rate was low. The alpha 1-IV collagen mRNA levels were low on type IV collagen gel or matrigel, whereas the alpha 1-I collagen mRNA levels remained high. In contrast, the alpha 1-I collagen mRNA levels were low on type I collagen gel, and the alpha 1-IV collagen mRNA levels were high. Cells on methyl cellulose formed floating aggregates, did not proliferate, and had a 5- to 10-fold decrease in both alpha 1-I and alpha 1-IV collagen mRNA levels. These phenotypic changes were largely reversible. Finally, when matrigel was layered over cells on fibronectin films, alpha 1-IV collagen mRNA levels decreased, but alpha 1-I collagen mRNA levels and proliferation remained high. Thus proliferation and alpha 1-I and alpha 1-IV collagen mRNA levels in mesangial cells were independently regulated and depended on attachment and the nature of the adjacent matrix.

Collagen and collagenase mRNAs in normal and sclerotic glomeruli: predictors of progression and response to therapy

Progressive glomerulosclerosis is associated with decreasing kidney function, eventuating in end-stage renal failure. There are multiple components of the extracellular matrix, and the exact composition in various renal diseases is not known. Thus, we examined some of the major components of the extracellular matrix (ECM) in murine and human glomerular diseases. We studied matrix synthesis and degradation at the level of gene expression and ECM composition in the intact glomerulus. To determine whether the composition of sclerosis was similar among diseases, we examined a normal mouse strain and compared it with strains which spontaneously developed glomerulosclerosis. The baseline levels of matrix components varied between different mouse strains, and this level correlated with their propensity to develop glomerulosclerosis. In addition, when glomerulosclerosis was induced, the baseline ECM mRNA level predicted the subsequent outcome. We studied mice transgenic for bovine growth hormone, since they develop progressive glomerulosclerosis. Treatment with heparin substantially decreased the lesions without changes in type IV collagen mRNAs. However, there was an up-regulation of both the mRNA and enzyme activity for the 92 kD matrix metalloproteinase. In contrast, when these mice were treated with either angiotensin converting enzyme inhibitors or angiotensin II (Ang II) receptor antagonists, the glomerulosclerosis was accentuated histologically and the ECM synthetic and degradative mRNAs were elevated. These data suggest that the mRNA levels reflect response to therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration of AGEs in vivo induces genes implicated in diabetic glomerulosclerosis

Administration of advanced glycosylation end products (AGEs), prepared on mouse albumin, to normal young adult mice, resulted in an increase in mean glomerular volume and up-regulation of laminin B1 and alpha 1 type IV collagen mRNAs measured by competitive PCR in single microdissected glomeruli. Both glomerular hypertrophy and overexpression of genes coding for extracellular matrix were abrogated when aminoguanidine, an inhibitor of AGE cross-linking, was added to the AGEs injections, suggesting that the glomerular response to AGEs was specific. The effects of AGEs administration in vivo are comparable to those occurring in the early stage of diabetic nephropathy, suggesting a participation of AGEs in these events.

Calcification in retroperitoneal non-Hodgkin lymphoma prior to treatment: a case report

Calcification in malignant lymphoma before treatment is rare. Here we report a case of low grade non-Hodgkin lymphoma of sclerosing type presenting as a retroperitoneal calcified mass. The calcification was demonstrated with various imaging modalities, including conventional radiographs, sonography, computed tomography (CT) and magnetic resonance (MR) imaging. This case and other isolated reports show that radiographical examinations may, rarely, reveal calcification in lymphoma prior to treatment.

Effects of streptozotocin treatment in growth hormone (GH) and GH antagonist transgenic mice

To investigate GH's role in diabetic end organ damage, experimental diabetes was induced with streptozotocin (STZ) in bovine GH (bGH) or bGH antagonist transgenic mice and in their nontransgenic (NTG) litter mates. Body growth, blood glucose, serum insulin-like growth factor-I levels, liver GH receptor (GHR) binding, and kidney histology of these animals were evaluated. After administration of multiple low doses of STZ, 90% of the mice developed hyperglycemia. The diabetic animals, especially those expressing GH and GH antagonist transgenes, demonstrated retarded body growth and reduced insulin-like growth factor-I levels when compared with their nondiabetic litter mates. Kidney histology revealed severe glomerulosclerosis in diabetic and nondiabetic bGH transgenic mice. Diabetic NTG mice exhibited moderate kidney lesions. Diabetic bGH antagonist transgenic mice possessed normal glomeruli indistinguishable from those seen in nondiabetic NTG mice. GHR-binding assays revealed that liver GHR-binding sites were significantly reduced in diabetic NTG mice and transgenic dwarf mice when compared with their nondiabetic controls. Conversely, liver GHR-binding ability was significantly increased in bGH transgenic mice as compared with their NTG littermates and remained high during diabetes. It is concluded that transgenic mice that express a GH antagonist are protected from diabetes and or GH-induced nephropathy.

Overexpression of transforming growth factor-beta 1 mRNA is associated with up-regulation of glomerular tenascin and laminin gene expression in nonobese diabetic mice

Nonobese diabetic (NOD) mice spontaneously develop immune-mediated insulin-dependent diabetes mellitus and nephropathy, providing an opportunity to study the early molecular events in a model of diabetic glomerulosclerosis. The expression of several genes coding for growth factors and extracellular matrix was examined in microdissected glomeruli, by the use of reverse transcription-competitive polymerase chain reaction, in diabetic NOD mice (mean duration of diabetes, 28.5 +/- 7 days) and age-matched nondiabetic NOD mice with normal glucose tolerance. The levels of mRNA coding for transforming growth factor-beta 1, tenascin, and laminin B1 increased 1.9-, 2.0-, and 1.7-fold, respectively, whereas platelet-derived growth factor (PDGF)-B, alpha 1(IV) collagen, 72-kd collagenase, alpha-smooth muscle actin, and beta-actin mRNA remained stable in the diabetic mice. The kidney advanced glycosylation end-products levels increased 2.1-fold in the diabetic mice, and the diabetic glomeruli showed an accumulation of tenascin and laminin but not of type IV collagen by immunofluorescence microscopy. There was no increase in cell number per glomerulus after the onset of diabetes, a finding consistent with stable PDGF-B and alpha-smooth muscle actin mRNA levels. These findings provide evidence that increased glomerular transforming growth factor-beta 1, but not PDGF-B, mRNA is associated with the up-regulation of tenascin and laminin expression after advanced glycosylation endproduct accumulation, early after the onset of diabetes.

Serum soluble HLA class I antigen levels in hemodialysis patients and following renal transplantation

We measured the serum levels of soluble HLA class I antigen (sHLA-I) to evaluate the immune status of uremia and following renal transplantation. Twenty-one hemodialysis (HD) patients had serum samples collected for sHLA-I analysis before and after HD and also during the initial posttransplant period. The serum sHLA-I levels in patients undergoing HD were higher than in the normal controls (574.8 +/- 431.1 vs. 415.6 +/- 256.1 ng/ml, p < 0.05). In the HD patients, HD duration was not correlated with serum sHLA-I levels (r = 0.01, p > 0.05), and pre- and post-HD serum sHLA-I levels were not significantly different (574.8 +/- 431.1 vs. 568.3 +/- 398.4 ng/ml, p > 0.05). After successful renal transplantation, the serum sHLA-I levels decreased significantly (574.8 +/- 431.1 vs. 226.7 +/- 202.8 ng/ml, p = 0.0001) but increased significantly during the rejection period as compared to the prerejection period (642.8 +/- 296.1 vs. 305.5 +/- 194.7 ng/ml, p = 0.0002). In conclusion, sHLA-I levels are stable in uremic status and can be used as a parameter for monitoring acute graft rejection in renal transplantation.

Prevalence and clinical course of hepatitis B and hepatitis C liver disease in ciclosporin-treated renal allograft recipients

We performed this study to evaluate prevalence and clinical course of hepatitis B surface antigen (HBsAg)-positive and anti-hepatitis C virus (HCV)-positive renal transplant recipients. HBsAg positivity was 13.7 and anti-HCV positivity 12.8%. Before transplantation, the HBsAg positivity was observed in in 83.5% of the patients, and 16.4% of the patients acquired HBsAg after renal transplantation. In the HCV group, anti-HCV positivity was observed in 47.1% before transplantation, and 19.6% acquired anti-HCV after renal transplantation. The prevalence of chronic hepatitis in the hepatitis B virus (HBV) and in the HCV groups was not different (25.7 vs. 25.5%). Among those with chronic hepatitis in the HBV group, 4 cases progressed to fulminant hepatic failure, 1 case progressed to the end-stage liver cirrhosis, and 1 case to hepatocellular carcinoma. However, in the HCV group, no case showed progression of chronic hepatitis. The overall mortality in the HBV and HCV groups was 25.3 and 7.8%, respectively (p = 0.001). Among 20 fatal cases in the HBV group 9, cases were liver disease related, but no liver disease related death occurred in the HCV group. In conclusion, HCV as well as HBV infections are quite prevalent and important causes of posttransplant chronic hepatitis, and the clinical course of anti-HCV-positive recipients is less aggressive than that of HBsAg-positive recipients.

Assessment of 72-kilodalton gelatinase and TIMP-1 gene expression in normal and sclerotic murine glomeruli

Mice transgenic for bovine growth hormone (bGH) develop progressive diffuse glomerulosclerosis. Because murine mesangial cells in vitro were found to express the genes for 72-kd gelatinase and the metalloproteinase inhibitor TIMP-1, the expression of these genes in vivo in isolated whole glomeruli from bGH mice and normal control littermates was examined. Intact glomeruli were isolated by microdissection and subjected to reverse transcription. TIMP-1 cDNA was not detected by standard polymerase chain reaction (PCR) in glomeruli from bGH or control mice. In contrast, cDNA for 72-kd gelatinase was detected by standard PCR in both bGH and control mice, and the level was subsequently measured by quantitative competitive PCR. The gelatinase cDNA level was 14.7 +/- 2.8 x 10(-4) attomoles/glomerulus in 2- to 3-month-old control mice and was unchanged in 6-month-old controls. The bGH mice had 3.5-fold and 4.5-fold higher cDNA levels at 2 to 3 months and 6 months of age, respectively. Finally, zymography of glomerular extracts revealed increased levels of 72-kd and 96- to 100-kd gelatinase activity in bGH glomeruli in comparison to that in controls. In summary, whereas the genes for both TIMP-1 and 72-kd gelatinase are expressed in vitro in cultured mesangial cells, only the gelatinase gene appeared to be expressed in vivo in intact glomeruli. In addition, there was an up-regulation in the glomerular expression of the 72-kd gelatinase in bGH mice, a murine model of glomerulosclerosis.

Five cases of cytomegalovirus infection detected by in situ hybridization and antigenemia assay

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.

MRI manifestations of gastrointestinal lymphoma

The magnetic resonance (MR) images of 11 cases of gastrointestinal lymphoma are presented. The findings include irregularly thickened mucosal folds, irregular submucosal infiltration, annular constricting lesion, exophytic tumor growth, mesenteric masses, and mesenteric/retroperitoneal lymphadenopathy. The tumors were homogeneous and intermediate in signal intensity on T1-weighted images. Heterogeneously increased signal intensities were noted on T2-weighted images. There was mild to moderate enhancement after intravenous administration of gadolinium dimeglumine (Gd-DTPA). The submucosal tumor infiltration might be outlined between the strongly GD-DTPA-enhanced mucosa and the low-intensity muscular layer. In one case that received tumor resection, the pathological examination showed destruction of most parts of the muscular layer, and the MR images did not disclose the low-intensity muscular zone.

Liver, renal and subcutaneous histopathology in PEPCK-bGH transgenic pigs

Transgenic pigs were created that harboured a phosphoenolpyruvate carboxykinase-bovine growth hormone construct (PEPCK-bGH). Four founder animals and two transgenic offspring from one line were evaluated between 6 1/2 and 12 months of age. There was no evidence of severe hepatic or renal lesions in these pigs, which characterised transgenic PEPCK-bGH mice previously described. While glomerular and tubular lesions in kidney sections were not identified in the transgenic pigs, mesangial cell proliferation was observed in two transgenic offspring from a single line. Additionally, glomerular size was significantly increased in four of four puberal transgenic swine when compared to age- and sex-matched controls (28.30 +/- 4.1 vs. 14.2 +/- 2.7 x 10(5) microns 3; representing 3 transgenic lines, p < 0.05). Surprisingly, no mature adipocytes were observed in subcutaneous sections obtained in transgenic GH pigs. Histological evaluation of these transgenic pigs further illustrates the requirement for precise control of growth-related genes and their protein products.

Abdominal pseudotumors and simulated lymphadenopathy in MRI: differential features with the use of retrograde air insufflation

In order to evaluate the contribution of retrograde air insufflation in decreasing the occurrence of pseudotumor appearance and mimicked lymphadenopathy due to nonair-distended bowel loops, we retrospectively compared two groups of magnetic resonance (MR) examinations. In the group receiving retrograde air insufflation, 10.8% (67 of 619) of images showed a tumor-like lesion due to nonair-distended bowel loop(s), whereas in the group not receiving air introduction, a tumor-like lesion was simulated in 45.6% (140 of 307) of images. Furthermore, a collapsed bowel loop(s) mimicking an enlarged lymph node close to the aorta, inferior vena cava, or bilateral iliac vessels was found in 9.5% (24 of 252) of images of the latter group, in contrast to only 1.8% (9 of 505) of images of the former group. This study shows that retrograde air insufflation greatly reduces the occurrence of pseudotumor appearance and false impression of paraaortic, paracaval, or parailiac lymphadenopathy secondary to nonair-distended bowel loop(s).

Advanced glycation end products up-regulate gene expression found in diabetic glomerular disease

Several lines of evidence suggest that the excessive accumulation of extracellular matrix in the glomeruli of diabetic kidneys may be due to reactive intermediates forming between glucose and matrix proteins called advanced glycation end products (AGEs). Normal mice received AGE-modified mouse serum albumin i.p. for 4 weeks, and glomerular extracellular matrix, growth factor mRNA levels, and morphology were examined. We found that AGE induced an increase in glomerular extracellular matrix alpha 1(IV) collagen, laminin B1, and transforming growth factor beta 1 mRNA levels, as measured by competitive PCR, as well as glomerular hypertrophy. The AGE response was specific because the coadministration of an AGE inhibitor, aminoguanidine, reduced all these changes. We conclude that AGEs affected expression of genes implicated in diabetic kidney disease and may play a major role in nephropathy.

MR imaging of sports-related muscle injuries

Magnetic resonance (MR) imaging of the thighs of 26 baseball athletes and one softball athlete were studied to evaluate muscle injuries. We documented the abnormalities present in MR imaging after a muscle injury and evaluated the role of MR imaging in muscle injuries. Fifteen of the athletes showed muscle abnormalities in MR images. These include muscle strains without tear, muscle tear, scar and chronic tendon injury. Having the advantages of high tissue contrast and multiplanar display capability, MR allowed direct visualization of the injured muscles and characterization of traumatic lesions. We conclude that MR could be a good imaging modality for evaluating muscle injuries.

Activation of a calcium- and pH-dependent phospholipase A2 by cyanide in PC12 cells

Previous studies suggested that alterations in phospholipid composition of plasma membranes may contribute to neuronal injury associated with cyanide-induced histotoxic hypoxia. This prompted a study of the effects of KCN on phospholipase A2 (PLA2), an enzyme which catalyzes breakdown of membrane phospholipids. PLA2 activity was measured by quantitating the release of [3H]arachidonic acid ([3H]AA) from rat pheochromocytoma (PC12) cells. KCN produced a time (1-15 min)- and concentration (0.5-10 mM)-dependent release of [3H]AA from the cells. When cells were incubated in Ca(2+)-free buffer, KCN (5 mM) was still able to release [3H]AA. In cells loaded with BAPTA, an intracellular Ca2+ chelator, cyanide-induced release of [3H]AA was blocked, indicating that mobilization of intracellular Ca2+ can activate the enzyme. The PLA2 inhibitors dibucaine (50 microM) and mepacrine (50 microM) inhibited KCN-mediated [3H]AA release. Incubation of PC12 cells in an extracellular pH of 6.50 reduced the KCN effect, whereas incubation at pH 7.90 enhanced [3H]AA release. These data indicate that in PC12 cells KCN activates a Ca(2+)- and pH-dependent PLA2 which may contribute to cyanide-induced cell damage.

Acute focal bacterial nephritis presented as acute renal failure and hepatic dysfunction in a renal transplant recipient

We describe acute focal bacterial nephritis (AFBN) presented as acute renal failure and hepatic dysfunction in a renal transplant recipient. He had received a renal transplantation 5 years previously and maintained good renal function without an episode of acute rejection or any urinary abnormalities. He had been an HBsAg carrier and showed mild elevation of liver enzymes after renal transplantation. For 5 days before admission, the patient suffered from fever, graft kidney swelling, tenderness and oliguria. On admission, renal biopsy was performed and solumedrol pulse therapy was started under the impression of acute rejection. The following laboratory findings revealed acute renal failure and hepatic dysfunction. From the abdomen CT and renal biopsy findings this case was confirmed as AFBN in a grafted kidney. With successive hemodialysis and antibiotic therapy clinical symptoms and renal function improved promptly. In acute hepatic dysfunction we discontinued cyclosporine (CsA) to prevent irreversible fulminant hepatic failure until the normalization of liver function. It should be considered that AFBN must be included in the differential diagnosis of acute rejection, and the early diagnosis and treatment of AFBN is important to save the grafted kidney. In addition, early withdrawal of CsA is essential to prevent irreversible hepatic failure when infection triggers hepatic dysfunction in HBsAg-positive renal transplant recipients.

Primary aldosteronism detected after renal transplantation

A 44-year old female was admitted to our hospital for evaluation of uncontrolled hypertension. She received renal transplantation 3 months ago and suffered from a tingling sensation and weakness on both hands. Laboratory findings (low serum potassium, low plasma renin activity and elevated plasma aldosterone level) was consistent with primary aldosteronism. Through the postural study for plasma aldosterone and the adrenal CT finding we diagnosed this case as adrenal adenoma, which was confirmed by surgical removal. A retrospective review of medical records showed that characteristic findings in primary aldosteronism (hypokalemia and low plasma renin activity) were masked by renal failure and became evident after successful renal transplantation. It was suggested that impaired urinary potassium excretion and excess release of renin from the ischemic kidney masked the characteristic findings of primary aldosteronism. To our knowledge, this is the first report documenting the change of renin-angiotensin-aldosterone system after renal transplantation in a case of coexistence of primary aldosteronism and chronic renal failure.

The role of ultrasound in scrotal trauma

We reviewed the sonograms of 16 cases with scrotal trauma and documented the spectrum of abnormalities that may be present in sonography after a scrotal injury. The sonographic findings included scrotal hematoceles, post-traumatic epididymitis, epididymal hematoma, testicular hematoma and/or infarction, testicular rupture, testicular swelling and hyperemia. Ultrasound is able to distinguish intratesticular and extratesticular lesions. The integrity of the testis could be evaluated as well. It should be the imaging modality of choice for the evaluation of scrotal trauma.

Mesangial cells from diabetic NOD mice constitutively secrete increased amounts of insulin-like growth factor-I

Experimental evidence has suggested that insulin-like growth factor-I (IGF-I) may contribute to diabetic complications. Previously, we and others have shown that normal glomerular mesangial cells have receptors for, synthesize, and exhibit a mitogenic response to IGF-I. We investigated the IGF-I response in cells derived from a genetic model of diabetes, the nonobese diabetic (NOD) mouse. Mesangial cell lines were derived from diabetic (D-NOD) and nondiabetic adult mice. D-NOD cells released more IGF-I into the supernatant and had a decreased binding of IGF-I to surface receptors. Analysis according to Scatchard revealed a decreased number of receptor sites on D-NOD cells, although the structure of the IGF-I receptor visualized by cross-linking was identical for both cell types. Preincubation of D-NOD cells with an antibody to IGF-I resulted in an increase in the number of receptor sites. This suggested that autocrine IGF-I was responsible for the decrease in D-NOD receptor number and that diabetes had resulted in a stable phenotypic change.

Human glomeruli express TIMP-1 mRNA and TIMP-2 protein and mRNA

Alterations in the balance between synthesis and degradation of extracellular matrix may result in glomerulosclerosis. The interaction between metalloproteinases and their inhibitors presumably modulates the rate of glomerular matrix degradation. We examined the gene expression of tissue inhibitor of metalloproteinases (TIMP)-1 and TIMP-2 in human glomeruli and TIMP-2 protein in tissue sections. Kidney tissue was obtained from adults undergoing nephrectomy for renal tumor (n = 9) or biopsy for nephrosis and renal failure (n = 1). Glomeruli were microdissected and subjected to reverse transcription. TIMP cDNAs were quantitated by competitive polymerase chain reaction assays. Five nephrectomy specimens had normal glomeruli and four had diffuse glomerulosclerosis. TIMP-1 and TIMP-2 cDNA levels, detected in glomeruli from all patients, were increased fourfold and threefold, respectively, in patients with glomerulosclerosis. The elevated TIMP cDNA levels could not be attributed to an increased number of glomerular cells. TIMP-2 protein was detected within normal and sclerotic glomeruli. In conclusion, both TIMP genes were expressed in normal glomeruli, and their level of expression was increased in glomerulosclerosis associated with renal carcinoma, suggesting that expression of these inhibitors may correlate with the development of sclerosis.

Abdominal MR imaging following antegrade air introduction into the intestinal loops

Air was used to distend the gastrointestinal tract and act as a contrast medium to effectively delineate the other abdominal organs/masses and to outline intraluminal or mural lesions. We used a nasogastric tube to introduce air into the stomach. Metoclopramide was administered to propel air throughout the gastrointestinal tract. Bowel peristalsis was then controlled by scopolamine butylbromide. Most of the alimentary tract could be distended by air. The normal bowel walls were barely visible between intraluminal signal-void air and extraluminal high-signal fat. Intraluminal tumor, wall thickening, and adjacent structures could be clearly delineated.

Ventricular tumors--CT evaluations of 28 cases

Ventricular neoplasms can be grouped together as a single disease entity because of the behavior of some of the tumors and similarities between the access of therapy and procedure of operation. In our series, the incidence of various ventricular neoplasms (shown in decreasing order) were metastasis, astrocytoma, ependymoma, meningioma, choroid plexus papillomas and oligodendroglioma. The intraventricular tumors included some metastasis involved by hematogenous spread, meningioms, and choroid plexus papilloma while paraventricular tumors included some of the systemic myeloproliferative disorders with ventricular seeding along with tumors with glial origins. Most of the patients with symptoms of intraventricular tumors also had symptoms related to increased intracranial pressure while those with paraventricular neoplasm presented symptoms related to focal signs or symptoms. CT scan with enhancement could provide a very good image modality except in some involvements in the posterior cranial fossa.

The effect of HLA mismatching on graft survival in living-donor kidney transplants: Catholic Medical Center, 1984 to 1993

This study focuses on the beneficial effect of HLA matching on long-term graft survival rates in CsA-treated living primary kidney transplants at Catholic Medical Center, 1984 to 1993. 1. An impressive 26% difference in kidney graft survival was observed at 5 years between recipients who received 0 and 2 HLA-DR mismatches (79% vs 53%). 2. Five-year kidney graft survival rates in the 0, 1, 2, and 3-HLA-B+DR mismatches were 87%, 76%, 77%, and 74%, respectively, which was significantly different from 54% survival rates in the 4-HLA-B+DR mismatch group. 3. The 5-year kidney graft survivals in the 0, 1, 2, HLA-DR-mismatched living-nonrelated donor group were 84%, 76%, and 39%, respectively, which were significant differences. 4. The 5-year kidney graft survivals in the 0, 1, 2, HLA-DR-mismatched living-related donor group were 75%, 79%, and 72%, respectively, which were not significant. 5. The effect of HLA-A, B, A+B, A+DR, and A+B+DR mismatches showed little difference among the groups with different mismatch numbers. In conclusion, better matching for the HLA-DR, B+DR antigens significantly improved kidney graft survivals in our CsA-treated primary living-donor transplant recipients.

Glomerulosclerosis and body growth are mediated by different portions of bovine growth hormone. Studies in transgenic mice

BACKGROUND

Mice transgenic for bovine growth hormone (bGH) gene have increased body weight and severe glomerulosclerosis leading to death in uremia.

EXPERIMENTAL DESIGN

The aim of this study was to determine if body growth and glomerulosclerosis were mediated by different bGH regions. Amino acid substitutions in the bGH alpha-helix III were generated, and lines of transgenic mice that expressed these products were developed. Female transgenic mice carrying the native bGH gene (bGH mice), a mutated bGH gene that encodes a destabilized alpha-helix III (bGH-L121P, E126G; bGH-m11 mice), or a mutated bGH gene that encodes a perfect amphiphilic alpha-helix III (bGH-E117L, G119R, A122D; bGH-m8 mice) were examined at 2-3 months and 6-9 months of age. Body, kidney, and heart weights were measured. Urinary glucose, albumin, creatinine, and serum glucose were measured in all mice. Serum levels of insulin-like growth factor I (IGF-I) were measured in the 2-3 month group. Whole blood hemoglobin A1 was measured in some mice of the 6-9 month group. Kidney sections were examined by light and immunofluorescence microscopy. Glomerular volume was measured and related to body weight by allometry.

RESULTS

The bGH-m11 mice developed glomerulosclerosis indistinguishable from that seen in bGH transgenic mice, even though they had normal body size. Glomerular growth exceeded body growth by allometry in both bGH and bGH-m11 strains. bGH-m8 mice had glomeruli of appropriate size and normal histologic appearance; however, they were dwarfs. IGF-I was increased in bGH mice; they also had an increased albumin/creatinine ratio at 6-9 months. None of the mice were hyperglycemic.

CONCLUSIONS

These data indicated that development of glomerulosclerosis and body growth promotion were mediated by different regions of the growth hormone molecule. The glomerular response to bGH was unique and consisted of increased size and glomerulosclerosis.

Glomerulosclerosis in mice transgenic for native or mutated bovine growth hormone gene

Mice transgenic for bovine growth hormone (bGH) develop an increase in body weight and glomerular lesions characterized by a disproportionate increment in glomerular volume and progressive mesangial sclerosis. The relationship between glomerular size and body growth in bGH mice was further investigated by examining mice transgenic for a mutated GH gene (bGH-m11) which failed to enhance body growth. The glomeruli in bGH-m11 mice exhibited an increase in size and glomerulosclerosis comparable to those found in bGH mice. The levels of alpha 1 type IV collagen mRNA, as measured by the competitive polymerase chain reaction in isolated microdissected glomeruli, were markedly elevated in mice transgenic for both bGH and bGH-m11 genes. These data suggest that body growth on one hand, and glomerular hypertrophy and sclerosis on the other hand, are mediated by different portions of GH or different second messenger signaling systems.