Looking at the Urine: The Renaissance of an Unbroken Tradition

3D plasmonic coral nanoarchitecture paper for label-free human urine sensing and deep learning-assisted cancer screening

Practical human biofluid sensing requires a sensor device to differentiate patients from the normal group with high sensitivity and specificity. Label-free molecular identification from human biofluids allows direct classification of abnormal samples, providing insights for disease diagnosis and finding of new biomarkers. Here, we introduce a label-free surface-enhanced Raman scattering sensor based on a three-dimensional plasmonic coral nanoarchitecture (3D-PCN), which has strong electromagnetic field enhancement through multiple hot spots. The 3D-PCN was synthesized on a paper substrate via direct one-step gold reduction, forming a coral-like nanoarchitecture with high absorption property for biofluids. This was fabricated as a urine test strip and then integrated with a handheld Raman system to develop an on-site urine diagnostic platform. The developed platform successfully classified the human prostate and pancreatic cancer urines in a label-free method supported by two types of deep learning networks, with high clinical sensitivity and specificity. Our technology has the potential to be utilized not only for urinary cancer diagnosis but also for various human biofluid sensing systems as a future point-of-care testing platform.

Metabolomics in Radiation Biodosimetry: Current Approaches and Advances

Triage and medical intervention strategies for unanticipated exposure during a radiation incident benefit from the early, rapid and accurate assessment of dose level. Radiation exposure results in complex and persistent molecular and cellular responses that ultimately alter the levels of many biological markers, including the metabolomic phenotype. Metabolomics is an emerging field that promises the determination of radiation exposure by the qualitative and quantitative measurements of small molecules in a biological sample. This review highlights the current role of metabolomics in assessing radiation injury, as well as considerations for the diverse range of bioanalytical and sampling technologies that are being used to detect these changes. The authors also address the influence of the physiological status of an individual, the animal models studied, the technology and analysis employed in interrogating response to the radiation insult, and variables that factor into discovery and development of robust biomarker signatures. Furthermore, available databases for these studies have been reviewed, and existing regulatory guidance for metabolomics are discussed, with the ultimate goal of providing both context for this area of radiation research and the consideration of pathways for continued development.

The Scientific Revolution--The Kidney and Nephrology in and about the Seventeenth Century (Part 1)

In the history of the evolution of the medical sciences, it is in the 17th century that the conscious, deliberate, and systematic study of the workings of the human body began. It was a product of the radical changing attitudes of this insurgent century when mathematical reasoning and mechanistic philosophy replaced the teleological outlook of earlier times. It was then that meticulous observation, reproducible quantification, experimental validation, and mathematical exactitude in the quest for truths launched the Scientific Revolution. The effect on medicine was a transformative change from a descriptive to an explanatory body of knowledge during the course of which rigorous anatomical dissections were used for the mechanical explanation of organ function, when morbid changes observed at postmortem began to be related to clinical features of disease, and when the secretive analytical methods of alchemy began to be refined for the study of chemical changes in living matter. Essentially what began with meticulous observations of anatomical features begat physiology and laid the foundations of pathology and chemistry. As a result, studies of organ structure, function, and changes in disease in general, and of the kidney in particular, were clarified and progressed at a rate never achieved theretofore.

The early modern kidney--nephrology in and about the nineteenth century (part 2)

Two basic science specialties that matured in the nineteenth century were instrumental in the transformation of medicine into a scientific discipline and in the process of establishing the evidentiary basis of the fundamental role of the kidney in maintaining homeostasis, whose continued exploration would lead to the emergence of nephrology in the following century. The first specialty was that of chemistry, which progressed from a descriptive to an analytical, organic, biological, and physical science that progressively eroded the animism of the "vital" forces of old and replaced it with the physicochemical forces and laws of chemical reactions that govern the "matters of life". The second specialty was that of cell biology, which established the cell as the structural and functional unit of living organisms, be they plant or animal. Refined microscopic technologies then helped to identify the structural components of the cell, amongst which the plasma membrane emerged as the most important in regulating the separation of the intracellular machinery from its external environment and thereby maintaining the internal milieu of cells. The interaction of these two specialties (chemistry, cell biology) clarified the functions of the cell in health and disease and extended it to the study of epithelial cell transport. This transforming turn of events established the role of the renal tubules in the vital function of the kidney of maintaining body homeostasis, a function well beyond that of the passive excretory filter of wastes and excess fluids it had been considered theretofore.

The fascinating history of urine examination

Examination of urine has fascinated people since the beginning of recorded history. It is arguably the oldest medical test and marks the beginning of laboratory medicine. Examination of urine, urinalysis, is still important today in evaluation of many pathologic conditions, including diabetes mellitus, infections, renal and inherited diseases, as well as genitourinary tract cancer. Although urine cytology is simple, safe, and inexpensive, it has poor sensitivity, especially for low-grade neoplasms. This shortcoming has led to a proliferation of new diagnostic techniques for evaluation of urine samples. Examination of urine has come a long way, from uroscopy to microscopy, and now to molecular testing. Although the new era of tumor markers looks promising, for now it still needs the help of "good old cytology."

The late medieval kidney--nephrology in and about the fourteenth century

The Late Medieval Period was a decisive period in the history of medicine. It was then that medical education was integrated into the universities that were coming into existence and when medicine made its transition from a menial trade to a regulated profession with a statutory basis of learning and graduation. It was also then that the necessities of understanding the fabric of the body was realized; for the first time in history, the study of anatomy and of human dissection were incorporated into the medical curriculum. This was a defining change whose subsequent expansion and evolution would bring about the study of function (physiology) and changes in disease (pathology). Few advances were made in the study of the kidney, which was considered part of the venous circulation, whose function was subservient to that of nutrition in eliminating excess fluid. Uroscopy flourished and reached unrealistic levels of dominance in the diagnosis, treatment, and prognostication of any and all diseases, especially in the hands of quacks and charlatans. Alchemy, a mysterious pseudo-science, blossomed into a discipline that nurtured experimentation and laid the rudimentary foundations of scientific study, chemistry, and pharmacology. It was also then that surgery took form as a specialty that actually provided much of the medical care of the period including that of the principal diseases of the kidney, obstruction and calculi, and thereby laid the foundations of what in time would become urology.

Urine as a specimen to diagnose infections in twenty-first century: focus on analytical accuracy

Urine as a clinical specimen to diagnose infections has been used since ancient times. Many rapid technologies to assist diagnosis of infections are currently in use. Alongside traditional enzyme immunoassays (EIA), new technologies have emerged. Molecular analysis of transrenal DNA to diagnose infections is also a rapidly growing field. The majority of EIAs utilize the detection of excreted sugar compounds of the outer microbial cell-wall shed into the bloodstream and excreted into the urine. This mini-review focuses on current knowledge on rapid urinary antigen detection tests to diagnose most common infections, and highlights their diagnostic utility. The past and the future of urinalysis are also briefly discussed. The analysis of the literature shows that some methods are not quantitative, and analytical sensitivity may remain suboptimal. In addition, the performance criteria and technical documentation of some commercial tests are insufficient. Clinical microbiologists and physicians should be alert to assay limitations.

Exosomes in urine: who would have thought...?

Normal urine contains thousands of proteins, largely due to the presence of 'exosomes,' tiny vesicles secreted into the urine by renal epithelial cells. These exosomes, demonstrated by Keller and colleagues to be also retrievable from amniotic fluid, offer great promise for future disease biomarker discovery studies.