Procuring rare (しい)* Japanese red blood cell units for a bleeding patient with anti-K11 requiring a life-saving procedure

Alloimmunization to K11 is an extremely rare event. However, given the potential clinical significance of K11 alloantibodies, allocating antigen-negative red blood cell (RBC) units is a clinical necessity. In brief, we report a 39-year-old woman with multiple comorbidities including a right lower-extremity, below-the-knee amputation, who developed aggressive osteomyelitis associated with continuous bloody oozing, leading to anemia. To address these issues, the patient required extremity amputation. Surgery required addressing the concomitant critical anemia (hemoglobin <5 g/dL). However, with anti-K11 (in addition to anti-Jk^a) identified, no compatible units were immediately on hand and transfusing crossmatch-incompatible, antigen-positive units was deemed too high a risk. After a national search by the American Rare Donor Program (ARDP) was unsuccessful, the ARDP identified 2 irradiated, group O, K₀ (Kell_null), Jk(a-) RBC units in Japan that were predicted to be crossmatch-compatible with the patient's plasma. The units were successfully procured and infused, without evidence of adverse reactions, and the patient was able to safely undergo amputation to save her life. This case report reviews the complexities of anti-K11 detection and confirmation, as well as the processes by which K11- RBC units may be procured, which could help others in the global transfusion community should they be faced with similar challenging cases.

Long-lasting poloidal ULF waves observed by multiple satellites and high-latitude SuperDARN radars

Poloidal ultra-low frequency (ULF) waves between 5-10 mHz were observed by multiple satellites and three high-latitude Super Dual Auroral Radar Network (SuperDARN) radars during the recovery phase of a moderate geomagnetic storm on Jan 24-27, 2016. The long-lasting ULF waves were observed in the magnetic field and energetic particle flux perturbations during three successive passes by two Geostationary Operational Environmental Satellites (GOES) through the dayside magnetosphere, during which plasmasphere expansion and refilling were observed by two Time History of Events and Macroscale Interactions during Substorms (THEMIS) probes. The radial magnetic field oscillation was in phase (~ 180° out of phase) with the northward (southward) moving proton flux oscillation at 95 keV, consistent with high-energy drift-bounce resonance signatures of protons with second harmonic poloidal standing Alfvén waves. The longitudinal extent of the waves approached 10 hours in local time on the dayside and gradually decreased with time. High-time resolution (~ 6 s) data from three high-latitude SuperDARN radars show that the wave intensification region was localized in latitude with a radial extent of ~ 135-225 km in the subauroral ionosphere. No signature of these waves were observed by ground-based magnetometers colocated with the GOES satellites suggesting that the poloidal waves were high-m mode and thus screened by the ionosphere. During this interval one of the THEMIS probes observed a bump-on-tail ion distribution at 1-3 keV which we suggest is the source of the long-lasting second harmonic poloidal ULF waves.

Biopreservation of hepatocytes: current concepts on hypothermic preservation, cryopreservation, and vitrification

Isolated liver cells (primarily isolated hepatocytes) have found important applications in science and medicine over the past 40 years in a wide range of areas, including physiological studies, investigations on liver metabolism, organ preservation and drug de-toxification, experimental and clinical transplantation. An integral component of many of these works is the need to store the isolated cells, either for short or long-term periods. This review covers the biopreservation of liver cells, with a focus on the history of liver cell biopreservation, the application of hypothermia for short-term storage, standard cryopreservation methods for isolated hepatocytes, the biopreservation of other types of liver cells, and recent developments such as vitrification of hepatocytes. By understanding the basis for the different approaches, it will be possible to select the best options for liver cell biopreservation in different applications, and identify ways to improve preservation protocols for the future.

A device to record ultra-rapid cooling profiles

This work deals with the construction and performance of a measuring system capable of estimating temperature at sufficiently high speed (up to 1000 samples per sec). Due to its simple design and the utilization of standard materials, it could serve to recording the cooling profile of ultra-rapid procedures. An immersion device was also developed with the purpose of normalize the penetration speed of the sample in the LN2. The device allows also the comparative analysis of different cooling profiles. The system consists of an immersion device of the sample in the cooling agent, a temperature measurement system developed by Kleihans F and a laptop computer. To test the system, we recorded the cooling profiles of 10 uL of distilled water and 6 M glycerol solution, obtaining a cooling rate of 8732 C/min and 4441 C/min respectively. Also we determine a cooling rate of 204.012 C/min during the immersion of the thermocouple assembly in LN2. Although, the same device, with small technical modifications related to the handling of the sample, could be used to evaluate the recovery from LN2 temperature to room temperature (re-warming).

Organ Preservation: Current Concepts and New Strategies for the Next Decade

SUMMARY: Organ transplantation has developed over the past 50 years to reach the sophisticated and integrated clinical service of today through several advances in science. One of the most important of these has been the ability to apply organ preservation protocols to deliver donor organs of high quality, via a network of organ exchange to match the most suitable recipient patient to the best available organ, capable of rapid resumption of life-sustaining function in the recipient patient. This has only been possible by amassing a good understanding of the potential effects of hypoxic injury on donated organs, and how to prevent these by applying organ preservation. This review sets out the history of organ preservation, how applications of hypothermia have become central to the process, and what the current status is for the range of solid organs commonly transplanted. The science of organ preservation is constantly being updated with new knowledge and ideas, and the review also discusses what innovations are coming close to clinical reality to meet the growing demands for high quality organs in transplantation over the next few years.

Structural, ultrastructural and functional studies of human cardiac valve allografts that suffered an increment of the cryostorage temperature

Human cardiac valve allografts (HVAs) suffer injuries during the cryopreservation period. Here, we described structural, ultrastructural and functional damages suffered by HVAs after an increment of their cryostorage temperature (100 degree C). Two experimental groups of pulmonary and aortic HVAs were compared: cryopreserved (HVAcryo) and cryopreserved with temperature changes (HVAΔT). Transmission electron microscopy (TEM) was used to analyze valve fibroblasts and extracellular matrix morphology. Total collagen amount was estimated using two different methods and fibroblast viability was assessed measuring their oxygen consumption rate. Porcine heart grafts valves were used to set the techniques. Disorganized collagen network was seen in HVAΔT by TEM. Fibroblasts showed damages in the cellular membrane and many secretor vesicles. Mitochondria and chromatin were also altered. HVAΔT had less amount of collagen and fibroblasts showed an oxygen consumption rate markedly diminished compared to HVAcryo. The increment of 100 degree C suffered by HVAs caused damages that made them unsuitable for clinical purposes.

Protective effects of a carbon monoxide-releasing molecule (CORM-3) during hepatic cold preservation

There is increasing evidence that carbon monoxide (CO), a signaling molecule generated during the degradation of heme by heme oxygenase-1 (HO-1) in biological systems, has a variety of cytoprotective actions, including anti-hypoxic effects at low temperatures. However, during liver cold preservation, a direct effect needs to be established. Here, we designed a study to analyze the role of CO, delivered via a carbon monoxide-releasing molecule (CO-RM) in the maintenance of liver function, and integrity in rats during cold ischemia/reperfusion (CI/R) injury. We used an isolated normothermic perfused liver system (INPL) following a clinically relevant model of ex vivo 48 h cold ischemia stored in a modified University of Wisconsin (UW) solution, to determine the specific effects of CO in a rat model. CO was generated from 50 microM tricarbonylchloro ruthenium-glycinato (CORM-3), a water-soluble transition metal carbonyl that exerts pharmacological activities via the liberation of controlled amounts of CO in biological systems. The physiological effects of CORM-3 were confirmed by the parallel use of a specific inactive compound (iCORM-3), which does not liberate CO in the cellular environment. CORM-3 addition was found to prevent the injury caused by cold storage by improving significantly the perfusion flow during reperfusion (by almost 90%), and by decreasing the intrahepatic resistance (by 88%) when compared with livers cold preserved in UW alone. Also, CORM-3 supplementation preserved good metabolic capacity as indicated by hepatic oxygen consumption, glycogen content, and release of lactate dehydrogenase. Liver histology was also partially preserved by CORM-3 treatment.

CONCLUSIONS

These findings suggest that CO-RM could be utilized as adjuvant therapeutics in UW solutions to limit the injury sustained by donor livers during cold storage prior to transplantation, as has been similarly proposed for the heart, and kidney.

A device to measure oxygen consumption during the hypothermic perfusion of the liver

This work deals with the construction and performance of a device designed to measure the oxygen consumption by the liver during hypothermic perfusion in the rat model. Due to its simple design and the utilization of standard materials, it could serve to determine the role of oxygenation during hypothermic perfusion of the liver. The system consists of a reservoir containing the preservation solution, a peristaltic pump and an internal oxygenator made of silicone tube. A five ports manifold connects the circulation to the liver (inflow), to a hydrostatic manometer and to two sample ports; the liver outflow and temperature sensor or gas calibration. Finally the exit port connects the circulation fluid with an oxygen electrode. The preservation solution is pumped through the liver at a constant pressure (77 i 15 mm H2O) and a perfusion flow of 0.39 - 0.49 mL per min per g liver. To test the system, two to four hours perfusion experiments were performed, at temperatures of 5 and 10 degree C. Two preservation solutions were evaluated: Custodiol and Bes-Gluconate-Sucrose. The solubility of oxygen in the preservation solutions was determined, and the oxygen consumption by preserved rat livers was measured.

The assessment of viability in isolated rat hepatocytes subjected to cold or subzero non-freezing preservation protocols using a propidium iodide modified test

A rapid and simple assay (6 min, two steps) is described for determination of cell viability of hepatocytes subjected to cold preservation protocols. In this method, cells are incubated with the fluorescent marker propidium iodide (PI) and the fluorescence intensity is measured before (direct fluorescence--Fd) and after (total fluorescence--Ft) addition of digitonin, which allows the dye to enter the hepatocytes. The Fd originated from non-viable cells that have membrane damage and taken up PI. The Ft originated from all cells in the sample. The ratio between the two fluorescence values is used as an indicator of cell viability. The assay was challenged versus two classical viability tests: LDH retention and Trypan Blue exclusion. Our assay shows good correlation only with Trypan Blue test. In addition, a fluorescence confocal microscopy protocol was used to evaluate the possible toxicity of PI in hepatocyte suspensions.

Effect of S-nitrosoglutathione (GSNO) added to the University of Wisconsin solution (UW): I) Morphological alteration during cold preservation/reperfusion of rat liver

Cold liver preservation in the University of Wisconsin solution (UW) followed by reperfusion alters hepatic parenchyma and stroma. In this study we demonstrated the benefit of adding S-nitrosoglutathione (GSNO) to the UW solution before cold storage, as an effective Nitric Oxide (NO) donor to prevent hepatic injury. Wistar adult rat livers were stored in UW solution (4 degrees C-48Hs) and then reperfused 60 minutes in the isolated perfused rat liver model (IPRL). Normal untreated livers and perfused livers, but not preserved were used as controls. Parenchymal damages were evaluated with Hematoxylin-Eosin stain and an inmunohistochemistry assay for albumin was used as functional test. To study the stroma, collagen type III and I networks were analyzed using Picro-sirius Red stain and Gordon Sweets' method for reticulin. After 48 Hs of cold preservation in UW solution livers showed few rounded endothelial cells inside sinusoidal lumen and extended areas of cell vacuolation. Albumin distribution was evident only around central veins and middle zones of the hepatic lobule. Collagens III and I networks were disorganized. When preserved with the addition of 100 microM GSNO and then reperfused, the hepatic morphology, in general, was conserved showing little vacuolation, fewer endothelial cells inside sinusoids and good albumin distribution around central veins and middle zones. The stroma had organized networks of collagen III and I. We concluded that the addition of 100 microM GSNO as a NO donor, can improve UW solution properties to preserve rat liver by maintaining the hepatic morphology and avoiding hepatic injury post cold preservation/reperfusion.

Glutathione synthesis during the rewarming of rat hepatocytes preserved in the University of Wisconsin solution

In this study, we used isolated rat hepatocytes to investigate the effect of nucleoside content of the preserved cells on the ability to synthesize glutathione (GSH) during the rewarming process. We cold-stored hepatocytes in University of Wisconsin (UW) solution (72 h, 0 degrees C, N(2)) without nucleosides and with the addition of 5 mM adenosine or 10 mM ATP. After 72 h of cold storage, we determined the GSH synthesis rate and the ATP content of the cells. We found a GSH synthesis rate similar to that of freshly isolated hepatocytes only in the group of cells cold-stored with 10 mM ATP. When we tested the cellular ATP concentrations, we found that controls and preserved cells with 10 mM ATP showed a similar value of ATP during the rewarming step. Our results suggested that the incorporation of ATP in the UW solution increased the ATP content and the rate of GSH synthesis of cold-stored hepatocytes during rewarming.

Glutathione content during the rinsing and rewarming process of rat hepatocytes preserved in University of Wisconsin solution

The addition of glutathione (GSH) to University of Wisconsin (UW) solution increases the intracellular content of GSH and decreases the release of lactate dehydrogenase used here as a measure of cell viability. However, we found a depletion of GSH when the cells were transferred from UW solution to the rewarming solution. This could sensitize the cells to various forms of oxidative injury. In this study we examined how different compositions of rinsing and rewarming solutions affected the GSH content and the viability of hepatocytes after 72 h of cold storage. For both the rinsing and the rewarming steps we used a Krebs-Henseleit solution with the addition of GSH, methionine, or both GSH and methionine. We found no loss of GSH when the hepatocytes were rinsed in the presence of 3 mM GSH. During the rewarming step we observed a loss of GSH in all of the study groups, but the cells that were incubated with 1 mM methionine showed a lesser depletion of GSH and improved viability. This finding may have valuable applications in hepatocellular transplantation and in the development of bioartificial liver support devices.

Current management of calculi in horseshoe kidneys

OBJECTIVES

To assess treatment options for calculi in horseshoe kidneys and the impact of extracorporeal shockwave lithotripsy (ESWL) on the management of renal stones.

MATERIAL AND METHODS

From June 1971 to January 1998, 52 patients with horseshoe kidneys and calculi received treatment at our Urologic Stone Unit. There were 40 men (77%) and 12 women (23%). Average patient age was 41 years (range: 10-70 years). Clinical onset, treatment received and outcome were evaluated retrospectively. A successful outcome was defined as a patient without residual calculi or with fragments <0.4 cm in size.

RESULTS

Clinical onset was mainly low back pain in 37 patients (71%). Eighty-nine stones were treated, i.e. an average of 1.7 treatments per patient. Before the ESWL era (May 1987), we performed two heminephrectomies, 16 pyelolithotomies, 12 pyelolithotomies combined with ureteropyeloplasty and one percutaneous nephrolithotomy. Since the advent of ESWL, seven pyelolithotomies and three pyelolithotomies combined with ureteropyloplasty have been done. ESWL was used to treat 48 calculi. In three cases the patient was placed in the prone position due to difficulties in stone focusing. In 37 cases (77%) patients were either rendered stone-free or had residual fragments <0.4 cm in size. Urinary diversion for obstruction was carried out in two cases (4%).

CONCLUSIONS

At present ESWL is the first-choice treatment for calculi in horseshoe kidneys. It involves no significant focusing difficulties and is associated with a low incidence of obstructive complications. Open surgery is indicated in cases of stone-related pyeloureteral stenosis and in the presence of calculi >2-2.5 cm in size.

Uptake of [(3)H]bilirubin in freshly isolated rat hepatocytes: role of free bilirubin concentration

Hepatocytic transport of physiological concentrations of unconjugated bilirubin (UCB) has not been determined in isolated liver cells. Initial uptake of highly purified [(3)H]UCB was measured in rat hepatocytes in the presence of human serum albumin at various free, unbound UCB concentrations, [UCB]. At [UCB]=42 nM (below aqueous solubility of 70 nM), uptake was strictly temperature dependent; this was much less evident at [UCB]=166 nM (supersaturated). At low, physiological UCB concentrations, specific UCB uptake showed saturative kinetics with an apparent K(m) of 41 nM, indicating carrier-mediated transport. With aqueous supersaturation, UCB entered hepatocytes mainly by passive diffusion.

Role of sodium nitroprusside in the improvement of rat liver preservation in University of Wisconsin solution: A study in the isolated perfused liver model

BACKGROUND

Long-term liver preservation is needed to transform liver transplantation from an emergency operation into an elective procedure and, therefore, to improve the results of liver transplantation.

AIMS

We have studied the possibility of extending the period of cold ischemia of the rat liver, maintaining good hemodynamics and functional conditions, by adding the NO donor sodium nitroprusside (NPNa) to the preservation solution.

MATERIALS AND METHODS

Rat livers were preserved for 24, 48, and 72 h in University of Wisconsin solution (UW) at 4 degrees C (groups I, II, and III) or UW to which 500 microM NPNa was added (groups IV, V, and VI). Following the preservation time, liver viability was assessed using the isolated perfused liver model. Lactate dehydrogenase (LDH) and K(+) release, bile flow, and portal resistance were evaluated in each group and compared with those of liver controls (group VII) excised and perfused without preservation.

RESULTS

Some deleterious effects can be seen during cold storage conditions as assessed by an increment in intrahepatic resistance and a diminution in the capacity of the organ to produce bile. On histological observation, we see vacuolated hepatocytes and free endothelial cells (detached) in the sinusoidal lumen. Addition of 500 microM NPNa to UW significantly moderates these injuries, with an improvement in intrahepatic circulation (less intrahepatic resistance), an increment in bile production, and better histological appearance of the organ. We were also able to determine the capacity of the UW + NPNa to produce NO.

CONCLUSION

We assume that the beneficial vascular effects of NPNa are mediated by NO production.

Renal transport of glycine during glutathione replenishment in rats

Renal transport of glycine was studied in control and glutathione-depleted rats. Diethylmaleate (4.0 mmol/kg body wt, ip) was used as a glutathione depletor agent and the studies were carried out 6 and 10 h post-diethylmaleate injection. Renal transport was measured in isolated rat kidney preparations by means of clearance techniques and in brush border membrane vesicles by a rapid filtration method. Tubular reabsorption of glycine, when compared to glomerular filtration rate, measured at different substrate tubular loads, was higher in treated kidneys. Tissue 14C accumulation was also higher in kidneys from diethylmaleate-treated animals. Studies with brush border membrane vesicles indicated that glutathione depletion induced higher sodium-dependent glycine uptake in contrast with control preparations. This adaptation was not associated with an increment in either tau-glutamyltransferase activity or in protein concentrations. These results could explain in part the replenishment of GSH cellular levels in glutathione-depleted kidneys by means of higher transport capacity for glycine (a glutathione precursor) which was maintained even when GSH levels were restored.

Difference in hepatic uptake of tetra- and di-bromosulfophthalein in rat. Role of hydrophobicity, binding to plasma proteins and affinity for plasma membrane carrier protein

The relative role of hydrophobicity, binding to plasma proteins and affinity for one of the plasma membrane transport proteins in the hepatic uptake of 3,4,5,6-tetra- (BSP) and 3,6-di- (DBSP) bromosulfophthalein was investigated in the rat. In terms of physicochemical characteristics, the two molecules show different pKa values and degrees of hydrophobicity, as determined from the n-octanol:water partition coefficient. In the intact animal, the plasma clearance and the plasma removal rate after a dose of 1.5 mumol/kg i.v. were significantly (P < 0.001) faster for BSP than DBSP, while no difference was found in the plasma distribution volume. The dissociation constant (Kd) of the high affinity binding sites of plasma proteins also differed for the two anions, being significantly lower for BSP than DBSP (0.95 +/- 0.02 vs 1.44 +/- 0.14 microM, P < 0.001). [35S]BSP uptake by liver plasma membrane vesicles was saturable with an apparent Km of 5.20 +/- 0.80 microM, and was competitively inhibited by DBSP (Ki 18.2 +/- 1.2 microM) indicating a common uptake system. The Kd value for binding of the organic anions to purified bilitranslocase, a plasma membrane protein involved in the electrogenic transport of pthaleins, was also significantly lower for BSP than DBSP (1.10 +/- 0.12 vs 3.02 +/- 0.27 microM, N = 3, P < 0.001), indicating a higher affinity of the former ligand for the carrier protein. No difference was observed in the capacity of the high affinity binding sites (32 +/- 3 vs 33 +/- 3 nmol/mg protein, BSP and DBSP, respectively). These data indicate that BSP and DBSP are two different cholephilic organic anions which share a common uptake mechanism, at least partly mediated by bilitranslocase. The greater affinity of BSP than DBSP for the carrier protein may account for the faster plasma disappearance rate of BSP observed in vivo, in spite of the higher plasma protein binding.

Carrier-mediated transport of tetrabromosulfonephthalein by rat liver plasma membrane vesicles

To investigate the molecular requirements and mechanisms for the hepatic uptake of phthaleins, the transport of tetrabromosulfonephthalein (TBS) was investigated in basolateral rat liver plasma membrane vesicles. TBS uptake was electrogenic as greatly accelerated by the creation of a positive-inside membrane potential by the addition of valinomycin in the presence of an inwardly directed potassium gradient. No effect was observed when the ionophore was added in the presence of a sodium gradient. The transport occurred into an osmotic-sensitive space and was saturable with an apparent Michaelis constant of 5.32 +/- 0.56 microM and a maximal velocity of 9.23 +/- 0.25 nmol.s-1.mg protein-1 (mean +/- SD, n = 3 experiments). TBS uptake was directly related to the extra-vesicular pH, indicating the deprotonated quinoid negative-charged form of the dye as the transported species. In contrast, TBS uptake was inversely related to the intravesicular pH, suggesting that protonation inside the vesicles may act as an efficient trap in transport process. Addition of polyclonal monospecific anti-bilitranslocase antibody to liver vesicles specifically inhibited TBS uptake rate (3.27 +/- 0.17 vs. 5.82 +/- 0.61 nmol.s-1.mg protein-1, n = 3, P less than 0.001). These data indicate that TBS is electrogenically transported across the liver cell plasma membrane by bilitranslocase. They also indicate that the presence of a negative charged group on the benzenic ring of the ligand is important in accounting for the transport.

Effect of ethinylestradiol and epomediol on bile flow and biliary lipid composition in rat

Epomediol (1,3,3-trimethyl-2-oxabicyclo(2.2.2.)octan-6,7-endo,endo-diol) (EPO) is a terpenoid compound shown to reverse 17 alpha-ethinylestradiol (EE)-induced cholestasis in rat. The effect is related to the restoration of normal liver plasma membrane fluidity values. To further characterize the effect of EPO, bile flow and biliary lipid composition were measured in rats treated either with EE or EE associated with EPO. EE significantly reduced the bile flow; this reduction was prevented by concomitant treatment with EPO with an increase in the bile salt secretion rate. EPO alone showed a choleretic effect. The biliary secretion rate of cholesterol was also significantly reduced by EE while being comparable to controls in EE-EPO-treated animals. Phospholipid (PL) biliary excretion was significantly (P less than 0.002) increased by EE either alone or combined with EPO. After EE treatment, the biliary PL composition showed a reduction in phosphatidylcholine (PC) concentration with a parallel increase in lyso-phosphatidylcholine (LPC) when compared to control animals (PC:LPC ratio 5.0 +/- 2.5 vs 26.8 +/- 9.9, mean +/- SD, P less than 0.005). EPO administration to EE-treated rats restored the biliary PC:LPC ratio to control values (27.6 +/- 10.6). EPO alone did not show any appreciable effect as compared to both control and EE-EPO treated animals. As increased concentrations of LPC have been reported to induce an alteration in the function of membrane lipids and membrane-associated proteins, such as regulatory enzymes for bile acid, cholesterol and phospholipid metabolism, these results suggest that the protective effect of EPO in EE-induced cholestasis may be related to the reversal of the alterations in membrane lipid composition and function induced by EE.

Effect of aging on metabolic zonation in rat liver: acinar distribution of GSH metabolism

The effect of age on the glutathione antioxidant system and its acinar distribution in rat liver was studied. GSH/GSSG ratio in blood and liver was lower in old than in young rats. Hepatic glutathione peroxidase and glutathione S-transferase activities were higher in old than in young rats, whereas hepatic gamma-glutamyl transpeptidase activity was lower in old than in young rats. Glutathione reductase and glucose-6-phosphate dehydrogenase activities did not change with age in rat liver. Total glutathione levels and glutathione peroxidase activity were higher in periportal than in perivenous areas of young rats, but this heterogeneous distribution did not occur in old rats. No change with age was found in hepatic zonation of glutathione reductase and glucose-6-phosphate dehydrogenase.

Effect of glutathione depletion on urinary acidification in the rat

Glutathione (GSH) depletion by diethyl maleate (DEM) administration and its rapid repletion were associated with the development of a moderate acidosis in the rat. The acidosis observed after DEM treatment could be a consequence of an impairment of lactate metabolism. GSH-depleted rats also showed an increased urine pH and a higher bicarbonate fractional excretion compared with control rats. Renal bicarbonate excretion was magnified when blood bicarbonate levels were normalized by means of a bicarbonate infusion in GSH-depleted rats; however, the amount of bicarbonate excreted in the urine was a very small fraction (less than 5%) of the calculated filtered load. GSH-depleted rats failed to elevate the relation urine minus blood (U-B) pCO2 as compared with control rats when they were subjected to a high bicarbonate load to the distal portions of the nephron. All these data were consistent with a distal renal tubular acidosis due to GSH depletion which could participate in the maintenance of the systemic acidosis, although it is unlikely that it is the primary cause of the acidosis.

Vulnerability of the thick ascending limb to glutathione depletion in rat kidney: effects of diuretics and indomethacin

Previous works supported the idea that the thick ascending limb of Henle was the target structure for glutathione (GSH) depletion effects. In order to obtain more evidence on this hypothesis, we compared GSH depletion effects with those of two loop diuretics: furosemide and ethacrynic acid. The submaximal tubular effects observed with furosemide were magnified when the kidneys were previously GSH depleted, but maximal tubular effects of furosemide were GSH independent. This last observation suggested that furosemide and GSH depletion have common sites or mechanisms of action. On the other hand, ethacrynic acid tubular effects were always magnified when the rats were GSH depleted. As it has been proposed that the renal actions of furosemide and ethacrynic acid are at least in part mediated by prostaglandins, another set of experiments was performed using indomethacin to examine the possible role of renal prostaglandins in GSH depletion effects. It was observed that indomethacin greatly improved tubular functions in GSH-depleted rats suggesting that an increase in prostaglandins levels should be involved in the renal defects observed during GSH depletion. All these data give additional support to the idea that the thick ascending limb cells may have a special sensitivity to the effects of GSH depletion probably mediated by prostaglandins.

Rat kidney function related to tissue glutathione levels. Effects of different glutathione depletors

1. Rat renal function was evaluated during acute depletion of glutathione (GSH) produced by different doses of diethyl-maleate (DEM) or buthionine-sulfoximine (BSO). 2. Similar alterations in renal function were observed when similar GSH levels were obtained independently of the GSH depletor employed. 3. These results confirm the relationship between GSH levels and renal function.

Biochemical and morphometric analysis of the effect of spironolactone on the livers from immature and adult rats

Biochemical and morphometric studies were carried out to characterize the effect of spironolactone (SP) on liver tissue from immature and adult young rats: 1. The SP produced an increase in total protein in all the groups. 2. Hypertrophy in 24 days-old rats. 3. Hypertrophy and hyperplasia in 48 days-old rats. 4. The morphometric studies were correlated to the biochemical parameters.

Rat kidney function related to tissue glutathione levels

Rat renal function was evaluated during acute depletion of glutathione (GSH) produced by different doses of diethyl-maleate (DEM). Significant alterations in renal function were observed when the GSH level diminished. The replenishment of GSH and the restoration of renal function were also investigated at various times after the injection. Similar time courses were observed of both the GSH level and renal functions, but the former was shortest. This suggests that the restoration to normal of GSH renal content was necessary in order to regain appropriate kidney function. Furthermore, the fact that impairment of sodium excretion occurred simultaneously with GSH depletion may be considered as evidence of the first event in GSH protective action. It may be hypothetized that the thick ascending limb is the principal renal target for this deficiency.

Hepatic transport and biliary excretion of sulfobromophthalein in aflatoxin B1-treated rats

The effects of a single dose of aflatoxin B1 (AFB1) on sulfobromophthalein (BSP) plasma disappearance, hepatic transport maximum (Tm), and relative storage capacity (S), were examined in rats 48 hr after AFB1 injection. BSP plasma concentration decay was delayed, and the BSP biliary excretion was diminished in treated animals. S and Tm values were unaltered. However, the Tm was reached in treated rats at a higher infusion rate. A Lineweaver-Burk plot of BSP biliary excretion rate vs BSP serum concentration curve showed a higher apparent Km in the AFB1-treated rats.

Endoscopic surgery of calculi in ureteroceles

Of 366 patients with lower ureteral calculi operated upon by the author, 25 (6.83%) had a stone in a ureterocele. Operation is necessary as these stones cannot pass spontaneously. If endoscopic surgery is undertaken, the following must be taken into account: the ureteral tone, and the size, number and type of ureterocele. In all of our cases we used an endoscopic 'smiling mouth' incision, associated in 6 cases with lithotrity. We obtained good results in 22 cases and in only 1 case was vesicoureteral reflux found postoperatively.

Impairment of bile secretion induced by aflatoxin B1 in the rat

The influence of Aflatoxin B1 on bile secretion was examined in rats. The toxin was given i.p. at a dose of 100 micrograms/kg body wt. It was observed 48 h after the injection a decrease in bile acid-independent and bile acid-dependent flow. Bile acid secretion was also decreased, whereas the outputs of cholesterol and phospholipids and the cholesterol saturation index of bile were unchanged. (14C) erythritol and (14C) sucrose biliary clearances decreased in parallel to bile flow, suggesting that the decrease in bile flow was of canalicular origin and that there was not alteration in the permeability of the biliary system.

Biliary excretion of sulfobromophthalein in isolated perfused livers from normal and spironolactone-treated rats

Bile flow and biliary excretion of sulfobromophthalein (BSP) was examined in isolated perfused livers from normal and spironolactone(SP)-treated rats. BSP biliary excretion contributed to the bile production in both groups. Moreover SP increased BSP biliary excretion but transfer of dye from plasma into liver was not affected.