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  • Kidney
  • Springer  (560)
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  • 1
    ISSN: 1432-1238
    Keywords: Key words Hydroxyethyl starch ; Elimination ; Pharmacology ; Kidney ; Gut
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Hydroxyethyl starch (HES) is mainly eliminated via the kidneys. Any information about extrarenal elimination obtained so far has been either incomplete or contradictory. The objective of this study was to quantify the intestinal excretion of infused HES with a mean molecular weight of 200,000 and a molar substitution of 0.5 (HES 200/0.5) and to compare the reappearance/recovery rate in urine and plasma.¶Design: Prospective clinical study without control group.¶Setting: The study was conducted at the Institute of Hypertension of the Society of Clinical Pharmacology, Vienna, Austria, which is an establishment for research in volunteers.¶Participants: The results of six out of seven healthy male volunteers were appropriate for analysis. One trial subject had to be excluded from the study because of severe protocol violation (mixing of stool and urine samples).¶Interventions and methods: Each volunteer was administered 500 ml of 10 % HES 200/0.5 in a 0.9 % NaCl solution intravenously within 1 h. A gut lavage with 6 l of a polysaccharide free solution was continuously administered from 3 h prior to until 2 h after the HES infusion to facilitate the collection of the samples and to exclude any source of error at analysis. HES was quantified with the hexokinase method.¶Measurements and results: Right from the beginning of the infusion until 10 h after its completion, the cumulative HES excretion with feces (principle parameter) and urine as well as selective plasma volume and HES plasma level were measured. Six and 14 h after the infusion had been completed, the recovery rates of HES in urine were about 30 % and 40 %, respectively, and in plasma about 23 % and 8 %, respectively. By contrast, not more than a kind of “background noise amount” of HES (about 0.2 %) could be recovered in feces ( mean value in % of the infused amount of the substance). Six and 14 h after the infusion had been completed, the total recovery rates of HES were 53 % and 49 %, respectively.¶Conclusion: In a physiologically unimpaired gut HES 200/0.5 is not, or only to an infinitesimal extent, eliminated via the intestine. The question if there is any alternative path to renal excretion for HES still remains to be answered. As the calculated reappearance/recovery rate of HES is only about 50 % of the administered dose, further investigations as to the final fate of HES appear necessary.
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Vein ; Kidney ; CT ; MR imaging ; Inferior vena cava
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 °C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly.
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Gadolinium ; Genitourinary system ; MR imaging ; Kidney ; Renal circulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to demonstrate the feasibility of the absolute renal blood flow quantification using MRI and injection of contrast media. Using a T1-weighted fast gradient sequence following an intravenous bolus injection of Gd-DTPA, dynamic images of the kidney were obtained in patients with well-functioning native kidneys (n = 7) or transplant (n = 9), with significant renal artery stenosis (n = 4) and with renal failure (n = 7). After signal intensity calibration, the absolute renal perfusion was equal to the wash-in slope of the renal transit curve divided by the contrast medium concentration at the peak of the bolus in the aorta. The cortical blood flow was 2.54 ± 1.16 ml/min per gram in well-functioning kidneys decreasing to 1.09 ± 0.75 ml/min per gram in case of renal artery stenosis (p = 0.04) and to 0.51 ± 0.34 ml/min per gram in case of renal failure (p 〈 0.001). These measurements were in agreement with previous results obtained by other methods. A standard MRI imaging sequence and a simple model can provide realistic quantitative data on renal perfusion. This work justifies further studies to compare this model with a gold standard for renal blood flow measurements.
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  • 4
    ISSN: 1432-2277
    Keywords: Key words Ischemia-reperfusion ; Heat shock ; HSP70 ; Heat shock factor (HSF) ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ischemia-reperfusion injury is known to induce the inducible form of the 70 kDa heat shock protein HSP70 i (or HSP72) mainly via rapid activation of heat shock transcription factor 1 (HSF1). However, little is known about the regulation of the HSF1 gene. We therefore studied the time course of HSF1 mRNA transcription and its relation to the expression pattern of the HSP70 i mRNA in the renal cortex, this being the most vulnerable and functionally most important part of the kidney, after different periods of unilateral renal ischemia (10–180 min) and reperfusion (up to 60 min) in male Wistar rats (10 weeks old). Immediately after ischemia there was a significant induction of HSP70 i genes. While HSP70 i expression constantly increased (up to 4-fold) during reperfusion, even to a higher extent with prolongation of ischemia, HSF1 mRNA remained constitutively expressed under all conditions. Thus, we conclude that during ischemia-reperfusion in rat kidneys, the heat shock response is regulated by other means than expressional changes of HSF1.
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  • 5
    ISSN: 1433-0385
    Keywords: Keywords: Carcinoma ; Colon ; Kidney ; Metastasis ; Pancreas ; Schlüsselwörter: Carcinom ; Niere ; Metastase ; Pankreas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Das Nierenzellcarcinom ist eine Tumorentität mit ungewöhnlichen Charakteristika. Eine der Besonderheiten besteht im relativ häufigen Auftreten von Spätmetastasen erst viele Jahre nach der Diagnose und Therapie des Primärtumors. Eine isolierte Metastasierung in das Pankreas wird extrem selten beobachtet. In der Literatur sind bisher nur 96 derartige Fälle beschrieben worden, wobei es sich in 89 Fällen um solitäre Metastasen handelte. Wir berichten über eine 69 jährige Patientin, bei der 2 Metastasen im Pankreas 12 Jahre nach einer Tumornephrektomie auftraten. Die Patientin wurde uns primär wegen eines Zweitcarcinoms im Coecum zugewiesen. In der präoperativen Diagnostik stellte sich eine 4 cm große Raumforderung im Corpus pancreatis dar. Intraoperativ erfolgte die histologische Diagnosestellung einer Pankreasmetastase des Nierencarcinoms. Neben der Rechtshemicolektomie wurden eine Pankreaslinksresektion und Splenektomie ausgeführt. Die histologische Aufarbeitung des Pankreaspräparats erbrachte den Befund einer zweiten Nierenzellcarcinommetastase. Eine radikale chirurgische Therapie ist für die weitere Prognose von großer Bedeutung. Adjuvante Therapiemöglichkeiten werden diskutiert. Aufgrund der Möglichkeit des Auftretens von Spätmetastasen noch nach Jahren ist eine sorgfältige und langfristige Nachbeobachtung für Patienten mit Nierenzellcarcinom unumgänglich.
    Notes: Abstract. Isolated pancreatic metastases from renal-cell carcinomas (RCC) are extremely rare. Only 96 cases of clinically diagnosed renal-cell carcinoma metastatic to the pancreas have been reported in the world literature, and 70 of the patients (including ours) underwent a definitive surgical resection. In many cases the time between the nephrectomy and diagnosis of metachronous metastases is reported to exceed 10 years. Therefore, the initial diagnosis may be overlooked when there is a prolonged disease-free interval. When it does occur simultaneously or metachronously, aggressive surgical resection, when possible, seems to be the most effective treatment for this metastatic lesion. Surgical resection can provide long-term survival in selected cases. We present the case of a 69-year-old woman in whom two pancreatic metastases were treated by a left-sided subtotal pancreatectomy with splenectomy, 12 years after radical nephrectomy for a RCC. The patient simultaneously presented with both a mass in the body of the pancreas and a right-sided colon cancer. Thus, the diagnosis of pancreatic metastasis of colon cancer was suspected initially. Both tumors were radically resected, and histological examination revealed two pancreatic metastases from the previous RCC. In the world literature this report represents the eighth case of multiple pancreatic metastases due to RCC. It illustrates a rare indication of pancreatic resection because of pancreatic metastasis. The need for prolonged follow-up of patients is emphasized. The few reports on surgically treated pancreatic metastases from RCC are reviewed after the presentation of this case.
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  • 6
    ISSN: 1432-2307
    Keywords: Key words Intravascular papillary endothelial hyperplasia ; Kidney ; Child ; Masson’s hemangioma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion which is thought to represent an unusual form of organizing thrombus. A case of IPEH in the kidney of a 7-year-old girl is described. She suffered from intermittent flank pain and gross hematuria for 6 months. On radiological examinations, well-defined hypoechoic lesions were identified in the medullary portion of the left kidney. A well-demarcated, sponge-like mass was noted on gross examination. It was an intravascular mass lined by a fibrous capsule of various thicknesses. It was characterized by papillary fronds lined with benign endothelial cells. This is the first description of a renal IPEH in a child.
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  • 7
    ISSN: 1279-8509
    Keywords: MALT lymphoma ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 8
    ISSN: 1432-198X
    Keywords: Key words Hutchinson-Gilford syndrome ; Progeria ; Kidney ; Nephrosclerosis ; Collagen ; Aging ; Adenoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  It has been suggested that progeria, a congenital disorder associated with clinical features that resemble premature aging, may be the result of a connective tissue abnormality. Although to date the clinical and pathologic features for 14 autopsied cases of progeria have been reported, details as to the renal changes in progeria are scanty. We investigated the histological features from a male and female with progeria who died aged 11 years and 20 years respectively. In our young male subject there was no glomerulosclerosis, while the kidney from the older subject showed focal renal scarring with focal glomerulosclerosis and associated tubular atrophy. Two small papillary adenomas were present within the renal cortex of the latter subject. In both cases non-sclerotic glomeruli were moderately enlarged with expansion of mesangial matrix. Immunohistochemical detection of collagens showed absence of collagen I and III within the mesangium of non-sclerotic glomeruli, while there was moderate to marked expression of collagen IV, V and VI. Collagen V is thought to be involved in matrix assembly while collagen VI probably has a regulatory role in extracellular matrix development and these are either not seen or are very weakly expressed in normal renal mesangium. The distribution of collagen within the mesangium of progeria kidney is evidence in support of the concept that progeria is a primary connective tissue disorder.
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  • 9
    ISSN: 1432-2013
    Keywords: Key words Human ; Liver ; Kidney ; Tissue distribution ; Immunofluorescence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The mRNA of a novel human cathepsin P is expressed at high levels in lung, liver and heart. Using antibodies raised against recombinant cathepsin P produced in Escherichia coli, a single protein band of 33 kDa was detected by immunoblotting an extract of human liver. By immunofluorescence, positive signals were observed in hepatocytes and Kupffer cells of liver, and the distal tubule cells of kidney showing mainly perimembranous distribution, indicating a role, as yet unknown, for this novel putative protease that is distinct from other cathepsins of the papain family.
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  • 10
    ISSN: 1432-198X
    Keywords: Key words Biopsy ; Kidney ; Complications ; Percutaneous ; Internet ; e-mail
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Technological improvements have reduced the frequency of complications in children receiving a percutaneous renal biopsy. No study has systematically compared the safety of open and percutaneous kidney biopsy. Yet many nephrologists consider a single native kidney an absolute contraindication to percutaneous biopsy. We have established an international registry of single native kidney biopsies in children and we now report our early results. Eight biopsies are included. Seven patients had percutaneous biopsies and one an open biopsy. None of the patients had major complications, and adequate tissue was obtained from all. Our limited experience indicates that the presence of a single native kidney is not an absolute indication for an open approach. We encourage our colleagues to report to the international registry in order to further document the safety of percutaneous biopsy of the single native kidney in children.
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  • 11
    ISSN: 1573-2584
    Keywords: Haemorrhagic complications ; Kidney ; Percutaneous lithotripsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 698 patients treated for nephrolithiasis with the application of percutaneous lithotripsy were analysed. In 32 cases increased bleeding in the course of the procedure occurred. It was controlled without surgery with blood transfusion, constant renal saline flow maintenance, electrocoagulation, kidney parenchyma pressing with thick drain and approach canal tamponade. In one case the approach to the kidney was obtained surgically and the kidney parenchyma was stitched with haemostatic suture. One patient required selective embolization due to kidney haemorrhage after nephrostomy drain removal.
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  • 12
    ISSN: 1573-2584
    Keywords: Diagnosis ; Echinococcosis ; Kidney ; Retroperitoneum ; Treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Four patients (3 male, 1 female) with isolated renal and 1 female patient with isolated retroperitoneal cysts were reviewed. The mean age of the patients was 46 (25–64). The most common presenting symptom was pain. Two cases were discovered incidentally by the observance of renal calcification onabdominal x-ray. Indirect hemagglutination test was positive in all cases but eosinophilia was present only in 1 (20%) case. Nephrectomy was performed to 1 patient who presented with hydaturia and had a large communicating cyst involving most of the kidney. Total cystectomy was performed in other renal cysts. Total cystectomy with wide excision of the involved muscle was performed to the retroperitoneal hydatid cyst.Patients were followed by an average of 23.8 (9–50) months with indirect hemagglutination test and USG. No evidence for recurrence was found up to date.
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  • 13
    ISSN: 1573-2584
    Keywords: Laparoscopy ; Kidney ; Retroperitonealspace ; Hydronephrosis ; Nephrectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hugely dilated kidneys can sometimes present as abdominal masses. These kidneys are invariably non-functioning and are managed by nephrectomy.We describe a case of massive kidney containing 12.5 litres on fluid which was managed by retroperitoneoscopic nephrectomy. The patient was a 24-year-old male who presented with a huge abdominal mass, anorexia and weight loss. Laparoscopic surgery for such a large kidney has not been previously reported. We discuss salient features of the procedure and elaborate on the modifications required in the case of significantly enlarged kidneys.
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  • 14
    ISSN: 1432-198X
    Keywords: Key words Apoptosis ; Ceramide ; Development ; Kidney ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Ceramide is emerging as an important hydrophobic sphingolipid involved in cell differentiation and apoptosis. Since apoptosis plays a significant role in cellular remodeling during renal morphogenesis, we measured ceramide content and apoptosis in the fetal (18 days gestation), neonatal (3, 7, and 14 days postnatal), and adult rat kidney. In addition, to determine whether developmental changes in ceramide content are tissue-specific, we compared renal ceramide content with that in lung and liver. Ceramide was measured by the diacylglycerol kinase assay, and apoptosis was determined by the TUNEL technique. Renal ceramide content fell over 100-fold from the fetus to the 7th postnatal day. Renal apoptosis paralleled ceramide content, with a greater than 300-fold decrease in apoptosis from fetal to adult life. Ceramide content of the lung and liver was significantly less than that of the kidney, and changed less with maturation. We conclude that maturational changes in ceramide content are tissue-specific, and that the high rate of apoptosis in the developing kidney may be related to the elevated ceramide content.
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  • 15
    ISSN: 1437-7799
    Keywords: Key words Chemokine ; Chemokine receptor ; Kidney ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The presence of leukocytes in the diseased kidneys is a hallmark of almost any kind of renal disease. Activated leukocytes are implicated in playing a crucial role in the pathogenesis of renal diseases. Recent investigations of the pathophysiological roles of chemokines and their cognate receptors have shed light on the detailed molecular mechanisms of leukocyte trafficking and activation in the diseased kidneys. This study summarizes findings that: (1) chemokine/chemokine receptor systems may be essentially involved in the pathogenesis of phase-specific renal disorders, (2) the measurement of urinary levels of chemokines may be clinically useful for monitoring different disease phases and activities in human renal diseases, and (3) interventions in chemokine/chemokine receptor systems may have potential as particular immunotherapeutic strategies to combat specific phases of renal diseases. Further investigations of anti-chemokine therapies for renal diseases will be required before clinical application is feasible.
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  • 16
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    Rheologica acta 39 (2000), S. 409-417 
    ISSN: 1435-1528
    Keywords: Key words Squeezing flow ; Rheology constitutive model ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Physics
    Notes: Abstract Large-amplitude oscillatory squeezing flow data are reported for a complex biological material, which is highly shear-thinning in oscillatory shear flow. This soft tissue has a linear viscoelastic limit at a strain of approximately 0.2%. The oscillatory squeezing flow data at large strain are analyzed using two constitutive models: a bi-viscosity Newtonian model, and a non-linear Maxwell model. It is found that although both models may have the same response in shape, the later matches with our non-linear experimental data better. It is also concluded that the non-linear response of the material in large amplitude oscillatory flow is mainly due to the shear thinning of the material.
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  • 17
    ISSN: 1432-1246
    Keywords: Key words Case report ; Kidney ; Brain ; Selenium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To examine mercury (Hg) and selenium (Se) levels in autopsy samples from a thermometer worker who had been exposed over a long period to, and monitored for, mercury vapor. Case report: Hg and Se levels were determined using radiochemical neutron activation analysis in a worker who had commited suicide 4 weeks after the end of 14 years of exposure and in an unexposed age-matched referent. Histochemical staining of cerebellum was performed according to the method of Danscher and Schrøder. Results: The Hg concentrations (wet weight) were 25 μg/g in the kidney cortex, 1.2 μg/g in the liver, 0.72 μg/g in the lung, 0.025 μg/g in the testis, and 0.014–0.018 μg/g in the cerebellum (gray matter, dentate nucleus, and white matter). The Se level in the kidney cortex was high, 4.6 μg/g, whereas the concentration detected in the other tissue samples was normal. Light microscopy of the cerebellum was normal, and no histochemical staining for mercury was observed. Autopsy samples from the referent showed low Hg and Se levels consistent with other reports. Conclusions: The observed kidney-Hg, which was 50–100 times higher than that occurring in the general population, is in agreement with previous sparse data from ongoing occupational exposure. The high Se level detected in the kidney indicates coaccumulation with mercury. The low Hg concentration found in the cerebellum was unexpected, since some reports have shown much higher brain-Hg long after the cessation of exposure.
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  • 18
    ISSN: 1432-1084
    Keywords: Key words: Helical CT ; Dynamic MR imaging ; Kidney ; Inflammation ; AIDS ; Aspergillosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Renal insufficiency or allergic reactions for X-ray contrast agents are frequent limitations in immunocompromised hosts such as neutropenic or AIDS patients. Due to a better tolerance of contrast agents in MRI, this technique is well suited for investigation of parenchymal organs. We demonstrate an allergic AIDS patient who presented with fever and flank pain. At sonography, anechoic renal lesions were supposed to be non-complicated cysts; however, on T2-weighted MRI, the center was of high signal. Dynamic contrast-enhanced MRI of the kidneys demonstrated an enhancing rim with ill-defined margins. The lesions were supposed to be multiple bilateral abscesses. Due to the multiple dynamic contrast series, a delayed enhancement of renal parenchyma was detectable adjacent to the lesion. This was suggested as accompanying local pyelonephritis and an infectious etiology became more reliable. Aspergillus fumigatus was identified by CT-guided biopsy as the underlying microorganism. The MR appearance of this manifestation has not been described previously.
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  • 19
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Magnetresonanzangiographie ; Magnetresonanzurographie ; Niere ; Phasenkontrast ; Schnelle Bildgebung ; Key words Magnetic resonance angiography ; Magnetic resonance urography ; Kidney ; Phase-contrast ; Fast imagin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aim: New diagnostic strategies for evaluation of the kidney by fast MR imaging techniques. Material and methods: A comprehensive morphologic and functional evaluation of the kidney is proposed using fast MR imaging of renal morphology, multiphase 3D gadolinium MR angiography, MR urography and MR flow measurements. A single MR examination is designed to grade renovascular disease and assess the hemodynamic and functional significance, detect and characterize renal lesions and evaluate the urinary tract. Results: The combined analysis of morphologic and functional data allows reliable assessment of renal artery stenosis, benign and malignant renal masses and diseases of the renal collecting system and ureters, as well as congenital abnormalities in good agreement to the results of conventional imaging modalities. The improved tissue contrast and additional functional information compensates for the disadvantage of a lower spatial resolution. Conclusion: Combined morphologic and functional MR examination represents a reliable, non-invasive and cost-effective alternative imaging modality for comprehensive diagnostic evaluation of renal disease.
    Notes: Zusammenfassung Fragestellung: Darstellung neuer diagnostischer Möglichkeiten im Bereich der Niere mittels schneller Magnetresonanz (MR)- Bildgebung. Methodik: Vorgestellt wird ein kombiniertes morphologisches und funktionelles Untersuchungskonzept bestehend aus schneller morphologischer Bildgebung, multiphasischer 3D-Gadolinium-MR-Angiographie, MR-Urographie und MR-Flußmessung. In einer einzigen MR-Untersuchung sollen vaskuläre Erkrankungen erfaßt, eingestuft und auf ihre hämodynamische und funktionelle Signifikanz überprüft werden, renale Läsionen detektiert und differenziert sowie die Harnabflußwege beurteilt werden. Ergebnisse: Durch Integration der gewonnenen morphologischen und funktionellen Daten lassen sich Nierenarterienstenosen, benigne und maligne renale Tumoren, Harnabflußstörungen und kongenitale Fehlbildungen mit ähnlicher Genauigkeit wie in den konventionellen radiologischen Verfahren erfassen. Der Nachteil der geringeren räumlichen Auflösung kann dabei weitgehend durch den besseren Gewebekontrast und die zusätzliche, funktionelle Information kompensiert werden. Schlußfolgerung: Ein kombiniertes MR-Untersuchungskonzept stellt ein zuverlässiges, nicht-invasives und kosteneffektives Verfahren zur umfassenden diagnostischen Abklärung der Niere dar.
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  • 20
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Kinderradiologie ; Niere ; Ableitende Harnwege ; Key words Pediatric radiology ; Kidney ; Urinary tract
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Imaging flow charts differ in pediatric and general radiology. The reasons are: different illnesses, different consequences arising out of imaging results and different sequence of imaging methods. Ultrasound is always the first imaging method of the urinary tract in infancy and childhood starts with ultrasound with the exception of severe abdominal trauma which is investigated by computertomography. The decision „normal or abnormal” is possible using ultrasound in the most pediatric cases. The diagnostic value and significance of ultrasound in infancy and childhood is far better than in general radiology because of the higher resolution of the high-frequency units taken. The result of the ultrasound examination should be the basis for the following imaging procedures. We will describe diagnostic flow charts starting with three important clinical symptoms: Prenatal pathology, urinary tract obstruction and urinary tract infection.
    Notes: Zusammenfassung Die diagnostischen Entscheidungsbäume in der Pädiatrischen Radiologie unterscheiden sich oft erheblich von denen der Erwachsenenradiologie. Die Ursache hierfür besteht im unterschiedlichen Erkrankungsspektrum, in den unterschiedlichen therapeutischen Konsequenzen, die aus einem erhobenen Befund gezogen werden und auch im unterschiedlichen Stellenwert der bildgebenden Verfahren. Abgesehen vom schweren Abdominaltrauma, das primär mittels Computertomographie (CT) untersucht werden muß, beginnt jede Nieren- und Harnwegsuntersuchung mit einer Ultraschall(US)-untersuchung Die Entscheidung, ob ein normaler oder ein pathologischer Befund der Bildgebung vorliegt, ist fast immer mittels US zu treffen. Die Aussagekraft und damit der diagnostische Stellenwert des US unterscheiden sich infolge der Möglichkeit, höherfrequente Schallsysteme mit exzellenter Auflösung zu verwenden, erheblich von der Situation im Erwachsenenalter. Erst in Kenntnis des sonographischen Befundes wird der Ablauf der weiteren Bildgebung (Szintigraphie, Röntgen, Magnetresonanztomographie (MRT) und sehr selten CT) festgelegt. Nachfolgend sollen, ausgehend von den wichtigsten klinischen Symptomen, die diagnostischen Flußschemata für drei häufige Standardsituationen in der Kinderradiologie dargestellt werden: Pränatal erkannte Harnwegspathologie, Harntransportstörung und Harnwegsinfektion.
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  • 21
    ISSN: 1432-2277
    Keywords: Key words Machine preservation ; Marginal donor ; Kidney ; Calcium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pulsatile preservation offers the advantage of pretransplant assessment of donor kidneys. Selected electrolyte concentrations of machine perfusate were measured over time in order to: (1) describe electrolyte changes in perfusate during the pulsatile preservation of expanded-criteria donor (ECD) kidneys, and (2) to assess the prognostic significance of these characteristics to early graft function. One hundred and fifty ECD kidneys were preserved in our laboratory between 1 January 1995 and 11 January 1997. ECD kidneys were defined as those requiring pretransplant biopsy. Kidneys were grouped by the presence or absence of delayed graft function (DGF), and perfusion parameters were measured every hour during pulsatile perfusion. All kidneys were preserved by continuous hypothermic pulsatile perfusion using Belzer II solution. Renal flow is decreased and renal resistance is increased in the presence of DGF in machine-preserved ECD kidneys. In addition, ionized calcium concentration of the machine perfusate is significantly elevated in the DGF group compared with the No DGF group (0.091 vs 0.054, P = 0.0016). The incidence of DGF is significantly lower in the ECD kidney. Among the pretransplant variables of donor characteristics, perfusion parameters and histology, perfusion parameters are highly predictive of early graft function. In addition, we found that ionized calcium concentration in the perfusate is significantly elevated in kidneys exhibiting DGF, which may have implications for assessing the suitability of donor kidneys for transplantation.
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  • 22
    ISSN: 1432-2277
    Keywords: Key words Non-heartbeating ; Ischemic ; Kidney ; Dextran ; Effect ; Canine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The use of non-heartbeating (NHB) donor kidneys has led to the search for new methods of viability-testing. We investigated, in a canine model, the relationship between the filtration of dextran 12,000 into urine and a certain period of warm ischemic time (WIT) during machine perfusion. Twenty-four canine kidneys were divided into three groups, sustaining 0 min, 30 min or 60 min of WIT. After cooling and flushing, the kidneys were perfused on a perfusion machine for 8 h. Three hundred milligrams of dextran 12,000 was added to the perfusate. In the perfusate, dextran and lactate dehydrogenase (LDH) concentrations were measured. Dextran concentrations were also analysed in urine. Intrarenal vascular resistance (IRR) was calculated from pressure and flow characteristics. The 30WIT group showed a higher dextran excretion rate than the other two groups. IRR and LDH measurements showed lower levels in the ischemic groups compared with the control group. Dextran 12,000 is not suitable as a viability test but does show interesting results regarding the low LDH and IRR levels in the ischemic groups.
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  • 23
    ISSN: 1432-0568
    Keywords: Key words Rat ; Papilla ; Kidney ; Lipid ; Fluorescent dyes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Renal medullary interstitial cells are a prevalent and characteristic feature of the inner medulla of the kidney, but the physiological significance of this is unclear. We have developed a method for imaging renal medullary interstitial cells in situ by loading the cells with fluorescent dyes and monitoring their distribution using confocal microscopy. The pH-sensitive probe 2’7’-bis-(carboxyethyl)-5-(and-6)-carboxyfluorescein acetoxymethyl ester was used as a marker of cytoplasmic volume and therefore of cell morphology. Nile Red was used to demonstrate the presence of renal medullary interstitial cell lipid droplets. Papillae were excised from 100 g Sprague-Dawley rats and loaded with the appropriate dye. The papillae were then examined using a Leica TCS 4D confocal microscope and oil immersion lenses. Fluorescence was excited (488 nm) using an argon laser and emission wavelengths above 515 nm collected using a long pass filter. Images of papillae loaded with 2’7’-bis-(carboxyethyl)-5-(and-6)-carboxyfluorescein acetoxymethyl ester clearly demonstrate a ladder-like arrangement of renal medullary interstitial cells. More detailed examination revealed the presence of cytoplasmic extensions that appear to make close contact with adjacent loops of Henle. Three-dimensional reconstructions of serial sections revealed spiral arrangements in some ladders of renal medullary interstitial cells. Nile Red-labelled lipid droplets of 0.5–1.0 µm diameter were located throughout the cytoplasm of renal medullary interstitial cells and especially within the cytoplasmic extensions. These experiments highlight the ability of confocal microscopy to allow investigation of renal medullary interstitial cells in situ.
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  • 24
    ISSN: 1430-3418
    Keywords: Aldose reductase ; Aminoguanidine ; Ascorbic acid ; Kidney ; Sorbinil ; Sorbitol ; Zopolrestat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Aldose reductase inhibitors (ARI) have been developed to reduce the conversion of high glucose levels to sorbitol, an important renal osmolyte that may rise to damaging levels in many tissues during diabetic hyperglycemia. Ascorbic acid (AA) and aminoguanidine (AMG) have also been reported to reduce sorbitol levels in diabetes: AMG in rat kidney, and AA in guinea pig lens and human erythrocytes. We tested the effects of AMG, AA, and Pfizer’s sorbinil and zopolrestat for 48 h on primary rat renal cell cultures, established from renal inner medullas of male Wistar rats 8–12 weeks old. Osmolyte contents in scraped cells were analysed by HPLC: 100 µM sorbinil and 20 µM zopolrestat decreased sorbitol levels (P〈0.05 and P〈0.001, respectively), and increased the content of another osmolyte, betaine (P〈0.01 and 〈0.01, respectively). The quantity of ATP in cells was unchanged, suggesting no short-term problems. In contrast, 10 mM AMG and 10 mM AA had no effect on sorbitol contents (in contrast to some previous studies). We then tested aldose reductase (AR) activity in crude homogenates of rat lens and renal inner medulla, with glyceraldehyde substrate. For both tissues, 5 µM zopolrestat inhibited AR activity by 92–94% (P〈0.002); 10 mM AA by 16–20% (P〈0.02); and 10 mM aminoguanidine by 22–24% (P〈0.03). We conclude that AMG and AA are not readily usable as inhibitors of renal AR.
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  • 25
    ISSN: 1432-0738
    Keywords: Key words Chloroform toxicity ; Metabolism ; B6C3F1 mice ; Liver ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The time course of some biochemical changes in the liver and in the kidney was studied in B6C3F1 male mice dosed with a single i.p. injection of 150 mg/kg body weight (b.w.) CHCl3. Hepatic and renal microsomal cytochrome P450 (P450) content and some related monooxygenase activities, CHCl3 oxidative and reductive metabolism, cytosolic reduced glutathione (GSH) content and serum markers of nephrotoxicity were measured. In the liver no biochemical changes were produced up to a week after chloroform treatment. On the contrary, the drug-metabolizing enzyme system in the kidney was dramatically and rapidly inactivated by chloroform treatment. Maximum loss of GSH (50%), P450 (80%) and of different enzymatic activities, including CHCl3 bioactivation, occurred during the first 5 h. These biochemical alterations are early effects, not secondary to morphological tissue changes. Kidney parameters, altered by chloroform treatment, returned to control values at different times: renal function markers became normal in 48 h; GSH levels were recovered at 96 h and the drug-metabolizing enzyme activities at longer times. The present results clearly show that repeated daily doses of chloroform, as those used in carcinogenicity tests, find renal tubular cells not at their physiological status, due to the changes produced by the first chloroform dose. Therefore the similarity in P450-dependent chloroform metabolism shown in vitro by hepatic and renal microsomes from untreated B6C3F1 male mice or in vivo in animals treated once, is lost during repeated treatments. These features should be considered in understanding the different susceptibility of the liver and the kidney to chloroform-induced tumours.
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  • 26
    ISSN: 1434-0879
    Keywords: Keywords Ischemia-reperfusion ; Heat shock ; HSP70 ; Kidney ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ischemia-reperfusion injury in the kidney is known to cause induction of the inducible form of the 70 kDa heat shock protein HSP70i (or HSP72). However, knowledge of the expressional regulation of the two coding genes for HSP70i –HSP70-1 gene and HSP70-2 gene – is very limited. We investigated the time course of HSP70-1 and -2 mRNA expression and its relation to cellular ATP levels in the renal cortex after different periods of unilateral warm renal ischemia (10–60 min) and reperfusion (up to 60 min) in 10-week-old male Wistar rats. Immediately after ischemia there was a significant induction of both HSP70i genes. While HSP70-1 expression constantly increased (up to 4-fold) during reperfusion, even to a higher extent with prolongation of ischemia, HSP70-2 mRNA – which was generally expressed at a far lower level than HSP70-1 mRNA – was strongly induced (3-fold) during reperfusion only after brief periods (10 min) of ischemia. Cellular ATP levels rapidly dropped to 5% with ischemia and the pattern of recovery during reperfusion significantly depended on the duration of the ischemic period, thus showing a good relation with the heat shock (protein) gene expression. We conclude that HSP70-2 is the more sensitive gene with a lower activation threshold by mild injury, while the HSP70-1 gene mediates the major response of heat shock protein induction after severe injury.
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  • 27
    ISSN: 1432-1238
    Keywords: Key words Renal replacement therapy ; Hemodialysis ; Hemofiltration ; Hemodiafiltration ; Dialysis ; Ultrafiltration ; Kidney failure ; acute ; Multiple organ failure ; Kidney ; Blood urea nitrogen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine whether the timing of initiation of continuous renal replacement therapy (CRRT) affects outcome in patients with post-traumatic acute renal failure (ARF). Design: The medical records of patients treated with CRRT for post-traumatic ARF were retrospectively reviewed. Chi-square testing was used to test frequencies between groups, and Student's t -test was used to compare means. Setting: A Level I trauma center. Patients: 100 Adult trauma patients treated with CRRT for ARF from 1989 to 1997. Patients were characterized as “early” or “late” starters, based upon whether the blood urea nitrogen (BUN) was less than or greater than 60 mg/dl, prior to CRRT initiation. Results: The mean BUN of the early and late starters was 42.6 and 94.5 mg/dl, respectively (p 〈 0.0001). CRRT was initiated earlier in the hospital course of early starters compared to late starters (hospital day 10.5 vs 19.4, p 〈 0.0001). Creatinine clearance prior to CRRT did not differ statistically between the two groups. No significant difference was found between early and late starters with respect to Injury Severity Score, admission Glasgow Coma Scale, presence of shock at admission, age, gender distribution, or trauma type. Admission laboratory values including BUN, serum creatinine, lactate, and bilirubin as well as fluid and blood requirements in the first 24 h were statistically the same for the two groups, suggesting a similar risk of developing renal failure. Survival rate was significantly increased among early starters compared to late starters (39.0 vs 20.0 %, respectively, p = 0.041). Conclusions: This retrospective review indicates that an earlier initiation of CRRT, based on pre-CRRT BUN, may improve the rate of survival of trauma patients who develop ARF.
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  • 28
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Spiral-CT ; Nieren ; Indikationen ; Applikationen ; Key words Spiral CT ; Kidney ; Indications ; Applications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The introduction on spiral computed tomography (spiral CT) has vastly enriched the methodological diversity of computer-tomographic scans. It allows for the recording of different perfusion or excretion stages of the kidney parenchyma of the urine draining paths by carrying out long-distance, phase-identical multiple examinations of the retroperitoneum. The description of the findings which are characterized by their local and contrasts behavior is possible. The following report describes the indications and technological process of kidney spiral CT using kidney-typical intravenous contrast media. Special emphasis is put on the advantages and limits of multiple phase spiral CT. Decisive preconditions are: 1. specific clinical query, 2. selection of the corresponding phase contrasts of the kidneys and uretra or bladder, 3. exact technical and temporal adjustment of the acquisition parameters. Scanning times are in the range of seconds. The overall examination can be carried out quick and without any major strain on the part of the patient. A sound proof and a general differentiation of focal kidney lesions can be derived from the acquired data. This is also true for kidneys and ureters findings. Bladder findings can be localized and differentiated according to stage. More than two „spiral acquisitions” should be carried out with re- straint taking exposure to radiation into account. Due to the sound registration of focal lesions, its capability of reproduction and its short-time examination, the spiral CT of the kidneys can be said to be the most effective current scanning method of the retroperitoneum following clinical examinations and sonography.
    Notes: Zusammenfassung Mit der Einführung der Spiral-Computertomographie (Spiral-CT) sind die methodischen Möglichkeiten der computertomographischen Schnittbilddiagnostik erheblich erweitert worden. So können durch länger- streckige, phasenidentische Mehrfachuntersuchungen des Retroperitoneums unterschiedliche Perfusions- bzw. Ausscheidungsphasen des Nierenparenchyms und der harnableitenden Wege erfaßt werden. Die Darstellung von Befunden, die sich durch ihre Lokalisation oder ihr Kontrastverhalten unterscheiden, ist somit möglich. Im vorliegenden Beitrag werden die Indikationen und technische Durchführung der Nieren-Spiral-CT unter Einsatz nierengängiger intravenöser Kontrastmittel beschrieben. Besonders wird auf die Vorteile und die Grenzen der Mehrphasen-Spiral-CT bei der Diagnostik fokaler Nierenläsionen eingegangen. Entscheidende Voraussetzungen sind: 1. Gezielte klinische Fragestellung, 2. Auswahl der entsprechenden Phasenkontrastierung der Nieren und Ureteren bzw. der Harnblase und 3. exakte technische und zeitliche Abstimmung der Akquisitionsparameter unter Berücksichtigung der Perfusionsverhältnisse entsprechender fokaler Nierenveränderungen. Die Scanzeiten liegen im Bereich von Sekunden. Die Gesamtuntersuchung ist schnell und für den Patienten wenig belastend durchführbar. Die Untersuchungsergebnisse erlauben vor allem einen treffsicheren Nachweis und eine weitgehende Differenzierung fokaler Nierenläsionen. Nierenbecken- bzw. ureterständige Befunde sind erfaßbar. Blasenbefunde können lokalisiert und stadienabhängig eingeordnet werden. Zurückhaltung ist bei mehr als 2 „Spiralakquisitionen” im Hinblick auf die Strahlenbelastung geboten. Die Spiral-CT der Nieren stellt aufgrund ihrer sicheren Erfassung fokaler Läsionen, ihrer Reproduzierbarkeit und der schnellen Untersuchungsführung derzeit das effektivste Schnittbildverfahren des Retroperitoneums dar. Nach klinischer Untersuchung und Sonographie ist die Nieren-CT entscheidender Bestandteil der Basisdiagnostik unklarer Befunde des Retroperitoneums.
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  • 29
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Nierentumor ; Embolisation ; Niere ; Angioplastie ; A. renalis ; Stents ; Nierentrauma ; Blutung ; Key words Renal carcinoma ; Tumor embolization ; Kidney ; Angioplasty ; Stent ; Renal artery ; Renal trauma ; Bleeding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary For imaging of renal pathology a broad spectrum of radiologic diagnostic procedures are available which are, sometimes and particularly more recently, competing among each other in their diagnostic yield and relevance. For tumorous lesions ultrasound, computed tomography and magnetic reso-nance imaging are performed predominantly. Angiography is no longer required with the exception of highly selected cases and in some specific preoperative workup requirements. Until recently, catheter based digital subtraction angiography has been consid- ered as gold standard. However, non-invasive techniques such as CT-angiography and MR-angiography are evolving parallel to their quantum leap of resolutions and readiness to use. Nevertheless, well accepted criteria for quality assessement of these new modalities are still lacking. More comparison studies are urgently warranted. Despite the availability of ultrashort pulse sequences applying the T1 relaxation reduction effect of gadolinium enhanced MR techniques overestimation of renal artery stenosis still po-ses a substantial problem. Renal intervention implies a variety of procedures such as plain angioplasty, stent placement, embolization of traumatic and both benign and malignant tumors. These methods have emerged over the last two decades from a more experimental nature to a fully accepted treatment option. When renal artery angioplasty is embedded in an aggressive approach including stenting as an adjunct for more complex cases, renal ostial lesions and a well organized follow-up regimen its therapeutic potential for treatment of renal insufficiency, malignant hypertension, for organ preservation bears a very high potential. Provided adequat periinterventional drug regimen restenosis rates may be as low as 10%. In highly selected cases capillary embolization might be used as an alternative to nephrectomy with a similar clinical outcome. Particularly the development of superselective small caliber embolization catheters parallel to further refinement of embolization material has aided to use superselective occlusion techniques in benign vascular lesions and renal trauma.
    Notes: Zusammenfassung In der Diagnostik von pathologischen Veränderungen der Nieren konkurrieren die Katheterangiographie, der Ultraschall, die Computertomographie und die Kernspintomographie. In der Abklärung renaler Raumforderungen stehen die Schnittbildverfahren heute im Vordergrund. In der Diagnostik von Nierenarterienstenosen ist die Angiographie bis heute der Goldstandard. Die weniger invasiven angiographischen Techniken der CT und der MRT sind in aufwendigen Studien der Angiographie der Nierenarterien ebenbürtig, es mangelt jedoch insbesondere für die immer häufiger zum Einsatz kommende MR-Angiographie an verbindlichen Qualitätskriterien. In der interventionellen Radiologie der Nieren sind die angiographischen Techniken der Nierenarterienangioplastie inklusive der Stentimplantation und die Embolisationstechniken ausgereift. Die klinischen Ergebnisse können gut gegen die der operativen Verfahren bestehen. Die interventionellen Verfahren haben somit ihren festen Platz im Spektrum der modernen minimal invasiven Medizin.
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  • 30
    ISSN: 1432-2161
    Keywords: Key words Extraskeletal myxoid chondrosarcoma ; Metastasis ; Kidney ; Pancreas ; Chemotherapy ; Knee
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Extraskeletal myxoid chondrosarcoma is an uncommon neoplasm, accounting for less than 2% of all soft tissue sarcomas. It affects adult males with a median age in the fifth decade at the time of diagnosis. The tumor usually arises in the deep soft tissues, especially in the lower extremities. Patients present with a gradually enlarging mass that may or may not be associated with pain. This report describes a 25-year-old man who initially presented with a 4- to 5-year history of right knee pain and an enlarging mass in the right knee. Evaluation revealed a cartilaginous neoplasm with no evidence of metastatic disease. The tumor was widely excised and an allograft reconstruction was performed. The patient was closely followed with an eventual above the knee amputation for recurrent myxoid chondrosarcoma. At 34 months, retroperitoneal metastases were noted on abdominal CT. The patient underwent a left radical nephrectomy, renal vein thrombectomy and enucleation of the mass in the right kidney, distal pancreatectomy, and splenectomy. The patient received postoperative chemotherapy. Forty-eight months after initial diagnosis, the patient was found to have recurrent abdominal and retroperitoneal lesions. At 64 months, the patient died from complications of extraskeletal myxoid chondrosarcoma.
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  • 31
    ISSN: 1432-2013
    Keywords: Key words Intestine ; Kidney ; Lithium ; Natriuresis ; Sodium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The effects on renal sodium excretion of giving lithium chloride (LiCl; 0.75 mmol per kg body mass) by gavage or intravenously were investigated. The experiments were carried out on Wistar-Kyoto (WKY) or spontaneously hypertensive (SHR) rats in metabolic cages. The rats had been on a low-salt diet for 4 days. Urine excretion of water, sodium and potassium was followed before and for 24 h after giving LiCl. An oral dose of LiCl evoked a more pronounced renal sodium excretion in either strain of rat as compared to that following intravenous administration, in agreement with previous observations of the effects of giving sodium chloride. Choline chloride (1.5 mmol per kg body mass) given by gavage to WKY rats or SHR evoked no change in the renal excretion of sodium. Based on the results of the present study and on observations reported in the literature, we propose that the intestinal tract contains a sodium ”sensor”, which upon activation releases a natriuretic factor to cause renal sodium excretion. The present results indicate that the proposed ”sensor” is sensitive to lithium but not chloride ions.
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  • 32
    ISSN: 1432-2013
    Keywords: Key words Calcium-sensing receptor ; CTAL ; Cytosolic calcium ; Kidney ; Phospholipase C ; V1a receptor ; RabCaR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The recently cloned rabbit kidney Ca2+-sensing receptor (RabCaR) was functionally characterized in microperfused rabbit cortical thick ascending limb (CTAL) segments. Reverse transcriptase polymerase chain reaction (RT-PCR) confirmed that this nephron segment contains mRNAs coding for the RabCaR. Elevation of the extracellular Ca2+ concentration ([Ca2+]e) from 1 to 5 mmol l–1 induced an increase in the fluorescence emission ratio (R), thus reflecting an increase in intracellular Ca2+ activity ([Ca2+]i). This increase was inhibited by verapamil, nifedipine and SKF 96365, and potentiated by a previous application of Bay K 8644. Neither verapamil nor Bay K 8644 modified the resting [Ca2+]i. This suggests that the basolateral Ca2+ influx induced by a high [Ca2+]e occurs via verapamil- and dihydropyridine-sensitive Ca2+ channels, which are not open under resting conditions. In contrast to that evoked by antidiuretic hormone (ADH), the [Ca2+]i increase induced by a high [Ca2+]e did not result from an accumulation of inositol phosphates. Neomycin, Gd3+, Mg2+, commonly used agonists of the Ca2+-sensing receptor, did not increase the [Ca2+]i. In the presence of verapamil, ADH still produced a transient [Ca2+]i increase that was not observed in the presence of an increased [Ca2+]e. These results suggest that the RabCaR in rabbit CTAL cells is not functionally coupled to phospholipase C. In conclusion, the high [Ca2+]e-induced [Ca2+]i increase involves verapamil- and dihydropyridine-sensitive Ca2+ channels and is independent of phosphoinositide metabolism. Whether these channels are activated by the RabCaR remains to be elucidated.
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  • 33
    ISSN: 1432-136X
    Keywords: Key words Eels ; Electrolytes ; Osmoregulation on land ; Kidney ; Stanniectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Hypercalcemia, hypomagnesia and hypophosphatemia were observed in freshwater (FW) eels (Anguilla rostrata LeSueur) after removal of the corpuscles of Stannius. These changes did not occur if Stanniectomized (CSX) eels were removed from FW and placed on land for 12 days but did occur after the eels were returned to FW. Therefore, changes in plasma electrolyte concentrations after CSX depended upon the branchial and/or integumental influx of ions. Plasma Na+, Cl− and osmolal concentrations decreased gradually in both sham-operated (SHM) and CSX eels on land (12 days) and in FW (12 days). Plasma K+almost doubled in both SHM and CSX eels after 4 days on land, remained elevated, and fell abruptly to normal within a day after the eels were returned in FW. After 2 days on land, urine flow rates in SHM and CSX eels had decreased by approximately 85%, osmolar clearance by 50% and positive free-water clearance by more than 90%. Body weights did not decrease when eels were on land so it was concluded that the reduced but continuous renal loss of water was counterbalanced by the integumental uptake of condensed water.
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  • 34
    ISSN: 1437-7799
    Keywords: Key words Mouse ; Uroguanylin ; Kidney ; Guanosine 3′,5′-Cyclic monophosphate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. We constructed the expression profile of proximal tubules, which is a database of 3′-directed partial cDNA sequences randomly collected from mouse proximal tubules. By comparing lists with those of various tissues, genes unique to each tissue can be identified. Methods. One of the sequences, GS4068, corresponding to a tissue-specific gene found only in mouse renal proximal tubules, was cloned and identified as mouse uroguanylin. Northern blot analyses were performed using mRNA isolated from the kidney and intestine of dehydrated and NaCl-loaded mice. In situ hybridization was done to localize its expression in the kidney. Results. In situ hybridization demonstrated that it was located around the corticomedullary junction of the kidney. Seventy-two h of dehydration induced the mRNA expression in the kidney but not in the intestine. Acute NaCl loading, however, did not induce mRNA in the kidney or in intestine. Conclusion. Mouse uroguanylin was localized presumably in the proximal tubules of the kidney. Its mRNA in the kidney was induced by 72-h dehydration, but not by acute NaCl loading.
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  • 35
    ISSN: 1438-2199
    Keywords: Amino acids ; 5/6 nephrectomy ; Renal failure ; Amino acid transport ; Kidney ; Triiodothyronine ; Dexamethasone ; Amino acid load ; Rats
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In anaesthetized adult female rats, the renal amino acid handling was measured six days after 5/6 nephrectomy (5/6NX). The distinct rise in blood urea nitrogen as well as the significant reduction in urine flow and GFR indicate an impairment of kidney function. In principle, in 5/6NX rats amino acid plasma concentrations were comparable to those of control animals with two intact kidneys, whereas the fractional excretions (FEAA) of most endogenous amino acids measured were significantly enhanced. After bolus injection of leucine or taurine (each 20 mg/100 g b.wt.) or glutamine (90 mg/ 100 g b.wt.), dissolved in 2m1 normal saline per 100 g b.wt., the FEAA of both the amino acids administered and the endogenous amino acids increased as a sign of overloaded amino acid reabsorption capacity. This effect was more pronounced in 5/6NX rats than in controls. As early as one hour after amino acid load, plasma concentrations and FEAA returned to baseline values of 5/6NX rats. A pretreatment with triiodothyronine (20,µg/100 g b.wt.) or dexamethasone (60 µg/100 g b.wt.), both given intraperitoneally once daily for 3 days, stimulated the renal amino acid transport capacity in 5/6NX rats: the increase in FEAA after amino acid load was significantly lower compared to non-pretreatred animals. This stimulation could be shown for the bolus amino acids and the endogenous amino acids and was more distinct in 5/6NX rats than in controls with two intact kidneys.
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  • 36
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 565-566 
    ISSN: 1437-9813
    Keywords: Key words Muscle-split incision ; Kidney ; Ureter ; Exposure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The subcostal muscle-split incision (SMSI) has been used in 108 consecutive operations for benign upper urinary tract disease. No wound-related complications have occurred. No conversion to other wounds has been required. The benefits of SMSI are described.
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  • 37
    ISSN: 1432-1084
    Keywords: Key words: Lymphangioma ; Lymphatic system ; Cysts ; CT ; US ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A case of bilateral renal lymphangiomatosis in an asymptomatic 50-year-old female is presented. Ultrasound and CT studies were performed. A finely septated fluid collection surrounding both kidneys and traversing the midline was found. Surgical biopsy was obtained and revealed findings compatible with lymphangiomatosis. A review of the literature of renal lymphangiomatosis is given.
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  • 38
    ISSN: 1432-1084
    Keywords: Key words: Rhabdoid tumor ; Kidney ; Brain tumor ; Percutaneous biopsy ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of a malignant rhabdoid tumor of the kidney (MRTK) associated with a cerebellar tumor. Diagnosis was confirmed before neoadjuvant chemotherapy by a percutaneous fine-needle biopsy of the abdominal tumor. The clinical and radiologic features of this rare association of childhood neoplasms are reviewed.
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  • 39
    ISSN: 1432-1084
    Keywords: Key words: Kidney ; transplantation ; Kidney ; neoplasms ; Kidney neoplasms ; diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A large urothelial tumor was detected by ultrasonography in the dilated collecting system of a well-functioning renal allograft 15 years after transplantation. The tumor was confirmed at computed tomography. Nephrectomy showed a transitional cell carcinoma. The occurrence of malignant tumors in renal allografts is a well known but rare complication.
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  • 40
    ISSN: 1432-1084
    Keywords: Key words: Renal cell carcinoma ; Transplantation ; Immunosuppression ; Kidney ; Neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We report a case of metastatic renal cell carcinoma arising in a cadaver transplant kidney 6 years after transplantation. Due to molecular analysis of the tumor tissue we could prove that the carcinoma originated from the male donor. After tumor resection and interruption of immunotherapy, the concomitant bone and lymph node metastases resolved with alpha-interferon and interleukin-2-based immunotherapy.
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  • 41
    ISSN: 1432-1238
    Keywords: Key words Blood vessels ; Kidney ; Renal circulation ; Renal vascular resistance ; Calcium ; Ionized calcium ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Calcium may be indicated in critically ill patients for hemodynamic support. Its well-known action includes peripheral vasoconstriction. Vascular effects of calcium are unknown, however, in the presence of hypertension or in combination with calcium channel blocking drugs, commonly prescribed in the treatment of hypertension. The renal vessels of the spontaneously hypertensive rat (SHR) represent a suitable study model, because their vascular reactivity closely agrees with that in hypertensive humans. The present study should clarify (a) are the renal vessels of SHR responsive to high and low ionized calcium ([Ca++] within the clinical ranges? (b) because release of nitric oxide is calcium ion dependent, are renal vascular responses altered after inhibition of NO synthase? (c) are vascular responses of SHR to hypercalcemia altered by the calcium channel blocking drug verapamil? Animals and interventions: We compared isolated kidneys of SHR and those of two strains of age-matched normotensive rats (NTR) in their responses to high and low [Ca++]. They were perfused with oxygenated, warmed (37 °C) albumin containing Krebs-Henseleit buffer. In protocol A (n = 8 for each rat strain) steady state high [Ca++] (1.88 mmol/l) and low [Ca++] (0.55 mmol/l) were instituted in randomized order. In protocol B (n = 8 for each rat strain) interventions identical to those of protocol A were instituted after inhibition of NO synthase with NG monomethyl-L-arginine (L-NMMA). In protocol C, high and low [Ca++] levels were instituted in SHR after verapamil pretreatment. At each [Ca++] we measured changes in renal flow at constant perfusion pressures of 100 and 150 mm Hg. Results: In SHR (perfusion pressure 100 mm Hg), high [Ca++] induced a decrease in renal flow (–11.8 ± 1.8 % of control), which was significantly greater (p 〈 0.05) than the change (− 6.1 ± 1.5 and − 6.9 ± 1.4 % of control) recorded in the two normotensive strains. In SHR (perfusion pressure 150 mmHg), high [Ca++] induced a decrease in renal flow (− 12 ± 1.3 % of control), also significantly greater (p 〈 0.05) than the changes (− 6.2 ± 1.1 and −5.8 ± 1.7 % of control) in the two normotensive strains. Similar differences and significances were again observed after L-NMMA pretreatment. In SHR, verapamil prevented renal vascular responses in SHR to both high and low [Ca++]. Conclusions: First, renal vascular responses to high [Ca++] in SHR are exaggerated. At the upper end of the hypercalcemia range the observed changes in renal flow at constant perfusion pressure were modest, however, and with lesser degrees of hypercalcemia they may be anticipated to be even less pronounced. Second, effects of high [Ca++] were abolished after verapamil. If these findings are clinically applicable, they are of interest when calcium is infused in patients with hypertension.
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  • 42
    ISSN: 1432-1084
    Keywords: Key words: MRI ; Urography ; Kidney ; Ureter ; Bladder
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of our study was to determine relative values of rapid acquisition relaxation enhancement (RARE) and half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences in breathhold magnetic resonance (MR) urography in healthy volunteers under nonobstructive conditions of the urinary tract. A total of 20 healthy volunteers underwent MR urography with breathhold RARE and HASTE sequences at 1.5 T. For evaluation, the urinary tract was divided into nine segments on each side. Visualization of segments and artifacts was scored and the intensity ratios (InR) were determined. The upper five urinary segments were sufficiently visualized with RARE and significantly better with HASTE (renal calices, p = 0.002–0.037). The middle and lower ureter was sufficiently delineated both with RARE and HASTE, but HASTE images were statistically superior (p = 0.009–0.041). Both in RARE and HASTE images, the lower ureter was frequently superimposed by bowel contents and bowel motion. Superimposition of genital organs degraded image quality in eight of ten female volunteers. InRs were superior with HASTE in the kidney and ureter (p = 0.0003–0.0125). RARE InRs were higher in the bladder (p = 0.0008–0.014). We concluded that neither the RARE nor the HASTE sequences allowed the evaluation of the entire urinary tract under nonobstructive conditions. Although it cannot entirely replace intravenous urography, MR urography seems to lend itself to combination with other MR techniques, particularly in the investigation of pelvic or retroperitoneal disease.
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  • 43
    ISSN: 1432-1076
    Keywords: Key words Homocysteine ; Kinetics ; Kidney ; Liver
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The plasma level of homocysteine (Hcy) and its oxidized products, i.e., plasma total Hcy (tHcy), is a function of the influx rate of Hcy to plasma and the plasma tHcy clearance. In vitro experiments show that proliferating cells usually export more Hcy than stationary cells and that the Hcy export increases in response to high methionine, low folate or low cobalamin level, and to agents interfering with Hcy remethylation. Comparison between various cell types suggests that hepatocytes have a unique ability to increase the Hcy export in response to extracellular methionine, probably due to its capacity to form adenosylmethionine. Some but not all cell types have an ability to use extracellular Hcy as a methionine source. Clearance studies in healthy subjects indicate that about 1.2 mmol Hcy is supplied from the cells to plasma per 24 h, which is only about 5–10% of total Hcy formed. Comparison of area under the curves after administration of Hcy and methionine shows that about 10% of the methionine administered is released to plasma as Hcy. Notably, only a few percent of Hcy from plasma is excreted unchanged in the urine, and this shows that most tHcy in plasma is metabolized. Folate or cobalamin deficient patients have normal plasma tHcy clearance, which suggests that their elevated tHcy level is due to increased Hcy export from tissues into the plasma compartment. In contrast, the hyperhomocysteinemia in renal failure is accounted for by a marked reduction in tHcy clearance, suggesting an important role of kidney in elimination of Hcy from plasma.
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  • 44
    ISSN: 1432-1084
    Keywords: Key words: Kidney ; US ; Kidney ; obstruction ; US ; Doppler studies ; Ureter ; obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to determine whether the intrarenal resistive index (RI) can be used for the diagnosis of acute obstruction in patients with renal colic and to determine whether the index is time-related. Seventy patients referred to the Emergency Department with acute renal colic and without known associated renal disease underwent duplex Doppler ultrasonography to determine the intrarenal RI at the symptomatic and asymptomatic side. The age range of the patients was 18–72 years. An RI greater than 0.68 and/or an interrenal difference in RI greater than 0.06 and/or an increase in RI of more than 11 % compared with the normal side proved reliable cut-off values to diagnose acute renal obstruction. In addition, time dependency of the increase in RI was noted. No significant differences were observed within the first 6 h after the onset of symptoms. From 6 to 48 h, however, the mean RI in the affected kidney (0.70 ± 0.06; mean ± SD) was significantly different from that in the normal kidney (0.59 ± 0.04) (P 〈 0.001). In the same period the mean difference in RI was 0.08–0.13 (P 〈 0.001). After 48 h the sensitivity of RI dropped substantially. It is concluded that renal duplex Doppler ultrasonography is useful for diagnosing acute renal obstruction between 6 and 48 h after the onset of symptoms.
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  • 45
    ISSN: 1432-1084
    Keywords: Key words: Kidney ; transplantation ; Ultrasonography ; Doppler studies ; Kidney ; blood flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of our study was to analyze changes in spectral Doppler waveforms between interlobar and interlobular arteries in renal transplants and to determine whether sampling location at interlobular level can be suitable for intrarenal resistive index (RI) measurements. Paired series of spectral tracings from interlobar arteries and respective interlobular branches were obtained in 62 consecutive renal transplants at 6.5-MHz Doppler frequency. The values of peak systolic velocity (PSV), end diastolic velocity (EDV) and RI were significantly (P 〈 0.01) reduced when calculated at interlobular level. In 38 % of cases, an interlobar RI higher than 0.70 corresponded to a normal interlobular RI. The values of PSV, EDV, and RI did not differ significantly at interlobular level between allograft subsets with normal and elevated serum creatinine level. Both intra- and interobserver variation were higher at interlobular than at interlobar level when performing the RI. During a conventional study of renal vasculature, an underestimation of abnormal RI findings can be expected from the incidental evaluation of interlobular tracings. We recommend sonologists to pay attention in accurately locating the sample volume at interlobar–arcuate level when evaluating intrarenal RI.
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  • 46
    ISSN: 1432-2277
    Keywords: Key words Hypertension ; immunosuppression ; kidney ; Kidney ; hypertension ; immunosuppression ; Immunosuppression ; kidney ; hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This prospective study investigated hypertension and renal vasoconstriction developing during the 1st year after renal transplantation in patients randomly allocated to treatment with FK 506 (n = 28) or CyA (n = 13). Starting doses were 0.2–0.3 mg/kg per day for FK 506 and 5–8 mg/kg per day for CyA; doses were subsequently adjusted to trough levels (5–15 ng/ml for FK 506 and 100–150 ng/ml for CyA). We compared 24-h ambulatory blood pressure measurement, antihypertensive treatment, serum creatinine, and resistance index (RI), measured by Doppler ultrasound at the level of the interlobar artery. Until month 2 of treatment, FK 506-treated patients had a significantly lower RI (8 %) and better renal graft function, as evidenced by significantly lower serum creatinine values. Some 13 % of FK 506-treated patients, compared to 70 % of CyA-treated patients (P 〈 0.01), needed additional antihypertensive drugs after transplantation to keep blood pressure stable. FK 506 treatment, at the above-mentioned dosages, was associated with a significantly higher number of infections (urinary tract infection, pyelonephritis, and pneumonia). We conclude that CyA produces greater renal vasoconstriction and systemic hypertension than FK 506, as reflected in higher renal interlobar artery RI values and a greater need for antihypertensive treatment. After 2 months of treatment and a reduction in CyA trough levels, the renal effects (i. e., lower RI and lower creatinine values), but not the systemic hypertensive effects, disappear.
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  • 47
    ISSN: 1432-2277
    Keywords: Key words Preservation ; kidney ; rat ; Cryopreservation ; kidney ; rat ; Kidney ; (cryo)preservation ; rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Improving organ preservation techniques for transplantation is one of the most important goals of transplantation research. We have established a new, nonfreezing cryopreservation method to optimize the viability of rat kidneys for transplantation with up to 4 M dimethylsulphoxide (DMSO) in EuroCollins solution (EC) at −5°C to −15 °C. We have confirmed the occurrence of a tubular and glomerular defect pattern that mediates acute tubular necrosis (ATN) and that may be a cause of major histocompatibility complex (MHC) independent immunological components of chronic transplant rejection. The extent of this defect [transplant survival and function, 31P-NMR spectroscopy, histological defect index] in the nonfreezing cryopreserved groups (n = 22) is significantly (P = 0.017) lower than in the simple cold storage group (n = 12). Quality and localization of the lesions in kidney transplants can elucidate the context of organ preservation, progressive hyperfiltration defects, and the occurrence of graft failure without elevated frequency of acute rejection episodes. These results indicate that further efforts to provide higher pretransplant organ viability without using it to prolong cold storage intervals may provide better insight into MHC-independent factors of chronic transplant failure and may result in improved long-term transplant outcome.
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  • 48
    ISSN: 1432-2307
    Keywords: Key words AIDS ; Microsporidium ; Kidney ; Transmission electron microscopy ; Polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe the occurrence of renal Encephalitozoon (Septata) intestinalis infection in a 35-year-old AIDS patient who died with disseminated tuberculosis. The patient did not complain of specific symptoms involving the kidney or lower urinary tract during life, but at autopsy, light microscopic examination of the kidney revealed numerous small round or oval bodies in the tubules and tubular cell cytoplasm that were interpreted as intracellular protozoa. Transmission electron microscopy of tissue retrieved from paraffin-embedded samples identified these organisms as microsporidia belonging to the Encephalitozoonidae family, but did not allow definitive identification of the species of infecting parasite. This was made possible only by means of Southern blot hybridization after the polymerase chain reaction, which recognized the micro-organism as E. intestinalis.
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  • 49
    ISSN: 1432-0584
    Keywords: Key words Hypercalcemia ; PTHrP ; B-cell lymphoma ; Bisphosphonate ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A patient with primary non-Hodgkin's (B-cell type) lymphoma of the kidney developed hypercalcemia at the terminal stage of the disease. Although the plasma parathyroid hormone level was low, urinary cyclic AMP excretion was elevated. Serum osteocalcin (BGP) was suppressed and the plasma level of 1,25(OH)2D was within the normal range. Serum concentrations of PTH-related protein (PTHrP)-like immunoreactivity (PRP-LI) were elevated, and the tissue concentration of PRP-LI in the postmortem lymph node showed high level along with elevated serum PRP-LI, furthermore the production of PTHrP by the tumor was demonstrated by immunohistochemistry and Northern blotting analysis. These findings indicate that the hypercalcemia of the patient was caused by the PTHrP-producing B-cell lymphoma. Hypercalcemia was restored to normocalcemia by bisphosphonate treatment. Our case will add further information on humoral hypercalcemia in B-cell lymphoma, which rarely has been demonstrated to produce PTHrP.
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  • 50
    ISSN: 1434-0879
    Keywords: Key words Osteopontin ; PTHrP ; Bisphosphonate ; Alendronate ; Urolithiasis ; Kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has been reported that osteopontin (OPN) plays an important role during urolithiasis as well as bone formation. Generation of stones in the urinary tract may be associated with osteoporosis and bisphosphonates are potent inhibitors of bone resorption, being used with effect in the management of bone disease. We therefore investigated the relationship between alendronate, a bisphosphonate derivative, and OPN expression in the kidney. Alendronate was administered to rats made hypercalcemic by treatment with parathyroid hormone-related peptide (PTHrP). The renal expression of OPN was then evaluated at both protein and mRNA levels. OPN expression was enhanced in the distal tubular cells of hypercalcemic rats and was decreased by alendronate. The observed inhibition of OPN expression suggests an ability of alendronate and other bisphosphonates to act as inhibitors of stone formation in the urinary tract.
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  • 51
    ISSN: 1434-0879
    Keywords: Key words CYP1A1 ; Kidney ; Renal cell carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cytochrome P450-isoenzyme, CYP1A1, is responsible for the metabolic activation of several precarcinogenic environmental chemicals to their carcinogenic intermediates. Microsomal CYP1A1 activity in renal cell carcinoma (RCC) and in normal renal tissue was determined by measuring spectrofluorometrically the hydroxylation rate of benzo[a]pyrene. The study included 50 patients who underwent nephrectomy for RCC. Tissue specimens were taken from renal tumours and, as a control, from macroscopic normal renal tissue adjacent to the tumours. Normal renal tissues that were adjacent to poorly differentiated grade 3 tumours and/or to metastatic RCC contained significantly higher CYP1A1 activities than renal tissues next to well-differentiated (P = 0.02) and/or organ-confined tumours (P = 0.001). In conclusion, those patients who had tumours that could be considered aggressive on the grounds of poor cell differentiation or a metastatic feature of tumour, had remarkably higher CYP1A1 activities in their kidneys than the patients with less aggressive renal tumours.
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  • 52
    ISSN: 1432-0843
    Keywords: Key words MIBG ; Kidney ; Bioamines ; Mitochondrial respiration ; NOS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract meta-Iodobenzylguanidine (MIBG) is a multipotent drug used in its radiolabeled form as a tumor-seeking radiopharmaceutical in the diagnosis and treatment of pheochromocytoma and neuroblastoma. Nonradiolabeled MIBG has also proved to be effective in the palliation of carcinoid syndromes and, on a predosing schedule, in enhancing the relative tumor uptake of a subsequent [131I]-MIBG dose in tumors of neuroadrenergic origin. In addition, MIBG is under investigation as an inhibitor of mitochondrial respiration and, as such, for its use in tumor-specific acidification. In this report we describe the side effects of nonradiolabeled MIBG on kidney function in mice. High doses of MIBG (40 mg/kg) reduced renal blood perfusion as measured by 86Rb distribution by 50%, which could be antagonized by the bioamine receptor blockers prazosin and cyproheptadine. MIBG also induced reversible renal damage as evidenced from a decrease in [51Cr]-ethylenediaminetetraacetic acid (EDTA) clearance and from histological damage, which was most pronounced in the distal tubuli. These effects were unrelated to reduced perfusion, however, and could not be antagonized by bioamine receptor blockers, Ca2+-channel blockers, or diuretics. Clearance effects of MIBG were mimicked by N-nitro-l-arginine methyl ester (l-NAME), a known inhibitor of nitric oxide synthase (NOS), and MIBG itself (100 μM) also inhibited NOS in vitro, suggesting that NOS inhibition by MIBG may have contributed to the observed reduction in renal clearance. The MIBG analog benzylguanidine (BG), which is equipotent in terms of mitochondrial inhibition, did not affect renal clearance, thus excluding mitochondrial inhibition as the main mechanism of MIBG-induced damage. MIBG, however, was much more cytotoxic than BG to kidney tubular cells in primary cultures. Although the renal effects of high-dose MIBG were reversible, alterations in the pharmacokinetics of concomitant medications by a temporary reduction in renal function should be taken into account in its clinical application.
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  • 53
    ISSN: 1432-2013
    Keywords: Key words Cl channel ; Cl conductance ; Brush-border ; Kidney ; Cl channel blocker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The chloride conductance in brush-border membrane vesicles prepared from pig kidney cortex was investigated using a light-scattering assay, anion-diffusion-potential-dependent Na+-D-glucose cotransport and 36Cl– influx. K+-diffusion-potential-driven salt exit from, or entry into, the vesicles was slow in the presence of gluconate, SO4 2– and F–, intermediate with Cl– and Br–, and fast with I–, NO3 –, and SCN–. Stimulation of Na+-D-glucose uptake followed a similar anion sequence. Conductive Cl– flux had a low activation energy and was inhibited by suphhydryl reagents, the stilbene disulphonates 4-acetamido-4’-isothiocyanatostilbene-2,2’-disulphonate (SITS) and 4,4’-diisothiocyanato-2,2’-disulphonate (DIDS), and the arylaminobenzoates diphenylamine-2-carboxylic acid (DPC) and 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB). Intravesicular Ca2+ and extravesicular nucleotides were without effect on conductive Cl– flux. These characteristics tentatively exclude some known Cl– channels and leave members of the ClC family as possible candidates responsible for the Cl– conductance in brush-border membranes.
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  • 54
    ISSN: 1432-2013
    Keywords: Key words Choline ; Kidney ; proximal tubule ; Tetraethylammonium (TEA) ; Transport
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We examined the influence of organic cation (OC) structure on the rate of turnover of the OC/H+ exchanger in rabbit renal brush-border membrane vesicles (BBMV). The rate of efflux of [14C]tetraethylammonium ([14C]TEA) from BBMV, measured in the presence of an inwardly directed chemical gradient for test agent, provided an indirect measure of activity of the OC/H+(OC) exchanger. The trans-stimulation of [14C]TEA efflux from BBMV was a saturable function of increasing extravesicular concentration of both unlabeled TEA and tetramethylammonium (TMA), with an apparent Michaelis constant (K t) for the interaction of these compounds with the OC/H+(OC) exchanger of 25 µM and 1 mM, respectively. The effect on [14C]TEA efflux of saturating extravesicular concentrations of a series of n-tetraalkylammonium compounds was examined. Whereas the short-chain compounds TMA and TEA markedly stimulated [14C]TEA efflux (by 830% and 690%, respectively), the long-chain compounds tetrapropylammonium and tetrabutylammonium were less effective, increasing efflux by only 40% and 120%, respectively. When the exchanger was saturated with tetrapentylammonium, mediated efflux of [14C]TEA was reduced. Increasing alkyl chain length was also correlated with an increase in the inhibitory effect (as measured by the apparent inhibition constant, K i, or the IC50 value) that these compounds had against transport of [14C]TEA by the OC/H+(OC) exchanger; i.e., there was a correlation between decreasing IC50 and decreasing turnover of the OC/H+(OC) exchanger. This same correlation was observed for a broader set of test agents of diverse molecular structure, including a series of n-tetraalkylammonium and -phosphonium compounds and the OCs, choline, N 1-methyl nicotinamide, 1-methyl-4-phenylpyridinium, and amiloride. Because high affinity of substrates for the OC/H+(OC) exchanger is correlated with increasing substrate hydrophobicity, we conclude that the interaction of hydrophobic OCs with the renal OC/H+(OC) exchanger results in the formation of a substrate-exchanger complex that has a comparatively low rate of turnover.
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  • 55
    ISSN: 1432-2013
    Keywords: Key words Epithelial monolayer ; Kidney ; Osmoregulation ; Sodium transport ; Noise analysis ; Actin ; Microtubules ; Dynein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Permeable supports with A6 cell monolayers were mounted in an Ussing chamber and bilaterally bathed with Ringer solution at room temperature. Short-circuit current (I sc) was recorded continuously, and noise analysis revealed microscopic channel current characteristics. Our investigation focuses on the stimulation of apical Na+ entry caused by exposing the serosal surface of the A6 cell monolayers to hyposmotic Ringer solution. To evaluate the possible role of the cytoskeleton in the regulation of Na+ channels in response to a change in osmolality we used four different experimental approaches. In the control group, which were not exposed to any cytoskeleton-influencing drugs, there was a 1.5-fold increase in I sc and in the number of open Na+ channels after osmotic stimulation. For the second group cytochalasin D (0.1 µg/ml) was present on the serosal side during the experiments. Neither I sc nor the number of open Na+ channels increased after osmotic stimulation. In the third group colchicine (0.2 mM) or nocodazole (20 µM) was present on the serosal side, which resulted in 1.8-fold and 1.5-fold increases in I sc as well as 3-fold and 2-fold increases in the number of Na+ channels, respectively. In the fourth experimental group erythro-9-(2-hydroxy-3-nonyl) adenine hydrochloride (EHNA, 0.5 mM), a dynein inhibitor, was present on the serosal side. In this group I sc decreased to about 0.4 µA/cm2, and subsequent application of amiloride abolished I sc completely. Under hyposmolar conditions EHNA abolished entirely the sensitivity of I sc to the osmotic challenge. Because of the EHNA-induced down-regulation of I sc, the density of apical Na+ channels in this experimental group could not be determined. These results show that the cytoskeleton is dominantly involved in osmotic channel regulation at the apical membrane, and that actin filaments, microtubules and molecular motors are involved in the recruitment of additional Na+ channels.
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  • 56
    ISSN: 1432-0878
    Keywords: Key words CNS ; MHC molecules ; Kidney ; Transplantation ; Allogeneic ; Rat [LEW(RT1) ; DA(RT1av1)]
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract  The expression of MHC class I and class II molecules in the cerebral cortex of rats was investigated at daily intervals from day 3 to day 6 after fully allogeneic (DA→LEW) and isogeneic (LEW→LEW) kidney transplantation. MHC class II molecules were temporarily induced on the previously negative microglial cells and on the endothelia of arterioles and venules during acute rejection. On the endothelia of all brain vessels MHC class I expression was enhanced. MHC class I+ cells with microglial cell morphology were discernible within the diffusely MHC class I+ brain parenchyma. In contrast, the brain parenchyma of isograft recipients and untreated control animals did not express detectable levels of MHC molecules. In conclusion, we demonstrate that a strong immune reaction in the periphery is able to activate microglial cells in the central nervous system.
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  • 57
    ISSN: 1432-0878
    Keywords: Key words Neurite outgrowth factor ; Immunoglobulin superfamily ; Extracellular matrix ; Development ; Oncogenesis ; Kidney ; Nephroblastoma ; Domestic fowl
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract  Gicerin, a cell-adhesion molecule belonging to the immunoglobulin superfamily, has both homophilic and heterophilic binding activities to neurite outgrowth factor, an extracellular matrix molecule in the laminin family. Gicerin is thought to play a role in the normal development of chicken kidney, because it is expressed abundantly in the embryonic organ and only slightly in the mature organ. In this study, we have examined the adhesive activity of gicerin in the kidney to characterize its function in organogenesis. We have also examined the function of gicerin in chicken nephroblastomas (“embryonic nephromas”), which show various structures resembling those in embryonic kidneys. Immunohistochemically, the expression patterns of gicerin and neurite outgrowth factor in nephroblastomas are similar to those of embryonic kidneys. Cell-aggregation assays have shown that primary culture cells from both embryonic kidneys and nephroblastomas have strong aggregation activities, and that each aggregation is partially inhibited by gicerin antibody. In contrast, cells from adult kidney exhibit weak aggregation activity that is not inhibited by the antibody. In addition, ligand blot analysis has revealed that gicerins in embryonic kidney and nephroblastoma bind to purified neurite outgrowth factor, whereas extracts from adult kidney show no positive reaction. These findings suggest that the homophilic and heterophilic adhesive activities of gicerin are involved in the formation of both normal kidney and nephroblastoma.
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  • 58
    ISSN: 1432-1912
    Keywords: Key words Gastrin ; Cholecystokinin ; CCKB receptors ; Kidney ; Glomeruli ; Collecting duct
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two types of receptors for gastrin and cholecystokinin (CCK) have been identified in the gastrointestinal tract and in the central nervous system: CCKA and CCKB receptors. Here we report evidence for the expression of CCKB receptors in the guinea-pig kidney. Specific binding sites for [125I]gastrin were detected in sections of the guinea-pig kidney: Binding was saturable, pH-, temperature- and time-dependent, and specific for gastrin-related peptides. The potencies for inhibition of binding of [125I]gastrin were CCK-8 〉 gastrin 17-I 〉 CCKB receptor antagonist L-365,260 〉 des(SO3)CCK-8 〉 CCKA receptor antagonist L-364,718. Autoradiography demonstrated specific [125I]gastrin binding to medullary collecting ducts and to a much lesser extent to glomeruli, but not over other structures. CCKB receptor cDNA fragments were amplified by RT-PCR from total kidney, isolated tubuli and from tissues known to express CCKB receptors such as stomach and brain. The kidney might therefore be a previously unidentified site of action for gastrin and cholecystokinin-related peptides.
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  • 59