Crystalluria

The paper considers a clinical role of crystalluria and its relation to urolithiasis. Examination of 185274 cases of symptomless crystalluria in the citizens of Kharkov and Kharkov region revealed oxalic-calcic urinary crystals in 12.2%, urate crystals in 3.6% and phosphate crystals in 1.2% of the examinees. Oxalic-calcic crystalluria in urgent urinary conditions occurs significantly more frequently (25.8%). Crystalluria was studied in 372 nephrolithiasis patients. Urinary crystals were found in 44.0%. The type of the crystals corresponded to chemical composition of the urinary concrements. Oxalic-calcic nephrolithiasis was detected in a younger group of patients (aged 37.3 +/- 1.3). It is suggested to consider crystalluria as microurolithiasis indicating predisposition to lithogenesis in the urinary tract and as a preclinical manifestation of urolithiasis.     

Crystalluria in marathon runners

Summary Crystal sizes (scanning electron microscopy) and distributions (Coulter Counter) as well as 24-h urinary sodium (Na) and calcium (Ca) excretions (flame atomic absorption) were determined in a group of black South African runners immediately after a marathon and again 3 weeks later. White runners and black and white control subjects were included in the study. Particle volume-size histograms for black controls and black runners were identical. There was no significant difference in the Na excretion of all the groups. However, while urinary Ca excretion was significantly raised in white runners relative to white controls, Ca excretion in black runners was unchanged relative to their controls. It is postulated that the lower rates of urinary Ca excretion may result from lower rates of Ca resorption from bone in response to the cyclical loading of running in black marathon runners. The results of this study suggest that black marathon runners are not prone to the same increased risk of renal stone formation as are white runners.     

Crystalluria in marathon runners

Summary Particle-volume size distribution curves for the urines of a group of male ultra-marathon runners have been recorded and show the same features as those reported in an earlier study involving standard marathon runners. It is again suggested that these features indicate risk of urinary stone formation although this does not appear to be increased by the more stressful ultra-marathon. Distribution curves obtained for female runners closely resemble those recorded for controls, thus rendering it impossible to assess their risk profile. A commonly observed feature of both the male and female urines was the presence of various urinary salts. Profuse calcium oxalate dihydrate crystals were detected in some samples 11 days after the race. It is suggested that entrapment sites within the urinary tract have a selective specificity for these crystals while urinary salts pass through unhindered.     

Crystalluria in marathon runners

Summary Epidemiological evidence suggests that marathon runners have a higher incidence of renal stone formation than occurs in the general population. Since crystalluria and stone disease are thought to be related, we subjected urine samples from a group of marathon runners to particle counting and sizing in a Coulter Counter equipped with a population accessory unit. The volume-size distribution curves so obtained were bimodal with one peak occurring in the 2–5 m diameter range and a second in the 15–32 m diameter range—a pattern that is remarkably similar to the distributions reported for recurrent idiopathic stone formers and distinctly different to those recorded for control subjects. Analyses by scanning electron microscopy and X-ray powder diffraction revealed other features which are regarded as typical of stone formers' crystalluria. These physicochemical data indicate that marathon runners may be at increased risk of urinary stone formation.     

Crystalluria in marathon runners

Summary In order to investigate further the possible relationship between urinary stone formation and marathon running, the crystalluria in seven male, stone forming runners was characterized. Particle size distribution curves (Coulter counter) and crystal number, size and morphology (scanning electron microscopy) were measured. These studies suggest that urinary stone formation may be accelerated in those subjects with previous histories of renal stone formation but that the nature of the crystalluria is favourably affected by an increase in fluid intake. The presence of large quantities of mucoid material in the urine of natural stone formers and its absence in the urine of stone-forming runners is cited as evidence for the existence of different aetiological mechanisms in these groups. It is concluded that while natural stone formers may be at chronic risk of stone formation due to pathological factors, marathon runners may be at acute risk due to factors associated with long distance running itself.     

Crystalluria in idiopathic recurrent calcium urolithiasis

Summary A retrospective study was done on the nature and degree of crystalluria in fasting and postprandial urine in patients with recurrent idiopathic calcium urolithiasis (RCU) for whom stone analysis was available. RCU was stratified into subgroups in accordance with stone analysis. The crystals were obtained and identified using a filter technique and polarization microscopy, respectively. Crystalluria score, relative saturation products (RSPs), and low-molecular-weight inhibitors were assessed. Calcium oxalate crystals were never observed in either male or female patients with stones composed exclusively of calcium oxalate, and only sporadically in patients with mixed stones (the additional component was calcium phosphate in most cases). Other crystalluria phases, such as amorphous calcium phosphate, a urate-containing phase, and a phase presenting as spherolytic particles, were slightly more frequent in patients with mixed stones. In contrast to crystalluria, RSPs and inhibitors differed in male and female patients, suggesting that crystalluria may not be under the exclusive control of these factors. The following conclusions were reached. (1) Calcium oxalate crystalluria is absent from RCU with pure calcium oxalate stones; hence, calcium oxalate crystalluria does not qualify as a diagnostic aid. (2) The co-existence of the isotropic phase and mixed stones may indicate that the formation of these concretions is characteristic for a major RCU subgroup. (3) On the basis of clinical chemistry and physicochemical data in urine and of crystalluria, it appears that the pathogenesis of RCU differs in male and female subjects.     

Sensitivity of Pseudomonas bacteria to iodopiron and dimexide determined by electron microscopy

A structure of the pyocyanic bacterium culture was studied by the method of electron microscopy of native preparations and ultrafine sections of the cells, which contained in the quantity of 10(5)/ml of suspension, and were treated with iodopiron in the concentration of 93.75 mg/ml, 10% dimexide solution and their combination. The increase in damaging effect on bacteria of the combined use of chemopreparations permits to recommend their complex administration in local pyocyanic infection in burned patients.     

Crystalluria: a neglected aspect of urinary sediment analysis

Crystalluria is a frequent finding in the routine examinationof urine sediments. In most instances the precipitation of crystalsof calcium oxalate, uric acid, triple phosphate, calcium phosphateand amorphous phosphates or urates is caused by transient supersaturationof the urine, ingestion of foods, or by changes of urine temperatureand/or pH which occur upon standing after micturition. In aminority of cases, however, crystalluria is associated withpathological conditions such as urolithiasis, acute uric acidnephropathy, ethylene glycol poisoning, hypereosinophilic syndrome.In addition, crystalluria can be due to drugs such as sulphadiazine,acyclovir, triamterene, piridoxylate, primidone, which underthe influence of various factors can crystallize within thetubular lumina and cause renal damage. In all these instancesthe study of crystalluria is diagnostically useful and is alsoimportant to follow the course of the disease. However, a propermethodological approach is necessary. This includes the handlingof freshly voided urine, the knowledge of the urinary pH, andthe use of a contrast phase microscope equipped with polarizingfilters.     

Altered reactivity of hemolysate-treated cultured smooth-muscle cells from rabbit basilar artery determined by digital imaging microscopy

During culture, smooth-muscle cells obtained from rabbit basilar arteries were examined for contractile activity by means of differential interference microscopy with a video analysis system (digital imaging microscopy system). This system proved useful for observing the contraction and ultrastructural changes of the living cells. Hemolysate-treated cells showed augmented responses to 5-hydroxytryptamine and leukotriene C4, but not to KCl. This augmented response diminished gradually during the culture period. Both a phospholipase C blocking agent, 2-nitro-4-carboxyphenyl-n,n-diphenylcarbamate (NCDC), and a myosin light chain kinase blocking agent, 1-(5-chloronaphthalenesulfonyl)-1H-hexahydro-1,4-diazepine (ML-9), suppressed this augmented response. Protein kinase C activity of the cells, as measured by Western blot analysis, did not increase during the period of culture with hemolysate. The results obtained suggest that hemolysate had the following effects on the cells: 1) acute but gradual contraction of the cells; 2) augmentation of cellular responses to vasoactive agents; and 3) progressive contraction and morphological alteration of the cells. Possible mechanisms by which hemolysate exerts these effects are discussed, taking into consideration the interrelationship between these effects.     

The distribution of zinc in the prostate of rhesus and cynomolgus monkeys determined by electron microscopy and x-ray microanalysis

The distribution of zinc in the prostate of the mature rhesus monkey is described. High levels of zinc were located in the nuclei of epithelial and basal cells in both lobes of the gland, while elevated concentrations of the metal were also found in secretory granules and along lateral cell membranes. A similar zinc distribution pattern was observed in the 2 lobes of the gland, but in general organelles in the cranial region had a higher content of the metal. In whole tissue, however, a 15 times greater zinc content was measured in the caudal lobe. This difference could be explained in terms of the high levels of the metal present in secretory granules and luminal secretion in the caudal lobe. A similar ultrastructural appearance and distribution of zinc was observed in the prostate of the cynomolgus monkey (Macaca fascicularis).     

Skin wound healing determined by water loss

An in vivo method of monitoring healing was tested incorporating an Evaporimeter measuring water evaporation; reepithelialization was detected through reestablishment of the water barrier. In the first study two wounds were created with a 2-mm biopsy punch on each of the backs of 15 rabbits and covered with occlusive and semiocclusive dressings. Water loss increased from a preoperative value of 6 g m-2 hr-1 to 55 g m-2 hr-1 after surgery. Water loss from the occluded site returned to baseline values in 9 days as opposed to 17 days for the semioccluded sites (P less than 0.05). The second study followed the healing of full-thickness 4 X 4-cm wounds in five rabbits treated with fine-mesh gauze and five treated with a human amnion dressing. Wound area and water loss were observed during the repair process. Visually measuring the wound area, the injuries appeared 100% healed on Day 30. The Evaporimeter continued to detect significantly increased water loss up until Day 45 when the original baseline values were reached. No differences were observed between the gauze and amnion groups. The Evaporimeter presents a simple yet accurate, noninvasive tool measuring the wound healing endpoint based on regeneration of the epidermal water barrier.     

Allograft viability determined by enzyme analysis.

Enzymatic analysis of the venous effluent of ischemically injured kidney failed to predict accurately the ability of an isochemically injured kidney to support life. Postoperative serum assay of lactic dehydrogenase (LDH) is of value in the assessment of the functional status of the kidney and correlates with response of the rejection episode to immunosuppression. However, by itself it cannot be a sole guide to withholding of therapy. Successful treatment is associated with a decline in LDH level, and failure to return to base line serves as a guide to irreversibility of the rejection reaction.     

Permeability of blood vessels in experimental gliomas: uptake of 99mTc-glucoheptonate and alteration in blood-brain barrier as determined by cytochemistry and electron microscopy

Experimental gliomas were induced in rats by prenatal exposure to ethyl nitrosourea. Changes in the blood-brain barrier were determined by the uptake of a water-soluble compound, 99mTc-glucoheptonate. Increased uptake of 99mTc-glucoheptonate was measured in intact tumors and in various sectors of dissected tumors. The extent of 99mTc-glucoheptonate uptake greatly varied among different tumors and among different sectors of the same tumor. Ultrastructural and cytochemical analysis of the capillary endothelial wall revealed major alterations in tight junctions, which became permeable to horseradish peroxidase. In brain tissue around the tumors, uptake of 99mTc-glucoheptonate and ultrastructure of tight junctions were comparable to normal brain capillaries. The results of the present study indicate that altered endothelial tight junctions may provide the main route of transport of 99mTc-glucoheptonate through the endothelial wall.     

Enhanced bone regeneration by electrical polarization of hydroxyapatite

We examined osteogenic cell responses and new bone formation on electrically polarized hydroxyapatite (HAp) plates implanted into calvarial bone defects in rats. In the first group of rats, test pieces were placed with their positively charged surfaces face down on the dura mater. In a second group, test pieces were placed with their negatively charged surfaces facedown on the dura mater. A third group received noncharged test pieces. Histological examination was carried out to characterize the newly formed bone as well as quantification. Enzyme histochemistry involving the detection of alkaline phosphatase and tartrate-resistant acid phosphatase was performed to quantify osteogenic cell activity. Bone growth was enhanced in the groups that received polarized HAp plates, both at the negatively and positively charged surfaces. In addition to the electrostatic force that attracts Ca2+ to the negatively charged surfaces, the suppressive effects on osteoclasts proliferation on the positively charged surfaces may enhance bone formation.     

Peritoneal dialysate volume determined by indicator dilution measurements

Dialysate volume was simultaneously determined by two different indicator dilution technique as a function of dwell time in a rabbit model of peritoneal dialysis using isotonic, hypertonic and hypotonic solutions. After a single injection of a large molecular weight index solute (SIIS) to the dialysis solution at a known concentration, the first indicator dilution technique determined dialysate volume by the change in the index solute concentration. In the second technique, dialysate volume was determined after multiple injections of a different index solute (MIIS) by measuring the change in concentration of the index solute two minutes after its injection into the dialysis solution. The volumes determined by SIIS were similar during isotonic, but larger during both hypertonic and hypotonic exchanges, than those determined by MIIS. Drained volume was dependent upon the peritoneal catheter used, was not different from that determined by MIIS, but was significantly smaller than that determined by SIIS. The present results suggest that systematic errors in volume measurements when using indicator dilution result from the loss of the index solute from the peritoneal cavity and are greater for SIIS than for MIIS. A model for fluid transfer during peritoneal dialysis showed that dialysate volumes determined by SIIS were useful, however, when estimating the rate of fluid movement across the peritoneal membrane.