肾综合征出血热若干体液因子和肾脏血液动力学变…

研究了２８例肾综合征出血热患者体液因子和肾脏血液动力学的变化。用放射免疫法检测血浆内皮素（ＥＴ）、Ｐ物质、血栓素Ｂ２、６－酮－前列腺Ｆｌ α（６－ｋ－ＰＧＦｌα）及血管紧张素－Ⅱ（ＡＴ－Ⅱ）的含量，用放射性核素计算机扫描成像摄影法测定了肾小球过率和肾有效血浆流量，结果发现，ＨＦＲＳ患者从发热期至多尿实期血浆ＥＴ、ＴＸＢ２、ＡＴ－Ⅱ均高于下沉水平，而血浆ＳＰ则低于下正常水平，６－Ｋ－ＰＧＦｌα除低血     

一氧化氮对孕鼠体内内皮素,血栓素B2,6—酮前列腺素水平的影响

通过４组４０只ＳＤ系雌性大鼠,人工阻断一氧化氮（ＮＯ）,研究ＮＯ减少对孕鼠体内内皮素（ＥＴ）、血栓素Ｂ２（ＴＸＢ２）、６－酮前列腺素Ｆ１α（６－Ｋｅｔｏ－ＰＧＦ１α）水平的影响。在给晚期妊娠及未妊娠大鼠阻断ＮＯ５天后,测其血浆ＥＴ、ＴＸＢ２、６－Ｋｅｔｏ－ＰＧＦ１α值。结果妊娠大鼠ＥＴ、ＴＸＢ２、６－Ｋｅｔｏ－ＰＧＦ１α值均升高、ＴＸＢ２／６－Ｋｅｔｏ－ＰＥＦ１α比值升高。作为代偿和保护机制,妊娠     

高渗盐水输入对低氧条件下失血性休克家兔内分泌功能的影响

本实验采用放免法观察了低氧条件下失血休克前后和输液治疗后的１４项内分泌激素改变。实验结果表明，低氧条件下复合急性失血性休克的血浆中ＡＮＰ，β－ＥＰ，ｋＰＧＦ１　，ＴＸＢ２，ＲＤＮ，ＡⅡ，ＡＬＤ，ＴＴＳＨ，ＧＨ等多种激素水平明显增高，输入高渗盐水或高盐液体后能使ＡＮＰ，β－ＥＰ，ＴＸＢ２，ＲＥＮ，ＡⅡ，ＡＬＤ，Ｔ３等增高的激素水平明显降低，同时使血浆６ｋＰＧＦ１α水平明显增高，也能使降低的ＣＳ和ＡＣ     

系统性硬化病血管内皮活性因子测定的临床意义

目的：从蛋白分子水平探讨血管内皮活性因子同系统性硬化病的关系。方法：选择４２例ＳＳｃ病人采用放射免疫测定法检测血浆内皮素（ＥＴ）、血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素Ｆ１α（６－Ｋ－ＰＧＦ１α）,采用Ｇｒｉｓｓ方法检测血浆一氧化氮（ＮＯ）水平,关免疫法检测细胞间粘附分子－１（ＩＣＡＭ－１）、选择素（Ｐ－Ｓ）。结果;所有ＳＳＣ患者均存在高ＥＴ、ＴＸＢ２、ＩＣＡＭ－１、Ｐ－Ｓ血症,存在低ＮＯ、６－     

梗阻性黄疸患者血浆TXB2,6—K—PGF1αRIA

本文采用放射免疫分析法检测６４例梗阻性黄疸病人（服消炎痛组ｎ＝３２，未服消炎痛组ｎ＝３２）手术前后外因浆血栓素Ａ２和前列环素（ＰＧＩ２）的稳定代谢产物ＴＸＢ２和６－Ｋ－ＰＧＦ１α浓度２，结果表明，未服消炎痛组术前血浆ＴＸＢ２、６－Ｋ－ＰＧＦ１α浓度及Ｔ／Ｐ显著升高，尤以ＴＸＢ２升高明显（Ｐ〈０．０１）。术后血浆ＴＸＢ２、６－Ｋ－ＰＧＦ１α下降，但ＴＸＢ２仍高于无黄疸组水平，Ｔ／Ｐ无明显变化（Ｐ〉０     

"肝郁"大鼠血浆TXA2、 PGI2水平与肝微循环变化及逍遥散作用

目的 探讨“肝郁”大鼠模型血浆ＴＸＡ２、ＰＧＩ２水平与肝微循环变化，揭示“肝郁致瘀”的机理。方法 用捆绑式限制大鼠活动制作肝郁大鼠模型，血浆６－ｋｅｔｏ－ＰＧＦ１α、ＴＸＢ２测定采用放射免疫分析法，肝微区、胃微区ＢＣＰＡ测定用ＬＤＦ－Ⅱ型激光微循环血流计。结果 造模大鼠一般于造模第３～４ｄ出现“肝郁”现象：肝郁大鼠血浆６－ｋｅｔｏ－ＰＧＦ１α明显降低（Ｐ〉０．０１）；ＴＸＢ２明显升高（Ｐ〈０．０１     

血栓闭塞性脉管炎患者血液TXB_2和6－酮－PGF1_α的变化

本文用放射免疫分析，检测了６３例血栓闭塞性脉管炎（ＴＡＯ）病人ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量及其比值的变化，并对其中３１例进行了治疗前后的对比。ＴＡＯ病人ＴＸＢ２含量增高，６－ｋｅｔｏ－ＰＧＦ１α含量下降，两者的比值上升。上述变化随病情的加重而明显。治疗前后比较的结果显示，随症状好转ＴＸＢ２值下降、６－ｋｅｔｏ－ＰＧＦ１α值上升、两者比值下降。血浆ＴＸＢ２含量的增加及ＴＸＢ２／ＰＧＦ１α值的增高是ＴＡＯ重要的病理现象；血浆ＰＧＦ１α含量的增加可能在对抗四肢末梢血管缺血中起到有益的保护作用；分析本病的变化时，对于ＴＸＢ２／ＰＧＦ１α值的分析比单纯对ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α值的分析更有理论和实际的意义。     

心肌缺血／再灌注对球结膜微循环的影响以及一氧化氮的调节作用

对照观察兔急性心肌缺血／再灌注时球结膜微循环的变化，测定动物血浆中内皮舒张因子／一氧化氮（ＥＤＲＦ／ＮＯ）、血栓素Ｂ２（ＴＸＢ２）、６－酮－前列腺素Ｆ１α（６－Ｋｅｔｏ－ＰＧＦ１α）、超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）的浓度变化，并用光镜和电镜对缺血／再灌注心肌组织作形态学观察。结果发现：（１）兔心肌缺血／再灌注后球结膜微循环异常；表现为Ａ３、Ａ４微动脉血管管径缩小，毛细血管交换距离增大。（２）血浆中ＥＤＲＦ／ＮＯ水平降低；（３）血浆ＴＸＢ２、ＭＤＡ水平升高，ＳＯＤ、６－Ｋｅｔｏ－ＰＧＦ１α下降；（４）光镜下：缺血区心肌组织细胞肿胀变性。电镜下：内皮细胞肿胀，部分毛细血管腔内有红细胞、白细胞附壁阻塞，线粒体肿胀，糖原颗粒减少。结果提示：心肌在较短时间缺血后再灌注（缺血３０ｍｉｎ再灌注３０ｍｉｎ）后就可产生组织损伤，这可能与血管内皮受损，ＥＤＲＦ／ＮＯ合成释放减少，缩血管物质ＴＸＡ２升高，血小板、白细胞粘附、聚集在血管内皮上，氧自由基产生过多等有关。上述因素共同作用导致缺血／再灌注心肌微循环功能障碍进而引起组织形态改变。     

常压缺氧大鼠血浆和肺组织TXB2和6—keto—PGF1α的动态变化

本文观察常压缺氧２４ｈ及１，２，４ｗ后大鼠血小板数及聚集率和血浆及肺ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α的动态变化。结果表明（１）缺氧大鼠血小板数呈先增加、后恢复、再下降，血小板聚集率呈先减少、后增加再减少的动态变化。（２）血浆ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α均明显升高。（３）肺组织６－ｋｅｔｏ－ＰＧＦ１α升高早于ＴＸＢ２，提示ＰＧＩ２参于早期缺氧肺血管张力调节。（４）缺氧大鼠２周时肺动脉高压达到     

慢性阻塞性肺病患者血浆血栓素B_2和6－酮－前列腺素F_（1α）含量的变化及其与肺动脉高压的关系

为了探讨慢性阻塞性肺病（ＣＯＰＤ）患者血栓素Ａ_２（ＴＸＡ_２）和前列环素（ＰＧＩ_２）与肺动脉高压的关系，我们对伴有和不伴有肺动脉高压的３０例缓解期ＣＯＰＤ患者血浆中血栓素Ｂ_２（ＴＸＢ_２）及６－酮－前列腺素Ｆ_（１α）（６－ｋｅｔｏ－ＰＧＦ_（１α））的含量变化进行了观察，还对７例伴肺动脉高压的ＣＯＰＤ患者不同病期的肺动脉平均压（ＰａＰ）、血浆ＴＸＢ_２及６－ｋｅｔｏ－ＰＧＦ_（１α）．水平作了对比分析。结果发现，缓解期ＣＯＰＤ患者中，伴肺动脉高压者血浆ＴＸＢ_２明显增高，６－ｋｅｔｏ－ＰＧＦ_（１α）显著下降，ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α）明显增大，与不伴肺动脉高压者比较，差异非常显著（Ｐ均＜０．０１），而不伴肺动脉高压者的这些指标与正常人的比较，则无统计学意义（Ｐ均＞０．０５）；与急性期比较，ＣＯＰＤ患者缓解期ＰａＰ明显下降，ＴＸＢ_２亦显著降低，６－ｋｅｔｏ－ＰＧＦ_（１α）明显升高，ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α）缩小（Ｐ均＜０．０１）；相关分析发现，伴肺动脉高压者ＰａＰ与ＴＸＢ_２呈明显正相关，与６－ｋｅｔｏ－ＰＧＦ_（１α）呈负相关（ｎ＝２８，ｒ＝＋０．４６、－０．３９，Ｐ均＜０．０５）     

Renal amyloidosis

Summary Lymphocyte subpopulations (B, T₄, T₈), monocytes/macrophages (LeuM₅, KiM₅) and HLA-DR antigen expression were studied immunohistochemically in frozen sections from 32 antral and 37 fundal biopsies of type-B chronic gastritis. Aberrant HLA-DR antigen expression in epithelial cells of gastric mucosa was found in all cases closely related to mononuclear infiltrates. Epithelial HLA-DR expression and mononuclear infiltrates were practically absent in foci of intestinal metaplasia. These findings suggest that an immunopathologic mechanism probably plays a role in initiation or perpetuation of type-B chronic gastritis.     

Renal ectopia

Summary Bilateral pelvic kidneys and a unilateral pelvic kidney were found in a male and female cadaver, respectively. The upper pole of the left pelvic kidney in the male impinged upon a lateral bony projection from the body of the 5th lumbar vertebra. A cyst was present at the lower pole of the same kidney. The vascular anatomy and the resultant variations of the normal anatomy of the pelvic structures have been described.

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Ectopie rénale

Résumé Deux reins pelviens ont été trouvés sur un cadavre de sexe masculin et un rein pelvien unilatéral sur un cadavre de sexe féminin. Le pôle supérieur du rein pelvien gauche chez l'homme se situait au niveau d'une exostose latérale du corps de la 5^e vertèbre lombaire. Il présentait de plus un kyste au niveau de son pôle inférieur. L'anato-mie vasculaire et les modifications des structures pelviennes résultant de cette variation ont été analysées.

     

Renal malakoplakia

Summary We report an unusual case of renal malakoplakia appearing as a solitary tumour with spread beyond the confines of the kidney, affecting adjoining organs. The Michaelis-Gutmann bodies were extraordinary large (>100 ) and contained inconspicuous amounts of lime-salts. Their ultrastructural features, however, were identical with those previously described for Michaelis-Gutmann bodies.     

Renal Adenoma

We report the results of clinicopathological and histochemical studies on 64 renal adenomas found in 22 patients. We selected typical renal adenomas for these studies, discarding borderline lesions. The ages of the patients ranged from 42 to 84 years, with an average of 61 years. Male to female sex ratio was 6.3:1. The background conditions included renal cell carcinoma, long-term dialysis, chronic glomerulonephritis, pyelonephritis, hydronephrosis and polycystic kidney. The sizes of the tumors ranged from 0.1 to 2.3 mm in maximum diameter, with an average of 0.9 mm. All the tumors were located in the cortex, especially in the superficial one-third. The cytoplasm of the tujntfr celis vtas predominantly eosinophilic, and the tumor structure Was predominantly papillary. Histochemical study of IS adenomas from 13 patients demonstrated that all of the adenomas were positive for EMA, and for at least one marker of the distal tubulus, i.e., DBA, PNA, SBA and PKK1, and that 9 adenomas/ were positive for at /east one marker of the proximal tubulus, i.e., LM1 and/LTA. Renal adenomas had predominant histochemical features of the distal tubulus, suggesting differentiation to a distal tubulus-like histology. Acta Pathol Jpn 39: 731 736, 1989.     

Renal oncocytosis

Renal oncocytosis is a rare disorder in which numerous oncocytic nodules develop in the kidney. An additional case is reported here. The patient was a 51-year-old woman who had received hemodialysis for 27 years. Nineteen years previously she had developed a tumorous lesion in the right kidney, which had been diagnosed as oncocytoma with laparotomic biopsy. Recently the kidney was removed because of enlargement of the tumor. The renal parenchyma was entirely replaced with numerous brownish nodules. Histologically, the nodules were composed of nests of uniform oncocytic cells. Ultrastructurally, the oncocytic cells contained numerous mitochondria. Immunohistochemical features of the nodules were identical to those of sporadic oncocytomas, that is, immunophenotypes similar to the distal nephron and reactivity with antimitochondrial antigen. Based on these findings, the lesion was diagnosed as renal oncocytosis. It was not possible to determine whether the larger nodules should be diagnosed as oncocytoma or a part of oncocytosis. Additionally, the germ line mutation of the Birt-Hogg-Dubé (BHD) syndrome gene was examined using the genomic DNA obtained from the peripheral lymphocytes, which failed to show any gene alteration. Despite the rare occurrence pathologists and urologists should be aware of renal oncocytosis, as a precursor lesion of renal oncocytoma and chromophobe renal cell carcinoma.     

Renal prostaglandins

Summary This brief review summarizes the important modulatory effects of endogenous renal prostaglandins (PGs) on renal function. A brief survey of current knowledge of renal PG synthesis reveals the shortcomings of biochemical in vitro studies and points out the necessity to improve methods of in vivo assessment. The problem of measuring circulating levels of PGs and the question of the importance of these PGs for renal function are discussed. Renal blood flow is shown to depend on renal PG's in situations of stress but not under basal conditions. However, in this respect the definition of stress has to include even the mild condition of sodium deprivation. An increasing number of disease states is emerging where renal blood flow is shown to depend on cyclooxygenase activity. Angiotensin II infused or synthesized endogenously seems to be the most likely stress mediator causing enhanced renal PG synthesis which opposes its vasoconstrictor activity. The role of PGs in sodium excretion is not well defined and controversial. In man, most available evidence supports a natriuretic role of renal PGs. However, this role can only be demonstrated under well defined conditions. Inhibitors of PG biosynthesis will cause sodium retention. However, following administration of these drugs a new steady state is reached rapidly characterized by suppressed plasma renin activity and aldosterone. Renal PGs alternate vasopressin effect on urine concentration. The mechanism for this is poorly understood and the role of cAMP in this interaction controversial. Recent evidence showing stimulation of renal PG synthesis by vasopressin independent of its pressor effect is presented. While the stimulatory role of kininogen and kinins on renal PG synthesis has been shown the functional consequences have not been sufficiently defined. Moreover, assessment of the activity of the renal kallikrein-kinin system is at present not possible and no physiological role in renal function has as yet been delineated. Regulation of renal renin release involves PGs. Evidence is presented in support of a role of prostacyclin in baroreceptor and macula densa mediated renin release.     

Renal botryomycosis

A case of visceral botryomycosis which arose in the left kidney of a 60-year-old woman is reported. This is the fifth reported case of renal botryomycosis which, in this patient, was mistaken clinically for a renal carcinoma. The lesion was composed of confluent abscesses containing 'sulphur granule-like' lesions in which irregularly lobed aggregates of Gram-negative organisms surrounded by an eosinophilic capsule were noted. Awareness of this unusual lesion is important because of its histopathological similarity to actinomycosis.