Deep nephron function after release of acute unilateral ureteral obstruction in the young rat.

The effects of acute unilateral ureteral obstruction (UUO) of 18 h duration on deep nephron function was evaluated in 14 weanling rats with the technique of micropuncture. After release of UUO, 3.4 +/- 0.66% (SE) of the filtered water remained at the tip of the collecting duct nearly fivefold greater than in controls (0.75 +/- 0.10%). Similar differences were seen in fractional sodium that remained at this site. The ratio of tubular fluid osmolality to that of plasma was also reduced in the UUO group (1.53 +/- 0.06 vs. 4.60 +/- 0.26 in controls, P less than 0.001). Single nephron glomerular filtration rate of cortical and deep nephrons was significantly less (P less than 0.001) after release of UUO. Although the percentage of filtering nephrons was significantly reduced in both nephron populations, the decline in glomerular filtration rate was greater in cortical than in juxtamedullary nephrons (cortical:juxtamedullary nephrons = 27.6 +/- 4.5% vs. 53.3 +/- 5.2% in controls, P less than 0.005) which suggests that single nephron glomerular filtration rate is redistributed to deep nephrons after release of UUO. In contrast to cortical nephrons, the amount of tubular fluid which remains near the bend of the loop of Henle of deep nephrons was greater after release of UUO. This appeared to be the result of a decrease in the reabsorption of both water (tubular fluid:plasma inulin = 2.41 +/- 0.16 vs. 7.94 +/- 0.69 in controls, P less than 0.001) and sodium (52.3 +/- 4% vs. 40.7 +/- 2.9% of the filtered sodium in controls, P less than 0.02). It is suggested that this altered reabsorption occurs along both the proximal tubule and descending limb of the loop of Henle of juxtamedullary nephrons. Inner medullary plasma flow (IMPF), as measured with the [125I]albumin-accumulation technique, was significantly depressed before release of UUO, but exceeded control values 90 min postrelease. Such changes imply that the filtration fraction of deep nephrons is decreased and that physical factors in the proximal tubular reabsorption of sodium have been altered. When papillary solute content was measured before release of UUO it was low (428 +/- 23 vs. 1,205 +/- 106 mosmol/kg in controls, P less than 0.001) which indicates that the decline in papillary osmolality is not a consequence of the increased IMPF seen after ureteral release, but rather precedes it. In fact, the decline in papillary osmolality may contribute to the increase in IMPF after release of UUO and to the decreased reabsorption of fluid along the descending limb of the loop of Henle.     

Use of Xpert MTB/RIF in a low prevalence setting in the Southwest of England

China empowers mobile health technologies to fight against COVID-19 pandemic. The success of mobile health here may be a useful reference for other parts of the world. We explore China's application of mobile health technologies to replenishing traditional public-health and social approaches for mitigating and suppressing COVID-19, and found that Internet hospitals alleviate the unavailability, inaccessibility, and inequity of health services during the outbreak; the fact-check and information-release platforms reduce the spread of misinformation; and the infection risk scoring systems facilitate restoring the order of production and life.     

Escape rhythm and paroxysmal tachyarrhythmia originating from the right bundle

A rare phenomenon of escape rhythm and paroxysmal tachycardia originating in the right bundle branch, in a young female without any organic heart disease, is presented.     

Development of circulating antiheart antibodies as a result of coronary bypass surgery

Antiheart antibodies have been implicated as a marker of postcardiotomy syndrome in patients undergoing coronary artery bypass. To assess the frequency of and contributory factors in the development of antiheart antibodies after coronary bypass procedures, 33 patients were examined for evidence of antiheart antibodies before and for seven days after routine coronary artery bypass operations. Overall titers of antiheart antibodies rose in approximately 66% of the patients. However, this rise was not accompanied by any major clinical symptoms. History of previous myocardial infarction or myocardial injury did not correlate with a higher frequency of development of antibodies. Antiheart antibodies appear to be a common consequence of coronary artery bypass operations and are not routinely associated with the development of postcardiotomy syndrome.     

Minocycline-induced autoimmune syndromes: An overview

OBJECTIVE: To increase awareness of minocycline-induced autoimmune syndromes. METHODS: Review of relevant publications from the American and European literature. RESULTS: Four minocycline-induced syndromes have been described in 82 patients: serum sickness, drug-induced lupus, autoimmune hepatitis, and vasculitis. Aside from sporadic cases of serum sickness, all other syndromes occurred in patients treated for acne. Drug-induced lupus and hepatitis were by far the most common events (66 cases). Except for serum sickness, which presented shortly (mean, 16 days) after minocycline, the autoimmune syndromes manifested after protracted use (mean, 25.3 months). As expected, the patients with acne were young (mean, 19.7 years). The most frequent symptoms were arthralgia, followed by arthritis, fever, and rash (73, 45, 38, and 29 patients, respectively). Serologically, antinuclear antibodies were the most common finding (63 positive of 68 tests); perinuclear anti-neutrophilic cytoplasmic antibodies (pANCA), when assayed, were similarly frequent (20 of 24 tests). Surprisingly, anti-histone antibodies were uncommon, even among patients with drug-induced lupus (4 of 31 tests). The clinical and serological features of the separate syndromes may overlap. The diagnostic value of pANCA, as well as its possible role in minocycline-induced autoimmunity, are discussed. CONCLUSIONS: Minocycline has the potential to evoke a variety of clinical and serological autoimmune expressions. The number of published reports may underestimate the frequency of this condition, which should be suspected and investigated in young patients with autoimmune manifestations.     

Reoperation Results of Arterial Involvement in Behçet''s Disease

Objectives to retrospectively evaluate the role of vascular interventions in Behçet's disease with arterial involvement. So far, little information is available on the surgical approach for arterial involvement in Behçet's disease. Material and methods between February 1989 and August 1997, among 178 patients with Behçet's disease referred to our clinic, vascular involvement was established in total of 67 patients (38%) which consisted of 59 venous (33%) and 12 (7%) arterial involvements requiring urgent surgical intervention. Primary arterial lesions were occlusive in one patient, aneurysm formation in nine or both in four. Results twelve primary operations and 12 reoperations were performed. The reasons for reoperations were anastomotic aneurysms, graft occlusion, occlusion of native vessel, graft infection, bleeding from anastomosis and aortoenteric fistula. First reoperation was performed after a mean period of 6.4 months (1–15 months). Postoperative follow-up was 12–60 months (mean 36 months) and three patients died during follow-up. Conclusions the surgical results were not satisfactory because of progressive graft thrombosis and formation of new aneurysms at the anastomosis. Aggressive medical treatment should be combined when major vessel involvement occurs. All types of arterial punctures for angiography or blood gases should be minimised because of the risk of new aneurysm formation. Surgical intervention is indicated only in patients with a growing aneurysm, acute rupture or severe ischaemia.