Cyclosporine A-induced kidney alterations are limited by melatonin in rats: an electron microscope study

The effect of melatonin on experimental prolonged cyclosporine A (CsA) nephrotoxicity was analyzed by electron microscopy and morphometry. Twenty female Wistar rats were divided into groups that received (1) CsA at a therapeutic dose (15 mg/kg/day) sc for 40 days; (2) olive oil, CsA vehicle, as controls; (3) CsA plus melaton (1 mg/kg) ip for the same time; (4) melatonin alone, as additional controls. All controls had normal renal ultrastructure. However, in CsA group, both tubular and glomerular alterations were observed. The authors found apoptotic and necrotic proximal tubules with disrupted brush border, swollen mitochondria, abundant lysosomes; in the glomerulus, amorphous basement membrane, and abnormal mesangial matrix. CsA plus melatonin administration partly prevented these changes. Nevertheless, fibrillar deposits in podocytes and basolateral membrane dilatations in proximal tubules were observed. Histopathological analysis on semithin sections and ultrastructural morphometry were also performed. CsA induced interstitial fibrosis, atrophy, and PAS positive inclusions in the proximal tubules. Moreover, CsA reduced glomerular and mesangial volume but enhanced mesangial matrix volume and basement membrane thickness. After CsA plus melatonin, these parameters were reduced in the proximal tubules and restored in the glomerulus. In conclusion, melatonin attenuated morpho-quantitative alterations induced by CsA in the rat kidney.     

Differences in gallstone structure in primary common bile duct lithiasis and gallbladder lithiasis

Summary Some differences between gallbladder lithiasis and primary common bile duct lithiasis are described. Microbiological cultures and biochemical analyses were carried out on the bile of two groups of patients: 27 suffering from gallbladder and 5 from primary common duct lithiasis. The microstructure and composition of gallstones were also examined by polarized light microscopy and X-ray diffraction. Women predominated in gallbladder lithiasis but not in primary common duct lithiasis group (P<0.05) and body weight was higher in the former group (P<0.02). Primary common duct lithiasis patients had a higher, although not significant, incidence of duodenal diverticulosis (P=0.15), and a higher incidence ofE. coli-positive cultures in bile (P<0.001). No significant difference in the biochemical composition of the bile was found between the groups. Brown pigment stones predominated in primary common duct lithiasis, while cholesterol stones did in gallbladder and secondary common duct lithiasis (P<0.0001). Stones formed in the gallbladder generally show linear, radial growths of cholesterol crystals, while those from the common duct present a polystratified, concentric deposition of microgranules composed mainly of pigmentary salts.These differences should be taken into account as additional criteria in the differential diagnosis between primary and secondary common duct lithiasis, as the classical criteria for diagnosing of the former greatly underestimate its actual incidence. The distinction between primary and secondary common duct lithiasis is of practical significance, since each entity requires different treatment.Abbreviations CBD common bile duct - CBDL common bile duct lithiasis - ERCP endoscopic retrograde cholangiopancreatography - GBL gallbladder lithiasis - HDL high density lipoproteins - PCBDL primary common bile duct lithiasis - SCBDL secondary common bile duct lithiasis - SGOT serum glutamic-oxalacetic transaminase - SGPT serum glutamic-pyruvic transaminase     

Analysis of the renal tissue of a woman chronically exposed to cadmium

Summary In a 61-year-old woman, who had been exposed for 20 years to cadmium in the production of Ni-Cd batteries, nephrectomy of the contracted kidney was performed. The removed kidney was examined histologically and the cadmium concentration was determined in the cortex (44.97 g g^–1) and in the medulla (7.71 g g^–1). The homogenates of the renal cortex and medulla were subjected to gel filtration on Sephadex G-75. In the cortex, as well as the medulla, cadmium was predominantly found in the low-molecular (metallothionein) fraction, but in the cortex, Cd content in this fraction was six times higher than in the medulla. The determination of SH groups and proteins in high- and low-molecular fractions indicates an induction of the metallothionein formation primarily in the renal cortex.     

Pharmacokinetics of cefradine, sulfamethoxazole and trimethoprim and their metabolites in a patient with peritonitis undergoing continuous ambulatory peritoneal dialysis

Cefradine and co-trimoxazole pharmacokinetics were studied in a patient with peritonitis that complicated continuous ambulatory peritoneal dialysis (CAPD). Concentrations in the plasma reached after oral administration of 500 mg cefradine four times daily and 400/80 mg co-trimoxazole four times daily were for cefradine 100g/ml, for trimethoprim 15g/ml, and for sulfamethoxazole 100/ml, respectively. In the dialysate concentrations were reached of 35–70/ml cefradine, 2–5/ml trimethoprim and 8–17g/ml sulfamethoxazole. The values for sulfamethoxazole are regarded too low to be clinically effective. Half-lives protein binding values and CAPD clearances are presented. Low CAPD clearances were obtained during the night and high values during the day. The dosage yielded too high plasma trimethoprim concentrations, while sulfamethoxazole dialysate concentrations were too low. It seems questionable therefore whether co-trimoxazole can be used orally for the treatment of CAPD peritonitis.     

Distribution of the [3H]-label from low doses of radioactive ochratoxin a ingested by rats,and evidence for DNA single-strand breaks caused in liver and kidneys

The distribution of a single low dose of [³H]ochratoxin A (OTA) in different tissues of male Wistar rats, after administration by intubation, was investigated after 5 h, 24 h and 48 h. This dose corresponds to concentrations encountered in naturally contaminated feed (4 ppm). The distribution of [³H]-label varied with the time elapsed after administration; at 5 h the highest specific label was found in the stomach contents and in decreasing order in: intestinal contents, lung, liver, kidney, heart, fat, intestine, testes, and the lowest in muscles, spleen and brain. With exception of brain, fat, stomach and lung, all tissues showed maximum levels at 24 h, after which time the label decreased steadily, whereas in fat it increased.After a 12-week feeding experiment, with doses of 288.8 g/kg corresponding to an intake of 4 ppm in feed each 48 h, the DNA in liver and kidneys was investigated for damage. By the alkaline elution method combined with micro-spectrofluorimetric determinations of DNA, evidence for DNA single-strand breaks was obtained. These findings support reports on the carcinogenic action of OTA.     

Acute renal dysfunction by cadmium injected with cysteine in relation to renal critical concentration of cadmium

In order to study the critical concentration of cadmium (Cd) in acute renal dysfunction following Cd, male mice were injected IV with Cd complexed with cysteine. The critical concentration was 10 g Cd/g wet weight in whole kidney and it was the same as that for Cdthionein (Cd-Th), which may suggest that the toxicity of Cd-Th is due to Cd ions liberated from Cd-Th in the kidneys. Renal Cd concentration was at first higher than the critical concentration, but decreased to the critical concentration by 24 h after administration. As an index for renal dysfunction, the uptake of p-aminohippurate (PAH) by renal cortical slices in vitro was sensitive, and showed the different time-course from those of urinary protein and glucose levels. The results suggest the usefulness of PAH uptake as an index. Incidental to the renal dysfunction, renal calcium levels exhibited a marked increase.     

纤维胆管镜治疗术后残余结石320例分析

（1）目的 总结320例胆管术后,经T管窦道纤维胆管镜治疗残余结石的经验。（2）方法 对320例胆管术后残余结石病人行纤维胆管镜取石,分析其临床表现并予以随访。（3）结果 结石取净287例,失败33例,（4）结论 纤维胆管镜对于术后胆管残余结石的治疗起着重要作用。     

胆道结石术后继发急性胆管炎病原菌及sCD14-ST和IL-8的诊断价值

目的探讨胆道结石术后继发急性胆管炎病原菌及可溶性CD14亚型(sCD14-ST)、白细胞介素-8(IL-8)的诊断价值。方法选择海南医学院第一附属医院2017年1月-2019年6月收治的胆道结石术后继发急性胆管炎患者62例作为研究对象,纳入研究组,选择同期医院收治的胆道结石术后未继发急性胆管炎的患者60例设为对照组;对研究组患者病原菌进行统计;比较不同急性胆管炎程度、不同预后结局患者血清sCD14-ST、IL-8水平;采用受试者工作特征曲线评估血清sCD14-ST、IL-8水平对于患者不良预后的诊断价值。结果 62例患者共培养分离病原菌67株,其中革兰阴性菌43株占64.18%,革兰阳性菌21株占31.34%,真菌3株占4.48%,以大肠埃希菌为主;重度急性胆管炎患者血清sCD14-ST、IL-8分别为(91.38±25.67)pg/ml、(45.28±13.61)pg/ml高于中度患者分别为(74.34±19.65)pg/ml、(32.06±10.44)pg/ml及轻度患者(P均<0.001),中度患者血清sCD14-ST、IL-8水平高于轻度患者(P均<0.001);预后不良患者急性胆管炎血清sCD14-ST、IL-8分别为(89.84±25.09)pg/ml、(41.94±12.28)pg/ml高于预后良好患者(P<0.05);sCD14-ST、IL-8对胆道结石术后急性胆管炎患者预后的截断值分别为65.65、29.31 pg/ml,其曲线下面积分别为0.841、0.768。结论胆道结石术后继发急性胆管炎病原以革兰阴性菌为主;运用血清sCD14-ST、IL-8可较好区分疾病严重程度,且对患者预后具有一定预测价值。