镉对小鼠肾脏细胞凋亡的影响

目的 研究镉对小鼠肾脏细胞凋亡的影响。方法 将小鼠分成5组,分别注射0．9％生理盐水,80、160、240或320mg／kg的CdCl2溶液,连续6周,于染毒4周和6周后每组处死一半小鼠,测定肾脏系数,用流式细胞术检测细胞凋亡,用免疫组化法测Bcl—2。结果 染镉组小鼠肾脏系数较对照组显著增高,而且细胞凋亡率较对照组明显增高,Bcl—2蛋白表达明显下降。结论 镉可诱导小鼠肾脏细胞凋亡。     

散发性肾透明细胞癌组织中VHL基因突变、血管内皮生长因子表达及其与微血管形成的关系

目的探讨国人散发性肾透明细胞癌(CCRCC)中von Hippd-Lndau(VHL)基因突变、血管内皮生长因子(VEGF)表达和微血管形成的关系和意义。方法应用聚合酶链反应(PCR)、PCR产物直接测序和免疫组化等方法分析77例散发性肾透明细胞癌中VHL基因突变、VEGF和微血管密度(MVD)的情况。结果VHL基因突变40例(51．9％),VEGF染色阳性61例(79．2％)。在VHL基因突变组中VEGF阳性率(92．5％)高于无突变组(64．9％),P=0．003;VHL基因突变组MVD均值(760．80／mm^2)也高于无突变组(547．03／mm^2),P=0．001。VEGF阳性组MVD均值(715．95／mm^2)高于VEGF阴性组(437．44／mm^2),P=0．001。在VEGF阳性组中,按照VHL基因是否突变分组,突变组MVD值仍高于无突变组,P=0．011。结论在国人散发性肾透明细胞癌中VHL基因突变率较高,其突变会使VEGF表达和MVD升高。VHL基因突变失活后除通过VEGF,还可能通过其他机制促进肿瘤微血管的形成,并因此可能增加了CCRCC的恶性能力。     

单核细胞RAGE表达上调:慢性肾功能衰竭微炎症的机制

目的探讨慢性肾功能衰竭(CRF)时细胞表面晚期糖基化终产物(AGE)受体(RAGE)的表达及其在单核细胞介导的炎症反应中的作用。方法96例非糖尿病CRF患者的断面队列研究。用密度梯度离心加免疫磁珠法分离外周血单核细胞(PMC),用特异性抗RAGE抗体染色、流式细胞仪检测PMC表面RAGE表达,Scatchard印迹法分析PMC结合AGE的位点数和亲和力,用ELISA法测定循环新蝶呤、TNF-α、C反应蛋白(CRP)和AGE水平。结果CRF患者PMC表面RAGE表达明显上调并随肾功能恶化而增加(r^2=0．73),RAGE上调程度与血浆AGE水平呈正相关(r=0．71);CRF患者PMC与AGE的结合位点数和亲和力明显高于正常人,在相同剂量AGE刺激下,CRF患者PMC生成的TNF-α明显多于正常PMC,且AGE诱导的TNF-α分泌可被抗RAGE抗体所抑制;患者PMC表面RAGE表达水平与循环TNF-α水平呈正相关(r=0．61),与单核细胞活化标志物——新蝶呤(r=0．65)和急性时相反应蛋白——CRP(r=0．44)呈正相关。结论CRF患者RAGE表达增加,RAGE上调可能通过促发炎症正反馈环导致单核细胞持续活化,从而参与CRF由单核细胞介导的全身微炎症反应。     

转化生长因子β1通过Smad2途径调节足细胞结缔组织生长因子表达

目的　研究肾脏足细胞是否表达结缔组织生长因子 (CTGF)以及TGFβ1对CTGF表达调控的信号途径。方法　以肾小球足细胞为对象 ,应用Western印迹分析技术 ,观察了 3种促进肾脏纤维化的蛋白因子 ,转化生长因子 β1(TGFβ1)、血小板源生长因子 (PDGF)和血管紧张素Ⅱ (AngⅡ )对体外培养的足细胞CTGF蛋白表达的影响 ,以及ERK、Smad两条信号途径在TGFβ1调节CTGF蛋白表达中的影响 ;逆转录 聚合酶链反应 (RT PCR)检测CTGFmRNA的变化。结果　体外培养的足细胞表达基础水平CTGF蛋白 ,2 0ng/mlPDGF和 10 -6mol/LAngII刺激 2 4小时后细胞内CTGF蛋白水平与对照相比差异无显著意义 (P >0 0 5 ) ,而 1ng/mlTGFβ1刺激 2 4h足细胞CTGF蛋白水平显著高于对照 (P <0 0 5 ) ,且增加呈TGFβ1剂量依赖趋势 ;1ng/mlTGFβ1刺激 12h可以使细胞CTGFmRNA表达增加。1ng/mlTGFβ1使足细胞Smad2 和细胞外信号调节激酶 (ERK1/ 2 )磷酸化 ,在刺激 30min达高峰 ;应用丝 /苏氨酸激酶抑制剂Staurosporine抑制Smad2 磷酸化可以消减TGFβ1刺激的CTGF蛋白增加 ,但ERK1/ 2 活化抑制剂PD 980 5 9阻断ERK1/ 2 磷酸化不能减弱TGFβ1刺激CTGF蛋白表达的效应。结论　在足细胞上 ,TGFβ1刺激CTGF表达依赖于Smad2 信号通路的活化 ,而不依赖于ERK1/     

Dietary exposure to cadmium at close to the current provisional tolerable weekly intake does not affect renal function among female Japanese farmers

Dietary cadmium (Cd) exposure and renal tubular function were investigated in 1381 female farmers from five districts in Japan (Japanese Multi-centered Environmental Toxicant Study project; JMETS). Dietary Cd exposure of the five populations was assessed from the individual Cd concentrations of the rice consumed by the study participants and the quantities of rice consumed daily. The populations showed a sequential difference in dietary Cd exposure, ranging from a level as low as that of the general Japanese population to one close to the current provisional tolerable weekly intake (PTWI). The levels of urinary Cd excretion, an indicator of Cd accumulation in the kidneys, increased along the same sequential pattern as dietary Cd exposure. However, no differences were observed among the populations in levels of urinary alpha 1-microglobulin and beta 2-microglobulin excretion, which are indicators of renal tubular function. These results indicate that the current PTWI is sufficient to prevent Cd-induced renal dysfunction among the general population.     

Microalbuminuria as a predictor of early glomerular injury in children with sickle cell disease

Objective : A cross sectional study was carried out to determine the prevalence of microalbuminuria in the pediatric patients with sickle cell disease.Methods : The study was carried out on 64 pediatric patients aged less than 14 years with documented HbSS, HbAS and HbS beta thalassemia, Microalbuminuria was estimated using single radial immuno diffusion technique. Majority of the study subjects were of HbSS type. 38.5% had symptoms for >2 years. 18.8% of the study population had significant microalbuminuria (19.2% of SS types and 18.8% of Hb AS types).Result : Microalbuminuria excretion was significantly more in patients >9 years of age as compared to young patients (p<0.05). Mean serum creatinine levels did not show any significant difference in the various study groups.Conclusion : Microalbuminuria estimation is a very important clinical marker of preclinical glomerular damage in patients with sickle cell disease. Its estimation would help in the early detection of such patients and prompt initiation of therapy.     

Fibrillary noncongophilic renal and extrarenal deposits: a report on 10 cases

Cases in which glomerular deposits of Congo red negative amyloid-like fibrils were demonstrated by electron microscopic identification are included in this study. In the 1,266 kidney biopsies studied, there were 9 biopsies from 8 patients with fibrillary glomerulonephritis and 2 biopsies from 2 patients with systemic lupus. In 1 case of fibrillary glomerulonephritis (FGN), autopsy was performed. Electron microscopic examination showed glomerular (100%) and extraglomerular (60%) fibrillary deposits in the biopsy samples of patients with FGN and also in patients with systemic lupus. In the autopsy case, similar fibrillary deposits were demonstrated in the kidney, pancreas, spleen, lungs, and liver. The diameter of the fibrils, which were arranged similarly in all cases, varied from 8 to 27 nm individually, the length being about 1.5 μm. The authors speculate that extraglomerular kidney fibrillary deposits concurrent with the same type of deposits in other organs suggests systemic manifestation of FGN.     

Parotid gland metastasis from renal cell carcinoma

OBJECTIVE: To discuss the diagnosis and management of metastatic renal cell carcinoma presenting as a parotid mass by studying such cases. STUDY DESIGN: Retrospective review. METHODS: Identification of 24 previously reported cases of renal cell carcinoma metastatic to the parotid gland in the English language literature and an analysis of a total of 25 patients including our case. RESULTS: Parotid metastasis was the initial presenting sign of the malignancy in the kidney in 14 of 25 (56%) cases; 11 of 25 (44%) cases presented with metachronous metastasis to the parotid. The most common presenting complaint was parotid mass. No case presented with facial paralysis. In three of six (50%) patients, fine-needle aspiration biopsy was diagnostic. CONCLUSIONS: In the majority of cases, parotid metastases are the first clinical sign of the renal cell carcinoma. Fine-needle aspiration biopsy can provide crucial information without parotidectomy as in our case. Parotidectomy with facial nerve preservation should be considered as a therapeutic option for solitary parotid metastasis.     

Post-Kidney Transplantation Iliac Artery Stenosis due to Iatrogenic Injury: Case Report

We report a case of left external iliac artery lesions as a complication of post-kidney transplantation due to vascular clamp application injury. The lesions were proximal stenosis and distal occlusion just near the graft anastomosis site and they were diagnosed incidentally during the embolization for arteriovenous fistula. Angiography confirmed the diagnosis and it was managed successfully by percutaneous interventional techniques.     

The effects of irrigation fluid volume and irrigation time on fluid electrolyte balance and hemodynamics in percutaneous nephrolithotripsy

Objective: to determine fluid-electrolyte andhemodynamics changes and complicationsassociated with irrigation fluid volume andtime in percutaneous nephrolithotripsy in that0.9% NaCI was used as irrigant.Methods: Standard anaesthetic procedureswere performed to 6 women and 16 men. Meanarterial pressure, heart rate, central venouspressure, Na⁺, K⁺, osmolality,haemoglobin, haematocrit were recorded before,during and after irrigation every 10 minutes.Creatinine and blood urea nitrogen weredetermined before and after irrigation.Moreover, the operation and irrigation times,irrigation fluid volume, total fluid outputversus input, blood transfusions andcomplications were recorded.Results: Mean arterial pressure, heartrate, central venous pressure, Na⁺,K⁺, osmolality did not changesignificantly during and after irrigation andno relationship was observed between those withirrigation volume and time. Creatinine andblood urea nitrogen values during and afterirrigation did not change significantly versusthose before irrigation. Although no bloodtransfusion was needed for any case during theprocedure, it was necessary for two cases afterthe procedure. One case with pneumothorax thatdeveloped during procedure was treated byinserting a thoracic tube.Conclusion: There were no significantchanges in fluid-electrolyte balance andhemodynamics related to both irrigation fluidvolume and irrigation time when 0.9% NaCI wasused in PNL.