Is cytomegalovirus a cause of ureteral stricture in renal transplant recipients?

Cytomegalovirus (CMV) is regarded as a predominant infectious agent in solid organ transplants. CMV disease has highly protean clinical manifestations. Nevertheless, urinary tract involvement seems to be very rare during CMV infection. We report two cases of renal transplant recipients in whom ureteral stricture developed in the course of CMV disease. Histologic data were available for them and were consistent with CMV infection. We discuss previous case reports and propose physiopathologic mechanisms. Received: 3 October 1996 Received after revision: 13 February 1997 Accepted: 17 February 1997     

Liver transplantation for fulminant hepatic failure: importance of renal failure

Abstract One hundred eighty-one consecutive patients with fulminant hepatic failure (FHF) presenting in a 2-year period were reviewed. In this cohort we examined the impact of pretransplant renal failure on mortality and morbidity following orthotopic liver transplantation (OLTx). Twenty-seven patients (18 female, 9 male) with a median age of 43.5 years (range 19–65 years) underwent OLTx. FHF was due to idiosyncratic drug reaction ( n = 4), paracetamol overdose ( n = 3), seronegative hepatitis ( n = 17), hepatitis B ( n = 1), veno-occlusive disease ( n = 1), and Wilson's disease ( n = 1). Renal failure was present in 14 patients, 7 of whom died (whereas there was 100 % survival in patients without renal failure). Pretransplant renal failure was associated with prolonged mechanical ventilation (13 days vs 6 days, P = 0.05), prolonged intensive care stay (17 days vs 8 days, P - 0.01) and prolonged hospital stay (27 vs 21 days, P = NS). Pretransplant renal failure did not predict renal dysfunction at 1 year after OLTx. We conclude that the survival of patients transplanted for FHF is inferior to that of patients transplanted for chronic liver disease (67 % vs 88 % 1-year survival in Birmingham). For patients with FHF undergoing transplantation, pretransplant renal failure strongly predicts poor outcome with significantly greater consumption of resources.     

小儿肾脏疾病血,尿内皮素的变化

目的研究小儿肾脏疾病血、尿内皮素（ＰＥＴ、ＵＥＴ）的水平及其相互关系。方法采用同位素放免方法检测了肾病综合征（ＮＳ），肾小球肾炎（ＧＮ），肾功能衰竭（ＲＦ）共７２例患儿血及尿中ＥＴ，血心钠素（ＡＮＰ）水平。结果ＮＳ，ＧＮ，ＲＦ三组的ＰＥＴ及ＵＥＴ值明显高于对照组，尤其ＲＦ组（Ｐ＜００５，Ｐ＜０．０１）。ＡＮＰ值在ＧＮ组和ＲＦ组明显高于对照组（Ｐ＜００１）。８例ＡＲＦ患儿恢复期血ＥＴ水平下降，６例ＣＲＦ患儿虽经治疗，但血ＥＴ水平不降或上升。结论ＥＴ在小儿肾脏疾病发病机理及病情进展中可能起重要作用，其值高低与病情严重程度及预后有关。     

人卵巢癌中肿瘤转移抑制基因nm23-H1编码蛋白的表达

目的：探讨人卵巢癌标本中，肿瘤转移抑制基因ｎｍ２３－Ｈ１编码蛋白ＮＤＰＫ－Ａ表达的临床意义及其与预后的关系。方法：应用免疫组织化学抗生蛋白链菌素－过氧化酶结合（Ｓ－Ｐ）法，检测５８例人卵巢癌标本中ｎｍ２３－Ｈ１蛋白水平。结果：ｎｍ２３－Ｈ１蛋白的表达与患者手术时是否有淋巴结及大网膜转移相关（Ｐ〈０．０５），但原发灶与转移灶间的阳性表达率相差不显著；与患者术后生存时间密切相关（Ｐ〈０．０１），术后生     

改良额颞-颞下窝入路切除中颅凹底内外沟通瘤

目的：为了更完全地切除中颅凹底内外沟通性肿瘤。方法：采用经过改良的Ｍｉｃｋｅｙ额颞颞下窝入路。其改良主要是将额骨瓣连同其表面附着的颞肌以及游离后的眶颧骨块一并向下翻开，并将手术程序作了相应改变。结果：成功切除了１３例肿瘤。术后３例恢复了轻工作，６例能自主生活，３例生活仍需别人照顾，１例复发未再次手术。结论：采用改良的额颞颞下窝入路对中颅凹底内外沟通性肿瘤暴露充分，切除广泛。Ｍｉｃｋｅｙ入路改良的优点：颞肌血运的保留，有利于骨瓣与正常颅骨的早期融合。同时颞肌附着点的保留，有利于咀嚼功能。     

心包内处理肺血管及心房部分切除治疗中心型肺癌

１９８７年５月至１９９３年１２月对１６例较晚期肺癌采用心包内处理肺血管及心房部分切除的方法作了全肺切除术，肿瘤均为中心型。ＣＴ扫描显示隆突下或主肺动脉窗淋巴结肿大者占５０％，术中见肺动脉，肺静脉均受累者８例，肺静脉受累者６例，２例作左心室部分切除，１５例恢复良好，１例术中大出血致心脏停搏，复苏后并发脑水肿昏迷死亡。我们认为，心包内处理肺血管全肺切除提高了手术切除率，且手术过程较安全可靠，作者对这种     

Renal vascular resistance in normal children – a color Doppler study

To investigate the relationship between age and renal vascular resistance and to establish nomative data of the systolic/diastolic ratio (S/D ratio), pulsatility index (PI), and resistant index (RI) of the renal artery in the normal pediatric population, we studied 252 normal children aged newborn to 13 years (a total of 449 kidneys) with a color Doppler unit. After the normality of the kidney was established, color flow mapping was performed to localize the segmental portion of the renal artery. Flow velocity waveforms were then obtained by pulsed Doppler, and S/D ratio, PI, and RI were calculated. Multiple regression analysis confirmed the age dependence of the S/D ratio, PI, and RI of the renal artery in normal children. Renal vascular resistance continuously declines after birth and stabilizes at the age of 102 – 130 months. Normative data for S/D ratio, PI, and RI of the renal artery in normal children were established for each age group. Since renal vascular resistance decreases with age and stabilizes at 8 – 10 years, we suggest using different normal ranges for each age group when studying renal vascular resistance in pediatric patients. Received October 5, 1995; received in revised form and accepted April 24, 1996     

Sialic acid concentrations in the urine of men with and without renal stones

Summary It has been suggested that urinary sialidase may play a role in the formation of renal stones. The present study was therefore undertaken to compare spectrophotometrically the different types of sialic acid concentrations and sialidase activities in fresh first morning urine specimens of men (21–65 years) with (13) and without (9) calcium oxalate renal stones. Although the free urinary sialic acid concentrations of the two groups of men were statistically about the same (P=0.0614), the total (P=0.003) and bound (P=0.0012) urinary sialic acid concentrations differed significantly. Both the total and bound sialic acid concentrations were lower in the urine specimens of the stone patients than in their healthy counterparts. This decrease in urinary sialic acid concentrations was firstly thought to be the result of elevated breakdown enzymes of sialic acid, which would favour the production of pyruvate. However, spectrophotometric determinations of the endogenous pyruvate concentrations of the two types of urine specimens did not differ significantly (P=0.0708). Secondly, the decrease in total urinary total sialic acid concentration of stone patients, could be attributed to less sialic acid synthesis or less renal excretion. Therefore, the same experiments were repeated using serum of 13 patients and 9 healthy men. Conversely, the total (P=0.4425) and bound (P=0.2850) serum sialic acid concentrations were found to be similar in the two types of subjects. However, the free serum sialic acid concentration of stone patients was significantly lower than in the healthy subjects (P=0.0062). This phenomenon is also reflected in the average ratio for serum free: bound sialic acid in healthy and stone patients, 1:7.9 and 1:18.7 respectively (P=0.0009). The lower free serum sialic acid concentration may lead to lower renal excretions of sialic acid. This may explain the decrease in total urinary sialic acid concentration in stone patients. The lower bound urinary sialic acid concentrations in patients was also reflected in the urinary free: bound sialic acid ratio for healthy (1:2.3) and stone patients (1:1.3). The difference between these two groups of men was highly significant (P=0.0001). This phenomenon might be explained by the urinary sialidase activities, which was spectrophotometrically determined at 334 nm at 37°C of 11 patients with stones and 17 healthy men. The ages of both groups of men were the same (P=0.326). An increase in urinary sialidase activity was observed with the stone patients (P=0.00001) when compared to specimens of healthy men. This might explain the decrease in urinary bound sialic acid concentration of the stone group. It seems from these results that the urinary concentration of sialic acid and the activity of urinary sialidase, may play a role in the pathogenesis of the multifactorial disease, urolithiasis.     

Posterior urethral valves in patients with Down syndrome

Renal and urological anomalies in Down syndrome (DS) have received little attention compared with the nephrourological findings described in other chromosomal abnormalities. Renal hypoplasia, hydroureteronephrosis, ureterovesical and ureteropelvic junction obstruction, and vesicoureteral reflux, but not posterior urethral valves, have been associated with DS. We report the occurrence of posterior urethral valves in three male infants with DS at a single institution. All had multiple urological procedures for correction or palliation of obstruction. Children with DS may have an increased risk for developing posterior urethral valves and obstructive uropathy. Furthermore, they may also develop chronic renal failure secondary to posterior urethral valves. Therefore, we suggests that infants with DS be screened with ultrasonography for renal and urological abnormalities early in life and, if abnormal, a contrast voiding cystourethrogram be performed to rule out posterior urethral valves or other bladder or urethral abnormalities. A review of the renal and urological anomalies in DS reported in the literature since 1960 is presented.     

P53基因突变、人乳头瘤病毒16，18型感染与肺鳞癌发病的关系

应用单链构象多态性分析多聚酶链反应ＥＢ染色法（ＰＣＲ－ＳＳＣＰ－ＥＢ）对４０例肺癌组织标本的Ｐ５３基因序列５～８外显子突变进行分析，同时应用ＰＣＲ方法检测上述标本及１８例肺良性疾病组织标本中ＨＰＶ１６、１８型ＤＮＡ相关序列，旨在分析二者在肺鳞癌发病中的作用及相互关系，并就肺鳞癌与Ｐ５３基因结构和功能异常的关系进行初步探讨。