Prevention of renal ischemia/reperfusion-induced injury in rats by leflunomide

OBJECTIVE: There is increasing evidence to suggest that toxic oxygen radicals play an essential role in the pathogenesis of ischemia/reperfusion (I/R) injury in the kidney. This study was designed to investigate the effects of leflunomide, an isoxazole derivative and a unique immunomodulatory agent, in I/R-induced renal injury in rats. METHODS: Forty female Sprague-Dawley rats were divided equally into four groups: (I) control (only leflunomide 10 mg/kg, intragastrically treated); (II) sham operated (only unilateral nephrectomy); (III) I/R; and (IV) leflunomide (10 mg/kg for two doses prior to experiment) plus I/R groups. In groups III and IV, after unilateral nephrectomy, the rats were subjected to 60 min of left renal pedicle occlusion, followed by 6 h of reperfusion. At the end of the reperfusion period, rats were killed and kidneys and blood were removed. Catalase, myeloperoxidase and xanthine oxidase activities, and malondialdehyde, nitric oxide and protein carbonyl levels were determined in renal tissue. Serum creatinine, blood urea nitrogen and aspartate aminotransferase were measured for the evaluation of renal function. In histopathological examination, renal damage was scored 0-3. RESULTS: Group III animals demonstrated severe deterioration of renal function, renal morphology and a significant renal oxidative stress. Pretreatment of animals with leflunomide markedly attenuated renal dysfunction, morphological alterations, reduced elevated oxidative stress products levels and restored the depleted renal antioxidant enzyme. CONCLUSION: The findings imply that oxygen radicals play a causal role in I/R-induced renal injury, and leflunomide exerts renoprotective effects probably by the radical scavenging and antioxidant activities with immunomodulatory effect.     

Clinicopathological Features of Childhood Nephrotic Syndrome in Northern Nigeria

The clinicopathological features of childhood nephrotic syndromein northern Nigeria were studied in 100 consecutive patients.The patients presented with gross anasarca and very low serumalbumin, which was <15 g/1 in 30 patients. The three mostfrequent histological diagnoses in 98 renal biopsies were membranoproliferativeglomerulonephritis (25), quartan malarial nephropathy (20),and proliferative glomerulonephritis (19): together they accountedfor 65 per cent of all biopsies. Only nine patients had minimalchange nephropathy. Antigens were detected by immunofluorescencein the glomeruli of 70 of 76 biopsies (92 per cent): Plasmodiummalariae was detected in 25 per cent and hepatitis B surfaceantigen in 24 per cent. The disease was characterized by progressivedeterioration in renal function and a high mortality rate of13 per cent. Nine of the 13 deaths occurred within one yearof diagnosis.     

Childhood bronchial asthma in northern Nigeria

A review of childhood bronchial asthma in Zaria, northern Nigeria is presented. An average of twenty-three cases a year were seen over a 4-year period. Features of the disease include low incidence, late age of onset, family history of asthma in only 16% of cases and absence of eczema, but positive skin tests, as evidence of atopy. The clinical features of the disease are similar to those described in children elsewhere. The apparent conflicting reports on the epidemiology of childhood bronchial asthma in Africa are probably due to the multifactorial nature of the disease: geographical, environmental, racial, as well as factors related to the life-style of the people.     

Is Postdilatation with a Noncompliant Balloon Necessary after Coronary Stent Deployment during Primary Angioplasty?

Background

Postdilatation (PD) with noncompliant balloon during elective percutaneous coronary intervention (PCI) is performed usually in clinical practice in order to optimize stent expansion. However, current knowledge about its use in patients undergoing primary PCI is controversial. This study aims to evaluate the angiographical and clinical results of PD in patients who underwent primary PCI with drug eluting stents (DESs).

Methods

A total of 405 consecutive patients (mean age 56.9 ± 12.3 years; 302 male) with ST elevation myocardial infarction were evaluated retrospectively. Patients received DES with or without predilatation according to physician's discretion. Eligible patients were divided into 2 groups based on PD procedure. The clinical end‐points were death, target vessel revascularization (TVR) and stent thrombosis at 6 months after PCI. The angiographic end‐points were postprocedural correct Thrombolysis in Myocardial Infarction (TIMI) frame count (cTFC), final TIMI flow, and myocardial blush grade (MBG).

Results

PD was performed in 214 patients (52.8%). Angiographical parameters such as TIMI flow, cTFC, and MBG did not differ after PD (P > 0.05). During 6‐month follow‐up, TVR and stent thrombosis rates were lower in the PD group (6 vs. 16, P = 0.03; and 3 vs. 10, P = 0.04, respectively). PD and diabetes were detected as independent predictors of MACE (β = 0.52, P = 0.01, and β = ?0.47, P = 0.02; respectively).

Conclusion

Our study revealed that PD does not yield adverse effects on final angiographic parameters when performed during primary PCI. Besides PD seems to decrease probability of stent thrombosis and TVR.

     

Immunohistochemical expression of multidrug resistance proteins in mature T/NK‐cell lymphomas

Multidrug resistance (MDR) is defined as resistance of tumor cells to a wide spectrum of structurally and functionally unrelated drugs. One of the most important mechanisms in mediating MDR is that involving cellular drug efflux transporters. Drug resistance is a common and formidable obstacle to therapy in mature T/NK‐cell lymphomas and the MDR phenotype is thought to be one of the contributing mechanisms. In this study we assessed the immunohistochemical expression of P‐gp (P‐glycoprotein), MRP‐1 (multidrug resistance associated protein 1), BCRP (breast cancer resistance protein) and LRP (lung resistance protein) in 45 mature T/NK‐cell lymphomas diagnosed at our hospital. We detected P‐gp expression in 31% (13/42), MRP‐1 expression in 74% (31/42), BCRP in 78% (32/ 41) and LRP in 59% (26/44) of the cases. These findings show that our T/NK‐cell lymphoma cases display high frequency of MDR protein expression.     

Urethral polyps in children: A review of the literature and report of two cases

A solitary polyp of the urethra is a rare benign fibroepithelial growth and has often been described in boys. Its occurrence in girls is exceptional. In the present paper, two children with solitary polyps of the urethra are presented and discussed. The first case was an 18-month-old boy with a posterior urethral polyp arising from the posterior urethra and extending to the bladder. It was excised by cystostomy because of an unsuccessful endoscopic removal attempt. The second case was a 2-year-old girl with an interlabial mass arising from the posterior wall of urethra and protruding from the external urethral meatus. It was excised transurethrally.     

Exogenous human recombinant interleukin-10 protects the kidney against hypoxia-induced renal injury in immature rats

AIM: The purpose of this study was to determine the effects of exogenous human recombinant interleukin-10 (rhIL-10) on hypoxia-induced renal injury in immature rats. METHOD: The study was performed on 1-day-old Sprague-Dawley rat pups. Group 1 (n = 8) served as non-hypoxic controls. Group 2 (untreated, n = 8) rats were subjected to hypoxia-reoxygenation (H/O) and were then returned to their mothers. Group 3 (rhIL-10 treated, n = 8) rats were subjected to H/O, were returned to their mothers, and were treated with rhIL-10 (75 microg/kg subcutaneously) for the next 3 days. All animals were killed on day 4 and renal specimens were obtained to determine the tissue level of malondialdehyde (MDA) and histological changes. RESULTS: In the untreated group, moderate or severe renal tubular necrosis was observed However, the tubular necrosis score was significantly less in the rhIL-10 treated rats than in the untreated rats (P < 0.05). In the untreated group, MDA levels were significantly increased compared with the control and rhIL-10 groups (P < 0.001 and P < 0.05, respectively). In the rhIL-10 treated group, MDA levels were not significantly different compared with the control group. CONCLUSION: RhIL-10 has a protective effect against hypoxia-induced renal injury in immature rats by depression of tissue MDA level and renal tubular necrosis score.     

Sialic acid in childhood renal diseases: Correlation with clinical and laboratory indices

There are many kinds of glycoproteins that have sialic acid residues and it has been reported that these are elevated in some renal diseases and their significance in the pathogenesis of several renal diseases has been investigated. In the present study the serum and urine levels of sialic acid were measured in healthy controls and in children with either poststreptococcal acute glomerulonephritis (PSAGN) or minimal change nephrotic syndrome (MCNS) to test if there is any correlation with clinical and laboratory indices. In PSAGN and MCNS patients the serum and urine sialic acid concentrations at onset and relapse were significantly different from healthy controls (Mann-Whitney U-test P < 0.005). There was not a significant correlation between the clinical severity, serum creatinine and complement C₃ levels and serum sialic acid concentrations in PSAGN patients. Also there was not a significant correlation between edema, serum albumin, IgG, transferrin, α-1-antitrypsin and serum sialic acid concentrations in MCNS patients. Although high serum and urine sialic acid levels were found in both PSAGN and MCNS patients, it does not have any clinical significance nor is it important as a diagnostic or prognostic marker.