• 【[人型支原体。急性肾盂肾炎的罕见病原体]。】 复制标题 收藏 收藏
    DOI:10.1055/s-2008-1047651 复制DOI
    作者列表:Küchle C,Abele-Horn M,Menninger M,Held E,Heesemann J
    BACKGROUND & AIMS: HISTORY AND CLINICAL FINDINGS:A 23-year-old woman was admitted with typical signs of an acute urinary tract infection: fever, pain on tapping over both renal areas and in both flanks, urgency and dysuria. She had a history of renal colic with spontaneous passage of a renal stone.

    INVESTIGATIONS:There was marked leukocytosis and raised C-reactive protein, leukocyturia and haematuria, but no nitrites or protein in the urine. All blood and urine cultures were sterile and renal ultrasound was unremarkable.

    DIAGNOSIS, TREATMENT AND COURSE:As signs and laboratory data indicated acute pyelonephritis (PN) she was treated with gyrase inhibiting antibiotics. But while symptoms improved, fever, leukocyturia and haematuria continued; no micro-organism could be demonstrated. Mycoplasma was therefore considered as a rare cause of PN. Special urine cultures then grew M. hominis, > 10(5) organisms/ml. On the basis of sensitivity tests doxycycline was administered. All symptoms quickly improved and all inflammation parameters and urine sediments became normal.

    CONCLUSION:In rare instances M. hominis may be isolated as the causative organism of PN. If, in cases with appropriate symptoms, routine tests fail to demonstrate the causative agent, M. hominis should be included in the differential diagnosis.

    背景与目标: 病史和临床发现 : 一名23岁的女性入院时出现了急性尿路感染的典型症状: 发热,在两个肾脏区域和两侧的拍打疼痛,尿急和排尿困难。她有肾绞痛病史,并自发通过肾结石。
    调查 : 白细胞增多,C反应蛋白升高,白细胞增多和血尿,但尿液中没有亚硝酸盐或蛋白质。所有血液和尿液培养物均无菌,肾脏超声检查无异常。
    诊断,治疗和病程 : 由于体征和实验室数据表明,她接受了gyrase治疗。抑制抗生素。但是,尽管症状有所改善,发热,白细胞减少和血尿仍在继续; 无法证明微生物。支原体因此被认为是PN的罕见原因。然后,特殊的尿液培养物长出了人型M.,> 10(5) 个生物/ml。根据敏感性测试,给予强力霉素。所有症状都迅速改善,所有炎症参数和尿沉淀物都恢复正常。
    结论 : 在极少数情况下,可能会分离出原始人作为PN的致病生物。如果在具有适当症状的情况下,常规检查未能证明病原体,则应将人M。人的鉴别诊断疾病包括在内。
  • 【急性肝衰竭的辅助部分原位肝移植。】 复制标题 收藏 收藏
    DOI:10.1016/s0168-8278(97)80109-2 复制DOI
    作者列表:Pereira SP,McCarthy M,Ellis AJ,Wendon J,Portmann B,Rela M,Heaton N,Williams R
    BACKGROUND & AIMS: BACKGROUND/AIMS:Auxiliary partial orthotopic liver transplantation holds potential advantages over conventional orthotopic liver transplantation, but experience with the technique in acute liver failure is limited.

    METHODS:We describe our initial experience in seven patients (4 men, 3 women; mean age 28, range 14-35 years) with acute liver failure (paracetamol 3, non A-E 2, autoimmune 1, Ecstasy 1) who fulfilled criteria for emergency transplantation. Preoperatively, the median international normalised ratio was seven (range 3.4-15), with a creatinine of 123 microM (51-389 microM) and bilirubin 320 microM (61-572 microM). The reasons for performing an auxiliary transplant were the patients' young age and stable preoperative condition (n = 5), or a significant psychiatric history precluding conventional transplantation (n = 2).

    RESULTS:All patients received blood group-matched left (n = 2) or right (n = 5) auxiliary grafts. Median duration of surgery was 8.5 h (7.3-10 h), with blood loss of 8.3 litres (4.6-14.6 litres). Post-transplant, the international normalised ratio and aspartate aminotransferase fell progressively in all patients, with median values at day 7 of 1.4 (1.0-2.4) and 108 IU/1 (78-910 IU/1). Three patients died from sepsis within the first postoperative month. At 2 weeks, four of six patients had partial regeneration of the native liver, which became complete in two of the survivors by 1 year.

    CONCLUSIONS:Although patient selection remains poorly defined, auxiliary partial orthotopic liver transplantation in acute liver failure is technically feasible and, in some patients, allows native liver regeneration and eventual immunosuppression withdrawal.

    背景与目标: 背景/目的 : 辅助部分原位肝移植比常规原位肝移植具有潜在的优势,但在急性肝衰竭方面的技术经验有限。
    方法 : 我们描述了7例急性肝衰竭 (扑热息痛3,非A-E 2,自身免疫性1,摇头丸1) 符合标准的患者 (4名男性,3名女性; 平均年龄28岁,范围14-35岁) 的初步经验。紧急移植。术前,国际标准化比率中位数为7 (范围3.4-15),肌酐为123微米 (51-389微米),胆红素320微米 (61-572微米)。进行辅助移植的原因是患者的年龄较小且术前状况稳定 (n = 5),或者有明显的精神病史而无法进行常规移植 (n = 2)。
    结果 : 所有患者均接受了血型匹配的左 (n = 2) 或右 (n = 5) 辅助移植物。手术的中位持续时间为8.5小时 (7.3-10小时),失血量为8.3升 (4.6-14.6升)。移植后,所有患者的国际标准化比率和天冬氨酸转氨酶均逐渐下降,在1.4第7天 (1.0-2.4) 和108 IU/1 (78-910 IU/1) 的中位数。术后第一个月内有3名患者死于败血症。在2周时,六名患者中有四名患者的天然肝脏部分再生,其中两名幸存者在1年内完全再生。
    结论 : 尽管患者选择的定义仍然很差,在急性肝衰竭中进行辅助部分原位肝移植在技术上是可行的,并且在某些患者中,允许天然肝脏再生并最终退出免疫抑制。
  • 【通过血管内超声记录不稳定型心绞痛和急性心肌梗死中冠状动脉小动脉粥样硬化斑块上的血栓。】 复制标题 收藏 收藏
    DOI:10.1016/s0002-9149(97)00199-9 复制DOI
    作者列表:Birnbaum Y,Luo H,Fishbein MC,Samuels B,Siegel RJ
    BACKGROUND & AIMS: Rupture of atheromatous plaques leading to acute coronary syndromes usually occur in lipid-reach and well-developed coronary lesions. We describe 2 unusual patients with acute coronary syndromes in whom there was angiographic and intravascular ultrasound evidence of an intraluminal thrombus overlying a small, nonocclusive plaque in an enlarged coronary artery.

    背景与目标: 导致急性冠状动脉综合征的动脉粥样硬化斑块破裂通常发生在脂质到达和发达的冠状动脉病变中。我们描述了2例不寻常的急性冠状动脉综合征患者,其中有血管造影和血管内超声证据表明腔内血栓覆盖了扩大的冠状动脉中的一个小的非闭塞斑块。
  • 【比较基于相机的99mTc-MAG3和24小时肌酐清除率评估肾功能。】 复制标题 收藏 收藏
    DOI:10.2214/AJR.05.1025 复制DOI
    作者列表:Esteves FP,Halkar RK,Issa MM,Grant S,Taylor A
    BACKGROUND & AIMS: OBJECTIVE:The 24-hour creatinine clearance is the standard clinical technique for measuring kidney function; however, this measurement is cumbersome and inconvenient for patients. We hypothesized that a camera-based technetium-99m mercaptoacetyltriglycine (MAG3) clearance obtained simultaneously with a standard MAG3 scan would correlate well with the 24-hour creatinine clearance and could serve as a simple marker of kidney function. MATERIALS AND METHODS:Data were obtained from a retrospective analysis of 28 patients with varying degrees of kidney dysfunction and 85 subjects evaluated for kidney donation. The MAG3 clearance was calculated using a camera-based technique without blood or urine sampling. The creatinine clearance was measured using the plasma creatinine and a 24-hour urine collection. The MAG3 and creatinine clearances were corrected for body surface area, and clearance values in healthy subjects and patients were compared using the paired Student's t test. The linear association between the MAG3 and creatinine clearances was expressed by Pearson's correlation coefficient. RESULTS:The mean MAG3 clearance in the potential kidney donors was 321 +/- 95 mL/min/1.73 m2 (95% CI, 171-546 mL/min/1.73 m2), significantly higher than the mean creatinine clearance of 152 +/- 51 mL/min/1.73 m2 (79-278 mL/min/1.73 m2, p < 0.001). The mean MAG3 clearance in patients was 153 +/- 70 mL/min/1.73 m2 (32-316 mL/min/1.73 m2) and was also significantly higher than the mean creatinine clearance of 74 +/- 36 mL/min/1.73 m2 (21-138 mL/min/1.73 m2, p < 0.001). The ratio of the mean creatinine clearance to the mean MAG3 clearance was essentially the same for volunteers and patients, 0.47 and 0.48, respectively. The Pearson's correlation between the MAG3 and creatinine clearances was 0.80 (0.72-0.86). CONCLUSION:The camera-based 99mTc-MAG3 clearance correlates well with the 24-hour creatinine clearance and can provide a simple and convenient index of kidney function.
    背景与目标:
  • 【烧伤和内脏损伤合并爆炸伤后腹壁全层损失的成功治疗。】 复制标题 收藏 收藏
    DOI:10.1097/01.BCR.0000238090.70355.6D 复制DOI
    作者列表:Başaran O,Karaarslan P,Sakalloğlu AE,Kesik E,Karakayalý H,Haberal M
    BACKGROUND & AIMS: :A 29-year-old man was admitted to our institution 10 days after he had undergone an urgent exploratory laparotomy at a local army hospital after a terrorist bombing attack. On admission, deep second-degree and third-degree burns involving 25% of the upper and lower extremities were present, together with a 25 x 10-cm abdominal full-thickness blast injury defect on the left side, an infected eviscerated midline incision, and a colostomy on the right side of the abdomen. The patient underwent a second laparotomy, at which time the intraabdominal abscess was drained, and the abdominal cavity was irrigated with saline. A jejunal perforation was found and sutured. The abdominal cavity was left open and covered with a Bogota bag for temporary closure. On postburn day 18, the patient underwent débridment and grafting of the third-degree burns to the left and right arm and right lower extremities. After several débridment sessions (postburn days 16, 18, 20, 22, and 24), an abdominal skin release and reapproximation were performed (postburn day 26). On postburn day 36, split-thickness skin grafts were placed directly on the granulated tissue of the intestines and on a defect in the left flank and iliac regions. Postoperatively, the patient did well. He was discharged on postburn day 78 with all wounds well healed. In our opinion, temporary closure followed by direct application of meshed split-thickness skin grafts to exposed abdominal viscera represents a simple method of reconstruction that can be safely performed, with minimal risk, on critically ill patients.
    背景与目标: : 一名29岁的男子在恐怖爆炸袭击后在当地一家军队医院接受紧急剖腹探查术10天后被送入我们的机构。入院时,出现了涉及上下肢25% 的深二度和三度烧伤,左侧有25x10 cm的腹部全层爆炸伤缺损,感染的内脏中线切口,以及腹部右侧的结肠造口术。患者接受了第二次剖腹手术,此时引流了腹腔内脓肿,并用盐水冲洗了腹腔。发现空肠穿孔并缝合。腹腔保持开放状态,并用波哥大袋覆盖,以暂时关闭。在烧伤后第18天,患者接受了三度烧伤的移植,并将其移植到左,右臂和右下肢。经过几次缓解 (烧伤后第16、18、20、22和24天) 后,进行了腹部皮肤释放和重新逼近 (烧伤后第26天)。在烧伤后的第36天,将厚度分开的皮肤移植物直接放置在肠的颗粒状组织以及左侧和ili区的缺损处。术后,患者表现良好。他在烧伤后第78天出院,所有伤口均愈合良好。在我们看来,暂时封闭,然后直接将网状厚度的皮肤移植物应用到暴露的腹部内脏上,代表了一种简单的重建方法,可以对危重病人安全地进行,风险最小。
  • 【肾脏能起到肺的作用吗?家兔缺血肾脏逆行灌注过程中的全身氧合和肾脏保存。】 复制标题 收藏 收藏
    DOI:10.1111/j.1464-410X.2006.06257.x 复制DOI
    作者列表:Humphreys MR,Ereth MH,Sebo TJ,Slezak JM,Dong Y,Blute ML,Gettman MT
    BACKGROUND & AIMS: OBJECTIVE:To investigate renal preservation by a novel method of perfusion using an oxygenated perfluorocarbon (PFC) emulsion via retrograde access to the kidney, as preserving renal function during urological surgery has been elusive, and the recognized technique of nephron-sparing surgery has increased its application and practice in modern urology. MATERIALS AND METHODS:After institutional review and approval, 30 New Zealand White rabbits were studied. In a solitary kidney model, each rabbit had the ureter catheterized before 40 min of renal artery occlusion. Each rabbit was randomized to one retrograde perfusion group, i.e. sham, normothermic PFC, chilled PFC, normothermic saline, and chilled saline. The rabbits were maintained for 2 weeks, during which renal function, urine output, systemic blood gases, weight and serum creatinine level were measured. After death, the kidneys were individually examined and graded by one renal pathologist unaware of the treatment. RESULTS:The rabbits treated with retrograde PFC perfusion (normothermic and chilled) had less change in their creatinine clearance, at 3.6 and 4.0 mL/min per kg, than the sham group, at 7.8 mL/min per kg, while also having significantly higher systemic venous oxygenation, at 26.3 and 10.0 mmHg, than the sham group, at 0.2 mmHg. Normothermic and chilled perfusion with PFC was also associated with less histological evidence of ischaemic damage, with mean (sd) scores of 13.0 (13.5) and 8.7 (4.5), respectively, than in the sham group, at 33.3 (16.8), while favourably matching the contralateral control kidney group, at 5.5 (2.3). The rabbits treated with saline retrograde perfusion also had better outcomes than the sham cohort. There were no adverse effects in any of the study arms or with the use of PFC. CONCLUSION:Retrograde oxygen delivery to the kidney through the urinary collecting system was successful in this pilot study. Renal function, laboratory and histological data indicate a trend towards renal preservation and even systemic oxygenation in the experimental groups compared with the sham rabbits, with no adverse effects attributed to this technique.
    背景与目标:
  • 【在急性护理环境中,护士在照顾病态肥胖患者时面临的挑战。】 复制标题 收藏 收藏
    DOI:10.1016/j.soard.2005.06.003 复制DOI
    作者列表:Drake D,Dutton K,Engelke M,McAuliffe M,Rose MA
    BACKGROUND & AIMS: BACKGROUND:Despite increasing numbers of morbidly obese patients admitted to acute care facilities for surgery or treatment of nonsurgical conditions, there is little evidence of the problems nurses face in providing care to these patients. Anecdotal evidence suggests that the care of these patients is more demanding than the care of nonobese patients. The objective of this study was to describe nurses' perceptions of the challenges that they face when caring for morbidly obese patients. METHODS:Focus groups of nurses from a tertiary care facility were convened. A trained facilitator posed questions to the group concerning various aspects of care for morbidly obese patients. Comments of respondents were categorized using NVIVO software. RESULTS:Nurses reported concerns about the increased staffing needs required for care of these patients and the particular challenges of the physical care. Concerns also included the availability, placement, and use of specialized equipment. Room size and the absence of some equipment were also problematic. Finally, nurses perceived safety issues, both for themselves and their patients. CONCLUSIONS:Morbidly obese patients in the acute care setting require specialized nursing care in terms of techniques, levels of staffing required, and the use of specialized equipment.
    背景与目标:
  • 【穿孔素介导的急性心肌炎心肌损伤。】 复制标题 收藏 收藏
    DOI:10.1016/0140-6736(90)92486-2 复制DOI
    作者列表:Young LH,Joag SV,Zheng LM,Lee CP,Lee YS,Young JD
    BACKGROUND & AIMS: :Endomyocardial specimens were obtained from 7 patients with acute myocarditis. Immunohistochemical examination of the mononuclear infiltrate showed mainly cytotoxic T lymphocytes and natural killer cells. Perforin (a pore-forming protein found in cytotoxic lymphocytes) was identified in this myocardial lymphocytic infiltrate and electron microscopy showed myocardial cell damage that may have been associated with these perforin containing lymphocytes. The results indicate that in acute idiopathic and viral myocarditis, myocardial damage may be due to the action of perforin-secreting lymphocytes.
    背景与目标: : 从7例急性心肌炎患者中获得心内膜心肌标本。对单核浸润的免疫组织化学检查显示主要是细胞毒性T淋巴细胞和自然杀伤细胞。在这种心肌淋巴细胞浸润中鉴定出穿孔素 (一种在细胞毒性淋巴细胞中发现的成孔蛋白),电子显微镜显示心肌细胞损伤可能与这些含有穿孔素的淋巴细胞有关。结果表明,在急性特发性和病毒性心肌炎中,心肌损伤可能是由于穿孔素分泌淋巴细胞的作用所致。
  • 【压力限制通气期间持续气管气吹入对急性肺损伤家兔肺表面活性物质的影响。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Zhu GF,Zhang W,Zong H,Liang Y
    BACKGROUND & AIMS: BACKGROUND:Pulmonary surfactant dysfunction may contribute to the development of ventilator induced lung injury (VILI). Tracheal gas insufflation (TGI) is a technique in which fresh gas is introduced into the trachea and augment ventilation by reducing the dead space of ventilatory system, reducing ventilatory pressures and tidal volume (V(T)) while maintaining constant partial arterial CO2 pressure (PaCO(2)). We hypothesised that TGI limited peak inspiratory pressure (PIP) and V(T) and would minimize conventional mechanical ventilation (CMV) induced pulmonary surfactant dysfunction and thereby attenuate VILI in rabbits with acute lung injury (ALI). METHODS:ALI was induced by intratracheal administration of lipopolysaccharide in anaesthetized, ventilated healthy adult rabbits randomly assigned to continuous TGI at 0.5 L/min (TGI group) or CMV group (n = 8 for each group), and subsequently ventilated with limited PIP and V(T) to maintain PaCO(2) within 35 to 45 mmHg for 4 hours. Physiological dead space to V(T) ratio (V(D)/V(T)), dynamic respiratory compliance (Cdyn) and partial arterial O(2) pressure (PaO(2)) were monitored. After ventilation, lungs were analysed for total phospholipids (TPL), total proteins (TP), pulmonary surfactant small to large aggregates ratio (SA/LA) in bronchoalveolar lavage fluid (BALF) and for determination of alveolar volume density (V(V)), myeloperoxidase and interleukin (IL)-8. RESULTS:TGI resulted in significant (P < 0.05 or P < 0.01) decrease in PIP [(22.4 +/- 1.8) cmH2O vs (29.5 +/- 1.1) cmH2O], V(T) [(6.9 +/- 1.3) ml/kg vs (9.8 +/- 1.11) ml/kg], V(D)/V(T) [(32 +/- 5)% vs (46 +/- 2)%], TP [(109 +/- 22) mg/kg vs (187 +/- 25) mg/kg], SA/LA (2.5 +/- 0.4 vs 5.4 +/- 0.7), myeloperoxidase [(6.2 +/- 0.5) U/g tissue vs (12.3 +/- 0.8) U/g tissue] and IL-8 [(987 +/- 106) ng/g tissue vs (24 +/- 3) mN/m] of BALF, and significant (P < 0.05) increase in Cdyn [(0.47 +/- 0.02) ml.cmH2O(-1).kg(-1) vs (0.31 +/- 0.02) ml.cmH2O(-1).kg(-1)], PaO(2) [(175 +/- 24) mmHg vs (135 +/- 26) mmHg], TPL/TP (52 +/- 8 vs 33 +/- 11) and Vv (0.65 +/- 0.05 vs 0.44 +/- 0.07) as compared with CMV. CONCLUSIONS:In this animal model of ALI, TGI decreased ventilatory requirements (PIP, V(T) and V(D)/V(T)), resulted in more favourable alveolar pulmonary surfactant composition and function and less severity of lung injury than CMV. TGI in combination with pressure limited ventilation may be a lung protective strategy for ALI.
    背景与目标:
  • 【儿童急性囊尾性脑膜炎: 对吡喹酮的反应。】 复制标题 收藏 收藏
    DOI:10.1080/02724936.1997.11747856 复制DOI
    作者列表:Visudhiphan P,Chiemchanya S
    BACKGROUND & AIMS: :Acute purulent meningitis as a manifestation of cerebral cysticercosis is uncommon. We report two children aged 12 months and 3 years who presented with clinical signs of acute meningitis and whose initial cerebrospinal fluid (CSF), except for negative culture, was typical of purulent meningitis. However, eosinophils were present in subsequent examinations of the CSF and the haemagglutination titre for cysticercus rose. Praziquantel was given to both children with dramatic improvement in clinical and CSF findings.
    背景与目标: : 急性化脓性脑膜炎作为脑囊虫病的表现并不常见。我们报告了两名年龄分别为12个月和3岁的儿童,他们表现出急性脑膜炎的临床症状,除阴性培养外,其初始脑脊液 (CSF) 是化脓性脑膜炎的典型表现。然而,在随后的CSF检查中存在嗜酸性粒细胞,并且囊尾蚴的血凝滴度上升。对两名临床和CSF表现均显着改善的儿童均给予吡喹酮。
  • 【肾源性干细胞隔离与鉴定。】 复制标题 收藏 收藏
    DOI:10.1681/ASN.2006030275 复制DOI
    作者列表:Gupta S,Verfaillie C,Chmielewski D,Kren S,Eidman K,Connaire J,Heremans Y,Lund T,Blackstad M,Jiang Y,Luttun A,Rosenberg ME
    BACKGROUND & AIMS: :Acute kidney injury is followed by regeneration of damaged renal tubular epithelial cells. The purpose of this study was to test the hypothesis that renal stem cells exist in the adult kidney and participate in the repair process. A unique population of cells that behave in a manner that is consistent with a renal stem cell were isolated from rat kidneys and were termed multipotent renal progenitor cells (MRPC). Features of these cells include spindle-shaped morphology; self-renewal for >200 population doublings without evidence for senescence; normal karyotype and DNA analysis; and expression of vimentin, CD90 (thy1.1), Pax-2, and Oct4 but not cytokeratin, MHC class I or II, or other markers of more differentiated cells. MRPC exhibit plasticity that is demonstrated by the ability of the cells to be induced to express endothelial, hepatocyte, and neural markers by reverse transcriptase-PCR and immunohistochemistry. The cells can differentiate into renal tubules when injected under the capsule of an uninjured kidney or intra-arterially after renal ischemia-reperfusion injury. Oct4 expression was seen in some tubular cells in the adult kidney, suggesting these cells may be candidate renal stem cells. It is proposed that MRPC participate in the regenerative response of the kidney to acute injury.
    背景与目标: : 急性肾损伤后,受损的肾小管上皮细胞再生。目的检验肾干细胞存在于成人肾脏并参与修复过程的假说。从大鼠肾脏中分离出一种独特的细胞群,其行为方式与肾干细胞一致,被称为多能肾祖细胞 (MRPC)。这些细胞的特征包括梭形形态;> 200种群倍增的自我更新,没有衰老的证据; 正常的核型和DNA分析; 波形蛋白,CD90 (thy1.1),Pax-2和10月4的表达,而不是细胞角蛋白,MHC I或II类,或更多分化细胞的其他标记。MRPC表现出可塑性,通过逆转录酶PCR和免疫组织化学诱导细胞表达内皮,肝细胞和神经标志物的能力证明了这种可塑性。当在未受伤的肾脏的胶囊下注射或在肾缺血再灌注损伤后动脉内注射时,细胞可以分化为肾小管。在成人肾脏的某些肾小管细胞中观察到10月4的表达,表明这些细胞可能是候选的肾干细胞。建议MRPC参与肾脏对急性损伤的再生反应。
  • 【两肾一夹高血压中白细胞浸润和ICAM-1表达。】 复制标题 收藏 收藏
    DOI:10.1093/ndt/12.5.899 复制DOI
    作者列表:Haller H,Park JK,Dragun D,Lippoldt A,Luft FC
    BACKGROUND & AIMS: How an increase in blood pressure, in and of itself, induces hypertensive nephrosclerosis is unclear. In an earlier study we found that leukocyte infiltration, proximal tubular cell proliferation, matrix deposition and interstitial fibrosis occur in the unclipped kidney of 2 K 1 C Goldblatt hypertensive rats. In this study we tested the hypothesis that the cell surface adhesion molecule ICAM-1 is expressed on the vascular endothelium and tubular epithelium of unclipped kidneys at 4 weeks. As a positive control, we examined the clipped kidney as well. We found that systolic blood pressure was significantly elevated in renovascular hypertensive rats compared to sham-operated controls after 4 weeks (198 +/- 5 mmHg vs 121 +/- 2 mmHg, P < 0.001). Furthermore, quantitative (densitometry) measurements showed that ICAM-1 expression on vascular endothelium and on tubular cells was significantly increased in unclipped kidneys compared to controls (P < 0.05). The same was true for monocyte and granulocyte infiltration (P < 0.05). These same variables were even more prominent in the clipped kidneys, compared to unclipped and control kidneys (P < 0.05). Our data show that ICAM-1 is expressed in unclipped kidneys exposed to hypertension as well as in clipped kidneys exposed to ischemia. We suggest that mechanical injury induced by increased blood pressure is responsible for an inflammatory adhesion molecule-mediated response and concomitant renal injury.

    背景与目标: 目前尚不清楚血压本身的升高如何引起高血压肾硬化。在较早的研究中,我们发现2 K 1 C Goldblatt高血压大鼠的未夹肾中发生白细胞浸润,近端肾小管细胞增殖,基质沉积和间质纤维化。在这项研究中,我们测试了以下假设: 细胞表面粘附分子ICAM-1在4周时在未夹住的肾脏的血管内皮和肾小管上皮上表达。作为阳性对照,我们也检查了截断的肾脏。我们发现,与假手术对照组相比,肾血管性高血压大鼠的收缩压在4周后显着升高 (198/- 5 mmHg vs 121/- 2 mmHg,P <0.001)。此外,定量 (密度测定法) 测量显示,与对照组相比,未夹住的肾脏在血管内皮和肾小管细胞上的ICAM-1表达显着增加 (P <0.05)。单核细胞和粒细胞浸润也是如此 (P <0.05)。与未夹肾和对照肾相比,这些相同的变量在夹肾中更为突出 (P <0.05)。我们的数据显示,ICAM-1在暴露于高血压的未夹肾以及暴露于缺血的夹肾中表达。我们建议由血压升高引起的机械损伤是炎症粘附分子介导的反应和伴随的肾损伤的原因。
  • 【儿童早期铅暴露青少年的伤害趋势。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2006.02.008 复制DOI
    作者列表:Kincl LD,Dietrich KN,Bhattacharya A
    BACKGROUND & AIMS: :This pilot study investigated adolescents with well-documented childhood lead burdens to determine the relationship between lead and unintentional injury. Adolescents completed a self-administered injury questionnaire. Results demonstrated that elevated childhood blood lead concentrations were significantly related to injury variables. Further study is necessary to understand adolescent health and safety implications.
    背景与目标: : 这项初步研究调查了有充分记录的儿童铅负担的青少年,以确定铅与意外伤害之间的关系。青少年完成了一份自我管理的伤害问卷。结果表明,儿童血铅浓度升高与损伤变量显着相关。为了了解青少年健康和安全的影响,有必要进行进一步的研究。
  • 【JTE-607是一种多种细胞因子产生抑制剂,可改善SCID小鼠异种移植急性髓细胞性白血病模型中的疾病。】 复制标题 收藏 收藏
    DOI:10.1016/j.exphem.2006.05.016 复制DOI
    作者列表:Uesato N,Fukui K,Maruhashi J,Tojo A,Tajima N
    BACKGROUND & AIMS: OBJECTIVE:Accumulating findings suggest that in acute myeloid leukemia (AML) patients, proinflammatory cytokines and growth factors play important roles in the proliferation and survival of AML cells in an autocrine and paracrine manner, leading to deterioration of AML. JTE-607 is a multiple cytokine inhibitor that potently suppresses production of proinflammatory cytokines. In the present study, we investigated the potency of JTE-607 as an antileukemic agent by exploiting a SCID mouse acute leukemia model. METHODS:SCID mice injected with anti-asialo-GM1 antibody were exposed to sublethal total-body irradiation at a dose of 3 Gy and then inoculated intravenously with AML cells. JTE-607 was administered using osmotic minipumps. The effects of JTE-607 on mouse survival time, human interleukin (IL)-8 levels in mouse plasma, and proportion of human CD45(+) cells in the bone marrow were studied. RESULTS:The survival time of the mice was strictly dependent on the number of U-937 cells proliferating in vivo. Administration of JTE-607 during the initial 7 days significantly prolonged survival of the mice, suggesting killing activity of JTE-607 against AML cells in vivo. Delayed administration of JTE-607 also prolonged the survival of mice bearing established leukemia with an effect comparable to the maximum tolerable dose of cytarabine. Flow cytometer analysis of bone marrow cells revealed decreased number of human CD45(+) cells. Human IL-8 level was also reduced by JTE-607. CONCLUSION:Our results indicate that JTE-607 has potential to be a new class of antileukemic drug that exerts inhibitory activities against both the proliferation and proinflammatory cytokine production of AML cells.
    背景与目标:
  • 【神经细胞粘附分子 (CD56) 阳性急性骨髓性白血病和骨髓增生异常综合征。】 复制标题 收藏 收藏
    DOI:10.1093/ajcp/107.6.653 复制DOI
    作者列表:Mann KP,DeCastro CM,Liu J,Moore JO,Bigner SH,Traweek ST
    BACKGROUND & AIMS: The CD56 antigen is normally expressed on natural-killer cells but has additionally been shown to be present on a variety of hematologic malignancies, including a subset of acute myelogenous leukemia (AML). There is disagreement, however, about its prognostic significance and its association with specific cytogenetic abnormalities. All clinical samples from June 1994, through September 1995, with increased myeloblasts were analyzed by multiparameter flow cytometry for anomalous expression of CD56. Patients with CD56+ blast cells were selected, and morphologic review was performed. Clinical information was obtained, and cytogenetic data were reviewed. Southern blot analysis to detect rearrangement of the mixed lineage leukemia (MLL) gene was performed when possible. The samples from 23 of 114 patients studied demonstrated anomalous expression of CD56 on myeloblasts, including patients with AML, myelodysplastic syndromes (MDS), and chronic myelogenous leukemia in blast crisis. The samples from 10 of 15 patients with CD56+ AML demonstrated at least partial monocytic differentiation. Dysplastic features were displayed in the samples of 12 patients. Correlation with specific cytogenetic abnormalities was not found. The MLL gene was rearranged in five of 18 patients. Seventeen patients have died, with a median survival of 4.6 months for patients with AML. Three have sustained a complete remission. One has findings of high-grade myelodysplastic syndrome. Two were unavailable for follow-up. Expression of CD56 was found in 20% of patients with increased myeloblasts, including patients with high-grade MDS, chronic myelogenous leukemia in blast crisis, and AML. This phenotype was associated with dysplasia, monocytic differentiation, and rearrangement of the MLL gene.

    背景与目标: CD56抗原通常在自然杀伤细胞上表达,但另外已显示出存在于多种血液系统恶性肿瘤中,包括急性骨髓性白血病 (AML) 的一部分。然而,关于其预后意义及其与特定细胞遗传学异常的关联存在分歧。通过多参数流式细胞术分析了所有来自1995年9月的成髓细胞增加的1994年6月的临床样本中cd56的异常表达。选择CD56 + 原始细胞的患者,并进行形态学检查。获得临床信息,并回顾细胞遗传学数据。在可能的情况下,进行Southern印迹分析以检测混合谱系白血病 (MLL) 基因的重排。来自114例患者中的23例的样本显示出CD56在成髓细胞上的异常表达,包括患有AML,骨髓增生异常综合征 (MDS) 和处于爆炸危机中的慢性粒细胞性白血病的患者。来自15例CD56 AML患者中的10例的样本显示出至少部分单核细胞分化。在12例患者的样本中显示出发育异常的特征。未发现与特定细胞遗传学异常的相关性。18例患者中有5例重排了MLL基因。17名患者死亡,AML患者的中位生存期为4.6个月。三个已经完全缓解。有人发现了高度骨髓增生异常综合征。两个无法进行随访。在20% 的成髓细胞增加的患者中发现了CD56的表达,包括患有高级别MDS,处于爆炸危机中的慢性粒细胞性白血病和AML的患者。这种表型与发育异常,单核细胞分化和MLL基因的重排有关。

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