Structure of rat kidneys following microwave accelerated fixation

In contrast to fixation of tissue in externally heated fixative, microwave-irradiation can generate uniform internal heat, which is of utmost importance for successful fixation of biological tissue. To evaluate the effectiveness of microwave-accelerated chemical fixation, we compared the structure of rat kidney fixed by a conventional method and a microwave-accelerated method, by scanning and transmission electron microscopy. Following perfusion, rat kidney pieces 1-2 mm in size were irradiated in Karnovsky's fixative in a domestic Amana microwave oven, till the temperature of the fixative reached 45-50 degrees C. For conventional fixation, tissue pieces were fixed overnight at room temperature in the same fixative. Both types of samples were processed further for electron microscopy using identical protocols. The microwave fixed samples showed excellent preservation of structure comparable to the samples fixed by the conventional method. Glomeruli and the renal tubules showed normal morphology with no cellular swelling. The cytoplasm and nuclear matrix of the epithelial cells was uniformly dense. Other fixation sensitive organelles like mitochondria and Golgi apparatus showed superior preservation with continuous membranes. These results demonstrate that microwave accelerated chemical fixation results in excellent preservation of tissue structure, reduces processing time significantly and is therefore a practical alternative to conventional protocols.

Origin of cells in the coronary intima during acute vascular rejection of the transplanted human heart

Acute vascular rejection of the coronary arteries in human heart transplants is characterized by a lymphocytic infiltrate and a thickened intima that contains numerous highly vacuolated cells. The origin of the vacuolated cells has been controversial. In this immunocytochemical and electron microscopic study of four patients with acute vascular rejection, the predominant cells in the coronary artery intima were host-derived lymphocytes and highly vacuolated smooth muscle cells. Lymphocytic infiltrates were composed of T cells with variable numbers of B cells. Macrophages were infrequent. Smooth muscle cells were identified by their reactivity to muscle-specific actin and ultrastructural features of a peripherally displaced elongated nucleus associated with abundant myofibrils. In addition, the vacuolated cells did not react with endothelial factor 8-related antigen or Ulex europaeus agglutinin, as would be expected of endothelial cells. The cytoplasmic vacuoles present in the smooth muscle cells appear to be swollen endoplasmic reticulum containing watery fluid consistent with the hypothesis that they result from altered ion movement across the plasma membrane in response to cellular injury.

Acute hyperoxaluria, renal injury and calcium oxalate urolithiasis

Single intraperitoneal injections of three, seven, or 10 mg. of sodium oxalate per 100 gm. of rat body weight were administered to male Sprague-Dawley rats. At various times after the injection, urine samples were analyzed for oxalate, and urinary enzymes, alkaline phosphatase, leucine aminopeptidase, gamma-glutamyl transpeptidase, and N-acetyl-beta-glucosaminidase. The kidneys were processed for light microscopy and renal calcium and oxalate determination. Oxalate administration resulted in an increase in urinary oxalate and formation of calcium oxalate crystals in the kidneys. The amount and duration of urinary excretion of excess oxalate and retention of crystals in the kidneys correlated with the dose of sodium oxalate administered. At a low oxalate dose of three mg./100 gm., crystals moved rapidly down the nephron and cleared the kidneys. At higher doses crystals were retained in kidneys and at a dose of 10 mg./100 gm. were still there seven days post-injection. Crystal retention was associated with enhanced excretion of urinary enzymes indicating renal tubular epithelial injury.

Studies on the prospect of bioprostheses by bovine aortic valve for human use

A total of 21 heart specimens from indigenous cattle (Bos indicus) were studied. The measurement and observation of bovine heart and aortic valve in different age group is the preliminary finding of this research work. After harvesting, the bovine aortic valves were measured and the sizes ranged from 21 mm to 35 mm in orifice diameter. In comparison with implanted aortic and mitral valves at NICVD in 1989, it indicates that the selected bovine heart valves (specially aortic valves) were similar to human valve size and can be used in future for implantation as far as the size is concerned. Now further study regarding making these tissue valves implantation worthy for clinical use is to be undertaken. We strongly feel the prospect is bright.

Acute vascular rejection of the coronary arteries in human heart transplantation: pathology and correlations with immunosuppression and cytomegalovirus infection

Prior studies of vascular rejection in transplanted human hearts have stressed the importance of accelerated coronary arteriosclerosis (chronic vascular rejection). We, however, have had four patients with sudden onset of acute heart failure within 90 days of transplantation who have died without significant myocardial interstitial rejection or the concentric intimal thickening with dense collagen that is typical of chronic vascular rejection. In contrast, the coronary arteries in our patients had a prominent lymphocytic infiltrate, a loosely organized intimal thickening composed of smooth muscle cells, and extensive endothelial injury. We believe that these changes define acute vascular rejection of the coronary artery. In 14 transplanted hearts obtained consecutively, at autopsy or at a second transplant procedure, graft failure was caused by acute coronary vascular rejection in six cases and by chronic coronary vascular rejection in one case. The remaining seven patients showed no evidence of vascular rejection and died primarily of sepsis. Cytomegalovirus (CMV) disease was present in 6 of 7 patients with vascular rejection, of which 43% were CMV-negative recipients of hearts from CMV-positive donors. The adoption of a triple-drug protocol, in which azathioprine was added to cyclosporine and prednisone, reduced the incidence of acute vascular rejection from 27% to 8%. We conclude that acute coronary vascular rejection may be initially seen as global cardiac ischemia in the absence of significant interstitial myocardial rejection. Further, acute vascular rejection should be pathologically distinguished from chronic vascular rejection, although both are probably stages in the natural history of immune-mediated vascular injury.

Retention of calcium oxalate crystals in renal tubules

Crystal retention within the renal tubules is essential for nephrolithiasis and the development of urinary stone disease. We studied the mechanisms involved in this process by inducing calcium oxalate crystal deposition within the rat renal tubules and examining them using various microscopic techniques. Crystals appeared to be retained either by attachment to the tubular epithelium or by aggregating with other crystals thus becoming large enough to be retained by their collective size.

Intestinal colonization with Enterobacteriaceae in Pakistani and Swedish hospital-delivered infants

Rectal cultures from Swedish and Pakistani hospital-delivered newborn infants were analysed regarding the early acquisition of enterobacteria. Swedish infants were delivered vaginally, Pakistani infants were delivered either vaginally or by caesarean section. The Swedish infants were all breast-fed, whereas breastfeeding was incomplete and often started late among the Pakistani infants. Both groups of Pakistani infants were more rapidly colonized with enterobacteria than were the Swedish infants. Cultures from Swedish infants seldom yielded more than one kind of enterobacteria; E. coli and Klebsiella were most frequently isolated. E. coli dominated in both Pakistani groups, but especially caesarean section delivered infants were in addition often colonized with Proteus, Klebsiella, Enterobacter or Citrobacter species. Breastfeeding from the first day of life reduced colonization with Klebsiella/Enterobacter/Citrobacter. The results suggest that environmental exposure, delivery mode and early feeding habits all influence the early intestinal colonization with enterobacteria.

Effect of magnesium on calcium oxalate urolithiasis

Previous studies have shown that hypomagnesuria induced by magnesium deficient diet causes calcium oxalate crystal deposition in renal tubules of hyperoxaluric rats and administration of magnesium to these rats results in prevention of calcium oxalate crystallization in their kidneys. Based on these studies magnesium was claimed to be beneficial for calcium oxalate stone patients. However, hypomagnesuria is not a common phenomenon. To better understand the role of magnesium as an inhibitor of calcium oxalate crystallization in urine, we studied the effect of magnesium on calcium oxalate urolithiasis in rats on a regular diet and a hyperoxaluric protocol. Excess magnesium was administered to male rats on regular diet and a lithogenic protocol. Magnesium administration to hyperoxaluric rats did not result in significant changes in urinary excretion of calcium or oxalate or in calcium oxalate relative supersaturation. Urinary excretion of citrate was also not significantly altered. Some animals from both groups, those on magnesium therapy and those not on magnesium therapy had crystals deposited in their renal tubules. We conclude that excess magnesium has no significant effect on calcium oxalate urolithiasis in normomagnesuric conditions.

Breast feeding and protection against neonatal sepsis in a high risk population

Protection against neonatal sepsis by breast feeding was investigated in a developing community. A case-control study was carried out with 42 cases from a hospital and 270 controls, matched for age and socioeconomic conditions from the community. Exclusive breast feeding was extremely rare, most babies being partially breast fed and a few being given formula feed or animal milk. A highly significant odds ratio of 18 was obtained, showing that even partial breast feeding protects against neonatal sepsis in such a population.

Pathogenesis of oxalate urolithiasis: lessons from experimental studies with rats

Calcium oxalate (CaOx) urolithiasis in rats is induced by producing hyperoxaluria. Depending on the degree and length of hyperoxaluria, CaOx crystals may either form in the nephron or the bladder and may or may not be retained in the kidneys. Crystals may nucleate in one part of the nephron and be retained in another part. Papillary collecting duct tubular epithelium and its basement membrane appear to be involved in crystal retention in the kidneys.

Cell injury associated calcium oxalate crystalluria

Renal tubular cell damage, resulting in membranuria, was induced by the administration of subcutaneous gentamicin to male Sprague-Dawley rats. One group of rats received gentamicin only, while a second group was given gentamicin plus ethylene glycol in drinking water at a concentration which increased urine oxalate but alone did not cause calcium oxalate crystalluria. Crystalluria occurred early in the combined treatment groups and persisted for the duration of the experiment. Crystalluria was not present in animals receiving gentamicin or ethylene glycol only. These results suggest that cellular fragments can serve as heterogeneous foci for the nucleation of calcium oxalate crystals.

Dextran sulfate disposition in the rat

Comparative studies of oral and intravenous administration of tritiated dextran sulfate in rats showed markedly different distribution patterns. Following IV dosing about 50 per cent of the radioactivity was recovered in feces and urine within 24 h. The major portion of the recoverable dose was eliminated in the urine as dextran sulfate within 3 h after administration. In orally treated rats only about 32 per cent of the 3H was recovered in the feces and urine, the major fraction being associated with unabsorbed dextran sulfate in the feces. The remainder of the dose in both treatment groups has apparently distributed throughout the rat body with some accumulation in the liver, kidney and spleen. Consequently, the disposition of about 67 per cent or the oral dose could not be fully accounted for by these excretion routes. However, separation with Sephadex columns showed similarities in the 24 h plasma and urine profiles of the IV and orally dosed rats which suggest that while the oral dose was absorbed as dextran sulfate, it underwent rapid metabolism to small molecular weight products prior to entering the systemic circulation which were then widely distributed within the rat.

Prophylactic glutamine protects the intestinal mucosa from radiation injury

Glutamine may be an essential dietary component, especially for the support of intestinal mucosal growth and function. This study evaluated the effects of a glutamine-enriched elemental diet, administered before whole-abdominal radiation on gut glutamine metabolism, mucosal morphometrics, and bacterial translocation. Rats were randomized to receive a nutritionally complete elemental diet that was glutamine-enriched or glutamine-free for 4 days. The animals were then subjected to a single dose of 1000 cGy x-radiation to the abdomen. After irradiation, all animals received the glutamine-free diet. Four days later the animals underwent laparotomy for sampling of arterial and portal venous blood, culture of mesenteric lymph nodes, and removal of the small intestine for microscopic examination. There was no difference in arterial glutamine or gut glutamine extraction between the two groups, but body weight loss was significantly diminished in the glutamine-fed rats. Rats receiving the glutamine-enriched elemental diet before radiation had a significant increase in jejunal villous number, villous height, and number of metaphase mitoses per crypt. Scanning electron microscopy confirmed the presence of an intact gut epithelium in eight of eight rats receiving prophylactic glutamine compared to one of eight animals in the glutamine-free group. Three of eight rats fed glutamine had culture positive mesenteric lymph nodes compared with five of seven rats receiving the glutamine-free diet. Glutamine exerts a protective effect on the small bowel mucosa by supporting crypt cell proliferation effect on accelerate healing of the acutely radiated bowel.

Prophylactic glutamine protects the intestinal mucosa from radiation injury

Glutamine may be an essential dietary component, especially for the support of intestinal mucosal growth and function. This study evaluated the effects of a glutamine-enriched elemental diet, administered before whole-abdominal radiation on gut glutamine metabolism, mucosal morphometrics, and bacterial translocation. Rats were randomized to receive a nutritionally complete elemental diet that was glutamine-enriched or glutamine-free for 4 days. The animals were then subjected to a single dose of 1000 cGy x-radiation to the abdomen. After irradiation, all animals received the glutamine-free diet. Four days later the animals underwent laparotomy for sampling of arterial and portal venous blood, culture of mesenteric lymph nodes, and removal of the small intestine for microscopic examination. There was no difference in arterial glutamine or gut glutamine extraction between the two groups, but body weight loss was significantly diminished in the glutamine-fed rats. Rats receiving the glutamine-enriched elemental diet before radiation had a significant increase in jejunal villous number, villous height, and number of metaphase mitoses per crypt. Scanning electron microscopy confirmed the presence of an intact gut epithelium in eight of eight rats receiving prophylactic glutamine compared to one of eight animals in the glutamine-free group. Three of eight rats fed glutamine had culture positive mesenteric lymph nodes compared with five of seven rats receiving the glutamine-free diet. Glutamine exerts a protective effect on the small bowel mucosa by supporting crypt cell proliferation effect on accelerate healing of the acutely radiated bowel.

Bladder stone in a human female: the case of an abnormally located intrauterine contraceptive device

A single 4.7 x 3.3 x 1.5 cm solid nodule was removed from the bladder of a 24 years old white female who had lost an intrauterine contraceptive device (IUD) installed approximately four years ago. The nodule showed no external evidence of an IUD or its string. An examination of the nodular surface by scanning electron microscopy (SEM) showed mostly amorphous material with some adherent filamentous structures. Its energy dispersive x-ray microanalysis revealed the presence of calcium and phosphorus suggesting that the nodule was actually a urolith. Fracturing the nodule exposed an embedded entity consistent with being a copper IUD. Apparently, the lost IUD had migrated from the uterus into the bladder where it became mineralized. Thus the solid nodule was actually a foreign body stone.

Membrane-associated crystallization of calcium oxalate in vitro

Incubation of proximal tubular brush border membrane in a metastable calcium oxalate solution of low supersaturation resulted in the equimolar depletion of calcium and oxalate and the formation of monoclinic calcium oxalate crystals. We propose that membrane fragments from sloughed epithelial cells of the nephron can similarly induce crystallization in urine that is metastable for calcium oxalate.

Intestinal permeability assessed with polyethylene glycols in children with diarrhea due to rotavirus and common bacterial pathogens in a developing community

Intestinal permeability was assessed with different-sized polyethylene glycols (PEG 400 and PEG 1,000) in small children with acute diarrhea. All children with acute diarrhea absorbed and excreted less PEG of all molecular sizes into the urine when compared with healthy control children (p less than 0.001). Children with acute rotavirus infection excreted significantly less PEG of all sizes than children with Shigella, Salmonella, and enteropathogenic Escherichia coli (EPEC) infection (p less than 0.001-0.01), suggesting a more severe mucosal lesion caused by rotavirus. In patients with severe malnutrition there was also a significant decrease in absorption of PEGs observed. In addition, malnourished patients with rotavirus diarrhea showed a pronounced decrease of PEGs in comparison with well-nourished patients. The ratio between the recovery of a large PEG molecule, 1,074 Da, and a small molecule, 370 Da, was utilized to assess the absorption of large molecules in relation to that of smaller ones. On applying this ratio, it was noted that the intestine in children with Shigella and EPEC infection was relatively more permeable to larger molecules than in healthy controls, while in rotavirus and Salmonella infection it was less permeable to larger molecules. In this study significant differences in the permeability characteristics were observed, suggesting etiology-specific effects on the mucosal barrier.

Paralytic ileus, a serious complication in acute diarrhoea disease among infants in developing countries

Intestinal hypomotility is a common late complication in infants with acute diarrhoeal disease in pakistan. Among the infants admitted to our gastrointestinal unit with a history of acute diarrhoea, 35% developed abdominal distension and 12% developed the full clinical picture of paralytic ileus. The infants with ileus were treated with decompression and total parenteral nutrition; in this group the mortality rate was 25%. We compared 30 infants who developed ileus (group A) with an age-matched control group of infants (group B) who were admitted because of acute diarrhoea but did not develope ileus. The use of antimotility drugs was significantly more frequent in group A. Serum-K was not different in in group A (3.92 +/- 0.22 mmol/l) and group B (4.32 +/- 0.18 mmol/1). However, there were more patients who had serum-K below 3 mmol/l in group A (8/30) than in group B (5/30). We conclude that the use of antimotility drugs predisposes to the development of ileus in infants with acute diarrhoea. Hypokalemia may contribute to ileus in a few cases but is generally not a prerequisite.

Urinary enzymes and calcium oxalate urolithiasis

Male Sprague-Dawley rats were challenged with various hyperoxaluric agents including ammonium oxalate, hydroxy-L-proline, and ethylene glycol. All treatments resulted in increased urinary oxalate. Associated with hyperoxaluria was an increase in urinary levels of renal enzymes, gamma-glutamyl transpeptidase, N-acetyl-beta-glucosaminidase, and alkaline phosphatase. Most of the rats did not demonstrate any significant change in urinary levels of beta-galactosidase. There was a highly significant positive correlation between urinary oxalate and N-acetyl-beta-glucosaminidase.

Hypocalcemia and hyperphosphatemia in severely dehydrated children with and without convulsions

Tetanic convulsions are not uncommon among severely dehydrated children in the developing countries. This raises the question whether these children have disturbances in the homeostasis of divalent ions. Serum values are reported of calcium, magnesium, phosphorus, sodium and potassium, as well as blood pH in children below 3 years of age with acute watery diarrhoea and with an estimated weight loss of about 10%. The study was performed on dehydrated children with (DC) or without (D) convulsions. Values were obtained on admission and following rehydration therapy (RT). On admission serum calcium was low in both D and DC children. Serum phosphorus was likewise elevated in both D and DC children. Serum magnesium was slightly elevated in the DC but not in the D group. No patient had hypernatremia. During RT, serum calcium increased significantly and serum phosphorus decreased significantly in D and DC children. Serum calcium showed a significant inverse correlation with serum phosphorus and a significant direct correlation with blood pH. Treatment of DC children with i.v. calcium and i.m. magnesium had no immediate effect on the convulsions. Our conclusion is that severely dehydrated children will develop hypocalcemia. The cause may be a redistribution of calcium into the cells, parallelled by a redistribution of phosphorus from the intra- to the extracellular space.

Presence of calcium oxalate crystals in the mammalian thyroid gland

Birefringent crystals of calcium oxalate have been previously identified in the colloid of human thyroid glands. We found such crystals in 19/20 adult thyroids at autopsy, in 4/20 infants at autopsy, and, using frozen sections, in 19/20 thyroids partially or totally removed at surgery. These crystals were soluble in hydrochloric acid, insoluble in acetic acid, and contained only calcium by energy dispersive X-ray microanalysis, confirming their calcium oxalate character. Similar crystals were found in equine and ovine thyroids.

In vitro precipitation of calcium oxalate in the presence of whole matrix or lipid components of the urinary stones

Organic matrix of human calcium oxalate urinary stones was obtained by demineralizing with EDTA. Lipids were extracted from the EDTA-insoluble matrix by chloroform methanol treatment. The whole matrix and its total lipid extract were then incubated in a metastable solution of calcium oxalate and depletion of calcium and oxalate ions from the calcifying solution was determined. Results of our studies described here show that urinary calcium oxalate stone matrix and its total lipid contents were capable of binding calcium and oxalate ions and of catalysing calcium oxalate crystal formation from a metastable calcium oxalate solution.

Presence of lipids in urinary stones: results of preliminary studies

The presence of lipids in urinary stones was determined by histochemical and biochemical methods. When crystals of calcium oxalate, made by mixing calcium chloride and potassium oxalate solutions and sections of human calcium oxalate urinary stones, were exposed to osmium vapors, there was no staining of the pure crystals whereas the stone sections were stained. De-paraffinized sections of demineralized calcium oxalate stones showed positive sudanophilia on staining with Sudan black B. Both these experiments indicate the presence of lipids in calcium oxalate stones. Lipids were extracted from uric acid, struvite, and calcium oxalate stones using standard techniques. Phospholipids were separated by one-dimensional thin layer chromatography. All the stones studied contained lipids. In calcium oxalate stones they accounted for 10.15% of the matrix. Calcium oxalate and struvite stones contained more phospholipids than uric acid stones. Cardiolipin, sphingomyelin, phosphatidyl choline, phosphatidyl inositol, phosphatidyl ethanolamine, phosphatidyl serine, and phosphatidyl glycerol were identified in lipid extracts. Demineralization by ethylenediaminetetra-acetate (EDTA) treatment increased lipid output from calcium oxalate stones by 15.5%.

The benefits of the very early introduction of powdered rice and dried edible seeds (Dal moong) in the oral rehydration solution during the treatment of acute infectious diarrhoea of infancy

We have examined whether the addition of powdered rice and pulses (Dal moong) to oral rehydration solution will decrease the purging rate and thereby increase the efficacy of the oral rehydration therapy. The study was carried out on 60 male infants, with acute watery diarrhoea, moderate dehydration but without fever, vomiting, or other conditions like septicaemia and meningitis. The infants were treated with either the standard WHO oral rehydration salt solution (ORS) or with a modified solution where glucose was removed and powdered rice and Dal moong were added. We found that the infants receiving ORS with powdered rice and Dal moong had significantly lower fluid losses in the stools, a significant and more rapid weight gain, and needed significantly less fluid than the infants receiving ORS only.

Urolithogenesis of mixed foreign body stones

Urine of male Sprague-Dawley rats was supersaturated for struvite and often contained struvite crystals. Ethylene glycol administration to these rats resulted in elevation of urinary oxalate and calcium oxalate supersaturation, and induced calcium oxalate crystalluria. Implantation of foreign bodies in their urinary bladders and changing their urinary ambient conditions by administering ethylene glycol for two weeks at two week intervals resulted in the formation of urinary stones of mixed composition containing calcium oxalate and struvite. Crystal-onto-crystal epitaxy did not appear to play any role in the development of these stones.

Role of scanning electron microscopy and x-ray microanalysis in the identification of urinary crystals

Urinary crystals can be identified by using analytical electron microscopic techniques of scanning electron microscopy and energy dispersive x-ray microanalysis. Crystal habit can be recognised by scanning electron microscopy and their chemical nature by elemental analysis. With a conventional detector the lightest element that can routinely be detected is sodium, but with a windowless or thin window detector even carbon can be detected. Thus almost all the commonly occurring urinary crystals including uric acid can be analysed by energy dispersive x-ray microanalysis.

Crystal-matrix relationships in experimentally induced urinary calcium oxalate monohydrate crystals, an ultrastructural study

Calcium oxalate monohydrate crystalluria was experimentally induced in male rats by administration of ethylene glycol. The crystalluria particles were separated by filtration and studied by scanning and transmission electron microscopy. They were associated with cellular degradation products. Organic material was present both on the surfaces of crystalluria particles as well as within them and was organized in radial striations and concentric laminations. It is proposed that crystal nuclei were formed by heterogeneous nucleation. These nuclei then adsorbed organic material and aggregated. The organic material polymerized resulting in the formation of a crystal-matrix unit which then grew and incorporated more organic material during the crystal growth.

Regulation of serum sodium in dehydrated and orally rehydrated infants. Influence of age and of purging rates

We have examined the control of serum sodium concentration (S-Na) in 60 male infants with acute diarrheal disease, moderate dehydration, but without the presence of fever, vomiting or other conditions. The infants were studied on admission and during oral rehydration therapy (ORT). We examined the effect of rapid reduction of the purging rate on the control of S-Na by adding pulverized rice and pulses (dal moong) to the rehydration solution. On admission S-Na was significantly inversely related to age. This correlation could not only be attributed to difference in stool sodium losses. Changes in S-Na and urinary K/Na ratio during oral rehydration therapy (ORT), were analyzed separately in infants below and above 4 month of age. During the first six hours of ORT, there was an increase in S-Na in all groups. During the following 18 hours, S-Na tended to normalize around 138 mmol/l. Normalization occurred faster if purging rate was reduced. In all groups urinary K/Na ratio (index of aldosterone production and, inversely, of sodium balance), was high at admission and fell during ORT. In the youngest infants (below 4 month of age) the fall was significantly more pronounced if the purging was reduced. We conclude that it is important to consider age when prescribing ORT. The capacity to correct disturbances in S-Na becomes more efficient during maintenance stage of ORT. Correction of S-Na and sodium balance is enhanced by rapid reduction of abnormal intestinal losses.

Morphology of urinary stone particles resulting from ESWL treatment

Fragments of urinary stones resulting from extracorporeal shock wave lithotripsy were examined by light and scanning electron microscopy. Calcium oxalate monohydrate and uric acid stone fragments were homogeneous and regular whereas struvite stone fragments were irregular in shape. Examination of the fractured surfaces revealed that the process of stone fragmentation involved fracture and cleavage of the crystals at some places and their separation from each other at others. In stones whose crystals are organised in layers, for instance calcium oxalate monohydrate and uric acid, crystalline layers separated along the concentric laminations. In struvite stones, which are an agglomeration of struvite and calcium phosphate crystals, major fragmentation occurred along the crystalline interfaces.

Identification of urinary stone and sediment crystals by scanning electron microscopy and x-ray microanalysis

A procedure based on scanning electron microscopic techniques is described for the identification of crystals in urinary sediments and stones. The crystals are identified by their morphology and elemental composition using scanning electron microscopy and x-ray microanalysis. The procedure has a number of advantages over conventional methods. It is easy to use. It is non-destructive so that both the exterior and interior of the same stone can be separately analyzed. It is the only technique in which information about spatial relationships between various crystals in a stone can be obtained easily. Scanning electron microscopic techniques can detect minor components, and analysis of a wide variety of materials ranging from amorphous substances to microcrystals to macroscopic stones is possible.

Scanning electron microscopy, x-ray diffraction, and electron microprobe analysis of calcific deposits on intrauterine contraceptive devices

Deposits found intrauterine contraceptive devices (IUDs) were studied by scanning electron microscopy, x-ray diffraction, and energy dispersive x-ray microanalysis. All seven devices, including five plastic and two copper IUDs, were coated with a crust containing cellular, acellular, and fibrillar material. The cellular material was composed of erythrocytes, leukocytes, cells of epithelial origin, sperm, and bacteria. Some of the bacteria were filamentous, with acute-angle branching. The fibrillar material appeared to be fibrin. Most of the acellular material was amorphous; calcite was identified by x-ray diffraction, and x-ray microanalysis showed only calcium. Some of the acellular material, particularly that on the IUD side of the crust, was organized in spherulitic crystals and was identified as calcium phosphate by x-ray microanalysis. The crust was joined to the IUD surface by a layer of fibrillar and amorphous material. It is suggested that the initial event in the formation of calcific deposits on IUD surfaces is the deposition of an amorphous and fibrillar layer. Various types of cells present in the endometrial environment adhere to this layer and then calcify. Thus, the deposition of calcific material on the IUDs is a calcification phenomenon, not unlike the formation of plaque on teeth. Hum Pathol 16:732-738, 1985.

Developmental morphology of calcium oxalate foreign body stones in rats

Calcium oxalate bladder stones were induced in male rats by implanting plastic foreign bodies and by adding ethylene glycol to their drinking water. The foreign body surface was first coated with cellular debris and some amorphous material. Encrustation with crystals of calcium oxalate started on the third day of implantation. Within 2 weeks the entire surface of a foreign body was covered with crystals and some noncrystalline material. Calcium oxalate monohydrate crystals consisted of platelike crystallites arranged in hemispherulitic or spherulitic habit. Calcium oxalate dihydrate crystals wee basically dipyramidal, a majority of them showing interpenetrant twinning. The stone grew by confluent crystal growth and crystal aggregation. A transformation of calcium oxalate monohydrate crystals to calcium oxalate dihydrate also occurred. The matrix consisting of cellular debris and urinary macromolecules was universally distributed in the stone including the inside of crystal bodies.

Relationship between experimentally induced crystalluria and relative supersaturation of various stone salts in rats

Calcium oxalate crystalluria was induced in laboratory rats by subcutaneous implantation of potassium oxalate containing mini-osmotic pumps in their intercapsular region. Concentrations of major urinary ions were measured and urinary supersaturations of various urinary salts were calculated using a computer programme. The urines of experimental animals that received oxalate had calcium oxalate crystals and higher supersaturations for calcium oxalate compared to their controls. Oxalate levels of the urines of experimental animals were higher than their controls and this increase was proportional to the increase in urinary supersaturation of calcium oxalate. No significant difference was found in the calcium levels of urines from experimental and control animals.

Crystal retention by injured urothelium of the rat urinary bladder

Injuries caused by hydrochloric acid or Triton X 100 application to the rat bladder urothelium, and the effects on calcium oxalate crystal retention, were examined by light and scanning electron microscopy. Damage due to either compound resulted in desquamation of urothelial cells. The crystals appeared to be retained by a fibrillar material, some of which was identified as fibrin. Heparin treatment of injured urothelium was found to prevent crystal retention.

Different secretory IgA antibody responses after immunization with inactivated and live poliovirus vaccines

The influence on secretory IgA antibody levels in milk and saliva of vaccination with oral, live poliovirus vaccine ( OPV ) and inactivated poliovirus vaccine (IPV) was studied. IPV, especially the antigen-rich Dutch vaccine, more often induced increases in antibody titers in milk (50%) than did OPV (26%) (P less than .01). OPV more often decreased the antibody levels in milk (40%) than did IPV (10%) (P less than .01). It was striking that mainly high prevaccination titers were decreased. The increases of IgA antibody in saliva were less striking. IPV caused increases as often in milk as in saliva, whereas OPV more often induced increases in IgA antibody in saliva, but there was a poor correlation between the changes in antibody titers in milk and those in saliva.

Renal papillary changes in patient with calcium oxalate lithiasis

We report the case of a white woman with bilateral renal calculi that were removed by bilateral nephrolithotomies. The morphology of renal tubular stones and the changes in papillary tissue were studied by light microscopy and scanning and transmission electron microscopy. The stones were made of calcium oxalate and were intratubular. Large calcium phosphate deposits were present in the interstitium. There was a marked interstitial fibrosis and tubular epithelial hyperplasia.

Microstructure of decalcified human calcium oxalate urinary stones

Human urinary stone fragments and sections were decalcified in ethylenediaminetetraacetic acid solution after embedding in 1% agar. These decalcified embedded stone specimens were then processed for scanning electron microscopy. After critical point drying the agar was removed and EDTA-insoluble stone residue was studied by scanning electron microscopy. This residue representing part of the stone matrix kept the original shape of the stone and was basically made of fibrous material. The fibers appeared to be arranged in matted sheets that were present as concentric laminations. In case of calcium oxalate dihydrate stones these fibrous sheets were also arranged as peripheral layers running parallel to the pyramidal faces of large calcium oxalate dihydrate crystals. In decalcified stones, crystals were represented by crystal ghosts. Often some vesicular material was present embedded in the fibrous sheets.

Effects of smoking on oral fat tolerance and high density lipoprotein cholesterol

Changes in serum triglyceride and high density lipoprotein (HDL) cholesterol after a fatty meal have been studied in smokers and nonsmokers. Average serum triglyceride during the study was higher in smokers than in non-smokers. In non-smokers there was a rise in the HDL2/HDL3 cholesterol ratio after oral fat, but not in smokers. These findings are compatible with the hypothesis that smoking interferes with the lipolysis of triglyceride rich lipoproteins and the conversion of HDL3 into HDL2.

Agar-embedded urinary stones: a technique useful for studying microscopic architecture

A procedure for studying urinary stones by various microscopic techniques is described. The stones are sectioned into approximately 0.2 to 1.0 mm. thick pieces using a low-speed saw. The sections are then embedded in agar and decalcified using 0.25 M ethylenediaminetetracetic acid at pH 7.2. The decalcified residue is then processed for light microscopy and scanning and transmission electron microscopy as with any other biological tissue. The results indicate that the ethylenediaminetetracetic acid-insoluble stone matrix keeps its architectural integrity and can be studied like other biological materials.

Experimental induction of crystalluria in rats using mini-osmotic pumps

Crystalluria was induced in male Sprague-Dawley rats by implanting potassium-oxalate-containing mini-osmotic pumps. Urine of all experimental animals had abundant crystals of calcium oxalate, hydroxypatite, struvite, and calcium phosphate. These crystals were similar in morphology to the crystals found in human crystalluria. Histological examination of kidneys and tissue samples from other organs revealed no abnormality. One group of animals was injected with sodium oxalate in addition to implantation of potassium-oxalate-containing mini-osmotic pumps. Bladder urine from these animals contained calcium oxalate microstones and their kidneys had deposits of calcium oxalate crystals.

Mucosal immunity

Mucosal defense is provided by a number of host factors countering the specific virulence factors of the many microorganisms infecting the mucous membranes. Secretory IgA antibodies presumably play an important role. Increase of the sIgA antibodies may most advantageously be attained by parenteral immunization, following mucosal priming. This was demonstrated in a rat model, where it was also noted that antigen injection into PP induced high milk IgA antibody levels. In man, parenteral vaccination against polio increased the sIgA antibody levels in the milk of mothers previously exposed naturally to the poliovirus. The response was relatively short-lived. In the previously unexposed, there was little or no response. By contrast peroral immunization with live poliovirus vaccine did not increase, or even decrease, the milk sIgA poliovirus antibody levels. Although salivary sIgA antibodies against antigens of colonizing E. coli appear during the first days of life, they are slow to increase. This deficiency is richly compensated for by all the sIgA antibodies that are provided the baby through the milk. No transfer of dimeric IgA into the milk could be shown in lactating rats, in contrast to what has been reported in mice. There is no evidence for a contribution to milk sIgA from serum in man. Close to parturition, human milk often contains some 7S IgA and various sizes of free SC, in addition to the dominating 11S sIgA. A few days later there is almost exclusively monomeric SC and 11S sIgA. IgG antibodies also play a role at the mucosal level. IgG2 antibodies against the bacterial polysaccharide capsule are as slow to appear as sIgA in ontogeny, possibly explaining the prevalence of infections with encapsulated bacteria and the poor response to polysaccharide vaccines in early childhood. Other defense factors preventing infections by way of mucous membranes may be important. Thus, oligosaccharides present in human milk seem to specifically prevent pneumococcal attachment to retropharyngeal cells. This anti-attachment capacity, in addition to that provided by milk and salivary IgA antibodies, may explain why breast-fed babies have less otitis media than formula-fed ones.

Experimental calcium oxalate nephrolithiasis in the rat. Role of the renal papilla

Calcium oxalate nephrolithiasis in rats, induced by single intraperitoneal injection of sodium oxalate, is associated with pathologic changes in the renal papillary tip. Calcium oxalate crystals appear in the tubular lumens, in the intercellular spaces between epithelial cells, and attached to the tubular epithelial basal lamina. Unusual paracrystalline structures also develop in the distal tubule associated with the basal lamina. Speculations are made about the role of these structures. The epithelial changes are primarily necrotic and are similar to those described in experimental papillary necrosis. Complete morphologic recovery occurs in 1-2 weeks.