Assessment of 72-kilodalton gelatinase and TIMP-1 gene expression in normal and sclerotic murine glomeruli

Mice transgenic for bovine growth hormone (bGH) develop progressive diffuse glomerulosclerosis. Because murine mesangial cells in vitro were found to express the genes for 72-kd gelatinase and the metalloproteinase inhibitor TIMP-1, the expression of these genes in vivo in isolated whole glomeruli from bGH mice and normal control littermates was examined. Intact glomeruli were isolated by microdissection and subjected to reverse transcription. TIMP-1 cDNA was not detected by standard polymerase chain reaction (PCR) in glomeruli from bGH or control mice. In contrast, cDNA for 72-kd gelatinase was detected by standard PCR in both bGH and control mice, and the level was subsequently measured by quantitative competitive PCR. The gelatinase cDNA level was 14.7 +/- 2.8 x 10(-4) attomoles/glomerulus in 2- to 3-month-old control mice and was unchanged in 6-month-old controls. The bGH mice had 3.5-fold and 4.5-fold higher cDNA levels at 2 to 3 months and 6 months of age, respectively. Finally, zymography of glomerular extracts revealed increased levels of 72-kd and 96- to 100-kd gelatinase activity in bGH glomeruli in comparison to that in controls. In summary, whereas the genes for both TIMP-1 and 72-kd gelatinase are expressed in vitro in cultured mesangial cells, only the gelatinase gene appeared to be expressed in vivo in intact glomeruli. In addition, there was an up-regulation in the glomerular expression of the 72-kd gelatinase in bGH mice, a murine model of glomerulosclerosis.

Five cases of cytomegalovirus infection detected by in situ hybridization and antigenemia assay

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.

MRI manifestations of gastrointestinal lymphoma

The magnetic resonance (MR) images of 11 cases of gastrointestinal lymphoma are presented. The findings include irregularly thickened mucosal folds, irregular submucosal infiltration, annular constricting lesion, exophytic tumor growth, mesenteric masses, and mesenteric/retroperitoneal lymphadenopathy. The tumors were homogeneous and intermediate in signal intensity on T1-weighted images. Heterogeneously increased signal intensities were noted on T2-weighted images. There was mild to moderate enhancement after intravenous administration of gadolinium dimeglumine (Gd-DTPA). The submucosal tumor infiltration might be outlined between the strongly GD-DTPA-enhanced mucosa and the low-intensity muscular layer. In one case that received tumor resection, the pathological examination showed destruction of most parts of the muscular layer, and the MR images did not disclose the low-intensity muscular zone.

Liver, renal and subcutaneous histopathology in PEPCK-bGH transgenic pigs

Transgenic pigs were created that harboured a phosphoenolpyruvate carboxykinase-bovine growth hormone construct (PEPCK-bGH). Four founder animals and two transgenic offspring from one line were evaluated between 6 1/2 and 12 months of age. There was no evidence of severe hepatic or renal lesions in these pigs, which characterised transgenic PEPCK-bGH mice previously described. While glomerular and tubular lesions in kidney sections were not identified in the transgenic pigs, mesangial cell proliferation was observed in two transgenic offspring from a single line. Additionally, glomerular size was significantly increased in four of four puberal transgenic swine when compared to age- and sex-matched controls (28.30 +/- 4.1 vs. 14.2 +/- 2.7 x 10(5) microns 3; representing 3 transgenic lines, p < 0.05). Surprisingly, no mature adipocytes were observed in subcutaneous sections obtained in transgenic GH pigs. Histological evaluation of these transgenic pigs further illustrates the requirement for precise control of growth-related genes and their protein products.

Abdominal pseudotumors and simulated lymphadenopathy in MRI: differential features with the use of retrograde air insufflation

In order to evaluate the contribution of retrograde air insufflation in decreasing the occurrence of pseudotumor appearance and mimicked lymphadenopathy due to nonair-distended bowel loops, we retrospectively compared two groups of magnetic resonance (MR) examinations. In the group receiving retrograde air insufflation, 10.8% (67 of 619) of images showed a tumor-like lesion due to nonair-distended bowel loop(s), whereas in the group not receiving air introduction, a tumor-like lesion was simulated in 45.6% (140 of 307) of images. Furthermore, a collapsed bowel loop(s) mimicking an enlarged lymph node close to the aorta, inferior vena cava, or bilateral iliac vessels was found in 9.5% (24 of 252) of images of the latter group, in contrast to only 1.8% (9 of 505) of images of the former group. This study shows that retrograde air insufflation greatly reduces the occurrence of pseudotumor appearance and false impression of paraaortic, paracaval, or parailiac lymphadenopathy secondary to nonair-distended bowel loop(s).

Advanced glycation end products up-regulate gene expression found in diabetic glomerular disease

Several lines of evidence suggest that the excessive accumulation of extracellular matrix in the glomeruli of diabetic kidneys may be due to reactive intermediates forming between glucose and matrix proteins called advanced glycation end products (AGEs). Normal mice received AGE-modified mouse serum albumin i.p. for 4 weeks, and glomerular extracellular matrix, growth factor mRNA levels, and morphology were examined. We found that AGE induced an increase in glomerular extracellular matrix alpha 1(IV) collagen, laminin B1, and transforming growth factor beta 1 mRNA levels, as measured by competitive PCR, as well as glomerular hypertrophy. The AGE response was specific because the coadministration of an AGE inhibitor, aminoguanidine, reduced all these changes. We conclude that AGEs affected expression of genes implicated in diabetic kidney disease and may play a major role in nephropathy.

MR imaging of sports-related muscle injuries

Magnetic resonance (MR) imaging of the thighs of 26 baseball athletes and one softball athlete were studied to evaluate muscle injuries. We documented the abnormalities present in MR imaging after a muscle injury and evaluated the role of MR imaging in muscle injuries. Fifteen of the athletes showed muscle abnormalities in MR images. These include muscle strains without tear, muscle tear, scar and chronic tendon injury. Having the advantages of high tissue contrast and multiplanar display capability, MR allowed direct visualization of the injured muscles and characterization of traumatic lesions. We conclude that MR could be a good imaging modality for evaluating muscle injuries.

Activation of a calcium- and pH-dependent phospholipase A2 by cyanide in PC12 cells

Previous studies suggested that alterations in phospholipid composition of plasma membranes may contribute to neuronal injury associated with cyanide-induced histotoxic hypoxia. This prompted a study of the effects of KCN on phospholipase A2 (PLA2), an enzyme which catalyzes breakdown of membrane phospholipids. PLA2 activity was measured by quantitating the release of [3H]arachidonic acid ([3H]AA) from rat pheochromocytoma (PC12) cells. KCN produced a time (1-15 min)- and concentration (0.5-10 mM)-dependent release of [3H]AA from the cells. When cells were incubated in Ca(2+)-free buffer, KCN (5 mM) was still able to release [3H]AA. In cells loaded with BAPTA, an intracellular Ca2+ chelator, cyanide-induced release of [3H]AA was blocked, indicating that mobilization of intracellular Ca2+ can activate the enzyme. The PLA2 inhibitors dibucaine (50 microM) and mepacrine (50 microM) inhibited KCN-mediated [3H]AA release. Incubation of PC12 cells in an extracellular pH of 6.50 reduced the KCN effect, whereas incubation at pH 7.90 enhanced [3H]AA release. These data indicate that in PC12 cells KCN activates a Ca(2+)- and pH-dependent PLA2 which may contribute to cyanide-induced cell damage.

Acute focal bacterial nephritis presented as acute renal failure and hepatic dysfunction in a renal transplant recipient

We describe acute focal bacterial nephritis (AFBN) presented as acute renal failure and hepatic dysfunction in a renal transplant recipient. He had received a renal transplantation 5 years previously and maintained good renal function without an episode of acute rejection or any urinary abnormalities. He had been an HBsAg carrier and showed mild elevation of liver enzymes after renal transplantation. For 5 days before admission, the patient suffered from fever, graft kidney swelling, tenderness and oliguria. On admission, renal biopsy was performed and solumedrol pulse therapy was started under the impression of acute rejection. The following laboratory findings revealed acute renal failure and hepatic dysfunction. From the abdomen CT and renal biopsy findings this case was confirmed as AFBN in a grafted kidney. With successive hemodialysis and antibiotic therapy clinical symptoms and renal function improved promptly. In acute hepatic dysfunction we discontinued cyclosporine (CsA) to prevent irreversible fulminant hepatic failure until the normalization of liver function. It should be considered that AFBN must be included in the differential diagnosis of acute rejection, and the early diagnosis and treatment of AFBN is important to save the grafted kidney. In addition, early withdrawal of CsA is essential to prevent irreversible hepatic failure when infection triggers hepatic dysfunction in HBsAg-positive renal transplant recipients.

Primary aldosteronism detected after renal transplantation

A 44-year old female was admitted to our hospital for evaluation of uncontrolled hypertension. She received renal transplantation 3 months ago and suffered from a tingling sensation and weakness on both hands. Laboratory findings (low serum potassium, low plasma renin activity and elevated plasma aldosterone level) was consistent with primary aldosteronism. Through the postural study for plasma aldosterone and the adrenal CT finding we diagnosed this case as adrenal adenoma, which was confirmed by surgical removal. A retrospective review of medical records showed that characteristic findings in primary aldosteronism (hypokalemia and low plasma renin activity) were masked by renal failure and became evident after successful renal transplantation. It was suggested that impaired urinary potassium excretion and excess release of renin from the ischemic kidney masked the characteristic findings of primary aldosteronism. To our knowledge, this is the first report documenting the change of renin-angiotensin-aldosterone system after renal transplantation in a case of coexistence of primary aldosteronism and chronic renal failure.

The role of ultrasound in scrotal trauma

We reviewed the sonograms of 16 cases with scrotal trauma and documented the spectrum of abnormalities that may be present in sonography after a scrotal injury. The sonographic findings included scrotal hematoceles, post-traumatic epididymitis, epididymal hematoma, testicular hematoma and/or infarction, testicular rupture, testicular swelling and hyperemia. Ultrasound is able to distinguish intratesticular and extratesticular lesions. The integrity of the testis could be evaluated as well. It should be the imaging modality of choice for the evaluation of scrotal trauma.

Mesangial cells from diabetic NOD mice constitutively secrete increased amounts of insulin-like growth factor-I

Experimental evidence has suggested that insulin-like growth factor-I (IGF-I) may contribute to diabetic complications. Previously, we and others have shown that normal glomerular mesangial cells have receptors for, synthesize, and exhibit a mitogenic response to IGF-I. We investigated the IGF-I response in cells derived from a genetic model of diabetes, the nonobese diabetic (NOD) mouse. Mesangial cell lines were derived from diabetic (D-NOD) and nondiabetic adult mice. D-NOD cells released more IGF-I into the supernatant and had a decreased binding of IGF-I to surface receptors. Analysis according to Scatchard revealed a decreased number of receptor sites on D-NOD cells, although the structure of the IGF-I receptor visualized by cross-linking was identical for both cell types. Preincubation of D-NOD cells with an antibody to IGF-I resulted in an increase in the number of receptor sites. This suggested that autocrine IGF-I was responsible for the decrease in D-NOD receptor number and that diabetes had resulted in a stable phenotypic change.

Human glomeruli express TIMP-1 mRNA and TIMP-2 protein and mRNA

Alterations in the balance between synthesis and degradation of extracellular matrix may result in glomerulosclerosis. The interaction between metalloproteinases and their inhibitors presumably modulates the rate of glomerular matrix degradation. We examined the gene expression of tissue inhibitor of metalloproteinases (TIMP)-1 and TIMP-2 in human glomeruli and TIMP-2 protein in tissue sections. Kidney tissue was obtained from adults undergoing nephrectomy for renal tumor (n = 9) or biopsy for nephrosis and renal failure (n = 1). Glomeruli were microdissected and subjected to reverse transcription. TIMP cDNAs were quantitated by competitive polymerase chain reaction assays. Five nephrectomy specimens had normal glomeruli and four had diffuse glomerulosclerosis. TIMP-1 and TIMP-2 cDNA levels, detected in glomeruli from all patients, were increased fourfold and threefold, respectively, in patients with glomerulosclerosis. The elevated TIMP cDNA levels could not be attributed to an increased number of glomerular cells. TIMP-2 protein was detected within normal and sclerotic glomeruli. In conclusion, both TIMP genes were expressed in normal glomeruli, and their level of expression was increased in glomerulosclerosis associated with renal carcinoma, suggesting that expression of these inhibitors may correlate with the development of sclerosis.

Abdominal MR imaging following antegrade air introduction into the intestinal loops

Air was used to distend the gastrointestinal tract and act as a contrast medium to effectively delineate the other abdominal organs/masses and to outline intraluminal or mural lesions. We used a nasogastric tube to introduce air into the stomach. Metoclopramide was administered to propel air throughout the gastrointestinal tract. Bowel peristalsis was then controlled by scopolamine butylbromide. Most of the alimentary tract could be distended by air. The normal bowel walls were barely visible between intraluminal signal-void air and extraluminal high-signal fat. Intraluminal tumor, wall thickening, and adjacent structures could be clearly delineated.

Ventricular tumors--CT evaluations of 28 cases

Ventricular neoplasms can be grouped together as a single disease entity because of the behavior of some of the tumors and similarities between the access of therapy and procedure of operation. In our series, the incidence of various ventricular neoplasms (shown in decreasing order) were metastasis, astrocytoma, ependymoma, meningioma, choroid plexus papillomas and oligodendroglioma. The intraventricular tumors included some metastasis involved by hematogenous spread, meningioms, and choroid plexus papilloma while paraventricular tumors included some of the systemic myeloproliferative disorders with ventricular seeding along with tumors with glial origins. Most of the patients with symptoms of intraventricular tumors also had symptoms related to increased intracranial pressure while those with paraventricular neoplasm presented symptoms related to focal signs or symptoms. CT scan with enhancement could provide a very good image modality except in some involvements in the posterior cranial fossa.

The effect of HLA mismatching on graft survival in living-donor kidney transplants: Catholic Medical Center, 1984 to 1993

This study focuses on the beneficial effect of HLA matching on long-term graft survival rates in CsA-treated living primary kidney transplants at Catholic Medical Center, 1984 to 1993. 1. An impressive 26% difference in kidney graft survival was observed at 5 years between recipients who received 0 and 2 HLA-DR mismatches (79% vs 53%). 2. Five-year kidney graft survival rates in the 0, 1, 2, and 3-HLA-B+DR mismatches were 87%, 76%, 77%, and 74%, respectively, which was significantly different from 54% survival rates in the 4-HLA-B+DR mismatch group. 3. The 5-year kidney graft survivals in the 0, 1, 2, HLA-DR-mismatched living-nonrelated donor group were 84%, 76%, and 39%, respectively, which were significant differences. 4. The 5-year kidney graft survivals in the 0, 1, 2, HLA-DR-mismatched living-related donor group were 75%, 79%, and 72%, respectively, which were not significant. 5. The effect of HLA-A, B, A+B, A+DR, and A+B+DR mismatches showed little difference among the groups with different mismatch numbers. In conclusion, better matching for the HLA-DR, B+DR antigens significantly improved kidney graft survivals in our CsA-treated primary living-donor transplant recipients.

Glomerulosclerosis and body growth are mediated by different portions of bovine growth hormone. Studies in transgenic mice

BACKGROUND

Mice transgenic for bovine growth hormone (bGH) gene have increased body weight and severe glomerulosclerosis leading to death in uremia.

EXPERIMENTAL DESIGN

The aim of this study was to determine if body growth and glomerulosclerosis were mediated by different bGH regions. Amino acid substitutions in the bGH alpha-helix III were generated, and lines of transgenic mice that expressed these products were developed. Female transgenic mice carrying the native bGH gene (bGH mice), a mutated bGH gene that encodes a destabilized alpha-helix III (bGH-L121P, E126G; bGH-m11 mice), or a mutated bGH gene that encodes a perfect amphiphilic alpha-helix III (bGH-E117L, G119R, A122D; bGH-m8 mice) were examined at 2-3 months and 6-9 months of age. Body, kidney, and heart weights were measured. Urinary glucose, albumin, creatinine, and serum glucose were measured in all mice. Serum levels of insulin-like growth factor I (IGF-I) were measured in the 2-3 month group. Whole blood hemoglobin A1 was measured in some mice of the 6-9 month group. Kidney sections were examined by light and immunofluorescence microscopy. Glomerular volume was measured and related to body weight by allometry.

RESULTS

The bGH-m11 mice developed glomerulosclerosis indistinguishable from that seen in bGH transgenic mice, even though they had normal body size. Glomerular growth exceeded body growth by allometry in both bGH and bGH-m11 strains. bGH-m8 mice had glomeruli of appropriate size and normal histologic appearance; however, they were dwarfs. IGF-I was increased in bGH mice; they also had an increased albumin/creatinine ratio at 6-9 months. None of the mice were hyperglycemic.

CONCLUSIONS

These data indicated that development of glomerulosclerosis and body growth promotion were mediated by different regions of the growth hormone molecule. The glomerular response to bGH was unique and consisted of increased size and glomerulosclerosis.

Glomerulosclerosis in mice transgenic for native or mutated bovine growth hormone gene

Mice transgenic for bovine growth hormone (bGH) develop an increase in body weight and glomerular lesions characterized by a disproportionate increment in glomerular volume and progressive mesangial sclerosis. The relationship between glomerular size and body growth in bGH mice was further investigated by examining mice transgenic for a mutated GH gene (bGH-m11) which failed to enhance body growth. The glomeruli in bGH-m11 mice exhibited an increase in size and glomerulosclerosis comparable to those found in bGH mice. The levels of alpha 1 type IV collagen mRNA, as measured by the competitive polymerase chain reaction in isolated microdissected glomeruli, were markedly elevated in mice transgenic for both bGH and bGH-m11 genes. These data suggest that body growth on one hand, and glomerular hypertrophy and sclerosis on the other hand, are mediated by different portions of GH or different second messenger signaling systems.

The contribution of increased collagen synthesis to human glomerulosclerosis: a quantitative analysis of alpha 2IV collagen mRNA expression by competitive polymerase chain reaction

We previously reported that one of the main components of the sclerotic material in human glomerular diseases was type IV collagen. In this study we examined the contribution of increased synthesis to this process at the gene expression level. Sufficient material has not been available to study type IV collagen synthesis by normal or sclerotic glomeruli in humans. We took advantage of the availability of nephrectomy specimens from patients with renal carcinoma, and of the observation that approximately 50% of these patients develop varying degrees of glomerulosclerosis. We microdissected glomeruli from 10 patients and analyzed them using in situ reverse transcription coupled with polymerase chain reaction (PCR) analyses (in situ RT-PCR). alpha 2IV collagen mRNA, after reverse transcription into cDNA, was detected in all patients and appeared to be increased in those with glomerulosclerosis (n = 5). A competitive PCR assay was developed to quantitate this change. There was an average 3.7-fold increase in glomerular type IV collagen cDNA in patients with significant sclerosis. This change was not due to an increased number of glomerular cells. Thus, glomerulosclerosis in humans is associated with an elevation of glomerular type IV collagen gene expression, suggesting that increased synthesis of type IV collagen may represent one component of this process.

Spinal muscular atrophy: MR evaluation

The neurogenic myopathy of spinal muscular atrophy (SMA) is degeneration of anterior horn cells of the spinal cord and associated muscle weakness. In three patients with the severe type, according to Dubowitz's classification, magnetic resonance imaging (MRI) of the lower extremity showed severe atrophy of the entire muscle bundles of the thigh and the calf. Nine intermediate type patients had ragged atrophy of muscle bundles of the thigh and the calf with selective preservation of adductor longus muscle. Five patients with the mild type had fatty infiltration of muscle bundles and increased intermuscular fat planes. MRI was insufficient for the evaluation of cervical cord abnormalities. MRI of the lower extremity was a reliable complementary modality for the diagnosis and follow-up of SMA patients.

Magnetic-field-induced birefringence in a homeotropic ferronematic liquid-crystal wedge

The magnetic-field-induced birefringence in wedged homeotropic ferronematic liquid crystals is studied. Theoretical results for small distortions are obtained in terms of the elastic continuum theory of liquid crystals. The results of birefringence measurements are in good agreement with the predictions of the theory.

Goodpasture's syndrome--a case report

Goodpasture's syndrome is a disease characterized by diffuse pulmonary hemorrhage and glomerulonephritis with circulating anti-glomerular basement membrane antibody (anti-GBM antibody). Although it is reported in the western world, it is rarely diagnosed in Taiwan. We report a 26-year-old male admitted due to pulmonary hemorrhage and rapid progressive glomerulonephritis. Renal biopsy showed diffuse glomerular proliferation and 90% crescent formation, and immunofluorescence stain showed diffuse linear staining of IgG, C3, IgA, IgM along glomerular basement membranes and tubular basement membranes. He was treated with immunosuppressive agents. Pulmonary hemorrhage improved rapidly, but his renal function was severely impaired and he remained dialysis dependent.

Automatic design of optical systems using a set of general skew ray tracing formulas

A general equation of high-order surfaces is given. If its second term is equal to zero, this equation will automatically reduce to the conic surfaces. By adding two parameters g and k into the conic equation, we are able to use only one euqation to describe the planar, cylindrical, and conic surfaces. A set of skew ray tracing formulas for these surfaces, including tilted and decentered elements, is derived. The formulas analytical and easy to use. Based on the tracing of skew rays, a merit function of the optical system is defined and an analytical formula for determining the narrowest cross-sectional position of skew rays is given. A program of skew ray tracing is edited for the Sharp-1500 pocket computer. An example for a 2-D infrared scanner is given. Based on the skew ray tracing formulas and by using the damped least-squares method, some examples for automatic design of optical systems are also shown on the IBM PC/XT personal computer.

Absence of cytokeratin in human hepatoma cell lines

The immunofluorescence study revealed that both our established human hepatoma cell lines, HA22T/VGH and HA47T/VGH, were absent of cytokeratin. This observation was further confirmed by a western blot study. However, they as well as the other human hepatoma cells, Hep G2, Hep 3B, and SK-Hep-1 expressed vimentin.