[The kidney, its anatomy and main functions]

The kidney performs several major functions: it eliminates toxins produced by cellular or xenobiotic metabolism, regulates the homeostasis of the internal environment and plays a hormonal role, producing erythropoietin, calcitriol and renin. Maintaining the body's homeostasis (hydric, ionic [sodium, potassium, calcium, phosphorus, etc.] or acid-base balance) requires the successive action of plasma filtration, followed by reabsorption/secretion mechanisms, which take place in the various portions of the kidney's functional unit known as the nephron. The initial part of the nephron, the glomerulus, is the site of filtration, while the tubule, which collects the glomerular filtrate, is the site of reabsorption/secretion, leading to the composition of the final urine. It's important to understand how these different structures work, before tackling the various disorders that can affect the kidney.

Role of foetal kidney size on kidney function in childhood: the born in bradford cohort renal study

BACKGROUND

Foetal and early childhood development contributes to the risk of adult non-communicable diseases such as hypertension and cardiovascular disease. We aimed to investigate whether kidney size at birth is associated with markers of kidney function at 7-11 years.

METHODS

Foetal kidney dimensions were measured using ultrasound scans at 34 weeks gestation and used to derive kidney volume (cm3) in 1802 participants in the Born in Bradford (BiB) birth cohort. Blood and urine samples were taken from those who participated in the BiB follow-up at 7-11 years (n = 630) and analysed for serum creatinine, cystatin C, urea, and urinary albumin to creatinine ratio (ACR), protein to creatinine ratio (PCR) and retinol binding protein (RBP). Estimated glomerular filtration rate (eGFR) was calculated using Schwartz creatinine only and combined with cystatin C, and cystatin C only Zappitelli and Filler equations. Linear regression was used to examine the association between foetal kidney volume and eGFR, ACR, PCR and blood pressure, unadjusted and adjusted for confounders.

RESULTS

Kidney volume was positively associated in adjusted models with eGFR calculated using Schwartz combined (0.64 ml/min diff per unit increase in volume, 95% CI 0.25 to 1.02), Zappitelli (0.79, 95% CI 0.38 to 1.20) and Filler (2.84, 95% CI 1.40 to 4.28). There was an association with the presence of albuminuria but not with its level, or with other urinary markers or with blood pressure.

CONCLUSION

Foetal kidney volume was associated with small increases in eGFR in mid-childhood. Longitudinal follow-up to investigate the relationship between kidney volume and markers of kidney function as children go through puberty is required.

Renal morphology and glomerular capillarisation in young adult sheep born moderately preterm

Preterm birth (delivery <37 weeks of gestation) is associated with impaired glomerular capillary growth in neonates; if this persists, it may be a contributing factor in the increased risk of hypertension and chronic kidney disease in people born preterm. Therefore, in this study, we aimed to determine the long-term impact of preterm birth on renal morphology, in adult sheep. Singleton male sheep were delivered moderately preterm at 132 days (~0.9) of gestation (n = 6) or at term (147 days gestation; n = 6) and euthanised at 14.5 months of age (early adulthood). Stereological methods were used to determine mean renal corpuscle and glomerular volumes, and glomerular capillary length and surface area, in the outer, mid and inner regions of the renal cortex. Glomerulosclerosis and interstitial collagen levels were assessed histologically. By 14.5 months of age, there was no difference between the term and preterm sheep in body or kidney weight. Renal corpuscle volume was significantly larger in the preterm sheep than the term sheep, with the preterm sheep exhibiting enlarged Bowman's spaces; however, there was no difference in glomerular volume between groups, with no impact of preterm birth on capillary length or surface area per glomerulus. There was also no difference in interstitial collagen levels or glomerulosclerosis index between groups. Findings suggest that moderate preterm birth does not adversely affect glomerular structure in early adulthood. The enlarged Bowman's space in the renal corpuscles of the preterm sheep kidneys, however, is of concern and merits further research into its cause and functional consequences.

Imaging intact human organs with local resolution of cellular structures using hierarchical phase-contrast tomography

Imaging intact human organs from the organ to the cellular scale in three dimensions is a goal of biomedical imaging. To meet this challenge, we developed hierarchical phase-contrast tomography (HiP-CT), an X-ray phase propagation technique using the European Synchrotron Radiation Facility (ESRF)'s Extremely Brilliant Source (EBS). The spatial coherence of the ESRF-EBS combined with our beamline equipment, sample preparation and scanning developments enabled us to perform non-destructive, three-dimensional (3D) scans with hierarchically increasing resolution at any location in whole human organs. We applied HiP-CT to image five intact human organ types: brain, lung, heart, kidney and spleen. HiP-CT provided a structural overview of each whole organ followed by multiple higher-resolution volumes of interest, capturing organotypic functional units and certain individual specialized cells within intact human organs. We demonstrate the potential applications of HiP-CT through quantification and morphometry of glomeruli in an intact human kidney and identification of regional changes in the tissue architecture in a lung from a deceased donor with coronavirus disease 2019 (COVID-19).

The lymphatics in kidney health and disease

The mammalian vascular system consists of two networks: the blood vascular system and the lymphatic vascular system. Throughout the body, the lymphatic system contributes to homeostatic mechanisms by draining extravasated interstitial fluid and facilitating the trafficking and activation of immune cells. In the kidney, lymphatic vessels exist mainly in the kidney cortex. In the medulla, the ascending vasa recta represent a hybrid lymphatic-like vessel that performs lymphatic-like roles in interstitial fluid reabsorption. Although the lymphatic network is mainly derived from the venous system, evidence supports the existence of lymphatic beds that are of non-venous origin. Following their development and maturation, lymphatic vessel density remains relatively stable; however, these vessels undergo dynamic functional changes to meet tissue demands. Additionally, new lymphatic growth, or lymphangiogenesis, can be induced by pathological conditions such as tissue injury, interstitial fluid overload, hyperglycaemia and inflammation. Lymphangiogenesis is also associated with conditions such as polycystic kidney disease, hypertension, ultrafiltration failure and transplant rejection. Although lymphangiogenesis has protective functions in clearing accumulated fluid and immune cells, the kidney lymphatics may also propagate an inflammatory feedback loop, exacerbating inflammation and fibrosis. Greater understanding of lymphatic biology, including the developmental origin and function of the lymphatics and their response to pathogenic stimuli, may aid the development of new therapeutic agents that target the lymphatic system.

Vitrification and Nanowarming of Kidneys

Vitrification can dramatically increase the storage of viable biomaterials in the cryogenic state for years. Unfortunately, vitrified systems ≥3 mL like large tissues and organs, cannot currently be rewarmed sufficiently rapidly or uniformly by convective approaches to avoid ice crystallization or cracking failures. A new volumetric rewarming technology entitled "nanowarming" addresses this problem by using radiofrequency excited iron oxide nanoparticles to rewarm vitrified systems rapidly and uniformly. Here, for the first time, successful recovery of a rat kidney from the vitrified state using nanowarming, is shown. First, kidneys are perfused via the renal artery with a cryoprotective cocktail (CPA) and silica-coated iron oxide nanoparticles (sIONPs). After cooling at -40 °C min-1 in a controlled rate freezer, microcomputed tomography (µCT) imaging is used to verify the distribution of the sIONPs and the vitrified state of the kidneys. By applying a radiofrequency field to excite the distributed sIONPs, the vitrified kidneys are nanowarmed at a mean rate of 63.7 °C min-1 . Experiments and modeling show the avoidance of both ice crystallization and cracking during these processes. Histology and confocal imaging show that nanowarmed kidneys are dramatically better than convective rewarming controls. This work suggests that kidney nanowarming holds tremendous promise for transplantation.

Novel G-CSF conjugated anionic globular dendrimer: Preparation and biological activity assessment

The most crucial role of granulocyte colony-stimulating factor (G-CSF) in the body is to increase the strength of immune system. In recent years, research on the use of nanoparticles in pharmaceuticals has been considered, most of which have been for drug-loading purposes. In this study, a novel G-CSF conjugated dendrimer was synthesized and characterized using different techniques. In vitro cytotoxicity was assessed on A549 and L929 cells, while abnormal toxicity was studied in mice. In vitro and in vivo biological activities were assessed in NFS60 cells and rats, respectively. In addition, in vivo distribution, plasma half-life, and histopathological effect were studied in rat. The characterization tests confirmed the successful conjugation. There was no difference between G-CSF cytotoxicity before and after conjugation, and no difference with the control group. No mice showed abnormal toxicity. Although in vitro biological activity revealed both conjugated and free G-CSF promote proliferation cells, biological activity decreased significantly after conjugation about one-third of the unconjugated form. Nonetheless, in vivo biological activity of conjugated G-CSF increased by more than 2.5-fold relative to the unconjugated form, totally. Fortunately, no histopathologic adverse effect was observed in vital rat tissues. Also, in vivo distribution of the conjugate was similar to the native protein with an enhanced terminal half-life. Our data revealed that G-CSF conjugated dendrimer could be considered as a candidate to improve the in vivo biological activity of G-CSF. Moreover, multivalent capability of the dendrimer may be used for other new potentials of G-CSF in future perspectives.

Mapping nephron mass in vivo using positron emission tomography

Nephron number varies widely in humans. A low nephron endowment at birth or a loss of functioning nephrons is strongly linked to increased susceptibility to chronic kidney disease. In this work, we developed a contrast agent, radiolabeled cationic ferritin (RadioCF), to map functioning glomeruli in vivo in the kidney using positron emission tomography (PET). PET radiotracers can be detected in trace doses (<30 nmol), making them useful for rapid clinical translation. RadioCF is formed from cationic ferritin (CF) and with a radioisotope, Cu-64, incorporated into the ferritin core. We showed that RadioCF binds specifically to kidney glomeruli after intravenous injection in mice, whereas radiolabeled noncationic ferritin (RadioNF) and free Cu-64 do not. We then showed that RadioCF-PET can distinguish kidneys in healthy wild-type (WT) mice from kidneys in mice with oligosyndactylism (Os/+), a model of congenital hypoplasia and low nephron mass. The average standardized uptake value (SUV) measured by PET 90 min after injection was 21% higher in WT mice than in Os/+ mice, consistent with the higher glomerular density in WT mice. The difference in peak SUV from SUV at 90 min correlated with glomerular density in male mice from both WT and Os/+ cohorts (R2 = 0.98). Finally, we used RadioCF-PET to map functioning glomeruli in a donated human kidney. SUV within the kidney correlated with glomerular number (R2= 0.78) measured by CF-enhanced magnetic resonance imaging in the same locations. This work suggests that RadioCF-PET appears to accurately detect nephron mass and has the potential for clinical translation.

Safety of natural anthraquinone emodin: an assessment in mice

BACKGROUND

Emodin, a natural anthraquinone, has shown potential as an effective therapeutic agent in the treatment of many diseases including cancer. However, its clinical development is hindered by uncertainties surrounding its potential toxicity. The primary purpose of this study was to uncover any potential toxic properties of emodin in mice at doses that have been shown to have efficacy in our cancer studies. In addition, we sought to assess the time course of emodin clearance when administered both intraperitoneally (I.P.) and orally (P.O.) in order to begin to establish effective dosing intervals.

METHODS

We performed a subchronic (12 week) toxicity study using 3 different doses of emodin (~ 20 mg/kg, 40 mg/kg, and 80 mg/kg) infused into the AIN-76A diet of male and female C57BL/6 mice (n = 5/group/sex). Body weight and composition were assessed following the 12-week feeding regime. Tissues were harvested and assessed for gross pathological changes and blood was collected for a complete blood count and evaluation of alanine transaminase (ALT), aspartate transaminase (AST) and creatinine. For the pharmacokinetic study, emodin was delivered intraperitoneally I.P. or P.O. at 20 mg/kg or 40 mg/kg doses to male and female mice (n = 4/group/sex/time-point) and circulating levels of emodin were determined at 1, 4 and 12 h following administration via liquid chromatography with tandem mass spectrometry (LC-MS/MS) analysis.

RESULTS

We found that 12 weeks of low (20 mg/kg), medium (40 mg/kg), or high (80 mg/kg) emodin feeding did not cause pathophysiological perturbations in major organs. We also found that glucuronidated emodin peaks at 1 h for both I.P. and P.O. administered emodin and is eliminated by 12 h. Interestingly, female mice appear to metabolize emodin at a faster rate than male mice as evidenced by greater levels of glucuronidated emodin at the 1 h time-point (40 mg/kg for both I.P. and P.O. and 20 mg/kg I.P.) and the 4-h time-point (20 mg/kg I.P.).

CONCLUSIONS

In summary, our studies establish that 1) emodin is safe for use in both male and female mice when given at 20, 40, and 80 mg/kg doses for 12 weeks and 2) sex differences should be considered when establishing dosing intervals for emodin treatment.

Toxicological and pharmacokinetic analysis at therapeutic dose of SRS27, an investigational anti-asthma agent

SRS27, an andrographolide analogue, had been proven to have therapeutic properties at a dose of 3 mg/kg in both in vitro and in vivo asthma models of our previous study. The present study focuses on the pharmacokinetic and toxicity profile of this compound to provide further evidence for the development of this compound as an anti-asthma agent. A simple pharmacokinetic study was performed in female BALB/c mice to measure blood plasma concentration of the compound at therapeutic dose. At a single dose of 3 mg/kg, SRS27 had a relatively short half-life but was able to achieve a concentration range of 13-19 μM that is related to its in vitro bioactivities. With regard to toxicity profile, SRS27 appears to be safe, as no histopathological changes were observed in the liver, kidneys and ovaries of SRS27-treated female BALB/c mice. In addition, there was no significant change in the mean body weight and organ weight of the animals in the SRS27-treated groups compared with the vehicle-treated control group at the end of the treatment. This fully supports the absence of any significant changes in peripheral blood leukocyte counts of SRS27-treated mice. Rewardingly, this acute toxicity study also revealed that SRS27 has a wide therapeutic window as no toxicity symptoms were detected with a dose up to 60 mg/kg daily when tested for 14 days. These results provide strong justification for further investigation of SRS27 as a potential new anti-asthma agent.

Variations in Laminar Arrangements of the Mesocolon and Retropancreatic Fascia: a Histological Study Using Human Fetuses Near Term

OBJECTIVE

The embryonic mesentery of the ascending and descending colons as well as the pancreas disappears due to peritoneal fusion, but there might be no or few photographic demonstrations of the intermediate morphologies during the process. The aims of this study were to characterize the morphological relationship of the interface between the renal fascia and peritoneum.

METHODS

Fourteen late-stage fetuses with crown rump lengths (CRLs) of 250-325 mm (gestational age: 30-38 weeks) were histologically examined.

RESULTS

The renal fascia, a thick or thin layer consisting of densely-distributed abundant fibers, was consistently separated from the renal capsule by a perirenal space containing fat. The transverse colon carried a typical mesocolon histologically different from the renal fascia. The ascending and descending mesocolons were irregularly divided into multiple laminae and the colic external longitudinal muscle appeared to directly contact the renal fascia. There was a spectrum of variations from multiple laminae to a single thick fascia between the pancreatic body and the left kidney or adrenal.

CONCLUSIONS

A fascial development after retroperitoneal fusion of the mesentery showed great individual and site-dependent differences in proportion of 1) a complete fusion with the renal fascia and 2) a multilaminar structure including the remnant peritoneum. These variations masked the likely stage-dependent change.

Kidney segmentation in neck-to-knee body MRI of 40,000 UK Biobank participants

The UK Biobank is collecting extensive data on health-related characteristics of over half a million volunteers. The biological samples of blood and urine can provide valuable insight on kidney function, with important links to cardiovascular and metabolic health. Further information on kidney anatomy could be obtained by medical imaging. In contrast to the brain, heart, liver, and pancreas, no dedicated Magnetic Resonance Imaging (MRI) is planned for the kidneys. An image-based assessment is nonetheless feasible in the neck-to-knee body MRI intended for abdominal body composition analysis, which also covers the kidneys. In this work, a pipeline for automated segmentation of parenchymal kidney volume in UK Biobank neck-to-knee body MRI is proposed. The underlying neural network reaches a relative error of 3.8%, with Dice score 0.956 in validation on 64 subjects, close to the 2.6% and Dice score 0.962 for repeated segmentation by one human operator. The released MRI of about 40,000 subjects can be processed within one day, yielding volume measurements of left and right kidney. Algorithmic quality ratings enabled the exclusion of outliers and potential failure cases. The resulting measurements can be studied and shared for large-scale investigation of associations and longitudinal changes in parenchymal kidney volume.

[Anatomical revivification of the structure of the belt vessel]

On the base of the records in Huangdi Neijing (Yellow Emperor 's Inner Classic) and relevant ancient literature, the anatomical structure of the belt vessel was revivified. The belt vessel covers the kidneys and inlays in the 14th vertebrae on the lumbar region. It joints qijie (qi street) at the groin and connects with the thoroughfare vessel, the conception vessel and the governor vessel, as well as the muscle region of foot-yangming meridian. Correspondingly, the related anatomic structure includes renal fascia and transversalis fascia. The transversalis fascia is the main part of the belt vessel structure. The superior lumbar triangle is the vulnerable spot of abdominal wall structure and also coincident with the localization of "3 cun away from the spinal column bilaterally". It is the optimal selection when stimulating the belt vessel. In late generations, "governing all of meridians" has been supplemented as the function of the belt vessel. The diaphragm extends to the transversalis fascia and renal fascia through the inferior diaphragmatic fascia and it is also the only structure that connects with the twelve meridians and five zang organs. Hence, modern acupuncture and moxibustion has actually transferred the structural center of the belt vessel from the transversalis fascia to the diaphragm.

Pigmentation formation and expression analysis of tyrosinase in Siniperca chuatsi

Animal pigmentation primarily depends on the presence and mixing ratio of chromatophores, functioning in animal survival and communication. For the benthic and carnivorous Siniperca chuatsi, pigmentation pattern is key to concealment and predation. In this study, the formation, distribution, and main pattern of chromatophores were observed in the embryos, larvae, skins, and visceral tissues from S. chuatsi. Melanophores were firstly visualized in the yolk sac at segmentation stage, and then they were migrated to the whole body and further clustered into the black stripes, bands, and patches. In adult S. chuatsi, the head, black band, and body side skins mainly contained melanophores, showing as deep or light black. The abdomen skin mainly contained iridophores, showing as silvery. In the eye, the pigment layers were located in the epithelial layers of iris and retina and shown as black. Then, the pigmentation-related gene, tyrosinase gene from S. chuatsi (Sc-tyr) was analyzed by bioinformatics and quantitative methods. The Sc-tyr gene encoded a protein with 540 amino acids (Sc-TYR). The Sc-TYR contained two copper ion binding sites, which were coordinated by six conserved histidines (H182, H205, H214, H366, H370, H393) and necessary for catalytic activity. The Sc-TYR was well conserved compared with TYR of various species with higher degree of sequence similarity with other fishes (77.6-98.3%). The qRT-PCR test showed that the Sc-tyr mRNA reached the peak value at segmentation stage in the embryo development, the black skins displayed a higher expression level than that in silvery skin, and the eye had the highest expression level compared with other tissues. Further research on enzyme activity showed that the expression patterns of tyrosinase activity were similar to that of the Sc-tyr mRNA. Comparing with the results of molecular and phenotype, it was found that the temporal and spatial distributions of tyrosinase corresponded well with changes in pigmentation patterns and the intensity of skin melanization. This study initially explored the pigmentation formation and tyrosinase expression, which served as a foundation for further insight into the genetics mechanism of body color formation in S. chuatsi.

An evaluation of preterm kidney size and function over the first two years of life

BACKGROUND

We carried out a study to determine the impact of prematurity on kidney development in the first 2 years of life.

METHODS

In this prospective study, extremely preterm neonates (gestation < 28 weeks) were recruited and underwent assessments at 6, 12, and 24 months of age. A cohort of neonates born term were also recruited and followed up for 24 months. The primary outcomes measured in this study were total kidney volume (TKV) and estimated glomerular filtration rate (eGFR); albuminuria and blood pressure measurements (all provided as mean (standard deviation)) were the secondary outcomes.

RESULTS

Fifty-three premature and 31 term neonates (control) were recruited. At the age of 24 months (corrected age), infants born preterm had significantly smaller TKV (56.1 (9.4) vs. 64.8 (10.2) mL; P = 0.006). There was no difference in eGFR. These preterm infants were smaller (11.25 (1.53) vs. 12.9 (1.8) kg; P = 0.002) and shorter (83.8 (3.0) vs. 86.3 (3.4) cm; P = 0.02) when compared with the control group. At 6, 12, and 18 months respectively, preterm infants had, relative to their height, significantly smaller kidney volumes (0.54 (0.1) vs. 0.59 (0.1) mL/cm, P = 0.05; 0.61 (0.1) vs.0.71 (0.1) mL/cm, P = 0.003; and 0.67 (0.1) vs.0.76 (0.1) mL/cm, P = 0.006).

CONCLUSIONS

Relative to body length, TKV in premature infants is smaller. Since length reflects adult body proportions more accurately than BSA, TKV to height ratio may be a more important measure in the child. Despite smaller TKV (and therefore fewer nephrons), infants born prematurely achieve similar eGFRs in the first 24 months of life, probably due to single-nephron hyperfiltration.

Comparative transcriptomic analysis reveals mechanisms of divergence in osmotic regulation of the turbot Scophthalmus maximus

The turbot Scophthalmus maximus has evolved extensive physiological ability to adapt to multiple environmental salinities. The morphological changes of the kidney indicated the adaptability difference and similarity of turbot to salinity stress. Identify transcriptome-wide differences between low-salinity seawater (LSW, salinity 5)- and high-salinity seawater (HSW, salinity 50)-acclimated kidneys of turbot to decipher the osmotic regulation mechanism. We identified 688 differentially expressed genes (DEGs) in the LSW-acclimated kidneys and 2441 DEGs in the HSW-acclimated kidneys of turbot compared with seawater-acclimated kidneys, respectively. We investigated three patterns of gene regulation to salinity stress that involved in ion channels and transporters, functions of calcium regulation, organic osmolytes, energy demand, cell cycle regulation, and cell protection. Additionally, protein-protein interaction (PPI) analysis of DEGs suggested the presence of a frequent functional interaction pattern and that crucial genes in the PPI network are involved in hyper-osmotic regulation. Based on the analysis of comparative transcriptome data and related literature reports, we conclude that the mechanisms responsible for osmotic regulation and its divergence in turbot are related to various genes that are involved in canonical physiological functions. These findings provide insight into the divergence in osmoregulation of turbot and valuable information about osmoregulation mechanisms that will benefit other studies in this field.

Ctcf is required for renin expression and maintenance of the structural integrity of the kidney

Renin cells are crucial for the regulation of blood pressure and fluid electrolyte homeostasis. We have recently shown that renin cells possess unique chromatin features at regulatory regions throughout the genome that may determine the identity and memory of the renin phenotype. The 3-D structure of chromatin may be equally important in the determination of cell identity and fate. CCCTC-binding factor (Ctcf) is a highly conserved chromatin organizer that may regulate the renin phenotype by controlling chromatin structure. We found that Ctcf binds at several conserved DNA sites surrounding and within the renin locus, suggesting that Ctcf may regulate the transcriptional activity of renin cells. In fact, deletion of Ctcf in cells of the renin lineage led to decreased endowment of renin-expressing cells accompanied by decreased circulating renin, hypotension, and severe morphological abnormalities of the kidney, including defects in arteriolar branching, and ultimately renal failure. We conclude that control of chromatin architecture by Ctcf is necessary for the appropriate expression of renin, control of renin cell number and structural integrity of the kidney.

Renal Volume Estimation Using Freehand Ultrasound Scans: An Ex Vivo Demonstration

Renal volume has the potential to serve as a robust biomarker for tracking the onset and progression of renal diseases and also for quantifying renal function. We propose a method to estimate renal volumes using freehand ultrasound scans at the point of care. A conventional ultrasound probe was augmented with an Intel RealSense D435 i camera. Visual inertial simultaneous localization and mapping was used to localize the probe in free space. The acquired 2-D ultrasound images, segmented by trained clinicians, were combined with the estimated poses of the probe to yield accurate volumes. The method was tested on two ex vivo sheep kidneys embedded in gelatin phantoms. Four different scanning protocols were tested: transverse linear, transverse fan, longitudinal linear and longitudinal fan. The estimated renal volumes were compared with those obtained using the water displacement method, the ellipsoidal method and computed tomography imaging. The water displacement method yielded mean volumes of 66.00 and 66.20 mL for kidneys 1 and 2, respectively (ground truth). Freehand ultrasound scans produced mean volumes of 64.08 mL (2.90% error) and 65.25 mL (1.40% error); the ellipsoidal method yielded volumes of 57.49 mL (12.90% error) and 60.15 mL (9.13% error); and computed tomography yielded a volume of 63.00 mL (4.54% error).

Renal microvasculature in the adult pipid frog, Xenopus laevis: A scanning electron microscope study of vascular corrosion casts

We studied the opisthonephric (mesonephric) kidneys of adult male and female Xenopus laevis using scanning electron microscopy (SEM) of vascular corrosion casts and light microscopy of paraplast embedded tissue sections. Both techniques displayed glomeruli from ventral to mid-dorsal regions of the kidneys with single glomeruli located dorsally close beneath the renal capsule. Glomeruli in general were fed by a single afferent arteriole and drained via a single thinner efferent arteriole into peritubular vessels. Light microscopy and SEM of vascular corrosion casts revealed sphincters at the origins of afferent arterioles, which arose closely, spaced from their parent renal arteries. The second source of renal blood supply via renal portal veins varied interindividually in branching patterns with vessels showing up to five branching orders before they became peritubular vessels. Main trunks and their first- and second-order branches revealed clear longish endothelial cell nuclei imprint patterns oriented parallel to the vessels longitudinal axis, a pattern characteristic for arteries. Peritubular vessels had irregular contours and were never seen as clear cylindrical structures. They ran rather parallel, anastomosed with neighbors and changed into renal venules and veins, which finally emptied into the ventrally located posterior caval vein. A third source of blood supply of the peritubular vessels by straight terminal portions of renal arteries (vasa recta) was not found.

Microwave assisted synthesis of polyacrylamide grafted polymeric blend of fenugreek seed mucilage-Polyvinyl alcohol (FSM-PVA-g-PAM) and its characterizations as tissue engineered scaffold and as a drug delivery device

Microwave assisted synthesis of graft copolymer of polymeric blend of Fenugreek seed mucilage (FSM)-Polyvinyl alcohol (PVA) with acrylamide (AM) was done by free radical polymerization using ammonium per sulfate (APS) as initiator. Varying amount of AM and APS was used to optimize the best grade based on highest percentage grafting efficiency and investigated with intrinsic viscosity measurement, Fourier Transformation infrared spectroscopy (FTIR),13C NMR spectra, X-ray diffraction, elemental analysis, Thermogravimetric analysis, Scanning electron microscopy. The results of intrinsic viscosity indicate that the optimized sample GF4 has longer chain length than in comparison to the native mucilage and thus exhibits more swelling tendencies and thus can be used as very good controlled release matrix system. The thermal analysis and X-ray indicates that GF4 is more stable and possess more amorphous properties than the native FSM. The NMR and FT-IR studies reveal that in GF4 there is prominent presence of amide and the hydroxyl groups indicating that grafting mechanism has efficiently taken place. Histological studies & SEM image for optimized grade implanted on animals revealed sufficient tissue growth and exhibited biodegradability proving the material to be biocompatible and suitable to be used as tissue engineered scaffolds. The controlled release behavior of the optimized polymeric system GF4 was evidenced by 95% release of loaded drug Enalapril maleate for 16 h. Graphical abstract.

Measurement method of optical properties of ex vivo biological tissues of rats in the near-infrared range

An optical fiber-based supercontinuum setup and a custom-made spectrophotometer that can measure spectra from 1100 to 2300 nm, are used to describe attenuation properties from different ex vivo rat tissues. Our method is able to differentiate between scattering and absorption coefficients in biological tissues. Theoretical assumptions combined with experimental measurements demonstrate that, in this infrared range, tissue attenuation and absorption can be accurately measured, and scattering can be described as the difference between both magnitudes. Attenuation, absorption, and scattering spectral coefficients of heart, brain, spleen, retina, and kidney are given by applying these theoretical and experimental methods. Light through these tissues is affected by high scattering, resulting in multiple absorption events, and longer wavelengths should be used to obtain lower attenuation values. It can be observed that the absorption coefficient has a similar behavior in the samples under study, with two main zones of absorption due to the water absorption bands at 1450 and 1950 nm, and with different absolute absorption values depending on the constituents of each tissue. The scattering coefficient can be determined, showing slight differences between retina and brain samples, and among heart, spleen and kidney tissues.

The relationship between body mass index and renal length in obese children

BACKGROUND

Obesity in the pediatric population is a severe public health problem and is associated with various comorbidities. Renal length is an important clinical parameter for the diagnosis and follow-up of renal diseases. The aim of this study was to determine the relationship between renal length (measured ultrasonographically) and body mass index (BMI) in obese children, and to develop nomograms for renal length according to BMI.

METHODS

Renal ultrasound was performed in 368 children without renal disease. Each child's age, gender, weight, height, and BMI (kg/m²) were recorded. The children were divided into three groups according to BMI percentiles: obese group: BMI ≥ 95th percentile; overweight group: BMI 85th-94th percentile; normal weight group: BMI 5th-84th percentile.

RESULTS

Weight, height, BMI, and right and left renal length differed significantly between the three groups (p = 0.001). There were significant correlations between renal length with age, weight, height, and BMI. Measurement of renal length was independently associated with BMI, age, and height. BMI was used to create renal length nomograms for obese children, based on multiple regression analysis (R² = 0.32 and p = 0.0001). Mean renal length was highest in the obese group (96.9 ± 13.4 mm) and lowest in the normal weight group (88.3 ± 12.9 mm).

CONCLUSIONS

Ultrasonographic measurement of the renal length according to BMI in children can be a useful method in evaluating these children. Smaller-than-normal kidneys can easily remain undiagnosed in obese and overweight children and this nomogram offers an additional method to evaluate the renal size in obese children.

Ultrasound Shear Wave Elastography and Doppler Sonography to Assess the Effect of Hydration on Human Kidneys: A Preliminary Observation

To assess the feasibility of ultrasound imaging in depicting the changes in kidney size, hemodynamics and cortex viscoelasticity after hydration, we prospectively performed 2-D ultrasound shear wave elastography (SWE) and Doppler sonography of bilateral kidneys in 30 volunteers. Kidney length, cortex shear wave velocity (SWV), shear wave dispersion (SWD), interlobar artery peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) were measured before and 60 min after with and without drinking water (1 L). The differences in kidney length, SWV, PSV, EDV and color pixel intensity before and after hydration were significant (p < 0.001), whereas these differences were not significant without hydration (p > 0.05). SWD and RI did not significantly differ with or without hydration. Inter- and intra-observer reliability in performing SWE and Doppler sonography was good. The use of Doppler sonography and ultrasound SWE to evaluate the effect of hydration on kidney size, hemodynamics and viscoelasticity seem to be feasible.

Sonographic nomogram of paediatric renal size in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

INTRODUCTION

A person's childhood is an important period of growth, and also one's most vulnerable, as one can be exposed to various pathologies, for example those that could affect the growth of one's kidney. Asians are physiologically different from Caucasians, and the nomogram renal size obtained from a Western population (mostly of Caucasians) is not be suitable for representing Asian children. As such a nomogram on paediatric renal size derived from Malaysia is needed.

METHODS

A total of 109 (64 males and 45 females) aged 0-12 in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) took part in this study. They underwent ultrasonography of both kidneys, and their demographic and anthropometric data were collected. The mean and standard deviations of the renal length and renal volume according to their age groups was calculated, and the final data was compared to the ones reported by Rosenbaum et al. (1984).

RESULT

Body weight and Body Surface Area (BSA) of the children reported the strongest correlation with renal size. Significant differences were found between local and the data from Rosenbaum et al (1984). A nomogram on paediatric renal size based on children in PPUKM was then created.

DISCUSSION

Ultrasonography is regarded as the standard method for determining renal size. Body weight and BSA were both strongly correlated with renal size. It was shown that the widely used nomograms derived from data obtained from Caucasian was not suitable to represent the population of Malaysian children.

Liver, Spleen, and Kidney Size in Children as Measured by Ultrasound: A Systematic Review

Ultrasound is commonly the first-line imaging modality for assessing the pediatric abdomen. An abnormal size of the liver, spleen, or kidneys may indicate disease, but the evaluation is challenging because the normal size changes with age. In addition, published normal value charts for children may vary by population and methods. In this systematic review, we summarized published data on the normal size of the pediatric liver, spleen, and kidneys as measured by ultrasound in which we found similar values across different populations, ages, and sexes.

Normal sonographic renal length measurements in an Australian pediatric population

BACKGROUND

Reference charts depicting normal growth are important for the sonographic assessment of the pediatric kidney. Limited charts are available for clinical use in an Australian population.

OBJECTIVE

To retrospectively collate sonographic renal length measurements in a cohort of low-risk Australian children aged newborn to 16 years to produce a reference table and comparison with other published charts.

MATERIALS AND METHODS

We identified consecutive pediatric patients who were at low risk for renal disease and had renal lengths measured. After exclusions, we included 941 renal lengths (male 490, female 451). We used linear regression to estimate the relationship of renal length with age, gender and side. We calculated percentile values of renal length according to age categories.

RESULTS

No statistically significant differences in mean renal length were observed between males and females, or for left and right kidneys. We tabulated reference data and provide them in a reference chart (1-, 2.5-, 5-, 10-, 50-, 90-, 97.5- and 99-percentiles).

CONCLUSION

We calculated new reference ranges for pediatric renal length using a larger cohort than previously published, from a population with diverse ethnicity.

Hydrogen sulphide-induced hypometabolism in human-sized porcine kidneys

Background

Since the start of organ transplantation, hypothermia-forced hypometabolism has been the cornerstone in organ preservation. Cold preservation showed to protect against ischemia, although post-transplant injury still occurs and further improvement in preservation techniques is needed. We hypothesize that hydrogen sulphide can be used as such a new preservation method, by inducing a reversible hypometabolic state in human sized kidneys during normothermic machine perfusion.

Methods

Porcine kidneys were connected to an ex-vivo isolated, oxygen supplemented, normothermic blood perfusion set-up. Experimental kidneys (n = 5) received a 85mg NaHS infusion of 100 ppm and were compared to controls (n = 5). As a reflection of the cellular metabolism, oxygen consumption, mitochondrial activity and tissue ATP levels were measured. Kidney function was assessed by creatinine clearance and fractional excretion of sodium. To rule out potential structural and functional deterioration, kidneys were studied for biochemical markers and histology.

Results

Hydrogen sulphide strongly decreased oxygen consumption by 61%, which was associated with a marked decrease in mitochondrial activity/function, without directly affecting ATP levels. Renal biological markers, renal function and histology did not change after hydrogen sulphide treatment.

Conclusion

In conclusion, we showed that hydrogen sulphide can induce a controllable hypometabolic state in a human sized organ, without damaging the organ itself and could thereby be a promising therapeutic alternative for cold preservation under normothermic conditions in renal transplantation.

Administration of ginger and/or thyme has ameliorative effects on liver and kidney functions of V-line rabbits: Histological and biochemical studies

This study was conducted to evaluate the effect of Zingiber officinale and Thymus vulgaris aqueous extracts as a natural antioxidant on liver and kidney functions and antioxidant status of growing rabbits. A total of 24 V-line male rabbits, 3 months old, 1.465 ± 0.12 kg average body weight (BW) were used in a complete randomized design. The rabbits were weighed individually and assigned randomly to four groups (6 animals/each). The first group (G1) was taken fresh water and served as control, rabbits of the second group (G2) were taken 100 mg/kg BW in drinking water of the Z. officinale aqueous extract daily. The third group (G3) was taken 50 mg/kg BW in drinking water of the T. vulgaris aqueous extract daily and the fourth group (G4) was taken 100 mg/kg BW of the Z. officinale aqueous extract plus 50 mg/kg BW of the T. vulgaris aqueous extract in drinking water daily. The oral administration of ginger and/or thyme aqueous extracts increased (p < .001) serum protein profile compared with control group. Moreover, results of group 2 showed significant (p < .001) decrease in cholesterol, triglyceride and very low-density lipoprotein cholesterol compared with group 3 and 4. Serum urea, uric acid and creatinine levels were significantly (p < .001) decreased in treated groups compared with control group. Oral administration of ginger and/or thyme aqueous extracts to growing rabbits increased (p < .001) total antioxidant capacity and glutathione content and the activity of superoxide dismutase, catalase and glutathione-S-transferase compared with the control group. In conclusion, the current study showed that oral administration of ginger and thyme aqueous extracts to growing rabbits showed no adverse effects on liver and kidney function parameters, histological structures and improved antioxidant status.

Evaluation of ultrasonographically determined ratios of kidney length to aorta diameter for assessment of kidney size in healthy young dogs

OBJECTIVE

To determine whether previously described cutoffs for ultrasonographically determined kidney length-to-aorta diameter ratio (KL:Ao) for evaluation of kidney size in adult dogs are applicable to healthy dogs 1 to 18 months of age and to assess interobserver and intraobserver variability for ultrasonographic kidney and aorta measurements in these dogs grouped according to age.

ANIMALS

82 dogs.

PROCEDURES

41 university-owned dogs and 41 client- or staff-owned dogs of 3 age groups (approx 1, 6, and 12 to 18 months of age) underwent ultrasonographic examination by 3 observers. Kidney length, kidney width, and diameter of the aorta were measured by each observer 3 times, and KL:Ao and kidney length-to-body weight ratio were calculated for each dog. Measurements and calculated ratios for the 3 age groups were compared by statistical methods; interobserver and intraobserver variability were calculated.

RESULTS

Mean kidney length, kidney width, and aorta diameter were smaller, and calculated KL:Ao and kidney length-to-body weight ratio were larger, for dogs of the 1-month age group than for dogs of the 6-month and 12 to 18-month age groups. There were significant interobserver differences for ultrasonographic measurements in all age groups; these were most frequent in the youngest group of dogs and affected KL:Ao for that group only.

CONCLUSIONS AND CLINICAL RELEVANCE

Results revealed that 1-month-old dogs have larger kidneys relative to body weight and aorta diameter than do older dogs. Interobserver variability for the youngest group of dogs indicated limited usefulness of these measurements and related ratios for neonatal dogs in clinical practice. The KL:Ao values for dogs ≥ 6 months of age in this study were similar to values previously described for dogs > 12 months of age.

Furcellaran-Coated Microcapsules as Carriers of Cyprinus carpio Skin-Derived Antioxidant Hydrolysate: An In Vitro and In Vivo Study

Carp skin gelatine hydrolysate (CSGH) may be a possible bioactive peptide source, as promising antioxidant properties have been noted during in vivo testing. Hence, the present study focused on improving the bioavailability of the antioxidant peptides from CSGH and on the use of furcellaran (FUR), which can protect the biopeptides during digestion in the gastrointestinal tract. Therefore, in this study, microcapsules coated with furcellaran and containing CSGH cores were prepared. The structural properties of the sample were determined using FT-IR and SEM analysis. The antioxidant properties of hydrolysate, uncoated, and encapsulated samples were investigated. In vivo analysis included determination of its safety in an animal organism and evaluation of the lipid profile, antioxidant blood status, and mRNA expression of some genes involved in antioxidant status in Wistar rats. The results showed no adverse effects of microencapsulated protein hydrolysates in laboratory animals. Nonetheless, there was a statistically significant rise in the level of total antioxidant status blood serum among animals consuming CSGH and not inducing oxidative stress. This can be viewed as a promising indication of the positive effects of antioxidant properties tested in vivo. The process of CSGH microencapsulation in FUR cause a decrease in antioxidant hydrolysate activity, both in vitro, as well as in healthy Wistar rats. When considering the results of the presented diverse therapeutic potential, further research on CSGH being a potential bioactive peptide source used as a functional food or nutraceutical, but with a different microencapsulation coating, is encouraged.

Spatiotemporal immune zonation of the human kidney

Tissue-resident immune cells are important for organ homeostasis and defense. The epithelium may contribute to these functions directly or by cross-talk with immune cells. We used single-cell RNA sequencing to resolve the spatiotemporal immune topology of the human kidney. We reveal anatomically defined expression patterns of immune genes within the epithelial compartment, with antimicrobial peptide transcripts evident in pelvic epithelium in the mature, but not fetal, kidney. A network of tissue-resident myeloid and lymphoid immune cells was evident in both fetal and mature kidney, with postnatal acquisition of transcriptional programs that promote infection-defense capabilities. Epithelial-immune cross-talk orchestrated localization of antibacterial macrophages and neutrophils to the regions of the kidney most susceptible to infection. Overall, our study provides a global overview of how the immune landscape of the human kidney is zonated to counter the dominant immunological challenge.

How do patient characteristics and anatomical features correlate to accuracy of organ dose reconstruction for Wilms' tumor radiation treatment plans when using a surrogate patient's CT scan?

In retrospective radiation treatment (RT) dosimetry, a surrogate anatomy is often used for patients without 3D CT. To gain insight in what the crucial aspects in a surrogate anatomy are to enable accurate dose reconstruction, we investigated the relation of patient characteristics and internal anatomical features with deviations in reconstructed organ dose using surrogate patient's CT scans. Abdominal CT scans of 35 childhood cancer patients (age: 2.1-5.6 yr; 17 boys, 18 girls) undergoing RT during 2004-2016 were included. Based on whether an intact right or left kidney is present in the CT scan, two groups were formed each containing 24 patients. From each group, four CTs associated with Wilms' tumor RT plans with an anterior-posterior-posterior-anterior field setup were selected as references. For each reference, a 2D digitally reconstructed radiograph was computed from the reference CT to simulate a 2D radiographic image and dose reconstruction was performed on the other CTs in the respective group. Deviations in organ mean dose (DE_mean) of the reconstructions versus the references were calculated, as were deviations in patient characteristics (i.e. age, height, weight) and in anatomical features including organ volume, location (in 3D), and spatial overlaps. Per reference, the Pearson's correlation coefficient between deviations in DE_mean and patient characteristics/features were studied. Deviation in organ locations and DE_mean for the liver, spleen, and right kidney were moderately correlated (R² > 0.5) for 8/8, 5/8, and 3/4 reference plans, respectively. Deviations in organ volume or spatial overlap and DE_mean for the right and left kidney were weakly correlated (0.3 < R² < 0.5) in 4/4 and 1/4 reference plans. No correlations (R² < 0.3) were found between deviations in age or height and DE_mean. Therefore, the performance of organ dose reconstruction using surrogate patients' CT scans is primarily related to deviation in organ location, followed by volume and spatial overlap. Further, results were plan dependent.

Zebrafish as a model for kidney function and disease

Kidney disease is a global problem with around three million people diagnosed in the UK alone and the incidence is rising. Research is critical to develop better treatments. Animal models can help to better understand the pathophysiology behind the various kidney diseases and to screen for therapeutic compounds, but the use especially of mammalian models should be minimised in the interest of animal welfare. Zebrafish are increasingly used, as they are genetically tractable and have a basic renal anatomy comparable to mammalian kidneys with glomerular filtration and tubular filtration processing. Here, we discuss how zebrafish have advanced the study of nephrology and the mechanisms underlying kidney disease.

Effect of Hydrostatic Pressure, Boundary Constraints and Viscosity on the Vaporization Threshold of Low-Boiling-Point Phase-Change Contrast Agents

The vaporization of low-boiling-point phase-change contrast agents (PCCAs) using ultrasound has been explored in vitro and in vivo. However, it has been reported that the pressure required for activation is higher in vivo, even after attenuation is accounted for. In this study, the effect of boundary constraints, hydrostatic pressure and viscosity on PCCA vaporization pressure threshold are evaluated to explore possible mechanisms for variations in in vivo vaporization behavior. Vaporization was measured in microtubes of varying inner diameter and a pressurized chamber under different hydrostatic pressures using a range of ultrasound pressures. Furthermore, the activation threshold was evaluated in the kidneys of rats. The results confirm that the vaporization threshold is higher in vivo and reveal an increasing activation threshold inversely proportional to constraining tube size and inversely proportional to surrounding viscosity in constrained environments. Counterintuitively, increased hydrostatic pressure had no significant effect experimentally on the PCCA vaporization threshold, although it was confirmed that this result was supported by homogeneous nucleation theory for liquid perfluorocarbon vaporization. These factors suggest that constraints caused by the surrounding tissue and capillary walls, as well as increased viscosity in vivo, contribute to the increased vaporization threshold compared with in vitro experiments, although more work is required to confirm all relevant factors.

Perfusion-weighted and diffusion-weighted magnetic resonance imaging of the liver, spleen, and kidneys of healthy adult male cats

OBJECTIVE To describe perfusion and diffusion characteristics of the liver, spleen, and kidneys of healthy adult male cats as determined by morphological, perfusion-weighted, and diffusion-weighted MRI. ANIMALS 12 healthy adult male cats. PROCEDURES Each cat was anesthetized. Morphological, perfusion-weighted, and diffusion-weighted MRI of the cranial aspect of the abdomen was performed. A region of interest (ROI) was established on MRI images for each of the following structures: liver, spleen, cortex and medulla of both kidneys, and skeletal muscle. Signal intensity was determined, and a time-intensity curve was generated for each ROI. The apparent diffusion coefficient (ADC) was calculated for the hepatic and splenic parenchyma and kidneys on diffusion-weighted MRI images. The normalized ADC for the liver was calculated as the ratio of the ADC for the hepatic parenchyma to the ADC for the splenic parenchyma. RESULTS Perfusion-weighted MRI variables differed among the 5 ROIs. Median ADC of the hepatic parenchyma was 1.38 × 10^-3 mm²/s, and mean ± SD normalized ADC for the liver was 1.86 ± 0.18. Median ADC of the renal cortex and renal medulla was 1.65 × 10^-3 mm²/s and 1.93 × 10^-3 mm²/s, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results provided preliminary baseline information about the diffusion and perfusion characteristics of structures in the cranial aspect of the abdomen of healthy adult male cats. Additional studies of cats of different sex and age groups as well as with and without cranial abdominal pathological conditions are necessary to validate and refine these findings.

Establish new formulas for the calculation of renal and isthmus depth in horseshoe kidney

This study was performed to develop a new formula to estimate the renal and isthmus depth in horseshoe kidney, and to compare the new formula with previously published formulas.Renal depth, isthmus depth, vertebral thickness, and total thickness (T, cm) of the body at the level of the kidneys were measured by CT in 124 adults. Their sex, age, height (H, cm), and weight (W, kg) were recorded. Multiple stepwise linear regression analysis was conducted. The 124 cases were divided into 2 random groups, of which the first group was used to derive a regressive formula and the second group was used to verify the formula and compare the formula with previously published formulas.Multiple stepwise linear regression analysis showed that the important variables in estimating the depth of each kidney were the body weight (W, kg) and the total thickness (T, cm) of the body at the level of the kidneys. The important variables in estimating the depth of isthmus soft tissue and vertebral thickness were W, T, and age, W. The new formula was the following: right renal depth (cm) = 0.273 × T + 0.043 × W + 1.086 (r = 0.82, P < .05; standardized regressive coefficient: T = 0.500, W = 0.367), left renal depth (cm) = 0.245 × T + 0.041 × W + 0.676 (r = 0.83, P < .05; standardized regressive coefficient: T = 0.520, W = 0.353); isthmus depth (cm) = soft tissue depth + vertebral thickness, soft tissue depth (cm) = 0.144 × T + 0.044 × W + 0.536 (r = 0.58, P < .05; standardized regressive coefficient: T = 0.272, W = 0.335), vertebral thickness (cm) = 0.012 × age + 0.018 × W + 3.683 (r = 0.53, P < .05; standardized regressive coefficient: age = 0.326, W = 0.438). It is much better than the literatures.The new renal depth estimation formula in horseshoe kidney that we derived by using multiple stepwise linear regression has greatly outperformed other 6 previously published formulas. Isthmus depth estimation formula can also get accurate results. Our new formula provides a more reliable and accurate renal and isthmus depth estimation and contributes to improving the methods used to estimate renal function from radionuclide renography in horseshoe kidney.

Endothelium structure and function in kidney health and disease

The kidney harbours different types of endothelia, each with specific structural and functional characteristics. The glomerular endothelium, which is highly fenestrated and covered by a rich glycocalyx, participates in the sieving properties of the glomerular filtration barrier and in the maintenance of podocyte structure. The microvascular endothelium in peritubular capillaries, which is also fenestrated, transports reabsorbed components and participates in epithelial cell function. The endothelium of large and small vessels supports the renal vasculature. These renal endothelia are protected by regulators of thrombosis, inflammation and complement, but endothelial injury (for example, induced by toxins, antibodies, immune cells or inflammatory cytokines) or defects in factors that provide endothelial protection (for example, regulators of complement or angiogenesis) can lead to acute or chronic renal injury. Moreover, renal endothelial cells can transition towards a mesenchymal phenotype, favouring renal fibrosis and the development of chronic kidney disease. Thus, the renal endothelium is both a target and a driver of kidney and systemic cardiovascular complications. Emerging therapeutic strategies that target the renal endothelium may lead to improved outcomes for both rare and common renal diseases.

The anatomy of the renal pyelocaliceal system studied by CTU

INTRODUCTION AND OBJECTIVES

Knowledge of the pyelocaliceal system anatomy is essential for the safe and successful performance of endourologic procedures. The purpose of this study was to provide a better understanding of the full three-dimensional pyelocaliceal system anatomy.

METHODS

Morphometric parameters of the three-dimensional reconstructions of computed tomography intravenous urography scans (n = 25 scans) were analyzed. Both kidneys were divided into three equal-sized segments (US: upper segment, MS: mid segment, LS: lower segment). Infundibular length (IL), infundibular width (IW), the number of calyces, and the transverse orientation in hours of a clock of each calyx as well as the dimension of the pyelum were determined.

RESULTS

The mean upper IL (n = 92) was longer than the middle (n = 154) and lower IL (n = 112) (30.6 ± 7.9 mm vs. 16.4 ± 7.7 mm vs. 16.0 ± 6.0 mm, respectively; P = < 0.0001). IW was significantly smaller in the MS [3.7 ± 1.9 mm], followed by the US [4.6 ± 1.9 mm], and the LS [4.9 ± 2.2] in the increasing order. No correlation was found between IL and IW (Pearson correlation coefficient = 0.1). The US calyces were predominantly orientated lateral (8-10 o'clock: 44.5%) and medial (2-4 o'clock: 30.5%), in the MS lateral (8-10 o'clock: 87.6%) and anterolateral in the LS (9-12 o'clock: 67.9%). 74% of the kidneys consisted of 6-8 calyces (mean 7.2 ± 1.4, range 4-10), with the majority of the calyces in the MS (3.1 ± 0.8) followed by the LS (2.24 ± 0.8), and US (1.8 ± 0.7). There were no statistical differences between the right and left kidneys in terms of IL (P = 0.112) and number of calyces (P = 0.685).

CONCLUSION

Anatomic differences between the three segments of the pyelocaliceal system in terms of IL, IW, calyces number, and orientation are seen and should be considered when performing an endourologic procedure.

Metabolic and NH4 excretion rate of fresh water species, Chondrostoma regium in response to environmental stressors, different scenarios for temperature and pH

Changes in water temperature and pH levels have substantial adverse effects on aquatic organisms, hence causing physiological constraint on their well-being. To understand the physiological responses of Chondrostoma regium to temperature or pH changes, standard metabolic rate (SMR), maximum metabolic rate (MMR), absolute and factorial aerobic scope (AS&FAS) as well as the specific rate of ammonia excretion (J_amm) were measured at following temperatures: acute low (3.5-4.5 °C), 24 h low (5.5-6.5 °C), 7 d low (5.5-6.5 °C), acute high (30-31 °C), 24 h high (29-30 °C), 7 d high (28-29 °C), and different pH treatments: acute low (4.3-4.4), 24 h low (4.3-4.4), 7 d low (6.3-6.4), acute high (9.8-9.9), 24 h high (9.8-9.9), 7 d high (8.8-8.9). A control group was also assigned to optimum temperature = 22-23 °C and pH = 7.8-7.9. These experimental ranges for each treatment were obtained based on critical thermal and pH thresholds, i.e., 1.9 to 31.7 °C and 2.7 to 11.1, respectively. SMR was enhanced significantly (P < 0.05) following pH treatments, except for 24 h low pH treatment. Results showed significant (P < 0.05) changes in both SMR and MMR at low and high temperature treatments. The AS was elevated following pH treatments except for acute low pH treatment in which AS significantly was declined (P < 0.05). Low temperature treatments resulted in lower AS while no significant changes in AS were observed in high temperatures. In all treatments, FAS value did not differ significantly from control, except for acute and 24 h low treatments of both temperature and pH. All high pH and temperature treatments showed a significant increase (P < 0.05) in J_amm. Histopathological results of gills indicated hyperplasia and fusion of secondary lamella and kidneys histopathology revealed necrosis and loss of tubular lumen in the most treatments. Results indicated that increases in water temperature or pH are more stressful than the lower ranges of them, suggesting higher capability of fish to adjust to the low levels of temperature or pH.

Fluorescent Imaging and Microscopy for Dynamic Processes in Rats

The rat is a favored model organism to study physiological function in vivo. This is largely due to the fact that it has been used for decades and is often more comparable to corresponding human conditions (both normal and pathologic) than mice. Although the development of genetic manipulations in rats has been slower than in mice, recent advances of new genomic editing tools allow for the generation of targeted global and specific cell type mutations in different rat strains. The rat is an ideal model for advancing imaging techniques like intravital multi-photon microscopy or IVMPM. Multi-photon excitation microscopy can be applied to visualize real-time physiologic events in multiple organs including the kidney. This imaging modality can generate four-dimensional high resolution images that are inherently confocal due to the fact that the photon density needed to excite fluorescence only occurs at the objective focal plane, not above or below. Additionally, longer excitation wavelengths allow for deeper penetration into tissue, improved excitation, and are inherently less phototoxic than shorter excitation wavelengths. Applying imaging tools to study physiology in rats has become a valuable scientific technique due to the relatively simple surgical procedures, improved quality of reagents, and reproducibility of established assays. In this chapter, the authors provide an example of the application of fluorescent techniques to study cardio-renal functions in rat models. Use of experimental procedures described here, together with multiple available genetically modified animal models, provide new prospective for the further application of multi-photon microscopy in basic and translational research.

Anatomic Patterns Of Right Renal Vein

BACKGROUND

Preoperative surgical planning assumes a central role in avoiding catastrophic outcomes of a surgery in the field of renal transplantation, and other urological procedures. This study was aimed to study the different anatomic patterns of human renal venous system.

METHODS

It is a descriptive cross-sectional study including 50 adult male cadavers with well-preserved kidneys, renal vasculature and the inferior vena cava. Cadavers with deformed or congenitally anomalous kidney, evidence of surgery, solitary kidney, tumours of kidneys or injured renal vessels / inferior vena cava were excluded from the study. The kidneys, renal veins and the inferior vena cava were exposed. After securing inferior vena cava fifty ml mixture of Indian ink and gelatine was injected into renal veins via inferior vena cava and was allowed to solidify. Following this, the renal venous anatomy was studied.

RESULTS

Twenty-eight cadavers had their right renal vein formed by 2 tributaries (56%), 13 (26%) had 3 tributaries, 5 (10%) had 4 tributaries, 1 cadaver had a posterior tributary (2%), while 3 cadavers had other numbers of tributaries (6%). Out of total 50 cadavers 40 (80%) had normal distribution of right renal vein. Additional renal veins were found in 14 (7%) cadavers, double renal veins in 1 (2%) and proximally double renal veins in 2 cadavers (4%)..

CONCLUSIONS

There is considerable variation in renal venous anatomy. Knowledge of common venous patterns is necessary for minimizing intraoperative damage to renal anatomy and to prevent intra- and post-operative complications..

ARFI shear-wave elastography with simulation of acute urinary tract obstruction in an ex vivo porcine kidney model

METHODS

A total of 20 heparinized pig kidneys were investigated at 10 intrapelvic hydrostatic pressure steps (0-90 mmHg). SWE (ARFI; Virtual TouchTM IQ, Siemens) measurements were taken at three different measuring regions and in two measuring sequences using a linear ultrasonography probe (9L4, Siemens). Median values of 10 shear-wave speed (SWS) measurements were calculated for each pressure step. Logarithmic transformed median SWS values were analyzed in a linear mixed model.

RESULTS

SWS increased significantly with increasing intrapelvic pressure. Median SWS for all kidneys in both measuring sequences and all measuring regions was 1.47 m/s (interquartile range [IQR], 0.38 m/s) at 0 mmHg, 1.94 m/s (IQR, 0.42 m/s) at 30 mmHg, 2.07 m/s (IQR, 0.43 m/s) at 60 mmHg, 2.24 m/s (IQR, 0.49 m/s) at 90 mmHg. The correlation between pelvic pressure increase and median SWS values for the central parenchyma was significantly higher compared with the peripheral parenchyma.

CONCLUSION

Acutely increased renal pelvic pressure correlates with increasing SWS values in ARFI elastography in an ex vivo porcine kidney model.

Impact of Encapsulation on in vitro and in vivo Performance of Volatile Nanoscale Phase-Shift Perfluorocarbon Droplets

Phase-shift droplets can be converted by sound from low-echogenicity, liquid-core agents into highly echogenic microbubbles. Many proposed applications in imaging and therapy take advantage of the high spatiotemporal control over this dynamic transition. Although some studies have reported increased circulation time of the droplets compared with microbubbles, few have directly explored the impact of encapsulation on droplet performance. With the goal of developing nanoscale droplets with increased circulatory persistence, we first evaluate the half-life of several candidate phospholipid encapsulations in vitro at clinical frequencies. To evaluate in vivo circulatory persistence, we develop a technique to periodically measure droplet vaporization from high-frequency B-mode scans of a mouse kidney. Results show that longer acyl chain phospholipids can dramatically reduce droplet degradation, increasing median half-life in vitro to 25.6 min-a 50-fold increase over droplets formed from phospholipids commonly used for clinical microbubbles. In vivo, the best-performing droplet formulations showed a median half-life of 18.4 min, more than a 35-fold increase in circulatory half-life compared with microbubbles with the same encapsulation in vivo. These findings also point to possible refinements that may improve nanoscale phase-shift droplet performance beyond those measured here.

Could male reproductive system be the main target of subchronic exposure to manganese in adult animals?

Manganese (Mn) is one of the most common chemical elements on Earth and an essential micronutrient in animal organism. However, in supraphysiological levels and long-term exposures, it is a potential toxicant. Although nervous system is the most studied in relation to Mn toxicity, other tissues can have their function impaired by Mn in high doses. The present study investigated the possible adverse effects of subchronic exposure to supraphysiologic level of Mn (5 mg/kg or 15 mg/kg, intraperitoneally) on reproductive, neurobehavioral, renal and hepatic parameters of male rats. For the first time, the vulnerability of these parameters to Mn was concomitantly investigated. While our results demonstrate that Mn treatments were not sufficient to produce a marked effect of neurotoxic, hepatotoxic or renal toxicity in adult rats, we found typical indicators of reproductive toxicity such as histopathological changes (major in testes and epididymis) and impaired sperm concentration and quality. Mn, under these experimental conditions, seems to exert reproductive toxicity by different testicular mechanisms, i.e. direct and indirect action on germ cells. On the other hand, exposure to Mn did not change the pattern of cognitive and emotional behaviors and the histological organization of kidneys of experimental rats. The liver showed a weight increasement and hidropic degeneration, probable due to the detoxification overload. In summary, for the first time it was demonstrated that adult male reproductive system was more sensitive to Mn toxicity than nervous, hepatic and renal systems, although nervous system is known as the main target tissue of this metal.

Infrared Light Structured Sensor Three-dimensional Approach to Estimate Kidney Volume: A Validation Study

OBJECTIVE

To validate a new procedure for the three-dimensional estimation of total renal parenchyma volumeusing a structured-light infrared laser sensor.

METHODS

To evaluate the accuracy of the sensor for assessing renal volume, we performed 3 experiments. Twenty freshly excised porcine kidneys were obtained. Experiment A, the water displacement method was used to obtain a determination of the renal parenchyma volume after immersing every kidney into 0.9% saline. Thereafter a structured sensor (Occipital, San Francisco, CA) was used to scan the kidney. Kidney sample surface was presented initially as a mesh and then imported into MeshLab (Visual Computing Lab, Pisa, Italy) software to obtain the surface volume. Experiment B, a partial excision of the kidney with measurement of the excised volume and remnant was performed. Experiment C, a renorrhaphy of the remnant kidney was performed then measured. Bias and limits of agreement (LOA) were determined using the Bland-Altman method. Reliability was assessed using the intraclass correlation coefficient (ICC).

RESULTS

Experiment A, the sensor bias was -1.95mL (LOA: -19.5 to 15.59, R² = 0.410) with slightly overestimating the volumes. Experiment B, remnant kidney after partial excision and excised kidneyvolume were measured showing a sensor bias of -0.5mL (LOA -5.34 to 4.20, R²= 0.490) and -0.6mL (LOA: -1.97.08 to 0.77, R² = 0.561), respectively. Experiment C, the sensor bias was -0.89mL (LOA -12.9 to 11.1, R²= 0.888). ICC was 0.9998.

CONCLUSION

The sensor is a reliable method for assessing total renal volume with high levels of accuracy.

Full-Field-of-View Time-Harmonic Elastography of the Native Kidney

The purpose of this study was to analyze full-field-of-view maps of renal shear wave speed (SWS) measured by time-harmonic elastography (THE) in healthy volunteers in terms of reproducibility, regional variation and physiologic effects. The kidneys of 37 healthy volunteers were investigated by multifrequency THE. The complete renal parenchyma, as well as cortex and medulla, was analyzed. A subgroup was investigated to test reproducibility (n = 3). Significant differences between SWS in cortex, medulla and full parenchyma were observed (2.10 ± 0.17, 1.35 ± 0.11 and 1.71 ± 0.16 m/s, all p values < 0.001) with mean intra-volunteer standard deviations of repeated measurements of 0.04 m/s (1.6%), 0.06 m/s (4.0%) and 0.08 m/s (4.5%), respectively. No effects of kidney anatomy, age, body mass index, blood pressure and heart rate on SWS were observed. THE allows generation of full-field-of-view SWS maps of native kidneys with high reproducibility.

Kidney segmentation in ultrasound, magnetic resonance and computed tomography images: A systematic review

BACKGROUND AND OBJECTIVE

Segmentation is an essential step in computer-aided diagnosis and treatment planning of kidney diseases. In recent years, several researchers proposed multiple techniques to segment the kidney in medical images from distinct imaging acquisition systems, namely ultrasound, magnetic resonance, and computed tomography. This article aims to present a systematic review of the different methodologies developed for kidney segmentation.

METHODS

With this work, it is intended to analyze and categorize the different kidney segmentation algorithms, establishing a comparison between them and discussing the most appropriate methods for each modality. For that, articles published between 2010 and 2016 were analyzed. The search was performed in Scopus and Web of Science using the expressions "kidney segmentation" and "renal segmentation".

RESULTS

A total of 1528 articles were retrieved from the databases, and 95 articles were selected for this review. After analysis of the selected articles, the reviewed segmentation techniques were categorized according to their theoretical approach.

CONCLUSIONS

Based on the performed analysis, it was possible to identify segmentation approaches based on distinct image processing classes that can be used to accurately segment the kidney in images of different imaging modalities. Nevertheless, further research on kidney segmentation must be conducted to overcome the current drawbacks of the state-of-the-art methods. Moreover, a standardization of the evaluation database and metrics is needed to allow a direct comparison between methods.

Acoustic Properties of Small Animal Soft Tissue in the Frequency Range 12-32 MHz

Quality assurance phantoms are made of tissue-mimicking materials (TMMs) the acoustic properties of which mimic those of soft tissue. However, the acoustic properties of many soft tissue types have not been measured at ultrasonic frequencies >9 MHz. With the increasing use of high-frequency ultrasound for both clinical and pre-clinical applications, it is of increasing interest to ensure that TMMs accurately reflect the acoustic properties of soft tissue at these higher frequencies. In this study, the acoustic properties of ex vivo brain, liver and kidney samples from 50 mice were assessed in the frequency range 12-32 MHz. Measurements were performed within 6 min of euthanasia in a phosphate-buffered saline solution maintained at 37.2 ± 0.2 °C. The measured mean values for the speed of sound for all organs were found to be higher than the International Electrotechnical Commission guideline recommended value for TMMs. The attenuation coefficients measured for brain, liver and kidney samples were compared with the results of previous studies at lower frequencies. Only the measured kidney attenuation coefficient was found to be in good agreement with the International Electrotechnical Commission guideline. The information provided in this study can be used as a baseline on which to manufacture a TMM suitable for high-frequency applications.

Practicable methods for histological section thickness measurement in quantitative stereological analyses

The accuracy of quantitative stereological analysis tools such as the (physical) disector method substantially depends on the precise determination of the thickness of the analyzed histological sections. One conventional method for measurement of histological section thickness is to re-embed the section of interest vertically to its original section plane. The section thickness is then measured in a subsequently prepared histological section of this orthogonally re-embedded sample. However, the orthogonal re-embedding (ORE) technique is quite work- and time-intensive and may produce inaccurate section thickness measurement values due to unintentional slightly oblique (non-orthogonal) positioning of the re-embedded sample-section. Here, an improved ORE method is presented, allowing for determination of the factual section plane angle of the re-embedded section, and correction of measured section thickness values for oblique (non-orthogonal) sectioning. For this, the analyzed section is mounted flat on a foil of known thickness (calibration foil) and both the section and the calibration foil are then vertically (re-)embedded. The section angle of the re-embedded section is then calculated from the deviation of the measured section thickness of the calibration foil and its factual thickness, using basic geometry. To find a practicable, fast, and accurate alternative to ORE, the suitability of spectral reflectance (SR) measurement for determination of plastic section thicknesses was evaluated. Using a commercially available optical reflectometer (F20, Filmetrics^®, USA), the thicknesses of 0.5 μm thick semi-thin Epon (glycid ether)-sections and of 1–3 μm thick plastic sections (glycolmethacrylate/ methylmethacrylate, GMA/MMA), as regularly used in physical disector analyses, could precisely be measured within few seconds. Compared to the measured section thicknesses determined by ORE, SR measures displayed less than 1% deviation. Our results prove the applicability of SR to efficiently provide accurate section thickness measurements as a prerequisite for reliable estimates of dependent quantitative stereological parameters.