Supranormal differential renal function in adults with ureteropelvic junction obstruction: Does it really exist?

Introduction

Some patients with ureteropelvic junction obstruction (UPJO) have supranormal differential renal function (snDRF). We aimed to study the outcomes of pyeloplasty in adult patients with UPJO and either snDRF or normal differential renal function (nDRF) and to identify preoperative factors responsible for the snDRF phenomenon.

Materials and Methods

We retrospectively retrieved data for all patients who underwent pyeloplasty and had snDRF (differential renal function [DRF] ≥55%) and nDRF (DRF between 45 and 55%) preoperatively. Preoperative radiological data using computed tomography or magnetic resonance imaging were correlated with the presence of snDRF phenomenon. In addition, scintigraphic findings pre- and post-operatively were also assessed to evaluate the functional outcomes.

Results

Of a total of 856 patients, 31 had snDRF (group 1) and 42 had nDRF (group 2). After a mean of 37 months' follow-up in Group 1, 22 patients developed DRF reduction with non-obstructive pattern. Mean DRF % decreased from 59 ± 2.8 to 48 ± 13 (P < 0.0001). However, in Group 2, five patients had DRF decrease. Four patients developed snDRF phenomenon postoperatively. Increased renal pelvis volume ≥50 mm³ and increased anteroposterior pelvic diameter (APD) ≥37 mm were found to predict snDRF phenomenon. The same findings, in addition to preoperative snDRF, correlated with postoperative DRF decrease.

Conclusion

SnDRF function could be expected in patients with increased renal pelvis volume and APD. The absolute value or changes in DRF are not reliable to judge treatment failure.

ESR dosimetric properties of some biomineral materials

Dosimetric properties of g-irradiated modern coral and bioactive glass (Bio-G) samples analyzed with electron spin resonance (ESR) have been separately reported (Hassan et al., 2004; Sharaf and Hassan, 2004) and compared with alanine. These are combined here to allow a three-way comparison between these materials.

A new ESR dosimeter based on bioglass material

Bioglass (Bio-G) samples were irradiated with 60Co gamma-rays to study radicals for dosimetric materials with electron spin resonance (ESR). The ESR spectrum of Bio-G is characterized by two main signals. The first signal at g approximately = 4.3 corresponds to Fe3+ impurities and the second signal at g approximately = 2.0130 with line-width 10.85 G is ascribed as a hole center. The gamma-ray dose response and thermal stability were studied to establish the suitability of bioglass as an ESR dosimeter. A radical formation efficiency, G-value, of 0.53 +/- 0.11 was obtained. The lifetime of radicals and the activation energy were estimated from Arrhenius plots to be approximately 255 +/- 46 days and 0.71 eV, respectively.

Molecular and immunohistochemical characterization of the onset and resolution of human renal allograft ischemia-reperfusion injury

BACKGROUND Following allotransplantation, renal ischemia-reperfusion (I/R) injury initiates a series of events that provokes counter-adaptive immunity. Though T cells clearly mediate allospecific immunity, the manner in which reperfusion events augment their activation has not been established. In addition, comprehensive analysis of I/R injury in humans has been limited. METHODS To evaluate the earliest events occurring following allograft reperfusion and gain insight into those factors linking reperfusion to alloimmunity, we examined human renal allografts 30 to 60 minutes postreperfusion (n=10) and compared them with allografts with normal function that had resolved their I/R injury insult (>1 month posttransplant, n=6) and to normal kidneys (living donor kidneys before procurement, n=8). Biopsies were processed both for immunohistochemical analysis as well as for transcript analysis by real-time quantitative polymerase chain reaction (RT-PCR). RESULTS Reperfusion injury was characterized by increased levels of gene transcripts known to be involved in cellular adhesion, chemotaxis, apoptosis, and monocyte recruitment and activation. T-cell-associated transcripts were generally absent. However, recovered allografts exhibited increased levels of T-cell and costimulation-related gene transcripts despite normal allograft function. Consistent with these findings, the immediate postreperfusion state was characterized histologically by tubular injury and monocyte infiltration, while the stable posttransplant state was notable for T-cell infiltration. CONCLUSIONS These data suggest that monocytes and transcripts related to their recruitment dominate the immediate postreperfusion state. This gives way to a T-cell dominant milieu even in grafts selected for their stable function and absence of rejection. These data have implications for understanding the fundamental link between I/R injury and alloimmunity.

Dual activity at an enzyme active site: 3 beta,20 alpha-hydroxysteroid oxidoreductase from fetal blood

An enzyme exhibiting both 3 beta and 20 alpha steroid reductase activities from calf fetal red blood cells was purified to homogeneity as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. 3 beta,20 alpha-Hydroxysteroid oxidoreductase (3 beta,20 alpha-HSD) was found to be a single-stranded polypeptide with a molecular weight of 55 000 +/- 1 000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Sephadex G-100 chromatography. The amino acid composition of 3 beta,20 alpha-HSD was obtained. 17 beta-Hydroxy-5 alpha-androstan-3-one and progesterone were substrates for the enzyme's 3 beta and 20 alpha reductase activities, respectively, which required NADPH for both 3 beta [Km = 9.4 microM; Vmax = 2.4 nmol min-1 (nmol of enzyme)-1] and 20 alpha [Km = 2.5 microM; Vmax = 2.4 nmol min-1 (nmol of enzyme)-1] reductase activities. 17 beta-Hydroxy-5 alpha-androstan-3-one competitively inhibited (Ki = 35 microM) 20 alpha reduction of progesterone. Incubating 3 beta,20 alpha-HSD with 19-nortestosterone 17-bromoacetate at pH 7.0 and 25 degrees C caused simultaneous, time-dependent, and irreversible losses of 3 beta and 20 alpha activities by a first-order kinetic process. Similar incubations with either of the 3 beta or 20 alpha substrates present at concentrations equal to their respective Km values practically doubled the time required for loss of 3 beta and 20 alpha enzyme activities. These data lead us to conclude that the active site of 3 beta,20 alpha-HSD contains 3 beta and 20 alpha dual activity.

Purification of 20 alpha-hydroxysteroid oxidoreductase from bovine fetal erythrocytes

NADPH-dependent 20 alpha-hydroxysteroid oxidoreductase (20 alpha-HSD; EC 1.1.1.149) from bovine fetal erythrocytes was obtained for the first time free of hemoglobin by a new 2,500-fold purification scheme. This was achieved by a sequence of calcium phosphate gel absorption, ammonium sulfate fractionation, and affinity chromatography. The present results lead us to believe that the NADPH-dependent 3 beta-hydroxysteroid oxidoreductase activity, which was co-purified with 20 alpha-activity, may originate at the active site of 20 alpha-HSD (2).

Immune deficiency in Hodgkin and non-Hodgkin lymphoma

Forty-three previously untreated Egyptian patients with Hodgkin's disease and thirty-five patients with non-Hodgkin lymphoma were studied with several readily available tests of immune function, number of peripheral blood lymphocytes, delayed hypersensitivity to two recall antigens, in vitro blastoid transformation by PHA, the capacity of E-rosette formation and surface marker criteria. The results were correlated to the histology, stage of disease and to the presence of general symptoms and signs.

Construction of phylogenetic trees by pattern recognition procedures

The sequence of a protein can be graphed as a discrete function and a cross-correlation between any two such number sets produces a similarity score. The scores are used to prepare a phylogenetic tree involving hierarchical cluster analysis, non-linear mapping, and minimal spanning routines. Changes are suggested in the sequences of cytochrome c's from Mediterranean fruit fly, locust, and rattlesnake. The method is faster than existing procedures and does not require human intervention at any stage.