[Precaliceal canalicular ectasia. Medullary microcystic disease].
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Biomedical subjects
Publications and source records attributed to J Camps.
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To investigate if the renal kallikrein-kinin system may be involved in the homeostasis of renal perfusion in cirrhosis, urinary kallikrein activity was measured in 11 normal subjects, 31 cirrhotics with ascites and preserved renal plasma flow (548.2 +/- 32.2 ml per min) and glomerular filtration rate (85.8 +/- 3.4 ml per min), and 18 cirrhotics with functional renal failure (renal plasma flow: 229.9 +/- 23.4 ml per min; glomerular filtration rate: 34.9 +/- 3.3 ml per min). Plasma renin activity, plasma norepinephrine concentration and the urinary excretion of prostaglandin E2 were also measured in these subjects. Cirrhotics without renal failure showed a significantly higher renin (4.9 +/- 1.1 ng per ml per hr), norepinephrine (458.2 +/- 50.4 pg per ml), urinary kallikrein (15.4 +/- 1.8 pkat per min) and urinary prostaglandin E2 (0.52 +/- 0.08 ng per min) than did normal subjects (1.08 +/- 0.1 ng per ml per hr, 218.1 +/- 18.2 pg per ml; 8.4 +/- 1.4 pkat per min and 0.24 +/- 0.02 ng per min, respectively). Cirrhotics with renal failure showed a significantly higher renin (16.1 +/- 3.4 ng per ml per hr) and norepinephrine (739.4 +/- 79.2 pg per ml), and a significantly lower urinary kallikrein (5.2 +/- 0.6 pkat per min) and urinary prostaglandin E2 (0.15 +/- 0.02 ng per min) than did normal subjects and cirrhotics without renal failure. Glomerular filtration rate correlated (p less than 0.001) with urinary kallikrein (r = 0.53), urinary prostaglandin E2 (r = 0.55), plasma renin (r = -0.41) and norepinephrine (r = -0.44).(ABSTRACT TRUNCATED AT 250 WORDS)
Several authors have suggested that the risk of developing aminoglycoside nephrotoxicity is greater in cirrhotic patients than in the noncirrhotic population. However, this has not been confirmed by other investigators. To compare the intensity and characteristics of aminoglycoside nephrotoxicity in cirrhotic and normal rats, 31 rats with carbon tetrachloride-induced cirrhosis with ascites and 35 control rats were treated with gentamicin. Each group of rats was divided into two subgroups in order to receive 10 or 40 mg per kg per day of gentamicin, and different subsets of animals were killed on Days 4, 8 and 12 of treatment for renal histological examination and determination of renal tissue gentamicin concentration. Urine volume, osmolality, sodium excretion and N-acetyl-beta-D-glucosaminidase activity were measured daily throughout the study. Creatinine clearance and trough plasma concentration of gentamicin were determined in each animal immediately before killing. There were no significant differences between cirrhotic and control rats in relation to the magnitude of changes in urine volume, osmolality, sodium excretion and N-acetyl-beta-D-glucosaminidase activity and creatinine clearance during gentamicin administration. The values of a histopathological score semiquantitatively assessing the renal morphological changes observed by light microscopy were not significantly different in cirrhotic and control rats. In addition, similar trough plasma and renal cortical tissue concentrations of gentamicin were observed in both groups of animals. These results suggest that, in this experimental model, cirrhosis does not increase the risk for aminoglycoside nephrotoxicity.
The influence of a simulated pulsatile pulpal pressure on the diffusion of NaCl through slices of human dentine (n = 12) was evaluated in vitro. The average hydraulic conductance of the slices of dentine was 0.0131 +/- 0.0031 microliter/cm2 per min per cmH2O(x +/- SD). A 1 mol/l NaCl solution was placed on one side of the slices of dentine and deionized water on the other side. The time needed to reach a steady state and the quantity of NaCl that diffused through the slice were successively measured on the same slice of dentine, under three conditions: without pressure simulation, with a static pressure of 1.5 kPa, and with a pulsatile pressure varying from 1.2 to 1.8 kPa. The pressure was applied to the deionized water. When a static pressure was applied, the time required to reach a steady state increased from 24 to 30 h. When a pulsatile pressure was applied the time required to reach a steady state decreased from 24 to 12 h. No statistically significant difference was found between the quantity of NaCl that had diffused when the steady state was reached.
OBJECTIVES: Dentine modifies pulpward diffusion of monomers leaching from restorative materials. Thus, remaining dentine thickness must be taken into account during in vitro cytotoxicity tests. This in vitro study was designed to determine the influence of dentine permeability on the outcome of a cytotoxicity test. METHODS: Dentine slices were made from 36 human third permanent molar teeth. The 36 dentine slices were divided into two groups according to their hydraulic conductance: high or low hydraulic conductance. The cytotoxicity of four dentine bonding agents of similar cytotoxicity was tested on dentine slices from each group. Four dilutions of the experimental culture medium were tested: undiluted, 1:2, 1:10 and 1:100. An analysis of variance was used to compare the cytotoxicity of the dentine bonding agents tested on high versus low hydraulic conductance. RESULTS: The cytotoxicity of the high hydraulic conductance (Lp) group was higher than that of low Lp group when tested with the undiluted test culture medium (p = 0.001). No difference was obtained with the 1:2, 1:10, 1:100 dilutions. CONCLUSIONS: Under the conditions of the study, the dentine bonding resins were more cytotoxic when applied onto dentine slices of high hydraulic conductance.
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Laparoscopic inguinal herniorrhaphy is an investigational procedure and the best technique and the exact indications are presently unclear. Preliminary results suggest that further investigation is indicated. A multi-center trial involving institutions from Europe and North America has recently been completed comparing various laparoscopic herniorrhaphy techniques. The rate of complications and recurrence was low despite the relative inexperience of the surgeon investigators. Laparoscopy affords an excellent exposure of the preperitoneal space which can be quite useful in repairing many inguinal hernias, especially those which are recurrent or otherwise complicated. It seems that laparoscopy will certainly have a place in the armamentarium of general surgeons caring for inguinal hernias. It is unlikely though that every inguinal hernia will best be repaired laparoscopically.
To study the effect of a safe dosage of allopurinol on ischemia-reperfusion damage following aortic surgery, 24 patients undergoing either elective or acute aortic reconstruction, were randomized to receive allopurinol or placebo, yielding four groups: elective/placebo (EP), elective/allopurinol (EA), acute/placebo (AP) and acute/allopurinol (AA). Blood concentrations of allopurinol, oxypurinol, uric acid, malondialdehyde, ascorbic acid, and 99mTc-albumin were determined perioperatively. Adequate concentrations and biochemical activity of allopurinol and oxypurinol were obtained, without side-effects. Malondialdehyde did not increase perioperatively, but was significantly higher in acute surgery than in elective surgery intraoperatively. Yet, ascorbic acid levels and 99mTc-albumin disappearance were not different from groups EP and EA. No influence of allopurinol was found on malondialdehyde, ascorbic acid and 99mTc-albumin. An influence of allopurinol may have been obscured, as patients in group AA were more hypotensive than in group AP. In conclusion, adequate allopurinol concentration can be obtained with a safe dosage in abdominal aortic surgery. Signs of ischemia-reperfusion injury were found in acute surgery, not in elective surgery. Therefore, further investigation on the clinical effect of allopurinol is only useful in acute aortic surgery.