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Studies on rickettsia-like organism disease of the tropical marine pearl oyster I: the fine structure and morphogenesis of pinctada maxima pathogen rickettsia-like organism

The present paper reports for the first time the discovery of a rickettsia-like organism (RLO) in the cultured tropical marine pearl oyster Pinctada maxima with mass mortality in the Hainan Province of China. This organism parasitizes the cytoplasm of host cells and forms intracytoplasmic eosinophilic inclusions. These organisms are extremely pleiomorphic in shape and average 967 x 551 nm in size, as measured in cross sections of transmission electron micrographs. The organisms exhibit clearly recognizable ultrastructural characteristics of prokaryotic bacteria-like cells, including two trilaminar membranes, an increasing electron-dense periplasmic ribosome zone, and a thread-like DNA nucleoidal structure. In addition to the above prokaryotic characteristics, the following unique biological characteristics were confirmed by TEM: (i) These organisms are usually located in host cells in two ways, namely, free in the cell cytoplasm and involved within membrane-limited phagolysosomes; (ii) The organisms exist in two morphological cell types, namely a small cell variant (SCV) and a large cell variant (LCV). The most important morphological difference between two cell types is that the SCV is obviously ribosome-rich in the periphery of the body, which makes SCV more electron-dense in the cytoplasm and narrower in the central nucleoid area than the LCV; (iii) Two propagative modes of the organisms, transverse binary fission and budding, are observed in cytoplasm and phagolysosomes of host cells under TEM, in which the budding is more often seen in phagolysosomes. These characteristics indicate that the organism is a separate species in the family Rickettsiaceae and should be classified into the genus Rickettsia. On the basis of the existence of the two propagative modes and two cell types, and intracellular location, we propose a developmental cycle for this organism which includes a vegetative differentiation stage to develop LCV by transverse binary fisson and a budding differentiation stage to develop resistant SCV. Copyright 1999 Academic Press.

Journal Article↗

Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects.

OBJECTIVE: The purpose of this study was to describe the distribution of pelvic organ support in a gynecologic clinic population to define the clinical disease state of pelvic organ prolapse and to analyze its epidemiologic condition. STUDY DESIGN: This was a multicenter observational study. Subjects who were seen at outpatient gynecology clinics who required an annual gynecologic examination underwent a pelvic organ prolapse quantification examination and completed a prolapse symptom questionnaire. Receiver operator characteristic curves were used to define pelvic organ prolapse with the use of symptoms and pelvic organ prolapse quantification examination measures. Standard age-adjusted univariate and multivariate logistic regression analysis were used to evaluate various relationships. RESULTS: The population consisted of 1004 women who were aged 18 to 83 years. The prevalence of pelvic organ prolapse quantification stages was 24% (stage 0), 38% (stage 1), 35% (stage 2), and 2% (stage 3). The definition of pelvic organ prolapse that was determined by the receiver operator characteristic curve was the leading edge of their vaginal wall that was -0.5 cm above the hymenal remnants. Multivariate analysis revealed age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus as risk factors for pelvic organ prolapse, as defined in this population. CONCLUSION: The results from this population suggest that there is a bell-shaped distribution of pelvic organ support in a gynecologic clinic population. Advancing age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus have the strongest correlations with prolapse.

Adolescent↗

Evolution of soil organic matter changes using pyrolysis and metabolic indices: a comparison between organic and mineral fertilization.

The aim of this study was to evaluate chemical and biochemical changes of organic matter in fertilized (ammonium nitrate) and amended (vermicompost and manure) soils using pyrolysis and metabolic indices. The metabolic potential [dehydrogenase (DH-ase)/water soluble organic carbon (WSOC)], the metabolic quotient (qCO2) and the microbial quotient (Cmic:Corg) were calculated as indices of soil organic matter evolution. Pyrolysis-gas chromatography (Py-GC) was used to study structural changes in the organic matter. Carbon forms and microbial biomass have been measured by dichromate oxidation and fumigation-extraction methods, respectively. Dehydrogenase activity has been tested using INT (p-Iodonitrotetrazolium violet) as substrate. The results showed that organic amendment increased soil microbial biomass and its activity which were strictly related to pyrolytic mineralization and humification indices (N/O, B/E3). Mineral fertilization caused a greater alteration of native soil organic matter than the organic amendments, in that a high release of WSOC and relatively large amounts of aliphatic pyrolytic products, were observed. Therefore, the pyrolysis and metabolic indices provided similar and complementary information on soil organic matter changes after mineral and organic fertilization.

Biomass↗

Evaluation of Epstein-Barr virus (EBV) antibody screening of organ donors for allocation of organs to EBV serostatus matched recipients.

OBJECTIVE: Posttransplant lymphoproliferative disorder (PTLD) is a life-threatening complication following organ transplantation. The greatest risk is seen in Epstein-Barr virus (EBV)-seronegative patients receiving allografts from EBV-seropositive donors. The severity and frequency of PTLD are particular concerns for pediatric patients, who frequently are EBV negative and hence more likely to be EBV infected from an EBV-positive organ donor. The aim of this study was to analyze the EBV serostatus of deceased organ donors and to assess the likelihood of recipient/donor matching for EBV serostatus. MATERIALS AND METHODS: Sera obtained from local deceased organ donors for the period 2004-2005 were retrospectively tested for EBV viral capsid antigen (VCA) IgG and IgM antibodies by an enzyme-linked immunosorbent assay (ELISA). The analysis included only data from those donors who were tested using a pretransfusion specimen (n = 459). The influence of various factors on the EBV serostatus of the donor was assessed, including age, gender, ethnicity, and cytomegalovirus (CMV) serostatus of the donor. RESULTS: Overall, only 27 (6%) of the 459 donors were EBV seronegative, with 94% being positive for IgG antibodies to EBV. A higher percentage of the EBV-seronegative donors were younger donors (age < or =35 years), compared with EBV-seropositive donors, 74% (n = 27) vs 31% (n = 432), P < .0001. A higher percentage (85%) of the younger (age < or =35 years) EBV-seronegative donors (n = 20) were also CMV seronegative. There was also a greater likelihood for the younger (age < or =35 years) CMV-seronegative donors to be EBV seronegative, compared with the older (age >35 years) CMV-seronegative donors, 20% (n = 83) vs 1% (n = 93), P < .0001. There was no influence of other factors examined on EBV serostatus. CONCLUSIONS: EBV-seronegative organ donors are infrequent and therefore provide only a limited supply of organs for patients in need of them. The higher frequency of EBV-seronegative donors being the younger donors will benefit the pediatric patients who have the greatest need for an EBV serostatus matched organ from a younger donor. Recent policy changes at the United Network for Organ Sharing (UNOS) giving priority to pediatric patients for kidneys from younger donors (age < or =35 years) and prospective EBV testing of donors will be helpful in the appropriate allocation of these organs.

Adult↗

Neurophysiological and behavioural evidence for an olfactory function for the dorsal organ and a gustatory one for the terminal organ in Drosophila melanogaster larvae.

Multicellular electrophysiological responses from the dorsal organ on the cephalic lobes of third instar Drosophila melanogaster larvae (wild-type Canton S) stimulated with a cold-trapped banana volatile extract showed that this structure has an olfactory function in the fruit fly. Responses of the dorsal organ were also recorded to constituents of the banana volatile extract as they eluted from a gas chromatographic column (GC-coupled dorsal organ electrophysiology). The active chemostimulants were identified as 2-heptanone, isoamyl alcohol, hexyl acetate, hexanol and hexyl butyrate by gas chromatography-coupled mass spectrometry. Applying the same recording system to the terminal organ sensilla, no responses were obtained to either the banana volatile bouquet or its constituents. By contrast, high frequency multicellular responses were recorded in response to touching the terminal organ with the gustatory stimuli KCl and grapefruit juice; responses were absent on similar stimulation of the dorsal organ with either NaCl or KCl. This suggests a role for olfaction by the dorsal organ and for gustation by the terminal organ in Drosophila larvae.In a 7-mm high wind tunnel with a thin 1.2% agar floor, the Drosophila larvae showed odour-conditioned upwind responses in an air stream of 0.1 m/s bearing banana volatiles. Drosophila larvae responded best to the odour of cut bananas. A 1:1 mixture of the banana odour constituents 2-heptanone and hexanol (at either 50 or 100 &mgr;g source dose each) proved as attractive as the known larval attractants propionic acid and isoamyl acetate on their own at 100 &mgr;g, whereas hexanol and 2-heptanone on their own at a 100 &mgr;g source dose were less attractive. The stronger behavioural response to the banana volatile bouquet and to the binary mixture serves to underline the multireceptor nature of the dorsal organ response to food odour in Drosophila.

Journal Article↗

Incorporation of organic tritium (3H) by marine organisms and sediment in the severn estuary/Bristol channel (UK).

Discharges of tritium (3H) into the Severn estuary/Bristol Channel (UK) arise from the authorized release of wastes from nuclear power plants at Hinkley Point and Berkley/Oldbury and from the Nycomed-Amersham radiochemical plant, via the sewer system, at Cardiff. The wastes from the nuclear power plants probably consist almost entirely of 3H2O, whereas those from the radiochemical plant also include uncharacterized 3H labelled organic compounds. The total 3H concentrations in demersal fish and other benthic organisms in the vicinity of the Cardiff Eastern sewer outfall are significantly elevated compared to those observed around other UK nuclear establishments. Concentrations in filtered seawater were approximately 10 Bq kg(-1) whilst levels in surface sediment, seaweed (Fucus vesiculosis) and mussels (Mytilus edulis)/flounder (Platichthys flesus) were in the order of 6 x 10(2), 2 x 10(3), and 10(5) Bq kg(-1) (dry weight), respectively. Almost all the 3H found in sediment and biota were organically bound tritium (OBT). The high concentration in these materials, relative to that in seawater, is due to the presence of bioavailable organic 3H labelled compounds in the radiochemical waste. It is suggested that bioaccumulation of 3H by benthic organisms and demersal fish occurs primarily via a pathway of physico-chemical sorption/bacterial transformation of dissolved 3H labelled organic compounds into particulate organic matter, and subsequent transfer up a web of sediment dwelling microbes and meiofauna. Variations in 3H accumulation between individual organisms have been interpreted in terms of their different feeding behaviour. Relatively low concentrations were observed in the herbivorous winkle (Littorina littorea) and the pelagic Sprat (Spratus spratus) compared with other benthic organisms and demersal fish. The elevated 3H concentrations in seafood, due to bioaccumulation of OBT, have low radiological significance even for the local critical group of seafood consumers.

Animals↗

Expression of human CD59 in transgenic pig organs enhances organ survival in an ex vivo xenogeneic perfusion model.

The serious shortage of available donor organs for patients with end stage organ failure who are in need of solid organ transplantation has led to a heightened interest in xenotransplantation. The major barrier to successful discordant xenotransplantation is hyperacute rejection. Hyperacute rejection results from the deposition of preformed antibodies that activate complement on the luminal surface of the vascular endothelium, leading to vessel occlusion and graft failure within minutes to hours. Endogenous membrane-associated complement inhibitors normally protect endothelial cells from autologous complement -- however, these molecules are species-restricted and therefore are ineffective at inhibiting activated xenogeneic complement. To address the pathogenesis of hyperacute rejection in the pig-to-human combination, F1 offspring were generated from a transgenic founder animal that was engineered to express the human terminal complement inhibitor hCD59. High-level cell surface expression of hCD59 was detected in the hearts and kidneys of these transgenic F1 animals, similar to expression levels in human kidney tissue. The hCD59 was expressed on both large vessel and capillary endothelium. Ex vivo perfusion experiments, using human blood as the perfusate, were performed with transgenic porcine hearts and kidneys to evaluate the ability of hCD59 to inhibit hyperacute rejection. These experiments demonstrated that transgenic organs expressing hCD69 resisted hyperacute rejection, as measured by increased organ function for both the hearts and the kidneys, as compared with control pig organs. Hearts from hCD59-expressing animals demonstrated a five-fold prolongation in function compared with controls, 109.8 +/- 20.7 min versus 21.2 +/- 2.9 min (P = 0.164). The hCD59-expressing kidneys also demonstrated significantly prolonged function at 157.8 +/- 27.0 min compared with 60.0 +/- 6.1 min for controls (P = 0.0174). Deposition of C9 neoantigen In the vasculature of porcine organs perfused with human blood was markedly reduced in organs expressing hCD59. These studies demonstrate that C5b-9 plays an important role in hyperacute rejection of a porcine organ perfused with human blood and suggest that donor pigs transgenic for hCD59 may be an integral component of successful clinical xenotransplantation.

Animals↗

Beyond the organ donor card: the effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members.

Although numerous studies have examined many of the predictors of signing an organ donor card, including knowledge, attitudes, values, and demographic variables, very few have examined the factors associated with individuals' willingness to communicate about organ donation with family members. Because organ donation does not take place without the permission of a person's next-of-kin, government agencies and organ procurement organizations have targeted communication with family members as a primary objective of organ donation campaigns. This study reports the results of a survey of a stratified random sample of adults at 2 local sites of a national employer. Results indicate that knowledge, attitude, and altruism are significantly related to 2 measures of willingness to communicate: past behavior (whether respondents had already discussed organ donation with family members) and a scale measuring willingness to communicate about organ donation in the future. Because the quality of discussions between the potential donor and his or her family will depend on how well the donor is able to address vital issues regarding donation, it is concluded that campaigns seeking to promote communication between family members about organ donation must simultaneously seek to increase knowledge, debunk myths, and bolster positive attitudes about donation.

Adult↗

[Utilisation of organs proceeding from donors with heart failure: review of the pathogenesis of organic damage and the possible mechanisms of prevention].

There is an evident imbalance between the number of patients awaiting a kidney transplant and the availability of organs proceeding from donors with brain death. A high number of patients die each day from heart failure, whose organs could be used for transplants if specific care is employed. Although centres do exist where these methods of extraction are established, the problems of organic damage have yet to be resolved, since one third of the organs are still lost, besides the increase in the need for early dialysis, and the number of dysfunctioning grafts two years after the transplant, when this type or organ is employed. There is increasingly detailed knowledge of the pathogenesis of organic damage following heart failure and reanimation, as well as of the damage following the conservation and reimplantation of the kidney. Knowledge of the maximum time of hot ischemic that an organ can withstand is of crucial importance if organs are not to be unduly discarded. Besides, the increasing understanding of the physiopathology of oxidative stress could make it possible for us, through the use of antioxidants, to attempt to improve the utilisation of the organs and diminish the incidence of dysfunctions and rejections.

English Abstract↗

Functional organization of tactile inputs from the hand in the cuneate nucleus and its relationship to organization in the somatosensory cortex.

Central processing of tactile inputs from the hand begins in the main cuneate nucleus and continues in the thalamus and area 3b cortex. Little is known about cuneate functional organization in primates or about how cuneate and area 3b organization are related. In this study, neurophysiologic approaches were used to evaluate how tactile inputs from the hand and adjacent body are organized in the cuneate nucleus of squirrel monkeys. Cuneate data on the organization of hand inputs were then compared with analogous area 3b data from our earlier cortical studies that used the same approaches. Evaluations of several cuneate properties, including (1) responsiveness to tactile stimulation, (2) incidences and sizes of receptive fields, (3) somatotopic progressions, (4) properties of representations, and (5) relationships between functional inputs and cytochrome oxidase staining, suggest that tactile afferents from the hand form consistently organized cuneate representations that, in turn, relate to the parcellated organization of cuneate structural substrates. Comparisons of cuneate and area 3b organization indicate that tactile processing from the brainstem to cortex involves a preservation of tactile responsiveness and somatotopic organization but, in addition, involves transformations that produce receptive field sharpening, suppression of hairy hand inputs, amplification and refinement of glabrous inputs, and relocations of representations. Ascending lemniscal substrates are characterized by cascading excitatory convergence/divergence that increments at successively higher levels between sensory afferents and area 3b. It is suggested that the observed preservations and transformations reflect this organization but, in addition, reflect mechanisms that cause counterbalancing sharpening and suppressions of hand inputs.

Afferent Pathways↗

Standardizing donation education for nursing students: one organ procurement organization's approach.

Nurses are often the primary source of donor referrals to an organ procurement organization. Early exposure to donation information during nursing school may enhance nurses' ability to identify and refer potential donors once they are in nursing practice. Although organ procurement organizations strive to provide donation education to nursing students, this process can drain an organization's resources. Therefore, to facilitate the educational process with a minimum of disruption to the function of the organ procurement organization, a standardized approach to donation was developed. After the program had been in place for more than a year, students and organ procurement organization staff alike reported great satisfaction with this standardized approach.

Curriculum↗

[Organ sharing network for organ transplantation from heart-beating deceased donors].

Organ sharing network is indispensable for ensuring the fair, smooth and rapid shipping transplant organs. In Japan, Kidney Transplant Network was founded in 1995, and thereafter reformed to Organ Transplant Network following the legislation and enforcement of Organ Transplant Act. Under these circumstances, 36 cases of the organ donation from heart-beating deceased donor have been realized, and consequently 27 cases of cardiac transplants, 22 cases of lung transplants, 28 cases of liver transplants and 20 cases of combined pancreas and kidney transplants were done as for March of 2005. Clinical outcomes of these transplantations can be compared favorably to those of the West countries. The number of death on the waiting list, however, amounted to 70 for cardiac transplant, 67 for lung transplant, 134 for liver transplant, which would be 2.5 to 5 times as much as those who underwent transplantation. To make a breakthrough in issues on the organ shortage, the public enlightenment, the promotion of donor cards/seals, the amendment of Organ Transplant Act and related regulations and the insurance coverage of the cost of organ donation/transplantation are urgent challenges today.

Brain Death↗

Mechanistic and kinetic evaluation of organic disinfection by-product and assimilable organic carbon (AOC) formation during the ozonation of drinking water.

Ozonation of drinking water results in the formation of low molecular weight (LMW) organic by-products. These compounds are easily utilisable by microorganisms and can result in biological instability of the water. In this study, we have combined a novel bioassay for assessment of assimilable organic carbon (AOC) with the detection of selected organic acids, aldehydes and ketones to study organic by-product formation during ozonation. We have investigated the kinetic evolution of LMW compounds as a function of ozone exposure. A substantial fraction of the organic compounds formed immediately upon exposure to ozone and organic acids comprised 60-80% of the newly formed AOC. Based on experiments performed with and without hydroxyl radical scavengers, we concluded that direct ozone reactions were mainly responsible for the formation of small organic compounds. It was also demonstrated that the laboratory-scale experiments are adequate models to describe the formation of LMW organic compounds during ozonation in full-scale treatment of surface water. Thus, the kinetic and mechanistic information gained during the laboratory-scale experiments can be utilised for upscaling to full-scale water treatment plants.

Carbon↗

Uptake and reaction of atmospheric organic vapours on organic films.

Films composed in whole or in part of organic compounds represent an important atmospheric interface. Urban surfaces are now known to be coated with a film ("grime") whose chemical composition somewhat resembles that of urban atmospheric aerosols. Such films may act as media in which atmospheric trace gases may be sequestered (leading to their removal from the gas phase); they may also act as reactive media, either as a "solvent" or as a source of reagents. Organic coatings on aqueous surfaces are also important, not just on ocean and lake surfaces ("biofilms") but also on the surfaces of fogwaters and atmospheric aerosol particles. We have initiated experimental uptake studies of trace gases into simple proxies for urban organic films using two techniques: a Knudsen cell effusion reactor and a laser-induced fluorescence method. We will discuss our first results on non-reactive uptake of organic compounds by organic films we use as proxies for urban grime coatings. In general, the measured uptake coefficients appear to track the octanol-air partition coefficients, at least qualitiatively. We have also measured the kinetics of reactions between gas-phase ozone and small polycyclic aromatic hydrocarbons (PAHs), when these are adsorbed at the air-aqueous interface or incorporated into an organic film. Reactions at the "clean" air-water interface and at a coated interface consisting of a monolayer of various amphiphilic organic compounds all follow a Langmuir-Hinshelwood mechanism, in which ozone first adsorbs to the air-aqueous interface, then reacts with already adsorbed PAH. By contrast, the reaction in the pure organic film occurs in the bulk phase. Under some circumstances, heterogeneous oxidation of PAHs by ozone may be as important in the atmosphere as their gas phase oxidation by OH.

Adsorption↗

Organs for transplantation: analysis of 27,000 cadaveric donor organs.

Organs from brain-dead cadaveric donors have been increasingly used for saving lives and preserving health. During the 5 calendar years 1984 through 1988, specific organ recovery patterns were reported for 10,488 donors of 27,833 vascular organs. Transplantation of 18,277 kidneys, 3425 hearts, 2957 livers, and 411 pancreatic grafts (as well as smaller numbers of lung, intestine, heart-lung, and multivisceral grafts) represented an organ utilization rate exceeding 90%. Organ sharing was common and had a beneficial effect overall. Renal allografts from multiorgan donors showed better early function and long-term survival. A steady decrease in organ wastage has been accompanied by a substantial increase in numbers of cadaveric multiorgan donors. The resource of life-saving cadaveric organs is effectively and widely dispersed, allowing increasingly common treatment of end-stage organ failure by transplantation.

Age Factors↗

Organ damage is preceded by changes in protein extravasation in an experimental model of multiple organ dysfunction syndrome.

Our objective was to determine the serial evolution of vascular permeability as measured by protein extravasation in various organs during the development of zymosan-induced multiple organ dysfunction syndrome (MODS). We evaluated the biodistribution of 111Indium-labeled nonspecific polyclonal immunoglobulin G (111In-IgG). On days 2, 5, 8, and 12 after intraperitoneal challenge with 1 mg/g zymosan, mice were killed. Heart, liver, spleen, kidneys, and the mesenteric lymph node complex and tissue samples of muscle, ileum, and colon were dissected free and weighed. 24 h before death, 10 micrograms of IgG labeled with 2 MBq 111In was injected i.v. Relative organ weights (ROW), wet to dry weight ratios (WDR), and a permeability index (PI) were calculated. ROW increased gradually until day 12. WDR also increased gradually in most organs. Lung WDR, however, initially increased, with a subsequent return to normal. Splenic WDR did not change over time. Liver, spleen, ileum, and colon PI were the highest on day 2, followed by a decrease toward normal. Lung PI showed a triphasic course with peak values at days 2 and 12. Mesenteric lymph node complex-PI was continuously elevated. WDR (tissue edema) and PI (protein extravasation) have different courses in various organs. Most organs displayed an early increase in PI, followed by a late decrease, while ROW (organ damage) was still increasing. It appears that organ damage is preceded by an increased protein extravasation.

Animals↗

[Transplantation in children: selection of donors and organization of organ procurement].

The rise of organ transplantation in children has resulted in an acute donor shortage. In 1987, a study was undertaken by the French-speaking Group of Paediatric Intensive Care with a triple goal: to evaluate the number of potential organ donors, to list and count the organs that have effectively been removed and to sensitize the teams of intensive care units (ICU) to the transplantation problem. This study showed that brain death occurs in one-third of the infants and children who die (i.e. about 200 each year). As a result of this study, over a two-years period the number of children whose organs had been removed (42 in 1988) as well as the number of organ procurement centres and multiple organ procurements have increased. One-half of the non-procurements are due to the parents' refusal, so that further advances are possible by sensitizing not only ICU teams but also the general public. It seems that the best solution would be to set up local organizations that would enable procurements to be performed within Paediatric ICU's. France-Transplant is of invaluable help to identify organ receivers and co-ordinate the activities of procurement teams.

Child↗

Transporters involved in the elimination of drugs in the kidney: organic anion transporters and organic cation transporters.

Transporters in the kidney mediate the secretion or reabsorption of many compounds and thereby influence the plasma levels of their substrates. Organic anion transporters and organic cation transporters are two major classes of secretory transporters in the mammalian kidney. During the past decade, significant progress has been made in the cloning, functional expression, and initial characterization of these transporters. To date, five organic cation transporters and nine organic anion transporters have been cloned. In this review, we summarize the available data on organic anion and organic cation transporters, focusing in particular on their molecular characteristics, tissue distribution, and inhibitor and substrate selectivities. Currently we have a good understanding of the inhibitor selectivities for most of these transporters, and with the development of more robust assays, we will soon have a better understanding of their substrate selectivities. Based on the available data, summarized in this review, it appears that many compounds interact with multiple transporters. Furthermore, there appears to be substantial overlap in the selectivities of organic cation transporters, and the same appears true for organic anion transporters. At the present time, it is unclear what the roles of these multiple transporters are in renal drug elimination. With the development of new assays, reagents, and experimental methods, we will soon have a better understanding of the roles of each transporter isoform in the renal elimination of drugs.

Animals↗