Asunto(s)
Infecciones por Virus de Epstein-Barr/diagnóstico , Infecciones por VIH/complicaciones , Neoplasias del Íleon/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Neoplasias Primarias Múltiples/diagnóstico , Tumor de Músculo Liso/diagnóstico , Adulto , Infecciones por Virus de Epstein-Barr/cirugía , Infecciones por Virus de Epstein-Barr/virología , Femenino , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Neoplasias del Íleon/cirugía , Neoplasias del Íleon/virología , Íleon/diagnóstico por imagen , Íleon/patología , Linfoma de Células B Grandes Difuso/cirugía , Linfoma de Células B Grandes Difuso/virología , Neoplasias Primarias Múltiples/cirugía , Neoplasias Primarias Múltiples/virología , Tumor de Músculo Liso/cirugía , Tumor de Músculo Liso/virología , Tomografía Computarizada por Rayos XRESUMEN
Purpose Clinically, repeat renal biopsies (RRBs) have been performed in lupus nephritis to identify changes in class, plan treatment and assist in prognostication. We set out to compare the histopathological features and outcomes of disease flare and protocol biopsy patients. Methods A retrospective descriptive study was conducted on repeat biopsies performed between January 1984 and December 2015 in lupus nephritis patients. Disease flares and protocol biopsies were compared. Results Of 614 systemic lupus erythematosus (SLE) renal biopsies, 127 (20.7%) RRBs were identified. Disease flare patients accounted for 96 (75.6%) and protocol biopsies for 31 (24.4%) of RRBs. Seventy (72.9%) disease flare patients retained their original class on repeat biopsy. When categorised as proliferative and non-proliferative histology, 83 (87.4%) of the disease flare biopsy patients remained histologically unchanged. Treatment remained unchanged in 57 (60.0%) patients following RRBs for disease flares. Response to immunosuppression in disease flare patients was poorer. Non-response was associated with increased chronicity index (OR = 1.33; 95% CI 1.01-1.76; p = 0.045). Thirty-three (36.3%) disease flare patients developed end-stage kidney disease (ESKD) in one year as compared to one (3.6%) protocol biopsy patient ( p = 0.003). ESKD in disease flare patients was associated with non-response to treatment (OR = 24.6; 95% CI 2.7-219.3; p = 0.004) on multivariate analysis. One-year mortality was 30.0% in the disease flare patients and 3.5% in protocol biopsy patients ( p = 0.018). Conclusion Repeat biopsies in disease flare patients infrequently led to histological class changes, failed to lead to change of treatment in the majority of patients, and were associated with poorer outcomes.
Asunto(s)
Riñón/patología , Nefritis Lúpica/patología , Adolescente , Adulto , Biopsia , Proliferación Celular , Distribución de Chi-Cuadrado , Progresión de la Enfermedad , Femenino , Humanos , Inmunosupresores/uso terapéutico , Fallo Renal Crónico/etiología , Fallo Renal Crónico/patología , Nefritis Lúpica/complicaciones , Nefritis Lúpica/tratamiento farmacológico , Nefritis Lúpica/mortalidad , Masculino , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Sudáfrica , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: The Cox Maze III procedure is considered the gold standard open surgical procedure for management of atrial fibrillation. This article outlines a unique case of a para-atrial mediastinal hematoma following a bilateral thoracoscopic left atrial Maze procedure mimicking malignancy. REPORT: A 60-year-old male, with past history of melanoma, underwent bilateral thoracoscopic left atrial mini maze procedure with radiofrequency energy and exclusion of the left atrial appendage. Seven months later, a chest computed tomography (CT) scan was performed to evaluate for pulmonary embolism. The CT scan unexpectedly showed an ill-defined, heterogeneous para-atrial mass immediately superior to the left atrium concerning for tumor and mediastinal adenopathy. The mass was moderately hypermetabolic on subsequent 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) scan. A follow-up PET/CT three months later demonstrated near-complete resolution of the para-atrial mass with minimal residual hematoma. CONCLUSION: Non-acute mediastinal hematoma following a maze procedure can potentially be confused with a tumor mass and/or lymphadenopathy on CT and FDG PET/CT. With knowledge of the potential for false-positive FDG uptake in a hematoma, the lesion was monitored, and unnecessary biopsy was avoided.
Asunto(s)
Apéndice Atrial/cirugía , Hematoma/diagnóstico por imagen , Enfermedades del Mediastino/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones , ToracoscopíaRESUMEN
Background Systemic lupus erythematosus is a multisystem disease with serious complications, including lupus nephritis. Systemic lupus erythematosus is prevalent in the Western Cape, predominantly affecting women in the prime of their lives. Renal biopsy is an important tool for the management of the lupus patient with kidney disease, guiding treatment and assessing prognosis. Aims The aim of this study was to ascertain if there has been a change in the spectrum of renal pathology, patient characteristics and long-term outcomes in patients with lupus nephritis in our region over three decades. Methods We reviewed 315 records of systemic lupus erythematosus patients with suspected renal disease who underwent renal biopsy in the Renal Unit at Tygerberg Hospital over three decades between January 1983 and December 2012. Results Lupus nephritis consistently affected young women. Class IV lupus nephritis remained the most common pattern throughout the three decades. The overall five-year survival for this cohort was 67% (95% confidence interval (CI), 60-72%). Conclusion Class IV lupus nephritis remained the most frequent class in our cohort of patients with the poorest survival rates compared to other classes. The prognosis of lupus nephritis in our region is considerably worse than that reported elsewhere in the world.
Asunto(s)
Glomérulos Renales/patología , Lupus Eritematoso Sistémico/epidemiología , Nefritis Lúpica/epidemiología , Nefritis Lúpica/patología , Adulto , Biopsia , Progresión de la Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/mortalidad , Lupus Eritematoso Sistémico/terapia , Nefritis Lúpica/mortalidad , Nefritis Lúpica/terapia , Masculino , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Estudios Retrospectivos , Sudáfrica/epidemiología , Factores de TiempoRESUMEN
BACKGROUND: Acute tubulointerstitial nephritis (ATIN) as a complication of antituberculous therapy has been most commonly reported due to rifampicin therapy. This reaction typically occurs following re-exposure to the drug. This study undertook to investigate the clinicopathological features of ATIN related to antituberculous therapy. METHODS: We performed a retrospective study of all adult patients with a biopsy-proven diagnosis of ATIN on chemotherapy for tuberculosis. The patients presented with acute renal failure at our institution during 1995 - 2007. The demographic, clinical, biochemical and histopathological features were studied. The patient outcome and management were analyzed. RESULTS: 41 patients had histologically proven ATIN. 23 (56%) were female. The mean age at presentation was 42 years. The most common regimen included rifampicin used intermittently to treat pulmonary tuberculosis. The average duration of antituberculosis therapy was 19 days before presentation and the duration of the acute illness averaged 5 days. The most common clinical manifestation included gastro-intestinal symptoms occurring in 35 (85%) patients with associated hepatitis biochemically in 20 (53%) patients. No skin rashes were observed and eosinophilia was only present in two patients. Hematuria was observed universally without any significant proteinuria. Anemia was present in 37 (90%) patients, with associated thrombocytopenia in 15 (37%). Rifampicin was discontinued in 37 (90%) cases. Nine (22%) patients required dialysis. One patient failed to recover renal function and 4 (10%) patients died. Mortality was related to overwhelming tuberculosis infection. The main factor predicting the need for dialysis was duration of oliguria. CONCLUSION: ATIN is a rare, but serious complication of repeat antituberculous therapy mainly due to re-exposure to rifampicin. Although the renal prognosis is generally good the disease does carry significant morbidity and mortality risks. A high index of suspicion is needed in re-treatment patients. A suggested screening test is for microhematuria with urine dipstix.
Asunto(s)
Antituberculosos/efectos adversos , Nefritis Intersticial/inducido químicamente , Adulto , Femenino , Humanos , Masculino , Estudios Retrospectivos , Rifampin/efectos adversosRESUMEN
A general approach to solubilization and possible in vivo activation of the transplatinum geometry is presented. The synthesis and characterization of new water-soluble cytotoxic transplatinum compounds are described. Use of acetate ligands (and carboxylate ligands in general) in trans-[Pt(OAc)(2)(L)(L')] results in significantly enhanced aqueous solubility and chemical stability in comparison to the parent dichlorides. The new compounds are the first cytotoxic transplatinum compounds containing an N(2)O(2) donor set, similar to carboplatin and oxaliplatin.
Asunto(s)
Acetatos/química , Aminas/química , Antineoplásicos/química , Quelantes/química , Compuestos Organoplatinos/química , Línea Celular Tumoral , Resistencia a Antineoplásicos , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Hidrólisis , Solubilidad , Relación Estructura-Actividad , AguaRESUMEN
BACKGROUND: Increased cancer incidence, particularly lymphoproliferative disease, is a complication of immunosuppression in organ transplantation. Non-Hodgkin's lymphomas (NHLs) occur frequently during the first year after transplantation, more so in North America than in Europe. METHODS: This study audited and correlated the demographic, clinical, pathological, and outcome features of post-transplant lymphoproliferative disorders (PTLDs) in a large centre in Oxford, and assessed whether the time of onset fitted more with the European or North American pattern. RESULTS: There were 1383 renal transplants in the study period and 27 patients developed lymphoma: 26 NHLs and one Hodgkin's disease (1.95%). Four of the patients never received cyclosporin. The mean time of diagnosis after transplant was 46 months. Most tumours (21/27) presented extranodally. Management included reduction of immunosuppression, surgical excision, antiviral treatment, radiotherapy, and chemotherapy. Three patients presented in the first post-transplant year-0.34% of cyclosporin managed patients-similar to the North American incidence, although the incidence of extranodal late PTLDs was also high (mean onset, 36 months v 15 months international mean). Post-transplant lymphomas were the most common malignancy associated with death in transplant patients. CONCLUSIONS: PTLDs occurred in 2% of renal transplant patients, presenting both in the first year in association with cyclosporin use, as in North America, but also in subsequent years, giving an overall presentation time later than the international mean. The disease usually presented extranodally, accounting for the wide range of symptoms and signs. Despite awareness and active management, the disease contributed to death in more that 50% of patients with PTLDs.
Asunto(s)
Terapia de Inmunosupresión/efectos adversos , Trasplante de Riñón , Linfoma/etiología , Adolescente , Adulto , Anciano , Ciclosporina/efectos adversos , Femenino , Humanos , Inmunosupresores/efectos adversos , Linfoma/patología , Linfoma/terapia , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Sistema de Registros , Resultado del TratamientoRESUMEN
Treatment of larvae of the ascidians Boltenia villosa (Family: Pyuridae) and Cnemidocarpa finmarkiensis (Family: Styelidae) with drugs that inhibit the function of the molecular chaperone HSP90 increased the frequency of tail resorption, the primary morphogenetic event of metamorphosis. If treatment was initiated at hatching, metamorphic events subsequent to tail resorption failed to occur, indicating an ongoing role for HSP90 during morphogenesis. Removal of tails from heads of mature, but not newly hatched larvae, induced metamorphosis of the head. Decapitation experiments indicate that the capacity of tails to shorten in response to inhibition of HSP90 function requires communication with heads. To identify candidate proteins with which HSP90 may interact to regulate metamorphosis, we noted that in mammalian cells, nitric oxide synthase (NOS) interacts with HSP90 and its activity is sensitive to drugs that inhibit HSP90 function. In addition, nitric oxide (NO) signaling in the marine snail Ilyanassa obsoleta is an important regulator of metamorphosis. Inhibition of NOS activity in these ascidian larvae with L-NAME increased the frequency of metamorphosis, consistent with a putative interaction of NOS and HSP90. NOS is present in tail muscle cells, implicating them as targets for the drug treatments, consistent with the decapitation experiments. Inhibition of soluble guanylyl cyclase, the most common effector of NO signaling, also increased the frequency of metamorphosis. In contrast to treatment with anti-HSP90 drugs, metamorphosis induced with L-NAME or ODQ was complete. The results presented suggest that an HSP90-dependent, NO-based regulatory mechanism localized in tails represses ascidian metamorphosis. We discuss these results in relation to the induction of ascidian metamorphosis by several unrelated agents.
Asunto(s)
GMP Cíclico/farmacología , Proteínas HSP90 de Choque Térmico/farmacología , Óxido Nítrico/farmacología , Urocordados/crecimiento & desarrollo , Animales , Larva/crecimiento & desarrollo , Metamorfosis Biológica , Óxido Nítrico Sintasa/metabolismo , Transducción de Señal , Cola (estructura animal)/crecimiento & desarrollo , Urocordados/fisiologíaRESUMEN
Hemangiomas represent the most common primary tumor of the liver. Clinically the significance of these lesions is highly variable. The management of hemangiomas is controversial and is intimately related to the size, symptoms, and associated comorbidities of the patients who harbor these benign tumors. Series suggest that the vast majority of hemangiomas are less than 4 cm, asymptomatic, and clinically incidental findings. Symptomatic hemangiomas are large and associated with a constellation of vague upper abdominal complaints including pain, mass, distention, early satiety, and weight loss. A number of small series of surgically treated symptomatic hemangiomas have demonstrated enucleation as a safe and effective intervention. We report a collection of case reports using embolization as a primary treatment of symptomatic hemangiomas. The first patient is a 73-year-old black man previously treated for prostate cancer by radical prostatectomy and radiation. He developed weight loss, abdominal fullness, and early satiety. His symptoms were attributed to a large left lateral segmental liver mass that was biopsy proven to be a hemangioma. The second patient is a 49-year-old black women who complained of weakness, fatigue, night sweats, and anemia. The only abnormality discovered was a large right posterior hemangioma. The third patient is a 49-year-old black women with unexplained right upper quadrant pain and anemia who was found to have a 19 x 11 x 7.5-cm left hepatic hemangioma by CT. All three patients underwent elective treatment of their hemangiomas with highly selective hepatic embolization. There were no significant complications related to the procedures. Symptoms resolved for all patients acutely after treatment. The use of embolization for hepatic hemangiomas provides safe and effective treatment of the patient's symptoms while avoiding operative intervention, extended hospitalization, or postoperative recuperation. This treatment modality should be considered for the symptomatic hemangioma under elective conditions.
Asunto(s)
Embolización Terapéutica , Hemangioma/terapia , Neoplasias Hepáticas/terapia , Anciano , Femenino , Hemangioma/diagnóstico por imagen , Arteria Hepática/diagnóstico por imagen , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Alcohol Polivinílico , RadiografíaAsunto(s)
Leucemia Mielomonocítica Aguda/complicaciones , Leucemia Mielomonocítica Aguda/patología , Neumonía por Pneumocystis/complicaciones , Adulto , Líquido del Lavado Bronquioalveolar , Humanos , Inmunohistoquímica , Masculino , Neumonía por Pneumocystis/diagnóstico , Neumonía por Pneumocystis/patología , Neumonía por Pneumocystis/cirugía , Cirugía Torácica Asistida por VideoRESUMEN
Ascidians are urochordates, marine invertebrates with non-feeding motile chordate tadpole larvae, except in the family Molgulidae. Urodele, or tailed, Molgulids have typical ascidian chordate tadpole larvae possessing tails with muscle cells, a notochord, and a dorsal hollow nerve cord. In contrast, anural (or tail-less) Molgulids lack a tail and defining chordate features. Molecular phylogenies generated with 18S and 28S ribosomal sequences indicate that Molgulid species fall into at least four distinct clades, three of which have multiple anural members. This refined and expanded phylogeny allows careful examination of the factors that may have influenced the evolution of tail-less ascidians.
Asunto(s)
Evolución Molecular , Larva/crecimiento & desarrollo , Filogenia , Urocordados/crecimiento & desarrollo , Urocordados/genética , Animales , Ecología , Geografía , Larva/genética , Urocordados/embriologíaRESUMEN
BACKGROUND AND OBJECTIVES: Patterns of nephrotic syndrome vary between regions and countries, and influence approaches to management. In the mid-1970s the University of Stellenbosch became involved in providing tertiary care to Namibia, including a paediatric nephrology service. The aim of this study was to document the clinical, pathological and outcome features of nephrotic syndrome in Namibian children. SUBJECTS: Seventy black Namibian children with nephrotic syndrome were managed from 1975 to 1988. Sixty-eight renal specimens (67 biopsies and 1 autopsy specimen) were evaluated. RESULTS: Twenty-nine of the 70 children (41.4%) were hepatitis B virus (HBV) carriers, of whom 25 (86.2%) were male. Of the 29, 26 had predominantly membranous glomerulonephritis (MGN), 1 mesangiocapillary glomerulonephritis (MCGN), and 1 focal segmental glomerulosclerosis (FSGS); 1 child in advanced renal failure was not biopsied. Five children (7.4%) showed minimal change disease (MCD), 11 (16.2%) FSGS and 15 (22.1%) diffuse mesangial proliferative glomerulonephritis (DMP). The remaining 10 children showed diffuse glomerulosclerosis (6), MCGN (3) and endocapillary proliferative GN (1). Four of the 5 children with MCD went into remission on immunosuppressive treatment. Of the 15 with DMP, 4 improved spontaneously and only 1 of those treated did not improve. Only 2 of those with FSGS improved on treatment. The children with HBV-associated MGN and MCGN were offered symptomatic rather than specific treatment. Thirteen children presented with degrees of chronic renal failure. Eight are known to have died, 3 of relentless nephrotic syndrome and 4 (of whom 3 were HBV carriers) of end-stage renal failure. One child died of penicillin anaphylaxis. CONCLUSIONS: The pattern of nephrotic syndrome in black Namibian children differed greatly from the non-African pattern elsewhere in that MCD was uncommon and HBV-associated GN was the most common single group. The most frequent pattern of HBV-associated GN was MGN with some mesangiocapillary features showing marked male predominance. MCD and DMP were potentially treatable and could only be identified by biopsy. HBV carrier rates exert a major influence on the proportions of morphological subgroups of nephrotic syndrome in children. As these HBV carrier rates alter in future due to the influence of vaccination and urbanisation, the relative size of nephrotic subgroups seems likely to alter.
Asunto(s)
Negro o Afroamericano , Síndrome Nefrótico/etnología , Adolescente , Biopsia , Población Negra , Niño , Preescolar , Ciclofosfamida/uso terapéutico , Femenino , Glomerulonefritis Membranoproliferativa/tratamiento farmacológico , Glomerulonefritis Membranoproliferativa/etnología , Glomerulonefritis Membranoproliferativa/patología , Glomerulonefritis Membranosa/tratamiento farmacológico , Glomerulonefritis Membranosa/etnología , Glomerulonefritis Membranosa/patología , Glomeruloesclerosis Focal y Segmentaria/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/etnología , Glomeruloesclerosis Focal y Segmentaria/patología , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/terapia , Humanos , Inmunosupresores/uso terapéutico , Lactante , Riñón/patología , Masculino , Namibia/epidemiología , Síndrome Nefrótico/tratamiento farmacológico , Síndrome Nefrótico/patología , Esteroides/uso terapéuticoRESUMEN
AIMS: To develop and test a neural network to assist in the histological diagnosis of early acute renal allograft rejection. METHODS AND RESULTS: We used three sets of biopsies to train and test the network: 100 'routine' biopsies from Leicester; 21 selected difficult biopsies which had already been evaluated by most of the renal transplant pathologists in the UK, in a study of the Banff classification of allograft pathology and 25 cases which had been classified as 'borderline' according to the Banff classification in a review of transplant biopsies from Oxford. The correct diagnosis for each biopsy was defined by careful retrospective clinical review. Biopsies where this review did not provide a clear diagnosis were excluded. Each biopsy was graded for 12 histological features and the data was entered into a simple single layer perception network, designed using the MATLAB neural network toolbox. Results were compared with logistic regression using the same data, and with 'conventional' histological diagnosis. If the network was trained only with the 100 'routine' cases, its performance with either of the other sets was poor. However, if either of the 'difficult' sets was added to the training group, testing with the other 'difficult' group improved dramatically; 19 of the 21 'Banff' study cases were diagnosed correctly. This was achieved using observations made by a trainee pathologist. The result is better than was achieved by any of the many experienced pathologists who had previously seen these biopsies (maximum 18/21 correct), and is considerably better than that achieved by using logistic regression with the same data. CONCLUSION: A neural network can provide a considerable improvement in the diagnosis of early acute allograft rejection, though further development work will be needed before this becomes a routine diagnostic tool. The selection of cases used to train the network is crucial to the quality of its performance. There is scope to improve the system further by incorporating clinical information. Other related areas where this approach is likely to be of value are discussed.
Asunto(s)
Rechazo de Injerto/diagnóstico , Trasplante de Riñón/patología , Riñón/patología , Redes Neurales de la Computación , Enfermedad Aguda , Biopsia , Estudios de Evaluación como Asunto , Humanos , Modelos Logísticos , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: The Banff classification for assessment of renal allograft biopsies was introduced as a standardized international classification of renal allograft pathology and acute rejection. Subsequent debate and evaluation studies have attempted to develop and refine the classification. A recent alternative classification, known as the National Institutes of Health Collaborative Clinical Trials in Transplantation (NIH-CCTT) classification, proposed three distinct types of acute rejection. The 1997 Fourth Banff meeting appeared to move towards a consensus for describing transplant biopsies, which incorporated both approaches. Patients who received a renal allograft at the Oxford Transplant Centre were managed by a combination of protocol and clinically indicated biopsies. We have undertaken a retrospective analysis of the biopsies correlated with the clinical outcome to test the prognostic value of the original Banff (Banff 93-95) and NIH-CCTT classifications. METHODS: Three hundred and eighty-two patients received renal allografts between May 1985 and December 1989, and were immunosuppressed using a standard protocol of cyclosporine, azathioprine and steroid. Adequate 5-year follow-up data were available on 351 patients, and of these, 293 had at least one satisfactory biopsy taken between days 2 and 35 after transplantation, the latter patients forming the study group. The D2-35 biopsies taken from these patients, which were not originally reported according to the Banff classification, were re-examined and classified according to the Banff 93-95 protocols. For each patient the biopsy found to be the most severely abnormal was selected, and the Banff and NIH-CCTT grading compared with the clinical outcome. RESULTS: Seven hundred and forty-three biopsies taken from 293 patients between days 2 and 35 after transplantation were examined and the patients categorized on the basis of the 'worst' Banff grading as follows. Normal or non-rejection, 20%; borderline, 34%; acute rejection grade I (AR I), 18%; AR IIA, 6%; AR IIB, 14%; AR III, 1%; AR IIIC, 3%; widespread necrosis 3%. The clinical outcome for the last two groups combined was very poor with 18% of grafts functioning at 3 months and 6% at 5 years. The other groups with vascular rejection (AR IIB and AR III) had an intermediate outcome, graft survival being 78% at 3 months and 61% at 5 years. The remaining four groups (normal, borderline, cellular AR I and AR IIA) had the best outcome: graft survival 95% at 3 months and 78% at 5 years with virtually no difference between the four groups. Three forms of acute rejection, namely tubulo-interstitial, vascular and transmural vascular, were identified, but only the latter two categories were associated with a poor outcome. CONCLUSIONS: The eight sub-categories of the Banff classification of renal allograft biopsies are associated with three different prognoses with respect to graft survival in the medium term. These three prognostic groups correspond to the three NIH-CCTT types. The data provide support for the consensus developed at Banff 97 separating tubulo-interstitial, vascular and transmural vascular rejection (types I, II and III acute rejection).
Asunto(s)
Trasplante de Riñón , Riñón/patología , Patología/métodos , Estudios de Evaluación como Asunto , Rechazo de Injerto/clasificación , Rechazo de Injerto/patología , Supervivencia de Injerto , Humanos , Túbulos Renales/patología , Necrosis , Pronóstico , Circulación Renal , Estudios Retrospectivos , Trasplante Homólogo , Resultado del Tratamiento , Vasculitis/patologíaRESUMEN
The developmental roles of factors associated with the nuclear complex of Halocynthia roretzi and Boltenia villosa oocytes were investigated by cutting mature oocytes into animal and vegetal merogons before and during GVBD. Animal and vegetal merogons were cultured in sea water until the GV cytoplasm had dispersed within the cytoplasm of control oocytes and then they were cross-fertilized and scored for their ability to undergo normal development. Halocynthia oocyte fragments produced from the animal region of oocytes containing intact GVs exhibited a low frequency of polyspermy, a high frequency of fertilization and cleavage, and a high frequency of expressing an epidermal antigen, Epi-2. In contrast, merogons produced from the vegetal region of Halocynthia oocytes in which GVs were intact exhibited a high frequency of polyspermy, did not undergo cell division, and expressed a high frequency of Epi-2 expression. When vegetal fragments were produced after the dispersal of approximately 50-70% of the GV nucleoplasm, these merogons exhibited a low frequency of polyspermy, high frequencies of cell division (including the formation of epidermal layer), and in most cases expressed Epi-2. Vegetal Boltenia fragments produced during GVBD in some cases developed into larvae. These results suggest that the ascidian GV nucleoplasm may contain factors required for fertilization and cell division and that epidermal determinants reside in the oocyte cytoplasm.
Asunto(s)
Fertilización/fisiología , Proteínas Nucleares/farmacología , Urocordados/embriología , Animales , División Celular , Proteínas Nucleares/metabolismo , Oocitos/citologíaRESUMEN
The present results provide the first evidence of a fibroblast growth factor (FGF) family protein in a urochordate. Anti-FGF2 immunoreactive hemoblast cells were detected at day 3 of juvenile development in a direct-developing urochordate ascidian, Molgula pacifica. The detection of FGF in hemoblast cells coincided with the appearance of distal-less protein along the proximal-distal axis of growing ampullae. Ampullae are limb-like, fluid-filled ectodermal appendages that contain hemoblast cells and have holdfast, respiratory, and immunological functions (1). Given the evolutionary conservation of the genes encoding FGF (2) their receptors (2), and distal-less (3) the present results suggest that the formation of non-homologous ascidian appendages shares genetic elements in common with proximal-distal axis formation in arthropod limbs and vertebrate limbs (4,5). The possible evolutionary implications of these findings are discussed.
RESUMEN
The theory that p58, a cytoskeletal protein, has an important role in ascidian muscle cell development was tested by altering normal distributions of orange-pigmented myoplasm in Boltenia villosa embryos and determining if muscle development is correlated with the presence of p58. Removal of the animal region of fertilized Boltenia eggs resulted in the redistribution of myoplasm into the anterior endoderm cells of the embryo. Despite alterations in the normal distribution of myoplasm, these embryos developed into larvae. However, when four-celled embryos that exhibited altered distributions of pigmented myoplasm were stained with NN18, an antibody that stains p58, a maximum of two blastomeres were stained, as in control embryos. Compression of Boltenia embryos at the four-celled stage caused the myoplasm to be partitioned into four blastomeres of an eight-celled embryo, instead of into two blastomeres. Compressed and cleavage-arrested eight-celled embryos developed myosin and muscle actin RNA in a maximum of four blastomeres, compared to a maximum of two blastomeres in control embryos. When compressed eight-celled embryos were stained with NN18, p58 was present in a maximum of four blastomeres. These results support the idea that the cytoskeletal protein p58 is associated with muscle cell determinants in ascidian eggs.
RESUMEN
Hepatitis B-associated glomerulonephritis is a relatively common cause of nephrotic syndrome in endemic areas affecting especially male children. When this disease affects girls or women, both the glomerular disease and the hepatitis B carrier state could affect subsequent pregnancies. This may be the first reported case of such a pregnancy. In this patient the partially remitted renal disease and the reduced infectivity of the hepatitis B carrier state decreased the influence of the disease on the pregnancy.