RESUMEN

The potential of digital subtraction angiography (DSA) to enable study of the physiology of renal transplantation after a single intravenous injection of nonionic iodinated contrast material stimulated this investigation into the possible nephrotoxicity of the contrast material used. Levels of urinary enzyme activity, used as markers of renal damage, were measured before, immediately after, and up to 72 hours after intravenous injection of nonionic iodinated contrast material in two groups of patients undergoing DSA. Twenty-six patients had undergone renal transplantation and 10 control patients had normal renal function. Both groups showed a transient rise in the level of urinary enzyme activity that peaked within 24 hours and returned to levels obtained before DSA within 72 hours. In the transplantation group, the baseline levels of enzymes were higher, and the response after administration of contrast material was greater. Nevertheless, the duration of the response was the same as in the control group, and the enzyme levels of all patients returned to their pre-DSA baseline levels.

Asunto(s)

Asunto(s)

RESUMEN

Previous studies have reported an association between Leber's optic neuropathy and deficiency of rhodanese activity in liver and rectal mucosa. We have studied the rhodanese isozymes in liver biopsies from three subjects with Leber's optic neuropathy. The rhodanese isozyme patterns were indistinguishable from controls both in relative intensity and position on the isoelectric focusing pH gradient. No new rhodanese isozymes were observed and there was no evidence of deficiency in any of the cases.

Asunto(s)

RESUMEN

Recently, the St. Thomas' Hospital cardioplegic solution No. 2 (Plegisol) has become available commercially in the UK. In a series of patients (n = 28) undergoing open heart surgery for a variety of lesions, a clinical validation was performed. Preservation of myocardial contractility was assessed biophysically by quantitative birefringence measurements of myocardial biopsy samples (full thickness apical left ventricle and right ventricle) taken (1) prior to ischaemia, (2) at the end of ischaemia and (3) 10-15 min after reperfusion during cardiopulmonary bypass. In addition, serum CK-MB values were measured in samples taken throughout the operation and for 4 days postoperatively. Postoperative ECG traces (taken every 6 h for 48 h and then daily up to 7 days) were analysed to identify the occurrence of perioperative infarction. There were no hospital deaths. Chronotropic support was required in 5 of 28 patients (18%) for transient heart block. Low cardiac output did not occur postoperatively. Birefringence measurements in biopsy samples taken at the end of the ischaemic period (immediately prior to reperfusion) indicated an apparent left ventricular deterioration in myocardial contractility in 12 of 28 patients (43%) when compared to biopsies sampled prior to the ischaemic period. However, after 10-15 min of aerobic reperfusion, measurements indicated that myocardial contractility recovered to almost pre-ischaemic levels in the majority of patients. Thus, in 22 of 28 patients (79%), left ventricular deterioration did not occur in post-ischaemic biopsy samples when compared to the pre-ischaemic biopsies. Similarly, 21 of 28 patients (75%) had no deterioration of birefringence values in right ventricular biopsies.(ABSTRACT TRUNCATED AT 250 WORDS)

Asunto(s)

RESUMEN

Renal transplant recipients were divided into five categories according to their clinical course from transplantation to their discharge from hospital. Total N-acetyl-beta-D-glucosaminidase (NAG) activity in urine was determined using a chromogenic substrate 2-methoxy-4-(2'-nitrovinyl)-phenyl 2-acetamido-2-deoxy-beta-D-glucopyranoside. The isoenzyme composition of the urine of each patient was determined by semi-automated DEAE-cellulose chromatography. Although raised NAG activity was found in stable transplant patients compared to controls, the level of activity was constant and no change in the isoenzyme profile was found. In reversible rejection there was a marked increase in the intermediate forms, particularly I2 and a concomitant fall in the relative amount of the A-form present but the profile became normal when the patient stabilised. Much more complex patterns were observed in patients who did not respond to treatment. Both the B and I forms were elevated with a fall in the A-form and in one case excretion of the serum As form was observed. The intermediate forms were always increased in rejection.

Asunto(s)

Asunto(s)

RESUMEN

The biochemical effects of CHIP have been studied in C3H mice with and without transplanted mammary tumour. The maximum tolerated dose of CHIP was first determined by lethality and intestinal crypt assays to be 40 mg kg-1 and this dose was used to assay the time course of gastric distension and the pattern of drug distribution. A high level of CHIP uptake was found in liver as well as kidney. For this reason, tests for both kidney and liver damage were undertaken up to 60 days post-treatment using a dose of 10 mg kg-1 Neoplatin for comparison. Despite the high level of platinum drug uptake in liver, there was no biochemical evidence of hepatocellular or cholestatic damage. From the renal point of view, there was the expected rise in serum urea after Neoplatin but not after CHIP and there was also a rise in urinary NAG after Neoplatin in tumour bearing mice. There was, however, evidence of suppression of protein levels including enzymes, following treatment with both drugs. Tumour-bearing mice respond differently from normal mice following treatment with platinum drugs. The study confirms that CHIP is less toxic than Neoplatin.

Asunto(s)

RESUMEN

Leber's hereditary optic neuropathy is a rare cause of progressive visual failure. Its cause is unknown, but one hypothesis is that patients have a defect in the detoxication of cyanide. One of the enzymes used in this detoxication is thiosulphate sulphurtransferase (rhodanese). The activity of this enzyme was measured in the rectal mucosa of a group of subjects with Leber's hereditary optic neuropathy, and it was found to be considerably reduced compared with that in a group of controls (p less than 0.001). This finding supports the hypothesis of an inborn error of cyanide detoxication in this condition.

Asunto(s)

RESUMEN

A study of C3H mice implanted with mammary tumours has shown that the levels of serum total protein, alanine transaminase and alkaline phosphatase are all lower than those found in normal mice, while aspartate transaminase is higher. Serum urea values were similar to normal levels, but creatinine was lower in males and higher in females. In the male mice, urine protein and urine N-acetyl-beta-D-glucosaminidase (NAG) activity were lower than in normal mice. Comparisons were made with age and sex matched controls which was found to be important for alkaline phosphatase, as this was shown to decrease with increasing age of the mice over the period from 10-30 weeks of age. The analyte values found in this study provide useful base-line data for assessing biochemical toxicity of cancer chemotherapy agents. It has been shown that some of these values can vary with age, or can be different if tumour-bearing mice are used instead of normal mice.

Asunto(s)

Asunto(s)

RESUMEN

This paper describes a comparison of the recently developed substrate 2-methoxy-4-(2'-nitrovinyl)-phenyl-2-acetamido-2-deoxy-beta-D-gluc opyranoside (MNP-GlcNAc) and the corresponding 4-methylumbelliferyl substrate (4-MU-GlcNAc) for the determination of urinary NAG. A good correlation (r = 0.977) was found between NAG activities in 366 urine samples from renal transplant patients determined by either the fluorimetric method or the colorimetric procedure. The colorimetric method may be used with confidence as an alternative to the fluorimetric assay and does have the advantage that colorimetry is widely used in clinical chemistry laboratories. Sample blanks are not normally required unless there is blood contamination in the urine which can easily be identified visually. The incorporation of the MNP-GlcNAc substrate into a kit suitable for the assay of urinary NAG using a simple battery-operated miniphotometer is also described. The presence of elevated NAG levels in urine can be detected rapidly and this procedure is suitable for routine monitoring of renal patients in the laboratory and may prove to be suitable for use by non-laboratory personnel in clinics or on the ward.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

A randomized prospective controlled study of prophylactic administration of mannitol 0.5 g/kg body weight in 40 children undergoing cardiopulmonary bypass surgery showed significant lower plasma creatinine concentrations and urinary albumin excretion rates in the treated compared to the control group.

Asunto(s)

RESUMEN

An attempt was made to explore the reasons why men develop coronary heart disease (CHD) despite being at low risk on the basis of established risk factors. A case control study was designed to take place after the end of a longitudinal study in which both low- and high-risk men who had developed CHD over the course of 5-6 years were compared with controls who had remained CHD-free, matched for initial risk characteristics. Low-risk men who had developed CHD had significantly lower levels of high density lipoprotein (HDL) cholesterol than their controls. This difference was not seen when high-risk men were compared with their controls. Apart from a suggestion that low risk cases had lower levels of free thyroxine (seen mainly when less severe categories of CHD were examined) there were no other significant differences between cases and controls (either low- or high-risk) in the other measured variables, which included levels of total testosterone and oestradiol in plasma, packed cell volume and heart rate. It is concluded that low levels of HDL cholesterol may partly explain why men who are otherwise at low risk develop CHD. This study design may be useful to test other hypotheses, particularly where it has not been possible to make the appropriate measurements at the start of a longitudinal study.

Asunto(s)

RESUMEN

Raised serum alkaline phosphatase (AP) levels were found in 13 of 76 patients (17%) with ankylosing spondylitis (AS), and 11 of these 13 underwent further investigation to determine the origin of the increased enzyme activity. Three had levels within the normal reference range on re-estimation, and, of the remaining 8, AP isoenzyme studies indicated an increased liver fraction in 6. Serum gamma-glutamyl transpeptidase (GGT) was raised in only 3 patients. Increased AP activity did not appear to be directly related to disease activity or to drug therapy. These findings confirm the occurrence of increased serum AP activity in AS but challenge a previously reported suggestion that bone is the source of the increased enzyme.

Asunto(s)

RESUMEN

Renal function was studied in 36 children who were randomly allocated to receive either gentamicin and cloxacillin or cephalothin as prophylactic antibiotic cover for complex cardiopulmonary bypass surgery. Both groups of children developed a similar degree of impairment of glomerular function with significant elevations in plasma creatinine concentrations and urine albumin excretion compared to preoperative levels which tended to resolve by the 5th postoperative day. The urine excretion of N-acetyl-glucosaminidase increased in both groups postoperatively but remained significantly elevated only in those children who had received gentamicin. These findings suggest that whilst gentamicin exerts a demonstrable nephrotoxic effect on the proximal renal tubules it does not contribute significantly to either the incidence or severity of postoperative renal glomerular impairment.

Asunto(s)

RESUMEN

A comparison was made of two established tests to see which was the better indicator of rejection after renal transplantation. Daily urine samples were assayed for excretion of N-acetyl-beta-D-glucosaminidase (NAG) and fibrin degradation products (FDP). Twenty-five rejection episodes were studied in 19 patients. Both indicators tended to move in parallel. NAG was more often elevated in rejection, namely in 96% of rejection episodes as against 76% for FDP, FDP had the advantage of fewer false positive results and when it correctly indicated rejection its increase above the baseline was relatively greater than for NAG, NAG and FDP can both provide early warning of rejection. NAG is preferred for its ease of assay. Assays are performed daily and are of practical value in clinical management. The results of assays must be interpreted in conjunction with all relevant information.

Asunto(s)

RESUMEN

The isoenzyme forms of N-acetyl-beta-D-glucosaminidase (NAG) have been studied in the urine of patients with renal disease, those with stable and rejecting renal transplants, and after surgery. Besides the increase in total urinary NAG excretion as an indicator of renal damage, changes were shown in the percentage of the intermediate isoenzyme forms of the enzyme, the greatest increase being demonstrated in the urine of patients following major surgery. Similar changes were found in some patients with rejecting renal transplants, suggesting that hypoxia may be the cause of the renal damage and enzyme release. More marginal increases in isoenzyme forms were found in urine of patients with renal impairment and nephrotic syndrome.

Asunto(s)

Asunto(s)