Dysregulation of kidney proteases in the pathogenesis of hypertension following unilateral nephrectomy in juvenile mice.

BACKGROUND: Unliteral nephrectomy (UNX) results in the reduction of kidney mass. The remaining kidney undergoes compensatory renal growth via hypertrophy of the glomeruli and renal tubules to maintain a normal glomerular filtration rate (GFR). These compensatory mechanisms result in increased capillary pressure and glomerular hyperfiltration to increase single nephron GFR. Over time, hyperfiltration may lead to kidney scarring and the development of hypertension. OBJECTIVES: The first objective of this study was to test the hypothesis that a 50% reduction in functioning nephrons in juvenile mice leads to increased blood pressure over a 24-hour phase. The second objective was to test the hypothesis that UNX leads to changes in the expression and activity of kidney proteases in juvenile mice. METHODS: Eight male C57B6 juvenile wild-type mice were subject to UNX and an equal number of mice were subject to sham (SH) surgery. Metabolic cage studies were performed for 5 weeks to collect urine produced during the inactive and active phases. Blood pressure was measured using the tail cuff method twice weekly and tail blood was collected on different days during the inactive or active phase of each animal. The mice were euthanized at the age of 9 weeks. Western blotting and immunohistochemistry were performed to investigate changes in renal protein expression of various cathepsins and renal kallikrein 1 (KLK1) between the two groups. Protease activity assays were performed using kidney lysates and urine samples from each group. RESULTS: Compared to the SH group, UNX mice showed a persistent increase in blood pressure at week 3 which progressed toward the end of the study at week 5 of age. Cathepsin B, D, and S expression and activity were up-regulated in kidney cortex lysates from UNX mice compared to the SH control group. KLK1 protein expression was down-regulated and urinary nitric oxide excretion was decreased in UNX mice compared to the SH control group. CONCLUSION: UNX results in the development of persistent and progressive hypertension. Down-regulation of KLK1 and up-regulation of various cathepsins may contribute to the development of hypertension via multiple mechanisms including a decrease in nitric oxide (NO) production.

Traditional practices of the ethnoveterinary plants in the Kaghan Valley, Western Himalayas-Pakistan / Prácticas tradicionales etnoveterinarias de las plantas en el valle de Kaghan, Himalaya occidental Pakistán

Introduction: Indigenous people in a far-flung mountainous area without basic facilities, mainly rely on medicinal plants to cope with various veterinary health problems. Objective: The present study was carried out to explore the traditional knowledge of ethnoveterinary practices in Kaghan Valley, district Mansehra, Western Himalayas-Pakistan. Method: Ethnoveterinary data were collected between February to October 2014 from nine villages of the Kaghan Valley by involving 80 local people include traditional healers using a semi-structured interview. Results: A sum of 41 plant taxa of ethnoveterinary medicinal plants was documented for treating livestock ailments. Out of which, herbaceous plants were recorded with high percentage (27 species, 65.8 %). Most of the species were used to treat gastrointestinal diseases (12 taxa), followed by health improvement (7 taxa). The widely used part of plants for livestock aliments was the whole plant (9 species) followed by leaves (7 species), and preparation were paste (18 species) followed by powder with 10 species. The highest used values were recorded for Arisaema costatum (0.82), Primula denticulata (0.76), and high relative frequency citations for Berberis lyceum and Dryopteris ramosa with 0.37 each. Among the plant species Skimmia laureola, Thymus linearis and Phytolacca latbenia were among the taxa with cent fidelity level. Conclusion: The flora used in traditional remedies of the valley was found mostly endemic due to excessive utilization. Thus, further chemical investigation, better utilization and conservation of indigenous use of the reported species should be considered for future work.

Introducción: Los pueblos indígenas de zonas montañosas lejanas sin facilidades básicas dependen principalmente de las plantas medicinales para afrontar problemas de salud de tipo veterinario. Objetivo: Explorar el conocimiento tradicional en las prácticas etnoveterinarias en el valle de Kaghan, distrito de Mansehra, Himalaya occidental-Pakistán. Métodos: Se recopilaron datos etnoveterinarios mediante una entrevista semiestructurada entre febrero y octubre de 2014 en nueve aldeas del valle de Kaghan, con la participación de 80 habitantes locales, incluidos curanderos tradicionales. Resultados: Se documentó un total de 41 taxones de plantas medicinales etnoveterinarias para el tratamiento de enfermedades del ganado. Se registró un alto porcentaje de plantas herbáceas (27 especies, 65.8 %). La mayoría de las especies utilizadas han sido para tratar enfermedades gastrointestinales (12 taxones), y mejora de la salud (7 taxones). Para el tratamiento de enfermedades del ganado, lo más usual fue utilizar la planta entera (9 especies), seguida de las hojas (7 especies), con preparación en pasta (18 especies) y en polvo (10 especies). Las especies registradas con más uso fueron: Arisaema costatum (0.82), Primula denticulata (0.76) y Berberis lyceum y Dryopteris ramosa con la misma alta frecuencia relativa (0.37 cada una). Las especies Skimmia laureola, Thymus linearis y Phytolacca latbenia se reportaron entre los taxones con mayor nivel de fidelidad porcentual. Conclusión: La flora utilizada en los remedios tradicionales del valle de Kaghan fue mayoritariamente endémica. Se propone para trabajos futuros mayor investigación química, y mayor utilización y conservación en las especies de plantas reportadas por los indígenas.

Correction of High-Grade Pseudogynecomastia After Massive Weight Loss: Modified Inferior Dermoglandular Pedicled Transverse Scar Reduction.

INTRODUCTION: Whereas body-contouring surgery after massive weight loss in women receives much attention, little attention has been devoted to accentuating the male physique. Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. The authors present their approach to high-grade pseudogynecomastia correction with preservation of the NAC on an inferior dermoglandular pedicle with transverse scar only closure and without any meaningful liposuction. MATERIALS AND METHODS: A description of comprehensive pseudogynecomastia correction with the aforementioned technique followed by review of 58 consecutive patients operated on in our clinic from January 2017 to June 2018. Epidemiological data such as age, weight, height, body mass index (BMI), weight loss, and the medical history of each patient were collected. All patients were photo-documented preoperatively and postoperatively in a standard manner. During the operation, weight of resected tissue and operative time were noted. RESULTS: Fifty-eight patients were operated on in a single stage. In our series, one patient had unilateral partial necrosis on nipple-areola complex, and two patients had minimal to moderate amounts of hematoma which were followed up without intervention. We did not encounter any infection-related complications or skin redundancy in our patients. Out of 58 patients, 55 of all the patients were highly satisfied with the aesthetic results. Three patients were mildly satisfied with the results, but they stress that moderate scar widening was the reason for the displeasure, not the definition of the chest which was deemed as satisfactory like the rest. CONCLUSION: Our technique obviates the need for skin resection in a second operation, allows immediate skin recontouring, and provides a viable nipple-areola complex at the desired location. The patient does not have to suffer prolonged stress while awaiting skin retraction and is protected from a second dose of anesthesia and hospitalization. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Health risk assessment through determining bioaccumulation of iron in forages grown in soil irrigated with city effluent.

The irrigation with sewage water can be useful if it has no negative effects on food crop yield, soil pollution, and health of humans. However, it includes various types of contaminants like heavy metals that pollute the soil and crops. In this regard, the aim of this study was to evaluate the possible health risks of heavy metals in forages. Forages both of summer and winter were grown with different water treatments (sewage water and tap water) in Department of Botany, University of Sargodha. The concentration of iron (Fe) in water, soil, and plant samples was determined. The Fe values in tap and sewage water were observed as 0.090 and 0.115 mg/L, respectively. The highest mean concentration of Fe was 9.608 mg/kg in the soil where Trifolium alexandrinum is grown, and the lowest mean concentration was 0.154 mg/kg which occurred in the soil where Trifolium resupinatum is grown in winter. The maximum mean concentration of Fe in the root samples of plants was observed as 2.483 mg/kg in Pennisetum typhoideum, and the minimum mean concentration occurred as 0.390 mg/kg in Zea mays grown in summer. The maximum bioconcentration factor value of Fe was observed for T. resupinatum (5.259) grown in winter. The maximum pollution load index value of Fe was observed for T. alexandrinum (0.1688). The maximum value of daily intake of metals was observed as 0.0731 in Medicago sativa, and the maximum health risk index value was determined as 0.1091 in P. typhoideum.

A distinctive presentation of diplopodia: a Y-metatarsal combining the extra foot and the extra digit of the main foot.

Diplopodia is a rare congenital anomaly and has been described as extra digits, metatarsals, and tarsal bones that form an extra foot or foot-like structure. Various skeletal deformities and anomalies involving other organ systems can accompany diplopodia. Treatment consists of surgery, splinting, and physical therapy, planned according to each patient's specific condition. We present a patient who had diplopodia with distinctive anatomic features (with postaxial polydactyly and without any anomaly of the tibia or fibula) compared with the previously reported cases, and concomitant anomalies, including left renal agenesis and anal atresia.

Foreign body penetrations of hand and wrist: a retrospective study.

BACKGROUND: Despite significant practical knowledge and experience on foreign body penetration injuries to the hand and/or wrist, deficient management and complications can still be encountered, and ignorance of its causative and eventual social aspects unfortunately is a substantial fact. This study aims to cover the clinical and social properties and the management of these kinds of injuries. METHODS: A retrospective analysis of 86 patients requiring evaluation and treatment in a Hand Surgery Division of a university hospital was performed. RESULTS: The median age was 32 (min: 4, max: 63). Industrial workers constituted the largest occupational group (n=22, 25.6%). Twenty-three (26.7%) of the cases were elective admissions. Thirteen (15.1%) patients had various comorbidities, and five (5.8%) had psychiatric diagnoses at the time of the injury. The index finger was the most frequent site of injury (n=29, 33.7%). General anesthesia was not necessary for the management of 94.2% of the cases. In 26 (30%) of the patients, neural, tendinous or osseous damage was observed. Twenty-four (30%) patients were included in a postoperative hand physiotherapy program. CONCLUSION: The practically well-known general features of the issue and those aspects that may still be overlooked currently are reevaluated herein, in light of our observational data.

Protective and therapeutic effects of licorice in rats with acute tubular necrosis.

OBJECTIVES: Various protective and therapeutic effects such as antioxidant, anti-inflammatory, anticancer, antihistaminic, and antibacterial effects have been depicted for licorice. However, its biological effects in the kidney are still not clear. Therefore, we aimed to investigate the efficiency of licorice in rats with gentamicin (GM)-induced acute tubular necrosis. DESIGN AND METHODS: Rats were randomized into the control group (only saline for 12 days), licorice group (licorice for 12 days), GM group (GM for 12 days), GM + licorice group, and licorice-treated GM group (licorice for 12 days after taking GM for 12 days). Blood urea, creatinine, and uric acid levels were measured and histopathological analyses of the kidneys were performed. The oxidative side of oxidant-antioxidant balance was evaluated by detecting lipid peroxidation (LPO) and total peroxide levels, and antioxidative side was determined by measuring total antioxidant capacity (TAC) and reduced glutathione (GSH) levels in plasma and kidney tissues. RESULTS: The oxidant-antioxidant balance seemed to be shifted to the oxidative side in the GM group when compared with the control and GM + licorice groups. In GM group, biochemical profiles showed a remarkable increase in blood uric acid, urea, and creatinine levels, and depletion of renal tissue and plasma TAC and GSH levels. In addition, histopathologic studies revealed severe acute tubular necrosis, congestion, and hyaline casts, verifying GM-induced nephrotoxicity. Licorice was effective in reduction of blood urea, creatinine, and uric acid levels, and also effective in decreasing the tubular necrosis score. Licorice treatment also significantly reduced LPO and total peroxide levels, and increased TAC and GSH levels in both renal tissue and blood. Moreover, these changes in rats subjected to the combined therapy (GM + licorice) were significantly less than those of GM group. CONCLUSIONS: Licorice ameliorates GM-induced nephrotoxicity and oxidative damage by scavenging oxygen free radicals, decreasing LPO, and improving antioxidant defense.