Characterization of adnexal lesions using photoacoustic imaging to improve sonographic O-RADS risk assessment.

OBJECTIVE: To assess the impact of photoacoustic imaging (PAI) on the assessment of ovarian/adnexal lesion(s) of different risk categories using the sonographic ovarian-adnexal imaging-reporting-data system (O-RADS) in women undergoing planned oophorectomy. METHOD: This prospective study enrolled women with ovarian/adnexal lesion(s) suggestive of malignancy referred for oophorectomy. Participants underwent clinical ultrasound (US) examination followed by coregistered US and PAI prior to oophorectomy. Each ovarian/adnexal lesion was graded by two radiologists using the US O-RADS scale. PAI was used to compute relative total hemoglobin concentration (rHbT) and blood oxygenation saturation (%sO2 ) colormaps in the region of interest. Lesions were categorized by histopathology into malignant ovarian/adnexal lesion, malignant Fallopian tube only and several benign categories, in order to assess the impact of incorporating PAI in the assessment of risk of malignancy with O-RADS. Malignant and benign histologic groups were compared with respect to rHbT and %sO2 and logistic regression models were developed based on tumor marker CA125 alone, US-based O-RADS alone, PAI-based rHbT with %sO2 , and the combination of CA125, O-RADS, rHbT and %sO2. Areas under the receiver-operating-characteristics curve (AUC) were used to compare the diagnostic performance of the models. RESULTS: There were 93 lesions identified on imaging among 68 women (mean age, 52 (range, 21-79) years). Surgical pathology revealed 14 patients with malignant ovarian/adnexal lesion, two with malignant Fallopian tube only and 52 with benign findings. rHbT was significantly higher in malignant compared with benign lesions. %sO2 was lower in malignant lesions, but the difference was not statistically significant for all benign categories. Feature analysis revealed that rHbT, CA125, O-RADS and %sO2 were the most important predictors of malignancy. Logistic regression models revealed an AUC of 0.789 (95% CI, 0.626-0.953) for CA125 alone, AUC of 0.857 (95% CI, 0.733-0.981) for O-RADS only, AUC of 0.883 (95% CI, 0.760-1) for CA125 and O-RADS and an AUC of 0.900 (95% CI, 0.815-0.985) for rHbT and %sO2 in the prediction of malignancy. A model utilizing all four predictors (CA125, O-RADS, rHbT and %sO2 ) achieved superior performance, with an AUC of 0.970 (95% CI, 0.932-1), sensitivity of 100% and specificity of 82%. CONCLUSIONS: Incorporating the additional information provided by PAI-derived rHbT and %sO2 improves significantly the performance of US-based O-RADS in the diagnosis of adnexal lesions. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Basaloid squamous cell carcinoma arising in [corrected] the renal pelvis.

Basaloid squamous cell carcinoma is an uncommon and highly aggressive variant that can occur anywhere squamous cancers occur. It is most often seen in the head and neck, the perianal region, and the female genital tract. It is extremely rare in the urinary system. In this article, we report the first known case of basaloid squamous cell carcinoma arising in the renal pelvis. Given the aggressive nature of this neoplasm, it should not be omitted from the differential diagnosis of neoplasms arising from the urothelium.

Intermittent feeding and fasting reduces diabetes incidence in BB rats.

Food intake may be one of several factors which influence the risk of development of insulin dependent diabetes mellitus, but the influence of the pattern of food supply has not been studied previously. The aim of the present study was to investigate the effect of intermittent feeding and fasting upon diabetes in BB rats. This study included three groups. Group 1 served as control and included 77 animals, 79% became diabetic. In groups 2 and 3, after weaning, food but not water was withdrawn from the animals: 24 h twice a week in group 2; 24 h every second day in group 3. Group 2 included 40 BB rats, 50% (p < 0.004) became diabetic. Group 3 included 44 BB rats, 52% (p < 0.01) became diabetic. No differences were seen between sexes. Degree of insulitis was not influenced by changed food supply. Regarding blood glucose, no influence was seen among diabetic animals, among non-diabetic animals changed food supply reduced blood glucose values obtained at the end of the study. Intermittent feeding and fasting tended to reduce mean age at the time of diagnosis of diabetes, significance was reached only in female animals from group 3 compared to group 1. Body weight was obtained weekly. Intermittent feeding and fasting caused a reduced weight gain in group 2 as well as in group 3 compared to control animals; however, most pronounced in group 3 and also more pronounced among males compared to females. For pre-diabetic and non-diabetic animals comparable influence on body weight was seen. The main conclusion in the study is that intermittent feeding and fasting reduced diabetes incidence in BB rats.

Podocyte damage is a critical step in the development of glomerulosclerosis in the uninephrectomised-desoxycorticosterone hypertensive rat.

The progressive renal disease model of chronic uninephrectomy-desoxycorticosterone-trimethylacetate (UNX-DOCA) hypertension is associated with mesangial proliferation as a major disease mechanism. A detailed structural analysis of the alterations in glomerular structure which accompany the development of sclerosis in this model has not been made. Male Munich-Wistar rats underwent UNX, received weekly injections of the aldosterone agonist DOCA and 1% sodium chloride as drinking solution and were compared with sham operated controls (CON). Thirty eight days after onset, UNX animals had an albuminuria of 183 +/- 180 mg/day versus 0.38 +/- 0.22 mg/day in CON. Kidneys were fixed by total body perfusion and renal tissue processed for light and electron-microscopy. Superficial and deep total glomerular volume increased from 2.18 +/- 0.15 (deep: 2.57 +/- 0.24) 10(6) microns 3 in CON to 3.98 +/- 0.81 (deep: 3.95 +/- 0.63) 10(6) microns 3 in UNX. In addition to overall tuft hypertrophy, structural analysis revealed severe destruction of tuft architecture with mesangial expansion and/or capillary ballooning, leading to local tuft enlargements. Podocytes overlying the expanded areas appeared unable to adapt to cover the increased tuft surfaces. They developed severe lesions in cell architecture leading to denudation of glomerular basement membrane (GBM)-areas. "Naked" GBM appears to represent a nidus for hyalinosis, thrombosis and synechia formation, which progresses to segmental sclerosis. In the UNX-DOCA model of chronic glomerular hypertension local mesangial expansion was frequently encountered but no evidence was found that mesangial proliferation and matrix production proceeded to sclerosis. The crucial damage to the glomerulus in this model would appear to be attributable to podocyte failure, with the resultant GBM denudation triggering synechia formation, hyalinosis and ultimately glomerulosclerosis.

[Determination of kidney circulation with radioxenon]. / Zur Methodik der Bestimmung der Nierendurchblutung mit Radioxenon

On 23 investigations in dogs the 133xenon eluation method was compared with the bloody measurement of the renal blood supply. The most favourable correlation presents the measurement of the initial decrease of the curves with r = 0.827 and y = 0.889x + 53.3, besides the modified hight-surface-method. Possibilities of error exist especially by the recirculation of xenon and the influence on the blood supply by the xenon-injection.

Topical treatment by urea reduces epidermal hyperproliferation and induces differentiation in psoriasis.

The mechanisms of action of urea-containing ointments in the treatment of eczema, ichthyosis and psoriasis are only partly known and related to proteolysis and keratinolysis. In this study, we have examined the effects of topical urea on epidermal proliferation and differentiation in 10 patients with psoriasis. Plaque type lesions were treated for 2 weeks with an ointment containing 10% urea, with the vehicle alone, or left untreated. Clinical score, hydration of the stratum corneum, transepidermal water loss (TEWL), and immunohistochemical studies were performed. Epidermal proliferation was assessed using the Ki-S3 proliferation-associated nuclear antigen. For epidermal differentiation antibodies against involucrin and against keratins CK 5, 6, 17 and CK 1, 5, 10, 14 were used. The patients showed a reduction of the clinical score (> 50%), a 2-fold increase in stratum corneum hydration (p < 0.01), and a small decrease in TEWL (N.S.) on the urea- treated compared to the untreated site. Light microscopy studies revealed a 29% reduction in epidermal thickness (p < 0.01); epidermal proliferation was decreased by 51% (p < 0.005). The altered expression of involucrin and of cytokeratins (reduction of CK 5, 1 and 10 and induction of CK 6 and 17) was partially reversed. The ointment base also improved psoriasis, but urea was significantly better than the vehicle (urea: 40% reduction in epidermal proliferation vs. vehicle). In summary, these studies show that urea influences epidermal proliferation and differentiation in psoriasis.

[Methods for determining the glomerular filtration rate in experiments with small animals: position report of the Animal Experiment Diagnosis of Kidney Function Study Group of the Society of Nephrology of East Germany]. / Methoden zur Bestimmung der glomerulären Filtrationsrate (GFR) in Versuchen an Kleintieren: Positionsbericht der Arbeitsgruppe "Tierexperimentelle Nierenfunktionsdiagnostik" der Gesellschaft für Nephrologie der DDR.

The methods of the investigation of the glomerular filtration rate (GFR) in the animal experiment on cats and rats used at present are demonstrated as survey and the results of the basic investigations are compared. The values in cats lie between 20 and 30 ml/min/100 g kidney, in rats GFR values are between 0.6 and 1.0 ml/min/100 g body mass and 0.6-0.3 ml/min/1 g kidney. The basic values are essentially influenced by the experimental conditions and determination methods so that only clearance values within the working team concerned are comparable.

[Modern study methods in experimental nephrology]. / Moderne Untersuchungsmethoden der experimentellen Nephrologie.

The investigation technique of the experimental nephrology comprise in-vivo and in-vitro methods. This order results from the increasing reduction of the size of the investigation object, beginning with the kidneys in the intact organism up to the subcellular structures. Modern investigation techniques such as the nuclear magnetic resonance spectrometry or the tubular microperfusion method with or without ion-selective micropotential measurement have opened new ways of approach and led to new recognitions concerning the function of the kidney in physiological and pathophysiological situations. To this among others belong the characterization of the tubulo-glomerular feedback and aspects of the humoral regulation of renal compensatory adaptation processes. It remains open whether in near future a new stage of experimental nephrology is beginning. It might take its starting point from the cultivation of nephronal cells and via bioartificial hybrid systems lead to new ways in simulating the tubular renal function.

The Munich Wistar Frömter rat: proteinuria and blood pressure in correlation to the number of superficial glomeruli.

Rats with a high number of superficial nephrons (MWF/Ztm) also show an elevated urinary protein excretion and a high systolic blood pressure. To investigate a possible correlation between the number of superficial glomeruli and these physiological changes, MWF/Ztm rats were crossed and backcrossed to Wistar cryptorchic (WC/Ztm) animals with no superficial nephrons in order to produce genotypes with differing numbers of superficial glomeruli. In the parental strains, the F1 hybrids and the 8 possible backcrosses, the number of superficial glomeruli, the distance of the 10 most superficial glomeruli to the renal surface, and the diameter of Bowman's capsules were determined by morphometric analysis. The excretion of total protein, in detail low molecular weight proteins, albumin, and high molecular weight proteins were measured quantitatively in 5 males of each genotype. Systolic blood pressure was determined by a tail-cuff method in conscious rats. Means of each variate of the 12 available genotypes were linearly correlated and demonstrate a close correlation between the amount of superficial nephrons and the observed physiological changes, i.e. the more superficial the glomeruli the higher the urinary protein excretion, especially albumin, and the higher the systolic blood pressure.

Influence of high-dose ketamine on the vascular reactivity of human and porcine isolated coronary artery segments.

The influence of ketamine on the vasomotor effect of histamine and serotonin was studied in isolated human and porcine coronary artery rings. Ketamine (10(-3) mol L-1) attenuated the contractile response to both mediators significantly (P < 0.05 for histamine concentrations of 3 x 10(-5) mol L-1 and above as well as for serotonin concentrations of 3 x 10(-8) mol L-1 and above). This effect of ketamine was observed in intact and endothelial denuded porcine rings (difference n.s.) as well as in coronary arteries from explanted human hearts of patients undergoing heart transplantation. It is concluded that this reduction of the contractile response to histamine and serotonin caused by ketamine is not dependent on the endothelial function (e.g. endothelium-derived relaxing factor).

[Treatment of experimental immune complex nephritis with indomethacin]. / Therapie der experimentellen Immunkomplexnephritis mit Indomethazin.

Functional, histological and immune-histological examination were performed in altogether 64 Wistar-rats, in order to control the effect of a therapy with 2 mg/kg per body weight indomethazine lasting 2 months at the model of an experimental immune complex nephritis. In 44 rats after presensibilisation an immune complex nephritis was performed by intraperitoneal injections with human serum albumin which were repeated three times a week. 24 glomerulonephritis animals and other 20 animals without glomerulonephritis were daily administered indomethazin through a tube probe, the remaining 20 animals with glomerulonephritis served as untreated control groups. The excretion function of the kidney was tested before the beginning of the experiment, 2 weeks after the beginning of the therapy and the regular serum injections, respectively, and before the end of the experiment by determination of the biological half-life period of 131J-hippuran. In every case one day before this the proteinuria during 24 hours was determined. At the end of the experiment the kidneys were examined histologically and immune-histologically. The results showed that indomethazin does not lead to a clear influence on the proteinuria in the immune complex nephritis of the rat. The excretion of 131J-hippuran was significantly restricted, whereas the histological and immune-histological preparations in the animals with foreign serum injections showed clear changes of the glomeruli in the sense of an early stage of the immune complex nephritis, however, they did not show any essential influence by indomethazin. That is, indomethazin had altogether no favourable effect on the immune complex nephritis of the rat.

Geometric magnetic frustration in Ba(2)Sn(2)Ga(3)ZnCr(7)O(22): a two-dimensional spinel based Kagomé lattice.

The properties of a two-dimensional geometrically frustrated magnetic material based on the Kagomé net, Ba(2)Sn(2)ZnGa(3)Cr(7)O(22), are reported. The Kagomé net is fully filled with magnetic ions. A Curie-Weiss theta theta(W) = -312 K is found with a spin glass transition at approximately 1.5 K, indicating strong geometrical magnetic frustration. This compound is the most two dimensional of a structural series with the geometrically frustrated materials ZnCr(2)O(4) and SrCr(8)Ga(4)O(19). The comparison of their properties tests the influence of different degrees of coupling between Kagomé layers on magnetic frustration within a single chemical and structural family.

Ultrastructural localization of Tamm-Horsfall glycoprotein (THP) in rat kidney as revealed by protein A-gold immunocytochemistry.

The present study describes the intracellular distribution of Tamm-Horsfall protein (THP) in rat kidney. The localization was determined by immunoelectron microscopy using the protein A-gold technique. Various fixation and embedding protocols were evaluated for this purpose. Brief perfusion fixation (3 min) with 1% glutaraldehyde and embedding in a highly hydrophilic glycol methacrylate-polyester mixture were most appropriate for antigen-antibody recognition and structural preservation. The overall tissue distribution of THP was evaluated by indirect immunofluorescence microscopy; reaction was strong along the entire thick ascending limb of the loop of Henle (TAL) with enhanced fluorescence in the apical cytoplasm. On the electron microscopic level immunogold labelling was concentrated over numerous membrane-bound vesicles which form a compartment in the apical cytoplasm. The Golgi region was consistently labelled, whereas the plasma membranes revealed only sporadic labelling at the luminal side, and basolateral membranes were mostly unlabelled. Quantitative evaluation of the gold labelling, which was separately done for the inner stripe, outer stripe and cortical TAL, consistently showed the highest particle density in the apical cytoplasm. Middle and basal levels in the TAL cells were only moderately labelled. The results are discussed with respect to the current opinion which describes THP as a membrane glycoprotein. We speculate that the accumulation of THP in the apical vesicular compartment of TAL cells indicates a storage site of the protein, possibly prior to extrusion via exocytosis of the vesicle contents.

[Bacteriologic, histologic and functional studies of the kidney in 5 days' therapy of experimental E. coli pyelonephritis with gentamycin. Comparison with 9 days' therapy]. / Bakteriologische, histologische und Funktionsuntersuchungen der Niere bei 5tägiger Therapie der experimentellen E.-coli-Pyelonephritis mit Gentamycin. Vergleich mit 9tägiger Therapie.

Short-term antibiotic treatment is recommended in infections of the lower urinary tract but its effectiveness is questioned in the upper urinary tract infections. We compared a 5 and a 9 day treatment of experimental E. coli 022 pyelonephritis after unilateral nephrectomy in 127 mal Wistar rats. We used 9 mg gentamycin per kg b.w. twice daily. I131 hippurat excretion was not decreased during the 5 day treatment but was only temporarily diminished during the 9 day treatment. Histologically the severe acute pyelonephritis was decreased after the 9 day treatment but not after 5 days of treatment. Bacteriologically almost all the kidneys were sterile after the 9 day treatment but the majority of the kidneys showed the injected strain of E. coli after the 5 day treatment. The results indicated that the shortened treatment was much less effective in our acute experimental pyelonephritis.

[Kidney function and bacteriological and histological research in the therapy of experimental E. coli pyelonephritis using trimethoprim-sulfamethoxazole (TMP-SMO)]. / Nierenfunktion, bakteriologische und histologische Untersuchungen bei Therapie der experimentellen E.-coli-Pyelonephritis mit Trimethoprim-Sulfamethoxazol (TMP-SMO).

40 uninephrectomized male Wistar rats with an experimental E.-coli-022-pyelonephritis (PN) were treated twice daily for 9 days with 30 mg trimethoprim and 150 mg sulfamethoxazole (TMP-SMO) i.p. Bacteriologically most of the kidneys became sterile. Histologically a significant reduction of the frequency of severe PN was found in the treated group. The biologic half-life of 131I-hippuran indicated a decrease of excretory function which was reversible. Urine osmolality and osmotic clearance were increased after oral water loading in 10 untreated control animals with PN but not in the treated group. The 9 day treatment had a favourable effect bacteriologically, histologically and also on renal function.

[Kidney function in spontaneously hypertensive rats under minoxidil treatment]. / Nierenfunktion bei spontan hypertonen Ratten unter Minoxidilbehandlung.

In 25 spontaneously hypertensive rats the blood pressure was lowered from 192 +/- 11.6 to 130 +/- 11.7 mm Hg and in 26 normotensive Wistar rats from 129 +/- 9.1 to 107 +/- 6.7 mm Hg by applying 1 mg/kg body weight minoxidil twice a day orally. 19 spontaneously hypertensive and 21 normotensive rats served as untreated control groups. During the treatment the glomerular filtration rate, determined by the slope clearance of Tc-99m-DTPA, remained unchanged. Under maximal water diuresis the excretion fraction of sodium was diminished compared with the control data. The Na+ and water reabsorption was increased in the proximal tubules (not an aldosterone effect) only in the treated spontaneously hypertensive rats. The potassium clearance was increased in this group, but decreased in the treated normotensive group. The different reactions of the renal tubular function to the treatment with minoxidil in spontaneously hypertensive compared with normotensive rats were discussed in connection with changes of membrane transport in essential hypertension.

[Acute granulomatous interstitial nephritis with iritis. Possible induction by non-steroidal antiphlogistics]. / Akute granulomatöse interstitielle Nephritis mit Iritis. Mögliche Auslösung durch nicht-steroidale Antiphlogistika.

A 49-year old woman developed non-oliguric acute renal failure accompanied by bilateral acute anterior uveitis, following a three weeks' period of lethargy, anorexia and temporary fever. Kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of lymphocytes and monocytes, as well as multiple perivascular epithelioid granulomas. A substantial improvement of renal function was achieved under treatment with systemic corticosteroids. The uveitis resolved completely under additional topical treatment. During a follow-up period of 9 months, there has been no relapse of nephritis or uveitis. The disease of this patient resembles the so-called TINU syndrome of unknown aetiology. Remarkable features of the present case are the histological diagnosis of granulomatous acute interstitial nephritis in the absence of systemic granulomatous disease, as well as a possible association with the administration of non-steroidal antiinflammatory drugs.

Immunohistochemical localization of a protein fraction derived from rabbit renal papilla.

Studies were carried out to define antigenic characteristics of the rabbit renal collecting duct. Renal papillae of adult rabbits were homogenized, centrifuged, and the 600 X g pellet was extracted with 0.5% Triton X-100 in the presence of 1 M NaCl. The crude extract was fractionated on an anion exchange column (DEAE cellulose). A fraction enriched in acidic proteins that co-purified with a radioactive 150 kd glycoprotein from cultured collecting duct cells (Minuth 1982), was used for immunization of guinea pigs. The antiserum shows the following characteristics as revealed by indirect immunofluorescence on the rabbit kidney: 1) Among all tubular epithelial cells only principal cells of the collecting duct and the connecting tubule cell show immunoreactivity. 2) The antiserum decorates the epithelial-interstitial interface of the whole collecting duct as well as of connecting tubule and thick ascending limb of Henle's loop. 3) There is immunoreactivity of interstitial fibers throughout the kidney. 4) Epithelial cells in a variety of other organs in rabbit did not react with the antiserum. Our data demonstrate an antigenic distinction of both, the connecting tubule cell and the principal cell, discriminating these cells from other tubular epithelial cells including the intercalated cells of the collecting duct system. Furthermore, our findings point to a heterogeneity along the distal nephron with respect to the constituents of the epithelial-interstitial interface.