Is solitary kidney really more resistant to ischemia? An experimental canine study.

PURPOSE: To our knowledge there are no evidence-based medicine data to date to critically judge the vulnerability of a solitary kidney to warm ischemia compared to paired kidneys. MATERIALS AND METHODS: Ten dogs were exposed to open right nephrectomy to create a solitary kidney model (group 1). Ten dogs with both kidneys were considered group 2. All dogs underwent warm ischemia by open occlusion of the left renal artery for 90 minutes. Dogs were sacrificed at different intervals (3 days to 4 weeks). All dogs were reevaluated by renogram before sacrifice and histopathology of the investigated kidney. The proinflammatory markers CD95 and tumor necrosis factor-α were assessed using real-time polymerase chain reaction. RESULTS: In group 1 clearance decreased by 20% at 1 week but basal function was regained starting at week 2. In group 2 clearance decreased more than 90% up to week 2. Recovery started at week 3 and by 4 weeks there was a 23% clearance reduction. Histopathological examination in group 1 revealed significant tubular necrosis (60%) at 3 days with regeneration starting at 1 week. In group 2 there was more pronounced tubular necrosis (90%) with regeneration starting at 2 weeks. The expression of proinflammatory markers was up-regulated in each group with higher, more sustained expression in group 2. CONCLUSIONS: Solitary kidney in a canine model is more resistant to ischemia than paired kidneys based on radiological, pathological and genetic evidence.

A New Strategy for Trichomonas Testing Female Adolescents in the Emergency Department.

STUDY OBJECTIVE: Sensitive trichomonas diagnostic testing has become available, including nucleic acid amplification tests (NAATs) and a rapid antigen test. The study purpose was to determine if adding sensitive trichomonas testing to routine female sexually transmitted infection (STI) evaluations would increase trichomonas identification and treatment. DESIGN: Two study time periods. Study time 1 (T1) was used for a retrospective review. Study time 2 (T2) was used for a prospective study. SETTING: Emergency Department. PARTICIPANTS: Symptomatic female patients aged 13-20 years (N = 447). INTERVENTIONS: Implementation of routing trichomonas testing in the Emergency Department during T2. MAIN OUTCOME MEASURES: Trichomonas diagnosis and treatment rates were compared during T1 and T2. RESULTS: During T1 31 of 234 of eligible patients (13%) were trichomonas-tested. Laboratory-confirmed trichomonas was identified in 3 of 234 (1.3%). During T2, 212 of 213 of eligible patients (99.5%) were trichomonas-tested; 39 of 212 tested trichomonas-positive (18.4%); 29 of 212 tested rapid trichomonas antigen test-positive (13.6%; P < .001), and 33 of 188 tested trichomonas NAAT-positive (15.5%; P < .001). Trichomonas treatment was given to 3 of 3 laboratory-confirmed trichomonas cases during T1 (100%) compared with 37 of 39 during T2 (95%; P = .688). During T1, 14 of 17 women who received trichomonas treatment (82.4%) did not have a laboratory-confirmed trichomonas diagnosis and during T2 13 of 52 women without a laboratory-confirmed trichomonas diagnosis (25%) were treated for trichomonas (P < .001). Rapid trichomonas antigen tests and trichomonas NAATs were concordant in 178 of 188 patients (94.6%). CONCLUSION: Incorporating trichomonas rapid antigen tests and NAATs into routine female adolescent STI testing significantly increased the number of laboratory-confirmed adolescent trichomonas diagnosis and treatment and are useful Emergency Department STI screening tools.

Ochratoxin A induces karyomegaly and cell cycle aberrations in renal tubular cells without relation to induction of oxidative stress responses in rats.

Ochratoxin A (OTA) is a renal carcinogen that induces karyomegaly in target renal tubular cells of the outer stripe of the outer medulla (OSOM). This study was performed to clarify the relationship between oxidative stress and the karyomegaly-inducing potential involving cell cycle aberration of OTA in the OSOM. Rats were treated with OTA for 28 days in combination with enzymatically modified isoquercitrin (EMIQ) or α-lipoic acid (ALA) as antioxidants. OTA increased the mRNA levels of the antioxidant enzyme-related genes Gpx1, Gpx2, Gstm1 and Nfe2l2, but did not increase the levels of Gsta5, Keap1, Nqo1, Hmox1, Aldh1a1, Por, Prdx1 and Txn1. OTA also did not change the levels of thiobarbituric acid-reactive substances, glutathione disulfide/reduced glutathione, and the immunoreactive tubular cell distribution of nuclear factor erythroid 2-related factor 2 in the OSOM. Co-treatment with EMIQ or ALA did not cause any changes in these parameters. As previously reported, OTA increased cell proliferation activity, apoptosis and immunohistochemical cellular distributions of molecules suggestive of induction of DNA damage and cell cycle aberrations involving spindle checkpoint disruption and cell cycle arrest. However, co-treatment with EMIQ or ALA did not suppress these changes, and ALA co-treatment increased the cell proliferation activity induced by OTA. These results suggest that OTA facilitates cell cycling involving cell cycle aberrations and apoptosis as a basis of the mechanism behind the development of karyomegaly and subsequent carcinogenicity targeting the OSOM, without relation to induction of oxidative stress. On the other hand, ALA may promote the OTA-induced proliferation of carcinogenic target cells.

Protection against renal ischaemia/reperfusion injury: A comparative experimental study of the effect of ischaemic preconditioning vs. postconditioning.

OBJECTIVE: To compare the effect of ischaemic preconditioning (Ipre) vs. ischaemic postconditioning (Ipost) on renal ischaemia/reperfusion (I/R) injury in rats. MATERIALS AND METHODS: In all, 120 male Sprague-Dawley rats were classified into four groups of 30 rats each, designated sham, control, Ipre and Ipost. Renal function, including serum creatinine, blood urea nitrogen (BUN), creatinine clearance (CrCl), fractional Na excretion (FENa) and renal histopathology were measured at 2, 24 and 48 h after ischaemia. Markers of lipid peroxidation (malondialdehyde, MDA), superoxide dismutase (SOD) and reduced glutathione (GSH) were measured in kidney tissues during the same intervals. RESULTS: Ipre caused a significant improvement in renal function, as indicated by a significant decrease in serum creatinine, BUN and FENa, with a significant increase in CrCl. However, Ipost caused no significant improvement in renal function. Morphologically Ipre caused a marked significant improvement in the renal tubular damage score compared to Ipost. Also, Ipre caused a significant decrease in MDA, and significant increase in GSH and SOD when compared to Ipost. CONCLUSION: Ipre is more potent than Ipost for improving the renal injury induced by I/R. Ipre caused a marked improvement in renal function and morphology, while Ipost caused a minimal improvement in morphology only. Moreover, Ipre caused a marked and significant reduction in oxidative stress in kidney tissues, while Ipost caused a minimal reduction.