Removal of mercury (II) from aqueous solution by activated carbon obtained from furfural.

The adsorption of Hg(II) from aqueous solution at 293 K by activated carbon obtained from furfural is studied. The carbon is prepared by polymerization of furfural following carbonization and activation of the obtained polymer material with water vapor at 800 degrees C. Adsorption studies of Hg(II) are carried out varying some conditions: treatment time, metal ion concentration, adsorbent amount and pH. It is determined that Hg(II) adsorption follows both Langmuir and Freundlich isotherms. The adsorption capacity of the carbon is 174 mg/g. It is determined that Hg(II) uptake increases with increasing pH. Desorption studies are performed with hot water. The percent recovery of Hg(II) is 6%.

Lupus-specific kidney deposits of HSP90 are associated with altered IgG idiotypic interactions of anti-HSP90 autoantibodies.

Previous studies have shown that autoantibodies to heat shock protein 90 (HSP90) are elevated in a significant proportion of patients with systemic lupus erythematosus (SLE) who are more likely to have renal disease and a low C3 level. Using samples from 24 patients, we searched for glomerular deposits of HSP90 in renal biopsy specimens from seven patients with lupus nephritis and 17 cases of glomerulonephritis from patients without SLE. Positive glomerular immunofluorescent staining for HSP90 was observed in six of seven cases of SLE and positive tubular staining in two of seven SLE patients. The staining for HSP90 was granular in nature and was located in subepithelial, subendothelial and mesangial areas. None of the non-SLE renal biopsies revealed positive staining for HSP90 deposition. Further we showed the presence of anti-HSP90 IgG autoantibodies in IgG from sera of patients with SLE as well as in normal human IgG (IVIg). In normal IgG this autoreactivity could be adsorbed almost completely on F(ab')2 fragments from the same IgG preparation, coupled to Sepharose and could be inhibited by the effluent obtained after subjecting normal IgG to HSP90 affinity column. These findings indicate that anti-HSP90 natural autoantibodies are blocked by idiotypic interactions within the IgG repertoire. Unlike natural autoantibodies, anti-HSP90 IgG from SLE patients' sera were only moderately adsorbed on F(ab')2 fragments of normal IgG. These results demonstrate that immunopathogenesis of lupus nephritis is associated with HSP90 (as an autoantigen) and that the pathology is associated with altered idiotypic regulation of the anti-HSP90 IgG autoantibodies.

[Secondary systemic amyloidosis A combined with primary glomerulonephritis and systemic diseases]. / Vtorichna sistemna amiloidoza A v suchetanie s purvichni glomerulonefriti i sistemni zaboliavaniia.

Amyloidosis is characterized by organic dysfunction as a result of deposition of amyloid substance in the walls of the small blood vessels and extracellularly in different organs. The involvement of the kidneys in systemic amyloidoses AL and AA has irreversible evolution to renal failure. The object of the study was to determine the prevalence of the secondary (reactive) systemic amyloidosis AA in combination with primary glomerulonephritis (PGN) and lupus nephropathy (SLE) and to create diagnostic approach for its early detection. The prevalence of amyloidosis among the renal biopsies in the Department of Nephrology by the Chair of Internal Diseases for the period 1981-1988, retrospectively, is 4% (in 11 out of 268 biopsies). For the period 1989-1996, prospectively, by directed quest, amyloid was found in 35 out of 269 renal biopsies (11%). For differentiation of AA preliminary treatment of the histologic material with KMnO4 was used. In 20 cases amyloidosis appeared as independent finding in the renal tissue, while in 15 it was combined with histologic picture of immune nephropathies: in 11 with primary glomerulonephritis (7% out of 155 PGN) and in 4 with systemic lupus erythematodes (11% out of 31 SLE). The combination of PGN with AA was almost always associated with chronic infections. It was most often observed in diffuse membranous GN or FSGSH. Our studies demonstrate increased prevalence of amyloidosis among the renal biopsies during the last years, which could be due to directed quest, but it could be a real fact, too. We suggest staining for amyloid in all renal biopsies, as well as its directed quest in mucosae of the gastro-intestinal tract and by aspiration of the abdominal subcutaneous fatty tissue in the patients with primary GN or systemic diseases.

Role of fibronectin in immune glomerulonephritis.

There is already a considerable amount of evidence suggesting that fibronectin (Fn) plays an important role in the pathogenic process in some forms of glomerulonephritis (GN). It has been postulated that Fn may participate in the progression or regression of glomerular diseases. The Fn is presented in the kidney as a normal component of the mesangium, and it is increased in the expanded mesangium in various forms of GN. This paper reports our efforts to investigate the role of Fn in plasma and kidney in patients with GN. Using monoclonal antibodies against human Fn in the ELISA and immunohistoperoxidase techniques to evaluate Fn, we investigated its quantity in connection with clinical state and morphological findings. We studied 93 patients with GN and 26 renal biopsies. The patients with active forms of mesangial proliferative, membranoproliferative and membranous GN showed increased plasma Fn, and the highest levels were in patients with nephrotic syndrome. Increased tissue Fn correlated with mesangial expansion and with IgG and C3 deposits. We speculate on possible mechanisms of the involvement of Fn in human chronic GN.

[Mesangial C3-glomerulonephritis]. / Mezangialen C3-glomerulonefrit.

12 patients with mesangial C3-glomerulonephritis, 7 women and 5 men, aged 16-42, mean age 29.7 years, were followed up for 1-18 years, mean time 5.7 years. The disease was manifested most often by macroscopic hematuria or low degree proteinuria. Single patients had arterial hypertension. In only one patient there was a nephrotic syndrome. For the period of observation, impairment of the renal function was found in none of the patients.

[Drug disease related to the use of nonsteroidal anti-inflammatory agents]. / Lekarstvena bolest vuv vruzka s upotreba na nesteroidni protivovuzpalitelni sredstva.

A case is presented of a woman with drug disease related to the use of non-steroid antiinflammatory drugs. The disease was manifested by combined impairment of several organs and systems: arthralgia, febrility, anorexia, fibroscopic data for superficial gastritis, iron deficiency anemia, angiospastic syndrome, impairement of the liver and the kidneys. The renal lesions differed from the usual for such cases tubulointerstitial changes and a mild mesangioproliferative glomerulonephritis without manifested clinical symptoms was found. Discontinuance of the treatment with the non-steroid antiinflammatory drugs lead to the disappearance of the complaints and normalization of all laboratory indices.

[Hypokalemic nephropathy from the chronic use of diuretics and laxatives]. / Khipokaliemichna nefropatiia pri khronichna upotreba na diuretitsi i slabitelni lekarstva.

The cases of two women with morphologically proved hypokalemic nephropathy related to chronic use of diuretics and purgatives are reported. The disease has been detected because of reduced urine quantity, increase of body mass and edema. The serum protein level is low. Sodium and potassium clearances are reduced. There is a metabolic alkalosis, serum renin and aldosterone levels are elevated. The histologic picture is typical with tubule cell vacuolization and sclerotic changes in the interstitium. The timely discovery of the cause of the disease leads to the discontinuance of the use of diuretics and purgatives and to complete recovery.

Nephrotoxic effect of the specific brain serotonin depletor para-chlorophenylalanine.

Brain serotonin depletion induced by peripheral parachlorophenylalanine (pCPA) is frequently used to evaluate the role of the central serotoninergic system in the regulation of a number of physiological functions, including the secretion of renin by the kidney. We found that due to the treatments applied in the protocol used for the investigation of pCPA effect on renin and vasopressin secretion in rats (300 mg/kg i.p. 64 and 40 h before sacrifice) renal injury was induced as well. Typical changes indicating acute renal failure were observed--an initial polyuria, natriuresis and body mass loss, succeeded by oliguria, decreased glomerular filtration rate, and salt and creatinine retention. Morphological changes in the glomeruli included a thickening of the basal membranes, a confluence and a reduced number of podocyte pedicles. A slight to moderate granular degeneration was observed in epithelial cells of the proximal convoluted tubule, combined with mitochondrial changes--an increase in number, matrix disorganization, and myelin degeneration. In conclusion, the renal function changes after i.p. pCPA may be due not to brain serotonin depletion-alone, but also to nephrotoxic effect.

[Role of hepatitis B virus infection in chronic glomerulonephritis]. / Le rôle de l'infection par le virus de l'hépatite B dans les glomérulonéphrites chroniques.

This study included 60 patients suffering from chronic glomerulonephritis (GN), confirmed by punch biopsy of the kidney. HBs antigen (Ag) was found in the sera of 5 patients, whereas anti-HBs and/or anti-HBc antibodies were found in 3 others. Of the 139 subjects carrying HBsAg or anti-HBc antibodies 117 suffered from chronic liver disease and 3 from chronic GN. Of the 11 patients afflicted with chronic GN and one with a hepatitis B virus (HBV) infection 9 had GN with IgA deposits and the other 2 had membranoproliferative GN. The renal tissue of these 11 patients was examined for the presence of HBs. HBc and HBe antigens using monoclonal antibodies. Virus particles were unsuccessfully sought by electron microscopy. It is possible that, in some patients infected with HBV and afflicted with chronic liver disease, the IgA deposits in the glomeruli result from the perturbed liver metabolism.

["De novo" glomerulonephritis in the transplanted kidney]. / Glomerulonefrit "de novo" v transplantiran bubrek.

A case of an 11-year-old boy is presented who had developed a severe nephrotic syndrome with massive edema, ascites, hydrothorax (protein loss with the urine up to 19 gr/24 h) 7 months after a successful kidney transplantation from a 16 years dead donor and a successfully treated crisis of transplant rejection by a good tissue compatibility. The needle renal biopsy revealed membranous glomerulonephritis I-II histological stage with data of rejection crisis by a basic disease of vesicoureteral refluxes and chronic pyelonephritis. Treatment with heparin, dipyridamole, human albumin, diuretics, sandimun and prednisolone led to a substantial improvement--mastered nephrotic syndrome, lowered to 1 g/24 h proteinuria and normal renal function.

[Indirect immunofluorescence in bladder tumors]. / Indirektna imunofluorestsentsiia pri tumorite na pikochniia mekhur.

Fourty three patients with transient-cell bladder carcinoma had complete investigations performed for determining maximal number of parameters characterizing the tumors--gross appearance (mode of growth and dissemination, size, multiplicity, localization, infiltration stage, differentiation grade), cytophotometric data (ploidy and proportion of cells in S-phase). In direct immunofluorescence was applied as diagnostic test for assessing the immune response of the organism to its own tumor. Information on the immune response was also obtained by determination of the IgA and IgG levels in the patients' sera. A clearcut correlation was found between tumor malignancy parameters and immunofluorescence intensity. Inferences were made on the value of indirect immunofluorescence for the diagnosis, choice of treatment and prognosis of bladder tumors. The trends in the further searches in the immunology of these tumors are outlined.

[Echographic diagnosis of diffuse kidney diseases]. / Ekhografska diagnostika na difuznite bubrechni zaboliavaniia.

In 24 patients with chronic glomerulonephritis the echographic findings were compared with some basic parameters established by histomorphologic examinations. In the echographic examinations 4 degrees of echogenicity were used (Rosenfield, Hrisak). The conclusion is that there is no typical echographic image for the different morphologically defined renal diseases. The cortical echogenicity depends on the degree of interstitial infiltration, the fibrous and sclerotic changes. The echographic image of the kidney is a mixed reflection of the histomorphologic changes of the glomeruli, tubules and interstice. A long-standing hypertension affects the echographic image by increasing the cortical echogenicity. A careful and thorough echographic examination of patients with chronic glomerulonephritis is obligatory but the basic diagnostic method is the needle renal biopsy.

[Clinical, laboratory and morphological characteristics of mesangioproliferative glomerulonephritis]. / Klinichni, laboratorni i morfologichni osobenosti na mezangioproliferativnite glomerulonefriti.

The mesangioproliferative glomerulonephritis (MPGN) is the most frequent morphological type of primary glomerulonephritis and it was found in 42.7% of the patients studied. The MPGN is not a single nosologic entity which is proved by the immunofluorescent findings, clinical and laboratory characteristics. Several immunofluorescent types with characteristic clinico-laboratory constellation and different etiopathogenesis could be defined. The most clearly defined types of MPGN are those with leading IgA and IgM precipitates. The similar immunofluorescent findings, clinico-laboratory characteristics, course and susceptibility to symptomatic and pathogenetic treatment in MPGN with leading IgG and C3 precipitates lead to the suggestion that there may exist different "phase" states in the course of the different types of MPGN. In spite of some characteristic differences in the symptomatology and course of the different types of MPGN their differentiation is possible only by kidney biopsy.

[Acute interstitial nephritis following the use of gentamycin]. / Ostur interstitsialen nefrit sled prilozhenie na gentamitsin.

The authors describe a patient that developed acute interstitial nephritis after gentamycin administration. The disease progressed with general lassitude, subfebrile temperature, oliguria, and increased nitrogen bodies in blood. After a short oliguric stage, polyuria followed and the renal function was completely normalized one month after the onset of the disease.

[Incidence of chronic glomerulonephritis and its hypertonic terminal-stage syndrome and the severity of the cardiovascular changes among 9015 autopsied patients over 14]. / Chestotata na khronichniia glomerulonefrit, na khipertonichniia mu sindrom v terminalniia stadii i tezhestta na surdechno-sudovite promeni sred 9015 autopsirani nad 14 godini.

Chronic glomerulonephritis (CGN) is responsible for 105 (1.16%) of all 9015 necropcies in a multi-specialized hospital but it occupies the third place after chronic pyelonephritis and diabetic glomerulosclerosis 9.20 per cent. In 91.4 per cent of the deceased of CGN arterial hypertension (AH) had been concomitant, with an average duration, according to anamnestic data, 6.28 years with a mainly light and moderate hypertrophy of left ventricle. Those that died of CGN without AH lived 9.20 years, on the average, wore than those with hypertension. In about 30 per cent of CGN with AH, the hypertension contributed to the lethal end prior to the terminal uremia--from cardiac insufficiency--25 per cent and cerebrovascular stroke 4.16 per cent. The significantly poorer atherogenesis in aorta and coronary and cerebral arteries is worth mentioning in case of CGN with hypertension as compared with the essential hypertension. (The deceased examined were not dialyzed). That atherogenesis is even poorer than hypertension of chronic pyelonephritis.