动脉插管化疗配合膀胱灌注治疗复发性、多发性、表浅性膀胱癌

目的:探讨腹壁下动脉插管化疗(inferior-epigastric artery chemotherapy,IAC)配合吡柔比星(THP)膀胱灌注治疗复发性、多发性和表浅性膀胱癌的疗效。方法:对12例复发性、多发性和表浅性膀胱移行细胞癌患者术后行腹壁下动脉插管化疗3个疗程后,开始行吡柔比星膀胱灌注,每次30 mg,每周1次共12次,以后每2周1次共6次,以后每月1次共6次,第二年重复,第三年每月一次。定期膀胱镜检查,进行随访。结果:12例复发性、多发性、浅表性膀胱移行细胞癌患者,术后随访时间24-48个月,肿瘤复发1例,复发率8.3%。不良反应主要为术后小膀胱,尿路刺激症状和尿常规异常。结论:腹壁下动脉插管化疗配合吡柔比星膀胱灌注治疗复发性、多发性和表浅性膀胱癌的效果明确,疗效满意,患者耐受性好,值得临床推广应用。     

肾盂灌注冲洗对肾脏功能和结构的影响

目的:探讨经皮肾镜碎石术肾盂灌注冲洗压对肾脏结构和功能的影响。方法:建立20头活体猪高压肾盂冲洗模型,建立24F肾造瘘通道,分别在0mmHg(作自身对照,只造瘘不灌注)、150mmHg、200mmHg、250mmHg、300mmHg压力下各冲洗30分钟。术中取肾组织送病理检查,监测肾单位光镜和电镜下的形态学改变;术后5天留取尿标本,应用免疫比浊测定法(ITM)检测尿微量白蛋白(ALB)和β2-微球蛋白(β2-MG);并于术后第5天再次取肾组织行病理检查观察肾单位的形态学改变。结果:所有灌注组术后都出现尿蛋白的增高,术后第1天和术前相比,都有显著差异(P<0.01)。形态学观察:当肾盂灌注冲洗压在150-200mmHg时,光镜下观察见肾小囊腔轻度扩张,压力超过250mmHg,肾小囊腔见红细胞和蛋白渗出物,肾小管扩张。电镜下见肾近曲小管上皮细胞内空泡形成,微绒毛排列杂乱、稀疏、部分微绒毛脱落。结论:肾盂灌注冲洗安全压不应超过200mmHg。     

肾盂灌注冲洗对肾脏功能和结构的影响

目的：探讨经皮肾镜碎石术肾盂灌注冲洗压对肾脏结构和功能的影响。方法：建立20头活体猪高压肾盂冲洗模型,建立24F肾造瘘通道,分别在0mmHg（作自身对照,只造瘘不灌注）、150mmHg、200mmHg、250mmHg、300mmHg压力下各冲洗30分钟。术中取肾组织送病理检查,监测肾单位光镜和电镜下的形态学改变;术后5天留取尿标本,应用免疫比浊测定法（ITM）检测尿微量白蛋白（ALB）和β2-微球蛋白（β2-MG）;并于术后第5天再次取肾组织行病理检查观察肾单位的形态学改变。结果：所有灌注组术后都出现尿蛋白的增高,术后第1天和术前相比,都有显著差异（P〈0.01）。形态学观察：当肾盂灌注冲洗压在150-200mmHg时,光镜下观察见肾小囊腔轻度扩张,压力超过250mmHg,肾小囊腔见红细胞和蛋白渗出物,肾小管扩张。电镜下见肾近曲小管上皮细胞内空泡形成,微绒毛排列杂乱、稀疏、部分微绒毛脱落。结论：肾盂灌注冲洗安全压不应超过200mmHg。     

小儿左肾巨大肾盂积水1例报道

1临床资料患儿,男,6岁。因左侧腰部胀痛及腹部日渐增大15天而来院诊治。患儿体质较差,极易感冒,无其它疾病史,半月前突感左侧腰部胀痛,日趋加剧,腹部逐日增大、纳差、呼吸困难加重,尿液逐渐减少。查体:左上腹部可触及大于成人拳头大小包块。拟诊为左肾积水,左肾肿瘤。行B超检查,静脉肾盂造影及CT平扫检查。B超示左中上腹部可见一囊性肿块,大小约12·4 cm×6·6 cm×6 cm,边缘似见肾实质结构回声,下腹探查膀胱上方稍偏左见一较小囊性肿块,排尿后有缩小趋向,左肾肾门结构及输尿管显示不清,考虑为左肾积水,左肾先天性异常。静脉肾盂造影前摄…     

黄缘盒龟细菌性感染的观察

利用电子显微镜,对一只濒死黄缘盒龟的心、肝、脾、肺、肾、胃和肠道进行了检查,在心、肝、脾、肾均发现一种短杆状细菌感染,受染器官均出现明显的病理变化,如线粒体、高尔基体和内质网均肿大变形. 肺部虽未找到细菌,但发现有明显的病变存在,如细支气管的微绒毛脱落,并可见坏死区. 胃和肠道未发现细菌感染,未见明显的病理改变.     

速尿在肾绞痛患者B超检查中的应用

目的 探讨静脉推注速尿在肾绞痛患者B超检查中的应用.方法对78例肾绞痛患者静脉推注速尿10~20 mg,15~20 min膀胱充盈后行B超检查.结果 78例患者全部膀胱充盈,适合行B超检查,均能清晰显示结石的部位、大小.结论 肾绞痛患者静脉推注速尿能在短时间内充盈膀胱,协助明确诊断,且使用简单、方便、安全,具有一定的临...     

棕熊肾脏的解剖学及光电镜观察

本文观察了棕熊肾脏的大体解剖和光、电镜下的组织结构。棕熊的肾脏为分叶肾,每个肾叶为多面锥体形。光镜下H—E染色切片标本可见肾实质有皮质和髓质两部分。皮质可见清晰的皮质迷路和髓放线结构。肾小体可分出血管极和尿极。血管球由毛细血管缠绕形成,外包有肾小囊。近曲小管管腔面可见刷状缘。在透射电镜下可见到摅过屏障由有孔内皮、基膜及足细胞的次级突起构成。电镜下还可看到近曲小管游离面紧密排列的微绒毛和基底面的质膜内褶结构。     

胎儿重复肾畸形的超声诊断及误诊原因分析

目的:探讨胎儿重复肾畸形的超声诊断的图像特征及误诊原因。方法:回顾分析我院30例经产前超声诊断为重复肾胎儿的超声图像及其临床资料。结果:30例重复肾胎儿中,出生后经手术或临床证实或终止妊娠后经解剖证实的共有27例,出生后经复查双肾正常的胎儿共有3例。27例重复肾胎儿中,单侧、双侧重复肾分别占22、5例,共32侧重复肾,其中合并输尿管扩张、合并输尿管囊肿的分别占14、4侧;合并其他系统气管畸形的胎儿共6侧,其中染色体三体综合征的有4例;出现4例误诊;胎儿重复肾声像图特征:1呈囊肿样改变肾上极占4侧,类圆形无回声区,壁较薄、光滑,与输尿管相通;2肾窦区可见两个不相通的肾盂,分离肾盂占11侧,未与输尿管相通;3肾窦区可见两个不相通肾盂,分离肾盂占14侧,上肾盂或下肾盂相连于输尿管;4 3侧肾窦区见两个不分离的肾盂,肾脏形态拉长,未与输尿管相通。结论:胎儿重复肾的超声声像图特征主要为两个不相通的肾盂;加强在胎儿中晚孕期时做常规多切面扫查,有利于提高对重复肾胎儿的确诊精确率,为临床评估胎儿提供借鉴。     

黄鳝的泌尿系统及其功能

黄鳝腹腔左侧有盲端的中空管状结构,不是退化性腺,而是十分特化的长管囊膀胱。膀胱内壁具大量发达的绒毛,绒毛表面是移行上皮。在绒毛内部或基部有丰富的血管,因此该管囊膀胱不仅可贮存尿液,而且可能对水分等有重吸收作用。在中肾管与膀胱相接处,膀胱腔背侧出现一条明显的纵行皱襞,即在其横切面上观为巨绒毛。巨绒毛形成的原因,主要是中肾管移入膀胱壁所致。中肾管在巨绒毛内移行一程后才开口于膀胱。因此,黄鳝的生殖腺不是一对,而是一个,位于腹腔右侧。黄鳝肾脏细长,呈“丫”,在腹腔背侧,紧贴脊椎。前端为头肾,无肾单位,仅是造血器官。中肾有类似于哺乳类的肾小体,但数量较少,主要分布在肾脏周缘。肾小管包括颈段、初级近曲小管、次级近曲小管、初级远曲小管和次级远曲小管。两中肾管位于两肾叶腹内侧,其上皮间或是假复层柱状上皮,间或是移行上皮。前者含有许多杯状细胞,并可见到顶浆分泌的现象。中肾的肾小管间组织是大量的红细胞样组织,头肾似具有贮存或释放刚成熟的红细胞的组织结构,因此黄鳝肾脏可能是体内主要的造血器官。     

树鼩实验感染基孔肯雅病毒的研究

选用3株基孔肯雅病毒人工感染成年树鼩,进行了病毒血症、抗体动态变化、内脏组织病理改变和病毒在宿主体内定位的研究。结果表明,感染树鼩能产生2～6天的病毒血症。血凝抑制(Hi)抗体第6天产生,第30～50天达高峰:中和(NT)抗体在第10天产生,第30～40天达高峰,二者相关性非常显著(P<0.01)。补体结合(CF)抗体第14天产生,第40～50天为高峰,以后逐渐下降。第8～12天能在其脑、肺、肝、脾和肾等组织查到病毒,经病理检查这些内脏组织呈炎性改变和出血倾向,表明该病毒能侵袭树鼩各主要脏器。试验认为树鼩对基孔肯雅病毒敏感。     

Localization of Mycoplasma pulmonis in mice.

Localization of Mycoplasma pulmonis was examined in mice infected by direct contact with previously infected mice. After contact with infected animals, the organisms were shown to become detectable first in the nasal and oral cavities and trachea on the next day, and then they were recovered from the middle ear and brain after 3 and 4 days, respectively. After 7 days of contact, isolation rates retained to be 100% in the nasal, oral and tracheal cavities, while 95% in the middle ear and brain, 25% in the lung and 20% in the vagina and uterus. The number of colonies was the most numerous from the nasal, uterine and vaginal cavities, followed by the trachea, middle ear, oral cavity, brain and lung in this order, except for a few mice having pneumonic lesions giving a large number of the organisms. The isolation rates with these organs were not changed even after 6 weeks of contact and organisms were never detected from the liver, spleen, kidney and heart. Mice from a naturally infected breeding colony showed similar finding to those sacrificed after 6 weeks of experimental contact.     

Pathogenicity of Hansenula anomala in a model of immunocompromised mice

Systemic infections caused by opportunistic fungi have shown an increased frequency in the past 10 years, particularly in immunocompromised patients. Hansenula anomala is an ascosporogenous yeast of the Ascomycetes class found in the skin, throat, and digestive tract transient normal flora. This study was conducted to compare the pathogenicity of H. anomala and Candida albicans in a model of immunocompromised mice. Thirty-eight Swiss mice were divided into two groups as follows: 30 animals received an intraperitoneal (i.p.) injection of cyclophosphamide (200 mg/kg) four days before the induction of infection with H. anomala (1 × 10⁶ yeasts/mL), and 8 animals received 100 mg/kg of cyclophosphamide at 3-day intervals during 3 weeks before inoculation of 1 × 10⁷ yeasts/mL. All animals were treated with amoxicillin/clavulanic acid (40 mg/kg) four days before induction of infection. A group of mice inoculatd with C. albicans (ATCC 64548) served as control. Tissue samples from the lung, spleen, liver, and kidney for histological and mycologic studies were obtained at necropsy. In each animal, the number of viable yeasts per gram of kidney was determined. The organs most frequently infected by H. anomala were the kidneys and the liver (20%), and the lung (10%). However, in conditions of sustained immunosuppression, H. anomala was found in 65.5% of the organs examined. It is concluded that in an experimental model of immunocompromised mice, the pathogenicity of H. anomala was low. This revised version was published online in August 2006 with corrections to the Cover Date.     

Renal Lysozyme Levels in Animals Developing Proteus mirabilis-Induced Pyelonephritis

In animals developing experimentally induced unilateral pyelonephritis, both the infected kidney (IK) and the contralateral noninfected kidney (NIK) showed an immediate increase in renal lysozyme activity of about 5 days' duration after the unilateral injection of viable Proteus mirabilis into the renal cortex. Lysozyme activities of the NIK were consistently higher than those of the IK. This initial increase was followed by a second increase which lasted throughout the period of observation (17 days), and enzyme activities of the NIK were consistently higher than those of the IK. In saline punctured kidneys of control animals, both the saline punctured kidney (SP) and the non-saline punctured kidney (NSP) showed only the immediate increase in renal lysozyme activity, which persisted until the SP was completely healed. These enzyme activities were less than those observed in the infected animals, but the response of the NSP was greater than that of the SP. Trauma not directed to the kidney does not produce a similar response of renal lysozyme. The elevated renal lysozyme of the NIK could not be shown to protect it from bacterial infection.     

Effect of oral administration of Arabic gum on cisplatin-induced nephrotoxicity in rats

It has been recently postulated from our laboratory that Arabic gum (AG) offers a protective effect in the kidney of rats against nephrotoxicity induced by gentamicin via inhibiting lipid peroxidation. It has also recently shown a powerful antioxidant effect through scavenging superoxide anions. In this study we utilized a rat model of cisplatin (CP)-induced nephrotoxicity to determine its peak time following (1, 2, 5, and 7 days) of a single CP (7.5 mg/kg, i.p.) injection. Also, a possible protective effect of cotreatment with AG (7.5 g/kg/day p.o.) on CP-induced nephrotoxicity was investigated. Biochemical as well as histological assessments were carried out. CP-induced nephrotoxicity was manifested by significant elevations of the functional parameters blood urea, serum creatinine, and kidney/body weight ratio. Maximum toxic effects of CP were observed 5 days after its injection, while it started after day 1 in the biochemical parameters, such as glutathione depletion in the kidney tissue with concomitant increases in lipid peroxides and platinum content. Additionally, severe necrosis and desquamation of tubular epithelial cells in renal cortex as well as interstitial nephritis were observed after 5 days in CP-treated animals. Five days after AG cotreatment with CP did not protect the kidney from the damaging effects of CP. However, it significantly reduced CP-induced lipid peroxidation. These findings suggest that lipid peroxidation is not the main cause of CP-induced nephrotoxicity but it is rather more dependent on other factors such as platinum disposition in renal interstitial tubules.     

Proteinase production and pathogenicity of Candida albicans. II. Virulence for mice of C. albicans strains of different proteinase activity

We have studied the virulence for mice of Candida albicans strains with different proteinase activity in the culture. The mortality rates for mice infected with the type Ia strains, which secrete proteinase whose activity porsisted for a week in vitro, were higher than those infected with the type Ib strains, which secrete proteinase whose activity declined at 2 or 3 days in vitro and the type II proteinase-deficient strains. This was substantiated by the number of colony-forming units (CFU) recovered from kidneys of mice infected with C. albicans. In the kidney tissues of mice infected with the type Ia strains, extensive invasion by fungal cells and the secretion of proteinase were histologically demonstrated, while in those infected with the type Ib and II strains fungal cells were rarely found. However, the mice infected with the type Ib strain NUM 978 were an exception; the recovery of CFU from the kidney was high, but the animals survived longer. Histologically, Candida cells were not colonized but interspersed in the tissue. Type II strain NUM 584 was found to be moderately virulent when infected at a high dose. These observations indicate that the proteinase plays a role in type Ia strains but that other factors are involved in the type Ib or II strains for the establishment of pathogenicity of C. albicans.     

Occurrence of atypical lymphocytes following intravenous injection of Candida albicans in mice

The occurrence of atypical lymphocytes has been observed in the course of experimental acute infection withCandida albicans in mice. In animals injected intravenously with 2.5 × 10⁶ ofCandida albicans cells, an increased number of monocytes was seen in 24 hours. Monocytes showed toxic vacuolisation in most instances in protoplasm and sometimes in the nuclei. Only a few atypical lymphocytes could be seen at that time. In the following days the number of monocytes diminished and the number of atypical lymphocytes increased. After four days atypical lymphocytes constituted frequently over 20 % of white cells. The autopsy of sacrificed or dead animals with the presence of such elevated percentages of atypical lymphocytes showed enlargement of cervical lymphnodes in all animals. In mice infected with 1.4 × 10³ ofCandida albicans cells, no level higher than 12% of atypical lymphocytes was seen. Pictures were returning to normal with only a few atypical lymphocytes present among the animals which survived for two months after infection withCandida albicans.This work was supported partially byDora Kaplan, Joan Sloan, Cathy Cooper. Memorial Funds and the Roon Foundation.     

The cell content of peritoneal exudates following the injection of neutral thiol protease into guinea pigs.

The cell content of the peritoneal exudate was examined 4 days after an intraperitoneal injection of glycogen in uninfected and Paragonimus westermani-infected guinea pigs. In uninfected animals a reduction in macrophage count and an accumulation of granulocytes in the exudate were observed at 3 and 6 hr after an intraperitoneal injection of purified neutral thiol protease from P. westermani metacercariae. No such effect occurred after the enzyme was injected into infected animals. At 9 hr after enzyme injection, vacuoles were found in the cytoplasm of macrophages in uninfected animals.     

Susceptibility and sensitivity of the Siberian lemming and Middendorff's vole to leptospirae of the grippotyphosa serogroup]

Siberian lemmings and Middendorf's voles were found to be susceptible to infection caused by Leptospira of the Grippotyphosa serogroup after the intraperitoneal injection of Leptospira culture, the application of the culture or infected urine to the skin, as well as after Leptospira-carrying animals were placed together with the animals to be infected. The infectious sensitivity of these animals to Leptospira was not high: leptospiruria was observed for 1-3 weeks; in some of the voles leptospiruria was slightly pronounced, whereas other voles had a great number of Leptospira in urine. Antibodies appeared in the blood on day 5 after infection, and their titers increased till days 61-63. In no case could Leptospira be isolated from the kidneys of the animals killed on days 61-83 of the experiment.     

气管插管法接种H5N1病毒感染恒河猴及系统组织病毒检测

目的测试气管插管法接种高致病性禽流感病毒H5N1感染恒河猴的优势效果及疾病分析,为有效感染恒河猴、制备H5N1疾病模型提供实验依据。方法使用人源H5N1病毒液经气管插管滴入恒河猴上呼吸道进行感染,观察感染恒河猴的临床表现,每天采集咽拭子、鼻灌洗液,在感染前2d感染后第3、5、7天采血,感染后第3和7天分别解剖1只恒河猴,取支气管淋巴结、肠淋巴结、鼻甲、心、肝、脾、肺、肾、肠、气管、脑及血液进行病毒分离、核酸载量检测和血常规测定。结果感染后第2天恒河猴出现食欲下降,活动减少,并伴有一过性体温升高,白细胞数和淋巴细胞数下降。咽拭子、鼻灌洗液、肺、心、气管、脑、肝、肾、肠和血液中都能分离到H5N1病毒。结论气管插管法接种H5N1病毒能有效感染恒河猴,并在猴体内多组织中分离、检测到病毒,为制备完善的H5N1模型和检测指标确定、进一步研究H5N1病毒的致病机制等奠定了基础。     

Experimental Infections of Dogs with Type C Influenza Virus

A study was performed to determine if type C influenza infection could be established in dogs as a model for human cases. Mongrel dogs were infected with the Ann Arbor/1/50 strain of type C influenza virus and were examined for clinical symptoms, virus isolation and antibody response. After the first exposure to the virus, all infected animals developed nasal discharge and some of them also showed swelling of the eyelids, and suffusion of the eyes with tears and eye mucus, within 1 to 4 days. The animals showed an increase in hemagglutination-inhibiting (HI) serum antibody, and recovery of the agent from the nasal swabs was successful. The symptoms lasted for as long as 10 days in most infected dogs, which was comparable to our human cases reported previously (Katagiri, S., Ohizumi, A., and Homma, M. 1983. J. Infect. Dis. 48 : 51–56). After the second and third virus exposures at intervals of 50 days, all animals developed the same symptoms as those described above and the rise in antibody titer was evident. The virus could be recovered from four of the six dogs 2 to 5 days after the second exposure and from one dog as late as 10 days after the third exposure. Increases in antibody titer in the IgM fraction were observed after every infection. In control dogs which were mock-infected with UV-inactivated virus, no symptoms were evident and recovery of the virus was not successful although an increase in HI serum antibody titer was seen. These results show that mongrel dogs are sensitive to type C influenza virus and that repeated infections characteristic of human influenza C can be experimentally produced in dogs.