Objective To investigate the protective effect of ulinastatin on erythrocyte in patients undergoing open heart surgery with cardiopulmonary bypass (CPB) .Methods Twenty NYHA class Ⅱ-Ⅲ patients (10 male, 10 female) aged 16-66 yr undergoing elective valve replacement under CPB were randomly divided into two groups: ulinastatin group (U, n = 10) and control group (C, n = 10) . Patients with hepato-renal disease, hyperlipoproteinemia, respiratory dysfunction, blood diseases or pulmonary hypertension were excluded. The patients were premedicated with intramuscular morphine 0.08 mg ? kg-1 and scopolamine 0.006 mg?kg-1 . Anesthesia was induced with midazolam 0.1 mg?kg-1 , fentanyl 10 ?g?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with intravenous midazolam and fentanyl. In group U the patients received ulinastatin 12000 U?kg-1 , of which half was given i.v. before CPB and the other half was added to the priming solution. In control group the patients received normal saline instead of ulinastatin. Blood samples were taken from radial artery before operation (T1), 15 min after initiation of CPB (T2), 15 min (T3) and 30 min (T4) after aortic declamping and 24 h after operation (T5) , for determination of plasma and erythrocyte MDA (P-MDA, E-MDA) levels and erythrocyte SOD (E-SOD) , Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activities.Results The levels of P-MDA and E-MDA were significantly increased at T2_5 in group C but only at T3 and T4 in group U compared to the baseline at T1 . The levels of P-MDA and E-MDA at T2-5 were significantly higher in group C than in group U. The E-SOD, Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase activities significantly increased at T2 compared to baseline at T1 , then gradually decreased in both groups. They were significantly higher at T3-5 in group U than in group C. Conclusion Ulinastatin can alleviate erythrocyte lipid peroxidation and protect erythrocyte during CPB.

No abstract available.
Bone and Bones* ; Dental Implants*

BACKGROUND/AIMS: This study aimed to investigate the prevalence of chronic kidney disease (CKD) and associated risk factors in a high-risk population in Korea. METHODS: A total of 6,045 participants aged ≥ 65 years (mean age, 73.0 ± 5.5) with diabetes or hypertension were enrolled. Participants were screened for CKD, which was defined as the presence of albuminuria (urine albumin-to-creatinine ratio ≥ 30 mg/g) or an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². RESULTS: The prevalence of CKD was 39.6% (women, 40.3%; men, 38.4%). Albuminuria was detected in 22.6% of participants, whereas eGFR < 60 mL/min/1.73 m² was found in 24.6% of participants. The prevalence of CKD by stage was 4.4% for stage 1, 10.4% for stage 2, 23.4% for stage 3, 0.9% for stage 4, and 0.3% for stage 5. Older age, concomitant diabetes and hypertension, higher body mass index, higher systolic and diastolic blood pressure, and higher hemoglobin A1c levels were independently associated with the presence of CKD in multivariate-adjusted analyses that included with age, sex, body mass index, hypertension, diabetes, and smoking. CONCLUSIONS: The prevalence of CKD was very high in the present high-risk Korean population. Our results suggest that a screening method for early detection of CKD in high-risk populations is needed in Korea.
Albuminuria ; Blood Pressure ; Body Mass Index ; Cross-Sectional Studies* ; Epidemiology ; Glomerular Filtration Rate ; Humans ; Hypertension ; Kidney Diseases ; Korea* ; Male ; Mass Screening ; Methods ; Prevalence ; Renal Insufficiency, Chronic* ; Risk Factors ; Smoke ; Smoking

Renal sodium and water reabsorption occurs through epithelial sodium transporters and aquaporin (AQP) water channels in various segments of tubules. We have demonstrated altered regulation of these transporters and channels in various pathophysiological conditions. In nephrotic syndrome and liver cirrhosis, expression of epithelial sodium channels (ENaC) was increased in the late distal convoluted tubule, connecting tubule, and collecting duct. In spontaneously hypertensive rats, the expression of Na,K-ATPase as well as that of ENaC was increased. In contrast, AQP1-3 and sodium transporters was decreased in the kidney from deoxycorticosterone acetate-salt hypertension. In two-kidney, one clip hypertension, the expression of Na,K-ATPase, NHE3, NKCC2 and ENaC subunits was decreased in the clipped kidney while remained unchanged in the contralateral kidney. We have also shown an increased activity of renal atrial natriuretic peptide system in postobstructive natriuresis/ diuresis. In acute kidney injury (cisplatin-, gentamicin- and ischemia/reperfusion-induced), the expression of Na,K-ATPase, NHE3, NKCC2 and AQP1-3 was decreased. The altered regulation of sodium transporters and AQP may be causally related with various kidney diseases and hypertension.
Acute Kidney Injury ; Aquaporins ; Desoxycorticosterone ; Diuresis ; Epithelial Sodium Channels ; Hypertension ; Kidney ; Kidney Diseases ; Liver Cirrhosis ; Nephrotic Syndrome ; Rats, Inbred SHR ; Sodium

Renal sodium and water reabsorption occurs through epithelial sodium transporters and aquaporin (AQP) water channels in various segments of tubules. We have demonstrated altered regulation of these transporters and channels in various pathophysiological conditions. In nephrotic syndrome and liver cirrhosis, expression of epithelial sodium channels (ENaC) was increased in the late distal convoluted tubule, connecting tubule, and collecting duct. In spontaneously hypertensive rats, the expression of Na,K-ATPase as well as that of ENaC was increased. In contrast, AQP1-3 and sodium transporters was decreased in the kidney from deoxycorticosterone acetate-salt hypertension. In two-kidney, one clip hypertension, the expression of Na,K-ATPase, NHE3, NKCC2 and ENaC subunits was decreased in the clipped kidney while remained unchanged in the contralateral kidney. We have also shown an increased activity of renal atrial natriuretic peptide system in postobstructive natriuresis/ diuresis. In acute kidney injury (cisplatin-, gentamicin- and ischemia/reperfusion-induced), the expression of Na,K-ATPase, NHE3, NKCC2 and AQP1-3 was decreased. The altered regulation of sodium transporters and AQP may be causally related with various kidney diseases and hypertension.
Acute Kidney Injury ; Aquaporins ; Desoxycorticosterone ; Diuresis ; Epithelial Sodium Channels ; Hypertension ; Kidney ; Kidney Diseases ; Liver Cirrhosis ; Nephrotic Syndrome ; Rats, Inbred SHR ; Sodium

Usual interstitial pneumonia (UIP) is one type of idiopathic interstitial pneumonia, characterized by its poor prognosis and gradual deterioration of clinical course. So it is important to distinguish UIP from other interstitial pneumonia. Defi nitive histological diagnosis of UIP requires lung biopsy. The criteria for diagnosis of UIP in the absence of a surgical lung biopsy were recently defi ned. We report a case of 75-year-old man who was diagnosed as bronchopneumonia with chief complaint of fever, dyspnea on fi rst visit, then fi nally diagnosed as UIP through the remaining of chest abnormality after treatment.
Aged ; Biopsy ; Bronchopneumonia ; Dyspnea ; Fever ; Humans ; Idiopathic Interstitial Pneumonias ; Idiopathic Pulmonary Fibrosis ; Lung ; Lung Diseases, Interstitial ; Prognosis ; Thorax

Purpose: We report a conjunctival myxoid stromal tumor (CMST), which is a rare benign conjunctival mass.Case summary: A 70-year-old man with a history of hypertension and cerebral infarction visited our hospital with a clear mass ofthe conjunctiva in the left eye. His visual acuity was normal, and no other abnormal findings were noted. A transparent, yellowish,jelly-like, 4 × 3 mm mass with a clear border between it and the surrounding tissue was found at the lower temporal part of theconjunctiva. The mass was mobile and there was no pain or tenderness. Excisional biopsy was performed on the mass.Histopathological examination showed reticular fibers located in an abundant mucus-like matrix with fusiform, astrocytic andscattered inflammatory cells. Immunologic examination revealed CD34 positive and SMA negative findings and we diagnosedthe mass as a CMST. Conclusions When there is a clear pale yellow to light pink mass with a clear border and a distinct vascular distribution or pigmentationin the conjunctiva, the possibility of a CMST must be considered. Histopathologic and immunologic examinationshould be performed through biopsy and evaluation for systemic disease should be performed as necessary.

Nitric oxide (NO) and atrial natriuretic peptide (ANP) may induce vascular relaxation by increasing the production of cyclic guanosine monophosphate (cGMP), an important mediator of vascular tone during sepsis. This study aimed to determine whether regulation of NO and the ANP system is altered in lipopolysaccharide (LPS)-induced kidney injury. LPS (10 mg.kg-1) was injected in the tail veins of male Sprague-Dawley rats; 12 hours later, the kidneys were removed. Protein expression of NO synthase (NOS) and neutral endopeptidase (NEP) was determined by semiquantitative immunoblotting. As an index of synthesis of NO, its stable metabolites (nitrite/nitrate, NOx) were measured using colorimetric assays. mRNA expression of the ANP system was determined by real-time polymerase chain reaction. To determine the activity of guanylyl cyclase (GC), the amount of cGMP generated in response to sodium nitroprusside (SNP) and ANP was calculated. Creatinine clearance decreased and fractional excretion of sodium increased in LPS-treated rats compared with the controls. Inducible NOS protein expression increased in LPS-treated rats, while that of endothelial NOS, neuronal NOS, and NEP remained unchanged. Additionally, urinary and plasma NOx levels increased in LPS-treated rats. SNP-stimulated GC activity remained unchanged in the glomerulus and papilla in the LPS-treated rats. mRNA expression of natriuretic peptide receptor (NPR)-C decreased in LPS-treated rats, while that of ANP and NPR-A did not change. ANP-stimulated GC activity reduced in the glomerulus and papilla. In conclusion, enhancement of the NO/cGMP pathway and decrease in ANP clearance were found play a role in the pathogenesis of LPS-induced kidney injury.
Animals ; Atrial Natriuretic Factor ; Creatinine ; Guanosine Monophosphate ; Guanylate Cyclase ; Humans ; Immunoblotting ; Kidney ; Male ; Neprilysin ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Nitroprusside ; Plasma ; Rats ; Real-Time Polymerase Chain Reaction ; Receptors, Peptide ; Relaxation ; RNA, Messenger ; Sepsis ; Sodium ; Veins

The present study was aimed to determine whether nitric oxide (NO) plays a role in the regulation of aquaporin (AQP) channels in the kidney. Male Brattleboro rats (250~300 g body weight) were used. The experimental group was treated with N(G)-nitro-L-arginine methyl ester (L-NAME, 100 mg/L drinking water) for 1 week, and cotreated with indomethacin (5 mg/kg, twice a day, i.p.) for the last two days. Control groups were treated with either L-NAME for 1 week, indomethacin for 2 days, or without any drug treatment. The abundance of AQP1, AQP2 and AQP3 proteins in the kidney was determined by Western blot analysis. Indomethacin downregulated AQP channels, whereas L-NAME by itself showed no significant effects on them. The indomethacin-induced downregulation of AQP2 and AQP3 was significantly blunted in L-NAME-treated rats, while that of AQP1 was not affected. These results suggest that endogenous NO, when stimulated, may downregulate AQP channels that are specifically regulated by AVP/cAMP pathway in the kidney.
Animals ; Aquaporin 3 ; Aquaporins* ; Blotting, Western ; Down-Regulation* ; Drinking ; Humans ; Indomethacin ; Kidney ; Male ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Rats* ; Rats, Brattleboro

Sodium retention is a hallmark of nephrotic syndrome. We investigated whether sodium retention is associated with changes of natriuretic peptide system at different stages (i.e., a sodium retaining stage and a compensatory stage) of nephrotic syndrome. At day 7 after PAN (puromycin aminonucleoside) injection, the urinary excretion of sodium was decreased, along with the development of ascites and positive sodium balance. The plasma and urinary ANP (atrial natriuretic peptide) immunoreactivities were increased. ANP mRNA expression was increased in the heart and kidney, whereas that of NPR (natriuretic peptide receptor)-A and NPR-C mRNA was decreased in the kidney. The expression of NEP was decreased in the kidney. At day 14, urinary excretion of sodium did not differ from the control. The plasma ANP level and heart ANP mRNA expression returned to their control values. The expression of ANP mRNA in the kidney was increased in association with increased urinary ANP immunoreactivities. The expression of NPR-A in the kidney became normal, whereas that of NPR-C kept decreased. The expression of NEP (neutral endopeptidase) remained decreased. These findings suggest that the increased renal ANP synthesis in association with decreased metabolism via NEP and NPR-C may play a compensatory role against the development of sodium retention in nephrotic syndrome. The decreased of NPR-A expression in the kidney may contribute to the ANP resistance at day 7. The subsequent recovery of NPR-A expression may play a role in promoting sodium excretion in later stage (at day 14).
Animals ; Ascites ; Atrial Natriuretic Factor ; Heart ; Kidney ; Nephrotic Syndrome ; Plasma ; Puromycin ; Puromycin Aminonucleoside ; Rats ; Retention (Psychology) ; RNA, Messenger ; Sodium