Kidney stone is a highly recurrent disease in the urinary tract system. Most kidney stones are calcium stones, usually consisting of either calcium oxalate or calcium phosphate. Supersaturation of soluble calcium, oxalate, phosphate, and citrate in the urine is the basis for calcium stone formation. Genetics, diet, low physical activity, and individual habits contribute to the formation of kidney stones. In this review, the associations of the risk of kidney stones with oxalate consumption and some individual habits, such as smoking, alcohol drinking, and opium consumption, are summarized.
Humans ; Calcium/urine* ; Oxalates ; Kidney Calculi/urine* ; Calcium Oxalate/urine* ; Habits

Acute Disease ; Humans ; Oxalates ; poisoning

Extracorporeal shock wave lithotripsy(ESWL) is becoming treatment of choice for most upper tract calculi, and especially EDAP made piezoelectric E. S. W. L. can treat kidney, upper ureter and lower ureter stones. We present the results of 245 consecutive treatments performed between May, 1987 and February, 1988 with piezoeletric shock wave lithotriptor. 1. The oldest patient was age of 78 and the youngest patient was age of 15 and there was no contraindication due to other systemic disease. 2. No anesthesia were required and only narcotics were given for pain that induced from shock wave, but one, 18 years old female with renal stone was treated with ketamine. 3. Response rate revealed that complete response was 174 cases (71%), partial response was 63 cases (25.7%) and non-response was 8 cases (3.3%). 4. In complete response cases, average requirement of shock wave storages were noted that renal stone was 323, upper ureter stone was 562 and lower ureter stone was 377 and then the shock wave storage was increase depend upon the location of the stone, such as kidney, lower ureter stone and upper ureter stone in priority. 5. Staghorn calculi, multiple renal stones, caliceal diverticular stones, renal stones with migration into the ureter while treatment, impact ureter stones, ureter stones with larger than 2.5 cm and obesity were poor response factors. 6. We adopted push up (9 cases), double J stent (6 cases), stone basket (6 cases), URS.(2 cases) and nephrostomy (1 cases) as auxiliary procedure. 7. Chemical composition of treated stones were that calcium oxalate and phosphate mixed stone8 were 50.6%, calcium oxalates 33.5%, struvites 10.5%, uric acid 3.9% and calcium phosphate 1.3%. 8. We experienced 11 cases (4.4%) of complications: 5 cases of stone street, 3 cases of post ESWL flank pain, 1 case of high fever, 1 case of sepsis and 1 case of perirencal hematoma. 9. As a result, we suggest that we should consider stone size, location, situation of patient and history of stone surgery for good effectiveness from treatment with E.S.W.L.
Adolescent ; Anesthesia ; Calcium ; Calcium Oxalate ; Calculi ; Female ; Fever ; Flank Pain ; Hematoma ; Humans ; Ketamine ; Kidney ; Lithotripsy* ; Narcotics ; Obesity ; Oxalates ; Sepsis ; Shock* ; Stents ; Ureter ; Uric Acid ; Urinary Calculi ; Urolithiasis*

PURPOSE: Recently, the whole DNA sequence of Bacillus subtilis (B. subtilis) was identified, revealing the existence of the YvrK gene encoding a 43 kD oxalate decarboxylase (OXDC), which degrades oxalate by a simple pathway. The objective of this study was to develop recombinant Escherichia coli (E. coli) expressing the Yvrk gene from B. subtilis. MATERIALS AND METHODS: After the extraction of total DNA from B. subtilis, the YvrK gene was cloned by polymerase chain reaction. The cloned DNA encoding OXDC was inserted into the pBAD/gIII-A vector, downstream of the L-arabinose promotor. The plasmid vector was transformed into TOP 10 E. coli, and the transformants were selected with ampicillin. The recombinant E. coli, named pBy, was then analyzed by DNA sequencing and Western blot. To evaluate the oxalate-degrading function of pBy, pBy was cultured in LB broth containing oxalate, and then the amount of oxalate in the medium was assessed. The oxalate-degrading activity of homogenates of pBy was evaluated. RESULTS: DNA sequencing showed the successful transformation of the YvrK gene into TOP 10 E. coli. Western blot analyses showed that pBy expressed OXDC. pBy removed oxalate during the overnight culture in oxalate-containing LB broth, and the homogenate of pBy degraded 90% of oxalate under acidic conditions. CONCLUSIONS: A recombinant E. coli expressing the YvrK gene was successfully produced. The bacteria showed potent oxalate-degrading activity. The results of this study will provide a solution to the treatment of calcium oxalate stones and hyperoxaluria, for which there are few medical treatment modalities.
Ampicillin ; Arabinose ; Bacillus subtilis ; Bacteria ; Base Sequence ; Blotting, Western ; Calcium Oxalate ; Carboxy-Lyases ; Clone Cells ; DNA ; Escherichia coli ; Hyperoxaluria ; Oxalates ; Plasmids ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo establish a method of high-performance liquid chromatography (HPLC) for determining the urine oxalate levle in rats with renal calcium oxalate calculus.

METHODSTotally 24 SPF Wistar healthy male rats were randomly divided into control group(n=12)and ethylene glycol (EG) group (n=12). Rats in EG group were administered intragastrically with 2% ammonium chloride (AC)2 ml/rat per day+1% ethylene glycol (EG), along with free access to drinking water.The control group was fed with deionized water, along with the intragastric administration of normal saline (1 ml per day). Twenty-eight days after modelling, the 24-hour urine samples were collected, and the urine oxalic acid levels were determined using HPLC and the results were compared with those of catalytic spectrophotometry using oxidation of methyl. During the HPLC, the samples were separated on Aglient 5TC-C18 (250×4.6 mm,5 Μm), eluted with mixture of methanol (0.1 mol/L) and ammonium acetate (15:85) at 1.2 ml/min, and detected at 314 nm, with the column temperature being 20 ℃.

RESULTSThe standard curves of high and low concentrations of oxalic acid were y=5909.1x+378730, R² =0.9984 and y=7810.5x-16635, R² =0.9967,respectively. The lowest detectable concentration in this method was 5 Μg/ml. The linear high concentration range of oxalate stood at 62.50-2000.00 Μg/ml, and the linear low concentration range of oxalate stood at 6.25-100.00 Μg/ml. Its average recovery was 95.1%, and its within-day and day-to-day precisions were 3.4%-10.8% and 3.8%-9.4%. Both HPLC and catalytic spectrophotometry showed significantly higher urinary oxalic acid concentration and 24 h urine oxalate level in EG group compared with the control group [urinary oxalic acid concentration: (736.35 ± 254.52) Μg/ml vs.(51.56 ± 36.34) Μg/ml,(687.35 ± 234.53) Μg/ml vs.(50.24 ± 42.34) Μg/ml;24 h urine oxalate level: (11.23 ± 4.12)mg vs.(0.87 ± 0.45)mg,(9.89 ± 3.55)mg vs. (0.77 ± 0.65)mg; all P<0.01]. No statistically significant difference was observed in the results of urinary oxalate concentration and 24 h urine oxalate level between HPLC and potassium chromate oxidation of methyl red spectrophotometry (all P>0.05).

CONCLUSIONHPLC is a simple, rapid, and precise method in detecting urine oxalate level in rats with renal calcium oxalate calculus, with high recovery rate.

Acetates ; Animals ; Azo Compounds ; Calcium Oxalate ; Calculi ; Chromates ; Chromatography, High Pressure Liquid ; Kidney ; Male ; Oxalates ; Potassium Compounds ; Rats ; Rats, Wistar ; Spectrophotometry ; Water

Oxalate nephropathy is commonly caused by ethylene glycol, vitamin C, and foods like star fruit that contain a lot of oxalate. Peanuts also have high oxalate contents. However, case reports of peanut-induced oxalate nephropathy are not common. Here, we describe a case of peanut-induced acute oxalate nephropathy with acute kidney injury and intend to demonstrate the conditions under which peanut-induced oxalate nephropathy is likely to occur.
Acute Kidney Injury* ; Arachis ; Ascorbic Acid ; Ethylene Glycol ; Fruit ; Oxalates

OBJECTIVES: To investigate the role of autophagy in oxalate-induced toxicity of human proximal renal tubular epithelial cell (HK-2). METHODS: HK-2 cells were exposed to oxalate (1 mmol/L) for 2 h and 3-methyladenine (3-MA) was used to inhibit autophagy. Then Western blotting was used to measure the expression of autophagy-related protein LC3II. Cell viability and cell apoptosis were measured by MTT assay and flow cytometry assay, respectively. RESULTS: Cytoplasmic vacuolization was observed in HK-2 cells after treating with oxalate for 2 h. However, 3-MA showed no effects on the formation of cytoplasmic vacuolization regardless of the dose at 1 or 5 mmol/L. The expression of LC3II protein was significantly increased in the HK-2 cells in the presence of oxalate (0.62±0.03 vs 0.35±0.02, CONCLUSIONS Autophagy of HK-2 cells is enhanced by oxalate at the concentration of 1 mmol/L. Inhibition of 3-MA-induced autophagy protects HK-2 cells from the oxalate-induced cytotoxicity.
Apoptosis ; Autophagy ; Cell Line ; Epithelial Cells ; Humans ; Oxalates/toxicity*

PURPOSE: In the present study, the difference in patients' nursing demands and nursing performance as perceived by the patients was examined. METHODS: The participants were 272 patients on maintenance hemodialysis at five university hospitals. Nursing need and nursing performance were measured using the tool developed by Lee for this study. RESULTS: The mean score for nursing demand was 3.35 points out of 4. The scores were higher for participants with middle school graduation or less, those not professing religion, and those whose medical insurance was of the medicaid type. The mean score for perceived nursing performance was 3.22 points out of 4. Nursing performance as perceived by hemodialysis patients was lower than nursing demand for 22 of 28 items. The item with the largest difference between nursing performance and nursing demand was 'Give a pain-free injection', followed by 'Explain about insurance benefits and supports' and 'Maintain quiet environment in the hemodialysis unit enabling rest during hemodialysis'. CONCLUSION: The results show that nursing performance as perceived by hemodialysis patients was lower than nursing demand. This result indicates a need to develop appropriate strategies to enhance nursing performance, especially for items that showed low nursing performance.
Hospitals, University ; Humans ; Insurance ; Insurance Benefits ; Medicaid ; Oxalates ; Renal Dialysis

Acute Kidney Injury ; Creatinine ; Humans ; Kidney ; Oxalates ; Retrospective Studies

BACKGROUND: Pain is the most common but severe physical symptom among cancer patients. This study aimed to identify correlation between pain and psychological symptoms for terminal cancer patients. METHODS: The total sample consisted of 69 subjects who were recruited through two hospice wards, limited to patients who were mentally alert and had no psychiatric diseases. The subjects were divided into two groups according to the numerical rating scale: the pain-free group, 0 to 3 points; and the pain group, 4 to 10 points. We used the Beck depression inventory (BDI), Beck anxiety inventory (BAI), mini-mental status examination-Korea (MMSE-K), and short form 36 health survey (SF-36). Logistic regression analysis was performed to verify the correlation between pain and other psychosocial disorders. RESULTS: The mean scores of BDI in the pain-free and pain groups were 25.7 and 31.5; mean BAI scores were 23.4 and 34.7; mean MMSE-K scores were 25.7 and 21.8, respectively. There were no significant differences between the two groups in SF-36 score except scores of body pain. The results of logistic regression analysis adjusted for age, sex, marital status, types of cancer, history of chemotherapy, or radiotherapy showed significant correlation between pain and depression (BDI > or = 24; odds ratio [OR], 4.199; 95% confidence interval [CI], 1.171 to 15.060), and pain and cognitive impairment (MMSE < 24; OR, 5.495; 95% CI, 1.449 to 20.843); but not between pain and anxiety (BAI > or = 22; OR, 3.011; 95% CI, 0.907 to 9.997). CONCLUSION: Pain significantly affects depression and cognitive impairment among advanced cancer patients in the hospice ward. Accordingly, more aggressive treatment of pain is required to reduce not only physical suffering but also physiological distress.
Anxiety ; Cognition ; Depression ; Health Surveys ; Hospices ; Humans ; Logistic Models ; Marital Status ; Odds Ratio ; Oxalates ; Stress, Psychological