1.Systemic lupus erythematosus with obstructive uropathy: Case report and review.
Ho Jung KIM ; Joon Yong PARK ; Sang Mok KIM ; Young Nam WOO ; Byung Hee KOH ; Oh Koo CHO ; Young Hyeh KO ; Moon Hyang PARK
Journal of Korean Medical Science 1995;10(6):462-469
We report a case of patient with documented SLE who displayed dysuria, gastrointestinal (GI) symptoms and renal insufficiency associated with the unusual occurrence of bilateral hydroureteronephrosis due to urterovesical junction stricture (obstructive uropathy). Pathologic investigations disclosed chronic interstitial cystitis (IC) with evidence of focal immune complex deposition in the blood vessel walls of the bladder. The GI symptoms and dysuria regressed with initial therapy for SLE with steroids. However, the persistent obstructive uropathy (OU) and renal insufficiency required bilateral nephrostomy followed by steroids plus intravenous pulse injection of cyclophosphamide. The obstructive uropathy was relieved even after removing the nephrostomy tube and renal function remained stable. Including this case, nineteen SLE patients associated with clinical and radiographic findings of OU were found in the world literature and reviewed to find any consistent pattern of clinical features. Most of the patients with OU in SLE were female (mean age, 31.7 yr) and orientals (63%), and had interstitial cystitis (89%) as a common underlying cause with concomitant involvement of the GI tract (89%) and WHO class IV or V advanced glomerulonephritis (67%). Despite the remarkable response (68%) to steroids in majority of OU patients associated with SLE, certain patients still required surgical correction (32%) and some even died (32%). OU, potentially reversible, was not an exception in patients with SLE, which might be overshadowed by other major organ involvement of SLE.
Adolescent
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Adult
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Female
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Human
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Lupus Erythematosus, Systemic/*complications/*pathology
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Urethral Obstruction/*complications/*pathology
2.Intraprostatic urinary reflux associated prostatitis caused by partial urethral obstruction in the rat model.
Wei LIU ; Shi-Wen LI ; Xin-Min ZHENG ; Li-Quan HU ; Yi LUO
National Journal of Andrology 2008;14(1):11-14
OBJECTIVETo investigate the pathogenesis of chronic prostatitis / chronic pelvic pain syndrome (CP / CPPS) by constructing the rat model of intraprostatic urinary reflux associated prostatitis caused by partial urethral obstruction.
METHODSFifty-four SD male rats were divided into an experiment group (n = 30) and a partial urethral obstruction (PUO) sham operation group (n = 24). Shinsuke Takechi's surgical method was adopted to achieve PUO and induce intraprostatic urinary reflux in the experiment group. While in the sham operation control group, the prostates were harvested at 1, 3 and 7 days after release from 3-day PUO, their morphological changes observed with the light microscope and the expression of cyclooxygenase-2 (COX-2) examined by immunohistochemistry.
RESULTSInflammation was observed in the prostate of the experiment group at 1, 3 and 7 days after release from PUO and alleviated with the passing of time, while the control group remained normal. The expression of COX-2 in the prostate was significantly higher in the experiment group than in the control (P < 0.05) and the staining of COX-2 became stronger with the lapse of time (P < 0.05).
CONCLUSIONAn animal model of intraprostatic urinary reflux associated prostatitis was constructed. The up-regulated expression of COX-2 induced by intraprostatic urinary reflux may be closely related with the development of CP / CPPS.
Animals ; Cyclooxygenase 2 ; biosynthesis ; Disease Models, Animal ; Immunohistochemistry ; Male ; Prostate ; enzymology ; pathology ; Prostatitis ; enzymology ; etiology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Urethral Obstruction ; complications
3.Retroperitoneal fibrosis: a clinical analysis of 18 cases.
Hua LIU ; Hang LI ; Xue-Wang LI
Acta Academiae Medicinae Sinicae 2007;29(6):769-771
OBJECTIVETo investigate the clinical features and outcomes of 18 patients with retroperitoneal fibrosis (RPF).
METHODWe retrospectively analyzed the clinical data of 18 RPF patients who received treatment in Peking Union Medical College Hospital from 1988 to 2004.
RESULTSThe initial symptoms included abdominal pain, notalgia, abdominal distension, and pyrexia. Elevated erythrocyte sedimentation rate (35-120 mm/h), immunoglobumin, and gamma globulin levels were found in 12 patients (66.7%), 4 patients (22.2%), and 5 patients (27.8%), respectively. Mild positive antinuclear antibody (1:160-1:320) was found in 3 patients (16.7%). Urethral obstructions were found by ultrasonography and intravenous pyelography, and the existence of post-peritoneal soft tissue shadow was confirmed by computerized tomography and magnetic resonance imaging. The final diagnosis included 15 primary RPF cases and 3 secondary RPF cases. Eleven patients only received drug therapy and 6 patients underwent surgery. The conditions improved in most patients, except that one patient died of tumor.
CONCLUSIONSThe initial symptoms of RPF are not specific. For patients with positive laboratory and radiological examination results, further imagings, surgeries, or interventional therapy may be considered.
Abdominal Pain ; complications ; Blood Sedimentation ; Fever ; complications ; Humans ; Immunoglobulins ; metabolism ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis ; diagnosis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Ultrasonography ; Urethral Obstruction ; diagnostic imaging ; gamma-Globulins ; metabolism
4.Peroxisome proliferator-activated receptor-γ agonist pioglitazone fails to attenuate renal fibrosis caused by unilateral ureteral obstruction in mice.
Ying ZHANG ; Jin WANG ; Qiao-dan ZHOU ; Cong-hui ZHANG ; Qing LI ; Shuai HUANG ; Juan ZHAN ; Kun WANG ; Yan-yan LIU ; Gang XU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2016;36(1):41-47
Renal tubulointerstitial fibrosis is the common ending of progressive renal disease. It is worth developing new ways to stop the progress of renal fibrosis. Peroxisome proliferator-activated receptor-γ (PPARγ) agonists have been studied to treat diabetic nephropathy, cisplatin-induced acute renal injury, ischemia reperfusion injury and adriamycin nephropathy. In this study, unilateral ureteral obstruction (UUO) was used to establish a different renal fibrosis model. PPAR? agonist pioglitazone was administrated by oral gavage and saline was used as control. At 7th and 14th day after the operation, mice were sacrificed for fibrosis test and T lymphocytes subsets test. Unexpectedly, through MASSON staining, immunohistochemistry for α-SMA, and Western blotting for a-SMA and PDGFR-β, we found that pioglitazone failed to attenuate renal fibrosis in UUO mice. However, flow cytometry showed that pioglitazone down-regulated Th1 cells, and up-regulated Th2 cells, Th17 cells and Treg cells. But the Th17/Treg ratio had no significant change by pioglitazone. Real-time PCR results showed that TGF-β and MCP-1 had no significant changes, at the same time, CD4(+) T cells associated cytokines were partially regulated by pioglitazone pretreatment. Taken together, pioglitazone failed to suppress renal fibrosis progression caused by UUO.
Animals
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Chemokine CCL2
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metabolism
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Fibrosis
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Kidney
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pathology
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Kidney Diseases
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drug therapy
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etiology
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Male
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Mice
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Mice, Inbred C57BL
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PPAR gamma
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agonists
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T-Lymphocyte Subsets
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drug effects
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Thiazolidinediones
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administration & dosage
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pharmacology
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therapeutic use
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Transforming Growth Factor beta
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metabolism
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Urethral Obstruction
;
complications
5.Effect of enalapril on the expression of TGF-beta1, p-Smad2/3 and Smad7 in renal interstitial fibrosis in rats.
Wangbin NING ; Lijian TAO ; Chunyan LIU ; Jian SUN ; Yun XIAO ; Jing HU ; Jiying CHEN ; Xuan ZHENG ; Wei WANG
Journal of Central South University(Medical Sciences) 2009;34(1):27-34
OBJECTIVE:
To explore the mechanism of enalapril for renal interstitial fibrosis by observing the effect of enalapril on the expression of transforming growth factor-beta1(TGF-beta1), p-Smad2/3 and Smad7 in renal tissuess of unilateral urethral obstruction (UUO) rat model.
METHODS:
Thirty female Sprague-Dawley(SD) rats were randomly subdivided into a sham-operated group, a model group and an enalapril treated group. UUO model was induced by ligating the left ureter of rats. All rats were sacrificed 14 days after UUO. Pathological changes of the renal tissue were observed by HE and Masson staining, the protein expressions of Collagen I (ColI), TGF-beta1, p-Smad2/3 and Smad7 were detected by immunohistochemical staining,and the mRNA expressions of TGF-beta1 and Smad7 were detected by RT-PCR.
RESULTS:
The renal interstitial damage index, the relative Collagen area and the expression of ColI in the model group significantly increased(P<0.01). Enalapril reduced these indexes. The protein and mRNA expressions of TGF-beta1 and the protein expressions of p-Smad2/3 were low in the sham-operated group, but were strongly positive in the model group, and enalapril could decrease the expressions of TGF-beta1 and p-Smad2/3(P<0.01). The protein and mRNA expressions of Smad7 in the model group were less than that in the sham-operated group(P<0.01),and enalapril could improve the expressions of Smad7(P<0.01).
CONCLUSION
Enalapril could inhibit the renal interstitial fibrosis by affecting TGF-beta1, p-Smad2/3 and Smad7 of TGF-beta/smads pathway in the renal tissues of UUO rats.
Angiotensin-Converting Enzyme Inhibitors
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pharmacology
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Animals
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Enalapril
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pharmacology
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Female
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Fibrosis
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prevention & control
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Kidney
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metabolism
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pathology
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RNA, Messenger
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genetics
;
metabolism
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Random Allocation
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Rats
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Rats, Sprague-Dawley
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Smad2 Protein
;
genetics
;
metabolism
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Smad3 Protein
;
genetics
;
metabolism
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Smad7 Protein
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genetics
;
metabolism
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Transforming Growth Factor beta1
;
genetics
;
metabolism
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Urethral Obstruction
;
complications