182 research outputs found
The CX3C-Chemokine Fractalkine in Kidney Diseases
No full textThe chemokine CX3C-L/FKN is expressed in both soluble and transmembrane/mucin hybrid forms, thus combining chemoattractant functions together with receptor/adhesion molecule properties. In contrast to other chemokine receptors, CX3C-R is expressed not only on lymphoid cell populations, but also on several intrinsic cells including tubular epithelial cells and renal fibroblasts where it regulates various aspects of cell viability, matrix synthesis and degradation, migration, inflammation as well as oxidative stress. In the kidney, the chemokines/receptor pair has been shown to play a role in nephrogenesis as well as in the pathogenesis primary and secondary nephropathies. In several animal models and human specimens with acute and chronic renal failure including allograft nephropathy, CX3C-L/CX3C-R has been shown to exert immune and non-immune mediated renal damages. A blockade of this chemokine system ameliorated acute and chronic renal damages, though the latter to a more robust extent. There seems to a role of the CX3C-L/CX3C-R pair in mediating acute renal inflammation as well as in progressive chronic renal failure. However, functional studies are lacking for many aspects and further studies are necessary to better define the functional properties of CX3 C-L/FKN and its receptor
Symbolic Gestures in Contemporary Protest Movements
No full textIn this chapter, the arts and humanities are addressed
in a discussion of symbolic gestures of protest. The
aim is to embed symbolic gestures of protest in broader
political sociology debates and explore how symbolic
gestures are used to convey different political
meanings. The chapter is structured as follows: the
first part begins by defining protest and embedding
it in the broader scientific debates on political participation.
Since protest is a form of political engagement,
we briefly review different types of political
behavior and place protest in the sphere of non-conventional
politics, which takes place outside the
formal institutions of the state. Then we elaborate on
which (constellations of) factors motivate protest.
In the second part of the chapter, we draw on real-life
examples to discuss how protesters convey messages
to political elites, the masses, and the media
by using symbolic gestures instead of words. In the
concluding section, we discuss how symbolic gestures
contribute to the production of resistance through
new disruptive meanings and frame
Bioimpedance analysis and intradialytic hypotension in intermittent hemodialysis
No full textBackground: Intradialytic hypotension (IDH) is one of the most severe complications during hemodialysis. Its appearance is caused in part by rapid fluid removal with concomitant failure in blood pressure regulation but also by other dialytic-dependent and independent factors. Patients and methods: We investigated total (TBW), extracellular (ECW) and intracellular water (ICW) in chronic intermittent hemodialysis dialysis hypotension-prone (CRF-HP, n = 11) and nonhypotension-prone (CRF-NHP, n = 10) patients with end-stage renal disease before, every 30 minutes during, as well as after dialysis and within onset of intradialytic hypotension by multifrequent bioimpedance analysis (BIA). Additionally, intradialytic time course of BIA in patients with acute renal failure (ARF) and septic shock (n = 10) was observed. Results: IDH occurred in 72.1% of CRF-HP and in 80% of ARF patients. In CRF-HP and CRF-NHP, ECW significantly decreased by -12.44 +/- 4.22% in CRF-HP and -9.0 +/- 6.2% in CRF-NHP comparing pre- and post-dialysis values (each p < 0.01). Conversely, ICW increased by +11.51 +/- 11.3% in CRF-HP and +18.4 25.2% in CRF-NHP (each p < 0.05). In patients with ART no significant changes could be detected. Calculated ECW/ICW and ECW/TBW ratio significantly decreased in CRF patients with a higher rate in CRF-HP patients (p < 0.05). Neither ECW/ICW nor ECW/TBW ratio correlated with mean arterial pressure. The onset of intradialytic hypotension (n = 35) did not differ intraindividually compared to nonnotensive periods (n = 411). Fluid removal in CRF patients seems to be mainly from the extracellular space. The reduced decreases in ECW/ICW and ECW/TBW ratios in CRF-HP compared to CRF-NHP may indicate an insufficient refilling from intra- to extracellular compartment in CRF-HP. Conclusion: In conclusion, multifrequent BIA is not capable to predict hypotension in the individual patient during a particular dialysis session
Effective treatment of hepatitis C-associated immune-complex nephritis with cryoprecipitate apheresis and antiviral therapy
No full textA 38-year-old pregnant woman (19th week of pregnancy) complained of fatigue, cold inducible paresthesias, generalized edema and mild arterial hypertension. Her past medical history was notable for frequent episodes of polyarthralgia and positivity for rheumatoid factor. On admission, acanthocyturia and unselective glomerular-tubular proteinuria with 19 g/d were detected with a slight decrease in creatinine clearance. Rheumatoid factor was robustly elevated and a cryocrit of 1.5 vol%, caused by a so far unknown replicative hepatitis C, was detected. Renal biopsy yielded membrano-proliferative glomerulonephritis. During pregnancy, high-dose corticosteroid therapy was administered. Edema disappeared and blood pressure normalized under albumin substitution and low-dose furosemide application. However, Cesarian section became necessary due to placental insufficiency at 27 weeks of gestation. Thereafter, neither virus load, cryocrit nor proteinuria decreased significantly under a combined therapy with pegylated interferon-a and ribavirin. Thus, cryoprecipitate apheresis was initiated resulting in robust decreases of clinical complaints, viral load, cryocrit and proteinuria. Cryoglobulinemia with renal involvement caused by hepatitis C is difficult to treat due to limitations of immunosuppressive and anti-viral therapy. In our patient, cryoprecipitate apheresis was a safe and effective therapeutic addition to standard therapy
Role of basic fibroblast growth factor (FGF-2) in diabetic nephropathy and mechanisms of its induction by hyperglycemia in human renal fibroblasts
No full textVasko R, Koziolek M, Ikehata M, Rastaldi MP, Jung K, Schmid H, Kretzler M, Muller GA, Strutz F. Role of basic fibroblast growth factor (FGF-2) in diabetic nephropathy and mechanisms of its induction by hyperglycemia in human renal fibroblasts. Am J Physiol Renal Physiol 296: F1452-F1463, 2009. First published March 11, 2009; doi: 10.1152/ajprenal.90352.2008.-Basic fibroblast growth factor (FGF-2) plays a role in renal fibrogenesis, although its potential implications for tubulointerstitial involvement in diabetic nephropathy are unknown. We evaluated the expression of FGF-2 in kidney biopsies from patients with diabetic nephropathy and studied the mechanisms of its induction in human renal fibroblasts under hyperglycemia. Tubulointerstitial expression of FGF-2 was significantly upregulated in diabetic nephropathy compared with control kidneys with a good correlation to the degree of the injury. Fibroblasts cultivated in high glucose displayed increased FGF-2 mRNA as well as protein synthesis and secretion compared with normal glucose. Proliferation rates under hyperglycemia were significantly higher and could be almost completely inhibited by addition of a neutralizing FGF-2 antibody. Alterations in proliferation were associated with changes in p27(kip1) expression. Hyperglycemia induced the expression of PKC-beta 1 and PKC-beta 2; however, only inhibition of PKC-beta 1 but not PKC-beta 2 led to a significant decrease of FGF-2 levels. Relevance of the culture findings and functional association was corroborated by colocalization of FGF-2 and PKC-beta in human diabetic kidneys in vivo. High glucose stimulated fibronectin synthesis and secretion, which could be substantially prevented by inhibition of PKC-beta 1 and to a lesser extent by inhibiting the FGF-2. Expression of active phosphorylated form of p38 mitogen-activated protein kinase was upregulated under hyperglycemia; however, its inhibition had no effects on FGF-2 synthesis. Our results implicate a role of FGF-2 in high glucose-altered molecular signaling in pathogenesis of diabetic renal disease.EU [QLG1-2002-01215]; Georg-August-Universit
Progressive renal failure in spontaneous-onset cholesterol crystal embolism
No full textCase Report: A 69-year-old man was admitted to the authors' hospital with an increase of plasma creatinine from 1.4 up to 4.9 mg/dl within 4 months and the clinical complaints of painful purple toes, recurrent epistaxis and disturbances of equilibrium. His past medical history was remarkable for three transient ischemic attacks and the diagnosis of a metabolic syndrome. Magnetic resonance imaging showed vasculitis-like lesions in the brain. Eosinophilia and tubular proteinuria were detected. Renal insufficiency was caused by cholesterol crystal embolism, as shown both by skin and renal biopsy. Aortic plaques were identified as the putative source of cholesterol embolization. Conclusion: In case of rapidly progressive renal failure, cholesterol crystal embolism must be considered even without preceding angiography
Domestication differentially affects cochlear nucleus subdivisions in the gerbil
No full textWe analyzed the effects of domestication on the subdivisions of the cochlear nucleus in the gerbil (Meriones unguiculatus) by comparing their volumes and rostrocaudal extents in laboratory gerbils and in age-matched F1 offspring of gerbils caught in the wild. In addition, soma size was systematically analyzed in the anteroventral cochlear nucleus of both groups. Total cochlear nucleus volume and rostrocaudal extent were not significantly different between groups either for young (postnatal day 9) animals before the onset of hearing or for young 4-month-old animals. However, the dorsal cochlear nucleus was significantly larger and the anteroventral cochlear nucleus was significantly smaller in young adults of the wild strain. Thus the relative proportions of the cochlear nucleus subdivisions differed between the groups. In addition, soma size was significantly larger in the low-frequency portion of the anterovental cochlear nucleus in domesticated gerbils compared to wild gerbils. To our knowledge, this is the first reported instance of a well-defined brain structure (e.g., the antreovental cochlear nucleus) being larger in the domesticated than in the wild form
Chronic course of a hemolytic uremic syndrome caused by a deficiency of factor H-related proteins (CFHR1 and CFHR3)
No full textA 36-year-old patient complained of progressing fatigue, lack of appetite, and weakness for a few weeks, for which he had been using paracetamol (acetaminophen) intermittently. He was referred to our center from another hospital with hemolysis, thrombocytopenia, and acute renal failure (ARF). On admission, the patient did not complain of any specific additional symptoms. Besides paracetamol, he had not received any other medication. The patient reported flu-like symptoms 3 months before admission. The family history was unremarkable. Physical examination revealed a pale-looking patient (180 cm; 81 kg) with icteric sclerae. He was tachycardic (110 heart beats per min) and had elevated blood pressure (155/90mmHg). No other physical abnormalities were detectable. Laboratory investigations are depicted in Table 1. Specific analyses: von Willebrand factor cleavage protease activity 31% (40-120%), von Willebrand Factor Multimere negative, antibodies to von Willebrand Factor cleavage protease negative, factor H 614 mgl(-1) (345-590 mgl(-1)). Western blot analyses with patient's serum revealed the presence of complement factor H (CFH) and complement factor H-like protein 1 (CFHL1), but no detectable levels of complement factor H-related proteins 1 and 3 (CFHR1 and CFHR3) (Figure 1a). Antibodies to CFHR1 were negative. Genetic analyses 1 showed no CFH mutation, but revealed homozygous deletion of a 83 kb genomic fragment representing CFHR3 and CFHR1 (Figure 1b). Kidneys were of normal size with increased density by ultrasound examination. Electrocardiography revealed ischemic changes posteroseptally, and hypertrophy of the left ventricle was diagnosed by echocardiography
Early diagnosis and follow-up of aortitis with [18F]FDG PET and MRI
No full textThe aim of this prospective study was to compare fluorine-18 fluorodeoxyglucose ([F-18]FDG) positron emission tomography (PET) with magnetic resonance imaging (MRI) in patients with early aortitis, at the time of initial diagnosis and during immunosuppressive therapy. The study population consisted of 15 patients (nine females and six males; median age 62 years, range 26-76 years) who presented with fever of unknown origin or an elevated erythrocyte sedimentation rate or elevated C-reactive protein and who showed pathological aortic [F-18]FDG uptake. Fourteen of these patients had features of early giant cell arteritis (GCA), while one had features of early Takayasu arteritis. During follow-up, seven PET scans were performed in six patients with GCA 4-30 months (median 19 months) after starting immunosuppressive medication. The results of [F-18]FDG imaging were compared with the results of MRI at initial evaluation and during follow-up and with the clinical findings. At baseline, abnormal [F-18]FDG uptake was present in 59/104 (56%) of the vascular regions studied in 15 patients. Seven follow-up PET studies were performed in six patients. Of 30 regions with initial pathological uptake in these patients, 24 (80%) showed normalisation of uptake during follow-up. Normalisation of [F-18]FDG uptake correlated with clinical improvement and with normalisation of the laboratory findings. All except one of the patients with positive aortic [F-18]FDG uptake were investigated with MRI and MRA. Thirteen of these 14 patients showed inflammation in at least one vascular region. Of 76 vascular regions studied, 41 (53%) showed vasculitis on MRI. Of 76 vascular regions studied with both PET and MRI, 47 were concordantly positive or negative on both modalities, 11 were positive on MRI only and 18 were positive on PET only. MRI was performed during, follow-up in six patients: of 17 regions with inflammatory changes, 15 regions remained unchanged and two showed improvement. Whole-body [F-18]FDG PET is valuable in the primary diagnosis of early aortitis. The results of [F-18]FDG PET and MRI in the diagnosis of aortitis in this study were comparable, but FDG imaging identified more vascular regions involved in the inflammatory process than did MRI. In a limited number of patients [F-18]FDG PET was more reliable than MRI in monitoring disease activity during immunosuppressive therapy
Diagnosis and follow up of aortitis in the elderly
No full textObjectives: To evaluate the correlation of MRI and [F-18]FDG-PET scans with the clinical course and inflammatory markers in patients with aortitis. Methods: Eight patients with aortitis presenting with unspecific GCA-like symptoms were examined. Aortitis was diagnosed and followed up by [F-18]FDG-PET and MRI. The aorta was divided into three vascular regions (ascending aorta, aortic arch, and descending aorta) to localise the aortic inflammation and compare both imaging techniques. Results were correlated with clinical and laboratory examinations. Results: At diagnosis, 20/24 vascular regions from eight patients were positive by [F-18]FDG-PET scan and 15/21 aortic regions by MRI. Patients were treated with corticosteroids and followed up for a mean (SD) of 13.3 (4.7) months. In [F-18]FDG-PET, 11/20 (55%) initially pathological aortic regions returned to normal in the follow up examination, which correlated closely with the clinical and laboratory follow up examination. Conversely, in MRI, 14/15 initially affected vascular regions were unchanged. Conclusions: [F-18]FDG-PET and MRI are both effective techniques for detecting early aortitis and have a high correlation with laboratory inflammatory measures. However, during the follow up examination, [F-18]FDG-PET uptake decreased in line with the clinical symptoms and inflammatory serum markers, whereas MRI scans gave more static results
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