Correlation between CT attenuation value of renal papilla and the occurrence and development of renal calculi / 现代泌尿外科杂志

【Objective】 To analyze the correlation between CT attenuation value of renal papilla and occurrence and development of renal calculi. 【Methods】 The clinical data of 100 patients with calcium oxalate stones treated during Aug.2020 and Jul.2022 were retrospectively analyzed, including 60 with primary stones, and 40 with recurrent stones. The 30 healthy volunteers were enrolled in the control group. CT attenuation value of renal papilla was measured with plain scan CT, and risk factors were identified with the receiver operating characteristic (ROC) curve. The correlation of CT attenuation value and 24 h urine metabolism was analyzed. 【Results】 The CT attenuation value of renal papilla was significantly higher in the primary group [34.92 (IQR: 3.84)] and recurrent group [43.00 (IQR: 8.74)] than in the control group [32.58 (IQR: 5.21)] (P<0.05). Compared with the primary group, the recurrent group had decreased citric acid level but increased calcium level in 24 h urine (P<0.05). The citrate ion and calcium ion were correlated with the CT attenuation value (P<0.05). 【Conclusion】 Patients with high renal papilla density have a high risk of stone formation and recurrence. Increased renal papilla density is a warning signal for the development of stones. The high calcium and low citric acid in 24 h urine have certain effects on the occurrence and development of urolithiasis. Intake of calcium should be limited and citric acid should be supplemented in patients with calcium oxalate stones.

Effect of Furosemide on the Morphogenesis of Neonatal Rat Renal Papilla / 대한해부학회지

In developing rat kidney, apoptosis plays an important role in the morphogenesis of renal papilla, and hyperosmolality is well known to be one of regulating factor in apoptosis. The aim of this study was to determine the effect of hypoosmolality induced furosemide in neonate on cell proliferation and apoptosis in renal papilla. One-dayold pups were given two times a day, at 12 hour intervals, subcutaneous injection of furosemide (10 mg/kg BW) or saline for 4 days or 7days. We identified thick ascending limb by labeling with antibody to BSC1 (bumetanide-sensitive Na/K/2Cl cotransporter) and type A intercalated cell in collecting duct by labeling with antibody to band 3 protein. We also inspected apoptosis with TdT-mediated dUTP nick end labeling (TUNEL) method and cell proliferation with immunostaining for proliferating cell nuclear antigen (PCNA). The effect of hypoosmolality induced furosemide on neonatal rat kidney. 1) In furosemide-treated animals, body and kidney weights were reduced compare to control groups. the length of renal papillae of furosemide-treated groups were shortened compare to control groups. 2) Transformation from a cuboidal epithelium of thick ascending limb to a squamous epithelium of ascending thin limb in renal papilla was delayed in furosemide-treated groups. 3) In the inner medullary collecting duct of furosemide-treated groups, elimination of type A intercalated cells was delayed compared to control groups. 4) Furosemide treatment reduced the apoptotic index in transforming thick ascending limb of Henle's loop and collecting duct in renal medulla. 5) PCNA-positive cells in the transforming thick ascending limb of Henle's loop and the collecting duct in renal medulla were decreased in number in furosemide-treated groups compared to control groups. These finding suggest that renal hypoosmolality induced furosemide treatment decrease not only apoptosis but also cell proliferation and may retard renal papilla growth at least in neonatal rat kidney.

Cavernous Hemangioma of the kidney: Report of a case

Hemangioma of the kidney is a relatively uncommon tumor, which is most commonly located in the tip of the papilla. This lesion is usually small and has been found incidentally at postmorten examination. About 200 cases of renal hemangioma have been reported since Virchow's original report in 1876. In renal hemangioma, cavernous hemangioma is the most common type. They can create diagnostic problem for the clinician and the radiologist. We experienced a case of renal cavernous hemangioma in the medulla of the upper pole. The patient was a twenty-seven-year-old male who had gross hematuria and right flank pain. A nephrectomy was performed. An ill-defined mass, 4.5x3.0x1.5 cm, was observed around the pelvis. Microscopically, the tumor mass was hemangioma of the cavernous type.