Localization of Diacylglycerol Kinase ζ in the Kidney of Adult Rats: Its Dominant Expression in Collecting Tubules and its Selective Lack in Proximal Tubules / Localización de Diacilglicerol Quinasa ζ en el Riñón de Ratas Adultas: su Expresión Dominante en Túbulos Colectores y su Carencia Selectiva en Túbulos Proximales

SUMMARY: Diacylglycerol kinase (DGK) exerts balancing the intracellular level between two-second messengers, diacylglycerol and phosphatidic acid, by its phosphorylation activity. DGK ζ is often localized in cell nuclei, suggesting its involvement in the regulation of intranuclear activities, including mitosis and apoptosis. The present immunohistochemical study of rat kidneys first revealed no detection levels of DGK ζ -immunoreactivity in nuclei of most proximal tubule epithelia in contrast to its distinct occurrence in cell nuclei of collecting and distal tubules with the former more dominant. This finding suggests that DGK ζ is a key factor regulating vulnerability to acute kidney injury in various renal tubules: its low expression represents the high vulnerability of proximal tubule cells, and its distinct expression does the resistance of collecting and distal tubule cells. In addition, this isozyme was more or less localized in nuclei of cells forming glomeruli as well as in endothelial nuclei of peritubular capillaries and other intrarenal blood vessels, and epithelial nuclei of glomerular capsules (Bowman's capsules) and renal calyces, including intrarenal interstitial cells.

La diacilglicerol quinasa (DGK) ejerce el equilibrio del nivel intracelular entre dos segundos mensajeros, diacilglicerol y ácido fosfatídico, por su actividad de fosforilación. La DGK ζ a menudo se localiza en los núcleos celulares, lo que sugiere su participación en la regulación de las actividades intranucleares, incluidas la mitosis y la apoptosis. El presente estudio inmunohistoquímico en riñones de rata no reveló niveles de detección de inmunorreactividad de DGK ζ en los núcleos de la mayoría de los epitelios de los túbulos proximales, en contraste a la detección en los núcleos celulares de los túbulos colectores y distales, siendo el primero más dominante. Este hallazgo sugiere que DGK ζ es un factor clave que regula la vulnerabilidad a la lesión renal aguda en varios túbulos renales: su baja expresión representa la alta vulnerabilidad de las células del túbulo proximal, y su expresión distinta hace a la resistencia de las células del túbulo colector y distal. Además, esta isoenzima estaba más o menos localizada en los núcleos de las células que forman los glomérulos, así como en los núcleos endoteliales de los capilares peritubulares y otros vasos sanguíneos intrarrenales, y en los núcleos epiteliales de las cápsulas glomerulares (cápsulas de Bowman) y los cálices renales, incluidas las células intersticiales intrarrenales.

Capacidad de Penetración y Difusión de la Medicación, Intraconducto en Túbulos Dentinales, Conductos Laterales e Istmos. Una Revisión Sistemática

RESUMEN: El objetivo de la terapia endodóntica consiste en tratar o prevenir la periodontitis apical. La efectiva eliminación o disminución de microbiota es esencial para la reparación periapical. Debido a esto, se utiliza el empleo de medicamentos intraconductos para tratar químicamente el sistema de conductos radiculares, y cobra relevancia la capacidad de penetración y difusión de dicho medicamento para entrar en contacto directo con los microorganismos que penetren dentro de los túbulos dentinales, conductos laterales e itsmos. Se realizó una revisión de la literatura en bases de datos electrónicas con los buscadores "Pubmed, Scielo y Google Académico", utilizando palabras clave para identificar la literatura publicada relevante en inglés. El análisis y los criterios de elegibilidad se documentaron de acuerdo con los elementos de informe para revisiones sistemáticas y meta-análisis (Preferred Reporting Items for Systematic Reviews and Meta-Analysis, PRISMA). No se impusieron restricciones sobre la fecha de publicación. Se recogieron datos sobre capacidad de difusión de medicación intraconductos en túbulos dentinales, conductos laterales e itsmos radiculares y se sometieron a análisis descriptivo de datos. La búsqueda bibliográfica en bases de datos electrónicas según los criterios de inclusión arrojó 45 títulos y resúmenes. Entre ellos, 7 artículos fueron seleccionados. Se determinó un rango de penetración del medicamento muy variable, entre 27,7 - 2350 μm y rango de difusión de 200-500 μm. Hay pocos estudios publicados que reporten la capacidad de penetración y difusión de la medicación intraconductos. El vehículo empleado y diámetro de las partículas en la preparación del medicamento y la eliminación de la capa de desecho aumentaría la capacidad de penetración/difusión del medicamento intraconductos dentro del túbulo dentinal, conductos laterales e itsmo.

ABSTRACT: The objective of endodontic therapy is to treat or prevent apical periodontitis. The effective elimination or reduction of the microbiota is essential for periapical repair. Due to this, the use of intracanal drugs is used to chemically treat the root canal system, and the penetration and diffusion capacity of said drug becomes relevant to come into direct contact with the microorganisms that penetrate inside the dentinal tubules, lateral canals and isthmus. A literature review was carried out in electronic databases with the search engines "Pubmed, Scielo and Google Academic", using keywords to identify the relevant published literature in English. The analysis and eligibility criteria were documented according to the reporting items for systematic reviews and meta-analyzes (Preferred Reporting Items for Systematic Reviews and Meta-Analysis, PRISMA). No restrictions were placed on the date of publication. Data on intracanal drug diffusion capacity in dentinal tubules, lateral canals and root isthmus were collected and subjected to descriptive data analysis. The bibliographic search in electronic databases according to the inclusion criteria yielded 45 titles and abstracts. Among them, 7 articles were selected. A highly variable drug penetration range was determined, between 27.7 - 2350 μm and a diffusion range of 200-500 μm. There are few published studies that report the penetration and diffusion capacity of intracanal medication. The vehicle used and the diameter of the particles in the preparation of the drug and the elimination of the waste layer would increase the penetration / diffusion capacity of the drug within the dentinal tubule, lateral canals and isthmus.

Tumor neuroendocrino, mucocele y adenoma tubulo-velloso: tres lesiones infrecuentes en el apéndice cecal / Neuroendocrine tumours, mucocele, and tubulovillous adenoma: three uncommon lesions in the cecal appendix

Introducción: los tumores del apéndice cecal constituyen un grupo heterogéneo de neoplasias con evolución y pronóstico variables; representan una pequeña parte de todas las neoplasias gastrointestinales y de las apendicetomías. Objetivo: realizar la comunicación de la presentación de tumores infrecuentes del apéndice cecal y revisar la literatura con énfasis la importancia del diagnóstico histopa-tológico. Presentación de caso: durante la necropsia del paciente HC: 199584 se realizó el diagnóstico histopatológico de un tumor neuroendocrino y mucocele apendicular y en la pieza quirúrgica del paciente HC: 223360 correspondiente a una apendicectomía se realizó el diagnóstico de adenoma tubulo-velloso, dadas que estas lesiones son poco frecuente se decide su comunicación y la revisión del tema en la literatura en idioma inglés y español a través de las bases de datos MEDLINE/PubMed, Elsevier, SciELO, EBSCO, Hinari y búsqueda avanzada en Google Scholar, encontrándose un total de 29 publicaciones entre 1990 a 2019. Conclusiones: el diagnóstico de tumores del apéndice cecal se realiza en forma incidental en el estudio anatomopatológico después de una apendicectomía por apendicitis aguda, es por ello que siempre se debe realizar el estudio histológico de la pieza quirúrgica, no solo para confirmar o negar el diagnostico que motivo la apendicetomía, sino para descartar la presencia de lesiones neoplásicas benignas o malignas.

Introduction: Tumors of the cecal appendix constitute a heterogeneous group of neoplasms with variable evolution and prognosis; they represent a small part of all gastrointestinal neoplasms and appendectomies. Objective: To communicate the presentation of infrequent tumours of the cecal appendix and to review the literature with emphasis on the importance of histopathological diagnosis. Case presentation: During the necropsy of patient HC: 199584, a histopathological diagnosis of carcinoid tumours and appendicular mucocele was made, and in the surgical specimen of patient HC: 223360 correspondings to an appendectomy, the diagnosis of tubu-lovillous adenoma were made, given that These lesions are rare, it is decided to communicate and review the subject in the literature in English and Spanish through the MEDLINE / PubMed, Elsevier, SciELO, EBSCO, Hinari and Advanced Search in Google Scholar data-bases, finding a total of 29 publications between 1990 to 2019. Conclusions: The diagnosis of tumours of the cecal appendix is made incidentally in the pathological study after an appendectomy for acute appendicitis, which is why the histological study of the surgical piece should always be carried out, not only to confirm or deny the diagnosis. What reason for the appendectomy but to rule out the presence of benign or malignant neoplastic lesions.

Uromodulin- Glycated Hemoglobin Ratio Plays The Trump In Diabetic Nephropathy Detection- A Case Control Study

Background:To investigate urine uromodulin as a marker for Diabetic nephropathy (DN) and its relation with glycaemic control.Material &Methods:a cross-sectional comparative study on 180 healthy controls (Group I), 205 patients of Diabetes Mellitus were classified as Group II without microalbuminuria and those with microalbuminuria as Group III.Urineuromodulin, albumin and creatinine was estimated along with routine biochemistry.Results:The FBS, PPBS, HbA1c and serum creatinine were lowest in Group I as compared to groups II and III (p < 0.01, <0.01, <0.01, 0.008 respectively). There was no difference in urine uromodulin levels among the three groups (p= 0.609) but the Uromodulin HbA1cRatio (UHR) showed a significant difference (p <0.01). UHR showed a statistically significant negative correlation with FBS, PPBS, HbA1c and urine (p= <0.01, <0.01, <0.01 and 0.004 respectively). The Odds of having DN with UHR > 8.6 was 0.49 (95% CI is 0.308-0.78).Conclusion:The non-occurrence of a diabetic complication that is nephropathy in our studygroup is favourable to those diabetic patients with a higher UHR (>8.6). Estimation of urine uromodulin will be beneficial along with albuminuria in detecting DN.

Morphological aspects of epididymal microscopy and rete testis in greater Rhea Americana / Aspectos morfológicos da microscopia do epitélio do epidídimo da Rhea americana

ABSTRACT: The purpose of this research was to study the histology and describe the microscopy findings of the epididymis epithelium of greater Rhea americana at three time periods: November 2005 (n=14), December 2006 (n= 20), and May 2007 (n= 20), to observe and compare the differences that occurred. We studied the epididymis from 54 rheas, bred in Santa Maria, Rio Grande do Sul, Brazil. The epididymis were collected during commercial slaughter and fixed in bouin. Optical microscopy was used to measure the cellular structure, types of cells, tubules, and stereological values like the epididymis epithelium diameters, lumen, thickness, and relative volume of the tissue structure. Additionally, electron microscopy was studied. In December 2006 and May 2007, the means of the epididymis tubular diameter were: 79.1 and 58.1 µm, epithelium thickness: 24.0 and 52.2 µm, and lumen diameter: 55.0 and 5.8 µm, respectively. Regarding the volumetric proportion, we reported the following values: epithelium volume 36.2 and 80.4%, lumen without spermatozoon 19.6 and 3.0%, lumen with spermatozoon 5.4 and 0.0%, interstitium 35.4 and 12.0%, blood vessels 3.5 and 4.6%, structures in cellular superficies 1.4 and 0%, lamina 1.4 and 3.2%, and artifacts 0.3 and 1.3%, respectively. The epididymis ducts had a circular form in transverse sections with spermatozoon only in November 2005 and December 2006. The Rhea's epididymis morphology was found to be similar to ostriches, roosters, and Japanese quail. Here, we present data from stereological microscopy (tubular diameter, epithelium thickness, and lumen diameter), volumetric proportion (epithelium, lumen without spermatozoon, lumen with spermatozoon, interstitium, blood vessels, structures in cellular superficies; cilium, estereocilium, and lamina) in this species during the repose and sexual activity period (reproductive season).

RESUMO: O objetivo desta pesquisa foi estudar a histologia e descrever os achados microscópicos do epitélio epidídimo de ema em três períodos: novembro/2005 (n = 14), dezembro/2006 (n = 20) e maio/2007 (n = 20), para observação e comparação das diferenças que ocorreram nesses tempos distintos. Estudamos o epidídimo de 54 animais, criados em Santa Maria, RS. Durante o abate comercial, os epidídimos foram coletados e fixados em Bouin. A microscopia óptica mede a estrutura celular, tipos de células, túbulos e valores estereológicos, como os diâmetros do epitélio do epidídimo, lúmen, espessura, volume relativo da estrutura do tecido. Em dezembro/2006 e maio/2007, as médias do diâmetro tubular do epidídimo foram: 79,1 e 58,1µm, espessura do epitélio: 24,0 e 52,2µm, diâmetro do lúmen: 55,0 e 5,8µm, respectivamente. Em relação à proporção volumétrica, encontramos os seguintes valores: volume epitelial 36,2 e 80,4%, lúmen sem espermatozoide 19,6 e 3,0%, lúmen com espermatozoide 5,4 e 0,0%, intestínio 35,4 e 12,0%, vasos sanguíneos 3,5 e 4,6%, estruturas celulares superfícies 1,4 e 0%, lâmina 1,4 e 3,2%, artefatos 0,3 e 1,3%, respectivamente. Os ductos do epidídimo apresentaram forma circular em cortes transversais com espermatozoide apenas em novembro/2005 e dezembro/2006. A morfologia do epidídimo de Rhea foi semelhante ao avestruz, galo e codornas japonesas. Apresentamos dados de microscopia estereológica (diâmetro tubular, espessura do epitélio, diâmetro do lúmen), proporção volumétrica, em porcentagem (epitélio, lúmen sem espermatozóide, lúmen com espermatozoide, intestório, vasos sanguíneos, estruturas em superfícies celulares - cílio - estereocílio, lâmina e artefatos) nesta espécie nos períodos de repouso e atividade sexual (estação reprodutiva).

Acetaminophen induces alterations to the renal tubular ultrastructure in a rat model of acute nephrotoxicity protected by resveratrol and quercetin / El acetaminofeno induce alteraciones en la ultraestructura tubular renal en un modelo de rata con nefrotoxicidad aguda protegida por resveratrol y quercetina

Acetaminophen (also called paracetamol, or APAP) induced nephrotoxicity is reported after accidental or intentional ingestion of an overdose of the drug. Renal tubular ultrastructural alterations induced by APAP overdose associated with the induction of biomarkers of kidney injury have not been investigated before. Also, we investigated whether the combined polyphenolic anti-inflammatory and antioxidants agents, resveratrol (RES) and quercetin (QUR) can protect against APAP-induced acute kidney injury. The model group of rats received a single dose of APAP (2 g/kg), whereas the protective group of rats was pre-treated for 7 days with combined doses of RES (30 mg/kg) and QUR (50 mg/kg) before being given a single dose of APAP. All rats were then sacrificed one day post APAP ingestion. Harvested kidney tissues were prepared for transmission electron microscopy (TEM) staining and blood samples were assayed for urea, creatinine, and biomarkers of inflammation and oxidative stress. TEM images and blood chemistry analysis showed that APAP overdose induced kidney damage as demonstrated by substantial alterations to the proximal convoluted tubule ultrastructure, and a significant (p<0.05) increase in urea, creatinine, tumor necrosis factor-alpha (TNF-a), and malondialdehyde (MDA) blood levels, which were protected by RES+QUR. These findings indicate that APAP induces alterations to the renal tubular ultrastructure, which is inhibited by resveratrol plus quercetin, which also decreases blood levels of kidney injury biomarkers.

El objetivo de este trabajo fue estudiar la nefrotoxicidad inducida por acetaminofeno (también llamado paracetamol o APAP) después de la ingestión accidental o intencional de una sobredosis de la droga. Las alteraciones ultraestructurales tubulares renales inducidas por sobredosis de APAP asociadas con la inducción de biomarcadores de daño renal no se han investigado. Además, estudiamos si los agentes combinados antiinflamatorios y antioxidantes polifenólicos, el resveratrol (RES) y la quercetina (QUR) pueden proteger contra la lesión renal aguda inducida por APAP. El grupo modelo de ratas recibió una dosis única de APAP (2 g / kg), mientras que el grupo protector de ratas se trató previamente durante 7 días con dosis combinadas de RES (30 mg / kg) y QUR (50 mg / kg) antes de recibir una dosis única de APAP. Todas las ratas se sacrificaron un día después de la ingestión de APAP. Los tejidos renales fueron preparados para el análisis a través de la microscopía electrónica de transmisión (MET). En las muestras de sangre se determinaron la urea, creatinina y los biomarcadores de inflamación y estrés oxidativo. Las imágenes MET y el análisis químico de la sangre mostraron que la sobredosis de APAP inducía daño renal, como lo demuestran las alteraciones sustanciales en la ultraestructura del túbulo contorneado proximal, y además, de un aumento significativo (p <0,05) de la urea, creatinina, factor de necrosis tumoral alfa y niveles sanguíneos de malondialdehído, protegidos por RES + QUR. Estos hallazgos indican que APAP induce alteraciones en la ultraestructura tubular renal, inhibida por el resveratrol más quercetina, que también disminuye los niveles sanguíneos de biomarcadores de daño renal.

Testicular histological evaluation and serum testosterone concentrations of bulls after chemical castration with calcium chloride / Avaliação histológica e das concentrações séricas de testosterona de touros após a castração química com cloreto de cálcio

Orchiectomized bulls have advantages in the meat quality and ease of handling. Chemical castration is an option for surgical castration and the sclerosing agents can be administered into the testicular or epididymis parenchyma. These agents have a lower incidence of complications than surgery, especially when associated with dimethylsulfoxide (DMSO), which has anti-inflammatory action and increases the absorption of other drugs. Thus, this study aimed to evaluate the effect of a single intratesticular injection of calcium chloride solution associated with DMSO for the chemical sterilization of bulls. Twenty-four young adult bulls were utilized, distributed into 3 groups (G20, G30 and G40, n = 8/group), according to the calcium chloride concentration (20, 30 and 40%), in 10mL volume. Serum concentrations of testosterone, body weight, testicular volume and ecotexture, clinical signs and behavior and were evaluated for 45 days. Thus, the animals were orchiectomized and testicles were assessed histologically. There were no changes in body weight, decreased serum testosterone concentrations (except G30), signs of scrotal sensitivity or changes in behavior over the period. However, there was significant increase in testicular volume, especially on the 2nd and 3rd day after treatment, with values returning to the value initials at 15 days. Testicular adherence and firm consistency were observed during orchiectomy. Ultrasound examination revealed a loss of integrity of the median raphe, with cavity formation and an alteration of the testicular echotexture. In the histological evaluation, coagulation necrosis of seminiferous tubules and interstitial cells was observed, mainly in the medial portion in all groups. Some animals presented total absence of tubular formations in all the studied groups, being the effects of greater intensity in the G40. Additionally, pronounced edema was noted in all groups, especially in G40. Inflammatory infiltrate, fibroplasia and neovascularization were found to be predominantly discrete. Based on the conditions used in this study, we conclude that calcium chloride associated with DMSO can be used as a method of chemical sterilization in bovines.(AU)

Bovinos orquiectomizados apresentam vantagens na qualidade da carne e facilidade no manejo. A quimioesterilização é uma opção à castração cirúrgica e os agentes esclerosantes podem ser administrados no parênquima testicular ou epidídimo. Estes produtos possuem menor incidência de complicações, comparados a cirurgia, especialmente quando associados ao dimetilsulfóxido (DMSO), que apresenta ação anti-inflamatória e aumenta a absorção de outros fármacos. Assim, este estudo teve como objetivo avaliar o efeito de uma única injeção intratesticular de solução de cloreto de cálcio associado com 0,5% de DMSO para a esterilização química de bovinos. Vinte e quatro touros adultos jovens foram utilizados, distribuídos em 3 grupos (G20, G30 e G40, n = 8/grupo) de acordo com a concentração de cloreto de cálcio (20, 30 e 40%), em um volume de 10mL. Foram avaliadas as concentrações séricas de testosterona, peso corporal, volume e ecotextura testicular, sinais clínicos e comportamento por 45 dias. A seguir, os animais foram submetidos à orquiectomia e os testículos avaliados histologicamente. Não foram observadas alterações do peso corporal, diminuição das concentrações de testosterona sérica (exceto no G30), sinais de sensibilidade escrotal ou alterações no comportamento no período avaliado. Porém, houve aumento significativo do volume testicular, especialmente nos 2º e 3º dia após o tratamento, com valores retornando aos iniciais aos 15 dias. Aderência e consistência firme dos testículos foram achados observados durante a orquiectomia. O exame ultrassonográfico revelou perda de integridade da rafe mediana, com formação de cavidades e alteração da ecotextura testicular. Na avaliação histológica, verificou-se necrose de coagulação de túbulos seminíferos e células intersticiais acentuada, principalmente, na porção medial em todos os grupos, sendo que em alguns animais havia ausência total das formações tubulares em todos os grupos estudados, sendo os efeitos de maior intensidade no G40. Além disso, edema foi acentuado em todos os grupos, principalmente em G40. Infiltrado inflamatório, fibroplasia e neovascularização foram achados predominantemente discretos. Com base nas condições utilizadas neste estudo, conclui-se que o cloreto de cálcio associado com o DMSO pode ser utilizado como um método de esterilização química em bovinos.(AU)

Establishment of a mouse model of chronic renal insufficiency induced by repeated administration of cisplatin / 中国实验动物学报

Objective To observe the changes of renal tubular injury and the extent of interstitial fibrosis in the C57BL/6 mouse models of chronic kidney disease(CKD),and provide experimental animal evidence for study of the pro-gression of acute kidney injury(AKI)to chronic kidney disease as well as its mechanisms. Methods Twenty-four 8-week-old male C57BL/6 mice were randomly and equally divided into control group, low-dose, medium-dose, and high-dose cisplatin groups,6 mice in each group. Mice in the cisplatin groups were administrated with 5,7 or 10 mg/kg cispla-tin by intraperitoneal injection once a week for 4 weeks. Plasma creatinine and 24-hour urinary protein were detected to as-sess the renal function. The mice were sacrificed, and plasma and kidney samples were collected for subsequent tests. Pathological changes were observed using periodic acid-Schiff(PAS)staining. To evaluate renal tubules injury, the ex-pression of kidney injury molecule 1(KIM-1)was examined by immunohistochemistry and the level of urinary N-Acetyl-β-D-glucosaminidase was detected with a commercial kit. The infiltration of CD3-positive T cells and F4/80-positive macro-phages was observed by immunohistochemistry(IHC)and immunofluorescence. The expression of collagen I and α-smooth muscle actin(α-SMA)were tested by immunohistochemistry to assess the renal fibrosis, while total kidney collagen was detected by Picrosirius red staining. Results In contrast to the normal control group,the kidney injury became more seri-ous in the cisplatin-treated mice as cisplatin concentration increased. Particularly,significant kidney damage was observed in the high-dose cisplatin group. Compared with the control group,the plasma creatinine and 24-hour urinary protein were significantly increased in the high-dose cisplatin group(P<0.05 and P<0.001)indicating impaired renal function. Mor-phologically,numerous clear vacuoles and necrosis were present in renal tubule epithelial cells in the high-dose cisplatin group. The expression of KIM-1 was markedly up-regulated and the level of urinary NAG was elevated. Infiltration of CD3-positive T cells and F4/80-positive macrophages was enhanced in the mice of high-dose cisplatin group. Data from immuno-histochemistry and picrosirius red staining showed that mice of the high-dose cisplatin group developed renal fibrosis evi-denced by markedly up-regulated expression of collagen I and α-SMA. Conclusions Repeated administration of 10 mg /kg cisplatin for 4 weeks can induce chronic renal insufficiency in mice,which may serve as a novel model for the research on underlying mechanisms of progression from acute kidney injury to chronic kidney disease.

Daño renal agudo secundario a nefritis tubulointersticial aguda por uso de medicamentos. Caso clínico / Acute renal damage secondary to acute tubulointerstitial nephritis drug use. Case report

Resumen Introducción: La nefritis tubulointersticial aguda (NTIA) es infrecuente en la edad pediátrica. Se caracteriza por la infiltración del parénquima renal por células mononucleares y/o polinucleares con afectación secundaria de los túbulos sin lesión glomerular, y puede ser producida por infecciones, enfermedades inmunológicas, fármacos, o ser de origen idiopático. Objetivo: Describir un caso de NTIA secundario a antiinflamatorios no esteroidales (AINE) en un lactante, con énfasis en esta aso ciación para ser considerada por los pediatras. Caso clínico: Lactante de 10 meses, sin antecedentes previos, trasladada a nuestro hospital por daño renal agudo estadio 3, clasificación KDIGO 2012. Los tres días previos recibió tratamiento con amoxicilina e ibuprofeno por otitis media aguda. En la exploración física destacaba leve edema palpebral con presión arterial normal. En la orina presentaba proteinuria no nefrótica con componente tubular, microhematuria y leucocituria. La ecografía renal no mostraba alteraciones. Ante la sospecha de NTIA se cambió el antibiótico a cefotaxima intrave nosa y se suspendió el ibuprofeno realizándose manejo conservador del daño renal agudo. Presentó aumento de la creatinina (4.14 mg/dL) y eosinofilia, siendo el estudio inmunológico negativo. Se trató con metilprednisolona, con normalización de la función renal. Conclusión: La NTIA se puede producir por cualquier medicamento mediante una reacción inmunológica idiosincrásica. Entre los medicamentos responsables se identifican fármacos de uso frecuente en la edad pediátrica, como los AINEs, por lo que se necesita una alta sospecha diagnóstica por parte de los pediatras.

Abstract Introduction: Acute tubulointerstitial nephritis (ATIN) is a rare entity in the pediatric age. It is de fined by the infiltration of the renal parenchyma by mononuclear and/or polynuclear cells with se condary involvement of the tubules, without glomerular injury. It can be triggered by infections or immunological diseases, drugs like NSAIDs or be of idiopathic origin. Objective: To raise awareness among pediatricians about the prescription of NSAIDs, especially to patients of less than a year old, since they can provoke renal damage. Case report: A ten month old child, with no nephrological an tecedents of interest, was transferred to our hospital due to acute renal failure stage 3 KDIGO 2012. The three previous days received treatment with amoxicillin and ibuprofen for acute otitis media. Physical examination revealed mild eyelid edema with normal blood pressure. In the urine analysis, there were non-nephrotic proteinuria with tubular component, microhematuria and leukocyturia. Renal ultrasound showed no abnormalities. ATIN was suspected and so the antibiotic was changed to intravenous cefotaxime and ibuprofen was discontinued, opting for conservative management of acute renal damage. There was an increase in the number of creatinine up to 4.14 mg/dL and eosinophilia, with the immunological study being negative. Treatment with methylprednisolone was initiated, achieving normalization of renal function. Discussion: NTIA can be produced by any me dication through an idiosyncratic immune reaction. Among the responsible drugs, there are ones commonly used in the pediatric age, such as NSAIDs. Therefore, the pediatricians should pay special attention during prescriptions and have a high diagnostic suspicion of this disease.

Mechanisms of tubulo-epithelial-mesenchymal transition in renal interstitial fibrosis / 国际儿科学杂志

Tubulo-epithelial-mesenchymal transition refers to the renal tubular epithelial cells transfor-mation into stromal cells through some regulatory factors,causing tissue pathological changes.More and more scholars believe that EMT plays a crucial role in the development and metastasis of renal interstitial fibrosis.As an important small RNA related to gene transcription regulation,miRNA has a close relationship with EMT-relat-ed gene expression and plays an important role in EMT,and has become a hotspot in EMT.The research progress of recent years is reviewed in this passage.

Síndrome de nefritis túbulo-intersticial agudo asociado a uveítis / Tubulointerstitial nephritis syndrome and uveitis

La uveítis intermedia es una enfermedad ocular caracterizada por la inflamación de la úvea, principalmente el vítreo anterior, la retina periférica y la pars plana. Diversas etiologías de carácter infeccioso, inflamatorio sistémico y local pueden asociarse a dicho fenómeno. Un cuadro infrecuente es el síndrome de nefritis túbulo-intersticial aguda asociado a uveítis. Presentamos el caso de una mujer de 64 años con antecedente de tiroiditis de Hashimoto, que desarrolló pérdida brusca de la agudeza visual en contexto de falla renal aguda. Se trata de una paciente con nefritis túbulo-intersticial aguda asociada a uveítis.

Intermediate uveitis is described as inflammation in the anterior vitreous, ciliary body and the peripheral retina. It is a subset of uveitis where the vitreous is the major site of damage. It has been reported to be associated with many local and systemic inflammatory and infectious diseases. An infrequent cause is the tubulointerstitial nephritis and uveitis syndrome. We report a case of an acute visual acuity loss related with renal failure in a 64 years old woman with Hashimoto disease. It was an acute tubulointerstitial nephritis and uveitis syndrome case.

Fracción de excreción de magnesio y estado del túbulo-intersticio en pacientes nefróticos / Fractional excretion of magnesium and status of tubulointerstitium in nephrotic patients

INTRODUCCIÓN: la fracción de excreción de los electrólitos puede constituir un marcador temprano de daño renal en las glomerulopatías. OBJETIVO: identificar la posible relación existente entre variables clínicas, fracción de excreción de magnesio y estado del túbulo-intersticio, en pacientes con proteinuria nefrótica a los que se les realizó biopsia renal en el Instituto de Nefrología entre abril de 2012 y junio de 2013. MÉTODOS: se realizó un estudio observacional analítico, transversal, en el que se excluyeron los pacientes con factores que modificaran la fracción de excreción de magnesio. A los 40 pacientes incluidos en el estudio se les recogieron datos antropométricos, demográficos y clínicos, se les midió la fracción de excreción de magnesio, se les practicó biopsia renal y se les cuantificó el porcentaje de fibrosis con el programa Image J. La información fue procesada mediante el paquete estadístico SPSS 15.0. Se utilizó la técnica estadística de análisis de distribución de frecuencias, en las variables cuantitativas se calcularon estadígrafos descriptivos. Fueron empleados los tests de Wilcoxon, de Kruskal Wallis y el coeficiente de correlación de Spearman's-rho, en las pruebas de hipótesis. RESULTADOS: se encontró correlación estadísticamente significativa de la fibrosis intersticial con la fracción de excreción de magnesio (rsp= 0,37, p= 0,02) y con la tasa de filtración glomerular (rsp= -0,56, p= 0,00). No fue encontrada asociación de la fracción de excreción de magnesio con el empleo de medicamentos, ni con el antecedente de hipertensión arterial. CONCLUSIÓN: la fibrosis intersticial se relaciona con la fracción de excreción de magnesio y con la tasa de filtración glomerular en pacientes con proteinuria nefrótica.

INTRODUCTION: fractional excretion of electrolytes can be used as an early marker of renal damage in glomerulopathies. OBJECTIVE: to identify the possible relationship between some clinical variables, the fractional excretion of magnesium and the tubulointerstitial status in patients with nephrotic proteinuria assisted at The National Institute of Nephrology from April 2012 to June 2013. METHODS: an observational analytical study was conducted. Patients with conditions that modify the fractional excretion of magnesium were excluded. 40 patients were included in this study at the Institute of Nephrology from April 2012 until June 2013, and their demographic, anthropometric and clinical data were collected; the fractional excretion of magnesium was measured as well. Renal biopsies were practiced to all patients and the percent of fibrosis was measured with the aid of image J program. Data were processed with Statistical package for Social Science (SPSS) version 15.0. The statistical technique of frequency distribution analysis was used; quantitative variables descriptive statistics were calculated. Wilcoxon tests, Kruskal Wallis and correlation coefficient Spearman's- rho were used in hypothesis tests. RESULTS: the percent of interstitial fibrosis was related to fractional excretion of magnesium (rsp= 0,37, p= 0,02) and glomerular filtration rate (rsp= -0,56, p= 0,00). No association of the fractional excretion of magnesium with the use of drugs or with history of hypertension was found. CONCLUSIONS: tubulointerstitial fibrosis is related to the fractional excretion of magnesium and glomerular filtration rate in patients with nephrotic proteinuria.

Análise morfológica e funcional do processo espermatogênico em cobaios (Cavia porcellus) da pré-puberdade até a pós-puberdade / Morphological and functional analysis of spermatogenesis in guinea pigs (Cavia porcellus) from pre-puberty to post-puberty

Este estudo descreveu as análises morfológica e funcional do processo espermatogênico em cobaios (Cavia porcellus) de cinco (S5); seis (S6); nove (S9) e onze (S11) semanas de idade (N=5/grupo). Os aspectos analisados incluíram a contagem das populações celulares presentes no estádio 1 do ciclo do epitélio seminífero (CES), eficiência das mitoses espermatogoniais (RMi), produção meiótica (RMe), rendimento geral da espermatogênese (RGE), índice de células de Sertoli (ICS) e capacidade de suporte das células de Sertoli (CSCS). Os resultados mostraram que número médio de espermatogônias A, espermatócitos primários em pré-leptóteno/leptóteno, espermatócitos primários em paquíteno, células espermatogênicas totais e células de Sertoli mostraram variações numéricas em função da idade, entretanto, não detectadas estatisticamente, enquanto espermátides arredondadas aumentaram significativamente na puberdade e depois se estabilizaram. A produção espermatogênica de cobaios de 5 a 11 semanas não atingiu o ponto de estabilização e o RMi, RMe, RGE, ICS e CSCS mostraram variação numérica significativa em função da idade. Os resultados demonstraram que Cavia porcellus na pós-puberdade 2 são um modelo experimental vantajoso para estudos de processos de reconhecimento homólogos, alinhamento, e sinapses durante a prófase meiótica; o rendimento intrínseco da espermatogênese em cobaios é semelhante ao relatado para ratos Wistar, pacas e cutias (Dasyprocta sp.) e menor do que em preás, enquanto que a eficiência funcional das células de Sertoli é superior a de cutias e ratos Wistar e inferior à de pacas, rato espinhoso e catetos. Concluiu-se que em cobaios a espermatogênese está completamente estabelecida na semana 6 de idade, indicando a fase púbere do desenvolvimento sexual, e até a semana 11 eles não atingiram a produção espermática diária máxima e, portanto, a maturidade sexual.

This study describes the morphological and functional analysis of spermatogenesis in guinea pigs (Cavia porcellus) with five (W5), six (W6), nine (W9) and eleven (W11) weeks of age (n=5/group). The aspects analyzed include counts of cell populations present in stage 1 of seminiferous epithelium cycle (SEC), efficiency of spermatogonial mitosis (EMi), meiotic production (EMe), overall yield of spermatogenesis (EOS), Sertoli cell index (SCI) and carrying capacity of Sertoli cells (CCSC). The results showed that the average number of spermatogonia type A, primary spermatocytes in pré-leptóteno/leptóteno, primary spermatocytes in pachytene, total spermatogenic cells and Sertoli cells showed numerical variations according to age; however they were statistically not detected, while round spermatids increased significantly at puberty and then stabilized. The spermatogenic production of 5 to 11-week-old guinea pigs did not reach the stabilization point, and the RMi, RME, EOS, SCI and CCSC showed significant number variation as a function of age. The results demonstrate that Cavia porcellus in post-pubertal stage 2 are an advantageous experimental model to address studies on the processes of homologous recognition, alignment, and synapsis during meiotic prophase; intrinsic yield of spermatogenesis in guinea pigs is similar to Wistar rats, paca and agouti (Dasyprocta sp.) and lower than in cavies, whereas the functional efficiency of Sertoli cells is higher than in agouti and Wistar rats, and lower than in pacas, spiny rat and collared peccaries. We conclude that in guinea pigs the spermatogenesis is fully established at 6 weeks of age, indicating the pubertal stage of sexual development, and until week 11 they do not reach the maximum daily sperm production and therefore sexual maturity.

Actualidad de la enfermedad renalpoliquística / Polycystic Renal Disease: An Update

La enfermedad renal poliquística (PKD) es una enfermedad genética común queconsiste en la aparición progresiva de lesiones quísticas en los riñones, que remplazanel parénquima renal, lo que conduce a enfermedad renal crónica terminal. La PKDtiene dos patrones de herencia: autosómico dominante y autosómico recesivo. Laforma autosómica dominante es más común y menos grave que la autosómica recesiva.Se conoce que la PKD es causada por mutación en varios loci humanos. La formaautosómica dominante puede ser causada por mutaciones en dos genes diferentes(PKD1 y PKD2); en tanto que la forma autosómica recesiva solo tiene un gen causal(PKHD1). Existen numerosas publicaciones que buscan explicar la fisiopatología dela enfermedad. Esto refleja un esfuerzo internacional por comprender la naturalezade la enfermedad, para desarrollar terapias que eviten la aparición de los quistes o laprogresión de los que ya están instaurados. El objetivo de esta revisión es difundirel conocimiento que se tiene hasta el momento, acerca de la enfermedad renalpoliquística. Por lo tanto, realizamos un breve recuento de las características clínicasde la enfermedad y el tratamiento actual disponible...

Polycystic Kidney Disease (PKD) is a commongenetic condition, which is characterizedby gradual appearance of multiple cysts in thekidneys; this causes the destruction of renalparenchyma leading to chronic renal disease.PKD has two patterns of inheritance: autosomaldominant and autosomal recessive. Theautosomal dominant form is more commonand less severe than the autosomal recessive. Itis known that PKD is caused by mutation in severalhuman loci. The autosomal dominant formcan be caused by mutations in 2 different genes(PKD1 and PKD2). The autosomal recessiveform has only one causal gene (PKHD1). Thereare numerous publications worldwide that seekto explain the pathophysiology of the disease;this reflects an international effort to understandthe nature of the disease, to develop therapiesto prevent the appearance of cysts or the progressionof those already existent lesions. The objectiveof this review is to update the knowledge wehave so far, about polycystic kidney disease thereforewe decided to conduct a brief review ofthe clinical features of disease and the treatmentavailable today...

Síndrome DRESS inducido por minociclina con desarrollo de nefritis intersticial aguda / DRESS syndrome induced by minocycline with development of acute interstitial nephritis

El síndrome DRESS (reacción a medicamentos con eosinofilia y síntomas sistémicos) es una rara y severa reacción de hipersensibilidad, caracterizado por anormalidades hematológicas y compromiso multiorgánico. Se reporta el caso de una mujer de 35 años con síndrome DRESS inducido por minociclina, la paciente desarrolló falla renal, nefritis intersticial severa, requiriendo manejo de soporte con hemodiálisis. La función renal se normalizó después de ocho semanas de tratamiento con corticoesteroides. (Acta Med Colomb 2012; 37: 89-92).

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is a rare and severe hypersensitivity reaction characterized by multiorgan involvement and hematological abnormalities. We present the case of a 35 year old woman with minocycline-induced DRESS syndrome. The patient developed severe interstitial nephritis with renal failure, requiring hemodialysis support management. Renal function returned to normal after eight weeks of treatment with corticosteroids. (Acta Med Colomb 2012; 37: 89-92).

Adenocarcinoma mucoproductor de colon con infiltración de estómago y metástasis ováricas (tumor de Krukenberg) / Colon mucoproducing adenocarcinoma with stomach infiltration and ovarian metastases (Krukenberg's tumor)

Se presenta una paciente femenina de 29 años, operada de urgencia por presentar un gran tumor que incluía cuerpo gástrico y colon trasverso, con una perforación gástrica. Se realizó una gastrectomía subtotal con colectomía trasversa en bloque que incluyó el epiplón mayor. El diagnóstico histológico fue adenocarcinoma túbulo papilar mucoproductor de origen colónico, que infiltra hasta la serosa y pared gástrica. Se realizó tratamiento adyuvante con poliquimioterapia. Diez meses después presenta un tumor en hipogastrio, que al tacto vaginal, correspondía a los órganos genitales, sospecha clínica que confirman el ultrasonido abdominal y la tomografía axial computarizada. El hallazgo transoperatorio fueron tumores voluminosos de ambos ovarios, y otro tumor que afectaba la unión rectosigmoide. Se realizó una histerectomía radical con ooforectomía bilateral y sigmoidectomía, se reseca la porción proximal del recto, y se cierra tipo Hartman. El diagnóstico histológico final fue metástasis en serosa uterina e intestinal, y en ambos ovarios de adenocarcinoma mucoproductor, túbulo papilar de intestino previamente diagnosticado (tumor de Krukenberg). Se complementó el tratamiento con poliquimioterapia adyuvante(AU)

This is the case of a woman aged 29 operated on of emergency due to a tumor involving gastric body and transverse colon with gastric perforation. A subtotal gastrectomy with block transverse colectomy including the greater omentum was carried out. The histological diagnosis was a mucoproducing papillary tubular adenocarcinoma of colonic origin infiltrating to serosa and gastric wall. An adjuvant treatment was applied with poly-chemotherapy. Ten months later appears a hypogastric tumor which at vaginal manual examination corresponding to genital organs, clinical suspicion confirmed by abdominal ultrasound and computerized axial tomography. The transoperative findings were bulky tumors of both ovaries and another tumor involving the rectosigmoid joint. A radical hysterectomy with bilateral oophorectomy and sigmoidectomy was carried out with resection of proximal rectal portion with type Hartman closure. The final histological diagnosis was a metastasis in uterine and intestinal serosa and in both ovaries a mucoproducing adenocarcinoma, previous papillary tubule was also diagnosed (Krukenberg's tumor). Treatment was applied using adjuvant poly-chemotherapy(AU)

Tubulopapillary carcinoma of the mammary gland in a maned wolf (Chrysocyon brachyurus): histopathological and immunophenotypical analysis / Carcinoma túbulo-papilar da glândula mamária em lobo guará fêmea (Chrysocyon brachyurus): análise histopatológica e imunofenotípica

A maned female wolf (Chrysocyon brachyurus) showed nodules in the inguinal and left abdominal cranial mammary glands. The mammary gland was surgically excised, and microscopic analysis revealed epithelial cell proliferation in a tubular and papillary pattern; delicate fibrovascular stalks presenting numerous layers of moderately pleomorfic epithelial cells were observed. This histologic appearance was compatible with a diagnosis of mammary tubulopapillary carcinoma. The immunohistochemical profile revealed nuclear positivity for estrogen (70 percent) and progesterone (at least 90 percent of the neoplastic cells). The myoepithelium-associated with neoplastic cells lacked integrity, as evidenced by failed smooth muscle alpha actin reactivity in microinvasive areas. A low proliferation index was observed (3.4 percent). To the authors' knowledge, the present case represents the first finding of female tubulopapillary carcinoma in a mammary gland in this species.

Um lobo guará fêmea (Chrysocyon brachyurus) apresentou nódulos nas mamas inguinal e abdominal cranial esquerda. As glândulas mamárias foram cirurgicamente excisadas, e na análise microscópica revelaram proliferação de células epiteliais em arranjo tubular e papilar com tecido conjuntivo de sustentação delicado e formação múltiplas camadas de células epiteliais moderadamente pleomórficas. Os achados histopatológicos foram compatíveis com carcinoma túbulo-papilar da glândula mamária. O estudo do perfil imuno-histoquímico mostrou positividade nuclear para estrógeno (70 por cento) e progesterona (em pelo menos 90 por cento das células). Observou-se perda da integridade da camada mioepitelial, adjacente a proliferação epitelial, evidenciada pela perda de reatividade para alfa actina de músculo liso em áreas de microinvasão. Índice de proliferação celular baixo foi observado (3,4 por cento). O presente relato representa a primeira descrição de um carcinoma túbulo-papilar da glândula mamária em uma fêmea desta espécie.

Estructura testicular y calidad seminal en ratones seleccionados por peso / Testicular structure and semen quality in mice lines selected for weight

La capacidad reproductiva femenina se modificó como consecuencia de la selección de peso realizada en un par de líneas de selección divergente durante 50 generaciones (s: bajo peso; s': alto peso), originadas a partir de una población testigo (t) de ratones CF1 y criadas en la Facultad de Ciencias Veterinarias (UNR). Se probó la existencia de diferencias reproductivas atribuibles al genotipo paterno observadas en el tamaño de camada al nacimiento y en los días transcurridos desde el ingreso a servicio hasta la parición. Con el propósito de explicar las diferencias se comparó la estructura testicular - peso testicular (PTEST), diámetro del túbulo seminífero (DTS), altura de su epitelio (AES) - y la calidad seminal - número de espermatozoides (NE), porcentaje de células anormales (AN), motilidad y desplazamiento de las células espermáticas (Parámetros CASA) -, en machos adultos de 10 a 14 semanas de edad. Se estimó el promedio del DTS y AES en 100 túbulos seminíferos por individuo. El semen se obtuvo de la porción caudal de los epidídimos y de los conductos deferentes. El recuento de espermatozoides se realizó en cámara de Neubauer hemocitométrica y el porcentaje de células anormales se calculó sobre 100 espermatozoides por extendido. Los parámetros de motilidad se determinaron con analizador computarizado de semen Ceros 12.1. La selección por peso diferenció significativamente a las líneas en el mismo sentido de la selección practicada para PTEST, AES y NE. Los machos de la línea más pesada (s') presentaron PTEST y AES mayores y tuvieron un mayor número de espermatozoides al compararlos con los de las líneas s y t (p<0,05). La calidad del semen, bajo las condiciones del setup utilizado, fue similar para los machos de las tres líneas. Por lo tanto, la calidad del semen no aportó a la explicación de las diferencias de fertilidad masculina entre las líneas.

Reproductive female capacity was affected by the genetic selection performed in a pair of lines of two-way selection of body weight for 50 generations (s: downward selection; s': upward selection). These lines were originated from a control CF1 mice population (t) at the Faculty of Veterinary Sciences (UNR). The existence of reproductive differences attributed to the male genotype in the litter size and in the interval from the service beginning to first parturition was proven. With the aim of explaining them, the testicular structure - testicular weight (PTEST), vas deferens diameter (DTS), epithelium height (AES) - and the semen quality - spermatozoa number (NE), abnormal cell percentage (AN), motility and movement of spermatic cells (CASA parameters) were compared, in adult males between 10 and 14 weeks of age. The means of the DTS and AES were estimated for 100 seminiferous tubules per individual. Semen was obtained from the caudal portion of the epididymides and vasa deferentia. Sperm count was performed in Neubauer hemocytometer and abnormal cell percentage was estimated over 100 spermatozoa per sample. Motility parameters were determined with a Ceros 12.1 semen computerized analyzer. Body weight selection occasioned significant differences between lines in the same way of the selection performed for PTEST, AES and NE. Males of the heaviest line (s') show heavier testicles, higher seminiferous epithelium and, consequently, a higher number of spermatozoa when compared with s and t males (p<0,05). Semen quality under the employed setup conditions was similar for males of the three lines. Therefore, semen quality does not contribute to the explanation of the fertility differences between lines.

Fractal Dimension of Dog Kidney Proximal Convoluted Tubuli Sections by Mean Box-Counting Algorithm / Dimensión Fractal de Secciones de los Túbulos Contorneados Proximales del Riñón Mediante un Algoritmo de Recuento de Cajas

The possibility of characterizing the proximal convoluted tubuli of the dog kidney by means of a unique and objective value, is an attractive idea in order to automate its recognition in anatomy and patology. For this, we obtained a fractal dimension of the proximal convoluted tubuli in the dog kidney by mean box-counting method. The fractal value we obtained is a flat dimension, and it is different than the line fractal dimension of the dog kidney arterial pattern, which was previously calculated by us (Gil et al., 2006). Thus, from optical microscopy images, we are able to obtain a single quantitative measure to discriminate these dog kidney components. This measures can use to automate its recognition. Fractal geometry provides many advantages when examining the complex microscopical images of natural objects.

La posibilidad de caracterizar los túbulos contorneados proximales del riñón de perro, mediante un valor único y objetivo, es una idea interesante para automatizar su reconocimiento en anatomía y en patología. Para ello, hemos obtenido la dimensión fractal de los túbulos contorneados proximales del riñón de perro, mediante la técnica de recuento de cajas. El valor fractal obtenido es una dimensión de superficie, diferente de la dimensión fractal lineal que calculamos previamente (Gil et al., 2006). De esta forma, desde imágenes microscópicas, nos es posible obtener una medida simple y cuantitativa para diferenciar estos compontes del riñón de perro. Esta medida puede usarse para automatizar su reconocimiento.

Tangential Algorithm for Calculation of the Fractal Dimension of Kidney Tubuli Sections / Algoritmo de Tangencialización para el Cálculo de la Dimensión Fractal de Túbulos Renales Seccionados

We have developed a new algorithm to calculate the fractal dimension of dog kidney proximal convoluted tubule section. This algorithm is intermediate between box-counting and perimeter-stepping algorithms. The result of this new algorithm and correlations found between fractal dimensions and other Euclidian values of these tubuli, suggest that this algorithm is adequate to calculate fractal dimensions by points.

Hemos desarrollado un nuevo algoritmo para calcular la dimensión fractal de las secciones de los túbulos contorneados proximales del riñón de perro. Este algoritmo es promedio de los que emplean el recuento de cajas y la medida del perímetro. El resultado de las medidas con este nuevo algoritmo y las correlaciones encontradas entre sus valores de dimensión fractal y otros valores euclidianos de dichos túbulos, sugieren la adecuación de método para calcular la dimensión fractal referida a puntos.