Evaluation of risk factors and prognosis on diodone-induced acute kidney injury according to ESUR and KDIGO criteria / 中南大学学报(医学版)

OBJECTIVE@#To investigate the incidence, risk factors and prognosis for contrast-induced acute kidney injury (CI-AKI) according to ESUR and KDIGO criteria in patients undergoing angiography.
@*METHODS@#We evaluated 260 patients undergoing angiography and/or intervention therapy from April 2011 to January 2012 in the Second Xiangya Hospital of Central South University. All patients received low-osmolality contrast agent (ioversol). Serum creatinine was measured before angiography or at 48 or 72 h after procedure. The multivariate logistic regression was used to analyze the risk factors of CI-AKI. The major adverse events were observed in a year of follow-up.
@*RESULTS@#Among the 260 patients, 23 experienced CI-AKI and the incidence was 8.8% according to ESUR criteria. Twelve patients experienced CI-AKI and the incidence was 4.6% according to KDIGO criteria. The multivariate logistic regression analysis showed that diabetes mellitus and dehydration were the independent risk factors for CI-AKI according to ESUR criteria; In another KDIGO criteria, chronic kidney disease (CKD), hypercholesterolemia and diabetes mellitus were the independent risk factors for CI-AKI. The prognosis study showed that the mortality of patients with CI-AKI were significantly higher than those without CI-AKI (P<0.05).
@*CONCLUSION@#The incidence of CI-AKI is associated with diagnostic criteria. Diabetes mellitus, CKD, dehydration and hypercholesterolemia were the independent risk factors for CI-AKI. CI-AKI is a relevant factor for mortality in a year after angiography and/or intervention therapy.

Evaluation of biomass production, carotenoid level and antioxidant capacity produced by Thermus filiformis using fractional factorial design

A fractional factorial design 2(5-1) was used to evaluate the effect of temperature, pH, and concentrations of yeast extract, tryptone and Nitsch's trace elements on the biomass, total carotenoids and protection against singlet oxygen by carotenoid extracts of the bacterium Thermus filiformis. In addition, the carotenoid composition was determined by high-performance liquid chromatography connected to a diode array and mass spectrometer detectors (HPLC-DAD-MS/MS). The production of biomass ranged from 0.113 to 0.658 g/L, the total carotenoid from 137.6 to 1,517.4 mg/g and the protection against singlet oxygen from 4.3 to 85.1 %. Results of the fractional factorial design showed that temperature had a negative effect on biomass production and a positive effect on carotenoid content and protection against singlet oxygen, besides, high levels of pH value, concentrations of yeast extract and tryptone had a positive effect on biomass production only at lower temperatures. The main carotenoids of T. filiformis were thermozeaxanthins. In the tested conditions, changes in the levels of the variables influenced the biomass, carotenoid production, and protection against singlet oxygen, although they did not influence the carotenoid profile. The results of this study provide a better understanding on the interactions among certain nutritional and cultivation conditions of a thermophile bacterium, Thermus filiformis, on biomass and carotenoid amounts, as well as on the antioxidant capacity.

Experimental Study on Visualization of Renal Parenchyma by Scintiscanning with Hg203 Neohydrin to Dog / 대한비뇨기과학회지

The detection of renal disorders now involves a series of complicated diagnostic procedure such as radiologic pyelography, function studies in laboratory and others These add up to a painful, expensive, and time consuming experience for the patient, others may be spared the discomfort of unnecessary. Consequently, the development of methods for preliminary screening of patients is significant both with regard to the diagnostic information obtained and to the selection of those patients requiring complete urologic work up. In particular, a reliable screening test is important in establishing or ruling out renal pathology as an underlying factor in hypertension the finding of a disorder of one kidney in the hypertensive patient may be at indication for nephrectomy or other surgical measures of renal artery. A positive preliminary investigation warrants precise diagnosis by aortography and confirmation by individual renal clearance tests. Finally the primary objective of the screening test is the restriction of more exacting procedures such as aortography with its inherent risk of serious complications to the preoperative evaluation of a demonstrated lesions. The visualization of an internal structure by determining the spatial distribution of a gamma radiation-emitting isotope was started in 1950 when Cassen and his associates utilized newly developed scintillation counters to print mechanically the spatial distribution of radioactive iodine in the thyroid gland. Visual and functional informations referable to each kidney separately may be obtained by radioisotopes and tracer or by scanning techniques rapidly and without trauma. The renogram or tracing of the renal uptake and excretion of a labeled contrast medium is a clinically useful measure of renal vascularity, tubular cell function, and the patency of the upper urinary passage, and especially valuable as a screening test for the hypertensive patient with suspected unilateral disease of the kidney. Similarly, scanning images are achieving an important place in medical diagnosis of irregularities effecting the kidneys and other specific organs. Radioactive contrast media, such as I131 labeled diodrast, miokon, Urokon, or hippuran have been widely used for renal function studies. They are entirety unsatisfactory, however, for renal scintillation scanning because they are rapidly excreted by the kidneys without retention in the renal parenchyma in contrast but mercurial diuretics labeled with radioactive mercury are concentrated to a high degree in the renal tubular cells, chiefly in the cortex, prior to their appearance in the urine (Borghgraef 1956.MaAfee and Wagner 1960). Following the report of these letter writers, scintillation scanning of the kidney after the intravenous injection of Hg Neohydrin have been widely used in urological clinics for preliminary screening method of renal disease such as delineating the parenchyma of the kidney and space-occupying lesions by Krevitz, Berk, and others(Reley, Blahd, Mins, Morgan, Kuhl, Bender, Simmons, Blau, Kim) and remained several problems which is anticipated to improvements in resolution for further using of renal scan. The main purposes of this experimental study were: 1) to learn at which period of time it is best to visualize the renal parenchyma following the intravenous administration of Hg Neohydrin, 2) to learn the minimal detectable size of space-occupying lesion within the kidney phantom, and 3) to compare the renal scan with aortography and pyelography on various period of hydronephrosis for visualization of renal parenchyma, 4) to compare the renal scan with aortography on various degree of narrowing of the renal artery for visualization of renal parenchyma. MATERIALS AND METHODS: These experiments have been performed on 17 normal adult mongrel dogs anesthetized with intravenous injection of sodium amycal. Ofthese 3 dogs were used for determining the optimal time of visualization of the renal parenchyma. 8 dogs for the visualization of the parenchyma of hydronephrotic kidneys as created by partial ligation of the left ureter for the period of 1. 2. 3 and 4 weeks as devided in 4 groups, and 6 dogs were used for the visualization of the narrowed renal artery produced by partial obstruction to various degrees. A wax phantom of the kidney was utilized for the study of detectable minimal size of the intrarenal space occupying lesion, the phantom measures 12.5 X 6.2 X 3.5cm. All animals underwent renal scintiacan received 80 microcuri of Hg neohydrin intravenously, they were placed in a prone position and the study was carried out using a Nuclear-Chicago dual scanner with a 62-hole coarse focusing collimator containing a 3x3 inch sodium iodide crystal, the collimator was passed back and forth over the target are at a rate of 12-15cm, per minute. The scan usually required 30 minutes for complete of scan. The pyelography was performed in retrograde way with 30% diodrast injected through ureteral catheter and the amount of dye injected was adjusted to replace the urine from renal pelvis. The aortography was performed by transfemoral arterial catheterization technique as described by Seldinge. RESULTS: 1. The optimal opacification period of renal parenchyma after injection of Hg 203 neohydrin was found to range from 1 to 6 hours 2. By kidney phantom study it was demonstrated that the space-occupying lesion measuring 2cm. in diameter can not be detected on scan. While the lesion measuring 3cm, or more can be successfully visualized. 3. The effect of partial obstruction of the ureter upon the renal scintiscan for visualization of renal parenchyma was not. dependable, the renal scintiscan continued to appear up to at least the 2 weeks after partial obstruction of ureter whereas the retrogredepyelography and aortography showed the definite picture of hydronephrosis to various degree. 4. The renal scan is inconsistent in many instances of renal artery stenosis, the scan showed a diminished concentration of mercury in the kidney with stenotic main renal artery and complete failure of visualization of the renal substance in cases with completely obstructed renal artery. 5. It is possible to demonstrate the value and usefulness of renal scan of Hg neohydrin as a routine preliminary screening test for renal pathology, the alteration of the concentration of the mercury can might be expected to give additional information.

A Clinical Study of the Organ Distribution and Renoscintigram with Hg203 Labeled Neohydrin in Renal Diseases / 대한비뇨기과학회지

The delineation of the functioning renal parenchyma by the scintiscanning technique has made it possible to supplement diagnostic informations obtained by ordinary urological laboratory data, intravenous pyelography, retrograde pyelography or aortic angiography. More recently, the Hean labeled neohydrin has turned out to be preferable to I131 labeled diodrast or hippuran for renoscintigram for that the former is more readily taken up by the renal cortex and retained by the renal tubules for certain period of time, while the latter istoo rapidly excreted in the urine to reveal satisfactory pictures of renoscan and the technique is complicated. In the present study, renal scintillation scanning and body surface counting in vivo by Hg203 neohydrin were performed on 10 normal cases and 50 patients, 2 renal tumor (Wilm's tumor), 12 renal tuberculosis, 6 renal calculi, 5 nephritis, 10 hydronephrosis. 1 nephrotic syndrome. 5 pyelonephritis, 1 polycystic kidney, 3 congenital anomalies (horse-shoe kidney) and 5 hypertension. After intravenous administration of about 100 microcuries of Hg203 labeled neohydrin, in vivo surface counting over the kidneys, liver, spleen, heart and thigh was performed prior to scan such kidneys at 5, 30, 60 and 90 minutes, respectively, by scintillation detector with 1.5 inches thick Na I crystal. Upon adequate concentration of Hg203 neohydrin in the kidneys, the outline of functioning renal parenchyma can then be recorded by scintillation scanning apparatus, 19 honey cone collimator. In body surface counting, the radioisotope concentration over normally functioning renal parenchyma is good, whereas the concentration over diseased parenchyma is poor and the hepatic uptakeof the isotope shows high, instead. This procedure would also be of diagnostic value in patients with renal vascular disease, by revealing renal function test. In renoscintigram of the patients having presumable renal diseases by ordinary urological survey and pyelographic techniques, space occupying lesions and dot irregularities of the kidney can be presented as filling defect on renoscan. Split renal function studies usually give some information about total functioning capacity of each kidney but no detailed information in limited areasof a kidney with segmental lesion can be drawn. The renal angiogram details in a precise way the size and course of the renal arteries, but contributes no information about function of the parenchyma. The renal biopsy is also a valuable diagnostic procedure which may provide a specific diagnosis if the biopsy is obtained from the right site of diseased area. And the radioisotope renogram has been used to detect unilateral renal disease and it provides some information about the vascular supply and functional capacity of each kidney but this procedure does not supply any knowledge on segmental renal lesion nor segmental renal function. The technique of renoscintigram using Hg203 neohydrin which supplements the disadvantages of conventional methods of renal function study is at the present most qualified to supply more knowledge on segmental renal function and morphological finding as well. Further-more, disappearance of the isotope from the blood and its urinary excretion rate were determined as no harm at all to the human body. In summary, the renoscintigram is of particular help in establishing the diagnosis of renal diseases where pyelographic evidence is equivocal or lacking and the diagnostic significance of this method is promising.

Kinetic Studies on the Competition Between Para-aminohippuric Acid(PAH) and Diodrast for Renal Trnsport in the Dog

No abstract available.